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Chen ZJ, Li XA, Brenner DJ, Hellebust TP, Hoskin P, Joiner MC, Kirisits C, Nath R, Rivard MJ, Thomadsen BR, Zaider M. AAPM Task Group Report 267: A joint AAPM GEC-ESTRO report on biophysical models and tools for the planning and evaluation of brachytherapy. Med Phys 2024; 51:3850-3923. [PMID: 38721942 DOI: 10.1002/mp.17062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 06/05/2024] Open
Abstract
Brachytherapy utilizes a multitude of radioactive sources and treatment techniques that often exhibit widely different spatial and temporal dose delivery patterns. Biophysical models, capable of modeling the key interacting effects of dose delivery patterns with the underlying cellular processes of the irradiated tissues, can be a potentially useful tool for elucidating the radiobiological effects of complex brachytherapy dose delivery patterns and for comparing their relative clinical effectiveness. While the biophysical models have been used largely in research settings by experts, it has also been used increasingly by clinical medical physicists over the last two decades. A good understanding of the potentials and limitations of the biophysical models and their intended use is critically important in the widespread use of these models. To facilitate meaningful and consistent use of biophysical models in brachytherapy, Task Group 267 (TG-267) was formed jointly with the American Association of Physics in Medicine (AAPM) and The Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology (GEC-ESTRO) to review the existing biophysical models, model parameters, and their use in selected brachytherapy modalities and to develop practice guidelines for clinical medical physicists regarding the selection, use, and interpretation of biophysical models. The report provides an overview of the clinical background and the rationale for the development of biophysical models in radiation oncology and, particularly, in brachytherapy; a summary of the results of literature review of the existing biophysical models that have been used in brachytherapy; a focused discussion of the applications of relevant biophysical models for five selected brachytherapy modalities; and the task group recommendations on the use, reporting, and implementation of biophysical models for brachytherapy treatment planning and evaluation. The report concludes with discussions on the challenges and opportunities in using biophysical models for brachytherapy and with an outlook for future developments.
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Affiliation(s)
- Zhe Jay Chen
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - X Allen Li
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - David J Brenner
- Center for Radiological Research, Columbia University Medical Center, New York, New York, USA
| | - Taran P Hellebust
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Peter Hoskin
- Mount Vernon Cancer Center, Mount Vernon Hospital, Northwood, UK
- University of Manchester, Manchester, UK
| | - Michael C Joiner
- Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Christian Kirisits
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Ravinder Nath
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mark J Rivard
- Department of Radiation Oncology, Brown University School of Medicine, Providence, Rhode Island, USA
| | - Bruce R Thomadsen
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Marco Zaider
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
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McElligott O, Nikandrovs M, McCavana P, McClean B, León Vintró L. Estimation of the relative biological effectiveness for double strand break induction of clinical kilovoltage beams using Monte Carlo simulations. Med Phys 2024; 51:3796-3805. [PMID: 38588477 DOI: 10.1002/mp.17060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/05/2024] [Accepted: 03/06/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND The Relative Biological Effectiveness (RBE) of kilovoltage photon beams has been previously investigated in vitro and in silico using analytical methods. The estimated values range from 1.03 to 1.82 depending on the methodology and beam energies examined. PURPOSE The focus of this work was to independently estimate RBE values for a range of clinically used kilovoltage beams (70-200 kVp) while investigating the suitability of using TOPAS-nBio for this task. METHODS Previously validated spectra of clinical beams were used to generate secondary electron spectra at several depths in a water tank phantom via TOPAS Monte Carlo (MC) simulations. Cell geometry was irradiated with the secondary electrons in TOPAS-nBio MC simulations. The deposited dose and the calculated number of DNA strand breaks were used to estimate RBE values. RESULTS Monoenergetic secondary electron simulations revealed the highest direct and indirect double strand break yield at approximately 20 keV. The average RBE value for the kilovoltage beams was calculated to be 1.14. CONCLUSIONS TOPAS-nBio was successfully used to estimate the RBE values for a range of clinical radiotherapy beams. The calculated value was in agreement with previous estimates, providing confidence in its clinical use in the future.
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Affiliation(s)
- Oran McElligott
- School of Physics, University College Dublin, Dublin, Ireland
| | - Mihails Nikandrovs
- School of Physics, University College Dublin, Dublin, Ireland
- St. Lukes Radiation Oncology Network, Dublin, Ireland
| | - Patrick McCavana
- St. Lukes Radiation Oncology Network, Dublin, Ireland
- Centre for Physics in Health and Medicine, University College Dublin, Dublin, Ireland
| | - Brendan McClean
- St. Lukes Radiation Oncology Network, Dublin, Ireland
- Centre for Physics in Health and Medicine, University College Dublin, Dublin, Ireland
| | - Luis León Vintró
- School of Physics, University College Dublin, Dublin, Ireland
- St. Lukes Radiation Oncology Network, Dublin, Ireland
- Centre for Physics in Health and Medicine, University College Dublin, Dublin, Ireland
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Bergeron DE, Cessna JT, Fitzgerald RP, Hamad G, Laureano-Pérez L, Pibida L, Zimmerman BE. Liquid scintillation efficiencies, gamma-ray emission intensities, and half-life for Gd-153. Appl Radiat Isot 2024; 203:111108. [PMID: 38000166 DOI: 10.1016/j.apradiso.2023.111108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
Gadolinium-153 was standardized for activity by live-timed anticoincidence counting and an ampoule was submitted to the international reference system (SIR). Absolute emission intensities for the main γ rays were determined with calibrated high-purity germanium (HPGe) and lithium-drifted silicon (Si(Li)) detectors. A revised decay scheme is indicated, with no probability of direct electron capture to the 153Eu ground state. Triple-to-double coincidence ratio (TDCR) efficiency curves indicate that the revised decay scheme is consistent with experiment. Half-life measurements agree with a previous NIST determination and show no sensitivity to chemical environment.
