Background and purpose: The purpose of this study was to design a radiation therapy treatment planning approach that would spare hematopoietically active bone marrow using [18F]FLT PET imaging. Materials and methods: We have developed an IMRT planning methodology to incorporate functional PET imaging using [18F]FLT scans. Plans were generated for two simulated cervical cancer patients, where pelvic active bone marrow regions were incorporated as avoidance regions based on the ranges: SUV4 ≥ 4; 4 > SUV3 ≥ 3; and 3 > SUV2 ≥ 2. Dose objectives were set to reduce bone marrow volume that received 10 (V10) and 20 (V20) Gy. Results: Active bone marrow regions identified by [18F]FLT with an SUV ≥ 2, SUV ≥ 3, and SUV ≥ 4 represented an average of 43.0%, 15.3%, and 5.8%, respectively of the total osseous pelvis for the two cases studied. Improved dose-volume histograms for all identified bone marrow SUV volumes and decreases in V10, and V20 were achieved without clinically significant changes to PTV or OAR doses. Conclusions: Incorporation of [ 18F]FLT PET in IMRT planning provides a methodology to reduce radiation dose to active bone marrow without compromising PTV or OAR dose objectives in pelvic malignancies.
- Bone marrow
- Cervical cancer
- [F]FLT PET
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging