Assessing the impact of radiation-induced changes in soft tissue density/thickness on the study of radiation-induced perfusion changes in the lung and heart

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dc.authoridZhou, Su-Min/0000-0002-7517-9653
dc.contributor.authorLawrence, Michael V.
dc.contributor.authorSaynak, Mert
dc.contributor.authorFried, David V.
dc.contributor.authorBateman, Ted A.
dc.contributor.authorGreen, Rebecca L.
dc.contributor.authorHubbs, Jessica L.
dc.contributor.authorJaszczak, Ronald J.
dc.date.accessioned2024-06-12T11:16:16Z
dc.date.available2024-06-12T11:16:16Z
dc.date.issued2012
dc.departmentTrakya Üniversitesien_US
dc.description.abstractPurpose: Abnormalities in single photon emission computed tomography (SPECT) perfusion within the lung and heart are often detected following radiation for tumors in/around the thorax (e. g., lung cancer or left-sided breast cancer). The presence of SPECT perfusion defects is determined by comparing pre- and post-RT SPECT images. However, RT may increase the density of the soft tissue surrounding the lung/heart (e. g., chest wall/breast) that could possibly lead to an apparent SPECT perfusion defect due to increased attenuation of emitted photons. Further, increases in tissue effective depth will also increase SPECT photon attenuation and may lead to apparent SPECT perfusion defects. The authors herein quantitatively assess the degree of density changes and effective depth in soft tissues following radiation in a series of patients on a prospective clinical study. Methods: Patients receiving thoracic RT were enrolled on a prospective clinical study including pre- and post-RT thoracic computed tomography (CT) scans. Using image registration, changes in tissue density and effective depth within the soft tissues were quantified (as absolute change in average CT Hounsfield units, HU, or tissue thickness, cm). Changes in HU and tissue effective depth were considered as a continuous variable. The potential impact of these tissue changes on SPECT images was estimated using simulation data from a female SPECT thorax phantom with varying tissue densities. Results: Pre- and serial post-RT CT images were quantitatively studied in 23 patients (4 breast cancer, 19 lung cancer). Data were generated from soft tissue regions receiving doses of 20-50 Gy. The average increase in density of the chest was 5 HU (range 46 to -69). The average change in breast density was a decrease of -1 HU (range 13 to -13). There was no apparent dose response in neither the dichotomous nor the continuous analysis. Seventy seven soft tissue contours were created for 19 lung cancer patients. The average change in tissue effective depth was +0.2 cm (range -1.9 to 2.2 cm). The changes in HU represent a <2% average change in tissue density. Based on simulation, the small degree of density and tissue effective depth change is unlikely to yield meaningful changes in either SPECT lung or heart perfusion. Conclusions: RT doses of 20-50 Gy can cause up to a 46 HU increase in soft tissue density 6 months post-RT. Post-RT soft tissue effective depth may increase by 2.0 cm. These modest increases in soft tissue density and effective depth are unlikely to be responsible for the perfusion changes seen on post-RT SPECT lung or heart scans. Further, there was no clear dose response of the soft tissue density changes. Ultimately, the authors findings suggest that prior perfusion reports do reflect changes in the physiology of the lungs and heart. (C) 2012 American Association of Physicists in Medicine. [http://dx.doi.org/10.1118/1.4766433]en_US
dc.description.sponsorshipDepartment of Defense [17-98-1-8071, BC010663]; Lance Armstrong Foundation; National Institutes of Health (NIH) [R01-CA69579]en_US
dc.description.sponsorshipThis work is supported in part by grants from the Department of Defense (17-98-1-8071 and BC010663), the Lance Armstrong Foundation, and the National Institutes of Health (NIH) (R01-CA69579).en_US
dc.identifier.doi10.1118/1.4766433
dc.identifier.endpage7649en_US
dc.identifier.issn0094-2405
dc.identifier.issue12en_US
dc.identifier.pmid23231312en_US
dc.identifier.scopus2-s2.0-84870938100en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage7644en_US
dc.identifier.urihttps://doi.org/10.1118/1.4766433
dc.identifier.urihttps://hdl.handle.net/20.500.14551/24264
dc.identifier.volume39en_US
dc.identifier.wosWOS:000311967400045en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAmer Assoc Physicists Medicine Amer Inst Physicsen_US
dc.relation.ispartofMedical Physicsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectThoracicen_US
dc.subjectSoft Tissueen_US
dc.subjectSPECTen_US
dc.subjectRadiation Therapyen_US
dc.subjectTissue Densityen_US
dc.subjectBreast-Cancer Patientsen_US
dc.subjectInduced Reductionsen_US
dc.subjectRadiotherapyen_US
dc.subjectInjuryen_US
dc.subjectTherapyen_US
dc.titleAssessing the impact of radiation-induced changes in soft tissue density/thickness on the study of radiation-induced perfusion changes in the lung and hearten_US
dc.typeArticleen_US

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