ORCID Profile
0000-0002-3422-9108
Current Organisation
Australian Bragg Centre for Proton Therapy and Research
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Nuclear physics | Nuclear and plasma physics | Law and society and socio-legal research | Mineral processing/beneficiation |
Publisher: AIP
Date: 2009
DOI: 10.1063/1.3120078
Publisher: MDPI AG
Date: 08-04-2021
DOI: 10.3390/JPM11040282
Abstract: Deep inspiration breath hold (DIBH) radiotherapy is a technique used to manage early stage left-sided breast cancer. This study compared dosimetric indices of patient-specific X-ray versus proton therapy DIBH plans to explore differences in target coverage, radiation doses to organs at risk, and the impact of breast size. Radiotherapy plans of sixteen breast cancer patients previously treated with DIBH radiotherapy were re-planned with hybrid inverse-planned intensity modulated X-ray radiotherapy (h-IMRT) and intensity modulated proton therapy (IMPT). The total prescribed dose was 40.05 Gy in 15 fractions for all cases. Comparisons between the clinical, h-IMRT, and IMPT evaluated doses to target volumes, organs at risk, and correlations between doses and breast size. Although no differences were observed in target volume coverage between techniques, the h-IMRT and IMPT were able to produce more even dose distributions and IMPT delivered significantly less dose to all organs at risk than both X-ray techniques. A moderate negative correlation was observed between breast size and dose to the target in X-ray techniques, but not IMPT. Both h-IMRT and IMPT produced plans with more homogeneous dose distribution than forward-planned IMRT and IMPT achieved significantly lower doses to organs at risk compared to X-ray techniques.
Publisher: IEEE
Date: 10-2011
Publisher: IOP Publishing
Date: 02-08-2017
DOI: 10.1088/0952-4746/32/3/339
Abstract: Treatment of low grade prostate cancer with permanent implant of radioactive seeds has become one of the most common brachytherapy procedures in use today. The implant procedure is usually performed with fluoroscopy image guidance to ensure that the seeds are deployed in the planned locations. In this situation the physician performing the transperineal implant is required to be close to the fluoroscopy unit and dose to the eye lens may be of concern. In 1991 the International Commission on Radiological Protection (ICRP) provided a recommended dose limit of 150 mSv yr(-1) for occupational exposures to the lens of the eye. With more long term follow-up data, this limit was revised in 2011 to 20 mSv yr(-1). With this revised limit in mind, we have investigated the dose to the lens of the eye received by physicians during prostate brachytherapy seed implantation. By making an approximation of annual workload, we have related the dose received to the annual background dose. Through clinical and phantom measurements with thermoluminescent dosimeters, it was found that the excess dose to the physician's eye lens received for a conservative estimate of annual workload was never greater than 100% of the annual background dose.
Publisher: Springer Science and Business Media LLC
Date: 29-01-2018
Publisher: Wiley
Date: 29-05-2012
DOI: 10.1118/1.4719963
Abstract: The objective of the current work was to develop an algorithm for growing a macroscopic tumor volume from in idual randomized quasi-realistic cells. The major physical and chemical components of the cell need to be modeled. It is intended to import the tumor volume into GEANT4 (and potentially other Monte Carlo packages) to simulate ionization events within the cell regions. A MATLAB© code was developed to produce a tumor coordinate system consisting of in idual ellipsoidal cells randomized in their spatial coordinates, sizes, and rotations. An eigenvalue method using a mathematical equation to represent in idual cells was used to detect overlapping cells. GEANT4 code was then developed to import the coordinate system into GEANT4 and populate it with in idual cells of varying sizes and composed of the membrane, cytoplasm, reticulum, nucleus, and nucleolus. Each region is composed of chemically realistic materials. The in-house developed MATLAB© code was able to grow semi-realistic cell distributions (~2 × 10(8) cells in 1 cm(3)) in under 36 h. The cell distribution can be used in any number of Monte Carlo particle tracking toolkits including GEANT4, which has been demonstrated in this work. Using the cell distribution and GEANT4, the authors were able to simulate ionization events in the in idual cell components resulting from 80 keV gamma radiation (the code is applicable to other particles and a wide range of energies). This virtual microdosimetry tool will allow for a more complete picture of cell damage to be developed.