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Affiliation(s)
- Denis E Bergeron
- Physical Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, 20899-8462, USA.
| | - Jeffrey T Cessna
- Physical Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, 20899-8462, USA
| | - Ryan P Fitzgerald
- Physical Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, 20899-8462, USA
| | - Gulakhshan Hamad
- Physical Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, 20899-8462, USA; Janssen Pharmaceuticals, Inc., Malvern, PA, 19355, USA
| | - Lizbeth Laureano-Pérez
- Physical Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, 20899-8462, USA
| | - Leticia Pibida
- Physical Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, 20899-8462, USA
| | - Brian E Zimmerman
- Physical Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, 20899-8462, USA
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Lamghari Y, Lu H, Bentourkia M. DNA damage by radiation as a function of electron energy and interaction at the atomic level with Monte Carlo simulation. Z Med Phys 2023; 33:489-498. [PMID: 35973908 PMCID: PMC10751702 DOI: 10.1016/j.zemedi.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022]
Abstract
In radiotherapy, X-ray or heavy ion beams target tumors to cause damage to their cell DNA. This damage is mainly induced by secondary low energy electrons. In this paper, we report the DNA molecular breaks at the atomic level as a function of electron energy and types of electron interactions using of Monte Carlo simulation. The number of DNA single and double strand breaks are compared to those from experimental results based on electron energies. In recent years, DNA atomistic models were introduced but still the simulations consider energy deposition in volumes of DNA or water equivalent material. We simulated a model of atomistic B-DNA in vacuum, forming 1122 base pairs of 30 nm in length. Each atom has been represented by a sphere whose radius equals the radius of van der Waals. We repeatedly simulated 10 million electrons for each energy from 4 eV to 500 eV and counted each interaction type with its position x, y, z in the volume of DNA. Based on the number and types of interactions at the atomic level, the number of DNA single and double strand breaks were calculated. We found that the dissociative electron attachment has the dominant effect on DNA strand breaks at energies below 10 eV compared to excitation and ionization. In addition, it is straightforward with our simulation to discriminate the strand and base breaks as a function of radiation interaction type and energy. In conclusion, the knowledge of DNA damage at the atomic level helps design direct internal therapeutic agents of cancer treatment.
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Affiliation(s)
- Youssef Lamghari
- Department of Nuclear Medicine and Radiobiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Huizhong Lu
- Department of Nuclear Medicine and Radiobiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - M'hamed Bentourkia
- Department of Nuclear Medicine and Radiobiology, University of Sherbrooke, Sherbrooke, QC, Canada.
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Han Y, Geng C, D-Kondo JN, Li M, Ramos-Méndez J, Altieri S, Liu Y, Tang X. Microdosimetric Analysis for Boron Neutron Capture Therapy via Monte Carlo Track Structure Simulation with Modified Lithium Cross-sections. Radiat Phys Chem Oxf Engl 1993 2023; 209:110956. [PMID: 37206625 PMCID: PMC10191410 DOI: 10.1016/j.radphyschem.2023.110956] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Boron neutron capture therapy (BNCT) is a cellular-level hadron therapy achieving therapeutic effects via the synergistic action of multiple particles, including Lithium, alpha, proton, and photon. However, evaluating the relative biological effectiveness (RBE) in BNCT remains challenging. In this research, we performed a microdosimetric calculation for BNCT using the Monte Carlo track structure (MCTS) simulation toolkit, TOPAS-nBio. This paper reports the first attempt to derive the ionization cross-sections of low-energy (>0.025 MeV/u) Lithium for MCTS simulation based on the effective charge cross-section scalation method and phenomenological double-parameter modification. The fitting parameters λ 1 = 1.101 , λ 2 = 3.486 were determined to reproduce the range and stopping power data from the ICRU report 73. Besides, the lineal energy spectra of charged particles in BNCT were calculated, and the influence of sensitive volume (SV) size was discussed. Condensed history simulation obtained similar results with MCTS when using Micron-SV while overestimating the lineal energy when using Nano-SV. Furthermore, we found that the microscopic boron distribution can significantly affect the lineal energy for Lithium, while the effect for alpha is minimal. Similar results to the published data by PHITS simulation were observed for the compound particles and monoenergetic protons when using micron-SV. Spectra with nano-SV reflected that the different track densities and absorbed doses in the nucleus together result in the dramatic difference in the macroscopic biological response of BPA and BSH. This work and the developed methodology could impact the research fields in BNCT where understanding radiation effects is crucial, such as the treatment planning system, source evaluation, and new boron drug development.
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Affiliation(s)
- Yang Han
- Nanjing University of Aeronautics and Astronautics, Department of Nuclear Science and Technology, Nanjing, 210016, China
- Joint International Research Laboratory on Advanced Particle Therapy, Nanjing 211100, China
- University of Pavia, Department of Physics, Pavia, 27100, Italy
| | - Changran Geng
- Nanjing University of Aeronautics and Astronautics, Department of Nuclear Science and Technology, Nanjing, 210016, China
- Joint International Research Laboratory on Advanced Particle Therapy, Nanjing 211100, China
| | - J. Naoki D-Kondo
- University of California San Francisco, Department of Radiation Oncology, San Francisco, CA 94115, USA
| | - Mingzhu Li
- Nanjing University of Aeronautics and Astronautics, Department of Nuclear Science and Technology, Nanjing, 210016, China
- Joint International Research Laboratory on Advanced Particle Therapy, Nanjing 211100, China
| | - José Ramos-Méndez
- University of California San Francisco, Department of Radiation Oncology, San Francisco, CA 94115, USA
| | - Saverio Altieri
- University of Pavia, Department of Physics, Pavia, 27100, Italy
- Istituto Nazionale di Fisica Nucleare (INFN), the section of Pavia, Pavia, 27100, Italy
| | - Yuanhao Liu
- Nanjing University of Aeronautics and Astronautics, Department of Nuclear Science and Technology, Nanjing, 210016, China
- Joint International Research Laboratory on Advanced Particle Therapy, Nanjing 211100, China
| | - Xiaobin Tang
- Nanjing University of Aeronautics and Astronautics, Department of Nuclear Science and Technology, Nanjing, 210016, China
- Joint International Research Laboratory on Advanced Particle Therapy, Nanjing 211100, China
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Walter AE, Cosper PF, Nickel KP, Ramesh S, Khan AU, DeWerd LA, Kimple RJ. Biological Characterization of the Effects of Filtration on the Xoft Axxent® Electronic Brachytherapy Source for Cervical Cancer Applications. Radiat Res 2023; 199:429-438. [PMID: 37014873 PMCID: PMC10288372 DOI: 10.1667/rade-22-00112.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/10/2023] [Indexed: 04/05/2023]
Abstract
Low-energy X-ray sources that operate in the kilovoltage energy range have been shown to induce more cellular damage when compared to their megavoltage counterparts. However, low-energy X-ray sources are more susceptible to the effects of filtration on the beam spectrum. This work sought to characterize the biological effects of the Xoft Axxent® source, a low-energy therapeutic X-ray source, both with and without the titanium vaginal applicator in place. It was hypothesized that there would be an increase in relative biological effectiveness (RBE) of the Axxent® source compared to 60Co and that the source in the titanium vaginal applicator (SIA) would have decreased biological effects compared to the bare source (BS). This hypothesis was drawn from linear energy transfer (LET) simulations performed using the TOPAS Monte Carlo user code as well a reduction in dose rate of the SIA compared to the BS. A HeLa cell line was maintained and used to evaluate these effects. Clonogenic survival assays were performed to evaluate differences in the RBE between the BS and SIA using 60Co as the reference beam quality. Neutral comet assay was used to assess induction of DNA strand damage by each beam to estimate differences in RBE. Quantification of mitotic errors was used to evaluate differences in chromosomal instability (CIN) induced by the three beam qualities. The BS was responsible for the greatest quantity of cell death due to a greater number of DNA double strand breaks (DSB) and CIN observed in the cells. The differences observed in the BS and SIA surviving fractions and RBE values were consistent with the 13% difference in LET as well as the factor of 3.5 reduction in dose rate of the SIA. Results from the comet and CIN assays were consistent with these results as well. The use of the titanium applicator results in a reduction in the biological effects observed with these sources, but still provides an advantage over megavoltage beam qualities. © 2023 by Radiation Research Society.
