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Ferreira Silvério N, van den Wollenberg W, Betgen A, Wiersema L, Marijnen C, Peters F, van der Heide UA, Simões R, Janssen T. Evaluation of Deep Learning Clinical Target Volumes Auto-Contouring for Magnetic Resonance Imaging-Guided Online Adaptive Treatment of Rectal Cancer. Adv Radiat Oncol 2024; 9:101483. [PMID: 38706833 PMCID: PMC11066509 DOI: 10.1016/j.adro.2024.101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/11/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose Segmentation of clinical target volumes (CTV) on medical images can be time-consuming and is prone to interobserver variation (IOV). This is a problem for online adaptive radiation therapy, where CTV segmentation must be performed every treatment fraction, leading to longer treatment times and logistic challenges. Deep learning (DL)-based auto-contouring has the potential to speed up CTV contouring, but its current clinical use is limited. One reason for this is that it can be time-consuming to verify the accuracy of CTV contours produced using auto-contouring, and there is a risk of bias being introduced. To be accepted by clinicians, auto-contouring must be trustworthy. Therefore, there is a need for a comprehensive commissioning framework when introducing DL-based auto-contouring in clinical practice. We present such a framework and apply it to an in-house developed DL model for auto-contouring of the CTV in rectal cancer patients treated with MRI-guided online adaptive radiation therapy. Methods and Materials The framework for evaluating DL-based auto-contouring consisted of 3 steps: (1) Quantitative evaluation of the model's performance and comparison with IOV; (2) Expert observations and corrections; and (3) Evaluation of the impact on expected volumetric target coverage. These steps were performed on independent data sets. The framework was applied to an in-house trained nnU-Net model, using the data of 44 rectal cancer patients treated at our institution. Results The framework established that the model's performance after expert corrections was comparable to IOV, and although the model introduced a bias, this had no relevant impact on clinical practice. Additionally, we found a substantial time gain without reducing quality as determined by volumetric target coverage. Conclusions Our framework provides a comprehensive evaluation of the performance and clinical usability of target auto-contouring models. Based on the results, we conclude that the model is eligible for clinical use.
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Affiliation(s)
| | | | - Anja Betgen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lisa Wiersema
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Corrie Marijnen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Femke Peters
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Uulke A. van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tomas Janssen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Duffton A, Harnett N, McNair HA, Bennett E, Clarkson M, Guilherme Couto J, Lawler G, Matthews K, Oliveira C, Rozanec N, Simões R, Tsang Y. RTT advanced practice and how it can change the future of radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 30:100245. [PMID: 38595787 PMCID: PMC11002743 DOI: 10.1016/j.tipsro.2024.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 04/11/2024] Open
Abstract
The radiation therapy (RT) landscape is continuously evolving, necessitating adaptation in roles and responsibilities of radiation therapists (RTTs). Advanced Practice Radiation Therapists (APRTs) have taken on a proactive role in expanding services and assuming responsibilities within multi-professional teams. A European Society for Radiotherapy and Oncology (ESTRO) brought geographically diverse and experienced RTTs together, to discuss how advanced practice (AP) in the RTT profession should be future-proofed and create a global platform for collaboration. Challenges in achieving consensus and standardisation of APRT was identified across jurisdictions, emphasising the importance of international collaboration. Whilst highlighting the pivotal role of APRTs in driving innovation, improving patient care, and navigating the complexities of modern RT practice, this position paper presents outcomes and recommendations from the workshop. Discussions highlighted the need for standardised role definitions, education frameworks, regulatory support, and career development pathways to enable the advancement of APRT effectively. Increasing networks and collaboration is recommended to ensure APRTs can shape the future of RT.
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Affiliation(s)
- Aileen Duffton
- Radiotherapy Department, Beatson West of Scotland Cancer Centre, Glasgow, UK
- Institute of Cancer Science, University of Glasgow, UK
| | - Nicole Harnett
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, CA
- Department of Radiation Oncology, University of Toronto, CA
| | - Helen A McNair
- Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Erica Bennett
- Bon Secours Radiotherapy Cork in partnership with UPMC Hillman Cancer Centre, Cork, IE
| | - Melanie Clarkson
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, UK
| | | | - Gavin Lawler
- Research & Innovation Infrastructures Unit, Research Strategy & Funding Directorate, Health Research Board, Dublin, IE
| | - Kristie Matthews
- Faculty of Medicine, Nursing and Health Sciences, Monash University, AU
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, AU
| | - Celeste Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), PT
| | - Natalie Rozanec
- Department of Radiation Oncology, University of Toronto, CA
- Stronach Regional Cancer Centre, Southlake Regional Health Centre, CA
| | - Rita Simões
- Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
- University College London Hospitals, London, UK
- Radiotherapy Trials quality assurance (RTTQA) group, UK
| | - Yatman Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, CA
- Department of Radiation Oncology, University of Toronto, CA
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Cruces C, Chero J, Ñacari LA, De Celis VR, Simões R, Luque JL. Two new Neotetraonchus species (Dactylogyridea, Dactylogyridae) parasitising the Peruvian sea catfish Galeichthys peruvianus (Siluriformes, Ariidae), including molecular data. J Helminthol 2024; 98:e35. [PMID: 38651383 DOI: 10.1017/s0022149x24000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
As part of a parasitological survey, several specimens of two new monopisthocotylean species, Neotetraonchus celsomanueli sp. nov. and N.peruvianus sp. nov. (Dactylogyridea, Dactylogyridae), were collected from the gill filaments of the Peruvian sea catfish Galeichthys peruvianus (Siluriformes, Ariidae) off Puerto Pizarro, Tumbes region, Peru. Neotetraonchus celsomanueli sp. nov. is characterised by an MCO with a T-shaped distal end and an accessory piece that is ribbed and expanded proximally with a worm-shaped termination. Neotetraonchus peruvianus sp. nov. is typified by its MCO, which has a sledgehammer-shaped distal end and an accessory piece with a claw-shaped distal end. Additionally, N.peruvianus sp. nov. is characterised by its jellyfish-shaped onchium. A partial 28S rDNA sequence was obtained from N.celsomanueli sp. nov., and a phylogenetic analysis was conducted. This analysis revealed the phylogenetic position of Neotetraonchus celsomanueli sp. nov. within a clade comprising monopisthocotylean parasites of diadromous and marine ariid catfishes, including Hamatopeduncularia spp., Chauhanellus spp., Thysanotohaptor Kritsky, Shameem, Kumari & Krishnaveni, , and Neocalceostomoides spinivaginalis Lim, 1995. This finding brings the number of known Neotetraonchus species to seven and represents the first described Neotetraonchus species infecting marine catfishes from Peru.
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Affiliation(s)
- C Cruces
- Programa de Pós-Graduação em Biologia Animal, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
- Laboratorio de Zoología de Invertebrados, Departamento Académico de Zoología, Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos (UNMSM), Av. Universitaria cruce con Av. Venezuela cuadra 34, Lima, Peru
| | - J Chero
- Laboratorio de Zoología de Invertebrados, Departamento Académico de Zoología, Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos (UNMSM), Av. Universitaria cruce con Av. Venezuela cuadra 34, Lima, Peru
| | - L A Ñacari
- Laboratorio de Ecología y Evolución de Parásitos, Facultad de Ciencias del Mar y Recursos Biológicos, Universidad de Antofagasta, 601 Angamos, Antofagasta, Chile
| | - V R De Celis
- Laboratorio de Genómica y Biología Evolutiva, Instituto de Ciencias y Tecnología, Universidad Ricardo Palma (URP), Av. Alfredo Benavides 5440 Santiago de Surco, Lima, Peru
| | - R Simões
- Departamento de Parasitologia Animal, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
| | - J L Luque
- Departamento de Parasitologia Animal, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
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Miranda I, Lourenço A, Simões R, Athayde J, Pereira H. Insights into cork weathering regarding colour, chemical and cellular changes in view of outdoor applications. PLoS One 2024; 19:e0301384. [PMID: 38574047 PMCID: PMC10994410 DOI: 10.1371/journal.pone.0301384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
A comprehensive analysis of outdoor weathering and soil burial of cork during 1-year experiments was carried out with measurements of CIELAB color parameters, cellular observations by scanning electron microscopy, and surface chemical features analysed by ATR-FTIR and wet chemical analysis. Cork applied in outdoor conditions above and below ground retained its physical structure and integrity without signs of deterioration or fracturing. The cellular structure was maintained with some small changes at the one-cell layer at the surface, featuring cellular expansion and minute cell wall fractures. Surface color and chemistry showed distinct results for outdoor exposure and soil burial. The weathered cork surfaces acquired a lighter color while the soil buried cork surfaces became darker. With outdoor weathering, the cork polar solubles increased (13.0% vs. 7.6% o.d. mass) while a substantial decrease of lignin occurred (about 28% of the original lignin was removed) leading to a suberin-enriched cork surface. The chemical impact on lignin is therefore responsible for the surface change towards lighter colors. Soil-burial induced hydrolysis of ester bonds of suberin and xylan, and the lignin-enriched cork surface displayed a dark brown color. FTIR and wet chemical results were consistent. Overall cork showed a considerable structural and physical stability that allows its application in outdoor conditions, namely for building façades or other surfacing applications. Architects and designers should take into account the color dynamics of the cork surfaces.
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Affiliation(s)
- Isabel Miranda
- Forest Research Center and Associate Laboratory TERRA, School of Agriculture, University of Lisbon, Lisboa, Portugal
| | - Ana Lourenço
- Forest Research Center and Associate Laboratory TERRA, School of Agriculture, University of Lisbon, Lisboa, Portugal
| | - Rita Simões
- Forest Research Center and Associate Laboratory TERRA, School of Agriculture, University of Lisbon, Lisboa, Portugal
| | - João Athayde
- Forest Research Center and Associate Laboratory TERRA, School of Agriculture, University of Lisbon, Lisboa, Portugal
| | - Helena Pereira
- Forest Research Center and Associate Laboratory TERRA, School of Agriculture, University of Lisbon, Lisboa, Portugal
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Fairweather D, Taylor RM, Simões R. Choosing the right questions - A systematic review of patient reported outcome measures used in radiotherapy and proton beam therapy. Radiother Oncol 2024; 191:110071. [PMID: 38142933 DOI: 10.1016/j.radonc.2023.110071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/01/2023] [Accepted: 12/16/2023] [Indexed: 12/26/2023]
Abstract
The implementation of PROMs into clinical practice has been shown to improve quality of care. This systematic review aims to identify which PROMs are suitable for implementation within routine clinical practice in a radiotherapy or PBT service.The bibliographic databases MEDLINE, EMBASE and EMCARE were searched. Articles published between 1st January 2008 to 1st June 2023, that reported PROMs being utilised as an outcome measure were included. Inclusion criteria also included being written in English, involving human patients, aged 16 and above, receiving external beam radiotherapy or PBT for six defined tumour sites. PROMs identified within the included articles were subjected to quality assessment using the COSMIN reporting guidelines. Results are reported as per PRISMA guidelines. A total of 268 studies were identified in the search, of which 52 fulfilled the inclusion criteria. The use of 39 different PROMs was reported. The PROMs identified were mostly tumour or site-specific quality of life (n = 23) measures but also included generic cancer (n = 3), health-related quality-of-life (n = 6), and symptom specific (n = 7) measures.None of the PROMs identified received a high GRADE score for good content. There were 13 PROMs that received a moderate GRADE score. The remaining PROMs either had limited evidence of development and validation within the patient cohorts investigated, or lacked relevance or comprehensiveness needed for routine PROMs collection in a radiotherapy or PBT service.This review highlights that there are a wide variety of PROMs being utilised within radiotherapy research, but most lack specificity to radiotherapy side-effects. There is a risk that by using non-specific PROMs in clinical practice, patients might not receive the supportive care that they need.
