pH-Responsive Amphiphilic Triblock Fluoropolymers as Assemble Oxygen Nanoshuttles for Enhancing PDT against Hypoxic Tumor.

Photodynamic therapy (PDT) is a cancer treatment strategy that utilizes photosensitizers to convert oxygen within tumors into reactive singlet oxygen (1O2) to lyse tumor cells. Nevertheless, pre-existing tumor hypoxia and oxygen consumption during PDT can lead to an insufficient oxygen supply, potentially reducing the photodynamic efficacy. In response to this issue, we have devised a pH-responsive amphiphilic triblock fluorinated polymer (PDP) using copper-mediated RDRP. This polymer, composed of poly(ethylene glycol) methyl ether acrylate, 2-(diethylamino)ethyl methacrylate, and (perfluorooctyl)ethyl acrylate, self-assembles in an aqueous environment. Oxygen, chlorine e6 (Ce6), and doxorubicin (DOX) can be codelivered efficiently by PDP. The incorporation of perfluorocarbon into the formulation enhances the oxygen-carrying capacity of PDP, consequently extending the lifetime of 1O2. This increased lifetime, in turn, amplifies the PDT effect and escalates the cellular cytotoxicity. Compared with PDT alone, PDP@Ce6-DOX-O2 NPs demonstrated significant inhibition of tumor growth. This study proposes a novel strategy for enhancing the efficacy of PDT.

Work Function Prediction by Graph Neural Networks for Configurationally Hybridized Boron-Doped Graphene.

Graphene, serving as electrodes, is widely applied in electronic and optoelectronic devices. Work function as one of the fundamental intrinsic characteristics of graphene directly affects the interfacial properties of the electrodes, thereby affecting the performance of the devices. Much work has been done to regulate the work function of graphene to expand its application fields, and doping has been demonstrated as an effective method. However, the numerous types of doped graphene make the investigation of its work function time-consuming and labor-intensive. In order to quickly obtain the relationship between the structure and property, a deep learning method is employed to predict the work function in this study. Specifically, a data set of over 30,000 compositions with the work function on boron-doped graphene at different concentrations and doping positions via density functional theory simulations was established through ab initio calculations. Then, a novel fusion model (GT-Net) combining transformers and graph neural networks (GNNs) was proposed. After that, improved effective GNN-based descriptors were developed. Finally, three different GNN methods were compared, and the results show that the proposed method could accurately predicate the work function with the R2 = 0.975 and RMSE = 0.027. This study not only provides the possibility of designing materials with specific properties at the atomic level but also demonstrates the performance of GNNs on graph-level tasks with the same graph structure and atomic number.

Chromatic aberration correction based on cross-channel information alignment in microscopy.

A microscope usually consists of dozens of complex lenses and requires careful assembly, alignment, and testing before use. Chromatic aberration correction is a significant step in the design of microscopes. Reducing chromatic aberration by improving optical design will inevitably increase the overall weight and size of the microscope, leading to more cost in manufacturing and maintenance. Nevertheless, the improvement in hardware can only achieve limited correction. In this paper, we propose an algorithm based on cross-channel information alignment to shift some of the correction tasks from optical design to post-processing. Additionally, a quantitative framework is established to evaluate the performance of the chromatic aberration algorithm. Our algorithm outperforms the other state-of-the-art methods in both visual appearance and objective assessments. The results indicate that the proposed algorithm can effectively obtain higher-quality images without changing the hardware or engaging the optical parameters.

PEGA-BA@Ce6@PFCE Micelles as Oxygen Nanoshuttles for Tumor Hypoxia Relief and Enhanced Photodynamic Therapy.

Tumor hypoxia, which is mainly caused by the inefficient microvascular systems induced by rapid tumor growth, is a common characteristic of most solid tumors and has been found to hinder treatment outcomes for many types of cancer therapeutics. In this study, an amphiphilic block copolymer, poly (ethylene glycol) methyl ether acrylate-block-n-butyl acrylate (PEGA-BA), was prepared via the ATRP method and self-assembled into core-shell micelles as nano radiosensitizers. These micelles encapsulated a photosensitizer, Chlorin e6 (Ce6), and demonstrated well-defined morphology, a uniform size distribution, and high oxygen loading capacity. Cell experiments showed that PEGA-BA@Ce6@PFCE micelles could effectively enter cells. Further in vitro anticancer studies demonstrated that the PEGA-BA@Ce6@PFCE micelles significantly suppressed the tumor cell survival rate when exposed to a laser.

