Tumor tracking based on correlation models in scanned ion beam therapy: an experimental study

Accurate dose delivery to extra-cranial lesions requires tumor motion compensation. An effective compensation can be achieved by real-time tracking of the target position, either measured in fluoroscopy or estimated through correlation models as a function of external surrogate motion. In this work, we integrated two internal/external correlation models (a state space model and an artificial neural network-based model) into a custom infra-red optical tracking system (OTS). Dedicated experiments were designed and conducted at GSI (Helmholtzzentrum für Schwerionenforschung). A robotic breathing phantom was used to reproduce regular and irregular internal target motion as well as external thorax motion. The position of a set of markers placed on the phantom thorax was measured with the OTS and used by the correlation models to infer the internal target position in real-time. Finally, the estimated target position was provided as input for the dynamic steering of a carbon ion beam. Geometric results showed that the correlation models transversal (2D) targeting error was always lower than 1.3 mm (root mean square). A significant decrease of the dosimetric error with respect to the uncompensated irradiation was achieved in four out of six experiments, demonstrating that phase shifts are the most critical irregularity for external/internal correlation models.

MUC5AC expression correlates with invasiveness and progression of extramammary Paget's disease

BACKGROUND

Patients with in situ extramammary Paget's disease (EMPD) tend to have a good prognosis, although dermal invasion and metastasis are associated with significantly increased morbidity and mortality. Previous studies have addressed mechanisms underlying the EMPD pathogenesis; however, no molecular markers that reflect invasiveness or progression have been established.

OBJECTIVE

This study aims to identify a reliable marker for predicting the risk of invasion and metastasis in EMPD.

METHODS

We performed an initial microarray screening for in situ, invasive or metastatic lymph node lesions of EMPD. We analysed 44 specimens from 38 primary EMPD cases by immunohistochemical staining.

RESULTS

We found that expressions of MUC5AC directly correlate with invasion and prognosis. Labelling rates of tumour cells were scored by staining intensity on a four-tiered scale (- to 3+) to investigate the correlation between the expression score of these molecular markers and the type of EMPD lesion. All the specimens scored positive (3+) for MUC1 and negative (-) for MUC6. MUC5AC expression was detected in 19 of 44 (43.2%) specimens. Invasive lesions and metastatic lymph nodes tended to express MUC5AC significantly higher than in situ lesions (P < 0.01). MUC2 was positive in 10 specimens (22.7%). There was no significant difference between the degree of MUC2 expression and invasiveness.

CONCLUSION

The degree of MUC5AC expression may correlate with the invasiveness and progression of EMPD, and may be a useful marker for identifying high-risk EMPD cases.

ROS evaluation for a series of CNTs and their derivatives using an ESR method with DMPO

Carbon nanotubes (CNTs) are important materials in advanced industries. It is a concern that pulmonary exposure to CNTs may induce carcinogenic responses. It has been recently reported that CNTs scavenge ROS though non-carbon fibers generate ROS. A comprehensive evaluation of ROS scavenging using various kinds of CNTs has not been demonstrated well. The present work specifically investigates ROS scavenging capabilities with a series of CNTs and their derivatives that were physically treated, and with the number of commercially available CNTs. CNT concentrations were controlled at 0.2 through 0.6 wt%. The ROS scavenging rate was measured by ESR with DMPO. Interestingly, the ROS scavenging rate was not only influenced by physical treatments, but was also dependent on individual manufacturing methods. Ratio of CNTs to DMPO/ hydrogen peroxide is a key parameter to obtain appropriate ROS quenching results for comparison of CNTs. The present results suggest that dangling bonds are not a sole factor for scavenging, and electron transfer on the CNT surface is not clearly determined to be the sole mechanism to explain ROS scavenging.

