Ruben Carmona1, Jakub Pritz1, Mark Bydder2, Sachin Gulaya1, He Zhu1, Casey W Williamson1, Christian S Welch2, Florin Vaida3, Graeme Bydder2, Loren K Mell4. 1. Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California. 2. Department of Radiology, University of California San Diego Medical Center, San Diego, California. 3. Biostatistics and Bioinformatics, Department of Family and Preventive Medicine, University of California San Diego Medical Center, San Diego, California. 4. Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California. Electronic address: lmell@ucsd.edu.
Abstract
PURPOSE: To quantify changes in bone marrow fat fraction and determine associations with peripheral blood cell counts. METHODS AND MATERIALS: In this prospective study, 19 patients received either highly myelotoxic treatment (radiation therapy plus cisplatin, 5-fluorouracil mitomycin C [FU/MMC], or cisplatin/5-FU/cetuximab) or less myelotoxic treatment (capecitabine-radiation therapy or no concurrent chemotherapy). Patients underwent MR imaging and venipuncture at baseline, midtreatment, and posttreatment visits. We performed mixed effects modeling of the mean proton density fat fraction (PDFF[%]) by linear time, treatment, and vertebral column region (lumbar [L]4-sacral [S]2 vs thoracic [T]10-L3 vs cervical[C]3-T9), while controlling for cumulative mean dose and other confounders. Spearman rank correlations were performed by white blood cell (WBC) counts versus the differences in PDFF(%) before and after treatment. RESULTS: Cumulative mean dose was associated with a 0.43% per Gy (P=.004) increase in PDFF(%). In the highly myelotoxic group, we observed significant changes in PDFF(%) per visit within L4-S2 (10.1%, P<.001) and within T10-L3 (3.93%, P=.01), relative to the reference C3-T9. In the less myelotoxic group, we did not observe significant changes in PDFF(%) per visit according to region. Within L4-S2, we observed a significant difference between treatment groups in the change in PDFF(%) per visit (5.36%, P=.04). Rank correlations of the inverse log differences in WBC versus the differences in PDFF(%) overall and within T10-S2 ranged from 0.69 to 0.78 (P<.05). Rank correlations of the inverse log differences in absolute neutrophil counts versus the differences in PDFF(%) overall and within L4-S2 ranged from 0.79 to 0.81 (P<.05). CONCLUSIONS: Magnetic resonance imaging fat quantification is sensitive to marrow composition changes that result from chemoradiation therapy. These changes are associated with peripheral blood cell counts. This study supports a rationale for bone marrow-sparing treatment planning to reduce the risk of hematologic toxicity. Published by Elsevier Inc.
PURPOSE: To quantify changes in bone marrow fat fraction and determine associations with peripheral blood cell counts. METHODS AND MATERIALS: In this prospective study, 19 patients received either highly myelotoxic treatment (radiation therapy plus cisplatin, 5-fluorouracil mitomycin C [FU/MMC], or cisplatin/5-FU/cetuximab) or less myelotoxic treatment (capecitabine-radiation therapy or no concurrent chemotherapy). Patients underwent MR imaging and venipuncture at baseline, midtreatment, and posttreatment visits. We performed mixed effects modeling of the mean proton density fat fraction (PDFF[%]) by linear time, treatment, and vertebral column region (lumbar [L]4-sacral [S]2 vs thoracic [T]10-L3 vs cervical[C]3-T9), while controlling for cumulative mean dose and other confounders. Spearman rank correlations were performed by white blood cell (WBC) counts versus the differences in PDFF(%) before and after treatment. RESULTS: Cumulative mean dose was associated with a 0.43% per Gy (P=.004) increase in PDFF(%). In the highly myelotoxic group, we observed significant changes in PDFF(%) per visit within L4-S2 (10.1%, P<.001) and within T10-L3 (3.93%, P=.01), relative to the reference C3-T9. In the less myelotoxic group, we did not observe significant changes in PDFF(%) per visit according to region. Within L4-S2, we observed a significant difference between treatment groups in the change in PDFF(%) per visit (5.36%, P=.04). Rank correlations of the inverse log differences in WBC versus the differences in PDFF(%) overall and within T10-S2 ranged from 0.69 to 0.78 (P<.05). Rank correlations of the inverse log differences in absolute neutrophil counts versus the differences in PDFF(%) overall and within L4-S2 ranged from 0.79 to 0.81 (P<.05). CONCLUSIONS: Magnetic resonance imaging fat quantification is sensitive to marrow composition changes that result from chemoradiation therapy. These changes are associated with peripheral blood cell counts. This study supports a rationale for bone marrow-sparing treatment planning to reduce the risk of hematologic toxicity. Published by Elsevier Inc.
Authors: Scott B Reeder; Angel R Pineda; Zhifei Wen; Ann Shimakawa; Huanzhou Yu; Jean H Brittain; Garry E Gold; Christopher H Beaulieu; Norbert J Pelc Journal: Magn Reson Med Date: 2005-09 Impact factor: 4.668
Authors: B R Rosen; D M Fleming; D C Kushner; K S Zaner; R B Buxton; W P Bennet; G L Wismer; T J Brady Journal: Radiology Date: 1988-12 Impact factor: 11.105
Authors: L S Elting; E B Rubenstein; C G Martin; D Kurtin; S Rodriguez; E Laiho; K Kanesan; S B Cantor; R S Benjamin Journal: J Clin Oncol Date: 2001-02-15 Impact factor: 44.544
Authors: Patrick J Bolan; Luke Arentsen; Thanasak Sueblinvong; Yan Zhang; Steen Moeller; Jori S Carter; Levi S Downs; Rahel Ghebre; Douglas Yee; Jerry Froelich; Susanta Hui Journal: J Magn Reson Imaging Date: 2013-02-28 Impact factor: 4.813
Authors: L A Johnson; B E Hoppel; E L Gerard; S P Miller; S H Doppelt; G C Zirzow; D I Rosenthal; J M Dambrosia; S C Hill; R O Brady Journal: Radiology Date: 1992-02 Impact factor: 11.105
Authors: Neil B Newman; Rebecca A Moss; Nell Maloney-Patel; Kristen Donohue; Teresa V Brown; Michael J Nissenblatt; Shou-En Lu; Salma K Jabbour Journal: J Gastrointest Oncol Date: 2017-06
Authors: Miriam A Bredella; Scott M Daley; Mannudeep K Kalra; J Keenan Brown; Karen K Miller; Martin Torriani Journal: Radiology Date: 2015-05-19 Impact factor: 11.105
Authors: 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 Journal: Int J Radiat Oncol Biol Phys Date: 2016-07-06 Impact factor: 7.038
Authors: M Khan; P Ambady; D Kimbrough; T Shoemaker; S Terezakis; J Blakeley; S D Newsome; I Izbudak Journal: AJNR Am J Neuroradiol Date: 2018-05-17 Impact factor: 3.825