SU-E-T-394: Comparison of Planned Dose Distribution Vs. Delivered Dose Distribution for Both IMRT and Proton Therapy Using Weekly Repeat 4DCT Data Sets

PURPOSE

To evaluate treatment deviations and the impact of treatment modality in the presence of breathing motion and anatomical changes during the course of lung cancer radiotherapy.

METHODS

Two non-small cell lung cancer patients were enrolled in a randomized clinical trial to compare IMRT and proton therapy. To rigorously evaluate the impact of motion and anatomical changes, we used a '5D' dose accumulation approach to sum dose distributions from phase-to-phase and week-to-week to the reference (end-expiration) phase of the original planning 4DCT data set. Six to eight weekly 4DCT data sets that consisted of 10 breathing phases were acquired during the treatment course. The original plan was re-calculated for each phase and deformably mapped to the reference phase to compare the 'delivered' dose distribution with the planned dose distribution of both the IMRT plan and the proton plan for each patient. DVHs derived from delivered dose distribution were compared to that from the planned dose distribution.

RESULTS

The delivered dose showed 3% and 2% increase in the dose to the CTV for IMRT and proton plan respectively. Target coverage remained acceptable despite tumor shrinkage from 29% to 49%. The doses to normal structures, such as lung and heart, increased more in the proton plan than in the IMRT plan. The V20 of the total lung volume increased by 4% and 6% from the delivered dose compared to the planned dose for IMRT and proton plan, respectively.

CONCLUSIONS

The results showed sufficient target coverage was maintained for both modalities. Increases in lung dose were observed in both modalities, but more in the proton arm, perhaps due to weight loss and tumor shrinkage. Adaptive proton therapy strategy is recommended to minimize normal tissue doses. Supported in part by NCI P01 CA021239-29A1.

SU-E-J-186: CT Textures Can be Predictive for Tumor Shrinkage

PURPOSE

To determine if NSCLC GTV CT textures can be predictive for tumor shrinkage after proton therapy with concurrent chemotherapy.

METHODS

Simulation and weekly 4DCTs were obtained from 25 patients with locally advanced NSCLC treated by proton therapy at a 74 Gy dose level with concurrent chemotherapy. In-house deformable image registration software based on the demons algorithm propagated the physician-generated planning GTV onto each weekly image set. GTV soft tissue volumes were then extracted from CT images by in-house software which pruned out voxels below a cutoff HU threshold. Patients whose normalized end-treatment pruned GTV was less than the group median were classified as 'strong responders.'The remaining patients were classified as 'weak responders.' For each pruned GTV, the MaZda texture analysis software generated quantitative 3D texture features based on the image histogram, absolute gradient, co-occurrence matrix, and run-length matrix. Using the Fisher coefficient, a subset of these texture features that were relevant to distinguishing the two response groups was obtained. In-house software and MaZda were then used to perform neural network data classification with leave-one-out cross-validation based on this texture feature subset. The true positive rate (TPR), false positive rate (FPR), classification accuracy, and one-sided p-values were recorded.

RESULTS

Six classification models were tested. Each model had a unique combination of feature extraction and analysis parameters. Taking 'strong responders' to be the 'positive' class, the average TPR was 0.66 (0.60 - 0.75), the average FPR was 0.36 (0.31 - 0.40), the average classification accuracy was 64.8% (60.0% - 68.0%), and the average one-sided p-value was 0.118 (0.055 - 0.215).

CONCLUSIONS

There is some evidence showing that NSCLC GTV CT textures can be predictive for tumor shrinkage after proton therapy. Further work should be done to include more patients, texture metrics, and data analysis techniques. The presenting author receives funding support from a Hertz Foundation Applied Science Fellowship.

