2022 World Conference on Lung Cancer (ePosters)-EP05.01-023. Feasibility of Functional Lung Avoidance using Ga-68 4D Ventilation Perfusion PET/CT: The HI-FIVE Trial

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The HI-FIVE trial, conducted by researchers from the Peter MacCallum Cancer Centre in Melbourne, Australia, assessed the feasibility of using functional lung avoidance (FLA) treatment planning in stage III non-small cell lung cancer (NSCLC). FLA incorporates functional information from 68Ga Ventilation Perfusion PET/CT imaging into treatment planning to reduce radiation toxicity and improve patient outcomes. The trial is the first to use 68Ga-4D-V/Q PET/CT imaging for FLA in patients.<br /><br />The trial enrolled 19 patients, with 18 evaluable for assessment. The feasibility endpoint was met for 15 of the 18 patients, indicating that FLA treatment was feasible in the majority of cases. The trial achieved a reduction in functional mean lung dose and functional V20Gy, while maintaining a mean heart dose of 30 Gy and heart V50Gy of 25%. Overall survival at 12 months was 83%, and only 11% of patients experienced grade 2 pneumonitis.<br /><br />However, the study highlighted the challenges of implementing FLA in clinical practice. The accessibility of FLA imaging techniques and their integration into radiation therapy workflows was identified as a major barrier. The trial demonstrated the feasibility of FLA at the institution but emphasized the need for cheaper and more accessible methods of generating functional volumes.<br /><br />Although FLA radiation therapy using 68Ga Ventilation Perfusion PET/CT is feasible, it remains unclear whether this approach improves patient toxicity or quality of life. Further research is needed to determine the advantages and benefits of FLA in NSCLC treatment.<br /><br />Overall, the HI-FIVE trial provides evidence supporting the feasibility and potential benefits of using functional lung avoidance in stage III NSCLC radiation therapy. The findings contribute to the growing body of research on the integration of advanced imaging techniques into treatment planning for improved outcomes in lung cancer patients.

Asset Subtitle

Nicholas Wentworth Bucknell

Meta Tag

Speaker Nicholas Wentworth Bucknell

Topic Locally Advanced Non-small Cell Lung Cancer - Chemoradiotherapy and Radiotherapy

Keywords

HI-FIVE trial

functional lung avoidance

FLA treatment planning

NSCLC

68Ga Ventilation Perfusion PET/CT imaging

radiation toxicity

patient outcomes

feasibility endpoint

functional mean lung dose

grade 2 pneumonitis