A dosimetric study of radionuclide therapy for bone marrow ablation

In a phase I clinical trial, six multiple myeloma patients, who were non-responsive to conventional therapy and were scheduled for bone marrow transplantation, received Holmium-166 ($\sp{166}$Ho) labeled to a bone seeking agent, DOTMP (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene-phosphonic acid), for the purpose of bone marrow ablation. The specific aims of my research within this protocol were to evaluate the toxicity and efficacy of $\sp{166}$Ho DOTMP by quantifying the in vivo pharmacokinetics and radiation dosimetry, and by correlating these results to the biologic response observed. The reproducibility of pharmacokinetics from multiple injections of $\sp{166}$Ho DOTMP administered to these myeloma patients was demonstrated from both blood and whole body retention. The skeletal concentration of $\sp{166}$Ho DOTMP was heterogenous in all six patients: high in the ribs, pelvis, and lumbar vertebrae regions, and relatively low in the femurs, arms, and head.^ A novel technique was developed to calculate the radiation dose to the bone marrow in each skeletal ROI, and was applied to all six $\sp{166}$Ho DOTMP patients. Radiation dose estimates for the bone marrow calculated using the standard MIRD "S" factors were compared with the average values derived from the heterogenous distribution of activity in the skeleton (i.e., the regional technique). The results from the two techniques were significantly different; the average of the dose estimates from the regional technique were typically 30% greater. Furthermore, the regional technique provided a range of radiation doses for the entire marrow volume, while the MIRD "S" factors only provided a single value. Dose volume histogram analysis of data from the regional technique indicated a range of dose estimates that varied by a factor of 10 between the high dose and low dose regions. Finally, the observed clinical response of cells and abnormal proteins measured in bone marrow aspirates and peripheral blood samples were compared with radiation dose estimates for the bone marrow calculated from the standard and regional technique. The results showed the regional technique values correlated more closely to several clinical response parameters. (Abstract shortened by UMI.) ^

Glacial Lake Wright, a High-Level Antarctic Lake During the LGM and Early Holocene

We report evidence of a large proglacial lake (Glacial Lake Wright) that existed in Wright Valley in the McMurdo Dry Valleys region of Antarctica at the last glacial maximum (LGM) and in the early Holocene. At its highstands, Glacial Lake Wright would have stretched 50 km and covered c. 210 km(2). Chronology for lake-level changes comes from 30 AMS radiocarbon dates of lacustrine algae preserved in deltas, shorelines, and glaciolacustrine deposits that extend up to 480 m above present-day lakes. Emerging evidence suggests that Glacial Lake Wright was only one of a series of large lakes to occupy the McMurdo Dry Valleys and the valleys fronting the Royal Society Range at the LGM. Although the cause of such high lake levels is not well understood, it is believed to relate to cool, dry conditions which produced fewer clouds, less snowfall, and greater amounts of absorbed radiation, leading to increased meltwater production.

What are the causes for the spread of GLE parameters deduced from NM data?

Investigations have shown that the analysis results of ground level enhancements (GLEs) based on neutron monitor (NM) data for a selected event can differ considerably depending the procedure used. This may have significant consequences e.g. for the assessment of radiation doses at flight altitudes. The reasons for the spread of the GLE parameters deduced from NM data can be manifold and are at present unclear. They include differences in specific properties of the various analysis procedures (e.g. NM response functions, different ways in taking into account the dynamics of the Earth’s magnetospheric field), different characterisations of the solar particle flux near Earth as well as the specific selection of NM stations used for the analysis. In the present paper we quantitatively investigate this problem for a time interval during the maximum phase of the GLE on 13 December 2006. We present and discuss the changes in the resulting GLE parameters when using different NM response functions, different model representations of the Earth’s magnetospheric field as well as different assumptions for the solar particle spectrum and pitch angle distribution near Earth. The results of the study are expected to yield a basis for the reduction in the spread of the GLE parameters deduced from NM data.