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Affiliation(s)
- Danielle Fairweather
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.
| | - Rachel M Taylor
- Centre for Nurse, Midwife and Allied Health Profession Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK; Department of Targeted Intervention, University College London, London, UK
| | - Rita Simões
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK; Radiotherapy Trials Quality Assurance (RTTQA) group, Mount Vernon Hospital, Northwood, UK
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Olaciregui-Ruiz I, Simões R, Jan-Jakob S. Deep learning-based tools to distinguish plan-specific from generic deviations in EPID-based in vivo dosimetry. Med Phys 2024; 51:854-869. [PMID: 38112213 DOI: 10.1002/mp.16895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Dose distributions calculated with electronic portal imaging device (EPID)-based in vivo dosimetry (EIVD) differ from planned dose distributions due to generic and plan-specific deviations. Generic deviations are characteristic to a class of plans. Examples include limitations in EIVD dose reconstruction, inaccuracies in treatment planning system (TPS) calculations and systematic machine deviations. Plan-specific deviations have an unpredictable character. Examples include discrepancies between the patient model used for dose calculation and the patient position or anatomy during delivery, random machine deviations, and data transfer, human or software errors. During the inspection work performed with traditional γ-evaluation statistical methods: (i) generic deviations raise alerts that need to be inspected but that rarely lead to action as their root cause is usually understood and (ii) the detection of relevant plan-specific deviations may be hindered by the presence of generic deviations. PURPOSE To investigate whether deep learning-based tools can help in identifying γ-alerts raised by generic deviations and in improving the detectability of plan-specific deviations. METHODS A 3D U-Net was trained as an autoencoder to reconstruct underlying patterns of generic deviations in γ-distributions. The network was trained for four treatment disease sites differently affected by generic deviations: volumetric modulated arc therapy (VMAT) lung (no known deviations), VMAT prostate (TPS inaccuracies), VMAT head-and-neck (EIVD limitations) and intensity modulated radiation therapy (IMRT) breast (large EIVD limitations). The network was trained with virtual non-transit γ-distributions: 60 train/10 validation for the VMAT sites and 30 train/10 validation for IMRT breast. It was hypothesized that in vivo γ-distributions obtained in the presence of plan-specific deviations would differ from those seen during training. For each disease site, the sensitivity of γ-analysis and the network to detect (synthetically introduced) patient-related deviations was compared by receiver operator characteristic analysis. The investigated deviations were patient positioning errors, weight gain or loss, and tumor volume changes. The clinical relevance was illustrated qualitatively with 793 in vivo clinical cases (141 lung, 136 head-and-neck, 209 prostate and 307 breast). RESULTS Error detectability of patient-related deviations was better with the network than with γ-analysis. The average area under the curve values over all sites were 0.86 ± 0.12(1SD) and 0.69 ± 0.25(1SD), respectively. Regarding in vivo clinical results, the percentage of cases differently classified by γ-analysis and the network was 1%, 19%, 18% and 64% for lung, head-and-neck, prostate, and breast, respectively. In head-and-neck and breast cases, 45 γ-only alerts were examined, of which 43 were attributed to EPID dose reconstruction limitations. For prostate, all 15 investigated γ-only alerts were due to known TPS inaccuracies. All 59 investigated network alerts were explained by either patient-related deviations or EPID acquisition incidents. Some patient-related deviations detected by the network were not detected by γ-analysis. CONCLUSIONS Deep learning-based tools trained to reconstruct underlying patterns of generic deviations in γ-distributions can be used to (i) automatically identify false positives within the set of γ-alerts and (ii) improve the detection of plan-specific deviations, hence minimizing the likelihood of false negatives. The presented method provides clear additional value to the γ-alert management process for large scale EIVD systems.
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Affiliation(s)
- Igor Olaciregui-Ruiz
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rita Simões
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sonke Jan-Jakob
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Rodríguez Outeiral R, Ferreira Silvério N, González PJ, Schaake EE, Janssen T, van der Heide UA, Simões R. Response letter to Wahid et al. regarding our publication "A network score-based metric to optimize the quality assurance of automatic radiotherapy target segmentations". Phys Imaging Radiat Oncol 2024; 29:100528. [PMID: 38235287 PMCID: PMC10792752 DOI: 10.1016/j.phro.2023.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Affiliation(s)
- Roque Rodríguez Outeiral
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Nicole Ferreira Silvério
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Patrick J. González
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Eva E. Schaake
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Tomas Janssen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Uulke A. van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
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Crockett C, Simões R. OncoFlash - Research Updates in a Flash! (December 2023 edition). Clin Oncol (R Coll Radiol) 2023; 35:761-763. [PMID: 37977692 DOI: 10.1016/j.clon.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- C Crockett
- Northern Ireland Cancer Centre, Belfast, United Kingdom.
| | - R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom
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Crockett C, Simões R. OncoFlash - Research Updates in a Flash! (October edition). Clin Oncol (R Coll Radiol) 2023; 35:627-629. [PMID: 37679018 DOI: 10.1016/j.clon.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Affiliation(s)
- C Crockett
- Northern Ireland Cancer Centre, Belfast, United Kingdom.
| | - R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom
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Malengue AS, Miranda I, Simões R, Lourenço A, Gominho J, Pereira H. Cork cellular and chemical features underlying bark environmental protection in the miombo species Parinari curatellifolia. Heliyon 2023; 9:e21135. [PMID: 37928381 PMCID: PMC10622615 DOI: 10.1016/j.heliyon.2023.e21135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/19/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
Parinari curatellifolia is an important evergreen tree from the Miombo woodland of south-central and eastern Africa. The bark is corky, suggesting an increased protection against the ecosystem high temperatures and drought conditions as well as against wild fires. The cork in the bark rhytidome of P. curatellifolia was analyzed here for the first time with a focus on chemical and cellular features. P. curatellifolia cork has the cellular characteristics of cork tissues, with typical honeycomb structure in the tangential section and a brick-wall layer in the transverse and radial sections, without intercellular voids. Chemically P. curatellifolia cork has 8.4 % extractives, 33.9 % suberin, 31.9 % lignin and 25.2 % polysaccharides of the cork. The hemicelluloses are mostly xylans, with a substantial proportion of arabinose and galactose. Suberin showed a proportion of long chain lipids to glycerol (LCLip:Gly, mass ratio) of 8.5, and the long chain monomeric composition included a similar proportion of α,ω-diacids and ω-hydroxy acids (35.4 % and 31.5 % of long chain monomers) with a substantial proportion of monoacids (19.4 % of long chain monomers). Lignin is a guaiacyl-syringyl lignin with S/G of 0.32 and H:G:S of 1:14.1:4.5. The rhytidome composition and the cellular and chemical features of its cork are in line with environment-targeted protective features namely as a transpiration and insulation barrier, and as an increased fire protection.
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Affiliation(s)
- Abílio Santos Malengue
- Centro de Estudos Florestais, Laboratório Associado Terra, Instituto Superior de Agronomia, Universidade de Lisboa, Portugal
- Faculdade de Ciências Agrarias da Universidade José Eduardo dos Santos, Huambo, Angola
| | - Isabel Miranda
- Centro de Estudos Florestais, Laboratório Associado Terra, Instituto Superior de Agronomia, Universidade de Lisboa, Portugal
| | - Rita Simões
- Centro de Estudos Florestais, Laboratório Associado Terra, Instituto Superior de Agronomia, Universidade de Lisboa, Portugal
| | - Ana Lourenço
- Centro de Estudos Florestais, Laboratório Associado Terra, Instituto Superior de Agronomia, Universidade de Lisboa, Portugal
| | - Jorge Gominho
- Centro de Estudos Florestais, Laboratório Associado Terra, Instituto Superior de Agronomia, Universidade de Lisboa, Portugal
| | - Helena Pereira
- Centro de Estudos Florestais, Laboratório Associado Terra, Instituto Superior de Agronomia, Universidade de Lisboa, Portugal
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Rodríguez Outeiral R, Ferreira Silvério N, González PJ, Schaake EE, Janssen T, van der Heide UA, Simões R. A network score-based metric to optimize the quality assurance of automatic radiotherapy target segmentations. Phys Imaging Radiat Oncol 2023; 28:100500. [PMID: 37869474 PMCID: PMC10587515 DOI: 10.1016/j.phro.2023.100500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Background and purpose Existing methods for quality assurance of the radiotherapy auto-segmentations focus on the correlation between the average model entropy and the Dice Similarity Coefficient (DSC) only. We identified a metric directly derived from the output of the network and correlated it with clinically relevant metrics for contour accuracy. Materials and Methods Magnetic Resonance Imaging auto-segmentations were available for the gross tumor volume for cervical cancer brachytherapy (106 segmentations) and for the clinical target volume for rectal cancer external-beam radiotherapy (77 segmentations). The nnU-Net's output before binarization was taken as a score map. We defined a metric as the mean of the voxels in the score map above a threshold (λ). Comparisons were made with the mean and standard deviation over the score map and with the mean over the entropy map. The DSC, the 95th Hausdorff distance, the mean surface distance (MSD) and the surface DSC were computed for segmentation quality. Correlations between the studied metrics and model quality were assessed with the Pearson correlation coefficient (r). The area under the curve (AUC) was determined for detecting segmentations that require reviewing. Results For both tasks, our metric (λ = 0.30) correlated more strongly with the segmentation quality than the mean over the entropy map (for surface DSC, r > 0.65 vs. r < 0.60). The AUC was above 0.84 for detecting MSD values above 2 mm. Conclusions Our metric correlated strongly with clinically relevant segmentation metrics and detected segmentations that required reviewing, indicating its potential for automatic quality assurance of radiotherapy target auto-segmentations.
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Affiliation(s)
- Roque Rodríguez Outeiral
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Nicole Ferreira Silvério
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Patrick J. González
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Eva E. Schaake
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Tomas Janssen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Uulke A. van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
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Moura AR, Santos AR, Losano JDA, Siqueira AFP, Hamilton TRS, Zanella R, Caires KC, Simões R. Evaluation of sperm and hormonal assessments in Wagyu, Nellore, and Angus bulls. ZYGOTE 2023; 31:507-516. [PMID: 37492001 DOI: 10.1017/s0967199423000278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Wagyu bulls are known to have a highly exacerbated libido, as shown by the intense sexual interest of young calves. Therefore we believe that Wagyu male animals have specialized Sertoli and Leydig cells that are directly involved with the sexual precocity in this breed as mature bulls have a small scrotal circumference. This study aimed to evaluate whether there were differences in the hormone and sperm characteristics of Wagyu bulls compared with the same characteristics of subspecies Bos indicus and Bos taurus sires. Frozen-thawed semen from Wagyu, Nellore, and Angus sires were analyzed for sperm kinetics (computer-assisted sperm analysis), plasma membrane integrity, chromatin integrity, acrosome status, mitochondrial activity, lipid peroxidation and hormone [luteinizing hormone (LH) and testosterone] serum concentration. The results showed that Wagyu had lower total motility and an increased number of sperm with no motility when compared with Nellore and Angus bulls. Wagyu breed did not differ from those breeds when considering plasma and acrosome membranes integrity, mitochondrial potential, chromatin resistance, sperm lipid peroxidation or hormone (LH and testosterone) concentrations. We concluded that Wagyu sires had lower total motility when compared with Nellore and Angus bulls. Wagyu breed did not differ from these breeds when considering plasma and acrosome membranes integrity, mitochondrial potential, chromatin resistance, sperm lipid peroxidation, or hormone (LH and testosterone) concentrations.
