Analyse des anti-inflammatorischen Pilzmetaboliten S-Curvularin in verschiedenen Modellen der rheumatoiden Arthritis

An der Entwicklung und Aufrechterhaltung chronisch-inflammatorischer Erkrankungen wie der rheumatoiden Arthritis (RA) ist die Fehlregulation verschiedener pro-inflammatorischer Gene von entscheidender Bedeutung. Bei der RA führt unter anderem eine erhöhte Expression der induzierbaren NO-Synthase (iNOS) zu einer gesteigerten NO-Produktion, was schließlich zum Knochenabbau beiträgt. Für eine Therapie der RA werden häufig Glukokortikoide eingesetzt, die jedoch viele Nebenwirkungen zeigen. Um eine mögliche Therapiealternative zu identifizieren, sollten die Effekte des anti-inflammatorisch wirksamen Pilzmetaboliten S-Curvularin in verschiedenen Modellen der RA analysiert werden.rnIn humanen C-28/I2-Chondrozyten als in vitro-Modell der RA führte die Inkubation mit einem Zytokingemisch zu einer Induktion der iNOS-Expression, die vom chondrogenen Differenzierungsgrad der Zellen abhängig war. Entscheidend für die iNOS-Induktion in C-28/I2-Zellen ist hauptsächlich der p38-MAPK-, der JAK-STAT- und der NF-kappa B-Signaltransduktionsweg. Eine Inkubation der Zellen mit S-Curvularin führte zu einer deutlichen Hemmung der iNOS-Expression. Dexamethason hatte hingegen keinen Effekt auf die iNOS-Expression, was vermutlich auf die fehlende Expression der Glukokortikoidrezeptor-mRNA zurückgeführt werden kann. Daher können von S-Curvularin abgeleitete Pharmaka möglicherweise auch in Fällen einer Steroidresistenz zur Therapie von RA-Patienten zum Einsatz kommen.rnIm Tiermodell der Kollagen-induzierten Arthritis konnte die anti-inflammatorische Wirkung von S-Curvularin auf mehreren Ebenen bestätigt werden. Die Pilzsubstanz reduzierte sowohl die Schwellung der Pfoten als auch die Expression CII-induzierter pro-inflammatorischer Gene, wie z.B. S100A8, Defb6, Camp und Mpo. Dabei waren die Effekte von S-Curvularin meist deutlicher als in Dexamethason-behandelten Mäusen. Die Analyse von Zytokinen (z.B. TNF-alpha, IL-1beta) und Chemokinen (z.B. MCP-1, MIP-1alpha) zeigte, dass die CII-induzierte Expression dieser pro-inflammatorischen Mediatoren in den Pfoten der Mäuse durch eine Therapie mit S-Curvularin und Dexamethason wieder reduziert werden konnte, wobei Unterschiede zwischen den Behandlungen beobachtet werden konnte.rnAuch im Tiermodell der LPS-induzierten akuten Entzündung wurde die iNOS- und die S100A8-Expression in verschiedenen Geweben S-Curvularin reduziert. rnrnS-Curvularin ist also in der Lage, in verschiedenen Modellen der RA und im akuten Entzündungsmodell die pro-inflammatorische Genexpression effizient zu hemmen und könnte somit in Zukunft eine Rolle in der Therapie der RA einnehmen.rn

LPS-induced modifications in spontaneous network activity causes neuronal apoptosis in neonatal cerebral cortex

