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Carver A, Baker S, Dumbill A, Horton S, Green S. Design and characterisation of a minibeam collimator utilising Monte Carlo simulation and a clinical linear accelerator. Phys Med Biol 2024; 69:135001. [PMID: 38759691 DOI: 10.1088/1361-6560/ad4d52] [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: 11/15/2023] [Accepted: 05/17/2024] [Indexed: 05/19/2024]
Abstract
Objective.Spatially fractionated radiotherapy is showing promise as a treatment modality. Initial focus was on beams of photons at low energy produced from a synchrotron but more recently research has expanded to include applications in proton therapy. Interest in photon beams remains and this is the focus of this paperApproach.This study presents a 3D printed tungsten minibeam collimator intended to produce peak-to-valley dose ratios (PVDR) of between seven and ten with a 1 MV, bremsstrahlung generated, photon beam. The design of the collimator is motivated by a Monte Carlo study estimating the PVDR for different collimator designs at different energies. This collimator was characterised on a clinical linear accelerator (Elekta VersaHD) as well as an orthovoltage unit.Main results.The performance of the fabricated collimator was measured on Elekta VersaHD running in unflattened mode with a 6 MV beam. On the Elekta VersaHD units the PVDR was measured to be between approximately 1.5 and 2.0 at 3 cm deep. For measurements with the orthovoltage unit PVDRs of greater than 10 were observed at a depth of 4 cm.Significance.The results confirmed that the predictions from simulation could be reproduced on linear accelerators currently in clinical usage, producing PVDRs between 2-2.5. Using the model to predict PVDRs using 1 MV photon beams, the threshold considered to produce enhanced normal tissue dose tolerance (>7) was surpassed. This suggests the possibility of using such techniques with versions of existing Linac technology which have been modified to operate at low energy and high beam currents.
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Affiliation(s)
- Antony Carver
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Sam Baker
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Andrew Dumbill
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Steven Horton
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Stuart Green
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Clements N, Esplen N, Bateman J, Robertson C, Dosanjh M, Korysko P, Farabolini W, Corsini R, Bazalova-Carter M. Mini-GRID radiotherapy on the CLEAR very-high-energy electron beamline: collimator optimization, film dosimetry, and Monte Carlo simulations. Phys Med Biol 2024; 69:055003. [PMID: 38295408 DOI: 10.1088/1361-6560/ad247d] [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: 08/10/2023] [Accepted: 01/31/2024] [Indexed: 02/02/2024]
Abstract
Objective.Spatially-fractionated radiotherapy (SFRT) delivered with a very-high-energy electron (VHEE) beam and a mini-GRID collimator was investigated to achieve synergistic normal tissue-sparing through spatial fractionation and the FLASH effect.Approach.A tungsten mini-GRID collimator for delivering VHEE SFRT was optimized using Monte Carlo (MC) simulations. Peak-to-valley dose ratios (PVDRs), depths of convergence (DoCs, PVDR ≤ 1.1), and peak and valley doses in a water phantom from a simulated 150 MeV VHEE source were evaluated. Collimator thickness, hole width, and septal width were varied to determine an optimal value for each parameter that maximized PVDR and DoC. The optimized collimator (20 mm thick rectangular prism with a 15 mm × 15 mm face with a 7 × 7 array of 0.5 mm holes separated by 1.1 mm septa) was 3D-printed and used for VHEE irradiations with the CERN linear electron accelerator for research beam. Open beam and mini-GRID irradiations were performed at 140, 175, and 200 MeV and dose was recorded with radiochromic films in a water tank. PVDR, central-axis (CAX) and valley dose rates and DoCs were evaluated.Main results.Films demonstrated peak and valley dose rates on the order of 100 s of MGy/s, which could promote FLASH-sparing effects. Across the three energies, PVDRs of 2-4 at 13 mm depth and DoCs between 39 and 47 mm were achieved. Open beam and mini-GRID MC simulations were run to replicate the film results at 200 MeV. For the mini-GRID irradiations, the film CAX dose was on average 15% higher, the film valley dose was 28% higher, and the film PVDR was 15% lower than calculated by MC.Significance.Ultimately, the PVDRs and DoCs were determined to be too low for a significant potential for SFRT tissue-sparing effects to be present, particularly at depth. Further beam delivery optimization and investigations of new means of spatial fractionation are warranted.
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Affiliation(s)
- Nathan Clements
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
| | - Nolan Esplen
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
| | - Joseph Bateman
- Department of Physics, University of Oxford, Oxford, United Kingdom
| | | | - Manjit Dosanjh
- Department of Physics, University of Oxford, Oxford, United Kingdom
- CERN, Geneva, Switzerland
| | - Pierre Korysko
- Department of Physics, University of Oxford, Oxford, United Kingdom
- CERN, Geneva, Switzerland
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di Franco F, Rosuel N, Gallin-Martel L, Gallin-Martel ML, Ghafooryan-Sangchooli M, Keshmiri S, Motte JF, Muraz JF, Pellicioli P, Ruat M, Serduc R, Verry C, Dauvergne D, Adam JF. Monocrystalline diamond detector for online monitoring during synchrotron microbeam radiotherapy. JOURNAL OF SYNCHROTRON RADIATION 2023; 30:1076-1085. [PMID: 37815374 PMCID: PMC10624038 DOI: 10.1107/s160057752300752x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/28/2023] [Indexed: 10/11/2023]
Abstract
Microbeam radiation therapy (MRT) is a radiotherapy technique combining spatial fractionation of the dose distribution on a micrometric scale, X-rays in the 50-500 keV range and dose rates up to 16 × 103 Gy s-1. Nowadays, in vivo dosimetry remains a challenge due to the ultra-high radiation fluxes involved and the need for high-spatial-resolution detectors. The aim here was to develop a striped diamond portal detector enabling online microbeam monitoring during synchrotron MRT treatments. The detector, a 550 µm bulk monocrystalline diamond, is an eight-strip device, of height 3 mm, width 178 µm and with 60 µm spaced strips, surrounded by a guard ring. An eight-channel ASIC circuit for charge integration and digitization has been designed and tested. Characterization tests were performed at the ID17 biomedical beamline of the European Synchrotron Radiation Facility (ESRF). The detector measured direct and attenuated microbeams as well as interbeam fluxes with a precision level of 1%. Tests on phantoms (RW3 and anthropomorphic head phantoms) were performed and compared with simulations. Synchrotron radiation measurements were performed on an RW3 phantom for strips facing a microbeam and for strips facing an interbeam area. A 2% difference between experiments and simulations was found. In more complex geometries, a preliminary study showed that the absolute differences between simulated and recorded transmitted beams were within 2%. Obtained results showed the feasibility of performing MRT portal monitoring using a microstriped diamond detector. Online dosimetric measurements are currently ongoing during clinical veterinary trials at ESRF, and the next 153-strip detector prototype, covering the entire irradiation field, is being finalized at our institution.
