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    Predictive value of vascular calcification identified in 4D planning CT of lung cancer patients treated with stereotactic body radiation therapy

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    Authors
    Abravan, Azadeh
    van Herk, Marcel
    Brewster, Frank
    Faivre-Finn, Corinne
    McWilliam, Alan
    Vasquez Osorio, Eliana
    Affiliation
    Division of Cancer Science, University of Manchester, Manchester, UK; Radiotherapy Related Research, The Christie Foundation Trust, Manchester, UK
    Issue Date
    2020
    
    Metadata
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    Abstract
    Purpose: The aim was to identify vascular calcification in 4DCT scan of lung cancer patients and establish the association between overall survival (OS) and vascular calcification, as surrogate for vascular health. Methods: Vascular calcification within the thoracic cavity were segmented in 334 lung cancer patients treated with stereotactic body radiation therapy (SBRT). This has been done automatically on 4D planning CT and average reconstruction scans. Correlation between cardiac comorbidity and calcification volumes was evaluated for patients with recorded Adult Co-Morbidity Evaluation (n = 303). Associations between the identified calcifications and OS were further investigated. Results: The volume of calcification from the average scan was significantly lower than from each phase (p < 0.001). The highest level of correlations between cardiac comorbidity and volume of the calcifications were found for one phase representing inhale and two phases representing exhale with the least motion blurring due to respiration (p < 0.005). The volume of the calcifications was subsequently averaged over these three phases. The average of calcification volumes over the three phases (denoted by inhale-exhale) showed the highest likelihood in univariate analysis and was chosen as vascular calcification measure. Cox-model suggested that tumor volume (Hazard Ratio [HR] = 1.46, p < 0.01) and inhale-exhale volume (HR = 1.05, p < 0.05) are independent factors predicting OS after adjusting for age, sex, and performance status. Conclusion: It was feasible to use. It 4DCT scan for identifying thoracic calcifications in lung cancer patients treated with SBRT. Calcification volumes from inhale-exhale phases had the highest correlation with overall cardiac comorbidity and the average of the calcification volume obtained from these phases was an independent predictive factor for OS.
    Citation
    Abravan A, van Herk M, Brewster F, Faivre-Finn C, McWilliam A, Vasquez Osorio EM. Predictive value of vascular calcification identified in 4D planning CT of lung cancer patients treated with stereotactic body radiation therapy. Phys Med. 2020;78:173-8.
    Journal
    Physica Medica
    URI
    http://hdl.handle.net/10541/623351
    DOI
    10.1016/j.ejmp.2020.09.010
    PubMed ID
    33038642
    Additional Links
    https://dx.doi.org/10.1016/j.ejmp.2020.09.010
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ejmp.2020.09.010
    Scopus Count
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