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Spatial mapping of functional pelvic bone marrow using FLT PET
Journal article   Open access   Peer reviewed

Spatial mapping of functional pelvic bone marrow using FLT PET

Sarah M McGuire, Yusuf Menda, Laura L Boles Ponto, Brandie Gross, Mindi TenNapel, Brian J Smith and John E Bayouth
Journal of applied clinical medical physics, Vol.15(4), pp.129–136-136
07/08/2014
DOI: 10.1120/jacmp.v15i4.4780
PMCID: PMC4161980
PMID: 25207403
url
https://doi.org/10.1120/jacmp.v15i4.4780View
Published (Version of record) Open Access

Abstract

The purpose of this study was to determine the ability of regions identified with bony landmarks on CT imaging to accurately represent active bone marrow when compared to FLT PET imaging. These surrogate regions could then be used to create a bone marrow sparing radiation therapy plan when FLT PET imaging is not available. Whole body (WB) FLT PET images were obtained of 18 subjects prior to chemoradiation therapy. The FLT image of each subject was registered to a CT image acquired for that subject to obtain anatomic information of the pelvis. Seventeen regions were identified based on features of the pelvic bones, sacrum, and femoral heads. The probability of FLT uptake being located in each of 17 different CT-based regions of the bony pelvis was calculated using Tukey's multiple comparison test. Statistical analysis of FLT uptake in the pelvis indicated four distinct groups within the 17 regions that had similar levels of activity. Regions located in the central part of the pelvis, including the superior part of the sacrum, the inner halves of the iliac crests, and the L5 vertebral body, had greater FLT uptake than those in the peripheral regions (p-value < 0.05). We have developed a method to use CT-defined pelvic bone regions to represent FLT PET-identified functional bone marrow. Individual regions that have a statistically significant probability of containing functional bone marrow can be used as avoidance regions to reduce radiation dose to functional bone marrow in radiation therapy planning. However, because likely active bone marrow regions and pelvic targets typically overlap, patient-specific spatial detail may be advantageous in IMRT planning scenarios and may best be provided using FLT PET imaging.
 Cell Proliferation Bone Marrow - pathology Humans Pelvic Bones - pathology Tomography, X-Ray Computed Bone Marrow - diagnostic imaging Fluorine Radioisotopes Positron-Emission Tomography - methods Dideoxynucleosides Radiopharmaceuticals Radiotherapy Planning, Computer-Assisted Pelvic Bones - diagnostic imaging

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