Deep learning promoted target volumes delineation of total marrow and total lymphoid irradiation for accelerated radiotherapy: A multi-institutional study.

BACKGROUND AND PURPOSE: One of the current roadblocks to the widespread use of Total Marrow Irradiation (TMI) and Total Marrow and Lymphoid Irradiation (TMLI) is the challenging difficulties in tumor target contouring workflow. This study aims to develop a hybrid neural network model that promotes accurate, automatic, and rapid segmentation of multi-class clinical target volumes. MATERIALS AND METHODS: Patients who underwent TMI and TMLI from January 2018 to May 2022 were included. Two independent oncologists manually contoured eight target volumes for patients on CT images. A novel Dual-Encoder Alignment Network (DEA-Net) was developed and trained using 46 patients from one internal institution and independently evaluated on a total of 39 internal and external patients. Performance was evaluated on accuracy metrics and delineation time. RESULTS: The DEA-Net achieved a mean dice similarity coefficient of 90.1 % ± 1.8 % for internal testing dataset (23 patients) and 91.1 % ± 2.5 % for external testing dataset (16 patients). The 95 % Hausdorff distance and average symmetric surface distance were 2.04 ± 0.62 mm and 0.57 ± 0.11 mm for internal testing dataset, and 2.17 ± 0.68 mm, and 0.57 ± 0.20 mm for external testing dataset, respectively, outperforming most of existing state-of-the-art methods. In addition, the automatic segmentation workflow reduced delineation time by 98 % compared to the conventional manual contouring process (mean 173 ± 29 s vs. 12168 ± 1690 s; P < 0.001). Ablation study validate the effectiveness of hybrid structures. CONCLUSION: The proposed deep learning framework achieved comparable or superior target volume delineation accuracy, significantly accelerating the radiotherapy planning process.

Total marrow lymphoid irradiation IMRT treatment using a novel CT-linac.

BACKGROUND: A novel CT-linac (kilovolt fan-beam CT-linac) has been introduced into total marrow and lymphoid irradiation (TMLI) treatment. Its integrated kilovolt fan-beam CT (kV FBCT) can be used not only for image guidance (IGRT) but also to re-calculate the dose. PURPOSE: This study reported our clinical routine on performing TMIL treatment on the CT-linac, as well as dose distribution comparison between planned and re-calculated based on IGRT FBCT image sets. METHODS: 11 sets of data from 5 male and 6 female patients who had underwent the TMLI treatment with uRT-linac 506c were selected for this study. The planning target volumes consist of all skeletal bones exclusion of the mandible and lymphatic sanctuary sites. A planned dose of 10 Gy was prescribed to all skeletal bones exclusion of the mandible in two fractions and 12 Gy in two fractions was prescribed to lymphatic sanctuary sites. Each TMLI plan contained two sub-plans, one dynamic IMRT for the upper body and the other VMAT for the lower extremity. Two attempts were made to obtain homogeneous dose in the overlapping region, i.e., applying two plans with different isocenters for the treatment of two fractions, and using a dose gradient matching scheme. The CT scans, including planning CT and IGRT FBCT, were stitched to a whole body CT scan for dose distribution evaluation. RESULTS: The average beam-on time of Planupper is 30.6 min, ranging from 24.9 to 37.5 min, and the average beam-on time of Planlower is 6.3 min, ranging from 5.7 to 8.2 min. For the planned dose distribution, the 94.79% of the PTVbone is covered by the prescription dose of 10 Gy (V10), and the 94.68% of the PTVlymph is covered by the prescription dose of 12 Gy (V12). For the re-calculated dose distribution, the 92.17% of the PTVbone is covered by the prescription dose of 10 Gy (V10), and the 90.07% of the PTVlymph is covered by the prescription dose of 12 Gy (V12). The results showed that there is a significant difference (p < 0.05) between planning V10, V12 and delivery V10, V12. There is no significant difference (p > 0.05) between planned dose and re-calculated dose on selected organs, except for right lens (p < 0.05, Dmax). The actual delivered maximum dose of right lens is apparently larger than the planned dose of it. CONCLUSION: TMLI treatment can be performed on the CT-linac with clinical acceptable quality and high efficiency. Evaluation of the recalculated dose on IGRT FBCT suggests the treatment was delivered with adequate target coverage.

A tumor cell exosome-mimicking multifunctional nanozyme for targeted breast cancer radiotherapy.

