Scripting automation e modelli bayesiani: Applicazioni cliniche in radioterapia e sviluppo di tecniche innovative per adaptive radiation therapy

La presente ricerca consiste nel validare ed automatizzare metodiche di Adaptive Radiation Therapy (ART), che hanno come obiettivo la personalizzazione continua del piano di trattamento radioterapico in base alle variazioni anatomiche e dosimetriche del paziente. Tali variazioni (casuali e/o sistematiche) sono identificabili mediante l’utilizzo dell’imaging diagnostico. Il lavoro svolto presso la struttura di Fisica Medica dell’Azienda Ospedaliera Universitaria del Policlinico di Modena, si inserisce in un progetto del Ministero della Salute del bando Giovani Ricercatori dal titolo: “Dose warping methods for IGRT and ADAPTIVERT: dose accumulation based on organ motion and anatomical variations of the patients during radiation therapy treatments”. Questa metodica si sta affermando sempre più come nuova opportunità di trattamento e, per tale motivo, nasce l’esigenza di studiare e automatizzare processi realizzabili nella pratica clinica, con un utilizzo limitato di risorse. Si sono sviluppati script che hanno permesso l’automazione delle operazioni di Adaptive e deformazioni, raccogliendo i dati di 51 pazienti sottoposti a terapia mediante Tomotherapy. L’analisi delle co-registrazioni deformabili delle strutture e delle dosi distribuite, ha evidenziato criticità del software che hanno reso necessario lo sviluppo di sistemi di controllo dei risultati, per facilitare l’utente nella revisione quotidiana dei casi clinici. La letteratura riporta un numero piuttosto limitato di esperienze sulla validazione e utilizzo su larga scala di questi tools, per tale motivo, si è condotto un esame approfondito della qualità degli algoritmi elastici e la valutazione clinica in collaborazione di fisici medici e medici radioterapisti. Sono inoltre stati sviluppati principi di strutturazione di reti Bayesiane, che consentono di predirre la qualità delle deformazioni in diversi ambiti clinici (H&N, Prostata, Polmoni) e coordinare il lavoro quotidiano dei professionisti, identificando i pazienti, per i quali sono apprezzabili variazioni morfo-dosimetriche significative. Da notare come tale attività venga sviluppata automaticamente durante le ore notturne, sfruttando l’automation come strumento avanzato e indipendente dall’operatore. Infine, il forte sviluppo, negli ultimi anni della biomeccanica applicata al movimento degli organi (dimostrato dalla numerosa letteratura al riguardo), ha avuto come effetto lo sviluppo, la valutazione e l’introduzione di algoritmi di deformazione efficaci. In questa direzione, nel presente lavoro, si sono analizzate quantitivamente le variazioni e gli spostamenti delle parotidi, rispetto all’inizio del trattamento, gettando le basi per una proficua linea di ricerca in ambito radioterapico.

Elemetary processes of radiation damage in organic molecules of biological interest

It was observed in the ‘80s that the radiation damage on biological systems strongly depends on processes occurring at the microscopic level, involving the elementary constituents of biological cells. Since then, lot of attention has been paid to study elementary processes of photo- and ion-chemistry of isolated organic molecule of biological interest. This work fits in this framework and aims to study the radiation damage mechanisms induced by different types of radiations on simple halogenated biomolecules used as radiosensitizers in radiotherapy. The research is focused on the photofragmentation of halogenated pyrimidine molecules (5Br-pyrimidine, 2Br-pyrimidine and 2Cl-pyrimidine) in the VUV range and on the 12C4+ ion-impact fragmentation of the 5Br-uracil and its homogeneous and hydrated clusters. Although halogen substituted pyrimidines have similar structure to the pyrimidine molecule, their photodissociation dynamics is quite different. These targets have been chosen with the purpose of investigating the effect of the specific halogen atom and site of halogenation on the fragmentation dynamics. Theoretical and experimental studies have highlighted that the site of halogenation and the type of halogen atom, lead either to the preferential breaking of the pyrimidinic ring or to the release of halogen/hydrogen radicals. The two processes can subsequently trigger different mechanisms of biological damage. To understand the effect of the environment on the fragmentation dynamic of the single molecule, the ion-induced fragmentation of homogenous and hydrated clusters of 5Br-uracil have been studied and compared to similar studies on the isolated molecule. The results show that the “protective effect” of the environment on the single molecule hold in the homogeneous clusters, but not in the hydrated clusters, where several hydrated fragments have been observed. This indicates that the presence of water molecules can inhibit some fragmentation channels and promote the keto-enol tautomerization, which is very important in the mutagenesis of the DNA.