Publisher: Informa UK Limited
Date: 21-12-2020
Publisher: Wiley
Date: 04-12-2023
DOI: 10.1111/AJCO.13896
Abstract: The Australian Bragg Centre for Proton Therapy and Research (ABCPTR) will be Australia's first proton beam therapy (PBT) facility. A model was developed to predict associated public hospital care requirements for patients during PBT, to facilitate resource planning for pediatric, adolescent and young adult (AYA), and adult public hospitals in South Australia. National incidence rates for specific cancer indications were obtained from the Australian Childhood Cancer Registry, Australian Institute of Health and Welfare and published data. Australian Bureau of Statistics national population projections were used to estimate new cases in 2025 and beyond. Radiation oncologists and pediatric oncologists from the Central Adelaide Local and Women's and Children's Health Network, along with international colleagues, provided guidance on chemotherapy utilization and inpatient admission estimates. It was estimated 180 patients (40.4%) within the adult population (≥25 years) and 265 patients (59.6%) within the pediatric/AYA population ( years) would be eligible for PBT in 2025. There was no indication adult cancers would require concurrent outpatient/inpatient chemotherapy, in contrast with pediatric and AYA patients (59.5% and 62.8% outpatient and 18.9% and 41.9% inpatient, respectively). It was estimated 53% and 29% of pediatric and AYA patients could require inpatient admission for toxicity related to disease, concurrent chemotherapy or PBT. Associated public hospital care requirements related to the delivery of a national PBT service were estimated. This has particular implications for planning of the new Women's and Children's hospital, co‐located with the ABCPTR. True data accuracy will be determined on future data generation and analysis.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.EJMP.2017.11.013
Abstract: Proton therapy can be a highly effective strategy for the treatment of tumours. However, compared with X-ray therapy it is more expensive and has limited availability. In addition, it is not always clear whether it will benefit an in idual patient more than a course of traditional X-ray therapy. Basing a treatment decision on outcomes of clinical trials can be difficult due to a shortage of data. Predictive modelling studies are becoming an attractive alternative to supplement clinical decisions. The aim of the current work is to present a Markov framework that compares clinical outcomes for proton and X-ray therapy. A Markov model has been developed which estimates the radiobiological effect of a given treatment plan. This radiobiological effect is estimated using the tumour control probability (TCP), normal tissue complication probability (NTCP) and second primary cancer induction probability (SPCIP). These metrics are used as transition probabilities in the Markov chain. The clinical outcome is quantified by the quality adjusted life expectancy. To demonstrate functionality, the model was applied to a 6-year-old patient presenting with skull base chordoma. The model was successfully developed to compare clinical outcomes for proton and X-ray treatment plans. For the ex le patient considered, it was predicted that proton therapy would offer a significant advantage compared with volumetric modulated arc therapy in terms of survival and mitigating injuries. The functionality of the model was demonstrated using the ex le patient. The proposed Markov method may be a useful tool for deciding on a treatment strategy for in idual patients.
Publisher: Springer Berlin Heidelberg
Date: 2009
Publisher: Wiley
Date: 07-07-2020
DOI: 10.1002/JMRS.416
Publisher: Wiley
Date: 20-10-2010
DOI: 10.1118/1.3504603
Publisher: Wiley
Date: 16-03-2021
DOI: 10.1002/MP.14780
Publisher: Wiley
Date: 06-2009
DOI: 10.1118/1.3182682
Publisher: Wiley
Date: 24-11-2022
DOI: 10.1002/JMRS.634
Abstract: Stereotactic ablative radiotherapy (SABR) can be a curative option for non‐small cell lung cancer (NSCLC) and oligometastatic lung disease. Volumetric modulated arc therapy (VMAT) has offered further advancements in terms of radiation dose shaping without compromising treatment times however there is potential for greater low‐dose exposure to the lung. This study was to assess whether VMAT lung SABR would result in any increase to the dosimetry parameters compared with three‐dimensional conformal radiotherapy (3D‐CRT) that could confer increased risk of radiation pneumonitis. A total of 53 and 30 3D‐CRT treatment plans of patients treated with 48 Gy in 4 fractions were compared. No statistically significant difference in planning target volumes between the VMAT 29.9 cc (range 12.4–58.5 cc) and 3D‐CRT 31.2 cc (range 12.3–58.3 cc) P = 0.79. The mean of total lung V5, ipsilateral lung V5 and contralateral lung V5 all showed a trend of being smaller in the VMAT treatment group‐ 14% versus 15.8%, 25.6% versus 30.4% and 1.6% versus 2.2%, respectively, but all were not statistically significant differences. Mean of the mean lung dose MLD, again showed a trend of being lower in the VMAT treatments but was also non‐significant, 2.6 Gy versus 3.0 Gy, P = 1.0. Mean V20 was the same in both cohorts, 3.3%. The dosimetry for 3D‐CRT and VMAT plans were not significantly different including V5, and therefore we conclude that VMAT treatment is unlikely to be associated with an increased risk of radiation pneumonitis.
