SU-E-T-626: Individualized Trade-Off of Dose Coverage and Sparing in IMRT Planning

PURPOSE

We present an evidence-based approach to quantifying the dose sparing trade-offs between different Organs-at-risk (OARs) and the trade-off between OAR dose sparing and target dose coverage in IMRT plans.

METHODS

The interaction between dose sparing of different OARs and between target dose coverage and OAR dose sparing are modeled using high-quality prior IMRT plans of prostate, head-and-neck (HN), and spine SBRT cases. The dose sparing for each OAR is modeled separately at first based on their own anatomical features and then the contributions from other OARs or PTV are added into the model to account for the possible trade-off effects in plans whose modeled OAR DVH deviates from that of actual plans.

RESULTS

The most significant OAR dose sparing trade-off is between bladder and rectum in prostate plans and between the left and the right parotids in HN plans. Trade-off is most apparent when the parotid on one side has very large overlap with the PTV. In most of these plans (83%), the planer chooses to loosen the dose constraint for that parotid in exchange for lower contra-lateral parotid median dose. The interaction between OAR dose sparing and PTV dose coverage is most significant in spine SBRT plans, (R2=0.37). Another important factor is the tightness of the geometric enclosure of PTV around OAR (R2=0.38).

CONCLUSIONS

The dosimetric trade-off between multiple OARs and between PTV and OAR in IMRT planning is quantified by studying prior plans. These findings will help physicians and planners obtain better OAR dose sparing by exploring different trade-off options for individual patient cases. Partially supported by a master research agreement with Varian Medical Systems, Inc.

Secreted factors from adipose tissue increase adipogenic differentiation of mesenchymal stem cells

OBJECTIVES

Adipose tissue engineering is one of the hottest topics in the field of regenerative medicine. Fat tissue has been considered as an abundant and accessible source of adult stem cells by tissue engineers, since it gives rise to adipose stem cells. However, recent reports have pointed out that adipose tissue, as a secretory and endocrine organ, might secrete cytokines that regulate body functions such as metabolism, infammation and more. In this study, we aim to investigate the adipogenic-inducing factors secreted by fat tissue.

MATERIALS AND METHODS

Conditioned medium were collected by culturing fat tissue fragments in plastic flasks. Mesenchymal stem cells (MSCs) cultured in conditioned medium (CM) to test the adipogenic-inducing factors. Oil red O staining, reverse transcription/polymerase chain reaction and immunocytofluorescent staining were performed to examine the differentiation of MSCs in CM.

RESULTS

MSCs cultured in CM of adipose tissue spontaneously differentiated into adipocytes. Furthermore, supplementation of insulin or dexamethasone to CM accelerated the process of lipid accumulation of differentiated MSCs.

DISCUSSION

Results from this study demonstrated that fat tissues secrete small molecules, which induce adipogenic differentiation of MSCs.

CONCLUSIONS

Our study provides clues for improving adipose tissue engineering by using fragmented adipose tissue as sources of fat-inducing factors.

Cellular and molecular mechanisms of silibinin induces cell-cycle arrest and apoptosis on HeLa cells

Silibinin, an effective anti-cancer and chemopreventive agent in various epithelial cancer models, has been reported to inhibit cancer cell growth through mitogenic signalling pathways including cervical cancer. However, the underlying mechanisms are still not well elucidated. Here, we assessed the effect of silibinin on human cervical carcinoma cell cycle modulation, apoptosis induction and associated molecular alterations by employing HeLa cell line. Silibinin treatment of HeLa cells resulted in a G2 arrest and induced a decrease in cyclin-dependent kinases involved in both G1 and G2 progression. In addition, silibinin showed a dose-dependent and a time-dependent apoptotic death in HeLa cells in both the mitochondrial pathway and the death receptor-mediated pathway, providing a strong rationale for future studies evaluating preventive and/or intervention strategies for silibinin in cervical cancer pre-clinical models.

Brain iron quantification in mild traumatic brain injury: a magnetic field correlation study

BACKGROUND AND PURPOSE

Experimental studies have suggested a role for iron accumulation in the pathology of TBI. Magnetic field correlation MR imaging is sensitive to the presence of non-heme iron. The aims of this study are to 1) assess the presence, if any, and the extent of iron deposition in the deep gray matter and regional white matter of patients with mTBI by using MFC MR imaging; and 2) investigate the association of regional brain iron deposition with cognitive and behavioral performance of patients with mTBI.