Radiation-induced defects in calcium fluoride and their influence on material properties under 193 nm laser irradiation

Calcium fluoride (CaF2) is one of the key lens materials in deep-ultraviolet microlithography because of its transparency at 193 nm and its nearly perfect optical isotropy. Its physical and chemical properties make it applicable for lens fabrication. The key feature of CaF2 is its extreme laser stability. rnAfter exposing CaF2 to 193 nm laser irradiation at high fluences, a loss in optical performance is observed, which is related to radiation-induced defect structures in the material. The initial rapid damage process is well understood as the formation of radiation-induced point defects, however, after a long irradiation time of up to 2 months, permanent damage of the crystals is observed. Based on experimental results, these permanent radiation-induced defect structures are identified as metallic Ca colloids.rnThe properties of point defects in CaF2 and their stabilization in the crystal bulk are calculated with density functional theory (DFT). Because the stabilization of the point defects and the formation of metallic Ca colloids are diffusion-driven processes, the diffusion coefficients for the vacancy (F center) and the interstitial (H center) in CaF2 are determined with the nudged elastic band method. The optical properties of Ca colloids in CaF2 are obtained from Mie-theory, and their formation energy is determined.rnBased on experimental observations and the theoretical description of radiation-induced point defects and defect structures, a diffusion-based model for laser-induced material damage in CaF2 is proposed, which also includes a mechanism for annealing of laser damage. rn

Fast and accurate numerical solutions in some problems of particle and radiation transport: synthetic acceleration for the method of short characteristics, Doppler-broadened scattering kernel, remote sensing of the cryosphere

The aim of this work is to present various aspects of numerical simulation of particle and radiation transport for industrial and environmental protection applications, to enable the analysis of complex physical processes in a fast, reliable, and efficient way. In the first part we deal with speed-up of numerical simulation of neutron transport for nuclear reactor core analysis. The convergence properties of the source iteration scheme of the Method of Characteristics applied to be heterogeneous structured geometries has been enhanced by means of Boundary Projection Acceleration, enabling the study of 2D and 3D geometries with transport theory without spatial homogenization. The computational performances have been verified with the C5G7 2D and 3D benchmarks, showing a sensible reduction of iterations and CPU time. The second part is devoted to the study of temperature-dependent elastic scattering of neutrons for heavy isotopes near to the thermal zone. A numerical computation of the Doppler convolution of the elastic scattering kernel based on the gas model is presented, for a general energy dependent cross section and scattering law in the center of mass system. The range of integration has been optimized employing a numerical cutoff, allowing a faster numerical evaluation of the convolution integral. Legendre moments of the transfer kernel are subsequently obtained by direct quadrature and a numerical analysis of the convergence is presented. In the third part we focus our attention to remote sensing applications of radiative transfer employed to investigate the Earth's cryosphere. The photon transport equation is applied to simulate reflectivity of glaciers varying the age of the layer of snow or ice, its thickness, the presence or not other underlying layers, the degree of dust included in the snow, creating a framework able to decipher spectral signals collected by orbiting detectors.

Measurement of the e + e - pi + pi - pi + pi - cross section using initial state radiation at BABAR

