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Clausen M, Ruangchan S, Sotoudegan A, Resch AF, Knäusl B, Palmans H, Georg D. Small field proton irradiation for in vivo studies: Potential and limitations when adapting clinical infrastructure. Z Med Phys 2023; 33:542-551. [PMID: 36357294 PMCID: PMC10751703 DOI: 10.1016/j.zemedi.2022.10.002] [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: 05/12/2022] [Revised: 09/22/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To evaluate the dosimetric accuracy for small field proton irradiation relevant for pre-clinical in vivo studies using clinical infrastructure and technology. In this context additional beam collimation and range reduction was implemented. METHODS AND MATERIALS The clinical proton beam line employing pencil beam scanning (PBS) was adapted for the irradiation of small fields at shallow depths. Cylindrical collimators with apertures of 15, 12, 7 and 5mm as well as two different range shifter types, placed at different distances relative to the target, were tested: a bolus range shifter (BRS) attached to the collimator and a clinical nozzle mounted range shifter (CRS) placed at a distance of 72cm from the collimator. The Monte Carlo (MC) based dose calculation engine implemented in the clinical treatment planning system (TPS) was commissioned for these two additional hardware components. The study was conducted with a phantom and cylindrical target sizes between 2 and 25mm in diameter following a dosimetric end-to-end test concept. RESULTS The setup with the CRS provided a uniform dose distribution across the target. An agreement of better than5% between the planned dose and the measurements was obtained for a target with 3mm diameter (collimator 5mm). A 2mm difference between the collimator and the target diameter (target being 2 mm smaller than the collimator) sufficed to cover the whole target with the planned dose in the setup with CRS. Using the BRS setup (target 8mm, collimator 12mm) resulted in non-homogeneous dose distributions, with a dose discrepancy of up to 10% between the planned and measured doses. CONCLUSION The clinical proton infrastructure with adequate beam line adaptations and a state-of-the-art TPS based on MC dose calculations enables small animal irradiations with a high dosimetric precision and accuracy for target sizes down to 3mm.
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Affiliation(s)
- Monika Clausen
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria.
| | - Sirinya Ruangchan
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria; Division of Therapeutic Radiation and Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Arame Sotoudegan
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria
| | - Andreas F Resch
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria
| | - Barbara Knäusl
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria
| | - Hugo Palmans
- Division of Medical Physics, MedAustron Ion Therapy Center, Wiener Neustadt, Austria; National Physical Laboratory, Teddington, United Kingdom
| | - Dietmar Georg
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria; Division of Medical Physics, MedAustron Ion Therapy Center, Wiener Neustadt, Austria
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2
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Biglin ER, Aitkenhead AH, Price GJ, Chadwick AL, Santina E, Williams KJ, Kirkby KJ. A preclinical radiotherapy dosimetry audit using a realistic 3D printed murine phantom. Sci Rep 2022; 12:6826. [PMID: 35474242 PMCID: PMC9042835 DOI: 10.1038/s41598-022-10895-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 04/05/2022] [Indexed: 11/08/2022] Open
Abstract
Preclinical radiation research lacks standardized dosimetry procedures that provide traceability to a primary standard. Consequently, ensuring accuracy and reproducibility between studies is challenging. Using 3D printed murine phantoms we undertook a dosimetry audit of Xstrahl Small Animal Radiation Research Platforms (SARRPs) installed at 7 UK centres. The geometrically realistic phantom accommodated alanine pellets and Gafchromic EBT3 film for simultaneous measurement of the dose delivered and the dose distribution within a 2D plane, respectively. Two irradiation scenarios were developed: (1) a 10 × 10 mm2 static field targeting the pelvis, and (2) a 5 × 5 mm2 90° arc targeting the brain. For static fields, the absolute difference between the planned dose and alanine measurement across all centres was 4.1 ± 4.3% (mean ± standard deviation), with an overall range of - 2.3 to 10.5%. For arc fields, the difference was - 1.2% ± 6.1%, with a range of - 13.1 to 7.7%. EBT3 dose measurements were greater than alanine by 2.0 ± 2.5% and 3.5 ± 6.0% (mean ± standard deviation) for the static and arc fields, respectively. 2D dose distributions showed discrepancies to the planned dose at the field edges. The audit demonstrates that further work on preclinical radiotherapy quality assurance processes is merited.
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Affiliation(s)
- Emma R Biglin
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3rd floor Proton Beam Therapy Centre, Oak Road, Manchester, M20 4BX, UK.
| | - Adam H Aitkenhead
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3rd floor Proton Beam Therapy Centre, Oak Road, Manchester, M20 4BX, UK
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - Gareth J Price
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3rd floor Proton Beam Therapy Centre, Oak Road, Manchester, M20 4BX, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Amy L Chadwick
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3rd floor Proton Beam Therapy Centre, Oak Road, Manchester, M20 4BX, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Elham Santina
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3rd floor Proton Beam Therapy Centre, Oak Road, Manchester, M20 4BX, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Kaye J Williams
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Karen J Kirkby
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3rd floor Proton Beam Therapy Centre, Oak Road, Manchester, M20 4BX, UK
- The Christie NHS Foundation Trust, Manchester, UK
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3
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Ba Sunbul N, Oraiqat I, Rosen B, Miller C, Meert C, Matuszak MM, Clarke S, Pozzi S, Moran JM, El Naqa I. Application of radiochromic gel dosimetry to commissioning of a megavoltage research linear accelerator for small-field animal irradiation studies. Med Phys 2021; 48:1404-1416. [PMID: 33378092 DOI: 10.1002/mp.14685] [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: 05/01/2020] [Revised: 11/25/2020] [Accepted: 12/17/2020] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To develop and implement an efficient and accurate commissioning procedure for small-field static beam animal irradiation studies on an MV research linear accelerator (Linatron-M9) using radiochromic gel dosimetry. MATERIALS The research linear accelerator (Linatron-M9) is a 9 MV linac with a static fixed collimator opening of 5.08 cm diameter. Lead collimators were manually placed to create smaller fields of 2 × 2 cm2 , 1 × 1 cm2 , and 0.5 × 0.5 cm2 . Relative dosimetry measurements were performed, including profiles, percent depth dose (PDD) curves, beam divergence, and relative output factors using various dosimetry tools, including a small volume ionization chamber (A14), GAFCHROMIC™ EBT3 film, and Clearview gel dosimeters. The gel dosimeter was used to provide a 3D volumetric reference of the irradiated fields. The Linatron profiles and relative output factors were extracted at a reference depth of 2 cm with the output factor measured relative to the 2 × 2 cm2 reference field. Absolute dosimetry was performed using A14 ionization chamber measurements, which were verified using a national standards laboratory remote dosimetry service. RESULTS Absolute dosimetry measurements were confirmed within 1.4% (k = 2, 95% confidence = 5%). The relative output factor of the small fields measured with films and gels agreed with a maximum relative percent error difference between the two methods of 1.1 % for the 1 × 1 cm2 field and 4.3 % for the 0.5 × 0.5 cm2 field. These relative errors were primarily due to the variability in the collimator positioning. The measured beam profiles demonstrated excellent agreement for beam size (measured as FWHM), within approximately 0.8 mm (or less). Film measurements were more accurate in the penumbra region due to the film's finer resolution compared with the gel dosimeter. Following the van Dyk criteria, the PDD values of the film and gel measurements agree within 11% in the buildup region starting from 0.5 cm depth and within 2.6 % beyond maximum dose and into the fall-off region for depths up to 5 cm. The 2D beam profile isodose lines agree within 0.5 mm in all regions for the 0.5 × 0.5 cm2 and the 1 × 1 cm2 fields and within 1 mm for the larger field of 2 × 2 cm2 . The 2D PDD curves agree within approximately 2% of the maximum in the typical therapy region (1-4 cm) for the 1 × 1 cm2 and 2 × 2 cm2 and within 5% for the 0.5 × 0.5 cm2 field. CONCLUSION This work provides a commissioning process to measure the beam characteristics of a fixed beam MV accelerator with detailed dosimetric evaluation for its implementation in megavoltage small animal irradiation studies. Radiochromic gel dosimeters are efficient small-field relative dosimetry tools providing 3D dose measurements allowing for full representation of dose, dosimeter misalignment corrections and high reproducibility with low inter-dosimeter variability. Overall, radiochromic gels are valuable for fast, full relative dosimetry commissioning in comparison to films for application in high-energy small-field animal irradiation studies.
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Affiliation(s)
- Noora Ba Sunbul
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, USA.,Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Ibrahim Oraiqat
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.,H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
| | - Benjamin Rosen
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Cameron Miller
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Christopher Meert
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Martha M Matuszak
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, USA.,Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Shaun Clarke
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Sara Pozzi
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Jean M Moran
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Issam El Naqa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.,H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
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Shi J, Xu K, Keyvanloo A, Udayakumar TS, Ahmad A, Yang F, Yang Y. A Multimodality Image Guided Precision Radiation Research Platform: Integrating X-ray, Bioluminescence, and Fluorescence Tomography With Radiation Therapy. Int J Radiat Oncol Biol Phys 2020; 108:1063-1072. [PMID: 32585336 DOI: 10.1016/j.ijrobp.2020.06.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/25/2020] [Accepted: 06/14/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE Small animal irradiation is crucial to the investigation of radiobiological mechanisms. The paradigm of clinical radiation therapy is trending toward high-precision, stereotactic treatment. However, translating this scheme to small animal irradiation is challenging owing to the lack of high-quality image guidance. To overcome this obstacle, we developed a multimodality image guided precision radiation platform. METHODS AND MATERIALS The platform consists of 4 modules: x-ray computed tomography (CT), bioluminescence tomography (BLT), fluorescence molecular tomography (FMT), and radiation therapy. CT provides animal anatomy and material density for radiation dose calculation, as well as body contour for BLT and FMT reconstruction. BLT and FMT provide tumor localization to guide radiation beams and molecular activity to evaluate treatment outcome. Furthermore, we developed a Monte Carlo-based treatment planning system (TPS) for 3-dimensional dose calculation, calibrated it using radiochromic films sandwiched in a water-equivalent phantom, and validated it using in vivo dosimeters surgically implanted into euthanized mice (n = 4). Finally, we performed image guided irradiation on mice bearing orthotopic breast and prostate tumors and confirmed radiation delivery using γH2AX histology. RESULTS The Monte Carlo-based TPS was successfully calibrated by benchmarking simulation dose against film measurement. For in vivo dosimetry measured in the euthanized mice, the average difference between the TPS calculated dose and measured dose was 3.86% ± 1.12%. Following the TPS-generated treatment plan, we successfully delivered 20 Gy dose to an animal bearing an orthotopic prostate tumor using 4 BLT-guided radiation beams and 5 Gy dose to an animal bearing an orthotopic breast tumor using a single FMT-guided radiation beam. γH2AX histology presented significantly more DNA damage in irradiated tumors and thus validated the dose delivery accuracy. CONCLUSIONS Combined with Monte Carlo TPS, this multimodality CT/BLT/FMT image guided small animal radiation platform can specifically localize tumors, accurately calculate dose distribution, precisely guide radiation delivery, and molecularly evaluate treatment response. It provides an advanced toolset for radiobiology and translational cancer research.
