The effect of polymer end-group on the formation of styrene - maleic acid lipid particles (SMALPs)

A series of block copolymers comprising styrene and maleic acid (SMA) has been prepared using RAFT polymerisation. RAFT often results in a large hydrophobic alkylthiocarbonylthio end group and this work examines its effect on the solution behaviour of the copolymers. SMA variants with, and without, this end group were synthesised and their behaviour compared with a commercially-available random copolymer of similar molecular weight. Dynamic light scattering and surface tension measurements found the RAFT-copolymers preferentially self-assembled into higher-order aggregates in aqueous solution. Small angle neutron scattering using deuterated styrene varients add support to the accepted model that these agreggates comprise a solvent-protected styrenic core with an acid-rich shell. Replacing the hydrophobic RAFT end group with a more hydrophilic nitrile caused differences in the resulting surface activity, attributed to the ability of the adjoining styrene homoblock to drive aggregation. Each of the copolymers formed SMALP nanodiscs with DMPC lipids, which were found to encapsulate a model membrane protein, gramicidin. However, end group variation affected solubilisition of DPPC, a lipid with a higher phase transition temperature. When using RAFT-copolymers terminated with a hydrophobic group, swelling of the bilayer and greater penetration of the homoblock into the nanodisc core occurred with increasing homoblock length. Conversely, commercial and nitrile-terminated RAFT-copolymers produced nanodisc sizes that stayed constant, instead indicating interaction at the edge of the lipid patch. The results highlight how even minor changes to the copolymer can modify the amphiphilic balance between regions, knowledge useful towards optimising copolymer structure to enhance and control nanodisc formation.

Bayesian methods provide a practical real-world evidence framework for evaluating the impact of changes in radiotherapy

PURPOSE

Retrospective studies have identified a link between the average set-up error of lung cancer patients treated with image-guided radiotherapy (IGRT) and survival. The IGRT protocol was subsequently changed to reduce the action threshold. In this study, we use a Bayesian approach to evaluate the clinical impact of this change to practice using routine 'real-world' patient data.

METHODS AND MATERIALS

Two cohorts of NSCLC patients treated with IGRT were compared: pre-protocol change (N = 780, 5 mm action threshold) and post-protocol change (N = 411, 2 mm action threshold). Survival models were fitted to each cohort and changes in the hazard ratios (HR) associated with residual set-up errors was assessed. The influence of using an uninformative and a skeptical prior in the model was investigated.

RESULTS

Following the reduction of the action threshold, the HR for residual set-up error towards the heart was reduced by up to 10%. Median patient survival increased for patients with set-up errors towards the heart, and remained similar for patients with set-up errors away from the heart. Depending on the prior used, a residual hazard ratio may remain.

CONCLUSIONS

Our analysis found a reduced hazard of death and increased survival for patients with residual set-up errors towards versus away from the heart post-protocol change. This study demonstrates the value of a Bayesian approach in the assessment of technical changes in radiotherapy practice and supports the consideration of adopting this approach in further prospective evaluations of changes to clinical practice.

Baseline MD Anderson Symptom Inventory Score is Strongly Associated With Patient-reported Acute and Late Toxicity Following (Chemo) Radiotherapy for Head and Neck Cancers

AIMS

Patient-reported outcomes measures (PROMs) are an increasingly recognised end point of radiotherapy studies. We hypothesised that the baseline PROMs score is the strongest predictor for acute and late scores after treatment. We assessed the strength of association of baseline MD Anderson Symptom Inventory (MDASI) scores, alongside other known factors for patient- or clinician-reported toxicity, with acute (6-week) and late (12-month) scores in head and neck cancer (HNC) patients following (chemo)radiotherapy.

MATERIALS AND METHODS

This was a retrospective analysis of longitudinal MDASI scores for 247 patients receiving (chemo)radiotherapy for HNC via multivariable linear regression. The factors investigated were: baseline symptom score, age, sex, concurrent chemotherapy, disease stage, radiotherapy fractionation, prior definitive surgery and performance status. Patients with a baseline score >4 in any item were defined as symptomatic in that category.

RESULTS

Patients rated symptomatic for an MDASI item pre-treatment on average reported statistically (P < 0.0005) and clinically (>-1.5) significant reductions in scores 6 weeks and 12 months after (chemo)radiotherapy for all considered sub-items except taste, dryness of mouth and problems with teeth. Conversely patients asymptomatic at baseline reported a worsening of scores at both time points. Other investigated factors showed little association with changes in MDASI scores following treatment.

CONCLUSIONS

Our data show that baseline MDASI scores are strongly associated with patient-reported toxicity 6 weeks and 12 months after (chemo)radiotherapy for HNC. Patients who are symptomatic at baseline can experience an early and durable benefit from treatment. This finding can inform discussions with patients before therapy and has implications for use of PROMs scores for the assessment of toxicity in randomised trials.