One of the most precisely measured quantities in particle physics is the magnetic moment of the muon, which describes its coupling to an external magnetic field. It is expressed in form of the anomalous magnetic moment of the muon a_mu=(g_mu-2)/2 and has been determined experimentally with a precision of 0.5 parts per million. The current direct measurement and the theoretical prediction of the standard model differ by more than 3.5 standard deviations. Concerning theory, the contribution of the QED and weak interaction to a_mu can be calculated with very high precision in a perturbative approach.rnAt low energies, however, perturbation theory cannot be used to determine the hadronic contribution a^had_mu. On the other hand, a^had_mu may be derived via a dispersion relation from the sum of measured cross sections of exclusive hadronic reactions. Decreasing the experimental uncertainty on these hadronic cross sections is of utmost importance for an improved standard model prediction of a_mu.rnrnIn addition to traditional energy scan experiments, the method of Initial State Radiation (ISR) is used to measure hadronic cross sections. This approach allows experiments at colliders running at a fixed centre-of-mass energy to access smaller effective energies by studying events which contain a high-energetic photon emitted from the initial electron or positron. Using the technique of ISR, the energy range from threshold up to 4.5GeV can be accessed at Babar.rnrnThe cross section e+e- -> pi+pi- contributes with approximately 70% to the hadronic part of the anomalous magnetic moment of the muon a_mu^had. This important channel has been measured with a precision of better than 1%. Therefore, the leading contribution to the uncertainty of a_mu^had at present stems from the invariant mass region between 1GeV and 2GeV. In this energy range, the channels e+e- -> pi+pi-pi+pi- and e+e- -> pi+pi-pi0pi0 dominate the inclusive hadronic cross section. The measurement of the process e+e- -> pi+pi-pi+pi- will be presented in this thesis. This channel has been previously measured by Babar based on 25% of the total dataset. The new analysis includes a more detailed study of the background contamination from other ISR and non-radiative background reactions. In addition, sophisticated studies of the track reconstruction as well as the photon efficiency difference between the data and the simulation of the Babar detector are performed. With these auxiliary studies, a reduction of the systematic uncertainty from 5.0% to 2.4% in the peak region was achieved.rnrnThe pi+pi-pi+pi- final state has a rich internal structure. Hints are seen for the intermediate states rho(770)^0 f_2(1270), rho(770)^0 f_0(980), as well as a_1(1260)pi. In addition, the branching ratios BR(jpsi -> pi+pi-pi+pi-) and BR(psitwos -> jpsi pi+pi-) are extracted.rn

Advanced aspects of radiation protection in the use of particle accelerators in the medical field

In this work, the well-known MC code FLUKA was used to simulate the GE PETrace cyclotron (16.5 MeV) installed at “S. Orsola-Malpighi” University Hospital (Bologna, IT) and routinely used in the production of positron emitting radionuclides. Simulations yielded estimates of various quantities of interest, including: the effective dose distribution around the equipment; the effective number of neutron produced per incident proton and their spectral distribution; the activation of the structure of the cyclotron and the vault walls; the activation of the ambient air, in particular the production of 41Ar, the assessment of the saturation yield of radionuclides used in nuclear medicine. The simulations were validated against experimental measurements in terms of physical and transport parameters to be used at the energy range of interest in the medical field. The validated model was also extensively used in several practical applications uncluding the direct cyclotron production of non-standard radionuclides such as 99mTc, the production of medical radionuclides at TRIUMF (Vancouver, CA) TR13 cyclotron (13 MeV), the complete design of the new PET facility of “Sacro Cuore – Don Calabria” Hospital (Negrar, IT), including the ACSI TR19 (19 MeV) cyclotron, the dose field around the energy selection system (degrader) of a proton therapy cyclotron, the design of plug-doors for a new cyclotron facility, in which a 70 MeV cyclotron will be installed, and the partial decommissioning of a PET facility, including the replacement of a Scanditronix MC17 cyclotron with a new TR19 cyclotron.

Simulations for Gravitational Lensing of 21 cm Radiation at EoR and Post-EoR Redshifts

