Quantitative morphologic evaluation of white matter in survivors of childhood medulloblastoma

In survivors of pediatric brain tumors, cranial radiation therapy can cause a debilitating cognitive decline associated with decreased volume in normal-appearing white matter (NAWM). We applied fractal geometry to quantify white matter (WM) integrity in the brain of medulloblastoma survivors. Fractal features of WM were evaluated by indices of fractal dimensions (FDs) of WM intensity and boundary on T1-weighted magnetic resonance images. The FD index of WM intensity was calculated by using a fractional Brownian motion model, and the FD index of WM boundary was calculated by using a box-counting method. Fractal features of WM on 116 magnetic resonance images of 58 patients with medulloblastoma were investigated at the start of therapy (Start TX) and approximately 2 years later (After TX). Patients were assigned to one of two groups based on change in NAWM volumes. Fractal features in patients with decreased NAWM volume were significantly greater After TX, whereas those in patients with increased NAWM volumes were not. Multiple linear regression analysis showed that fractal features were strongly correlated with NAWM volumes After TX in patients with decreased NAWM volume. These results demonstrated significant deficit in NAWM integrity and WM density changes in children treated for medulloblastoma. Multiple regression analysis illustrated that deficits in NAWM integrity in these children may partly explain the decrease in NAWM volume. We conclude that fractal geometry can be used to monitor the morphologic effects of neurotoxicity in brain tumor survivors.     

Gamma ray radiation induced visible light absorption in P-doped silica fibers at low dose levels

A CCD Fiber Optic Spectrometer has been used to monitor the gamma ray radiation induced loss in P-doped fibers at different dopant concentrations (1, 5 and 10 mol%) with a light source (an incandescent bulb with a temperature of 2800–3000 K). The range of dose rates is limited to that used in medical applications (cancer treatments), that is 0.1 to 1.0 Gray per minute (Gy/min). At low integral dose level (<2.0 Gy) four absorption peaks were observed (470, 502, 540 and 600 nm) within the visible region. It has been observed that the radiation induced loss at 470 and 600 nm depends strongly on dose rate. At dose rates of 0.2 and 0.5 Gy/min the induced loss shows nonlinear relation to the total dose. However, at high dose rate (1.0 Gy/min) and low dose rate (0.1 Gy/min) it seems to have a linear dependence with total dose. The conversion from NBOHCs to GeX centers was observed during gamma radiation at low dose rates (0.1–0.5 Gy/min). At the wavelength of 502 and 540 nm, the radiation induced losses show excellent linear relations with total dose (<2.0 Gy) with little dose rate dependence. Experimental results show that the sensitivity (induced loss (dB) per meter fiber per Gy) of 5 mol% P-doped silica fiber is more than 30 times greater than that of a standard multi-mode (MM) communication fiber. The results suggest that P-doped silica fiber is a good candidate as a sensing component in fiber optic dosimetry, especially for radiation therapy applications.     

Changes in MR signal intensity and contrast enhancement of therapeutically irradiated soft tissue

Increased MR signal intensity was observed on T₂-weighted, STIR, and Gadolinium-DTPA-enhanced T₁-weighted images of subcutaneous and muscular soft tissue in 9 of 10 children treated with combination chemotheraphy and radiation therapy (RT) for malignancy in the pelvis or an extremity. Total radiation doses ranged from 59.5 to 65 Gy. Eight of the patients with these changes received hyperfractionated RT (seven for Ewing sarcoma and one for perineal rhabdomyosarcoma); one was treated for pelvic hemangiopericytoma with once-daily fractions. Evidence of soft tissue damage became apparent as early as the sixth week of RT and was seen for up to 69 wk post-RT. There was no clear MR evidence of RT-induced soft tissue damage in one patient, who underwent hyperfractionated RT for pelvic rhabdomyosarcoma. Other MR findings in this group included evidence of bladder wall thickening in three of the seven patients given pelvic RT and increased T₁-weighted signal of irradiated marrow in nine patients. All patients had clinical evidence of skin, soft tissue, or epithelial radiation effects. Increased MR signal intensity secondary to RT-induced damage can be differentiated from widespread tumor by geometric borders that conform to the margins of the radiation field.     

