A pipeline for evaluation of machine learning/AI models to quantify PD-L1 immunohistochemistry

Immunohistochemistry (IHC) is used to guide treatment decisions in multiple cancer types. For treatment with checkpoint inhibitors, PD-L1 IHC is used as a companion diagnostic. However, the scoring of PD-L1 is complicated by its expression in cancer and immune cells. Separation of cancer and non-cancer regions is needed to calculate tumor proportion scores (TPS) of PD-L1, which is based on the percentage of PD-L1 positive cancer cells. Evaluation of PD-L1 expression requires highly experienced pathologists and is often challenging and time consuming. Here we used a multi-institutional cohort of 77 lung cancer cases stained centrally with the PD-L1 22C3 clone. We developed a four-step pipeline for measuring TPS that includes the co-registration of H&E, PD-L1 and negative control (NC) digital slides for exclusion of necrosis, segmentation of cancer regions and quantification of PD-L1+ cells. As cancer segmentation is a challenging step for TPS generation, we trained DeepLab V3 in the Visiopharm software package to outline cancer regions in PD-L1 and negative control (NC) images and evaluated the model performance by mean intersection over union (mIoU) against manual outlines. Only 14 cases were required to accomplish an mIoU of 0.82 for cancer segmentation in hematoxylin stained NC cases. For PD-L1 stained slides, a model trained on PD-L1 tiles augmented by registered NC tiles achieved an mIoU of 0.79. In segmented cancer regions from whole slide images, the digital TPS achieved an accuracy of 75% against the manual TPS scores from the pathology report. Major reasons for algorithmic inaccuracies include the inclusion of immune cells in cancer outlines and poor nuclear segmentation of cancer cells. Our transparent and stepwise approach and performance metrics can be applied to any IHC assay to provide pathologists with important insights when to apply and how to evaluate commercial automated IHC scoring systems.

Impact of data transfer between treatment planning systems on dosimetric parameters

PURPOSE

In radiotherapy it is often necessary to transfer a patient's DICOM (Digital Imaging and COmmunications in Medicine) dataset from one system to another for re-treatment, plan-summation or registration purposes. The aim of the study is to evaluate effects of dataset transfer between treatment planning systems.

MATERIALS AND METHODS

Twenty-five patients treated in a 0.35T MR-Linac (MRidian, ViewRay) for locally-advanced pancreatic cancer were enrolled. For each patient, a nominal dose distribution was optimized on the planning MRI. Each plan was daily re-optimized if needed to match the anatomy and exported from MRIdian-TPS (ViewRay Inc.) to Eclipse-TPS (Siemens-Varian). A comparison between the two TPSs was performed considering the PTV and OARs volumes (cc), as well as dose coverages and clinical constraints.

RESULTS

From the twenty-five enrolled patients, 139 plans were included in the data comparison. The median values of percentage PTV volume variation are 10.8 % for each fraction, while percentage differences of PTV coverage have a mean value of -1.4 %. The median values of the percentage OARs volume variation are 16.0 %, 7.0 %, 10.4 % and 8.5 % for duodenum, stomach, small and large bowel, respectively. The percentage variations of the dose constraints are 41.0 %, 52.7 % and 49.8 % for duodenum, stomach and small bowel, respectively.

CONCLUSIONS

This study has demonstrated a non-negligible variation in size and dosimetric parameters when datasets are transferred between TPSs. Such variations should be clinically considered. Investigations are focused on DICOM structure algorithm employed by the TPSs during the transfer to understand the cause of such variations.

Thermally-Activated Shape Memory Behavior of Biodegradable Blends Based on Plasticized PLA and Thermoplastic Starch

Biodegradable blends based on plasticized poly(lactic acid) PLA and thermoplastic starch (TPS) have been obtained. The influence of the PLA plasticizer as a compatibility agent has been studied by using two different plasticizers such as neat oligomeric lactic acid (OLA) and functionalized with maleic acid (mOLA). In particular, the morphological, thermal, and mechanical properties have been studied as well as the shape memory ability of the melt-processed materials. Therefore, the influence of the interaction between different plasticizers and the PLA matrix as well as the compatibility between the two polymeric phases on the thermally-activated shape memory properties have been studied. It is very interesting to use the same additive able to act as both plasticizer and compatibilizer, decreasing the glass transition temperature of PLA to a temperature close to the physiological one, obtaining a material suitable for potential biomedical applications. In particular, we obtain that OLA-plasticized blend (oPLA/TPS) show very good thermally-activated capability at 45 °C and 50% deformation, while the blend obtained by using maleic OLA (moPLA/TPS) did not show shape memory behavior at 45 °C and 50% deformation. This fact is due to their morphological changes and the loss of two well-distinguished phases, one acting as fixed phase and the other one acting as switching phase to typically obtain shape memory response. Therefore, the thermally-activated shape memory results show that it is very important to make a balance between plasticizer and compatibilizer, considering the need of two well-established phases to obtain shape memory response.

IOeRT conventional and FLASH treatment planning system implementation exploiting fast GPU Monte Carlo: The case of breast cancer

Partial breast irradiation for the treatment of early-stage breast cancer patients can be performed by means of Intra Operative electron Radiation Therapy (IOeRT). One of the main limitations of this technique is the absence of a treatment planning system (TPS) that could greatly help in ensuring a proper coverage of the target volume during irradiation. An IOeRT TPS has been developed using a fast Monte Carlo (MC) and an ultrasound imaging system to provide the best irradiation strategy (electron beam energy, applicator position and bevel angle) and to facilitate the optimisation of dose prescription and delivery to the target volume while maximising the organs at risk sparing. The study has been performed in silico, exploiting MC simulations of a breast cancer treatment. Ultrasound-based input has been used to compute the absorbed dose maps in different irradiation strategies and a quantitative comparison between the different options was carried out using Dose Volume Histograms. The system was capable of exploring different beam energies and applicator positions in few minutes, identifying the best strategy with an overall computation time that was found to be completely compatible with clinical implementation. The systematic uncertainty related to tissue deformation during treatment delivery with respect to imaging acquisition was taken into account. The potential and feasibility of a GPU based full MC TPS implementation of IOeRT breast cancer treatments has been demonstrated in-silico. This long awaited tool will greatly improve the treatment safety and efficacy, overcoming the limits identified within the clinical trials carried out so far.

Effect of migration on the functionality of zinc oxide nanoparticle in polybutylene adipate terephthalate/thermoplastic starch films: A food simulant study

Active packaging relies on controlled release of antimicrobials for food protection; however, uncontrolled migration due to environmental factors poses safety and functionality challenges. This study investigated the stability of zinc oxide nanoparticle (ZnONP) in poly(butylene-adipate-co-terephthalate)/thermoplastic starch (PBAT/TPS) biopolymer film for active food packaging applications. While incorporating ZnONP significantly enhanced the properties and active functionalities (UV-light blocking, antimicrobial activity) of PBAT/TPS film, food simulants posed significant stability challenges. Notably, exposure to 3 % acetic acid (acidic food simulant) triggered complete detachment and dissolution of ZnONPs from the film surface, leading to pore formation and subsequent internal ZnO dissolution. This resulted in dramatic alterations to the bionanocomposite films, including increased opacity, water vapor permeability, and decreased thermal stability, mechanical properties, and active functionalities. In contrast, 10 % ethanol (aqueous food simulant) had minimal impact, suggesting higher ZnO stability in neutral environments. Importantly, ZnO migration analysis revealed thresholds for safe application: 1 % ZnONP for acidic food contact and up to 5 % for aqueous foodstuffs. These findings highlight the critical role of environmental factors in ZnONP stability and emphasize the need for strategic optimization of ZnO content for achieving both functionality and safety in active biopolymer packaging.

Genome-Wide Identification of Trehalose-6-phosphate Synthase (TPS) Gene Family Reveals the Potential Role in Carbohydrate Metabolism in Peach

Trehalose-6-phosphate synthase (TPS) is essential for plant growth and development, linking trehalose-6-phosphate (T6P) to carbon metabolism. However, little is known about the TPS gene family in peaches and their potential roles in regulating carbohydrates in peach fruit. In this study, nine TPS genes were identified in the peach genome and named according to the homologous genes in Arabidopsis. Phylogenetic analysis showed that three subfamilies were identified, including TPSI, TPSII-1, and TPSII-2, which were also consistent with gene structure analysis. Considerable cis-elements were enriched in the promoters, including plant hormone-related elements. Tissue-specific analysis showed that these TPS genes were mainly expressed in leaves, stems, and fruit, showing different expression patterns for each gene. In addition, during fruit development, the content of trehalose-6-phosphate (T6P) was positively correlated with the expression of PpTPS7a and negatively with sucrose non-fermenting-1-related kinase 1 (SnRK1) activity. Transient overexpression and silencing of PpTPS7a in peach fruit validated its function in regulating T6P content and SnRK1 activity.

Automated marker-free longitudinal infrared breast image registration by GA-PSO

The automated marker-free longitudinal Infrared (IR) breast image registration overcomes several challenges like no anatomic fiducial markers on the body surface, blurry boundaries, heat pattern variation by environmental and physiological factors, nonrigid deformation, etc, has the ability of quantitative pixel-wise analysis with the heat energy and patterns change in a time course study. To achieve the goal, scale-invariant feature transform, Harris corner, and Hessian matrix were employed to generate the feature points as anatomic fiducial markers, and hybrid genetic algorithm and particle swarm optimization minimizing the matching errors was used to find the appropriate corresponding pairs between the 1st IR image and thenth IR image. Moreover, the mechanism of the IR spectrogram hardware system has a high level of reproducibility. The performance of the proposed longitudinal image registration system was evaluated by the simulated experiments and the clinical trial. In the simulated experiments, the mean difference of our system is 1.64 mm, which increases 57.58% accuracy than manual determination and makes a 17.4% improvement than the previous study. In the clinical trial, 80 patients were captured several times of IR breast images during chemotherapy. Most of them were well aligned in the spatiotemporal domain. In the few cases with evident heat pattern dissipation and spatial deviation, it still provided a reliable comparison of vascular variation. Therefore, the proposed system is accurate and robust, which could be considered as a reliable tool for longitudinal approaches to breast cancer diagnosis.