Radiotherapy (RT) has been extensively used for the treatment of breast cancer. However, the efficacy of RT is reduced by the high content of reducing species within cells (such as glutathione (GSH)). In addition, high-dose radiotherapy is often accompanied by serious side effects. In an attempt to resolve these issues, a tumor cell exosome-mimicking multifunctional nanozyme system (CuPy-Au@EM) was developed as a radiosensitizer, which consists of an internal AuNP-embedded CuPy nanozyme core and an external tumor cell exosome membrane. The exosome membrane protein on the surface of CuPy-Au@EM leads to the accurate localization of nano-materials in the tumor site; simultaneously, the level of H2O2 will be enhanced because of the GOx-like activity of AuNPs. Then CuPy-Au@EM would continue to trigger a rapid decline in cellular GSH content and the production of a large number of hydroxyl radicals (˙OH) through its glutathione peroxidase (GPx) and peroxidase (POD) activities allows for the extension of the radiotherapeutic cascade. Studies conducted in vivo and in vitro demonstrated that the combination of CuPy-Au@EM and moderate dose RT (4 Gy) can significantly reduce tumor proliferation. These findings indicated that CuPy-Au@EM nanospheres could be plausibly developed into promising radio-sensitizers on tumors.

Microfluidic Synthesis of the Tumor Microenvironment-Responsive Nanosystem for Type-I Photodynamic Therapy.

Type I photosensitizers with aggregation-induced emission luminogens (AIE-gens) have the ability to generate high levels of reactive oxygen species (ROS), which have a good application prospect in cancer photodynamic therapy (PDT). However, the encapsulation and delivery of AIE molecules are unsatisfactory and seriously affect the efficiency of a practical therapy. Faced with this issue, we synthesized the metal-organic framework (MOF) in one step using the microfluidic integration technology and encapsulated TBP-2 (an AIE molecule) into the MOF to obtain the composite nanomaterial ZT. Material characterization showed that the prepared ZT had stable physical and chemical properties and controllable size and morphology. After being endocytosed by tumor cells, ZT was degraded in response to the acidic tumor microenvironment (TME), and then TBP-2 molecules were released. After stimulation by low-power white light, a large amount of •OH and H2O2 was generated by TBP-2 through type I PDT, thereby achieving a tumor-killing effect. Further in vitro cell experiments showed good biocompatibility of the prepared ZT. To the best of our knowledge, this report is the first on the microfluidic synthesis of multifunctional MOF for type I PDT in response to the TME. Overall, the preparation of ZT by the microfluidic synthesis method provides new insight into cancer therapy.

Synergistic Radiosensitization Mediated by Chemodynamic Therapy via a Novel Biodegradable Peroxidases Mimicking Nanohybrid.

Purpose: Reactive oxygen species (ROS) are practically essential in radiotherapy to damage cancer cells; however, they are always inadequate for some malignant entities. Here, we designed a biodegradable mesoporous silica decorated with hemin and glucose oxidase (GOD@Hemin-MSN) to generate a chemodynamic therapy in order to enhance the killing capacity of radiotherapy. Methods: Mesoporous silica, as an outstanding drug carrier, can deliver hemin and glucose oxidase to the tumor site. With high level of metabolism activity, cancer cells are abundant in glucose, which can be oxidized into H2O2 by glucose oxidase (GOD) on site. The generated H2O2 is subsequently converted into intracellular ROS, especially hydroxyl radical within the tumor microenvironment, by hemin, which has mimetic peroxidase properties. By this means, the ROS can be supplemented or enriched to facilitate the killing of tumor cells. Results: The chemodynamic therapy induced by GOD@Hemin-MSN produced quantities of ROS, which compensated for their inadequacy as a result of radiotherapy, and exhibited remarkable antitumor efficacy, with a tumor inhibition rate of 91.5% in A549 tumor-bearing mice. Conclusion: This work has validated GOD@Hemin-MSN as a radiosensitizer in chemodynamic therapy, which showed biocompatibility and potential for translational application.

Platelet Membranes Coated Gold Nanocages for Tumor Targeted Drug Delivery and Amplificated Low-Dose Radiotherapy.

