B Zhou*, J Wang, Y Lei, K Higgins, J Bradley, J Zhang, J Zhou, J Roper, X Yang, T Liu, Emory University, Atlanta, GA

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  B Zhou

TH-C-202-1 (Thursday, 7/14/2022) 10:00 AM - 11:00 AM [Eastern Time (GMT-4)]

Room 202

Purpose: To develop a lung ultrasound (LUS) scan protocol to assess pneumonitis in patients receiving radiotherapy (RT) for lung cancer.

Methods: Twelve participants were enrolled under IRB approval: 3 healthy volunteers (36 ± 4.6 years) and 9 patients (67.7 ± 7.4 years) – 5 during RT and 4 post RT for lung cancer. Two scan protocols were evaluated: (a) Lung scans were performed on the irradiated volume and contralateral lung which serves as the control; and (b) Irradiated lung was scanned in 3 (anterior, lateral and posterior) intercostal spaces. All participants were scanned in a sitting position under normal breathing while LUS videos were recorded. Both linear and convex transducers were used for comparative study. For all patients, chest CT or synthetic CT images acquired on the same day of ultrasound were used as the gold standard for pneumonitis evaluation.

Results: For healthy volunteers, no B-lines were shown in LUS images. Based on the CT and synthetic CT images, 7 out of 9 patients were observed with pneumonitis. In this preliminary study, 5 patients showed B-lines in LUS. Thus, the successful diagnostic rate of pneumonitis from LUS was 71.4%. For the irradiated lungs with pneumonitis, numerous B-lines (ranging from 1 to 5) were seen in the LUS at the intercostal spaces. The scan protocol with anterior, lateral and posterior intercostal spaces provided a comprehensive assessment of irradiated lung. Comparing with the linear array transducer, the convex transducer provided a better visualization of pleural line.

Conclusion: We have developed a LUS protocol to evaluate pneumonitis following lung RT. For the irradiated lung, the number of B-lines in the LUS were correlated with the lung abnormality present in the CT images. These data suggest that LUS could be useful for quantitative assessment of radiation-induced pneumonitis.

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