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Gadolinium has been recently proposed, as neutron capture agent in NCT (Neutron Capture Therapy), due to both the nuclide high neutron capture cross section, and the remarkable selective uptake inside tumour tissue that Gd-loaded compounds, can provide. When a neutron external source is supplied, different Gd nuclear reactions, and the generated Auger electrons in particular, cause a high local energy deposition, which results in a tumour cell inactivation. Preliminary micro- as well as macrodosimetric Monte Carlo computational investigations show that the tumour-to-healthy tissue biological damage ratio is in close relation to the neutron beam energy spectrum. The results points out that the optimum neutron spectrum, to be used for Gd-NCT, seems to lie in the 1 to 10 keV energy range.In order to 'tailor' such spectra, an original, accelerator-driven, neutron source and spectrum shaping assembly for hospital-based Gd-NCT are presented and preliminary results are reported. [ABSTRACT FROM AUTHOR]

Present standard treatment planning (TP) for glioblastoma multiforme (GBM – a kind of brain tumor), used in all boron neutron capture therapy (BNCT) trials, requires the construction (based on CT and/or MRI images) of a 3D model of the patient head, in which several regions, corresponding to different anatomical structures, are identified. The model is then employed by a computer code to simulate radiation transport in human tissues. The assumption is always made that considering a single value of boron concentration for each specific region will not lead to significant errors in dose computation. The concentration values are estimated “indirectly”, on the basis of previous experience and blood sample analysis.This paper describes an original approach, with the introduction of data on the in vivo boron distribution, acquired by a positron emission tomography (PET) scan after labeling the BPA (borono-phenylalanine) with the positron emitter 18F. The feasibility of this approach was first tested with good results using the code CARONTE. Now a complete TPS is under development. The main features of the first version of this code are described and the results of a preliminary study are presented. Significant differences in dose computation arise when the two different approaches (“standard” and “PET-based”) are applied to the TP of the same GBM case. [Copyright &y& Elsevier]

Since October 1997, a clinical trial of Boron Neutron Capture Therapy (BNCT) for glioblastoma patients has been in progress at the High Flux Reactor, Petten, the Netherlands. The trial is a European Organisation for Research and Treatment of Cancer (EORTC) protocol (#11 961) and, as such, must be conducted following the highest quality management and procedures, according to good clinical practice and also other internationally accepted codes. The complexity of BNCT involves not only strict international procedures, but also a variety of techniques to measure the different aspects of the irradiation involved when treating the patient. Applications include: free beam measurements using packets of activation foils; in-phantom measurements for beam calibration using ionisation chambers, pn-diodes and activation foils; monitoring of the irradiation beam during patient treatment using fission chambers and GM-counters; boron in blood measurements using prompt gamma ray spectroscopy; radiation protection of the patient and staff using portable radiation dosimeters and personal dosimeters; and in vivo measurements of the boron in the patient using a prompt gamma ray telescope. The procedures and applications of such techniques are presented here, with particular emphasis on the importance of the quality assurance/quality control procedures and its reporting. [Copyright &y& Elsevier]