A preclinical radiotherapy dosimetry audit using a realistic 3D printed murine phantom

Preclinical radiation research lacks standardized dosimetry procedures that provide traceability to a primary standard. Consequently, ensuring accuracy and reproducibility between studies is challenging. Using 3D printed murine phantoms we undertook a dosimetry audit of Xstrahl Small Animal Radiation Research Platforms (SARRPs) installed at 7 UK centres. The geometrically realistic phantom accommodated alanine pellets and Gafchromic EBT3 film for simultaneous measurement of the dose delivered and the dose distribution within a 2D plane, respectively. Two irradiation scenarios were developed: (1) a 10 × 10 mm2 static field targeting the pelvis, and (2) a 5 × 5 mm2 90° arc targeting the brain. For static fields, the absolute difference between the planned dose and alanine measurement across all centres was 4.1 ± 4.3% (mean ± standard deviation), with an overall range of - 2.3 to 10.5%. For arc fields, the difference was - 1.2% ± 6.1%, with a range of - 13.1 to 7.7%. EBT3 dose measurements were greater than alanine by 2.0 ± 2.5% and 3.5 ± 6.0% (mean ± standard deviation) for the static and arc fields, respectively. 2D dose distributions showed discrepancies to the planned dose at the field edges. The audit demonstrates that further work on preclinical radiotherapy quality assurance processes is merited.

Fluorescent styrene maleic acid copolymers to facilitate membrane protein studies in lipid nanodiscs

Fluorescently-labelled variants of poly(styrene-co-maleic acid), SMA, have been synthesised by RAFT copolymerisation. We show that low ratios of vinyl fluorophores, analogous to styrene, can be successfully incorporated during polymerisation without detriment to nanodisc formation upon interaction with lipids. These novel copolymers are capable of encapuslating lipids and the model membrane protein, gramicidin, and hence have the potential to be applied in fluorescence-based biological studies. To demonstrate this, energy transfer is used to probe polymer-protein interactions in nanodiscs. The copolymers may also be used to monitor nanodisc self assembly by exploiting aggregation-caused-quenching (ACQ).

The interaction of styrene maleic acid copolymers with phospholipids in Langmuir monolayers, vesicles and nanodiscs; a structural study

HYPOTHESIS

Self-assembly of amphipathic styrene maleic acid copolymers with phospholipids in aqueous solution results in the formation of 'nanodiscs' containing a planar segment of phospholipid bilayer encapsulated by a polymer belt. Recently, studies have reported that lipids rapidly exchange between both nanodiscs in solution and external sources of lipids. Outstanding questions remain regarding details of polymer-lipid interactions, factors influencing lipid exchange and structural effects of such exchange processes. Here, the dynamic behaviour of nanodiscs is investigated, specifically the role of membrane charge and polymer chemistry.

EXPERIMENTS

Two model systems are investigated: fluorescently labelled phospholipid vesicles, and Langmuir monolayers of phospholipids. Using fluorescence spectroscopy and time-resolved neutron reflectometry, the membrane potential, monolayer structure and composition are monitored with respect to time upon polymer and nanodisc interactions.

FINDINGS

In the presence of external lipids, polymer chains embed throughout lipid membranes, the extent of which is governed by the net membrane charge. Nanodiscs stabilised by three different polymers will all exchange lipids and polymer with monolayers to differing extents, related to the properties of the stabilising polymer belt. These results demonstrate the dynamic nature of nanodiscs which interact with the local environment and are likely to deposit both lipids and polymer at all stages of use.

Membrane extraction with styrene-maleic acid copolymer results in insulin receptor autophosphorylation in the absence of ligand

Extraction of integral membrane proteins with poly(styrene-co-maleic acid) provides a promising alternative to detergent extraction. A major advantage of extraction using copolymers rather than detergent is the retention of the lipid bilayer around the proteins. Here we report the first functional investigation of the mammalian insulin receptor which was extracted from cell membranes using poly(styrene-co-maleic acid). We found that the copolymer efficiently extracted the insulin receptor from 3T3L1 fibroblast membranes. Surprisingly, activation of the insulin receptor and proximal downstream signalling was detected upon copolymer extraction even in the absence of insulin stimulation. Insulin receptor and IRS1 phosphorylations were above levels measured in the control extracts made with detergents. However, more distal signalling events in the insulin signalling cascade, such as the phosphorylation of Akt were not observed. Following copolymer extraction, in vitro addition of insulin had no further effect on insulin receptor or IRS1 phosphorylation. Therefore, under our experimental conditions, the insulin receptor is not functionally responsive to insulin. This study is the first to investigate receptor tyrosine kinases extracted from mammalian cells using a styrene-maleic acid copolymer and highlights the importance of thorough functional characterisation when using this method of protein extraction.

Ab initio reconstruction of small angle scattering data for membrane proteins in copolymer nanodiscs

Background

Small angle scattering techniques are beginning to be more widely utilised for structural analysis of biological systems. However, applying these techniques to study membrane proteins still remains problematic, due to sample preparation requirements and analysis of the resulting data. The development of styrene-maleic acid co-polymers (SMA) to extract membrane proteins into nanodiscs for further study provides a suitable environment for structural analysis.

