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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-07-2015 | Original Article

Role of perfusion SPECT in prediction and measurement of pulmonary complications after radiotherapy for lung cancer

Authors: Katherina P. Farr, Stine Kramer, Azza A. Khalil, Anni Morsing, Cai Grau

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2015

Abstract

Purpose

The purpose of the study was to evaluate the ability of baseline perfusion defect score (DS) on SPECT to predict the development of severe symptomatic radiation pneumonitis (RP) and to evaluate changes in perfusion on SPECT as a method of lung perfusion function assessment after curative radiotherapy (RT) for non-small-cell lung cancer (NSCLC).

Methods

Patients with NSCLC undergoing curative RT were included prospectively. Perfusion SPECT/CT and global pulmonary function tests (PFT) were performed before RT and four times during follow-up. Functional activity on SPECT was measured using a semiquantitative perfusion DS. Pulmonary morbidity was graded by the National Cancer Institute’s Common Terminology Criteria for Adverse Events version 4 for pneumonitis. Patients were divided into two groups according to the severity of RP.

Results

A total of 71 consecutive patients were included in the study. Baseline DS was associated with chronic obstructive pulmonary disease. A significant inverse correlation was found between baseline DS and forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide. Patients with severe RP had significantly higher baseline total lung DS (mean 5.43) than those with no or mild symptoms (mean DS 3.96, p < 0.01). PFT results were not different between these two groups. The odds ratio for total lung DS was 7.8 (95 % CI 1.9 – 31) demonstrating the ability of this parameter to predict severe RP. Adjustment for other potential confounders known to be associated with increased risk of RP was performed and did not change the odds ratio. The median follow-up time after RT was 8.4 months. The largest DS increase of 13.3 % was associated with severe RP at 3 months of follow-up (p < 0.01). The development of severe RP during follow-up was not associated with changes in PFT results.

Conclusion

Perfusion SPECT is a valuable method for predicting severe RP and for assessing changes in regional functional perfusion after curative RT comparable with global PFT.

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Title: Role of perfusion SPECT in prediction and measurement of pulmonary complications after radiotherapy for lung cancer
Authors: Katherina P. Farr
Stine Kramer
Azza A. Khalil
Anni Morsing
Cai Grau
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3052-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Role of perfusion SPECT in prediction and measurement of pulmonary complications after radiotherapy for lung cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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