Effect of Glycyrrhizae Radix et Rhizoma-containing Serum on LPS-induced Inflammation in Caco2 Cells Based on Inhibition of Ferroptosis by Nrf2/HO-1 Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Glycyrrhizae Radix et Rhizoma （GR）-containing serum on lipopolysaccharide （LPS）-induced inflammation in human colon epithelial adenocarcinoma cells （Caco2） based on inhibition of ferroptosis by the nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） pathway. MethodCaco2 cells were divided into a normal group， a model group （LPS， 200 μg·L-1）， low-， medium-， and high-dose GR-containing serum groups （5%， 10%， 20%）， and a ferroptosis inhibitor group （3-amino-4-cyclohexylamino-benzoic acid ethyl ester， Fer-1， 10 μmol·L-1）. The cells in the normal group were cultured normally， while those in other groups underwent the induction of an inflammation model. The cells in the low-， medium-， and high-dose GR-containing serum groups were treated with 5%， 10%， and 20% GR-containing serum for 24 hours， respectively， and the cells in the ferroptosis inhibitor group were treated with Fer-1 for 24 hours. Transmission electron microscopy was used to observe mitochondrial morphology in each group. Flow cytometry was used to detect intracellular Fe2+ levels. Microplate assays were performed to measure superoxide dismutase （SOD） activity， malondialdehyde （MDA） and glutathione peroxidase （GSH-Px） levels. Enzyme-linked immunosorbent assay （ELISA） was used to measure interleukin-1β （IL-1β）， IL-6， IL-10， and tumor necrosis factor-α （TNF-α） levels. Western blot was used to measure the expression levels of Nrf2， HO-1， ferritin heavy chain 1 （FTH1）， and glutathione peroxidase 4 （GSH-Px4） proteins. Small interfering RNA （siRNA） was used to investigate the role of Nrf2 in ferroptosis regulation. The cells after interference were divided into a negative control （NC） group， a Si-Nrf2 group， a GR-containing serum （20%） + Si-Nrf2 group， and a GR-containing serum （20%） + NC group. Microplate assays were performed to measure MDA， SOD， and GSH-Px levels， and Western blot was used to measure the expression levels of Nrf2， HO-1， FTH1， and GSH-Px4 proteins. ResultCompared with the normal group， the model group showed mitochondrial contraction， increased mitochondrial membrane thickness， and smaller mitochondrial morphology， increased Fe2+ content （P<0.01）， blunted SOD activity （P<0.01）， decreased GSH-Px expression （P<0.01）， increased MDA content （P<0.01）， reduced expression levels of Nrf2 and HO-1 （P<0.05）， reduced FTH1 expression （P<0.01）， and down-regulated GSH-Px4 expression （P<0.01）. In the GR-containing serum groups， the medium- and high-dose groups showed a significant decrease in Fe2+ content （P<0.01）， potentiated SOD and GSH-Px activities （P<0.01）， and decreased MDA levels （P<0.01）. The high-dose group showed a significant increase in Nrf2 expression （P<0.05）， and the medium-dose group showed increased expression of HO-1 and GSH-Px4 proteins （P<0.05）. The expression levels of FTH1 significantly increased in the low-， medium-， and high-dose groups （P<0.01）. The study on mechanism revealed that compared with the NC group， the cells transfected with Nrf2 siRNA showed increased MDA content （P<0.01）， blunted SOD activity （P<0.01）， decreased GSH-Px activity （P<0.01）， decreased expression of Nrf2 and HO-1 （P<0.01）， and reduced levels of FTH1 and GSH-Px4 proteins （P<0.01）. Compared with the Si-Nrf2 group， the cells treated with GR-containing serum showed a decrease in MDA content （P<0.01）， an increase in SOD activity （P<0.01）， an increase in GSH-Px activity （P<0.01）， increased expression of Nrf2 and FTH1 proteins （P<0.05）， and higher expression levels of HO-1 and GSH-Px4 proteins （P<0.01）. ConclusionGR-containing serum can reduce the inflammatory cytokines and oxidative stress levels in LPS-induced Caco2 cells. Its mechanism is related to the promotion of Nrf2/HO-1 signaling pathway expression， alleviating intracellular lipid peroxidation and inhibiting ferroptosis.

