Daniele Carlotti

@policlinicocampusbiomedico.it

Operative Research Unit of Radiation Oncology
Fondazione Policlinico Universitario Campus Bio-Medico

Daniele Carlotti


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https://researchid.co/carlotti.dan

RESEARCH, TEACHING, or OTHER INTERESTS

Radiation, Artificial Intelligence, Oncology, Radiology, Nuclear Medicine and imaging
7

Scopus Publications

46

Scholar Citations

4

Scholar h-index

1

Scholar i10-index

Scopus Publications

  • In silico evaluation of the potential of very high energy electrons delivered in both conventional and FLASH regimes for the SBRT treatment of pancreatic cancer: A report of three case studies
    A. De Gregorio, A. Muscato, A. Burattini, D. Carlotti, M. Fiore, G. Franciosini, T. Insero, M. Marafini, V. Marè, V. Patera, F. Quattrini, S. Ramella, A. Schiavi, M. Toppi, G. Traini, A. Trigilio, A. Sarti
    Physica Medica, 2025
    BACKGROUND AND PURPOSE: As the incidence and mortality rates of pancreatic cancer continue to rise, the search for effective treatments is becoming increasingly urgent. Among the therapeutic approaches, highly hypofractionated stereotactic treatments are being explored. This paper explores the potential of Very High Energy Electrons (VHEE) in the range of 80-130 MeV, in light of recent advances in compact accelerator technology and its compatibility with ultra-high dose rate (UHDR) delivery. MATERIALS AND METHODS: Using dose-volume histograms and dose maps, we compared VHEE treatment plans simulated and optimized assuming both conventional and UHDR delivery scenarios against state-of-the-art volumetric modulated arc therapy (VMAT) treatment plans that were used to treat three patients. Dose maps have been obtained assuming an IMRT-like geometry. The implemented VHEE beam model assumes a C-band compact accelerating technology. Results show that electrons below 130 MeV have a clear potential for the effective treatment of pancreatic cancer, even if delivered in conventional conditions. UHDR delivery has been explored evaluating the gain that the FLASH effect could provide in terms of dose escalation to the PTV while constraining the maximum allowed biological dose to the duodenum. CONCLUSION: The obtained results demonstrate the suitability of VHEE for pancreatic cancer treatment with optimized plans that are clinically acceptable even without considering the additional sparing from the FLASH effect. Their suitability for being delivered at FLASH rates makes them an excellent candidate for the future of external beam radiotherapy.
  • Ablative Five-Fraction Stereotactic Radiotherapy in Elderly Patients with Pancreatic Cancer: A Single Institution Experience
    Michele Fiore, Gian Marco Petrianni, Gabriele D’Ercole, Elena Onorati, Pasquale Trecca, Rita Alaimo, Daniele Carlotti, Edy Ippolito, Rolando Maria D’Angelillo, Sara Ramella
    Journal of Clinical Medicine, 2024
    Background: Pancreatic cancer, with its poor prognosis, is frequently diagnosed in elderly patients who may be ineligible for surgery or chemoradiation due to age or comorbidities. Stereotactic body radiotherapy (SBRT) offers a targeted approach by delivering precise, high-dose radiation to a limited volume in few fractions. This study aims to evaluate the efficacy and safety of SBRT in elderly pancreatic cancer patients. Methods: Patients with pancreatic cancer received SBRT using Volumetric Modulated Arc Therapy in schedules of five dose fractions tailored to the tolerance of adjacent tissues. Progression-free survival (PFS), local progression-free survival (LPFS), metastasis-free survival (MFS) and overall survival (OS) were analysed. Toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Results: Median follow-up was 9.5 months (range, 4–37.2 months). The 1-year, 2-year and 3-year LPFS rates were 88%, 73% and 54%, respectively (median not reached). Median PFS, MFS and OS were 29.6 months, 32.6 months, and 24.1 months, respectively. SBRT was well tolerated with acute and late toxicity rates of 6% and 9%, respectively. Conclusionsd: SBRT appears to be an effective and safe option for elderly pancreatic cancer patients, achieving high local control with minimal toxicity.
