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Biomedical subjects

M Benassi

Publications and source records attributed to M Benassi.

At least 19 recordsLinked to original sources

Experimental determination of calibration settings of a commercially available radionuclide calibrator for various clinical measurement geometries and radionuclides.

Following the approach of the National Primary Laboratory of the UK (NPL) for the calibration of radionuclide calibrators, but using a commercially available instrument with no data available in the literature, the radionuclide calibrator response was investigated as a function of different measurement geometries at the "Regina Elena" National Cancer Institute (IRE) in Rome. Working with Italian National Metrology Institute for ionising radiation quantities (ENEA-INMRI), specific calibration factors with traceability to national primary standards were determined for different types of glass vials, solid capsules and plastic syringes, investigating three radionuclides with different energy spectra (Tc-99m, In-111, I-131). For each kind of syringe, calibration correction factors for different filling volumes were calculated. For Tc-99m and I-131 the difference between measured and true activity was in the range 2-7%, depending on measurement geometry. For In-111 a large percentage deviation from the true activity value was found in each geometry considered, reaching 35%. The magnitude of this difference is particularly dependent on the energies of the emitted photons.

Calibration↗

On measuring the output of an IORT mobile dedicated accelerator.

In the present work, dose-to-water values derived from Fricke (operated by the Italian Primary Standard Dosimetry Laboratory) and alanine (operated by the Istituto Superiore di Sanità, Italy) measurements in IORT electron beams characterised by a high dose per pulse were compared to show the extent of equivalence of the two dosimetry systems. This study demonstrates agreement (within 2%) of the two dosimetry systems for plane-base IORT applicators, but in the case of small diameter (40 mm) and bevelled (22.5 degrees ) applicators, Fricke dosemeters underestimated doses by 2.4%. For base bevelled IORT applicators (22.5 degrees or more) with small diameter ( approximately 40 mm or less) reduced dimensions of the dosemeter are needed. Under these measurement conditions, the alanine dosemeter gives better accuracy in beam output determination compared with the Fricke dosemeter used.

Equipment Failure Analysis↗

MRI quality control tools for procedures and analyses.

Quality control in MRI includes acceptance tests on the installation of a new scanner and tests representative of the system's performance during clinical practice. The first tests are time consuming and carried out to evaluate the agreement of the system with the prescribed procurement specifications. The second tests identify the equipment malfunction requiring maintenance are not time consuming and are suited to a busy clinical scanner. The paper evaluates the feasibility of the AAPM protocols (1,2) and proposes procedures and practical tools to achieve this purpose. The MRI images, captured from the scanner and transferred in DICOM (Digital Imaging and Communications in Medicine) format by a local network, are analyzed by computerized worksheets and commercial software.

Calibration↗

Comparison of dose distributions in IMRT planning using the gamma function.

Intensity-modulated radiotherapy (IMRT) (1) is an advanced form of 3-D conformal radiotherapy. It uses non uniform spatial modifications in the intensity of the beams across the irradiated field. Consequently, it is necessary to develop sophisticated tools to compare measured and calculated dose distributions in order to verify the accuracy of the results of the planned dose distribution. Different methods have been developed to evaluate the accordance between measured and calculated doses, such as the point-to-point dose difference or the evaluation of the distance between two closed points having the same dose value (2-4). The verification method proposed by Low (5-7) seems to be more complete since it takes into account both the dose difference (DD) and the distance to agreement (DTA), allowing to define a "score", the gamma value, at each point of interest. A software tool (DDE: Dose Distribution Evaluator), based on Low's method, to evaluate the agreement between dose distribution matrices has been implemented. In particular, the proposed gamma curve, as a function of the isodose levels, gives real-time information useful for decision making about the treatment plan. The paper describes the software, and reports the obtained results in a simple geometry and in several clinical cases (head-neck and prostate). Comparison between measured data (film and MapCheck) and calculated data (CadPlan) using DDE has shown very good agreements. Thanks to its higher resolution, film dosimetry showed better accuracy than the MapCheck technique. Similar results can be obtained also with the MapCheck technique when proper measurement methods are used.

Dose-Response Relationship, Radiation↗

A possible quality control protocol for Doppler ultrasound for organizational time optimization.

