Expanding SCINTIX Biology-Guided Radiotherapy Beyond Lung and Bone: A Planning Feasibility and Dosimetric Study on the RefleXion X1 System

作者：Haozhao Zhang, Grant Gibbard, Chenyang Shen, T. Banks, Hao Peng, Angela Da Silva, G. Kuduvalli, Todd A. Aguilera, Tu Dan, Shahed N. Badiyan, Kenneth D. Westover, David J. Sher, Aurélie Garant, Raquibul Hannan, Steve Jiang, Orhan K. Öz, Robert Timmerman, Bin Cai · 发表于：Technology in Cancer Research & Treatment · 年份：2025 · DOI：10.1177/15330338251365334 · 被引用次数：5 · 研究领域：Advanced Radiotherapy Techniques、Lung Cancer Diagnosis and Treatment、Medical Imaging Techniques and Applications

X1 platform, recently received FDA clearance for FDG-guided treatment of lung and bone tumors. This study evaluates the feasibility and dosimetric quality of Biology-Guided Radiotherapy (BgRT) plans for FDG-avid lesions in anatomical sites beyond current indications using processed diagnostic PET (dPET) images.MethodsEleven previously treated FDG-avid lesions in ten patients (sites: liver, head and neck, pancreas, kidney, pelvic/abdominal nodes) were retrospectively analyzed. dPET images were processed to emulate RefleXion X1 PET characteristics. BgRT plans were generated using a non-clinical version of the RefleXion treatment planning system, delivering stereotactic body radiation therapy-level doses (48Gy/3fx for liver, 40Gy/5fx for other sites). Plan deliverability was evaluated based on normalized target signal (NTS >2.7) and activity concentration (AC > 5 kBq/ml). Plans were categorized based on the presence of dose-limiting organs at risk (OAR) constraints. Dosimetric parameters were assessed according to institutional standards. Statistical analyses examined relationships between dPET standardized uptake value (SUV), PET-derived parameters, planning target volume (PTV) characteristics, and plan complexity.ResultsBgRT plans were successfully generated for all lesions. All met the NTS threshold (mean = 9.3); 72.7% met the AC goal (mean = 12.1 kBq/ml). Among cases with dPET SUV > 6, 87.5% met AC criterion, supporting this threshold as a reasonable selection criterion. Pla...