During the perinatal period the developing brain is most vulnerable to inflammation. Prenatal infection or exposure to inflammatory factors can have a profound impact on fetal neurodevelopment with long-term neurological deficits, such as cognitive impairment, learning deficits, perinatal brain damage and cerebral palsy. Inflammation in the brain is characterized by activation of resident immune cells, especially microglia and astrocytes whose activation is associated with a variety of neurodegenerative disorders like Alzheimer´s disease and Multiple sclerosis. These cell types express, release and respond to pro-inflammatory mediators such as cytokines, which are critically involved in the immune response to infection. It has been demonstrated recently that cytokines also directly influence neuronal function. Glial cells are capable of releaseing the pro-inflammatory cytokines MIP-2, which is involved in cell death, and tumor necrosis factor alpha (TNFalpha), which enhances excitatory synaptic function by increasing the surface expression of AMPA receptors. Thus constitutively released TNFalpha homeostatically regulates the balance between neuronal excitation and inhibition in an activity-dependent manner. Since TNFalpha is also involved in neuronal cell death, the interplay between neuronal activity MIP-2 and TNFalpha may control the process of cell death and cell survival in developing neuronal networks. An increasing body of evidence suggests that neuronal activity is important in the regulation of neuronal survival during early development, e.g. programmed cell death (apoptosis) is augmented when neuronal activity is blocked. In our study we were interested on the impact of inflammation on neuronal activity and cell survival during early cortical development. To address this question, we investigated the impact of inflammation on neuronal activity and cell survival during early cortical development in vivo and in vitro. Inflammation was experimentally induced by application of the endotoxin lipopolysaccharide (LPS), which initiates a rapid and well-characterized immune response. I studied the consequences of inflammation on spontaneous neuronal network activity and cell death by combining electrophysiological recordings with multi-electrode arrays and quantitative analyses of apoptosis. In addition, I used a cytokine array and antibodies directed against specific cytokines allowing the identification of the pro-inflammatory factors, which are critically involved in these processes. In this study I demonstrated a direct link between inflammation-induced modifications in neuronal network activity and the control of cell survival in a developing neuronal network for the first time. Our in vivo and in vitro recordings showed a fast LPS-induced reduction in occurrence of spontaneous oscillatory activity. It is indicated that LPS-induced inflammation causes fast release of proinflammatory factors which modify neuronal network activity. My experiments with specific antibodies demonstrate that TNFalpha and to a lesser extent MIP-2 seem to be the key mediators causing activity-dependent neuronal cell death in developing brain. These data may be of important clinical relevance, since spontaneous synchronized activity is also a hallmark of the developing human brain and inflammation-induced alterations in this early network activity may have a critical impact on the survival of immature neurons.

On arc-routing problems

Das Basisproblem von Arc-Routing Problemen mit mehreren Fahrzeugen ist das Capacitated Arc-Routing Problem (CARP). Praktische Anwendungen des CARP sind z.B. in den Bereichen Müllabfuhr und Briefzustellung zu finden. Das Ziel ist es, einen kostenminimalen Tourenplan zu berechnen, bei dem alle erforderlichen Kanten bedient werden und gleichzeitig die Fahrzeugkapazität eingehalten wird. In der vorliegenden Arbeit wird ein Cut-First Branch-and-Price Second Verfahren entwickelt. In der ersten Phase werden Schnittebenen generiert, die dem Master Problem in der zweiten Phase hinzugefügt werden. Das Subproblem ist ein kürzeste Wege Problem mit Ressourcen und wird gelöst um neue Spalten für das Master Problem zu liefern. Ganzzahlige CARP Lösungen werden durch ein neues hierarchisches Branching-Schema garantiert. Umfassende Rechenstudien zeigen die Effektivität dieses Algorithmus. Kombinierte Standort- und Arc-Routing Probleme ermöglichen eine realistischere Modellierung von Zustellvarianten bei der Briefzustellung. In dieser Arbeit werden jeweils zwei mathematische Modelle für Park and Loop und Park and Loop with Curbline vorgestellt. Die Modelle für das jeweilige Problem unterscheiden sich darin, wie zulässige Transfer Routen modelliert werden. Während der erste Modelltyp Subtour-Eliminationsbedingungen verwendet, werden bei dem zweiten Modelltyp Flussvariablen und Flusserhaltungsbedingungen eingesetzt. Die Rechenstudie zeigt, dass ein MIP-Solver den zweiten Modelltyp oft in kürzerer Rechenzeit lösen kann oder bei Erreichen des Zeitlimits bessere Zielfunktionswerte liefert.

