We apply functional and molecular imaging techniques to developing radiotherapy personalised to each patients’ individual tumour biology.
Medical imaging has for a long time played an absolutely central role in radiotherapy. Radiation treatments are carefully planned using patient-specific information from x-ray computed tomography (CT). An accurate 3D computer model of each patient’s anatomy is made using the CT data, with the tumour and surrounding normal organs carefully identified. Radiation treatments are then designed and simulated by computer before being delivered in the clinic. Advances in magnetic resonance imaging (MRI) and positron emission tomography (PET) now enables us to map not just patient anatomy but also physiological function, giving important information about the biochemistry of tumours as well as their physical characteristics (size and location).
For example, we know that regions of tumours that have low oxygen levels (hypoxic) are often resistant to both radiotherapy and chemotherapy. By imaging hypoxic tumour regions we can monitor response to therapy and, for patients who do not appear to be responding to treatment, either escalate radiation dose or add a hypoxia-modifying drug (or both). Dynamic contrast-enhanced (DCE) and diffusion-weighted MRI can be used to map blood flow and perfusion and/or diffusion properties in tissue, telling us about oxygen supply. PET can be used to map glucose metabolism using positron emitting radionuclides such as fluorine-18 labelled fluorodeoxyglucose (18F-FDG) and hypoxia using fluoromisonidazole (18F-FMISO).
In close collaboration with radiation oncologists within the Department of Oncology and the Churchill Hospital, we are planning, conducting and analysing a range of clinical trials acquiring a range of functional imaging (18F-FMISO and 18F-FDG PET, DCE MRI and perfusion CT) for a number of diseases including rectal, anal, pancreatic and oesophageal cancer. Data from these trials is being used to learn which imaging modality (or combination) gives the most useful information for either guiding individual patient treatments or for monitoring biological response during therapy, allowing treatments to be adapted to optimise response based on the biological profile of individual patients.
(In collaboration with Dr Samantha Warren & Dr Maria Hawkins)
Mike Partridge has been a Senior Group Leader of the Radiotherapy Physics Research Group at the CRUK/MRC Oxford Institute for Radiation Oncology within the Department of Oncology since 2012. He is a Fellow of the Institute of Physics. He has been working in medical imaging and radiotherapy research since 1999. He studied Natural Sciences at Cambridge University and obtained a PhD in imaging at Cranfield University before working as a postdoctoral scientist at the Institute of Cancer Research and The Royal Marsden Hospital in London, and at the German Cancer Research Centre in Heidelberg.
DR Grimes C Kelly, K Bloch & M Partridge, “A method for estimating oxygen consumption rate in multicellular tumour spheroids” J. R. Soc. Interface 11:20131124 (2014)
S Warren, M Partridge, R Carrington, C Hurt, T Crosby, and MA Hawkins, “Radiobiological determination of dose escalation and normal tissue toxicity in definitive chemoradiotherpy for oesophageal cancer” Int J Radiation Oncol Biol Phys 90 423–429 (2014)
J Wilson, M Partridge, MA Hawkins, “The application of functional imaging techniques to personalise chemoradiotherapy in upper gastrointestinal malignancies”, Clinical Oncology 26 581–596 (2014)
J Wilson, S Mukherjee, K-Ye Chu, TB Brunner, M Partridge and M Hawkins, “Challenges in using 18F-fluorodeoxyglucose-PET-CT to define a biological radiotherapy boost volume in locally advanced pancreatic cancer” Radiation Oncology 2014, 9:146 doi:10.1186/1748-717X-9-146
TB Brunner, U Nestle, A-L Grosu and M Partridge, “SBRT in pancreatic cancer: What is the therapeutic window?” Radiother Oncol (2014) View report.
Daniel Bulte, Postdoctoral Researcher
Brian Burns, Postdoctoral Researcher
David Grimes, Postdoctoral Researcher
Marcin Paczkowski, DPhil Student
Tanuj Puri, Postdoctoral Researcher
Daniel Warren, Postdoctoral Researcher
Samantha Warren, Postdoctoral Researcher