Acceptance tests quantitatively determine equipment performance characteristics. Before a new probe is accepted, performance tests can be also used to compare performance of other probes. Routine performance tests verify device operational stability over the time. We developed an efficient and effective testing programme aiming to demonstrate changes in imaging performance relevant to clinical quantitative use of pulsed and colour Doppler. For each scanner-transducer tested, we introduced some quantitative and semi-quantitative parameters in relation to the clinical request for which the equipment was chosen. The proposed quantitative tests may also be used as qualitative tests, when it is suspected that scanner performance is deteriorating. The measurements, obtained with different units, differed also in the case of probes operating at the same depth and peak velocity. Without a quality control (QC) program, significant variations are likely to be reported when peak velocity of the same flow is measured with different instruments. Our experience suggests that modern digital equipments used in serial measurements may be stable over the time and that calibrated phantom may enable preventive identification of corrective action to units and probes. Manufacturers and independent laboratories applying a quality control protocol can increase our experience to recognize and deal with the involved problems.

Blood Flow Velocity↗

Influence of time interval between surgery and radiotherapy on tumor regrowth.

UNLABELLED: In order to evaluate the influence of time intervals between tumor cell injection and radiotherapy on tumor control and regrowth after surgery, we performed two kinds of experiments on C3D2F1 mice bearing a mammary carcinoma inoculated in the foot or leg. 1st experiment: tumor in foot. END POINT: Tumor Control Probability (TCP). Single dose radiation treatments (RT) were administered at different period times from injection time of tumor cells (day 1). 1st group: unirradiated control, 2nd group: RT on day 2 (TCP50 29 +/- 2.1 Gy), 3rd group: RT on day 7 (TCP 52.5 +/- 2.9 Gy), 4th group: RT on day 12 (TCP50 61.9 + 2.4 Gy). 2nd experiment: tumor in leg. END POINT: percentage of tumor regrowth. Mice were randomly assigned to three groups: 1st control group (tumor growth in all mice), 2nd surgical excision of macroscopically evident tumor on day 7-9 from injection (tumor regrowth in 85% of mice), 3rd as the previous group plus 30 Gy radiation treatment within 24 hours from excision (tumor regrowth in 33% of cases). The radiation dose was selected on the basis of TCP50 observed in the 1st experiment for mice with sub-clinical disease. These data indicate that the radiation dose able to control 50% of tumors increases with the time interval between tumor cells injection and RT. A short time interval between surgery and RT should increase the probability of local control, supporting the rationale of intraoperative radiation therapy (IORT) as adjuvant therapy after surgical resection, when subclinical residual cells are suspected.

Animals↗

Radiation exposure of personnel during intraoperative radiotherapy (IORT): radiation protection aspects.

Intraoperative radiotherapy (IORT) is a multidisciplinary procedure which combines two conventional methods of cancer treatment surgery and radiation therapy. The purpose is to deliver a large single dose to the surgically exposed tumor bed while minimizing doses to normal tissues. Intraoperative radiation therapy (IORT) is a technique which allows irradiating the patient directly after the surgical operation using a linear accelerator that can be situated in the operating room. For medical accelerators with energy over 10MeV the need to characterize the neutron spectra for this particular situation arises from the fact that, when neutron spectra is not fully known, it becomes necessary to be more cautious introducing a weight factor wR of 20 (maximum value). This leads to overesteem the equivalent dose due to neutrons and it indicates to introduce additional (mobile) shields for photon and neutrons radiation not easily achievable in an operating room.

Combined Modality Therapy↗

Optimization of intensity modulated radiation therapy: assessing the complexity of the problem.

Intensity modulated radiation therapy (IMRT) is one of the most innovative techniques in oncological radiotherapy, allowing to conform the dose delivery to the tumoral target, preserving the normal tissue. The high number of parameters involved in the IMRT treatment planning requires an automated approach to the beam modulation. Such optimization process consists in the search of the global minimum of a cost function representing a quality index for the treatment. The complexity of this task, has been analyzed with a statistical approach for three clinical cases of particular interest in IMRT. Our main result is that a cost function based on dose-volume constraints entails lower complexity of the optimization process, in terms of the choice of the parameters defining the cost function and in a smaller sensitivity to the initial conditions for the optimization algorithm.

Radiotherapy Dosage↗

Comparison of conformal radiation therapy techniques within the dynamic radiotherapy project 'Dynarad'.

