Speaker
Summary
Introduction: Charged particle therapy with protons and stable carbon ions enables highly precise dose delivery, but it is sensitive to uncertainties in the beam range [1]. In-beam positron emission tomography (IB-PET) allows for a non-invasive in vivo range monitoring during irradiation [2]. However, low count rates, biological washout, and broad activity distributions have limited its clinical use. An alternative is the use of radioactive ion beams (RIBs) for simultaneous treatment and IB-PET imaging. RIBs can provide improved signal quality and a closer match with the dose fall-off, enabling more precise in vivo beam range monitoring. Until recently, clinical use was constrained by the challenges of producing RIBs at sufficient intensity [3].
Description of the Work: With the intensity upgrade of the SIS-18 synchrotron at GSI Darmstadt, RIBs can now be produced at intensities sufficient for preclinical therapeutic applications [3]. Within this framework, the BARB experiment was initiated, aimed at performing the first in vivo tumour treatment with RIBs4. A mouse osteosarcoma was irradiated with 11C-ions, and treatment delivery was monitored online using the SIRMIO in-beam PET scanner [5]. The tumour was implanted in the neck, near the spinal cord, increasing the risk of radiation-induced myelopathy from even slight beam-range variations. Complete tumour control was achieved with a single 20 Gy fraction, with IB-PET imaging allowing precise dose-range localization and sparing of the spinal cord [4].
Conclusions: This study demonstrates, for the first time, the feasibility of using 11C-ion RIBs to achieve tumour control while enabling simultaneous precise in vivo IB-PET monitoring of dose range. RIBs therapy offers a pathway toward safer, margin-reduced, image-guided treatments. These results can represent a significant step toward the future clinical translation of RIB therapy [4].
References: [1] Durante, M., Debus, J. & Loeffler, J. S. (2021) Physics and biomedical challenges of cancer therapy with accelerated heavy ions. Nat. Rev. Phys. 3, 777–790, https://doi.org/10.1038/s42254-021-00368-5
[2] Parodi, K. & Polf, J. C. (2018) In vivo range verification in particle therapy. Med. Phys. 45, e1036–e1050. https://doi.org/10.1002/mp.12960
[3] Durante, M. & Parodi, K. (2020) Radioactive beams in particle therapy: Past, present, and future. Front. Phys. 8, 326, https://doi.org/10.3389/fphy.2020.00326
[4] Boscolo, D., Lovatti, G., Sokol, O. et al. (2025) Image-guided treatment of mouse tumours with radioactive ion beams. Nat. Phys. https://doi.org/10.1038/s41567-025-02993-8
[5] Gerlach, S. et al. (2020) Beam characterization and feasibility study for a small animal irradiation platform at clinical proton therapy facilities. Phys. Med. Biol. 65, 245045, https://doi.org/10.1088/1361-6560/abc832
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