La radiothérapie moderne combine les techniques complexes et les traitements personnalisés, avec le risque que certaines évolutions et erreurs ayant lieu au cours de traitement passent inaperçues. Ces aléas peuvent entraîner des conséquences graves pour la santé du patient. Dans cette perspective, nous avons étudié le potentiel d'un système de dosimétrie in vivo de transit pour le suivi continu du patient et, par conséquent, la radiothérapie adaptative. L'expérience clinique et des tests de faisabilité ont permis de définir les axes de travail principaux: l'automatisation et la simplification du procédé d'analyse des contrôles. Les développements incluent la création d'une bibliothèque de données standard et une série d'analyses de causes racines, permettant ainsi de renforcer la précision du système, d'améliorer l'automatisation de sa mise en place et d'identifier des pistes pour une analyse efficace des résultats et pour la création d'outils supplémentaires facilitant le suivi et l'adaptation du traitement en routine clinique. / Modern radiation therapy combines complex techniques and personalized treatments, with the risk that certain evolutions and errors occurring during the course of the treatment might go unnoticed. These fluctuations may cause great damage to the health of the patient. In this perspective, we worked on the potential of a transit in vivo dosimetry system for continuous monitoring of the patient and, hereafter, adaptive radiotherapy. Our clinical experience and feasibility testing determined the main lines of work : automatization and simplification of the results analysis method. The developments included the creation of a golden data library and a series of root cause analyzes, allowing us to strengthen the accuracy of the system, to enhance the automatization of the setup and to identify tracks for an efficient analysis of the results and for the creation of additional analytical tools to facilitate the monitoring and adaptation of the treatments in clinical routine.

No Brasil, para fins de planejamento de barreiras físicas em instalações radiográficas ou para a verificação dos níveis de restrição de dose em levantamentos radiométricos, deve ser usada a grandeza operacional equivalente de dose ambiente. Na prática, os monitores de radiação utilizados em proteção radiológica apresentam suas leituras na grandeza dosimétrica kerma no ar. Portanto, é preciso utilizar um coeficiente que converta esta grandeza dosimétrica na grandeza operacional recomendada. As normas nacionais estabelecem que o coeficiente de conversão no valor de 1,14 Sv/Gy deve ser usado para realizar esta operação, desconsiderando a diferença na distribuição espectral dos fótons dos feixes de raios X comumente encontrados em salas de radiologia convencional. O presente trabalho tem por objetivo determinar os coeficientes de conversão considerando a distribuição espectral da radiação secundária e secundária transmitida através de placas de argamassa baritada. Para atingir os objetivos propostos, foi desenvolvida uma metodologia experimental para as medições dos espectros das radiações secundárias e secundárias transmitidas usando um sistema espectroscópico com detector de CdTe e uma câmara de ionização de 1800 cm3. A região torácica de um objeto simulador antropomórfico, RANDO® Man, foi usada como região espalhadora. Foram utilizadas tensões no tubo entre 40 kV e 150 kV com intervalos na tensão de 10 kV. Os ângulos de espalhamento foram de 30°, 60°, 90° 120° e 150° em relação ao eixo do feixe primário. Como atenuador da radiação secundária foram utilizadas placas de argamassa baritada com espessuras de aproximadamente 10, 15, 20 e 25 mm. Os resultados mostram que, para a radiação secundária, os coeficientes de conversão são maiores que o valor estabelecido no Brasil. Num exemplo típico de levantamento radiométrico, a estimativa do equivalente de dose ambiente determinado usando o coeficiente de conversão calculado a partir dos espectros resultou em um valor cerca de 40 % superior ao equivalente de dose ambiente calculado a partir do coeficiente adotado pela norma nacional. / In Brazil, for planning purposes of the physical barriers in a radiographic installation and for levels verification of dose restriction in radiometric surveys, the ambient dose equivalent operational quantity should be used. In practice, radiation monitors used in radiation protection, are calibrated in dosimetry quantity air kerma. Therefore, it is important to use a conversion coefficient, which turns this dosimetric quantity into a recommended operational quantity. The rules followed in Brazil still establish that the value of the conversion coefficient, 1.14 Sv/Gy, must be used in area monitoring, disregarding differences between the beam types with different photon spectral distribution, commonly found in conventional radiology rooms. Consequently, this work aims to determine the conversion coefficients considering the spectral distribution of the secondary radiation and secondary-transmitted radiation through barium mortar plates. To achieve the proposed objectives, it has been developed an experimental method for measurement of secondary and secondary transmitted spectra using a spectroscopic system with CdTe detector and an ionization chamber 1800 cm3. The thoracic region of an anthropomorphic phantom, RANDO® Man, was used as a scatter region. The voltages used began 40 kV up to 150 kV in displacements of 10 kV, the scattering angles were 30°, 60°, 90° 120° and 150° with respect to the axis of the primary beam. As attenuator object of the secondary radiation was used barium mortar plates with thicknesses of 10, 15, 20 and 25 mm approximately. The results show that for the secondary radiation, the conversion coefficients are greater than the value set in Brazil. In a typical example of radiometric survey, the estimated ambient dose equivalent using the conversion coefficient calculated from the spectra, is a 40% higher compared to the value obtained using the coefficient recommended in Brazil.