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Affiliation(s)
- A R Moura
- Center for Natural and Human Sciences, Federal University of ABC, Santo André, Sao Paulo, Brazil
| | - A R Santos
- Center for Natural and Human Sciences, Federal University of ABC, Santo André, Sao Paulo, Brazil
| | - J D A Losano
- Department of Animal Sciences, University of Florida, USA
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, Brazil
| | - A F P Siqueira
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, Brazil
| | - T R S Hamilton
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, Brazil
| | - R Zanella
- Escola de Ciências Agrárias Inovação e Negócios, Curso de Medicina Veterinária, Universidade de Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
- Programa de Pós Graduação em BioExperimentação, Universidade de Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | - K C Caires
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii, Manoa, Hawaii, USA
| | - R Simões
- Center for Natural and Human Sciences, Federal University of ABC, Santo André, Sao Paulo, Brazil
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13
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Simões R, Augustin Y, Gulliford S, Dehbi HM, Hoskin P, Miles E, Harrington K, Miah AB. Toxicity, normal tissue and dose-volume planning parameters for radiotherapy in soft tissue sarcoma of the extremities: A systematic review of the literature. Radiother Oncol 2023; 186:109739. [PMID: 37315584 DOI: 10.1016/j.radonc.2023.109739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Patients with soft tissue sarcoma of the extremities (STSE) are left with high incidence of toxicities after Radiotherapy (RT). Understanding the normal tissue dose relationship with the development of long-term toxicities may enable better RT planning in order to reduce treatment toxicities for STSE. This systematic review of the literature aims at reporting the incidence of acute and late toxicities and identifying RT delineation guidance the normal tissues structures and dose-volume parameters for STSE. METHODS A literature search of PUBMED-MEDLINE for studies that reported data on RT toxicity outcomes, delineation guidelines and dose-volume parameters for STSE from 2000 to 2022. Data has been tabulated and reported. RESULTS Thirty of 586 papers were selected after exclusion criteria. External beam RT prescriptions ranged from 30 to 72 Gy. The majority of studies reported the use of Intensity Modulated RT (IMRT) (27%). Neo-adjuvant RT was used in 40%. The highest long-term toxicities were subcutaneous and lymphoedema, reported when delivering 3DCRT. IMRT had a lower incidence of toxicities. Normal tissue outlining such as weight-bearing bones, skin and subcutaneous tissue, corridor and neurovascular bundle was recommended in 6 studies. Nine studies recommended the use of dose-volume constraints, but only one recommended evidence-based dose-volume constraints. CONCLUSION Although the literature is replete with toxicity reports, there is a lack of evidence-based guidance on normal tissue and dose-volume parameters and strategies to reduce the normal tissues irradiation when optimising RT plans for STSE are poor compared to other tumour sites.
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Affiliation(s)
- Rita Simões
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK; Radiotherapy Trials Quality Assurance (RTTQA) group, Mount Vernon Hospital, Northwood, UK; University College London Hospital NHS Foundation Trust, London, UK.
| | | | - Sarah Gulliford
- University College London Hospital NHS Foundation Trust, London, UK; University College London, London, UK.
| | | | - Peter Hoskin
- Radiotherapy Trials Quality Assurance (RTTQA) group, Mount Vernon Hospital, Northwood, UK; University of Manchester, Manchester, UK.
| | - Elizabeth Miles
- Radiotherapy Trials Quality Assurance (RTTQA) group, Mount Vernon Hospital, Northwood, UK.
| | - Kevin Harrington
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK.
| | - Aisha B Miah
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK.
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Pereira H, Simões R, Miranda I. Cuticular Waxes and Cutin in Terminalia catappa Leaves from the Equatorial São Tomé and Príncipe Islands. Molecules 2023; 28:6365. [PMID: 37687194 PMCID: PMC10489119 DOI: 10.3390/molecules28176365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
This study presents for the first time an analysis of the content and chemical composition of the cuticular waxes and cutin in the leaves of the widespread and important tropical species Terminalia catappa. The leaves were collected in the equatorial Atlantic islands of São Tomé and Príncipe, in the Gulf of Guinea. The epicuticular and intracuticular waxes were determined via dichloromethane extraction and their chemical composition via GC-MS analysis, and the content and monomeric composition of cutin were determined after depolymerization via methanolysis. The leaves contained an epidermal cuticular coverage of 52.8 μg cm-2 of the cuticular waxes (1.4% of mass) and 63.3 μg cm-2 (1.5% of mass) of cutin. Cuticular waxes include mainly n-alkanols and fatty acids, with a substantial proportion of terpenes in the more easily solubilized fraction, and sterols in the more embedded waxes. Cutin is mostly constituted by C16 fatty acids and dihydroxyacids, also including aromatic monomers, suggesting a largely linear macromolecular arrangement. The high proportion of triacontanol, α-amyrin, β-amyrin, germanicol, and lupeol in the easily solubilized cuticular fraction may explain the bioactive properties attributed to the T. catappa leaves via the popular medicine, which allows us to consider them as a potential source for the extraction of these compounds.
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Affiliation(s)
- Helena Pereira
- Centro de Estudos Florestais (CEF), Laboratório Associado Terra, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (R.S.); (I.M.)
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15
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Silva DP, Coelho M, Soares T, Vale TC, Correia Guedes L, Maciel ROH, Antunes AP, Camargos ST, Valadas A, Godinho C, Maia DP, Pita Lobo P, Maia RD, Teodoro T, Rieder CR, Velon AG, Tumas V, Barbosa ER, Teive HA, Ferraz HB, Rosas MJ, Calado A, Lampreia T, Simões R, Vila‐Chã N, Costa MM, Rodrigues AM, Caniça V, Cardoso F, Ferreira JJ. Handicap as a Measure of Perceived-Health Status in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:1172-1180. [PMID: 37635780 PMCID: PMC10450228 DOI: 10.1002/mdc3.13826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/31/2023] [Accepted: 06/11/2023] [Indexed: 08/29/2023] Open
Abstract
Background Handicap is a patient-centered measure of health status that encompasses the impact of social and physical environment on daily living, having been assessed in advanced and late-stage Parkinson's Disease (PD). Objective To characterize the handicap of a broader sample of patients. Methods A cross-sectional study of 405 PD patients during the MDS-UPDRS Portuguese validation study, using the MDS-UPDRS, Unified Dyskinesias Rating Scale, Nonmotor symptoms questionnaire, PDQ-8 and EQ-5D-3L. Handicap was measured using the London Handicap Scale (LHS). Results Mean age was 64.42 (±10.3) years, mean disease duration 11.30 (±6.5) years and median HY 2 (IQR, 2-3). Mean LHS was 0.652 (±0.204); "Mobility," "Occupation" and "Physical Independence" were the most affected domains. LHS was significantly worse in patients with longer disease duration, older age and increased disability. In contrast, PDQ-8 did not differentiate age groups. Handicap was significantly correlated with disease duration (r = -0.35), nonmotor experiences of daily living (EDL) (MDS-UPDRS-I) (r = -0.51), motor EDL (MDS-UPDRS-II) (r = -0.69), motor disability (MDS-UPDRS-III) (r = -0.49), axial signs of MDS-UPDRS-III (r = -0.55), HY (r = -0.44), presence of nonmotor symptoms (r = -0.51) and PDQ-8 index (r = -0.64) (all P < 0.05). Motor EDL, MDS-UPDRS-III and PDQ-8 independently predicted Handicap (adjusted R 2 = 0.582; P = 0.007). Conclusions The LHS was easily completed by patients and caregivers. Patients were mild-moderately handicapped, which was strongly determined by motor disability and its impact on EDL, and poor QoL. Despite correlated, handicap and QoL seem to differ in what they measure, and handicap may have an added value to QoL. Handicap seems to be a good measure of perceived-health status in a broad sample of PD.
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Affiliation(s)
- Daniela Pimenta Silva
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
| | - Miguel Coelho
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | | | | | - Leonor Correia Guedes
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | | | - Ana Patrícia Antunes
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
| | | | - Anabela Valadas
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM)
| | - Débora Palma Maia
- Movement Disorders UnitFederal University of Minas GeraisBelo HorizonteBrazil
| | - Patrícia Pita Lobo
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | - Raphael Doyle Maia
- Movement Disorders Unit, Hospital Universitário Cassiano Antônio MoraesFederal University of Espírito SantoEspírito SantoBrazil
| | - Tiago Teodoro
- Instituto de Medicina MolecularLisbonPortugal
- Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals National Health Service Foundation TrustLondonUnited Kingdom
- Neuroscience Research Centre, Institute of Molecular and Clinical SciencesSt. George's University of LondonLondonUK
| | - Carlos R. Rieder
- Movement Disorders UnitHospital Santa Casa de Misericórdia de Porto AlegrePorto AlegreBrazil
- Federal University of Health Sciences of Porto AlegrePorto AlegreBrazil
| | - Ana Graça Velon
- Serviço de Neurologia do Centro Hospitalar de Trás‐os‐Montes e Alto DouroVila RealPortugal
| | - Vítor Tumas
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto School of MedicineUniversity of São PauloRibeirão PretoBrazil
| | - Egberto Reis Barbosa
- Universidade de São Paulo, Faculdade de MedicinaDepartamento de Neurologia, Centro de Distúrbios do MovimentoSão PauloBrazil
| | - Hélio A.G. Teive
- Department of NeurologyUniversidade Federal do ParanáCuritibaBrazil
| | | | | | - Ana Calado
- Serviço de Neurologia do Centro Hospitalar de Lisboa CentralLisbonPortugal
| | - Tânia Lampreia
- Serviço de NeurologiaHospital Egas Moniz, Centro Hospitalar Lisboa OcidentalLisbonPortugal
| | - Rita Simões
- Serviço de NeurologiaHospital Beatriz ÂngeloLisbonPortugal
| | - Nuno Vila‐Chã
- Serviço de Neurologia do Hospital de Santo António, Centro Hospitalar Universitário do PortoPortoPortugal
| | - Maria Manuela Costa
- Serviço de NeurologiaHospital Pedro HispanoMatosinhosPortugal
- Serviço de NeurologiaHospital das Forças ArmadasPortoPortugal
| | | | | | - Francisco Cardoso
- Movement Disorders UnitFederal University of Minas GeraisBelo HorizonteBrazil
| | - Joaquim J. Ferreira
- CNS – Campus NeurológicoTorres VedrasPortugal
- Laboratory of Clinical Pharmacology, Faculty of MedicineUniversity of LisbonLisbonPortugal
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Crockett C, Simões R. OncoFlash - Research Updates in a Flash! (August 2023 Edition). Clin Oncol (R Coll Radiol) 2023; 35:556-558. [PMID: 37394266 DOI: 10.1016/j.clon.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Affiliation(s)
- C Crockett
- Northern Ireland Cancer Centre, Belfast, United Kingdom.