3-T MR-guided brachytherapy for gynecologic malignancies

Gynecologic malignancies are a leading cause of death in women worldwide. Standard treatment for many primary and recurrent gynecologic cancer cases includes external-beam radiation followed by brachytherapy. Magnetic resonance (MR) imaging is beneficial in diagnostic evaluation, in mapping the tumor location to tailor radiation dose and in monitoring the tumor response to treatment. Initial studies of MR guidance in gynecologic brachytherapy demonstrate the ability to optimize tumor coverage and reduce radiation dose to normal tissues, resulting in improved outcomes for patients.     

Cancer risk estimation caused by radiation exposure during endovascular procedure

The objective of this study was to identify the radiation exposure dose of patients, as well as staff caused by fluoroscopy for C-arm-assisted vascular surgical operation and to estimate carcinogenic risk due to such exposure dose. The study was conducted in 71 patients (53 men and 18 women) who had undergone vascular surgical intervention at the division of vascular surgery in the University Hospital from November of 2011 to April of 2012. It had used a mobile C-arm device and calculated the radiation exposure dose of patient (dose–area product, DAP). Effective dose was measured by attaching optically stimulated luminescence on the radiation protectors of staff who participates in the surgery to measure the radiation exposure dose of staff during the vascular surgical operation. From the study results, DAP value of patients was 308.7 Gy cm² in average, and the maximum value was 3085 Gy cm². When converted to the effective dose, the resulted mean was 6.2 m Gy and the maximum effective dose was 61.7 milliSievert (mSv). The effective dose of staff was 3.85 mSv; while the radiation technician was 1.04 mSv, the nurse was 1.31 mSv. All cancer incidences of operator are corresponding to 2355 persons per 100,000 persons, which deemed 1 of 42 persons is likely to have all cancer incidences. In conclusion, the vascular surgeons should keep the radiation protection for patient, staff, and all participants in the intervention in mind as supervisor of fluoroscopy while trying to understand the effects by radiation by themselves to prevent invisible danger during the intervention and to minimize the harm.     

Gamma radiation effects on the DPB SFS in space FOGs applications

Superfluorescent fiber source (SFS) is generally considered to be promising in optical sensing. In this paper, the gamma radiation effect on the double pass backward (DPB) SFS was investigated. Firstly, a sample of DPB SFS together with a 9 m Er-doped fiber (EDF) was irradiated by ⁶⁰Co source with radiation dose rate of 3.6 Gy/h and total dose of 200 Gy. And the results were analyzed to find that at the very start of radiation the RIL of the sampled Er-doped fiber was greater than that of sampled SFS while at about 100 Gy the RIL slope of the EDF became less than that of the SFS. Above all, the loss from EDF was dominant to that from the SFS in gamma radiation environment. Mean wavelength of the SFS drifted about 4 nm mainly caused by the radiation loss. In the end, the potential influence to FOGs in space applications was simulated.     

Comparison of TSE, TGSE, and CPMG measurement techniques for MR polymer gel dosimetry

A radiation dose distribution that optimally conforms to the target volume is of major interest for stereotactic radiotherapy. For this purpose treatment plans have to be verified experimentally before transferring to the patient. The requirements regarding dose accuracy and spatial resolution can be fulfilled with tissue equivalent polymer gel dosimeters which offer the possibility to visualize 3D dose distributions. Herewith, dosimetry can be performed by the spin-spin relaxation rate R2 which varies with the absorbed dose. In this work, different MR measurement techniques were evaluated: The standard Carr-Purcell-Meiboom-Gill (CPMG) method, a modified Turbo-Spin-Echo (TSE) sequence, and a modified Turbo-Gradient-Spin-Echo (TGSE) sequence. Experiments were performed both with a homogeneous water phantom and an irradiated polymer gel. The results show that TGSE and especially TSE are suited well for MR polymer gel dosimetry: The acquisition time of both techniques can be reduced in comparison to CPMG by a factor of 5. The accuracy of dose determination for doses between 2 Gy and 13 Gy lies between 5.6% and 2.0% (TSE), 9.0% and 3.2% (TGSE), and 7.9% and 2.7% (CPMG). These investigations show that especially TSE can be handled as a substitute or at least an alternative to CPMG for the verification of treatment plans in stereotactic radiotherapy.     

