Image Alignment for Multiple Camera High Dynamic Range Microscopy

PubMed Central

Eastwood, Brian S.; Childs, Elisabeth C.

2012-01-01

This paper investigates the problem of image alignment for multiple camera high dynamic range (HDR) imaging. HDR imaging combines information from images taken with different exposure settings. Combining information from multiple cameras requires an alignment process that is robust to the intensity differences in the images. HDR applications that use a limited number of component images require an alignment technique that is robust to large exposure differences. We evaluate the suitability for HDR alignment of three exposure-robust techniques. We conclude that image alignment based on matching feature descriptors extracted from radiant power images from calibrated cameras yields the most accurate and robust solution. We demonstrate the use of this alignment technique in a high dynamic range video microscope that enables live specimen imaging with a greater level of detail than can be captured with a single camera. PMID:22545028

High dynamic range coding imaging system

NASA Astrophysics Data System (ADS)

Wu, Renfan; Huang, Yifan; Hou, Guangqi

2014-10-01

We present a high dynamic range (HDR) imaging system design scheme based on coded aperture technique. This scheme can help us obtain HDR images which have extended depth of field. We adopt Sparse coding algorithm to design coded patterns. Then we utilize the sensor unit to acquire coded images under different exposure settings. With the guide of the multiple exposure parameters, a series of low dynamic range (LDR) coded images are reconstructed. We use some existing algorithms to fuse and display a HDR image by those LDR images. We build an optical simulation model and get some simulation images to verify the novel system.

An HDR imaging method with DTDI technology for push-broom cameras

NASA Astrophysics Data System (ADS)

Sun, Wu; Han, Chengshan; Xue, Xucheng; Lv, Hengyi; Shi, Junxia; Hu, Changhong; Li, Xiangzhi; Fu, Yao; Jiang, Xiaonan; Huang, Liang; Han, Hongyin

2018-03-01

Conventionally, high dynamic-range (HDR) imaging is based on taking two or more pictures of the same scene with different exposure. However, due to a high-speed relative motion between the camera and the scene, it is hard for this technique to be applied to push-broom remote sensing cameras. For the sake of HDR imaging in push-broom remote sensing applications, the present paper proposes an innovative method which can generate HDR images without redundant image sensors or optical components. Specifically, this paper adopts an area array CMOS (complementary metal oxide semiconductor) with the digital domain time-delay-integration (DTDI) technology for imaging, instead of adopting more than one row of image sensors, thereby taking more than one picture with different exposure. And then a new HDR image by fusing two original images with a simple algorithm can be achieved. By conducting the experiment, the dynamic range (DR) of the image increases by 26.02 dB. The proposed method is proved to be effective and has potential in other imaging applications where there is a relative motion between the cameras and scenes.

TU-C-201-03: The Use of Checklists and Audit Tools for Safety and QA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prisciandaro, J.

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less

High Dynamic Range Imaging at the Quantum Limit with Single Photon Avalanche Diode-Based Image Sensors †

PubMed Central

Mattioli Della Rocca, Francescopaolo

2018-01-01

This paper examines methods to best exploit the High Dynamic Range (HDR) of the single photon avalanche diode (SPAD) in a high fill-factor HDR photon counting pixel that is scalable to megapixel arrays. The proposed method combines multi-exposure HDR with temporal oversampling in-pixel. We present a silicon demonstration IC with 96 × 40 array of 8.25 µm pitch 66% fill-factor SPAD-based pixels achieving >100 dB dynamic range with 3 back-to-back exposures (short, mid, long). Each pixel sums 15 bit-planes or binary field images internally to constitute one frame providing 3.75× data compression, hence the 1k frames per second (FPS) output off-chip represents 45,000 individual field images per second on chip. Two future projections of this work are described: scaling SPAD-based image sensors to HDR 1 MPixel formats and shrinking the pixel pitch to 1–3 µm. PMID:29641479

MO-B-BRC-01: Introduction [Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prisciandaro, J.

2016-06-15

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

MO-C-17A-11: A Segmentation and Point Matching Enhanced Deformable Image Registration Method for Dose Accumulation Between HDR CT Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhen, X; Chen, H; Zhou, L

2014-06-15

Purpose: To propose and validate a novel and accurate deformable image registration (DIR) scheme to facilitate dose accumulation among treatment fractions of high-dose-rate (HDR) gynecological brachytherapy. Method: We have developed a method to adapt DIR algorithms to gynecologic anatomies with HDR applicators by incorporating a segmentation step and a point-matching step into an existing DIR framework. In the segmentation step, random walks algorithm is used to accurately segment and remove the applicator region (AR) in the HDR CT image. A semi-automatic seed point generation approach is developed to obtain the incremented foreground and background point sets to feed the randommore » walks algorithm. In the subsequent point-matching step, a feature-based thin-plate spline-robust point matching (TPS-RPM) algorithm is employed for AR surface point matching. With the resulting mapping, a DVF characteristic of the deformation between the two AR surfaces is generated by B-spline approximation, which serves as the initial DVF for the following Demons DIR between the two AR-free HDR CT images. Finally, the calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. Results: The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative results as well as the visual inspection of the DIR indicate that our proposed method can suppress the interference of the applicator with the DIR algorithm, and accurately register HDR CT images as well as deform and add interfractional HDR doses. Conclusions: We have developed a novel and robust DIR scheme that can perform registration between HDR gynecological CT images and yield accurate registration results. This new DIR scheme has potential for accurate interfractional HDR dose accumulation. This work is supported in part by the National Natural ScienceFoundation of China (no 30970866 and no 81301940)« less

New segmentation-based tone mapping algorithm for high dynamic range image

NASA Astrophysics Data System (ADS)

Duan, Weiwei; Guo, Huinan; Zhou, Zuofeng; Huang, Huimin; Cao, Jianzhong

2017-07-01

The traditional tone mapping algorithm for the display of high dynamic range (HDR) image has the drawback of losing the impression of brightness, contrast and color information. To overcome this phenomenon, we propose a new tone mapping algorithm based on dividing the image into different exposure regions in this paper. Firstly, the over-exposure region is determined using the Local Binary Pattern information of HDR image. Then, based on the peak and average gray of the histogram, the under-exposure and normal-exposure region of HDR image are selected separately. Finally, the different exposure regions are mapped by differentiated tone mapping methods to get the final result. The experiment results show that the proposed algorithm achieve the better performance both in visual quality and objective contrast criterion than other algorithms.

Automatic face recognition in HDR imaging

NASA Astrophysics Data System (ADS)

Pereira, Manuela; Moreno, Juan-Carlos; Proença, Hugo; Pinheiro, António M. G.

2014-05-01

The gaining popularity of the new High Dynamic Range (HDR) imaging systems is raising new privacy issues caused by the methods used for visualization. HDR images require tone mapping methods for an appropriate visualization on conventional and non-expensive LDR displays. These visualization methods might result in completely different visualization raising several issues on privacy intrusion. In fact, some visualization methods result in a perceptual recognition of the individuals, while others do not even show any identity. Although perceptual recognition might be possible, a natural question that can rise is how computer based recognition will perform using tone mapping generated images? In this paper, a study where automatic face recognition using sparse representation is tested with images that result from common tone mapping operators applied to HDR images. Its ability for the face identity recognition is described. Furthermore, typical LDR images are used for the face recognition training.

Towards a robust HDR imaging system

NASA Astrophysics Data System (ADS)

Long, Xin; Zeng, Xiangrong; Huangpeng, Qizi; Zhou, Jinglun; Feng, Jing

2016-07-01

High dynamic range (HDR) images can show more details and luminance information in general display device than low dynamic image (LDR) images. We present a robust HDR imaging system which can deal with blurry LDR images, overcoming the limitations of most existing HDR methods. Experiments on real images show the effectiveness and competitiveness of the proposed method.

HDR video synthesis for vision systems in dynamic scenes

NASA Astrophysics Data System (ADS)

Shopovska, Ivana; Jovanov, Ljubomir; Goossens, Bart; Philips, Wilfried

2016-09-01

High dynamic range (HDR) image generation from a number of differently exposed low dynamic range (LDR) images has been extensively explored in the past few decades, and as a result of these efforts a large number of HDR synthesis methods have been proposed. Since HDR images are synthesized by combining well-exposed regions of the input images, one of the main challenges is dealing with camera or object motion. In this paper we propose a method for the synthesis of HDR video from a single camera using multiple, differently exposed video frames, with circularly alternating exposure times. One of the potential applications of the system is in driver assistance systems and autonomous vehicles, involving significant camera and object movement, non- uniform and temporally varying illumination, and the requirement of real-time performance. To achieve these goals simultaneously, we propose a HDR synthesis approach based on weighted averaging of aligned radiance maps. The computational complexity of high-quality optical flow methods for motion compensation is still pro- hibitively high for real-time applications. Instead, we rely on more efficient global projective transformations to solve camera movement, while moving objects are detected by thresholding the differences between the trans- formed and brightness adapted images in the set. To attain temporal consistency of the camera motion in the consecutive HDR frames, the parameters of the perspective transformation are stabilized over time by means of computationally efficient temporal filtering. We evaluated our results on several reference HDR videos, on synthetic scenes, and using 14-bit raw images taken with a standard camera.

Penrose high-dynamic-range imaging

NASA Astrophysics Data System (ADS)

Li, Jia; Bai, Chenyan; Lin, Zhouchen; Yu, Jian

2016-05-01

High-dynamic-range (HDR) imaging is becoming increasingly popular and widespread. The most common multishot HDR approach, based on multiple low-dynamic-range images captured with different exposures, has difficulties in handling camera and object movements. The spatially varying exposures (SVE) technology provides a solution to overcome this limitation by obtaining multiple exposures of the scene in only one shot but suffers from a loss in spatial resolution of the captured image. While aperiodic assignment of exposures has been shown to be advantageous during reconstruction in alleviating resolution loss, almost all the existing imaging sensors use the square pixel layout, which is a periodic tiling of square pixels. We propose the Penrose pixel layout, using pixels in aperiodic rhombus Penrose tiling, for HDR imaging. With the SVE technology, Penrose pixel layout has both exposure and pixel aperiodicities. To investigate its performance, we have to reconstruct HDR images in square pixel layout from Penrose raw images with SVE. Since the two pixel layouts are different, the traditional HDR reconstruction methods are not applicable. We develop a reconstruction method for Penrose pixel layout using a Gaussian mixture model for regularization. Both quantitative and qualitative results show the superiority of Penrose pixel layout over square pixel layout.

High-dynamic-range imaging for cloud segmentation

NASA Astrophysics Data System (ADS)

Dev, Soumyabrata; Savoy, Florian M.; Lee, Yee Hui; Winkler, Stefan

2018-04-01

Sky-cloud images obtained from ground-based sky cameras are usually captured using a fisheye lens with a wide field of view. However, the sky exhibits a large dynamic range in terms of luminance, more than a conventional camera can capture. It is thus difficult to capture the details of an entire scene with a regular camera in a single shot. In most cases, the circumsolar region is overexposed, and the regions near the horizon are underexposed. This renders cloud segmentation for such images difficult. In this paper, we propose HDRCloudSeg - an effective method for cloud segmentation using high-dynamic-range (HDR) imaging based on multi-exposure fusion. We describe the HDR image generation process and release a new database to the community for benchmarking. Our proposed approach is the first using HDR radiance maps for cloud segmentation and achieves very good results.

An Integrated Tone Mapping for High Dynamic Range Image Visualization

NASA Astrophysics Data System (ADS)

Liang, Lei; Pan, Jeng-Shyang; Zhuang, Yongjun

2018-01-01

There are two type tone mapping operators for high dynamic range (HDR) image visualization. HDR image mapped by perceptual operators have strong sense of reality, but will lose local details. Empirical operators can maximize local detail information of HDR image, but realism is not strong. A common tone mapping operator suitable for all applications is not available. This paper proposes a novel integrated tone mapping framework which can achieve conversion between empirical operators and perceptual operators. In this framework, the empirical operator is rendered based on improved saliency map, which simulates the visual attention mechanism of the human eye to the natural scene. The results of objective evaluation prove the effectiveness of the proposed solution.

Gamut mapping in a high-dynamic-range color space

NASA Astrophysics Data System (ADS)

Preiss, Jens; Fairchild, Mark D.; Ferwerda, James A.; Urban, Philipp

2014-01-01

In this paper, we present a novel approach of tone mapping as gamut mapping in a high-dynamic-range (HDR) color space. High- and low-dynamic-range (LDR) images as well as device gamut boundaries can simultaneously be represented within such a color space. This enables a unified transformation of the HDR image into the gamut of an output device (in this paper called HDR gamut mapping). An additional aim of this paper is to investigate the suitability of a specific HDR color space to serve as a working color space for the proposed HDR gamut mapping. For the HDR gamut mapping, we use a recent approach that iteratively minimizes an image-difference metric subject to in-gamut images. A psychophysical experiment on an HDR display shows that the standard reproduction workflow of two subsequent transformations - tone mapping and then gamut mapping - may be improved by HDR gamut mapping.

Performance evaluation of objective quality metrics for HDR image compression

NASA Astrophysics Data System (ADS)

Valenzise, Giuseppe; De Simone, Francesca; Lauga, Paul; Dufaux, Frederic

2014-09-01

Due to the much larger luminance and contrast characteristics of high dynamic range (HDR) images, well-known objective quality metrics, widely used for the assessment of low dynamic range (LDR) content, cannot be directly applied to HDR images in order to predict their perceptual fidelity. To overcome this limitation, advanced fidelity metrics, such as the HDR-VDP, have been proposed to accurately predict visually significant differences. However, their complex calibration may make them difficult to use in practice. A simpler approach consists in computing arithmetic or structural fidelity metrics, such as PSNR and SSIM, on perceptually encoded luminance values but the performance of quality prediction in this case has not been clearly studied. In this paper, we aim at providing a better comprehension of the limits and the potentialities of this approach, by means of a subjective study. We compare the performance of HDR-VDP to that of PSNR and SSIM computed on perceptually encoded luminance values, when considering compressed HDR images. Our results show that these simpler metrics can be effectively employed to assess image fidelity for applications such as HDR image compression.

SU-G-201-16: Thermal Imaging in Source Visualization and Radioactivity Measurement for High Dose Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, X; Lei, Y; Zheng, D

2016-06-15

Purpose: High Dose Rate (HDR) brachytherapy poses a special challenge to radiation safety and quality assurance (QA) due to its high radioactivity, and it is thus critical to verify the HDR source location and its radioactive strength. This study demonstrates a new method for measuring HDR source location and radioactivity utilizing thermal imaging. A potential application would relate to HDR QA and safety improvement. Methods: Heating effects by an HDR source were studied using Finite Element Analysis (FEA). Thermal cameras were used to visualize an HDR source inside a plastic applicator made of polyvinylidene difluoride (PVDF). Using different source dwellmore » times, correlations between the HDR source strength and heating effects were studied, thus establishing potential daily QA criteria using thermal imaging Results: For an Ir1?2 source with a radioactivity of 10 Ci, the decay-induced heating power inside the source is ∼13.3 mW. After the HDR source was extended into the PVDF applicator and reached thermal equilibrium, thermal imaging visualized the temperature gradient of 10 K/cm along the PVDF applicator surface, which agreed with FEA modeling. For Ir{sup 192} source activities ranging from 4.20–10.20 Ci, thermal imaging could verify source activity with an accuracy of 6.3% with a dwell time of 10 sec, and an accuracy of 2.5 % with 100 sec. Conclusion: Thermal imaging is a feasible tool to visualize HDR source dwell positions and verify source integrity. Patient safety and treatment quality will be improved by integrating thermal measurements into HDR QA procedures.« less

Clinical evaluation of a medical high dynamic range display

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marchessoux, Cedric, E-mail: cedric.marchessoux@ba

Purpose: Recent new medical displays do have higher contrast and higher luminance but do not have a High Dynamic Range (HDR). HDR implies a minimum luminance value close to zero. A medical HDR display prototype based on two Liquid Crystal layers has been developed. The goal of this study is to evaluate the potential clinical benefit of such display in comparison with a low dynamic range (LDR) display. Methods: The study evaluated the clinical performance of the displays in a search and detection task. Eight radiologists read chest x-ray images some of which contained simulated lung nodules. The study usedmore » a JAFROC (Jacknife Free Receiver Operating Characteristic) approach for analyzing FROC data. The calculated figure of merit (FoM) is the probability that a lesion is rated higher than all rated nonlesions on all images. Time per case and accuracy for locating the center of the nodules were also compared. The nodules were simulated using Samei’s model. 214 CR and DR images [half were “healthy images” (chest nodule-free) and half “diseased images”] were used resulting in a total number of nodules equal to 199 with 25 images with 1 nodule, 51 images with 2 nodules, and 24 images with 3 nodules. A dedicated software interface was designed for visualizing the images for each session. For the JAFROC1 statistical analysis, the study is done per nodule category: all nodules, difficult nodules, and very difficult nodules. Results: For all nodules, the averaged FoM{sub HDR} is slightly higher than FoM{sub LDR} with 0.09% of difference. For the difficult nodules, the averaged FoM{sub HDR} is slightly higher than FoM{sub LDR} with 1.38% of difference. The averaged FoM{sub HDR} is slightly higher than FoM{sub LDR} with 0.71% of difference. For the true positive fraction (TPF), both displays (the HDR and the LDR ones) have similar TPF for all nodules, but looking at difficult and very difficult nodules, there are more TP for the HDR display. The true positive fraction has been also computed in function of the local average luminance around the nodules. For the lowest luminance range, there is more than 30% in favor of the HDR display. For the highest luminance range, there is less than 6% in favor of the LDR display. Conclusions: This study shows the potential benefit of using a HDR display in radiology.« less

Display of high dynamic range images under varying viewing conditions

NASA Astrophysics Data System (ADS)

Borer, Tim

2017-09-01

Recent demonstrations of high dynamic range (HDR) television have shown that superb images are possible. With the emergence of an HDR television production standard (ITU-R Recommendation BT.2100) last year, HDR television production is poised to take off. However research to date has focused principally on HDR image display only under "dark" viewing conditions. HDR television will need to be displayed at varying brightness and under varying illumination (for example to view sport in daytime or on mobile devices). We know, from common practice with conventional TV, that the rendering intent (gamma) should change under brighter conditions, although this is poorly quantified. For HDR the need to render images under varying conditions is all the more acute. This paper seeks to explore the issues surrounding image display under varying conditions. It also describes how visual adaptation is affected by display brightness, surround illumination, screen size and viewing distance. Existing experimental results are presented and extended to try to quantify these effects. Using the experimental results it is described how HDR images may be displayed so that they are perceptually equivalent under different viewing conditions. A new interpretation of the experimental results is reported, yielding a new, luminance invariant model for the appropriate display "gamma". In this way the consistency of HDR image reproduction should be improved, thereby better maintaining "creative intent" in television.

Evaluation of privacy in high dynamic range video sequences

NASA Astrophysics Data System (ADS)

Řeřábek, Martin; Yuan, Lin; Krasula, Lukáš; Korshunov, Pavel; Fliegel, Karel; Ebrahimi, Touradj

2014-09-01

The ability of high dynamic range (HDR) to capture details in environments with high contrast has a significant impact on privacy in video surveillance. However, the extent to which HDR imaging affects privacy, when compared to a typical low dynamic range (LDR) imaging, is neither well studied nor well understood. To achieve such an objective, a suitable dataset of images and video sequences is needed. Therefore, we have created a publicly available dataset of HDR video for privacy evaluation PEViD-HDR, which is an HDR extension of an existing Privacy Evaluation Video Dataset (PEViD). PEViD-HDR video dataset can help in the evaluations of privacy protection tools, as well as for showing the importance of HDR imaging in video surveillance applications and its influence on the privacy-intelligibility trade-off. We conducted a preliminary subjective experiment demonstrating the usability of the created dataset for evaluation of privacy issues in video. The results confirm that a tone-mapped HDR video contains more privacy sensitive information and details compared to a typical LDR video.

Color sensitivity of the multi-exposure HDR imaging process

NASA Astrophysics Data System (ADS)

Lenseigne, Boris; Jacobs, Valéry Ann; Withouck, Martijn; Hanselaer, Peter; Jonker, Pieter P.

2013-04-01

Multi-exposure high dynamic range(HDR) imaging builds HDR radiance maps by stitching together different views of a same scene with varying exposures. Practically, this process involves converting raw sensor data into low dynamic range (LDR) images, estimate the camera response curves, and use them in order to recover the irradiance for every pixel. During the export, applying white balance settings and image stitching, which both have an influence on the color balance in the final image. In this paper, we use a calibrated quasi-monochromatic light source, an integrating sphere, and a spectrograph in order to evaluate and compare the average spectral response of the image sensor. We finally draw some conclusion about the color consistency of HDR imaging and the additional steps necessary to use multi-exposure HDR imaging as a tool to measure the physical quantities such as radiance and luminance.

Inverse Tone Mapping Based upon Retina Response

PubMed Central

Huo, Yongqing; Yang, Fan; Brost, Vincent

2014-01-01

The development of high dynamic range (HDR) display arouses the research of inverse tone mapping methods, which expand dynamic range of the low dynamic range (LDR) image to match that of HDR monitor. This paper proposed a novel physiological approach, which could avoid artifacts occurred in most existing algorithms. Inspired by the property of the human visual system (HVS), this dynamic range expansion scheme performs with a low computational complexity and a limited number of parameters and obtains high-quality HDR results. Comparisons with three recent algorithms in the literature also show that the proposed method reveals more important image details and produces less contrast loss and distortion. PMID:24744678

A detail enhancement and dynamic range adjustment algorithm for high dynamic range images

NASA Astrophysics Data System (ADS)

Xu, Bo; Wang, Huachuang; Liang, Mingtao; Yu, Cong; Hu, Jinlong; Cheng, Hua

2014-08-01

Although high dynamic range (HDR) images contain large amounts of information, they have weak texture and low contrast. What's more, these images are difficult to be reproduced on low dynamic range displaying mediums. If much more information is to be acquired when these images are displayed on PCs, some specific transforms, such as compressing the dynamic range, enhancing the portions of little difference in original contrast and highlighting the texture details on the premise of keeping the parts of large contrast, are needed. To this ends, a multi-scale guided filter enhancement algorithm which derives from the single-scale guided filter based on the analysis of non-physical model is proposed in this paper. Firstly, this algorithm decomposes the original HDR images into base image and detail images of different scales, and then it adaptively selects a transform function which acts on the enhanced detail images and original images. By comparing the treatment effects of HDR images and low dynamic range (LDR) images of different scene features, it proves that this algorithm, on the basis of maintaining the hierarchy and texture details of images, not only improves the contrast and enhances the details of images, but also adjusts the dynamic range well. Thus, it is much suitable for human observation or analytical processing of machines.

Local contrast-enhanced MR images via high dynamic range processing.

PubMed

Chandra, Shekhar S; Engstrom, Craig; Fripp, Jurgen; Neubert, Ales; Jin, Jin; Walker, Duncan; Salvado, Olivier; Ho, Charles; Crozier, Stuart

2018-09-01

To develop a local contrast-enhancing and feature-preserving high dynamic range (HDR) image processing algorithm for multichannel and multisequence MR images of multiple body regions and tissues, and to evaluate its performance for structure visualization, bias field (correction) mitigation, and automated tissue segmentation. A multiscale-shape and detail-enhancement HDR-MRI algorithm is applied to data sets of multichannel and multisequence MR images of the brain, knee, breast, and hip. In multisequence 3T hip images, agreement between automatic cartilage segmentations and corresponding synthesized HDR-MRI series were computed for mean voxel overlap established from manual segmentations for a series of cases. Qualitative comparisons between the developed HDR-MRI and standard synthesis methods were performed on multichannel 7T brain and knee data, and multisequence 3T breast and knee data. The synthesized HDR-MRI series provided excellent enhancement of fine-scale structure from multiple scales and contrasts, while substantially reducing bias field effects in 7T brain gradient echo, T 1 and T 2 breast images and 7T knee multichannel images. Evaluation of the HDR-MRI approach on 3T hip multisequence images showed superior outcomes for automatic cartilage segmentations with respect to manual segmentation, particularly around regions with hyperintense synovial fluid, across a set of 3D sequences. The successful combination of multichannel/sequence MR images into a single-fused HDR-MR image format provided consolidated visualization of tissues within 1 omnibus image, enhanced definition of thin, complex anatomical structures in the presence of variable or hyperintense signals, and improved tissue (cartilage) segmentation outcomes. © 2018 International Society for Magnetic Resonance in Medicine.

TU-F-BRF-02: MR-US Prostate Registration Using Patient-Specific Tissue Elasticity Property Prior for MR-Targeted, TRUS-Guided HDR Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, X; Rossi, P; Ogunleye, T

2014-06-15

Purpose: High-dose-rate (HDR) brachytherapy has become a popular treatment modality for prostate cancer. Conventional transrectal ultrasound (TRUS)-guided prostate HDR brachytherapy could benefit significantly from MR-targeted, TRUS-guided procedure where the tumor locations, acquired from the multiparametric MRI, are incorporated into the treatment planning. In order to enable this integration, we have developed a MR-TRUS registration with a patient-specific biomechanical elasticity prior. Methods: The proposed method used a biomechanical elasticity prior to guide the prostate volumetric B-spline deformation in the MRI and TRUS registration. The patient-specific biomechanical elasticity prior was generated using ultrasound elastography, where two 3D TRUS prostate images were acquiredmore » under different probe-induced pressures during the HDR procedure, which takes 2-4 minutes. These two 3D TRUS images were used to calculate the local displacement (elasticity map) of two prostate volumes. The B-spline transformation was calculated by minimizing the Euclidean distance between the normalized attribute vectors of the prostate surface landmarks on the MR and TRUS. This technique was evaluated through two studies: a prostate-phantom study and a pilot study with 5 patients undergoing prostate HDR treatment. The accuracy of our approach was assessed through the locations of several landmarks in the post-registration and TRUS images; our registration results were compared with the surface-based method. Results: For the phantom study, the mean landmark displacement of the proposed method was 1.29±0.11 mm. For the 5 patients, the mean landmark displacement of the surface-based method was 3.25±0.51 mm; our method, 1.71±0.25 mm. Therefore, our proposed method of prostate registration outperformed the surfaced-based registration significantly. Conclusion: We have developed a novel MR-TRUS prostate registration approach based on patient-specific biomechanical elasticity prior. Successful integration of multi-parametric MR and TRUS prostate images provides a prostate-cancer map for treatment planning, enables accurate dose planning and delivery, and potentially enhances prostate HDR treatment outcome.« less

FZUImageReg: A toolbox for medical image registration and dose fusion in cervical cancer radiotherapy

PubMed Central

Bai, Penggang; Du, Min; Ni, Xiaolei; Ke, Dongzhong; Tong, Tong

2017-01-01

The combination external-beam radiotherapy and high-dose-rate brachytherapy is a standard form of treatment for patients with locally advanced uterine cervical cancer. Personalized radiotherapy in cervical cancer requires efficient and accurate dose planning and assessment across these types of treatment. To achieve radiation dose assessment, accurate mapping of the dose distribution from HDR-BT onto EBRT is extremely important. However, few systems can achieve robust dose fusion and determine the accumulated dose distribution during the entire course of treatment. We have therefore developed a toolbox (FZUImageReg), which is a user-friendly dose fusion system based on hybrid image registration for radiation dose assessment in cervical cancer radiotherapy. The main part of the software consists of a collection of medical image registration algorithms and a modular design with a user-friendly interface, which allows users to quickly configure, test, monitor, and compare different registration methods for a specific application. Owing to the large deformation, the direct application of conventional state-of-the-art image registration methods is not sufficient for the accurate alignment of EBRT and HDR-BT images. To solve this problem, a multi-phase non-rigid registration method using local landmark-based free-form deformation is proposed for locally large deformation between EBRT and HDR-BT images, followed by intensity-based free-form deformation. With the transformation, the software also provides a dose mapping function according to the deformation field. The total dose distribution during the entire course of treatment can then be presented. Experimental results clearly show that the proposed system can achieve accurate registration between EBRT and HDR-BT images and provide radiation dose warping and fusion results for dose assessment in cervical cancer radiotherapy in terms of high accuracy and efficiency. PMID:28388623

Comparison of two laboratory-based systems for evaluation of halos in intraocular lenses

PubMed Central

Alexander, Elsinore; Wei, Xin; Lee, Shinwook

2018-01-01

Purpose Multifocal intraocular lenses (IOLs) can be associated with unwanted visual phenomena, including halos. Predicting potential for halos is desirable when designing new multifocal IOLs. Halo images from 6 IOL models were compared using the Optikos modulation transfer function bench system and a new high dynamic range (HDR) system. Materials and methods One monofocal, 1 extended depth of focus, and 4 multifocal IOLs were evaluated. An off-the-shelf optical bench was used to simulate a distant (>50 m) car headlight and record images. A custom HDR system was constructed using an imaging photometer to simulate headlight images and to measure quantitative halo luminance data. A metric was developed to characterize halo luminance properties. Clinical relevance was investigated by correlating halo measurements to visual outcomes questionnaire data. Results The Optikos system produced halo images useful for visual comparisons; however, measurements were relative and not quantitative. The HDR halo system provided objective and quantitative measurements used to create a metric from the area under the curve (AUC) of the logarithmic normalized halo profile. This proposed metric differentiated between IOL models, and linear regression analysis found strong correlations between AUC and subjective clinical ratings of halos. Conclusion The HDR system produced quantitative, preclinical metrics that correlated to patients’ subjective perception of halos. PMID:29503526

Multi-exposure high dynamic range image synthesis with camera shake correction

NASA Astrophysics Data System (ADS)

Li, Xudong; Chen, Yongfu; Jiang, Hongzhi; Zhao, Huijie

2017-10-01

Machine vision plays an important part in industrial online inspection. Owing to the nonuniform illuminance conditions and variable working distances, the captured image tends to be over-exposed or under-exposed. As a result, when processing the image such as crack inspection, the algorithm complexity and computing time increase. Multiexposure high dynamic range (HDR) image synthesis is used to improve the quality of the captured image, whose dynamic range is limited. Inevitably, camera shake will result in ghost effect, which blurs the synthesis image to some extent. However, existed exposure fusion algorithms assume that the input images are either perfectly aligned or captured in the same scene. These assumptions limit the application. At present, widely used registration based on Scale Invariant Feature Transform (SIFT) is usually time consuming. In order to rapidly obtain a high quality HDR image without ghost effect, we come up with an efficient Low Dynamic Range (LDR) images capturing approach and propose a registration method based on ORiented Brief (ORB) and histogram equalization which can eliminate the illumination differences between the LDR images. The fusion is performed after alignment. The experiment results demonstrate that the proposed method is robust to illumination changes and local geometric distortion. Comparing with other exposure fusion methods, our method is more efficient and can produce HDR images without ghost effect by registering and fusing four multi-exposure images.

Rendering of HDR content on LDR displays: an objective approach

NASA Astrophysics Data System (ADS)

Krasula, Lukáš; Narwaria, Manish; Fliegel, Karel; Le Callet, Patrick

2015-09-01

Dynamic range compression (or tone mapping) of HDR content is an essential step towards rendering it on traditional LDR displays in a meaningful way. This is however non-trivial and one of the reasons is that tone mapping operators (TMOs) usually need content-specific parameters to achieve the said goal. While subjective TMO parameter adjustment is the most accurate, it may not be easily deployable in many practical applications. Its subjective nature can also influence the comparison of different operators. Thus, there is a need for objective TMO parameter selection to automate the rendering process. To that end, we investigate into a new objective method for TMO parameters optimization. Our method is based on quantification of contrast reversal and naturalness. As an important advantage, it does not require any prior knowledge about the input HDR image and works independently on the used TMO. Experimental results using a variety of HDR images and several popular TMOs demonstrate the value of our method in comparison to default TMO parameter settings.

HDR imaging and color constancy: two sides of the same coin?

NASA Astrophysics Data System (ADS)

McCann, John J.

2011-01-01

At first, we think that High Dynamic Range (HDR) imaging is a technique for improved recordings of scene radiances. Many of us think that human color constancy is a variation of a camera's automatic white balance algorithm. However, on closer inspection, glare limits the range of light we can detect in cameras and on retinas. All scene regions below middle gray are influenced, more or less, by the glare from the bright scene segments. Instead of accurate radiance reproduction, HDR imaging works well because it preserves the details in the scene's spatial contrast. Similarly, on closer inspection, human color constancy depends on spatial comparisons that synthesize appearances from all the scene segments. Can spatial image processing play similar principle roles in both HDR imaging and color constancy?

SU-E-T-574: Fessiblity of Using the Calypso System for HDR Interstitial Catheter Reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, J S; Ma, C

2014-06-01

Purpose: It is always a challenge to reconstruct the interstitial catheter for high dose rate (HDR) brachytherapy on patient CT or MR images. This work aims to investigate the feasibility of using the Calypso system (Varian Medical, CA) for HDR catheter reconstruction utilizing its accuracy on tracking the electromagnetic transponder location. Methods: Experiment was done with a phantom that has a HDR interstitial catheter embedded inside. CT scan with a slice thickness of 1.25 mm was taken for this phantom with two Calypso beacon transponders in the catheter. The two transponders were connected with a wire. The Calypso system wasmore » used to record the beacon transponders’ location in real time when they were gently pulled out with the wire. The initial locations of the beacon transponders were used for registration with the CT image and the detected transponder locations were used for the catheter path reconstruction. The reconstructed catheter path was validated on the CT image. Results: The HDR interstitial catheter was successfully reconstructed based on the transponders’ coordinates recorded by the Calypso system in real time when the transponders were pulled in the catheter. After registration with the CT image, the shape and location of the reconstructed catheter are evaluated against the CT image and the result shows an accuracy of 2 mm anywhere in the Calypso detectable region which is within a 10 cm X 10 cm X 10 cm cubic box for the current system. Conclusion: It is feasible to use the Calypso system for HDR interstitial catheter reconstruction. The obstacle for its clinical usage is the size of the beacon transponder whose diameter is bigger than most of the interstitial catheters used in clinic. Developing smaller transponders and supporting software and hardware for this application is necessary before it can be adopted for clinical use.« less

Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization

NASA Astrophysics Data System (ADS)

Gay, H. A.; Allison, R. R.; Downie, G. H.; Mota, H. C.; Austerlitz, C.; Jenkins, T.; Sibata, C. H.

2007-06-01

A number of patients with lung cancer receive either palliative or curative high-dose-rate (HDR) endobronchial brachytherapy. Up to a third of patients treated with endobronchial HDR die from hemoptysis. Rather than accept hemoptysis as an expected potential consequence of HDR, we have calculated the radial dose distribution for an Ir-192 HDR source, rigorously examined the dose and prescription points recommended by the American Brachytherapy Society (ABS), and performed a radiobiological-based analysis. The radial dose rate of a commercially available Ir-192 source was calculated with a Monte Carlo simulation. Based on the linear quadratic model, the estimated palliative, curative and blood vessel rupture radii from the center of an Ir-192 source were obtained for the ABS recommendations and a series of customized HDR prescriptions. The estimated radius at risk for blood vessel perforation for the ABS recommendations ranges from 7 to 9 mm. An optimized prescription may in some situations reduce this radius to 4 mm. The estimated blood perforation radius is generally smaller than the palliative radius. Optimized and individualized endobronchial HDR prescriptions are currently feasible based on our current understanding of tumor and normal tissue radiobiology. Individualized prescriptions could minimize complications such as fatal hemoptysis without sacrificing efficacy. Fiducial stents, HDR catheter centering or spacers and the use of CT imaging to better assess the relationship between the catheter and blood vessels promise to be useful strategies for increasing the therapeutic index of this treatment modality. Prospective trials employing treatment optimization algorithms are needed.

Image processing pipeline for segmentation and material classification based on multispectral high dynamic range polarimetric images.

PubMed

Martínez-Domingo, Miguel Ángel; Valero, Eva M; Hernández-Andrés, Javier; Tominaga, Shoji; Horiuchi, Takahiko; Hirai, Keita

2017-11-27

We propose a method for the capture of high dynamic range (HDR), multispectral (MS), polarimetric (Pol) images of indoor scenes using a liquid crystal tunable filter (LCTF). We have included the adaptive exposure estimation (AEE) method to fully automatize the capturing process. We also propose a pre-processing method which can be applied for the registration of HDR images after they are already built as the result of combining different low dynamic range (LDR) images. This method is applied to ensure a correct alignment of the different polarization HDR images for each spectral band. We have focused our efforts in two main applications: object segmentation and classification into metal and dielectric classes. We have simplified the segmentation using mean shift combined with cluster averaging and region merging techniques. We compare the performance of our segmentation with that of Ncut and Watershed methods. For the classification task, we propose to use information not only in the highlight regions but also in their surrounding area, extracted from the degree of linear polarization (DoLP) maps. We present experimental results which proof that the proposed image processing pipeline outperforms previous techniques developed specifically for MSHDRPol image cubes.

Creating cinematic wide gamut HDR-video for the evaluation of tone mapping operators and HDR-displays

NASA Astrophysics Data System (ADS)

Froehlich, Jan; Grandinetti, Stefan; Eberhardt, Bernd; Walter, Simon; Schilling, Andreas; Brendel, Harald

2014-03-01

High quality video sequences are required for the evaluation of tone mapping operators and high dynamic range (HDR) displays. We provide scenic and documentary scenes with a dynamic range of up to 18 stops. The scenes are staged using professional film lighting, make-up and set design to enable the evaluation of image and material appearance. To address challenges for HDR-displays and temporal tone mapping operators, the sequences include highlights entering and leaving the image, brightness changing over time, high contrast skin tones, specular highlights and bright, saturated colors. HDR-capture is carried out using two cameras mounted on a mirror-rig. To achieve a cinematic depth of field, digital motion picture cameras with Super-35mm size sensors are used. We provide HDR-video sequences to serve as a common ground for the evaluation of temporal tone mapping operators and HDR-displays. They are available to the scientific community for further research.

SU-E-T-124: Dosimetric Comparison of HDR Brachytherapy and Intensity Modulated Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, J; Wu, H; Das, I

2014-06-01

Purpose: Brachytherapy is known to be able to deliver more radiation dose to tumor while minimizing radiation dose to surrounding normal tissues. Proton therapy also provides superior dose distribution due to Bragg peak. Since both HDR and Intensity Modulated Proton Therapy (IMPT) are beneficial for their quick dose drop off, our goal in this study is to compare the pace of dose gradient drop-off between HDR and IMPT plans based on the same CT image data-set. In addition, normal tissues sparing were also compared among HDR, IMPT and SBRT. Methods: Five cervical cancer cases treated with EBRT + HDR boostmore » combination with Tandem and Ovoid applicator were used for comparison purpose. Original HDR plans with prescribed dose of 5.5 Gy x 5 fractions were generated and optimized. The 100% isodose line of HDR plans was converted to a dose volume, and treated as CTV for IMPT and SBRT planning. The same HDR CT scans were also used for IMPT plan and SBRT plan for direct comparison. The philosophy of the IMPT and SBRT planning was to create the same CTV coverage as HDR plans. All three modalities treatment plans were compared to each other with a set of predetermined criteria. Results: With similar target volume coverage in cervix cancer boost treatment, HDR provides a slightly sharper dose drop-off from 100% to 50% isodose line, averagely in all directions compared to IMPT. However, IMPT demonstrated more dose gradient drop-off at the junction of the target and normal tissues by providing more normal tissue sparing and superior capability to reduce integral dose. Conclusion: IMPT is capable of providing comparable dose drop-off as HDR. IMPT can be explored as replacement for HDR brachytherapy in various applications.« less

Guided filter-based fusion method for multiexposure images

NASA Astrophysics Data System (ADS)

Hou, Xinglin; Luo, Haibo; Qi, Feng; Zhou, Peipei

2016-11-01

It is challenging to capture a high-dynamic range (HDR) scene using a low-dynamic range camera. A weighted sum-based image fusion (IF) algorithm is proposed so as to express an HDR scene with a high-quality image. This method mainly includes three parts. First, two image features, i.e., gradients and well-exposedness are measured to estimate the initial weight maps. Second, the initial weight maps are refined by a guided filter, in which the source image is considered as the guidance image. This process could reduce the noise in initial weight maps and preserve more texture consistent with the original images. Finally, the fused image is constructed by a weighted sum of source images in the spatial domain. The main contributions of this method are the estimation of the initial weight maps and the appropriate use of the guided filter-based weight maps refinement. It provides accurate weight maps for IF. Compared to traditional IF methods, this algorithm avoids image segmentation, combination, and the camera response curve calibration. Furthermore, experimental results demonstrate the superiority of the proposed method in both subjective and objective evaluations.

WE-E-BRD-01: HDR Brachytherapy I: Overview of Clinical Application and QA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Libby, B; Showalter, T

2014-06-15

With the increased usage of high dose rate (HDR) brachytherapy and the introduction of dedicated image guided brachytherapy suites, it is necessary to review the processes and procedures associated with safely delivering these treatments in the expedited time scales that dedicated treatment suites afford. The speakers will present the clinical aspects of switching from LDR to HDR treatments, including guidelines for patient selection, and the clinical outcomes comparing LDR to HDR. The speakers will also discuss the HDR treatment process itself, because the shortened clinical timeline involved with a streamlined scan/plan/treat workflow can introduce other issues. Safety and QA aspectsmore » involved with the streamlined process, including increased personnel required for parallel tasks, and possible interfering tasks causing delays in patient treatments will also be discussed. Learning Objectives: To understand the clinical aspects of HDR Brachytherapy, including common clinical indications, patient selection, and the evolving evidence in support of this therapeutic modality To review the current prominent clinical trials for HDR brachytherapy To interpret the established guidelines for HDR brachytherapy quality assurance for implementation into practical clinical settings. To introduce the basic requirements for image guided brachytherapy.« less

A research on radiation calibration of high dynamic range based on the dual channel CMOS

NASA Astrophysics Data System (ADS)

Ma, Kai; Shi, Zhan; Pan, Xiaodong; Wang, Yongsheng; Wang, Jianghua

2017-10-01

The dual channel complementary metal-oxide semiconductor (CMOS) can get high dynamic range (HDR) image through extending the gray level of the image by using image fusion with high gain channel image and low gain channel image in a same frame. In the process of image fusion with dual channel, it adopts the coefficients of radiation response of a pixel from dual channel in a same frame, and then calculates the gray level of the pixel in the HDR image. For the coefficients of radiation response play a crucial role in image fusion, it has to find an effective method to acquire these parameters. In this article, it makes a research on radiation calibration of high dynamic range based on the dual channel CMOS, and designs an experiment to calibrate the coefficients of radiation response for the sensor it used. In the end, it applies these response parameters in the dual channel CMOS which calibrates, and verifies the correctness and feasibility of the method mentioned in this paper.

Hierarchical tone mapping for high dynamic range image visualization

NASA Astrophysics Data System (ADS)

Qiu, Guoping; Duan, Jiang

2005-07-01

In this paper, we present a computationally efficient, practically easy to use tone mapping techniques for the visualization of high dynamic range (HDR) images in low dynamic range (LDR) reproduction devices. The new method, termed hierarchical nonlinear linear (HNL) tone-mapping operator maps the pixels in two hierarchical steps. The first step allocates appropriate numbers of LDR display levels to different HDR intensity intervals according to the pixel densities of the intervals. The second step linearly maps the HDR intensity intervals to theirs allocated LDR display levels. In the developed HNL scheme, the assignment of LDR display levels to HDR intensity intervals is controlled by a very simple and flexible formula with a single adjustable parameter. We also show that our new operators can be used for the effective enhancement of ordinary images.

An improved artifact removal in exposure fusion with local linear constraints

NASA Astrophysics Data System (ADS)

Zhang, Hai; Yu, Mali

2018-04-01

In exposure fusion, it is challenging to remove artifacts because of camera motion and moving objects in the scene. An improved artifact removal method is proposed in this paper, which performs local linear adjustment in artifact removal progress. After determining a reference image, we first perform high-dynamic-range (HDR) deghosting to generate an intermediate image stack from the input image stack. Then, a linear Intensity Mapping Function (IMF) in each window is extracted based on the intensities of intermediate image and reference image, the intensity mean and variance of reference image. Finally, with the extracted local linear constraints, we reconstruct a target image stack, which can be directly used for fusing a single HDR-like image. Some experiments have been implemented and experimental results demonstrate that the proposed method is robust and effective in removing artifacts especially in the saturated regions of the reference image.

A gEUD-based inverse planning technique for HDR prostate brachytherapy: Feasibility study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Giantsoudi, D.; Department of Radiation Oncology, Francis H. Burr Proton Therapy Center, Boston, Massachusetts 02114; Baltas, D.

2013-04-15

Purpose: The purpose of this work was to study the feasibility of a new inverse planning technique based on the generalized equivalent uniform dose for image-guided high dose rate (HDR) prostate cancer brachytherapy in comparison to conventional dose-volume based optimization. Methods: The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO (Hybrid Inverse Planning Optimization) is compared with alternative plans, which were produced through inverse planning using the generalized equivalent uniform dose (gEUD). All the common dose-volume indices for the prostate and the organs at risk were considered together with radiobiological measures. The clinical effectiveness of the differentmore » dose distributions was investigated by comparing dose volume histogram and gEUD evaluators. Results: Our results demonstrate the feasibility of gEUD-based inverse planning in HDR brachytherapy implants for prostate. A statistically significant decrease in D{sub 10} or/and final gEUD values for the organs at risk (urethra, bladder, and rectum) was found while improving dose homogeneity or dose conformity of the target volume. Conclusions: Following the promising results of gEUD-based optimization in intensity modulated radiation therapy treatment optimization, as reported in the literature, the implementation of a similar model in HDR brachytherapy treatment plan optimization is suggested by this study. The potential of improved sparing of organs at risk was shown for various gEUD-based optimization parameter protocols, which indicates the ability of this method to adapt to the user's preferences.« less

Live HDR video streaming on commodity hardware

NASA Astrophysics Data System (ADS)

McNamee, Joshua; Hatchett, Jonathan; Debattista, Kurt; Chalmers, Alan

2015-09-01

High Dynamic Range (HDR) video provides a step change in viewing experience, for example the ability to clearly see the soccer ball when it is kicked from the shadow of the stadium into sunshine. To achieve the full potential of HDR video, so-called true HDR, it is crucial that all the dynamic range that was captured is delivered to the display device and tone mapping is confined only to the display. Furthermore, to ensure widespread uptake of HDR imaging, it should be low cost and available on commodity hardware. This paper describes an end-to-end HDR pipeline for capturing, encoding and streaming high-definition HDR video in real-time using off-the-shelf components. All the lighting that is captured by HDR-enabled consumer cameras is delivered via the pipeline to any display, including HDR displays and even mobile devices with minimum latency. The system thus provides an integrated HDR video pipeline that includes everything from capture to post-production, archival and storage, compression, transmission, and display.

Fast exposure time decision in multi-exposure HDR imaging

NASA Astrophysics Data System (ADS)

Piao, Yongjie; Jin, Guang

2012-10-01

Currently available imaging and display system exists the problem of insufficient dynamic range, and the system cannot restore all the information for an high dynamic range (HDR) scene. The number of low dynamic range(LDR) image samples and fastness of exposure time decision impacts the real-time performance of the system dramatically. In order to realize a real-time HDR video acquisition system, this paper proposed a fast and robust method for exposure time selection in under and over exposure area which is based on system response function. The method utilized the monotony of the imaging system. According to this characteristic the exposure time is adjusted to an initial value to make the median value of the image equals to the middle value of the system output range; then adjust the exposure time to make the pixel value on two sides of histogram be the middle value of the system output range. Thus three low dynamic range images are acquired. Experiments show that the proposed method for adjusting the initial exposure time can converge in two iterations which is more fast and stable than average gray control method. As to the exposure time adjusting in under and over exposed area, the proposed method can use the dynamic range of the system more efficiently than fixed exposure time method.

Crowdsourcing-based evaluation of privacy in HDR images

NASA Astrophysics Data System (ADS)

Korshunov, Pavel; Nemoto, Hiromi; Skodras, Athanassios; Ebrahimi, Touradj

2014-05-01

The ability of High Dynamic Range imaging (HDRi) to capture details in high-contrast environments, making both dark and bright regions clearly visible, has a strong implication on privacy. However, the extent to which HDRi affects privacy when it is used instead of typical Standard Dynamic Range imaging (SDRi) is not yet clear. In this paper, we investigate the effect of HDRi on privacy via crowdsourcing evaluation using the Microworkers platform. Due to the lack of HDRi standard privacy evaluation dataset, we have created such dataset containing people of varying gender, race, and age, shot indoor and outdoor and under large range of lighting conditions. We evaluate the tone-mapped versions of these images, obtained by several representative tone-mapping algorithms, using subjective privacy evaluation methodology. Evaluation was performed using crowdsourcing-based framework, because it is a popular and effective alternative to traditional lab-based assessment. The results of the experiments demonstrate a significant loss of privacy when even tone-mapped versions of HDR images are used compared to typical SDR images shot with a standard exposure.

Image registration for multi-exposed HDRI and motion deblurring

NASA Astrophysics Data System (ADS)

Lee, Seok; Wey, Ho-Cheon; Lee, Seong-Deok

2009-02-01

In multi-exposure based image fusion task, alignment is an essential prerequisite to prevent ghost artifact after blending. Compared to usual matching problem, registration is more difficult when each image is captured under different photographing conditions. In HDR imaging, we use long and short exposure images, which have different brightness and there exist over/under satuated regions. In motion deblurring problem, we use blurred and noisy image pair and the amount of motion blur varies from one image to another due to the different exposure times. The main difficulty is that luminance levels of the two images are not in linear relationship and we cannot perfectly equalize or normalize the brightness of each image and this leads to unstable and inaccurate alignment results. To solve this problem, we applied probabilistic measure such as mutual information to represent similarity between images after alignment. In this paper, we discribed about the characteristics of multi-exposed input images in the aspect of registration and also analyzed the magnitude of camera hand shake. By exploiting the independence of luminance of mutual information, we proposed a fast and practically useful image registration technique in multiple capturing. Our algorithm can be applied to extreme HDR scenes and motion blurred scenes with over 90% success rate and its simplicity enables to be embedded in digital camera and mobile camera phone. The effectiveness of our registration algorithm is examined by various experiments on real HDR or motion deblurring cases using hand-held camera.

A Novel Form of Breast Intraoperative Radiation Therapy With CT-Guided High-Dose-Rate Brachytherapy: Results of a Prospective Phase 1 Clinical Trial

DOE Office of Scientific and Technical Information (OSTI.GOV)

Showalter, Shayna L., E-mail: snl2t@virginia.edu; Petroni, Gina; Trifiletti, Daniel M.

Purpose: Existing intraoperative radiation therapy (IORT) techniques are criticized for the lack of image guided treatment planning and energy deposition with, at times, poor resultant dosimetry and low radiation dose. We pioneered a novel method of IORT that incorporates customized, computed tomography (CT)-based treatment planning and high-dose-rate (HDR) brachytherapy to overcome these drawbacks: CT-HDR-IORT. Methods and Materials: A phase 1 study was conducted to demonstrate the feasibility and safety of CT-HDR-IORT. Eligibility criteria included age ≥50 years, invasive or in situ breast cancer, tumor size <3 cm, and N0 disease. Patients were eligible before or within 30 days of breast-conserving surgery (BCS). BCSmore » was performed, and a multilumen balloon catheter was placed. CT images were obtained, a customized HDR brachytherapy plan was created, and a dose of 12.5 Gy was delivered to 1-cm depth from the balloon surface. The catheter was removed, and the skin was closed. The primary endpoints were feasibility and acute toxicity. Feasibility was defined as IORT treatment interval (time from CT acquisition until IORT completion) ≤90 minutes. The secondary endpoints included dosimetry, cosmetic outcome, quality of life, and late toxicity. Results: Twenty-eight patients were enrolled. The 6-month follow-up assessments were completed by 93% of enrollees. The median IORT treatment interval was 67.2 minutes (range, 50-108 minutes). The treatment met feasibility criteria in 26 women (93%). The dosimetric goals were met in 22 patients (79%). There were no Radiation Therapy Oncology Group grade 3+ toxicities; 6 patients (21%) experienced grade 2 events. Most patients (93%) had good/excellent cosmetic outcomes at the last follow-up visit. Conclusions: CT-HDR-IORT is feasible and safe. This promising approach for a conformal, image-based, higher-dose breast IORT is being evaluated in a phase 2 trial.« less

Ghost detection and removal based on super-pixel grouping in exposure fusion

NASA Astrophysics Data System (ADS)

Jiang, Shenyu; Xu, Zhihai; Li, Qi; Chen, Yueting; Feng, Huajun

2014-09-01

A novel multi-exposure images fusion method for dynamic scenes is proposed. The commonly used techniques for high dynamic range (HDR) imaging are based on the combination of multiple differently exposed images of the same scene. The drawback of these methods is that ghosting artifacts will be introduced into the final HDR image if the scene is not static. In this paper, a super-pixel grouping based method is proposed to detect the ghost in the image sequences. We introduce the zero mean normalized cross correlation (ZNCC) as a measure of similarity between a given exposure image and the reference. The calculation of ZNCC is implemented in super-pixel level, and the super-pixels which have low correlation with the reference are excluded by adjusting the weight maps for fusion. Without any prior information on camera response function or exposure settings, the proposed method generates low dynamic range (LDR) images which can be shown on conventional display devices directly with details preserving and ghost effects reduced. Experimental results show that the proposed method generates high quality images which have less ghost artifacts and provide a better visual quality than previous approaches.

WE-DE-201-11: Sensitivity and Specificity of Verification Methods Based On Total Reference Air Kerma (TRAK) Or On User Provided Dose Points for Graphically Planned Skin HDR Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Damato, A; Devlin, P; Bhagwat, M

Purpose: To investigate the sensitivity and specificity of a novel verification methodology for image-guided skin HDR brachytherapy plans using a TRAK-based reasonableness test, compared to a typical manual verification methodology. Methods: Two methodologies were used to flag treatment plans necessitating additional review due to a potential discrepancy of 3 mm between planned dose and clinical target in the skin. Manual verification was used to calculate the discrepancy between the average dose to points positioned at time of planning representative of the prescribed depth and the expected prescription dose. Automatic verification was used to calculate the discrepancy between TRAK of themore » clinical plan and its expected value, which was calculated using standard plans with varying curvatures, ranging from flat to cylindrically circumferential. A plan was flagged if a discrepancy >10% was observed. Sensitivity and specificity were calculated using as a criteria for true positive that >10% of plan dwells had a distance to prescription dose >1 mm different than prescription depth (3 mm + size of applicator). All HDR image-based skin brachytherapy plans treated at our institution in 2013 were analyzed. Results: 108 surface applicator plans to treat skin of the face, scalp, limbs, feet, hands or abdomen were analyzed. Median number of catheters was 19 (range, 4 to 71) and median number of dwells was 257 (range, 20 to 1100). Sensitivity/specificity were 57%/78% for manual and 70%/89% for automatic verification. Conclusion: A check based on expected TRAK value is feasible for irregularly shaped, image-guided skin HDR brachytherapy. This test yielded higher sensitivity and specificity than a test based on the identification of representative points, and can be implemented with a dedicated calculation code or with pre-calculated lookup tables of ideally shaped, uniform surface applicators.« less

High Dynamic Range Imaging Using Multiple Exposures

NASA Astrophysics Data System (ADS)

Hou, Xinglin; Luo, Haibo; Zhou, Peipei; Zhou, Wei

2017-06-01

It is challenging to capture a high-dynamic range (HDR) scene using a low-dynamic range (LDR) camera. This paper presents an approach for improving the dynamic range of cameras by using multiple exposure images of same scene taken under different exposure times. First, the camera response function (CRF) is recovered by solving a high-order polynomial in which only the ratios of the exposures are used. Then, the HDR radiance image is reconstructed by weighted summation of the each radiance maps. After that, a novel local tone mapping (TM) operator is proposed for the display of the HDR radiance image. By solving the high-order polynomial, the CRF can be recovered quickly and easily. Taken the local image feature and characteristic of histogram statics into consideration, the proposed TM operator could preserve the local details efficiently. Experimental result demonstrates the effectiveness of our method. By comparison, the method outperforms other methods in terms of imaging quality.

Hdr Imaging for Feature Detection on Detailed Architectural Scenes

NASA Astrophysics Data System (ADS)

Kontogianni, G.; Stathopoulou, E. K.; Georgopoulos, A.; Doulamis, A.

2015-02-01

3D reconstruction relies on accurate detection, extraction, description and matching of image features. This is even truer for complex architectural scenes that pose needs for 3D models of high quality, without any loss of detail in geometry or color. Illumination conditions influence the radiometric quality of images, as standard sensors cannot depict properly a wide range of intensities in the same scene. Indeed, overexposed or underexposed pixels cause irreplaceable information loss and degrade digital representation. Images taken under extreme lighting environments may be thus prohibitive for feature detection/extraction and consequently for matching and 3D reconstruction. High Dynamic Range (HDR) images could be helpful for these operators because they broaden the limits of illumination range that Standard or Low Dynamic Range (SDR/LDR) images can capture and increase in this way the amount of details contained in the image. Experimental results of this study prove this assumption as they examine state of the art feature detectors applied both on standard dynamic range and HDR images.

High dynamic range adaptive real-time smart camera: an overview of the HDR-ARTiST project

NASA Astrophysics Data System (ADS)

Lapray, Pierre-Jean; Heyrman, Barthélémy; Ginhac, Dominique

2015-04-01

Standard cameras capture only a fraction of the information that is visible to the human visual system. This is specifically true for natural scenes including areas of low and high illumination due to transitions between sunlit and shaded areas. When capturing such a scene, many cameras are unable to store the full Dynamic Range (DR) resulting in low quality video where details are concealed in shadows or washed out by sunlight. The imaging technique that can overcome this problem is called HDR (High Dynamic Range) imaging. This paper describes a complete smart camera built around a standard off-the-shelf LDR (Low Dynamic Range) sensor and a Virtex-6 FPGA board. This smart camera called HDR-ARtiSt (High Dynamic Range Adaptive Real-time Smart camera) is able to produce a real-time HDR live video color stream by recording and combining multiple acquisitions of the same scene while varying the exposure time. This technique appears as one of the most appropriate and cheapest solution to enhance the dynamic range of real-life environments. HDR-ARtiSt embeds real-time multiple captures, HDR processing, data display and transfer of a HDR color video for a full sensor resolution (1280 1024 pixels) at 60 frames per second. The main contributions of this work are: (1) Multiple Exposure Control (MEC) dedicated to the smart image capture with alternating three exposure times that are dynamically evaluated from frame to frame, (2) Multi-streaming Memory Management Unit (MMMU) dedicated to the memory read/write operations of the three parallel video streams, corresponding to the different exposure times, (3) HRD creating by combining the video streams using a specific hardware version of the Devebecs technique, and (4) Global Tone Mapping (GTM) of the HDR scene for display on a standard LCD monitor.

The effect of split pixel HDR image sensor technology on MTF measurements

NASA Astrophysics Data System (ADS)

Deegan, Brian M.

2014-03-01

Split-pixel HDR sensor technology is particularly advantageous in automotive applications, because the images are captured simultaneously rather than sequentially, thereby reducing motion blur. However, split pixel technology introduces artifacts in MTF measurement. To achieve a HDR image, raw images are captured from both large and small sub-pixels, and combined to make the HDR output. In some cases, a large sub-pixel is used for long exposure captures, and a small sub-pixel for short exposures, to extend the dynamic range. The relative size of the photosensitive area of the pixel (fill factor) plays a very significant role in the output MTF measurement. Given an identical scene, the MTF will be significantly different, depending on whether you use the large or small sub-pixels i.e. a smaller fill factor (e.g. in the short exposure sub-pixel) will result in higher MTF scores, but significantly greater aliasing. Simulations of split-pixel sensors revealed that, when raw images from both sub-pixels are combined, there is a significant difference in rising edge (i.e. black-to-white transition) and falling edge (white-to-black) reproduction. Experimental results showed a difference of ~50% in measured MTF50 between the falling and rising edges of a slanted edge test chart.

SU-G-201-01: An Automated Treatment Plan Quality Assurance Program for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, Y; Tan, J; Jiang, S

Purpose: Plan specific quality assurance (QA) is an important step in high dose rate (HDR) brachytherapy to ensure the integrity of a treatment plan. The conventional approach is to assemble a set of plan screen-captures in a document and have an independent plan-checker to verify it. Not only is this approach cumbersome and time-consuming, using a document also limits the items that can be verified, hindering plan quality and patient safety. We have initiated efforts to develop a web-based HDR brachytherapy QA system called AutoBrachy QA, for comprehensive and efficient QA. This abstract reports a new plugin in this systemmore » for the QA of a cylinder HDR brachytherapy treatment. Methods: A cylinder plan QA module was developed using Python. It was plugged into our AutoBrachy QA system. This module extracted information from CT images and treatment plan. Image processing techniques were employed to obtain geometric parameters, e.g. cylinder diameter. A comprehensive set of eight geometrical and eight dosimetric features of the plan were validated against user specified planning parameter, such as prescription value, treatment depth and length, etc. A PDF document was generated, consisting of a summary QA sheet with all the QA results, as well as images showing plan details. Results: The cylinder QA program has been implemented in our clinic. To date, it has been used in 11 patient cases and was able to successfully perform QA tests in all of them. The QA program reduced the average plan QA time from 7 min using conventional manual approach to 0.5 min. Conclusion: Being a new module in our AutoBrachy QA system, an automated treatment plan QA module for cylinder HDR brachytherapy has been successfully developed and clinically implemented. This module improved clinical workflow and plan integrity compared to the conventional manual approach.« less

Modeling a color-rendering operator for high dynamic range images using a cone-response function

NASA Astrophysics Data System (ADS)

Choi, Ho-Hyoung; Kim, Gi-Seok; Yun, Byoung-Ju

2015-09-01

Tone-mapping operators are the typical algorithms designed to produce visibility and the overall impression of brightness, contrast, and color of high dynamic range (HDR) images on low dynamic range (LDR) display devices. Although several new tone-mapping operators have been proposed in recent years, the results of these operators have not matched those of the psychophysical experiments based on the human visual system. A color-rendering model that is a combination of tone-mapping and cone-response functions using an XYZ tristimulus color space is presented. In the proposed method, the tone-mapping operator produces visibility and the overall impression of brightness, contrast, and color in HDR images when mapped onto relatively LDR devices. The tone-mapping resultant image is obtained using chromatic and achromatic colors to avoid well-known color distortions shown in the conventional methods. The resulting image is then processed with a cone-response function wherein emphasis is placed on human visual perception (HVP). The proposed method covers the mismatch between the actual scene and the rendered image based on HVP. The experimental results show that the proposed method yields an improved color-rendering performance compared to conventional methods.

Is there a preference for linearity when viewing natural images?

NASA Astrophysics Data System (ADS)

Kane, David; Bertamío, Marcelo

2015-01-01

The system gamma of the imaging pipeline, defined as the product of the encoding and decoding gammas, is typically greater than one and is stronger for images viewed with a dark background (e.g. cinema) than those viewed in lighter conditions (e.g. office displays).1-3 However, for high dynamic range (HDR) images reproduced on a low dynamic range (LDR) monitor, subjects often prefer a system gamma of less than one,4 presumably reflecting the greater need for histogram equalization in HDR images. In this study we ask subjects to rate the perceived quality of images presented on a LDR monitor using various levels of system gamma. We reveal that the optimal system gamma is below one for images with a HDR and approaches or exceeds one for images with a LDR. Additionally, the highest quality scores occur for images where a system gamma of one is optimal, suggesting a preference for linearity (where possible). We find that subjective image quality scores can be predicted by computing the degree of histogram equalization of the lightness distribution. Accordingly, an optimal, image dependent system gamma can be computed that maximizes perceived image quality.

Research on HDR image fusion algorithm based on Laplace pyramid weight transform with extreme low-light CMOS

NASA Astrophysics Data System (ADS)

Guan, Wen; Li, Li; Jin, Weiqi; Qiu, Su; Zou, Yan

2015-10-01

Extreme-Low-Light CMOS has been widely applied in the field of night-vision as a new type of solid image sensor. But if the illumination in the scene has drastic changes or the illumination is too strong, Extreme-Low-Light CMOS can't both clearly present the high-light scene and low-light region. According to the partial saturation problem in the field of night-vision, a HDR image fusion algorithm based on the Laplace Pyramid was researched. The overall gray value and the contrast of the low light image is very low. We choose the fusion strategy based on regional average gradient for the top layer of the long exposure image and short exposure image, which has rich brightness and textural features. The remained layers which represent the edge feature information of the target are based on the fusion strategy based on regional energy. In the process of source image reconstruction with Laplacian pyramid image, we compare the fusion results with four kinds of basal images. The algorithm is tested using Matlab and compared with the different fusion strategies. We use information entropy, average gradient and standard deviation these three objective evaluation parameters for the further analysis of the fusion result. Different low illumination environment experiments show that the algorithm in this paper can rapidly get wide dynamic range while keeping high entropy. Through the verification of this algorithm features, there is a further application prospect of the optimized algorithm. Keywords: high dynamic range imaging, image fusion, multi-exposure image, weight coefficient, information fusion, Laplacian pyramid transform.

A comparison of needle tip localization accuracy using 2D and 3D trans-rectal ultrasound for high-dose-rate prostate cancer brachytherapy treatment planning

NASA Astrophysics Data System (ADS)

Hrinivich, W. Thomas; Hoover, Douglas A.; Surry, Kathleen; Edirisinghe, Chandima; Montreuil, Jacques; D'Souza, David; Fenster, Aaron; Wong, Eugene

2016-03-01

Background: High-dose-rate brachytherapy (HDR-BT) is a prostate cancer treatment option involving the insertion of hollow needles into the gland through the perineum to deliver a radioactive source. Conventional needle imaging involves indexing a trans-rectal ultrasound (TRUS) probe in the superior/inferior (S/I) direction, using the axial transducer to produce an image set for organ segmentation. These images have limited resolution in the needle insertion direction (S/I), so the sagittal transducer is used to identify needle tips, requiring a manual registration with the axial view. This registration introduces a source of uncertainty in the final segmentations and subsequent treatment plan. Our lab has developed a device enabling 3D-TRUS guided insertions with high S/I spatial resolution, eliminating the need to align axial and sagittal views. Purpose: To compare HDR-BT needle tip localization accuracy between 2D and 3D-TRUS. Methods: 5 prostate cancer patients underwent conventional 2D TRUS guided HDR-BT, during which 3D images were also acquired for post-operative registration and segmentation. Needle end-length measurements were taken, providing a gold standard for insertion depths. Results: 73 needles were analyzed from all 5 patients. Needle tip position differences between imaging techniques was found to be largest in the S/I direction with mean+/-SD of -2.5+/-4.0 mm. End-length measurements indicated that 3D TRUS provided statistically significantly lower mean+/-SD insertion depth error of -0.2+/-3.4 mm versus 2.3+/-3.7 mm with 2D guidance (p < .001). Conclusions: 3D TRUS may provide more accurate HDR-BT needle localization than conventional 2D TRUS guidance for the majority of HDR-BT needles.

MO-FG-210-02: Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Libby, B.

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

Towards enabling ultrasound guidance in cervical cancer high-dose-rate brachytherapy

NASA Astrophysics Data System (ADS)

Wong, Adrian; Sojoudia, Samira; Gaudet, Marc; Yap, Wan Wan; Chang, Silvia D.; Abolmaesumi, Purang; Aquino-Parsons, Christina; Moradi, Mehdi

2014-03-01

MRI and Computed Tomography (CT) are used in image-based solutions for guiding High Dose Rate (HDR) brachytherapy treatment of cervical cancer. MRI is costly and CT exposes the patients to ionizing radiation. Ultrasound, on the other hand, is affordable and safe. The long-term goal of our work is to enable the use of multiparametric ultrasound imaging in image-guided HDR for cervical cancer. In this paper, we report the development of enabling technology for ultrasound guidance and tissue typing. We report a system to obtain the 3D freehand transabdominal ultrasound RF signals and B-mode images of the uterus, and a method for registration of ultrasound to MRI. MRI and 3D ultrasound images of the female pelvis were registered by contouring the uterus in the two modalities, creating a surface model, followed by rigid and B-spline deformable registration. The resulting transformation was used to map the location of the tumor from the T2-weighted MRI to ultrasound images and to determine cancerous and normal areas in ultrasound. B-mode images show a contrast for cancer vs. normal tissue. Our study shows the potential and the challenges of ultrasound imaging in guiding cervical cancer treatments.

A Novel Method to Increase LinLog CMOS Sensors’ Performance in High Dynamic Range Scenarios

PubMed Central

Martínez-Sánchez, Antonio; Fernández, Carlos; Navarro, Pedro J.; Iborra, Andrés

2011-01-01

Images from high dynamic range (HDR) scenes must be obtained with minimum loss of information. For this purpose it is necessary to take full advantage of the quantification levels provided by the CCD/CMOS image sensor. LinLog CMOS sensors satisfy the above demand by offering an adjustable response curve that combines linear and logarithmic responses. This paper presents a novel method to quickly adjust the parameters that control the response curve of a LinLog CMOS image sensor. We propose to use an Adaptive Proportional-Integral-Derivative controller to adjust the exposure time of the sensor, together with control algorithms based on the saturation level and the entropy of the images. With this method the sensor’s maximum dynamic range (120 dB) can be used to acquire good quality images from HDR scenes with fast, automatic adaptation to scene conditions. Adaptation to a new scene is rapid, with a sensor response adjustment of less than eight frames when working in real time video mode. At least 67% of the scene entropy can be retained with this method. PMID:22164083

A novel method to increase LinLog CMOS sensors' performance in high dynamic range scenarios.

PubMed

Martínez-Sánchez, Antonio; Fernández, Carlos; Navarro, Pedro J; Iborra, Andrés

2011-01-01

Images from high dynamic range (HDR) scenes must be obtained with minimum loss of information. For this purpose it is necessary to take full advantage of the quantification levels provided by the CCD/CMOS image sensor. LinLog CMOS sensors satisfy the above demand by offering an adjustable response curve that combines linear and logarithmic responses. This paper presents a novel method to quickly adjust the parameters that control the response curve of a LinLog CMOS image sensor. We propose to use an Adaptive Proportional-Integral-Derivative controller to adjust the exposure time of the sensor, together with control algorithms based on the saturation level and the entropy of the images. With this method the sensor's maximum dynamic range (120 dB) can be used to acquire good quality images from HDR scenes with fast, automatic adaptation to scene conditions. Adaptation to a new scene is rapid, with a sensor response adjustment of less than eight frames when working in real time video mode. At least 67% of the scene entropy can be retained with this method.

The Ansel Adams zone system: HDR capture and range compression by chemical processing

NASA Astrophysics Data System (ADS)

McCann, John J.

2010-02-01

We tend to think of digital imaging and the tools of PhotoshopTM as a new phenomenon in imaging. We are also familiar with multiple-exposure HDR techniques intended to capture a wider range of scene information, than conventional film photography. We know about tone-scale adjustments to make better pictures. We tend to think of everyday, consumer, silver-halide photography as a fixed window of scene capture with a limited, standard range of response. This description of photography is certainly true, between 1950 and 2000, for instant films and negatives processed at the drugstore. These systems had fixed dynamic range and fixed tone-scale response to light. All pixels in the film have the same response to light, so the same light exposure from different pixels was rendered as the same film density. Ansel Adams, along with Fred Archer, formulated the Zone System, staring in 1940. It was earlier than the trillions of consumer photos in the second half of the 20th century, yet it was much more sophisticated than today's digital techniques. This talk will describe the chemical mechanisms of the zone system in the parlance of digital image processing. It will describe the Zone System's chemical techniques for image synthesis. It also discusses dodging and burning techniques to fit the HDR scene into the LDR print. Although current HDR imaging shares some of the Zone System's achievements, it usually does not achieve all of them.

Do High Dynamic Range threatments improve the results of Structure from Motion approaches in Geomorphology?

NASA Astrophysics Data System (ADS)

Gómez-Gutiérrez, Álvaro; Juan de Sanjosé-Blasco, José; Schnabel, Susanne; de Matías-Bejarano, Javier; Pulido-Fernández, Manuel; Berenguer-Sempere, Fernando

2015-04-01

In this work, the hypothesis of improving 3D models obtained with Structure from Motion (SfM) approaches using images pre-processed by High Dynamic Range (HDR) techniques is tested. Photographs of the Veleta Rock Glacier in Spain were captured with different exposure values (EV0, EV+1 and EV-1), two focal lengths (35 and 100 mm) and under different weather conditions for the years 2008, 2009, 2011, 2012 and 2014. HDR images were produced using the different EV steps within Fusion F.1 software. Point clouds were generated using commercial and free available SfM software: Agisoft Photoscan and 123D Catch. Models Obtained using pre-processed images and non-preprocessed images were compared in a 3D environment with a benchmark 3D model obtained by means of a Terrestrial Laser Scanner (TLS). A total of 40 point clouds were produced, georeferenced and compared. Results indicated that for Agisoft Photoscan software differences in the accuracy between models obtained with pre-processed and non-preprocessed images were not significant from a statistical viewpoint. However, in the case of the free available software 123D Catch, models obtained using images pre-processed by HDR techniques presented a higher point density and were more accurate. This tendency was observed along the 5 studied years and under different capture conditions. More work should be done in the near future to corroborate whether the results of similar software packages can be improved by HDR techniques (e.g. ARC3D, Bundler and PMVS2, CMP SfM, Photosynth and VisualSFM).

SU-E-T-237: Deformable Image Registration and Deformed Dose Composite for Volumetric Evaluation of Multimodal Gynecological Cancer Treatments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Albani, D; Sherertz, T; Ellis, R

2015-06-15

Purpose: Radiotherapy plans for patients with cervical cancer treated with EBRT followed by HDR brachytherapy are optimized by constraining dose to organs at risk (OARs). Risk of treatment related toxicities is estimated based on the dose received to the hottest 2cc (D2cc) of the bladder, bowel, rectum, and sigmoid. To account for intrafractional variation in OAR volume and positioning, a dose deformation method is proposed for more accurate evaluation of dose distribution for these patients. Methods: Radiotherapy plans from five patients who received 50.4Gy pelvic EBRT followed by 30Gy in five fractions of HDR brachytherapy, using split-ring and tandem applicators,more » were retrospectively evaluated using MIM Software version 6.0. Dose accumulation workflows were used for initial deformation of EBRT and HDR planning CTs onto a common HDR planning CT. The Reg Refine tool was applied with user-specified local alignments to refine the deformation. Doses from the deformed images were transferred to the common planning CT. Deformed doses were scaled to the EQD2, following the linear-quadratic BED model (considered α/β ratio for tumor as 10, and 3 for rest of the tissues), and then combined to create the dose composite. MIM composite doses were compared to the clinically-reported plan assessments based upon the American Brachytherapy Society (ABS) guidelines for cervical HDR brachytherapy treatment. Results: Bladder D2cc exhibited significant reduction (−11.4%±3.85%, p< 0.02) when evaluated using MIM deformable dose composition. Differences observed for bowel, rectum, and sigmoid D2cc were not significant (−0.58±7.37%, −4.13%±13.7%, and 8.58%±4.71%, respectively and p>0.05 for all) relative to the calculated values used clinically. Conclusion: Application of deformable dose composite techniques may lead to more accurate total dose reporting and can allow for elevated dose to target structures with the assurance of not exceeding dose to OARs. Further study into deformable dose composition and correlation with clinical outcomes is warranted.« less

Characterizing Response to Elemental Unit of Acoustic Imaging Noise: An fMRI Study

PubMed Central

Luh, Wen-Ming; Talavage, Thomas M.

2010-01-01

Acoustic imaging noise produced during functional magnetic resonance imaging (fMRI) studies can hinder auditory fMRI research analysis by altering the properties of the acquired time-series data. Acoustic imaging noise can be especially confounding when estimating the time course of the hemodynamic response (HDR) in auditory event-related fMRI (fMRI) experiments. This study is motivated by the desire to establish a baseline function that can serve not only as a comparison to other quantities of acoustic imaging noise for determining how detrimental is one's experimental noise, but also as a foundation for a model that compensates for the response to acoustic imaging noise. Therefore, the amplitude and spatial extent of the HDR to the elemental unit of acoustic imaging noise (i.e., a single ping) associated with echoplanar acquisition were characterized and modeled. Results from this fMRI study at 1.5 T indicate that the group-averaged HDR in left and right auditory cortex to acoustic imaging noise (duration of 46 ms) has an estimated peak magnitude of 0.29% (right) to 0.48% (left) signal change from baseline, peaks between 3 and 5 s after stimulus presentation, and returns to baseline and remains within the noise range approximately 8 s after stimulus presentation. PMID:19304477

Image-based multichannel vaginal cylinder brachytherapy for the definitive treatment of gynecologic malignancies in the vagina.

PubMed

Gebhardt, Brian J; Vargo, John A; Kim, Hayeon; Houser, Christopher J; Glaser, Scott M; Sukumvanich, Paniti; Olawaiye, Alexander B; Kelley, Joseph L; Edwards, Robert P; Comerci, John T; Courtney-Brooks, Madeleine; Beriwal, Sushil

2018-06-18

Brachytherapy is integral to vaginal cancer treatment and is typically delivered using an intracavitary single-channel vaginal cylinder (SCVC) or an interstitial brachytherapy (ISBT) applicator. Multi-channel vaginal cylinder (MCVC) applicators allow for improved organ-at-risk (OAR) sparing compared to SCVC while maintaining target coverage. We present clinical outcomes of patients treated with image-based high dose-rate (HDR) brachytherapy using a MCVC. Sixty patients with vaginal cancer (27% primary vaginal and 73% recurrence from other primaries) were treated with combination external beam radiotherapy (EBRT) and image-based HDR brachytherapy utilizing a MCVC if residual disease thickness was 7 mm or less after EBRT. All pts received 3D image-based BT to a total equivalent dose of 70-80 Gy. The median high-risk clinical target volume was 24.4 cm 3 (interquartile range [IQR], 14.1), with a median dose to 90% of 77.2 Gy (IQR, 2.8). After a median follow-up of 45 months (range, 11-78), the 4-year local-regional control, distant control, DFS, and OS rates were 92.6%, 76.1%, 64.0%, and 67.2%, respectively. The 4-year LRC rates were similar between the primary vaginal (92%) and recurrent (93%) groups (p = 0.290). Pts with lymph node positive disease had a lower rate of distant control at 4 years (22.7% vs. 89.0%, p < 0.001). There were no Grade 3 or higher acute complications. The 4-year rate of late Grade 3 or higher toxicity was 2.7%. Clinical outcomes of pts with primary and recurrent vaginal cancer treated definitively in a systematic manner with combination EBRT with image-guided HDR BT utilizing a MCVC applicator demonstrate high rates of local control and low rates of severe morbidity. The MCVC technique allows interstitial implantation to be avoided in select pts with ≤7 mm residual disease thickness following EBRT while maintaining excellent clinical outcomes with extended 4-year follow-up in this rare malignancy. Copyright © 2018. Published by Elsevier Inc.

Robust image registration for multiple exposure high dynamic range image synthesis

NASA Astrophysics Data System (ADS)

Yao, Susu

2011-03-01

Image registration is an important preprocessing technique in high dynamic range (HDR) image synthesis. This paper proposed a robust image registration method for aligning a group of low dynamic range images (LDR) that are captured with different exposure times. Illumination change and photometric distortion between two images would result in inaccurate registration. We propose to transform intensity image data into phase congruency to eliminate the effect of the changes in image brightness and use phase cross correlation in the Fourier transform domain to perform image registration. Considering the presence of non-overlapped regions due to photometric distortion, evolutionary programming is applied to search for the accurate translation parameters so that the accuracy of registration is able to be achieved at a hundredth of a pixel level. The proposed algorithm works well for under and over-exposed image registration. It has been applied to align LDR images for synthesizing high quality HDR images..

A novel GATA3 nonsense mutation in a newly diagnosed adult patient of hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome.

PubMed

Nanba, Kazutaka; Usui, Takeshi; Nakamura, Michikazu; Toyota, Yuko; Hirota, Keisho; Tamanaha, Tamiko; Kawashima, Sachiko-Tsukamoto; Nakao, Kanako; Yuno, Akiko; Tagami, Tetsuya; Naruse, Mitsuhide; Shimatsu, Akira

2013-01-01

Hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome is an autosomal dominant disorder caused by a GATA3 gene mutation. Here we report a novel mutation of GATA3 in a patient diagnosed with HDR syndrome at the age of 58 with extensive intracranial calcification. A 58-year-old Japanese man showed severe hypocalcemia and marked calcification in the basal ganglia, cerebellum, deep white matter, and gray-white junction on computed tomography (CT). The serum intact parathyroid hormone level was relatively low against low serum calcium concentration. The patient had been diagnosed with bilateral sensorineural deafness in childhood and had a family history of hearing disorders. Imaging studies revealed no renal anomalies. The patient was diagnosed with HDR syndrome, and genetic testing was performed. Genetic analysis of GATA3 showed a novel nonsense mutation at codon 198 (S198X) in exon 3. The S198X mutation leads to a loss of two zinc finger deoxyribonucleic acid (DNA) binding domains and is considered to be responsible for HDR syndrome. We identified a novel nonsense mutation of GATA3 in an adult patient with HDR syndrome who showed extensive intracranial calcification.

Handheld directional reflectometer: an angular imaging device to measure BRDF and HDR in real time

NASA Astrophysics Data System (ADS)

Mattison, Phillip R.; Dombrowski, Mark S.; Lorenz, James M.; Davis, Keith J.; Mann, Harley C.; Johnson, Philip; Foos, Bryan

1998-10-01

Many applications require quantitative measurements of surface light scattering, including quality control on production lines, inspection of painted surfaces, inspection of field repairs, etc. Instruments for measuring surface scattering typically fall into two main categories, namely bidirectional reflectometers, which measure the angular distribution of scattering, and hemispherical directional reflectometers, which measure the total scattering into the hemisphere above the surface. Measurement of the bi-directional reflectance distribution function (BRDF) gives the greatest insight into how light is scattered from a surface. Measurements of BRDF, however, are typically very lengthy measurements taken by moving a source and detector to map the scattering. Since BRDF has four angular degrees of freedom, such measurements can require hours to days to complete. Instruments for measuring BRDF are also typically laboratory devices, although a field- portable bi-directional reflectometer does exist. Hemispherical directional reflectance (HDR) is a much easier measurement to make, although care must be taken to use the proper methodology when measuring at wavelengths beyond 10 micrometer, since integrating spheres (typically used to make such measurements) are very energy inefficient and lose their integrating properties at very long wavelengths. A few field- portable hemispherical directional reflectometers do exist, but typically measure HDR only at near-normal angles. Boeing Defense and Space Group and Surface Optics Corporation, under a contract from the Air Force Research Laboratory, have developed a new hand-held instrument capable of measuring both BRDF and HDR using a unique, patented angular imaging technique. A combination of an hemi-ellipsoidal mirror and an additional lens translate the angular scatter from a surface into a two-dimensional spatial distribution, which is recorded by an imaging array. This configuration fully maps the scattering from a half-hemisphere above the surface with more than 30,000 angularly-resolved points and update rates to 60 measurements per second. The instrument then computes HDR from the measured BDR. For ease of use, the instrument can also compare both the BRDF and HDR to preset limits, generating a Pass/Fail indicator for HDR and a high-acceptable-low image display of BRDF. Beam incidence elevation is variable from normal incidence ((theta) equals 0 degrees) to 5 degrees off grazing ((theta) equals 85 degrees), while scattering is measured to nearly 90 degrees off normal. Such capability is extremely important for any application requiring knowledge of surface appearance at oblique viewing angles. The current instrument operates over the range of 3 micrometer to 12 micrometer, with extension into the visible band possible.

Evaluating HDR photos using Web 2.0 technology

NASA Astrophysics Data System (ADS)

Qiu, Guoping; Mei, Yujie; Duan, Jiang

2011-01-01

High dynamic range (HDR) photography is an emerging technology that has the potential to dramatically enhance the visual quality and realism of digital photos. One of the key technical challenges of HDR photography is displaying HDR photos on conventional devices through tone mapping or dynamic range compression. Although many different tone mapping techniques have been developed in recent years, evaluating tone mapping operators prove to be extremely difficult. Web2.0, social media and crowd-sourcing are emerging Internet technologies which can be harnessed to harvest the brain power of the mass to solve difficult problems in science, engineering and businesses. Paired comparison is used in the scientific study of preferences and attitudes and has been shown to be capable of obtaining an interval-scale ordering of items along a psychometric dimension such as preference or importance. In this paper, we exploit these technologies for evaluating HDR tone mapping algorithms. We have developed a Web2.0 style system that enables Internet users from anywhere to evaluate tone mapped HDR photos at any time. We adopt a simple paired comparison protocol, Internet users are presented a pair of tone mapped images and are simply asked to select the one that they think is better or click a "no difference" button. These user inputs are collected in the web server and analyzed by a rank aggregation algorithm which ranks the tone mapped photos according to the votes they received. We present experimental results which demonstrate that the emerging Internet technologies can be exploited as a new paradigm for evaluating HDR tone mapping algorithms. The advantages of this approach include the potential of collecting large user inputs under a variety of viewing environments rather than limited user participation under controlled laboratory environments thus enabling more robust and reliable quality assessment. We also present data analysis to correlate user generated qualitative indices with quantitative image statistics which may provide useful guidance for developing better tone mapping operators.

Transition from LDR to HDR brachytherapy for cervical cancer: Evaluation of tumor control, survival, and toxicity.

PubMed

Romano, K D; Pugh, K J; Trifiletti, D M; Libby, B; Showalter, T N

In 2012, our institution transitioned from low-dose-rate (LDR) brachytherapy to high dose-rate (HDR) brachytherapy. We report clinical outcomes after brachytherapy for cervical cancer at our institution over a continuous 10-year period. From 2004 to 2014, 258 women (184 LDR and 74 HDR) were treated with tandem and ovoid brachytherapy in the multidisciplinary management of International Federation of Gynecology and Obstetrics Stages IA-IVB cervical cancer. Clinical and treatment-related prognostic factors including age, stage, smoking status, relevant doses, and toxicity data were recorded. Median followup for the LDR and HDR groups was 46 months and 12 months, respectively. The majority of patients (92%) received external beam radiotherapy as well as concurrent chemotherapy (83%) before the start of brachytherapy. For all stages, the 1-year local control and overall survival (OS) rates were comparable between the LDR and HDR groups (87% vs. 81%, p = 0.12; and 75% vs. 85%, p = 0.16), respectively. Factors associated with OS on multivariate analysis include age, stage, and nodal involvement. On multivariate analysis, severe toxicity (acute or chronic) was higher with HDR than LDR (24% vs. 10%, p = 0.04). Additional prognostic factors associated with increased severe toxicity include former/current smokers and total dose to lymph nodes. This comparative retrospective analysis of a large cohort of women treated with brachytherapy demonstrates no significant difference in OS or local control between the LDR and HDR. Acute and chronic toxicity increased shortly after the implementation of HDR, highlighting the importance of continued refinement of HDR methods, including integrating advanced imaging. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

SU-G-JeP2-14: MRI-Based HDR Prostate Brachytherapy: A Phantom Study for Interstitial Catheter Reconstruction with 0.35T MRI Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, S; Kamrava, M; Yang, Y

Purpose: To evaluate the accuracy of interstitial catheter reconstruction with 0.35T MRI images for MRI-based HDR prostate brachytherapy. Methods: Recently, a real-time MRI-guided radiotherapy system combining a 0.35T MRI system and three cobalt 60 heads (MRIdian System, ViewRay, Cleveland, OH, USA) was installed in our department. A TrueFISP sequence for MRI acquisition at lower field on Viewray was chosen due to its fast speed and high signal-to-noise efficiency. Interstitial FlexiGuide needles were implanted into a tissue equivalent ultrasound prostate phantom (CIRS, Norfolk, Virginia, USA). After an initial 15s pilot MRI to confirm the location of the phantom, planning MRI wasmore » acquired with a 172s TrueFISP sequence. The pulse sequence parameters included: flip angle = 60 degree, echo time (TE) =1.45 ms, repetition time (TR) = 3.37 ms, slice thickness = 1.5 mm, field of view (FOV) =500 × 450mm. For a reference image, a CT scan was followed. The CT and MR scans were then fused with the MIM Maestro (MIM software Inc., Cleveland, OH, USA) and sent to the Oncentra Brachy planning system (Elekta, Veenendaal, Netherlands). Automatic catheter reconstruction using CT and MR image intensities followed by manual reconstruction was used to digitize catheters. The accuracy of catheter reconstruction was evaluated from the catheter tip location. Results: The average difference between the catheter tip locations reconstructed from the CT and MR in the transverse, anteroposterior, and craniocaudal directions was −0.1 ± 0.1 mm (left), 0.2 ± 0.2 mm (anterior), and −2.3 ± 0.5 mm (cranio). The average distance in 3D was 2.3 mm ± 0.5 mm. Conclusion: This feasibility study proved that interstitial catheters can be reconstructed with 0.35T MRI images. For more accurate catheter reconstruction which can affect final dose distribution, a systematic shift should be applied to the MR based catheter reconstruction in HDR prostate brachytherapy.« less

Effect of tone mapping operators on visual attention deployment

NASA Astrophysics Data System (ADS)

Narwaria, Manish; Perreira Da Silva, Matthieu; Le Callet, Patrick; Pepion, Romuald

2012-10-01

High Dynamic Range (HDR) images/videos require the use of a tone mapping operator (TMO) when visualized on Low Dynamic Range (LDR) displays. From an artistic intention point of view, TMOs are not necessarily transparent and might induce different behavior to view the content. In this paper, we investigate and quantify how TMOs modify visual attention (VA). To that end both objective and subjective tests in the form of eye-tracking experiments have been conducted on several still image content that have been processed by 11 different TMOs. Our studies confirm that TMOs can indeed modify human attention and fixation behavior significantly. Therefore our studies suggest that VA needs consideration for evaluating the overall perceptual impact of TMOs on HDR content. Since the existing studies so far have only considered the quality or aesthetic appeal angle, this study brings in a new perspective regarding the importance of VA in HDR content processing for visualization on LDR displays.

Research on Formation Mechanisms of Hot Dry Rock Resources in China

NASA Astrophysics Data System (ADS)

Wang, G.; Xi, Y.

2017-12-01

As an important geothermal resource, hot dry rock(HDR) reserves have been studied in many countries. HDR resources in China have huge capacity and have become one of the most important resources for the potential replacement of fossil fuels. However, HDR resources are difficult to develop and utilise. Technologies for use with HDR, such as high-temperature drilling, reservoir characterisation, reservoir fracturing, microseismic monitoring and high-temperature power stations, originate from the field of oil and drilling. Addressing how to take advantage of these developed technologies is a key factor in the development of HDR reserves. Based on the thermal crustal structure in China, HDR resources can be divided into four types: high radioactive heat production, sedimentary basin, modern volcano and the inner-plate active tectonic belt. The prospective regions of HDR resources are located in South Tibet, West Yunnan, the southeast coast of China, Bohai Rim, Songliao Basin and Guanzhong Basin. The related essential technologies are relatively mature, and the prospect of HDR power generation is promising. Therefore, analysing the formation mechanisms of HDR resources and promoting the transformation of technological achievements, large-scale development and the utilisation of HDR resources can be achieved in China.

Use of cone-beam imaging to correct for catheter displacement in high dose-rate prostate brachytherapy.

PubMed

Holly, Rick; Morton, Gerard C; Sankreacha, Raxa; Law, Niki; Cisecki, Thomas; Loblaw, D Andrew; Chung, Hans T

2011-01-01

To determine the magnitude of catheter displacement between time of planning and time of treatment delivery for patients undergoing high dose-rate (HDR) brachytherapy, the dosimetric impact of catheter displacement, and the ability to improve dosimetry by catheter readjustment. Twenty consecutive patients receiving single fraction HDR brachytherapy underwent kilovoltage cone-beam CT in the treatment room before treatment. If catheter displacement was apparent, catheters were adjusted and imaging repeated. Both sets of kilovoltage cone-beam CT image sets were coregistered off-line with the CT data set used for planning with rigid fusion of anatomy based on implanted fiducials. Catheter displacement was measured on both sets of images and dosimetry calculated. Mean internal displacement of catheters was 11mm. This would have resulted in a decrease in mean volume receiving 100% of prescription dose (V(100)) from the planned 97.6% to 77.3% (p<0.001), a decrease of the mean dose to 90% of the prostate (D(90)) from 110.5% to 72.9% (p<0.001), and increase in dose to 10% of urethra (urethra D(10)) from 118% to 125% (p=0.0094). Each 1cm of catheter displacement resulted in a 20% decrease in V(100) and 36% decrease in D(90). Catheter readjustment resulted in a final treated mean V(100) of 90.2% and D(90) of 97.4%, both less than planned. Mean urethra D(10) remained higher at126% (p=0.0324). Significantly, internal displacement of HDR catheters commonly occurs between time of CT planning and treatment delivery, even when only a single fraction is used. The adverse effects on dosimetry can be partly corrected by readjustment of catheter position. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Enhancement tuning and control for high dynamic range images in multi-scale locally adaptive contrast enhancement algorithms

NASA Astrophysics Data System (ADS)

Cvetkovic, Sascha D.; Schirris, Johan; de With, Peter H. N.

