食管癌三维适形放疗和常规放疗比较

目的对比研究三维适形放疗（3DCRT）和常规模拟机定位放疗两种不同方法在食管癌放射治疗中的优缺点。方法 20例食管癌患者采用3DCRT方法进行治疗,应用同一治疗计划系统,制定适形放疗和常规模拟机定位放疗方案。结果与常规模拟定位机定位放疗相比,食管癌照射中3DCRT有最好的剂量分布,既可明显提高靶区的剂量,同时能较好地保护正常组织。结论食管癌的适形放疗技术能降低正常组织的放射损伤和并发症,提高放疗治疗的适形度,改善靶区的剂量分布。     

上海引进国外最新放疗系统RapidArc

近日,上海复旦大学附属肿瘤医院引进国外最新的放疗设备——弧形动态调强放射治疗机RapidArc。将国际上最新型的放疗设备系统RapidAre引入,结合该院抗癌优势,上海有了最快2分钟照射杀肿瘤的放疗新技术,让七成病人获得了治疗上的“解放”。     

二维回转培养对MLO-Y4骨样细胞PKD2表达定位及胞内钙信号的影响

目的：PKD2（polycystin2,多囊肾病蛋白2）能够在细胞膜上形成无选择性的阳离子通道,在肾上皮细胞中PKD2与初级纤毛共定位,通过改变胞内的钙信号过程参与细胞对力学刺激的响应。本实验通过二维回转培养来模拟失重效应,旨在探讨二维回转培养对MLO-Y4骨样细胞PKD2表达定位,及胞内钙信号的影响。初步了解PKD2在小鼠骨样细胞MLO-Y4响应力学刺激过程中起的作用。方法：采用二维回转培养骨样细胞MLO-Y4,用RT-PCR和western blotting检测PKD2的表达,用荧光共聚焦显微镜检测细胞中PKD2与初级纤毛的定位及细胞内钙离子含量。结果：与对照组相比,在二维回转培养后,骨样细胞MLO-Y4的PKD2表达在mRNA和蛋白水平都有明显的下降,PKD2、PKD1（polycystin1,多囊肾病蛋白1）和乙酰化的α-tubulin共定位,同时二维回转培养降低了细胞内钙离子含量。结论：在二维回转培养下,PKD2可能通过调节自身表达来改变细胞膜上PKD通道的数目和开放情况来影响细胞内钙离子含量,参与骨细胞对细胞外应力的感受过程,其详细机制还有待进一步实验研究。这将对探讨骨细胞响应力学刺激的具体机制提供重要的理论依据。     

回转模拟失重对心肌成纤维细胞Ⅰ型胶原代谢的影响

为探讨模拟失重对心肌成纤维细胞Ⅰ型胶原代谢的影响 ,本研究采用回转器模拟失重效应 ,通过免疫细胞化学和反转录聚合酶链式反应 (RT PCR)研究了回转模拟失重对原代培养的新生大鼠心肌成纤维细胞Ⅰ型胶原蛋白及mRNA表达 ,以及胶原降解抑制物———金属蛋白酶组织抑制因子 (Tissueinhibitorofmetallopro teinase ,TIMP)mRNA表达的影响。免疫细胞化学染色显示回转组Ⅰ型胶原蛋白沉积增加 ;RT PCR分析显示Ⅰ型胶原α1链 (TypeⅠcollagenα1chain ,ColⅠA1)mRNA表达没有明显变化 ,TIMP 1、TIMP 2及TIMP 3的mRNA表达均增强。提示在回转模拟失重条件下 ,心肌成纤维细胞Ⅰ型胶原蛋白沉积增加 ,作为胶原降解抑制物的TIMP可能是造成胶原沉积的原因     