  • IOeRT conventional and FLASH treatment planning system implementation exploiting fast GPU Monte Carlo: The case of breast cancer
    G. Franciosini, D. Carlotti, F. Cattani, A. De Gregorio, V. De Liso, F. De Rosa, M. Di Francesco, F. Di Martino, G. Felici, J. Harold Pensavalle, M.C. Leonardi, M. Marafini, A. Muscato, F. Paiar, V. Patera, P. Poortmans, A. Sciubba, A. Schiavi, M. Toppi, G. Traini, A. Trigilio, A. Sarti
    Physica Medica, 2024
    Partial breast irradiation for the treatment of early-stage breast cancer patients can be performed by means of Intra Operative electron Radiation Therapy (IOeRT). One of the main limitations of this technique is the absence of a treatment planning system (TPS) that could greatly help in ensuring a proper coverage of the target volume during irradiation. An IOeRT TPS has been developed using a fast Monte Carlo (MC) and an ultrasound imaging system to provide the best irradiation strategy (electron beam energy, applicator position and bevel angle) and to facilitate the optimisation of dose prescription and delivery to the target volume while maximising the organs at risk sparing. The study has been performed in silico, exploiting MC simulations of a breast cancer treatment. Ultrasound-based input has been used to compute the absorbed dose maps in different irradiation strategies and a quantitative comparison between the different options was carried out using Dose Volume Histograms. The system was capable of exploring different beam energies and applicator positions in few minutes, identifying the best strategy with an overall computation time that was found to be completely compatible with clinical implementation. The systematic uncertainty related to tissue deformation during treatment delivery with respect to imaging acquisition was taken into account. The potential and feasibility of a GPU based full MC TPS implementation of IOeRT breast cancer treatments has been demonstrated in-silico. This long awaited tool will greatly improve the treatment safety and efficacy, overcoming the limits identified within the clinical trials carried out so far.
  • COVID-19 therapy optimization by AI-driven biomechanical simulations
    E. Agrimi, A. Diko, D. Carlotti, A. Ciardiello, M. Borthakur, S. Giagu, S. Melchionna, C. Voena
    European Physical Journal Plus, 2023
  • Treatment planning of intracranial lesions with VHEE: comparing conventional and FLASH irradiation potential with state-of-the-art photon and proton radiotherapy
    A. Muscato, L. Arsini, G. Battistoni, L. Campana, D. Carlotti, F. De Felice, A. De Gregorio, M. De Simoni, C. Di Felice, Y. Dong, G. Franciosini, M. Marafini, I. Mattei, R. Mirabelli, S. Muraro, M. Pacilio, L. Palumbo, V. Patera, A. Schiavi, A. Sciubba, M. Schwarz, S. Sorbino, V. Tombolini, M. Toppi, G. Traini, A. Trigilio, A. Sarti
    Frontiers in Physics, 2023