2009-01-01

For real-time imaging in surveillance applications, visibility of details is of primary importance to ensure customer confidence. If we display High Dynamic-Range (HDR) scenes whose contrast spans four or more orders of magnitude on a conventional monitor without additional processing, results are unacceptable. Compression of the dynamic range is therefore a compulsory part of any high-end video processing chain because standard monitors are inherently Low- Dynamic Range (LDR) devices with maximally two orders of display dynamic range. In real-time camera processing, many complex scenes are improved with local contrast enhancements, bringing details to the best possible visibility. In this paper, we show how a multi-scale high-frequency enhancement scheme, in which gain is a non-linear function of the detail energy, can be used for the dynamic range compression of HDR real-time video camera signals. We also show the connection of our enhancement scheme to the processing way of the Human Visual System (HVS). Our algorithm simultaneously controls perceived sharpness, ringing ("halo") artifacts (contrast) and noise, resulting in a good balance between visibility of details and non-disturbance of artifacts. The overall quality enhancement, suitable for both HDR and LDR scenes, is based on a careful selection of the filter types for the multi-band decomposition and a detailed analysis of the signal per frequency band.

Occurrence Prospect of HDR and Target Site Selection Study in Southeastern of China

NASA Astrophysics Data System (ADS)

Lin, W.; Gan, H.

2017-12-01

Hot dry rock (HDR) geothermal resource is one of the most important clean energy in future. Site selection a HDR resource is a fundamental work to explore the HDR resources. This paper compiled all the HDR development projects domestic and abroad, and summarized the location of HDR geothermal geological index. After comparing the geological background of HDR in the southeast coastal area of China, Yangjiang Xinzhou in Guangdong province, Leizhou Peninsula area, Lingshui in Hainan province and Huangshadong in Guangzhou were selected from some key potential target area along the southeast coast of China. Deep geothermal field model of the study area is established based on the comprehensive analysis of the target area of deep geothermal geological background and deep thermal anomalies. This paper also compared the hot dry rock resources target locations, and proposed suggestions for the priority exploration target area and exploration scheme.

Analysis of visual quality improvements provided by known tools for HDR content

NASA Astrophysics Data System (ADS)

Kim, Jaehwan; Alshina, Elena; Lee, JongSeok; Park, Youngo; Choi, Kwang Pyo

2016-09-01

In this paper, the visual quality of different solutions for high dynamic range (HDR) compression using MPEG test contents is analyzed. We also simulate the method for an efficient HDR compression which is based on statistical property of the signal. The method is compliant with HEVC specification and also easily compatible with other alternative methods which might require HEVC specification changes. It was subjectively tested on commercial TVs and compared with alternative solutions for HDR coding. Subjective visual quality tests were performed using SUHD TVs model which is SAMSUNG JS9500 with maximum luminance up to 1000nit in test. The solution that is based on statistical property shows not only improvement of objective performance but improvement of visual quality compared to other HDR solutions, while it is compatible with HEVC specification.

Systematic quantification of HDR and NHEJ reveals effects of locus, nuclease, and cell type on genome-editing.

PubMed

Miyaoka, Yuichiro; Berman, Jennifer R; Cooper, Samantha B; Mayerl, Steven J; Chan, Amanda H; Zhang, Bin; Karlin-Neumann, George A; Conklin, Bruce R

2016-03-31

Precise genome-editing relies on the repair of sequence-specific nuclease-induced DNA nicking or double-strand breaks (DSBs) by homology-directed repair (HDR). However, nonhomologous end-joining (NHEJ), an error-prone repair, acts concurrently, reducing the rate of high-fidelity edits. The identification of genome-editing conditions that favor HDR over NHEJ has been hindered by the lack of a simple method to measure HDR and NHEJ directly and simultaneously at endogenous loci. To overcome this challenge, we developed a novel, rapid, digital PCR-based assay that can simultaneously detect one HDR or NHEJ event out of 1,000 copies of the genome. Using this assay, we systematically monitored genome-editing outcomes of CRISPR-associated protein 9 (Cas9), Cas9 nickases, catalytically dead Cas9 fused to FokI, and transcription activator-like effector nuclease at three disease-associated endogenous gene loci in HEK293T cells, HeLa cells, and human induced pluripotent stem cells. Although it is widely thought that NHEJ generally occurs more often than HDR, we found that more HDR than NHEJ was induced under multiple conditions. Surprisingly, the HDR/NHEJ ratios were highly dependent on gene locus, nuclease platform, and cell type. The new assay system, and our findings based on it, will enable mechanistic studies of genome-editing and help improve genome-editing technology.

Evaluation of High Dynamic Range Photography as a Luminance Mapping Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Inanici, Mehlika; Galvin, Jim

2004-12-30

The potential, limitations, and applicability of the High Dynamic Range (HDR) photography technique is evaluated as a luminance mapping tool. Multiple exposure photographs of static scenes are taken with a Nikon 5400 digital camera to capture the wide luminance variation within the scenes. The camera response function is computationally derived using the Photosphere software, and is used to fuse the multiple photographs into HDR images. The vignetting effect and point spread function of the camera and lens system is determined. Laboratory and field studies have shown that the pixel values in the HDR photographs can correspond to the physical quantitymore » of luminance with reasonable precision and repeatability.« less

SU-F-T-65: AutomaticTreatment Planning for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, Y; Tan, J; Jiang, S

Purpose: High dose rate (HDR) brachytherapy treatment planning is conventionally performed in a manual fashion. Yet it is highly desirable to perform computerized automated planning to improve treatment planning efficiency, eliminate human errors, and reduce plan quality variation. The goal of this research is to develop an automatic treatment planning tool for HDR brachytherapy with a cylinder applicator for vaginal cancer. Methods: After inserting the cylinder applicator into the patient, a CT scan was acquired and was loaded to an in-house developed treatment planning software. The cylinder applicator was automatically segmented using image-processing techniques. CTV was generated based on user-specifiedmore » treatment depth and length. Locations of relevant points (apex point, prescription point, and vaginal surface point), central applicator channel coordinates, and dwell positions were determined according to their geometric relations with the applicator. Dwell time was computed through an inverse optimization process. The planning information was written into DICOM-RT plan and structure files to transfer the automatically generated plan to a commercial treatment planning system for plan verification and delivery. Results: We have tested the system retrospectively in nine patients treated with vaginal cylinder applicator. These cases were selected with different treatment prescriptions, lengths, depths, and cylinder diameters to represent a large patient population. Our system was able to generate treatment plans for these cases with clinically acceptable quality. Computation time varied from 3–6 min. Conclusion: We have developed a system to perform automated treatment planning for HDR brachytherapy with a cylinder applicator. Such a novel system has greatly improved treatment planning efficiency and reduced plan quality variation. It also served as a testbed to demonstrate the feasibility of automatic HDR treatment planning for more complicated cases.« less

An automated approach for tone mapping operator parameter adjustment in security applications

NASA Astrophysics Data System (ADS)

Krasula, LukáÅ.¡; Narwaria, Manish; Le Callet, Patrick

2014-05-01

High Dynamic Range (HDR) imaging has been gaining popularity in recent years. Different from the traditional low dynamic range (LDR), HDR content tends to be visually more appealing and realistic as it can represent the dynamic range of the visual stimuli present in the real world. As a result, more scene details can be faithfully reproduced. As a direct consequence, the visual quality tends to improve. HDR can be also directly exploited for new applications such as video surveillance and other security tasks. Since more scene details are available in HDR, it can help in identifying/tracking visual information which otherwise might be difficult with typical LDR content due to factors such as lack/excess of illumination, extreme contrast in the scene, etc. On the other hand, with HDR, there might be issues related to increased privacy intrusion. To display the HDR content on the regular screen, tone-mapping operators (TMO) are used. In this paper, we present the universal method for TMO parameters tuning, in order to maintain as many details as possible, which is desirable in security applications. The method's performance is verified on several TMOs by comparing the outcomes from tone-mapping with default and optimized parameters. The results suggest that the proposed approach preserves more information which could be of advantage for security surveillance but, on the other hand, makes us consider possible increase in privacy intrusion.

Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

PubMed

Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

LDR vs. HDR brachytherapy for localized prostate cancer: the view from radiobiological models.

PubMed

King, Christopher R

2002-01-01

Permanent LDR brachytherapy and temporary HDR brachytherapy are competitive techniques for clinically localized prostate radiotherapy. Although a randomized trial will likely never be conducted comparing these two forms of brachytherapy, a comparative radiobiological modeling analysis proves useful in understanding some of their intrinsic differences, several of which could be exploited to improve outcomes. Radiobiological models based upon the linear quadratic equations are presented for fractionated external beam, fractionated (192)Ir HDR brachytherapy, and (125)I and (103)Pd LDR brachytherapy. These models incorporate the dose heterogeneities present in brachytherapy based upon patient-derived dose volume histograms (DVH) as well as tumor doubling times and repair kinetics. Radiobiological parameters are normalized to correspond to three accepted clinical risk factors based upon T-stage, PSA, and Gleason score to compare models with clinical series. Tumor control probabilities (TCP) for LDR and HDR brachytherapy (as monotherapy or combined with external beam) are compared with clinical bNED survival rates. Predictions are made for dose escalation with HDR brachytherapy regimens. Model predictions for dose escalation with external beam agree with clinical data and validate the models and their underlying assumptions. Both LDR and HDR brachytherapy achieve superior tumor control when compared with external beam at conventional doses (<70 Gy), but similar to results from dose escalation series. LDR brachytherapy as boost achieves superior tumor control than when used as monotherapy. Stage for stage, both LDR and current HDR regimens achieve similar tumor control rates, in agreement with current clinical data. HDR monotherapy with large-dose fraction sizes might achieve superior tumor control compared with LDR, especially if prostate cancer possesses a high sensitivity to dose fractionation (i.e., if the alpha/beta ratio is low). Radiobiological models support the current clinical evidence for equivalent outcomes in localized prostate cancer with either LDR or HDR brachytherapy using current dose regimens. However, HDR brachytherapy dose escalation regimens might be able to achieve higher biologically effective doses of irradiation in comparison to LDR, and hence improved outcomes. This advantage over LDR would be amplified should prostate cancer possess a high sensitivity to dose fractionation (i.e., a low alpha/beta ratio) as the current evidence suggests.

Novel techniques for enhancement and segmentation of acne vulgaris lesions.

PubMed

Malik, A S; Humayun, J; Kamel, N; Yap, F B-B

2014-08-01

More than 99% acne patients suffer from acne vulgaris. While diagnosing the severity of acne vulgaris lesions, dermatologists have observed inter-rater and intra-rater variability in diagnosis results. This is because during assessment, identifying lesion types and their counting is a tedious job for dermatologists. To make the assessment job objective and easier for dermatologists, an automated system based on image processing methods is proposed in this study. There are two main objectives: (i) to develop an algorithm for the enhancement of various acne vulgaris lesions; and (ii) to develop a method for the segmentation of enhanced acne vulgaris lesions. For the first objective, an algorithm is developed based on the theory of high dynamic range (HDR) images. The proposed algorithm uses local rank transform to generate the HDR images from a single acne image followed by the log transformation. Then, segmentation is performed by clustering the pixels based on Mahalanobis distance of each pixel from spectral models of acne vulgaris lesions. Two metrics are used to evaluate the enhancement of acne vulgaris lesions, i.e., contrast improvement factor (CIF) and image contrast normalization (ICN). The proposed algorithm is compared with two other methods. The proposed enhancement algorithm shows better result than both the other methods based on CIF and ICN. In addition, sensitivity and specificity are calculated for the segmentation results. The proposed segmentation method shows higher sensitivity and specificity than other methods. This article specifically discusses the contrast enhancement and segmentation for automated diagnosis system of acne vulgaris lesions. The results are promising that can be used for further classification of acne vulgaris lesions for final grading of the lesions. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

High versus low-dose rate brachytherapy for cervical cancer.

PubMed

Patankar, Sonali S; Tergas, Ana I; Deutsch, Israel; Burke, William M; Hou, June Y; Ananth, Cande V; Huang, Yongmei; Neugut, Alfred I; Hershman, Dawn L; Wright, Jason D

2015-03-01

Brachytherapy plays an important role in the treatment of cervical cancer. While small trials have shown comparable survival outcomes between high (HDR) and low-dose rate (LDR) brachytherapy, little data is available in the US. We examined the utilization of HDR brachytherapy and analyzed the impact of type of brachytherapy on survival for cervical cancer. Women with stages IB2-IVA cervical cancer treated with primary (external beam and brachytherapy) radiotherapy between 2003-2011 and recorded in the National Cancer Database (NCDB) were analyzed. Generalized linear mixed models and Cox proportional hazards regression were used to examine predictors of HDR brachytherapy use and the association between HDR use and survival. A total of 10,564 women including 2681 (25.4%) who received LDR and 7883 (74.6%) that received HDR were identified. Use of HDR increased from 50.2% in 2003 to 83.9% in 2011 (P<0.0001). In a multivariable model, year of diagnosis was the strongest predictor of use of HDR. While patients in the Northeast were more likely to receive HDR therapy, there were no other clinical or socioeconomic characteristics associated with receipt of HDR. In a multivariable Cox model, survival was similar between the HDR and LDR groups (HR=0.93; 95% CI 0.83-1.03). Similar findings were noted in analyses stratified by stage and histology. Kaplan-Meier analyses demonstrated no difference in survival based on type of brachytherapy for stage IIB (P=0.68), IIIB (P=0.17), or IVA (P=0.16) tumors. The use of HDR therapy has increased rapidly. Overall survival is similar for LDR and HDR brachytherapy. Copyright © 2015 Elsevier Inc. All rights reserved.

High versus Low-Dose Rate Brachytherapy for Cervical Cancer

PubMed Central

Patankar, Sonali S.; Tergas, Ana I.; Deutsch, Israel; Burke, William M.; Hou, June Y.; Ananth, Cande V.; Huang, Yongmei; Neugut, Alfred I.; Hershman, Dawn L.; Wright, Jason D.

2015-01-01

Objectives Brachytherapy plays an important role in the treatment of cervical cancer. While small trials have shown comparable survival outcomes between high (HDR) and low-dose rate (LDR) brachytherapy, little data is available in the US. We examined the utilization of HDR brachytherapy and analyzed the impact of type of brachytherapy on survival for cervical cancer. Methods Women with stage IB2–IVA cervical cancer treated with primary (external beam and brachytherapy) radiotherapy between 2003–2011 and recorded in the National Cancer Database (NCDB) were analyzed. Generalized linear mixed models and Cox proportional hazards regression were used to examine predictors of HDR brachytherapy use and the association between HDR use and survival. Results A total of 10,564 women including 2681 (25.4%) who received LDR and 7883 (74.6%) that received HDR were identified. Use of HDR increased from 50.2% in 2003 to 83.9% in 2011 (P<0.0001). In a multivariable model, year of diagnosis was the strongest predictor of use of HDR. While patients in the Northeast were more likely to receive HDR therapy, there were no other clinical or socioeconomic characteristics associated with receipt of HDR. In a multivariable Cox model, survival was similar between the HDR and LDR groups (HR=0.93; 95% 0.83–1.03). Similar findings were noted in analyses stratified by stage and histology. Kaplan-Meier analyses demonstrated no difference in survival based on type of brachytherapy for stage IIB (P=0.68), IIIB (P=0.17), or IVA (P=0.16) tumors. Conclusions The use of HDR therapy has increased rapidly. Overall survival is similar for LDR and HDR brachytherapy. PMID:25575481

MO-FG-210-00: US Guided Systems for Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-01: Commissioning An US System for Brachytherapy: An Overview of Physics, Instrumentation, and Techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, Z.

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-03: Intraoperative Ultrasonography-Guided Positioning of Plaque Brachytherapy in the Treatment of Choroidal Melanoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lamb, J.

2015-06-15

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

Fat Necrosis After Partial-Breast Irradiation With Brachytherapy or Electron Irradiation Versus Standard Whole-Breast Radiotherapy-4-Year Results of a Randomized Trial

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loevey, Katalin; Fodor, Janos; Major, Tibor

Purpose: To examine the incidence and clinical relevance of fat necrosis after accelerated partial-breast irradiation (PBI) using interstitial high-dose-rate brachytherapy (HDR-BT) in comparison with partial-breast electron irradiation (ELE) and whole-breast irradiation (WBI). Methods and Materials: Between 1998 and 2004, 258 early-stage breast cancer patients were randomized to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy HDR-BT (n = 88) or 50 Gy ELE (n = 40). The incidence of fat necrosis, its impact on cosmetic outcome, accompanying radiologic features, and clinical symptoms were evaluated. Results: The 4-yearmore » actuarial rate of fat necrosis was 31.1% for all patients, and 31.9%, 36.5%, and 17.7% after WBI, HDR-BT and ELE, respectively (p{sub WBI/HDR-BT} = 0.26; p{sub WBI/ELE} = 0.11; p{sub ELE/HDR-BT} = 0.025). The respective rate of asymptomatic fat necrosis was 20.2%, 25.3%, and 10% of patients. The incidence of symptomatic fat necrosis was not significantly different after WBI (8.5%), HDR-BT (11.4%), and ELE (7.5%). Symptomatic fat necrosis was significantly associated with a worse cosmetic outcome, whereas asymptomatic fat necrosis was not. Fat necrosis was detectable with mammography and/or ultrasound in each case. Additional imaging examinations were required in 21% of cases and aspiration cytology in 42%. Conclusions: Asymptomatic fat necrosis is a common adverse event of breast-conserving therapy, having no significant clinical relevance in the majority of the cases. The incidence of both symptomatic and asymptomatic fat necrosis is similar after conventional WBI and accelerated partial-breast HDR-BT.« less

Quality assurance of HDR prostate plans: program implementation at a community hospital.

PubMed

Rush, Jennifer B; Thomas, Michael D

2005-01-01

Adenocarcinoma of the prostate is currently the most commonly diagnosed cancer in men in the United States, and the second leading cause of cancer mortality. The utilization of radiation therapy is regarded as the definitive local therapy of choice for intermediate- and high-risk disease, in which there is increased risk for extracapsular extension, seminal vesicle invasion, or regional node involvement. High-dose-rate (HDR) brachytherapy is a logical treatment modality to deliver the boost dose to an external beam radiation therapy (EBRT) treatment to increase local control rates. From a treatment perspective, the utilization of a complicated treatment delivery system, the compressed time frame in which the procedure is performed, and the small number of large dose fractions make the implementation of a comprehensive quality assurance (QA) program imperative. One aspect of this program is the QA of the HDR treatment plan. Review of regulatory and medical physics professional publications shows that substantial general guidance is available. We provide some insight to the implementation of an HDR prostate plan program at a community hospital. One aspect addressed is the utilization of the low-dose-rate (LDR) planning system and the use of existing ultrasound image sets to familiarize the radiation therapy team with respect to acceptable HDR implant geometries. Additionally, the use of the LDR treatment planning system provided a means to prospectively determine the relationship between the treated isodose volume and the product of activity and time for the department's planning protocol prior to the first HDR implant. For the first 12 HDR prostate implants, the root-mean-square (RMS) deviation was 3.05% between the predicted product of activity and time vs. the actual plan values. Retrospective re-evaluation of the actual implant data reduced the RMS deviation to 2.36%.

SU-F-BRA-04: Prostate HDR Brachytherapy with Multichannel Robotic System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Joseph, F Maria; Podder, T; Yu, Y

Purpose: High-dose-rate (HDR) brachytherapy is gradually becoming popular in treating patients with prostate cancers. However, placement of the HDR needles at desired locations into the patient is challenging. Application of robotic system may improve the accuracy of the clinical procedure. This experimental study is to evaluate the feasibility of using a multichannel robotic system for prostate HDR brachytherapy. Methods: In this experimental study, the robotic system employed was a 6-DOF Multichannel Image-guided Robotic Assistant for Brachytherapy (MIRAB), which was designed and fabricated for prostate seed implantation. The MIRAB has the provision of rotating 16 needles while inserting them. Ten prostatemore » HDR brachytherapy needles were simultaneously inserted using MIRAB into a commercially available prostate phantom. After inserting the needles into the prostate phantom at desired locations, 2mm thick CT slices were obtained for dosimetric planning. HDR plan was generated using Oncetra planning system with a total prescription dose of 34Gy in 4 fractions. Plan quality was evaluated considering dose coverage to prostate and planning target volume (PTV), with 3mm margin around prostate, as well as the dose limit to the organs at risk (OARs) following the American Brachytherapy Society (ABS) guidelines. Results: From the CT scan, it is observed that the needles were inserted straight into the desired locations and they were adequately spaced and distributed for a clinically acceptable HDR plan. Coverage to PTV and prostate were about 91% (V100= 91%) and 96% (V100=96%), respectively. Dose to 1cc of urethra, rectum, and bladder were within the ABS specified limits. Conclusion: The MIRAB was able to insert multiple needles simultaneously into the prostate precisely. By controlling the MIRAB to insert all the ten utilized needles into the prostate phantom, we could achieve the robotic HDR brachytherapy successfully. Further study for assessing the system’s performance and reliability is in progress.« less

Gloss discrimination and eye movements

NASA Astrophysics Data System (ADS)

Phillips, Jonathan B.; Ferwerda, James A.; Nunziata, Ann

2010-02-01

Human observers are able to make fine discriminations of surface gloss. What cues are they using to perform this task? In previous studies, we identified two reflection-related cues-the contrast of the reflected image (c, contrast gloss) and the sharpness of reflected image (d, distinctness-of-image gloss)--but these were for objects rendered in standard dynamic range (SDR) images with compressed highlights. In ongoing work, we are studying the effects of image dynamic range on perceived gloss, comparing high dynamic range (HDR) images with accurate reflections and SDR images with compressed reflections. In this paper, we first present the basic findings of this gloss discrimination study then present an analysis of eye movement recordings that show where observers were looking during the gloss discrimination task. The results indicate that: 1) image dynamic range has significant influence on perceived gloss, with surfaces presented in HDR images being seen as glossier and more discriminable than their SDR counterparts; 2) observers look at both light source highlights and environmental interreflections when judging gloss; and 3) both of these results are modulated by surface geometry and scene illumination.

Objective quality assessment of tone-mapped images.

PubMed

Yeganeh, Hojatollah; Wang, Zhou

2013-02-01

Tone-mapping operators (TMOs) that convert high dynamic range (HDR) to low dynamic range (LDR) images provide practically useful tools for the visualization of HDR images on standard LDR displays. Different TMOs create different tone-mapped images, and a natural question is which one has the best quality. Without an appropriate quality measure, different TMOs cannot be compared, and further improvement is directionless. Subjective rating may be a reliable evaluation method, but it is expensive and time consuming, and more importantly, is difficult to be embedded into optimization frameworks. Here we propose an objective quality assessment algorithm for tone-mapped images by combining: 1) a multiscale signal fidelity measure on the basis of a modified structural similarity index and 2) a naturalness measure on the basis of intensity statistics of natural images. Validations using independent subject-rated image databases show good correlations between subjective ranking score and the proposed tone-mapped image quality index (TMQI). Furthermore, we demonstrate the extended applications of TMQI using two examples-parameter tuning for TMOs and adaptive fusion of multiple tone-mapped images.

Current situation of high-dose-rate brachytherapy for cervical cancer in Brazil*

PubMed Central

da Silva, Rogério Matias Vidal; Pinezi, Juliana Castro Dourado; Macedo, Luiz Eduardo Andrade; Souza, Divanízia do Nascimento

2014-01-01

Objective To assess the current situation of high-dose-rate (HDR) brachytherapy for cancer of the cervix in Brazil, regarding apparatuses, planning methods, prescription, fractionation schedule and evaluation of dose in organs at risk. Materials and Methods In the period between March/2012 and May/2013, a multiple choice questionnaire was developed and sent to 89 Brazilian hospitals which perform HDR brachytherapy. Results Sixty-one services answered the questionnaire. All regions of the country experienced a sharp increase in the number of HDR brachytherapy services in the period from 2001 to 2013. As regards planning, although a three-dimensional planning software was available in 91% of the centers, conventional radiography was mentioned by 92% of the respondents as their routine imaging method for such a purpose. Approximately 35% of respondents said that brachytherapy sessions are performed after teletherapy. The scheme of four 7 Gy intracavitary insertions was mentioned as the most frequently practiced. Conclusion The authors observed that professionals have difficulty accessing adjuvant three-dimensional planning tools such as computed tomography and magnetic resonance imaging. PMID:25741073

3D workflow for HDR image capture of projection systems and objects for CAVE virtual environments authoring with wireless touch-sensitive devices

NASA Astrophysics Data System (ADS)

Prusten, Mark J.; McIntyre, Michelle; Landis, Marvin

2006-02-01

A 3D workflow pipeline is presented for High Dynamic Range (HDR) image capture of projected scenes or objects for presentation in CAVE virtual environments. The methods of HDR digital photography of environments vs. objects are reviewed. Samples of both types of virtual authoring being the actual CAVE environment and a sculpture are shown. A series of software tools are incorporated into a pipeline called CAVEPIPE, allowing for high-resolution objects and scenes to be composited together in natural illumination environments [1] and presented in our CAVE virtual reality environment. We also present a way to enhance the user interface for CAVE environments. The traditional methods of controlling the navigation through virtual environments include: glove, HUD's and 3D mouse devices. By integrating a wireless network that includes both WiFi (IEEE 802.11b/g) and Bluetooth (IEEE 802.15.1) protocols the non-graphical input control device can be eliminated. Therefore wireless devices can be added that would include: PDA's, Smart Phones, TabletPC's, Portable Gaming consoles, and PocketPC's.

Cervical Gross Tumor Volume Dose Predicts Local Control Using Magnetic Resonance Imaging/Diffusion-Weighted Imaging—Guided High-Dose-Rate and Positron Emission Tomography/Computed Tomography—Guided Intensity Modulated Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dyk, Pawel; Jiang, Naomi; Sun, Baozhou

2014-11-15

Purpose: Magnetic resonance imaging/diffusion weighted-imaging (MRI/DWI)-guided high-dose-rate (HDR) brachytherapy and {sup 18}F-fluorodeoxyglucose (FDG) — positron emission tomography/computed tomography (PET/CT)-guided intensity modulated radiation therapy (IMRT) for the definitive treatment of cervical cancer is a novel treatment technique. The purpose of this study was to report our analysis of dose-volume parameters predicting gross tumor volume (GTV) control. Methods and Materials: We analyzed the records of 134 patients with International Federation of Gynecology and Obstetrics stages IB1-IVB cervical cancer treated with combined MRI-guided HDR and IMRT from July 2009 to July 2011. IMRT was targeted to the metabolic tumor volume and lymph nodesmore » by use of FDG-PET/CT simulation. The GTV for each HDR fraction was delineated by use of T2-weighted or apparent diffusion coefficient maps from diffusion-weighted sequences. The D100, D90, and Dmean delivered to the GTV from HDR and IMRT were summed to EQD2. Results: One hundred twenty-five patients received all irradiation treatment as planned, and 9 did not complete treatment. All 134 patients are included in this analysis. Treatment failure in the cervix occurred in 24 patients (18.0%). Patients with cervix failures had a lower D100, D90, and Dmean than those who did not experience failure in the cervix. The respective doses to the GTV were 41, 58, and 136 Gy for failures compared with 67, 99, and 236 Gy for those who did not experience failure (P<.001). Probit analysis estimated the minimum D100, D90, and Dmean doses required for ≥90% local control to be 69, 98, and 260 Gy (P<.001). Conclusions: Total dose delivered to the GTV from combined MRI-guided HDR and PET/CT-guided IMRT is highly correlated with local tumor control. The findings can be directly applied in the clinic for dose adaptation to maximize local control.« less

SU-E-T-254: Development of a HDR-BT QA Tool for Verification of Source Position with Oncentra Applicator Modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kumazaki, Y; Miyaura, K; Hirai, R

2015-06-15

Purpose: To develop a High Dose Rate Brachytherapy (HDR-BT) quality assurance (QA) tool for verification of source position with Oncentra applicator modeling, and to report the results of radiation source positions with this tool. Methods: We developed a HDR-BT QA phantom and automated analysis software for verification of source position with Oncentra applicator modeling for the Fletcher applicator used in the MicroSelectron HDR system. This tool is intended for end-to-end tests that mimic the clinical 3D image-guided brachytherapy (3D-IGBT) workflow. The phantom is a 30x30x3 cm cuboid phantom with radiopaque markers, which are inserted into the phantom to evaluate applicatormore » tips and reference source positions; positions are laterally shifted 10 mm from the applicator axis. The markers are lead-based and scatter radiation to expose the films. Gafchromic RTQA2 films are placed on the applicators. The phantom includes spaces to embed the applicators. The source position is determined as the distance between the exposed source position and center position of two pairs of the first radiopaque markers. We generated a 3D-IGBT plan with applicator modeling. The first source position was 6 mm from the applicator tips, and the second source position was 10 mm from the first source position. Results: All source positions were consistent with the exposed positions within 1 mm for all Fletcher applicators using in-house software. Moreover, the distance between source positions was in good agreement with the reference distance. Applicator offset, determined as the distance from the applicator tips at the first source position in the treatment planning system, was accurate. Conclusion: Source position accuracy of applicator modeling used in 3D-IGBT was acceptable. This phantom and software will be useful as a HDR-BT QA tool for verification of source position with Oncentra applicator modeling.« less

Signal enhancement in optical projection tomography via virtual high dynamic range imaging of single exposure

NASA Astrophysics Data System (ADS)

Yang, Yujie; Dong, Di; Shi, Liangliang; Wang, Jun; Yang, Xin; Tian, Jie

2015-03-01

Optical projection tomography (OPT) is a mesoscopic scale optical imaging technique for specimens between 1mm and 10mm. OPT has been proven to be immensely useful in a wide variety of biological applications, such as developmental biology and pathology, but its shortcomings in imaging specimens containing widely differing contrast elements are obvious. The longer exposure for high intensity tissues may lead to over saturation of other areas, whereas a relatively short exposure may cause similarity with surrounding background. In this paper, we propose an approach to make a trade-off between capturing weak signals and revealing more details for OPT imaging. This approach consists of three steps. Firstly, the specimens are merely scanned in 360 degrees above a normal exposure but non-overexposure to acquire the projection data. This reduces the photo bleaching and pre-registration computation compared with multiple different exposures in conventional high dynamic range (HDR) imaging method. Secondly, three virtual channels are produced for each projection image based on the histogram distribution to simulate the low, normal and high exposure images used in the traditional HDR technology in photography. Finally, each virtual channel is normalized to the full gray scale range and three channels are recombined into one image using weighting coefficients optimized by a standard eigen-decomposition method. After applying our approach on the projection data, filtered back projection (FBP) algorithm is carried out for 3-dimentional reconstruction. The neonatal wild-type mouse paw has been scanned to verify this approach. Results demonstrated the effectiveness of the proposed approach.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hobbs, R; Le, Y; Armour, E

Purpose: Dose-response studies in radiation therapy are typically using single response values for tumors across ensembles of tumors. Using the high dose rate (HDR) treatment plan dose grid and pre- and post-therapy FDG-PET images, we look for correlations between voxelized dose and FDG uptake response in individual tumors. Methods: Fifteen patients were treated for localized rectal cancer using 192Ir HDR brachytherapy in conjunction with surgery. FDG-PET images were acquired before HDR therapy and 6–8 weeks after treatment (prior to surgery). Treatment planning was done on a commercial workstation and the dose grid was calculated. The two PETs and the treatmentmore » dose grid were registered to each other using non-rigid registration. The difference in PET SUV values before and after HDR was plotted versus absorbed radiation dose for each voxel. The voxels were then separated into bins for every 400 cGy of absorbed dose and the bin average values plotted similarly. Results: Individual voxel doses did not correlate with PET response; however, when group into tumor subregions corresponding to dose bins, eighty percent of the patients showed a significant positive correlation (R2 > 0) between PET uptake difference in the targeted region and the absorbed dose. Conclusion: By considering larger ensembles of voxels, such as organ average absorbed dose or the dose bins considered here, valuable information may be obtained. The dose-response correlations as measured by FDG-PET difference potentially underlines the importance of FDG-PET as a measure of response, as well as the value of voxelized information.« less

In vivo gene correction with targeted sequence substitution through microhomology-mediated end joining.

PubMed

Shin, Jeong Hong; Jung, Soobin; Ramakrishna, Suresh; Kim, Hyongbum Henry; Lee, Junwon

2018-07-07

Genome editing technology using programmable nucleases has rapidly evolved in recent years. The primary mechanism to achieve precise integration of a transgene is mainly based on homology-directed repair (HDR). However, an HDR-based genome-editing approach is less efficient than non-homologous end-joining (NHEJ). Recently, a microhomology-mediated end-joining (MMEJ)-based transgene integration approach was developed, showing feasibility both in vitro and in vivo. We expanded this method to achieve targeted sequence substitution (TSS) of mutated sequences with normal sequences using double-guide RNAs (gRNAs), and a donor template flanking the microhomologies and target sequence of the gRNAs in vitro and in vivo. Our method could realize more efficient sequence substitution than the HDR-based method in vitro using a reporter cell line, and led to the survival of a hereditary tyrosinemia mouse model in vivo. The proposed MMEJ-based TSS approach could provide a novel therapeutic strategy, in addition to HDR, to achieve gene correction from a mutated sequence to a normal sequence. Copyright © 2018 Elsevier Inc. All rights reserved.

Single-layer HDR video coding with SDR backward compatibility

NASA Astrophysics Data System (ADS)

Lasserre, S.; François, E.; Le Léannec, F.; Touzé, D.

2016-09-01

The migration from High Definition (HD) TV to Ultra High Definition (UHD) is already underway. In addition to an increase of picture spatial resolution, UHD will bring more color and higher contrast by introducing Wide Color Gamut (WCG) and High Dynamic Range (HDR) video. As both Standard Dynamic Range (SDR) and HDR devices will coexist in the ecosystem, the transition from Standard Dynamic Range (SDR) to HDR will require distribution solutions supporting some level of backward compatibility. This paper presents a new HDR content distribution scheme, named SL-HDR1, using a single layer codec design and providing SDR compatibility. The solution is based on a pre-encoding HDR-to-SDR conversion, generating a backward compatible SDR video, with side dynamic metadata. The resulting SDR video is then compressed, distributed and decoded using standard-compliant decoders (e.g. HEVC Main 10 compliant). The decoded SDR video can be directly rendered on SDR displays without adaptation. Dynamic metadata of limited size are generated by the pre-processing and used to reconstruct the HDR signal from the decoded SDR video, using a post-processing that is the functional inverse of the pre-processing. Both HDR quality and artistic intent are preserved. Pre- and post-processing are applied independently per picture, do not involve any inter-pixel dependency, and are codec agnostic. Compression performance, and SDR quality are shown to be solidly improved compared to the non-backward and backward-compatible approaches, respectively using the Perceptual Quantization (PQ) and Hybrid Log Gamma (HLG) Opto-Electronic Transfer Functions (OETF).

Development of 3D ultrasound needle guidance for high-dose-rate interstitial brachytherapy of gynaecological cancers

NASA Astrophysics Data System (ADS)

Rodgers, J.; Tessier, D.; D'Souza, D.; Leung, E.; Hajdok, G.; Fenster, A.

2016-04-01

High-dose-rate (HDR) interstitial brachytherapy is often included in standard-of-care for gynaecological cancers. Needles are currently inserted through a perineal template without any standard real-time imaging modality to assist needle guidance, causing physicians to rely on pre-operative imaging, clinical examination, and experience. While two-dimensional (2D) ultrasound (US) is sometimes used for real-time guidance, visualization of needle placement and depth is difficult and subject to variability and inaccuracy in 2D images. The close proximity to critical organs, in particular the rectum and bladder, can lead to serious complications. We have developed a three-dimensional (3D) transrectal US system and are investigating its use for intra-operative visualization of needle positions used in HDR gynaecological brachytherapy. As a proof-of-concept, four patients were imaged with post-insertion 3D US and x-ray CT. Using software developed in our laboratory, manual rigid registration of the two modalities was performed based on the perineal template's vaginal cylinder. The needle tip and a second point along the needle path were identified for each needle visible in US. The difference between modalities in the needle trajectory and needle tip position was calculated for each identified needle. For the 60 needles placed, the mean trajectory difference was 3.23 +/- 1.65° across the 53 visible needle paths and the mean difference in needle tip position was 3.89 +/- 1.92 mm across the 48 visible needles tips. Based on the preliminary results, 3D transrectal US shows potential for the development of a 3D US-based needle guidance system for interstitial gynaecological brachytherapy.

Prediction of HDR quality by combining perceptually transformed display measurements with machine learning

NASA Astrophysics Data System (ADS)

Choudhury, Anustup; Farrell, Suzanne; Atkins, Robin; Daly, Scott

2017-09-01

We present an approach to predict overall HDR display quality as a function of key HDR display parameters. We first performed subjective experiments on a high quality HDR display that explored five key HDR display parameters: maximum luminance, minimum luminance, color gamut, bit-depth and local contrast. Subjects rated overall quality for different combinations of these display parameters. We explored two models | a physical model solely based on physically measured display characteristics and a perceptual model that transforms physical parameters using human vision system models. For the perceptual model, we use a family of metrics based on a recently published color volume model (ICT-CP), which consists of the PQ luminance non-linearity (ST2084) and LMS-based opponent color, as well as an estimate of the display point spread function. To predict overall visual quality, we apply linear regression and machine learning techniques such as Multilayer Perceptron, RBF and SVM networks. We use RMSE and Pearson/Spearman correlation coefficients to quantify performance. We found that the perceptual model is better at predicting subjective quality than the physical model and that SVM is better at prediction than linear regression. The significance and contribution of each display parameter was investigated. In addition, we found that combined parameters such as contrast do not improve prediction. Traditional perceptual models were also evaluated and we found that models based on the PQ non-linearity performed better.

Evaluation of color encodings for high dynamic range pixels

NASA Astrophysics Data System (ADS)

Boitard, Ronan; Mantiuk, Rafal K.; Pouli, Tania

2015-03-01

Traditional Low Dynamic Range (LDR) color spaces encode a small fraction of the visible color gamut, which does not encompass the range of colors produced on upcoming High Dynamic Range (HDR) displays. Future imaging systems will require encoding much wider color gamut and luminance range. Such wide color gamut can be represented using floating point HDR pixel values but those are inefficient to encode. They also lack perceptual uniformity of the luminance and color distribution, which is provided (in approximation) by most LDR color spaces. Therefore, there is a need to devise an efficient, perceptually uniform and integer valued representation for high dynamic range pixel values. In this paper we evaluate several methods for encoding colour HDR pixel values, in particular for use in image and video compression. Unlike other studies we test both luminance and color difference encoding in a rigorous 4AFC threshold experiments to determine the minimum bit-depth required. Results show that the Perceptual Quantizer (PQ) encoding provides the best perceptual uniformity in the considered luminance range, however the gain in bit-depth is rather modest. More significant difference can be observed between color difference encoding schemes, from which YDuDv encoding seems to be the most efficient.

Under-utilisation of high-dose-rate brachytherapy boost in men with intermediate-high risk prostate cancer treated with external beam radiotherapy.

PubMed

Ong, Wee Loon; Evans, Sue M; Millar, Jeremy L

2018-04-01

The aim of this study was to evaluate the use of high-dose-rate brachytherapy (HDR-BT) boost with definitive external beam radiotherapy (EBRT) in prostate cancer (CaP) management. The study population comprised men with intermediate-high risk CaP captured in the population-based Prostate Cancer Outcome Registry Victoria (PCOR-Vic), treated with EBRT from January 2010 to December 2015. The primary outcome is the proportion of men who received HDR-BT boost. Multivariate logistic regressions were used to evaluate the effect of patient-, tumour- and treatment-factors on the likelihood of HDR-BT use. Medicare Benefit Schedule (MBS) data was accessed to evaluate the Australia-wide pattern of HDR-BT use. One thousand eight hundred and six patients were included in this study - 886 (49%) intermediate-risk, and 920 (51%) high-risk CaP patients. Overall, only 124 (7%) patients had EBRT + HDR-BT - 47 (5%) intermediate-risk and 77 (8%) high-risk CaP patients (P = 0.01). There is higher proportion of patients who had HDR-BT in public institutions (7% public vs. 3% private, P = 0.005) and in metropolitan centres (9% metropolitan vs. 2% regional, P < 0.001). In multivariate analyses, older patients were less likely to have HDR-BT (OR = 0.92; 95% CI = 0.89-0.94, P < 0.001), while patients with high-risk CaP (OR = 1.8; 95% CI = 1.3-2.7; P = 0.002) treated in metropolitan centres (OR = 5.0; 95% CI = 2.6-9.8; P < 0.001) and public institutions (OR = 3.8; 95% CI = 1.5-9.4; P = 0.005) were more likely to have EBRT + HDR-BT. There was significant decline in numbers of HDR-BT performed throughout Australia, from 313 cases in 2010 to 125 cases in 2015. High-dose-rate brachytherapy is under-utilised with EBRT in this contemporary population-based cohort of Victorian men with CaP. The decline in HDR-BT use was also observed nationally. © 2017 The Royal Australian and New Zealand College of Radiologists.

Limb neurovascular control during altered otolithic input in humans

NASA Technical Reports Server (NTRS)

Monahan, Kevin D.; Ray, Chester A.

2002-01-01

Head-down rotation (HDR), which activates the vestibulosympathetic reflex, increases leg muscle sympathetic nerve activity (MSNA) and produces calf vasoconstriction with no change in either cardiac output or arterial blood pressure. Based on animal studies, it was hypothesized that differential control of arm and leg MSNA explains why HDR does not alter arterial blood pressure. Fifteen healthy subjects were studied. Heart rate, arterial blood pressure, forearm and calf blood flow, and leg MSNA responses were measured during HDR in these subjects. Simultaneous recordings of arm and leg MSNA were obtained from five of the subjects. Forearm and calf blood flow, vascular conductances, and vascular resistances were similar before HDR, as were arm and leg MSNA. HDR elicited similar significant increases in leg (Delta 6 +/- 1 bursts min(-1); 59 +/- 16 % from baseline) and arm MSNA (Delta 5 +/- 1 bursts min(-1); 80 +/- 28 % from baseline). HDR significantly decreased calf (-19 +/- 2 %) and forearm vascular conductance (-12 +/- 2 %) and significantly increased calf (25 +/- 4 %) and forearm vascular resistance (15 +/- 2 %), with 60 % greater vasoconstriction in the calf than in the forearm. Arterial blood pressure and heart rate were not altered by HDR. These results indicate that there is no differential control of MSNA in the arm and leg during altered feedback from the otolith organs in humans, but that greater vasoconstriction occurs in the calf than in the forearm. These findings indicate that vasodilatation occurs in other vascular bed(s) to account for the lack of increase in arterial blood pressure during HDR.

New method for obtaining position and time structure of source in HDR remote afterloading brachytherapy unit utilizing light emission from scintillator

PubMed Central

Hanada, Takashi; Katsuta, Shoichi; Yorozu, Atsunori; Maruyama, Koichi

2009-01-01

When using a HDR remote afterloading brachytherapy unit, results of treatment can be greatly influenced by both source position and treatment time. The purpose of this study is to obtain information on the source of the HDR remote afterloading unit, such as its position and time structure, with the use of a simple system consisting of a plastic scintillator block and a charge‐coupled device (CCD) camera. The CCD camera was used for recording images of scintillation luminescence at a fixed rate of 30 frames per second in real time. The source position and time structure were obtained by analyzing the recorded images. For a preset source‐step‐interval of 5 mm, the measured value of the source position was 5.0±1.0mm, with a pixel resolution of 0.07 mm in the recorded images. For a preset transit time of 30 s, the measured value was 30.0±0.6 s, when the time resolution of the CCD camera was 1/30 s. This system enabled us to obtain the source dwell time and movement time. Therefore, parameters such as I192r source position, transit time, dwell time, and movement time at each dwell position can be determined quantitatively using this plastic scintillator‐CCD camera system. PACS number: 87.53.Jw

Patient specific optimization-based treatment planning for catheter-based ultrasound hyperthermia and thermal ablation

NASA Astrophysics Data System (ADS)

Prakash, Punit; Chen, Xin; Wootton, Jeffery; Pouliot, Jean; Hsu, I.-Chow; Diederich, Chris J.

2009-02-01

A 3D optimization-based thermal treatment planning platform has been developed for the application of catheter-based ultrasound hyperthermia in conjunction with high dose rate (HDR) brachytherapy for treating advanced pelvic tumors. Optimal selection of applied power levels to each independently controlled transducer segment can be used to conform and maximize therapeutic heating and thermal dose coverage to the target region, providing significant advantages over current hyperthermia technology and improving treatment response. Critical anatomic structures, clinical target outlines, and implant/applicator geometries were acquired from sequential multi-slice 2D images obtained from HDR treatment planning and used to reconstruct patient specific 3D biothermal models. A constrained optimization algorithm was devised and integrated within a finite element thermal solver to determine a priori the optimal applied power levels and the resulting 3D temperature distributions such that therapeutic heating is maximized within the target, while placing constraints on maximum tissue temperature and thermal exposure of surrounding non-targeted tissue. This optimizationbased treatment planning and modeling system was applied on representative cases of clinical implants for HDR treatment of cervix and prostate to evaluate the utility of this planning approach. The planning provided significant improvement in achievable temperature distributions for all cases, with substantial increase in T90 and thermal dose (CEM43T90) coverage to the hyperthermia target volume while decreasing maximum treatment temperature and reducing thermal dose exposure to surrounding non-targeted tissues and thermally sensitive rectum and bladder. This optimization based treatment planning platform with catheter-based ultrasound applicators is a useful tool that has potential to significantly improve the delivery of hyperthermia in conjunction with HDR brachytherapy. The planning platform has been extended to model thermal ablation, including the addition of temperature dependent attenuation, perfusion, and tissue damage. Pilot point control at the target boundaries was implemented to control power delivery to each transducer section, simulating an approach feasible for MR guided procedures. The computer model of thermal ablation was evaluated on representative patient anatomies to demonstrate the feasibility of using catheter-based ultrasound thermal ablation for treatment of benign prostate hyperplasia (BPH) and prostate cancer, and to assist in designing applicators and treatment delivery strategies.

High dose rate brachytherapy for oral cancer

PubMed Central

YamazakI, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Furukawa, Souhei; Koizumi, Masahiko; Ogawa, Kazuhiko

2013-01-01

Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. PMID:23179377

High dose rate brachytherapy for oral cancer.

PubMed

Yamazaki, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Furukawa, Souhei; Koizumi, Masahiko; Ogawa, Kazuhiko

2013-01-01

Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, H

Purpose: To evaluate the dosimetric metrics of HDR Ring and Tandem applicator Brachytherapy for primary cervical cancers. Methods: The dosimetric metrics of high-risk clinical target volumes (HDR-CTV) of 12 patients (in total 60 fractions/plans) treated with the HDR ring and tandem applicators were retrospectively analyzed. Ring diameter is from 2.6 to 3.4 cm, tandem length is from 4 to 6 cm, and the angle is either 45 or 60 degrees. The first fraction plan was MR guided, the MR images were then used as a reference for contouring the HR-CTV in CT images of following 4 fractions. The nominal prescriptionmore » dose was between 5.2 and 5.8 Gy at the point A. The plans were adjusted to cover at least 90% of the HR-CTV by 90% of the prescription dose and to reduce the doses to the bladder, rectum and bowel-bag. Minimum target dose of D100 and D90 were converted into the biologically equivalent EBRT dose D90-iso and D100-iso (using α/β=10 Gy, 2 Gy/fx). Equivalent uniform doses (EUD) based on the average cancer killing across the target volume were calculated by the modified linear quadratic model (MLQ) from the differential dose volume histogram (DVH) tables. Results: The average D90iso of all plans is 8.1 Gy (ranging from 6.2 to 15 Gy, median 7.8 Gy); the average D100iso is just 4.1 Gy (ranging from 1.8 to 7.8 Gy; median 3.9 Gy). The average EUD is 7.0 Gy (ranging from 6.1 to 9.6 Gy, median 6.9 Gy), which is 87% of the D90iso, and 170% of the D100iso. Conclusion: The EUDs is smaller than D90iso but greater than D100iso. Because the EUD takes into account the intensive cancer cell killing in the high dose zone of HR-CTV, MLQ calculated EUD apparently is more relevant than D90 and D100 to describe the HDR brachytherapy treatment quality.« less

Iridium-Knife: Another knife in radiation oncology.

PubMed

Milickovic, Natasa; Tselis, Nikolaos; Karagiannis, Efstratios; Ferentinos, Konstantinos; Zamboglou, Nikolaos

Intratarget dose escalation with superior conformity is a defining feature of three-dimensional (3D) iridium-192 ( 192 Ir) high-dose-rate (HDR) brachytherapy (BRT). In this study, we analyzed the dosimetric characteristics of interstitial 192 Ir HDR BRT for intrathoracic and cerebral malignancies. We examined the dose gradient sharpness of HDR BRT compared with that of linear accelerator-based stereotactic radiosurgery and stereotactic body radiation therapy, usually called X-Knife, to demonstrate that it may as well be called a Knife. Treatment plans for 10 patients with recurrent glioblastoma multiforme or intrathoracic malignancies, five of each entity, treated with X-Knife (stereotactic radiosurgery for glioblastoma multiforme and stereotactic body radiation therapy for intrathoracic malignancies) were replanned for simulated HDR BRT. For 3D BRT planning, we used identical structure sets and dose prescription as for the X-Knife planning. The indices for qualitative treatment plan analysis encompassed planning target volume coverage, conformity, dose falloff gradient, and the maximum dose-volume limits to different organs at risk. Volume coverage in HDR plans was comparable to that calculated for X-Knife plans with no statistically significant difference in terms of conformity. The dose falloff gradient-sharpness-of the HDR plans was considerably steeper compared with the X-Knife plans. Both 3D 192 Ir HDR BRT and X-Knife are effective means for intratarget dose escalation with HDR BRT achieving at least equal conformity and a steeper dose falloff at the target volume margin. In this sense, it can reasonably be argued that 3D 192 Ir HDR BRT deserves also to be called a Knife, namely Iridium-Knife. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

SU-F-T-20: Novel Catheter Lumen Recognition Algorithm for Rapid Digitization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dise, J; McDonald, D; Ashenafi, M

Purpose: Manual catheter recognition remains a time-consuming aspect of high-dose-rate brachytherapy (HDR) treatment planning. In this work, a novel catheter lumen recognition algorithm was created for accurate and rapid digitization. Methods: MatLab v8.5 was used to create the catheter recognition algorithm. Initially, the algorithm searches the patient CT dataset using an intensity based k-means filter designed to locate catheters. Once the catheters have been located, seed points are manually selected to initialize digitization of each catheter. From each seed point, the algorithm searches locally in order to automatically digitize the remaining catheter. This digitization is accomplished by finding pixels withmore » similar image curvature and divergence parameters compared to the seed pixel. Newly digitized pixels are treated as new seed positions, and hessian image analysis is used to direct the algorithm toward neighboring catheter pixels, and to make the algorithm insensitive to adjacent catheters that are unresolvable on CT, air pockets, and high Z artifacts. The algorithm was tested using 11 HDR treatment plans, including the Syed template, tandem and ovoid applicator, and multi-catheter lung brachytherapy. Digitization error was calculated by comparing manually determined catheter positions to those determined by the algorithm. Results: he digitization error was 0.23 mm ± 0.14 mm axially and 0.62 mm ± 0.13 mm longitudinally at the tip. The time of digitization, following initial seed placement was less than 1 second per catheter. The maximum total time required to digitize all tested applicators was 4 minutes (Syed template with 15 needles). Conclusion: This algorithm successfully digitizes HDR catheters for a variety of applicators with or without CT markers. The minimal axial error demonstrates the accuracy of the algorithm, and its insensitivity to image artifacts and challenging catheter positioning. Future work to automatically place initial seed positions would improve the algorithm speed.« less

Hot dry rock geothermal energy: status of exploration and assessment. Report No. 1 of the hot dry rock assessment panel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1977-06-01

The status of knowledge of attempts to utilize hot dry rock (HDR) geothermal energy is summarized. It contains (1) descriptions or case histories of the ERDA-funded projects at Marysville, MT, Fenton Hill, NM, and Coso Hot Springs, CA; (2) a review of the status of existing techniques available for exploration and delineation of HDR; (3) descriptions of other potential HDR sites; (4) definitions of the probable types of HDR resource localities; and (5) an estimate of the magnitude of the HDR resource base in the conterminous United States. The scope is limited to that part of HDR resource assessment relatedmore » to the determination of the extent and character of HDR, with emphasis on the igneous-related type. It is estimated that approximately 74 Q (1 Q = 1,000 Quads) of heat is stored in these sites within the conterminous U.S. at depths less than 10 km and temperatures above 150/sup 0/C, the minimum for power generation. (Q = 10/sup 18/ BTU = 10/sup 21/J; the total U.S. consumption for 1972 was approximately 0.07 Q). Approximately 6300 Q are stored in the conduction-dominated parts of the crust in the western U.S. (23% of the total surface area), again at depths less than 10 km and temperatures above 150/sup 0/C. Nearly 10,000 Q are believed to be contained in crustal rocks underlying the entire conterminous U.S., at temperatures above 150/sup 0/C. The resource base is significantly larger for lower grade heat. (JGB)« less

The Role of Argumentation in Hypothetico-Deductive Reasoning during Problem-Based Learning in Medical Education: A Conceptual Framework

ERIC Educational Resources Information Center

Ju, Hyunjung; Choi, Ikseon

2018-01-01

One of the important goals of problem-based learning (PBL) in medical education is to enhance medical students' clinical reasoning--hypothetico-deductive reasoning (HDR) in particular--through small group discussions. However, few studies have focused on explicit strategies for promoting students' HDR during group discussions in PBL. This paper…

A novel system for commissioning brachytherapy applicators: example of a ring applicator

NASA Astrophysics Data System (ADS)

Fonseca, Gabriel P.; Van den Bosch, Michiel R.; Voncken, Robert; Podesta, Mark; Verhaegen, Frank

2017-11-01

A novel system was developed to improve commissioning and quality assurance of brachytherapy applicators used in high dose rate (HDR). It employs an imaging panel to create reference images and to measure dwell times and dwell positions. As an example: two ring applicators of the same model were evaluated. An applicator was placed on the surface of an imaging panel and a HDR 192Ir source was positioned in an imaging channel above the panel to generate an image of the applicator, using the gamma photons of the brachytherapy source. The applicator projection image was overlaid with the images acquired by capturing the gamma photons emitted by the source dwelling inside the applicator. We verified 0.1, 0.2, 0.5 and 1.0 cm interdwell distances for different offsets, applicator inclinations and transfer tube curvatures. The data analysis was performed using in-house developed software capable of processing the data in real time, defining catheters and creating movies recording the irradiation procedure. One applicator showed up to 0.3 cm difference from the expected position for a specific dwell position. The problem appeared intermittently. The standard deviations of the remaining dwell positions (40 measurements) were less than 0.05 cm. The second ring applicator had a similar reproducibility with absolute coordinate differences from expected values ranging from  -0.10 up to 0.18 cm. The curvature of the transfer tube can lead to differences larger than 0.1 cm whilst the inclination of the applicator showed a negligible effect. The proposed method allows the verification of all steps of the irradiation, providing accurate information about dwell positions and dwell times. It allows the verification of small interdwell positions (⩽0.1 cm) and reduces measurement time. In addition, no additional radiation source is necessary since the HDR 192Ir source is used to generate an image of the applicator.

Methanogenic heterodisulfide reductase (HdrABC-MvhAGD) uses two noncubane [4Fe-4S] clusters for reduction.

PubMed

Wagner, Tristan; Koch, Jürgen; Ermler, Ulrich; Shima, Seigo

2017-08-18

In methanogenic archaea, the carbon dioxide (CO 2 ) fixation and methane-forming steps are linked through the heterodisulfide reductase (HdrABC)-[NiFe]-hydrogenase (MvhAGD) complex that uses flavin-based electron bifurcation to reduce ferredoxin and the heterodisulfide of coenzymes M and B. Here, we present the structure of the native heterododecameric HdrABC-MvhAGD complex at 2.15-angstrom resolution. HdrB contains two noncubane [4Fe-4S] clusters composed of fused [3Fe-4S]-[2Fe-2S] units sharing 1 iron (Fe) and 1 sulfur (S), which were coordinated at the CCG motifs. Soaking experiments showed that the heterodisulfide is clamped between the two noncubane [4Fe-4S] clusters and homolytically cleaved, forming coenzyme M and B bound to each iron. Coenzymes are consecutively released upon one-by-one electron transfer. The HdrABC-MvhAGD atomic model serves as a structural template for numerous HdrABC homologs involved in diverse microbial metabolic pathways. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

A Cysteine-Rich CCG Domain Contains a Novel [4Fe-4S] Cluster Binding Motif As Deduced From Studies With Subunit B of Heterodisulfide Reductase From Methanothermobacter Marburgensis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hamann, N.; Mander, G.J.; Shokes, J.E.

Heterodisulfide reductase (HDR) of methanogenic archaea with its active-site [4Fe-4S] cluster catalyzes the reversible reduction of the heterodisulfide (CoM-S-S-CoB) of the methanogenic coenzyme M (CoM-SH) and coenzyme B (CoB-SH). CoM-HDR, a mechanistic-based paramagnetic intermediate generated upon half-reaction of the oxidized enzyme with CoM-SH, is a novel type of [4Fe-4S]{sup 3+} cluster with CoM-SH as a ligand. Subunit HdrB of the Methanothermobacter marburgensis HdrABC holoenzyme contains two cysteine-rich sequence motifs (CX{sub 31-39}CCX{sub 35-36}CXXC), designated as CCG domain in the Pfam database and conserved in many proteins. Here we present experimental evidence that the C-terminal CCG domain of HdrB binds this unusualmore » [4Fe-4S] cluster. HdrB was produced in Escherichia coli, and an iron-sulfur cluster was subsequently inserted by in vitro reconstitution. In the oxidized state the cluster without the substrate exhibited a rhombic EPR signal (g{sub zyx} = 2.015, 1.995, and 1.950) reminiscent of the CoM-HDR signal. {sup 57}Fe ENDOR spectroscopy revealed that this paramagnetic species is a [4Fe-4S] cluster with {sup 57}Fe hyperfine couplings very similar to that of CoM-HDR. CoM-{sup 33}SH resulted in a broadening of the EPR signal, and upon addition of CoM-SH the midpoint potential of the cluster was shifted to values observed for CoM-HDR, both indicating binding of CoM-SH to the cluster. Site-directed mutagenesis of all 12 cysteine residues in HdrB identified four cysteines of the C-terminal CCG domain as cluster ligands. Combined with the previous detection of CoM-HDR-like EPR signals in other CCG domain-containing proteins our data indicate a general role of the C-terminal CCG domain in coordination of this novel [4Fe-4S] cluster. In addition, Zn K-edge X-ray absorption spectroscopy identified an isolated Zn site with an S{sub 3}(O/N){sub 1} geometry in HdrB and the HDR holoenzyme. The N-terminal CCG domain is suggested to provide ligands to the Zn site.« less

A method for verification of treatment delivery in HDR prostate brachytherapy using a flat panel detector for both imaging and source tracking.

PubMed

Smith, Ryan L; Haworth, Annette; Panettieri, Vanessa; Millar, Jeremy L; Franich, Rick D

2016-05-01

Verification of high dose rate (HDR) brachytherapy treatment delivery is an important step, but is generally difficult to achieve. A technique is required to monitor the treatment as it is delivered, allowing comparison with the treatment plan and error detection. In this work, we demonstrate a method for monitoring the treatment as it is delivered and directly comparing the delivered treatment with the treatment plan in the clinical workspace. This treatment verification system is based on a flat panel detector (FPD) used for both pre-treatment imaging and source tracking. A phantom study was conducted to establish the resolution and precision of the system. A pretreatment radiograph of a phantom containing brachytherapy catheters is acquired and registration between the measurement and treatment planning system (TPS) is performed using implanted fiducial markers. The measured catheter paths immediately prior to treatment were then compared with the plan. During treatment delivery, the position of the (192)Ir source is determined at each dwell position by measuring the exit radiation with the FPD and directly compared to the planned source dwell positions. The registration between the two corresponding sets of fiducial markers in the TPS and radiograph yielded a registration error (residual) of 1.0 mm. The measured catheter paths agreed with the planned catheter paths on average to within 0.5 mm. The source positions measured with the FPD matched the planned source positions for all dwells on average within 0.6 mm (s.d. 0.3, min. 0.1, max. 1.4 mm). We have demonstrated a method for directly comparing the treatment plan with the delivered treatment that can be easily implemented in the clinical workspace. Pretreatment imaging was performed, enabling visualization of the implant before treatment delivery and identification of possible catheter displacement. Treatment delivery verification was performed by measuring the source position as each dwell was delivered. This approach using a FPD for imaging and source tracking provides a noninvasive method of acquiring extensive information for verification in HDR prostate brachytherapy.

SU-F-T-23: Correspondence Factor Correction Coefficient for Commissioning of Leipzig and Valencia Applicators with the Standard Imaging IVB 1000

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donaghue, J; Gajdos, S

Purpose: To determine the correction factor of the correspondence factor for the Standard Imaging IVB 1000 well chamber for commissioning of Elekta’s Leipzig and Valencia skin applicators. Methods: The Leipzig and Valencia applicators are designed to treat small skin lesions by collimating irradiation to the treatment area. Published output factors are used to calculate dose rates for clinical treatments. To validate onsite applicators, a correspondence factor (CFrev) is measured and compared to published values. The published CFrev is based on well chamber model SI HDR 1000 Plus. The CFrev is determined by correlating raw values of the source calibration setupmore » (Rcal,raw) and values taken when each applicator is mounted on the same well chamber with an adapter (Rapp,raw). The CFrev is calculated by using the equation CFrev =Rapp,raw/Rcal,raw. The CFrev was measured for each applicator in both the SI HDR 1000 Plus and the SI IVB 1000. A correction factor, CFIVB for the SI IVB 1000 was determined by finding the ratio of CFrev (SI IVB 1000) and CFrev (SI HDR 1000 Plus). Results: The average correction factors at dwell position 1121 were found to be 1.073, 1.039, 1.209, 1.091, and 1.058 for the Valencia V2, Valencia V3, Leipzig H1, Leipzig H2, and Leipzig H3 respectively. There were no significant variations in the correction factor for dwell positions 1119 through 1121. Conclusion: By using the appropriate correction factor, the correspondence factors for the Leipzig and Valencia surface applicators can be validated with the Standard Imaging IVB 1000. This allows users to correlate their measurements with the Standard Imaging IVB 1000 to the published data. The correction factor is included in the equation for the CFrev as follows: CFrev= Rapp,raw/(CFIVB*Rcal,raw). Each individual applicator has its own correction factor, so care must be taken that the appropriate factor is used.« less

A method for verification of treatment delivery in HDR prostate brachytherapy using a flat panel detector for both imaging and source tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, Ryan L., E-mail: ryan.smith@wbrc.org.au; Millar, Jeremy L.; Franich, Rick D.

Purpose: Verification of high dose rate (HDR) brachytherapy treatment delivery is an important step, but is generally difficult to achieve. A technique is required to monitor the treatment as it is delivered, allowing comparison with the treatment plan and error detection. In this work, we demonstrate a method for monitoring the treatment as it is delivered and directly comparing the delivered treatment with the treatment plan in the clinical workspace. This treatment verification system is based on a flat panel detector (FPD) used for both pre-treatment imaging and source tracking. Methods: A phantom study was conducted to establish the resolutionmore » and precision of the system. A pretreatment radiograph of a phantom containing brachytherapy catheters is acquired and registration between the measurement and treatment planning system (TPS) is performed using implanted fiducial markers. The measured catheter paths immediately prior to treatment were then compared with the plan. During treatment delivery, the position of the {sup 192}Ir source is determined at each dwell position by measuring the exit radiation with the FPD and directly compared to the planned source dwell positions. Results: The registration between the two corresponding sets of fiducial markers in the TPS and radiograph yielded a registration error (residual) of 1.0 mm. The measured catheter paths agreed with the planned catheter paths on average to within 0.5 mm. The source positions measured with the FPD matched the planned source positions for all dwells on average within 0.6 mm (s.d. 0.3, min. 0.1, max. 1.4 mm). Conclusions: We have demonstrated a method for directly comparing the treatment plan with the delivered treatment that can be easily implemented in the clinical workspace. Pretreatment imaging was performed, enabling visualization of the implant before treatment delivery and identification of possible catheter displacement. Treatment delivery verification was performed by measuring the source position as each dwell was delivered. This approach using a FPD for imaging and source tracking provides a noninvasive method of acquiring extensive information for verification in HDR prostate brachytherapy.« less

Catheter-based ultrasound hyperthermia with HDR brachytherapy for treatment of locally advanced cancer of the prostate and cervix

NASA Astrophysics Data System (ADS)

Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant; Juang, Titania; Scott, Serena; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I. C.

2011-03-01

A clinical treatment delivery platform has been developed and is being evaluated in a clinical pilot study for providing 3D controlled hyperthermia with catheter-based ultrasound applicators in conjunction with high dose rate (HDR) brachytherapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within HDR brachytherapy implants during radiation therapy in the treatment of cervix and prostate. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2-4 cm length × 180 deg and 3-4 cm × 360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2-3 transducers × dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and six prostate implants. 100 % of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia target volume (HTV) and clinical target volume (CTV) are reported. Catheter-based ultrasound hyperthermia with HDR appears feasible with therapeutic temperature coverage of the target volume within the prostate or cervix while sparing surrounding more sensitive regions.

Food Intake Recording Software System, version 4 (FIRSSt4): A self-completed 24-h dietary recall for children

USDA-ARS?s Scientific Manuscript database

The Food Intake Recording Software System, version 4 (FIRSSt4), is a web-based 24-h dietary recall (24 hdr) self-administered by children based on the Automated Self-Administered 24-h recall (ASA24) (a self-administered 24 hdr for adults). The food choices in FIRSSt4 are abbreviated to include only ...

Correlating subcortical interhemispheric connectivity and cortical hemispheric dominance in brain tumor patients: A repetitive navigated transcranial magnetic stimulation study.

PubMed

Sollmann, Nico; Ille, Sebastian; Tussis, Lorena; Maurer, Stefanie; Hauck, Theresa; Negwer, Chiara; Bauer, Jan S; Ringel, Florian; Meyer, Bernhard; Krieg, Sandro M

2016-02-01

The present study aims to investigate the relationship between transcallosal interhemispheric connectivity (IC) and hemispheric language lateralization by using a novel approach including repetitive navigated transcranial magnetic stimulation (rTMS), hemispheric dominance ratio (HDR) calculation, and rTMS-based diffusion tensor imaging fiber tracking (DTI FT). 31 patients with left-sided perisylvian brain lesions underwent diffusion tensor imaging (DTI) and rTMS language mapping. Cortical language-positive rTMS spots were used to calculate HDRs (HDR: quotient of the left-sided divided by right-sided naming error rates for corresponding left- and right-sided cortical regions) and to create regions of interest (ROIs) for DTI FT. Then, fibers connecting the rTMS-based ROIs of both hemispheres were tracked, and the correlation of IC to HDRs was calculated via Spearman's rank correlation coefficient (rs). Fibers connecting rTMS-based ROIs of both hemispheres were detected in 12 patients (38.7%). Within the patients in which IC was detected, the mean number of subcortical IC fibers ± standard deviation (SD) was 138.0 ± 346.5 (median: 7.5; range: 1-1,217 fibers). Regarding rs for the correlation of HDRs and fiber numbers of patients that showed IC, only moderate correlation was revealed. Our approach might be beneficial and technically feasible for further investigation of the relationship between IC and language lateralization. However, only moderate correlation was revealed in the present study. Copyright © 2015 Elsevier B.V. All rights reserved.

360-degree 3D transvaginal ultrasound system for high-dose-rate interstitial gynaecological brachytherapy needle guidance

NASA Astrophysics Data System (ADS)

Rodgers, Jessica R.; Surry, Kathleen; D'Souza, David; Leung, Eric; Fenster, Aaron

2017-03-01

Treatment for gynaecological cancers often includes brachytherapy; in particular, in high-dose-rate (HDR) interstitial brachytherapy, hollow needles are inserted into the tumour and surrounding area through a template in order to deliver the radiation dose. Currently, there is no standard modality for visualizing needles intra-operatively, despite the need for precise needle placement in order to deliver the optimal dose and avoid nearby organs, including the bladder and rectum. While three-dimensional (3D) transrectal ultrasound (TRUS) imaging has been proposed for 3D intra-operative needle guidance, anterior needles tend to be obscured by shadowing created by the template's vaginal cylinder. We have developed a 360-degree 3D transvaginal ultrasound (TVUS) system that uses a conventional two-dimensional side-fire TRUS probe rotated inside a hollow vaginal cylinder made from a sonolucent plastic (TPX). The system was validated using grid and sphere phantoms in order to test the geometric accuracy of the distance and volumetric measurements in the reconstructed image. To test the potential for visualizing needles, an agar phantom mimicking the geometry of the female pelvis was used. Needles were inserted into the phantom and then imaged using the 3D TVUS system. The needle trajectories and tip positions in the 3D TVUS scan were compared to their expected values and the needle tracks visualized in magnetic resonance images. Based on this initial study, 360-degree 3D TVUS imaging through a sonolucent vaginal cylinder is a feasible technique for intra-operatively visualizing needles during HDR interstitial gynaecological brachytherapy.

Comparative evaluation of two-dimensional radiography and three dimensional computed tomography based dose-volume parameters for high-dose-rate intracavitary brachytherapy of cervical cancer: a prospective study.

PubMed

Madan, Renu; Pathy, Sushmita; Subramani, Vellaiyan; Sharma, Seema; Mohanti, Bidhu Kalyan; Chander, Subhash; Thulkar, Sanjay; Kumar, Lalit; Dadhwal, Vatsla

2014-01-01

Dosimetric comparison of two dimensional (2D) radiography and three-dimensional computed tomography (3D-CT) based dose distributions with high-dose-rate (HDR) intracavitry radiotherapy (ICRT) for carcinoma cervix, in terms of target coverage and doses to bladder and rectum. Sixty four sessions of HDR ICRT were performed in 22 patients. External beam radiotherapy to pelvis at a dose of 50 Gray in 27 fractions followed by HDR ICRT, 21 Grays to point A in 3 sessions, one week apart was planned . All patients underwent 2D-orthogonal and 3D-CT simulation for each session. Treatment plans were generated using 2D-orthogonal images and dose prescription was made at point A. 3D plans were generated using 3D-CT images after delineating target volume and organs at risk. Comparative evaluation of 2D and 3D treatment planning was made for each session in terms of target coverage (dose received by 90%, 95% and 100% of the target volume: D90, D95 and D100 respectively) and doses to bladder and rectum: ICRU-38 bladder and rectum point dose in 2D planning and dose to 0.1cc, 1cc, 2cc, 5cc, and 10cc of bladder and rectum in 3D planning. Mean doses received by 100% and 90% of the target volume were 4.24 ± 0.63 and 4.9 ± 0.56 Gy respectively. Doses received by 0.1cc, 1cc and 2cc volume of bladder were 2.88 ± 0.72, 2.5 ± 0.65 and 2.2 ± 0.57 times more than the ICRU bladder reference point. Similarly, doses received by 0.1cc, 1cc and 2cc of rectum were 1.80 ± 0.5, 1.48 ± 0.41 and 1.35 ± 0.37 times higher than ICRU rectal reference point. Dosimetric comparative evaluation of 2D and 3D CT based treatment planning for the same brachytherapy session demonstrates underestimation of OAR doses and overestimation of target coverage in 2D treatment planning.

A multicentre 'end to end' dosimetry audit for cervix HDR brachytherapy treatment.

PubMed

Palmer, Antony L; Diez, Patricia; Gandon, Laura; Wynn-Jones, Andrea; Bownes, Peter; Lee, Chris; Aird, Edwin; Bidmead, Margaret; Lowe, Gerry; Bradley, David; Nisbet, Andrew

2015-02-01

To undertake the first multicentre fully 'end to end' dosimetry audit for HDR cervix brachytherapy, comparing planned and delivered dose distributions around clinical treatment applicators, with review of local procedures. A film-dosimetry audit was performed at 46 centres, including imaging, applicator reconstruction, treatment planning and delivery. Film dose maps were calculated using triple-channel dosimetry and compared to RTDose data from treatment planning systems. Deviations between plan and measurement were quantified at prescription Point A and using gamma analysis. Local procedures were also discussed. The mean difference between planned and measured dose at Point A was -0.6% for plastic applicators and -3.0% for metal applicators, at standard uncertainty 3.0% (k=1). Isodose distributions agreed within 1mm over a dose range 2-16Gy. Mean gamma passing rates exceeded 97% for plastic and metal applicators at 3% (local) 2mm criteria. Two errors were found: one dose normalisation error and one applicator library misaligned with the imaged applicator. Suggestions for quality improvement were also made. The concept of 'end to end' dosimetry audit for HDR brachytherapy has been successfully implemented in a multicentre environment, providing evidence that a high level of accuracy in brachytherapy dosimetry can be achieved. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of time, attendance of medical staff, and resources during interstitial brachytherapy for prostate cancer : DEGRO-QUIRO trial.

PubMed

Tselis, N; Maurer, U; Popp, W; Sack, H; Zamboglou, N

2014-04-01

The German Society of Radiation Oncology initiated a multicenter trial to evaluate core processes and subprocesses of radiotherapy by prospective evaluation of all important procedures in the most frequent malignancies treated by radiation therapy. The aim of this analysis was to assess the required resources for interstitial high-dose-rate (HDR) and low-dose-rate (LDR) prostate brachytherapy (BRT) based on actual time measurements regarding allocation of personnel and room occupation needed for specific procedures. Two radiotherapy centers (community hospital of Offenbach am Main and community hospital of Eschweiler) participated in this prospective study. Working time of the different occupational groups and room occupancies for the workflow of prostate BRT were recorded and methodically assessed during a 3-month period. For HDR and LDR BRT, a total of 560 and 92 measurements, respectively, were documented. The time needed for treatment preplanning was median 24 min for HDR (n = 112 measurements) and 6 min for LDR BRT (n = 21). Catheter implantation with intraoperative HDR real-time planning (n = 112), postimplantation HDR treatment planning (n = 112), and remotely controlled HDR afterloading irradiation (n = 112) required median 25, 39, and 50 min, respectively. For LDR real-time planning (n = 39) and LDR treatment postplanning (n = 32), the assessed median duration was 91 and 11 min, respectively. Room occupancy and overall mean medical staff times were 194 and 910 min respectively, for HDR, and 113 and 371 min, respectively, for LDR BRT. In this prospective analysis, the resource requirements for the application of HDR and LDR BRT of prostate cancer were assessed methodically and are presented for first time.

Industrial applications of hot dry rock geothermal energy

NASA Astrophysics Data System (ADS)

Duchane, D. V.

1992-07-01

Geothermal resources in the form of naturally occurring hot water or steam have been utilized for many years. While these hydrothermal resources are found in many places, the general case is that the rock at depth is hot, but does not contain significant amounts of mobile fluid. An extremely large amount of geothermal energy is found around the world in this hot dry rock (HDR). Technology has been under development for more than twenty years at the Los Alamos National Laboratory in the United States and elsewhere to develop the technology to extract the geothermal energy from HDR in a form useful for electricity generation, space heating, or industrial processing. HDR technology is especially attractive for industrial applications because of the ubiquitous distribution of the HDR resource and the unique aspects of the process developed to recover it. In the HDR process, as developed at Los Alamos, water is pumped down a well under high pressure to open up natural joints in hot rock and create an artificial geothermal reservoir. Energy is extracted by circulating water through the reservoir. Pressurized hot water is returned to the surface through the production well, and its thermal energy is extracted for practical use. The same water is then recirculated through the system to mine more geothermal heat. Construction of a pilot HDR facility at Fenton Hill, NM, USA, has recently been completed by the Los Alamos National Laboratory. It consists of a large underground reservoir, a surface plant, and the connecting wellbores. This paper describes HDR technology and the current status of the development program. Novel industrial applications of geothermal energy based on the unique characteristics of the HDR energy extraction process are discussed.

Dosimetric and radiobiological comparison of volumetric modulated arc therapy, high-dose rate brachytherapy, and low-dose rate permanent seeds implant for localized prostate cancer.

PubMed

Yang, Ruijie; Zhao, Nan; Liao, Anyan; Wang, Hao; Qu, Ang

2016-01-01

To investigate the dosimetric and radiobiological differences among volumetric modulated arc therapy (VMAT), high-dose rate (HDR) brachytherapy, and low-dose rate (LDR) permanent seeds implant for localized prostate cancer. A total of 10 patients with localized prostate cancer were selected for this study. VMAT, HDR brachytherapy, and LDR permanent seeds implant plans were created for each patient. For VMAT, planning target volume (PTV) was defined as the clinical target volume plus a margin of 5mm. Rectum, bladder, urethra, and femoral heads were considered as organs at risk. A 78Gy in 39 fractions were prescribed for PTV. For HDR and LDR plans, the dose prescription was D90 of 34Gy in 8.5Gy per fraction, and 145Gy to clinical target volume, respectively. The dose and dose volume parameters were evaluated for target, organs at risk, and normal tissue. Physical dose was converted to dose based on 2-Gy fractions (equivalent dose in 2Gy per fraction, EQD2) for comparison of 3 techniques. HDR and LDR significantly reduced the dose to rectum and bladder compared with VMAT. The Dmean (EQD2) of rectum decreased 22.36Gy in HDR and 17.01Gy in LDR from 30.24Gy in VMAT, respectively. The Dmean (EQD2) of bladder decreased 6.91Gy in HDR and 2.53Gy in LDR from 13.46Gy in VMAT. For the femoral heads and normal tissue, the mean doses were also significantly reduced in both HDR and LDR compared with VMAT. For the urethra, the mean dose (EQD2) was 80.26, 70.23, and 104.91Gy in VMAT, HDR, and LDR brachytherapy, respectively. For localized prostate cancer, both HDR and LDR brachytherapy were clearly superior in the sparing of rectum, bladder, femoral heads, and normal tissue compared with VMAT. HDR provided the advantage in sparing of urethra compared with VMAT and LDR. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Dosimetric and radiobiological comparison of volumetric modulated arc therapy, high-dose rate brachytherapy, and low-dose rate permanent seeds implant for localized prostate cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Ruijie, E-mail: ruijyang@yahoo.com; Zhao, Nan; Liao, Anyan

To investigate the dosimetric and radiobiological differences among volumetric modulated arc therapy (VMAT), high-dose rate (HDR) brachytherapy, and low-dose rate (LDR) permanent seeds implant for localized prostate cancer. A total of 10 patients with localized prostate cancer were selected for this study. VMAT, HDR brachytherapy, and LDR permanent seeds implant plans were created for each patient. For VMAT, planning target volume (PTV) was defined as the clinical target volume plus a margin of 5 mm. Rectum, bladder, urethra, and femoral heads were considered as organs at risk. A 78 Gy in 39 fractions were prescribed for PTV. For HDR andmore » LDR plans, the dose prescription was D{sub 90} of 34 Gy in 8.5 Gy per fraction, and 145 Gy to clinical target volume, respectively. The dose and dose volume parameters were evaluated for target, organs at risk, and normal tissue. Physical dose was converted to dose based on 2-Gy fractions (equivalent dose in 2 Gy per fraction, EQD{sub 2}) for comparison of 3 techniques. HDR and LDR significantly reduced the dose to rectum and bladder compared with VMAT. The D{sub mean} (EQD{sub 2}) of rectum decreased 22.36 Gy in HDR and 17.01 Gy in LDR from 30.24 Gy in VMAT, respectively. The D{sub mean} (EQD{sub 2}) of bladder decreased 6.91 Gy in HDR and 2.53 Gy in LDR from 13.46 Gy in VMAT. For the femoral heads and normal tissue, the mean doses were also significantly reduced in both HDR and LDR compared with VMAT. For the urethra, the mean dose (EQD{sub 2}) was 80.26, 70.23, and 104.91 Gy in VMAT, HDR, and LDR brachytherapy, respectively. For localized prostate cancer, both HDR and LDR brachytherapy were clearly superior in the sparing of rectum, bladder, femoral heads, and normal tissue compared with VMAT. HDR provided the advantage in sparing of urethra compared with VMAT and LDR.« less

Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Larissa J.; Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu

2012-12-01

Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adversemore » Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure adequate tumor coverage while minimizing the D2cc to the rectum.« less

Increased γ-H2A.X intensity in response to chronic medium-dose-rate γ-ray irradiation.

PubMed

Sugihara, Takashi; Murano, Hayato; Tanaka, Kimio

2012-01-01

The molecular mechanisms of DNA repair following chronic medium-dose-rate (MDR) γ-ray-induced damage remain largely unknown. We used a cell function imager to quantitatively measure the fluorescence intensity of γ-H2A.X foci in MDR (0.015 Gy/h and 0.06 Gy/h) or high-dose-rate (HDR) (54 Gy/h) γ-ray irradiated embryonic fibroblasts derived from DNA-dependent protein kinase mutated mice (scid/scid mouse embryonic fibroblasts (scid/scid MEFs)). The obtained results are as follows: (1) Automatic measurement of the intensity of radiation-induced γ-H2A.X foci by the cell function imager provides more accurate results compared to manual counting of γ-H2A.X foci. (2) In high-dose-rate (HDR) irradiation, γ-H2A.X foci with high fluorescence intensity were observed at 1 h after irradiation in both scid/scid and wild-type MEFs. These foci were gradually reduced through de-phosphorylation at 24 h or 72 h after irradiation. Furthermore, the fluorescence intensity at 24 h increased to a significantly greater extent in scid/scid MEFs than in wild-type MEFs in the G(1) phase, although no significant difference was observed in G(2)/M-phase MEFs, suggesting that DNA-PKcs might be associated with non-homologous-end-joining-dependent DNA repair in the G(1) phase following HDR γ-ray irradiation. (3) The intensity of γ-H2A.X foci for continuous MDR (0.06 Gy/h and 0.015 Gy/h) irradiation increased significantly and in a dose-dependent fashion. Furthermore, unlike HDR-irradiated scid/scid MEFs, the intensity of γ-H2A.X foci in MDR-irradiated scid/scid MEFs showed no significant increase in the G(1) phase at 24 h, indicating that DNA repair systems using proteins other than DNA-PKcs might induce cell functioning that are subjected to MDR γ-ray irradiation. Our results indicate that the mechanism of phosphorylation or de-phosphorylation of γ-H2A.X foci induced by chronic MDR γ-ray irradiation might be different from those induced by HDR γ-ray irradiation.

TU-D-201-07: Severity Indication in High Dose Rate Brachytherapy Emergency Response Procedure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, K; Rustad, F

Purpose: Understanding the corresponding dose to different staff during the High Dose Rate (HDR) Brachytherapy emergency response procedure could help to develop a strategy in efficiency and effective action. In this study, the variation and risk analysis methodology was developed to simulation the HDR emergency response procedure based on severity indicator. Methods: A GammaMedplus iX HDR unit from Varian Medical System was used for this simulation. The emergency response procedure was decomposed based on risk management methods. Severity indexes were used to identify the impact of a risk occurrence on the step including dose to patient and dose to operationmore » staff by varying the time, HDR source activity, distance from the source to patient and staff and the actions. These actions in 7 steps were to press the interrupt button, press emergency shutoff switch, press emergency button on the afterloader keypad, turn emergency hand-crank, remove applicator from the patient, disconnect transfer tube and move afterloader from the patient, and execute emergency surgical recovery. Results: Given the accumulated time in second at the assumed 7 steps were 15, 5, 30, 15, 180, 120, 1800, and the dose rate of HDR source is 10 Ci, the accumulated dose in cGy to patient at 1cm distance were 188, 250, 625, 813, 3063, 4563 and 27063, and the accumulated exposure in rem to operator at outside the vault, 1m and 10cm distance were 0.0, 0.0, 0.1, 0.1, 22.6, 37.6 and 262.6. The variation was determined by the operators in action at different time and distance from the HDR source. Conclusion: The time and dose were estimated for a HDR unit emergency response procedure. It provided information in making optimal decision during the emergency procedure. Further investigation would be to optimize and standardize the responses for other emergency procedure by time-spatial-dose severity function.« less

A Prospective Cohort Study to Compare Treatment Results Between 2 Fractionation Schedules of High-Dose-Rate Intracavitary Brachytherapy (HDR-ICBT) in Patients With Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Eng-Yen; School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taiwan; Sun, Li-Min

Purpose: To compare the treatment results of 2 fractionation schedules for high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer. Methods and Materials: From June 2001 through January 2008, 267 patients with stage IB-IVA cervical cancer were enrolled in the study. All patients underwent 4-field pelvic irradiation and HDR-ICBT. The median central and parametrial doses were 39.6 Gy and 45 Gy, respectively. Patient underwent either 6 Gy Multiplication-Sign 4 (HDR-4) (n=144) or 4.5 Gy Multiplication-Sign 6 (HDR-6) (n=123) to point A of ICBT using {sup 192}Ir isotope twice weekly. The rates of overall survival, locoregional failure, distant metastasis, proctitis, cystitis,more » and enterocolitis were compared between HDR-4 and HDR-6. Results: There were no significant differences in the demographic data between HDR-4 and HDR-6 except for total treatment time. The 5-year proctitis rates were 23.0% and 21.5% in HDR-4 and HDR-6 (P=.399), respectively. The corresponding rates of grade 2-4 proctitis were 18.7% and 9.6% (P=.060). The corresponding rates of grades 3-4 proctitis were 5.2% and 1.3% (P=.231). Subgroup analysis revealed that HDR-4 significantly increased grade 2-4 proctitis in patients aged {>=}62 years old (P=.012) but not in patients aged <62 years (P=.976). The rates of overall survival, locoregional failure, distant metastasis, cystitis, and enterocolitis were not significantly different between HDR-4 and HDR-6 schedules. Conclusion: The small fraction size of HDR-ICBT is associated with grade 2 proctitis without compromise of prognosis in elderly patients. This schedule is suggested for patients who tolerate an additional 2 applications of HDR-ICBT.« less

Trans-Pacific HDR Satellite Communications Experiment Phase-2 Project Plan and Experimental Network

NASA Technical Reports Server (NTRS)

Hsu, Eddie; Kadowaki, Naoto; Yoshimura, Naoko; Takahashi, Takashi; Yoshikawa, Makoto; Bergman, Larry; Bhasin, Kul

2000-01-01

The trans-Pacific high data rate (TP-HDR) satellite communications experiment was proposed at the Japan-U.S. Cooperation in Space (JUCS) Program Workshop held in Hawaii in 1993 and remote high definition video post-production was demonstrated as the first phase trial. ATM-based 45 Mbps trans-Pacific link was established in the first phase, and the following experiments with 155 Mbps was planned as the phase 2. This paper describes the experimental network configuration and project plan of TP-HDR experiment phase 2. Additional information is provided in the original.

A radiation quality correction factor k for well-type ionization chambers for the measurement of the reference air kerma rate of (60)Co HDR brachytherapy sources.

PubMed

Schüller, Andreas; Meier, Markus; Selbach, Hans-Joachim; Ankerhold, Ulrike

2015-07-01

The aim of this study was to investigate whether a chamber-type-specific radiation quality correction factor kQ can be determined in order to measure the reference air kerma rate of (60)Co high-dose-rate (HDR) brachytherapy sources with acceptable uncertainty by means of a well-type ionization chamber calibrated for (192)Ir HDR sources. The calibration coefficients of 35 well-type ionization chambers of two different chamber types for radiation fields of (60)Co and (192)Ir HDR brachytherapy sources were determined experimentally. A radiation quality correction factor kQ was determined as the ratio of the calibration coefficients for (60)Co and (192)Ir. The dependence on chamber-to-chamber variations, source-to-source variations, and source strength was investigated. For the PTW Tx33004 (Nucletron source dosimetry system (SDS)) well-type chamber, the type-specific radiation quality correction factor kQ is 1.19. Note that this value is valid for chambers with the serial number, SN ≥ 315 (Nucletron SDS SN ≥ 548) onward only. For the Standard Imaging HDR 1000 Plus well-type chambers, the type-specific correction factor kQ is 1.05. Both kQ values are independent of the source strengths in the complete clinically relevant range. The relative expanded uncertainty (k = 2) of kQ is UkQ = 2.1% for both chamber types. The calibration coefficient of a well-type chamber for radiation fields of (60)Co HDR brachytherapy sources can be calculated from a given calibration coefficient for (192)Ir radiation by using a chamber-type-specific radiation quality correction factor kQ. However, the uncertainty of a (60)Co calibration coefficient calculated via kQ is at least twice as large as that for a direct calibration with a (60)Co source.

A Ferredoxin- and F420H2-Dependent, Electron-Bifurcating, Heterodisulfide Reductase with Homologs in the Domains Bacteria and Archaea

PubMed Central

Yan, Zhen

2017-01-01

ABSTRACT Heterodisulfide reductases (Hdr) of the HdrABC class are ancient enzymes and a component of the anaerobic core belonging to the prokaryotic common ancestor. The ancient origin is consistent with the widespread occurrence of genes encoding putative HdrABC homologs in metabolically diverse prokaryotes predicting diverse physiological functions; however, only one HdrABC has been characterized and that was from a narrow metabolic group of obligate CO2-reducing methanogenic anaerobes (methanogens) from the domain Archaea. Here we report the biochemical characterization of an HdrABC homolog (HdrA2B2C2) from the acetate-utilizing methanogen Methanosarcina acetivorans with unusual properties structurally and functionally distinct from the only other HdrABC characterized. Homologs of the HdrA2B2C2 archetype are present in phylogenetically and metabolically diverse species from the domains Bacteria and Archaea. The expression of the individual HdrA2, HdrB2, and HdrB2C2 enzymes in Escherichia coli, and reconstitution of an active HdrA2B2C2 complex, revealed an intersubunit electron transport pathway dependent on ferredoxin or coenzyme F420 (F420H2) as an electron donor. Remarkably, HdrA2B2C2 couples the previously unknown endergonic oxidation of F420H2 and reduction of ferredoxin with the exergonic oxidation of F420H2 and reduction of the heterodisulfide of coenzyme M and coenzyme B (CoMS-SCoB). The unique electron bifurcation predicts a role for HdrA2B2C2 in Fe(III)-dependent anaerobic methane oxidation (ANME) by M. acetivorans and uncultured species from ANME environments. HdrA2B2C2, ubiquitous in acetotrophic methanogens, was shown to participate in electron transfer during acetotrophic growth of M. acetivorans and proposed to be essential for growth in the environment when acetate is limiting. PMID:28174314

Generalized assorted pixel camera: postcapture control of resolution, dynamic range, and spectrum.

PubMed

Yasuma, Fumihito; Mitsunaga, Tomoo; Iso, Daisuke; Nayar, Shree K

2010-09-01

We propose the concept of a generalized assorted pixel (GAP) camera, which enables the user to capture a single image of a scene and, after the fact, control the tradeoff between spatial resolution, dynamic range and spectral detail. The GAP camera uses a complex array (or mosaic) of color filters. A major problem with using such an array is that the captured image is severely under-sampled for at least some of the filter types. This leads to reconstructed images with strong aliasing. We make four contributions in this paper: 1) we present a comprehensive optimization method to arrive at the spatial and spectral layout of the color filter array of a GAP camera. 2) We develop a novel algorithm for reconstructing the under-sampled channels of the image while minimizing aliasing artifacts. 3) We demonstrate how the user can capture a single image and then control the tradeoff of spatial resolution to generate a variety of images, including monochrome, high dynamic range (HDR) monochrome, RGB, HDR RGB, and multispectral images. 4) Finally, the performance of our GAP camera has been verified using extensive simulations that use multispectral images of real world scenes. A large database of these multispectral images has been made available at http://www1.cs.columbia.edu/CAVE/projects/gap_camera/ for use by the research community.

A Pilot Study of Catheter-Based Ultrasound Hyperthermia with HDR Brachytherapy for Treatment of Locally Advanced Cancer of the Prostate and Cervix

NASA Astrophysics Data System (ADS)

Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant; Juang, Titania; Scott, Serena; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I. C.

2011-09-01

Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within temporary HDR brachytherapy implants during radiation therapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2-4 cm length×180 deg and 3-4 cm×360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2-3 transducers x dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and four prostate implants. 100% of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia target volume (HTV) and clinical target volume (CTV) are reported. Catheter-based ultrasound hyperthermia with HDR appears feasible with therapeutic temperature coverage of the target volume within the prostate or cervix while sparing surrounding more sensitive regions.

In vivo TLD dose measurements in catheter-based high-dose-rate brachytherapy.