Publisher: IEEE
Date: 2007
Publisher: Wiley
Date: 13-10-2008
DOI: 10.1118/1.2986139
Abstract: The limited spatial resolution in proton computed tomography (pCT) in comparison to x-ray CT is related to multiple Coulomb scattering (MCS) within the imaged object. The current generation pCT design utilizes silicon detectors that measure the position and direction of in idual protons prior to and post-traversing the patient to maximize the knowledge of the path of the proton within the imaged object. For efficient reconstruction with the proposed pCT system, one needs to develop compact and flexible mathematical formalisms that model the effects of MCS as the proton traverses the imaged object. In this article, a compact, matrix-based most likely path (MLP) formalism is presented employing Bayesian statistics and a Gaussian approximation of MCS. Using GEANT4 simulations in a homogeneous 20 cm water cube, the MLP expression was found to be able to predict the Monte Carlo tracks of 200 MeV protons to within 0.6 mm on average when employing 3sigma cuts on the relative exit angle and exit energy. These cuts were found to eliminate the majority of events not conforming to the Gaussian model of MCS used in the MLP derivation. M riszwana Banu
Publisher: Wiley
Date: 10-2017
DOI: 10.1002/MP.12491
Publisher: Springer Science and Business Media LLC
Date: 10-02-2020
Publisher: Wiley
Date: 13-05-2016
DOI: 10.1118/1.4948683
Abstract: The accuracy of proton dose calculation is dependent on the ability to correctly characterize patient tissues with medical imaging. The most common method is to correlate computed tomography (CT) numbers obtained via single-energy CT (SECT) with proton stopping power ratio (SPR). CT numbers, however, cannot discriminate between a change in mass density and change in chemical composition of patient tissues. This limitation can have consequences on SPR calibration accuracy. Dual-energy CT (DECT) is receiving increasing interest as an alternative imaging modality for proton therapy treatment planning due to its ability to discriminate between changes in patient density and chemical composition. In the current work we use a phantom of known composition to demonstrate the dosimetric advantages of proton therapy treatment planning with DECT over SECT. A phantom of known composition was scanned with a clinical SECT radiotherapy CT-simulator. The phantom was rescanned at a lower X-ray tube potential to generate a complimentary DECT image set. A set of reference materials similar in composition to the phantom was used to perform a stoichiometric calibration of SECT CT number to proton SPRs. The same set of reference materials was used to perform a DECT stoichiometric calibration based on effective atomic number. The known composition of the phantom was used to assess the accuracy of SPR calibration with SECT and DECT. Intensity modulated proton therapy (IMPT) treatment plans were generated with the SECT and DECT image sets to assess the dosimetric effect of the imaging modality. Isodose difference maps and root mean square (RMS) error calculations were used to assess dose calculation accuracy. SPR calculation accuracy was found to be superior, on average, with DECT relative to SECT. Maximum errors of 12.8% and 2.2% were found for SECT and DECT, respectively. Qualitative examination of dose difference maps clearly showed the dosimetric advantages of DECT imaging, compared to SECT imaging for IMPT dose calculation for the case investigated. Quantitatively, the maximum dose calculation error in the SECT plan was 7.8%, compared to a value of 1.4% in the DECT plan. When considering the high dose target region, the root mean square (RMS) error in dose calculation was 2.1% and 0.4% for SECT and DECT, respectively. DECT-based proton treatment planning in a commercial treatment planning system was successfully demonstrated for the first time. DECT is an attractive imaging modality for proton therapy treatment planning owing to its ability to characterize density and chemical composition of patient tissues. SECT and DECT scans of a phantom of known composition have been used to demonstrate the dosimetric advantages obtainable in proton therapy treatment planning with DECT over the current approach based on SECT.
