Radiation-induced lung injury patterns and the misdiagnosis after SBRT of lung cancer
•Radiation-induced lung injury after SBRT was various and complicated.•The complicated injury patterns may induce misdiagnosis in clinical practice.•Our data showed that 24.5% patients were misdiagnosed after receiving SBRT.•Based on Koening’s classification, mass-like pattern was misdiagnosed the m...
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| Veröffentlicht in: | European journal of radiology 2019-12, Vol.121, p.108708-108708, Article 108708 |
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| container_title | European journal of radiology |
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| creator | Zhu, Xueru Li, Xiaoyang Gu, Hengle Yu, Wen Fu, Xiaolong |
| description | •Radiation-induced lung injury after SBRT was various and complicated.•The complicated injury patterns may induce misdiagnosis in clinical practice.•Our data showed that 24.5% patients were misdiagnosed after receiving SBRT.•Based on Koening’s classification, mass-like pattern was misdiagnosed the most.•A nomogram was developed and showed a predictive value in clinical practice.
To analyze radiation-induced lung injury (RIL) after stereotactic body radiotherapy (SBRT) of lung cancer and the subsequent clinical problems.
106 lung cancer patients treated with SBRT were included, their computed tomography (CT) scans were reviewed. Late injury pattern was classified by Koening’s, radiologist’ diagnosis reports for RIL was reviewed. Logistic regression was used to analyze the predictive model of injury pattern, which was also validated by ROC curve.
Radiographic late injury within at least 6 months after SBRT was concluded. The majority of late RIL was mass-like pattern, not the modified conventional pattern. 36.8% patients showed acute injury, which trend to occur late lung injury earlier than patients who were not found acute injury (p = 0.0185). 24.5% RIL cases were misdiagnosed to tumor progression by radiologists. Most misdiagnosis occurred among mass-like pattern. Per fraction dose (p |
| doi_str_mv | 10.1016/j.ejrad.2019.108708 |
| format | Article |
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To analyze radiation-induced lung injury (RIL) after stereotactic body radiotherapy (SBRT) of lung cancer and the subsequent clinical problems.
106 lung cancer patients treated with SBRT were included, their computed tomography (CT) scans were reviewed. Late injury pattern was classified by Koening’s, radiologist’ diagnosis reports for RIL was reviewed. Logistic regression was used to analyze the predictive model of injury pattern, which was also validated by ROC curve.
Radiographic late injury within at least 6 months after SBRT was concluded. The majority of late RIL was mass-like pattern, not the modified conventional pattern. 36.8% patients showed acute injury, which trend to occur late lung injury earlier than patients who were not found acute injury (p = 0.0185). 24.5% RIL cases were misdiagnosed to tumor progression by radiologists. Most misdiagnosis occurred among mass-like pattern. Per fraction dose (p < 0.0001), prescription isodose line (p = 0.027) and age (p = 0.089) trend to associate with the occurrence of mass-like injury pattern. Nomogram was established based on these parameters, ROC curve showed that area under the ROC curve (AUC) of the nomogram was 0.767 (95% CI = 0.677-0.857), which was better than any factors along.
SBRT for lung cancer patients was safe, the majority of late RIL was mass-like pattern. This injury was difficult to be distinguished from tumor progression, which leaded to misdiagnosis of 24.5% patients receiving SBRT. A nomogram based on age, per fraction dose and the prescription isodose line may assist the diagnosis in clinical practice.</description><identifier>ISSN: 0720-048X</identifier><identifier>EISSN: 1872-7727</identifier><identifier>DOI: 10.1016/j.ejrad.2019.108708</identifier><identifier>PMID: 31704600</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Aged ; Diagnostic Errors - statistics & numerical data ; Female ; Humans ; Logistic Models ; Lung - diagnostic imaging ; Lung - radiation effects ; Lung cancer ; Lung Injury - diagnostic imaging ; Lung Injury - etiology ; Lung Neoplasms - radiotherapy ; Male ; Predictive model ; Radiation Injuries - diagnostic imaging ; Radiation-induced lung injury ; Radiosurgery - adverse effects ; ROC Curve ; Stereotactic body radiotherapy ; Tomography, X-Ray Computed - methods</subject><ispartof>European journal of radiology, 2019-12, Vol.121, p.108708-108708, Article 108708</ispartof><rights>2019 Elsevier B.V.</rights><rights>Copyright © 2019 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-b693c656dc27b817d174630d42e122c0fae90ceee0ac0a26e13c0c3c0c6936723</citedby><cites>FETCH-LOGICAL-c359t-b693c656dc27b817d174630d42e122c0fae90ceee0ac0a26e13c0c3c0c6936723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0720048X19303584$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31704600$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Xueru</creatorcontrib><creatorcontrib>Li, Xiaoyang</creatorcontrib><creatorcontrib>Gu, Hengle</creatorcontrib><creatorcontrib>Yu, Wen</creatorcontrib><creatorcontrib>Fu, Xiaolong</creatorcontrib><title>Radiation-induced lung injury patterns and the misdiagnosis after SBRT of lung cancer</title><title>European journal of radiology</title><addtitle>Eur J Radiol</addtitle><description>•Radiation-induced lung injury after SBRT was various and complicated.•The complicated injury patterns may induce misdiagnosis in clinical practice.•Our data showed that 24.5% patients were misdiagnosed after receiving SBRT.•Based on Koening’s classification, mass-like pattern was misdiagnosed the most.•A nomogram was developed and showed a predictive value in clinical practice.
