Hybrid split-arc partial-field volumetric modulated arc therapy: an improved beam arrangement for linear accelerator-based hippocampal-avoidance whole brain radiation therapy

Background: This technical note aims to verify the hippocampus and adjacent organs at risk (OARs) sparing ability of an improved beam arrangement, namely hybrid split-arc partial-field volumetric modulated arc therapy (VMAT) (Hsapf-VMAT) during whole brain radiation therapy (WBRT). Materials and methods: Computed tomography simulation images of 22 patients with brain metastases were retrieved in this retrospective planning study. The hippocampus was manually delineated according to the criterion of RTOG 0933. Plans delivering 30 Gy in 10 fractions were generated for each patient using split-arc partial-field VMAT (sapf-VMAT) and Hsapf-VMAT. The sapf-VMAT plans consisted of 4 arc fields of 179.9° each with reduced field size. The Hsapf-VMAT consisted of 4 arc fields similar to sapf-VMAT in addition to 2 lateral opposing static fields. Statistical comparisons between treatment plans of both techniques were performed using the paired t-test at 5% level significance. Results: The results demonstrated that Hsapf-VMAT can achieve superior dose sparing in hippocampus which is comparable to sapf-VMAT (p > 0.05). In both eyes, Hsapf-VMAT had significantly lower Dmean and Dmax compared to sapf-VMAT (p < 0.005). Decrease in Dmax of both lenses using Hsapf-VMAT (p < 0.005) were statistically significant when compared to sapf-VMAT. Hsapf-VMAT demonstrated significant reduction of Dmean and Dmedian to the optic nerves (p < 0.05). Whole brain planning target volume (PTV) coverage was not compromised in both techniques. Conclusion: The present study adopts a hybrid technique, namely Hsapf-VMAT, for hippocampal sparing WBRT. Hsapf-VMAT can achieve promising dose reduction to the hippocampus, both eyes and lenses. Therefore, Hsapf-VMAT can be considered an improved version of sapf-VMAT

Accuracy and reliability of cetacean cranial measurements using computed tomography three dimensional volume rendered images.

Computed tomography (CT) has become more readily available for post-mortem examination, offering an alternative to cetacean cranial measurements obtained manually. Measurement error may result in possible variation in cranial morphometric analysis. This study aimed to evaluate the accuracy and reliability of cetacean cranial measurements obtained by CT three-dimensional volume rendered images (3DVRI). CT scans of 9 stranded cetaceans were performed. The acquired images were reconstructed using bone reconstruction algorithms. The reconstructed crania obtained by 3DVRI were visualized after excluding other body structures. Accuracy of cranial measurements obtained by CT 3DVRI was evaluated by comparing with that obtained by manual approach as standard of reference. Reproducibility and repeatability of cranial measurements obtained by CT 3DVRI were evaluated using intraclass correlation coefficient (ICC). The results demonstrated that cranial measurements obtained by CT 3DVRI yielded high accuracy (88.05%- 99.64%). High reproducibility (ICC ranged from 0.897 to 1.000) and repeatability (ICC ranged from 0.919 to 1.000 for operator 1 and ICC range from 0.768 to 1.000 for operator 2) were observed in cranial measurements obtained by CT 3DVRI. Therefore, cranial measurements obtained by CT 3DVRI could be considered as virtual alternative to conventional manual approach. This may help the development of a normative reference for current cranial maturity and discriminant analysis studies in cetaceans

Descriptions of cetacean cranial measurements in the present study.

<p>Descriptions of cetacean cranial measurements in the present study.</p

Key to cranial measurements made on CT 3DVRI of <i>Neophocaena phocaenoides</i>.

<p>For abbreviations, refer to <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0174215#pone.0174215.t001" target="_blank">Table 1</a>.</p

Accuracy of cetacean cranial measurements obtained by CT 3DVRI, using cranial measurements obtained by conventional manual approach as standard of reference.

<p>Accuracy of cetacean cranial measurements obtained by CT 3DVRI, using cranial measurements obtained by conventional manual approach as standard of reference.</p

Key to cranial measurements made on CT 3DVRI of <i>Sousa chinensis</i>.

<p>For abbreviations, refer to <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0174215#pone.0174215.t001" target="_blank">Table 1</a>.</p

Inter-operator (reproducibility) variability of cetacean cranial measurements obtained by CT 3DVRI.

<p>Inter-operator (reproducibility) variability of cetacean cranial measurements obtained by CT 3DVRI.</p

Cross-sectional anatomy, computed tomography, and magnetic resonance imaging of the banded houndshark (Triakis scyllium)

Due to their important phylogenetic position among extant vertebrates, sharks are an invaluable group in evolutionary developmental biology studies. A thorough understanding of shark anatomy is essential to facilitate these studies and documentation of this iconic taxon. With the increasing availability of cross-sectional imaging techniques, the complicated anatomy of both cartilaginous and soft tissues can be analyzed non-invasively, quickly, and accurately. The aim of this study is to provide a detailed anatomical description of the normal banded houndshark (Triakis scyllium) using computed tomography (CT) and magnetic resonance imaging (MRI) along with cryosection images. Three banded houndsharks were scanned using a 64-detector row spiral CT scanner and a 3 T MRI scanner. All images were digitally stored and assessed using open-source Digital Imaging and Communications in Medicine viewer software in the transverse, sagittal, and dorsal dimensions. The banded houndshark cadavers were then cryosectioned at approximately 1-cm intervals. Corresponding transverse cryosection images were chosen to identify the best anatomical correlations for transverse CT and MRI images. The resulting images provided excellent detail of the major anatomical structures of the banded houndshark. The illustrations in the present study could be considered as a useful reference for interpretation of normal and pathological imaging studies of sharks.Y

Radiological Investigation of Gas Embolism in the East Asian Finless Porpoise (Neophocaena asiaeorientalis sunameri)

Cetaceans have long been considered biologically adapted to suffer no adverse effects from diving-related tissue gas tension. However, increasing reports of gas embolism in cetaceans inhabiting European, Mediterranean and American waters have challenged the conventional understanding of marine mammal diving physiology. In human hyperbaric medicine, virtopsy techniques such as post-mortem computed tomography (PMCT) facilitate the visualization of gas embolism and could be performed adjunct to conventional autopsy. This research presents the first case of gas embolism identified in an East Asian finless porpoise inhabiting Asian waters. Massive gas embolic lesions were found in the liver, which had been compressing both the lungs and abdominal organs, and signs of pneumonia and parasitic infection were observed in both lungs. It is hypothesized that this porpoise might have been unable to expel in vivo gas bubbles from its circulation due to pulmonary dysfunction. Consequently, gas bubbles agglomerated in the liver, resulting in the development of gas embolic lesions. The findings of the present study provide insights into the occurrence of gas embolism in the East Asian finless porpoise, highlighting the potential of PMCT as a promising tool for the diagnosis of gas embolism in stranded cetaceans.N