Methods

We use small angle neutron scattering (SANS) with three different contrasts to determine structural information for two different polymer nanodisc-incorporated proteins, Outer membrane protein F (OmpF) and gramicidin. Ab initio modelling was applied to generate protein/lipid structures from the SANS data. Other complementary structural methodologies, such as DLS, CD and TEM were compared alongside this data with known protein crystal structures.

Results

A single-phase model was constructed for gramicidin-containing nanodiscs, which showed dimer formation in the centre of the nanodisc. For OmpF-nanodiscs we were able to construct a multi-phase model, providing structural information on the protein/lipid and polymer components of the sample.

Conclusions

Polymer-nanodiscs can provide a suitable platform to investigate certain membrane proteins using SANS, alongside other structural methodologies. However, differences between the published crystal structure and OmpF-nanodiscs were observed, suggesting the nanodisc structure could be altering the folding of the protein.

General significance

Small angle scattering techniques can provide structural information on the protein and polymer nanodisc without requiring crystallisation of the protein. Additional complementary techniques, such as ab initio modelling, can generate alternative models both the protein and nanodisc system.

Development of Methodology to Investigate the Surface SMALPome of Mammalian Cells

Extraction of membrane proteins from biological membranes has traditionally involved detergents. In the past decade, a new technique has been developed, which uses styrene maleic acid (SMA) copolymers to extract membrane proteins into nanodiscs without the requirement of detergents. SMA nanodiscs are compatible with analytical techniques, such as small-angle scattering, NMR spectroscopy, and DLS, and are therefore an attractive medium for membrane protein characterization. While mass spectrometry has also been reported as a technique compatible with copolymer extraction, most studies have focused on lipidomics, which involves solvent extraction of lipids from nanodiscs prior to mass-spectrometry analysis. In this study, mass spectrometry proteomics was used to investigate whether there are qualitative or quantitative differences in the mammalian plasma membrane proteins extracted with SMA compared to a detergent control. For this, cell surface proteins of 3T3L1 fibroblasts were biotinylated and extracted using either SMA or detergent. Following affinity pull-down of biotinylated proteins with NeutrAvidin beads, samples were analyzed by nanoLC-MS. Here, we report for the first time, a global proteomics protocol for detection of a mammalian cell "SMALPome", membrane proteins incorporated into SMA nanodiscs. Removal of SMA from samples prior to processing of samples for mass spectrometry was a crucial step in the protocol. The reported surface SMALPome of 3T3L1 fibroblasts consists of 205 integral membrane proteins. It is apparent that the detergent extraction method used is, in general, quantitatively more efficient at extracting proteins from the plasma membrane than SMA extraction. However, samples prepared following detergent extraction contained a greater proportion of proteins that were considered to be "non-specific" than in samples prepared from SMA extracts. Tantalizingly, it was also observed that proteins detected uniquely or highly preferentially in pull-downs from SMA extracts were primarily multi-spanning membrane proteins. These observations hint at qualitative differences between SMA and detergent extraction that are worthy of further investigation.

Reliability and prognostic value of radiomic features are highly dependent on choice of feature extraction platform

OBJECTIVE

To investigate the effects of Image Biomarker Standardisation Initiative (IBSI) compliance, harmonisation of calculation settings and platform version on the statistical reliability of radiomic features and their corresponding ability to predict clinical outcome.

METHODS

The statistical reliability of radiomic features was assessed retrospectively in three clinical datasets (patient numbers: 108 head and neck cancer, 37 small-cell lung cancer, 47 non-small-cell lung cancer). Features were calculated using four platforms (PyRadiomics, LIFEx, CERR and IBEX). PyRadiomics, LIFEx and CERR are IBSI-compliant, whereas IBEX is not. The effects of IBSI compliance, user-defined calculation settings and platform version were assessed by calculating intraclass correlation coefficients and confidence intervals. The influence of platform choice on the relationship between radiomic biomarkers and survival was evaluated using univariable cox regression in the largest dataset.

RESULTS

The reliability of radiomic features calculated by the different software platforms was only excellent (ICC > 0.9) for 4/17 radiomic features when comparing all four platforms. Reliability improved to ICC > 0.9 for 15/17 radiomic features when analysis was restricted to the three IBSI-compliant platforms. Failure to harmonise calculation settings resulted in poor reliability, even across the IBSI-compliant platforms. Software platform version also had a marked effect on feature reliability in CERR and LIFEx. Features identified as having significant relationship to survival varied between platforms, as did the direction of hazard ratios.

CONCLUSION

IBSI compliance, user-defined calculation settings and choice of platform version all influence the statistical reliability and corresponding performance of prognostic models in radiomics.