A systematic approach for calibrating a Monte Carlo code to a treatment planning system for obtaining dose, LET, variable proton RBE and out-of-field dose

Objective. While integration of variable relative biological effectiveness (RBE) has not reached full clinical implementation, the importance of having the ability to recalculate proton treatment plans in a flexible, dedicated Monte Carlo (MC) code cannot be understated . Here we provide a step-wise method for calibrating dose from a MC code to a treatment planning system (TPS), to obtain required parameters for calculating linear energy transfer (LET), variable RBE and in general enabling clinical realistic research studies beyond the capabilities of a TPS.Approach. Initially, Pristine Bragg peaks (PBP) were calculated in both the Eclipse TPS and the FLUKA MC code. A rearranged Bortfeld energy-range relation was applied to the initial energy of the beam to fine-tune the range of the MC code at 80% dose level distal to the PBP. The energy spread was adapted by dividing the TPS range by the MC range for dose level 80%-20% distal to the PBP. Density and relative proton stopping power were adjusted by comparing the TPS and MC for different Hounsfield units. To find the relationship of dose per primary particle from the MC to dose per monitor unit in the TPS, integration was applied to the area of the Bragg curve. The calibration was validated for spread-out Bragg peaks (SOBP) in water and patient treatment plans. Following the validation, variable RBE were calculated using established models.Main results.The PBPs ranges were within ±0.3mm threshold, and a maximum of 5.5% difference for the SOBPs was observed. The patient validation showed excellent dose agreement between the TPS and MC, with the greatest differences for the lung tumor patient.Significance. Aprocedure for calibrating a MC code to a TPS was developed and validated. The procedure enables MC-based calculation of dose, LET, variable RBE, advanced (secondary) particle tracking and more from treatment plans.

Dosimetric impact of hollow intraoral stents for head and neck cancer radiotherapy: A phantom study

PURPOSE

To investigate the dosimetric impact of the calculation boundaries and dose calculation algorithms of radiotherapy in head and neck cancer patients with an opened oral cavity connected to the exterior by a hollow intraoral positioning stent.

METHODS AND MATERIALS

A homemade silicone phantom with an opened oral cavity was placed in a CIRS head phantom to model head and neck cancer patients with a hollow intraoral positioning stent. 3D-CRT plans were designed on CT images of the phantom in Monaco and Pinnacle3 treatment planning systems (TPSs) with the same beam parameters. The default boundary and manually extrapolated boundary were both adopted in these two TPSs to explore the dosimetric impact on treatment plans. The nanoDot™ optically stimulated luminescence dosimeters (OSLDs) were chosen to measure the planned dose surrounding the oral cavity of the head phantom after calibration.

RESULT

The doses in the air cavity and two measuring points at the joint area were dramatically changed from 0.0, 92.4 and 148.8 cGy to 177.8, 244.2 and 244.1 cGy in Monaco after adopting the extrapolated boundary. While the calculated doses at the same place were changed from 61.2, 143.7 and 198.3 cGy to 175.4, 234.7 and 233.2 cGy in Pinnacle3 with a similar calculation boundary. For the Monaco TPS, the relative errors compared to the OSLD measured doses were 2.94 ± 1.93%, 0.53 ± 8.64%, 2.65 ± 1.87% and 3.93 ± 1.69% at 4 measuring positions. In contrast, the relative errors 4.03 ± 1.93%, 4.85 ± 8.64%, 7.61 ± 1.87% and 5.61 ± 1.69% were observed in Pinnacle3 .

CONCLUSION

The boundary setting of an opened oral cavity in TPSs has a significant dosimetric impact on head and neck cancer radiotherapy. An extrapolated boundary should be manually set up to include the whole oral cavity in the dose calculation domain to avoid major dose deviations.

Dosimetric validation of the couch and coil model for high-field MR-linac treatment planning

PURPOSE

The precision of the dose delivery in radiation therapy with high-field MR-linacs is challenging due to the substantial variation in the beam attenuation of the patient positioning system (PPS) (the couch and coils) as a function of the gantry angle. This work aimed to compare the attenuation of two PPSs located at two different MR-linac sites through measurements and calculations in the treatment planning system (TPS).

METHODS

Attenuation measurements were performed at every 1° gantry angle at the two sites with a cylindrical water phantom with a Farmer chamber inserted along the rotational axis of the phantom. The phantom was positioned with the chamber reference point (CRP) at the MR-linac isocentre. A compensation strategy was applied to minimise sinusoidal measurement errors due to, e.g. air cavity or setup. A series of tests were performed to assess the sensitivity to measurement uncertainties. The dose to a model of the cylindrical water phantom with the PPS added was calculated in the TPS (Monaco v5.4 as well as in a development version Dev of an upcoming release), for the same gantry angles as for the measurements. The TPS PPS model dependency of the dose calculation voxelisation resolution was also investigated.

RESULTS

A comparison of the measured attenuation of the two PPSs yielded differences of less than 0.5% for most gantry angles. The maximum deviation between the attenuation measurements for the two different PPSs exceeded ±1% at two specific gantry angles 115° and 245°, where the beam traverses the most complex PPS structures. The attenuation increases from 0% to 25% in 15° intervals around these angles. The measured and calculated attenuation, as calculated in v5.4, was generally within 1-2% with a systematic overestimation of the attenuation for gantry angles around 180°, as well as a maximum error of 4-5% for a few discrete angles in 10° gantry angle intervals around the complex PPS structures. The PPS modelling was improved compared to v5.4 in Dev, especially around 180°, and the results of those calculations were within ±1%, but with a similar 4% maximum deviation for the most complex PPS structures.

CONCLUSIONS

Generally, the two tested PPS structures exhibit very similar attenuation as a function of the gantry angle, including the angles with a steep change in attenuation. Both TPS versions, v5.4 and Dev delivered clinically acceptable accuracy of the calculated dose, as the differences in the measurements were overall better than ±2%. Additionally, Dev improved the accuracy of the dose calculation to ±1% for gantry angles around 180°.

Oxy-Butane Ablation Testing of Thermal Protection Systems Based on Nanomodified Phenolic Resin Matrix Materials

Two classes of thermal protection systems composed of a carbon-fibre-reinforced (CFRP) layer and an ablative material layer joined with a thermo-resistant ceramic adhesive were developed. The two classes differ in the composition of the ablative material reinforcing compound. In the first class, the ablative material is based on micronic-sized cork granules, and in the second class, the ablative material is reinforced with carbonic felt. For both classes of thermal protection systems, the reinforcement material was impregnated in simple phenolic resin, and nanometric additive, consisting of silicon carbide nanoparticles added in two different weight contents (1 and 2% by weight) relative to the resin. The thermal conductivity for the ablative materials in the thermal protection systems structure was determined. A test facility using oxy-butane flame was developed through which the thermal protection systems developed were tested at extreme temperatures, to simulate some thermal conditions in space applications. The materials were characterised from a morphostructural point of view using optical and scanning electron microscopy after thermal testing. The TPS composed of the carbon-felt-based ablative layer showed improved behaviour compared to the cork-based ablative ones in terms of the temperature increase rate during thermal conductivity testing, mass loss, as well as morphostructural appearance and material erosion after oxy-butane testing. The nSiC-based samples in both sets of TPSs showed improved behaviour compared to the un-filled ones, considering the temperature increase, mass loss, and morphostructure of the eroded material.

Effect of PD-L1 Expression for the PD-1/L1 Inhibitors on Non-small Cell Lung Cancer: A Meta-analysis Based on Randomised Controlled Trials

AIMS

As PD-L1 expression has been proposed as one of the cancer biomarkers for non-small cell lung cancer (NSCLC), the predictive value of tumour proportional score (TPS) in the effect of immunotherapy [programmed death protein-1/ligand 1 (PD-1/L1) inhibitors] for NSCLC is worth exploring further. Here, we aimed to summarise the outcomes of current NSCLC randomised controlled trials (RCTs) and explore the predictive value of TPS in clinical immunotherapy, including immune checkpoint inhibitors (ICIs) with or without chemotherapy.

MATERIALS AND METHODS

RCTs published by PubMed, Medline, Embase and Scopus before February 2023 comparing immunotherapy (PD-1/L1 with or without other therapy) versus a control group in advanced or metastatic NSCLC were included to assess the prognosis according to the patients' TPS with 1% and 50% as the thresholds. The primary endpoints were overall survival and progression-free survival.

RESULTS

In total, 28 RCTs containing 17 266 participants with advanced or metastatic NSCLC were included in this meta-analysis. Statistical results showed that compared with TPS <1%, ≥1% or within 1-49%, patients with TPS ≥50% benefited more significantly from the immunotherapy. A subgroup analysis showed that when TPS was <1%, ≥1% or within 1-49%, ICIs + chemotherapy had better efficacy than ICIs alone; PD-1 (such as pembrolizumab) inhibitors had better efficacy than PD-L1 inhibitors (such as atezolizumab).

CONCLUSION

The efficacy of immunotherapy (PD-1/L1 inhibitors) for advanced or metastatic NSCLC is influenced by TPS.