Neste trabalho foi desenvolvido um sistema on-line para a avaliação de doses fetais em radiologia diagnóstica, chamado Dose Fetal Web. A metodologia empregada no sistema estima a dose fetal a partir de dados referentes a exames radiológicos realizados pela paciente gestante, ou a partir da monitoração pessoal de uma IOE gestante. Os dados de entrada deste programa são associados às tabelas de coeficientes de conversão de dose uterina para dose fetal, NUD, geradas por meio de simulações pelo método de Monte Carlo. Este sistema incorpora informações de operação de equipamentos de hospitais e clínicas radiológicas acompanhados por um programa de garantia de qualidade, bem como dados reais de parâmetros fetais e maternos coletados durante exames de ultra-sonografia obstétrica. A dose fetal médica, a dose fetal ocupacional e os riscos radiológicos associados a estas exposições foram avaliados por meio de estudos de casos simulados usando o sistema on-line. No caso hipotético de uma gestante ocupacionalmente exposta (IOE), foi avaliada uma base de dados reais de serviços de hemodinâmica. Além disso, a distribuição de cargas de trabalho de salas de cateterismo cardíaco foi incorporada ao modelo matemático. Estas duas metodologias foram implementadas na avaliação da dose fetal ocupacional, a fim de avaliar estes casos particulares de exposição, que oferecem níveis mais altos de doses ocupacionais aos profissionais expostos. / In this work, an online system called Dose Fetal Web was developed for the evaluation of fetal doses in diagnostic radiology. The methodology used in this system estimates the fetal dose from data related to radiologic diagnostic examinations of a pregnant patient, or from the routine individual monitoring dosimetry of a pregnant worker. The input data of this program are associated to the conversion-coefficients tables of uterine to fetal dose, NUD, generated by means of Monte Carlo simulations. This system incorporates operational information of equipment in hospitals and radiological facilities which are attended by a quality assurance program, as well as real maternal and fetal parameter data collected during obstetric ultrasound.The fetal dose from both medical and occupational exposures of the pregnant woman, as well as the risks associated with these exposures, were evaluated by means of simulated case studies using the on-line system. In the hypothetical case of an occupationally-exposed pregnant worker, a real database regarding routine individual monitoring dosimetry in Cath Lab facilities was evaluated. Moreover, the workload spectrum of a cardiac angiographic room was incorporated into the mathematical model. These two methodologies were used in the evaluation of the occupational fetal dose, in order to evaluate these particular cases of exposure, which offer higher occupational dose levels to the exposed staff.

