Fetal dose assessment in a pregnant patient with brain tumor: A comparative study of proton PBS and 3DCRT/VMAT radiation therapy techniques.

PURPOSE: The treatment of brain tumors in pregnant patients poses challenges, as the out-of-field dose exposure to the fetus can potentially be harmful. A pregnant patient with prior radiation treatment was presented with a brain tumor at our clinic. This work reports on our pre-treatment study that compared fetal dose exposure between intensity-modulated proton therapy (IMPT) using pencil beam scanning (PBS) and conventional photon 3D conformal radiation therapy (3DCRT) and volumetric-modulated arc therapy (VMAT), and the subsequent pregnant patient's radiation treatment. MATERIALS AND METHODS: Pre-treatment measurements of clinical plans, 3DCRT, VMAT, and IMPT, were conducted on a phantom. Measurements were performed using a device capable of neutron detections, closely following AAPM guidelines, TG158. For photon measurements, fetus shielding was utilized. On patient treatment days, which was determined to be proton treatment, shielding was used only during daily imaging for patient setup. Additionally, an in vivo measurement was conducted on the patient. RESULTS: Measurements showed that IMPT delivered the lowest fetal dose, considering both photon and neutron out-of-field doses to the fetus, even when shielding was implemented for photon measurements. Additionally, the proton plans demonstrated superior treatment for the mother, a reirradiation case. CONCLUSION: The patient was treated with proton therapy, and the baby was subsequently delivered at full term with no complications. This case study supports previous clinical findings and advocates for the expanded use of proton therapy in this patient population.

In Vivo EPR Resolution Enhancement Using Techniques Known from Quantum Computing Spin Technology.

A crucial issue with in vivo biological/medical EPR is its low signal-to-noise ratio, giving rise to the low spectroscopic resolution. We propose quantum hyperpolarization techniques based on 'Heat Bath Algorithmic Cooling', allowing possible approaches for improving the resolution in magnetic resonance spectroscopy and imaging.

A novel approach for Venezia ovoid commissioning with a comprehensive analysis of source positions in high-dose-rate brachytherapy.

PURPOSE: The lunar design of a Venezia ovoid makes commissioning of the applicator very challenging with traditional autoradiography. In this study, we propose a novel solution to ovoid commissioning and a quality assurance (QA) workflow to effectively assess the entire source path. METHODS AND MATERIALS: A two-step commissioning process, using electron radiation and radiochromic films, was developed to verify the most distal source position. The ovoid was first attached to a film and was irradiated with a 12 MeV linac beam. This process was repeated on a separate, unexposed film, followed by irradiating it with a HDR source at the most distal position. Two lengths, including the ovoid thickness and the distance between the irradiated spot and the ovoid's outer surface, were obtained from the films' intensity maps. The offset value was calculated from the subtraction of the two measured lengths. Besides acquiring the offset, a source positional simulator (SPS) and a series of planar x-rays from two orthogonal orientations were used to characterize source movement within the ovoid. RESULTS: Compared to x-ray-based autoradiography, the electron exposure significantly improved the ovoid's visibility on film. Our approach did not use surrogate, which further improved measurement outcomes by decreasing inherent uncertainties. The SPS results suggested the source movement was complex within the cervicovaginal area, but it was predictable with the proposed QA workflow. CONCLUSION: We introduced a novel, surrogate-free method to commission the Venezia ovoid, which facilitated a manual applicator reconstruction. Additionally, we recommended QA multiple source positions to safely use the ovoid in clinical settings.

A synthetic two-spin quantum bit: g-engineered exchange-coupled biradical designed for controlled-NOT gate operations.

A quantum gate: A system of two coupled electron spins that is useful for simple quantum computing operations has been prepared by synthesis of a biradical 1 and co-crystallization with an isomorphous host molecule. The two weakly exchange-coupled quantum bits (target qubit blue and control qubit red) span four electron spin states. The electron spin transition is denoted by two black arrows.

Dosimetric effects of the Smit sleeve on high-dose-rate brachytherapy tandem and ovoids plans for patients with locally advanced cervical cancer.

PURPOSE: Smit sleeves are used to facilitate insertion of the intrauterine tandem during brachytherapy for cervical cancer. When a tandem and ovoids system is used the base of the Smit sleeve displaces the ovoids distally. The dosimetric impact of this displacement is not known. Herein we performed a dosimetric analysis to quantify this impact on the integral dose and dose delivered to the organs at risk (OARs). MATERIAL AND METHODS: Eleven high-dose-rate brachytherapy plans in which a Smit sleeve was used with a tandem and ovoids were reviewed. A second set of plans was generated modifying the position of the ovoids to simulate absence of the Smit sleeve. The high-risk clinical tumor volume (HR-CTV) dose coverage was maintained the same for both sets of plans by appropriately rescaling the dwell times of the simulated plan. The mean integral dose, D2cc to the OARs (bladder, bowel, sigmoid and rectum) and the ICRU rectum point dose were compared between the original and modified plans using a paired two-sample t-test. RESULTS: Simulating removal of the Smit sleeve was associated with an average reduction in the mean integral dose of 6.1% (p < 0.001) and an average reduction of 10.9% (p = 0.004) to the rectal D2cc. Doses to the remaining OARs decreased to a lesser magnitude with only that of the sigmoid being statistically significant. CONCLUSIONS: The use of a Smit sleeve with a tandem and ovoids system could lead to the delivery of a higher mean integral dose to achieve similar HR-CTV coverage. In addition, it could increase the dose to surrounding OARs, primarily the rectum. The clinical significance of these findings is unknown, but the potential dosimetric impact of using a Smit sleeve should be taken into consideration during the planning when this device is used.

Randomized benchmarking of quantum gates implemented by electron spin resonance.

Spin systems controlled and probed by magnetic resonance have been valuable for testing the ideas of quantum control and quantum error correction. This paper introduces an X-band pulsed electron spin resonance spectrometer designed for high-fidelity coherent control of electron spins, including a loop-gap resonator for sub-millimeter sized samples with a control bandwidth ∼40MHz. Universal control is achieved by a single-sideband upconversion technique with an I-Q modulator and a 1.2GS/s arbitrary waveform generator. A single qubit randomized benchmarking protocol quantifies the average errors of Clifford gates implemented by simple Gaussian pulses, using a sample of gamma-irradiated quartz. Improvements in unitary gate fidelity are achieved through phase transient correction and hardware optimization. A preparation pulse sequence that selects spin packets in a narrowed distribution of static fields confirms that inhomogeneous dephasing (1/T2(∗)) is the dominant source of gate error. The best average fidelity over the Clifford gates obtained here is 99.2%, which serves as a benchmark to compare with other technologies.