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Affiliation(s)
- Autumn E. Walter
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Pippa F. Cosper
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- University of Wisconsin, Carbone Cancer Center, Madison, WI
| | - Kwangok P. Nickel
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Shrey Ramesh
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Ahtesham U. Khan
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Larry A. DeWerd
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- University of Wisconsin, Carbone Cancer Center, Madison, WI
| | - Randall J. Kimple
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- University of Wisconsin, Carbone Cancer Center, Madison, WI
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7
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Hadadi A, Ghanavati S. 75Se - A promising alternative to 192Ir for potential use in the skin cancer brachytherapy: A Monte Carlo simulation study using FLUKA code. Appl Radiat Isot 2023; 197:110786. [PMID: 37023694 DOI: 10.1016/j.apradiso.2023.110786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023]
Abstract
This study aimed to evaluate the possibility of utilizing the HDR 75Se source for skin cancer brachytherapy. In this work, based on the BVH-20 skin applicator, two cup-shaped applicators, without and with the flattening filter, were modeled. To obtain the optimal flattening filter shape, an approach based on the MC simulation in combination with an analytical estimation was used. Then, the dose distributions for 75Se-applicators were generated using MC simulations in water, and their dosimetric characterizations such as flatness, symmetry, and penumbra were evaluated. Furthermore, the radiation leakage in the backside of the applicators was estimated by additional MC simulation. Finally, to evaluate the treatment times, calculations were performed for two 75Se-applicators assuming 5 Gy per fraction. The flatness, symmetry, and penumbra values for the 75Se-applicator without the flattening filter were estimated to be 13.7%, 1.05, and 0.41 cm respectively. The corresponding values for 75Se-applicator with the flattening filter were estimated to be 1.6%, 1.06, and 0.10 cm respectively. The radiation leakage value at a distance of 2 cm from the applicator surface was calculated to be 0.2% and 0.4% for the 75Se-applicator without and with the flattening filter respectively. Our results showed that the treatment time for the 75Se-applicator is comparable with that of the 192Ir-Leipzig applicator. The findings revealed that the dosimetric parameters of the 75Se applicator are comparable with the 192Ir skin applicator. Overall, the 75Se source can be an alternative to 192Ir sources for HDR brachytherapy of skin cancer.
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Bui A, Bekerat H, Childress L, Sankey J, Seuntjens J, Enger SA. Effects of incoming particle energy and cluster size on the G-value of hydrated electrons. Phys Med 2023; 107:102540. [PMID: 36804695 DOI: 10.1016/j.ejmp.2023.102540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
In hydrated electron (e-aq) dosimetry, absorbed radiation dose to water is measured by monitoring the concentration of radiation-induced e-aq. However, to obtain accurate dose, the radiation chemical yield of e-aq, G(e-aq), is needed for the radiation quality/setup under investigation. The aim of this study was to investigate the time-evolution of the G-values for the main generated reactive species during water radiolysis using GEANT4-DNA. The effects of cluster size and linear energy transfer (LET) on G(e-aq) were examined. Validity of GEANT4-DNA for calculation of G(e-aq) for clinically relevant energies was studied. Three scenarios were investigated with different phantom sizes and incoming electron energies (1 keV to 1 MeV). The time evolution of G(e-aq) was in good agreement with published data and did not change with decreasing phantom size. The time-evolution of the G-values increases with increasing LET for all radiolytic species. The particle tracks formed with high-energy electrons are separated and the resulting reactive species develop independently in time. With decreasing energy, the mean separation distance between reactive species decreases. The particle tracks might not initially overlap but will overlap shortly thereafter due to diffusion of reactive species, increasing the probability of e-aq recombination with other species. This also explains the decrease of G(e-aq) with cluster size and LET. Finally, if all factors are kept constant, as the incoming electron energy increases to clinically relevant energies, G(e-aq) remains similar to its value at 1 MeV, hence GEANT4-DNA can be used for clinically relevant energies.
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Affiliation(s)
- Alaina Bui
- Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Quebec, Canada.
| | - Hamed Bekerat
- Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Quebec, Canada; Radiation Oncology Department, Jewish General Hospital, Montréal, Quebec, Canada
| | - Lilian Childress
- Department of Physics, McGill University, Montréal, Quebec, Canada
| | - Jack Sankey
- Department of Physics, McGill University, Montréal, Quebec, Canada
| | - Jan Seuntjens
- Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada
| | - Shirin A Enger
- Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Quebec, Canada
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Chermat R, Ziaee M, Mak DY, Refet-Mollof E, Rodier F, Wong P, Carrier JF, Kamio Y, Gervais T. Radiotherapy on-chip: microfluidics for translational radiation oncology. LAB ON A CHIP 2022; 22:2065-2079. [PMID: 35477748 DOI: 10.1039/d2lc00177b] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The clinical importance of radiotherapy in the treatment of cancer patients justifies the development and use of research tools at the fundamental, pre-clinical, and ultimately clinical levels, to investigate their toxicities and synergies with systemic agents on relevant biological samples. Although microfluidics has prompted a paradigm shift in drug discovery in the past two decades, it appears to have yet to translate to radiotherapy research. However, the materials, dimensions, design versatility and multiplexing capabilities of microfluidic devices make them well-suited to a variety of studies involving radiation physics, radiobiology and radiotherapy. This review will present the state-of-the-art applications of microfluidics in these fields and specifically highlight the perspectives offered by radiotherapy on-a-chip in the field of translational radiobiology and precision medicine. This body of knowledge can serve both the microfluidics and radiotherapy communities by identifying potential collaboration avenues to improve patient care.