| | - R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom
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17
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Crockett C, Simões R. OncoFlash - Research Updates in a Flash! (June 2023 edition). Clin Oncol (R Coll Radiol) 2023; 35:351-353. [PMID: 37150545 DOI: 10.1016/j.clon.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Affiliation(s)
- C Crockett
- Northern Ireland Cancer Centre, Belfast, United Kingdom.
| | - R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom
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Rodríguez Outeiral R, González PJ, Schaake EE, van der Heide UA, Simões R. Deep learning for segmentation of the cervical cancer gross tumor volume on magnetic resonance imaging for brachytherapy. Radiat Oncol 2023; 18:91. [PMID: 37248490 DOI: 10.1186/s13014-023-02283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/16/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Segmentation of the Gross Tumor Volume (GTV) is a crucial step in the brachytherapy (BT) treatment planning workflow. Currently, radiation oncologists segment the GTV manually, which is time-consuming. The time pressure is particularly critical for BT because during the segmentation process the patient waits immobilized in bed with the applicator in place. Automatic segmentation algorithms can potentially reduce both the clinical workload and the patient burden. Although deep learning based automatic segmentation algorithms have been extensively developed for organs at risk, automatic segmentation of the targets is less common. The aim of this study was to automatically segment the cervical cancer GTV on BT MRI images using a state-of-the-art automatic segmentation framework and assess its performance. METHODS A cohort of 195 cervical cancer patients treated between August 2012 and December 2021 was retrospectively collected. A total of 524 separate BT fractions were included and the axial T2-weighted (T2w) MRI sequence was used for this project. The 3D nnU-Net was used as the automatic segmentation framework. The automatic segmentations were compared with the manual segmentations used for clinical practice with Sørensen-Dice coefficient (Dice), 95th Hausdorff distance (95th HD) and mean surface distance (MSD). The dosimetric impact was defined as the difference in D98 (ΔD98) and D90 (ΔD90) between the manual segmentations and the automatic segmentations, evaluated using the clinical dose distribution. The performance of the network was also compared separately depending on FIGO stage and on GTV volume. RESULTS The network achieved a median Dice of 0.73 (interquartile range (IQR) = 0.50-0.80), median 95th HD of 6.8 mm (IQR = 4.2-12.5 mm) and median MSD of 1.4 mm (IQR = 0.90-2.8 mm). The median ΔD90 and ΔD98 were 0.18 Gy (IQR = -1.38-1.19 Gy) and 0.20 Gy (IQR =-1.10-0.95 Gy) respectively. No significant differences in geometric or dosimetric performance were observed between tumors with different FIGO stages, however significantly improved Dice and dosimetric performance was found for larger tumors. CONCLUSIONS The nnU-Net framework achieved state-of-the-art performance in the segmentation of the cervical cancer GTV on BT MRI images. Reasonable median performance was achieved geometrically and dosimetrically but with high variability among patients.
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Affiliation(s)
- Roque Rodríguez Outeiral
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, CX, The Netherlands
| | - Patrick J González
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, CX, The Netherlands
| | - Eva E Schaake
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, CX, The Netherlands
| | - Uulke A van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, CX, The Netherlands
| | - Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, Amsterdam, CX, The Netherlands.
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Simões R, Jayaprakash KT. OncoFlash - Research Updates in a Flash! (April 2023). Clin Oncol (R Coll Radiol) 2023; 35:216-218. [PMID: 36894204 DOI: 10.1016/j.clon.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom.
| | - K T Jayaprakash
- Cancer Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Oncology, The Queen Elizabeth Hospital King's Lynn, King's Lynn, United Kingdom
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20
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Simões R, Jayaprakash KT. OncoFlash - Research Updates in a Flash! (February 2023). Clin Oncol (R Coll Radiol) 2023; 35:70-71. [PMID: 36639180 DOI: 10.1016/j.clon.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom.
| | - K T Jayaprakash
- Cancer Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Oncology, The Queen Elizabeth Hospital King's Lynn, King's Lynn, United Kingdom
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Thomson DJ, Cruickshank C, Baines H, Banner R, Beasley M, Betts G, Bulbeck H, Charlwood F, Christian J, Clarke M, Donnelly O, Foran B, Gillies C, Griffin C, Homer JJ, Langendijk JA, Lee LW, Lester J, Lowe M, McPartlin A, Miles E, Nutting C, Palaniappan N, Prestwich R, Price JM, Roberts C, Roe J, Shanmugasundaram R, Simões R, Thompson A, West C, Wilson L, Wolstenholme J, Hall E. TORPEdO: A phase III trial of intensity-modulated proton beam therapy versus intensity-modulated radiotherapy for multi-toxicity reduction in oropharyngeal cancer. Clin Transl Radiat Oncol 2023; 38:147-154. [PMID: 36452431 PMCID: PMC9702982 DOI: 10.1016/j.ctro.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
•There is a lack of prospective level I evidence for the use of PBT for most adult cancers including oropharyngeal squamous cell carcinoma (OPSCC).•TORPEdO is the UK's first PBT clinical trial and aims to determine the benefits of PBT for OPSCC.•Training and support has been provided before and during the trial to reduce variations of contouring and radiotherapy planning.•There is a strong translational component within TORPEdO. Imaging and physics data along with blood, tissue collection will inform future studies in refining patient selection for IMPT.
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Affiliation(s)
| | | | - Helen Baines
- Radiotherapy Trials QA Group (RTTQA), The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Russell Banner
- Swansea Bay University Health Board, Swansea, United Kingdom
| | | | - Guy Betts
- Manchester University NHS Foundation Trust. Manchester, United Kingdom
| | - Helen Bulbeck
- Brainstrust – The Brain Cancer People, Cowes, United Kingdom
| | | | - Judith Christian
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Matthew Clarke
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Olly Donnelly
- Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Bernadette Foran
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Callum Gillies
- University College Hospitals London NHS Foundation Trust, London, United Kingdom
| | - Clare Griffin
- The Institute of Cancer Research, London, United Kingdom
| | - Jarrod J. Homer
- Manchester University NHS Foundation Trust. Manchester, United Kingdom
| | - Johannes A. Langendijk
- University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Lip Wai Lee
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - James Lester
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Matthew Lowe
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - Elizabeth Miles
- Radiotherapy Trials QA Group (RTTQA), Mount Vernon Hospital, Northwood, United Kingdom
| | - Christopher Nutting
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Robin Prestwich
- The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - James M. Price
- The Christie NHS Foundation Trust, Manchester, United Kingdom
- The University of Manchester, Manchester, United Kingdom
| | - Clare Roberts
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Justin Roe
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Imperial College, London, United Kingdom
| | | | - Rita Simões
- Radiotherapy Trials QA Group (RTTQA), Mount Vernon Hospital, Northwood, United Kingdom
| | - Anna Thompson
- University College Hospitals London NHS Foundation Trust, London, United Kingdom
| | - Catharine West
- The University of Manchester, Manchester, United Kingdom
| | - Lorna Wilson
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Jane Wolstenholme
- Health Economics Research Centre, University of Oxford, United Kingdom
| | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
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Simões R, Thippu Jayaprakash K. OncoFlash - Research Updates in a Flash! (October 2022). Clin Oncol (R Coll Radiol) 2022; 34:617-619. [PMID: 36115684 DOI: 10.1016/j.clon.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom.
| | - K Thippu Jayaprakash
- Cancer Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Oncology, The Queen Elizabeth Hospital King's Lynn, King's Lynn, United Kingdom
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23
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Simões R, Jayaprakash K. OncoFlash – Research Updates in a Flash! (August 2022). Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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González PJ, Simões R, Kiers K, Janssen TM. Explaining the dosimetric impact of contouring errors in head and neck radiotherapy. Biomed Phys Eng Express 2022; 8. [PMID: 35732139 DOI: 10.1088/2057-1976/ac7b4c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/22/2022] [Indexed: 11/12/2022]
Abstract
Objective. Auto-contouring of organs at risk (OAR) is becoming more common in radiotherapy. An important issue in clinical decision making is judging the quality of the auto-contours. While recent studies considered contour quality by looking at geometric errors only, this does not capture the dosimetric impact of the errors. In this work, we studied the relationship between geometrical errors, the local dose and the dosimetric impact of the geometrical errors.Approach. For 94 head and neck patients, unmodified atlas-based auto-contours and clinically used delineations of the parotid glands and brainstem were retrieved. VMAT plans were automatically optimized on the auto-contours and evaluated on both contours. We defined the dosimetric impact on evaluation (DIE) as the difference in the dosimetric parameter of interest between the two contours. We developed three linear regression models to predict the DIE using: (1) global geometric metrics, (2) global dosimetric metrics, (3) combined local geometric and dosimetric metrics. For model (3), we next determined the minimal amount of editing information required to produce a reliable prediction. Performance was assessed by the root mean squared error (RMSE) of the predicted DIE using 5-fold cross-validation.Main results. In model (3), the median RMSE of the left parotid was 0.4 Gy using 5% of the largest editing vectors. For the right parotid and brainstem the results were 0.5 Gy using 10% and 0.4 Gy using 1% respectively. The median RMS of the DIE was 0.6 Gy, 0.7 Gy and 0.9 Gy for the left parotid, the right parotid and the brainstem, respectively. Model (3), combining local dosimetric and geometric quantities, outperformed the models that used only geometric or dosimetric information.Significance. We showed that the largest local errors plus the local dose suffice to accurately predict the dosimetric impact, opening the door to automated dosimetric QA of auto-contours.
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Affiliation(s)
- Patrick J González
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Karen Kiers
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tomas M Janssen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Rodríguez Outeiral R, Bos P, van der Hulst HJ, Al-Mamgani A, Jasperse B, Simões R, van der Heide UA. Strategies for tackling the class imbalance problem of oropharyngeal primary tumor segmentation on magnetic resonance imaging. Phys Imaging Radiat Oncol 2022; 23:144-149. [PMID: 36035088 PMCID: PMC9405079 DOI: 10.1016/j.phro.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 07/29/2022] [Accepted: 08/10/2022] [Indexed: 12/05/2022] Open
Abstract
Loss functions that account for class imbalance may not improve the segmentations. Our two-stage segmentation approach can outperform the 3D U-Net. A fully-automatic two-stage approach can perform comparably to a semi-automatic approach.
Background and purpose Contouring oropharyngeal primary tumors in radiotherapy is currently done manually which is time-consuming. Autocontouring techniques based on deep learning methods are a desirable alternative, but these methods can render suboptimal results when the structure to segment is considerably smaller than the rest of the image. The purpose of this work was to investigate different strategies to tackle the class imbalance problem in this tumor site. Materials and methods A cohort of 230 oropharyngeal cancer patients treated between 2010 and 2018 was retrospectively collected. The following magnetic resonance imaging (MRI) sequences were available: T1-weighted, T2-weighted, 3D T1-weighted after gadolinium injection. Two strategies to tackle the class imbalance problem were studied: training with different loss functions (namely: Dice loss, Generalized Dice loss, Focal Tversky loss and Unified Focal loss) and implementing a two-stage approach (i.e. splitting the task in detection and segmentation). Segmentation performance was measured with Sørensen–Dice coefficient (Dice), 95th Hausdorff distance (HD) and Mean Surface Distance (MSD). Results The network trained with the Generalized Dice Loss yielded a median Dice of 0.54, median 95th HD of 10.6 mm and median MSD of 2.4 mm but no significant differences were observed among the different loss functions (p-value > 0.7). The two-stage approach resulted in a median Dice of 0.64, median HD of 8.7 mm and median MSD of 2.1 mm, significantly outperforming the end-to-end 3D U-Net (p-value < 0.05). Conclusion No significant differences were observed when training with different loss functions. The two-stage approach outperformed the end-to-end 3D U-Net.
