Development of Novel Focal Irradiation Tool for High-Precision Irradiation Using Clinical Brachytherapy System

PURPOSE/OBJECTIVE(S)

Several small animals, including mice, are used to conduct research on state-of-the-art radiation therapy techniques or treatment-related toxicity. However, it is difficult to conduct the focal irradiation to a shallow depth on small animals, because irradiation using LINAC has limitations in energy and field size. The purpose of this paper was to develop a focal irradiation tool for high-precision irradiation and to evaluate beam characteristics.

MATERIALS/METHODS

We designed the collimator of 1 mm diameter consisting of tungsten material for high-precision irradiation applied to the clinical brachytherapy system and the percent depth dose and horizontal profile were measured. We compared the depth dose and horizontal profile with 4 mm diameter SRS cone for 6 MV in LINAC. We measured the PDD and horizontal profile using EBT3 film for high-precision irradiation of 1 mm diameter using Ir-192 source. In case of 4 mm diameter, the beam was measured using edge detector. In addition, all measurements were compared with the results of planning tool simulation.

RESULTS

In case of focal irradiation tool, the maximum dose showed at the surface for both measurement and simulation, and 26% and 32% doses at 1 mm depth, respectively. In addition, FWHM at a 1 mm depth showed that high-precision irradiation was possible with measurement and simulation results of 1.86 and 1.28 mm. In case of LINAC, the maximum dose was showed at a depth of 1 cm and 0.8 cm in the measurement and simulation, respectively. Even if the smallest cone is used, the FWHM at a dmax depth was 4.0 mm in both simulation and measurement.

CONCLUSION

We overcame the limitation for energy and field size through the focal irradiation tool for high-precision irradiation. The focal irradiation tool enables high dose delivery to the shallow depth. In addition, small FWHM reduced dose delivery to the periphery at a specific depth and enabled accurate dose delivery. These results mean that the focal irradiation tool can be useful in small animal experiments that require accurate doses near the shallow depth.

Effects of plasma turbulence on the nonlinear evolution of magnetic island in tokamak

Magnetic islands (MIs), resulting from a magnetic field reconnection, are ubiquitous structures in magnetized plasmas. In tokamak plasmas, recent researches suggested that the interaction between an MI and ambient turbulence can be important for the nonlinear MI evolution, but a lack of detailed experimental observations and analyses has prevented further understanding. Here, we provide comprehensive observations such as turbulence spreading into an MI and turbulence enhancement at the reconnection site, elucidating intricate effects of plasma turbulence on the nonlinear MI evolution.

Magnetic reconnection and plasma turbulence occur in atmospheric and magnetized laboratory plasmas. Here the authors report evolution of magnetic islands and plasma turbulence in tokamak plasmas using high resolution 2D electron cyclotron emission diagnostics.

New sonographic marker of borderline ovarian tumor: microcystic pattern of papillae and solid components

OBJECTIVE

To describe and evaluate the utility of a new sonographic microcystic pattern, which is typical of borderline ovarian tumor (BOT) papillary projections, solid component(s) and/or septa, as a new ultrasound marker that is capable of distinguishing BOT from other adnexal masses, and to present/obtain histologic confirmation.

METHODS

In this retrospective study, we identified women with a histologic diagnosis of BOT following surgical resection who had undergone preoperative transvaginal ultrasound (TVS) examination. All images were reviewed for presence or absence of thin-walled, fluid-filled cluster(s) of 1-3-mm cystic formations, associated with solid component(s), papillary projections and/or septa. From the same cases, histopathologic slides of each BOT were examined for presence of any of these microcystic features which had been identified on TVS. To confirm that the microcystic TVS pattern is unique to BOTs, we also selected randomly from our ultrasound and surgical database 20 cases of epithelial ovarian cancer and 20 cases of benign cystadenoma, for review by the same pathologists. To confirm the novelty of our findings, we searched PubMed for literature published in the English language between 2010 and 2018 to determine whether the association between microcystic tissue pattern and BOT has been described previously.