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Affiliation(s)
- Rodin Chermat
- μFO Lab, Polytechnique Montréal, Montréal, QC, Canada.
- Institut du Cancer de Montréal, (ICM), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Maryam Ziaee
- μFO Lab, Polytechnique Montréal, Montréal, QC, Canada.
- Institut du Cancer de Montréal, (ICM), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - David Y Mak
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Elena Refet-Mollof
- μFO Lab, Polytechnique Montréal, Montréal, QC, Canada.
- Institut du Cancer de Montréal, (ICM), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Francis Rodier
- Institut du Cancer de Montréal, (ICM), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
- Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montreal, QC, Canada
| | - Philip Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Institut du Cancer de Montréal, (ICM), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Jean-François Carrier
- Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montreal, QC, Canada
- Département de Physique, Université de Montréal, Montréal, QC, Canada
- Département de Radio-oncologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Yuji Kamio
- Département de Radio-oncologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
- Département de Pharmacologie et Physiologie, Université de Montréal, Montreal, QC, Canada
| | - Thomas Gervais
- μFO Lab, Polytechnique Montréal, Montréal, QC, Canada.
- Institut du Cancer de Montréal, (ICM), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
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Valdes‐Cortez C, Niatsetski Y, Perez‐Calatayud J, Ballester F, Vijande J. A Monte Carlo study of the relative biological effectiveness in surface brachytherapy. Med Phys 2022; 49:5576-5588. [DOI: 10.1002/mp.15774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
| | - Yury Niatsetski
- R&D Elekta Brachytherapy Waardgelder 1, 3905 TH Veenendaal The Netherlands
| | - Jose Perez‐Calatayud
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED) Instituto de Investigación Sanitaria La Fe (IIS‐La Fe)‐Universitat de Valencia (UV)
- Radiotherapy Department La Fe Hospital Valencia Spain
- Radiotherapy Department Hospital Clinica Benidorm Alicante Spain
| | - Facundo Ballester
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED) Instituto de Investigación Sanitaria La Fe (IIS‐La Fe)‐Universitat de Valencia (UV)
- Department of Atomic, Molecular and Nuclear Physics University of Valencia Burjassot Spain
| | - Javier Vijande
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED) Instituto de Investigación Sanitaria La Fe (IIS‐La Fe)‐Universitat de Valencia (UV)
- Department of Atomic, Molecular and Nuclear Physics University of Valencia Burjassot Spain
- Instituto de Física Corpuscular IFIC (UV‐CSIC) Burjassot Spain
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11
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Lindborg L, Lillhök J, Kyriakou I, Emfietzoglou D. Dose-mean lineal energy values for electrons by different Monte Carlo codes: Consequences for estimates of radiation quality in photon beams. Med Phys 2021; 49:1286-1296. [PMID: 34905630 DOI: 10.1002/mp.15412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The microdosimetric quantity lineal energy and its mean values have proven useful for quantifying radiation quality in many situations. The ratio of dose-mean lineal energies is perhaps the simplest quantity for quantifying differences between two radiation qualities. However, published dose-mean lineal energy values from different codes may differ significantly with potential influence on radiation quality estimates. PURPOSE The purpose was to compare dose-mean lineal energy values from different track-structure data sets for condensed water vapor and liquid water, and to evaluate the influence on radiation quality estimations for some photon sources. METHODS Published dose-mean lineal energy values for 0.1 keV to 1 MeV electrons in spheres with diameters 2 nm to 1 μm, calculated with water vapor and liquid water track structure codes and proximity functions, were collected, analyzed, and compared. Data for cylinders were converted to spheres using a theoretical transformation published by Kellerer. A new set of dose-mean lineal energy values was calculated to cover the whole range of volumes of interest here using the GEANT4-DNA code. The influence from the differences between codes on radiation quality calculations was estimated using dose-mean lineal energy ratios for the photon sources 125 I, 169 Yb, and 192 Ir relative to 60 Co. RESULTS The theoretical relation for converting the dose-mean lineal energy between different geometrical volumes, results in differences up to 10% between cylinders and spheres depending on electron energy and target size, in agreement with published simulated results. For spheres with diameter above 100 nm, dose-mean lineal energy values for condensed water vapor and liquid water are with few exceptions within ±10%. Below 100 nm, the difference increases with decreasing diameter reaching a factor of two at 2 nm. The values from water vapor codes are in general larger than from liquid water codes. If the dose-mean lineal energy ratio is based on condensed water vapor instead of liquid water, the ratio differs less than 9% for the nuclides 125 I, 169 Yb, and 192 Ir relative to 60 Co independent of the volume simulated. However, a specific value of the dose-mean lineal energy ratio, is found at a larger target diameter in liquid water than in condensed water vapor. CONCLUSIONS When ratios of the dose-mean lineal energy are used as a measure of the radiation quality it is important to compare values for geometrically equal target shapes. A practical method of converting values for cylinders of equal diameter and height to spheres was demonstrated. Although dose-mean lineal energy values calculated with water vapor and liquid water codes may differ significantly, the radiation quality, in terms of ratios of dose-mean lineal energy, for the three photon sources 192 Ir, 169 Yb, and 125 I relative to 60 Co, agree within 9%. The same ratio appears at a larger diameter when a liquid water code is used. It is therefore important to use the same code in radiation quality investigations. The present findings may be of special interest in studies related to the relative biological effectiveness (RBE).