Innovative Polymer Composites with Natural Fillers Produced by Additive Manufacturing (3D Printing)-A Literature Review

In recent years, plastics recycling has become one of the leading environmental and waste management issues. Along with the main advantage of plastics, which is undoubtedly their long life, the problem of managing their waste has arisen. Recycling is recognised as the preferred option for waste management, with the aim of reusing them to create new products using 3D printing. Additive manufacturing (AM) is an emerging and evolving rapid tooling technology. With 3D printing, it is possible to achieve lightweight structures with high dimensional accuracy and reduce manufacturing costs for non-standard geometries. Currently, 3D printing research is moving towards the production of materials not only of pure polymers but also their composites. Bioplastics, especially those that are biodegradable and compostable, have emerged as an alternative for human development. This article provides a brief overview of the possibilities of using thermoplastic waste materials through the application of 3D printing, creating innovative materials from recycled and naturally derived materials, i.e., biomass (natural reinforcing fibres) in 3D printing. The materials produced from them are ecological, widely available and cost-effective. Research activities related to the production of bio-based materials have gradually increased over the last two decades, with the aim of reducing environmental problems. This article summarises the efforts made by researchers to discover new innovative materials for 3D printing.

Diagnosis of Low-Grade Urothelial Neoplasm in the Era of the Second Edition of the Paris System for Reporting Urinary Cytology

BACKGROUND

The Paris System for Reporting Urinary Cytology (TPS) is considered the gold standard when it comes to diagnostic classifications of urine specimens. Its second edition brought some important changes, including the abolition of the diagnostic category of "low-grade urothelial neoplasm (LGUN)", acknowledging the inability of cytology to reliably discern low-grade urothelial lesions.

METHODS

In this retrospective study, we assessed the validity of this change, studying the cytological diagnoses of histologically diagnosed low-grade urothelial carcinomas during a three-year period. Moreover, we correlated the sum of the urinary cytology diagnoses of this period with the histological diagnoses, whenever available.

RESULTS

Although all the cytological diagnoses of LGUN were concordant with the histological diagnoses, most low-grade urothelial carcinomas were misdiagnosed cytologically. Subsequently, the positive predictive value (PPV) of urinary cytology for the diagnosis of LGUN was 100%, while the sensitivity was only 21.7%. Following the cyto-histopathological correlation of the sum of the urinary cytology cases, the sensitivity of urinary cytology for the diagnosis of high-grade urothelial carcinoma (HGUC) was demonstrated to be 90.1%, the specificity 70.8%, the positive predictive value (PPV) 60.3%, the negative predictive value (NPV) 93.6% and the overall accuracy 77.2%, while for LGUN, the values were 21.7%, 97.2%, 87.5%, 58.6% and 61.9%, respectively. Risk of high-grade malignancy was 0% for the non-diagnostic (ND), 4.8% for the non-high-grade urothelial carcinoma (NHGUC), 33.3% for the atypical urothelial cells (AUCs), 65% for the suspicious for high-grade urothelial carcinoma (SHGUC), 100% for the HGUC and 12.5% for the LGUN diagnostic categories.

CONCLUSIONS

This study validates the incorporation of the LGUN in the NHGUC diagnostic category in the second edition of TPS. Moreover, it proves the ability of urinary cytology to safely diagnose HGUC and stresses the pivotal role of its diagnosis.

Dosimetric evaluation of high-Z inhomogeneity with modern algorithms: A collaborative study

PURPOSE

To evaluate modern dose calculation algorithms with high-Z prosthetic devices used in radiation treatment.

METHODS

A bilateral hip prosthetic patient was selected to see the effect of modern algorithms from the commercial system for plan comparisons. The CT data with dose constraints were sent to various institutions for dose calculations. The dosimetric parameters, D98%, D90%, D50% and D2% were compared. A water phantom with an actual prosthetic device was used to measure the dose using a parallel plate ionization chamber.

RESULTS

Dosimetric variability in PTV coverage was significant (>10%) among various treatment planning algorithms. The comparison of PTV dosimetric parameters, D98%, D90%, D50% and D2% as well as organs at risk (OAR) have large discrepancies compared to our previous publication with older algorithms (https://doi.org/10.1016/j.ejmp.2022.02.007) but provides realistic dose distribution with better homogeneity index (HI). Backscatter and forward scatter attenuation of the prosthesis was measured showing differences <15.7% at the interface among various algorithms.

CONCLUSIONS

Modern algorithms dose distributions have improved greatly compared to older generation algorithms. However, there is still significant differences at high-Z-tissue interfaces compared to the measurements. To ensure accuracy, it's important to take precautions avoiding placing any prosthesis in the beam direction and using type C algorithms.

An open-source development based on photogrammetry for a real-time IORT treatment planning system

PURPOSE

This study presents a treatment planning system for intraoperative low-energy photon radiotherapy based on photogrammetry from real images of the surgical site taken in the operating room.

MATERIAL AND METHODS

The study population comprised 15 patients with soft-tissue sarcoma. The system obtains the images of the area to be irradiated with a smartphone or tablet, so that the absorbed doses in the tissue can be calculated from the reconstruction without the need for computed tomography. The system was commissioned using 3D printing of the reconstructions of the tumor beds. The absorbed doses at various points were verified using radiochromic films that were suitably calibrated for the corresponding energy and beam quality.

RESULTS

The average reconstruction time of the 3D model from the video sequence in the 15 patients was 229,6±7,0 s. The entire procedure, including video capture, reconstruction, planning, and dose calculation was 520,6±39,9 s. Absorbed doses were measured on the 3D printed model with radiochromic film, the differences between these measurements and those calculated by the treatment planning system were 1.4% at the applicator surface, 2.6% at 1 cm, 3.9% at 2 cm and 6.2% at 3 cm.

CONCLUSIONS

The study shows a photogrammetry-based low-energy photon IORT planning system, capable of obtaining real-time images inside the operating room, immediately after removal of the tumor and immediately before irradiation. The system was commissioned with radiochromic films measurements in 3D-printed model.

Reproducibility in PD-L1 Immunohistochemistry Quantification through the Tumor Proportion Score and the Combined Positive Score: Could Dual Immunostaining Help Pathologists?

We studied the pathologists' agreements in quantifying PD-L1 expression through the tumor proportion score (TPS) and the combined positive score (CPS) using single PD-L1 immunohistochemistry (S-IHC) and double immunohistochemistry (D-IHC) combining PD-L1 staining and tumor cell markers. S-IHC and D-IHC were applied to 15 cancer samples to generate 60 digital IHC slides (30 whole slides images and 30 regions of interest of 1 mm²) for PD-L1 expression quantification using both TPS and CPS, twice by four pathologists. Agreements were estimated calculating intraclass correlation coefficients (ICC). Both S-IHC and D-IHC slides analyses resulted in excellent (for TPS, ICC > 0.9) to good (for CPS, ICC > 0.75) inter- and intra-pathologist agreements with slightly higher ICC with D-IHC than with S-IHC. S-IHC resulted in higher TPS and CPS than D-IHC (+5.6 and +6.1 mean differences, respectively). High reproducibility in the quantification of PD-L1 expression is attainable using S-IHC and D-IHC.

Arc-Jet Tests of Carbon-Phenolic-Based Ablative Materials for Spacecraft Heat Shield Applications

We developed and tested two carbon-phenolic-based ablators for future Korean spacecraft heat shield applications. The ablators are developed with two layers: an outer recession layer, fabricated from carbon-phenolic material, and an inner insulating layer, fabricated either from cork or silica-phenolic material. The ablator specimens were tested in a 0.4 MW supersonic arc-jet plasma wind tunnel at heat flux conditions ranging from 6.25 MW/m² to 9.4 MW/m², with either specimen being stationary or transient. Stationary tests were conducted for 50 s each as a preliminary investigation, and the transient tests were conducted for ~110 s each to stimulate a spacecraft's atmospheric re-entry heat flux trajectory. During the tests, each specimen's internal temperatures were measured at three locations: 25 mm, 35 mm, and 45 mm from the specimen stagnation point. During the stationary tests, a two-color pyrometer was used to measure specimen stagnation-point temperatures. During the preliminary stationary tests, the silica-phenolic-insulated specimen's reaction was normal compared to the cork-insulated specimen; hence, only the silica-phenolic-insulated specimens were further subjected to the transient tests. During the transient tests, the silica-phenolic-insulated specimens were stable, and the internal temperatures were lower than 450 K (~180 °C), achieving the main objective of this study.

Development and Validation of a Duplex RT-qPCR for Detection of Peach Latent Mosaic Viroid and Comparison of Different Nucleic-Acid-Extraction Protocols

Peach latent mosaic viroid (PLMVd) is an important pathogen that causes disease in peaches. Control of this viroid remains problematic because most PLMVd variants are symptomless, and although there are many detection tests in use, the reliability of PCR-based methods is compromised by the complex, branched secondary RNA structure of the viroid and its genetic diversity. In this study, a duplex RT-qPCR method was developed and validated against two previously published single RT-qPCRs, which were potentially able to detect all known PLMVd variants when used in tandem. In addition, in order to simplify the sample preparation, rapid-extraction protocols based on the use of crude sap or tissue printing were compared with commercially available RNA purification kits. The performance of the new procedure was evaluated in a test performance study involving five participant laboratories. The new method, in combination with rapid-sample-preparation approaches, was demonstrated to be feasible and reliable, with the advantage of detecting all different PLMVd isolates/variants assayed in a single reaction, reducing costs for routine diagnosis.

Validation of RayStation Monte Carlo dose calculation algorithm for multiple LINACs

PURPOSE

A photon Monte Carlo (MC) model was commissioned for flattened (FF) and flattening filter free (FFF) 6 MV beam energy. The accuracy of this model, as a single model to be used for three beam matched LINACs, was evaluated.

