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Gilbert O. Raasch, Conference director; Principal B.W. Hunsaker, Conference host.

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A finite-difference time-domain (FDTD) thermal model has been developed to compute the temperature elevation in the Sprague Dawley rat due to electromagnetic energy deposition in high-field magnetic resonance imaging (MRI). The field strengths examined ranged from 11.75-23.5 T (corresponding to H-1 resonances of 0.5-1 GHz) and an N-stub birdcage resonator was used to both transmit radio-frequency energy and receive the MRI signals. With an in-plane resolution of 1.95 mm, the inhomogeneous rat phantom forms a segmented model of 12 different tissue types, each having its electrical and thermal parameters assigned. The steady-state temperature distribution was calculated using a Pennes 'bioheat' approach. The numerical algorithm used to calculate the induced temperature distribution has been successfully validated against analytical solutions in the form of simplified spherical models with electrical and thermal properties of rat muscle. As well as assisting with the design of MRI experiments and apparatus, the numerical procedures developed in this study could help in future research and design of tumour-treating hyperthermia applicators to be used on rats in vivo.

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Here we study the impact of high optical power, within the C-band, on the reliability of modern single mode fibre. Our experiments show that modern fibre demonstrates >10 dB higher power handling performance beyond what has previously been reported.

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BACKGROUND: Prostate cancer might have high radiation-fraction sensitivity that would give a therapeutic advantage to hypofractionated treatment. We present a pre-planned analysis of the efficacy and side-effects of a randomised trial comparing conventional and hypofractionated radiotherapy after 5 years follow-up.

METHODS: CHHiP is a randomised, phase 3, non-inferiority trial that recruited men with localised prostate cancer (pT1b-T3aN0M0). Patients were randomly assigned (1:1:1) to conventional (74 Gy delivered in 37 fractions over 7·4 weeks) or one of two hypofractionated schedules (60 Gy in 20 fractions over 4 weeks or 57 Gy in 19 fractions over 3·8 weeks) all delivered with intensity-modulated techniques. Most patients were given radiotherapy with 3-6 months of neoadjuvant and concurrent androgen suppression. Randomisation was by computer-generated random permuted blocks, stratified by National Comprehensive Cancer Network (NCCN) risk group and radiotherapy treatment centre, and treatment allocation was not masked. The primary endpoint was time to biochemical or clinical failure; the critical hazard ratio (HR) for non-inferiority was 1·208. Analysis was by intention to treat. Long-term follow-up continues. The CHHiP trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN97182923.

FINDINGS: Between Oct 18, 2002, and June 17, 2011, 3216 men were enrolled from 71 centres and randomly assigned (74 Gy group, 1065 patients; 60 Gy group, 1074 patients; 57 Gy group, 1077 patients). Median follow-up was 62·4 months (IQR 53·9-77·0). The proportion of patients who were biochemical or clinical failure free at 5 years was 88·3% (95% CI 86·0-90·2) in the 74 Gy group, 90·6% (88·5-92·3) in the 60 Gy group, and 85·9% (83·4-88·0) in the 57 Gy group. 60 Gy was non-inferior to 74 Gy (HR 0·84 [90% CI 0·68-1·03], pNI=0·0018) but non-inferiority could not be claimed for 57 Gy compared with 74 Gy (HR 1·20 [0·99-1·46], pNI=0·48). Long-term side-effects were similar in the hypofractionated groups compared with the conventional group. There were no significant differences in either the proportion or cumulative incidence of side-effects 5 years after treatment using three clinician-reported as well as patient-reported outcome measures. The estimated cumulative 5 year incidence of Radiation Therapy Oncology Group (RTOG) grade 2 or worse bowel and bladder adverse events was 13·7% (111 events) and 9·1% (66 events) in the 74 Gy group, 11·9% (105 events) and 11·7% (88 events) in the 60 Gy group, 11·3% (95 events) and 6·6% (57 events) in the 57 Gy group, respectively. No treatment-related deaths were reported.

INTERPRETATION: Hypofractionated radiotherapy using 60 Gy in 20 fractions is non-inferior to conventional fractionation using 74 Gy in 37 fractions and is recommended as a new standard of care for external-beam radiotherapy of localised prostate cancer.

FUNDING: Cancer Research UK, Department of Health, and the National Institute for Health Research Cancer Research Network.

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Understanding spatial patterns of land use and land cover is essential for studies addressing biodiversity, climate change and environmental modeling as well as for the design and monitoring of land use policies. The aim of this study was to create a detailed map of land use land cover of the deforested areas of the Brazilian Legal Amazon up to 2008. Deforestation data from and uses were mapped with Landsat-5/TM images analysed with techniques, such as linear spectral mixture model, threshold slicing and visual interpretation, aided by temporal information extracted from NDVI MODIS time series. The result is a high spatial resolution of land use and land cover map of the entire Brazilian Legal Amazon for the year 2008 and corresponding calculation of area occupied by different land use classes. The results showed that the four classes of Pasture covered 62% of the deforested areas of the Brazilian Legal Amazon, followed by Secondary Vegetation with 21%. The area occupied by Annual Agriculture covered less than 5% of deforested areas; the remaining areas were distributed among six other land use classes. The maps generated from this project ? called TerraClass - are available at INPE?s web site (http://www.inpe.br/cra/projetos_pesquisas/terraclass2008.php)

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Recent data indicate that levels of overweight and obesity are increasing at an alarming rate throughout the world. At a population level (and commonly to assess individual health risk), the prevalence of overweight and obesity is calculated using cut-offs of the Body Mass Index (BMI) derived from height and weight. Similarly, the BMI is also used to classify individuals and to provide a notional indication of potential health risk. It is likely that epidemiologic surveys that are reliant on BMI as a measure of adiposity will overestimate the number of individuals in the overweight (and slightly obese) categories. This tendency to misclassify individuals may be more pronounced in athletic populations or groups in which the proportion of more active individuals is higher. This differential is most pronounced in sports where it is advantageous to have a high BMI (but not necessarily high fatness). To illustrate this point we calculated the BMIs of international professional rugby players from the four teams involved in the semi-finals of the 2003 Rugby Union World Cup. According to the World Health Organisation (WHO) cut-offs for BMI, approximately 65% of the players were classified as overweight and approximately 25% as obese. These findings demonstrate that a high BMI is commonplace (and a potentially desirable attribute for sport performance) in professional rugby players. An unanswered question is what proportion of the wider population, classified as overweight (or obese) according to the BMI, is misclassified according to both fatness and health risk? It is evident that being overweight should not be an obstacle to a physically active lifestyle. Similarly, a reliance on BMI alone may misclassify a number of individuals who might otherwise have been automatically considered fat and/or unfit.