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Correlation of Regional Lung Ventilation and Gas Transfer to Red Blood Cells: Implications for Functional-Avoidance Radiation Therapy Planning.

Publication ,  Journal Article
Rankine, LJ; Wang, Z; Driehuys, B; Marks, LB; Kelsey, CR; Das, SK
Published in: Int J Radiat Oncol Biol Phys
August 1, 2018

PURPOSE: To investigate the degree to which lung ventilation and gas exchange are regionally correlated, using the emerging technology of hyperpolarized (HP)-129Xe magnetic resonance imaging (MRI). METHODS AND MATERIALS: Hyperpolarized-129Xe MRI studies were performed on 17 institutional review board-approved human subjects, including 13 healthy volunteers, 1 emphysema patient, and 3 non-small cell lung cancer patients imaged before and approximately 11 weeks after radiation therapy (RT). Subjects inhaled 1 L of HP-129Xe mixture, followed by the acquisition of interleaved ventilation and gas exchange images, from which maps were obtained of the relative HP-129Xe distribution in three states: (1) gaseous, in lung airspaces; (2) dissolved interstitially, in alveolar barrier tissue; and (3) transferred to red blood cells (RBCs), in the capillary vasculature. The relative spatial distributions of HP-129Xe in airspaces (regional ventilation) and RBCs (regional gas transfer) were compared. Further, we investigated the degree to which ventilation and RBC transfer images identified similar functional regions of interest (ROIs) suitable for functionally guided RT. For the RT patients, both ventilation and RBC functional images were used to calculate differences in the lung dose-function histogram and functional effective uniform dose. RESULTS: The correlation of ventilation and RBC transfer was ρ = 0.39 ± 0.15 in healthy volunteers. For the RT patients, this correlation was ρ = 0.53 ± 0.02 before treatment and ρ = 0.39 ± 0.07 after treatment; for the emphysema patient it was ρ = 0.24. Comparing functional ROIs, ventilation and RBC transfer demonstrated poor spatial agreement: Dice similarity coefficient = 0.50 ± 0.07 and 0.26 ± 0.12 for the highest-33%- and highest-10%-function ROIs in healthy volunteers, and in RT patients (before treatment) these were 0.58 ± 0.04 and 0.40 ± 0.04. The average magnitude of the differences between RBC- and ventilation-derived functional effective uniform dose, fV20Gy, fV10Gy, and fV5Gy were 1.5 ± 1.4 Gy, 4.1% ± 3.8%, 5.0% ± 3.8%, and 5.3% ± 3.9%, respectively. CONCLUSION: Ventilation may not be an effective surrogate for true regional lung function for all patients.

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Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

August 1, 2018

Volume

101

Issue

5

Start / End Page

1113 / 1122

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon
  • Signal-To-Noise Ratio
  • Respiration
  • Radiotherapy Planning, Computer-Assisted
  • Pulmonary Emphysema
  • Oncology & Carcinogenesis
  • Middle Aged
  • Magnetic Resonance Imaging
  • Lung Neoplasms
 

Citation

APA
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ICMJE
MLA
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Rankine, L. J., Wang, Z., Driehuys, B., Marks, L. B., Kelsey, C. R., & Das, S. K. (2018). Correlation of Regional Lung Ventilation and Gas Transfer to Red Blood Cells: Implications for Functional-Avoidance Radiation Therapy Planning. Int J Radiat Oncol Biol Phys, 101(5), 1113–1122. https://doi.org/10.1016/j.ijrobp.2018.04.017
Rankine, Leith J., Ziyi Wang, Bastiaan Driehuys, Lawrence B. Marks, Chris R. Kelsey, and Shiva K. Das. “Correlation of Regional Lung Ventilation and Gas Transfer to Red Blood Cells: Implications for Functional-Avoidance Radiation Therapy Planning.Int J Radiat Oncol Biol Phys 101, no. 5 (August 1, 2018): 1113–22. https://doi.org/10.1016/j.ijrobp.2018.04.017.
Rankine LJ, Wang Z, Driehuys B, Marks LB, Kelsey CR, Das SK. Correlation of Regional Lung Ventilation and Gas Transfer to Red Blood Cells: Implications for Functional-Avoidance Radiation Therapy Planning. Int J Radiat Oncol Biol Phys. 2018 Aug 1;101(5):1113–22.
Rankine, Leith J., et al. “Correlation of Regional Lung Ventilation and Gas Transfer to Red Blood Cells: Implications for Functional-Avoidance Radiation Therapy Planning.Int J Radiat Oncol Biol Phys, vol. 101, no. 5, Aug. 2018, pp. 1113–22. Pubmed, doi:10.1016/j.ijrobp.2018.04.017.
Rankine LJ, Wang Z, Driehuys B, Marks LB, Kelsey CR, Das SK. Correlation of Regional Lung Ventilation and Gas Transfer to Red Blood Cells: Implications for Functional-Avoidance Radiation Therapy Planning. Int J Radiat Oncol Biol Phys. 2018 Aug 1;101(5):1113–1122.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

August 1, 2018

Volume

101

Issue

5

Start / End Page

1113 / 1122

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon
  • Signal-To-Noise Ratio
  • Respiration
  • Radiotherapy Planning, Computer-Assisted
  • Pulmonary Emphysema
  • Oncology & Carcinogenesis
  • Middle Aged
  • Magnetic Resonance Imaging
  • Lung Neoplasms