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Clinical Trial
. 2005 Dec;77(3):271-7.
doi: 10.1016/j.radonc.2005.08.008. Epub 2005 Nov 7.

The incorporation of SPECT functional lung imaging into inverse radiotherapy planning for non-small cell lung cancer

Judith A Christian  1 , Mike Partridge, Elena Nioutsikou, Gary Cook, Helen A McNair, Bernadette Cronin, Frederic Courbon, James L Bedford, Michael Brada
Affiliations
Clinical Trial

The incorporation of SPECT functional lung imaging into inverse radiotherapy planning for non-small cell lung cancer

Judith A Christian et al. Radiother Oncol. 2005 Dec.

Abstract

Background and purpose: Patients with non-small cell lung cancer (NSCLC) often have inhomogeneous lung perfusion. Radiotherapy planning computed tomography (CT) scans have been accurately co-registered with lung perfusion single photon emission computed tomography (SPECT) scans to design radiotherapy treatments which limit dose to healthy 'perfused' lung.

Patients and methods: Patients with localised NSCLC had CT and SPECT scans accurately co-registered in the planning system. The SPECT images were used to define a volume of perfused 'functioning' lung (FL). Inverse planning software was used to create 3D-conformal plans, the planning objective being either to minimise the dose to whole lungs (WL) or to minimise the dose to FL.

Results: Four plans were created for each of six patients. The mean difference in volume between WL and FL was 1011.7 cm(3) (range 596.2-1581.1cm(3)). One patient with bilateral upper lobe perfusion deficits had a 16% reduction in FLV(20) (the percentage volume of functioning lung receiving >or=20 Gy). The remaining patients had inhomogeneous perfusion deficits such that inverse planning was not able to sufficiently optimise beam angles to avoid functioning lung.

Conclusion: SPECT perfusion images can be accurately co-registered with radiotherapy planning CT scans and may be helpful in creating treatment plans for patients with large perfusion deficits.

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