The present invention relates generally to devices and methods for generating and using x-rays, and more specifically to devices and methods for generating and using substantially monochromatic x-rays.
X-ray radiation is used in a number of processes including medical and non-medical diagnostics and therapeutics. Conventional x-ray equipment, such as the equipment used in medical facilities, utilize broadband x-ray radiation (also referred to as bremsstrahlung) having a wide range of energies. Such broadband x-ray equipment is typically used for diagnostic imaging as well as for radiation based therapeutics such as in the treatment of tumors. However, much of the bandwidth of the x-ray energy is not useful for imaging or therapeutics because low-energy x-rays (10-30 keV) do not efficiently penetrate the body to reach the target tissue, and body tissue is nearly transparent to high-energy x-rays (such as from linear accelerators in the MeV range). Since much of the bandwidth of x-ray energy generated by typical broadband x-ray machines is not useful for imaging or therapeutics, subjects imaged or treated with these machines are exposed to a much larger radiation dose than would otherwise be necessary. Exposure to x-rays can increase the risk of a patient having an unwanted side effect, such as the causing tumor. Therefore, it is desirable to develop devices and methods that can decrease a subject exposure to x-rays during diagnostic and therapeutic treatments. Thus, there is a need for cost effective equipment capable of generating x-rays over a narrower useful bandwidth, such as a substantially monochromatic x-ray, to decrease x-ray exposure of subjects.
One type of device for generating substantially monochromatic x-ray energy utilizes fluorescent x-ray emitting sources that, when exposed to bremsstrahlung x-ray energy, fluoresce substantially monochromatic x-ray energy. The efficiencies of these devices to convert bremsstrahlung x-ray energy to monochromatic X-ray energy are typically too low to generate monochromatic X-rays with sufficient intensities to be useful for either diagnostic or therapeutic purposes. To overcome these inefficiency issues, specially designed bremsstrahlung emitting x-ray tubes have been designed for use with fluorescent monochromatic x-ray emitting sources. However, newly designed x-ray tubes typically cannot be used in existing machines without expensive retrofitting or replacement of existing x-ray equipment. Since X-ray equipment is expensive and difficult to retrofit or replace, adaptors are needed that are capable of efficiently generating narrower bandwidth X-ray energy from existing broadband X-ray emitting equipment.
Described herein are devices for converting a broadband x-ray beam to at least one substantially monochromatic x-ray beam. The devices may be an adaptor for use with existing x-ray machines and include a shielded housing having an inner cavity and a fluorescent target disposed in the inner cavity. The fluorescent target emits at least one substantially monochromatic x-ray beam when exposed to a broadband x-ray beam. The housing includes a first opening in the housing configured to allow a broadband x-ray beam from an x-ray source to enter the inner cavity and irradiate the fluorescent target and a second opening in the housing configured to allow the at least one substantially monochromatic x-ray beam emitted by the fluorescent target to exit the housing.
Also described herein are sources for at least one substantially monochromatic x-ray beam. In one embodiment, the monochromatic x-ray beam source includes a vacuum chamber, an electron source in the vacuum chamber which radiates focused electrons in a direction to strike an anode and generate a broadband x-ray, and a fluorescent target in the vacuum chamber having a planar surface arranged in the path of the broadband x-ray. The planar surface has an angle relative to the path of the broadband x-ray in the range of about 30 degrees to about 60 degrees. In another embodiment, the monochromatic x-ray beam source includes a vacuum chamber, an electron source in the vacuum chamber which radiates focused electrons in a direction to strike an anode that includes at least a first and a second fluorescent-element. The surface of the anode is planar and has an angle relative to the path of the electrons in the range of about 30 degrees to about 60 degrees.
Also described herein is a method of delivering locally concentrated radiation to a sample. The method includes introducing at least one high Z element to the tissue and simultaneously irradiating the high Z element in the sample with at least a first substantially monochromatic x-ray beam and a second substantially monochromatic x-ray beam. The first substantially monochromatic x-ray beam has an energy sufficient to ionize the k-shell of the high Z element thereby allowing an electron from an outer shell to collapse to the k-shell and release an x-ray photon, and the second substantially monochromatic x-ray beam has an energy sufficient to elevate an electron from the k-shell into a vacancy in an outer shell thereby reionizing the k-shell and sustaining the local x-ray emission cycle. This embodiment is particularly useful with radiation therapy using high Z element containing radiosensitizing agents to kill malignant cells.
