1
|
Kampfer S, Dobiasch S, Combs SE, Wilkens JJ. Development of a PTV margin for preclinical irradiation of orthotopic pancreatic tumors derived from a well-known recipe for humans. Z Med Phys 2023:S0939-3889(23)00042-9. [PMID: 37225604 DOI: 10.1016/j.zemedi.2023.03.005] [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: 12/19/2022] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 05/26/2023]
Abstract
In human radiotherapy a safety margin (PTV margin) is essential for successful irradiation and is usually part of clinical treatment planning. In preclinical radiotherapy research with small animals, most uncertainties and inaccuracies are present as well, but according to the literature a margin is used only scarcely. In addition, there is only little experience about the appropriate size of the margin, which should carefully be investigated and considered, since sparing of organs at risk or normal tissue is affected. Here we estimate the needed margin for preclinical irradiation by adapting a well-known human margin recipe from van Herck et al. to the dimensions and requirements of the specimen on a small animal radiation research platform (SARRP). We adjusted the factors of the described formula to the specific challenges in an orthotopic pancreatic tumor mouse model to establish an appropriate margin concept. The SARRP was used with its image-guidance irradiation possibility for arc irradiation with a field size of 10 × 10 mm2 for 5 fractions. Our goal was to irradiate the clinical target volume (CTV) of at least 90% of our mice with at least 95% of the prescribed dose. By carefully analyzing all relevant factors we gain a CTV to planning target volume (PTV) margin of 1.5 mm for our preclinical setup. The stated safety margin is strongly dependent on the exact setting of the experiment and has to be adjusted for other experimental settings. The few stated values in literature correspond well to our result. Even if using margins in the preclinical setting might be an additional challenge, we think it is crucial to use them to produce reliable results and improve the efficacy of radiotherapy.
Collapse
Affiliation(s)
- Severin Kampfer
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Physics Department, Technical University of Munich (TUM), Garching, Germany.
| | - Sophie Dobiasch
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, Germany.
| | - Stephanie E Combs
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Germany.
| | - Jan J Wilkens
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Physics Department, Technical University of Munich (TUM), Garching, Germany; Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, Germany.
| |
Collapse
|
2
|
Verhaegen F, Butterworth KT, Chalmers AJ, Coppes RP, de Ruysscher D, Dobiasch S, Fenwick JD, Granton PV, Heijmans SHJ, Hill MA, Koumenis C, Lauber K, Marples B, Parodi K, Persoon LCGG, Staut N, Subiel A, Vaes RDW, van Hoof S, Verginadis IL, Wilkens JJ, Williams KJ, Wilson GD, Dubois LJ. Roadmap for precision preclinical x-ray radiation studies. Phys Med Biol 2023; 68:06RM01. [PMID: 36584393 DOI: 10.1088/1361-6560/acaf45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/30/2022] [Indexed: 12/31/2022]
Abstract
This Roadmap paper covers the field of precision preclinical x-ray radiation studies in animal models. It is mostly focused on models for cancer and normal tissue response to radiation, but also discusses other disease models. The recent technological evolution in imaging, irradiation, dosimetry and monitoring that have empowered these kinds of studies is discussed, and many developments in the near future are outlined. Finally, clinical translation and reverse translation are discussed.
Collapse
Affiliation(s)
- Frank Verhaegen
- MAASTRO Clinic, Radiotherapy Division, GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
- SmART Scientific Solutions BV, Maastricht, The Netherlands
| | - Karl T Butterworth
- Patrick G. Johnston, Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Anthony J Chalmers
- School of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - Rob P Coppes
- Departments of Biomedical Sciences of Cells & Systems, Section Molecular Cell Biology and Radiation Oncology, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Dirk de Ruysscher
- MAASTRO Clinic, Radiotherapy Division, GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Sophie Dobiasch
- Department of Radiation Oncology, Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Germany
- Department of Medical Physics, Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Germany
| | - John D Fenwick
- Department of Medical Physics & Biomedical Engineering University College LondonMalet Place Engineering Building, London WC1E 6BT, United Kingdom
| | | | | | - Mark A Hill
- MRC Oxford Institute for Radiation Oncology, University of Oxford, ORCRB Roosevelt Drive, Oxford OX3 7DQ, United Kingdom
| | - Constantinos Koumenis
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Kirsten Lauber
- Department of Radiation Oncology, University Hospital, LMU München, Munich, Germany
- German Cancer Consortium (DKTK), Partner site Munich, Germany
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester, NY, United States of America
| | - Katia Parodi
- German Cancer Consortium (DKTK), Partner site Munich, Germany
