Treatment delivery with active beam scanning in proton radiation therapy introduces the problem of interplay effects when pencil beam motion occurs on a similar time scale as intra-fractional tumor motion. In situations where fractionation may not provide enough repetition to blur the effects of interplay, repeated delivery or 'repainting' of each field several times within a fraction has been suggested. The purpose of this work was to investigate the effectiveness of different repainting strategies in proton beam scanning. To assess the dosimetric impact of interplay effects, we performed a series of simulations considering the following parameters: tumor motion amplitude, breathing period, asymmetry in the motion trajectory for the target and time required to change the beam energy for the delivery system. Several repainting strategies were compared in terms of potential vulnerability to a dose delivery error. Breathing motion perpendicular to the beam direction (representing superior-inferior type tumor motion in patients) was considered and modeled as an asymmetric sine function with a peak-to-peak amplitude of between 10 and 30 mm. The results show that motion effects cause a narrowing of the high-dose profile and widening of the penumbra. The 90% isodose area was reduced significantly when considering a large motion amplitude of 3 cm. The broadening of the penumbra appears to depend only on the amplitude of tumor motion (assuming harmonic motion). The delivered dose exhibits a shift of 10-15% of the tumor amplitude (or 1-5 mm) in the caudal direction due to breathing asymmetry observed for both sin(4)(x) and sin(6)(x) motion. Of the five repainting techniques studied, so-called 'breath sampling' turned out to be most effective in reducing dose errors with a minimal increase in treatment time. In this method, each energy level is repainted at several evenly spaced times within one breathing period. To keep dose delivery errors below 5% while minimizing treatment time, it is recommended that breath sampling repainting be employed using 5-10 paintings per field for an assumed tumor volume of 8.5 x 8.5 x 10 cm(3). For smaller tumor volumes more repaintings will be required, while for larger volumes five repaintings should be sufficient to achieve the required dose accuracy.

We present an experimental study of a novel method to verify the range of proton therapy beams. Differential cross sections were measured for 15 prompt gamma-ray lines from proton-nuclear interactions with (12)C and (16)O at proton energies up to 150 MeV. These cross sections were used to model discrete prompt gamma-ray emissions along proton pencil-beams. By fitting detected prompt gamma-ray counts to these models, we simultaneously determined the beam range and the oxygen and carbon concentration of the irradiated matter. The performance of the method was assessed in two phantoms with different elemental concentrations, using a small scale prototype detector. Based on five pencil-beams with different ranges delivering 5 × 10(8) protons and without prior knowledge of the elemental composition at the measurement point, the absolute range was determined with a standard deviation of 1.0-1.4 mm. Relative range shifts at the same dose level were detected with a standard deviation of 0.3-0.5 mm. The determined oxygen and carbon concentrations also agreed well with the actual values. These results show that quantitative prompt gamma-ray measurements enable knowledge of nuclear reaction cross sections to be used for precise proton range verification in the presence of tissue with an unknown composition.

For decades, lipid droplets have been considered as the main cellular organelles involved in the fat storage, because of their lipid composition. However, in recent years, some new and totally unexpected roles have been discovered for them: (i) they are active sites for synthesis and storage of inflammatory mediators, and (ii) they are key players in cancer cells and tissues, especially in cancer stem cells. In this review, we summarize the main concepts related to the lipid droplet structure and function and their involvement in inflammatory and cancer processes.

Dual energy computed tomography (DECT) can provide simultaneous estimation of relative electron density ρe and effective atomic number Zeff. The ability to obtain these quantities (ρe, Zeff) has been shown to benefit selected radiotherapy applications where tissue characterization is required. The conventional analysis method (spectral method) relies on knowledge of the CT scanner photon spectra which may be difficult to obtain accurately. Furthermore an approximate empirical attenuation correction of the photon spectrum through the patient is necessary. We present an alternative approach based on a parameterization of the measured ratio of low and high kVp linear attenuation coefficients for deriving Zeff which does not require the estimation of the CT scanner spectra. In a first approach, the tissue substitute method (TSM), the Rutherford parameterization of the linear attenuation coefficients was employed to derive a relation between Zeff and the ratio of the linear attenuation coefficients measured at the low and high kVp of the CT scanner. A phantom containing 16 tissue mimicking inserts was scanned with a dual source DECT scanner at 80 and 140 kVp. The data from the 16 inserts phantom was used to obtain model parameters for the relation between Zeff and [Formula: see text]. The accuracy of the method was evaluated with a second phantom containing 4 tissue mimicking inserts. The TSM was compared to a more complex approach, the reference tissue method (RTM), which requires the derivation of stoichiometric fit parameters. These were derived from the 16 inserts phantom scans and used to calculate CT numbers at 80 and 140 kVp for a set of tabulated reference human tissues. Model parameters for the parameterization of [Formula: see text] were estimated for this reference tissue dataset and compared to the results of the TSM. Residuals on Zeff for the reference tissue dataset for both TSM and RTM were compared to those obtained from the spectral method. The tissue substitutes were well fitted by the TSM with R(2) = 0.9930. Residuals on Zeff for the phantoms were similar between the TSM and spectral methods for Zeff < 8 while they were improved by the TSM for higher Zeff. The RTM fitted the reference tissue dataset well with R(2) = 0.9999. Comparing the Zeff extracted from TSM and the more complex RTM to the known values from the reference tissue dataset yielded errors of up to 0.3 and 0.15 units of Zeff respectively. The parameterization approach yielded standard deviations which were up to 0.3 units of Zeff higher than those observed with the spectral method for Zeff around 7.5. Procedures for the DECT estimation of Zeff removing the need for estimates of the CT scanner spectra have been presented. Both the TSM and the more complex RTM performed better than the spectral method. The RTM yielded the best results for the reference human tissue dataset reducing errors from up to 0.3 to 0.15 units of Zeff compared to the simpler TSM. Both TSM and RTM are simpler to implement than the spectral method which requires est...