Exploring the Mechanism and Experimental Verification of Alhagi Sparsifolia Shap.in Treating Sepsis Based on Network Pharmacology / 世界科学技术-中医药现代化

Objective Network pharmacology and molecular docking and molecular dynamics techniques were used to investigate the mechanism of action of Alhagi sparsifolia Shap.in the treatment of sepsis and to perform animal experimental verification.Methods First,we screened the effective ingredients and their action targets of Alhagi sparsifolia Shap.,meanwhile,screened relevant action targets for the treatment of sepsis,constructed a protein interaction(PPI)network,and performed topology analysis to draw a TCM disease target network diagram.Second,Kyoto Encyclopedia of genes and genomes enrichment analysis was performed for core targets in the network diagram,along with gene ontology functional enrichment analysis.This was followed by molecular docking and molecular dynamics simulation experiment validation of the core targets.Finally,mice were used for the verification of animal experiments.Results Thirty active components of Alhagi sparsifolia Shap.were screened out,and the top 5 ranked by degree value were quercetin,(-)-epigallocatechin,(-)-Epigallocatechin Gallate,genistein,kaempferol and epigallocatechin with 196 action targets;2144 disease-related targets for sepsis,105 targets for Alhagi sparsifolia Shap.-sepsis intersection,and the core targets were TNF,IL-6,AKT1,VEGFA,CASP3,IL-1β Et al.PI3K-Akt,TNF,HIF-1,AGE-RAGE,IL-17 and other signaling pathways are involved to mediate inflammatory responses,apoptosis and other biological processes to exert therapeutic effects on sepsis.Molecular docking results showed that camelina flavanoids bound equally well to each key target,among which the conformations with the lowest binding energy were(-)-Epigallocatechin Gallate-IL-6 and quercetin-IL-6.Molecular dynamics simulations were performed on the two pairs of complexes,and the results indicated that the stable binding could be achieved through a combination of electrostatic,van der Waals potential,and hydrogen bonding interactions.Animal experiments confirmed that Alhagi sparsifolia Shap.could inhibit the activation of PI3K/Akt signaling pathway,decrease the protein expression of Caspase-3,VEGF and reduced peripheral blood inflammatory factors secretion of TNF-α、IL-1βand IL-6,alleviating inflammatory injury in tissues and organs.Conclusion The therapeutic effect of Alhagi sparsifolia Shap.on sepsis is achieved through multi biological processes,multi targets,and multi pathways.It provides a certain theoretical basis for the clinical application of camel spines as well as sepsis treatment.

Research on automatic segmentation of female bowel based on Dense V-Network neural network / 中华放射肿瘤学杂志

Objective:To resolve the issue of poor automatic segmentation of the bowel in women with pelvic tumors, a Dense V-Network model was established, trained and evaluated to accurately and automatically delineate the bowel of female patients with pelvic tumors.Methods:Dense Net and V-Net network models were combined to develop a Dense V-Network algorithm for automatic segmentation of 3D CT images. CT data were collected from 160 patients with cervical cancer, 130 of which were randomly selected as the training set to adjust the model parameters, and the remaining 30 were used as test set to evaluate the effect of automatic segmentation.Results:Eight parameters including Dice similarity coefficient (DSC) were utilized to quantitatively evaluate the segmentation effect. The DSC value, JD, ΔV, SI, IncI, HD (cm), MDA (mm), and DC (mm) of the small intestine were 0.86±0.03, 0.25±0.04, 0.10±0.07, 0.88±0.05, 0.85±0.05, 2.98±0.61, 2.40±0.45 and 4.13±1.74, which were better than those of any other single algorithm.Conclusion:Dense V-Network algorithm proposed in this paper can deliver accurate segmentation of the bowel organs. It can be applied in clinical practice after slight revision by physicians.