Targeted cancer diagnosis with radiolabeled endostatin

Nuclear imaging is used for non-invasive detection, staging and therapeutic monitoring of tumors through the use of radiolabeled probes. Generally, these probes are used for applications in which they provide passive, non-specific information about the target. Therefore, there is a significant need for actively-targeted radioactive probes to provide functional information about the site of interest. This study examined endostatin, an endogenous inhibitor of tumor angiogenesis, which has affinity for tumor vasculature. The major objective of this study was to develop radiolabeled analogues of endostatin through novel chemical and radiochemical syntheses, and to determine their usefulness for tumor imaging using in vitro and in vivo models of vascular, mammary and prostate tumor cells. I hypothesize that this binding will allow for a non-invasive approach to detection of tumor angiogenesis, and such detection can be used for therapeutic monitoring to determine the efficacy of anti-angiogenic therapy. ^ The data showed that endostatin could be successfully conjugated to the bifunctional chelator ethylenedicysteine (EC), and radiolabeled with technetium-99m and gallium-68, providing a unique opportunity to use a single precursor for both nuclear imaging modalities: 99mTc for single photon emission computed tomography and 68Ga for positron emission tomography, respectively. Both radiolabeled analogues showed increased binding as a function of time in human umbilical vein endothelial cells and mammary and prostate tumor cells. Binding could be blocked in a dose-dependent manner by unlabeled endostatin implying the presence of endostatin receptors on both vascular and tumor cells. Animal biodistribution studies demonstrated that both analogues were stable in vivo, showed typical reticuloendothelial and renal excretion and produced favorable absorbed organ doses for application in humans. The imaging data provide evidence that the compounds quantitate tumor volumes with clinically-useful tumor-to-nontumor ratios, and can be used for treatment follow-up to depict changes occurring at the vascular and cellular levels. ^ Two novel endostatin analogues were developed and demonstrated interaction with vascular and tumor cells. Both can be incorporated into existing nuclear imaging platforms allowing for potential wide-spread clinical benefit as well as serving as a diagnostic tool for elucidation of the mechanism of action of endostatin. ^

Proton therapy versus intensity modulated x-ray therapy in the treatment of prostate cancer: Estimating secondary cancer risks

External beam radiation therapy is used to treat nearly half of the more than 200,000 new cases of prostate cancer diagnosed in the United States each year. During a radiation therapy treatment, healthy tissues in the path of the therapeutic beam are exposed to high doses. In addition, the whole body is exposed to a low-dose bath of unwanted scatter radiation from the pelvis and leakage radiation from the treatment unit. As a result, survivors of radiation therapy for prostate cancer face an elevated risk of developing a radiogenic second cancer. Recently, proton therapy has been shown to reduce the dose delivered by the therapeutic beam to normal tissues during treatment compared to intensity modulated x-ray therapy (IMXT, the current standard of care). However, the magnitude of stray radiation doses from proton therapy, and their impact on this incidence of radiogenic second cancers, was not known. ^ The risk of a radiogenic second cancer following proton therapy for prostate cancer relative to IMXT was determined for 3 patients of large, median, and small anatomical stature. Doses delivered to healthy tissues from the therapeutic beam were obtained from treatment planning system calculations. Stray doses from IMXT were taken from the literature, while stray doses from proton therapy were simulated using a Monte Carlo model of a passive scattering treatment unit and an anthropomorphic phantom. Baseline risk models were taken from the Biological Effects of Ionizing Radiation VII report. A sensitivity analysis was conducted to characterize the uncertainty of risk calculations to uncertainties in the risk model, the relative biological effectiveness (RBE) of neutrons for carcinogenesis, and inter-patient anatomical variations. ^ The risk projections revealed that proton therapy carries a lower risk for radiogenic second cancer incidence following prostate irradiation compared to IMXT. The sensitivity analysis revealed that the results of the risk analysis depended only weakly on uncertainties in the risk model and inter-patient variations. Second cancer risks were sensitive to changes in the RBE of neutrons. However, the findings of the study were qualitatively consistent for all patient sizes and risk models considered, and for all neutron RBE values less than 100. ^