RESULTS

Included in the final analysis were 62 patients (67 ovaries) with preoperative TVS and surgically confirmed BOT on pathologic examination. The mean patient age at surgery was 39.8 years. The mean BOT size at TVS was 60.7 mm. Of the 67 BOTs, 47 (70.1%) were serous, 15 (22.4%) were mucinous and five (7.5%) were seromucinous. We observed on TVS a microcystic pattern in the papillary projections, solid component(s) and/or septa in 60 (89.6%) of the 67 BOTs, including 46 (97.9%) of the 47 serous BOTs, 11 (73.3%) of the 15 mucinous BOTs and three (60.0%) of the five seromucinous BOTs. On microscopic evaluation, 60 (89.6%) of the 67 samples had characteristic 1-3-mm fluid-filled cysts similar to those seen on TVS. In seven cases there was a discrepancy between sonographic and histologic observation of a microcystic pattern. The 20 cystadenomas were mostly unilocular and/or multilocular and largely avascular. None of them or the 20 epithelial ovarian malignancies displayed microcystic characteristics, either on TVS or at histology. On review of 23 published articles in the English medical literature, containing 163 sonographic images of BOT, we found that, while all images contained it, there was no description of the microcystic tissue pattern.

CONCLUSION

We report herein a novel sonographic marker of BOT, a 'microcystic pattern' of BOT papillary projections, solid component(s) and/or septa. This was seen in the majority of both serous and mucinous BOT cases. Importantly, based on comparison of sonographic images and histopathology of benign entities and malignancies, the microcystic appearance seems to be unique to BOTs. No similar description has been published previously. Utilization of this new marker should help to identify BOT correctly, discriminating it from ovarian cancer and benign ovarian pathology, and should ensure appropriate clinical and surgical management. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Efficient assembly of multi-color fiberless optoelectrodes with on-board light sources for neural stimulation and recording

Fiberless optoelectrodes are an emerging tool to enable brain circuit mapping by providing precise optical modulation and electrical monitoring of many neurons. While optoelectrodes having an on-board light source offer compact and optically efficient device solutions, many of them fail to provide robust thermal and electrical design to fully exploit the recording capabilities of the device. In this work, we present a novel fiberless multicolor optoelectrode solution, which meets the optical and thermal design requirements of an in vivo neural optoelectrode and offers potential for low-noise neural recording. The total optical loss measured for 405 nm and 635 nm wavelengths through the waveguide is 11.7±1.1 dB and 9.9±0.7 dB, corresponding to respective irradiances of 1928 mW/mm2 and 2905 mW/mm2 at the waveguide tip from 6 mW laser diode chips. The efficient thermal packaging enables continuous device operation for up to 190 seconds at 10% duty cycle. We validated the fully packaged device in the intact brain of anesthetized mice co-expressing Channelrhodopsin-2 and Archaerhodopsin in the hippocampal CA1 region and achieved activation and silencing of the same neurons. We discuss improvements made to reduce the stimulation artifact induced by applying currents to the laser diode chips.

Abstract P4-03-03: Microenvironment induced DDR2 mediates stromal-cancer interactions and metastasis growth in breast cancer

This abstract was not presented at the symposium.

The optimal tumor response assessment in patients with HCC after treatment of TACE

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Background: WHO or RECIST has been considered as suboptimal methods for tumor response assessment in HCC, especially receiving locoregional therapies. Recently, new modified methods having concept of viable tumor has been proposed. Herein we compared the efficacy to assess response and to predict prognosis between WHO, RECIST, EASL, mRECIST in HCC patients receiving TACE.

Methods: We retrospectively reviewed 141 HCC patients who were newly diagnosed and received TACE between August 2005 and November 2006. Among them, 98 patients who were available for assessing treatment response were analyzed at 1 month after 2nd TACE. We evaluated intermethod aggreement between methods and assessed the efficacy predicting time to progression (TTP) and overall survival (OS).