KEY POINTS

• Reliability of radiomic features varies between feature calculation platforms and with choice of software version. • Image Biomarker Standardisation Initiative (IBSI) compliance improves reliability of radiomic features across platforms, but only when calculation settings are harmonised. • IBSI compliance, user-defined calculation settings and choice of platform version collectively affect the prognostic value of features.

Radiomics as a personalized medicine tool in lung cancer: Separating the hope from the hype

Radiomics has become a popular image analysis method in the last few years. Its key hypothesis is that medical images harbor biological, prognostic and predictive information that is not revealed upon visual inspection. In contrast to previous work with a priori defined imaging biomarkers, radiomics instead calculates image features at scale and uses statistical methods to identify those most strongly associated to outcome. This builds on years of research into computer aided diagnosis and pattern recognition. While the potential of radiomics to aid personalized medicine is widely recognized, several technical limitations exist which hinder biomarker translation. Aspects of the radiomic workflow lack repeatability or reproducibility under particular circumstances, which is a key requirement for the translation of imaging biomarkers into clinical practice. One of the most commonly studied uses of radiomics is for personalized medicine applications in Non-Small Cell Lung Cancer (NSCLC). In this review, we summarize reported methodological limitations in CT based radiomic analyses together with suggested solutions. We then evaluate the current NSCLC radiomics literature to assess the risk associated with accepting the published conclusions with respect to these limitations. We review different complementary scoring systems and initiatives that can be used to critically appraise data from radiomics studies. Wider awareness should improve the quality of ongoing and future radiomics studies and advance their potential as clinically relevant biomarkers for personalized medicine in patients with NSCLC.

Sonochemical production and activation of responsive polymer microspheres

This paper reports work aimed at extending previous studies of the sonochemical method for forming microspheres. It shows that a previously reported method for encapsulating and delivering hydrophilic species using a 'double emulsion' method can be used with chitosan or thiolated poly(methacrylic acid), PMAA_SH, based systems. One particular application involves targeted catalysis where gold nanoparticles are incorporated into chitosan microspheres and can be released to catalyse the borohydride reduction of 4-nitrophenol. Also reported is the use of ultrasound to 'trigger' the reduction reaction of 4-nitrophenol by rupturing nanoparticle-containing microspheres to release the catalyst. We also demonstrate that more sustainable and potentially lower environmental impact processes can be prepared by substituting commercial vegetable oil for the hydrocarbons used previously. We also report for the first time the use of responsive block copolymers to form microspheres. The copolymers consist of PMAA_SH blocks around a central, responsive block of poly(ethylene glycol), poly(4-vinylphenyl boronic acid) or poly(N-isopropylacrylamide) to give systems that potentially respond to pH, sugar concentrations or temperature.

Preclinical dosimetry: exploring the use of small animal phantoms

Preclinical radiotherapy studies using small animals are an indispensable step in the pathway from in vitro experiments to clinical implementation. As radiotherapy techniques advance in the clinic, it is important that preclinical models evolve to keep in line with these developments. The use of orthotopic tumour sites, the development of tissue-equivalent mice phantoms and the recent introduction of image-guided small animal radiation research platforms has enabled similar precision treatments to be delivered in the laboratory.

These technological developments, however, are hindered by a lack of corresponding dosimetry standards and poor reporting of methodologies. Without robust and well documented preclinical radiotherapy quality assurance processes, it is not possible to ensure the accuracy and repeatability of dose measurements between laboratories. As a consequence current RT-based preclinical models are at risk of becoming irrelevant.

In this review we explore current standardization initiatives, focusing in particular on recent developments in small animal irradiation equipment, 3D printing technology to create customisable tissue-equivalent dosimetry phantoms and combining these phantoms with commonly used detectors.

Comparison of the effects of gamma or sonochemical irradiation of carbon nanotubes and the influence on the mechanical and dielectric properties of chitosan nanocomposites

Chitosan-carbon nanotube (Chi-CNT) composite materials have been prepared with CNTs that were surface treated using either dilute acid combined with 20 kHz ultrasound or gamma-irradiation in air. The mechanical and dielectric properties have been measured and compared. Both modification methods gave nanocomposites with much improved tensile properties over native chitosan. The sonochemically treated samples were stronger with higher tensile strength but at the expense of lower elasticity and extensibility than found when γ-irradiation was used. Impedance spectra showed differences in the polymer chain transitions and in the conduction mechanisms within the nanocomposites. The results correlated well with previous work suggesting that the two modification techniques result in CNT surfaces with higher polarity. This enhances interfacial interactions with the chitosan matrix although the extent of functionalisation was greater in the sonochemical case. This work demonstrates that sonochemical modification under mild conditions is a useful method for modifying CNTs for inclusion in nanocomposite materials. However, the resulting material properties depend on the level of treatment so that the sonochemical conditions need to be carefully evaluated and controlled if the effects are to be optimised.

