Winter Johanna, Galek Marek, Matejcek Christoph, Wilkens Jan J, Aulenbacher Kurt, Combs Stephanie E, Bartzsch Stefan
Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Institute of Radiation Medicine, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany.
Technical University of Munich, School of Medicine and Klinikum rechts der Isar, Department of Radiation Oncology, Munich, Germany.
Phys Imaging Radiat Oncol. 2020 Jun 11;14:74-81. doi: 10.1016/j.phro.2020.05.010. eCollection 2020 Apr.
Microbeam radiotherapy (MRT) is a preclinical concept in radiation oncology with arrays of alternating micrometer-wide high-dose peaks and low-dose valleys. Experiments demonstrated a superior normal tissue sparing at similar tumor control rates with MRT compared to conventional radiotherapy. Possible clinical applications are currently limited to large third-generation synchrotrons. Here, we investigated the line-focus X-ray tube as an alternative microbeam source.
We developed a concept for a high-voltage supply and an electron source. In Monte Carlo simulations, we assessed the influence of X-ray spectrum, focal spot size, electron incidence angle, and photon emission angle on the microbeam dose distribution. We further assessed the dose distribution of microbeam arc therapy and suggested to interpret this complex dose distribution by equivalent uniform dose.
An adapted modular multi-level converter can supply high-voltage powers in the megawatt range for a few seconds. The electron source with a thermionic cathode and a quadrupole can generate an eccentric, high-power electron beam of several 100 keV energy. Highest dose rates and peak-to-valley dose ratios (PVDRs) were achieved for an electron beam impinging perpendicular onto the target surface and a focal spot smaller than the microbeam cross-section. The line-focus X-ray tube simulations demonstrated PVDRs above 20.
The line-focus X-ray tube is a suitable compact source for clinical MRT. We demonstrated its technical feasibility based on state-of-the-art high-voltage and electron-beam technology. Microbeam arc therapy is an effective concept to increase the target-to-entrance dose ratio of orthovoltage microbeams.
微束放射疗法(MRT)是放射肿瘤学中的一种临床前概念,其具有交替排列的微米级宽的高剂量峰和低剂量谷的阵列。实验表明,与传统放射疗法相比,MRT在相似的肿瘤控制率下对正常组织的 sparing 效果更佳。目前,其可能的临床应用仅限于大型第三代同步加速器。在此,我们研究了线聚焦X射线管作为替代微束源的情况。
我们开发了一种高压电源和电子源的概念。在蒙特卡洛模拟中,我们评估了X射线谱、焦点尺寸、电子入射角和光子发射角对微束剂量分布的影响。我们还评估了微束弧形疗法的剂量分布,并建议通过等效均匀剂量来解释这种复杂的剂量分布。
一种适配的模块化多级转换器可在兆瓦范围内提供几秒的高压功率。带有热离子阴极和四极杆的电子源可产生能量为几百keV的偏心、高功率电子束。当电子束垂直撞击靶表面且焦点尺寸小于微束横截面时,可实现最高剂量率和峰谷剂量比(PVDR)。线聚焦X射线管模拟显示PVDR高于20。
线聚焦X射线管是适用于临床MRT的紧凑型源。我们基于先进的高压和电子束技术证明了其技术可行性。微束弧形疗法是提高正交电压微束靶区与入射剂量比的有效概念。