A Systematic Analysis of Errors in Target Localization and Treatment Delivery for Stereotactic Radiosurgery Using 2D/3D Image Registration

PURPOSE: To determine the localization uncertainties associated with 2-dimensional/3-dimensional image registration in comparison to 3-dimensional/3-dimensional image registration in 6 dimensions on a Varian Edge Linac under various imaging conditions. METHODS: The systematic errors in 6 dimensions were assessed by comparing automatic 2-dimensional/3-dimensional (kV/MV vs computed tomography) with 3-dimensional/3-dimensional (cone beam computed tomography vs computed tomography) image registrations under various conditions encountered in clinical applications. The 2-dimensional/3-dimensional image registration uncertainties for 88 patients with different treatment sites including intracranial and extracranial were evaluated by statistically analyzing 2-dimensional/3-dimensional pretreatment verification shifts of 192 fractions in stereotactic radiosurgery and stereotactic body radiotherapy. RESULTS: The systematic errors of 2-dimensional/3-dimensional image registration using kV-kV, MV-kV, and MV-MV image pairs were within 0.3 mm and 0.3° for the translational and rotational directions within a 95% confidence interval. No significant difference ( P \u3e .05) in target localization was observed with various computed tomography slice thicknesses (0.8, 1, 2, and 3 mm). Two-dimensional/3-dimensional registration had the best accuracy when pattern intensity and content filter were used. For intracranial sites, means ± standard deviations of translational errors were -0.20 ± 0.70 mm, 0.04 ± 0.50 mm, and 0.10 ± 0.40 mm for the longitudinal, lateral, and vertical directions, respectively. For extracranial sites, means ± standard deviations of translational errors were -0.04 ± 1.00 mm, 0.2 ± 1.0 mm, and 0.1 ± 1.0 mm for the longitudinal, lateral, and vertical directions, respectively. Two-dimensional/3-dimensional image registration for intracranial and extracranial sites had comparable systematic errors that were approximately 0.2 mm in the translational direction and 0.08° in the rotational direction. CONCLUSION: The standard 2-dimensional/3-dimensional image registration tool available on the Varian Edge radiosurgery device, a state-of-the-art system, is helpful for robust and accurate target positioning for image-guided stereotactic radiosurgery

Bulge formation from SSCs in a responding cuspy dark matter halo

We simulate the bulge formation in very late-type dwarf galaxies from circumnuclear super star clusters (SSCs) moving in a responding cuspy dark matter halo (DMH). The simulations show that (1) the response of DMH to sinking of SSCs is detectable only in the region interior to about 200 pc. The mean logarithmic slope of the responding DM density profile over that area displays two different phases: the very early descent followed by ascent till approaching to 1.2 at the age of 2 Gyrs. (2) the detectable feedbacks of the DMH response on the bulge formation turned out to be very small, in the sense that the formed bulges and their paired nuclear cusps in the fixed and the responding DMH are basically the same, both are consistent with $HST$ observations. (3) the yielded mass correlation of bulges to their nuclear (stellar) cusps and the time evolution of cusps' mass are accordance with recent findings on relevant relations. In combination with the consistent effective radii of nuclear cusps with observed quantities of nuclear clusters, we believe that the bulge formation scenario that we proposed could be a very promising mechanism to form nuclear clusters.Comment: 27 pages, 11 figures, accepted for publication in Ap

Viscoelastic behaviour of human mesenchymal stem cells

<p>Abstract</p> <p>Background</p> <p>In this study, we have investigated the viscoelastic behaviour of individual human adult bone marrow-derived mesenchymal stem cells (hMSCs) and the role of F-actin filaments in maintaining these properties, using micropipette aspiration technique together with a standard linear viscoelastic solid model.</p> <p>Results</p> <p>Under a room temperature of 20°C, the instantaneous and equilibrium Young's modulus, <it>E</it>₀and <it>E</it>_∞, were found to be 886 ± 289 Pa and 372 ± 125 Pa, respectively, while the apparent viscosity, <it>μ</it>, was 2710 ± 1630 Pa·s. hMSCs treated with cytochalasin D up to 20 μM at 20°C registered significant drop of up to 84% in stiffness and increase of up to 255% in viscosity. At the physiological temperature of 37°C, <it>E</it>₀and <it>E</it>_∞have decreased by 42–66% whereas <it>μ </it>has increased by 95%, compared to the control. Majority of the hMSCs behave as viscoelastic solid with a rapid initial increase in aspiration length and it gradually levels out with time. Three other types of non-typical viscoelastic behavior of hMSCs were also seen.</p> <p>Conclusion</p> <p>hMSCs behave as viscoelastic solid. Its viscoelstic behaviour are dependent on the structural integrity of the F-actin filaments and temperature.</p

Phase diagram of a Bose-Fermi mixture in a one-dimensional optical lattice in terms of fidelity and entanglement