Synthesis, Radiolabelling and In Vitro Imaging of Multifunctional Nanoceramics

Molecular imaging has become a powerful technique in preclinical and clinical research aiming towards the diagnosis of many diseases. In this work, we address the synthetic challenges in achieving lab-scale, batch-to-batch reproducible copper-64- and gallium-68-radiolabelled metal nanoparticles (MNPs) for cellular imaging purposes. Composite NPs incorporating magnetic iron oxide cores with luminescent quantum dots were simultaneously encapsulated within a thin silica shell, yielding water-dispersible, biocompatible and luminescent NPs. Scalable surface modification protocols to attach the radioisotopes 64Cu (t1/2=12.7 h) and 68Ga (t1/2=68 min) in high yields are reported, and are compatible with the time frame of radiolabelling. Confocal and fluorescence lifetime imaging studies confirm the uptake of the encapsulated imaging agents and their cytoplasmic localisation in prostate cancer (PC-3) cells. Cellular viability assays show that the biocompatibility of the system is improved when the fluorophores are encapsulated within a silica shell. The functional and biocompatible SiO2 matrix represents an ideal platform for the incorporation of 64Cu and 68Ga radioisotopes with high radiolabelling incorporation.

Results from a clinical trial evaluating the efficacy of real-time body surface visual feedback in reducing patient motion during lung cancer radiotherapy

INTRODUCTION

Optical surface measurement devices are a maturing technology in radiotherapy. The challenge for such devices is to demonstrate how they can improve clinical care. We present results from a phase 1 clinical trial designed to test the hypothesis that if presented with live data from a novel optical measurement device, showing their deviation from an ideal radiotherapy treatment position, patients will be able to better control their motion and increase their geometrical conformance.

METHOD AND MATERIALS

Fourteen lung cancer patients were enrolled in a prospective clinical study and asked to use a variety of visual feedback schema from a novel in-house developed optical surface measurement device. The magnitude and regularity of their body surface motion using the different schema was compared to that when free-breathing at three time-points throughout their radiotherapy treatment schedule. Additionally, 4D Cone Beam CT data, acquired simultaneously with the optical measurements, was used to test if improvements in external motion are reflected in changes in internal tumor motion.

RESULTS

The primary endpoint of the trial, device tolerability assessed by the fraction of participants completing all study sessions, was 86%. Secondary endpoints showed that use of the visual feedback device was found to statistically significantly decrease body surface motion magnitude by an average of 17% over the study cohort, although not universally. Similarly body surface motion variability was decreased by 18% on average. Internal tumor motion magnitude was also found to be statistically significantly decreased by an average of 14% when using the feedback device. Reduction in external motion was predictive of reduced internal motion but no evidence of a simple correlation between changes in internal and external motion magnitude was found.

CONCLUSIONS

Visual feedback of live motion is well tolerated by lung cancer patients and can reduce both body surface and tumor motion.

Sonochemical modification of carbon nanotubes for enhanced nanocomposite performance

Multi-walled carbon nanotubes (CNTs) have been treated using 20kHz ultrasound in combination with dilute nitric and sulfuric acids at much lower concentrations than previously reported. The measurements revealed an optimum set of sonication conditions (in this case 30min at 12Wcm^-2) exists to overcome aggregation of the nanotubes and to allow efficient dispersion in ethanol or in chitosan. Transmission electron microscopy and Raman spectroscopy suggested the removal of amorphous material and reduction of the CNT diameter as well as modifications to their defect structures. The surface oxidation was determined by FTIR spectroscopy. At longer times or higher ultrasound intensities, degradation such as nanotube shortening and additional defect generation in the graphitic network occurred and the benefits of using ultrasound decreased. The modified CNTs were used as fillers for chitosan films and gave a tenfold increase in tensile strength and integrity of the films. The methodology was combined with sonochemical generation of gold or iron oxide nanoparticles to produce a range of functional membranes for catalytic reductive hydrogenation or dye degradation under conditions that are more environmentally benign than those previously used. Our results further add to the usefulness of sonochemistry as a valuable tool in preparative materials chemistry but also illustrate the crucial importance of careful control over the experimental conditions if optimum results are to be obtained.

Sonochemical production of nanoparticle metal oxides for potential use in dentistry

Two types of ultrasonic instruments used in dentistry have been compared with a sonochemical horn for the production of copper oxide and zinc oxide nanoparticles. The nanoparticles can be produced from benign reagents using dental instruments as the source of sonochemical enhancement. The process has been operated in resin models of teeth in a preliminary exploration of the potential of the method for enhancing procedures such as root canal surgery. The technique is potentially useful but further work is needed for a full assessment of using in-situ generated nanoparticles as an aid to disinfection during some types of dental surgery.

Eco-friendly synthesis and catalytic application of chitosan/gold/carbon nanotube nanocomposite films

Novel eco-friendly chitosan nanocomposite membranes containing gold nanoparticles and carbon nanotubes (CNTs) have been synthesized to produce reusable catalytic membranes.

