Stereotactic body radiotherapy of central lung tumours using a 1.5 T MR-linac: First clinical experiences.

Background: MRI-guidance may aid better discrimination between Organs at Risk (OARs) and target volumes in proximity of the mediastinum. We report the first clinical experiences with Stereotactic Body Radiotherapy (SBRT) of (ultra)central lung tumours on a 1.5 T MR-linac. Materials and Methods: Patients with an (ultra)central lung tumour were selected for MR-linac based SBRT treatment. A T2-weighted 3D sequence MRI acquired during free breathing was used for daily plan adaption. Prior to each fraction, contours of Internal Target Volume (ITV) and OARs were deformably propagated and amended by a radiation oncologist. Inter-fractional changes in volumes and coverage of target volumes as well as doses in OARs were evaluated in offline and online treatment plans. Results: Ten patients were treated and completed 60 Gy in 8 or 12 fractions. In total 104 fractions were delivered. The median time in the treatment room was 41 min with a median beam-on time of 8.9 min. No grade ≥3 acute toxicity was observed. In two patients, the ITV significantly decreased during treatment (58 % and 37 %, respectively) due to tumour shrinkage. In the other patients, 81 % of online ITVs were within ±15 % of the volume of fraction 1. Comparison with the pre-treatment plan showed that ITV coverage of the online plan was similar in 52 % and improved in 34 % of cases. Adaptation to meet OAR constraints, led to decreased ITV coverage in 14 %. Conclusions: We describe the workflow for MR-guided Radiotherapy and the feasibility of using 1.5 T MR-linac for SBRT of (ultra) central lung tumours.

Temperature impacts Atlantic salmon's (Salmo salar) immunological response to infectious salmon anemia virus (ISAv).

Ocean temperatures continue to rise annually due to the ever-growing consequences of global climate change. These temperature changes can have an impact on the immunological robustness of cultured fish, especially cold-water species such as Atlantic salmon. The salmon farming industry already loses hundreds of millions of dollars each year to infectious and non-infectious diseases. One particularly important and WOAH reportable disease is infectious salmon anemia caused by the orthomyxovirus ISAv. Considering the changing environment, it is necessary to find ways to mitigate the effect of diseases on the industry. For this study, 20 Atlantic salmon families were housed in each of 38 different tanks at the AVC, with half of the fish being kept at 10 °C and half being kept at 20 °C. Donor Atlantic salmon IP- injected with a highly virulent ISAv isolate (HPR4; TCID50 of 1 × 105/mL) were added to each tank as the source of co-habitation infection. Both temperatures were sampled at onset of mortality in co-habited fish and at resolution of mortality. Family background and temperature significantly impacted ISAv load, as assessed by qPCR, time to mortality and overall mortality. Mortality was more acute at 20 °C, but overall mortality was higher at 10 °C. Based on percent mortality calculated over the course of the study, different families demonstrated different levels of survival. The three families that demonstrated the highest percent mortality, and the three families with the lowest percent mortality were then assessed for their antiviral responses using relative gene expression. Genes significantly upregulated between the unexposed fish and ISAv exposed fish included mx1, il4/13a, il12rb2, and trim25, and these were further impacted by temperature. Understanding how ISAv resistance is impacted by temperature can help identify seasonal risks of ISAv outbreaks as well as ideal responses to be targeted through immunopotentiation.

First experimental exploration of real-time cardiorespiratory motion management for future stereotactic arrhythmia radioablation treatments on the MR-linac.

