We present a high-speed photon counter for use with two-photon microscopy. Counting pulses of photocurrent, as opposed to analog integration, maximizes the signal-to-noise ratio so long as the uncertainty in the count does not exceed the gain-noise of the photodetector. Our system extends this improvement through an estimate of the count that corrects for the censored period after detection of an emission event. The same system can be rapidly reconfigured in software for fluorescence lifetime imaging, which we illustrate by distinguishing between two spectrally similar fluorophores in an in vivo model of microstroke.

The objective was to compare intensity‐modulated radiation therapy (IMRT) with 3D conformal proton therapy (3DCPT) in the treatment of cervical cancer. In particular, each technique's ability to spare pelvic bone marrow (PBM) was of primary interest in this study. A total of six cervical cancer patients (3 postoperative and 3 intact) were planned and analyzed. All plans had uniform 1.0 cm CTV‐PTV margin and satisfied the 95% PTV with 100% isodose (prescription dose=450.2emGy) coverage. Dose‐volume histograms (DVH) were analyzed for comparison. The overall PTV and PBM volumes were 1035.9±192.2 cc and 1151.4±198.3 cc, respectively. In terms of PTV dose conformity index (DCI) and dose homogeneity index (DHI), 3DCPT was slightly superior to IMRT with 1.00±0.001,0.2em1.01±0.02, and 1.10±0.02,0.2em1.13±0.01, respectively. In addition, 3DCPT demonstrated superiority in reducing lower doses (i.e., V30 or less) to PBM, small bowel and bladder. Particularly in PBM, average V10 and V20 reductions of 10.8% and 7.4%false(p=0.001 and 0.04), respectively, were observed. However, in the higher dose range, IMRT provided better sparing (>0.2emnormalV30). For example, in small bowel and PBM, average reductions in V45 of 4.9% and 10.0%false(p=0.048 and 0.008), respectively, were observed. Due to its physical characteristics such as low entrance dose, spread‐out Bragg peak and finite particle range of protons, 3DCPT illustrated superior target coverage uniformity and sparing of the lower doses in PBM and other organs. Further studies are, however, needed to fully exploit the benefits of protons for general use in cervical cancer.PACS number: 87.55.D‐, 87.55.dk

This work compares two accelerated partial breast irradiation modalities, MammoSite brachytherapy and three‐dimensional conformal radiotherapy (3D‐CRT), to a new method, strut‐adjusted volume implant (SAVI) brachytherapy, following NSABP B‐39 guidelines. A total of 21 patients treated at UC San Diego with the SAVI device were evaluated in this comparison. Nine of the 21 patients were eligible for all three modalities and were dosimetrically compared evaluating V90, V150, V200, total target volume, maximum skin, lung, and chestwall/rib dose. The target volumes (PTV_EVAL) differed with SAVI, having the least total volume at 59.9 cc vs. 71.5 cc and 351.6 cc for MammoSite and 3D‐CRT, respectively. The median V90, V150 and V200 for the three modalities were 97.7%, 25.0 cc, 10.4 cc (SAVI) vs. 97.6%, 23.9 cc, 5.0 cc (MammoSite) vs. 100% (V90 3D‐CRT). The maximum dose for SAVI, MammoSite, and 3D‐CRT, respectively, relative to the prescribed dose, for the lung: 80.0%, 150.0%, and 104.9%; for rib: 108.8%, 225.0%, and 114.7%; for skin: 75.0%, 135.0%, and 108.6%. Comparing modalities, PTV coverage varied between 97.6%–100.0% with more breast tissue covered by 3D‐CRT, as expected, given the differences between external beam and brachytherapy. The maximum lung, skin and rib doses were lowest for the SAVI, highlighting its ability to conform to exclude normal tissues. In offering partial breast radiation, the availability of a variety of techniques allows for maximal patient eligibility, and comparison of individual method pros and cons may guide the most appropriate choice for each patient.PACS number: 87.53.Jw; 87.53.Kn; 87.55.D

Diffusely scattered calcifications visible with mammography are almost always benign. Certain patterns, however, should arouse concern. For example, extensive comedocarcinoma is associated with large areas of mammographically visible calcium deposition. The authors identified 10 women in whom calcifications were visible throughout large volumes of breast tissue at mammography. The calcifications did not resemble those typical of extensive comedocarcinoma, yet they were associated with extensive breast cancer. Their mammographic pattern was characterized by a strikingly wild, chaotic appearance with profuse deposition of calcium. As in many cancers, the particles were heterogeneous, but unlike in most carcinomas, many deposits had a typically benign morphology. Histologic examination showed that even these typically benign calcifications were associated with malignant cells. The authors believe that the apocrine features displayed by many of the cancer cells in these 10 patients may explain the unusual profusion of calcium deposits.

Of 335 women who underwent lumpectomy and radiation therapy for breast cancer, 42 subsequently developed calcifications. Particles typical of calcified suture material were identified in 21 of the 42 women (50%). No obvious calcified suture material was found in approximately 1,140 women of 38,000 (3%) who had undergone mammography after they had previously undergone breast biopsy for a benign lesion and thus had not undergone radiation therapy. Calcified suture material rarely develops in the nonirradiated breast, but it is common after radiation therapy and should not be confused with recurrent breast cancer. These calcifications are likely the result of delayed resorption of catgut sutures, which provide a matrix on which calcium can precipitate in a suitable local environment.