    The treatment of deep-seated tumours with electrons of very high energies (VHEE, 70–150 MeV) has already been explored in the past, suggesting that a dosimetric coverage comparable with state-of-the-art proton (PT) or photon radiotherapy (RT) could be achieved with a large (> 10) number of fields and high electron energy. The technical and economical challenges posed by the deployment of such beams in treatment centres, together with the expected small therapeutic gain, prevented the development of such technique. This scenario could radically change in the light of recent developments that occurred in the compact, high-gradient, electron acceleration technology and, additionally, of the experimental evidence of the sparing of organs at risk achieved in ultra-high dose rate irradiation, also referred to as FLASH. Electrons with the energy required to treat intracranial lesions could be provided, at dose rates compatible with what is needed to trigger the FLASH effect, by accelerators that are a few metres long, and the organ sparing could be exploited to significantly simplify the irradiation geometry, decreasing the number of fields needed to treat a patient. In this paper, the case of two patients affected by a chordoma and a meningioma, respectively, treated with protons in Trento (IT) is presented. The proton plans have been compared with VHEE plans and X-ray intensity-modulated radiotherapy (IMRT) plans. The VHEE plans were first evaluated in terms of physical dose distribution and then assuming that the FLASH regimen can be achieved. VHEE beams demonstrated their potential in obtaining plans that have comparable tumour coverage and organs at risk sparing when benchmarked against current state-of-the-art IMRT and PT. These results were obtained with a number of explored fields that was in the range between 3 and 7, consistent with what is routinely performed in IMRT and PT conventional irradiations. The FLASH regimen, in all cases, showed its potential in reducing damage to the organs placed nearby the target volume, allowing, particularly in the chordoma case where the irradiation geometry is more challenging, a better tumour coverage with respect to the conventional treatments.
  • Multimodal evaluation of 19F-BPA internalization in pancreatic cancer cells for boron capture and proton therapy potential applications
    Andrea Ciardiello, Saverio Altieri, Francesca Ballarini, Valerio Bocci, Silva Bortolussi, Laura Cansolino, Daniele Carlotti, Mario Ciocca, Riccardo Faccini, Angelica Facoetti, Cinzia Ferrari, Luca Ficcadenti, Emiliano Furfaro, Stefano Giagu, Francesco Iacoangeli, Giampiero Macioce, Carlo Mancini-Terracciano, Andrea Messina, Luisa Milazzo, Severina Pacifico, Simona Piccolella, Ian Postuma, Dante Rotili, Valerio Vercesi, Cecilia Voena, Francesca Vulcano, Silvia Capuani
    Physica Medica, 2022
  • Use of bremsstrahlung radiation to identify hidden weak β- Sources: Feasibility and possible use in radio-guided surgery
    D. Carlotti, F. Collamati, R. Faccini, P. Fresch, F. Iacoangeli, C. Mancini-Terracciano, M. Marafini, R. Mirabelli, L. Recchia, A. Russomando, E. Solfaroli Camillocci, M. Toppi, G. Traini, V. Bocci
    Journal of Instrumentation, 2017
    The recent interest in β^− radionuclides for radio-guided surgery derives from the feature of the β radiation to release energy in few millimeters of tissue. Such feature can be used to locate residual tumors with a probe located in its immediate vicinity, determining the resection margins with an accuracy of millimeters. The drawback of this technique is that it does not allow to identify tumors hidden in more than few mm of tissue. Conversely, the bremsstrahlung X-rays emitted by the interaction of the β− radiation with the nuclei of the tissue are relatively penetrating. To complement the β− probes, we have therefore developed a detector based on cadmium telluride, an X-ray detector with a high quantum efficiency working at room temperature. We measured the secondary emission of bremsstrahlung photons in a target of Polymethylmethacrylate (PMMA) with a density similar to living tissue. The results show that this device allows to detect a 1 ml residual or lymph-node with an activity of 1 kBq hidden under a layer of 10 mm of PMMA with a 3:1 signal to noise, i.e. with a five sigma discrimination in less than 5 s.

