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OtherBASIC SCIENCE INVESTIGATIONS

Linear Regression Model for Predicting Patient-Specific Total Skeletal Spongiosa Volume for Use in Molecular Radiotherapy Dosimetry

James M. Brindle, A. Alexandre Trindade, Amish P. Shah, Derek W. Jokisch, Phillip W. Patton, J. Carlos Pichardo and Wesley E. Bolch
Journal of Nuclear Medicine November 2006, 47 (11) 1875-1883;
James M. Brindle
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A. Alexandre Trindade
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Amish P. Shah
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Derek W. Jokisch
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Phillip W. Patton
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J. Carlos Pichardo
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Wesley E. Bolch
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  • FIGURE 1. 
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    FIGURE 1. 

    Comparison of original CT images and corresponding segmented images of skeletal spongiosa within 5 transverse views through 1 study cadaver. (A and B) Superior region of skull (pink: cranium). (C and D) Inferior regions of skull (pink: cranium; blue: mandible). (E and F) Upper torso region (orange: humeral heads; navy blue: clavicles; cyan: scapulae; teal: cervical vertebrae; magenta: ribs). (G and H) Midtorso region (green: sternum; yellow: thoracic vertebrae; cyan: scapulae; magenta: ribs). (I and J) Pelvic region (red: ossa coxae; light blue: sacrum).

Tables

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    TABLE 1

    Skeletal Sites (and Quantities) Used for Spongiosa Volume Estimation*

    Skeletal site (no. of bones)% of total body active marrow
    Cranium (1)7.6
    Mandible (1)0.8
    Humeral heads (2)2.3
    Clavicles (2)0.8
    Scapulae (2)2.8
    Sternum (1)3.1
    Ribs (12)16.1
    Cervical vertebrae (7)3.9
    Thoracic vertebrae (12)16.1
    Lumbar vertebrae (5)12.3
    Sacrum (1)9.9
    Proximal femora (2)6.7
    Ossa coxae (2)17.5
    • ↵* Table 1 is adapted from Table 9-4 in International Commission on Radiological Protection. Basic Anatomical and Physiological Data for Use in Radiological Protection: Reference Values. New York, NY: International Commission on Radiological Protection; 2002. ICRP Publication 89. Copyright 2002, International Commission on Radiological Protection.

    • View popup
    TABLE 2

    Anthropometric Measurements Obtained for Use in Multiple Regression Analysis

    ParameterAbbreviationMeasurement (cm)
    HeightHTTotal body height
    Os coxae widthOC.WMaximum width of os coxae viewed in CT scout image (projection)
    Os coxae heightOC.HAverage of maximum heights of left and right sides of os coxae viewed in CT scout image (projection)
    Os coxae lengthOC.LAverage of maximum lengths of left and right sides of os coxae viewed in transverse plane of 3D CT dataset
    Bitrochanteric breadthBi.BDistance between exterior portions of greater trochanters viewed in CT scout image (projection)
    Anterior sacral heightASHDistance from anterior sacral promontory to apex of sacrum viewed in sagittal plane of 3D CT dataset
    Sacral widthS.WMaximum width of sacrum viewed in transverse plane of 3D CT dataset
    L5 thicknessL5.TThickness of L5 vertebra viewed in sagittal plane of 3D CT dataset; measurements were made parallel to anterior surface of vertebral body and approximately 1.5 cm into vertebral body
    S1 breadthS1.BDistance between 2 most lateral points on superior surface of S1 viewed in transverse plane of 3D CT dataset
    Femoral head perimeterPAverage of maximum perimeters of left and right femoral heads viewed in sagittal plane of 3D CT dataset
    Feret's diameterFDMeasurement is based on femoral head perimeter; this measurement is referred to as caliper length, as it represents longest distance between any 2 points along selected boundary; in this study, perimeter measurement served as this boundary
    Maximum height of femoral headMax.HMaximum height of femoral head viewed in sagittal plane of 3D CT dataset; each measurement represented average for left and right femoral heads
    Maximum width of femoral headMax.WMaximum width of femoral head viewed in sagittal plane of 3D CT dataset; each measurement represented average for left and right femoral heads
    Humeral head breadthHHDistance between exterior portions of right and left proximal humeral heads viewed in CT scout image (projection)
    Femoral heightFHMaximum height of femoral bones viewed in CT scout image (projection); each measurement represented average for left and right femoral bones
    • View popup
    TABLE 3

    Values for Predictor Variables Obtained from 20 Cadavers for Use in Multiple Regression Analysis*

