Correlations of Total Pelvic Spongiosa Volume With Both Anthropometric Parameters and Computed Tomography–Based Skeletal Size Measurements

Brindle, James; Myers, Scott L.; Bolch, Wesley E.

doi:10.1089/cbr.2006.21.352

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…Kidney volume included renal cortex and medulla, and excluded renal pelvis. Red marrow mass, as defined by Stabin et al [23] in standard man and woman phantoms, was adapted to the patient's height as follows [24]:…”

Section: Lu-dotatate Activity Quantification In Source Volumesmentioning

confidence: 99%

A dosimetry procedure for organs-at-risk in 177Lu peptide receptor radionuclide therapy of patients with neuroendocrine tumours

et al. 2018

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Peptide receptor radionuclide therapy with 177 Lu-DOTATATE has become a standard treatment modality in neuroendocrine tumours (NETs). No consensus has yet been reached however regarding the absorbed dose threshold for lesion response, the absorbed dose limit to organs-at-risk, and the optimal fractionation and activity to be administered. This is partly due to a lack of uniform and comparable dosimetry protocols. The present article details the development of an organ-at-risk dosimetry procedure, which could be implemented and used routinely in a clinical context. Methods: Forty-seven patients with NETs underwent 177 Lu-DOTATATE therapy. Three SPECT/CT images were acquired at 4, 24 and 144-192 h post-injection. Three blood samples were obtained together with the SPECT/CT acquisitions and 2 additional samples were obtained around 30 min and 1 h post-injection. A bi-exponential fit was used to compute the source organ time-integrated activity coefficients. Coefficients were introduced into OLINDA/EXM software to compute organ-at-risk absorbed doses. Median values for all patients were computed for absorbed dose coefficient D A / 0 and for late effective half-life T 1/2eff for kidneys, spleen and red marrow. Results: Dosimetry resulted in a median[interquartile range] of 0.78[0.35], 1.07[0.58] and 0.028[0.010] Gy/ GBq for D A / 0 and of 55[9], 71[9] and 52[18] h for T 1/2eff for kidneys, spleen and red marrow respectively. Conclusions: A dosimetry procedure for organs-at-risk in 177 Lu-DOTATATE therapy based on serial SPECT/CT images and blood samples can be implemented routinely in a clinical context with limited patient burden. The results obtained were in accordance with those of other centres.

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Section: Lu-dotatate Activity Quantification In Source Volumesmentioning

confidence: 99%

A dosimetry procedure for organs-at-risk in 177Lu peptide receptor radionuclide therapy of patients with neuroendocrine tumours

et al. 2018

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“…The rationale for our choice of anatomic measurements is outlined in Brindle et al (13). Measurements have been focused primarily on the os coxae primarily because (i) a large percentage of the TSSV is located in this site (7,14,22) and (ii) measurements can be easily performed on a pelvic CT.…”

Section: Anatomic Measurementsmentioning

confidence: 99%

Method for Estimating Skeletal Spongiosa Volume and Active Marrow Mass in the Adult Male and Adult Female

