Radiation-induced airway changes and downstream ventilation decline in a swine model

Eric M Wallat; Antonia E Wuschner; Mattison J Flakus; Gary E Christensen; Joseph M Reinhardt; Dhanansayan Shanmuganayagam; John E Bayouth

doi:10.1088/2057-1976/ac3197

Back

Radiation-induced airway changes and downstream ventilation decline in a swine model

Journal article

Peer reviewed

Radiation-induced airway changes and downstream ventilation decline in a swine model

Eric M Wallat, Antonia E Wuschner, Mattison J Flakus, Gary E Christensen, Joseph M Reinhardt, Dhanansayan Shanmuganayagam and John E Bayouth

Biomedical physics & engineering express, Vol.7(6), p.65039

10/29/2021

DOI: 10.1088/2057-1976/ac3197

PMCID: PMC8785227

PMID: 34670195

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/8785227View

Open Access

Abstract

Purpose. To investigate indirect radiation-induced changes in airways as precursors to atelectasis post radiation therapy (RT). Methods. Three Wisconsin Miniature Swine (WMSTM) underwent a research course of 60 Gy in 5 fractions delivered to a targeted airway/vessel in the inferior left lung. The right lung received a max point dose <5 Gy. Airway segmentation was performed on the pre- and three months post-RT maximum inhale phase of the four-dimensional (4D) computed tomography (CT) scans. Changes in luminal area (Ai) and square root of wall area ($\sqrt{{WA}}$) for each airway were investigated. Changes in ventilation were assessed using the Jacobian ratio and were measured in three different regions: the inferior left lung <5 Gy (ILL), the superior left lung <5 Gy (SLL), and the contralateral right lung <5 Gy (RL). Results. Airways (n = 25) in the right lung for all swine showed no significant changes (p = 0.48) in Ai post-RT compared to pre-RT. Airways (n = 28) in the left lung of all swine were found to have a significant decrease (p < 0.001) in Ai post-RT compared to pre-RT, correlated (Pearson R = −0.97) with airway dose. Additionally, $\sqrt{{WA}}$ decreased significantly (p < 0.001) with airway dose. Lastly, the Jacobian ratio of the ILL (0.883) was lower than that of the SLL (0.932) and the RL (0.955). Conclusions. This work shows that for the swine analyzed, there were significant correlations between Ai and $\sqrt{{WA}}$ change with radiation dose. Additionally, there was a decrease in lung function in the regions of the lung supplied by the irradiated airways compared to the regions supplied by unirradiated airways. These results support the hypothesis that airway dose should be considered during treatment planning in order to potentially preserve functional lung and reduce lung toxicities.

4DCT

bronchial stenosis

pulmonary functional imaging

radiation therapy response

Details

Title: Subtitle: Radiation-induced airway changes and downstream ventilation decline in a swine model
Creators: Eric M Wallat - University of Wisconsin–Madison
Antonia E Wuschner - University of Wisconsin–Madison
Mattison J Flakus - University of Wisconsin–Madison
Gary E Christensen - University of Iowa
Joseph M Reinhardt - University of Iowa
Dhanansayan Shanmuganayagam - University of Wisconsin–Madison
John E Bayouth - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: Biomedical physics & engineering express, Vol.7(6), p.65039
DOI: 10.1088/2057-1976/ac3197
PMID: 34670195
PMCID: PMC8785227
NLM abbreviation: Biomed Phys Eng Express
ISSN: 2057-1976
eISSN: 2057-1976
Publisher: IOP Publishing
Number of pages: 11
Grant note: CA166703 / National Cancer Institute (https://doi.org/10.13039/100000054)
Language: English
Date published: 10/29/2021
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Iowa Technology Institute; Radiation Oncology; Radiation Research Laboratory; The Iowa Institute for Biomedical Imaging; Holden Comprehensive Cancer Center
Record Identifier: 9984198004702771

Metrics

25 Record Views

11 Times Cited - Web of Science