Triangular Resection Epicanthoplasty: A Novel Method of Minimizing Hypertrophic Scar After Medial Epicanthoplasty.

Medial epicanthoplasty is a crucial component in Asian cosmetic eyelid surgery. Conventional surgical methods have mandated wide undermining for the purpose of sufficient release. However, excessive undermining may result in hypertrophic scar or webbing deformities. To minimize undesirable results, the authors are proposing a novel approach. From March 2010 to December 2017, a triangular resection epicanthoplasty was performed in 421 Asian patients. The authors' procedure consists of triangular skin resection, the release of orbicularis oculi muscle and upper half medial epicanthal tendon, and dog ear correction. No complication regarding scarring or webbing was reported. The revision was performed in 18 cases where the patients wanted additional correction. The triangular resection epicanthoplasty offers both optimal results and minimal scar with relative simplicity.

Regression and pseudoprogression of pediatric optic pathway glioma in patients treated with proton beam therapy.

PURPOSE: We examined regression patterns in pediatric optic pathway gliomas (OPGs) after proton beam therapy (PBT) and evaluated local control and visual outcomes. METHODS: A total of 42 brain magnetic resonance imaging (MRI) scans from seven consecutive sporadic OPGs that were initially treated with chemotherapy and received PBT between June 2007 and September 2016 at the National Cancer Center, Korea were analyzed. Patients underwent brain MRI regularly before and after PBT. Total tumor, cystic lesion, and solid enhancing lesion area delineation and volume calculations were performed on gadolinium-enhanced T1-weighted MRI using Eclipse version 13, Varian. RESULTS: The median follow-up period after PBT was 70 months (range 47-88). The median age at the time of PBT was 7 years (range 4-16) and the median duration of chemotherapy before referral to PBT center was 25 months (range 3-70). The median time to the greatest increase in cystic volume was 32 months (range 12-43) after PBT. Solid enhancing lesion volume gradually decreased throughout the follow-up period. On an individual basis, total volume change was varied. However, on average, it regressed, although at a slower rate than solid enhancing lesion volume did. The local control rate was 85.7% (5-year progression-free survival rate, 80%; 5-year overall survival rate, 100%) and the rate of vision preservation was 71.4% (five of seven patients). CONCLUSION: The regression patterns in pediatric OPGs after PBT involve significant cystic change. Therefore, total volume is not appropriate for evaluating response. Care by a multidisciplinary team is necessary to manage clinical symptoms related to radiologic changes.

Assessment of a Therapeutic X-ray Radiation Dose Measurement System Based on a Flexible Copper Indium Gallium Selenide Solar Cell.

Several detectors have been developed to measure radiation doses during radiotherapy. However, most detectors are not flexible. Consequently, the airgaps between the patient surface and detector could reduce the measurement accuracy. Thus, this study proposes a dose measurement system based on a flexible copper indium gallium selenide (CIGS) solar cell. Our system comprises a customized CIGS solar cell (with a size 10 × 10 cm2 and thickness 0.33 mm), voltage amplifier, data acquisition module, and laptop with in-house software. In the study, the dosimetric characteristics, such as dose linearity, dose rate independence, energy independence, and field size output, of the dose measurement system in therapeutic X-ray radiation were quantified. For dose linearity, the slope of the linear fitted curve and the R-square value were 1.00 and 0.9999, respectively. The differences in the measured signals according to changes in the dose rates and photon energies were <2% and <3%, respectively. The field size output measured using our system exhibited a substantial increase as the field size increased, contrary to that measured using the ion chamber/film. Our findings demonstrate that our system has good dosimetric characteristics as a flexible in vivo dosimeter. Furthermore, the size and shape of the solar cell can be easily customized, which is an advantage over other flexible dosimeters based on an a-Si solar cell.

Evaluation of Caspase-3 and Ki-67 expression in squamous cell hyperplasia of the stomach induced by Platycodi radix water extract in Sprague-Dawley rats.