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Affiliation(s)
- Francesca di Franco
- Université Grenoble-Alpes, CNRS, Grenoble INP, LPSC UMR5821, 38000 Grenoble, France
| | - Nicolas Rosuel
- Université Grenoble-Alpes, CNRS, Grenoble INP, LPSC UMR5821, 38000 Grenoble, France
| | | | | | | | - Sarvenaz Keshmiri
- Université Grenoble-Alpes, UGA/INSERM UA7 STROBE, 2280 Rue de la Piscine, 38400 Saint-Martin d’Hères, France
| | - Jean-François Motte
- Université Grenoble-Alpes, Institut Néel, CNRS, Grenoble-INP, Grenoble, France
| | - Jean-François Muraz
- Université Grenoble-Alpes, CNRS, Grenoble INP, LPSC UMR5821, 38000 Grenoble, France
| | | | | | - Raphael Serduc
- Université Grenoble-Alpes, UGA/INSERM UA7 STROBE, 2280 Rue de la Piscine, 38400 Saint-Martin d’Hères, France
- Centre Hospitalier Universitaire Grenoble-Alpes, CS10217, 38043 Grenoble, France
| | - Camille Verry
- Centre Hospitalier Universitaire Grenoble-Alpes, CS10217, 38043 Grenoble, France
| | - Denis Dauvergne
- Université Grenoble-Alpes, CNRS, Grenoble INP, LPSC UMR5821, 38000 Grenoble, France
| | - Jean-François Adam
- Université Grenoble-Alpes, UGA/INSERM UA7 STROBE, 2280 Rue de la Piscine, 38400 Saint-Martin d’Hères, France
- Centre Hospitalier Universitaire Grenoble-Alpes, CS10217, 38043 Grenoble, France
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Barnes MJ, Afshar N, Cameron M, Hausermann D, Hardcastle N, Lerch M. The design and characterization of a novel dynamic collimator system for synchrotron radiotherapy applications. Med Phys 2023; 50:5806-5816. [PMID: 37531199 DOI: 10.1002/mp.16664] [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: 05/04/2023] [Revised: 07/13/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Novel synchrotron radiotherapy techniques are currently limited to using prefabricated beam-limiting blocks for field definition. For large experiments, a single square tungsten block is often used for every treatment since conformal blocks are both patient and field specific, and require long lead times for fabrication. Future synchrotron radiotherapy treatments would benefit from a dynamic collimator system. PURPOSE We developed and tested a novel collimator design for use on the Imaging and Medical Beamline (IMBL) at the ANSTO Australian Synchrotron. METHODS The maximum usable beam size on IMBL is 50-mm wide by 3-mm tall. Given the beam shape, targets must be vertically scanned through the synchrotron beam to cover the target volume. To shape the beam, a novel collimator design was developed, consisting of two semi-circular leaves made from 4-mm thick tungsten sheets, with each leaf capable of both vertical and horizontal movement. A software model was created to optimize motor trajectories and generate deliverable treatment fields. A series of geometric field shapes and clinical target volumes were delivered using the collimator and imaged with a digital imaging detector. Four similarity metrics (volumetric similarity, DICE, and the average and maximum Hausdorff distances) were used to measure differences between the input and planned fields, and the planned and delivered fields. RESULTS Differences between input and planned fields increased with delivery speed, and were worse for rectangular and square fields compared to circular fields. However, the differences between planned and delivered fields were small, where the maximum average deviation between the fields was 0.25 mm (one pixel). Field repeatability was consistent with no difference (σ = 0 for all metrics) observed in consecutively delivered fields. CONCLUSIONS We have successfully built and demonstrated a novel collimator for synchrotron radiotherapy applications on IMBL. Several design improvements have been highlighted and will be addressed in future revisions the collimator. However, in its current state, the collimator enables dynamically delivered conformal treatment fields to be utilized on IMBL, and is ready to support the forthcoming canine treatments on IMBL.
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Affiliation(s)
- Micah J Barnes
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
- ANSTO Australian Synchrotron, Clayton, Victoria, Australia
- Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Nader Afshar
- ANSTO Australian Synchrotron, Clayton, Victoria, Australia
| | | | | | - Nicholas Hardcastle
- Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael Lerch
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
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Towards neuro-oncologic clinical trials of high dose rate synchrotron Microbeam Radiation Therapy: first treatment of a spontaneous canine brain tumor. Int J Radiat Oncol Biol Phys 2022; 113:967-973. [DOI: 10.1016/j.ijrobp.2022.04.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/13/2022] [Accepted: 04/16/2022] [Indexed: 11/22/2022]
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Non-Targeted Effects of Synchrotron Radiation: Lessons from Experiments at the Australian and European Synchrotrons. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12042079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Studies have been conducted at synchrotron facilities in Europe and Australia to explore a variety of applications of synchrotron X-rays in medicine and biology. We discuss the major technical aspects of the synchrotron irradiation setups, paying specific attention to the Australian Synchrotron (AS) and the European Synchrotron Radiation Facility (ESRF) as those best configured for a wide range of biomedical research involving animals and future cancer patients. Due to ultra-high dose rates, treatment doses can be delivered within milliseconds, abiding by FLASH radiotherapy principles. In addition, a homogeneous radiation field can be spatially fractionated into a geometric pattern called microbeam radiotherapy (MRT); a coplanar array of thin beams of microscopic dimensions. Both are clinically promising radiotherapy modalities because they trigger a cascade of biological effects that improve tumor control, while increasing normal tissue tolerance compared to conventional radiation. Synchrotrons can deliver high doses to a very small volume with low beam divergence, thus facilitating the study of non-targeted effects of these novel radiation modalities in both in-vitro and in-vivo models. Non-targeted radiation effects studied at the AS and ESRF include monitoring cell–cell communication after partial irradiation of a cell population (radiation-induced bystander effect, RIBE), the response of tissues outside the irradiated field (radiation-induced abscopal effect, RIAE), and the influence of irradiated animals on non-irradiated ones in close proximity (inter-animal RIBE). Here we provide a summary of these experiments and perspectives on their implications for non-targeted effects in biomedical fields.
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Cavallone M, Prezado Y, De Marzi L. Converging Proton Minibeams with Magnetic Fields for Optimized Radiation Therapy: A Proof of Concept. Cancers (Basel) 2021; 14:cancers14010026. [PMID: 35008189 PMCID: PMC8750079 DOI: 10.3390/cancers14010026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Proton MiniBeam Radiation Therapy (pMBRT) is a novel strategy that combines the benefits of minibeam radiation therapy with the more precise ballistics of protons to further optimize the dose distribution and reduce radiation side effects. The aim of this study is to investigate possible strategies to couple pMBRT with dipole magnetic fields to generate a converging minibeam pattern and increase the center-to-center distance between minibeams. Magnetic field optimization was performed so as to obtain the same transverse dose profile at the Bragg peak position as in a reference configuration with no magnetic field. Monte Carlo simulations reproducing realistic pencil beam scanning settings were used to compute the dose in a water phantom. We analyzed different minibeam generation techniques, such as the use of a static multislit collimator or a dynamic aperture, and different magnetic field positions, i.e., before or within the water phantom. The best results were obtained using a dynamic aperture coupled with a magnetic field within the water phantom. For a center-to-center distance increase from 4 mm to 6 mm, we obtained an increase of peak-to-valley dose ratio and decrease of valley dose above 50%. The results indicate that magnetic fields can be effectively used to improve the spatial modulation at shallow depth for enhanced healthy tissue sparing.
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Affiliation(s)
- Marco Cavallone
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Institut Curie, Campus Universitaire, PSL Research University, 91898 Orsay, France
- Correspondence: (M.C.); (L.D.M.)
| | - Yolanda Prezado
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France;
| | - Ludovic De Marzi
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Institut Curie, Campus Universitaire, PSL Research University, 91898 Orsay, France
- Institut Curie, Campus Universitaire, PSL Research University, University Paris Saclay, INSERM LITO, 91898 Orsay, France
- Correspondence: (M.C.); (L.D.M.)
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Laissue JA, Barré S, Bartzsch S, Blattmann H, Bouchet AM, Djonov VG, Haberthür D, Hlushchuk R, Kaser-Hotz B, Laissue PP, LeDuc G, Reding SO, Serduc R. Tolerance of Normal Rabbit Facial Bones and Teeth to Synchrotron X-Ray Microbeam Irradiation. Radiat Res 2021; 197:233-241. [PMID: 34755190 DOI: 10.1667/rade-21-00032.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/30/2021] [Indexed: 11/03/2022]
Abstract
Microbeam radiation therapy, an alternative radiosurgical treatment under preclinical investigation, aims to safely treat muzzle tumors in pet animals. This will require data on the largely unknown radiation toxicity of microbeam arrays for bones and teeth. To this end, the muzzle of six young adult New Zealand rabbits was irradiated by a lateral array of microplanar beamlets with peak entrance doses of 200, 330 or 500 Gy. The muzzles were examined 431 days postirradiation by computed microtomographic imaging (micro-CT) ex vivo, and extensive histopathology. The boundaries of the radiation field were identified histologically by microbeam tracks in cartilage and other tissues. There was no radionecrosis of facial bones in any rabbit. Conversely, normal incisor teeth exposed to peak entrance doses of 330 Gy or 500 Gy developed marked caries-like damage, whereas the incisors of the two rabbits exposed to 200 Gy remained unscathed. A single, unidirectional array of microbeams with a peak entrance dose ≤200 Gy (valley dose14 Gy) did not damage normal bone, teeth and soft tissues of the muzzle of normal rabbits longer than one year after irradiation. Because of that, Microbeam radiation therapy of muzzle tumors in pet animals is unlikely to cause sizeable damage to normal teeth, bone and soft tissues, if a single array as used here delivers a limited entrance dose of 200 Gy and a valley dose of ≤14 Gy.