Direct observation of long-lived isomers in 212Bi

Long-lived isomers in (212)Bi have been studied following (238)U projectile fragmentation at 670 MeV per nucleon. The fragmentation products were injected as highly charged ions into a storage ring, giving access to masses and half-lives. While the excitation energy of the first isomer of (212)Bi was confirmed, the second isomer was observed at 1478(30) keV, in contrast to the previously accepted value of >1910 keV. It was also found to have an extended Lorentz-corrected in-ring half-life >30 min, compared to 7.0(3) min for the neutral atom. Both the energy and half-life differences can be understood as being due a substantial, though previously unrecognized, internal decay branch for neutral atoms. Earlier shell-model calculations are now found to give good agreement with the isomer excitation energy. Furthermore, these and new calculations predict the existence of states at slightly higher energy that could facilitate isomer deexcitation studies.

Quantitative MRI analysis of salivary glands in sickle cell disease

OBJECTIVES

The purpose of this prospective study was to characterize the MR relaxometric features of the major salivary glands in patients with sickle cell disease (SCD).

METHODS

15 patients with SCD (aged 19.8-43.6 years) and 12 controls were imaged with the mixed turbo-spin echo pulse sequence. The major salivary glands were manually segmented and T1, T2 and secular T2 relaxometry histograms were modelled with Gaussian functions.

RESULTS

Shortened T1 relaxation times were seen solely in the submandibular glands of patients with SCD (747.5±54.8 ms vs 807.1±38.3 ms, p<0.001). Slight T2 and secular T2 shortening were seen in the parotid gland; however, this difference was not significant (p=0.07). The sublingual gland showed no changes under MR relaxometry. There was no difference in glandular volumes, and no correlation was demonstrated between history of blood transfusion and salivary gland relaxometry.

CONCLUSIONS

Patients with SCD exhibited changes in quantitative MRI T1 relaxometry histograms of the submandibular glands.

Cold-nuclear-matter effects on heavy-quark production in d+Au collisions at sqrt[S(NN)]=200 GeV

The PHENIX experiment has measured electrons and positrons at midrapidity from the decays of hadrons containing charm and bottom quarks produced in d+Au and p+p collisions at sqrt[S(NN)]=200 GeV in the transverse-momentum range 0.85 ≤ p(T)(e) ≤ 8.5 GeV/c. In central d+Au collisions, the nuclear modification factor R(dA) at 1.5<p(T)<5 GeV/c displays evidence of enhancement of these electrons, relative to those produced in p+p collisions, and shows that the mass-dependent Cronin enhancement observed at the Relativistic Heavy Ion Collider extends to the heavy D meson family. A comparison with the neutral-pion data suggests that the difference in cold-nuclear-matter effects on light- and heavy-flavor mesons could contribute to the observed differences between the π(0) and heavy-flavor-electron nuclear modification factors R(AA).

Evolution of π(0) suppression in Au+Au collisions from √(s(NN))=39 to 200 GeV

Neutral-pion π(0) spectra were measured at midrapidity (|y|<0.35) in Au+Au collisions at √(s(NN))=39 and 62.4 GeV and compared with earlier measurements at 200 GeV in a transverse-momentum range of 1<p(T)<10 GeV/c. The high-p(T) tail is well described by a power law in all cases, and the powers decrease significantly with decreasing center-of-mass energy. The change of powers is very similar to that observed in the corresponding spectra for p+p collisions. The nuclear modification factors (R(AA)) show significant suppression, with a distinct energy, centrality, and p(T) dependence. Above p(T)=7 GeV/c, R(AA) is similar for √(s(NN))=62.4 and 200 GeV at all centralities. Perturbative-quantum-chromodynamics calculations that describe R(AA) well at 200 GeV fail to describe the 39 GeV data, raising the possibility that, for the same p(T) region, the relative importance of initial-state effects and soft processes increases at lower energies. The p(T) range where π(0) spectra in central Au+Au collisions have the same power as in p+p collisions is ≈5 and 7 GeV/c for √(s(NN))=200 and 62.4 GeV, respectively. For the √(s(NN))=39 GeV data, it is not clear whether such a region is reached, and the x(T) dependence of the x(T)-scaling power-law exponent is very different from that observed in the √(s(NN))=62 and 200 GeV data, providing further evidence that initial-state effects and soft processes mask the in-medium suppression of hard-scattered partons to higher p(T) as the collision energy decreases.

