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

Taiki Magome; Jerry Froelich; Yutaka Takahashi; Luke Arentsen; Shernan Holtan; Michael R Verneris; Keenan Brown; Akihiro Haga; Keiichi Nakagawa; Jennifer L Holter Chakrabarty; Sebastian Giebel; Jeffrey Wong; Kathryn Dusenbery; Guy Storme; Susanta K Hui

doi:10.1016/j.ijrobp.2016.06.2459

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

Taiki Magome, Jerry Froelich, Yutaka Takahashi, Luke Arentsen, Shernan Holtan, Michael R Verneris, Keenan Brown, Akihiro Haga, Keiichi Nakagawa, Jennifer L Holter Chakrabarty, Sebastian Giebel, Jeffrey Wong, Kathryn Dusenbery, Guy Storme, Susanta K Hui

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

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.

Original language	English
Pages (from-to)	679-687
Number of pages	9
Journal	International Journal of Radiation Oncology, Biology, Physics
Volume	96
Issue number	3
DOIs	https://doi.org/10.1016/j.ijrobp.2016.06.2459
Publication status	Published - 1 Nov 2016

Bibliographical note

Keywords

Adult
Bone Marrow/diagnostic imaging
Cadaver
Dose-Response Relationship, Radiation
Female
Humans
Leukemia/diagnostic imaging
Male
Middle Aged
Radiography, Dual-Energy Scanned Projection/methods
Radiotherapy Dosage
Radiotherapy, Image-Guided/methods
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed/methods
Whole Body Imaging/methods
Whole-Body Irradiation/methods

Access to Document

10.1016/j.ijrobp.2016.06.2459

Handle.net

Persistent link

Cite this

Magome, T., Froelich, J., Takahashi, Y., Arentsen, L., Holtan, S., Verneris, M. R., Brown, K., Haga, A., Nakagawa, K., Holter Chakrabarty, J. L., Giebel, S., Wong, J., Dusenbery, K., Storme, G., & Hui, S. K. (2016). Evaluation of Functional Marrow Irradiation Based on Skeletal Marrow Composition Obtained Using Dual-Energy Computed Tomography. International Journal of Radiation Oncology, Biology, Physics, 96(3), 679-687. https://doi.org/10.1016/j.ijrobp.2016.06.2459

@article{1901d0d10de643e39866a82538465aba,

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

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.",

keywords = "Adult, Bone Marrow/diagnostic imaging, Cadaver, Dose-Response Relationship, Radiation, Female, Humans, Leukemia/diagnostic imaging, Male, Middle Aged, Radiography, Dual-Energy Scanned Projection/methods, Radiotherapy Dosage, Radiotherapy, Image-Guided/methods, Reproducibility of Results, Sensitivity and Specificity, Tomography, X-Ray Computed/methods, Whole Body Imaging/methods, Whole-Body Irradiation/methods",

author = "Taiki Magome and Jerry Froelich and Yutaka Takahashi and Luke Arentsen and Shernan Holtan and Verneris, {Michael R} and Keenan Brown and Akihiro Haga and Keiichi Nakagawa and {Holter Chakrabarty}, {Jennifer L} and Sebastian Giebel and Jeffrey Wong and Kathryn Dusenbery and Guy Storme and Hui, {Susanta K}",

year = "2016",

month = nov,

day = "1",

doi = "10.1016/j.ijrobp.2016.06.2459",

language = "English",

volume = "96",

pages = "679--687",

journal = "International Journal of Radiation Oncology, Biology, Physics",

issn = "0360-3016",

publisher = "Elsevier Inc.",

number = "3",

}

Magome, T, Froelich, J, Takahashi, Y, Arentsen, L, Holtan, S, Verneris, MR, Brown, K, Haga, A, Nakagawa, K, Holter Chakrabarty, JL, Giebel, S, Wong, J, Dusenbery, K, Storme, G & Hui, SK 2016, 'Evaluation of Functional Marrow Irradiation Based on Skeletal Marrow Composition Obtained Using Dual-Energy Computed Tomography', International Journal of Radiation Oncology, Biology, Physics, vol. 96, no. 3, pp. 679-687. https://doi.org/10.1016/j.ijrobp.2016.06.2459

TY - JOUR

T1 - Evaluation of Functional Marrow Irradiation Based on Skeletal Marrow Composition Obtained Using Dual-Energy Computed Tomography

AU - Magome, Taiki

AU - Froelich, Jerry

AU - Takahashi, Yutaka

AU - Arentsen, Luke

AU - Holtan, Shernan

AU - Verneris, Michael R

AU - Brown, Keenan

AU - Haga, Akihiro

AU - Nakagawa, Keiichi

AU - Holter Chakrabarty, Jennifer L

AU - Giebel, Sebastian

AU - Wong, Jeffrey

AU - Dusenbery, Kathryn

AU - Storme, Guy

AU - Hui, Susanta K

PY - 2016/11/1

Y1 - 2016/11/1

N2 - 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.

AB - 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.

KW - Adult

KW - Bone Marrow/diagnostic imaging

KW - Cadaver

KW - Dose-Response Relationship, Radiation

KW - Female

KW - Humans

KW - Leukemia/diagnostic imaging

KW - Male

KW - Middle Aged

KW - Radiography, Dual-Energy Scanned Projection/methods

KW - Radiotherapy Dosage

KW - Radiotherapy, Image-Guided/methods

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Tomography, X-Ray Computed/methods

KW - Whole Body Imaging/methods

KW - Whole-Body Irradiation/methods

U2 - 10.1016/j.ijrobp.2016.06.2459

DO - 10.1016/j.ijrobp.2016.06.2459

M3 - Article

C2 - 27681765

SN - 0360-3016

VL - 96

SP - 679

EP - 687

JO - International Journal of Radiation Oncology, Biology, Physics

JF - International Journal of Radiation Oncology, Biology, Physics

IS - 3

ER -

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

Abstract

Bibliographical note

Keywords

Access to Document

Handle.net

Fingerprint

Cite this