Lai Priscilla, Cai Zhongli, Pignol Jean-Philippe, Lechtman Eli, Mashouf Shahram, Lu Yijie, Winnik Mitchell A, Jaffray David A, Reilly Raymond M
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada. TECHNA Institute/Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Phys Med Biol. 2017 Oct 27;62(22):8581-8599. doi: 10.1088/1361-6560/aa9106.
Permanent seed implantation (PSI) brachytherapy is a highly conformal form of radiation therapy but is challenged with dose inhomogeneity due to its utilization of low energy radiation sources. Gold nanoparticles (AuNP) conjugated with electron emitting radionuclides have recently been developed as a novel form of brachytherapy and can aid in homogenizing dose through physical distribution of radiolabeled AuNP when injected intratumorally (IT) in suspension. However, the distribution is unpredictable and precise placement of many injections would be difficult. Previously, we reported the design of a nanoparticle depot (NPD) that can be implanted using PSI techniques and which facilitates controlled release of AuNP. We report here the 3D dose distribution resulting from a NPD incorporating AuNP labeled with electron emitters (Y, Lu, In) of different energies using Monte Carlo based voxel level dosimetry. The MCNP5 Monte Carlo radiation transport code was used to assess differences in dose distribution from simulated NPD and conventional brachytherapy sources, positioned in breast tissue simulating material. We further compare these dose distributions in mice bearing subcutaneous human breast cancer xenografts implanted with Lu-AuNP NPD, or injected IT with Lu-AuNP in suspension. The radioactivity distributions were derived from registered SPECT/CT images and time-dependent dose was estimated. Results demonstrated that the dose distribution from NPD reduced the maximum dose 3-fold when compared to conventional seeds. For simulated NPD, as well as NPD implanted in vivo, Y delivered the most homogeneous dose distribution. The tumor radioactivity in mice IT injected with Lu-AuNP redistributed while radioactivity in the NPD remained confined to the implant site. The dose distribution from radiolabeled AuNP NPD were predictable and concentric in contrast to IT injected radiolabeled AuNP, which provided irregular and temporally variant dose distributions. The use of NPD may serve as an intermediate between PSI and radiation delivered by radiolabeled AuNP by providing a controlled method to improve delivery of prescribed doses as well as homogenize dose from low penetrating electron sources.
永久性粒子植入(PSI)近距离放射治疗是一种高度适形的放射治疗形式,但由于其使用低能量辐射源,面临着剂量不均匀性的挑战。与发射电子的放射性核素共轭的金纳米颗粒(AuNP)最近已被开发为一种新型的近距离放射治疗形式,当以悬浮液形式瘤内注射(IT)时,可通过放射性标记的AuNP的物理分布帮助使剂量均匀化。然而,其分布是不可预测的,进行多次精确注射也很困难。此前,我们报道了一种纳米颗粒储存库(NPD)的设计,该储存库可使用PSI技术植入,并有助于AuNP的控释。我们在此报告使用基于蒙特卡洛的体素级剂量测定法,由包含用不同能量的发射电子体(钇、镥、铟)标记的AuNP组成的NPD所产生的三维剂量分布。使用MCNP5蒙特卡洛辐射传输代码来评估模拟的NPD与置于乳腺组织模拟材料中的传统近距离放射治疗源在剂量分布上的差异。我们进一步比较了在植入了镥-金纳米颗粒NPD的皮下人乳腺癌异种移植小鼠中,或在瘤内注射悬浮液形式的镥-金纳米颗粒的小鼠中的这些剂量分布。放射性分布来自配准的SPECT/CT图像,并估计了随时间变化的剂量。结果表明,与传统种子相比,NPD的剂量分布使最大剂量降低了3倍。对于模拟的NPD以及体内植入的NPD,钇提供了最均匀的剂量分布。瘤内注射镥-金纳米颗粒的小鼠体内的肿瘤放射性发生了重新分布,而NPD中的放射性仍局限于植入部位。与瘤内注射放射性标记的AuNP相比(后者提供不规则且随时间变化的剂量分布),放射性标记的AuNP NPD的剂量分布是可预测的且呈同心状。通过提供一种可控方法来改善规定剂量的递送以及使来自低穿透性电子源的剂量均匀化,NPD的使用可作为PSI与放射性标记的AuNP递送的辐射之间的一种中间方式。