Desde o seu desenvolvimento na década de 1970 a tomografia computadorizada (TC) passou por grandes mudanças tecnológicas, tornando-se uma importante ferramenta diagnóstica para a medicina. Consequentemente o papel da TC em diagnóstico por imagem expandiu-se rapidamente, principalmente devido a melhorias na qualidade da imagem e tempo de aquisição. A dose de radiação recebida por pacientes devido a tais procedimentos vem ganhando atenção, levando a comunidade científica e os fabricantes a trabalharem juntos em direção a determinação e otimização de doses. Nas últimas décadas muitas metodologias para dosimetria em pacientes têm sido propostas, baseadas especialmente em cálculos utilizando a técnica Monte Carlo ou medições experimentais com objetos simuladores e dosímetros. A possibilidade de medições in vivo também está sendo investigada. Atualmente as principais técnicas para a otimização da dose incluem redução e/ou modulação da corrente anódica. O presente trabalho propõe uma metodologia experimental para estimativa de doses absorvidas pelos pulmões devido a protocolos clínicos de TC, usando um objeto simulador antropomórfico adulto e dosímetros termoluminescentes de Fluoreto de Lítio (LiF). Sete protocolos clínicos diferentes foram selecionados, com base em sua relevância com respeito à otimização de dose e frequência na rotina clínica de dois hospitais de grande porte: Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad) e Instituto do Câncer do Estado de São Paulo Octávio Frias de Oliveira (ICESP). Quatro protocolos de otimização de dose foram analisados: Auto mA, Auto + Smart mA, Baixa Dose (BD) e Ultra Baixa Dose (UBD). Os dois primeiros protocolos supracitados buscam redução de dose por meio de modulação da corrente anódica, enquanto os protocolos BD e UBD propõem a redução do valor da corrente anódica, mantendo-a constante. Os protocolos BD e UBD proporcionaram redução de dose de 72,7(8) % e 91(1) %, respectivamente; 16,8(1,3) % e 35,0(1,2) % de redução de dose foram obtidas com os protocolos Auto mA e Auto + Smart mA, respectivamente. As estimativas de dose para os protocolos analisados neste estudo são compatíveis com estudos similares publicados na literatura, demonstrando a eficiência da metodologia para o cálculo de doses absorvidas no pulmão. Sua aplicabilidade pode ser estendida a diferentes órgãos, diferentes protocolos de CT e diferentes tipos de objetos simuladores antropomórficos (pediátricos, por exemplo). Por fim, a comparação entre os valores de doses estimadas para os pulmões e valores de estimativas de doses dependentes do tamanho (Size Specific Dose Estimates SSDE) demonstrou dependência linear entre as duas grandezas. Resultados de estudos similares exibiram comportamentos similares para doses no reto, sugerindo que doses absorvidas pelos uma órgãos podem ser linearmente dependente dos valores de SSDE, com coeficientes lineares específicos para cada órgão. Uma investigação mais aprofundada sobre doses em órgãos é necessária para avaliar essa hipótese. / Since its development in 1970s the computer tomography (CT) technique have gone through major technological advances, becoming an important diagnostic tool in medicine. Consequently the role of CT in diagnostic imaging expanded rapidly, mainly due to improvements in image quality and speed of acquisition. The radiation dose imparted in patients undergoing CT scans has gained attention, leading the radiology community (radiologists, medical physicists and manufacturers) to work together towards dose estimation and optimization. New methodologies for patients dosimetry have been proposed in the past decades, based specially on Monte Carlo calculations or experimental measurements with phantoms and dosimeters. In vivo methodologies are also under investigation. Current dose optimization strategies include mainly tube current reduction and/or tube current modulation. The present work proposes a methodology to experimentally estimate lung absorbed doses due to clinical CT protocols using an adult anthropomorphic phantom and Lithium Fluorite (LiF) thermoluminescent dosimeters (TLD). Seven clinical protocols were selected for phantom irradiation, based on their relevance regarding dose optimization and frequency in two major hospitals routine: the Institute of Radiology from the Medical Faculty from the University of São Paulo (Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo InRad) and the Cancer Institute of the State of São Paulo Octávio Frias de Oliveira (Instituto do Câncer do Estado de São Paulo Octávio Frias de Oliveira ICESP). Fours thorax protocols for dose optimization were analyzed: Auto mA, Auto + Smart mA, Low Dose (LD) and Ultra Low Dose (ULD) thorax. The first two aforementioned protocols seek dose reduction by tube current modulation, while the last two propose a decrease on the constant tube current value. Values of 72.9(8) % and 91(1) % of lung dose reduction were achieved with LD and ULD protocols, respectively. Auto mA and Auto + Smart mA provided 16.8(1.3) % and 35.0(1.2) % of lung dose reduction, respectively. The results from all analyzed protocols are compatible with similar studies published in literature, demonstrating the efficiency of the methodology to lung absorbed dose estimation. Its applicability could be extended to different organs, different clinical CT protocols and pediatric phantoms. Moreover, comparison of lung absorbed doses and Size Specific Dose Estimates (SSDE) for the studied protocols exhibited a tendency of linear dependency. Results from similar studies demonstrate a similar behavior between rectal doses and SSDE, suggesting that organ absorbed doses and SSDE values may be linearly dependent, with organ-specific linear coefficients. Further investigation in organ doses is necessary to evaluate this assumption.