We study the ground-state phase diagram of a Bose-Fermi mixture loaded in a one-dimensional optical lattice by computing the ground-state fidelity and quantum entanglement. We find that the fidelity is able to signal quantum phase transitions between the Luttinger liquid phase, the density-wave phase, and the phase separation state of the system; and the concurrence can be used to signal the transition between the density-wave phase and the Ising phase.Comment: 4 pages 3 figure

Post-treatment follow-up study of abdominal cystic echinococcosis in Tibetan communities of northwest Sichuan Province, China

Background: Human cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, with the liver as the most frequently affected organ, is known to be highly endemic in Tibetan communities of northwest Sichuan Province. Antiparasitic treatment with albendazole remains the primary choice for the great majority of patients in this resource-poor remote area, though surgery is the most common approach for CE therapy that has the potential to remove cysts and lead to complete cure. The current prospective study aimed to assess the effectiveness of community based use of cyclic albendazole treatment in Tibetan CE cases, and concurrently monitor the changes of serum specific antibody levels during treatment. Methodology/Principal Findings: Ultrasonography was applied for diagnosis and follow-up of CE cases after cyclic albendazole treatment in Tibetan communities of Sichuan Province during 2006 to 2008, and serum specific IgG antibody levels against Echinococcus granulosus recombinant antigen B in ELISA was concurrently monitored in these cases. A total of 196 CE cases were identified by ultrasound, of which 37 (18.9%) showed evidence of spontaneous healing/involution of hepatic cyst(s) with CE4 or CE5 presentations. Of 49 enrolled CE cases for treatment follow-up, 32.7% (16) were considered to be cured based on B-ultrasound after 6 months to 30 months regular albendazole treatment, 49.0% (24) were improved, 14.3% (7) remained unchanged, and 4.1% (2) became aggravated. In general, patients with CE2 type cysts (daughter cysts present) needed a longer treatment course for cure (26.4 months), compared to cases with CE1 (univesicular cysts) (20.4 months) or CE3 type (detached cyst membrane or partial degeneration of daughter cysts) (9 months). In addition, the curative duration was longer in patients with large (.10 cm) cysts (22.3 months), compared to cases with medium (5– 10 cm) cysts (17.3 months) or patients with small (,5 cm) cysts (6 months). At diagnosis, seven (53.8%) of 13 cases with CE1 type cysts without any previous intervention showed negative specific IgG antibody response to E. granulosus recombinant antigen B (rAgB). However, following 3 months to 18 months albendazole therapy, six of these 7 initially seronegative CE1 cases sero-converted to be specific IgG antibody positive, and concurrently ultrasound scan showed that cysts changed to CE3a from CE1 type in all the six CE cases. Two major profiles of serum specific IgG antibody dynamics during albendazole treatment were apparent in CE cases: (i) presenting as initial elevation followed by subsequent decline, or (ii) a persistent decline. Despite a decline, however, specific antibody levels remained positive in most improved or cured CE cases. Conclusions: This was the first attempt to follow up community-screened cystic echinococcosis patients after albendazole therapy using ultrasonography and serology in an endemic Tibetan region. Cyclic albendazole treatment proved to be effective in the great majority of CE cases in this resource-poor area, but periodic abdominal ultrasound examination was necessary to guide appropriate treatment. Oral albendazole for over 18 months was more likely to result in CE cure. Poor drug compliance resulted in less good outcomes. Serology with recombinant antigen B could provide additional limited information about the effectiveness of albendazole in CE cases. Post-treatment positive specific IgG antibody seroconversion, in initially seronegative, CE1 patients was considered a good indication for positive therapeutic efficacy of albendazole

How does CBCT reconstruction algorithm impact on deformably mapped targets and accumulated dose distributions?

PURPOSE: We performed quantitative analysis of differences in deformable image registration (DIR) and deformable dose accumulation (DDA) computed on CBCT datasets reconstructed using the standard (Feldkamp-Davis-Kress: FDK_CBCT) and a novel iterative (iterative_CBCT) CBCT reconstruction algorithms. METHODS: Both FDK_CBCT and iterative_CBCT images were reconstructed for 323 fractions of treatment for 10 prostate cancer patients. Planning CT images were deformably registered to each CBCT image data set. After daily dose distributions were computed, they were mapped to planning CT to obtain deformed doses. Dosimetric and image registration results based CBCT images reconstructed by two algorithms were compared at three levels: (A) voxel doses over entire dose calculation volume, (B) clinical constraint results on targets and sensitive structures, and (C) contours propagated to CBCT images using DIR results based on three algorithms (SmartAdapt, Velocity, and Elastix) were compared with manually delineated contours as ground truth. RESULTS: (A) Average daily dose differences and average normalized DDA differences between FDK_CBCT and iterative_CBCT were ≤1 cGy. Maximum daily point dose differences increased from 0.22 ± 0.06 Gy (before the deformable dose mapping operation) to 1.33 ± 0.38 Gy after the deformable dose mapping. Maximum differences of normalized DDA per fraction were up to 0.80 Gy (0.42 ± 0.19 Gy). (B) Differences in target minimum doses were up to 8.31 Gy (-0.62 ± 4.60 Gy) and differences in critical structure doses were 0.70 ± 1.49 Gy. (C) For mapped prostate contours based on iterative_CBCT (relative to standard FDK_CBCT), dice similarity coefficient increased by 0.10 ± 0.09 (p \u3c 0.0001), mass center distances decreased by 2.5 ± 3.0 mm (p \u3c 0.00005), and Hausdorff distances decreased by 3.3 ± 4.4 mm (p \u3c 0.00015). CONCLUSIONS: The new iterative CBCT reconstruction algorithm leads to different mapped volumes of interest, deformed and cumulative doses than results based on conventional FDK_CBCT