METHODS

Multiple models were created in RayStation v.10A for three linacs equipped with Elekta "Agility" collimator. A clinically commissioned collapsed cone (CC) algorithm (GoldCC), a MC model automatically created from the CC algorithm without further optimization (CCtoMC) and an optimized MC model (GoldMC) were compared with measurements. The validation of the model was performed by following the recommendations of IAEA TRS 430 and comprised of basic validation in a water tank, validation in a heterogeneous phantom and validation of complex IMRT/VMAT paradigms using gamma analysis of calculated and measured dose maps in a 2D-Array.

RESULTS

Dose calculation with the GoldMC model resulted in a confidence level of 3% for point measurements in water tank and heterogeneous phantom for measurements performed in all three linacs. The same confidence level resulted for GoldCC model. Dose maps presented an agreement for all models on par to each other with γ criteria 2%/2mm.

CONCLUSIONS

The GoldMC model showed a good agreement with measured data and is determined to be accurate for clinical use for all three linacs in this study.

Radiomics of Tumor Heterogeneity in 18F-FDG-PET-CT for Predicting Response to Immune Checkpoint Inhibition in Therapy-Naïve Patients with Advanced Non-Small-Cell Lung Cancer

We aimed to evaluate the predictive and prognostic value of baseline ¹⁸F-FDG-PET-CT (PET-CT) radiomic features (RFs) for immune checkpoint-inhibitor (CKI)-based first-line therapy in advanced non-small-cell lung cancer (NSCLC) patients. In this retrospective study 44 patients were included. Patients were treated with either CKI-monotherapy or combined CKI-based immunotherapy-chemotherapy as first-line treatment. Treatment response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST). After a median follow-up of 6.4 months patients were stratified into "responder" (n = 33) and "non-responder" (n = 11). RFs were extracted from baseline PET and CT data after segmenting PET-positive tumor volume of all lesions. A Radiomics-based model was developed based on a Radiomics signature consisting of reliable RFs that allow classification of response and overall progression using multivariate logistic regression. These RF were additionally tested for their prognostic value in all patients by applying a model-derived threshold. Two independent PET-based RFs differentiated well between responders and non-responders. For predicting response, the area under the curve (AUC) was 0.69 for "PET-Skewness" and 0.75 predicting overall progression for "PET-Median". In terms of progression-free survival analysis, patients with a lower value of PET-Skewness (threshold < 0.2014; hazard ratio (HR) 0.17, 95% CI 0.06-0.46; p < 0.001) and higher value of PET-Median (threshold > 0.5233; HR 0.23, 95% CI 0.11-0.49; p < 0.001) had a significantly lower probability of disease progression or death. Our Radiomics-based model might be able to predict response in advanced NSCLC patients treated with CKI-based first-line therapy.

LcERF134 increases the production of monoterpenes by activating the terpene biosynthesis pathway in Litsea cubeba

Litsea cubeba, an aromatic species of the Lauraceae family, produces a diverse array of monoterpenes. The biosynthesis of monoterpenes is regulated by transcriptional factors (TFs), such as APETALA2/ethylene response factor (AP2/ERF). However, the regulatory mechanisms that control the AP2/ERF gene responsible for the biosynthesis of monoterpenes in L. cubeba have yet to be elucidated. Here, we identified an AP2/ERF gene, LcERF134, as an activator for the accumulation of citral and other monoterpenes. The expression level of LcERF134 was consistent with terpene synthase LcTPS42 in the pericarp. The transient overexpression of LcERF134 significantly increased monoterpene production in L. cubeba as well as the expression of rate-limiting genes involved in the monoterpene biosynthesis pathway. Furthermore, yeast one-hybrid, dual-luciferase and electrophoretic mobility shift assays demonstrated that LcERF134 activated the monoterpene biosynthesis pathway by directly binding to the GCC-box elements of the LcTPS42 and LcGPPS.SSU1 promoters. However, the overexpression of LcERF134 in tomatoes had no impact on the synthesis of monoterpenes, thus indicating that LcERF134 is a species-specific TF. Our research demonstrated that LcERF134 significantly increased the biosynthesis of monoterpenes by inducing the expression of LcTPS42 and LcGPPS.SSU1, thus offering insight into how to enhance the flavor of L. cubeba essential oil.

Grapevine genome analysis demonstrates the role of gene copy number variation in the formation of monoterpenes

Volatile organic compounds such as terpenes influence the quality parameters of grapevine through their contribution to the flavour and aroma profile of berries. Biosynthesis of volatile organic compounds in grapevine is relatively complex and controlled by multiple genes, the majority of which are unknown or uncharacterised. To identify the genomic regions that associate with modulation of these compounds in grapevine berries, volatile metabolic data generated via GC-MS from a grapevine mapping population was used to identify quantitative trait loci (QTLs). Several significant QTLs were associated with terpenes, and candidate genes were proposed for sesquiterpene and monoterpene biosynthesis. For monoterpenes, loci on chromosomes 12 and 13 were shown to be associated with geraniol and cyclic monoterpene accumulation, respectively. The locus on chromosome 12 was shown to contain a geraniol synthase gene (VvGer), while the locus on chromosome 13 contained an α-terpineol synthase gene (VvTer). Molecular and genomic investigation of VvGer and VvTer revealed that these genes were found in tandemly duplicated clusters, displaying high levels of hemizygosity. Gene copy number analysis further showed that not only did VvTer and VvGer copy numbers vary within the mapping population, but also across recently sequenced Vitis cultivars. Significantly, VvTer copy number correlated with both VvTer gene expression and cyclic monoterpene accumulation in the mapping population. A hypothesis for a hyper-functional VvTer allele linked to increased gene copy number in the mapping population is presented and can potentially lead to selection of cultivars with modulated terpene profiles. The study highlights the impact of VvTPS gene duplication and copy number variation on terpene accumulation in grapevine.

Genome-wide analyzation and functional characterization on the TPS family provide insight into the biosynthesis of mono-terpenes in the camphor tree

Terpene synthase (TPS) plays an important role in terpenoids biosynthesis. Cinnamomum camphora (camphor tree) contains dozens of terpenoids with medicinal value, especially borneol, which has been widely used since ancient times. However, limited information is available regarding the genome-wide identification and characterization of the TPS family in the C. camphora. In this study, 82 CcTPS genes were identified from the camphor tree genome (CTG). Gene cluster and sequence syntenic analysis suggested that tandem duplication occurred within the TPS family of the CTG, especially for the TPS-b subfamily. The chemotype-specific gene expression analysis showed significantly differential expression patterns among six chemotypes. It is worth noting that three genes (CcTPS26, CcTPS49 and CcTPS72) exhibited relatively high expression in the borneol-type camphor tree, compared to the other five chemotypes. Further functional characterization of them indicated that they were all bornyl diphosphate synthases (BPPSs), which function in catalyzing GPP into BPP and then undergoes dephosphorylation to yield borneol. This is the first report that multiple BPPSs exist within a single species. Intriguingly, CcTPS49 and CcTPS72 lead to the generation of dextral-borneol, while CcTPS26 contributes to the biosynthesis of levo-borneol. In addition, the functional characterization of another six CcTPSs suggested that they are responsible for the biosynthesis of linalool, eucalyptol and several other monoterpenes in camphor tree. In conclusion, these novel results provide a foundation for further exploration of the role of the CcTPS gene family and shed light on a better understanding of the biosynthesis and accumulation of monoterpenes in camphor tree.

Thermal Ablation Experiments of Carbon Phenolic and SiC-Coated Carbon Composite Materials Using a High-Velocity Oxygen-Fuel Torch

For future spacecraft TPS (heat shield) applications, ablation experiments of carbon phenolic material specimens with two lamination angles (0° and 30°) and two specially designed SiC-coated carbon-carbon composite specimens (with either cork or graphite base) were conducted using an HVOF material ablation test facility. The heat flux test conditions ranged from 3.25 to 11.5 MW/m², corresponding to an interplanetary sample return re-entry heat flux trajectory. A two-color pyrometer, an IR camera, and thermocouples (at three internal locations) were used to measure the specimen temperature responses. At the 11.5 MW/m² heat flux test condition, the 30° carbon phenolic specimen's maximum surface temperature value is approximately 2327 K, which is approximately 250 K higher than the corresponding value of the SiC-coated specimen with a graphite base. The 30° carbon phenolic specimen's recession value is approximately 44-fold greater, and the internal temperature values are approximately 1.5-fold lower than the corresponding values of the SiC-coated specimen with a graphite base. This indicates that increased surface ablation and a higher surface temperature relatively reduced heat transfer to the 30° carbon phenolic specimen's interior, leading to lower internal temperature values compared to those of the SiC-coated specimen with a graphite base. During the tests, a phenomenon of periodic explosions occurred on the 0° carbon phenolic specimen surfaces. The 30° carbon phenolic material is considered more suitable for TPS applications due to its lower internal temperatures, as well as the absence of abnormal material behavior as observed in the 0° carbon phenolic material.