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Affiliation(s)
- Jean Albert Laissue
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
| | - Sébastien Barré
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
| | - Stefan Bartzsch
- Department of Radiation Oncology, Klinikum rechts der Isar - TU Munich, Germany
| | - Hans Blattmann
- Niederwiesstrasse 13C, CH-5417 Untersiggenthal, Switzerland
| | - Audrey M Bouchet
- INSERM UA8, "Radiations : Défense, Santé, Environnement," 69008 Lyon, France
| | | | - David Haberthür
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
| | - Ruslan Hlushchuk
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
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Smyth LML, Crosbie JC, Sloggett C, Rogers PAW, Donoghue JF. Spatially Fractionated X-Ray Microbeams Elicit a More Sustained Immune and Inflammatory Response in the Brainstem than Homogenous Irradiation. Radiat Res 2021; 196:355-365. [PMID: 34270776 DOI: 10.1667/rade-20-00082.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/22/2021] [Indexed: 11/03/2022]
Abstract
Synchrotron microbeam radiation therapy (MRT) is a preclinical irradiation technique which could be used to treat intracranial malignancies. The goal of this work was to discern differences in gene expression and the predicted regulation of molecular pathways in the brainstem after MRT versus synchrotron broad-beam radiation therapy (SBBR). Healthy C57BL/6 mice received whole-head irradiation with median acute toxic doses of MRT (241 Gy peak dose) or SBBR (13 Gy). Brains were harvested 4 and 48 h postirradiation and RNA was extracted from the brainstem. RNA-sequencing was performed to identify differentially expressed genes (false discovery rate < 0.01) relative to nonirradiated controls and significantly regulated molecular pathways and biological functions were identified (Benjamini-Hochberg corrected P < 0.05). Differentially expressed genes and regulated pathways largely reflected a pro-inflammatory response 4 h after both MRT and SBBR which was sustained at 48 h postirradiation for MRT. Pathways relating to radiation-induced viral mimicry, including HMGB1, NF-κB and interferon signaling cascades, were predicted to be uniquely activated by MRT. Local microglia, as well as circulating leukocytes, including T cells, were predicted to be activated by MRT. Our findings affirm that the transcriptomic signature of MRT is distinct from broad-beam radiotherapy, with a sustained inflammatory and immune response up to 48 h postirradiation.
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Affiliation(s)
- Lloyd M L Smyth
- Department of Obstetrics & Gynaecology, University of Melbourne, Royal Women's Hospital, Parkville, Australia
| | | | - Clare Sloggett
- Melbourne Bioinformatics, University of Melbourne, Parkville, Australia
| | - Peter A W Rogers
- Department of Obstetrics & Gynaecology, University of Melbourne, Royal Women's Hospital, Parkville, Australia
| | - Jacqueline F Donoghue
- Department of Obstetrics & Gynaecology, University of Melbourne, Royal Women's Hospital, Parkville, Australia
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Boerma M, Davis CM, Jackson IL, Schaue D, Williams JP. All for one, though not one for all: team players in normal tissue radiobiology. Int J Radiat Biol 2021; 98:346-366. [PMID: 34129427 DOI: 10.1080/09553002.2021.1941383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE As part of the special issue on 'Women in Science', this review offers a perspective on past and ongoing work in the field of normal (non-cancer) tissue radiation biology, highlighting the work of many of the leading contributors to this field of research. We discuss some of the hypotheses that have guided investigations, with a focus on some of the critical organs considered dose-limiting with respect to radiation therapy, and speculate on where the field needs to go in the future. CONCLUSIONS The scope of work that makes up normal tissue radiation biology has and continues to play a pivotal role in the radiation sciences, ensuring the most effective application of radiation in imaging and therapy, as well as contributing to radiation protection efforts. However, despite the proven historical value of preclinical findings, recent decades have seen clinical practice move ahead with altered fractionation scheduling based on empirical observations, with little to no (or even negative) supporting scientific data. Given our current appreciation of the complexity of normal tissue radiation responses and their temporal variability, with tissue- and/or organ-specific mechanisms that include intra-, inter- and extracellular messaging, as well as contributions from systemic compartments, such as the immune system, the need to maintain a positive therapeutic ratio has never been more urgent. Importantly, mitigation and treatment strategies, whether for the clinic, emergency use following accidental or deliberate releases, or reducing occupational risk, will likely require multi-targeted approaches that involve both local and systemic intervention. From our personal perspective as five 'Women in Science', we would like to acknowledge and applaud the role that many female scientists have played in this field. We stand on the shoulders of those who have gone before, some of whom are fellow contributors to this special issue.
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Affiliation(s)
- Marjan Boerma
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Catherine M Davis
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Isabel L Jackson
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dörthe Schaue
- Department of Radiation Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jacqueline P Williams
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Clinical microbeam radiation therapy with a compact source: specifications of the line-focus X-ray tube. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2021; 14:74-81. [PMID: 33458318 PMCID: PMC7807643 DOI: 10.1016/j.phro.2020.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/20/2020] [Accepted: 05/29/2020] [Indexed: 02/02/2023]
Abstract
Line-focus X-ray tubes are suitable for clinical microbeam radiation therapy (MRT). A modular high-voltage supply safely enables high electron beam powers. An electron accelerator was designed to generate an eccentric focal spot. We simulated a peak-to-valley dose ratio above 20 for single-field MRT. Microbeam arc therapy spares healthy brain tissue compared to single-field MRT.
Background and purpose Microbeam radiotherapy (MRT) is a preclinical concept in radiation oncology with arrays of alternating micrometer-wide high-dose peaks and low-dose valleys. Experiments demonstrated a superior normal tissue sparing at similar tumor control rates with MRT compared to conventional radiotherapy. Possible clinical applications are currently limited to large third-generation synchrotrons. Here, we investigated the line-focus X-ray tube as an alternative microbeam source. Materials and methods We developed a concept for a high-voltage supply and an electron source. In Monte Carlo simulations, we assessed the influence of X-ray spectrum, focal spot size, electron incidence angle, and photon emission angle on the microbeam dose distribution. We further assessed the dose distribution of microbeam arc therapy and suggested to interpret this complex dose distribution by equivalent uniform dose. Results An adapted modular multi-level converter can supply high-voltage powers in the megawatt range for a few seconds. The electron source with a thermionic cathode and a quadrupole can generate an eccentric, high-power electron beam of several 100 keV energy. Highest dose rates and peak-to-valley dose ratios (PVDRs) were achieved for an electron beam impinging perpendicular onto the target surface and a focal spot smaller than the microbeam cross-section. The line-focus X-ray tube simulations demonstrated PVDRs above 20. Conclusion The line-focus X-ray tube is a suitable compact source for clinical MRT. We demonstrated its technical feasibility based on state-of-the-art high-voltage and electron-beam technology. Microbeam arc therapy is an effective concept to increase the target-to-entrance dose ratio of orthovoltage microbeams.
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Toward personalized synchrotron microbeam radiation therapy. Sci Rep 2020; 10:8833. [PMID: 32483249 PMCID: PMC7264143 DOI: 10.1038/s41598-020-65729-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/08/2020] [Indexed: 12/12/2022] Open
Abstract
Synchrotron facilities produce ultra-high dose rate X-rays that can be used for selective cancer treatment when combined with micron-sized beams. Synchrotron microbeam radiation therapy (MRT) has been shown to inhibit cancer growth in small animals, whilst preserving healthy tissue function. However, the underlying mechanisms that produce successful MRT outcomes are not well understood, either in vitro or in vivo. This study provides new insights into the relationships between dosimetry, radiation transport simulations, in vitro cell response, and pre-clinical brain cancer survival using intracerebral gliosarcoma (9LGS) bearing rats. As part of this ground-breaking research, a new image-guided MRT technique was implemented for accurate tumor targeting combined with a pioneering assessment of tumor dose-coverage; an essential parameter for clinical radiotherapy. Based on the results of our study, we can now (for the first time) present clear and reproducible relationships between the in vitro cell response, tumor dose-volume coverage and survival post MRT irradiation of an aggressive and radioresistant brain cancer in a rodent model. Our innovative and interdisciplinary approach is illustrated by the results of the first long-term MRT pre-clinical trial in Australia. Implementing personalized synchrotron MRT for brain cancer treatment will advance this international research effort towards clinical trials.
