Seven Seconds for a Lifetime

The logistical problem

Stefan Bartzsch regularly sat on the train from London to Grenoble. In his luggage were tissue samples he was not allowed to take on a plane. Bartzsch is a physicist. At the university hospital of the Technical University of Munich (TUM), and previously at the Institute of Cancer Research in London, he studies new technologies for radiotherapy. In France stood the research facility he relied on for years: a synchrotron, a ring of concrete and magnets almost a kilometre in circumference. This is the European Synchrotron Radiation Facility (ESRF) — one of only a few places in the world capable of producing the brilliant X-ray light Bartzsch needed. There, he searched for the perfect X-ray field: one that destroys the tumour while sparing healthy tissue.

The trips to Grenoble were a major undertaking. For irradiations that lasted only seconds, Bartzsch spent many hours on the train. Valuable time disappeared from the laboratory. At some point, a question began travelling with him: could he bring the synchrotron to London? Or even directly to patients?

Frustration with a logistical problem has grown into a technology that CollimateHealth now plans to take exactly there. Together with colleagues from TUM, Forschungszentrum Jülich and Johannes Gutenberg University Mainz, Bartzsch wants to shrink the giant in Grenoble until microbeam radiotherapy fits into any hospital — an ambitious goal for an interdisciplinary team.

A Fork in the Tissue

“Today’s radiotherapy is a compromise,” says Hans Maria Heÿn, co-founder and CEO of CollimateHealth. Hospitals use devices called linear accelerators for radiation treatment. In principle, they work like a torch: they shine a broad, uniform field into the body. That beam hits everything in its path: the tumour, but also healthy tissue in front of it and behind it. Clinicians therefore spread the dose across 20 to 30 sessions so the body has time to recover. The approach works. But it has limits.

„Healthy tissue survives so well in the spaces between the microbeams that it can quickly repair the damage in the cells hit by the prongs."

— Dr. Stefan Bartzsch

Stefan Bartzsch’s experiments at the synchrotron in Grenoble follow a different logic. The beam does not act like a flat surface. It forms a pattern in which hair-thin tracks of high dose alternate with areas that receive far less radiation — like the prongs of a fork. In those narrow prongs, tumour cells die reliably and send out signals that also cause tumour cells in the gaps between them to die.

“Healthy tissue survives so well in the spaces between the microbeams that it can quickly repair the damage in the cells hit by the prongs. A clinical device for microbeam radiotherapy could therefore make anti-cancer effects possible that conventional radiotherapy methods simply cannot achieve,” says Bartzsch.

The Mechanical Backbone from Jülich

The CollimateHealth team has indeed found a way to shrink technology from high-performance physics far enough for it to fit easily into hospitals. Its device needs less than ten square metres of floor space and frees clinics from having to build heavy radiation bunkers underground.

Jülich provided crucial support. Engineers at the Institute of Technology and Engineering (ITE) at Forschungszentrum Jülich developed a technological heart of the new irradiation system: a high-performance rotating anode. It absorbs the high energy from the particle acceleration and converts it into X-rays.

„This combination brings the performance of kilometre-scale accelerators into ordinary treatment rooms.”

— Dr. Johanna Winter

Inside the X-ray beam sits the component that gave the start-up its name: the collimator. This microscopically fine sieve fans out a massive beam into so-called microbeams — more precisely, into micrometre-wide high-dose regions and broader low-dose regions where the dose stays below the tissue tolerance threshold. In other words, it creates exactly the fork-like pattern the treatment needs.

“The device works through the interplay of collimator, rotating anode and electron accelerator. This combination brings the power of kilometre-long accelerators into ordinary treatment rooms,” says Johanna Winter, co-founder and CTO of CollimateHealth.

Widening the Therapeutic Window

That interplay is designed to solve a problem doctors call the “therapeutic window”: the narrow line between a dose high enough to destroy the tumour and a dose low enough to avoid life-threatening injury to the surrounding healthy tissue. “Until now, this window has often been very narrow,” says Bartzsch. The new approach could widen that margin eightfold.

Microbeams in the Treatment Room

CollimateHealth’s innovation compresses the capabilities of the giant facility in Grenoble into a compact system about 1.5 metres in size. That could move microbeam radiation therapy — and its potential to save lives — out of large international research facilities and into standard clinical treatment rooms, with a footprint of less than 10 m².

Preclinical studies have also revealed an unexpected but very useful side effect: the microbeams fundamentally change the biology of the tumour. While conventional radiotherapy often weakens the immune system, this technique appears to act like a wake-up call. As the tumour breaks apart under the precise fork-like radiation pattern, it releases signals that the immune system had previously missed. Researchers call this “in situ vaccination” — a vaccination against the tumour, directly inside the tissue.

In the process, they observe a phenomenon that appears only rarely and unreliably in oncology: the abscopal effect. The activated immune system learns to recognise the enemy in the irradiated region so precisely that it suddenly starts attacking tumour sites and metastases elsewhere in the body — areas that were never directly irradiated.

„The lenght of the treatment is just a second, sometimes two seconds, because our dose rate is so high – in between a heartbeat."

— Dr. Hans Maria Heÿn

Munich, 2028

The first patients are expected to receive treatment with the technology at TUM Klinikum rechts der Isar in Munich, in 2028. By then, CollimateHealth must continue developing the system for clinical use, complete successful preclinical studies and pass the required approval procedures.

For people with tumours that are currently difficult to treat — for example in the brain, breast or lungs — the technology could open up new possibilities. “Where thirty exhausting sessions are standard today, perhaps two or three short appointments will one day be enough. The irradiation itself would then take only seven seconds,” Heÿn hopes. Shorter than the deep breath Bartzsch took on the platform before boarding yet another train to France.

CollimateHealth's official website

^{Image credit: Collimate Health; Forschungszentrum Jülich; Falling Walls Foundation: Amrei Schulz}

Perspectives: The new Issue

Some diagnoses change the way we view our own lives, often leading to a long road, full of uncertainty and unanswered questions.

In this issue, we meet researchers who are developing new approaches to treating cancer, chronic pain and other diseases. Their work is producing insights that could one day change how we view these diagnoses.

» Download Issue (German, PDF)

Read more

The Layer Master

The Layer Master

Transfer Talents

Researchers and Their Innovations

More Time for Real Science

None of nine

Service: Transfer at FZ Jülich

FZ Jülich Innovation Fund

1m Euros each year

JUICE: Innovation & Entrepreneurship Education

Innovation Jumpstart Booster

Be first to hear from us

Submit to our newsletter