Platycodi radix is widely used in traditional herbal medicine for the treatment of bronchitis, asthma, pulmonary tuberculosis, hypertension, hyperlipidemia, and diabetes. This study aimed to investigate cell proliferation (Ki-67) and apoptosis (Caspase-3) potential in squamous cell hyperplasia of the stomach induced by a Platycodi radix water extract in a subchronic toxicity study. One hundred formalin-fixed, paraffin-embedded stomach tissues of rats treated with Platycodi radix at doses of 0, 500, 1,000, and 3,000 mg/kg body weight/day were used for the analysis. They were conventionally stained using hematoxylin and eosin (H&E) and immunohistochemically (IHC) stained using caspase-3 and Ki-67 antibodies. The incidence of squamous cell hyperplasia was significantly increased in the 3,000 mg/kg b.w./day treatment group in both sexes (p<0.01). However, the hyperplastic change was completely repaired after 4 weeks of recovery period. Ki-67 expression was similar in all groups, with no statistically significant differences among the groups. Caspase-3 expression was significantly increased in both sexes in the 3,000 mg/kg b.w./day treatment group (p<0.01), compared with the vehicle control groups, and then reduced to normal levels in the recovery groups in both sexes. In conclusion, this study showed that squamous cell hyperplasia induced by the Platycodi radix water extract in the limiting ridge of the stomach is not considered to be abnormal proliferative change; as a result, squamous cell hyperplasia is considered to be a non-adverse effect when induced by the oral administration of the Platycodi radix water extract once daily for 13 weeks in rats.

Current status on synthesis, properties and applications of CsPbX3(X = Cl, Br, I) perovskite quantum dots/nanocrystals.

The quantum confinement effect and interesting optical properties of cesium lead halide (CsPbX3; X = Cl, Br, I) perovskite quantum dots (QDs) and nanocrystals (NCs) have given a new horizon to lighting and photonic applications. Given the exponential rate at which scientific results on CsPbX3NCs are published in the last few years, it can be expected that the research in CsPbX3NCs will further receive increasing scientific interests in the near future and possibly lead to great commercial opportunities to realize these materials based practical applications. With the rapid progress in the single-photon emitting CsPbX3QDs and NCs, practical applications of the quantum technologies such as single-photon emitting light-emitting diode, quantum lasers, quantum computing might soon be possible. But to reach at cutting edge of stable perovskite QDs/NCs, the study of fundamental insight and theoretical aspects of crystal design is yet insufficient. Even more, it has aroused many unanswered questions related to the stability, optical and electronic properties of the CsPbX3QDs. Aim of the present review is to illustrate didactically a precise study of recent progress in the synthesis, properties and applications of CsPbX3QDs and NCs. Critical issues that currently restrict the applicability of these QDs will be identified and advanced methodologies currently in the developing queue, to overcome the roadblock, will be presented. And finally, the prospects for future directions will be provided.

A 13-week subchronic toxicity study of a Dioscorea Rhizome water extract in rats.

Dioscorea Rhizome is widely used as a traditional herbal medicine to treat asthma, diarrhea, cough, bronchitis, spermatorrhea, leukorrhea, and rheumatoid arthritis. This study investigated the potential subchronic toxicity of a D. Rhizome water extract (DRWE) after repeated oral administration at 0, 800, 2000, and 5000 mg/kg/day in rats for 13 weeks. During the study period, clinical signs, mortality, body weight, food consumption, water consumption, urinalysis, ophthalmoscopy, hematology, serum biochemistry, gross pathology, organ weights, and histopathology were examined. The 13-week repeated oral administration of DRWE to rats resulted in an increased incidence of zona glomerulosa hypertrophy and hyperplasia in the adrenal gland at dose levels of ≥2000 mg/kg/day in both sexes. However, these findings are considered as non-adverse adaptive changes because of minimal histological changes in the lesions, which were not accompanied by any corresponding alterations in serum electrolytes and adrenal gland weight. No treatment-related adverse effects on clinical signs, body weight, food and water consumption, ophthalmic examination, urinalysis, hematology, serum biochemistry, necropsy findings, and organ weights were observed at any dose tested. Under the present experimental conditions, the no-observed-adverse-effect level of the DRWE was considered to be 5000 mg/kg/day in both sexes, and no target organs were identified.

