BLOOD: A fast, customizable, and patient-specific computational framework for assessing whole-body lymphocyte dose, survival, and replenishment after radiotherapy treatments

作者：López-Martínez IN, Espinoza I, Muñoz-Hernández I, Munoz-Schuffenegger P, Sánchez-Nieto B · 发表于：Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) · 年份：2026 · DOI：10.1016/j.ejmp.2026.105771 · 研究领域：Lymphocytes、Radiation Dosage、Humans、Radiotherapy Dosage、Radiotherapy Planning, Computer-Assisted、Liver Neoplasms、Cell Survival、Carcinoma, Hepatocellular、Tomography, X-Ray Computed、Time Factors

BACKGROUND: Radiation therapy (RT) can cause radiation-induced lymphopenia (RIL), a reduction in circulating lymphocytes (CL). Estimating radiation dose to CL is crucial to predict RIL. PURPOSE: To develop a computational tool for calculating patient-specific CL doses and predicting post-RT CL counts. METHODS: A circulatory network model was created using published data on blood flow between organs. Patient-specific organ locations and volumes were generated from whole-body CT reconstructions from RT planning CT images. Dose-volume histograms (DVHs) were obtained from the treatment planning system for organs within the 5% isodose curve, while peripheral organ DVHs were modeled analytically. Blood flow was simulated during RT to produce a CL-specific DVH. This served as input to an adapted tumor-immune interaction model. The tool was tested on twelve hepatocellular carcinoma (HCC) patients by comparing predicted and actual post-RT CL counts. RESULTS: The framework, named BLOOD, is fast, user-friendly, and allows for personalized parameters, including initial CL count, circulation, and treatment details. The average absolute difference between predicted and measured post-RT LC counts was 12.3%. BLOOD also quantified the impact of peripheral dose on CL survival, showing that it contributed to approximately 10% of CL death in 9 Gy/fraction treatments. CONCLUSIONS: BLOOD is a novel, patient-specific computational tool for estimating CL dose and survival following RT. Successfu...