MATERIALS AND METHODS

We prospectively enrolled 28 patients with mTBI. Eighteen healthy subjects served as controls. The subjects were administered the Stroop color word test, the Verbal Fluency Task, and the Post-Concussion Symptoms Scale. The MR imaging protocol (on a 3T imager) consisted of conventional brain imaging and MFC sequences. After the calculation of parametric maps, MFC was measured by using a region of interest approach. MFC values across groups were compared by using analysis of covariance, and the relationship of MFC values and neuropsychological tests were evaluated by using Spearman correlations.

RESULTS

Compared with controls, patients with mTBI demonstrated significant higher MFC values in the globus pallidus (P = .002) and in the thalamus (P = .036). In patients with mTBI, Stroop test scores were associated with the MFC value in frontal white matter (r = -0.38, P = .043).

CONCLUSIONS

MFC values were significantly elevated in the thalamus and globus pallidus of patients with mTBI, suggesting increased accumulation of iron. This supports the hypothesis that deep gray matter is a site of injury in mTBI and suggests a possible role for iron accumulation in the pathophysiological events after mTBI.

Activity of the new cephalosporin CXA-101 (FR264205) against Pseudomonas aeruginosa isolates from chronically-infected cystic fibrosis patients

Chronic respiratory infection caused by Pseudomonas aeruginosa is the main driver of morbidity and mortality in cystic fibrosis (CF) patients. The development of resistance to all available antibiotics is a frequent outcome of these infections. The present study aimed to evaluate the activity of the new cephalosporin CXA-101 (FR264205) against a collection of 100 isolates obtained from 50 CF patients from two Spanish hospitals. The collection included the first (early) and the last (late) available isolate from each patient (average interval 68 ± 39 months). The MIC50 and MIC90 of CXA-101 were 0.5 and 2 mg/L and the geometric mean MIC was 0.7 mg/L; the MICs for 95% of the isolates were ≤8 mg/L (tentative breakpoint). Only meropenem yielded comparable results, although the MIC90 of this antibiotic was significantly higher (8 mg/L). CXA-101 showed conserved activity against a high proportion of isolates resistant to each of the antibiotics tested (ceftazidime, cefepime, piperacillin-tazobactam, imipenem, meropenem, levofloxacin and tobramycin), with MIC50 values of 1-2 mg/L. Moreover, CXA-101 retained good activity against multidrug-resistant strains, with MIC50 and MIC90 values of 2 and 16 mg/L. CXA-101 was also active against late CF isolates (the MIC for 96% was ≤8 mg/L); it was the only antibiotic tested to which a similar percentage of early and late isolates was susceptible. These results show that, despite a slight increase in MICs, major cross-resistance to CXA-101 did not develop during treatment of CF patients with the currently available antipseudomonal agents. Therefore, CXA-101 is envisaged as a valuable alternative for the treatment of chronic respiratory infection caused by P. aeruginosa in CF patients.

High-content analysis in monastrol suppressor screens. A neural network-based classification approach

OBJECTIVES

High-content screening (HCS) via automated fluorescent microscopy is a powerful technology for the effective expression of cellular processes. However, HCS will generally produce tremendous image datasets, which leads to difficulties of handling and analyzing. We proposed an automatic classification approach for simultaneous feature extraction and cell phenotype recognition of monoaster and bipolar cells in HCS system.

METHODS

The proposed approach was composed of image segmentation, feature extraction, and classification. The image segmentation was based on the Laplacian of Gaussian (LoG) edge detection method. For the reduction of noise effect on cellular images, we employed an adaptive threshold in microtubule channel. The principal component analysis was used in the feature selection process. The classification was performed with a back-propagation neural network (BPNN). Using the current approach, the cell phases were distinguished from three-channel acquisitions of cellular images and the numbers of bipolar and monoaster cells were automatically counted.

