The biological effectiveness of low-energy photons

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Onkologisches Zentrum Klinik für Strahlentherapie und Radioonkologie Medizinische Strahlenphysik The biological effectiveness of low-energy photons Elisabetta Gargioni University Medical Center Hamburg-Eppendorf Department for Radiotherapy and Radio-Oncology Martinistr. 52 20246 Hamburg

Methods for assessing biological effectiveness of ionizing radiation Linear-Quadratic (LQ) model for cell survival Microdosimetric quantities in combination with biological data Particle-track simulations of DNA damage

LQ model for cell survival S(D) = S linear F quadratic = e -αd e -βd2 = e -(α D+βD2 )

Estimate of biological effectiveness Linear or α-component: One-particle events (DSB) non-repairable damage: αd Quadratic or β-component: Two-particle events (DSB) repairable damage: βd 2

Biological effectiveness from α-values Group Cell type Photon energy Lehnert et al. (2008) Human epith. cells 10 kv 25 kvp RBE 200kV 1.39 1.46 RBE 0.1, 200kV 1.21 ± 0.03 1.13 ± 0.03 Panteleeva et al. Keratinocytes 25 kvp 1.33 ± 0.27 (2003) Panteleeva et al. (2003) Frankerberg et al. (2002) Frankenberg- Schwager et al. (2002) Mouse fibroblasts Human hybrid cell lines CGL1 Exponentially growing cells 25 kvp 1.25 ± 0.07 29 kv 29 kvp 30 kvp 29 kvp 3.6 4.38±1.8 7 1.3 1.0 1.2 Source: Nikjoo & Lindborg, Phys. Med. Biol. (2010), R65 and references therein

Microdosimetry concepts Microscopic volume δ y ε = Lineal Energy δ δ l δ y F = 0 yf (y)dy

Microdosimetric spectra for different photon energies (D = 1 µm) d(y) = y y F f (y)

Microdosimetry and RBE Ionizing radiation energy deposition in the cell, typical for a given radiation quality but independent of end point d(y) Cells react with a biological response function, typical for a given end point ε, but independent of radiation quality q ε (y) ~RBE for low dose: α ε = N i=1 q εi (y)d i (y)

Example of a biological response function Dicentric chromosome aberration in human lymphocytes Source: Zaider & Brenner, Radiat. Res. (1985), 302

Example: RBE of IORT spectrum Spectra in air and solid water 5 mm 20 mm Source: Herskind et al., Int. J. Radiat. Onc. Biol. Phys. (2008), 1575

RBE of IORT spectrum Endpoint: dicentrics for human lymphocites Source: Brenner et al., Phys. Med. Biol. (1999), 323

Example: microdosimetric spectra for mammography x rays Average quality factor according to ICRU 40: Q = 1 D D(y)Q(y)dy Source: Verhaegen & Reniers, Radiat. Res. (2004), 592

Average quality factor for mammography x rays Depth (cm) 0.1 1.5 2.5 3.5 5.0 TABLE 2 Average Quality Factors, Q, as a Function of Depth in 50/50 Breast Tissue for the Seven Radiation Qualities Molybdenum/ molybdenum, 28 kvp 1.41 1.38 1.36 1.35 1.33 Depth (cm) 0.1 1.5 2.5 3.5 5.0 Rhodium/ rhodium, 28 kvp Average Quality 1.37 1.34 1.33 1.31 1.29 Molybdenum/ molybdenum, 28 kvp 1.41 1.38 1.36 1.35 1.33 Rhodium/ aluminum, 28 kvp 1.33 1.31 1.29 1.28 1.27 Average quality factor, Q Gaseous water/ rhodium, 28 kvp 1.34 1.33 1.31 1.30 1.28 Molybdenum/ rhodium, 28 kvp 1.38 1.36 1.34 1.33 1.31 Molybdenum/ molybdenum, 25 kvp 1.42 1.39 1.38 1.37 1.36 Molybdenum/ rhodium, 32 kvp 1.37 1.35 1.33 1.32 1.30 Source: Verhaegen & Reniers, Radiat. Res. (2004), 592

Other photon energies Endpoint: chromosome aberration Cell type Endpoint Energy RBE as α- ratio Lymphocytes Dicentrics 60 Co 1.0 250 kvp 1.6 30 kvp 3.0 Peripheral blood Dicentrics 60 Co 30 kv Mammary gland epithelial cells MCF-12A Human peripheral lymphocytes Dicentrics & centric rings Dicentrics 200 kvp 25 kvp 10 kvp 60 Co 10 kvp 29 kvp 220 kvp 1.0 1.79 ± 0.56 1.0 1.08 ± 0.08 1.43 ± 0.12 1.0 7.20 ± 2.98 6.12 ± 2.51 3.74 ± 1.46 Source: Nikjoo & Lindborg, Phys. Med. Biol. (2010), R65 and references therein

Particle-track simulation for modelling DNA damage: from simple... DNA segment simulated as a water cylinder, 2 cm in diameter, 2 cm in height Nucleosome simulated as a water cylinder, 10 cm in diameter, 5 nm in height

... to very complex geometries Example: PARTRAC Source: Friedland et al., Radiat. Environ. Biophys. (1999) 39-47)

Information from particle track-structure simulation Frequency distribution of energy deposition in a volume of interest microdosimetric quantities relative quality factors (with respect to a reference radiation) Ionization cluster-size distributions + chemical pathways severity of initial damage to DNA

Example: RBE from DNA damage Group Photon energy RBE (DSB) Friedland et al (1999), calc Hsiao &Stewart (2008), calc 60 Co 220 kvp Al K C K 60 Co 220 kvp (unf.) 29 kvp (Mo) 1.0 1.1 1.6 1.4 1.0 1.1 1.17 Nikjoo et al. (1997,1999,2002), calc (monoen. e-) Kuhne et al. (2005), meas. Frankenberg et al. (1981,1986), meas. Al K 2.6 C K 3.7 C K 2.0 Al K C K 2.8 3.2

Example: RBE for IORT spectra Group Spectrum Cell type Endpoint RBE low dose Brenner et al (1999), computational microdosimetry Renier et al. (2008), Monte Carlo damage simulation Marthinsen et al. (2010), measured 60 Co 40 kvp 60 Co 40-50 kvp 6 MV 50 kvp Lymphocytes Breast tissue Breast cancer cells: MCF-7 T47-D Dicentrics 1.0 3.05 RBE high dose 1.0 1.53 DSB in DNA 1.0 1.49 Cell survival 1.0 1.9 3.1 1.0 1.4 1.4

Discussion - I Computational micro- and nanodosimetry is a useful tool to assess biological effectiveness of low-energy photons, comparing satisfactorily with experimental data Physical particle-track quantities can be directly measured (with micro- or nanodosimeters) they can be used to assess the average quality of ionizing radiation

Discussion - II However, they need to be combined with biological parameters (chemical pathways, free radical reaction probabilities, ) in order to compare results from calculations and radiobiological experiments

Discussion - III DNA initial damage is the underlying quantity, however.. It is necessary to specify the biological system (cell lines) and biological endpoint (cell survival, chromosome aberration, neoplastic tranformation). Also: are we interested in radiation protection or in radiotherapy? Repair kinetics plays a role!

Thank you! FINAL MESSAGE: please be sure that you know how to use your calculated data!