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Respiratory Magnetic Resonance Imaging for Radiation Therapy and Treatment of Lung Cancer

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Respiratory Magnetic Resonance Imaging for Radiation Therapy and Treatment of Lung Cancer – PowerPoint PPT presentation

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Title: Respiratory Magnetic Resonance Imaging for Radiation Therapy and Treatment of Lung Cancer


1
Respiratory Magnetic Resonance Imaging for
Radiation Therapy and Treatment of Lung Cancer
  • G Parraga PhD

Imaging Research Laboratories Robarts Research
Institute Department of Medical
Biophysics Graduate Program in Biomedical
Engineering Department of Medical Imaging The
University of Western Ontario
Tuesday March 3, 2009
2
London Lung Imaging Research Team
3
LUNG CANCER IMAGING
4
LUNG CANCER IMAGING
5
Overarching Aims
Interconnecting factors contribute to lowering
the burden of disease
6
Overarching Aims
Interconnecting factors contribute to lowering
the burden of disease
7
Overarching Aims
Interconnecting factors contribute to lowering
the burden of disease
8
Overarching Aims
Interconnecting factors contribute to lowering
the burden of disease
9
Overarching Aims
Interconnecting factors contribute to lowering
the burden of disease
10
Overarching Aims
Interconnecting factors contribute to lowering
the burden of disease
11
Ongoing Projects
  • Stroke and Heart Attack Risk
  • MRI and 3DUS of carotid vessel disease as
    predictors of patient risk, treatment effects,
    disease progression
  • Rheumatoid arthritis, post kidney transplant,
    dialysis, diabetes, stroke family history, stroke
    symptoms
  • Lung Cancer Detection and Tumour Response
  • 3D Endobronchial ultrasound for nodes
  • Image analysis tools for tumour volume/shape
    response
  • Respiratory Disease MR and CT imaging
  • CF, COPD, asthma, Radiation-induced lung injury

12
3He MRI New tools for Respiratory Disease?
  • Hyperpolarized 3He MRI
  • 3He MRI Phenotypes of inflammation
  • Application to Radiation-induced lung injury

13
Respiratory Disease Current Diagnostic Tools
14
Respiratory Disease Current Diagnostic Tools
15
Respiratory Disease Current Diagnostic Tools
16
Respiratory Anatomy Airways Airspaces
Adapted from Weibel E.R. Lung Morphometry and
Models in Respiratory Physiology.1989.
17
Conventional Thoracic 1H MRI
18
Hyperpolarized 3He MRI Facilities
19
3He Magnetic Resonance Image Center Coronal Slice
20
RESULTS Older Healthy Volunteers
58 yr old healthy volunteer FEV1 108pred
69 yr old healthy volunteer FEV1 105pred
Mathew et al, Acad Radiol 2008 15776-785
21
3He MRI GOLD Stage II COPD
62y female FEV1 62pred
61y male FEV1 68pred
22
3He MRI GOLD Stage III COPD
62y female FEV1 42pred
72y male FEV1 49pred
23
Assessing Function and StructureVentilation
Defects and Apparent Diffusion Coefficient
24
3He MRI Phenotypes of Lung Function
  • Ventilation Volume
  • Ventilation Defect
  • Volume

Thoracic Volume
25
Research Goals and Questions
  • Establishing feasibility, clinical relevance and
    utility
  • What regional lung functional changes can be
    measured in vivo after treatment?
  • How do we validate our findings? (Pathology,
    outcomes)
  • Developing new tools to translate method to
    clinical trials and practice

26
Coxson et al 2008 submitted
FEV149pred
FEV149pred
27
Radiation Induced Lung Injury (RILI)
  • Radiation Induced Lung Injury
  • Pneumonitis Fibrosis
  • Interstitial pulmonary inflammation
  • Prevalence 5-37 of patients receiving thoracic
    irradiation
  • Diagnosis
  • Clinical Symptoms
  • Chest x ray
  • X-ray computed tomography (CT)

Mathew et al Med Phys 2008 submitted
28
Radiation Induced Lung Injury (RILI)
Mathew et al Med Phys 2008 submitted
29
Objectives
A
  • Measure hyperpolarized 3Helium (3He) MRI
    Phenotypes after RILI symptoms reported (BL) and
    6 months later (FU)
  • Retrospective Analysis

B
A Subject 001 3He overlay B Subject 001
radiation treatment plan
Mathew et al Med Phys 2008 submitted
30
Methods
  • Seven subjects with RILI recruited, provided
    written informed consent
  • Pulmonary function testing
  • spirometry
  • plethysmography
  • CT
  • MRI

31
Results Subject Demographics
32
Results Radiation Parameters
33
Results Subject 004
  • 76 year old male
  • Bronchoalveolar carcinoma and adenocarcinoma
  • FEV1 44pred

CT Axial
3He MRI
CT Coronal
34
Results Subject 002
  • 55 year old male
  • Stage 3B squamous cell carcinoma
  • FEV1 54pred

CT Axial
3He MRI
CT Coronal
35
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36
Results 3He MRI Measurements
37
Baseline and Follow up Ventilation Images
Radiation Start Date April 4th 2007
38
Baseline and Follow up Ventilation Images
Radiation Start Date August 23rd 2007
39
Longitudinal Differences
ND No data for one of the two visits
ND No data for one of the two visits
40
Baseline to Follow up Comparison
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41
Baseline to Follow up Comparison
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42
Baseline to Follow up Comparison
43
Summary
  • Changes in contralateral lung function /
    structure post-RILI
  • Registration methods determined to evaluate
    changes in structure/function over time
  • Feasibility in severely compromised patients
  • Future study to evaluate 3He MRI prediction of
    RILI

44
Acknowledgements Disclosures
Collaborators George Rodrigues MD Glenn Bauman
MD Dave McCormack MD Chris Licskai MD Nigel
Paterson MD Giles Santyr PhD Roya Etemad-Rezai
MD Aaron Fenster PhD GY Zou PhD Harvey Coxson
PhD (Vancouver) Trainees Lindsay Mathew
BSc Miranda Kirby BSc Laura Wilson BS Anna
Rozik Hassaan Ahmed BSc Stephen Choy BEng
Research Staff Andrew Wheatley BSc Alexei
Ouriadov PhD Chris Piechowicz BA RPT Shayna
McKay BSc Sandra Halko CCRC, RPT Liz Lorusso RTMR
RTR Cyndi Harper Little RTMR RTR
45
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