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Biomedical subjects

R Sloboda

Publications and source records attributed to R Sloboda.

11 recordsLinked to original sources

Metastatic adenocarcinoma of the cervix in a delivery-induced traumatic lower vaginal tear.

BACKGROUND: Noncontiguous vaginal metastasis is rare in cervical cancer and is usually reported in the context of traumatic implantation. Traumatic vaginal implantation of cervical carcinoma has been documented in episiotomy, port site, or incision scars. CASE: We report the only case in the literature with vaginal metastasis associated with traumatic vaginal tear presenting with concomitant metastasis and the second case in the literature with a concomitant vaginal metastasis. Treatment consisted of organ-sparing chemoradiotherapy. Although the previous literature suggests that nonsurgical management of traumatic implantation metastases is associated with survivals of less than 1 year, there is no confirmed recurrent disease after 1 year of follow-up in our reported case. CONCLUSION: The feasibility and initial favorable outcome with chemoradiation is demonstrated in this rare presentation.

Adenocarcinoma↗

Comprehensive Monte Carlo calculation of the point spread function for a commercial a-Si EPID.

Images produced by commercial amorphous silicon electronic portal imaging devices (a-Si EPIDs) are subject to multiple blurring processes. Implementation of these devices for fluence measurement requires that the blur be removed from the images. A standard deconvolution operation can be performed to accomplish this assuming the blur kernel is spatially invariant and accurately known. This study determines a comprehensive blur kernel for the Varian aS500 EPID. Monte Carlo techniques are used to derive a dose kernel and an optical kernel, which are then combined to yield an overall blur kernel for both 6 and 15 MV photon beams. Experimental measurement of the line spread function (LSF) is used to verify kernel shape. Kernel performance is gauged by comparing EPID image profiles with in-air dose profiles measured using a diamond detector (approximating fluence) both before and after the EPID images have been deconvolved. Quantitative comparisons are performed using the chi metric, an extension of the well-known y metric, using acceptance criteria of 0.0784 cm (1 pixel width) distance-to-agreement (deltad) and 2% of the relative central axis fluence (deltaD). Without incorporating any free parameters, acceptance was increased from 49.0% of pixels in a cross-plane profile for a 6 MV 10 x 10 cm2 open field to 92.0%. For a 10 x 10 cm2 physically wedged field, acceptance increased from 40.3% to 73.9%. The effect of the optical kernel was found to be negligible for these chi acceptance parameters, however for (deltaD= 1%, deltad = 0.0784 cm) we observed an improvement from 66.1% (without) to 78.6% (with) of chi scores <1 (from 20.6% before deconvolution). It is demonstrated that an empirical kernel having a triple exponential form or a semiempirical kernel based on a simplified model of the detector stack can match the performance of the comprehensive kernel.

Calibration↗

Consequences of the spectral response of an a-Si EPID and implications for dosimetric calibration.

One of the attractive features of amorphous silicon electronic portal imaging devices (a-Si EPIDs) as dosimetric tools is that for open fields they are known to exhibit a generally linear relation between pixel value and incident energy fluence as measured by an ion chamber. It has also been established that a-Si EPIDs incorporating high atomic number phosphors such as Gd2O2S:Tb exhibit a disproportionately large response to low-energy (<1 MeV) photons. The present work examines the consequences of this hypersensitivity in a commercially available EPID, the Varian aS500, with respect to energy fluence calibration in a 6 MV radiotherapy beam. EPIDs may be deployed in situations where the spectrum of the incident beam is modified by passing through a compensator or through a patient or phantom. By examining the specific case of a beam hardened by passage through compensator material, we show that the discrepancy between open and attenuated beam calibration curves can be as high as 8%. A Monte Carlo study using a comprehensive model of the aS500 shows that this difference can be explained by spectral changes, and further suggests that it can be reduced by the addition of an external copper plate. We consider configurations with the plate placed directly on top of the EPID cassette and 15 cm above the cassette, supported by Styrofoam. In order to reduce the maximum discrepancy to <4%, it was found that a copper thickness of approximately 0.7 cm was required in the elevated configuration. Improvement was minimal with the copper in the contact configuration. Adding 0.7 cm of copper in the elevated configuration reduced the contrast-to-noise ratio by 19% and the modulation transfer for a given spatial frequency by 30%.