Also described herein is a diagnostic method that includes irradiating a sample with a first substantially monochromatic x-ray beam and a second monochromatic x-ray beam and detecting the first substantially monochromatic x-ray beam and the second monochromatic x-ray beam that pass through the sample.
X-ray fluorescence operates on the principle that the illumination of a fluorescent target with x-ray energy results in the emission of x-ray energy having a different energy range. The energy range of the emitted x-ray is determined by the atomic composition of the fluorescent target. Aspects of the invention are directed to x-ray sources and adaptors that utilize x-ray fluorescent principles to generate substantially monochromatic x-rays, as well as methods of utilizing monochromatic x-rays for therapeutic and diagnostic uses.
When photons of ionizing x-ray energy (such as bremsstrahlung x-ray energy) strike an atom, the energy may be either reflected or absorbed by the atom. With reference to
The most well known monochromatic X-rays correspond to the Kα line, which is the strongest atomic transition in terms of probability or cross section relative to other higher transitions. The Kα line corresponds to the x-rays that result from the transition of an electron from the L shell to the K shell. Thus, Kα x-rays are proposed as the primary agents for the substantially monochromatic diagnostic and therapeutic process described herein. However, higher energy transitions such as Kβ, Kγ, etc. are also relevant to devices, compositions, and methods described herein. For example, as illustrated in
With reference back to
Auger emissions can be especially beneficial when the target atom is a high Z atom, i.e., an atom with a atomic weight of greater than 26, and the high Z atom is loaded into a tissue, as discussed in greater detail below. The ejected Auger emission electron is capable of travelling about 1 to about 100 μm into the surrounding tissue before losing its energy, mostly localized to within about 10 μm. The damage to cells along the ejected electron's path is great because the density of the energy transfer per micrometer is much higher than regular electrons or x-ray photons. This deposition of energy is similar to how protons deposit energy to a target tissue at the end of their ranges. At specific resonant energies, the very low energy Auger electrons may also attach themselves to the DNA of malignant cells causing single and double-strand breakups. Aspects of the present invention applying these principles will provide a low cost devices and methods having a similar effectiveness as proton beam devices which cost in the hundreds of millions of dollars.
Avoiding auger emission from common elements present in the body having an atomic number up to iron (Z=26) could be advantageous for limiting radiation dose in most tissues of the body. Thus, one embodiment of the invention uses monochromatic x-ray beams having a characteristic energy that limits Auger emissions from these common elements, i.e., having an atomic number of up to 26. It has also been observed that some diseased tissues, such as cancerous tissues, have relatively high levels of calcium (Z=20) and iron (Z=26) compared to surrounding tissues. Thus, in some embodiments, it may be advantageous to target these tissue with monochromatic irradiation that will target atoms having an atomic number of at least 20, or at least 26.
With reference to
Some aspects of the invention are directed to methods employing two or more substantially monochromatic x-ray beams. For these methods, multiple substantially monochromatic x-ray beams may generated in a number of ways. For example, the fluorescent target 24 of
High Z elements are used in some embodiments of the present invention because elements fluoresce in response to x-rays with efficiencies that increases with the atomic number (Z). Nanoparticles of high Z elements, such as gold (Z=79), platinum (Z=78), and other generally non-reactive and non-toxic elements are ideal for use in biological tissues. High Z elements can be associated with at least one of medical device, a contrast agent, a nanoparticle, a chemotherapy agent, a radiotherapy agent, and combinations thereof. An exemplary medical device is a vascular stent. In addition, radiosensitizing molecular agents widely used in imaging, such as bromodeoxyuridine (BUdR) or iodeoxyuridine (IUdR) are also useful since they contain high Z elements Br (Z=35) and I (Z=53) respectively. In addition to the high Z elements listed above, other preferable high Z elements include Zr, Cu, Ag, Mo, Kr, U, Gd, W and combinations thereof. While high Z elements may be preferred, other elements may be useful with certain embodiments of the invention. The useful elements, such as high Z elements, can be used alone or in combination, such as in a nanoparticle, or can be targeted to a specific tissue such through association with an antibody or receptor ligand that targets the tissue of interest, such as a benign tumor, a malignant tumor, a lesion, an infectious agent, a plaque, a cyst, a blood vessel and combinations thereof. For example, nanoparticles of high Z elements can be designed and coated with antigens so as to target antibodies in the tissues of interest such cancerous tumors. The nanostructures may assume various shapes such as nanospheres, nanorods, nanotubes etc. Upon x-ray irradiation, a nano-plasma is created resulting in Auger cascades that would kill cancerous cells to which the nanostructures are attached.
