Integrating 2D dosimetry and cell survival analysis for predicting local effect in spatially fractionated radiotherapy
DOI:
https://doi.org/10.2340/1651-226X.2025.44599Keywords:
Neoplasms, Radiotherapy, Cell survival, Models, Biological, Dose-Response RelationshipAbstract
Background and purpose: Robust methods for analysis and prediction of local cell survival after spatially fractionated radiotherapy (SFRT) in vitro remain limited. We present a methodology integrating spatial dosimetry with colony formation assessment and modelling to improve prediction of SFRT-induced responses.
Patient/material and methods: A549 lung cancer cells were irradiated with 220 kV X-rays in three field patterns: open, striped, and dotted. Colony centroid locations were mapped from scanned images of culture flasks. Dose distributions were measured using radiochromic film dosimetry. Digital images with colony locations and dose maps were divided into 1 mm² quadrats. A Poisson regression model was fitted to colony counts per quadrat, incorporating linear-quadratic (LQ) model parameters α and β. A modified LQ (MLQ) model included an additional interaction between dose and nearest distance to a peak region, with parameter δ.
Results: The methodology was successfully implemented. LQ fitting across all quadrats and patterns yielded α = 0.254 Gy−¹ and β = 0.039 Gy−², while the MLQ model gave α = 0.249 Gy−¹, β = 0.032 Gy−², and δ = −0.040 Gy−¹ cm−¹. Parameter uncertainty was below 0.5%. The MLQ model showed slightly lower fitting errors than the LQ model, indicating improved predictive accuracy.
Interpretation: We introduce a novel analysis pipeline for 2D localization of colonies and SFRT survival modelling in vitro. Findings suggest that distance to peak dose regions significantly influences local SFRT effects. Incorporating this spatial factor via an MLQ model may enhance understanding and prediction of SFRT-induced survival.
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Prezado Y, Grams M, Jouglar E, Martínez-Rovira I, Ortiz R, Seco J, et al. Spatially fractionated radiation therapy: a critical review on current status of clinical and preclinical studies and knowledge gaps. Phys Med Biol. 2024;69(10):10TR02.
https://doi.org/10.1088/1361-6560/ad4192 DOI: https://doi.org/10.1088/1361-6560/ad4192
Yan W, Khan MK, Wu X, Simone CB, 2nd, Fan J, Gressen E, et al. Spatially fractionated radiation therapy: history, present and the future. Clin Transl Radiat Oncol. 2020;20:30–8.
https://doi.org/10.1016/j.ctro.2019.10.004 DOI: https://doi.org/10.1016/j.ctro.2019.10.004
Laissue JA, Blattmann H, Slatkin DN. [Alban Kohler (1874–1947): inventor of grid therapy]. Z Med Phys. 2012;22(2):90–9.
https://doi.org/10.1016/j.zemedi.2011.07.002 DOI: https://doi.org/10.1016/j.zemedi.2011.07.002
Marks H. Clinical experience with irradiation through a grid. Radiology. 1952;58(3):338–42.
https://doi.org/10.1148/58.3.338 DOI: https://doi.org/10.1148/58.3.338
Mohiuddin M, Fujita M, Regine WF, Megooni AS, Ibbott GS, Ahmed MM. High-dose spatially-fractionated radiation (GRID): a new paradigm in the management of advanced cancers. Int J Radiat Oncol Biol Phys. 1999;45(3):721–7.
https://doi.org/10.1016/S0360-3016(99)00170-4 DOI: https://doi.org/10.1016/S0360-3016(99)00170-4
Neuner G, Mohiuddin MM, Vander Walde N, Goloubeva O, Ha J, Yu CX, et al. High-dose spatially fractionated GRID radiation therapy (SFGRT): a comparison of treatment outcomes with Cerrobend vs. MLC SFGRT. Int J Radiat Oncol Biol Phys. 2012;82(5):1642–9.
https://doi.org/10.1016/j.ijrobp.2011.01.065 DOI: https://doi.org/10.1016/j.ijrobp.2011.01.065
Daguenet E, Louati S, Wozny AS, Vial N, Gras M, Guy JB, et al. Radiation-induced bystander and abscopal effects: important lessons from preclinical models. Br J Cancer. 2020;123(3):339–48.
https://doi.org/10.1038/s41416-020-0942-3 DOI: https://doi.org/10.1038/s41416-020-0942-3
Jenkins SV, Johnsrud AJ, Dings RPM, Griffin RJ. Bystander effects in spatially fractionated radiation therapy: from molecule to organism to clinical implications. Semin Radiat Oncol. 2024;34(3):284–91.
https://doi.org/10.1016/j.semradonc.2024.05.004 DOI: https://doi.org/10.1016/j.semradonc.2024.05.004
Knight JA, 2nd, Trosper N, Misa J, Bernard ME, Fabian D, Kudrimoti M, et al. Reported early clinical outcomes of forward-planned multileaf collimator-based 3-dimensional conformal spatially fractionated radiation therapy technique for large and Bulky tumors. Int J Radiat Oncol Biol Phys. 2025;122(4):1060–8.