PubMed

Adlienė, Diana; Jakštas, Karolis; Urbonavičius, Benas Gabrielis

2015-07-01

Routine in vivo dosimetry is well established in external beam radiotherapy; however, it is restricted mainly to detection of gross errors in high-dose-rate (HDR) brachytherapy due to complicated measurements in the field of steep dose gradients in the vicinity of radioactive source and high uncertainties. The results of in vivo dose measurements using TLD 100 mini rods and TLD 'pin worms' in catheter-based HDR brachytherapy are provided in this paper alongside with their comparison with corresponding dose values obtained using calculation algorithm of the treatment planning system. Possibility to perform independent verification of treatment delivery in HDR brachytherapy using TLDs is discussed. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

VhuD Facilitates Electron Flow from H2 or Formate to Heterodisulfide Reductase in Methanococcus maripaludis

PubMed Central

Costa, Kyle C.; Lie, Thomas J.; Xia, Qin

2013-01-01

Flavin-based electron bifurcation has recently been characterized as an essential energy conservation mechanism that is utilized by hydrogenotrophic methanogenic Archaea to generate low-potential electrons in an ATP-independent manner. Electron bifurcation likely takes place at the flavin associated with the α subunit of heterodisulfide reductase (HdrA). In Methanococcus maripaludis the electrons for this reaction come from either formate or H2 via formate dehydrogenase (Fdh) or Hdr-associated hydrogenase (Vhu). However, how these enzymes bind to HdrA to deliver electrons is unknown. Here, we present evidence that the δ subunit of hydrogenase (VhuD) is central to the interaction of both enzymes with HdrA. When M. maripaludis is grown under conditions where both Fdh and Vhu are expressed, these enzymes compete for binding to VhuD, which in turn binds to HdrA. Under these conditions, both enzymes are fully functional and are bound to VhuD in substoichiometric quantities. We also show that Fdh copurifies specifically with VhuD in the absence of other hydrogenase subunits. Surprisingly, in the absence of Vhu, growth on hydrogen still occurs; we show that this involves F420-reducing hydrogenase. The data presented here represent an initial characterization of specific protein interactions centered on Hdr in a hydrogenotrophic methanogen that utilizes multiple electron donors for growth. PMID:24039260

Highly efficient CRISPR/HDR-mediated knock-in for mouse embryonic stem cells and zygotes.

PubMed

Wang, Bangmei; Li, Kunyu; Wang, Amy; Reiser, Michelle; Saunders, Thom; Lockey, Richard F; Wang, Jia-Wang

2015-10-01

The clustered regularly interspaced short palindromic repeat (CRISPR) gene editing technique, based on the non-homologous end-joining (NHEJ) repair pathway, has been used to generate gene knock-outs with variable sizes of small insertion/deletions with high efficiency. More precise genome editing, either the insertion or deletion of a desired fragment, can be done by combining the homology-directed-repair (HDR) pathway with CRISPR cleavage. However, HDR-mediated gene knock-in experiments are typically inefficient, and there have been no reports of successful gene knock-in with DNA fragments larger than 4 kb. Here, we describe the targeted insertion of large DNA fragments (7.4 and 5.8 kb) into the genomes of mouse embryonic stem (ES) cells and zygotes, respectively, using the CRISPR/HDR technique without NHEJ inhibitors. Our data show that CRISPR/HDR without NHEJ inhibitors can result in highly efficient gene knock-in, equivalent to CRISPR/HDR with NHEJ inhibitors. Although NHEJ is the dominant repair pathway associated with CRISPR-mediated double-strand breaks (DSBs), and biallelic gene knock-ins are common, NHEJ and biallelic gene knock-ins were not detected. Our results demonstrate that efficient targeted insertion of large DNA fragments without NHEJ inhibitors is possible, a result that should stimulate interest in understanding the mechanisms of high efficiency CRISPR targeting in general.

High Dose Rate Brachytherapy in Two 9 Gy Fractions in the Treatment of Locally Advanced Cervical Cancer - a South Indian Institutional Experience.

PubMed

Ghosh, Saptarshi; Rao, Pamidimukkala Bramhananda; Kotne, Sivasankar

2015-01-01

Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. This is a prospective institutional study in Southern India carried on from 1st June 2012 to 31st July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borot de Battisti, M; Maenhout, M; Lagendijk, J J W

Purpose: This study assesses the potential of Fiber Bragg Grating (FBG)-based sensing for real-time needle (including catheter or tube) tracking during MR-guided HDR brachytherapy. Methods: The proposed FBG-based sensing tracking approach involves a MR-compatible stylet composed of three optic fibers with nine sets of embedded FBG sensors each. When the stylet is inserted inside the lumen of the needle, the FBG sensing system can measure the needle’s deflection. For localization of the needle in physical space, the position and orientation of the stylet base are mandatory. For this purpose, we propose to fix the stylet base and determine its positionmore » and orientation using a MR-based calibration as follows. First, the deflection of a needle inserted in a phantom in two different configurations is measured during simultaneous MR-imaging. Then, after segmentation of the needle shapes on the MR-images, the position and orientation of the stylet base is determined using a rigid registration of the needle shapes on both MR and FBG-based measurements. The calibration method was assessed by measuring the deflection of a needle in a prostate phantom in five different configurations using FBG-based sensing during simultaneous MR-imaging. Any two needle shapes were employed for the calibration step and the proposed FGB-tracking approach was subsequently evaluated on the other three needles configurations. The tracking accuracy was evaluated by computing the Euclidian distance between the 3D FBG vs. MR-based measurements. Results: Over all needle shapes tested, the average(standard deviation) Euclidian distance between the FBG and MR-based measurements was 0.79mm(0.37mm). The update rate and latency of the FBG-based measurements were 100ms and 300ms respectively. Conclusion: The proposed FBG-based protocol can measure the needle position with an accuracy, precision, update rate and latency eligible for accurate needle steering during MR-guided HDR brachytherapy. M. Borot de Battisti is funded by Philips Medical Systems Nederland B.V.; M. Moerland is principal investigator on a contract funded by Philips Medical Systems Nederland B.V.; G. Hautvast and D. Binnekamp are fulltime employees of Philips Medical Systems Nederland B.V.« less

Image-guided high dose rate endorectal brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Devic, Slobodan; Vuong, Te; Moftah, Belal

2007-11-15

Fractionated high dose rate endorectal brachytherapy (HDR-EBT) using CT-based treatment planning is an alternative method for preoperative down-sizing and down-staging of advanced rectal adeno-carcinomas. The authors present an image guidance procedure that was developed to ensure daily dose reproducibility for the four brachytherapy treatment fractions. Since the applicator might not be placed before each treatment fraction inside the rectal lumen in the same manner as it was placed during the 3D CT volume acquisition used for treatment planning, there is a shift along the catheter axis that may have to be performed. The required shift is determined by comparison ofmore » a daily radiograph with the treatment planning digitally-reconstructed radiograph (DRR). A procedure is developed for DRR reconstruction from the 3D data set used for the treatment planning, and two possible daily longitudinal shifts are illustrated: above and below the planning dose distribution. The authors also describe the procedure for rotational alignment illustrated on a clinical case. Reproduction of the treatment planned dose distribution on a daily basis is crucial for the success of fractionated 3D based brachytherapy treatments. Due to the cylindrical symmetry of the applicator used for preoperative HDR-EBT, two types of adjustments are necessary: applicator rotation and dwell position shift along the applicator's longitudinal axis. The impact of the longitudinal applicator shift prior to treatment delivery for 62 patients treated in our institution is also assessed.« less

MO-C-17A-10: Comparison of Dose Deformable Accumulation by Using Parallel and Serial Approaches

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gao, Z; Li, M; Wong, J

Purpose: The uncertainty of dose accumulation over multiple CT datasets with deformable fusion may have significant impact on clinical decisions. In this study, we investigate the difference of two dose summation approaches involving deformable fusion. Methods: Five patients, four external beam and one brachytherapy(BT), were chosen for the study. The BT patient was treated with CT-based HDR. The CT image sets acquired in the imageguidance process (8-11 CTs/patient) were used to determine the dose delivered to the four external beam patients. (prostate, pelvis, lung and head and neck). For the HDR patient (cervix), five CT image sets and the correspondingmore » BT plans were used. In total 44 CT datasets and RT dose/plans were imported into the image fusion software MiM (6.0.4) for analysis.For each of the five clinical cases, the dose from each fraction was accumulated into the primary CT dataset by using both Parallel and Serial approaches. The dose-volume histogram (DVH) for CTV and selected organs-at-risks (OAR) were generated. The D95(CTV), OAR(mean) and OAR(max) for the four external beam cases the D90(CTV), and the max dose to bladder and rectum for the BT case were compared. Results: For the four external beam patients, the difference in D95(CTV) were <1.2% PD between the parallel and the serial approaches. The differences of the OAR(mean) and the OAR(max ) range from 0 to 3.7% and <1% PD respectively. For the HDR patient, the dose difference for D90 is 11% PD while that of the max dose to bladder and rectum were 11.5% and 23.3% respectively. Conclusion: For external beam treatments, the parallel and serial approaches have <5% difference probably because tumor volume and OAR have less changes from fraction to fraction. For the brachytherapy case, >10% dose difference between the two approaches was observed as significant volume changes of tumor and OAR were observed among treatment fractions.« less

SU-F-19A-09: Propagation of Organ at Risk Contours for High Dose Rate Brachytherapy Planning for Cervical Cancer: A Deformable Image Registration Comparison

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bellon, M; Kumarasiri, A; Kim, J

Purpose: To compare the performance of two deformable image registration (DIR) algorithms for contour propagation and to evaluate the accuracy of DIR for use with high dose rate (HDR) brachytherapy planning for cervical cancer. Methods: Five patients undergoing HDR ring and tandem brachytherapy were included in this retrospective study. All patients underwent CT simulation and replanning prior to each fraction (3–5 fractions total). CT-to-CT DIR was performed using two commercially available software platforms: SmartAdapt, Varian Medical Systems (Demons) and Velocity AI, Velocity Medical Solutions (B-spline). Fraction 1 contours were deformed and propagated to each subsequent image set and compared tomore » contours manually drawn by an expert clinician. Dice similarity coefficients (DSC), defined as, DSC(A,B)=2(AandB)/(A+B) were calculated to quantify spatial overlap between manual (A) and deformed (B) contours. Additionally, clinician-assigned visual scores were used to describe and compare the performance of each DIR method and ultimately evaluate which was more clinically acceptable. Scoring was based on a 1–5 scale—with 1 meaning, “clinically acceptable with no contour changes” and 5 meaning, “clinically unacceptable”. Results: Statistically significant differences were not observed between the two DIR algorithms. The average DSC for the bladder, rectum and rectosigmoid were 0.82±0.08, 0.67±0.13 and 0.48±0.18, respectively. The poorest contour agreement was observed for the rectosigmoid due to limited soft tissue contrast and drastic anatomical changes, i.e., organ shape/filling. Two clinicians gave nearly equivalent average scores of 2.75±0.91 for SmartAdapt and 2.75±0.94 for Velocity AI—indicating that for a majority of the cases, more than one of the three contours evaluated required major modifications. Conclusion: Limitations of both DIR algorithms resulted in inaccuracies in contour propagation in the pelvic region, thus hampering the clinical utility of this technology. Further work is required to optimize these algorithms and take advantage of the potential of DIR for HDR brachytherapy planning.« less

SU-C-202-02: A Comprehensive Evaluation of Adaptive Daily Planning for Cervical Cancer HDR Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meerschaert, R; Paul, A; Zhuang, L

Purpose: To evaluate adaptive daily planning for cervical cancer patients who underwent high-dose-rate intra-cavitary brachytherapy (HDR-ICBT). Methods: This study included 22 cervical cancer patients who underwent 5 fractions of HDR ICBT. Regions of interest (ROIs) including high-risk clinical tumor volume (HR-CTV) and organs-at-risk (OARs) were manually contoured on daily CT images. All patients were treated with adaptive daily plans, which involved ROI delineation and dose optimization at each treatment fraction. Single treatment plans were retrospectively generated by applying the first treatment fraction’s dwell times adjusted for decay and dwell positions of the applicator to subsequent treatment fractions. Various existing similaritymore » metrics were calculated for the ROIs to quantify interfractional organ variations. A novel similarity score (JRARM) was established, which combined both volumetric overlap metrics (DSC, JSC, and RVD) and distance metrics (ASD, MSD, and RMSD). Linear regression was performed to determine a relationship between inter-fractional organ variations of various similarity metrics and D2cc variations from both plans. Wilcoxon Signed Rank Tests were used to assess adaptive daily plans and single plans by comparing EQD2 D2cc (α/β=3) for OARs. Results: For inter-fractional organ variations, the sigmoid demonstrated the greatest variations based on the JRARM and DSC similarity metrics. Comparisons between paired ROIs showed differences in JRARM scores and DSCs at each treatment fraction. RVD, MSD, and RMSD were found to be significantly correlated to D2cc variations for bladder and sigmoid. The comparison between plans found that adaptive daily planning provided lower EQD2 D2cc of OARs than single planning, specifically for the sigmoid (p=0.015). Conclusion: Substantial inter-fractional organ motion can occur during HDR-BT, which may significantly affect D2cc of OARs. Adaptive daily planning provides improved dose sparing for OARs compared to single planning.« less

SU-E-T-149: Brachytherapy Patient Specific Quality Assurance for a HDR Vaginal Cylinder Case

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barbiere, J; Napoli, J; Ndlovu, A

2015-06-15

Purpose: Commonly Ir-192 HDR treatment planning system commissioning is only based on a single absolute measurement of source activity supplemented by tabulated parameters for multiple factors without independent verification that the planned distribution corresponds to the actual delivered dose. The purpose on this work is to present a methodology using Gafchromic film with a statistically valid calibration curve that can be used to validate clinical HDR vaginal cylinder cases by comparing the calculated plan dose distribution in a plane with the corresponding measured planar dose. Methods: A vaginal cylinder plan was created with Oncentra treatment planning system. The 3D dosemore » matrix was exported to a Varian Eclipse work station for convenient extraction of a 2D coronal dose plane corresponding to the film position. The plan was delivered with a sheet of Gafchromic EBT3 film positioned 1mm from the catheter using an Ir-192 Nucletron HDR source. The film was then digitized with an Epson 10000 XL color scanner. Film analysis is performed with MatLab imaging toolbox. A density to dose calibration curve was created using TG43 formalism for a single dwell position exposure at over 100 points for statistical accuracy. The plan and measured film dose planes were registered using a known dwell position relative to four film marks. The plan delivered 500 cGy to points 2 cm from the sources. Results: The distance to agreement of the 500 cGy isodose between the plan and film measurement laterally was 0.5 mm but can be as much as 1.5 mm superior and inferior. The difference between the computed plan dose and film measurement was calculated per pixel. The greatest errors up to 50 cGy are near the apex. Conclusion: The methodology presented will be useful to implement more comprehensive quality assurance to verify patient-specific dose distributions.« less

Cosmetic changes following surgery and accelerated partial breast irradiation using HDR interstitial brachytherapy : Evaluation by a multidisciplinary/multigender committee.

PubMed

Soror, Tamer; Kovács, György; Seibold, Nina; Melchert, Corinna; Baumann, Kristin; Wenzel, Eike; Stojanovic-Rundic, Suzana

2017-05-01

Patients with early-stage breast cancer can benefit from adjuvant accelerated partial breast irradiation (APBI) following breast-conserving surgery (BCS). This work reports on cosmetic results following APBI using multicatheter high-dose-rate interstitial brachytherapy (HDR-IBT). Between 2006 and 2014, 114 patients received adjuvant APBI using multicatheter HDR-IBT. For each patient, two photographs were analyzed: the first was taken after surgery (baseline image) and the second at the last follow-up visit. Cosmesis was assessed by a multigender multidisciplinary team using the Harvard Breast Cosmesis Scale. Dose-volume histogram (DVH) parameters and the observed cosmetic results were investigated for potential correlations. The median follow-up period was 3.5 years (range 0.6-8.5 years). The final cosmetic scores were 30% excellent, 52% good, 14.5% fair, and 3.5% poor. Comparing the baseline and follow-up photographs, 59.6% of patients had the same score, 36% had a better final score, and 4.4% had a worse final score. Only lower target dose nonuniformity ratio (DNR) values (0.3 vs. 0.26; p = 0.009) were significantly associated with improved cosmetic outcome vs. same/worse cosmesis. APBI using multicatheter HDR-IBT adjuvant to BCS results in favorable final cosmesis. Deterioration in breast cosmesis occurs in less than 5% of patients. The final breast cosmetic outcome in patients treated with BCS and APBI using multicatheter HDR-IBT is influenced primarily by the cosmetic result of the surgery. A lower DNR value is significantly associated with a better cosmetic outcome.

Near constant-time optimal piecewise LDR to HDR inverse tone mapping

NASA Astrophysics Data System (ADS)

Chen, Qian; Su, Guan-Ming; Yin, Peng

2015-02-01

In a backward compatible HDR image/video compression, it is a general approach to reconstruct HDR from compressed LDR as a prediction to original HDR, which is referred to as inverse tone mapping. Experimental results show that 2- piecewise 2nd order polynomial has the best mapping accuracy than 1 piece high order or 2-piecewise linear, but it is also the most time-consuming method because to find the optimal pivot point to split LDR range to 2 pieces requires exhaustive search. In this paper, we propose a fast algorithm that completes optimal 2-piecewise 2nd order polynomial inverse tone mapping in near constant time without quality degradation. We observe that in least square solution, each entry in the intermediate matrix can be written as the sum of some basic terms, which can be pre-calculated into look-up tables. Since solving the matrix becomes looking up values in tables, computation time barely differs regardless of the number of points searched. Hence, we can carry out the most thorough pivot point search to find the optimal pivot that minimizes MSE in near constant time. Experiment shows that our proposed method achieves the same PSNR performance while saving 60 times computation time compared to the traditional exhaustive search in 2-piecewise 2nd order polynomial inverse tone mapping with continuous constraint.

Sci-Thur AM: YIS – 03: Combining sagittally-reconstructed 3D and live-2D ultrasound for high-dose-rate prostate brachytherapy needle segmentation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hrinivich, Thomas; Hoover, Douglas; Surry, Kathlee

Ultrasound-guided high-dose-rate prostate brachytherapy (HDR-BT) needle segmentation is performed clinically using live-2D sagittal images. Organ segmentation is then performed using axial images, introducing a source of geometric uncertainty. Sagittally-reconstructed 3D (SR3D) ultrasound enables both needle and organ segmentation, but suffers from shadow artifacts. We present a needle segmentation technique augmenting SR3D with live-2D sagittal images using mechanical probe tracking to mitigate image artifacts and compare it to the clinical standard. Seven prostate cancer patients underwent TRUS-guided HDR-BT during which the clinical and proposed segmentation techniques were completed in parallel using dual ultrasound video outputs. Calibrated needle end-length measurements were usedmore » to calculate insertion depth errors (IDEs), and the dosimetric impact of IDEs was evaluated by perturbing clinical treatment plan source positions. The proposed technique provided smaller IDEs than the clinical approach, with mean±SD of −0.3±2.2 mm and −0.5±3.7mm respectively. The proposed and clinical techniques resulted in 84% and 43% of needles with IDEs within ±3mm, and IDE ranges across all needles of [−7.7mm, 5.9mm] and [−9.3mm, 7.7mm] respectively. The proposed and clinical IDEs lead to mean±SD changes in the volume of the prostate receiving the prescription dose of −0.6±0.9% and −2.0±5.3% respectively. The proposed technique provides improved HDR-BT needle segmentation accuracy over the clinical technique leading to decreased dosimetric uncertainty by eliminating the axial-to-sagittal registration, and mitigates the effect of shadow artifacts by incorporating mechanically registered live-2D sagittal images.« less

A Ferredoxin- and F 420 H 2 -Dependent, Electron-Bifurcating, Heterodisulfide Reductase with Homologs in the Domains Bacteria and Archaea

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, Zhen; Wang, Mingyu; Ferry, James G.

Heterodisulfide reductases (Hdr) of the HdrABC class are ancient enzymes and a component of the anaerobic core belonging to the prokaryotic common ancestor. The ancient origin is consistent with the widespread occurrence of genes encoding putative HdrABC homologs in metabolically diverse prokaryotes predicting diverse physiological functions; but, only one HdrABC has been characterized and that was from a narrow metabolic group of obligate CO 2-reducing methanogenic anaerobes (methanogens) from the domainArchaea. Here we report the biochemical characterization of an HdrABC homolog (HdrA2B2C2) from the acetate-utilizing methanogenMethanosarcina acetivoranswith unusual properties structurally and functionally distinct from the only other HdrABC characterized. Homologsmore » of the HdrA2B2C2 archetype are present in phylogenetically and metabolically diverse species from the domainsBacteriaandArchaea. The expression of the individual HdrA2, HdrB2, and HdrB2C2 enzymes inEscherichia coli, and reconstitution of an active HdrA2B2C2 complex, revealed an intersubunit electron transport pathway dependent on ferredoxin or coenzyme F 420(F 420H 2) as an electron donor. Remarkably, HdrA2B2C2 couples the previously unknown endergonic oxidation of F 420H 2and reduction of ferredoxin with the exergonic oxidation of F 420H 2and reduction of the heterodisulfide of coenzyme M and coenzyme B (CoMS-SCoB). The unique electron bifurcation predicts a role for HdrA2B2C2 in Fe(III)-dependent anaerobic methane oxidation (ANME) byM. acetivoransand uncultured species from ANME environments. HdrA2B2C2, ubiquitous in acetotrophic methanogens, was shown to participate in electron transfer during acetotrophic growth ofM. acetivoransand proposed to be essential for growth in the environment when acetate is limiting.IMPORTANCEDiscovery of the archetype HdrA2B2C2 heterodisulfide reductase with categorically unique properties extends the understanding of this ancient family beyond CO 2-reducing methanogens to include diverse prokaryotes from the domainsBacteriaandArchaea. Furthermore, the unprecedented coenzyme F 420-dependent electron bifurcation, an emerging fundamental principle of energy conservation, predicts a role for HdrA2B2C2 in diverse metabolisms, including anaerobic CH 4-oxidizing pathways. Our results document an electron transport role for HdrA2B2C2 in acetate-utilizing methanogens responsible for at least two-thirds of the methane produced in Earth’s biosphere. The previously unavailable heterologous production of individual subunits and the reconstitution of HdrA2B2C2 with activity have provided an understanding of intersubunit electron transfer in the HdrABC class and a platform for investigating the principles of electron bifurcation.« less

A Ferredoxin- and F 420 H 2 -Dependent, Electron-Bifurcating, Heterodisulfide Reductase with Homologs in the Domains Bacteria and Archaea

DOE PAGES

Yan, Zhen; Wang, Mingyu; Ferry, James G.; ...

2017-02-07

Heterodisulfide reductases (Hdr) of the HdrABC class are ancient enzymes and a component of the anaerobic core belonging to the prokaryotic common ancestor. The ancient origin is consistent with the widespread occurrence of genes encoding putative HdrABC homologs in metabolically diverse prokaryotes predicting diverse physiological functions; but, only one HdrABC has been characterized and that was from a narrow metabolic group of obligate CO 2-reducing methanogenic anaerobes (methanogens) from the domainArchaea. Here we report the biochemical characterization of an HdrABC homolog (HdrA2B2C2) from the acetate-utilizing methanogenMethanosarcina acetivoranswith unusual properties structurally and functionally distinct from the only other HdrABC characterized. Homologsmore » of the HdrA2B2C2 archetype are present in phylogenetically and metabolically diverse species from the domainsBacteriaandArchaea. The expression of the individual HdrA2, HdrB2, and HdrB2C2 enzymes inEscherichia coli, and reconstitution of an active HdrA2B2C2 complex, revealed an intersubunit electron transport pathway dependent on ferredoxin or coenzyme F 420(F 420H 2) as an electron donor. Remarkably, HdrA2B2C2 couples the previously unknown endergonic oxidation of F 420H 2and reduction of ferredoxin with the exergonic oxidation of F 420H 2and reduction of the heterodisulfide of coenzyme M and coenzyme B (CoMS-SCoB). The unique electron bifurcation predicts a role for HdrA2B2C2 in Fe(III)-dependent anaerobic methane oxidation (ANME) byM. acetivoransand uncultured species from ANME environments. HdrA2B2C2, ubiquitous in acetotrophic methanogens, was shown to participate in electron transfer during acetotrophic growth ofM. acetivoransand proposed to be essential for growth in the environment when acetate is limiting.IMPORTANCEDiscovery of the archetype HdrA2B2C2 heterodisulfide reductase with categorically unique properties extends the understanding of this ancient family beyond CO 2-reducing methanogens to include diverse prokaryotes from the domainsBacteriaandArchaea. Furthermore, the unprecedented coenzyme F 420-dependent electron bifurcation, an emerging fundamental principle of energy conservation, predicts a role for HdrA2B2C2 in diverse metabolisms, including anaerobic CH 4-oxidizing pathways. Our results document an electron transport role for HdrA2B2C2 in acetate-utilizing methanogens responsible for at least two-thirds of the methane produced in Earth’s biosphere. The previously unavailable heterologous production of individual subunits and the reconstitution of HdrA2B2C2 with activity have provided an understanding of intersubunit electron transfer in the HdrABC class and a platform for investigating the principles of electron bifurcation.« less

A Ferredoxin- and F420H2-Dependent, Electron-Bifurcating, Heterodisulfide Reductase with Homologs in the Domains Bacteria and Archaea.

PubMed

Yan, Zhen; Wang, Mingyu; Ferry, James G

2017-02-07

Heterodisulfide reductases (Hdr) of the HdrABC class are ancient enzymes and a component of the anaerobic core belonging to the prokaryotic common ancestor. The ancient origin is consistent with the widespread occurrence of genes encoding putative HdrABC homologs in metabolically diverse prokaryotes predicting diverse physiological functions; however, only one HdrABC has been characterized and that was from a narrow metabolic group of obligate CO 2 -reducing methanogenic anaerobes (methanogens) from the domain Archaea Here we report the biochemical characterization of an HdrABC homolog (HdrA2B2C2) from the acetate-utilizing methanogen Methanosarcina acetivorans with unusual properties structurally and functionally distinct from the only other HdrABC characterized. Homologs of the HdrA2B2C2 archetype are present in phylogenetically and metabolically diverse species from the domains Bacteria and Archaea The expression of the individual HdrA2, HdrB2, and HdrB2C2 enzymes in Escherichia coli, and reconstitution of an active HdrA2B2C2 complex, revealed an intersubunit electron transport pathway dependent on ferredoxin or coenzyme F 420 (F 420 H 2 ) as an electron donor. Remarkably, HdrA2B2C2 couples the previously unknown endergonic oxidation of F 420 H 2 and reduction of ferredoxin with the exergonic oxidation of F 420 H 2 and reduction of the heterodisulfide of coenzyme M and coenzyme B (CoMS-SCoB). The unique electron bifurcation predicts a role for HdrA2B2C2 in Fe(III)-dependent anaerobic methane oxidation (ANME) by M. acetivorans and uncultured species from ANME environments. HdrA2B2C2, ubiquitous in acetotrophic methanogens, was shown to participate in electron transfer during acetotrophic growth of M. acetivorans and proposed to be essential for growth in the environment when acetate is limiting. Discovery of the archetype HdrA2B2C2 heterodisulfide reductase with categorically unique properties extends the understanding of this ancient family beyond CO 2 -reducing methanogens to include diverse prokaryotes from the domains Bacteria and Archaea The unprecedented coenzyme F 420 -dependent electron bifurcation, an emerging fundamental principle of energy conservation, predicts a role for HdrA2B2C2 in diverse metabolisms, including anaerobic CH 4 -oxidizing pathways. The results document an electron transport role for HdrA2B2C2 in acetate-utilizing methanogens responsible for at least two-thirds of the methane produced in Earth's biosphere. The previously unavailable heterologous production of individual subunits and the reconstitution of HdrA2B2C2 with activity have provided an understanding of intersubunit electron transfer in the HdrABC class and a platform for investigating the principles of electron bifurcation. Copyright © 2017 Yan et al.

SU-E-T-509: Inter-Observer and Inter-Modality Contouring Analysis for Organs at Risk for HDR Gynecological Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sadeghi, P; Smith, W; Tom Baker Cancer Centre, Calgary, AB

2015-06-15

Purpose This study quantifies errors associated with MR-guided High Dose Rate (HDR) gynecological brachytherapy. Uncertainties in this treatment results from contouring, organ motion between imaging and treatment delivery, dose calculation, and dose delivery. We focus on interobserver and inter-modality variability in contouring and the motion of organs at risk (OARs) in the time span between the MR and CT scans (∼1 hour). We report the change in organ volume and position of center of mass (CM) between the two imaging modalities. Methods A total of 8 patients treated with MR-guided HDR brachytherapy were included in this study. Two observers contouredmore » the bladder and rectum on both MR and CT scans. The change in OAR volume and CM position between the MR and CT imaging sessions on both image sets were calculated. Results The absolute mean bladder volume change between the two imaging modalities is 67.1cc. The absolute mean inter-observer difference in bladder volume is much lower at 15.5cc (MR) and 11.0cc (CT). This higher inter-modality volume difference suggests a real change in the bladder filling between the two imaging sessions. Change in Rectum volume inter-observer standard error of means (SEM) is 3.18cc (MR) and 3.09cc (CT), while the inter-modality SEM is 3.65cc (observer 1), and 2.75cc (observer 2). The SEM for rectum CM position in the superior-inferior direction was approximately three times higher than in other directions for both the inter—observer (0.77 cm, 0.92 cm for observers 1 and 2, respectively) and inter-modality (0.91 cm, 0.95 cm for MR and CT, respectively) variability. Conclusion Bladder contours display good consistency between different observers on both CT and MR images. For rectum contouring the highest inconsistency stems from the observers’ choice of the superior-inferior borders. A complete analysis of a larger patient cohort will enable us to separate the true organ motion from the inter-observer variability.« less

Chroma sampling and modulation techniques in high dynamic range video coding

NASA Astrophysics Data System (ADS)

Dai, Wei; Krishnan, Madhu; Topiwala, Pankaj

2015-09-01

High Dynamic Range and Wide Color Gamut (HDR/WCG) Video Coding is an area of intense research interest in the engineering community, for potential near-term deployment in the marketplace. HDR greatly enhances the dynamic range of video content (up to 10,000 nits), as well as broadens the chroma representation (BT.2020). The resulting content offers new challenges in its coding and transmission. The Moving Picture Experts Group (MPEG) of the International Standards Organization (ISO) is currently exploring coding efficiency and/or the functionality enhancements of the recently developed HEVC video standard for HDR and WCG content. FastVDO has developed an advanced approach to coding HDR video, based on splitting the HDR signal into a smoothed luminance (SL) signal, and an associated base signal (B). Both signals are then chroma downsampled to YFbFr 4:2:0 signals, using advanced resampling filters, and coded using the Main10 High Efficiency Video Coding (HEVC) standard, which has been developed jointly by ISO/IEC MPEG and ITU-T WP3/16 (VCEG). Our proposal offers both efficient coding, and backwards compatibility with the existing HEVC Main10 Profile. That is, an existing Main10 decoder can produce a viewable standard dynamic range video, suitable for existing screens. Subjective tests show visible improvement over the anchors. Objective tests show a sizable gain of over 25% in PSNR (RGB domain) on average, for a key set of test clips selected by the ISO/MPEG committee.

Microbial oxidative sulfur metabolism: biochemical evidence of the membrane-bound heterodisulfide reductase-like complex of the bacterium Aquifex aeolicus.

PubMed

Boughanemi, Souhela; Lyonnet, Jordan; Infossi, Pascale; Bauzan, Marielle; Kosta, Artémis; Lignon, Sabrina; Giudici-Orticoni, Marie-Thérèse; Guiral, Marianne

2016-08-01

The Hdr (heterodisulfide reductase)-like enzyme is predicted, from gene transcript profiling experiments previously published, to be essential in oxidative sulfur metabolism in a number of bacteria and archaea. Nevertheless, no biochemical and physicochemical data are available so far about this enzyme. Genes coding for it were identified in Aquifex aeolicus, a Gram-negative, hyperthermophilic, chemolithoautotrophic and microaerophilic bacterium that uses inorganic sulfur compounds as electron donor to grow. We provide biochemical evidence that this Hdr-like enzyme is present in this sulfur-oxidizing prokaryote (cultivated with thiosulfate or elemental sulfur). We demonstrate, by immunolocalization and cell fractionation, that Hdr-like enzyme is associated, presumably monotopically, with the membrane fraction. We show by co-immunoprecipitation assay or partial purification, that the Hdr proteins form a stable complex composed of at least five subunits, HdrA, HdrB1, HdrB2, HdrC1 and HdrC2, present in two forms of high molecular mass on native gel (∼240 and 450 kDa). These studies allow us to propose a revised model for dissimilatory sulfur oxidation pathways in A. aeolicus, with Hdr predicted to generate sulfite. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Using a hot dry rock geothermal reservoir for load following

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, D.W.; Duteau, R.J.

1995-01-01

Field measurements and modeling have shown the potential for using a Hot Dry Rock (HDR) geothermal reservoir for electric load following: either with Power-Peaking from a base-load operating condition, or for Pumped Storage of off-peak electric energy with a very significant thermal augmentation of the stored mechanical energy during periods of power production. For the base-load with power- peaking mode of operation, and HDR reservoir appears capable of producing over twice its nominal power output for short -- 2 to 4 hour -- periods of time. In this mode of operation, the reservoir normally would be produced under a high-backpressuremore » condition with the HDR reservoir region near the production well highly inflated. Upon demand, the production backpressure would be sharply reduced, surging the production flow. The analytical tool used in these investigations has been the transient finite element model of the an HDR reservoir called GEOCRACK, which is being developed by Professor Dan Swenson and his students at Kansas State University. This discrete-element representation of a jointed rock mass has recently been validated for transient operations using the set of cyclic reservoir operating data obtained at the end of the LTFT.« less

Efficient Generation of Gene-Modified Pigs Harboring Precise Orthologous Human Mutation via CRISPR/Cas9-Induced Homology-Directed Repair in Zygotes.

PubMed

Zhou, Xiaoyang; Wang, Lulu; Du, Yinan; Xie, Fei; Li, Liang; Liu, Yu; Liu, Chuanhong; Wang, Shiqiang; Zhang, Shibing; Huang, Xingxu; Wang, Yong; Wei, Hong

2016-01-01

Precise genetic mutation of model animals is highly valuable for functional investigation of human mutations. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9)-induced homology-directed repair (HDR) is usually used for precise genetic mutation, being limited by the relatively low efficiency compared with that of non-homologous end joining (NHEJ). Although inhibition of NHEJ was shown to enhance HDR-derived mutation, in this work, without inhibition of NHEJ, we first generated gene-modified pigs harboring precise orthologous human mutation (Sox10 c.A325>T) via CRISPR/Cas9-induced HDR in zygotes using single-strand oligo DNA (ssODN) as template with an efficiency as high as 80%, indicating that pig zygotes exhibited high activities of HDR relative to NHEJ and were highly amendable to genetic mutation via CIRSPR/Cas9-induced HDR. Besides, we found a higher concentration of ssODN remarkably reduced HDR-derived mutation in pig zygotes, suggesting a possible balance for optimal HDR-derived mutation in zygotes between the excessive accessibility to HDR templates and the activities of HDR relative to NHEJ which appeared to be negatively correlated to ssODN concentration. In addition, the HDR-derived mutation, as well as those from NHEJ, extensively integrated into various tissues including gonad of founder pig without detected off-targeting, suggesting CRISPR/Cas9-induced HDR in zygotes is a reliable approach for precise genetic mutation in pigs. © 2015 WILEY PERIODICALS, INC.

The FlxABCD-HdrABC proteins correspond to a novel NADH dehydrogenase/heterodisulfide reductase widespread in anaerobic bacteria and involved in ethanol metabolism in Desulfovibrio vulgaris Hildenborough.

PubMed

Ramos, Ana Raquel; Grein, Fabian; Oliveira, Gonçalo P; Venceslau, Sofia S; Keller, Kimberly L; Wall, Judy D; Pereira, Inês A C

2015-07-01

Flavin-based electron bifurcation (FBEB) is an important mechanism for the energy metabolism of anaerobes. A new family of NADH dehydrogenases, the flavin oxidoreductase (FlxABCD, previously called FloxABCD), was proposed to perform FBEB in sulphate-reducing organisms coupled with heterodisulfide reductase (HdrABC). We found that the hdrABC-flxABCD gene cluster is widespread among anaerobic bacteria, pointing to a general and important role in their bioenergetics. In this work, we studied FlxABCD of Desulfovibrio vulgaris Hildenborough. The hdr-flx genes are part of the same transcriptional unit and are increased in transcription during growth in ethanol-sulfate, and to a less extent during pyruvate fermentation. Two mutant strains were generated: one where expression of the hdr-flx genes was interrupted and another lacking the flxA gene. Both strains were unable to grow with ethanol-sulfate, whereas growth was restored in a flxA-complemented strain. The mutant strains also produced very reduced amounts of ethanol compared with the wild type during pyruvate fermentation. Our results show that in D. vulgaris, the FlxABCD-HdrABC proteins are essential for NADH oxidation during growth on ethanol, probably involving a FBEB mechanism that leads to reduction of ferredoxin and the small protein DsrC, while in fermentation they operate in reverse, reducing NAD(+) for ethanol production. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

Increased γ-H2A.X Intensity in Response to Chronic Medium-Dose-Rate γ-Ray Irradiation

PubMed Central

Sugihara, Takashi; Murano, Hayato; Tanaka, Kimio

2012-01-01

Background The molecular mechanisms of DNA repair following chronic medium-dose-rate (MDR) γ-ray-induced damage remain largely unknown. Methodology/Principal Findings We used a cell function imager to quantitatively measure the fluorescence intensity of γ-H2A.X foci in MDR (0.015 Gy/h and 0.06 Gy/h) or high-dose-rate (HDR) (54 Gy/h) γ-ray irradiated embryonic fibroblasts derived from DNA-dependent protein kinase mutated mice (scid/scid mouse embryonic fibroblasts (scid/scid MEFs)). The obtained results are as follows: (1) Automatic measurement of the intensity of radiation-induced γ-H2A.X foci by the cell function imager provides more accurate results compared to manual counting of γ-H2A.X foci. (2) In high-dose-rate (HDR) irradiation, γ-H2A.X foci with high fluorescence intensity were observed at 1 h after irradiation in both scid/scid and wild-type MEFs. These foci were gradually reduced through de-phosphorylation at 24 h or 72 h after irradiation. Furthermore, the fluorescence intensity at 24 h increased to a significantly greater extent in scid/scid MEFs than in wild-type MEFs in the G1 phase, although no significant difference was observed in G2/M-phase MEFs, suggesting that DNA-PKcs might be associated with non-homologous-end-joining-dependent DNA repair in the G1 phase following HDR γ-ray irradiation. (3) The intensity of γ-H2A.X foci for continuous MDR (0.06 Gy/h and 0.015 Gy/h) irradiation increased significantly and in a dose-dependent fashion. Furthermore, unlike HDR-irradiated scid/scid MEFs, the intensity of γ-H2A.X foci in MDR-irradiated scid/scid MEFs showed no significant increase in the G1 phase at 24 h, indicating that DNA repair systems using proteins other than DNA-PKcs might induce cell functioning that are subjected to MDR γ-ray irradiation. Conclusions Our results indicate that the mechanism of phosphorylation or de-phosphorylation of γ-H2A.X foci induced by chronic MDR γ-ray irradiation might be different from those induced by HDR γ-ray irradiation. PMID:23028931

4D analysis of influence of patient movement and anatomy alteration on the quality of 3D U/S-based prostate HDR brachytherapy treatment delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Milickovic, Natasa; Mavroidis, Panayiotis; Tselis, Nikolaos

2011-09-15

Purpose: Modern HDR brachytherapy treatment for prostate cancer based on the 3D ultrasound (U/S) plays increasingly important role. The purpose of this study is to investigate possible patient movement and anatomy alteration between the clinical image set acquisition, made after the needle implantation, and the patient irradiation and their influence on the quality of treatment. Methods: The authors used 3D U/S image sets and the corresponding treatment plans based on a 4D-treatment planning procedure: plans of 25 patients are obtained right after the needle implantation (clinical plan is based on this 3D image set) and just before and after themore » treatment delivery. The authors notice the slight decrease of treatment quality with increase of time gap between the clinical image set acquisition and the patient irradiation. 4D analysis of dose-volume-histograms (DVHs) for prostate: CTV1 = PTV, and urethra, rectum, and bladder as organs at risk (OARs) and conformity index (COIN) is presented, demonstrating the effect of prostate, OARs, and needles displacement. Results: The authors show that in the case that the patient body movement/anatomy alteration takes place, this results in modification of DVHs and radiobiological parameters, hence the plan quality. The observed average displacement of needles (1 mm) and of prostate (0.57 mm) is quite small as compared with the average displacement noted in several other reports [A. A. Martinez et al., Int. J. Radiat. Oncol., Biol., Phys. 49(1), 61-69 (2001); S. J. Damore et al., Int. J. Radiat. Oncol., Biol., Phys. 46(5), 1205-1211 (2000); P. J. Hoskin et al., Radiotherm. Oncol. 68(3), 285-288 (2003); E. Mullokandov et al., Int. J. Radiat. Oncol., Biol., Phys. 58(4), 1063-1071 (2004)] in the literature. Conclusions: Although the decrease of quality of dosimetric and radiobiological parameters occurs, this does not cause clinically unacceptable changes to the 3D dose distribution, according to our clinical protocol.« less

Spatial imaging in color and HDR: prometheus unchained

NASA Astrophysics Data System (ADS)

McCann, John J.

2013-03-01

The Human Vision and Electronic Imaging Conferences (HVEI) at the IS and T/SPIE Electronic Imaging meetings have brought together research in the fundamentals of both vision and digital technology. This conference has incorporated many color disciplines that have contributed to the theory and practice of today's imaging: color constancy, models of vision, digital output, high-dynamic-range imaging, and the understanding of perceptual mechanisms. Before digital imaging, silver halide color was a pixel-based mechanism. Color films are closely tied to colorimetry, the science of matching pixels in a black surround. The quanta catch of the sensitized silver salts determines the amount of colored dyes in the final print. The rapid expansion of digital imaging over the past 25 years has eliminated the limitations of using small local regions in forming images. Spatial interactions can now generate images more like vision. Since the 1950's, neurophysiology has shown that post-receptor neural processing is based on spatial interactions. These results reinforced the findings of 19th century experimental psychology. This paper reviews the role of HVEI in color, emphasizing the interaction of research on vision and the new algorithms and processes made possible by electronic imaging.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shen, S; Kim, R; Benhabib, S

Purpose: HDR brachytherapy using interstitial needle template for cervical cancer is commonly delivered in 4-5 fractions. Routine verification of needle positions before each fraction is often based on radiographic imaging of implanted fiducial markers. The current study evaluated interfractional displacement of implanted fiducial markers using CT images. Methods: 9 sequential patients with cervical interstitial needle implants were evaluated. The superior and inferior borders of the target volumes were defined by fiducial markers in planning CT. The implant position was verified with kV orthogonal images before each fraction. A second CT was acquired prior 3rd fraction (one or 2 days postmore » planning CT). Distances from inferior and superior fiducial markers to pubic symphysis plane (perpendicular to vaginal obtulator)were measured. Distance from needle tip of a reference needle (next to the inferior marker) to the pubic symphysis plane was also determined. The difference in fiducial marker distance or needle tip distance between planning CT and CT prior 3rd fraction were measured to assess markers migration and needle displacement. Results: The mean inferior marker displacement was 4.5 mm and ranged 0.9 to 11.3 mm. The mean superior marker displacement was 2.7 mm and ranged 0 to 10.4 mm. There was a good association between inferior and superior marker displacement (r=0.95). Mean averaged inferior and superior marker displacement was 3.3 mm and ranged from 0.1 to 10.9 mm, with a standard deviation of 3.2 mm. The mean needle displacement was 5.6 mm and ranged 0.2 to 15.6 mm. Needle displacements were reduced (p<0.05) after adjusting according to needle-to-fiducials distance. Conclusion: There were small fiducial marker displacements between HDR fractions. Our study suggests a target margin of 9.7 mm to cover interfractional marker displacements (in 95% cases) for pretreatment verification based on radiographic imaging.« less

β-Cell Failure in Diet-Induced Obese Mice Stratified According to Body Weight Gain: Secretory Dysfunction and Altered Islet Lipid Metabolism Without Steatosis or Reduced β-Cell Mass

PubMed Central

Peyot, Marie-Line; Pepin, Emilie; Lamontagne, Julien; Latour, Martin G.; Zarrouki, Bader; Lussier, Roxane; Pineda, Marco; Jetton, Thomas L.; Madiraju, S.R. Murthy; Joly, Erik; Prentki, Marc

2010-01-01

OBJECTIVE C57Bl/6 mice develop obesity and mild hyperglycemia when fed a high-fat diet (HFD). Although diet-induced obesity (DIO) is a widely studied model of type 2 diabetes, little is known about β-cell failure in these mice. RESEARCH DESIGN AND METHODS DIO mice were separated in two groups according to body weight gain: low- and high-HFD responders (LDR and HDR). We examined whether mild hyperglycemia in HDR mice is due to reduced β-cell mass or function and studied islet metabolism and signaling. RESULTS HDR mice were more obese, hyperinsulinemic, insulin resistant, and hyperglycemic and showed a more altered plasma lipid profile than LDR. LDR mice largely compensated insulin resistance, whereas HDR showed perturbed glucose homeostasis. Neither LDR nor HDR mice showed reduced β-cell mass, altered islet glucose metabolism, and triglyceride deposition. Insulin secretion in response to glucose, KCl, and arginine was impaired in LDR and almost abolished in HDR islets. Palmitate partially restored glucose- and KCl-stimulated secretion. The glucose-induced rise in ATP was reduced in both DIO groups, and the glucose-induced rise in Ca2+ was reduced in HDR islets relatively to LDR. Glucose-stimulated lipolysis was decreased in LDR and HDR islets, whereas fat oxidation was increased in HDR islets only. Fatty acid esterification processes were markedly diminished, and free cholesterol accumulated in HDR islets. CONCLUSIONS β-Cell failure in HDR mice is not due to reduced β-cell mass and glucose metabolism or steatosis but to a secretory dysfunction that is possibly due to altered ATP/Ca2+ and lipid signaling, as well as free cholesterol deposition. PMID:20547980

Low‑dose radiation‑induced apoptosis in human leukemia K562 cells through mitochondrial pathways.

PubMed

Xin, Yong; Zhang, Hai-Bin; Tang, Tian-You; Liu, Gui-Hong; Wang, Jian-She; Jiang, Guan; Zhang, Long-Zhen

2014-09-01

High‑dose total body irradiation (TBI) has an established role as preparative regimen for bone‑marrow transplantation in the treatment of chronic myelogenous leukemia (CML), but this regimen still has a relatively high rate of acute and late toxicity. Low‑dose radiation (LDR) induces apoptosis of tumor cells and has numerous beneficial effects on normal tissues, including radiation homeostasis and adaptive response. Based on the previous evidence, in the present study, K562 cells were exposed to LDR, high‑dose radiation (HDR), and LDR in combination with HDR to investigate the possible mechanism of the apoptotic effect and hypersensitivity induced by LDR. The apoptotic rate increased in all radiation groups in a time‑dependent manner. An upregulation of Bax protein expression and a downregulation of Bcl‑xl in a dose‑dependent manner in human leukemia K562 cells was observed. However, the expression of p53 protein did not change in all of the radiation cell groups. The mitochondrial membrane potential (ΔΨm) in K562 cells decreased in all of the radiation cell groups in a dose‑dependent manner. Furthermore, the decrease of ΔΨm was enhanced in the LDR/HDR group compared with that in the LDR or HDR groups. The activity of caspase‑3 was enhanced in all of the radiation groups. In the LDR/HDR group, the activity of caspase‑3 was higher than that in the HDR or LDR groups. The present study provided preliminary experimental evidence of LDR being beneficial in combination with TBI in the treatment of CML.

Photon counting readout pixel array in 0.18-μm CMOS technology for on-line gamma-ray imaging of 103palladium seeds for permanent breast seed implant (PBSI) brachytherapy

NASA Astrophysics Data System (ADS)

Goldan, A. H.; Karim, K. S.; Reznik, A.; Caldwell, C. B.; Rowlands, J. A.

2008-03-01

Permanent breast seed implant (PBSI) brachytherapy technique was recently introduced as an alternative to high dose rate (HDR) brachytherapy and involves the permanent implantation of radioactive 103Palladium seeds into the surgical cavity of the breast for cancer treatment. To enable accurate seed implantation, this research introduces a gamma camera based on a hybrid amorphous selenium detector and CMOS readout pixel architecture for real-time imaging of 103Palladium seeds during the PBSI procedure. A prototype chip was designed and fabricated in 0.18-μm n-well CMOS process. We present the experimental results obtained from this integrated photon counting readout pixel.

Does an Algorithmic Approach to Using Brachytherapy and External Beam Radiation Result in Good Function, Local Control Rates, and Low Morbidity in Patients With Extremity Soft Tissue Sarcoma?

PubMed

Klein, Jason; Ghasem, Alex; Huntley, Samuel; Donaldson, Nathan; Keisch, Martin; Conway, Sheila

2018-03-01

High-dose-rate brachytherapy (HDR-BT) and external-beam radiation therapy (EBRT) are two modalities used in the treatment of soft tissue sarcoma. Previous work at our institution showed early complications and outcomes for patients treated with HDR-BT, EBRT, or a combination of both radiation therapy modalities. As the general indications for each of these approaches to radiation therapy differ, it is important to evaluate the use of each in an algorithmic way, reflecting how they are used in contemporary practice at sites that use these treatments. QUESTION/PURPOSES: (1) To determine the proportions of intermediate- and long-term complications associated with the use of brachytherapy in the treatment of primary high-grade extremity soft tissue sarcomas; (2), to characterize the long-term morbidity of the three radiation treatment groups using the Radiation Therapy Oncology Group/ European Organization for Research and Treatment of Cancer (RTOG/EORTC) Late Radiation Morbidity Scoring Scheme; (3) to determine whether treatment with HDR-BT, EBRT, and HDR-BT+EBRT therapy, in combination with limb-salvage surgery, results in acceptable local control in this high-risk group of sarcomas. We retrospectively studied data from 171 patients with a diagnosis of high-grade extremity soft tissue sarcoma treated with limb-sparing surgery and radiation therapy between 1990 and 2012 at our institution, with a mean followup of 72 months. Of the 171 patients, 33 (20%) were treated with HDR-BT, 128 (75%) with EBRT, and 10 (6%) with HDR-BT+EBRT. We excluded 265 patients with soft tissue sarcomas owing to axial tumor location, previous radiation to the affected extremity, incomplete patient records, patients receiving primary amputation, recurrent tumors, pediatric patients, low- and intermediate-grade tumors, and rhabdoid histology. Fifteen patients (9%) were lost to followup for any reason including died of disease or other causes during the first 12 months postoperatively. This included four patients who received HDR-BT (12%), 11 who received EBRT (9%), and none who received HDR-BT+EBRT (0%) with less than 12 months followup. Determination of radiation therapy technique for each patient was individualized in a multidisciplinary forum of sarcoma specialists. Anticipated close or positive surgical margins and a low likelihood of complex soft tissue procedures were factors that encouraged use of brachytherapy, whereas the anticipated need for secondary procedures and/or soft tissue coverage encouraged use of EBRT alone. Combination therapy was used when the treatment volume exceeded the treatment field of the brachytherapy catheters or when the catheters were used to boost a close or positive surgical margin. Local recurrence, complications, and morbidity outcomes scores (RTOG) were calculated based on chart review. Between-group comparisons pertaining to the proportion of patients experiencing complications, morbidity outcomes scores, and local recurrence rates were not performed because of dissimilarities among the patients in each group at baseline. The HDR-BT treatment group showed a high incidence of intermediate-term complications, with the three most common being: deep infection (33%, 11 of 33); dehiscence and delayed wound healing (24%, eight of 33); and seroma and hematoma (21%, seven of 33). The EBRT group showed a high incidence of intermediate- and long-term complications with the three most common being: chronic radiation dermatitis (35%, 45 of 128); fibrosis (27%, 35 of 128); and chronic pain and neuritis (13%, 16 of 128). The RTOG scores for each treatment group were: HDR-BT 0.8 ± SD 1.2; EBRT 1.9 ± 2.0; and HDR-BT+EBRT 1.7 ± 1.7. Overall, 142 of 169 (84%) patients were free from local recurrence: 27 (82%) in the HDR-BT group, 108 (86%) in the EBRT group, and seven (70%) in the combination therapy group. In this single-institution study, an algorithmic approach to using HDR-BT and EBRT in the treatment of patients with high-grade soft tissue sarcomas can yield acceptable complication rates, good morbidity outcome scores, and a high degree of local control. Based on these results, we believe HDR-BT is best for patients with an anticipated close margin, a positive surgical margin, and for patients who are unlikely to receive a complex soft tissue procedure. Conversely, if a secondary procedure and/or soft tissue coverage are likely to be used, EBRT alone may be reasonable. Finally, combination therapy might be considered when the treatment volume exceeded the treatment field capacity for HDR-BT or when the catheters were used to boost a close or positive surgical margin. Level IV, therapeutic study.

TU-AB-201-06: Evaluation of Electromagnetically Guided High- Dose Rate Brachytherapy for Ablative Treatment of Lung Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pinkham, D.W.; Shultz, D.; Loo, B.W.

Purpose: The advent of electromagnetic navigation bronchoscopy has enabled minimally invasive access to peripheral lung tumors previously inaccessible by optical bronchoscopes. As an adjunct to Stereotactic Ablative Radiosurgery (SABR), implantation of HDR catheters can provide focal treatments for multiple metastases and sites of retreatments. The authors evaluate a procedure to deliver ablative doses via Electromagnetically-Guided HDR (EMG-HDR) to lung metastases, quantify the resulting dosimetry, and assess its role in the comprehensive treatment of lung cancer. Methods: A retrospective study was conducted on ten patients, who, from 2009 to 2011, received a hypo-fractionated SABR regimen with 6MV VMAT to lesions inmore » various lobes ranging from 1.5 to 20 cc in volume. A CT visible pathway was delineated for EM guided placement of an HDR applicator (catheter) and dwell times were optimized to ensure at least 98% prescription dose coverage of the GTV. Normal tissue doses were calculated using inhomogeneity corrections via a grid-based Boltzmann solver (Acuros-BV-1.5.0). Results: With EMG-HDR, an average of 83% (+/−9% standard deviation) of each patient’s GTV received over 200% of the prescription dose, as compared to SABR where the patients received an average maximum dose of 125% (+/−5%). EMG-HDR enabled a 59% (+/−12%) decrease in the aorta maximum dose, a 63% (+/−26%) decrease in the spinal cord max dose, and 57% (+/−23%) and 70% (+/−17%) decreases in the volume of the body receiving over 50% and 25% of the prescription dose, respectively. Conclusion: EMG-HDR enables delivery of higher ablative doses to the GTV, while concurrently reducing surrounding normal tissue doses. The single catheter approach shown here is limited to targets smaller than 20 cc. As such, the technique enables ablation of small lesions and a potentially safe and effective retreatment option in situations where external beam utility is limited by normal tissue constraints.« less

Multimodality Image-Guided HDR/IMRT in Prostate Cancer: Combined Molecular Targeting Using Nanoparticle MR, 3D MRSI, and 11C Acetate PET Imaging

DTIC Science & Technology

2005-08-01

Ph.D. Panos Fatouros, Ph.D. Jerry Hirsch, MSc, PharmD Rhonda Hoyle Kristin Schmidt Dorin Tudor, Ph.D. Jie Liu CONTRACTING ORGANIZATION: Virginia...McClish, Ph.D., Panos Fatouros, Ph.D., Jerry Hirsch, MSc, PharmD, 5e. TASK NUMBER Rhonda Hoyle, Kristin Schmidt, Dorin Tudor, Ph.D., Jie Liu 5f. WORK UNIT

An improved method to estimate reflectance parameters for high dynamic range imaging

NASA Astrophysics Data System (ADS)

Li, Shiying; Deguchi, Koichiro; Li, Renfa; Manabe, Yoshitsugu; Chihara, Kunihiro

2008-01-01

Two methods are described to accurately estimate diffuse and specular reflectance parameters for colors, gloss intensity and surface roughness, over the dynamic range of the camera used to capture input images. Neither method needs to segment color areas on an image, or to reconstruct a high dynamic range (HDR) image. The second method improves on the first, bypassing the requirement for specific separation of diffuse and specular reflection components. For the latter method, diffuse and specular reflectance parameters are estimated separately, using the least squares method. Reflection values are initially assumed to be diffuse-only reflection components, and are subjected to the least squares method to estimate diffuse reflectance parameters. Specular reflection components, obtained by subtracting the computed diffuse reflection components from reflection values, are then subjected to a logarithmically transformed equation of the Torrance-Sparrow reflection model, and specular reflectance parameters for gloss intensity and surface roughness are finally estimated using the least squares method. Experiments were carried out using both methods, with simulation data at different saturation levels, generated according to the Lambert and Torrance-Sparrow reflection models, and the second method, with spectral images captured by an imaging spectrograph and a moving light source. Our results show that the second method can estimate the diffuse and specular reflectance parameters for colors, gloss intensity and surface roughness more accurately and faster than the first one, so that colors and gloss can be reproduced more efficiently for HDR imaging.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schüller, Andreas, E-mail: andreas.schueller@ptb.de; Meier, Markus; Selbach, Hans-Joachim

Purpose: The aim of this study was to investigate whether a chamber-type-specific radiation quality correction factor k{sub Q} can be determined in order to measure the reference air kerma rate of {sup 60}Co high-dose-rate (HDR) brachytherapy sources with acceptable uncertainty by means of a well-type ionization chamber calibrated for {sup 192}Ir HDR sources. Methods: The calibration coefficients of 35 well-type ionization chambers of two different chamber types for radiation fields of {sup 60}Co and {sup 192}Ir HDR brachytherapy sources were determined experimentally. A radiation quality correction factor k{sub Q} was determined as the ratio of the calibration coefficients for {supmore » 60}Co and {sup 192}Ir. The dependence on chamber-to-chamber variations, source-to-source variations, and source strength was investigated. Results: For the PTW Tx33004 (Nucletron source dosimetry system (SDS)) well-type chamber, the type-specific radiation quality correction factor k{sub Q} is 1.19. Note that this value is valid for chambers with the serial number, SN ≥ 315 (Nucletron SDS SN ≥ 548) onward only. For the Standard Imaging HDR 1000 Plus well-type chambers, the type-specific correction factor k{sub Q} is 1.05. Both k{sub Q} values are independent of the source strengths in the complete clinically relevant range. The relative expanded uncertainty (k = 2) of k{sub Q} is U{sub k{sub Q}} = 2.1% for both chamber types. Conclusions: The calibration coefficient of a well-type chamber for radiation fields of {sup 60}Co HDR brachytherapy sources can be calculated from a given calibration coefficient for {sup 192}Ir radiation by using a chamber-type-specific radiation quality correction factor k{sub Q}. However, the uncertainty of a {sup 60}Co calibration coefficient calculated via k{sub Q} is at least twice as large as that for a direct calibration with a {sup 60}Co source.« less

NOTE: Monte Carlo evaluation of kerma in an HDR brachytherapy bunker

NASA Astrophysics Data System (ADS)

Pérez-Calatayud, J.; Granero, D.; Ballester, F.; Casal, E.; Crispin, V.; Puchades, V.; León, A.; Verdú, G.

2004-12-01

In recent years, the use of high dose rate (HDR) after-loader machines has greatly increased due to the shift from traditional Cs-137/Ir-192 low dose rate (LDR) to HDR brachytherapy. The method used to calculate the required concrete and, where appropriate, lead shielding in the door is based on analytical methods provided by documents published by the ICRP, the IAEA and the NCRP. The purpose of this study is to perform a more realistic kerma evaluation at the entrance maze door of an HDR bunker using the Monte Carlo code GEANT4. The Monte Carlo results were validated experimentally. The spectrum at the maze entrance door, obtained with Monte Carlo, has an average energy of about 110 keV, maintaining a similar value along the length of the maze. The comparison of results from the aforementioned values with the Monte Carlo ones shows that results obtained using the albedo coefficient from the ICRP document more closely match those given by the Monte Carlo method, although the maximum value given by MC calculations is 30% greater.

Do medical students generate sound arguments during small group discussions in problem-based learning?: an analysis of preclinical medical students' argumentation according to a framework of hypothetico-deductive reasoning.

PubMed

Ju, Hyunjung; Choi, Ikseon; Yoon, Bo Young

2017-06-01

Hypothetico-deductive reasoning (HDR) is an essential learning activity and a learning outcome in problem-based learning (PBL). It is important for medical students to engage in the HDR process through argumentation during their small group discussions in PBL. This study aimed to analyze the quality of preclinical medical students' argumentation according to each phase of HDR in PBL. Participants were 15 first-year preclinical students divided into two small groups. A set of three 2-hour discussion sessions from each of the two groups during a 1-week-long PBL unit on the cardiovascular system was audio-recorded. The arguments constructed by the students were analyzed using a coding scheme, which included four types of argumentation (Type 0: incomplete, Type 1: claim only, Type 2: claim with data, and Type 3: claim with data and warrant). The mean frequency of each type of argumentation according to each HDR phase across the two small groups was calculated. During small group discussions, Type 1 arguments were generated most often (frequency=120.5, 43%), whereas the least common were Type 3 arguments (frequency=24.5, 8.7%) among the four types of arguments. The results of this study revealed that the students predominantly made claims without proper justifications; they often omitted data for supporting their claims or did not provide warrants to connect the claims and data. The findings suggest instructional interventions to enhance the quality of medical students' arguments in PBL, including promoting students' comprehension of the structure of argumentation for HDR processes and questioning.

Pancreatic β-Cell Dysfunction in Diet-Induced Obese Mice: Roles of AMP-Kinase, Protein Kinase Cε, Mitochondrial and Cholesterol Metabolism, and Alterations in Gene Expression

PubMed Central

Pepin, Émilie; Al-Mass, Anfal; Attané, Camille; Zhang, Kezhuo; Lamontagne, Julien; Lussier, Roxane; Madiraju, S. R. Murthy; Joly, Erik; Ruderman, Neil B.; Sladek, Robert; Prentki, Marc; Peyot, Marie-Line

2016-01-01

Diet induced obese (DIO) mice can be stratified according to their weight gain in response to high fat diet as low responders (LDR) and high responders (HDR). This allows the study of β-cell failure and the transitions to prediabetes (LDR) and early diabetes (HDR). C57BL/6N mice were fed for 8 weeks with a normal chow diet (ND) or a high fat diet and stratified as LDR and HDR. Freshly isolated islets from ND, LDR and HDR mice were studied ex-vivo for mitochondrial metabolism, AMPK activity and signalling, the expression and activity of key enzymes of energy metabolism, cholesterol synthesis, and mRNA profiling. Severely compromised glucose-induced insulin secretion in HDR islets, as compared to ND and LDR islets, was associated with suppressed AMP-kinase activity. HDR islets also showed reduced acetyl-CoA carboxylase activity and enhanced activity of 3-hydroxy-3-methylglutaryl-CoA reductase, which led respectively to elevated fatty acid oxidation and increased cholesterol biosynthesis. HDR islets also displayed mitochondrial membrane hyperpolarization and reduced ATP turnover in the presence of elevated glucose. Expression of protein kinase Cε, which reduces both lipolysis and production of signals for insulin secretion, was elevated in DIO islets. Genes whose expression increased or decreased by more than 1.2-fold were minor between LDR and ND islets (17 differentially expressed), but were prominent between HDR and ND islets (1508 differentially expressed). In HDR islets, particularly affected genes were related to cell cycle and proliferation, AMPK signaling, mitochondrial metabolism and cholesterol metabolism. In conclusion, chronically reduced AMPK activity, mitochondrial dysfunction, elevated cholesterol biosynthesis in islets, and substantial alterations in gene expression accompany β-cell failure in HDR islets. The β-cell compensation process in the prediabetic state (LDR) is largely independent of transcriptional adaptive changes, whereas the transition to early diabetes (HDR) is associated with major alterations in gene expression. PMID:27043434

Commissioning of a 3D image‐based treatment planning system for high‐dose‐rate brachytherapy of cervical cancer

PubMed Central

Kim, Yongbok; Modrick, Joseph M.; Pennington, Edward C.

2016-01-01

The objective of this work is to present commissioning procedures to clinically implement a three‐dimensional (3D), image‐based, treatment‐planning system (TPS) for high‐dose‐rate (HDR) brachytherapy (BT) for gynecological (GYN) cancer. The physical dimensions of the GYN applicators and their values in the virtual applicator library were varied by 0.4 mm of their nominal values. Reconstruction uncertainties of the titanium tandem and ovoids (T&O) were less than 0.4 mm on CT phantom studies and on average between 0.8‐1.0 mm on MRI when compared with X‐rays. In‐house software, HDRCalculator, was developed to check HDR plan parameters such as independently verifying active tandem or cylinder probe length and ovoid or cylinder size, source calibration and treatment date, and differences between average Point A dose and prescription dose. Dose‐volume histograms were validated using another independent TPS. Comprehensive procedures to commission volume optimization algorithms and process in 3D image‐based planning were presented. For the difference between line and volume optimizations, the average absolute differences as a percentage were 1.4% for total reference air KERMA (TRAK) and 1.1% for Point A dose. Volume optimization consistency tests between versions resulted in average absolute differences in 0.2% for TRAK and 0.9 s (0.2%) for total treatment time. The data revealed that the optimizer should run for at least 1 min in order to avoid more than 0.6% dwell time changes. For clinical GYN T&O cases, three different volume optimization techniques (graphical optimization, pure inverse planning, and hybrid inverse optimization) were investigated by comparing them against a conventional Point A technique. End‐to‐end testing was performed using a T&O phantom to ensure no errors or inconsistencies occurred from imaging through to planning and delivery. The proposed commissioning procedures provide a clinically safe implementation technique for 3D image‐based TPS for HDR BT for GYN cancer. PACS number(s): 87.55.D‐ PMID:27074463

Genotoxic effects of high dose rate X-ray and low dose rate gamma radiation in ApcMin/+ mice.

PubMed

Graupner, Anne; Eide, Dag M; Brede, Dag A; Ellender, Michele; Lindbo Hansen, Elisabeth; Oughton, Deborah H; Bouffler, Simon D; Brunborg, Gunnar; Olsen, Ann Karin

2017-10-01

Risk estimates for radiation-induced cancer in humans are based on epidemiological data largely drawn from the Japanese atomic bomb survivor studies, which received an acute high dose rate (HDR) ionising radiation. Limited knowledge exists about the effects of chronic low dose rate (LDR) exposure, particularly with respect to the application of the dose and dose rate effectiveness factor. As part of a study to investigate the development of colon cancer following chronic LDR vs. acute HDR radiation, this study presents the results of genotoxic effects in blood of exposed mice. CBAB6 F1 Apc +/+ (wild type) and Apc Min/+ mice were chronically exposed to estimated whole body absorbed doses of 1.7 or 3.2 Gy 60 Co-γ-rays at a LDR (2.2 mGy h -1 ) or acutely exposed to 2.6 Gy HDR X-rays (1.3 Gy min -1 ). Genotoxic endpoints assessed in blood included chromosomal damage (flow cytometry based micronuclei (MN) assay), mutation analyses (Pig-a gene mutation assay), and levels of DNA lesions (Comet assay, single-strand breaks (ssb), alkali labile sites (als), oxidized DNA bases). Ionising radiation (ca. 3 Gy) induced genotoxic effects dependent on the dose rate. Chromosomal aberrations (MN assay) increased 3- and 10-fold after chronic LDR and acute HDR, respectively. Phenotypic mutation frequencies as well as DNA lesions (ssb/als) were modulated after acute HDR but not after chronic LDR. The Apc Min/+ genotype did not influence the outcome in any of the investigated endpoints. The results herein will add to the scant data available on genotoxic effects following chronic LDR of ionising radiation. Environ. Mol. Mutagen. 58:560-569, 2017. © 2017 The Authors Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society. © 2017 The Authors Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society.

Genotoxic effects of high dose rate X‐ray and low dose rate gamma radiation in ApcMin/+ mice

PubMed Central

Eide, Dag M.; Brede, Dag A.; Ellender, Michele; Lindbo Hansen, Elisabeth; Oughton, Deborah H.; Bouffler, Simon D.; Brunborg, Gunnar; Olsen, Ann Karin

2017-01-01

Risk estimates for radiation‐induced cancer in humans are based on epidemiological data largely drawn from the Japanese atomic bomb survivor studies, which received an acute high dose rate (HDR) ionising radiation. Limited knowledge exists about the effects of chronic low dose rate (LDR) exposure, particularly with respect to the application of the dose and dose rate effectiveness factor. As part of a study to investigate the development of colon cancer following chronic LDR vs. acute HDR radiation, this study presents the results of genotoxic effects in blood of exposed mice. CBAB6 F1 Apc+/+ (wild type) and ApcMin/+ mice were chronically exposed to estimated whole body absorbed doses of 1.7 or 3.2 Gy 60Co‐γ‐rays at a LDR (2.2 mGy h−1) or acutely exposed to 2.6 Gy HDR X‐rays (1.3 Gy min−1). Genotoxic endpoints assessed in blood included chromosomal damage (flow cytometry based micronuclei (MN) assay), mutation analyses (Pig‐a gene mutation assay), and levels of DNA lesions (Comet assay, single‐strand breaks (ssb), alkali labile sites (als), oxidized DNA bases). Ionising radiation (ca. 3 Gy) induced genotoxic effects dependent on the dose rate. Chromosomal aberrations (MN assay) increased 3‐ and 10‐fold after chronic LDR and acute HDR, respectively. Phenotypic mutation frequencies as well as DNA lesions (ssb/als) were modulated after acute HDR but not after chronic LDR. The ApcMin/+ genotype did not influence the outcome in any of the investigated endpoints. The results herein will add to the scant data available on genotoxic effects following chronic LDR of ionising radiation. Environ. Mol. Mutagen. 58:560–569, 2017. © 2017 The Authors Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society PMID:28856770

Spectral and temperature-dependent infrared emissivity measurements of painted metals for improved temperature estimation during laser damage testing

NASA Astrophysics Data System (ADS)

Baumann, Sean M.; Keenan, Cameron; Marciniak, Michael A.; Perram, Glen P.

2014-10-01

A database of spectral and temperature-dependent emissivities was created for painted Al-alloy laser-damage-testing targets for the purpose of improving the uncertainty to which temperature on the front and back target surfaces may be estimated during laser-damage testing. Previous temperature estimates had been made by fitting an assumed gray-body radiance curve to the calibrated spectral radiance data collected from the back surface using a Telops Imaging Fourier Transform Spectrometer (IFTS). In this work, temperature-dependent spectral emissivity measurements of the samples were made from room temperature to 500 °C using a Surface Optics Corp. SOC-100 Hemispherical Directional Reflectometer (HDR) with Nicolet FTS. Of particular interest was a high-temperature matte-black enamel paint used to coat the rear surfaces of the Al-alloy samples. The paint had been assumed to have a spectrally flat and temperatureinvariant emissivity. However, the data collected using the HDR showed both spectral variation and temperature dependence. The uncertainty in back-surface temperature estimation during laser-damage testing made using the measured emissivities was improved from greater than +10 °C to less than +5 °C for IFTS pixels away from the laser burn-through hole, where temperatures never exceeded those used in the SOC-100 HDR measurements. At beam center, where temperatures exceeded those used in the SOC-100 HDR, uncertainty in temperature estimates grew beyond those made assuming gray-body emissivity. Accurate temperature estimations during laser-damage testing are useful in informing a predictive model for future high-energy-laser weapon applications.

SU-G-TeP2-07: Dosimetric Characterization of a New HDR Multi-Channel Esophageal Applicator for Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhao, A; Gao, S; Greskovich, J

2016-06-15

Purpose: To characterize the dose distribution of a new multi-channel esophageal applicator for brachytherapy HDR treatment, and particularly the effect of the presence of air or water in the applicator’s expansion balloon. Methods: A new multi-channel (6) inflatable applicator for esophageal HDR has been developed in house and tested in a simple water phantom. CT image sets were obtained under several balloon expansions (80ml of air, 50 cc of water), and channel loadings and used with the Oncentra (Elekta) planning system based on TG43 formalism. 400 cGy was prescribed to a plane 1cm away from the applicator. Planar dose distributionsmore » were measured for that plane and one next to the applicator using Gafchromic EBT3 film and scanned by a Vidar VXR-12 film digitizer. Film and TPS generated dose distributions of film were sent to OmniPro I’mRT (iba DOSIMETRY) for analysis. 2D dose profiles in both X and Y directions were compared and gamma analysis performed. Results: Film dose measurement of the air-inflated applicator is lower than the TPS calculated dose by as much as 60%. Only 80.8% of the pixels passed the gamma criteria (3%/3mm). For the water-inflated applicator, the measured film dose is fairly close to the TPS calculated dose (typically within <3%). 99.84% of the pixels passed the gamma criteria (3%/3mm). Conclusion: TG43 based calculations worked well when water was used in the expansion balloon. However, when air is present in that balloon, the neglect of heterogeneity corrections in the TG43 calculation results in large differences between calculated and measured doses. This could result in severe underdosing when used in a patient. This study illustrates the need for a TPS with an advanced algorithm which can account for heterogeneity. Supported by Innovations Department, Cleveland Clinic.« less

Caffeine inhibits homology-directed repair of I-SceI-induced DNA double-strand breaks.

PubMed

Wang, Huichen; Boecker, Wilfried; Wang, Hongyan; Wang, Xiang; Guan, Jun; Thompson, Larry H; Nickoloff, Jac A; Iliakis, George

2004-01-22

We recently reported that two Chinese hamster mutants deficient in the RAD51 paralogs XRCC2 and XRCC3 show reduced radiosensitization after treatment with caffeine, thus implicating homology-directed repair (HDR) of DNA double-strand breaks (DSBs) in the mechanism of caffeine radiosensitization. Here, we investigate directly the effect of caffeine on HDR initiated by DSBs induced by a rare cutting endonuclease (I-SceI) into one of two direct DNA repeats. The results demonstrate a strong inhibition by caffeine of HDR in wild-type cells, and a substantial reduction of this effect in HDR-deficient XRCC3 mutant cells. Inhibition of HDR and cell radiosensitization to killing shows similar dependence on caffeine concentration suggesting a cause-effect relationship between these effects. UCN-01, a kinase inhibitor that effectively abrogates checkpoint activation in irradiated cells, has only a small effect on HDR, indicating that similar to radiosensitization, inhibition of checkpoint signaling is not sufficient for HDR inhibition. Recombination events occurring during treatment with caffeine are characterized by rearrangements reminiscent to those previously reported for the XRCC3 mutant, and immunofluorescence microscopy demonstrates significantly reduced formation of IR-specific RAD51 foci after caffeine treatment. In summary, our results identify inhibition of HDR as a significant contributor to caffeine radiosensitization.

ATM loss leads to synthetic lethality in BRCA1 BRCT mutant mice associated with exacerbated defects in homology-directed repair.

PubMed

Chen, Chun-Chin; Kass, Elizabeth M; Yen, Wei-Feng; Ludwig, Thomas; Moynahan, Mary Ellen; Chaudhuri, Jayanta; Jasin, Maria

2017-07-18

BRCA1 is essential for homology-directed repair (HDR) of DNA double-strand breaks in part through antagonism of the nonhomologous end-joining factor 53BP1. The ATM kinase is involved in various aspects of DNA damage signaling and repair, but how ATM participates in HDR and genetically interacts with BRCA1 in this process is unclear. To investigate this question, we used the Brca1 S1598F mouse model carrying a mutation in the BRCA1 C-terminal domain of BRCA1. Whereas ATM loss leads to a mild HDR defect in adult somatic cells, we find that ATM inhibition leads to severely reduced HDR in Brca1 S1598F cells. Consistent with a critical role for ATM in HDR in this background, loss of ATM leads to synthetic lethality of Brca1 S1598F mice. Whereas both ATM and BRCA1 promote end resection, which can be regulated by 53BP1, 53bp1 deletion does not rescue the HDR defects of Atm mutant cells, in contrast to Brca1 mutant cells. These results demonstrate that ATM has a role in HDR independent of the BRCA1-53BP1 antagonism and that its HDR function can become critical in certain contexts.

SU-F-T-32: Evaluation of the Performance of a Multiple-Array-Diode Detector for Quality Assurance Tests in High-Dose-Rate Brachytherapy with Ir-192 Source

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harpool, K; De La Fuente Herman, T; Ahmad, S

Purpose: To evaluate the performance of a two-dimensional (2D) array-diode- detector for geometric and dosimetric quality assurance (QA) tests of high-dose-rate (HDR) brachytherapy with an Ir-192-source. Methods: A phantom setup was designed that encapsulated a two-dimensional (2D) array-diode-detector (MapCheck2) and a catheter for the HDR brachytherapy Ir-192 source. This setup was used to perform both geometric and dosimetric quality assurance for the HDR-Ir192 source. The geometric tests included: (a) measurement of the position of the source and (b) spacing between different dwell positions. The dosimteric tests include: (a) linearity of output with time, (b) end effect and (c) relative dosemore » verification. The 2D-dose distribution measured with MapCheck2 was used to perform the previous tests. The results of MapCheck2 were compared with the corresponding quality assurance testes performed with Gafchromic-film and well-ionization-chamber. Results: The position of the source and the spacing between different dwell-positions were reproducible within 1 mm accuracy by measuring the position of maximal dose using MapCheck2 in contrast to the film which showed a blurred image of the dwell positions due to limited film sensitivity to irradiation. The linearity of the dose with dwell times measured from MapCheck2 was superior to the linearity measured with ionization chamber due to higher signal-to-noise ratio of the diode readings. MapCheck2 provided more accurate measurement of the end effect with uncertainty < 1.5% in comparison with the ionization chamber uncertainty of 3%. Although MapCheck2 did not provide absolute calibration dosimeter for the activity of the source, it provided accurate tool for relative dose verification in HDR-brachytherapy. Conclusion: The 2D-array-diode-detector provides a practical, compact and accurate tool to perform quality assurance for HDR-brachytherapy with an Ir-192 source. The diodes in MapCheck2 have high radiation sensitivity and linearity that is superior to Gafchromic-films and ionization chamber used for geometric and dosimetric QA in HDR-brachytherapy, respectively.« less

Automated high-dose rate brachytherapy treatment planning for a single-channel vaginal cylinder applicator

NASA Astrophysics Data System (ADS)

Zhou, Yuhong; Klages, Peter; Tan, Jun; Chi, Yujie; Stojadinovic, Strahinja; Yang, Ming; Hrycushko, Brian; Medin, Paul; Pompos, Arnold; Jiang, Steve; Albuquerque, Kevin; Jia, Xun

2017-06-01

High dose rate (HDR) brachytherapy treatment planning is conventionally performed manually and/or with aids of preplanned templates. In general, the standard of care would be elevated by conducting an automated process to improve treatment planning efficiency, eliminate human error, and reduce plan quality variations. Thus, our group is developing AutoBrachy, an automated HDR brachytherapy planning suite of modules used to augment a clinical treatment planning system. This paper describes our proof-of-concept module for vaginal cylinder HDR planning that has been fully developed. After a patient CT scan is acquired, the cylinder applicator is automatically segmented using image-processing techniques. The target CTV is generated based on physician-specified treatment depth and length. Locations of the dose calculation point, apex point and vaginal surface point, as well as the central applicator channel coordinates, and the corresponding dwell positions are determined according to their geometric relationship with the applicator and written to a structure file. Dwell times are computed through iterative quadratic optimization techniques. The planning information is then transferred to the treatment planning system through a DICOM-RT interface. The entire process was tested for nine patients. The AutoBrachy cylindrical applicator module was able to generate treatment plans for these cases with clinical grade quality. Computation times varied between 1 and 3 min on an Intel Xeon CPU E3-1226 v3 processor. All geometric components in the automated treatment plans were generated accurately. The applicator channel tip positions agreed with the manually identified positions with submillimeter deviations and the channel orientations between the plans agreed within less than 1 degree. The automatically generated plans obtained clinically acceptable quality.

Towards high dynamic range extensions of HEVC: subjective evaluation of potential coding technologies

NASA Astrophysics Data System (ADS)

Hanhart, Philippe; Řeřábek, Martin; Ebrahimi, Touradj

2015-09-01

This paper reports the details and results of the subjective evaluations conducted at EPFL to evaluate the responses to the Call for Evidence (CfE) for High Dynamic Range (HDR) and Wide Color Gamut (WCG) Video Coding issued by Moving Picture Experts Group (MPEG). The CfE on HDR/WCG Video Coding aims to explore whether the coding efficiency and/or the functionality of the current version of HEVC standard can be signi_cantly improved for HDR and WCG content. In total, nine submissions, five for Category 1 and four for Category 3a, were compared to the HEVC Main 10 Profile based Anchor. More particularly, five HDR video contents, compressed at four bit rates by each proponent responding to the CfE, were used in the subjective evaluations. Further, the side-by-side presentation methodology was used for the subjective experiment to discriminate small differences between the Anchor and proponents. Subjective results shows that the proposals provide evidence that the coding efficiency can be improved in a statistically noticeable way over MPEG CfE Anchors in terms of perceived quality within the investigated content. The paper further benchmarks the selected objective metrics based on their correlations with the subjective ratings. It is shown that PSNR-DE1000, HDRVDP- 2, and PSNR-Lx can reliably detect visible differences between the proposed encoding solutions and current HEVC standard.

Interactive multiobjective optimization for anatomy-based three-dimensional HDR brachytherapy

NASA Astrophysics Data System (ADS)

Ruotsalainen, Henri; Miettinen, Kaisa; Palmgren, Jan-Erik; Lahtinen, Tapani

2010-08-01

In this paper, we present an anatomy-based three-dimensional dose optimization approach for HDR brachytherapy using interactive multiobjective optimization (IMOO). In brachytherapy, the goals are to irradiate a tumor without causing damage to healthy tissue. These goals are often conflicting, i.e. when one target is optimized the other will suffer, and the solution is a compromise between them. IMOO is capable of handling multiple and strongly conflicting objectives in a convenient way. With the IMOO approach, a treatment planner's knowledge is used to direct the optimization process. Thus, the weaknesses of widely used optimization techniques (e.g. defining weights, computational burden and trial-and-error planning) can be avoided, planning times can be shortened and the number of solutions to be calculated is small. Further, plan quality can be improved by finding advantageous trade-offs between the solutions. In addition, our approach offers an easy way to navigate among the obtained Pareto optimal solutions (i.e. different treatment plans). When considering a simulation model of clinical 3D HDR brachytherapy, the number of variables is significantly smaller compared to IMRT, for example. Thus, when solving the model, the CPU time is relatively short. This makes it possible to exploit IMOO to solve a 3D HDR brachytherapy optimization problem. To demonstrate the advantages of IMOO, two clinical examples of optimizing a gynecologic cervix cancer treatment plan are presented.

A fast inverse treatment planning strategy facilitating optimized catheter selection in image-guided high-dose-rate interstitial gynecologic brachytherapy.

PubMed

Guthier, Christian V; Damato, Antonio L; Hesser, Juergen W; Viswanathan, Akila N; Cormack, Robert A

2017-12-01

Interstitial high-dose rate (HDR) brachytherapy is an important therapeutic strategy for the treatment of locally advanced gynecologic (GYN) cancers. The outcome of this therapy is determined by the quality of dose distribution achieved. This paper focuses on a novel yet simple heuristic for catheter selection for GYN HDR brachytherapy and their comparison against state of the art optimization strategies. The proposed technique is intended to act as a decision-supporting tool to select a favorable needle configuration. The presented heuristic for catheter optimization is based on a shrinkage-type algorithm (SACO). It is compared against state of the art planning in a retrospective study of 20 patients who previously received image-guided interstitial HDR brachytherapy using a Syed Neblett template. From those plans, template orientation and position are estimated via a rigid registration of the template with the actual catheter trajectories. All potential straight trajectories intersecting the contoured clinical target volume (CTV) are considered for catheter optimization. Retrospectively generated plans and clinical plans are compared with respect to dosimetric performance and optimization time. All plans were generated with one single run of the optimizer lasting 0.6-97.4 s. Compared to manual optimization, SACO yields a statistically significant (P ≤ 0.05) improved target coverage while at the same time fulfilling all dosimetric constraints for organs at risk (OARs). Comparing inverse planning strategies, dosimetric evaluation for SACO and "hybrid inverse planning and optimization" (HIPO), as gold standard, shows no statistically significant difference (P > 0.05). However, SACO provides the potential to reduce the number of used catheters without compromising plan quality. The proposed heuristic for needle selection provides fast catheter selection with optimization times suited for intraoperative treatment planning. Compared to manual optimization, the proposed methodology results in fewer catheters without a clinically significant loss in plan quality. The proposed approach can be used as a decision support tool that guides the user to find the ideal number and configuration of catheters. © 2017 American Association of Physicists in Medicine.

Artifacts in slab average-intensity-projection images reformatted from JPEG 2000 compressed thin-section abdominal CT data sets.

PubMed

Kim, Bohyoung; Lee, Kyoung Ho; Kim, Kil Joong; Mantiuk, Rafal; Kim, Hye-ri; Kim, Young Hoon

2008-06-01

The objective of our study was to assess the effects of compressing source thin-section abdominal CT images on final transverse average-intensity-projection (AIP) images. At reversible, 4:1, 6:1, 8:1, 10:1, and 15:1 Joint Photographic Experts Group (JPEG) 2000 compressions, we compared the artifacts in 20 matching compressed thin sections (0.67 mm), compressed thick sections (5 mm), and AIP images (5 mm) reformatted from the compressed thin sections. The artifacts were quantitatively measured with peak signal-to-noise ratio (PSNR) and a perceptual quality metric (High Dynamic Range Visual Difference Predictor [HDR-VDP]). By comparing the compressed and original images, three radiologists independently graded the artifacts as 0 (none, indistinguishable), 1 (barely perceptible), 2 (subtle), or 3 (significant). Friedman tests and exact tests for paired proportions were used. At irreversible compressions, the artifacts tended to increase in the order of AIP, thick-section, and thin-section images in terms of PSNR (p < 0.0001), HDR-VDP (p < 0.0001), and the readers' grading (p < 0.01 at 6:1 or higher compressions). At 6:1 and 8:1, distinguishable pairs (grades 1-3) tended to increase in the order of AIP, thick-section, and thin-section images. Visually lossless threshold for the compression varied between images but decreased in the order of AIP, thick-section, and thin-section images (p < 0.0001). Compression artifacts in thin sections are significantly attenuated in AIP images. On the premise that thin sections are typically reviewed using an AIP technique, it is justifiable to compress them to a compression level currently accepted for thick sections.

WE-A-17A-06: Evaluation of An Automatic Interstitial Catheter Digitization Algorithm That Reduces Treatment Planning Time and Provide Means for Adaptive Re-Planning in HDR Brachytherapy of Gynecologic Cancers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dise, J; Liang, X; Lin, L

Purpose: To evaluate an automatic interstitial catheter digitization algorithm that reduces treatment planning time and provide means for adaptive re-planning in HDR Brachytherapy of Gynecologic Cancers. Methods: The semi-automatic catheter digitization tool utilizes a region growing algorithm in conjunction with a spline model of the catheters. The CT images were first pre-processed to enhance the contrast between the catheters and soft tissue. Several seed locations were selected in each catheter for the region growing algorithm. The spline model of the catheters assisted in the region growing by preventing inter-catheter cross-over caused by air or metal artifacts. Source dwell positions frommore » day one CT scans were applied to subsequent CTs and forward calculated using the automatically digitized catheter positions. This method was applied to 10 patients who had received HDR interstitial brachytherapy on an IRB approved image-guided radiation therapy protocol. The prescribed dose was 18.75 or 20 Gy delivered in 5 fractions, twice daily, over 3 consecutive days. Dosimetric comparisons were made between automatic and manual digitization on day two CTs. Results: The region growing algorithm, assisted by the spline model of the catheters, was able to digitize all catheters. The difference between automatic and manually digitized positions was 0.8±0.3 mm. The digitization time ranged from 34 minutes to 43 minutes with a mean digitization time of 37 minutes. The bulk of the time was spent on manual selection of initial seed positions and spline parameter adjustments. There was no significance difference in dosimetric parameters between the automatic and manually digitized plans. D90% to the CTV was 91.5±4.4% for the manual digitization versus 91.4±4.4% for the automatic digitization (p=0.56). Conclusion: A region growing algorithm was developed to semi-automatically digitize interstitial catheters in HDR brachytherapy using the Syed-Neblett template. This automatic digitization tool was shown to be accurate compared to manual digitization.« less

Inorganic scintillation detectors based on Eu-activated phosphors for 192Ir brachytherapy

PubMed Central

Kertzscher, Gustavo; Beddar, Sam

2017-01-01

The availability of real-time treatment verification during high-dose-rate (HDR) brachytherapy is currently limited. Therefore, we studied the luminescence properties of the widely commercially available scintillators using the inorganic materials Eu-activated phosphors Y2O3:Eu, YVO4:Eu, Y2O2S:Eu, and Gd2O2S:Eu to determine whether they could be used to accurately and precisely verify HDR brachytherapy doses in real time. The suitability for HDR brachytherapy of inorganic scintillation detectors (ISDs) based on the 4 Eu-activated phosphors in powder form was determined based on experiments with a 192Ir HDR brachytherapy source. The scintillation intensities of the phosphors were 16 to 134 times greater than that of the commonly used organic plastic scintillator BCF-12. High signal intensities were achieved with an optimized packing density of the phosphor mixture and with a shortened fiber-optic cable. The influence of contaminating Cerenkov and fluorescence light induced in the fiber-optic cable (stem signal) was adequately suppressed by inserting between the fiber-optic cable and the photodetector a 25-nm band-pass filter centered at the emission peak. The spurious photoluminescence signal induced by the stem signal was suppressed by placing a long-pass filter between the scintillation detector volume and the fiber-optic cable. The time-dependent luminescence properties of the phosphors were quantified by measuring the non-constant scintillation during irradiation and the afterglow after the brachytherapy source had retracted. We demonstrated that a mixture of Y2O3:Eu and YVO4:Eu suppressed the time-dependence of the ISDs and that the time-dependence of Y2O2S:Eu and Gd2O2S:Eu introduced large measurement inaccuracies. We conclude that ISDs based on a mixture of Y2O3:Eu and YVO4:Eu are promising candidates for accurate and precise real-time verification technology for HDR BT that is cost effective and straightforward to manufacture. Widespread dissemination of this technology could lead to an improved understanding of error types and frequencies during BT and to improved patient safety during treatment. PMID:28475494

Inorganic scintillation detectors based on Eu-activated phosphors for 192Ir brachytherapy

NASA Astrophysics Data System (ADS)

Kertzscher, Gustavo; Beddar, Sam

2017-06-01

The availability of real-time treatment verification during high-dose-rate (HDR) brachytherapy is currently limited. Therefore, we studied the luminescence properties of the widely commercially available scintillators using the inorganic materials Eu-activated phosphors Y2O3:Eu, YVO4:Eu, Y2O2S:Eu, and Gd2O2S:Eu to determine whether they could be used to accurately and precisely verify HDR brachytherapy doses in real time. The suitability for HDR brachytherapy of inorganic scintillation detectors (ISDs) based on the 4 Eu-activated phosphors in powder form was determined based on experiments with a 192Ir HDR brachytherapy source. The scintillation intensities of the phosphors were 16-134 times greater than that of the commonly used organic plastic scintillator BCF-12. High signal intensities were achieved with an optimized packing density of the phosphor mixture and with a shortened fiber-optic cable. The influence of contaminating Cerenkov and fluorescence light induced in the fiber-optic cable (stem signal) was adequately suppressed by inserting between the fiber-optic cable and the photodetector a 25 nm band-pass filter centered at the emission peak. The spurious photoluminescence signal induced by the stem signal was suppressed by placing a long-pass filter between the scintillation detector volume and the fiber-optic cable. The time-dependent luminescence properties of the phosphors were quantified by measuring the non-constant scintillation during irradiation and the afterglow after the brachytherapy source had retracted. We demonstrated that a mixture of Y2O3:Eu and YVO4:Eu suppressed the time-dependence of the ISDs and that the time-dependence of Y2O2S:Eu and Gd2O2S:Eu introduced large measurement inaccuracies. We conclude that ISDs based on a mixture of Y2O3:Eu and YVO4:Eu are promising candidates for accurate and precise real-time verification technology for HDR BT that is cost effective and straightforward to manufacture. Widespread dissemination of this technology could lead to an improved understanding of error types and frequencies during BT and to improved patient safety during treatment.

Gene conversion is strongly induced in human cells by double-strand breaks and is modulated by the expression of BCL-x(L)

NASA Technical Reports Server (NTRS)

Wiese, Claudia; Pierce, Andrew J.; Gauny, Stacey S.; Jasin, Maria; Kronenberg, Amy; Chatterjee, A. (Principal Investigator)

2002-01-01

Homology-directed repair (HDR) of DNA double-strand breaks (DSBs) contributes to the maintenance of genomic stability in rodent cells, and it has been assumed that HDR is of similar importance in DSB repair in human cells. However, some outcomes of homologous recombination can be deleterious, suggesting that factors exist to regulate HDR. We demonstrated previously that overexpression of BCL-2 or BCL-x(L) enhanced the frequency of X-ray-induced TK1 mutations, including loss of heterozygosity events presumed to arise by mitotic recombination. The present study was designed to test whether HDR is a prominent DSB repair pathway in human cells and to determine whether ectopic expression of BCL-x(L) affects HDR. Using TK6-neo cells, we find that a single DSB in an integrated HDR reporter stimulates gene conversion 40-50-fold, demonstrating efficient DSB repair by gene conversion in human cells. Significantly, DSB-induced gene conversion events are 3-4-fold more frequent in TK6 cells that stably overexpress the antiapoptotic protein BCL-X(L). Thus, HDR plays an important role in maintaining genomic integrity in human cells, and ectopic expression of BCL-x(L) enhances HDR of DSBs. This is the first study to highlight a function for BCL-x(L) in modulating DSB repair in human cells.