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Lansonneur P, Mammar H, Nauraye C, Patriarca A, Hierso E, Dendale R, Prezado Y, De Marzi L. First proton minibeam radiation therapy treatment plan evaluation. Sci Rep 2020; 10:7025. [PMID: 32341427 PMCID: PMC7184593 DOI: 10.1038/s41598-020-63975-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/08/2020] [Indexed: 11/09/2022] Open
Abstract
Proton minibeam radiation therapy (pMBRT) is a novel dose delivery method based on spatial dose fractionation. pMBRT has been shown to be promising in terms of reduced side effects and superior tumour control in high-grade glioma-bearing rats compared to standard irradiation. These findings, together with the recent optimized implementation of pMBRT in a clinical pencil beam scanning system, have triggered reflection on the possible application to patient treatments. In this context, the present study was designed to conduct a first theoretical investigation of the clinical potential of this technique. For this purpose, a dedicated dose engine was developed and used to evaluate two clinically relevant patient treatment plans (high-grade glioma and meningioma). Treatment plans were compared with standard proton therapy plans assessed by means of a commercial treatment planning system (ECLIPSE-Varian Medical systems) and Monte Carlo simulations. A multislit brass collimator consisting of 0.4 mm wide slits separated by a centre-to-centre distance of 4 or 6 mm was placed between the nozzle and the patient to shape the planar minibeams. For each plan, spread-out Bragg peaks and homogeneous dose distributions (±7% dose variations) can be obtained in target volumes. The Peak-to-Valley Dose Ratios (PVDR) were evaluated between 9.2 and 12.8 at a depth of 20 mm for meningioma and glioma, respectively. Dose volume histograms (DVHs) for target volumes and organs at risk were quantitatively compared, resulting in a slightly better target homogeneity with standard PT than with pMBRT plans, but similar DVHs for deep-seated organs-at-risk and lower average dose for shallow organs. The proposed delivery method evaluated in this work opens the way to an effective treatment for radioresistant tumours and will support the design of future clinical research.
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Affiliation(s)
- P Lansonneur
- Institut Curie, PSL Research University, Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, 91898, Orsay, France
| | - H Mammar
- Institut Curie, PSL Research University, Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, 91898, Orsay, France
| | - C Nauraye
- Institut Curie, PSL Research University, Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, 91898, Orsay, France
| | - A Patriarca
- Institut Curie, PSL Research University, Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, 91898, Orsay, France
| | - E Hierso
- Institut Curie, PSL Research University, Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, 91898, Orsay, France
| | - R Dendale
- Institut Curie, PSL Research University, Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, 91898, Orsay, France
| | - Y Prezado
- Institut Curie, PSL Research University, University Paris Saclay, Inserm U 1021-CNRS UMR 3347, 91898, Orsay, France
| | - L De Marzi
- Institut Curie, PSL Research University, Radiation Oncology Department, Proton Therapy Centre, Centre Universitaire, 91898, Orsay, France. .,Institut Curie, PSL Research University, University Paris Saclay, Inserm U 1021-CNRS UMR 3347, 91898, Orsay, France.
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14
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Locomotion and eating behavior changes in Yucatan minipigs after unilateral radio-induced ablation of the caudate nucleus. Sci Rep 2019; 9:17082. [PMID: 31745153 PMCID: PMC6863900 DOI: 10.1038/s41598-019-53518-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/28/2019] [Indexed: 11/27/2022] Open
Abstract
The functional roles of the Caudate nucleus (Cd) are well known. Selective Cd lesions can be found in neurological disorders. However, little is known about the dynamics of the behavioral changes during progressive Cd ablation. Current stereotactic radiosurgery technologies allow the progressive ablation of a brain region with limited adverse effects in surrounding normal tissues. This could be of high interest for the study of the modified behavioral functions in relation with the degree of impairment of the brain structures. Using hypofractionated stereotactic radiotherapy combined with synchrotron microbeam radiation, we investigated, during one year after irradiation, the effects of unilateral radio-ablation of the right Cd on the behavior of Yucatan minipigs. The right Cd was irradiated to a minimal dose of 35.5 Gy delivered in three fractions. MRI-based morphological brain integrity and behavioral functions, i.e. locomotion, motivation/hedonism were assessed. We detected a progressive radio-necrosis leading to a quasi-total ablation one year after irradiation, with an additional alteration of surrounding areas. Transitory changes in the motivation/hedonism were firstly detected, then on locomotion, suggesting the influence of different compensatory mechanisms depending on the functions related to Cd and possibly some surrounding areas. We concluded that early behavioral changes related to eating functions are relevant markers for the early detection of ongoing lesions occurring in Cd-related neurological disorders.
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15
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Pellicioli P, Bartzsch S, Donzelli M, Krisch M, Bräuer-Krisch E. High resolution radiochromic film dosimetry: Comparison of a microdensitometer and an optical microscope. Phys Med 2019; 65:106-113. [PMID: 31450120 DOI: 10.1016/j.ejmp.2019.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Microbeam radiation therapy is a developing technique that promises superior tumour control and better normal tissue tolerance using spatially fractionated X-ray beams only tens of micrometres wide. Radiochromic film dosimetry at micrometric scale was performed using a microdensitometer, but this instrument presents limitations in accuracy and precision, therefore the use of a microscope is suggested as alternative. The detailed procedures developed to use the two devices are reported allowing a comparison. METHODS Films were irradiated with single microbeams and with arrays of 50 µm wide microbeams spaced by a 400 µm pitch, using a polychromatic beam with mean energy of 100 keV. The film dose measurements were performed using two independent instruments: a microdensitometer (MDM) and an optical microscope (OM). RESULTS The mean values of the absolute dose measured with the two instruments differ by less than 5% but the OM provides reproducibility with a standard deviation of 1.2% compared to up to 7% for the MDM. The resolution of the OM was determined to be ~ 1 to 2 µm in both planar directions able to resolve pencil beams irradiation, while the MDM reaches at the best 20 µm resolution along scanning direction. The uncertainties related to the data acquisition are 2.5-3% for the OM and 9-15% for the MDM. CONCLUSION The comparison between the two devices validates that the OM provides equivalent results to the MDM with better precision, reproducibility and resolution. In addition, the possibility to study dose distributions in two-dimensions over wider areas definitely sanctions the OM as substitute of the MDM.
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Affiliation(s)
- P Pellicioli
- The European Synchrotron Radiation Facility, ID17 Biomedical Beamline, Grenoble, France; Inserm UA7 STROBE, Grenoble Alpes University, Grenoble, France; Swansea University Medical School, Singleton Park, Swansea SA2 8PP, United Kingdom.
