Radiotherapy in the presence of contrast agents: a general figure of merit and its application to gold nanoparticles

Delivering sufficient dose to tumours while sparing surrounding tissue is one of the primary challenges of radiotherapy, and in common practice this is typically achieved by using highly penetrating MV photon beams and spatially shaping dose. However, there has been a recent increase in interest in the possibility of using contrast agents with high atomic number to enhance the dose deposited in tumours when used in conjunction with kV x-rays, which see a significant increase in absorption due to the heavy element's high-photoelectric cross-section at such energies. Unfortunately, the introduction of such contrast agents significantly complicates the comparison of different source types for treatment efficacy, as the dose deposited now depends very strongly on the exact composition of the spectrum, making traditional metrics such as beam quality less valuable. To address this, a 'figure of merit' is proposed, which yields a value which enables the direct comparison of different source types for tumours at different depths inside a patient. This figure of merit is evaluated for a 15 MV LINAC source and two 150 kVp sources (both of which make use of a tungsten target, one with conventional aluminium filtration, while the other uses a more aggressive thorium filter) through analytical methods as well as numerical models, considering tissue treated with a realistic concentration and uptake ratio of gold nanoparticle contrast agents (10 mg ml(-1) concentration in 'tumour' volume, 10: 1 uptake ratio). Finally, a test case of human neck phantom is considered with a similar contrast agent to compare the abstract figure to a more realistic treatment situation. Good agreement was found both between the different approaches to calculate the figure of merit, and between the figure of merit and the effectiveness in a more realistic patient scenario. Together, these observations suggest that there is the potential for contrast-enhanced kilovoltage radiation to be a useful therapeutic tool for a number of classes of tumour on dosimetric considerations alone, and they point to the need for further research in this area.

An experiment for two-color photoionization using high intensity extreme-UNT free electron and near-IR laser pulses

We describe an experimental system designed for single-shot photoelectron spectroscopy on free atoms and molecules at the Free Electron Laser in Hamburg (FLASH at DESY). The combination of the extreme ultra-violet (EUV) Free Electron Laser and a temporally synchronized optical fs laser (Ti:Sapphire) enables a variety of two-color pump-probe experiments. The spectral, temporal and spatial characteristics of both the EUV FEL and the optical laser pulses, the experimental procedure to control their overlap as well as the performance of an electron spectrometer used to obtain single-shot photoelectron spectra are discussed. As an illustration of the capabilities of this set-up, some results on two-photon two-color ionization of rare gases are presented. (c) 2007 Elsevier B.V. All rights reserved.

MODULATED BACKSCATTER MICROWAVE SECURITY SENSOR

A system capable of deployment as a microwave security sensor which can automatically reject background clutter is presented. The principle of operation is based on analog homodyne detection using 1. Q single side-band down conversion of an AM backscattered modulating signal envelope. A demonstrator is presented which operates with a carrier frequency of 2 GHz and 500 KHz backscattered signal. When deployed in a multipath rich open plan office environment the S/N ratio obtained at the detection output was better than 20 dB at 20 in range with 20 dBm EIRP in a 2 MHz detection bandwidth despite the presence of time varying and static clutter. (C) 2009 Wiley Periodicals, Inc. Microwave Opt Technol Lett 51: 2492-2495, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.24636

An analysis of geometric uncertainty calculations for prostate radiotherapy in clinical practice.

Margins are used in radiotherapy to assist in the calculation of planning target volumes. These margins can be determined by analysing the geometric uncertainties inherent to the radiotherapy planning and delivery process. An important part of this process is the study of electronic portal images collected throughout the course of treatment. Set-up uncertainties were determined for prostate radiotherapy treatments at our previous site and the new purpose-built centre, with margins determined using a number of different methods. In addition, the potential effect of reducing the action level from 5 mm to 3 mm for changing a patient set-up, based on off-line bony anatomy-based portal image analysis, was studied. Margins generated using different methodologies were comparable. It was found that set-up errors were reduced following relocation to the new centre. Although a significant increase in the number of corrections to a patient's set-up was predicted if the action level was reduced from 5 mm to 3 mm, minimal reduction in patient set-up uncertainties would be seen as a consequence. Prescriptive geometric uncertainty analysis not only supports calculation and justification of the margins used clinically to generate planning target volumes, but may also best be used to monitor trends in clinical practice or audit changes introduced by new equipment, technology or practice. Simulations on existing data showed that a 3 mm rather than a 5 mm action level during off-line, bony anatomy-based portal imaging would have had a minimal benefit for the patients studied in this work.