RESULTS

The validity of this approach was examined by the application of screening the response of drug compounds in suppressing Monastrol. Our results indicate that the proposed algorithm could improve the recognition rates of monoaster and bipolar cells to 97.98% and 93.12%, respectively, compared with 97.02% and 86.96% obtained from the same samples by multi-phenotypic mitotic analysis (MMA).

CONCLUSIONS

We have shown that BPNN is a valuable tool to classify cell phenotype. To further improve the classification performance, more test data, more optimized feature selection approaches, and advanced classifier may be required and will be investigated in future works.

The microfilament cytoskeleton plays a vital role in salt and osmotic stress tolerance in Arabidopsis

Although recent studies have suggested that the microfilament (MF) cytoskeleton of plant cells participates in the response to salt stress, it remains unclear as to whether the MF cytoskeleton actually plays an active role in a plant's ability to withstand salt stress. In the present study, we report for the first time the role of MFs in salt tolerance of Arabidopsis thaliana. Our experiments revealed that Arabidopsis seedlings treated with 150 mm NaCl maintained MF assembly and bundle formation, whereas treatment with 250 mm NaCl initially induced MF assembly but subsequently caused MF disassembly. A corresponding change in the fluorescence intensity of MFs was also observed; that is, a sustained rise in fluorescence intensity in seedlings exposed to 150 mm NaCl and an initial rise and subsequent fall in seedlings exposed to 250 mm NaCl. These results suggest that MF assembly and bundles are induced early after salt stress treatment, while MF polymerization disappears after high salt stress. Facilitation of MF assembly with phalloidin rescued wild-type seedlings from death, whereas blocking MFs assembly with latrunculin A and cytochalasin D resulted in few survivors under salt stress. Pre-treatment of seedlings with phalloidin also clearly increased plant ability to withstand salt stress. MF assembly increased survival of Arabidopsis salt-sensitive sos2 mutants under salt stress and rescued defective sos2 mutants. Polymerization of MFs and its role in promoting survival was also found in plants exposed to osmotic stress. These findings suggest that the MF cytoskeleton participates and plays a vital role in responses to salt and osmotic stress in Arabidopsis.

The impact of NOTCH1, FBW7 and PTEN mutations on prognosis and downstream signaling in pediatric T-cell acute lymphoblastic leukemia: a report from the Children's Oncology Group

We explored the impact of mutations in the NOTCH1, FBW7 and PTEN genes on prognosis and downstream signaling in a well-defined cohort of 47 patients with pediatric T-cell acute lymphoblastic leukemia (T-ALL). In T-ALL lymphoblasts, we identified high-frequency mutations in NOTCH1 (n=16), FBW7 (n=5) and PTEN (n=26). NOTCH1 mutations resulted in 1.3- to 3.3-fold increased transactivation of an HES1 reporter construct over wild-type NOTCH1; mutant FBW7 resulted in further augmentation of reporter gene activity. NOTCH1 and FBW7 mutations were accompanied by increased median transcripts for NOTCH1 target genes (HES1, DELTEX1 and cMYC). However, none of these mutations were associated with treatment outcome. Elevated HES1, DELTEX1 and cMYC transcripts were associated with significant increases in transcript levels of several chemotherapy relevant genes, including MDR1, ABCC5, reduced folate carrier, asparagine synthetase, thiopurine methyltransferase, BCL2 and dihydrofolate reductase. PTEN transcripts positively correlated with HES1 and cMYC transcript levels. Our results suggest that (1) multiple factors should be considered with attempting to identify molecular-based prognostic factors for pediatric T-ALL, and (2) depending on the NOTCH1 signaling status, modifications in the types or dosing of standard chemotherapy drugs for T-ALL, or combinations of agents capable of targeting NOTCH1, AKT and/or mTOR with standard chemotherapy agents may be warranted.

Cryogenic ion trapping systems with surface-electrode traps

We present two simple cryogenic rf ion trap systems in which cryogenic temperatures and ultra high vacuum pressures can be reached in as little as 12 h. The ion traps are operated either in a liquid helium bath cryostat or in a low vibration closed cycle cryostat. The fast turn around time and availability of buffer gas cooling made the systems ideal for testing surface-electrode ion traps. The vibration amplitude of the closed cycled cryostat was found to be below 106 nm. We evaluated the systems by loading surface-electrode ion traps with (88)Sr(+) ions using laser ablation, which is compatible with the cryogenic environment. Using Doppler cooling we observed small ion crystals in which optically resolved ions have a trapped lifetime over 2500 min.

