“To fight tumors we need more energy. To transfer more energy we need a more penetrating particle.”

CLINICAL NUCLEAR ONCOLOGY BY nIORT®; OUR MEDICAL DEVICE


TheranostiCentre is an innovative SME who developed a new intraoperative radiotherapy system that uses fast neutron beams to irradiate a wider class of solid tumors at different stages. The device, NEUTRONBRUSH® is efficient and compact and can be positioned in an operating room, it is mobile and does not contain radioactive sources.

What are the advantages of the NEUTRONBRUSH® device?

Unparalleled Efficiency

The neutron radiation of nIORT® (neutron IntraOperative RadioTherapy) has antitumoral efficiency 16 times superior compared to other forms of radiation such as X-rays and electrons. This will allow to treat a wider class of solid tumors at different stages.

Product

NEUTRONBRUSH® has its main component, a neutron generator (NG) that emits heavy particles without electric charge: fast neutrons. The NEUTRONBRUSH® has specifically been designed to administer the nIORT® (neutron Intraoperative RadioTherapy) in an operating room. It has compact dimensions: 30 cm width, 40 cm length and a total weight of less than 100 kg.

Treatment Efficiency

Therapeutic efficiencies and limited treatment times in cases for which the traditional IORT is not completely effective and for tumours difficult to treat with other therapies.
 

Lower Investment and Treatment Costs

The cost of the device is estimated lower than the actual similar medical devices used for IORT. The treatment will be cheaper than the External Beam Radiation Therapy (as it is a high-dose single-fraction administration compared to the multiples application of the External Beam Radiation Therapy) giving the patient more comfort and convenience.

Reduction of Recurrences

Boost nIORT® should not require External Beam Radiation Therapy (EBRT) for solid cancers of clinical stages I through III because of its high-dose Linear Energy Transfer (LET). Furthermore, it eliminates the wait between surgery and completion of the radiotherapy treatment, reducing the risk of recurrences.
  • TheranostiCentre

Timeline and Progress


Current Status of the Project


The prototype of the Neutron Generator will soon be positioned at Centro di Ricerche ENEA at Brasimone (Bologna) where further tests on an anthropomorphic phantom will be directed to define the most efficient clinical dose. A collaboration with important clinics and hospitals specialized in cancer treatment will support us in refining and optimizing the medical device for the operating room administration.


Previous Steps:

How it Works and Monte Carlo MCNP Simulations

The nIORT® is administered with a medical device basically composed by a CNG (Compact Neutron Generator) and a BSA (Beam Shaping Assembly), that shields and (partially) collimates neutrons towards a circular exit window for irradiation. The CNG is a compact light ion accelerator of deuterons that exploits the DD (Deuterium-Deuterium) fusion reactions to generate fast neutrons (2.45 MeV energy) into a Titanium (Ti) target under DC high electrical voltage (100 kV-10 mA power generator). The current technology is nowadays mature for industrial and medical development of this kind of CNG, having some specific advantageous features such as: to provide a high and almost mono-energetic neutron flux; to have a high/safety standards; do not produce high level wastes; can be made compact, mobile and light with a comparably lower costs compared to other IOERT mobile technologies devices. The CNG-BSA system design was addressed by a detailed study with the MCNP code in which the whole CNG-BSA system was modelled: the apparatus takes up t he volume of a cylinder with an external diameter of 30 cm and a length of about 40 cm (for a total weight lower than 100kg). The small size and weight permit the CNG-BSA remote handling by a robotic arm and its utilization in an operating room dedicated to IORT. Working at 100 kV-10 mA power, the CNG supplies a neutron yield at the Ti Target of 3.3 109 [s-1]. With the possibility to tune the exit window diameter in the 1 ÷ 6 cm range, the CNG-BSA irradiation performances (due to neutrons and secondary photons created by neutrons interactions with the BSA walls and with the tumour bed tissue in front of the irradiation window) can be summarised as it follows:

  • a neutron flux at the irradiation window of 1.01 ÷ 0.51 108 [cm-2 s-1];
  • a maximum neutron flux in the tumour bed tissue of 9.1 ÷ 7.3 107 [cm-2 s-1];
  • a maximum photon flux in the tumour bed tissue of 4.9 ÷ 4.8 106 [cm-2 s-1];
  • a maximum equivalent (or biological) dose rate in the tumour bed tissue of 2.36 ÷ 2.10 [Sv min -1].
The equivalent dose rate profiles obtained with different window diameters differ mostly in the surface tissues: the peak values are above 2 Sv / min for all diameters in the 1 ÷ 6 cm range and decrease by a factor ≅ 4 at 3 cm depth, that should preserve the nearest organs from harmful radiations. Focusing on the superficial tissues (i.e.; open wound tumour bed), the maximum dose rates are delivered at the window centre and decreases by moving towards the window borders.

The CNG-BSA is able to operate in (at least) 3 regimes having different dose targets:

  • the Boost nIORT® with the clinical end-points of about 10 Sv ;
  • the Radical nIORT® with the clinical end-point of 20 Sv as peak dose in the tumour bed;
  • the Ultra radical nIORT® with the clinical end-point of 20 Sv as average dose in the tumour bed over the whole irradiation window area.
The high flux and the high Relative Biological Effectiveness (RBE) of neutrons (16 in the CNG-BSA, vs. 1 for X-rays and electrons) permits to deliver the Boost, Radical and Ultra-Radical nIORT® applications in very limited treatment times of ∼ 5 ÷ 20 minutes, depending on the clinical end-point and the window diameter chosen. There is also a general consensus that the high RBE of neutrons induces bystander effects, abscopal effects and hinders Epithelial-Mesenchymal Transitions (EMT).

Who We Are

TheranostiCentre is a Small Medium Enterprise based in Milan with lab in Centro di Ricerche ENEA at Brasimone(Bologna), Italy, whose mission is the integration of different multidisciplinary technologies for the treatment of solid cancer. The core of TheranostiCentre is the scientific research, implying all necessary skills to add value to the company scientific assets. TheranostiCentre is responsible for patenting and developing the technologies studied up to the stage in which it will be possible to confer them to partner companies for production and marketing on vast scale. TheranostiCentre has and is looking for strategic partnerships worldwide further to the ones with ENEA and Berkion Technology with the necessary skills for the finalization of prototypes, tests and protocols for advanced intraoperative radiotherapy.


TheranostiCentre International Student Community

TheranostiCentre is cooperating with young students and researchers to study the applications of neutron radiotherapy to oncology fields.

Our Team

MAURIZIO MARTELLINI

THEORETICAL PHYSICIST


Co-founder and scientific director of TheranostiCentre

GIUSEPPE GHERARDI

NUCLEAR EXPERT


Co-founder of TheranostiCentre

Dott. Paolo Galmozzi

SOLE ADMINISTRATOR


TheranostiCentre CEO

Dott.ssa Lidia Falzone

PROJECT MANAGER


TheranostiCentre

Antonietta Rizzo

ENEA


Expert in the Integration of Chemical and Physical techniques for interdisciplinary applications

Giuseppe Ottaviano

ENEA


Physicist researcher, Radiation Protection Expert n. 438, ENEA, TNMT Laboratory National Data Centre - Radionuclides

Massimo Sarotto

ENEA


Researcher with twenty years of experience in simulations for the transport of particles with the code Monte Carlo (MCNP)

Daniele Martelli

ENEA


Head of the Prototype Design Laboratory of the Experimental Engineering, Fusion and Technology Division for the Department of Nuclear Safety

Together we can do it

We welcome your questions and comments.