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München, Garching b. Munich, Germany
| | | | - Nick Staut
- SmART Scientific Solutions BV, Maastricht, The Netherlands
| | - Anna Subiel
- National Physical Laboratory, Medical Radiation Science Hampton Road, Teddington, Middlesex, TW11 0LW, United Kingdom
| | - Rianne D W Vaes
- MAASTRO Clinic, Radiotherapy Division, GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Ioannis L Verginadis
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jan J Wilkens
- Department of Radiation Oncology, Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Germany
- Physics Department, Technical University of Munich (TUM), Germany
| | - Kaye J Williams
- Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
| | - George D Wilson
- Department of Radiation Oncology, Beaumont Health, MI, United States of America
- Henry Ford Health, Detroit, MI, United States of America
| | - Ludwig J Dubois
- The M-Lab, Department of Precision Medicine, GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
3
|
Rezaeifar B, Wolfs CJA, Lieuwes NG, Biemans R, Reniers B, Dubois LJ, Verhaegen F. A deep learning and Monte Carlo based framework for bioluminescence imaging center of mass-guided glioblastoma targeting. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac79f8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/17/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Objective. Bioluminescence imaging (BLI) is a valuable tool for non-invasive monitoring of glioblastoma multiforme (GBM) tumor-bearing small animals without incurring x-ray radiation burden. However, the use of this imaging modality is limited due to photon scattering and lack of spatial information. Attempts at reconstructing bioluminescence tomography (BLT) using mathematical models of light propagation show limited progress. Approach. This paper employed a different approach by using a deep convolutional neural network (CNN) to predict the tumor’s center of mass (CoM). Transfer-learning with a sizeable artificial database is employed to facilitate the training process for, the much smaller, target database including Monte Carlo (MC) simulations of real orthotopic glioblastoma models. Predicted CoM was then used to estimate a BLI-based planning target volume (bPTV), by using the CoM as the center of a sphere, encompassing the tumor. The volume of the encompassing target sphere was estimated based on the total number of photons reaching the skin surface. Main results. Results show sub-millimeter accuracy for CoM prediction with a median error of 0.59 mm. The proposed method also provides promising performance for BLI-based tumor targeting with on average 94% of the tumor inside the bPTV while keeping the average healthy tissue coverage below 10%. Significance. This work introduced a framework for developing and using a CNN for targeted radiation studies for GBM based on BLI. The framework will enable biologists to use BLI as their main image-guidance tool to target GBM tumors in rat models, avoiding delivery of high x-ray imaging dose to the animals.
Collapse
|
4
|
Lappas G, Staut N, Lieuwes NG, Biemans R, Wolfs CJ, van Hoof SJ, Dubois LJ, Verhaegen F. Inter-observer variability of organ contouring for preclinical studies with cone beam Computed Tomography imaging. Phys Imaging Radiat Oncol 2022; 21:11-17. [PMID: 35111981 PMCID: PMC8790504 DOI: 10.1016/j.phro.2022.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 12/28/2022] Open
Abstract
Background and purpose In preclinical radiation studies, there is great interest in quantifying the radiation response of healthy tissues. Manual contouring has significant impact on the treatment-planning because of variation introduced by human interpretation. This results in inconsistencies when assessing normal tissue volumes. Evaluation of these discrepancies can provide a better understanding on the limitations of the current preclinical radiation workflow. In the present work, interobserver variability (IOV) in manual contouring of rodent normal tissues on cone-beam Computed Tomography, in head and thorax regions was evaluated. Materials and methods Two animal technicians performed manually (assisted) contouring of normal tissues located within the thorax and head regions of rodents, 20 cases per body site. Mean surface distance (MSD), displacement of center of mass (ΔCoM), DICE similarity coefficient (DSC) and the 95th percentile Hausdorff distance (HD95) were calculated between the contours of the two observers to evaluate the IOV. Results For the thorax organs, right lung had the lowest IOV (ΔCoM: 0.08 ± 0.04 mm, DSC: 0.96 ± 0.01, MSD:0.07 ± 0.01 mm, HD95:0.20 ± 0.03 mm) while spinal cord, the highest IOV (ΔCoM:0.5 ± 0.3 mm, DSC:0.81 ± 0.05, MSD:0.14 ± 0.03 mm, HD95:0.8 ± 0.2 mm). Regarding head organs, right eye demonstrated the lowest IOV (ΔCoM:0.12 ± 0.08 mm, DSC: 0.93 ± 0.02, MSD: 0.15 ± 0.04 mm, HD95: 0.29 ± 0.07 mm) while complete brain, the highest IOV (ΔCoM: 0.2 ± 0.1 mm, DSC: 0.94 ± 0.02, MSD: 0.3 ± 0.1 mm, HD95: 0.5 ± 0.1 mm). Conclusions Our findings reveal small IOV, within the sub-mm range, for thorax and head normal tissues in rodents. The set of contours can serve as a basis for developing an automated delineation method for e.g., treatment planning.
