Risk of Secondary Malignant Neoplasms From Proton Therapy and Intensity-Modulated X-Ray Therapy for Early-Stage Prostate Cancer

Purpose: To assess the risk of a secondary malignant neoplasm (SMN) from proton therapy relative to intensity-modulated radiation therapy (IMRT) using X-rays, taking into account contributions from both primary and secondary sources of radiation, for prostate cancer. Methods and Materials: A proton therapy plan and a 6-MV IMRT plan were constructed for 3 patients with early-stage adenocarcinoma of the prostate. Doses from the primary fields delivered to organs at risk of developing an SMN were determined from treatment plans. Secondary doses from the proton therapy and IMRT were determined from Monte Carlo simulations and available measured data, respectively. The risk of an SMN was estimated from primary and secondary doses on an organ-by-organ basis by use of risk models from the Committee on the Biological Effects of Ionizing Radiation. Results: Proton therapy reduced the risk of an SMN by 26% to 39% compared with IMRT. The risk of an SMN for both modalities was greatest in the in-field organs. However, the risks from the in-field organs were considerably lower with the proton therapy plan than with the IMRT plan. This reduction was attributed to the substantial sparing of the rectum and bladder from exposure to the therapeutic beam by the proton therapy plan. Conclusions: When considering exposure to primary and secondary radiation, proton therapy can reduce the risk of an SMN in prostate patients compared with contemporary IMRT. © 2009 Elsevier Inc. All rights reserved

Investigation of dose perturbations and the radiographic visibility of potential fiducials for proton radiation therapy of the prostate

Image guidance using implanted fiducial markers is commonly used to ensure accurate and reproducible target positioning in radiation therapy for prostate cancer. The ideal fiducial marker is clearly visible in kV imaging, does not perturb the therapeutic dose in the target volume and does not cause any artifacts on the CT images used for treatment planning. As yet, ideal markers that fully meet all three of these criteria have not been reported. In this study, 12 fiducial markers were evaluated for their potential clinical utility in proton radiation therapy for prostate cancer. In order to identify the good candidates, each fiducial was imaged using a CT scanner as well as a kV imaging system. Additionally, the dose perturbation caused by each fiducial was quantified using radiochromic film and a clinical proton beam. Based on the results, three fiducials were identified as good candidates for use in proton radiotherapy of prostate cancer. © 2011 Institute of Physics and Engineering in Medicine

Validation of the particle size distribution obtained with the laser in-situ scattering and transmission (LISST) meter in flow-through mode

High spatial and temporal resolution estimates of the particle size distribution (PSD) in the surface ocean can enable improved understanding of biogeochemistry and ecosystem dynamics. Oceanic PSD measurements remain rare due to the time-consuming, manual sampling methods of common particle sizing instruments. Here, we evaluate the utility of measuring particle size data at high spatial resolution with a commercially-available submersible laser di raction particle sizer (LISST-100X, Sequoia Scientific), operating in an automated mode with continuously flowing seawater. The LISST PSD agreed reasonably well with discrete PSD measurements obtained with a Coulter Counter and data from the flow-through sampling Imaging Flow-Cytobot, validating our methodology. Total particulate area and Volume derived from the LISST PSD agreed well with beam-attenuation and particulate organic carbon respectively, further validating the LISST PSD. Furthermore, When compared to the measured spectral characteristics of particulate beam attenuation, we find a significant correlation. However, no significant relationship between the PSD and spectral particulate backscattering was found

Risk of radiogenic second cancers following volumetric modulated arc therapy and proton arc therapy for prostate cancer

Prostate cancer patients who undergo radiotherapy are at an increased risk to develop a radiogenic second cancer. Proton therapy has been shown to reduce the predicted risk of second cancer when compared to intensity modulated radiotherapy. However, it is unknown if this is also true for the rotational therapies proton arc therapy and volumetric modulated arc therapy (VMAT). The objective of this study was to compare the predicted risk of cancer following proton arc therapy and VMAT for prostate cancer. Proton arc therapy and VMAT plans were created for three patients. Various risk models were combined with the dosimetric data (therapeutic and stray dose) to predict the excess relative risk (ERR) of cancer in the bladder and rectum. Ratios of ERR values (RRR) from proton arc therapy and VMAT were calculated. RRR values ranged from 0.74 to 0.99, and all RRR values were shown to be statistically less than 1, except for the value calculated with the linear-non-threshold risk model. We conclude that the predicted risk of cancer in the bladder or rectum following proton arc therapy for prostate cancer is either less than or approximately equal to the risk following VMAT, depending on which risk model is applied. © 2012 Institute of Physics and Engineering in Medicine

Reducing stray radiation dose to patients receiving passively scattered proton radiotherapy for prostate cancer

Proton beam radiotherapy exposes healthy tissue to stray radiation emanating from the treatment unit and secondary radiation produced within the patient. These exposures provide no known benefit and may increase a patient\u27s risk of developing a radiogenic second cancer. The aim of this study was to explore strategies to reduce stray radiation dose to a patient receiving a 76 Gy proton beam treatment for cancer of the prostate. The whole-body effective dose from stray radiation, E, was estimated using detailed Monte Carlo simulations of a passively scattered proton treatment unit and an anthropomorphic phantom. The predicted value of E was 567 mSv, of which 320 mSv was attributed to leakage from the treatment unit; the remainder arose from scattered radiation that originated within the patient. Modest modifications of the treatment unit reduced E by 212 mSv. Surprisingly, E from a modified passive-scattering device was only slightly higher (109 mSv) than from a nozzle with no leakage, e.g., that which may be approached with a spot-scanning technique. These results add to the body of evidence supporting the suitability of passively scattered proton beams for the treatment of prostate cancer, confirm that the effective dose from stray radiation was not excessive, and, importantly, show that it can be substantially reduced by modest enhancements to the treatment unit. © 2008 Institute of Physics and Engineering in Medicine