Algorithms↗

Measurement of relative output for 90Sr ophthalmic applicators using radiochromic film.

The treatment of various superficial lesions of the eye has, for many years, been conducted using strontium 90 (90Sr) ophthalmic applicators that have a steep dose gradient near their surface. A new applicator acquired by a treatment facility must have its output compared with that of any older applicators already in use to ensure consistent treatments. These measurements may be done using available dosimeters such as film and thermoluminescent detectors. Our work made use of radiochromic film and a document scanner to perform relative output measurements for 4 different 90Sr ophthalmic applicators acquired from the same manufacturer (Amersham Healthcare, Arlington Heights, IL) over a span of 28 years. Relative outputs were found to vary by < 10% with respect to the manufacturer's values, which is well within the uncertainty limit for absolute output of 20% specified by the manufacturer. The film measurements were verified using thermoluminescent dosimeters. Radiochromic film was also used to obtain a percentage depth dose curve and a 2 dimensional isodose distribution in a plane perpendicular to the active surface for the newest applicator (SIA 20).

Eye Diseases↗

Fluorescent taxoids.

BACKGROUND: Taxol is a natural product produced by the Pacific Yew, Taxus brevifolia, that has emerged as a prominent chemotherapeutic agent for the treatment of solid tumors. Taxol's biochemical mode of action has been well studied: it binds to microtubules, stabilizing them and preventing their depolymerization to tubulin subunits. At lower dosage levels, taxol also interferes with the normal dynamics of the tubulin-microtubule equilibrium. This biochemical effect causes taxol's ultimate physiological effect, cell cycle arrest; taxol is thought to block anaphase A of mitosis. Taxol also causes a number of intriguing secondary effects on interphase cells that are poorly understood. We believed that a bio-active fluorescent taxol derivative could be a useful tool in the study of these cellular mechanisms, especially in interphase cells. RESULTS: We have synthesized and characterized a series of stable, fluorescently labeled derivatives of taxol that bind to microtubules and have cytotoxicities similar to that of taxol. Fluorescence microscopy experiments in interphase human foreskin fibroblast (HFF) cells indicate that one of these, a sulforhodamine taxoid, is particularly well suited for optical microscopy. The use of this taxoid in HFF cells revealed a previously undetected localization of taxoids to the nucleolus during interphase. CONCLUSIONS: The production of a new fluorescent derivative of taxol provides a useful tool, enabling cellular biologists to study taxol's mechanism of action. It is hoped that this material will prove particularly useful for the study of taxol's effects upon interphase cells. Although in common usage for the last 20 years, Taxol is now a registered trademark of Bristol-Myers Squibb. The copyright of Bristol-Myers Squibb is recognized when Taxol or taxol is used in this article.

Antineoplastic Agents↗

Analytical representation of head scatter factors for shaped photon beams using a two-component x-ray source model.

An analytic representation proposed for the relative intensity distribution of the extra-focal source in a two-component x-ray source model serves as the basis for calculation. From this representation, a closed-form expression for head scatter factors defined on the central beam axis is derived by integrating over the area of the extra-focal source plane visible from the measurement point. The resulting expression is applicable to photon beams from different Varian accelerators and different photon energies, and includes effects arising from beam shaping with cerrobend blocks or multileaf collimators (MLCs). For 6- and 15-MV photon beams from Varian 600C and 2300CD accelerators (Varian Oncology Systems, Palo Alto, CA), 361 measured head scatter factors for square, rectangular, asymmetric, and arbitrarily shaped fields, formed by either the X and Y jaws, the MLC and Y jaws, or by the MLC alone, were compared with model calculations. Results show that 93.4% of calculated values match corresponding experimental points to within 0.5%, the average deviation being 0.23% and the maximum deviation 0.9%. Thus, as a consequence of this work, the different influence of the X jaws, the Y jaws, and the MLC on head scatter factors is quantitatively described. In particular, it is demonstrated that in the case of radially symmetric scattering, the collimator exchange effect arises as a result of the different distances of the X and Y jaws from the focal spot.