A fusion network model based on limited training samples for the automatic segmentation of pelvic endangered organs / 生物医学工程学杂志

When applying deep learning to the automatic segmentation of organs at risk in medical images, we combine two network models of Dense Net and V-Net to develop a Dense V-network for automatic segmentation of three-dimensional computed tomography (CT) images, in order to solve the problems of degradation and gradient disappearance of three-dimensional convolutional neural networks optimization as training samples are insufficient. This algorithm is applied to the delineation of pelvic endangered organs and we take three representative evaluation parameters to quantitatively evaluate the segmentation effect. The clinical result showed that the Dice similarity coefficient values of the bladder, small intestine, rectum, femoral head and spinal cord were all above 0.87 (average was 0.9); Jaccard distance of these were within 2.3 (average was 0.18). Except for the small intestine, the Hausdorff distance of other organs were less than 0.9 cm (average was 0.62 cm). The Dense V-Network has been proven to achieve the accurate segmentation of pelvic endangered organs.

Evaluation of the auto-segmentation based on self-registration and Atlas in adaptive radiotherapy for cervical cancer / 中华放射肿瘤学杂志

Objective To evaluate the accuracy and validate the feasibility of auto-segmentation based on self-registration and Atlas in adaptive radiotherapy for cervical cancer using MIM-Maestro software.Methods The CT scan images and delineation results of 60 cervical cancer patients were obtained to establish the Atlas template database.The planning CT (pCT) and replanning CT (rCT) images were randomly selected from 15 patients for the contouring of clinical target volume (CTV) and organs at risk (OAR) by an experienced radiation oncologist.The rCT images of 15 patients were auto-contoured using Atlas-based auto-segmentation (Atlas group),and mapping contours from the pCT to the rCT images was performed by rigid and deformable image registration (rigid group and deformable group).The time for the three methods of auto-segmentation was also recorded.The similarity of the auto-contours and reference contours was assessed using dice similarity coefficient (DSC),overlap index (OI),the average hausdorff distance (AHD) and the deviation of centroid (DC),and the results were statistically compared among three groups by using one-way analysis of variance.Results The mean time was 89.2 s,22.4 s and 42.6 s in the Atlas,rigid and deformable groups respectively.The DSC,OI and AHD for the CTV and rectum in the rigid and deformable groups significantly differed from those in the Atlas group (all P＜0.001).In the rigid and deformable groups,the OI for the intestine significantly differed from that in the Atlas group.The mean DSC for CTV was 0.89 in the rigid and deformable groups,and 0.76 in the Atlas group.The optimal delineation of the bladder,pelvis and femoral heads was obtained in the deformable group.Conclusions AIl three methods of auto-segmentation can automatically and rapidly contour the CTV and OARs.The performance in the deformable group is better than that in the rigid and Atlas groups.

Clinical efficacy of preoperative SIB-IMRT for 26 cases of locally-advanced low rectal cancer / 中华放射肿瘤学杂志

Objective To evaluate the feasibility and clinical efficacy of preoperative simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) combined with neoadjuvant chemotherapy of capecitabine in patients with locally-advanced low rectal cancer.Methods Between 2015 and 2016,26 patients admitted to 301 Hospital who were diagnosed with locally-advanced low rectal cancer,which was located within 5 cm from the anal verge,were enrolled in this investigation.Dose fractionation pattern was delivered:58.75 Gy in 25 fractions (2.35 Gy/fraction) for rectal cancer and lymph node metastasis and 50 Gy in 25 fractions for the pelvic lymphatic drainage area and simultaneously combined with capecitabine chemotherapy (825 mg/m2,bid d 1-5 weekly).One cycle of capecitabine (1 250 mg/m2,twice daily,d 1-14)was given at one week after the completion of chemoradiotherapy (CRT).Total mesorectal excision (TME)was performed at 6 to 8 weeks after the completion of CRT.The primary endpoints included pathological complete response rate (ypCR) and sphincter-preserving rate.The secondary endpoints included acute toxicity,tumor downstaging rate and postoperative complications.Results Twenty-six patients successfully completed neoadjuvant CRT,25 of them underwent surgical resection and one patient failed to receive surgery due to pxrianal edema.Postoperative ypCR rate was 32％ (8/25),the sphincter-preserving rate was 60％ (15/25),the tumor downstaging rate was 92％ (23/25) and the R0 resection rate was 100％.During the period of CRT,grade 1 and 2 adverse events occurred in 24 patients,grade 3 radiation dermatitis was noted in 2 cases.No ≥ grade 4 acute adverse event was observed.Postoperative complications included ureteral injury in one case and intestinal obstruction in one patient.Conclusions Preoperative SIB-IMRT combined with neoadjuvant chemotherapy of capecitabine is a feasible and safe treatment for patients with locallyadvanced low rectal cancer,which yields expected ypCR rate,R0 resection rate and sphincter-preserving rate.Nevertheless,the long-term clinical benefits remain to be elucidated.Clinical Trial Registry Chinese Clinical Trial Registry,registration number:ChiCTR-ONC-12002387.