| | - S Bartzsch
- Helmholtz-Centre Munich, Institute of Innovative Radiation Therapy, Munich, Germany; Klinikum rechts der Isar, Department for Radiation Oncology, Technical University of Munich, Germany
| | - M Donzelli
- The European Synchrotron Radiation Facility, ID17 Biomedical Beamline, Grenoble, France; ICR - The Institute of Cancer Research, London, United Kingdom
| | - M Krisch
- The European Synchrotron Radiation Facility, ID17 Biomedical Beamline, Grenoble, France
| | - E Bräuer-Krisch
- The European Synchrotron Radiation Facility, ID17 Biomedical Beamline, Grenoble, France
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16
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Potez M, Fernandez-Palomo C, Bouchet A, Trappetti V, Donzelli M, Krisch M, Laissue J, Volarevic V, Djonov V. Synchrotron Microbeam Radiation Therapy as a New Approach for the Treatment of Radioresistant Melanoma: Potential Underlying Mechanisms. Int J Radiat Oncol Biol Phys 2019; 105:1126-1136. [PMID: 31461675 DOI: 10.1016/j.ijrobp.2019.08.027] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/04/2019] [Accepted: 08/18/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE Synchrotron microbeam radiation therapy (MRT) is a method that spatially distributes the x-ray beam into several microbeams of very high dose (peak dose), regularly separated by low-dose intervals (valley dose). MRT selectively spares normal tissues, relative to conventional (uniform broad beam [BB]) radiation therapy. METHODS AND MATERIALS To evaluate the effect of MRT on radioresistant melanoma, B16-F10 murine melanomas were implanted into mice ears. Tumors were either treated with MRT (407.6 Gy peak; 6.2 Gy valley dose) or uniform BB irradiation (6.2 Gy). RESULTS MRT induced significantly longer tumor regrowth delay than did BB irradiation. A significant 24% reduction in blood vessel perfusion was observed 5 days after MRT, and the cell proliferation index was significantly lower in melanomas treated by MRT compared with BB. MRT provoked a greater induction of senescence in melanoma cells. Bio-Plex analyses revealed enhanced concentration of monocyte-attracting chemokines in the MRT group: MCP-1 at D5, MIP-1α, MIP-1β, IL12p40, and RANTES at D9. This was associated with leukocytic infiltration at D9 after MRT, attributed mainly to CD8 T cells, natural killer cells, and macrophages. CONCLUSIONS In light of its potential to disrupt blood vessels that promote infiltration of the tumor by immune cells and its induction of senescence, MRT could be a new therapeutic approach for radioresistant melanoma.
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Affiliation(s)
- Marine Potez
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | | | - Audrey Bouchet
- Institute of Anatomy, University of Bern, Bern, Switzerland; Synchrotron Radiation for Biomedicine, INSERM UA7, 71 rue des Martyrs, 38000 Grenoble, France
| | | | - Mattia Donzelli
- Biomedical Beamline ID17, European Synchrotron Radiation Facility, Grenoble, France; Joint Department of Physics, The Institute of Cancer Research and the Royal Marsden Hospital, London, United Kingdom
| | - Michael Krisch
- Biomedical Beamline ID17, European Synchrotron Radiation Facility, Grenoble, France
| | - Jean Laissue
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Vladislav Volarevic
- Department of Microbiology and Immunology, Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Valentin Djonov
- Institute of Anatomy, University of Bern, Bern, Switzerland.
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17
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Identifying optimal clinical scenarios for synchrotron microbeam radiation therapy: A treatment planning study. Phys Med 2019; 60:111-119. [DOI: 10.1016/j.ejmp.2019.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/20/2019] [Accepted: 03/19/2019] [Indexed: 12/25/2022] Open
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18
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Donzelli M, Oelfke U, Bräuer-Krisch E. Introducing the concept of spiral microbeam radiation therapy (spiralMRT). Phys Med Biol 2019; 64:065005. [PMID: 30650386 DOI: 10.1088/1361-6560/aaff23] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
MOTIVATION With interlaced microbeam radiation therapy (MRT) a first kilovoltage radiotherapy (RT) concept combining spatially fractionated entrance beams and homogeneous dose distribution at the target exists. However, this technique suffers from its high sensitivity to positioning errors of the target relative to the radiation source. With spiral microbeam radiation therapy (spiralMRT), this publication introduces a new irradiation geometry, offering similar spatial fractionation properties as interlaced MRT, while being less vulnerable to target positioning uncertainties. METHODS The dose distributions achievable with spiralMRT in a simplified human head geometry were calculated with Monte Carlo simulations based on Geant4 and the dependence of the result on the microbeam pitch, total field size, and photon energy were analysed. A comparison with interlaced MRT and conventional megavoltage tomotherapy was carried out. RESULTS SpiralMRT can deliver homogeneous dose distributions, while using spatially fractionated entrance beams. The valley dose of spiralMRT entrance beams is by up to 40% lower than the corresponding tomotherapy dose, thus indicating a better normal tissue sparing. The optimum photon energy is found to be around [Formula: see text]. CONCLUSIONS SpiralMRT is a promising approach to delivering homogeneous dose distributions with spatially fractionated entrance beams, possibly decreasing normal tissue side effects in hypofractionated RT.
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Affiliation(s)
- Mattia Donzelli
- European Synchrotron Radiation Facility, Biomedical beamline ID17, Grenoble, France. Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom. Author to whom any correspondence should be addressed
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19
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Meyer J, Eley J, Schmid TE, Combs SE, Dendale R, Prezado Y. Spatially fractionated proton minibeams. Br J Radiol 2019; 92:20180466. [PMID: 30359081 PMCID: PMC6541186 DOI: 10.1259/bjr.20180466] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/11/2018] [Accepted: 10/15/2018] [Indexed: 12/26/2022] Open
Abstract
Extraordinary normal tissue response to highly spatially fractionated X-ray beams has been explored for over 25 years. More recently, alternative radiation sources have been developed and utilized with the aim to evoke comparable effects. These include protons, which lend themselves well for this endeavour due to their physical depth dose characteristics as well as corresponding variable biological effectiveness. This paper addresses the motivation for using protons to generate spatially fractionated beams and reviews the technological implementations and experimental results to date. This includes simulation and feasibility studies, collimation and beam characteristics, dosimetry and biological considerations as well as the results of in vivo and in vitro studies. Experimental results are emerging indicating an extraordinary normal tissue sparing effect analogous to what has been observed for synchrotron generated X-ray microbeams. The potential for translational research and feasibility of spatially modulated proton beams in clinical settings is discussed.
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Affiliation(s)
- Juergen Meyer
- Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - John Eley
- Department of Radiation Oncology, School of Medicine, University of Maryland, Baltimore, MD, USA
| | | | | | - Remi Dendale
- Institut Curie, Centre de Protonthérapie d’Orsay, Orsay, France
| | - Yolanda Prezado
- Laboratoire d'Imagerie et Modélisation en Neurobiologie et Cancérologie (IMNC), Centre National de la Recherche Scientifique, Universités Paris 11 and Paris 7, Campus d'Orsay, Orsay, France
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20
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Lobachevsky PN, Ventura J, Giannakandropoulou L, Forrester H, Palazzolo JS, Haynes NM, Stevenson AW, Hall CJ, Mason J, Pollakis G, Pateras IS, Gorgoulis V, Terzoudi GI, Hamilton JA, Sprung CN, Georgakilas AG, Martin OA. A Functional Immune System Is Required for the Systemic Genotoxic Effects of Localized Irradiation. Int J Radiat Oncol Biol Phys 2018; 103:1184-1193. [PMID: 30529375 DOI: 10.1016/j.ijrobp.2018.11.066] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 11/19/2018] [Accepted: 11/29/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE Nontargeted effects of ionizing radiation, by which unirradiated cells and tissues are also damaged, are a relatively new paradigm in radiobiology. We recently reported radiation-induced abscopal effects (RIAEs) in normal tissues; namely, DNA damage, apoptosis, and activation of the local and systemic immune responses in C57BL6/J mice after irradiation of a small region of the body. High-dose-rate, synchrotron-generated broad beam or multiplanar x-ray microbeam radiation therapy was used with various field sizes and doses. This study explores components of the immune system involved in the generation of these abscopal effects. METHODS AND MATERIALS The following mice with various immune deficiencies were irradiated with the microbeam radiation therapy beam: (1) SCID/IL2γR-/- (NOD SCID gamma, NSG) mice, (2) wild-type C57BL6/J mice treated with an antibody-blocking macrophage colony-stimulating factor 1 receptor, which depletes and alters the function of macrophages, and (3) chemokine ligand 2/monocyte chemotactic protein 1 null mice. Complex DNA damage (ie, DNA double-strand breaks), oxidatively induced clustered DNA lesions, and apoptotic cells in tissues distant from the irradiation site were measured as RIAE endpoints and compared with those in wild-type C57BL6/J mice. RESULTS Wild-type mice accumulated double-strand breaks, oxidatively induced clustered DNA lesions, and apoptosis, enforcing our RIAE model. However, these effects were completely or partially abrogated in mice with immune disruption, highlighting the pivotal role of the immune system in propagation of systemic genotoxic effects after localized irradiation. CONCLUSIONS These results underline the importance of not only delineating the best strategies for tumor control but also mitigating systemic radiation toxicity.
