TU-E-BRB-11: End-To-End Positioning Quality Assurance for Image-Guided Radiosurgery of Multiple Targets Using a Single-Isocenter

PURPOSE

Using a single isocenter significantly reduces delivery times in radiosurgery involving multiple targets. However, because not every target can be placed at isocenter with this type of treatment, a conventional Winston-Lutz test cannot be used. We describe a novel Winston-Lutz like mulitarget test (MTT) for verifying accurate positioning.

METHODS

A target phantom, comprised of an acrylic plate with recesses for three 3/4″ spheres was constructed and a high-resolution (0.5×0.5×0.8 mm) CT scan obtained with PTFE spheres placed in the recesses. The scan was imported into a commercial treatment planning system and multiple beams were prepared, having their isocenter at the centroid of the arrangement of spheres. Every beam incorporated three MLC-defined rectangular apertures that circumscribed the spheres. Custom software selected setup parameters (table, gantry and collimator angle, MLC openings) such that the spheres were centered as precisely as possible within their respective MLC fields, considering the discrete width of collimator leaves. The phantom, with the PTFE replaced by steel spheres, was placed on the treatment couch and imaged using stereoscopic x-ray beams. A 6 degree-of-freedom robotic couch applied translations and rotations to reproduce the CT position. A MV EPID rendered images of the spheres within their respective apertures, allowing identification of sphere and aperture centers. Any error upstream would manifest itself as inaccurate centering of a sphere.

RESULTS

Eight beams with table angle 0 and two beams each with table angles 49.7, 89.8, 272.3, and 310.1 were selected. The maximum calculated distance between any sphere and the respective aperture center was 0.07 mm. The median difference measured from the MV images ranged from 0.1 mm to 1.4 mm with a median of 0.8 mm.

CONCLUSIONS

The MTT is a practical end-to-end test for quality assurance of the entire positioning process in multitarget radiosurgery, from CT scanning to beam delivery.

Thymic stromal lymphopoietin promotes the proliferation of human trophoblasts via phosphorylated STAT3-mediated c-Myc upregulation

Our previous study has demonstrated that thymic stromal lymphopoietin (TSLP) stimulates trophoblast proliferation and invasion, suggesting TSLP plays an important role in the placentation in early human pregnancy, but the intracellular molecular mechanism is currently unknown. The present study is undertaken to investigate whether the STAT3-c-Myc signaling pathway is involved in TSLP-mediated trophoblast proliferation. Primary human first-trimester trophoblasts were treated with TSLP only, or TSLP combined with different signaling inhibitors (STAT3, STAT5, AKT, and ERK). The levels of STAT3 tyrosine phosphorylation and c-Myc expression were determined by using Western blot analysis, and the proliferation of trophoblasts was analyzed by BrdU cell proliferation assay. JEG-3 cells were transfected with siRNA targeting to c-Myc, and the proliferation was determined in JEG-3 cells treated with TSLP only, or TSLP combined with c-Myc silencing. It was revealed that treatment with TSLP significantly enhanced STAT3 phosphorylation and c-Myc expression in human trophoblasts. The effect of TSLP upregulation on trophoblast proliferation was abrogated completely by either STAT3 inhibitor or c-Myc siRNA silence. We further found that the upregulation of TSLP on c-Myc expression was abrogated completely by the STAT3 inhibitor, which suggests that the intracellular STAT3 phosphorylation is an upstream signal of c-Myc expression in the TSLP-stimulated trophoblast proliferation. These results suggest that TSLP may upregulate c-Myc expression through activation of STAT3 pathway, thereby inducing trophoblast proliferation.

Spatial-temporal expression of pum1 and pum2 in medaka Oryzias latipes

Two pumilios, pum1 and pum2, were identified in medaka Oryzias latipes. Oryzias latipes pum1 and pum2 are ubiquitous in the adult tissues but with specific expression in the germ cells of gonads, ovary and testis. Pum1 is expressed in the spermatogonia to spermatocytes whilst pum2 presents in spermatocytes of testis only. Oryzias latipes pum1 and pum2 are maternally supplied RNA with ubiquitous expression in the early stages, and embryonic expression of pum1 and pum2 may begin from early gastrula. Both pum1 and pum2 are expressed in the tissues including brain, eye and trunk, and both are expressed in the gonads after hatching. Taken together, Pum1 and Pum2 may play important roles in embryonic and germ cell development of O. latipes.