Present research priorities
Ultra-high-dose-rate (UHDR) radiotherapy, or FLASH-RT, is a novel technology involving the use of ultra-fast delivery of radiotherapy treatment at dose-rates that are several orders of magnitude higher than the conventional radiotherapy (CONV) in clinical practice (FLASH>=40Gy/s and CONV~0.1Gy/s). FLASH radiotherapy demonstrates a striking biological sparing effect of normal tissues while keeping similar anti-tumor efficacy, termed the “FLASH effect”. The molecular mechanism behind the FLASH effect is still unknown.
The current research interests of the division are: 1) to investigate the mechanism behind the FLASH effect and SFRT, 2) to investigate the mechanism of radiation triggered DNA damage via reactive oxygen species (ROS), 3) to develop novel imaging technologies to reduce the Bragg peak positioning "uncertainties" for ion-beam radiotherapy, using Helium beam imaging and prompt gamma spectroscopy.
Current developments
Investigating the oxygen depletion hypothesis during FLASH RT delivery.
We demonstrated that oxygen depletion doesn't occur at FLASH does rates (Jansen 2021 [1]), by measuring directly oxygen consumption during radiation delivery. The oxygen consumption was shown to be less at high dose rates, contrary to the oxygen depletion hypothesis.
Evaluating the dose-rate dependency of FLASH Effect
In a follow-up study published in Medical Physics Journal (Zhang 2024 [2]), we demonstrated that the dose rate dependency of the FLASH effect was related to the competition between the solvated electron (eaq) and hydroxyl radical (OH). Current research focuses on understanding the mechanism by which FLASH is protecting healthy cells from radiation effects.
Studying the mechanism by which spatial fractionated radiotherapy (SFRT) achieves high tumor control.
We proposed that hydrogen peroxide (H2O2) could provide an indirect estimate of the efficacy of SFRT (Dal Bello 2020 [3], Zhang 2023 [4]). Future animal studies are being designed to further investigate the role H2O2 in SFRT.
Methods and technologies
BONEOSCOPY Technology for Particle Therapy
A novel technology for in vivo spectroscopic analysis of tissue during particle beam therapy is being developed as part of the European Innovation Council's (EIC) Pathfinder Open funding program. Metastatic bone cancer is an incurable disease and one of the most complex cancers to treat. Due to the high dose, tumor imaging is currently performed at the beginning and end of standard particle radiation therapy (PRT), making personalized treatment difficult. The primary goal of the Pathfinder Open: BoneOscopy project is to develop a radically new technology to enable informed medical decisions by monitoring bone cancer on a daily basis during PRT. (https://accelopment.com/projects/boneoscopy/)
IFIGENIA Technology for Nuclear Medicine and Molecular Imaging
Nuclear medicine and molecular imaging are widely used to diagnose and treat a wide range of diseases, including cancer, cardiovascular disease and brain disorders such as Alzheimer's and Parkinson's disease. However, the number of nuclear medicine procedures in Europe is significantly lower because most European countries lack the specialized equipment needed to produce the radioisotopes. Within the framework of the Horizon European Research Executive Agency (REA), funding has been received to develop a center of excellence (Excellence Hub) in South Eastern Europe (Greece, Slovenia, Bosnia and Herzegovina and Cyprus) to develop a novel accelerator dedicated to securing a production platform for a wide range of radioisotopes, in cooperation with DKFZ (Seco and Benesova Labs), CERN (Papaphilippou Lab) and GSI. A LINear ACcelerator (LINAC) provides a compact, cost-effective and environmentally friendly option that can be located in close proximity to hospitals. The tunability of LINACs allows energy levels, currents and targets to be adjusted, enabling the production of a wide range of radioisotopes. In particular, a similar facility, called NUSANO[5], is being built in West Valley City, Utah, USA, and will be operational in 2025. The novel center of excellence is called "IFIGENIA".