A model for quantitative changes in the magnetic resonance parameters of muscle in children after therapeutic irradiation

Purpose/ObjectiveThis study aimed to develop objective models of radiation effects on musculature in children with soft tissue sarcoma using treatment dosimetry and clinical and quantitative magnetic resonance imaging (MRI) parameters that may be used to guide treatment planning or predict side effects.MethodsIn the initial 13 patients undergoing external beam radiation therapy (RT) on a Phase II study of conformal or intensity-modulated RT for the treatment of soft tissue sarcoma approved by an Institutional Review Board, we evaluated quantitative MRI changes in the musculature to assess radiation-related treatment effects. Patients with soft tissue sarcoma, including Ewing's sarcoma, had quantitative T₁, T₂ and dynamic enhanced MRI (DEMRI) performed before, during (Week 4) and after RT (Week 12). Regions of interest were selected in consistent locations within and outside the high-dose regions (on ipsilateral and contralateral sides when available). Mean RT dose, T₁, T₂ and DEMRI parameters were calculated and modeled using a mixed random coefficient dose model.ResultsThe mean doses to the high- and low-dose regions were 56.4 Gy (41.8–75.3 Gy) and 13.0 Gy (0.1–37.5 Gy), respectively. Compared with tissues distant from the tumor bed, maximal enhancement was significantly increased in tissues adjacent to the tumor/tumor bed prior to RT (60.6 vs. 44.2, P=.045) and remained elevated after 12 weeks. T₁ was significantly elevated in tissues adjacent to the tumor bed prior to RT (942.4 vs. 759.0, P=.0078). The slope of longitudinal change in T₁ was greater for tissues that received low-dose irradiation than those that received high-dose irradiation (P=.0488). The effect of dose on the slope of T₂ was different (P=.0333) when younger and older patients are compared.ConclusionsAcute affects of irradiation in muscle are quantifiable via MRI. These models provide evidence that quantifiable MRI parameters may be correlated with patient parameters of radiation dose and clinical factors including patient age. Long-term follow-up will be required to determine if acute changes correlate with clinically significant late effects.     

Raman spectroscopic study of serum albumins: an effect of proton‐ and γ‐irradiation

Raman spectroscopy was applied to analyse structural changes in serum albumins (bovine serum albumin, BSA; human serum albumin, HSA) following proton and γ‐irradiation (0.5, 5 and 50 Gy). Characteristic Raman bands of both polypeptide backbone and amino acid residues were sensitive to irradiation. Significant damage of HSA/BSA was observed only at the highest dose (50 Gy). Raman spectra confirmed radiation‐induced denaturation, destruction of helical structures and aggregation of serum albumins. The differences in the dose‐dependent effects of proton and γ‐radiation on studied proteins are discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

Macroscopic tumor volume of malignant glioma determined by contrast-enhanced magnetic resonance imaging with and without magnetization transfer contrast

The purposes of this study were to compare the conspicuity and lesion volume of contrast-enhancing macroscopic malignant glioma determined by postcontrast magnetic resonance (MR) imaging with and without magnetization transfer (MT) saturation, and to discuss possible implications for radiotherapy planning. Nineteen patients (age 24–60 years) with histologically proven malignant glioma were prospectively examined by MR imaging. After the administration of gadolinium dimeglumine (0.1 mmol/kg body weight), the lesions were imaged with an MT-weighted FLASH (fast, low-angle shot) pulse sequence and with a conventional T₁-weighted spin-echo (SE) sequence without MT saturation. The mean tumor volumes of gliomas measured on MT-weighted FLASH images were significantly (p < .01) larger than those obtained from T₁-weighted SE images (45 ± 15 cm³ vs. 33 ± 10 cm³). The mean contrast-to-noise ratio of enhancing lesions on MT-weighted FLASH was 48 ± 14 compared with 30 ± 14 on SE images, representing a significant (p < .01) improvement. We conclude that the volume of contrast enhancement of malignant glioma identified on MT-weighted FLASH images represents the area of disrupted blood-brain barrier. If this volume of subtle contrast enhancement is caused by tumor infiltration and represents the boost target volume for stereotactic radiosurgery or brachytherapy, MT-weighted FLASH images would be better than T₁-weighted SE images to define these volumes. These improved delineation of areas at highest risk for recurrence following radiation therapy should enhance the efficacy of treatment planning for high-boost therapy.     