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Affiliation(s)
- Junwei Shi
- University of Miami School of Medicine, Miami, Florida
| | - Keying Xu
- University of Miami School of Medicine, Miami, Florida; University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | | | - Anis Ahmad
- University of Miami School of Medicine, Miami, Florida
| | - Fei Yang
- University of Miami School of Medicine, Miami, Florida
| | - Yidong Yang
- University of Miami School of Medicine, Miami, Florida; Department of Radiation Oncology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; School of Physical Sciences, University of Science and Technology of China, Hefei, China.
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5
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Bristow RG, Alexander B, Baumann M, Bratman SV, Brown JM, Camphausen K, Choyke P, Citrin D, Contessa JN, Dicker A, Kirsch DG, Krause M, Le QT, Milosevic M, Morris ZS, Sarkaria JN, Sondel PM, Tran PT, Wilson GD, Willers H, Wong RKS, Harari PM. Combining precision radiotherapy with molecular targeting and immunomodulatory agents: a guideline by the American Society for Radiation Oncology. Lancet Oncol 2019; 19:e240-e251. [PMID: 29726389 DOI: 10.1016/s1470-2045(18)30096-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 10/30/2017] [Accepted: 12/18/2017] [Indexed: 02/07/2023]
Abstract
The practice of radiation oncology is primarily based on precise technical delivery of highly conformal, image-guided external beam radiotherapy or brachytherapy. However, systematic research efforts are being made to facilitate individualised radiation dose prescriptions on the basis of gene-expressssion profiles that reflect the radiosensitivity of tumour and normal tissue. This advance in precision radiotherapy should complement those benefits made in precision cancer medicine that use molecularly targeted agents and immunotherapies. The personalisation of cancer therapy, predicated largely on genomic interrogation, is facilitating the selection of therapies that are directed against driver mutations, aberrant cell signalling, tumour microenvironments, and genetic susceptibilities. With the increasing technical power of radiotherapy to safely increase local tumour control for many solid tumours, it is an opportune time to rigorously explore the potential benefits of combining radiotherapy with molecular targeted agents and immunotherapies to increase cancer survival outcomes. This theme provides the basis and foundation for this American Society for Radiation Oncology guideline on combining radiotherapy with molecular targeting and immunotherapy agents.
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Affiliation(s)
- Robert G Bristow
- Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada.
| | - Brian Alexander
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Scott V Bratman
- Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - J Martin Brown
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Kevin Camphausen
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Peter Choyke
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Deborah Citrin
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joseph N Contessa
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA
| | - Adam Dicker
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - David G Kirsch
- Department of Radiation Oncology and Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA
| | | | - Quynh-Thu Le
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Michael Milosevic
- Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Zachary S Morris
- Department of Human Oncology, University of Wisconsin, Madison, WI, USA
| | - Jann N Sarkaria
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Paul M Sondel
- Department of Human Oncology, University of Wisconsin, Madison, WI, USA
| | - Phuoc T Tran
- Department of Radiation Oncology and Molecular Radiation Sciences, Department of Oncology, and Department of Urology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - George D Wilson
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, USA
| | - Henning Willers
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca K S Wong
- Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Paul M Harari
- Department of Human Oncology, University of Wisconsin, Madison, WI, USA
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6
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Toward a pre-clinical irradiator using clinical infrastructure. Phys Med 2019; 58:21-31. [PMID: 30824146 DOI: 10.1016/j.ejmp.2019.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/02/2019] [Accepted: 01/04/2019] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Pre-clinical irradiation systems use kilovoltage x-ray systems to deliver small fields of radiation in static beam arrangements or arcs. The systems are costly and the radiobiological effectiveness of kilovoltage beams is known to differ from the megavoltage photon beams used clinically. This work used Developer mode on the Varian TrueBeam STx linear accelerator to create a pre-clinical irradiator capable of treating millimeter-sized targets. MATERIALS AND METHODS A treatment field defined by a single opposed leaf pair was used to deliver arc-based treatments. Dynamic couch trajectories were used to create a shortened virtual isocentre. Initially, a pre-treatment imaging procedure was used to quantify target misalignment at control points along the arcs and determine appropriate couch positional corrections. This was followed by the treatment arcs in which the positional corrections were implemented. Monte Carlo simulations and radiochromic film were used to calculate and measure dose distributions. RESULTS A 1 mm leaf separation produced the optimal dose distributions. Couch position corrections up to 2.1 mm were required to maintain a target at virtual isocentre. Application of couch corrections reduced non-coplanar arc treatments dose profile by 1.2 mm at 30% of the maximum dose. Treatment of a 1 mm diameter target would result in falloff distances to the 80%, 50% and 25% of the 90% prescription line of 0.3 mm, 0.5 mm and 1.3 mm from the target edge respectively. CONCLUSIONS This work has demonstrated that it is possible to deliver highly compact dose distributions using megavoltage photon beams from existing clinical infrastructure.
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7
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Wang YF, Lin SC, Na YH, Black PJ, Wuu CS. Dosimetric verification and commissioning for a small animal image-guided irradiator. ACTA ACUST UNITED AC 2018; 63:145001. [DOI: 10.1088/1361-6560/aacdcd] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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8
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Stewart JMP, Stapleton S, Chaudary N, Lindsay PE, Jaffray DA. Spatial frequency performance limitations of radiation dose optimization and beam positioning. Phys Med Biol 2018; 63:125006. [PMID: 29762137 DOI: 10.1088/1361-6560/aac501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The flexibility and sophistication of modern radiotherapy treatment planning and delivery methods have advanced techniques to improve the therapeutic ratio. Contemporary dose optimization and calculation algorithms facilitate radiotherapy plans which closely conform the three-dimensional dose distribution to the target, with beam shaping devices and image guided field targeting ensuring the fidelity and accuracy of treatment delivery. Ultimately, dose distribution conformity is limited by the maximum deliverable dose gradient; shallow dose gradients challenge techniques to deliver a tumoricidal radiation dose while minimizing dose to surrounding tissue. In this work, this 'dose delivery resolution' observation is rigorously formalized for a general dose delivery model based on the superposition of dose kernel primitives. It is proven that the spatial resolution of a delivered dose is bounded by the spatial frequency content of the underlying dose kernel, which in turn defines a lower bound in the minimization of a dose optimization objective function. In addition, it is shown that this optimization is penalized by a dose deposition strategy which enforces a constant relative phase (or constant spacing) between individual radiation beams. These results are further refined to provide a direct, analytic method to estimate the dose distribution arising from the minimization of such an optimization function. The efficacy of the overall framework is demonstrated on an image guided small animal microirradiator for a set of two-dimensional hypoxia guided dose prescriptions.
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Affiliation(s)
- James M P Stewart
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
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9
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MR-CBCT image-guided system for radiotherapy of orthotopic rat prostate tumors. PLoS One 2018; 13:e0198065. [PMID: 29847586 PMCID: PMC5976174 DOI: 10.1371/journal.pone.0198065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/14/2018] [Indexed: 01/20/2023] Open
Abstract
Multi-modality image-guided radiotherapy is the standard of care in contemporary cancer management; however, it is not common in preclinical settings due to both hardware and software limitations. Soft tissue lesions, such as orthotopic prostate tumors, are difficult to identify using cone beam computed tomography (CBCT) imaging alone. In this study, we characterized a research magnetic resonance (MR) scanner for preclinical studies and created a protocol for combined MR-CBCT image-guided small animal radiotherapy. Two in-house dual-modality, MR and CBCT compatible, phantoms were designed and manufactured using 3D printing technology. The phantoms were used for quality assurance tests and to facilitate end-to-end testing for combined preclinical MR and CBCT based treatment planning. MR and CBCT images of the phantoms were acquired utilizing a Varian 4.7 T scanner and XRad-225Cx irradiator, respectively. The geometry distortion was assessed by comparing MR images to phantom blueprints and CBCT. The corrected MR scans were co-registered with CBCT and subsequently used for treatment planning. The fidelity of 3D printed phantoms compared to the blueprint design yielded favorable agreement as verified with the CBCT measurements. The geometric distortion, which varied between -5% and 11% throughout the scanning volume, was substantially reduced to within 0.4% after correction. The distortion free MR images were co-registered with the corresponding CBCT images and imported into a commercial treatment planning software SmART Plan. The planning target volume (PTV) was on average 19% smaller when contoured on the corrected MR-CBCT images relative to raw images without distortion correction. An MR-CBCT based preclinical workflow was successfully designed and implemented for small animal radiotherapy. Combined MR-CBCT image-guided radiotherapy for preclinical research potentially delivers enhanced relevance to human radiotherapy for various disease sites. This novel protocol is wide-ranging and not limited to the orthotopic prostate tumor study presented in the study.
