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 termablative (SABR)was added to reflect the aim of the treatment,
which is to destroy the tumor...
Methods and materials
Patients Selection
Two-hundred thirteen patients that underwent SABR at our Institution from January 2013 to January 2017 were retrospectively evaluated.
Inclusion criteria were: an available pre-treatment contrast-enhanced computed tomography (CT) and a minimum imaging follow-up of 6 months at our Institution.
Fifty patients (N = 50) were enrolled.
Demographical and clinical information were collected for all patients,
including age,
tumor size,
tumor site,
histological subtype (Table 1),
number of treated nodules (Table 2) and SABR delivery technique.
Nine patients presented synchronous nodules and were treated...
Results
Fifty patients underwent SABR on 64 nodules.
38 patients underwent a single SABR procedure.
11 patients had SABR on two different nodules.
One patient was treated four times with SABR on different lesions.
Of 64 nodules treated with SABR only 36 have a first CT within 6 month from the end of SABR.
Our data about acute lung injury are limited but in line with the literature (6),we identified: 13 diffuse consolidation (36%),
8 patchy consolidation (22%),
2 diffuse GGO (6%),
6 patchy GGO (17%)...
Conclusion
Nguyencriteria for early identification of LR is useful and can raise the radiological sensitivity up to 100%,
nevertheless the identification of 3 HRFs has a low PPV (58%) and the guide of a radiologist expert in the field is mandatory to avoid false positive whose causes are mainly SABR side effects such as radiation induced pneumonia and atelectasia.
We remark the use of CC growth parameter since it is the most performant single HRFs of LR (sensitivity 80%,
specificity 91%,
PPV 75% and NPV 93%).
Personal information
Simone Mennella,MD; resident,
department of Diagnostic Imaging and Interventional Radiology,
University of Genoa and San Paolo Community Hospital,
Savona.
Ilaria Pulzato,MD; department of Diagnostic Imaging and Interventional Radiology,
University of Genoa and S.
Martino Polyclinic,
Genoa.
Gianluca Ficarra,MD; resident,
department of Diagnostic Imaging and Interventional Radiology,
University of Genoa and S.
Martino Polyclinic,
Genoa.
Emanuele Barabino,MD; resident,
department of Diagnostic Imaging and Interventional Radiology,
University of Genoa and S.
Martino Polyclinic,
Genoa.
Stefano Vagge,MD,
PHD; department of Radiation Oncology,
University of Genoa and S.
Martino...
References
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