The objective of the dynamic radiotherapy project 'Dynarad' within the European Community has been to compare and grade treatment techniques that are currently applied or being developed at the participating institutions. Cervical cancer was selected as the tumour site on the grounds that the involved organs at risk, mainly the rectum and the bladder, are very close to the tumour and partly located inside the internal target volume. In this work, a solid phantom simulating the pelvic anatomy was used by institutions in Belgium, France, Greece, Holland, Italy, Sweden and the United Kingdom. The results were evaluated using both biological and physical criteria. The main purpose of this parallel evaluation is to test the value of biological and physical evaluations in comparing treatment techniques. It is demonstrated that the biological objective functions allow a much higher conformality and a more clinically relevant scoring of the outcome. Often external beam treatment techniques have to be combined with intracavitary therapy to give clinically acceptable results. However, recent developments can reduce or even eliminate this need by delivering more conformal dose distributions using intensity modulated external dose delivery. In these cases the reliability of the patient set-up procedure becomes critical for the effectiveness of the treatment.

European Union↗

Dosimetric protocols in radiotherapy: a computer program.

A computer program to evaluate the dose to water in a specified point for low, medium and high energy photon and electron radiotherapeutic beams using different ionization chambers, phantom materials and new dosimetric standard protocols has been developed. The absorbed dose to air cavity calibration factors of the ionization chambers at the radiation quality, the updated physical quantities and dosimetric parameters are part of the data base, which is extendable to individual users' needs. Moreover, the management software permits comparison of different dosimetric protocols and reduction of errors on the dose delivered to patients.

Humans↗

Effect of cisplatin and c-myb antisense phosphorothioate oligodeoxynucleotides combination on a human colon carcinoma cell line in vitro and in vivo.

We investigated the effect of c-myb antisense phosphorothioate oligodeoxynucleotides [(S)ODNs] and cisplatin (CDDP) combination on the human colon carcinoma cell line LoVo Dx both in vitro and in nude mice bearing LoVo Dx solid tumour. We show that antisense (S)ODN treatment decreases c-myb mRNA and protein expression, induces growth arrest in the G1 phase of the cell cycle, and inhibits cell proliferation. In vivo treatment with c-myb antisense (S)ODNs results in a reduction in tumour growth. A greater inhibition of cell proliferation in vitro and a higher increase of tumour growth inhibition and growth delay in vivo were obtained with the combination of (S)ODNs and CDDP than when the two agents were administered separately. This comparative study, using the same tumour cell line in vitro and in vivo, suggests that c-myb antisense (S)ODNs might be useful in the therapy of colon cancer in combination with antineoplastic drugs.

Animals↗

Rhein enhances the effect of adriamycin on mitochondrial respiration by increasing antibiotic-membrane interaction.

The effect of the combination of Adriamycin (ADM) with rhein (RH), an anti-inflammatory drug, on the electron flow through site III and IV of the respiratory chain of rat liver mitochondria was investigated. RH, even at high concentrations, does not inhibit either duroquinol (DHQ) oxidation or cytochrome oxidase activity both of which are decreased by ADM in a dose-dependent manner. The analysis of interaction, performed with the isobolar method, shows a strong synergistic effect that cannot be ascribed to increased permeability of the mitochondrial membranes brought about by RH. The mechanism by which RH potentiates the effect of ADM on DHQ oxidation and cytochrome oxidase activity is most likely to be changes induced in the physical status of the inner mitochondrial membrane such as to permit low ADM concentrations to bind and segregate enough cardiolipin to inhibit electron transport through complex III and IV.

Animals↗

Study on the reference dose level in radiotherapy treatment planning.

