Ventilation Using Radiographic Examination: Functional Lung Imaging Techniques for the Reduction of Toxicity in Functional Avoidance Radiation Therapy

What this Trial Is About

This research evaluates different functional lung imaging techniques to improve radiation therapy planning for stages II-IV non-small cell lung cancer. It aims to identify the best use of fluoroscopic and CT ventilation imaging methods, assess dosimetric differences in treatment plans, establish quality assurance procedures, and determine clinically acceptable accuracy thresholds. The study builds on evidence that preserving healthy lung tissue during radiation may reduce side effects like radiation pneumonitis, a common and serious inflammation of lung tissue after treatment. Participants undergo multiple imaging scans before radiotherapy, including standard 4DCT, pulmonary function tests, breath hold CT scans, nuclear medicine scans (Galligas PET and Tc-99m MAA SPECT), fluoroscopy at different chest angles, and 4D cone beam CT. These scans are repeated at treatment end to compare new imaging methods against established ones. The study does not change usual patient care; all receive standard radiation treatment while the new imaging techniques are evaluated. During the study, participants provide data through imaging and lung function tests, allowing researchers to compare ventilation and perfusion images from various methods. The primary measure is the physiological accuracy of X-ray-based ventilation imaging within a week of scanning. Secondary measures include differences in radiation dose to functioning lung, predicted reductions in radiation pneumonitis risk, workflow impact, and improvements in image reconstruction. Follow-up continues for up to one year or until death to monitor ventilation changes and validate imaging accuracy.

Ventilation Using Radiographic Examination: Functional Lung Imaging Techniques for the Reduction of Toxicity in Functional Avoidance Radiation Therapy