Optimal Design for Marker-assisted Gene Pyramiding in Cross Population

Marker-assisted gene pyramiding aims to produce individuals with superior economic traits according to the optimal breeding scheme which involves selecting a series of favorite target alleles after cross of base populations and pyramiding them into a single genotype. Inspired by the science of evolutionary computation, we used the metaphor of hill-climbing to model the dynamic behavior of gene pyramiding. In consideration of the traditional cross program of animals along with the features of animal segregating populations, four types of cross programs and two types of selection strategies for gene pyramiding are performed from a practical perspective. Two population cross for pyramiding two genes (denoted II), three population cascading cross for pyramiding three genes(denoted III), four population symmetry (denoted IIII-S) and cascading cross for pyramiding four genes (denoted IIII-C), and various schemes (denoted cross program-A–E) are designed for each cross program given different levels of initial favorite allele frequencies, base population sizes and trait heritabilities. The process of gene pyramiding breeding for various schemes are simulated and compared based on the population hamming distance, average superior genotype frequencies and average phenotypic values. By simulation, the results show that the larger base population size and the higher the initial favorite allele frequency the higher the efficiency of gene pyramiding. Parents cross order is shown to be the most important factor in a cascading cross, but has no significant influence on the symmetric cross. The results also show that genotypic selection strategy is superior to phenotypic selection in accelerating gene pyramiding. Moreover, the method and corresponding software was used to compare different cross schemes and selection strategies.

SU-E-J-52: Validation of 3D Structure Projection Onto 2D DRR in Commercial Treatment Planning Systems

PURPOSE

The use of structure overlay on setup DRRs can aid the image alignment procedure for daily image-guided setup procedures. However, the accuracy of a 3D region-of-interest (ROI) projected on a 2D digitally reconstructed radiograph (DRR) has rarely been evaluated quantitatively. The goal of this study is to test the accuracy of two commercial treatment planning systems (TPS) in producing overlay structures on setup DRRs.

METHOD AND MATERIALS

We designed a novel method to identify landmarks which were on the boundary of the projected ROI on a DRR. The 3D ROIvolume is composed of a stack of 2D curves. We first mathematically project each 2D curve onto a beams-eye-view (BEV) plane. Next, we detectthe boundary points of the projected curves. Those boundary points serve aslandmarks. Finally, we project the binary mask of the 3D ROI volume using ray tracing method onto the BEV plane. This projected binary mask is used to exclude the false landmarks. Once those landmarks are detected, wecompute the distance between the landmarks and ROI outlines from the TPS.

RESULTS

We applied our validation method to 13 ROIs from a lung patient and 4 simulated ROIs on 2 BEV DRRs for two different TPS (Eclipse and Pinnacle). Average distance between the landmarks and ROIoutlines was 0.5mm for both Eclipse and Pinnacle approaches, which is close to the pixel resolution of the DRR. The maximum distance andaverage maximum distance was 2mm and 1 mm, respectively, for both TPS.The maximum distance occurred at points where the ROI curve has a sharpchange between slices.

CONCLUSION

The accuracy of Eclipse and Pinnacle ROI projection method seems to be acceptable to within 1mm althoughprojection error can be as large as 2mm when structure shape has a sharp variation from one slice to the next.

Leukemia-related chromosomal loss detected in hematopoietic progenitor cells of benzene-exposed workers

Benzene exposure causes acute myeloid leukemia and hematotoxicity, shown as suppression of mature blood and myeloid progenitor cell numbers. As the leukemia-related aneuploidies monosomy 7 and trisomy 8 previously had been detected in the mature peripheral blood cells of exposed workers, we hypothesized that benzene could cause leukemia through the induction of these aneuploidies in hematopoietic stem and progenitor cells. We measured loss and gain of chromosomes 7 and 8 by fluorescence in situ hybridization in interphase colony-forming unit-granulocyte-macrophage (CFU-GM) cells cultured from otherwise healthy benzene-exposed (n=28) and unexposed (n=14) workers. CFU-GM monosomy 7 and 8 levels (but not trisomy) were significantly increased in subjects exposed to benzene overall, compared with levels in the control subjects (P=0.0055 and P=0.0034, respectively). Levels of monosomy 7 and 8 were significantly increased in subjects exposed to <10 p.p.m. (20%, P=0.0419 and 28%, P=0.0056, respectively) and ≥ 10 p.p.m. (48%, P=0.0045 and 32%, 0.0354) benzene, compared with controls, and significant exposure-response trends were detected (P(trend)=0.0033 and 0.0057). These data show that monosomies 7 and 8 are produced in a dose-dependent manner in the blood progenitor cells of workers exposed to benzene, and may be mechanistically relevant biomarkers of early effect for benzene and other leukemogens.

