Feasibility of intensity-modulated and image-guided radiotherapy for functional organ preservation in locally advanced laryngeal cancer

Purpose: The study aims to assess the feasibility of intensity-modulated and image-guided radiotherapy (IMRT, and IGRT, respectively) for functional preservation in locally advanced laryngeal cancer. A retrospective review of 27 patients undergoing concurrent chemoradiation for locally advanced laryngeal cancers (8 IMRT, 19 IGRT) was undertaken. In addition to regular clinical examinations, all patients had PET imaging at 4 months and 10 months after radiotherapy, then yearly. Loco-regional control, speech quality and feeding-tube dependency were assessed during follow-up visits. Results: At a median follow-up of 20 months (range 6-57 months), four out of 27 patients (14.8%) developed local recurrence and underwent salvage total laryngectomy. One patient developed distant metastases following salvage surgery. Among the 23 patients who conserved their larynx with no sign of recurrence at last follow-up, 22 (95%) reported normal or near normal voice quality, allowing them to communicate adequately. Four patients (14.8%) had long-term tube feeding-dependency because of severe dysphagia (2 patients) and chronic aspiration (2 patients, with ensuing death from aspiration pneumonia in one patient). Conclusions and Clinical Relevance: Functional laryngeal preservation is feasible with IMRT and IGRT for locally advanced laryngeal cancer. However, dysphagia and aspiration remain serious complications, due most likely to high radiation dose delivery to the pharyngeal musculatures. © 2012 Nguyen et al

Chasing the identification of ASCA Galactic Objects (ChIcAGO): An X-ray survey of unidentified sources in the galactic plane. I : Source sample and initial results

We present the Chasing the Identification of ASCA Galactic Objects (ChIcAGO) survey, which is designed to identify the unknown X-ray sources discovered during the ASCA Galactic Plane Survey (AGPS). Little is known about most of the AGPS sources, especially those that emit primarily in hard X-rays (2-10 keV) within the Fx 10-13 to 10-11 erg cm -2 s-1 X-ray flux range. In ChIcAGO, the subarcsecond localization capabilities of Chandra have been combined with a detailed multiwavelength follow-up program, with the ultimate goal of classifying the >100 unidentified sources in the AGPS. Overall to date, 93 unidentified AGPS sources have been observed with Chandra as part of the ChIcAGO survey. A total of 253 X-ray point sources have been detected in these Chandra observations within 3′ of the original ASCA positions. We have identified infrared and optical counterparts to the majority of these sources, using both new observations and catalogs from existing Galactic plane surveys. X-ray and infrared population statistics for the X-ray point sources detected in the Chandra observations reveal that the primary populations of Galactic plane X-ray sources that emit in the Fx 10-13 to 10-11 erg cm -2 s-1 flux range are active stellar coronae, massive stars with strong stellar winds that are possibly in colliding wind binaries, X-ray binaries, and magnetars. There is also another primary population that is still unidentified but, on the basis of its X-ray and infrared properties, likely comprises partly Galactic sources and partly active galactic nuclei.Peer reviewedSubmitted Versio

The Deepest Radio Study of the Pulsar Wind Nebula G21.5-0.9: Still No Evidence for the Supernova Shell

We report on sensitive new 1.4-GHz VLA radio observations of the pulsar wind nebula G21.5-0.9, powered by PSR J1833-1034, and its environs. Our observations were targeted at searching for the radio counterpart of the shell-like structure seen surrounding the pulsar wind nebula in X-rays. Some such radio emission might be expected as the ejecta from the <~ 1000 yr old supernova expand and interact with the surrounding medium. We find, however, no radio emission from the shell, and can place a conservative 3-sigma upper limit on its 1-GHz surface brightness of 7 x 10^-22 W/m^2/Hz/sr, comparable to the lowest limits obtained for radio emission from shells around other pulsar-wind nebulae. Our widefield radio image also shows the presence of two extended objects of low-surface brightness. We re-examine previous 327-MHz images, on which both the new objects are visible. We identify the first, G21.64-0.84, as a new shell-type supernova remnant, with a diameter of ~13' and an unusual double-shell structure. The second, G21.45-0.59, ~1' in diameter, is likely an HII region.Comment: 8 Pages, submitted to MNRA

Feasibility of Tomotherapy-Based Image-Guided Radiotherapy for Locally Advanced Oropharyngeal Cancer

PURPOSE: The study aims to assess the feasibility of tomotherapy-based image-guided (IGRT) radiotherapy for locally advanced oropharyngeal cancer. A retrospective review of 33 patients undergoing concurrent chemoradiation for locally advanced oropharyngeal cancers was conducted. Radiotherapy planning, treatment toxicity and loco-regional control were assessed. RESULTS: At a median follow-up of 32 months (6-47 months), no patient developed loco-regional recurrence. Two patients (6%) developed distant metastases. Grade 3-4 acute toxicity was respectively 72% and 25% for mucositis and gastrointestinal toxicity. Two patients (6%) had long-term dependence on tube feedings. Dose-volume histogram demonstrated excellent target volume coverage and low radiation dose to the organs at risk for complications. CONCLUSIONS AND CLINICAL RELEVANCE: IGRT provides excellent loco-regional control but acute toxicity remains significant and needs to be addressed in future prospective trials. The feasibility of Tomotherapy to decrease radiation dose to the normal tissues merits further investigations

