title: Interleaved carbon minibeams: an experimental radiosurgery method with clinical potential.
abstract: OBJECTIVE
  To evaluate the efficacy of "interleaved carbon minibeams" for ablating a 6.5-mm target in a rabbit brain with little damage to the surrounding brain. The method is based on the well-established tissue-sparing effect of arrays of thin planes of radiation.
  
  
  METHODS
  Broad carbon beams from the National Aeronautics and Space Agency Space Radiation Facility at Brookhaven National Laboratory were segmented into arrays of parallel, horizontal, 0.3-mm-thick planar beams (minibeams). The minibeams' gradual broadening in tissues resulted in 0.525-mm beam thickness at the target's proximal side in the spread-out Bragg peak. Interleaving was therefore implemented by choosing a 1.05 mm beam spacing on-center. The anesthetized rabbit, positioned vertically on a stage capable of rotating about a vertical axis, was exposed to arrays from four 90° angles, with the stage moving up by 0.525 mm in between. This produced a solid radiation field at the target while exposing the nontargeted tissues to single minibeam arrays. The target "physical" absorbed dose was 40.2 Gy.
  
  
  RESULTS
  The rabbit behaved normally during the 6-month observation period. Contrast magnetic resonance imaging and hematoxylin and eosin histology at 6 months showed substantial focal target damage with little damage to the surrounding brain.
  
  
  CONCLUSIONS
  We plan to evaluate the method's therapeutic efficacy by comparing it with broad-beam carbon therapy in animal models. The method's merits would combine those of carbon therapy (i.e., tight target dose because of the carbon's Bragg-peak, sharp dose falloff, and high relative biological effectiveness at the target), together with the method's low impact on the nontargeted tissues. The method's smaller impact on the nontargeted brain might allow carbon therapy at higher target doses and/or lower normal tissue impact, thus leading to a more effective treatment of radioresistant tumors. It should also make the method more amenable to administration in either a single dose fraction or in a small number of fractions.
authors.affiliation: Medical Department, Brookhaven National Laboratory, Upton, NY 11973-5000, USA. dilmanian@bnl.gov
authors.forename: F Avraham
authors.initials: FA
authors.lastname: Dilmanian
authors.forename: Adam
authors.initials: A
authors.lastname: Rusek
authors.forename: Giovanna R
authors.initials: GR
authors.lastname: Fois
authors.forename: John
authors.initials: J
authors.lastname: Olschowka
authors.forename: Nicolle R
authors.initials: NR
authors.lastname: Desnoyers
authors.forename: Jane Y
authors.initials: JY
authors.lastname: Park
authors.forename: Istvan
authors.initials: I
authors.lastname: Dioszegi
authors.forename: Bari
authors.initials: B
authors.lastname: Dane
authors.forename: Ruiliang
authors.initials: R
authors.lastname: Wang
authors.forename: Dardo
authors.initials: D
authors.lastname: Tomasi
authors.forename: Hedok
authors.initials: H
authors.lastname: Lee
authors.forename: Sean D
authors.initials: SD
authors.lastname: Hurley
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Coyle
authors.forename: Allen G
authors.initials: AG
authors.lastname: Meek
authors.forename: M Kerry
authors.initials: MK
authors.lastname: O'Banion
mesh_terms: D000818:Animals; D001522:Behavior, Animal / Q000528:radiation effects; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D002244:Carbon / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D009010:Monte Carlo Method; D058958:Organs at Risk / Q000528:radiation effects*; D056888:Patient Positioning / Q000379:methods; D011817:Rabbits; D011833:Radiation Injuries, Experimental / Q000517:prevention & control; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D012062:Relative Biological Effectiveness
chemical_list: D002244:Carbon