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• W4240321191 abstract "We have validated the use of a 3D deformable image registration algorithm in mapping the motion of a phantom lung tumor. We then applied the method to measure regional intra-tumor response in lung cancer patients treated with induction chemotherapy followed by concurrent chemoradiation. Numerous methods have been developed to quantify global tumor response to therapy. We describe for the first time a method to quantify response within radiographically defined intra-tumor sub-populations. A deformable image registration algorithm using a 3D optical flow method was developed to obtain a displacement vector between each voxel in a pair of related CT scans. The algorithm was validated by mapping the displacement of each voxel in a phantom lung tumor CT scan to a corresponding CT scan with a known 1.2cm and 2.4cm displacement. We then applied this method to a series of four recent lung cancer patients treated on a phase III protocol with two cycles of carboplatin-taxol based chemotherapy followed by concurrent chemoradiation with weekly carboplatin-taxol. Each patient obtained a high resolution spiral CT scan prior to treatment, after induction chemotherapy and after chemoradiation. A total of 32 tumor sub-populations were identified by dividing each pre-treatment tumor volume into octants. Each voxel of the pre-treatment scan was then independently mapped to the post-chemotherapy and post-radiation CT scans. The volume of the mapped tumor sub-populations were then compared to the pre-treatment CT scan as a measure of regional tumor response to each therapy. The measured displacement of the phantom lung tumor voxels was 1.20 and 2.40 cm with a full-width at tenth maximum of 0.008 and 0.006 cm respectively. The maximum error in voxel displacement was 1 mm. In the patient CT data sets, the mapped voxels of the intra-tumor regions were visualized on each of the post-treatment scans as represented in the color overlays of the CT scans in the figure. From this representative course it is evident that significant differences in response to therapy can be measured within tumor sub-populations. Although one tumor responded uniformly with less than 10% difference between octants, the other tumors responded with greater than 20% variation between the maximally and minimally responding octants. In one case, the residual volume in the maximally and minimally responding octants were 6.7% and 75.7% respectively. The residual tumor volume in each octant ranged from 26.7% to 86.9% with a mean of 59.2% after induction chemotherapy compared with a range of 6.7% to 75.7% with a mean of 39.8% after concurrent chemoradiation. A pair-wise comparison of the response to chemotherapy and concurrent chemoradiation in each of the 32 octants measured revealed no correlation between response to chemotherapy and response to concurrent chemoradiation with a correlation coefficient of r = 0.40. We have validated a new method of mapping voxel motion between related CT scans. We then successfully applied this technique to measure regional intra-tumor response to therapy. One tumor appeared to respond uniformly, while others responded with significant regional heterogeneity suggesting the existence of tumor sub-populations with a range of therapeutic sensitivity. Finally, despite the prevailing belief that response to chemotherapy predicts for response to radiation, the magnitude of this response was not correlated within sub-populations of the tumor in our study." @default.
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• W4240321191 date "2004-09-01" @default.
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• W4240321191 title "Quantitative measurement of regional tumor response to therapy" @default.
• W4240321191 doi "https://doi.org/10.1016/s0360-3016(04)01208-8" @default.
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