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10
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Verhaegen F, Dubois L, Gianolini S, Hill MA, Karger CP, Lauber K, Prise KM, Sarrut D, Thorwarth D, Vanhove C, Vojnovic B, Weersink R, Wilkens JJ, Georg D. ESTRO ACROP: Technology for precision small animal radiotherapy research: Optimal use and challenges. Radiother Oncol 2018; 126:471-478. [PMID: 29269093 DOI: 10.1016/j.radonc.2017.11.016] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/21/2017] [Indexed: 11/30/2022]
Abstract
Many radiotherapy research centers have recently installed novel research platforms enabling the investigation of the radiation response of tumors and normal tissues in small animal models, possibly in combination with other treatment modalities. Many more research institutes are expected to follow in the coming years. These novel platforms are capable of mimicking human radiotherapy more closely than older technology. To facilitate the optimal use of these novel integrated precision irradiators and various small animal imaging devices, and to maximize the impact of the associated research, the ESTRO committee on coordinating guidelines ACROP (Advisory Committee in Radiation Oncology Practice) has commissioned a report to review the state of the art of the technology used in this new field of research, and to issue recommendations. This report discusses the combination of precision irradiation systems, small animal imaging (CT, MRI, PET, SPECT, bioluminescence) systems, image registration, treatment planning, and data processing. It also provides guidelines for reporting on studies.
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Affiliation(s)
- Frank Verhaegen
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
| | - Ludwig Dubois
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
| | | | - Mark A Hill
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, UK
| | - Christian P Karger
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg, Germany; National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Kirsten Lauber
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-University of Munich, Germany
| | - Kevin M Prise
- Centre for Cancer Research & Cell Biology, Queen's University Belfast, UK
| | - David Sarrut
- Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Centre Léon Bérard, France
| | - Daniela Thorwarth
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Germany
| | - Christian Vanhove
- Institute Biomedical Technology (IBiTech), Medical Imaging and Signal Processing (MEDISIP), Ghent University, Belgium
| | - Boris Vojnovic
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, UK
| | - Robert Weersink
- Department of Radiation Oncology, University of Toronto, Department of Radiation Medicine, Princess Margaret Hospital, Canada
| | - Jan J Wilkens
- Department of Radiation Oncology, Technical University of Munich, Klinikum rechts der Isar, Germany
| | - Dietmar Georg
- Division of Medical Radiation Physics, Department of Radiation Oncology and Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria
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11
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Hill MA, Thompson JM, Kavanagh A, Tullis IDC, Newman RG, Prentice J, Beech J, Gilchrist S, Smart S, Fokas E, Vojnovic B. The Development of Technology for Effective Respiratory-Gated Irradiation Using an Image-Guided Small Animal Irradiator. Radiat Res 2017; 188:247-263. [PMID: 28715250 DOI: 10.1667/rr14753.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The development of image-guided small animal irradiators represents a significant improvement over standard irradiators by enabling preclinical studies to mimic radiotherapy in humans. The ability to deliver tightly collimated targeted beams, in conjunction with gantry or animal couch rotation, has the potential to maximize tumor dose while sparing normal tissues. However, the current commercial platforms do not incorporate respiratory gating, which is required for accurate and precise targeting in organs subject to respiration related motions that may be up to the order of 5 mm in mice. Therefore, a new treatment head assembly for the Xstrahl Small Animal Radiation Research Platform (SARRP) has been designed. This includes a fast X-ray shutter subsystem, a motorized beam hardening filter assembly, an integrated transmission ionization chamber to monitor beam delivery, a kinematically positioned removable beam collimator and a targeting laser exiting the center of the beam collimator. The X-ray shutter not only minimizes timing errors but also allows beam gating during imaging and treatment, with irradiation only taking place during the breathing cycle when tissue movement is minimal. The breathing related movement is monitored by measuring, using a synchronous detector/lock-in amplifier that processes diffuse reflectance light from a modulated light source. After thresholding of the resulting signal, delays are added around the inhalation/exhalation phases, enabling the "no movement" period to be isolated and to open the X-ray shutter. Irradiation can either be performed for a predetermined time of X-ray exposure, or through integration of a current from the transmission monitor ionization chamber (corrected locally for air density variations). The ability to successfully deliver respiratory-gated X-ray irradiations has been demonstrated by comparing movies obtained using planar X-ray imaging with and without respiratory gating, in addition to comparing dose profiles observed from a collimated beam on EBT3 radiochromic film mounted on the animal's chest. Altogether, the development of respiratory-gated irradiation facilitates improved dose delivery during animal movement and constitutes an important new tool for preclinical radiation studies. This approach is particularly well suited for irradiation of orthotopic tumors or other targets within the chest and abdomen where breathing related movement is significant.
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Affiliation(s)
- M A Hill
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - J M Thompson
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - A Kavanagh
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - I D C Tullis
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - R G Newman
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - J Prentice
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - J Beech
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - S Gilchrist
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - S Smart
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - E Fokas
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
| | - B Vojnovic
- Cancer Research UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Gray Laboratories, Oxford OX3 7DQ, United Kingdom
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Kufeld M, Escobar H, Marg A, Pasemann D, Budach V, Spuler S. Localized irradiation of mouse legs using an image-guided robotic linear accelerator. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:156. [PMID: 28480192 DOI: 10.21037/atm.2017.03.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To investigate the potential of human satellite cells in muscle regeneration small animal models are useful to evaluate muscle regeneration. To suppress the inherent regeneration ability of the tibialis muscle of mice before transplantation of human muscle fibers, a localized irradiation of the mouse leg should be conducted. We analyzed the feasibility of an image-guided robotic irradiation procedure, a routine treatment method in radiation oncology, for the focal irradiation of mouse legs. METHODS After conducting a planning computed tomography (CT) scan of one mouse in its customized mold a three-dimensional dose plan was calculated using a dedicated planning workstation. 18 Gy have been applied to the right anterior tibial muscle of 4 healthy and 12 mice with immune defect in general anesthesia using an image-guided robotic linear accelerator (LINAC). The mice were fixed in a customized acrylic mold with attached fiducial markers for image guided tracking. RESULTS All 16 mice could be irradiated as prevised without signs of acute radiation toxicity or anesthesiological side effects. The animals survived until scarification after 8, 21 and 49 days as planned. The procedure was straight forward and the irradiation process took 5 minutes to apply the dose of 18 Gy. CONCLUSIONS Localized irradiation of mice legs using a robotic LINAC could be conducted as planned. It is a feasible procedure without recognizable side effects. Image guidance offers precise dose delivery and preserves adjacent body parts and tissues.
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Affiliation(s)
- Markus Kufeld
- Charité CyberKnife Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Helena Escobar
- Max Delbrück Center for Molecular Medicine, Mobile DNA group, Berlin, Germany
| | - Andreas Marg
- Muscle Research Unit, Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Diana Pasemann
- Charité CyberKnife Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Volker Budach
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Simone Spuler
- Muscle Research Unit, Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine, Berlin, Germany
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13
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Sharma S, Narayanasamy G, Clarkson R, Chao M, Moros EG, Zhang X, Yan Y, Boerma M, Paudel N, Morrill S, Corry P, Griffin RJ. Study of Image Qualities From 6D Robot-Based CBCT Imaging System of Small Animal Irradiator. Technol Cancer Res Treat 2017; 16:811-818. [PMID: 28355964 PMCID: PMC5762036 DOI: 10.1177/1533034617700558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To assess the quality of cone beam computed tomography images obtained by a robotic arm-based and image-guided small animal conformal radiation therapy device. Method and Materials: The small animal conformal radiation therapy device is equipped with a 40 to 225 kV X-ray tube mounted on a custom made gantry, a 1024 × 1024 pixels flat panel detector (200 μm resolution), a programmable 6 degrees of freedom robot for cone beam computed tomography imaging and conformal delivery of radiation doses. A series of 2-dimensional radiographic projection images were recorded in cone beam mode by placing and rotating microcomputed tomography phantoms on the “palm’ of the robotic arm. Reconstructed images were studied for image quality (spatial resolution, image uniformity, computed tomography number linearity, voxel noise, and artifacts). Results: Geometric accuracy was measured to be 2% corresponding to 0.7 mm accuracy on a Shelley microcomputed tomography QA phantom. Qualitative resolution of reconstructed axial computed tomography slices using the resolution coils was within 200 μm. Quantitative spatial resolution was found to be 3.16 lp/mm. Uniformity of the system was measured within 34 Hounsfield unit on a QRM microcomputed tomography water phantom. Computed tomography numbers measured using the linearity plate were linear with material density (R2 > 0.995). Cone beam computed tomography images of the QRM multidisk phantom had minimal artifacts. Conclusion: Results showed that the small animal conformal radiation therapy device is capable of producing high-quality cone beam computed tomography images for precise and conformal small animal dose delivery. With its high-caliber imaging capabilities, the small animal conformal radiation therapy device is a powerful tool for small animal research.
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Affiliation(s)
- Sunil Sharma
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Department of Radiation Oncology, East Carolina University, Greenville, NC, USA
| | - Ganesh Narayanasamy
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Richard Clarkson
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ming Chao
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Radiation Oncology, Mount Sinai Hospital, New York, NY, USA
| | - Eduardo G Moros
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Xin Zhang
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yulong Yan
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Department of Radiation Oncology, University of Texas Southwestern, Dallas, TX, USA
| | - Marjan Boerma
- Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nava Paudel
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Steven Morrill
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Peter Corry
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Robert J Griffin
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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14
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Felix MC, Glatting G, Giordano FA, Brockmann MA, Wenz F, Fleckenstein J. Collimator optimization for small animal radiation therapy at a micro-CT. Z Med Phys 2017; 27:56-64. [DOI: 10.1016/j.zemedi.2016.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 05/22/2016] [Accepted: 05/25/2016] [Indexed: 11/16/2022]
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15
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Karagounis IV, Abatzoglou IM, Koukourakis MI. Technical Note: Partial body irradiation of mice using a customized PMMA apparatus and a clinical 3D planning/LINAC radiotherapy system. Med Phys 2017; 43:2200. [PMID: 27147332 DOI: 10.1118/1.4945274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In vivo radiobiology experiments involving partial body irradiation (PBI) of mice are of major importance because they allow for the evaluation of individual organ tolerance; overcoming current limitations of experiments using lower dose, whole body irradiation. In the current study, the authors characterize and validate an effective and efficient apparatus for multiple animal PBI, directed to the head, thorax, or abdomen of mice. METHODS The apparatus is made of polymethylmethacrylate and consists of a rectangular parallelepiped prism (40 cm × 16 cm × 8 cm), in which five holes were drilled to accomodate standard 60 ml syringes, each housing an unanesthetized, fully immobilized mouse. Following CT-scanning and radiotherapy treatment planning, radiation fields were designed to irradiate the head, thorax, or abdomen of the animal. Thermoluminescent dosimeters (TLDs) were used to confirm the treatment planning dosimetry for primary beam and scattered radiation. RESULTS Mice are efficiently placed into 60 ml syringes and immobilized, without the use of anesthetics. Although partial rotational movement around the longitudinal axis and a minor 2 mm forward/backward movement are permitted, this does not compromise the irradiation of the chosen body area. TLDs confirmed the dose values predicted by the treatment planning dosimetry, both for primary beam and scattered radiation. CONCLUSIONS The customized PMMA apparatus described and validated is cost-effective, convenient to use, and efficient in performing PBI without the use of anesthesia. The developed apparatus permits the isolated irradiation of the mouse head, thorax, and abdomen. Importantly, the apparatus allows the delivery of PBI to five mice, simultaneously, representing an efficient way to effectively expose a large number of animals to PBI through multiple daily fractions, simulating clinical radiotherapy treatment schedules.
