Objectively Quantifying Radiation Esophagitis with Novel Computed Tomography-Based Metrics

The authors examined radiation-induced esophageal expansion as an objective and continuous CT-based measure of radiation esophagitis. A method to reduce esophageal expansion calculation uncertainty from anatomic variability was tested and applied to these metrics. Results showed that esophageal expansion is highly correlated to radiation esophagitis grade, and several candidate metric values were discovered for use as endpoints in toxicity prediction modeling. In addition, the anatomic variability correction method provides a more accurate quantification of esophageal expansion.