PET-Guided Modeling of Mucosal Boron Heterogeneity Improves Dose-Toxicity Prediction in BNCT

The authors aimed to determine if mucosal boron heterogeneity, as measured by fluoro-boronophenylalanine positron emission tomography (18F-BPA PET), can enhance the prediction of oral mucositis in patients undergoing boron neutron capture therapy (BNCT) for head and neck cancer. Their findings indicated that the uptake-defined biological dose metric (D0.05cc) significantly correlated with toxicity outcomes, outperforming traditional anatomical dose calculations based on uniform boron distribution. This suggests that incorporating functional imaging may improve patient-specific dose constraints and toxicity predictions in BNCT.