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Monaco V, Ali OH, Bersani D, Abujami M, Boscardin M, Cartiglia N, Betta GFD, Data E, Donetti M, Ferrero M, Ficorella F, Giordanengo S, Villarreal OAM, Milian FM, Mohammadian-Behbahani MR, Olivares DM, Pullia M, Tommasino F, Verroi E, Vignati A, Cirio R, Sacchi R. Performance of LGAD strip detectors for particle counting of therapeutic proton beams. Phys Med Biol 2023; 68:235009. [PMID: 37827167 DOI: 10.1088/1361-6560/ad02d5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/12/2023] [Indexed: 10/14/2023]
Abstract
Objective. The performance of silicon detectors with moderate internal gain, named low-gain avalanche diodes (LGADs), was studied to investigate their capability to discriminate and count single beam particles at high fluxes, in view of future applications for beam characterization and on-line beam monitoring in proton therapy.Approach. Dedicated LGAD detectors with an active thickness of 55μm and segmented in 2 mm2strips were characterized at two Italian proton-therapy facilities, CNAO in Pavia and the Proton Therapy Center of Trento, with proton beams provided by a synchrotron and a cyclotron, respectively. Signals from single beam particles were discriminated against a threshold and counted. The number of proton pulses for fixed energies and different particle fluxes was compared with the charge collected by a compact ionization chamber, to infer the input particle rates.Main results. The counting inefficiency due to the overlap of nearby signals was less than 1% up to particle rates in one strip of 1 MHz, corresponding to a mean fluence rate on the strip of about 5 × 107p/(cm2·s). Count-loss correction algorithms based on the logic combination of signals from two neighboring strips allow to extend the maximum counting rate by one order of magnitude. The same algorithms give additional information on the fine time structure of the beam.Significance. The direct counting of the number of beam protons with segmented silicon detectors allows to overcome some limitations of gas detectors typically employed for beam characterization and beam monitoring in particle therapy, providing faster response times, higher sensitivity, and independence of the counts from the particle energy.
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Affiliation(s)
- Vincenzo Monaco
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Omar Hammad Ali
- Fondazione Bruno Kessler, Center for Sensors & Devices , Trento, Italy
| | - Davide Bersani
- Istituto Nazionale di Fisica Nucleare, sezione di Pisa, Italy
| | - Mohammed Abujami
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Maurizio Boscardin
- Fondazione Bruno Kessler, Center for Sensors & Devices , Trento, Italy
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
| | | | - Gian Franco Dalla Betta
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
- Università degli Studi di Trento, Trento, Italy
| | - Emanuele Data
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Marco Donetti
- CNAO, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - Marco Ferrero
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | | | | | | | - Felix Mas Milian
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
- Universidade Estadual de Santa Cruz, Department of Exact and Technological Sciences, Ilhéus, Brazil
| | | | - Diango Montalvan Olivares
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Marco Pullia
- CNAO, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
- Università degli Studi di Trento, Trento, Italy
| | - Enrico Verroi
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
| | - Anna Vignati
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Roberto Cirio
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Roberto Sacchi
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
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Di Fino L, Romoli G, Santi Amantini G, Boretti V, Lunati L, Berucci C, Messi R, Rizzo A, Albicocco P, De Donato C, Masciantonio G, Morone MC, Nobili G, Baiocco G, Mentana A, Pullia M, Tommasino F, Carrubba E, Bardi A, Passerai M, Castagnolo D, Mascetti G, Crisconio M, Matthiä D, Narici L. Radiation measurements in the International Space Station, Columbus module, in 2020-2022 with the LIDAL detector. Life Sci Space Res (Amst) 2023; 39:26-42. [PMID: 37945086 DOI: 10.1016/j.lssr.2023.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 11/12/2023]
Abstract
The Light Ion Detector for ALTEA (LIDAL) is a new instrument designed to measure flux, energy spectra and Time of Flight of ions in a space habitat. It was installed in the International Space Station (Columbus) on January 19, 2020 and it is still operating. This paper presents the results of LIDAL measurements in the first 17 months of operation (01/2020-05/2022). Particle flux, dose rate, Time of Flight and spectra are presented and studied in the three ISS orthogonal directions and in the different geomagnetic regions (high latitude, low latitude, and South Atlantic Anomaly, SAA). The results are consistent with previous measurements. Dose rates range between 1.8 nGy/s and 2.4 nGy/s, flux between 0.21 particles/(sr cm2 s) and 0.32 particles/(sr cm2 s) as measured across time and directions during the full orbit. These data offer insights concerning the radiation measurements in the ISS and demonstrate the capabilities of LIDAL as a unique tool for the measurement of space radiation in space habitats, also providing novel information relevant to assess radiation risks for astronauts.
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Affiliation(s)
- L Di Fino
- ASI - Agenzia Spaziale Italiana, Rome, Italy.
| | - G Romoli
- Physics Department, Università di Roma Tor Vergata, Rome, Italy; INFN - Roma Tor Vergata, Rome Italy
| | | | - V Boretti
- Physics Department, Università di Roma Tor Vergata, Rome, Italy
| | - L Lunati
- Physics Department, Università di Roma Tor Vergata, Rome, Italy
| | - C Berucci
- Physics Department, Università di Roma Tor Vergata, Rome, Italy; INFN - Roma Tor Vergata, Rome Italy
| | - R Messi
- Physics Department, Università di Roma Tor Vergata, Rome, Italy; INFN - Roma Tor Vergata, Rome Italy
| | - A Rizzo
- ENEA, Radioprotection Institute (IRP), via Anguillarese 301, 00123, Rome, Italy
| | | | | | | | - M C Morone
- Physics Department, Università di Roma Tor Vergata, Rome, Italy; INFN - Roma Tor Vergata, Rome Italy
| | - G Nobili
- INFN - Roma Tor Vergata, Rome Italy
| | - G Baiocco
- Physics Department, University of Pavia, Pavia, Italy
| | - A Mentana
- Physics Department, University of Pavia, Pavia, Italy
| | - M Pullia
- CNAO, Str. Campeggi, 53, Pavia, Italy
| | - F Tommasino
- University of Trento, Department of Physics, Povo TN, Italy
| | - E Carrubba
- Kayser Italia, Via di Popogna, 501, 57128 Livorno, Italy
| | - A Bardi
- Kayser Italia, Via di Popogna, 501, 57128 Livorno, Italy
| | - M Passerai
- Kayser Italia, Via di Popogna, 501, 57128 Livorno, Italy
| | - D Castagnolo
- Telespazio, Via Louis Bleriot, 82 - c/o Centro R. Bonifacio, 80144 Napoli, Italy
| | - G Mascetti
- ASI - Agenzia Spaziale Italiana, Rome, Italy
| | - M Crisconio
- ASI - Agenzia Spaziale Italiana, Rome, Italy
| | - D Matthiä
- German Aerospace Center (DLR), Institute of Aerospace Medicine, 51147 Cologne, Germany
| | - L Narici
- ASI - Agenzia Spaziale Italiana, Rome, Italy; Physics Department, Università di Roma Tor Vergata, Rome, Italy; INFN - Roma Tor Vergata, Rome Italy
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Bianchi A, Selva A, Rossignoli M, Pasquato F, Missiaggia M, La Tessa C, Scifoni E, Tommasino F, Conte V. Microdosimetric analysis of the radiation quality of two different proton beams in the distal edge of the depth-dose profile. Radiat Prot Dosimetry 2023; 199:1979-1983. [PMID: 37819318 DOI: 10.1093/rpd/ncac236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 10/13/2023]
Abstract
Proton-therapy exploits the advantageous depth-dose profile of protons to induce the highest damage to tumoral cells in the last millimetres of their range in sharp Bragg Peak. To cover the whole tumoral volume, beams of different energies are combined to create the Spread Out Bragg Peak (SOBP). In passive modulated beams, the energy spread is created with modulators in which the highest energy beam is degraded through different thicknesses of calibrated plastic materials. The highest energy is chosen depending on the deepest point that needs to be treated. This study aims to investigate differences in the radiation quality in the distal edge of SOBP beams with different initial energy and modulation techniques based on microdosimetric measurements with mini Tissue-Equivalent Proportional Counters. The beams investigated are the 62 MeV proton SOBP of the clinical facility of CATANA and the 148 MeV proton SOBP of the research beam line of the proton-therapy centre of Trento.
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Affiliation(s)
- A Bianchi
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - A Selva
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - M Rossignoli
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - F Pasquato
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - M Missiaggia
- University of Trento, Dipartimento di Fisica, 38123 Povo Trento, Italy
- Trento Institute of Fundamental Physics and Applications, 38123 Povo Trento, Italy
| | - C La Tessa
- University of Trento, Dipartimento di Fisica, 38123 Povo Trento, Italy
- Trento Institute of Fundamental Physics and Applications, 38123 Povo Trento, Italy
| | - E Scifoni
- Trento Institute of Fundamental Physics and Applications, 38123 Povo Trento, Italy
| | - F Tommasino
- University of Trento, Dipartimento di Fisica, 38123 Povo Trento, Italy
- Trento Institute of Fundamental Physics and Applications, 38123 Povo Trento, Italy
| | - V Conte
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
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Vignati A, Mas Milian F, Shakarami Z, Abujami M, Bersani D, Data E, Donetti M, Ferrero V, Galeone C, Giordanengo S, Hammad Ali O, Marti Villarreal OA, Medina E, Montalvan Olivares D, Paternoster G, Tommasino F, Cirio R, Monaco V, Sacchi R. Calibration method and performance of a time-of-flight detector to measure absolute beam energy in proton therapy. Med Phys 2023; 50:5817-5827. [PMID: 37493525 DOI: 10.1002/mp.16637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 07/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND The beam energy is one of the most significant parameters in particle therapy since it is directly correlated to the particles' penetration depth inside the patient. Nowadays, the range accuracy is guaranteed by offline routine quality control checks mainly performed with water phantoms, 2D detectors with PMMA wedges, or multi-layer ionization chambers. The latter feature low sensitivity, slow collection time, and response dependent on external parameters, which represent limiting factors for the quality controls of beams delivered with fast energy switching modalities, as foreseen in future treatments. In this context, a device based on solid-state detectors technology, able to perform a direct and absolute beam energy measurement, is proposed as a viable alternative for quality assurance measurements and beam commissioning, paving the way for online range monitoring and treatment verification. PURPOSE This work follows the proof of concept of an energy monitoring system for clinical proton beams, based on Ultra Fast Silicon Detectors (featuring tenths of ps time resolution in 50 μm active thickness, and single particle detection capability) and time-of-flight techniques. An upgrade of such a system is presented here, together with the description of a dedicated self-calibration method, proving that this second prototype is able to assess the mean particles energy of a monoenergetic beam without any constraint on the beam temporal structure, neither any a priori knowledge of the beam energy for the calibration of the system. METHODS A new detector geometry, consisting of sensors segmented in strips, has been designed and implemented in order to enhance the statistics of coincident protons, thus improving the accuracy of the measured time differences. The prototype was tested on the cyclotron proton beam of the Trento Protontherapy Center (TPC). In addition, a dedicated self-calibration method, exploiting the measurement of monoenergetic beams crossing the two telescope sensors for different flight distances, was introduced to remove the systematic uncertainties independently from any external reference. RESULTS The novel calibration strategy was applied to the experimental data collected at TPC (Trento) and CNAO (Pavia). Deviations between measured and reference beam energies in the order of a few hundreds of keV with a maximum uncertainty of 0.5 MeV were found, in compliance with the clinically required water range accuracy of 1 mm. CONCLUSIONS The presented version of the telescope system, minimally perturbative of the beam, relies on a few seconds of acquisition time to achieve the required clinical accuracy and therefore represents a feasible solution for beam commission, quality assurance checks, and online beam energy monitoring.