Genome-Wide Identification and Characterization of the Trehalose-6-Phosphate Synthetase Gene Family in Chinese Cabbage (Brassica rapa) and Plasmodiophora brassicae during Their Interaction

Trehalose is a nonreducing disaccharide that is widely distributed in various organisms. Trehalose-6-phosphate synthase (TPS) is a critical enzyme responsible for the biosynthesis of trehalose, which serves important functions in growth and development, defense, and stress resistance. Although previous studies have found that the clubroot pathogen Plasmodiophora brassicae can lead to the accumulation of trehalose in infected Arabidopsis organs, it has been proposed that much of the accumulated trehalose is derived from the pathogen. At present, there is very little evidence to verify this view. In this study, a comprehensive analysis of the TPS gene family was conducted in Brassica rapa and Plasmodiophora brassicae. A total of 14 Brassica rapa TPS genes (BrTPSs) and 3 P. brassicae TPS genes (PbTPSs) were identified, and the evolutionary characteristics, functional classification, and expression patterns were analyzed. Fourteen BrTPS genes were classified into two distinct classes according to phylogeny and gene structure. Three PbTPSs showed no significant differences in gene structure and protein conserved motifs. However, evolutionary analysis showed that the PbTPS2 gene failed to cluster with PbTPS1 and PbTPS3. Furthermore, cis-acting elements related to growth and development, defense and stress responsiveness, and hormone responsiveness were predicted in the promoter region of the BrTPS genes. Expression analysis of most BrTPS genes at five stages after P. brassicae interaction found no significant induction. Instead, the expression of the PbTPS genes of P. brassicae was upregulated, which was consistent with the period of trehalose accumulation. This study deepens our understanding of the function and evolution of BrTPSs and PbTPSs. Simultaneously, clarifying the biosynthesis of trehalose in the interaction between Brassica rapa and P. brassicae is also of great significance.

Perceptions of Paris: an international survey in preparation for The Paris System for Reporting Urinary Cytology 2.0 (TPS 2.0)

INTRODUCTION

An international panel of experts in the field of urinary cytopathology conducted a survey, supported by the American Society of Cytopathology, to seek opinions, gather evidence, and identify practice patterns regarding urinary cytology before and after the introduction of The Paris System for Reporting Urinary Cytopathology (TPS). Results from this survey were utilized in the development of the second edition of TPS (TPS-2.0).

MATERIALS AND METHODS

The study group, originally formed during the 2013 International Congress of Cytology, reconvened at the 2019 annual meeting of the American Society of Cytopathology. To prepare for the second edition of TPS, the group generated a survey that included 43 questions related to the taxonomy and practice of urinary cytology.

RESULTS

A total of 523 participant responses were collected, and 451 from 54 countries passed a qualifying screen. Three hundred ninety-four participants provided information about their work settings. Eighty-two percent (218/266) of responding participants use TPS. One hundred sixty-eight people who responded on their urinary cytology atypia rates reported an average decrease from 21.6% to 16%. Over three fourths of participants felt that the same criteria should be used for upper and lower tract interpretations and for instrumented and voided samples. There were varied opinions on addressing atypical squamous cells and suggestions for an expanded discussion of the issue to be included in TPS 2.0.

CONCLUSIONS

Results of the survey demonstrate strong support for TPS and show a decreased self-reported atypia rate in the laboratories using TPS. The majority of participants related that the criteria put forth for the reporting categories were user-friendly and applied with relative ease. The comment section of the survey included suggestions from the participants for further improvement of TPS. Results of this survey have been useful in fine-tuning and advancing TPS. They were considered along with recent literature to generate the second edition of TPS.

Immunotherapy and Modern Radiotherapy Technique for Older Patients with Locally Advanced Head and Neck Cancer: A Proposed Paradigm by the International Geriatric Radiotherapy Group

The standard of care for locally advanced head and neck cancer is concurrent chemoradiation or postoperative irradiation with or without chemotherapy. Surgery may not be an option for older patients (70 years old or above) due to multiple co-morbidities and frailty. Additionally, the standard chemotherapy of cisplatin may not be ideal for those patients due to oto- and nephrotoxicity. Though carboplatin is a reasonable alternative for cisplatin in patients with a pre-existing hearing deficit or renal dysfunction, its efficacy may be inferior to cisplatin for head and neck cancer. In addition, concurrent chemoradiation is frequently associated with grade 3-4 mucositis and hematologic toxicity leading to poor tolerance among older cancer patients. Thus, a new algorithm needs to be developed to provide optimal local control while minimizing toxicity for this vulnerable group of patients. Recently, immunotherapy with check point inhibitors (CPI) has attracted much attention due to the high prevalence of program death-ligand 1 (PD-L1) in head and neck cancer. In patients with recurrent or metastatic head and neck cancer refractory to cisplatin-based chemotherapy, CPI has proven to be superior to conventional chemotherapy for salvage. Those with a high PD-L1 expression defined as 50% or above or a high tumor proportion score (TPS) may have an excellent response to CPI. This selected group of patients may be candidates for CPI combined with modern radiotherapy techniques, such as intensity-modulated image-guided radiotherapy (IM-IGRT), volumetric arc therapy (VMAT) or proton therapy if available, which allow for the sparing of critical structures, such as the salivary glands, oral cavity, cochlea, larynx and pharyngeal muscles, to improve the patients' quality of life. In addition, normal organs that are frequently sensitive to immunotherapy, such as the thyroid and lungs, are spared with modern radiotherapy techniques. In fit or carefully selected frail patients, a hypofractionated schedule may be considered to reduce the need for daily transportation. We propose a protocol combining CPI and modern radiotherapy techniques for older patients with locally advanced head and neck cancer who are not eligible for cisplatin-based chemotherapy and have a high TPS. Prospective studies should be performed to verify this hypothesis.

Genome-wide association analysis and transcriptome reveal novel loci and a candidate regulatory gene of fatty acid biosynthesis in sesame (Sesamum indicum L.)

The regulatory mechanisms of fatty acid (FA) biosynthesis and triacylglycerols (TAGs) assembly remain largely misunderstood in sesame. Gas chromatography was used to analyze the natural variation in FA compositions and oil content (OC) in 400 sesame accessions grown in three different environments. The phenotypic data was associated with the newly released SNP data from whole-genome resequencing, and 43 significant loci for FA and OC were identified. Comparative transcriptomics analysis of high-OC and low-OC materials was performed, and 515 differentially expressed genes (DEGs) were identified across three seed developmental stages. By integrating the genome-wide association study (GWAS) and DEGs analysis, twenty candidate genes were identified, of which SiTPS1 (trehalose-6-phosphate synthase 1) has emerged as a key regulatory gene of FAs and TAGs metabolism in sesame. Overexpression of SiTPS1 in transgenic Arabidopsis influenced FA composition and significantly increased OC. Our study provides resources for the markers-based improvement of OC and quality in sesame and other crops.

Temporal population structure, a genetic dating method for ancient Eurasian genomes from the past 10,000 years

Radiocarbon dating is the gold standard in archeology to estimate the age of skeletons, a key to studying their origins. Many published ancient genomes lack reliable and direct dates, which results in obscure and contradictory reports. We developed the temporal population structure (TPS), a DNA-based dating method for genomes ranging from the Late Mesolithic to today, and applied it to 3,591 ancient and 1,307 modern Eurasians. TPS predictions aligned with the known dates and correctly accounted for kin relationships. TPS dating of poorly dated Eurasian samples resolved conflicting reports in the literature, as illustrated by one test case. We also demonstrated how TPS improved the ability to study phenotypic traits over time. TPS can be used when radiocarbon dating is unfeasible or uncertain or to develop alternative hypotheses for samples younger than 10,000 years ago, a limitation that may be resolved over time as ancient data accumulate.

FLASH radiotherapy treatment planning and models for electron beams

The FLASH effect designates normal tissue sparing at ultra-high dose rate (UHDR, >40 Gy/s) compared to conventional dose rate (∼0.1 Gy/s) irradiation while maintaining tumour control and has the potential to improve the therapeutic ratio of radiotherapy (RT). UHDR high-energy electron (HEE, 4-20 MeV) beams are currently a mainstay for investigating the clinical potential of FLASH RT for superficial tumours. In the future very-high energy electron (VHEE, 50-250 MeV) UHDR beams may be used to treat deep-seated tumours. UHDR HEE treatment planning focused at its initial stage on accurate dosimetric modelling of converted and dedicated UHDR electron RT devices for the clinical transfer of FLASH RT. VHEE treatment planning demonstrated promising dosimetric performance compared to clinical photon RT techniques in silico and was used to evaluate and optimise the design of novel VHEE RT devices. Multiple metrics and models have been proposed for a quantitative description of the FLASH effect in treatment planning, but an improved experimental characterization and understanding of the FLASH effect is needed to allow for an accurate and validated modelling of the effect in treatment planning. The importance of treatment planning for electron FLASH RT will augment as the field moves forward to treat more complex clinical indications and target sites. In this review, TPS developments in HEE and VHEE are presented considering beam models, characteristics, and future FLASH applications.

Cyto-histo correlation and false-negative urine: Before and after the Paris system for reporting urinary cytology

BACKGROUND

The impact of implementing the Paris system (TPS) on the rate of discrepant cases in the negative for high-grade urothelial carcinoma (NHGUC) category that had a subsequent diagnosis of high-grade urothelial carcinoma (HGUC) on histology is not well studied.

METHODS

We adopted TPS in May 2019. We searched discrepant cases with negative urine cytology 2017-2019 in our cyto-histo correlation database. The urine cytology and follow-up biopsy/resection were reviewed by a cytopathologist who also did Genitourinary (GU) Pathology subspecialty sign-out. Voided urine and instrumented urine were included in this study.

RESULTS

There were total of 70 discrepant cases with negative cytology interpretation but HGUC on the subsequent biopsy or resected specimen. Following the TPS criteria, the rate of discrepant negative cytology cases increased from 6 cases between January 2017 and May 2019 to 64 cases after May 2019 when we adopted TPS. There were 2 discrepant negative cases in 2017, 3 cases in 2018, and 65 cases in 2019. Out of 65 cases in 2019, 64 cases were identified after May 2019. Additional 55 urine cytology slides were reviewed according to the TPS criteria, of which, the diagnoses remained unchanged in 45 (82%) cases and 10 (19%) cases were reassigned to either atypical or suspicious categories. The discrepancy was noted more on the instrumented urine and the upper tract urine. However, the false-negative rate rose faster in voided urine and lower tract urine. The risk of HGUC with the category of NHGUC was 0.03% in 2017, 0.05% in 2018, and 1.06% in 2019 at our institution. The increase in false-negative rate could not be attributed to a single cytopathologist.

