CT number calibration audit in photon radiation therapy.

BACKGROUND: Inadequate computed tomography (CT) number calibration curves affect dose calculation accuracy. Although CT number calibration curves registered in treatment planning systems (TPSs) should be consistent with human tissues, it is unclear whether adequate CT number calibration is performed because CT number calibration curves have not been assessed for various types of CT number calibration phantoms and TPSs. PURPOSE: The purpose of this study was to investigate CT number calibration curves for mass density (ρ) and relative electron density (ρe ). METHODS: A CT number calibration audit phantom was sent to 24 Japanese photon therapy institutes from the evaluating institute and scanned using their individual clinical CT scan protocols. The CT images of the audit phantom and institute-specific CT number calibration curves were submitted to the evaluating institute for analyzing the calibration curves registered in the TPSs at the participating institutes. The institute-specific CT number calibration curves were created using commercial phantom (Gammex, Gammex Inc., Middleton, WI, USA) or CIRS phantom (Computerized Imaging Reference Systems, Inc., Norfolk, VA, USA)). At the evaluating institute, theoretical CT number calibration curves were created using a stoichiometric CT number calibration method based on the CT image, and the institute-specific CT number calibration curves were compared with the theoretical calibration curve. Differences in ρ and ρe over the multiple points on the curve (Δρm and Δρe,m , respectively) were calculated for each CT number, categorized for each phantom vendor and TPS, and evaluated for three tissue types: lung, soft tissues, and bones. In particular, the CT-ρ calibration curves for Tomotherapy TPSs (ACCURAY, Sunnyvale, CA, USA) were categorized separately from the Gammex CT-ρ calibration curves because the available tissue-equivalent materials (TEMs) were limited by the manufacturer recommendations. In addition, the differences in ρ and ρe for the specific TEMs (ΔρTEM and Δρe,TEM , respectively) were calculated by subtracting the ρ or ρe of the TEMs from the theoretical CT-ρ or CT-ρe calibration curve. RESULTS: The mean ± standard deviation (SD) of Δρm and Δρe,m for the Gammex phantom were -1.1 ± 1.2 g/cm3 and -0.2 ± 1.1, -0.3 ± 0.9 g/cm3 and 0.8 ± 1.3, and -0.9 ± 1.3 g/cm3 and 1.0 ± 1.5 for lung, soft tissues, and bones, respectively. The mean ± SD of Δρm and Δρe,m for the CIRS phantom were 0.3 ± 0.8 g/cm3 and 0.9 ± 0.9, 0.6 ± 0.6 g/cm3 and 1.4 ± 0.8, and 0.2 ± 0.5 g/cm3 and 1.6 ± 0.5 for lung, soft tissues, and bones, respectively. The mean ± SD of Δρm for Tomotherapy TPSs was 2.1 ± 1.4 g/cm3 for soft tissues, which is larger than those for other TPSs. The mean ± SD of Δρe,TEM for the Gammex brain phantom (BRN-SR2) was -1.8 ± 0.4, implying that the tissue equivalency of the BRN-SR2 plug was slightly inferior to that of other plugs. CONCLUSIONS: Latent deviations between human tissues and TEMs were found by comparing the CT number calibration curves of the various institutes.

[Development of a Phantom and Analysis Program for Assessment of Positional Accuracy of Image-guided Radiation Therapy].

PURPOSE: We created a phantom and analysis program for the assessment of IGRT positional accuracy. We verified the accuracy of analysis and the practicality of this evaluation method at several facilities. METHOD: End-to-end test was performed using an in-house phantom, and EPID images were acquired after displacement by an arbitrary amount using a micrometer, with after image registration as the reference. The difference between the center of the target and the irradiated field was calculated using our in-house analysis program and commercial software. The end-to-end test was conducted at three facilities, and the IGRT positional accuracy evaluation was verified. RESULT: The maximum difference between the displacement of the target determined from the EPID image and the arbitrary amount of micrometer displacement was 0.24 mm for the in-house analysis program and 0.30 mm for the commercial software. The maximum difference between the center of the target and the irradiation field on EPID images acquired at the three facilities was 0.97 mm. CONCLUSION: The proposed evaluation method using our in-house phantom and analysis program can be used for the assessment of IGRT positional accuracy.

