Background: Due to the large variability in the prostate gland of different patient groups, manual segmentation is time-consuming and subject to inter-and intra-reader variations. Hence, we propose a U-Net model to automatically segment the prostate and its zones, including the peripheral zone (PZ), transitional zone (TZ), anterior fibromuscular stroma (AFMS), and urethra on the MRI [T2-weighted (T2W), diffusionweighted (DWI), and apparent diffusion coefficient (ADC)], and multimodality image fusion.Methods: A total of 91 eligible patients were retrospectively identified; 50 patients were considered for training process in a 10-fold cross-validation fashion and 41 ones for external test. Firstly, images were registered, and cropping was performed through a bounding box. In addition to T2W, DWI, and ADC separately, fused images were used. We considered three combinations, including T2W+DWI, T2W+ADC, and DWI+ADC, using wavelet transform. U-Net was applied to segment the prostate and its zones, AFMS, and urethra in a 10-fold cross-validation fashion. Eventually, dice score (DSC), intersection over union (IoU), precision, recall, and Hausdorff distance (HD) were used to evaluate the proposed model.Results: Using T2W images alone on the external test images, higher DSC, IoU, precision, and recall was achieved than the individual DWI and ADC images.
Background: Accurate dose assessment and correct identification of irradiated from non-irradiated people are goals of biological dosimetry in radiation accidents. Objectives: Changes in the FDXR and the RAD51 gene expression (GE) levels were here analyzed in response to total body exposure (TBE) to a 6 MV x-ray beam in rats. We determined the accuracy for absolute quantification of GE to predict the dose at 24 hours. Materials and Methods: For this in vivo experimental study, using simple randomized sampling, peripheral blood samples were collected from a total of 20 Wistar rats at 24 hours following exposure of total body to 6 MV X-ray beam energy with doses (0.2, 0.5, 2 and 4 Gy) for TBE in Linac Varian 2100C/D (Varian, USA) in Golestan Hospital, in Ahvaz, Iran. Also, 9 rats was irradiated with a 6MV X-ray beam at doses of 1, 2, 3 Gy in 6MV energy as a validation group. A sham group was also included. After RNA extraction and DNA synthesis, GE changes were measured by the QRT-PCR technique and an absolute quantification strategy by taqman methodology in peripheral blood from rats. ROC analysis was used to distinguish irradiated from non-irradiated samples (qualitative dose assessment) at a dose of 2 Gy. Results: The best fits for mean of responses were polynomial equations with a R2 of 0.98 and 0.90 (for FDXR and RAD51 dose response curves, respectively). Dose response of the FDXR gene produced a better mean dose estimation of irradiated "validation" samples compared to the RAD51 gene at doses of 1, 2 and 3 Gy. FDXR gene expression separated the irradiated rats from controls with a sensitivity, specificity and accuracy of 87.5%, 83.5% and 81.3%, respectively, 24 hours after dose of 2 Gy. These values were significantly (p<0.05) higher than the 75%, 75% and 75%, respectively, obtained using gene expression of RAD51 analysis at a dose of 2 Gy. Conclusions: Collectively, these data suggest that absolute quantification by gel purified quantitative RT-PCR can be used to measure the mRNA copies for GE biodosimetry studies at comparable accuracy to similar methods. In the case of TBE with 6MV energy, FDXR gene expression analysis is more precise than that with RAD51 for quantitative and qualitative dose assessment.
Background: Mean inactivation dose is a useful radiobiological parameter for the comparison of human cell survival curves. Objectives: Given the importance and accuracy of these parameters, in the present study, the radio sensitivity enhancement of colon cancer (HT-29) cells in the presence of gold nanoparticles (GNPs) were studied using the mean inactivation dose (MID). Materials and Methods: Naked-GNPs with 50 nm diameters were incubated with HT-29 cells. The cytotoxicity and uptake of these particles on HT-29 cells were assessed. After determining the optimum GNPs concentration, the cells were incubated with gold nanoparticle for 24 hours. The change in the MID value as well as the radio sensitization enhancement under irradiation with 9 MV X-ray beams in the presence of GNPs were evaluated by multiple (3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) MTS assay. Results: Cell survival in the presence of GNPs was more than 90% and the maximum uptake of GNPs was observed at 60 µM of gold nanoparticles. In contrast, in the presence of GNPs combined with radiation, cell survival and MID value significantly decreased, so that the radio sensitization enhancement was 1.4. Conclusions: Due to the significant reduction in the mean inactivation dose of colon cancer cells in the presence of gold nanoparticles, it seems that GNPs are suitable options to achieve a new approach in order to improve radiotherapy efficiency without increasing the prescribed radiation dose.
Utilization of high energy photons (>10MV) with an optimal weight using a mixed energy technique is a practical way to generate a homogenous dose distribution while maintaining adequate target coverage in intact breast radiotherapy. This study represents a model for estimation of this optimal weight for day to day clinical usage. For this purpose, treatment planning computed tomography scans of thirty-three consecutive early stage breast cancer patients following breast conservation surgery were analyzed. After delineation of the breast clinical target volume (CTV) and placing opposed wedge paired isocenteric tangential portals, dosimeteric calculations were conducted and dose volume histograms (DVHs) were generated, first with pure 6MV photons and then these calculations were repeated ten times with incorporating 18MV photons (ten percent increase in weight per step) in each individual patient. For each calculation two indexes including maximum dose in the breast CTV (D max ) and the volume of CTV which covered with 95% Isodose line (V CTV, 95%IDL ) were measured according to the DVH data and then normalized values were plotted in a graph. The optimal weight of 18MV photons was defined as the intersection point of D max and V CTV, 95%IDL graphs. For creating a model to predict this optimal weight multiple linear regression analysis was used based on some of the breast and tangential field parameters.The best fitting model for prediction of 18MV photons optimal weight in breast radiotherapy using mixed energy technique, incorporated chest wall separation plus central lung distance (Adjusted R2=0.776). In conclusion, this study represents a model for the estimation of optimal beam weighting in breast radiotherapy using mixed photon energy technique for routine day to day clinical usage.
Relative electron densities of body tissues (ρ) for radiotherapy treatment planning are normally obtained by CT scanning of tissue substitute materials (TSMs) and producing a Hounsfield Unit-ρ calibration curve. Aiming for more accurate, simultaneous characterization of ρ and effective atomic number (Z) of real tissues, an in-house phantom (including 10 water solutions plus composite cork as TSMs) was constructed and scanned at 4 kVps. Dual-energy algorithms were applied to 80-140 and 100-140 kVp combination scans, for better differentiation of tissues with same attenuation coefficient at 120 kVp but different ρ and Z. Stoichiometric calibration and closeness of the ρ of the 11 TSMs to real tissues (≤ 0.5%) resulted in smaller ρ calculation discrepancies, compared to studies with commercial phantoms (p < 0.024). Applying an energy subtraction algorithm further mitigated errors by spectral separation and reduction of beam hardening artifacts and noise, reducing the mean and standard deviation of the absolute difference of ρ at 80-140 kVp (p < 0.003) and 100-140 kVp (p < 0.0001) scans, compared to 120 kVp scan, respectively. Moreover, a parametrization algorithm decreased the Z discrepancy from real tissues at 80-140 kVp scans; for thyroid, the residual error was ≤ 0.18 units of Z (vs. 0.2 with the Gammex 467 phantom from a previous study). These results further suggest that a dual-energy algorithm in combination with stoichiometry can decrease errors in calculation of the ρ of real tissues to ameliorate inhomogeneity for dose calculation in radiotherapy treatment planning, especially when the energy spectrum of the X-ray tube of the CT machine is not available.
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