TY - JOUR
T1 - Personalized estimation of dose to red bone marrow and the associated leukaemia risk attributable to pelvic kilo-voltage cone beam computed tomography scans in image-guided radiotherapy
AU - Zhang, Yibao
AU - Yan, Yulong
AU - Nath, Ravinder
AU - Bao, Shanglian
AU - Deng, Jun
PY - 2012/7/21
Y1 - 2012/7/21
N2 - The aim of this study is to investigate the imaging dose to red bone marrow (RBM) and the associated leukaemia risks attributable to pelvic kilo-voltage cone beam computed tomography (kVCBCT) scans in image-guided radiation therapy (IGRT). The RBM doses of 42 patients (age 2.7-86.4years) were calculated using Monte Carlo simulations. The trabecular spongiosa was segmented to substitute RBM rather than the whole bone. Quantitative correlations between anthropometric variables such as age, physical bone density (PBD) and RBM dose were established. Personalized leukaemia risk was evaluated using an improved Boice model which included the age-associated RBM involvement. An incremental leukaemia risk of 29%-82% (mean = 45%) was found to be associated with 40 pelvic kVCBCT scans in the subject group used in a typical external beam radiation therapy course. Higher risks were observed in children. Due to the enhanced photoelectric effect in high atomic number materials, PBD was observed to strongly affect the RBM dose. Considerable overestimations (9%-42%, mean = 28%) were observed if the whole bone doses were used as surrogates of RBM doses. The personalized estimation of RBM dose and associated leukaemia risk caused by pelvic kVCBCT scans is clinically feasible with the proposed empirical models. Higher radiogenic cancer risks are associated with repeated kVCBCT scans in IGRT of cancer patients, especially children.
AB - The aim of this study is to investigate the imaging dose to red bone marrow (RBM) and the associated leukaemia risks attributable to pelvic kilo-voltage cone beam computed tomography (kVCBCT) scans in image-guided radiation therapy (IGRT). The RBM doses of 42 patients (age 2.7-86.4years) were calculated using Monte Carlo simulations. The trabecular spongiosa was segmented to substitute RBM rather than the whole bone. Quantitative correlations between anthropometric variables such as age, physical bone density (PBD) and RBM dose were established. Personalized leukaemia risk was evaluated using an improved Boice model which included the age-associated RBM involvement. An incremental leukaemia risk of 29%-82% (mean = 45%) was found to be associated with 40 pelvic kVCBCT scans in the subject group used in a typical external beam radiation therapy course. Higher risks were observed in children. Due to the enhanced photoelectric effect in high atomic number materials, PBD was observed to strongly affect the RBM dose. Considerable overestimations (9%-42%, mean = 28%) were observed if the whole bone doses were used as surrogates of RBM doses. The personalized estimation of RBM dose and associated leukaemia risk caused by pelvic kVCBCT scans is clinically feasible with the proposed empirical models. Higher radiogenic cancer risks are associated with repeated kVCBCT scans in IGRT of cancer patients, especially children.
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U2 - 10.1088/0031-9155/57/14/4599
DO - 10.1088/0031-9155/57/14/4599
M3 - Article
C2 - 22750636
AN - SCOPUS:84863503925
SN - 0031-9155
VL - 57
SP - 4599
EP - 4612
JO - Physics in medicine and biology
JF - Physics in medicine and biology
IS - 14
ER -