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Affiliation(s)
- Anna Vignati
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Felix Mas Milian
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
- Department of Exact and Technological Sciences, Universidade Estadual de Santa Cruz, Ilhéus, Brazil
| | - Zahra Shakarami
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Mohammed Abujami
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Davide Bersani
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Emanuele Data
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Marco Donetti
- Centro Nazionale di Adroterapia Oncologica, CNAO, Pavia, Italy
| | | | - Cosimo Galeone
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | | | - Omar Hammad Ali
- FBK, Fondazione Bruno Kessler, Center for Sensors and Devices, Trento, Italy
| | | | - Elisabetta Medina
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Diango Montalvan Olivares
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | | | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications, TIFPA-INFN, Povo, Trento, Italy
- Department of Physics, University of Trento, Povo, Trento, Italy
| | - Roberto Cirio
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Vincenzo Monaco
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
| | - Roberto Sacchi
- Dipartimento di Fisica, Università degli Studi di Torino, Torino, Italy
- INFN, sezione di Torino, Torino, Italy
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Scaringella M, Bruzzi M, Farace P, Fogazzi E, Righetto R, Rit S, Tommasino F, Verroi E, Civinini C. The INFN proton computed tomography system for relative stopping power measurements: calibration and verification. Phys Med Biol 2023; 68:154001. [PMID: 37379855 DOI: 10.1088/1361-6560/ace2a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/28/2023] [Indexed: 06/30/2023]
Abstract
Objective. This paper describes the procedure to calibrate the three-dimensional (3D) proton stopping power relative to water (SPR) maps measured by the proton computed tomography (pCT) apparatus of the Istituto Nazionale di Fisica Nucleare (INFN, Italy). Measurements performed on water phantoms are used to validate the method. The calibration allowed for achieving measurement accuracy and reproducibility to levels below 1%.Approach. The INFN pCT system is made of a silicon tracker for proton trajectory determination followed by a YAG:Ce calorimeter for energy measurement. To perform the calibration, the apparatus has been exposed to protons of energies ranging from 83 to 210 MeV. Using the tracker, a position-dependent calibration has been implemented to keep the energy response uniform across the calorimeter. Moreover, correction algorithms have been developed to reconstruct the proton energy when this is shared in more than one crystal and to consider the energy loss in the non-uniform apparatus material. To verify the calibration and its reproducibility, water phantoms have been imaged with the pCT system during two data-taking sessions.Main results. The energy resolution of the pCT calorimeter resulted to beσEE≅0.9%at 196.5 MeV. The average values of the water SPR in fiducial volumes of the control phantoms have been calculated to be 0.995±0.002. The image non-uniformities were below 1%. No appreciable variation of the SPR and uniformity values between the two data-taking sessions could be identified.Significance. This work demonstrates the accuracy and reproducibility of the calibration of the INFN pCT system at a level below 1%. Moreover, the uniformity of the energy response keeps the image artifacts at a low level even in the presence of calorimeter segmentation and tracker material non-uniformities. The implemented calibration technique allows the INFN-pCT system to face applications where the precision of the SPR 3D maps is of paramount importance.
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Affiliation(s)
- Monica Scaringella
- Istituto Nazionale di Fisica Nucleare sezione di Firenze, Via G. Sansone 1, Sesto Fiorentino (Fi), Italy
| | - Mara Bruzzi
- Istituto Nazionale di Fisica Nucleare sezione di Firenze, Via G. Sansone 1, Sesto Fiorentino (Fi), Italy
- Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, via G. Sansone 1, Sesto Fiorentino (Fi), Italy
| | - Paolo Farace
- Medical Physics Department, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), Via Paolo Orsi, 1, Trento, Italy
- Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Povo (Tn), Italy
| | - Elena Fogazzi
- Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Povo (Tn), Italy
- Dipartimento di Fisica Università di Trento, via Sommarive 14, Povo (Tn), Italy
| | - Roberto Righetto
- Medical Physics Department, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), Via Paolo Orsi, 1, Trento, Italy
- Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Povo (Tn), Italy
| | - Simon Rit
- University of Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS, UMR 5220, U1294 F-69373, Lyon, France
| | - Francesco Tommasino
- Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Povo (Tn), Italy
- Dipartimento di Fisica Università di Trento, via Sommarive 14, Povo (Tn), Italy
| | - Enrico Verroi
- Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Povo (Tn), Italy
| | - Carlo Civinini
- Istituto Nazionale di Fisica Nucleare sezione di Firenze, Via G. Sansone 1, Sesto Fiorentino (Fi), Italy
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Fogazzi E, Trevisan D, Farace P, Righetto R, Rit S, Scaringella M, Bruzzi M, Tommasino F, Civinini C. Characterization of the INFN proton CT scanner for cross-calibration of x-ray CT. Phys Med Biol 2023. [PMID: 37201529 DOI: 10.1088/1361-6560/acd6d3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The goal of this study was to assess the imaging performances of the pCT system developed in the framework of INFN-funded (Italian National Institute of Nuclear Physics) research projects. The spatial resolution, noise power spectrum and RSP accuracy has been investigated, as a preliminary step to implement a new cross-calibration method for x-ray CT (xCT). 
Approach: The INFN pCT apparatus, made of four planes of silicon micro-strip detectors and a YAG:Ce scintillating calorimeter, reconstructs 3D RSP maps by a filtered-back projection algorithm. The imaging performances (i.e. spatial resolution, noise power spectrum and RSP accuracy) of the pCT system were assessed on a custom-made phantom, made of plastic materials with different densities ([0.66, 2.18] g/cm3). For comparison, the same phantom was acquired with a clinical xCT system.
Main results: The spatial resolution analysis revealed the non-linearity of the imaging system, showing different imaging responses in air or water phantom background. Applying the Hann filter in the pCT reconstruction, it was possible to investigate the imaging potential of the system. Matching the spatial resolution value of the xCT (0.54 lp/mm) and acquiring both with the same dose level (11.6 mGy), the pCT appeared to be less noisy than xCT, with an RSP standard deviation of 0.0063. Concerning the RSP accuracy, the measured Mean Absolute Percentage Errors were (0.23+-0.09)% in air and (0.21+-0.07)% in water.
Significance: The obtained performances confirm that the INFN pCT system provides a very accurate RSP estimation, appearing to be a feasible clinical tool for verification and correction of xCT calibration in proton treatment planning.
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Affiliation(s)
- Elena Fogazzi
- Dipartimento di Fisica, Università degli Studi di Trento, Via Sommarive, 14, Povo (TN), 38122, ITALY
| | - Diego Trevisan
- Medical Physics Unit, , Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), via Paolo Orsi, 1, Trento, 38122, ITALY
| | - Paolo Farace
- Medical Physics Unit, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), via Paolo Orsi, 1, Trento, 38122, ITALY
| | - Roberto Righetto
- Medical Physics Unit, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), via Paolo Orsi, 1, Trento, Trento, 38122, ITALY
| | - Simon Rit
- Université de Lyon, CREATIS ; CNRS UMR5220 ; Inserm U1206 ; INSA-Lyon ; Université Lyon 1, CREATIS, Centre Léon Bérard, Lyon, 69373, FRANCE
| | - Monica Scaringella
- Istituto Nazionale di Fisica Nucleare Sezione di Firenze, Via G. Sansone 1, Sesto Fiorentino, 50019, ITALY
| | - Mara Bruzzi
- Dipartimento di Fisica e Astronomia, Universita di Firenze, Via G. Sansone, 1, Sesto Fiorentino, 50019, ITALY
| | - Francesco Tommasino
- Physics, University of Trento, via Sommarive, 14, Trento, Trentino-Alto Adige, 38122, ITALY
| | - Carlo Civinini
- Istituto Nazionale di Fisica Nucleare Sezione di Firenze, Via G. Sansone, 1, Sesto Fiorentino, 50019, ITALY
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Tommasino F, Cartechini G, Righetto R, Farace P, Cianchetti M. Does variable RBE affect toxicity risks for mediastinal lymphoma patients? NTCP-based evaluation after proton therapy treatment. Phys Med 2023; 108:102569. [PMID: 36989976 DOI: 10.1016/j.ejmp.2023.102569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/04/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION Mediastinal lymphoma (ML) is a solid malignancy affecting young patients. Modern combined treatments allow obtaining good survival probability, together with a long life expectancy, and therefore with the need to minimize treatment-related toxicities. We quantified the expected toxicity risk for different organs and endpoints in ML patients treated with intensity-modulated proton therapy (IMPT) at our centre, accounting also for uncertainties related to variable RBE. METHODS Treatment plans for ten ML patients were recalculated with a TOPAS-based Monte Carlo code, thus retrieving information on LET and allowing the estimation of variable RBE. Published NTCP models were adopted to calculate the toxicity risk for hypothyroidism, heart valve defects, coronary heart disease and lung fibrosis. NTCP was calculated assuming both constant (i.e. 1.1) and variable RBE. The uncertainty associated with individual radiosensitivity was estimated by random sampling α/β values before RBE evaluation. RESULTS Variable RBE had a minor impact on hypothyroidism risk for 7 patients, while it led to significant increase for the remaining three (+24% risk maximum increase). Lung fibrosis was slightly affected by variable RBE, with a maximum increase of ≅ 1%. This was similar for heart valve dysfunction, with the exception of one patient showing an about 10% risk increase, which could be explained by means of large heart volume and D1 increase. DISCUSSION The use of NTCP models allows for identifying those patients associated with a higher toxicity risk. For those patients, it might be worth including variable RBE in plan evaluation.
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Missiaggia M, Cartechini G, Tommasino F, Scifoni E, La Tessa C. Investigation of In-Field and Out-of-Field Radiation Quality With Microdosimetry and Its Impact on Relative Biological Effectiveness in Proton Therapy. Int J Radiat Oncol Biol Phys 2023; 115:1269-1282. [PMID: 36442542 DOI: 10.1016/j.ijrobp.2022.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/09/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Using microdosimetry, this study investigated the relative biological effectiveness (RBE) and quality factor (Q¯) variations in field and out of field as a function of radiation quality for clinical protons. METHODS AND MATERIALS A water phantom with a spread-out Bragg peak (SOBP) was irradiated to acquire microdosimetric spectra at several distal and lateral depths with a tissue equivalent proportional counter. The measurements were used as inputs to microdosimetric kinetic and Loncol models to determine the RBE spatial distribution and compare it with predictions from the dose-averaged linear energy transfer-based McNamara model. Q¯ values and biological and dose equivalent values were also calculated. RESULTS The data demonstrated that radiation quality changed more rapidly with depth than lateral distance from the SOBP. In beam, yD ranged from approximately 4 keV/μm at the entrance to 8 keV/μm at the SOBP far end, reaching approximately 15 keV/μm at the penumbra. Out of field, the overall highest value of 23 ± 2 keV/μm was observed at the beam-edge penumbra. Radiation quality changes caused RBE deviations from the clinical value of 1.1, whose extent depends on the approach used for assessing radiation quality as well as on the radiobiological model. For RBE10, microdosimetry-based models appeared to better reproduce the radiobiological data than the dose-averaged linear energy transfer model. Out of field, both the RBE and Q¯ values appeared to have limitations in describing the radiation biological effectiveness. This research also presents a first comprehensive benchmark of TOPAS code against in-field and out-of-field microdosimetric spectra of therapeutic protons. CONCLUSIONS Further investigation will be necessary to evaluate the quantitative effects of RBE variations on treatment planning and assess the clinical consequences in terms of both tumor control and normal-tissue toxicity. The achievement of this goal calls for accurate radiobiological data to validate the RBE models.
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Affiliation(s)
- Marta Missiaggia
- Department of Physics, University of Trento, Trento, Italy; Trento Institute of Fundamental Physics and Applications (INFN-TIFPA), Trento, Italy; Department of Radiation Oncology, University of Miami, Miami, Florida
| | - Giorgio Cartechini
- Department of Physics, University of Trento, Trento, Italy; Trento Institute of Fundamental Physics and Applications (INFN-TIFPA), Trento, Italy
| | - Francesco Tommasino
- Department of Physics, University of Trento, Trento, Italy; Trento Institute of Fundamental Physics and Applications (INFN-TIFPA), Trento, Italy
| | - Emanuele Scifoni
- Trento Institute of Fundamental Physics and Applications (INFN-TIFPA), Trento, Italy
| | - Chiara La Tessa
- Department of Physics, University of Trento, Trento, Italy; Trento Institute of Fundamental Physics and Applications (INFN-TIFPA), Trento, Italy; Department of Radiation Oncology, University of Miami, Miami, Florida.