Analisi di algoritmi per reti di sensori radar uwb basati su misure sperimentali

In un sistema radar è fondamentale rilevare, riconoscere e cercare di seguire il percorso di un eventuale intruso presente in un’area di osservazione al fine ultimo della sicurezza, sia che si consideri l’ambito militare, che anche quello civile. A questo proposito sono stati fatti passi avanti notevoli nella creazione e sviluppo di sistemi di localizzazione passiva che possano rilevare un target (il quale ha come unica proprietà quella di riflettere un segnale inviato dal trasmettitore), in modo che esso sia nettamente distinto rispetto al caso di assenza dell’intruso stesso dall’area di sorveglianza. In particolare l’ultilizzo di Radar Multistatico (ossia un trasmettitore e più ricevitori) permette una maggior precisione nel controllo dell’area d’osservazione. Tra le migliori tecnologie a supporto di questa analisi vi è l’UWB (Ultra Wide-Band), che permette di sfruttare una banda molto grande con il riscontro di una precisione che può arrivare anche al centimetro per scenari in-door. L’UWB utilizza segnali ad impulso molto brevi, a banda larga e che quindi permettono una risoluzione elevata, tanto da consentire, in alcune applicazioni, di superare i muri, rimuovendo facilmente gli elementi presenti nell’ambiente, ossia il clutter. Quindi è fondamentale conoscere algoritmi che permettano la detection ed il tracking del percorso compiuto dal target nell’area. In particolare in questa tesi vengono elaborati nuovi algoritmi di Clustering del segnale ricevuto dalla riflessione sull’intruso, utilizzati al fine di migliorare la visualizzazione dello stesso in post-processing. Infine questi algoritmi sono stati anche implementati su misure sperimentali attuate tramite nodi PulsOn 410 Time Domain, al fine ultimo della rilevazione della presenza di un target nell’area di osservazione dei nodi.

Computing primal solutions with exact arithmetics in SCIP.

The research for exact solutions of mixed integer problems is an active topic in the scientific community. State-of-the-art MIP solvers exploit a floating- point numerical representation, therefore introducing small approximations. Although such MIP solvers yield reliable results for the majority of problems, there are cases in which a higher accuracy is required. Indeed, it is known that for some applications floating-point solvers provide falsely feasible solutions, i.e. solutions marked as feasible because of approximations that would not pass a check with exact arithmetic and cannot be practically implemented. The framework of the current dissertation is SCIP, a mixed integer programs solver mainly developed at Zuse Institute Berlin. In the same site we considered a new approach for exactly solving MIPs. Specifically, we developed a constraint handler to plug into SCIP, with the aim to analyze the accuracy of provided floating-point solutions and compute exact primal solutions starting from floating-point ones. We conducted a few computational experiments to test the exact primal constraint handler through the adoption of two main settings. Analysis mode allowed to collect statistics about current SCIP solutions' reliability. Our results confirm that floating-point solutions are accurate enough with respect to many instances. However, our analysis highlighted the presence of numerical errors of variable entity. By using the enforce mode, our constraint handler is able to suggest exact solutions starting from the integer part of a floating-point solution. With the latter setting, results show a general improvement of the quality of provided final solutions, without a significant loss of performances.