Modeling brain tissue volumes over the lifespan: quantitative analysis of postmortem weights and in vivo MR images

Normative measurements of brain gray matter and white matter tissue volumes across the lifespan have not yet been established. The purpose of this article was to use mathematical modeling and analytical functions to demonstrate the growth trajectory of gray matter and white matter from age 0 to age 90. For each gender, brain weight functions were generated by utilizing existing autopsy data from 4400 subjects. Brain gray matter, white matter and lateral ventricular volumes were measured from 39 MR volumes of normal individuals. These were converted to weight by multiplying the tissue volumes by the specific gravity of that tissue. White matter volumes were described by a saturating exponential function, and the gray matter volume function was calculated by subtracting the white matter weight function from the brain weight function. For each gender, equations were generated for white matter and gray matter volumes as a function of age over the lifespan.     

A rapid and reliable semiautomated method for measurement of total abdominal fat volumes using magnetic resonance imaging

The aim of this study was the development of a reliable and fast method to estimate total abdominal fat volumes (TAF) in diabetic subjects on the basis of T1-weighted MR images. Thirty-seven patients with diabetes were examined (age 48 +/- 13 y mean +/- SD). A semiautomated computer assisted software program was developed to quantify intraabdominal (IAF), subcutaneous (SCF), and total abdominal fat volumes (TAF). The variability of image analysis for fat measurements between two observers and within observers was assessed. Mean volumes (+/- SD) for IAF, SCF and TAF were 10.5 1 (+/- 5.0 1), 15.1 1 (+/-7.3 1) and 25.7 1 (+/-11.5 1), respectively. Inter- and intraobserver reliability was excellent (r = 0.999 to r = 1.0). Per patient, the analysis required nine minutes in addition to a scan duration of seven minutes. As this analytic method using T1-weighted MR images allows a fast and reliable quantification of TAF, IAF and SCF, it may serve as a valuable tool for respective studies in diabetic subjects.     

12C6+束辐照引起的实验猪皮肤急性损伤反应的研究

探讨了正常皮肤对重离子辐照急性损伤反应的耐受性, 为重离子治癌临床应用提供安全性检测的实验依据。实验前10 min, 实验猪肌肉注射复方氯胺酮1.2 mg/kg进行麻醉, 然后在兰州重离子研究装置（HIRFL）辐照终端利用12C6+束照射, 辐照剂量分别为0, 12, 21和27 Gy, 辐照分3次完成, 剂量率约为1.2 Gy/min, Bragg峰区照射, 辐照后每隔7 d对照射野拍照并活检取样, 做HE组织病理学观察。不同剂量12C6+离子束辐照实验猪皮肤后, 皮肤外观反应随辐照剂量增大而加快, 表现为肿胀和色素沉积等; 皮肤组织结构的变化明显, 上皮细胞排列紊乱、 萎缩、 空泡变性; 基本恢复正常所需时间也越长, 且都存在明显的剂量效应关系。结果表明, 辐照剂量范围为0—27 Gy时, 重离子对正常皮肤的辐照是安全的。The tolerance of the normal skin to the acute radiation injury reaction induced by heavy ion beams has been studied experimentally. The experimental pigs were injected with 1.2 mg/kg ketamine in 10 min before irradiation and were irradiated with 0, 12 , 21 and 27 Gy 12C6+ ion at a dose rate of 1.2 Gy/min at the Heavy Ion Research Facility in Lanzhou（HIRFL）. The total radiation dose was finished by 3 times at Bragg Peak Region of Heavy Ion Beams.The radiation fields of skin were taken photo and performed biopsy. The contaneous tissues of radiation fields were stained by HE and examined histopatholo gical changes every seven days after irradiation. The results indicated that the cutaneous appearance reaction became more faster with radiation dosage rising and presented with swollen, melanin forming and so on after irradiated by the carbon ions at different dosage. The Pathological examination showed noticeable changes in histological and structural of experimental pigs skin, such as atrophy, vacuolation, denaturation and arranged irregularly in epithelial cells. Furthermore, the time for return to normality became longer with the increasing of radiation dosage. All indexes demonstrated correlation between the does and effects. It is concluded that the irradiation of heavy ion beams to normal skin is security when the radiation dose range is about 0—27 Gy.     

