Nanoparticle-based
radio-enhancement has the potential to improve
cancer cell eradication by augmenting the photoelectric cross-section
of targeted cancer cells relative to the healthy surroundings. Encouraging
results have been reported for various nanomaterials, including gold
and hafnia. However, the lack of scalable synthesis methods and comparative
studies is prohibitive to rationalized material design and hampers
translation of this promising cancer management strategy. Here, we
present a scalable (>100 g day–1) and sterile
alternative
to conventional batch synthesis of group IV metal oxides (TiO2, ZrO2, and HfO2), which yields near-monodisperse
ultrasmall metal oxide nanoparticles with radio-enhancement properties.
Access to group IV oxide nanoparticles, which solely differ in atomic
number but otherwise exhibit comparable morphologies, sizes, and surface
chemistries, enables the direct comparison of their radio-enhancement
properties to rationally guide material selection for optimal radio-enhancement
performance. We show that the metal oxide nanoparticles exhibit atomic-number-dependent
radio-enhancement in cancer cells (HT1080 and HeLa), which is attenuated
to baseline levels in normal fibroblasts (normal human dermal fibroblasts).
The observed radio-enhancement effects show excellent agreement with
physical dose enhancement and nanoparticle dosimetry calculations.
Direct benchmarking against gold nanoparticles, the current gold standard
in the field, rationalizes the use of hafnia nanoparticles based on
their radio-enhancement performance, which is superior to equi-sized
gold nanoparticles. Taken together, the competitive radio-enhancement
properties for near-monodisperse nanoparticles produced by scalable
and sterile flame spray synthesis offer a route to overcoming key
roadblocks in the translation of nanoparticle-based radio-enhancers.