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Simões R, Jayaprakash KT. OncoFlash - Research Updates in a Flash! (June 2022). Clin Oncol (R Coll Radiol) 2022; 34:351-352. [PMID: 35512928 DOI: 10.1016/j.clon.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- R Simões
- University College London Hospitals NHS Foundation Trust, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom; Radiotherapy Trials Quality Assurance (RTTQA) Group, Northwood, United Kingdom.
| | - K T Jayaprakash
- Cancer Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Oncology, The Queen Elizabeth Hospital King's Lynn, King's Lynn, United Kingdom
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Loggetto S, Veríssimo M, Darrigo-Junior L, Simões R, Bernardo W, Braga J. Guidelines on sickle cell disease: secondary stroke prevention in children and adolescents. Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular guidelines project: Associação Médica Brasileira - 2022. Hematol Transfus Cell Ther 2022; 44:246-255. [PMID: 35305940 PMCID: PMC9123578 DOI: 10.1016/j.htct.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/02/2022] Open
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Simões R, Miranda I, Pereira H. Cutin extraction and composition determined under differing depolymerisation conditions in cork oak leaves. Phytochem Anal 2022; 33:127-135. [PMID: 34155712 DOI: 10.1002/pca.3075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Cutin is a biopolyester involved in waterproofing aerial plant organs, including leaves. Cutin quantification and compositional profiling require depolymerisation, namely by methanolysis, but specific protocols are not available. OBJECTIVES Investigate how different methanolysis conditions regarding catalyst concentration effect cutin depolymerisation and monomer release, to better define protocols for cutin content determination and composition profiling. MATERIAL AND METHODS Cork oak (Quercus suber) dewaxed leaves were reacted with five sodium methoxide (NaOMe) concentrations. Extracts were analysed: glycerol by high-performance liquid chromatography (HPLC) and long-chain lipids by gas chromatography-mass spectrometry (GC-MS). RESULTS Cutin was completely removed by 3% NaOMe (8.4% of dewaxed leaves), while mild 0.1% and 0.01% NaOMe methanolysis only depolymerised 14% of total cutin. Reactivity of cutin ester bonds is not homogeneous and glyceridic ester bonds are more easily cleaved, releasing the existing glycerol already under the mildest conditions (0.53% with 0.01% NaOMe and 0.41% with 3% NaOMe). The composition of cutin extracts varies with depolymerisation extent, with easier release of alkanoic acids and alkanols, respectively, 34.9% and 8.8% of total monomers at 0.1% NaOMe, while ω-hydroxyacids (49.3% of total monomers) and α,ω-diacids (9.0% of the monomers) are solubilised under more intensive reactive conditions. CONCLUSION Cutin of Quercus suber leaves is confirmed as a glyceridic polyester of ω-hydroxyacids and alkanoic acids, with minor content of α,ω-diacids, and including coumarate moieties. The protocol for the determination of cutin content and compositional profiling was established regarding catalyst concentration. The molar composition of cutin suggests a macromolecular assembly based on glycerol linked to lipid oligomeric chains with moderate cross-linking.
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Affiliation(s)
- Rita Simões
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal
| | - Isabel Miranda
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal
| | - Helena Pereira
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal
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Taghavi M, Staal FCR, Simões R, Hong EK, Lambregts DMJ, van der Heide UA, Beets-Tan RGH, Maas M. CT radiomics models are unable to predict new liver metastasis after successful thermal ablation of colorectal liver metastases. Acta Radiol 2021; 64:5-12. [PMID: 34918955 DOI: 10.1177/02841851211060437] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patients with colorectal liver metastases (CRLM) who undergo thermal ablation are at risk of developing new CRLM after ablation. Identification of these patients might enable individualized treatment. PURPOSE To investigate whether an existing machine-learning model with radiomics features based on pre-ablation computed tomography (CT) images of patients with colorectal cancer can predict development of new CRLM. MATERIAL AND METHODS In total, 94 patients with CRLM who were treated with thermal ablation were analyzed. Radiomics features were extracted from the healthy liver parenchyma of CT images in the portal venous phase, before thermal ablation. First, a previously developed radiomics model (Original model) was applied to the entire cohort to predict new CRLM after 6 and 24 months of follow-up. Next, new machine-learning models were developed (Radiomics, Clinical, and Combined), based on radiomics features, clinical features, or a combination of both. RESULTS The external validation of the Original model reached an area under the curve (AUC) of 0.57 (95% confidence interval [CI]=0.56-0.58) and 0.52 (95% CI=0.51-0.53) for 6 and 24 months of follow-up. The new predictive radiomics models yielded a higher performance at 6 months compared to 24 months. For the prediction of CRLM at 6 months, the Combined model had slightly better performance (AUC=0.60; 95% CI=0.59-0.61) compared to the Radiomics and Clinical models (AUC=0.55-0.57), while all three models had a low performance for the prediction at 24 months (AUC=0.52-0.53). CONCLUSION Both the Original and newly developed radiomics models were unable to predict new CLRM based on healthy liver parenchyma in patients who will undergo ablation for CRLM.
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Affiliation(s)
- Marjaneh Taghavi
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Femke CR Staal
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rita Simões
- Department of Radiotherapy, Netherland Cancer Institute, Amsterdam, The Netherlands
| | - Eun K Hong
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Doenja MJ Lambregts
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Regina GH Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Monique Maas
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Salazar SB, Valez N, Sotti-Novais D, Simões R, Souza JA, Faustino MJ, Mendonça C, Lopes MM, Rodrigues V, Mira NP. Unveiling azole resistance mechanisms in Candida glabrata clinical isolates encoding wild-type or gain-of-function CgPdr1 alleles. Access Microbiol 2021. [DOI: 10.1099/acmi.cc2021.po0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The relevance of C. glabrata as a human pathogen is linked with its poor susceptibility to azoles as well as its extreme genomic plasticity that allows the rapid acquisition of resistance. Extensive characterization of azole-resistant C. glabrata strains unveiled the central role of the transcriptional regulator CgPdr1 in the resistance phenotype, with many strains encoding hyperactive (or gain-of-function; GOF) CgPdr1 alleles. Large scale profiling of a collection of clinical C. glabrata isolates recovered in hospitals of the Lisbon area, in Portugal, led to the identification of 11 strains exhibiting resistance to fluconazole and voriconazole, while 2 were only resistant to fluconazole. Among these strains, 10 were found to encode alleles of the CgPDR1 gene harbouring multiple non-synonymous SNPs that were not found in the alleles encoded by susceptible strains, including K274Q, I392M and I803T not previously described as GOF mutations. The isolates encoding these alleles were found to over-express several CgPdr1 target genes including the azole efflux pump CgCDR1 sustaining the idea that these represent new gain-of-function CgPdr1 alleles. Only one of the identified azole-resistant strains was found to encode a CgPDR1 allele fully identical to the one encoded by susceptible strains. To better understand the resistance phenotype of this strain, its transcriptome was compared with the one of a susceptible strain and of strains encoding CgPdr1 GOF alleles. The results of this comparative transcriptomic analysis will be discussed shedding light into the different azole-resistance mechanisms evolved by C. glabrata, including those independent of CgPdr1 GOF strains.
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Affiliation(s)
- Sara B. Salazar
- Department of Bioengineering, Institute for Bioengineering and Biosciences
| | - Noémi Valez
- Department of Bioengineering, Institute for Bioengineering and Biosciences
| | | | - Rita Simões
- Department of Bioengineering, Institute for Bioengineering and Biosciences
| | - José António Souza
- Department of Bioengineering, Institute for Bioengineering and Biosciences
| | | | - Catarina Mendonça
- Department of Bioengineering, Institute for Bioengineering and Biosciences
| | - Maria Manuel Lopes
- Faculdade de Farmácia da Universidade de Lisboa, Departamento de Microbiologia e Imunologia
| | | | - Nuno P. Mira
- Department of Bioengineering, Institute for Bioengineering and Biosciences
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Gonçalves A, Oliveira J, Simões R, Canas N, Vale J. Hemiparkinsonism Secondary to Giant Aneurysm. Neurology 2021; 98:325-326. [PMID: 34873016 DOI: 10.1212/wnl.0000000000013150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ana Gonçalves
- Department of Neurology, Hospital Beatriz Ângelo, Loures, Portugal
| | - João Oliveira
- Department of Neuroradiology, Hospital Beatriz Ângelo , Loures, Portugal
| | - Rita Simões
- Department of Neurology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Nuno Canas
- Department of Neurology, Hospital Beatriz Ângelo, Loures, Portugal
| | - José Vale
- Department of Neurology, Hospital Beatriz Ângelo, Loures, Portugal
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Forster M, Mendes R, Guerrero Urbano T, Evans M, Lei M, Spanswick V, Miles E, Simões R, Wheeler G, Forsyth S, White L. 866P ORCA-2: A phase I study of olaparib in addition to cisplatin-based concurrent chemoradiotherapy for patients with high risk locally advanced (LA) squamous cell carcinoma of the head and neck (HNSCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Gonzalez P, Mans A, Schaake E, Nowee M, van der Heide U, Simões R. PD-0927 MRI-based deep learning auto-contouring for organs-at-risk in gynecological brachytherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07206-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Nowee ME, van Pelt VWJ, Walraven I, Simões R, Liskamp CP, Lambregts DMJ, Heijmink S, Schaake E, van der Heide UA, Janssen TM. The impact of image acquisition time on registration, delineation and image quality for magnetic resonance guided radiotherapy of prostate cancer patients. Phys Imaging Radiat Oncol 2021; 19:85-89. [PMID: 34355071 PMCID: PMC8325094 DOI: 10.1016/j.phro.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/03/2021] [Accepted: 07/01/2021] [Indexed: 12/22/2022]
Abstract
Background and Purpose Magnetic resonance (MR) guided radiotherapy utilizes MR images for (online) plan adaptation and image guidance. The aim of this study was to investigate the impact of variation in MR acquisition time and scan resolution on image quality, interobserver variation in contouring and interobserver variation in registration. Materials and Methods Nine patients with prostate cancer were included. Four T2-weighted 3D turbo spin echo (T2w 3D TSE) sequences were acquired with different acquisition times and resolutions. Two radiologists assessed image quality, conspicuity of the capsule, peripheral zone and central gland architecture and motion artefacts on a 5 point scale. Images were delineated by two radiation oncologists and interobserver variation was assessed by the 95% Hausdorff distance. Seven observers registered the MR images on the planning CT. Registrations were compared on systematic offset and interobserver variation. Results Acquisition times ranged between 1.3 and 6.3 min. Overall image quality and capsule definition were significantly worse for the MR sequence with an acquisition time of 1.3 min compared to the other sequences. Median 95% Hausdorff distance showed no significant differences in interobserver variation of contouring. Systematic offset and interobserver variation in registration were small (<1 mm) and of no clinical significance. Conclusions Our results can be used to effectively shorten overall fraction time for online adaptive MR guided radiotherapy by optimising the imaging sequence used for registration. From the sequences studied, a sequence of 3.1 min with anisotropic voxels of 1.2 × 1.2 × 2.4 mm3 provided the shortest acquisition time without compromising image quality.