CONCLUSION

After adopting TPS for reporting urine cytology, there was an increase in HGUC from negative urine cytology which was subsequently confirmed on histology as cases of HGUC. The quality control of negative urines could be important monitoring the process when implementing TPS.

Comparative transcriptome analysis provides insight into the molecular mechanisms of long-day photoperiod in Moringa oleifera

Moringa oleifera, is commonly cultivated as a vegetable in tropical and subtropical regions because of nutritional and medicinal benefits of its fruits, immature pods, leaves, and flowers. Flowering at the right time is one of the important traits for crop yield in M.oleifera. Under normal conditions, photoperiod is one of the key factors in determining when plant flower. However, the molecular mechanism underlying the effects of a long-day photoperiod on Moringa is not clearly understood. In the present study, deep RNA sequencing and sugar metabolome were conducted of Moringa leaves under long-day photoperiod. As a result, differentially expressed genes were significantly associated with starch and sucrose pathway and the circadian rhythm-plant pathway. In starch and sucrose pathway, sucrose, fructose, trehalose, glucose, and maltose exhibited pronounced rhythmicity over 24 h, and TPS (trehalose-6-phosphate synthase) genes constituted key regulatory genes. In an Arabidopsis overexpression line hosting the MoTPS1 or MoTPS2 genes, flowering occurred earlier under a short-day photoperiod. These results will support molecular breeding of Moringa and may help clarify to genetic architecture of long-day photoperiod related traits.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12298-022-01186-4.

Dosimetric accuracy of three dose calculation algorithms for radiation therapy of in situ non-small cell lung carcinoma

Background

Study determines differences in calculated dose distributions for non-small cell lung carcinoma (NSC LC) patients. NSC LC cases were investigated, being the most common lung cancer treated by radiotherapy in our clinical practice.

Materials and methods

A retrospective study of 15 NSCLC patient dose distributions originally calculated using standard superposition (SS) and recalculated using collapsed cone (CC ) and Monte Carlo (MC) based algorithm expressed as dose to medium in medium (MCD_m) and dose to water in medium (MCD_w,) was performed so that prescribed dose covers at least 99% of the gross target volume (GTV). Statistical analysis was performed for differences of conformity index (CI), heterogeneity index (HI), gradient index (GI), dose delivered to 2% of the volume (D_2%), mean dose (D_mean) and percentage of volumes covered by prescribed dose (V_70Gy). For organs at risk (OARs), D_mean and percentage of volume receiving 20 Gy and 5Gy (V_20Gy, V_5Gy) were analysed.

Results

Statistically significant difference for GTVs was observed between MCD_w and SS algorithm in mean dose only. For planning target volumes (PTVs), statistically significant differences were observed in prescribed dose coverage for CC, MCD_m and MCD_w. The differences in mean CI value for the CC algorithm and mean HI value for MCD_m and MCD_w were statistically significant. There is a statistically significant difference in the number of MUs for MCD_m and MCD_w compared to SS.

Conclusion

All investigated algorithms succeed in managing the restrictive conditions of the clinical goals. This study shows the drawbacks of the CC algorithm compared to other algorithms used.

Dosimetric evaluation of high-Z inhomogeneity used for hip prosthesis: A multi-institutional collaborative study

PURPOSE

A multi-institutional investigation for dosimetric evaluation of high-Z hip prosthetic device in photon beam.

METHODS

A bilateral hip prosthetic case was chosen. An in-house phantom was built to replicate the human pelvis with two different prostheses. Dosimetric parameters: dose to the target and organs at risk (OARs) were compared for the clinical case generated by various treatment planning system (TPS) with varied algorithms. Single beam plans with different TPS for phantom using 6 MV and 15 MV photon beams with and without density correction were compared with measurement.

RESULTS

Wide variations in target and OAR dosimetry were recorded for different TPS. For clinical case ideal PTV coverage was noted for plans generated with Corvus and Prowess TPS only. However, none of the TPS were able to meet plan objective for the bladder. Good correlation was noticed for the measured and the Pinnacle TPS for corrected dose calculation at the interfaces as well as the dose ratio in elsewhere. On comparing measured and calculated dose, the difference across the TPS varied from -20% to 60% for 6 MV and 3% to 50% for the 15 MV, respectively.

CONCLUSION

Most TPS do not provide accurate dosimetry with high-Z prosthesis. It is important to check the TPS under extreme conditions of beams passing through the high-Z region. Metal artifact reduction algorithms may reduce the difference between the measured and calculated dose but still significant differences exist. Further studies are required to validate the calculational accuracy.

Insights Into the Molecular Mechanisms of Late Flowering in Prunus sibirica by Whole-Genome and Transcriptome Analyses

Freezing during the flowering of Prunus sibirica is detrimental to fruit production. The late flowering (LF) type, which is delayed by 7-15 days compared with the normal flowering (NF) type, avoids damages at low temperature, but the molecular mechanism of LF remains unclear. Therefore, this study was conducted to comprehensively characterize floral bud differentiation. A histological analysis showed that initial floral bud differentiation was delayed in the LF type compared to the NF type. Genome-wide associated studies (GWAS) showed that a candidate gene (PaF106G0600023738.01) was significantly associated with LF type. It was identified as trehalose-6-phosphate phosphatase (PsTPPF), which is involved in trehalose-6-phosphate (Tre6P) signaling pathway and acts on floral transition. A whole-transcriptome RNA sequencing analysis was conducted, and a total of 6,110 differential expression (DE) mRNAs, 1,351 DE lncRNAs, and 148 DE miRNAs were identified. In addition, 24 DE mRNAs related with floral transition were predicted, and these involved the following: three interactions between DE lncRNAs and DE mRNAs of photoperiod pathway with two mRNAs (COP1, PaF106G0400018289.01 and CO3, MXLOC_025744) and three lncRNAs (CCLR, LTCONS_00031803, COCLR1, LTCONS_00046726, and COCLR2, LTCONS_00046731); one interaction between DE miRNAs and DE mRNAs with one mRNA, encoding trehalose-6-phosphate synthase (PsTPS1, PaF106G0100001132.01), and one miRNA (miRNA167h). Combined with the expression profiles and Tre6P levels, functions of PsTPPF and PsTPS1 in Tre6P regulation were considered to be associated with flowering time. A new network of ceRNAs correlated with LF was constructed, and it consisted of one mRNA (PsTPS1), one lncRNA (TCLR, LTCONS_00034157), and one miRNA (miR167h). This study provided insight into the molecular regulatory mechanism of LF in Prunus sibirica.

MrTPS3 and MrTPS20 Are Responsible for β-Caryophyllene and α-Pinene Production, Respectively, in Red Bayberry (Morella rubra)

Red bayberry is a sweet, tart fruit native to China and grown widely in the south. The key organic compounds forming the distinctive aroma in red bayberry, are terpenoids, mainly β-caryophyllene and α-pinene. However, the key genes responsible for different terpenoids are still unknown. Here, transcriptome analysis on samples from four cultivars, during fruit development, with different terpenoid production, provided candidate genes for volatile organic compound (VOC) production. Terpene synthases (TPS) are key enzymes regulating terpenoid biosynthesis, and 34 TPS family members were identified in the red bayberry genome. MrTPS3 in chromosome 2 and MrTPS20 in chromosome 7 were identified as key genes regulating β-caryophyllene and α-pinene synthesis, respectively, by qRT-PCR. Subcellular localization and enzyme activity assay showed that MrTPS3 was responsible for β-caryophyllene (sesquiterpenes) production and MrTPS20 for α-pinene (monoterpenes). Notably, one amino acid substitution between dark color cultivars and light color cultivars resulted in the loss of function of MrTPS3, causing the different β-caryophyllene production. Our results lay the foundation to study volatile organic compounds (VOCs) in red bayberry and provide potential genes for molecular breeding.

TPS-b family genes involved in signature aroma terpenes emission in ripe kiwifruit

Aroma is a critical factor influencing consumer acceptability of ripe fruit. When fruit are eaten, the aroma travels retronasally from the mouth into the olfactory receptors located in the nose after exhaling. In kiwifruit (Actinidia spp.), terpene volatiles such as α-terpinolene and 1,8-cineole have been shown to contribute to the characteristic aroma of ripe fruit. Notably, 1,8-cineole contributes a key floral/eucalyptus note to the aroma of ripe A. chinensis 'Hort16A' kiwifruit, based on sensory descriptive and discriminant analysis. Emission of α-terpinolene and 1,8-cineole in kiwifruit is induced by ethylene, and production peaks when fruit are at eating ripeness. Two monoterpene synthase TPS-b family genes have been isolated from the fruit of A. arguta and A. chinensis that produce α-terpinolene and 1,8-cineole, respectively. Here we discuss terpene volatiles with respect to fruit aroma and consumer sensory evaluation, analyze the gene structure and conserved motifs of TPS-b genes in published kiwifruit genomes and then construct a transcriptional regulatory network based on Actinidia TPS-b. These data provide further insights into the potential molecular mechanisms underlying signature monoterpene synthesis to improve flavor in kiwifruit.