Dosimetric comparison of helical tomotherapy and volume-modulated arc therapy for upper thoracic esophageal carcinoma / 中华放射医学与防护杂志

Objective To compare the dosimetric differences between helical tomotherapy (HT) and volume-modulated arc therapy (VMAT) in the treatment of upper thoracic esophageal carcinoma (UTEC).Methods A total of 10 patients with UTEC were randomly selected.HT plan and double-arc VMAT plan were designed and optimized for each patient.The prescription dose was 50 Gy/30 fractions for gross target volume (GTV), 66 Gy/30 fractions for planned target volume (PTV).The dose distribution and conformal index (CI), homogeneity index (HI) of target volume, the D1％, D5％, Dg5％, D99％, and dose of organ at risk (OAR) were analyzed by using the dose volume histogram (DVH).The monitor units and delivery time were also evaluated.Results For GTV and PTV, the D99％ of HT plans were slightly higher than those of VMAT plans (t =4.476, 3.756, P ＜ 0.05) , but no significant differences in D1％ , D5％ , D95％ , HI and CI (P ＞ 0.05) were found.The V10, V15, V20 and mean lung dose (MLD) to the total-lung of HT plans were all significantly lower than those of VMAT plans (t =-3.369,-4.824, -4.869,-3.657, P ＜ 0.05).There were no significant differences for V5, V30 and Dmax of cord (P ＞ 0.05).The monitor units and delivery time of VMAT plans were significantly lower than those of HT plans (t =13.970, 7.982, P ＜ 0.05).Conclusions Both HT and VMAT are appropriate for esophageal cancer radiotherapy.HT significantly reduces the radiation dose of the total-lung, while VMAT has obvious advantages in efficiency.

The Dose Effect of Isocenter Selection during IMRT Dose Verification with the 2D Chamber Array / 中国医疗器械杂志

To investigate the dose effect of isocenter difference during IMRT dose verification with the 2D chamber array. The samples collected from 10 patients were respectively designed for IMRT plans, the isocenter of which was independently defined as P(o), P(x) and P(y). P(o) was fixed on the target center and the other points shifted 8cm from the target center in the orientation of x/y. The PTW729 was used for 2D dose verification in the 3 groups which beams of plans were set to 0 degrees. The γ-analysis passing rates for the whole plan and each beam were gotten using the different standards in the 3 groups, The results showed the mean passing rate of γ-analysis was highest in the P(o) group, and the mean passing rate of the whole plan was better than that of each beam. In addition, it became worse with the increase of dose leakage between the leaves in P(y) group. Therefore, the determination of isocenter has a visible effect for IMRT dose verification of the 2D chamber array, The isocenter of the planning design should be close to the geometric center of target.

Real-time patient transit dose verification of volumetric modulated arc therapy by a 2D ionization chamber array / 中华放射肿瘤学杂志

Objective To study the real?time dose verification with 2D array ion chamber array in volumetric modulated arc therapy ( VMAT) with a 2D array ion chamber array. Methods The 2D ion chamber array was fixed on the panel of electronic portal imaging device (EPID). Source?detector distance (SDD) was 140 cm. 8 mm RW3 solid water was added to the 2D array to improve the signal noise ratio. Patient plans for esophageal, prostate and liver cancers were selected to be delivered on the cylindrical Cheese phantom 5 times in order to validate the reproducibility of doses. Real?time patient transit dose measurements were performed at each fraction. Dose distributions were evaluated using gamma index criteria of 3 mm DTA and 3% dose difference referred to the first time result. Results The gamma index pass rate in the Cheese phantom were about 98%;the gamma index pass rate for esophageal, prostate and liver cancer patient were about 92%, 92% and 94%, respectively. Gamma pass rate for all single fraction were more than 90%. Conclusions The 2D array is capable of monitoring the real time transit doses during VMAT delivery. It is helpful to improve the treatment accuracy.

