Abstract
Objective To explore the dosimetric characteristics of single photon emission computed tomography (SPECT) combined with bone marrow sparing intensity modulated radiotherapy in patients with cervical cancer. Methods Twenty patients with cervical cancer after hysterectomy were performed on 99Tc thiocolloid SPECT bone marrow imaging to determine the active bone marrow in the pelvis. SPECT image combined with the simulation CT was used as the primary planning data set. Two plans for bone marrow sparing modulated radiotherapy were generated according to the bone marrow volume defined by SPECT and outline of the pelvis (SPECT-IMRT planning and BMS-IMRT planning). Furthermore, the target section and the dosimetric distribution in organs at risk (bone marrow, small intestine, rectum and bladder) in the two plannings were compared. The prescribed dose to the PTV was 45 Gy. Results The volume of the bone marrow in SPECT-IMRT planning and BMS-IMRT planning was (238.15±36.82) and (1 100.61±109.92) cm3, respectively (t=33.273, P 0.05). The PTV coverage rate and exposure dose of other organs at risk (small intestine, rectum and bladder) in the two plannings were not significantly different (P>0.05). Conclusions SPECT bone marrow imaging could clearly show the range of active bone marrow on CT scan images. Compared with BMS-IMRT, SPECT-IMRT could further reduce the dose volume of high-dose radiation (V30, V40 and V45). Yet the clinical significance of this advantage also needs to be confirmed by large-scale clinical studies. Key words: Cervical neoplasm; Radiotherapy; Intensity-modulated; Single photon emission computed tomography
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