Voxel-Level Dosimetry for Combined Iodine 131 Radiopharmaceutical Therapy and External Beam Radiation Therapy Treatment Paradigms for Head and Neck Cancer.
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| Title: | Voxel-Level Dosimetry for Combined Iodine 131 Radiopharmaceutical Therapy and External Beam Radiation Therapy Treatment Paradigms for Head and Neck Cancer. |
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| Authors: | Adam, David P.1 (AUTHOR), Grudzinski, Joseph J.2 (AUTHOR), Marsh, Ian R.1 (AUTHOR), Hill, Patrick M.3 (AUTHOR), Cho, Steve Y.2,4 (AUTHOR), Bradshaw, Tyler J.2 (AUTHOR), Longcor, Jarrod5 (AUTHOR), Burr, Adam3,4 (AUTHOR), Bruce, Justine Y.4,6 (AUTHOR), Harari, Paul M.3,4 (AUTHOR), Bednarz, Bryan P.1,7 (AUTHOR) bbednarz2@wisc.edu |
| Source: | International Journal of Radiation Oncology, Biology, Physics. Jul2024, Vol. 119 Issue 4, p1275-1284. 10p. |
| Subjects: | External beam radiotherapy, Medical dosimetry, Single-photon emission computed tomography, Radiopharmaceuticals, Absorbed dose |
| Abstract: | Targeted radiopharmaceutical therapy (RPT) in combination with external beam radiation therapy (EBRT) shows promise as a method to increase tumor control and mitigate potential high-grade toxicities associated with re-treatment for patients with recurrent head and neck cancer. This work establishes a patient-specific dosimetry framework that combines Monte Carlo–based dosimetry from the 2 radiation modalities at the voxel level using deformable image registration (DIR) and radiobiological constructs for patients enrolled in a phase 1 clinical trial combining EBRT and RPT. Serial single-photon emission computed tomography (SPECT)/computed tomography (CT) patient scans were performed at approximately 24, 48, 72, and 168 hours postinjection of 577.2 MBq/m2 (15.6 mCi/m2) CLR 131, an iodine 131–containing RPT agent. Using RayStation, clinical EBRT treatment plans were created with a treatment planning CT (TPCT). SPECT/CT images were deformably registered to the TPCT using the Elastix DIR module in 3D Slicer software and assessed by measuring mean activity concentrations and absorbed doses. Monte Carlo EBRT dosimetry was computed using EGSnrc. RPT dosimetry was conducted using RAPID, a GEANT4-based RPT dosimetry platform. Radiobiological metrics (biologically effective dose and equivalent dose in 2-Gy fractions) were used to combine the 2 radiation modalities. The DIR method provided good agreement for the activity concentrations and calculated absorbed dose in the tumor volumes for the SPECT/CT and TPCT images, with a maximum mean absorbed dose difference of –11.2%. Based on the RPT absorbed dose calculations, 2 to 4 EBRT fractions were removed from patient EBRT treatments. For the combined treatment, the absorbed dose to target volumes ranged from 57.14 to 75.02 Gy. When partial volume corrections were included, the mean equivalent dose in 2-Gy fractions to the planning target volume from EBRT + RPT differed –3.11% to 1.40% compared with EBRT alone. This work demonstrates the clinical feasibility of performing combined EBRT + RPT dosimetry on TPCT scans. Dosimetry guides treatment decisions for EBRT, and this work provides a bridge for the same paradigm to be implemented within the rapidly emerging clinical RPT space. [ABSTRACT FROM AUTHOR] |
| Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
| FullText | Text: Availability: 0 |
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| Header | DbId: egs DbLabel: Engineering Source An: 177877026 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Voxel-Level Dosimetry for Combined Iodine 131 Radiopharmaceutical Therapy and External Beam Radiation Therapy Treatment Paradigms for Head and Neck Cancer. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Adam%2C+David+P%2E%22">Adam, David P.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Grudzinski%2C+Joseph+J%2E%22">Grudzinski, Joseph J.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marsh%2C+Ian+R%2E%22">Marsh, Ian R.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hill%2C+Patrick+M%2E%22">Hill, Patrick M.</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cho%2C+Steve+Y%2E%22">Cho, Steve Y.</searchLink><relatesTo>2,4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bradshaw%2C+Tyler+J%2E%22">Bradshaw, Tyler J.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Longcor%2C+Jarrod%22">Longcor, Jarrod</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burr%2C+Adam%22">Burr, Adam</searchLink><relatesTo>3,4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bruce%2C+Justine+Y%2E%22">Bruce, Justine Y.