Use of megavoltage CT(MVCT) in helical tomotherapy for head and neck dose calculation / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and accuracy of using Megavoltage CT(MVCT) for head and neck dose calculation.</p><p><b>METHODS</b>The cheese Phantom was imaged using MVCT scanner, and the MVCT value density calibration curve was established. Conventional CT and MVCT image of nasopharyngeal carcinoma was acquired respectively, and IMRT plan was designed on conventional CT image of NPC patient. The conventional CT plan was copied to MVCT image. The dose distribution was calculated for tumor and normal tissue using the MVCT value density calibration curve, and compared with that of conventional CT. Ten NPC patients were collected for dose verification of IMRT plan on MVCT images.</p><p><b>RESULTS</b>The MVCT numbers depended linearly on the electron density of the sample, and the stability of the MVCT numbers to electron density was good.The error between the measured dose and calculated dose in measured point was less than 3%.The isodose distribution was well agreement with that calculated by planning system.</p><p><b>CONCLUSIONS</b>Performing dose recalculation using MVCT of Tomotherapy in head and neck region was feasible.and the dose distributions on kVCT and MVCT were in excellent agreement.</p>

Dosimetric calibration of CT pencil chamber in cobalt beams / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To explore the dose-length product calibration method for pencil ionization chamber in cobalt beams.</p><p><b>METHODS</b>The PTW TM30009 ionization chamber was placed into the central hole of T40017 head phantom and irradiated 60 s in 20 cm x 20 cm cobalt beam. The charge was collected with UNIDOS electrometer. Absorbed doses were measured with TM30013 0.6 mL farmer-type chamber under the same condition. The CT chamber calibration factor was expressed in dose-length product. Dose linearity and spatial response were also investigated.</p><p><b>RESULTS</b>The calibration factor in dose-length product was derived from measured data. Dose linearity and spatial response were good in cobalt beams.</p><p><b>CONCLUSION</b>It is feasible to calibrate the CT chamber in cobalt beams for patient dose evaluation in MVCT.</p>

Effects of the overexpression imprinted gene PHLDA2 on radiosensitivity of osteosarcoma / 中华放射医学与防护杂志

Objective To study the effects of PHLDA2 overexpression on radiosensitivity and the underlying mechanisms in human osteosarcoma U2OS cell line.Methods To obtain the subclone,cells were exposed to G418 persistently after transfection of pEGFP-C3-PHLDA2 vector into U2OS cells.Three groups of blank control (U2OS),negative control (U2OS-neo) and transfected group (U2OS-PHLDA2) were used.The expression of PHLDA2 in the subclone cells was determined by Western blot.After exposure to X-ray irradiation,cellular growth activity and survival were detected by CKK-8 assay and colony formation assay,respectively.The cell apoptosis was measured by the Annexin V/PI staining,and the apoptotic protein was analyzed by Western blot.The in-vivo effects of PHLDA2 on irradiation were evaluated by xenografts.Results Compared with U2OS group and U2OS-neogroup,the sabclone cells were successfully obtained by G418 selection,in which the expression of PHLDA2 was upregulated(t =13.73,16.28,P ＜ 0.05).In vitro,PHLDA2 overexpression significantly enhanced the response to radiation in U2OS cells with a reduction of colony survival and proliferation with the increase of doses (t =5.00-8.23,P ＜0.05;t =-2.52--1.26,P ＜ 0.05).In vivo,PHLDA2-upregulated xenografts had more radiosensitivity than control groups with a significant inhibition of tumor growth (t =3.27,2.91,P ＜ 0.05).After 8 Gy irradiation,the apoptosis was significantly increased (t =10.11,9.61,P ＜ 0.05),accompanied with the activation of Caspased-3 in U2OS-PHLDA2 cells,which was presented by upregulation of cleaved Caspase-3 (t =11.26,10.72,P ＜ 0.05).Conclusions Exogenetic expression of PHLDA2 could significantly enhance the radiosensitivity of human osteosarcoma cells,which may be attributed to the activation of Caspase-3 that increases irradiation-induced apoptosis.