Measurement of direct photons in Au+Au collisions at √(s(NN))=200 GeV

We report the measurement of direct photons at midrapidity in Au+Au collisions at √(s(NN))=200 GeV. The direct photon signal was extracted for the transverse momentum range of 4 GeV/c<p(T)<22 GeV/c, using a statistical method to subtract decay photons from the inclusive photon sample. The direct photon nuclear modification factor R(AA) was calculated as a function of p(T) for different Au+Au collision centralities using the measured p+p direct photon spectrum and compared to theoretical predictions. R(AA) was found to be consistent with unity for all centralities over the entire measured p(T) range. Theoretical models that account for modifications of initial direct photon production due to modified parton distribution functions in Au and the different isospin composition of the nuclei predict a modest change of R(AA) from unity. They are consistent with the data. Models with compensating effects of the quark-gluon plasma on high-energy photons, such as suppression of jet-fragmentation photons and induced-photon bremsstrahlung from partons traversing the medium, are also consistent with this measurement.

Search for the Θ+ pentaquark via the π(-)p→K(-)X reaction at 1.92 GeV/c

The Θ(+) pentaquark baryon was searched for via the π(-)p→K(-)X reaction with a missing mass resolution of 1.4 MeV/c(2) (FWHM) at the Japan Proton Accelerator Research Complex (J-PARC). π(-) meson beams were incident on the liquid hydrogen target with a beam momentum of 1.92 GeV/c. No peak structure corresponding to the Θ(+) mass was observed. The upper limit of the production cross section averaged over the scattering angle of 2° to 15° in the laboratory frame is obtained to be 0.26 μb/sr in the mass region of 1.51-1.55 GeV/c(2). The upper limit of the Θ(+) decay width is obtained to be 0.72 and 3.1 MeV for J(Θ)(P)=1/2(+) and J(Θ)(P)=1/2(-), respectively, using the effective Lagrangian approach.

Observation of direct-photon collective flow in Au + Au collisions at √s(NN)] = 200 GeV

The second Fourier component v(2) of the azimuthal anisotropy with respect to the reaction plane is measured for direct photons at midrapidity and transverse momentum (p(T)) of 1-12 GeV/c in Au + Au collisions at √s(NN)] = 200 GeV. Previous measurements of this quantity for hadrons with p(T) < 6 GeV/c indicate that the medium behaves like a nearly perfect fluid, while for p(T) > 6 GeV/c a reduced anisotropy is interpreted in terms of a path-length dependence for parton energy loss. In this measurement with the PHENIX detector at the Relativistic Heavy Ion Collider we find that for p(T) > 4 GeV/c the anisotropy for direct photons is consistent with zero, which is as expected if the dominant source of direct photons is initial hard scattering. However, in the p(T) < 4 GeV/c region dominated by thermal photons, we find a substantial direct-photon v(2) comparable to that of hadrons, whereas model calculations for thermal photons in this kinematic region underpredict the observed v(2).

A standard for absorbed dose rate to water in a 60Co field using a graphite calorimeter at the National Metrology Institute of Japan

A primary standard for the absorbed dose rate to water in a ⁶⁰Co radiation field has been newly established at the National Metrology Institute of Japan. This primary standard combines the calorimetric measurements using a graphite calorimeter with the ionometric measurements using a thick-walled graphite cavity ionisation chamber. The calorimeter is operated in the constant temperature mode using AC Wheatstone bridges. The absorbed dose rate to water was determined to be 12 mGy s⁻¹ at a point of 1 m from the radiation source and at a water depth of 5 g cm⁻². The uncertainty on the calibration coefficient in terms of the absorbed dose to water of an ionisation chamber using this standard was estimated to be 0.39 % (k=1).

