The Role of Functional Imaging in the Diagnosis and Management of Late Normal Tissue Injury

Elizabeth S. Evans, Carol A. Hahn, Zafer Kocak, Su Min Zhou, Lawrence B. Marks

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Normal tissue injury after radiation therapy (RT) can be defined based on either clinical symptoms or laboratory/radiologic tests. In the research setting, functional imaging (eg, single-photon emission computed tomography [SPECT], positron-emission tomography [PET], and magnetic resonance imaging [MRI]) is useful because it provides objective quantitative data such as metabolic activity, perfusion, and soft-tissue contrast within tissues and organs. For RT-induced lung, heart, and parotid gland injury, pre- and post-RT SPECT images can be compared with the dose- and volume-dependent nature of regional injury. In the brain, SPECT can detect changes in perfusion and blood flow post-RT, and PET can detect metabolic changes, particularly to regions of the brain that have received doses above 40 to 50 Gy. On MRI, changes in contrast-enhanced images, T1 and T2 relaxation times, and pulmonary vascular resistance at different intervals pre- and post-RT show its ability to detect and distinguish different phases of radiation pneumonitis. Similarly, conventional and diffusion-weighted MRI can be used to differentiate between normal tissue edema, necrosis, and tumor in the irradiated brain, and magnetic resonance spectroscopy can measure changes in compounds, indicative of membrane and neuron disruption. The use of functional imaging is a powerful tool for early detection of RT-induced normal tissue injury, which may be related to long-term clinically significant injury.

Original languageEnglish (US)
Pages (from-to)72-80
Number of pages9
JournalSeminars in Radiation Oncology
Volume17
Issue number2
DOIs
StatePublished - Apr 1 2007

Fingerprint

Delayed Diagnosis
radiation therapy
Radiotherapy
tomography
Wounds and Injuries
Single-Photon Emission-Computed Tomography
brain
magnetic resonance
glands
Positron-Emission Tomography
positrons
Brain
photons
Perfusion
Magnetic Resonance Imaging
Radiation Pneumonitis
salivary glands
edema
dosage
Diffusion Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

The Role of Functional Imaging in the Diagnosis and Management of Late Normal Tissue Injury. / Evans, Elizabeth S.; Hahn, Carol A.; Kocak, Zafer; Zhou, Su Min; Marks, Lawrence B.

In: Seminars in Radiation Oncology, Vol. 17, No. 2, 01.04.2007, p. 72-80.

Research output: Contribution to journalArticle

Evans, Elizabeth S. ; Hahn, Carol A. ; Kocak, Zafer ; Zhou, Su Min ; Marks, Lawrence B. / The Role of Functional Imaging in the Diagnosis and Management of Late Normal Tissue Injury. In: Seminars in Radiation Oncology. 2007 ; Vol. 17, No. 2. pp. 72-80.
@article{07cde1a8503e435680024f57dae3dedf,
title = "The Role of Functional Imaging in the Diagnosis and Management of Late Normal Tissue Injury",
abstract = "Normal tissue injury after radiation therapy (RT) can be defined based on either clinical symptoms or laboratory/radiologic tests. In the research setting, functional imaging (eg, single-photon emission computed tomography [SPECT], positron-emission tomography [PET], and magnetic resonance imaging [MRI]) is useful because it provides objective quantitative data such as metabolic activity, perfusion, and soft-tissue contrast within tissues and organs. For RT-induced lung, heart, and parotid gland injury, pre- and post-RT SPECT images can be compared with the dose- and volume-dependent nature of regional injury. In the brain, SPECT can detect changes in perfusion and blood flow post-RT, and PET can detect metabolic changes, particularly to regions of the brain that have received doses above 40 to 50 Gy. On MRI, changes in contrast-enhanced images, T1 and T2 relaxation times, and pulmonary vascular resistance at different intervals pre- and post-RT show its ability to detect and distinguish different phases of radiation pneumonitis. Similarly, conventional and diffusion-weighted MRI can be used to differentiate between normal tissue edema, necrosis, and tumor in the irradiated brain, and magnetic resonance spectroscopy can measure changes in compounds, indicative of membrane and neuron disruption. The use of functional imaging is a powerful tool for early detection of RT-induced normal tissue injury, which may be related to long-term clinically significant injury.",
author = "Evans, {Elizabeth S.} and Hahn, {Carol A.} and Zafer Kocak and Zhou, {Su Min} and Marks, {Lawrence B.}",
year = "2007",
month = "4",
day = "1",
doi = "10.1016/j.semradonc.2006.11.003",
language = "English (US)",
volume = "17",
pages = "72--80",
journal = "Seminars in Radiation Oncology",
issn = "1053-4296",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - The Role of Functional Imaging in the Diagnosis and Management of Late Normal Tissue Injury

