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Robust quantification of CT-ventilation biomarker techniques and repeatability in a porcine model
Mattison J Flakus1, Antonia E Wuschner1, Eric M Wallat1
1Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Medical Physics
|March 31, 2023
Summary
Computed tomography (CT)-ventilation biomarkers show strong agreement between different imaging techniques in controlled pig studies. This confirms their repeatability for potential use in radiation therapy planning.
Area of Science:
- Medical imaging
- Pulmonary function testing
- Radiation oncology
Background:
- Computed tomography (CT) imaging enables derivation of local lung ventilation biomarkers.
- CT-ventilation biomarkers are valuable for functional avoidance radiation therapy (RT) by optimizing dose delivery to lung regions with high ventilation.
- Understanding biomarker repeatability is crucial for widespread clinical implementation of CT-ventilation biomarkers.
Purpose of the Study:
- To assess the repeatability of CT-ventilation biomarkers.
- To evaluate the dependence of these biomarkers on image acquisition and post-processing methods.
- To characterize CT-ventilation biomarker performance in anesthetized and mechanically ventilated pigs.
Main Methods:
- Multiple four-dimensional CT (4DCT) and breath-hold CT (BH-CT) scans were acquired from five pigs.
- Local expansion ratios (LERs) were calculated using Jacobian-based post-processing techniques as surrogates for ventilation.
- Breathing maneuvers were controlled, and intra- and interday repeatability, along with acquisition and post-processing technique dependence, were analyzed.
Main Results:
- CT-ventilation biomarkers demonstrated strong agreement across different comparisons, including between acquisition techniques (Spearman correlation > 0.8).
- Intra- and interday repeatability showed significant differences (p < 0.01).
- Post-processing techniques (LER2 and LERN) did not significantly impact intraday repeatability.
Conclusions:
- CT-ventilation biomarkers derived from consecutive 4DCT and BH-CT scans exhibit strong agreement in controlled experimental settings.
- These findings support the reliability of CT-ventilation biomarkers for clinical applications.
- Further validation in human subjects is warranted.