Objective.Stereotactic arrhythmia radioablation (STAR) is a novel, non-invasive treatment for refractory ventricular tachycardia (VT). The VT isthmus is subject to both respiratory and cardiac motion. Rapid cardiac motion presents a unique challenge. In this study, we provide first experimental evidence for real-time cardiorespiratory motion-mitigated MRI-guided STAR on the 1.5 T Unity MR-linac (Elekta AB, Stockholm, Sweden) aimed at simultaneously compensating cardiac and respiratory motions.Approach.A real-time cardiorespiratory motion-mitigated radiotherapy workflow was developed on the Unity MR-linac in research mode. A 15-beam intensity-modulated radiation therapy treatment plan (1 × 25 Gy) was created in Monaco v.5.40.01 (Elekta AB) for the Quasar MRI4Dphantom (ModusQA, London, ON). A film dosimetry insert was moved by combining either artificial (cos4, 70 bpm, 10 mm peak-to-peak) or subject-derived (59 average bpm, 15.3 mm peak-to-peak) cardiac motion with respiratory (sin, 12 bpm, 20 mm peak-to-peak) motion. A balanced 2D cine MRI sequence (13 Hz, field-of-view = 400 × 207 mm2, resolution = 3 × 3 × 15 mm3) was developed to estimate cardiorespiratory motion. Cardiorespiratory motion was estimated by rigid registration and then deconvoluted into cardiac and respiratory components. For beam gating, the cardiac component was used, whereas the respiratory component was used for MLC-tracking. In-silico dose accumulation experiments were performed on three patient data sets to simulate the dosimetric effect of cardiac motion on VT targets.Main results.Experimentally, a duty cycle of 57% was achieved when simultaneously applying respiratory MLC-tracking and cardiac gating. Using film, excellent agreement was observed compared to a static reference delivery, resulting in a 1%/1 mm gamma pass rate of 99%. The end-to-end gating latency was 126 ms on the Unity MR-linac. Simulations showed that cardiac motion decreased the target's D98% dose between 0.1 and 1.3 Gy, with gating providing effective mitigation.Significance.Real-time MRI-guided cardiorespiratory motion management greatly reduces motion-induced dosimetric uncertainty and warrants further research and development for potential future use in STAR.

Simultaneous multi-slice accelerated 4D-MRI for radiotherapy guidance.

4D-MRI is becoming increasingly important for daily guidance of thoracic and abdominal radiotherapy. This study exploits the simultaneous multi-slice (SMS) technique to accelerate the acquisition of a balanced turbo field echo (bTFE) and a turbo spin echo (TSE) coronal 4D-MRI sequence performed on 1.5 T MRI scanners. SMS single-shot bTFE and TSE sequences were developed to acquire a stack of 52 coronal 2D images over 30 dynamics. Simultaneously excited slices were separated by half the field of view. Slices intersecting with the liver-lung interface were used as navigator slices. For each navigator slice location, an end-exhale dynamic was automatically identified, and used to derive the self-sorting signal by rigidly registering the remaining dynamics. Navigator slices were sorted into 10 amplitude bins, and the temporal relationship of simultaneously excited slices was used to generate sorted 4D-MRIs for 12 healthy volunteers. The self-sorting signal was validated using anin vivopeak-to-peak motion analysis. The smoothness of the liver-lung interface was quantified by comparing to sagittal cine images acquired directly after the SMS-4D-MRI sequence. To ensure compatibility with the MR-linac radiotherapy workflow, the 4D-MRIs were transformed into 3D mid-position (MidP) images using deformable image registration. Consistency of the deformable vector fields was quantified in terms of the distance discordance metric (DDM) in the body. The SMS-4D-TSE sequence was additionally acquired for 3 lung cancer patients to investigate tumor visibility. SMS-4D-MRI acquisition and processing took approximately 7 min. 4D-MRI reconstruction was possible for 26 out of 27 acquired datasets. Missing data in the sorted 4D-MRIs varied from 4%-26% for the volunteers and varied from 8%-24% for the patients. Peak-to-peak (SD) amplitudes analysis agreed within 1.8 (1.1) mm and 0.9 (0.4) mm between the sorted 4D-MRIs and the self-sorting signals of the volunteers and patients, respectively. Liver-lung interface smoothness was found to be in the range of 0.6-3.1 mm for volunteers. The percentage of DDM values smaller than 2 mm was in the range of 85%-89% and 86%-92% for the volunteers and patients, respectively. Lung tumors were clearly visibility in the SMS-4D-TSE images and MidP images. Two fast SMS-accelerated 4D-MRI sequences were developed resulting in T2/T1or T2weighted contrast. The SMS-4D-MRIs and derived 3D MidP-MRIs yielded anatomically plausible images and good tumor visibility. SMS-4D-MRI is therefore a strong candidate to be used for treatment simulation and daily guidance of thoracic and abdominal MR-guided radiotherapy.

