Integrating a low-field open MR scanner with a static proton research beam line: proof of concept.

On-line image guidance using magnetic resonance (MR) imaging is expected to improve the targeting accuracy of proton therapy. However, to date no combined system exists. In this study, for the first time a low-field open MR scanner was integrated with a static proton research beam line to test the feasibility of simultaneous irradiation and imaging. The field-of-view of the MR scanner was aligned with the beam by taking into account the Lorentz force induced beam deflection. Various imaging sequences for extremities were performed on a healthy volunteer and on a patient with a soft-tissue sarcoma of the upper arm, both with the proton beam line switched off. T 1-weighted spin echo images of a tissue-mimicking phantom were acquired without beam, with energised beam line magnets and during proton irradiation. Beam profiles were acquired for the MR scanner's static magnetic field alone and in combination with the dynamic gradient fields during the acquisition of different imaging sequences. It was shown that MR imaging is feasible in the electromagnetically contaminated environment of a proton therapy facility. The observed quality of the anatomical MR images was rated to be sufficient for target volume definition and positioning. The tissue-mimicking phantom showed no visible beam-induced image degradation. The beam profiles depicted no influence due to the dynamic gradient fields of the imaging sequences. This study proves that simultaneous irradiation and in-beam MR imaging is technically feasible with a low-field MR scanner integrated with a static proton research beam line.

DNA double-strand break signalling: X-ray energy dependence of residual co-localised foci of gamma-H2AX and 53BP1.

PURPOSE: The application of ionising radiation for medical purposes requires the investigation of induced and persistent DNA damages, especially for soft X-rays that are assumed to be more effective than higher energy photons. Therefore, we examined the energy dependent time and dose response of residual DNA damage foci for soft X-rays in comparison to 200 kV photons. MATERIALS AND METHODS: DNA damage present in cell line 184A1 within 48 h after irradiations with 10 kV, 25 kV and 200 kV photons was analysed by immunochemical detection of co-localised gamma-H2AX (phosphorylated histone H2AX) and 53BP1 (tumour protein 53 binding protein) foci. RESULTS: The dose dependencies of the colocated foci revealed significant energy dependent differences with increasing amounts of residual foci at decreasing X-ray energy independent on postirradiation time. Dose-dependent RBE (relative biological effectiveness) values ranging from 4 to 7 were determined for 10 kV relative to 200 kV X-rays based on the 24 hour dose responses. For 25 kV photons, ratios considerably higher than one were obtained only for doses above 2 Gy. CONCLUSIONS: The expected energy dependence with increasing DNA damage at decreasing photon energy was confirmed for the residual co-localised foci measured at different time points after irradiation.