Circulating Tissue Polypeptide-Specific Antigen in Pre-Diagnostic Pancreatic Cancer Samples

Simple Summary

Detecting cancer early significantly increases the chances of successful (surgical) treatment. Pancreatic cancer is one of the deadliest cancer forms, since it is usually discovered at a late and already spread stage. Finding biomarkers showing pancreatic cancer at an early stage is a possible approach to early detection and improved treatment. The aim of our study was to assess the potential of tissue polypeptide specific antigen (TPS) as a biomarker for early pancreatic cancer detection. We studied TPS levels in blood plasma samples from a population-based biobank in Västerbotten, Sweden that were collected before individuals were diagnosed with pancreatic cancer. Although TPS levels are raised at diagnosis, this occurs late, and thus TPS does not seem to hold promise as an early detection marker for pancreatic cancer.

Abstract

Early detection of pancreatic ductal adenocarcinoma (PDAC) is challenging, and late diagnosis partly explains the low 5-year survival. Novel and sensitive biomarkers are needed to enable early PDAC detection and improve patient outcomes. Tissue polypeptide specific antigen (TPS) has been studied as a biomarker in PDAC diagnostics, and it has previously been shown to reflect clinical status better than the ‘golden standard’ biomarker carbohydrate antigen 19-9 (CA 19-9) that is most widely used in the clinical setting. In this cross-sectional case-control study using pre-diagnostic plasma samples, we aim to evaluate the potential of TPS as a biomarker for early PDAC detection. Furthermore, in a subset of individuals with multiple samples available at different time points before diagnosis, a longitudinal analysis was used. We assessed plasma TPS levels using enzyme-linked immunosorbent assay (ELISA) in 267 pre-diagnostic PDAC plasma samples taken up to 18.8 years before clinical PDAC diagnosis and in 320 matched healthy controls. TPS levels were also assessed in 25 samples at PDAC diagnosis. Circulating TPS levels were low both in pre-diagnostic samples of future PDAC patients and in healthy controls, whereas TPS levels at PDAC diagnosis were significantly increased (odds ratio 1.03; 95% confidence interval: 1.01–1.05) in a logistic regression model adjusted for age. In conclusion, TPS levels increase late in PDAC progression and hold no potential as a biomarker for early detection.

Heterogeneous distribution of PD-L1 expression in the IASLC/ATS/ERS classification of lung adenocarcinoma

BACKGROUND

PD-L1 expression in tumor cells can predict the efficacy of PD-1/PD-L1 inhibitors and prognosis in patients. However, the correlation between the PD-L1 expression and the novel lung adenocarcinoma classification are obscure.

METHODS

94 lung adenocarcinoma cases were reviewed in the Third Affiliated Hospital of Soochow University from January to December 2019. PD-L1 (DAKO 22C3) was used to test the PD-L1 expression in lung cancer tissue.

RESULT

TPS was used to interpret the PD-L1 expression. The negative, low positive and high positive of PD-L1 were 52 cases (55.30%), 29 cases (30.90%) and 13 cases (13.80%). The subtype ratio of acinar, lepidic and solid in adenocarcinoma were correlation with the PD-L1 TPS (r =  - 0.37, P < 0.001; r =  - 0.22, P = 0.013; r = 0.68, P < 0.001). The results of χ² test showed the PD-L1 expression had the significant difference with gender (P = 0.027), age (P = 0.018), smoking history (P = 0.021), lymph node metastasis (P = 0.001), TNM stage (P = 0.002), acinar structure (P = 0.017) and solid structure (P < 0.001). Multi-factor linear regression results suggested that solid structure, TNM stage and smoking history were associated with PD-L1 expression (P < 0.05). The solid structure showed more capability to PD-L1 expression (β = 0.398).

CONCLUSION

PD-L1 expression was heterogeneity in lung adenocarcinoma. The solid structure, TNM stage and smoking history were correlation to up-regulation of PD-L1 expression, and solid structure was the most importance factor.

Development of whole-body representation and dose calculation in a commercial treatment planning system

For the epidemiological evaluation of long-term side effects of radiotherapy patients, it is important to know the doses to organs and tissues everywhere in the patient. Computed tomography (CT) images of the patients which contain the anatomical information are sometimes available for each treated patient. However, the available CT scans usually cover only the treated volume of the patient including the target and surrounding anatomy. To overcome this limitation, in this work we describe the development of a software tool using the Varian Eclipse Scripting API for extending a partial-body CT to a whole-body representation in the treatment planning system for dose calculation. The whole-body representation is created by fusing the partial-body CT with a similarly sized whole-body computational phantom selected from a library containing 64 phantoms of different heights, weights, and genders. The out-of-field dose is calculated with analytical models from the literature and merged with the treatment planning system-calculated dose. To test the method, the out-of-field dose distributions on the computational phantoms were compared to dose calculations on whole-body patient CTs. The mean doses, D2% and D98% were compared in 26 organs and tissues for 14 different treatment plans in 5 patients using 3D-CRT, IMRT, VMAT, coplanar and non-coplanar techniques. From these comparisons we found that mean relative differences between organ doses ranged from -10% and +20% with standard deviations of up to 40%. The developed method will help epidemiologists and researchers estimate organ doses outside the treated volume when only limited treatment planning CT information is available.

Halobacterium salinarum and Haloferax volcanii Comparative Transcriptomics Reveals Conserved Transcriptional Processing Sites

Post-transcriptional processing of messenger RNA is an important regulatory strategy that allows relatively fast responses to changes in environmental conditions. In halophile systems biology, the protein perspective of this problem (i.e., ribonucleases which implement the cleavages) is generally more studied than the RNA perspective (i.e., processing sites). In the present in silico work, we mapped genome-wide transcriptional processing sites (TPS) in two halophilic model organisms, Halobacterium salinarum NRC-1 and Haloferax volcanii DS2. TPS were established by reanalysis of publicly available differential RNA-seq (dRNA-seq) data, searching for non-primary (monophosphorylated RNAs) enrichment. We found 2093 TPS in 43% of H. salinarum genes and 3515 TPS in 49% of H. volcanii chromosomal genes. Of the 244 conserved TPS sites found, the majority were located around start and stop codons of orthologous genes. Specific genes are highlighted when discussing antisense, ribosome and insertion sequence associated TPS. Examples include the cell division gene ftsZ2, whose differential processing signal along growth was detected and correlated with post-transcriptional regulation, and biogenesis of sense overlapping transcripts associated with IS200/IS605. We hereby present the comparative, transcriptomics-based processing site maps with a companion browsing interface.

Evaluation of IGRT-Induced Imaging Doses and Secondary Cancer Risk for SBRT Early Lung Cancer Patients In Silico Study

Objectives:

This study performed dosimetry studies and secondary cancer risk assessments on using electronic portal imaging device (EPID) and cone beam computed tomography (CBCT) as image guided tools for the early lung cancer patients treated with SBRT.

Methods:

The imaging doses from MV-EPID and kV-CBCT of the Edge accelerator were retrospectively added to sixty-one SBRT treatment plans of early lung cancer patients. The MV-EPID imaging dose (6MV Photon beam) was calculated in Pinnacle TPS, and the kV-CBCT imaging dose was simulated and calculated by modeling of the kV energy beam in TPS using Pinnacle automatic modeling program. Three types of plans, namely Plan_EPID, Plan_CBCT and Plan_origin, were generated with incorporating doses of EPID, CBCT and no imaging, respectively, for analysis. The effects of imaging doses on dose-volume-histogram (DVH) and plan quality were analyzed, and the excess absolute risk (EAR) of secondary cancer for ipsilateral lung was evaluated.

Results:

The regions that received less than 50 cGy were significantly impacted by the imaging doses, while the isodose lines greater than 1000 cGy were barely changed. The DVH values of ipsilateral lung increased the most in Plan_EPID, followed by Plan_CBCT. Compared to Plan_origin on the average, the estimated EAR of ipsilateral lung in Plan_EPID increased by 3.43%, while the corresponding EAR increase in Plan_CBCT was much smaller (about 0.4%). Considering only the contribution of the imaging dose, the EAR values for the ipsilateral lung due to the MV-EPID dose in 5 years,10 years and 15 years were 1.49 cases, 2.09 cases and 2.88 cases per 10⁴PY respectively, and those due to the kV-CBCT dose were about 9 times lower, correspondingly.

Conclusions:

The imaging doses produced by MV-EPID and kV-CBCT had little effects on the target dose coverage. The secondary cancer risk caused by MV-EPID dose is more than 8.5 times that of kV-CBCT.

Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy

Background

The purpose of this study is to develop a clinical application program that automatically calculates the effect for secondary cancer risk (SCR) of individual patient. The program was designed based on accurate dose calculations using patient computed tomography (CT) data and Monte Carlo engine. Automated patient-specific evaluation program was configured to calculate SCR.

Methods

The application program is designed to re-calculate the beam sequence of treatment plan using the Monte Carlo engine and patient CT data, so it is possible to accurately calculate and evaluate scatter and leakage radiation, difficult to calculate in TPS. The Monte Carlo dose calculation system was performed through stoichiometric calibration using patient CT data. The automatic SCR evaluation program in application program created with a MATLAB was set to analyze the results to calculate SCR. The SCR for organ of patient was calculated based on Biological Effects of Ionizing Radiation (BEIR) VII models. The program is designed to sequentially calculate organ equivalent dose (OED), excess absolute risk (EAR), excess relative risk (ERR), and the lifetime attributable risk (LAR) in consideration of 3D dose distribution analysis. In order to confirm the usefulness of the developed clinical application program, the result values from clinical application program were compared with the manual calculation method used in the previous study.

Results

The OED values calculated in program were calculated to be at most approximately 13.3% higher than results in TPS. The SCR result calculated by the developed clinical application program showed a maximum difference of 1.24% compared to the result of the conventional manual calculation method. And it was confirmed that EAR, ERR and LAR values can be easily calculated by changing the biological parameters.