MRI-guided mid-position liver radiotherapy: Validation of image processing and registration steps.

BACKGROUND & PURPOSE: To propose a novel mid-position (midP) workflow for MRI-guided liver SBRT and provide a validation of the required midP-MRI generation and registration steps. MATERIALS & METHODS: The first step of the midP workflow is the generation of a simulation midP-MRI from a 4D-MRI scan using deformable image registration. Next, a planning midP-CT is warped to the midP-MRI to enable planning in the midP-MRI anatomy. For daily MRI-guidance, three different registration methods to the simulation midP-MRI are proposed; (1) 4D rigid registration of all phases of the daily 4D-MRI, (2) 3D rigid registration of the daily midP-MRI, and (3) 3D deformable registration of the daily midP-MRI. The midP-MRI image quality was assessed with respect to 4D-MRI acquisition time, which is related to over-sampling of the data acquisition (i.e. number of dynamics). The deformable registration precision for the midP-MRI generation was validated using the distance discordance metric (DDM). The deformable CT-MRI and daily MRI-MRI registration accuracies were quantified using the 'full circle method'. RESULTS: The DDM was 1.5 mm (median) within the liver, independent of the number of dynamics. The root-mean-squared difference between midP-MRIs based on 10 and 60 dynamics was only 5.2%. The full circle CT-MRI deformable registration error had a median 3D vector length of 1.8 mm in the liver. The daily MRI-MRI registration error was submillimeter for all three evaluated methods. CONCLUSION: The feasibility of an MRI-guided mid-position workflow for liver SBRT is supported by the demonstrated high precision of all image processing and registration steps.

MRI-guidance for motion management in external beam radiotherapy: current status and future challenges.

High precision conformal radiotherapy requires sophisticated imaging techniques to aid in target localisation for planning and treatment, particularly when organ motion due to respiration is involved. X-ray based imaging is a well-established standard for radiotherapy treatments. Over the last few years, the ability of magnetic resonance imaging (MRI) to provide radiation-free images with high-resolution and superb soft tissue contrast has highlighted the potential of this imaging modality for radiotherapy treatment planning and motion management. In addition, these advantageous properties motivated several recent developments towards combined MRI radiation therapy treatment units, enabling in-room MRI-guidance and treatment adaptation. The aim of this review is to provide an overview of the state-of-the-art in MRI-based image guidance for organ motion management in external beam radiotherapy. Methodological aspects of MRI for organ motion management are reviewed and their application in treatment planning, in-room guidance and adaptive radiotherapy described. Finally, a roadmap for an optimal use of MRI-guidance is highlighted and future challenges are discussed.

Pathologic features of mycobacteriosis in naturally infected Syngnathidae and novel transcriptome assembly in association with disease.

Syngnathidae (seahorses, seadragons and pipefish) suffer significant losses from non-tuberculous mycobacteria. However, they produce markedly different lesions in response to the disease compared to other teleost species, notably infrequent granuloma formation. This study evaluated 270 syngnathid fish, from which 92 were diagnosed with mycobacteriosis by histopathology, culture or both. Microscopic lesions variably consisted of random foci of coagulative necrosis in multiple organs, containing high numbers of free bacteria and large aggregates or sheets of macrophages with cytoplasm laden with acid-fast bacilli. Mycobacterial associated granulomas were identified in only six seahorses. Five fish had positive cultures with no observed microscopic changes. RNA-seq of the head kidney was performed to investigate the transcriptome of two infected and six non-infected lined seahorses Hippocampus erectus. Assembled and annotated putative transcripts serve to enrich the database for this species, as well as provide baseline data for understanding the pathogenesis of mycobacteriosis in seahorses. Putative components of the innate immune system (IL-1ß, IL-6, TNF, NOS, Toll-like receptor 1, MHC Class I, NF-κß, transforming growth factor beta, MyD88) were identified in the RNA-seq data set. However, a homolog for a key component in the TH1 adaptive immune response, interferon-gamma, was not identified and may underlie the unique pathologic presentation.

