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Title: SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice

Abstract

Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with ALL and SCLC, and we have shown the potential of PCI in select breast cancer patients through a mouse model (manuscript in preparation). We developed a computational model using our experimental results to demonstrate the advantage of treating brain micro-metastases early. Methods: MATLAB was used to develop the computational model of brain metastasis and PCI in mice. The number of metastases per mouse and the volume of metastases from four- and eight-week endpoints were fit to normal and log-normal distributions, respectively. Model input parameters were optimized so that model output would match the experimental number of metastases per mouse. A limiting dilution assay was performed to validate the model. The effect of radiation at different time points was computationally evaluated through the endpoints of incidence, number of metastases, and tumor burden. Results: The correlation between experimental number of metastases per mouse and the Gaussian fit was 87% and 66% at the two endpoints. The experimental volumes and the log-normal fit had correlations of 99% and 97%. In the optimized model, the correlation between number ofmore » metastases per mouse and the Gaussian fit was 96% and 98%. The log-normal volume fit and the model agree 100%. The model was validated by a limiting dilution assay, where the correlation was 100%. The model demonstrates that cells are very sensitive to radiation at early time points, and delaying treatment introduces a threshold dose at which point the incidence and number of metastases decline. Conclusion: We have developed a computational model of brain metastasis and PCI in mice that is highly correlated to our experimental data. The model shows that early treatment of subclinical disease is highly advantageous.« less

Authors:
; ;  [1]
  1. MD Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
22538172
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 42; Journal Issue: 6; Other Information: (c) 2015 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; CORRELATIONS; IRRADIATION; MAMMARY GLANDS; METASTASES; MICE; NEOPLASMS; RADIOTHERAPY; SIMULATION; THRESHOLD DOSE

