Modern radiation therapy using highly automated linear accelerators is a complex process that maximizes doses to tumors and minimizes incident dose to normal tissues. Dosimeters can help determine the radiation dose delivered to target diseased tissue while minimizing damage to surrounding healthy tissue. However, existing dosimeters can be complex to fabricate, expensive, and cumbersome to operate. Here, we demonstrate studies of a liquid phase, visually evaluated plasmonic nanosensor that detects radiation doses commonly employed in fractionated radiotherapy (1-10 Gy) for tumor ablation. We accomplished this by employing ionizing radiation, in concert with templating lipid surfactant micelles, in order to convert colorless salt solutions of univalent gold ions (Au(1)) to maroon-colored dispersions of plasmonic gold nanoparticles. Differences in color intensities of nanoparticle dispersions were employed as quantitative indicators of the radiation dose. The nanoparticles thus formed were characterized using UV-vis absorbance spectroscopy, dynamic light scattering, and transmission electron microscopy. The role of lipid surfactants on nanoparticle formation was investigated by varying the chain lengths while maintaining the same headgroup and counterion; the effect of surfactant concentration on detection efficacy was also investigated. The plasmonic nanosensor was able to detect doses as low as 0.5 Gy and demonstrated a linear detection range of 0.5-2 Gy or 5-37 Gy depending on the concentration of the lipid surfactant employed. The plasmonic nanosensor was also able to detect radiation levels in anthropomorphic prostate phantoms when administered together with endorectal balloons, indicating its potential utility as a dosimeter in fractionated radiotherapy for prostate cancer. Taken together, our results indicate that this simple visible nanosensor has strong potential to be used as a dosimeter for validating delivered radiation doses in fractionated radiotherapies in a variety of clinical settings.

A key reason for the persistently grim statistics associated with metastatic ovarian cancer is resistance to conventional agents, including platinum-based chemotherapies. A major source of treatment failure is the high degree of genetic and molecular heterogeneity, which results from significant underlying genomic instability, as well as stromal and physical cues in the microenvironment. Ovarian cancer commonly disseminates via transcoelomic routes to distant sites, which is associated with the frequent production of malignant ascites, as well as the poorest prognosis. In addition to providing a cell and protein-rich environment for cancer growth and progression, ascitic fluid also confers physical stress on tumors. An understudied area in ovarian cancer research is the impact of fluid shear stress on treatment failure. Here, we investigate the effect of fluid shear stress on response to platinum-based chemotherapy and the modulation of molecular pathways associated with aggressive disease in a perfusion model for adherent 3D ovarian cancer nodules. Resistance to carboplatin is observed under flow with a concomitant increase in the expression and activation of the epidermal growth factor receptor (EGFR) as well as downstream signaling members mitogen-activated protein kinase/extracellular signal-regulated kinase (MEK) and extracellular signal-regulated kinase (ERK). The uptake of platinum by the 3D ovarian cancer nodules was significantly higher in flow cultures compared to static cultures. A downregulation of phospho-focal adhesion kinase (p-FAK), vinculin, and phospho-paxillin was observed following carboplatin treatment in both flow and static cultures. Interestingly, low-dose anti-EGFR photoimmunotherapy (PIT), a targeted photochemical modality, was found to be equally effective in ovarian tumors grown under flow and static conditions. These findings highlight the need to further develop PIT-based combinations that target the EGFR, and sensitize ovarian cancers to chemotherapy in the context of flow-induced shear stress. Keywords: ovarian cancer; epidermal growth factor receptor (EGFR); mitogen-activated protein kinase/extracellular signal-regulated kinase (MEK); extracellular signal-regulated kinase (ERK); chemoresistance; fluid shear stress; ascites; perfusion model; photoimmunotherapy (PIT); photodynamic therapy (PDT); carboplatin J. Clin. Med. 2020, 9, 924 3 of 27 anatomical structures [4,[27][28][29][30]]. An area that remains understudied is the effect of fluid shear stress on response to chemotherapy and the modulation of molecular pathways associated with aggressive disease [11,16,17,31]. J. Clin. Med. 2020, 9, x FOR PEER REVIEW 3 of 27 Figure 1. (A) A schematic of ovarian cancer metastases involving tumor cells or clusters (yellow) shedding from a primary site and disseminating along ascitic currents of peritoneal fluid (green arrows) in the abdominal cavity. Ovarian cancer typically disseminates in four common abdominopelvic sites: (1) cul-de-sac (an extension of the peritoneal cavity between the r...

Radiotherapy is a highly complex and efficient treatment modality for ablation of malignant tumors. Despite several technological advances, determination of the dose delivered to the tumor remains a challenge due to limitations of complex fabrication, cumbersome operation, and high costs associated with current dosimeters. Here, we describe fundamental studies and development of a novel gel-based colorimetric nanosensor for detecting therapeutic levels of X-rays (1-10 Gy) administered in clinical radiotherapy. Following exposure to X-rays, gold salts in the gel were converted to nanoparticles within the matrix, resulting in the formation of a maroon-colored plasmonic gel. Differences in color intensity of the gel following irradiation were used as a quantitative indicator of the radiation dose employed. The gelbased nanosensor was able to detect doses as low as 0.5 Gy, and demonstrated a linear detection range of 0 -3 Gy, which indicates its application in the fractionated radiotherapy regime. The gel was also able to successfully report therapeutic levels of radiation doses administered to anthropomorphic tissue phantoms. The range of detection, ease of fabrication, simplicity of colorimetric detection, and relatively lower costs indicate that this technology can be potentially translated to different radiotherapy applications in the clinic.

Ever since the discovery of radioactivity,b eneficial use of ionizing radiation has been pursued for the betterment of human health. In particular, fractionated radiotherapy is commonlyu sed in the clinic fora blation of malignant tumors. Use of higher radiation dose fractionsa nd complex dose trajectories necessitate measurements of radiation dose delivered to the target tissue and surrounding tissues in order to ensure patient safety.T raditional dosimeters including polymer gel dosimeters, radiochromic films and metal-oxide semiconductor field effect transistors (MOSFETs) suffer from limitations, whichc omplicate their day-to-day use in the clinic. Molecular and nanoscale systems offer great potentialf or the development of effective sensors of ionizingr adiation,w hich can lead to quantitative dosimeters in biological settings. Thisr eview discusses recent developments based on organic and inorganic molecular and nanoscale dosimeters including quantum dots,p olymers and plasmonic nanoparticles as platforms for radiation sensing. Potential advantages and challenges of translating these technologiestoc linical applicationsare also discussed.

Despite the emergence of sophisticated technologies in treatment planning and administration, routine determination of delivered radiation doses remains a challenge due to limitations associated with conventional dosimeters. Here, we describe a gel-based nanosensor for the colorimetric detection and quantification of topographical radiation dose profiles in radiotherapy. Exposure to ionizing radiation results in the conversion of gold ions in the gel to gold nanoparticles, which render a visual change in color in the gel due to their plasmonic properties. The intensity of color formed in the gel was used as a quantitative reporter of ionizing radiation. The gel nanosensor was used to detect complex topographical dose patterns including those administered to an anthropomorphic phantom and live canine patients undergoing clinical radiotherapy. The ease of fabrication, operation, rapid readout, colorimetric detection, and relatively low cost illustrate the translational potential of this technology for topographical dose mapping in radiotherapy applications in the clinic.