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Affiliation(s)
- M E Nowee
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - V W J van Pelt
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - I Walraven
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C P Liskamp
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D M J Lambregts
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Heijmink
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E Schaake
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - U A van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - T M Janssen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Rodríguez Outeiral R, Bos P, Al-Mamgani A, Jasperse B, Simões R, van der Heide UA. Oropharyngeal primary tumor segmentation for radiotherapy planning on magnetic resonance imaging using deep learning. Phys Imaging Radiat Oncol 2021; 19:39-44. [PMID: 34307917 PMCID: PMC8295848 DOI: 10.1016/j.phro.2021.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/31/2021] [Accepted: 06/21/2021] [Indexed: 12/14/2022]
Abstract
Reducing the context around the tumor results in better segmentations with CNNs. Combining multiple MRI sequences as input can be beneficial to segmentation networks. A semi-automatic approach is fast and can potentially improve the accuracy of segmentations.
Background and purpose Segmentation of oropharyngeal squamous cell carcinoma (OPSCC) is needed for radiotherapy planning. We aimed to segment the primary tumor for OPSCC on MRI using convolutional neural networks (CNNs). We investigated the effect of multiple MRI sequences as input and we proposed a semi-automatic approach for tumor segmentation that is expected to save time in the clinic. Materials and methods We included 171 OPSCC patients retrospectively from 2010 until 2015. For all patients the following MRI sequences were available: T1-weighted, T2-weighted and 3D T1-weighted after gadolinium injection. We trained a 3D UNet using the entire images and images with reduced context, considering only information within clipboxes around the tumor. We compared the performance using different combinations of MRI sequences as input. Finally, a semi-automatic approach by two human observers defining clipboxes around the tumor was tested. Segmentation performance was measured with Sørensen–Dice coefficient (Dice), 95th Hausdorff distance (HD) and Mean Surface Distance (MSD). Results The 3D UNet trained with full context and all sequences as input yielded a median Dice of 0.55, HD of 8.7 mm and MSD of 2.7 mm. Combining all MRI sequences was better than using single sequences. The semi-automatic approach with all sequences as input yielded significantly better performance (p < 0.001): a median Dice of 0.74, HD of 4.6 mm and MSD of 1.2 mm. Conclusion Reducing the amount of context around the tumor and combining multiple MRI sequences improved the segmentation performance. A semi-automatic approach was accurate and clinically feasible.
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Affiliation(s)
- Roque Rodríguez Outeiral
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Paula Bos
- Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.,Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Abrahim Al-Mamgani
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Bas Jasperse
- Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Uulke A van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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Severiano E Sousa C, Fabbri M, Godinho C, Simões R, Chendo I, Coelho M, Martins IP, Ferreira JJ. Clinical Diagnostic Criteria Have a High Impact on the Frequency of Dementia in Late-Stage Parkinson's Disease. Front Neurol 2021; 12:652424. [PMID: 34093399 PMCID: PMC8172803 DOI: 10.3389/fneur.2021.652424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Cognitive impairment is a potential late feature of Parkinson's disease (PD). However, studies in patients with late-stage PD are lacking due to the particular characteristics of this population. Objectives: To evaluate the frequency of dementia in late-stage PD patients and to assess the impact of using different diagnostic criteria. Methods: We conducted a cross-sectional study to estimate the frequency of dementia in late-stage PD patients using the International Parkinson and Movement Disorders Society (MDS) (Level II) clinical diagnostic criteria as the primary outcome. We also applied other diagnostic criteria [MDS (Level I), DSM-IV, and DSM-5 criteria] to determine their applicability and impact on dementia frequency. Results: 93 participants with a mean age of 75.8 years (SD 6.8) and 16.5 years (SD 7.5) of disease duration were included. 64.3% were classified as demented using the International Parkinson and Movement Disorders Society (MDS) (Level II) clinical diagnostic criteria. We observed a high discrepancy on the frequency of dementia depending on the criteria applied [6.2% with MDS (Level I), 58.8% with DSM-IV, and 72.0% with DSM-5 criteria]. Conclusions: We found a frequency of dementia below what was observed in similar populations. The particular characteristics of our sample may have contributed as protective factors for late-stage dementia. Dementia frequency varied depending on the criteria used mainly due to the presence of major depression.
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Affiliation(s)
- Catarina Severiano E Sousa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Margherita Fabbri
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Department of Neurosciences, Clinical Investigation Center 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico do Centro de Investigação Interdisciplinar Egas Moniz, Escola Superior de Saúde Egas Moniz, Almada, Portugal
| | - Rita Simões
- Neurology Department, Hospital Beatriz Ângelo, Loures, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Inês Chendo
- Campus Neurológico Sénior, Torres Vedras, Portugal.,Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal.,Clínica Universitária de Psiquiatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Miguel Coelho
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal
| | - Isabel Pavão Martins
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Laboratório de Estudos da Linguagem, Instituto de Medicina Molecular de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
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Papaconstadopoulos P, González P, Carbaat C, Simões R, Beemster H, Koetsveld F, Remeijer P, Janssen T. An anomaly detector as a clinical decision support system for parotid gland delineations. Phys Med Biol 2021; 66. [PMID: 33906177 DOI: 10.1088/1361-6560/abfbf5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/27/2021] [Indexed: 11/11/2022]
Abstract
Purpose. Auto-contouring (AC) is rapidly becoming standard practice for OAR contouring. However, in clinical practice, clinicians still need to manually check and correct contours. Anomaly detection systems (ADS) can aid the clinical decision process by suggesting which structures require corrections or not, greatly enhancing the value of AC. The purpose of this work is to develop and evaluate a decision support system for detecting anomalies in the case of parotid gland delineations. METHODS Head and neck parotid gland delineations (1037 right, 1038 left), were retrieved from the Netherlands Cancer Institute (NKI) database. Morphological and image-based features were extracted from each patient's CT and structure set. An isolation forest model was initially trained on 70% of the data, of which 10% had synthetically generated anomalies and validated on the remaining 30% of clinical data. The ADS was tested on an independent set of 250 patients (Normal: 174, Anomalies: 76) and on a clinical autocontouring software. RESULTS Applied to the validation set, the ADS system resulted in area under the curve (AUC) values of 0.93 and 0.94 for the parotid left and right respectively. Image features appeared more important than morphological, but using all features resulted marginally in the best model. Applied to the test set the ADS system reached an accuracy level of 0.83 and 0.81 for the parotid left and right respectively. The ADS was particularly sensitive to uniform expansions/contractions, misplacements, extra/missing slices and anisotropic over-contouring. CONCLUSION Anomaly detection can serve as a powerful contour quality assurance tool, especially for cases of organ misplacement and over-contouring.
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Affiliation(s)
| | - Patrick González
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Casper Carbaat
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Herbert Beemster
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Folkert Koetsveld
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Peter Remeijer
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tomas Janssen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Simões R, Pimentel C, Ferreira-Dias S, Miranda I, Pereira H. Phytochemical characterization of phloem in maritime pine and stone pine in three sites in Portugal. Heliyon 2021; 7:e06718. [PMID: 33898836 PMCID: PMC8055561 DOI: 10.1016/j.heliyon.2021.e06718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/09/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022] Open
Abstract
This study analyzes the content and chemical profile of extractives present in the young phloem of mature trees of maritime pine (Pinus pinaster) and stone pine (P. pinea) in three sites in Portugal located in different climatic environments. The cross-sites average of extractives was similar in both pines with 38.5% in P. pinea and 37.7% in P. pinaster phloem. The hydrophilic fraction represented 82% and 70% of P. pinea and P. pinaster total extractives respectively, with large contents of phenolic compounds, flavonoids and tannins, and showed very high oxygen scavenging and reducing ability. Lipophilic extractives were present in higher proportion in P. pinaster phloem than in P. pinea phloem, and showed a large content of resin acids, with the predominance of abietic acid in P. pinaster, and dehydroabietic acid in P. pinea phloems, and of alkanoic acids. P. pinaster and P. pinea have specific defences related to phloem production of resin and phenolic compounds with the ratio phenolic-to-oleoresin compounds higher for P. pinea (4.7 vs 2.3 for P. pinaster) and constant in the three sites. The phytochemical content and composition of the young phloem of P. pinaster and P. pinea showed site differences highlighting the relationship between environment and metabolic production.
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Affiliation(s)
- Rita Simões
- Forest Research Centre (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal
| | - Carla Pimentel
- Forest Research Centre (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal
| | - Suzana Ferreira-Dias
- Linking Landscape, Environment, Agriculture and Food (LEAF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal
| | - Isabel Miranda
- Forest Research Centre (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal
| | - Helena Pereira
- Forest Research Centre (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal
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van Pelt V, Gerrets S, Simões R, Elkhuizen P, Janssen T. Evaluation of delineating the target volume by radiation therapists in breast cancer patients. Tech Innov Patient Support Radiat Oncol 2021; 17:78-81. [PMID: 34007911 PMCID: PMC8110937 DOI: 10.1016/j.tipsro.2021.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/12/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022] Open
Abstract
Aim Breast radiotherapy accounts for a significant workload in radiotherapy departments. In 2015 it became clinical practice at the Netherlands Cancer Institute for radiation therapists (RTTs) to delineate the clinical target volume of the breast tissue (CTVbreast) and in 2017 axilla level I-II (CTVln12) according to a delineation atlas. All RTTs were trained and got individual feedback. The aim of this retrospective study was to investigate the variation between the CTVbreast with or without CTVln12 delineated by a trained group of radiation therapists and the clinical adjusted delineations by the radiation oncologist/physician assistant (RO/PA), in a large group of patients treated between January 2017 and June 2020. Materials and Methods 1012 computer tomography based delineations of CTVbreast and 146 of CTVln12 were collected from January 2017-June 2020. The RTT and RO/PA delineations were compared using the Dice coefficient and the 95th percentile Hausdorff Distance (95%HD). Statistical significance of the differences was tested using a Mann-Whitney test. Results Differences in CTVbreast delineations were small. A median Dice score of 1.00 for all years, where 83% of the patients had a Dice score > 0.99. For CTVln12 the magnitude of edits made by RO/PAs decreased over time, with the Dice increasing from a median of 0.87 in 2017 to 0.90 in 2020 (p = 0.031). The 95%HD decreased from a median of 0.93 cm in 2017 to 0.61 cm in 2020 (p = 0.051). Conclusions This retrospective study shows that trained dedicated RTTs are capable in delivering the same quality delineations as RO/PAs. The low variability supports the increasing role of RTTs in the contouring process, likely making it more time efficient.
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Affiliation(s)
| | | | | | | | - T.M. Janssen
- Corresponding author at: Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
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Taghavi M, Trebeschi S, Simões R, Meek DB, Beckers RCJ, Lambregts DMJ, Verhoef C, Houwers JB, van der Heide UA, Beets-Tan RGH, Maas M. Machine learning-based analysis of CT radiomics model for prediction of colorectal metachronous liver metastases. Abdom Radiol (NY) 2021; 46:249-256. [PMID: 32583138 DOI: 10.1007/s00261-020-02624-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Early identification of patients at risk of developing colorectal liver metastases can help personalizing treatment and improve oncological outcome. The aim of this study was to investigate in patients with colorectal cancer (CRC) whether a machine learning-based radiomics model can predict the occurrence of metachronous metastases. METHODS In this multicentre study, the primary staging portal venous phase CT of 91 CRC patients were retrospectively analysed. Two groups were assessed: patients without liver metastases at primary staging, or during follow-up of ≥ 24 months (n = 67) and patients without liver metastases at primary staging but developed metachronous liver metastases < 24 months after primary staging (n = 24). After liver parenchyma segmentation, 1767 radiomics features were extracted for each patient. Three predictive models were constructed based on (1) radiomics features, (2) clinical features and (3) a combination of clinical and radiomics features. Stability of features across hospitals was assessed by the Kruskal-Wallis test and inter-correlated features were removed if their correlation coefficient was higher than 0.9. Bayesian-optimized random forest with wrapper feature selection was used for prediction models. RESULTS The three predictive models that included radiomics features, clinical features and a combination of radiomics with clinical features resulted in an AUC in the validation cohort of 86% (95%CI 85-87%), 71% (95%CI 69-72%) and 86% (95% CI 85-87%), respectively. CONCLUSION A machine learning-based radiomics analysis of routine clinical CT imaging at primary staging can provide valuable biomarkers to identify patients at high risk for developing colorectal liver metastases.