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Affiliation(s)
- Pavel N Lobachevsky
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Jessica Ventura
- University of Melbourne Department of Obstetrics & Gynaecology and Royal Women's Hospital
| | - Lina Giannakandropoulou
- School of Applied Mathematical & Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Helen Forrester
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research and Monash University, Clayton, Victoria, Australia
| | - Jason S Palazzolo
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Nicole M Haynes
- Cancer Therapeutics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Andrew W Stevenson
- Commonwealth Scientific and Industrial Research Organisation, Clayton, Victoria, Australia; Australian Synchrotron, Clayton, Victoria, Australia
| | | | - Joel Mason
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Gerasimos Pollakis
- School of Applied Mathematical & Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Ioannis S Pateras
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, University of Athens, Athens, Greece
| | - Vassilis Gorgoulis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, University of Athens, Athens, Greece; Biomedical Research Foundation, Academy of Athens, Athens, Greece; Institute for Cancer Sciences and Manchester Centre for Cellular Metabolism, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Georgia I Terzoudi
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, National Center for Scientific Research 'Demokritos', Athens, Greece
| | - John A Hamilton
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St. Albans, Victoria, Australia
| | - Carl N Sprung
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research and Monash University, Clayton, Victoria, Australia
| | - Alexandros G Georgakilas
- School of Applied Mathematical & Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Olga A Martin
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia; Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
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21
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Comparative toxicity of synchrotron and conventional radiation therapy based on total and partial body irradiation in a murine model. Sci Rep 2018; 8:12044. [PMID: 30104646 PMCID: PMC6089899 DOI: 10.1038/s41598-018-30543-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 07/30/2018] [Indexed: 11/09/2022] Open
Abstract
Synchrotron radiation can facilitate novel radiation therapy modalities such as microbeam radiation therapy (MRT) and high dose-rate synchrotron broad-beam radiation therapy (SBBR). Both of these modalities have unique physical properties that could be exploited for an improved therapeutic effect. While pre-clinical studies report promising normal tissue sparing phenomena, systematic toxicity data are still required. Our objective was to characterise the toxicity of SBBR and MRT and to calculate equivalent doses of conventional radiation therapy (CRT). A dose-escalation study was performed on C57BLJ/6 mice using total body and partial body irradiations. Dose-response curves and TD50 values were subsequently calculated using PROBIT analysis. For SBBR at dose-rates of 37 to 41 Gy/s, we found no evidence of a normal tissue sparing effect relative to CRT. Our findings also show that the MRT valley dose, rather than the peak dose, best correlates with CRT doses for acute toxicity. Importantly, longer-term weight tracking of irradiated animals revealed more pronounced growth impairment following MRT compared to both SBBR and CRT. Overall, this study provides the first in vivo dose-equivalence data between MRT, SBBR and CRT and presents systematic toxicity data for a range of organs that can be used as a reference point for future pre-clinical work.
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22
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Smyth LM, Rogers PAW, Crosbie JC, Donoghue JF. Characterization of Diffuse Intrinsic Pontine Glioma Radiosensitivity using Synchrotron Microbeam Radiotherapy and Conventional Radiation Therapy In Vitro. Radiat Res 2018; 189:146-155. [PMID: 29364085 DOI: 10.1667/rr4633.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Synchrotron microbeam radiation therapy is a promising preclinical radiotherapy modality that has been proposed as an alternative to conventional radiation therapy for diseases such as diffuse intrinsic pontine glioma (DIPG), a devastating pediatric tumor of the brainstem. The primary goal of this study was to characterize and compare the radiosensitivity of two DIPG cell lines (SF7761 and JHH-DIPG-1) to microbeam and conventional radiation. We hypothesized that these DIPG cell lines would exhibit differential responses to each radiation modality. Single cell suspensions were exposed to microbeam (112, 250, 560, 1,180 Gy peak dose) or conventional (2, 4, 6 and 8 Gy) radiation to produce clonogenic cell-survival curves. Apoptosis induction and the cell cycle were also analyzed five days postirradiation using flow cytometry. JHH-DIPG-1 cells displayed greater radioresistance than SF7761 to both microbeam and conventional radiation, with higher colony formation and increased accumulation of G2/M-phase cells. Apoptosis was significantly increased in SF7761 cells compared to JHH-DIPG-1 after microbeam irradiation, demonstrating cell-line specific differential radiosensitivity to microbeam radiation. Additionally, biologically equivalent doses to microbeam and conventional radiation were calculated based on clonogenic survival, furthering our understanding of the response of cancer cells to these two radiotherapy modalities.
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Affiliation(s)
- L M Smyth
- a University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville 3052, Australia.,b Epworth Radiation Oncology, Epworth HealthCare, Richmond 3121, Australia
| | - P A W Rogers
- a University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville 3052, Australia
| | - J C Crosbie
- c School of Science, RMIT University, Melbourne 3001, Australia.,d William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne 3004, Australia; and
| | - J F Donoghue
- a University of Melbourne, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville 3052, Australia.,c School of Science, RMIT University, Melbourne 3001, Australia.,e Hudson Institute of Medical Research, Monash University, Clayton 3168, Australia
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23
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Barbone GE, Bravin A, Romanelli P, Mittone A, Bucci D, Gaaβ T, Le Duc G, Auweter S, Reiser MF, Kraiger MJ, Hrabě de Angelis M, Battaglia G, Coan P. Micro-imaging of Brain Cancer Radiation Therapy Using Phase-contrast Computed Tomography. Int J Radiat Oncol Biol Phys 2018; 101:965-984. [PMID: 29976510 DOI: 10.1016/j.ijrobp.2018.03.063] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 03/23/2018] [Accepted: 03/29/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE Experimental neuroimaging provides a wide range of methods for the visualization of brain anatomic morphology down to subcellular detail. Still, each technique-specific detection mechanism presents compromises among the achievable field-of-view size, spatial resolution, and nervous tissue sensitivity, leading to partial sample coverage, unresolved morphologic structures, or sparse labeling of neuronal populations and often also to obligatory sample dissection or other sample invasive manipulations. X-ray phase-contrast imaging computed tomography (PCI-CT) is an experimental imaging method that simultaneously provides micrometric spatial resolution, high soft-tissue sensitivity, and ex vivo full organ rodent brain coverage without any need for sample dissection, staining or labeling, or contrast agent injection. In the present study, we explored the benefits and limitations of PCI-CT use for in vitro imaging of normal and cancerous brain neuromorphology after in vivo treatment with synchrotron-generated x-ray microbeam radiation therapy (MRT), a spatially fractionated experimental high-dose radiosurgery. The goals were visualization of the MRT effects on nervous tissue and a qualitative comparison of the results to the histologic and high-field magnetic resonance imaging findings. METHODS AND MATERIALS MRT was administered in vivo to the brain of both healthy and cancer-bearing rats. At 45 days after treatment, the brain was dissected out and imaged ex vivo using propagation-based PCI-CT. RESULTS PCI-CT visualizes the brain anatomy and microvasculature in 3 dimensions and distinguishes cancerous tissue morphology, necrosis, and intratumor accumulation of iron and calcium deposits. Moreover, PCI-CT detects the effects of MRT throughout the treatment target areas (eg, the formation of micrometer-thick radiation-induced tissue ablation). The observed neurostructures were confirmed by histologic and immunohistochemistry examination and related to the micro-magnetic resonance imaging data. CONCLUSIONS PCI-CT enabled a unique 3D neuroimaging approach for ex vivo studies on small animal models in that it concurrently delivers high-resolution insight of local brain tissue morphology in both normal and cancerous micro-milieu, localizes radiosurgical damage, and highlights the deep microvasculature. This method could assist experimental small animal neurology studies in the postmortem evaluation of neuropathology or treatment effects.
