Gy Dose Research Articles

Effects of radiotherapy dose and application time on the load-to-failure values of teeth filled with different sealers

BackgroundThe materials used in root canal filling and radiotherapy (RT) application can affect the load-to-failure of the teeth. This study aimed to compare the load-to-failure of the teeth filled with AH Plus (AHP) or AH Plus bioceramic (AHPB) before or after 60 Gy- and 70 Gy-dose radiotherapy.Materials and methodsOne hundred and ten maxillary incisors were endodontically prepared up to ProTaper Next X4 instruments. The teeth were randomly divided into 5 main groups as: non-irradiated, root canal treatment (RCT) before 60 Gy radiotherapy, RCT before 70 Gy radiotherapy, RCT after 60 Gy radiotherapy, RCT after 70 Gy radiotherapy. These groups were divided into 2 subgroups for filling material: AHP ve AHPB. After filling and radiotherapy procedures, the teeth were fixed on the thermoplastic mask plane. The plane were placed in the middle of a rectangular prism shaped glass phantom, and irradiated via a linear accelerator device. The teeth were then embedded in cylindrical acrylic blocks and the force (N) that caused the fracture was recorded under the Universal testing device. Student t-test was used for statistical comparisons. Statistical significance level was determined as p < 0.05.ResultsAfter 70 Gy dose radiotherapy, the group filled with AHPB showed statistically significantly lower fracture strength than the group filled with AHP (p < 0.05). In the control group, before 60 Gy RT group, after 60 Gy RT group, and before 70 Gy RT group, the sealers had statistically significantly similar load-to-failure. (p > 0.05).ConclusionThe group filled with AHPB caused a lower fracture strength than the group filled with AHP following a 70 Gy dose of RT. The sealers in the control group, before 60 Gy RT group, after 60 Gy RT group, and before 70 Gy RT group exhibited comparable load-to-failure values.

A Tissue‐Equivalent, Reusable Dosimeter for 3D Verification of Radiotherapy

AbstractA new tissue‐equivalent, reusable material for dosimetric verification of radiotherapy is developed and characterized. The material comprises a hydrogel matrix containing copper‐doped lithium fluoride nanoparticles that exhibit optically stimulated luminescence (OSL). Using a laser light sheet and a sensitive camera equipped with appropriate filters, the OSL signal is read out layer by layer thus constructing the 3D dose distribution. The good tissue equivalence allows the new material to register the dose from a prescribed treatment plan as if delivered to a patient. Cubic dosimeters measuring 50 × 50 × 50 mm3 are developed and used to measure 3D dose distributions (from voxels measuring 0.8 × 0.8 × 1.0 mm3) with a statistical dose precision of 5% at 100 Gy dose levels. The spatial precision of offsets in dose gradients between planned and measured dose distributions is below the voxel size. A 3% / 3 mm gamma analysis between a prescribed treatment plan and the retrieved and corrected readout yields a pass rate of 89.5%. Light scattering within the dosimetric volume affects the dosimeter performance, indicating the potential for future improvements of spatial and dose precision. In conclusion, the dosimeter system shows high promise for future clinical validation of radiotherapy.

Relationship between radiation dose and cerebral microbleed formation in dogs with intracranial tumors.

Cerebral microbleeds (CMBs) are a possible sequela in human brain tumor patients treated with radiation therapy (RT). No such association is reported in dogs. To investigate whether CMBs occur in dogs after radiotherapy, and if there is an association between number and dose, and an increase over time. Thirty-four client-owned dogs irradiated for primary intracranial neoplasia. ≥2 magnetic resonance imaging (MRI) scans including susceptibility-weighted imaging (SWI) were required. Retrospective, observational, single-center study. Cerebral microbleeds identified on 3 T SWI were counted within the entire brain, and within low- (<20 Gy), intermediate- (20-30 Gy), and high- (>30 Gy) dose regions. A generalized linear mixed-effects model was used to analyze the relationship between the CMBs count and the predictor variables (irradiation dose, time after treatment). Median follow-up time was 12.6 months (range, 1.8-37.6 months). Eighty-three MR scans were performed. In 4/15 dogs (27%, 95% CI, 10%-52%) CMBs were present at baseline. ≥1 CMBs after RT were identified in 21/34 dogs (62%, 95% CI, 45%-77%). With each month, the number of CMBs increased by 14% (95% CI, 11%-16%; P < .001). The odds of developing CMBs in the high-dose region are 4.7 times (95% CI, 3.9-5.6; P < .001) greater compared with the low-dose region. RT is 1 possible cause of CMBs formation in dogs. Cerebral microbleeds are most likely to occur in the peritumoral high-dose volume, to be chronic, and to increase in number over time. Their clinical relevance remains unknown.

