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Research

Radiation Biophysics and Medical Physics

La Tessa Lab

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Investigator / Contact Person Chiara La Tessa, Ph.D.
Lab 305-243-4882
Office 305-243-4882
Email chiara.latessa@miami.edu

Core Research Technologies

Microdosimetry

At a scale comparable to a cell nucleus, where the biological damage induced by radiation occurs, the energy deposition is affected by stochastic fluctuations and cannot be accurately described with macroscopic mean values, such as the dose or the linear energy transfer (LET). Microdosimetry has been proposed as a methodology for characterizing radiation field quality in micrometer-sized volumes and represents the bridge between physical characteristics of the radiation and biological outcomes. It has been exploited by radiobiological models, such as the Microdosimetric Kinetic Model (MKM), for predicting cell survival and relative biological effectiveness (RBE). We are using microdosimetry to characterize the in- and out-of-field radiation field in particle therapy, and use it as a tool for assessing biological outcomes. We are also developing a new microdosimeter, which has unique features than existing detectors and will allow for a superior characterization of radiation quality in particle therapy.

Radiobiological Models

Radiobiological models for cell survival and RBE prediction are a key part of treatment planning systems (TPS) for calculating the dose delivered. An inaccurate determination of the RBE can lead to an underdosage to the tumor, limiting treatment success, or an overdosage to normal tissue, increasing the probability of complications. The main limitation shared by all existing models is the assumption that all variables follow a Poisson distribution and thus can be described by their mean. This assumption neglects stochastic fluctuations of energy deposition both from cell to cell and from dose fractionation (time variable), which can be especially significant in highly mixed radiation fields that occur at the beam edges and in the distal region. We have developed the general stochastic microdosimetry-based kinetic model (GSM2), that consider the stochastic behavior of both energy deposition and cell inactivation, providing the radiation response of the irradiated tissue, and predict both cell survival and RBE. We are currently conducting cell survival experiments here at the University of Miami Dwoskin Proton Therapy Center to validate GSM2. Cells are irradiated with known doses of proton radiation and cell survival is obtained. The survival is used to calculate the RBE, which is then compared to the model's predictions for validation.

Artificial Intelligence applied to Radiation Oncology

Among the major revolution of our century, artificial intelligence and data analysis are without any doubt among the most relevant. Machine and Deep Learning (ML and DL) models are nowadays systematically used in many fields. We recently started gaining interest in application of machine and deep learning techniques applied to medical physics and radiation oncology. We have implemented a machine learning model to track particles in microdosimetry to overcome experimental limitations of our new detector. We have also developed a fully machine and deep learning algorithm to predict biological effectiveness of a wide range of ions relevant both for radiotherapy and for radioprotection (ANAKIN).

Ongoing Projects

  • Normal Tissue Toxicities

    La Tessa’s lab focuses on understanding and reducing normal tissue toxicities associated with proton therapy. The current projects focus on sequela associated to the treatment of brain, head and neck, and breast cancers.

    Radiation necrosis is a serious late complication of brain radiation therapy, potentially leading to debilitating symptoms such as headaches, seizures, cognitive dysfunction, and speech or vision deficits. Our research aims to identify both clinical and dosimetric predictors of necrosis and to explore its association with cognitive decline using advanced modeling approaches. In addition, we study the temporal evolution of radiation necrosis to better understand its onset and progression over time. By integrating these insights, we aim to develop a predictive model that assess individual risk and support more proactive, personalized strategies for patient management and care.

    Oral mucositis and xerostomia are among the most common and debilitating side effects of radiation therapy for head and neck cancers. Oral mucositis involves inflammation of the mucosal lining, which can lead to painful ulcers, while xerostomia results from reduced salivary gland function, causing chronic dry mouth. These toxicities can compromise treatment adherence and significantly diminish patients’ quality of life. Our lab investigates how key dosimetric metrics and radiation quality parameters influence the development of these toxicities. By integrating clinical data with advanced modeling techniques, we aim to develop comprehensive risk prediction models to better personalize treatment planning and ultimately reduce the incidence of the adverse effects.

    Skin toxicity is a frequent side effect in breast cancer patients undergoing radiation therapy, ranging from mild erythema to severe desquamation. While often considered less life-threatening, these reactions can cause significant discomfort, limit treatment continuity, and affect cosmetic outcomes. Our research aims to characterize the clinical and dosimetric factors associated with skin toxicity in proton therapy, with the goal of developing predictive models that inform treatment planning and minimize patient burden.

  • Treatment Plan Optimization

    The current clinical practice assumes a constant RBE, disregarding any dependence on dose, radiation quality and biological endpoint, and might results in an incorrect estimate of the dose delivered during treatment, especially to normal tissue. Taking advantage of our new models (GSM2 and ANAKIN), we are working to implement variable RBE into commercial TPS. Furthermore, we are developing machine learning-based normal tissue complications probability (NTCP) models for various toxicities, which can be also implemented into TPSs to assess the risk of complications for individual patients, and further optimize the dose plans to reduce complications.
  • Treatment Plan Verification

    To further improve treatment effectiveness, we are investigating a new approach to monitor in-patient proton range. TPS rely on imaging approaches to locate tumors, but there are sizable uncertainties at the time of irradiation due to anatomical modifications, patient alignment, beam delivery and dose calculation. A mispositioning potentially translates into an under-dosage of the tumor as well as an over-dosage of the normal tissue, which can significantly hinder treatment efficacy. We developed a novel strategy for real-time range and dose verification. The methodology is based on the detection of prompt gammas, whose production is enhanced with a non-radioactive element transported selectively to the tumor with a drug carrier. Nuclear interactions of this element with protons generate a signature gamma spectrum, whose intensity is correlated with beam range, and from which the tumor position can be reconstructed.

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