ATM loss leads to synthetic lethality in BRCA1 BRCT mutant mice associated with exacerbated defects in homology-directed repair

PubMed Central

Chen, Chun-Chin; Kass, Elizabeth M.; Yen, Wei-Feng; Ludwig, Thomas; Moynahan, Mary Ellen; Chaudhuri, Jayanta; Jasin, Maria

2017-01-01

BRCA1 is essential for homology-directed repair (HDR) of DNA double-strand breaks in part through antagonism of the nonhomologous end-joining factor 53BP1. The ATM kinase is involved in various aspects of DNA damage signaling and repair, but how ATM participates in HDR and genetically interacts with BRCA1 in this process is unclear. To investigate this question, we used the Brca1S1598F mouse model carrying a mutation in the BRCA1 C-terminal domain of BRCA1. Whereas ATM loss leads to a mild HDR defect in adult somatic cells, we find that ATM inhibition leads to severely reduced HDR in Brca1S1598F cells. Consistent with a critical role for ATM in HDR in this background, loss of ATM leads to synthetic lethality of Brca1S1598F mice. Whereas both ATM and BRCA1 promote end resection, which can be regulated by 53BP1, 53bp1 deletion does not rescue the HDR defects of Atm mutant cells, in contrast to Brca1 mutant cells. These results demonstrate that ATM has a role in HDR independent of the BRCA1–53BP1 antagonism and that its HDR function can become critical in certain contexts. PMID:28659469

Adherence to Vaginal Dilation Following High Dose Rate Brachytherapy for Endometrial Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Friedman, Lois C., E-mail: Lois.Friedman@UHhospitals.org; Abdallah, Rita; Schluchter, Mark

Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer. Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs. Results: Seventy-eight ofmore » 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy. Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study.« less

Toward a 3D transrectal ultrasound system for verification of needle placement during high-dose-rate interstitial gynecologic brachytherapy.

PubMed

Rodgers, Jessica Robin; Surry, Kathleen; Leung, Eric; D'Souza, David; Fenster, Aaron

2017-05-01

Treatment for gynecologic cancers, such as cervical, recurrent endometrial, and vaginal malignancies, commonly includes external-beam radiation and brachytherapy. In high-dose-rate (HDR) interstitial gynecologic brachytherapy, radiation treatment is delivered via hollow needles that are typically inserted through a template on the perineum with a cylinder placed in the vagina for stability. Despite the need for precise needle placement to minimize complications and provide optimal treatment, there is no standard intra-operative image-guidance for this procedure. While some image-guidance techniques have been proposed, including magnetic resonance (MR) imaging, X-ray computed tomography (CT), and two-dimensional (2D) transrectal ultrasound (TRUS), these techniques have not been widely adopted. In order to provide intra-operative needle visualization and localization during interstitial brachytherapy, we have developed a three-dimensional (3D) TRUS system. This study describes the 3D TRUS system and reports on the system validation and results from a proof-of-concept patient study. To obtain a 3D TRUS image, the system rotates a conventional 2D endocavity transducer through 170 degrees in 12 s, reconstructing the 2D frames into a 3D image in real-time. The geometry of the reconstruction was validated using two geometric phantoms to ensure the accuracy of the linear measurements in each of the image coordinate directions and the volumetric accuracy of the system. An agar phantom including vaginal and rectal canals, as well as a model uterus and tumor, was designed and used to test the visualization and localization of the interstitial needles under idealized conditions by comparing the needles' positions between the 3D TRUS scan and a registered MR image. Five patients undergoing HDR interstitial gynecologic brachytherapy were imaged using the 3D TRUS system following the insertion of all needles. This image was manually, rigidly registered to the clinical postinsertion CT scan based on the vaginal cylinder of the needle template. The positions of the tips and the trajectory of the needle paths were compared between the modalities. The observed geometric errors of the system were ≤ 0.3 mm in each of the three coordinate planes of the 3D US image and the mean measured volumetric error was 0.10 cm 3 . In the phantom study, the mean needle tip difference was 1.54 ± 0.71 mm and the mean trajectory difference was 0.94 ± 0.89 degrees (n = 14). In the in vivo study, a total of 73 needles were placed, of which 88% of needles were visible and 79% of tips were identifiable in the 3D TRUS images. Six of the nine needles that were not visible were due to shadowing artifacts created by the presence of the vaginal cylinder of the needle template. The mean distance between corresponding needle tips in the two modalities was 3.82 ± 1.86 mm and the mean trajectory difference was 3.04 ± 1.63 degrees for the five patients. In this proof-of-concept study, the 3D TRUS system allowed for localization of needles not obscured by shadowing artifacts, providing a method for visualizing needles intra-operatively during HDR interstitial brachytherapy of gynecologic cancers and providing the potential for 3D image-guidance. © 2017 American Association of Physicists in Medicine.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Folkert, Michael R.; Tong, William Y.; LaQuaglia, Michael P.

Purpose: To assess outcomes and toxicity of high-dose-rate intraoperative radiation therapy (HDR-IORT) in the management of pediatric sarcoma. Methods and Materials: Seventy-five pediatric patients underwent HDR-IORT for sarcoma from May 1993 to November 2013. The median age was 9 years old (36 patients were ≤6 years old). HDR-IORT was part of initial therapy in 37 patients (49%) and for recurrent disease in 38 patients (51%). Forty-one patients (55%) received HDR-IORT and postoperative external beam RT (PORT), and 22 patients (29%) were previously treated with external beam radiation therapy to the IORT site. Local control (LC), overall survival (OS) and event-free survival (EFS)more » were estimated using Kaplan-Meier methods. Results: At a median follow-up of 7.8 years for surviving patients, 5-year projected rates of LC, EFS, and OS were 63% (95% confidence interval [CI] 50%-76%), 33% (95% CI 21%-45%), and 43% (95% CI 30%-55%), with a median survival of 3.1 years. The 5-year LC, EFS, and OS rates for patients with recurrent disease were 46% (95% CI, 28%-64%), 30% (95% CI, 13%-46%), and 36% (95% CI, 18%-54%). Acute toxicity ≥grade 3 occurred in 2 (2.5%) treatments; late toxicity ≥grade 3 occurred in 4 (5.3%) patients 0.3-9.9 years after HDR-IORT. The incidence of toxicity ≥grade 3 was not associated with HDR-IORT applicator size, HDR-IORT dose, prior RT or PORT, or prior or postoperative chemotherapy, but all toxicity ≥grade 3 occurred in patients ≤6 years treated with HDR-IORT doses ≥12 Gy. Conclusions: HDR-IORT is a well-tolerated component of multimodality therapy for pediatric sarcoma, allowing additional local treatment while reducing external beam exposure. Taking clinical considerations into account, doses between 8-12 Gy are appropriate for HDR-IORT in patients ≤6 years of age.« less

Comparative dosimetric and radiobiological assessment among a nonstandard RapidArc, standard RapidArc, classical intensity-modulated radiotherapy, and 3D brachytherapy for the treatment of the vaginal vault in patients affected by gynecologic cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pedicini, Piernicola, E-mail: ppiern@libero.it; Caivano, Rocchina; Fiorentino, Alba

2012-01-01

To evaluate a nonstandard RapidArc (RA) modality as alternative to high-dose-rate brachytherapy (HDR-BRT) or IMRT treatments of the vaginal vault in patients with gynecological cancer (GC). Nonstandard (with vaginal applicator) and standard (without vaginal applicator) RapidArc plans for 27 women with GC were developed to compare with HDR-BRT and IMRT. Dosimetric and radiobiological comparison were performed by means of dose-volume histogram and equivalent uniform dose (EUD) for planning target volume (PTV) and organs at risk (OARs). In addition, the integral dose and the overall treatment times were evaluated. RA, as well as IMRT, results in a high uniform dose onmore » PTV compared with HDR-BRT. However, the average of EUD for HDR-BRT was significantly higher than those with RA and IMRT. With respect to the OARs, standard RA was equivalent of IMRT but inferior to HDR-BRT. Furthermore, nonstandard RA was comparable with IMRT for bladder and sigmoid and better than HDR-BRT for the rectum because of a significant reduction of d{sub 2cc}, d{sub 1cc}, and d{sub max} (p < 0.01). Integral doses were always higher than HDR-BRT, although the values were very low. Delivery times were about the same and more than double for HDR-BRT compared with IMRT and RA, respectively. In conclusion, the boost of dose on vaginal vault in patients affected by GC delivered by a nonstandard RA technique was a reasonable alternative to the conventional HDR-BRT because of a reduction of delivery time and rectal dose at substantial comparable doses for the bladder and sigmoid. However HDR-BRT provides better performance in terms of PTV coverage as evidenced by a greater EUD.« less

Functional evidence for the critical amino-terminal conserved domain and key amino acids of Arabidopsis 4-HYDROXY-3-METHYLBUT-2-ENYL DIPHOSPHATE REDUCTASE.

PubMed

Hsieh, Wei-Yu; Sung, Tzu-Ying; Wang, Hsin-Tzu; Hsieh, Ming-Hsiun

2014-09-01

The plant 4-HYDROXY-3-METHYLBUT-2-ENYL DIPHOSPHATE REDUCTASE (HDR) catalyzes the last step of the methylerythritol phosphate pathway to synthesize isopentenyl diphosphate and its allyl isomer dimethylallyl diphosphate, which are common precursors for the synthesis of plastid isoprenoids. The Arabidopsis (Arabidopsis thaliana) genomic HDR transgene-induced gene-silencing lines are albino, variegated, or pale green, confirming that HDR is essential for plants. We used Escherichia coli isoprenoid synthesis H (Protein Data Bank code 3F7T) as a template for homology modeling to identify key amino acids of Arabidopsis HDR. The predicted model reveals that cysteine (Cys)-122, Cys-213, and Cys-350 are involved in iron-sulfur cluster formation and that histidine (His)-152, His-241, glutamate (Glu)-242, Glu-243, threonine (Thr)-244, Thr-312, serine-379, and asparagine-381 are related to substrate binding or catalysis. Glu-242 and Thr-244 are conserved only in cyanobacteria, green algae, and land plants, whereas the other key amino acids are absolutely conserved from bacteria to plants. We used site-directed mutagenesis and complementation assay to confirm that these amino acids, except His-152 and His-241, were critical for Arabidopsis HDR function. Furthermore, the Arabidopsis HDR contains an extra amino-terminal domain following the transit peptide that is highly conserved from cyanobacteria, and green algae to land plants but not existing in the other bacteria. We demonstrated that the amino-terminal conserved domain was essential for Arabidopsis and cyanobacterial HDR function. Further analysis of conserved amino acids in the amino-terminal conserved domain revealed that the tyrosine-72 residue was critical for Arabidopsis HDR. These results suggest that the structure and reaction mechanism of HDR evolution have become specific for oxygen-evolving photosynthesis organisms and that HDR probably evolved independently in cyanobacteria versus other prokaryotes. © 2014 American Society of Plant Biologists. All Rights Reserved.

SU-F-BRF-09: A Non-Rigid Point Matching Method for Accurate Bladder Dose Summation in Cervical Cancer HDR Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, H; Zhen, X; Zhou, L

2014-06-15

Purpose: To propose and validate a deformable point matching scheme for surface deformation to facilitate accurate bladder dose summation for fractionated HDR cervical cancer treatment. Method: A deformable point matching scheme based on the thin plate spline robust point matching (TPSRPM) algorithm is proposed for bladder surface registration. The surface of bladders segmented from fractional CT images is extracted and discretized with triangular surface mesh. Deformation between the two bladder surfaces are obtained by matching the two meshes' vertices via the TPS-RPM algorithm, and the deformation vector fields (DVFs) characteristic of this deformation is estimated by B-spline approximation. Numerically, themore » algorithm is quantitatively compared with the Demons algorithm using five clinical cervical cancer cases by several metrics: vertex-to-vertex distance (VVD), Hausdorff distance (HD), percent error (PE), and conformity index (CI). Experimentally, the algorithm is validated on a balloon phantom with 12 surface fiducial markers. The balloon is inflated with different amount of water, and the displacement of fiducial markers is benchmarked as ground truth to study TPS-RPM calculated DVFs' accuracy. Results: In numerical evaluation, the mean VVD is 3.7(±2.0) mm after Demons, and 1.3(±0.9) mm after TPS-RPM. The mean HD is 14.4 mm after Demons, and 5.3mm after TPS-RPM. The mean PE is 101.7% after Demons and decreases to 18.7% after TPS-RPM. The mean CI is 0.63 after Demons, and increases to 0.90 after TPS-RPM. In the phantom study, the mean Euclidean distance of the fiducials is 7.4±3.0mm and 4.2±1.8mm after Demons and TPS-RPM, respectively. Conclusions: The bladder wall deformation is more accurate using the feature-based TPS-RPM algorithm than the intensity-based Demons algorithm, indicating that TPS-RPM has the potential for accurate bladder dose deformation and dose summation for multi-fractional cervical HDR brachytherapy. This work is supported in part by the National Natural ScienceFoundation of China (no 30970866 and no 81301940)« less

Commissioning of a well type chamber for HDR and LDR brachytherapy applications: a review of methodology and outcomes.

PubMed

Mukwada, Godfrey; Neveri, Gabor; Alkhatib, Zaid; Waterhouse, David K; Ebert, Martin

2016-03-01

For safe and accurate dose delivery in brachytherapy, associated equipment is subject to commissioning and ongoing quality assurance (QA). Many centres depend on the use of a well-type chamber ('well chamber') for performing brachytherapy dosimetry. Documentation of well chamber commissioning is scarce despite the important role the chamber plays in the whole brachytherapy QA process. An extensive and structured commissioning of the HDR 1000 plus well chamber (Standard Imaging Inc, Middleton WI) for HDR and LDR dosimetry was undertaken at Sir Charles Gairdner Hospital. The methodology and outcomes of this commissioning is documented and presented as a guideline to others involved in brachytherapy. The commissioning tests described include mechanical integrity, leakage current, directional dependence, response, length of uniform response, the influence of insert holders, ion collection efficiency, polarity effect, accuracy of measured air kerma strength (S(K)) or reference air kerma rate (K(R)) and baseline setting (for ongoing constancy checks). For the HDR 1000 plus well chamber, some of the insert holders modify the response curve. The measured sweet length was 2.5 cm which is within 0.5% of that specified by the manufacturer. Correction for polarity was negligible (0.9999) and ion recombination was small (0.9994). Directional dependence was small (less than 0.2%) and leakage current was negligible. The measured K(R) for (192)Ir agreed within 0.11% compared with a second well chamber of similar model and was within 0.5% of that determined via a free-in-air measurement method. Routine constancy checks over a year agreed with the baseline within 0.4%.

TU-AB-201-02: An Automated Treatment Plan Quality Assurance Program for Tandem and Ovoid High Dose-Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tan, J; Shi, F; Hrycushko, B

2015-06-15

Purpose: For tandem and ovoid (T&O) HDR brachytherapy in our clinic, it is required that the planning physicist manually capture ∼10 images during planning, perform a secondary dose calculation and generate a report, combine them into a single PDF document, and upload it to a record- and-verify system to prove to an independent plan checker that the case was planned correctly. Not only does this slow down the already time-consuming clinical workflow, the PDF document also limits the number of parameters that can be checked. To solve these problems, we have developed a web-based automatic quality assurance (QA) program. Methods:more » We set up a QA server accessible through a web- interface. A T&O plan and CT images are exported as DICOMRT files and uploaded to the server. The software checks 13 geometric features, e.g. if the dwell positions are reasonable, and 10 dosimetric features, e.g. secondary dose calculations via TG43 formalism and D2cc to critical structures. A PDF report is automatically generated with errors and potential issues highlighted. It also contains images showing important geometric and dosimetric aspects to prove the plan was created following standard guidelines. Results: The program has been clinically implemented in our clinic. In each of the 58 T&O plans we tested, a 14- page QA report was automatically generated. It took ∼45 sec to export the plan and CT images and ∼30 sec to perform the QA tests and generate the report. In contrast, our manual QA document preparation tooks on average ∼7 minutes under optimal conditions and up to 20 minutes when mistakes were made during the document assembly. Conclusion: We have tested the efficiency and effectiveness of an automated process for treatment plan QA of HDR T&O cases. This software was shown to improve the workflow compared to our conventional manual approach.« less

SU-F-T-29: The Important of Each Fraction Image-Guided Planning for Postoperative HDR-Brachytherapy in Endometrial Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piriyasang, D; Pattaranutaporn, P; Manokhoon, K

2016-06-15

Purpose: Cylindrical applicators are often used for postoperative HDRbrachytherapy in endometrial carcinoma. It has been considered that dosimetric variation between fractions for this treatment is minimal and might not be necessary to perform treatment planning for every fractions. At our institute, it is traditional to perform treatment planning with CT simulation on the first fraction and uses this plan for the rest of treatment. This study was aim to evaluate the errors of critical structure doses between the fractions when simulation and planning were done for first fraction only. Methods: Treatment plans of 10 endometrial carcinoma patients who received postoperativemore » HDR-brachytherapy and underwent CT-simulation for every HDR-fractions at our department were retrospectively reviewed. All of these patients were treated with cylindrical applicator and prescribed dose 15Gy in 3 fractions to 0.5cm from vaginal surface. The treatment plan from the first fraction was used to simulate in second and third CT-simulation. Radiation dose for critical structures in term of Dose-to-2cc (D2cc) were evaluated and compared between planning CT. Results: The D2cc for bladder and rectum were evaluated. For bladder, the mean error of D2cc estimation for second and third fractions was 7.6% (0.1–20.1%, SD=5.7). And the mean error for D2cc of rectum was 8.5% (0.1–29.4%, SD=8.5). Conclusion: The critical structure doses could be significant difference between fractions which may affects treatment outcomes or toxicities. From our data, image-guided brachytherapy at least with CT-Simulation should be done for every treatment fractions.« less

Scalable and Versatile Genome Editing Using Linear DNAs with Microhomology to Cas9 Sites in Caenorhabditis elegans

PubMed Central

Paix, Alexandre; Wang, Yuemeng; Smith, Harold E.; Lee, Chih-Yung S.; Calidas, Deepika; Lu, Tu; Smith, Jarrett; Schmidt, Helen; Krause, Michael W.; Seydoux, Geraldine

2014-01-01

Homology-directed repair (HDR) of double-strand DNA breaks is a promising method for genome editing, but is thought to be less efficient than error-prone nonhomologous end joining in most cell types. We have investigated HDR of double-strand breaks induced by CRISPR-associated protein 9 (Cas9) in Caenorhabditis elegans. We find that HDR is very robust in the C. elegans germline. Linear repair templates with short (∼30–60 bases) homology arms support the integration of base and gene-sized edits with high efficiency, bypassing the need for selection. Based on these findings, we developed a systematic method to mutate, tag, or delete any gene in the C. elegans genome without the use of co-integrated markers or long homology arms. We generated 23 unique edits at 11 genes, including premature stops, whole-gene deletions, and protein fusions to antigenic peptides and GFP. Whole-genome sequencing of five edited strains revealed the presence of passenger variants, but no mutations at predicted off-target sites. The method is scalable for multi-gene editing projects and could be applied to other animals with an accessible germline. PMID:25249454

Efficient Knock-in of a Point Mutation in Porcine Fibroblasts Using the CRISPR/Cas9-GMNN Fusion Gene.

PubMed

Gerlach, Max; Kraft, Theresia; Brenner, Bernhard; Petersen, Björn; Niemann, Heiner; Montag, Judith

2018-06-13

During CRISPR/Cas9 mediated genome editing, site-specific double strand breaks are introduced and repaired either unspecific by non-homologous end joining (NHEJ) or sequence dependent by homology directed repair (HDR). Whereas NHEJ-based generation of gene knock-out is widely performed, the HDR-based knock-in of specific mutations remains a bottleneck. Especially in primary cell lines that are essential for the generation of cell culture and animal models of inherited human diseases, knock-in efficacy is insufficient and needs significant improvement. Here, we tested two different approaches to increase the knock-in frequency of a specific point mutation into the MYH7 -gene in porcine fetal fibroblasts. We added a small molecule inhibitor of NHEJ, SCR7 (5,6-bis((E)-benzylideneamino)-2-mercaptopyrimidin-4-ol), during genome editing and screened cell cultures for the point mutation. However, this approach did not yield increased knock-in rates. In an alternative approach, we fused humanized Cas9 (hCas9) to the N-terminal peptide of the Geminin gene ( GMNN ). The fusion protein is degraded in NHEJ-dominated cell cycle phases, which should increase HDR-rates. Using hCas9- GMNN and point mutation-specific real time PCR screening, we found a two-fold increase in genome edited cell cultures. This increase of HDR by hCas9- GMNN provides a promising way to enrich specific knock-in in porcine fibroblast cultures for somatic cloning approaches.

Reduced toxicity with equivalent outcomes using three-dimensional volumetric (3DV) image-based versus nonvolumetric point-based (NV) brachytherapy in a cervical cancer population.

PubMed

Thomas, Kimberly M; Maquilan, Genevieve; Stojadinovic, Strahinja; Medin, Paul; Folkert, Michael R; Albuquerque, Kevin

Brachytherapy (BT) techniques have historically used a two-dimensional nonvolumetric (NV) system involving dose prescribed to a point fixed in space. We compared dosimetric, toxicity, and oncologic outcomes for volumetric planning (3DV) versus CT point-based planning. Patients treated with external beam radiation therapy and high dose rate (HDR) intracavitary BT were included (n = 71). Patients planned with NV BT treated from 2009 to 2011 (n = 37) were compared to patients planned with 3DV BT treated from 2012 to 2014 (n = 34). Investigators delineated volumes for organs at risk clinical target volumes for the 2009-2011 NV cohort. Acute and chronic toxicity data were graded. The mean HDR clinical target volume D90 received in the NV and 3DV cohorts were significantly different (p < 0.001). The mean dose to point A was significantly higher in the NV cohort than in the 3DV cohort (p < 0.001). There were significantly more Grade 3 or higher gastrointestinal toxicities in the NV cohort (p = 0.048). There was a nonsignificant trend toward improved oncologic outcomes for patients undergoing CT-based planning. 3DV BT allows for a significant reduction of dose to critical structures, resulting in decreased gastrointestinal toxicity, while delivering noninferior doses to the high-risk clinical target volume. Outcomes were improved in the 3D cohort trending toward statistical significance. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

A functional (E)-4-hydroxy-3-methylbut-2-enyl diphosphate reductase exhibits diurnal regulation of expression in Stevia rebaudiana (Bertoni).

PubMed

Kumar, Hitesh; Kumar, Sanjay

2013-09-15

The leaves of stevia [Stevia rebaudiana (Bertoni)] are a rich source of steviol glycosides that are used as non-calorific sweetener in many countries around the world. Steviol moiety of steviol glycosides is synthesized via plastidial 2C-methyl-D-erythritol 4-phosphate pathway, where (E)-4-hydroxy-3-methylbut-2-enyl diphosphate reductase (HDR) is the key enzyme. HDR catalyzes the simultaneous conversion of (E)-4-hydroxy-3-methylbut-2-enyl diphosphate into five carbon isoprenoid units, isopentenyl diphosphate and dimethylallyl diphosphate. Stevia HDR (SrHDR) successfully rescued HDR lethal mutant strain MG1655 ara<>ispH upon genetic complementation, suggesting SrHDR to encode a functional protein. The gene exhibited diurnal variation in expression. To identify the possible regulatory elements, upstream region of the gene was cloned and putative cis-acting elements were detected by in silico analysis. Electrophoretic mobility shift assay, using a putative light responsive element GATA showed the binding of nuclear proteins (NP) isolated from leaves during light period of the day, but not with the NP from leaves during the dark period. Data suggested the involvement of GATA box in light mediated gene regulation of SrHDR in stevia. Copyright © 2013 Elsevier B.V. All rights reserved.

Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 with improved proof-reading enhances homology-directed repair.

PubMed

Kato-Inui, Tomoko; Takahashi, Gou; Hsu, Szuyin; Miyaoka, Yuichiro

2018-05-18

Genome editing using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) predominantly induces non-homologous end joining (NHEJ), which generates random insertions or deletions, whereas homology-directed repair (HDR), which generates precise recombination products, is useful for wider applications. However, the factors that determine the ratio of HDR to NHEJ products after CRISPR/Cas9 editing remain unclear, and methods by which the proportion of HDR products can be increased have not yet been fully established. We systematically analyzed the HDR and NHEJ products after genome editing using various modified guide RNAs (gRNAs) and Cas9 variants with an enhanced conformational checkpoint to improve the fidelity at endogenous gene loci in HEK293T cells and HeLa cells. We found that these modified gRNAs and Cas9 variants were able to enhance HDR in both single-nucleotide substitutions and a multi-kb DNA fragment insertion. Our results suggest that the original CRISPR/Cas9 system from the bacterial immune system is not necessarily the best option for the induction of HDR in genome editing and indicate that the modulation of the kinetics of conformational checkpoints of Cas9 can optimize the HDR/NHEJ ratio.

Prospects for the commercial development of hot dry rock geothermal energy in New Mexico

NASA Astrophysics Data System (ADS)

Duchane, D. V.; Goff, F.

A vast store of energy is available to the world in the form of hot dry rock (HDR) which exists almost everywhere beneath the surface of the earth. The Los Alamos National Laboratory has developed technology to mine the heat from HDR by using techniques developed in the petroleum industry. In practice, an artificial reservoir is created in the hot rock and water is circulated through the reservoir to extract the thermal energy and bring it to the surface. There are virtually no adverse environmental effects from an HDR plant when the system is operated in a closed-loop mode with the process water continually recirculated. An experimental plant at Fenton Hill, NM is now undergoing long-term testing to demonstrate that energy can be obtained from HDR on a sustained basis with operational procedures which are readily adaptable to industry. Significant HDR resources exist in the state of New Mexico. Resources in the Valles Caldera, Zuni Uplift, and Rio Grande Rift have been evaluated in detail. Studies indicate that it should be possible to economically develop high grade HDR resources with technology available today. As advanced concepts for developing and operating HDR systems are investigated, even more widespread utilization of the technology will be commercially feasible.

Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tward, Jonathan D., E-mail: Jonathan.Tward@hci.utah.edu; Jarosek, Stephanie; Chu, Haitao

Purpose: Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Methods and Materials: Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results–Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, andmore » the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Results: Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Conclusions: Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus EBRT) increases the risk of severe UAEs compared with HDR alone or LDR alone. The highest increased risk of urinary toxicity occurs within the 2 years after therapy and then declines to an approximately 1% increase in incidence per year.« less

Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy.

PubMed

Tward, Jonathan D; Jarosek, Stephanie; Chu, Haitao; Thorpe, Cameron; Shrieve, Dennis C; Elliott, Sean

2016-08-01

Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results-Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, and the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus EBRT) increases the risk of severe UAEs compared with HDR alone or LDR alone. The highest increased risk of urinary toxicity occurs within the 2 years after therapy and then declines to an approximately 1% increase in incidence per year. Copyright © 2016. Published by Elsevier Inc.

Hemispheric language dominance measured by repetitive navigated transcranial magnetic stimulation and postoperative course of language function in brain tumor patients.

PubMed

Ille, Sebastian; Kulchytska, Nataliia; Sollmann, Nico; Wittig, Regina; Beurskens, Eva; Butenschoen, Vicki M; Ringel, Florian; Vajkoczy, Peter; Meyer, Bernhard; Picht, Thomas; Krieg, Sandro M

2016-10-01

The resection of left-sided perisylvian brain lesions harbors the risk of postoperative aphasia. Because it is known that language function can shift between hemispheres in brain tumor patients, the preoperative knowledge of the patient's language dominance could be helpful. We therefore investigated the hemispheric language dominance by repetitive navigated transcranial magnetic stimulation (rTMS) and surgery-related deficits of language function. We pooled the bicentric language mapping data of 80 patients undergoing the resection of left-sided perisylvian brain lesions in our two university neurosurgical departments. We calculated error rates (ERs; ER = errors per stimulations) for both hemispheres and defined the hemispheric dominance ratio (HDR) as the quotient of the left- and right-sided ER (HDR >1= left dominant; HDR <1= right dominant). The course of the patient's language function was evaluated and correlated with the preoperative HDR. Only three of 80 patients (4%) presented with permanent surgery-related aphasia and 24 patients (30%) with transient surgery-related aphasia. The mean HDR (± standard deviation) of patients with new aphasia after five days was significantly higher (1.68±1.07) than the HDR of patients with no new language deficit (1.37±1.08) (p=0.0482). With a predefined cut-off value of 0.5 for HDR, we achieved a sensitivity for predicting new aphasia of 100%. A higher preoperative HDR significantly correlates with an increased risk for transient aphasia. Moreover, the intensive preoperative workup in this study led to a considerably low rate of permanent aphasia. Copyright © 2016 Elsevier Ltd. All rights reserved.

HDR syndrome with a novel mutation in GATA3 mimicking a congenital X-linked stapes gusher: a case report.

PubMed

Yang, Aram; Kim, Jinsup; Ki, Chang-Seok; Hong, Sung Hwa; Cho, Sung Yoon; Jin, Dong-Kyu

2017-10-26

Hypoparathyroidism, sensorineural hearing loss, and renal disease (HDR) syndrome, also known as Barakat syndrome, is a rare genetic disorder with high phenotypic heterogeneity caused by haploinsufficiency of the GATA3 gene on chromosome 10p14-p15. For these reasons, the diagnosis of HDR syndrome is challenging and requires a high index of suspicion as well as genetic analysis. A 14-month-old boy, with sensorineural hearing loss in both ears, showed typical radiological features of X-linked stapes gusher on preoperative temporal bone computed tomography (CT) for cochlear implantations. Then after his discharge from hospital, he suffered a hypocalcemic seizure and we discovered a renal cyst during investigation of hypocalcemia. He was finally diagnosed with HDR syndrome by clinical findings, which were confirmed by molecular genetic testing. Direct sequencing of the GATA3 gene showed a heterozygous 2-bp deletion (c.1201_1202delAT), which is predicted to cause a frameshift of the reading frame (p.Met401Valfs*106). To our knowledge, this is the first case of HDR syndrome with a novel de novo variant mimicking a congenital X-linked stapes gusher syndrome. Novel mutations and the diversity of clinical manifestations expand the genotypic and phenotypic spectrum of HDR syndrome. Diagnosis of HDR syndrome is still challenging, but clinicians should consider it in their differential diagnosis for children with a wide range of clinical manifestations including hypocalcemia induced seizures and deafness. We hope that this case will contribute to further understanding and studies of HDR-associated GATA3 mutations.

The Application of Elliptic Cylindrical Phantom in Brachytherapy Dosimetric Study of HDR 192Ir Source

NASA Astrophysics Data System (ADS)

Ahn, Woo Sang; Park, Sung Ho; Jung, Sang Hoon; Choi, Wonsik; Do Ahn, Seung; Shin, Seong Soo

2014-06-01

The purpose of this study is to determine the radial dose function of HDR 192Ir source based on Monte Carlo simulation using elliptic cylindrical phantom, similar to realistic shape of pelvis, in brachytherapy dosimetric study. The elliptic phantom size and shape was determined by analysis of dimensions of pelvis on CT images of 20 patients treated with brachytherapy for cervical cancer. The radial dose function obtained using the elliptic cylindrical water phantom was compared with radial dose functions for different spherical phantom sizes, including the Williamsion's data loaded into conventional planning system. The differences in the radial dose function for the different spherical water phantoms increase with radial distance, r, and the largest differences in the radial dose function appear for the smallest phantom size. The radial dose function of the elliptic cylindrical phantom significantly decreased with radial distance in the vertical direction due to different scatter condition in comparison with the Williamson's data. Considering doses to ICRU rectum and bladder points, doses to reference points can be underestimated up to 1-2% at the distance from 3 to 6 cm. The radial dose function in this study could be used as realistic data for calculating the brachytherapy dosimetry for cervical cancer.

WE-DE-201-07: Measurement of Real-Time Dose for Tandem and Ovoid Brachytherapy Procedures Using a High Precision Optical Fiber Radiation Detector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Belley, MD; Current Address Rhode Island Hospital, Providence, RI; Faught, A

Purpose: Development of a novel on-line dosimetry tool is needed to move toward patient-specific quality assurance measurements for Ir-192 HDR brachytherapy to verify accurate dose delivery to the intended location. This work describes the development and use of a nano-crystalline yttrium oxide inorganic scintillator based optical-fiber detector capable of acquiring real-time high-precision dose measurements during tandem and ovoid (T&O) gynecological (GYN) applicator Ir-192 HDR brachytherapy procedures. Methods: An optical-fiber detector was calibrated by acquiring light output measurements in liquid water at 3, 5, 7, and 9cm radial source-detector-distances from an Ir-192 HDR source. A regression model was fit to themore » data to describe the relative light output per unit dose (TG-43 derived) as a function of source-detector-distance. Next, the optical-fiber detector was attached to a vaginal balloon fixed to a Varian Fletcher-Suit-Delclos-style applicator (to mimic clinical setup), and localized by acquiring high-resolution computed tomography (CT) images. To compare the physical point dose to the TPS calculated values (TG-43 and Acuros-BV), a phantom measurement was performed, by submerging the T&O applicator in a liquid water bath and delivering a treatment template representative of a clinical T&O procedure. The fiber detector collected scintillation signal as a function of time, and the calibration data was applied to calculate both real-time dose rate, and cumulative dose. Results: Fiber cumulative dose values were 100.0cGy, 94.3cGy, and 348.9cGy from the tandem, left ovoid, and right ovoid dwells, respectively (total of 443.2cGy). A plot of real time dose rate during the treatment was also acquired. The TPS values at the fiber location were 458.4cGy using TG-43, and 437.6cGy using Acuros-BV calculated as Dm,m (per TG-186). Conclusion: The fiber measured dose value agreement was 3% vs TG-43 and −1% vs Acuros-BV. This fiber detector opens up new possibilities for performing patient-specific quality assurance for Ir-192 HDR GYN procedures. Funding from Coulter Foundation, Duke Bio-medical Engineering. Company is being created around the detector technology. Duke holds patents on the technology.« less

Varying-energy CT imaging method based on EM-TV

NASA Astrophysics Data System (ADS)

Chen, Ping; Han, Yan

2016-11-01

For complicated structural components with wide x-ray attenuation ranges, conventional fixed-energy computed tomography (CT) imaging cannot obtain all the structural information. This limitation results in a shortage of CT information because the effective thickness of the components along the direction of x-ray penetration exceeds the limit of the dynamic range of the x-ray imaging system. To address this problem, a varying-energy x-ray CT imaging method is proposed. In this new method, the tube voltage is adjusted several times with the fixed lesser interval. Next, the fusion of grey consistency and logarithm demodulation are applied to obtain full and lower noise projection with a high dynamic range (HDR). In addition, for the noise suppression problem of the analytical method, EM-TV (expectation maximization-total Jvariation) iteration reconstruction is used. In the process of iteration, the reconstruction result obtained at one x-ray energy is used as the initial condition of the next iteration. An accompanying experiment demonstrates that this EM-TV reconstruction can also extend the dynamic range of x-ray imaging systems and provide a higher reconstruction quality relative to the fusion reconstruction method.

High Dynamic Range Spectral Imaging Pipeline For Multispectral Filter Array Cameras.

PubMed

Lapray, Pierre-Jean; Thomas, Jean-Baptiste; Gouton, Pierre

2017-06-03

Spectral filter arrays imaging exhibits a strong similarity with color filter arrays. This permits us to embed this technology in practical vision systems with little adaptation of the existing solutions. In this communication, we define an imaging pipeline that permits high dynamic range (HDR)-spectral imaging, which is extended from color filter arrays. We propose an implementation of this pipeline on a prototype sensor and evaluate the quality of our implementation results on real data with objective metrics and visual examples. We demonstrate that we reduce noise, and, in particular we solve the problem of noise generated by the lack of energy balance. Data are provided to the community in an image database for further research.

High dynamic range CMOS (HDRC) imagers for safety systems

NASA Astrophysics Data System (ADS)

Strobel, Markus; Döttling, Dietmar

2013-04-01

The first part of this paper describes the high dynamic range CMOS (HDRC®) imager - a special type of CMOS image sensor with logarithmic response. The powerful property of a high dynamic range (HDR) image acquisition is detailed by mathematical definition and measurement of the optoelectronic conversion function (OECF) of two different HDRC imagers. Specific sensor parameters will be discussed including the pixel design for the global shutter readout. The second part will give an outline on the applications and requirements of cameras for industrial safety. Equipped with HDRC global shutter sensors SafetyEYE® is a high-performance stereo camera system for safe three-dimensional zone monitoring enabling new and more flexible solutions compared to existing safety guards.

Phase III randomized trial comparing LDR and HDR brachytherapy in treatment of cervical carcinoma.

PubMed

Lertsanguansinchai, Prasert; Lertbutsayanukul, Chawalit; Shotelersuk, Kanjana; Khorprasert, Chonlakiet; Rojpornpradit, Prayuth; Chottetanaprasith, Taywin; Srisuthep, Apiradee; Suriyapee, Sivalee; Jumpangern, Chotika; Tresukosol, Damrong; Charoonsantikul, Chulee

2004-08-01

Intracavitary brachytherapy plays an important role in the treatment of cervical carcinoma. Previous results have shown controversy between the effect of dose rate on tumor control and the occurrence of complications. We performed a prospective randomized clinical trial to compare the clinical outcomes between low-dose-rate (LDR) and high-dose-rate (HDR) intracavitary brachytherapy for treatment of invasive uterine cervical carcinoma. A total of 237 patients with previously untreated invasive carcinoma of the uterine cervix treated at King Chulalongkorn Memorial Hospital were randomized between June 1995 and December 2001. Excluding ineligible, incomplete treatment, and incomplete data patients, 109 and 112 patients were in the LDR and HDR groups, respectively. All patients were treated with external beam radiotherapy and LDR or HDR intracavitary brachytherapy using the Chulalongkorn treatment schedule. The median follow-up for the LDR and HDR groups was 40.2 and 37.2 months, respectively. The actuarial 3-year overall and relapse-free survival rate for all patients was 69.6% and 70%, respectively. The 3-year overall survival rate in the LDR and HDR groups was 70.9% and 68.4% (p = 0.75) and the 3-year pelvic control rate was 89.1% and 86.4% (p = 0.51), respectively. The 3-year relapse-free survival rate in both groups was 69.9% (p = 0.35). Most recurrences were distant metastases, especially in Stage IIB and IIIB patients. Grade 3 and 4 complications were found in 2.8% and 7.1% of the LDR and HDR groups (p = 0.23). Comparable outcomes were demonstrated between LDR and HDR intracavitary brachytherapy. Concerning patient convenience, the lower number of medical personnel needed, and decreased radiation to health care workers, HDR intracavitary brachytherapy is an alternative to conventional LDR brachytherapy. The high number of distant failure suggests that other modalities such as systemic concurrent or adjuvant chemotherapy might lower this high recurrence, especially in Stage IIB and IIIB.

Genome editing using CRISPR/Cas9-based knock-in approaches in zebrafish.

PubMed

Albadri, Shahad; Del Bene, Filippo; Revenu, Céline

2017-05-15

With its variety of applications, the CRISPR/Cas9 genome editing technology has been rapidly evolving in the last few years. In the zebrafish community, knock-out reports are constantly increasing but insertion studies have been so far more challenging. With this review, we aim at giving an overview of the homologous directed repair (HDR)-based knock-in generation in zebrafish. We address the critical points and limitations of the procedure such as cutting efficiency of the chosen single guide RNA, use of cas9 mRNA or Cas9 protein, homology arm size etc. but also ways to circumvent encountered issues with HDR insertions by the development of non-homologous dependent strategies. While imprecise, these homology-independent mechanisms based on non-homologous-end-joining (NHEJ) repair have been employed in zebrafish to generate reporter lines or to accurately edit an open reading frame by the use of intron-targeting modifications. Therefore, with higher efficiency and insertion rate, NHEJ-based knock-in seems to be a promising approach to target endogenous loci and to circumvent the limitations of HDR whenever it is possible and appropriate. In this perspective, we propose new strategies to generate cDNA edited or tagged insertions, which once established will constitute a new and versatile toolbox for CRISPR/Cas9-based knock-ins in zebrafish. Copyright © 2017 Elsevier Inc. All rights reserved.

Real-Time Verification of a High-Dose-Rate Iridium 192 Source Position Using a Modified C-Arm Fluoroscope

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nose, Takayuki, E-mail: nose-takayuki@nms.ac.jp; Chatani, Masashi; Otani, Yuki

Purpose: High-dose-rate (HDR) brachytherapy misdeliveries can occur at any institution, and they can cause disastrous results. Even a patient's death has been reported. Misdeliveries could be avoided with real-time verification methods. In 1996, we developed a modified C-arm fluoroscopic verification of an HDR Iridium 192 source position prevent these misdeliveries. This method provided excellent image quality sufficient to detect errors, and it has been in clinical use at our institutions for 20 years. The purpose of the current study is to introduce the mechanisms and validity of our straightforward C-arm fluoroscopic verification method. Methods and Materials: Conventional X-ray fluoroscopic images aremore » degraded by spurious signals and quantum noise from Iridium 192 photons, which make source verification impractical. To improve image quality, we quadrupled the C-arm fluoroscopic X-ray dose per pulse. The pulse rate was reduced by a factor of 4 to keep the average exposure compliant with Japanese medical regulations. The images were then displayed with quarter-frame rates. Results: Sufficient quality was obtained to enable observation of the source position relative to both the applicators and the anatomy. With this method, 2 errors were detected among 2031 treatment sessions for 370 patients within a 6-year period. Conclusions: With the use of a modified C-arm fluoroscopic verification method, treatment errors that were otherwise overlooked were detected in real time. This method should be given consideration for widespread use.« less

Real-Time Verification of a High-Dose-Rate Iridium 192 Source Position Using a Modified C-Arm Fluoroscope.

PubMed

Nose, Takayuki; Chatani, Masashi; Otani, Yuki; Teshima, Teruki; Kumita, Shinichirou

2017-03-15

High-dose-rate (HDR) brachytherapy misdeliveries can occur at any institution, and they can cause disastrous results. Even a patient's death has been reported. Misdeliveries could be avoided with real-time verification methods. In 1996, we developed a modified C-arm fluoroscopic verification of an HDR Iridium 192 source position prevent these misdeliveries. This method provided excellent image quality sufficient to detect errors, and it has been in clinical use at our institutions for 20 years. The purpose of the current study is to introduce the mechanisms and validity of our straightforward C-arm fluoroscopic verification method. Conventional X-ray fluoroscopic images are degraded by spurious signals and quantum noise from Iridium 192 photons, which make source verification impractical. To improve image quality, we quadrupled the C-arm fluoroscopic X-ray dose per pulse. The pulse rate was reduced by a factor of 4 to keep the average exposure compliant with Japanese medical regulations. The images were then displayed with quarter-frame rates. Sufficient quality was obtained to enable observation of the source position relative to both the applicators and the anatomy. With this method, 2 errors were detected among 2031 treatment sessions for 370 patients within a 6-year period. With the use of a modified C-arm fluoroscopic verification method, treatment errors that were otherwise overlooked were detected in real time. This method should be given consideration for widespread use. Copyright © 2016 Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moura, Eduardo S., E-mail: emoura@wisc.edu; Micka, John A.; Hammer, Cliff G.

Purpose: This work presents the development of a phantom to verify the treatment planning system (TPS) algorithms used for high-dose-rate (HDR) brachytherapy. It is designed to measure the relative dose in a heterogeneous media. The experimental details used, simulation methods, and comparisons with a commercial TPS are also provided. Methods: To simulate heterogeneous conditions, four materials were used: Virtual Water™ (VM), BR50/50™, cork, and aluminum. The materials were arranged in 11 heterogeneity configurations. Three dosimeters were used to measure the relative response from a HDR {sup 192}Ir source: TLD-100™, Gafchromic{sup ®} EBT3 film, and an Exradin™ A1SL ionization chamber. Tomore » compare the results from the experimental measurements, the various configurations were modeled in the PENELOPE/penEasy Monte Carlo code. Images of each setup geometry were acquired from a CT scanner and imported into BrachyVision™ TPS software, which includes a grid-based Boltzmann solver Acuros™. The results of the measurements performed in the heterogeneous setups were normalized to the dose values measured in the homogeneous Virtual Water™ setup and the respective differences due to the heterogeneities were considered. Additionally, dose values calculated based on the American Association of Physicists in Medicine-Task Group 43 formalism were compared to dose values calculated with the Acuros™ algorithm in the phantom. Calculated doses were compared at the same points, where measurements have been performed. Results: Differences in the relative response as high as 11.5% were found from the homogeneous setup when the heterogeneous materials were inserted into the experimental phantom. The aluminum and cork materials produced larger differences than the plastic materials, with the BR50/50™ material producing results similar to the Virtual Water™ results. Our experimental methods agree with the PENELOPE/penEasy simulations for most setups and dosimeters. The TPS relative differences with the Acuros™ algorithm were similar in both experimental and simulated setups. The discrepancy between the BrachyVision™, Acuros™, and TG-43 dose responses in the phantom described by this work exceeded 12% for certain setups. Conclusions: The results derived from the phantom measurements show good agreement with the simulations and TPS calculations, using Acuros™ algorithm. Differences in the dose responses were evident in the experimental results when heterogeneous materials were introduced. These measurements prove the usefulness of the heterogeneous phantom for verification of HDR treatment planning systems based on model-based dose calculation algorithms.« less

SU-E-T-310: Dosimetric Comparison of Tandem and Ovoid (TO) Vs. Tandem and Ring (TR) Applicators in High-Dose Rate (HDR) Brachytherapy (BT) for the Treatment of Locally-Advanced Cervical-Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuo, L; Viswanathan, A; Damato, A

2015-06-15

Purpose: To investigate the dosimetric differences associated with the use of TO or TR applicators for cervical-cancer HDR BT. Methods: The records of all cervical-cancer patients treated with image-guided HDR BT in 2013 were reviewed. Image-based planning based on isodose line and DVH metrics inspections was performed following the GEC-ESTRO recommendations. CTV volume, CTV D90, and rectum, bladder and sigmoid D2cc were collected as % of the prescription dose (80Gy EQD2). Patients receiving both TO and TR were identified and plans were compared (paired analysis). A Student T-test was used to evaluate statistical significance (p ≤ 0.05). Results: Twenty-eight patientsmore » were identified (20 TR only, 4 TO only, 4 TO and TR), associated with 116 plans (109 TR, 7 TO). Overall metrics: CTV volume, 26.5±10.4 cm3 (TR) and 39.1±14.0 cm3 (TO, p < 0.01); CTV D90, 126±28% (TR) and 110±15% (TO, p = 0.15); rectum D2cc, 56±11% (TR) and 58±19% (TO, p = 0.91); bladder D2cc, 74±20% (TR) and 88±19% (TO, p = 0.09); sigmoid D2cc, 52±17% (TR) and 49±20% (TO, p = 0.63). The paired analysis results were: CTV volume, 37.3±11.9 cm3 (TR) and 51.0±23.1 cm3 (TO, p = 0.23); CTV D90, 111±12% (TR) and 101±17% (TO, p = 0.50); rectum D2cc, 56±12% (TR) and 53±16% (TO, p = 0.71); bladder D2cc, 73±14% (TR) and 90±20% (TO, p = 0.22); sigmoid D2cc, 59±10% (TR) and 59±22% (TO, p = 0.98). Conclusion: TR and TO were both used with good dosimetric results. TO were used for patients with larger CTV volumes than TR, although paired analysis suggest that tissue distortion and contouring bias may partially explain this Result. CTV D90 on average > 80 Gy EQD2 were achieved in both groups despite the different CTV volume. Higher bladder D2cc for TO than TR was observed.« less

Source position verification and dosimetry in HDR brachytherapy using an EPID.

PubMed

Smith, R L; Taylor, M L; McDermott, L N; Haworth, A; Millar, J L; Franich, R D

2013-11-01

Accurate treatment delivery in high dose rate (HDR) brachytherapy requires correct source dwell positions and dwell times to be administered relative to each other and to the surrounding anatomy. Treatment delivery inaccuracies predominantly occur for two reasons: (i) anatomical movement or (ii) as a result of human errors that are usually related to incorrect implementation of the planned treatment. Electronic portal imaging devices (EPIDs) were originally developed for patient position verification in external beam radiotherapy and their application has been extended to provide dosimetric information. The authors have characterized the response of an EPID for use with an (192)Ir brachytherapy source to demonstrate its use as a verification device, providing both source position and dosimetric information. Characterization of the EPID response using an (192)Ir brachytherapy source included investigations of reproducibility, linearity with dose rate, photon energy dependence, and charge build-up effects associated with exposure time and image acquisition time. Source position resolution in three dimensions was determined. To illustrate treatment verification, a simple treatment plan was delivered to a phantom and the measured EPID dose distribution compared with the planned dose. The mean absolute source position error in the plane parallel to the EPID, for dwells measured at 50, 100, and 150 mm source to detector distances (SDD), was determined to be 0.26 mm. The resolution of the z coordinate (perpendicular distance from detector plane) is SDD dependent with 95% confidence intervals of ± 0.1, ± 0.5, and ± 2.0 mm at SDDs of 50, 100, and 150 mm, respectively. The response of the EPID is highly linear to dose rate. The EPID exhibits an over-response to low energy incident photons and this nonlinearity is incorporated into the dose calibration procedure. A distance (spectral) dependent dose rate calibration procedure has been developed. The difference between measured and planned dose is less than 2% for 98.0% of pixels in a two-dimensional plane at an SDD of 100 mm. Our application of EPID dosimetry to HDR brachytherapy provides a quality assurance measure of the geometrical distribution of the delivered dose as well as the source positions, which is not possible with any current HDR brachytherapy verification system.

Evaluation of water binding, seed coat permeability and germination characteristics of wheat seeds equilibrated at different relative humidities.

PubMed

Chatterjee, Nabamita; Nagarajan, Shantha

2006-08-01

The relative binding of seed water and seed coat membrane stability were measured in two contrasting wheat (Triticum aestivum L) varieties, HDR 77 (drought-tolerant) and HD 2009 (susceptible) using seed water sorption isotherms, electrical conductivity (EC) of leachates and desorption-absorption isotherms. Analysis of sorption isotherm at 25 degrees C showed that the seeds of HDR 77 had significantly higher number of strong binding sites, with correspondingly greater amount of seed water as strongly bound water, as compared to HD 2009. Total number of binding sites was also higher in HDR 77 than HD 2009, which explained the better desiccation tolerance and higher capacity to bind water in seeds of HDR 77. EC of seed leachate in both varieties did not change with respect to change in equilibrium relative humidity (RII), indicating the general seed coat membrane stability of wheat seeds. However, absolute conductivity values were higher for HD 2009. showing its relatively porous seed coat membrane. Significantly lower area enclosed by the desorption-absorption isotherm loop in HDR 77, as compared to HD 2009 also indicated the greater membrane integrity of HDR 77. Germination and seedling vigour of HD 2009 were reduced when equilibrated over very low and very high RH. In contrast, germination and vigour in HDR 77 were maintained high, except at very high RH, indicating again its desiccation tolerance. Thus, the study demonstrated the relative drought tolerance of HDR 77, on the basis of seed water-binding characteristics and seed membrane stability. Seed membrane stability as measured by seed leachate conductivity or as area under dehydration-rehydration loop may be used as a preliminary screening test for drought tolerance in wheat.

Hot dry rock geothermal energy development program. Semiannual report, October 1, 1978-March 31, 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, M.C.; Nunz, G.J.; Cremer, G.M.

1979-09-01

The potential of energy extracted from hot dry rock (HDR) was investigated as a commercailly feasible alternate energy source. Run Segments 3 and 4 were completed in the prototype reservoir of the Phase I energy-extraction system at Fenton Hill, New Mexico. Results of these tests yielded significant data on the existing system and this information will be applicable to future HDR systems. Plans and operations initiating a Phase II system are underway at the Fenton Hill site. This system, a deeper, hotter commercial-size reservoir, is intended to demonstrate the longevity and economics of an HDR system. Major activity occurred inmore » evaluation of the national resource potential and in characterizing possible future HDR geothermal sites. Work has begun in the institutional and industrial support area to assess the economics and promote commercial interest in HDR systems as an alternate energy source.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jozsef, G

Purpose: To build a test device for HDR afterloaders capable of checking source positions, times at positions and estimate the activity of the source. Methods: A catheter is taped on a plastic scintillation sheet. When a source travels through the catheter, the scintillator sheet lights up around the source. The sheet is monitored with a video camera, and records the movement of the light spot. The center of the spot on each image on the video provides the source location, and the time stamps of the images can provide the dwell time the source spend in each location. Finally, themore » brightness of the light spot is related to the activity of the source. A code was developed for noise removal, calibrate the scale of the image to centimeters, eliminate the distortion caused by the oblique view angle, identifying the boundaries of the light spot, transforming the image into binary and detect and calculate the source motion, positions and times. The images are much less noisy if the camera is shielded. That requires that the light spot is monitored in a mirror, rather than directly. The whole assembly is covered from external light and has a size of approximately 17×35×25cm (H×L×W) Results: A cheap camera in BW mode proved to be sufficient with a plastic scintillator sheet. The best images were resulted by a 3mm thick sheet with ZnS:Ag surface coating. The shielding of the camera decreased the noise, but could not eliminate it. A test run even in noisy condition resulted in approximately 1 mm and 1 sec difference from the planned positions and dwell times. Activity tests are in progress. Conclusion: The proposed method is feasible. It might simplify the monthly QA process of HDR Brachytherapy units.« less

Significance of manipulating tumour hypoxia and radiation dose rate in terms of local tumour response and lung metastatic potential, referring to the response of quiescent cell populations

PubMed Central

Masunaga, S; Matsumoto, Y; Kashino, G; Hirayama, R; Liu, Y; Tanaka, H; Sakurai, Y; Suzuki, M; Kinashi, Y; Maruhashi, A; Ono, K

2010-01-01

The purpose of this study was to evaluate the influence of manipulating intratumour oxygenation status and radiation dose rate on local tumour response and lung metastases following radiotherapy, referring to the response of quiescent cell populations within irradiated tumours. B16-BL6 melanoma tumour-bearing C57BL/6 mice were continuously given 5-bromo-2′-deoxyuridine (BrdU) to label all proliferating (P) cells. They received γ-ray irradiation at high dose rate (HDR) or reduced dose rate (RDR) following treatment with the acute hypoxia-releasing agent nicotinamide or local hyperthermia at mild temperatures (MTH). Immediately after the irradiation, cells from some tumours were isolated and incubated with a cytokinesis blocker. The responses of the quiescent (Q) and total (proliferating + Q) cell populations were assessed based on the frequency of micronuclei using immunofluorescence staining for BrdU. In other tumour-bearing mice, 17 days after irradiation, macroscopic lung metastases were enumerated. Following HDR irradiation, nicotinamide and MTH enhanced the sensitivity of the total and Q-cell populations, respectively. The decrease in sensitivity at RDR irradiation compared with HDR irradiation was slightly inhibited by MTH, especially in Q cells. Without γ-ray irradiation, nicotinamide treatment tended to reduce the number of lung metastases. With γ-rays, in combination with nicotinamide or MTH, especially the former, HDR irradiation decreased the number of metastases more remarkably than RDR irradiation. Manipulating both tumour hypoxia and irradiation dose rate have the potential to influence lung metastasis. The combination with the acute hypoxia-releasing agent nicotinamide may be more promising in HDR than RDR irradiation in terms of reducing the number of lung metastases. PMID:20739345

HDR and LDR Brachytherapy in the Treatment of Lip Cancer: the Experience of the Catalan Institute of Oncology.

PubMed

Ayerra, Arrate Querejeta; Mena, Estefanía Palacios; Fabregas, Joan Pera; Miguelez, Cristina Gutiérrez; Guedea, Ferran

2010-03-01

Lip cancer can be treated by surgery, external radiotherapy, and/or brachytherapy (BT). In recent years, BT has become increasingly favored for this type of cancer. The aim of the present study was to analyze local control and survival of patients treated at our institution between July 1989 and June 2008. We performed a retrospective study of 121 patients (109 males and 12 females) who underwent lip cancer brachytherapy from July 1989 to June 2008. Median age was 67 years and median follow-up was 31.8 months (range 20-188 months). Out of 121 patients, 100 (82.6%) were treated with low dose rate (LDR) BT while the remaining 21 patients (17.4%) received high dose rate (HDR) BT. The most common cell type was squamous cell carcinoma (115 cases; 95%) and most tumors were located on the lower lip (107 patients; 88.4%). Most cases were either stage T1 (62 patients; 51.2%), or T2 (44 cases; 36.4%). After 15 years of follow-up, overall survival was 89.5%, cause-specific survival 97.8%, and disease-free survival 86.6%. Local, regional, and distant control at 15 years were 90%, 92%, and 98.8%, respectively. Grade 3 mucosal toxicity was observed in 23% of patients treated with LDR compared to 33% of HDR patients, and grade 4 mucosal toxicity in 9% versus 0% in the HDR group. Our findings confirm that brachytherapy is an effective treatment for lip cancer. The results from our series are in line with those published elsewhere. Based on our limited data, HDR appears to be equally as good as LDR, although this needs to be confirmed by further studies.

Clinical implementation and failure mode and effects analysis of HDR skin brachytherapy using Valencia and Leipzig surface applicators.

PubMed

Sayler, Elaine; Eldredge-Hindy, Harriet; Dinome, Jessie; Lockamy, Virginia; Harrison, Amy S

2015-01-01

The planning procedure for Valencia and Leipzig surface applicators (VLSAs) (Nucletron, Veenendaal, The Netherlands) differs substantially from CT-based planning; the unfamiliarity could lead to significant errors. This study applies failure modes and effects analysis (FMEA) to high-dose-rate (HDR) skin brachytherapy using VLSAs to ensure safety and quality. A multidisciplinary team created a protocol for HDR VLSA skin treatments and applied FMEA. Failure modes were identified and scored by severity, occurrence, and detectability. The clinical procedure was then revised to address high-scoring process nodes. Several key components were added to the protocol to minimize risk probability numbers. (1) Diagnosis, prescription, applicator selection, and setup are reviewed at weekly quality assurance rounds. Peer review reduces the likelihood of an inappropriate treatment regime. (2) A template for HDR skin treatments was established in the clinic's electronic medical record system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planner as well as increases the detectability of an error. (3) A screen check was implemented during the second check to increase detectability of an error. (4) To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display, facilitating data entry and verification. (5) VLSAs are color coded and labeled to match the electronic medical record prescriptions, simplifying in-room selection and verification. Multidisciplinary planning and FMEA increased detectability and reduced error probability during VLSA HDR brachytherapy. This clinical model may be useful to institutions implementing similar procedures. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

SU-G-TeP1-01: A Simulation Study to Investigate Maximum Allowable Deformations of Implant Geometry Before Plan Objectives Are Violated in Prostate HDR Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Babier, A; Joshi, C; Cancer Center of Southeastern Ontario, Kingston General Hospital, Kingston, Ontario

Purpose: In prostate HDR brachytherapy dose distributions are highly sensitive to changes in prostate volume and catheter displacements. We investigate the maximum deformations in implant geometry before planning objectives are violated. Methods: A typical prostate Ir-192 HDR brachytherapy reference plan was calculated on the Oncentra planning system, which used CT images from a tissue equivalent prostate phantom (CIRS Model 053S) embedded inside a pelvis wax phantom. The prostate was deformed and catheters were displaced in simulations using a code written in MATLAB. For each deformation dose distributions were calculated, based on TG43 methods, using the MATLAB code. The calculations weremore » validated through comparison with Oncentra calculations for the reference plan, and agreed within 0.12%SD and 0.3%SD for dose and volume, respectively. Isotropic prostate volume deformations of up to +34% to −27% relative to its original volume, and longitudinal catheter displacements of 7.5 mm in superior and inferior directions were simulated. Planning objectives were based on American Brachytherapy Society guidelines for prostate and urethra volumes. A plan violated the planning objectives when less than 90% of the prostate volume received the prescribed dose or higher (V{sub 100}), or the urethral volume receiving 125% of prescribed dose or higher was more than 1 cc (U{sub 125}). Lastly, the dose homogeneity index (DHI=1-V{sub 150}/V{sub 100}) was evaluated; a plan was considered sub-optimal when the DHI fell below 0.62. Results and Conclusion: Planning objectives were violated when the prostate expanded by 10.7±0.5% or contracted by 11.0±0.2%; objectives were also violated when catheters were displaced by 4.15±0.15 mm and 3.70±0.15 mm in the superior and inferior directions, respectively. The DHI changes did not affect the plan optimality, except in the case of prostate compression. In general, catheter displacements have a significantly larger impact on plan optimality than prostate volume changes.« less

A fast and automatic fusion algorithm for unregistered multi-exposure image sequence

NASA Astrophysics Data System (ADS)

Liu, Yan; Yu, Feihong

2014-09-01

Human visual system (HVS) can visualize all the brightness levels of the scene through visual adaptation. However, the dynamic range of most commercial digital cameras and display devices are smaller than the dynamic range of human eye. This implies low dynamic range (LDR) images captured by normal digital camera may lose image details. We propose an efficient approach to high dynamic (HDR) image fusion that copes with image displacement and image blur degradation in a computationally efficient manner, which is suitable for implementation on mobile devices. The various image registration algorithms proposed in the previous literatures are unable to meet the efficiency and performance requirements in the application of mobile devices. In this paper, we selected Oriented Brief (ORB) detector to extract local image structures. The descriptor selected in multi-exposure image fusion algorithm has to be fast and robust to illumination variations and geometric deformations. ORB descriptor is the best candidate in our algorithm. Further, we perform an improved RANdom Sample Consensus (RANSAC) algorithm to reject incorrect matches. For the fusion of images, a new approach based on Stationary Wavelet Transform (SWT) is used. The experimental results demonstrate that the proposed algorithm generates high quality images at low computational cost. Comparisons with a number of other feature matching methods show that our method gets better performance.

Rerouting Cellular Electron Flux To Increase the Rate of Biological Methane Production

PubMed Central

Catlett, Jennie L.; Ortiz, Alicia M.

2015-01-01

Methanogens are anaerobic archaea that grow by producing methane, a gas that is both an efficient renewable fuel and a potent greenhouse gas. We observed that overexpression of the cytoplasmic heterodisulfide reductase enzyme HdrABC increased the rate of methane production from methanol by 30% without affecting the growth rate relative to the parent strain. Hdr enzymes are essential in all known methane-producing archaea. They function as the terminal oxidases in the methanogen electron transport system by reducing the coenzyme M (2-mercaptoethane sulfonate) and coenzyme B (7-mercaptoheptanoylthreonine sulfonate) heterodisulfide, CoM-S-S-CoB, to regenerate the thiol-coenzymes for reuse. In Methanosarcina acetivorans, HdrABC expression caused an increased rate of methanogenesis and a decrease in metabolic efficiency on methylotrophic substrates. When acetate was the sole carbon and energy source, neither deletion nor overexpression of HdrABC had an effect on growth or methane production rates. These results suggest that in cells grown on methylated substrates, the cell compensates for energy losses due to expression of HdrABC with an increased rate of substrate turnover and that HdrABC lacks the appropriate electron donor in acetate-grown cells. PMID:26162885

Radiation Parameters of High Dose Rate Iridium -192 Sources

NASA Astrophysics Data System (ADS)

Podgorsak, Matthew B.

A lack of physical data for high dose rate (HDR) Ir-192 sources has necessitated the use of basic radiation parameters measured with low dose rate (LDR) Ir-192 seeds and ribbons in HDR dosimetry calculations. A rigorous examination of the radiation parameters of several HDR Ir-192 sources has shown that this extension of physical data from LDR to HDR Ir-192 may be inaccurate. Uncertainty in any of the basic radiation parameters used in dosimetry calculations compromises the accuracy of the calculated dose distribution and the subsequent dose delivery. Dose errors of up to 0.3%, 6%, and 2% can result from the use of currently accepted values for the half-life, exposure rate constant, and dose buildup effect, respectively. Since an accuracy of 5% in the delivered dose is essential to prevent severe complications or tumor regrowth, the use of basic physical constants with uncertainties approaching 6% is unacceptable. A systematic evaluation of the pertinent radiation parameters contributes to a reduction in the overall uncertainty in HDR Ir-192 dose delivery. Moreover, the results of the studies described in this thesis contribute significantly to the establishment of standardized numerical values to be used in HDR Ir-192 dosimetry calculations.

Knock-in of large reporter genes in human cells via CRISPR/Cas9-induced homology-dependent and independent DNA repair

PubMed Central

He, Xiangjun; Tan, Chunlai; Wang, Feng; Wang, Yaofeng; Zhou, Rui; Cui, Dexuan; You, Wenxing; Zhao, Hui; Ren, Jianwei; Feng, Bo

2016-01-01

CRISPR/Cas9-induced site-specific DNA double-strand breaks (DSBs) can be repaired by homology-directed repair (HDR) or non-homologous end joining (NHEJ) pathways. Extensive efforts have been made to knock-in exogenous DNA to a selected genomic locus in human cells; which, however, has focused on HDR-based strategies and was proven inefficient. Here, we report that NHEJ pathway mediates efficient rejoining of genome and plasmids following CRISPR/Cas9-induced DNA DSBs, and promotes high-efficiency DNA integration in various human cell types. With this homology-independent knock-in strategy, integration of a 4.6 kb promoterless ires-eGFP fragment into the GAPDH locus yielded up to 20% GFP+ cells in somatic LO2 cells, and 1.70% GFP+ cells in human embryonic stem cells (ESCs). Quantitative comparison further demonstrated that the NHEJ-based knock-in is more efficient than HDR-mediated gene targeting in all human cell types examined. These data support that CRISPR/Cas9-induced NHEJ provides a valuable new path for efficient genome editing in human ESCs and somatic cells. PMID:26850641

Knock-in of large reporter genes in human cells via CRISPR/Cas9-induced homology-dependent and independent DNA repair.

PubMed

He, Xiangjun; Tan, Chunlai; Wang, Feng; Wang, Yaofeng; Zhou, Rui; Cui, Dexuan; You, Wenxing; Zhao, Hui; Ren, Jianwei; Feng, Bo

2016-05-19

CRISPR/Cas9-induced site-specific DNA double-strand breaks (DSBs) can be repaired by homology-directed repair (HDR) or non-homologous end joining (NHEJ) pathways. Extensive efforts have been made to knock-in exogenous DNA to a selected genomic locus in human cells; which, however, has focused on HDR-based strategies and was proven inefficient. Here, we report that NHEJ pathway mediates efficient rejoining of genome and plasmids following CRISPR/Cas9-induced DNA DSBs, and promotes high-efficiency DNA integration in various human cell types. With this homology-independent knock-in strategy, integration of a 4.6 kb promoterless ires-eGFP fragment into the GAPDH locus yielded up to 20% GFP+ cells in somatic LO2 cells, and 1.70% GFP+ cells in human embryonic stem cells (ESCs). Quantitative comparison further demonstrated that the NHEJ-based knock-in is more efficient than HDR-mediated gene targeting in all human cell types examined. These data support that CRISPR/Cas9-induced NHEJ provides a valuable new path for efficient genome editing in human ESCs and somatic cells. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

SU-F-P-42: “To Navigate, Or Not to Navigate: HDR BT in Recurrent Spine Lesions”

DOE Office of Scientific and Technical Information (OSTI.GOV)

Voros, L; Cohen, G; Zaider, M

Purpose: We compare the accuracy of HDR catheter placement for paraspinal lesions using O-arm CBCT imaging combined with StealthStation navigation and traditional fluoroscopically guided catheter placement. Methods: CT and MRI scans were acquired pre-treatment to outline the lesions and design treatment plans (pre-plans) to meet dosimetric constrains. The pre-planned catheter trajectories were transferred into the StealthStation Navigation system prior to the surgery. The StealthStation is an infra red (IR) optical navigation system used for guidance of surgical instruments. An intraoperative CBCT scan (O-arm) was acquired with reference IR optical fiducials anchored onto the patient and registered with the preplan imagemore » study to guide surgical instruments in relation to the patients’ anatomy and to place the brachytherapy catheters along the pre-planned trajectories. The final treatment plan was generated based on a 2nd intraoperative CBCT scan reflecting achieved implant geometry. The 2nd CBCT was later registered with the initial CT scan to compare the preplanned dwell positions with actual dwell positions (catheter placements). Similar workflow was used in placement of 8 catheters (1 patient) without navigation, but under fluoroscopy guidance in an interventional radiology suite. Results: A total of 18 catheters (3 patients) were placed using navigation assisted surgery. Average displacement of 0.66 cm (STD=0.37cm) was observed between the pre-plan source positions and actual source positions in the 3 dimensional space. This translates into an average 0.38 cm positioning error in one direction including registration errors, digitization errors, and the surgeons ability to follow the planned trajectory. In comparison, average displacement of non-navigated catheters was 0.50 cm (STD=0.22cm). Conclusion: Spinal lesion HDR brachytherapy planning is a difficult task. Catheter placement has a direct impact on target coverage and dose to critical structures. While limited to a handful of patients, our experience shows navigation and fluoroscopy guided placement yield similar results.« less

SU-E-T-315: Planning and Verification of CT-Based HDR Intraluminal Brachytherapy Treatment for Malignant Obstructive Jaundice.

PubMed

Svoboda, A; Lo, Y; Sheu, R; Dumane, V; Rosenzweig, K

2012-06-01

To present our experience using CT to plan and verify intraluminal HDR treatment for a patient with obstructive jaundice. Due to the obstruction's proximity to the small bowel, along with small bowel adhesions from past surgical history, it was imperative to verify source position relative to the bowel before each treatment. Treatment was administered to a total dose of 2000cGy in 5 fractions via a 6F intraluminal catheter inserted into the patient's 14F percutaneous drainage catheter. Graduations on the intraluminal catheter were used to measure the exact length of catheter inserted in to the patient's drainage tube allowing reproducibility. Dummy seeds inserted during CT were identified by iteratively aligning the planning system's 3D reconstruction axis to the catheter at multiple points as it snaked through the liver. Taking in to account the known offset between actual dwell positions and dummy source positions, we determined what dwell positions to activate for planning. CT verification was performed prior to each treatment to insure that the drainage catheter had not moved and that the distance from treatment site to small bowel was adequate. Dummy seeds and anatomical landmarks were identified on the scout image and correlated to the CT. Verification CTs showed remarkable consistency in the day-to-day drainage catheter position. The physician was able to easily identify the small bowel of concern on the CT and determine if a safe distance existed for treatment. The method outlined in this work provides a safe means by which to treat bile duct obstructions using HDR when critical structures are nearby. We were prepared to make real-time adjustments to our treatment plan to account for significant variation, but found it unnecessary to do so in this particular case. © 2012 American Association of Physicists in Medicine.

SU-G-201-07: Dosimetric Verification of a 3D Printed HDR Skin Brachytherapy Applicator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rasmussen, K; Stanley, D; Eng, T

Purpose: The use of radiation as a treatment modality for skin cancer has increased significantly over the last decade with standardized applicators. Utilizing 3D printing, the ability to make applicators specifically designed for each patient’s anatomy has become economically feasible. With this in mind it was the aim of this study to determine the dosimetric accuracy of a 3-D printed HDR brachytherapy applicator for the skin. Methods: A CT reference image was used to generate a custom applicator based on an anthropomorphic head and neck phantom. To create the applicator a 1cm expansion anteriorly with 0.5cmX0.5cm trenches on the outermore » surface that were spaced 1cm sup-inf to accommodate standard 6F flexible catheters. The applicator was printed using PLA material using a printrbot simple printer. A treatment plan optimized to deliver a clinically representative volume was created in Oncentra and delivered with a nucletron afterloader. Measurements were made using TLDs and EBT3 gafchromic film that were placed between the applicator and the phantom’s forehead. An additional piece of film was also used to qualitatively asses the dose distribution in the transverse plane. Using a standard vaginal cylinder and bolus, a standardized curve correlating TLD and film exposure-to-radiation dose was established by irradiating film to known doses (200,500,700 cGy) at a 3.5 cm radius distance. Results: Evaluated TLDs showed the absolute dose delivered to the skin surface using the 3-D printed bolus was 615cGy±6%, with a mean predicted TPS value in the measured area of 617.5±7%. Additionally, planar dose distributions had good qualitative agreement with calculated TPS isodoses. Conclusion: This work demonstrates patient specific 3-D printed HDR brachytherapy applicators for skin cancer treatments are practical and accurate in TPS calculations but additional measurements are needed to verify additional sites and dose at depth.« less

Small molecules enhance CRISPR genome editing in pluripotent stem cells.

PubMed

Yu, Chen; Liu, Yanxia; Ma, Tianhua; Liu, Kai; Xu, Shaohua; Zhang, Yu; Liu, Honglei; La Russa, Marie; Xie, Min; Ding, Sheng; Qi, Lei S

2015-02-05

The bacterial CRISPR-Cas9 system has emerged as an effective tool for sequence-specific gene knockout through non-homologous end joining (NHEJ), but it remains inefficient for precise editing of genome sequences. Here we develop a reporter-based screening approach for high-throughput identification of chemical compounds that can modulate precise genome editing through homology-directed repair (HDR). Using our screening method, we have identified small molecules that can enhance CRISPR-mediated HDR efficiency, 3-fold for large fragment insertions and 9-fold for point mutations. Interestingly, we have also observed that a small molecule that inhibits HDR can enhance frame shift insertion and deletion (indel) mutations mediated by NHEJ. The identified small molecules function robustly in diverse cell types with minimal toxicity. The use of small molecules provides a simple and effective strategy to enhance precise genome engineering applications and facilitates the study of DNA repair mechanisms in mammalian cells. Copyright © 2015 Elsevier Inc. All rights reserved.

Design and testing of a phantom and instrumented gynecological applicator based on GaN dosimeter for use in high dose rate brachytherapy quality assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guiral, P.; Ribouton, J.; Jalade, P.

Purpose: High dose rate brachytherapy (HDR-BT) is widely used to treat gynecologic, anal, prostate, head, neck, and breast cancers. These treatments are typically administered in large dose per fraction (>5 Gy) and with high-gradient-dose-distributions, with serious consequences in case of a treatment delivery error (e.g., on dwell position and dwell time). Thus, quality assurance (QA) or quality control (QC) should be systematically and independently implemented. This paper describes the design and testing of a phantom and an instrumented gynecological applicator for pretreatment QA and in vivo QC, respectively. Methods: The authors have designed a HDR-BT phantom equipped with four GaN-basedmore » dosimeters. The authors have also instrumented a commercial multichannel HDR-BT gynecological applicator by rigid incorporation of four GaN-based dosimeters in four channels. Specific methods based on the four GaN dosimeter responses are proposed for accurate determination of dwell time and dwell position inside phantom or applicator. The phantom and the applicator have been tested for HDR-BT QA in routine over two different periods: 29 and 15 days, respectively. Measurements in dwell position and time are compared to the treatment plan. A modified position–time gamma index is used to monitor the quality of treatment delivery. Results: The HDR-BT phantom and the instrumented applicator have been used to determine more than 900 dwell positions over the different testing periods. The errors between the planned and measured dwell positions are 0.11 ± 0.70 mm (1σ) and 0.01 ± 0.42 mm (1σ), with the phantom and the applicator, respectively. The dwell time errors for these positions do not exhibit significant bias, with a standard deviation of less than 100 ms for both systems. The modified position–time gamma index sets a threshold, determining whether the treatment run passes or fails. The error detectability of their systems has been evaluated through tests on intentionally introduced error protocols. With a detection threshold of 0.7 mm, the error detection rate on dwell position is 22% at 0.5 mm, 96% at 1 mm, and 100% at and beyond 1.5 mm. On dwell time with a dwell time threshold of 0.1 s, it is 90% at 0.2 s and 100% at and beyond 0.3 s. Conclusions: The proposed HDR-BT phantom and instrumented applicator have been tested and their main characteristics have been evaluated. These systems perform unsupervised measurements and analysis without prior treatment plan information. They allow independent verification of dwell position and time with accuracy of measurements comparable with other similar systems reported in the literature.« less

Time to PSA rise differentiates the PSA bounce after HDR and LDR brachytherapy of prostate cancer

PubMed Central

Skowronek, Janusz

2018-01-01

Purpose To investigate the differences in prostate-specific antigen (PSA) bounce (PB) after high-dose-rate (HDR-BT) or low-dose-rate (LDR-BT) brachytherapy alone in prostate cancer patients. Materials and methods Ninety-four patients with localized prostate cancer (T1-T2cN0), age ranged 50-81 years, were treated with brachytherapy alone between 2008 and 2010. Patients were diagnosed with adenocarcinoma, Gleason score ≤ 7. The LDR-BT total dose was 144-145 Gy, in HDR-BT – 3 fractions of 10.5 or 15 Gy. The initial PSA level (iPSA) was assessed before treatment, then PSA was rated every 3 months over the first 2 years, and every 6 months during the next 3 years. Median follow-up was 3.0 years. Results Mean iPSA was 7.8 ng/ml. In 58 cases, PSA decreased gradually without PB or biochemical failure (BF). In 24% of patients, PB was observed. In 23 cases (24%), PB was observed using 0.2 ng/ml definition; in 10 cases (11%), BF was diagnosed using nadir + 2 ng/ml definition. The HDR-BT and LDR-BT techniques were not associated with higher level of PB (26 vs. 22%, p = 0.497). Time to the first PSA rise finished with PB was significantly shorter after HDR-BT then after LDR-BT (median, 10.5 vs. 18.0 months) during follow-up. Predictors for PB were observed only after HDR-BT. Androgen deprivation therapy (ADT) and higher Gleason score decreased the risk of PB (HR = 0.11, p = 0.03; HR = 0.51, p = 0.01). The higher PSA nadir and longer time to PSA nadir increased the risk of PB (HR 3.46, p = 0.02; HR 1.04, p = 0.04). There was no predictors for PB after LDR-BT. Conclusions HDR-BT and LDR-BT for low and intermediate risk prostate cancer had similar PB rate. The PB occurred earlier after HDR-BT than after LDR-BT. ADT and higher Gleason score decreased, and higher PSA nadir and longer time to PSA nadir increased the risk of PB after HDR-BT. PMID:29619050

Time to PSA rise differentiates the PSA bounce after HDR and LDR brachytherapy of prostate cancer.

PubMed

Burchardt, Wojciech; Skowronek, Janusz

2018-02-01

To investigate the differences in prostate-specific antigen (PSA) bounce (PB) after high-dose-rate (HDR-BT) or low-dose-rate (LDR-BT) brachytherapy alone in prostate cancer patients. Ninety-four patients with localized prostate cancer (T1-T2cN0), age ranged 50-81 years, were treated with brachytherapy alone between 2008 and 2010. Patients were diagnosed with adenocarcinoma, Gleason score ≤ 7. The LDR-BT total dose was 144-145 Gy, in HDR-BT - 3 fractions of 10.5 or 15 Gy. The initial PSA level (iPSA) was assessed before treatment, then PSA was rated every 3 months over the first 2 years, and every 6 months during the next 3 years. Median follow-up was 3.0 years. Mean iPSA was 7.8 ng/ml. In 58 cases, PSA decreased gradually without PB or biochemical failure (BF). In 24% of patients, PB was observed. In 23 cases (24%), PB was observed using 0.2 ng/ml definition; in 10 cases (11%), BF was diagnosed using nadir + 2 ng/ml definition. The HDR-BT and LDR-BT techniques were not associated with higher level of PB (26 vs. 22%, p = 0.497). Time to the first PSA rise finished with PB was significantly shorter after HDR-BT then after LDR-BT (median, 10.5 vs. 18.0 months) during follow-up. Predictors for PB were observed only after HDR-BT. Androgen deprivation therapy (ADT) and higher Gleason score decreased the risk of PB (HR = 0.11, p = 0.03; HR = 0.51, p = 0.01). The higher PSA nadir and longer time to PSA nadir increased the risk of PB (HR 3.46, p = 0.02; HR 1.04, p = 0.04). There was no predictors for PB after LDR-BT. HDR-BT and LDR-BT for low and intermediate risk prostate cancer had similar PB rate. The PB occurred earlier after HDR-BT than after LDR-BT. ADT and higher Gleason score decreased, and higher PSA nadir and longer time to PSA nadir increased the risk of PB after HDR-BT.

A dosimetric comparison of {sup 169}Yb versus {sup 192}Ir for HDR prostate brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lymperopoulou, G.; Papagiannis, P.; Sakelliou, L.

2005-12-15

For the purpose of evaluating the use of {sup 169}Yb for prostate High Dose Rate brachytherapy (HDR), a hypothetical {sup 169}Yb source is assumed with the exact same design of the new microSelectron source replacing the {sup 192}Ir active core by pure {sup 169}Yb metal. Monte Carlo simulation is employed for the full dosimetric characterization of both sources and results are compared following the AAPM TG-43 dosimetric formalism. Monte Carlo calculated dosimetry results are incorporated in a commercially available treatment planning system (SWIFT{sup TM}), which features an inverse treatment planning option based on a multiobjective dose optimization engine. The qualitymore » of prostate HDR brachytherapy using the real {sup 192}Ir and hypothetical {sup 169}Yb source is compared in a comprehensive analysis of different prostate implants in terms of the multiobjective dose optimization solutions as well as treatment quality indices such as Dose Volume Histograms (DVH) and the Conformal Index (COIN). Given that scattering overcompensates for absorption in intermediate photon energies and distances in the range of interest to prostate HDR brachytherapy, {sup 169}Yb proves at least equivalent to {sup 192}Ir irrespective of prostate volume. This has to be evaluated in view of the shielding requirements for the {sup 169}Yb energies that are minimal relative to that for {sup 192}Ir.« less

Risk assessment in ginecology and obstetrics in Sicily: an approach based on Wolff's Criteria.

PubMed

Matranga, D; Marsala, M G L; Vadalà, M; Morici, M; Restivo, V; Ferrara, C; Vitale, F; Firenze, A

2013-01-01

To apply Wolff's Criteria to hospital discharge records (HDR) in order to detect adverse events worthy of further study. Gynecology and Obstetrics Units of three Sicilian hospitals were considered and HDR regarding ordinary and day hospital admissions in 2008 were collected. A matched case-control study was designed, by random selection of 10 controls at maximum for each case. Matching was performed on the variables age and speciality of admission (gynecology or obstetrics). Out of a total of 7011 HDR examined, 114 cases were identified with Wolff's Criteria. Multivariate analysis confirmed a statistically significant association with the origin of admission, diagnosis at the acceptance and length of stay: there was a decreased risk of Wolff's event in patients having urgent admission compared to elective (OR = 0.47, 95% CI = [0.28-0.78]), an increased risk in patients reporting tumor (OR = 5:41, 95 % CI [1.89-15.47]) and other causes (OR = 2.16, 95% CI [1.10-4.24]) compared to delivery diagnosis at acceptance and in patients whose length of stay was more than 6 days (OR = 23.17, 95% CI = [12.56-42.7]) compared to less or equal than 3 days Wolff's Criteria can be applied for the analysis of clinical risk in hospitals with different structural characteristics, on condition that the HDR database is complete and good quality.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schindel, Joshua; Muruganandham, Manickam; Pigge, F. Christopher

Purpose: To present a novel marker-flange, addressing source-reconstruction uncertainties due to the artifacts of a titanium intracavitary applicator used for magnetic resonance imaging (MRI)-guided high-dose-rate (HDR) brachytherapy (BT); and to evaluate 7 different MRI marker agents used for interstitial prostate BT and intracavitary gynecologic HDR BT when treatment plans are guided by MRI. Methods and Materials: Seven MRI marker agents were analyzed: saline solution, Conray-60, copper sulfate (CuSO{sub 4}) (1.5 g/L), liquid vitamin E, fish oil, 1% agarose gel (1 g agarose powder per 100 mL distilled water), and a cobalt–chloride complex contrast (C4) (CoCl{sub 2}/glycine = 4:1). A plastic,more » ring-shaped marker-flange was designed and tested on both titanium and plastic applicators. Three separate phantoms were designed to test the marker-flange, interstitial catheters for prostate BT, and intracavitary catheters for gynecologic HDR BT. T1- and T2-weighted MRI were analyzed for all markers in each phantom and quantified as percentages compared with a 3% agarose gel background. The geometric accuracy of the MR signal for the marker-flange was measured using an MRI-CT fusion. Results: The CuSO{sub 4} and C4 markers on T1-weighted MRI and saline on T2-weighted MRI showed the highest signals. The marker-flange showed hyper-signals of >500% with CuSO{sub 4} and C4 on T1-weighted MRI and of >400% with saline on T2-weighted MRI on titanium applicators. On T1-weighted MRI, the MRI signal inaccuracies of marker-flanges were measured <2 mm, regardless of marker agents, and that of CuSO{sub 4} was 0.42 ± 0.14 mm. Conclusion: The use of interstitial/intracavitary markers for MRI-guided prostate/gynecologic BT was observed to be feasible, providing accurate source pathway reconstruction. The novel marker-flange can produce extremely intense, accurate signals, demonstrating its feasibility for gynecologic HDR BT.« less

'Cold shock' increases the frequency of homology directed repair gene editing in induced pluripotent stem cells.

PubMed

Guo, Q; Mintier, G; Ma-Edmonds, M; Storton, D; Wang, X; Xiao, X; Kienzle, B; Zhao, D; Feder, John N

2018-02-01

Using CRISPR/Cas9 delivered as a RNA modality in conjunction with a lipid specifically formulated for large RNA molecules, we demonstrate that homology directed repair (HDR) rates between 20-40% can be achieved in induced pluripotent stem cells (iPSC). Furthermore, low HDR rates (between 1-20%) can be enhanced two- to ten-fold in both iPSCs and HEK293 cells by 'cold shocking' cells at 32 °C for 24-48 hours following transfection. This method can also increases the proportion of loci that have undergone complete sequence conversion across the donor sequence, or 'perfect HDR', as opposed to partial sequence conversion where nucleotides more distal to the CRISPR cut site are less efficiently incorporated ('partial HDR'). We demonstrate that the structure of the single-stranded DNA oligo donor can influence the fidelity of HDR, with oligos symmetric with respect to the CRISPR cleavage site and complementary to the target strand being more efficient at directing 'perfect HDR' compared to asymmetric non-target strand complementary oligos. Our protocol represents an efficient method for making CRISPR-mediated, specific DNA sequence changes within the genome that will facilitate the rapid generation of genetic models of human disease in iPSCs as well as other genome engineered cell lines.

Vaginal Dose Is Associated With Toxicity in Image Guided Tandem Ring or Ovoid-Based Brachytherapy.

PubMed

Susko, Matthew; Craciunescu, Oana; Meltsner, Sheridan; Yang, Yun; Steffey, Beverly; Cai, Jing; Chino, Junzo

2016-04-01

To calculate vaginal doses during image guided brachytherapy with volume-based metrics and correlate with long-term vaginal toxicity. In this institutional review board-approved study, institutional databases were searched to identify women undergoing computed tomography and/or magnetic resonance-guided brachytherapy at the Duke Cancer Center from 2009 to 2015. All insertions were contoured to include the vagina as a 3-dimensional structure. All contouring was performed on computed tomography or magnetic resonance imaging and used a 0.4-cm fixed brush to outline the applicator and/or packing, expanded to include any grossly visible vagina. The surface of the cervix was specifically excluded from the contour. High-dose-rate (HDR) and low-dose-rate (LDR) doses were converted to the equivalent dose in 2-Gy fractions using an α/β of 3 for late effects. The parameters D0.1cc, D1cc, and D2cc were calculated for all insertions and summed with prior external beam therapy. Late and subacute toxicity to the vagina were determined by the Common Terminology Criteria for Adverse Events version 4.0 and compared by the median and 4th quartile doses, via the log-rank test. Univariate and multivariate hazard ratios were calculated via Cox regression. A total of 258 insertions in 62 women who underwent definitive radiation therapy including brachytherapy for cervical (n=48) and uterine cancer (n=14) were identified. Twenty HDR tandem and ovoid, 32 HDR tandem and ring, and 10 LDR tandem and ovoid insertions were contoured. The median values (interquartile ranges) for vaginal D0.1cc, D1cc, and D2cc were 157.9 (134.4-196.53) Gy, 112.6 (96.7-124.6) Gy, and 100.5 (86.8-108.4) Gy, respectively. At the 4th quartile cutoff of 108 Gy for D2cc, the rate of late grade 1 toxicity at 2 years was 61.2% (95% confidence interval [CI] 43.0%-79.4%) below 108 Gy and 83.9% (63.9%-100%) above (P=.018); grade 2 or greater toxicity was 36.2% (95% CI 15.8%-56.6%) below 108 Gy and 70.7% (95% CI 45.2%-96.2%) above (P=.004); and grade 3 or worse toxicity was 9.9% (95% CI 0.0%-23.6%) below 108 Gy and 30.0% (95% CI 4.7%-55.3%) above (P=.025). This association was maintained on multivariate analysis, independent of covariates such as applicator type, age, and dose rate. Vaginal dose was associated with all grades of vaginal toxicity. Confirmation at other sites using this methodology will be necessary to establish reproducibility; however, the integration of routine calculation of vaginal dose may be warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

[Comparison between administrative and clinical databases in the evaluation of cardiac surgery performance].

PubMed

Rosato, Stefano; D'Errigo, Paola; Badoni, Gabriella; Fusco, Danilo; Perucci, Carlo A; Seccareccia, Fulvia

2008-08-01

The availability of two contemporary sources of information about coronary artery bypass graft (CABG) interventions, allowed 1) to verify the feasibility of performing outcome evaluation studies using administrative data sources, and 2) to compare hospital performance obtainable using the CABG Project clinical database with hospital performance derived from the use of current administrative data. Interventions recorded in the CABG Project were linked to the hospital discharge record (HDR) administrative database. Only the linked records were considered for subsequent analyses (46% of the total CABG Project). A new selected population "clinical card-HDR" was then defined. Two independent risk-adjustment models were applied, each of them using information derived from one of the two different sources. Then, HDR information was supplemented with some patient preoperative conditions from the CABG clinical database. The two models were compared in terms of their adaptability to data. Hospital performances identified by the two different models and significantly different from the mean was compared. In only 4 of the 13 hospitals considered for analysis, the results obtained using the HDR model did not completely overlap with those obtained by the CABG model. When comparing statistical parameters of the HDR model and the HDR model + patient preoperative conditions, the latter showed the best adaptability to data. In this "clinical card-HDR" population, hospital performance assessment obtained using information from the clinical database is similar to that derived from the use of current administrative data. However, when risk-adjustment models built on administrative databases are supplemented with a few clinical variables, their statistical parameters improve and hospital performance assessment becomes more accurate.

Dose and dose rate effects of whole-body gamma-irradiation: I. Lymphocytes and lymphoid organs

NASA Technical Reports Server (NTRS)

Pecaut, M. J.; Nelson, G. A.; Gridley, D. S.

2001-01-01

The major goal of part I of this study was to compare varying doses and dose rates of whole-body gamma-radiation on lymphoid cells and organs. C57BL/6 mice (n = 75) were exposed to 0, 0.5, 1.5, and 3.0 Gy gamma-rays (60Co) at 1 cGy/min (low-dose rate, LDR) and 80 cGy/min (high-dose rate, HDR) and euthanized 4 days later. A significant dose-dependent loss of spleen mass was observed with both LDR and HDR irradiation; for the thymus this was true only with HDR. Decreasing leukocyte and lymphocyte numbers occurred with increasing dose in blood and spleen at both dose rates. The numbers (not percentages) of CD3+ T lymphocytes decreased in the blood in a dose-dependent manner at both HDR and LDR. Splenic T cell counts decreased with dose only in HDR groups; percentages increased with dose at both dose rates. Dose-dependent decreases occurred in CD4+ T helper and CD8+ T cytotoxic cell counts at HDR and LDR. In the blood the percentages of CD4+ cells increased with increasing dose at both dose rates, whereas in the spleen the counts decreased only in the HDR groups. The percentages of the CD8+ population remained stable in both blood and spleen. CD19+ B cell counts and percentages in both compartments declined markedly with increasing HDR and LDR radiation. NK1.1+ natural killer cell numbers and proportions remained relatively stable. Overall, these data indicate that the observed changes were highly dependent on the dose, but not dose rate, and that cells in the spleen are more affected by dose rate than those in blood. The results also suggest that the response of lymphocytes in different body compartments may be variable.

Modelling second malignancy risks from low dose rate and high dose rate brachytherapy as monotherapy for localised prostate cancer.

