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Internal and/or External Radiotherapy and Dosimetric Evaluation: From Cellular Level to the Patient

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (20 July 2024) | Viewed by 7196

Special Issue Editors


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Guest Editor
MedicalPhysics Unit, IRCCS IstitutoRomagnolo per lo Studio deiTumori (IRST) “Dino Amadori”, 47014 Meldola, Italy
Interests: medical physics; dosimetry; radiation therapy; radiobiology; radiotherapy; cytotoxicity; raman spectroscopy; radioactivity

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Guest Editor
Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
Interests: radiotherapy; nuclear medicine; dosimetry and radiobiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are inviting submissions to the Special Issue on "Internal and/or External Radiotherapy and Dosimetric Evaluation: From Cellular Level to the Patient", which aims to cover the recent outstanding developments of radiotherapy and nuclear medicine treatments.  

Radiotherapy and nuclear medicine have a central role in the multidisciplinary field of oncology, either considered individually as possible way to irradiate tumors in combination with other modalities of treatment or in a combination of internal and external radiotherapy.

In recent years, both have experienced great improvements and developments, such as the increased number of particle therapy facilities worldwide; the concept of "theranostic"; a deeper understanding of tumor biology; improvements in imaging (together with radiomics and deep learning methods) from diagnosis and staging passing through treatment and finally to follow-up.

Although these are some of the goals achieved, the answers to questions ranging from the cellular level down to the patient remain opened. Some examples are: the possibility of using spectroscopy investigations to study cancer cell radioresistance; the basis to trigger a certain type of cell death after ionizing radiation treatment; the precise dosimetry evaluation of the treatment performed; dosimetric and radiobiological impact related to the treatment schedule with the possibility of a less toxic effect to normal tissues or improved tumor control/survival.

In this Special Issue, we invite you to contribute with original research articles exploring application of radiotherapy and/or nuclear medicine therapy on cell cultures and/or patients. Theoretical and experimental studies are welcome for submission, as well as are comprehensive reviews and editorials.

Potential topics include, but are not limited to:

  • Basic research on cell cultures exposed to ionizing radiation;
  • Spectroscopic investigation on cell cultures exposed to ionizing radiation;
  • Dosimetry and radiobiological study at the cellular and/or animal level;
  • Radiobiology analysis of in vitro assays with tumor cell lines and in animal models of cancer;
  • Diagnostic nuclear medicine (PET, SPECT, and hybrid imaging);
  • Quantitative imaging;
  • Advances in nuclear medicine dosimetry;
  • Therapeutic nuclear medicine;
  • Advances in radiotherapy planning and delivery;
  • Basic research in radiotherapy;
  • Pre-treatment and/or in vivo dosimetric evaluation of ionizing radiation treatments or online dosimetry;
  • Software and instruments for dose assessment;
  • Radiomics;
  • Predictive models.

Dr. Emilio Mezzenga
Dr. Lidia Strigari
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cell research
  • animal research
  • cancer cells
  • spectroscopy
  • Raman spectroscopy
  • FT-IR spectroscopy
  • radiotherapy
  • particle therapy
  • molecular radiotherapy
  • radiobiology
  • dosimetry
  • radiomics

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Published Papers (5 papers)