With reference to
The device 20 includes a shielded housing 22 having an inner cavity 24 and a fluorescent target 26, 26′ disposed in the inner cavity 24. The housing 22 also has a first opening 30 configured to allow a broadband x-ray beam from an x-ray source to enter the inner cavity 24 and irradiate the fluorescent target 26, 26′. The housing 22 also has a second opening 34 configured to allow a substantially monochromatic x-ray beam emitted by the fluorescent target 26, 26′ to exit the housing 22. The first and second openings may optionally be covered with a glass 28 and 29 that will not interfere with the broadband or monochromatic energy passing through the housing.
The fluorescent target 26, 26′ is disposed on the inner cavity 24 as such an angle relative to the first and second openings 30, 34 such that upon irradiation by a broadband x-ray entering the first opening 30, the fluorescent substantially monochromatic x-ray beam can exit the housing 22 through the second opening 34. The fluorescent target 26 is angled relative to the path of the broadband beam so as to limit contamination of the substantially monochromatic beam with the broadband beam. The angle of the fluorescent target 26 relative to the path of the broadband x-ray beam is may vary between about 30 degrees to about 60 degrees. Advantageously, the angle is between about 40 degrees and about 50 degrees. Most advantageously, the angle is about 45 degrees. The angle of the fluorescent target relative to the broadband x-ray beam, or in the alternative, relative to the first and/or second openings, may be adjustable, such as through the use of one or more set screws 38, 40 (
The fluorescent target 26 may include any element of the Periodic Table. The elements used in the fluorescent target 26 are selected to emit characteristic substantially monochromatic x-ray beams having a desired bandwidth. Advantageously, the fluorescent target 26 utilizes a single element, such as a high Z element, that fluoresces at the desired bandwidth. The fluorescent target 26 may include two or more elements, such as two or more high Z elements, that emit two or more substantially monochromatic x-ray beams, with each substantially monochromatic x-ray beam emanating from the respective element. In one embodiment, the fluorescent target 26 includes at least two high Z elements that are selected to function in the resonant absorption/resonant emission method described above. In another embodiment, the fluorescent target 26 includes at least two elements that are selected to provide improved imaging. In one embodiment, the fluorescent target 26 is substantially planar. However, non-planar geometries are readily constructed. For example, as shown in
The housing 22 may further include a structure or structures configured for reversibly couple the housing to an x-ray machine so as to maintain a fixed geometry between the fluorescent target 26, 26′ and the x-ray machine. As mentioned above, one use for the device 22 is as an adaptor or converter for use with existing broadband x-ray equipment such as the broadband x-ray source 10 in
The device 20 may also include a beam-shaping apparatus configured to shape the narrower bandwidth x-ray beam. The beam-shaping apparatus is at least one of a pair of jaws 44, 46, 48, and 50 forming a rectangular beam, a set of iris shutters forming a polygonal shaped beam, and a set of leaves forming an irregularly shaped beam. Beam shaping structures, also known in the art as collimators, may be employed in various forms and may be manually or electronically controlled. In one embodiment, data collected during use of the device 20 is used to control the shape of the beam so that the x-ray dose may be given only to a precisely targeted space that may have some slight movement.
With reference to
Similar to the fluorescent target 26 of the device 22 illustrated in
With reference to
With reference to
Sometimes even with selection of the most preferable angle, it is not possible to eliminate substantial contamination by broadband bremsstrahlung radiation, and it is therefore desirable to use filters to remove the unwanted components of the spectrum. Such filters can be fabricated using the same high Z element as the anode 122. This has the advantage that the substantially monochromatic radiation will pass through the filter without significant absorption, while radiation at other energies is absorbed. When the target 122 includes more than high Z element, such filter can be fabricated using the same high Z elements as in target 122, or only one of these elements.