Salon nail care with superficial self-disclosure vitalizes psychological state.

Physical attractiveness has long been established as a desirable trait in society. Physically attractive individuals are considered more competent, successful, and sociable. Numerous studies have examined the influence of makeup on physical attractiveness and its subjective psychological effects. However, the effect of nail care has not yet been examined. This study aimed to explore the psychological effects of nail care. Female Japanese participants (N = 334) completed an online questionnaire. The results showed that nail care positively elevated three aspects: positive emotions, relaxation, and vitalization. Moreover, they confirmed significant differences between receiving nail care from salon manicurists and self-performed nail care in terms of positive emotions and relaxation. The results indicated that nail care altered the appearance of the recipients' nails and their self-esteem, including their feelings, mood, and motivation. Furthermore, this study indicates that it may be preferable for both manicurists and clients not to self-disclose in-depth, as this would negate the positive effects of nail care. The study concludes with recommendations for future research.

What Promotes the Happiness of Vacationers? A Focus on Vacation Experiences for Japanese People During Winter Vacation.

Several studies on tourism have examined the effects of vacation and travel on individuals' wellbeing. However, relatively little is known about the underlying psychological factors and mechanisms. Therefore, this study aimed to investigate the effects of a winter vacation on individuals' wellbeing. A total of 507 participants (255 men and 252 women) completed three questionnaires at three different time points. The questionnaires comprised psychological scales and items to seek demographic information so that the changes in their wellbeing could be assessed. The results revealed that people who traveled had higher subjective wellbeing than those who did not. Moreover, out of the four elements of the recovery experience, mastery was the only one influenced subsequent subjective wellbeing. The findings suggest that it is crucial to take vacations and to savor recovery experiences while off work. In particular, experiencing new and challenging events during a vacation was the most significant predictor of vacationers' subsequent wellbeing. Our results clarify what type of vacation is most effective for wellbeing. The results can help tourism practitioners manage their customers' experiences better during their vacations, and these efforts will arguably contribute not only to the wellbeing of vacationers but also to future company growth.

Stoichiometric CT number calibration using three-parameter fit model for ion therapy.

PURPOSE: Treatment planning for ion therapy involves the conversion of computed tomography number (CTN) into a stopping-power ratio (SPR) relative to water. The purpose of this study was to create a CTN-to-SPR calibration table using a stoichiometric CTN calibration model with a three-parameter fit model for ion therapy, and to demonstrate its effectiveness by comparing it with a conventional stoichiometric CTN calibration model. METHODS: We inserted eight tissue-equivalent materials into a CTN calibration phantom and used six CT scanners at five radiotherapy institutes to scan the phantom. We compared the theoretical CTN-to-SPR calibration tables created using the three-parameter fit and conventional models to the measured CTN-to-SPR calibration table in three tissue types: lung, adipose/muscle, and cartilage/spongy bone. We validated the estimated SPR differences in all cases and in a worst-case scenario, which revealed the largest estimated SPR difference in lung tissue. RESULTS: For all cases, the means ± standard deviations of the estimated SPR difference for the three-parameter fit method model were -0.1 ± 1.0%, 0.3 ± 0.7%, and 2.4 ± 0.6% for the lung, adipose/muscle, and cartilage/spongy bone, respectively. For the worst-case scenario, the estimated SPR differences of the conventional and the three-parameter fit models were 2.9% and -1.4% for the lung tissue, respectively. CONCLUSIONS: The CTN-to-SPR calibration table of the three-parameter fit model was consistent with that of the measurement and decreased the calibration error for low-density tissues, even for the worst-case scenario.

Palladium-Catalyzed Difunctionalization of 1,3-Diene with Amine and Disilane under a Mild Re-oxidation System.

A highly regioselective and stereoselective difunctionalization reaction of 1,3-diene with amine and disilane to form C-N and C-Si bonds via a one-step Pd/Cu/O2 system is disclosed. The difunctionalization reaction affords allylic silanes, including the allylic amine moiety, in up to 92 % yield in the absence of any acid, base, or external ligand. The developed synthetic methodology can be scaled to 100 g in high yield with high Z-selectivity, which demonstrates the feasibility of the reaction for industrial applications.

Development of a CT number calibration audit phantom in photon radiation therapy: A pilot study.

