Estimation of lung tumor position from multiple anatomical features on 4D-CT using multiple regression analysis.

To estimate the lung tumor position from multiple anatomical features on four-dimensional computed tomography (4D-CT) data sets using single regression analysis (SRA) and multiple regression analysis (MRA) approach and evaluate an impact of the approach on internal target volume (ITV) for stereotactic body radiotherapy (SBRT) of the lung. Eleven consecutive lung cancer patients (12 cases) underwent 4D-CT scanning. The three-dimensional (3D) lung tumor motion exceeded 5 mm. The 3D tumor position and anatomical features, including lung volume, diaphragm, abdominal wall, and chest wall positions, were measured on 4D-CT images. The tumor position was estimated by SRA using each anatomical feature and MRA using all anatomical features. The difference between the actual and estimated tumor positions was defined as the root-mean-square error (RMSE). A standard partial regression coefficient for the MRA was evaluated. The 3D lung tumor position showed a high correlation with the lung volume (R = 0.92 ± 0.10). Additionally, ITVs derived from SRA and MRA approaches were compared with ITV derived from contouring gross tumor volumes on all 10 phases of the 4D-CT (conventional ITV). The RMSE of the SRA was within 3.7 mm in all directions. Also, the RMSE of the MRA was within 1.6 mm in all directions. The standard partial regression coefficient for the lung volume was the largest and had the most influence on the estimated tumor position. Compared with conventional ITV, average percentage decrease of ITV were 31.9% and 38.3% using SRA and MRA approaches, respectively. The estimation accuracy of lung tumor position was improved by the MRA approach, which provided smaller ITV than conventional ITV.

Difference in dose-volumetric data between the analytical anisotropic algorithm, the dose-to-medium, and the dose-to-water reporting modes of the Acuros XB for lung stereotactic body radiation therapy.

The purpose of this study was to evaluate the difference in dose-volumetric data between the analytical anisotropic algorithms (AAA) and the two dose reporting modes of the Acuros XB, namely, the dose to water (AXB_Dw) and dose to medium (AXB_Dm) in lung stereotactic body radiotherapy (SBRT). Thirty-eight plans were generated using the AXB_Dm in Eclipse Treatment Planning System (TPS) and then recalculated with the AXB_Dw and AAA, using identical beam setup. A dose of 50 Gy in 4 fractions was prescribed to the isocenter and the planning target volume (PTV) D95%. The isocenter was always inside the PTV. The following dose-volumetric parameters were evaluated; D2%, D50%, D95%, and D98% for the internal target volume (ITV) and the PTV. Two-tailed paired Student's t-tests determined the statistical significance. Although for most of the parameters evaluated, the mean differences observed between the AAA, AXB_Dm, and AXB_Dw were statistically significant (p < 0.05), absolute differences were rather small, in general less than 5% points. The maximum mean difference was observed in the ITV D50% between the AXB_Dm and the AAA and was 1.7% points under the isocenter prescription and 3.3% points under the D95 prescription. AXB_Dm produced higher values than AXB_Dw with differences ranging from 0.4 to 1.1% points under isocenter prescription and 0.0 to 0.7% points under the PTV D95% prescription. The differences observed under the PTV D95% prescription were larger compared to those observed for the isocenter prescription between AXB_Dm and AAA, AXB_Dm and AXB_Dw, and AXB_Dw and AAA. Although statistically significant, the mean differences between the three algorithms are within 3.3% points.

A novel antibody for human induced pluripotent stem cells and embryonic stem cells recognizes a type of keratan sulfate lacking oversulfated structures.

We have generated a monoclonal antibody (R-10G) specific to human induced pluripotent stem (hiPS)/embryonic stem (hES) cells by using hiPS cells (Tic) as an antigen, followed by differential screening of mouse hybridomas with hiPS and human embryonal carcinoma (hEC) cells. Upon western blotting with R-10G, hiPS/ES cell lysates gave a single but an unusually diffuse band at a position corresponding to >250 kDa. The antigen protein was isolated from the induced pluripotent stem (iPS) cell lysates with an affinity column of R-10G. The R-10G positive band was resistant to digestion with peptide N-glycanase F (PNGase F), neuraminidase, fucosidase, chondrotinase ABC and heparinase mix, but it disappeared almost completely on digestion with keratanase, keratanase II and endo-ß-galactosidase, indicating that the R-10G epitope is a keratan sulfate. The carrier protein of the R-10G epitope was identified as podocalyxin by liquid chromatography/mass spectrometry (LC/MS/MS) analysis of the R-10G positive-protein band material obtained on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The R-10G epitope is a type of keratan sulfate with some unique properties. (1) The epitope is expressed only on hiPS/ES cells, i.e. not on hEC cells, unlike those recognized by the conventional hiPS/ES marker antibodies. (2) The epitope is a type of keratan sulfate lacking oversulfated structures and is not immunologically cross-reactive with high-sulfated keratan sulfate. (3) The R-10G epitope is distributed heterogeneously on hiPS cells, suggesting that a single colony of undifferentiated hiPS cells consists of different cell subtypes. Thus, R-10G is a novel antibody recognizing hiPS/ES cells, and should be a new molecular probe for disclosing the roles of glycans on these cells.