21 cm cosmology opens an observational window to previously unexplored cosmological epochs such as the Epoch of Reionization (EoR), the Cosmic Dawn and the Dark Ages using powerful radio interferometers such as the planned Square Kilometer Array (SKA). Among all the other applications which can potentially improve the understanding of standard cosmology, we study the promising opportunity given by measuring the weak gravitational lensing sourced by 21 cm radiation. We performed this study in two different cosmological epochs, at a typical EoR redshift and successively at a post-EoR redshift. We will show how the lensing signal can be reconstructed using a three dimensional optimal quadratic lensing estimator in Fourier space, using single frequency band or combining multiple frequency band measurements. To this purpose, we implemented a simulation pipeline capable of dealing with issues that can not be treated analytically. Considering the current SKA plans, we studied the performance of the quadratic estimator at typical EoR redshifts, for different survey strategies and comparing two thermal noise models for the SKA-Low array. The simulation we performed takes into account the beam of the telescope and the discreteness of visibility measurements. We found that an SKA-Low interferometer should obtain high-fidelity images of the underlying mass distribution in its phase 1 only if several bands are stacked together, covering a redshift range that goes from z=7 to z=11.5. The SKA-Low phase 2, modeled in order to improve the sensitivity of the instrument by almost an order of magnitude, should be capable of providing images with good quality even when the signal is detected within a single frequency band. Considering also the serious effect that foregrounds could have on this detections, we discussed the limits of these results and also the possibility provided by these models of measuring an accurate lensing power spectrum.

Measurement of the e + e - pi + pi - cross section using initial state radiation at BESIII

The future goal of modern physics is the discovery of physics beyond the Standard Model. One of the most significant hints for New Physics can be seen in the anomalous magnetic moment of the muon - one of the most precise measured variables in modern physics and the main motivation of this work. This variable is associated with the coupling of the muon, an elementary particle, to an external electromagnetic field and is defined as a = (g - 2)/2, whereas g is the gyromagnetic factor of the muon. The muon anomaly has been measured with a relative accuracy of 0.5·10-6. However, a difference between the direct measurement and the Standard Model prediction of 3.6 standard deviations can be observed. This could be a hint for the existence of New Physics. Unfortunately, it is, yet, not significant enough to claim an observation and, thus, more precise measurements and calculations have to be performed.rnThe muon anomaly has three contributions, whereas the ones from quantum electrodynamics and weak interaction can be determined from perturbative calculations. This cannot be done in case of the hadronic contributions at low energies. The leading order contribution - the hadronic vacuum polarization - can be computed via a dispersion integral, which needs as input hadronic cross section measurements from electron-positron annihilations. Hence, it is essential for a precise prediction of the muon anomaly to measure these hadronic cross sections, σ(e+e-→hadrons), with high accuracy. With a contribution of more than 70%, the final state containing two charged pions is the most important one in this context.rnIn this thesis, a new measurement of the σ(e+e-→π+π-) cross section and the pion form factor is performed with an accuracy of 0.9% in the dominant ρ(770) resonance region between 600 and rn900 MeV at the BESIII experiment. The two-pion contribution to the leading-order (LO) hadronic vacuum polarization contribution to (g - 2) from the BESIII result, obtained in this work, is computed to be a(ππ,LO,600-900 MeV) = (368.2±2.5stat±3.3sys)·10-10. With the result presented in this thesis, we make an important contribution on the way to solve the (g - 2) puzzle.

Novel transparent and flexible transistors for radiation harsh environment

La scoperta dei semiconduttori amorfi ha segnato l’era della microelettronica su larga scala rendendo possibile il loro impiego nelle celle solari o nei display a matrice attiva. Infatti, mentre i semiconduttori a cristalli singoli non sono consoni a questo tipo di applicazioni e i s. policristallini presentano il problema dei bordi di grano, i film amorfi possono essere creati su larga scala (>1 m^2) a basse temperature (ad es. <400 °C) ottenendo performance soddisfacenti sia su substrati rigidi che flessibili. Di recente la ricerca sta compiendo un grande sforzo per estendere l’utilizzo di questa nuova elettronica flessibile e su larga scala ad ambienti soggetti a radiazioni ionizzanti, come lo sono i detector di radiazioni o l’elettronica usata in applicazioni spaziali (satelliti). A questa ricerca volge anche la mia tesi, che si confronta con la fabbricazione e la caratterizzazione di transistor a film sottili basati su ossidi semiconduttori ad alta mobilità e lo studio della loro resistenza ai raggi X. La micro-fabbricazione, ottimizzazione e caratterizzazione dei dispositivi è stata realizzata nei laboratori CENIMAT e CEMOP dell’Università Nova di Lisbona durante quattro mesi di permanenza. Tutti i dispositivi sono stati creati con un canale n di ossido di Indio-Gallio-Zinco (IGZO). Durante questo periodo è stato realizzato un dispositivo dalle ottime performance e con interessanti caratteristiche, una delle quali è la non variazione del comportamento capacitivo in funzione della frequenza e la formidabile resistenza alle radiazioni. Questo dispositivo presenta 114 nm di dielettrico, realizzato con sette strati alternati di SiO2/ Ta2O5. L’attività di ricerca svolta al Dipartimento di Fisica e Astronomia di Bologna riguarda prevalentemente lo studio degli effetti delle radiazioni ionizzanti su TFTs. Gli esperimenti hanno rivelato che i dispositivi godono di una buona stabilità anche se soggetti alle radiazioni. Infatti hanno mostrato performance pressoché inalterate anche dopo un’esposizione a 1 kGy di dose cumulativa di raggi X mantenendo circa costanti parametri fondamentali come la mobilità, il threshold voltage e la sub-threshold slope. Inoltre gli effetti dei raggi X sui dispositivi, così come parametri fondamentali quali la mobilità, si sono rivelati essere notevolmente influenzati dallo spessore del dielettrico.

