Gold nanoparticle-enhanced radiotherapy: Dependence of the macroscopic dose enhancement on the microscopic localization of the nanoparticles within the tumor vasculature.

In gold nanoparticle-enhanced radiotherapy, intravenously administered nanoparticles tend to accumulate in the tumor tissue by means of the so-called permeability and retention effect and upon irradiation with x-rays, the nanoparticles release a secondary electron field that increases the absorbed dose that would otherwise be obtained from the interaction of the x-rays with tissue alone. The concentration of the nanoparticles in the tumor, number of nanoparticles per unit of mass, which determines the total absorbed dose imparted, can be measured via magnetic resonance or computed tomography images, usually with a resolution of several millimeters. Using a tumor vasculature model with a resolution of 500 nm, we show that for a given concentration of nanoparticles, the dose enhancement that occurs upon irradiation with x-rays greatly depends on whether the nanoparticles are confined to the tumor vasculature or have already extravasated into the surrounding tumor tissue.

Feasibility of Tc-99 m sestamibi uptake quantification with few-projection emission tomography.

Background: Molecular breast imaging uses Tc-99 m sestamibi to obtain functional images of the breast. Determining the Tc-99 m sestamibi uptake in volumes of interest in the breast may be useful in assessing the response to neoadjuvant chemotherapy or for the purposes of breast cancer risk assessment.

Purpose: To determine, using Monte Carlo simulation, if emission tomography can be used to quantify the uptake of Tc-99 m sestamibi in molecular breast imaging and if so, to determine the accuracy as a function of the number of projections used in the reconstruction process.

Combined Megavoltage and Contrast-Enhanced Radiotherapy as an Intrafraction Motion Management Strategy in Lung SBRT.

Using Monte Carlo simulation and a realistic patient model, it is shown that the volume of healthy tissue irradiated at therapeutic doses can be drastically reduced using a combination of standard megavoltage and kilovoltage X-ray beams with a contrast agent previously loaded into the tumor, without the need to reduce standard treatment margins. Four-dimensional computed tomography images of 2 patients with a centrally located and a peripherally located tumor were obtained from a public database and subsequently used to plan robotic stereotactic body radiotherapy treatments. Two modalities are assumed: conventional high-energy stereotactic body radiotherapy and a treatment with contrast agent loaded in the tumor and a kilovoltage X-ray beam replacing the megavoltage beam (contrast-enhanced radiotherapy).

Ion chamber response to kilovoltage x-rays in the presence of a contrast agent.

Contrast enhanced radiotherapy is a relatively new treatment modality in which a radiological contrast agent is uploaded into a tumor that is subsequently irradiated with kilovoltage x-ray beams thus maximizing absorption of radiation through the photoelectric effect. As with other treatment modalities, experimental verification of absorbed dose distributions is a necessary step as part of the quality assurance process. In this paper, we address the question of how the response to kilovoltage x-rays exhibited by an ion chamber is modified when a radiological contrast agent is incorporated into the irradiated medium.

Directional scatter imaging for the stereoscopic tracking of fiducial markers in a single kV exposure.

Purpose: To demonstrate, via Monte Carlo simulation, that an image obtained from the patient-generated scattered radiation forced to impinge on the detector from a known direction by means of parallel-focused grids, can be used to complement the information conveyed by the primary image, such that accurate stereoscopic three-dimensional localization of fiducial markers can be achieved in a single kV x-ray exposure.

Methods: A voxelized Zubal phantom was used to model the process of fiducial marker localization. The markers were represented as made of gold and cylindrical in shape with dimensions of 5 mm in length and 1 mm in diameter.