title: Approaching Oxygen-Guided Intensity-Modulated Radiation Therapy.
abstract: The outcome of cancer radiation treatment is strongly correlated with tumor oxygenation. The aim of this study is to use oxygen tension distributions in tumors obtained using Electron Paramagnetic Resonance (EPR) imaging to devise better tumor radiation treatment. The proposed radiation plan is delivered in two steps. In the first step, a uniform 50% tumor control dose (TCD50) is delivered to the whole tumor. For the second step an additional dose boost is delivered to radioresistant, hypoxic tumor regions. FSa fibrosarcomas grown in the gastrocnemius of the legs of C3H mice were used. Oxygen tension images were obtained using a 250 MHz pulse imager and injectable partially deuterated trityl OX63 (OX71) spin probe. Radiation was delivered with a novel animal intensity modulated radiation therapy (IMRT) XRAD225Cx microCT/radiation therapy delivery system. In a simplified scheme for boost dose delivery, the boost area is approximated by a sphere, whose radius and position are determined using an EPR O2 image. The sphere that irradiates the largest fraction of hypoxic voxels in the tumor was chosen using an algorithm based on Receiver Operator Characteristic (ROC) analysis. We used the fraction of irradiated hypoxic volume as the true positive determinant and the fraction of irradiated normoxic volume as the false positive determinant in the terms of that analysis. The most efficient treatment is the one that demonstrates the shortest distance from the ROC curve to the upper left corner of the ROC plot. The boost dose corresponds to the difference between TCD90 and TCD50 values. For the control experiment an identical radiation dose to the normoxic tumor area is delivered.
authors.affiliation: Center for EPR Imaging In Vivo Physiology, University of Chicago, Chicago, IL, USA.|Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA.
authors.forename: Boris
authors.initials: B
authors.lastname: Epel
authors.affiliation: Center for EPR Imaging In Vivo Physiology, University of Chicago, Chicago, IL, USA.|Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA.
authors.forename: Gage
authors.initials: G
authors.lastname: Redler
authors.affiliation: Center for EPR Imaging In Vivo Physiology, University of Chicago, Chicago, IL, USA.|Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Pelizzari
authors.affiliation: Center for EPR Imaging In Vivo Physiology, University of Chicago, Chicago, IL, USA.|Novosibirsk Institute of Organic Chemistry, Novosibirsk, Russia.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Tormyshev
authors.affiliation: Center for EPR Imaging In Vivo Physiology, University of Chicago, Chicago, IL, USA. h-halpern@uchicago.edu.|Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA. h-halpern@uchicago.edu.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Halpern
mesh_terms: D000818:Animals; D054893:Cone-Beam Computed Tomography; D004578:Electron Spin Resonance Spectroscopy; D051379:Mice; D008809:Mice, Inbred C3H; D009374:Neoplasms, Experimental / Q000000981:diagnostic imaging / Q000378:metabolism / Q000532:radiotherapy*; D010100:Oxygen / Q000378:metabolism*; D012372:ROC Curve; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*
chemical_list: D010100:Oxygen
keywords: EPR imaging; Oxygen guided therapy; Oxygen imaging; Radiation therapy