Endocavitary in vivo Dosimetry for IMRT Treatments of Gynecologic Tumors

The accuracy and reproducibility of endometrial carcinoma treatment with intensity-modulated radiotherapy (IMRT) was assessed by means of in vivo dosimetry. Six patients who had previously undergone radical hysterectomy for endometrial carcinoma were treated with IMRT using a vaginal applicator with radio-opaque fiducial markers. An ion-chamber inserted into the applicator supplied an endocavitary in vivo dosimetry for quality assurance purposes. The ratio R = D/D_TPS between the in vivo measured dose D and the predicted dose by the treatment planning system D_TPS was determined for every fraction of the treatment. Results showed that 90% and 100% of the ratios resulted equal to 1 within 5% and 10%, respectively. The mean value of the ratios distribution for the 6 patients was R = 0.995 and the SD = 0.034. The ratio R* between the measured and predicted total doses for each patient was near to 1, within 2%. The dosimetric results suggest that the use of a vaginal applicator in an image-guided approach could make the interfractions target position stable and reproducible, allowing a safe use of the IMRT technique in the treatment of postoperative vaginal vault. In vivo dosimetry may supply useful information about the discrimination of random vs. systematic errors. The workload is minimum and this in vivo dosimetry can be applied also in the clinical routine.     

活体荧光成像技术评价X射线对小鼠乳腺癌移植瘤的治疗效果

目的 建立荧光素酶标记的小鼠乳腺癌细胞爪垫淋巴结转移模型,监测肿瘤早期淋巴结转移,并用荧光成像评价X射线局部治疗效果。方法 将表达荧光素酶的小鼠乳腺癌细胞系4T1-Luc接种至裸鼠爪垫皮下,建立爪垫皮下淋巴结转移模型。通过裸鼠活体荧光成像系统连续观察肿瘤细胞在淋巴结中的转移情况,并将有早期淋巴转移的荷瘤裸鼠按随机数字表法分为对照组和治疗组,活体荧光成像系统观察治疗效果,HE染色观察评价病理形态学变化。结果 成功建立了小鼠乳腺癌淋巴结转移模型,爪垫原发灶肿瘤体积与荧光光子数呈正相关性（r=0.958,P<0.001）,在肿瘤接种的第24天,治疗组爪垫肿瘤和腘窝处肿瘤部位的荧光光子数较对照组呈显著性降低（t=32.58,P<0.05）;用荧光光子数计算抑瘤率高达85%以上。HE染色观察到治疗组较对照组移植瘤坏死明显。结论 运用活体生物发光成像技术能够动态、客观、灵敏、可视化地评估X射线对小鼠乳腺癌肿瘤的抑瘤效应。     

电子顺磁共振在体测量指甲剂量方法的可行性研究

目的 针对核应急医学救援剂量评估的需求,为解决指甲电子顺磁共振（EPR）剂量评估方法中机械诱发信号难以分离的问题,探讨指甲EPR在体测量的可行性。方法 利用自研的指甲在体EPR测量装置,对未剪碎指甲进行整体测量,在无机械诱发信号干扰的条件下研究指甲的本底信号及辐射诱发信号特性,探索通过水处理恢复本底信号的方法;开展指甲实际在体EPR测量实验,评价在体测量条件对EPR波谱的影响。结果 未剪碎指甲的本底信号分布服从正态分布,不同性别志愿者的指甲本底信号差异无统计学意义（P>0.05）;在2~10 Gy范围内建立了剂量响应关系,指甲辐射诱发信号半衰期约为5 d;建立了变温结合水处理的本底信号恢复方法,处理后指甲EPR信号与本底信号差异无统计学意义（P>0.05）;获得了实际在体测量条件下的指甲EPR波谱。结论 利用本方法可以获得不含有机械诱发信号的EPR波谱,初步验证了指甲在体EPR测量用于剂量评估的可行性。     

