Dosimetric evaluation of iodine-125 brachytherapy for brain tumors using MR guidance combined with a three-dimensional non co-planar template.

PURPOSE: To investigate the consistency between preoperative and postoperative dosimetry when 125I brachytherapy for brain tumors is performed with magnetic resonance (MR) guidance and a three-dimensional non co-planar template (3DNPT). METHODS AND MATERIALS: Thirty patients with brain tumors (metastatic or gliomas) underwent radioactive 125I seed implantation. A preoperative treatment plan was determined with MR imaging, and the operation was done under 3DNPT assistance and MR guidance. The dosimetry was verified postoperatively based on postoperative CT-MR fusion images. Postoperative dosimetric parameters and implant quality indices were defined and compared with those in the preoperative treatment plan. Furthermore, a comparison of preoperative and postoperative doses to normal brain tissues and organs at risk was also performed. RESULTS: All mean postoperative dosimetries were calculated. Target coverage parameters D90, D100, %CTV100, %CTV150, and %CTV200 were 143.6 cGy, 76.6 cGy, 88.2%, 63.1%, and 41.4%, respectively. The values of implant quality indices CI, EI, and HI were 0.75, 0.14, and 0.28, respectively. No significant differences between most preoperative and postoperative dosimetric parameters were found (p > 0.05). The differences were also insignificant for organs at risk. Postoperative %CTV150 and %CTV200 were higher than the preoperative, whereas postoperative HI was significantly lower than in the treatment plan. CONCLUSIONS: Magnetic resonance guidance combined with 3DNPT allows accurate positioning and direction in 125I brachytherapy for brain tumors. However, seed distribution and dose homogeneity require further improvement.

Identification of Annexin A1 protein expression in human gastric adenocarcinoma using proteomics and tissue microarray.

AIM: To study the differential expression of Annexin A1 (ANXA1) protein in human gastric adenocarcinoma. This study was also designed to analyze the relationship between ANXA1 expression and the clinicopathological parameters of gastric carcinoma. METHODS: Purified gastric adenocarcinoma cells (GAC) and normal gastric epithelial cells (NGEC) were obtained from 15 patients with gastric cancer by laser capture microdissection. All of the peptide specimens were labeled as ¹8O/¹6O after trypsin digestion. Differential protein expressions were quantitatively identified between GAC and NGEC by nanoliter-reverse-phase liquid chromatography-mass/mass spectrometry (nano-RPLC-MS/MS). The expressions of ANXA1 in GAC and NGEC were verified by western blot analysis. The tissue microarray containing the expressed ANXA1 in 75 pairs of gastric carcinoma and paracarcinoma specimens was detected by immunohistochemistry (IHC). The relationship between ANXA1 expression and clinicopathological parametes of gastric carcinoma was analyzed. RESULTS: A total of 78 differential proteins were identified. Western blotting revealed that ANXA1 expression was significantly upregulated in GAC (2.17/1, P < 0.01). IHC results showed the correlations between ANXA1 protein expression and the clinicopathological parameters, including invasive depth (T stage), lymph node metastasis (N stage), distant metastasis (M stage) and tumour-lymph node metastasis stage (P < 0.01). However, the correlations between ANXA1 protein expression and the remaining clinicopathological parameters, including sex, age, histological differentiation and the size of tumour were not found (P > 0.05). CONCLUSION: The upregulated ANXA1 expression may be associated with carcinogenesis, progression, invasion and metastasis of GAC. This protein could be considered as a biomarker of clinical prognostic prediction and targeted therapy of GAC.