Sonochemical characterisation of ultrasonic dental descalers

An ultrasonic dental descaling instrument has been characterised using sonochemical techniques. Mapping the emission from luminol solution revealed the distribution of cavitation produced in water around the tips. Hydroxyl radical production rates arising from water sonolysis were measured using terephthalate dosimetry and found to be in the range of μmolmin(-1), comparable with those from a sonochemical horn. Removal of an ink coating from a glass slide showed that cleaning occurred primarily where the tip contacted the surface but was also observed in regions where cavitation occurred even when the tip did not contact the surface. Differences in behaviour were noted between different tip designs and computer simulation of the acoustic pressure distributions using COMSOL showed the reasons behind the different behaviour of the tip designs.

A computational simulation study on the acoustic pressure generated by a dental endosonic file: effects of intensity, file shape and volume

One of the uses of ultrasound in dentistry is in the field of endodontics (i.e. root canal treatment) in order to enhance cleaning efficiency during the treatment. The acoustic pressures generated by the oscillation of files in narrow channels has been calculated using the COMSOL simulation package. Acoustic pressures in excess of the cavitation threshold can be generated and higher values were found in narrower channels. This parallels experimental observations of sonochemiluminescence. The effect of varying the channel width and length and the dimensions and shape of the file are reported. As well as explaining experimental observations, the work provides a basis for the further development and optimisation of the design of endosonic files.

Synergistic effects of combining ultrasound with the Fenton process in the degradation of Reactive Blue 19

The decoloration of reactive dye C.I. Reactive Blue 19 (RB 19) using combined ultrasound with the Fenton process has been investigated. The effect of varying the concentrations of hydrogen peroxide and iron sulfate, initial pH, ultrasonic power, initial dye concentration and dissolved gas on the decoloration and degradation efficiencies was measured. Calibration of the ultrasound systems was performed using calorimetric measurements and oxidative species monitoring using the Fricke dosimeter and degradations were carried out with a 20 kHz probe type transducer at 2, 4, 6 and 8 W cm(-2) of acoustic intensity at 15, 25, 50 and 75 mg L(-1) initial dye concentrations. First order rate kinetics was observed. It was found that while the degradation rate due to ultrasound alone was slow, sonication significantly accelerated the Fenton reaction. While the results were similar to those reported for other dyes, the effects occurred at lower concentrations. The rate and extent of decoloration of RB 19 increased with rising hydrogen peroxide concentration, ultrasonic powers and iron sulfate concentration but decreased with increasing dye concentration. An optimum pH value of pH=3.5 was found. The rate of decoloration was higher when dissolved oxygen was present as compared with nitrogen and argon confirming the solution phase mechanism of the degradation.

Biomimetic polyorganosiloxanes: model compounds for new materials

The chemistry of N-organosilylalkyl-substituted heterocyclic bases (thymine, adenine and cytosine) is described, covering the structures of model compounds, the synthesis of substituted oligo-siloxanes and a preliminary report of the synthesis of a poly(organosiloxane) with pendant N-alkyl(heterocycle) functionalities. N-Alkenylthymines CH2=CH(CH2)(n)T (T = thymine, n = 1 (1), 2 (2), 3 (3)) have been prepared and 2 hydrosilylated to form PhMe2Si(CH2)4T (5). Alternatively, 5 was prepared by reaction of PhMe2Si(CH2)4Br (6) with (O,O-SiMe3)2T, a method which has also been used to prepare PhMe2Si(CH2)4A (7) and PhMe2Si(CH2)4C (8) (A = adenine, C = cytosine). Model di- and tri-siloxanes [Br(CH2)4(Me)2Si]2O (10), Me3SiOSi(Me)2(CH2)4Br (11), PhMe2SiOSi(Me)2(CH2)4Br (12) and (Me3SiO)2(Me)Si(CH2)4Br (13) have been prepared by hydrosilylation of H2C[double bond, length as m-dash]C(H)(CH2)4Br with an appropriate hydrosiloxane and used to prepare Me3SiO(Me)2Si(CH2)4T (14), Me3SiO(Me)2Si(CH2)4A (15) (both from 11), and (Me3SiO)2(Me)Si(CH2)4T (16), (Me3SiO)2(Me)Si(CH2)4A (17) (both from 13). 10 reacts with thymine to give a mixture of the pyrimidocyclophane cyclo-T-N,N-[(CH2)4(Me)2Si]2O (19) and [T(CH2)4Si(Me)2]2O (20), while cytosine reacts similarly to form cyclo-C-N,N-[(CH2)4(Me)2Si]2O (21; as an imine) and [C(CH2)4Si(Me)2]2O (22); adenine only generates [A(CH2)4Si(Me)2]2O (18) in an analogous synthesis. Using a related protocol, polymeric {[MeSi(O)(CH2)4Br]2[Me2SiO]98}n (23) has been converted to {[MeSi(O)(CH2)4T]2[Me2SiO]98}n (24) and {[MeSi(O)(CH2)4A]2[Me2SiO]98}n (25). The structures of 4, 5, 8, 19 and 21, along with a 2 : 1 adduct of 5 with Ni(dithiobiuret)2 (9) are reported.