Modeling the survival of T-cell lymphocytes using compound branching processes

Radiotherapy has been a method of choice in cancer treatment for a number of years. Mathematical modeling is an important tool in studying the survival behavior of any cell as well as its radiosensitivity. One particular cell under investigation is the normal T-cell, the radiosensitivity of which may be indicative to the patient's tolerance to radiation doses.^ The model derived is a compound branching process with a random initial population of T-cells that is assumed to have compound distribution. T-cells in any generation are assumed to double or die at random lengths of time. This population is assumed to undergo a random number of generations within a period of time. The model is then used to obtain an estimate for the survival probability of T-cells for the data under investigation. This estimate is derived iteratively by applying the likelihood principle. Further assessment of the validity of the model is performed by simulating a number of subjects under this model.^ This study shows that there is a great deal of variation in T-cells survival from one individual to another. These variations can be observed under normal conditions as well as under radiotherapy. The findings are in agreement with a recent study and show that genetic diversity plays a role in determining the survival of T-cells. ^

Regulación de la hidratación y la turgencia foliares por mecanismos evitadores del estrés, y resistencia a déficit hídrico en vid

El transporte del agua en las plantas es impulsado por diferencias de energía libre entre el suelo y la atmósfera, y está regulado por mecanismos biológicos evitadores, como el cierre estomático. La hidratación y la turgencia foliares resultan del equilibrio entre ΨL del apoplasto, el potencial osmótico del simplasto y la elasticidad de los tejidos. Sobre esta base se conjeturó que las interacciones de los mecanismos evitadores del estrés hídrico de la planta tienen un rol clave en la definición de su resistencia a déficit hídrico. Para probar esta hipótesis se construyó un modelo mecanístico basado en las leyes del flujo de savia de Van de Honert, de difusión de Fick, de elasticidad de Hooke, la ecuación de Gardner para el flujo del agua en la rizósfera y el modelo de conductancia estomática (gs) de Buckley. Mediante el modelo se demostró teóricamente que la hidratación y la turgencia foliares dependen de la oferta de agua edáfica (representada por el potencial hídrico del suelo) y de la demanda evaporativa de la atmósfera (representada por la radiación absorbida, la temperatura del aire, la velocidad del viento y el déficit de presión de vapor de la atmósfera). También que los mecanismos evitadores del estrés hídrico -i.e., conductancia hidráulica de la planta, conductancia estomática, elasticidad del tejido y potencial osmótico a turgencia máxima- son todos necesarios para determinar la hidratación y la turgencia foliares. El modelo también demostró que la conductancia hidráulica suelo-hoja (kL) depende de la fracción de agua edáfica transpirable (FTSW) con un patrón de decaimiento sigmoide, a medida que el suelo se seca. Esto implica que las variables que dependen en parte de kL (i.e., gs, transpiración, fotosíntesis y superficie foliar) también dependen de FTSW con el mismo patrón. El modelo se probó experimentalmente a distintos niveles de humedad edáfica (desde déficit hídrico nulo, hasta severo) en cinco variedades de vid y mostró un poder predictivo superior al 90%. En todas las variedades las gs se asociaron linealmente con las kL observadas, al considerar todas las situaciones de déficit hídrico en conjunto, si bien la pendiente de estas relaciones fueron distintas en cada variedad. La contrastación experimental mostró que, en una escala de tiempo de varios meses, las variedades más evitadoras -i.e., Grenache y Cereza- mantuvieron mayor kL, ajuste osmótico y rigidez de los tejidos y una menor pendiente de la relación de gs vs. kL, que las variedades menos evitadoras -i.e., Malbec y Syrah-. La menor pendiente de la relación entre gs y kL, en las variedades más evitadoras, estuvo asociada a una mayor cantidad de estomas, en relación con la cantidad de células epidérmicas. Los variedades más evitadoras bajo déficit hídrico moderado -i.e., con una fracción de agua edáfica transpirable entre 0,6 y 0,4- tuvieron mayor superficie foliar y produjeron más biomasa, favoreciendo raíces profundas y densas, y ahorrando agua. Chardonnay mantuvo una alta hidratación y turgencia a expensas de un alto gasto de agua debido a que privilegiaba una alta kL por sobre el ajuste estomático, por lo que no podría considerarse en forma estricta como muy evitadora.