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9
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Romoli G, Di Fino L, Santi Amantini G, Boretti V, Lunati L, Berucci C, Messi R, Rizzo A, Albicocco P, De Donato C, Masciantonio G, Morone MC, Nobili G, Baiocco G, Mentana A, Pullia M, Tommasino F, Carrubba E, Bardi A, Passerai M, Castagnolo D, Mascetti G, Crisconio M, Narici L. LIDAL, a Time-of-Flight Radiation Detector for the International Space Station: Description and Ground Calibration. Sensors (Basel) 2023; 23:3559. [PMID: 37050619 PMCID: PMC10098940 DOI: 10.3390/s23073559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/14/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
LIDAL (Light Ion Detector for ALTEA, Anomalous Long-Term Effects on Astronauts) is a radiation detector designed to measure the flux, the energy spectra and, for the first time, the time-of-flight of ions in a space habitat. It features a combination of striped silicon sensors for the measurement of deposited energy (using the ALTEA device, which operated from 2006 to 2012 in the International Space Station) and fast scintillators for the time-of-flight measurement. LIDAL was tested and calibrated using the proton beam line at TIFPA (Trento Institute for Fundamental Physics Application) and the carbon beam line at CNAO (National Center for Oncology Hadron-therapy) in 2019. The performance of the time-of-flight system featured a time resolution (sigma) less than 100 ps. Here, we describe the detector and the results of these tests, providing ground calibration curves along with the methodology established for processing the detector's data. LIDAL was uploaded in the International Space Station in November 2019 and it has been operative in the Columbus module since January 2020.
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Affiliation(s)
- Giulia Romoli
- Department of Physics, University of Rome Tor Vergata, 00133 Rome, Italy
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
| | | | | | - Virginia Boretti
- Department of Physics, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Luca Lunati
- Department of Physics, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Carolina Berucci
- Department of Physics, University of Rome Tor Vergata, 00133 Rome, Italy
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
| | - Roberto Messi
- Department of Physics, University of Rome Tor Vergata, 00133 Rome, Italy
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
| | - Alessandro Rizzo
- Institute of Radioprotection (IRP), Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), 00123 Roma, Italy
| | - Pietro Albicocco
- National Institute for Nuclear Physics—Frascati National Laboratory, 00044 Rome, Italy
| | - Cinzia De Donato
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giuseppe Masciantonio
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
| | - Maria Cristina Morone
- Department of Physics, University of Rome Tor Vergata, 00133 Rome, Italy
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giovanni Nobili
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giorgio Baiocco
- Department of Physics, University of Pavia, 27100 Pavia, Italy
| | - Alice Mentana
- Department of Physics, University of Pavia, 27100 Pavia, Italy
| | - Marco Pullia
- The National Center for Oncological Hadron-Therapy (CNAO), 27100 Pavia, Italy
| | | | | | | | | | | | | | | | - Livio Narici
- Department of Physics, University of Rome Tor Vergata, 00133 Rome, Italy
- National Institute for Nuclear Physics (INFN), University of Rome Tor Vergata, 00133 Rome, Italy
- Italian Space Agency (ASI), 00133 Rome, Italy
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10
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Tommasino F, Cardamone C, Tortora V, Sabbatino F, Di Sarno C, Caputo A. Diagnosis of Langerhans cell histiocytosis on cytological examination of cerebrospinal fluid: Report of the first case. Diagn Cytopathol 2022; 50:E377-E381. [PMID: 35950687 DOI: 10.1002/dc.25040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 01/07/2023]
Abstract
Langerhans cell histiocytosis (LCH) is a disease of unknown etiology characterized by a proliferation of histiocytic cells resembling dendritic Langerhans cells. LCH can be unifocal or multifocal, with one- or many-organ involvement. The serous fluids are rarely involved. Cytological diagnosis of LCH is possible and relies on recognition of the typical cytomorphological features and subsequent immunocytochemical confirmation. Given the possibility of multisystem involvement, after diagnosing LCH it is necessary to carry out staging exams such as a bone survey, abdominal ultrasound, complete blood count, screening for diabetes insipidus and pulmonary function tests. We present the first case of LCH where the diagnosis was reached on cytological material from the cerebrospinal fluid. To the best of our knowledge, this is the first such case reported in the international literature to date. The morphological and immunocytochemical characteristics of our case are described, and the relevant literature is reviewed.
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Affiliation(s)
| | - Chiara Cardamone
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Vincenzo Tortora
- Department of Medicine, University of Naples "Federico II", Naples, Italy
| | | | - Chiara Di Sarno
- Department of Precision Medicine, University of Naples "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy.,Department of Medicine, University of Naples "Federico II", Naples, Italy
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11
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Attili A, Scifoni E, Tommasino F. Modelling the HPRT-gene mutation induction of particle beams: systematic in vitro data collection, analysis and microdosimetric kinetic model implementation. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac8c80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/24/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Objective. Since the early years, particle therapy treatments have been associated with concerns for late toxicities, especially secondary cancer risk (SCR). Nowadays, this concern is related to patients for whom long-term survival is expected (e.g. breast cancer, lymphoma, paediatrics). In the aim to contribute to this research, we present a dedicated statistical and modelling analysis aiming at improving our understanding of the RBE for mutation induction (
RBE
M
˜
) for different particle species. Approach. We built a new database based on a systematic collection of RBE data for mutation assays of the gene encoding for the purine salvage enzyme hypoxanthine-guanine phosphoribosyltransferase from literature (105 entries, distributed among 3 cell lines and 16 particle species). The data were employed to perform statistical and modelling analysis. For the latter, we adapted the microdosimetric kinetic model (MKM) to describe the mutagenesis in analogy to lethal lesion induction. Main results. Correlation analysis between RBE for survival (RBES) and
RBE
M
˜
reveals significant correlation between these two quantities (ρ = 0.86, p < 0.05). The correlation gets stronger when looking at subsets of data based on cell line and particle species. We also show that the MKM can be successfully employed to describe
RBE
M
˜
,
obtaining comparably good agreement with the experimental data. Remarkably, to improve the agreement with experimental data the MKM requires, consistently in all the analysed cases, a reduced domain size for the description of mutation induction compared to that adopted for survival. Significance. We were able to show that RBES and
RBE
M
˜
are strongly related quantities. We also showed for the first time that the MKM could be successfully applied to the description of mutation induction, representing an endpoint different from the more traditional cell killing. In analogy to the RBES,
RBE
M
˜
can be implemented into treatment planning system evaluations.
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12
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Bianchi A, Selva A, Rossignoli M, Pasquato F, Missiaggia M, Scifoni E, La Tessa C, Tommasino F, Conte V. Microdosimetry with a mini-TEPC in the spread-out Bragg peak of 148 MeV protons. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Garbacz M, Gajewski J, Durante M, Kisielewicz K, Krah N, Kopeć R, Olko P, Patera V, Rinaldi I, Rydygier M, Schiavi A, Scifoni E, Skóra T, Skrzypek A, Tommasino F, Rucinski A. Quantification of biological range uncertainties in patients treated at the Krakow proton therapy centre. Radiat Oncol 2022; 17:50. [PMID: 35264184 PMCID: PMC8905899 DOI: 10.1186/s13014-022-02022-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Variable relative biological effectiveness (vRBE) in proton therapy might significantly modify the prediction of RBE-weighted dose delivered to a patient during proton therapy. In this study we will present a method to quantify the biological range extension of the proton beam, which results from the application of vRBE approach in RBE-weighted dose calculation. Methods and materials The treatment plans of 95 patients (brain and skull base patients) were used for RBE-weighted dose calculation with constant and the McNamara RBE model. For this purpose the Monte Carlo tool FRED was used. The RBE-weighted dose distributions were analysed using indices from dose-volume histograms. We used the volumes receiving at least 95% of the prescribed dose (V95) to estimate the biological range extension resulting from vRBE approach. Results The vRBE model shows higher median value of relative deposited dose and D95 in the planning target volume by around 1% for brain patients and 4% for skull base patients. The maximum doses in organs at risk calculated with vRBE was up to 14 Gy above dose limit. The mean biological range extension was greater than 0.4 cm. Discussion Our method of estimation of biological range extension is insensitive for dose inhomogeneities and can be easily used for different proton plans with intensity-modulated proton therapy (IMPT) optimization. Using volumes instead of dose profiles, which is the common method, is more universal. However it was tested only for IMPT plans on fields arranged around the tumor area. Conclusions Adopting a vRBE model results in an increase in dose and an extension of the beam range, which is especially disadvantageous in cancers close to organs at risk. Our results support the need to re-optimization of proton treatment plans when considering vRBE.
Supplementary Information The online version contains supplementary material available at 10.1186/s13014-022-02022-5.
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Affiliation(s)
- Magdalena Garbacz
- Institute of Nuclear Physics Polish Academy of Sciences, 31342, Kraków, Poland.
| | - Jan Gajewski
- Institute of Nuclear Physics Polish Academy of Sciences, 31342, Kraków, Poland
| | - Marco Durante
- GSI Helmholtzzentrum fur Schwerionenforschung, 64291, Darmstadt, Germany.,The Technical University of Darmstadt, 64289, Darmstadt, Germany
| | - Kamil Kisielewicz
- National Oncology Institute, National Research Institute, Krakow Branch, 31115, Kraków, Poland
| | - Nils Krah
- University of Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Centre Léon Bérard, France.,University of Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3, IP2I Lyon, UMR 5822, Villeurbanne, France
| | - Renata Kopeć
- Institute of Nuclear Physics Polish Academy of Sciences, 31342, Kraków, Poland
| | - Paweł Olko
- Institute of Nuclear Physics Polish Academy of Sciences, 31342, Kraków, Poland
| | - Vincenzo Patera
- INFN - Section of Rome, 00185, Rome, Italy.,Department of Basic and Applied Sciences for Engineering, Sapienza University of Rome, 00161, Rome, Italy
| | | | - Marzena Rydygier
- Institute of Nuclear Physics Polish Academy of Sciences, 31342, Kraków, Poland
| | | | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications, TIFPA-INFN, 38123, Povo, Trento, Italy
| | - Tomasz Skóra
- National Oncology Institute, National Research Institute, Krakow Branch, 31115, Kraków, Poland
| | | | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications, TIFPA-INFN, 38123, Povo, Trento, Italy.,Department of Physics, University of Trento, 38123, Povo, Trento, Italy
| | - Antoni Rucinski
- Institute of Nuclear Physics Polish Academy of Sciences, 31342, Kraków, Poland
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14
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Cordoni F, Attili A, Tommasino F, Boscolo D, Fuss M, La Tessa C, Scifoni E. FLASH Mechanisms Track (Oral Presentations) A MULTISCALE EXTENSION OF THE GENERALIZED STOCHASTIC MICRODOSIMETRIC MODEL (GSM2) TO DESCRIBE DYNAMICAL OXYGENATION AND FAST REACTION KINETICS FOR UNRAVELING THE FLASH EFFECT. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01517-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Spinelli A, Fiorino C, Schwarz M, Tommasino F, Bellinzona E, Del Vecchio A, Mangili P, Shakarami Z, Deantoni C, Cianchetti M, Attili A, Galli R, Bisio A, Perani L, Simoniello P, Fuss M, Pawelke J, Wong J, Durante M, Scifoni E. FLASH Mechanisms Track (Oral Presentations) ADVANCED DOSIMETRY AND BIOPHYSICAL MODELING FOR PRECLINICAL FLASH RADIOTHERAPY. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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16
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Bellinzona EV, Grzanka L, Attili A, Tommasino F, Friedrich T, Krämer M, Scholz M, Battistoni G, Embriaco A, Chiappara D, Cirrone GAP, Petringa G, Durante M, Scifoni E. Biological Impact of Target Fragments on Proton Treatment Plans: An Analysis Based on the Current Cross-Section Data and a Full Mixed Field Approach. Cancers (Basel) 2021; 13:cancers13194768. [PMID: 34638254 PMCID: PMC8507563 DOI: 10.3390/cancers13194768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary Proton therapy is now an established external radiotherapy modality for cancer treatment. Clinical routine currently neglects the radiobiological impact of nuclear target fragments even if experimental evidences show a significant enhancement in cell-killing effect due to secondary particles. This paper quantifies the contribution of proton target fragments of different charge in different irradiation scenarios and compares the computationally predicted corrections to the overall biological dose with experimental data. Abstract Clinical routine in proton therapy currently neglects the radiobiological impact of nuclear target fragments generated by proton beams. This is partially due to the difficult characterization of the irradiation field. The detection of low energetic fragments, secondary protons and fragments, is in fact challenging due to their very short range. However, considering their low residual energy and therefore high LET, the possible contribution of such heavy particles to the overall biological effect could be not negligible. In this context, we performed a systematic analysis aimed at an explicit assessment of the RBE (relative biological effectiveness, i.e., the ratio of photon to proton physical dose needed to achieve the same biological effect) contribution of target fragments in the biological dose calculations of proton fields. The TOPAS Monte Carlo code has been used to characterize the radiation field, i.e., for the scoring of primary protons and fragments in an exemplary water target. TRiP98, in combination with LEM IV RBE tables, was then employed to evaluate the RBE with a mixed field approach accounting for fragments’ contributions. The results were compared with that obtained by considering only primary protons for the pristine beam and spread out Bragg peak (SOBP) irradiations, in order to estimate the relative weight of target fragments to the overall RBE. A sensitivity analysis of the secondary particles production cross-sections to the biological dose has been also carried out in this study. Finally, our modeling approach was applied to the analysis of a selection of cell survival and RBE data extracted from published in vitro studies. Our results indicate that, for high energy proton beams, the main contribution to the biological effect due to the secondary particles can be attributed to secondary protons, while the contribution of heavier fragments is mainly due to helium. The impact of target fragments on the biological dose is maximized in the entrance channels and for small α/β values. When applied to the description of survival data, model predictions including all fragments allowed better agreement to experimental data at high energies, while a minor effect was observed in the peak region. An improved description was also obtained when including the fragments’ contribution to describe RBE data. Overall, this analysis indicates that a minor contribution can be expected to the overall RBE resulting from target fragments. However, considering the fragmentation effects can improve the agreement with experimental data for high energy proton beams.