Self-management of patient body position, pose, and motion using wide-field, real-time optical measurement feedback: results of a volunteer study

PURPOSE

We present the results of a clinical feasibility study, performed in 10 healthy volunteers undergoing a simulated treatment over 3 sessions, to investigate the use of a wide-field visual feedback technique intended to help patients control their pose while reducing motion during radiation therapy treatment.

METHODS AND MATERIALS

An optical surface sensor is used to capture wide-area measurements of a subject's body surface with visualizations of these data displayed back to them in real time. In this study we hypothesize that this active feedback mechanism will enable patients to control their motion and help them maintain their setup pose and position. A capability hierarchy of 3 different level-of-detail abstractions of the measured surface data is systematically compared.

RESULTS

Use of the device enabled volunteers to increase their conformance to a reference surface, as measured by decreased variability across their body surfaces. The use of visual feedback also enabled volunteers to reduce their respiratory motion amplitude to 1.7 ± 0.6 mm compared with 2.7 ± 1.4 mm without visual feedback.

CONCLUSIONS

The use of live feedback of their optically measured body surfaces enabled a set of volunteers to better manage their pose and motion when compared with free breathing. The method is suitable to be taken forward to patient studies.

Automated delineation of radiotherapy volumes: are we going in the right direction?

Rapid and accurate delineation of target volumes and multiple organs at risk, within the enduring International Commission on Radiation Units and Measurement framework, is now hugely important in radiotherapy, owing to the rapid proliferation of intensity-modulated radiotherapy and the advent of four-dimensional image-guided adaption. Nevertheless, delineation is still generally clinically performed with little if any machine assistance, even though it is both time-consuming and prone to interobserver variation. Currently available segmentation tools include those based on image greyscale interrogation, statistical shape modelling and body atlas-based methods. However, all too often these are not able to match the accuracy of the expert clinician, which remains the universally acknowledged gold standard. In this article we suggest that current methods are fundamentally limited by their lack of ability to incorporate essential human clinical decision-making into the underlying models. Hybrid techniques that utilise prior knowledge, make sophisticated use of greyscale information and allow clinical expertise to be integrated are needed. This may require a change in focus from automated segmentation to machine-assisted delineation. Similarly, new metrics of image quality reflecting fitness for purpose would be extremely valuable. We conclude that methods need to be developed to take account of the clinician's expertise and honed visual processing capabilities as much as the underlying, clinically meaningful information content of the image data being interrogated. We illustrate our observations and suggestions through our own experiences with two software tools developed as part of research council-funded projects.

Ultrasound promoted reaction of Rhodamine B with sodium hypochlorite using sonochemical and dental ultrasonic instruments

The sonochemical acceleration of bleaching of Rhodamine B by sodium hypochlorite has been studied using ultrasound intensities in the range 0-7 W cm(-2). Using a 20 kHz ultrasonic horn, it was shown that ultrasound could significantly shorten the treatment time and/or the concentration of hypochlorite required for the reaction. A number of intermediate species formed during the reaction have been identified. It was demonstrated that the same sonochemical reactions occur during the use of dental ultrasound instruments of the type used in endodontics where hypochlorite solutions act as disinfectants. Results showed pseudo-first order degradation kinetics for the degradation of Rhodamine B for both types of source. Both the distribution of cavitation and the resulting bleaching reactions were dependent on the design of the tips. The bleaching reaction can therefore be used to characterise the behaviour of dental instruments and aid in the optimisation of their performance.

Next generation optical surface sensing for real-time measurement in radiotherapy

With the introduction of intensive new treatments such as hypo-fractionation and proton beam therapy, localization of the tumor target volume and tracking of points across the skin entrance surface have become critically important. Optical metrology has been used to monitor the patient's bulk position and motion throughout treatment. However systems have not been capable of high temporal and spatial resolution whole-surface topology measurement. We describe the implementation of such a system based on Fourier profilometry. Its algorithm is split into four separate processing stages, including spatial phase determination: descriptions of each stage are given along with the modifications made to increase performance. The optimized system is capable of processing 23 frames per second (fps), with each frame providing 512 × 512 measured points. The data density, accuracy and performance of the system are an order of magnitude improvement on commercially available clinical systems. We show that this performance permits genuinely real-time measurement of a patient, live during both setup and radiation treatment delivery. It is also fast enough to provide smooth dynamic visualizations of motion at all points on the wrap-around body surface for radiotherapy staff and intuitive, direct feed-back to patients.

Ultrasound promoted Wurtz coupling of alkyl bromides and dibromides

Sonochemically enhanced Wurtz coupling using lithium metal has been investigated for a number of isomeric alkyl bromides under a variety conditions. The products result from direct coupling of short lived radicals formed at the metal surface rather than the secondary radicals which can be formed during coupling of aromatic halides and thus give rise to a single major product. Coupling has been extended to dibrominated aryl and alkyl compounds as well as showing that aryl-alkyl coupling is possible. Dibrominated alkyls were found to give low molecular weight oligomers although no reaction occurred for 1,2-isomers. The growth of oligomers in THF may be solubility limited. A simple model is proposed to explain these findings.

