Dose to circulating blood in intensity-modulated total body irradiation, total marrow irradiation, and total marrow and lymphoid irradiation

IF 3.2 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Medical physics Pub Date : 2025-06-08 DOI:10.1002/mp.17913

Bingqi Guo, Sheen Cherian, Erin S. Murphy, Craig S. Sauter, Ronald M. Sobecks, Seth Rotz, Rabi Hanna, Jacob G. Scott, Ping Xia

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引用次数: 0

Abstract

Background

Multi-isocentric intensity-modulated (IM) total body irradiation (TBI), total marrow irradiation (TMI), and total marrow and lymphoid irradiation (TMLI) are gaining popularity. A question arises on the impact of the interplay between blood circulation and dynamic delivery on blood dose.

Purpose

This study answers the question by introducing a new whole-body blood circulation modeling technique.

Methods

A whole-body CT with intravenous contrast was used to develop the blood circulation model. Fifteen organs and tissues, heart chambers, and great vessels were segmented using a deep-learning-based auto-contouring software. The main blood vessels were segmented using an in-house algorithm. Blood density, velocity, time-to-heart, and perfusion distributions were derived for systole, diastole, and portal circulations and used to simulate trajectories of blood particles during delivery. With the same prescription of 12 Gy in 8 fractions, doses to circulating blood were calculated for three plans: (1) an IM-TBI plan prescribing uniform dose to the whole body while reducing lung and kidney doses; (2) a TMI plan treating all bones; and (3) a TMLI plan treating all bones, major lymph nodes, and spleen; TMI and TMLI plans were optimized to reduce doses to non-target tissue.

Results

Circulating blood received 1.57 ± 0.43 Gy, 1.04 ± 0.32 Gy, and 1.09 ± 0.32 Gy in one fraction and 12.60 ± 1.21 Gy, 8.34 ± 0.88 Gy, and 8.71 ± 0.92 Gy in 8 fractions in IM-TBI, TMI, and TMLI, respectively. The interplay effect of blood motion with IM delivery did not change the mean dose, but changed the dose heterogeneity of the circulating blood. Fractionation reduced the blood dose heterogeneity.

Conclusions

A novel whole-body blood circulating model was developed based on patient-specific anatomy and realistic blood dynamics, concentration, and perfusion. Using the blood circulation model, we developed a dosimetry tool for circulating blood in IM-TBI, TMI, and TMLI.

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调强全身照射、全骨髓照射、全骨髓及淋巴细胞照射对循环血液的剂量。

背景：多重等中心调强（IM）全身照射（TBI）、全骨髓照射（TMI）和全骨髓及淋巴细胞照射（TMLI）越来越受欢迎。关于血液循环和动态给药之间的相互作用对血液剂量的影响，出现了一个问题。目的：本研究通过引入一种新的全身血液循环建模技术来回答这个问题。方法：采用全身CT加静脉造影剂建立血液循环模型。使用基于深度学习的自动轮廓软件对15个器官和组织、心室和大血管进行了分割。使用内部算法对主要血管进行分割。得出收缩期、舒张期和门静脉循环的血液密度、速度、到心时间和灌注分布，并用于模拟分娩过程中血液颗粒的轨迹。以8份12 Gy的相同处方，计算三种方案对循环血液的剂量：(1)IM-TBI方案，规定统一的全身剂量，同时减少肺和肾剂量；(2)全骨TMI计划；(3)治疗所有骨骼、主要淋巴结和脾脏的TMLI计划；优化TMI和TMLI计划以减少对非靶组织的剂量。结果：IM-TBI、TMI和TMLI的循环血液分别为1.57±0.43 Gy、1.04±0.32 Gy、1.09±0.32 Gy和12.60±1.21 Gy、8.34±0.88 Gy、8.71±0.92 Gy。血液运动与IM给药的相互作用没有改变平均剂量，但改变了循环血液的剂量异质性。分离降低了血剂量的异质性。结论：基于患者特异性解剖和真实血液动力学、浓度和灌注，建立了一种新的全身血液循环模型。利用血液循环模型，我们开发了IM-TBI、TMI和TMLI循环血液剂量测定工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical physics 医学-核医学

CiteScore

6.80

自引率

15.80%

发文量

660

审稿时长

1.7 months

期刊介绍： Medical Physics publishes original, high impact physics, imaging science, and engineering research that advances patient diagnosis and therapy through contributions in 1) Basic science developments with high potential for clinical translation 2) Clinical applications of cutting edge engineering and physics innovations 3) Broadly applicable and innovative clinical physics developments Medical Physics is a journal of global scope and reach. By publishing in Medical Physics your research will reach an international, multidisciplinary audience including practicing medical physicists as well as physics- and engineering based translational scientists. We work closely with authors of promising articles to improve their quality.