Prospective Study on Radiation Induced Cardiotoxicity Assessed By PET-CT for Locally Advanced Non-Small Cell Lung Cancer (NSCLC)

Prior treatment

• Patients treated with stereotactic body radiotherapy (SBRT).
• Prior thoracic radiotherapy.
  • Exclusion for Coronary computed tomography angiography (CCTA)
• Patients on radioactive iodine therapy.
  • Exclusion for 18F-Flurpiridaz PET/CT Test
• Second-degree AV block, third-degree AV block, and sinus node disease (such as sick sinus syndrome or symptomatic bradycardia) without a functioning pacemaker.
  • Note: Resting 12-lead EKG will be ordered at the time of enrollment to be performed prior to PET/CT stress test.

Other illness

• History of a severe anaphylactic reaction to iodinated contrast.
• Renal insufficiency (defined as estimated CrCl less than 30 mL/min).
• Patients with bronchospastic diseases including asthma and chronic obstructive pulmonary disease (COPD) who have an acute exacerbation or active wheezing (a high-pitched, musical, adventitious lung sound produced by airflow through the narrowed airways) on the day of PET CT exam.

Other

• Inability to hold breath for more than 5 seconds.
• Patients who are hypotensive (systolic blood pressure less than 90 mm Hg) on the day of the PET/CT scan.

• Age ≥ 18 at time of consent
• Ability to provide written informed consent and HIPAA authorization
• Stage III NSCLC per AJCC 8th edition guideline, confirmed by pathological diagnosis and PET/CT.
• To receive standard definitive concurrent chemoradiation therapy per NCCN guidelines.
• Tumor estimated to be within 2cm of heart contour or anticipated MHD\>10Gy per treating physician.