Assessment and topographic characterization of locoregional recurrences in head and neck tumours

Purpose: To evaluate the differences between three methods of classification of recurrences in patients with head and neck tumours treated with Radiation Therapy (RT). Materials and methods: 367 patients with head and neck tumours were included in the study. Tumour recurrences were delineated in the CT images taken during patient follow-up and deformable registration was used to transfer this volume into the planning CT. The methods used to classify recurrences were: methodCTV quantified the intersection volume between the recurrence and the Clinical Target Volume (CTV); methodTV quantified the intersection between the Treated Volume and the recurrence (for method CTV and TV, recurrences were classified in-field if more than 95% of their volume were inside the volume of interest, marginal if the intersection was between 20-95% and outfield otherwise); and methodCOM was based on the position of the Centre Of Mass of the recurrence. A dose assessment in the recurrence volume was also made. Results: The 2-year Kaplan-Meier locoregional recurrence incidence was 10%. Tumour recurrences occurred in 22 patients in a mean time of 16.5 ± 9.4 months resulting in 28 recurrence volumes. The percentage of in-field recurrences for methods CTV, TV and COM was 7%, 43% and 50%, respectively. Agreement between the three methods in characterizing individually in-field and marginal recurrences was found only in six cases. Methods CTV and COM agreed in 14. The percentage of outfield recurrences was 29% using all methods. For local recurrences (in-field or marginal to gross disease) the average difference between the prescribed dose and D 98% in the recurrence volume was -5.2 ± 3.5% (range: -10.1%-0.9%). Conclusions: The classification of in-field and marginal recurrences is very dependent on the method used to characterize recurrences. Using methods TV and COM the largest percentage of tumour recurrences occurred in-field in tissues irradiated with high doses. Keywords: Head and neck tumours, Radiation therapy, Characterization of tumour recurrences, Geometric methods, Dosimetric assessmen

Application of a spring-dashpot system to clinical lung tumor motion data

A spring-dashpot system based on the Voigt model was developed to model the correlation between abdominal respiratory motion and tumor motion during lung radiotherapy. The model was applied to clinical data comprising 52 treatment beams from 10 patients, treated on the Mitsubishi Real-Time Radiation Therapy system, Sapporo, Japan. In Stage 1, model parameters were optimized for individual patients and beams to determine reference values and to investigate how well the model can describe the data. In Stage 2, for each patient the optimal parameters determined for a single beam were applied to data from other beams to investigate whether a beam-specific set of model parameters is sufficient to model tumor motion over a course of treatment. In Stage 1 the baseline root mean square (RMS) residual error for all individually-optimized beam data was 0.90 plus or minus 0.40 mm. In Stage 2, patient-specific model parameters based on a single beam were found to model the tumor position closely, even for irregular beam data, with a mean increase with respect to Stage 1 values in RMS error of 0.37 mm. On average the obtained model output for the tumor position was 95% of the time within an absolute bound of 2.0 mm and 2.6 mm in Stage 1 and 2, respectively. The model was capable of dealing with baseline, amplitude and frequency variations of the input data, as well as phase shifts between the input tumor and output abdominal signals. These results indicate that it may be feasible to collect patient-specific model parameters during or prior to the first treatment, and then retain these for the rest of the treatment period. The model has potential for clinical application during radiotherapy treatment of lung tumors

Probing embryonic tissue mechanics with laser hole-drilling

We use laser hole-drilling to assess the mechanics of an embryonic epithelium during development - in vivo and with subcellular resolution. We ablate a subcellular cylindrical hole clean through the epithelium, and track the subsequent recoil of adjacent cells (on ms time scales). We investigate dorsal closure in the fruit fly with emphasis on apical constriction of amnioserosa cells. The mechanical behavior of this epithelium falls between that of a continuous sheet and a 2D cellular foam (a network of tensile interfaces). Tensile stress is carried both by cell-cell interfaces and by the cells' apical actin networks. Our results show that stress is slightly concentrated along interfaces (1.6-fold), but only in early closure. Furthermore, closure is marked by a decrease in the recoil power-law exponent - implying a transition to a more solid-like tissue. We use the site- and stage-dependence of the recoil kinetics to constrain how the cellular mechanics change during closure. We apply these results to test extant computational models.Comment: 23 pages with 9 figures (require color