Real-time optical measurement of the dynamic body surface for use in guided radiotherapy

Optical measurements are increasingly used in radiotherapy. In this paper we present, in detail, the design and implementation of a multi-channel optical system optimized for fast, high spatial resolution, dynamic body surface measurement in guided therapy. We include all algorithmic modifications and calibration procedures required to create a robust, practical system for clinical use. Comprehensive static and dynamic phantom validation measurements in the radiotherapy treatment room show: conformance with simultaneously measured cone beam CT data to within 1 mm over 62% ± 8% of the surface and 2 mm over 90% ± 3%; agreement with the measured radius of a precision geometrical phantom to within 1 mm; and true real-time performance with image capture through to surface display at 23 Hz. An example patient dataset is additionally included, indicating similar performance in the clinic.

Reduction of motion artefacts in on-board cone beam CT by warping of projection images

OBJECTIVE

We describe the development and testing of a motion correction method for flat panel imager-based cone beam CT (CBCT) based on warping of projection images.

METHODS

Markers within or on the surface of the patient were tracked and their mean three-dimensional (3D) position calculated. The two-dimensional (2D) cone beam projection images were then warped before reconstruction to place each marker at the projection from its mean 3D position. The motion correction method was tested using simulated cone beam projection images of a deforming virtual phantom, real CBCT images of a moving breast phantom and clinical CBCT images of a patient with breast cancer and another with pancreatic cancer undergoing radiotherapy.

RESULTS

In phantom studies, the method was shown to greatly reduce motion artefacts in the locality of the radiotherapy target and allowed the true surface shape to be accurately recovered. The breast phantom motion-compensated surface was within 1 mm of the true surface shape for 90% of surface points and greater than 2 mm from the true surface at only 2% of points. Clinical CBCT images showed improved image quality in the locality of the radiotherapy target after motion correction.

CONCLUSION

The proposed method is effective in reducing motion artefacts in CBCT images.

Direct observation of cavitation fields at 23 and 515 kHz

Direct observation of cavitation fields using photography, sonoluminescence and luminol "mapping" is reported for a 23 kHz horn sonicator and a 515 kHz plate transducer system. The effect of sound intensity and added surfactant on the cavitation fields is described. The observations support previously reported results suggesting significant differences in the cavitation fields between the two sonication systems.

Preparation and in vitro evaluation of topical formulations based on polystyrene-poly-2-hydroxyl methacrylate nanoparticles

The skin disposition of topically applied nanoparticles with varying degrees of hydrophobicity, composed of different proportions of polystyrene (PS) and poly-(2-hydroxyethyl methacrylate) (HEMA), and of an associated, model "active" (Nile Red), was investigated. PS-HEMA copolymer nanoparticles were fluorescently labeled, via the covalent incorporation of a small quantity of fluorescein methacrylate, and characterized by dynamic light scattering, transmission electron microscopy and NMR. The fluorophore, Nile Red, was dispersed into the nanoparticles and its loading was determined by ultracentrifugation. Skin uptake was assessed in vitro following a 6 h application of the nanoparticle formulation, via stratum corneum (SC) tape-stripping and confocal microscopy. Nanoparticle diameters were below 100 nm. Progressive introduction of HEMA decreased particle hydrophobicity and reduced Nile Red loading. Uptake of Nile Red into the skin, as assessed both by the amounts extracted from the SC and by confocal microscopy, decreased as the percentage HEMA increased. Confocal microscopy confirmed that nanoparticles could not move beyond the superficial SC, but did show affinity for hair follicle openings. In conclusion, the loading of a lipophilic "active" into nanoparticles, and its subsequent release when these formulations are applied topically, are sensitive to the composition and relative hydrophobicity of the carrier.

Cavitation occurrence around ultrasonic dental scalers

Ultrasonic scalers are used in dentistry to remove calculus and other contaminants from teeth. One mechanism which may assist in the cleaning is cavitation generated in cooling water around the scaler. The vibratory motion of three designs of scaler tip in a water bath has been characterised by laser vibrometry, and compared with the spatial distribution of cavitation around the scaler tips observed using sonochemiluminescence from a luminol solution. The type of cavitation was confirmed by acoustic emission analysed by a 'Cavimeter' supplied by NPL. A node/antinode vibration pattern was observed, with the maximum displacement of each type of tip occurring at the free end. High levels of cavitation activity occurred in areas surrounding the vibration antinodes, although minimal levels were observed at the free end of the tip. There was also good correlation between vibration amplitude and sonochemiluminescence at other points along the scaler tip. 'Cavimeter' analysis correlated well with luminol observations, suggesting the presence of primarily transient cavitation.