Feasibility of image-guided radiotherapy based on helical tomotherapy to reduce contralateral parotid dose in head and neck cancer

Background To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases. Methods A retrospective review of 52 patients undergoing radiotherapy for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed. Results Mean contralateral parotid dose and the volume of the contralateral parotid receiving 40 Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20 Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26 Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was, respectively, 14.1 Gy and 24.7 Gy for the SC and CC plans (p < 0.0001). The volume of contralateral parotid receiving 40 Gy or more was respectively 5.3% and 18.2% (p < 0.0001) Conclusion Tomotherapy for head and neck cancer minimized radiotherapy dose to the contralateral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage

A joint spectro-imaging analysis of the XMM-Newton and HESS observations of the supernova remnant RX J1713.7-3946

The supernova remnant (SNR) RX J1713.7-3946 (also known as G347.3-0.5) is part of the class of remnants dominated by synchrotron emission in X-rays. It is also one of the few shell-type SNRs observed at TeV energies allowing to investigate particle acceleration at SNRs shock. Our goal is to compare spatial and spectral properties of the remnant in X- and gamma-rays to understand the nature of the TeV emission. This requires to study the remnant at the same spatial scale at both energies. To complement the non-thermal spectrum of the remnant, we attempt to provide a reliable estimate for the radio flux density. In radio, we revisited ATCA data and used HI and mid-infrared observations to disentangle the thermal from the non-thermal emission. In X-rays, we produced a new mosaic of the remnant and degraded the spatial resolution of the X-ray data to the resolution of the HESS instrument to perform spatially resolved spectroscopy at the same spatial scale in X- and gamma-rays. Radial profiles were obtained to investigate the extension of the emission at both energies. We found that part of the radio emission within the SNR contours is thermal in nature. Taking this into account, we provide new lower and upper limits for the integrated synchrotron flux of the remnant at 1.4 GHz of 22 Jy and 26 Jy respectively. In X-rays, we obtained the first full coverage of RX J1713.7-3946 with XMM-Newton. The spatial variation of the photon index seen at small scale in X-rays is smeared out at HESS resolution. A non-linear correlation between the X- and gamma-ray fluxes of the type Fx \propto Fg^2.41 is found.Comment: 13 pages, 10 figures, accepted for publication in A&A. An image of the remnant with higher definition will be distributed through the XMM-Newton image gallery (http://xmm.esac.esa.int/external/xmm_science/gallery/public/

Measurement of in vitro cardiac deformation by means of 3D digital image correlation and ultrasound 2D speckle-tracking echocardiography

Ultrasound-based 2D speckle-tracking echocardiography (US-2D-STE) is increasingly used to assess the functionality of the heart. In particular, the analysis of cardiac strain plays an important role in the identification of several cardiovascular diseases. However, this imaging technique presents some limitations associated with its operating principle that result in low accuracy and reproducibility of the measurement. In this study, an experimental framework for multimodal strain imaging in an in vitro porcine heart was developed. Specifically, the aim of this work was to analyse displacement and strain in the heart by means of 3D digital image correlation (3D-DIC) and US-2D-STE. Over a single cardiac cycle, displacement values obtained from the two techniques were in strong correlation, although systematically larger displacements were observed with 3D-DIC. Notwithstanding an absolute comparison of the strain measurements was not possible to achieve between the two methods, maximum principal strain directions computed with 3D-DIC were consistent with the longitudinal and circumferential strain distribution measured with US-2D-STE. 3D-DIC confirmed its high repeatability in quantifying displacement and strain over multiple cardiac cycles, unlike US-2D-STE which is affected by accumulated errors over time (i.e. drift). To conclude, this study demonstrates the potential of 3D-DIC to perform dynamic measurement of displacement and strain during heart deformations and supports future applications of this method in ex vivo beating heart platforms, which replicate more fully the complex contraction of the heart

A newly-discovered young massive star cluster at the end of the Galactic Bar

We present a near-infrared study of the candidate star cluster Mercer 81, located at the centre of the G338.4+0.1 HII region, and close to the TeV gamma-ray source HESS 1640-465. Using HST/NICMOS imaging and VLT/ISAAC spectroscopy we have detected a compact and highly extincted cluster of stars, though the bright stars in the centre of the field are in fact foreground objects. The cluster contains nine stars with strong Paschen-alpha emission, one of which we identify as a Wolf-Rayet (WR) star, as well as an A-type supergiant. The line-of-sight extinction is very large, $A_{V}\sim 45$, illustrating the challenges of locating young star clusters in the Galactic Plane. From a quantitative analysis of the WR star we argue for a cluster age of 3.7$^{+0.4}_{-0.5}$\,Myr, and, assuming that all emission-line stars are WRs, a cluster mass of \ga 10^4\msun. A kinematic analysis of the cluster's surrounding HII-region shows that the cluster is located in the Galactic disk at a distance of 11$\pm$2\,kpc. This places the cluster close to where the far end of the Bar intersects the Norma spiral arm. This cluster, as well as the nearby cluster [DBS2003]179, represent the first detections of active star cluster formation at this side of the Bar, in contrast to the near side which is well known to have recently undergone a $\sim 10^6$\msun\ starburst episode.Comment: 12 pages, 9 figures. Accepted for publication in MNRA