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Affiliation(s)
- Elettra Valentina Bellinzona
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 38123 Trento, Italy; (E.V.B.); (F.T.)
- Department of Physics, University of Trento, 38123 Trento, Italy;
| | - Leszek Grzanka
- The Department of Radiation Research and Proton Radiotherapy, Institute of Nuclear Physics, Polish Academy of Sciences, 31-342 Krakow, Poland;
| | - Andrea Attili
- “Roma Tre” Section, INFN—National Institute for Nuclear Physics, 00146 Roma, Italy;
| | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 38123 Trento, Italy; (E.V.B.); (F.T.)
- Department of Physics, University of Trento, 38123 Trento, Italy;
| | - Thomas Friedrich
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
| | - Michael Krämer
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
| | - Michael Scholz
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
| | | | - Alessia Embriaco
- “Pavia” Section, INFN—National Institute for Nuclear Physics, 6-27100 Pavia, Italy;
| | - Davide Chiappara
- Laboratori Nazionali del Sud, INFN—National Institute for Nuclear Physics, 95125 Catania, Italy; (D.C.); (G.A.P.C.); (G.P.)
| | - Giuseppe A. P. Cirrone
- Laboratori Nazionali del Sud, INFN—National Institute for Nuclear Physics, 95125 Catania, Italy; (D.C.); (G.A.P.C.); (G.P.)
| | - Giada Petringa
- Laboratori Nazionali del Sud, INFN—National Institute for Nuclear Physics, 95125 Catania, Italy; (D.C.); (G.A.P.C.); (G.P.)
| | - Marco Durante
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
- Institut für Physik Kondensierter Materie, Technische Universität, 64289 Darmstadt, Germany
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 38123 Trento, Italy; (E.V.B.); (F.T.)
- Department of Physics, University of Trento, 38123 Trento, Italy;
- Correspondence:
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17
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Garbacz M, Cordoni FG, Durante M, Gajewski J, Kisielewicz K, Krah N, Kopeć R, Olko P, Patera V, Rinaldi I, Rydygier M, Schiavi A, Scifoni E, Skóra T, Tommasino F, Rucinski A. Study of relationship between dose, LET and the risk of brain necrosis after proton therapy for skull base tumors. Radiother Oncol 2021; 163:143-149. [PMID: 34461183 DOI: 10.1016/j.radonc.2021.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 07/27/2021] [Accepted: 08/21/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE We investigated the relationship between RBE-weighted dose (DRBE) calculated with constant (cRBE) and variable RBE (vRBE), dose-averaged linear energy transfer (LETd) and the risk of radiographic changes in skull base patients treated with protons. METHODS Clinical treatment plans of 45 patients were recalculated with Monte Carlo tool FRED. Radiographic changes (i.e. edema and/or necrosis) were identified by MRI. Dosimetric parameters for cRBE and vRBE were computed. Biological margin extension and voxel-based analysis were employed looking for association of DRBE(vRBE) and LETd with brain edema and/or necrosis. RESULTS When using vRBE, Dmax in the brain was above the highest dose limits for 38% of patients, while such limit was never exceeded assuming cRBE. Similar values of Dmax were observed in necrotic regions, brain and temporal lobes. Most of the brain necrosis was in proximity to the PTV. The voxel-based analysis did not show evidence of an association with high LETd values. CONCLUSIONS When looking at standard dosimetric parameters, the higher dose associated with vRBE seems to be responsible for an enhanced risk of radiographic changes. However, as revealed by a voxel-based analysis, the large inter-patient variability hinders the identification of a clear effect for high LETd.
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Affiliation(s)
- Magdalena Garbacz
- Institute of Nuclear Physics Polish Academy of Sciences, 31342 Krakow, Poland.
| | - Francesco Giuseppe Cordoni
- University of Verona, Department of Computer Science, Verona, Italy; Trento Institute for Fundamental Physics and Applications, TIFPA-INFN, Trento, Italy
| | - Marco Durante
- GSI Helmholtzzentrum fur Schwerionenforschung, Darmstadt, Germany; The Technical University of Darmstadt, Germany
| | - Jan Gajewski
- Institute of Nuclear Physics Polish Academy of Sciences, 31342 Krakow, Poland
| | - Kamil Kisielewicz
- National Oncology Institute, National Research Institute, Krakow Branch, Krakow, Poland
| | - Nils Krah
- University of Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Centre Léon Bérard, France; University of Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3, IP2I Lyon, UMR 5822, Villeurbanne, France
| | - Renata Kopeć
- Institute of Nuclear Physics Polish Academy of Sciences, 31342 Krakow, Poland
| | - Paweł Olko
- Institute of Nuclear Physics Polish Academy of Sciences, 31342 Krakow, Poland
| | - Vincenzo Patera
- INFN - Section of Rome, Italy; Department of Basic and Applied Sciences for Engineering, Sapienza University of Rome, Italy
| | - Ilaria Rinaldi
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marzena Rydygier
- Institute of Nuclear Physics Polish Academy of Sciences, 31342 Krakow, Poland
| | - Angelo Schiavi
- Department of Basic and Applied Sciences for Engineering, Sapienza University of Rome, Italy
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications, TIFPA-INFN, Trento, Italy
| | - Tomasz Skóra
- National Oncology Institute, National Research Institute, Krakow Branch, Krakow, Poland
| | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications, TIFPA-INFN, Trento, Italy; Department of Physics, University of Trento, Trento, Italy
| | - Antoni Rucinski
- Institute of Nuclear Physics Polish Academy of Sciences, 31342 Krakow, Poland
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Gerlach S, Pinto M, Kurichiyanil N, Grau C, Hérault J, Hillbrand M, Poulsen PR, Safai S, Schippers JM, Schwarz M, Søndergaard CS, Tommasino F, Verroi E, Vidal M, Yohannes I, Schreiber J, Parodi K. Corrigendum: Beam characterization and feasibility study for a small animal irradiation platform at clinical proton therapy facilities (2020 Phys. Med. Biol.65 245045). Phys Med Biol 2021; 66. [PMID: 34037545 DOI: 10.1088/1361-6560/abf00e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/18/2021] [Indexed: 11/11/2022]
Affiliation(s)
- S Gerlach
- Department for Medical Physics, Ludwig-Maximilians-Universität München, Am Coulombwall 1, D-85748 Garching, Germany
| | - M Pinto
- Department for Medical Physics, Ludwig-Maximilians-Universität München, Am Coulombwall 1, D-85748 Garching, Germany
| | - N Kurichiyanil
- Department for Medical Physics, Ludwig-Maximilians-Universität München, Am Coulombwall 1, D-85748 Garching, Germany
| | - C Grau
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.,Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - J Hérault
- Centre Antoine Lacassagne, Nice, France.,Fédération Claude Lalanne-Université Côte d'Azur, Nice, France
| | - M Hillbrand
- Rinecker Proton Therapy Center, München, Germany
| | - P R Poulsen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.,Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - S Safai
- Paul Scherrer Institute, Villigen, Switzerland
| | | | - M Schwarz
- Trento Institute for Fundamental Physics and Applications, National Institute for Nuclear Physics, Povo, Italy.,Protontherapy Department, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - C S Søndergaard
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - F Tommasino
- Trento Institute for Fundamental Physics and Applications, National Institute for Nuclear Physics, Povo, Italy.,Department of Physics, University of Trento, Povo, Italy
| | - E Verroi
- Trento Institute for Fundamental Physics and Applications, National Institute for Nuclear Physics, Povo, Italy
| | - M Vidal
- Centre Antoine Lacassagne, Nice, France.,Fédération Claude Lalanne-Université Côte d'Azur, Nice, France
| | - I Yohannes
- Rinecker Proton Therapy Center, München, Germany
| | - J Schreiber
- Department for Medical Physics, Ludwig-Maximilians-Universität München, Am Coulombwall 1, D-85748 Garching, Germany
| | - K Parodi
- Department for Medical Physics, Ludwig-Maximilians-Universität München, Am Coulombwall 1, D-85748 Garching, Germany
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Farace P, Tommasino F, Righetto R, Fracchiolla F, Scaringella M, Bruzzi M, Civinini C. Technical Note: CT calibration for proton treatment planning by cross-calibration with proton CT data. Med Phys 2021; 48:1349-1355. [PMID: 33382083 DOI: 10.1002/mp.14698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/30/2020] [Accepted: 12/23/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE This study explores the possibility of a new method for x-ray computed tomography (CT) calibration by means of cross-calibration with proton CT (pCT) data. The proposed method aims at a more accurate conversion of CT Hounsfield Units (HU) into proton stopping power ratio (SPR) relative to water to be used in proton-therapy treatment planning. METHODS X-ray CT scan was acquired on a synthetic anthropomorphic phantom, composed of different tissue equivalent materials (TEMs). A pCT apparatus was instead adopted to obtain a reference three-dimensional distribution of the phantom's SPR values. After rigid registration, the x-ray CT was artificially blurred to the same resolution of pCT. Then a scatter plot showing voxel-by-voxel SPR values as a function of HU was employed to link the two measurements and thus obtaining a cross-calibrated x-ray CT calibration curve. The cross-calibration was tested at treatment planning system and then compared with a conventional calibration based on exactly the same TEMs constituting the anthropomorphic phantom. RESULTS Cross-calibration provided an accurate SPR mapping, better than by conventional TEMs calibration. The dose distribution of single beams optimized on the reference SPR map was recomputed on cross-calibrated CT, showing, with respect to conventional calibration, minor deviation at the dose fall-off (lower than 1%). CONCLUSIONS The presented data demonstrated that, by means of reference pCT data, a heterogeneous phantom can be used for CT calibration, paving the way to the use of biological samples, with their accurate description of patients' tissues. This overcomes the limitations of conventional CT calibration requiring homogenous samples, only available by synthetic TEMs, which fail in accurately mimicking the properties of biological tissues. Once a heterogeneous biological sample is provided with its corresponding reference SPR maps, a cross-calibration procedure could be adopted by other PT centers, even when not equipped with a pCT system.
