Variations induced by body weight and background lesion normalization in standardized uptake value estimated by F18-FDG PET/CT.

AIM: This work aims to study the impact of different SUV variants in terms of mean and maximum measures as well as various normalization methods with respect to body weight, body mass index, body surface area, and lean body mass in patients with lymphoma. METHODS: Sixty-nine patients (34 male-35 female) were retrospectively selected. All patients had undergone F18-FDG PET/CT using the standard imaging protocol. In the first part of this study, SUVmean and SUVmax of patients' lesions and three background sites including liver, aorta, and muscle were determined. Then, the normalization of lesion SUV to body weight and body background sites was performed. The ratio of lesion SUVmax to body background sites (muscle, aorta, and liver) SUVmax was determined in addition to the ratio of lesion SUVmean to body background sites SUVmean. The second part of the study included the calculations of the body mass index (BMI), body surface area (BSA), and lean body mass (LBM). The normalization of lesion, liver, aorta, and muscle SUV to BMI, BSA, and LBM was calculated and compared to each other. RESULTS: After performing the appropriate statistical calculations, the results showed that there is a significant difference in SUV measurements between the three background sites. Lesions normalized to the liver were significantly lower than those normalized to aorta and muscle and the results also showed a higher magnitude of lesions normalized to muscle in comparison to the aorta. The SUVmax and SUVmean normalized to different body weight indices showed the lowest variation with BSA and BMI while being increasingly higher with lean body mass using the two methods James and Janmahasatian, respectively, and then highest with body weight. CONCLUSION: The SUVmax and SUVmean showed lower variance in comparison to other background regions. Less variation was also remarkable in SUVmean normalized to BSA and Janma lean mass and also when SUVmax is normalized to James lean body mass. The SUVmax normalized to lean (i.e., James) as well as SUVmean normalized to lean (i.e., Janma) and BSA showed a significant independence with body weight.

Quantifying inter- and intra-fraction variations of breast cancer radiotherapy with skin dose measurements.

Aim. The aim of the current study was to compare between the deep inspiration breath-hold (DIBH) technique and free-breathing (FB) method in the treatment delivery uncertainty of breast cancer radiotherapy using skin dose measurements.Methods. In a prospective manner, eighty patients were randomly selected for skin dose measurements, and they were assigned to two groups. DIBH (40 patients) and FB (40 patients). The systematic inter-fraction dose variation was quantified using the mean percentage error (MPE) between the average measured total dose per session in three consecutive sessions and the corresponding calculated point dose from the treatment planning system. The random inter-fraction dose variation was quantified using the standard deviation (SD) of the dose delivered by the medial or lateral tangential fields, or the total session dose in the three sessions (SDMT, SDLT, or SDtotal, respectively). While the random intra-fraction dose variation was quantified using the SD of the dose difference between the medial and lateral tangential fields in three consecutive sessions (SDMT-LT).Results. There was no statistically significant difference in MPE between the DIBH and FB groups (p = 0.583). Moreover, the mean SDtotaland SDMTof the DIBH group were significantly lower than that of the FB group (2.75 ± 2.33 cGy versus 4.45 cGy ± 4.33, p = 0.048) and (1.94 ± 1.63 cGy versus 3.76 ± 3.42 cGy, p = 0.007), respectively. However, there was no significant difference in the mean SDLTand SDMT-LTbetween the two groups (p > 0.05).Conclusion. In addition to the advantage of reducing the cardiopulmonary radiation doses in left breast cancer, the DIBH technique could reduce the treatment delivery uncertainty compared to the FB method due to the significant reduction in the random inter-fraction dose variations.

Polymeric Nanocarriers for Effective Synergistic Action of Sorafenib Tosylate and Gold-sensitized Gamma Radiation Against HepG2 Cells.

