Evaluation of the IAEA-TRS 483 protocol for the dosimetry of small fields (square and stereotactic cones) using multiple detectors.

The IAEA TRS 483 protocol1 for the dosimetry of small static fields in radiotherapy was used to calculate output factors for the Elekta Synergy linac at the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). Small field output factors for both square and circular fields were measured using nine different detectors. The "corrected" output factors (ratio of detector readings multiplied by the appropriate correction factor from the protocol) showed better consistency compared to the "uncorrected" output factors (ratio of detector readings only), with the relative standard deviation decreasing by approximately 1% after the application of the relevant correction factors. Comparisons relative to an arbitrarily chosen PTW 60019 microDiamond detector showed a reduction of maximal variation for the corrected values of approximately 3%. A full uncertainty budget was prepared to analyze the consistency of the output factors. Agreement within uncertainties between all detectors and field sizes was found, except for the 15 mm circular field. The results of this study show that the application of IAEA TRS 4831 when measuring small fields will improve the consistency of small field measurements when using multiple detectors contained within the protocol.

Reversing the Effects of a Peripheral Nerve Block with Normal Saline: A Randomised Controlled Trial.

OBJECTIVE: The objective of the present study was to determine whether or not the effects of peripheral nerve block can be reversed by flushing normal saline down a peripheral nerve block catheter following the completion of arteriovenous (AV) fistula surgery. METHODS: In the present study, 38 patients undergoing AV fistula surgery were recruited, and a brachial plexus block with a peripheral nerve catheter was established. Following surgery, the patients were randomised to either the control group or the washout group, where 10 mL of normal saline was flushed down the peripheral nerve catheter at 15-minute intervals for 1 h while the patients were in the postoperative recovery room. An observer blinded to the patient group allocation assessed motor and sensory functions in all patients at 15-minute intervals for 1 h, and pain scores were recorded. RESULTS: There was no difference in time to resolution of motor or sensory block in the two groups. The median changes in the motor score were 1.5 out of 10 for the control group and 2 for the washout group (p=0.95). The median changes in the sensory score were 3 out of 10 for the control group and 1 for the washout group (p=0.14). There were no differences in pain scores over the study period in either group (p=0.44). CONCLUSION: We were unable to show any useful improvement in block resolution with normal saline washout of supraclavicular or infraclavicular brachial plexus blocks following AV fistula surgery.

Samarium doped titanium dioxide nanoparticles as theranostic agents in radiation therapy.

PURPOSE: Titanium dioxide nanoparticles (TiO2 NPs) have been investigated for their role as radiosensitisers for radiation therapy. The study aims to increase the efficiency of these NPs by synthesising them with samarium. METHODS: Samarium-doped TiO2 NPs (Ti(Sm)O2 NPs) were synthesised using a solvothermal method. Transmission electron microscopy (TEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDS) were performed for characterising of the Ti(Sm)O2 NPs. The intracellular uptake and cytotoxicity were assessed in vitro using A549 and DU145 cancer cell lines. Furthermore, the effect of dose enhancement and generation of reactive oxygen species (ROS) in response to 6 MV X-rays was evaluated. Additionally, the image contrast properties were investigated using computed tomography (CT) images. RESULTS: The synthesised Ti(Sm)O2 NPs were about 13 nm in diameter as determined by TEM. The XRD pattern of Ti(Sm)O2 NPs was consistent with that of anatase-type TiO2. EDS confirmed the presence of samarium in the nanoparticles. At 200 µg/ml concentration, no differences in cellular uptake and cytotoxicity were observed between TiO2 NPs and Ti(Sm)O2 NPs in both A549 and DU145 cells. However, the combination of Ti(Sm)O2 NPs and X-rays elicited higher cytotoxic effect and ROS generation in the cells than that with TiO2 NPs and X-rays. The CT numbers of Ti(Sm)O2 NPs were systematically higher than that of TiO2 NPs. CONCLUSIONS: The Ti(Sm)O2 NPs increased the dose enhancement of MV X-ray beams than that elicited by TiO2 NPs. Samarium improved the efficiency of TiO2 NPs as potential radiosensitising agent.

Application of the 'Spiking' method to the measurement of low dose radiation (≤ 1Gy) using alanine dosimeters.

Alanine dosimeters are limited in radiotherapy by poor sensitivity at low doses (< 5Gy). A set of alanine dosimeters were 'spiked' with a large dose of radiation, (~30Gy, 6MV X-rays) and additional doses ranging between 0.5 and 10Gy. The radical yield was measured by Electron Paramagnetic Resonance (EPR) spectroscopy, and after subtraction of the contribution from the "spike" dose, a linear correlation between the radiation dose and the area of the central EPR signal was obtained for doses between 0.5 and 10Gy (regression value of 0.9890), and for the central peak's amplitude (regression value of 0.9895). Overall, this method is easy to perform, requires no complex EPR signal analysis, and offers much potential to extend the current usage of alanine dosimeters in radiotherapy.

Synthesis and cytotoxic activity of N-[(alkylamino)alkyl]carboxamide derivatives of 7-oxo-7H-benz[de]anthracene, 7-oxo-7H-naphtho[1,2,3-de]quinoline, and 7-oxo-7H-benzo[e]perimidine.

7-Oxo-7H-naphtho[1,2,3-de]quinoline-11-carboxamides and analogues were prepared and evaluated for in vitro and in vivo antitumor activity. Chromophore variations included 'deaza' (7-oxo-7H-benz[de]anthracene) and 'diaza' (7-oxo-7H-benzo[e]perimidine) analogues, and side chain variations included chiral alpha-methyl compounds. The naphthoquinolines were the most cytotoxic, with IC(50) values of 5-20 nM, and showed the strongest DNA binding, with high selectivity for G-C rich DNA. The chiral alpha-methyl analogues were 10-20-fold more cytotoxic than the parent des-methyl compound. Both enantiomers provided substantial growth delays against s.c. colon 38 tumors in mice, with the R-enantiomer more active than the S (tumor growth delays of >35 and 12 days, respectively).