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Compensator-based proton therapy of lung cancer using an un-gated treatment while allowing the patient to breathe freely requires a compensator design that ensures tumor coverage throughout respiration. Our investigation had two purposes: one is to investigate the dosimetric impact when a composite compensator correction is applied, or is not, and the other one is to evaluate the significance of using different respiratory phases as the reference computed tomography (CT) for treatment planning dose calculations. A 4D-CT-based phantom study and a real patient treatment planning study were performed. A 3D MIP dataset generated over all phases of the acquired 4D-CT scans was adopted to design the field-specific composite aperture and compensator. In the phantom study, the MIP-based compensator design plan named plan D was compared to the other three plans, in which average intensity projection (AIP) images in conjunction with the composite target volume contour copied from the MIP images were used. Relative electron densities within the target envelope were assigned either to original values from the AIP image dataset (plan A) or to predetermined values, 0.8 (plan B) and 0.9 (plan C). In the patient study, the dosimetric impact of a compensator design based on the MIP images (plan ITV(MIP)) was compared to designs based on end-of-inhale (EOI) (plan ITV(EOI)) and middle-of-exhale (MOE) CT images (plan ITV(MOE)). The dose distributions were recalculated for each phase. Throughout the ten phases, it shows that D(GTV)(min) changed slightly from 86% to 89% (SD = 0.9%) of prescribed dose (PD) in the MIP plan, while varying greatly from 10% to 79% (SD = 26.7%) in plan A, 17% to 73% (SD = 22.5%) in plan B and 53% to 73% (SD = 6.8%) in plan C. The same trend was observed for D(GTV)(mean) and V95 with less amplitude. In the MIP-based plan ITV(MIP), D(GTV)(mean) was almost identically equal to 95% in each phase (SD = 0.5%). The patient study verified that the MIP approach increased the minimum value of D99 of the clinical target volume (CTV) by 58.8% compared to plan ITV(EOI) and 12.9% compared to plan ITV(MOE). Minimum values of D99 were 37.60%, 83.50% and 96.40% for plan ITV(EOI), plan ITV(MOE) and plan ITV(MIP), respectively. Standard deviations of D99 were significantly decreased (SD = 0.5%) in the MIP plan as compared to plan ITV(EOI) (SD = 18.9%) or plan ITV(MOE) (SD = 4.0%). These studies demonstrate that the use of MIP images to design the patient-specific composite compensators provide superior and consistent tumor coverage throughout the entire respiratory cycle whilst maintaining a low average normal lung dose. The additional benefit of the MIP-based design approach is that the dose calculation can be implemented on any single phase as long as it uses the aperture and compensator optimized from the MIP images. This also reduces the requirement for contouring on all breathing phases down to just one.
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http://dx.doi.org/10.1088/0031-9155/53/12/019 | DOI Listing |
J Patient Rep Outcomes
December 2024
Department of Rheumatology, Hôpitaux Universitaires de Strasbourg, INSERM UMR-S 1109, Centre National de Référence des Maladies Auto-immunes Systémiques Rares (RESO), Strasbourg, France.
Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with heterogeneous clinical manifestations which significantly impacts the daily lives of patients. Herein, we aimed to (i) investigate patients' perspectives on and experience with SLE; (ii) identify meaningful aspects of health (MAHs) and concepts of interest (COIs) in SLE that could be evaluated using digital clinical measures (DCMs); and (iii) identify target DCMs for their assessment.
Methods: A mixed-methods, multistep approach was deployed for (i) exploring patients' experience with SLE through a social media listening study and focused group discussions with patients; (ii) mapping patients' experiences to define MAHs and identify COIs measurable using DCMs; (iii) selecting DCMs for the target COIs; and (iv) identifying types of wearable sensors for measuring COIs in the patients.
Cell Mol Life Sci
December 2024
Shanghai Key Laboratory of Biliary Tract Disease Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
Background: Glioblastoma (GB) is the stage IV of glioma and mesenchymal GB represents the most common and malignant subtype characterized with elevated expression of a mesenchymal marker YKL-40 and resistance to immune drug therapy. Here, we determined if YKL-40 regulates kynurenine (Kyn) pathway (KP) metabolism that contributes to establishing an immune suppressive microenvironment in GB.
Methods: Tumor cells expressing YKL-40 from GB patients were isolated and activated cellular metabolisms were identified via gene microarray analysis.
J Hum Nutr Diet
February 2025
State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: The association between tea consumption and mortality among very elderly individuals, with or without cardiovascular and cerebrovascular diseases (CCD), including stroke, remains unclear. This study hypothesised that a significant association exists.
Methods: We analysed data from two waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), spanning 1998/2000 to 2018, with a maximum follow-up of 20 years.
Phys Med
December 2024
The Skandion Clinic, Uppsala, Sweden; Medical Radiation Sciences, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Purpose: To propose a methodology for integrating the out-of-field and imaging doses to the in-field dose received by radiotherapy (RT) patients. In addition, the impact of considering the total dose in planning and radiation-induced second malignancies (RISM) risk assessment will be evaluated in several scenarios comprising photon and proton treatments.
Methods: The total dose is the voxel-wise sum of the doses from the different radiation sources (accounting for the radiobiological effectiveness) produced during the whole RT chain.
Small
December 2024
Key Laboratory of Photonic and Electronic Bandgap Materials Ministry of Education, School of Physics and Electronic Engineering, Harbin Normal University, Harbin, 150025, China.
Extracting uranium from seawater is crucial for tapping oceanic resources vital to future energy supply. This study synthesized a novel nitrogen vacancy carbon nitride (NCN) grafted polyethyleneimine (PEI) composite material (NCNP). Experiments and molecular dynamics simulations reveal that NCNP effectively hinders the diffusion of uranyl ions (UO ) to the NCN surface, thereby inhibiting electron transfer reactions.
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