Fas-activated serine/threonine phosphoprotein promotes immune-mediated pulmonary inflammation

We generated Fas-activated serine threonine phosphoprotein (FAST)-deficient mice (FAST(-/-)) to study the in vivo role of FAST in immune system function. In a model of house dust mite-induced allergic pulmonary inflammation, wild type mice develop a mixed cellular infiltrate composed of eosinophils, lymphocytes, and neutrophils. FAST(-/-) mice develop airway inflammation that is distinguished by the near absence of neutrophils. Similarly, LPS-induced alveolar neutrophil recruitment is markedly reduced in FAST(-/-) mice compared with wild type controls. This is accompanied by reduced concentrations of cytokines (TNF-alpha and IL-6 and -23) and chemoattractants (MIP-2 and keratinocyte chemoattractant) in bronchoalveolar lavage fluids. Because FAST(-/-) neutrophils exhibit normal chemotaxis and survival, impaired neutrophil recruitment is likely to be due to reduced production of chemoattractants within the pulmonary parenchyma. Studies using bone marrow chimeras implicate lung resident hematopoietic cells (e.g., pulmonary dendritic cells and/or alveolar macrophages) in this process. In conclusion, our results introduce FAST as a proinflammatory factor that modulates the function of lung resident hematopoietic cells to promote neutrophil recruitment and pulmonary inflammation.

Attenuation of cerebrospinal fluid inflammation by the nonbacteriolytic antibiotic daptomycin versus that by ceftriaxone in experimental pneumococcal meningitis

Antibiotic-induced bacteriolysis exacerbates inflammation and brain damage in bacterial meningitis. Here the quality and temporal kinetics of cerebrospinal fluid (CSF) inflammation were assessed in an infant rat pneumococcal meningitis model for the nonbacteriolytic antibiotic daptomycin versus ceftriaxone. Daptomycin led to lower CSF concentrations of interleukin 1beta (IL-1beta), IL-10, IL-18, monocyte chemoattractant protein 1 (MCP-1), and macrophage inflammatory protein 1 alpha (MIP-1alpha) (P < 0.05). In experimental pneumococcal meningitis, daptomycin treatment resulted in more rapid bacterial killing, lower CSF inflammation, and less brain damage than ceftriaxone treatment.

Evolution of gene expression changes in newborn rats after mechanical ventilation with reversible intubation

Mechanical ventilation (MV) is life-saving but potentially harmful for lungs of premature infants. So far, animal models dealt with the acute impact of MV on immature lungs, but less with its delayed effects. We used a newborn rodent model including non-surgical and therefore reversible intubation with moderate ventilation and hypothesized that there might be distinct gene expression patterns after a ventilation-free recovery period compared to acute effects directly after MV. Newborn rat pups were subjected to 8 hr of MV with 60% oxygen (O(2)), 24 hr after injection of lipopolysaccharide (LPS), intended to create a low inflammatory background as often recognized in preterm infants. Animals were separated in controls (CTRL), LPS injection (LPS), or full intervention with LPS and MV with 60% O(2) (LPS + MV + O(2)). Lungs were recovered either directly following (T:0 hr) or 48 hr after MV (T:48 hr). Histologically, signs of ventilator-induced lung injury (VILI) were observed in LPS + MV + O(2) lungs at T:0 hr, while changes appeared similar to those known from patients with chronic lung disease (CLD) with fewer albeit larger gas exchange units, at T:48 hr. At T:0 hr, LPS + MV + O(2) increased gene expression of pro-inflammatory MIP-2. In parallel anti-inflammatory IL-1Ra gene expression was increased in LPS and LPS + MV + O(2) groups. At T:48 hr, pro- and anti-inflammatory genes had returned to their basal expression. MMP-2 gene expression was decreased in LPS and LPS + MV + O(2) groups at T:0 hr, but no longer at T:48 hr. MMP-9 gene expression levels were unchanged directly after MV. However, at T:48 hr, gene and protein expression increased in LPS + MV + O(2) group. In conclusion, this study demonstrates the feasibility of delayed outcome measurements after a ventilation-free period in newborn rats and may help to further understand the time-course of molecular changes following MV. The differences obtained from the two time points could be interpreted as an initial transitory increase of inflammation and a delayed impact of the intervention on structure-related genes.

