Volume 21, Issue 1 (Paramedical Sciences and Military Health- Spring- 2026)
Paramedical Sciences and Military Health 2026, 21(1): 72-81 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Aghasizadeh S, Mohammadkarim A, Ghorbani M, Rajaeinejad M. High-Z Nanoparticles as Radiosensitizers for Dose Enhancement in HDR Brachytherapy: A Systematic Review of Monte Carlo Simulations with Ir-192, Co-60 and Yb-169 Radionuclides. Paramedical Sciences and Military Health 2026; 21 (1) :72-81
URL: http://jps.ajaums.ac.ir/article-1-514-en.html
URL: http://jps.ajaums.ac.ir/article-1-514-en.html
1- Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran.
2- Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran. & Department of Radiology, Faculty of Parmedicine, AJA University of Medical Sciences, Tehran, Iran. ,mohammadkarim.medphys@gmail.com
3- Cancer Epidemiology Research Center, AJA University of Medical Sciences, Tehran, Iran. & Department of Laboratory Sciences, School of Allied Medical Sciences, Research Center for Cancer Screening and Epidemiology, AJA University of Medical Sciences, Tehran, Iran.
4- Cancer Epidemiology Research Center, AJA University of Medical Sciences, Tehran, Iran.
2- Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran. & Department of Radiology, Faculty of Parmedicine, AJA University of Medical Sciences, Tehran, Iran. ,
3- Cancer Epidemiology Research Center, AJA University of Medical Sciences, Tehran, Iran. & Department of Laboratory Sciences, School of Allied Medical Sciences, Research Center for Cancer Screening and Epidemiology, AJA University of Medical Sciences, Tehran, Iran.
4- Cancer Epidemiology Research Center, AJA University of Medical Sciences, Tehran, Iran.
Abstract: (17 Views)
Introduction: High-dose-rate (HDR) brachytherapy is recognized as one of the most effective radiotherapy techniques for the treatment of localized tumors. However, tumor radioresistance and the limitations on increasing the does without damaging healthy tissues remain challenging. The use of high atomic number (high-Z) nanoparticles as radiosensitizers has emerged as a promising strategy to overcome these barriers.
Materials and Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive search was performed across major scientific databases to identify studies employing Monte Carlo simulations (e.g., MCNP, Geant4, ...) to evaluate the dose-enhancing effects of nanoparticles in HDR brachytherapy using Ir-192, Co-60, and Yb-169 sources.
Results: The findings revealed that bismuth (Z=83) and gold (Z=79) nanoparticles consistently produced the highest dose enhancement; whereas, lower-Z nanoparticles such as iron and titanium demonstrated negligible effects. Reported dose enhancement factors (DEF) ranged from 1.008 to 2.8, showing a strong positive correlation with nanoparticle concentration. Nevertheless, saturation and reduced efficiency were observed at very high concentrations. Nanoparticle size played a secondary but notable role, particularly with low-energy sources. A pronounced dependence of dose enhancement on source energy was confirmed. The greatest effect observed for Yb-169 and the least effect observed for Co-60 due to the dominance of Compton scattering at higher photon energies.
Conclusion: This systematic review demonstrates that combining high-Z nanoparticles, especially gold and bismuth, with low-energy HDR brachytherapy sources can significantly increase tumor dose without elevating dose to healthy tissues. These results highlight high-Z nanoparticles as a promising radiosensitization strategy for future cancer radiotherapy. However, further preclinical and clinical investigations are required to validate their efficacy and safety.
Materials and Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive search was performed across major scientific databases to identify studies employing Monte Carlo simulations (e.g., MCNP, Geant4, ...) to evaluate the dose-enhancing effects of nanoparticles in HDR brachytherapy using Ir-192, Co-60, and Yb-169 sources.
Results: The findings revealed that bismuth (Z=83) and gold (Z=79) nanoparticles consistently produced the highest dose enhancement; whereas, lower-Z nanoparticles such as iron and titanium demonstrated negligible effects. Reported dose enhancement factors (DEF) ranged from 1.008 to 2.8, showing a strong positive correlation with nanoparticle concentration. Nevertheless, saturation and reduced efficiency were observed at very high concentrations. Nanoparticle size played a secondary but notable role, particularly with low-energy sources. A pronounced dependence of dose enhancement on source energy was confirmed. The greatest effect observed for Yb-169 and the least effect observed for Co-60 due to the dominance of Compton scattering at higher photon energies.
Conclusion: This systematic review demonstrates that combining high-Z nanoparticles, especially gold and bismuth, with low-energy HDR brachytherapy sources can significantly increase tumor dose without elevating dose to healthy tissues. These results highlight high-Z nanoparticles as a promising radiosensitization strategy for future cancer radiotherapy. However, further preclinical and clinical investigations are required to validate their efficacy and safety.
Keywords: HDR brachytherapy, Nanoparticles, Dose enhancement factor, Monte Carlo simulation, Radiosensitizer
Type of Study: review |
Subject:
full articles
Received: 2025/12/27 | Accepted: 2026/02/24 | Published: 2026/03/10
Received: 2025/12/27 | Accepted: 2026/02/24 | Published: 2026/03/10
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