PubMed

Murray, Louise; Mason, Joshua; Henry, Ann M; Hoskin, Peter; Siebert, Frank-Andre; Venselaar, Jack; Bownes, Peter

2016-08-01

To estimate the risks of radiation-induced rectal and bladder cancers following low dose rate (LDR) and high dose rate (HDR) brachytherapy as monotherapy for localised prostate cancer and compare to external beam radiotherapy techniques. LDR and HDR brachytherapy monotherapy plans were generated for three prostate CT datasets. Second cancer risks were assessed using Schneider's concept of organ equivalent dose. LDR risks were assessed according to a mechanistic model and a bell-shaped model. HDR risks were assessed according to a bell-shaped model. Relative risks and excess absolute risks were estimated and compared to external beam techniques. Excess absolute risks of second rectal or bladder cancer were low for both LDR (irrespective of the model used for calculation) and HDR techniques. Average excess absolute risks of rectal cancer for LDR brachytherapy according to the mechanistic model were 0.71 per 10,000 person-years (PY) and 0.84 per 10,000 PY respectively, and according to the bell-shaped model, were 0.47 and 0.78 per 10,000 PY respectively. For HDR, the average excess absolute risks for second rectal and bladder cancers were 0.74 and 1.62 per 10,000 PY respectively. The absolute differences between techniques were very low and clinically irrelevant. Compared to external beam prostate radiotherapy techniques, LDR and HDR brachytherapy resulted in the lowest risks of second rectal and bladder cancer. This study shows both LDR and HDR brachytherapy monotherapy result in low estimated risks of radiation-induced rectal and bladder cancer. LDR resulted in lower bladder cancer risks than HDR, and lower or similar risks of rectal cancer. In absolute terms these differences between techniques were very small. Compared to external beam techniques, second rectal and bladder cancer risks were lowest for brachytherapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A dosimetric analysis of intensity-modulated radiation therapy (IMRT) as an alternative to adjuvant high-dose-rate (HDR) brachytherapy in early endometrial cancer patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aydogan, Bulent; Mundt, Arno J.; Department of Radiation Oncology, University of Illinois at Chicago, Chicago, IL

2006-05-01

Purpose: To evaluate the role of intensity-modulated radiation treatment (IMRT) as an alternative to high-dose-rate (HDR) brachytherapy in the treatment of the vagina in postoperative early endometrial cancer patients after surgery. Methods and Materials: Planning computed tomography (CT) scans of 10 patients previously treated with HDR were used in this study. In all cases, a dose of 700 cGy/fraction was prescribed at a distance of 0.5 cm from the cylinder surface. The same CT scans were then used in IMRT planning. In this paradigm, the vaginal cylinder represents a component of a hypothetical immobilization system that would be indexed tomore » the linac treatment table. Results: Our study showed that IMRT provided relatively lower rectal doses than HDR when treatment was prescribed at a distance of 0.5 cm away from the cylinder surface. Maximum rectal doses were lower with IMRT compared with HDR (average: 89.0% vs. 142.6%, respectively, p < 0.05). Moreover, the mean rectal dose was lower in IMRT plans compared with HDR plans with treatment prescribed either to the surface (average: 14.8% vs. 21.4%, respectively, p < 0.05) or to 0.5 cm (average: 19.6% vs. 33.5%, respectively, p < 0.05). IMRT plans had planning target volume (PTV) coverage comparable with HDR (average PTV minimum for treatment prescribed to 0.5 cm: 93.9% vs. 92.1%, p = 0.71, respectively) with less inhomogeneity (average PTV maximum: 110.8% vs. 381.6%, p < 0.05). Conclusion: Our dosimetric analysis suggests that when used in conjunction with a suitable immobilization system, IMRT may provide an alternative to HDR brachytherapy in women with early endometrial cancer after hysterectomy. However, more studies are needed to evaluate the clinical merit of the IMRT in these patients.« less

Interfraction patient motion and implant displacement in prostate high dose rate brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fox, C. D.; Kron, T.; Leahy, M.

Purpose: To quantify movement of prostate cancer patients undergoing treatment, using an in-house developed motion sensor in order to determine a relationship between patient movement and high dose rate (HDR) brachytherapy implant displacement. Methods: An electronic motion sensor was developed based on a three axis accelerometer. HDR brachytherapy treatment for prostate is delivered at this institution in two fractions 24 h apart and 22 patients were monitored for movement over the interval between fractions. The motion sensors functioned as inclinometers, monitoring inclination of both thighs, and the inclination and roll of the abdomen. The implanted HDR brachytherapy catheter set wasmore » assessed for displacement relative to fiducial markers in the prostate. Angle measurements and angle differences over a 2 s time base were binned, and the standard deviations of the resulting frequency distributions used as a metric for patient motion in each monitored axis. These parameters were correlated to measured catheter displacement using regression modeling. Results: The mean implant displacement was 12.6 mm in the caudal direction. A mean of 19.95 h data was recorded for the patient cohort. Patients generally moved through a limited range of angles with a mean of the exception of two patients who spent in excess of 2 h lying on their side. When tested for a relationship between movement in any of the four monitored axes and the implant displacement, none was significant. Conclusions: It is not likely that patient movement influences HDR prostate implant displacement. There may be benefits to patient comfort if nursing protocols were relaxed to allow patients greater freedom to move while the implant is in situ.« less

In vivo urethral dose measurements: a method to verify high dose rate prostate treatments.

PubMed

Brezovich, I A; Duan, J; Pareek, P N; Fiveash, J; Ezekiel, M

2000-10-01

Radiation doses delivered in high dose rate (HDR) brachytherapy are susceptible to many inaccuracies and errors, including imaging, planning and delivery. Consequently, the dose delivered to the patient may deviate substantially from the treatment plan. We investigated the feasibility of using TLD measurements in the urethra to estimate the discrepancy in treatments for prostate cancer. The dose response of the 1 mm diam, 6 mm long LiF rods that we used for the in vivo measurements was calibrated with the 192Ir HDR source, as well as a 60Co teletherapy unit. A train of 20 rods contained in a sterile plastic tube was inserted into the urethral (Foley) catheter for the duration of a treatment fraction, and the measured doses were compared to the treatment plan. Initial results from a total of seven treatments in four patients show good agreement between theory and experiment. Analysis of any one treatment showed agreement within 11.7% +/- 6.2% for the highest dose encountered in the central prostatic urethra, and within 10.4% +/- 4.4% for the mean dose. Taking the average over all seven treatments shows agreement within 1.7% for the maximum urethral dose, and within 1.5% for the mean urethral dose. Based on these initial findings it seems that planned prostate doses can be accurately reproduced in the clinic.

The dorso-lateral recess of the hypothalamic ventricle in neonatal rats.

PubMed

Menéndez, A; Alvarez-Uría, M

1987-10-01

Light and electron microscopy of the hypothalamic ventricle in neonatal rats demonstrate morphological specializations of the ventricular wall at the level of the premammillary region of the third ventricle. The morphological features are: (1) A ventricular recess that we have called the "hypothalamic dorso-lateral recess" (HDR). (2) The presence of intraventricular capillaries near the dorso-lateral recess. (3) The HDR possessing a specialized ependymal lining; this consists of non-ciliated cells with short microvilli and bleb-like processes. (4) The existence of cerebrospinal fluid-contacting neurons within the HDR. (5) The presence of numerous phagocytic supraependymal cells. The HDR is not found in adult rats. This indicates that the dorso-lateral recess may play a physiological role during development.

High-dose-rate intraoperative radiation therapy: the nuts and bolts of starting a program

PubMed Central

Moningi, Shalini; Armour, Elwood P.; Terezakis, Stephanie A.; Efron, Jonathan E.; Gearhart, Susan L.; Bivalacqua, Trinity J.; Kumar, Rachit; Le, Yi; Kien Ng, Sook; Wolfgang, Christopher L.; Zellars, Richard C.; Ellsworth, Susannah G.; Ahuja, Nita

2014-01-01

High-dose-rate intraoperative radiation therapy (HDR-IORT) has historically provided effective local control (LC) for patients with unresectable and recurrent tumors. However, IORT is limited to only a few specialized institutions and it can be difficult to initiate an HDR-IORT program. Herein, we provide a brief overview on how to initiate and implement an HDR-IORT program for a selected group of patients with gastrointestinal and pelvic solid tumors using a multidisciplinary approach. Proper administration of HDR-IORT requires institutional support and a joint effort among physics staff, oncologists, surgeons, anesthesiologists, and nurses. In order to determine the true efficacy of IORT for various malignancies, collaboration among institutions with established IORT programs is needed. PMID:24790628

MO-AB-BRA-03: Development of Novel Real Time in Vivo EPID Treatment Verification for Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fonseca, G; Podesta, M; Reniers, B

2016-06-15

Purpose: High Dose Rate (HDR) brachytherapy treatments are employed worldwide to treat a wide variety of cancers. However, in vivo dose verification remains a challenge with no commercial dosimetry system available to verify the treatment dose delivered to the patient. We propose a novel dosimetry system that couples an independent Monte Carlo (MC) simulation platform and an amorphous silicon Electronic Portal Imaging Device (EPID) to provide real time treatment verification. Methods: MC calculations predict the EPID response to the photon fluence emitted by the HDR source by simulating the patient, the source dwell positions and times, and treatment complexities suchmore » as tissue compositions/densities and different applicators. Simulated results are then compared against EPID measurements acquired with ∼0.14s time resolution which allows dose measurements for each dwell position. The EPID has been calibrated using an Ir-192 HDR source and experiments were performed using different phantoms, including tissue equivalent materials (PMMA, lung and bone). A source positioning accuracy of 0.2 mm, without including the afterloader uncertainty, was ensured using a robotic arm moving the source. Results: An EPID can acquire 3D Cartesian source positions and its response varies significantly due to differences in the material composition/density of the irradiated object, allowing detection of changes in patient geometry. The panel time resolution allows dose rate and dwell time measurements. Moreover, predicted EPID images obtained from clinical treatment plans provide anatomical information that can be related to the patient anatomy, mostly bone and air cavities, localizing the source inside of the patient using its anatomy as reference. Conclusion: Results obtained show the feasibility of the proposed dose verification system that is capable to verify all the brachytherapy treatment steps in real time providing data about treatment delivery quality and also applicator/structure motion during or between treatments.« less

Comparison of organ doses for patients undergoing balloon brachytherapy of the breast with HDR 192Ir or electronic sources using Monte Carlo simulations in a heterogeneous human phantom1

PubMed Central

Mille, Matthew M.; Xu, X. George; Rivard, Mark J.

2010-01-01

Purpose: Accelerated partial breast irradiation via interstitial balloon brachytherapy is a fast and effective treatment method for certain early stage breast cancers. The radiation can be delivered using a conventional high-dose rate (HDR) 192Ir gamma-emitting source or a novel electronic brachytherapy (eBx) source which uses lower energy x rays that do not penetrate as far within the patient. A previous study [A. Dickler, M. C. Kirk, N. Seif, K. Griem, K. Dowlatshahi, D. Francescatti, and R. A. Abrams, “A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy,” Brachytherapy 6, 164–168 (2007)] showed that the target dose is similar for HDR 192Ir and eBx. This study compares these sources based on the dose received by healthy organs and tissues away from the treatment site. Methods: A virtual patient with left breast cancer was represented by a whole-body, tissue-heterogeneous female voxel phantom. Monte Carlo methods were used to calculate the dose to healthy organs in a virtual patient undergoing balloon brachytherapy of the left breast with HDR 192Ir or eBx sources. The dose-volume histograms for a few organs which received large doses were also calculated. Additional simulations were performed with all tissues in the phantom defined as water to study the effect of tissue inhomogeneities. Results: For both HDR 192Ir and eBx, the largest mean organ doses were received by the ribs, thymus gland, left lung, heart, and sternum which were close to the brachytherapy source in the left breast. eBx yielded mean healthy organ doses that were more than a factor of ∼1.4 smaller than for HDR 192Ir for all organs considered, except for the three closest ribs. Excluding these ribs, the average and median dose-reduction factors were ∼28 and ∼11, respectively. The volume distribution of doses in nearby soft tissue organs that were outside the PTV were also improved with eBx. However, the maximum dose to the closest rib with the eBx source was 5.4 times greater than that of the HDR 192Ir source. The ratio of tissue-to-water maximum rib dose for the eBx source was ∼5. Conclusions: The results of this study indicate that eBx may offer lower toxicity to most healthy tissues, except nearby bone. TG-43 methods have a tendency to underestimate dose to bone, especially the ribs. Clinical studies evaluating the negative health effects caused by irradiating healthy organs are needed so that physicians can better understand when HDR 192Ir or eBx might best benefit a patient. PMID:20229875

Patterns of brachytherapy practice for patients with carcinoma of the cervix (1996-1999): a patterns of care study.

PubMed

Erickson, Beth; Eifel, Patricia; Moughan, Jennifer; Rownd, Jason; Iarocci, Thomas; Owen, Jean

2005-11-15

To analyze the details of brachytherapy practice in patients treated for carcinoma of the cervix in the United States between 1996 and 1999. Radiation facilities were selected from a stratified random sample. Patients were randomly selected from lists of eligible patients treated at each facility. A total of 442 patients' records were reviewed in 59 facilities to obtain data about patients' characteristics, evaluation, tumor extent, and treatment. National estimates were made using weights that reflected the relative contribution of each institution and of each patient within the sampled institutions. From our survey we estimate that 16,375 patients were treated in the United States during this study period. Unless otherwise specified, brachytherapy practice was based on the 408 patients who had their brachytherapy or all their treatment at the surveyed facility. A total of 91.5% of patients underwent brachytherapy at the initial treating institution; 8.5% were referred to a second site for brachytherapy. Forty-two percent of U.S. facilities referred at least some patients to a second facility for brachytherapy. Of U.S. facilities that treated < or =2 eligible patients per year, 61% referred all of their patients to a second facility for brachytherapy or treated with external RT alone; none of the U.S. facilities with larger experience (>2 eligible patients per year) referred all their patients to a second facility for brachytherapy treatment, but 28% referred some patients to an outside facility for brachytherapy. Overall, 94% of patients who completed treatment with curative intent received brachytherapy. Of these patients who had brachytherapy, 77.8%, 13.3%, and 0.9%, respectively, were treated with low-dose-rate (LDR), high-dose-rate (HDR), or a combination of HDR and LDR brachytherapy; 7.9% had interstitial brachytherapy (5.7% LDR and 1.9% HDR, 0.3% mixed). In facilities that treated >2 patients per year, 15.5% and 9.4% of brachytherapy procedures included HDR or interstitial, respectively; in facilities that treated fewer patients, 3.4% had HDR brachytherapy, and only 1.2% had interstitial brachytherapy. Patients treated with LDR intracavitary radiotherapy had one (23.5%), two (74.1%), or three (2.4%) implants. For patients treated with curative intent who completed radiation therapy with LDR intracavitary radiation therapy without hysterectomy, the median brachytherapy dose to Point A was 40.3 Gy, and the median total dose to Point A was 82.9 Gy. Patients were treated with HDR intracavitary radiation therapy using a variety of treatment schedules using 1-2 fractions (7.5%), 3-4 fractions (17.4%), 5-6 fractions (38.5%), 7-9 fractions (33.5%), or 12 fractions (3%). Fraction sizes were <500 cGy (29.5%), 500-<600 (25.2%), 600 (28.1%), >600 (8%), or unknown (9.2%). For patients treated with HDR, the median total dose to Point A (corrected for fraction size using a alpha/beta = 10) was 85.8 Gy (range: 56.2-116.1 Gy). At institutions treating <500 new patients per year, the percentage of patients receiving a brachytherapy dose <40 Gy was significantly higher than at institutions treating > or =500 new patients per year (p < 0.0001). For LDR intracavitary radiation therapy, 5.8% had neither bladder nor rectal doses recorded for any of their implants, whereas in HDR intracavitary radiation therapy, 73.4% had neither bladder nor rectal doses recorded for any of their implants. The median total duration of radiation therapy was identical for patients who had HDR or LDR intracavitary radiation therapy (57 days). For LDR at institutions treating <500 new patients per year, the percentage of patients with treatment duration >56 days was significantly greater than at institutions > or =500 new patients per year (p = 0.002). Of the patients who had LDR intracavitary radiation therapy implants, 65% were treated using tandem and shielded Fletcher-Suit-Delclos colpostats; other patients had mini ovoids (10.9%), cylinders (3.9%), Henschke (3.7%), or other/mixed applicators (16.5%). In contrast, of patients treated with HDR intracavitary radiation therapy, 68.7% had tandem and rings, 18.2% Fletcher-Suit-Delclos ovoids, 7.5% mini ovoids, 2.3% cylinders, and 3.2% other or mixed applicators. The median duration of treatment and median Point A dose were very similar for patients treated with HDR or LDR. Patients with HDR were treated using a variety of treatment schedules. Different applicator types were favored for LDR vs. HDR. Of patients treated with HDR, 73.4% had no brachytherapy bladder or rectal doses recorded, suggesting that full dosimetric calculations were performed only for the first fraction in many institutions. Facility size significantly impacted on referral to another institution for brachytherapy, brachytherapy dose, and treatment duration.

SU-F-T-36: Dosimetric Comparison of Point Based Vs. Target Based Prescription for Intracavitary Brachytherapy in Cancer of the Cervix

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ashenafi, M; McDonald, D; Peng, J

Purpose: Improved patient imaging used for planning the treatment of cervical cancer with Tandem and Ovoid (T&O) Intracavitary high-dose-rate brachytherapy (HDR) now allows for 3D delineation of target volumes and organs-at-risk. However, historical data relies on the conventional point A-based planning technique. A comparative dosimetric study was performed by generating both target-based (TBP) and point-based (PBP) plans for ten clinical patients. Methods: Treatment plans created using Elekta Oncentra v. 4.3 for ten consecutive cervical cancer patients were analyzed. All patients were treated with HDR using the Utrecht T&O applicator. Both CT and MRI imaging modalities were utilized to delineate clinicalmore » target volume (CTV) and organs-at-risk (rectum, sigmoid, bladder, and small bowel). Point A (left and right), vaginal mucosa, and ICRU rectum and bladder points were defined on CT. Two plans were generated for each patient using two prescription methods (PBP and TBP). 7Gy was prescribed to each point A for each PBP plan and to the target D90% for each TBP plan. Target V90%, V100%, and V200% were evaluated. In addition, D0.1cc and D2cc were analyzed for each organ-at-risk. Differences were assessed for statistical significance (p<0.05) by use of Student’s t-test. Results: Target coverage was comparable for both planning methods, with each method providing adequate target coverage. TBP showed lower absolute dose to the target volume than PBP (D90% = 7.0Gy vs. 7.4Gy, p=0.028), (V200% = 10.9cc vs. 12.8cc, p=0.014), (ALeft = 6.4Gy vs. 7Gy, p=0.009), and (ARight = 6.4Gy vs. 7Gy, p=0.013). TBP also showed a statistically significant reduction in bladder, rectum, small bowel, and sigmoid doses compared to PBP. There was no statistically significant difference in vaginal mucosa or ICRU-defined rectum and bladder dose. Conclusion: Target based prescription resulted in substantially lower dose to delineated organs-at-risk compared to point based prescription, while maintaining similar target coverage.« less

Results of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) in treatment of obstructive endobronchial non-small cell lung cancer

NASA Astrophysics Data System (ADS)

Weinberg, Benjamin D.; Allison, Ron R.; Sibata, Claudio; Parent, Teresa; Downie, Gordon

2009-06-01

We reviewed the outcome of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) for patients with symptomatic obstruction from endobronchial non-small cell lung cancer. Methods: Nine patients who received combined PDT and HDR for endobronchial cancers were identified and their charts reviewed. The patients were eight males and one female aged 52-73 at diagnosis, initially presenting with various stages of disease: stage IA (N=1), stage IIA (N=1), stage III (N=6), and stage IV (N=1). Intervention was with HDR (500 cGy to 5 mm once weekly for 3 weeks) and PDT (2 mg/kg Photofrin, followed by 200 J/cm2 illumination 48 hours post infusion). Treatment group 1 (TG-1, N=7) received HDR first; Treatment group 2 (TG-2, N=2) received PDT first. Patients were followed by regular bronchoscopies. Results: Treatments were well tolerated, all patients completed therapy, and none were lost to follow-up. In TG-1, local tumor control was achieved in six of seven patients for: 3 months (until death), 15 months, 2+ years (until death), 2+ years (ongoing), and 5+ years (ongoing, N=2). In TG-2, local control was achieved in only one patient, for 84 days. Morbidities included: stenosis and/or other reversible benign local tissue reactions (N=8); photosensitivity reaction (N=2), and self-limited pleural effusion (N=2). Conclusions: Combined HDR/PDT treatment for endobronchial tumors is well tolerated and can achieve prolonged local control with acceptable morbidity when PDT follows HDR and when the spacing between treatments is one month or less. This treatment regimen should be studied in a larger patient population.

Interaction of the vestibular system and baroreflexes on sympathetic nerve activity in humans

NASA Technical Reports Server (NTRS)

Ray, C. A.

2000-01-01

Muscle sympathetic nerve activity (MSNA) is altered by vestibular otolith stimulation. This study examined interactive effects of the vestibular system and baroreflexes on MSNA in humans. In study 1, MSNA was measured during 4 min of lower body negative pressure (LBNP) at either -10 or -30 mmHg with subjects in prone posture. During the 3rd min of LBNP, subjects lowered their head over the end of a table (head-down rotation, HDR) to engage the otolith organs. The head was returned to baseline upright position during the 4th min. LBNP increased MSNA above baseline during both trials with greater increases during the -30-mmHg trial. HDR increased MSNA further during the 3rd min of LBNP at -10 and -30 mmHg (Delta32% and Delta34%, respectively; P < 0.01). MSNA returned to pre-HDR levels during the 4th min of LBNP when the head was returned upright. In study 2, MSNA was measured during HDR, LBNP, and simultaneously performed HDR and LBNP. The sum of MSNA responses during individual HDR and LBNP trials was not significantly different from that observed during HDR and LBNP performed together (Delta131 +/- 28 vs. Delta118 +/- 47 units and Delta340 +/- 77 vs. Delta380 +/- 90 units for the -10 and -30 trials, respectively). These results demonstrate that vestibular otolith stimulation can increase MSNA during unloading of the cardiopulmonary and arterial baroreflexes. Also, the interaction between the vestibulosympathetic reflex and baroreflexes is additive in humans. These studies indicate that the vestibulosympathetic reflex may help defend against orthostatic challenges in humans by increasing sympathetic outflow.

Poster — Thur Eve — 40: Automated Quality Assurance for Remote-Afterloading High Dose Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Anthony; Ravi, Ananth

2014-08-15

High dose rate (HDR) remote afterloading brachytherapy involves sending a small, high-activity radioactive source attached to a cable to different positions within a hollow applicator implanted in the patient. It is critical that the source position within the applicator and the dwell time of the source are accurate. Daily quality assurance (QA) tests of the positional and dwell time accuracy are essential to ensure that the accuracy of the remote afterloader is not compromised prior to patient treatment. Our centre has developed an automated, video-based QA system for HDR brachytherapy that is dramatically superior to existing diode or film QAmore » solutions in terms of cost, objectivity, positional accuracy, with additional functionalities such as being able to determine source dwell time and transit time of the source. In our system, a video is taken of the brachytherapy source as it is sent out through a position check ruler, with the source visible through a clear window. Using a proprietary image analysis algorithm, the source position is determined with respect to time as it moves to different positions along the check ruler. The total material cost of the video-based system was under $20, consisting of a commercial webcam and adjustable stand. The accuracy of the position measurement is ±0.2 mm, and the time resolution is 30 msec. Additionally, our system is capable of robustly verifying the source transit time and velocity (a test required by the AAPM and CPQR recommendations), which is currently difficult to perform accurately.« less

Validating Fricke dosimetry for the measurement of absorbed dose to water for HDR 192Ir brachytherapy: a comparison between primary standards of the LCR, Brazil, and the NRC, Canada.

PubMed

Salata, Camila; David, Mariano Gazineu; de Almeida, Carlos Eduardo; El Gamal, Islam; Cojocaru, Claudiu; Mainegra-Hing, Ernesto; McEwen, Malcom

2018-04-05

Two Fricke-based absorbed dose to water standards for HDR Ir-192 dosimetry, developed independently by the LCR in Brazil and the NRC in Canada have been compared. The agreement in the determination of the dose rate from a HDR Ir-192 source at 1 cm in a water phantom was found to be within the k  =  1 combined measurement uncertainties of the two standards: D NRC /D LCR   =  1.011, standard uncertainty  =  2.2%. The dose-based standards also agreed within the uncertainties with the manufacturer's stated dose rate value, which is traceable to a national standard of air kerma. A number of possible influence quantities were investigated, including the specific method for producing the ferrous-sulphate Fricke solution, the geometry of the holder, and the Monte Carlo code used to determine correction factors. The comparison highlighted the lack of data on the determination of G(Fe 3+ ) in this energy range and the possibilities for further development of the holders used to contain the Fricke solution. The comparison also confirmed the suitability of Fricke dosimetry for Ir-192 primary standard dose rate determinations at therapy dose levels.

Validating Fricke dosimetry for the measurement of absorbed dose to water for HDR 192Ir brachytherapy: a comparison between primary standards of the LCR, Brazil, and the NRC, Canada

NASA Astrophysics Data System (ADS)

Salata, Camila; Gazineu David, Mariano; de Almeida, Carlos Eduardo; El Gamal, Islam; Cojocaru, Claudiu; Mainegra-Hing, Ernesto; McEwen, Malcom

2018-04-01

Two Fricke-based absorbed dose to water standards for HDR Ir-192 dosimetry, developed independently by the LCR in Brazil and the NRC in Canada have been compared. The agreement in the determination of the dose rate from a HDR Ir-192 source at 1 cm in a water phantom was found to be within the k  =  1 combined measurement uncertainties of the two standards: D NRC/D LCR  =  1.011, standard uncertainty  =  2.2%. The dose-based standards also agreed within the uncertainties with the manufacturer’s stated dose rate value, which is traceable to a national standard of air kerma. A number of possible influence quantities were investigated, including the specific method for producing the ferrous-sulphate Fricke solution, the geometry of the holder, and the Monte Carlo code used to determine correction factors. The comparison highlighted the lack of data on the determination of G(Fe3+) in this energy range and the possibilities for further development of the holders used to contain the Fricke solution. The comparison also confirmed the suitability of Fricke dosimetry for Ir-192 primary standard dose rate determinations at therapy dose levels.

Validation of a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial HDR brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poulin, Eric; Beaulieu, Luc, E-mail: Luc.Beaulieu@phy.ulaval.ca; Gardi, Lori

Purpose: In current clinical practice, there is no integrated 3D ultrasound (3DUS) guidance system clinically available for breast brachytherapy. In this study, the authors present a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial high dose rate (HDR) brachytherapy treatment. Methods: For this work, a new computer controlled robotic 3DUS system was built to perform a hybrid motion scan, which is a combination of a 6 cm linear translation with a 30° rotation at both ends. The new 3DUS scanner was designed to fit on a modified Kuske assembly, keeping the current template grid configuration butmore » modifying the frame to allow the mounting of the 3DUS system at several positions. A finer grid was also tested. A user interface was developed to perform image reconstruction, semiautomatic segmentation of the surgical bed as well as catheter reconstruction and tracking. A 3D string phantom was used to validate the geometric accuracy of the reconstruction. The volumetric accuracy of the system was validated with phantoms using magnetic resonance imaging (MRI) and computed tomography (CT) images. In order to accurately determine whether 3DUS can effectively replace CT for treatment planning, the authors have compared the 3DUS catheter reconstruction to the one obtained from CT images. In addition, in agarose-based phantoms, an end-to-end procedure was performed by executing six independent complete procedures with both 14 and 16 catheters, and for both standard and finer Kuske grids. Finally, in phantoms, five end-to-end procedures were performed with the final CT planning for the validation of 3DUS preplanning. Results: The 3DUS acquisition time is approximately 10 s. A paired Student t-test showed that there was no statistical significant difference between known and measured values of string separations in each direction. Both MRI and CT volume measurements were not statistically different from 3DUS volume (Student t-test: p > 0.05) and they were significantly correlated to 3DUS measurement (Pearson test: MRI p < 0.05 and CT p < 0.001). The mean angular separation distance between catheter trajectories segmented from 3DUS and CT images was 0.42° ± 0.24°, while the maximum and mean trajectory separations were 0.51 ± 0.19 and 0.37 ± 0.17 mm, respectively. Overall, the new finer grid has performed significantly better in terms of dosimetric indices. The planning target volume dosimetric indices were not found statistically different between 3DUS and CT planning (Student t-test, p > 0.05). Both the skin and the pectoral muscle dosimetric indices were within ABS guidelines. Conclusions: A novel robot-assisted 3DUS system was designed and validated. To their knowledge, this is the first system capable of performing real-time guidance and planning of breast multicatheter HDR brachytherapy treatments. Future investigation will test the feasibility of using the system in the clinic and for permanent breast brachytherapy.« less

SU-E-T-785: Using Systems Engineering to Design HDR Skin Treatment Operation for Small Lesions to Enhance Patient Safety

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saw, C; Baikadi, M; Peters, C

2015-06-15

Purpose: Using systems engineering to design HDR skin treatment operation for small lesions using shielded applicators to enhance patient safety. Methods: Systems engineering is an interdisciplinary field that offers formal methodologies to study, design, implement, and manage complex engineering systems as a whole over their life-cycles. The methodologies deal with human work-processes, coordination of different team, optimization, and risk management. The V-model of systems engineering emphasize two streams, the specification and the testing streams. The specification stream consists of user requirements, functional requirements, and design specifications while the testing on installation, operational, and performance specifications. In implementing system engineering tomore » this project, the user and functional requirements are (a) HDR unit parameters be downloaded from the treatment planning system, (b) dwell times and positions be generated by treatment planning system, (c) source decay be computer calculated, (d) a double-check system of treatment parameters to comply with the NRC regulation. These requirements are intended to reduce human intervention to improve patient safety. Results: A formal investigation indicated that the user requirements can be satisfied. The treatment operation consists of using the treatment planning system to generate a pseudo plan that is adjusted for different shielded applicators to compute the dwell times. The dwell positions, channel numbers, and the dwell times are verified by the medical physicist and downloaded into the HDR unit. The decayed source strength is transferred to a spreadsheet that computes the dwell times based on the type of applicators and prescribed dose used. Prior to treatment, the source strength, dwell times, dwell positions, and channel numbers are double-checked by the radiation oncologist. No dosimetric parameters are manually calculated. Conclusion: Systems engineering provides methodologies to effectively design the HDR treatment operation that minimize human intervention and improve patient safety.« less

SU-F-T-234: Quality Improvements in the Electronic Medical Record of Patients Treated with High Dose-Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Diener, T; Wilkinson, D

Purpose: To improve workflow efficiency and patient safety by assessing the quality control documentation for HDR brachytherapy within our Electronic Medical Record System (Mosaiq). Methods: A list of parameters based on NRC regulations, our quality management program (QMP), recommendations of the ACR and the American Brachytherapy Society, and HDR treatment planning risks identified in our previous FMEA study was made. Next, the parameter entries were classified according to the type of data input—manual, electronic, or both. Manual entry included the electronic Brachytherapy Treatment Record (BTR) and pre-treatment Mosaiq Assessments list. Oncentra Treatment Reports (OTR) from the Oncentra Treatment Control Systemmore » constituted the electronic data. The OTR includes a Pre-treatment Report for each fraction, and a Treatment Summary Report at the completion of treatment. Each entry was then examined for appropriateness and completeness of data; adjustments and additions as necessary were then made. Results: Ten out of twenty-one recorded treatment parameters were identified to be documented within both the BTR and OTR. Of these ten redundancies, eight were changed from recorded values to a simple checklist in the BTR to avoid recording errors. The other redundancies were kept in both documents due to their value to ensuring patient safety. An edit was made to the current BTR quality assessment; this change revises the definition of a medical event in accordance with ODH Regulation 3701:1-58-101. One addition was made to the current QMP documents regarding HDR. This addition requires a physician to be present through the duration of HDR treatment in accordance with ODH Regulation 3701:1-58-59; Paragraph (F); Section (2); Subsection (a). Conclusion: Careful examination of HDR documentation that originates from different sources can help to improve the accuracy and reliability of the documents. In addition, there may be a small improvement in efficiency due to elimination of unnecessary redundancies.« less

A Real-Time Air Dispersion Modeling System.

DTIC Science & Technology

1984-04-01

8217 UNFORMATTED’) READ (SUNITI, REC=I) HD 5 ICNT=2 FLAGI-. FALSE. DO 20 I=2,HD,1 IF (.NOT. FLA6i) FLAG1-.TRUE. READ(SUNIT1, REC-I) HEAD, HDR ICHECK =0 DO 13 JG=1,9...lt IF (HDR(JG) NE. 0) ICHECKI1 13 CONTINUE IF ( ICHECK .EQ. 0) SOTO 28 IF (SKEY(2) .NE. ’*’) THEN IF (SKEY(2 .NE. 𔄁’) THEN DO 12 K-1,9,1 IF (HDR(K) .EQ

The feasibility study and characterization of a two-dimensional diode array in "magic phantom" for high dose rate brachytherapy quality assurance.

PubMed

Espinoza, A; Beeksma, B; Petasecca, M; Fuduli, I; Porumb, C; Cutajar, D; Corde, S; Jackson, M; Lerch, M L F; Rosenfeld, A B

2013-11-01

High dose rate (HDR) brachytherapy is a radiation treatment technique capable of delivering large dose rates to the tumor. Radiation is delivered using remote afterloaders to drive highly active sources (commonly (192)Ir with an air KERMA strength range between 20,000 and 40,000 U, where 1 U = 1 μGy m(2)/h in air) through applicators directly into the patient's prescribed region of treatment. Due to the obvious ramifications of incorrect treatment while using such an active source, it is essential that there are methods for quality assurance (QA) that can directly and accurately verify the treatment plan and the functionality of the remote afterloader. This paper describes the feasibility study of a QA system for HDR brachytherapy using a phantom based two-dimensional 11 × 11 epitaxial diode array, named "magic phantom." The HDR brachytherapy treatment plan is translated to the phantom with two rows of 10 (20 in total) HDR source flexible catheters, arranged above and below the diode array "magic plate" (MP). Four-dimensional source tracking in each catheter is based upon a developed fast iterative algorithm, utilizing the response of the diodes in close proximity to the (192)Ir source, sampled at 100 ms intervals by a fast data acquisition (DAQ) system. Using a (192)Ir source in a solid water phantom, the angular response of the developed epitaxial diodes utilized in the MP and also the variation of the MP response as a function of the source-to-detector distance (SDD) were investigated. These response data are then used by an iterative algorithm for source dwelling position determination. A measurement of the average transit speed between dwell positions was performed using the diodes and a fast DAQ. The angular response of the epitaxial diode showed a variation of 15% within 360°, with two flat regions above and below the detector face with less than 5% variation. For SDD distances of between 5 and 30 mm the relative response of the epitaxial diodes used in the MP is in good agreement (within 8%) with radial dose function measurements found within the TG-43 protocol, with SDD of up to 70 mm showing a 40% over response. A method for four-dimensional localization of the HDR source was developed, allowing the source dwell position to be derived within 0.50 mm of the expected position. An estimation of the average transit speed for varying step sizes was determined and was found to increase from (12.8 ± 0.3) up to (38.6 ± 0.4) cm/s for a step size of 2.5 and 50 mm, respectively. Our characterization of the designed QA "magic phantom" with MP in realistic HDR photon fields demonstrates the promising performance for real-time source position tracking in four dimensions and measurements of transit times. Further development of this system will allow a full suite for QA in HDR brachytherapy and analysis, and for future in vivo tracking.

Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer.

PubMed

Ecke, Thorsten H; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

2016-11-10

High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D'Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis ( p = 0.009), PSA on date of first HDR-BT ( p = 0.033), and PSA on date of first follow-up after one year ( p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

SU-F-T-27: A Comparative Case Study Among Four Modalities for the Superficial Treatment of Squamous Cell Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ashenafi, M; Koch, N; Peng, J

Purpose: We performed a comparative planning study among High Dose Rate (HDR) brachytherapy, superficial electrons, Volume Modulated Arc Therapy (VMAT), and Helical IMRT (Tomotherapy) for squamous cell carcinoma of the abdominal wall with consideration for the underlining bowel. Methods: A 69-year old female presented with squamous cell carcinoma protruding 8mm beyond the anterior skin surface of the midabdomen was considered for treatment. The patient had a ventral hernia which resulted in the reduction of the abdominal wall thickness and the adjacent small bowel being the dose limiting structure. Four plans were generated using different treatment modalities: a) an enface electronmore » field (eMC, Eclipse v. 11), b) Tomotherapy (HI-Art II v.5.0.5), c) VMAT (Acuros, Eclipse v. 11), and d) HDR using a Freiburg applicator (Oncentra v. 4.3). The following plan objectives were used for all four plans: for the CTV target, V90% ≥90% (61.8Gy2/2).For the small bowel, D0.1cc < 56.2 Gy2/2 was a hard constraint and expressed as a percentage of the prescription for comparison to demonstrate the dose fall-off achieved among the modalities.For HDR, V200% <0.1cc was an additional constraint. Multiple dosimetric parameters, including those listed above, were compared among the four modalities. Results: The HDR plan showed comparable target coverage compared to the Tomotherapy plan and better coverage compared to the electron plan. Small bowel doses (D0.1cc) were lower in HDR plan compared to Tomotherapy, electron, & VMAT plans (88.8%, 89.6%, 90.9%, & 96.6%). Integral dose to the whole body (V5%) was much higher for HDR, VMAT, and Tomotherapy when compared to electron plan by factors of seven, eight, and ten, respectively. After reviewing all treatment modalities, the physician selected HDR owing to better control of the small bowel dose while maintaining adequate target coverage. Conclusion: This case study demonstrated HDR can successfully treat superficial lesions with superior sparing of underlying structures.« less

Radiobiological equivalent of low/high dose rate brachytherapy and evaluation of tumor and normal responses to the dose.

PubMed

Manimaran, S

2007-06-01

The aim of this study was to compare the biological equivalent of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy in terms of the more recent linear quadratic (LQ) model, which leads to theoretical estimation of biological equivalence. One of the key features of the LQ model is that it allows a more systematic radiobiological comparison between different types of treatment because the main parameters alpha/beta and micro are tissue-specific. Such comparisons also allow assessment of the likely change in the therapeutic ratio when switching between LDR and HDR treatments. The main application of LQ methodology, which focuses on by increasing the availability of remote afterloading units, has been to design fractionated HDR treatments that can replace existing LDR techniques. In this study, with LDR treatments (39 Gy in 48 h) equivalent to 11 fractions of HDR irradiation at the experimental level, there are increasing reports of reproducible animal models that may be used to investigate the biological basis of brachytherapy and to help confirm theoretical predictions. This is a timely development owing to the nonavailability of sufficient retrospective patient data analysis. It appears that HDR brachytherapy is likely to be a viable alternative to LDR only if it is delivered without a prohibitively large number of fractions (e.g., fewer than 11). With increased scientific understanding and technological capability, the prospect of a dose equivalent to HDR brachytherapy will allow greater utilization of the concepts discussed in this article.

Effect of gender on vestibular sympathoexcitation

NASA Technical Reports Server (NTRS)

Ray, C. A.

2000-01-01

Studies have suggested that premenopausal women are more prone to orthostatic intolerance than men. Additionally, it has been postulated that the vestibulosympathetic reflex is important in regulating postural-related changes in sympathetic activity. The purpose of the present study was to determine whether men and women differ in their sympathetic and cardiovascular responses to stimulation of the otolith organs elicited by head-down rotation (HDR). Heart rate (HR), arterial pressure, calf blood flow (CBF), and leg muscle sympathetic nerve activity (MSNA) were measured during 3 min of HDR in the prone posture in 33 women and 30 men. With the exception of HR (71 +/- 2 and 63 +/- 1 beats/min for women and men, respectively; P < 0.01), all baseline variables were not different between genders. There were no gender differences in responses to HDR. MSNA increased 72 +/- 33 units (43%) in the men and 88 +/- 15 units (59%) in the women during HDR (P < 0.01). CBF decreased [-0.6 +/- 0.1 (15%) and -0.5 +/- 0.1 (19%) ml. min(-1). 100 ml(-1)] and calf vascular resistance increased [8 +/- 2 (21%) and 11 +/- 3 (25%) units during HDR for men and women, respectively (P < 0.01)]. Both in the men and women, HR increased 2 +/- 1 beats/min (P < 0.01). These results demonstrate that sympathetic activation during HDR in the prone posture is similar in men and women. Therefore, these findings suggest that the vestibulosympathetic reflex is not different between healthy men and women.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borot de Battisti, M; Maenhout, M; Lagendijk, J J W

Purpose: To develop adaptive planning with feedback for MRI-guided focal HDR prostate brachytherapy with a single divergent needle robotic implant device. After each needle insertion, the dwell positions for that needle are calculated and the positioning of remaining needles and dosimetry are both updated based on MR imaging. Methods: Errors in needle positioning may occur due to inaccurate needle insertion (caused by e.g. the needle’s bending) and unpredictable changes in patient anatomy. Consequently, the dose plan quality might dramatically decrease compared to the preplan. In this study, a procedure was developed to re-optimize, after each needle insertion, the remaining needlemore » angulations, source positions and dwell times in order to obtain an optimal coverage (D95% PTV>19 Gy) without exceeding the constraints of the organs at risk (OAR) (D10% urethra<21 Gy, D1cc bladder<12 Gy and D1cc rectum<12 Gy). Complete HDR procedures with 6 needle insertions were simulated for a patient MR-image set with PTV, prostate, urethra, bladder and rectum delineated. Random angulation errors, modeled by a Gaussian distribution (standard deviation of 3 mm at the needle’s tip), were generated for each needle insertion. We compared the final dose parameters for the situations (I) without re-optimization and (II) with the automatic feedback. Results: The computation time of replanning was below 100 seconds on a current desk computer. For the patient tested, a clinically acceptable dose plan was achieved while applying the automatic feedback (median(range) in Gy, D95% PTV: 19.9(19.3–20.3), D10% urethra: 13.4(11.9–18.0), D1cc rectum: 11.0(10.7–11.6), D1cc bladder: 4.9(3.6–6.8)). This was not the case without re-optimization (median(range) in Gy, D95% PTV: 19.4(14.9–21.3), D10% urethra: 12.6(11.0–15.7), D1cc rectum: 10.9(8.9–14.1), D1cc bladder: 4.8(4.4–5.2)). Conclusion: An automatic guidance strategy for HDR prostate brachytherapy was developed to compensate errors in needle positioning and improve the dose distribution. Without re-optimization, target coverage and OAR constraints may not be achieved. M. Borot de Battisti is funded by Philips Medical Systems Nederland B.V.; M. Moerland is principal investigator on a contract funded by Philips Medical Systems Nederland B.V.; G. Hautvast and D. Binnekamp are full-time employees of Philips Medical Systems Nederland B.V.« less

A study of optimization techniques in HDR brachytherapy for the prostate

NASA Astrophysics Data System (ADS)

Pokharel, Ghana Shyam

Several studies carried out thus far are in favor of dose escalation to the prostate gland to have better local control of the disease. But optimal way of delivery of higher doses of radiation therapy to the prostate without hurting neighboring critical structures is still debatable. In this study, we proposed that real time high dose rate (HDR) brachytherapy with highly efficient and effective optimization could be an alternative means of precise delivery of such higher doses. This approach of delivery eliminates the critical issues such as treatment setup uncertainties and target localization as in external beam radiation therapy. Likewise, dosimetry in HDR brachytherapy is not influenced by organ edema and potential source migration as in permanent interstitial implants. Moreover, the recent report of radiobiological parameters further strengthen the argument of using hypofractionated HDR brachytherapy for the management of prostate cancer. Firstly, we studied the essential features and requirements of real time HDR brachytherapy treatment planning system. Automating catheter reconstruction with fast editing tools, fast yet accurate dose engine, robust and fast optimization and evaluation engine are some of the essential requirements for such procedures. Moreover, in most of the cases we performed, treatment plan optimization took significant amount of time of overall procedure. So, making treatment plan optimization automatic or semi-automatic with sufficient speed and accuracy was the goal of the remaining part of the project. Secondly, we studied the role of optimization function and constraints in overall quality of optimized plan. We have studied the gradient based deterministic algorithm with dose volume histogram (DVH) and more conventional variance based objective functions for optimization. In this optimization strategy, the relative weight of particular objective in aggregate objective function signifies its importance with respect to other objectives. Based on our study, DVH based objective function performed better than traditional variance based objective function in creating a clinically acceptable plan when executed under identical conditions. Thirdly, we studied the multiobjective optimization strategy using both DVH and variance based objective functions. The optimization strategy was to create several Pareto optimal solutions by scanning the clinically relevant part of the Pareto front. This strategy was adopted to decouple optimization from decision such that user could select final solution from the pool of alternative solutions based on his/her clinical goals. The overall quality of treatment plan improved using this approach compared to traditional class solution approach. In fact, the final optimized plan selected using decision engine with DVH based objective was comparable to typical clinical plan created by an experienced physicist. Next, we studied the hybrid technique comprising both stochastic and deterministic algorithm to optimize both dwell positions and dwell times. The simulated annealing algorithm was used to find optimal catheter distribution and the DVH based algorithm was used to optimize 3D dose distribution for given catheter distribution. This unique treatment planning and optimization tool was capable of producing clinically acceptable highly reproducible treatment plans in clinically reasonable time. As this algorithm was able to create clinically acceptable plans within clinically reasonable time automatically, it is really appealing for real time procedures. Next, we studied the feasibility of multiobjective optimization using evolutionary algorithm for real time HDR brachytherapy for the prostate. The algorithm with properly tuned algorithm specific parameters was able to create clinically acceptable plans within clinically reasonable time. However, the algorithm was let to run just for limited number of generations not considered optimal, in general, for such algorithms. This was done to keep time window desirable for real time procedures. Therefore, it requires further study with improved conditions to realize the full potential of the algorithm.

Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques

PubMed Central

Bradley, David; Nisbet, Andrew

2012-01-01

This study provides a review of recent publications on the physics-aspects of dosimetric accuracy in high dose rate (HDR) brachytherapy. The discussion of accuracy is primarily concerned with uncertainties, but methods to improve dose conformation to the prescribed intended dose distribution are also noted. The main aim of the paper is to review current practical techniques and methods employed for HDR brachytherapy dosimetry. This includes work on the determination of dose rate fields around brachytherapy sources, the capability of treatment planning systems, the performance of treatment units and methods to verify dose delivery. This work highlights the determinants of accuracy in HDR dosimetry and treatment delivery and presents a selection of papers, focusing on articles from the last five years, to reflect active areas of research and development. Apart from Monte Carlo modelling of source dosimetry, there is no clear consensus on the optimum techniques to be used to assure dosimetric accuracy through all the processes involved in HDR brachytherapy treatment. With the exception of the ESTRO mailed dosimetry service, there is little dosimetric audit activity reported in the literature, when compared with external beam radiotherapy verification. PMID:23349649

Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques.

PubMed

Palmer, Antony; Bradley, David; Nisbet, Andrew

2012-06-01

This study provides a review of recent publications on the physics-aspects of dosimetric accuracy in high dose rate (HDR) brachytherapy. The discussion of accuracy is primarily concerned with uncertainties, but methods to improve dose conformation to the prescribed intended dose distribution are also noted. The main aim of the paper is to review current practical techniques and methods employed for HDR brachytherapy dosimetry. This includes work on the determination of dose rate fields around brachytherapy sources, the capability of treatment planning systems, the performance of treatment units and methods to verify dose delivery. This work highlights the determinants of accuracy in HDR dosimetry and treatment delivery and presents a selection of papers, focusing on articles from the last five years, to reflect active areas of research and development. Apart from Monte Carlo modelling of source dosimetry, there is no clear consensus on the optimum techniques to be used to assure dosimetric accuracy through all the processes involved in HDR brachytherapy treatment. With the exception of the ESTRO mailed dosimetry service, there is little dosimetric audit activity reported in the literature, when compared with external beam radiotherapy verification.

Radiometric calibration of wide-field camera system with an application in astronomy

NASA Astrophysics Data System (ADS)

Vítek, Stanislav; Nasyrova, Maria; Stehlíková, Veronika

2017-09-01

Camera response function (CRF) is widely used for the description of the relationship between scene radiance and image brightness. Most common application of CRF is High Dynamic Range (HDR) reconstruction of the radiance maps of imaged scenes from a set of frames with different exposures. The main goal of this work is to provide an overview of CRF estimation algorithms and compare their outputs with results obtained under laboratory conditions. These algorithms, typically designed for multimedia content, are unfortunately quite useless with astronomical image data, mostly due to their nature (blur, noise, and long exposures). Therefore, we propose an optimization of selected methods to use in an astronomical imaging application. Results are experimentally verified on the wide-field camera system using Digital Single Lens Reflex (DSLR) camera.

Only Image Based for the 3d Metric Survey of Gothic Structures by Using Frame Cameras and Panoramic Cameras

NASA Astrophysics Data System (ADS)

Pérez Ramos, A.; Robleda Prieto, G.

2016-06-01

Indoor Gothic apse provides a complex environment for virtualization using imaging techniques due to its light conditions and architecture. Light entering throw large windows in combination with the apse shape makes difficult to find proper conditions to photo capture for reconstruction purposes. Thus, documentation techniques based on images are usually replaced by scanning techniques inside churches. Nevertheless, the need to use Terrestrial Laser Scanning (TLS) for indoor virtualization means a significant increase in the final surveying cost. So, in most cases, scanning techniques are used to generate dense point clouds. However, many Terrestrial Laser Scanner (TLS) internal cameras are not able to provide colour images or cannot reach the image quality that can be obtained using an external camera. Therefore, external quality images are often used to build high resolution textures of these models. This paper aims to solve the problem posted by virtualizing indoor Gothic churches, making that task more affordable using exclusively techniques base on images. It reviews a previous proposed methodology using a DSRL camera with 18-135 lens commonly used for close range photogrammetry and add another one using a HDR 360° camera with four lenses that makes the task easier and faster in comparison with the previous one. Fieldwork and office-work are simplified. The proposed methodology provides photographs in such a good conditions for building point clouds and textured meshes. Furthermore, the same imaging resources can be used to generate more deliverables without extra time consuming in the field, for instance, immersive virtual tours. In order to verify the usefulness of the method, it has been decided to apply it to the apse since it is considered one of the most complex elements of Gothic churches and it could be extended to the whole building.

Brachytherapy for cervix cancer: low-dose rate or high-dose rate brachytherapy – a meta-analysis of clinical trials

PubMed Central

Viani, Gustavo A; Manta, Gustavo B; Stefano, Eduardo J; de Fendi, Ligia I

2009-01-01

Background The literature supporting high-dose rate brachytherapy (HDR) in the treatment of cervical carcinoma derives primarily from retrospective series. However, controversy still persists regarding the efficacy and safety of HDR brachytherapy compared to low-dose rate (LDR) brachytherapy, in particular, due to inadequate tumor coverage for stage III patients. Whether LDR or HDR brachytherapy produces better results for these patients in terms of survival rate, local control rate and the treatment complications remain controversial. Methods A meta-analysis of RCT was performed comparing LDR to HDR brachytherapy for cervix cancer treated for radiotherapy alone. The MEDLINE, EMBASE, CANCERLIT and Cochrane Library databases, as well as abstracts published in the annual proceedings were systematically searched. We assessed methodological quality for each outcome by grading the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. We used "recommend" for strong recommendations, and "suggest" for weak recommendations. Results Pooled results from five randomized trials (2,065 patients) of HDR brachytherapy in cervix cancer showed no significant increase of mortality (p = 0.52), local recurrence (p = 0.68), or late complications (rectal; p = 0.7, bladder; p = 0.95 or small intestine; p = 0.06) rates as compared to LDR brachytherapy. In the subgroup analysis no difference was observed for overall mortality and local recurrence in patients with clinical stages I, II and III. The quality of evidence was low for mortality and local recurrence in patients with clinical stage I, and moderate for other clinical stages. Conclusion Our meta-analysis shows that there are no differences between HDR and LDR for overall survival, local recurrence and late complications for clinical stages I, II and III. By means of the GRADE system, we recommend the use of HDR for all clinical stages of cervix cancer. PMID:19344527

Looking skyward to study ecosystem carbon dynamics

USGS Publications Warehouse

Dye, Dennis G.

2012-01-01

Between May and October 2011 the U.S. Geological Survey (USGS), in cooperation with the U.S. Department of Energy's Atmospheric Radiation Measurement (ARM) program, conducted a field campaign at the ARM Southern Great Plains site in north central Oklahoma to evaluate a new instrument for quantitative image-based monitoring of sky conditions and solar radiation. The High Dynamic Range All-Sky Imaging System (HDR-ASIS) was developed by USGS to support studies of cloud- and aerosol-induced variability in the geometric properties of solar radiation (the sky radiance distribution) and its effects on photosynthesis and uptake of carbon dioxide (CO2) by terrestrial ecosystems. Under a clean, cloudless atmosphere when the Sun is above the horizon, most of the solar radiation reaching an area of the Earth's surface is concentrated in a beam coming directly from the Sun; a relatively small proportion arrives as diffuse radiation from the rest of the sky. Clouds and atmospheric aerosols cause increased scattering of the beam radiation, which increases the proportion of diffuse radiation at the surface.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma, R; Zhu, X; Li, S

Purpose: High Dose Rate (HDR) brachytherapy forward planning is principally an iterative process; hence, plan quality is affected by planners’ experiences and limited planning time. Thus, this may lead to sporadic errors and inconsistencies in planning. A statistical tool based on previous approved clinical treatment plans would help to maintain the consistency of planning quality and improve the efficiency of second checking. Methods: An independent dose calculation tool was developed from commercial software. Thirty-three previously approved cervical HDR plans with the same prescription dose (550cGy), applicator type, and treatment protocol were examined, and ICRU defined reference point doses (bladder, vaginalmore » mucosa, rectum, and points A/B) along with dwell times were collected. Dose calculation tool then calculated appropriate range with a 95% confidence interval for each parameter obtained, which would be used as the benchmark for evaluation of those parameters in future HDR treatment plans. Model quality was verified using five randomly selected approved plans from the same dataset. Results: Dose variations appears to be larger at the reference point of bladder and mucosa as compared with rectum. Most reference point doses from verification plans fell between the predicted range, except the doses of two points of rectum and two points of reference position A (owing to rectal anatomical variations & clinical adjustment in prescription points, respectively). Similar results were obtained for tandem and ring dwell times despite relatively larger uncertainties. Conclusion: This statistical tool provides an insight into clinically acceptable range of cervical HDR plans, which could be useful in plan checking and identifying potential planning errors, thus improving the consistency of plan quality.« less

Clinical outcome of high-dose-rate interstitial brachytherapy in vulvar cancer: A single institutional experience.

PubMed

Mahantshetty, Umesh; Naga, Pushpa; Engineer, Reena; Sastri, Supriya; Ghadi, Yogesh; Upreti, Udita; Somesan, Vijaya; Kadam, Sudarshan; Kohle, Satish; Deshpande, Deepak; Shrivastava, Shyam Kishore

With an aim to evaluate and report high dose date interstitial brachytherapy (HDR-ISBT) in vulvar cancers, we undertook this retrospective analysis. Histologically proven vulvar cancers treated with HDR-ISBT between 2001 and 2016 were analyzed. Radiotherapy details, clinical outcome in terms of local control rates, survivals, and toxicities were evaluated. A total of 38 patients received HDR-ISBT, with definitive radiation in 29 (76.3%), adjuvant postoperative in six (15.8%) and salvage radiation in three (7.9%) patients. Of them, 29 patients received brachytherapy boost and nine patients ISBT alone. BT procedure included freehand plastic tube technique in 23 (single [n = 5] or multiple plane [n = 18]), 13 patients with template based and two patients combined approach. Patients with brachytherapy alone received median EQD2 of 38.4 Gy 10 (35.5-46.7 Gy 10 ), as boost received median 23.3 Gy 10 (13-37.3 Gy 10 ). At 3-month post-treatment response evaluation, 30 patients achieved clinically complete response, two patients partial response and six maintained postoperative status. With a median follow-up of 30 months, 29 (76.3%) were disease free, and 9 (23.7%) patients had relapsed disease with four patients expired due to disease and two died of other causes. The 5-year overall survival, disease free survival, and local control rates were 82%, 51%, and 77%, respectively. HDR-ISBT in vulvar cancer is a feasible and a viable option with acceptable and comparable outcomes. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Introducing a Public Stereoscopic 3D High Dynamic Range (SHDR) Video Database

NASA Astrophysics Data System (ADS)

Banitalebi-Dehkordi, Amin

2017-03-01

High dynamic range (HDR) displays and cameras are paving their ways through the consumer market at a rapid growth rate. Thanks to TV and camera manufacturers, HDR systems are now becoming available commercially to end users. This is taking place only a few years after the blooming of 3D video technologies. MPEG/ITU are also actively working towards the standardization of these technologies. However, preliminary research efforts in these video technologies are hammered by the lack of sufficient experimental data. In this paper, we introduce a Stereoscopic 3D HDR database of videos that is made publicly available to the research community. We explain the procedure taken to capture, calibrate, and post-process the videos. In addition, we provide insights on potential use-cases, challenges, and research opportunities, implied by the combination of higher dynamic range of the HDR aspect, and depth impression of the 3D aspect.

Color appearance and color rendering of HDR scenes: an experiment

NASA Astrophysics Data System (ADS)

Parraman, Carinna; Rizzi, Alessandro; McCann, John J.

2009-01-01

In order to gain a deeper understanding of the appearance of coloured objects in a three-dimensional scene, the research introduces a multidisciplinary experimental approach. The experiment employed two identical 3-D Mondrians, which were viewed and compared side by side. Each scene was subjected to different lighting conditions. First, we used an illumination cube to diffuse the light and illuminate all the objects from each direction. This produced a low-dynamicrange (LDR) image of the 3-D Mondrian scene. Second, in order to make a high-dynamic range (HDR) image of the same objects, we used a directional 150W spotlight and an array of WLEDs assembled in a flashlight. The scenes were significant as each contained exactly the same three-dimensional painted colour blocks that were arranged in the same position in the still life. The blocks comprised 6 hue colours and 5 tones from white to black. Participants from the CREATE project were asked to consider the change in the appearance of a selection of colours according to lightness, hue, and chroma, and to rate how the change in illumination affected appearance. We measured the light coming to the eye from still-life surfaces with a colorimeter (Yxy). We captured the scene radiance using multiple exposures with a number of different cameras. We have begun a programme of digital image processing of these scene capture methods. This multi-disciplinary programme continues until 2010, so this paper is an interim report on the initial phases and a description of the ongoing project.

Foreign Humanitarian Assistance

DTIC Science & Technology

2009-03-17

based products and is adequate for the widest range of cultural or religious dietary restrictions. HDR will maintain the health of moderately...rehydration, fortified nutritional products, and micronutrient supplements; provide post- rape-care kits, including post-exposure prophylaxis for human

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goyal, M; Shobhit University, Meerut, Uttar Pradesh; Manjhi, J

Purpose: This study evaluated dosimetric parameters for actual treatment plans versus decay corrected treatment plans for cervical HDR brachytherapy. Methods: 125 plans of 25 patients, who received 5 fractions of HDR brachytherapy, were evaluated in this study. Dose was prescribed to point A (ICRU-38) and High risk clinical tumor volume (HR-CTV) and organs at risk (OAR) were, retrospectively, delineated on original CT images by treating physician. First HDR plan was considered as reference plan and decay correction was applied to calculate treatment time for subsequent fractions, and was applied, retrospectively, to determine point A, HR-CTV D90, and rectum and bladdermore » doses. Results: The differences between mean point A reference doses and the point A doses of the plans computed using decay times were found to be 1.05%±0.74% (−2.26% to 3.26%) for second fraction; −0.25%±0.84% (−3.03% to 3.29%) for third fraction; 0.04%±0.70% (−2.68% to 2.56%) for fourth fraction and 0.30%±0.81% (−3.93% to 2.67%) for fifth fraction. Overall mean point A dose difference, for all fractions, was 0.29%±0.38% (within ± 5%). Mean rectum and bladder dose differences were calculated to be −3.46%±0.12% and −2.47%±0.09%, for points, respectively, and −1.72%±0.09% and −0.96%±0.06%, for D2cc, respectively. HR-CTV D90 mean dose difference was found to be −1.67% ± 0.11%. There was no statistically significant difference between the reference planned point A doses and that calculated using decay time to the subsequent fractions (p<0.05). Conclusion: This study reveals that a decay corrected treatment will provide comparable dosimetric results and can be utilized for subsequent fractions of cervical HDR brachytherapy instead of actual treatment planning. This approach will increase efficiency, decrease workload, reduce patient observation time between applicator insertion and treatment delivery. This would be particularly useful for institutions with limited resources or large patient populations with limited access to care.« less

Phase II Trial of Combined High-Dose-Rate Brachytherapy and External Beam Radiotherapy for Adenocarcinoma of the Prostate: Preliminary Results of RTOG 0321

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hsu, I-Chow, E-mail: ihsu@radonc.ucsf.ed; Bae, Kyounghwa; Shinohara, Katsuto

2010-11-01

Purpose: To estimate the rate of late Grade 3 or greater genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) after treatment with external beam radiotherapy and prostate high-dose-rate (HDR) brachytherapy. Methods and Materials: Each participating institution submitted computed tomography-based HDR brachytherapy dosimetry data electronically for credentialing and for each study patient. Patients with locally confined Stage T1c-T3b prostate cancer were eligible for the present study. All patients were treated with 45 Gy in 25 fractions using external beam radiotherapy and one HDR implant delivering 19 Gy in two fractions. All AEs were graded according to the Common Terminology Criteria formore » Adverse Events, version 3.0. Late GU/GI AEs were defined as those occurring >9 months from the start of the protocol treatment, in patients with {>=}18 months of potential follow-up. Results: A total of 129 patients from 14 institutions were enrolled in the present study. Of the 129 patients, 125 were eligible, and AE data were available for 112 patients at analysis. The pretreatment characteristics of the patients were as follows: Stage T1c-T2c, 91%; Stage T3a-T3b, 9%; prostate-specific antigen level {<=}10 ng/mL, 70%; prostate-specific antigen level >10 but {<=}20 ng/mL, 30%; and Gleason score 2-6, 10%; Gleason score 7, 72%; and Gleason score 8-10, 18%. At a median follow-up of 29.6 months, three acute and four late Grade 3 GU/GI AEs were reported. The estimated rate of late Grade 3-5 GU and GI AEs at 18 months was 2.56%. Conclusion: This is the first prospective, multi-institutional trial of computed tomography-based HDR brachytherapy and external beam radiotherapy. The technique and doses used in the present study resulted in acceptable levels of AEs.« less

Aging attenuates the vestibulosympathetic reflex in humans

NASA Technical Reports Server (NTRS)

Ray, Chester A.; Monahan, Kevin D.

2002-01-01

BACKGROUND: The vestibular system contributes to sympathetic activation by engagement of the otolith organs. However, there is a significant loss of vestibular function with aging. Therefore, the purpose of the present study was to determine if young and older individuals differ in their cardiovascular and sympathetic responses to otolithic stimulation (ie, head-down rotation, HDR). We hypothesized that responses to otolithic stimulation would be attenuated in older adults because of morphological and physiological alterations that occur in the vestibular system with aging. METHODS AND RESULTS: Arterial blood pressure, heart rate, muscle sympathetic nerve activity (MSNA), and head rotation were measured during HDR in 11 young (26 +/- 1 years) and 11 older (64 +/- 1 years) subjects in the prone posture. Five older subjects performed head rotation (chin to chest) in the lateral decubitus position, which simulates HDR but does not alter afferent inputs from the vestibular system. MSNA responses to HDR were significantly attenuated in older as compared with young subjects (P<0.01). MSNA increased in the older subjects by only 12 +/- 5% as compared with 85 +/- 16% in the young. Furthermore, HDR elicited significant reductions in mean arterial blood pressure in older (Delta-6 +/- 1 mm Hg; P<0.01) but not young subjects (Delta1 +/- 1 mm Hg). In contrast to HDR, head rotation performed in the lateral decubitus position did not elicit hypotension. MSNA responses to baroreceptor unloading and the cold pressor test were not different between the age groups. CONCLUSIONS: These data indicate that aging attenuates the vestibulosympathetic reflex in humans and may contribute to the increased prevalence of orthostatic hypotension with age.

Brachytherapy for Buccal Cancer: From Conventional Low Dose Rate (LDR) or Mold Technique to High Dose Rate Interstitial Brachytherapy (HDR-ISBT).

PubMed

Kotsuma, Tadayuki; Yamazaki, Hideya; Masui, Koji; Yoshida, Ken; Shimizutani, Kimishige; Akiyama, Hironori; Murakami, Shumei; Isohashi, Fumiaki; Yoshioka, Yasuo; Ogawa, Kazuhiko; Tanaka, Eiichi

2017-12-01

To examine the effectiveness of newly-installed high-dose-rate interstitial brachytherapy (HDR-ISBT) for buccal cancer. We retrospectively reviewed 36 patients (25 men and 11 women) with buccal cancer treated with curative brachytherapy with or without external radiotherapy with a median follow-up of 99 months. A total of 15 HDR-ISBT (median 48 Gy/ 8 fractions, range=24-60 Gy) patients were compared to conventional 15 cases LDR-ISBT (70 Gy, range=42.8-110 Gy) and 7 molds techniques (15 Gy, range=9-74 Gy). A total of 31 patients also underwent external radiotherapy (30 Gy, range=24-48 Gy). They comprised of 3T1, 23 T2, 8 T3, 3 T4 including 11 node positive cases. HDR-ISBT provided 82% of local control rate at 5 years, whereas conventional brachytherapy showed 72% [p=0.44; LDR-ISBT (65%), mold therapy (85.7%)]. Patients with early lesions (T1-2 or stage I-II) showed better local control rates than those with advanced lesions (T3-4 or stage III-IV). Severe late grade 3 complications developed in two patients treated with LDR-ISBT and EBRT. There is no significant difference in toxicity grade ≤2 between conventional brachytherapy (5/15=33%) and HDR-ISBT (7/32=32%, p=0.92). HDR-ISBT achieved good and comparable local control rates to conventional brachytherapy without elevating the toxicity. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

SU-G-201-15: Nomogram as an Efficient Dosimetric Verification Tool in HDR Prostate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liang, J; Todor, D

Purpose: Nomogram as a simple QA tool for HDR prostate brachytherapy treatment planning has been developed and validated clinically. Reproducibility including patient-to-patient and physician-to-physician variability was assessed. Methods: The study was performed on HDR prostate implants from physician A (n=34) and B (n=15) using different implant techniques and planning methodologies. A nomogram was implemented as an independent QA of computer-based treatment planning before plan execution. Normalized implant strength (total air kerma strength Sk*t in cGy cm{sup 2} divided by prescribed dose in cGy) was plotted as a function of PTV volume and total V100. A quadratic equation was used tomore » fit the data with R{sup 2} denoting the model predictive power. Results: All plans showed good target coverage while OARs met the dose constraint guidelines. Vastly different implant and planning styles were reflected on conformity index (entire dose matrix V100/PTV volume, physician A implants: 1.27±0.14, physician B: 1.47±0.17) and PTV V150/PTV volume ratio (physician A: 0.34±0.09, physician B: 0.24±0.07). The quadratic model provided a better fit for the curved relationship between normalized implant strength and total V100 (or PTV volume) than a simple linear function. Unlike the normalized implant strength versus PTV volume nomogram which differed between physicians, a unique quadratic model based nomogram (Sk*t)/D=−0.0008V2+0.0542V+1.1185 (R{sup 2}=0.9977) described the dependence of normalized implant strength on total V100 over all the patients from both physicians despite two different implant and planning philosophies. Normalized implant strength - total V100 model also generated less deviant points distorting the smoothed ones with a significantly higher correlation. Conclusion: A simple and universal, excel-based nomogram was created as an independent calculation tool for HDR prostate brachytherapy. Unlike similar attempts, our nomogram is insensitive to implant style and does not rely on reproducing dose calculations using TG-43 formalism, thus making it a truly independent check.« less

The IPEM code of practice for determination of the reference air kerma rate for HDR 192Ir brachytherapy sources based on the NPL air kerma standard

NASA Astrophysics Data System (ADS)

Bidmead, A. M.; Sander, T.; Locks, S. M.; Lee, C. D.; Aird, E. G. A.; Nutbrown, R. F.; Flynn, A.

2010-06-01

This paper contains the recommendations of the high dose rate (HDR) brachytherapy working party of the UK Institute of Physics and Engineering in Medicine (IPEM). The recommendations consist of a Code of Practice (COP) for the UK for measuring the reference air kerma rate (RAKR) of HDR 192Ir brachytherapy sources. In 2004, the National Physical Laboratory (NPL) commissioned a primary standard for the realization of RAKR of HDR 192Ir brachytherapy sources. This has meant that it is now possible to calibrate ionization chambers directly traceable to an air kerma standard using an 192Ir source (Sander and Nutbrown 2006 NPL Report DQL-RD 004 (Teddington: NPL) http://publications.npl.co.uk). In order to use the source specification in terms of either RAKR, \\dot K_R (ICRU 1985 ICRU Report No 38 (Washington, DC: ICRU); ICRU 1997 ICRU Report No 58 (Bethesda, MD: ICRU)), or air kerma strength, SK (Nath et al 1995 Med. Phys. 22 209-34), it has been necessary to develop algorithms that can calculate the dose at any point around brachytherapy sources within the patient tissues. The AAPM TG-43 protocol (Nath et al 1995 Med. Phys. 22 209-34) and the 2004 update TG-43U1 (Rivard et al 2004 Med. Phys. 31 633-74) have been developed more fully than any other protocol and are widely used in commercial treatment planning systems. Since the TG-43 formalism uses the quantity air kerma strength, whereas this COP uses RAKR, a unit conversion from RAKR to air kerma strength was included in the appendix to this COP. It is recommended that the measured RAKR determined with a calibrated well chamber traceable to the NPL 192Ir primary standard is used in the treatment planning system. The measurement uncertainty in the source calibration based on the system described in this COP has been reduced considerably compared to other methods based on interpolation techniques.

Prediction-guided quantization for video tone mapping

NASA Astrophysics Data System (ADS)

Le Dauphin, Agnès.; Boitard, Ronan; Thoreau, Dominique; Olivier, Yannick; Francois, Edouard; LeLéannec, Fabrice

2014-09-01

Tone Mapping Operators (TMOs) compress High Dynamic Range (HDR) content to address Low Dynamic Range (LDR) displays. However, before reaching the end-user, this tone mapped content is usually compressed for broadcasting or storage purposes. Any TMO includes a quantization step to convert floating point values to integer ones. In this work, we propose to adapt this quantization, in the loop of an encoder, to reduce the entropy of the tone mapped video content. Our technique provides an appropriate quantization for each mode of both the Intra and Inter-prediction that is performed in the loop of a block-based encoder. The mode that minimizes a rate-distortion criterion uses its associated quantization to provide integer values for the rest of the encoding process. The method has been implemented in HEVC and was tested over two different scenarios: the compression of tone mapped LDR video content (using the HM10.0) and the compression of perceptually encoded HDR content (HM14.0). Results show an average bit-rate reduction under the same PSNR for all the sequences and TMO considered of 20.3% and 27.3% for tone mapped content and 2.4% and 2.7% for HDR content.

Technology Insight: Combined external-beam radiation therapy and brachytherapy in the management of prostate cancer.

PubMed

Hurwitz, Mark D

2008-11-01

External-beam radiation therapy (EBRT) combined with brachytherapy is an attractive treatment option for selected patients with clinically localized prostate cancer. This therapeutic strategy offers dosimetric coverage if local-regional microscopic disease is present and provides a highly conformal boost of radiation to the prostate and immediate surrounding tissues. Either low-dose-rate (LDR) permanent brachytherapy or high-dose-rate (HDR) temporary brachytherapy can be combined with EBRT; such combined-modality therapy (CMT) is typically used to treat patients with intermediate-risk to high-risk, clinically localized disease. Controversy persists with regard to indications for CMT, choice of LDR or HDR boost, isotope selection for LDR, and integration of EBRT and brachytherapy. Initial findings from prospective, multicenter trials of CMT support the feasibility of this strategy. Updated results from these trials as well as those of ongoing and new phase III trials should help to define the role of CMT in the management of prostate cancer. In the meantime, long-term expectations for outcomes of CMT are based largely on the experience of single institutions, which demonstrate that CMT with EBRT and either LDR or HDR brachytherapy can provide freedom from disease recurrence with acceptable toxicity.

High dynamic spectroscopy using a digital micromirror device and periodic shadowing.

PubMed

Kristensson, Elias; Ehn, Andreas; Berrocal, Edouard

2017-01-09

We present an optical solution called DMD-PS to boost the dynamic range of 2D imaging spectroscopic measurements up to 22 bits by incorporating a digital micromirror device (DMD) prior to detection in combination with the periodic shadowing (PS) approach. In contrast to high dynamic range (HDR), where the dynamic range is increased by recording several images at different exposure times, the current approach has the potential of improving the dynamic range from a single exposure and without saturation of the CCD sensor. In the procedure, the spectrum is imaged onto the DMD that selectively reduces the reflection from the intense spectral lines, allowing the signal from the weaker lines to be increased by a factor of 2⁸ via longer exposure times, higher camera gains or increased laser power. This manipulation of the spectrum can either be based on a priori knowledge of the spectrum or by first performing a calibration measurement to sense the intensity distribution. The resulting benefits in detection sensitivity come, however, at the cost of strong generation of interfering stray light. To solve this issue the Periodic Shadowing technique, which is based on spatial light modulation, is also employed. In this proof-of-concept article we describe the full methodology of DMD-PS and demonstrate - using the calibration-based concept - an improvement in dynamic range by a factor of ~100 over conventional imaging spectroscopy. The dynamic range of the presented approach will directly benefit from future technological development of DMDs and camera sensors.

A dose-volume analysis of magnetic resonance imaging-aided high-dose-rate image-based interstitial brachytherapy for uterine cervical cancer.

PubMed

Yoshida, Ken; Yamazaki, Hideya; Takenaka, Tadashi; Kotsuma, Tadayuki; Yoshida, Mineo; Furuya, Seiichi; Tanaka, Eiichi; Uegaki, Tadaaki; Kuriyama, Keiko; Matsumoto, Hisanobu; Yamada, Shigetoshi; Ban, Chiaki

2010-07-01

To investigate the feasibility of our novel image-based high-dose-rate interstitial brachytherapy (HDR-ISBT) for uterine cervical cancer, we evaluated the dose-volume histogram (DVH) according to the recommendations of the Gynecological GEC-ESTRO Working Group for image-based intracavitary brachytherapy (ICBT). Between June 2005 and June 2007, 18 previously untreated cervical cancer patients were enrolled. We implanted magnetic resonance imaging (MRI)-available plastic applicators by our unique ambulatory technique. Total treatment doses were 30-36 Gy (6 Gy per fraction) combined with external beam radiotherapy (EBRT). Treatment plans were created based on planning computed tomography with MRI as a reference. DVHs of the high-risk clinical target volume (HR CTV), intermediate-risk CTV (IR CTV), and the bladder and rectum were calculated. Dose values were biologically normalized to equivalent doses in 2-Gy fractions (EQD(2)). The median D90 (HR CTV) and D90 (IR CTV) per fraction were 6.8 Gy (range, 5.5-7.5) and 5.4 Gy (range, 4.2-6.3), respectively. The median V100 (HR CTV) and V100 (IR CTV) were 98.4% (range, 83-100) and 81.8% (range, 64-93.8), respectively. When the dose of EBRT was added, the median D90 and D100 of HR CTV were 80.6 Gy (range, 65.5-96.6) and 62.4 Gy (range, 49-83.2). The D(2cc) of the bladder was 62 Gy (range, 51.4-89) and of the rectum was 65.9 Gy (range, 48.9-76). Although the targets were advanced and difficult to treat effectively by ICBT, MRI-aided image-based ISBT showed favorable results for CTV and organs at risk compared with previously reported image-based ICBT results. (c) 2010 Elsevier Inc. All rights reserved.

Transillumination and HDR Imaging for Proximal Caries Detection.

PubMed

Lederer, A; Kunzelmann, K H; Hickel, R; Litzenburger, F

2018-02-01

The purpose was to develop an in vitro model for the validation of near-infrared transillumination (NIRT) for proximal caries detection, to enhance NIRT with high-dynamic-range imaging (HDRI), and to compare both methods, using micro-computed tomography (µCT) as a reference standard. Both proximal surfaces of 53 healthy or decayed permanent human teeth were examined using the Diagnocam (DC) (KaVo) and NIRT with HDRI (NIRT-HDRI). NIRT was combined with HDRI to improve the diagnostic performance by reducing under- and overexposed image areas. For NIRT-HDRI, an exposure series was captured and merged into a single HDR image. A classification was applied according to lesion depth. All surfaces were assessed twice by 2 trained examiners, and additionally with µCT for validation. The Kappa statistic was used to calculate inter-rater reliability and agreement between DC and NIRT-HDRI. Inter-rater reliability (weighted Kappa, wκ) showed very good agreement for the DC (0.90) and NIRT-HDRI (0.96). The overall agreement (wκ) was almost perfect (0.85). In the individual categories (0 to 4), the agreement (simple Kappa) ranged from almost perfect (category 4) to moderate (1 and 2) to substantial (categories 0 and 3). Sensitivity and specificity of sound surfaces, enamel, and dentin caries ranged from 0.57 to 0.99 and were similar for both methods in the different categories. NIRT-HDRI had a higher sensitivity for sound surfaces and enamel caries, as well as a higher specificity for dentin caries. Regarding the obtained images, HDRI allowed for the detection of caries within a greater range of luminance levels, resulting in a more detailed visualization of structures without under- or overexposure. However, HDRI this did not improve the diagnostics significantly. Distinguishing between a processed demineralized enamel and dentin lesions appears to be a problem specific to NIRT and cannot be balanced using HDRI.

SU-E-J-49: Design and Fabrication of Custom 3D Printed Phantoms for Radiation Therapy Research and Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jenkins, C; Xing, L

2015-06-15

Purpose The rapid proliferation of affordable 3D printing techniques has enabled the custom fabrication of items ranging from paper weights to medical implants. This study investigates the feasibility of utilizing the technology for developing novel phantoms for use in radiation therapy quality assurance (QA) procedures. Methods A phantom for measuring the geometric parameters of linear accelerator (LINAC) on-board imaging (OBI) systems was designed using SolidWorks. The design was transferred to a 3D printer and fabricated using a fused deposition modeling (FDM) technique. Fiducials were embedded in the phantom by placing 1.6 mm diameter steel balls in predefined holes and securingmore » them with silicone. Several MV and kV images of the phantom were collected and the visibility and geometric accuracy were evaluated. A second phantom, for use in the experimental evaluation of a high dose rate (HDR) brachytherapy dosimeter, was designed to secure several applicator needles in water. The applicator was fabricated in the same 3D printer and used for experiments. Results The general accuracy of printed parts was determined to be 0.1 mm. The cost of materials for the imaging and QA phantoms were $22 and $5 respectively. Both the plastic structure and fiducial markers of the imaging phantom were visible in MV and kV images. Fiducial marker locations were determined to be within 1mm of desired locations, with the discrepancy being attributed to the fiducial attachment process. The HDR phantom secured the applicators within 0.5 mm of the desired locations. Conclusion 3D printing offers an inexpensive method for fabricating custom phantoms for use in radiation therapy quality assurance. While the geometric accuracy of such parts is limited compared to more expensive methods, the phantoms are still highly functional and provide a unique opportunity for rapid fabrication of custom phantoms for use in radiation therapy QA and research.« less

Development and implementation of a remote audit tool for high dose rate (HDR) Ir-192 brachytherapy using optically stimulated luminescence dosimetry

PubMed Central

Casey, Kevin E.; Alvarez, Paola; Kry, Stephen F.; Howell, Rebecca M.; Lawyer, Ann; Followill, David

2013-01-01

Purpose: The aim of this work was to create a mailable phantom with measurement accuracy suitable for Radiological Physics Center (RPC) audits of high dose-rate (HDR) brachytherapy sources at institutions participating in National Cancer Institute-funded cooperative clinical trials. Optically stimulated luminescence dosimeters (OSLDs) were chosen as the dosimeter to be used with the phantom. Methods: The authors designed and built an 8 × 8 × 10 cm3 prototype phantom that had two slots capable of holding Al2O3:C OSLDs (nanoDots; Landauer, Glenwood, IL) and a single channel capable of accepting all 192Ir HDR brachytherapy sources in current clinical use in the United States. The authors irradiated the phantom with Nucletron and Varian 192Ir HDR sources in order to determine correction factors for linearity with dose and the combined effects of irradiation energy and phantom characteristics. The phantom was then sent to eight institutions which volunteered to perform trial remote audits. Results: The linearity correction factor was kL = (−9.43 × 10−5 × dose) + 1.009, where dose is in cGy, which differed from that determined by the RPC for the same batch of dosimeters using 60Co irradiation. Separate block correction factors were determined for current versions of both Nucletron and Varian 192Ir HDR sources and these vendor-specific correction factors differed by almost 2.6%. For the Nucletron source, the correction factor was 1.026 [95% confidence interval (CI) = 1.023–1.028], and for the Varian source, it was 1.000 (95% CI = 0.995–1.005). Variations in lateral source positioning up to 0.8 mm and distal/proximal source positioning up to 10 mm had minimal effect on dose measurement accuracy. The overall dose measurement uncertainty of the system was estimated to be 2.4% and 2.5% for the Nucletron and Varian sources, respectively (95% CI). This uncertainty was sufficient to establish a ±5% acceptance criterion for source strength audits under a formal RPC audit program. Trial audits of four Nucletron sources and four Varian sources revealed an average RPC-to-institution dose ratio of 1.000 (standard deviation = 0.011). Conclusions: The authors have created an OSLD-based 192Ir HDR brachytherapy source remote audit tool which offers sufficient dose measurement accuracy to allow the RPC to establish a remote audit program with a ±5% acceptance criterion. The feasibility of the system has been demonstrated with eight trial audits to date. PMID:24320455

High- and low-dose-rate intraoperative radiotherapy for thoracic malignancies resected with close or positive margins.

PubMed

Fleming, Christopher; Rimner, Andreas; Cohen, Gil'ad N; Woo, Kaitlin M; Zhang, Zhigang; Rosenzweig, Kenneth E; Alektiar, Kaled M; Zelefsky, Michael J; Bains, Manjit S; Wu, Abraham J

2016-01-01

Local recurrence is a significant problem after surgical resection of thoracic tumors. As intraoperative radiotherapy (IORT) can deliver radiation directly to the threatened margin, we have used this therapy in an attempt to reduce local recurrence, using high-dose-rate (HDR) as well as low-dose-rate (LDR) techniques. We performed a retrospective review of patients undergoing LDR ((125)I) mesh placement or HDR ((192)Ir) afterloading therapy during lung tumor resection between 2001 and 2013 at our institution. Competing risks methods were used to estimate the cumulative incidence of local failure. We also assessed possible predictive factors of local failure. Fifty-nine procedures (41 LDR and 18 HDR) were performed on 58 patients. Median follow-up was 55.1 months. Cumulative incidence of local failure at 1, 2, and 3 years was 28.5%, 34.2%, and 34.2%, respectively. Median overall survival was 39.9 months. There was no significant difference in local failure according to margin status, HDR vs. LDR, use of adjuvant external beam radiotherapy, or metastatic vs. primary tumor. Two patients (3.4%) experienced Grade 3+ toxicities likely related to brachytherapy. Additionally, 7 patients experienced Grade 3+ postsurgical complications unlikely related to brachytherapy. IORT is associated with good local control after resection of thoracic tumors otherwise at very high risk for local recurrence. There is a low incidence of severe toxicity attributable to brachytherapy. HDR-IORT appears to have equivalent outcomes to LDR-IORT. HDR or LDR-IORT can, therefore, be considered in situations where the oncologic completeness of thoracic tumor resection is in doubt. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Direct evidence that prostate tumors show high sensitivity to fractionation (low alpha/beta ratio), similar to late-responding normal tissue.

PubMed

Brenner, David J; Martinez, Alvaro A; Edmundson, Gregory K; Mitchell, Christina; Thames, Howard D; Armour, Elwood P

2002-01-01

A direct approach to the question of whether prostate tumors have an atypically high sensitivity to fractionation (low alpha/beta ratio), more typical of the surrounding late-responding normal tissue. Earlier estimates of alpha/beta for prostate cancer have relied on comparing results from external beam radiotherapy (EBRT) and brachytherapy, an approach with significant pitfalls due to the many differences between the treatments. To circumvent this, we analyze recent data from a single EBRT + high-dose-rate (HDR) brachytherapy protocol, in which the brachytherapy was given in either 2 or 3 implants, and at various doses. For the analysis, standard models of tumor cure based on Poisson statistics were used in conjunction with the linear-quadratic formalism. Biochemical control at 3 years was the clinical endpoint. Patients were matched between the 3 HDR vs. 2 HDR implants by clinical stage, pretreatment prostate-specific antigen (PSA), Gleason score, length of follow-up, and age. The estimated value of alpha/beta from the current analysis of 1.2 Gy (95% CI: 0.03, 4.1 Gy) is consistent with previous estimates for prostate tumor control. This alpha/beta value is considerably less than typical values for tumors (> or =8 Gy), and more comparable to values in surrounding late-responding normal tissues. This analysis provides strong supporting evidence that alpha/beta values for prostate tumor control are atypically low, as indicated by previous analyses and radiobiological considerations. If true, hypofractionation or HDR regimens for prostate radiotherapy (with appropriate doses) should produce tumor control and late sequelae that are at least as good or even better than currently achieved, with the added possibility that early sequelae may be reduced.

[Motor vehicle crash fatalities at 30 days in Spain].

PubMed

Pérez, Katherine; Pérez, Catherine; Cirera, Eva; Borrell, Carme; Plasencia, Antoni

2006-01-01

To assess level of fulfillment and utility of the hospital discharge register (HDR) as a complementary source of information for estimating the number of deaths at 30 days due to motor vehicle crashes in Spain. It is a cross-sectional study were we compared the number of people injured due to motor vehicle crashes hospitalised in a public hospital (HDR), in Spain during 2001, with the number of people severely injured or killed due to motor vehicle crashes reported by the police database (Dirección General de Tráfico, DGT) for the same year. A descriptive analysis was carried out by age, sex and region (Autonomous Community), as well as an estimation of the percentage of under-reporting of deaths by the DGT based on two assumptions. Police reported 27,272 severe injuries and 4,811 deaths during first 24 hours after the crash and after applying a fatality adjustment factor estimated 706 more deaths up to 30 days after the crash. The HDR reported 40,174 urgent hospitalisations. Of these, 1,099 died during the day of hospitalisation or within the following 30 days. The police only notified 68% of all cases that required hospitalisation. According to the number of deaths reported by police and contrasted with hospital register, estimations of the number of deaths at 30 days made by police could represent a level of under-reporting of between 3% and 6.6%, depending on the assumption considered. This study showed that the HDR is an information source that complements police statistics and is useful to estimate the number of deaths and non-fatal injuries due to motor vehicle crashes in Spain.

SU-E-T-413: Examining Acquisition Rate for Using MatriXX Ion Chamber Array to Measure HDR Brachytherapy Treatments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wagar, M; Bhagwat, M; O’Farrell, D

2015-06-15

Purpose: There are unique obstacles to implementing the MatriXX ionchamber array as a QA tool in Brachytherapy given that the device is designed for use in the MV energy range. One of the challenges we investigate is the affect of acquisition rates on dose measurement accuracy for HDR treatment plans. Methods: A treatment plan was optimized in Oncentra Brachy TPS to deliver a planar dose to a 5×5cm region at 10mm depth. The applicator was affixed to the surface of the MatriXX array. The plan was delivered multiple times using a Nucleatron HDR afterloader with a 2.9Ci Ir192 source. Formore » each measurement the sampling rate of the MatriXX movie mode was varied (30ms and 500ms). This experiment was repeated with identical parameters, following a source exchange, with an 11.2Ci Ir192 source. Finally, a single snap measurement was acquired. Analysis was preformed to evaluate the fidelity of the dose delivery for each iteration of the experiment. Evaluation was based on the comparison between the measured and TPS predicted dose. Results: Higher sample rates induce a greater discrepancy between the predicted and measured dose. Delivering the plan using a lower activity source also produced greater discrepancy in the measurement due to the increased delivery time. Analyzing the single snap measurement showed little difference from the 500ms integral dose measurement. Conclusion: The advantage of using movie mode for HDR treatment delivery QA is the ability for real time source tracking in addition to dose measurement. Our analysis indicates that 500ms is an optimal frame rate.« less

Changes of loading tensile force-stretch relationships of rabbit mesenteric vein after 21 days of head-down rest

NASA Astrophysics Data System (ADS)

Yao, Yong-Jie; Sun, Hui-Pin; Yue, Yong; Sun, Xi-Qing; Wu, Xing-Yu

Changes of venous compliance may contribute to postflight orthostatic intolerance; however, direct animal studies to address the changes of venous compliance to microgravity have been rare. The purpose of this study was to determine compliance changes of mesenteric veins of rabbits after 21 days of head-down rest (HDR). Twenty-four healthy male New Zealand Rabbits were randomly divided into 21 days of HDR group, horizontal immobilization group (HIG) and control group (Ctrl), with eight in each. Loading tensile force-stretch relationships of mesenteric vein segments were constructed after 21 d HDR. With the increase of loading tensile force, both longitudinal and circumferential stretches of vein samples increased significantly. Under the same loading tensile force, mesenteric vein of the HDR showed significant increase both in circumferential stretch and longitudinal stretches compared to those of Ctrl group and HIG group. These results indicate that, a 21-day simulated weightlessness leads to increase of mesenteric venous compliance.

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Erickson, Beth A.; Demanes, D. Jeffrey; Ibbott, Geoffrey S.

2011-03-01

High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal,more » breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.« less

SU-F-T-28: Evaluation of BEBIG HDR Co-60 After-Loading System for Skin Cancer Treatment Using Conical Surface Applicator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Safigholi, H; Soliman, A; Song, W Y

Purpose: To evaluate the possibility of utilizing the BEBIG HDR 60Co remote after-loading system for malignant skin surface treatment using Monte Carlo (MC) simulation technique. Methods: First TG-43 parameters of BEBIG-Co-60 and Nucletron Ir-192-mHDR-V2 brachytherapy sources were simulated using MCNP6 code to benchmark the sources against the literature. Second a conical tungsten-alloy with 3-cm diameter of Planning-Target-Volume (PTV) at surface for use with a single stepping HDR source is designed. The HDR source is modeled parallel to treatment plane at the center of the conical applicator with a source surface distance (SSD) of 1.5-cm and a removable plastic end-cap withmore » a 1-mm thickness. Third, MC calculated dose distributions from HDR Co-60 for conical surface applicator were compared with the simulated data using HDR Ir-192 source. The initial calculations were made with the same conical surface applicator (standard-applicator) dimensions as the ones used with the Ir-192 system. Fourth, the applicator wall-thickness for the Co-60 system was increased (doubled) to diminish leakage dose to levels received when using the Ir-192 system. With this geometry, percentage depth dose (PDD), and relative 2D-dose profiles in transverse/coronal planes were normalized at 3-mm prescription-depth evaluated along the central axis. Results: PDD for Ir-192 and Co-60 were similar with standard and thick-walled applicator. 2D-relative dose distribution of Co-60, inside the standard-conical-applicator, generated higher penumbra (7.6%). For thick-walled applicator, it created smaller penumbra (<4%) compared to Ir-192 source in the standard-conicalapplicator. Dose leakage outside of thick-walled applicator with Co-60 source was approximately equal (≤3%) with standard applicator using Ir-192 source. Conclusion: Skin cancer treatment with equal quality can be performed with Co-60 source and thick-walled conical applicators instead of Ir-192 with standard applicators. These conical surface applicator must be used with a protective plastic end-cap to eliminate electron contamination and over-dosage of the skin.« less

After low and high dose-rate interstitial brachytherapy followed by IMRT radiotherapy for intermediate and high risk prostate cancer.

PubMed

Nakamura, Satoshi; Murakami, Naoya; Inaba, Koji; Wakita, Akihisa; Kobayashi, Kazuma; Takahashi, Kana; Okamoto, Hiroyuki; Umezawa, Rei; Morota, Madoka; Sumi, Minako; Igaki, Hiroshi; Ito, Yoshinori; Itami, Jun

2016-05-03

The study aimed to compare urinary symptoms in patients with clinically localized prostate cancer after a combination of either low-dose-rate or high-dose-rate interstitial brachytherapy along with intensity-modulated radiation therapy (LDR-ISBT + IMRT or HDR-ISBT + IMRT). From June 2009 to April 2014, 16 and 22 patients were treated with LDR-ISBT + IMRT and HDR-ISBT + IMRT, respectively. No patient from these groups was excluded from this study. The prescribed dose of LDR-ISBT, HDR-ISBT, and IMRT was 115 Gy, 20 Gy in 2 fractions, and 46 Gy in 23 fractions, respectively. Obstructive and irritative urinary symptoms were assessed by the International Prostate Symptom Score (IPSS) examined before and after treatments. After ISBT, IPSS was evaluated in the 1st and 4th weeks, then every 2-3 months for the 1st year, and every 6 months thereafter. The median follow-up of the patients treated with LDR-ISBT + IMRT and HDR-ISBT + IMRT was 1070.5 days and 1048.5 days, respectively (p = 0.321). The IPSS-increment in the LDR-ISBT + IMRT group was greater than that in the HDR-ISBT + IMRT between 91 and 180 days after ISBT (p = 0.015). In the LDR-ISBT + IMRT group, the IPSS took longer time to return to the initial level than in the HDR-ISBT + IMRT group (in LDR-ISBT + IMRT group, the recovery time was 90 days later). The dose to urethra showed a statistically significant association with the IPSS-increment in the irritative urinary symptoms (p = 0.011). Clinical outcomes were comparable between both the groups. Both therapeutic modalities are safe and well suited for patients with clinically localized prostate cancer; however, it took patients longer to recover from LDR-ISBT + IMRT than from HDR-ISBT + IMRT. It is possible that fast dose delivery induced early symptoms and early recovery, while gradual dose delivery induced late symptoms and late recovery. Urethral dose reductions were associated with small increments in IPSS.