Helminth infection protects against high fat diet-induced obesity via induction of alternatively activated macrophages

Epidemiological studies indicate an inverse correlation between the prevalence of the so-called western diseases, such as obesity and metabolic syndrome, and the exposure to helminths. Obesity, a key risk factor for many chronic health problems, is rising globally and is accompanied by low-grade inflammation in adipose tissues. The precise mechanism by which helminths modulate metabolic syndrome and obesity is not fully understood. We infected high fat diet (HFD)-induced obese mice with the intestinal nematode parasite Heligmosomoides polygyrus and observed that helminth infection resulted in significantly attenuated obesity. Attenuated obesity corresponded with marked upregulation of uncoupling protein 1 (UCP1), a key protein involved in energy expenditure, in adipose tissue, suppression of glucose and triglyceride levels, and alteration in the expression of key genes involved in lipid metabolism. Moreover, the attenuated obesity in infected mice was associated with enhanced helminth-induced Th2/Treg responses and M2 macrophage polarization. Adoptive transfer of helminth-stimulated M2 cells to mice that were not infected with H. polygyrus resulted in a significant amelioration of HFD-induced obesity and increased adipose tissue browning. Thus, our results provide evidence that the helminth-dependent protection against obesity involves the induction of M2 macrophages

Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014

Background: In the last decade, scrub typhus (ST) has been emerging or re-emerging in some areas of Asia, including Guangzhou, one of the most affected endemic areas of ST in China. Methods: Based on the data on all cases reported in Guangzhou from 2006 to 2014, we characterized the epidemiological features, and identified environmental determinants for the spatial distribution of ST using a panel negative binomial model. Results: A total of 4821 scrub typhus cases were reported in Guangzhou during 2006-2014. The annual incidence increased noticeably and the increase was relatively high and rapid in rural townships and among elderly females. The majority of cases (86.8%) occurred during May-October, and farmers constituted the majority of the cases, accounting for 33.9% in urban and 61.6% in rural areas. The number of housekeeper patients had a rapid increment in both rural and urban areas during the study period. Atmospheric pressure and relative humidity with lags of 1 or 2 months, distributions of broadleaved forest and rural township were identified as determinants for the spatiotemporal distribution of scrub typhus. Conclusion: Our results indicate that surveillance and public education need to be focused on the elderly farmers in rural areas covered with broadleaf forest in southern China

Interplay between magnetism and superconductivity and appearance of a second superconducting transition in alpha-FeSe at high pressure

We synthesized tetragonal alpha-FeSe by melting a powder mixture of iron and selenium at high pressure. Subsequent annealing at normal pressure results in removing traces of hexagonal beta- FeSe, formation of a rather sharp transition to superconducting state at Tc ~ 7 K, and the appearance of a magnetic transition near Tm = 120 K. Resistivity and ac-susceptibility were measured on the annealed sample at hydrostatic pressure up to 4.5 GPa. A magnetic transition visible in ac-susceptibility shifts down under pressure and the resistive anomaly typical for a spin density wave (SDW) antiferromagnetic transition develops near the susceptibility anomaly. Tc determined by the appearance of a diamagnetic response in susceptibility, increases linearly under pressure at a rate dTc/dP = 3.5 K/GPa. Below 1.5 GPa, the resistive superconducting transition is sharp; the width of transition does not change with pressure; and, Tc determined by a peak in drho/dT increases at a rate ~ 3.5 K/GPa. At higher pressure, a giant broadening of the resistive transition develops. This effect cannot be explained by possible pressure gradients in the sample and is inherent to alpha-FeSe. The dependences drho(T)/dT show a signature for a second peak above 3 GPa which is indicative of the appearance of another superconducting state in alpha-FeSe at high pressure. We argue that this second superconducting phase coexists with SDW antiferromagnetism in a partial volume fraction and originates from pairing of charge carriers from other sheets of the Fermi surface