Results of analyses of fur samples from the San Joaquin Kit Fox and associated soil and water samples from the Naval Petroleum Reserve No. 1, Tupman, California

The purpose of this study was to determine whether analysis of the elemental content of fur from San Joaquin kit foxes (Vulpes macrotis mutica) and of water and soil from kit fox habitats could be used to make inferences concerning the cause of an observed decline in the kit fox population on Naval Petroleum Reserve No. 1 (NPR-1). Fur samples that had been collected previously from NPR-1, another oil field (NPR-2), and two sites with no oil development were subjected to neutron activation analysis. In addition, soil samples were collected from the home ranges of individual foxes from undisturbed portions of major soil types on NPR-1 and from wastewater samples were collected from tanks and sumps and subjected to neutron activation analysis. Most elemental concentrations in fur were highest at Camp Roberts and lowest on the undeveloped portions of NPR-I. Fur concentrations were intermediate on the developed oil fields but were correlated with percent disturbance and with number of wells on NPR-1 and NPR-2. The fact that most elements covaried across the range of sites suggests that some pervasive source such as soil was responsible. However, fur concentrations were not correlated with soft concentrations. The kit foxes on the developed portion of NPR-1 did not have concentrations of elements in fur relative to other sites that would account for the population decline in the early 1980s. The oil-related elements As, Ba, and V were elevated in fox fur from oil fields, but only As was sufficiently elevated to suggest a risk of toxicity in individual foxes. However, arsenic concentrations suggestive of sublethal toxicity were found in only 0.56% of foxes from developed oil fields, too few to account for a population decline

Unsteady flow in rotating drums using laser Doppler velocimetry

Non-destructive measurements by laser Doppler velocimetry is employed to study unsteady flow in a hollow drum filled with liquid. The drum is suddenly accelerated from rest or is suddenly decelerated from a steady rotation to rest. Pure water and glycerin-water mixtures are used as the test liquid in which polyethylenelatex particles are mixed as the light scattering tracer. The boundary layer formation, the time history of velocity, momentum and kinetic energy of the liquid, the wall-to-fluid force transfer, and the transient response time are determined. Also determined are the effects of side walls and fluid viscosity on the transient flow response. Of importance is the disclosure of Ekman layer instability near the inner radial wall of the test drum. It is actuated by the centripetal acceleration-induced buoyancy force.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47081/1/348_2004_Article_BF00230728.pd

Economic and biological costs of cardiac imaging

Medical imaging market consists of several billion tests per year worldwide. Out of these, at least one third are cardiovascular procedures. Keeping in mind that each test represents a cost, often a risk, and a diagnostic hypothesis, we can agree that every unnecessary and unjustifiable test is one test too many. Small individual costs, risks, and wastes multiplied by billions of examinations per year represent an important population, society and environmental burden. Unfortunately, the appropriateness of cardiac imaging is extra-ordinarily low and there is little awareness in patients and physicians of differential costs, radiological doses, and long term risks of different imaging modalities. For a resting cardiac imaging test, being the average cost (not charges) of an echocardiogram equal to 1 (as a cost comparator), the cost of a CT is 3.1x, of a SPECT 3.27x, of a Cardiovascular Magnetic Resonance imaging 5.51x, of a PET 14.03x, and of a right and left heart catheterization 19.96x. For stress cardiac imaging, compared with the treadmill exercise test equal to 1 (as a cost comparator), the cost of stress echocardiography is 2.1x and of a stress SPECT scintigraphy is 5.7x. Biohazards and downstream long-term costs linked to radiation-induced oncogenesis should also be considered. The radiation exposure is absent in echo and magnetic resonance, and corresponds to 500 chest x rays for a sestamibi cardiac stress scan and to 1150 chest x rays for a thallium scan. The corresponding extra-risk in a lifetime of fatal cancer is 1 in 2000 exposed patients for a sestamibi stress and 1 in 1000 for a thallium scan. Increased awareness of economic, biologic, and environmental costs of cardiac imaging will hopefully lead to greater appropriateness, wisdom and prudence from both the prescriber and the practitioner. In this way, the sustainability of cardiac imaging will eventually improve