Adjunctive daptomycin attenuates brain damage and hearing loss more efficiently than rifampin in infant rat pneumococcal meningitis

Exacerbation of cerebrospinal fluid (CSF) inflammation in response to bacteriolysis by beta-lactam antibiotics contributes to brain damage and neurological sequelae in bacterial meningitis. Daptomycin, a nonlytic antibiotic acting on Gram-positive bacteria, lessens inflammation and brain injury compared to ceftriaxone. With a view to a clinical application for pediatric bacterial meningitis, we investigated the effect of combining daptomycin or rifampin with ceftriaxone in an infant rat pneumococcal meningitis model. Eleven-day-old Wistar rats with pneumococcal meningitis were randomized to treatment starting at 18 h after infection with (i) ceftriaxone (100 mg/kg of body weight, subcutaneously [s.c.], twice a day [b.i.d.]), (ii) daptomycin (10 mg/kg, s.c., daily) followed 15 min later by ceftriaxone, or (iii) rifampin (20 mg/kg, intraperitoneally [i.p.], b.i.d.) followed 15 min later by ceftriaxone. CSF was sampled at 6 and 22 h after the initiation of therapy and was assessed for concentrations of defined chemokines and cytokines. Brain damage was quantified by histomorphometry at 40 h after infection and hearing loss was assessed at 3 weeks after infection. Daptomycin plus ceftriaxone versus ceftriaxone significantly (P < 0.04) lowered CSF concentrations of monocyte chemoattractant protein 1 (MCP-1), MIP-1α, and interleukin 6 (IL-6) at 6 h and MIP-1α, IL-6, and IL-10 at 22 h after initiation of therapy, led to significantly (P < 0.01) less apoptosis, and significantly (P < 0.01) improved hearing capacity. While rifampin plus ceftriaxone versus ceftriaxone also led to lower CSF inflammation (P < 0.02 for IL-6 at 6 h), it had no significant effect on apoptosis and hearing capacity. Adjuvant daptomycin could therefore offer added benefits for the treatment of pediatric pneumococcal meningitis.

β-Caryophyllene ameliorates cisplatin-induced nephrotoxicity in a cannabinoid 2 receptor-dependent manner

(E)-β-caryophyllene (BCP) is a natural sesquiterpene found in many essential oils of spice (best known for contributing to the spiciness of black pepper) and food plants with recognized anti-inflammatory properties. Recently it was shown that BCP is a natural agonist of endogenous cannabinoid 2 (CB(2)) receptors, which are expressed in immune cells and mediate anti-inflammatory effects. In this study we aimed to test the effects of BCP in a clinically relevant murine model of nephropathy (induced by the widely used antineoplastic drug cisplatin) in which the tubular injury is largely dependent on inflammation and oxidative/nitrative stress. β-caryophyllene dose-dependently ameliorated cisplatin-induced kidney dysfunction, morphological damage, and renal inflammatory response (chemokines MCP-1 and MIP-2, cytokines TNF-α and IL-1β, adhesion molecule ICAM-1, and neutrophil and macrophage infiltration). It also markedly mitigated oxidative/nitrative stress (NOX-2 and NOX-4 expression, 4-HNE and 3-NT content) and cell death. The protective effects of BCP against biochemical and histological markers of nephropathy were absent in CB(2) knockout mice. Thus, BCP may be an excellent therapeutic agent to prevent cisplatin-induced nephrotoxicity through a CB(2) receptor-dependent pathway. Given the excellent safety profile of BCP in humans it has tremendous therapeutic potential in a multitude of diseases associated with inflammation and oxidative stress.

Platelet chemokines and their receptors: what is their relevance to platelet storage and transfusion practice?