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Affiliation(s)
- Paolo Farace
- Protontherapy Unit, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy.,Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Trento, Italy
| | - Francesco Tommasino
- Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Trento, Italy.,Department of Physics, University of Trento, via Sommarive, 14, Trento, Italy
| | - Roberto Righetto
- Protontherapy Unit, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy.,Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Trento, Italy
| | - Francesco Fracchiolla
- Protontherapy Unit, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy.,Istituto Nazionale di Fisica Nucleare TIFPA, via Sommarive, 14, Trento, Italy
| | - Monica Scaringella
- Istituto Nazionale di Fisica Nucleare sezione di Firenze, Via G. Sansone 1, Sesto Fiorentino, Italy
| | - Mara Bruzzi
- Istituto Nazionale di Fisica Nucleare sezione di Firenze, Via G. Sansone 1, Sesto Fiorentino, Italy.,Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, via G. Sansone 1, Sesto Fiorentino, Italy
| | - Carlo Civinini
- Istituto Nazionale di Fisica Nucleare sezione di Firenze, Via G. Sansone 1, Sesto Fiorentino, Italy
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20
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Missiaggia M, Cartechini G, Scifoni E, Rovituso M, Tommasino F, Verroi E, Durante M, La Tessa C. Microdosimetric measurements as a tool to assess potential in-field and out-of-field toxicity regions in proton therapy. Phys Med Biol 2020; 65:245024. [PMID: 32554886 DOI: 10.1088/1361-6560/ab9e56] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Relative biological effectiveness (RBE) variations are thought to be one of the primary causes of unexpected normal-tissue toxicities during tumor treatments with charged particles. Unlike carbon therapy, where treatment planning is optimized on the basis of the RBE-weighted dose, a constant RBE value of 1.1 is currently used in proton therapy. Assuming a uniform value can lead to under- or over-dosage, not just to the tumor but also to surrounding normal tissue. RBE changes have been linked with dose/fraction, the biological endpoint and beam properties. Understanding radiation quality and the associated RBE can improve the prediction of normal-tissue toxicities. In this study, we exploited microdosimetry for characterizing radiation quality in proton therapy in-field, and off-beam at 20 (beam edge), 50 (close out-of-field) and 100 (far out-of-field) mm from the beam center. We measured the lineal energy y spectra in a water phantom irradiated with 152 MeV protons, from which beam quality as well as the physical dose could be obtained. Taking advantage of the linear quadratic model and a modified version of the microdosimetric kinetic model, the microdosimetric data were combined with radiobiological parameters (α and β) of human salivary gland tumor cells for assessing cell survival RBE and RBE-weighted dose. The results indicate that if a dose of 60 Gy is delivered to the peak, the beam edge receives up to 6 Gy while the close and far out-of-field regions receive doses on the order of 10-3 Gy and 10-4 Gy, respectively. The RBE estimate in-beam shows large variations, ranging from 1.0 ± 0.2 at the entrance channel to 2.51 ± 0.15 at the tail. The beam edge follows a similar trend but the RBE calculated at the Bragg peak depth is 2.27 ± 0.17, i.e. twice the RBE in-beam (1.05 ± 0.15). Out-of-field, the estimated RBE is always significantly higher than 1.1 and increases with increasing lateral distance, reaching the overall highest value of 3.4 ± 0.3 at a depth of 206 mm and a lateral distance of 10 mm. The combination of RBE and dose into the biological dose points to the beam edge and the end-of-range in-beam as the areas with the highest risk of potential toxicities.
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Affiliation(s)
- M Missiaggia
- University of Trento, Via Sommarive 14, 38123 Trento, Italy. Trento Institute of Fundamental Physics and Applications (TIFPA), Via Sommarive 14, 38123 Trento, Italy
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21
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Gerlach S, Pinto M, Kurichiyanil N, Grau C, Hérault J, Hillbrand M, Poulsen PR, Safai S, Schippers JM, Schwarz M, Søndergaard CS, Tommasino F, Verroi E, Vidal M, Yohannes I, Schreiber J, Parodi K. Beam characterization and feasibility study for a small animal irradiation platform at clinical proton therapy facilities. Phys Med Biol 2020; 65:245045. [DOI: 10.1088/1361-6560/abc832] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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22
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Embriaco A, Attili A, Bellinzona EV, Dong Y, Grzanka L, Mattei I, Muraro S, Scifoni E, Tommasino F, Valle SM, Battistoni G. FLUKA simulation of target fragmentation in proton therapy. Phys Med 2020; 80:342-346. [PMID: 33271390 DOI: 10.1016/j.ejmp.2020.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 09/02/2020] [Accepted: 09/20/2020] [Indexed: 12/25/2022] Open
Abstract
In proton therapy, secondary fragments are created in nuclear interactions of the beam with the target nuclei. The secondary fragments have low kinetic energies and high atomic numbers as compared to primary protons. Fragments have a high LET and deposit all their energy close to the generation point. For their characteristics, secondary fragments can alter the dose distribution and lead to an increase of RBE for the same delivered physical dose. Moreover, the radiobiological impact of target fragmentation is significant mostly in the region before the Bragg peak, where generally healthy tissues are present, and immediately after Bragg peak. Considering the high biological impact of those particles, especially in the case of healthy tissues or organs at risk, the inclusion of target fragmentation processes in the dose calculation of a treatment planning system can be relevant to improve the treatment accuracy and for this reason it is one of the major tasks of the MoVe IT project. In this study, Monte Carlo simulations were employed to fully characterize the mixed radiation field generated by target fragmentation in proton therapy. The dose averaged LET has been evaluated in case of a Spread Out Bragg Peak (SOBP). Starting from LET distribution, RBE has been evaluated with two different phenomenological models. In order to characterize the mixed radiation field, the production cross section has been evaluated by means of the FLUKA code. The future development of present work is to generate a MC database of fragments fluence to be included in TPS.
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Affiliation(s)
- A Embriaco
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Italy.
| | - A Attili
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma Tre, Italy
| | - E V Bellinzona
- Universitá degli studi di Trento, Italy; TIFPA Trento Institute for Fundamental Physics and Application, Italy
| | - Y Dong
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Italy; Universitá degli studi di Milano, Italy
| | - L Grzanka
- Institute of Nuclear Physics, Kraków, Poland
| | - I Mattei
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Italy
| | - S Muraro
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Italy
| | - E Scifoni
- TIFPA Trento Institute for Fundamental Physics and Application, Italy
| | - F Tommasino
- Universitá degli studi di Trento, Italy; TIFPA Trento Institute for Fundamental Physics and Application, Italy
| | - S M Valle
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Italy
| | - G Battistoni
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Italy; TIFPA Trento Institute for Fundamental Physics and Application, Italy
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Civinini C, Scaringella M, Brianzi M, Intravaia M, Randazzo N, Sipala V, Rovituso M, Tommasino F, Schwarz M, Bruzzi M. Relative stopping power measurements and prosthesis artifacts reduction in proton CT. ACTA ACUST UNITED AC 2020; 65:225012. [DOI: 10.1088/1361-6560/abb0c8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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24
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Tommasino F, Cartechini G, Fracchiolla F, Menegotti L, Scifoni E, La Tessa C, Schwarz M, Farace P. PO-1425: Secondary cancer risk in breast cancer patients treated with protons compared to 3D-CRT and VMAT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01443-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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25
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Widesott L, Dionisi F, Fracchiolla F, Tommasino F, Centonze M, Amichetti M, Del Greco M. Proton or photon radiosurgery for cardiac ablation of ventricular tachycardia? Breath and ECG gated robust optimization. Phys Med 2020; 78:15-31. [PMID: 32911373 DOI: 10.1016/j.ejmp.2020.08.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/20/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Ventricular tachycardia (VT) is a life-threatening heart disorder. The aim of this preliminary study is to assess the feasibility of stereotactic body radiation therapy (SBRT) photon and proton therapy (PT) plans for the treatment of VT, adopting robust optimization technique for both irradiation techniques. METHODS ECG gated CT images (in breath hold) were acquired for one patient. Conventional planning target volume (PTV) and robust optimized plans (25GyE in single fraction) were simulated for both photon (IMRT, 5 and 9 beams) and proton (SFO, 2 beams) plans. Robust optimized plans were obtained both for protons and photons considering in the optimization setup errors (5 mm in the three orthogonal directions), range (±3.5%) and the clinical target volume (CTV) motion due to heartbeat and breath-hold variability. RESULTS The photon robust optimization method, compared to PTV-based plans, showed a reduction in the average dose to the heart by about 25%; robust optimization allowed also reducing the mean dose to the left lung from 3.4. to 2.8 Gy for 9-beams configuration and from 4.1 to 2.9 Gy for 5-beams configuration. Robust optimization with protons, allowed further reducing the OAR doses: average dose to the heart and to the left lung decreased from 7.3 Gy to 5.2 GyE and from 2.9 Gy to 2.2 GyE, respectively. CONCLUSIONS Our study demonstrates the importance of the optimization technique adopted in the treatment planning system for VT treatment. It has been shown that robust optimization can significantly reduce the dose to healthy cardiac tissues and that PT further increases this gain.
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Affiliation(s)
- Lamberto Widesott
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy.
| | - Francesco Dionisi
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Francesco Fracchiolla
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Francesco Tommasino
- Department of Physics, University of Trento, Trento, Italy; Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute of Nuclear Physics (INFN), Trento, Italy
| | - Maurizio Centonze
- Department of Diagnostic Imaging, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Maurizio Amichetti
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Maurizio Del Greco
- Department of Cardiac, Santa Maria del Carmine Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Rovereto, Italy
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Pisciotta P, Costantino A, Cammarata FP, Torrisi F, Calabrese G, Marchese V, Cirrone GAP, Petringa G, Forte GI, Minafra L, Bravatà V, Gulisano M, Scopelliti F, Tommasino F, Scifoni E, Cuttone G, Ippolito M, Parenti R, Russo G. Evaluation of proton beam radiation-induced skin injury in a murine model using a clinical SOBP. PLoS One 2020; 15:e0233258. [PMID: 32442228 PMCID: PMC7244158 DOI: 10.1371/journal.pone.0233258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 05/03/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of this paper is to characterize the skin deterministic damage due to the effect of proton beam irradiation in mice occurred during a long-term observational experiment. This study was initially defined to evaluate the insurgence of myelopathy irradiating spinal cords with the distal part of a Spread-out Bragg peak (SOBP). To the best of our knowledge, no study has been conducted highlighting high grades of skin injury at the dose used in this paper. Nevertheless these effects occurred. In this regard, the experimental evidence of significant insurgence of skin injury induced by protons using a SOBP configuration will be shown. Skin damages were classified into six scores (from 0 to 5) according to the severity of the injuries and correlated to ED50 (i.e. the radiation dose at which 50% of animals show a specific score) at 40 days post-irradiation (d.p.i.). The effects of radiation on the overall animal wellbeing have been also monitored and the severity of radiation-induced skin injuries was observed and quantified up to 40 d.p.i.