肌管细化是失重性肌萎缩结构和功能变化的基础

本文通过新生大鼠原代培养获取骨骼肌肌管,利用水平回转器模拟失重效应,通过F-actin/G-actin以及F-actin/pERK免疫细胞化学染色,观察研究了模拟失重对肌管形态、微丝及磷酸化ERK表达的影响。通过建立的航天飞行失重性肌萎缩的细胞学模型研究发现:回转后肌管变细,F-actin染色减弱伴有G-actin染色增强,同时pERK染色减弱。表明回转模拟失重条件下肌管发生萎缩、微丝解聚并伴随信号转导活性分子磷酸化ERK表达下降。提示肌管细化是失重性肌萎缩结构和功能变化的结构基础     

单光子发射计算机断层扫描肺灌注显像(SPECT/CT)在肺恶性肿瘤放疗中 的应用进展

放射性肺损伤是肺恶性肿瘤放疗后常见的并发症,其限制肺恶性肿瘤的放疗剂量并影响总体疗效及患者生存质量。本文复习放射性肺损伤发生机制及影响因素,分析剂量体积直方图、肺功能测定、TGF-β1等临床常用放射性肺损伤评估指标的利弊。参考近年文献,总结了单光子发射计算机断层扫描肺灌注显像(SPECT/CT)在肺恶性肿瘤放疗中的应用,从其原理、区域肺功能的显像、对放疗的评估与指导应用几方面阐述。认为SPECT/CT能实时反映区域肺功能、肺功能改变以及其解剖定位,可在放疗中起监测作用,对准确评估肺功能、预测放疗后肺损伤,优化放疗计划有重要价值。SPECT/CT肺灌注显像还需要多中心、大样本、长时间随访资料进一步深入研究。     

轮藻假根中的平衡石在回转器水平回转时的运动

利用回转器重现了在ＴＥＸＵＳ火箭抛物线飞行的微重力实验中轮藻假根内平衡石和假根基部方向的运动。在快速回转器上回转１５ｍｉｎ时,假根中的平衡石复合体中心离假根顶端的距离比在原来沿重力方向生长的假根中的距离增加了６０％。细胞松弛素Ｄ的实验证实平衡石的这种运动是和肌动蛋白丝相关,而且在重力场中作用于平衡石的向基力也是肌动蛋白丝产生的。因此回转器和细胞松弛素Ｄ的实验证实了在地球上,平衡石的位置取决于作用方     

轮藻假根中的平衡石在回转器水平回转时的运动(英文)

利用回转器重现了在TEXUS火箭抛物线飞行的微重力实验中轮藻假根内平衡石向假根基部方向的运动。在快速回转器上回转15 min时,假根中的平衡石复合体中心离假根顶端的距离比在原来沿重力方向生长的假根中的距离增加了60%。细胞松弛素D的实验证实平衡石的这种运动是和肌动蛋白丝相关,而且在重力场中作用于平衡石的向基力也是肌动蛋白丝产生的。因此回转器和细胞松弛素D的实验证实了在地球上,平衡石的位置取决于作用方向相反的重力和肌动蛋白丝作用力的动态平衡的假说。然后在快速回转器上,平衡石中心在一个新的位置上维持了30 min左右的稳定,也就是出现了一个新的动态平衡状态。这一新的状态是在原先的向着假根顶端的重力和向着假根基部的肌动蛋白丝作用力的平衡在回转器上被打破后再经约有15 min时达到的。更进一步的快速回转器实验还展示了可能因平衡石位置的这一变化而启动的肌动蛋白丝的再组织和由此产生的平衡石向假根顶端方向再转运的过程。快速和慢速回转器实验在这里的结果有差异,推测是和回转器上颗粒的振幅随回转器转速的增加而减小有关。加之,轮藻假根的单细胞性质,因此在假根处于回转轴上时,快速回转器是更适合这项模拟失重的研究。总之,在失重条件下平衡石和肌动蛋白丝的关系是可以利用回转器来研究的。     