Interaction of High Intensity Picosecond Laser Pulses with Large Pre-formed Plasmas

The interaction of short (1-2 ps) laser pulses with solid targets at irradiances of over 1016 Wcm~2 , in the presence of a substantial prepulse has been investigated. High absorption of laser energy is found even at high angles of incidence, with evidence for a resonance absorption peak being found for S, P, and circular polarizations. It is considered that this may be a result of refraction and beam filamentation, which causes loss of distinct polarization. Measurements of hard X-ray emission (~ 100 keV) confirm a resonance absorption type peak at 45-50°, again for all three cases. Typically, 5-15% of the incident light is back-reflected by stimulated Brillouin scatter, with spatially resolved spectra showing evidence of beam hot-spots at high intensity. The possibility that filamentation and refraction of the beam can explain the lack of polarization dependence in the absorption and hard X-ray emission data is discussed.

Personnel radiation dose considerations in the use of an integrated PET–CT scanner for radiotherapy treatment planning of an integrated PET-CT scanner for radiotherapy treatment planning

The acquisition of radiotherapy planning scans on positron emission tomography (PET)-CT scanners requires the involvement of radiotherapy radiographers. This study assessed the radiation dose received by these radiographers during this process. Radiotherapy planning F- fluorodeoxyglucose (F-FDG) PET-CT scans were acquired for 28 non-small cell lung cancer patients. In order to minimise the radiation dose received, a two-stage process was used in which the most time-consuming part of the set-up was performed before the patient received their F-FDG injection. Throughout this process, the radiographers wore electronic personal dosemeters and recorded the doses received at different stages of the process. The mean total radiation dose received by a radiotherapy radiographer was 5.1±2.6 mSv per patient. The use of the two-stage process reduced the time spent in close proximity to the patient by approximately a factor of four. The two-stage process was effective in keeping radiation dose to a minimum. The use of a pre-injection set-up session reduces the radiation dose to the radiotherapy radiographers because of their involvement in PET-CT radiotherapy treatment planning scans by approximately a factor of three.

The role of PET/CT scanning in radiotherapy planning

The introduction of functional data into the radiotherapy treatment planning process is currently the focus of significant commercial, technical, scientific and clinical development. The potential of such data from positron emission tomography (PET) was recognized at an early stage and was integrated into the radiotherapy treatment planning process through the use of image fusion software. The combination of PET and CT in a single system (PET/CT) to form an inherently fused anatomical and functional dataset has provided an imaging modality which could be used as the prime tool in the delineation of tumour volumes and the preparation of patient treatment plans, especially when integrated with virtual simulation. PET imaging typically using F-Fluorodeoxyglucose (F-FDG) can provide data on metabolically active tumour volumes. These functional data have the potential to modify treatment volumes and to guide treatment delivery to cells with particular metabolic characteristics. This paper reviews the current status of the integration of PET and PET/CT data into the radiotherapy treatment process. Consideration is given to the requirements of PET/CT data acquisition with reference to patient positioning aids and the limitations imposed by the PET/CT system. It also reviews the approaches being taken to the definition of functional/ tumour volumes and the mechanisms available to measure and include physiological motion into the imaging process. The use of PET data must be based upon a clear understanding of the interpretation and limitations of the functional signal. Protocols for the implementation of this development remain to be defined, and outcomes data based upon clinical trials are still awaited. © 2006 The British Institute of Radiology.

The efficacy of lead shielding in megavoltage radiotherapy.

The dose received by anatomical structures which are apparently shielded by lead blocks during a course of megavoltage radiotherapy may not be negligible. The dose has three main components; there is that due to radiation transmitted through the shielding block, that due to radiation scattered within the patient and that due to radiation scattered prior to reaching the patient and so circumventing the shield. A calculation method which separates the three components has been investigated and the results have been compared with measurements in a wide range of test situations for both cobalt-60 and 6 MV photon beams. The method of calculation predicts the dose behind the shielding block with acceptable accuracy in all the conditions investigated.