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Affiliation(s)
| | - Jan Lillhök
- Swedish Radiation Safety Authority, Stockholm, Sweden
| | - Ioanna Kyriakou
- Medical Physics Laboratory, University of Ioannina Medical School, Ioannina, Greece
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Daems N, Michiels C, Lucas S, Baatout S, Aerts A. Gold nanoparticles meet medical radionuclides. Nucl Med Biol 2021; 100-101:61-90. [PMID: 34237502 DOI: 10.1016/j.nucmedbio.2021.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 12/15/2022]
Abstract
Thanks to their unique optical and physicochemical properties, gold nanoparticles have gained increased interest as radiosensitizing, photothermal therapy and optical imaging agents to enhance the effectiveness of cancer detection and therapy. Furthermore, their ability to carry multiple medically relevant radionuclides broadens their use to nuclear medicine SPECT and PET imaging as well as targeted radionuclide therapy. In this review, we discuss the radiolabeling process of gold nanoparticles and their use in (multimodal) nuclear medicine imaging to better understand their specific distribution, uptake and retention in different in vivo cancer models. In addition, radiolabeled gold nanoparticles enable image-guided therapy is reviewed as well as the enhancement of targeted radionuclide therapy and nanobrachytherapy through an increased dose deposition and radiosensitization, as demonstrated by multiple Monte Carlo studies and experimental in vitro and in vivo studies.
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Affiliation(s)
- Noami Daems
- Radiobiology Research Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium.
| | - Carine Michiels
- Unité de Recherche en Biologie Cellulaire-NARILIS, University of Namur, Rue de Bruxelles 61, 5000 Namur, Belgium
| | - Stéphane Lucas
- Laboratory of Analysis by Nuclear Reaction (LARN)-NARILIS, University of Namur, Rue de Bruxelles 61, 5000 Namur, Belgium
| | - Sarah Baatout
- Radiobiology Research Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium
| | - An Aerts
- Radiobiology Research Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium
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13
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Dayyani M, Hoseinian-Azghadi E, Miri-Hakimabad H, Rafat-Motavalli L, Abdollahi S, Mohammadi N. Radiobiological comparison between Cobalt-60 and Iridium-192 high-dose-rate brachytherapy sources: Part I-cervical cancer. Med Phys 2021; 48:6213-6225. [PMID: 34415623 DOI: 10.1002/mp.15177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/26/2021] [Accepted: 07/30/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study aimed to compare the biological effective doses (BEDs) to clinical target volume (CTV) and organs at risk (OARs) for cervical cancer patients treated with high-dose-rate (HDR) Iridium-192 (192 Ir) or Cobalt-60 (60 Co) brachytherapy (BT) boost and to determine if the radiobiological differences between the two isotopes are clinically relevant. METHODS Considering all radiosensitivity parameters and their reported variations, the BEDs to CTV and OARs during HDR 60 Co/192 Ir BT boost were evaluated at the voxel level. The anatomical differences between individuals were also taken into account by retrospectively considering 25 cervical cancer patients. The intrafraction repair, proliferation, hypoxia-induced radiosensitivity heterogeneity, relative biological effectiveness (RBE), and source aging dose-rate variation were also taken into account. The comparisons in CTV were performed based on equivalent uniform BED (EUBED). RESULTS Considering nominal parameters with no RBE correction, the CTV EUBEDs were almost similar with a median ratio of ∼1.00 (p < 0.00001), whereas RBE correction resulted in 3.9%-5.5% (p = 0.005, median = 4.8%) decrease for 60 Co with respect to 192 Ir. For OARs, the median values of D2cc (in EQD23 ) for 60 Co were lower than that of 192 Ir up to 9.2% and 11.3% (p < 0.00001) for nominal parameters and fast repair conditions, respectively. In addition, for a nominal value (reported range) of radiosensitive parameters, the CTV EUBED differences of up to 6% (5%-10%) were assessed for HDR-BT component. CONCLUSION The RBE values are the most important cause of discrepancies between the two sources. By comparing BED/EUBEDs to CTV and OARs between 60 Co and 192 Ir sources, this numerical study suggests that a dose escalation to ∼4% is feasible and safe while sparing well the surrounding normal tissues. This 4% dose escalation should be benchmarked with clinical evidences (such as the results of clinical trials) before it can be used in clinical practice.
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Affiliation(s)
- Mahdieh Dayyani
- Radiation Oncology Department, Reza Radiotherapy and Oncology Center, Mashhad, Iran
| | | | - Hashem Miri-Hakimabad
- Physics Department, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Laleh Rafat-Motavalli
- Physics Department, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Sara Abdollahi
- Medical Physics Department, Reza Radiotherapy and Oncology Center, Mashhad, Iran
| | - Najmeh Mohammadi
- Physics Department, Faculty of Science, Sahand University of Technology, Tabriz, Iran
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DeCunha JM, Villegas F, Vallières M, Torres J, Camilleri-Broët S, Enger SA. Patient-specific microdosimetry: a proof of concept. Phys Med Biol 2021; 66. [PMID: 34384070 DOI: 10.1088/1361-6560/ac1d1e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/12/2021] [Indexed: 11/12/2022]
Abstract
Microscopic energy deposition distributions from ionizing radiation are used to predict the biological effects of an irradiation and vary depending on biological target size. Ionizing radiation is thought to kill cells or inhibit cell cycling mainly by damaging DNA in the cell nucleus. The size of cells and nuclei depends on tissue type, cell cycle, and malignancy, all of which vary between patients. The aim of this study was to develop methods to perform patient-specific microdosimetry, that being, determining microdosimetric quantities in volumes that correspond to the sizes of cells and nuclei observed in a patient's tissue. A histopathological sample extracted from a stage I lung adenocarcinoma patient was analyzed. A pouring simulation was used to generate a three-dimensional tissue model from cell and nucleus size information determined from the histopathological sample. Microdosimetric distributions including f(y) and d(y) were determined for Co-60,Ir-192,Yb-169 and I-125 in a patient-specific model containing a distribution of cell and nucleus sizes. Fixed radius models and a summation method (where f(y) from many fixed radii models are summed) were compared to the full patient-specific model to evaluate their suitability for fast determination of patient-specific microdosimetric parameters. Fixed radius models do not provide a close approximation of the full patient-specific model y ̅_f or y ̅_d for the lower energy sources investigated, Yb-169 and I-125. The higher energy sources investigated, Co-60 and Ir-192 are less sensitive to target size variation than Yb-169 and I-125. A summation method yields the most accurate approximation of the full model d(y) for all radioisotopes investigated. A summation method allows for the computation of patient-specific microdosimetric distributions with the computing power of a personal computer. With appropriate biological inputs the microdosimetric distributions computed using these methods can yield a patient-specific relative biological effectiveness as part of a multiscale treatment planning approach.