Biophysical Phenomena↗

Analytical representation of head scatter factors for shaped photon beams using a two-component x-ray source model.

An analytic representation proposed for the relative intensity distribution of the extra-focal source in a two-component x-ray source model serves as the basis for calculation. From this representation, a closed-form expression for head scatter factors defined on the central beam axis is derived by integrating over the area of the extra-focal source plane visible from the measurement point. The resulting expression is applicable to photon beams from different Varian accelerators and different photon energies, and includes effects arising from beam shaping with cerrobend blocks or multileaf collimators (MLCs). For 6- and 15-MV photon beams from Varian 600 C and 2300 CD accelerators (Varian Oncology Systems, Palo Alto, CA), 361 measured head scatter factors for square, rectangular, asymmetric, and arbitrarily shaped fields, formed by either the X and Y jaws, the MLC and Y jaws, or by the MLC alone, were compared with model calculations. Results show that 93.4% of calculated values match corresponding experimental points to within 0.5%, the average deviation being 0.23% and the maximum deviation 0.9%. Thus, as a consequence of this work, the different influence of the X jaws, the Y jaws, and the MLC on head scatter factors is quantitatively described. In particular, it is demonstrated that in the case of radially symmetric scattering, the collimator exchange effect arises as a result of the different distances of the X and Y jaws from the focal spot.

Biophysical Phenomena↗

Parametrization of head-scatter factors for rectangular photon fields using an equivalent square formalism.

Head-scatter factors of symmetric square and rectangular fields (field center on the central beam axis) defined by the upper (Y) and lower (X) jaws for 6 and 15 MV photon beams from 2300CD and 600C accelerators (Varian Associates, Inc., Palo Alto, CA) were measured, as well as those for fields shaped by the Y jaws and the multileaf collimator (MLC) of the 2300CD. For rectangular fields, the head-scatter factor for the field (x = a and y = b) was different from that for the field (y = a and x = b). This difference was 2% -3% for fields defined by conventional collimators when [formula, see text] was large, and became 4%-5% when the MLC and YT jaws were used to shape the fields with the X jaws retracted. In order to calculate values for head-scatter factors of rectangular fields accurately using an equivalent square formalism, the side of the equivalent square should be obtained with different weights for lower and upper jaws, as proposed by Vadash and Bjärngard [Med. Phys. 20, 733-734 (1993)]. Our measurements demonstrate that the relative weight (G) of upper and lower jaws is strongly dependent on their distances from the x-ray source, while the beam energy has little effect on the value of G. We further show that G can be calculated simply from these distances. An analytical representation for head-scatter factors of square and rectangular fields is also developed in this paper. The quality of this representation was judged by the root-mean-square (rms) deviation from measured head-scatter factors, which ranged from 0.11%-0.27%.

Head↗

A spin-spin relaxation rate investigation of the gelatin ferrous sulphate NMR dosimeter.

Spin-spin NMR relaxation rate in the ferrous sulphate gelatin dosimeter has been studied in terms of pH, gelatin concentration, the addition of benzoic acid, and sample size. It is demonstrated that R2 is more sensitive to changes in Fe3+ ion concentration than R1 when measuring at frequencies of 64 and 100 MHz. pH has an important effect on dose response curves, and oxygen depletion occurs significantly more rapidly in FeSO4 gelatin than in the liquid FeSO4, resulting in a saturation dose of approximately 80 Gy at depths greater than approximately 3 mm in phantom. The concentration of gelatin can be increased to 12% by weight, and the dosimeter will continue to exhibit a linear dose response. Sensitivity is maintained at higher gel concentrations by pH compensation. Addition of low-concentration benzoic acid to the system does not alter the dose response of the gelatin FeSO4 system. Finally, spontaneous oxidation of Fe2+ ions does not significantly alter the shape of dose response curves but does result in increases in R2 by up to 4% per day.

Algorithms↗