二维回转培养对MLO-Y4骨样细胞PKD2表达定位 及胞内钙信号的影响

目的：PKD2(polycystin2,多囊肾病蛋白2)能够在细胞膜上形成无选择性的阳离子通道,在肾上皮细胞中PKD2 与初级纤毛 共定位,通过改变胞内的钙信号过程参与细胞对力学刺激的响应。本实验通过二维回转培养来模拟失重效应,旨在探讨二维回转 培养对MLO-Y4 骨样细胞PKD2 表达定位,及胞内钙信号的影响。初步了解PKD2 在小鼠骨样细胞MLO-Y4 响应力学刺激过程 中起的作用。方法：采用二维回转培养骨样细胞MLO-Y4,用RT-PCR和western blotting检测PKD2的表达,用荧光共聚焦显微镜 检测细胞中PKD2 与初级纤毛的定位及细胞内钙离子含量。结果：与对照组相比,在二维回转培养后,骨样细胞MLO-Y4 的PKD2 表达在mRNA和蛋白水平都有明显的下降,PKD2、PKD1(polycystin1,多囊肾病蛋白1)和乙酰化的α-tubulin 共定位,同时二维回 转培养降低了细胞内钙离子含量。结论：在二维回转培养下,PKD2可能通过调节自身表达来改变细胞膜上PKD 通道的数目和开 放情况来影响细胞内钙离子含量,参与骨细胞对细胞外应力的感受过程,其详细机制还有待进一步实验研究。这将对探讨骨细胞 响应力学刺激的具体机制提供重要的理论依据。     

水平回转对马铃薯细胞超微结构的影响

本文报道了水平回转即模拟微重力条件下马铃薯植株的生长及叶片细胞超微结构的变化,如:植株长高,叶片细胞出现了壁质分离现象,部分细胞壁扭曲、收缩变形,部分叶绿体片层结构出现了弯曲、排列疏松、内含物溢出,部分线粒体出现了边缘模糊及嵴消失,同时有细胞内淀粉粒明显增多的现象发生。在脱离水平回转即模拟微重力处理一周后,电镜观察发现变异的超微结构出现不同程度的恢复。     

Image quality for radiotherapy CT simulators with different scanner bore size

PurposeWe compare image quality parameters derived from phantom images taken on three commercially available radiotherapy CT simulators. To make an unbiased evaluation, we assured images were obtained with the same surface dose measured using XR-QA2 model GafChromic™ film placed at the imaging phantom surface for all three CT-simulators.MethodsRadiotherapy CT simulators GE LS 16, Philips Brilliance Big Bore, and Toshiba Aquilion LB were compared in terms of spatial resolution, low contrast detectability, image uniformity, and contrast to noise ratio using CATPHAN-504 phantom, scanned with Head and Pelvis protocols. Dose was measured at phantom surface, with CT scans repeated until doses on all scanners were within 2%.ResultsIn terms of spatial resolution, the GE simulator appears slightly better, while Philips CT images are superior in terms of SNR for both scanning protocols. The CNR results show that Philips CT images appear to be better, except for high Z material, while Toshiba appears to fit in between the two simulators.ConclusionsWhile the image quality parameters for three RT CT simulators show comparable results, the scanner bore size is of vital importance in various radiotherapy applications. Since the image quality is a function of a large number of confounding parameters, any loss in image quality due to scanner bore size could be compensated by the appropriate choice of scanning parameters, including the exposure and by balancing between the additional imaging dose to the patient and high image quality required in highly conformal RT techniques.     