RECENT SCHOLAR PUBLICATIONS

  • Implementation of risk management in radiation therapy using the system of evaluation of risk in radiotherapy (SEVRRA) platform
    CDA Ribeiro, D Carlotti, G Meffe, V Maré, M Fiore, S Ramella
    Physica Medica: European Journal of Medical Physics 142 , 2026
    2026
  • Feasibility study and treatment planning for flash radiotherapy with very-high energy electron (VHEE) beams: the case of lung cancer
    F Quattrini, A Burattini, D Carlotti, A De Gregorio, M Fiore, G Franciosini, ...
    Physica Medica: European Journal of Medical Physics 142 , 2026
    2026
  • EP. 08.13 Machine Learning Prediction of Overall Survival in Stage III Unresectable NSCLC: Data Analysis From a Single Center Prospective Cohort
    E Ippolito, V Marè, C Talocco, C Greco, M Fiore, D Carlotti, A Iurato, ...
    Journal of Thoracic Oncology 20 (10), S752-S753 , 2025
    2025
  • In silico evaluation of the potential of very high energy electrons delivered in both conventional and FLASH regimes for the SBRT treatment of pancreatic cancer: A report of …
    A De Gregorio, A Muscato, A Burattini, D Carlotti, M Fiore, G Franciosini, ...
    Physica Medica 137, 105076 , 2025
    2025
  • 4685 Next generation: dose delivery optimization for VHEE treatment
    G Franciosini, A De Gregorio, D Carlotti, M Marafini, A Burattini, V Patera, ...
    Radiotherapy and Oncology 206, S25 , 2025
    2025
  • Basic Safety and Essential Performance for FLASH-IOeRT
    F Di Martino, E Amato, AG Amico, S Andreoli, M Bruzzi, D Carlotti, ...
    PHYSICA MEDICA , 2025
    2025
  • Ablative Five-Fraction Stereotactic Radiotherapy in Elderly Patients with Pancreatic Cancer: A Single Institution Experience
    M Fiore, GM Petrianni, G D’Ercole, E Onorati, P Trecca, R Alaimo, ...
    Journal of Clinical Medicine 13 (24), 7739 , 2024
    2024
  • Dose Prescription with Very High Energy Electron (VHEE): The Clinical Dosimetric Approach Applied to Challenging Cases in Conventional and Flash Delivery Scenarios
    D Carlotti, A De Gregorio, M Fiore, G Franciosini, T Insero, M Marafini, ...
    International Journal of Radiation Oncology, Biology, Physics 120 (2), e104-e105 , 2024
    2024
  • PP26. 05 IN-SILICO STUDY OF VHEE TREATMENTS: PANCREATIC AND LUNG CANCER IN CONVENTIONAL AND FLASH REGIMES
    A de Gregorio, D Carlotti, M Fiore, G Franciosini, T Insero, V Marè, ...
    Physica Medica 125, 103927 , 2024
    2024
  • PS02. 40 IN VIVO DOSIMETRY VERIFICATION FOR GYNAECOLOGICAL CANCER BRACHYTHERAPY WITH IR-192 SOURCE: PRELIMINARY CLINICAL RESULTS ON PATIENTS WITH QED DIODES
    V Marè, D Carlotti, L Vicenzi, R Alaimo, R Conti, G D'ERCOLE, ...
    Physica Medica 125, 104063 , 2024
    2024
  • IN-SILICO STUDY OF VHEE TREATMENTS POTENTIAL IN CONVENTIONAL AND FLASH REGIMES
    G Franciosini, D Carlotti, A De Gregorio, M Fiore, T Insero, V Marè, ...
    International Journal of Particle Therapy 12, 100326 , 2024
    2024
  • 2400: In-silico study of VHEE treatments: pancreatic and lung cancer in conventional and FLASH regimes.
    A De Gregorio, D Carlotti, M Fiore, G Franciosini, T Insero, V Maré, ...
    Radiotherapy and Oncology 194, S3663-S3666 , 2024
    2024
  • IOeRT conventional and FLASH treatment planning system implementation exploiting fast GPU Monte Carlo: The case of breast cancer
    G Franciosini, D Carlotti, F Cattani, A De Gregorio, V De Liso, F De Rosa, ...
    Physica Medica 121, 103346 , 2024
    2024
    Citations: 7
  • New Advantage in Stereotactic Treatment of Lung and Pancreatic Cancer. Performance of Ultra-High Energy Electron (VHEE) Therapy Adjuvanted to the FLASH Effect: Clinical …
    D Carlotti, A Muscato, A De Gregorio, M de Simoni, M Fiore, G Franciosini, ...
    International Journal of Radiation Oncology* Biology* Physics 117 (2), e648-e649 , 2023
    2023
    Citations: 1
  • # 928 Quality Assurance For Clinical Practice In Cervical Cancer Brachytherapy With Ir-192 Source: In Vivo Dosimetry With QED Diodes
    V Marè, D Carlotti, M Fiore, L Vicenzi, R Guarnaccia, P Matteucci, A Iurato, ...
    International Journal of Gynecological Cancer 33, A102 , 2023
    2023
  • Treatment planning of intracranial lesions with VHEE: comparing conventional and FLASH irradiation potential with state-of-the-art photon and proton radiotherapy
    A Muscato, L Arsini, G Battistoni, L Campana, D Carlotti, F De Felice, ...
    Frontiers in Physics 11, 1185598 , 2023
    2023
    Citations: 22
  • COVID-19 therapy optimization by AI-driven biomechanical simulations
    E Agrimi, A Diko, D Carlotti, A Ciardiello, M Borthakur, S Giagu, ...
    The European Physical Journal Plus 138 (2), 182 , 2023
    2023
    Citations: 5
  • VHEE CONVENTIONAL AND FLASH TREATMENT PLANNING: THE CASE OF CHORDOMA AND MENINGIOMA LESIONS
    A Muscato, G Battistoni, L Campana, D Carlotti, F De Felice, ...
    Physica Medica 115 , 2023
    2023
  • MO-0477 Potential of Very High Energy Electron (FLASH) beams in pancreatic and head-and-neck treatments
    A Muscato, L Arsini, L Campana, D Carlotti, A De Gregorio, F De Felice, ...
    Radiotherapy and Oncology 182 , 2023
    2023
  • PO-2031 Development of a TPS for Very High Energy Electrons delivered at FLASH rates
    A De Gregorio, D Carlotti, M Fischetti, G Franciosini, M Marafini, I Mattei, ...
    Radiotherapy and Oncology 182 , 2023
    2023