SU-E-T-366: Clinical Implementation of MR-Guided Vaginal Cylinder Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owrangi, A; Jolly, S; Balter, J

2014-06-01

Purpose: To evaluate the accuracy of MR-based vaginal brachytherapy source localization using an in-house MR-visible marker versus the alignment of an applicator model to MR images. Methods: Three consecutive patients undergoing vaginal HDR brachytherapy with a plastic cylinder were scanned with both CT and MRI (including T1- and T2- weighted images). An MR-visible source localization marker, consisting of a sealed thin catheter filled with either water (for T2 contrast) or Gd-doped water (for T1 contrast), was assembled shortly before scanning. Clinically, the applicator channel was digitized on CT with an x-ray marker. To evaluate the efficacy of MR-based applicator reconstruction,more » each MR image volume was aligned locally to the CT images based on the region containing the cylinder. Applicator digitization was performed on the MR images using (1) the MR visible marker and (2) alignment of an applicator surface model from Varian's Brachytherapy Planning software to the MRI images. Resulting source positions were compared with the original CT digitization. Results: Although the source path was visualized by the MR marker, the applicator tip proved difficult to identify due to challenges in achieving a watertight seal. This resulted in observed displacements of the catheter tip, at times >1cm. Deviations between the central source positions identified via aligning the applicator surface model to MR and using the xray marker on CT ranged from 0.07 – 0.19 cm and 0.07 – 0.20 cm on T1- weighted and T2-weighted images, respectively. Conclusion: Based on the current study, aligning the applicator model to MRI provides a practical, current approach to perform MR-based brachytherapy planning. Further study is needed to produce catheters with reliably and reproducibly identifiable tips. Attempts are being made to improve catheter seals, as well as to increase the viscosity of the contrast material to decrease fluid mobility inside the catheter.« less

Dosimetric impact of applicator displacement during high dose rate (HDR) Cobalt-60 brachytherapy for cervical cancer: A planning study

NASA Astrophysics Data System (ADS)

Yong, J. S.; Ung, N. M.; Jamalludin, Z.; Malik, R. A.; Wong, J. H. D.; Liew, Y. M.; Ng, K. H.

2016-02-01

We investigated the dosimetric impact of applicator displacement on dose specification during high dose rate (HDR) Cobalt-60 (Co-60) brachytherapy for cervical cancer through a planning study. Eighteen randomly selected HDR full insertion plans were restrospectively studied. The tandem and ovoids were virtually shifted translationally and rotationally in the x-, y- and z-axis directions on the treatment planning system. Doses to reference points and volumes of interest in the plans with shifted applicators were compared with the original plans. The impact of dose displacement on 2D (point-based) and 3D (volume-based) treatment planning techniques was also assessed. A ±2 mm translational y-axis applicator shift and ±4° rotational x-axis applicator shift resulted in dosimetric changes of more than 5% to organs at risk (OAR) reference points. Changes to the maximum doses to 2 cc of the organ (D2cc) in 3D planning were statistically significant and higher than the reference points in 2D planning for both the rectum and bladder (p<0.05). Rectal D2cc was observed to be the most sensitive to applicator displacement among all dose metrics. Applicator displacement that is greater than ±2 mm translational y-axis and ±4° rotational x-axis resulted in significant dose changes to the OAR. Thus, steps must be taken to minimize the possibility of applicator displacement during brachytherapy.

The use of photostimulable phosphor systems for periodic quality assurance in radiotherapy.

PubMed

Conte, L; Bianchi, C; Cassani, E; Monciardini, M; Mordacchini, C; Novario, R; Strocchi, S; Stucchi, P; Tanzi, F

2008-03-01

The fusion of radiological and optical images can be achieved through charging a photostimulable phosphor plate (PSP) with an exposure to a field of X- or gamma-rays, followed by exposure to an optical image which discharges the plate in relation to the amount of incident light. According to this PSP characteristic, we developed a simple method for periodic quality assurance (QA) of light/radiation field coincidence, distance indicator, field size indicators, crosshair centering, coincidence of radiation and mechanical isocenter for linear accelerators. The geometrical accuracy of radiological units can be subjected to the same QA method. Further, the source position accuracy for an HDR remote afterloader can be checked by taking an autoradiography of the radioactive source and simultaneously an optical image of a reference geometrical system.

Hot dry rock geothermal energy: A renewable energy resource that is ready for development now

NASA Astrophysics Data System (ADS)

Brown, D. W.; Potter, R. M.; Myers, C. W.

Hot dry rock (HDR) geothermal energy, which utilizes the natural heat contained in the earth's crust, is a very large and well-distributed resource of nonpolluting, and essentially renewable, energy that is available globally. Its use could help mitigate climatic change and reduce acid rain, two of the major environmental consequences of our ever-increasing use of fossil fuels for heating and power generation. In addition, HDR, as a readily available source of indigenous energy, can reduce our nations's dependence on imported oil, enhancing national security and reducing our trade deficit. On a national scale we can begin to develop this new source, using it directly for power generation or for direct-heat applications, or indirectly in hybrid geothermal/fossil-fuel power plants. In the HDR concept, which has been demonstrated in the field in two different applications and flow-tested for periods up to one year, heat is recovered from the earth by pressurized water in a closed-loop circulation system. As a consequence, minimal effluents are released to the atmosphere, and no wastes are produced. This paper describes the nature of the HDR resource and the technology required to implement the heat-mining concept. An assessment of the requirements for establishing HDR feasibility is presented in the context of providing a commercially competitive energy source.

Interaction between vestibulosympathetic and skeletal muscle reflexes on sympathetic activity in humans

NASA Technical Reports Server (NTRS)

Ray, C. A.

2001-01-01

Evidence from animals indicates that skeletal muscle afferents activate the vestibular nuclei and that both vestibular and skeletal muscle afferents have inputs to the ventrolateral medulla. The purpose of the present study was to investigate the interaction between the vestibulosympathetic and skeletal muscle reflexes on muscle sympathetic nerve activity (MSNA) and arterial pressure in humans. MSNA, arterial pressure, and heart rate were measured in 17 healthy subjects in the prone position during three experimental trials. The three trials were 2 min of 1) head-down rotation (HDR) to engage the vestibulosympathetic reflex, 2) isometric handgrip (IHG) at 30% maximal voluntary contraction to activate skeletal muscle afferents, and 3) HDR and IHG performed simultaneously. The order of the three trials was randomized. HDR and IHG performed alone increased total MSNA by 46 +/- 16 and 77 +/- 24 units, respectively (P < 0.01). During the HDR plus IHG trial, MSNA increased 142 +/- 38 units (P < 0.01). This increase was not significantly different from the sum of the individual trials (130 +/- 41 units). This finding was also observed with mean arterial pressure (sum = 21 +/- 2 mmHg and HDR + IHG = 22 +/- 2 mmHg). These findings suggest that there is an additive interaction for MSNA and arterial pressure when the vestibulosympathetic and skeletal muscle reflexes are engaged simultaneously in humans. Therefore, no central modulation exists between these two reflexes with regard to MSNA output in humans.

Cliché, Gossip, and Anecdote as Supervision Training

ERIC Educational Resources Information Center

Grealy, Liam

2016-01-01

This article expands on a co-authored project with Timothy Laurie on the practices and ethics of higher degree research (HDR) supervision (or advising): "What does good HDR supervision look like?" in contemporary universities. It connects that project with scholarship on the relevance of "common sense" to questions of…

Nonlinear mapping of the luminance in dual-layer high dynamic range displays

NASA Astrophysics Data System (ADS)

Guarnieri, Gabriele; Ramponi, Giovanni; Bonfiglio, Silvio; Albani, Luigi

2009-02-01

It has long been known that the human visual system (HVS) has a nonlinear response to luminance. This nonlinearity can be quantified using the concept of just noticeable difference (JND), which represents the minimum amplitude of a specified test pattern an average observer can discern from a uniform background. The JND depends on the background luminance following a threshold versus intensity (TVI) function. It is possible to define a curve which maps physical luminances into a perceptually linearized domain. This mapping can be used to optimize a digital encoding, by minimizing the visibility of quantization noise. It is also commonly used in medical applications to display images adapting to the characteristics of the display device. High dynamic range (HDR) displays, which are beginning to appear on the market, can display luminance levels outside the range in which most standard mapping curves are defined. In particular, dual-layer LCD displays are able to extend the gamut of luminance offered by conventional liquid crystals towards the black region; in such areas suitable and HVS-compliant luminance transformations need to be determined. In this paper we propose a method, which is primarily targeted to the extension of the DICOM curve used in medical imaging, but also has a more general application. The method can be modified in order to compensate for the ambient light, which can be significantly greater than the black level of an HDR display and consequently reduce the visibility of the details in dark areas.

Accuracy Evaluation of Oncentra™ TPS in HDR Brachytherapy of Nasopharynx Cancer Using EGSnrc Monte Carlo Code.

PubMed

Hadad, K; Zohrevand, M; Faghihi, R; Sedighi Pashaki, A

2015-03-01

HDR brachytherapy is one of the commonest methods of nasopharyngeal cancer treatment. In this method, depending on how advanced one tumor is, 2 to 6 Gy dose as intracavitary brachytherapy is prescribed. Due to high dose rate and tumor location, accuracy evaluation of treatment planning system (TPS) is particularly important. Common methods used in TPS dosimetry are based on computations in a homogeneous phantom. Heterogeneous phantoms, especially patient-specific voxel phantoms can increase dosimetric accuracy. In this study, using CT images taken from a patient and ctcreate-which is a part of the DOSXYZnrc computational code, patient-specific phantom was made. Dose distribution was plotted by DOSXYZnrc and compared with TPS one. Also, by extracting the voxels absorbed dose in treatment volume, dose-volume histograms (DVH) was plotted and compared with Oncentra™ TPS DVHs. The results from calculations were compared with data from Oncentra™ treatment planning system and it was observed that TPS calculation predicts lower dose in areas near the source, and higher dose in areas far from the source relative to MC code. Absorbed dose values in the voxels also showed that TPS reports D90 value is 40% higher than the Monte Carlo method. Today, most treatment planning systems use TG-43 protocol. This protocol may results in errors such as neglecting tissue heterogeneity, scattered radiation as well as applicator attenuation. Due to these errors, AAPM emphasized departing from TG-43 protocol and approaching new brachytherapy protocol TG-186 in which patient-specific phantom is used and heterogeneities are affected in dosimetry.

Accuracy Evaluation of Oncentra™ TPS in HDR Brachytherapy of Nasopharynx Cancer Using EGSnrc Monte Carlo Code

PubMed Central

Hadad, K.; Zohrevand, M.; Faghihi, R.; Sedighi Pashaki, A.

2015-01-01

Background HDR brachytherapy is one of the commonest methods of nasopharyngeal cancer treatment. In this method, depending on how advanced one tumor is, 2 to 6 Gy dose as intracavitary brachytherapy is prescribed. Due to high dose rate and tumor location, accuracy evaluation of treatment planning system (TPS) is particularly important. Common methods used in TPS dosimetry are based on computations in a homogeneous phantom. Heterogeneous phantoms, especially patient-specific voxel phantoms can increase dosimetric accuracy. Materials and Methods In this study, using CT images taken from a patient and ctcreate-which is a part of the DOSXYZnrc computational code, patient-specific phantom was made. Dose distribution was plotted by DOSXYZnrc and compared with TPS one. Also, by extracting the voxels absorbed dose in treatment volume, dose-volume histograms (DVH) was plotted and compared with Oncentra™ TPS DVHs. Results The results from calculations were compared with data from Oncentra™ treatment planning system and it was observed that TPS calculation predicts lower dose in areas near the source, and higher dose in areas far from the source relative to MC code. Absorbed dose values in the voxels also showed that TPS reports D90 value is 40% higher than the Monte Carlo method. Conclusion Today, most treatment planning systems use TG-43 protocol. This protocol may results in errors such as neglecting tissue heterogeneity, scattered radiation as well as applicator attenuation. Due to these errors, AAPM emphasized departing from TG-43 protocol and approaching new brachytherapy protocol TG-186 in which patient-specific phantom is used and heterogeneities are affected in dosimetry. PMID:25973408

Modest validity and fair reproducibility of dietary patterns derived by cluster analysis.

PubMed

Funtikova, Anna N; Benítez-Arciniega, Alejandra A; Fitó, Montserrat; Schröder, Helmut

2015-03-01

Cluster analysis is widely used to analyze dietary patterns. We aimed to analyze the validity and reproducibility of the dietary patterns defined by cluster analysis derived from a food frequency questionnaire (FFQ). We hypothesized that the dietary patterns derived by cluster analysis have fair to modest reproducibility and validity. Dietary data were collected from 107 individuals from population-based survey, by an FFQ at baseline (FFQ1) and after 1 year (FFQ2), and by twelve 24-hour dietary recalls (24-HDR). Repeatability and validity were measured by comparing clusters obtained by the FFQ1 and FFQ2 and by the FFQ2 and 24-HDR (reference method), respectively. Cluster analysis identified a "fruits & vegetables" and a "meat" pattern in each dietary data source. Cluster membership was concordant for 66.7% of participants in FFQ1 and FFQ2 (reproducibility), and for 67.0% in FFQ2 and 24-HDR (validity). Spearman correlation analysis showed reasonable reproducibility, especially in the "fruits & vegetables" pattern, and lower validity also especially in the "fruits & vegetables" pattern. κ statistic revealed a fair validity and reproducibility of clusters. Our findings indicate a reasonable reproducibility and fair to modest validity of dietary patterns derived by cluster analysis. Copyright © 2015 Elsevier Inc. All rights reserved.

TU-D-201-06: HDR Plan Prechecks Using Eclipse Scripting API

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palaniswaamy, G; Morrow, A; Kim, S

Purpose: Automate brachytherapy treatment plan quality check using Eclipse v13.6 scripting API based on pre-configured rules to minimize human error and maximize efficiency. Methods: The HDR Precheck system is developed based on a rules-driven approach using Eclipse scripting API. This system checks for critical plan parameters like channel length, first source position, source step size and channel mapping. The planned treatment time is verified independently based on analytical methods. For interstitial or SAVI APBI treatment plans, a Patterson-Parker system calculation is performed to verify the planned treatment time. For endobronchial treatments, an analytical formula from TG-59 is used. Acceptable tolerancesmore » were defined based on clinical experiences in our department. The system was designed to show PASS/FAIL status levels. Additional information, if necessary, is indicated appropriately in a separate comments field in the user interface. Results: The HDR Precheck system has been developed and tested to verify the treatment plan parameters that are routinely checked by the clinical physicist. The report also serves as a reminder or checklist for the planner to perform any additional critical checks such as applicator digitization or scenarios where the channel mapping was intentionally changed. It is expected to reduce the current manual plan check time from 15 minutes to <1 minute. Conclusion: Automating brachytherapy plan prechecks significantly reduces treatment plan precheck time and reduces human errors. When fully developed, this system will be able to perform TG-43 based second check of the treatment planning system’s dose calculation using random points in the target and critical structures. A histogram will be generated along with tabulated mean and standard deviation values for each structure. A knowledge database will also be developed for Brachyvision plans which will then be used for knowledge-based plan quality checks to further reduce treatment planning errors and increase confidence in the planned treatment.« less

Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma.

PubMed

Wootton, Jeffery H; Hsu, I-Chow Joe; Diederich, Chris J

2011-02-01

The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6-7.4 MHz that are unsectored (360 degrees), bisectored (2 x 180 degrees), or trisectored (3 x 120 degrees) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. The CTV in HDR brachytherapy plans extends 20.5 +/- 5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4 +/- 7.3 mm from the tandem. Simulations indicate that for 60 min treatments the applicator can heat to 41 degrees C and deliver > 5EM(43 degrees C) over 4-5 cm diameter with Tmax < 45 degrees C and 1 kg m(-3) s(-1) blood perfusion. The 41 degrees C contour diameter is reduced to 3-4 cm at 3 kg m(-3) s(-1) perfusion. Differential power control to transducer elements and sectors demonstrates tailoring of heating along the device length and in angle. Sector cuts are associated with a 14-47 degrees acoustic dead zone, depending on cut width, resulting in a approximately 2-4 degrees C temperature reduction within the dead zone below Tmax. Dead zones can be oriented for thermal protection of the rectum and bladder. Fabricated devices have acoustic efficiencies of 33.4%-51.8% with acoustic output that is well collimated in length, reflects the sectoring strategy, and is strongly correlated with temperature distributions. A catheter-based ultrasound applicator was developed for endocervical implantation with locally targeted, 3-D conformal thermal delivery to the uterine cervix. Feasibility of heating clinically relevant target volumes was demonstrated with power control along the device length and in angle to treat the cervix with minimal thermal dose delivery to the rectum and bladder.

A generic high-dose rate {sup 192}Ir brachytherapy source for evaluation of model-based dose calculations beyond the TG-43 formalism

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ballester, Facundo, E-mail: Facundo.Ballester@uv.es; Carlsson Tedgren, Åsa; Granero, Domingo

Purpose: In order to facilitate a smooth transition for brachytherapy dose calculations from the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) formalism to model-based dose calculation algorithms (MBDCAs), treatment planning systems (TPSs) using a MBDCA require a set of well-defined test case plans characterized by Monte Carlo (MC) methods. This also permits direct dose comparison to TG-43 reference data. Such test case plans should be made available for use in the software commissioning process performed by clinical end users. To this end, a hypothetical, generic high-dose rate (HDR) {sup 192}Ir source and a virtual watermore » phantom were designed, which can be imported into a TPS. Methods: A hypothetical, generic HDR {sup 192}Ir source was designed based on commercially available sources as well as a virtual, cubic water phantom that can be imported into any TPS in DICOM format. The dose distribution of the generic {sup 192}Ir source when placed at the center of the cubic phantom, and away from the center under altered scatter conditions, was evaluated using two commercial MBDCAs [Oncentra{sup ®} Brachy with advanced collapsed-cone engine (ACE) and BrachyVision ACUROS{sup TM}]. Dose comparisons were performed using state-of-the-art MC codes for radiation transport, including ALGEBRA, BrachyDose, GEANT4, MCNP5, MCNP6, and PENELOPE2008. The methodologies adhered to recommendations in the AAPM TG-229 report on high-energy brachytherapy source dosimetry. TG-43 dosimetry parameters, an along-away dose-rate table, and primary and scatter separated (PSS) data were obtained. The virtual water phantom of (201){sup 3} voxels (1 mm sides) was used to evaluate the calculated dose distributions. Two test case plans involving a single position of the generic HDR {sup 192}Ir source in this phantom were prepared: (i) source centered in the phantom and (ii) source displaced 7 cm laterally from the center. Datasets were independently produced by different investigators. MC results were then compared against dose calculated using TG-43 and MBDCA methods. Results: TG-43 and PSS datasets were generated for the generic source, the PSS data for use with the ACE algorithm. The dose-rate constant values obtained from seven MC simulations, performed independently using different codes, were in excellent agreement, yielding an average of 1.1109 ± 0.0004 cGy/(h U) (k = 1, Type A uncertainty). MC calculated dose-rate distributions for the two plans were also found to be in excellent agreement, with differences within type A uncertainties. Differences between commercial MBDCA and MC results were test, position, and calculation parameter dependent. On average, however, these differences were within 1% for ACUROS and 2% for ACE at clinically relevant distances. Conclusions: A hypothetical, generic HDR {sup 192}Ir source was designed and implemented in two commercially available TPSs employing different MBDCAs. Reference dose distributions for this source were benchmarked and used for the evaluation of MBDCA calculations employing a virtual, cubic water phantom in the form of a CT DICOM image series. The implementation of a generic source of identical design in all TPSs using MBDCAs is an important step toward supporting univocal commissioning procedures and direct comparisons between TPSs.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Susko, Matthew; Craciunescu, Oana; Meltsner, Sheridan

Purpose: To calculate vaginal doses during image guided brachytherapy with volume-based metrics and correlate with long-term vaginal toxicity. Methods and Materials: In this institutional review board–approved study, institutional databases were searched to identify women undergoing computed tomography and/or magnetic resonance–guided brachytherapy at the Duke Cancer Center from 2009 to 2015. All insertions were contoured to include the vagina as a 3-dimensional structure. All contouring was performed on computed tomography or magnetic resonance imaging and used a 0.4-cm fixed brush to outline the applicator and/or packing, expanded to include any grossly visible vagina. The surface of the cervix was specifically excludedmore » from the contour. High-dose-rate (HDR) and low-dose-rate (LDR) doses were converted to the equivalent dose in 2-Gy fractions using an α/β of 3 for late effects. The parameters D0.1cc, D1cc, and D2cc were calculated for all insertions and summed with prior external beam therapy. Late and subacute toxicity to the vagina were determined by the Common Terminology Criteria for Adverse Events version 4.0 and compared by the median and 4th quartile doses, via the log-rank test. Univariate and multivariate hazard ratios were calculated via Cox regression. Results: A total of 258 insertions in 62 women who underwent definitive radiation therapy including brachytherapy for cervical (n=48) and uterine cancer (n=14) were identified. Twenty HDR tandem and ovoid, 32 HDR tandem and ring, and 10 LDR tandem and ovoid insertions were contoured. The median values (interquartile ranges) for vaginal D0.1cc, D1cc, and D2cc were 157.9 (134.4-196.53) Gy, 112.6 (96.7-124.6) Gy, and 100.5 (86.8-108.4) Gy, respectively. At the 4th quartile cutoff of 108 Gy for D2cc, the rate of late grade 1 toxicity at 2 years was 61.2% (95% confidence interval [CI] 43.0%-79.4%) below 108 Gy and 83.9% (63.9%-100%) above (P=.018); grade 2 or greater toxicity was 36.2% (95% CI 15.8%-56.6%) below 108 Gy and 70.7% (95% CI 45.2%-96.2%) above (P=.004); and grade 3 or worse toxicity was 9.9% (95% CI 0.0%-23.6%) below 108 Gy and 30.0% (95% CI 4.7%-55.3%) above (P=.025). This association was maintained on multivariate analysis, independent of covariates such as applicator type, age, and dose rate. Conclusions: Vaginal dose was associated with all grades of vaginal toxicity. Confirmation at other sites using this methodology will be necessary to establish reproducibility; however, the integration of routine calculation of vaginal dose may be warranted.« less

Evaluation of hybrid inverse planning and optimization (HIPO) algorithm for optimization in real-time, high-dose-rate (HDR) brachytherapy for prostate.

PubMed

Pokharel, Shyam; Rana, Suresh; Blikenstaff, Joseph; Sadeghi, Amir; Prestidge, Bradley

2013-07-08

The purpose of this study is to investigate the effectiveness of the HIPO planning and optimization algorithm for real-time prostate HDR brachytherapy. This study consists of 20 patients who underwent ultrasound-based real-time HDR brachytherapy of the prostate using the treatment planning system called Oncentra Prostate (SWIFT version 3.0). The treatment plans for all patients were optimized using inverse dose-volume histogram-based optimization followed by graphical optimization (GRO) in real time. The GRO is manual manipulation of isodose lines slice by slice. The quality of the plan heavily depends on planner expertise and experience. The data for all patients were retrieved later, and treatment plans were created and optimized using HIPO algorithm with the same set of dose constraints, number of catheters, and set of contours as in the real-time optimization algorithm. The HIPO algorithm is a hybrid because it combines both stochastic and deterministic algorithms. The stochastic algorithm, called simulated annealing, searches the optimal catheter distributions for a given set of dose objectives. The deterministic algorithm, called dose-volume histogram-based optimization (DVHO), optimizes three-dimensional dose distribution quickly by moving straight downhill once it is in the advantageous region of the search space given by the stochastic algorithm. The PTV receiving 100% of the prescription dose (V100) was 97.56% and 95.38% with GRO and HIPO, respectively. The mean dose (D(mean)) and minimum dose to 10% volume (D10) for the urethra, rectum, and bladder were all statistically lower with HIPO compared to GRO using the student pair t-test at 5% significance level. HIPO can provide treatment plans with comparable target coverage to that of GRO with a reduction in dose to the critical structures.

Clinical analysis of speculum-based vaginal packing for high-dose-rate intracavitary tandem and ovoid brachytherapy in cervical cancer

PubMed Central

Sud, Shivani; Roth, Toni

2018-01-01

Purpose Intra-vaginal packing is used to fix the applicator and displace organs at risk (OAR) during high-dose-rate intracavitary tandem and ovoid brachytherapy (HDR-ICB). We retain the speculum from applicator placement as a dual-function bladder and rectum retractor during treatment. Our objective is to review salient techniques for OAR displacement, share our packing technique, and determine the reduction in dose to OAR and inter-fraction variability of dose to OAR, associated with speculum-based vaginal packing (SBVP) in comparison to conventional gauze packing during HDR-ICB. Material and methods We reviewed HDR-ICB treatment plans for 45 patients, including 10 who underwent both conventional gauze packing and SBVP. Due to institutional inter-provider practice differences, patients non-selectively received either packing procedure. Packing was performed under conscious sedation, followed by cone beam computed tomography used for dosimetric planning. Maximum absolute and percent-of-prescription dose to the International Commission of Radiation Units bladder and rectal points in addition to D0.1cc, D1.0cc, and D2.0cc volumes of the bladder and rectum were analyzed and compared for each packing method using an independent sample t-test. Results Of the 179 fractions included, 73% and 27% used SBVP and gauze packing, respectively. For patients prescribed 6 Gy to point A, SBVP was associated with reduced mean D0.1cc bladder dose, inter-fraction variability in D0.1cc bladder dose by 9.3% (p = 0.026) and 9.0%, respectively, and statistically equivalent rectal D0.1cc, D1.0cc, and D2.0cc. Patients prescribed 5.5 Gy or 5 Gy to point A after dose optimization, were less likely to benefit from SBVP. In the intra-patient comparison, 80% of patients had reduction in at least one rectum or bladder parameter. Conclusions In patients with conducive anatomy, SBVP is a cost-efficient packing method that is associated with improved bladder sparing and comparable rectal sparing relative to gauze packing during HDR-ICB without general anesthesia. PMID:29619054

Selection-dependent and Independent Generation of CRISPR/Cas9-mediated Gene Knockouts in Mammalian Cells.

PubMed

Sternburg, Erin L; Dias, Kristen C; Karginov, Fedor V

2017-06-16

The CRISPR/Cas9 genome engineering system has revolutionized biology by allowing for precise genome editing with little effort. Guided by a single guide RNA (sgRNA) that confers specificity, the Cas9 protein cleaves both DNA strands at the targeted locus. The DNA break can trigger either non-homologous end joining (NHEJ) or homology directed repair (HDR). NHEJ can introduce small deletions or insertions which lead to frame-shift mutations, while HDR allows for larger and more precise perturbations. Here, we present protocols for generating knockout cell lines by coupling established CRISPR/Cas9 methods with two options for downstream selection/screening. The NHEJ approach uses a single sgRNA cut site and selection-independent screening, where protein production is assessed by dot immunoblot in a high-throughput manner. The HDR approach uses two sgRNA cut sites that span the gene of interest. Together with a provided HDR template, this method can achieve deletion of tens of kb, aided by the inserted selectable resistance marker. The appropriate applications and advantages of each method are discussed.

Development and implementation of a remote audit tool for high dose rate (HDR) Ir-192 brachytherapy using optically stimulated luminescence dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Casey, Kevin E.; Kry, Stephen F.; Howell, Rebecca M.

Purpose: The aim of this work was to create a mailable phantom with measurement accuracy suitable for Radiological Physics Center (RPC) audits of high dose-rate (HDR) brachytherapy sources at institutions participating in National Cancer Institute-funded cooperative clinical trials. Optically stimulated luminescence dosimeters (OSLDs) were chosen as the dosimeter to be used with the phantom.Methods: The authors designed and built an 8 × 8 × 10 cm{sup 3} prototype phantom that had two slots capable of holding Al{sub 2}O{sub 3}:C OSLDs (nanoDots; Landauer, Glenwood, IL) and a single channel capable of accepting all {sup 192}Ir HDR brachytherapy sources in current clinicalmore » use in the United States. The authors irradiated the phantom with Nucletron and Varian {sup 192}Ir HDR sources in order to determine correction factors for linearity with dose and the combined effects of irradiation energy and phantom characteristics. The phantom was then sent to eight institutions which volunteered to perform trial remote audits.Results: The linearity correction factor was k{sub L}= (−9.43 × 10{sup −5}× dose) + 1.009, where dose is in cGy, which differed from that determined by the RPC for the same batch of dosimeters using {sup 60}Co irradiation. Separate block correction factors were determined for current versions of both Nucletron and Varian {sup 192}Ir HDR sources and these vendor-specific correction factors differed by almost 2.6%. For the Nucletron source, the correction factor was 1.026 [95% confidence interval (CI) = 1.023–1.028], and for the Varian source, it was 1.000 (95% CI = 0.995–1.005). Variations in lateral source positioning up to 0.8 mm and distal/proximal source positioning up to 10 mm had minimal effect on dose measurement accuracy. The overall dose measurement uncertainty of the system was estimated to be 2.4% and 2.5% for the Nucletron and Varian sources, respectively (95% CI). This uncertainty was sufficient to establish a ±5% acceptance criterion for source strength audits under a formal RPC audit program. Trial audits of four Nucletron sources and four Varian sources revealed an average RPC-to-institution dose ratio of 1.000 (standard deviation = 0.011).Conclusions: The authors have created an OSLD-based {sup 192}Ir HDR brachytherapy source remote audit tool which offers sufficient dose measurement accuracy to allow the RPC to establish a remote audit program with a ±5% acceptance criterion. The feasibility of the system has been demonstrated with eight trial audits to date.« less

Hydrodynamically-driven drug release during interstitial flow through hollow fibers implanted near lymphatics

PubMed Central

Dukhin, Stanislav S.; Labib, Mohamed E.

2016-01-01

Current drug delivery devices (DDD) are mainly based on the use of diffusion as the main transport process. Diffusion-driven processes can only achieve low release rate because diffusion is a slow process. This represents a serious obstacle in the realization of recent successes in the suppression of lymphatic metastasis and in the prevention of limb and organ transplant rejection. Surprisingly, it was overlooked that there is a more favorable drug release mode which can be achieved when a special DDD is implanted near lymphatics. This opportunity can be realized when the interstitial fluid flow penetrates a drug delivery device of proper design and allows such fluid to flow out of it. This design is based on hollow fibers loaded with drug and whose hydrodynamic permeability is much higher than that of the surrounding tissue. The latter is referred to as hollow fiber of high hydrodynamic permeability (HFHP). The interstitial flow easily penetrates the hollow fiber membrane as well as its lumen with a higher velocity than that in the adjacent tissue. The interstitial liquid stream entering the lumen becomes almost saturated with drug as it flows out of the HFHP. This is due to the drug powder dissolution in the lumens of HFHP which forms a strip of drug solution that crosses the interstitium and finally enters the lymphatics. This hydrodynamically-driven release (HDR) may exceed the concomitant diffusion-driven release (DDR) by one or even two orders of magnitude. The hydrodynamics of the two-compartment media is sufficient for developing the HDR theory which is detailed in this paper. Convective diffusion theory for two compartments (membrane of hollow fiber and adjacent tissue) is required for exact quantification when a small contribution of DDR to predominating HDR is present. Hence, modeling is important for HDR which would lead to establishing a new branch in physico-chemical hydrodynamics. The release rate achieved with the use of HFHP increases proportional to the number of hollow fibers in the fabric employed in drug delivery. Based on this contribution, it is now possible to simultaneously provide high release rates and long release durations, thus overcoming a fundamental limitation in drug delivery. Perhaps this breakthrough in long-term drug delivery has potential applications in targeting lymphatics and in treating cancer and cancer metastasis without causing the serious side effects of systemic drugs. PMID:28579697

Interstitial rotating shield brachytherapy for prostate cancer.

PubMed

Adams, Quentin E; Xu, Jinghzu; Breitbach, Elizabeth K; Li, Xing; Enger, Shirin A; Rockey, William R; Kim, Yusung; Wu, Xiaodong; Flynn, Ryan T

2014-05-01

To present a novel needle, catheter, and radiation source system for interstitial rotating shield brachytherapy (I-RSBT) of the prostate. I-RSBT is a promising technique for reducing urethra, rectum, and bladder dose relative to conventional interstitial high-dose-rate brachytherapy (HDR-BT). A wire-mounted 62 GBq(153)Gd source is proposed with an encapsulated diameter of 0.59 mm, active diameter of 0.44 mm, and active length of 10 mm. A concept model I-RSBT needle/catheter pair was constructed using concentric 50 and 75 μm thick nickel-titanium alloy (nitinol) tubes. The needle is 16-gauge (1.651 mm) in outer diameter and the catheter contains a 535 μm thick platinum shield. I-RSBT and conventional HDR-BT treatment plans for a prostate cancer patient were generated based on Monte Carlo dose calculations. In order to minimize urethral dose, urethral dose gradient volumes within 0-5 mm of the urethra surface were allowed to receive doses less than the prescribed dose of 100%. The platinum shield reduced the dose rate on the shielded side of the source at 1 cm off-axis to 6.4% of the dose rate on the unshielded side. For the case considered, for the same minimum dose to the hottest 98% of the clinical target volume (D(98%)), I-RSBT reduced urethral D(0.1cc) below that of conventional HDR-BT by 29%, 33%, 38%, and 44% for urethral dose gradient volumes within 0, 1, 3, and 5 mm of the urethra surface, respectively. Percentages are expressed relative to the prescription dose of 100%. For the case considered, for the same urethral dose gradient volumes, rectum D(1cc) was reduced by 7%, 6%, 6%, and 6%, respectively, and bladder D(1cc) was reduced by 4%, 5%, 5%, and 6%, respectively. Treatment time to deliver 20 Gy with I-RSBT was 154 min with ten 62 GBq (153)Gd sources. For the case considered, the proposed(153)Gd-based I-RSBT system has the potential to lower the urethral dose relative to HDR-BT by 29%-44% if the clinician allows a urethral dose gradient volume of 0-5 mm around the urethra to receive a dose below the prescription. A multisource approach is necessary in order to deliver the proposed (153)Gd-based I-RSBT technique in reasonable treatment times.

Comparison between in vivo dosimetry and barium contrast technique for prediction of rectal complications in high-dose-rate intracavitary radiotherapy in cervix cancer patients.

PubMed

Huh, Seung Jae; Lim, Do Hoon; Ahn, Yong Chan; Lee, Jeong Eun; Kang, Min Kyu; Shin, Seong Soo; Shin, Kyung Hwan; Kim, Bokyung; Park, Won; Han, Youngyih

2003-03-01

To investigate the correlation between late rectal complications and rectal dose in cervix cancer patients treated with high-dose-rate intracavitary radiotherapy (HDR ICR) and to analyze factors reducing rectal complications. A total of 136 patients with cervix cancer who were treated with external beam radiotherapy (EBRT) and HDR ICR from 1995 to 1999 were retrospectively analyzed. Radiotherapy (RT) consisted of EBRT plus HDR ICR. The median EBRT dose was 50.4 Gy, and midline block was done after 30-50 Gy of EBRT. A total of six fractions of HDR ICR with 4 Gy fraction size each were applied twice per week to the A point. The rectal dose was calculated at the rectal reference point using the barium contrast criteria. In vivo measurement of the rectal dose was performed with thermoluminescent dosimeter (TLD) during HDR ICR. The median follow-up period was 26 months (range 6-60 months). A total of 16 patients (12%) experienced rectal bleeding, which occurred 4-33 months (median 11 months) after the completion of RT. The calculated rectal doses did not differ in patients with rectal bleeding and those without, but the measured rectal doses were higher in affected patients. The differences of the measured ICR fractional rectal dose, ICR total rectal dose, and total rectal biologically equivalent dose (BED) were statistically significant. When the measured ICR total rectal dose exceeded 16 Gy, the ratio of the measured rectal dose to A point dose was > 70%; when the measured rectal BED exceeded 110 Gy(3), a high possibility of late rectal complications could be found. In vivo dosimetry using TLD during HDR ICR was a good predictor of late rectal complications. Hence, if data from in vivo dosimetry shows any possibility of rectal bleeding, efforts should be made to reduce the rectal dose.

Rectal bleeding after high-dose-rate brachytherapy combined with hypofractionated external-beam radiotherapy for localized prostate cancer: Impact of rectal dose in high-dose-rate brachytherapy on occurrence of grade 2 or worse rectal bleeding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Akimoto, Tetsuo; Katoh, Hiroyuki; Kitamoto, Yoshizumi

2006-06-01

Purpose: To evaluate the incidence of Grade 2 or worse rectal bleeding after high-dose-rate (HDR) brachytherapy combined with hypofractionated external-beam radiotherapy (EBRT), with special emphasis on the relationship between the incidence of rectal bleeding and the rectal dose from HDR brachytherapy. Methods and Materials: The records of 100 patients who were treated by HDR brachytherapy combined with EBRT for {>=}12 months were analyzed. The fractionation schema for HDR brachytherapy was prospectively changed, and the total radiation dose for EBRT was fixed at 51 Gy. The distribution of the fractionation schema used in the patients was as follows: 5 Gy xmore » 5 in 13 patients; 7 Gy x 3 in 19 patients; and 9 Gy x 2 in 68 patients. Results: Ten patients (10%) developed Grade 2 or worse rectal bleeding. Regarding the correlation with dosimetric factors, no significant differences were found in the average percentage of the entire rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose from EBRT between those with bleeding and those without. The average percentage of the entire rectal volume receiving 10%, 30%, 50%, 80%, and 90% of the prescribed radiation dose from HDR brachytherapy in those who developed rectal bleeding was 77.9%, 28.6%, 9.0%, 1.5%, and 0.3%, respectively, and was 69.2%, 22.2%, 6.6%, 0.9%, and 0.4%, respectively, in those without bleeding. The differences in the percentages of the entire rectal volume receiving 10%, 30%, and 50% between those with and without bleeding were statistically significant. Conclusions: The rectal dose from HDR brachytherapy for patients with prostate cancer may have a significant impact on the incidence of Grade 2 or worse rectal bleeding.« less

Hot Dry Rock; Geothermal Energy

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1990-01-01

The commercial utilization of geothermal energy forms the basis of the largest renewable energy industry in the world. More than 5000 Mw of electrical power are currently in production from approximately 210 plants and 10 000 Mw thermal are used in direct use processes. The majority of these systems are located in the well defined geothermal generally associated with crustal plate boundaries or hot spots. The essential requirements of high subsurface temperature with huge volumes of exploitable fluids, coupled to environmental and market factors, limit the choice of suitable sites significantly. The Hot Dry Rock (HDR) concept at any depthmore » originally offered a dream of unlimited expansion for the geothermal industry by relaxing the location constraints by drilling deep enough to reach adequate temperatures. Now, after 20 years intensive work by international teams and expenditures of more than $250 million, it is vital to review the position of HDR in relation to the established geothermal industry. The HDR resource is merely a body of rock at elevated temperatures with insufficient fluids in place to enable the heat to be extracted without the need for injection wells. All of the major field experiments in HDR have shown that the natural fracture systems form the heat transfer surfaces and that it is these fractures that must be for geothermal systems producing from naturally fractured formations provide a basis for directing the forthcoming but, equally, they require accepting significant location constraints on HDR for the time being. This paper presents a model HDR system designed for commercial operations in the UK and uses production data from hydrothermal systems in Japan and the USA to demonstrate the reservoir performance requirements for viable operations. It is shown that these characteristics are not likely to be achieved in host rocks without stimulation processes. However, the long term goal of artificial geothermal systems developed by systematic engineering procedures at depth may still be attained if high temperature sites with extensive fracturing are developed or exploited. [DJE -2005]« less

A multicentre audit of HDR/PDR brachytherapy absolute dosimetry in association with the INTERLACE trial (NCT015662405).

PubMed

Díez, P; Aird, E G A; Sander, T; Gouldstone, C A; Sharpe, P H G; Lee, C D; Lowe, G; Thomas, R A S; Simnor, T; Bownes, P; Bidmead, M; Gandon, L; Eaton, D; Palmer, A L

2017-11-09

A UK multicentre audit to evaluate HDR and PDR brachytherapy has been performed using alanine absolute dosimetry. This is the first national UK audit performing an absolute dose measurement at a clinically relevant distance (20 mm) from the source. It was performed in both INTERLACE (a phase III multicentre trial in cervical cancer) and non-INTERLACE brachytherapy centres treating gynaecological tumours. Forty-seven UK centres (including the National Physical Laboratory) were visited. A simulated line source was generated within each centre's treatment planning system and dwell times calculated to deliver 10 Gy at 20 mm from the midpoint of the central dwell (representative of Point A of the Manchester system). The line source was delivered in a water-equivalent plastic phantom (Barts Solid Water) encased in blocks of PMMA (polymethyl methacrylate) and charge measured with an ion chamber at 3 positions (120° apart, 20 mm from the source). Absorbed dose was then measured with alanine at the same positions and averaged to reduce source positional uncertainties. Charge was also measured at 50 mm from the source (representative of Point B of the Manchester system). Source types included 46 HDR and PDR 192 Ir sources, (7 Flexisource, 24 mHDR-v2, 12 GammaMed HDR Plus, 2 GammaMed PDR Plus, 1 VS2000) and 1 HDR 60 Co source, (Co0.A86). Alanine measurements when compared to the centres' calculated dose showed a mean difference (±SD) of  +1.1% (±1.4%) at 20 mm. Differences were also observed between source types and dose calculation algorithm. Ion chamber measurements demonstrated significant discrepancies between the three holes mainly due to positional variation of the source within the catheter (0.4%-4.9% maximum difference between two holes). This comprehensive audit of absolute dose to water from a simulated line source showed all centres could deliver the prescribed dose to within 5% maximum difference between measurement and calculation.

Detecting Single-Nucleotide Substitutions Induced by Genome Editing.

PubMed

Miyaoka, Yuichiro; Chan, Amanda H; Conklin, Bruce R

2016-08-01

The detection of genome editing is critical in evaluating genome-editing tools or conditions, but it is not an easy task to detect genome-editing events-especially single-nucleotide substitutions-without a surrogate marker. Here we introduce a procedure that significantly contributes to the advancement of genome-editing technologies. It uses droplet digital polymerase chain reaction (ddPCR) and allele-specific hydrolysis probes to detect single-nucleotide substitutions generated by genome editing (via homology-directed repair, or HDR). HDR events that introduce substitutions using donor DNA are generally infrequent, even with genome-editing tools, and the outcome is only one base pair difference in 3 billion base pairs of the human genome. This task is particularly difficult in induced pluripotent stem (iPS) cells, in which editing events can be very rare. Therefore, the technological advances described here have implications for therapeutic genome editing and experimental approaches to disease modeling with iPS cells. © 2016 Cold Spring Harbor Laboratory Press.

Non-Homologous End Joining and Homology Directed DNA Repair Frequency of Double-Stranded Breaks Introduced by Genome Editing Reagents.

PubMed

Zaboikin, Michail; Zaboikina, Tatiana; Freter, Carl; Srinivasakumar, Narasimhachar

2017-01-01

Genome editing using transcription-activator like effector nucleases or RNA guided nucleases allows one to precisely engineer desired changes within a given target sequence. The genome editing reagents introduce double stranded breaks (DSBs) at the target site which can then undergo DNA repair by non-homologous end joining (NHEJ) or homology directed recombination (HDR) when a template DNA molecule is available. NHEJ repair results in indel mutations at the target site. As PCR amplified products from mutant target regions are likely to exhibit different melting profiles than PCR products amplified from wild type target region, we designed a high resolution melting analysis (HRMA) for rapid identification of efficient genome editing reagents. We also designed TaqMan assays using probes situated across the cut site to discriminate wild type from mutant sequences present after genome editing. The experiments revealed that the sensitivity of the assays to detect NHEJ-mediated DNA repair could be enhanced by selection of transfected cells to reduce the contribution of unmodified genomic DNA from untransfected cells to the DNA melting profile. The presence of donor template DNA lacking the target sequence at the time of genome editing further enhanced the sensitivity of the assays for detection of mutant DNA molecules by excluding the wild-type sequences modified by HDR. A second TaqMan probe that bound to an adjacent site, outside of the primary target cut site, was used to directly determine the contribution of HDR to DNA repair in the presence of the donor template sequence. The TaqMan qPCR assay, designed to measure the contribution of NHEJ and HDR in DNA repair, corroborated the results from HRMA. The data indicated that genome editing reagents can produce DSBs at high efficiency in HEK293T cells but a significant proportion of these are likely masked by reversion to wild type as a result of HDR. Supplying a donor plasmid to provide a template for HDR (that eliminates a PCR amplifiable target) revealed these cryptic DSBs and facilitated the determination of the true efficacy of genome editing reagents. The results indicated that in HEK293T cells, approximately 40% of the DSBs introduced by genome editing, were available for participation in HDR.

WE-AB-207B-04: A Preliminary Investigation of Indicators for Treatment Outcomes of CT Guided Cervical Cancer Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meerschaert, R; Paul, A; Chen, W

Purpose: To identify indicators for recurrence in cervical cancer patients treated with high-dose-rate brachytherapy (HDR-BT). Methods: A total of 37 biopsy proven uterine cervical cancer patients of stage IB-IVA treated between 2011 and 2015 were included in this study. All patients were treated with 37.8–52.2Gy of external beam radiotherapy (EBRT) plus 5 × 5.0–6.5Gy of HDR-BT. Patient age, standard deviation of high-risk clinical tumor volume (HR-CTVSD) collected throughout HDR-BT, and D90 (EQD2, α/β=10Gy) of the HR-CTV were investigated as potential indicators for local/distant recurrence using ROC analysis. The optimal cutoff value was identified through the Youden index and was subsequentlymore » used to obtain a group assignment for all patients. Another two comparing groups were defined per evidence of post-EBRT tumor shrinkage based on the pre-HDR MR scan. Kaplan-Meier curves were generated for recurrence-free proportions for comparing groups where time was measured from the final HDR treatment date to the date of the final follow-up exam and compared through Cox regression. Results: Patients had a median follow-up of 12 months, where 16% had local pelvic recurrence and 16% had distant recurrence. HR-CTVSD was identified as a statistically significant indicator for recurrence (AUC=0.802, p=0.007) compared to D90 (AUC=0.655, p=0.167) and patient age (AUC=0.683, p=0.103). HR-CTVSD of 6.26cc was chosen as the optimal cutoff value, which was used as the basis for patient group assignment. Patients with HR-CTVSD>6.26cc had a hazard ratio of 3.92 (95% CI-1.37, 11.24; p=0.011) for recurrence compared to HRCTVSD≤ 6.26cc. Patients without evidence of post-EBRT tumor shrinkage compared to those with had a hazard ratio of 4.28 (95% CI-1.14, 16.15; p=0.032) for recurrence. Conclusion: HR-CTVSD was identified as an indicator for recurrence and an optimal value of 6.26cc was established in our study. In addition, patients without evidence of post-EBRT tumor shrinkage demonstrated an increased recurrence rate.« less

TU-H-CAMPUS-JeP3-05: Adaptive Determination of Needle Sequence HDR Prostate Brachytherapy with Divergent Needle-By-Needle Delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borot de Battisti, M; Maenhout, M; Lagendijk, J J W

Purpose: To develop a new method which adaptively determines the optimal needle insertion sequence for HDR prostate brachytherapy involving divergent needle-by-needle dose delivery by e.g. a robotic device. A needle insertion sequence is calculated at the beginning of the intervention and updated after each needle insertion with feedback on needle positioning errors. Methods: Needle positioning errors and anatomy changes may occur during HDR brachytherapy which can lead to errors in the delivered dose. A novel strategy was developed to calculate and update the needle sequence and the dose plan after each needle insertion with feedback on needle positioning errors. Themore » dose plan optimization was performed by numerical simulations. The proposed needle sequence determination optimizes the final dose distribution based on the dose coverage impact of each needle. This impact is predicted stochastically by needle insertion simulations. HDR procedures were simulated with varying number of needle insertions (4 to 12) using 11 patient MR data-sets with PTV, prostate, urethra, bladder and rectum delineated. Needle positioning errors were modeled by random normally distributed angulation errors (standard deviation of 3 mm at the needle’s tip). The final dose parameters were compared in the situations where the needle with the largest vs. the smallest dose coverage impact was selected at each insertion. Results: Over all scenarios, the percentage of clinically acceptable final dose distribution improved when the needle selected had the largest dose coverage impact (91%) compared to the smallest (88%). The differences were larger for few (4 to 6) needle insertions (maximum difference scenario: 79% vs. 60%). The computation time of the needle sequence optimization was below 60s. Conclusion: A new adaptive needle sequence determination for HDR prostate brachytherapy was developed. Coupled to adaptive planning, the selection of the needle with the largest dose coverage impact increases chances of reaching the clinical constraints. M. Borot de Battisti is funded by Philips Medical Systems Nederland B.V.; M. Moerland is principal investigator on a contract funded by Philips Medical Systems Nederland B.V.; G. Hautvast and D. Binnekamp are fulltime employees of Philips Medical Systems Nederland B.V.« less

Enhancement of Higher Degree Candidates' Research Literacy: A Pilot Study of International Students

ERIC Educational Resources Information Center

Han, Jinghe; Schuurmans-Stekhoven, James

2017-01-01

Research literacy (RL) training for higher degree research (HDR) students has been reduced to information technology focus by librarians and as writing practice in research supervision which is an 'underdress' for the issue. This paper argues that holistic research literacy training support should be provided to HDR students, especially those from…

GASPACHO: a generic automatic solver using proximal algorithms for convex huge optimization problems

NASA Astrophysics Data System (ADS)

Goossens, Bart; Luong, Hiêp; Philips, Wilfried

2017-08-01

Many inverse problems (e.g., demosaicking, deblurring, denoising, image fusion, HDR synthesis) share various similarities: degradation operators are often modeled by a specific data fitting function while image prior knowledge (e.g., sparsity) is incorporated by additional regularization terms. In this paper, we investigate automatic algorithmic techniques for evaluating proximal operators. These algorithmic techniques also enable efficient calculation of adjoints from linear operators in a general matrix-free setting. In particular, we study the simultaneous-direction method of multipliers (SDMM) and the parallel proximal algorithm (PPXA) solvers and show that the automatically derived implementations are well suited for both single-GPU and multi-GPU processing. We demonstrate this approach for an Electron Microscopy (EM) deconvolution problem.

Computational model of lightness perception in high dynamic range imaging

NASA Astrophysics Data System (ADS)

Krawczyk, Grzegorz; Myszkowski, Karol; Seidel, Hans-Peter

2006-02-01

An anchoring theory of lightness perception by Gilchrist et al. [1999] explains many characteristics of human visual system such as lightness constancy and its spectacular failures which are important in the perception of images. The principal concept of this theory is the perception of complex scenes in terms of groups of consistent areas (frameworks). Such areas, following the gestalt theorists, are defined by the regions of common illumination. The key aspect of the image perception is the estimation of lightness within each framework through the anchoring to the luminance perceived as white, followed by the computation of the global lightness. In this paper we provide a computational model for automatic decomposition of HDR images into frameworks. We derive a tone mapping operator which predicts lightness perception of the real world scenes and aims at its accurate reproduction on low dynamic range displays. Furthermore, such a decomposition into frameworks opens new grounds for local image analysis in view of human perception.

SU-E-T-362: Automatic Catheter Reconstruction of Flap Applicators in HDR Surface Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buzurovic, I; Devlin, P; Hansen, J

2014-06-01

Purpose: Catheter reconstruction is crucial for the accurate delivery of radiation dose in HDR brachytherapy. The process becomes complicated and time-consuming for large superficial clinical targets with a complex topology. A novel method for the automatic catheter reconstruction of flap applicators is proposed in this study. Methods: We have developed a program package capable of image manipulation, using C++class libraries of The-Visualization-Toolkit(VTK) software system. The workflow for automatic catheter reconstruction is: a)an anchor point is placed in 3D or in the axial view of the first slice at the tip of the first, last and middle points for the curvedmore » surface; b)similar points are placed on the last slice of the image set; c)the surface detection algorithm automatically registers the points to the images and applies the surface reconstruction filter; d)then a structured grid surface is generated through the center of the treatment catheters placed at a distance of 5mm from the patient's skin. As a result, a mesh-style plane is generated with the reconstructed catheters placed 10mm apart. To demonstrate automatic catheter reconstruction, we used CT images of patients diagnosed with cutaneous T-cell-lymphoma and imaged with Freiburg-Flap-Applicators (Nucletron™-Elekta, Netherlands). The coordinates for each catheter were generated and compared to the control points selected during the manual reconstruction for 16catheters and 368control point Results: The variation of the catheter tip positions between the automatically and manually reconstructed catheters was 0.17mm(SD=0.23mm). The position difference between the manually selected catheter control points and the corresponding points obtained automatically was 0.17mm in the x-direction (SD=0.23mm), 0.13mm in the y-direction (SD=0.22mm), and 0.14mm in the z-direction (SD=0.24mm). Conclusion: This study shows the feasibility of the automatic catheter reconstruction of flap applicators with a high level of positioning accuracy. Implementation of this technique has potential to decrease the planning time and may improve overall quality in superficial brachytherapy.« less

Parallel evolution of Batesian mimicry supergene in two Papilio butterflies, P. polytes and P. memnon

PubMed Central

Itoh, Takehiko

2018-01-01

Batesian mimicry protects animals from predators when mimics resemble distasteful models. The female-limited Batesian mimicry in Papilio butterflies is controlled by a supergene locus switching mimetic and nonmimetic forms. In Papilio polytes, recent studies revealed that a highly diversified region (HDR) containing doublesex (dsx-HDR) constitutes the supergene with dimorphic alleles and is likely maintained by a chromosomal inversion. In the closely related Papilio memnon, which exhibits a similar mimicry polymorphism, we performed whole-genome sequence analyses in 11 butterflies, which revealed a nearly identical dsx-HDR containing three genes (dsx, Nach-like, and UXT) with dimorphic sequences strictly associated with the mimetic/nonmimetic phenotypes. In addition, expression of these genes, except that of Nach-like in female hind wings, showed differences correlated with phenotype. The dimorphic dsx-HDR in P. memnon is maintained without a chromosomal inversion, suggesting that a separate mechanism causes and maintains allelic divergence in these genes. More abundant accumulation of transposable elements and repetitive sequences in the dsx-HDR than in other genomic regions may contribute to the suppression of chromosomal recombination. Gene trees for Dsx, Nach-like, and UXT indicated that mimetic alleles evolved independently in the two Papilio species. These results suggest that the genomic region involving the above three genes has repeatedly diverged so that two allelic sequences of this region function as developmental switches for mimicry polymorphism in the two Papilio species. The supergene structures revealed here suggest that independent evolutionary processes with different genetic mechanisms have led to parallel evolution of similar female-limited polymorphisms underlying Batesian mimicry in Papilio butterflies. PMID:29675466

The use of nomograms in LDR-HDR prostate brachytherapy.

PubMed

Pujades, Ma Carmen; Camacho, Cristina; Perez-Calatayud, Jose; Richart, José; Gimeno, Jose; Lliso, Françoise; Carmona, Vicente; Ballester, Facundo; Crispín, Vicente; Rodríguez, Silvia; Tormo, Alejandro

2011-09-01

The common use of nomograms in Low Dose Rate (LDR) permanent prostate brachytherapy (BT) allows to estimate the number of seeds required for an implant. Independent dosimetry verification is recommended for each clinical dosimetry in BT. Also, nomograms can be useful for dose calculation quality assurance and they could be adapted to High Dose Rate (HDR). This work sets nomograms for LDR and HDR prostate-BT implants, which are applied to three different institutions that use different implant techniques. Patients treated throughout 2010 till April 2011 were considered for this study. This example was chosen to be the representative of the latest implant techniques and to ensure consistency in the planning. A sufficient number of cases for both BT modalities, prescription dose and different work methodology (depending on the institution) were taken into account. The specific nomograms were built using the correlation between the prostate volume and some characteristic parameters of each BT modality, such as the source Air Kerma Strength, number of implanted seeds in LDR or total radiation time in HDR. For each institution and BT modality, nomograms normalized to the prescribed dose were obtained and fitted to a linear function. The parameters of the adjustment show a good agreement between data and the fitting. It should be noted that for each institution these linear function parameters are different, indicating that each centre should construct its own nomograms. Nomograms for LDR and HDR prostate brachytherapy are simple quality assurance tools, specific for each institution. Nevertheless, their use should be complementary to the necessary independent verification.

The use of nomograms in LDR-HDR prostate brachytherapy

PubMed Central

Camacho, Cristina; Perez-Calatayud, Jose; Richart, José; Gimeno, Jose; Lliso, Françoise; Carmona, Vicente; Ballester, Facundo; Crispín, Vicente; Rodríguez, Silvia; Tormo, Alejandro

2011-01-01

Purpose The common use of nomograms in Low Dose Rate (LDR) permanent prostate brachytherapy (BT) allows to estimate the number of seeds required for an implant. Independent dosimetry verification is recommended for each clinical dosimetry in BT. Also, nomograms can be useful for dose calculation quality assurance and they could be adapted to High Dose Rate (HDR). This work sets nomograms for LDR and HDR prostate-BT implants, which are applied to three different institutions that use different implant techniques. Material and methods Patients treated throughout 2010 till April 2011 were considered for this study. This example was chosen to be the representative of the latest implant techniques and to ensure consistency in the planning. A sufficient number of cases for both BT modalities, prescription dose and different work methodology (depending on the institution) were taken into account. The specific nomograms were built using the correlation between the prostate volume and some characteristic parameters of each BT modality, such as the source Air Kerma Strength, number of implanted seeds in LDR or total radiation time in HDR. Results For each institution and BT modality, nomograms normalized to the prescribed dose were obtained and fitted to a linear function. The parameters of the adjustment show a good agreement between data and the fitting. It should be noted that for each institution these linear function parameters are different, indicating that each centre should construct its own nomograms. Conclusions Nomograms for LDR and HDR prostate brachytherapy are simple quality assurance tools, specific for each institution. Nevertheless, their use should be complementary to the necessary independent verification. PMID:23346120

Efficient gene targeting by homology-directed repair in rat zygotes using TALE nucleases.

PubMed

Remy, Séverine; Tesson, Laurent; Menoret, Séverine; Usal, Claire; De Cian, Anne; Thepenier, Virginie; Thinard, Reynald; Baron, Daniel; Charpentier, Marine; Renaud, Jean-Baptiste; Buelow, Roland; Cost, Gregory J; Giovannangeli, Carine; Fraichard, Alexandre; Concordet, Jean-Paul; Anegon, Ignacio

2014-08-01

The generation of genetically modified animals is important for both research and commercial purposes. The rat is an important model organism that until recently lacked efficient genetic engineering tools. Sequence-specific nucleases, such as ZFNs, TALE nucleases, and CRISPR/Cas9 have allowed the creation of rat knockout models. Genetic engineering by homology-directed repair (HDR) is utilized to create animals expressing transgenes in a controlled way and to introduce precise genetic modifications. We applied TALE nucleases and donor DNA microinjection into zygotes to generate HDR-modified rats with large new sequences introduced into three different loci with high efficiency (0.62%-5.13% of microinjected zygotes). Two of these loci (Rosa26 and Hprt1) are known to allow robust and reproducible transgene expression and were targeted for integration of a GFP expression cassette driven by the CAG promoter. GFP-expressing embryos and four Rosa26 GFP rat lines analyzed showed strong and widespread GFP expression in most cells of all analyzed tissues. The third targeted locus was Ighm, where we performed successful exon exchange of rat exon 2 for the human one. At all three loci we observed HDR only when using linear and not circular donor DNA. Mild hypothermic (30°C) culture of zygotes after microinjection increased HDR efficiency for some loci. Our study demonstrates that TALE nuclease and donor DNA microinjection into rat zygotes results in efficient and reproducible targeted donor integration by HDR. This allowed creation of genetically modified rats in a work-, cost-, and time-effective manner. © 2014 Remy et al.; Published by Cold Spring Harbor Laboratory Press.

Efficient gene targeting by homology-directed repair in rat zygotes using TALE nucleases

PubMed Central

Remy, Séverine; Tesson, Laurent; Menoret, Séverine; Usal, Claire; De Cian, Anne; Thepenier, Virginie; Thinard, Reynald; Baron, Daniel; Charpentier, Marine; Renaud, Jean-Baptiste; Buelow, Roland; Cost, Gregory J.; Giovannangeli, Carine; Fraichard, Alexandre; Concordet, Jean-Paul; Anegon, Ignacio

2014-01-01

The generation of genetically modified animals is important for both research and commercial purposes. The rat is an important model organism that until recently lacked efficient genetic engineering tools. Sequence-specific nucleases, such as ZFNs, TALE nucleases, and CRISPR/Cas9 have allowed the creation of rat knockout models. Genetic engineering by homology-directed repair (HDR) is utilized to create animals expressing transgenes in a controlled way and to introduce precise genetic modifications. We applied TALE nucleases and donor DNA microinjection into zygotes to generate HDR-modified rats with large new sequences introduced into three different loci with high efficiency (0.62%–5.13% of microinjected zygotes). Two of these loci (Rosa26 and Hprt1) are known to allow robust and reproducible transgene expression and were targeted for integration of a GFP expression cassette driven by the CAG promoter. GFP-expressing embryos and four Rosa26 GFP rat lines analyzed showed strong and widespread GFP expression in most cells of all analyzed tissues. The third targeted locus was Ighm, where we performed successful exon exchange of rat exon 2 for the human one. At all three loci we observed HDR only when using linear and not circular donor DNA. Mild hypothermic (30°C) culture of zygotes after microinjection increased HDR efficiency for some loci. Our study demonstrates that TALE nuclease and donor DNA microinjection into rat zygotes results in efficient and reproducible targeted donor integration by HDR. This allowed creation of genetically modified rats in a work-, cost-, and time-effective manner. PMID:24989021

Rectal Bleeding After High-Dose-Rate Brachytherapy Combined With Hypofractionated External-Beam Radiotherapy for Localized Prostate Cancer: The Relationship Between Dose-Volume Histogram Parameters and the Occurrence Rate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Okamoto, Masahiko, E-mail: masaoka@showa.gunma-u.ac.jp; Ishikawa, Hitoshi; Ebara, Takeshi

2012-02-01

Purpose: To determine the predictive risk factors for Grade 2 or worse rectal bleeding after high-dose-rate brachytherapy (HDR-BT) combined with hypofractionated external-beam radiotherapy (EBRT) for prostate cancer using dose-volume histogram analysis. Methods and Materials: The records of 216 patients treated with HDR-BT combined with EBRT were analyzed. The treatment protocols for HDR-BT were 5 Gy Multiplication-Sign five times in 3 days or 7 Gy Multiplication-Sign three, 10.5 Gy Multiplication-Sign two, or 9 Gy Multiplication-Sign two in 2 days. The EBRT doses ranged from 45 to 51 Gy with a fractional dose of 3 Gy. Results: In 20 patients Grade 2more » or worse rectal bleeding developed, and the cumulative incidence rate was 9% at 5 years. By converting the HDR-BT and EBRT radiation doses into biologic effective doses (BED), the BED{sub 3} at rectal volumes of 5% and 10% in the patients who experienced bleeding were significantly higher than those in the remaining 196 patients. Univariate analysis showed that a higher rectal BED{sub 3-5%} and the use of fewer needles in brachytherapy were correlated with the incidence of bleeding, but BED{sub 3-5%} was found to be the only significant factor on multivariate analysis. Conclusions: The radiation dose delivered to small rectal lesions as 5% is important for predicting Grade 2 or worse rectal bleeding after HDR-BT combined with EBRT for prostate cancer.« less

SU-E-T-205: Improving Quality Assurance of HDR Brachytherapy: Verifying Agreement Between Planned and Delivered Dose Distributions Using DICOM RTDose and Advanced Film Dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palmer, A L; University of Surrey, Guildford, Surrey; Bradley, D A

Purpose: HDR brachytherapy is undergoing significant development, and quality assurance (QA) checks must keep pace. Current recommendations do not adequately verify delivered against planned dose distributions: This is particularly relevant for new treatment planning system (TPS) calculation algorithms (non TG-43 based), and an era of significant patient-specific plan optimisation. Full system checks are desirable in modern QA recommendations, complementary to device-centric individual tests. We present a QA system incorporating TPS calculation, dose distribution export, HDR unit performance, and dose distribution measurement. Such an approach, more common in external beam radiotherapy, has not previously been reported in the literature for brachytherapy.more » Methods: Our QA method was tested at 24 UK brachytherapy centres. As a novel approach, we used the TPS DICOM RTDose file export to compare planned dose distribution with that measured using Gafchromic EBT3 films placed around clinical brachytherapy treatment applicators. Gamma analysis was used to compare the dose distributions. Dose difference and distance to agreement were determined at prescription Point A. Accurate film dosimetry was achieved using a glass compression plate at scanning to ensure physically-flat films, simultaneous scanning of known dose films with measurement films, and triple-channel dosimetric analysis. Results: The mean gamma pass rate of RTDose compared to film-measured dose distributions was 98.1% at 3%(local), 2 mm criteria. The mean dose difference, measured to planned, at Point A was -0.5% for plastic treatment applicators and -2.4% for metal applicators, due to shielding not accounted for in TPS. The mean distance to agreement was 0.6 mm. Conclusion: It is recommended to develop brachytherapy QA to include full-system verification of agreement between planned and delivered dose distributions. This is a novel approach for HDR brachytherapy QA. A methodology using advanced film dosimetry and gamma comparison to DICOM RTDose files has been demonstrated as suitable to fulfil this need.« less

SU-C-BRD-02: A Team Focused Clinical Implementation and Failure Mode and Effects Analysis of HDR Skin Brachytherapy Using Valencia and Leipzig Surface Applicators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sayler, E; Harrison, A; Eldredge-Hindy, H

Purpose: and Leipzig applicators (VLAs) are single-channel brachytherapy surface applicators used to treat skin lesions up to 2cm diameter. Source dwell times can be calculated and entered manually after clinical set-up or ultrasound. This procedure differs dramatically from CT-based planning; the novelty and unfamiliarity could lead to severe errors. To build layers of safety and ensure quality, a multidisciplinary team created a protocol and applied Failure Modes and Effects Analysis (FMEA) to the clinical procedure for HDR VLA skin treatments. Methods: team including physicists, physicians, nurses, therapists, residents, and administration developed a clinical procedure for VLA treatment. The procedure wasmore » evaluated using FMEA. Failure modes were identified and scored by severity, occurrence, and detection. The clinical procedure was revised to address high-scoring process nodes. Results: Several key components were added to the clinical procedure to minimize risk probability numbers (RPN): -Treatments are reviewed at weekly QA rounds, where physicians discuss diagnosis, prescription, applicator selection, and set-up. Peer review reduces the likelihood of an inappropriate treatment regime. -A template for HDR skin treatments was established in the clinical EMR system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planning physicist, and increases the detectability of an error during the physics second check. -A screen check was implemented during the second check to increase detectability of an error. -To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display. This facilitates data entry and verification. -VLAs are color-coded and labeled to match the EMR prescriptions, which simplifies in-room selection and verification. Conclusion: Multidisciplinary planning and FMEA increased delectability and reduced error probability during VLA HDR Brachytherapy. This clinical model may be useful to institutions implementing similar procedures.« less

Rectal Dose and Source Strength of the High-Dose-Rate Iridium-192 Both Affect Late Rectal Bleeding After Intracavitary Radiation Therapy for Uterine Cervical Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isohashi, Fumiaki, E-mail: isohashi@radonc.med.osaka-u.ac.j; Yoshioka, Yasuo; Koizumi, Masahiko

2010-07-01

Purpose: The purpose of this study was to reconfirm our previous findings that the rectal dose and source strength both affect late rectal bleeding after high-dose-rate intracavitary brachytherapy (HDR-ICBT), by using a rectal dose calculated in accordance with the definitions of the International Commission on Radiation Units and Measurements Report 38 (ICRU{sub RP}) or of dose-volume histogram (DVH) parameters by the Groupe Europeen de Curietherapie of the European Society for Therapeutic Radiology and Oncology. Methods and Materials: Sixty-two patients who underwent HDR-ICBT and were followed up for 1 year or more were studied. The rectal dose for ICBT was calculatedmore » by using the ICRP{sub RP} based on orthogonal radiographs or the DVH parameters based on computed tomography (CT). The total dose was calculated as the biologically equivalent dose expressed in 2-Gy fractions (EQD{sub 2}). The relationship between averaged source strength or the EQD{sub 2} and late rectal bleeding was then analyzed. Results: When patients were divided into four groups according to rectal EQD{sub 2} ({>=} or =} or <2.4 cGy.m{sup 2}.h{sup -1}), the group with both a high EQD{sub 2} and a high source strength showed a significantly greater probability of rectal bleeding for ICRU{sub RP}, D{sub 2cc}, and D{sub 1cc}. The patients with a median rectal dose above the threshold level did not show a greater frequency of rectal bleeding unless the source strength exceeded 2.4 cGy.m{sup 2}.h{sup -1}. Conclusions: Our results obtained with data based on ICRU{sub RP} and CT-based DVH parameters indicate that rectal dose and source strength both affect rectal bleeding after HDR-ICBT.« less

Support services for higher degree research students: a survey of three Australian universities

NASA Astrophysics Data System (ADS)

Silva, Pujitha; Woodman, Karen; Taji, Acram; Travelyan, James; Samani, Shamim; Sharda, Hema; Narayanaswamy, Ramesh; Lucey, Anthony; Sahama, Tony; KDV Yarlagadda, Prasad

2016-09-01

A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services in terms of academic, administrative, social and settlement, language and miscellaneous (other) supports. All three universities showed similarities in the type of academic support services offered, while differing in social and settlement and language support services in terms of the location and the level of accessibility of these services. The study also examined the specific support services available for culturally and linguistically diverse (CALD) students. The three universities differed in their emphases in catering to CALD needs, with their allocation of resources reflecting these differences. The organisation of these services within the universities was further assessed to determine possible factors that may influence the effective delivery of these services, by considering HDR and CALD student specific issues. The findings and tools developed by this study may be useful to HDR supervisors and university administrators in identifying key support services to better improve outcomes for the HDR students and universities.

Imaging of implant needles for real-time HDR-brachytherapy prostate treatment using biplane ultrasound transducers.

PubMed

Siebert, Frank-André; Hirt, Markus; Niehoff, Peter; Kovács, György

2009-08-01

Ultrasound imaging is becoming increasingly important in prostate brachytherapy. In high-dose-rate (HDR) real-time planning procedures the definition of the implant needles is often performed by transrectal ultrasound. This article describes absolute measurements of the visibility and accuracy of manual detection of implant needle tips and compares measurement results of different biplane ultrasound systems in transversal and longitudinal (i.e., sagittal) ultrasound modes. To obtain a fixed coordinate system and stable conditions the measurements were carried out in a water tank using a dedicated marker system. Needles were manually placed in the phantom until the observer decided by the real-time ultrasound image that the zero position was reached. A comparison of three different ultrasound systems yielded an offset between 0.8 and 3.1 mm for manual detection of the needle tip in ultrasound images by one observer. The direction of the offset was discovered to be in the proximal direction, i.e., the actual needle position was located more distally compared to the ultrasound-based definition. In the second part of the study, the ultrasound anisotropy of trocar implant needles is reported. It was shown that the integrated optical density in a region of interest around the needle tip changes with needle rotation. Three peaks were observed with a phase angle of 120 degrees. Peaks appear not only in transversal but also in longitudinal ultrasound images, with a phase shift of 60 degrees. The third section of this study shows results of observer dependent influences on needle tip detection in sagittal ultrasound images considering needle rotation. These experiments were carried out using the marker system in a water tank. The needle tip was placed exactly at the position z=0 mm. It was found that different users tend to differently interpret the same ultrasound images. The needle tip was manually detected five times in the ultrasound images by three experienced observers at positions (+/- standard deviation) -0.53 +/- 0.16, -0.16 +/- 0.14, and -0.30 +/- 0.16 mm using a gain of 15 dB. The minus sign indicates that the needle tips were detected more proximally than the actual position of the needle tip. When using a gain of -15 dB the mean values of two observers resulted in -0.62 +/- 0.08 and -0.51 +/- 0.12 mm. Additionally an alternative approach to the direct needle tip definition was investigated. Two observers detected the solid part of the needle tip in sagittal images. This solid part, often named as "dead space end," is the distance between the needle tip and the beginning of the hollow part of the implant needle. The dead space end is 6.2 mm for the investigated needle type. Two users found mean values of -6.70 +/- 0.16 and -7.00 +/- 0.06 mm, respectively, for 15 dB gain and -6.90 +/- 0.09 and -7.02 +/- 0.06 mm using the -15 dB gain setting. The results show that ultrasound-based needle tip definition in sagittal viewing mode is accurate. The inter- and intraobserver errors should, however, be taken into account. A lower gain setting of the ultrasound system reduces the intraobserver error.

GATA3 mutation in a family with hypoparathyroidism, deafness and renal dysplasia syndrome.

PubMed

Zhu, Zi-Yang; Zhou, Qiao-Li; Ni, Shi-Ning; Gu, Wei

2014-08-01

The hypoparathyroidism, deafness and renal dysplasia (HDR) syndrome is an autosomal dominant disorder primarily caused by GATA3 gene mutation. We report here a case that both of a Chinese boy and his father had HDR syndrome which caused by a novel mutation of GATA3. Polymerase chain reaction and DNA sequencing was performed to detect the exons of the GATA3 gene for mutation analysis. Sequence analysis of GATA3 revealed a heterozygous nonsense mutation in this family: a mutation of GATA3 at exon 2 (c.515C >A) that resulted in a premature stop at codon 172 (p.S172X) with a loss of two zinc finger domains. We identified a novel nonsense mutation which will expand the spectrum of HDR-associated GATA3 mutations.

Neoadjuvant radiotherapy with or without chemotherapy followed by extrafascial hysterectomy for locally advanced endometrial cancer clinically extending to the cervix or parametria.

PubMed

Vargo, John A; Boisen, Michelle M; Comerci, John T; Kim, Hayeon; Houser, Christopher J; Sukumvanich, Paniti; Olawaiye, Alexander B; Kelley, Joseph L; Edwards, Robert P; Huang, Marilyn; Courtney-Brooks, Madeleine; Beriwal, Sushil

2014-11-01

For locally-advanced uterine cancer clinically extending to the cervix, two treatment paradigms exist: surgical staging radical hysterectomy with tailored adjuvant therapy or neoadjuvant therapy followed by a less extensive simple hysterectomy. Currently, insufficient data exists to guide consensus guidelines and practical application of preoperative radiotherapy. Retrospective IRB approved cohort study from 1999 to 2014 of 36 endometrial cancer patients with clinical involvement of cervix±parametria treated with neoadjuvant external beam radiotherapy (45-50.4Gy in 25-28 fractions) and image-based HDR brachytherapy (5-5.5Gy times 3-4 fractions)±chemotherapy followed by extrafascial hysterectomy performed at a median of 6weeks after radiotherapy. All patients had clinical cervical extension, 50% also had parametria extension, and 31% had nodal involvement. At the time of surgery 91% had no clinical cervical involvement, 58% had no pathologic cervical involvement, and all had margin negative resection. The pathologic complete response rate was 24%. Median follow-up from the time of surgery was 20months (range: 0-153). The 3-year local control, regional control, distant control, disease free survival and overall survival rates were 96%, 89%, 84%, 73%, and 100%. The 3-year rate of grade 3 complications was 11%, with no grade 4+ toxicity. Neoadjuvant radiation therapy±chemotherapy followed by extrafascial hysterectomy appears to be a viable option for patients with endometrial cancer clinically extending to the cervix and parametria. The HDR brachytherapy schema of 5-5.5Gy times 3-4 fractions, for a cumulative EQD2 of 60-70Gy, is well tolerated with high rates of clinical and pathological response. Copyright © 2014 Elsevier Inc. All rights reserved.

WE-G-BRA-07: Analyzing the Safety Implications of a Brachytherapy Process Improvement Project Utilizing a Novel System-Theory-Based Hazard-Analysis Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tang, A; Samost, A; Viswanathan, A

Purpose: To investigate the hazards in cervical-cancer HDR brachytherapy using a novel hazard-analysis technique, System Theoretic Process Analysis (STPA). The applicability and benefit of STPA to the field of radiation oncology is demonstrated. Methods: We analyzed the tandem and ring HDR procedure through observations, discussions with physicists and physicians, and the use of a previously developed process map. Controllers and their respective control actions were identified and arranged into a hierarchical control model of the system, modeling the workflow from applicator insertion through initiating treatment delivery. We then used the STPA process to identify potentially unsafe control actions. Scenarios weremore » then generated from the identified unsafe control actions and used to develop recommendations for system safety constraints. Results: 10 controllers were identified and included in the final model. From these controllers 32 potentially unsafe control actions were identified, leading to more than 120 potential accident scenarios, including both clinical errors (e.g., using outdated imaging studies for planning), and managerial-based incidents (e.g., unsafe equipment, budget, or staffing decisions). Constraints identified from those scenarios include common themes, such as the need for appropriate feedback to give the controllers an adequate mental model to maintain safe boundaries of operations. As an example, one finding was that the likelihood of the potential accident scenario of the applicator breaking during insertion might be reduced by establishing a feedback loop of equipment-usage metrics and equipment-failure reports to the management controller. Conclusion: The utility of STPA in analyzing system hazards in a clinical brachytherapy system was demonstrated. This technique, rooted in system theory, identified scenarios both technical/clinical and managerial in nature. These results suggest that STPA can be successfully used to analyze safety in brachytherapy and may prove to be an alternative to other hazard analysis techniques.« less

Presumed atypical HDR syndrome associated with Band Keratopathy and pigmentary retinopathy.

PubMed

Kim, Cinoo; Cheong, Hae Il; Kim, Jeong Hun; Yu, Young Suk; Kwon, Ji Won

2011-01-01

This report describes presumed atypical hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome associated with unexpected ocular findings. The patient had exotropia, bilateral band keratopathy, and pigmentary retinopathy, including attenuated retinal vessels and atrophy of the retinal pigment epithelium. Even though the calcific plaques were successfully removed, visual acuity in both eyes gradually decreased and electroretinography was extinguished. Copyright 2009, SLACK Incorporated.

A multicentre audit of HDR/PDR brachytherapy absolute dosimetry in association with the INTERLACE trial (NCT015662405)

NASA Astrophysics Data System (ADS)

Díez, P.; Aird, E. G. A.; Sander, T.; Gouldstone, C. A.; Sharpe, P. H. G.; Lee, C. D.; Lowe, G.; Thomas, R. A. S.; Simnor, T.; Bownes, P.; Bidmead, M.; Gandon, L.; Eaton, D.; Palmer, A. L.

2017-12-01

A UK multicentre audit to evaluate HDR and PDR brachytherapy has been performed using alanine absolute dosimetry. This is the first national UK audit performing an absolute dose measurement at a clinically relevant distance (20 mm) from the source. It was performed in both INTERLACE (a phase III multicentre trial in cervical cancer) and non-INTERLACE brachytherapy centres treating gynaecological tumours. Forty-seven UK centres (including the National Physical Laboratory) were visited. A simulated line source was generated within each centre’s treatment planning system and dwell times calculated to deliver 10 Gy at 20 mm from the midpoint of the central dwell (representative of Point A of the Manchester system). The line source was delivered in a water-equivalent plastic phantom (Barts Solid Water) encased in blocks of PMMA (polymethyl methacrylate) and charge measured with an ion chamber at 3 positions (120° apart, 20 mm from the source). Absorbed dose was then measured with alanine at the same positions and averaged to reduce source positional uncertainties. Charge was also measured at 50 mm from the source (representative of Point B of the Manchester system). Source types included 46 HDR and PDR 192Ir sources, (7 Flexisource, 24 mHDR-v2, 12 GammaMed HDR Plus, 2 GammaMed PDR Plus, 1 VS2000) and 1 HDR 60Co source, (Co0.A86). Alanine measurements when compared to the centres’ calculated dose showed a mean difference (±SD) of  +1.1% (±1.4%) at 20 mm. Differences were also observed between source types and dose calculation algorithm. Ion chamber measurements demonstrated significant discrepancies between the three holes mainly due to positional variation of the source within the catheter (0.4%-4.9% maximum difference between two holes). This comprehensive audit of absolute dose to water from a simulated line source showed all centres could deliver the prescribed dose to within 5% maximum difference between measurement and calculation.

Evaluation of water-mimicking solid phantom materials for use in HDR and LDR brachytherapy dosimetry

NASA Astrophysics Data System (ADS)

Schoenfeld, Andreas A.; Thieben, Maike; Harder, Dietrich; Poppe, Björn; Chofor, Ndimofor

2017-12-01

In modern HDR or LDR brachytherapy with photon emitters, fast checks of the dose profiles generated in water or a water-equivalent phantom have to be available in the interest of patient safety. However, the commercially available brachytherapy photon sources cover a wide range of photon emission spectra, and the range of the in-phantom photon spectrum is further widened by Compton scattering, so that the achievement of water-mimicking properties of such phantoms involves high requirements on their atomic composition. In order to classify the degree of water equivalence of the numerous commercially available solid water-mimicking phantom materials and the energy ranges of their applicability, the radial profiles of the absorbed dose to water, D w, have been calculated using Monte Carlo simulations in these materials and in water phantoms of the same dimensions. This study includes the HDR therapy sources Nucletron Flexisource Co-60 HDR (60Co), Eckert und Ziegler BEBIG GmbH CSM-11 (137Cs), Implant Sciences Corporation HDR Yb-169 Source 4140 (169Yb) as well as the LDR therapy sources IsoRay Inc. Proxcelan CS-1 (131Cs), IsoAid Advantage I-125 IAI-125A (125I), and IsoAid Advantage Pd-103 IAPd-103A (103Pd). Thereby our previous comparison between phantom materials and water surrounding a Varian GammaMed Plus HDR therapy 192Ir source (Schoenfeld et al 2015) has been complemented. Simulations were performed in cylindrical phantoms consisting of either water or the materials RW1, RW3, Solid Water, HE Solid Water, Virtual Water, Plastic Water DT, Plastic Water LR, Original Plastic Water (2015), Plastic Water (1995), Blue Water, polyethylene, polystyrene and PMMA. While for 192Ir, 137Cs and 60Co most phantom materials can be regarded as water equivalent, for 169Yb the materials Plastic Water LR, Plastic Water DT and RW1 appear as water equivalent. For the low-energy sources 106Pd, 131Cs and 125I, only Plastic Water LR can be classified as water equivalent.

Clinical and mutational spectrum of hypoparathyroidism, deafness and renal dysplasia syndrome.

PubMed

Belge, Hendrica; Dahan, Karin; Cambier, Jean-François; Benoit, Valérie; Morelle, Johann; Bloch, Julie; Vanhille, Philippe; Pirson, Yves; Demoulin, Nathalie

2017-05-01

Hypoparathyroidism, deafness and renal dysplasia (HDR) syndrome is a rare autosomal dominant disorder, secondary to mutations in the GATA-3 gene. Due to its wide range of penetrance and expressivity, the disease may not always be recognized. We herein describe clinical and genetic features of patients with HDR syndrome, highlighting diagnostic clues. Medical records of eight patients from five unrelated families exhibiting GATA-3 mutations were reviewed retrospectively, in conjunction with all previously reported cases. HDR syndrome was diagnosed in eight patients between the ages of 18 and 60 years. Sensorineural deafness was consistently diagnosed, ranging from clinical hearing loss since infancy in seven patients to deafness detected only by audiometry in adulthood in one single patient. Hypoparathyroidism was present in six patients (with hypocalcaemia and inaugural seizures in two out of six). Renal abnormalities observed in six patients were diverse and of dysplastic nature. Three patients displayed nephrotic-range proteinuria and reached end-stage renal disease (ESRD) between the ages of 19 and 61 years, whilst lesions of focal and segmental glomerulosclerosis were histologically demonstrated in one of them. Interestingly, phenotype severity differed significantly between a mother and son within one family. Five new mutations of GATA-3 were identified, including three missense mutations affecting zinc finger motifs [NM_001002295.1: c.856A>G (p.N286D) and c.1017C>G (p.C339W)] or the conserved linker region [c.896G>A (p.R299G)], and two splicing mutations (c.924+4_924+19del and c.1051-2A>G). Review of 115 previously reported cases of GATA-3 mutations showed hypoparathyroidism and deafness in 95% of patients, and renal abnormalities in only 60%. Overall, 10% of patients had reached ESRD. We herein expand the clinical and mutational spectrum of HDR syndrome, illustrating considerable inter- and intrafamilial phenotypic variability. Diagnosis of HDR should be considered in any patient with hypoparathyroidism and deafness, whether associated with renal abnormalities or not. HDR diagnosis is established through identification of a mutation in the GATA-3 gene. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Evaluation of water-mimicking solid phantom materials for use in HDR and LDR brachytherapy dosimetry.

PubMed

Schoenfeld, Andreas A; Thieben, Maike; Harder, Dietrich; Poppe, Björn; Chofor, Ndimofor

2017-11-21

In modern HDR or LDR brachytherapy with photon emitters, fast checks of the dose profiles generated in water or a water-equivalent phantom have to be available in the interest of patient safety. However, the commercially available brachytherapy photon sources cover a wide range of photon emission spectra, and the range of the in-phantom photon spectrum is further widened by Compton scattering, so that the achievement of water-mimicking properties of such phantoms involves high requirements on their atomic composition. In order to classify the degree of water equivalence of the numerous commercially available solid water-mimicking phantom materials and the energy ranges of their applicability, the radial profiles of the absorbed dose to water, D w , have been calculated using Monte Carlo simulations in these materials and in water phantoms of the same dimensions. This study includes the HDR therapy sources Nucletron Flexisource Co-60 HDR ( 60 Co), Eckert und Ziegler BEBIG GmbH CSM-11 ( 137 Cs), Implant Sciences Corporation HDR Yb-169 Source 4140 ( 169 Yb) as well as the LDR therapy sources IsoRay Inc. Proxcelan CS-1 ( 131 Cs), IsoAid Advantage I-125 IAI-125A ( 125 I), and IsoAid Advantage Pd-103 IAPd-103A ( 103 Pd). Thereby our previous comparison between phantom materials and water surrounding a Varian GammaMed Plus HDR therapy 192 Ir source (Schoenfeld et al 2015) has been complemented. Simulations were performed in cylindrical phantoms consisting of either water or the materials RW1, RW3, Solid Water, HE Solid Water, Virtual Water, Plastic Water DT, Plastic Water LR, Original Plastic Water (2015), Plastic Water (1995), Blue Water, polyethylene, polystyrene and PMMA. While for 192 Ir, 137 Cs and 60 Co most phantom materials can be regarded as water equivalent, for 169 Yb the materials Plastic Water LR, Plastic Water DT and RW1 appear as water equivalent. For the low-energy sources 106 Pd, 131 Cs and 125 I, only Plastic Water LR can be classified as water equivalent.

Developing A Directional High-Dose Rate (d-HDR) Brachytherapy Source

NASA Astrophysics Data System (ADS)

Heredia, Athena Yvonne

Conventional sources used in brachytherapy provide nearly isotropic or radially symmetric dose distributions. Optimizations of dose distributions have been limited to varied dwell times at specified locations within a given treatment volume, or manipulations in source position for seed implantation techniques. In years past, intensity modulated brachytherapy (IMBT) has been used to reduce the amount of radiation to surrounding sensitive structures in select intracavitary cases by adding space or partial shields. Previous work done by Lin et al., at the University of Wisconsin-Madison, has shown potential improvements in conformality for brachytherapy treatments using a directionally shielded low dose rate (LDR) source for treatments in breast and prostate. Directional brachytherapy sources irradiate approximately half of the radial angles around the source, and adequately shield a quarter of the radial angles on the opposite side, with sharp gradient zones between the treated half and shielded quarter. With internally shielded sources, the radiation can be preferentially emitted in such a way as to reduce toxicities in surrounding critical organs. The objective of this work is to present findings obtained in the development of a new directional high dose rate (d-HDR) source. To this goal, 103Pd (Z = 46) is reintroduced as a potential radionuclide for use in HDR brachytherapy. 103Pd has a low average photon energy (21 keV) and relatively short half -life (17 days), which is why it has historically been used in low dose rate applications and implantation techniques. Pd-103 has a carrier-free specific activity of 75000 Ci/g. Using cyclotron produced 103Pd, near carrier-free specific activities can be achieved, providing suitability for high dose rate applications. The evolution of the d-HDR source using Monte Carlo simulations is presented, along with dosimetric parameters used to fully characterize the source. In addition, a discussion on how to obtain elemental palladium, Pd(0), will be discussed in detail. Directional HDR has the potential to improve upon current treatments, providing better dose conformality to the target volume, while maintaining the benefits of HDR applications.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jabbari, Siavash; Weinberg, Vivian K.; Kaprealian, Tania

Purpose: High dose rate (HDR) brachytherapy has been established as an excellent monotherapy or after external-beam radiotherapy (EBRT) boost treatment for prostate cancer (PCa). Recently, dosimetric studies have demonstrated the potential for achieving similar dosimetry with stereotactic body radiotherapy (SBRT) compared with HDR brachytherapy. Here, we report our technique, PSA nadir, and acute and late toxicity with SBRT as monotherapy and post-EBRT boost for PCa using HDR brachytherapy fractionation. Patients and Methods: To date, 38 patients have been treated with SBRT at University of California-San Francisco with a minimum follow-up of 12 months. Twenty of 38 patients were treated withmore » SBRT monotherapy (9.5 Gy Multiplication-Sign 4 fractions), and 18 were treated with SBRT boost (9.5 Gy Multiplication-Sign 2 fractions) post-EBRT and androgen deprivation therapy. PSA nadir to date for 44 HDR brachytherapy boost patients with disease characteristics similar to the SBRT boost cohort was also analyzed as a descriptive comparison. Results: SBRT was well tolerated. With a median follow-up of 18.3 months (range, 12.6-43.5), 42% and 11% of patients had acute Grade 2 gastrourinary and gastrointestinal toxicity, respectively, with no Grade 3 or higher acute toxicity to date. Two patients experienced late Grade 3 GU toxicity. All patients are without evidence of biochemical or clinical progression to date, and favorably low PSA nadirs have been observed with a current median PSA nadir of 0.35 ng/mL (range, <0.01-2.1) for all patients (0.47 ng/mL, range, 0.2-2.1 for the monotherapy cohort; 0.10 ng/mL, range, 0.01-0.5 for the boost cohort). With a median follow-up of 48.6 months (range, 16.4-87.8), the comparable HDR brachytherapy boost cohort has achieved a median PSA nadir of 0.09 ng/mL (range, 0.0-3.3). Conclusions: Early results with SBRT monotherapy and post-EBRT boost for PCa demonstrate acceptable PSA response and minimal toxicity. PSA nadir with SBRT boost appears comparable to those achieved with HDR brachytherapy boost.« less

Dosimetric perturbations due to an implanted cardiac pacemaker in MammoSite{sup Registered-Sign} treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sung, Wonmo; Kim, Siyong; Kim, Jung-in

2012-10-15

Purpose: To investigate dose perturbations for pacemaker-implanted patients in partial breast irradiation using high dose rate (HDR) balloon brachytherapy. Methods: Monte Carlo (MC) simulations were performed to calculate dose distributions involving a pacemaker in Ir-192 HDR balloon brachytherapy. Dose perturbations by varying balloon-to-pacemaker distances (BPD = 50 or 100 mm) and concentrations of iodine contrast medium (2.5%, 5.0%, 7.5%, and 10.0% by volume) in the balloon were investigated for separate parts of the pacemaker (i.e., battery and substrate). Relative measurements using an ion-chamber were also performed to confirm MC results. Results: The MC and measured results in homogeneous media withoutmore » a pacemaker agreed with published data within 2% from the balloon surface to 100 mm BPD. Further their dose distributions with a pacemaker were in a comparable agreement. The MC results showed that doses over the battery were increased by a factor of 3, compared to doses without a pacemaker. However, there was no significant dose perturbation in the middle of substrate but up to 70% dose increase in the substrate interface with the titanium capsule. The attenuation by iodine contrast medium lessened doses delivered to the pacemaker by up to 9%. Conclusions: Due to inhomogeneity of pacemaker and contrast medium as well as low-energy photons in Ir-192 HDR balloon brachytherapy, the actual dose received in a pacemaker is different from the homogeneous medium-based dose and the external beam-based dose. Therefore, the dose perturbations should be considered for pacemaker-implanted patients when evaluating a safe clinical distance between the balloon and pacemaker.« less

SU-G-201-03: Automation of High Dose Rate Brachytherapy Quality Assurance: Development of a Radioluminescent Detection System for Simultaneous Detection of Activity, Timing, and Positioning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jenkins, C; Xing, L; Fahimian, B

Purpose: Accuracy of positioning, timing and activity is of critical importance for High Dose Rate (HDR) brachytherapy delivery. Respective measurements via film autoradiography, stop-watches and well chambers can be cumbersome, crude or lack dynamic source evaluation capabilities. To address such limitations, a single device radioluminescent detection system enabling automated real-time quantification of activity, position and timing accuracy is presented and experimentally evaluated. Methods: A radioluminescent sheet was fabricated by mixing Gd?O?S:Tb with PDMS and incorporated into a 3D printed device where it was fixated below a CMOS digital camera. An Ir-192 HDR source (VS2000, VariSource iX) with an effective activemore » length of 5 mm was introduced using a 17-gauge stainless steel needle below the sheet. Pixel intensity values for determining activity were taken from an ROI centered on the source location. A calibration curve relating intensity values to activity was generated and used to evaluate automated activity determination with data gathered over 6 weeks. Positioning measurements were performed by integrating images for an entire delivery and fitting peaks to the resulting profile. Timing measurements were performed by evaluating source location and timestamps from individual images. Results: Average predicted activity error over 6 weeks was .35 ± .5%. The distance between four dwell positions was determined by the automated system to be 1.99 ± .02 cm. The result from autoradiography was 2.00 ± .03 cm. The system achieved a time resolution of 10 msec and determined the dwell time to be 1.01 sec ± .02 sec. Conclusion: The system was able to successfully perform automated detection of activity, positioning and timing concurrently under a single setup. Relative to radiochromic and radiographic film-based autoradiography, which can only provide a static evaluation positioning, optical detection of temporary radiation induced luminescence enables dynamic detection of position enabling automated quantification of timing with millisecond accuracy.« less

Australian patterns of prostate cancer care: Are they evolving?

