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![Page 1: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/1.jpg)
BETA ENHANCERS: TOWARDS A NEW
IMPLEMENTATION FOR BNCT ON SUPERFICIAL TUMORSEsteban Fabián Boggio1
Lucas Provenzano2
Sara Gonzalez2,3
Juan Manuel Longhino1
1Bariloche Atomic Center, Atomic Energy National Commission (CNEA)2Constituyentes Atomic Center, Atomic Energy National Commission
(CNEA)3National Council of Scientific and Technical Research (CONICET)
![Page 2: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/2.jpg)
INTRODUCTION
![Page 3: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/3.jpg)
RA-6 Reactor The RA-6 Reactor is located in
San Carlos de Bariloche, Patagonia, Argentina
It is a MTR, open pool type, with low-enrichment uranium fuels
1MW thermal power Used for Training, Research and
Education, being used on regularly basis within Nuclear Engineering at Balseiro Institute (IB) Operating facilities : neutrography, activation analysis and… BNCT
Facilities under construction: neutrons diffractometry and PGNAA
![Page 4: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/4.jpg)
BNCT neutron beam Hyperthermal beam: developed through epithermal
neutrons spectra moderation, including a partial thermalization stage
Maximum thermal neutron flux at 1cm depth, suitable for treating skin melanoma
0 1 2 3 4 5 6 7 8 9 100.0E+00
2.0E+08
4.0E+08
6.0E+08
8.0E+08
1.0E+09
1.2E+09
Axial thermal flux
Axial epithermal flux
Depth in phantom [cm]
Neutr
on f
lux [
n/c
m2.s
]
![Page 5: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/5.jpg)
Clinical trials As from October 2003 until June 2007: 10 irradiations
in 7 patients (Phase I-II protocol: toxicity and efficacy) Medical prescription: maximum dose on skin (Organ
At Risk, OAR)
9 skin areas 6/9 epithelitis G1 3/9 epithelitis G3
88 tumors (in field) 63% (CR) 72% (OR)
![Page 6: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/6.jpg)
The new BNCT treatment facility
Argentine BNCT Project is at the moment ready to restart the melanoma clinical trials
![Page 7: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/7.jpg)
BETA ENHANCERS
![Page 8: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/8.jpg)
Beta Enhancers Due to beam penetration, total absorbed dose in the
first few millimeters of tissue is lower than in the maximum flux
Introduction of a suitable device over the irradiated volume has been considered in order to allow a local dose increase without substantially perturbing the primary in-depth dose profile
For the proposal, some materials have interesting properties: high neutron capture cross section very short-lived activation products high energy beta particles emission decay
This Beta Enhancers can be used to compensate or increase the absorbed dose in the first millimeters depth of BNCT treatment
![Page 9: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/9.jpg)
MCNP calculations Three Beta
Enhancers foils were modelled on the surface of a polystyrene solid phantom, exposed to the BNCT calculation source: Indium (0,127mm thick) Rhodium (0,025mm thick) Silver (0,127mm thick)
0 2 4 6 8 10 12 140
10
20
30
40
50
60
Indium Rhodium Silver
Depth in phantom [mm]
Dose r
ate
by B
eta
Enhance
r [c
Gy/m
in]
![Page 10: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/10.jpg)
MCNP calculations Thermal neutrons
flux perturbation as a depth function
0 2 4 6 8 10 12 14 160%
20%
40%
60%
80%
100%Indium (electrons + photons)
Rhodium (electrons + pho-tons)
Silver (electrons + photons)
Indium (only photons)
Rhodium (only photons)
Silver (only photons)
Depth in phantom [mm]
Depth [mm] Indium Rhodium Silver0,5 5,4% 1,7% 2,2%1,5 4,1% 1,3% 1,7%2,5 3,4% 1,1% 1,3%3,5 2,9% 0,9% 1,1%4,5 2,4% 0,8% 0,9%7,5 1,7% 0,6% 0,6%15 0,8% 0,3% 0,3%
Relative dose depth distribution by Beta Enhancers