To analyze radiation-induced lung injury (RIL) after stereotactic body radiotherapy (SBRT) of lung cancer and the subsequent clinical problems.
106 lung cancer patients treated with SBRT were included, their computed tomography (CT) scans were reviewed. Late injury pattern was classified by Koening’s, radiologist’ diagnosis reports for RIL was reviewed. Logistic regression was used to analyze the predictive model of injury pattern, which was also validated by ROC curve.
Radiographic late injury within at least 6 months after SBRT was concluded. The majority of late RIL was mass-like pattern, not the modified conventional pattern. 36.8% patients showed acute injury, which trend to occur late lung injury earlier than patients who were not found acute injury (p = 0.0185). 24.5% RIL cases were misdiagnosed to tumor progression by radiologists. Most misdiagnosis occurred among mass-like pattern. Per fraction dose (p < 0.0001), prescription isodose line (p = 0.027) and age (p = 0.089) trend to associate with the occurrence of mass-like injury pattern. Nomogram was established based on these parameters, ROC curve showed that area under the ROC curve (AUC) of the nomogram was 0.767 (95% CI = 0.677-0.857), which was better than any factors along.
SBRT for lung cancer patients was safe, the majority of late RIL was mass-like pattern. This injury was difficult to be distinguished from tumor progression, which leaded to misdiagnosis of 24.5% patients receiving SBRT. A nomogram based on age, per fraction dose and the prescription isodose line may assist the diagnosis in clinical practice.</description><subject>Aged</subject><subject>Diagnostic Errors - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - radiation effects</subject><subject>Lung cancer</subject><subject>Lung Injury - diagnostic imaging</subject><subject>Lung Injury - etiology</subject><subject>Lung Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Predictive model</subject><subject>Radiation Injuries - diagnostic imaging</subject><subject>Radiation-induced lung injury</subject><subject>Radiosurgery - adverse effects</subject><subject>ROC Curve</subject><subject>Stereotactic body radiotherapy</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0720-048X</issn><issn>1872-7727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotn78AkH26GXrJNkmuwcPKn5BQfADvIU0ma1Z2mxNdgX_valbPXoIA5PnzWQeQk4oTChQcd5MsAnaThjQKnVKCeUOGdNSslxKJnfJGCSDHIrybUQOYmwAYFpUbJ-MOJVQCIAxeX3S1unOtT533vYGbbbs_SJzvunDV7bWXYfBx0x7m3XvmK1cTPzCt9GlZp0us-erp5esrYec0d5gOCJ7tV5GPN7WQ_J6e_NyfZ_PHu8eri9nueHTqsvnouJGTIU1TM5LKi2VheBgC4aUMQO1xgoMIoI2oJlAyg2YzUlBIRk_JGfDu-vQfvQYO5X-Z3C51B7bPirGKeeCUVEmlA-oCW2MAWu1Dm6lw5eioDY-VaN-fKqNTzX4TKnT7YB-vkL7l_kVmICLAcC05qfDoKJxmBxYF9B0yrbu3wHfLpKHIQ</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Zhu, Xueru</creator><creator>Li, Xiaoyang</creator><creator>Gu, Hengle</creator><creator>Yu, Wen</creator><creator>Fu, Xiaolong</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201912</creationdate><title>Radiation-induced lung injury patterns and the misdiagnosis after SBRT of lung cancer</title><author>Zhu, Xueru ; Li, Xiaoyang ; Gu, Hengle ; Yu, Wen ; Fu, Xiaolong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-b693c656dc27b817d174630d42e122c0fae90ceee0ac0a26e13c0c3c0c6936723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Diagnostic Errors - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - radiation effects</topic><topic>Lung cancer</topic><topic>Lung Injury - diagnostic imaging</topic><topic>Lung Injury - etiology</topic><topic>Lung Neoplasms - radiotherapy</topic><topic>Male</topic><topic>Predictive model</topic><topic>Radiation Injuries - diagnostic imaging</topic><topic>Radiation-induced