Evaluation of the dosimetric effect of scattered protons in clinical practice in passive scattering proton therapy.

The present study verified and evaluated the dosimetric effects of protons scattered from a snout and an aperture in clinical practice, when a range compensator was included. The dose distribution calculated by a treatment planning system (TPS) was compared with the measured dose distribution and the dose distribution calculated by Monte Carlo simulation at several depths. The difference between the measured and calculated results was analyzed using Monte Carlo simulation with filtration of scattering in the snout and aperture. The dependence of the effects of scattered protons on snout size, beam range, and minimum thickness of the range compensator was also investigated using the Monte Carlo simulation. The simulated and measured results showed that the additional dose compared with the results calculated by the TPS at shallow depths was mainly due to protons scattered by the snout and aperture. This additional dose was filtered by the structure of the range compensator so that it was observed under the thin region of the range compensator. The maximum difference was measured at a depth of 16 mm (8.25%), with the difference decreasing with depth. Analysis of protons contributing to the additional dose showed that the contribution of protons scattered from the snout was greater than that of protons scattered from the aperture when a narrow snout was used. In the Monte Carlo simulation, this effect of scattered protons was reduced when wider snouts and longer-range proton beams were used. This effect was also reduced when thicker range compensator bases were used, even with a narrow snout. This study verified the effect of scattered protons even when a range compensator was included and emphasized the importance of snout-scattered protons when a narrow snout is used for small fields. It indicated that this additional dose can be reduced by wider snouts, longer range proton beams, and thicker range compensator bases. These results provide a better understanding of the additional dose from scattered protons in clinical practice.

Microwave hydrothermal synthesis and upconversion properties of BiVO4 nanoparticles.

Nanomaterials are the subject of extensive investigations due to their applications in medicine, multimodal imaging, volumetric displays, and photonics. Here, lanthanide-doped bismuth vanadate (BiVO4) upconverting nanoparticles (UCNPs) have been reported. The nanoparticles have been synthesized by a microwave hydrothermal method. As-synthesized nanoparticles are highly crystalline in the tetragonal zircon phase with particles about 200 nm in size. Under 980 nm excitation, intense multicolor visible and near-infrared upconversion emissions are observed. Moreover, broadband infrared downshifting emissions are also observed. Time-resolved emission measurements have been carried out to investigate the involved upconversion and energy transfer mechanism. The BiVO4-based UCNPs may provide a new class of nanomaterials for multifunctional applications.

Facial expression monitoring system for predicting patient's sudden movement during radiotherapy using deep learning.

PURPOSE: Imaging, breath-holding/gating, and fixation devices have been developed to minimize setup errors so that the prescribed dose can be exactly delivered to the target volume in radiotherapy. Despite these efforts, additional patient monitoring devices have been installed in the treatment room to view patients' whole-body movement. We developed a facial expression recognition system using deep learning with a convolutional neural network (CNN) to predict patients' advanced movement, enhancing the stability of the radiation treatment by giving warning signs to radiation therapists. MATERIALS AND METHODS: Convolutional neural network model and extended Cohn-Kanade datasets with 447 facial expressions of source images for training were used. Additionally, a user interface that can be used in the treatment control room was developed to monitor real-time patient's facial expression in the treatment room, and the entire system was constructed by installing a camera in the treatment room. To predict the possibility of patients' sudden movement, we categorized facial expressions into two groups: (a) uncomfortable expressions and (b) comfortable expressions. We assumed that the warning sign about the sudden movement was given when the uncomfortable expression was recognized. RESULTS: We have constructed the facial expression monitoring system, and the training and test accuracy were 100% and 85.6%, respectively. In 10 patients, their emotions were recognized based on their comfortable and uncomfortable expressions with 100% detection rate. The detected various emotions were represented by a heatmap and motion prediction accuracy was analyzed for each patient. CONCLUSION: We developed a system that monitors the patient's facial expressions and predicts patient's advanced movement during the treatment. It was confirmed that our patient monitoring system can be complementarily used with the existing monitoring system. This system will help in maintaining the initial setup and improving the accuracy of radiotherapy for the patients using deep learning in radiotherapy.