The role of platelets as inflammatory cells is demonstrated by the fact that they can release many growth factors and inflammatory mediators, including chemokines, when they are activated. The best known platelet chemokine family members are platelet factor 4 (PF4) and beta-thromboglobulin (beta-TG), which are synthesized in megakaryocytes, stored as preformed proteins in alpha-granules and released from activated platelets. However, platelets also contain many other chemokines such as interleukin-8 (IL-8), growth-regulating oncogene-alpha(GRO-alpha), epithelial neutrophil-activating protein 78 (ENA-78), regulated on activation normal T expressed and secreted (RANTES), macrophage inflammatory protein-1alpha (MIP-1alpha), and monocyte chemotactic protein-3 (MCP-3). They also express chemokine receptors such as CCR4, CXCR4, CCR1 and CCR3. Platelet activation is a feature of many inflammatory diseases such as heparin-induced thrombocytopenia, acquired immunodeficiency syndrome, and congestive heart failure. Substantial amounts of PF4, beta-TG and RANTES are released from platelets on activation, which may occur during storage. Although very few data are available on the in vivo effects of transfused chemokines, it has been suggested that the high incidence of adverse reactions often observed after platelet transfusions may be attributed to the chemokines present in the plasma of stored platelet concentrates.

Clinical validation of an automated vessel-segmentation software of the extracranial-carotid arteries based on 3D-MRA: A prospective study

OBJECTIVES: To determine the accuracy of automated vessel-segmentation software for vessel-diameter measurements based on three-dimensional contrast-enhanced magnetic resonance angiography (3D-MRA). METHOD: In 10 patients with high-grade carotid stenosis, automated measurements of both carotid arteries were obtained with 3D-MRA by two independent investigators and compared with manual measurements obtained by digital subtraction angiography (DSA) and 2D maximum-intensity projection (2D-MIP) based on MRA and duplex ultrasonography (US). In 42 patients undergoing carotid endarterectomy (CEA), intraoperative measurements (IOP) were compared with postoperative 3D-MRA and US. RESULTS: Mean interoperator variability was 8% for measurements by DSA and 11% by 2D-MIP, but there was no interoperator variability with the automated 3D-MRA analysis. Good correlations were found between DSA (standard of reference), manual 2D-MIP (rP=0.6) and automated 3D-MRA (rP=0.8). Excellent correlations were found between IOP, 3D-MRA (rP=0.93) and US (rP=0.83). CONCLUSION: Automated 3D-MRA-based vessel segmentation and quantification result in accurate measurements of extracerebral-vessel dimensions.

Cathepsin D specifically cleaves the chemokines macrophage inflammatory protein-1 alpha, macrophage inflammatory protein-1 beta, and SLC that are expressed in human breast cancer

Cathepsin D (Cath-D) expression in human primary breast cancer has been associated with a poor prognosis. In search of a better understanding of the Cath-D substrates possibly involved in cancer invasiveness and metastasis, we investigated the potential interactions between this protease and chemokines. Here we report that purified Cath-D, as well as culture supernatants from the human breast carcinoma cell lines MCF-7 and T47D, selectively degrade macrophage inflammatory protein (MIP)-1 alpha (CCL3), MIP-1 beta (CCL4), and SLC (CCL21). Proteolysis was totally blocked by the protease inhibitor pepstatin A, and specificity of Cath-D cleavage was demonstrated using a large chemokine panel. Whereas MIP-1 alpha and MIP-1 beta degradation was rapid and complete, cleavage of SLC was slow and not complete. Mass spectrometry analysis showed that Cath-D cleaves the Leu(58) to Trp(59) bond of SLC producing two functionally inactive fragments. Analysis of Cath-D proteolysis of a series of monocyte chemoattractant protein-3/MIP-1 beta hybrids indicated that processing of MIP-1 beta might start by cleaving off amino acids located in the C-terminal domain. In situ hybridization studies revealed MIP-1 alpha, MIP-1 beta, and Cath-D gene expression mainly in the stromal compartment of breast cancers whereas SLC transcripts were found in endothelial cells of capillaries and venules within the neoplastic tissues. Cath-D production in the breast carcinoma cell lines MCF-7 and T47D, as assessed by enzyme-linked immunosorbent assay of culture supernatants and cell lysates, was not affected by stimulation with chemokines such as interleukin-8 (CXCL8), SDF-1 (CXCL12), and SLC. These data suggest that inactivation of chemokines by Cath-D possibly influences regulatory mechanisms in the tumoral extracellular microenvironment that in turn may affect the generation of the antitumoral immune response, the migration of cancer cells, or both processes.

