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Parodi, Katia ORCID: 0000-0001-7779-6690; Assmann, Walter; Belka, Claus ORCID: 0000-0002-1287-7825; Bortfeldt, Jonathan ORCID: 0000-0002-0777-985X; Clevert, Dirk-André ORCID: 0000-0003-3889-5447; Dedes, George ORCID: 0000-0003-0071-513X; Kalunga, Ronaldo; Kundel, Sonja; Kurichiyanil, Neeraj ORCID: 0000-0002-3119-8334; Lämmer, Paulina; Lascaud, Julie; Lauber, Kirsten ORCID: 0000-0002-8141-0452; Lovatti, Giulio; Meyer, Sebastian ORCID: 0000-0002-2510-7045; Nitta, Munetaka ORCID: 0000-0002-1335-9536; Pinto, Marco ORCID: 0000-0001-6835-2561; Safari, Mohammad; Schnürle, Katrin; Schreiber, Jörg ORCID: 0000-0001-9904-9389; Thirolf, Peter G. ORCID: 0000-0002-6191-3319; Wieser, Hans-Peter ORCID: 0000-0002-2309-7963; Würl, Matthias ORCID: 0000-0003-3044-449X (2019): Towards a novel small animal proton irradiation platform: the SIRMIO project. In: Acta Oncologica, Vol. 58, No. 10: pp. 1470-1475
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Background: Precision small animal radiotherapy research is a young emerging field aiming to provide new experimental insights into tumour and tissue models in different microenvironments, to unravel the complex mechanisms of radiation damage in target and non-target tissues and assess the efficacy of novel therapeutic strategies. To this end, for photon therapy, modern small animal radiotherapy research platforms have been developed over the last years and are meanwhile commercially available. Conversely, for proton therapy, which holds a great potential for an even superior outcome than photon therapy, no commercial system exists yet. Material and methods: The project SIRMIO (Small Animal Proton Irradiator for Research in Molecular Image-guided Radiation-Oncology) aims at realizing and demonstrating an innovative portable prototype system for precision small animal proton irradiation, suitable for integration at existing clinical treatment facilities. The proposed design combines precise dose application with novel in-situ multi-modal anatomical image guidance and in-vivo verification of the actual treatment delivery for precision small animal irradiation. Results and conclusions: This manuscript describes the status of the different components under development, featuring a dedicated beamline for degradation and focusing of clinical proton beams, along with novel detector systems for in-situ imaging. The foreseen workflow includes pre-treatment proton transmission imaging for treatment planning and position verification, complemented by ultrasonic tumour localization, followed by image-guided delivery with on-site range verification by means of ionoacoustics (for pulsed beams) and positron-emission-tomography (PET, for continuous beams). The proposed compact and cost-effective system promises to open a new era in small animal proton therapy research, contributing to the basic understanding of in-vivo radiation action to identify areas of potential breakthroughs in radiotherapy for future translation into innovative clinical strategies.

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