Microwave hydrothermal synthesis and upconversion properties of Yb3+/Er3+ doped YVO4 nanoparticles.

Yb3+ and Er3+ doped YVO4 (Yb3+/Er3+:YVO4) nanoparticles with highly efficient near-infrared to visible upconversion properties have been synthesized by microwave hydrothermal process. Uniform-sized Yb3+/Er3+:YVO4 nanoparticles were synthesized within 1 h at 140 °C which is relatively faster than the conventional hydrothermal process. Under 980 nm laser excitation, strong green and less strong red emissions are observed which are attributed to 2H11/2, 4S3/2 to 4I15/2 and 4F9/2 to 4I15/2 transitions of Er3+ respectively. The emission intensity is found to depend strongly on the concentration of Yb3+. The quadratic dependence of upconversion intensity on the excitation power indicates that the upconversion process is governed by two-photon absorption process.

Revisiting Degrees of Freedom of Full-Duplex Systems with Opportunistic Transmission: An Improved User Scaling Law.

It was recently studied how to achieve the optimal degrees of freedom (DoF) in a multi-antenna full-duplex system with partial channel state information (CSI). In this paper, we revisit the DoF of a multiple-antenna full-duplex system using opportunistic transmission under the partial CSI, in which a full-duplex base station having M transmit antennas and M receive antennas supports a set of half-duplex mobile stations (MSs) having a single antenna each. Assuming no self-interference, we present a new hybrid opportunistic scheduling method that achieves the optimal sum DoF under an improved user scaling law. Unlike the state-of-the-art scheduling method, our method is designed in the sense that the scheduling role between downlink MSs and uplink MSs is well-balanced. It is shown that the optimal sum DoF of 2 M is asymptotically achievable provided that the number of MSs scales faster than SNR M , where SNR denotes the signal-to-noise ratio. This result reveals that, in our full-duplex system, better performance on the user scaling law can be obtained without extra CSI, compared to the prior work that showed the required user scaling condition (i.e., the minimum number of MSs for guaranteeing the optimal DoF) of SNR 2 M - 1 . Moreover, the average interference decaying rate is analyzed. Numerical evaluation is performed to not only validate our analysis but also show superiority of the proposed method over the state-of-the-art method.

The Hot-Water Extract of Smilacis Chinae Rhizome Suppresses 2,4-Dinitrochlorobenzene and House Dust Mite-Induced Atopic Dermatitis-Like Skin Lesions in Mice.

Smilacis Chinae Rhizome (SCR) has been used as an oriental folk medicine for various biological activities. However, its effect on atopic dermatitis (AD) remains undetermined to date. We assessed the effect of orally administered hot-water extract of SCR on AD-like skin lesions in mice and its underlying mechanisms. AD-like murine model was prepared by repeated alternate application of house dust mite (Dermatophagoides farinae) extract (DFE) and 2,4-dinitrochlorobenzene (DNCB) for 4 weeks, topically to the ears. Daily oral administration of SCR for 3 and 4 weeks significantly reduced inflammatory ear thickening, with the effect being enhanced at the earlier start and longer period of administration. This effect was accompanied by a significant decrease in both Th2 and Th1 serum antibodies (total IgE, DFE-specific IgE, and IgG2a). Histological analysis showed that SCR markedly decreased the epidermal/dermal ear thickening and the dermal infiltration of inflammatory cells. Furthermore, SCR suppressed DFE/DNCB-induced expression of IL-4, IL-13, IL-17, IL-18, TSLP, and IFN-γ genes in the ear tissue. Taken together, our observations demonstrate that chronic oral administration of SCR exerts beneficial effect in mouse AD model, suggesting that SCR has the therapeutic potential as an orally active treatment of AD by modulating both Th1 and Th2 responses.