Quantitative MRI analysis of craniofacial bone marrow in patients with sickle cell disease

BACKGROUND AND PURPOSE

Assessment of bone marrow is most commonly performed qualitatively in the spine or other large long bones. The craniofacial bones are less ideal for bone marrow analysis because of the relatively small bone marrow volume. Because patients with SCD often undergo repeated brain imaging to evaluate for cerebral vaso-occlusive disease, quantitative assessment of craniofacial bone marrow is a reasonable possibility in these patients. The purpose of this study was to investigate specific sickle cell disease changes in craniofacial bone marrow quantitatively by analyzing T1, T2, and secular-T2 relaxation times and volume with the use of quantitative MRI.

MATERIALS AND METHODS

Fourteen patients with SCD and 17 control subjects were imaged with the mixed TSE pulse sequence at 1.5T. The craniofacial bones were manually segmented by using 3D Slicer to generate bone marrow volumes and to provide T1, T2, and secular-T2 relaxation times.

RESULTS

All subjects exhibited a bimodal T1 histogram. In the SCD group, there was a decrease in amplitude in the first T1 peak and an increase in amplitude in the second T1 peak. The first T1 peak showed a significant increase in relaxation time compared with control subjects (P < .0001), whereas there was no significant difference in the second T1 peak. T2 and secular-T2 relaxation times were significantly shorter in the SCD group (T2, P < .0001; secular-T2, P < .0001). Increasing numbers of blood transfusions resulted in a decrease in T2 and secular-T2 times. Patients with SCD exhibited a larger bone marrow volume compared with control subjects, even after standardization.

CONCLUSIONS

Patients with SCD exhibited significant quantifiable changes in the craniofacial bone marrow because of failure of red-to-yellow marrow conversion and iron deposition that can be identified by qMRI relaxometry and volumetry. Both qMRI relaxometry and volumetry may be used as noninvasive tools for assessment of disease severity.

Classes of conduct disorder symptoms and their life course correlates in a US national sample

BACKGROUND

Population data on conduct disorder (CD) symptoms can help determine whether hypothesized subtypes of CD are sufficiently disparate in their familial, psychiatric and life course correlates to distinguish separate diagnostic entities.

METHOD

Latent class analysis (LCA) of CD symptoms occurring before age 15 was conducted in a national sample of adults aged 18-44 years from the National Epidemiological Study of Alcohol and Related Conditions. Associations of latent class membership with parental behavior problems, onset of psychiatric disorders and anti-social behaviors after age 15, adolescent life events (e.g. high school drop-out), and past-year life events (e.g. divorce/separation, bankruptcy) were estimated.

RESULTS

LCA identified a no-CD class with low prevalence of all symptoms, three intermediate classes - deceit/theft, rule violations, aggression - and a severe class. The prevalence of CD, according to DSM-IV criteria, was 0% in the no-CD class, between 13.33% and 33.69% in the intermediate classes and 62.20% in the severe class. Latent class membership is associated with all the familial, psychiatric and life course outcomes examined. Among the intermediate classes, risk for subsequent mood/anxiety disorders and anti-social behavior was higher in the deceit/theft and aggressive classes than in the rule violations class. However, risk for adolescent life events is highest in the rule violations class.

CONCLUSIONS

CD symptoms tend to occur in a partially ordered set of classes in the general population. Prognostically meaningful distinctions can be drawn between classes, but only at low levels of symptoms.

Diagnostic Ability of Fluid-Attenuated Inversion Recovery MR Imaging to Detect Remnant or Recurrent Meningiomas after Resection

It has been suggested that a difference in signal intensity (SI) between the resection cavity and normal cerebrospinal fluid (CSF) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) in partially resected gliomas indicates subsequent or coincident tumor progression. We considered that this would hold true for resected meningiomas as well. Hence, we aimed to assess whether or not such a difference in the SI during the follow-up evaluation helps predict residual or recurrent tumor in resected meningiomas. We evaluated 63 patients with resected meningiomas. The SI within the resection cavity observed on FLAIR images was qualitatively and quantitatively assessed during follow-up. Qualitative analysis comprised visual comparison of the SI in the resection cavity with that of normal CSF by neuroradiologists. The SI in the resection cavity was quantitatively assessed by region of interest (ROI) analysis and normalized against the background noise and CSF SI. Normalized SI recorded during follow-up was compared with that recorded immediately after resection. Tumor progression was defined as a 20% or greater increase in the diameter of the longest residual or recurrent meningioma (Response Evaluation Criteria in Solid Tumors). The sensitivity and specificity of the elevated SI in the resection cavity for indicating residual or recurrent tumor were calculated. Qualitative analysis by FLAIR MRI showed that patients with remnant tumor following surgery had a prolonged SI increase in the resection cavity. Further, SI increase could not always be observed before recurrence, and both SI increase and regrowth remnant/recurrence could be detected in the same MRI examination. In resected meningiomas, leakage of tumor elements into the resection cavity, presumably tumor cells, manifests as an SI increase on FLAIR images and indicates residual or recurrent tumor. However, unlike the previous reports on partially resected gliomas, we concluded that the SI change does not always precede tumor progression or recurrence.