Publisher: IOP Publishing
Date: 09-06-2010
Publisher: Elsevier BV
Date: 02-2020
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/968429
Abstract: The major differences between the physics models in Geant4-DNA and RITRACKS Monte Carlo packages are investigated. Proton and electron ionisation interactions and electron excitation interactions in water are investigated in the current work. While these packages use similar semiempirical physics models for inelastic cross-sections, the implementation of these models is demonstrated to be significantly different. This is demonstrated in a simple Monte Carlo simulation designed to identify differences in interaction cross-sections.
Publisher: AIP
Date: 2009
DOI: 10.1063/1.3120073
Publisher: Wiley
Date: 12-06-2013
DOI: 10.1118/1.4808150
Abstract: Investigation of increased radiation dose deposition due to gold nanoparticles (GNPs) using a 3D computational cell model during x-ray radiotherapy. Two GNP simulation scenarios were set up in Geant4 a single 400 nm diameter gold cluster randomly positioned in the cytoplasm and a 300 nm gold layer around the nucleus of the cell. Using an 80 kVp photon beam, the effect of GNP on the dose deposition in five modeled regions of the cell including cytoplasm, membrane, and nucleus was simulated. Two Geant4 physics lists were tested: the default Livermore and custom built Livermore/DNA hybrid physics list. 10(6) particles were simulated at 840 cells in the simulation. Each cell was randomly placed with random orientation and a diameter varying between 9 and 13 μm. A mathematical algorithm was used to ensure that none of the 840 cells overlapped. The energy dependence of the GNP physical dose enhancement effect was calculated by simulating the dose deposition in the cells with two energy spectra of 80 kVp and 6 MV. The contribution from Auger electrons was investigated by comparing the two GNP simulation scenarios while activating and deactivating atomic de-excitation processes in Geant4. The physical dose enhancement ratio (DER) of GNP was calculated using the Monte Carlo model. The model has demonstrated that the DER depends on the amount of gold and the position of the gold cluster within the cell. In idual cell regions experienced statistically significant (p < 0.05) change in absorbed dose (DER between 1 and 10) depending on the type of gold geometry used. The DER resulting from gold clusters attached to the cell nucleus had the more significant effect of the two cases (DER ≈ 55). The DER value calculated at 6 MV was shown to be at least an order of magnitude smaller than the DER values calculated for the 80 kVp spectrum. Based on simulations, when 80 kVp photons are used, Auger electrons have a statistically insignificant (p < 0.05) effect on the overall dose increase in the cell. The low energy of the Auger electrons produced prevents them from propagating more than 250-500 nm from the gold cluster and, therefore, has a negligible effect on the overall dose increase due to GNP. The results presented in the current work show that the primary dose enhancement is due to the production of additional photoelectrons.
Publisher: Wiley
Date: 09-09-2009
DOI: 10.1118/1.3218759
Abstract: An accurate system matrix is required for quantitative proton CT (pCT) image reconstruction with iterative projection algorithms. The system matrix is composed of chord lengths of in idual proton path intersections with reconstruction pixels. In previous work, reconstructions were performed assuming constant intersection chord lengths, which led to systematic errors of the reconstructed proton stopping powers. The purpose of the present work was to introduce a computationally efficient variable intersection chord length in order to improve the accuracy of the system matrix. An analytical expression that takes into account the discrete stepping nature of the pCT most likely path (MLP) reconstruction procedure was created to describe an angle-dependent effective mean chord length function. A pCT dataset was simulated with GEANT4 using a parallel beam of 200 MeV protons intersecting a computerized head phantom consisting of tissue-equivalent materials with known relative stopping power. The phantom stopping powers were reconstructed with the constant chord length, exact chord length, and effective mean chord length approaches, in combination with the algebraic reconstruction technique. Relative stopping power errors were calculated for each anatomical phantom region and compared for the various methods. It was found that the error of approximately 10% in the mean reconstructed stopping power value for a given anatomical region, resulting from a system matrix with a constant chord length, could be reduced to less than 0.5% with either the effective mean chord length or exact chord length approaches. Reconstructions with the effective mean chord length were found to be approximately 20% faster than reconstructions with an exact chord length. The effective mean chord length method provides the possibility for more accurate, computationally efficient quantitative pCT reconstructions.