Results: The results of tumor responses (number of CR/ PR/ SD/ PD) by WHO/ RECIST/ EASL/ mRECIST were 1/ 14/ 74/ 9, 1/ 12/ 77/ 8, 34/ 34/ 25/ 5, 34/ 28/ 31/ 5, respectively. The κvalue of intermethod agreement for EASL vs WHO, EASL vs RECIST, mRECIST vs WHO, and mRECIST vs RECIST was 0.102, 0.088, 0.112 and 0.122, respectively. The κvalue for WHO vs RECIST and EASL vs mRECIST was 0.759 and 0.883 (p=0.00). Hazard ratios for TTP in responders compared with nonresponders were 0.313 (95% CI; 0.19-0.52, p=0.00) for EASL and 0.335 (95% CI; 0.21-0.54, p=0.00) for mRECIST. Hazard ratios for survival in responders compared with nonresponders were 0.208 (95% CI; 0.12-0.37, p=0.00) for EASL and 0.269 (95% CI; 0.15-0.48, p=0.00) for mRECIST. In the univariate analysis, tumor size, infiltrative type, PVT, EASL responder, and mRECIST responder were significant risk factors for survival. Multivariate analysis showed EASL responder (HR 0.165, 95% CI 0.056-0.486, p=0.001) and infiltrative type (HR 4.504, 95% CI 1.579-12.848, p=0.005) were independent predictable factors for survival.

Conclusions: The recent proposed methods showed different characteristics from preexisting methods in assessing treatment response and furthermore, responder by EASL method was independent predictor for survival in HCC patients receiving TACE. EASL method should be applied as response assessment method for HCC patients receiving TACE.

No significant financial relationships to disclose.

The Neural Nanoprobe: Physically Decoupling the Neural Recording Site From the Headstage

The ability to record neural ensembles from awake, behaving animals is one of the most important and successful components of the neuroscience experimental toolbox. However, even the most advanced modern systems have limitations due to the physical coupling of the recording site with the headstage. These systems can only record from a limited number of structures at any one time and have particular difficulty recording large ensembles from animals with thin skulls (e.g., mice, songbirds). Current systems cannot record from fragile structures (spinal cord, peripheral nerves and ganglia) during behavior because the wire electrodes would shred the fragile nerves as the animal moves. We propose the concept of a neural nanoprobe that is physically decoupled from a separately implanted waystation. Because the nanoprobes are not connected to the waystation by physical wires, multiple nanoprobes could be placed in multiple neural structures, all transmitting to a single, separate waystation. Because the nanoprobes effectively float in the cellular matrix, they are safe to put in fragile structures. The waystation does not need to be implanted in the fragile structures; it only needs to be electrically coupled to them. The first step to the realization of this device is a low-power, high-fidelity method for communicating between the nanoprobe and the waystation. In this abstract, we report a successful test proving the viability of using the brain itself as the conducting medium through which the nanoprobe and waystation can communicate. Initial tests show that neural signals from multiple transmission sites can be sent to a single, separated receiver. We first identified the current-loss of sine-waves transmitted through live (anesthetized) brain tissue. We found negligible current-loss across frequencies ranging from 100 kHz–50 MHz across distances as much as 15 mm. As these frequencies are larger than any known frequencies used by neural signals, they are unlikely to interfere with neural function. We next measured the ability to transmit and receive pre-recorded neural signals (sampled at 20 kHz), using pre–recorded signals to determine the fidelity of transmission. The two different signals were transmitted, received, and successfully demodulated with high-fidelity, even with transmission currents as low as 2 μA. Both the transmitters and the receiver each had their own battery power supply to ensure that they used separate, floating grounds. Finally, to ensure that the intra-brain communication signals did not interfere with neural activity, we recorded extra-cellular potentials before, during, and after the test. No changes were observed in spike shape, spike frequency, bursting, or other cellular properties, demonstrating the safety of this technique. Supported by a grant from the Institute for Engineering in Medicine (U Minnesota) and training grant support from T90-DK070106. Corresponding author; email: redish@umn.edu