An Automatic Clock-Induced-Spurs Detector Based on Energy Detection for Direct Digital Frequency Synthesizer.

A clock-induced-spurs detector, composed of a programmable low-pass filter (LPF), energy detector and spur detection algorithm, is presented and applied to a four-channel 1 gigabit-samples-per-second (GSPS) direct digital frequency synthesizer (DDS). The proposed detector realizes the detection of spurs based on energy-detection, and the spur detection algorithm is adopted to automatically extract the amplitude and phase of clock-induced spurs, generated by the intermodulation of harmonic spurs and multiple clocks. Finally, the extracted features are sent to auxiliary DDS to decrease the target spur, following which the detector can be turned off to save power. Additionally, the detected characteristics under different output conditions can be read out through the interface for rapid frequency switching. The proposed detector integrated into a DDS is fabricated with a 65 nm complementary metal oxide semiconductor (CMOS) process and has an area of 190 µm × 320 µm. The measured power consumption is roughly 38 mW, consuming 6% that of a single-channel DDS. The test results show that the spurious-free dynamic range (SFDR) of this DDS can be successfully enhanced from -43.1 dBc to roughly -59.9 dBc without any off-chip instruments. This effectively proves that the detection accuracy of this detector can reach around -81 dBm.

Correlates of loneliness in older adults in Shanghai, China: does age matter?

BACKGROUND: Loneliness is a public health concern with serious health consequences in older adults. Despite a large body of research on the correlates of loneliness, little is known about the age group differences in the correlates. Given that the older adult population is heterogeneous, this study aims to examine the correlates of loneliness in older adults in Shanghai, and to explore how the correlates vary across different age groups. METHODS: We used the Shanghai Urban Neighborhood Survey (SUNS) which was conducted in 2016 and 2017. The total sample size of older adults included in the analysis was 2770. Loneliness was measured using the sum of the 6 items derived from the De Jong Gierveld Loneliness Scale. Correlates include demographic variables, health conditions, social factors, and new media use. Regression analysis was used to examine the correlates of loneliness first in the whole sample, and then in the young old (60-79 years old) and the old old (80+ years old) separately. RESULTS: The mean of loneliness score was 18.48 (SD = 5.77). The old old reported a higher level of loneliness than the young old. Variables, including age, living arrangement, marital status, education, health, family functioning, volunteering, square dancing, and new media use were found to be significant in the whole sample. Most of the significant correlates observed in the young old were identical to the findings reported for the total sample, with an exception for living arrangement. Self-rated health (SRH) and family functioning were two important correlates for the old old. CONCLUSIONS: Correlates of loneliness vary for the young old and the old old. The older adults at higher risk of loneliness deserve more attention and concern. Future interventions should be tailored to the young old and the old old to better help older adults alleviate loneliness and enhance their well-being.

Impact of Physical Interventions, Phosphorus Fertilization, and the Utilization of Soil Amendments on the Absorption of Cadmium by Lettuce Grown in a Solar-Powered Greenhouse.