Macroscopic tunneling of a membrane in an optomechanical double-well potential

The macroscopic tunneling of an optomechanical membrane is considered. A cavity mode which couples quadratically to the membranes position can create highly tunable adiabatic double-well potentials, which together with the high Q factors of such membranes render the observation of macroscopic tunneling possible. A suitable, pulsed measurement scheme using a linearly coupled mode of the cavity for the verification of the effect is studied.

Anti-cancer activities of tea epigallocatechin-3-gallate in breast cancer patients under radiotherapy

The purpose of this study was to test the hypothesis that administration of epigallocatechin-3-gallate (EGCG), a polyphenol present in abundance in widely consumed tea, inhibits cell proliferation, invasion, and angiogenesis in breast cancer patients. EGCG in 400 mg capsules was orally administered three times daily to breast cancer patients undergoing treatment with radiotherapy. Parameters related to cell proliferation, invasion, and angiogenesis were analyzed while blood samples were collected at different time points to determine efficacy of the EGCG treatment. Compared to patients who received radiotherapy alone, those given radiotherapy plus EGCG for an extended time period (two to eight weeks) showed significantly lower serum levels of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), and reduced activation of metalloproteinase-9 and metalloproteinase-2 (MMP9/MMP2). Addition of sera obtained from patients treated with combination of radiotherapy and EGCG feeding for 2-8 weeks to in vitro cultures of highly-metastatic human MDA-MB-231 breast cancer cells resulted in the following significant changes: (1) suppression of cell proliferation and invasion; (2) arrest of cell cycles at the G0/G1 phase; (3) reduction of activation of MMP9/MMP2, expressions of Bcl-2/Bax, c-Met receptor, NF-κB, and the phosphorylation of Akt. MDA-MB-231 cells exposed to 5-10 µM EGCG also showed significant augmentation of the apoptosis inducing effects of γ-radiation, concomitant with reduced NF-κB protein level and AKT phosphorylation. These results provide hitherto unreported evidence that EGCG potentiated efficacy of radiotherapy in breast cancer patients, and raise the possibility that this tea polyphenol has potential to be a therapeutic adjuvant against human metastatic breast cancer.

αA- and αB-crystallins interact with caspase-3 and Bax to guard mouse lens development

The small heat shock protein, α-crystallin, exists in two isoforms, αA and αB, and displays strong ability against stress-induced apoptosis. Regarding their functional mechanisms, we and others have demonstrated that they are able to regulate members in both caspase and Bcl-2 families. In addition, we have also shown that αA and αB may display differential anti-apoptotic mechanisms under certain stress conditions. While αA-crystallin regulates activation of the AKT signaling pathway, αB negatively regulates the MAPK pathway to suppress apoptosis induced by UV and oxidative stress. Although previous studies revealed that αA and αB could regulate members in both caspase and Bcl-2 families, the molecular mechanism, especially the in vivo regulation still waits to be elucidated. In the present communication, we present both in vitro and in vivo evidence to further demonstrate the regulation of caspase-3 and Bax by αA and αB. First, Surface Plasmon Resonance (SPR) and yeast two-hybrid selection analysis demonstrate that αA and αB directly bind to caspase-3 and Bax with differential affinities. Second, immunohistochemistry reveals that αA and αB regulate caspase-3 and Bax at different developmental stages of mouse embryo. Third, coimmunoprecipitation shows that αA and αB form in vivo interacting complexes with caspase-3 and Bax. Together, our results further confirm that αA and αB regulate caspase-3 and Bax in vitro and in vivo to regulate lens differentiation.

