In the morning…
- Room 2 -
In the morning of this last day of conference Michael Baumann and Steve Myers chaired a session dedicated to a very interesting discussion about the OPENMED project, which aims at establishing an open-access facility for biomedical research based on the existing Low Energy Ion Ring (LEIR) at CERN. The first speaker, Ghislain Roy, from CERN, explained the motivations for such a project. There is a strong need for a biomedical facility able to provide particle beams of different types and energies to external users, for radiobiology and detector development. Currently these studies are carried out in nuclear physics laboratories and ion beam therapy centers (out of treatment hours and in some spare lines dedicated to research), but there is a lack of beam-time, in particular for ions with energy of more than 50MeV/n. According to Roy, the characteristics of beam energy, size and availability of LEIR make it an ideal candidate for conversion to such a biomedical test-bed facility.
A wish list for the proposed new facility was presented by Mike Waligórski, from the Polish Academy of Science in Kraków. The basics requirements were about the accelerator (in terms of type of particles, energies, and beam intensity) and detectors for beam profiling. However, ideally, the new structure should also host a well-equipped biological laboratory for cell culture and bio-assays, make experienced technicians available to the external researchers, and have a managing officer, who would follow and supervise all the activities.
The third presentation, given by Philippe Lambin, from Maastricht University (The Netherlands), focused on the radiobiological research motivations for the OPENMED project. The proposed facility would allow researchers to carry out systematic studies with different dose distributions and with new ions (not only protons and carbon ions), in order to assess both the tumor control and the healthy tissue damage.
- Room 3 -
The last morning of the conference featured presentations on the MEDICIS-PROMED programme. MEDICIS-Produced Radioisotope Beams for Medicine, of its full name, is a Marie Sklodowska-Curie Innovative Training Network of the Horizon 2020 EU programme. It officially started in April 2015 and just concluded its kick-off week at CERN. Johanna Pitters, one of the 15 young researchers recruited for the project, and John Prior, from the CHUV Hospital of Lausanne, explained the goals of the programme, which plans to use radioactive ion beams of CERN’s ISOLDE facility to produce specific ions to be used in innovative radiopharmaceuticals or to perform hadron therapy treatments.
The MEDICIS-PROMED presentation gave rise to interesting exchanges within the audience and opened the door to further collaborations. Actually, the Canada's National Laboratory for Particle and Nuclear physics (TRIUMF), represented by Yann Seimbille, will soon be part of a collaboration that also involves the University Hospital of Geneva and the EPFL, in the framework of the MEDICIS-PROMED consortium.
TRIUMF has several facilities where scientists can exploit proton beams with energies ranging from 13 to 500 MeV. Such a variety of beams allows them to produce isotopes with potential applications in molecular imaging or radiotherapy. In particular, Seimbille showed that the laboratory developed a simple method to produce various radiometals (i.e. 44Sc, 68Ga, 86Y and 89Zr) using a modified liquid-target system.
During the second part of the morning, chaired by Esther Troost, we focused on clinics studies. Researchers from Switzerland, the United-States, Italy and The Netherlands shared the results of very recent studies on different topics, ranging from isotopes production, glioblastoma and carcinoma treatments, to big data.
At 11:30 a.m., the attendees joined the young researchers in the main hall of the CICG for another session of poster viewing.
We’ll be back at 12:45 a.m., for the presentation of the 6 winning posters, in Room 4, don’t miss it!
In the afternoon…
- Room 2 -
In the afternoon another panel discussion focused on targeting strategies. Dag Rune Olsen, from the University of Bergen (Norway), highlighted the importance of precise imaging (‘from anatomical to quantitative imaging’) for assessing the functional status of the vascular system within tumors and adjacent tissues. Dynamic contrast-enhanced (CDE) CT and MRI imaging are techniques based on CT and MRI scan with the injection of some contrast agents: although they can be performed with conventional clinical scanners, they require specialist image analysis to extract biomarkers of tumor vascular function.
Dag Rune Olsen talking about 'quantitative imaging'. (Picture: Salvatore Fiore)
Advanced molecular imaging techniques are as well involved in the detection of tumor hypoxia in order to increase hypoxic cell killing efficiency. As explained by Vincent Gregoire, from the St-Luc University Hospital of Brussels, radiation dose escalation allows an higher success rate in destroying hypoxic tumor cells, but its main drawback is the possible increase of negative effect son healthy tissues due to higher dose delivery. If the location in the tumor of the hypoxic tissue is precisely known, it is possible to employ the so-called ‘dose-painting’ technique: the dose is selectively increased on a very limited portion of tissue. Several methods have been developed to detect tumor hypoxia, and among them the use of PET-labeled nitroimidazole compounds is particularly suited for quantitative hypoxia determination in humans.
The last session of the day tackled the critical topic of cancer resistance to radiotherapy, discussing some strategies to overcome this obstacle. In the case of radioresistant prostatic cancer, as described by Mechthild Krause, from the University Hospital and the Technische Universität of Dresden, specific biomarkers can be used in order to identify patients with such types of cancer and in a second phase, to individualize radiation dose as well as a tailored combination od radiation and systemic treatments.
Later, Marc Vooijs, from Maastricht University, reported about studies on new techniques to increase the efficacy of treatments of radioresistant gliobastomas based on the use of inhibitors of some cellular signaling systems.
Mechthild Krause during her talk. (Picture: Salvatore Fiore)
Between questions and discussions, the moment of the final comments arrived. The two co-chairs of ICTR-PHE, Manjit Dosanjh and Jacques Bernier, addressed their greetings and thanks to all the speakers, the chairpersons, the participants, as well as to the organizing team, and invited all to the next edition of the conference, that will be held in 2018. (See the following Anaïs' blog entry for more details on the concluding remarks.)