    CadaverAge at death (y)HTOC.WOC.HOC.LBi.BASHS.WL5.TS1.BPFDMax.HMax.WHHFH
    135188.232.723.324.529.711.712.72.86.116.15.24.85.346.852.3
    266172.228.721.823.226.912.913.22.45.514.54.74.54.935.647.7
    377156.829.720.120.231.010.311.92.24.012.74.14.03.934.141.9
    468181.227.621.622.027.410.710.82.45.115.35.04.75.139.950.2
    581175.829.323.124.028.511.413.82.55.815.14.94.55.038.648.5
    672165.227.621.322.029.910.411.62.45.514.74.74.54.738.947.4
    770159.133.620.120.530.39.212.92.54.712.84.23.94.238.642.8
    862157.526.320.020.124.68.511.72.45.012.44.13.74.033.343.0
    967171.131.521.321.827.911.313.12.85.614.64.84.34.738.747.3
    1078175.033.622.523.228.512.512.02.75.614.94.84.44.941.349.3
    1182162.932.320.521.027.210.512.52.25.713.24.43.94.338.446.0
    1278149.928.319.720.027.110.111.42.65.412.74.13.94.134.741.4
    1373159.630.320.820.828.213.212.52.34.613.24.34.34.234.843.0
    1476165.023.620.920.924.910.210.92.64.913.64.44.14.534.742.6
    1568168.032.020.320.626.712.113.72.35.612.03.93.63.935.945.5
    1680158.431.220.320.431.18.711.92.55.112.44.03.83.935.942.6
    1775156.933.821.121.628.312.113.72.13.712.24.13.44.034.744.4
    1875165.030.520.620.631.811.212.82.74.812.84.24.14.235.443.3
    1940169.226.020.020.326.011.811.72.14.812.34.04.14.138.443.3
    2073168.630.321.221.431.211.812.52.34.613.54.44.24.141.146.7
    • ↵* Abbreviations are explained in Table 2. All measurements are given in centimeters.

    • View popup
    TABLE 4

    Results of Various Model Selection Methods

    Selection methodMultiple R2VariableCoefficientCoefficient estimateCoefficient P
    Stepwise0.88InterceptEmbedded Image−4,791.3<0.001
    OC.WEmbedded Image−37.10.033
    OC.HEmbedded Image313.90.002
    Max.WEmbedded Image266.90.188
    Adjusted R20.89InterceptEmbedded Image−4,449.7<0.001
    OC.WEmbedded Image−41.70.024
    OC.HEmbedded Image315.20.003
    Max.WEmbedded Image430.00.110
    Max.HEmbedded Image−230.20.333
    AICc and BIC0.87InterceptEmbedded Image−5,585.5<0.001
    OC.WEmbedded Image−46.30.006
    OC.HEmbedded Image420.6<0.001
    • View popup
    TABLE 5

    Segmented and Predicted TSSVs, Percentage Errors, and Prediction Intervals

    TSSV (cm3)Prediction interval (cm3)
    CadaverSegmentedPredicted% DifferenceLowerUpper
    12,493.202,829.2212.32,361.113,238.37
    22,151.142,252.105.41,865.492,667.37
    31,265.241,498.8019.91,135.631,898.27
    42,380.452,179.13−7.61,802.322,598.67
    52,852.192,739.06−3.92,288.723,194.71
    62,256.332,054.81−7.91,684.092,471.77
    71,364.311,302.17−4.9864.821,731.79
    81,426.071,604.5015.41,240.512,051.06
    92,300.991,885.72−18.01,554.462,219.14
    102,318.722,344.980.21,889.392,757.00
    111,410.271,556.4010.51,156.991,959.10
    121,354.311,364.803.1981.011,810.94
    131,764.061,749.00−0.21,364.342,155.29
    142,137.162,035.88−1.71,631.362,569.59
    151,585.721,450.49−8.21,051.161,859.43
    161,661.101,482.29−10.21,097.151,886.21
    171,788.231,724.12−4.21,296.502,128.45
    181,590.721,661.025.11,276.672,066.95
    191,716.771,814.37−6.71,181.142,022.66
    201,605.731,937.7321.21,594.542,297.44
    • View popup
    TABLE 6

    Regional Percentage Distribution of Trabecular Spongiosa by Skeletal Site*

    Skeletal site% Active bone marrow†% Marrow cellularity‡% Total bone marrow (ICRP adult)Mean ± SD % TSSV (present study)
    Cranium7.63810.49.3 ± 1.55
    Mandible0.8381.11.0 ± 0.15
    Scapulae2.8383.83.9 ± 0.38
    Clavicles0.8331.31.5 ± 0.14
    Sternum3.1702.32.1 ± 0.25
    Ribs16.17012.09.3 ± 0.77
    Cervical vertebrae3.9702.92.5 ± 0.15
    Thoracic vertebrae16.17012.011.9 ± 0.52
    Lumbar vertebrae12.3709.110.1 ± 0.64
    Sacrum9.9707.47.5 ± 0.53
    Ossa coxae17.54819.022.5 ± 1.04
    Femora (proximal)6.72514.012.8 ± 0.50
    Humeri (proximal)2.3254.85.5 ± 0.24
    • ↵* For comparison, data on percentage distribution of total bone marrow for ICRP reference adult (male or female; age, 40 y) are shown.

    • ↵† Data are from Table 40 in International Commission on Radiological Protection (21).

    • ↵‡ Data are from Table 41 in International Commission on Radiological Protection (21).

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Journal of Nuclear Medicine: 47 (11)
Journal of Nuclear Medicine
Vol. 47, Issue 11
November 2006
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Linear Regression Model for Predicting Patient-Specific Total Skeletal Spongiosa Volume for Use in Molecular Radiotherapy Dosimetry
James M. Brindle, A. Alexandre Trindade, Amish P. Shah, Derek W. Jokisch, Phillip W. Patton, J. Carlos Pichardo, Wesley E. Bolch
Journal of Nuclear Medicine Nov 2006, 47 (11) 1875-1883;

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Linear Regression Model for Predicting Patient-Specific Total Skeletal Spongiosa Volume for Use in Molecular Radiotherapy Dosimetry
James M. Brindle, A. Alexandre Trindade, Amish P. Shah, Derek W. Jokisch, Phillip W. Patton, J. Carlos Pichardo, Wesley E. Bolch
Journal of Nuclear Medicine Nov 2006, 47 (11) 1875-1883;
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