Schistosoma mekongi and Schistosoma japonicum: Differences in the distribution of eggs in the viscera of mice.

The difference in the distribution of Schistosoma eggs in the viscera has not been clearly elucidated in the two closely related species Schistosoma japonicum and Schistosoma mekongi. In this study, we quantitatively compared the distribution of eggs in mice infected with the two species. In S. mekongi-infected mice, 56.6% to 69.4% of total eggs were found in the distal small intestine 9 to 15 weeks after infection, while in S. japonicum-infected mice, 48.8% to 71.8% of eggs were found in the proximal small intestine during the same period. There were significantly more eggs in the liver in mice infected with S. japonicum than in those infected with S. mekongi. The number of adult worms recovered did not differ between the two species during the study period. The total number of eggs laid in the tissues also did not differ between the two species at 12 to 15 weeks postinfection, but in the earlier period the total number of eggs was significantly fewer in S. mekongi-infected than in S. japonicum-infected mice, suggesting the delayed maturation of the former compared with the latter. These results clearly show that S. japonicum and S. mekongi exhibit different oviposition behavior in their hosts.

A rapid and simplified ELISA using whole blood samples of Schistosoma japonicum-infected rabbits.

A rapid and simplified ELISA using whole blood samples of Schistosoma japonicum-infected rabbits was compared with a conventional ELISA. This whole-blood ELISA has advantages. The volume of crude egg antigens, whole blood samples, and conjugates was only 0.05 ml. The incubation time was shortened to 5 minutes. Wells were washed three to five times with PBS-Tween after each procedure. Optical density values were measured in 10 minutes after transfer of 0.1 ml of substrate. Constant temperature was not necessary. The entire procedure took only 20-30 minutes.

Development of the rapid and simple elisa (whole blood-ELISA) using coconut water-tween as a wash solution for whole blood sample from Schistosoma japonicum-infected rabbit and human.

PBS-Tween as a wash solution, prepared with distilled water, is used in ELISA. In areas where schistosomiasis is endemic, however, distilled water is hard to come by. We have modified a WHOLE BLOOD-ELISA test to use coconut water-Tween as a wash solution, because coconut water is easy to come by and cheap in the tropics. We applied the test to whole blood samples from rabbits and humans infected with Schistosoma japonicum. This modified WHOLE BLOOD-ELISA was confirmed to be a rapid, simple, and cost-effective method.

Development of the rapid and simplified ELISA (WHOLE BLOOD-ELISA) using samples of Schistosoma japonicum-infected human whole blood.

An ELISA technique was developed using samples of Schistosoma japonicum-infected human whole blood based on the conventional ELISA. In this study, the following were demonstrated. 1) Whole blood samples could be used. 2) The volume of whole blood and conjugate could be reduced to 0.05 ml. 3) The incubation time was shortened to 5 minutes. 4) The optical density could be measured at 10 minutes after transferring the substrate and the volume was reduced to 0.1 ml. 5) It did not require a fixed temperature setting. 6) The operation time was as short as 20 to 30 minutes. 7) The optical density values were almost the same as the conventional ELISA and were not influenced by other common intestinal helminthic infections. 8) The observed variations from day to day including effects of sampling in stool examination were negated by the results of this ELISA technique. 9) Based on correlation with stool examination results, criteria can be formulated in which optical density values of 0.3 and above as positive, 0.1 to less than 0.3 as doubtful, and less than 0.1 as negative. Whenever an immunological field survey is necessary, before and after a selective or a mass treatment control program, this WHOLE BLOOD-ELISA, which was shown to be rapid and simple, is recommended.

Efficacy of administration of praziquantel on 2 days 2 weeks apart against Schistosoma japonicum eggs in mice.