Continuous high doses of radiation can cause irreversible side effects and radiation resistance; thus, advanced radiosensitizers are urgently needed. To overcome this problem, we developed a nano platelet radiosensitization system (PCA) by coating the chemotherapeutic drug cisplatin (CDDP) loaded gold nanocages (AuNs) within the platelet membrane. The developed PCA system may enable AuNs to have immune escape and targeting capabilities. After administration, PCA will actively target tumor cells and avoid being cleared by the immune system. Subsequently, CDDP, which destroys tumor cell DNA, can not only kill tumor cells directly but also combine with AuNs, which deposit radiation energy into tumor tissues, reducing RT resistance. In vivo and in vitro studies revealed that the combination of PCA with RT (2Gy) efficiently inhibits tumor proliferation without causing side effects such as inflammation. To conclude, this is the first attempt to use platelet membranes to correctly transport AuNs while also accomplishing low-dose RT, which could help AuNs-based tumor RT become more effective.

A Novel H2O2 Generator for Tumor Chemotherapy-Enhanced CO Gas Therapy.

Carbon monoxide (CO) gas therapy is a promising cancer treatment. However, gas delivery to the tumor site remains problematic. Proper tunable control of CO release in tumors is crucial to increasing the efficiency of CO treatment and reducing the risk of CO poisoning. To overcome such challenges, we designed ZCM, a novel stable nanotechnology delivery system comprising manganese carbonyl (MnCO) combined with anticancer drug camptothecin (CPT) loaded onto a zeolitic imidazole framework-8 (ZIF-8). After intravenous injection, ZCM gradually accumulates in cancerous tissues, decomposing in the acidic tumor microenvironment, releasing CPT and MnCO. CPT acts as a chemotherapy agent destroying tumors and producing copious H2O2. MnCO can react with the H2O2 to generate CO, powerfully damaging the tumor. Both in vitro and in vivo experiments indicate that the ZCM system is both safe and has excellent tumor inhibition properties. ZCM is a novel system for CO controlled release, with significant potential to improve future cancer therapy.

An Injectable Hydrogel for Enhanced FeGA-Based Chemodynamic Therapy by Increasing Intracellular Acidity.

Hydroxyl radical (•OH)-mediated chemodynamic therapy (CDT) is an emerging antitumor strategy, however, acid deficiency in the tumor microenvironment (TME) hampers its efficacy. In this study, a new injectable hydrogel was developed as an acid-enhanced CDT system (AES) for improving tumor therapy. The AES contains iron-gallic acid nanoparticles (FeGA) and α-cyano-4-hydroxycinnamic acid (α-CHCA). FeGA converts near-infrared laser into heat, which results in agarose degradation and consequent α-CHCA release. Then, as a monocarboxylic acid transporter inhibitor, α-CHCA can raise the acidity in TME, thus contributing to an increase in ·OH-production in FeGA-based CDT. This approach was found effective for killing tumor cells both in vitro and in vivo, demonstrating good therapeutic efficacy. In vivo investigations also revealed that AES had outstanding biocompatibility and stability. This is the first study to improve FeGA-based CDT by increasing intracellular acidity. The AES system developed here opens new opportunities for effective tumor treatment.

Oral pH value predicts the incidence of radiotherapy related caries in nasopharyngeal carcinoma patients.

Radiotherapy-related caries is a complication of radiotherapy for nasopharyngeal carcinoma; however, factors influencing the occurrence, accurate prediction of onset, and protective factors of radiotherapy-related caries remain unclear. This study analyzed risk factors, disease predictors, and protective factors for radiotherapy-related caries in nasopharyngeal carcinoma. This prospective study included 138 nasopharyngeal carcinoma patients receiving radical radiotherapy at our hospital during June 2012-December 2016 and were followed up for dental caries. Patients' clinical data on radiotherapy were collected, dynamic monitoring was performed to assess changes in oral pH values, and a questionnaire survey was administered to collect patients' lifestyle habits. Time-dependent cox regression trees, event-free Kaplan-Meier curve, Mann-Whitely U test were used to analysis the results. The median follow-up time was 30 (12-60) months. Radiotherapy-related caries occurred in 28 cases (20.3%). Univariate analyses showed that radiotherapy-related caries was associated with patient's age, oral saliva pH value, green tea consumption, and radiation dose to sublingual glands, but not with the radiation dose to the parotid and submandibular glands. Multivariate analysis showed that oral saliva pH value [hazard ratio (HR) = 0.390, 95% confidence interval = 0.204-0.746] was an independent prognostic factor for radiotherapy-related caries. Patients with oral saliva pH values ≤ 5.3 in the 9th month after radiotherapy represented a significantly higher risks for radiotherapy-related caries (p < 0.001). Green tea consumption was associated with the occurrence of radiotherapy-related caries, and oral saliva pH values could predict the occurrence of radiotherapy-related caries. Limiting radiation doses to sublingual glands can reduce the occurrence of radiotherapy-related caries.

