Keywords:
Lung, Thorax, Nuclear medicine, CT, Gamma knife, PET-CT, VMAT and Tomotherapy, Radiation therapy / Oncology, Education, Radiotherapy techniques, Image guided radiotherapy, Tissue characterisation
Authors:
S. Mennella1, I. Pulzato1, G. Ficarra2, E. Barabino1, S. vagge2, G. Cittadini2; 1Genova/IT, 2Genoa/IT
DOI:
10.26044/ecr2019/C-3635
Aims and objectives
Although Lars Leksell developed the concept of stereotactic radiation therapy (SBRT) to deliver precise radiation doses to the brain in the 1940s,
SBRT is defined by the American College of Radiology as an “external beam radiation therapy method used to very precisely deliver a high dose of radiation to an extra-cranial target within the body,
using either a single dose or a small number of fractions (hypofractionated)” (1).
The term ablative (SABR) was added to reflect the aim of the treatment,
which is to destroy the tumor cells both,
directly through delivery of radiation and indirectly through destruction of the supplying vasculature (2,3).
SBRT uses multiple planar and nonplanar beams with multileaf collimators to accurately target the tumor.
This targeting results in large ablative radiation doses to the tumor with a rapid dose drop-off in the surrounding normal tissue (4).
The past two decades have seen a rapid growth in use SBRT for the management of lung lesions.
The main role of SBRT is treatment of early-stage node-negative Non-small-cell Lung cancer (NSCLC) in medically inoperable patients or in patients who decline surgery but is also used to treat recurrent disease and in the management of multiple synchronous lung cancers.
Moreover it is currently challenging the role of surgery for early-stage operable disease.
Since SABR is acquiring a pivotal role in the management of lung lesions the radiologist need to familiarize with post-therapy imaging to distinguish normal findings from local recurrence.
The aims of our study are to evaluate acute and late imaging after SABR and to test in our cohort of patients the accuracy of high risk features (HRFs) proposed by a recent consensus meeting (Nguyen et al.5) in detecting local recurrence.