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Affiliation(s)
- Pietro Pisciotta
- Physics and Astronomy Department, University of Catania, Catania, Italy
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Cefalù (PA), Italy
- National Laboratory of South, National Institute for Nuclear Physics (LNS-INFN), Catania, Italy
| | - Angelita Costantino
- Laboratory of Molecular and Cellular Physiology, Biomedical and Biotechnological Sciences Department, University of Catania, Catania, Italy
| | - Francesco Paolo Cammarata
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Cefalù (PA), Italy
- National Laboratory of South, National Institute for Nuclear Physics (LNS-INFN), Catania, Italy
- * E-mail: (FPC); (RP)
| | - Filippo Torrisi
- National Laboratory of South, National Institute for Nuclear Physics (LNS-INFN), Catania, Italy
- Laboratory of Molecular and Cellular Physiology, Biomedical and Biotechnological Sciences Department, University of Catania, Catania, Italy
| | - Giovanna Calabrese
- Laboratory of Molecular and Cellular Physiology, Biomedical and Biotechnological Sciences Department, University of Catania, Catania, Italy
| | - Valentina Marchese
- Laboratory of Molecular and Cellular Physiology, Biomedical and Biotechnological Sciences Department, University of Catania, Catania, Italy
- Centre for Advanced Preclinical in vivo Research (CAPiR), University of Catania, Catania, Italy
| | | | - Giada Petringa
- National Laboratory of South, National Institute for Nuclear Physics (LNS-INFN), Catania, Italy
| | - Giusi Irma Forte
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Cefalù (PA), Italy
| | - Luigi Minafra
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Cefalù (PA), Italy
| | - Valentina Bravatà
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Cefalù (PA), Italy
| | - Massimo Gulisano
- Laboratory of Synthetic and Systems Biology, Drug Science Department, University of Catania, Catania, Italy
- Molecular Preclinical and Translational Imaging Research Center (IMPRonTe), University of Catania, Catania, Italy
| | - Fabrizio Scopelliti
- Radiopharmacy Laboratory Nuclear Medicine Department, Cannizzaro Hospital, Catania, Italy
| | - Francesco Tommasino
- Department of Physics, University of Trento, Povo, Italy
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, INFN, Povo, Italy
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, INFN, Povo, Italy
| | - Giacomo Cuttone
- National Laboratory of South, National Institute for Nuclear Physics (LNS-INFN), Catania, Italy
| | - Massimo Ippolito
- Nuclear Medicine Department, Cannizzaro Hospital, Catania, Italy
| | - Rosalba Parenti
- Laboratory of Molecular and Cellular Physiology, Biomedical and Biotechnological Sciences Department, University of Catania, Catania, Italy
- Centre for Advanced Preclinical in vivo Research (CAPiR), University of Catania, Catania, Italy
- Molecular Preclinical and Translational Imaging Research Center (IMPRonTe), University of Catania, Catania, Italy
- * E-mail: (FPC); (RP)
| | - Giorgio Russo
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Cefalù (PA), Italy
- National Laboratory of South, National Institute for Nuclear Physics (LNS-INFN), Catania, Italy
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Mattei I, Alexandrov A, Alunni Solestizi L, Ambrosi G, Argiro S, Bartosik N, Battistoni G, Belcari N, Biondi S, Bisogni MG, Bruni G, Camarlinghi N, Carra P, Catanzani E, Ciarrocchi E, Cerello P, Clozza A, Colombi S, De Lellis G, Del Guerra A, De Simoni M, Di Crescenzo A, Donetti M, Dong Y, Durante M, Embriaco A, Emde M, Faccini R, Ferrero V, Ferroni F, Fiandrini E, Finck C, Fiorina E, Fischetti M, Francesconi M, Franchini M, Galli L, Gentile V, Hetzel R, Hild S, Iarocci E, Ionica M, Kanxheri K, Kraan AC, Lante V, Lauria A, La Tessa C, Lopez Torres E, Massimi C, Marafini M, Mengarelli A, Mirabelli R, Montesi MC, Morone MC, Morrocchi M, Muraro S, Narici L, Pastore A, Pastrone N, Patera V, Pennazio F, Placidi P, Pullia M, Ramello L, Ridolfi R, Rosso V, Rovituso M, Sanelli C, Sartorelli G, Sato O, Savazzi S, Scavarda L, Schiavi A, Schuy C, Scifoni E, Sciubba A, Secher A, Selvi M, Servoli L, Silvestre G, Sitta M, Spighi R, Spiriti E, Sportelli G, Stahl A, Tomassini S, Tommasino F, Traini G, Toppi M, Valeri T, Valle SM, Vanstalle M, Villa M, Weber U, Zoccoli A, Sarti A. Measurement of 12C Fragmentation Cross Sections on C, O, and H in the Energy Range of Interest for Particle Therapy Applications. IEEE Trans Radiat Plasma Med Sci 2020. [DOI: 10.1109/trpms.2020.2972197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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28
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Tommasino F, Widesott L, Fracchiolla F, Lorentini S, Righetto R, Algranati C, Scifoni E, Dionisi F, Scartoni D, Amelio D, Cianchetti M, Schwarz M, Amichetti M, Farace P. Clinical implementation in proton therapy of multi-field optimization by a hybrid method combining conventional PTV with robust optimization. Phys Med Biol 2020; 65:045002. [PMID: 31851957 DOI: 10.1088/1361-6560/ab63b9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
To implement a robust multi-field optimization (MFO) technique compatible with the application of a Monte Carlo (MC) algorithm and to evaluate its robustness. Nine patients (three brain, five head-and-neck, one spine) underwent proton treatment generated by a novel robust MFO technique. A hybrid (hMFO) approach was implemented, planning dose coverage on isotropic PTV compensating for setup errors, whereas range calibration uncertainties are incorporated into PTV robust optimization process. hMFO was compared with single-field optimization (SFO) and full robust multi-field optimization (fMFO), both on the nominal plan and the worst-case scenarios assessed by robustness analysis. The SFO and the fMFO plans were normalized to hMFO on CTV to obtain iso-D95 coverage, and then the organs at risk (OARs) doses were compared. On the same OARs, in the normalized nominal plans the potential impact of variable relative biological effectiveness (RBE) was investigated. hMFO reduces the number of scenarios computed for robust optimization (from twenty-one in fMFO to three), making it practicable with the application of a MC algorithm. After normalizing on D95 CTV coverage, nominal hMFO plans were superior compared to SFO in terms of OARs sparing (p < 0.01), without significant differences compared to fMFO. The improvement in OAR sparing with hMFO with respect to SFO was preserved in worst-case scenarios (p < 0.01), confirming that hMFO is as robust as SFO to physical uncertainties, with no significant differences when compared to the worst case scenarios obtained by fMFO. The dose increase on OARs due to variable RBE was comparable to the increase due to physical uncertainties (i.e. 4-5 Gy(RBE)), but without significant differences between these techniques. hMFO allows improving plan quality with respect to SFO, with no significant differences with fMFO and without affecting robustness to setup, range and RBE uncertainties, making clinically feasible the application of MC-based robust optimization.
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Affiliation(s)
- Francesco Tommasino
- Department of Physics, University of Trento, Via Sommarive, 14-38123 Povo (TN), Italy. Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), Povo, Italy. Author to whom any correspondence should be addressed
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29
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Catalano R, Petringa G, Cuttone G, Bonanno V, Chiappara D, Musumeci M, Puglia S, Stella G, Scifoni E, Tommasino F, Cirrone G. Transversal dose profile reconstruction for clinical proton beams: A detectors inter-comparison. Phys Med 2020; 70:133-138. [DOI: 10.1016/j.ejmp.2020.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 01/04/2020] [Accepted: 01/06/2020] [Indexed: 11/24/2022] Open
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Righetto R, Clemens LP, Lorentini S, Fracchiolla F, Algranati C, Tommasino F, Dionisi F, Cianchetti M, Schwarz M, Farace P. Accurate proton treatment planning for pencil beam crossing titanium fixation implants. Phys Med 2020; 70:28-38. [PMID: 31954210 DOI: 10.1016/j.ejmp.2020.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To present a planning strategy for proton pencil-beam scanning when titanium implants need to be crossed by the beam. METHODS We addressed three issues: the implementation of a CT calibration curve to assign to titanium the correct stopping power; the effect of artefacts on CT images and their reduction by a dedicated algorithm; the differences in dose computation depending on the dose engine, pencil-beam vs Monte-Carlo algorithms. We performed measurement tests on a simple cylinder phantom and on a real implant. These phantoms were irradiated with three geometries (single spots, uniform mono-energetic layer and uniform box), measuring the exit dose either by radio-chromic film or multi-layer ionization chamber. The procedure was then applied on two patients treated for chordoma. RESULTS We had to set in the calibration curve a mass density equal to 4.37 g/cm3 to saturated Hounsfield Units, in order to have the correct stopping power assigned to titanium in TPS. CT artefact reduction algorithm allowed a better reconstruction of the shape and size of the implant. Monte-Carlo resulted accurate in computing the dose distribution whereas the pencil-beam algorithm failed due to sharp density interfaces between titanium and the surrounding material. Finally, the treatment plans obtained on two patients showed the impact of the dose engine algorithm, with 10-20% differences between pencil-beam and Monte-Carlo in small regions distally to the titanium screws. CONCLUSION The described combination of CT calibration, artefacts reduction and Monte-Carlo computation provides a reliable methodology to compute dose in patients with titanium implants.
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Affiliation(s)
- Roberto Righetto
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy.
| | | | - Stefano Lorentini
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Francesco Fracchiolla
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Carlo Algranati
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Francesco Tommasino
- Department of Physics, University of Trento, Povo, Italy; Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), Povo, Italy
| | - Francesco Dionisi
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Marco Cianchetti
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Marco Schwarz
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy; Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), Povo, Italy
| | - Paolo Farace
- Proton Therapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
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Palma G, Taffelli A, Fellin F, D'Avino V, Scartoni D, Tommasino F, Scifoni E, Durante M, Amichetti M, Schwarz M, Amelio D, Cella L. Modelling the risk of radiation induced alopecia in brain tumor patients treated with scanned proton beams. Radiother Oncol 2019; 144:127-134. [PMID: 31805517 DOI: 10.1016/j.radonc.2019.11.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To develop normal tissue complication probability (NTCP) models for radiation-induced alopecia (RIA) in brain tumor patients treated with proton therapy (PT). METHODS AND MATERIALS We analyzed 116 brain tumor adult patients undergoing scanning beam PT (median dose 54 GyRBE; range 36-72) for CTCAE v.4 grade 2 (G2) acute (≤90 days), late (>90 days) and permanent (>12 months) RIA. The relative dose-surface histogram (DSH) of the scalp was extracted and used for Lyman-Kutcher-Burman (LKB) modelling. Moreover, DSH metrics (Sx: the surface receiving ≥ X Gy, D2%: near maximum dose, Dmean: mean dose) and non-dosimetric variables were included in a multivariable logistic regression NTCP model. Model performances were evaluated by the cross-validated area under the receiver operator curve (ROC-AUC). RESULTS Acute, late and permanent G2-RIA was observed in 52%, 35% and 19% of the patients, respectively. The LKB models showed a weak dose-surface effect (0.09 ≤ n ≤ 0.19) with relative steepness 0.29 ≤ m ≤ 0.56, and increasing tolerance dose values when moving from acute and late (22 and 24 GyRBE) to permanent RIA (44 GyRBE). Multivariable modelling selected S21Gy for acute and S25Gy, for late G2-RIA as the most predictive DSH factors. Younger age was selected as risk factor for acute G2-RIA while surgery as risk factor for late G2-RIA. D2% was the only variable selected for permanent G2-RIA. Both LKB and logistic models exhibited high predictive performances (ROC-AUCs range 0.86-0.90). CONCLUSION We derived NTCP models to predict G2-RIA after PT, providing a comprehensive modelling framework for acute, late and permanent occurrences that, once externally validated, could be exploited for individualized scalp sparing treatment planning strategies in brain tumor patients.
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Affiliation(s)
- Giuseppe Palma
- National Research Council, Institute of Biostructures and Bioimaging, Napoli, Italy
| | - Alberto Taffelli
- Istituto Nazionale di Fisica Nucleare, Trento Institute for Fundamental Physics and Applications, Trento, Italy
| | - Francesco Fellin
- Trento Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Vittoria D'Avino
- National Research Council, Institute of Biostructures and Bioimaging, Napoli, Italy
| | - Daniele Scartoni
- Trento Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Francesco Tommasino
- Istituto Nazionale di Fisica Nucleare, Trento Institute for Fundamental Physics and Applications, Trento, Italy; University of Trento, Physics Department, Trento, Italy
| | - Emanuele Scifoni
- Istituto Nazionale di Fisica Nucleare, Trento Institute for Fundamental Physics and Applications, Trento, Italy
| | - Marco Durante
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany; Technische Universität Darmstadt, Institut für Festkörperphysik, Darmstadt, Germany
| | - Maurizio Amichetti
- Trento Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Marco Schwarz
- Istituto Nazionale di Fisica Nucleare, Trento Institute for Fundamental Physics and Applications, Trento, Italy; Trento Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Dante Amelio
- Trento Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Laura Cella
- National Research Council, Institute of Biostructures and Bioimaging, Napoli, Italy.