Study on the quality assurance of diagnostic X-ray machines and assessment of the absorbed dose to patients

Radiation exposure and image quality in X-ray diagnostic radiology provide a clear understanding of the relationship between the radiation dose delivered to a patient and image quality in optimizing medical diagnostic radiology. Because a certain amount of radiation is unavoidably delivered to patients, this should be as low as reasonably achievable. Several X-ray diagnostic machines were used at different medical diagnostic centers in Egypt for studying the beam quality and the dose delivered to the patient. This article studies the factors affecting the beam quality, such as the kilo-volt peak (kVp), exposure time (mSc), tube current (mAs) and the absorbed dose in (μGy) for different examinations. The maximum absorbed dose measured per mAs was 594±239 and 12.5±3.7 μGy for the abdomen and the chest, respectively, while the absorbed dose at the elbow was 18±6 μGy, which was the minimum dose recorded. The compound and expanded uncertainties accompanying these measurements were 4±0.35% and 8±0.7%, respectively. The measurements were done through quality control tests as acceptance procedures.     

辐射损伤小鼠胸腺组织的FTIR光谱变化与辐射剂量的关系

应用傅里叶变换红外(FTIR)光谱分析辐射损伤小鼠胸腺组织随辐射剂量增加的生化变化过程,为临床评估患者辐射剂量提供新的研究思路。结果表明,随着辐射剂量的增加,辐射损伤小鼠胸腺组织FTIR光谱的主要吸收峰位变化表现在照射2,3,5Gy时,在1 550,1 460,1 400及1 640 cm-1处峰位发生移位(P<0.05),峰高差异表现在：(1)与核酸有关的谱带1 085和1 236 cm-1的峰强比呈下降趋势,(2)与蛋白质有关的谱带1 640与1 550 cm-1的峰强比随剂量增加明显下降,(3)与脂类有关的谱带2 958,2 925,1 460及1 400 cm-1未发生明显的变化。研究结果表明傅里叶变换红外光谱有望成为临床估算受照剂量的新方法。     

Investigation of the optical absorption characteristics of slow-cooled LiF:Mg,Ti (TLD-100)

The optical absorption (OA) spectrum of LiF:Mg,Ti has been studied as a function of dose at two different cooling rates following the 400 °C pre-irradiation anneal in order to further investigate the role of cooling rate in the thermoluminescence (TL) mechanisms of this material. “Slow-cooling” following the pre-irradiation 400 °C anneal substantially decreases the OA bands at 3.25 eV and 4.0 eV, in agreement with the overall loss in TL peaks 2–5 intensity using slow-cooling routines. Slow-cooling appears to shift the maximum intensity of peak 5 to lower temperatures (a behaviour which has been attributed to an enhanced intensity of peak 5a), however, no difference in the shape of the 4.0 eV OA band is detected following “slow-cooling”. Apparently the OA band related to peak 5a is too close in energy to the peak 5 OA band to be observed due to lack of sufficient resolution and spectral deconvolution process or it is not present at room temperature (RT) and formed during heating of the sample. The intensity of the 4.0 eV OA band does not change if the sample (prior to irradiation to a standard dose of 200 Gy) is irradiated to 4 kGy followed by a 500 °C/1 h post-irradiation anneal. This result demonstrates that the loss of intensity at high levels of dose (so-called radiation damage) of TL glow peak 5 results from alteration of the LCs or to the creation of additional competitive centers and is not correlated with the dose behaviour of the TCs.     

Medical treatment of radiation injuries—Current US status

A nuclear incident or major release of radioactive materials likely would result in vast numbers of patients, many of whom would require novel therapy. Fortunately, the numbers of radiation victims in the United States (USA) have been limited to date. If a mass-casualty situation occurs, there will be a need to perform rapid, accurate dose estimates and to provide appropriate medications and other treatment to ameliorate radiation injury.The medical management of radiation injury is complex. Radiation injury may include acute radiation sickness (ARS) from external and/or internal radiation exposure, internal organ damage from incorporated radioactive isotopes, and cutaneous injury. Human and animal data have shown that optimal medical care may nearly double the survivable dose of ionizing radiation. Current treatment strategies for radiation injuries are discussed with concentration on the medical management of the hematopoietic syndrome.In addition, priority areas for continuing and future research into both acute deterministic injuries and also long-term stochastic sequelae of radiation exposure have been identified. There are several near-term novel therapies that appear to offer excellent prognosis for radiation casualties, and these are also described.     

