Journal
CLINICAL ONCOLOGY
Volume 28, Issue 11, Pages 695-707Publisher
ELSEVIER SCIENCE LONDON
DOI: 10.1016/j.clon.2016.08.005
Keywords
CT ventilation; lung avoidance; magnetic resonance imaging (MRI); non-small cell lung cancer (NSCLC); radiation therapy planning; radiation-induced lung injury
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Funding
- Sheffield Hospitals Charity
- Weston Park Hospital Charity
- University of Sheffield James Morrison Fund
- National Institute of Health Research
- British Heart Foundation [SP/14/6/31350] Funding Source: researchfish
- Medical Research Council [MR/M008894/1] Funding Source: researchfish
- National Institute for Health Research [NIHR-RP-R3-12-027] Funding Source: researchfish
- MRC [MR/M008894/1] Funding Source: UKRI
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For patients with lung cancer undergoing curative intent radiotherapy, functional lung imaging can be incorporated into treatment planning to modify the dose distribution within non-target volume lung by differentiation of lung regions that are functionally defective or viable. This concept of functional image-guided lung avoidance treatment planning has been investigated with several imaging modalities, primarily single photon emission computed tomography (SPECT), but also hyperpolarised gas magnetic resonance (MR) imaging, positron emission tomography (PET) and computed tomography (CT)-based measures of lung biomechanics. Here, we review the application of each of these modalities, review practical issues of lung avoidance implementation, including image registration and the role of both ventilation and perfusion imaging, and provide guidelines for reporting of future lung avoidance planning studies. (C) 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
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