Radiation dosimetry effect evaluation of a carbon fiber couch on novel uRT-linac 506c accelerator.

Recently, a diagnostic helical CT is integrated into a linear accelerator, called uRT-linac 506c, whose CT scanning dataset can be directly used to do simulation. This novel structure provides a possibility for online adaptive radiotherapy. For adaptive radiotherapy, the carbon fiber couch is an essential external device for supporting and positioning patients. And the effect on dose attenuation and distribution caused by a couch is inevitable and vital for precise treatment. In this research, the couch equipped with uRT-linac 506c was evaluated on the radiation dosimetry effect. The treatment couch equipped on the uRT-linac 506c accelerator was evaluated, and its effect on the attenuation, surface dose and dose buildup were measured for different phantom positions (offset = 0 cm, offset = + 10 cm and offset = - 10 cm, respectively) and different gantry angles. Since uRT-linac 506c is exclusively capable to provide diagnostic CT scanning data with real relative electron density (RED), this CT scanning data of the couch can be used directly in uRT-TPS to design plans. This scanned couch dataset was designated as the model A. The model B was a dummy structure of a treatment couch inserted with artificially preset RED. The dose calculation accuracy of these two models was compared using PB, CC, and MC on uRT-TPS. With the effect of carbon fiber couch, the surface dose was increased at least 97.94% for 25 × 25 cm2 field and 188.83% for 10 × 10 cm2 field, compared with those without. At different phantom positions (offset = 0, + 10, - 10 cm), the attenuation for 6 MV photon beam at gantry angle 180° were 4.4%, 4.4%, and 4.3%, respectively, and varied with changes of gantry angle. There do exists dose deviation between measurement and TPS calculation with the involvement of treatment couch, among the three algorithms, MC presented the least deviation, and the model A made less and steadier deviation than the model B, showing promising superiority. The attenuation, surface dose, and buildup effects of the carbon fiber couch in this study were measured similarly to most counterparts. The dose deviation calculated based on the couch dataset scanned by the diagnostic helical CT was smaller than those based on a dummy couch. This result suggests that an accelerator equipped with a diagnostic CT, which can help reduce the dose deviation of the carbon fiber couch, is a promising platform for online adaptive radiotherapy.

Pretreatment serum vitamin level predicts severity of radiation-induced oral mucositis in patients with nasopharyngeal carcinoma.

BACKGROUND: Radiation-induced mucositis (RIOM) is a common radiotherapy toxicity. We aimed to evaluate the relationship of serum vitamin status with RIOM among nasopharyngeal carcinoma (NPC) patients who underwent radiotherapy. METHODS: NPC patients who underwent concurrent chemoradiotherapy with available pretreatment serum vitamin values were included. Serum vitamin levels and clinical characteristics were collected. Logistic regression analysis and receiver operating characteristic curves were conducted to explore the potential risk factors and corresponding cut-off values for severe RIOM. RESULTS: Two hundred and forty NPC patients were enrolled. Multivariate regression analysis showed that mean oral cavity radiation dose (OR = 2.042; 95% CI = 1.585-2.630; P < .001), weekly concurrent chemotherapy (OR = 3.898; 95% CI = 1.085-14.004; P = .037), lower serum level of vitamin B2 (OR = 0.951; 95% CI = 0.924-0.978; P < .001), and vitamin C (OR = 0.455; 95% CI = 0.346-0.598; P < .001) were independent risk factors for developing severe RIOM. CONCLUSIONS: The findings of this study revealed that serum vitamin status could predict the severity of RIOM, providing a theoretical basis for the prevention and treatment of RIOM.

Analyzation of the local confidence limits for IMRT and VMAT based on AAPM TG119 report.