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Affiliation(s)
- Ilias V Karagounis
- Department of Radiotherapy-Oncology, Radiopathology and Radiobiology Unit, Medical School, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Ioannis M Abatzoglou
- Medical Physics Department, University General Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
| | - Michael I Koukourakis
- Department of Radiotherapy-Oncology, Radiopathology and Radiobiology Unit, Medical School, Democritus University of Thrace, Alexandroupolis 68100, Greece
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16
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Yu J, Zhang B, Iordachita II, Reyes J, Lu Z, Brock MV, Patterson MS, Wong JW, Wang KKH. Systematic study of target localization for bioluminescence tomography guided radiation therapy. Med Phys 2017; 43:2619. [PMID: 27147371 DOI: 10.1118/1.4947481] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To overcome the limitation of CT/cone-beam CT (CBCT) in guiding radiation for soft tissue targets, the authors developed a spectrally resolved bioluminescence tomography (BLT) system for the small animal radiation research platform. The authors systematically assessed the performance of the BLT system in terms of target localization and the ability to resolve two neighboring sources in simulations, tissue-mimicking phantom, and in vivo environments. METHODS Multispectral measurements acquired in a single projection were used for the BLT reconstruction. The incomplete variables truncated conjugate gradient algorithm with an iterative permissible region shrinking strategy was employed as the optimization scheme to reconstruct source distributions. Simulation studies were conducted for single spherical sources with sizes from 0.5 to 3 mm radius at depth of 3-12 mm. The same configuration was also applied for the double source simulation with source separations varying from 3 to 9 mm. Experiments were performed in a standalone BLT/CBCT system. Two self-illuminated sources with 3 and 4.7 mm separations placed inside a tissue-mimicking phantom were chosen as the test cases. Live mice implanted with single-source at 6 and 9 mm depth, two sources at 3 and 5 mm separation at depth of 5 mm, or three sources in the abdomen were also used to illustrate the localization capability of the BLT system for multiple targets in vivo. RESULTS For simulation study, approximate 1 mm accuracy can be achieved at localizing center of mass (CoM) for single-source and grouped CoM for double source cases. For the case of 1.5 mm radius source, a common tumor size used in preclinical study, their simulation shows that for all the source separations considered, except for the 3 mm separation at 9 and 12 mm depth, the two neighboring sources can be resolved at depths from 3 to 12 mm. Phantom experiments illustrated that 2D bioluminescence imaging failed to distinguish two sources, but BLT can provide 3D source localization with approximately 1 mm accuracy. The in vivo results are encouraging that 1 and 1.7 mm accuracy can be attained for the single-source case at 6 and 9 mm depth, respectively. For the 2 sources in vivo study, both sources can be distinguished at 3 and 5 mm separations, and approximately 1 mm localization accuracy can also be achieved. CONCLUSIONS This study demonstrated that their multispectral BLT/CBCT system could be potentially applied to localize and resolve multiple sources at wide range of source sizes, depths, and separations. The average accuracy of localizing CoM for single-source and grouped CoM for double sources is approximately 1 mm except deep-seated target. The information provided in this study can be instructive to devise treatment margins for BLT-guided irradiation. These results also suggest that the 3D BLT system could guide radiation for the situation with multiple targets, such as metastatic tumor models.
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Affiliation(s)
- Jingjing Yu
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231 and School of Physics and Information Technology, Shaanxi Normal University, Shaanxi 710119, China
| | - Bin Zhang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231
| | - Iulian I Iordachita
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland 21218
| | - Juvenal Reyes
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231
| | - Zhihao Lu
- Department of Oncology and Department of Surgery, Johns Hopkins University, Baltimore, Maryland 21231 and Key laboratory of Carcinogenesis and Translational Research, Department of GI Oncology, Peking University, Beijing Cancer Hospital and Institute, Beijing 100142, China
| | - Malcolm V Brock
- Department of Oncology and Department of Surgery, Johns Hopkins University, Baltimore, Maryland 21231
| | - Michael S Patterson
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - John W Wong
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231
| | - Ken Kang-Hsin Wang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231
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Sharma S, Narayanasamy G, Przybyla B, Webber J, Boerma M, Clarkson R, Moros EG, Corry PM, Griffin RJ. Advanced Small Animal Conformal Radiation Therapy Device. Technol Cancer Res Treat 2017; 16:45-56. [PMID: 26792490 PMCID: PMC5616115 DOI: 10.1177/1533034615626011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/01/2015] [Accepted: 12/16/2015] [Indexed: 11/16/2022] Open
Abstract
We have developed a small animal conformal radiation therapy device that provides a degree of geometrical/anatomical targeting comparable to what is achievable in a commercial animal irradiator. small animal conformal radiation therapy device is capable of producing precise and accurate conformal delivery of radiation to target as well as for imaging small animals. The small animal conformal radiation therapy device uses an X-ray tube, a robotic animal position system, and a digital imager. The system is in a steel enclosure with adequate lead shielding following National Council on Radiation Protection and Measurements 49 guidelines and verified with Geiger-Mueller survey meter. The X-ray source is calibrated following AAPM TG-61 specifications and mounted at 101.6 cm from the floor, which is a primary barrier. The X-ray tube is mounted on a custom-made "gantry" and has a special collimating assembly system that allows field size between 0.5 mm and 20 cm at isocenter. Three-dimensional imaging can be performed to aid target localization using the same X-ray source at custom settings and an in-house reconstruction software. The small animal conformal radiation therapy device thus provides an excellent integrated system to promote translational research in radiation oncology in an academic laboratory. The purpose of this article is to review shielding and dosimetric measurement and highlight a few successful studies that have been performed to date with our system. In addition, an example of new data from an in vivo rat model of breast cancer is presented in which spatially fractionated radiation alone and in combination with thermal ablation was applied and the therapeutic benefit examined.
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Affiliation(s)
- Sunil Sharma
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ganesh Narayanasamy
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Beata Przybyla
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jessica Webber
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Marjan Boerma
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Richard Clarkson
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eduardo G. Moros
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Peter M. Corry
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Robert J. Griffin
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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18
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Schüler E, Trovati S, King G, Lartey F, Rafat M, Villegas M, Praxel AJ, Loo BW, Maxim PG. Experimental Platform for Ultra-high Dose Rate FLASH Irradiation of Small Animals Using a Clinical Linear Accelerator. Int J Radiat Oncol Biol Phys 2017; 97:195-203. [DOI: 10.1016/j.ijrobp.2016.09.018] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/15/2016] [Accepted: 09/14/2016] [Indexed: 11/24/2022]
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19
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Ford E, Emery R, Huff D, Narayanan M, Schwartz J, Cao N, Meyer J, Rengan R, Zeng J, Sandison G, Laramore G, Mayr N. An image-guided precision proton radiation platform for preclinicalin vivoresearch. Phys Med Biol 2016; 62:43-58. [DOI: 10.1088/1361-6560/62/1/43] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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20
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Reinhart AM, Fast MF, Ziegenhein P, Nill S, Oelfke U. A kernel-based dose calculation algorithm for kV photon beams with explicit handling of energy and material dependencies. Br J Radiol 2016; 90:20160426. [PMID: 27785933 PMCID: PMC5605017 DOI: 10.1259/bjr.20160426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: Mimicking state-of-the-art patient radiotherapy with high-precision irradiators for small animals is expected to advance the understanding of dose–effect relationships and radiobiology in general. We work on the implementation of intensity-modulated radiotherapy-like irradiation schemes for small animals. As a first step, we present a fast analytical dose calculation algorithm for keV photon beams. Methods: We follow a superposition–convolution approach adapted to kV X-rays, based on previous work for microbeam therapy. We assume local energy deposition at the photon interaction point due to the short electron ranges in tissue. This allows us to separate the dose calculation into locally absorbed primary dose and the scatter contribution, calculated in a point kernel approach. We validate our dose model against Geant4 Monte Carlo (MC) simulations and compare the results to Muriplan (XStrahl Ltd, Camberley, UK). Results: For field sizes of (1 mm)2 to (1 cm)2 in water, the depth dose curves show a mean disagreement of 1.7% to MC simulations, with the largest deviations in the entrance region (4%) and at large depths (5% at 7 cm). Larger discrepancies are observed at water-to-bone boundaries, in bone and at the beam edges in slab phantoms and a mouse brain. Calculation times are in the order of 5 s for a single beam. Conclusion: The algorithm shows good agreement with MC simulations in an initial validation. It has the potential to become an alternative to full MC dose calculation. Advances in knowledge: The presented algorithm demonstrates the potential of kernel-based dose calculation for kV photon beams. It will be valuable in intensity-modulated radiotherapy and inverse treatment planning for high precision small-animal radiotherapy.
