Transcript Document

Ytterbium-169 Based
High Dose Rate Brachytherapy
Alexander Bogdanov, Atommedcenter LLC
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Why use Yb-169 based High Dose Rate micro sources
A new approach to the cancer therapy, improving quality of therapy, minimizing
radiation dose on healthy tissues and reducing risks of further complications
 High Dose Rate (HDR)
therapy of both surface
and internal cancers
 Therapy of head-neck
cancers
 Near critical organ
localization therapy
 Endovascular radiosurgery and to prevent
rest enosis in stent
operations
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The Main Advantages of Yb-169 Micro-sources
Radionuclide:
Co-60
Cs-137
Ir-192
Yb-169
Tm-170
I-125
Pd-103
Average energy of
photon emission
1250 keV
662 keV
380 keV
93 keV
84 keV
28 keV
21 keV
Half-life
5,3 years
30,2 years
74 days
32 days 128 days 59,4 days 17 days
 Softer emission spectrum (63–217 keV) compared with Ir-192 and Co-60 sources
 They can be used for treatment of superficial cancers and internal cancers
 They can be used with any apparatus for brachytherapy
 Easy to handle
 This sources can be used for endovascular radiosurgery and prevent restenosis in
stent operations
 Equivalent activity from 0.5 to 15 Ci
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Yb-169 Source Design
Titanium capsule is housed in
a steel capsule with a tail (cable and shaft)
Before an irradiation titanium capsule contains of
Ytterbium oxide powder (Yb2O3), enriched by stabile
isotope Yb-168
Yb2O3 powder
Tube capillary
Bottom-globule
The enrichment of Yb isotope ω(168Yb) = 35.8±0.3%
Currently available techniques allows enrichment
up to 90%
This design allows using Yb-169 based HDR micro sources with any commercially
available apparatuses for brachytherapy
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Pre-clinical Trials of Yb-169 Based HDR Brachytherapy
Positive biological effect of the source has been proved on
tumors in animals
Irradiation of rats with sarcoma М-1 by Yb-169 based
HDR micro sources
Dynamics of tumor volume change after
irradiation with Yb-169
20 days after irradiation with Yb-169
no irradiation
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Current Status of the Project
Currently the project is under transition to the clinical trials
On the previous project phases the following tasks has been completed:
 Calculations and durability tests of the Yb-169 sources;
 Reactor irradiation study of the construction materials used for manufacturing
source body;
 Experimental estimation of the absorbed doses in the tissue equivalent phantom;
 Experimental study of the dose characteristics using water phantom;
 Study of the medical and biological characteristics of the Yb-169 sources;
 Recommendations on the medical use and radiation safety of the Yb-169 sources.
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Market Potential Estimation
Potential consumers:
FSBI “N.N.Blokhin RCRC” RAMS”
P.A. Herzen Moscow Cancer Research Institute
Federal State Healthcare Institution Clinical
Hospital No. 8 of FMBA of Russia, Obninsk,
Kaluga Oblast
Russian Scientific Center of Roentgenoradiology
Federal State Healthcare Institution L.G. Sokolov
Clinical Hospital No. 122 of FMBA of Russia, St.
Petersburg
Average cost of therapy is “1”
The market size (Russia) is estimated at 500 HDR apparatuses (~3000 src/year)
Medical Radialogical Research Center, Obninsk
State Medical and Preventive Institution
Chelyabinsk
District
Clinical
Oncological
Dispensary, Chelyabinsk
Initial high investment in the building up radiation therapy
complex will be later compensated by lower operational
expenses compared to other therapy methods!
