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Radiological differential diagnosis between fibrosis and recurrence after stereotactic body radiation therapy (SBRT) in early stage non-small cell lung cancer (NSCLC)
- Source :
- Translational Lung Cancer Research. 6:S1-S7
- Publication Year :
- 2017
- Publisher :
- AME Publishing Company, 2017.
-
Abstract
- Background: Parenchymal changes after stereotactic body radiation therapy (SBRT) make differential diagnosis between treatment outcomes and disease recurrence often difficult. The purpose of our study was to identify the radiographic features detectable at computed tomography (CT) scan [high-risk features (HRFs)] that allow enough specificity and sensitivity for early detection of recurrence. Methods: We retrospectively evaluated patients who underwent SBRT for inoperable early stage nonsmall cell lung cancer (NSCLC). The median delivered dose performed was 50 Gy in 5 fractions prescribed to 80% isodose. All patients underwent chest CT scan before SBRT and at 3, 6, 12, 18, 24 months after, and then annually. Each CT scan was evaluated and benign and HRFs were recorded.18F-fluorodeoxyglucose- CT was not used routinely. Results: Forty-five patients were included (34 males, 11 females; median age: 77 years; stage IA: 77.8%, stage IB: 22.2%; median follow-up: 21.7 months). Two year and actuarial local control was 77%. HRFs were identified in 20 patients. The most significant predictor of relapse was an enlarging opacity at 12 months (P < 0.001) with 84.6% sensitivity and 71.8% specificity. The presence of â¥2 HRFs demonstrated a high sensibility (92.3%) and specificity (71.9%) (P < 0.0001). Conclusions: Detection of HRFs is predictive of relapse with a sensibility that increases with the number of HRFs observed. This observation may allow to better define the diagnostic follow algorithm up suggesting to performing further exams only in patients with > 2 HRFs.
- Subjects :
- medicine.medical_specialty
business.industry
Stereotactic body radiation therapy
Radiography
non-small cell lung cancer (NSCLC)
Non-small cell lung cancer (NSCLC)
medicine.disease
030218 nuclear medicine & medical imaging
03 medical and health sciences
Stereotactic body radiation therapy (SBRT)
0302 clinical medicine
Oncology
Fibrosis
030220 oncology & carcinogenesis
Radiological weapon
Local recurrence
medicine
Original Article
Radiology
Stage (cooking)
Differential diagnosis
Radiological predictor
business
Nuclear medicine
Lung cancer
Subjects
Details
- ISSN :
- 22264477 and 22186751
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- Translational Lung Cancer Research
- Accession number :
- edsair.doi.dedup.....257cffd7ff61bf69a1a0a9273bd93a8d