A novel 3D polymer gel dosimeter based on polymethyl methacrylate gel (PMMAG) for radiotherapy: Ultrasonic evaluation

This study investigates the characteristics of a novel polymer gel dosimeter (PMMAG) for radiotherapy applications, focusing on its radiation absorption and sensitivity properties. The PMMAG dosimeters were evaluated using both UV–vis spectrophotometry and ultrasonic techniques. The results of the study, UV–vis analysis revealed a significant increase in dose response with the introduction of a cross-linker, peaking at a monomer-to-cross-linker ratio of 5:3. Sensitivity analysis indicated optimal sensitivity at this ratio, with values reaching 0.021 a.u./Gy. Ultrasound evaluation showed that the speed of sound and attenuation coefficient demonstrated a linear relationship and a strong positive correlation with an increase in the applied radiation dose, with the highest sensitivity observed at 8 Gy. The optimal sample exhibited the highest dose-response values at both 4 Gy and 8 Gy doses. Sensitivity values ranged from 2.1 to 2.75. The ultrasonic measurements demonstrated a significantly larger dynamic range in dose response curves compared to UV–vis dose-response data. It is concluded that ultrasound shows great potential as a technique for the evaluation of polymer gel dosimeters. The PMMAG can be introduced as a novel dosimeter for ionizing radiation dosimetry, validated through both optical and ultrasound assessment methods. The consistent and reliable performance of the PMMAG dosimeters makes them suitable for various applications in radiation therapy.

An efficient and easy-to-use protocol for induction of haploids in cucumber through parthenogenic embryo development

BackgroundCucumber (Cucumis sativus L.) is a model crop to study cell biology, including the development of haploids and doubled haploids in vegetable crops. In plant breeding, haploid and doubled haploids are valuable tools for developing pure homozygous inbred lines and accelerating genetic progress by reducing the time required for breeding cycles. Besides, the haploids are also valuable in genomic studies. We are reporting the induction of haploids in cucumber involving gynoecious and parthenocarpic genotypes for the first time. This study aimed to assess the efficient induction of haploids through pollination with gamma-irradiated pollen in cucumber. The effect of gamma irradiation dose on pollen viability and germination, fruit setting percentage, seed development, and haploid embryo development in cucumber hybrid genotypes were studied in detail. The goal was to utilize this information to produce haploid plants for genomics and transformation works in this model vegetable crop.ResultsPollination was done on six cucumber genotypes using varying doses of gamma rays (100, 200, 300, 400, and 500 Gy). Genotypes, doses of irradiation, and embryo developmental stage influenced the successful generation of in-vitro haploid plants. The optimal timeframe for embryo rescue was found to be 25 to 30 days after pollination. Haploid embryos were effectively induced using irradiated pollen at 400 to 500 Gy doses. Parthenogenetic plantlets were analyzed, and their ploidy level was confirmed through stomatal physiology, cytology (mitosis), and flow cytometry methods.ConclusionThrough parthenogenic embryo development, it is possible to induce a large number of haploids in cucumber. This technique’s power lies in its ability to streamline the breeding process, enhance genetic gain, and produce superior cultivars that contribute to sustainable agriculture and food security.

