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Besides the treatment of patients in clinical trials, the MedAustron accelerator facility offers the opportunity for performing non-clinical research. On the one hand, areas of research close to the medical application will be addressed, i.e. translational research. On the other hand, the particle beams can generally be used for scientific projects in radiation physics and applied particle physics. Accordingly, special research projects are mainly performed in co-operation with the Medical University of Vienna and the TU Wien. In addition, there is a strong collaboration with the Institute of High Energy Physics of the Austrian Academy of Sciences, the University of Applied Sciences Wiener Neustadt, and the Medical University of Graz. The proposed projects have been recommended by an independent Advisory Board. An Executive Committee supports the practical research work on-site and follows up the research progress. The coordination of the non-clinical research activities is carried out by Thomas Schreiner and Dietmar Georg.
For the research period from 2019 until 2021, the commissioning of carbon ions and 800 MeV protons is carried out. Moreover, six dedicated research projects have been defined, i.e. intrafraction and interfraction adaptive radiation therapy, imaging with ion beams, magnetic resonance guided particle therapy, energy transfer mechanisms and applications in biology and physics, and pre-clinical research.
Intrafraction Adaptive Radiation Therapy
Treating moving targets with scanned particle beams is a global and general research topic in ion-beam therapy since more than a decade. For intrafraction adaptive radiation therapy, i.e. changes during during one irradiation session, the main focus is on medical image processing for markerless tumour tracking, four-dimensional dosimetry, and sophisticated approaches for treatment planning.
Interfraction Adaptive Radiation Therapy
Also interfraction adaptive radiation therapy considers changes due to moving targets. Here, the motion may be slower, i.e. changes between the single sessions (fractions) from day to day. Treatment adaptions are mainly based on magnetic resonance iamging providing information on morphologic changes and changes in tumour characteristics. For image assessment, deep learning approaches are applied.
Magnetic Resonance Assisted Particle Therapy
Research in the context of magnetic resonance (MR) guided beam delivery or the development towards a combination of MR imaging and ion-beam therapy is a new aspiring topic. In contrast to photons, the ion treatment beam itself is influenced by the magnetic field. The impact on dose distribution, dosimetry measurements, and consequently on patient treatment need to be studied in an early phase of MR guided particle therapy.
Ion Beam Imaging
MedAustron offers the opportunity to study proton computed tomography with energies of up to 800 MeV, i.e. far beyond the clinically used proton energies. For decreasing range uncertainties in the final treatment planning process, it is of special interest to develop new methods for improving stopping power determination.
Energy Transfer Mechanisms
The current approach of treatment prescription in ion-beam therapy is based on the product of the absorbed dose to water and a biological weighting factor, which is found to be insufficient for providing a comprehensive method to quantify the biological outcome of radiation. Therefore, experimental measurements of microdosimetric spectra are performed, which will constitute the main basis for the correlation with radiobiological data.
Pre-Clinical Research
Pre-clinical research focuses on molecular and immunological mechanisms in the tumour and its microenvironment that contribute to therapy resistance. Effects of ion-beam therapy on the tumour microenvironment are currently unknown and will be investigated in adequate spheroid models and xenograft models. It is envisaged to include non-invasive pre-clinical imaging methods to visualise radiation-induced processes in tumours.