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Research

18 pages, 5599 KiB  
Article
The Essential Role of Monte Carlo Simulations for Lung Dosimetry in Liver Radioembolization—Part B: 166Ho Microspheres
by Edoardo d’Andrea, Andrea Politano, Bartolomeo Cassano, Nico Lanconelli, Marta Cremonesi, Vincenzo Patera and Massimiliano Pacilio
Appl. Sci. 2025, 15(2), 958; https://doi.org/10.3390/app15020958 - 19 Jan 2025
Viewed by 540
Abstract
This study compares dosimetric approaches for lung dosimetry in 166 radioembolization (Ho-TARE) with direct Monte Carlo (MC) simulations on a voxelized anthropomorphic phantom derived from a real patient’s CT scan, preserving the patient’s lung density distribution. Lung dosimetry was assessed for five lung [...] Read more.
This study compares dosimetric approaches for lung dosimetry in 166 radioembolization (Ho-TARE) with direct Monte Carlo (MC) simulations on a voxelized anthropomorphic phantom derived from a real patient’s CT scan, preserving the patient’s lung density distribution. Lung dosimetry was assessed for five lung shunt (LS) scenarios with conventional methods: the mono-compartmental organ-level approach (MIRD), voxel S-value convolution for soft tissue (kST, ICRU soft tissue with 1.04 g/cm3) and lung tissue (kLT, ICRU lung tissue with 0.296 g/cm3), local density rescaling (kSTL and kLTL, respectively, for soft tissue and lung tissue), or global rescaling for a lung mean density of 0.221 g/cm3 (kLT221). Significant underestimations in the mean absorbed dose (AD) were observed, with relative differences with respect to the reference (MC) of −64% for MIRD, −93% for kST, −56% for kSTL, −76% for kLT, −68% for kLT221, and −60% for kLTL. Given the high heterogeneity of lung tissue, standard dosimetric approaches cannot accurately estimate the AD. Additionally, MC results for 166Ho showed notable spatial absorbed dose inhomogeneity, highlighting the need for tailored lung dosimetry in Ho-TARE accounting for the patient-specific lung density distribution. MC-based dosimetry thus proves to be essential for safe and effective radioembolization treatment planning in the presence of LS. Full article
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16 pages, 3120 KiB  
Article
Bone Scintigraphy in Cardiac Transthyretin-Related Amyloidosis: A Novel Time-Saving Tool for Semiquantitative Analysis, with Good Potential for Predicting Different Etiologies
by Susanna Mattoni, Maria Francesca Morrone, Giuseppe Della Gala, Sonia Elisa Prisco, Maurizio Sguazzotti, Giulia Saturi, Simone Longhi, Stefano Fanti, Rachele Bonfiglioli and Lidia Strigari
Appl. Sci. 2024, 14(21), 9982; https://doi.org/10.3390/app14219982 - 31 Oct 2024
Viewed by 807
Abstract
(1) Background: The visual and semiquantitative analysis of Technetium-99metastable-3,3-diphospono-1,2-propanodicarboxylic acid (99mTc-DPD) bone scintigraphy is promising for diagnosing cardiac amyloidosis but time-consuming. We validated a faster method, the geometric mean (GM) method with a semi-automated workflow, for heart–whole body (WB) ratio (H/WBr), [...] Read more.
(1) Background: The visual and semiquantitative analysis of Technetium-99metastable-3,3-diphospono-1,2-propanodicarboxylic acid (99mTc-DPD) bone scintigraphy is promising for diagnosing cardiac amyloidosis but time-consuming. We validated a faster method, the geometric mean (GM) method with a semi-automated workflow, for heart–whole body (WB) ratio (H/WBr), heart retention (Hr), and WB retention (WBr) calculations compared to the classic method (CM) established in the literature. The capability of semiquantitative scintigraphy indexes to differentiate the etiology in transthyretin-related cardiac amyloidosis (cATTR) patients was investigated. (2) Methods: H/WBr, Hr, and WBr were calculated by extracting counts for WB, kidneys, bladder, and heart on early and late planar image scans and applying background, scan-time, and decay corrections, using CM and GM both on a referring workstation and on a semi-automated workflow in external software. The comparison between CM and GM was assessed with Pearson’s correlation, Lin’s Concordance Correlation Coefficient (CCC), and Bland–Altman analysis. H/WBr, Hr, and WBr and several clinical variables were used