Safety studies on intravenous infusion of a potent angiogenesis inhibitor: taurocholate-conjugated low molecular weight heparin derivative LHT7 in preclinical models.

CONTEXT: As a class of angiogenesis inhibitors, heparin conjugates have shown significant effectiveness in several studies. OBJECTIVES: The purpose of our current study is to evaluate the effectiveness and safety of infusing the conjugate of low molecular weight heparin and taurocholate (LHT7), which has been developed as a potent angiogenesis inhibitor. METHODS: To evaluate its safety, the method of intravenous infusion was compared with its i.v. bolus administration. Intravenous infusion was administered at a rate of 400 µl/min/kg of body weight for 30 min. Pharmacokinetic (PK) analysis, organ accumulation, and plasma concentration profiles of LHT7 were measured. The anticancer effect of LHT7 was evaluated in murine and human xenograft models, and preclinical studies were performed in SD rats and beagle dogs. RESULTS: The results of the PK studies showed reduced organ accumulation in mice and the AUC(0-96 h) (area under the curve) was increased up to 1485 ± 125 h × µg/ml. The efficacy, at dose 1 mg/kg/2 d was higher for i.v. infusion than for i.v. bolus administration in both murine and human cancer models. The preclinical studies showed the safety dose of LHT7 is less than 20 mg/kg in SD rats and in the next safety analysis in beagle dogs showed that there were no organ-specific adverse effects in higher doses, such as, 12 mg/kg. LHT7 showed sustained effects with minimized adverse events when administered through i.v. infusion. CONCLUSIONS: LHT7 (i.v. infusion) could be safely used for further clinical development as a multi-targeting anti-angiogenic agent.

Range shift verification in spot scanning proton therapy using gamma electron vertex imaging.

BACKGROUND: In proton therapy, a highly steep distal dose penumbra can be utilized for dose conformity, given the Bragg peak characteristic of protons. However, the location of the Bragg peak in patients (i.e., the beam range) is very sensitive to range uncertainty. Even a small shift of beam range can produce a significant variation of delivered dose to tumor and normal tissues, thus degrading treatment quality and threatening patient safety. This range uncertainty issue, therefore, is one of the important aspects to be managed in proton therapy. PURPOSE: For better management of range uncertainty, range verification has been widely studied, and prompt gamma imaging (PGI) is considered one of the promising methods in that effort. In this context, a PGI system named the gamma electron vertex imaging (GEVI) system was developed and recently upgraded for application to pencil-beam scanning (PBS) proton therapy. Here, we report the first experimental results using the therapeutic spot scanning proton beams. METHODS: A homogeneous slab phantom and an anthropomorphic phantom were employed. Spherical and cubic planning target volumes (PTVs) were defined. Various range shift scenarios were introduced. Prompt gamma (PG) measurement was synchronized with beam irradiation. The measured PG distributions were aggregated to improve the PG statistics. The range shift was estimated based on the relative change of the centroid in the measured PG distribution. The estimated range shifts were analyzed by range shift mapping, confidence interval (CI) estimation, and statistical hypothesis testing. RESULTS: The range shift mapping results showed an obvious measured range shift tendency following the true shift values. However, some fluctuations were found for spots that had still-low PG statistics after spot aggregation. The 99% CI distributions showed clearly distributed range shift measurement data. The overall accuracy and precision for all investigated scenarios were 0.36 and 0.20 mm, respectively. The results of one-sample t-tests confirmed that every shift scenario could be observed up to 1 mm of shift. The ANOVA results proved that the measured range shift data could be discriminated from one another, except for 16 (of 138) comparison cases having 1-2 mm shift differences. CONCLUSIONS: This study demonstrated the feasibility of the GEVI system for measurement of range shift in spot scanning proton therapy. Our experimental results showed that the proton beam can be measured up to 1 mm of range shift with high accuracy and precision. We believe that the GEVI system is one of the most promising PGI systems for in vivo range verification. Further research for application to more various cases and patient treatments is planned.