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Affiliation(s)
- Anna Merle Reinhart
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Martin F Fast
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Peter Ziegenhein
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Simeon Nill
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Uwe Oelfke
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
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21
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Xie T, Zaidi H. Development of computational small animal models and their applications in preclinical imaging and therapy research. Med Phys 2016; 43:111. [PMID: 26745904 DOI: 10.1118/1.4937598] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The development of multimodality preclinical imaging techniques and the rapid growth of realistic computer simulation tools have promoted the construction and application of computational laboratory animal models in preclinical research. Since the early 1990s, over 120 realistic computational animal models have been reported in the literature and used as surrogates to characterize the anatomy of actual animals for the simulation of preclinical studies involving the use of bioluminescence tomography, fluorescence molecular tomography, positron emission tomography, single-photon emission computed tomography, microcomputed tomography, magnetic resonance imaging, and optical imaging. Other applications include electromagnetic field simulation, ionizing and nonionizing radiation dosimetry, and the development and evaluation of new methodologies for multimodality image coregistration, segmentation, and reconstruction of small animal images. This paper provides a comprehensive review of the history and fundamental technologies used for the development of computational small animal models with a particular focus on their application in preclinical imaging as well as nonionizing and ionizing radiation dosimetry calculations. An overview of the overall process involved in the design of these models, including the fundamental elements used for the construction of different types of computational models, the identification of original anatomical data, the simulation tools used for solving various computational problems, and the applications of computational animal models in preclinical research. The authors also analyze the characteristics of categories of computational models (stylized, voxel-based, and boundary representation) and discuss the technical challenges faced at the present time as well as research needs in the future.
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Affiliation(s)
- Tianwu Xie
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva 4 CH-1211, Switzerland
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva 4 CH-1211, Switzerland; Geneva Neuroscience Center, Geneva University, Geneva CH-1205, Switzerland; and Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen 9700 RB, The Netherlands
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Ford E, Deye J. Current Instrumentation and Technologies in Modern Radiobiology Research—Opportunities and Challenges. Semin Radiat Oncol 2016; 26:349-55. [DOI: 10.1016/j.semradonc.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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23
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Awan MJ, Dorth J, Mani A, Kim H, Zheng Y, Mislmani M, Welford S, Yuan J, Wessels BW, Lo SS, Letterio J, Machtay M, Sloan A, Sohn JW. Development and Validation of a Small Animal Immobilizer and Positioning System for the Study of Delivery of Intracranial and Extracranial Radiotherapy Using the Gamma Knife System. Technol Cancer Res Treat 2016; 16:203-210. [PMID: 27444980 DOI: 10.1177/1533034616658394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The purpose of this research is to establish a process of irradiating mice using the Gamma Knife as a versatile system for small animal irradiation and to validate accurate intracranial and extracranial dose delivery using this system. A stereotactic immobilization device was developed for small animals for the Gamma Knife head frame allowing for isocentric dose delivery. Intercranial positional reproducibility of a reference point from a primary reference animal was verified on an additional mouse. Extracranial positional reproducibility of the mouse aorta was verified using 3 mice. Accurate dose delivery was validated using film and thermoluminescent dosimeter measurements with a solid water phantom. Gamma Knife plans were developed to irradiate intracranial and extracranial targets. Mice were irradiated validating successful targeted radiation dose delivery. Intramouse positional variability of the right mandible reference point across 10 micro-computed tomography scans was 0.65 ± 0.48 mm. Intermouse positional reproducibility across 2 mice at the same reference point was 0.76 ± 0.46 mm. The accuracy of dose delivery was 0.67 ± 0.29 mm and 1.01 ± 0.43 mm in the coronal and sagittal planes, respectively. The planned dose delivered to a mouse phantom was 2 Gy at the 50% isodose with a measured thermoluminescent dosimeter dose of 2.9 ± 0.3 Gy. The phosphorylated form of member X of histone family H2A (γH2AX) staining of irradiated mouse brain and mouse aorta demonstrated adjacent tissue sparing. In conclusion, our system for preclinical studies of small animal irradiation using the Gamma Knife is able to accurately deliver intracranial and extracranial targeted focal radiation allowing for preclinical experiments studying focal radiation.
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Affiliation(s)
- Musaddiq J Awan
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Jennifer Dorth
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Arvind Mani
- 2 Department of Computer Science and Electrical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Haksoo Kim
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Yiran Zheng
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Mazen Mislmani
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Scott Welford
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Jiankui Yuan
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Barry W Wessels
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Simon S Lo
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - John Letterio
- 3 Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
| | - Mitchell Machtay
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
| | - Andrew Sloan
- 4 Department of Neurosurgery, Case Western Reserve University, Cleveland, OH, USA
| | - Jason W Sohn
- 1 Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, USA
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Noblet C, Chiavassa S, Smekens F, Sarrut D, Passal V, Suhard J, Lisbona A, Paris F, Delpon G. Validation of fast Monte Carlo dose calculation in small animal radiotherapy with EBT3 radiochromic films. Phys Med Biol 2016; 61:3521-35. [DOI: 10.1088/0031-9155/61/9/3521] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tillner F, Thute P, Löck S, Dietrich A, Fursov A, Haase R, Lukas M, Rimarzig B, Sobiella M, Krause M, Baumann M, Bütof R, Enghardt W. Precise image-guided irradiation of small animals: a flexible non-profit platform. Phys Med Biol 2016; 61:3084-108. [DOI: 10.1088/0031-9155/61/8/3084] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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26
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Zhang B, Wang KKH, Yu J, Eslami S, Iordachita I, Reyes J, Malek R, Tran PT, Patterson MS, Wong JW. Bioluminescence Tomography-Guided Radiation Therapy for Preclinical Research. Int J Radiat Oncol Biol Phys 2015; 94:1144-53. [PMID: 26876954 DOI: 10.1016/j.ijrobp.2015.11.039] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 10/26/2015] [Accepted: 11/29/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE In preclinical radiation research, it is challenging to localize soft tissue targets based on cone beam computed tomography (CBCT) guidance. As a more effective method to localize soft tissue targets, we developed an online bioluminescence tomography (BLT) system for small-animal radiation research platform (SARRP). We demonstrated BLT-guided radiation therapy and validated targeting accuracy based on a newly developed reconstruction algorithm. METHODS AND MATERIALS The BLT system was designed to dock with the SARRP for image acquisition and to be detached before radiation delivery. A 3-mirror system was devised to reflect the bioluminescence emitted from the subject to a stationary charge-coupled device (CCD) camera. Multispectral BLT and the incomplete variables truncated conjugate gradient method with a permissible region shrinking strategy were used as the optimization scheme to reconstruct bioluminescent source distributions. To validate BLT targeting accuracy, a small cylindrical light source with high CBCT contrast was placed in a phantom and also in the abdomen of a mouse carcass. The center of mass (CoM) of the source was recovered from BLT and used to guide radiation delivery. The accuracy of the BLT-guided targeting was validated with films and compared with the CBCT-guided delivery. In vivo experiments were conducted to demonstrate BLT localization capability for various source geometries. RESULTS Online BLT was able to recover the CoM of the embedded light source with an average accuracy of 1 mm compared to that with CBCT localization. Differences between BLT- and CBCT-guided irradiation shown on the films were consistent with the source localization revealed in the BLT and CBCT images. In vivo results demonstrated that our BLT system could potentially be applied for multiple targets and tumors. CONCLUSIONS The online BLT/CBCT/SARRP system provides an effective solution for soft tissue targeting, particularly for small, nonpalpable, or orthotopic tumor models.
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Affiliation(s)
- Bin Zhang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ken Kang-Hsin Wang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Jingjing Yu
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland; School of Physics and Information Technology, Shaanxi Normal University, Shaanxi, China
| | - Sohrab Eslami
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland
| | - Juvenal Reyes
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Reem Malek
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Phuoc T Tran
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Oncology and Urology, Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland
| | - Michael S Patterson
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - John W Wong
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
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Stewart JMP, Ansell S, Lindsay PE, Jaffray DA. Online virtual isocenter based radiation field targeting for high performance small animal microirradiation. Phys Med Biol 2015; 60:9031-46. [PMID: 26540304 DOI: 10.1088/0031-9155/60/23/9031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Advances in precision microirradiators for small animal radiation oncology studies have provided the framework for novel translational radiobiological studies. Such systems target radiation fields at the scale required for small animal investigations, typically through a combination of on-board computed tomography image guidance and fixed, interchangeable collimators. Robust targeting accuracy of these radiation fields remains challenging, particularly at the millimetre scale field sizes achievable by the majority of microirradiators. Consistent and reproducible targeting accuracy is further hindered as collimators are removed and inserted during a typical experimental workflow. This investigation quantified this targeting uncertainty and developed an online method based on a virtual treatment isocenter to actively ensure high performance targeting accuracy for all radiation field sizes. The results indicated that the two-dimensional field placement uncertainty was as high as 1.16 mm at isocenter, with simulations suggesting this error could be reduced to 0.20 mm using the online correction method. End-to-end targeting analysis of a ball bearing target on radiochromic film sections showed an improved targeting accuracy with the three-dimensional vector targeting error across six different collimators reduced from [Formula: see text] mm (mean ± SD) to [Formula: see text] mm for an isotropic imaging voxel size of 0.1 mm.
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Affiliation(s)
- James M P Stewart
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5S 3E2, Canada. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada
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Felix MC, Fleckenstein J, Kirschner S, Hartmann L, Wenz F, Brockmann MA, Glatting G, Giordano FA. Image-Guided Radiotherapy Using a Modified Industrial Micro-CT for Preclinical Applications. PLoS One 2015; 10:e0126246. [PMID: 25993010 PMCID: PMC4438006 DOI: 10.1371/journal.pone.0126246] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/30/2015] [Indexed: 11/30/2022] Open
Abstract
Purpose/Objective Although radiotherapy is a key component of cancer treatment, its implementation into pre-clinical in vivo models with relatively small target volumes is frequently omitted either due to technical complexity or expected side effects hampering long-term observational studies. We here demonstrate how an affordable industrial micro-CT can be converted into a small animal IGRT device at very low costs. We also demonstrate the proof of principle for the case of partial brain irradiation of mice carrying orthotopic glioblastoma implants. Methods/Materials A commercially available micro-CT originally designed for non-destructive material analysis was used. It consists of a CNC manipulator, a transmission X-ray tube (10–160 kV) and a flat-panel detector, which was used together with custom-made steel collimators (1–5 mm aperture size). For radiation field characterization, an ionization chamber, water-equivalent slab phantoms and radiochromic films were used. A treatment planning tool was implemented using a C++ application. For proof of principle, NOD/SCID/γc−/− mice were orthotopically implanted with U87MG high-grade glioma cells and irradiated using the novel setup. Results The overall symmetry of the radiation field at 150 kV was 1.04±0.02%. The flatness was 4.99±0.63% and the penumbra widths were between 0.14 mm and 0.51 mm. The full width at half maximum (FWHM) ranged from 1.97 to 9.99 mm depending on the collimator aperture size. The dose depth curve along the central axis followed a typical shape of keV photons. Dose rates measured were 10.7 mGy/s in 1 mm and 7.6 mGy/s in 5 mm depth (5 mm collimator aperture size). Treatment of mice with a single dose of 10 Gy was tolerated well and resulted in central tumor necrosis consistent with therapeutic efficacy. Conclusion A conventional industrial micro-CT can be easily modified to allow effective small animal IGRT even of critical target volumes such as the brain.
