METHODS article
Front. Oncol.
Sec. Radiation Oncology
This article is part of the Research TopicRadiation Spatial Fractionation—A novel approach to integrate Physics, Biology, and Immunology for high therapeutic index radiotherapyView all 15 articles
Novel Use of Peak Optimized Particle Therapy for Delivery of Three-Dimensional Spatially Fractionated Radiotherapy (POP-SFRT)
Provisionally accepted
James William Snider1,2*
Pouya Sabouri3
Sina Mossahebi4
Arpit Chhabra5
Jason Molitoris4
Tejan Diwanji6Katja Langen7William F. Regine4
Mingyao Zhu7
Charles B. Simone5- 1Proton International, LLC, Alpharetta, United States
- 2Partners in Healthcare Technology, LLC, Alpharetta, United States
- 3University of Arkansas for Medical Sciences, Little Rock, United States
- 4University of Maryland School of Medicine, Baltimore, United States
- 5New York Proton Center, New York, United States
- 6Mid-Atlantic Permanente Medical Group PC, Rockville, United States
- 7Emory University School of Medicine, Atlanta, United States
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Spatially fractionated radiotherapy (SFRT) has been delivered safely and effectively mostly utilizing beamlets of megavoltage photons in recent years. Particle therapy offers the promise of improved dose distributions with less exposure of surrounding normal tissues. However, most efforts have focused on mimicking the beamlets of traditional SFRT two-dimensional therapy (also known as GRID), potentially sacrificing advantages that could be achieved with scanned particle beams. We, herein, lay out the rationale for and execution of a novel pencil beam scanning proton therapy technique for SFRT that prioritizes pristine Bragg peak delivery in an interleaved and rotated three-dimensional SFRT (LATTICE) format. We propose that this patented (US11478665B2) technique optimizes particle SFRT therapy radiobiologic effect, minimizes normal tissue and superficial dose, and allows for alternative SFRT applications across a course of therapy. This technique lends itself to further exploration in delivery techniques, fractionation, and ultra-high dose rates.
Keywords: FLASH radiotherapy, Lattice, particle therapy, Proton therapy, Spatially fractionated radiotherapy
Received: 31 Oct 2025; Accepted: 21 Jan 2026.
Copyright: © 2026 Snider, Sabouri, Mossahebi, Chhabra, Molitoris, Diwanji, Langen, Regine, Zhu and Simone. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: James William Snider
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