Combination therapy with radiation or cisplatin enhances the potency of Ad5/35 chimeric oncolytic adenovirus in a preclinical model of head and neck cancer

Ad5/35 chimeric oncolytic viruses (OVs) have earlier been shown to increase the level of vector transduction, intratumoral virus spread and survival in a number of xenograft models when compared with Ad5-based viruses. Because radiation and chemotherapy are the current standards of care for most cancer indications, Ad5/35 OVs have been tested here in combination with either radiation or chemotherapy in a head and neck cancer (HNC) xenograft model to determine whether such combination therapies enhance the potency of the virus, thereby leading to a greater therapeutic effect. In mice treated with either Ad5 OV (OV-5) or Ad5/35 chimeric OV (OV-5T35H), there was a delay in tumor progression compared with animals treated with phosphate-buffered saline (PBS) alone. When Ad5/35 chimeric OV and radiation were used in combination, there was a further delay in tumor progression, which resulted in a significant increase in the mean survival time of tumor-bearing mice compared with Ad5/35 or Ad5 OV monotherapy or to the combination of Ad5 OV with radiation, which was significantly less potent (P<0.0001) compared with the Ad5/35 OV plus radiation combination. Similarly, a combination of Ad5/35 chimeric OV with cisplatin significantly delayed tumor progression compared with Ad5/35 OV or Ad5 OV virus alone or with the combination of Ad5 virus with cisplatin (P<0.01). In summary, the combination of the potent Ad5/35 chimeric OV with either radiation or chemotherapy leads to significantly increased survival of mice bearing highly aggressive tumors, and may therefore offer an effective treatment strategy for patients with difficult to treat HNC.

Streptococcus mutans and Streptococcus sanguinis colonization correlated with caries experience in children

The aim of this study was to examine the colonization of Streptococcus mutans and Streptococcus sanguinis in the oral cavity and the association with severe early childhood caries (S-ECC). Saliva and plaque samples were collected from 14 S-ECC children and 8 caries-free (CF) children. All S-ECC children were S. mutans positive; 100% of CF children and 93% of S-ECC children were S. sanguinis positive. The children's caries severity was positively correlated with levels of S. mutans (p < 0.001), total oral streptococci (p < 0.01), total cultivable oral bacteria (p < 0.05), and children's age (p < 0.05). Logistic regression analysis showed that the interaction of S. sanguinis with S. mutans was a significant factor associated with the caries status in children, suggesting that the relative levels of these two microorganisms in the oral cavity play an important role in caries development.

Glycogen synthase kinase 3beta: a novel marker and modulator of inflammatory injury in chronic renal allograft disease

One key cell-signaling event central to inflammation in kidney diseases, including chronic renal allograft dysfunction or disease (CRAD), is the activation of NF-kappaB, which controls transcription of numerous proinflammatory mediators. Glycogen synthase kinase (GSK) 3beta is an indispensable element of NF-kappaB activation, however, the exact role of GSK3beta in the pathogenesis of inflammatory kidney diseases like CRAD is uncertain and was examined. Immunohistochemistry staining of GSK3beta was weak in normal kidneys, but was markedly induced in inflamed allograft kidneys, with prominent cytoplasmic staining of tubular cells in areas of inflammation. Net GSK3beta activity is regulated by inhibitory phosphorylation of its serine 9 residue, and this occurred in CRAD. Thus, the magnitude of GSK3beta inactivation was inversely correlated with the degree of injury as assessed by Banff criteria. In vitro in cultured human tubular epithelial cells, GSK3beta overexpression augmented, while GSK3beta silencing diminished proinflammatory cellular responses to TNF-alpha stimulation, including NF-kappaB activation and expression of chemokines MCP-1 and RANTES. These inflammatory responses were obliterated by GSK3beta inhibitors. Collectively, GSK3beta plays an important role in mediating proinflammatory NF-kappaB activation and renal inflammation. Suppression of GSK3beta activity might represent a novel therapeutic strategy to treat CRAD.