Feasibility study for the development of multilayered solar cells for proton linear energy transfer depth profile measurement.

BACKGROUND: Previous study proposed a method to measure linear energy transfer (LET) at specific points using the quenching magnitude of thin film solar cells. This study was conducted to propose a more advanced method for measuring the LET distribution. PURPOSE: This study focuses on evaluating the feasibility of estimating the proton LET distribution in proton therapy. The feasibility of measuring the proton LET and dose distribution simultaneously using a single-channel configuration comprising two solar cells with distinct quenching constants is investigated with the objective of paving the way for enhanced proton therapy dosimetry. METHODS: Two solar cells with different quenching constants were used to estimate the proton LET distribution. Detector characteristics (e.g., dose linearity and dose-rate dependency) of the solar cells were evaluated to assess their suitability for dosimetry applications. First, using a reference beam condition, the quenching constants of the two solar cells were determined according to the modified Birks equation. The signal ratios of the two solar cells were then evaluated according to proton LET in relation to the estimated quenching constants. The proton LET distributions of six test beams were obtained by measuring the signal ratios of the two solar cells at each depth, and the ratios were evaluated by comparing them with those calculated by Monte Carlo simulation. RESULTS: The detector characterization of the two solar cells including dose linearity and dose-rate dependence affirmed their suitability for use in dosimetry applications. The maximum difference between the LET measured using the two solar cells and that calculated by Monte Carlo simulation was 2.34 keV/µm. In the case of the dose distribution measured using the method proposed in this study, the maximum difference between range measured using the proposed method and that measured using a multilayered ionization chamber was 0.7 mm. The expected accuracy of simultaneous LET and dose distribution measurement using the method proposed in this study were estimated to be 3.82%. The signal ratios of the two solar cells, which are related to quenching constants, demonstrated the feasibility of measuring LET and dose distribution simultaneously. CONCLUSION: The feasibility of measuring proton LET and dose distribution simultaneously using two solar cells with different quenching constants was demonstrated. Although the method proposed in this study was evaluated using a single channel by varying the measuring depth, the results suggest that the proton LET and dose distribution can be simultaneously measured if the detector is configured in a multichannel form. We believe that the results presented in this study provide the envisioned transition to a multichannel configuration, with the promise of substantially advancing proton therapy's accuracy and efficacy in cancer treatment.

A spontaneous epithelial-myoepithelial carcinoma of the submandibular gland in a sprague-dawley rat.

The present report describes a rare case of spontaneous tumor of the salivary gland in a male Sprague-Dawley rat. The clinically confirmed mass rapidly developed in the cervical region between 19 and 21 weeks of age, and the animal was subsequently euthanized. At necropsy, a well-circumscribed nodule approximately 7 × 6 cm in diameter was found at the site of the salivary gland. The cut surface of the nodule was lobulated and soft and had a pinkish tan fish-flesh appearance. One large cyst (approximately 3 × 2 cm in size) containing reddish fluid was also present in the nodule. Histopathologically, the tumor, with a partially lobulated structure, was surrounded by a thin fibrous capsule. The majority of tumor cells formed a diffuse solid sheet structure that mainly consisted of small ovoid or spindle-shaped cells. In the tumor periphery, some cells were arranged in nest-like structures. Small duct-like structures lined with a monolayer of cuboidal epithelial cells resembling an intercalated duct or large polygonal clear cells with a myoepithelial component were also observed. Mitotic figures and necrotic foci were frequently observed in solid areas. Immunohistochemically, the tumor cells were positive for cytokeratin, epithelial membrane antigen, vimentin, p63, α-smooth muscle actin and calponin. The cells were negative for calcitonin, synaptophysin and chromogranin A. On the basis of these findings, the tumor was diagnosed as an epithelial-myoepithelial carcinoma originating from the luminal epithelial cells and myoepithelial cells in the submandibular gland.

Flexible real-time skin dosimeter based on a thin-film copper indium gallium selenide solar cell for electron radiation therapy.