Publisher: Wiley
Date: 06-06-2022
DOI: 10.1002/MP.15727
Abstract: Proton imaging makes use of high‐energy, low‐intensity proton beams that fully traverse the patient and has been suggested to reduce range uncertainty in proton therapy. Upright patient positioning with proton imaging is being considered for a fixed beam room of a new proton therapy facility currently under construction. Considering that the yield and energy spectrum of secondary radiation from high‐energy proton beams is proton beam energy dependent, an assessment of radiation shielding at the energies required for proton imaging should be performed prior to use. Furthermore, NCRP 144 recommends that pion production be considered for proton energies greater than 300 MeV, which are not typically utilized for proton therapy but may be required for proton imaging. The purpose of this work was to determine whether proton treatment and imaging with an upright patient positioning system on a fixed beamline were acceptable from a radiation shielding perspective. This is the first report on radiation shielding assessment of proton imaging applications and includes consideration of pion production at the proton beam energy of 330 MeV. The Geant4 Monte Carlo toolkit was used for the radiation shielding assessment. The calculations consisted of the generation of secondary particle phase‐space files by simulating the passage of high‐energy proton beams in two target materials, and subsequent simulation of the secondary particles in the proton therapy facility geometry. Particle fluence was converted to operational and protection radiation safety quantities with a custom python script for assessment of instantaneous and annual doses, respectively. The total yields of pions from a 330‐MeV proton beam were many orders of magnitude less than that of neutrons and photons. Three‐dimensional maps of ambient dose rate for a 330‐MeV proton beam showed doses arising from secondary neutrons and photons far exceed those arising from pion production. Incorporating representative annual workloads into the calculation demonstrated that proton imaging doses outside the shielded area were negligible compared to those arising from proton therapy. Pion production has a negligible impact on the radiation shielding of proton imaging at 330 MeV relative to neutron and photon production. Radiation shielding designed for proton therapy is adequate for high‐energy proton imaging applications.
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/702675
Publisher: Wiley
Date: 02-2023
Abstract: Proton‐to‐photon comparative treatment planning is a current requirement of Australian Government funding for patients to receive proton beam therapy (PBT) overseas, and a future requirement for Medicare funding of PBT in Australia. Because of the fundamental differences in treatment plan creation and evaluation between PBT and conventional radiation therapy with x‐rays (XRT), there is the potential for a lack of consistency in the process of comparing PBT and XRT treatment plans. This may have an impact on patient eligibility assessment for PBT. The objective of these guidelines is to provide a practical reference document for centres performing proton‐to‐photon comparative planning and thereby facilitate national uniformity.
Publisher: Elsevier BV
Date: 12-2201
Publisher: Springer Science and Business Media LLC
Date: 31-08-2021
DOI: 10.1007/S13246-021-01048-5
Abstract: Inter-fractional anatomical variations in head and neck (H&N) cancer patients can lead to clinically significant dosimetric changes. Adaptive re-planning should thus commence to negate any potential over-dosage to organs-at-risk (OAR), as well as potential under-dosage to target lesions. The aim of this study is to explore the correlation between transit fluence, as measured at an electronic portal imaging device (EPID), and dose volume histogram (DVH) metrics to target and OAR structures in a simulated environment. Planning data of eight patients that have previously undergone adaptive radiotherapy for H&N cancer using volumetric modulated arc therapy (VMAT) at the Royal Adelaide Hospital were selected for this study. Through delivering the original treatment plan to both the planning and rescan CTs of these eight patients, predicted electronic portal images (EPIs) and DVH metrics corresponding to each data set were extracted using a novel RayStation script. A weighted projection mask was developed for target and OAR structures through considering the intra-angle overlap between fluence and structure contours projected onto the EPIs. The correlation between change in transit fluence and planning target volume (PTV) D98 and spinal cord D0.03cc with and without the weighting mask applied was investigated. PTV D98 was strongly correlated with mean fluence percentage difference both with and without the weighting mask applied (R
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.EJMP.2016.04.006
Abstract: The use of radioisotopes in nuclear medicine is essential for diagnosing and treating cancer. The optimization of their production is a key factor in maximizing the production yield and minimizing the associated costs. An efficient approach to this problem is the use of Monte Carlo simulations prior to experimentation. By predicting isotopes yields, one can study the isotope of interest expected activity for different energy ranges. One can also study the target contamination with other radioisotopes, especially undesired radioisotopes of the wanted chemical element which are difficult to separate from the irradiated target and might result in increasing the dose when delivering the radiopharmaceutical product to the patient. The aim of this work is to build and validate a Monte Carlo simulation platform using the GEANT4 toolkit to model the solid target system of the South Australian Health and Medical Research Institute (SAHMRI) GE Healthcare PETtrace cyclotron. It includes a GEANT4 Graphical User Interface (GUI) where the user can modify simulation parameters such as the energy, shape and current of the proton beam, the target geometry and material, the foil geometry and material and the time of irradiation. The paper describes the simulation and presents a comparison of simulated and experimental/theoretical yields for various nuclear reactions on an enriched nickel 64 target using the GEANT4 physics model QGSP_BIC_AllHP, a model recently developed to evaluate with high precision the interaction of protons with energies below 200MeV available in Geant4 version 10.1. The simulation yield of the (64)Ni(p,n)(64)Cu reaction was found to be 7.67±0.074 mCi·μA(-1) for a target energy range of 9-12MeV. Szelecsenyi et al. (1993) gives a theoretical yield of 6.71mCi·μA(-1) and an experimental yield of 6.38mCi·μA(-1). The (64)Ni(p,n)(64)Cu cross section obtained with the simulation was also verified against the yield predicted from the nuclear database TENDL and compared to experimental yield obtained from literature.
