Evidence map›Paper›PMID 37364800›Full record

ArticleInternational journal of radiation oncology, biology, physics2023

FLASH Effects Induced by Orthovoltage X-Rays.

Devin Miles, Daniel Sforza, John W Wong, Kathleen Gabrielson, Khaled Aziz, Mahadevappa Mahesh, Jonathan B Coulter, Ismaeel Siddiqui, Phuoc T Tran, Akila N Viswanathan and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of radiation oncology, biology, physics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 28 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. A Feasibility Study of Preclinical Ocular X-Ray FLASH Radiation Therapy.International journal of radiation oncology, biology, physics · 2025
    Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge.International journal of molecular sciences · 2024
    Review
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Devin MilesDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Daniel SforzaDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
John W WongDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Kathleen GabrielsonDepartment of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Khaled AzizDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Mahadevappa MaheshDepartment of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Jonathan B CoulterDepartment of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ismaeel SiddiquiDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Phuoc T TranDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
Akila N ViswanathanDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Mohammad RezaeeDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: mrezaee1@jh.edu.
Johns Hopkins University · USUniversity of Maryland, Baltimore · US

Funding

Resource Sharing CoreU54CA273956 · NCI · UNIVERSITY OF MARYLAND BALTIMORE · PI Phuoc T. Tran · 2022 to 2026
$8.9M
Tumor-barcoding coupled with high-throughput sequencing of a novel chemoradiation resistant SCLC mouse modelU01CA231776 · NCI · JOHNS HOPKINS UNIVERSITY · PI HANN, CHRISTINE L., MARCHIONNI, LUIGI · 2018 to 2022
$3.9M
Integrating bioinformatics into multiscale models for hepatocellular carcinomaU01CA212007 · NCI · JOHNS HOPKINS UNIVERSITY · PI EWALD, ANDREW JOSEF, FERTIG, ELANA · 2018 to 2022
$3.2M
Tumor-barcoding coupled with high-throughput sequencing for quantitative radiogenomics of the abscopal response in NSCLCR01CA271540 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Phuoc T. Tran · 2023 to 2026
$2.3M
An ultra-high (FLASH) dose rate x-ray cabinet system for pre-clinical laboratory radiation researchR01CA262097 · NCI · JOHNS HOPKINS UNIVERSITY · PI REZAEE, MOHAMMAD · 2021 to 2024
$2.1M
NCI NIH HHS R01 CA262097NCI NIH HHS U01 CA231776
6 · The paper itself

Abstract

purposeThis work describes the first implementation and in vivo study of ultrahigh-dose-rate radiation (>37 Gy/s; FLASH) effects induced by kilovoltage (kV) x-ray from a rotating-anode x-ray source. METHODS AND MATERIALS: A high-capacity rotating-anode x-ray tube with an 80-kW generator was implemented for preclinical FLASH radiation research. A custom 3-dimensionally printed immobilization and positioning tool was developed for reproducible irradiation of a mouse hind limb. Calibrated Gafchromic (EBT3) film and thermoluminescent dosimeters (LiF:Mg,Ti) were used for in-phantom and in vivo dosimetry. Healthy FVB/N and FVBN/C57BL/6 outbred mice were irradiated on 1 hind leg to doses up to 43 Gy at FLASH (87 Gy/s) and conventional (CONV; <0.05 Gy/s) dose rates. The radiation doses were delivered using a single pulse with the widths up to 500 ms and 15 minutes at FLASH and CONV dose rates. Histologic assessment of radiation-induced skin damage was performed at 8 weeks posttreatment. Tumor growth suppression was assessed using a B16F10 flank tumor model in C57BL6J mice irradiated to 35 Gy at both FLASH and CONV dose rates.

resultsFLASH-irradiated mice experienced milder radiation-induced skin injuries than CONV-irradiated mice, visible by 4 weeks posttreatment. At 8 weeks posttreatment, normal tissue injury was significantly reduced in FLASH-irradiated animals compared with CONV-irradiated animals for histologic endpoints including inflammation, ulceration, hyperplasia, and fibrosis. No difference in tumor growth response was observed between FLASH and CONV irradiations at 35 Gy. The normal tissue sparing effects of FLASH irradiations were observed only for high-severity endpoint of ulceration at 43 Gy, which suggests the dependency of biologic endpoints to FLASH radiation dose.

conclusionsRotating-anode x-ray sources can achieve FLASH dose rates in a single pulse with dosimetric properties suitable for small-animal experiments. We observed FLASH normal tissue sparing of radiation toxicities in mouse skin irradiated at 35 Gy with no sacrifice to tumor growth suppression. This study highlights an accessible new modality for laboratory study of the FLASH effect.

Indexed as

NeoplasmsRadiation InjuriesAnimalsMiceMice, Inbred C57BLRadiographyRadiometryX-Rays

Identifiers

PMID37364800
PMCPMC11189000
OpenAlexW4381953048

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.