CC chemokines and the receptors CCR3 and CCR5 are differentially expressed in the nonneoplastic leukocytic infiltrates of Hodgkin disease

Lymph nodes with Hodgkin disease (HD) harbor few neoplastic cells in a marked leukocytic infiltrate. Since chemokines are likely to be involved in the recruitment of these leukocytes, the expression of potentially relevant chemokines and chemokine receptors were studied in lymph nodes from 24 patients with HD and in 5 control lymph nodes. The expression of regulated on activation, normal T cell expressed and secreted (RANTES), monocyte chemotactic protein (MCP)-1, macrophage inflammatory protein (MIP)-1alpha, and MIP-1beta was analyzed by in situ hybridization and that of CCR3 and CCR5 by immunohistochemistry and flow cytometry. It was found that, overall, the expression of all 4 chemokines was markedly enhanced, but the cellular source was different. RANTES was expressed almost exclusively by T cells whereas the expression of MCP-1, MIP-1alpha, and MIP-1beta was confined largely to macrophages. In control lymph nodes, chemokine expression was low, with the exception of MIP-1alpha in macrophages. CCR3 and CCR5 were highly expressed in T cells of HD involved but not of control lymph nodes. CCR3 was equally distributed in CD4+ and CD8+ cells, but CCR5 was associated largely with CD4+ cells. In HD lymph nodes, CCR3 and CCR5 were also expressed in B cells, which normally do not express these receptors. All these chemokines and receptors studied, by contrast, were absent in the neoplastic cells. It was concluded that chemokines are involved in the formation of the HD nonneoplastic leukocytic infiltrate. Expression of CCR3 and CCR5 appears to be characteristic of HD, but the roles of these receptors' up-regulation for the disease process remain unclear.

Thoracic target volume delineation using various maximum-intensity projection computed tomography image sets for stereotactic body radiation therapy

The motion of lung tumors during respiration makes the accurate delivery of radiation therapy to the thorax difficult because it increases the uncertainty of target position. The adoption of four-dimensional computed tomography (4D-CT) has allowed us to determine how a tumor moves with respiration for each individual patient. Using information acquired during a 4D-CT scan, we can define the target, visualize motion, and calculate dose during the planning phase of the radiotherapy process. One image data set that can be created from the 4D-CT acquisition is the maximum-intensity projection (MIP). The MIP can be used as a starting point to define the volume that encompasses the motion envelope of the moving gross target volume (GTV). Because of the close relationship that exists between the MIP and the final target volume, we investigated four MIP data sets created with different methodologies (3 using various 4D-CT sorting implementations, and one using all available cine CT images) to compare target delineation. It has been observed that changing the 4D-CT sorting method will lead to the selection of a different collection of images; however, the clinical implications of changing the constituent images on the resultant MIP data set are not clear. There has not been a comprehensive study that compares target delineation based on different 4D-CT sorting methodologies in a patient population. We selected a collection of patients who had previously undergone thoracic 4D-CT scans at our institution, and who had lung tumors that moved at least 1 cm. We then generated the four MIP data sets and automatically contoured the target volumes. In doing so, we identified cases in which the MIP generated from a 4D-CT sorting process under-represented the motion envelope of the target volume by more than 10% than when measured on the MIP generated from all of the cine CT images. The 4D-CT methods suffered from duplicate image selection and might not choose maximum extent images. Based on our results, we suggest utilization of a MIP generated from the full cine CT data set to ensure a representative inclusive tumor extent, and to avoid geometric miss.