MicroRNAs in erythroid and megakaryocytic differentiation and megakaryocyte-erythroid progenitor lineage commitment

MicroRNAs (miRNAs) are a class of small regulatory noncoding RNAs that modulate the expression of their target genes through either mRNA degradation or inhibition of protein translation. In recent years, miRNAs have been shown to be critical regulators of hematopoiesis and have important roles in the differentiation of specific lineages. Here, we summarize our current understanding of miRNAs involved in hematopoiesis with a focus on the role of miRNAs in regulating erythroid and megakaryocytic differentiation and megakaryocyte-erythroid progenitor lineage commitment.

First evidence of direct CP violation in charmless two-body decays of Bs0 mesons

Using a data sample corresponding to an integrated luminosity of 0.35  fb-1 collected by LHCb in 2011, we report the first evidence of CP violation in the decays of Bs0} mesons to K±π∓ pairs, ACP(Bs0→Kπ)=0.27±0.08(stat)±0.02(syst), with a significance of 3.3σ. Furthermore, we report the most precise measurement of CP violation in the decays of B0 mesons to K±π∓ pairs, ACP(B0→Kπ)=-0.088±0.011(stat)±0.008(syst), with a significance exceeding 6σ.

Effect of triptolide on progesterone production from cultured rat granulosa cells

Triptolide(CAS 38748-32-2), a major active component of Tripterygium wilfordii Hook F (TWHF), is known to have multiple pharmacological activities. However, studies have also shown that triptolide is highly disrupt to the reproductive system by disrupting normal steroid hormone signaling. In the present study, we investigated the effect of triptolide (5, 10, or 20 nM for 24 h) on progesterone production by rat granulosa cells. Triptolide inhibited both basal and human chorionic gonadotropin (HCG)- and 8-bromo-cAMP-stimulated progesterone production as revealed by RIA assay. Furthermore, the HCG-evoked increase in cellular cAMP content was also inhibited by triptolide, indicating that disruption of the cAMP/PKA signaling pathway may mediate the deleterious effects of triptolide on progesterone regulation. In addition, triptolide inhibited 25-OH-cholesterol-stimulated progesterone production, suggesting that activity of the P450 side chain cleavage (P450scc) enzyme was also be inhibited by triptolide. Western blot and quantitative real-time PCR (qRT-PCR) assays further revealed that triptolide decreased mRNA and protein expression of P450scc and the steroidogenic regulatory (StAR) protein in granulosa cells. In contrast, cell viability tests using 3-(4,5-dimethyl-thiazol-2-yl)-2,5- diphenyl-tetrazolium bromide (MTT) indicated that triptolide did not cause measurable cell death at doses that suppressed steroidogenesis. The reproductive toxicity of triptolide may be caused by disruption of cAMP/PKA-mediated expression of a number of progesterone synthesis enzymes or regulatory proteins, leading to reduced progesterone synthesis and reproductive dysfunction.

P2RY1 and P2RY12 polymorphisms and on-aspirin platelet reactivity in patients with coronary artery disease

INTRODUCTION

Association of P2RY1 and P2RY12 polymorphisms with on-aspirin platelet reactivity was investigated.

MATERIALS AND METHODS

Platelet reactivity was assessed by the light transmission aggregometry and TxB(2) assay in 423 patients with coronary artery disease (CAD) on aspirin. High residual platelet reactivity (RPR) was defined by ≥20% and ≥70% maximal aggregation stimulated with 0.5 mg/mL arachidonic acid (AA) and 10 μm ADP, respectively. Moderate RPR was considered aggregation ≥20% with AA, ≥70% with ADP, or ≥1 ng/mL stimulated TxB(2) . Fourteen P2RY1 and 35 P2RY12 single nucleotide polymorphisms (SNPs) were genotyped.

RESULTS

High RPR was detected in 24% of the patients. Moderate RPR was observed in 31% with AA, 57% with 5 μm ADP, and 82% with 10 μm ADP. Stimulated TxB(2) was ≥1 ng/mL in 23% of patients. P2RY12 SNP rs9859538 was associated with high RPR (OR = 2.16, 95% CI = 1.24-3.75, P-value = 0.004). Four P2RY12 SNPs, rs1491974, rs10513398, rs3732765, and rs10935841, showed association with moderate RPR (OR = 1.79-2.94, P-value = 0.04-0.028), while five, rs7615865, rs1388623, rs1388622, rs7634096, and rs7637803, were associated with low RPR (OR = 0.50-0.55, P-value = 0.008-0.026), following ADP stimulation. TxB(2) level <1 ng/mL was linked to five P2RY1 SNPs, rs1439010, rs1371097, rs701265, rs12497578, and rs2312265 (OR = 0.36-0.54, P-value = 0.003-0.039).