MOST CITED SCHOLAR PUBLICATIONS

  • Treatment planning of intracranial lesions with VHEE: comparing conventional and FLASH irradiation potential with state-of-the-art photon and proton radiotherapy
    A Muscato, L Arsini, G Battistoni, L Campana, D Carlotti, F De Felice, ...
    Frontiers in Physics 11, 1185598 , 2023
    2023
    Citations: 22
  • Multimodal evaluation of 19F-BPA internalization in pancreatic cancer cells for boron capture and proton therapy potential applications
    A Ciardiello, S Altieri, F Ballarini, V Bocci, S Bortolussi, L Cansolino, ...
    Physica Medica 94, 75-84 , 2022
    2022
    Citations: 8
  • IOeRT conventional and FLASH treatment planning system implementation exploiting fast GPU Monte Carlo: The case of breast cancer
    G Franciosini, D Carlotti, F Cattani, A De Gregorio, V De Liso, F De Rosa, ...
    Physica Medica 121, 103346 , 2024
    2024
    Citations: 7
  • COVID-19 therapy optimization by AI-driven biomechanical simulations
    E Agrimi, A Diko, D Carlotti, A Ciardiello, M Borthakur, S Giagu, ...
    The European Physical Journal Plus 138 (2), 182 , 2023
    2023
    Citations: 5
  • Use of bremsstrahlung radiation to identify hidden weak β − sources: feasibility and possible use in radio-guided surgery
    D Carlotti, F Collamati, R Faccini, P Fresch, F Iacoangeli, ...
    Journal of Instrumentation 12 (11), P11006-P11006 , 2017
    2017
    Citations: 3
  • New Advantage in Stereotactic Treatment of Lung and Pancreatic Cancer. Performance of Ultra-High Energy Electron (VHEE) Therapy Adjuvanted to the FLASH Effect: Clinical …
    D Carlotti, A Muscato, A De Gregorio, M de Simoni, M Fiore, G Franciosini, ...
    International Journal of Radiation Oncology* Biology* Physics 117 (2), e648-e649 , 2023
    2023
    Citations: 1
  • Implementation of risk management in radiation therapy using the system of evaluation of risk in radiotherapy (SEVRRA) platform
    CDA Ribeiro, D Carlotti, G Meffe, V Maré, M Fiore, S Ramella
    Physica Medica: European Journal of Medical Physics 142 , 2026
    2026
  • Feasibility study and treatment planning for flash radiotherapy with very-high energy electron (VHEE) beams: the case of lung cancer
    F Quattrini, A Burattini, D Carlotti, A De Gregorio, M Fiore, G Franciosini, ...
    Physica Medica: European Journal of Medical Physics 142 , 2026
    2026
  • EP. 08.13 Machine Learning Prediction of Overall Survival in Stage III Unresectable NSCLC: Data Analysis From a Single Center Prospective Cohort
    E Ippolito, V Marè, C Talocco, C Greco, M Fiore, D Carlotti, A Iurato, ...
    Journal of Thoracic Oncology 20 (10), S752-S753 , 2025
    2025