Publisher: Springer Science and Business Media LLC
Date: 26-04-2016
DOI: 10.1007/S13246-016-0447-9
Abstract: Correct modelling of the interaction parameters of patient tissues is of vital importance in proton therapy treatment planning because of the large dose gradients associated with the Bragg peak. Different 3D imaging techniques yield different information regarding these interaction parameters. Given the rapidly expanding interest in proton therapy, this review is written to make readers aware of the current challenges in accounting for tissue heterogeneities and the imaging systems that are proposed to tackle these challenges. A summary of the interaction parameters of interest in proton therapy and the current and developmental 3D imaging techniques used in proton therapy treatment planning is given. The different methods to translate the imaging data to the interaction parameters of interest are reviewed and a summary of the implementations in several commercial treatment planning systems is presented.
Publisher: Wiley
Date: 03-04-2020
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.EJMP.2016.09.007
Abstract: Emerging radiotherapy treatments including targeted particle therapy, hadron therapy or radiosensitisation of cells by high-Z nanoparticles demand the theoretical determination of radiation track structure at the nanoscale. This is essential in order to evaluate radiation damage at the cellular and DNA level. Since 2007, Geant4 offers physics models to describe particle interactions in liquid water at the nanometre level through the Geant4-DNA Package. This package currently provides a complete set of models describing the event-by-event electromagnetic interactions of particles with liquid water, as well as developments for the modelling of water radiolysis. Since its release, Geant4-DNA has been adopted as an investigational tool in kV and MV external beam radiotherapy, hadron therapies using protons and heavy ions, targeted therapies and radiobiology studies. It has been benchmarked with respect to other track structure Monte Carlo codes and, where available, against reference experimental measurements. While Geant4-DNA physics models and radiolysis modelling functionalities have already been described in detail in the literature, this review paper summarises and discusses a selection of representative papers with the aim of providing an overview of a) geometrical descriptions of biological targets down to the DNA size, and b) the full spectrum of current micro- and nano-scale applications of Geant4-DNA.
Publisher: MDPI AG
Date: 02-05-2022
Abstract: Hypofractionated radiotherapy is an attractive approach for minimizing patient burden and treatment cost. Technological advancements in external beam radiotherapy (EBRT) delivery and image guidance have resulted in improved targeting and conformality of the absorbed dose to the disease and a reduction in dose to healthy tissue. These advances in EBRT have led to an increasing adoption and interest in hypofractionation. Furthermore, for many treatment sites, proton beam therapy (PBT) provides an improved absorbed dose distribution compared to X-ray (photon) EBRT. In the past 10 years there has been a notable increase in reported clinical data involving hypofractionation with PBT, reflecting the interest in this treatment approach. This review will discuss the reported clinical data and radiobiology of hypofractionated PBT. Over 50 published manuscripts reporting clinical results involving hypofractionation and PBT were included in this review, ~90% of which were published since 2010. The most common treatment regions reported were prostate, lung and liver, making over 70% of the reported results. Many of the reported clinical data indicate that hypofractionated PBT can be well tolerated, however future clinical trials are still needed to determine the optimal fractionation regime.
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.APRADISO.2014.03.006
Abstract: Radio-resistant hypoxic tumor cells are significant contributors to the locoregional recurrences and distant metastases that mark failure of radiotherapy. Due to restricted tissue oxygenation, chronically hypoxic tumor cells frequently become necrotic and thus there is often an association between chronically hypoxic and necrotic tumor regions. This simulation study is the first in a series to determine the feasibility of hypoxic cell killing after first targeting adjacent areas of necrosis with either an α- or β-emitting radioimmunoconjugate.
