4DCT-Ventilation Imaging in Radiotherapy

Recent developments in four-dimensional computed tomography (4DCT)-based ventilation imaging have enabled noninvasive, patient-specific assessment of regional lung function directly from standard planning CT data. This technique generates voxel-level ventilation maps that can be integrated into radiation treatment planning to minimize dose to functional lung regions, potentially improving clinical outcomes and reducing the risk of post-treatment toxicity.

4DCT-ventilation methods have been clinically validated through a series of retrospective and prospective studies, demonstrating strong correlations between 4DCT-derived ventilation metrics and standard pulmonary function test outcomes. These studies have also shown the feasibility of incorporating ventilation maps into functional avoidance planning, allowing more precise targeting of radiotherapy while preserving healthy lung tissue. In addition, 4DCT-ventilation imaging offers potential for predicting post-surgical lung function, supporting more informed clinical decision-making. Ongoing efforts aim to translate these advances into routine clinical practice and further expand their applications through AI-based predictive modeling of patient outcomes, ultimately enabling more personalized and function-preserving radiation therapy strategies.