Verification of the couch automatic movement accuracy for Hi-ART tomotherapy / 中国医疗器械杂志

The QUASAR Penta-guide Phantom with fiducial markers was scanned, and the CT images were transferred to Pinnacle workstation. Skin and target volumes were contoured and transferred to TomoPlan treatment planning system. The phantom was scanned with Megavoltage CT (MVCT). MVCT images were matched to the planning CT. Automatic adjustment of treatment couch was completed. It was found that the green laser coincided with the etched center crosshairs in lateral and longitudinal directions with an error less than 2 mm. However 2 mm vertical tabletop lag was found, but could be eventually corrected. Verifications for specific patients with head and pelvic tumors were also completed, the residual setup error were analyzed. The automatic movement of tabletop after image match is satisfactory.

Automatic detection algorithm of the diaphragm motion based on Canny edge detection and wavelet transform / 中华放射医学与防护杂志

Objective To develop a new automatic detection algorithm of the diaphragm motion based on Canny edge detection and wavelet transform.Methods On-line fluoroscopic images under free breathing were enhanced by using the wavelet transform.After the wavelet transform,edge detection was carried out for the enhanced image.Canny edge detection algorithm was used to achieve the diaphragm edge.Programs were written in Matlab to track the position of the diaphragm.The diaphragm movement curves were derived to evaluate the characteristics of patients respiratory motion.Results Under calm free breathing,the amplitude and period of diaphragm motion acquired by means of the wavelet transform and Canny edge detection were in good agreement with manual measurement.There were six to seven respiratory cycles in a XVI MotionViewTM.The magnitude of diaphragm movement was not exactly the same in the cranio-caudal (CC) direction.The magnitude was from 6.7 mm to 8.0 mm with an average of 7.4 mm.The movements of the respiratory motion cycles had little variations in amplitude and period for the same patient between fractions except emotional excitement or cough.Conclusions The automatic diaphragm detection methods developed in this paper are precise,and can effectively reflect the characteristics of the respiratory motion.The method can save much time and improve the measure precision greatly compared with the manual measurement.

Dosimetric evaluation of three techniques in postoperative radiotherapy for rectal cancer / 中华放射医学与防护杂志

Objective To evaluate the dosimetric characteristics of helical tomotherapy (HT),intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) for postoperative radiotherapy of rectal cancer.Methods Ten male patients with stage Ⅱ or Ⅲ middle or low position rectal cancer were selected retrospectively.All of the 10 patients underwent Dixon surgery and CT simulation orientation.The target volumes and normal organs were drawn in the CT images and the plans for HT,IMRT and 3D-CRT were designed.The prescribed dose was given 50 Gy in 25 fractions,covering at least 95％ of the planning target volume.Results All plans met the needs of the prescribed doses.The HT and IMRT plans met the needs of dose limit to organs at risk,however,the 3D-CRT plans failed to do that.The conformity indexes of HT,IMRT and 3D-CRT plans were 0.86,0.82 and 0.62,respectively (F =206.81,P ＜ 0.001),and the homogeneity indexes were 0.001,0.157,and 0.205,respectively (x2 =15.8,P ＜ 0.001).The 3D-CRT plans had larger volumes than the HT plans and IMRT plans in the high-dose regions such as pelvic V50,bladder V40,bowel V50 and femoral head D5 (P ＜ 0.05),but the differences between the HT plans and IMRT plans were not statistically significant (P ＞0.05).The V15 value of bowel of HT plans were higher than those of the IMRT and 3D-CRT plans (71.1％ vs.63.3％ and 67.7％,respectively).However,there was no significantly difference.Conclusions All of the HT,IMRT and 3D-CRT plans are able to meet the prescription dose requirement of the target regions of rectal cancer.The HT plans show the best dose homogeneity and target conformity,followed by the IMRT plans,and then the 3D-CRT plans.The HT plans meet the needs of all OARs slightly better than the IMRT plans.3D-CRT plans are simple and practical with poor protective ability toward the OARs.

