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Author Magome, Taiki ♦ Froelich, Jerry ♦ Takahashi, Yutaka ♦ Arentsen, Luke ♦ Holtan, Shernan ♦ Verneris, Michael R. ♦ Brown, Keenan ♦ Haga, Akihiro ♦ Nakagawa, Keiichi ♦ Holter Chakrabarty, Jennifer L. ♦ Giebel, Sebastian ♦ Wong, Jeffrey ♦ Dusenbery, Kathryn ♦ Storme, Guy ♦ Hui, Susanta K.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword RADIOLOGY AND NUCLEAR MEDICINE ♦ BIOMEDICAL RADIOGRAPHY ♦ BONE MARROW ♦ COMPUTERIZED TOMOGRAPHY ♦ DOSIMETRY ♦ GY RANGE 10-100 ♦ IMAGES ♦ IRRADIATION ♦ RADIATION DOSES ♦ RADIATION HAZARDS ♦ RADIOTHERAPY
Abstract 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.
ISSN 03603016
Educational Use Research
Learning Resource Type Article
Publisher Date 2016-11-01
Publisher Place United States
Journal International Journal of Radiation Oncology, Biology and Physics
Volume Number 96
Issue Number 3


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