Evaluation of tumour motion and internal/external correlation in lung SABR.

OBJECTIVE: This study aims to analyse lung tumour motion and to investigate the correlation between the internal tumour motion acquired from four-dimensional computed tomography (4DCT) and the motion of an external surrogate. METHODS: A data set of 363 4DCT images was analysed. Tumours were classified based on their anatomical lobes. The recorded gross tumour volume (GTV) information included the centroid GTV motion in the superior-inferior, anteroposterior and left-right directions, and in three-dimensions (3D). For the internal/external correlation, the RPM surrogate breathing signals of 260 patients were analysed via an in-house script. The external motion was correlated with the 3D centroid motion, and the maximum tumour motion via Spearman's correlation. The effect of tumour volume on the amount of motion was evaluated. RESULTS: The greatest 3D tumour amplitude was found for tumours located in the lower part of the lung, with a maximum of 26.7 mm. The Spearman's correlation of the internal 3D motion was weak in the upper (r = 0.21) and moderate in the middle (r = 0.51) and the lower (r = 0.52) lobes. There was no obvious difference in the correlation coefficients between the maximum tumour displacement and the centroid motion. No correlation was found between the tumour volume and the magnitude of motion. CONCLUSION: Our results suggest that tumour location can be a good predictor of its motion. However, tumour size is a poor predictor of the motion. ADVANCES IN KNOWLEDGE: This knowledge of the distribution of tumour motion throughout the thoracic regions will be valuable to research groups investigating the refinement of motion management strategies.

Treatment planning with a 2.5 MV photon beam for radiation therapy.

PURPOSE: The shallow depth of maximum dose and higher dose fall-off gradient of a 2.5 MV beam along the central axis that is available for imaging on linear accelerators is investigated for treatment of shallow tumors and sparing the organs at risk (OARs) beyond it. In addition, the 2.5 MV beam has an energy bridging the gap between kilo-voltage (kV) and mega-voltage (MV) beams for applications of dose enhancement with high atomic number (Z) nanoparticles. METHODS: We have commissioned and utilized a MATLAB-based, open-source treatment planning software (TPS), matRad, for intensity-modulated radiation therapy (IMRT) dose calculations. Treatment plans for prostate, liver, and head and neck (H&N), nasal cavity, two orbit cases, and glioblastoma multiforme (GBM) were performed and compared to a conventional 6 MV beam. Additional Monte Carlo calculations were also used for benchmarking the central axis dose. RESULTS: Both beams had similar planning target volume (PTV) dose coverage for all cases. However, the 2.5 MV beam deposited 6%-19% less integral doses to the nasal cavity, orbit, and GBM cases than 6 MV photons. The mean dose to the heart in the liver plan was 10.5% lower for 2.5 MV beam. The difference between the doses to OARs of H&N for two beams was under 3%. Brain mean dose, brainstem, and optic chiasm max doses were, respectively, 7.5%-14.9%, 2.2%-8.1%, and 2.5%-19.0% lower for the 2.5 MV beam in the nasal cavity, orbit, and GBM plans. CONCLUSIONS: This study demonstrates that the 2.5 MV beam can produce clinically relevant treatment plans, motivating future efforts for design of single-energy LINACs. Such a machine will be capable of producing beams at this energy beneficial for low- and middle-income countries, and investigations on dose enhancement from high-Z nanoparticles.

Adaptive radiotherapy for head and neck cancer reduces the requirement for rescans during treatment due to spinal cord dose.

BACKGROUND: Patients treated with radiotherapy for head and neck (H&N) cancer often experience anatomical changes. The potential compromises to Planning Target Volume (PTV) coverage or Organ at Risk (OAR) sparing has prompted the use of adaptive radiotherapy (ART) for these patients. However, implementation of ART is time and resource intensive. This study seeks to define a clinical trigger for H&N re-plans based on spinal cord safety using kV Cone-Beam Computed Tomography (CBCT) verification imaging, in order to best balance clinical benefit with additional workload. METHODS: Thirty-one H&N patients treated with Volumetric Modulated Arc Therapy (VMAT) who had a rescan CT (rCT) during treatment were included in this study. Contour volume changes between the planning CT (pCT) and rCT were determined. The original treatment plan was calculated on the pCT, CBCT prior to the rCT, pCT deformed to the anatomy of the CBCT (dCT), and rCT (considered the gold standard). The dose to 0.1 cc (D0.1cc) spinal cord was evaluated from the Dose Volume Histograms (DVHs). RESULTS: The median dose increase to D0.1cc between the pCT and rCT was 0.7 Gy (inter-quartile range 0.2-1.9 Gy, p < 0.05). No correlation was found between contour volume changes and the spinal cord dose increase. Three patients exhibited an increase of 7.0-7.2 Gy to D0.1cc, resulting in a re-plan; these patients were correctly identified using calculations on the CBCT/dCT. CONCLUSIONS: An adaptive re-plan can be triggered using spinal cord doses calculated on the CBCT/dCT. Implementing this trigger can reduce patient appointments and radiation dose by eliminating up to 90% of additional un-necessary CT scans, reducing the workload for radiographers, physicists, dosimetrists, and clinicians.

Fragmentation of neutral amino acids and small peptides by intense, femtosecond laser pulses.

High power femtosecond laser pulses have unique properties that could lead to their application as ionization or activation sources in mass spectrometry. By concentrating many photons into pulse lengths approaching the timescales associated with atomic motion, very strong electric field strengths are generated, which can efficiently ionize and fragment molecules without the need for resonant absorption. However, the complex interaction between these pulses and biomolecular species is not well understood. To address this issue, we have studied the interaction of intense, femtosecond pulses with a number of amino acids and small peptides. Unlike previous studies, we have used neutral forms of these molecular targets, which allowed us to investigate dissociation of radical cations without the spectra being complicated by the action of mobile protons. We found fragmentation was dominated by fast, radical-initiated dissociation close to the charge site generated by the initial ionization or from subsequent ultrafast migration of this charge. Fragments with lower yields, which are useful for structural determinations, were also observed and attributed to radical migration caused by hydrogen atom transfer within the molecule.

Femtosecond lasers for mass spectrometry: proposed application to catalytic hydrogenation of butadiene.

Mass spectra from the interaction of intense, femtosecond laser pulses with 1,3-butadiene, 1-butene, and n-butane have been obtained. The proportion of the fragment ions produced as a function of intensity, pulse length, and wavelength was investigated. Potential mass spectrometry applications, for example in the analysis of catalytic reaction products, are discussed.

Observation of Ultrafast Charge Migration in an Amino Acid.

We present the first direct measurement of ultrafast charge migration in a biomolecular building block - the amino acid phenylalanine. Using an extreme ultraviolet pulse of 1.5 fs duration to ionize molecules isolated in the gas phase, the location of the resulting hole was probed by a 6 fs visible/near-infrared pulse. By measuring the yield of a doubly charged ion as a function of the delay between the two pulses, the positive hole was observed to migrate to one end of the cation within 30 fs. This process is likely to originate from even faster coherent charge oscillations in the molecule being dephased by bond stretching which eventually localizes the final position of the charge. This demonstration offers a clear template for observing and controlling this phenomenon in the future.