PubMed Central

Lo, Jonathon; Papa, Nathan; Bolton, Damien M.; Murphy, Declan; Lawrentschuk, Nathan

2015-01-01

Background Approaches to prostate cancer (PCa) care have changed in recent years out of concern for overdiagnosis and overtreatment. Despite these changes, many patients continue to undergo some form of curative treatment and with a growing perception among multidisciplinary clinicians that more aggressive treatments are being favored. This study examines patterns of PCa care in Australia, focusing on current rates of screening and aggressive interventions that consist of high-dose-rate (HDR) brachytherapy and pelvic lymph node dissection (PLND). Methods Health services data were used to assess Australian men undergoing PCa screening and treatment from 2001 to 2014. Age-specific rates of prostate-specific antigen (PSA) screening were calculated. Ratios of radical prostatectomy (RP) with PLND to RP without PLND, and HDR brachytherapy to low-dose-rate (LDR) brachytherapy were determined by state jurisdictions. Results From 2008, the rate of PSA screening trended downward significantly with year for all age ranges (P < 0.02) except men aged ≥ 85 (P = 0.56). PLND rates for 2008–2014 were lower than rates for 2001–2007 across all states and territories. From 2008 to 2014, PLND was performed ≥ 2.7 times more frequently in New South Wales and the Australian Capital Territory than in other jurisdictions. Since 2007, brachytherapy practice across Australia has evolved towards a relatively low use of HDR brachytherapy (ratio of HDR to LDR brachytherapy < 0.5 for all jurisdictions except the Australian Capital Territory). Conclusion Rates of PLND and HDR brachytherapy for PCa have declined in Australia, providing evidence for the effect of stage migration due to widespread PSA screening. Currently, PSA screening rates remain high among older men, which may expose them to unnecessary investigations and treatment-related morbidity. PMID:27014660

High-dose-rate Intracavitary Radiotherapy in the Management of Cervical Intraepithelial Neoplasia 3 and Carcinoma In Situ Presenting With Poor Histologic Factors After Undergoing Excisional Procedures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Yong Bae, E-mail: ybkim3@yuhs.ac; Kim, Young Tae; Cho, Nam Hoon

2012-09-01

Purpose: To assess the effectiveness of high-dose-rate intracavitary radiotherapy (HDR-ICR) in patients with cervical intraepithelial neoplasia 3 (CIN 3) and carcinoma in situ (CIS) presenting with poor histologic factors for predicting residual disease after undergoing diagnostic excisional procedures. Methods and Materials: This study was a retrospective analysis of 166 patients with CIN 3 (n=15) and CIS (n=151) between October 1986 and December 2005. They were diagnosed by conization (n=158) and punch biopsy (n=8). Pathologic analysis showed 135 cases of endocervical gland involvement (81.4%), 74 cases of positive resection margins (44.5%), and 52 cases of malignant cells on endocervical curettage (31.3%).more » All patients were treated with HDR-ICR using Co{sup 60} or Ir{sup 192} at a cancer center. The dose was prescribed at point A located 2 cm superior to the external os and 2 cm lateral to the axis of the tandem for intact uterus. Results: Median age was 61 years (range, 29-77). The median total dose of HDR-ICR was 30 Gy/6 fractions (range, 30-52). At follow-up (median, 152 months), 2 patients developed recurrent diseases: 1 CIN 2 and 1 invasive carcinoma. One hundred and forty patients survived and 26 patients died, owing to nonmalignant intercurrent disease. Rectal bleeding occurred in one patient; however, this symptom subsided with conservative management. Conclusions: Our data showed HDR-ICR is an effective modality for CIN 3 and CIS patients presenting with poor histologic factors after excisional procedures. HDR-ICR should be considered as a definitive treatment in CIN 3 and CIS patients with possible residual disease after undergoing excisional procedures.« less

A national survey of HDR source knowledge among practicing radiation oncologists and residents: Establishing a willingness-to-pay threshold for cobalt-60 usage.

PubMed

Mailhot Vega, Raymond; Talcott, Wesley; Ishaq, Omar; Cohen, Patrice; Small, Christina J; Duckworth, Tamara; Sarria Bardales, Gustavo; Perez, Carmen A; Schiff, Peter B; Small, William; Harkenrider, Matthew M

Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. A nationwide survey of U.S. radiation oncologists was conducted from June to July 2015, assessing knowledge of HDR sources, brachytherapy unit shielding, and factors that may influence source-selection decision-making. Self-identified decision makers in radiotherapy equipment purchase and acquisition were asked their WTP on shielding should a more cost-effective source become available. Four hundred forty surveys were completed and included. Forty-four percent were ABS members. Twenty percent of respondents identified Co-60 as an HDR source. Respondents who identified Co-60 were significantly more likely to be ABS members, have attended a national brachytherapy conference, and be involved in brachytherapy selection. Sixty-six percent of self-identified decision makers stated that their facility would switch to a more cost-effective source than Ir-192, if available. Cost and experience were the most common reasons provided for not switching. The most common WTP value selected by respondents was <$25,000. A majority of respondents were unaware of Co-60 as a commercially available HDR source. This investigation was novel in directly assessing decision makers to establish WTP for shielding costs that source change to Co-60 may require. These results will be used to establish WTP threshold for future cost-benefit analysis. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Paintings, photographs, and computer graphics are calculated appearances

NASA Astrophysics Data System (ADS)

McCann, John

2012-03-01

Painters reproduce the appearances they see, or visualize. The entire human visual system is the first part of that process, providing extensive spatial processing. Painters have used spatial techniques since the Renaissance to render HDR scenes. Silver halide photography responds to the light falling on single film pixels. Film can only mimic the retinal response of the cones at the start of the visual process. Film cannot mimic the spatial processing in humans. Digital image processing can. This talk studies three dramatic visual illusions and uses the spatial mechanisms found in human vision to interpret their appearances.

Interstitial rotating shield brachytherapy for prostate cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adams, Quentin E., E-mail: quentin-adams@uiowa.edu; Xu, Jinghzu; Breitbach, Elizabeth K.

Purpose: To present a novel needle, catheter, and radiation source system for interstitial rotating shield brachytherapy (I-RSBT) of the prostate. I-RSBT is a promising technique for reducing urethra, rectum, and bladder dose relative to conventional interstitial high-dose-rate brachytherapy (HDR-BT). Methods: A wire-mounted 62 GBq{sup 153}Gd source is proposed with an encapsulated diameter of 0.59 mm, active diameter of 0.44 mm, and active length of 10 mm. A concept model I-RSBT needle/catheter pair was constructed using concentric 50 and 75 μm thick nickel-titanium alloy (nitinol) tubes. The needle is 16-gauge (1.651 mm) in outer diameter and the catheter contains a 535more » μm thick platinum shield. I-RSBT and conventional HDR-BT treatment plans for a prostate cancer patient were generated based on Monte Carlo dose calculations. In order to minimize urethral dose, urethral dose gradient volumes within 0–5 mm of the urethra surface were allowed to receive doses less than the prescribed dose of 100%. Results: The platinum shield reduced the dose rate on the shielded side of the source at 1 cm off-axis to 6.4% of the dose rate on the unshielded side. For the case considered, for the same minimum dose to the hottest 98% of the clinical target volume (D{sub 98%}), I-RSBT reduced urethral D{sub 0.1cc} below that of conventional HDR-BT by 29%, 33%, 38%, and 44% for urethral dose gradient volumes within 0, 1, 3, and 5 mm of the urethra surface, respectively. Percentages are expressed relative to the prescription dose of 100%. For the case considered, for the same urethral dose gradient volumes, rectum D{sub 1cc} was reduced by 7%, 6%, 6%, and 6%, respectively, and bladder D{sub 1cc} was reduced by 4%, 5%, 5%, and 6%, respectively. Treatment time to deliver 20 Gy with I-RSBT was 154 min with ten 62 GBq {sup 153}Gd sources. Conclusions: For the case considered, the proposed{sup 153}Gd-based I-RSBT system has the potential to lower the urethral dose relative to HDR-BT by 29%–44% if the clinician allows a urethral dose gradient volume of 0–5 mm around the urethra to receive a dose below the prescription. A multisource approach is necessary in order to deliver the proposed {sup 153}Gd-based I-RSBT technique in reasonable treatment times.« less

Targeting MRS-Defined Dominant Intraprostatic Lesions with Inverse-Planned High Dose Rate Brachytherapy. Addendum

DTIC Science & Technology

2009-06-01

imagining) into the HDR brachytherapy treatment planning has been demonstrated. Using the inverse planning program IPSA , dose escalation of target...Principles and Clinical Applications of IPSA ; Nucletron International Physics Seminar, Vaals, Netherlands, Sept 13-16, 2006. 7 IPSA ...experience with IPSA for prostate cancer treatment in HDR Brachytherapy, 4ième séminaire francophone de curiethérapie, Arcachon, France, June 15, 2006

Evaluation of the response of concurrent high dose rate intracavitary brachytherapy with external beam radiotherapy in management of early stage carcinoma cervix.

PubMed

Patidar, Arvind Kumar; Kumar, H S; Walke, Rahul V; Hirapara, Pushpendra H; Jakhar, Shankar Lal; Bardia, M R

2012-10-01

To evaluate local disease control and early complications of concomitant brachytherapy with external beam-radiotherapy in early stage carcinoma cervix. Fifty patients of early stage carcinoma cervix (FIGO-IB/IIA) were randomly divided into study group concomitant external beam irradiation (EBRT) and HDR-ICBT (intra-cavitary brachytherapy, xrt = 50 Gy/25 Fr, HDR 5.2 Gy*5 Fr) and the control group EBRT followed by HDR-ICBT (xrt = 50 Gy/25 Fr, HDR 7.5 Gy*3 Fr). Acute reactions and local disease response were compared between treatment and at 6-month follow up. Median overall treatment times were 38 and 61 days in the study and the control groups, respectively. Acute skin reactions and diarrhea were more in the study but manageable. At the completion of the study, there were 80 and 68 % complete responses, 16 and 20 % partial responses, 0 and 8 % stable diseases in the study group and the control group, respectively. Response was better in the study group but statistically insignificant. Larger number of patients and longer follow up are required to arrive at concrete conclusion.

Precision genome editing in the CRISPR era.

PubMed

Salsman, Jayme; Dellaire, Graham

2017-04-01

With the introduction of precision genome editing using CRISPR-Cas9 technology, we have entered a new era of genetic engineering and gene therapy. With RNA-guided endonucleases, such as Cas9, it is possible to engineer DNA double strand breaks (DSB) at specific genomic loci. DSB repair by the error-prone non-homologous end-joining (NHEJ) pathway can disrupt a target gene by generating insertions and deletions. Alternatively, Cas9-mediated DSBs can be repaired by homology-directed repair (HDR) using an homologous DNA repair template, thus allowing precise gene editing by incorporating genetic changes into the repair template. HDR can introduce gene sequences for protein epitope tags, delete genes, make point mutations, or alter enhancer and promoter activities. In anticipation of adapting this technology for gene therapy in human somatic cells, much focus has been placed on increasing the fidelity of CRISPR-Cas9 and increasing HDR efficiency to improve precision genome editing. In this review, we will discuss applications of CRISPR technology for gene inactivation and genome editing with a focus on approaches to enhancing CRISPR-Cas9-mediated HDR for the generation of cell and animal models, and conclude with a discussion of recent advances and challenges towards the application of this technology for gene therapy in humans.

Vestibulosympathetic reflex during mental stress

NASA Technical Reports Server (NTRS)

Carter, Jason R.; Ray, Chester A.; Cooke, William H.

2002-01-01

Increases in sympathetic neural activity occur independently with either vestibular or mental stimulation, but it is unknown whether sympathetic activation is additive or inhibitive when both stressors are combined. The purpose of the present study was to investigate the combined effects of vestibular and mental stimulation on sympathetic neural activation and arterial pressure in humans. Muscle sympathetic nerve activity (MSNA), arterial pressure, and heart rate were recorded in 10 healthy volunteers in the prone position during 1) head-down rotation (HDR), 2) mental stress (MS; using arithmetic), and 3) combined HDR and MS. HDR significantly (P < 0.05) increased MSNA (9 +/- 2 to 13 +/- 2 bursts/min). MS significantly increased MSNA (8 +/- 2 to 13 +/- 2 bursts/min) and mean arterial pressure (87 +/- 2 to 101 +/- 2 mmHg). Combined HDR and MS significantly increased MSNA (9 +/- 1 to 16 +/- 2 bursts/min) and mean arterial pressure (89 +/- 2 to 100 +/- 3 mmHg). Increases in MSNA (7 +/- 1 bursts/min) during the combination trial were not different from the algebraic sum of each trial performed alone (8 +/- 2 bursts/min). We conclude that the interaction for MSNA and arterial pressure is additive during combined vestibular and mental stimulation. Therefore, vestibular- and stress-mediated increases of MSNA appear to occur independently in humans.

The vestibulosympathetic reflex in humans: neural interactions between cardiovascular reflexes

NASA Technical Reports Server (NTRS)

Ray, Chester A.; Monahan, Kevin D.

2002-01-01

1. Over the past 5 years, there has been emerging evidence that the vestibular system regulates sympathetic nerve activity in humans. We have studied this issue in humans by using head-down rotation (HDR) in the prone position. 2. These studies have clearly demonstrated increases in muscle sympathetic nerve activity (MSNA) and calf vascular resistance during HDR. These responses are mediated by engagement of the otolith organs and not the semicircular canals. 3. However, differential activation of sympathetic nerve activity has been observed during HDR. Unlike MSNA, skin sympathetic nerve activity does not increase with HDR. 4. Examination of the vestibulosympathetic reflex with other cardiovascular reflexes (i.e. barorereflexes and skeletal muscle reflexes) has shown an additive interaction for MSNA. 5. The additive interaction between the baroreflexes and vestibulosympathetic reflex suggests that the vestibular system may assist in defending against orthostatic challenges in humans by elevating MSNA beyond that of the baroreflexes. 6. In addition, the further increase in MSNA via otolith stimulation during isometric handgrip, when arterial pressure is elevated markedly, indicates that the vestibulosympathetic reflex is a powerful activator of MSNA and may contribute to blood pressure and flow regulation during dynamic exercise. 7. Future studies will help evaluate the importance of the vestibulosympathetic reflex in clinical conditions associated with orthostatic hypotension.

The evolution of brachytherapy for prostate cancer.

PubMed

Zaorsky, Nicholas G; Davis, Brian J; Nguyen, Paul L; Showalter, Timothy N; Hoskin, Peter J; Yoshioka, Yasuo; Morton, Gerard C; Horwitz, Eric M

2017-06-30

Brachytherapy (BT), using low-dose-rate (LDR) permanent seed implantation or high-dose-rate (HDR) temporary source implantation, is an acceptable treatment option for select patients with prostate cancer of any risk group. The benefits of HDR-BT over LDR-BT include the ability to use the same source for other cancers, lower operator dependence, and - typically - fewer acute irritative symptoms. By contrast, the benefits of LDR-BT include more favourable scheduling logistics, lower initial capital equipment costs, no need for a shielded room, completion in a single implant, and more robust data from clinical trials. Prospective reports comparing HDR-BT and LDR-BT to each other or to other treatment options (such as external beam radiotherapy (EBRT) or surgery) suggest similar outcomes. The 5-year freedom from biochemical failure rates for patients with low-risk, intermediate-risk, and high-risk disease are >85%, 69-97%, and 63-80%, respectively. Brachytherapy with EBRT (versus brachytherapy alone) is an appropriate approach in select patients with intermediate-risk and high-risk disease. The 10-year rates of overall survival, distant metastasis, and cancer-specific mortality are >85%, <10%, and <5%, respectively. Grade 3-4 toxicities associated with HDR-BT and LDR-BT are rare, at <4% in most series, and quality of life is improved in patients who receive brachytherapy compared with those who undergo surgery.

Time-driven activity-based cost comparison of prostate cancer brachytherapy and intensity-modulated radiation therapy.

PubMed

Dutta, Sunil W; Bauer-Nilsen, Kristine; Sanders, Jason C; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

To evaluate the delivery cost of frequently used radiotherapy options offered to patients with intermediate- to high-risk prostate cancer using time-driven activity-based costing and compare the results with Medicare reimbursement and relative value units (RVUs). Process maps were created to represent each step of prostate radiotherapy treatment at our institution. Salary data, equipment purchase costs, and consumable costs were factored into the cost analysis. The capacity cost rate was determined for each resource and calculated for each treatment option from initial consultation to its completion. Treatment options included low-dose-rate brachytherapy (LDR-BT), combined high-dose-rate brachytherapy single fraction boost with 25-fraction intensity-modulated radiotherapy (HDR-BT-IMRT), moderately hypofractionated 28-fraction IMRT, conventionally fractionated 39-fraction IMRT, and conventionally fractionated (2 Gy/fraction) 23-fraction pelvis irradiation with 16-fraction prostate boost. The total cost to deliver LDR-BT, HDR-BT-IMRT, moderately hypofractionated 28-fraction IMRT, conventionally fractionated 39-fraction IMRT, conventionally fractionated 39-fraction IMRT, and conventionally fractionated (2 Gy/fraction) 23-fraction pelvis irradiation with 16-fraction prostate boost was $2719, $6517, $4173, $5507, and $5663, respectively. Total reimbursement for each course was $3123, $10,156, $7862, $9725, and $10,377, respectively. Radiation oncology attending time was 1.5-2 times higher for treatment courses incorporating BT. Attending radiation oncologist's time consumed per RVU was higher with BT (4.83 and 2.56 minutes per RVU generated for LDR-BT and HDR-BT-IMRT, respectively) compared to without BT (1.41-1.62 minutes per RVU). Time-driven activity-based costing analysis identified higher delivery costs associated with prostate BT compared with IMRT alone. In light of recent guidelines promoting BT for intermediate- to high-risk disease, re-evaluation of payment policies is warranted to encourage BT delivery. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Monte Carlo dose calculations for high-dose-rate brachytherapy using GPU-accelerated processing.

PubMed

Tian, Z; Zhang, M; Hrycushko, B; Albuquerque, K; Jiang, S B; Jia, X

2016-01-01

Current clinical brachytherapy dose calculations are typically based on the Association of American Physicists in Medicine Task Group report 43 (TG-43) guidelines, which approximate patient geometry as an infinitely large water phantom. This ignores patient and applicator geometries and heterogeneities, causing dosimetric errors. Although Monte Carlo (MC) dose calculation is commonly recognized as the most accurate method, its associated long computational time is a major bottleneck for routine clinical applications. This article presents our recent developments of a fast MC dose calculation package for high-dose-rate (HDR) brachytherapy, gBMC, built on a graphics processing unit (GPU) platform. gBMC-simulated photon transport in voxelized geometry with physics in (192)Ir HDR brachytherapy energy range considered. A phase-space file was used as a source model. GPU-based parallel computation was used to simultaneously transport multiple photons, one on a GPU thread. We validated gBMC by comparing the dose calculation results in water with that computed TG-43. We also studied heterogeneous phantom cases and a patient case and compared gBMC results with Acuros BV results. Radial dose function in water calculated by gBMC showed <0.6% relative difference from that of the TG-43 data. Difference in anisotropy function was <1%. In two heterogeneous slab phantoms and one shielded cylinder applicator case, average dose discrepancy between gBMC and Acuros BV was <0.87%. For a tandem and ovoid patient case, good agreement between gBMC and Acruos BV results was observed in both isodose lines and dose-volume histograms. In terms of the efficiency, it took ∼47.5 seconds for gBMC to reach 0.15% statistical uncertainty within the 5% isodose line for the patient case. The accuracy and efficiency of a new GPU-based MC dose calculation package, gBMC, for HDR brachytherapy make it attractive for clinical applications. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

An efficient multiple exposure image fusion in JPEG domain

NASA Astrophysics Data System (ADS)

Hebbalaguppe, Ramya; Kakarala, Ramakrishna

2012-01-01

In this paper, we describe a method to fuse multiple images taken with varying exposure times in the JPEG domain. The proposed algorithm finds its application in HDR image acquisition and image stabilization for hand-held devices like mobile phones, music players with cameras, digital cameras etc. Image acquisition at low light typically results in blurry and noisy images for hand-held camera's. Altering camera settings like ISO sensitivity, exposure times and aperture for low light image capture results in noise amplification, motion blur and reduction of depth-of-field respectively. The purpose of fusing multiple exposures is to combine the sharp details of the shorter exposure images with high signal-to-noise-ratio (SNR) of the longer exposure images. The algorithm requires only a single pass over all images, making it efficient. It comprises of - sigmoidal boosting of shorter exposed images, image fusion, artifact removal and saturation detection. Algorithm does not need more memory than a single JPEG macro block to be kept in memory making it feasible to be implemented as the part of a digital cameras hardware image processing engine. The Artifact removal step reuses the JPEGs built-in frequency analysis and hence benefits from the considerable optimization and design experience that is available for JPEG.

Coherent structure dynamics and identification during the multistage transitions of polymeric turbulent channel flow

NASA Astrophysics Data System (ADS)

Zhu, Lu; Xi, Li

2018-04-01

Drag reduction induced by polymer additives in wall-bounded turbulence has been studied for decades. A small dosage of polymer additives can drastically reduce the energy dissipation in turbulent flows and alter the flow structures at the same time. As the polymer-induced fluid elasticity increases, drag reduction goes through several stages of transition with drastically different flow statistics. While much attention in the area of polymer-turbulence interactions has been focused on the onset and the asymptotic stage of maximum drag reduction, the transition between the two intermediate stages – low-extent drag reduction (LDR) and high-extent drag reduction (HDR) – likely reflects a qualitative change in the underlying vortex dynamics according to our recent study [1]. In particular, we proposed that polymers start to suppress the lift-up and bursting of vortices at HDR, leading to the localization of turbulent structures. To test our hypothesis, a statistically robust conditional sampling algorithm, based on Jenong and Hussain [2]’s work, was adopted in this study. The comparison of conditional eddies between the Newtonian and the highly elastic turbulence shows that (i) the lifting “strength” of vortices is suppressed by polymers as reflected by the decreasing lifting angle of the conditional eddy and (ii) the curvature of vortices is also eliminated as the orientation of the head of the conditional eddy changes. In summary, the results of conditional sampling support our hypothesis of polymer-turbulence interactions during the LDR-HDR transition.

Across light: through colour

NASA Astrophysics Data System (ADS)

Azevedo, Isabel; Richardson, Martin; Bernardo, Luis Miguel

2012-03-01

The speed at which our world is changing is reflected in the shifting way artistic images are created and produced. Holography can be used as a medium to express the perception of space with light and colour and to make the material and the immaterial experiments with optical and digital holography. This paper intends to be a reflection on the final product of that process surrounding a debate of ideas for new experimental methodologies applied to holographic images. Holography is a time-based medium and the irretrievable linear flow of time is responsible for a drama, unique to traditional cinematography. If the viewers move to left or right, they see glimpses of the next scene or the previous one perceived a second ago. This interaction of synthetic space arises questions such as: can we see, in "reality", two forms in the same space? Trying to answer this question, a series of works has been created. These concepts are embryonic to a series of digital art holograms and lenticulars technique's titled "Across Light: Through Colour". They required some technical research and comparison between effects from different camera types, using Canon IS3 and Sony HDR CX105.

SU-F-19A-03: Dosimetric Advantages in Critical Structure Dose Sparing by Using a Multichannel Cylinder in High Dose Rate Brachytherapy to Treat Vaginal Cuff Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Syh, J; Syh, J; Patel, B

2014-06-15

Purpose: The multichannel cylindrical vaginal applicator is a variation of traditional single channel cylindrical vaginal applicator. The multichannel applicator has additional peripheral channels that provide more flexibility in the planning process. The dosimetric advantage is to reduce dose to adjacent organ at risk (OAR) such as bladder and rectum while maintaining target coverage with the dose optimization from additional channels. Methods: Vaginal HDR brachytherapy plans are all CT based. CT images were acquired in 2 mm thickness to keep integrity of cylinder contouring. The CTV of 5mm Rind with prescribed treatment length was reconstructed from 5mm expansion of inserted cylinder.more » The goal was 95% of CTV covered by 95% of prescribed dose in both single channel planning (SCP)and multichannel planning (MCP) before proceeding any further optimization for dose reduction to critical structures with emphasis on D2cc and V2Gy . Results: This study demonstrated noticeable dose reduction to OAR was apparent in multichannel plans. The D2cc of the rectum and bladder were showing the reduced dose for multichannel versus single channel. The V2Gy of the rectum was 93.72% and 83.79% (p=0.007) for single channel and multichannel respectively (Figure 1 and Table 1). To assure adequate coverage to target while reducing the dose to the OAR without any compromise is the main goal in using multichannel vaginal applicator in HDR brachytherapy. Conclusion: Multichannel plans were optimized using anatomical based inverse optimization algorithm of inverse planning simulation annealing. The optimization solution of the algorithm was to improve the clinical target volume dose coverage while reducing the dose to critical organs such as bladder, rectum and bowels. The comparison between SCP and MCP demonstrated MCP is superior to SCP where the dwell positions were based on geometric array only. It concluded that MCP is preferable and is able to provide certain features superior to SCP.« less

Dosimetric evaluation of high-dose-rate interstitial brachytherapy boost treatments for localized prostate cancer.

PubMed

Fröhlich, Georgina; Agoston, Péter; Lövey, József; Somogyi, András; Fodor, János; Polgár, Csaba; Major, Tibor

2010-07-01

To quantitatively evaluate the dose distributions of high-dose-rate (HDR) prostate implants regarding target coverage, dose homogeneity, and dose to organs at risk. Treatment plans of 174 implants were evaluated using cumulative dose-volume histograms (DVHs). The planning was based on transrectal ultrasound (US) imaging, and the prescribed dose (100%) was 10 Gy. The tolerance doses to rectum and urethra were 80% and 120%, respectively. Dose-volume parameters for target (V90, V100, V150, V200, D90, D(min)) and quality indices (DNR [dose nonuniformity ratio], DHI [dose homogeneity index], CI [coverage index], COIN [conformal index]) were calculated. Maximum dose in reference points of rectum (D(r)) and urethra (D(u)), dose to volume of 2 cm(3) of the rectum (D(2ccm)), and 0.1 cm(3) and 1% of the urethra (D(0.1ccm) and D1) were determined. Nonparametric correlation analysis was performed between these parameters. The median number of needles was 16, the mean prostate volume (V(p)) was 27.1 cm(3). The mean V90, V100, V150, and V200 were 99%, 97%, 39%, and 13%, respectively. The mean D90 was 109%, and the D(min) was 87%. The mean doses in rectum and urethra reference points were 75% and 119%, respectively. The mean volumetric doses were D(2ccm) = 49% for the rectum, D(0.1ccm) = 126%, and D1 = 140% for the urethra. The mean DNR was 0.37, while the DHI was 0.60. The mean COIN was 0.66. The Spearman rank order correlation coefficients for volume doses to rectum and urethra were R(D(r),D(2ccm)) = 0.69, R(D(u),D0.(1ccm)) = 0.64, R(D(u),D1) = 0.23. US-based treatment plans for HDR prostate implants based on the real positions of catheters provided acceptable dose distributions. In the majority of the cases, the doses to urethra and rectum were kept below the defined tolerance levels. For rectum, the dose in reference points correlated well with dose-volume parameters. For urethra dose characterization, the use of D1 volumetric parameter is recommended.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miyasaka, Y; Kadoya, N; Ito, K

Purpose: Accurate deformable image registration (DIR) between external beam radiotherapy (EBRT) and HDR brachytherapy (BT) CT images in cervical cancer is challenging. DSC has been evaluated only on the basis of the consistency of the structure, and its use does not guarantee an anatomically reasonable deformation. We evaluate the DIR accuracy for cervical cancer with DSC and anatomical landmarks using a 3D-printed pelvis phantom. Methods: A 3D-printed, deformable female pelvis phantom was created on the basis of the patient’s CT image. Urethane and silicon were used as materials for creating the uterus and bladder, respectively, in the phantom. We performedmore » DIR in two cases: case-A with a full bladder (170 ml) in both the EBRT and BT images and case-B with a full bladder in the BT image and a half bladder (100 ml) in the EBRT image. DIR was evaluated using DSCs and 70 uterus and bladder landmarks. A Hybrid intensity and structure DIR algorithm with two settings (RayStation) was used. Results: In the case-A, DSCs of the intensity-based DIR were 0.93 and 0.85 for the bladder and uterus, respectively, whereas those of hybrid-DIR were 0.98 and 0.96, respectively. The mean landmark error values of intensity-based DIR were 0.73±0.29 and 1.70±0.19 cm for the bladder and uterus, respectively, whereas those of Hybrid-DIR were 0.43±0.33 and 1.23±0.25 cm, respectively. In both cases, the Hybrid-DIR accuracy was better than the intensity-based DIR accuracy for both evaluation methods. However, for several bladder landmarks, the Hybrid-DIR landmark errors were larger than the corresponding intensity-based DIR errors (e.g., 2.26 vs 1.25 cm). Conclusion: Our results demonstrate that Hybrid-DIR can perform with a better accuracy than the intensity-based DIR for both DSC and landmark errors; however, Hybrid-DIR shows a larger landmark error for some landmarks because the technique focuses on both the structure and intensity.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borot de Battisti, Maxence, E-mail: M.E.P.Borot@um

Purpose: The development of MR-guided high dose rate (HDR) brachytherapy is under investigation due to the excellent tumor and organs at risk visualization of MRI. However, MR-based localization of needles (including catheters or tubes) has inherently a low update rate and the required image interpretation can be hampered by signal voids arising from blood vessels or calcifications limiting the precision of the needle guidance and reconstruction. In this paper, a new needle tracking prototype is investigated using fiber Bragg gratings (FBG)-based sensing: this prototype involves a MR-compatible stylet composed of three optic fibers with nine sets of embedded FBG sensorsmore » each. This stylet can be inserted into brachytherapy needles and allows a fast measurement of the needle deflection. This study aims to assess the potential of FBG-based sensing for real-time needle (including catheter or tube) tracking during MR-guided intervention. Methods: First, the MR compatibility of FBG-based sensing and its accuracy was evaluated. Different known needle deflections were measured using FBG-based sensing during simultaneous MR-imaging. Then, a needle tracking procedure using FBG-based sensing was proposed. This procedure involved a MR-based calibration of the FBG-based system performed prior to the interventional procedure. The needle tracking system was assessed in an experiment with a moving phantom during MR imaging. The FBG-based system was quantified by comparing the gold-standard shapes, the shape manually segmented on MRI and the FBG-based measurements. Results: The evaluation of the MR compatibility of FBG-based sensing and its accuracy shows that the needle deflection could be measured with an accuracy of 0.27 mm on average. Besides, the FBG-based measurements were comparable to the uncertainty of MR-based measurements estimated at half the voxel size in the MR image. Finally, the mean(standard deviation) Euclidean distance between MR- and FBG-based needle position measurements was equal to 0.79 mm(0.37 mm). The update rate and latency of the FBG-based needle position measurement were 100 and 300 ms, respectively. Conclusions: The FBG-based needle tracking procedure proposed in this paper is able to determine the position of the complete needle, under MR-imaging, with better accuracy and precision, higher update rate, and lower latency compared to current MR-based needle localization methods. This system would be eligible for MR-guided brachytherapy, in particular, for an improved needle guidance and reconstruction.« less

The Statistical Knowledge Gap in Higher Degree by Research Students: The Supervisors' Perspective

ERIC Educational Resources Information Center

Baglin, James; Hart, Claire; Stow, Sarah

2017-01-01

This study sought to gain an understanding of the current statistical training and support needs for Australian Higher Degree by Research (HDR) students and their supervisors. The data reported herein are based on the survey responses of 191 (18.7%) eligible supervisors from a single Australian institution. The survey was composed of both…

Harmony search optimization for HDR prostate brachytherapy

NASA Astrophysics Data System (ADS)

Panchal, Aditya

In high dose-rate (HDR) prostate brachytherapy, multiple catheters are inserted interstitially into the target volume. The process of treating the prostate involves calculating and determining the best dose distribution to the target and organs-at-risk by means of optimizing the time that the radioactive source dwells at specified positions within the catheters. It is the goal of this work to investigate the use of a new optimization algorithm, known as Harmony Search, in order to optimize dwell times for HDR prostate brachytherapy. The new algorithm was tested on 9 different patients and also compared with the genetic algorithm. Simulations were performed to determine the optimal value of the Harmony Search parameters. Finally, multithreading of the simulation was examined to determine potential benefits. First, a simulation environment was created using the Python programming language and the wxPython graphical interface toolkit, which was necessary to run repeated optimizations. DICOM RT data from Varian BrachyVision was parsed and used to obtain patient anatomy and HDR catheter information. Once the structures were indexed, the volume of each structure was determined and compared to the original volume calculated in BrachyVision for validation. Dose was calculated using the AAPM TG-43 point source model of the GammaMed 192Ir HDR source and was validated against Varian BrachyVision. A DVH-based objective function was created and used for the optimization simulation. Harmony Search and the genetic algorithm were implemented as optimization algorithms for the simulation and were compared against each other. The optimal values for Harmony Search parameters (Harmony Memory Size [HMS], Harmony Memory Considering Rate [HMCR], and Pitch Adjusting Rate [PAR]) were also determined. Lastly, the simulation was modified to use multiple threads of execution in order to achieve faster computational times. Experimental results show that the volume calculation that was implemented in this thesis was within 2% of the values computed by Varian BrachyVision for the prostate, within 3% for the rectum and bladder and 6% for the urethra. The calculation of dose compared to BrachyVision was determined to be different by only 0.38%. Isodose curves were also generated and were found to be similar to BrachyVision. The comparison between Harmony Search and genetic algorithm showed that Harmony Search was over 4 times faster when compared over multiple data sets. The optimal Harmony Memory Size was found to be 5 or lower; the Harmony Memory Considering Rate was determined to be 0.95, and the Pitch Adjusting Rate was found to be 0.9. Ultimately, the effect of multithreading showed that as intensive computations such as optimization and dose calculation are involved, the threads of execution scale with the number of processors, achieving a speed increase proportional to the number of processor cores. In conclusion, this work showed that Harmony Search is a viable alternative to existing algorithms for use in HDR prostate brachytherapy optimization. Coupled with the optimal parameters for the algorithm and a multithreaded simulation, this combination has the capability to significantly decrease the time spent on minimizing optimization problems in the clinic that are time intensive, such as brachytherapy, IMRT and beam angle optimization.

Evaluation of 2 × 24-h dietary recalls combined with a food-recording booklet, against a 7-day food-record method among schoolchildren.

PubMed

Trolle, E; Amiano, P; Ege, M; Bower, E; Lioret, S; Brants, H; Kaic-Rak, A; de Boer, E J; Andersen, L F

2011-07-01

The aim of this study was to evaluate the estimated energy, nutrient and food intake from the suggested trans-European methodology for undertaking representative dietary surveys among schoolchildren: 2 × 24-h dietary recalls (24-HDRs) combined with a food-recording booklet (FRB), using EPIC-Soft pc-program (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study), against a 7-day food-record (7-dFR) method among Danish schoolchildren. A total of 74 children aged 7-8 years and 70 children aged 12-13 years were recruited through the Civil Registration System in Denmark. Each child and one of their parents completed two face-to-face 24-HDRs, combined with optional use of a FRB, followed by a 7-day-estimated FR. Energy intake was significantly higher with the 24-HDR method than with the 7-dFR method for both age groups. Mean energy intake was 6% higher for the youngest (P = 0.02) and 11% for the oldest children (P = 0.01); underreporting of energy occurs among the oldest children, being less present with the 24-HDR method. The intakes of carbohydrate and dietary fiber (absolute and related to energy) were significantly higher with the 24-HDR than with the 7-dFR for both age groups (P < 0.001). No significant differences between the two methods were observed for absolute intake of fat and added sugar between both age groups, and for intake of protein among the 7- to 8-year olds. The percentage of energy intake from fat from the 24-HDR, however, was significantly lower for both age groups and for energy intake from added sugar for the 12- to 13-year olds. The 2 × 24-HDR method compared with the 7-dFR yields relatively good values on the group level for many macronutrients and foods. However, some differences in estimated intakes of macronutrients suggest the need to carefully adapt the tools to be age and country specific. There is a tendency for parents and schoolchildren to report a healthier diet with the 24-HDR than with the FRs; this results in some concern about the method and has to be studied further.

In vivo measurements for high dose rate brachytherapy with optically stimulated luminescent dosimeters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sharma, Renu; Jursinic, Paul A.

2013-07-15

Purpose: To show the feasibility of clinical implementation of OSLDs for high dose-rate (HDR) in vivo dosimetry for gynecological and breast patients. To discuss how the OSLDs were characterized for an Ir-192 source, taking into account low gamma energy and high dose gradients. To describe differences caused by the dose calculation formalism of treatment planning systems.Methods: OSLD irradiations were made using the GammaMedplus iX Ir-192 HDR, Varian Medical Systems, Milpitas, CA. BrachyVision versions 8.9 and 10.0, Varian Medical Systems, Milpitas, CA, were used for calculations. Version 8.9 used the TG-43 algorithm and version 10.0 used the Acuros algorithm. The OSLDsmore » (InLight Nanodots) were characterized for Ir-192. Various phantoms were created to assess calculated and measured doses and the angular dependence and self-absorption of the Nanodots. Following successful phantom measurements, patient measurements for gynecological patients and breast cancer patients were made and compared to calculated doses.Results: The OSLD sensitivity to Ir-192 compared to 6 MV is between 1.10 and 1.25, is unique to each detector, and changes with accumulated dose. The measured doses were compared to those predicted by the treatment planning system and found to be in agreement for the gynecological patients to within measurement uncertainty. The range of differences between the measured and Acuros calculated doses was -10%-14%. For the breast patients, there was a discrepancy of -4.4% to +6.5% between the measured and calculated doses at the skin surface when the Acuros algorithm was used. These differences were within experimental uncertainty due to (random) error in the location of the detector with respect to the treatment catheter.Conclusions: OSLDs can be successfully used for HDR in vivo dosimetry. However, for the measurements to be meaningful one must account for the angular dependence, volume-averaging, and the greater sensitivity to Ir-192 gamma rays than to 6 MV x-rays if 6 MV x-rays were used for OSLD calibration. The limitations of the treatment planning algorithm must be understood, especially for surface dose measurements. Use of in vivo dosimetry for HDR brachytherapy treatments is feasible and has the potential to detect and prevent gross errors. In vivo HDR brachytherapy should be included as part of the QA for a HDR brachytherapy program.« less

Electromagnetic tracking (EMT) technology for improved treatment quality assurance in interstitial brachytherapy.

PubMed

Kellermeier, Markus; Herbolzheimer, Jens; Kreppner, Stephan; Lotter, Michael; Strnad, Vratislav; Bert, Christoph

2017-01-01

Electromagnetic Tracking (EMT) is a novel technique for error detection and quality assurance (QA) in interstitial high dose rate brachytherapy (HDR-iBT). The purpose of this study is to provide a concept for data acquisition developed as part of a clinical evaluation study on the use of EMT during interstitial treatment of breast cancer patients. The stability, accuracy, and precision of EMT-determined dwell positions were quantified. Dwell position reconstruction based on EMT was investigated on CT table, HDR table and PDR bed to examine the influence on precision and accuracy in a typical clinical workflow. All investigations were performed using a precise PMMA phantom. The track of catheters inserted in that phantom was measured by manually inserting a 5 degree of freedom (DoF) sensor while recording the position of three 6DoF fiducial sensors on the phantom surface to correct motion influences. From the corrected data, dwell positions were reconstructed along the catheter's track. The accuracy of the EMT-determined dwell positions was quantified by the residual distances to reference dwell positions after using a rigid registration. Precision and accuracy were investigated for different phantom-table and sensor-field generator (FG) distances. The measured precision of the EMT-determined dwell positions was ≤ 0.28 mm (95th percentile). Stability tests showed a drift of 0.03 mm in the first 20 min of use. Sudden shaking of the FG or (large) metallic objects close to the FG degrade the precision. The accuracy with respect to the reference dwell positions was on all clinical tables < 1 mm at 200 mm FG distance and 120 mm phantom-table distance. Phantom measurements showed that EMT-determined localization of dwell positions in HDR-iBT is stable, precise, and sufficiently accurate for clinical assessment. The presented method may be viable for clinical applications in HDR-iBT, like implant definition, error detection or quantification of uncertainties. Further clinical investigations are needed. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Dosimetric intercomparison of permanent Ho-166 seed's implants and HDR Ir-192 brachytherapy in breast cancer.

PubMed

de Campos, Tarcisio Passos Ribeiro; Nogueira, Luciana Batista; Trindade, Bruno; Cuperschmid, Ethel Mizrahy

2016-01-01

To provide a comparative dosimetric analysis of permanent implants of Ho(166)-seeds and temporary HDR Ir(192)-brachytherapy through computational simulation. Brachytherapy with Ir(192)-HDR or LDR based on temporary wires or permanent radioactive seed implants can be used as dose reinforcement for breast radiation therapy. Permanent breast implants have not been a practical clinical routine; although, I(125) and Pd(103)-seeds have already been reported. Biodegradable Ho(166)-ceramic-seeds have been addressed recently. Simulations of implants of nine Ho(166)-seeds and equivalent with HDR Ir(192)-brachytherapy were elaborated in MCNP5, shaped in a computational multivoxel simulator which reproduced a female thorax phantom. Spatial dose rate distributions and dose-volume histograms were generated. Protocol's analysis involving exposure time, seed's activities and dose were performed. Permanent Ho(166)-seed implants presented a maximum dose rate per unit of contained activity (MDR) of 1.1601 μGy h(-1) Bq(-1); and, a normalized MDR in standard points (8 mm, equidistant to 03-seeds - SP1, 10 mm - SP2) of 1.0% (SP1) and 0.5% (SP2), respectively. Ir(192)-brachytherapy presented MDR of 4.3945 × 10(-3) μGy h(-1) Bq(-1); and, 30% (SP1), and 20% (SP2). Therefore, seed's implant activities of 333 MBq (Ho(166)) and 259 GBq (Ir(192)) produced prescribed doses of 58 Gy (SP1; 5d) and 56 Gy (SP1, 5 fractions, 6 min), respectively. Breast Ho(166)-implants of 37-111 MBq are attractive due to the high dose rate near 6-10 mm from seeds, equivalent to Ir(192)-brachytherapy of 259 GBq (3 fractions, 6 min) providing similar dose in standard points at a week; however, with spatial dose distribution better confined. The seed positioning can be adjusted for controlling the breast tumor, in stages I and II, in flat and deep tumors, without any breast volumetric limitation.

SU-E-T-459: Impact of Source Position and Traveling Time On HDR Skin Surface Applicator Dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jeong, J; Barker, C; Zaider, M

Purpose: Observed dosimetric discrepancy between measured and treatment planning system (TPS) predicted values, during applicator commissioning, were traced to source position uncertainty in the applicator. We quantify the dosimetric impact of this geometric uncertainty, and of the source traveling time inside the applicator, and propose corrections for clinical use. Methods: We measured the dose profiles from the Varian Leipzig-style (horizontal) HDR skin applicator, using EBT3 film, photon diode, and optically stimulated luminescence dosimeter (OSLD) and three different GammaMed HDR afterloders. The dose profiles and depth dose of each aperture were measured at several depths (up to about 10 mm, dependingmore » on the dosimeter). The measured dose profiles were compared with Acuros calculated profiles in BrachyVision TPS. For the impact of the source position, EBT3 film measurements were performed with applicator, facing-down and facing-up orientations. The dose with and without source traveling was measured with diode detector using HDR timer and electrometer timer, respectively. Results: Depth doses measured using the three dosimeters were in good agreement, but were consistently higher than the Acuros dose calculations. Measurements with the applicator facing-up were significantly lower than those in the facing-down position with maximum difference of about 18% at the surface, due to source sag inside the applicator. Based on the inverse-square law, the effective source sag was evaluated to be about 0.5 mm from the planned position. The additional dose from the source traveling was about 2.8% for 30 seconds with 10 Ci source, decreasing with increased dwelling time and decreased source activity. Conclusion: Due to the short source-to-surface distance of the applicator, the small source sag inside the applicator has significant dosimetric impact, which should be considered before the clinical use of the applicator. Investigation of the effect for other applicators that have relatively large source lumen inner diameter may be warranted. Christopher Barker and Gil’ad Cohen are receiving research support for a study of skin surface brachytherapy from Elekta.« less

Trans-Pacific HDR Satellite Communications Experiment Phase-2: Experimental Network and Demonstration Plan

NASA Technical Reports Server (NTRS)

Kadowaki, Naoto; Yoshimura, Naoko; Takahashi, Takashi; Yoshikawa, Makoto; Hsu, Eddie; Bergman, Larry; Bhasin, Kul; Gary, Pat

1998-01-01

The trans-Pacific high data rate (TP-HDR) satellite communications experiment was proposed at the Japan-U.S. Cooperation in Space (JUCS) Program Workshop held in Hawaii in 1993 and remote high definition video post-production was demonstrated as the first phase trial. Following the first phase, the second phase experiment is currently prepared. This paper describes the experimental network configuration, application demonstration, and performance evaluation plan of the second phase experiment.

Vestibulosympathetic reflex during orthostatic challenge in aging humans

NASA Technical Reports Server (NTRS)

Monahan, Kevin D.; Ray, Chester A.

2002-01-01

Aging attenuates the increase in muscle sympathetic nerve activity (MSNA) and elicits hypotension during otolith organ engagement in humans. The purpose of the present study was to determine the neural and cardiovascular responses to otolithic engagement during orthostatic stress in older adults. We hypothesized that age-related impairments in the vestibulosympathetic reflex would persist during orthostatic challenge in older subjects and might compromise arterial blood pressure regulation. MSNA, arterial blood pressure, and heart rate responses to head-down rotation (HDR) performed with and without lower body negative pressure (LBNP) in prone subjects were measured. Ten young (27 +/- 1 yr) and 11 older subjects (64 +/- 1 yr) were studied prospectively. HDR performed alone elicited an attenuated increase in MSNA in older subjects (Delta106 +/- 28 vs. Delta20 +/- 7% for young and older subjects). HDR performed during simultaneous orthostatic stress increased total MSNA further in young (Delta53 +/- 15%; P < 0.05) but not older subjects (Delta-5 +/- 4%). Older subjects demonstrated consistent significant hypotension during HDR performed both alone (Delta-6 +/- 2 mmHg) and during LBNP (Delta-7 +/- 2 mmHg). These data provide experimental support for the concept that age-related impairments in the vestibulosympathetic reflex persist during orthostatic challenge in older adults. Furthermore, these findings are consistent with the concept that age-related alterations in vestibular function might contribute to altered orthostatic blood pressure regulation with age in humans.

In vivo dosimeters for HDR brachytherapy: a comparison of a diamond detector, MOSFET, TLD, and scintillation detector.

PubMed

Lambert, Jamil; Nakano, Tatsuya; Law, Sue; Elsey, Justin; McKenzie, David R; Suchowerska, Natalka

2007-05-01

The large dose gradients in brachytherapy necessitate a detector with a small active volume for accurate dosimetry. The dosimetric performance of a novel scintillation detector (BrachyFOD) is evaluated and compared to three commercially available detectors, a diamond detector, a MOSFET, and LiF TLDs. An 192Ir HDR brachytherapy source is used to measure the depth dependence, angular dependence, and temperature dependence of the detectors. Of the commercially available detectors, the diamond detector was found to be the most accurate, but has a large physical size. The TLDs cannot provide real time readings and have depth dependent sensitivity. The MOSFET used in this study was accurate to within 5% for distances of 20 to 50 mm from the 192Ir source in water but gave errors of 30%-40% for distances greater than 50 mm from the source. The BrachyFOD was found to be accurate to within 3% for distances of 10 to 100 mm from an HDR 192Ir brachytherapy source in water. It has an angular dependence of less than 2% and the background signal created by Cerenkov radiation and fluorescence of the plastic optical fiber is insignificant compared to the signal generated in the scintillator. Of the four detectors compared in this study the BrachyFOD has the most favorable combination of characteristics for dosimetry in HDR brachytherapy.

An experimental MOSFET approach to characterize (192)Ir HDR source anisotropy.

PubMed

Toye, W C; Das, K R; Todd, S P; Kenny, M B; Franich, R D; Johnston, P N

2007-09-07

The dose anisotropy around a (192)Ir HDR source in a water phantom has been measured using MOSFETs as relative dosimeters. In addition, modeling using the EGSnrc code has been performed to provide a complete dose distribution consistent with the MOSFET measurements. Doses around the Nucletron 'classic' (192)Ir HDR source were measured for a range of radial distances from 5 to 30 mm within a 40 x 30 x 30 cm(3) water phantom, using a TN-RD-50 MOSFET dosimetry system with an active area of 0.2 mm by 0.2 mm. For each successive measurement a linear stepper capable of movement in intervals of 0.0125 mm re-positioned the MOSFET at the required radial distance, while a rotational stepper enabled angular displacement of the source at intervals of 0.9 degrees . The source-dosimeter arrangement within the water phantom was modeled using the standardized cylindrical geometry of the DOSRZnrc user code. In general, the measured relative anisotropy at each radial distance from 5 mm to 30 mm is in good agreement with the EGSnrc simulations, benchmark Monte Carlo simulation and TLD measurements where they exist. The experimental approach employing a MOSFET detection system of small size, high spatial resolution and fast read out capability allowed a practical approach to the determination of dose anisotropy around a HDR source.

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation.

PubMed

Jaberi, Ramin; Siavashpour, Zahra; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-12-01

Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in 'organs-applicators', while maintaining target dose at the original level. There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients' plans to be able to serve as a clinical tool.

Dosimetric characteristics of a new unit for electronic skin brachytherapy

PubMed Central

Garcia-Martinez, Teresa; Chan, Jan-Pieter; Perez-Calatayud, Jose

2014-01-01

Purpose Brachytherapy with radioactive high dose rate (HDR) 192Ir source is applied to small skin cancer lesions, using surface applicators, i.e. Leipzig or Valencia type. New developments in the field of radiotherapy for skin cancer include electronic brachytherapy. This technique involves the placement of an HDR X-ray source close to the skin, therefore combining the benefits of brachytherapy with the reduced shielding requirements and targeted energy of low energy X-rays. Recently, the Esteya® Electronic Brachytherapy System (Esteya EBS, Elekta AB-Nucletron, Stockholm, Sweden) has been developed specifically for HDR brachytherapy treatment of surface lesions. The system provides radionuclide free HDR brachytherapy by means of a small 69.5 kV X-ray source. The purpose of this study is to obtain the dosimetric characterization required for clinical implementation, providing the detailed methodology to perform the commissioning. Material and methods Flatness, symmetry and penumbra, percentage of depth dose (PDD), kV stability, HVL, output, spectrum, linearity, and leakage have been evaluated for a set of applicators (from 10 mm to 30 mm in diameter). Results Flatness and symmetry resulted better than 5% with around 1 mm of penumbra. The depth dose gradient is about 7%/mm. A kV value of 68.4 ± 1.0 kV (k = 1) was obtained, in good agreement with manufacturer data (69.5 kV). HVL was 1.85 mm Al. Dose rate for a typical 6 Gy to 7 Gy prescription resulted about 3.3 Gy/min and the leakage value was < 100 µGy/min. Conclusions The new Esteya® Electronic Brachytherapy System presents excellent flatness and penumbra as with the Valencia applicator case, combined with an improved PDD, allowing treatment of lesions of up to a depth of 5 mm in combination with reduced treatment duration. The Esteya unit allows HDR brachytherapy superficial treatment within a minimally shielded environment due its low energy. PMID:24790622

SU-E-T-758: To Determine the Source Dwell Positions of HDR Brachytherapy Using 2D 729 Ion Chamber Array

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kumar, Syam; Sitha

2015-06-15

Purpose: Determination of source dwell positions of HDR brachytherapy using 2D 729 ion chamber array Methods: Nucletron microselectron HDR and PTW 2D array were used for the study. Different dwell positions were assigned in the HDR machine. Rigid interstitial needles and vaginal applicator were positioned on the 2D array. The 2D array was exposed for this programmed dwell positions. The positional accuracy of the source was analyzed after the irradiation of the 2D array. This was repeated for different dwell positions. Different test plans were transferred from the Oncentra planning system and irradiated with the same applicator position on themore » 2D array. The results were analyzed using the in house developed excel program. Results: Assigned dwell positions versus corresponding detector response were analyzed. The results show very good agreement with the film measurements. No significant variation found between the planned and measured dwell positions. Average dose response with 2D array between the planned and nearby dwell positions was found to be 0.0804 Gy for vaginal cylinder applicator and 0.1234 Gy for interstitial rigid needles. Standard deviation between the doses for all the measured dwell positions for interstitial rigid needle for 1 cm spaced positions were found to be 0.33 and 0.37 for 2cm spaced dwell positions. For intracavitory vaginal applicator this was found to be 0.21 for 1 cm spaced dwell positions and 0.06 for 2cm spaced dwell positions. Intracavitory test plans reproduced on the 2D array with the same applicator positions shows the ideal dose distribution with the TPS planned. Conclusion: 2D array is a good tool for determining the dwell position of HDR brachytherapy. With the in-house developed program in excel it is easy and accurate. The traditional way with film analysis can be replaced by this method, as the films will be more costly.« less

SU-E-T-795: Validations of Dose Calculation Accuracy of Acuros BV in High-Dose-Rate (HDR) Brachytherapy with a Shielded Cylinder Applicator Using Monte Carlo Simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Y; Department of Engineering Physics, Tsinghua University, Beijing; Tian, Z

Purpose: Acuros BV has become available to perform accurate dose calculations in high-dose-rate (HDR) brachytherapy with phantom heterogeneity considered by solving the Boltzmann transport equation. In this work, we performed validation studies regarding the dose calculation accuracy of Acuros BV in cases with a shielded cylinder applicator using Monte Carlo (MC) simulations. Methods: Fifteen cases were considered in our studies, covering five different diameters of the applicator and three different shielding degrees. For each case, a digital phantom was created in Varian BrachyVision with the cylinder applicator inserted in the middle of a large water phantom. A treatment plan withmore » eight dwell positions was generated for these fifteen cases. Dose calculations were performed with Acuros BV. We then generated a voxelized phantom of the same geometry, and the materials were modeled according to the vendor’s specifications. MC dose calculations were then performed using our in-house developed fast MC dose engine for HDR brachytherapy (gBMC) on a GPU platform, which is able to simulate both photon transport and electron transport in a voxelized geometry. A phase-space file for the Ir-192 HDR source was used as a source model for MC simulations. Results: Satisfactory agreements between the dose distributions calculated by Acuros BV and those calculated by gBMC were observed in all cases. Quantitatively, we computed point-wise dose difference within the region that receives a dose higher than 10% of the reference dose, defined to be the dose at 5mm outward away from the applicator surface. The mean dose difference was ∼0.45%–0.51% and the 95-percentile maximum difference was ∼1.24%–1.47%. Conclusion: Acuros BV is able to accurately perform dose calculations in HDR brachytherapy with a shielded cylinder applicator.« less

External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison

PubMed Central

Melchert, Corinna; Kovács, György

2016-01-01

Purpose This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Material and methods We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms. Results There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01). Conclusions Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer. PMID:27648082

Baculovirus-based genome editing in primary cells.

PubMed

Mansouri, Maysam; Ehsaei, Zahra; Taylor, Verdon; Berger, Philipp

2017-03-01

Genome editing in eukaryotes became easier in the last years with the development of nucleases that induce double strand breaks in DNA at user-defined sites. CRISPR/Cas9-based genome editing is currently one of the most powerful strategies. In the easiest case, a nuclease (e.g. Cas9) and a target defining guide RNA (gRNA) are transferred into a target cell. Non-homologous end joining (NHEJ) repair of the DNA break following Cas9 cleavage can lead to inactivation of the target gene. Specific repair or insertion of DNA with Homology Directed Repair (HDR) needs the simultaneous delivery of a repair template. Recombinant Lentivirus or Adenovirus genomes have enough capacity for a nuclease coding sequence and the gRNA but are usually too small to also carry large targeting constructs. We recently showed that a baculovirus-based multigene expression system (MultiPrime) can be used for genome editing in primary cells since it possesses the necessary capacity to carry the nuclease and gRNA expression constructs and the HDR targeting sequences. Here we present new Acceptor plasmids for MultiPrime that allow simplified cloning of baculoviruses for genome editing and we show their functionality in primary cells with limited life span and induced pluripotent stem cells (iPS). Copyright © 2017 Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weiss, Joel T.; Becker, Julian; Shanks, Katherine S.

There is a compelling need for a high frame rate imaging detector with a wide dynamic range, from single x-rays/pixel/pulse to >10{sup 6} x-rays/pixel/pulse, that is capable of operating at both x-ray free electron laser (XFEL) and 3rd generation sources with sustained fluxes of > 10{sup 11} x-rays/pixel/s [1, 2, 3]. We propose to meet these requirements with the High Dynamic Range Pixel Array Detector (HDR-PAD) by (a) increasing the speed of charge removal strategies [4], (b) increasing integrator range by implementing adaptive gain [5], and (c) exploiting the extended charge collection times of electron-hole pair plasma clouds that formmore » when a sufficiently large number of x-rays are absorbed in a detector sensor in a short period of time [6]. We have developed a measurement platform similar to the one used in [6] to study the effects of high electron-hole densities in silicon sensors using optical lasers to emulate the conditions found at XFELs. Characterizations of the employed tunable wavelength laser with picosecond pulse duration have shown Gaussian focal spots sizes of 6 ± 1 µm rms over the relevant spectrum and 2 to 3 orders of magnitude increase in available intensity compared to previous measurements presented in [6]. Results from measurements on a typical pixelated silicon diode intended for use with the HDR-PAD (150 µm pixel size, 500 µm thick sensor) are presented.« less

Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer.

PubMed

McGuffin, M; Merino, T; Keller, B; Pignol, J-P

2017-03-01

Standard treatment for early breast cancer includes whole breast irradiation (WBI) after breast-conserving surgery. Recently, accelerated partial breast irradiation (APBI) has been proposed for well-selected patients. A cost and cost-effectiveness analysis was carried out comparing WBI with two APBI techniques. An activity-based costing method was used to determine the treatment cost from a societal perspective of WBI, high dose rate brachytherapy (HDR) and permanent breast seed implants (PBSI). A Markov model comparing the three techniques was developed with downstream costs, utilities and probabilities adapted from the literature. Sensitivity analyses were carried out for a wide range of variables, including treatment costs, patient costs, utilities and probability of developing recurrences. Overall, HDR was the most expensive ($14 400), followed by PBSI ($8700), with WBI proving the least expensive ($6200). The least costly method to the health care system was WBI, whereas PBSI and HDR were less costly for the patient. Under cost-effectiveness analyses, downstream costs added about $10 000 to the total societal cost of the treatment. As the outcomes are very similar between techniques, WBI dominated under cost-effectiveness analyses. WBI was found to be the most cost-effective radiotherapy technique for early breast cancer. However, both APBI techniques were less costly to the patient. Although innovation may increase costs for the health care system it can provide cost savings for the patient in addition to convenience. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Building gene co-expression networks using transcriptomics data for systems biology investigations: Comparison of methods using microarray data

PubMed Central

Kadarmideen, Haja N; Watson-haigh, Nathan S

2012-01-01

Gene co-expression networks (GCN), built using high-throughput gene expression data are fundamental aspects of systems biology. The main aims of this study were to compare two popular approaches to building and analysing GCN. We use real ovine microarray transcriptomics datasets representing four different treatments with Metyrapone, an inhibitor of cortisol biosynthesis. We conducted several microarray quality control checks before applying GCN methods to filtered datasets. Then we compared the outputs of two methods using connectivity as a criterion, as it measures how well a node (gene) is connected within a network. The two GCN construction methods used were, Weighted Gene Co-expression Network Analysis (WGCNA) and Partial Correlation and Information Theory (PCIT) methods. Nodes were ranked based on their connectivity measures in each of the four different networks created by WGCNA and PCIT and node ranks in two methods were compared to identify those nodes which are highly differentially ranked (HDR). A total of 1,017 HDR nodes were identified across one or more of four networks. We investigated HDR nodes by gene enrichment analyses in relation to their biological relevance to phenotypes. We observed that, in contrast to WGCNA method, PCIT algorithm removes many of the edges of the most highly interconnected nodes. Removal of edges of most highly connected nodes or hub genes will have consequences for downstream analyses and biological interpretations. In general, for large GCN construction (with > 20000 genes) access to large computer clusters, particularly those with larger amounts of shared memory is recommended. PMID:23144540

Advanced Shipboard Communications Demonstrations with ACTS

NASA Technical Reports Server (NTRS)

Axford, Roy A.; Jedrey, Thomas C.; Rupar, Michael A.

2000-01-01

For ships at sea. satellites provide the only option for high data rate (HDR), long haul communications. Furthermore the demand for HDR satellite communications (SATCOM) for military and commercial ships. and other offshore platforms is increasing. Presently the bulk of this maritime HDR SATCOM connectivity is provided via C-band and X-band. However, the shipboard antenna sizes required to achieve a data rate of, say T 1 (1.544 Mbps) with present C-/X-band SATCOM systems range from seven to ten feet in diameter. This limits the classes of ships to which HDR services can be provided to those which are large enough to accommodate the massive antennas. With its high powered K/Ka-band spot beams, the National Aeronautics and Space Administration's (NASA) Advanced Communications Technology Satellite (ACTS) was able to provide T I and higher rate services to ships at sea using much smaller shipboard antennas. This paper discusses three shipboard HDR SATCOM demonstrations that were conducted with ACTS between 1996 and 1998. The first demonstration involved a 2 Mbps link provided to the seismic survey ship MN Geco Diamond equipped with a 16-inch wide, 4.5-inch tall, mechanically steered slotted waveguide array antenna developed by the Jet Propulsion Laboratory. In this February 1996 demonstration ACTS allowed supercomputers ashore to process Geco Diamond's voluminous oceanographic seismic data in near real time. This capability allowed the ship to adjust its search parameters on a daily basis based on feedback from the processed data, thereby greatly increasing survey efficiency. The second demonstration was conducted on the US Navy cruiser USS Princeton (CG 59) with the same antenna used on Geco Diamond. Princeton conducted a six-month (January-July 1997) Western Hemisphere solo deployment during which time T1 connectivity via ACTS provided the ship with a range of valuable tools for operational, administrative and quality-of-life tasks. In one instance, video teleconferencing (VTC) via ACTS allowed the ship to provide life-saving emergency medical aid, assisted by specialists ashore. to a fellow mariner - the Master of a Greek cargo ship. The third demonstration set what is believed to be the all-time SATCOM data rate record to a ship at sea, 45 Mbps in October 1998. This Lake Michigan (Chicago area) demonstration employed one of ACTS' fixed beams and involved the smallest of the three vessels, the 45-foot Bayliner M/V Entropy equipped with a modified commercial-off-the-shelf one-meter antenna. A variety of multi-media services were provided to Entropy through a stressing range of sea states. These three demonstrations provided a preview of the capabilities that could be provided to future mariners on a more routine basis when K/Ka-band SATCOM systems are widely deployed.

Radiobiological evaluation of the influence of dwell time modulation restriction in HIPO optimized HDR prostate brachytherapy implants.

PubMed

Mavroidis, Panayiotis; Katsilieri, Zaira; Kefala, Vasiliki; Milickovic, Natasa; Papanikolaou, Nikos; Karabis, Andreas; Zamboglou, Nikolaos; Baltas, Dimos

2010-09-01

One of the issues that a planner is often facing in HDR brachytherapy is the selective existence of high dose volumes around some few dominating dwell positions. If there is no information available about its necessity (e.g. location of a GTV), then it is reasonable to investigate whether this can be avoided. This effect can be eliminated by limiting the free modulation of the dwell times. HIPO, an inverse treatment plan optimization algorithm, offers this option. In treatment plan optimization there are various methods that try to regularize the variation of dose non-uniformity using purely dosimetric measures. However, although these methods can help in finding a good dose distribution they do not provide any information regarding the expected treatment outcome as described by radiobiology based indices. The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO and modulation restriction (MR) has been compared to alternative plans with HIPO and free modulation (without MR). All common dose-volume indices for the prostate and the organs at risk have been considered together with radiobiological measures. The clinical effectiveness of the different dose distributions was investigated by calculating the response probabilities of the tumors and organs-at-risk (OARs) involved in these prostate cancer cases. The radiobiological models used are the Poisson and the relative seriality models. Furthermore, the complication-free tumor control probability, P + and the biologically effective uniform dose ([Formula: see text]) were used for treatment plan evaluation and comparison. Our results demonstrate that HIPO with a modulation restriction value of 0.1-0.2 delivers high quality plans which are practically equivalent to those achieved with free modulation regarding the clinically used dosimetric indices. In the comparison, many of the dosimetric and radiobiological indices showed significantly different results. The modulation restricted clinical plans demonstrated a lower total dwell time by a mean of 1.4% that was proved to be statistically significant ( p = 0.002). The HIPO with MR treatment plans produced a higher P + by 0.5%, which stemmed from a better sparing of the OARs by 1.0%. Both the dosimetric and radiobiological comparison shows that the modulation restricted optimization gives on average similar results with the optimization without modulation restriction in the examined clinical cases. Concluding, based on our results, it appears that the applied dwell time regularization technique is expected to introduce a minor improvement in the effectiveness of the optimized HDR dose distributions.

Radiobiological evaluation of the influence of dwell time modulation restriction in HIPO optimized HDR prostate brachytherapy implants

PubMed Central

Katsilieri, Zaira; Kefala, Vasiliki; Milickovic, Natasa; Papanikolaou, Nikos; Karabis, Andreas; Zamboglou, Nikolaos; Baltas, Dimos

2010-01-01

Purpose One of the issues that a planner is often facing in HDR brachytherapy is the selective existence of high dose volumes around some few dominating dwell positions. If there is no information available about its necessity (e.g. location of a GTV), then it is reasonable to investigate whether this can be avoided. This effect can be eliminated by limiting the free modulation of the dwell times. HIPO, an inverse treatment plan optimization algorithm, offers this option. In treatment plan optimization there are various methods that try to regularize the variation of dose non-uniformity using purely dosimetric measures. However, although these methods can help in finding a good dose distribution they do not provide any information regarding the expected treatment outcome as described by radiobiology based indices. Material and methods The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO and modulation restriction (MR) has been compared to alternative plans with HIPO and free modulation (without MR). All common dose-volume indices for the prostate and the organs at risk have been considered together with radiobiological measures. The clinical effectiveness of the different dose distributions was investigated by calculating the response probabilities of the tumors and organs-at-risk (OARs) involved in these prostate cancer cases. The radiobiological models used are the Poisson and the relative seriality models. Furthermore, the complication-free tumor control probability, P+ and the biologically effective uniform dose (D¯¯) were used for treatment plan evaluation and comparison. Results Our results demonstrate that HIPO with a modulation restriction value of 0.1-0.2 delivers high quality plans which are practically equivalent to those achieved with free modulation regarding the clinically used dosimetric indices. In the comparison, many of the dosimetric and radiobiological indices showed significantly different results. The modulation restricted clinical plans demonstrated a lower total dwell time by a mean of 1.4% that was proved to be statistically significant (p = 0.002). The HIPO with MR treatment plans produced a higher P+ by 0.5%, which stemmed from a better sparing of the OARs by 1.0%. Conclusions Both the dosimetric and radiobiological comparison shows that the modulation restricted optimization gives on average similar results with the optimization without modulation restriction in the examined clinical cases. Concluding, based on our results, it appears that the applied dwell time regularization technique is expected to introduce a minor improvement in the effectiveness of the optimized HDR dose distributions. PMID:27853473

Development of a TLD mailed system for remote dosimetry audit for (192)Ir HDR and PDR sources.

PubMed

Roué, Amélie; Venselaar, Jack L M; Ferreira, Ivaldo H; Bridier, André; Van Dam, Jan

2007-04-01

In the framework of an ESTRO ESQUIRE project, the BRAPHYQS Physics Network and the EQUAL-ESTRO laboratory have developed a procedure for checking the absorbed dose to water in the vicinity of HDR or PDR sources using a mailed TLD system. The methodology and the materials used in the procedure are based on the existing EQUAL-ESTRO external radiotherapy dose checks. A phantom for TLD postal dose assurance service, adapted to accept catheters from different HDR afterloaders, has been developed. The phantom consists of three PMMA tubes supporting catheters placed at 120 degrees around a central TLD holder. A study on the use of LiF powder type DTL 937 (Philitech) has been performed in order to establish the TLD calibration in dose-to-water at a given distance from (192)Ir source, as well as to determine all correction factors to convert the TLD reading into absorbed dose to water. The dosimetric audit is based on the comparison between the dose to water measured with the TL dosimeter and the dose calculated by the clinical TPS. Results of the audits are classified in four different levels depending on the ratio of the measured dose to the stated dose. The total uncertainty budget in the measurement of the absorbed dose to water using TLD near an (192)Ir HDR source, including TLD reading, correction factors and TLD calibration coefficient, is determined as 3.27% (1s). To validate the procedures, the external audit was first tested among the members of the BRAPHYQS Network. Since November 2004, the test has been made available for use by all European brachytherapy centres. To date, 11 centres have participated in the checks and the results obtained are very encouraging. Nevertheless, one error detected has shown the usefulness of this audit. A method of absorbed dose to water determination in the vicinity of an (192)Ir brachytherapy source was developed for the purpose of a mailed TL dosimetry system. The accuracy of the procedure was determined. This method allows a check of the whole dosimetry chain for this type of brachytherapy afterloading system and can easily be performed by mail to any institution in the European area and elsewhere. Such an external audit can be an efficient QC method complementary to internal quality control as it can reveal some errors which are not observable by other means.

High dose rate 192Ir source calibration: A single institution experience

NASA Astrophysics Data System (ADS)

Abdullah, R.; Abdullah, N. H.; Mohamed, M.; Idris, N. R. N.; Yusoff, A. L.; Chen, S. C.; Zakaria, A.

2017-05-01

Measurement of source strength of new high dose rate (HDR) 192Ir supplied by the manufacturer is part of quality assurance recommended by Radiation Safety Section, Ministry of Health of Malaysia. The source strength is determined in reference air kerma rate (RAKR). The purpose of this study was to evaluate RAKR measurement of 192Ir using well-type ionisation chamber with RAKR stated in the certificate provided by the manufacturer. A retrospective study on 19 MicroSelectron HDR 192Ir Classic from 2001 to 2009 and 12 MicroSelectron HDR 192Ir V2 sources from 2009 to 2016 supplied by manufacturer were compared. From the study, the agreement between measured RAKR and RAKR stated in the certificate by manufacturer for all 32 sources supplied were within ±2.5%. As a conclusion, a threshold level of ±2.5% can be used as suitable indicator to spot problems of the brachytherapy system in Department of Nuclear Medicine Radiotherapy and Oncology, Hospital USM.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shanks, Katherine S.; Philipp, Hugh T.; Weiss, Joel T.

Experiments at storage ring light sources as well as at next-generation light sources increasingly require detectors capable of high dynamic range operation, combining low-noise detection of single photons with large pixel well depth. XFEL sources in particular provide pulse intensities sufficiently high that a purely photon-counting approach is impractical. The High Dynamic Range Pixel Array Detector (HDR-PAD) project aims to provide a dynamic range extending from single-photon sensitivity to 10{sup 6} photons/pixel in a single XFEL pulse while maintaining the ability to tolerate a sustained flux of 10{sup 11} ph/s/pixel at a storage ring source. Achieving these goals involves themore » development of fast pixel front-end electronics as well as, in the XFEL case, leveraging the delayed charge collection due to plasma effects in the sensor. A first prototype of essential electronic components of the HDR-PAD readout ASIC, exploring different options for the pixel front-end, has been fabricated. Here, the HDR-PAD concept and preliminary design will be described.« less

[Developments in brachytherapy].

PubMed

Ikeda, H

1995-09-01

Brachytherapy is one of the ideal methods of radiotherapy because of the concentration of a high dose on the target. Recent developments, including induction of afterloading method, utilization of small-sized high-activity sources such as Iridium-192, and induction of high technology and computerization, have made for shortening of irradiation time and source handling, which has led to easier management of the patient during treatment. Dose distribution at high dose rate (HDR) is at least as good as that of low dose rate (LDR), and selection of fractionation and treatment time assures even greater biological effects on hypoxic tumor cells than LDR. Experience with HDR brachytherapy in uterine cervix cancer using Cobalt-60 during the past 20 years in this country has gradually been evaluated in U.S. and Europe. The indications for HDR treatment have extended to esophagus, bronchus, bile duct, brain, intraoperative placement of source guide, and perineal region using templates, as well as the conventional use for uterus, tongue and so on.

Telomere Length Determines TERRA and R-Loop Regulation through the Cell Cycle.

PubMed

Graf, Marco; Bonetti, Diego; Lockhart, Arianna; Serhal, Kamar; Kellner, Vanessa; Maicher, André; Jolivet, Pascale; Teixeira, Maria Teresa; Luke, Brian

2017-06-29

Maintenance of a minimal telomere length is essential to prevent cellular senescence. When critically short telomeres arise in the absence of telomerase, they can be repaired by homology-directed repair (HDR) to prevent premature senescence onset. It is unclear why specifically the shortest telomeres are targeted for HDR. We demonstrate that the non-coding RNA TERRA accumulates as HDR-promoting RNA-DNA hybrids (R-loops) preferentially at very short telomeres. The increased level of TERRA and R-loops, exclusively at short telomeres, is due to a local defect in RNA degradation by the Rat1 and RNase H2 nucleases, respectively. Consequently, the coordination of TERRA degradation with telomere replication is altered at shortened telomeres. R-loop persistence at short telomeres contributes to activation of the DNA damage response (DDR) and promotes recruitment of the Rad51 recombinase. Thus, the telomere length-dependent regulation of TERRA and TERRA R-loops is a critical determinant of the rate of replicative senescence. Copyright © 2017 Elsevier Inc. All rights reserved.

A novel adaptive needle insertion sequencing for robotic, single needle MR-guided high-dose-rate prostate brachytherapy

NASA Astrophysics Data System (ADS)

Borot de Battisti, M.; de Senneville, B. Denis; Hautvast, G.; Binnekamp, D.; Lagendijk, J. J. W.; Maenhout, M.; Moerland, M. A.

2017-05-01

MR-guided high-dose-rate (HDR) brachytherapy has gained increasing interest as a treatment for patients with localized prostate cancer because of the superior value of MRI for tumor and surrounding tissues localization. To enable needle insertion into the prostate with the patient in the MR bore, a single needle MR-compatible robotic system involving needle-by-needle dose delivery has been developed at our institution. Throughout the intervention, dose delivery may be impaired by: (1) sub-optimal needle positioning caused by e.g. needle bending, (2) intra-operative internal organ motion such as prostate rotations or swelling, or intra-procedural rectum or bladder filling. This may result in failure to reach clinical constraints. To assess the first aforementioned challenge, a recent study from our research group demonstrated that the deposited dose may be greatly improved by real-time adaptive planning with feedback on the actual needle positioning. However, the needle insertion sequence is left to the doctor and therefore, this may result in sub-optimal dose delivery. In this manuscript, a new method is proposed to determine and update automatically the needle insertion sequence. This strategy is based on the determination of the most sensitive needle track. The sensitivity of a needle track is defined as its impact on the dose distribution in case of sub-optimal positioning. A stochastic criterion is thus presented to determine each needle track sensitivity based on needle insertion simulations. To assess the proposed sequencing strategy, HDR prostate brachytherapy was simulated on 11 patients with varying number of needle insertions. Sub-optimal needle positioning was simulated at each insertion (modeled by typical random angulation errors). In 91% of the scenarios, the dose distribution improved when the needle was inserted into the most compared to the least sensitive needle track. The computation time for sequencing was less than 6 s per needle track. The proposed needle insertion sequencing can therefore assist in delivering an optimal dose in HDR prostate brachytherapy.

Long-term outcomes of high-dose-rate brachytherapy for intermediate- and high-risk prostate cancer with a median follow-up of 10 years.

PubMed

Yaxley, John W; Lah, Kevin; Yaxley, Julian P; Gardiner, Robert A; Samaratunga, Hema; MacKean, James

2017-07-01

To evaluate the long-term outcomes of high-dose-rate (HDR) brachytherapy for patients with intermediate- and high-risk prostate cancer. We retrospectively analysed a prospective longitudinal cohort database including a single-surgeon series of 507 consecutive men treated with external beam radiotherapy and an HDR prostate brachytherapy boost between August 2000 and December 2009. The risk factors used were based on the D'Amico classification. We measured the incidence of no biochemical evidence of disease (bNED) based on the Phoenix definition of failure (nadir PSA + 2 ng/mL). We also reviewed the incidence of urethral stricture in this cohort. With minimum and median follow-ups of 6 and 10.3 years, respectively, the bNED rates for men with intermediate- and high risk disease were 93.3% and 74.2%, respectively, at 5 years and 86.9% and 56.1%, respectively, at 10 years. The 10-year bNED rate for men with only one intermediate-risk factor was 94%, whereas for patients with all three high-risk factors it was 39.5%. The overall urethral stricture rate was 13.6%. Before 2005, the urethral stricture rate was 28.9% and after January 2005 it was 4.2%. For the 271 men with a minimum follow-up of 10 years the actuarial 10-year prostate cancer-specific survival rate was 90.8% and the actuarial overall survival rate was 86.7%. For men with intermediate- or high-risk prostate cancer features, who are considered not suitable for, or wish to avoid a radical prostatectomy, HDR prostate brachytherapy remains an appropriate treatment option. From December 2004, prevention strategies decreased the risk of post-brachytherapy urethral strictures. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Impact of a commercially available model-based dose calculation algorithm on treatment planning of high-dose-rate brachytherapy in patients with cervical cancer.

PubMed

Abe, Kota; Kadoya, Noriyuki; Sato, Shinya; Hashimoto, Shimpei; Nakajima, Yujiro; Miyasaka, Yuya; Ito, Kengo; Umezawa, Rei; Yamamoto, Takaya; Takahashi, Noriyoshi; Takeda, Ken; Jingu, Keiichi

2018-03-01

We evaluated the impact of model-based dose calculation algorithms (MBDCAs) on high-dose-rate brachytherapy (HDR-BT) treatment planning for patients with cervical cancer. Seven patients with cervical cancer treated using HDR-BT were studied. Tandem and ovoid applicators were used in four patients, a vaginal cylinder in one, and interstitial needles in the remaining two patients. MBDCAs were applied to the Advanced Collapsed cone Engine (ACE; Elekta, Stockholm, Sweden). All plans, which were originally calculated using TG-43, were re-calculated using both ACE and Monte Carlo (MC) simulations. Air was used as the rectal material. The mean difference in the rectum D2cm3 between ACErec-air and MCrec-air was 8.60 ± 4.64%, whereas that in the bladder D2cm3 was -2.80 ± 1.21%. Conversely, in the small group analysis (n = 4) using water instead of air as the rectal material, the mean difference in the rectum D2cm3 between TG-43 and ACErec-air was 11.87 ± 2.65%, whereas that between TG-43 and ACErec-water was 0.81 ± 2.04%, indicating that the use of water as the rectal material reduced the difference in D2cm3 between TG-43 and ACE. Our results suggested that the differences in the dose-volume histogram (DVH) parameters of TG-43 and ACE were large for the rectum when considerable air (gas) volume was present in it, and that this difference was reduced when the air (gas) volume was reduced. Also, ACE exhibited better dose calculation accuracy than that of TG-43 in this situation. Thus, ACE may be able to calculate the dose more accurately than TG-43 for HDR-BT in treating cervical cancers, particularly for patients with considerable air (gas) volume in the rectum.

Impact of a commercially available model-based dose calculation algorithm on treatment planning of high-dose-rate brachytherapy in patients with cervical cancer

PubMed Central

Abe, Kota; Kadoya, Noriyuki; Sato, Shinya; Hashimoto, Shimpei; Nakajima, Yujiro; Miyasaka, Yuya; Ito, Kengo; Umezawa, Rei; Yamamoto, Takaya; Takahashi, Noriyoshi; Takeda, Ken; Jingu, Keiichi

2018-01-01

Abstract We evaluated the impact of model-based dose calculation algorithms (MBDCAs) on high-dose-rate brachytherapy (HDR-BT) treatment planning for patients with cervical cancer. Seven patients with cervical cancer treated using HDR-BT were studied. Tandem and ovoid applicators were used in four patients, a vaginal cylinder in one, and interstitial needles in the remaining two patients. MBDCAs were applied to the Advanced Collapsed cone Engine (ACE; Elekta, Stockholm, Sweden). All plans, which were originally calculated using TG-43, were re-calculated using both ACE and Monte Carlo (MC) simulations. Air was used as the rectal material. The mean difference in the rectum D2cm3 between ACErec-air and MCrec-air was 8.60 ± 4.64%, whereas that in the bladder D2cm3 was −2.80 ± 1.21%. Conversely, in the small group analysis (n = 4) using water instead of air as the rectal material, the mean difference in the rectum D2cm3 between TG-43 and ACErec-air was 11.87 ± 2.65%, whereas that between TG-43 and ACErec-water was 0.81 ± 2.04%, indicating that the use of water as the rectal material reduced the difference in D2cm3 between TG-43 and ACE. Our results suggested that the differences in the dose–volume histogram (DVH) parameters of TG-43 and ACE were large for the rectum when considerable air (gas) volume was present in it, and that this difference was reduced when the air (gas) volume was reduced. Also, ACE exhibited better dose calculation accuracy than that of TG-43 in this situation. Thus, ACE may be able to calculate the dose more accurately than TG-43 for HDR-BT in treating cervical cancers, particularly for patients with considerable air (gas) volume in the rectum. PMID:29378024

Is there a place for brachytherapy in the salvage treatment of cervical lymph node metastases of head and neck cancers?

PubMed

Bartochowska, Anna; Skowronek, Janusz; Wierzbicka, Malgorzata; Leszczynska, Malgorzata; Szyfter, Witold

2015-01-01

Therapeutic options are limited for unresectable isolated cervical lymph node recurrences. The purpose of the study was to evaluate the feasibility, safety, and efficacy of high-dose-rate (HDR) and pulsed-dose-rate (PDR) brachytherapy (BT) in such cases. Sixty patients have been analyzed. All them had previously been treated with radical radiotherapy or chemoradiotherapy with or without surgery. PDR-BT and HDR-BT were used in 49 and 11 patients, respectively. In PDR-BT, a dose per pulse of 0.6-0.8 Gy (median 0.7 Gy) was given up to a median total dose of 20 Gy (range, 20-40 Gy). HDR-BT delivered a median total dose of 24 Gy (range, 7-60 Gy) in 3-10 fractions at 3-6 Gy per fraction. The overall survival and lymph node control rates at 1 and 2 years were estimated for 31.7% and 19%, and 41.4% and 27.3%, respectively. Serious late side effects (soft tissue necrosis) were observed in 11.7% of patients. Adverse events occurred statistically more often in patients >59 years (p = 0.02). HDR-BT and PDR-BT are feasible in previously irradiated patients with isolated regional lymph node metastases of head and neck cancers. The techniques should be considered if surgery is contraindicated. They provide acceptable toxicity and better tumor control than chemotherapy alone. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Hypofractionated accelerated CT-guided interstitial ¹⁹²Ir-HDR-Brachytherapy as re-irradiation in inoperable recurrent cervical lymphadenopathy from head and neck cancer.

PubMed

Tselis, Nikolaos; Ratka, Markus; Vogt, Hans-Georg; Kolotas, Christos; Baghi, Mehran; Baltas, Dimos; Fountzilas, George; Georgoulias, Vassilios; Ackermann, Hanns; Zamboglou, Nikolaos

2011-01-01

Despite significant improvements in the treatment of head and neck cancer (HNC), lymph node recurrences remain a clinical challenge after primary radiotherapy. The value of interstitial (IRT) brachytherapy (BRT) for control of lymph node recurrence remains unclear. In order to clarify its role a retrospective review was undertaken on the value of computed tomography (CT)-guided IRT high-dose-rate (HDR)-BRT in isolated recurrent disease from HNC. From 2000 to 2007, 74 patients were treated for inoperable recurrent cervical lymphadenopathy. All patients had previously been treated with radical radiotherapy or chemoradiation with or without surgery. The HDR-BRT delivered a median salvage dose of 30.0 Gy (range, 12.0-36.0 Gy) in twice-daily fractions of 2.0-5.0 Gy in 71 patients and of 30.0 Gy (range, 10.0-36.0 Gy) in once-daily fractions of 6.0-10.0 Gy in three patients. The overall and disease-free survival rates at one, two and three years were 42%, 19%, 6%, and 42%, 37% and 19%, respectively. The local control probability at one, two and three years was 67% at all three time points. Grade III-IV complications occurred in 13% of patients. In patients with inoperable recurrent neck disease from HNC, hypofractionated accelerated CT-guided IRT-HDR-BRT can play an important role in providing palliation and tumor control. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Response of a rice paddy soil methanogen to syntrophic growth as revealed by transcriptional analyses.

PubMed

Liu, Pengfei; Yang, Yanxiang; Lü, Zhe; Lu, Yahai

2014-08-01

Members of Methanocellales are widespread in paddy field soils and play the key role in methane production. These methanogens feature largely in these organisms’ adaptation to low H2 and syntrophic growth with anaerobic fatty acid oxidizers. The adaptive mechanisms, however, remain unknown. In the present study, we determined the transcripts of 21 genes involved in the key steps of methanogenesis and acetate assimilation of Methanocella conradii HZ254, a strain recently isolated from paddy field soil. M. conradii was grown in monoculture and syntrophically with Pelotomaculum thermopropionicum (a propionate syntroph) or Syntrophothermus lipocalidus (a butyrate syntroph). Comparison of the relative transcript abundances showed that three hydrogenase-encoding genes and all methanogenesis-related genes tested were upregulated in cocultures relative to monoculture. The genes encoding formylmethanofuran dehydrogenase (Fwd), heterodisulfide reductase (Hdr), and the membrane-bound energy-converting hydrogenase (Ech) were the most upregulated among the evaluated genes. The expression of the formate dehydrogenase (Fdh)-encoding gene also was significantly upregulated. In contrast, an acetate assimilation gene was downregulated in cocultures. The genes coding for Fwd, Hdr, and the D subunit of F420-nonreducing hydrogenase (Mvh) form a large predicted transcription unit; therefore, the Mvh/Hdr/Fwd complex, capable of mediating the electron bifurcation and connecting the first and last steps of methanogenesis, was predicted to be formed in M. conradii. We propose that Methanocella methanogens cope with low H2 and syntrophic growth by (i) stabilizing the Mvh/Hdr/Fwd complex and (ii) activating formatedependent methanogenesis.

Creating a monomeric endonuclease TALE-I-SceI with high specificity and low genotoxicity in human cells.

PubMed

Lin, Jianfei; Chen, He; Luo, Ling; Lai, Yongrong; Xie, Wei; Kee, Kehkooi

2015-01-01

To correct a DNA mutation in the human genome for gene therapy, homology-directed repair (HDR) needs to be specific and have the lowest off-target effects to protect the human genome from deleterious mutations. Zinc finger nucleases, transcription activator-like effector nuclease (TALEN) and CRISPR-CAS9 systems have been engineered and used extensively to recognize and modify specific DNA sequences. Although TALEN and CRISPR/CAS9 could induce high levels of HDR in human cells, their genotoxicity was significantly higher. Here, we report the creation of a monomeric endonuclease that can recognize at least 33 bp by fusing the DNA-recognizing domain of TALEN (TALE) to a re-engineered homing endonuclease I-SceI. After sequentially re-engineering I-SceI to recognize 18 bp of the human β-globin sequence, the re-engineered I-SceI induced HDR in human cells. When the re-engineered I-SceI was fused to TALE (TALE-ISVB2), the chimeric endonuclease induced the same HDR rate at the human β-globin gene locus as that induced by TALEN, but significantly reduced genotoxicity. We further demonstrated that TALE-ISVB2 specifically targeted at the β-globin sequence in human hematopoietic stem cells. Therefore, this monomeric endonuclease has the potential to be used in therapeutic gene targeting in human cells. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

Oncentra brachytherapy planning system.

PubMed

Yang, Jack

2018-03-27

In modern cancer management, treatment planning has progressed as a contemporary tool with all the advances in computing power in recent years. One of the advanced planning tools uses 3-dimensional (3D) data sets for accurate dose distributions in patient prescription. Among these planning processes, brachytherapy has been a very important part of a successful cancer management program, offering clinical benefits with specific or combined treatments with external beam therapy. In this chapter, we mainly discussed the Elekta Oncentra planning system, which is the main treatment planning tool for high-dose rate (HDR) modality in our facility and in many other facilities in the United States. HDR is a technically advanced form of brachytherapy; a high-intensity radiation source (3.6 mm in length) is delivered with step motor in submillimeter precision under computer guidance directly into the tumor areas while minimizing injury to surrounding normal healthy tissue. Oncentra planning is the key component to generate a deliverable brachytherapy procedure, which is executed on the microSelectron V3 remote afterloader treatment system. Creating a highly conformal plan can be a time-consuming task. The development of Oncentra software (version 4.5.3) offers a variety of useful tools that facilitate many of the clinical challenging tasks for planning, such as contouring and image reconstruction, as well as rapid planning calculations with dose and dose volume histogram analysis. Oncentra Brachy module creates workflow and optimizes the planning accuracy for wide varieties of clinical HDR treatments, such as skin, gynecologic (GYN), breast, prostate, and many other applications. The treatment file can also be transferred to the afterloader control station for speedy delivery. The design concept, calculation algorithms, and optimization modules presented some key characteristics to plan and treat the patients effectively and accurately. The dose distribution and accuracy of several clinical sample cases were discussed to illustrate the effectiveness and clinical efficacy. The American Association of Physicists in Medicine brachytherapy reports of TG-43 and TG-186 were also described and compared in evaluations of fundamental calculation methodologies. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

On the experimental validation of model-based dose calculation algorithms for 192Ir HDR brachytherapy treatment planning

NASA Astrophysics Data System (ADS)

Pappas, Eleftherios P.; Zoros, Emmanouil; Moutsatsos, Argyris; Peppa, Vasiliki; Zourari, Kyveli; Karaiskos, Pantelis; Papagiannis, Panagiotis

2017-05-01

There is an acknowledged need for the design and implementation of physical phantoms appropriate for the experimental validation of model-based dose calculation algorithms (MBDCA) introduced recently in 192Ir brachytherapy treatment planning systems (TPS), and this work investigates whether it can be met. A PMMA phantom was prepared to accommodate material inhomogeneities (air and Teflon), four plastic brachytherapy catheters, as well as 84 LiF TLD dosimeters (MTS-100M 1  ×  1  ×  1 mm3 microcubes), two radiochromic films (Gafchromic EBT3) and a plastic 3D dosimeter (PRESAGE). An irradiation plan consisting of 53 source dwell positions was prepared on phantom CT images using a commercially available TPS and taking into account the calibration dose range of each detector. Irradiation was performed using an 192Ir high dose rate (HDR) source. Dose to medium in medium, Dmm , was calculated using the MBDCA option of the same TPS as well as Monte Carlo (MC) simulation with the MCNP code and a benchmarked methodology. Measured and calculated dose distributions were spatially registered and compared. The total standard (k  =  1) spatial uncertainties for TLD, film and PRESAGE were: 0.71, 1.58 and 2.55 mm. Corresponding percentage total dosimetric uncertainties were: 5.4-6.4, 2.5-6.4 and 4.85, owing mainly to the absorbed dose sensitivity correction and the relative energy dependence correction (position dependent) for TLD, the film sensitivity calibration (dose dependent) and the dependencies of PRESAGE sensitivity. Results imply a LiF over-response due to a relative intrinsic energy dependence between 192Ir and megavoltage calibration energies, and a dose rate dependence of PRESAGE sensitivity at low dose rates (<1 Gy min-1). Calculations were experimentally validated within uncertainties except for MBDCA results for points in the phantom periphery and dose levels  <20%. Experimental MBDCA validation is laborious, yet feasible. Further work is required for the full characterization of dosimeter response for 192Ir and the reduction of experimental uncertainties.

Validation of the Five-Phase Method for Simulating Complex Fenestration Systems with Radiance against Field Measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geisler-Moroder, David; Lee, Eleanor S.; Ward, Gregory J.

2016-08-29

The Five-Phase Method (5-pm) for simulating complex fenestration systems with Radiance is validated against field measurements. The capability of the method to predict workplane illuminances, vertical sensor illuminances, and glare indices derived from captured and rendered high dynamic range (HDR) images is investigated. To be able to accurately represent the direct sun part of the daylight not only in sensor point simulations, but also in renderings of interior scenes, the 5-pm calculation procedure was extended. The validation shows that the 5-pm is superior to the Three-Phase Method for predicting horizontal and vertical illuminance sensor values as well as glare indicesmore » derived from rendered images. Even with input data from global and diffuse horizontal irradiance measurements only, daylight glare probability (DGP) values can be predicted within 10% error of measured values for most situations.« less

Bringing Fenton Hill into the Digital Age: Data Conversion in Support of the Geothermal Technologies Office Code Comparison Study Challenge Problems

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, Signe K.; Kelkar, Sharad M.; Brown, Don W.