Conclusions

We have developed a patient-specific SCR evaluation program that can be used conveniently in the clinic. The program consists of a Monte Carlo dose calculation system for accurate calculation of scatter and leakage radiation and a patient-specific automatic SCR evaluation program using 3D dose distribution. The clinical application program that improved the disadvantages of the existing process can be used as an index for evaluating a patient treatment plan.

Automated tumor proportion scoring for PD-L1 expression based on multistage ensemble strategy in non-small cell lung cancer

Introduction

Programmed cell death ligand-1 (PD-L1) expression is a promising biomarker for identifying treatment related to non-small cell lung cancer (NSCLC). Automated image analysis served as an aided PD-L1 scoring tool for pathologists to reduce inter- and intrareader variability. We developed a novel automated tumor proportion scoring (TPS) algorithm, and evaluated the concordance of this image analysis algorithm with pathologist scores.

Methods

We included 230 NSCLC samples prepared and stained using the PD-L1(SP263) and PD-L1(22C3) antibodies separately. The scoring algorithm was based on regional segmentation and cellular detection. We used 30 PD-L1(SP263) slides for algorithm training and validation.

Results

Overall, 192 SP263 samples and 117 22C3 samples were amenable to image analysis scoring. Automated image analysis and pathologist scores were highly concordant [intraclass correlation coefficient (ICC) = 0.873 and 0.737]. Concordances at moderate and high cutoff values were better than at low cutoff values significantly. For SP263 and 22C3, the concordances in squamous cell carcinomas were better than adenocarcinomas (SP263 ICC = 0.884 vs 0.783; 22C3 ICC = 0.782 vs 0.500). In addition, our automated immune cell proportion scoring (IPS) scores achieved high positive correlation with the pathologists TPS scores.

Conclusions

The novel automated image analysis scoring algorithm permitted quantitative comparison with existing PD-L1 diagnostic assays and demonstrated effectiveness by combining cellular and regional information for image algorithm training. Meanwhile, the fact that concordances vary in different subtypes of NSCLC samples, which should be considered in algorithm development.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12967-021-02898-z.

Effect of the Paris system for reporting urinary cytology with histologic follow-up

BACKGROUND

The Paris system (TPS) for Reporting Urinary Cytology provides a standardized reporting system whose main focus is the diagnosis of high-grade urothelial carcinoma (HGUC). We conducted a study to see the impact of The Paris System on our cytologic diagnoses with associated histology.

MATERIALS AND METHODS

We reviewed our pathology database regarding urinary specimens in the year before implementation of The Paris System and the year after. We gathered the data regarding cytologic diagnosis and concurrent/subsequent histology.

RESULTS

Over a 1-year period from 2016-2017, 486 urine cytology specimens were identified before implementation of The Paris System and diagnosed as follows: 83% benign/negative, 10% atypical, 2% suspicious, 5% HGUC, 0.2% low grade urothelial neoplasm (LGUN), and 0.2% unsatisfactory. Over a next 1-year period from 2017 to 2018, 602 specimens used TPS and diagnosed as follows: 85% negative for HGUC, 6% atypical, 3% suspicious, 4% HGUC, 0.17% LGUN, and 2% unsatisfactory. Although, not listed as a standardized category in The Paris System, our institution used "Negative for high-grade, cannot rule out low-grade urothelial neoplasm (NHL)" as a subcategory of Negative for HGUC. 4% of the cases fell into this category. Focusing on the Atypical category before TPS, histology was available in 15/49 (31%) cases. Of these, 40% had HGUC. Regarding the Atypical category after TPS, histology was available in 21/36 (58%) cases. Of these, 52% were HGUC. For the NHL category, concurrent histology was available in 13/26 (50%) cases. Of these, 67% were low grade urothelial neoplasms.

CONCLUSION

Our study showed that TPS lowered the rate of Atypical from 10% to 6%. After the implementation of TPS, Atypical corresponded to a higher rate of high-grade urothelial carcinoma. Also, the NHL subcategory had a high positive predictive value for diagnosing low grade urothelial neoplasms.

Poly(butylene adipate-co-terephthalate)/thermoplastic starch/zeolite 5A films: Effects of compounding sequence and plasticizer content

This work investigated the effect of the compounding sequence and the glycerol content on poly(butylene adipate-co-terephthalate)/thermoplastic starch/zeolite 5A (PBAT/TPS/Z5A) composites. The composite pellets and films were prepared by an extrusion process using a PBAT:TPS ratio of 60:40, Z5A loading of 3 wt%, and glycerol contents of 35 and 40 parts per hundred parts of starch (phs). Prior to blown film extrusion, the composite pellets were produced by two compounding sequences: sequence I (SI)-mixing PBAT with Z5A prior to blending with TPS; sequence II (SII)-mixing TPS with Z5A before blending with PBAT. The SII compounding sequence provided improved mixing between PBAT and TPS, leading to increased continuous phase region and a reduced TPS dispersed phase size. Increasing the glycerol content decreased the viscosity and size of the TPS dispersed phase and gave rise to a more uniform dispersion of the TPS domains and Z5A particles. Compounding Z5A via the SII sequence with a glycerol content of 40 phs effectively improved the mixing and the performance of the PBAT/TPS blend.

Analysis of Relative Scent Intensity, Volatile Compounds and Gene Expression in Freesia "Shiny Gold"

Scent is one of the most important economic traits in Freesia hybrida. "Shiny Gold", a popular cultivar in South Korea, is widely cultivated for its scent. The relative scent intensity of "Shiny Gold" was approximately 16% higher in full-bloomed flower when compared to the yellow bud stage, while tissue-specifically, tepals showed higher intensity in electronic-nose (e-nose) analysis. E-nose analysis also showed that the scent intensity of "Shiny Gold" was higher and lower than "10C3-424" and "10C3-894", respectively, and was similar to "Yvonne". These results correlated to those of the olfactory tests. In total, 19 volatile compounds, including linalool, β-ocimene, D-limonene, trans-β-ionone were detected in gas chromatography-mass spectrometry analysis. Among these, linalool was the major volatile compound, accounting for 38.7% in "Shiny Gold". Linalool synthase and TPS gene expression corresponded to the scent intensity of the four cultivars, with the lowest expression in the "10C3-424". TPS 2, TPS 3, TPS 5, TPS 6 and TPS 8 were highly expressed in both bud and flower in "Shiny Gold", while the expression of TPS 4 was lower, relative to other TPS genes in both the flowering stages. These results may aid in enhancing scent composition in Freesia cultivars using marker-assisted selection.

Assessing the out-of-field dose calculation accuracy by eclipse treatment planning system in sliding window IMRT of prostate cancer patients

AIM

The objective of this study was to evaluate out-of-field dose distribution calculation accuracy by the Anisotropic Analytical Algorithm (AAA), version 13.0.26, in Eclipse TPS, (Varian Medical Systems, Palo Alto, Ca, USA) for sliding window IMRT delivery technique in prostate cancer patients.

MATERIALS AND METHODS

Prostate IMRT plans with nine coplanar were calculated with the AAA Eclipse treatment planning system. To assess the accuracy of dose calculation predicted by the Eclipse in normal tissue and OARs located out of radiation field areas, including the rectum, bladder, right and left head of the femur, absolute organ dose value, and dose distribution were measured using the Delta⁴⁺ IMRT phantom.

RESULTS

In the out-of-field areas, underestimation of -0.66% in organs near the field edge to -39.63% in organs far from the field edge (2.5 and 7.3 cm respectively) occurred in the TPS calculations. The percentage of dose deviation for the femoral heads was 95.7 on average while for the organ closer to the target (rectum) it was 79.81.

CONCLUSIONS

AAA dosimetry algorithm (used in Eclipse TPS) showed poor dose calculation in areas beyond the treatment fields border where underestimation varies with the distance from the field edges. A significant underestimation was found for the AAA algorithm in the sliding window IMRT technique (P-value > 0.05).

Study of Industrial Grade Thermal Insulation at Elevated Temperatures

Thermal insulation is used for preventing heat losses or heat gains in various applications. In industries that process combustible products, inorganic-materials-based thermal insulation may, if proven sufficiently heat resistant, also provide heat protection in fire incidents. The present study investigated the performance and breakdown temperature of industrial thermal insulation exposed to temperatures up to 1200 °C, i.e., temperatures associated with severe hydrocarbon fires. The thermal insulation properties were investigated using thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and by heating 50 mm cubes in a muffle furnace to temperatures in the range of 600 to 1200 °C with a 30 min holding time. The room temperature thermal conductivity was also recorded after each heat treatment. Upon heating, the mineral-based oil dust binder was released at temperatures in the range of 300 to 500 °C, while the Bakelite binder was released at temperatures in the range of 850 to 960 °C. The 50 mm test cubes experienced increasing levels of sintering in the temperature range of 700 to 1100 °C. At temperatures above 1100 °C, the thermal insulation started degrading significantly. Due to being heat-treated to 1200 °C, the test specimen morphology was similar to a slightly porous rock and the original density of 140 kg/m³ increased to 1700 kg/m³. Similarly, the room temperature thermal conductivity increased from 0.041 to 0.22 W/m∙K. The DSC analysis confirmed an endothermic peak at about 1200 °C, indicating melting, which explained the increase in density and thermal conductivity. Recently, 350 kW/m² has been set as a test target heat flux, i.e., corresponding to an adiabatic temperature of 1200 °C. If a thin layer of thermally robust insulation is placed at the heat-exposed side, the studied thermal insulation may provide significant passive fire protection, even when exposed to heat fluxes up to 350 kW/m². It is suggested that this is further analysed in future studies.