Real-time auto-adaptive margin generation for MLC-tracked radiotherapy.

In radiotherapy, abdominal and thoracic sites are candidates for performing motion tracking. With real-time control it is possible to adjust the multileaf collimator (MLC) position to the target position. However, positions are not perfectly matched and position errors arise from system delays and complicated response of the electromechanic MLC system. Although, it is possible to compensate parts of these errors by using predictors, residual errors remain and need to be compensated to retain target coverage. This work presents a method to statistically describe tracking errors and to automatically derive a patient-specific, per-segment margin to compensate the arising underdosage on-line, i.e. during plan delivery. The statistics of the geometric error between intended and actual machine position are derived using kernel density estimators. Subsequently a margin is calculated on-line according to a selected coverage parameter, which determines the amount of accepted underdosage. The margin is then applied onto the actual segment to accommodate the positioning errors in the enlarged segment. The proof-of-concept was tested in an on-line tracking experiment and showed the ability to recover underdosages for two test cases, increasing [Formula: see text] in the underdosed area about [Formula: see text] and [Formula: see text], respectively. The used dose model was able to predict the loss of dose due to tracking errors and could be used to infer the necessary margins. The implementation had a running time of 23 ms which is compatible with real-time requirements of MLC tracking systems. The auto-adaptivity to machine and patient characteristics makes the technique a generic yet intuitive candidate to avoid underdosages due to MLC tracking errors.

Stress, nutrition and parental care in a teleost fish: exploring mechanisms with supplemental feeding and cortisol manipulation.

Parental care is an essential life-history component of reproduction for many animal species, and it entails a suite of behavioural and physiological investments to enhance offspring survival. These investments can incur costs to the parent, reducing their energetic and physiological condition, future reproductive capabilities and survival. In fishes, relatively few studies have focused on how these physiological costs are mediated. Male smallmouth bass provide parental care for developing offspring until the brood reaches independence. During this energetically demanding life stage, males cease active foraging as they vigorously defend their offspring. Experimental manipulation of cortisol levels (via implantation) and food (via supplemental feeding) in parental males was used to investigate the fitness consequences of parental care. Improving the nutritional condition of nest-guarding males increased their reproductive success by reducing premature nest abandonment. However, supplemental feeding and cortisol treatment had no effect on parental care behaviours. Cortisol treatment reduced plasma lymphocyte numbers, but increased neutrophil and monocyte concentrations, indicating a shift in immune function. Supplemental feeding improved the physiological condition of parental fish by reducing the accumulation of oxidative injury. Specifically, supplemental feeding reduced the formation of 8-hydroxy-2'-deoxyguanosine (8-OHdG) on DNA nucleotides. Increasing the nutritional condition of parental fish can reduce the physiological cost associated with intensive parental activity and improve overall reproductive success, illustrating the importance of nutritional condition as a key modulator of parental fitness.

Assessment of MLC tracking performance during hypofractionated prostate radiotherapy using real-time dose reconstruction.

By adapting to the actual patient anatomy during treatment, tracked multi-leaf collimator (MLC) treatment deliveries offer an opportunity for margin reduction and healthy tissue sparing. This is assumed to be especially relevant for hypofractionated protocols in which intrafractional motion does not easily average out. In order to confidently deliver tracked treatments with potentially reduced margins, it is necessary to monitor not only the patient anatomy but also the actually delivered dose during irradiation. In this study, we present a novel real-time online dose reconstruction tool which calculates actually delivered dose based on pre-calculated dose influence data in less than 10 ms at a rate of 25 Hz. Using this tool we investigate the impact of clinical target volume (CTV) to planning target volume (PTV) margins on CTV coverage and organ-at-risk dose. On our research linear accelerator, a set of four different CTV-to-PTV margins were tested for three patient cases subject to four different motion conditions. Based on this data, we can conclude that tracking eliminates dose cold spots which can occur in the CTV during conventional deliveries even for the smallest CTV-to-PTV margin of 1 mm. Changes of organ-at-risk dose do occur frequently during MLC tracking and are not negligible in some cases. Intrafractional dose reconstruction is expected to become an important element in any attempt of re-planning the treatment plan during the delivery based on the observed anatomy of the day.