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Affiliation(s)
- Giacomo E Barbone
- Department of Physics, Ludwig Maximilians University, Garching, Germany
| | - Alberto Bravin
- European Synchrotron Radiation Facility, Grenoble, France
| | | | | | - Domenico Bucci
- Department of Molecular Pathology, Neuropharmacology Section, I.R.C.C.S. Neuromed, Pozzilli, Italy
| | - Thomas Gaaβ
- Department of Clinical Radiology, Ludwig Maximilians University, Munich, Germany
| | | | - Sigrid Auweter
- Department of Clinical Radiology, Ludwig Maximilians University, Munich, Germany
| | - Maximilian F Reiser
- Department of Clinical Radiology, Ludwig Maximilians University, Munich, Germany
| | - Markus J Kraiger
- Institute of Experimental Genetics and German Mouse Clinic, German Research Center for Environmental Health, Neuherberg, Germany
| | - Martin Hrabě de Angelis
- Institute of Experimental Genetics and German Mouse Clinic, German Research Center for Environmental Health, Neuherberg, Germany; Department of Experimental Genetics, School of Life Science Weihenstephan, Technical University of Munich, Freising, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Giuseppe Battaglia
- Department of Molecular Pathology, Neuropharmacology Section, I.R.C.C.S. Neuromed, Pozzilli, Italy
| | - Paola Coan
- Department of Physics, Ludwig Maximilians University, Garching, Germany; Department of Clinical Radiology, Ludwig Maximilians University, Munich, Germany.
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Blyth BJ, Cole AJ, MacManus MP, Martin OA. Radiation therapy-induced metastasis: radiobiology and clinical implications. Clin Exp Metastasis 2017; 35:223-236. [PMID: 29159430 DOI: 10.1007/s10585-017-9867-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 11/11/2017] [Indexed: 12/19/2022]
Abstract
Radiation therapy is an effective means of achieving local control in a wide range of primary tumours, with the reduction in the size of the tumour(s) thought to mediate the observed reductions in metastatic spread in clinical trials. However, there is evidence to suggest that the complex changes induced by radiation in the tumour environment can also present metastatic risks that may counteract the long-term efficacy of the treatment. More than 25 years ago, several largely theoretical mechanisms by which radiation exposure might increase metastatic risk were postulated. These include the direct release of tumour cells into the circulation, systemic effects of tumour and normal tissue irradiation and radiation-induced changes in tumour cell phenotype. Here, we review the data that has since emerged to either support or refute these putative mechanisms focusing on how the unique radiobiology underlying modern radiotherapy modalities might alter these risks.
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Affiliation(s)
- Benjamin J Blyth
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia. .,Cancer Research Division, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.
| | - Aidan J Cole
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Centre for Cancer Research and Cell Biology, Queen's University Belfast, Lisburn Road, Belfast, BT9 7BL, UK
| | - Michael P MacManus
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Olga A Martin
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Cancer Research Division, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010, Australia
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Bazyar S, Inscoe CR, O’Brian ET, Zhou O, Lee YZ. Minibeam radiotherapy with small animal irradiators; in vitro and in vivo feasibility studies. ACTA ACUST UNITED AC 2017; 62:8924-8942. [DOI: 10.1088/1361-6560/aa926b] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Ventura J, Lobachevsky PN, Palazzolo JS, Forrester H, Haynes NM, Ivashkevich A, Stevenson AW, Hall CJ, Ntargaras A, Kotsaris V, Pollakis GC, Potsi G, Skordylis K, Terzoudi G, Pateras IS, Gorgoulis VG, Georgakilas AG, Sprung CN, Martin OA. Localized Synchrotron Irradiation of Mouse Skin Induces Persistent Systemic Genotoxic and Immune Responses. Cancer Res 2017; 77:6389-6399. [PMID: 29113972 DOI: 10.1158/0008-5472.can-17-1066] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/07/2017] [Accepted: 09/19/2017] [Indexed: 11/16/2022]
Abstract
The importance of nontargeted (systemic) effects of ionizing radiation is attracting increasing attention. Exploiting synchrotron radiation generated by the Imaging and Medical Beamline at the Australian Synchrotron, we studied radiation-induced nontargeted effects in C57BL/6 mice. Mice were locally irradiated with a synchrotron X-ray broad beam and a multiplanar microbeam radiotherapy beam. To assess the influence of the beam configurations and variations in peak dose and irradiated area in the response of normal tissues outside the irradiated field at 1 and 4 days after irradiation, we monitored oxidatively induced clustered DNA lesions (OCDL), DNA double-strand breaks (DSB), apoptosis, and the local and systemic immune responses. All radiation settings induced pronounced persistent systemic effects in mice, which resulted from even short exposures of a small irradiated area. OCDLs were elevated in a wide variety of unirradiated normal tissues. In out-of-field duodenum, there was a trend for elevated apoptotic cell death under most irradiation conditions; however, DSBs were elevated only after exposure to lower doses. These genotoxic events were accompanied by changes in plasma concentrations of macrophage-derived cytokine, eotaxin, IL10, TIMP1, VEGF, TGFβ1, and TGFβ2, along with changes in tissues in frequencies of macrophages, neutrophils, and T lymphocytes. Overall, our findings have implications for the planning of therapeutic and diagnostic radiation treatments to reduce the risk of radiation-related adverse systemic effects. Cancer Res; 77(22); 6389-99. ©2017 AACR.
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Affiliation(s)
- Jessica Ventura
- Molecular Radiation Biology Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Pavel N Lobachevsky
- Molecular Radiation Biology Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jason S Palazzolo
- Molecular Radiation Biology Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Helen Forrester
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research and Monash University, Clayton, Victoria, Australia
| | - Nicole M Haynes
- Cancer Therapeutics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Alesia Ivashkevich
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research and Monash University, Clayton, Victoria, Australia.,Radiation Oncology, Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Andrew W Stevenson
- CSIRO, Clayton, Victoria, Australia.,Australian Synchrotron, Clayton, Victoria, Australia
| | | | - Andreas Ntargaras
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Vasilis Kotsaris
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Gerasimos Ch Pollakis
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Gianna Potsi
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Konstantinos Skordylis
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Georgia Terzoudi
- Laboratory of Health Physics, Radiobiology and Cytogenetics, Institute of Nuclear and Radiological Sciences and Technology, Energy and Safety, National Center for Scientific Research 'Demokritos', Athens, Greece
| | - Ioannis S Pateras
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassilis G Gorgoulis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Biomedical Research Foundation of the Academy of Athens, Athens, Greece.,Faculty Institute for Cancer Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Alexandros G Georgakilas
- Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Carl N Sprung
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research and Monash University, Clayton, Victoria, Australia
| | - Olga A Martin
- Molecular Radiation Biology Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. .,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.,Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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27
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X-ray microbeam measurements with a high resolution scintillator fibre-optic dosimeter. Sci Rep 2017; 7:12450. [PMID: 28963506 PMCID: PMC5622140 DOI: 10.1038/s41598-017-12697-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/18/2017] [Indexed: 01/08/2023] Open
Abstract
Synchrotron microbeam radiation therapy is a novel external beam therapy under investigation, that uses highly brilliant synchrotron x-rays in microbeams 50 μm width, with separation of 400 μm, as implemented here. Due to the fine spatial fractionation dosimetry of these beams is a challenging and complicated problem. In this proof-of-concept work, we present a fibre optic dosimeter that uses plastic scintillator as the radiation conversion material. We claim an ideal one-dimensional resolution of 50 μm. Using plastic scintillator and fibre optic makes this dosimeter water-equivalent, a very desirable dosimetric property. The dosimeter was tested at the Australian Synchrotron, on the Imaging and Medical Beam-Line. The individual microbeams were able to be resolved and the peak-to-valley dose ratio and the full width at half maximum of the microbeams was measured. These results are compared to a semiconductor strip detector of the same spatial resolution. A percent depth dose was measured and compared to data acquired by an ionisation chamber. The results presented demonstrate significant steps towards the development of an optical dosimeter with the potential to be applied in quality assurance of microbeam radiation therapy, which is vital if clinical trials are to be performed on human patients.