Measurements of higher order flow harmonics in Au+Au collisions at √s(NN)=200 GeV

Flow coefficients ν(n) for n=2, 3, 4, characterizing the anisotropic collective flow in Au+Au collisions at √s(NN)=200 GeV, are measured relative to event planes Ψ(n), determined at large rapidity. We report ν(n) as a function of transverse momentum and collision centrality, and study the correlations among the event planes of different order n. The ν(n) are well described by hydrodynamic models which employ a Glauber Monte Carlo initial state geometry with fluctuations, providing additional constraining power on the interplay between initial conditions and the effects of viscosity as the system evolves. This new constraint can serve to improve the precision of the extracted shear viscosity to entropy density ratio η/s.

The indications for a diverting stoma in low anterior resection for rectal cancer: a prospective multicentre study of 222 patients from Japanese cancer centers

AIM

The aim of the study was to determine the present state of diverting stoma construction in Japanese cancer centres and to investigate the relationship between symptomatic leakage and diverting stoma after low anterior resection for rectal cancer.

METHOD

Two hundred and twenty-two consecutive patients undergoing low anterior resection for rectal cancer located within 10 cm from the anal verge were investigated in a prospective, multicenter study.

RESULTS

The overall leakage rate was 9.0% (20/222). Of 31 cases with an anastomosis within 2.0 cm from the anal verge, 22 (71%) had a diverting stoma. Of cases anastomosed within 5.0 cm, the absence of a diverting stoma and tumour size were significantly related to an increased rate of leakage [leakage in 13 (12.7%) of 102 cases without a diverting stoma; in three (3.8%) of 80 cases with a diverting stoma]. Among anastomoses within 2.0 cm from the anal verge, leakage occurred in four (44.4%) of nine cases without and in none (0%) of 22 cases with a diverting stoma.

CONCLUSION

We recommend a diverting stoma for an anastomosis within 5.0 cm of the anal verge and strongly recommend it for a very low anastomosis within 2.0 cm.

Second-order autocorrelation of XUV FEL pulses via time resolved two-photon single ionization of He

Second-order autocorrelation spectra of XUV free-electron laser pulses from the Spring-8 Compact SASE Source (SCSS) have been recorded by time and momentum resolved detection of two-photon single ionization of He at 20.45 eV using a split-mirror delay-stage in combination with high-resolution recoil-ion momentum spectroscopy (COLTRIMS). From the autocorrelation trace we extract a coherence time of 8 ± 2 fs and a mean pulse duration of 28 ± 5 fs, much shorter than estimations based on electron bunch-length measurements. Simulations within the partial coherence model [Opt. Lett. 35, 3441 (2010)] are in agreement with experiment if a pulse-front tilt across the FEL beam diameter is taken into account that leads to a temporal shift of about 6 fs between both pulse replicas.