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Affiliation(s)
- Joseph M DeCunha
- Oncology, McGill University Medical Physics Unit, Montreal, Quebec, CANADA
| | - Fernanda Villegas
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, SWEDEN
| | - Martin Vallières
- Department of Computer Science, University of Sherbrooke, Sherbrooke, Quebec, CANADA
| | - Jose Torres
- Pathology, McGill University Health Centre, 1001 Decarie Blvd, E04.4246, Montreal, Quebec, H4A 1J1, CANADA
| | - Sophie Camilleri-Broët
- Department of Pathology, McGill University Faculty of Medicine, Montreal, Quebec, CANADA
| | - Shirin A Enger
- Medical Physics Unit, McGill University, Montreal, Quebec, CANADA
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15
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Kyriakou I, Tremi I, Georgakilas AG, Emfietzoglou D. Microdosimetric investigation of the radiation quality of low-medium energy electrons using Geant4-DNA. Appl Radiat Isot 2021; 172:109654. [PMID: 33676082 DOI: 10.1016/j.apradiso.2021.109654] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 02/06/2023]
Abstract
The increasing clinical use of low-energy photon and electron sources (below few tens of keV) has raised concerns on the adequacy of the existing approximation of an energy-independent radiobiological effectiveness. In this work, the variation of the quality factor (Q) and relative biological effectiveness (RBE) of electrons over the low-medium energy range (0.1 keV-1 MeV) is examined using several microdosimetry-based Monte Carlo methodologies with input data obtained from Geant4-DNA track-structure simulations. The sensitivity of the results to the different methodologies, Geant4-DNA physics models, and target sizes is examined. Calculations of Q and RBE are based on the ICRU Report 40 recommendations, the Kellerer-Hahn approximation, the site version of the theory of dual radiation action (TDRA), the microdosimetric kinetic model (MKM) of cell survival, and the calculated yield of DNA double strand breaks (DSB). The stochastic energy deposition spectra needed as input in the above approaches have been calculated for nanometer spherical volumes using the different electron physics models of Geant4-DNA. Results are normalized at 100 keV electrons which is here considered the reference radiation. It is shown that in the energy range ~50 keV-1 MeV, the calculated Q and RBE are approximately unity (to within 1-2%) irrespective of the methodology, Geant4-DNA physics model, and target size. At lower energies, Q and RBE become energy-dependent reaching a maximum value of ~1.5-2.5 between ~200 and 700 eV. The detailed variation of Q and RBE at low energies depends mostly upon the adopted methodology and target size, and less so upon the Geant4-DNA physics model. Overall, the DSB yield predicts the highest RBE values (with RBEmax≈2.5) whereas the MKM the lowest RBE values (with RBEmax≈1.5). The ICRU Report 40, Kellerer-Hahn, and TDRA methods are in excellent agreement (to within 1-2%) over the whole energy range predicting a Qmax≈2. In conclusion, the approximation Q=RBE=1 was found to be valid only above ~50 keV whereas at lower energies both Q and RBE become strongly energy-dependent. It is envisioned that the present work will contribute towards establishing robust methodologies to determine theoretically the energy-dependence of radiation quality of individual electrons which may then be used in subsequent calculations involving practical electron and photon radiation sources.
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Affiliation(s)
- Ioanna Kyriakou
- Medical Physics Laboratory, University of Ioannina Medical School, 45110, Ioannina, Greece.
| | - Ioanna Tremi
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens (NTUA), Zografou, Athens, Greece
| | - Alexandros G Georgakilas
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens (NTUA), Zografou, Athens, Greece
| | - Dimitris Emfietzoglou
- Medical Physics Laboratory, University of Ioannina Medical School, 45110, Ioannina, Greece
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16
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DeCunha JM, Poole CM, Vallières M, Torres J, Camilleri-Broët S, Rayes RF, Spicer JD, Enger SA. Development of patient-specific 3D models from histopathological samples for applications in radiation therapy. Phys Med 2021; 81:162-169. [PMID: 33461029 DOI: 10.1016/j.ejmp.2020.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/16/2020] [Accepted: 12/12/2020] [Indexed: 11/17/2022] Open
Abstract
The biological effects of ionizing radiation depend on the tissue, tumor type, radiation quality, and patient-specific factors. Inter-patient variation in cell/nucleus size may influence patient-specific dose response. However, this variability in dose response is not well investigated due to lack of available cell/nucleus size data. The aim of this study was to develop methods to derive cell/nucleus size distributions from digital images of 2D histopathological samples and use them to build digital 3D models for use in cellular dosimetry. Nineteen of sixty hematoxylin and eosin stained lung adenocarcinoma samples investigated passed exclusion criterion to be analyzed in the study. A difference of gaussians blob detection algorithm was used to identify nucleus centers and quantify cell spacing. Hematoxylin content was measured to determine nucleus radius. Pouring simulations were conducted to generate one-hundred 3D models containing volumes of equivalent cell spacing and nuclei radius to those in histopathological samples. The nuclei radius distributions of non-tumoral and cancerous regions appearing in the same slide were significantly different (p < 0.01) in all samples analyzed. The median nuclear-cytoplasmic ratio was 0.36 for non-tumoral cells and 0.50 for cancerous cells. The average cellular and nucleus packing densities in the 3D models generated were 65.9% (SD: 1.5%) and 13.3% (SD: 0.3%) respectively. Software to determine cell spacing and nuclei radius from histopathological samples was developed. 3D digital tissue models containing volumes with equivalent cell spacing, nucleus radius, and packing density to cancerous tissues were generated.