Publisher: Wiley
Date: 04-08-2017
DOI: 10.1002/MP.12450
Abstract: To investigate the feasibility of a 3D imaging system utilizing a A Geant4 Monte Carlo simulation was performed with the novel imaging system. The simulation was repeated with a typical 120 kV X-ray tube spectrum while maintaining all other parameters. Dual energy Images generated by gamma emissions of
Publisher: Wiley
Date: 06-2011
DOI: 10.1118/1.3612304
Publisher: IOP Publishing
Date: 03-2017
Publisher: Springer Science and Business Media LLC
Date: 23-10-2019
DOI: 10.1007/S13246-019-00810-0
Abstract: While proton beam therapy (PBT) can offer increased sparing of healthy tissue, it is associated with large capital costs and as such, has limited availability. Furthermore, it has not been well established whether PBT has significant clinical advantages over conventional volumetric modulated arc therapy (VMAT) for all tumour types. PBT can potentially offer improved clinical outcomes for base of skull chordoma (BOSCh) patients compared with photon (X-ray) therapy, however the cost-effectiveness of these treatments is unclear. In this study, the cost-effectiveness of PBT in the treatment of BOSCh patients is assessed, based on an analysis of comparative radiotherapy treatment plans using a radiobiological Markov model. Seven BOSCh patients had treatment plans for the delivery of intensity modulated proton therapy and VMAT retrospectively analysed. The patient outcome (in terms of tumour local control and normal tissue complications) after receiving each treatment was estimated with a radiobiological Markov model. In addition, the model estimated the cost of both the primary treatment and treating any resultant adverse events. The incremental cost-effectiveness ratio (ICER) was obtained for each patient. PBT was found to be cost-effective for 5 patients and cost-saving for 2. The mean ICER was AUD$1,990 per quality adjusted life year gained. Variation of model parameters resulted in the proton treatments remaining cost-effective for these patients. Based on this cohort, PBT is a cost-effective treatment for patients with BOSCh. This supports the inclusion of PBT for BOSCh in the Medicare Services Advisory Committee 1455 application.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2015
Publisher: IEEE
Date: 10-2009
Publisher: IEEE
Date: 10-2009
Publisher: IOP Publishing
Date: 05-04-2017
Publisher: IOP Publishing
Date: 27-03-2015
DOI: 10.1088/0031-9155/60/8/3217
Abstract: The preliminary framework of a combined radiobiological model is developed and calibrated in the current work. The model simulates the production of in idual cells forming a tumour, the spatial distribution of in idual ionization events (using Geant4-DNA) and the stochastic biochemical repair of DNA double strand breaks (DSBs) leading to the prediction of survival or death of in idual cells. In the current work, we expand upon a previously developed tumour generation and irradiation model to include a stochastic ionization damage clustering and DNA lesion repair model. The Geant4 code enabled the positions of each ionization event in the cells to be simulated and recorded for analysis. An algorithm was developed to cluster the ionization events in each cell into simple and complex double strand breaks. The two lesion kinetic (TLK) model was then adapted to predict DSB repair kinetics and the resultant cell survival curve. The parameters in the cell survival model were then calibrated using experimental cell survival data of V79 cells after low energy proton irradiation. A monolayer of V79 cells was simulated using the tumour generation code developed previously. The cells were then irradiated by protons with mean energies of 0.76 MeV and 1.9 MeV using a customized version of Geant4. By replicating the experimental parameters of a low energy proton irradiation experiment and calibrating the model with two sets of data, the model is now capable of predicting V79 cell survival after low energy (<2 MeV) proton irradiation for a custom set of input parameters. The novelty of this model is the realistic cellular geometry which can be irradiated using Geant4-DNA and the method in which the double strand breaks are predicted from clustering the spatial distribution of ionisation events. Unlike the original TLK model which calculates a tumour average cell survival probability, the cell survival probability is calculated for each cell in the geometric tumour model developed in the current work. This model uses fundamental measurable microscopic quantities such as genome length rather than macroscopic radiobiological quantities such as alpha/beta ratios. This means that the model can be theoretically used under a wide range of conditions with a single set of input parameters once calibrated for a given cell line.
Location: Australia
Start Date: 2023
End Date: 12-2027
Amount: $4,999,600.00
Funder: Australian Research Council
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