Alexandra Moignier1, David Broggio1, Sylvie Derreumaux2, Anne Beaudré3, Théodore Girinsky3, Jean-François Paul4, Damien Drubay5, Dimitrios Lefkopoulos3, Didier Franck1, Bernard Aubert6, Eric Deutsch3, Jean Bourhis3. 1. Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SDI/LEDI, France. 2. Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SER/UEM, France. Electronic address: sylvie.derreumaux@irsn.fr. 3. Institut Gustave Roussy, Service de Radiothérapie Oncologique, France. 4. Centre Chirurgical Marie-Lannelongue, Service de Radiologie, France. 5. Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LEPID, France. 6. Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SER/UEM, France.
Abstract
BACKGROUND AND PURPOSE: The dose effect-effect relationship for cardiac diseases following radiotherapy suffers from uncertainties. Three dimensional coronary artery (CA) dose calculation after mediastinal Hodgkin lymphoma radiotherapy was performed, using the patient's coronary CT angiography (CCTA), and the relationship between the coronary arteries' radiation doses and the risk of stenosis was estimated. MATERIALS AND METHODS: Radiotherapy simulation CT scans and CCTAs of patients treated for a mediastinal Hodgkin lymphoma were used to merge thoracic and detailed cardiovascular anatomies. Radiation treatment parameters were used to estimate CA radiation doses. Twenty-one patients without coronary stenosis (controls) were matched with twelve patients with stenosis (cases). CA segments were considered as sub-volumes of interest. Radiation doses to stenotic segments were compared with those received by normal segments (from cases and controls) using a logistic regression. RESULTS: In eleven cases out of twelve, the highest of the coronary dose distribution was on a damaged segment. Logistic regression with CA segments yielded an odds ratio associated with the risk of coronary stenosis of 1.049 per additional gray with the CA segment median dose (95% confidence interval, 1.004-1.095; p-value <0.05). CONCLUSION: The CA segment dose significantly increased the risk of stenosis on the segment. Such personalized CA dose calculations on larger cohorts are expected to improve the understanding of the cardiovascular radiation dose-effect relationship.
BACKGROUND AND PURPOSE: The dose effect-effect relationship for cardiac diseases following radiotherapy suffers from uncertainties. Three dimensional coronary artery (CA) dose calculation after mediastinal Hodgkin lymphoma radiotherapy was performed, using the patient's coronary CT angiography (CCTA), and the relationship between the coronary arteries' radiation doses and the risk of stenosis was estimated. MATERIALS AND METHODS: Radiotherapy simulation CT scans and CCTAs of patients treated for a mediastinal Hodgkin lymphoma were used to merge thoracic and detailed cardiovascular anatomies. Radiation treatment parameters were used to estimate CA radiation doses. Twenty-one patients without coronary stenosis (controls) were matched with twelve patients with stenosis (cases). CA segments were considered as sub-volumes of interest. Radiation doses to stenotic segments were compared with those received by normal segments (from cases and controls) using a logistic regression. RESULTS: In eleven cases out of twelve, the highest of the coronary dose distribution was on a damaged segment. Logistic regression with CA segments yielded an odds ratio associated with the risk of coronary stenosis of 1.049 per additional gray with the CA segment median dose (95% confidence interval, 1.004-1.095; p-value <0.05). CONCLUSION: The CA segment dose significantly increased the risk of stenosis on the segment. Such personalized CA dose calculations on larger cohorts are expected to improve the understanding of the cardiovascular radiation dose-effect relationship.
Authors: Frances Duane; Marianne C Aznar; Freddie Bartlett; David J Cutter; Sarah C Darby; Reshma Jagsi; Ebbe L Lorenzen; Orla McArdle; Paul McGale; Saul Myerson; Kazem Rahimi; Sindu Vivekanandan; Samantha Warren; Carolyn W Taylor Journal: Radiother Oncol Date: 2017-02-21 Impact factor: 6.280
Authors: Marc D Piroth; René Baumann; Wilfried Budach; Jürgen Dunst; Petra Feyer; Rainer Fietkau; Wulf Haase; Wolfgang Harms; Thomas Hehr; David Krug; Arnd Röser; Felix Sedlmayer; Rainer Souchon; Frederik Wenz; Rolf Sauer Journal: Strahlenther Onkol Date: 2018-10-11 Impact factor: 3.621
Authors: Valentin Walker; Anne Crijns; Johannes Langendijk; Daan Spoor; Rozemarijn Vliegenthart; Stephanie E Combs; Michael Mayinger; Arantxa Eraso; Ferran Guedea; Manuela Fiuza; Susana Constantino; Radia Tamarat; Dominique Laurier; Jean Ferrières; Elie Mousseaux; Elisabeth Cardis; Sophie Jacob Journal: JMIR Res Protoc Date: 2018-10-01