PURPOSE: The reference dose level of the dose distribution in the tumor volume is studied. METHODS AND MATERIALS: The study is performed using a formula based on the Linear Quadratic (LQ) model. The calculated reference dose level to which the prescribed dose must be referred, for the eradication of a homogeneous tumor, is investigated by varying the dose distribution, that is, the dose volume histogram shape, its range, the prescribed total dose, the fraction size and the linear quadratic model parameters, alpha and beta. RESULTS: For all the simulated dose volume histograms the calculated reference dose level is lower than the mean dose level, depending on the range of dose variation and the considered tumor sensitivity. When the dose nonuniformity is not too great the reference dose level is very near to the mean dose level; when the inhomogeneity of dose distribution is high the reference level is clearly lower than the mean level but not necessarily equal to the minimum level in the tumor. For the dose volume histograms derived from the actual dose distributions obtained from a two tangential beams technique, a four beams technique and a moving beam technique, the reference levels are calculated and compared with the ICRU 29 reference point dose level. In two cases the reference levels are lower than the level at the ICRU 29 reference point. In the case of the four beams technique, the two levels are equal. CONCLUSION: These theoretical results show the possibility of administering the prescribed dose to a dose level higher than the minimum in the tumor, with the same value of Tumor Control Probability (TCP) as the one corresponding to a uniform tumor irradiation. The application of the proposed study can offer a general support to the choice of the reference dose level, based on the actual dose distribution in the tumor volume.

Humans↗

Magnetic resonance guided radiosurgery in children: tridimensional extrapolation from isodose neuroimaging superimposition.

In stereotactic radiosurgery, thin external beams of ionizing radiation concentrated in a single dose onto a sharply defined target are employed to treat lesions within the brain, avoiding doses which may produce unwanted damage to the surrounding healthy tissue. The dynamic irradiation technique used with the linear accelerator employs variable arcs of irradiation rotating around the isocenter of the target. The technique of stereotactic magnetic resonance (MR) guided radiosurgery is supported by a dedicated computerized system for treatment planning simulation. The system, based on a personal computer, allows the acquisition, reconstruction, and visualization of the target volume from MR images, and permits calculation and visualization of a three-dimensional dose distribution directly superimposed upon MR images of the lesion. The desired goal of destroying neoplastic tissue without damaging cerebral parenchyma is of particular importance in children. Consequently, adapting the three-dimensional isodose profiles to the morphology of the lesion to be treated is crucial. From this, the importance of the computer simulation is evident, as it permits one to go deeply into the study of isodose distribution, changing beam collimation, and the number and amplitude of arcs of irradiation.

Brain Neoplasms↗

A simple method to calculate the influence of dose inhomogeneity and fractionation in normal tissue complication probability evaluation.

PURPOSE: Since volumetric dose distributions are available with 3-dimensional radiotherapy treatment planning they can be used in statistical evaluation of response to radiation. This report presents a method to calculate the influence of dose inhomogeneity and fractionation in normal tissue complication probability evaluation. METHODS: The mathematical expression for the calculation of normal tissue complication probability has been derived combining the Lyman model with the histogram reduction method of Kutcher et al. [14] and using the normalized total dose (NTD) instead of the total dose. RESULTS: The fitting of published tolerance data, in case of homogeneous or partial brain irradiation, has been considered. For the same total or partial volume homogeneous irradiation of the brain, curves of normal tissue complication probability have been calculated with fraction size of 1.5 Gy and of 3 Gy instead of 2 Gy, to show the influence of fraction size. The influence of dose distribution inhomogeneity and alpha/beta value has also been simulated: considering alpha/beta = 1.6 Gy or alpha/beta = 4.1 Gy for kidney clinical nephritis, the calculated curves of normal tissue complication probability are shown. CONCLUSION: Combining NTD calculations and histogram reduction techniques, normal tissue complication probability can be estimated taking into account the most relevant contributing factors, including the volume effect.

Brain↗

Estimate of normal tissue damage in treatment planning for stereotactic radiotherapy.

A personal computer (PC) system was developed to perform treatment planning for radiosurgery and stereotactic radiotherapy. These techniques of irradiation of the brain may be accomplished with a linear accelerator by performing several non-coplanar arcs of a highly collimated beam focused at a fixed point. The PC system allows the acquisition, reconstruction and the visualization of the target volume from CT or MR images, and then it permits to calculate a three-dimensional (3-D) dose distribution due to small photon beams and to visualize it. The software calculates not only total dose distribution, administered fractionated or in single fraction, but also the NTD2 (normalized total dose) predicted to have a biological effect equivalent to the single irradiation. The choice of the best technique is supported by the dose volume histograms (DVH) calculation and by an estimate of complication probability to the brain normal tissue (NTCP). The algorithm for NTCP calculation is based on two models: the linear quadratic and the logistic. A comparison of three different dose calculations for a typical cerebral target volume is presented to demonstrate the system performances.

Algorithms↗