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Affiliation(s)
- Manuela C. Felix
- Medical Radiation Physics/Radiation Protection, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jens Fleckenstein
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefanie Kirschner
- Department of Neuroradiology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Linda Hartmann
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frederik Wenz
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marc A. Brockmann
- Department of Neuroradiology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Aachen, Germany
| | - Gerhard Glatting
- Medical Radiation Physics/Radiation Protection, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- * E-mail:
| | - Frank A. Giordano
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Jeong J, Chen Q, Febo R, Yang J, Pham H, Xiong JP, Zanzonico PB, Deasy JO, Humm JL, Mageras GS. Adaptation, Commissioning, and Evaluation of a 3D Treatment Planning System for High-Resolution Small-Animal Irradiation. Technol Cancer Res Treat 2015; 15:460-71. [PMID: 25948321 DOI: 10.1177/1533034615584522] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/01/2015] [Indexed: 01/24/2023] Open
Abstract
Although spatially precise systems are now available for small-animal irradiations, there are currently limited software tools available for treatment planning for such irradiations. We report on the adaptation, commissioning, and evaluation of a 3-dimensional treatment planning system for use with a small-animal irradiation system. The 225-kV X-ray beam of the X-RAD 225Cx microirradiator (Precision X-Ray) was commissioned using both ion-chamber and radiochromic film for 10 different collimators ranging in field size from 1 mm in diameter to 40 × 40 mm(2) A clinical 3-dimensional treatment planning system (Metropolis) developed at our institution was adapted to small-animal irradiation by making it compatible with the dimensions of mice and rats, modeling the microirradiator beam orientations and collimators, and incorporating the measured beam data for dose calculation. Dose calculations in Metropolis were verified by comparison with measurements in phantoms. Treatment plans for irradiation of a tumor-bearing mouse were generated with both the Metropolis and the vendor-supplied software. The calculated beam-on times and the plan evaluation tools were compared. The dose rate at the central axis ranges from 74 to 365 cGy/min depending on the collimator size. Doses calculated with Metropolis agreed with phantom measurements within 3% for all collimators. The beam-on times calculated by Metropolis and the vendor-supplied software agreed within 1% at the isocenter. The modified 3-dimensional treatment planning system provides better visualization of the relationship between the X-ray beams and the small-animal anatomy as well as more complete dosimetric information on target tissues and organs at risk. It thereby enhances the potential of image-guided microirradiator systems for evaluation of dose-response relationships and for preclinical experimentation generally.
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Affiliation(s)
- Jeho Jeong
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Qing Chen
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Robert Febo
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Jie Yang
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Hai Pham
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Jian-Ping Xiong
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Pat B Zanzonico
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - John L Humm
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Gig S Mageras
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Frenzel T, Grohmann C, Schumacher U, Krüll A. Partial body irradiation of small laboratory animals with an industrial X-ray tube. Z Med Phys 2014; 24:352-62. [DOI: 10.1016/j.zemedi.2014.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 02/06/2014] [Accepted: 02/06/2014] [Indexed: 11/28/2022]
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Sharma S, Moros EG, Boerma M, Sridharan V, Han EY, Clarkson R, Hauer-Jensen M, Corry PM. A novel technique for image-guided local heart irradiation in the rat. Technol Cancer Res Treat 2014; 13:593-603. [PMID: 24000983 PMCID: PMC3951712 DOI: 10.7785/tcrtexpress.2013.600256] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/28/2013] [Accepted: 01/30/2013] [Indexed: 11/06/2022] Open
Abstract
In radiotherapy treatment of thoracic, breast and chest wall tumors, the heart may be included (partially or fully) in the radiation field. As a result, patients may develop radiation-induced heart disease (RIHD) several years after exposure to radiation. There are few methods available to prevent or reverse RIHD and the biological mechanisms remain poorly understood. In order to further study the effects of radiation on the heart, we developed a model of local heart irradiation in rats using an image-guided small animal conformal radiation therapy device (SACRTD) developed at our institution. First, Monte Carlo based simulations were used to design an appropriate collimator. EBT-2 films were used to measure relative dosimetry, and the absolute dose rate at the isocenter was measured using the AAPM protocol TG-61. The hearts of adult male Sprague-Dawley rats were irradiated with a total dose of 21 Gy. For this purpose, rats were anesthetized with isoflurane and placed in a custom-made vertical rat holder. Each heart was irradiated with a 3-beam technique (one AP field and 2 lateral fields), with each beam delivering 7 Gy. For each field, the heart was visualized with a digital flat panel X-ray imager and placed at the isocenter of the 1.8 cm diameter beam. In biological analysis of radiation exposure, immunohistochemistry showed γH2Ax foci and nitrotyrosine throughout the irradiated hearts but not in the lungs. Long-term follow-up of animals revealed histopathological manifestations of RIHD, including myocardial degeneration and fibrosis. The results demonstrate that the rat heart irradiation technique using the SACRTD was successful and that surrounding untargeted tissues were spared, making this approach a powerful tool for in vivo radiobiological studies of RIHD. Functional and structural changes in the rat heart after local irradiation are ongoing.
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Affiliation(s)
- Sunil Sharma
- Department of Radiation Oncology, Radiation Oncology Center, University of Arkansas for Medical _Sciences, Little Rock, AR .
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Tillner F, Thute P, Bütof R, Krause M, Enghardt W. Pre-clinical research in small animals using radiotherapy technology – a bidirectional translational approach. Z Med Phys 2014; 24:335-51. [DOI: 10.1016/j.zemedi.2014.07.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 07/18/2014] [Accepted: 07/18/2014] [Indexed: 01/17/2023]
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Verhaegen F, van Hoof S, Granton PV, Trani D. A review of treatment planning for precision image-guided photon beam pre-clinical animal radiation studies. Z Med Phys 2014; 24:323-34. [DOI: 10.1016/j.zemedi.2014.02.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 12/31/2022]
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Butterworth KT, Redmond KM, McMahon SJ, Cole AJ, Jain S, McCarthy HO, O'Sullivan JM, Hounsell AR, Prise KM. Conventional in vivo irradiation procedures are insufficient to accurately determine tumor responses to non-uniform radiation fields. Int J Radiat Biol 2014; 91:257-61. [PMID: 25347147 DOI: 10.3109/09553002.2014.980468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To determine differences in overall tumor responses measured by volumetric assessment and bioluminescence imaging (BLI) following exposure to uniform and non-uniform radiation fields in an ectopic prostate tumor model. MATERIALS AND METHODS Bioluminescent human prostate tumor xenografts were established by subcutaneous implantation into male mice. Tumors were irradiated with uniform or non-uniform field configurations using conventional in vivo irradiation procedures performed using a 225 kVp generator with custom lead shielding. Tumor responses were measured using Vernier calipers and by BLI using an in vivo imaging system. Survival was defined as the time to quadroupling of pre-treatment tumor volume. RESULTS The correlation between BLI and tumor volume measurements was found to be different for un-irradiated (R = 0.61), uniformly irradiated (R = 0.34) and partially irradiated (R = 0.30) tumors. Uniformly irradiated tumors resulted in an average tumor growth delay of 60 days with median survival of 75 days, compared to partially irradiated tumors which showed an average growth delay of 24 days and median survival of 38 days. CONCLUSIONS Correlation between BLI and tumor volume measurements is lower for partially irradiated tumors than those exposed to uniform dose distributions. The response of partially irradiated tumors suggests non-uniformity in response beyond physical dose distribution within the target volume. Dosimetric uncertainty associated with conventional in vivo irradiation procedures prohibits their ability to accurately determine tumor response to non-uniform radiation fields and stresses the need for image guided small animal radiation research platforms.
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Affiliation(s)
- Karl T Butterworth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast
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Grams MP, Wilson ZC, Sio TT, Beltran CJ, Tryggestad EJ, Gupta SK, Blackwell CR, McCollough KP, Sarkaria JN, Furutani KM. Design and characterization of an economical (192)Ir hemi-brain small animal irradiator. Int J Radiat Biol 2014; 90:936-942. [PMID: 24844370 PMCID: PMC4564891 DOI: 10.3109/09553002.2014.922719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the design and dosimetric characterization of a simple and economical small animal irradiator. MATERIALS AND METHODS A high dose rate (HDR) (192)Ir brachytherapy source from a commercially available afterloader was used with a 1.3 cm thick tungsten collimator to provide sharp beam penumbra suitable for hemi-brain irradiation of mice. The unit was equipped with continuous gas anesthesia to allow robust animal immobilization. Dosimetric characterization of the device was performed with Gafchromic film measurements. RESULTS The tungsten collimator provided a sharp penumbra suitable for hemi-brain irradiation, and dose rates on the order of 200 cGy/minute were achieved. The sharpness of the penumbra attainable with this device compares favorably to those measured experimentally for 6 MV photons, and 6 and 20 MeV electron beams from a linear accelerator, and was comparable to those measured for a 300 kVp orthovoltage beam and a Monte Carlo simulated 90 MeV proton beam. CONCLUSIONS Due to its simplicity and low cost, the apparatus described is an attractive alternative for small animal irradiation experiments requiring steep dose gradients.