Dynamics of halocarbons in coastal surface waters during short term mesocosm experiments

The aim of the present study was to evaluate the influence of different light quality, especially ultraviolet radiation (UVR), on the dynamics of volatile halogenated organic compounds (VHOCs) at the sea surface. Short term experiments were conducted with floating gas-tight mesocosms of different optical qualities. Six halocarbons (CH3I, CHCl3, CH2Br2, CH2ClI, CHBr3 and CH2I2), known to be produced by phytoplankton, together with a variety of biological and environmental variables were measured in the coastal southern Baltic Sea and in the Raunefjord (North Sea). These experiments showed that ambient levels of UVR have no significant influence on VHOC dynamics in the natural systems. We attribute it to the low radiation doses that phytoplankton cells receive in a normal turbulent surface mixed layer. The VHOC concentrations were influenced by their production and removal processes, but they were not correlated with biological or environmental parameters investigated. Diatoms were most likely the dominant biogenic source of VHOCs in the Baltic Sea experiment, whereas in the Raunefjord experiment macroalgae probably contributed strongly to the production of VHOCs. The variable stable carbon isotope signatures (d13C values) of bromoform (CHBr3) also indicate that different autotrophic organisms were responsible for CHBr3 production in the two coastal environments. In the Raunefjord, despite strong daily variations in CHBr3 concentration, the carbon isotopic ratio was fairly stable with a mean value of -26 per mil. During the declining spring phytoplankton bloom in the Baltic Sea, the d13C values of CHBr3 were enriched in 13C and showed noticeable diurnal changes (-12 per mil ± 4). These results show that isotope signature analysis is a useful tool to study both the origin and dynamics of VHOCs in natural systems.

Measurement of 8-hydroxy-2′-deoxyguanosine in DNA by high-performance liquid chromatography-mass spectrometry: comparison with measurement by gas chromatography-mass spectrometry

Measurement of 8-hydroxy-2′-deoxyguanosine (8-OH-dGuo) in DNA by high-performance liquid chromatography/mass spectrometry (LC/MS) was studied. A methodology was developed for separation by LC of 8-OH-dGuo from intact and modified nucleosides in DNA hydrolyzed by a combination of four enzymes: DNase I, phosphodiesterases I and II and alkaline phosphatase. The atmospheric pressure ionization-electrospray process was used for mass spectral measurements. A stable isotope-labeled analog of 8-OH-dGuo was used as an internal standard for quantification by isotope-dilution MS (IDMS). Results showed that LC/IDMS with selected ion-monitoring (SIM) is well suited for identification and quantification of 8-OH-dGuo in DNA at background levels and in damaged DNA. The sensitivity level of LC/IDMS-SIM was found to be comparable to that reported previously using LC-tandem MS (LC/MS/MS). It was found that approximately five lesions per 106 DNA bases can be detected using amounts of DNA as low as 2 µg. The results also suggest that this lesion may be quantified in DNA at levels of one lesion per 106 DNA bases, or even lower, when more DNA is used. Up to 50 µg of DNA per injection were used without adversely affecting the measurements. Gas chromatography/isotope-dilution MS with selected-ion monitoring (GC/IDMS-SIM) was also used to measure this compound in DNA following its removal from DNA by acidic hydrolysis or by hydrolysis with Escherichia coli Fpg protein. The background levels obtained by LC/IDMS-SIM and GC/IDMS-SIM were almost identical. Calf thymus DNA and DNA isolated from cultured HeLa cells were used for this purpose. This indicates that these two techniques can provide similar results in terms of the measurement of 8-OH-dGuo in DNA. In addition, DNA in buffered aqueous solution was damaged by ionizing radiation at different radiation doses and analyzed by LC/IDMS-SIM and GC/IDMS-SIM. Again, similar results were obtained by the two techniques. The sensitivity of GC/MS-SIM for 7,8-dihydro-8-oxoguanine was also examined and found to be much greater than that of LC/MS-SIM and the reported sensitivity of LC/MS/MS for 8-OH-dGuo. Taken together, the results unequivocally show that LC/IDMS-SIM is well suited for sensitive and accurate measurement of 8-OH-dGuo in DNA and that both LC/IDMS-SIM and GC/IDMS-SIM can provide similar results.