The aim of this study was to generate a local confidence limit (CL) for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques for Clinac IX linear accelerator using the American Association of Physicists in Medicine (AAPM) Task Group (TG119) protocol. The results were compared with the published studies to test the capability and quality of the VMAT technique in our clinic. We used TG119 cases to create plans for IMRT and VMAT in Eclipse Treatment Planning System for Clinac IX using 6 MV and 10 MV photons. Two preliminary and 5 clinical test cases were created based on the dose prescriptions and planning objectives provided by TG119. Verification plans were created in a planning slab phantom, 2D matrix dosimetry system (MatriXX) with multicube phantom and a volumetric phantom (Delta4). Radiation absorption doses to high-dose points in the planning target volume region and low-dose points in avoidance structures were measured with a 0.125 cc semiflex thimble ionization chamber (PTW). The measured and planned doses were normalized with respect to their prescription doses and intercompared with each other. The gamma analysis was carried out for MatriXX and Delta4 adopting the acceptance criteria of 3% dose difference and 3 mm distance to agreement with 10% threshold dose, respectively. The local CLs with the bench mark set by TG119 were obtained for point, composite planar and field-by-field measurements for IMRT and VMAT with different energies. In this study, the CLs for the high-dose regions of IMRT with 6 MV and 10 MV were 0.025 and 0.014, respectively. For VMAT, they were 0.032 and 0.018. The counterpart CL was 0.045 in TG119. And in organs at risk region, the CLs of IMRT with 6 MV and 10 MV beam were 0.022 and 0.019, respectively, with the counterpart CL indicated by TG119 was 0.047. For VMAT with 6 MV and 10 MV photon beams, the CLs were measured 0.030 and 0.027 with Delta4, respectively. The CLs of the maximum gamma passing for all values were 2.0 in 6 MV VMAT plan, which however recommended in TG119 was 12.4. The data presented here showed all the CLs in our clinic meet the criteria of TG119 report well. All these local CLs reached the goals mentioned in AAPM TG119, which indicated that the local clinic had commissioned IMRT and VMAT techniques with adequate accuracy. Prior to the clinical application practice, it is essential to verify with the TG119 test cases for IMRT and VMAT, which allows us to better understand the basic capability of VMAT technology.

Dosimetric comparison of different algorithms in stereotactic body radiation therapy (SBRT) plan for non-small cell lung cancer (NSCLC).

PURPOSES: The main aim of the study was to investigate the dosimetric difference between acuros XB algorithm (AXB), anisotropic analytic algorithm (AAA), and pencil beam convolution (PBC) algorithm in stereotactic body radiation therapy (SBRT) plan for non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Thirty-eight NSCLC patients were included. GTV, PTV, and organs at risk were delineated by the radiation oncologists. Three optimized SBRT plans for each patients were gained using three algorithms of AXB, AAA, and PBC with the identical plan parameters. Dosimetric endpoints were collected and compared among the three plans, including dosimetric criteria: V100%, V90%, PTV Dmin, Dmax, Dmean, homogeneity index (HI), and Paddick conformity index (CI). RESULTS: AXB plan resulted in decreased V100% with a mean difference 6.14% compared with PBC plan (For V100%, AXB vs AAA vs PBC=93.44% vs 95.54% vs 99.58%, P<0.05). Three plans showed no significant difference as to the parameter V90%. AXB plan leaded to reduced Dmin of PTV compared with other two algorithms (For Dmin of PTV, AXB vs AAA vs PBC=4048cGy vs 4365Gy vs 4873Gy, P<0.05). PBC induced the enhanced trend of Dmax of PTV compared with other two algorithms (Dmax among three algorithms, P>0.05); and increased the Dmean of PTV in three algorithms with significant difference (For Dmean of PTV, AXB vs AAA vs PBC=5332cGy vs 5330Gy vs 5785Gy, P<0.05). AXB algorithm achieved a similar plan conformity with other two algorithms (For CI, AXB vs AAA vs PBC=0.80 vs 0.85 vs 0.71, P>0.05). CONCLUSION: For SBRT plan of NSCLC, AAA and PBC algorithms overestimate target coverage, AXB algorithm is recommended for the SBRT plan of NSCLC.

Optimal dose limitation strategy for bone marrow sparing in intensity-modulated radiotherapy of cervical cancer.