Porphobilinogen synthase from pea: expression from an artificial gene, kinetic characterization, and novel implications for subunit interactions

Porphobilinogen synthase (PBGS) is present in all organisms that synthesize tetrapyrroles such as heme, chlorophyll, and vitamin B(12). The homooctameric metalloenzyme catalyzes the condensation of two 5-aminolevulinic acid molecules to form the tetrapyrrole precursor porphobilinogen. An artificial gene encoding PBGS of pea (Pisum sativum L.) was designed to overcome previous problems during bacterial expression caused by suboptimal codon usage and was constructed by recursive polymerase chain reaction from synthetic oligonucleotides. The recombinant 330 residue enzyme without a putative chloroplast transit peptide was expressed in Escherichia coli and purified in 100-mg quantities. The specific activity is protein concentration dependent, which indicates that a maximally active octamer can dissociate into less active smaller units. The enzyme is most active at slightly alkaline pH; it shows two pK(a) values of 7.4 and 9.7. Atomic absorption spectroscopy shows maximal binding of three Mg(II) per subunit; kinetic data support two functionally distinct types of Mg(II) and the third appears to be nonphysiologic and inhibitory. Analysis of the protein concentration dependence of the specific activity suggests that the minimal functional unit is a tetramer. A model of octameric pea PBGS was built to predict the location of intermolecular disulfide linkages that were revealed by nonreducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis. As verified by site-specific mutagenesis, disulfide linkages can form between four cysteines per octamer, each located five amino acids from the C-terminus. These data are consistent with the protein undergoing conformational changes and the idea that whole-body motion can occur between subunits.

A comparison of maximum cystometric bladder capacity with maximum environmental voided volumes

The aim of the study was, to determine whether maximum cystometric capacity accurately reflects the maximum functional bladder volume in women with urinary incontinence. We performed a retrospective chart review involving 85 women between the ages of 22 and 89 with primary complaints of urinary incontinence. The maximum cystometric capacity as determined by cystometry was compared with the maximum environmental voided volumes as recorded in a 24-hour voiding diary, using Pearson's correlation coefficients and paired t-tests. Patients diagnosed as having a small bladder capacity (< 300 ml maximum volume) based on cystometry were also examined with contingency table analysis to determine whether the bladder volumes in the voiding diaries supported the diagnosis of a small bladder. In 85 subjects the average maximum cystometric capacity was 14.7% less than the maximum volume recorded in the voiding diary. The correlation between the maximum cystometric capacity and maximum functional bladder volume was r = 0.473 (P < 0.001). However, there was a statistically significant difference between the two volumes by paired t-test analysis (P = 0.006). Using cystometry to diagnose small bladder capacity showed a sensitivity of 62.9% and a specificity of 71.2% when using voiding diary volumes as the criterion standard. The positive predictive value was 51.4% and the negative predictive value was 84.0%. These results suggest that whereas the maximum bladder capacity measured by cystometry correlates with maximum environmental bladder capacity as determined by 24-hour voiding diaries, there is a statistically significant difference. The diagnosis of a small bladder should not be based on office cystometry alone.