RTOG 0915-compliant patient specific QA for lung stereotactic body radiotherapy using the new PTW 1600SRS detector array

PurposeAn area of focus in radiotherapy is the treatment of oligometastatic lung cancer using highly conformal techniques such as SBRT, performed using VMAT that involves flattening filter free (FFF) beams. This study proposes a new calibration procedure for PTW Octavius 1600SRS detector array and was designed to also evaluate clinical and dosimetric aspects of a patient-specific quality assurance (PSQA) for lung SBRT patients. MethodsThe cohort consists of 20 patients, treated for lung metastases using SBRT with 50 Gy dose in 5 fractions (10 Gy/fr). The proposed calibration method uses only one calibration factor determined at maximum dose rate of 6MV FFF photon beam. The dosimetric accuracy of achieving a high dose gradient was analyzed using the RTOG 0915 protocol and was confirmed by PSQA procedures using the PTW Octavius 1600SRS detector. ResultsConformity index, gradient index, maximum dose at 2 cm and V20 parameters were evaluated with clinical favorable results, with only two plans with lesions situated in the inferior lobe exceeding the deviation allowed for the gradient index. Gamma passing rates using the new calibration method were 98.93% and 99.38% for different gamma criteria of 2 mm/2% and 1 mm/3%, respectively. ConclusionsThe proposed method for calibration using one calibration factor at maximum dose rate for the involved photon beam shows clinically acceptable gamma passing rates. Employing the RTOG 0915 protocol for lung SBRT treatment plan evaluation brings important dosimetric information about treatment plan quality and dose gradient fall-off which can be correlated with the results achieved during the pretreatment verification procedures.

Multi-segments conformal plan optimization for head and neck cancer.

To evaluate better dose distribution with three-dimensional radiation therapy, and to compare it with multi-segmented treatment planning techniques in patients with head and neck cancer. The prospective study was conducted at the Baghdad Centre for Radiation Therapy and Nuclear Medicine, Baghdad, Iraq, and comprised data of 50 patients with head and neck cancerous tumours from June 2021 to February 2022. There were 35 (70%) females and 15(30%) males. The mean age was 47.31 ± 3.95 years (range 19 - 69 years The patients had undergone computed tomography simulation. The images were exported to Monaco 5.1 for contouring by the radiation oncologist. The data was then imported to XiO planning system. Each plan was repeated twice; once with three-dimensional conformal radiation therapy and the other with field-in-field technique. Data was analysed using SPSS 24. There were 50 patients whose data was analysed. The results showed significant differences between three-dimensional conformal radiation therapy and field-in-field techniques for dose coverage at 90% and 95% volumes (p<0.05). There was a significant difference between the two techniques for 2Gy dose (p<0.05), but the difference was not significant for 5Gy dose (p>0.05). The field-in-field treatment planning technique was found to be more effective than the threedimensional conformal radiation therapy technique.

Radiotherapy for painful shoulder syndrome: aretrospective evaluation.

We evaluated the efficacy of low-dose radiotherapy for painful shoulder syndrome from an orthopedic perspective. Patients with painful shoulder syndrome were recruited for this retrospective clinical quality assessment from January 2011 to December 2017. Patients were treated with alinear accelerator or an orthovoltage device at individual doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy. To assess response, we used the von Pannewitz score with five levels: "worsened," "unaffected," "improved," "significantly improved," and "symptom free." "Good treatment success" was defined as "significantly improved" and "symptom free." Within-group and between-group differences were statistically evaluated. Of 236 recruited patients (150 women, 86men; mean age66.3 [range 31-96] years), 180 patients underwent radiotherapy with alinear accelerator and 56with an orthovoltage device. Fractionation was 12 × 0.5 Gy in 120 patients, 6 × 0.5 Gy in 74, and 6 × 1 Gy in 42patients. Treatments were completed in one series for 223 and in two series at least 6weeks apart for 13patients. Of the 236 patients, 163 patients (69.1%) agreed to be re-interviewed at amedian of 10.5 (range 4-60) months after radiotherapy completion. Directly after radiotherapy, 30.9% (73patients) had "good treatment success," which had increased to 55.2% (90patients) at follow-up. Protracted pain improvement with low-dose radiotherapy is possible in painful shoulder syndrome. Patients with refractory pain because of subacromial syndrome or shoulder osteoarthritis should also be evaluated for radiotherapy.

Agro-morphological evaluation of gamma ray-induced mutant populations and isolation of harder grain mutants in wheat (Triticum aestivum L.)