Neutron radiation resistance of photomultipliers for the LUCID detector in the ATLAS experiment at LHC

Durante il Long Shutdown 1 di LHC sono stati cambiati i fotomoltiplicatori del rivelatore di luminosità LUCID di ATLAS. I due modelli candidati per la sostituzione sono stati sottoposti a test di resistenza alla radiazione di gamma e neutroni. In questa tesi si riportano i risultati delle misure di dark current, risposta spettrale, guadagno relativo e assoluto, prima e dopo l’irraggiamento con neutroni. L’unica differenza di rilievo riguarda un aumento della dark current, gli altri parametri non presentano variazioni entro la precisione delle misure. Non ci sono differenze sostanziali tra i due modelli per quanto riguarda la resistenza alle radiazioni.

Studies on ToF-PET using Cherenkov radiation

La tomografia ad emissione di positroni (PET) è una tecnica di imaging di medicina nucleare, utilizzata oggi diffusamente in ambito clinico. Essa fornisce immagini e informazioni fisiologiche dei processi funzionali all’interno del corpo. La PET si basa sulla rilevazione di fotoni di annichilazione prodotti in seguito al decadimento di un radio farmaco iniettato nel paziente. I rilevatori convenzionali sono costituiti da un materiale scintillatore accoppiato ad un fotomoltiplicatore, solitamente un PMT o SiPM. Uno sviluppo della PET è la Time of Flight PET (ToF PET), attualmente già in commercio ed utilizzata con prestazioni eccellenti. Un’ulteriore modifica, che potenzialmente permetterebbe di ottenere una migliore risoluzione temporale, è la ToF PET basata sulla rilevazione di fotoni tramite radiazione Cherenkov, invece che luce di scintillazione. Questo lavoro di tesi è incentrato dunque su questa tecnica specifica. Si illustra una rassegna di pubblicazioni scientifiche degli ultimi anni riguardo ad essa con i relativi risultati ottenuti e i possibili sviluppi futuri. Infine si propone un approfondimento personale, nel quale, tramite un programma scritto in ROOT, si è realizzata una geometria di un sistema di rilevazione ToF PET. Esso prevede la rilevazione dei fotoni di annichilazione tramite un radiatore Cherenkov accoppiato ad un SiPM. In futuro questo potrà essere implementato e utilizzato per simulare il processo fisico della PET, verificando la validità e le prestazioni del sistema così sviluppato.