lung injury</topic><topic>Radiosurgery - adverse effects</topic><topic>ROC Curve</topic><topic>Stereotactic body radiotherapy</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Xueru</creatorcontrib><creatorcontrib>Li, Xiaoyang</creatorcontrib><creatorcontrib>Gu, Hengle</creatorcontrib><creatorcontrib>Yu, Wen</creatorcontrib><creatorcontrib>Fu, Xiaolong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Xueru</au><au>Li, Xiaoyang</au><au>Gu, Hengle</au><au>Yu, Wen</au><au>Fu, Xiaolong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiation-induced lung injury patterns and the misdiagnosis after SBRT of lung cancer</atitle><jtitle>European journal of radiology</jtitle><addtitle>Eur J Radiol</addtitle><date>2019-12</date><risdate>2019</risdate><volume>121</volume><spage>108708</spage><epage>108708</epage><pages>108708-108708</pages><artnum>108708</artnum><issn>0720-048X</issn><eissn>1872-7727</eissn><abstract>•Radiation-induced lung injury after SBRT was various and complicated.•The complicated injury patterns may induce misdiagnosis in clinical practice.•Our data showed that 24.5% patients were misdiagnosed after receiving SBRT.•Based on Koening’s classification, mass-like pattern was misdiagnosed the most.•A nomogram was developed and showed a predictive value in clinical practice.
To analyze radiation-induced lung injury (RIL) after stereotactic body radiotherapy (SBRT) of lung cancer and the subsequent clinical problems.
106 lung cancer patients treated with SBRT were included, their computed tomography (CT) scans were reviewed. Late injury pattern was classified by Koening’s, radiologist’ diagnosis reports for RIL was reviewed. Logistic regression was used to analyze the predictive model of injury pattern, which was also validated by ROC curve.
Radiographic late injury within at least 6 months after SBRT was concluded. The majority of late RIL was mass-like pattern, not the modified conventional pattern. 36.8% patients showed acute injury, which trend to occur late lung injury earlier than patients who were not found acute injury (p = 0.0185). 24.5% RIL cases were misdiagnosed to tumor progression by radiologists. Most misdiagnosis occurred among mass-like pattern. Per fraction dose (p < 0.0001), prescription isodose line (p = 0.027) and age (p = 0.089) trend to associate with the occurrence of mass-like injury pattern. Nomogram was established based on these parameters, ROC curve showed that area under the ROC curve (AUC) of the nomogram was 0.767 (95% CI = 0.677-0.857), which was better than any factors along.
SBRT for lung cancer patients was safe, the majority of late RIL was mass-like pattern. This injury was difficult to be distinguished from tumor progression, which leaded to misdiagnosis of 24.5% patients receiving SBRT. A nomogram based on age, per fraction dose and the prescription isodose line may assist the diagnosis in clinical practice.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>31704600</pmid><doi>10.1016/j.ejrad.2019.108708</doi><tpages>1</tpages></addata></record> |
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| subjects | Aged Diagnostic Errors - statistics & numerical data Female Humans Logistic Models Lung - diagnostic imaging Lung - radiation effects Lung cancer Lung Injury - diagnostic imaging Lung Injury - etiology Lung Neoplasms - radiotherapy Male Predictive model Radiation Injuries - diagnostic imaging Radiation-induced lung injury Radiosurgery - adverse effects ROC Curve Stereotactic body radiotherapy Tomography, X-Ray Computed - methods |
| title | Radiation-induced lung injury patterns and the misdiagnosis after SBRT of lung cancer |
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