Abstract Gamma ray-induced mutations have been widely used to improve existing crop germplasm and create novel genetic variation. In the current study, a multi-year experiment was carried out to induce and isolate mutants with desirable agro-morphological traits and improved grain hardness through evaluation of induced mutant populations generated in soft-textured wheat variety HPW 89 irradiated with gamma ray dose of 250, 300 and 350 Gy. Mutagen sensitivity studies revealed a higher frequency of biological damage and seedling mortality for doses beyond 300 Gy in the M1 generation. However, the mutagenic treatments in the M2–3 populations significantly altered the magnitude of the biometrical traits. Results from the variability and association studies among traits showed that biological yield per plant, 1000-grain weight, spike length, grains per spike and plant height may be prioritized for higher genetic gain and could be used as selection criteria parameters. Multivariate analysis indicated induction of heterogeneity among mutant populations. Overall, 250–300 Gy doses were found ideal for a successful wheat mutation programme and 293 agro-morphologically superior wheat mutants were identified, out of which 108 had semi-hard grain texture based on single kernel characterization system. Among these, nine mutants were found to have the highest grain hardness index due to induced changes in one or both puroindoline genes. Hence, these mutants identified for several traits along with harder grain texture will serve as important genetic resource in future wheat-breeding programmes.

The Influence of X-ray Radiation on the Morphological, Biochemical, and Molecular Changes in Copiapoa tenuissima Seedlings

Cactaceae are a significant group of ornamental plants in the horticultural market. In the present study, X-rays were used for the first time to induce mutational changes in the cactus Copiapoa tenuissima. The aim of this study was to assess the genetic variability in seedlings exposed to in vitro X-ray irradiation at doses of 0, 15, 20, 25, and 50 Gy (radiation time from 5 min 13 s to 17 min 22 s) by morphological analysis, a spectrophotometric evaluation of plant pigment content, and the confirmation of changes at the genetic level using SCoT (start codon targeted) markers. The results showed that the percentage of colorful seedlings increased with the radiation dose and was the highest for the 50 Gy dose (4.89%). The radiation doses of 25 and 50 Gy generated seedlings with a new color (orange-brown), which had not yet been observed in C. tenuissima. With the increase in the radiation dose, as compared to control seedlings, brown seedlings showed an increase in the concentrations of carotenoids, chlorophyll a, and chlorophyll b, while green seedlings showed an increase in the concentrations of anthocyanins and chlorophyll b and a decrease in the concentrations of carotenoids and chlorophyll a. The unweighted pair group method analysis showed a very large genetic distance among the tested genotypes exposed to X-rays. The results of the present study provide a novel direction for using X-rays to breed new cultivars of C. tenuissima.

Serum exosomal miRNA promote glioma progression by targeting SOS1 via abscopal effect of radiation

IntroductionLocal exposure to ionizing radiation (IR) can induce changes in biological processes in distant tissues and organs. Exosomes are nanoscale vesicles that transport biomolecules, mediate communication between cells and tissues, and can affect the abscopal effects of radiotherapy. MethodsMice were treated with 8.0 Gy doses of chest and abdomen IR, after which serum samples were taken 24 h after exposure. Their serum exosomes were then isolated via ultracentrifugation and the small RNA portions were extracted for sequencing and bioinformatic analysis. Exosomes were injected intravenously into the mice to assess their ability to cross the blood-brain barrier (BBB). Glioma cells and glioma stem cells (GSCs) were examined for malignant biological behaviors, stemness, and tumorigenic capacity after co-culturing with different groups of exosomes. ResultsWe found that serum exosomes crossed the BBB in mice after local IR exposure-which induced decreases in the expression of BBB tight-junction proteins and increased brain endothelial cell apoptosis. Exosomes from the exposed groups promoted malignant biological behaviors, stemness, and tumorigenic capacity in glioma cells and GSCs by upregulating the expression of SOS1. Phospho-MEK1/2 and Phospho-ERK1/2, of the MAPK signaling pathway, were found to be up-regulated in cells that were co-cultured with the exposing groups of the exosomes. Further analyses demonstrated that differentially expressed levels of miR-93–5p in mouse serum exosomes regulated the cellular expression of SOS1. ConclusionFollowing local IR exposure, serum exosomes cross the BBB to promote the progression of distant gliomas. Exosomal microRNAs play an important role in this process.

