Background & Objective: Radiation-induced lung injury is commonly following radiotherapy (RT)for tumors in,and around the thorax. Lung function is usually assessed by pulmonary function tests (PFTs), but RT-induced regional changes of pulmonary function cannot be accurately evaluated by PFTs. Lung perfusion scintigraphy compared with other radiographic methods can well assess the regional pulmonary physiological function,and 3-dimension conformal radiotherapy (3D-CRT) planning system can quantitatively calculate irradiation dosage. This study was to assess early changes in the pulmonary function of patients with lung cancer receiving thoracic 3D-CRT by lung perfusion scintigraphy.
Methods: Nineteen patients receiving thoracic 3D-CRT for lung cancer were studied. Single photon emission computed tomography (SPECT) lung perfusion scan,and X-ray or CT scan before RT, and after 40-50 Gy radiation were performed. Pre-RT SPECT lung perfusion images were classified by comparing lung perfusion defect with area of radiological abnormality before RT. Grade 0: no lung perfusion defect in the area of radiological abnormality. Grade 1: the size of radiological abnormality is similar to the area of lung perfusion defect. Grade 2: the area of lung perfusion defect is bigger than that of radiological abnormality,and extend to 1 pulmonary lobe. Grade 3: the area of lung perfusion defect exceed 1 pulmonary lobe. The radiation field with more than 20 Gy was drawn as a region of interest (ROI). The proportion of radioactive count within this ROI to total lung count in one slice was calculated to assess changes in pulmonary function after RT. Student's t test was used for statistical analyses.
Results: All patients had lung perfusion defect, 9 patients with grade 1 damage, 5 patients with grade 2 damage, and 5 patients with grade 3 damage. All tumors in the 19 patients were reduced with variant degree after 40-50 Gy radiation in CT or X-ray images. The mean radioactive proportions of ROI in 19 patients were (53.7+/-29.8)% before radiation,and (57.6+/-22.6)% during RT, the difference wasn't significant (P=0.280). The relatively decreased post-RT lung perfusion was observed in 6 patients, whereas the relatively increased post-RT lung perfusion was observed in 13 patients.
Conclusion: SPECT lung perfusion scans is a simple, convenient, and useful method for assessing pre-RT regional lung function,and monitoring the changes in regional lung function after irradiation.
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Int J Comput Assist Radiol Surg
January 2025
Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.
Purpose: Pulmonary perfusion imaging is a key lung health indicator with clinical utility as a diagnostic and treatment planning tool. However, current nuclear medicine modalities face challenges like low spatial resolution and long acquisition times which limit clinical utility to non-emergency settings and often placing extra financial burden on the patient. This study introduces a novel deep learning approach to predict perfusion imaging from non-contrast inhale and exhale computed tomography scans (IE-CT).
View Article and Find Full Text PDFJ Thorac Dis
December 2024
Department of Surgery, University of Alabama Birmingham, Birmingham, AL, USA.
Background: While patients are assessed for their ability to tolerate surgery through physiologic evaluations such as pulmonary function tests, ventilation-perfusion scans, and exercising testing, some patients still require home oxygen therapy after pulmonary resection. It is not well understood what the associated risk factors are, how long patients need supplemental oxygen, and if this requirement is associated with worse long-term outcomes. Given these knowledge gaps, we sought to conduct a systematic review of pulmonary resections and new postoperative home oxygen requirement.
View Article and Find Full Text PDFJ Cardiol Cases
October 2024
Department of Cardiology, Mater Dei Hospital, Msida, Malta.
Unlabelled: Pulmonary vein (PV) stenosis is a rare complication following PV isolation (PVI) for atrial fibrillation. Despite the benefit of early intervention, screening is not conducted, emphasizing the importance of maintaining a high index of suspicion. Standardized management approaches are unavailable for this serious complication.
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Consultant Cardiothoracic & Transplant Surgeon, Surgical Director Transplantation and Mechanical Circulatory Support, Royal Papworth Hospital, United Kingdom, UK. Electronic address:
Respir Res
January 2025
Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), 13 Hangkong Road, Wuhan, 430030, China.
This study introduced a novel dual fixation method for the pulmonary vasculature and lung tissue in pulmonary hypertension (PH) rats, addressing the limitations of traditional fixation methods that failed to accurately preserve the in vivo status of pulmonary vascular morphology. The modified method involved a dual fixation process, combining individualized ventilation support and vascular perfusion to simulate the respiratory motion, pulmonary artery pressure and right ventricular output of the rat under in vivo conditions. Utilizing a monocrotaline-induced PH rat model, this study compared the dual fixation with the traditional immersion fixation, focusing on the quantitative assessment of alveolar expansion degree, capillary patency, endothelial cell quantity and wall thickness of pulmonary vein and artery.
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