to implement LASSO, Random Forest (RF), and Neural Network (NN) models to predict mutated and wild-type ATTR etiologies. ROC curves and AUC were calculated. (3) Results: Hr, WBr, and H/WBr using CM and GM were highly correlated. Bland–Altman analysis between CM and GM showed biases of 0.12% [CI:0.04%;0.19%] for H/WBr, 0.07% [CI: 0.01%; 0.13%] for Hr, and -0.50% [CI: −1.22%; 0.22%] for WBr. LASSO and NN models had good performance in predicting etiologies with AUC values of 87.3% and 73.6%, respectively. The RF model showed a poorer AUC of 55.8%. (4) Conclusions: The GM in the assisted workflow was validated against the CM. LASSO and NN approaches allowed a good prediction performance to be obtained for patient etiology. Full article
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17 pages, 2647 KiB  
Article
The Essential Role of Monte Carlo Simulations for Lung Dosimetry in Liver Radioembolization with 90Y Microspheres
by Edoardo d’Andrea, Nico Lanconelli, Marta Cremonesi, Vincenzo Patera and Massimiliano Pacilio
Appl. Sci. 2024, 14(17), 7684; https://doi.org/10.3390/app14177684 - 30 Aug 2024
Cited by 1 | Viewed by 1683
Abstract
This study compares various methodologies for lung dosimetry in radioembolization using Monte Carlo (MC) simulations. A voxelized anthropomorphic phantom, created from a real patient’s CT scan, preserved the actual density distribution of the lungs. Lung dosimetry was evaluated for five lung-shunt (LS) cases [...] Read more.
This study compares various methodologies for lung dosimetry in radioembolization using Monte Carlo (MC) simulations. A voxelized anthropomorphic phantom, created from a real patient’s CT scan, preserved the actual density distribution of the lungs. Lung dosimetry was evaluated for five lung-shunt (LS) cases using traditional methods: the mono-compartmental organ-level approach (MIRD), local energy deposition (LED), and convolution with voxel S-values, either with local density corrections (SVOX_L) or without (SVOX_ST). Additionally, a novel voxel S-value (VSV) kernel for lung tissue with an ICRU density of 0.296 g/cm3 was developed. Calculations were performed using either the ICRU lung density (Lung_296), the average lung density of the phantom (Lung_221), or the local density (Lung_L). The comparison revealed significant underestimations in the mean absorbed dose (AD) for the classical approaches: approximately −40% for MIRD, −27% for LED, −28% for SVOX_L, and −88% for SVOX_ST. Similarly, calculations with the lung VSV kernel showed underestimations of about −62% for Lung_296, −50% for Lung_221, and −35% for Lung_L. Given the high heterogeneity of lung tissue, traditional dosimetric methods fail to provide accurate estimates of the mean AD for the lungs. Therefore, MC dosimetry based on patient images is recommended as the preferred method for precise assessment of lung AD during radioembolization. Full article
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13 pages, 4442 KiB  
Article
Patient-Specific Dosimetry Evaluations in Theranostics Software for Internal Radiotherapy
by Elisa Grassi, Domenico Finocchiaro, Federica Fioroni, George Andl, Angelina Filice, Annibale Versari, Ayman El Ouati, Emiliano Spezi and Mauro Iori
Appl. Sci. 2024, 14(16), 7345; https://doi.org/10.3390/app14167345 - 20 Aug 2024
Viewed by 1068
Abstract
In Internal Radiotherapy, radiopharmaceutical dosimetry provides an accurate estimation of absorbed radiation doses to organs at risk and tumours. In this paper Velocity Theranostics (Varian Medical Systems), is investigated. Its performances are compared to OLINDA 2.0 in both an anthropomorphic phantom and a [...] Read more.