Dose rate dependent genotoxic and metabolic effects predict onset of impaired development and mortality in Atlantic salmon (S. salar) embryos exposed to chronic gamma radiation

Release of radionuclides to the environment from either nuclear weapon and fuel cycles or from naturally occurring radionuclides (NORM) may cause long term contamination of aquatic ecosystems and chronic exposure of living organisms to ionizing radiation, which in turn could lead to adverse effects compromising the sustainability of populations. To address the effects of chronic ionizing radiation on the development of fish, Atlantic salmon embryos were exposed from fertilization until hatching (88 days, 550 day-degree) to dose rates from 1 to 30 mGy·h−1 gamma radiation (60Co). The lowest adopted dose rate was similar to the highest doses measured in some water bodies right after the Chernobyl accident (1 mGy·h−1), however, well above current environmentally realistic scenarios (20 μGy·h−1), or the threshold assumed for significant effects on fish population (40 μGy·h−1). Dose dependent effects were observed on survival, hatching, morbidity, DNA damage, antioxidant defenses, and metabolic status. Histopathological analysis showed dose rate dependent impairment of eye and brain tissues development and establishment of epidermal mucus cell layers accompanied by increased DNA damage at doses ≥1.3 Gy (dose rates ≥1 mGy·h−1).At ≥32.8 Gy (dose rates ≥20 mGy·h−1) deformities and developmental growth defects resulted in respective 46 and 95 % pre-hatch mortality. The 10 mGy·h−1 exposure (≥ 12 Gy total dose) caused significantly increased DNA damage, impaired eye development, and both premature and delayed hatching, while no deformities or effect on survival were observed. We observed a dose rate dependent reduction from dose rate ≥ 20 mGy·h−1 (≥ 27 Gy total dose) on antioxidant SOD, catalase and glutathione reductase enzyme activities. The reduction of antioxidant enzyme activities was in line with observed developmental delay and disturbance to time of hatching. Metabolomic profiles showed a clear shift at dose rates ≥10 mGy·h−1 (≥ 12 Gy total dose) in pathways related to oxidative stress, detoxification, DNA damage and repair. Due to gamma radiation exposure, a switch of central metabolism from glycolysis, citric acid cycle and lactate production towards pentose phosphate pathway indicated a rewiring mechanism for increased production of reductive equivalents to maintain redox homeostasis at the expense of energy output and thus embryonic development.

Long-Term Outcomes After Cyberknife Radiosurgery for Nonfunctioning Pituitary Adenomas.

Stereotactic radiosurgery (SRS) has been widely adopted as an important adjunctive treatment modality for managing nonfunctioning pituitary adenomas (NFPAs). However, current studies on the long-term effects of SRS on pituitary adenomas have been largely limited by small sample sizes and short follow-up periods. The aim of this study was to evaluate the long-term outcomes of SRS for NFPAs. We conducted a retrospective review of 178 patients with NFPAs who received Cyberknife radiosurgery at a single institution between February 2008 and July 2021. Long-term outcomes of tumor control, new-onset hypopituitarism, and new visual disorders were assessed. During a median radiological follow-up of 49.7 months (range, 2.5-158.1 months), only 11 (7.0%) patients experienced tumor progression. The progression-free survival at 3, 5, and 10 years was 97.47%, 95.57%, and 93.04%, respectively. New-onset hypopituitarism was diagnosed in 27 (16.9%) patients with a median clinical follow-up duration of 71.2 months (range, 11.5-175.4 months). The median time from SRS to new-onset hypopituitarism was 28.3 months (range, 2.8-101.7 months). The cumulative incidence of new-onset hypopituitarism at 3, 5, and 10 years was 8.47%, 12.43%, and 15.25%, respectively. Biological effective dose >140 Gy and single fraction equivalent dose >16.0 Gy were significant risk factors for new-onset hypopituitarism (P = .046). Other adverse events were experienced by 15 (8.4%) patients, 9 (5.1%) of whom presented with new visual disorders. Development of new visual disorders was associated with a pretreatment tumor volume of >2.5 mL (P = .044). SRS is an effective and relatively safe means of managing both primary and residual/recurrent NFPAs.