This study aimed to evaluate the effects of physical measures and the applications of phosphorus fertilizer and soil conditioner on the growth of lettuce (Lactuca sativa) and its uptake of cadmium (Cd). In a solar greenhouse that contained soil enriched with cadmium (Cd) (1.75 ± 0.41 mg/kg) with lettuce used as a test plant, field experimental methods were utilized to explore the influence of physical measures, such as deep plowing and soil covering, and the applications of phosphorus fertilizer, including diammonium phosphate (DAP), calcium magnesium phosphate (CMP), and calcium superphosphate (SSP), and soil conditioners, such as biochar, attapulgite clay, and nano-hydroxyapatite, on the uptake of Cd in lettuce. The results indicated that the concentrations of Cd in the aboveground parts of lettuce were 1.49 ± 0.45, 1.26 ± 0.02, 1.00 ± 0.21, and 0.24 ± 0.13 mg/kg when the soil was plowed 30, 40, and 50 cm deep, respectively, and when the soil was covered with 15 cm, this resulted in reductions of 27.5%, 38.3%, 51.4%, and 88.4%, respectively, compared with the control treatment that entailed plowing to 15 cm. When 75, 150, and 225 kg/ha of phosphorus pentoxide (P2O5) were applied compared with the lack of application, the contents of Cd in the aboveground parts of lettuce increased by 2.0%, 54.5%, and 73.7%, respectively, when DAP was applied; by 52.5%, 48.5%, and 8.1%, respectively, when CMP was applied; and by 13.1%, 61.6%, and 90.9%, respectively, when SSP was applied. When the amounts of biochar applied were 0, 2, 4, 6, 8, 10, and 12 t/ha, the contents of Cd in the aboveground parts of lettuce were 1.36 ± 0.27, 1.47 ± 0.56, 1.80 ± 0.73, 1.96 ± 0.12, 1.89 ± 0.52, 1.44 ± 0.30, and 1.10 ± 0.27 mg/kg, respectively. Under concentrations of 0, 40, 80, 120, 160, and 200 kg/ha, the application of nano-hydroxyapatite resulted in Cd contents of 1.34 ± 0.56, 1.47 ± 0.10, 1.60 ± 0.44, 1.70 ± 0.21, 1.31 ± 0.09, and 1.51 ± 0.34 mg/kg, respectively. The concentrations of Cd in the aboveground parts of lettuce treated with attapulgite clay were 1.44 ± 0.48, 1.88 ± 0.67, 2.10 ± 0.80, 2.24 ± 0.75, 1.78 ± 0.41, and 1.88 ± 0.48 mg/kg, respectively. In summary, under the conditions in this study, deep plowing and soil covering measures can reduce the concentration of Cd in the aboveground parts of lettuce. The application of phosphorus fertilizer increased the concentration of Cd in the aboveground parts of lettuce. The application of higher amounts of DAP and SSP led to greater concentrations of Cd in the aboveground parts of lettuce. The application of higher amounts of CMP caused a lower concentration of Cd in the aboveground parts of lettuce. When biochar, attapulgite clay, and nano-hydroxyapatite were applied, the concentration of Cd in the aboveground parts of lettuce increased in parallel with the increase in the concentration of application when low amounts were applied. In contrast, when high amounts were applied, the concentration of Cd in the aboveground parts of lettuce began to decrease.

Effect of brackish water irrigation on cadmium migration in a soil-maize system.

Phytoremediation is an effective way to reduce heavy metal content in agricultural soil. The effects of brackish water irrigation on phytoremediation efficiency of plants have not yet been completely understood. In this study, the effects of brackish water irrigation on cadmium (Cd) uptake by maize as the phytoremediator were investigated. In a pot experiment, maize seedlings were grown in soil with exogenously added Cd (0, 5, 10, or 15 mg kg-1) and irrigated with deionized water (T1), natural brackish water (T2), or water with NaCl with salinity equal to that of natural brackish water (T3). Salt stress and cation antagonism caused by brackish water affected maize plant growth and Cd uptake. Under 5, 10, and 15 mg kg-1 Cd, Cd accumulation in maize shoots was 5.55, 7.08, and 5.71 µg plant-1; 4.08, 3.04, and 5.38 µg plant-1; and 2.48, 3.44, and 5.33 µg plant-1 under the T1, T2, and T3 treatments, respectively. Cd accumulation in the shoots was significantly lower under the T2 and T3 treatments than under the T1 treatment at 5 and 10 mg kg-1 Cd; however, no significant differences were observed among all treatments at 15 mg kg-1 Cd. These findings indicated that phytoremediation efficiency decreased in response to both salt stress and cation antagonism caused by brackish water under low soil-Cd concentrations; however, this effect was negligible under high soil-Cd concentration. Therefore, brackish water irrigation can be considered for the phytoremediation of soils contaminated with high Cd levels to save freshwater resources.

A review of lactate-lactylation in malignancy: its potential in immunotherapy.

Lactic acid was formerly regarded as a byproduct of metabolism. However, extensive investigations into the intricacies of cancer development have revealed its significant contributions to tumor growth, migration, and invasion. Post-translational modifications involving lactate have been widely observed in histone and non-histone proteins, and these modifications play a crucial role in regulating gene expression by covalently attaching lactoyl groups to lysine residues in proteins. This discovery has greatly enhanced our comprehension of lactic acid's involvement in disease pathogenesis. In this article, we provide a comprehensive review of the intricate relationship between lactate and tumor immunity, the occurrence of lactylation in malignant tumors, and the exploitation of targeted lactate-lactylation in tumor immunotherapy. Additionally, we discuss future research directions, aiming to offer novel insights that could inform the investigation, diagnosis, and treatment of related diseases.