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Simões R, Miranda I, Pereira H. Chemical composition of leaf cutin in six Quercus suber provenances. Phytochemistry 2021; 181:112570. [PMID: 33166753 DOI: 10.1016/j.phytochem.2020.112570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 06/11/2023]
Abstract
The cutin content and composition of cork oak (Quercus suber) leaves was determined in six provenances with different seed geographical origin spreading across the species natural distribution. The cutin layer on the leaf surface was on average 518 μg/cm2 of leaf area and represented 6.7% of the leaf dry weight, with no significant differences among provenances. Cutin depolymerisation was carried out by transesterification on whole leaves. The cutin composition of cork oak leaves is presented here for the first time. It is essentially composed of long-chain aliphatic ω-hydroxy fatty acids (44.4% of the total monomers), mostly with mid-chain hydroxyl and epoxy groups, fatty acids (20.7%), and a smaller proportion of α,ω-dicarboxylic acids (6.5%). The predominant compounds are 10,16-dihydroxy hexadecanoic acid (17.7-25.2%) and 9,10,18-trihydroxyoctadecanoic acid (15.6-18.0%). Alkanols represent 2.8% and aromatic compounds 12.8%, mainly coumarates. Isolation of cuticles from Q. suber leaves was performed using an enzymatic separation procedure and the fragments were analysed. Cuticle isolation is difficult and direct depolymerisation applied to whole leaves proved a suitable method to study cutin monomeric composition, which did not differ substantially to that of the isolated cuticles. No differences between provenances were found regarding cutin content and composition, thereby ruling out a significant genetic determination of these traits, but rather a highly adaptive phenotypic plasticity of cork oak. Although overall similar in their chemical nature, cutin and suberin in cork oak differ in the proportion of the major chemical families, i.e. ω-hydroxy acids, α,ω-diacids, and fatty acids.
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Affiliation(s)
- Rita Simões
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisboa, Portugal
| | - Isabel Miranda
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisboa, Portugal.
| | - Helena Pereira
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisboa, Portugal
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Simões R, Rodrigues A, Ferreira-Dias S, Miranda I, Pereira H. Chemical Composition of Cuticular Waxes and Pigments and Morphology of Leaves of Quercus suber Trees of Different Provenance. Plants (Basel) 2020; 9:plants9091165. [PMID: 32916803 PMCID: PMC7570358 DOI: 10.3390/plants9091165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/27/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
The chemical composition of cuticular waxes and pigments and the morphological features of cork oak (Quercus suber) leaves were determined for six samples with seeds of different geographical origins covering the natural distribution of the species. The leaves of all samples exhibited a hard texture and oval shape with a dark green colour on the hairless adaxial surface, while the abaxial surface was lighter, with numerous stomata and densely covered with trichomes in the form of stellate multicellular hairs. The results suggest an adaptive role of leaf features among samples of different provenance and the potential role of such variability in dealing with varying temperatures and rainfall regimes through local adaptation and phenotypic plasticity, as was seen in the trial site, since no significant differences in leaf traits among the various specimens were found, for example, specific leaf area 55.6-67.8 cm2/g, leaf size 4.6-6.8 cm2 and photosynthetic pigment (total chlorophyll, 31.8-40.4 µg/cm2). The leaves showed a substantial cuticular wax layer (154.3-235.1 µg/cm2) composed predominantly of triterpenes and aliphatic compounds (61-72% and 17-23% of the identified compounds, respectively) that contributed to forming a nearly impermeable membrane that helps the plant cope with drought conditions. These characteristics are related to the species and did not differ among trees of different seed origin. The major identified compound was lupeol, indicating that cork oak leaves may be considered as a potential source of this bioactive compound.
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Affiliation(s)
- Rita Simões
- Centro de Estudos Florestais (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (R.S.); (A.R.); (H.P.)
| | - Ana Rodrigues
- Centro de Estudos Florestais (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (R.S.); (A.R.); (H.P.)
| | - Suzana Ferreira-Dias
- Linking Landscape, Environment, Agriculture and Food (LEAF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal;
| | - Isabel Miranda
- Centro de Estudos Florestais (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (R.S.); (A.R.); (H.P.)
| | - Helena Pereira
- Centro de Estudos Florestais (CEF), Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (R.S.); (A.R.); (H.P.)
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Pinto J, Almeida P, Ribeiro F, Simões R. Cardiopulmonary Resuscitation Induced Consciousness A Case Report in an Elderly Patient. Eur J Case Rep Intern Med 2020; 7:001409. [PMID: 32133313 PMCID: PMC7050970 DOI: 10.12890/2020_001409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 12/03/2019] [Indexed: 11/05/2022] Open
Abstract
Cardiopulmonary resuscitation-induced consciousness is a rarely described and often misunderstood phenomenon, although it can be encountered. High quality cardiopulmonary resuscitation (CPR) may lead a patient to recover consciousness while in cardiac arrest. The authors present the case of an 89-year-old male patient who received CPR after a cardiac arrest. Spontaneous movements during CPR were noted and prompted several CPR interruptions. These movements immediately stopped during chest compression pauses. Physical restraint was used in order to be able to continue with the CPR algorithm, but sedation may be the best approach. Guidelines on how to identify and manage these cases need to be developed. LEARNING POINTS Although rare, cardiopulmonary resuscitation-induced consciousness is a phenomenon that physicians should be aware of, given the implications it may have during resuscitation manoeuvres.Cardiopulmonary resuscitation-induced consciousness can readily be recognised by the presence during cardiac arrest of spontaneous and purposeful patient movements that immediately cease after stopping chest compressions.The use of sedative and analgesic drugs such as ketamine may be the best choice to manage cardiopulmonary resuscitation-induced consciousness, as an alternative to physical restraint.
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Affiliation(s)
- Joel Pinto
- Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Paulo Almeida
- Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Fani Ribeiro
- Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Rita Simões
- Intensive Care Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
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Simões R, Miles E, Yang H, Le Grange F, Bhat R, Forsyth S, Seddon B. IMRiS phase II study of IMRT in limb sarcomas: Results of the pre-trial QA facility questionnaire and workshop. Radiography (Lond) 2020; 26:71-75. [PMID: 31902458 DOI: 10.1016/j.radi.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/21/2019] [Accepted: 08/28/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Soft tissue sarcomas of the extremities (STSE) are rare malignancies. We report current UK practice for immobilisation of soft tissue sarcoma of STSE, as part of the initial study set-up within the IMRiS trial, a phase II study of intensity modulated radiotherapy (IMRT) in primary bone and soft tissue sarcoma. METHODS A facility questionnaire (FQ) was circulated to 29 IMRiS centres investigating the variation in immobilisation devices, planning techniques, and imaging protocols. A workshop was held to address concerns raised by centres. It focused on STSE immobilisation and patient set-up. Robustness of patient set-up at each centre was evaluated based on the following criteria: evidence of local set-up audit, calculation of margins based on set-up audit results, imaging frequency, and number of patients treated per centre per annum. RESULTS Twenty-seven (93%) questionnaires were returned. 30% (8/27) of responders routinely treated STSE with IMRT. The remaining 70% (19/27) had little or no experience with IMRT for STSE. Vacuum bags were the most frequent immobilisation device (9/27), followed by thermoplastic shells (7/27). Nine centres had audited their local set-up; however, only 4 had calculated margins in response to the results. Ten centres were classified as having high level of robustness. CONCLUSIONS Immobilisation devices and planning techniques for STSE are inconsistent across centres. Robustness of set-up is an important tool to ensure quality of results in a multicentre trial setting with such different levels of experience. The IMRiS trial Quality Assurance programme encourages centres to assess robustness of set-up through local audit and subsequent calculation of treatment margins. IMPLICATIONS FOR PRACTICE This is the first study that used robustness criteria to tailor QA support to individual centres.
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Affiliation(s)
- R Simões
- National Radiotherapy Trials Quality Assurance Group, Mount Vernon Hospital, London, UK.
| | - E Miles
- National Radiotherapy Trials Quality Assurance Group, Mount Vernon Hospital, London, UK
| | - H Yang
- National Radiotherapy Trials Quality Assurance Group, Mount Vernon Hospital, London, UK
| | - F Le Grange
- University College of London Hospital, London, UK
| | - R Bhat
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
| | - S Forsyth
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
| | - B Seddon
- University College of London Hospital, London, UK
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Ferreira V, Simões R, Gonçalves RS, Machado L, Roriz P. The optimal degree of lateral wedge insoles for reducing knee joint load: a systematic review and meta-analysis. Arch Physiother 2019; 9:18. [PMID: 31890292 PMCID: PMC6921534 DOI: 10.1186/s40945-019-0068-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 11/08/2019] [Indexed: 12/17/2022] Open
Abstract
Background Lateral wedge insoles are traditionally used to reduce the adduction moment that crosses the knee during walking in people with medial knee osteoarthritis. However, the best degree to reduce knee joint load is not yet well established. Methods Electronic databases were searched from their inception until May 2017. Included studies reported on the immediate biomechanical effects of different degrees of lateral wedge insoles during walking in people with knee osteoarthritis. The main measures of interest relating to the biomechanics were the first and second peak of external knee adduction moment and knee adduction angular impulse. For the comparison of the biomechanical effects of different degrees of insoles, the studies were divided in three subgroups: insoles with a degree higher than 0° and equal to or lower than 5°; insoles higher than 5° and equal to or lower than 9°; and insoles higher than 9°. Eligible studies were pooled using random-effects meta-analysis. Results Fifteen studies with a total of 415 participants met all eligibility criteria and were included in the final review and meta-analysis. The overall effect suggests that lateral wedge insoles resulted in a statistically significant reduction in the first peak (standardized mean difference [SMD] -0.25; 95% confidence interval [CI] -0.36, - 0.13; P < 0.001), second peak (SMD -0.26 [95% CI -0.48, - 0.04]; P = 0.02) and knee adduction angular impulse (SMD -0.17 [95% CI -0.31, - 0.03]; P = 0.02). The test of subgroups found no statistically significant differences. Conclusion Systematic review and meta-analysis suggests that lateral wedge insoles cause an overall slight reduction in the biomechanical parameters. Higher degrees do not show higher reductions than lower degrees. Prior analysis of biomechanical parameters may be a valid option for selecting the optimal angle of wedge that best fits in knee osteoarthritis patients with the lowest possible degree.