Pyrroloquinoline Quinone Alleviates Mitochondria Damage in Radiation-Induced Lung Injury in a MOTS-c-Dependent Manner.

Radiation-induced lung injury (RILI) is a prevalent complication of thoracic tumor radiotherapy and accidental radiation exposure. Pyrroloquinoline quinone (PQQ), a novel vitamin B, plays a crucial role in delaying aging, antioxidation, anti-inflammation, and antiapoptosis. This study aims to investigate the protective effect and mechanisms of PQQ against RILI. C57BL/6 mice were exposed to a 20 Gy dose of X-ray radiation on the entire thorax with or without daily oral administration of PQQ for 2 weeks. PQQ effectively mitigated radiation-induced lung tissue damage, inflammation, oxidative stress, and epithelial cell apoptosis. Additionally, PQQ significantly inhibited oxidative stress and mitochondrial damage in MLE-12 cells. Mechanistically, PQQ upregulated the mRNA and protein levels of MOTS-c in irradiated lung tissue and MLE-12 cells. Knockdown of MOTS-c by siRNA substantially attenuated the protective effects of PQQ on oxidative stress, inflammation, and apoptosis. In conclusion, PQQ alleviates RILI by preserving mitochondrial function through a MOTS-c-dependent mechanism, suggesting that PQQ may serve as a promising nutraceutical intervention against RILI.

Metformin-loaded chitosan nanoparticles augment silver nanoparticle-induced radiosensitization in breast cancer cells during radiation therapy

Recent research has focused on enhancing tumor response to radiation therapy using radiosensitizers to increase radiation absorption by cancerous tissues. This study utilized silver nanoparticles (AgNPs) as radiation sensitizers and chitosan as a nanocarrier to deliver metformin to breast cancer cells. Metformin-loaded chitosan nanoparticles (Met NPs) and AgNPs were synthesized and characterized. MCF-7 breast cancer cells were pretreated with Met NPs, followed by treatment with AgNPs and irradiation with X-rays at 2, 4, and 8 Gy doses. Cellular cytotoxicity, apoptosis, DNA damage, and 3D spheroid formation were evaluated. The synthesized Met NPs and AgNPs had average diameters of 51.5 ± 9.4 nm and 3.02 ± 0.03 nm, respectively. Cellular cytotoxicity assessment revealed the highest cytotoxicity in MCF-7 cells pretreated with Met NPs, treated with AgNPs, and irradiated with 8 Gy. Flow cytometry analysis demonstrated a 67.58 % apoptosis rate in cells pretreated with Met NPs, compared to 30.42 % in cells pretreated with plain metformin. DAPI staining revealed a 1.8-fold increase in DNA damage in cells pretreated with Met NPs and Ag NPs upon exposure to radiation. The 3D spheroid culture model confirmed a 60 % enhancement in the radiosensitivity of breast cancer cells in the presence of Met NPs and Ag NPs. The combination of Met NPs and Ag NPs represents a promising strategy to improve the therapeutic efficacy of radiation therapy for breast cancer treatment. The delivery of metformin can potentiate the radiosensitizing effects of Ag NPs, offering a novel approach to enhance cancer cells' response to radiation.

First-Strike Rapid Predictive Dosimetry and Dose Response for 177Lu-PSMA Therapy in Metastatic Castration-Resistant Prostate Cancer.