PURPOSE: In photon radiation therapy, computed tomography (CT) numbers are converted into values for mass density (MD) or relative electron density to water (RED). CT-MD or CT-RED calibration tables are relevant for human body dose calculation in an inhomogeneous medium. CT-MD or CT-RED calibration tables are influenced by patient imaging (CT scanner manufacturer, scanning parameters, and patient size), the calibration process (tissue-equivalent phantom manufacturer, and selection of tissue-equivalent material), differences between tissue-equivalent materials and standard tissues, and the dose calculation algorithm applied; however, a CT number calibration audit has not been established. The purposes of this study were to develop a postal audit phantom, and to establish a CT number calibration audit process. METHODS: A conventional stoichiometric calibration conducts a least square fit of the relationships between the MD, material weight, and measured CT number, using two parameters. In this study, a new stoichiometric CT number calibration scheme has been empirically established, using three parameters to harmonize the calculated CT number with the measured CT number for air and lung tissue. In addition, the suitable material set and the minimal number of materials required for stoichiometric CT number calibration were determined. The MDs and elemental weights from the International Commission on Radiological Protection Publication 110 were used as standard tissue data, to generate the CT-MD and CT-RED calibration tables. A small-sized, CT number calibration phantom was developed for a postal audit, and stoichiometric CT number calibration with the phantom was compared to the CT number calibration tables registered in the radiotherapy treatment planning systems (RTPSs) associated with five radiotherapy institutions. RESULTS: When a least square fit was performed for the stoichiometric CT number calibration with the three parameters, the calculated CT number showed better agreement with the measured CT number. We established stoichiometric CT number calibration using only two materials because the accuracy of the process was determined not by the number of used materials but by the number of elements contained. The stoichiometric CT number calibration was comparable to the tissue-substitute calibration, with a dose difference less than 1%. An outline of the CT number calibration audit was demonstrated through a multi-institutional study. CONCLUSIONS: We established a new stoichiometric CT number calibration method for validating the CT number calibration tables registered in RTPSs. We also developed a CT number calibration phantom for a postal audit, which was verified by the performances of multiple CT scanners located at several institutions. The new stoichiometric CT number calibration has the advantages of being performed using only two materials, and decreasing the difference between the calculated and measured CT numbers for air and lung tissue. In the future, a postal CT number calibration audit might be achievable using a smaller phantom.

4D modeling in a gimbaled linear accelerator by using gold anchor markers.

PURPOSE: The purpose of this study was to verify whether the dynamic tumor tracking (DTT) feature of a Vero4DRT system performs with 10-mm-long and 0.28 mm diameter gold anchor markers. METHODS: Gold anchor markers with a length of 10 mm and a diameter of 0.28 mm were used. Gold anchor markers were injected with short and long types into bolus material. These markers were sandwiched by a Tough Water (TW) phantom in the bolus material. For the investigation of 4-dimensional (4D) modeling feasibility under various phantom thicknesses, the TW phantom was added at 2 cm intervals (in upper and lower each by 1 cm). A programmable respiratory motion table was used to simulate breathing-induced organ motion, with an amplitude of 30 mm and a breathing cycle of 3 s. X-ray imaging parameters of 80 kV and 125 kV (320 mA and 5 ms) were used. The least detection error of the fiducial marker was defined as the 4D-modeling limitation. RESULTS: The 4D modeling process was attempted using short and long marker types and its limitation with the short and long types was with phantom thicknesses of 6 and 10 cm at 80 kV and 125 kV, respectively. However, the loss in detectability of the gold anchor because of 4D-modeling errors was found to be approximately 6% (2/31) with a phantom thickness of 2 cm under 125 kV. 4D-modeling could be performed except under the described conditions. CONCLUSIONS: This work showed that a 10-mm-long gold anchor marker in short and long types can be used with DTT for short water equivalent path length site, such as lung cancer patients, in the Vero4DRT system.

Image quality and absorbed dose comparison of single- and dual-source cone-beam computed tomography.