PURPOSE: One of the key parameters towards effective and synergistic combinatorial anticancer therapeutic models is the nanocarrier. Nearly all previous studies have been limited to one nanocarrier for one drug. However, a comparative study on two polymeric nanocarriers for the same drug against the same cancer cell and under the same conditions helps to rationalize the properties of each polymeric nanocarrier to the effectiveness of the drug-loaded nanocapsules. METHODS: In this study, two of biocompatible polymers, namely poly lactic-co-glycolic acid (PLGA) and polyε-caprolactone (PCL), were used for co-delivery of sorafenib tosylate and gold nanoparticles (G). RESULTS: The anticancer effects of sorafenib tosylate (ST) combined with gold-sensitized radiation therapy were studied and rationalized to the physicochemical properties of each nanocarrier. Both models inhibited the proliferation of HepG2 cells via cell cycle arrest. The use of PCL and PLGA as nanocarriers for the proposed combined (chemo-radio) therapeutic model reduced the viability of HepG2 cells to 26% and 8%, respectively. PCL and PLGA models showed high necrosis levels (15.1 and 16.2, respectively). CONCLUSION: Both PCL and PLGA are good nanocarriers for the proposed combined model. Compared to PCL NPs, PLGA NPs showed enhanced release, higher cytotoxicity and higher necrosis levels.

The necessity of using deep inspiration breath-hold in the radiotherapy of left breast cancer patients who undergo the UK FAST trial.

AIM: The purpose of the current study was to compare between deep inspiration breath-hold (DIBH) and free-breathing (FB) method in the setup reproducibility and to perform a dosimetric comparison between both methods in left-sided breast cancer patients who undergo the UK FAST trial. MATERIALS AND METHODS: The online matching correction data were retrospectively collected for 50 patients treated with the FAST trial. They were equally divided into DIBH and FB groups to compare between both methods in the setup reproducibility and create the appropriate planning target volume (PTV) margin. Ten patients out of the fifty were scanned in DIBH and FB to perform a dosimetric comparison with the strict acceptance criteria of the FAST trial. RESULTS: All heart dosimetric parameters of the DIBH was significantly lower than that of FB (p < 0.001), and the lung V30% of DIBH plans was significantly lower than FB plans (p = 0.03). There was no statistically significant difference between the two methods in the other organs at risk doses. To fulfill the heart and lung constraints in FB plans, the PTV V90% was reduced by 3.4%, and three plans would not attain the PTV acceptance criteria. There was no significant difference between the systematic or random setup errors between both methods except the left-right random shift was significantly lower in DIBH cases (p = 0.004). The calculated PTV margins were (4 mm, 3 mm, and 4 mm) for DIBH group, and (5 mm, 6 mm, and 8 mm) for FB group in the anterior-posterior, superior-inferior, and left-right shifts, respectively. CONCLUSION: It is highly warranted to treat left-sided breast cancer patients with the DIBH technique when the UK FAST trial is employed for treatment.

Assessment of DNA damage in Ehlrich carcinoma after treatment with doxorubicin encapsulated in nanoscales thermosensitive liposomes in combination with localized hyperthermia.

Nanoscales thermosensitive liposomes (TSL) composed of synthetic lipids (dipalmitoylphosphatidylcholine, and distearoylphosphatidylcholine), were used for doxorubicin encapsulation with 70% encapsulated efficiency. The liposomes were characterized by dynamic light scattering, transmission electron microscopy and turbidity method. Additionally, the liposomes exhibited a significant release of doxorubicin (Dox) by 60% within 5 min at 42°C. To assess the therapeutic efficacy of Dox in combination with hyperthermia, Dox free and encapsulated TSL were administered directly to Ehrlich tumor bearing mice at 1 mg/kg dose. Immediately after the drug administration, hyperthermia was applied to mention the temperature inside the tumor site at 42°C either for 5 min and 30 min. The results indicate a significant increase in the percent of apoptotic and necrotic cells in the treated group. Moreover, disrupts the integrity and the amount of intact DNA in tumor cells. In conclusion, Dox and hyperthermia may serve as a useful targeted drug delivery system for management of Ehrlich carcinoma.