The devices and methods described herein are useful for therapeutic and diagnostic purposes. Moreover, the devices and methods may be used in an integrated system that both provides an image of the subject and administers a therapeutic x-ray dose to the subject based on data collected from the image. In addition to medical uses, the devices and methods may be useful in other areas wherein x-rays are employed such as with monochromatic x-ray crystallography, non-destructive testing of materials, security scanning of packages and cargo, screening of materials for contaminates, and evaluating the structural integrity of objects such as metal fatigue testing.
A fluorescent target comprised of a plate of either copper or zirconium was irradiated with a broadband x-ray beam from a Oldelft Simulix-HP/20T x-ray simulator. The broadband beam had an energy of 80 keV. The fluorescent plate was set at an angle of 45 degrees relative to the broadband x-ray beam. X-ray film, both ultra sensitive and conventional, were placed in a lead encased housing and situated in the path of the monochromatic x-ray beam emitted from the fluorescent target. The film was situated at a 45 degree angle relative to the fluorescent target.
As seen in
A standard electron gun of up to 70 keV energy is vacuum-fitted with a gadolinium-tungsten anode. The monochromatic X-ray photons (isotropically emitted) are harvested at a 90 degree or an oblique angle from the gadolinium-tungsten target in order to obtain a pristine narrowband photon beam. The relative thickness of gadolinium vs. tungsten is optimized using a Monte Carlo simulation. The goal of the Monte Carlo optimization is to achieve just enough tungsten 2p→1s photons (at 58-59 keV depending on fine structure splitting) to act as the trigger photon, which initiates the 1s photoionization in gadolinium (at 50.2 keV) in vivo, i.e., in the sample. Gadolinium is known to have enhanced uptake in tumors such as breast cancer. Another goal of such Monte Carlo optimization is to obtain sufficient flux of gadolinium characteristic photons to sustain the Auger emission engine in vivo. A recent Monte Carlo simulation run showed that the ratio (by number) of all fluorescent photons (average energy 45.6 keV) to incident electrons impinging on a gadolinium anode in the 90 degree geometry would be 0.00034% at 55 keV incident electron energy for a gadolinium target of 1 mm radius and 5 mm height, irradiating an area placed 1 cm away from the target. Using the nominal incident electron current of 6 mA, this would translate to 55.7 cGy/min of pristine fluorescent photons. This is sufficient for therapeutic purposes.
An electron gun of up to 120 keV energy is vacuum-fitted with a gold-depleted uranium anode. The uranium component of the composite anode target will fluoresce predominantly at 94-95 keV, whereas the gold component of the composite target will fluoresce predominantly at 66-67 keV. When this beam is made to impinge on cells, an animal or a human containing gold aggregates such as gold coating on coronary stents, or nanoparticles in specific regions (tumor, or suspicious area of uptake of targeted agents), the higher energy radiation packet at 94-95 keV will first ionize the K shell electron in gold, which requires 80.7 keV. The most likely event that follows is downward transition of an L shell electron in the ionized gold, causing release of 67-68 keV energy. This energy, being released in a high atomic number species with many orbital electrons, will likely lead to Auger electron emissions. The electrons from the Auger emission, will leave the gold atom, and travel about 1 micrometer to about 10 micrometers in the surrounding tissue before completely losing its energy. The damage to cell(s) along Auger electron's path is great, because the density of energy transfer per micrometer is much higher than regular electrons or photons, and would be similar to protons.
Similar to Example 3 above, a platinum and depleted uranium anode will create fluorescent monochromatic beams consisting of 94-95 keV and 65 keV packets. This beam is useful for imaging where and when platinum-based chemotherapy drugs are aggregated and how the drug is distributed throughout a malignant area; combining platinum-based chemotherapy drug with Auger radiation as described in Example 3 above to achieve synergistic effects of tumor cell kill.
In all cases, a certain portion of L→K energy release in vivo will lead not to Auger electron emission, but fluorescent photon emission. These fluorescent photons can be detected using X-ray imaging devices or spectrometer devices, as commonly practiced in radiology and X-ray astronomy, which serve as a fingerprint of where enhanced radiation effects are taking place in vivo. Thus the methodology embodied in the present invention can also be used to achieve in vivo imaging and image-guided therapy. In this respect, in vivo imaging is similar to nuclear medicine imaging applications but without the need for radiopharmaceuticals; the image-guided therapy method is directly imaging where therapy is concurrently taking effect, i.e., serves as a direct verification of the location and magnitude of dose deposition.