Pichardo¹,

Trindade²,

Brindle³

et al. 2007

Journal of Nuclear Medicine

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Active bone marrow is one of the more radiosensitive tissues in the human body and, hence, it is important to predict and possibly avoid myelotoxicity in radionuclide therapies. The MIRD schema currently used to calculate marrow dose generally requires knowledge of the patient's total skeletal active marrow mass-a value that, at present, cannot be directly measured. Conceptually, the active marrow mass in a given skeletal region may be obtained given knowledge of the trabecular spongiosa volume (SV) of the bone site. A recent study has established a multiple regression model to easily calculate total skeletal SV (or TSSV) based on simple skeletal measurements obtained from a pelvic CT scan or radiograph. This model, based on data from only 20 cadavers, did not account for sex differences in TSSV. This study thus extends this work toward sex-specific models. Methods: Twenty male and 20 female cadavers were subjected to whole-body CT. Bone sites containing active bone marrow were manually segmented to obtain SV at each site. In addition to age and height, 14 CT-based skeletal measurements were recorded for each cadaver. Multiple linear regression techniques were used to determine the best subset of measurements that allowed an accurate prediction of TSSV. Results: A pooled model (R 2 5 0.76) and a sex-specific model (R 2 5 0.79) are provided. A leave-one-out analysis reveals that these models predict total SV with less than 10% error for 50%-70% of subjects, and with less than 20% error for 70%-90% of subjects. Tables were constructed that provide the percent distribution of SV in active-marrow containing bone sites for both males and females. Conclusion: This study provides models that can be used to simply, yet accurately, predict total SV in individuals within the clinical setting. The models require only 2 or 3 skeletal measurements that can be easily measured on a pelvic CT scan. Even though this study does not conclusively determine which model is best at predicting TSSV, the sex-specific model is most consistent at providing reasonable estimates of TSSV. This study also explains how the predictive TSSV model can be used to estimate patient-specific active bone marrow mass under the assumption of reference values of marrow volume fraction and bone marrow cellularity by skeletal site.

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“…Finally, total marrow mass was assumed to be that of standard phantoms. Individual marrow volume was not established as in our prior studies or projections based on the anthropometric parameters described (20). Nevertheless, this study reflects an effort to improve background radioactivity correction, which intuitively improved the accuracy of imaging-based marrow dosimetry.…”

Section: Discussionmentioning

confidence: 99%

A Method to Correct for Radioactivity in Large Vessels That Overlap the Spine in Imaging-Based Marrow Dosimetry of Lumbar Vertebrae

Meredith

Shen²,

Forero³

et al. 2008

J Nucl Med

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Accurate marrow dosimetry for radionuclide therapy based on imaging methods has been challenging because of a variety of factors. One of the uncertainties in image quantification of lumbar vertebrae is correction for radioactivity in large blood vessels anterior to the vertebrae. We developed a method to correct for background radioactivity contributed from blood in large vessels and tested it in a pilot study. Methods: CT images of 26 patients receiving 111 In-or 131 I-labeled conjugates were used to measure the inside diameters of the aorta and inferior vena cava (IVC) at the top of L2 and the bottom of L4 and to measure the length of this vessel segment. The volume was calculated for this vessel segment, and then the radioactivity in that volume at each imaging time was determined using a time-variant blood radioactivity concentration as established by serial blood samples. This vessel segment typically overlapped with lumbar vertebrae in anterior and posterior whole-body images. The contribution of this background radioactivity to the cumulated activity of the lumbar spine region of interest (ROI) from serial g-camera images was determined, taking into account differences in attenuation between vessel segments and lumbar vertebrae. Results: The total blood volumes varied from 25 to 94 mL, with a mean of 51 mL. This mean is 76% of the mean marrow volume of 3 lumbar vertebrae measured in some of these patients. Thirteen of the 14 patients evaluated for aortic position had the aortic segment completely within the L2-L4 ROI. For the IVC, a mean of 72% was in the L2-L4 ROI. Adjusting for radioactivity in major blood vessels that were in the ROI led to lower marrow dose estimates. Conclusion: To improve the accuracy of lumbar spine imaging-based marrow dosimetry, one can adjust radioactivity in the large vessels by methods that measure the volume, position, and depth of vessels in the ROI.

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Correlations of Total Pelvic Spongiosa Volume With Both Anthropometric Parameters and Computed Tomography–Based Skeletal Size Measurements

Cited by 7 publications

References 15 publications

A dosimetry procedure for organs-at-risk in 177Lu peptide receptor radionuclide therapy of patients with neuroendocrine tumours

A dosimetry procedure for organs-at-risk in 177Lu peptide receptor radionuclide therapy of patients with neuroendocrine tumours

Method for Estimating Skeletal Spongiosa Volume and Active Marrow Mass in the Adult Male and Adult Female

A Method to Correct for Radioactivity in Large Vessels That Overlap the Spine in Imaging-Based Marrow Dosimetry of Lumbar Vertebrae

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