无损检测用15MeV电子直线加速器主束内光中子剂量的测量与MC模拟计算

通过实验和模拟计算研究了无损检测用15MeV电子直线加速器X射线主束内的中子剂量. 加速器采用了铜复合靶和钨加含硼聚乙烯的屏蔽结构, 能够有效地减少光中子的产生, 中子产额在1/1000n/γ以下. 但由于主束内光子剂量很大, 中子的绝对强度也不容忽视. 针对加速器周围强X射线脉冲辐射场的特点, 采用了被 动型的中子剂量测量方法, 加速器正常工作情况下, 使用CR-39片和双电离室测量了等中心处中子对X射线的剂量当量比率, 分别为0.19mSv/Gy X-ray和0.060mSv/Gy X-ray. 利用MCNP5模拟计算了实验相应点的中子对X射线的剂量当量比率, 为0.092mSv/Gy X-ray, 与实验测量结果在数量级上一致. 加速器主射束上D_n/D_γ<1/1000,小于辐射防护标准对中子泄漏剂量的规定值, 从而验证了屏蔽结构的安全性.     

Determination of the radiation dose scattered outside the target volume treated with IMRT technique

Intensity Modulated Radiation Therapy (IMRT) is an advanced mode of high precision radiation therapy that uses computer controlled linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. This is achieved using a more precise adjustment of the beam to the three dimensional shape of the tumor by modulating or controlling the intensity of the radiation beam in multiple small volumes. IMRT also allows higher radiation doses to be focused to regions within the tumor while minimizing the dose to surrounding normal critical structures. This work aims at determining the radiation dose in two target volumes (tumors) treated at same time and the scattered dose distribution in organs at risk using thermoluminescent dosimeters of LiF:Mg,Ti for IMRT treatment technique and a polymethylmethacrylate (PMMA) phantom. The shortest distance between the cavities 1 and 2 that simulate tumors is 1.5 cm and the shortest distances from the cavity 1 to the cavities 3, 4 and 5 are, respectively, 1.9 cm, 2.2 cm and 2.65 cm. The shortest distance from the cavity 2 to cavities 3, 4 and 5 are, respectively, 5.4 cm; 5.7 cm and 1.5 cm. The relative difference for the doses measured by TLD-100 and provided by the TPS were +3.7% and −1.38%. The out-of-target doses received by cavities 3, 4 and 5 corresponded on average to 19.36, 17.84% and 6.72% of the highest dose received by the cavity 1 and the doses received by cavities 3, 4 and 5 corresponded on average to 29.51%, 27.20% and 10.24% of the dose received by cavity 2.     

MR quantification of muscle fatty replacement in McArdle''s disease

McArdle's disease is an energy-dependant disorder of skeletal muscle caused by the inability to break down glycogen. The aim of this study was to quantify fatty replacement in patients with McArdle's disease. Calf and thigh axial spin echo T₁-weighted magnetic resonance (MR) images (repetition time 500 ms, echo time 25 ms) were obtained at 0.5 T in nine patients with McArdle's disease (age 51 ± 16 years, range 26–74) and nine sex- and age-matched healthy subjects (age 52 ± 16 years, range 29–78) to quantify intramuscular fat. Regions of interest were drawn manually, encompassing the largest cross section of muscle. A fatty replacement index (IF) was determined from histograms of signal in the regions of interest in calf and thigh muscles. In normal subjects, IF = 3.6 ± 2.8% in calf and 4.9 ± 2.3% in thigh. In patients, IF = 11 ± 9.3% in calf and 13.5 ± 10.4% in thigh, significantly different from IF values in normal subjects (p = .03). IF correlated well with age in patients (p = .03). In older patients, up to 25% of the muscle volume was replaced by fat. Patients with McArdle's disease, usually weakly disabled, exhibit significant muscle fatty replacement on MR images. These findings suggest a progressive muscle loss over time related to the disease process.