O desenvolvimento da tecnologia de tomografia computadorizada (TC) trouxe maiores possibilidades em medicina diagnóstica. É um método não invasivo de se explorar o corpo humano detalhadamente. Com o aumento das aplicações em TC, aumenta a preocupação com as altas taxas de dose administradas quando comparada com outras modalidades de diagnóstico por imagem. A comunidade científica e os fabricantes uniram esforços para alcançar níveis menores de dose possíveis, sem comprometer a qualidade da imagem diagnóstica. O maior e relativamente novo avanço nessa busca para diminuir os níveis de dose é o controle automático de exposição (CAE) em TC. Esses sistemas foram projetados para ponderar a distribuição de dose ao longo do comprimento de varredura e entre pacientes, levando em consideração o tamanho e as diferentes densidades de tecidos irradiados. Baseando-se na geometria de aquisição em TC, os sistemas CAE são altamente complexos. Sendo assim, sua forma de funcionamento ainda não é inteiramente conhecida. O presente trabalho tem como objetivo avaliar o desempenho clínico dos sistemas CAE, suas susceptibilidades ao usuário e, com isso, ajudar na otimização de dose em pacientes. A abordagem utilizada para avaliar os sistemas CAE de três dos maiores fabricantes de TC no Brasil, General Electric, Philips e Toshiba, foi pela extração dos valores de corrente anódica do cabeçalho da sequência de imagens no padrão DICOM, medição e análise do ruído das imagens dessas sequências e a medição da distribuição da dose ao longo do comprimento de varredura nas superfícies e dentro de dois simuladores de paciente de formatos diferentes. A variação da corrente anódica de cada equipamento de TC associada à qualidade da imagem resultante fornece o desempenho do sistema CAE. As medições de distribuição de dose fornecem o perfil de dose resultante da modulação de corrente. Medições com e sem o sistema CAE acionado foram feitas para quantificar a importância em termos de dose desses sistemas. Os resultados obtidos permitem otimizações no uso dos sistemas CAE e, consequentemente, a redução da dose no paciente sem comprometer a qualidade diagnóstica da imagem. / The development of the computed tomography (CT) technology has brought wider possibilities on diagnostic medicine. It is a non-invasive method to see the human body in details. As the CT application increases, it raises the concern about patient dose, because the higher dose levels imparted compared to other diagnostic imaging modalities. The radiology community (radiologists, medical physicists and manufacturer) are working together to find the lowest dose level possible, without compromising the diagnostic image quality. The greatest and relatively new advance to lower the patient dose is the automatic exposure control (AEC) systems in CT. These systems are designed to ponder the dose distribution along the patient scanning and between patients taking into account their sizes and irradiated tissue densities. Based on the CT scanning geometry, the AEC-systems are very complex and their functioning is yet not fully understood. This work aims to evaluate the clinical performance of AEC-systems and their susceptibilities to assist on possible patient dose optimizations. The approach to evaluate the AEC-systems of three of the leading CT manufacturers in Brazil, General Electric, Philips and Toshiba, was the extraction of tube current modulation data from the DICOM standard image sequences, measurement and analysis of the image noise of those image sequences and measurement of the dose distribution along the scan length on the surface and inside of two different phantoms configurations. The tube current modulation of each CT scanner associated to the resulted image quality provides the performance of the AEC-system. The dose distribution measurements provide the dose profile due to the tube current modulation. Dose measurements with the AEC-system ON and OFF were made to quantify the impact of these systems regarding patient dose. The results attained give rise to optimizations on the AEC-systems applications and, by consequence, decreases the patient dose without compromising the diagnostic image quality.

