Nan Li1, Sonal S Noticewala1, Casey W Williamson1, Hanjie Shen1, Igor Sirak2, Rafal Tarnawski3, Umesh Mahantshetty4, Carl K Hoh5, Kevin L Moore1, Loren K Mell6. 1. Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, United States. 2. Department of Oncology and Radiotherapy, University Hospital, Hradec Kralove, Czech Republic. 3. Clinic of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland. 4. Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. 5. Department of Radiology, Division of Nuclear Medicine, University of California San Diego, La Jolla, United States. 6. Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, United States. Electronic address: lmell@ucsd.edu.
Abstract
BACKGROUND: To test the hypothesis that atlas-based active bone marrow (ABM)-sparing intensity modulated radiation therapy (IMRT) yields similar dosimetric results compared to custom ABM-sparing IMRT for cervical cancer patients. METHODS: We sampled 62 cervical cancer patients with pre-treatment FDG-PET/CT in training (n=32) or test (n=30) sets. ABM was defined as the subvolume of the pelvic bone marrow (PBM) with standardized uptake value (SUV) above the mean on the average FDG-PET image (ABMAtlas) vs. the individual's PET (ABMCustom). Both were deformed to the planning CT. Overlap between the two subvolumes was measured using the Dice coefficient. Three IMRT plans designed to spare PBM, ABMAtlas, or ABMCustom were compared for 30 test patients. Dosimetric parameters were used to evaluate plan quality. RESULTS: ABMAtlas and ABMCustom volumes were not significantly different (p=0.90), with a mean Dice coefficient of 0.75, indicating good agreement. Compared to IMRT plans designed to spare PBM and ABMCustom, ABMAtlas-sparing IMRT plans achieved excellent target coverage and normal tissue sparing, without reducing dose to ABMCustom (mean ABMCustom dose 29.4Gy vs. 27.1Gyvs. 26.9Gy, respectively; p=0.10); however, PTV coverage and bowel sparing were slightly reduced. CONCLUSIONS: Atlas-based ABM sparing IMRT is clinically feasible and may obviate the need for customized ABM-sparing as a strategy to reduce hematologic toxicity.
BACKGROUND: To test the hypothesis that atlas-based active bone marrow (ABM)-sparing intensity modulated radiation therapy (IMRT) yields similar dosimetric results compared to custom ABM-sparing IMRT for cervical cancerpatients. METHODS: We sampled 62 cervical cancerpatients with pre-treatment FDG-PET/CT in training (n=32) or test (n=30) sets. ABM was defined as the subvolume of the pelvic bone marrow (PBM) with standardized uptake value (SUV) above the mean on the average FDG-PET image (ABMAtlas) vs. the individual's PET (ABMCustom). Both were deformed to the planning CT. Overlap between the two subvolumes was measured using the Dice coefficient. Three IMRT plans designed to spare PBM, ABMAtlas, or ABMCustom were compared for 30 test patients. Dosimetric parameters were used to evaluate plan quality. RESULTS: ABMAtlas and ABMCustom volumes were not significantly different (p=0.90), with a mean Dice coefficient of 0.75, indicating good agreement. Compared to IMRT plans designed to spare PBM and ABMCustom, ABMAtlas-sparing IMRT plans achieved excellent target coverage and normal tissue sparing, without reducing dose to ABMCustom (mean ABMCustom dose 29.4Gy vs. 27.1Gyvs. 26.9Gy, respectively; p=0.10); however, PTV coverage and bowel sparing were slightly reduced. CONCLUSIONS: Atlas-based ABM sparing IMRT is clinically feasible and may obviate the need for customized ABM-sparing as a strategy to reduce hematologic toxicity.
Authors: Tahir Yusufaly; Austin Miller; Ana Medina-Palomo; Casey W Williamson; Hannah Nguyen; Jessica Lowenstein; Charles A Leath; Ying Xiao; Kevin L Moore; Katherine M Moxley; Carlos M Chevere-Mourino; Tony Y Eng; Tarrick Zaid; Loren K Mell Journal: Int J Radiat Oncol Biol Phys Date: 2020-07-03 Impact factor: 7.038
Authors: Casey W Williamson; Igor Sirák; Ronghui Xu; Lorraine Portelance; Lichun Wei; Rafal Tarnawski; Umesh Mahantshetty; Elena S Heide; Catheryn M Yashar; Michael T McHale; Walter Bosch; Jessica Lowenstein; Cheryl C Saenz; Steve Plaxe; Ramez Eskander; John Einck; Arno J Mundt; Jyoti Mayadev; Loren K Mell Journal: Int J Radiat Oncol Biol Phys Date: 2021-08-20 Impact factor: 7.038
Authors: Ines Vendrell; Arlindo R Ferreira; André N Abrunhosa-Branquinho; Patrícia Miguel Semedo; Catarina F Pulido; Marília Jorge; Maria Filomena de Pina; Conceição Pinto; Luís Costa Journal: Medicine (Baltimore) Date: 2018-07 Impact factor: 1.889
Authors: Lucas K Vitzthum; Elena S Heide; Helen Park; Casey W Williamson; Paige Sheridan; Minh-Phuong Huynh-Le; Igor Sirak; Lichun Wei; Rafal Tarnawski; Umesh Mahantshetty; Cammie Nguyen; Jyoti Mayadev; Catheryn M Yashar; Assuntina G Sacco; Loren K Mell Journal: Front Oncol Date: 2020-07-21 Impact factor: 6.244
Authors: T Kumar; A Schernberg; F Busato; M Laurans; I Fumagalli; I Dumas; E Deutsch; C Haie-Meder; C Chargari Journal: Cancer Manag Res Date: 2019-07-08 Impact factor: 3.989