Collapse
Affiliation(s)
- Georgios Lappas
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Nick Staut
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | | | - Rianne Biemans
- SmART Scientific Solutions BV, Maastricht, the Netherlands
| | - Cecile J.A. Wolfs
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Stefan J. van Hoof
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | | | - Frank Verhaegen
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
- The M-Lab, Department of Precision Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
- Corresponding author at: Department of Radiation Oncology (MAASTRO), GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| |
Collapse
|
5
|
van Hoof SJ, Verde JB, Verhaegen F. Dose painting by dynamic irradiation delivery on an image-guided small animal radiotherapy platform. Br J Radiol 2019; 92:20180744. [PMID: 30706718 DOI: 10.1259/bjr.20180744] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE: Using synchronized three-dimensional stage translation and multiangle radiation delivery to improve conformality and homogeneity of radiation delivery to complexly shaped target volumes for precision preclinical radiotherapy. METHODS: A CT image of a mouse was used to design irradiation plans to target the spinal cord and an orthotopic lung tumour. A dose painting method is proposed that combines heterogeneous two-dimensional area irradiations from multiple beam directions. For each beam direction, a two-dimensional area was defined based on the projection of the target volume. Each area was divided into many single beam Monte Carlo simulations, based on radiochromic film characterization of a 2.4 mm beam of a commercial precision image-guided preclinical irradiation platform. Beam-on time optimization including all simulated beams from multiple beam directions was used to achieve clinically relevant irradiation objects. Dose painting irradiation plans were compared to irradiation plans using a fixed aperture and rotatable variable aperture collimator. RESULTS: Irradiation plans for the proposed dose painting approach achieved good target coverage, similar dose to avoidance structures in comparison with irradiation using a rotatable variable aperture collimator, and considerably less dose to avoidance volumes in comparison with irradiation using a non-rotatable fixed aperture collimator. Required calculations and beam-on times were considerably longer for the dose painting method. CONCLUSION: It was shown that the proposed dose painting strategy is a valuable extension to increase the versatility of current generation precision preclinical radiotherapy platforms. More conformal and homogeneous dose delivery may be achieved at the cost of increased radiation planning and delivery duration. ADVANCES IN KNOWLEDGE: More advanced radiation planning for image-guided preclinical radiotherapy platforms can improve target dose conformality and homogeneity with the use of optimized dynamic irradiations with synchronized couch translation. The versatility of these platforms can be increased without hardware modifications.
Collapse
Affiliation(s)
- Stefan J van Hoof
- 1 Department of Radiation Oncology, (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Joana B Verde
- 1 Department of Radiation Oncology, (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Frank Verhaegen
- 1 Department of Radiation Oncology, (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center , Maastricht , The Netherlands
| |
Collapse
|
6
|
Almeida IP, Vaniqui A, Schyns LE, van der Heyden B, Cooley J, Zwart T, Langenegger A, Verhaegen F. Exploring the feasibility of a clinical proton beam with an adaptive aperture for pre-clinical research. Br J Radiol 2018; 92:20180446. [PMID: 30362812 DOI: 10.1259/bjr.20180446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To investigate whether the Mevion S250i with HYPERSCAN clinical proton system could be used for pre-clinical research with millimetric beams. METHODS: The nozzle of the proton beam line, consisting of an energy modulation system (EMS) and an adaptive aperture (AA), was modelled with the TOPAS Monte Carlo Simulation Toolkit. With the EMS, the 230 MeV beam nominal range can be decreased in multiples of 2.1 mm. Monte Carlo dose calculations were performed in a mouse lung tumour CT image. The AA allows fields as small as 5 × 1 mm2 to be used for irradiation. The best plans to give 2 Gy to the tumour were derived from a set of discrete energies allowed by the EMS, different field sizes and beam directions. The final proton plans were compared to a precision photon irradiation plan. Treatment times were also assessed. RESULTS: Seven different proton beam plans were investigated, with a good coverage to the tumour (D95 > 1.95 Gy, D5 < 2.3 Gy) and with potentially less damage to the organs at risk than the photon plan. For very small fields and low energies, the number of protons arriving to the target drops to 1-3%, nevertheless the treatment times would be below 5 s. CONCLUSION: The proton plans made in this study, collimated by an AA, could be used for animal irradiation. ADVANCES IN KNOWLEDGE: This is one of the first study to demonstrate the feasibility of pre-clinical research with a clinical proton beam with an adaptive aperture used to create small fields.
Collapse
Affiliation(s)
- Isabel P Almeida
- 1 Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastrich , Netherlands
| | - Ana Vaniqui
- 1 Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastrich , Netherlands
| | - Lotte Ejr Schyns
- 1 Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastrich , Netherlands
| | - Brent van der Heyden
- 1 Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastrich , Netherlands
| | - James Cooley
- 2 Mevion Medical Systems Inc , Littleton, MA , USA
| | | | | | - Frank Verhaegen
- 1 Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastrich , Netherlands
| |
Collapse
|