We compared a group of mice given multiple oral doses of praziquantel (PZQ) on 1 day 7 weeks after infection with Schistosoma japonicum and another group given multiple doses of PZQ over 2 days (7 and 9 weeks after infection) by examining the number of schistosome eggs and oograms in their tissues and feces. In the 1-day-protocol group (4 x 100 mg/kg x 1 day), calcified dead eggs or shells accounted for 77.4 and 70.1% of the total EPG (the total number of immature eggs, mature eggs, and calcified eggs and shells per 1 g tissue) in the liver and small intestine, respectively, 11 weeks after infection. Shells accounted for nearly half of the total EPG (54.3% liver and 46.6% small intestine). Mature eggs accounted for 8.4% (liver) and 5.1% (small intestine) of the total EPG. Only shells were found in the feces. In the 2-day-protocol group (4 x 100 mg/kg x 2 days, 2 weeks apart), dead eggs accounted for 87.2 and 89.5% of the total EPG in the liver and small intestine, respectively, 11 weeks after infection. Shells accounted for 62.5% (liver) and 75.8% (small intestine) of the total EPG. In the 2-day group, mature eggs accounted for 0.9% (liver) and 0.6% (small intestine) of the total EPG. In liver and small intestine, the EPG of immature and mature eggs in the 2-day group was significantly smaller than in the 1-day group. Especially, the tendency was clear in the case of the EPG of mature eggs. There were no schistosome eggs in the feces of the 2-day group. We found that administration of PZQ over 2 days separated by a 2-week interval was effective against S. japonicum.

Multivariate analysis of factors predicting prostate dose in intensity-modulated radiotherapy.

We conducted a multivariate analysis to determine relationships between prostate radiation dose and the state of surrounding organs, including organ volumes and the internal angle of the levator ani muscle (LAM), based on cone-beam computed tomography (CBCT) images after bone matching. We analyzed 270 CBCT data sets from 30 consecutive patients receiving intensity-modulated radiation therapy for prostate cancer. With patients in the supine position on a couch with the HipFix system, data for center of mass (COM) displacement of the prostate and the state of individual organs were acquired and compared between planning CT and CBCT scans. Dose distributions were then recalculated based on CBCT images. The relative effects of factors on the variance in COM, dose covering 95% of the prostate volume (D95%), and percentage of prostate volume covered by the 100% isodose line (V100%) were evaluated by a backward stepwise multiple regression analysis. COM displacement in the anterior-posterior direction (COMAP) correlated significantly with the rectum volume (δVr) and the internal LAM angle (δθ; R = 0.63). Weak correlations were seen for COM in the left-right (R = 0.18) and superior-inferior directions (R = 0.31). Strong correlations between COMAP and prostate D95% and V100% were observed (R ≥ 0.69). Additionally, the change ratios in δVr and δθ remained as predictors of prostate D95% and V100%. This study shows statistically that maintaining the same rectum volume and LAM state for both the planning CT simulation and treatment is important to ensure the correct prostate dose in the supine position with bone matching.

Evaluation of different set-up error corrections on dose-volume metrics in prostate IMRT using CBCT images.

We investigated the effect of different set-up error corrections on dose-volume metrics in intensity-modulated radiotherapy (IMRT) for prostate cancer under different planning target volume (PTV) margin settings using cone-beam computed tomography (CBCT) images. A total of 30 consecutive patients who underwent IMRT for prostate cancer were retrospectively analysed, and 7-14 CBCT datasets were acquired per patient. Interfractional variations in dose-volume metrics were evaluated under six different set-up error corrections, including tattoo, bony anatomy, and four different target matching groups. Set-up errors were incorporated into planning the isocenter position, and dose distributions were recalculated on CBCT images. These processes were repeated under two different PTV margin settings. In the on-line bony anatomy matching groups, systematic error (∑) was 0.3 mm, 1.4 mm, and 0.3 mm in the left-right, anterior-posterior (AP), and superior-inferior directions, respectively. ∑ in three successive off-line target matchings was finally comparable with that in the on-line bony anatomy matching in the AP direction. Although doses to the rectum and bladder wall were reduced for a small PTV margin, averaged reductions in the volume receiving 100% of the prescription dose from planning were within 2.5% under all PTV margin settings for all correction groups, with the exception of the tattoo set-up error correction only (≥ 5.0%). Analysis of variance showed no significant difference between on-line bony anatomy matching and target matching. While variations between the planned and delivered doses were smallest when target matching was applied, the use of bony anatomy matching still ensured the planned doses.