Computed Tomography (CT) is a modality of radiodiagnostic that represents only 15% of the medical procedures performed in this field, nonetheless, this technique contributes with 50% of the collective dose. Procedures that delivers high doses, such as CT, need to be administered under a strict protocol of quality control (QC), because there will always be risks to the health of the patients when they are submitted to high dose exams. From this scenario, the necessity of evaluate the parameters of the X ray beam which the patient is rising; one of the main parameters to be monitored is the dose delivered by the CT exam. It is impossible to perform QC tests in a patient, that is why objects that simulates the attenuation profile of some part of the human body are used. In this specific research, the goal was the construction of a human head phantom. This phantom were built from easy access materials with the goal to be more financially advantageous to use it than its internationals competitors, hence it was spent only U$ 160.00 on its construction. International phantom prices can be more than U$ 4,600.00. Among the analyzed materials in this research, dolomite and polymethyl methacrylate (PMMA) were chose to manufacture the phantom, due its measurements of linear attenuation coefficients (m/) in different proportions, it was decided that dolomite and PMMA in a 1:1 proportion attenuates the X ray beam like the reference material (bone). Dosimetric studies were made in the phantom using an ionization chamber. Its results showed that the effective dose estimative in the dolomite phantom is (2.70 + 0.03) mSv and in the CTDI phantom is (3.67 + 0.04) mSv. Effective dose estimatives found in the literature for head computed tomography exams are in the range of 0.9 – 4.0 mSv. Effective dose measured with the phantom developed in this research are within this range. / A tomografia computadorizada (CT) é uma modalidade do radiodiagnóstico que representa aproximadamente 15% do total dos procedimentos médicos realizados nesta área, entretanto, esta técnica contribui com cerca de 50% da dose coletiva. Procedimentos que depositam altas doses, tais como a CT, devem passar por rigorosos testes de controle de qualidade (CQ), uma vez que sempre há riscos para a saúde do paciente quando ele é submetido a exames com doses elevadas. Daí surge a necessidade de avaliar os parâmetros do feixe de raios X aos quais o paciente está sendo submetido; um dos principais a ser monitorado é a dose a que se está expondo-o ao se realizar um exame CT. A realização dos testes de CQ em pacientes é inviável, por isso, são utilizados objetos simuladores que tentam replicar o perfil de atenuação de alguma parte do corpo humano. No caso específico desse trabalho, o objetivo foi a construção de um objeto simulador (ou phantom) da cabeça humana. Este phantom foi construído com materiais de fácil acesso para que ficasse mais vantajoso financeiramente quando comparado com seus concorrentes internacionais, uma vez que foram gastos apenas R$ 350,00 na sua confecção. Os objetos simuladores importados podem chegar a custar até mais de R$ 10.000,00. Dentre os materiais analisados neste trabalho, foram escolhidos, para serem usados na confecção do phantom, a dolomita e polímero de metilmetacrilato (PMMA). Tendo em vista os resultados das medidas de coeficientes de atenuação mássico (m/) desses materiais em diferentes proporções, foi definido que em uma proporção em massa de 1:1 entre a dolomita e a resina acrílica, o perfil de atenuação de raios X do objeto simulador se aproxima com o da referência (osso). Estudos dosimétricos foram feitos no objeto simulador usando uma câmara de ionização. Seus resultados mostraram que a estimativa de dose efetiva para o objeto simulador de dolomita é de (2,70 + 0,03) mSv e para o geométrico de acrílico é de (3,67 + 0,04) mSv. Os valores para dose efetiva encontrados na literatura sugerem que exames da cabeça de tomografia computadorizada estão em um intervalo de 0,9 – 4,0 mSv. As doses efetivas obtidas com o objeto simulador desenvolvido por esta pesquisa citadas anteriormente, encontram-se dentro desse intervalo.

