Verification of rebuild-up effect on superficial cardiac lesion of ventricular tachycardia using 3-D printed phantom in volumetric-modulated arc therapy planning.

The aim of the study was to evaluate dose distributions on the superficial cardiac lesion surrounded by low-density lungs. Volumetric modulated arc therapy (VMAT) technique was applied to optimize the dose distribution using the anisotropic analytic algorithm (AAA) and Acuros XB algorithm (AXB) using the 3-D printed cardiac phantom. We used four full and half arcs with 6-MV and 15-MV photons to investigate the rebuild-up effect near the planning target volume (PTV). Depending on the calculation algorithm (AAA vs. AXB) for full arcs plans, V95 of PTV differed by 27% for 6-MV and 29% for 15-MV, and D95 for 6-MV and 15-MV shows 24% and 30%, respectively. The maximum doses in the AXB plans on PTV were 5.1% higher than those in AAA plans at 6-MV, and 3.8% higher at 15-MV. In addition, half arcs treatment plans showed a very similar tendency with full arcs plans. Film dosimetry showed significant differences from the planned results in the AAA plans. Particularly, the dose mismatch occurred between the cardiac PTV and the left lung interface. In the case of 6-MV plans calculated by AAA, the maximum dose increased from 4.1 to 7.7% in the PTV. Furthermore, it showed that 50% of the width of dose profiles was reduced by 1.3 cm in the 6-MV plan. Conversely, in the case of the plans using the AXB algorithm, the maximum dose increased by 2.0-5.0%. In contrast to the AAA algorithm, the dose patterns at the interface demonstrated a good agreement with the plans. Dose fluctuation on the interface between superficial cardiac lesions and low-density lungs can lead to an error in the estimation of accurate dose delivery for the case of VT SBRT.

Effects of image distortion and Hounsfield unit variations on radiation treatment plans: An extended field-of-view reconstruction in a large bore CT scanner.

This study aimed to evaluate the effect of image distortion and Hounsfield unit (HU) variation due to the extended field-of-view (eFOV) of the large-bore (LB) computed tomography (CT) on dose distribution. Both home-made inhomogeneity and breast phantoms were scanned at the geometric center position and four different offset positions. We also performed dose optimizations based on different breast phantom CT sets for evaluating the effects of image artifacts on the intensity-modulated radiation techniques. The volume changes were 0.0% to 0.5% in the air, -0.5% to 3.0% in the water, and 4.0% to 5.0% in the high-density material of the inhomogeneity phantom. Both phantoms scanning results indicate that more distortions occurred in the eFOV area due to the biased scanning center. The gamma index differences ranged from 0.87% to 4.87% for the FIF plan and from 0.52% to 6.26% for the VMAT plan. This resulted in decrease of the minimum (7.3-13.1%), maximum (-0.8-2.2%), and mean doses (-0.2-4.4%). We recommend that it should be evaluated whether the applied CT would have an appropriate eFOV range for clinical radiation treatment planning for patients.

Her4 is necessary for establishing peripheral projections of the trigeminal ganglia in zebrafish.

Transcripts of notch and its target genes have been detected in some differentiating neurons. However, the role of Notch in neuronal differentiation remains poorly defined. Here, we show that a subset of differentiating sensory neurons in the trigeminal ganglia express her4. Expression of her4 requires Notch signaling during neurogenesis but not during differentiation, when peripheral projections of the trigeminal ganglia are established. These projections develop poorly in her4 morphants. While many components of the canonical Notch signaling pathway are not required for late her4 expression or peripheral axon outgrowth in trigeminal neurons, simultaneous knock-down of Notch receptors prevents establishment of these peripheral projections. These observations suggest that Her4 and Notch play a role in peripheral outgrowth of sensory neurons.