蒙特卡罗方法和三维数字人体模型在放疗计划质量保证中的应用

放射治疗的质量保证是保证放射治疗成功的有力方法。对于放疗计划的验证和评估有CT模拟机、仿体等方法,这些方法各有优缺点。文章提出了一种用人体图像数据构造仿真模型的方法,并用蒙特卡罗软件和美国“可视人项目”的数据集计算该模型在接受放射治疗时体内剂量的三维分布。由于采用人体的真实图像数据,以及蒙特卡罗方法计算粒子输运时的准确性,该方法能够得到真实的三维剂量分布。     

The status of medical physics in radiotherapy in China

PurposeTo present an overview of the status of medical physics in radiotherapy in China, including facilities and devices, occupation, education, research, etc.Materials and methodsThe information about medical physics in clinics was obtained from the 9-th nationwide survey conducted by the China Society for Radiation Oncology in 2019. The data of medical physics in education and research was collected from the publications of the official and professional organizations.ResultsBy 2019, there were 1463 hospitals or institutes registered to practice radiotherapy and the number of accelerators per million population was 1.5. There were 4172 medical physicists working in clinics of radiation oncology. The ratio between the numbers of radiation oncologists and medical physicists is 3.51. Approximately, 95% of medical physicists have an undergraduate or graduate degrees in nuclear physics and biomedical engineering. 86% of medical physicists have certificates issued by the Chinese Society of Medical Physics. There has been a fast growth of publications by authors from mainland of China in the top international medical physics and radiotherapy journals since 2018.ConclusionsDemand for medical physicists in radiotherapy increased quickly in the past decade. The distribution of radiotherapy facilities in China became more balanced. High quality continuing education and training programs for medical physicists are deficient in most areas. The role of medical physicists in the clinic has not been clearly defined and their contributions have not been fully recognized by the community.     

Cine 4DCT imaging artifacts: Quantification and correlations with scanning parameters and target kinetics

To study temporal resolved computed tomography imaging (4-Dimensional Computed Tomography: 4DCT) artifacts correlations with scanning parameters and target kinetics and to assess uncertainty introduced by 4DCT in radiotherapy treatment planning.In this work we classified 4DCT artifacts as finite gantry rotation speed related (FGS) and finite sampling frequency related (FSF). We studied FGS artifacts using a respiratory phantom and FSF artifacts using a Monte Carlo simulation of acquisition timing.From our analysis FGS localization error is comparable with image resolution determined by voxel dimensions. Remaining FGS artifacts are correlated with gantry rotation time (Trot), target velocity (v) and their interaction.FSF artifacts occurrence is correlated with sampling ratio (SR), i.e. the ratio of patient respiratory period (Tresp) and sampling time (Ts).In the studied velocity range (0–2 cm/s), using a Trot of 0,5s and a SR higher than 15, FGS and FSF artifacts became comparable with other sources of uncertainty.Our considerations are valid for “ideal” breathing pattern only. When variations from periodical breathing, high target velocity (more than 2 cm/s) or high peak to peak amplitude (more than 2 cm) are present, patient specific images artifacts analysis is recommended.     

Cardiovascular effects of a fractional -Gz force during a relatively prolonged exposure

Artificial hypogravity was created by having subjects remain in a supine position while undergoing rotation in an artificial gravity simulator. Various cardiovascular variables, such as heart rate, cardiac output, thoracic electric impedance, and blood pressure were measured. Results indicated that the hypogravity force produced a headward fluid shift, as seen by a decrease in thoracic impedance, which triggers regulatory neuroendocrine mechanisms. These findings are presented and discussed.     

A New Simulator for Bio-Tribological Study

A new bio-tribological simulator system was designed and built for basic wear tests on artificial hip joint materials and for common tribological studies applications. The module of hip joint simulator is consisted of Flexion and Extension (FE), Abduction and Adduction (AA) and Internal and External Rotation (IER). Preliminary tests were done with a 28 mm CoCrMo femoral head and a Ultra High Molecular Weight Polyethylene (UHMWPE) cup. Results showed that the wear rate was close to the clinical one. A frequency control system and a heating system were developed to offer a wide range of rotation frequency and temperature so as to provide proper experiments. In the Pin-on-Disk (POD) part, eight precision-made pins were generated and an advanced computer system was built up to measure the friction coefficient of the tests samples.     