A variety of medical inventions have been tried for preventing restenosis at the site of stenting in coronary artery angioplasty or peripheral artery angioplasty. Radiation has been used prophylactically to reduce the chance of restenosis. However, radiation is difficult to deliver precisely while sparing adjacent critical organs (e.g., heart, lung) after stent placement, and therefore is commonly delivered during angioplasty catheterization via radioactive beads. With the methods and devices of the present invention, target the atomic number composition of the stent may be targeted to any desired radiation dose either immediately after angioplasty/stenting or any time afterwards to prevent restenosis. That is, a stent or scaffold that includes or is coated with a high Z element can be used to treat the cardiovascular disease. Preferred high Z elements for inclusion in the stent include gold or platinum. With a stent that includes at least one high Z element, doctors can use radiation with high rate of interaction with the high Z element to deposit sufficient dose locally to reduce and eliminate restenosis. Only blood vessels immediately adjacent to the stent will receive significant radiation, i.e., this methodology is “self-targeting” to the stent. There is currently no method to repeatedly treat re-occlusion of the stent (re-occlusion is a natural immune response of the body to the foreign object).
The present methods can be used in cancer radiation therapy, especially in conjunction with high atomic number contrast injection such as iodine, gadolinium, gold nanoparticles, or in combination with other chemotherapy drug administration such as Cisplatin, Carboplatin, Bromodeoxyuridine, iododeoxyuridine. It is readily appreciated that this list is not meant to be exhaustive; instead, rapid proliferation of new generations of tumor-targeting nanoparticles, monoclonal antibodies, or any other future inventions can be tagged or may already contain a high atomic number moiety. The process and method of the present invention are readily adaptable to any such high atomic number compounds simply by using an anode of that atomic element and one sufficiently heavier element easily chosen based on the principles expounded in the present invention. It is especially well suited to ablation of tumor vasculatures, which would shut down the supply of nutrients and energy to the tumor or small metastasis.
The present devices and methods can be useful with any diagnostic imaging that utilizes x-rays to decrease the dose administered to the patient. For example, with dental X-rays, the parotid gland, thyroid, facial tissue, tongue, oral cavity would all receive a lower dose of radiation. These soft tissue structures are prone to cancer development when exposed to X-rays ionizing radiation. The present invention by virtue of its monochromacity of X-rays permits excellent imaging at low exposures, because unlike broadband radiation, all photons are equally useful.
Aspects of the invention are useful with dual energy X-ray absorptiometry for measuring bone mineral density for such diagnostic applications as detecting osteoporosis. Current commercial systems employ two sets of broadband X-rays at different kVp to achieve differential imaging of the higher atomic number minerals in the bone. The present invention uses two or more discrete energies, which can be suitably chosen to differentiate and quantify various mineral distributions. The methods and devices described here provide a novel method for conducting dual energy X-ray absorptiometry.
Aspects of the invention are useful for mammography. Molybdenum or rhodium anodes are currently used in mammography X-ray machines, but not the simultaneous deployment of both elements in one image. Aspects of the present invention provide a plurality of anode elements and thus a plurality of discrete energies for achieving differential contrast of endogenous higher atomic number constituents in breast cancers which could prove extremely useful in breast cancer screening, as well as in screening for other types of cancers.
Imaging and therapy using monochromatic x-rays is also highly advantageous in optimizing a radiation dose a priori. The interaction of single-energy x-rays with the body and radio sensitized tumor can be more easily modeled with numerical simulations than that of broadband radiation. Monte Carlo simulation codes such as the open software code GEANT4 can be employed to simulate and compute more precisely the administered dose to tumor cells as opposed to intervening healthy tissue.
The Present application claims priority to U.S. Ser. No. 61/393,960 filed Oct. 18, 2010, the disclosure of which is hereby incorporated herein by reference in its entirety.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US11/56694 | 10/18/2011 | WO | 00 | 7/22/2013 |
Number | Date | Country | |
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61393960 | Oct 2010 | US |