Real-time follow-up radiation therapy can guarantee safer and more effective cancer treatment

For the first time, ANN ARBOR-Radiation, which is used to treat half of cancer patients, can be measured
during treatment with precise 3D imaging developed at the University of Michigan.

By capturing and amplifying the tiny sound waves produced when X-rays heat human tissue, medical professionals can map the radiation dose in the body, providing them with new data
to guide treatment in real time.
This is the first perspective
of interactions that doctors couldn't "see" before.

Jonathan Rubin Professor of Biomedical Engineering, Professor of Radiology, and corresponding author of Nature Biotechnology, said: "Once you start transmitting radiation, the body is almost a black box
.
" He also leads the Optical Imaging Laboratory
at the University of Michigan.

"We don't know exactly where the X-rays hit the inside of the human body, or how much radiation
we're delivering to the target.
And every body is different, so predicting these two aspects is tricky
.
”

Radiation therapy is used to treat thousands of cancer patients each year, bombarding an area
of the body with high-energy waves and particles, usually X-rays.
Radiation can directly kill cancer cells or destroy them, making them impossible to spread
.

These benefits are undermined by a lack of accuracy, as radiation therapy often kills and destroys healthy cells
in the area around the tumor.
It also increases the risk of
new cancers.

With real-time 3D imaging, doctors can more accurately direct radiation at cancer cells and limit exposure to neighboring
tissues.
To do this, they just need to "listen"
.

When X-rays are absorbed by human tissue, they are converted into heat energy
.
This heating causes the tissue to expand rapidly, and this expansion creates sound waves
.

Sound waves are so weak that they are usually not detectable
by typical ultrasound techniques.
U-M's novel ionizing radiation acoustic wave imaging system detects sound waves
through an array of ultrasonic transducers placed on the patient's side.
The signal is amplified and then transferred to an ultrasonic device for image reconstruction
.

With these images in hand, oncology clinics can alter radiation levels or trajectories during treatment to ensure safer and more effective treatment
.

Wei Zhang, a biomedical engineering researcher and first author of the study, said: "In the future, we can use imaging information to compensate for uncertainties
during radiotherapy due to localization, organ movement and anatomical changes.
" "This will allow us to deliver doses precisely to cancer tumors
.
"

Another benefit of the University of Michigan technology is that it can be easily added to current radiation therapy equipment without drastically altering the process
clinicians are already accustomed to.

Kyle Cuneo, associate professor of radiation oncology at Michigan Medical School, said: "In future applications, this technology could be used to personalize and adjust each radiation treatment to ensure that normal tissue remains at a safe dose and tumors receive the expected dose
.
" "This technique is particularly beneficial
when the target is close to radiation-sensitive organs, such as the small intestine or stomach.
"

The research team, led by the University of Michigan, included Wang, Cuneo and Issam El Naqa
, adjunct professor of radiation oncology at the University of Michigan School of Medicine.
The team works with
partners at Moffitt Cancer Center.

The University of Michigan has filed for patent protection and is looking for partners to help bring the technology to market
.
The research was supported
by the National Cancer Institute and the Michigan Clinical and Health Institute.