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Experimental validation Thermoluminescence detectors TLD700 (Harshaw) Four TLDs at 1, 2, 3 and 4mm depth at a polystyrene solid
phantom Irradiated at hyperthermal beam with and without Beta
Enhancer on surface in order to measure the enhanced local dose Results are compared with MCNP experiment modelling
0 0.5 1 1.5 2 2.5 3 3.5 40
10
20
30
40
50Indium (experience)
Rhodium (experience)
Indium (MCNP)
Rhodium (MCNP)
Depth [mm]
Dose r
ate
by B
eta
Enhance
r [c
Gy/m
in]
![Page 12: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/12.jpg)
Experimental validation Gafchromic EBT3 films (Ashland) Film stack from 0 to 4.8mm depth at a polystyrene solid phantom Irradiated at hyperthermal beam with and without Beta
Enhancer on surface in order to measure the enhanced local doses
Results are compared with MCNP experiment modelling
-0.5 0.5 1.5 2.5 3.5 4.50
20
40
60
80
100Rhodium (experience)
Rhodium (MCNP)
Silver (experience)
Silver (MCNP)
Depth [mm]
Dose r
ate
by B
eta
Enhance
r [c
Gy/m
in]
![Page 13: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/13.jpg)
TREATMENT PLANNING
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Real case presentation Patient treated on 2005: four nodules in the foot base
Nodule I
Nodule II y III
Nodule IV
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Multicell reconstruction Digital reconstruction of
the target volume geometry is performed by the Multicell software
In contrast to other reconstruction methods, which discretized the volume using cubic units (voxels) of constant size, this software is capable to perform an adaptive variation of these dimensions in order to optimize the geometric accuracy
Indium foils
![Page 16: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/16.jpg)
Irradiation time criterion Conventionally, OAR (skin) is defined as
5mm thick tissue from surface of the treatment volume
BNCT irradiation time is obtained by maximum dose at skin
Therefore, total doses at nodules are assessed
When Beta Enhancers are applied, maximum dose at OAR is reached earlier, which impose a time limitation to the BNCT treatment
One approach is not to consider the nodules from the skin as OAR in order to not perturb the original treatment time
![Page 17: Esteban Fabián Boggio 1 Lucas Provenzano 2 Sara Gonzalez 2,3 Sara Gonzalez 2,3 Juan Manuel Longhino 1 1 Bariloche Atomic Center, Atomic Energy National.](https://reader038.fdocuments.in/reader038/viewer/2022103122/56649c985503460f949547f6/html5/thumbnails/17.jpg)
Results: Nodule IDose rate (MODE NP) [Gyw/min] Dose rate (MODE E) [Gyw/min] Dose rate (MODE NPE)
[Gyw/min]
+27%
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Results: Nodules II and IIIDose rate (MODE NP) [Gyw/min] Dose rate (MODE E) [Gyw/min] Dose rate (MODE NPE)
[Gyw/min]
+14%+12%
Dose rate [Gyw/min]
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Results: Nodule IVDose rate (MODE NP) [Gyw/min] Dose rate (MODE E) [Gyw/min] Dose rate (MODE NPE)
[Gyw/min]
+27%
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Results: Skin (OAR)
This hot area represents less than 0.02% of the
total skin volumen
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CONCLUSIONS
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Three Beta Enhancers alternatives have been studied using adequate materials
MCNP calculations and its experimental correlations demonstrates a good agreement
A considerable improvement in local absorbed dose of cancerous tissue is shown in DVH, specially in the most superficial nodules
The original neutron flux used for the BNCT treatment is not significantly perturbed at depth
Therefore, Beta Enhancers are a useful complementary tool for superficial dose enhancement on very superficial tumors in patients treatment planning
Conclusions
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KIITOS OIKEIN PALJON!THANK YOU VERY MUCH!
¡MUCHAS GRACIAS!