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Tommasino F, Cella L, Farace P. In Regard to DeCesaris et al. Int J Radiat Oncol Biol Phys 2019; 105:676-677. [PMID: 31540598 DOI: 10.1016/j.ijrobp.2019.06.2547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 05/22/2019] [Accepted: 06/25/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Francesco Tommasino
- University of Trento, Department of Physics, Trento, Italy; Istituto Nazionale di Fisica Nucleare, Trento Institute for Fundamental Physics and Applications, Trento, Italy
| | - Laura Cella
- National Research Council Institute of Biostructures and Bioimaging, Napoli, Italy
| | - Paolo Farace
- Protontherapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
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Palma G, Taffelli A, Fellin F, D'Avino V, Scartoni D, Tommasino F, Scifoni E, Durante M, Amichetti M, Schwarz M, Amelio D, Cella L. NTCP Models for Permanent Radiation Induced Alopecia in Brain Tumor Patients Treated with Scanned Proton Beams. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fellin F, Iacco M, D'Avino V, Tommasino F, Farace P, Palma G, Conson M, Giacomelli I, Zucchetti C, Falcinelli L, Amichetti M, Aristei C, Cella L. Potential skin morbidity reduction with intensity-modulated proton therapy for breast cancer with nodal involvement. Acta Oncol 2019; 58:934-942. [PMID: 30938217 DOI: 10.1080/0284186x.2019.1591638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Different modern radiation therapy treatment solutions for breast cancer (BC) and regional nodal irradiation (RNI) have been proposed. In this study, we evaluate the potential reduction in radiation-induced skin morbidity obtained by intensity modulated proton therapy (IMPT) compared with intensity modulated photon therapy (IMXT) for left-side BC and RNI. Material and Methods: Using CT scans from 10 left-side BC patients, treatment plans were generated using IMXT and IMPT techniques. A dose of 50 Gy (or Gy [RBE] for IMPT) was prescribed to the target volume (involved breast, the internal mammary, supraclavicular, and infraclavicular nodes). Two single filed optimization IMPT (IMPT1 and IMPT2) plans were calculated without and with skin optimization. For each technique, skin dose-metrics were extracted and normal tissue complication probability (NTCP) models from the literature were employed to estimate the risk of radiation-induced skin morbidity. NTCPs for relevant organs-at-risk (OARs) were also considered for reference. The non-parametric Anova (Friedman matched-pairs signed-rank test) was used for comparative analyses. Results: IMPT improved target coverage and dose homogeneity even if the skin was included into optimization strategy (HIIMPT2 = 0.11 vs. HIIMXT = 0.22 and CIIMPT2 = 0.96 vs. CIIMXT = 0.82, p < .05). A significant relative skin risk reduction (RR = NTCPIMPT/NTCPIMXT) was obtained with IMPT2 including the skin in the optimization with a RR reduction ranging from 0.3 to 0.9 depending on the analyzed skin toxicity endpoint/model. Both IMPT plans attained significant OARs dose sparing compared with IMXT. As expected, the heart and lung doses were significantly reduced using IMPT. Accordingly, IMPT always provided lower NTCP values. Conclusions: IMPT guarantees optimal target coverage, OARs sparing, and simultaneously minimizes the risk of skin morbidity. The applied model-based approach supports the potential clinical relevance of IMPT for left-side BC and RNI and might be relevant for the setup of cost-effectiveness evaluation strategies based on NTCP predictions, as well as for establishing patient selection criteria.
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Affiliation(s)
- Francesco Fellin
- Protontherapy Department, Azienda Provinciale per I Servizi Sanitari (APSS), Trento, Italy
| | - Martina Iacco
- Perugia General Hospital, Medical Physics Unit, Perugia, Italy
| | - Vittoria D'Avino
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - Francesco Tommasino
- Department of Physics, University of Trento, Povo, Italy
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Povo, Italy
| | - Paolo Farace
- Protontherapy Department, Azienda Provinciale per I Servizi Sanitari (APSS), Trento, Italy
| | - Giuseppe Palma
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - Manuel Conson
- Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Irene Giacomelli
- Protontherapy Department, Azienda Provinciale per I Servizi Sanitari (APSS), Trento, Italy
| | | | | | - Maurizio Amichetti
- Protontherapy Department, Azienda Provinciale per I Servizi Sanitari (APSS), Trento, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, Perugia General Hospital, Perugia, Italy
- Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy
| | - Laura Cella
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
- National Institute for Nuclear Physics (INFN), Naples, Italy
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Tommasino F, Rovituso M, Lorentini S, La Tessa C, Petringa G, Cirrone P, Romano F, Scifoni E, Schwarz M, Durante M. STUDY FOR A PASSIVE SCATTERING LINE DEDICATED TO RADIOBIOLOGY EXPERIMENTS AT THE TRENTO PROTON THERAPY CENTER. Radiat Prot Dosimetry 2019; 183:274-279. [PMID: 30535406 DOI: 10.1093/rpd/ncy238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The recent worldwide spread of Proton Therapy centers paves the way to new opportunities for basic and applied research related to the use of accelerated proton beams. Clinical centers make use of proton beam energies up to about 230 MeV. This represents an interesting energy range for a large spectrum of applications, including detector testing, radiation shielding and space research. Additionally, radiobiology research might benefit for a larger availability of proton beams, especially in those centers where a room dedicated to research activities also exists. Here, we describe the initial activities for the setup of a radiobiology irradiation facility at the Trento Proton Therapy Center. Data referring to the characterization of the beam in air are essential to that purpose and will be presented. A basic setup for large field irradiation will be also proposed, which is needed for the majority of in vitro and in vivo radiobiology experiments.
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Affiliation(s)
- F Tommasino
- Department of Physics, University of Trento, Povo, Italy
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Povo, Italy
| | - M Rovituso
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Povo, Italy
| | - S Lorentini
- Protontherapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - C La Tessa
- Department of Physics, University of Trento, Povo, Italy
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Povo, Italy
| | - G Petringa
- Laboratori Nazionali del Sud, National Institute for Nuclear Physics (INFN), Catania, Italy
| | - P Cirrone
- Laboratori Nazionali del Sud, National Institute for Nuclear Physics (INFN), Catania, Italy
| | - F Romano
- Laboratori Nazionali del Sud, National Institute for Nuclear Physics (INFN), Catania, Italy
- National Physics Laboratory, Acoustic and Ionizing Radiation Division, Middlesex, United Kingdom
| | - E Scifoni
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Povo, Italy
| | - M Schwarz
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Povo, Italy
- Protontherapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - M Durante
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Povo, Italy
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Garbacz M, Baran J, Battistoni G, Durante M, Gajewski J, Krah N, Krzempek K, Patera V, Pawlik-Niedzwiecka M, Rinaldi I, Sas-Korczynska B, Scifoni E, Skrzypek A, Schiavi A, Tommasino F, Rucinski A. EP-1884 Commissioning and clinical validation of FRED: Monte Carlo on GPU for proton beam therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32304-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tommasino F, Widesott L, Fracchiolla F, Lorentini S, Righetto R, Algranati C, Scifoni E, Dionisi F, Scartoni D, Amelio D, Cianchetti M, Schwarz M, Amichetti M, Farace P. EP-1837 A new hybrid approach to allow robust Monte Carlo-based multi-field optimization in proton therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32257-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tommasino F, Lorentini S, Schwarz M, Fellin F, Farace P. PV-0137: Dosimetric uncertainties in pencil beam proton therapy for breast cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30447-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Brownstein JM, Wisdom AJ, Castle KD, Mowery YM, Guida P, Lee CL, Tommasino F, Tessa CL, Scifoni E, Gao J, Luo L, Campos LDS, Ma Y, Williams N, Jung SH, Durante M, Kirsch DG. Characterizing the Potency and Impact of Carbon Ion Therapy in a Primary Mouse Model of Soft Tissue Sarcoma. Mol Cancer Ther 2018; 17:858-868. [PMID: 29437879 PMCID: PMC5912881 DOI: 10.1158/1535-7163.mct-17-0965] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/28/2017] [Accepted: 02/01/2018] [Indexed: 12/11/2022]
Abstract
Carbon ion therapy (CIT) offers several potential advantages for treating cancers compared with X-ray and proton radiotherapy, including increased biological efficacy and more conformal dosimetry. However, CIT potency has not been characterized in primary tumor animal models. Here, we calculate the relative biological effectiveness (RBE) of carbon ions compared with X-rays in an autochthonous mouse model of soft tissue sarcoma. We used Cre/loxP technology to generate primary sarcomas in KrasLSL-G12D/+; p53fl/fl mice. Primary tumors were irradiated with a single fraction of carbon ions (10 Gy), X-rays (20 Gy, 25 Gy, or 30 Gy), or observed as controls. The RBE was calculated by determining the dose of X-rays that resulted in similar time to posttreatment tumor volume quintupling and exponential growth rate as 10 Gy carbon ions. The median tumor volume quintupling time and exponential growth rate of sarcomas treated with 10 Gy carbon ions and 30 Gy X-rays were similar: 27.3 and 28.1 days and 0.060 and 0.059 mm3/day, respectively. Tumors treated with lower doses of X-rays had faster regrowth. Thus, the RBE of carbon ions in this primary tumor model is 3. When isoeffective treatments of carbon ions and X-rays were compared, we observed significant differences in tumor growth kinetics, proliferative indices, and immune infiltrates. We found that carbon ions were three times as potent as X-rays in this aggressive tumor model and identified unanticipated differences in radiation response that may have clinical implications. Mol Cancer Ther; 17(4); 858-68. ©2018 AACR.
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Affiliation(s)
- Jeremy M Brownstein
- Department of Radiation Oncology, Duke University Health System, Durham, North Carolina
| | - Amy J Wisdom
- Department of Pharmacology & Cancer Biology, Duke University, Durham, North Carolina
| | - Katherine D Castle
- Department of Pharmacology & Cancer Biology, Duke University, Durham, North Carolina
| | - Yvonne M Mowery
- Department of Radiation Oncology, Duke University Health System, Durham, North Carolina
| | - Peter Guida
- Department of Biology, Brookhaven National Laboratory, Upton, New York
| | - Chang-Lung Lee
- Department of Radiation Oncology, Duke University Health System, Durham, North Carolina
| | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications, National Institute for Nuclear Physics (INFN), Trento, Italy
- Department of Physics, University of Trento, Trento, Italy
| | - Chiara La Tessa
- Brookhaven National Laboratory, Upton, New York
- Trento Institute for Fundamental Physics and Applications, National Institute for Nuclear Physics (INFN), Trento, Italy
- Department of Physics, University of Trento, Trento, Italy
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications, National Institute for Nuclear Physics (INFN), Trento, Italy
| | - Junheng Gao
- Department of Biostatistics and Informatics, Duke University, Durham, North Carolina
| | - Lixia Luo
- Department of Radiation Oncology, Duke University Health System, Durham, North Carolina
| | | | - Yan Ma
- Department of Radiation Oncology, Duke University Health System, Durham, North Carolina
| | - Nerissa Williams
- Department of Radiation Oncology, Duke University Health System, Durham, North Carolina
| | - Sin-Ho Jung
- Department of Biostatistics and Informatics, Duke University, Durham, North Carolina
| | - Marco Durante
- Trento Institute for Fundamental Physics and Applications, National Institute for Nuclear Physics (INFN), Trento, Italy
| | - David G Kirsch
- Department of Radiation Oncology, Duke University Health System, Durham, North Carolina.
- Department of Pharmacology & Cancer Biology, Duke University, Durham, North Carolina
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Alfonsi L, Ambroglini F, Ambrosi G, Ammendola R, Assante D, Badoni D, Belyaev V, Burger W, Cafagna A, Cipollone P, Consolini G, Conti L, Contin A, Angelis E, Donato C, Franceschi G, Santis A, Santis C, Diego P, Durante M, Fornaro C, Guandalini C, Laurenti G, Laurenza M, Lazzizzera I, Lolli M, Manea C, Marcelli L, Marcucci F, Masciantonio G, Osteria G, Palma F, Palmonari F, Panico B, Patrizii L, Picozza P, Pozzato M, Rashevskaya I, Ricci M, Rovituso M, Scotti V, Sotgiu A, Sparvoli R, Spataro B, Spogli L, Tommasino F, Ubertini P, Vannaroni G, Xuhui S, Zoffoli S. The HEPD particle detector and the EFD electric field detector for the CSES satellite. Radiat Phys Chem Oxf Engl 1993 2017. [DOI: 10.1016/j.radphyschem.2016.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tommasino F, Nahum A, Cella L. Increasing the power of tumour control and normal tissue complication probability modelling in radiotherapy: recent trends and current issues. Transl Cancer Res 2017. [DOI: 10.21037/tcr.2017.06.03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Tommasino F, Durante M, D'Avino V, Liuzzi R, Conson M, Farace P, Palma G, Schwarz M, Cella L, Pacelli R. Model-based approach for quantitative estimates of skin, heart, and lung toxicity risk for left-side photon and proton irradiation after breast-conserving surgery. Acta Oncol 2017; 56:730-736. [PMID: 28281862 DOI: 10.1080/0284186x.2017.1299218] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Proton beam therapy represents a promising modality for left-side breast cancer (BC) treatment, but concerns have been raised about skin toxicity and poor cosmesis. The aim of this study is to apply skin normal tissue complication probability (NTCP) model for intensity modulated proton therapy (IMPT) optimization in left-side BC. MATERIAL AND METHODS Ten left-side BC patients undergoing photon irradiation after breast-conserving surgery were randomly selected from our clinical database. Intensity modulated photon (IMRT) and IMPT plans were calculated with iso-tumor-coverage criteria and according to RTOG 1005 guidelines. Proton plans were computed with and without skin optimization. Published NTCP models were employed to estimate the risk of different toxicity endpoints for skin, lung, heart and its substructures. RESULTS Acute skin NTCP evaluation suggests a lower toxicity level with IMPT compared to IMRT when the skin is included in proton optimization strategy (0.1% versus 1.7%, p < 0.001). Dosimetric results show that, with the same level of tumor coverage, IMPT attains significant heart and lung dose sparing compared with IMRT. By NTCP model-based analysis, an overall reduction in the cardiopulmonary toxicity risk prediction can be observed for all IMPT compared to IMRT plans: the relative risk reduction from protons varies between 0.1 and 0.7 depending on the considered toxicity endpoint. CONCLUSIONS Our analysis suggests that IMPT might be safely applied without increasing the risk of severe acute radiation induced skin toxicity. The quantitative risk estimates also support the potential clinical benefits of IMPT for left-side BC irradiation due to lower risk of cardiac and pulmonary morbidity. The applied approach might be relevant on the long term for the setup of cost-effectiveness evaluation strategies based on NTCP predictions.
