Kilovoltage x-ray beam therapy

Access to radiotherapy therapy is limited in low- and middle-income countries (LMIC). In some LMIC <10% of eligible patients have access to radiotherapy due to its high cost. The standard of RT care is the delivery of high-energy (6-15 MV) photons, generated by a medical linear accelerator (linac), to the site of disease. Linacs utilize a number of expensive technologies, such as precisely machined waveguides and high-voltage generators, to accelerate electrons to relativistic speeds. Upon collision with a tungsten target these electrons produce megavoltage (MV) bremsstrahlung photons, which are filtered, collimated, and directed to the site of treatment. The high energy of these photons necessitates expensive treatment infrastructure known as "vaults" to house the linac in order to shield medical personnel from radiation. The result of this high cost is strain on healthcare systems.

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The goal of this project is to design a low-cost radiotherapy device that uses kilovoltage x-rays. Compared the linac-driven megavoltage x-rays, high beam attenuation and low beam output have to be overcome. So far, we have demonstrated proof of principle by means of Monte Carlo simulations and some limited experiments on phantoms. In collaboration with McGill University, we have developed KVAT treatment planning optimization. We have demonstrated that the most suitable candidates for KVAT treatments might be breast and lung patients, but not prostate patients. Our industrial partner Precision RT (Las Vegas, NV) is currently testing the first machine prototype and we are assisting with the experimental validation.

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Magdalena Bazalova-Carter