- Room 4 -
On Monday, more than 80 young researchers arrived at the 2016 ICTR-PHE conference. They carried the posters presenting their last research carefully rolled in their bag. One by one pinned on the main conference hall panels, the posters raised a lot of interest and triggered many discussions during the whole week.
The presentation of the 6 winning posters this afternoon was a true highlight of the whole conference: at the special session, chaired by Manjit Dosanjh and Jacques Bernier, gathered many people willing to listen to the young researchers who’ll probably make the future of the medical imaging field. And it is my pleasure to give you the names of those researchers and a description of the work they presented:
- Emanuele Scifoni and Olga Sokol (GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt) - Helium and Oxygen beam models in TRiP98: implementation, treatment planning tests and experimental verification
Olga Sokol. (Picture: Salvatore Fiore)
Since some of the most modern ion therapy facilities are offering or considering the irradiation with alternative ion beams, beyond proton and carbon, it has raised new attention the need for a proper description of these beams, in order to exploit their use for specific applications.In particular, helium and oxygen beams are presently available in the research cave of the Heidelberg Ion therapy facility (HIT). The work presented by Sokol today developed and integrated in a research treatment planning system (TRiP98), specific beam models for these ions, which have been validated experimentally on different levels.
- Mattia Donzelli (European Synchrotron Radiation Facility of Grenoble) - Brain motion induced artefacts in Microbeam Radiation Therapy: a Monte Carlo study
Mattia Donzelli (right) receiving his award from Manjit Dosanjh. (Picture: Salvatore Fiore)
Organ motion has not been an issue in Microbeam Radiation Therapy (MRT), as long as preclinical research was carried out in small samples, such as cell cultures and rodents.The possible future treatment of human brain tumours using microbeam radiation may however be affected by cardio-synchronous tissue pulsation. The work carried out by Donzelli has demonstrated that the effect of even small organ motions occurring at heart rate frequencies in the brain can only be tolerated at high dose rates of approximately 10 Gy/s.
- Grischa Klimpki (Paul Scherrer Institute) - Fast dose modulation in proton therapy with continuous line scanning
Grischa Klimpki (right) receiving his award from Jacques Bernier. (Picture: Salvatore Fiore)
The accuracy of scanned proton therapy suffer dead times in delivery that accumulate with increasing number of rescans for all discrete scanning techniques, especially for spot scanning.For this purpose, Klimpki pursued the implementation of a novel delivery technique, in which he scans the beam continuously along straight lines while quickly modulating the scan speed and/or beam current to shape the dose profile. This is a fast scanning technique that offers the possibility to deliver arbitrary dose distributions by quickly modulating the scan speed and beam current.
- Karol Brzezinski (Universitat de València - University of Groningen) (absent this afternoon) - Increasing PET scanner resolution using a Silicon detector probe
A high-resolution silicon detector probe, in coincidence with a conventional PET scanner, is expected to provide images of higher spatial resolution than those achievable using the scanner alone, due to the finer pixelisation of the probe detector. A PET-probe prototype is being developed utilizing this principle. The system includes a probe consisting of ten layers of silicon detectors, each a 80×52 array of 1×1×1 mm3 pixels, to be operated in coincidence with a modern clinical PET scanner.
- Pankaj Chaudhary (University of Belfast) - Laser accelerated ultra high dose rate protons induced DNA damage under hypoxic conditions
Significant advances in laser technologies have led to the prospect of using laser- accelerated ions emitted in ultra short bursts, as a future, cost-saving alternative to conventional accelerators. An understanding of the radiobiological effects at the ultrahigh dose rate delivered by these short ions pulses on human cells under hypoxic conditions is important for the development and further advancement of this technology towards clinical applications. Chaudhary presented here measurements of DNA damage with pulsed protons at ultrahigh dose rate (109-1010 Gy/s) under hypoxic conditions.
- Brent Huisman (Université de Lyon) - Accelerated Prompt Gamma estimation for clinical Proton Therapy simulations
As Thomas Bortfeld and Saad Aldawood explained during the week, there is a rising interest in the particle therapy community to use prompt gammas (PG), a natural byproduct of particle treatment, for range verification and eventually dose control. However, PG production is a rare process, which is still hard to estimate during a proton treatment plan executed by a Monte-Carlo simulation. Huisman presented a generic PG yield estimator, drop-in usable with any geometry and beam configuration. He showed a gain of around three orders of magnitude compared to analog Monte-Carlo.
Let’s conclude this session and this very successful edition of the ICTR-PHE conference with a word from the chairs:
“It’s really important that young researchers have access to these sorts of conferences, where they can talk to senior scientists and have their work exposed,” explained Manjit Dosanjh. We’ve seen that everybody now is talking about personalised medicine - even the healthcare companies are looking forward to the development of these precise treatments, because they’re more cost effective. In the next years, funds will go toward this new medicine, and it is now the challenge we have to meet. Let’s see in the next editions of the conference if we’ll come up with solutions!”
“We can say we’ve met the objective of this conference, which is to create interactions between physics, biology and medicine,” added Jacques Bernier. “From the first to the last day, I’ve seen constructive exchanges not only in the conference rooms, but also in the corridors, where discussions are often more open. I’ve been impressed by many wonderful lectures, which promise great progress in the future.”
“Many participants came to us to tell us how much they enjoyed the conference and its atmosphere!” concluded Dosanjh.
Have a nice evening, and see you in 2018!