Spatial patterns in markers of contaminant exposure, glucose and glycogen metabolism, and immunological response in juvenile winter flounder (Pseudoplueronectes americanus).

Inshore winter flounder (Pseudoplueronectes americanus) populations in NY, USA have reached record low numbers in recent years, and recruitment into the fishery appears to be limited by survival of post-settlement juvenile fish. In order to identify cellular pathways associated with site-specific variation in condition and mortality, we examined differential mRNA expression in juvenile winter flounder collected from six different bays across a gradient in human population density and sewage inputs. Illumina sequencing of pooled samples of flounder from contrasting degraded sites and less impacted sites was used to guide our choice of targets for qPCR analysis. 253 transcripts of >100bp were differentially expressed, with 60% showing strong homology to mostly teleost sequences within the NCBI database. Based on these data, transcripts representing nine genes of interest associated with contaminant exposure, immune response and glucose and glycogen metabolism were examined by qPCR in individual flounder from each site. Statistically significant site-specific differences were observed in expression of all but one gene, although patterns in expression were complex with only one (vitellogenin), demonstrating a west to east gradient consistent with known loadings of municipal sewage effluent. Principal components analysis (PCA) identified relationships among the genes evaluated. Our data indicate that juvenile winter flounder are responding to estrogenic chemicals in more urbanized coastal bays, and suggests potential mechanistic links between immune response, contaminant exposure and energy metabolism.

Measures of immune system status in young-of-the-year winter flounder Pseudopleuronectes americanus.

The immune status of young-of-the-year (YOY) winter flounder Pseudopleuronectes americanus was evaluated in fish collected from six areas around Long Island, NY, U.S.A. representing more urban areas with high population density in the west, to less densely populated more rural areas in to the east. Gene expression markers for innate immunity (pleurocidin) and contaminant exposure (cytochrome P4501A; cyp1a) were measured in liver and fin of fish collected at each site. Expression of pleurocidin was significantly higher in fin than liver, but was highly variable among individuals. Some statistically significant differences in pleurocidin expression among sites were observed, although elevated levels were not associated with degree of urbanization. Expression was related in part to fish size: a positive correlation between expression and total length (LT ) of fish was observed with the largest LT class (>125 mm) exhibiting significantly elevated pleurocidin expression as compared with fish in the smaller LT class. This indicates that immune competency may increase with age. No site-specific differences in cyp1a expression were observed. These data suggest that exposure to aromatic hydrocarbon contaminants is fairly widespread throughout the study area and that any differences in pleurocidin expression in YOY P. americanus are probably due to other factors. Antimicrobial activity was also measured as a functional indicator of immune response. Activity was highly variable, showing no significant site-specific differences, and no significant correlation to pleurocidin expression. The lack of correlation between pleurocidin expression and antimicrobial activity indicates that other antimicrobial peptides may be active against the bacteria tested or that other factors are influencing antimicrobial activity. This is the first quantitative evaluation of pleurocidin expression in YOY P. americanus from an urban area. Further work is needed to characterize factors controlling pleurocidin expression, as well as other indicators of immune response in young fish.

Automated marker tracking using noisy X-ray images degraded by the treatment beam.

This study demonstrates the feasibility of automated marker tracking for the real-time detection of intrafractional target motion using noisy kilovoltage (kV) X-ray images degraded by the megavoltage (MV) treatment beam. The authors previously introduced the in-line imaging geometry, in which the flat-panel detector (FPD) is mounted directly underneath the treatment head of the linear accelerator. They found that the 121 kVp image quality was severely compromised by the 6 MV beam passing through the FPD at the same time. Specific MV-induced artefacts present a considerable challenge for automated marker detection algorithms. For this study, the authors developed a new imaging geometry by re-positioning the FPD and the X-ray tube. This improved the contrast-to-noise-ratio between 40% and 72% at the 1.2 mAs/image exposure setting. The increase in image quality clearly facilitates the quick and stable detection of motion with the aid of a template matching algorithm. The setup was tested with an anthropomorphic lung phantom (including an artificial lung tumour). In the tumour one or three Calypso beacons were embedded to achieve better contrast during MV radiation. For a single beacon, image acquisition and automated marker detection typically took around 76 ± 6 ms. The success rate was found to be highly dependent on imaging dose and gantry angle. To eliminate possible false detections, the authors implemented a training phase prior to treatment beam irradiation and also introduced speed limits for motion between subsequent images.