PURPOSE: Various dosimeters have been proposed for skin dosimetry in electron radiotherapy. However, one main drawback of these skin dosimeters is their lack of flexibility, which could make accurate dose measurements challenging due to air gaps between a curved patient surface and dosimeter. Therefore, the purpose of this study is to suggest a novel flexible skin dosimeter based on a thin-film copper indium gallium selenide (CIGS) solar cell, and to evaluate its dosimetric characteristics. METHODS: The CIGS solar cell dosimeter consisted of (a) a customized thin-film CIGS solar cell and (b) a data acquisition (DAQ) system. The CIGS solar cell with a thickness of 0.33 mm was customized to a size of 10 × 10 mm2 . This customized solar cell plays a role in converting therapeutic electron radiation into electrical signals. The DAQ system was composed of a voltage amplifier with a gain of 1000, a voltage input module, a DAQ chassis, and an in-house software. This system converted the electrical analog signals (from solar cell) to digital signals with a sampling rate of ≤50 kHz and then quantified/visualized the digital signals in real time. We quantified the linearity/ sampling rate effect/dose rate dependence/energy dependence/field size output factor/reproducibility/curvature/bending recoverability/angular dependence of the CIGS solar cell dosimeter in therapeutic electron beams. To evaluate clinical feasibility, we measured the skin point doses by attaching the CIGS solar cell to an anthropomorphic phantom surface (for forehead, mouth, and thorax). The CIGS-measured doses were compared with calculated doses (by treatment planning system) and measured doses (by optically stimulated luminescent dosimeter). RESULTS: The normalized signals of the solar cell dosimeter increased linearly as the delivered dose increased. The gradient of the linearly fitted line was 1.00 with an R-square of 0.9999. The sampling rates (2, 10, and 50 kHz) of the solar cell dosimeter showed good performance even at low doses (<50 cGy). The solar cell dosimeter exhibited dose rate independence within 1% and energy independence within 3% error margins. The signals of the solar cell dosimeter were similar (<1%) when penetrating the same side of the CIGS cell regardless of the rotation angle of the solar cell. The field size output factor measured by the solar cell dosimeter was comparable to that measured by the ion chamber. The solar cell signals were similar between the baseline (week 1) and the last time point (week 4). Our detector showed curvature independence within 1.8% (curvatures of <0.10 mm- ) and bending recovery (curvature of 0.10 mm-1 ). The differences between measured doses (CIGS solar cell dosimeter vs. optically stimulated luminescent dosimeter) were 7.1%, 9.6%, and 1.0% for forehead, mouth, and thorax, respectively. CONCLUSION: We present the construction of a flexible skin dosimeter based on a CIGS solar cell. Our findings demonstrate that the CIGS solar cell has a potential to be a novel flexible skin dosimeter for electron radiotherapy. Moreover, this dosimeter is manufactured with low cost and can be easily customized to various size/shape, which represents advantages over other dosimeters.

Feature Importance Analysis of a Deep Learning Model for Predicting Late Bladder Toxicity Occurrence in Uterine Cervical Cancer Patients.

(1) In this study, we developed a deep learning (DL) model that can be used to predict late bladder toxicity. (2) We collected data obtained from 281 uterine cervical cancer patients who underwent definitive radiation therapy. The DL model was trained using 16 features, including patient, tumor, treatment, and dose parameters, and its performance was compared with that of a multivariable logistic regression model using the following metrics: accuracy, prediction, recall, F1-score, and area under the receiver operating characteristic curve (AUROC). In addition, permutation feature importance was calculated to interpret the DL model for each feature, and the lightweight DL model was designed to focus on the top five important features. (3) The DL model outperformed the multivariable logistic regression model on our dataset. It achieved an F1-score of 0.76 and an AUROC of 0.81, while the corresponding values for the multivariable logistic regression were 0.14 and 0.43, respectively. The DL model identified the doses for the most exposed 2 cc volume of the bladder (BD2cc) as the most important feature, followed by BD5cc and the ICRU bladder point. In the case of the lightweight DL model, the F-score and AUROC were 0.90 and 0.91, respectively. (4) The DL models exhibited superior performance in predicting late bladder toxicity compared with the statistical method. Through the interpretation of the model, it further emphasized its potential for improving patient outcomes and minimizing treatment-related complications with a high level of reliability.