CONCLUSIONS

Polymorphisms in P2RY1 and P2RY12 are associated with on-aspirin platelet reactivity in patients with CAD.

Neuropeptide Y mediates the short-term hypometabolic effect of estrogen deficiency in mice

BACKGROUND

Estrogen deficiency increases body weight or total and central adiposity and decreases energy expenditure. Hypothalamic neuropeptide Y (NPY) expression is altered by estrogen deficiency in rodents, but the long-term consequences on energy homeostasis are unknown.

OBJECTIVE

To investigate the role of NPY in the changes in energy expenditure and physical activity, as well as the associated changes in body weight and composition in response to short-term and long-term estrogen deficiency.

DESIGN

Sham and ovariectomy (OVX) operations were performed at 8 weeks of age in wild-type (WT) and NPY(-/-) mice. Energy expenditure, physical activity, body composition and weight, as well as food intake were measured at 10-18 days (short-term) and 46-54 days (long-term) after OVX.

RESULTS

OVX influences energy homeostasis differently at early compared with later time-points. At the early but not the late time point, OVX in WT mice reduced oxygen consumption and energy expenditure and tended to reduce resting metabolic rate. Interestingly, these effects of short-term estrogen deficiency were ablated by NPY deletion, with NPY(-/-) mice exhibiting significant increases in energy expenditure and resting metabolic rate. In addition to these hypermetabolic effects, OVX NPY(-/-) mice exhibited significantly lower body weight and whole-body fat mass relative to OVX WT controls at the short-term but not the long-term time point. Food intake and physical activity were unaltered by OVX, but NPY(-/-) mice exhibited significant reductions in these parameters relative to WT.

CONCLUSION

The effects of estrogen deficiency to reduce energy metabolism are transient, and NPY is critical to this effect as well as the early OVX-induced obesity.

Targeted therapy via oral administration of attenuated Salmonella expression plasmid-vectored Stat3-shRNA cures orthotopically transplanted mouse HCC

The development of RNA interference-based cancer gene therapies has been delayed due to the lack of effective tumor-targeting delivery systems. Attenuated Salmonella enterica serovar Typhimurium (S. Typhimurium) has a natural tropism for solid tumors. We report here the use of attenuated S. Typhimurium as a vector to deliver shRNA directly into tumor cells. Constitutively activated signal transducer and activator of transcription 3 (Stat3) is a key transcription factor involved in both hepatocellular carcinoma (HCC) growth and metastasis. In this study, attenuated S. Typhimurium was capable of delivering shRNA-expressing vectors to the targeted cancer cells and inducing RNA interference in vivo. More importantly, a single oral dose of attenuated S. Typhimurium carrying shRNA-expressing vectors targeting Stat3 induced remarkably delayed and reduced HCC (in 70% of mice). Cancer in these cured mice did not recur over 2 years following treatment. These data demonstrated that RNA interference combined with Salmonella as a delivery system may offer a novel clinical approach for cancer gene therapy.

Differential branching fraction and angular analysis of the decay B0 → K*0 μ+ μ-

The angular distributions and the partial branching fraction of the decay B0 → K*0 μ+ μ- are studied by using an integrated luminosity of 0.37  fb(-1) of data collected with the LHCb detector. The forward-backward asymmetry of the muons, A(FB), the fraction of longitudinal polarization, F(L), and the partial branching fraction dB/dq2 are determined as a function of the dimuon invariant mass. The measurements are in good agreement with the standard model predictions and are the most precise to date. In the dimuon invariant mass squared range 1.00-6.00  GeV2/c4, the results are A(FB)=-0.06(-0.14)(+0.13)±0.04, F(L)=0.55±0.10±0.03, and dB/dq2=(0.42±0.06±0.03)×10(-7)  c4/GeV2. In each case, the first error is statistical and the second systematic.

