Evaluation of Functional Marrow Irradiation Based on Skeletal Marrow Composition Obtained Using Dual-Energy Computed Tomography

被引:11
|
作者
Magome, Taiki [1 ,2 ,3 ]
Froelich, Jerry [4 ]
Takahashi, Yutaka [2 ,5 ]
Arentsen, Luke [6 ]
Holtan, Shernan [7 ]
Verneris, Michael R. [7 ]
Brown, Keenan [8 ]
Haga, Akihiro [3 ]
Nakagawa, Keiichi [3 ]
Chakrabarty, Jennifer L. Holter [9 ]
Giebel, Sebastian [10 ]
Wong, Jeffrey [11 ]
Dusenbery, Kathryn [6 ]
Storme, Guy [12 ]
Hui, Susanta K. [2 ,6 ,11 ]
机构
[1] Komazawa Univ, Fac Hlth Sci, Dept Radiol Sci, Tokyo, Japan
[2] Univ Minnesota, Masonic Canc Ctr, Minneapolis, MN USA
[3] Tokyo Univ Hosp, Dept Radiol, Tokyo, Japan
[4] Univ Minnesota, Dept Radiol, Minneapolis, MN 55455 USA
[5] Osaka Univ, Dept Radiat Oncol, Osaka, Japan
[6] Univ Minnesota, Dept Therapeut Radiol, Minneapolis, MN USA
[7] Univ Minnesota, Blood & Marrow Transplant Program, Minneapolis, MN USA
[8] Mindways Software Inc, Austin, TX USA
[9] Oklahoma Hlth Sci Ctr, Coll Med, Oklahoma City, OK USA
[10] M Curie Sklodowska Mem Inst, Ctr Comprehens Canc, Dept Bone Marrow Transplantat, Gliwice, Poland
[11] City Hope Natl Med Ctr, Beckman Res Inst, Dept Radiat Oncol, Duarte, CA USA
[12] Univ Ziekenhuis Brussel, Dept Radiotherapy, Brussels, Belgium
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2016年 / 96卷 / 03期
基金
美国国家卫生研究院; 日本学术振兴会;
关键词
BONE-MARROW; HELICAL TOMOTHERAPY; MULTIPLE-MYELOMA; CANCER-PATIENTS; RADIATION-THERAPY; TOTAL-BODY; FAT; CHEMOTHERAPY; MICROENVIRONMENT; TRANSPLANTATION;
D O I
10.1016/j.ijrobp.2016.06.2459
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To develop an imaging method to characterize and map marrow composition in the entire skeletal system, and to simulate differential targeted marrow irradiation based on marrow composition. Methods and Materials: Whole-body dual energy computed tomography (DECT) images of cadavers and leukemia patients were acquired, segmented to separate bone marrow components, namely, bone, red marrow (RM), and yellow marrow (YM). DECT-derived marrow fat fraction was validated using histology of lumbar vertebrae obtained from cadavers. The fractions of RM (RMF = RM/total marrow) and YMF were calculated in each skeletal region to assess the correlation of marrow composition with sites and ages. Treatment planning was simulated to target irradiation differentially at a higher dose (18 Gy) to either RM or YM and a lower dose (12 Gy) to the rest of the skeleton. Results: A significant correlation between fat fractions obtained from DECT and cadaver histology samples was observed (r=0.861, P<.0001, Pearson). The RMF decreased in the head, neck, and chest was significantly inversely correlated with age but did not show any significant age-related changes in the abdomen and pelvis regions. Conformity of radiation to targets (RM, YM) was significantly dependent on skeletal sites. The radiation exposure was significantly reduced (P<.05, t test) to organs at risk (OARs) in RM and YM irradiation compared with standard total marrow irradiation (TMI). Conclusions: Whole-body DECT offers a new imaging technique to visualize and measure skeletal-wide marrow composition. The DECT-based treatment planning offers volumetric and site-specific precise radiation dosimetry of RM and YM, which varies with aging. Our proposed method could be used as a functional compartment of TMI for further targeted radiation to specific bone marrow environment, dose escalation, reduction of doses to OARs, or a combination of these factors. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:679 / 687
页数:9
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