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Sparing healthy brain tissue while delivering higher radiation dose to tumors

Lankenau Medical Center April 15, 2022 Research News

Article among most cited in 2021 in peer-reviewed Journal of Applied Clinical Medical Physics

Since Albert DeNittis, MD, joined Lankenau Medical Center, part of Main Line Health, as chief of radiation oncology in 2000, the oncology community's techniques of determining the optimal radiation dose to treat brain tumors have barely changed.

"Then my colleague, senior medical physicist David Wang [PhD], came to me and said he had ideas for a better way," DeNittis said. "The potential is enormous."

The response to an article authored by Wang, DeNittis, and Yibing Hu reflects the interest in the radiation oncology communities. "Strategies to optimize stereotactic radiosurgery plans for brain tumors with volumetric-modulated arc therapy" was among the top-cited articles in 2021 in The Journal of Applied Clinical Medical Physics.

The research focuses on stereotactic radiosurgery (SRS), a technique to deliver precisely focused radiation beams to treat tumors in the brain. It is not surgery in the traditional sense because there is no incision, instead using 3D imaging to minimize impact to surrounding healthy tissue. Wang used data from 50 SRS procedures conducted at Main Line Health from 2014-2017 where volumetric modulated arc therapy (VMAT) was used.

VMAT delivers photons generated by a linear accelerator to conform to a tumor's shape. Tiny beams as small as the size of a pencil tip, with varying intensities, are aimed at the tumor and rotated 360 degrees around the patient. The treatment typically requires only a single two-minute dose.

"I had thought about how to deliver radiation more effectively for more than 10 years," Wang said. "But I had not done the research. There are so many factors in the process. But now, I believe I have found a more optimal technique."

Based on Wang's analysis, the new radiation-dosing technique spares 35% more tissue than standard methods of radiation.

"He devised this method purely through theoretical physics rather than in the clinic," said DeNittis, a professor with the Lankenau Institute for Medical Research, part of Main Line Health. "I think that's why it has drawn so much interest. It's more reliable, it's definitely safer due to the reduced radiation dose, and it's potentially more effective since more dose can be delivered to tumors."

The technique would be applicable to treatment planning for multiple types of brain tumors where sparing the tissue peripheral to the target is critical. A human clinical trial is the next step.

About Lankenau Institute for Medical Research

Lankenau Institute for Medical Research (LIMR) is a nonprofit biomedical research institute located on the campus of Lankenau Medical Center and is part of Main Line Health. Founded in 1927, LIMR's mission is to improve human health and well-being. Using its ACAPRENEURIALTM model that integrates academic and entrepreneurial approaches, faculty and staff are devoted to advancing innovative new strategies to address formidable medical challenges including cancer, cardiovascular disease, tissue regeneration, gastrointestinal disorders and autoimmune diseases such as diabetes and arthritis. LIMR's principal investigators conduct basic, preclinical and clinical research, using their findings to explore ways to improve disease detection, diagnosis, treatment and prevention. They are committed to extending the boundaries of human health through technology transfer and training of the next generation of scientists and physicians.

About Main Line Health

Founded in 1985, Main Line Health is a not-for-profit health system serving Philadelphia and its suburbs. Main Line Health's commitment—to deliver advanced medicine for treating and curing disease, playing an important role in prevention and disease management as well as training physicians and other health care providers—reflects our intent to be the region's premier choice for clinical care, research, and education. A team of nearly 13,000 employees and more than 2,000 physicians care for patients throughout the Main Line Health System.

At Main Line Health's core are four of the region's most respected acute care hospitals—Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital—as well as one of the nation's premier facilities for rehabilitative medicine, Bryn Mawr Rehabilitation Hospital.

Main Line Health also includes Mirmont Treatment Center for drug and alcohol recovery; Main Line Health HomeCare & Hospice, which includes skilled home health care, hospice and home infusion services; Main Line Health Centers, primary and specialty care, lab and radiology, and other outpatient services located in Broomall, Collegeville, Concordville, Exton, King of Prussia and Newtown Square; Lankenau Institute for Medical Research, a biomedical research organization; and Main Line HealthCare, one of the region's largest multispecialty physician networks.

Main Line Health is the recipient of numerous awards for quality care, and service, including U.S. News & World Report's Best Hospitals, System Magnet® designation; the nation's highest distinction for nursing excellence and the Mid-Atlantic Alliance for Performance Excellence (MAAPE) Excellence Award. Main Line Health is committed to creating an environment of diversity, respect, equity, and inclusion, has proudly received awards in this area and has embraced the American Hospital Association's #123forEquity Pledge to Act to eliminate disparities in care. We are dedicated to advancing patient-centered care, education, and research to help patients stay healthy and live their best lives.

For more information, visit mainlinehealth.org and connect with us on social media:

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Larry Hanover
Communications Manager, LIMR
Office: 484.580.1186
[email protected]