Irradiação de drogas vegetais: aspectos microbiológicos e químicos

Apesar da industrialização no setor farmacêutico, o emprego de drogas vegetais constitui desafio atual quando considerado alternativa terapêutica para as populações de baixa renda ou aquelas que apresentam tradição no uso dessas drogas. Além disso, tendências modernas valorizam a variedade de espécies com propriedades curativas, em particular as espécies brasileiras, desafiando os pesquisadores a intensificar investigações nessa área e induzindo à população um crescente consumo. Assim, questões relacionadas à qualidade dessas drogas apresentam fundamental importância. Devido à origem, a carga microbiana detectada nas mesmas é normalmente elevada, oferecendo riscos potenciais ao usuário. Desta forma, a avaliação de sua qualidade sanitária constitui etapa obrigatória no que se refere ao aspecto de segurança ao consumidor. Além disso, a eficácia terapêutica pode igualmente ser comprometida por decomposição de componentes, decorrente da ação de microrganismos. Com o objetivo de eliminar os efeitos decorrentes da biocarga presente nas drogas vegetais, agentes descontaminantes, de natureza física ou química, têm sido empregados. A utilização de tais procedimentos de descontaminação, prevista na legislação vigente, requer estudos relacionados à estabilidade dos princípios ativos após exposição ao agente selecionado. Dentre os agentes destaca-se a irradiação gama, amplamente utilizada em função de sua aplicabilidade na ausência de água e de temperatura elevada, além de apresentar alta penetrabilidade e reduzir, com eficácia, a carga microbiana viável. Os objetivos do presente trabalho foram avaliar os efeitos de diferentes doses de radiação ionizante sobre a carga microbiana de quatro espécies de drogas vegetais: alcachofra (Cynara scolymus L.), camomila (Matricaria recutita L.), ginkgo (Ginkgo biloba L.) e guaraná (Paullinia cupana H.B.K.), bem como detectar possíveis alterações provocadas pela radiação sobre os teores de seus princípios ativos. As análises microbiológicas e químicas foram realizadas antes e após irradiação com doses médias de 5,5 kGy, 11,4 kGy e 17,8 kGy. Os resultados obtidos anteriormente à irradiação revelaram elevados níveis de contaminação: média de 4,1 x106 para microrganismos aeróbicos totais e 3,3x105 para fungos. Após descontaminação, a dose média de 11,4 kGy, reduziu a carga de microrganismos aeróbicos totais a níveis menores ou iguais a 102 em todas as drogas, com exceção da camomila proveniente do fornecedor B (3,2x104). Para os fungos, a menor dose aplicada (5,5 kGy) foi suficiente para reduzir a contagem a níveis da ordem de 10. Com relação à determinação dos marcadores nas drogas vegetais, os resultados obtidos não revelaram alterações significativas nos teores de cafeína no guaraná e de glicosídeos flavonoídicos no ginkgo. Para a camomila, as amostras antes a após irradiação, apresentaram o mesmo teor de óleo volátil bem como ausência de diferenças significativas no teor de α-bisabolol. Em contraste, observou-se redução no teor de 7-glicosil apigenina após submissão à radiação ionizante, indicando degradação decorrente do processo. Com relação à alcachofra, permanece ainda desconhecida a influência da radiação devido à ausência de metodologias adequadas para extração e determinação da cinarina.

