RESUMEN
A system for automated quality assurance in radiotherapy of a therapist's registration was designed and tested in clinical practice. The approach compliments the clinical software's automated registration in terms of algorithm configuration and performance, and constitutes a practical approach for ensuring safe patient setups. Per our convergence analysis, evolutionary algorithms perform better in finding the global optima of the cost function with discrepancies from a deterministic optimizer seen sporadically.
Asunto(s)
Posicionamiento del Paciente/métodos , Planificación de la Radioterapia Asistida por Computador/métodos , Radioterapia Guiada por Imagen/métodos , Algoritmos , Humanos , Posicionamiento del Paciente/normas , Posicionamiento del Paciente/estadística & datos numéricos , Garantía de la Calidad de Atención de Salud , Planificación de la Radioterapia Asistida por Computador/normas , Planificación de la Radioterapia Asistida por Computador/estadística & datos numéricos , Radioterapia Guiada por Imagen/estadística & datos numéricos , Programas InformáticosRESUMEN
BACKGROUND: The standard of care for glioblastoma (GBM) is maximal safe resection followed by radiation therapy with chemotherapy. Currently, contrast-enhanced MRI is used to define primary treatment volumes for surgery and radiation therapy. However, enhancement does not identify the tumor entirely, resulting in limited local control. Proton spectroscopic MRI (sMRI), a method reporting endogenous metabolism, may better define the tumor margin. Here, we develop a whole-brain sMRI pipeline and validate sMRI metrics with quantitative measures of tumor infiltration. METHODS: Whole-brain sMRI metabolite maps were coregistered with surgical planning MRI and imported into a neuronavigation system to guide tissue sampling in GBM patients receiving 5-aminolevulinic acid fluorescence-guided surgery. Samples were collected from regions with metabolic abnormalities in a biopsy-like fashion before bulk resection. Tissue fluorescence was measured ex vivo using a hand-held spectrometer. Tissue samples were immunostained for Sox2 and analyzed to quantify the density of staining cells using a novel digital pathology image analysis tool. Correlations among sMRI markers, Sox2 density, and ex vivo fluorescence were evaluated. RESULTS: Spectroscopic MRI biomarkers exhibit significant correlations with Sox2-positive cell density and ex vivo fluorescence. The choline to N-acetylaspartate ratio showed significant associations with each quantitative marker (Pearson's ρ = 0.82, P < .001 and ρ = 0.36, P < .0001, respectively). Clinically, sMRI metabolic abnormalities predated contrast enhancement at sites of tumor recurrence and exhibited an inverse relationship with progression-free survival. CONCLUSIONS: As it identifies tumor infiltration and regions at high risk for recurrence, sMRI could complement conventional MRI to improve local control in GBM patients.
Asunto(s)
Ácido Aspártico/análogos & derivados , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patología , Colina/metabolismo , Glioblastoma/metabolismo , Glioblastoma/patología , Factores de Transcripción SOXB1/metabolismo , Ácido Aminolevulínico/administración & dosificación , Ácido Aspártico/metabolismo , Biomarcadores/metabolismo , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Encéfalo/patología , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Recuento de Células , Supervivencia sin Enfermedad , Glioblastoma/diagnóstico por imagen , Glioblastoma/cirugía , Humanos , Interpretación de Imagen Asistida por Computador , Imagen por Resonancia Magnética/métodos , Neuronavegación/métodos , Imagen Óptica/métodos , Fármacos Fotosensibilizantes/administración & dosificación , Espectroscopía de Protones por Resonancia Magnética/métodos , Factores de RiesgoRESUMEN
Standard-of-care therapy for glioblastomas, the most common and aggressive primary adult brain neoplasm, is maximal safe resection, followed by radiation and chemotherapy. Because maximizing resection may be beneficial for these patients, improving tumor extent of resection (EOR) with methods such as intraoperative 5-aminolevulinic acid fluorescence-guided surgery (FGS) is currently under evaluation. However, it is difficult to reproducibly judge EOR in these studies due to the lack of reliable tumor segmentation methods, especially for postoperative magnetic resonance imaging (MRI) scans. Therefore, a reliable, easily distributable segmentation method is needed to permit valid comparison, especially across multiple sites. We report a segmentation method that combines versatile region-of-interest blob generation with automated clustering methods. We applied this to glioblastoma cases undergoing FGS and matched controls to illustrate the method's reliability and accuracy. Agreement and interrater variability between segmentations were assessed using the concordance correlation coefficient, and spatial accuracy was determined using the Dice similarity index and mean Euclidean distance. Fuzzy C-means clustering with three classes was the best performing method, generating volumes with high agreement with manual contouring and high interrater agreement preoperatively and postoperatively. The proposed segmentation method allows tumor volume measurements of contrast-enhanced T 1-weighted images in the unbiased, reproducible fashion necessary for quantifying EOR in multicenter trials.
RESUMEN
We offer here evidence for halogen bonding induced by silver nanoparticles (SNPs) in a multilayer containing 4-iodobenzoate ion (4IBI) and CCl(4). SERS experiments show in the monolayer that CCl(4) does not adsorb and 4-iodobenzoic acid (4IBA) adsorbs as 4IBI. SEIRA experiments reveal that 4IBI forms in the multilayer during deposition from CCl(4) on SNPs. Further infrared experiments on clean BaF(2) prove that 4IBI formation caused by underlying SNPs was necessary for CCl(4) inclusion in a 4IBI multilayer. Several potential scenarios involving intermolecular attraction between CCl(4) and 4IBI are proposed to explain the results. Although halogen bonding involving solvents has been theoretically and experimentally demonstrated in solution phase chemistry, in bulk crystals, and at the monolayer level, here it is shown that halogen bonding interactions can also be significant in multilayer films. Results from this work will likely impact a range of applications across diverse fields where halogen bonding in thin films and nucleation chemistry are important.
RESUMEN
SEIRA, SERS, TPD and DFT were used to study 4-nitrophenol (4NP), 3-nitrophenol (3NP) and 2-nitrophenol (2NP) adsorption on nanoscale silver films/powder. SERS and DFT demonstrated that 4NP adsorbed as the 4-nitrophenolate ion. SEIRA results revealed that a 4NP multilayer condensed differently using deposition solvents with and without polar bonds. 3NP and 2NP adsorption were not altered by the polar properties of the solvent. The nanoscale properties of the silver films/powder were shown to impact how the polar properties of the deposition solvent altered nitrophenol adsorption. In the SEIRA spectra of 4NP and 3NP a C=O stretch was observed above 1700cm(-1) using a highly volatile n-pentane deposition solvent. No other solvent yielded such a peak for 4NP or 3NP adsorption including n-heptane. 2NP had a C=O stretch regardless of deposition solvent. A C=O stretch confirmed nitrophenol ionization in the monolayer and pointed toward the significance of resonance in NP adsorption. 2NP never formed a multilayer at high exposures as demonstrated using TPD and SEIRA. Results of this work will have environmental implications and will aid biochemical and industrial applications where phenolic compounds are employed.