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Affiliation(s)
- Francesco Tommasino
- Department of Physics, University of Trento, Povo, Italy
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), Povo, Italy
| | - Marco Durante
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), Povo, Italy
| | - Vittoria D'Avino
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
- Department of Naples, National Institute for Nuclear physics (INFN), Naples, Italy
| | - Raffaele Liuzzi
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - Manuel Conson
- Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Paolo Farace
- Department of Protontherapy, Azienda Provinciale per I Servizi Sanitari (APSS), Trento, Italy
| | - Giuseppe Palma
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
- Department of Naples, National Institute for Nuclear physics (INFN), Naples, Italy
| | - Marco Schwarz
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), Povo, Italy
- Department of Protontherapy, Azienda Provinciale per I Servizi Sanitari (APSS), Trento, Italy
| | - Laura Cella
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
- Department of Naples, National Institute for Nuclear physics (INFN), Naples, Italy
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
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Lo Presti D, Gallo G, Bonanno DL, Longhitano F, Bongiovanni DG, Reito S, Randazzo N, Leonora E, Sipala V, Tommasino F. An Innovative Proton Tracking System for Qualification of Particle Beam in Real-Time. IEEE Trans Radiat Plasma Med Sci 2017. [DOI: 10.1109/trpms.2017.2690842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Cerri M, Tinganelli W, Negrini M, Helm A, Scifoni E, Tommasino F, Sioli M, Zoccoli A, Durante M. Hibernation for space travel: Impact on radioprotection. Life Sci Space Res (Amst) 2016; 11:1-9. [PMID: 27993187 DOI: 10.1016/j.lssr.2016.09.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 06/06/2023]
Abstract
Hibernation is a state of reduced metabolic activity used by some animals to survive in harsh environmental conditions. The idea of exploiting hibernation for space exploration has been proposed many years ago, but in recent years it is becoming more realistic, thanks to the introduction of specific methods to induce hibernation-like conditions (synthetic torpor) in non-hibernating animals. In addition to the expected advantages in long-term exploratory-class missions in terms of resource consumptions, aging, and psychology, hibernation may provide protection from cosmic radiation damage to the crew. Data from over half century ago in animal models suggest indeed that radiation effects are reduced during hibernation. We will review the mechanisms of increased radioprotection in hibernation, and discuss possible impact on human space exploration.
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Affiliation(s)
- Matteo Cerri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Piazza di Porta S.Donato 2, 40126 Bologna, Italy; National Institute of Nuclear Physics (INFN), Section of Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Walter Tinganelli
- National Institute of Nuclear Physics (INFN), Trento Institute for Fundamental Physics and Applications (TIFPA), Via Sommarive 14, 38123 Trento, Italy
| | - Matteo Negrini
- National Institute of Nuclear Physics (INFN), Section of Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Alexander Helm
- National Institute of Nuclear Physics (INFN), Trento Institute for Fundamental Physics and Applications (TIFPA), Via Sommarive 14, 38123 Trento, Italy
| | - Emanuele Scifoni
- National Institute of Nuclear Physics (INFN), Trento Institute for Fundamental Physics and Applications (TIFPA), Via Sommarive 14, 38123 Trento, Italy
| | - Francesco Tommasino
- National Institute of Nuclear Physics (INFN), Trento Institute for Fundamental Physics and Applications (TIFPA), Via Sommarive 14, 38123 Trento, Italy; Department of Physics, University of Trento, Via Sommarive 14, 38123 Trento, Italy
| | - Maximiliano Sioli
- National Institute of Nuclear Physics (INFN), Section of Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy ; Department of Physics and Astronomy, University of Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Antonio Zoccoli
- National Institute of Nuclear Physics (INFN), Section of Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy ; Department of Physics and Astronomy, University of Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Marco Durante
- National Institute of Nuclear Physics (INFN), Trento Institute for Fundamental Physics and Applications (TIFPA), Via Sommarive 14, 38123 Trento, Italy.
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Cella L, Tommasino F, D'Avino V, Palma G, Pastore F, Conson M, Schwarz M, Liuzzi R, Pacelli R, Durante M. OC-0552: Skin-NTCP driven optimization for breast proton treatment plans. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31802-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Purpose Charged particle therapy (CPT) is currently based on the use of protons or carbon ions for the treatment of deep-seated and/or radioresistant tumors, which are known to return poor prognosis in photon treatments. A renovated interest has recently been observed in the possibility of extending the spectrum of ions used in CPT. The potential and limitations of different particle species will be discussed in this work, with special regard to 1H, 4He, 12C, and 16O, that is, those presently available in the most advanced particle therapy clinical centers. Materials and Methods Literature information has been screened, as well as additional analysis has been performed, aimed at the comparison of basic physical and biological properties of several ions. The research treatment planning system TRiP98 is also employed to compare the dose distribution resulting from exposure to the different ions in different configurations, including the irradiation of hypoxic targets. Results Particles of intermediate charge, such as helium and lithium, offer an increased physical selectivity compared with protons, while having reduced biological effectiveness compared with carbon. The latter aspect translates into a less sensitive biological optimization of CPT treatments, though still more effective than protons in killing cancer cells. At the same time, in view of their increased linear energy transfer, heavier ions, like oxygen, are considered attractive, especially for the treatment of hypoxic tumors. While the higher biological dose released in the entrance dose represents in general a drawback for ions heavier than carbon, for oxygen beam this effect may be balanced by the lower dose increase requested to overcome hypoxia. Conclusions The possibility of delivering radiation quality-optimized CPT treatments seems to be the new challenge in heavy ion therapy. The potential and limitations of different particle species, according to different sensitivity and morphological scenarios, makes combined treatments of different ions an intriguing option. New ions could open new scenarios in cancer therapy, but would represent as well an opportunity for the treatment of specific non-cancer disease such as atrial fibrillation.
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Affiliation(s)
- Francesco Tommasino
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Department of Physics, University of Trento, Povo, Italy
| | - Emanuele Scifoni
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), Department of Physics, University of Trento, Povo, Italy
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Friedrich T, Tommasino F, Herr L, Scholz U, Hufnagl A, Durante M, Scholz M. The relevance of DNA damage clustering on the nanometer and micrometer scale for the quantitative prediction of radiation effects. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tommasino F, Friedrich T, Scholz U, Taucher-Scholz G, Durante M, Scholz M. Application of the local effect model to predict DNA double-strand break rejoining after photon and high-LET irradiation. Radiat Prot Dosimetry 2015; 166:66-70. [PMID: 25877535 DOI: 10.1093/rpd/ncv164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In the recent version of the local effect model (LEM), the biological effects of ionising radiation can be well described trough the consideration of DNA double-strand breaks (DSB) clustering at the micrometre scale. Assuming a giant-loop organisation for the chromatin higher-order structure, two classes of DSB are defined, namely isolated (iDSB) and clustered DSB (cDSB), according to whether exactly one or more than one DSB are induced in a loop, respectively. Here, a DSB kinetic rejoining model based on the LEM is applied to the description of two specific aspects of DSB rejoining, namely the dose dependence of the rejoining capacity after photon radiation and the residual damage observed at late times after ion irradiation. Based on the hypothesis that iDSB and cDSB can be associated to the fast and slow components of rejoining, the model is able to reproduce the experimental data, therefore supporting the relevance of micrometre scale clustering of damage for photon radiation as well as for high-LET radiation.
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Affiliation(s)
- F Tommasino
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - T Friedrich
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - U Scholz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - G Taucher-Scholz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - M Durante
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany Institut für Festkörperphysik, Technische Universität Darmstadt, Darmstadt, Germany
| | - M Scholz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
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Abstract
Pancreatic ductal adenocarcinoma is the only cancer for which deaths are predicted to increase in 2014 and beyond. Combined radiochemotherapy protocols using gemcitabine and hypofractionated X-rays are ongoing in several clinical trials. Recent results indicate that charged particle therapy substantially increases local control of resectable and unresectable pancreas cancer, as predicted from previous radiobiology studies considering the high tumor hypoxia. Combination with chemotherapy improves the overall survival (OS). We compared published data on X-ray and charged particle clinical results with or without adjuvant chemotherapy calculating the biological effective dose. We show that chemoradiotherapy with protons or carbon ions results in 1 year OS significantly higher than those obtained with other treatment schedules. Further hypofractionation using charged particles may result in improved local control and survival. A comparative clinical trial using the standard X-ray scheme vs. the best current standard with carbon ions is crucial and may open new opportunities for this deadly disease.
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Affiliation(s)
- Marco Durante
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung , Darmstadt , Germany ; Department of Physics, Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), University of Trento , Trento , Italy
| | - Francesco Tommasino
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung , Darmstadt , Germany ; Department of Physics, Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), University of Trento , Trento , Italy
| | - Shigeru Yamada
- Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS) , Chiba , Japan
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Tommasino F, Friedrich T, Jakob B, Meyer B, Durante M, Scholz M. Induction and Processing of the Radiation-Induced Gamma-H2AX Signal and Its Link to the Underlying Pattern of DSB: A Combined Experimental and Modelling Study. PLoS One 2015; 10:e0129416. [PMID: 26067661 PMCID: PMC4465900 DOI: 10.1371/journal.pone.0129416] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/10/2015] [Indexed: 12/23/2022] Open
Abstract
We present here an analysis of DSB induction and processing after irradiation with X-rays in an extended dose range based on the use of the γH2AX assay. The study was performed by quantitative flow cytometry measurements, since the use of foci counting would result in reasonable accuracy only in a limited dose range of a few Gy. The experimental data are complemented by a theoretical analysis based on the GLOBLE model. In fact, original aim of the study was to test GLOBLE predictions against new experimental data, in order to contribute to the validation of the model. Specifically, the γH2AX signal kinetics has been investigated up to 24 h after exposure to increasing photon doses between 2 and 500 Gy. The prolonged persistence of the signal at high doses strongly suggests dose dependence in DSB processing after low LET irradiation. Importantly, in the framework of our modelling analysis, this is related to a gradually increased fraction of DSB clustering at the micrometre scale. The parallel study of γH2AX dose response curves shows the onset of a pronounced saturation in two cell lines at a dose of about 20 Gy. This dose is much lower than expected according to model predictions based on the values usually adopted for the DSB induction yield (≈ 30 DSB/Gy) and for the γH2AX foci extension of approximately 2 Mbp around the DSB. We show and discuss how theoretical predictions and experimental findings can be in principle reconciled by combining an increased DSB induction yield with the assumption of a larger genomic extension for the single phosphorylated regions. As an alternative approach, we also considered in our model the possibility of a 3D spreading-mechanism of the H2AX phosphorylation around the induced DSB, and applied it to the analysis of both the aspects considered. Our results are found to be supportive for the basic assumptions on which GLOBLE is built. Apart from giving new insights into the H2AX phosphorylation process, experiments performed at high doses are of relevance in the context of radiation therapy, where hypo-fractionated schemes become increasingly popular.
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Affiliation(s)
- Francesco Tommasino
- GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt, Germany
- * E-mail:
| | - Thomas Friedrich
- GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt, Germany
| | - Burkhard Jakob
- GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt, Germany
| | - Barbara Meyer
- GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt, Germany
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Marco Durante
- GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt, Germany
- Technische Universität Darmstadt, Institut für Festkörperphysik, Darmstadt, Germany
| | - Michael Scholz
- GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt, Germany
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