Linkage position determination in a novel set of permethylated neutral trisaccharides by collisional-induced dissociation and tandem mass spectrometry

A set of neutral permethylated trisaccharides identical in the non-reducing (A----B) disaccharide and linkage isomeric in the reducing terminal (B----C) disaccharide has been synthesized. Collision-activated tandem mass spectrometry was used for analysis of the B----C linkage position. The trisaccharides, gal(beta 1----4)glc(beta 1----X)glc, where X = 3, 4 and 6, were synthesized and examined using fast atom bombardment collision-induced dissociation tandem mass spectrometry. Results were rationalized using molecular modeling. We have previously reported results for determination of the A----B linkage position with isomeric sets of synthetic trisaccharides containing internal amino sugars. The neutral trisaccharides were synthesized to isolate electronic effects of the amino group. An approach of relating daughter ion to parent ion ratios and collision energy offset was used to generate slopes that predict linkage position in glc beta 1----X glc reducing end glycoside form of terminal trisaccharides.

Synthesis of four novel trisaccharides by induction of loose acceptor specificity in Gal beta 1----4 transferase (EC 2.4.1.22): Galp(beta 1----4)Glcp(X)Glc where X = beta 1----3: beta 1----4: beta 1----6: alpha 1----4

Development of tandem mass spectral methods for direct linkage determination in oligosaccharides requires sets of trisaccharides differing only in one structural parameter. In this case, we chose the position of linkage to the reducing-end hexose. These sets of compounds would also be useful for the development of high-resolution separation techniques geared to resolve linkage types. Conventional organic synthesis of such a set could take as long as 2-5 months for each member of the set. Each trisaccharide would require 10-20 steps of synthesis. Instead, we utilized low pH to induce a loose acceptor specificity for bovine milk galactosyltransferase (lactose synthase: EC 2.4.1.22) and by this method, within 2 weeks, generated four novel oligosaccharides for NMR and mass spectral studies. The disaccharides cellobiose (beta 1----4), laminaribiose (beta 1----3), gentiobiose (beta 1----6) and maltose (alpha 1----4) acted as acceptors for EC 2.4.1.22 under these conditions. The beta 1----2-linked disaccharide, sophorose, was not commercially available and is not included in this study. The alpha-linked disaccharides were also examined, but except for the alpha 1----4 disaccharide maltose, were very poor acceptors under a variety of conditions. From these four acceptors, the following four novel trisaccharides were synthesized in micromole amounts, suitable for studies of linkage position using low-energy collision-induced-dissociation tandem mass spectrometry (FAB-MS-CID-MS), and for NMR: Galp(beta 1----4)Glcp(beta 1----3)-Glc, Galp(beta 1----4)Glcp(beta 1----4)Glc, Galp(beta 1----4)Glcp(beta 1----6)-Glc and Galp(beta 1----4)Glcp(alpha 1----4)Glc.

Non-reducing terminal linkage position determination in intact and permethylated synthetic oligosaccharides having a penultimate amino sugar: fast atom bombardment ionization, collisional-induced dissociation and tandem mass spectrometry

Certain linkage positions in oligosaccharides can be discerned by collision-activated dissociation mass spectrometry, rationalized by molecular modelling. Previous work on synthetic oligosaccharides has suggested that daughter ion patterns can distinguish among intact compounds which terminate in alpha-L-fucose and have a penultimate amino sugar. The current study indicates that these observations can be extended to oligosaccharides terminating in beta-D-galactose. In addition, we have observed that protonated, ammoniated and lithiated molecular ions all produce linkage-specific daughter ion spectra in these two sets of oligosaccharides. Sodiated molecular ions could be fragmented usefully under high collision energy offset conditions; potassiated ions were stable and not dissociable under conditions available in a triple-quadrupole instrument. We also show linkage discernment among the permethylated set of these six synthetic oligosaccharides. Methylated derivatives of this set of compounds give more useful product ions, including a 3-linkage specific ion. A novel relationship was noted by a plot of collision energy against (daughter ion/parent ion) ratio, which gave a unique slope for each of the non-reducing terminal linkage positions 3, 4 and 6 in the set of six compounds. The slope of this plot is related to the ability of each linkage position in the oligosaccharide to absorb collisional energy. Rotational freedom of the individual glycosidic linkage is hypothesized to play a role in this phenomenon.