Finding an improved amorphous-silicon x-ray flat-panel detector configuration for the in-line geometry.

We have previously investigated the use of a conventional amorphous-silicon flat-panel detector (FPD) for intrafractional image guidance in the in-line geometry. In this configuration, the FPD is mounted between the patient and the treatment head, with the front of the FPD facing towards the patient. By geometrically separating signals from the diagnostic (kV) and treatment (MV) beams, it is possible to monitor the patient and treatment beam at the same time. In this study, we propose an FPD design based on existing technology with a 70% reduced up-stream areal density that is more suited to this new application. We have investigated our FPD model by means of a validated Monte Carlo simulation. Experimentally, simple rectangular fields were used to irradiate through the detector and observe the impact of removing detector components such as the support structure or the phosphor screen on the measured signal. The proposed FPD performs better than the conventional FPD: (i) attenuation of the MV beam is decreased by 60%; (ii) the MV signal is reduced by 20% for the primary MV field region which can avoid saturation of the FPD; and (iii) long range scatter from the MV into the kV region of the detector is greatly reduced.

Immunostimulation of Salmo salar L., and its effect on Lepeophtheirus salmonis (Krøyer) P-glycoprotein mRNA expression following subsequent emamectin benzoate exposure.

Control of sea lice, Lepeophtheirus salmonis, on farmed Atlantic salmon, Salmo salar, relies heavily on chemotherapeutants. However, reduced efficacy of many treatments and need for integrated sea lice management plans require innovative strategies. Resistance to emamectin benzoate (EMB), a major sea lice parasiticide, has been linked with P-glycoprotein (P-gp) expression. We hypothesized that host immunostimulation would complement EMB treatment outcome. Lepeophtheirus salmonis-infected Atlantic salmon were fed immunostimulatory or control feeds. Sea lice were collected for 24-h EMB bioassays 1 and 2 weeks prior to commencement of EMB treatment of the fish. Two weeks after cessation of immunostimulant-treated feed, EMB was administered at 150 µg kg(-1) fish biomass for 7 days. The bioassay revealed stage, gender and immunostimulant-related differences in EMB EC(50) . Sea lice attached to salmon with a history of immunostimulation exhibited significantly greater survival than those on control feeds, despite similar levels of EMB in host tissues. Lepeophtheirus salmonis from salmon with a history of immunostimulation also exhibited higher P-gp mRNA expression as well as greater survivability compared to controls. Administration of immunostimulants prior to EMB treatment caused increased expression of P-gp mRNA which could have consequently caused decreased efficacy of the parasiticide.

Combinatorial effects of administration of immunostimulatory compounds in feed and follow-up administration of triple-dose SLICE® (emamectin benzoate) on Atlantic salmon, Salmo salar L., infection with Lepeophtheirus salmonis.