[Analysis on volatile constituents of Semen Ziziphi Spinosae by HS-SPME-GC-MS].

OBJECTIVE: To establish a rapid and simple method for the determination of volatile constituents in Semen Ziziphi Spinosae. METHODS: The volatile constituents in Semen Ziziphi Spinosae were extracted by head space solid-phase microextraction (HS-SPME) and analysed by GC-MS. RESULTS: Powder of sample was pre-heated for 30 min at 90 degrees C, then headspace-extracted with 65 microm PDMS/DVB fiber for 50 min. After desorbed for 5 min at 250 degrees C, the separation was well completed on a Rxi -50 capillary column. 126 kinds of volatile compounds were isolated and 116 compounds were identified. The amounts of compound from the volatile constituents were determined by area normalization method. The main components extracted by HS-SPME were alkane (32.08%), terpenoid and derivatives of oxygenated terpenoid (27.06%). CONCLUSION: The method is simple, fast and accurate, and it is suitable for the determination of the volatile constituents in fruit of Ziziphus jujuba.

A novel digital tomosynthesis (DTS) reconstruction method using a deformation field map.

We developed a novel digital tomosynthesis (DTS) reconstruction method using a deformation field map to optimally estimate volumetric information in DTS images. The deformation field map is solved by using prior information, a deformation model, and new projection data. Patients' previous cone-beam CT (CBCT) or planning CT data are used as the prior information, and the new patient volume to be reconstructed is considered as a deformation of the prior patient volume. The deformation field is solved by minimizing bending energy and maintaining new projection data fidelity using a nonlinear conjugate gradient method. The new patient DTS volume is then obtained by deforming the prior patient CBCT or CT volume according to the solution to the deformation field. This method is novel because it is the first method to combine deformable registration with limited angle image reconstruction. The method was tested in 2D cases using simulated projections of a Shepp-Logan phantom, liver, and head-and-neck patient data. The accuracy of the reconstruction was evaluated by comparing both organ volume and pixel value differences between DTS and CBCT images. In the Shepp-Logan phantom study, the reconstructed pixel signal-to-noise ratio (PSNR) for the 60 degrees DTS image reached 34.3 dB. In the liver patient study, the relative error of the liver volume reconstructed using 60 degrees projections was 3.4%. The reconstructed PSNR for the 60 degrees DTS image reached 23.5 dB. In the head-and-neck patient study, the new method using 60 degrees projections was able to reconstruct the 8.1 degrees rotation of the bony structure with 0.0 degrees error. The reconstructed PSNR for the 60 degrees DTS image reached 24.2 dB. In summary, the new reconstruction method can optimally estimate the volumetric information in DTS images using 60 degrees projections. Preliminary validation of the algorithm showed that it is both technically and clinically feasible for image guidance in radiation therapy.

Dosimetric characteristics of novalis Tx system with high definition multileaf collimator.

A new Novalis Tx system equipped with a high definition multileaf collimator (HDMLC) recently became available to perform both image-guided radiosurgery and conventional radiotherapy. It is capable of delivering a highly conformal radiation dose with three energy modes: 6 MV photon energy, 15 MV photon energy, and 6 MV photon energy in a stereotactic radiosurgery mode with 1000 MU/min dose rate. Dosimetric characteristics of the new Novalis Tx treatment unit with the HDMLC are systematically measured for commissioning. A high resolution diode detector and miniion-chamber detector are used to measure dosimetric data for a range of field sizes from 4 x 4 mm to 400 x 400 mm. The commissioned Novalis Tx system has passed the RPC stereotactic radiosurgery head phantom irradiation test. The Novalis Tx system not only expands its capabilities with three energy modes, but also achieves better beam conformity and sharer beam penumbra with HDMLC. Since there is little beam data information available for the new Novalis Tx system, we present in this work the dosimetric data of the new modality for reference and comparison.

Predicting lung radiotherapy-induced pneumonitis using a model combining parametric Lyman probit with nonparametric decision trees.