Determination of the proton LET using thin film solar cells coated with scintillating powder.

PURPOSE: The amount of luminescent light detected in a scintillator is reduced with increased proton linear energy transfer (LET) despite receiving the same proton dose, through a phenomenon called quenching. This study evaluated the ability of a solar cell coated with scintillating powder (SC-SP) to measure therapeutic proton LET by measuring the quenching effect of the scintillating powder using a solar cell while simultaneously measuring the dose of the proton beam. METHODS: SC-SP was composed of a flexible thin film solar cell and scintillating powder. The LET and dose of the pristine Bragg peak in the 14 cm range were calculated using a validated Monte Carlo model of a double scattering proton beam nozzle. The SC-SP was evaluated by measuring the proton beam under the same conditions at specific depths using SC-SP and Markus chamber. Finally, the 10 and 20 cm range pristine Bragg peaks and 5 cm spread-out Bragg peak (SOBP) in the 14 cm range were measured using the SC-SP and the Markus chamber. LETs measured using the SC-SP were compared with those calculated using Monte Carlo simulations. RESULTS: The quenching factors of the SC-SP and solar cell alone, which were slopes of linear fit obtained from quenching correction factors according to LET, were 0.027 and 0.070 µm/keV (R2 : 0.974 and 0.975). For pristine Bragg peaks in the 10 and 20 cm ranges, the maximum differences between LETs measured using the SC-SP and calculated using Monte Carlo simulations were 0.5 keV/µm (15.7%) and 1.2 keV/µm (12.0%), respectively. For a 5 cm SOBP proton beam, the LET measured using the SC-SP and calculated using Monte Carlo simulations differed by up to 1.9 keV/µm (18.7%). CONCLUSIONS: Comparisons of LETs for pristine Bragg peaks and SOBP between measured using the SC-SP and calculated using Monte Carlo simulations indicated that the solar cell-based system could simultaneously measure both LET and dose in real-time and is cost-effective.

Development of a real-time in vivo dosimetry tool for electron beam therapy using a flexible thin film solar cell coated with scintillator powder.

PURPOSE: A real-time solar cell based in vivo dosimetry system (SC-IVD) was developed using a flexible thin film solar cell and scintillating powder. The present study evaluated the clinical feasibility of the SC-IVD in electron beam therapy. METHODS: A thin film solar cell was coated with 100 mg of scintillating powder using an optical adhesive to enhance the sensitivity of the SC-IVD. Calibration factors were obtained by dividing the dose, measured at a reference depth for 6-20 MeV electron beam energy, by the signal obtained using the SC-IVD. Dosimetric characteristics of SC-IVDs containing variable quantities of scintillating powder (0-500 mg) were evaluated, including energy, dose rate, and beam angle dependencies, as well as dose linearity. To determine the extent to which the SC-IVD affected the dose to the medium, doses at R90 were compared depending on whether the SC-IVD was on the surface. Finally, the accuracy of surface doses measured using the SC-IVD was evaluated by comparison with surface doses measured using a Markus chamber. RESULTS: Charge measured using the SC-IVD increased linearly with dose and was within 1% of the average signal according to the dose rate. The signal generated by the SC-IVD increased as the beam angle increased. The presence of the SC-IVD on the surface of a phantom resulted in a 0.5%-2.2% reduction in dose at R90 for 6-20 MeV electron beams compared with the bare phantom. Surface doses measured using the SC-IVD system and Markus chamber differed by less than 5%. CONCLUSIONS: The dosimetric characteristics of the SC-IVD were evaluated in this study. The results showed that it accurately measured the surface dose without a significant difference of dose in the medium when compared with the Markus chamber. The flexibility of the SC-IVD allows it to be attached to a patient's skin, enabling real-time and cost-effective measurement.