Several immunostimulatory feed additives have shown the ability to induce protective responses in Atlantic salmon to infection with Lepeophtheirus salmonis. However, even the most encouraging results rarely surpass a 50% protective index in the host. That fact coupled with the well-documented limitations of single-therapy strategies in the effective management of parasitic infections generally make it imperative to identify therapies that can be combined in an integrated pest management approach for sea lice. With this in mind, we hypothesized that immunostimulatory feeds could enhance the protection provided by SLICE® emamectin benzoate (EMB). To test this hypothesis, Atlantic salmon were fed one of two different immunostimulatory feeds (CpG ODN or Aquate®) for c. 7 weeks, challenged with L. salmonis copepodids early within that immunostimulatory feed period and then placed on a triple-dose (150 µg kg(-1) ) feed of SLICE® for 1 week following the completion of the immunostimulatory feeding period. CpG ODN (2 mg kg(-1) ) and the commercial yeast extract (Aquate® 0.2%) inclusion in feeds were able to successfully induce inflammatory gene expression (interleukin-1ß) in the head kidneys of infected fish at 13 and 26 days post-exposure (DPE), and 13 DPE, respectively. Lice burdens were lower on fish fed CpG ODN (18%) or Aquate® (19%) diets; however, due to variability, these were not statistically significant over time. Despite no statistically significant reductions in lice numbers, by 33 DPE fish on immunostimulatory feeds had significantly reduced cortisol levels when compared to infected fish on control diet. Cortisol levels in fish receiving an immunostimulatory diet were no different from initial baseline levels prior to infection, whereas the levels in control diet fish were significantly elevated from all other time points. Despite the positive effects on infection of fish fed immunostimulatory feeds, no synergism was observed with follow-up treatment with SLICE® . In fact, highest survival of lice was observed in fish with prior immunostimulation.

CpG inclusion in feed reduces sea lice, Lepeophtheirus salmonis, numbers following re-infection.

Lepeophtheirus salmonis infections in Atlantic salmon, Salmo salar, have been characterized by little to no hyperplastic response and a biphasic immune response that results in chronic inflammation with tissue repair as the infection progresses. We hypothesized that CpG administration with prior lice exposure would enhance epithelial inflammatory mechanisms and boost the Atlantic salmon immune response to L. salmonis, leading to greater protection against infection. We administered multiple exposures of L. salmonis to two groups of Atlantic salmon and compared responses against first-time exposed Atlantic salmon. Following re-exposure, CpG fed fish exhibited increased skin expression of interleukin (IL)-1ß and IL-12 ß compared to control previously exposed (CPE) and control first-time exposed (CFE) animals, respectively. This inflammatory enhancement occurred with significantly lower expression of matrix metalloproteinase-9 (MMP 9), both systemically (spleen) and locally (skin). Reduced MMP 9 expression was a hallmark of the re-infected fish (occurred in both tissues at both times). When significant differences were present in the skin or spleen, the two re-exposed groups showed greater similarity than with the first exposure group. Lice numbers on CpG fed fish were significantly lower than CFE fish at 7 days post-re-infection (dpri), and although they were not significantly different at 17 dpri, the trend of lower lice levels remained. CpG fed fish also showed nearly twofold greater protection than CPE when compared to the CFE group (48.5% vs. 27.0% reductions at 7 dpri and 27.2% vs. 13.1% reductions at 17 dpri, respectively). The enhanced protection of CpG oligodeoxynucleotide administration to previous exposure was consistent across all body surfaces and suggests that CpG can not only enhance innate responses to L. salmonis in Atlantic salmon, but also further stimulate adaptive responses.

Immunophysiology of Atlantic sturgeon, Acipenser oxyrinchus oxyrinchus (Mitchill), and the relationship to parasitic copepod, Dichelesthium oblongum (Abilgaard) infection.

The copepod parasite, Dichelesthium oblongum, is known to infect the Atlantic sturgeon, Acipenser oxyrinchus oxyrinchus, within the area near New York city, USA, known as the NY Bight. The gross pathology associated with the juvenile and adult copepod stages along with the parasite's link in causing changes in sturgeon osmoregulatory capabilities has led us to investigate the host immunophysiology in relation to this host-parasite system. All the host variables, which included gill Na(+) -K(+) -ATPase activity, serum alkaline phosphatase (AP) and white blood cell differential counts, were affected in a non-linear manner by the copepod parasite. The parasites increased the host gill Na(+) -K(+) -ATPase activity and serum AP along with the percentage granulocytes while decreasing the percentage lymphocytes. A new method, developed to sample and preserve white blood cells in the field for future flow cytometry analysis, proved adequate. The effects of fish size, location and time of sampling were accounted for by the use of generalized linear models, and their effects on the host variables are discussed.