Citation Formats

Smith, D, Debeb, B, and Woodward, W. SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice. United States: N. p., 2015. Web. doi:10.1118/1.4925027.
Smith, D, Debeb, B, & Woodward, W. SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice. United States. doi:10.1118/1.4925027.
Smith, D, Debeb, B, and Woodward, W. Mon . "SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice". United States. doi:10.1118/1.4925027.
@article{osti_22538172,
title = {SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice},
author = {Smith, D and Debeb, B and Woodward, W},
abstractNote = {Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with ALL and SCLC, and we have shown the potential of PCI in select breast cancer patients through a mouse model (manuscript in preparation). We developed a computational model using our experimental results to demonstrate the advantage of treating brain micro-metastases early. Methods: MATLAB was used to develop the computational model of brain metastasis and PCI in mice. The number of metastases per mouse and the volume of metastases from four- and eight-week endpoints were fit to normal and log-normal distributions, respectively. Model input parameters were optimized so that model output would match the experimental number of metastases per mouse. A limiting dilution assay was performed to validate the model. The effect of radiation at different time points was computationally evaluated through the endpoints of incidence, number of metastases, and tumor burden. Results: The correlation between experimental number of metastases per mouse and the Gaussian fit was 87% and 66% at the two endpoints. The experimental volumes and the log-normal fit had correlations of 99% and 97%. In the optimized model, the correlation between number of metastases per mouse and the Gaussian fit was 96% and 98%. The log-normal volume fit and the model agree 100%. The model was validated by a limiting dilution assay, where the correlation was 100%. The model demonstrates that cells are very sensitive to radiation at early time points, and delaying treatment introduces a threshold dose at which point the incidence and number of metastases decline. Conclusion: We have developed a computational model of brain metastasis and PCI in mice that is highly correlated to our experimental data. The model shows that early treatment of subclinical disease is highly advantageous.},
doi = {10.1118/1.4925027},
journal = {Medical Physics},
number = 6,
volume = 42,
place = {United States},
year = {Mon Jun 15 00:00:00 EDT 2015},
month = {Mon Jun 15 00:00:00 EDT 2015}
}
  • Purpose: The Leksell Gamma Knife (GK) B & C series contains 201 Cobalt-60 sources with a helmet. The new model, Perfexion uses 192 Cobalt-60 sources without a helmet; using IRIS system for collimation and stereotactic guidance to deliver SRS to brain tumors. Relative dose to extracranial organs at risk (OARs) is measured in phantom in this study for Perfexion and C-series GK. Materials & Methods: Measurements were performed in a Rando anthropomorphic phantom on both systems using a large ion chamber (Keithley-175) for each collimator. The Keithley-175 cc ion chamber was sandwiched between phantom slices at various locations in themore » phantom to correspond to different extracranial OARs (thyroid, heart, kidney, ovary and testis, etc.) The dose measurement was repeated with OSL detectors for each position and collimator. Results: A large variation is observed in the normalized dose between these two systems. The dose beyond the housing falls off exponentially for Perfexion. Dose beyond the C-series GK housing falls off exponentially from 0–20cm then remains relatively constant from 20–40cm and again falls off with distance but less rapidly. The variation of extracranial dose with distance for each collimator is found to be parallel to each other for both systems. Conclusion: Whole body dose is found to vary significantly between these systems. It is important to measure the extracranial dose, especially for young patients. It is estimated that dose falls off exponentially from the GK housing and is about 1% for large collimators at 75 cm. The dose is two-orders of magnitude smaller for the 4mm collimator. However, this small dose for patient may be significant radiologically.« less
  • Purpose: We evaluate the feasibility of using robustness optimization (RO) function to improve the planning efficiency of pencil beam scanning (PBS) craniospinal irradiation (CSI) with gradient matching technique. Methods: A CSI patient was planned with 2 lateral brain fields and 4 posterior fields to cover the entire spine to maximal field of 24 cm × 20 cm on a compact PBS gantry, ProteusONE. CSI plans were generated using traditional volumetric gradient dose optimization (VGDO) and robustness optimization (RO) method respectively. In traditional VGDO, besides the sectioned spine target volumes, gradient volume (GV) were generated as 4 equally spaced structures e.g.more » 80%, 60%, 40%, and 20% of prescription dose. In RO method, only sectioned spine target volumes with an overlap of 4cm were created. In the robustness optimization settings, 5mm uncertainty in superior and inferior direction was defined for auto gradient optimization. Dosimetric metrics of conformity number (CN), homogeneity index (HI), and maximal cord doses were compared in Raystation version 4.6.100.6. Results: In VGDO method, total 16 GV structures and five 100% dose level target structures were contoured compared to total 5 target structures in RO method which saves 30 min in contour. With the same PTV coverage (95% volume receive 30.6Gy prescription dose), maximum cord dose is 32.64Gy in VGDO and 31.94Gy in RO. HI is 1.03 and 1.04 for VGDO and RO respectively. CN is 0.93 and 0.94 for VGDO and RO respectively. Conclusions: The dosimetric comparison demonstrated both methods are equivalent in terms of plan quality. With robust optimization for CSI gradient matching, it efficiently reduces the amount of planning target contour structure by factor of 4 and thus improves the planning efficiency especially for 4 or more gradient junction area.« less
  • Purpose: Micro-Computed Tomography (micro-CT) has been widely used as a non-invasive, high-resolution imaging modality in preclinical research. However, tumors cannot be well distinguished, since their density are similar to those of surrounding tissues, and the tumors’ natural contrast is very low. The benefits of using Gold Nanoparticles (AuNPs) as a promising high atomic weight contrast agent have been published in recent years. The aim of this study is to investigate the efficacy of AuNPs as contrast agents using different energy x-rays. Methods: The left flank of an immune-compromised athymic nude mouse was implanted with subcutaneous xenograft model of human lungmore » cancer line, A549 cells (from ATCC). After 14 days, this mouse was imaged with dual energy cone-beam micro-CT. The selected energies were 45 kVp and 65 kVp. 10µg AuNPs (200 µg/ml concentration) approximately 12 nm in size were injected subcutaneously into the tumor. The mouse was imaged 0, 3 and 24 hours post-injection. During scanning, this mouse was anesthetized. All projection raw data have been optimized and then images were reconstructed with the FDK Algorithm. Results: Based on images, at 0 hour, AuNPs provided obvious contrast no matter which energy selected, 45 kVp or 65 kVp; and using 45 kVp X-ray, AuNps showed greater contrast. After 3 hours or evenand longer, AuNPs distributed throughout the whole body of mouse, and they were not shown clearly shown in the images. Conclusion: In this study, we investigated the efficacy of AuNPs as image contrast agents at different energies with dual-energy micro-CT, using 200µg/mL of AuNPs. Sufficiently high concentrations of AuNPs are needed to be able to track intratumoral distribution. Images showed good contrast immediately following the administration of the agent but results were poor after 3 hours.« less
  • Purpose: Neurocognitive impairment (NI) in patients with small cell lung cancer (SCLC) after whole brain radiation treatment (WBRT) is a significant cause of morbidity. Hippocampal avoidance (HA) during WBRT may mitigate or prevent NI in such patients. However, this has not been tested in SCLC patients. The estimated risk of metastases in the HA region (HM) in patients with SCLC at diagnosis or after WBRT is unknown. Our study aimed to determine the risk of HM in patients with SCLC and to assess correlated clinical factors. Methods and Materials: Patients with SCLC who experienced brain metastases (BM) at presentation (demore » novo) or after WBRT treated at the Saskatoon Cancer Centre between 2005 and 2012 were studied. Relevant neuroimaging was independently reviewed by a neuroradiologist. HM was defined as metastases within 5 mm of the hippocampus. Logistic regression analysis was performed to assess correlation between various clinical variables and HM. Results: Seventy eligible patients were identified. Of 59 patients presenting with de novo BM, 3 patients (5%, 95% confidence interval [CI]: 0%-10.7%) had HM. Collectively there were 359 (range, 1-33) de novo BM with 3 (0.8%, 95% CI: 0%-1.7%) HM deposits. Twenty patients experienced progression of metastatic disease in the brain after WBRT. Of the 20 patients, only 1 patient (5%, 95% CI: 0%-14.5%) experienced HM. On logistic regression, no factors significantly correlated with HM. Conclusion: The overall incidence of HM before or after WBRT in SCLC patients is low, providing preliminary support for the safety of HA during planned clinical trials of HA-WBRT for SCLC.« less
  • Computed cranial tomographic scans were performed as part of the pretreatment evaluation and at six- to nine-month intervals posttreatment in 13 patients with small cell lung carcinoma. All patients received 3000 rad of prophylactic cranial irradiation delivered over two weeks in ten treatment fractions in conjunction with multiagent chemotherapy. Posttreatment scans documented an extraordinarily high frequency of abnormalities including cerebral atrophy (100%), ventricular dilatation (70%), and decreased coefficient of absorption in the white matter (15%). Unexplained neurologic abnormalities developed in four of six patients living at least 15 months after institution of therapy. As the number of long-term survivors ofmore » this type of lung cancer increases, the need for prospective comprehensive neuropsychologic assessment to determine the clinical significance of these changes is needed.« less