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Affiliation(s)
- Michael P Grams
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Zachary C Wilson
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Terence T Sio
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Chris J Beltran
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Erik J Tryggestad
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Shiv K Gupta
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Charles R Blackwell
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Kevin P McCollough
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Jann N Sarkaria
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
| | - Keith M Furutani
- Department of Radiation Oncology , Mayo Clinic , Rochester , Minnesota , USA
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Kim H, Fabien J, Zheng Y, Yuan J, Brindle J, Sloan A, Yao M, Lo S, Wessels B, Machtay M, Welford S, Sohn JW. Establishing a process of irradiating small animal brain using a CyberKnife and a microCT scanner. Med Phys 2014; 41:021715. [PMID: 24506606 DOI: 10.1118/1.4861713] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Establish and validate a process of accurately irradiating small animals using the CyberKnife G4 System (version 8.5) with treatment plans designed to irradiate a hemisphere of a mouse brain based on microCT scanner images. METHODS These experiments consisted of four parts: (1) building a mouse phantom for intensity modulated radiotherapy (IMRT) quality assurance (QA), (2) proving usability of a microCT for treatment planning, (3) fabricating a small animal positioning system for use with the CyberKnife's image guided radiotherapy (IGRT) system, and (4)in vivo verification of targeting accuracy. A set of solid water mouse phantoms was designed and fabricated, with radiochromic films (RCF) positioned in selected planes to measure delivered doses. After down-sampling for treatment planning compatibility, a CT image set of a phantom was imported into the CyberKnife treatment planning system--MultiPlan (ver. 3.5.2). A 0.5 cm diameter sphere was contoured within the phantom to represent a hemispherical section of a mouse brain. A nude mouse was scanned in an alpha cradle using a microCT scanner (cone-beam, 157 × 149 pixels slices, 0.2 mm longitudinal slice thickness). Based on the results of our positional accuracy study, a planning treatment volume (PTV) was created. A stereotactic body mold of the mouse was "printed" using a 3D printer laying UV curable acrylic plastic. Printer instructions were based on exported contours of the mouse's skin. Positional reproducibility in the mold was checked by measuring ten CT scans. To verify accurate dose delivery in vivo, six mice were irradiated in the mold with a 4 mm target contour and a 2 mm PTV margin to 3 Gy and sacrificed within 20 min to avoid DNA repair. The brain was sliced and stained for analysis. RESULTS For the IMRT QA using a set of phantoms, the planned dose (6 Gy to the calculation point) was compared to the delivered dose measured via film and analyzed using Gamma analysis (3% and 3 mm). A passing rate of 99% was measured in areas of above 40% of the prescription dose. The final inverse treatment plan was comprised of 43 beams ranging from 5 to 12.5 mm in diameter (2.5 mm size increments are available up to 15 mm in diameter collimation). Using the Xsight Spine Tracking module, the CyberKnife system could not reliably identify and track the tiny mouse spine; however, the CyberKnife system could identify and track the fiducial markers on the 3D mold.In vivo positional accuracy analysis using the 3D mold generated a mean error of 1.41 mm ± 0.73 mm when fiducial markers were used for position tracking. Analysis of the dissected brain confirmed the ability to target the correct brain volume. CONCLUSIONS With the use of a stereotactic body mold with fiducial markers, microCT imaging, and resolution down-sampling, the CyberKnife system can successfully perform small-animal radiotherapy studies.
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Affiliation(s)
- Haksoo Kim
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106
| | - Jeffrey Fabien
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - Yiran Zheng
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - Jake Yuan
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - James Brindle
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - Andrew Sloan
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106
| | - Min Yao
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - Simon Lo
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - Barry Wessels
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - Mitchell Machtay
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
| | - Scott Welford
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106
| | - Jason W Sohn
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106
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Weersink RA, Ansell S, Wang A, Wilson G, Shah D, Lindsay PE, Jaffray DA. Integration of optical imaging with a small animal irradiator. Med Phys 2014; 41:102701. [DOI: 10.1118/1.4894730] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bazalova M, Nelson G, Noll JM, Graves EE. Modality comparison for small animal radiotherapy: a simulation study. Med Phys 2014; 41:011710. [PMID: 24387502 DOI: 10.1118/1.4842415] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Small animal radiation therapy has advanced significantly in recent years. Whereas in the past dose was delivered using a single beam and a lead shield for sparing of healthy tissue, conformal doses can be now delivered using more complex dedicated small animal radiotherapy systems with image guidance. The goal of this paper is to investigate dose distributions for three small animal radiation treatment modalities. METHODS This paper presents a comparison of dose distributions generated by the three approaches-a single-field irradiator with a 200 kV beam and no image guidance, a small animal image-guided conformal system based on a modified microCT scanner with a 120 kV beam developed at Stanford University, and a dedicated conformal system, SARRP, using a 220 kV beam developed at Johns Hopkins University. The authors present a comparison of treatment plans for the three modalities using two cases: a mouse with a subcutaneous tumor and a mouse with a spontaneous lung tumor. A 5 Gy target dose was calculated using the EGSnrc Monte Carlo codes. RESULTS All treatment modalities generated similar dose distributions for the subcutaneous tumor case, with the highest mean dose to the ipsilateral lung and bones in the single-field plan (0.4 and 0.4 Gy) compared to the microCT (0.1 and 0.2 Gy) and SARRP (0.1 and 0.3 Gy) plans. The lung case demonstrated that due to the nine-beam arrangements in the conformal plans, the mean doses to the ipsilateral lung, spinal cord, and bones were significantly lower in the microCT plan (2.0, 0.4, and 1.9 Gy) and the SARRP plan (1.5, 0.5, and 1.8 Gy) than in single-field irradiator plan (4.5, 3.8, and 3.3 Gy). Similarly, the mean doses to the contralateral lung and the heart were lowest in the microCT plan (1.5 and 2.0 Gy), followed by the SARRP plan (1.7 and 2.2 Gy), and they were highest in the single-field plan (2.5 and 2.4 Gy). For both cases, dose uniformity was greatest in the single-field irradiator plan followed by the SARRP plan due to the sensitivity of the lower energy microCT beam to target heterogeneities and image noise. CONCLUSIONS The two treatment planning examples demonstrate that modern small animal radiotherapy techniques employing image guidance, variable collimation, and multiple beam angles deliver superior dose distributions to small animal tumors as compared to conventional treatments using a single-field irradiator. For deep-seated mouse tumors, however, higher-energy conformal radiotherapy could result in higher doses to critical organs compared to lower-energy conformal radiotherapy. Treatment planning optimization for small animal radiotherapy should therefore be developed to take full advantage of the novel conformal systems.
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Affiliation(s)
- Magdalena Bazalova
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
| | - Geoff Nelson
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
| | - John M Noll
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
| | - Edward E Graves
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
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Lindsay PE, Granton PV, Gasparini A, Jelveh S, Clarkson R, van Hoof S, Hermans J, Kaas J, Wittkamper F, Sonke JJ, Verhaegen F, Jaffray DA. Multi-institutional dosimetric and geometric commissioning of image-guided small animal irradiators. Med Phys 2014; 41:031714. [DOI: 10.1118/1.4866215] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Noblet C, Chiavassa S, Paris F, Supiot S, Lisbona A, Delpon G. Underestimation of dose delivery in preclinical irradiation due to scattering conditions. Phys Med 2014; 30:63-8. [DOI: 10.1016/j.ejmp.2013.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 02/20/2013] [Accepted: 03/04/2013] [Indexed: 10/27/2022] Open
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Stewart JMP, Lindsay PE, Jaffray DA. Two-dimensional inverse planning and delivery with a preclinical image guided microirradiator. Med Phys 2013; 40:101709. [DOI: 10.1118/1.4819935] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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42
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Walker AJ, Alcorn S, Narang A, Nugent K, Wild AT, Herman JM, Tran PT. Radiosensitizers in pancreatic cancer--preclinical and clinical exploits with molecularly targeted agents. Curr Probl Cancer 2013; 37:301-12. [PMID: 24331186 PMCID: PMC3868005 DOI: 10.1016/j.currproblcancer.2013.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
There has been an explosion in the number of molecularly targeted agents engineered to inhibit specific molecular pathways driving the tumorigenic phenotype in cancer cells. Some of these molecularly targeted agents have demonstrated robust clinical effects, but few result in meaningful durable responses. Therapeutic radiation is used to treat a majority of cancer patients with recent technologic and pharmacologic enhancements, leading to improvements in the therapeutic ratio for cancer care. Radiotherapy has a very specific role in select cases of postoperative and locally advanced pancreatic cancer patients, but control of metastatic disease still appears to be the major limiting factor behind improvements in cure. Recent rapid autopsy pathologic findings suggest a sub-group of advanced pancreatic cancer patients where death is caused from local disease progression and who would thus benefit from improved local control. One promising approach is to combine molecularly targeted agents with radiotherapy to improve tumor response rates and likelihood of durable local control. We review suggested recommendations on the investigation of molecularly targeted agents as radiosensitizers from preclinical studies to implementation in phase I–II clinical trials. We then discuss a select set of molecularly targeted therapies that we believe show promise as radiosensitizers in the treatment of pancreatic cancer.
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Affiliation(s)
- Amanda J. Walker
- Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Sara Alcorn
- Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Amol Narang
- Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Katriana Nugent
- Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Aaron T. Wild
- Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Joseph M. Herman
- Department of Radiation Oncology and Molecular Radiation Sciences, Oncology, and Surgery, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 401 N Broadway Street Baltimore, MD 21231, , Phone (410) 502-3823, Fax (410) 502-1419
| | - Phuoc T. Tran
- Department of Radiation Oncology and Molecular Radiation Sciences, Oncology, and Urology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 401 N Broadway Street Baltimore, MD 21231, , Phone (410) 614-3880, Fax (410) 502-1419
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Molecularly targeted agents as radiosensitizers in cancer therapy--focus on prostate cancer. Int J Mol Sci 2013; 14:14800-32. [PMID: 23863691 PMCID: PMC3742274 DOI: 10.3390/ijms140714800] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 06/27/2013] [Accepted: 06/27/2013] [Indexed: 12/12/2022] Open
Abstract
As our understanding of the molecular pathways driving tumorigenesis improves and more druggable targets are identified, we have witnessed a concomitant increase in the development and production of novel molecularly targeted agents. Radiotherapy is commonly used in the treatment of various malignancies with a prominent role in the care of prostate cancer patients, and efforts to improve the therapeutic ratio of radiation by technologic and pharmacologic means have led to important advances in cancer care. One promising approach is to combine molecularly targeted systemic agents with radiotherapy to improve tumor response rates and likelihood of durable control. This review first explores the limitations of preclinical studies as well as barriers to successful implementation of clinical trials with radiosensitizers. Special considerations related to and recommendations for the design of preclinical studies and clinical trials involving molecularly targeted agents combined with radiotherapy are provided. We then apply these concepts by reviewing a representative set of targeted therapies that show promise as radiosensitizers in the treatment of prostate cancer.