Suppression of back-to-back hadron pairs at forward rapidity in d+Au collisions at √s(NN)=200 GeV

Back-to-back hadron pair yields in d+Au and p+p collisions at √s(NN)=200 GeV were measured with the PHENIX detector at the Relativistic Heavy Ion Collider. Rapidity separated hadron pairs were detected with the trigger hadron at pseudorapidity |η|<0.35 and the associated hadron at forward rapidity (deuteron direction, 3.0<η<3.8). Pairs were also detected with both hadrons measured at forward rapidity; in this case, the yield of back-to-back hadron pairs in d+Au collisions with small impact parameters is observed to be suppressed by a factor of 10 relative to p+p collisions. The kinematics of these pairs is expected to probe partons in the Au nucleus with a low fraction x of the nucleon momenta, where the gluon densities rise sharply. The observed suppression as a function of nuclear thickness, p(T), and η points to cold nuclear matter effects arising at high parton densities.

Rhabdomyolysis of the head and neck: computed tomography and magnetic resonance imaging findings

Rhabdomyolysis is rare in the head and neck. Early diagnosis and treatment is essential to prevent serious complications such as hyperkalaemia, acidosis, acute renal failure and disseminated intravascular coagulation. We present a case of rhabdomyolysis of the head and neck. CT and MRI findings supported the diagnosis of rhabdomyolysis with the patient's clinical and laboratory findings. While imaging is not crucial, it can aid in the detection of rhabdomyolysis and narrow the differential diagnosis along with laboratory findings and physical examination.

Pharmacoresistant convulsions and visual hallucinations around two weeks after selegiline overdose: a case report

A case of pharmacoresistant convulsions after selegiline overdose is reported. A 50-year-old male having been suffering from bipolar II disorder for 16 years attempted suicide by taking an overdose of 195 mg selegiline with other psychotropics. He developed recurrent pharmacoresistant seizure from 12th day to 19th day after selegiline overdose. He also had visual hallucinations and temporary high blood pressure. The authors suspect that the catecholamine-influenced convulsions and visual hallucinations that manifested during the period increased by the MAO-inhibiting action of selegiline which lasts about 2 weeks.

Cold nuclear matter effects on J/ψ yields as a function of rapidity and nuclear geometry in d+A collisions at sqrt[s(NN)]=200 GeV

We present measurements of J/ψ yields in d+Au collisions at sqrt[s(NN)]=200  GeV recorded by the PHENIX experiment and compare them with yields in p+p collisions at the same energy per nucleon-nucleon collision. The measurements cover a large kinematic range in J/ψ rapidity (-2.2<y<2.4) with high statistical precision and are compared with two theoretical models: one with nuclear shadowing combined with final state breakup and one with coherent gluon saturation effects. In order to remove model dependent systematic uncertainties we also compare the data to a simple geometric model. The forward rapidity data are inconsistent with nuclear modifications that are linear or exponential in the density weighted longitudinal thickness, such as those from the final state breakup of the bound state.

Clinical and radiologic findings of inner ear involvement in sickle cell disease

BACKGROUND AND PURPOSE

SCD has been reported to involve the inner ear and result in LH and LO. Our purpose was to examine the prevalence of inner ear involvement and to assess the relationship between clinical and imaging findings in patients with SCD.

MATERIALS AND METHODS

Review of our institution's imaging data base for patients with SCD who underwent imaging of the brain or head and neck region or both by CT, MR, or both from 2004 to 2008 was performed. Presenting symptoms, type of SCD, sex, imaging studies performed, and imaging findings were documented.

RESULTS

Among 89 patients with SCD identified (41 males, 48 females), 17 patients (14 males, 3 females; 10-48 years old) underwent imaging evaluation for inner ear complaints, including SNHL, dizziness, vertigo, and tinnitus. LH was identified in 3 patients (3 males) and LO was identified in another 3 patients (2 males, 1 female). All patients with LH had sickle-hemoglobin C disease, whereas those with LO consisted of 2 patients homozygous for HbS (2) and 1 with HbS/β-thalassemia. Patients with LH presented with vestibular symptoms (2 vertigo, 1 dizziness), whereas patients with LO presented with SNHL. LH was seen in the basal turn of cochlea and vestibule, whereas LO involved the lateral semicircular canal.

CONCLUSIONS

LH and LO were found in approximately one-third of patients with SCD with inner ear symptoms and preferentially affected males.