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Affiliation(s)
- Vitor Ferreira
- 1School of Health Sciences, ESSUA - School of Health, Edificio 30, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Rita Simões
- Santa Casa da Misericórdia da Mealhada, Aveiro, Portugal
| | - Rui Soles Gonçalves
- 3Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal University of Coimbra, Centre for Health Studies and Research, Coimbra, Portugal
| | - Leandro Machado
- CIF2D, LABIOMEP, Faculdade de Desporto da Universidade do Porto, Coimbra, Portugal
| | - Paulo Roriz
- CIDESD-ISMAI, INESC-TEC, LABIOMEP, Coimbra, Portugal
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Simões R, Wortel G, Wiersma TG, Janssen TM, van der Heide UA, Remeijer P. Geometrical and dosimetric evaluation of breast target volume auto-contouring. Phys Imaging Radiat Oncol 2019; 12:38-43. [PMID: 33458293 PMCID: PMC7807634 DOI: 10.1016/j.phro.2019.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/15/2019] [Accepted: 11/20/2019] [Indexed: 11/17/2022]
Abstract
Background and purpose Automatic delineations are often used as a starting point in the radiotherapy contouring workflow, after which they are manually reviewed and adapted. The purpose of this work was to quantify the geometric differences between automatic and manually edited breast clinical target volume (CTV) contours and evaluate the dosimetric impact of such differences. Materials and methods Eighty-seven automatically generated and manually edited contours of the left breast were retrieved from our clinical database. The automatic contours were obtained with a commercial auto-segmentation toolbox. The geometrical comparison was performed both locally and globally using the Dice score and the 95% Hausdorff distance (HD). Two treatment plans were generated for each patient and the obtained dosimetric differences were quantified using dose-volume histogram (DVH) parameters in the lungs, heart and planning target volume (PTV). An inter-observer variability study with four observers was performed on a subset of ten patients. Results A median Dice score of 0.95 and a median 95% HD of 9.7 mm were obtained. Larger breasts were consistently under-contoured. Cranial under-contouring resulted in more than 5% relative decrease in PTV coverage in 15% of the patients while lateroposterior over-contouring increased the lung V20Gy by a maximum of 2%. The inter-observer variability of the PTV coverage was smaller than the difference between PTV coverage achieved by the automatic and the consensus contours. Conclusions Cranial under-contouring resulted in under-treatment, while lateroposterior over-contouring resulted in an increased lung dosage that is clinically irrelevant, showing the need to consider dose distributions to assess the clinical impact of local geometrical differences.
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Affiliation(s)
- Rita Simões
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Geert Wortel
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Terry G Wiersma
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tomas M Janssen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Uulke A van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Peter Remeijer
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Miranda I, Simões R, Medeiros B, Nampoothiri KM, Sukumaran RK, Rajan D, Pereira H, Ferreira-Dias S. Valorization of lignocellulosic residues from the olive oil industry by production of lignin, glucose and functional sugars. Bioresour Technol 2019; 292:121936. [PMID: 31398542 DOI: 10.1016/j.biortech.2019.121936] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
Spent olive pomace from the two-phase extraction system of virgin olive oil and olive pomace oil, is a major agro-industrial residue. Present study aimed at the valorization of residual olive pomace and stones (seeds) by hydrothermal treatment and enzymatic hydrolysis of glucans. Both residues contain lignin (31.2% and 42.1%), glucans (13.8% and 15.3%) and xylans (18.9% and 20.3%). After hydrothermal pretreatment (130 °C, 30 min; severity factor log R0 = 2.99), 65% and 75% of hemicelluloses (65% of xylan) were hydrolysed into xylo-oligosaccharides in pomace and stones, respectively. Cellulose and lignin were not substantially affected. Three commercial enzyme preparations, Saczyme Yield, Ultimase BWL 40 and Celluclast 1.5 L, were evaluated for saccharification of pomace or stones at three biomass loads (10, 20 and 30%, w/v). Saczyme and Ultimase were active with high solid loads (30%), reaching 80 and 90% of glucan conversion in pomace, and 40 and 55% in stones, respectively, after 5 h.
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Affiliation(s)
- Isabel Miranda
- Universidade de Lisboa, Instituto Superior de Agronomia, Centro de Estudos Florestais, Lisbon, Portugal
| | - Rita Simões
- Universidade de Lisboa, Instituto Superior de Agronomia, Centro de Estudos Florestais, Lisbon, Portugal
| | - Barbara Medeiros
- Universidade de Lisboa, Instituto Superior de Agronomia, LEAF, Linking Landscape, Environment, Agriculture and Food, Lisbon, Portugal
| | - Kesavan Madhavan Nampoothiri
- Microbial Processes and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (NIIST), Trivandrum, Kerala, India
| | - Rajeev K Sukumaran
- Microbial Processes and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (NIIST), Trivandrum, Kerala, India
| | - Devi Rajan
- Microbial Processes and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (NIIST), Trivandrum, Kerala, India
| | - Helena Pereira
- Universidade de Lisboa, Instituto Superior de Agronomia, Centro de Estudos Florestais, Lisbon, Portugal
| | - Suzana Ferreira-Dias
- Universidade de Lisboa, Instituto Superior de Agronomia, LEAF, Linking Landscape, Environment, Agriculture and Food, Lisbon, Portugal.
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Dinis Fernandes C, Simões R, Ghobadi G, Heijmink SW, Schoots IG, de Jong J, Walraven I, van der Poel HG, van Houdt PJ, Smolic M, Pos FJ, van der Heide UA. Multiparametric MRI Tumor Probability Model for the Detection of Locally Recurrent Prostate Cancer After Radiation Therapy: Pathologic Validation and Comparison With Manual Tumor Delineations. Int J Radiat Oncol Biol Phys 2019; 105:140-148. [DOI: 10.1016/j.ijrobp.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/17/2019] [Accepted: 05/05/2019] [Indexed: 12/12/2022]
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Hamilton TRS, Simões R, Mendes CM, Goissis MD, Nakajima E, Martins EAL, Visintin JA, Assumpção MEOA. Detection of protamine 2 in bovine spermatozoa and testicles. Andrology 2019; 7:373-381. [PMID: 30920782 DOI: 10.1111/andr.12610] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/14/2019] [Accepted: 02/25/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sperm DNA integrity is crucial for transmission of genetic information to future generations and DNA damage can occur during chromatin packaging. Chromatin packaging involves the replacement of somatic nucleosomal histones by nuclear proteins called protamines. Protamine 1 (PRM1) is transcribed and translated in spermatids of all mammals; however, protamine 2 (PRM2) is transcribed in low levels in spermatids and it is not yet described in bull mature spermatozoa. OBJECTIVES The aim of this study was to assess gene and protein expression of PRM2 and corroborate gene and protein expression of PRM1 in bull spermatozoa and testis. MATERIALS AND METHODS For this purpose, absolute q-RT-PCR was performed to calculate the number of copies of PRM1 and PRM2 mRNAs in bovine epididymal spermatozoa and testicular tissue. Western blot and mass spectrometry were performed to identify PRM1 and PRM2 in samples of bovine epididymal spermatozoa. Samples of bovine testicular tissue were collected to identify PRM1 and PRM2 by immunohistochemistry. RESULTS We evaluated that the number of PRM1 mRNA copies was about hundred times higher than PRM2 mRNA copies in sperm and testicular samples (p < 0.0001). In addition, we estimated the PRM1: PRM2 ratio based on mRNA number of copies. In spermatozoa, the ratio was 1: 0.014, and in testicle, the ratio was 1: 0.009. We also evaluated the immunolocalization for PRM1 and PRM2 in bovine testis, and both proteins were detected in spermatids. Western blot and mass spectrometry in bovine epididymal spermatozoa confirmed these results. CONCLUSION Our work identifies, for the first time, PRM2 in bovine epididymal spermatozoa and in testis. Further studies are still needed to understand the role of PRM2 on the chromatin of the spermatozoa and to verify how possible changes in PRM2 levels may influence the bull fertility.
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Affiliation(s)
- T R S Hamilton
- Department of Animal Reproduction, School of Veterinary Medicine, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, Sao Paulo, Brazil
| | - R Simões
- Center for Natural and Human Sciences, Federal University of ABC, Santo André, Brazil
| | - C M Mendes
- Department of Animal Reproduction, School of Veterinary Medicine, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, Sao Paulo, Brazil
| | - M D Goissis
- Department of Animal Reproduction, School of Veterinary Medicine, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, Sao Paulo, Brazil
| | - E Nakajima
- Process Development Laboratory, Inovation Division, Butantan Institute, São Paulo, Brazil
| | - E A L Martins
- Process Development Laboratory, Inovation Division, Butantan Institute, São Paulo, Brazil
| | - J A Visintin
- Department of Animal Reproduction, School of Veterinary Medicine, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, Sao Paulo, Brazil
| | - M E O A Assumpção
- Department of Animal Reproduction, School of Veterinary Medicine, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, Sao Paulo, Brazil
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Hatton MQF, Lawless CA, Faivre-Finn C, Landau D, Lester JF, Fenwick J, Simões R, McCartney E, Boyd KA, Haswell T, Shaw A, Paul J. Accelerated, Dose escalated, Sequential Chemoradiotherapy in Non-small-cell lung cancer (ADSCaN): a protocol for a randomised phase II study. BMJ Open 2019; 9:e019903. [PMID: 30700475 PMCID: PMC6352760 DOI: 10.1136/bmjopen-2017-019903] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 07/23/2018] [Accepted: 11/05/2018] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Lung cancer is the most common cause of cancer mortality in the UK, and non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Most patients present with inoperable disease; therefore, radiotherapy plays a major role in treatment. However, the majority of patients are not suitable for the gold standard treatment (concurrent chemoradiotherapy) due to performance status and comorbidities. Novel strategies integrating radiotherapy advances and radiobiological knowledge need to be evaluated in patients treated with sequential chemoradiotherapy. Four separate dose escalation accelerated radiotherapy schedules have been completed in UK (CHART-ED, IDEAL-CRT, I-START and Isotoxic IMRT). This study will compare these schedules with a UK standard sequential chemoradiotherapy schedule of 55 Gy in 20 fractions over 4 weeks. As it would be impossible to test all schedules in a phase III study, the aim is to use a combined randomised phase II screening/'pick the winner' approach to identify the best schedule to take into a randomised phase III study against conventionally fractionated radiotherapy. METHODS AND ANALYSIS Suitable patients will have histologically/cytologically confirmed, stage III NSCLC and are able to undergo chemoradiotherapy treatment. The study will recruit 360 patients; 120 on the standard arm and 60 on each experimental arm. Patients will complete 2-4 cycles of platinum-based chemotherapy before being randomised to one of the radiotherapy schedules. The primary endpoint is progression-free survival, with overall survival, time to local-regional failure, toxicity and cost-effectiveness as secondary objectives. ETHICS AND DISSEMINATION The study has received ethical approval (research ethics committee (REC) reference: 16/WS/0165) from the West of Scotland REC 1. The trial is conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. Trial results will be published in a peer-reviewed journal and presented internationally. TRIAL REGISTRATION NUMBER ISRCTN47674500.
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Affiliation(s)
| | - Claire Anne Lawless
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - David Landau
- Guy's & St. Thomas' NHS Trust, Guy's Hospital, London, UK
| | | | - John Fenwick
- Department of Physics, Clatterbridge Cancer Centre, Bebington, UK
| | - Rita Simões
- National Radiotherapy Trials Quality Assurance (RTTQA) Group, Mount Vernon Hospital, Middlesex, UK
| | - Elaine McCartney
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Kathleen Anne Boyd
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Tom Haswell
- National Cancer Research Institute Consumer Liaison Group, London, UK
| | - Ann Shaw
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - James Paul
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
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