Inter-subject cerebrovascular variability: a source of uncertainty for dose calculation to circulating blood cells for glioblastoma patients treated with modern radiotherapy techniques

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dc.contributor.authorHammi, Abdelkhalek
dc.contributor.authorShusharina, Nadya
dc.contributor.authorDjuffouo, Sonya
dc.date.accessioned2025-09-24T10:58:51Z
dc.date.available2025-09-24T10:58:51Z
dc.date.issued2024-08-21
dc.description.abstractPurpose. To assess how inter-subject variations in brain vasculature among glioblastoma (GBM) patients affects the calculated dose received by circulating blood cells (CBC) during radiotherapy and its subsequent impact on CBC depletion. Methods. Ten GBM patients treated with either intensity-modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) were selected. For each patient, 23 cerebrovascular models were developed based on 23 healthy subject MR-angiography data to simulate intra- and inter-subject blood vessel diversity. Based on the corresponding treatment plan of the patient, the dose to CBC was calculated for all the 230 scenarios. The impact of inter-subject variation on fraction of irradiated blood volume (VD>0 cGy) and lymphocyte kill rates as a function of the clinical target volume (CTV) size and treatment technique were analyzed. Results. The dose fluctuation to CBC was higher in IMRT plans compared to VMAT plans. The uncertainty in the VD>0 cGy was 18.3% for IMRT and 2.0% (CI95%) for VMAT and the dispersion of the D2% index was 6 cGy for IMRT and 1 cGy for VMAT (CI95%) for one single treatment fraction of 200 cGy. The uncertainty in killed CBC due to inter-subject diversity in brain blood vessel increased with increasing CTV size and was σ = 11.2%. Conclusions. VMAT showed greater robustness against inter-subject variation in blood vessels compared to IMRT. We recommend considering the uncertainty in depleting CBC resulting from the use of less patient-specific and generic blood vessel phantoms to improve the radiation-induced lymphopenia assessments.en
dc.identifier.urihttp://hdl.handle.net/2003/43994
dc.language.isoen
dc.relation.ispartofseriesPhysics in medicine and biology; 69(17)
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectCirculating blood cellsen
dc.subjectDose uncertaintyen
dc.subjectIntersubject variationen
dc.subjectBrain vasculatureen
dc.subjectVMAT and IMRTen
dc.subjectGlioblastoma Abstracten
dc.subject.ddc530
dc.titleInter-subject cerebrovascular variability: a source of uncertainty for dose calculation to circulating blood cells for glioblastoma patients treated with modern radiotherapy techniquesen
dc.typeText
dc.type.publicationtypeArticle
dcterms.accessRightsopen access
eldorado.dnb.deposittrue
eldorado.doi.registerfalse
eldorado.secondarypublicationtrue
eldorado.secondarypublication.primarycitationHammi, A., Shusharina, N., & Djuffouo, S. (2024). Inter-subject cerebrovascular variability: a source of uncertainty for dose calculation to circulating blood cells for glioblastoma patients treated with modern radiotherapy techniques. Physics in Medicine and Biology, 69(17), Article 175010. https://doi.org/10.1088/1361-6560/ad69f9
eldorado.secondarypublication.primaryidentifierhttps://doi.org/10.1088/1361-6560/ad69f9

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