  • In silico evaluation of the potential of very high energy electrons delivered in both conventional and FLASH regimes for the SBRT treatment of pancreatic cancer: A report of …
    A De Gregorio, A Muscato, A Burattini, D Carlotti, M Fiore, G Franciosini, ...
    Physica Medica 137, 105076 , 2025
    2025
  • 4685 Next generation: dose delivery optimization for VHEE treatment
    G Franciosini, A De Gregorio, D Carlotti, M Marafini, A Burattini, V Patera, ...
    Radiotherapy and Oncology 206, S25 , 2025
    2025
  • Basic Safety and Essential Performance for FLASH-IOeRT
    F Di Martino, E Amato, AG Amico, S Andreoli, M Bruzzi, D Carlotti, ...
    PHYSICA MEDICA , 2025
    2025
  • Ablative Five-Fraction Stereotactic Radiotherapy in Elderly Patients with Pancreatic Cancer: A Single Institution Experience
    M Fiore, GM Petrianni, G D’Ercole, E Onorati, P Trecca, R Alaimo, ...
    Journal of Clinical Medicine 13 (24), 7739 , 2024
    2024
  • Dose Prescription with Very High Energy Electron (VHEE): The Clinical Dosimetric Approach Applied to Challenging Cases in Conventional and Flash Delivery Scenarios
    D Carlotti, A De Gregorio, M Fiore, G Franciosini, T Insero, M Marafini, ...
    International Journal of Radiation Oncology, Biology, Physics 120 (2), e104-e105 , 2024
    2024
  • PP26. 05 IN-SILICO STUDY OF VHEE TREATMENTS: PANCREATIC AND LUNG CANCER IN CONVENTIONAL AND FLASH REGIMES
    A de Gregorio, D Carlotti, M Fiore, G Franciosini, T Insero, V Marè, ...
    Physica Medica 125, 103927 , 2024
    2024
  • PS02. 40 IN VIVO DOSIMETRY VERIFICATION FOR GYNAECOLOGICAL CANCER BRACHYTHERAPY WITH IR-192 SOURCE: PRELIMINARY CLINICAL RESULTS ON PATIENTS WITH QED DIODES
    V Marè, D Carlotti, L Vicenzi, R Alaimo, R Conti, G D'ERCOLE, ...
    Physica Medica 125, 104063 , 2024
    2024
  • IN-SILICO STUDY OF VHEE TREATMENTS POTENTIAL IN CONVENTIONAL AND FLASH REGIMES
    G Franciosini, D Carlotti, A De Gregorio, M Fiore, T Insero, V Marè, ...
    International Journal of Particle Therapy 12, 100326 , 2024
    2024
  • 2400: In-silico study of VHEE treatments: pancreatic and lung cancer in conventional and FLASH regimes.
    A De Gregorio, D Carlotti, M Fiore, G Franciosini, T Insero, V Maré, ...
    Radiotherapy and Oncology 194, S3663-S3666 , 2024
    2024
  • # 928 Quality Assurance For Clinical Practice In Cervical Cancer Brachytherapy With Ir-192 Source: In Vivo Dosimetry With QED Diodes
    V Marè, D Carlotti, M Fiore, L Vicenzi, R Guarnaccia, P Matteucci, A Iurato, ...
    International Journal of Gynecological Cancer 33, A102 , 2023
    2023
  • VHEE CONVENTIONAL AND FLASH TREATMENT PLANNING: THE CASE OF CHORDOMA AND MENINGIOMA LESIONS
    A Muscato, G Battistoni, L Campana, D Carlotti, F De Felice, ...
    Physica Medica 115 , 2023
    2023