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Bazyar S, Inscoe CR, Benefield T, Zhang L, Lu J, Zhou O, Lee YZ. Neurocognitive sparing of desktop microbeam irradiation. Radiat Oncol 2017; 12:127. [PMID: 28800740 PMCID: PMC5554005 DOI: 10.1186/s13014-017-0864-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 08/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Normal tissue toxicity is the dose-limiting side effect of radiotherapy. Spatial fractionation irradiation techniques, like microbeam radiotherapy (MRT), have shown promising results in sparing the normal brain tissue. Most MRT studies have been conducted at synchrotron facilities. With the aim to make this promising treatment more available, we have built the first desktop image-guided MRT device based on carbon nanotube x-ray technology. In the current study, our purpose was to evaluate the effects of MRT on the rodent normal brain tissue using our device and compare it with the effect of the integrated equivalent homogenous dose. METHODS Twenty-four, 8-week-old male C57BL/6 J mice were randomly assigned to three groups: MRT, broad-beam (BB) and sham. The hippocampal region was irradiated with two parallel microbeams in the MRT group (beam width = 300 μm, center-to-center = 900 μm, 160 kVp). The BB group received the equivalent integral dose in the same area of their brain. Rotarod, marble burying and open-field activity tests were done pre- and every month post-irradiation up until 8 months to evaluate the cognitive changes and potential irradiation side effects on normal brain tissue. The open-field activity test was substituted by Barnes maze test at 8th month. A multilevel model, random coefficients approach was used to evaluate the longitudinal and temporal differences among treatment groups. RESULTS We found significant differences between BB group as compared to the microbeam-treated and sham mice in the number of buried marble and duration of the locomotion around the open-field arena than shams. Barnes maze revealed that BB mice had a lower capacity for spatial learning than MRT and shams. Mice in the BB group tend to gain weight at the slower pace than shams. No meaningful differences were found between MRT and sham up until 8-month follow-up using our measurements. CONCLUSIONS Applying MRT with our newly developed prototype compact CNT-based image-guided MRT system utilizing the current irradiation protocol can better preserve the integrity of normal brain tissue. Consequently, it enables applying higher irradiation dose that promises better tumor control. Further studies are required to evaluate the full extent effects of this novel modality.
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Affiliation(s)
- Soha Bazyar
- Department of Biomedical Engineering, The University of North Carolina at Chapel Hill, 350 Chapman Hall, 4Chapel Hill, NC, 27599, USA.
| | - Christina R Inscoe
- Department of Applied Physics Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Thad Benefield
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Lei Zhang
- Department of Applied Physics Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jianping Lu
- Department of Applied Physics Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, USA.,Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Otto Zhou
- Department of Applied Physics Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, USA.,Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA.,Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Yueh Z Lee
- Department of Biomedical Engineering, The University of North Carolina at Chapel Hill, 350 Chapman Hall, 4Chapel Hill, NC, 27599, USA. .,Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, USA. .,Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA. .,Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA. .,Department of Radiology, The University of North Carolina at Chapel Hill, CB#7510, Chapel Hill, NC, 27599, USA.
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Schültke E, Balosso J, Breslin T, Cavaletti G, Djonov V, Esteve F, Grotzer M, Hildebrandt G, Valdman A, Laissue J. Microbeam radiation therapy - grid therapy and beyond: a clinical perspective. Br J Radiol 2017; 90:20170073. [PMID: 28749174 PMCID: PMC5853350 DOI: 10.1259/bjr.20170073] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Microbeam irradiation is spatially fractionated radiation on a micrometer scale. Microbeam irradiation with therapeutic intent has become known as microbeam radiation therapy (MRT). The basic concept of MRT was developed in the 1980s, but it has not yet been tested in any human clinical trial, even though there is now a large number of animal studies demonstrating its marked therapeutic potential with an exceptional normal tissue sparing effect. Furthermore, MRT is conceptually similar to macroscopic grid based radiation therapy which has been used in clinical practice for decades. In this review, the potential clinical applications of MRT are analysed for both malignant and non-malignant diseases.
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Affiliation(s)
- Elisabeth Schültke
- 1 Department of Radiooncology, Rostock University Medical Center, Rostock, Germany
| | - Jacques Balosso
- 2 Departement of Radiation Oncology and Medical Physics, University Grenoble Alpes (UGA) and Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France
| | - Thomas Breslin
- 3 Department of Oncology, Clinical Sciences, Lund University, Lund, Sweden.,4 Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Guido Cavaletti
- 5 Experimental Neurology Unit and Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Valentin Djonov
- 6 Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Francois Esteve
- 2 Departement of Radiation Oncology and Medical Physics, University Grenoble Alpes (UGA) and Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France
| | - Michael Grotzer
- 7 Department of Oncology, University Children's Hospital of Zurich, Zurich, Switzerland
| | - Guido Hildebrandt
- 1 Department of Radiooncology, Rostock University Medical Center, Rostock, Germany
| | - Alexander Valdman
- 8 Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Jean Laissue
- 6 Institute of Anatomy, University of Bern, Bern, Switzerland
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Livingstone J, Adam JF, Crosbie JC, Hall CJ, Lye JE, McKinlay J, Pelliccia D, Pouzoulet F, Prezado Y, Stevenson AW, Häusermann D. Preclinical radiotherapy at the Australian Synchrotron's Imaging and Medical Beamline: instrumentation, dosimetry and a small-animal feasibility study. JOURNAL OF SYNCHROTRON RADIATION 2017; 24:854-865. [PMID: 28664893 DOI: 10.1107/s1600577517006233] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/25/2017] [Indexed: 06/07/2023]
Abstract
Therapeutic applications of synchrotron X-rays such as microbeam (MRT) and minibeam (MBRT) radiation therapy promise significant advantages over conventional clinical techniques for some diseases if successfully transferred to clinical practice. Preclinical studies show clear evidence that a number of normal tissues in animal models display a tolerance to much higher doses from MRT compared with conventional radiotherapy. However, a wide spread in the parameters studied makes it difficult to make any conclusions about the associated tumour control or normal tissue complication probabilities. To facilitate more systematic and reproducible preclinical synchrotron radiotherapy studies, a dedicated preclinical station including small-animal irradiation stage was designed and installed at the Imaging and Medical Beamline (IMBL) at the Australian Synchrotron. The stage was characterized in terms of the accuracy and reliability of the vertical scanning speed, as this is the key variable in dose delivery. The measured speed was found to be within 1% of the nominal speed for the range of speeds measured by an interferometer. Furthermore, dose measurements confirm the expected relationship between speed and dose and show that the measured dose is independent of the scan direction. Important dosimetric parameters such as peak dose, valley dose, the collimator output factor and peak-to-valley dose ratio are presented for 5 mm × 5 mm, 10 mm × 10 mm and 20 mm × 20 mm field sizes. Finally, a feasibility study on three glioma-bearing rats was performed. MRT and MBRT doses were prescribed to achieve an average dose of 65 Gy in the target, and magnetic resonance imaging follow-up was performed at various time points after irradiation to follow the tumour volume. Although it is impossible to draw conclusions on the different treatments with such a small number of animals, the feasibility of end-to-end preclinical synchrotron radiotherapy studies using the IMBL preclinical stage is demonstrated.
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Affiliation(s)
| | - Jean François Adam
- Equipe d'accueil Rayonnement Synchrotron et Recherche Médicale, Université Grenoble-Alpes, Grenoble, France
| | - Jeffrey C Crosbie
- School of Science, RMIT University, Melbourne, Victoria 3001, Australia
| | - Chris J Hall
- Australian Synchrotron, Clayton, Victoria 3168, Australia
| | - Jessica E Lye
- Australian Radiation Protection and Nuclear Safety Agency, Yallambie, Victoria 3085, Australia
| | | | - Daniele Pelliccia
- School of Science, RMIT University, Melbourne, Victoria 3001, Australia
| | | | - Yolanda Prezado
- Unité Imagerie et Modelisation en Neurobiologie et Cancerologie, Centre Nationnal de la Recherche Scientifique, Orsay, France
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31
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Poole CM, Day LRJ, Rogers PAW, Crosbie JC. Synchrotron microbeam radiotherapy in a commercially available treatment planning system. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa5f1a] [Citation(s) in RCA: 12] [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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32
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Pelliccia D, Crosbie JC, Larkin KG. Phase contrast image guidance for synchrotron microbeam radiotherapy. Phys Med Biol 2016; 61:5942-55. [DOI: 10.1088/0031-9155/61/16/5942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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