PURPOSE: Dual-source cone-beam computed tomography (DCBCT) is currently available in the Vero4DRT image-guided radiotherapy system. We evaluated the image quality and absorbed dose for DCBCT and compared the values with those for single-source CBCT (SCBCT). METHODS: Image uniformity, Hounsfield unit (HU) linearity, image contrast, and spatial resolution were evaluated using a Catphan phantom. The rotation angle for acquiring SCBCT and DCBCT images is 215° and 115°, respectively. The image uniformity was calculated using measurements obtained at the center and four peripheral positions. The HUs of seven materials inserted into the phantom were measured to evaluate HU linearity and image contrast. The Catphan phantom was scanned with a conventional CT scanner to measure the reference HU for each material. The spatial resolution was calculated using high-resolution pattern modules. Image quality was analyzed using ImageJ software ver. 1.49. The absorbed dose was measured using a 0.6-cm3 ionization chamber with a 16-cm-diameter cylindrical phantom, at the center and four peripheral positions of the phantom, and calculated using weighted cone-beam CT dose index (CBCTDIw ). RESULTS: Compared with that of SCBCT, the image uniformity of DCBCT was slightly reduced. A strong linear correlation existed between the measured HU for DCBCT and the reference HU, although the linear regression slope was different from that of the reference HU. DCBCT had poorer image contrast than did SCBCT, particularly with a high-contrast material. There was no significant difference between the spatial resolutions of SCBCT and DCBCT. The absorbed dose for DCBCT was higher than that for SCBCT, because in DCBCT, the two x-ray projections overlap between 45° and 70°. CONCLUSIONS: We found that the image quality was poorer and the absorbed dose was higher for DCBCT than for SCBCT in the Vero4DRT.

[Influence of Changing Respirator Pattern on Dynamic Tumor Tracking Accuracy with Gimbaled Linac System Using a Digital Camera].

It is important for high-precision radiation therapy that tracking accuracy in dynamic tumor tracking (DTT) using the gimbal X-ray head. We evaluated the tracking accuracy under various respiratory patterns differ from a correlation model [four-dimensional model (4D-model)] in real-time using a digital camera. A sheet of paper with luminous line was placed on the programmable respiratory motion table (CIRS Inc.) and operated with the laser projector. The luminous line was defined as a target and the laser was defined as a gimbal. Motion table was operated at a period of 4 s and amplitude of ±10 mm to create 4D-modeling. This movement was defined as the basic operation. To investigate the tracking accuracy, target and gimbal positions were recorded using a digital camera under amplitudes (±5-20 mm) and periods (2-8 s) and analyzed by ImageJ software (NIH). The maximum tracking errors under various period and amplitude were 1.7-0.9 mm and 0.4-1.9 mm, respectively. From the creation of 4D-modeling, it was confirmed that when the period has shortened and the amplitude has increased, tracking accuracy was reduced.

Quality assurance of a gimbaled head swing verification using feature point tracking.

To perform dynamic tumor tracking (DTT) for clinical applications safely and accurately, gimbaled head swing verification is important. We propose a quantitative gimbaled head swing verification method for daily quality assurance (QA), which uses feature point tracking and a web camera. The web camera was placed on a couch at the same position for every gimbaled head swing verification, and could move based on a determined input function (sinusoidal patterns; amplitude: ± 20 mm; cycle: 3 s) in the pan and tilt directions at isocenter plane. Two continuous images were then analyzed for each feature point using the pyramidal Lucas-Kanade (LK) method, which is an optical flow estimation algorithm. We used a tapped hole as a feature point of the gimbaled head. The period and amplitude were analyzed to acquire a quantitative gimbaled head swing value for daily QA. The mean ± SD of the period were 3.00 ± 0.03 (range: 3.00-3.07) s and 3.00 ± 0.02 (range: 3.00-3.07) s in the pan and tilt directions, respectively. The mean ± SD of the relative displacement were 19.7 ± 0.08 (range: 19.6-19.8) mm and 18.9 ± 0.2 (range: 18.4-19.5) mm in the pan and tilt directions, respectively. The gimbaled head swing was reliable for DTT. We propose a quantitative gimbaled head swing verification method for daily QA using the feature point tracking method and a web camera. Our method can quantitatively assess the gimbaled head swing for daily QA from baseline values, measured at the time of acceptance and commissioning.

D-glucosamine promotes transfection efficiency during electroporation.