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Jensen MD, Hrinivich WT, Jung JA, Holdsworth DW, Drangova M, Chen J, Wong E. Implementation and commissioning of an integrated micro-CT/RT system with computerized independent jaw collimation. Med Phys 2013; 40:081706. [DOI: 10.1118/1.4812422] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chow JC. Dosimetric impact of monoenergetic photon beams in the small-animal irradiation with inhomogeneities: A Monte Carlo evaluation. Radiat Phys Chem Oxf Engl 1993 2013. [DOI: 10.1016/j.radphyschem.2013.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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Wack L, Ngwa W, Tryggestad E, Tsiamas P, Berbeco R, Ng SK, Hesser J, Zygmanski P. High throughput film dosimetry in homogeneous and heterogeneous media for a small animal irradiator. Phys Med 2013; 30:36-46. [PMID: 23510532 DOI: 10.1016/j.ejmp.2013.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 02/04/2013] [Accepted: 02/11/2013] [Indexed: 10/27/2022] Open
Abstract
PURPOSE We have established a high-throughput Gafchromic film dosimetry protocol for narrow kilovoltage beams in homogeneous and heterogeneous media for small-animal radiotherapy applications. The kV beam characterization is based on extensive Gafchromic film dosimetry data acquired in homogeneous and heterogeneous media. An empirical model is used for parameterization of depth and off-axis dependence of measured data. METHODS We have modified previously published methods of film dosimetry to suit the specific tasks of the study. Unlike film protocols used in previous studies, our protocol employs simultaneous multi-channel scanning and analysis of up to nine Gafchromic films per scan. A scanner and background correction were implemented to improve accuracy of the measurements. Measurements were taken in homogeneous and inhomogeneous phantoms at 220 kVp and a field size of 5 × 5 mm(2). The results were compared against Monte Carlo simulations. RESULTS Dose differences caused by variations in background signal were effectively removed by the corrections applied. Measurements in homogeneous phantoms were used to empirically characterize beam data in homogeneous and heterogeneous media. Film measurements in inhomogeneous phantoms and their empirical parameterization differed by about 2%-3%. The model differed from MC by about 1% (water, lung) to 7% (bone). Good agreement was found for measured and modelled off-axis ratios. CONCLUSIONS EBT2 films are a valuable tool for characterization of narrow kV beams, though care must be taken to eliminate disturbances caused by varying background signals. The usefulness of the empirical beam model in interpretation and parameterization of film data was demonstrated.
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Affiliation(s)
- L Wack
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, USA; Department of Experimental Radiation Oncology, University Medical Center, Mannheim, Germany.
| | - W Ngwa
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, USA
| | - E Tryggestad
- Department of Radiation Oncology and Molecular Radiation Sciences, John Hopkins University, Baltimore, USA
| | - P Tsiamas
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, USA
| | - R Berbeco
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, USA
| | - S K Ng
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, USA
| | - J Hesser
- Department of Experimental Radiation Oncology, University Medical Center, Mannheim, Germany
| | - P Zygmanski
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, USA.
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Eslami S, Yang Y, Wong J, Patterson MS, Iordachita I. An Integrated X-Ray/Optical Tomography System for Pre-clinical Radiation Research. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2013; 8668:866830. [PMID: 25745539 DOI: 10.1117/12.2008060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The current Small Animal Radiation Research Platform (SARRP) is poor for localizing small soft tissue targets for irradiation or tumor models growing in a soft tissue environment. Therefore, an imaging method complementary to x-ray CT is required to localize the soft tissue target's Center of Mass (CoM) to within 1 mm. In this paper, we report the development of an integrated x-ray/bioluminescence imaging/tomography (BLI/BLT) system to provide a pre-clinical, high resolution irradiation system. This system can be used to study radiation effects in small animals under the conebeam computed tomography (CBCT) imaging guidance by adding the bioluminescence imaging (BLI) system as a standalone system which can also be docked onto the SARRP. The proposed system integrates two robotic rotating stages and an x-ray source rated at maximum 130 kVp and having a small variable focal spot. A high performance and low noise CCD camera mounted in a light-tight housing along with an optical filter assembly is used for multi-wavelength BL tomography. A three-mirror arrangement is implemented to eliminate the need of rotating the CCD camera for acquiring multiple views. The mirror system is attached to a motorized stage to capture images in angles between 0-90° (for the standalone system). Camera and CBCT calibration are accomplished.
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Affiliation(s)
- S Eslami
- ERC - Computer-Integrated Surgical Systems and Technology (CISST), Johns Hopkins University, Baltimore, MD USA
| | - Y Yang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Wong
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M S Patterson
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, Canada
| | - I Iordachita
- ERC - Computer-Integrated Surgical Systems and Technology (CISST), Johns Hopkins University, Baltimore, MD USA
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A LabVIEW Platform for Preclinical Imaging Using Digital Subtraction Angiography and Micro-CT. J Med Eng 2013; 2013:581617. [PMID: 27006920 PMCID: PMC4782637 DOI: 10.1155/2013/581617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Accepted: 01/21/2013] [Indexed: 12/02/2022] Open
Abstract
CT and digital subtraction angiography (DSA) are ubiquitous in the clinic. Their preclinical equivalents are valuable imaging methods for studying disease models and treatment. We have developed a dual source/detector X-ray imaging system that we have used for both micro-CT and DSA studies in rodents. The control of such a complex imaging system requires substantial software development for which we use the graphical language LabVIEW (National Instruments, Austin, TX, USA). This paper focuses on a LabVIEW platform that we have developed to enable anatomical and functional imaging with micro-CT and DSA. Our LabVIEW applications integrate and control all the elements of our system including a dual source/detector X-ray system, a mechanical ventilator, a physiological monitor, and a power microinjector for the vascular delivery of X-ray contrast agents. Various applications allow cardiac- and respiratory-gated acquisitions for both DSA and micro-CT studies. Our results illustrate the application of DSA for cardiopulmonary studies and vascular imaging of the liver and coronary arteries. We also show how DSA can be used for functional imaging of the kidney. Finally, the power of 4D micro-CT imaging using both prospective and retrospective gating is shown for cardiac imaging.
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McGurk R, Hadley C, Jackson IL, Vujaskovic Z. Development and dosimetry of a small animal lung irradiation platform. HEALTH PHYSICS 2012; 103:454-62. [PMID: 23091878 PMCID: PMC4615601 DOI: 10.1097/hp.0b013e3182632526] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Advances in large scale screening of medical countermeasures for radiation-induced normal tissue toxicity are currently hampered by animal irradiation paradigms that are both inefficient and highly variable among institutions. Here, a novel high-throughput small animal irradiation platform is introduced for use in orthovoltage small animal irradiators. Radiochromic film and metal oxide semiconductor field effect transistor detectors were used to examine several parameters, including 2D field uniformity, dose rate consistency, and shielding transmission. The authors posit that this setup will improve efficiency of drug screens by allowing for simultaneous targeted irradiation of multiple animals to improve efficiency within a single institution. Additionally, they suggest that measurement of the described parameters in all centers conducting countermeasure studies will improve the translatability of findings among institutions. The use of tissue equivalent phantoms in performing dosimetry measurements for small animal irradiation experiments was also investigated. Though these phantoms are commonly used in dosimetry, the authors recorded a significant difference in both the entrance and target tissue dose rates between euthanized rats and mice with implanted detectors and the corresponding phantom measurement. This suggests that measurements using these phantoms may not provide accurate dosimetry for in vivo experiments. Based on these measurements, the authors propose that this small animal irradiation platform can increase the capacity of animal studies by allowing for more efficient animal irradiation. They also suggest that researchers fully characterize the parameters of whatever radiation setup is in use in order to facilitate better comparison among institutions.
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Affiliation(s)
- Ross McGurk
- Medical Physics Graduate Program, Duke University Medical Center, Durham, NC 27710, USA
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An integrated method for reproducible and accurate image-guided stereotactic cranial irradiation of brain tumors using the small animal radiation research platform. Transl Oncol 2012; 5:230-7. [PMID: 22937174 DOI: 10.1593/tlo.12136] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 05/23/2012] [Accepted: 05/24/2012] [Indexed: 12/22/2022] Open
Abstract
Preclinical studies of cranial radiation therapy (RT) using animal brain tumor models have been hampered by technical limitations in the delivery of clinically relevant RT. We established a bioimageable mouse model of glioblastoma multiforme (GBM) and an image-guided radiation delivery system that facilitated precise tumor localization and treatment and which closely resembled clinical RT. Our novel radiation system makes use of magnetic resonance imaging (MRI) and bioluminescent imaging (BLI) to define tumor volumes, computed tomographic (CT) imaging for accurate treatment planning, a novel mouse immobilization system, and precise treatments delivered with the Small Animal Radiation Research Platform. We demonstrated that, in vivo, BLI correlated well with MRI for defining tumor volumes. Our novel restraint system enhanced setup reproducibility and precision, was atraumatic, and minimized artifacts on CT imaging used for treatment planning. We confirmed precise radiation delivery through immunofluorescent analysis of the phosphorylation of histone H2AX in irradiated brains and brain tumors. Assays with an intravenous near-infrared fluorescent probe confirmed that radiation of orthografts increased disruption of the tumor blood-brain barrier (BBB). This integrated model system, which facilitated delivery of precise, reproducible, stereotactic cranial RT in mice and confirmed RT's resultant histologic and BBB changes, may aid future brain tumor research.
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