Fabrication and Dosimetric Characteristics of Silicon Elastomer-Based Bolus Using External Beam Radiotherapy

OBJECTIVE

A study on dosimetric characteristics of silicon elastomer-based bolus was carried out using a Linear accelerator (Varian - Unique Performance). The study is performed to know if the silicone elastomer based bolus can be used in the radiotherapy. A bolus is a tissue equivalent material used to provide uniform dose to the uneven surface contours. It is exposed during the radiation therapy and also provides maximum dose (dmax) to treat surface tumors in case of high energy photons like megavoltage therapy photons. It is used in the case of external beam radiation therapy.

METHODS

In this study, the bolus was fabricated using PDMS substrate with a curing agent by the ratio of 10:1. The bolus was fabricated in two thicknesses 0.5cm and 1cm. The dosimetric characteristics like transmission factor, mass attenuation coefficient, durability, homogeneity, density test of the fabricated bolus were studied.

RESULTS

The dosimetric characteristics of the silicone elastomer based bolus were studied over a period of one month by exposing it in a 6MV photon. The result of the study shows that the silicone elastomer based bolus fabricated, satisfies the dosimetric characteristics needed for a tissue equivalent bolus to be used in the radiation therapy.

CONCLUSIONS

The fabricated bolus could increase the percentage surface dose, reduce skin-sparing effect, and protect OAR. The aim of this is to provide an adjustable, transparent, and easily fabricated, less expensive, nontoxic bolus which can be used in the radiotherapy.

Oxone®-Mediated TEMPO-Oxidized Cellulose Nanomaterials form I and form II

The 2,2,6,6-tetramethylpiperidin-1-oxyl (TEMPO) oxidation of cellulose, when mediated with Oxone^® (KHSO₅), can be performed simply and under mild conditions. Furthermore, the products of the reaction can be isolated into two major components: Oxone^®-mediated TEMPO-oxidized cellulose nanomaterials Form I and Form II (OTO-CNM Form I and Form II). This study focuses on the characterization of the properties of OTO-CNMs. Nanoparticle-sized cellulose fibers of 5 and 16 nm, respectively, were confirmed through electron microscopy. Infrared spectroscopy showed that the most carboxylation presented in Form II. Conductometric titration showed a two-fold increase in carboxylation from Form I (800 mmol/kg) to Form II (1600 mmol/kg). OTO-CNMs showed cellulose crystallinity in the range of 64–68% and crystallite sizes of 1.4–3.3 nm, as shown through XRD. OTO-CNMs show controlled variability in hydrophilicity with contact angles ranging from 16 to 32°, within or below the 26–47° reported in the literature for TEMPO-oxidized CNMs. Newly discovered OTO-CNM Form II shows enhanced hydrophilic properties as well as unique crystallinity and chemical functionalization in the field of bio-sourced material and nanocomposites.

An In-Vitro Study for Early Detection and to Distinguish Breast and Lung Malignancies Using the Pcb Technology Based Nanodosimeter

Since the early detection of cancer increases the chance of successful treatment, the present study focused to confirm the suitability of an indigenously fabricated multilayer PCB technology based 3D positive ion detector to detect breast and lung malignancy at an early stage. The 3D positive ion detector is a type of gas filled radiation detector works under the principle of ion induced ionization using an exempted micro curie activity source. Earlier studies report that malignant cells can be detected by analyzing the Volatile Organic Compounds (VOCs) exhaled by those cells that serve as eminent biomarkers for malignant detection. Based on this, the present study analyzed the signals produced in the detector by VOCs exhaled from 140 biopsy tissue samples that include tissue of normal and all stages of breast and lung malignancy. To strengthen the present data, the normal and advanced breast and lung malignant tissues were also analyzed using the Gas Chromatography- Mass Spectrometry (GC-MS). From this study, it is confirmed that the present 3D positive ion detector can be used to detect both breast and lung malignancy and also to distinguish them based on the variation in four basic physical parameters of the output pulse such as frequency, amplitude, rise time and fall time and four derived parameters of the pulse such as FWHM, area of the pulse, ionization cluster size, and ion drift time.