PURPOSE: To develop and test a model to predict for lung radiation-induced Grade 2+ pneumonitis. METHODS AND MATERIALS: The model was built from a database of 234 lung cancer patients treated with radiotherapy (RT), of whom 43 were diagnosed with pneumonitis. The model augmented the predictive capability of the parametric dose-based Lyman normal tissue complication probability (LNTCP) metric by combining it with weighted nonparametric decision trees that use dose and nondose inputs. The decision trees were sequentially added to the model using a "boosting" process that enhances the accuracy of prediction. The model's predictive capability was estimated by 10-fold cross-validation. To facilitate dissemination, the cross-validation result was used to extract a simplified approximation to the complicated model architecture created by boosting. Application of the simplified model is demonstrated in two example cases. RESULTS: The area under the model receiver operating characteristics curve for cross-validation was 0.72, a significant improvement over the LNTCP area of 0.63 (p = 0.005). The simplified model used the following variables to output a measure of injury: LNTCP, gender, histologic type, chemotherapy schedule, and treatment schedule. For a given patient RT plan, injury prediction was highest for the combination of pre-RT chemotherapy, once-daily treatment, female gender and lowest for the combination of no pre-RT chemotherapy and nonsquamous cell histologic type. Application of the simplified model to the example cases revealed that injury prediction for a given treatment plan can range from very low to very high, depending on the settings of the nondose variables. CONCLUSIONS: Radiation pneumonitis prediction was significantly enhanced by decision trees that added the influence of nondose factors to the LNTCP formulation.

On-board patient positioning for head-and-neck IMRT: comparing digital tomosynthesis to kilovoltage radiography and cone-beam computed tomography.

PURPOSE: High-precision intensity-modulated radiotherapy demands high patient positioning accuracy. On-board digital tomosynthesis (DTS) provides three-dimensional (3D) image guidance for daily positioning with a lower imaging dose, faster acquisition, and more geometric flexibility than 3D cone-beam computed tomography (CBCT). This clinical study evaluated DTS as a daily imaging technique for patient positioning and compared the results with 3D CBCT and two-dimensional (2D) radiography. METHODS AND MATERIALS: Head and neck cancer patients undergoing intensity-modulated radiotherapy were studied. For each session, the patient was positioned using laser marks. On-board imaging data sets, including 2D kilovoltage radiographs, DTS, and CBCT, were obtained to measure the daily patient positioning variations. The mean and standard deviations of the positioning variations in the translational and rotational directions were calculated. The positioning differences among 2D radiography, DTS, and CBCT were analyzed. RESULTS: Image data sets were collected from 65 treatment fractions for 10 patients. The systematic patient positioning variation was <0.10 cm and 1.0 degrees one dimensionally. The random variations were 0.27-0.34 cm in the translational and 0.93 degrees -1.99 degrees in the rotational direction. The mean vector isocenter variation was 0.48 cm. DTS with 40 degrees and 20 degrees scan angles in the coronal or sagittal directions yielded the same results for patient positioning. DTS performance was comparable to that of CBCT, with positioning differences of <0.1 cm and 0.5 degrees . The positioning difference between 2D radiography and DTS was approximately 0.1 cm and 0.2 cm in the vertical/longitudinal and lateral directions. CONCLUSION: Our results have demonstrated that DTS is a comparable 3D imaging technique to CBCT for daily patient positioning of head-and-neck patients as determined by manual registration of bony anatomy.

The impact of induction chemotherapy and the associated tumor response on subsequent radiation-related changes in lung function and tumor response.

PURPOSE: To assess the impact of induction chemotherapy, and associated tumor shrinkage, on the subsequent radiation-related changes in pulmonary function and tumor response. METHODS AND MATERIALS: As part of a prospective institutional review board-approved study, 91 evaluable patients treated definitively with thoracic radiation therapy (RT) for unresectable lung cancer were analyzed. The rates of RT-associated pulmonary toxicity and tumor response were compared in the patients with and without pre-RT chemotherapy. In the patients receiving induction chemotherapy, the rates of RT-associated pulmonary toxicity and tumor response were compared in the patients with and without a response (modified Response Evaluation Criteria in Solid Tumor criteria) to the pre-RT chemotherapy. Comparisons of the rates of improvements in pulmonary function tests (PFTs) post-RT, dyspnea requiring steroids, and percent declines in PFTs post-RT were compared in patient subgroups using Fisher's exact test, analysis of variance, and linear or logistic regression. RESULTS: The use of pre-RT chemotherapy appears to increase the rate of radiation-induced pneumonitis (p = 0.009-0.07), but has no consistent impact on changes in PFTs. The degree of induction chemotherapy-associated tumor shrinkage is not associated with the rate of subsequent RT-associated pulmonary toxicity. The degree of tumor response to chemotherapy is not related to the degree of tumor response to RT. CONCLUSIONS: Additional study is needed to better clarify the impact of chemotherapy on radiation-associated disfunction.

