A New Approach for Skeletal Dose Estimate for Large-Scale Radiotherapy Patients in Epidemiological Studies
Y Yeom1*, L Braunstein2, L Morton3, K Bolton4, H Ju5, H Choi6, N Greenstein7, C Lee8, (1) Yonsei University, Wonju, Gangwon-do, KR, (2) Memorial Sloan-Kettering Cancer Center, New York, NY, (3)National Cancer Institute, Bethesda, MD, (4) Washington University School Of Medicine, ,,(5) Yonsei University, ,,(6) University of Maryland-College Park, ,,(7) Princeton University, ,,(8) National Cancer Institute, Bethesda, MD
Presentations
PO-GePV-M-336 (Sunday, 7/10/2022) [Eastern Time (GMT-4)]
ePoster Forums
Purpose: To present a new method for the rapid reconstruction of active bone marrow (ABM) doses of radiotherapy among cancer patients, to support a large-scale cohort study on the assessment of clonal hematopoiesis and leukemia risk following radiotherapy.
Methods: We manually segmented site-specific bones for forty radiotherapy patients. We automatically segmented the bones by matching a whole-body computational human phantom, in which the skeletal system is divided into 34 bone sites, to patient CT images via 3D skeletal registration. The bones segmented both manually and automatically were then combined with the patient dose matrix calculated by the treatment planning system (TPS) to derive patient ABM dose. We evaluated the performance of the automatic method in geometric and dosimetric accuracy by comparison with the manual approach.
Results: The pelvis showed the best geometric performance [volume overlap fraction (VOF): 52% (mean) with 23% (σ) and average distance (AD): 0.8 cm (mean) with 0.5 cm (σ)]. The pelvis also showed the best dosimetry performance [absorbed dose difference (ADD): 0.7 Gy (mean) with 1.0 Gy (σ)]. Some bones showed unsatisfactory performances such as the cervical vertebrae [ADD: 5.2 Gy (mean) with 10.8 Gy (σ)]. This impact on the total ABM dose, however, was not significant. An excellent agreement for the total ABM dose was indeed observed [ADD: 0.4 Gy (mean) with 0.4 Gy (σ)]. The computation time required for dose calculation using our method was rapid (about one minute per patient).
Conclusion: We confirmed that our method estimates ABM doses across treatment sites accurately, while providing high computational efficiency. The method will be used to reconstruct patient-specific ABM doses for dose-response assessment in a large cohort study. The method can also be applied to prospective dose calculation within a clinical TPS to support clinical decision making at the point of care.
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