基于EPID在体剂量验证在肺癌和食管癌动态调强放疗中的应用研究

目的对肺癌和食管癌患者在放疗过程中行基于电子射野影像装置(EPID)的在体剂量验证,探讨影响在体剂量验证结果准确性的因素,并推荐应用在体剂量验证的流程及规范。方法单纯随机抽样法选取2022年5月至2022年8月在金华市中心医院放疗科行食管癌和肺癌放疗的患者32例(其中,肺癌14例,食管癌18例),在uRT-TPOIS计划系统上制作动态调强放疗(dIMRT)及EPID在体剂量验证(In vivo EPID)计划,使用uRT-linac 506c直线加速器进行治疗。治疗过程中行在体剂量验证,其中,肺癌病例行In vivo EPID的分次共238次,执行图像引导放疗(IGRT)共80次,食管癌病例行In vivo EPID的分次共414次,执行IGRT共105次。设置阈值并获取每个射野的2Dγ通过率,分析低于阈值的分次射野,并结合在线CT影像及三维重建剂量结果,进一步分析影响γ通过率下降的主要因素。结果肺癌、食管癌3 mm/5%γ通过率均值分别为95.1%±5.7%、96.5%±4.5%;3 mm/3%γ通过率均值为91.5%±8.4%、92.2%±4.9%;2 mm/2%γ通过率均值分别为:79.1%±14.1%、83.7.2%±8.2%,病种之间通过率差异无统计学意义(P>0.05)。靠近0°/180°射野组(A组)的γ通过率高于靠近90°/270°射野组(B组)(3 mm/5%,Z=-25.4,P<0.05;3 mm/3%,Z=-26.8,P<0.05)。通过IGRT纠正摆位误差,可显著提高γ通过率(IGRT和非IGRT下,3 mm/5%γ通过率均值为96.3%±5.1%、96.0%±4.9%,Z=-5.50,P<0.05;3 mm/3%γ通过率均值92.3%±8.0%、91.3%±7.7%,Z=-9.54,P<0.05)。肿瘤及正常组织体积变化和运动变化、定位和治疗前准备充分与否等都会影响在体剂量验证的结果。结论放疗过程中进行EPID在体剂量验证能避免错误照射,但需规范EPID在体剂量验证流程,以避免人为因素等导致的通过率降低。     

基于电子射野影像系统与加速器日志文件重建模体内剂量的初步比较

目的 研究基于电子射野影像系统（EPID）与加速器日志文件（dynalogs file）重建模体内剂量的差异性。方法 收集12例盆腔患者的容积旋转调强（VMAT）计划,将计划信息复制到“Cheese”模体上重新计算剂量,而后在瓦里安加速器（RapidArc）上执行,“Cheese”模体置于等中心处获取射野影像（EPI）,将EPI传入EPIgray软件中重建剂量。同时利用Mobius软件调用加速器日志文件,实现对模体计划剂量的重建。以A1SL型号的电离室和配套的剂量仪测量整个计划执行结束后射野等中心（电离室中心）处剂量值,在计划系统（TPS）中读取电离室敏感体积体内的平均剂量值（设置电离室中心与等中心重合）。结果 电离室测量值与TPS中读取的等中心处剂量值相比,两者偏差为1.31%。两种方式重建的射野等中心的剂量分别与电离室测量数值相比,差异均无统计学意义（P>0.05）。结论 两种重建体内剂量的方法均能为VMAT在体剂量验证提供参考。     

Midline Dose Verification with Diode In Vivo Dosimetry for External Photon Therapy of Head and Neck and Pelvis Cancers During Initial Large-Field Treatments

During radiotherapy treatments, quality assurance/control is essential, particularly dose delivery to patients. This study was designed to verify midline doses with diode in vivo dosimetry.Dosimetry was studied for 6-MV bilateral fields in head and neck cancer treatments and 10-MV bilateral and anteroposterior/posteroanterior (AP/PA) fields in pelvic cancer treatments. Calibrations with corrections of diodes were performed using plastic water phantoms; 190 and 100 portals were studied for head and neck and pelvis treatments, respectively. Calculations of midline doses were made using the midline transmission, arithmetic mean, and geometric mean algorithms. These midline doses were compared with the treatment planning system target doses for lateral or AP (PA) portals and paired opposed portals. For head and neck treatments, all 3 algorithms were satisfactory, although the geometric mean algorithm was less accurate and more uncertain. For pelvis treatments, the arithmetic mean algorithm seemed unacceptable, whereas the other algorithms were satisfactory. The random error was reduced by using averaged midline doses of paired opposed portals because the asymmetric effect was averaged out. Considering the simplicity of in vivo dosimetry, the arithmetic mean and geometric mean algorithm should be adopted for head/neck and pelvis treatments, respectively.     

Determination of 5-hydroxy-l-[β-C]tryptophan and its in vivo-formed radiolabeled metabolites in brain tissue using high performance liquid chromatography: A study supporting radiotracer kinetics obtained with positron emission tomography

A high performance liquid chromatographic system was developed for separation of ¹¹C-labeled 5-hydroxy- -tryptophan ([¹¹C]HTP) and in vivo formed radiolabeled metabolites in rat brain tissue. Analysis of brain homogenate revealed that the main part of the radioactivity was associated with ¹¹C-labeled 5-hydroxyindole-3-acetic acid after intravenous injection of [¹¹C]HTP to the rat. The serotonin synthesis rate in the brain was calculated and closely correlated to the serotonin synthesis rate in monkey and human measured using positron emission tomography.