In Internal Radiotherapy, radiopharmaceutical dosimetry provides an accurate estimation of absorbed radiation doses to organs at risk and tumours. In this paper Velocity Theranostics (Varian Medical Systems), is investigated. Its performances are compared to OLINDA 2.0 in both an anthropomorphic phantom and a group of patients. Velocity Theranostics was evaluated with a cohort of patients (15) treated with 177Lu radiolabelled peptides. The absorbed doses were calculated for the liver, spleen and kidneys, separately with OLINDA 2.0 and Velocity Theranostics using the same set of images. To reduce the contribution of Time-integrated activities (TIAs) on the results and to merely compare the dose calculation algorithms, the OLINDA 2.0 absorbed doses were calculated using the TIA values calculated in Velocity Theranostics. The absorbed doses from Velocity Theranostics were found to be correlated with the doses from OLINDA 2.0 with the TIAs from Theranostics (Lin’s coefficient = 0.894 and R2 = 0.9531). Absorbed doses from Velocity Theranostics are reliable at least as reliable as those for OLINDA 2.0, with many advantages regarding accuracy of calculations and robustness. In conclusion, the personalisation of dosimetry may be totally fulfilled by computational systems for absorbed dose in internal radiotherapy, equipped with a complete workflow and borrowed from external radiotherapy. Full article
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12 pages, 2313 KiB  
Article
The Role of Lung Density in the Voxel-Based Dosimetry of 90Y-TARE Evaluated with the Voxel S-Value (VSV) Method and Fast Monte Carlo Simulation
by Amedeo Capotosti, Roberto Moretti, Maria Vaccaro, Cintia De Almeida Ribeiro, Lorenzo Placidi, Matteo Nardini, Guenda Meffe, Davide Cusumano, Luca Zagaria, Marina De Risi, Germano Perotti, Lucia Leccisotti, Marco De Spirito, Roberto Iezzi and Luca Indovina
Appl. Sci. 2024, 14(3), 1019; https://doi.org/10.3390/app14031019 - 25 Jan 2024
Cited by 2 | Viewed by 1708
Abstract
(1) Background: In 90Y-TARE treatments, lung-absorbed doses should be calculated according to the manufacturer’s instructions, using the MIRD-scheme. This scheme is derived from the assumption that 90Y-microspheres deliver the dose in a water-equivalent medium. Since the density of the lungs is [...] Read more.
(1) Background: In 90Y-TARE treatments, lung-absorbed doses should be calculated according to the manufacturer’s instructions, using the MIRD-scheme. This scheme is derived from the assumption that 90Y-microspheres deliver the dose in a water-equivalent medium. Since the density of the lungs is quite different from that of the liver, the absorbed dose to the lungs could vary considerably, especially at the liver/lungs interface. The aim of this work is to compare the dosimetric results obtained by two dedicated software packages implementing a water-equivalent dose calculation and a Monte Carlo (MC) simulation, respectively. (2) Methods: An anthropomorphic IEC phantom and a retrospective selection of 24 patients with a diagnosis of HCC were taken into account. In the phantom study, starting from a 90Y-PET/CT acquisition, the liver cavity was manually fixed with a uniform activity concentration on PET series, while the lung compartment was manually expanded on a CT series to simulate a realistic situation in which the liver and lungs are adjacent. These steps were performed by using MIM 90Y SurePlan. Then, a first simulation was carried out with only the liver cavity filled, while a second one was carried out, in which the lung compartment was also manually fixed with a uniform activity concentration corresponding to 10% lung shunt fraction. MIM 90Y SurePlan was used to obtain Voxel S-Value (VSV) approach dose values; instead, Torch was used to obtain MC approach dose values for both the phantom and the patients. (3) Results: In the phantom study, the percentage mean dose differences (∆D%) between VSV and MC in the first and second simulation, respectively were found to be 1.2 and 0.5% (absolute dose variation, ∆D, of 0.7 and 0.3 Gy) for the liver, −56 and 70% (∆D of −0.3 and −16.2 Gy) for the lungs, and −48 and −60% (∆D of −4.3 and −16.5 Gy) for the Liver/Lungs Edge region. The patient study reports similar results with ∆D% between VSV and MC of 7.0%, 4.1% and 6.7% for the whole liver, healthy liver, and tumor, respectively, while the result was −61.2% for the left lung and −61.1% for both the right lung and lungs. (4) Conclusion: Both VSV and MC allowed accurate radiation dose estimation with small differences (<7%) in regions of uniform water-equivalent density (i.e., within the liver). Larger differences between the two methods (>50%) were observed for air-equivalent regions in the phantom simulation and the patient study. Full article
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