Performance characteristics of a novel megavoltage cone-beam-computed tomography device.

In this work, the image quality of a novel megavoltage cone-beam-computed tomography (CBCT) scanner is compared to three other image-guided radiation therapy devices by analysing images of different-sized quality assurance phantoms. The following devices are compared in terms of image uniformity, signal-to-noise ratio, contrast-to-noise ratio (CNR), electron density to HU conversion, presampling modulation transfer function (MTF(pre)) and combined spatial resolution and noise (Q-factor): (i) the Siemens Artiste kilovoltage (kV) (121 kV) CBCT device, (ii) the Artiste treatment beam line (TBL), 6 MV, (iii) the Tomotherapy (3.5 MV) fan-beam CT and (iv) Siemens' novel approach using a carbon target for a dedicated imaging beam line (IBL), 4.2 MV. Machine settings were selected to produce the same imaging dose for all devices. For a head phantom, IBL scans display CNR values 2.6 ± 0.3 times higher than for the TBL at the same dose level (for a CT-number range of -200 to -60 HU). kV CBCT, on the other hand, displays CNR values 7.9 ± 0.3 times higher than the IBL. There was no significant deviation in spatial resolution between IBL, TBL and Tomotherapy in terms of 50% and 10% MTF(pre). For kV CBCT, the MTF(pre) was significantly higher than those for other devices. In our Q-factor analysis, the IBL (14.6) scores higher than the TBL (7.9) and Tomotherapy (9.7) due to its lower noise level. The linearity of electron density to HU conversion is demonstrated for different-sized phantoms. Employing the IBL instead of the TBL significantly reduces the imaging dose by up to a factor of 5 at a constant image quality level, providing an immediate benefit for the patient.

Interactions between hypoxia and sewage-derived contaminants on gene expression in fish embryos.

Fish embryos were used to evaluate the interaction among common environmental and chemical stressors found in urban coastal environments, namely hypoxia, aryl hydrocarbon receptor (AhR) agonists, and estrogenic compounds. At the molecular level, the systems responding to these stressors share common response factors, and evidence exists for cross-talk between them. Biomarkers of exposure to these stressors, cytochrome P4501a (Cyp1a), estrogen receptor alpha (ERα), brain cytochrome P450 aromatase (Cyp19a2 or AromB), and hypoxia inducible factor 1 alpha (Hif-1α) mRNA expression were examined using qRT-PCR simultaneously in embryos of two well studied species, the Atlantic killifish, Fundulus heteroclitus, and the zebrafish Danio rerio. Embryos of both species were exposed to the model Cyp1a inducer ß-naphthoflavone (BNF) or 17-ß estradiol (E2) under either normoxic or hypoxic (5% oxygen atmosphere) conditions and harvested prior to hatch at 9 days post fertilization (dpf) for the killifish, and 48h post fertilization (hpf) for the zebrafish. BNF significantly induced Cyp1a expression in embryos of both species with killifish embryos being more responsive (700-fold>control) than zebrafish embryos (7-100-fold>control). AromB was also significantly influenced by treatment, but to a lesser extent, with mean expression levels increased by less than two-fold over control values in response to E2, and in one case upregulated by BNF. ERα and Hif-1α were constitutively expressed in embryos of both species, but expression was unaffected by exposure to either BNF or E2. Hypoxic conditions downregulated AromB expression strongly in killifish but not in zebrafish embryos. The impact of hypoxia on expression of other genes in either species was inconsistent, although an interactive effect between hypoxia and BNF on several of the genes evaluated was observed. These data are the first to examine expression patterns of these important environmental response genes together in embryos of two important model fish species. The results support the use of Cyp1a expression as a biomarker of AhR agonists in fish embryos, and indicate that AromB may be more responsive than ERα to estrogenic chemicals at this stage in development. Hif-1α expression was not found to be a good biomarker of hypoxic exposure in either killifish or zebrafish embryos. The interaction observed between BNF and co-exposure to hypoxia warrants further investigation. Finally killifish embryos are generally more sensitive than zebrafish embryos at this stage of development supporting their use in environmental assessments.