We devised and clinically validated a schema of rapid personalized predictive dosimetry for 177Lu-PSMA-I&T in metastatic castration-resistant prostate cancer. It supersedes traditional empiric prescription by providing clinically meaningful predicted absorbed doses for first-strike optimization. Methods: Prostate-specific membrane antigen PET was conceptualized as a simulation study that captures the complex dosimetric interplay between tumor, marrow, and kidneys at a single time point. Radiation principles of fractionation, heterogeneity, normal-organ constraints (marrow, kidney), absorbed dose, and dose rate were introduced. We created a predictive calculator in the form of a free, open-source, and user-friendly spreadsheet that can be completed within minutes. Our schema achieves speed and accuracy by sampling tissue radioconcentrations (kBq/cm3) to be analyzed in conjunction with clinical input from the user that reflect dosimetric preconditions. The marrow-absorbed dose constraint was 0.217 Gy (dose rate, ≤0.0147 Gy/h) per fraction with an interfraction interval of at least 6 wk. Results: Our first 10 patients were analyzed. The first-strike mean tumor-absorbed dose threshold for any prostate-specific antigen (PSA) response was more than 10 Gy (dose rate, >0.1 Gy/h). The metastasis with the lowest first-strike tumor-absorbed dose correlated the best with the percentage decrease of PSA; its threshold to achieve hypothetical zero PSA was 20 Gy or more. Each patient's PSA doubling time can be used to personalize their unique absorbed dose-response threshold. The predicted mean first-strike prescription constrained by marrow-absorbed dose rate per fraction was 11.0 ± 4.0 GBq. Highly favorable conditions (tumor sink effect) were dosimetrically expressed as the combination of tumor-to-normal-organ ratios of more than 150 for marrow and more than 4 for kidney. Our schema obviates the traditional role of the SUV as a predictive parameter. Conclusion: Our rapid schema is feasible to implement in any busy real-world theranostics unit and exceeds today's best practice standards. Our dosimetric thresholds and predictive parameters can radiobiologically rationalize each patient's first-strike prescription down to a single becquerel. Favorable tumor-to-normal-organ ratios can be prospectively exploited by predictive dosimetry to optimize the first-strike prescription. The scientific framework of our schema may be applied to other systemic radionuclide therapies.

Tumor volume changes after stereotactic, hypofractionated and conventional radiotherapy in paragangliomas of head and neck.

The aim of this study is comparison the effectiveness of stereotactic, hypofractionated and conventional radiotherapy assessed by the tumor volume changes of paraganglioma located in the head and neck region concerning fractional and total doses. We analyzed 76 patients after radiotherapy due to paraganglioma who were assigned to 3 groups considering fractional (≤2 Gy, 3-5.5 Gy, ≥6 Gy) and total (≤20 Gy, 21-40 Gy, >40 Gy) doses. The volumes of irradiated tumors were measured and compared based on diagnostic images performed before and after the treatment. The mean tumor volume after the treatment with the lowest fractional dose (≤2 Gy) was decreased by 14.4 cm3. In patients treated with higher fractional doses (>2 Gy), the mean tumor volumes decreased by less than 1 cm3 for hypofractionated and stereotactic radiotherapy. 15.9 cm3 reduction of the mean tumor volume after the treatment with the highest RT total dose (>40 Gy) was stated. In patients treated with total doses ≤20 Gy and 21-40 Gy, the mean tumor volume was stable and reduced by 1.15 cm3, respectively. The analysis demonstrates a statistically significant (p < 0.05) treatment advantage in patients after the lowest fractional and highest total doses. The reduction of the tumor's volume was reported after conventional and unconventional radiotherapy. The most significant depletion of the paraganglioma volume was noted after a factional dose ≤2 Gy and a total dose >40 Gy.

Single preoperative radiation therapy with delayed surgery for low-risk breast cancer: Oncologic outcome, toxicity and cosmesis of the SPORT-DS phase I trial

BackgroundA novel approach using single-fraction preoperative partial breast irradiation (PBI) for low-risk breast cancer is under study. We sought to investigate the rate of pathologic response (pR), toxicities and cosmetic results related to this new treatment strategy. MethodsWomen of 65 years or older with stage I unifocal luminal A breast cancer were eligible for inclusion in this phase I prospective trial. Patients received a single 20 Gy dose of PBI followed by breast-conserving surgery (BCS) 3 months later. The primary endpoint was the pR rate, and the secondary endpoints were radiation therapy-related toxicity and cosmetic results. ResultsThirteen patients were treated, with a median age of 71. Eleven patients (84.6 %) had pR with a median residual cellularity of 1 % (range: 0–10 %). At median follow-up of 48.5 months, no recurrences or cancer-related deaths were recorded. Acute radiation therapy-related toxicity were limited to grade 1 dermatitis and breast pain. At the 1-year follow-up, there were one grade 2 fat necrosis and two grade 3 toxicities (wound infection and hematoma). Only grade 1 toxicities remained at 2 years, but one grade 2 toxicity (fibrosis/induration) developed by the 3-year follow-up. Three-year patient-reported cosmetic outcomes were good or excellent in 60 % of patients. ConclusionsSingle-fraction preoperative PBI preceding BCS for low-risk breast cancer is feasible, relatively well tolerated and leads to a high level of pR. The 3-month interval after PBI seems to place surgery in a post-radiation inflammatory phase. Further delay between PBI and surgery could improve pR and cosmetic outcome. NCT03917498.