First observation of η(1405) decays into f(0)(980)π0

The decays J/ψ → γ π+ π- π0 and J/ψ → γ π0 π0 π0 are analyzed using a sample of 225×10(6) J/ψ events collected with the BESIII detector. The decay of η(1405) → f(0)(980)π0 with a large isospin violation is observed for the first time. The width of the f(0)(980) observed in the dipion mass spectra is anomalously narrower than the world average. Decay rates for three-pion decays of the η' are also measured precisely.

Glucose-induced beta cell dysfunction in vivo in rats: link between oxidative stress and endoplasmic reticulum stress

AIMS/HYPOTHESIS

Endoplasmic reticulum (ER) stress has been implicated in glucose-induced beta cell dysfunction. However, its causal role has not been established in vivo. Our objective was to determine the causal role of ER stress and its link to oxidative stress in glucose-induced beta cell dysfunction in vivo.

METHODS

Healthy Wistar rats were infused i.v. with glucose for 48 h to achieve 20 mmol/l hyperglycaemia with or without the co-infusion of the superoxide dismutase mimetic tempol (TPO), or the chemical chaperones 4-phenylbutyrate (PBA) or tauroursodeoxycholic acid (TUDCA). This was followed by assessment of beta cell function and measurement of ER stress markers and superoxide in islets.

RESULTS

Glucose infusion for 48 h increased mitochondrial superoxide and ER stress markers and impaired beta cell function. Co-infusion of TPO, which we previously found to reduce mitochondrial superoxide and prevent glucose-induced beta cell dysfunction, reduced ER stress markers. Similar to findings with TPO, co-infusion of PBA, which decreases mitochondrial superoxide, prevented glucose-induced beta cell dysfunction in isolated islets. TUDCA was also effective. Also similar to findings with TPO, PBA prevented beta cell dysfunction during hyperglycaemic clamps in vivo and after hyperglycaemia (15 mmol/l) for 96 h.

CONCLUSIONS/INTERPRETATION

Here, we causally implicate ER stress in hyperglycaemia-induced beta cell dysfunction in vivo. We show that: (1) there is a positive feedback cycle between oxidative stress and ER stress in glucose-induced beta cell dysfunction, which involves mitochondrial superoxide; and (2) this cycle can be interrupted by superoxide dismutase mimetics as well as chemical chaperones, which are of potential interest to preserve beta cell function in type 2 diabetes.

Cysteamine improves growth performance and gastric ghrelin expression in preweaning piglets

The aim of the present study was to investigate the effect of cysteamine on growth performance of preweaning piglets and gastric expression of ghrelin mRNA in vivo and in vitro. Twelve litters of newborn piglets were allocated randomly to control and treatment groups. From 15 d of age, piglets in the control group were fed basal creep diet, whereas the treatment group received basal diet supplemented with 120 mg cysteamine per kg of diet until weaning on 35 d of age. Body weight gain, creep feed consumption, and diarrhea rates were recorded, and gastric mucosal tissues were collected for quantifying mRNA expression. To evaluate the direct effect of cysteamine on gastric ghrelin expression, primary cultures of gastric mucosal cells isolated from 35-d-old piglets were exposed to cysteamine for 20 h at 0, 1, 10, and 100 μg/mL, respectively. Dietary cysteamine increased (P < 0.05) average daily creep feed consumption and BW gain in preweaning pigs, which was accompanied by reduction in diarrhea rates. At 35 d of age, piglets treated with cysteamine showed increased (P < 0.05) ghrelin and gastrin and decreased (P < 0.05) somatostatin mRNA expression in gastric mucosa. Moreover, dietary cysteamine treatment increased serum concentration of gastrin (P < 0.05). In vitro, cysteamine significantly increased ghrelin mRNA expression in gastric mucosal cells at the concentration of 10 μg/mL. In conclusion, dietary cysteamine is effective in improving the growth performance and health condition of preweaning piglets, which is associated with its stimulatory effects on gastric ghrelin mRNA expression both in vivo and in vitro.