Use of ¹⁸F-BPA PET images and image registration to enhance radiation treatment planning for boron neutron capture therapy

Conventional radiation therapy coupled with chemotherapy and surgery has proven unsuccessful for Glioblastoma Multiforrne (GBM) patients. A binary treatment therapy such as boron neutron capture therapy (BNCT) may be promising. The Monte-Carlo based simulation environment for radiation therapy (SERA) software is used to simulate the dose administered to a patient undergoing BNCT. The boron concentration used to determine the boron component of the dose has been measured directly during surgery. Point sampling and averaging of the tumor tissue resulted in an estimate of a uniform boron concentration scaling factor of 3.5. This factor is used to scale the boron component of the dose linearly and homogenously within the tumor and target volumes. Current methods should be improved. The average dose to the tumor cells by such a method could be improved by better methods of quantifying the in-vivo boron biodistribution. A better method of determining the in-vivo IOB biodistribution includes radiolabeling para-Boronophenylalanine (p-BPA) with 18F and imaging the pharmaceutical using positron emission tomography (PET). This biodistribution of 18F-BPA can then be used to better predict the average dose delivered to the tumor and target regions.