https://doi.org/10.1016/j.ijrobp.2025.04.016 DOI: https://doi.org/10.1016/j.ijrobp.2025.04.016
Xu P, Wang S, Zhou J, Yuan K, Wang X, Li L, et al. Spatially fractionated radiotherapy (Lattice SFRT) in the palliative treatment of locally advanced bulky unresectable head and neck cancer. Clin Transl Radiat Oncol. 2024;48:100830.
https://doi.org/10.1016/j.ctro.2024.100830 DOI: https://doi.org/10.1016/j.ctro.2024.100830
Grams MP, Mateus CQ, Mashayekhi M, Mutter RW, Djonov V, Fazzari JM, et al. Minibeam radiation therapy treatment (MBRT): commissioning and first clinical implementation. Int J Radiat Oncol Biol Phys. 2024;120(5):1423–34.
https://doi.org/10.1016/j.ijrobp.2024.06.035 DOI: https://doi.org/10.1016/j.ijrobp.2024.06.035
Ahmed MM, Wu X, Mohiuddin M, Perez NC, Zhang H, Amendola BE, et al. Optimizing GRID and lattice spatially fractionated radiation therapy: innovative strategies for radioresistant and Bulky tumor management. Semin Radiat Oncol. 2024;34(3):310–22.
https://doi.org/10.1016/j.semradonc.2024.05.002 DOI: https://doi.org/10.1016/j.semradonc.2024.05.002
Fernandez-Palomo C, Chang S, Prezado Y. Should peak dose be used to prescribe spatially fractionated radiation therapy? – A review of preclinical studies. Cancers. 2022;14(15):3625.
https://doi.org/10.3390/cancers14153625 DOI: https://doi.org/10.3390/cancers14153625
Cahoon P, Giacometti V, Casey F, Russell E, McGarry C, Prise KM, et al. Investigating spatial fractionation and radiation induced bystander effects: a mathematical modelling approach. Phys Med Biol. 2021;66(22):225007.
https://doi.org/10.1088/1361-6560/ac3119 DOI: https://doi.org/10.1088/1361-6560/ac3119
Peng V, Suchowerska N, Esteves ADS, Rogers L, Claridge Mackonis E, Toohey J, et al. Models for the bystander effect in gradient radiation fields: Range and signalling type. J Theor Biol. 2018;455:16–25.
https://doi.org/10.1016/j.jtbi.2018.06.027 DOI: https://doi.org/10.1016/j.jtbi.2018.06.027
Peng V, Suchowerska N, Rogers L, Claridge Mackonis E, Oakes S, McKenzie DR. Grid therapy using high definition multileaf collimators: realizing benefits of the bystander effect. Acta Oncol. 2017;56(8):1048–59.
https://doi.org/10.1080/0284186X.2017.1299939 DOI: https://doi.org/10.1080/0284186X.2017.1299939
Arous D, Lie JL, Hsland BV, Borsting M, Edin NFJ, Malinen E. 2D mapping of radiation dose and clonogenic survival for accurate assessment of in vitro X-ray GRID irradiation effects. Phys Med Biol. 2023;68(2):025024.
https://doi.org/10.1088/1361-6560/acaf20 DOI: https://doi.org/10.1088/1361-6560/acaf20
Arous D, Schrunner S, Hanson I, Edin NFJ, Malinen E. Principal component-based image segmentation: a new approach to outline cell colonies. Comput Methods Biomech Biomed Eng-Imaging Visual. 2023;11(1):18–30.
https://doi.org/10.1080/21681163.2022.2035822 DOI: https://doi.org/10.1080/21681163.2022.2035822
Niroomand-Rad A, Chiu-Tsao ST, Grams MP, Lewis DF, Soares CG, Van Battum LJ, et al. Full report of AAPM Task Group 235 radiochromic film dosimetry: an update to TG-55. Med Phys. 2020;47(12):5986–6025.
https://doi.org/10.1002/mp.14497 DOI: https://doi.org/10.1002/mp.14497
Roback P, Legler J. Beyond multiple linear regression: applied generalized linear models and multilevel models in R. Boca Raton, FL. Chapman & Hall/CRC; 2024.
Asur RS, Sharma S, Chang CW, Penagaricano J, Kommuru IM, Moros EG, et al. Spatially fractionated radiation induces cytotoxicity and changes in gene expression in bystander and radiation adjacent murine carcinoma cells. Radiat Res. 2012;177(6):751–65.
https://doi.org/10.1667/RR2780.1 DOI: https://doi.org/10.1667/RR2780.1
Butterworth KT, McMahon SJ, McKee JC, Patel G, Ghita M, Cole AJ, et al. Time and cell type dependency of survival responses in co-cultured tumor and fibroblast cells after exposure to modulated radiation fields. Radiat Res. 2015;183(6):656–64.
https://doi.org/10.1667/RR13992.1 DOI: https://doi.org/10.1667/RR13992.1
Asur R, Butterworth KT, Penagaricano JA, Prise KM, Griffin RJ. High dose bystander effects in spatially fractionated radiation therapy. Cancer Lett. 2015;356(1):52–7.
https://doi.org/10.1016/j.canlet.2013.10.032 DOI: https://doi.org/10.1016/j.canlet.2013.10.032
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