Unforeseen outcomes: Unveiling cyst formation post stereotactic radiosurgery in brain arteriovenous malformations cases

IntroductionCyst formation after stereotactic radiosurgery (SRS) for brain arteriovenous malformations (AVMs) is a rare, delayed but important complication. Prompt recognition and appropriate treatment is essential for good outcome. MethodsWe analysed our institute’s Gamma knife treatment records from 2008 to 2023 and analysed AVM treated patients by gamma knife radiosurgery (GKRS). Patients with cyst formation and with adequate follow up were identified. Clinical details, management and prognosis of these patients was studied in detail along with prior literature review. ResultsA total of 921 AVM patients were treated in the above period and 7 patients were identified with cyst formation. The mean nidus volume was 12.98 ml, the mean radio surgical marginal dose was 23.57 Gy and maximal dose 47.21 Gy. The mean interval gap between SRS and cyst detection was 6.45 years. The mean volume of cyst cavity formed was 47.85 ml. Patients presented either with features of raised intracranial pressure (3) or focal neurological deficits (3) or seizures (1). 3 patients had achieved angiographic nidus obliteration at the time of cyst detection. Treatment was mostly on surgical lines with cyst fenestration(2 patients), excision (3 patients) and emergency decompressive craniectomy (1 patient). 1 patient required additional Ommaya insertion. Conservative management was followed for 1 patient. Residual nidus was treated either by concomitant excision or embolization or redo GKRS.Favourable outcome was seen in 6 out of 7 patients (85.71%) post cyst management with symptomatic and radiological improvement whereas 1 patient (14.28%) died due to refractory status epilepticus secondary to malignant cerebral edema. ConclusionCyst formation after GKRS for AVM treatment is an often-neglected complication due to its low incidence and often long latency period. Long term follow up of patients is hence necessary for prompt recognition. Diagnostic DSA should be done in all patients with cysts to look for residual nidus. Asymptomatic ones can be followed up conservatively while surgical treatment is required for symptomatic cases. Ventricular diversion like Ommaya or cystoperitoneal shunt may be necessary in some cases. Treatment outcome is usually favourable provided timely detection is done.

Space-Like Irradiation Exacerbated Cognitive Deficits and Amyloid Pathology in CRND8 Mouse Model of Alzheimer's Disease.

Space radiation was linked to neurological damage and behavioral deficits which raised concerns of increased degenerative risk on the brain and development of Alzheimer's disease following space travel. In this study, we investigated the effects of irradiation by 56Fe and 28Si in CRND8 mice, an Alzheimer's disease mouse model. Six-month-old CRND8 mice were exposed to whole body irradiation by 56Fe and 28Si at 0.5 Gy and 2 Gy doses. Behavior tests were administered 1-month to 3-months post-irradiation. Amyloid deposition and other pathological changes were analyzed 3-months and/or 6-months post-irradiation. The Novel Object Recognition test showed some decline in 8-month-old mice compared to non-irradiated CRND8 mice. Male mice also showed a loss of freezing behavior in the fear conditioning contextual test following irradiation. Golgi staining revealed a loss of spines in hippocampal neurons after irradiation. Total amyloid immunohistochemistry showed a robust increase in 3-months post-irradiation 56Fe groups which became normalized to non-irradiated group by 6-months post-irradiation. However, 2 Gy 28Si caused a trend towards increased plaque load at 3-months post-irradiation which became significant at 6-months post irradiation only in male CRND8 mice. While 0.5 Gy Fe did not induce obvious changes in the total number of iba-1 positive microglia, more hippocampal microglia were found to express PCNA after 0.5 Gy Fe treatment, suggesting potential involvement of microglial dysfunction. Overall, our study provides new evidence of gender-specific and ion-dependent effects of space radiation on cognition and amyloid pathology in AD models.