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Nanoparticles have proven to be biocompatible and suitable for many biomedical applications. Currently, hyperthermia cancer treatments based on Fe nanoparticle infusion excited by alternating magnetic fields are commonly used. In addition to this, MRI-based image-guided radiotherapy represents, nowadays, one of the most promising accurate radiotherapy modalities. Hence, assessing the feasibility of combining both techniques requires preliminary characterization of the corresponding dosimetry effects. The present work reports on a theoretical and numerical simulation feasibility study aimed at pointing out preliminary dosimetry issues. Spatial dose distributions incorporating magnetic nanoparticles in MRI-based image-guided radiotherapy have been obtained by Monte Carlo simulation approaches accounting for all relevant radiation interaction properties as well as charged particles coupling with strong external magnetic fields, which are representative of typical MRI-LINAC devices. Two main effects have been evidenced: local dose enhancement (up to 60% at local level) within the infused volume, and non-negligible changes in the dose distribution at the interfaces between different tissues, developing to over 70% for low-density anatomical cavities. Moreover, cellular uptakes up to 10% have been modeled by means of considering different Fe nanoparticle concentrations. A theoretical temperature-dependent model for the thermal enhancement ratio (TER) has been used to account for radiosensitization due to hyperthermia. The outcomes demonstrated the reliability of the Monte Carlo approach in accounting for strong magnetic fields and mass distributions from patient-specific anatomy CT scans to assess dose distributions in MRI-based image-guided radiotherapy combined with magnetic nanoparticles, while the hyperthermic radiosensitization provides further and synergic contributions.

Both analytical and numerical methods have proven to be suitable for describing radiation transport and interactions. The standard Boltzmann formalism derived from statistical mechanics requires to be specifically re-formulated to account for the interactions with external electromagnetic fields. Verifying the proper implementation of the external electromagnetic field coupling in Monte Carlo simulation codes is a key issue to confirm the feasibility of using such a tool to describe complex applications like image-guided radiotherapy based on integrating magnetic resonance scanner to the radiant field of ionizing radiation along with the subsequent dosimetric effects. The present work reports on the feasibility and reliability of the Monte Carlo FLUKA and PENELOPE main codes to assess electron trajectory in presence of strong magnetic fields. The obtained results confirm the ability of FLUKA and Penelope to model the alterations in the electron trajectories due to external magnetic field effects, also demonstrating an excellent agreement between both codes and with the theoretical-analytical model.

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