BACKGROUND: To quantify the dosimetric parameters of different bone marrow sparing strategies and to determine the optimal strategy for cervical cancer patients undergoing postoperative intensity-modulated radiotherapy (IMRT). METHODS: Fifteen patients with cervical cancer were selected for analysis. The planning target volume (PTV) and the organs at risks (OAR) including small bowel, bladder, rectum, femoral heads, os coxae (OC), lumbosacral spine (LS) and bone marrow (BM) were contoured. For each patient, four IMRT plans with different strategies were generated, including one plan without BM as the dose-volume constraint, namely IMRT (N) plan, and three bone marrow sparing (BMS-IMRT) plans. The three BMS-IMRT plans used the BM, OC, OC and LS respectively, as the BM OAR, namely as IMRT (BM), IMRT (OC) and IMRT (OC + LS) plans. Dose volumes for the target and the OARs were compared using analysis of variance (ANOVA). RESULTS: Compared with IMRT (N) plans, the dose to the small bowel, bladder, rectum and femoral heads showed no increase in the three BMS-IMRT plans. However, the irradiated dose to BM, OC and LS significantly decreased. In particular, the mean dose of BM, OC and LS decreased by about 5Gy (p < 0.05) in IMRT (BM) plans while the average volume receiving ≥20, ≥30, ≥40Gy decreased by 7.1-24.2%. The LS volume receiving 40Gy showed the highest decrease (about 31.2%, p < 0.05) in IMRT (OC + LS) plans. On the other hand, in comparison with IMRT (BM), IMRT (OC) reduced the dose volume of to the OC, but increased the dose to LS while IMRT (OC + LS) plans reduced both the OC and the LS volume at all dose levels. Specifically, the V20 of OC and LS in the IMRT (OC + LS) plan decreased by 11.5 and 11.2%, respectively. CONCLUSION: By introducing the os coxae and lumbosacral spine as the dose-volume constraints, the IMRT plans exhibited the best sparing of the bone marrow without compromising the dose to surrounding normal structures. Therefore, we recommend adding the os coxae and lumbosacral spine as the BM OAR in such plans.

Value of multi-b value DWI in the assessment of early cerebral changes in asymptomatic HIV-positive adolescents.

Background Magnetic resonance imaging (MRI) and functional MRI techniques have been widely used in the diagnosis of human immunodeficiency virus (HIV) infection related diseases. Purpose To explore whether magnetic resonance diffusion-weighted imaging (DWI) can track water molecular diffusion changes in the brain of asymptomatic HIV-positive adolescents. Material and Methods Multi-b value DWI was performed in 23 adolescents, including 15 HIV-positive participants and eight HIV-negative healthy participants. Mean apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (ADCs) values, fast apparent diffusion coefficient (ADCf) values, distribution diffusion coefficient (DDC) values, and heterogeneity index (α) values were calculated within regions of interest (ROIs) in the frontal lobes, basal ganglia, and temporal lobe. Non-parametric tests were then performed. Results In the bilateral frontal lobes, the mean α values in HIV-positive participants were significantly increased compared with those in healthy participants (right side P = 0.001; left side P = 0.000). In the left frontal lobe, the mean DDC value in HIV-positive participants was significantly increased compared with that in healthy participants ( P = 0.008). In the bilateral frontal lobes, the mean ADCf values in HIV-positive participants were significantly lower than those in healthy participants (right side P = 0.011; left side P = 0.008). In the left basal ganglia, the mean α values in HIV-positive participants were significantly lower than that in healthy participants ( P = 0.013). Conclusion Multi-b value DWI could reflect the early characteristics of water molecule diffusion in HIV infections.

Application of brain multi-b-value diffusion-weighted imaging (DWI) in adolescent orphans from AIDS families.

