A methodology for incorporating functional bone marrow sparing in IMRT planning for pelvic radiation therapy

作者：McGuire Sarah M^*; Menda Yusuf; Ponto Laura L Boles; Gross Brandie; Juweid Malik; Bayouth John E

来源：Radiotherapy and Oncology, 2011, 99(1): 49-54.

DOI：10.1016/j.radonc.2011.01.025

• Cervical cancer
• IMRT
• [(18)F]FLT PET
• Bone marrow

Background and purpose: The purpose of this study was to design a radiation therapy treatment planning approach that would spare hematopoietically active bone marrow using [(18)F]FLT PET imaging.
Materials and methods: We have developed an IMRT planning methodology to incorporate functional PET imaging using [18F]FLT scans. Plans were generated for two simulated cervical cancer patients, where pelvic active bone marrow regions were incorporated as avoidance regions based on the ranges: SUV4 >= 4; 4 > SUV3 >= 3; and 3 > SUV2 >= 2. Dose objectives were set to reduce bone marrow volume that received 10 (V(10)) and 20 (V(20)) Gy.
Results: Active bone marrow regions identified by [(18)F]FLT with an SUV >= 2, SUV >= 3, and SUV >= 4 represented an average of 43.0%, 15.3%, and 5.8%, respectively of the total osseous pelvis for the two cases studied. Improved dose-volume histograms for all identified bone marrow SUV volumes and decreases in V(10), and V(20) were achieved without clinically significant changes to PTV or OAR doses.
Conclusions: Incorporation of [(18)F]FLT PET in IMRT planning provides a methodology to reduce radiation dose to active bone marrow without compromising PTV or OAR dose objectives in pelvic malignancies.

• 出版日期2011-4