Site-specific conjugation allows modulation of click reaction stoichiometry for pretargeted SPECT imaging

Antibody pretargeting is a promising strategy for improving molecular imaging, wherein the separation in time of antibody targeting and radiolabeling can lead to rapid attainment of high contrast, potentially increased sensitivity, and reduced patient radiation exposure. The inverse electron demand Diels-Alder ‘click’ reaction between trans-cyclooctene (TCO) conjugated antibodies and radiolabeled tetrazines presents an ideal platform for pretargeted imaging due to rapid reaction kinetics, bioorthogonality, and potential for optimization of both slow and fast clearing components. Herein, we evaluated a series of anti-human epidermal growth factor receptor 2 (HER2) pretargeting antibodies containing distinct molar ratios of site-specifically incorporated TCO. The effect of stoichiometry on tissue distribution was assessed for pretargeting TCO-modified antibodies (monitored by ¹²⁵I) and subsequent accumulation of an ¹¹¹In-labeled tetrazine in a therapeutically relevant HER2+tumor-bearing mouse model. Single photon emission computed tomography (SPECT) imaging was also employed to assess tumor imaging at various TCO-to-monoclonal antibody (mAb) ratios. Increasing TCO-to-mAb molar ratios correlated with increased in vivo click reaction efficiency evident by increased tumor distribution and systemic exposure of ¹¹¹In-labeled tetrazines. The pharmacokinetics of TCO-modified antibodies did not vary with stoichiometry. Pretargeted SPECT imaging of HER2-expressing tumors using ¹¹¹In-labeled tetrazine demonstrated robust click reaction with circulating antibody at ~2 hours and good tumor delineation for both the 2 and 6 TCO-to-mAb ratio variants at 24 hours, consistent with a limited cell-surface pool of pretargeted antibody and benefit from further distribution and internalization. To our knowledge, this represents the first reported systematic analysis of how pretargeted imaging is affected solely by variation in click reaction stoichiometry through site-specific conjugation chemistry.

Diagnostic whole body scan (pre-therapy scan) in differentiated thyroid cancer: A single center community hospital experience

OBJECTIVE

Diagnostic whole body scan (pre-therapy scan) with either I-123 or I-131 (radioactive isotopes of iodine) is performed to assess the extent of thyroid cancer especially distant metastasis prior to administering the therapeutic dose of I-131. Our aim of the following study was to determine the utility of the diagnostic pre-therapy scan in the management of differentiated thyroid cancer.

MATERIALS AND METHODS

It was a case-control study carried out by retrospective chart review, of a randomly selected 100 patients with differentiated thyroid cancer who had followed in our community hospital over the course of 1 year. We collected data on multiple variables in the subjects - including age, gender, pre-operative size of the nodules, diagnosis, stage of the malignancy, size of the tumor, multifocality, lymphovascular invasion, dose of radioiodine used for remnant ablation, recurrence rates and persistence rates. Continuous variables were compared using the independent sample Mann-Whitney U-test whereas the Chi-square test was used for nominal variables.

RESULTS

The mean dose of radioactive iodine administered was 97.56 (±27.98) in the pre-therapy scan group and it was 97.23 (±32.40) in the control group. There was no difference between the two groups (P - 0.45). There was also no difference in the recurrence rates between the groups (P = 1.0). There was a trend toward a higher degree of persistent cancer in the group that had the pre-therapy scans (P - 0.086).

CONCLUSION

Pre-therapy scan may not affect the dose of radio-iodine I-131 used for remnant ablation of differentiated thyroid cancer and does not influence the recurrence rates. This was especially true with respect to I-131 remnant ablation for low risk tumors.

Puromycin-sensitive aminopeptidase is the major peptidase responsible for digesting polyglutamine sequences released by proteasomes during protein degradation

Long stretches of glutamine (Q) residues are found in many cellular proteins. Expansion of these polyglutamine (polyQ) sequences is the underlying cause of several neurodegenerative diseases (e.g. Huntington's disease). Eukaryotic proteasomes have been found to digest polyQ sequences in proteins very slowly, or not at all, and to release such potentially toxic sequences for degradation by other peptidases. To identify these key peptidases, we investigated the degradation in cell extracts of model Q-rich fluorescent substrates and peptides containing 10-30 Q's. Their degradation at neutral pH was due to a single aminopeptidase, the puromycin-sensitive aminopeptidase (PSA, cytosol alanyl aminopeptidase). No other known cytosolic aminopeptidase or endopeptidase was found to digest these polyQ peptides. Although tripeptidyl peptidase II (TPPII) exhibited limited activity, studies with specific inhibitors, pure enzymes and extracts of cells treated with siRNA for TPPII or PSA showed PSA to be the rate-limiting activity against polyQ peptides up to 30 residues long. (PSA digests such Q sequences, shorter ones and typical (non-repeating) peptides at similar rates.) Thus, PSA, which is induced in neurons expressing mutant huntingtin, appears critical in preventing the accumulation of polyQ peptides in normal cells, and its activity may influence susceptibility to polyQ diseases.

Clinical trials in wound care. II: Achieving statistical significance

Clinical trials must be well designed in order to produce statistically and clinically significant results. This article describes the randomisation techniques that can prevent bias, the importance of sample size and the concept of power analysis.

Clinical trials in wound care I: the advantages and limitations of different clinical trial designs

Clinical trials need to be robust if practitioners are to apply their recommendations into practice. This article describes the various research designs used in wound care and the pitfalls that may compromise the reliability and validity of the results.