Prediction of locoregional control in head and neck squamous cell carcinoma with serial CT perfusion during radiotherapy

BACKGROUND AND PURPOSE

Tumor hypoxia is a known factor of radioresistance in HNSCC. CTP is a noninvasive method of measuring tumor perfusion in vivo. The purpose of our study was to determine serial changes in tumor perfusion in HNSCC during a course of RT by using CTP and to correlate tumor perfusion measurements to LRC.

MATERIALS AND METHODS

A prospective study was performed in 15 patients with HNSCC receiving definitive RT who underwent serial CTP before RT; at weeks 2, 4, and 6 of RT; and 6 weeks after RT. The median follow-up was 28 months (range, 6-44 months). Thirteen patients achieved LRC, and 2 patients had LRF. Tumor perfusion parameters, including BF, BV, MTT, and CP, were obtained by using a deconvolution-based analysis.

RESULTS

Pretreatment tumor BF was significantly higher in patients who achieved LRC, 118.0 mL/100 g/min, compared with those with LRF, 53.4 mL/100 g/min (P = .004). Similarly, pretreatment CP was higher in patients with LRC, 16.6 mL/100 g/min, compared with those with LRF, 7.7 mL/100 g/min (P = .02). At week 2 of RT, tumor BF parameters showed a 27.5% increase versus an 18.1% decrease from pretreatment BF values (P = .046) in patients with LRC and LRF, respectively. A decrease in BF and BV was observed in both groups 6 weeks after RT compared with these values at baseline scanning.

CONCLUSIONS

An increase in tumor BF and CP by using CTP early during a course of RT predicts LRC in patients with HNSCC treated with RT.

Pyoderma gangrenosum of the eyelid: report of two cases and review of the literature

Pyoderma gangrenosum (PG) of the eyelid is extremely rare, and its proper management is essential for the preservation of visual function. Here, we report 2 cases of PG of the eyelid with intraorbital involvement. In both cases, the skin and intraorbital lesions improved after systemic immunosuppressive therapies; however, corneal perforation occurred in 1 case. In order to assess the clinical features of PG of the eyelid and to obtain clues for optimal treatment, we reviewed 15 well-documented cases in the literature, including the present cases. Corneal perforation occurred in 4 cases and defective ocular motility in 1 case. Three patients eventually underwent enucleation of the affected eye. Our cases and the literature review clearly indicate that MRI is a powerful tool for evaluating the extent of extracutaneous PG lesions around the eye and that early diagnosis and immediate immunosuppressive therapy are crucial for the preservation of visual acuity.

Three-electron interatomic Coulombic decay from the inner-valence double-vacancy states in NeAr

We have unambiguously identified interatomic Coulombic decay in NeAr from the inner-valence double-vacancy state Ne-Ar(2+)(3s(-2)) to outer-valence triple-vacancy states Ne(+)(2p(-1))-Ar(2+)(3p(-2)) by momentum-resolved electron-ion multicoincidence. This is the first observation of interatomic Coulombic decay where three electrons (3e) participate. The results suggest that this 3e interatomic Coulombic decay is significantly faster than other competing processes like fluorescence decay and charge transfer via curve crossing.

Nonbifurcating cervical carotid artery diagnosed by MR angiography

BACKGROUND AND PURPOSE

A nonbifurcating cervical carotid artery is a branching anomaly in which the ECA has no proximal main trunk. We report its incidence and characteristic features on MRA.

MATERIALS AND METHODS

We retrospectively reviewed MRAs of 2866 patients obtained by using a standard noncontrast MRA protocol and two 1.5T MR imaging units and reviewed the English language literature to assess the occurrence and features of this nonbifurcating artery.

RESULTS

We diagnosed 6 cases, indicating an incidence of 0.21%, and found 11 cases reported in the literature. Analysis of all 17 cases demonstrated no laterality or sex predominance. The most prevalent pattern of branching order from proximal to distal was the F-L trunk, the distal trunk of the ECA, and the OA.

CONCLUSIONS

A nonbifurcating cervical carotid artery is rare but not as extremely rare as previously considered, and its correct diagnosis is necessary to avoid complications during interventional radiologic procedures or head and neck surgeries.