Ultra-short pulses in linear and nonlinear media

We consider the evolution of ultra-short optical pulses in linear and nonlinear media. For the linear case, we first show that the initial-boundary value problem for Maxwell's equations in which a pulse is injected into a quiescent medium at the left endpoint can be approximated by a linear wave equation which can then be further reduced to the linear short-pulse equation. A rigorous proof is given that the solution of the short pulse equation stays close to the solutions of the original wave equation over the time scales expected from the multiple scales derivation of the short pulse equation. For the nonlinear case we compare the predictions of the traditional nonlinear Schr\"odinger equation (NLSE) approximation which those of the short pulse equation (SPE). We show that both equations can be derived from Maxwell's equations using the renormalization group method, thus bringing out the contrasting scales. The numerical comparison of both equations to Maxwell's equations shows clearly that as the pulse length shortens, the NLSE approximation becomes steadily less accurate while the short pulse equation provides a better and better approximation

Age as the Second Parameter in NGC 288 / NGC 362? I. Turnoff Ages: a Purely Differential Comparison

We present deep V,I photometry of the globular clusters NGC 288, NGC 362 and NGC 1851 obtained during a single observational run under strictly homogeneous conditions. We use the bimodal horizontal branch (HB) of NGC 1851 as a ``bridge'' to obtain the optimum relative match between the HBs of NGC 288 and NGC 362. In this way we can effectively remove the uncertainties associated with distance, reddening and inhomogeneities in the absolute calibration, thus obtaining a very robust, purely differential estimate of the age difference between these two clusters. According to the bridge test, NGC 288 is found to be older than NGC 362 by 2 +- 1 Gyr. This result is fully confirmed also by all classical differential age diagnostics, either based on the luminosity or color of the main sequence turnoff point.Comment: Accepted by The Astronomical Journal - 30 pages, 6 tables, 14 figures, LaTeX, the emulateapj5.sty macro is used. Fig. 2 and Fig. 3 are provided in reduced resolution. Full resolution versions available upon request to the first author ([email protected]). Minor changes due to modifications in the companion paper (Pap II

The influence of training level on manual flight in connection to performance, scan pattern, and task load.

This work focuses on the analysis of pilots’ performance during manual flight operations in different stages of training and situations and also examines the influence of training on gaze strategy. The secure and safe operation of air traffic is highly dependent on the individual performances of the pilots. Before becoming a pilot, he/she has to acquire a broad set of skills by training to pass all the necessary qualification and licensing standards. A basic skill for every pilot is manual control operations, which is a closed-loop control process with several cross-coupled variables. Even with increased automation in the cockpit, the manual control operations are essential for every pilot as a last resort in the event of automation failure. A key element in the analysis of manual flight operations is the development over time in relation to performance and visual perception. An experiment with 28 participants (including 11 certified pilots) was conducted in a Boeing 737 simulated in a high-fidelity setting. For defined flight phases, the dynamic time warping method was applied to evaluate the performance for selected criteria, and eye-tracking methodology was utilized to analyze the gaze-pattern development. The manipulation of experience and workload influences the performance and the gaze pattern at the same time. Findings suggest that the increase of workload has an increased effect on pilots depending on the flight phase. Gaze patterns from experienced pilots provide insights into the training requirements of both novices and experts. The connection between workload, performance and gaze pattern is complex and needs to be analyzed under as many differing conditions. The results imply the necessity to evaluate manual flight operations with respect to more flight phases and a detailed selection of performance indications

T cell response kinetics determines neuroinfection outcomes during murine HSV infection

Herpes simplex virus-2 (HSV-2) and HSV-1 both can cause genital herpes, a chronic infection that establishes a latent reservoir in the nervous system. Clinically, the recurrence frequency of HSV-1 genital herpes is considerably less than HSV-2 genital herpes, which correlates with reduced neuronal infection. The factors dictating the disparate outcomes of HSV-1 and HSV-2 genital herpes are unclear. In this study, we show that vaginal infection of mice with HSV-1 leads to the rapid appearance of mature DCs in the draining lymph node, which is dependent on an early burst of NK cell-mediated IFN-γ production in the vagina that occurs after HSV-1 infection but not HSV-2 infection. Rapid DC maturation after HSV-1 infection, but not HSV-2 infection, correlates with the accelerated generation of a neuroprotective T cell response and early accumulation of IFN-γ-producing T cells at the site of infection. Depletion of T cells or loss of IFN-γ receptor (IFN-γR) expression in sensory neurons both lead to a marked loss of neuroprotection only during HSV-1, recapitulating a prominent feature of HSV-2 infection. Our experiments reveal key differences in host control of neuronal HSV-1 and HSV-2 infection after genital exposure of mice, and they define parameters of a successful immune response against genital herpes