Sterilization of allograft bone: is 25 kGy the gold standard for gamma irradiation?

For several decades, a dose of 25 kGy of gamma irradiation has been recommended for terminal sterilization of medical products, including bone allografts. Practically, the application of a given gamma dose varies from tissue bank to tissue bank. While many banks use 25 kGy, some have adopted a higher dose, while some choose lower doses, and others do not use irradiation for terminal sterilization. A revolution in quality control in the tissue banking industry has occurred in line with development of quality assurance standards. These have resulted in significant reductions in the risk of contamination by microorganisms of final graft products. In light of these developments, there is sufficient rationale to re-establish a new standard dose, sufficient enough to sterilize allograft bone, while minimizing the adverse effects of gamma radiation on tissue properties. Using valid modifications, several authors have applied ISO standards to establish a radiation dose for bone allografts that is specific to systems employed in bone banking. These standards, and their verification, suggest that the actual dose could be significantly reduced from 25 kGy, while maintaining a valid sterility assurance level (SAL) of 10−6. The current paper reviews the methods that have been used to develop radiation doses for terminal sterilization of medical products, and the current trend for selection of a specific dose for tissue banks.

Recent developments in computed tomography for urolithiasis: diagnosis and characterization.

Objective. To critically evaluate the current literature in an effort to establish the current role of radiologic imaging, advances in computed tomography (CT) and standard film radiography in the diagnosis, and characterization of urinary tract calculi. Conclusion. CT has a valuable role when utilized prudently during surveillance of patients following endourological therapy. In this paper, we outline the basic principles relating to the effects of exposure to ionizing radiation as a result of CT scanning. We discuss the current developments in low-dose CT technology, which have resulted in significant reductions in CT radiation doses (to approximately one-third of what they were a decade ago) while preserving image quality. Finally, we will discuss an important recent development now commercially available on the latest generation of CT scanners, namely, dual energy imaging, which is showing promise in urinary tract imaging as a means of characterizing the composition of urinary tract calculi.

Accumulation de dose à partir de champs de déformation 4D appliqués aux traitements au CyberKnife et à l'IMRT

Le cancer pulmonaire est la principale cause de décès parmi tous les cancers au Canada. Le pronostic est généralement faible, de l'ordre de 15% de taux de survie après 5 ans. Les déplacements internes des structures anatomiques apportent une incertitude sur la précision des traitements en radio-oncologie, ce qui diminue leur efficacité. Dans cette optique, certaines techniques comme la radio-chirurgie et la radiothérapie par modulation de l'intensité (IMRT) visent à améliorer les résultats cliniques en ciblant davantage la tumeur. Ceci permet d'augmenter la dose reçue par les tissus cancéreux et de réduire celle administrée aux tissus sains avoisinants. Ce projet vise à mieux évaluer la dose réelle reçue pendant un traitement considérant une anatomie en mouvement. Pour ce faire, des plans de CyberKnife et d'IMRT sont recalculés en utilisant un algorithme Monte Carlo 4D de transport de particules qui permet d'effectuer de l'accumulation de dose dans une géométrie déformable. Un environnement de simulation a été développé afin de modéliser ces deux modalités pour comparer les distributions de doses standard et 4D. Les déformations dans le patient sont obtenues en utilisant un algorithme de recalage déformable d'image (DIR) entre les différentes phases respiratoire générées par le scan CT 4D. Ceci permet de conserver une correspondance de voxels à voxels entre la géométrie de référence et celles déformées. La DIR est calculée en utilisant la suite ANTs («Advanced Normalization Tools») et est basée sur des difféomorphismes. Une version modifiée de DOSXYZnrc de la suite EGSnrc, defDOSXYZnrc, est utilisée pour le transport de particule en 4D. Les résultats sont comparés à une planification standard afin de valider le modèle actuel qui constitue une approximation par rapport à une vraie accumulation de dose en 4D.

Study of DNA damage with a new system for irradiation of samples in a nuclear reactor

FAPESP:97/5550