OBJECTIVE: To evaluate the application value of multi-b-value diffusion-weighted imaging (DWI) with mono-exponential model and stretched-exponential model in the diagnosis of HIV-positive patients. METHODS: Multi-b-value (0, 50, 150, 200, 400, 600, 800 s mm(-2)) DWI was performed in 23 adolescent orphans from AIDS families, including 15 HIV-positive subjects and 8 HIV-negative healthy subjects. Apparent diffusion coefficient (ADC) values were fitted by mono-exponential model; distribution diffusion coefficient (DDC) values and heterogeneity index (α) values were fitted by stretched-exponential model in bilateral basal ganglia, then non-parametric tests were performed. RESULTS: The signal intensity attenuation in multi-b-value DWI could be well described by both mono-exponential model and stretched-exponential model. In the left basal ganglia, mean α-values in HIV-positive subjects (α = 0.848 ± 0.068) were significantly lower than that in healthy subjects (α = 0.923 ± 0.050, p = 0.013). There was no statistical difference of α-values between HIV-positive subjects and healthy control subjects in the right basal ganglia. Apart from these, there were also no statistical differences of DDC values or ADC values between two groups in bilateral basal ganglia (all p > 0.05). In bilateral basal ganglia, DDC values were positively correlated with ADC values in HIV-positive patients (right basal ganglia: r = 0.832, p = 0.000; left basal ganglia: r = 0.770, p = 0.001) as well as in healthy cases (right basal ganglia: r = 0.927, p = 0.001; left basal ganglia: r = 0.878, p = 0.004). Receiver operating characteristic (ROC) curve analysis yielded area under the ROC curve (Az) values of 0.817 (p = 0.014 < 0.05) in the left basal ganglia. The sensitivity and specificity were 62.5% and 86.7%, respectively. CONCLUSION: Through the study of asymptomatic HIV-positive subjects when b < 1000 s mm(-2), we can see stretched-exponential model DWI can provide more information than mono-exponential model DWI. ADVANCES IN KNOWLEDGE: Multi-b-value DWI was performed in subjects with HIV. DWI measurements could be neuroimaging biomarkers of cerebral injury in the course of HIV infection.

Thermally stable amorphous mesoporous aluminophosphates with controllable P/Al ratio: synthesis, characterization, and catalytic performance for selective O-methylation of catechol.

Amorphous mesoporous aluminophosphates (AlPO) with P/Al molar ratio in the range 0.8-1.15 are synthesized by using the citric acid (CA) route and are systematically characterized using N(2)-adsorption, XRD, SEM, solid-state CP-MAS NMR, FT-IR, TG-DTA, CO(2)-TPD, and NH(3)-TPD. The characterization studies show that the change in P/Al ratio could affect the structure, texture, thermal stability, and surface acid-base properties of AlPO. Samples with a relatively low P/Al ratio (< or =1.0) exhibit uniform amorphous mesoporous character and high thermal stability (up to 1173 K). Partial crystallization of the AlPO framework easily occurred on the sample with higher P/Al ratio (> or =1.1), thus leading to significant decrease of surface area and formation of particle pile mesopores. Both weak acid and weak base sites are observed over AlPO materials, and the amounts of acid-base sites can be effectively controlled by adjusting the P/Al ratio. The presence of suitable interaction between citric acid and AlPO framework is critical for the formation of mesoporous structures. Both CA and PO(4) units are considered to be ligands to coordinate with aluminum ions, forming relative uniform complexes (such as CA-Al-PO(4)) in the as-synthesized AlPO materials. The mesoporous structure of AlPO materials is obtained after the rapid decomposition of citric acid. Vapor phase selective O-methylation of catechol with methanol reaction is carried out to investigate the catalytic performances of AlPO materials with different P/Al ratios. Among them, AlP(1.1)O shows the highest activity (88.4% conversion of catechol) and the highest yield of guaiacol (74.3%). The presence of suitable weak acid-base pairs may play an important role on the title reaction.

Synthesis and pore formation study of amorphous mesoporous aluminophosphates in the presence of citric acid.

Amorphous mesoporous aluminophosphates (AlPO) with high thermal stability were synthesized from Al(NO3)3 and H3PO4 in the presence of citric acid (CA). The effects of different synthetic conditions, such as pH value, citric acid content, and calcined temperature, on the formation of the mesoporous structure of AlPO materials were investigated. The results of N2 adsorption/desorption and other characterization means demonstrate that the presence of a certain amount of citric acid in the synthetic mixture can result in the formation of uniform mesoporous AlPO materials in a wide pH range from 3.5 to 10. Thermal gravimetry and differential thermal analysis suggest that the existence of a moderate interaction between citric acid and the AlPO network might be a critical factor in obtaining uniform mesostructure. Therefore, as an organic additive, citric acid can be regarded as a template for the mesopore formation of AlPO materials.

Synthesis of amorphous mesoporous aluminophosphate materials with high thermal stability using a citric acid route.

Amorphous mesoporous aluminophosphate materials synthesized from precursors of Al(NO3)3/H3PO4/NH4OH in the presence of citric acid, exhibit high specific surface areas, narrow pore size distributions and excellent thermal stabilities.