Evaluation of Functional Marrow Irradiation Based on Skeletal Marrow Composition Obtained Using Dual-Energy Computed Tomography
- Department of Radiological Sciences, Faculty of Health Sciences, Komazawa University, Tokyo (Japan)
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota (United States)
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota (United States)
- Department of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota (United States)
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota (United States)
- Mindways Software Inc, Austin, Texas (United States)
- Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan)
- College of Medicine, Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States)
- Department of Bone Marrow Transplantation, Comprehensive Cancer Center M. Curie-Sklodowska Memorial Institute, Gliwice (Poland)
- Department of Radiation Oncology, Beckman Research Institute, City of Hope, Duarte, California (United States)
- Department of Radiotherapy, Universitair Ziekenhuis Brussel, Brussels (Belgium)
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.
- OSTI ID:
- 22645689
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 96, Issue 3; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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