Satterlee Andrew B, Attayek Peter, Midkiff Bentley, Huang Leaf
Division of Molecular Pharmaceutics and Center for Nanotechnology in Drug Delivery, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7571, USA.
UNC and NCSU Joint Department of Biomedical Engineering, Chapel Hill, NC, 27599, USA.
Radiat Oncol. 2017 Mar 17;12(1):54. doi: 10.1186/s13014-017-0794-z.
ᅟ: Accurate and quantitative dosimetry for internal radiation therapy can be especially challenging, given the heterogeneity of patient anatomy, tumor anatomy, and source deposition. Internal radiotherapy sources such as nanoparticles and monoclonal antibodies require high resolution imaging to accurately model the heterogeneous distribution of these sources in the tumor. The resolution of nuclear imaging modalities is not high enough to measure the heterogeneity of intratumoral nanoparticle deposition or intratumoral regions, and mathematical models do not represent the actual heterogeneous dose or dose response. To help answer questions at the interface of tumor dosimetry and tumor biology, we have modeled the actual 3-dimensional dose distribution of heterogeneously delivered radioactive nanoparticles in a tumor after systemic injection.
24 h after systemic injection of dually fluorescent and radioactive nanoparticles into a tumor-bearing mouse, the tumor was cut into 342 adjacent sections and imaged to quantify the source distribution in each section. The images were stacked to generate a 3D model of source distribution, and a novel MATLAB code was employed to calculate the dose to cells on a middle section in the tumor using a low step size dose kernel.
The average dose calculated by this novel 3D model compared closely with standard ways of calculating average dose, and showed a positive correlation with experimentally determined cytotoxicity in vivo. The high resolution images allowed us to determine that the dose required to initiate radiation-induced H2AX phosphorylation was approximately one Gray. The nanoparticle distribution was further used to model the dose distribution of two other radionuclides.
The ability of this model to quantify the absorbed dose and dose response in different intratumoral regions allows one to investigate how source deposition in different tumor areas can affect dose and cytotoxicity, as well as how characteristics of the tumor microenvironment, such as hypoxia or high stromal areas, may affect the potency of a given dose.
鉴于患者解剖结构、肿瘤解剖结构和源沉积的异质性,精确且定量的内照射放射治疗剂量测定可能极具挑战性。诸如纳米颗粒和单克隆抗体等内照射放射治疗源需要高分辨率成像,以准确模拟这些源在肿瘤中的异质分布。核成像模态的分辨率不足以测量瘤内纳米颗粒沉积或瘤内区域的异质性,而数学模型也无法代表实际的异质剂量或剂量反应。为了帮助回答肿瘤剂量测定与肿瘤生物学交叉领域的问题,我们对全身注射后肿瘤中异质递送的放射性纳米颗粒的实际三维剂量分布进行了建模。
将双荧光和放射性纳米颗粒全身注射到荷瘤小鼠体内24小时后,将肿瘤切成342个相邻切片并成像,以量化每个切片中的源分布。将图像叠加以生成源分布的三维模型,并使用一种新颖的MATLAB代码,通过低步长剂量内核计算肿瘤中间切片上细胞的剂量。
通过这种新颖的三维模型计算出的平均剂量与计算平均剂量的标准方法密切相关,并与体内实验确定的细胞毒性呈正相关。高分辨率图像使我们能够确定引发辐射诱导的H2AX磷酸化所需的剂量约为1格雷。纳米颗粒分布进一步用于模拟另外两种放射性核素的剂量分布。
该模型能够量化不同瘤内区域的吸收剂量和剂量反应,这使人们能够研究不同肿瘤区域的源沉积如何影响剂量和细胞毒性,以及肿瘤微环境的特征(如缺氧或高基质区域)如何影响给定剂量的效力。