<p>Radiation-induced lung injury (RILI) is a common condition in the setting of lung and breast cancer. Often, patients who suffer from RILI experience pneumonitis and pulmonary fibrosis months after treatment. These pathologies have commonly been modeled using mice and observing their deterioration until mortality and quantifying pathology on histological sections.<b> </b></p> <p>With this study, we used a longitudinal microCT and a 7T MRI to characterize male C57Bl/6 mice irradiated with a single dose of 20 Gy to the whole thoracic area delivered by an X-Rad cabinent irradiator. CT was performed with a respiratory gating sequence at 2 week timepoints to construct an RIPF model. The fraction of RIPF to total lung volume was calculated at each time point from images, and the data was anaylzed using one-way ANOVA Welch and Dunnett’s T3 multiple comparisons tests. Tidal lung volumes were also calculated and anlyazed in a simlar manner. Mice were then imaged using MRI and CT at 0, 5, and 8 week timepoints to compare results. These results were analyzed for comparison (ANOVA and Dunnett’s T3) and correlation (Pearson’s r) with each other. Histology was later performed using H&E and Trichrome stains to provide ex-vivo verification of pathology.<b> </b>At the 10-12 week time point ( ) significant RIPF formed. Weeks proceeding showed increased significance until the 22+ week timepoint, which showed less statistical significance ( ) due to increased variance at this timepoint. Dunnett’s T3 test showed no significant differences between tidal lung volumes over time. Tests also showed no significant differences between CT and MRI results with a correlation coefficient of .<b> </b>Early in the study, problems arose when pre-marture mortality was occurring to a significant portion of our subjects. Analysis later showed issues during irradiation that resulted in significant dose being absorbed by the stomach. Adjusting our shiedling lead to increased early survival of our subjects enabling us to contine our study. Significant RIPF development was not significant until 10-12 weeks post-irradiation, then RIPF became more severe at proceeding timepoints. Tidal lung volume showed no significant deviation over the development of RIPF. This result is most likely affected by the variation of results at later timepoints, since several mice with severe RIPF were significantly hindered in their ability to breathe during the study. MRI results showed close correlation with CT results and prodcued similar values at early timepoints. However, noticeable differences were seen at later timepoints when significant RIPF developed ( ). <b></b></p>

Significant discrepancies had been identified by many research groups world wide between calculated and measured neutron doses from the ⁷Li(p,n) accelerator based neutron source, and therefore precise characterization of the source was needed. In this work neutron spectra from the ⁷Li(p,n) source were measured with a ³He ion chamber in the incident proton energy range from 1.95 to 2.3 MeV. The ³He detector is hypersensitive to slow neutrons, so a time-of-flight based slow neutron rejection acquisition system was built and tested. The system is based on an electrostatic proton chopper and an acquisition system working on coincidence mode. The response function of the ³He was extended down to 30 keV neutron energy and the collected neutron spectra were unfolded using two methods: van Cittert iterative algorithm with Jansson constraint, and a regularized constrained inversion. Theoretical neutron spectra emitted by the ⁷Li(p,n) source were calculated and compared with experimental unfolded spectra, as well as with results of the Monte Carlo simulations of the lithium target assembly and the walls of the experimental area. Using fluence to kerma conversion coefficients, the neutron dose was calculated and compared with results obtained from an independent experiment using the microdosimetric technique with a tissue equivalent proportional counter. Total neutron yield of the ⁷Li(p,n) reaction was measured using induced activity of ⁷Be. Results showed a negative energy offset of the incident proton beam between 50 and 58 keV with respect to the generating voltmeter indication of the accelerator terminal. Shapes of the measured neutron spectra showed significant moderation originating from neutron scattering on the lithium target assembly and walls of the experimental area. When accounting for this offset, neutron yields showed an agreement with calculated values within 22% for 1.95 MeV and within approximately 7% for higher proton energies. / Thesis / Doctor of Philosophy (PhD)

No description available.

<p dir="ltr">Human brain tumors present significant challenges due to their heterogeneous nature, known as intra-tumoral heterogeneity (ITH), which evolves over space and time, leading to treatment resistance and poor patient outcomes. Current diagnostic methods rely on pre-surgical imaging and single biopsy samples, providing only a partial understanding of the tumor microenvironment (TME) and often resulting in incomplete targeting of tumor mutations, leaving residual disease vulnerable to recurrence. Our hypothesis proposes a novel approach: utilizing multimodal and multiparametric <i>in vivo</i> imaging to map the cellular and molecular characteristics of the TME. By correlating imaging signatures with underlying somatic and genomic aberrations, we aim to develop a predictive model guiding personalized targeted therapies to effectively address the heterogeneity of brain tumors.</p><p dir="ltr">To achieve this goal, we designed, tested, and validated a predictive model through a pilot study using clinical MRI scans and one stereotactic biopsy sample. Subsequently, we optimized a multimodal and multiparametric imaging protocol including MRI and PET scans, to acquire comprehensive morphological, functional, and molecular data from the TME. Additionally, we established a detailed pipeline for subject recruitment, data collection, and post-processing to ensure the robustness and reliability of our model.</p><p dir="ltr">This innovative approach has the potential to overcome the limitations of current diagnostic methods by providing a comprehensive understanding of the TME using minimally-invasive imaging techniques. By correlating imaging data with ground truth pathology and genomics, this model will enhance brain tumor diagnosis and facilitate the implementation of targeted therapies, ultimately improving treatment response and patient outcomes.</p>