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Affiliation(s)
- Joseph M DeCunha
- Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
| | | | - Martin Vallières
- Department of Computer Science, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Jose Torres
- Department of Pathology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Sophie Camilleri-Broët
- Department of Pathology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Roni F Rayes
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Division of Upper GI and Thoracic Surgery, Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - Jonathan D Spicer
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Division of Upper GI and Thoracic Surgery, Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - Shirin A Enger
- Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Québec, Canada; Research Institute of the McGill University Health Center, Montréal, Québec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
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Hopfensperger KM, Adams Q, Kim Y, Wu X, Xu W, Patwardhan K, Thammavong B, Caster J, Flynn RT. Needle-free cervical cancer treatment using helical multishield intracavitary rotating shield brachytherapy with the 169 Yb Isotope. Med Phys 2020; 47:2061-2071. [PMID: 32073669 PMCID: PMC7377278 DOI: 10.1002/mp.14101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To assess the capability of an intracavitary 169 Yb-based helical multishield rotating shield brachytherapy (RSBT) delivery system to treat cervical cancer. The proposed RSBT delivery system contains a pair of 1.25 mm thick platinum partial shields with 45° and 180° emission angles, which travel in a helical pattern within the applicator. METHODS A helically threaded tandem applicator with a 45° tandem curvature containing a helically threaded catheter was designed. A 0.6 mm diameter 169 Yb source with a length of 10.5 mm was simulated. A 37-patient treatment planning study, based on Monte Carlo dose calculations using MCNP5, was conducted with high-risk clinical target volumes (HR-CTVs) of 41.2-192.8 cm3 (average ± standard deviation of 79.9 ± 35.8 cm3 ). All patients were assumed to receive 25 fractions of 1.8 Gy of external beam radiation therapy (EBRT) before receiving 5 fractions of high-dose-rate brachytherapy (HDR-BT). For each patient, 192 Ir-based intracavitary (IC) HDR-BT, 192 Ir-based intracavitary/interstitial (IC/IS) HDR-BT using a hybrid applicator with eight IS needles, and 169 Yb-based RSBT plans were generated. RESULTS For the IC, IC/IS, and RSBT treatment plans, 38%, 84%, and 86% of the plans, respectively, met the planning goal of an HR-CTV D90 (minimum dose to hottest 90%) of 85 GyEQD2 (α/β = 10 Gy). Median (25th percentile, 75th percentile) treatment times for IC, IC/IS, and RSBT were 11.71 (6.62, 15.40) min, 68.00 (45.02, 80.02) min, and 25.30 (13.87, 35.39) min, respectively. 192 Ir activities ranging from 159.1-370 GBq (4.3-10 Ci) and 169 Yb activities ranging from 429.2-999 GBq (11.6-27 Ci) were used, which correspond to the same clinical ranges of dose rates at 1 cm off-source-axis in water. Extra needle insertion and planning time beyond that needed for intracavitary-only approaches was accounted for in the IC/IS treatment time calculations. CONCLUSION 169 Yb-based RSBT for cervical cancer met the HR-CTV D90 goal of 85 Gy in a greater percentage of the patients considered than IC/IS (86% vs 84%, respectively) and can reduce overall treatment time relative to IC/IS. 169 Yb-based RSBT could be used to replace IC/IS in instances where IC/IS treatment is not available, especially in instances when HR-CTV volumes are ≥30 cm3 .
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Affiliation(s)
- Karolyn M Hopfensperger
- Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center for the Engineering Arts and Sciences, Iowa City, IA, 52242, USA
| | - Quentin Adams
- Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Xiaodong Wu
- Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, IA, 52242, USA
| | - Weiyu Xu
- Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, IA, 52242, USA
| | - Kaustubh Patwardhan
- Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | | | - Joseph Caster
- Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Ryan T Flynn
- Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
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Famulari G, Alfieri J, Duclos M, Vuong T, Enger SA. Can intermediate-energy sources lead to elevated bone doses for prostate and head & neck high-dose-rate brachytherapy? Brachytherapy 2020; 19:255-263. [DOI: 10.1016/j.brachy.2019.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/12/2019] [Accepted: 12/15/2019] [Indexed: 01/03/2023]
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19
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Margis S, Magouni M, Kyriakou I, Georgakilas AG, Incerti S, Emfietzoglou D. Microdosimetric calculations of the direct DNA damage induced by low energy electrons using the Geant4-DNA Monte Carlo code. Phys Med Biol 2020; 65:045007. [PMID: 31935692 DOI: 10.1088/1361-6560/ab6b47] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To calculate the yield of direct DNA damage induced by low energy electrons using Monte Carlo generated microdosimetric spectra at the nanometer scale and examine the influence of various simulation inputs. The potential of classical microdosimetry to offer a viable and simpler alternative to more elaborate mechanistic approaches for practical applications is discussed. Track-structure simulations with the Geant4-DNA low-energy extension of the Geant4 Monte Carlo toolkit were used for calculating lineal energy spectra in spherical volumes with dimensions relevant to double-strand-break (DSB) induction. The microdosimetric spectra were then used to calculate the yield of simple and clustered DSB based on literature values of the threshold energy of DNA damage. The influence of the different implementations of the dielectric function of liquid water available in Geant4-DNA (Option 2 and Option 4 constructors), as well as the effect of particle tracking cutoff energy and target size are examined. Frequency- and dose-mean lineal energies in liquid-water spheres of 2, 2.3, 2.6, and 3.4 nm diameter, as well as, number of simple and clustered DSB/Gy/cell are presented for electrons over the 100 eV to 100 keV energy range. Results are presented for both the 'default' (Option 2) and 'Ioannina' (Option 4) physics models of Geant4-DNA applying several commonly used tracking cutoff energies (10, 20, 50, 100 eV). Overall, the choice of the physics model and target diameter has a moderate effect (up to ~10%-30%) on the DSB yield whereas the effect of the tracking cutoff energy may be significant (>100%). Importantly, the yield of both simple and clustered DSB was found to vary significantly (by a factor of 2 or more) with electron energy over the examined range. The yields of electron-induced simple and clustered DSB exhibit a strong energy dependence over the 100 eV-100 keV range with implications to radiation quality issues. It is shown that a classical microdosimetry approach for the calculation of DNA damage based on lineal energy spectra in nanometer-size targets predicts comparable results to computationally intensive mechanistic approaches which use detailed atomistic DNA geometries, thus, offering a relatively simple and robust alternative for some practical applications.