The Geothermal Technologies Office Code Comparison Study (GTO-CCS) was established by the U.S. Department of Energy to facilitate collaboration among members of the geothermal modeling community and to evaluate and improve upon the ability of existing codes to simulate thermal, hydrological, mechanical, and chemical processes associated with complex enhanced geothermal systems (EGS). The first stage of the project, which has been completed, involved comparing simulations for seven benchmark problems that were primarily designed using well-prescribed, simplified data sets. In the second stage, the participating teams are tackling two challenge problems based on the EGS research conducted in hot dry rockmore » (HDR) at Fenton Hill, near Los Alamos, New Mexico. The Fenton Hill project, conducted by Los Alamos National Laboratory (LANL) from 1970 to 1995, was the world’s first HDR demonstration project. One of the criteria for selecting this experiment as the basis for the challenge problems was the amount and availability of data for generating model inputs. The Fenton Hill HDR system consisted of two reservoirs – an earlier Phase I reservoir tested from 1974 to 1981 and a deeper Phase II reservoir tested from 1980 to 1995. Detailed accounts of both phases of the HDR project have been presented in a number of books and reports, including a recently published summary of the lessons learned and a final report with a chronological description of the Fenton Hill project, prepared by LANL. Project documents and records have been archived and made public through the National Geothermal Data System (NGDS). Some of the data acquired from Phase II are available in electronic format readable on modern computers. These include the microseismic data from some of the important experiments (e.g. the massive hydraulic fracturing test conducted in 1983) and the injection/production wellhead data from the circulation tests conducted between 1992-1995. However, much of the data collected during the project, while publicly available, currently only exist in the form of tables or graphs within scanned documents. Therefore, in support of the GTO-CCS, the data needed for developing simulation inputs are being compiled and converted to platform independent, open readable formats so that all participating teams will have access to the same electronic data set. In some cases this requires conversion using optical character recognition, digitizing existing images, and generating the appropriate metadata from project documents. The GTO-Velo knowledge management framework, developed by Pacific Northwest National Laboratory (PNNL), was used for the benchmark problem stage of the comparison study and will also be used as the data repository for the challenge problem data sets. It is staggering and impractical to convert all published data for the Fenton Hill site, so the focus is on data that supports simulations for the three topical areas defined by the study for the challenge problems: 1) reservoir creation/stimulation, 2) reactive and passive transport, and 3) thermal recovery. Conversion of these data provide value not only to GTO-CCS participants, but also to members of the geothermal community at large who may be interested in revisiting the Fenton Hill experiment in the future.« less

The Automated Self-Administered 24-Hour Dietary Recall for Children, 2012 version, for youth aged 9 to 11 Years: A validation study

USDA-ARS?s Scientific Manuscript database

Our objective was to validate the 2012 version of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids-2012), a self-administered web-based 24-hour dietary recall (24hDR) instrument, among children aged 9 to 11 years, in two sites using a quasiexperimental design. In one s...

SU-E-T-10: A Clinical Implementation and the Dosimetric Evidence in High Dose Rate Vaginal Multichannel Applicator Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Syh, J; Syh, J; Patel, B

2015-06-15

Purpose: The multichannel cylindrical applicator has a distinctive modification of the traditional single channel cylindrical applicator. The novel multichannel applicator has additional peripheral channels that provide more flexibility both in treatment planning process and outcomes. To protect by reducing doses to adjacent organ at risk (OAR) while maintaining target coverage with inverse plan optimization are the goals for such novel Brachytherapy device. Through a series of comparison and analysis of reults in more than forty patients who received HDR Brachytherapy using multichannel vaginal applicator, this procedure has been implemented in our institution. Methods: Multichannel planning was CT image based. Themore » CTV of 5mm vaginal cuff rind with prescribed length was well reconstructed as well as bladder and rectum. At least D95 of CTV coverage is 95% of prescribed dose. Multichannel inverse plan optimization algorithm not only shapes target dose cloud but set dose avoids to OAR’s exclusively. The doses of D2cc, D5cc and D5; volume of V2Gy in OAR’s were selected to compare with single channel results when sole central channel is only possibility. Results: Study demonstrates plan superiorly in OAR’s doe reduction in multi-channel plan. The D2cc of the rectum and bladder were showing a little lower for multichannel vs. single channel. The V2Gy of the rectum was 93.72% vs. 83.79% (p=0.007) for single channel vs. multichannel respectively. Absolute reduced mean dose of D5 by multichannel was 17 cGy (s.d.=6.4) and 44 cGy (s.d.=15.2) in bladder and rectum respectively. Conclusion: The optimization solution in multichannel was to maintain D95 CTV coverage while reducing the dose to OAR’s. Dosimetric advantage in sparing critical organs by using a multichannel applicator in HDR Brachytherapy treatment of the vaginal cuff is so promising and has been implemented clinically.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Safigholi, H; Soliman, A; Song, W

Purpose: To evaluate various shielding materials such as Gold (Au), Osmium (Os), Tantalum (Ta), and Tungsten (W) based alloys for use with a novel intensity modulation capable direction modulated brachytherapy (DMBT) tandem applicator for image guided cervical cancer HDR brachytherapy. Methods: The novel MRI-compatible DMBT tandem, made from nonmagnetic tungsten-alloy rod with diameter of 5.4 mm, has 6 symmetric peripheral holes of 1.3 mm diameter with 2.05 mm distance from the center for a high degree intensity modulation capacity. The 0.3 mm thickness of bio-compatible plastic tubing wraps the tandem. MCNPX was used for Monte Carlo simulations of the shieldsmore » and the mHDR Ir-192 V2 source. MC-generated 3D dose matrices of different shielding materials of Au, Os, Ta, and W with 1 mm3 resolution were imported into an in-house-coded inverse optimization planning system to evaluate 19 clinical patient plans. Prescription dose was 15Gy. All plans were normalized to receive the same HRCTV D90. Results: In general, the plan qualities for various shielding materials were similar. The OAR D2cc for bladder was very similar for Au, Os, and Ta with 11.64±2.30Gy. For W, it was very close 11.65±2.30Gy. The sigmoid D2cc was 9.82±2.46Gy for Au and Os while it was 9.84±2.48Gy for Ta and W. The rectum D2cc was 7.44±3.06Gy for Au, 7.43±3.07Gy for Os, 7.48±3.05Gy for Ta, and 7.47±3.05Gy for W. The HRCTV D98 and V100 were very close with 16.37±1.87 Gy and 97.37±1.93 Gy, on average, respectively. Conclusion: Various MRI-compatible shielding alloys were investigated for the DMBT tandem applicator. The clinical plan qualities were not significantly different among these various alloys, however. Therefore, the candidate metals (or in combination) can be used to select best alloys for MRI image guided cervical cancer brachytherapy using the novel DMBT applicator that is capable of unprecedented level of intensity modulation.« less

TH-AB-BRA-04: Dosimetric Evaluation of MR-Guided HDR Brachytherapy Planning for Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamio, Y; Barkati, M; Beliveau-Nadeau, D

2016-06-15

Purpose: To perform a retrospective study on 16 patients that had both CT and T2-weighted MR scans done at first fraction using the Utrecht CT/MR applicator (Elekta Brachytherapy) in order to evaluate uncertainties associated with an MR-only planning workflow. Methods: MR-workflow uncertainties were classified in three categories: reconstruction, registration and contouring. A systematic comparison of the CT and MR contouring, manual reconstruction and optimization process was performed to evaluate the impact of these uncertainties on the recommended GEC ESTRO DVH parameters: D90% and V100% for HR-CTV as well as D2cc for bladder, rectum, sigmoid colon and small bowel. This comparisonmore » was done using the following four steps: 1. Catheter reconstruction done on MR images with original CT-plan contours and dwell times. 2. OAR contours adjusted on MR images with original CT-plan reconstruction and dwell times. 3. Both reconstruction and contours done on MR images with original CT-plan dwell times. 4. Entire MR-based workflow optimized dwell times reimported to the original CT-plan. Results: The MR-based reconstruction process showed average D2cc deviations of 4.5 ± 3.0%, 1.5 ± 2.0%, 2.5 ± 2.0% and 2.0 ± 1.0% for the bladder, rectum, sigmoid colon and small bowels respectively with a maximum of 10%, 6%, 6% and 4%. The HR-CTV’s D90% and V100% average deviations was found to be 4.0 ± 3.0%, and 2.0 ± 2.0% respectively with a maximum of 10% and 6%. Adjusting contours on MR-images was found to have a similar impact. Finally, the optimized MR-based workflow dwell times were found to still give acceptable plans when re-imported to the original CT-plan which validated the entire workflow. Conclusion: This work illustrates a systematic validation method for centers wanting to move towards an MR-only workflow. This work will be expanded to model based reconstruction, PD-weighted images and other types of applicators.« less

High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution and Mature Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zamboglou, Nikolaos; Tselis, Nikolaos, E-mail: ntselis@hotmail.com; Baltas, Dimos

2013-03-01

Purpose: To report the clinical outcome of high-dose-rate (HDR) interstitial (IRT) brachytherapy (BRT) as sole treatment (monotherapy) for clinically localized prostate cancer. Methods and Materials: Between January 2002 and December 2009, 718 consecutive patients with clinically localized prostate cancer were treated with transrectal ultrasound (TRUS)-guided HDR monotherapy. Three treatment protocols were applied; 141 patients received 38.0 Gy using one implant in 4 fractions of 9.5 Gy with computed tomography-based treatment planning; 351 patients received 38.0 Gy in 4 fractions of 9.5 Gy, using 2 implants (2 weeks apart) and intraoperative TRUS real-time treatment planning; and 226 patients received 34.5 Gy,more » using 3 single-fraction implants of 11.5 Gy (3 weeks apart) and intraoperative TRUS real-time treatment planning. Biochemical failure was defined according to the Phoenix consensus, and toxicity was evaluated using Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 52.8 months. The 36-, 60-, and 96-month biochemical control and metastasis-free survival rates for the entire cohort were 97%, 94%, and 90% and 99%, 98%, and 97%, respectively. Toxicity was scored per event, with 5.4% acute grade 3 genitourinary and 0.2% acute grade 3 gastrointestinal toxicity. Late grade 3 genitourinary and gastrointestinal toxicities were 3.5% and 1.6%, respectively. Two patients developed grade 4 incontinence. No other instance of grade 4 or greater acute or late toxicity was reported. Conclusion: Our results confirm IRT-HDR-BRT is safe and effective as monotherapy for clinically localized prostate cancer.« less

Comparison of different treatment planning optimization methods for vaginal HDR brachytherapy with multichannel applicators: A reduction of the high doses to the vaginal mucosa is possible.

PubMed

Carrara, Mauro; Cusumano, Davide; Giandini, Tommaso; Tenconi, Chiara; Mazzarella, Ester; Grisotto, Simone; Massari, Eleonora; Mazzeo, Davide; Cerrotta, Annamaria; Pappalardi, Brigida; Fallai, Carlo; Pignoli, Emanuele

2017-12-01

A direct planning approach with multi-channel vaginal cylinders (MVCs) used for HDR brachytherapy of vaginal cancers is particularly challenging. Purpose of this study was to compare the dosimetric performances of different forward and inverse methods used for the optimization of MVC-based vaginal treatments for endometrial cancer, with a particular attention to the definition of strategies useful to limit the high doses to the vaginal mucosa. Twelve postoperative vaginal HDR brachytherapy treatments performed with MVCs were considered. Plans were retrospectively optimized with three different methods: Dose Point Optimization followed by Graphical Optimization (DPO + GrO), Inverse Planning Simulated Annealing with two different class solutions as starting conditions (surflPSA and homogIPSA) and Hybrid Inverse Planning Optimization (HIPO). Several dosimetric parameters related to target coverage, hot spot extensions and sparing of organs at risk were analyzed to evaluate the quality of the achieved treatment plans. Dose homogeneity index (DHI), conformal index (COIN) and a further parameter quantifying the proportion of the central catheter loading with respect to the overall loading (i.e., the central catheter loading index: CCLI) were also quantified. The achieved PTV coverage parameters were highly correlated with each other but uncorrelated with the hot spot quantifiers. HomogIPSA and HIPO achieved higher DHIs and CCLIs and lower volumes of high doses than DPO + GrO and surflPSA. Within the investigated optimization methods, HIPO and homoglPSA showed the highest dose homogeneity to the target. In particular, homogIPSA resulted also the most effective in reducing hot spots to the vaginal mucosa. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Towards the Experimental Assessment of the DQE in SPECT Scanners

NASA Astrophysics Data System (ADS)

Fountos, G. P.; Michail, C. M.

2017-11-01

The purpose of this work was to introduce the Detective Quantum Efficiency (DQE) in single photon emission computed tomography (SPECT) systems using a flood source. A Tc-99m-based flood source (Eγ = 140 keV) consisting of a radiopharmaceutical solution of dithiothreitol (DTT, 10-3 M)/Tc-99m(III)-DMSA, 40 mCi/40 ml bound to the grains of an Agfa MammoRay HDR Medical X-ray film) was prepared in laboratory. The source was placed between two PMMA blocks and images were obtained by using the brain tomographic acquisition protocol (DatScan-brain). The Modulation Transfer Function (MTF) was evaluated using the Iterative 2D algorithm. All imaging experiments were performed in a Siemens e-Cam gamma camera. The Normalized Noise Power spectra (NNPS) were obtained from the sagittal views of the source. The higher MTF values were obtained for the Flash Iterative 2D with 24 iterations and 20 subsets. The noise levels of the SPECT reconstructed images, in terms of the NNPS, were found to increase as the number of iterations increase. The behavior of the DQE was influenced by both MTF and NNPS. As the number of iterations was increased, higher MTF values were obtained, however with a parallel, increase of magnitude in image noise, as depicted from the NNPS results. DQE values, which were influenced by both MTF and NNPS, were found higher when the number of iterations results in resolution saturation. The method presented here is novel and easy to implement, requiring materials commonly found in clinical practice and can be useful in the quality control of SPECT scanners.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, S; Ellis, R; Traughber, B

Purpose: Treating gynecological cancers with interstitial high-dose-rate (HDR) brachytherapy requires precise reconstruction of catheter positions to obtain accurate dosimetric plans. In this study, we investigated the degree of reproducibility of dosimetric plans for Syed HDR brachytherapy. Methods: We randomly selected five patients having cervix-vaginal cancer who were recently treated in our clinic with interstitial HDR brachytherapy with a prescription dose of 25–30 Gy in five fractions. Interstitial needles/catheters were placed under fluoroscopic guidance and intra-operative 3T MRI scan was performed to confirm the desired catheter placement for adequate target volume coverage. A CT scan was performed and fused with themore » MRI for delineating high-risk CTV (HR-CTV), intermediate-risk CTV (IR-CTV) and OARs. HDR treatment plans were generated using Oncentra planning software. A single plan was used for all five fractions of treatment for each patient. For this study, we took the original clinical plan and removed all the reconstructed catheters from the plan keeping the original contours unchanged. Then, we manually reconstructed all the catheters and entered the same dwell time from the first original clinical plan. The dosimetric parameters studied were: D90 for HR-CTV and IR-CV, and D2cc for bladder, rectum, sigmoid and bowel. Results: The mean of absolute differences in dosimetric coverage (D90) were (range): 1.3% (1.0–2.0%) and 2.0% (0.9–3.6%) for HR-CTV and IR-CTV, respectively. In case of OARs, the mean of absolute variations in D2cc were (range): 4.7% (0.7–8.9%) for bladder, 1.60% (0.3–3.2%) for rectum, 1.6% (0–3.9%) for sigmoid, and 1.8% (0–5.1%) for bowel. Conclusion: Overall, the reproducibility of interstitial HDR plans was within clinically acceptable limit. Observed maximum variation in D2cc for bladder. If number of catchers and dwell points were relatively low or any one catheter was heavily loaded, then reproducibility of the plan was more sensitive to the accuracy of catheter reconstruction.« less

SU-E-T-620: Dosimetric Compliance Study for a New Prostate Protocol of Combined High Dose Rate Brachytherapy and Stereotactic Body Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peng, C; Giaddui, T; Den, R

2014-06-15

Purpose: To investigate the adherence of treatment plans of prostate cancer patients with the dosimetric compliance criteria of the new in house phase I trial of high dose rate (HDR) brachytherapy combined with stereotactic body radiotherapy (SBRT) for intermediate risk prostate cancer patients. Methods: Ten prostate cancer patients were treated using this trial. They received one fraction of HDR to 15Gy, followed by external beam(EB) boost of 3.2Gy(Level 1, five patients) or 3.94Gy(level 2, five patients) per fraction for 10 or 7 fractions, respectively, both equivalent to EB treatments of 113.5Gy in 2Gy fractions. The EB plans were either IMRTmore » or VMAT plans. DVH analysis was performed to verify the adherence of treatment plans to the dosimetric criteria of the trial. Results: For Level 1 patients, target coverage were adequate, with CTV V32Gy(%) of 99.0±1.0 (mean ± 1 standard deviation), and PTV V31Gy(%) of 99.6±0.3. PTV V32.9Gy(%) is 1.4±3.1 and PTVmax is 32.9±0.2Gy. Rectum, bladder and femoral heads sparing were well within protocol criteria. For Level 2 patients, CTV V27.6Gy(%) is 98.7±1.8; PTV V26.7Gy(%) is 99.0±1.4. PTV V28.4Gy(%) is 1.3±1.4, with three patients having minor deviation from protocol. Again critical structures were spared compliant to the protocol. The analysis of HDR plans show similar results, with adequate dose coverage to the prostate and sparing of critical structures including urethra and rectum. V100(%) and V90(%) of prostate are 96.0±1.1 and 98.9±0.5. Urethra D10(%) is 113.1±2.9. Rectum V80(cc) is 1.4±0.5. Hotspot in prostate is substantially higher than what the protocol specifies. But the criteria for hotspot are only guidelines, serving to lower the dose to urethra . Conclusion: This new high biological equivalent dose prostate trial has been carried out successfully for ten patients. Based on dosimetric analysis, all HDR and external plans were compliant to the protocol criteria, with only minor deviations.« less

Hot Dry Rock Geothermal Energy Development Program. Annual report, fiscal year 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cremer, G.M.; Duffield, R.B.; Smith, M.C.

1980-08-01

The Fenton Hill Project is still the principal center for developing methods, equipment, and instrumentation for creating and utilizing HDR geothermal reservoirs. The search for a second site for a similar experimental system in a different geological environment has been intensified, as have the identification and characterization of other HDR areas that may prove suitable for either experimental or commercial development. The Phase I fracture system was enlarged during FY79. Drilling of the injection well of the Phase II system began at Fenton Hill in April 1979. Environmental monitoring of the Fenton Hill area continued through FY79. The environmental studiesmore » indicate that the hot dry rock operations have caused no significant environmental impact. Other supporting activities included rock physics, rock mechanics, fracture mapping, and instrumentation development. Two closely related activities - evaluation of the potential HDR energy resource of the US and the selection of a site for development of a second experimental heat-extraction system generally similar to that at Fenton Hill - have resulted in the collection of geology, hydrology, and heat-flow data on some level of field activity in 30 states. The resource-evaluation activity included reconnaissance field studies and a listing and preliminary characterization of US geothermal areas in which HDR energy extraction methods may be applicable. The selection of Site 2 has taken into account such legal, institutional, and economic factors as land ownership and use, proximity to possible users, permitting and licensing requirements and procedures, environmental issues, areal extent of the geothermal area, and visibility to and apparent interest by potential industrial developers.« less

A novel process for introducing a new intraoperative program: a multidisciplinary paradigm for mitigating hazards and improving patient safety.

PubMed

Rodriguez-Paz, Jose M; Mark, Lynette J; Herzer, Kurt R; Michelson, James D; Grogan, Kelly L; Herman, Joseph; Hunt, David; Wardlow, Linda; Armour, Elwood P; Pronovost, Peter J

2009-01-01

Since the Institute of Medicine's report, To Err is Human, was published, numerous interventions have been designed and implemented to correct the defects that lead to medical errors and adverse events; however, most efforts were largely reactive. Safety, communication, team performance, and efficiency are areas of care that attract a great deal of attention, especially regarding the introduction of new technologies, techniques, and procedures. We describe a multidisciplinary process that was implemented at our hospital to identify and mitigate hazards before the introduction of a new technique: high-dose-rate intraoperative radiation therapy, (HDR-IORT). A multidisciplinary team of surgeons, anesthesiologists, radiation oncologists, physicists, nurses, hospital risk managers, and equipment specialists used a structured process that included in situ clinical simulation to uncover concerns among care providers and to prospectively identify and mitigate defects for patients who would undergo surgery using the HDR-IORT technique. We identified and corrected 20 defects in the simulated patient care process before application to actual patients. Subsequently, eight patients underwent surgery using the HDR-IORT technique with no recurrence of simulation-identified or unanticipated defects. Multiple benefits were derived from the use of this systematic process to introduce the HDR-IORT technique; namely, the safety and efficiency of care for this select patient population was optimized, and this process mitigated harmful or adverse events before the inclusion of actual patients. Further work is needed, but the process outlined in this paper can be universally applied to the introduction of any new technologies, treatments, or procedures.

Error Analysis of non-TLD HDR Brachytherapy Dosimetric Techniques

NASA Astrophysics Data System (ADS)

Amoush, Ahmad

The American Association of Physicists in Medicine Task Group Report43 (AAPM-TG43) and its updated version TG-43U1 rely on the LiF TLD detector to determine the experimental absolute dose rate for brachytherapy. The recommended uncertainty estimates associated with TLD experimental dosimetry include 5% for statistical errors (Type A) and 7% for systematic errors (Type B). TG-43U1 protocol does not include recommendation for other experimental dosimetric techniques to calculate the absolute dose for brachytherapy. This research used two independent experimental methods and Monte Carlo simulations to investigate and analyze uncertainties and errors associated with absolute dosimetry of HDR brachytherapy for a Tandem applicator. An A16 MicroChamber* and one dose MOSFET detectors† were selected to meet the TG-43U1 recommendations for experimental dosimetry. Statistical and systematic uncertainty analyses associated with each experimental technique were analyzed quantitatively using MCNPX 2.6‡ to evaluate source positional error, Tandem positional error, the source spectrum, phantom size effect, reproducibility, temperature and pressure effects, volume averaging, stem and wall effects, and Tandem effect. Absolute dose calculations for clinical use are based on Treatment Planning System (TPS) with no corrections for the above uncertainties. Absolute dose and uncertainties along the transverse plane were predicted for the A16 microchamber. The generated overall uncertainties are 22%, 17%, 15%, 15%, 16%, 17%, and 19% at 1cm, 2cm, 3cm, 4cm, and 5cm, respectively. Predicting the dose beyond 5cm is complicated due to low signal-to-noise ratio, cable effect, and stem effect for the A16 microchamber. Since dose beyond 5cm adds no clinical information, it has been ignored in this study. The absolute dose was predicted for the MOSFET detector from 1cm to 7cm along the transverse plane. The generated overall uncertainties are 23%, 11%, 8%, 7%, 7%, 9%, and 8% at 1cm, 2cm, 3cm, and 4cm, 5cm, 6cm, and 7cm, respectively. The Nucletron Freiburg flap applicator is used with the Nucletron remote afterloader HDR machine to deliver dose to surface cancers. Dosimetric data for the Nucletron 192Ir source were generated using Monte Carlo simulation and compared with the published data. Two dimensional dosimetric data were calculated at two source positions; at the center of the sphere of the applicator and between two adjacent spheres. Unlike the TPS dose algorithm, The Monte Carlo code developed for this research accounts for the applicator material, secondary electrons and delta particles, and the air gap between the skin and the applicator. *Standard Imaging, Inc., Middleton, Wisconsin USA † OneDose MOSFET, Sicel Technologies, Morrisville NC ‡ Los Alamos National Laboratory, NM USA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Willis-Richards, J.; Watanable, K.; Yamaguchi, T.

A set of models of HDR systems is presented which attempts to explain the formation and operation of HDR systems using only the in-situ properties of the fractured rock mass, the earth stress field, the engineering intervention applied by way of stimulation and the relative positions and pressures of the well(s). A statistical and rock mechanics description of fractures in low permeability rocks provides the basis for modeling of stimulation, circulation and water loss in HDR systems. The model uses a large number of parameters, chiefly simple directly measurable quantities, describing the rock mass and fracture system. The effect ofmore » stimulation (raised fluid pressure allowing slip) on fracture apertures is calculated, and the volume of rock affected per volume of fluid pumped estimated. The total rock volume affected by stimulation is equated with the rock volume containing the associated AE (microseismicity). The aperture and compliance properties of the stimulated fractures are used to estimate impedance and flow within the reservoir. Fluid loss from the boundary of the stimulated volume is treated using radial leak-off with pressure-dependent permeability.« less

An improved triangulation laser rangefinder using a custom CMOS HDR linear image sensor

NASA Astrophysics Data System (ADS)

Liscombe, Michael

3-D triangulation laser rangefinders are used in many modern applications, from terrain mapping to biometric identification. Although a wide variety of designs have been proposed, laser speckle noise still provides a fundamental limitation on range accuracy. These works propose a new triangulation laser rangefinder designed specifically to mitigate the effects of laser speckle noise. The proposed rangefinder uses a precision linear translator to laterally reposition the imaging system (e.g., image sensor and imaging lens). For a given spatial location of the laser spot, capturing N spatially uncorrelated laser spot profiles is shown to improve range accuracy by a factor of N . This technique has many advantages over past speckle-reduction technologies, such as a fixed system cost and form factor, and the ability to virtually eliminate laser speckle noise. These advantages are made possible through spatial diversity and come at the cost of increased acquisition time. The rangefinder makes use of the ICFYKWG1 linear image sensor, a custom CMOS sensor developed at the Vision Sensor Laboratory (York University). Tests are performed on the image sensor's innovative high dynamic range technology to determine its effects on range accuracy. As expected, experimental results have shown that the sensor provides a trade-off between dynamic range and range accuracy.

[A novel serial port auto trigger system for MOSFET dose acquisition].

PubMed

Luo, Guangwen; Qi, Zhenyu

2013-01-01

To synchronize the radiation of microSelectron-HDR (Nucletron afterloading machine) and measurement of MOSFET dose system, a trigger system based on interface circuit was designed and corresponding monitor and trigger program were developed on Qt platform. This interface and control system was tested and showed stable operate and reliable work. This adopted serial port detect technique may expand to trigger application of other medical devices.

Validation of the automated self-administered 24-hour dietary recall for children (ASA24-Kids) among 9- to 11-year-old youth

USDA-ARS?s Scientific Manuscript database

Our purpose was to validate ASA24-Kids-2012, a self-administered web-based 24-hour dietary recall (24hDR) among 9- to 11-year-old children. Sixty-nine children in two sites participated in the study. In one site, trained staff observed and recorded types and portions of foods and drinks consumed by ...

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation

PubMed Central

Jaberi, Ramin; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-01-01

Purpose Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. Results A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in ‘organs-applicators’, while maintaining target dose at the original level. Conclusions There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients’ plans to be able to serve as a clinical tool. PMID:29441094

Clinical comparison of two linear-quadratic model-based isoeffect fractionation schemes of high-dose-rate intracavitary brachytherapy for cervical cancer.

PubMed

Wang, Chong-Jong; Huang, Eng-Yen; Sun, Li-Min; Chen, Hui-Chun; Fang, Fu-Min; Hsu, Hsuan-Chih; Changchien, Chan-Chao; Leung, Stephen Wan

2004-05-01

Two linear-quadratic model-based isoeffect fractionation schemes of high-dose-rate intracavitary brachytherapy (HDR-IC) were used to treat cervical cancer in two consecutive periods. Patient outcomes and complications were analyzed and compared. Between November 1987 and December 1996, a total of 541 women diagnosed with cervical cancer were treated with curative-intent radiotherapy. Patients were categorized into two groups according to the two isoeffect schemes used. Group 1 consisted of 254 patients treated with external beam radiotherapy (EBRT) plus 7.2 Gy HDR-IC to Point A for three fractions in the first period. Group 2 consisted of 284 patients treated with EBRT plus 4.8 Gy HDR-IC for five fractions in the second period. The goal of the new scheme for the latter group was to deliver an isoeffect dose that maintained similar tumor control but reduced normal tissue complications. The calculated biologically effective dose (BED(10), assuming an alpha/beta ratio = 10) of EBRT plus HDR-IC for tumor and acute responding tissue in Groups 1 and 2 was 90 Gy(10) (52.8 + 37.2 Gy) and 88.6 Gy(10) (53.1 + 35.5 Gy), respectively. The corresponding BED(3) for late responding tissue (assuming an alpha/beta ratio = 3) in Groups 1 and 2 was 146.7 Gy(3) (73.3 + 73.4 Gy) and 134.4 Gy(3) (72 + 62.4 Gy), respectively. Patients were followed for 6.1-15.2 years (median, 9.8 years). Overall, 66 patients (12.2%) developed pelvic recurrence. Of these, 53 patients had central recurrence. Of the 53 patients with central recurrence, 24 (9.4%) were in Group 1 and 29 (10.1%) in Group 2 (p = 0.722). The actuarial pelvic control rate for Groups 1 and 2 was 88.2% and 86.3% at 5 years and 87.3% and 85.5% at 10 years, respectively (p = 0.504). The actuarial overall survival rate for Groups 1 and 2 was 63.5% and 56.1% at 5 years and 47.8% and 49.3% at 10 years, respectively (p = 0.734). The actuarial proctitis rate for Groups 1 and 2 was 49.7% and 32.7% at 5 years and 50.5% and 32.7% at 10 years, respectively (p <0.001). Most of the decrease in the rate of proctitis was a result of a decrease in the incidence of low-grade proctitis (38% vs. 22%). The incidence of high-grade complications remained unchanged, 8% vs. 7%. The actuarial cystitis rate for Groups 1 and 2 was 14.3% vs. 11.4% at 5 years and 24.1% vs. 15% at 10 years, respectively (p = 0.134). Multivariate analysis revealed that the fractionation scheme (three fractions vs. five fractions) was a significant factor influencing the proctitis rate (p = 0.004, hazard ratio = 0.807; 95% confidence interval, 0.697-0.934), but not the local pelvic control rate, overall survival rate, or cystitis rate. The treatment results of the two groups maintained similar outcomes, while the complications decreased. The linear-quadratic model correctly predicted this outcome. Biologically, the manipulation of the fraction size in our study suggested that the sensitivity of the late responding tissue to the fractional change from 7.2 Gy to 4.8 Gy in HDR-IC is high and detectable clinically. The success, however, had its limitations, and the improvement was confined to low-grade complications.

Effect of using different U/S probe Standoff materials in image geometry for interventional procedures: the example of prostate

PubMed Central

Diamantopoulos, Stefanos; Butt, Saeed; Katsilieri, Zaira; Kefala, Vasiliki; Zogal, Pawel; Sakas, George; Baltas, Dimos

2011-01-01

Purpose This study investigates the distortion of geometry of catheters and anatomy in acquired U/S images, caused by utilizing various stand-off materials for covering a transrectal bi-planar ultrasound probe in HDR and LDR prostate brachytherapy, biopsy and other interventional procedures. Furthermore, an evaluation of currently established water-bath based quality assurance (QA) procedures is presented. Material and methods Image acquisitions of an ultrasound QA setup were carried out at 5 MHz and 7 MHz. The U/S probe was covered by EA 4015 Silicone Standoff kit, or UA0059 Endocavity balloon filled either with water or one of the following: 40 ml of Endosgel®, Instillagel®, Ultraschall gel or Space OAR™ gel. The differences between images were recorded. Consequently, the dosimetric impact of the observed image distortion was investigated, using a tissue equivalent ultrasound prostate phantom – Model number 053 (CIRS Inc., Norfolk, VA, USA). Results By using the EA 4015 Silicone Standoff kit in normal water with sound speed of 1525 m/s, a 3 mm needle shift was observed. The expansion of objects appeared in radial direction. The shift deforms also the PTV (prostate in our case) and other organs at risk (OARs) in the same way leading to overestimation of volume and underestimation of the dose. On the other hand, Instillagel® and Space OAR™ “shrinks” objects in an ultrasound image for 0.65 mm and 0.40 mm, respectively. Conclusions The use of EA 4015 Silicone Standoff kit for image acquisition, leads to erroneous contouring of PTV and OARs and reconstruction and placement of catheters, which results to incorrect dose calculation during prostate brachytherapy. Moreover, the reliability of QA procedures lies mostly in the right temperature of the water used for accurate simulation of real conditions of transrectal ultrasound imaging. PMID:23346130

Is there any place for LDR brachytherapy for head and neck carcinomas in HDR era?

PubMed

Fijuth, Jacek

2009-03-01

In Poland, the classical LDR brachytherapy for head and neck carcinomas with Ir-192 wires or hairpins has completely disappeared some time ago after 30 years of successful clinical use. Can this technique be fully and safely replaced by HDR or PDR application? This option seems attractive because of new possibilities of 3D reconstruction and computer real-time treatment planning and optimization. However, in my opinion, long time is needed to get a clinical and scientific experience that has been accumulated for decades with the use of LDR technique.

Optimization for high-dose-rate brachytherapy of cervical cancer with adaptive simulated annealing and gradient descent.

PubMed

Yao, Rui; Templeton, Alistair K; Liao, Yixiang; Turian, Julius V; Kiel, Krystyna D; Chu, James C H

2014-01-01

To validate an in-house optimization program that uses adaptive simulated annealing (ASA) and gradient descent (GD) algorithms and investigate features of physical dose and generalized equivalent uniform dose (gEUD)-based objective functions in high-dose-rate (HDR) brachytherapy for cervical cancer. Eight Syed/Neblett template-based cervical cancer HDR interstitial brachytherapy cases were used for this study. Brachytherapy treatment plans were first generated using inverse planning simulated annealing (IPSA). Using the same dwell positions designated in IPSA, plans were then optimized with both physical dose and gEUD-based objective functions, using both ASA and GD algorithms. Comparisons were made between plans both qualitatively and based on dose-volume parameters, evaluating each optimization method and objective function. A hybrid objective function was also designed and implemented in the in-house program. The ASA plans are higher on bladder V75% and D2cc (p=0.034) and lower on rectum V75% and D2cc (p=0.034) than the IPSA plans. The ASA and GD plans are not significantly different. The gEUD-based plans have higher homogeneity index (p=0.034), lower overdose index (p=0.005), and lower rectum gEUD and normal tissue complication probability (p=0.005) than the physical dose-based plans. The hybrid function can produce a plan with dosimetric parameters between the physical dose-based and gEUD-based plans. The optimized plans with the same objective value and dose-volume histogram could have different dose distributions. Our optimization program based on ASA and GD algorithms is flexible on objective functions, optimization parameters, and can generate optimized plans comparable with IPSA. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Flavin-Based Electron Bifurcation, Ferredoxin, Flavodoxin, and Anaerobic Respiration With Protons (Ech) or NAD+ (Rnf) as Electron Acceptors: A Historical Review

PubMed Central

Buckel, Wolfgang; Thauer, Rudolf K.

2018-01-01

Flavin-based electron bifurcation is a newly discovered mechanism, by which a hydride electron pair from NAD(P)H, coenzyme F420H2, H2, or formate is split by flavoproteins into one-electron with a more negative reduction potential and one with a more positive reduction potential than that of the electron pair. Via this mechanism microorganisms generate low- potential electrons for the reduction of ferredoxins (Fd) and flavodoxins (Fld). The first example was described in 2008 when it was found that the butyryl-CoA dehydrogenase-electron-transferring flavoprotein complex (Bcd-EtfAB) of Clostridium kluyveri couples the endergonic reduction of ferredoxin (E0′ = −420 mV) with NADH (−320 mV) to the exergonic reduction of crotonyl-CoA to butyryl-CoA (−10 mV) with NADH. The discovery was followed by the finding of an electron-bifurcating Fd- and NAD-dependent [FeFe]-hydrogenase (HydABC) in Thermotoga maritima (2009), Fd-dependent transhydrogenase (NfnAB) in various bacteria and archaea (2010), Fd- and H2-dependent heterodisulfide reductase (MvhADG-HdrABC) in methanogenic archaea (2011), Fd- and NADH-dependent caffeyl-CoA reductase (CarCDE) in Acetobacterium woodii (2013), Fd- and NAD-dependent formate dehydrogenase (HylABC-FdhF2) in Clostridium acidi-urici (2013), Fd- and NADP-dependent [FeFe]-hydrogenase (HytA-E) in Clostridium autoethanogrenum (2013), Fd(?)- and NADH-dependent methylene-tetrahydrofolate reductase (MetFV-HdrABC-MvhD) in Moorella thermoacetica (2014), Fd- and NAD-dependent lactate dehydrogenase (LctBCD) in A. woodii (2015), Fd- and F420H2-dependent heterodisulfide reductase (HdrA2B2C2) in Methanosarcina acetivorans (2017), and Fd- and NADH-dependent ubiquinol reductase (FixABCX) in Azotobacter vinelandii (2017). The electron-bifurcating flavoprotein complexes known to date fall into four groups that have evolved independently, namely those containing EtfAB (CarED, LctCB, FixBA) with bound FAD, a NuoF homolog (HydB, HytB, or HylB) harboring FMN, NfnB with bound FAD, or HdrA harboring FAD. All these flavoproteins are cytoplasmic except for the membrane-associated protein FixABCX. The organisms—in which they have been found—are strictly anaerobic microorganisms except for the aerobe A. vinelandii. The electron-bifurcating complexes are involved in a variety of processes such as butyric acid fermentation, methanogenesis, acetogenesis, anaerobic lactate oxidation, dissimilatory sulfate reduction, anaerobic- dearomatization, nitrogen fixation, and CO2 fixation. They contribute to energy conservation via the energy-converting ferredoxin: NAD+ reductase complex Rnf or the energy-converting ferredoxin-dependent hydrogenase complex Ech. This Review describes how this mechanism was discovered. PMID:29593673

Evaluation of urinary resveratrol as a biomarker of dietary resveratrol intake in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

PubMed

Zamora-Ros, Raul; Rothwell, Joseph A; Achaintre, David; Ferrari, Pietro; Boutron-Ruault, Marie-Christine; Mancini, Francesca R; Affret, Aurelie; Kühn, Tilman; Katzke, Verena; Boeing, Heiner; Küppel, Sven; Trichopoulou, Antonia; Lagiou, Pagona; La Vecchia, Carlo; Palli, Domenico; Contiero, Paolo; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Noh, Hwayoung; Freisling, Heinz; Romieu, Isabelle; Scalbert, Augustin

2017-06-01

In vitro studies have shown several beneficial properties of resveratrol. Epidemiological evidence is still scarce, probably because of the difficulty in estimating resveratrol exposure accurately. The current study aimed to assess the relationships between acute and habitual dietary resveratrol and wine intake and urinary resveratrol excretion in a European population. A stratified random subsample of 475 men and women from four countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) cross-sectional study, who had provided 24-h urine samples and completed a 24-h dietary recall (24-HDR) on the same day, were included. Acute and habitual dietary data were collected using standardised 24-HDR software and a validated country-specific dietary questionnaire, respectively. Phenol-Explorer was used to estimate the intake of resveratrol and other stilbenes. Urinary resveratrol was analysed using tandem MS. Spearman's correlation coefficients between estimated dietary intakes of resveratrol and other stilbenes and consumption of wine, their main food source, were very high (r>0·9) when measured using dietary questionnaires and were slightly lower with 24-HDR (r>0·8). Partial Spearman's correlations between urinary resveratrol excretion and intake of resveratrol, total stilbenes or wine were found to be higher when using the 24-HDR (R 2 partial approximately 0·6) than when using the dietary questionnaires (R 2 partial approximately 0·5). Moderate to high correlations between dietary resveratrol, total stilbenes and wine, and urinary resveratrol concentrations were observed. These support the earlier findings that 24-h urinary resveratrol is an effective biomarker of both resveratrol and wine intakes. These correlations also support the validity of the estimation of resveratrol intake using the dietary questionnaire and Phenol-Explorer.

Dose and dose rate effects of whole-body proton irradiation on leukocyte populations and lymphoid organs: part I

NASA Technical Reports Server (NTRS)

Gridley, Daila S.; Pecaut, Michael J.; Dutta-Roy, Radha; Nelson, Gregory A.

2002-01-01

The goal of part I of this study was to evaluate the effects of whole-body proton irradiation on lymphoid organs and specific leukocyte populations. C57BL/6 mice were exposed to the entry region of the proton Bragg curve to total doses of 0.5 gray (Gy), 1.5 Gy, and 3.0 Gy, each delivered at a low dose rate (LDR) of 1 cGy/min and high dose rate (HDR) of 80 cGy/min. Non-irradiated and 3 Gy HDR gamma-irradiated groups were included as controls. At 4 days post-irradiation, highly significant radiation dose-dependent reductions were observed in the mass of both lymphoid organs and the numbers of leukocytes and T (CD3(+)), T helper (CD3(+)/CD4(+)), T cytotoxic (CD3(+)/CD8(+)), and B (CD19(+)) cells in both blood and spleen. A less pronounced dose effect was noted for natural killer (NK1.1(+) NK) cells in spleen. Monocyte, but not granulocyte, counts in blood were highly dose-dependent. The numbers for each population generally tended to be lower with HDR than with LDR radiation; a significant dose rate effect was found in the percentages of T and B cells, monocytes, and granulocytes and in CD4(+):CD8(+) ratios. These data indicate that mononuclear cell response to the entry region of the proton Bragg curve is highly dependent upon the total dose and that dose rate effects are evident with some cell types. Results from gamma- and proton-irradiated groups (both at 3 Gy HDR) were similar, although proton-irradiation gave consistently lower values in some measurements.

Phase I/II trial of single-fraction high-dose-rate brachytherapy-boosted hypofractionated intensity-modulated radiation therapy for localized adenocarcinoma of the prostate.

PubMed

Myers, Michael A; Hagan, Michael P; Todor, Dorin; Gilbert, Lynn; Mukhopadhyay, Nitai; Randolf, Jessica; Heimiller, Jeffrey; Anscher, Mitchell S

2012-01-01

A Phase I/II protocol was conducted to examine the toxicity and efficacy of the combination of intensity-modulated radiation therapy (IMRT) with a single-fraction high-dose-rate (HDR) brachytherapy implant. From 2001 through 2006, 26 consecutive patients were treated on the trial. The primary objective was to demonstrate a high rate of completion without experiencing a treatment-limiting toxicity. Eligibility was limited to patients with T stage ≤2b, prostate-specific antigen (PSA) ≤20, and Gleason score ≤7. Treatment began with a single HDR fraction of 6Gy to the entire prostate and 9Gy to the peripheral zone, followed by IMRT optimized to deliver in 28 fractions with a normalized total dose of 70Gy. Patients received 50.4Gy to the pelvic lymph node. The prostate dose (IMRT and HDR) resulted in an average biologic equivalent dose >128Gy (α/β=3). Patients whose pretreatment PSA was ≥10ng/mL, Gleason score 7, or stage ≥T2b received short-term androgen ablation. Median followup was 53 months (9-68 months). There were no biochemical failures by either the American Society of Therapeutic Radiology and Oncology or the Phoenix definitions. The median nadir PSA was 0.32ng/mL. All the 26 patients completed the treatment as prescribed. The rate of Grade 3 late genitourinary toxicity was 3.8% consisting of a urethral stricture. There was no other Grade 3 or 4 genitourinary or gastrointestinal toxicities. Single-fraction HDR-boosted IMRT is a safe effective method of dose escalation for localized prostate cancer. Copyright © 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Validating the pivotal role of the immune system in low-dose radiation-induced tumor inhibition in Lewis lung cancer-bearing mice.

PubMed

Zhou, Lei; Zhang, Xiaoying; Li, Hui; Niu, Chao; Yu, Dehai; Yang, Guozi; Liang, Xinyue; Wen, Xue; Li, Min; Cui, Jiuwei

2018-04-01

Although low-dose radiation (LDR) possesses the two distinct functions of inducing hormesis and adaptive responses, which result in immune enhancement and tumor inhibition, its clinical applications have not yet been elucidated. The major obstacle that hinders the application of LDR in the clinical setting is that the mechanisms underlying induction of tumor inhibition are unclear, and the risks associated with LDR are still unknown. Thus, to overcome this obstacle and elucidate the mechanisms mediating the antitumor effects of LDR, in this study, we established an in vivo lung cancer model to investigate the participation of the immune system in LDR-induced tumor inhibition and validated the pivotal role of the immune system by impairing immunity with high-dose radiation (HDR) of 1 Gy. Additionally, the LDR-induced adaptive response of the immune system was also observed by sequential HDR treatment in this mouse model. We found that LDR-activated T cells and natural killer cells and increased the cytotoxicity of splenocytes and the infiltration of T cells in the tumor tissues. In contrast, when immune function was impaired by HDR pretreatment, LDR could not induce tumor inhibition. However, when LDR was administered before HDR, the immunity could be protected from impairment, and tumor growth could be inhibited to some extent, indicating the induction of the immune adaptive response by LDR. Therefore, we demonstrated that immune enhancement played a key role in LDR-induced tumor inhibition. These findings emphasized the importance of the immune response in tumor radiotherapy and may help promote the application of LDR as a novel approach in clinical practice. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

The effect of low dose rate on metabolomic response to radiation in mice

PubMed Central

Goudarzi, Maryam; Mak, Tytus D.; Chen, Congju; Smilenov, Lubomir B.; Brenner, David J.

2014-01-01

Metabolomics has been shown to have utility in assessing responses to exposure by ionizing radiation (IR) in easily accessible biofluids such as urine. Most studies to date from our laboratory and others have employed γ-irradiation at relatively high dose rates (HDR), but many environmental exposure scenarios will probably be at relatively low dose rates (LDR). There are well-documented differences in the biologic responses to LDR compared to HDR, so an important question is to assess LDR effects at the metabolomics level. Our study took advantage of a modern mass spectrometry approach in exploring the effects of dose rate on the urinary excretion levels of metabolites 2 days after IR in mice. A wide variety of statistical tools were employed to further focus on metabolites, which showed responses to LDR IR exposure (0.00309 Gy/min) distinguishable from those of HDR. From a total of 709 detected spectral features, more than 100 were determined to be statistically significant when comparing urine from mice irradiated with 1.1 or 4.45 Gy to that of sham-irradiated mice 2 days post-exposure. The results of this study show that LDR and HDR exposures perturb many of the same pathways such as TCA cycle and fatty acid metabolism, which also have been implicated in our previous IR studies. However, it is important to note that dose rate did affect the levels of particular metabolites. Differences in urinary excretion levels of such metabolites could potentially be used to assess an individual's exposure in a radiobiological event and thus would have utility for both triage and injury assessment. PMID:25047638

Institutional experience of interstitial brachytherapy for head and neck cancer with a comparison of high- and low dose rate practice.

PubMed

Mohanti, Bidhu Kalyan; Sahai, Puja; Thakar, Alok; Sikka, Kapil; Bhasker, Suman; Sharma, Atul; Sharma, Seema; Bahadur, Sudhir

2014-01-01

To describe our institutional experience with high dose rate (HDR) interstitial brachytherapy (IBT) compared with previously reported results on the low dose rate (LDR) practice for head and neck cancer. Eighty-four patients with oral cavity (n=70) or oropharyngeal cancer (n=14) were treated with 192Ir HDR-IBT. Seventy-eight patients had stage I or II tumour. The patients treated with IBT alone (n=42) received 39-42 Gy/10-14 fractions (median=40 Gy/10 fractions). With respect to the combination therapy group (n=42), prescription dose comprised of 12-18 Gy/3-6 fractions (median=15 Gy/5 fractions) for IBT and 40-50 Gy/20-25 fractions (median=50 Gy/25 fractions) for external radiotherapy. Brachytherapy was given as 2 fractions per day 6 hours apart with 4 Gy per fraction for monotherapy and 3 Gy per fraction for combination therapy. Four patients were not evaluable in the analysis of outcome. The primary site relapse rates were 23.8% (10/42) and 68.4% (26/38) in patients treated with IBT alone and combination therapy, respectively (p<0.001). Salvage surgery was performed in 19 patients. The 5-year local control rate was estimated at 62% and the disease-free survival (DFS) rate at 52% for all patients. Local control with respect to T1 and T2 tumours was 84% and 42%, respectively. Our present series on HDR-IBT and the previous report on LDR-IBT for head and neck cancer demonstrated similar DFS rates at 5 years (52%). The rate of regional failure in node-negative patients was <20% in both of our series. HDR-IBT offers similar results to LDR-IBT for head and neck cancer.

SU-F-T-63: Dosimetric Relevance of the Valencia and Leipzig HDR Applicators Plastic Cap

DOE Office of Scientific and Technical Information (OSTI.GOV)

Granero, D; Candela-Juan, C; Vijande, J

Purpose: Utilization of HDR brachytherapy treatment of skin lesions using collimated applicators, such as the Valencia or Leipzig is increasing. These applicators are made of cup-shaped tungsten material in order to focalize the radiation into the lesion and to protect nearby tissues. These applicators have an attachable plastic cap that removes secondary electrons generated in the applicator and flattens the treatment surface. The purpose of this study is to examine the dosimetric impact of this cap, and the effect if the cap is not placed during the HDR fraction delivery. Methods: Monte Carlo simulations have been done using the codemore » Geant4 for the Valencia and Leipzig applicators. Dose rate distributions have been obtained for the applicators with and without the plastic cap. An experimental study using EBT3 radiochromic film has been realized in order to verify the Monte Carlo results. Results: The Monte Carlo simulations show that absorbed dose in the first millimeter of skin can increase up to 180% for the Valencia applicator if the plastic cap is absent and up to 1500% for the Leipzig applicators. At deeper distances the increase of dose is smaller being about 10–15%. Conclusion: Important differences have been found if the plastic cap of the applicators is absent in the treatment producing an overdosage in the skin. The user should have a checklist to remind him check always before HDR fraction delivery to insure the plastic cap is placed on the applicator. This work was supported in part by Generalitat Valenciana under Project PROMETEOII/2013/010, by the Spanish Government under Project No. FIS2013-42156, and by a research agreement with Elekta Brachytherapy, Veenendaal, The Netherlands.« less

Custom-made micro applicators for high-dose-rate brachytherapy treatment of chronic psoriasis.

PubMed

Buzurovic, Ivan M; O'Farrell, Desmond A; Bhagwat, Mandar S; Hansen, Jorgen L; Harris, Thomas C; Friesen, Scott; Cormack, Robert A; Devlin, Phillip M

2017-06-01

In this study, we present the treatment of the psoriatic nail beds of patients refractory to standard therapies using high-dose-rate (HDR) brachytherapy. The custom-made micro applicators (CMMA) were designed and constructed for radiation dose delivery to small curvy targets with complicated topology. The role of the HDR brachytherapy treatment was to stimulate the T cells for an increased immune response. The patient diagnosed with psoriatic nail beds refractory to standard therapies received monthly subunguinal injections that caused significant pain and discomfort in both hands. The clinical target was defined as the length from the fingertip to the distal interphalangeal joint. For the accurate and reproducible setup in the multi-fractional treatment delivery, the CMMAs were designed. Five needles were embedded into the dense plastic mesh and covered with 5 mm bolus material for each micro applicator. Five CMMAs were designed, resulting in the usage of 25 catheters in total. The prescription dose was planned to the depth of the anterior surface of the distal phalanx, allowing for the sparing of the surrounding tissue. The total number of the active dwell positions was 145 with step size of 5 mm. The total treatment time was 115 seconds with a 7.36 Ci activity of the 192 Ir source. The treatment resulted in good pain control. The patient did not require further injections to the nail bed. After this initial treatment, additional two patients with similar symptoms received HDR brachytherapy. The treatment outcome was favorable in all cases. The first HDR brachytherapy treatment of psoriasis of the nail bed is presented. The initial experience revealed that brachytherapy treatment was well-tolerated and resulted in adequate control of the disease. A larger cohort of patients will be required for additional conclusions related to the long-term clinical benefits.

Dose distribution verification for GYN brachytherapy using EBT Gafchromic film and TG-43 calculation.

PubMed

Gholami, Somayeh; Mirzaei, Hamid Reza; Jabbary Arfaee, Ali; Jaberi, Ramin; Nedaie, Hassan Ali; Rabi Mahdavi, Seied; Rajab Bolookat, Eftekhar; Meigooni, Ali S

2016-01-01

Verification of dose distributions for gynecological (GYN) brachytherapy implants using EBT Gafchromic film. One major challenge in brachytherapy is to verify the accuracy of dose distributions calculated by a treatment planning system. A new phantom was designed and fabricated using 90 slabs of 18 cm × 16 cm × 0.2 cm Perspex to accommodate a tandem and Ovoid assembly, which is normally used for GYN brachytherapy treatment. This phantom design allows the use of EBT Gafchromic films for dosimetric verification of GYN implants with a cobalt-60 HDR system or a LDR Cs-137 system. Gafchromic films were exposed using a plan that was designed to deliver 1.5 Gy of dose to 0.5 cm distance from the lateral surface of ovoids from a pair of ovoid assembly that was used for treatment vaginal cuff. For a quantitative analysis of the results for both LDR and HDR systems, the measured dose values at several points of interests were compared with the calculated data from a commercially available treatment planning system. This planning system was utilizing the TG-43 formalism and parameters for calculation of dose distributions around a brachytherapy implant. The results of these investigations indicated that the differences between the calculated and measured data at different points were ranging from 2.4% to 3.8% for the LDR Cs-137 and HDR Co-60 systems, respectively. The EBT Gafchromic films combined with the newly designed phantom could be utilized for verification of the dose distributions around different GYN implants treated with either LDR or HDR brachytherapy procedures.

Interstitial radiation therapy for early-stage nasal vestibule cancer: A continuing quest for optimal tumor control and cosmesis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levendag, Peter C.; Nijdam, Wideke M.; Moolenburgh, Sanne E. van

Introduction: This article reports on the effectiveness, cosmetic outcome, and costs of interstitial high-dose-rate (HDR) brachytherapy for early-stage cancer of the nasal vestibule (NV) proper and/or columella high-dose-rate (HDR). Methods and Materials: Tumor control, survival, cosmetic outcome, functional results, and costs were established in 64 T1/T2N0 nasal vestibule cancers treated from 1991-2005 by fractionated interstitial radiation therapy (IRT) only. Total dose is 44 Gy: 2 fractions of 3 Gy per day, 6-hour interval, first and last fraction 4 Gy. Cosmesis is noted in the chart by the medical doctor during follow-up, by the patient (visual analog scale), and by amore » panel. Finally, full hospital costs are computed. Results: A local relapse-free survival rate of 92% at 5 years was obtained. Four local failures were observed; all four patients were salvaged. The neck was not treated electively; no neck recurrence in follow-up was seen. Excellent cosmetic and functional results were observed. With 10 days admission for full treatment, hospital costs amounted to Euro 5772 ($7044). Conclusion: Excellent tumor control, cosmesis, and function of nasal airway passage can be achieved when HDR-IRT for T1/T2N0 NV cancers is used. For the more advanced cancers (Wang classification: T3 tumor stage), we elect to treat by local excision followed by a reconstructive procedure. The costs, admission to hospital inclusive, for treatment by HDR-IRT amounts to Euro 5772 ($7044 US). This contrasts substantially with the full hospital costs when NV cancers are treated by plastic reconstructive surgery, being on average threefold as expensive.« less

[Quality indicators for the assessment of ST-segment elevation acute myocardial infarction (STEMI) networks. How hospital discharge records could be integrated with Emergency medical services data: the Emilia-Romagna STEMI network experience].

PubMed

Pavesi, Pier Camillo; Guastaroba, Paolo; Casella, Gianni; Berti, Elena; De Palma, Rossana; Di Bartolomeo, Stefano; Di Pasquale, Giuseppe

2015-09-01

The assessment of the regional network for ST-segment elevation acute myocardial infarction (STEMI) is fundamental for quality assurance. Since 2011 all Italian Health Authorities, in addition to hospital discharge records (HDR), must provide a standardized information flow (ERD) about emergency department (ED) and emergency medical system (EMS) activities. The aim of this study was to evaluate whether data integration of ERD with HDR may allow the development of appropriate quality indicators. Patients admitted to coronary care units (CCU) for STEMI between January 1 to December 31, 2013, were identified from the regional HDR database. All data were linked to those of the regional ERD database. Four quality indicators were defined: 1) rates of EMS activation, 2) rates of EMS direct transfer to the catheterization laboratory (Cath-lab), 3) transfer rates from a Spoke to a Hub hospital with angioplasty facilities, and 4) median time spent in ED. In 2013, 2793 patients with STEMI were admitted to the CCU. Of these, 1684 patients (60%) activated EMS and were transported to Spoke or Hub hospitals; 955 (57%) entered directly in CCU/Cath-lab; 677 were transferred directly to a Hub hospital ED without being admitted to a Spoke hospital. The median ED time in Hub hospital was 47 min (IQR 24-136) and in Spoke hospital 53 min (IQR 30-131). The integration among administrative data banks (i.e., HDR with ERD) allowed the assessment of the regional STEMI network and the identification of potentially useful quality indicators. Their easy availability should enable comparisons with local, national and international standards, and may favor quality improvement.

High-dose-rate (HDR) brachytherapy for the treatment of benign obstructive endobronchial granulation tissue

DOE Office of Scientific and Technical Information (OSTI.GOV)

Madu, Chika N.; Machuzak, Michael S.; Sterman, Daniel H.

Background: Severe airway obstruction can occur in the setting of benign granulation tissue forming at bronchial anastomotic sites after lung transplantation in up to 20% of patients. Many of these benign lesions respond to stent placement, laser ablation, or balloon bronchoplasty. However, in certain cases, proliferation of granulation tissue may persist despite all therapeutic attempts. This study describes a series of refractory patients treated with high-dose-rate (HDR) brachytherapy for benign proliferation of granulation tissue, causing airway compromise. Methods and Materials: Between April 2002 and June 2005, 5 patients with significant airway compromise from recurrent granulation tissue were treated with HDRmore » brachytherapy. All patients had previously failed to maintain a patent airway despite multiple bronchoscopic interventions. Treatment was delivered using an HDR brachytherapy afterloader with {sup 192}Ir. Dose prescription was to a depth of 1 cm. All patients were treated weekly, with total doses ranging from 10 Gy to 21 Gy in two to three fractions. Results: The median follow-up was 12 months. All patients experienced a reduction in therapeutic bronchoscopic procedures after HDR brachytherapy compared with the pretreatment period. With the exception of possible radiation-induced bronchitis in 1 patient, there were no other treatment related complications. At the time of this report, 2 patients have died and the other 3 are alive with marked symptomatic improvement and reduced bronchoscopic procedures. Conclusion: High-dose-rate brachytherapy is an effective treatment for benign proliferation of granulation tissue causing airway obstruction. The early response to therapy is encouraging and further follow-up is necessary to determine long-term durability and late effects.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, E; Yuan, F; Templeton, A

Purpose: The ultimate goal of radiotherapy treatment planning is to find a treatment that will yield a high tumor-control-probability(TCP) with an acceptable normal-tissue-complication probability(NTCP). Yet most treatment planning today is not based upon optimization of TCPs and NTCPs, but rather upon meeting physical dose and volume constraints defined by the planner. We design treatment plans that optimize TCP directly and contrast them with the clinical dose-based plans. PET image is incorporated to evaluate gain in TCP for dose escalation. Methods: We build a nonlinear mixed integer programming optimization model that maximizes TCP directly while satisfying the dose requirements on themore » targeted organ and healthy tissues. The solution strategy first fits the TCP function with a piecewise-linear approximation, then solves the problem that maximizes the piecewise linear approximation of TCP, and finally performs a local neighborhood search to improve the TCP value. To gauge the feasibility, characteristics, and potential benefit of PET-image guided dose escalation, initial validation consists of fifteen cervical cancer HDR patient cases. These patients have all received prior 45Gy of external radiation dose. For both escalated strategies, we consider 35Gy PTV-dose, and two variations (37Gy-boost to BTV vs 40Gy-boost) to PET-image-pockets. Results: TCP for standard clinical plans range from 59.4% - 63.6%. TCP for dose-based PET-guided escalated-dose-plan ranges from 63.8%–98.6% for all patients; whereas TCP-optimized plans achieves over 91% for all patients. There is marginal difference in TCP among those with 37Gy-boosted vs 40Gy-boosted. There is no increase in rectum and bladder dose among all plans. Conclusion: Optimizing TCP directly results in highly conformed treatment plans. The TCP-optimized plan is individualized based on the biological PET-image of the patients. The TCP-optimization framework is generalizable and has been applied successfully to other external-beam delivery modalities. A clinical trial is on-going to gauge the clinical significance. Partially supported by the National Science Foundation.« less

SU-F-19A-02: Comparison of Absorbed Dose to Water Standards for HDR Ir-192 Brachytherapy Between the LCR, Brazil and NRC, Canada

DOE Office of Scientific and Technical Information (OSTI.GOV)

Salata, C; David, M; Almeida, C de

2014-06-15

Purpose: To compare absorbed dose to water standards for HDR brachytherapy dosimetry developed by the Radiological Science Laboratory of Rio de Janeiro State University (LCR) and the National Research Council, Canada (NRC). Methods: The two institutions have separately developed absorbed dose standards based on the Fricke dosimetry system. There are important differences between the two standards, including: preparation and read-out of the Fricke solution, irradiation geometry of the Fricke holder in relation to the Ir-192 source, and determination of the G-value to be used at Ir-192 energies. All measurements for both standards were made directly at the NRC laboratory (i.e.,more » no transfer instrument was used) using a single Ir-192 source (microSelectron v2). In addition, the NRC group has established a self-consistent method to determine the G-value for Ir-192, based on an interpolation between G-values obtained at Co-60 and 250kVp X-rays, and this measurement was repeated using the LCR Fricke solution to investigate possible systematic uncertainties. Results: G-values for Co-60 and 250 kVp x-rays, obtained using the LCR Fricke system, agreed with the NRC values within 0.5 % and 1 % respectively, indicating that the general assumption of universal G-values is appropriate in this case. The standard uncertainty in the determination of G for Ir-192 is estimated to be 0.6 %. For the comparison of absorbed dose measurements at the reference point for Ir-192 (1 cm depth in water, perpendicular to the seed long-axis), the ratio Dw(NRC)/Dw(LCR) was found to be 1.011 with a combined standard uncertainty of 1.7 %, k=1. Conclusion: The agreement in the absorbed dose to water values for the LCR and NRC systems is very encouraging. Combined with the lower uncertainty in this approach compared to the present air-kerma approach, these results reaffirm the use of Fricke solution as a potential primary standard for HDR Ir-192 brachytherapy.« less

Thermal dosimetry analysis combined with patient-specific thermal modeling of clinical interstitial ultrasound hyperthermia integrated within HDR brachytherapy for treatment of locally advanced prostate cancer

NASA Astrophysics Data System (ADS)

Salgaonkar, Vasant A.; Wootton, Jeff; Prakash, Punit; Scott, Serena; Hsu, I. C.; Diederich, Chris J.

2017-03-01

This study presents thermal dosimetry analysis from clinical treatments where ultrasound hyperthermia (HT) was administered following high-dose rate (HDR) brachytherapy treatment for locally advanced prostate cancer as part of a clinical pilot study. HT was administered using ultrasound applicators from within multiple 13-g brachytherapy catheters implanted along the posterior periphery of the prostate. The heating applicators were linear arrays of sectored tubular transducers (˜7 MHz), with independently powered array elements enabling energy deposition with 3D spatial control. Typical heat treatments employed time-averaged peak acoustic intensities of 1 - 3 W/cm2 and lasted for 60 - 70 minutes. Throughout the treatments, temperatures at multiple points were monitored using multi-junction thermocouples, placed within available brachytherapy catheters throughout mid-gland prostate and identified as the hyperthermia target volume (HTV). Clinical constraints allowed placement of 8 - 12 thermocouple sensors in the HTV and patient-specific 3D thermal modeling based on finite element methods (FEM) was used to supplement limited thermometry. Patient anatomy, heating device positions, orientations, and thermometry junction locations were obtained from patient CT scans and HDR and hyperthermia planning software. The numerical models utilized the applied power levels recorded during the treatments. Tissue properties such as perfusion and acoustic absorption were varied within physiological ranges such that squared-errors between measured and simulated temperatures were minimized. This data-fitting was utilized for 6 HT treatments to estimate volumetric temperature distributions achieved in the HTV and surrounding anatomy devoid of thermocouples. For these treatments, the measured and simulated T50 values in the hyperthermia target volume (HTV) were between 40.1 - 43.9 °C and 40.3 - 44.9 °C, respectively. Maximum temperatures between 46.8 - 49.8 °C were measured during these treatments and the corresponding range obtained from simulation was 47.3 - 51.1 °C. Based on the simulations, the maximum temperatures in the bladder and the rectum were below 41.7 °C and 41.1 °C, respectively.

DNA lesion identity drives choice of damage tolerance pathway in murine cell chromosomes.

PubMed

Cohen, Isadora S; Bar, Carmit; Paz-Elizur, Tamar; Ainbinder, Elena; Leopold, Karoline; de Wind, Niels; Geacintov, Nicholas; Livneh, Zvi

2015-02-18

DNA-damage tolerance (DDT) via translesion DNA synthesis (TLS) or homology-dependent repair (HDR) functions to bypass DNA lesions encountered during replication, and is critical for maintaining genome stability. Here, we present piggyBlock, a new chromosomal assay that, using piggyBac transposition of DNA containing a known lesion, measures the division of labor between the two DDT pathways. We show that in the absence of DNA damage response, tolerance of the most common sunlight-induced DNA lesion, TT-CPD, is achieved by TLS in mouse embryo fibroblasts. Meanwhile, BP-G, a major smoke-induced DNA lesion, is bypassed primarily by HDR, providing the first evidence for this mechanism being the main tolerance pathway for a biologically important lesion in a mammalian genome. We also show that, far from being a last-resort strategy as it is sometimes portrayed, TLS operates alongside nucleotide excision repair, handling 40% of TT-CPDs in repair-proficient cells. Finally, DDT acts in mouse embryonic stem cells, exhibiting the same pattern—mutagenic TLS included—despite the risk of propagating mutations along all cell lineages. The new method highlights the importance of HDR, and provides an effective tool for studying DDT in mammalian cells.

DNA lesion identity drives choice of damage tolerance pathway in murine cell chromosomes

PubMed Central

Cohen, Isadora S.; Bar, Carmit; Paz-Elizur, Tamar; Ainbinder, Elena; Leopold, Karoline; de Wind, Niels; Geacintov, Nicholas; Livneh, Zvi

2015-01-01

DNA-damage tolerance (DDT) via translesion DNA synthesis (TLS) or homology-dependent repair (HDR) functions to bypass DNA lesions encountered during replication, and is critical for maintaining genome stability. Here, we present piggyBlock, a new chromosomal assay that, using piggyBac transposition of DNA containing a known lesion, measures the division of labor between the two DDT pathways. We show that in the absence of DNA damage response, tolerance of the most common sunlight-induced DNA lesion, TT-CPD, is achieved by TLS in mouse embryo fibroblasts. Meanwhile, BP-G, a major smoke-induced DNA lesion, is bypassed primarily by HDR, providing the first evidence for this mechanism being the main tolerance pathway for a biologically important lesion in a mammalian genome. We also show that, far from being a last-resort strategy as it is sometimes portrayed, TLS operates alongside nucleotide excision repair, handling 40% of TT-CPDs in repair-proficient cells. Finally, DDT acts in mouse embryonic stem cells, exhibiting the same pattern—mutagenic TLS included—despite the risk of propagating mutations along all cell lineages. The new method highlights the importance of HDR, and provides an effective tool for studying DDT in mammalian cells. PMID:25589543

GATA3 controls the specification of prosensory domain and neuronal survival in the mouse cochlea

PubMed Central

Luo, Xiong-jian; Deng, Min; Xie, Xiaoling; Huang, Liang; Wang, Hui; Jiang, Lichun; Liang, Guoqing; Hu, Fang; Tieu, Roger; Chen, Rui; Gan, Lin

2013-01-01

HDR syndrome (also known as Barakat syndrome) is a developmental disorder characterized by hypoparathyroidism, sensorineural deafness and renal disease. Although genetic mapping and subsequent functional studies indicate that GATA3 haplo-insufficiency causes human HDR syndrome, the role of Gata3 in sensorineural deafness and auditory system development is largely unknown. In this study, we show that Gata3 is continuously expressed in the developing mouse inner ear. Conditional knockout of Gata3 in the developing inner ear disrupts the morphogenesis of mouse inner ear, resulting in a disorganized and shortened cochlear duct with significant fewer hair cells and supporting cells. Loss of Gata3 function leads to the failure in the specification of prosensory domain and subsequently, to increased cell death in the cochlear duct. Moreover, though the initial generation of cochleovestibular ganglion (CVG) cells is not affected in Gata3-null mice, spiral ganglion neurons (SGNs) are nearly depleted due to apoptosis. Our results demonstrate the essential role of Gata3 in specifying the prosensory domain in the cochlea and in regulating the survival of SGNs, thus identifying a molecular mechanism underlying human HDR syndrome. PMID:23666531

Biological effective dose evaluation in gynaecological brachytherapy: LDR and HDR treatments, dependence on radiobiological parameters, and treatment optimisation.

PubMed

Bianchi, C; Botta, F; Conte, L; Vanoli, P; Cerizza, L

2008-10-01

This study was undertaken to compare the biological efficacy of different high-dose-rate (HDR) and low-dose-rate (LDR) treatments of gynaecological lesions, to identify the causes of possible nonuniformity and to optimise treatment through customised calculation. The study considered 110 patients treated between 2001 and 2006 with external beam radiation therapy and/or brachytherapy with either LDR (afterloader Selectron, (137)Cs) or HDR (afterloader microSelectron Classic, (192)Ir). The treatments were compared in terms of biologically effective dose (BED) to the tumour and to the rectum (linear-quadratic model) by using statistical tests for comparisons between independent samples. The difference between the two treatments was statistically significant in one case only. However, within each technique, we identified considerable nonuniformity in therapeutic efficacy due to differences in fractionation schemes and overall treatment time. To solve this problem, we created a Microsoft Excel spreadsheet allowing calculation of the optimal treatment for each patient: best efficacy (BED(tumour)) without exceeding toxicity threshold (BED(rectum)). The efficacy of a treatment may vary as a result of several factors. Customised radiobiological evaluation is a useful adjunct to clinical evaluation in planning equivalent treatments that satisfy all dosimetric constraints.

Brachytherapy improves biochemical failure-free survival in low- and intermediate-risk prostate cancer compared with conventionally fractionated external beam radiation therapy: a propensity score matched analysis.

PubMed

Smith, Graham D; Pickles, Tom; Crook, Juanita; Martin, Andre-Guy; Vigneault, Eric; Cury, Fabio L; Morris, Jim; Catton, Charles; Lukka, Himu; Warner, Andrew; Yang, Ying; Rodrigues, George

2015-03-01

To compare, in a retrospective study, biochemical failure-free survival (bFFS) and overall survival (OS) in low-risk and intermediate-risk prostate cancer patients who received brachytherapy (BT) (either low-dose-rate brachytherapy [LDR-BT] or high-dose-rate brachytherapy with external beam radiation therapy [HDR-BT+EBRT]) versus external beam radiation therapy (EBRT) alone. Patient data were obtained from the ProCaRS database, which contains 7974 prostate cancer patients treated with primary radiation therapy at four Canadian cancer institutions from 1994 to 2010. Propensity score matching was used to obtain the following 3 matched cohorts with balanced baseline prognostic factors: (1) low-risk LDR-BT versus EBRT; (2) intermediate-risk LDR-BT versus EBRT; and (3) intermediate-risk HDR-BT+EBRT versus EBRT. Kaplan-Meier survival analysis was performed to compare differences in bFFS (primary endpoint) and OS in the 3 matched groups. Propensity score matching created acceptable balance in the baseline prognostic factors in all matches. Final matches included 2 1:1 matches in the intermediate-risk cohorts, LDR-BT versus EBRT (total n=254) and HDR-BT+EBRT versus EBRT (total n=388), and one 4:1 match in the low-risk cohort (LDR-BT:EBRT, total n=400). Median follow-up ranged from 2.7 to 7.3 years for the 3 matched cohorts. Kaplan-Meier survival analysis showed that all BT treatment options were associated with statistically significant improvements in bFFS when compared with EBRT in all cohorts (intermediate-risk EBRT vs LDR-BT hazard ratio [HR] 4.58, P=.001; intermediate-risk EBRT vs HDR-BT+EBRT HR 2.08, P=.007; low-risk EBRT vs LDR-BT HR 2.90, P=.004). No significant difference in OS was found in all comparisons (intermediate-risk EBRT vs LDR-BT HR 1.27, P=.687; intermediate-risk EBRT vs HDR-BT+EBRT HR 1.55, P=.470; low-risk LDR-BT vs EBRT HR 1.41, P=.500). Propensity score matched analysis showed that BT options led to statistically significant improvements in bFFS in low- and intermediate-risk prostate cancer patient populations. Copyright © 2015 Elsevier Inc. All rights reserved.

Brachytherapy Improves Biochemical Failure–Free Survival in Low- and Intermediate-Risk Prostate Cancer Compared With Conventionally Fractionated External Beam Radiation Therapy: A Propensity Score Matched Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, Graham D.; Pickles, Tom; Crook, Juanita

2015-03-01

Purpose: To compare, in a retrospective study, biochemical failure-free survival (bFFS) and overall survival (OS) in low-risk and intermediate-risk prostate cancer patients who received brachytherapy (BT) (either low-dose-rate brachytherapy [LDR-BT] or high-dose-rate brachytherapy with external beam radiation therapy [HDR-BT+EBRT]) versus external beam radiation therapy (EBRT) alone. Methods and Materials: Patient data were obtained from the ProCaRS database, which contains 7974 prostate cancer patients treated with primary radiation therapy at four Canadian cancer institutions from 1994 to 2010. Propensity score matching was used to obtain the following 3 matched cohorts with balanced baseline prognostic factors: (1) low-risk LDR-BT versus EBRT; (2)more » intermediate-risk LDR-BT versus EBRT; and (3) intermediate-risk HDR-BT+EBRT versus EBRT. Kaplan-Meier survival analysis was performed to compare differences in bFFS (primary endpoint) and OS in the 3 matched groups. Results: Propensity score matching created acceptable balance in the baseline prognostic factors in all matches. Final matches included 2 1:1 matches in the intermediate-risk cohorts, LDR-BT versus EBRT (total n=254) and HDR-BT+EBRT versus EBRT (total n=388), and one 4:1 match in the low-risk cohort (LDR-BT:EBRT, total n=400). Median follow-up ranged from 2.7 to 7.3 years for the 3 matched cohorts. Kaplan-Meier survival analysis showed that all BT treatment options were associated with statistically significant improvements in bFFS when compared with EBRT in all cohorts (intermediate-risk EBRT vs LDR-BT hazard ratio [HR] 4.58, P=.001; intermediate-risk EBRT vs HDR-BT+EBRT HR 2.08, P=.007; low-risk EBRT vs LDR-BT HR 2.90, P=.004). No significant difference in OS was found in all comparisons (intermediate-risk EBRT vs LDR-BT HR 1.27, P=.687; intermediate-risk EBRT vs HDR-BT+EBRT HR 1.55, P=.470; low-risk LDR-BT vs EBRT HR 1.41, P=.500). Conclusions: Propensity score matched analysis showed that BT options led to statistically significant improvements in bFFS in low- and intermediate-risk prostate cancer patient populations.« less

Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer

NASA Astrophysics Data System (ADS)

Wootton, Jeffery H.; Prakash, Punit; Hsu, I.-Chow Joe; Diederich, Chris J.

2011-07-01

Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue >=41 °C in a hyperthermia treatment volume was maximized with constraints Tmax <= 47 °C, Trectum <= 41.5 °C, and Tbladder <= 42.5 °C. Hyperthermia treatment was modeled for generalized implant configurations and complex configurations from a database of patients (n = 14) treated with HDR brachytherapy. Various combinations of endocervical (360° or 2 × 180° output; 6 mm OD) and interstitial (180°, 270°, or 360° output; 2.4 mm OD) applicators within catheter locations from brachytherapy implants were modeled, with perfusion constant (1 or 3 kg m-3 s-1) or varying with location or temperature. Device positioning, sectoring, active length and aiming were empirically optimized to maximize thermal coverage. Conformable heating of appreciable volumes (>200 cm3) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 °C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T90 in example patient cases was 40.5-42.7 °C (1.9-39.6 EM43 °C) at 1 kg m-3 s-1 with 10/14 patients >=41 °C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T90 >= 41 °C in clinically practical implant configurations. Catheter-based ultrasound devices, when adhering to the guidelines, show potential to generate conformal therapeutic heating ranging from a single endocervical device targeting small volumes local to the cervix (<2 cm radial) to a combination of a 2 × 180° endocervical and directional interstitial applicators in the lateral periphery to target much larger volumes (6 cm radial), while preferentially limiting heating of the bladder and rectum.

Targeted gene knock-in by homology-directed genome editing using Cas9 ribonucleoprotein and AAV donor delivery.

PubMed

Gaj, Thomas; Staahl, Brett T; Rodrigues, Gonçalo M C; Limsirichai, Prajit; Ekman, Freja K; Doudna, Jennifer A; Schaffer, David V

2017-06-20

Realizing the full potential of genome editing requires the development of efficient and broadly applicable methods for delivering programmable nucleases and donor templates for homology-directed repair (HDR). The RNA-guided Cas9 endonuclease can be introduced into cells as a purified protein in complex with a single guide RNA (sgRNA). Such ribonucleoproteins (RNPs) can facilitate the high-fidelity introduction of single-base substitutions via HDR following co-delivery with a single-stranded DNA oligonucleotide. However, combining RNPs with transgene-containing donor templates for targeted gene addition has proven challenging, which in turn has limited the capabilities of the RNP-mediated genome editing toolbox. Here, we demonstrate that combining RNP delivery with naturally recombinogenic adeno-associated virus (AAV) donor vectors enables site-specific gene insertion by homology-directed genome editing. Compared to conventional plasmid-based expression vectors and donor templates, we show that combining RNP and AAV donor delivery increases the efficiency of gene addition by up to 12-fold, enabling the creation of lineage reporters that can be used to track the conversion of striatal neurons from human fibroblasts in real time. These results thus illustrate the potential for unifying nuclease protein delivery with AAV donor vectors for homology-directed genome editing. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

An in vivo investigative protocol for HDR prostate brachytherapy using urethral and rectal thermoluminescence dosimetry.

PubMed

Toye, Warren; Das, Ram; Kron, Tomas; Franich, Rick; Johnston, Peter; Duchesne, Gillian

2009-05-01

To develop an in vivo dosimetry based investigative action level relevant for a corrective protocol for HDR brachytherapy boost treatment. The dose delivered to points within the urethra and rectum was measured using TLD in vivo dosimetry in 56 patients. Comparisons between the urethral and rectal measurements and TPS calculations showed differences, which are related to the relative position of the implant and TLD trains, and allowed shifts of implant position relative to the prostate to be estimated. Analysis of rectal dose measurements is consistent with implant movement, which was previously only identified with the urethral data. Shift corrected doses were compared with results from the TPS. Comparison of peak doses to the urethra and rectum has been assessed against the proposed corrective protocol to limit overdosing these critical structures. An initial investigative level of 20% difference between measured and TPS peak dose was established, which corresponds to 1/3 of patients which was practical for the caseload. These patients were assessed resulting in corrective action being applied for one patient. Multiple triggering for selective investigative action is outlined. The use of a single in vivo measurement in the first fraction optimizes patient benefit at acceptable cost.

Modification of the mean near-wall velocity profile of a high-Reynolds number turbulent boundary layer with the injection of drag-reducing polymer solutions

NASA Astrophysics Data System (ADS)

Elbing, Brian R.; Perlin, Marc; Dowling, David R.; Ceccio, Steven L.

2013-08-01

The current study explores the influence of polymer drag reduction on the near-wall velocity distribution in a turbulent boundary layer (TBL) and its dependence on Reynolds number. Recent moderate Reynolds number direct numerical simulation and experimental studies presented in White et al. [Phys. Fluids 24, 021701 (2012)], 10.1063/1.3681862 have challenged the classical representation of the logarithmic dependence of the velocity profile for drag-reduced flows, especially at drag reduction levels above 40%. In the present study, high Reynolds number data from a drag reduced TBL is presented and compared to the observations of White et al. [Phys. Fluids 24, 021701 (2012)], 10.1063/1.3681862. Data presented here were acquired in the TBL flow on a 12.9-m-long flat plate at speeds to 20.3 m s-1, achieving momentum thickness based Reynolds number to 1.5 × 105, which is an order of magnitude greater than that available in the literature. Polyethylene oxide solutions with an average molecular weight of 3.9 × 106 g mol-1 were injected into the flow at various concentrations and volumetric fluxes to achieve a particular level of drag reduction. The resulting mean near-wall velocity profiles show distinctly different behavior depending on whether they fall in the low drag reduction (LDR) or the high drag reduction (HDR) regimes, which are nominally divided at 40% drag reduction. In the LDR regime, the classical view that the logarithmic slope remains constant at the Newtonian value and the intercept constant increases with increasing drag reduction appears to be valid. However, in the HDR regime the behavior is no longer universal. The intercept constant continues to increase linearly in proportion to the drag reduction level until a Reynolds-number-dependent threshold is achieved, at which point the intercept constant rapidly decreases to that predicted by the ultimate profile. The rapid decrease in the intercept constant is due to the corresponding increase in the profile slope in the HDR regime. There was significant scatter in the observed slope in the HDR regime, but the scatter did not appear to be Reynolds number dependent. Finally, the ultimate profiles for flows at maximum drag reduction were examined and did not exhibit a logarithmic functional relationship, which is the classical empirical relationship suggested by Virk [J. Am. Inst. Chem. Eng. 21, 625-656 (1975)], 10.1002/aic.690210402.

EM-navigated catheter placement for gynecologic brachytherapy: an accuracy study

NASA Astrophysics Data System (ADS)

Mehrtash, Alireza; Damato, Antonio; Pernelle, Guillaume; Barber, Lauren; Farhat, Nabgha; Viswanathan, Akila; Cormack, Robert; Kapur, Tina

2014-03-01

Gynecologic malignancies, including cervical, endometrial, ovarian, vaginal and vulvar cancers, cause significant mortality in women worldwide. The standard care for many primary and recurrent gynecologic cancers consists of chemoradiation followed by brachytherapy. In high dose rate (HDR) brachytherapy, intracavitary applicators and /or interstitial needles are placed directly inside the cancerous tissue so as to provide catheters to deliver high doses of radiation. Although technology for the navigation of catheters and needles is well developed for procedures such as prostate biopsy, brain biopsy, and cardiac ablation, it is notably lacking for gynecologic HDR brachytherapy. Using a benchtop study that closely mimics the clinical interstitial gynecologic brachytherapy procedure, we developed a method for evaluating the accuracy of image-guided catheter placement. Future bedside translation of this technology offers the potential benefit of maximizing tumor coverage during catheter placement while avoiding damage to the adjacent organs, for example bladder, rectum and bowel. In the study, two independent experiments were performed on a phantom model to evaluate the targeting accuracy of an electromagnetic (EM) tracking system. The procedure was carried out using a laptop computer (2.1GHz Intel Core i7 computer, 8GB RAM, Windows 7 64-bit), an EM Aurora tracking system with a 1.3mm diameter 6 DOF sensor, and 6F (2 mm) brachytherapy catheters inserted through a Syed-Neblett applicator. The 3D Slicer and PLUS open source software were used to develop the system. The mean of the targeting error was less than 2.9mm, which is comparable to the targeting errors in commercial clinical navigation systems.

MACS-Himalaya: A photogrammetric aerial oblique camera system designed for highly accurate 3D-reconstruction and monitoring in steep terrain and under extreme illumination conditions

NASA Astrophysics Data System (ADS)

Brauchle, Joerg; Berger, Ralf; Hein, Daniel; Bucher, Tilman

2017-04-01

The DLR Institute of Optical Sensor Systems has developed the MACS-Himalaya, a custom built Modular Aerial Camera System specifically designed for the extreme geometric (steep slopes) and radiometric (high contrast) conditions of high mountain areas. It has an overall field of view of 116° across-track consisting of a nadir and two oblique looking RGB camera heads and a fourth nadir looking near-infrared camera. This design provides the capability to fly along narrow valleys and simultaneously cover ground and steep valley flank topography with similar ground resolution. To compensate for extreme contrasts between fresh snow and dark shadows in high altitudes a High Dynamic Range (HDR) mode was implemented, which typically takes a sequence of 3 images with graded integration times, each covering 12 bit radiometric depth, resulting in a total dynamic range of 15-16 bit. This enables dense image matching and interpretation for sunlit snow and glaciers as well as for dark shaded rock faces in the same scene. Small and lightweight industrial grade camera heads are used and operated at a rate of 3.3 frames per second with 3-step HDR, which is sufficient to achieve a longitudinal overlap of approximately 90% per exposure time at 1,000 m above ground at a velocity of 180 km/h. Direct georeferencing and multitemporal monitoring without the need of ground control points is possible due to the use of a high end GPS/INS system, a stable calibrated inner geometry of the camera heads and a fully photogrammetric workflow at DLR. In 2014 a survey was performed on the Nepalese side of the Himalayas. The remote sensing system was carried in a wingpod by a Stemme S10 motor glider. Amongst other targets, the Seti Valley, Kali-Gandaki Valley and the Mt. Everest/Khumbu Region were imaged at altitudes up to 9,200 m. Products such as dense point clouds, DSMs and true orthomosaics with a ground pixel resolution of up to 15 cm were produced in regions and outcrops normally inaccessible to aerial imagery. These data are used in the fields of natural hazards, geomorphology and glaciology (see Thompson et al., CR4.3). In the presentation the camera system is introduced and examples and applications from the Nepal campaign are given.

SU-F-T-24: Impact of Source Position and Dose Distribution Due to Curvature of HDR Transfer Tubes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khan, A; Yue, N

2016-06-15

Purpose: Brachytherapy is a highly targeted from of radiotherapy. While this may lead to ideal dose distributions on the treatment planning system, a small error in source location can lead to change in the dose distribution. The purpose of this study is to quantify the impact on source position error due to curvature of the transfer tubes and the impact this may have on the dose distribution. Methods: Since the source travels along the midline of the tube, an estimate of the positioning error for various angles of curvature was determined using geometric properties of the tube. Based on themore » range of values a specific shift was chosen to alter the treatment plans for a number of cervical cancer patients who had undergone HDR brachytherapy boost using tandem and ovoids. Impact of dose to target and organs at risk were determined and checked against guidelines outlined by radiation oncologist. Results: The estimate of the positioning error was 2mm short of the expected position (the curved tube can only cause the source to not reach as far as with a flat tube). Quantitative impact on the dose distribution is still in the process of being analyzed. Conclusion: The accepted positioning tolerance for the source position of a HDR brachytherapy unit is plus or minus 1mm. If there is an additional 2mm discrepancy due to tube curvature, this can result in a source being 1mm to 3mm short of the expected location. While we do always attempt to keep the tubes straight, in some cases such as with tandem and ovoids, the tandem connector does not extend as far out from the patient so the ovoid tubes always contain some degree of curvature. The dose impact of this may be significant.« less

Petrologic considerations for hot dry rock geothermal site selection in the Clear Lake Region, California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stimac, J.; Goff, F.; Hearn, B.C. Jr.

1992-01-01

The Clear Lake area is well known for anomalous heat flow, thermal springs, hydrothermal mineral deposits, and Quaternary volcanism. These factors, along with the apparent lack of a large reservoir of geothermal fluid north of Collayomi fault make the Clear Lake area an attractive target for hot dry rock (HDR) geothermal development. Petrologic considerations provide some constraints on site selection for HDR development. Spatial and temporal trends in volcanism in the Coast Ranges indicate that magmatism has migrated to the north with time, paralleling passage of the Mendocino triple junction and propagation of the San Andreas fault. Volcanism in themore » region may have resulted from upwelling of hot asthenosphere along the southern margin of the subducted segment of the Gorda plate. Spatial and temporal trends of volcanism within the Clear Lake volcanic field are similar to larger-scale trends of Neogene volcanism in the Cost Ranges. Volcanism (especially for silicic compositions) shows a general migration to the north over the {approximately}2 Ma history of the field, with the youngest two silicic centers located at Mt. Konocti and Borax Lake. The Mt. Konocti system (active from {approximately} 0.6 to 0.3 Ma) was large and long-lived, whereas the Borax Lake system is much smaller but younger (0.09 Ma). Remnants of silicic magma bodies under Mt. Konocti may be in the latter stages of cooling, whereas a magma body centered under Borax Lake may be in the early stages of development. The existence of an upper crustal silicic magma body of under Borax Lake has yet to be demonstrated by passive geophysics, however, subsurface temperatures in the area as high (> 200{degrees}C at 2000 m) as those beneath the Mt. Konocti area. Based on petrologic considerations alone, the Mt. Konocti-Borax Lake area appears to be the most logical choice for HDR geothermal development in the region.« less

Efficient introduction of specific homozygous and heterozygous mutations using CRISPR/Cas9.

PubMed

Paquet, Dominik; Kwart, Dylan; Chen, Antonia; Sproul, Andrew; Jacob, Samson; Teo, Shaun; Olsen, Kimberly Moore; Gregg, Andrew; Noggle, Scott; Tessier-Lavigne, Marc

2016-05-05

The bacterial CRISPR/Cas9 system allows sequence-specific gene editing in many organisms and holds promise as a tool to generate models of human diseases, for example, in human pluripotent stem cells. CRISPR/Cas9 introduces targeted double-stranded breaks (DSBs) with high efficiency, which are typically repaired by non-homologous end-joining (NHEJ) resulting in nonspecific insertions, deletions or other mutations (indels). DSBs may also be repaired by homology-directed repair (HDR) using a DNA repair template, such as an introduced single-stranded oligo DNA nucleotide (ssODN), allowing knock-in of specific mutations. Although CRISPR/Cas9 is used extensively to engineer gene knockouts through NHEJ, editing by HDR remains inefficient and can be corrupted by additional indels, preventing its widespread use for modelling genetic disorders through introducing disease-associated mutations. Furthermore, targeted mutational knock-in at single alleles to model diseases caused by heterozygous mutations has not been reported. Here we describe a CRISPR/Cas9-based genome-editing framework that allows selective introduction of mono- and bi-allelic sequence changes with high efficiency and accuracy. We show that HDR accuracy is increased dramatically by incorporating silent CRISPR/Cas-blocking mutations along with pathogenic mutations, and establish a method termed 'CORRECT' for scarless genome editing. By characterizing and exploiting a stereotyped inverse relationship between a mutation's incorporation rate and its distance to the DSB, we achieve predictable control of zygosity. Homozygous introduction requires a guide RNA targeting close to the intended mutation, whereas heterozygous introduction can be accomplished by distance-dependent suboptimal mutation incorporation or by use of mixed repair templates. Using this approach, we generated human induced pluripotent stem cells with heterozygous and homozygous dominant early onset Alzheimer's disease-causing mutations in amyloid precursor protein (APP(Swe)) and presenilin 1 (PSEN1(M146V)) and derived cortical neurons, which displayed genotype-dependent disease-associated phenotypes. Our findings enable efficient introduction of specific sequence changes with CRISPR/Cas9, facilitating study of human disease.

Detecting the subtle shape differences in hemodynamic responses at the group level

PubMed Central

Chen, Gang; Saad, Ziad S.; Adleman, Nancy E.; Leibenluft, Ellen; Cox, Robert W.

2015-01-01

The nature of the hemodynamic response (HDR) is still not fully understood due to the multifaceted processes involved. Aside from the overall amplitude, the response may vary across cognitive states, tasks, brain regions, and subjects with respect to characteristics such as rise and fall speed, peak duration, undershoot shape, and overall duration. Here we demonstrate that the fixed-shape (FSM) or adjusted-shape (ASM) methods may fail to detect some shape subtleties (e.g., speed of rise or recovery, or undershoot). In contrast, the estimated-shape method (ESM) through multiple basis functions can provide the opportunity to identify some subtle shape differences and achieve higher statistical power at both individual and group levels. Previously, some dimension reduction approaches focused on the peak magnitude, or made inferences based on the area under the curve (AUC) or interaction, which can lead to potential misidentifications. By adopting a generic framework of multivariate modeling (MVM), we showcase a hybrid approach that is validated by simulations and real data. With the whole HDR shape integrity maintained as input at the group level, the approach allows the investigator to substantiate these more nuanced effects through the unique HDR shape features. Unlike the few analyses that were limited to main effect, two- or three-way interactions, we extend the modeling approach to an inclusive platform that is more adaptable than the conventional GLM. With multiple effect estimates from ESM for each condition, linear mixed-effects (LME) modeling should be used at the group level when there is only one group of subjects without any other explanatory variables. Under other situations, an approximate approach through dimension reduction within the MVM framework can be adopted to achieve a practical equipoise among representation, false positive control, statistical power, and modeling flexibility. The associated program 3dMVM is publicly available as part of the AFNI suite. PMID:26578853