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Market. Main Players
The major players of the automated brachytherapy complexes market are the
following:
Companies
Country
Production for brachytherapy
Varian Medical Systems
USA
GammaMedplus, GammaMedplus3/24, Varisource,
GammaMed 12
Eckert & Ziegler BEBIG GmbH
Germany
MultiSource-HDR, Bebig Curietron LDR/MDR, Сurietron
192 Oris
Nucletron (bought by Elekta
in Sept. 2011)
Sweden
Selectron LDR, microSelectron LDR/MDR,
microSelectron-HDR, microSelectron-PDR, SeedSelectron, Selectron-HDR
Buchler
Germany
GMBH
JSC «NIITFA"
Russia
AGAT-VT
Average price of the imported brachytherapy complexes in Russia is 30-35 mil. rub., while Russianmade complexes cost around 18 – 25 mil. rub
Со-60 and Ir-192 are mainly used as radiation sources for brachytherapy
Yb-169 until now is not used in clinical practice for brachytherapy
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Cooperation. Partners
Cyclotron Co., Ltd,
Obninsk,
JSC IRM,
г. Yekaterinburg
Manufacturing a titanium
capsule containing Yb-168 oxide
Titanium capsule irradiation
inside a reactor
Coordination
Medical Radialogical
Research Center
Commercialization
Study of the dosimetric,
biological and medical
characteristics of Yb-169
sources
“Isotope Technologies”,
Minsk
Source manufacture
Technical tests
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Proposal for cooperation with Varian
 Ytterbium-169 (169Yb) based HDR micro-sources
for HDR
Afterloader for HDR w/out 60Co/192Ir-conteiner, applicators
and accessories (or Mick Radio-Nuclear Instruments)
Results of pre-clinical trials
3D treatment planning system
Russia
Clinical trials
USA
Brachytherapy of breast, prostate cancer; head-neck localizations and other surface and
internal cancers
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Contacts:
Alexander Bogdanov
[email protected]
Tel.: +7 495 232 0345
Moscow, Russia, 115230 Warshavskoye sh, 46
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Приложения
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Models and dimensions of Yb-169 based high-energy micro
sources
Overall dimensions, mm
Power air cerma
Equivalent
Sources with Holder
Source model
External
Active core on distance 1m,
activity,
(Plug and Shaft)
mGy/h
Bq (Ci)
D1
L1
D
L*
d*
l*
GYb169М04.210
0,77
1,9х1010(0,5)
GYb169М04.410
1,55
3,7х1010(1)
GYb169М04.111
4,64
1,1х1011(3)
GYb169М04.211 1,1±0,05 5,0+0,1 1,1±0,05 1000-3000 0,7 2,1
7,73
1,8х1011(5)
GYb169М04.311
11,59
2,8х1011(7.5)
GYb169М04.411
15,45
3,7х1011(10)
GYb169М04.610
23,18
5,6х1011(15)
GYb169М05.210
0,77
1,9х1010(0,5)
GYb169М05.410
1,55
3,7х1010(1)
GYb169М05.111
4,64
1,1х1011(3)
GYb169М05.211 1,1±0,05 5,0+0,1 1,1±0,05 1000-3000 0,7 2,1
7,73
1,8х1011(5)
GYb169М05.311
11,59
2,8х1011(7.5)
GYb169М05.411
15,45
3,7х1011(10)
GYb169М05.610
23,18
5,6х1011(15)
GYb169М06.210
0,77
1,9х1010(0,5)
GYb169М06.410
1,55
3,7х1010(1)
GYb169М06.111
4,64
1,1х1011(3)
GYb169М06.211 1,1±0,05 5,0+0,1 1,1±0,05 1000-3000 0,7 2,1
7,73
1,8х1011(5)
GYb169М06.311
11,59
2,8х1011(7.5)
GYb169М06.411
15,45
3,7х1011(10)
11(15)
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GYb169М06.610
23,18
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Energy spectrum (or distribution) of gamma quanta
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The measurement of absorbed dose distribution in a mammary
gland phantom using a tissue equivalent phantom
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Three models of a steel construction depending on a holder
design
GYT169M04
GYT169M06
GYT169M05
1. Titanium capsule
2. Cable
3. 169Yb
4. Steel capsule
5. Plug
6. Shaft
* Sizes for inquiries (are defined
by the customer)
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Relative Distribution of Yb-169 Dose in Living Tissues
“Organ” of human
phantom
ovaries
bowel
lung (left)
Absorbed dose rate,
Gy/min
0,00011±0,000013
0,00019±0,0009
0,009±0,0013
stomach / ventriclus
0,00078±0,00010
liver
0,0016±0,00020
thyroid gland
0,0009±0,0001
rectum
0,0005±0,0001
bone marrow
0,0061±0,0033
esophagus
0,012±0,010
bladder
0,00005±0,0002
brain
0,00039±0,0002
salivary glands
0,0037±0,0023
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Dependence of relative tumor volume change ST on the time
after irradiation
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Photos of Yb-169 based HDR micro sources
High energy micro
source on basis of 169Yb
Operational wound at a cancer of a
mammary gland with the
subsequent Brachytherapy by
radioisotope
Steel capsule
Shaft
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Statistics of cancer
СМЕРТНОСТЬ ОТ РАКА В МИРЕ (МЛН./ГОД)
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ТУБЕРКУЛЁЗ
12
МАЛЯРИЯ
10
8
ВИЧ
6
РАК
4
2
0
1990
2000
2010
2020
ИСТОЧНИК ДАННЫХ: ВСЕМИРНЫЙ БАНК
Структура злокачественных новообразований
мужского населения России
Структура злокачественных новообразований
женского населения России
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