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Affiliation(s)
- Stefanos Margis
- Medical Physics Laboratory, University of Ioannina Medical School, 45110 Ioannina, Greece
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20
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Nusrat H, Karim-Picco S, Pang G, Paudel M, Sarfehnia A. Maximum RBE change in 192Ir, 125I, and 169Yb brachytherapy and the corresponding effect on treatment planning. Biomed Phys Eng Express 2020; 6:015021. [PMID: 33438609 DOI: 10.1088/2057-1976/ab638e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The purpose of this study was to examine RBE variation as a function of distance from the radioactive source, and the potential impact of this variation on a realistic prostate brachytherapy treatment plan. METHODS Three brachytherapy sources (125I, 192Ir, and 169Yb) were modelled in Geant4 Monte Carlo code, and the resulting electron energy spectrum in water in 3D space around these sources was scored (voxel size of 2 mm3). With this energy spectrum, microdosimetric techniques were used to calculate the maximum RBE, RBEM, as a function of distance from the source. RBEM of 125I relative to 192Ir was calculated in order to validate simulations against literature; all other RBEM calculations were done by normalizing electron fluence at various distances to the source position. In order to examine the impact of RBEM variation in treatment planning, a realistic 192Ir prostate plan was re-evaluated in terms of RBE instead of absorbed dose. RESULTS The RBEM of 125I, 192Ir, and 169Yb at 8 cm away from the source was 0.994 (+/-0.002), 1.030 (+/-0.003), and 1.066 (+/-0.008), respectively. RBEM in the HDR prostate treatment plan exhibited several hot (+3.6% in RBEM) spots. CONCLUSIONS The large increase RBEM observed in 169Yb has not yet been described in the literature. Despite the presence of radiobiological hotspots in the HDR treatment, these variations are likely nominal and clinically insignificant.
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Affiliation(s)
- Humza Nusrat
- Department of Physics, Ryerson University, 350 Victoria St., M5B 2K3 Toronto, ON, Canada
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21
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Famulari G, Duclos M, Enger SA. A novel
169
Yb‐based dynamic‐shield intensity modulated brachytherapy delivery system for prostate cancer. Med Phys 2019; 47:859-868. [DOI: 10.1002/mp.13959] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/04/2019] [Accepted: 12/06/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Gabriel Famulari
- Medical Physics Unit McGill University Montréal Québec H4A 3J1Canada
| | - Marie Duclos
- Department of Oncology McGill University Montréal Québec H4A 3J1Canada
| | - Shirin A. Enger
- Medical Physics Unit McGill University Montréal Québec H4A 3J1Canada
- Department of Oncology McGill University Montréal Québec H4A 3J1Canada
- Research Institute of the McGill University Health Centre Montréal Québec H3H 2R9Canada
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22
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Shoemaker T, Vuong T, Glickman H, Kaifi S, Famulari G, Enger SA. Dosimetric Considerations for Ytterbium-169, Selenium-75, and Iridium-192 Radioisotopes in High-Dose-Rate Endorectal Brachytherapy. Int J Radiat Oncol Biol Phys 2019; 105:875-883. [DOI: 10.1016/j.ijrobp.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 05/09/2019] [Accepted: 07/10/2019] [Indexed: 02/02/2023]
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Kumar M, Pandey U, Yadav Y, Gandhi SS, Saxena SK, Kumar Y, Nuwad J, Dash A. Utilization of Chemical Deposition Technique for Preparation of Miniature 170Tm Sources and Preliminary Quality Assessment for Potential Use in Brachytherapy. Cancer Biother Radiopharm 2019; 34:24-32. [DOI: 10.1089/cbr.2018.2524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Manoj Kumar
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Usha Pandey
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Yugandhara Yadav
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai, India
| | - Shyamala S. Gandhi
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai, India
| | | | - Yogendra Kumar
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai, India
| | - Jitendra Nuwad
- Chemistry Division, Bhabha Atomic Research Center, Mumbai, India
| | - Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Center, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
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Adams Q, Hopfensperger KM, Kim Y, Wu X, Xu W, Shukla H, McGee J, Caster JM, Flynn RT. Effectiveness of Rotating Shield Brachytherapy for Prostate Cancer Dose Escalation and Urethral Sparing. Int J Radiat Oncol Biol Phys 2018; 102:1543-1550. [PMID: 30092333 PMCID: PMC6363898 DOI: 10.1016/j.ijrobp.2018.07.2015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/08/2018] [Accepted: 07/26/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE To compare single-fraction 153Gd-based rotating shield brachytherapy (RSBT) for prostate cancer with conventional 192Ir-based high-dose-rate brachytherapy (HDR-BT) in a planning study that radiobiologically accounts for dose rate and relative biological effectiveness. RSBT was used for planning target volume (PTV) dose escalation without increasing urethral dose for monotherapy, or for urethral sparing without decreasing PTV dose as a boost to external beam radiation therapy. METHODS AND MATERIALS Twenty-six patients were studied. PTV doses were expressed as equivalent dose delivered in 2 Gy fractions (EQD2), accounting for relative biological effectiveness (1.00 for 192Ir and 1.15 for 153Gd), dose protraction (114-minute repair half-time), and tumor dose response (α/β of 3.41 Gy). HDR-BT dose was prescribed such that 90% of the PTV received 110% of the prescription dose of 19 Gy for dose escalation and 15 Gy for urethral sparing, corresponding to EQD290% values (minimum EQD2 to the hottest 90% of the PTV) of 93.9 GyEQD2 and 60.7 GyEQD2, respectively. Twenty 90.95 GBq 153Gd RSBT sources and one 370 GBq 192Ir HDR-BT source were modeled. RESULTS For dose escalation with fresh sources, RSBT increased PTV EQD290% by 42.5% ± 8.4% (average ± standard deviation) without increasing urethral D10%, with treatment times of 216.8 ± 28.9 minutes versus 15.1 ± 2.1 minutes. After 1 half-life (240.4 days for 153Gd and 73.8 days for 192Ir), EQD290% increased 20.5% ± 9.1%. For urethral sparing with fresh sources, RSBT decreased urethral D10% by 26.0% ± 3.4% without decreasing PTV EQD290%, with treatment times of 133.6 ± 16.5 minutes versus 12.0 ± 1.7 minutes. After 1 half-life, urethral D10% decreased 20.2% ± 4.8%. CONCLUSIONS RSBT can increase PTV EQD90% or decrease urethral D10% relative to HDR-BT at the cost of increased treatment time. Source aging reduces RSBT benefit, but RSBT remains theoretically superior to HDR-BT by >20% after 1 half-life has elapsed.
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Affiliation(s)
- Quentin Adams
- Department of Radiation Oncology, University of Iowa, Iowa City, Iowa.
| | | | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, Iowa City, Iowa
| | - Xiaodong Wu
- Department of Radiation Oncology, University of Iowa, Iowa City, Iowa; Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa
| | - Weiyu Xu
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa
| | | | - James McGee
- OSF Saint Francis Medical Center, Peoria, Illinois
| | - Joseph M Caster
- Department of Radiation Oncology, University of Iowa, Iowa City, Iowa
| | - Ryan T Flynn
- Department of Radiation Oncology, University of Iowa, Iowa City, Iowa
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