AU - Evans, Elizabeth S.

AU - Hahn, Carol A.

AU - Kocak, Zafer

AU - Zhou, Su Min

AU - Marks, Lawrence B.

PY - 2007/4/1

Y1 - 2007/4/1

N2 - Normal tissue injury after radiation therapy (RT) can be defined based on either clinical symptoms or laboratory/radiologic tests. In the research setting, functional imaging (eg, single-photon emission computed tomography [SPECT], positron-emission tomography [PET], and magnetic resonance imaging [MRI]) is useful because it provides objective quantitative data such as metabolic activity, perfusion, and soft-tissue contrast within tissues and organs. For RT-induced lung, heart, and parotid gland injury, pre- and post-RT SPECT images can be compared with the dose- and volume-dependent nature of regional injury. In the brain, SPECT can detect changes in perfusion and blood flow post-RT, and PET can detect metabolic changes, particularly to regions of the brain that have received doses above 40 to 50 Gy. On MRI, changes in contrast-enhanced images, T1 and T2 relaxation times, and pulmonary vascular resistance at different intervals pre- and post-RT show its ability to detect and distinguish different phases of radiation pneumonitis. Similarly, conventional and diffusion-weighted MRI can be used to differentiate between normal tissue edema, necrosis, and tumor in the irradiated brain, and magnetic resonance spectroscopy can measure changes in compounds, indicative of membrane and neuron disruption. The use of functional imaging is a powerful tool for early detection of RT-induced normal tissue injury, which may be related to long-term clinically significant injury.

AB - Normal tissue injury after radiation therapy (RT) can be defined based on either clinical symptoms or laboratory/radiologic tests. In the research setting, functional imaging (eg, single-photon emission computed tomography [SPECT], positron-emission tomography [PET], and magnetic resonance imaging [MRI]) is useful because it provides objective quantitative data such as metabolic activity, perfusion, and soft-tissue contrast within tissues and organs. For RT-induced lung, heart, and parotid gland injury, pre- and post-RT SPECT images can be compared with the dose- and volume-dependent nature of regional injury. In the brain, SPECT can detect changes in perfusion and blood flow post-RT, and PET can detect metabolic changes, particularly to regions of the brain that have received doses above 40 to 50 Gy. On MRI, changes in contrast-enhanced images, T1 and T2 relaxation times, and pulmonary vascular resistance at different intervals pre- and post-RT show its ability to detect and distinguish different phases of radiation pneumonitis. Similarly, conventional and diffusion-weighted MRI can be used to differentiate between normal tissue edema, necrosis, and tumor in the irradiated brain, and magnetic resonance spectroscopy can measure changes in compounds, indicative of membrane and neuron disruption. The use of functional imaging is a powerful tool for early detection of RT-induced normal tissue injury, which may be related to long-term clinically significant injury.

UR - http://www.scopus.com/inward/record.url?scp=33947505362&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947505362&partnerID=8YFLogxK

U2 - 10.1016/j.semradonc.2006.11.003

DO - 10.1016/j.semradonc.2006.11.003

M3 - Article

C2 - 17395037

AN - SCOPUS:33947505362

VL - 17

SP - 72

EP - 80

JO - Seminars in Radiation Oncology

JF - Seminars in Radiation Oncology

SN - 1053-4296

IS - 2

ER -