Radiation output evaluation of kilovoltage cone beam CT unit / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To evaluate the radiation output and stability of linac-integrated kV cone beam CT unit.</p><p><b>METHODS</b>Air kermas in radiographic mode were measured with 0.6 cc ion chamber and Unidos electrometer for Synergy-integrated XVI kV cone beam CT unit. Air kermas vs image frames were measured in fluoroscopic mode. Output stability and depth doses were measured.</p><p><b>RESULTS</b>The air kerma increased quadratically with the increased tube voltage, while increasing linearly with the tube current, exposure time, and number of frames. The radiation output stability and its change with the gantry angle were within +/-1%. The percentage depth dose increased with higher tube voltage.</p><p><b>CONCLUSION</b>The radiation output of XVI is stable. The radiation outputs change considerably with the preset parameters. Parameters should be optimally chosen to reduce the patient dose.</p>

Analysis of megavoltage computed tomography imaging on a helical tomotherapy unit / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To evaluate the image quality of megavoltage computed Tomography imaging.</p><p><b>METHODS</b>The HU uniformity and linearity, image noise, spatial resolution, low contrast resolution and spatial linearity in MVCT mode were evaluated with Catphan 600 phantom, and the factor of pitch was also evaluated. Influencing factors of image quality were also discussed.</p><p><b>RESULTS</b>The MVCT values depended linearly on the physical density of the sample. The MVCT values uniformity was good. The spatial resolution was 4 lp/cm. The use of an MV Beam for imaging results in the loss of low contrast resolution, but it is sufficient for pretreatment image guidance. The geometric accuracy was good.</p><p><b>CONCLUSIONS</b>The image quality of MVCT is less than that of KVCT, but is good enough for IGRT.</p>

Penumbra measuremnts of BeamModulatorTM multileaf collimator / 中华放射医学与防护杂志

Objective To evaluate the penumbra of a new multileaf collimator equipped with Elekta Synergy accelerator. Methods The penumbra were derived from beam profiles measured in air and water using PinPoint ion chamber with PTW MP3 water phantom. Variations of penumbra with X-ray beam energy, depth in water, and leaf position were investigated. Results The penumbra in air for 6 MV X-ray was 2 mm less than that at depth of maximal dose in water. The penumbra of leaf side was 1 mm less than that of the leaf end. The penumbra had close relationship with beam energy, depth in water and leaf position. Penumbra was increased with beam quality and water depth. The leaf position had great influence on the penumbra. Conclusions The penumbra of the multileaf collimator is related to its original design and radiation delivery technique. Special considerations should be taken into during treatment planning.Regular measurement should be performed to guarantee the delivery quality.

Effective dose evaluation for linac-integrated kV cone beam CT / 中华放射医学与防护杂志

Objective To evaluate the variations of effective doges with the preset scanning parameters from linac-integrated kV cone beam CT( CBCT). Methods Weighted CT dose index(CTDIW) were measured with PTW TM30009 CT ion chamber in head phantom and body phantom, respectively, for different combinations of tube voltage, mAs, collimator and gantry rotation range. Dose length products(DLP) were derived from CTDIW and effective doses(E) were calculated by the DLP and EDLP. Results CTDIW and effective dose had the quadratical relationship with tube voltage, depending linearly on product of tube current and exposure time. Effective dose had close relationship with the collimator and the gantry rotation range. Both the DLP and ED for CBCT were lower than the reference dose level recommended for conventional CT. Conclusions Effective dose from CBCT has a close relationship with the scanning parameters. Optimal imaging parameters should be chosen according to the patient's anatomy to reduce patient dose.

Measurement of MV CT dose index for Hi-ART helical tomotherapy unit / 中华放射医学与防护杂志

Objective To evaluate the patient dose from Hi-ART MV helical CT imaging in image-guided radiotherapy.Methods Weighted CT dose index (CTDI_W) was measured with PTW TM30009 CT ion chamber in head and body phantoms,respectively,for slice thicknesses of 2,4,6 mm with scanned range of 5 cm and 15 cm.Dose length products (DLP) were subsequently calculated.The CTDI_W and DLP were compared with XVI kV CBCT and ACQSim simulator CT for routine clinical protocols.Results An inverse relationship between CTDI and the slice thickness was found.The dose distribution was inhomogeneous owing to the attenuation of the couch.CTDI and DLP had close relationship with the slice thickness and the scanned range.Patient dose from MVCT was lower than XVI CBCT for head,but larger for body scan.Results CTDI_W can be used to assess the patient dose in MV helical CT due to its simplicity for measurement and reproducibility.Regular measurement should be performed in QA & QC program.Appropriate slice thickness and scan range should be chosen to reduce the patient dose.