Abstract
e13570 Background: Hematologic toxicity (HT) is a significant problem in patients undergoing chemoradiotherapy (CRT) for pelvic malignancies. We tested the hypothesis that image-guided radiation therapy (IGRT) could reduce functional bone marrow (FBM) radiation dose, potentially reducing HT. Methods: We enrolled 10 patients with cervix (n=5) or anal (n=5) cancer onto a prospective IRB-approved protocol. Patients underwent CT simulation plus (1) whole body 18F-FDG-PET/CT and (2) quantitative MRI using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (MRI-IDEAL). Regions of high standardized uptake value (SUV) (increased glucose metabolism) on PET and low fat fraction (high cellularity) on MRI-IDEAL indicated higher FBM concentrations. The PET/CT and MRI-IDEAL were registered with the simulation CT, and FBM was automatically segmented based on the mean SUV and fat fraction within the pelvic bone. For each patient, 4 plans were compared: intensity modulated radiation ...
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