Whole-Body Distribution of Leukemia and Functional Total Marrow Irradiation Based on FLT-PET and Dual-Energy CT.

IF 2.2 4区 医学 Q3 BIOCHEMICAL RESEARCH METHODS
Taiki Magome, Jerry Froelich, Shernan G Holtan, Yutaka Takahashi, Michael R Verneris, Keenan Brown, Kathryn Dusenbery, Jeffrey Wong, Susanta K Hui
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引用次数: 11

Abstract

This report describes a multimodal whole-body 3'-deoxy-3'[(18)F]-fluorothymidine positron emission tomography (FLT-PET) and dual-energy computed tomography (DECT) method to identify leukemia distribution within the bone marrow environment (BME) and to develop disease- and/or BME-specific radiation strategies. A control participant and a newly diagnosed patient with acute myeloid leukemia prior to induction chemotherapy were scanned with FLT-PET and DECT. The red marrow (RM) and yellow marrow (YM) of the BME were segmented from DECT using a basis material decomposition method. Functional total marrow irradiation (fTMI) treatment planning simulations were performed combining FLT-PET and DECT imaging to differentially target irradiation to the leukemia niche and the rest of the skeleton. Leukemia colonized both RM and YM regions, adheres to the cortical bone in the spine, and has enhanced activity in the proximal/distal femur, suggesting a potential association of leukemia with the BME. The planning target volume was reduced significantly in fTMI compared with conventional TMI. The dose to active disease (standardized uptake value >4) was increased by 2-fold, while maintaining doses to critical organs similar to those in conventional TMI. In conclusion, a hybrid system of functional-anatomical-physiological imaging can identify the spatial distribution of leukemia and will be useful to both help understand the leukemia niche and develop targeted radiation strategies.

Abstract Image

Abstract Image

Abstract Image

基于FLT-PET和双能CT的白血病全身分布和功能性全骨髓照射。
本报告描述了一种多模态全身3'-脱氧-3'[(18)F]-氟胸腺嘧啶正电子发射断层扫描(FLT-PET)和双能计算机断层扫描(DECT)方法,用于识别骨髓环境(BME)内的白血病分布,并制定疾病和/或BME特异性放射策略。对一名对照组和一名新诊断的急性髓系白血病患者进行诱导化疗前的FLT-PET和DECT扫描。采用基料分解法对BME的红髓(RM)和黄髓(YM)进行分割。结合FLT-PET和DECT成像进行功能性全骨髓照射(fTMI)治疗计划模拟,以区分靶向照射到白血病生态位和骨骼的其余部分。白血病可在RM和YM区域定居,粘附于脊柱皮质骨,并增强股骨近端/远端活动,提示白血病与BME的潜在关联。与传统TMI相比,fTMI的规划目标体积明显减少。对活动性疾病(标准摄取值>4)的剂量增加了2倍,而对关键器官的剂量与传统TMI相似。总之,功能-解剖-生理成像的混合系统可以识别白血病的空间分布,有助于了解白血病的生态位和制定靶向放疗策略。
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
Molecular Imaging
Molecular Imaging Biochemistry, Genetics and Molecular Biology-Biotechnology
自引率
3.60%
发文量
21
期刊介绍: Molecular Imaging is a peer-reviewed, open access journal highlighting the breadth of molecular imaging research from basic science to preclinical studies to human applications. This serves both the scientific and clinical communities by disseminating novel results and concepts relevant to the biological study of normal and disease processes in both basic and translational studies ranging from mice to humans.
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