Updated assessment of the six-minute walk test as predictor of acute radiation-induced pneumonitis.

PURPOSE: To assess the utility of the 6-minute walk test (6MWT) as a predictor of symptomatic radiation-induced pneumonitis (RP). METHODS: As part of a prospective trial to study radiation-induced lung injury, 53 patients receiving thoracic radiotherapy (RT) underwent a pre-RT 6MWT, pulmonary function tests (PFTs), and had >or=3-month follow-up for prospective assessment of Grade 2 or worse RP (requiring medications or worse). Dosimetric parameters (e.g., the percentage of lung receiving >or=30 Gy) were extracted from the lung dose-volume histogram. The correlations between the 6MWT and PFT results were assessed using Pearson's correlation. The receiver operating characteristic technique was used in patient subgroups to evaluate the predictive capacities for RP of the dosimetric parameters, 6MWT results, and PFT results, or the combination (using discriminant analysis) of all three metrics. ROCKIT software was used to compare the receiver operating characteristic areas between each predictive model. The association of the decline in 6MWT with the development of RP was evaluated using Fisher's exact test. RESULTS: The pre-RT PFT and 6MWT results correlated weakly (r = 0.44-0.57, p or=30 Gy, receiver operating characteristic area 0.73, p = 0.03). Including the PFT or 6MWT results with the percentage of lung receiving >or=30 Gy did not improve the predictions. The predictive abilities of dosimetric-based models improved when the analysis was restricted to those patients whose tumors were not causing regional lung dysfunction. No correlation was found between the decline in the 6MWT result and the RP rate (p = 0.6). CONCLUSION: Although the PFTs and 6MWT are related to each other, the correlation coefficients were weak, suggesting that they could be measuring different physiologic functions. In the present data set, the addition of the PFTs or 6MWT did not increase the ability of the dosimetric parameters to predict for acute symptomatic RP. Additional work is needed to better understand the interaction among the PFT results, exercise tolerance (6MWT), and the risk of RT-induced lung dysfunction.

Prospective assessment of dosimetric/physiologic-based models for predicting radiation pneumonitis.

PURPOSE: Clinical and 3D dosimetric parameters are associated with symptomatic radiation pneumonitis rates in retrospective studies. Such parameters include: mean lung dose (MLD), radiation (RT) dose to perfused lung (via SPECT), and pre-RT lung function. Based on prior publications, we defined pre-RT criteria hypothesized to be predictive for later development of pneumonitis. We herein prospectively test the predictive abilities of these dosimetric/functional parameters on 2 cohorts of patients from Duke and The Netherlands Cancer Institute (NKI). METHODS AND MATERIALS: For the Duke cohort, 55 eligible patients treated between 1999 and 2005 on a prospective IRB-approved study to monitor RT-induced lung injury were analyzed. A similar group of patients treated at the NKI between 1996 and 2002 were identified. Patients believed to be at high and low risk for pneumonitis were defined based on: (1) MLD; (2) OpRP (sum of predicted perfusion reduction based on regional dose-response curve); and (3) pre-RT DLCO. All doses reflected tissue density heterogeneity. The rates of grade > or =2 pneumonitis in the "presumed" high and low risk groups were compared using Fisher's exact test. RESULTS: In the Duke group, pneumonitis rates in patients prospectively deemed to be at "high" vs. "low" risk are 7 of 20 and 9 of 35, respectively; p = 0.33 one-tailed Fisher's. Similarly, comparable rates for the NKI group are 4 of 21 and 6 of 44, respectively, p = 0.41 one-tailed Fisher's. CONCLUSION: The prospective model appears unable to accurately segregate patients into high vs. low risk groups. However, considered retrospectively, these data are consistent with prior studies suggesting that dosimetric (e.g., MLD) and functional (e.g., PFTs or SPECT) parameters are predictive for RT-induced pneumonitis. Additional work is needed to better identify, and prospectively assess, predictors of RT-induced lung injury.

Minimizing image noise in on-board CT reconstruction using both kilovoltage and megavoltage beam projections.