</searchLink><relatesTo>4,6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Harari%2C+Paul+M%2E%22">Harari, Paul M.</searchLink><relatesTo>3,4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bednarz%2C+Bryan+P%2E%22">Bednarz, Bryan P.</searchLink><relatesTo>1,7</relatesTo> (AUTHOR)<i> bbednarz2@wisc.edu</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Jul2024, Vol. 119 Issue 4, p1275-1284. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22External+beam+radiotherapy%22">External beam radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+dosimetry%22">Medical dosimetry</searchLink><br /><searchLink fieldCode="DE" term="%22Single-photon+emission+computed+tomography%22">Single-photon emission computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Radiopharmaceuticals%22">Radiopharmaceuticals</searchLink><br /><searchLink fieldCode="DE" term="%22Absorbed+dose%22">Absorbed dose</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Targeted radiopharmaceutical therapy (RPT) in combination with external beam radiation therapy (EBRT) shows promise as a method to increase tumor control and mitigate potential high-grade toxicities associated with re-treatment for patients with recurrent head and neck cancer. This work establishes a patient-specific dosimetry framework that combines Monte Carlo–based dosimetry from the 2 radiation modalities at the voxel level using deformable image registration (DIR) and radiobiological constructs for patients enrolled in a phase 1 clinical trial combining EBRT and RPT. Serial single-photon emission computed tomography (SPECT)/computed tomography (CT) patient scans were performed at approximately 24, 48, 72, and 168 hours postinjection of 577.2 MBq/m2 (15.6 mCi/m2) CLR 131, an iodine 131–containing RPT agent. Using RayStation, clinical EBRT treatment plans were created with a treatment planning CT (TPCT). SPECT/CT images were deformably registered to the TPCT using the Elastix DIR module in 3D Slicer software and assessed by measuring mean activity concentrations and absorbed doses. Monte Carlo EBRT dosimetry was computed using EGSnrc. RPT dosimetry was conducted using RAPID, a GEANT4-based RPT dosimetry platform. Radiobiological metrics (biologically effective dose and equivalent dose in 2-Gy fractions) were used to combine the 2 radiation modalities. The DIR method provided good agreement for the activity concentrations and calculated absorbed dose in the tumor volumes for the SPECT/CT and TPCT images, with a maximum mean absorbed dose difference of –11.2%. Based on the RPT absorbed dose calculations, 2 to 4 EBRT fractions were removed from patient EBRT treatments. For the combined treatment, the absorbed dose to target volumes ranged from 57.14 to 75.02 Gy. When partial volume corrections were included, the mean equivalent dose in 2-Gy fractions to the planning target volume from EBRT + RPT differed –3.11% to 1.40% compared with EBRT alone. This work demonstrates the clinical feasibility of performing combined EBRT + RPT dosimetry on TPCT scans. Dosimetry guides treatment decisions for EBRT, and this work provides a bridge for the same paradigm to be implemented within the rapidly emerging clinical RPT space. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/j.ijrobp.2024.02.005 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 1275 Subjects: – SubjectFull: External beam radiotherapy Type: general – SubjectFull: Medical dosimetry Type: general – SubjectFull: Single-photon emission computed tomography Type: general – SubjectFull: Radiopharmaceuticals Type: general – SubjectFull: Absorbed dose Type: general Titles: – TitleFull: Voxel-Level Dosimetry for Combined Iodine 131 Radiopharmaceutical Therapy and External Beam Radiation Therapy Treatment Paradigms for Head and Neck Cancer. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Adam, David P. – PersonEntity: Name: NameFull: Grudzinski, Joseph J. – PersonEntity: Name: NameFull: Marsh, Ian R. – PersonEntity: Name: NameFull: Hill, Patrick M. – PersonEntity: Name: NameFull: Cho, Steve Y. – PersonEntity: Name: NameFull: Bradshaw, Tyler J. – PersonEntity: Name: NameFull: Longcor, Jarrod – PersonEntity: Name: NameFull: Burr, Adam – PersonEntity: Name: NameFull: Bruce, Justine Y. – PersonEntity: Name: NameFull: Harari, Paul M. – PersonEntity: Name: NameFull: Bednarz, Bryan P. IsPartOfRelationships: – BibEntity: Dates: – D: 15 M: 07 Text: Jul2024 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 03603016 Numbering: – Type: volume Value: 119 – Type: issue Value: 4 Titles: – TitleFull: International Journal of Radiation Oncology, Biology, Physics Type: main |
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