Surface cloud radiative forcing from broadband radiation measurements on the Antarctic plateau

Surface based measurements systems play a key role in defining the ground truth for climate modeling and satellite product validation. The Italian-French station of Concordia is operative year round since 2005 at Dome C (75°S, 123°E, 3230 m) on the East Antarctic Plateau. A Baseline Surface Radiation Network (BSRN) site was deployed and became operational since January 2006 to measure downwelling components of the radiation budget, and successively was expanded in April 2007 to measure upwelling radiation. Hence, almost a decade of measurement is now available and suitable to define a statistically significant climatology for the radiation budget of Concordia including eventual trends, by specifically assessing the effects of clouds and water vapor on SW and LW net radiation. A well known and robust clear sky-id algorithm (Long and Ackerman, 2000) has been operationally applied on downwelling SW components to identify cloud free events and to fit a parametric equation to determine clear-sky reference along the Antarctic daylight periods (September to April). A new model for surface broadband albedo has been developed in order to better describe the features the area. Then, a novel clear-sky LW parametrization, based on a-priori assumption about inversion layer structure, combined with daily and annual oscillations of the surface temperature, have been adopted and validated. The longwave based method is successively exploited to extend cloud radiative forcing studies to nighttime period (winter). Results indicated inter-annual and intra-annual warming behaviour, i.e. 13.70 W/m2 on the average, specifically approaching neutral effect in summer, when SW CRF compensates LW CRF, and warming along the rest of the year due prevalentely to CRF induced on the LW component.

The role of mass spectrometry-based metabolomics in medical countermeasures against radiation

Radiation metabolomics can be defined as the global profiling of biological fluids to uncover latent, endogenous small molecules whose concentrations change in a dose-response manner following exposure to ionizing radiation. In response to the potential threat of nuclear or radiological terrorism, the Center for High-Throughput Minimally Invasive Radiation Biodosimetry was established to develop field-deployable biodosimeters based, in part, on rapid analysis by mass spectrometry of readily and easily obtainable biofluids. In this review, we briefly summarize radiation biology and key events related to actual and potential nuclear disasters, discuss the important contributions the field of mass spectrometry has made to the field of radiation metabolomics, and summarize current discovery efforts to use mass spectrometry-based metabolomics to identify dose-responsive urinary constituents, and ultimately to build and deploy a noninvasive high-throughput biodosimeter.

Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures

The goals of any treatment of cervical spine injuries are: return to maximum functional ability, minimum of residual pain, decrease of any neurological deficit, minimum of residual deformity and prevention of further disability. The advantages of surgical treatment are the ability to reach optimal reduction, immediate stability, direct decompression of the cord and the exiting roots, the need for only minimum external fixation, the possibility for early mobilisation and clearly decreased nursing problems. There are some reasons why those goals can be reached better by anterior surgery. Usually the bony compression of the cord and roots comes from the front therefore anterior decompression is usually the procedure of choice. Also, the anterior stabilisation with a plate is usually simpler than a posterior instrumentation. It needs to be stressed that closed reduction by traction can align the fractured spine and indirectly decompress the neural structures in about 70%. The necessary weight is 2.5 kg per level of injury. In the upper cervical spine, the odontoid fracture type 2 is an indication for anterior surgery by direct screw fixation. Joint C1/C2 dislocations or fractures or certain odontoid fractures can be treated with a fusion of the C1/C2 joint by anterior transarticular screw fixation. In the lower and middle cervical spine, anterior plating combined with iliac crest or fibular strut graft is the procedure of choice, however, a solid graft can also be replaced by filled solid or expandable vertebral cages. The complication of this surgery is low, when properly executed and anterior surgery may only be contra-indicated in case of a significant lesion or locked joints.

Occurrence and types of dental injuries among patients with maxillofacial fractures

The aim of this retrospective study was to clarify the occurrence and types of dental injuries in 389 patients who had been diagnosed with facial fractures, and to analyze whether the occurrence of dental injury correlates to gender, age, trauma mechanism and type of facial fracture. Dental injuries were observed in 62 patients (16%). The most common type of injury was a crown fracture (48%). Dental injuries were multiple in most patients (63%). Almost half (48%) of all injured teeth were severely injured. Most injured teeth (61%) were in the maxilla. The incisor region was the most prevalent site in both the mandible (45%) and the maxilla (56%). The occurrence of dental injury correlated significantly with trauma mechanism and fracture type: motor vehicle accidents and mandibular fracture were significant predictors for dental trauma. The notable rate of dental injury observed in the present study emphasizes the importance of a thorough examination of the oral cavity in all patients who have sustained facial fracture. Referral to a dental practice for further treatment and follow up as soon as possible after discharge from hospital is fundamental.