A mechanical supination sprain simulator for studying ankle supination sprain kinematics

This study presents a free-fall mechanical supination sprain simulator for evaluating the ankle joint kinematics during a simulated ankle supination sprain injury. The device allows the foot to be in an anatomical position before the sudden motion, and also allows different degrees of supination, or a combination of inversion and plantarflexion. Five subjects performed simulated supination sprain trials in five different supination angles. Ankle motion was captured by a motion analysis system, and the ankle kinematics were reported in plantarflexion/dorsiflexion, inversion/eversion and internal/external rotation planes. Results showed that all sprain motions were not pure single-plane motions but were accompanied by motion in other two planes, therefore, different degrees of supination were achieved. The presented sprain simulator allows a more comprehensive study of the kinematics of ankle sprain when compared with some previous laboratory research designs.     

Artificial intelligence in radiotherapy

Artificial intelligence (AI) has already been implemented widely in the medical field in the recent years. This paper first reviews the background of AI and radiotherapy. Then it explores the basic concepts of different AI algorithms and machine learning methods, such as neural networks, that are available to us today and how they are being implemented in radiotherapy and diagnostic processes, such as medical imaging, treatment planning, patient simulation, quality assurance and radiation dose delivery. It also explores the ongoing research on AI methods that are to be implemented in radiotherapy in the future. The review shows very promising progress and future for AI to be widely used in various areas of radiotherapy. However, basing on various concerns such as availability and security of using big data, and further work on polishing and testing AI algorithms, it is found that we may not ready to use AI primarily in radiotherapy at the moment.     

Assessment of the variation in CT scanner performance (image quality and Hounsfield units) with scan parameters,for image optimisation in radiotherapy treatment planning

PurposeTo define a method and investigate how the adjustment of scan parameters affected the image quality and Hounsfield units (HUs) on a CT scanner used for radiotherapy treatment planning. A lack of similar investigations in the literature may be a contributing factor in the apparent reluctance to optimise radiotherapy CT protocols.MethodA Catphan phantom was used to assess how image quality on a Toshiba Aquilion LB scanner changed with scan parameters. Acquisition and reconstruction field-of-view (FOV), collimation, image slice thickness, effective mAs per rotation and reconstruction algorithm were varied. Changes were assessed for HUs of different materials, high contrast spatial resolution (HCSR), contrast-noise ratio (CNR), HU uniformity, scan direction low contrast and CT dose-index.ResultsCNR and HCSR varied most with reconstruction algorithm, reconstruction FOV and effective mAs. Collimation, but not image slice width, had a significant effect on CT dose-index with narrower collimation giving higher doses. Dose increased with effective mAs. Highest HU differences were seen when changing reconstruction algorithm: 56 HU for densities close to water and 117 HU for bone-like materials. Acquisition FOV affected the HUs but reconstruction FOV and effective mAs did not.ConclusionsAll the scan parameters investigated affected the image quality metrics. Reconstruction algorithm, reconstruction FOV, collimation and effective mAs were most important. Reconstruction algorithm and acquisition FOV had significant effect on HU. The methodology is applicable to radiotherapy CT scanners when investigating image quality optimisation, prior to assessing the impact of scan protocol changes on clinical CT images and treatment plans.     

Rotation isomerization of side chains of globular proteins and its effect on the x-ray scattering curves of proteins in a solution

A new method has been developed for averaging the intensity of X-ray diffuse scattering of proteins by different conformations of side groups. The method is based on the algorithm allowing to calculate statistical weights of rotation isomers of side chains. It is shown that for protein structures obtained from high resolution crystallographic data, conformations of the majority of surface groups correspond to rotation isomers with the greatest statistical weight. It has been found that for medium size proteins (with molecular weight varying from 15,000 to 30,000 dalton) whose structure has been determined at high resolution, the influence of rotation isomerization of side chains on the scattering indicatrices does not exceed 5%. The influence of side chains mobility on the scattering curves of large proteins is also small. For these two classes of proteins the rotation isomerization of side groups can be ignored when interpreting significant (exceeding 10%) divergences between experimental and theoretical scattering curves.