Early detection of acute radiation-induced lung injury with multi-section CT perfusion imaging: An initial experience.
OBJECTIVE
To explore the value of 64-section computed tomography (CT) perfusion imaging (CTPI) in the early diagnosis of acute radiation-induced lung injury (ARILI).


METHODS
Fifty-one patients with oesophageal cancers or malignant thymomas received postoperative radiation therapy with a 60-62 Gy dose and underwent CTPI at pre- and post-radiation therapy time points (week 0, week 4, week 8, and week 12 respectively). The CTPI values were prospectively compared and analysed in order to evaluate the diagnostic utility of CTPI in the early diagnosis of ARILI.


RESULTS
Eighteen cases (18/51) of ARILI were diagnosed. The mean values of relative regional blood flow (rrBF), relative regional volume (rrBV), and relative regional permeability surface (rrPS) in the ARILI group were correspondingly higher than those of the non-ARILI group. At week 4, rrBF, rrBV, and rrPS in the ARILI group were significantly higher than those at pre-radiation (each p < 0.05). In the non-ARILI group, rrBF and rrBV were higher than those at pre-radiation (each p < 0.05); however, rrPS was not statistically different from that of pre-irradiation. Applying the diagnostic threshold value of rrPS = 1.22, the sensitivity, specificity, and positive and negative predictive values of CTPI for early diagnosis of ARILI were better than those of CT.


CONCLUSIONS
CTPI metrics may reflect haemodynamic changes in the post-irradiation lung and can detect cases of early ARILI that appear normal at CT. CTPI is a promising technique for early diagnosis of ARILI.
Imaging Center, Wuxi People's Hospital, Nanjing Medical University, Jiangsu Province 214023, China.
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Hu
Imaging Center, Wuxi People's Hospital, Nanjing Medical University, Jiangsu Province 214023, China. Electronic address: frankhu1978@qq.com.
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Fang
Imaging Center, Wuxi People's Hospital, Nanjing Medical University, Jiangsu Province 214023, China.
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Chen
Imaging Center, Wuxi People's Hospital, Nanjing Medical University, Jiangsu Province 214023, China.
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Yao
Imaging Center, Wuxi People's Hospital, Nanjing Medical University, Jiangsu Province 214023, China.
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Qian
Radiotherapy Center, The First Affiliated Hospital of Suzhou University, Jiangsu Province 226001, China.
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JY
Zhou
Radiotherapy Center, The First Affiliated Hospital of Suzhou University, Jiangsu Province 226001, China.
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J
Guo
Department of Radiology, LAC+USC Medical Center, University of Southern California, 1200 N State St, Los Angeles, CA, United States of America.
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Lerner
Imaging Center, The First Affiliated Hospital of Suzhou University, Jiangsu Province 226001, China. Electronic address: 54555154@qq.com.
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Hu
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008168:Lung / Q000098:blood supply / Q000000981:diagnostic imaging; D055370:Lung Injury / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000000981:diagnostic imaging*; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*