D-Glucosamine is a useful medicament in various fields of medicine and dentistry. With respect to stability of the cell membrane, it has been reported that bradykinin-induced nociceptive responses are significantly suppressed by the direct application of D-glucosamine. Electroporation is usually used to effectively introduce foreign genes into tissue culture cells. Buffers for electroporation with or without D-glucosamine are used in experiments of transfection vectors. This is the first study to indirectly observe the stability and protection of the osteoblast membrane against both electric stress and gene uptake (the proton sponge hypothesis: osmotic rupture during endosomes prior to fusion with lysosomes) in electroporation with D-glucosamine application. The transfection efficiency was evaluated as the fluorescence intensity of the transfected green fluorescent protein (GFP) in the cultured cells (osteoblasts; NOS-1 cells). The transfection efficiency increased over 30% in the electroporation samples treated with D-glucosamine-supplemented buffer after one day. The membrane absorption of D-glucosamine is the primary mechanism of membrane stress induced by electric stress. This new function of D-glucosamine is useful and meaningful for developing more effective transformation procedures.

Early gene and protein expression associated with osteoblast differentiation in response to fish collagen peptides powder.

This study was designed to investigate the biological effects of fish collagen peptide (FCP) on human osteoblasts. Human osteoblasts were treated with 0.1% FCP, which was the optimal concentration confirmed by the increase in alkaline phosphatase activity. After one, three, five and seven days of culture, the number of FCP-treated cells increased significantly compared with untreated cells. In a real-time PCR analysis, the expression of osteocalcin, osteopontin, BMP-2 and integrin ß3 mRNAs in FCP-treated cells showed increases compared with untreated cells after three days of culture. After seven days of culture, the expression levels of osteopontin and integrin ß3 were still higher in the FCP-treated cells than in untreated cells. The production of osteocalcin, osteopontin and integrin ß3 proteins in FCP-treated cells also showed increases after seven days of culture. Furthermore, FCP accelerated matrix mineralization in the cultures. The present study indicates the potential utility of FCP as a biomaterial.

Zinc as an essential trace element in the acceleration of matrix vesicles-mediated mineral deposition.

BACKGROUND: Zinc (Zn) has a potent stimulatory effect on osteoblastic bone formation and an inhibitory effect on osteoclastic bone resorption. PURPOSE: The effect of Zn on the function of matrix vesicles (MVs) remains controversial. The purpose of this study was to investigate the effect of Zn on alkaline phosphatase (ALP) activity of osteoblasts and in the initial biological MVs-mediated mineral deposition. STUDY DESIGN: Osteoblasts were treated with varying concentrations of Zn dissolved in culture medium. After three, five, and seven days of culture, ALP activity was assayed. For the detection of a low level of calcium concentration in MVs, X-ray fluorescence (XRF) analyses were applied. The effect of Zn for the transformation of calcium phosphate was analyzed using a scanning electron microscope fitted with an energy dispersive X-ray microanalysis (EDX) system. RESULTS: The ALP activity of osteoblasts in culture medium supplemented with 1 × 10(-5) M of Zn was significantly increased at both five and seven days. XRF data demonstrated higher levels of calcium concentration over time in the Zn-supplemented group. EDX data showed that mineral deposits beginning on day 3 were transformed from whitlockite to calcium phosphate near hydroxyapatite, and that Zn accelerated this transformation. CONCLUSIONS: The proper concentration of Zn increased the ALP activity of osteoblasts after five and seven days of incubation. The present XRF and EDX data suggest that the increase of mineral deposition with Zn exposure for one to five days might be mediated by the activation of ALP and calcium-binding proteins.

[A case of a pediatric patient with tuberous sclerosis (Bourneville-Pringle disease) and frequent epileptic seizure for intensive dental treatment under general anesthesia].

Tuberous sclerosis (Bourneville-Pringle disease) is a rare disease with a triad of mental retardation, epilepsy, and facial spot. Management of the patients with tuberous sclerosis under general anesthesia has been previously reported. However, there are few case reports about management under general anesthesia of a pediatric patient with tuberous sclerosis with frequent epileptic seizure. Here, we report a case of a pediatric patient with tuberous sclerosis and frequent epileptic seizure who underwent intensive dental treatment under general anesthesia with careful management of epilepsy. The patient was discharged on the day of surgery without any complications. In this case report, we discussed the appropriate assessment of the complications of tuberous sclerosis; such as, of central nervous, circulatory, respiratory, endocrine, and urinary systems including the management of general anesthesia.