We studied a recently proposed aggregated CT reconstruction technique which combines the complementary advantages of kilovoltage (kV) and megavoltage (MV) x-ray imaging. Various phantoms were imaged to study the effects of beam orientations and geometry of the imaging object on image quality of reconstructed CT. It was shown that the quality of aggregated CT was correlated with both kV and MV beam orientations and the degree of this correlation depended upon the geometry of the imaging object. The results indicated that the optimal orientations were those when kV beams pass through the thinner portion and MV beams pass through the thicker portion of the imaging object. A special preprocessing procedure was also developed to perform contrast conversions between kV and MV information prior to image reconstruction. The performance of two reconstruction methods, one filtered backprojection method and one iterative method, were compared. The effects of projection number, beam truncation, and contrast conversion on the CT image quality were investigated.

A neural network model to predict lung radiation-induced pneumonitis.

A feed-forward neural network was investigated to predict the occurrence of lung radiation-induced Grade 2+ pneumonitis. The database consisted of 235 patients with lung cancer treated using radiotherapy, of whom 34 were diagnosed with Grade 2+ pneumonitis at follow-up. The network was constructed using an algorithm that alternately grew and pruned it, starting from the smallest possible network, until a satisfactory solution was found. The weights and biases of the network were computed using the error back-propagation approach. Momentum and variable leaning techniques were used to speed convergence. Using the growing/pruning approach, the network selected features from 66 dose and 27 non-dose variables. During network training, the 235 patients were randomly split into ten groups of approximately equal size. Eight groups were used to train the network, one group was used for early stopping training to prevent overfitting, and the remaining group was used as a test to measure the generalization capability of the network (cross-validation). Using this methodology, each of the ten groups was considered, in turn, as the test group (ten-fold cross-validation). For the optimized network constructed with input features selected from dose and non-dose variables, the area under the receiver operating characteristics (ROC) curve for cross-validated testing was 0.76 (sensitivity: 0.68, specificity: 0.69). For the optimized network constructed with input features selected only from dose variables, the area under the ROC curve for cross-validation was 0.67 (sensitivity: 0.53, specificity: 0.69). The difference between these two areas was statistically significant (p = 0.020), indicating that the addition of non-dose features can significantly improve the generalization capability of the network. A network for prospective testing was constructed with input features selected from dose and non-dose variables (all data were used for training). The optimized network architecture consisted of six input nodes (features), four hidden nodes, and one output node. The six input features were: lung volume receiving > 16 Gy (V16), generalized equivalent uniform dose (gEUD) for the exponent a = 1 (mean lung dose), gEUD for the exponent a = 3.5, free expiratory volume in 1 s (FEV1), diffusion capacity of carbon monoxide (DLCO%), and whether or not the patient underwent chemotherapy prior to radiotherapy. The significance of each input feature was individually evaluated by omitting it during network training and gauging its impact by the consequent deterioration in cross-validated ROC area. With the exception of FEV1 and whether or not the patient underwent chemotherapy prior to radiotherapy, all input features were found to be individually significant (p < 0.05). The network for prospective testing is publicly available via internet access.

Photon caliper to achieve submillimeter positioning accuracy.

The purpose of this study was to demonstrate the feasibility of using a commercial two-dimensional (2D) detector array with an inherent detector spacing of 5 mm to achieve submillimeter accuracy in localizing the radiation isocenter. This was accomplished by delivering the Vernier 'dose' caliper to a 2D detector array where the nominal scale was the 2D detector array and the non-nominal Vernier scale was the radiation dose strips produced by the high-definition (HD) multileaf collimators (MLCs) of the linear accelerator. Because the HD MLC sequence was similar to the picket fence test, we called this procedure the Vernier picket fence (VPF) test. We confirmed the accuracy of the VPF test by offsetting the HD MLC bank by known increments and comparing the known offset with the VPF test result. The VPF test was able to determine the known offset within 0.02 mm. We also cross-validated the accuracy of the VPF test in an evaluation of couch hysteresis. This was done by using both the VPF test and the ExacTrac optical tracking system to evaluate the couch position. We showed that the VPF test was in agreement with the ExacTrac optical tracking system within a root-mean-square value of 0.07 mm for both the lateral and longitudinal directions. In conclusion, we demonstrated the VPF test can determine the offset between a 2D detector array and the radiation isocenter with submillimeter accuracy. Until now, no method to locate the radiation isocenter using a 2D detector array has been able to achieve such accuracy.