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Sample records for bsh-based intra-operative bnct

  1. Clinical results of boron neutron capture therapy (BNCT) for glioblastoma

    International Nuclear Information System (INIS)

    Kageji, T.; Mizobuchi, Y.; Nagahiro, S.; Nakagawa, Y.; Kumada, H.

    2011-01-01

    The purpose of this study was to evaluate the clinical outcome of BSH-based intra-operative BNCT (IO-BNCT) and BSH and BPA-based non-operative BNCT (NO-BNCT). We have treated 23 glioblastoma patients with BNCT without any additional chemotherapy since 1998. The median survival time (MST) of BNCT was 19.5 months, and 2-year, 3-year and 5-year survival rates were 26.1%, 17.4% and 5.8%, respectively. This clinical result of BNCT in patients with GBM is superior to that of single treatment of conventional radiotherapy compared with historical data of conventional treatment. - Highlights: ► In this study, we evaluate the clinical outcome of boron neutron capture therapy (BNCT) for malignant brain tumors. ► We have treated 23 glioblastoma (GBM) patients with BNCT without any additional chemotherapy. ► Clinical results of BNCT in patients with GBM are superior to that of single treatment of conventional radiotherapy compared with historical data of conventional treatment.

  2. Clinical results of BNCT for malignant brain tumors in children

    International Nuclear Information System (INIS)

    Nakagawa, Yoshinobu; Kageji, Teruyoshi; Mizobuchi, Yoshifumi; Kumada, Hiroaki; Nakagawa, Yoshiaki

    2009-01-01

    It is very difficult to treat the patients with malignant brain tumor in children, especially under 3 years, because the conventional irradiation cannot be applied due to the damage of normal brain tissue. However, boron neutron capture therapy (BNCT) has tumor selectivity such that it can make damage only in tumor cells. We evaluated the clinical results and courses in patients with malignant glioma under 15 years. Among 183 patients with brain tumors treated by our group using BSH-based intra-operative BNCT, 23 patients were under 15 years. They included 4 patients under 3 years. There were 3 glioblastomas (GBM), 6 anaplastic astrocytomas(AAS), 7 primitive neuroectodermal tumors (PNET), 6 pontine gliomas and 1 anaplastic ependymoma. All GBM and PNET patients died due to CSF and/or CNS dissemination without local tumor regrowth. All pontine glioma patients died due to regrowth of the tumor. Four of 6 anaplastic astrocytoma and 1 anaplastic ependymoma patients alive without tumor recurrence. BNCT can be applied to malignant brain tumors in children, especially under 3 years instead of conventional radiation. Although it can achieve the local control in the primary site, it cannot prevent CSF dissemination in patients with glioblastoma.

  3. Intra-operative radiation treatment of cancers

    International Nuclear Information System (INIS)

    Dubois, J.B.; Joyeux, H.; Solassol, C.; Pujol, H.

    1986-01-01

    Intra-operative radiation treatment (I.O.R.T.) is concerning the treatment either of an unresectable tumor or of tumor bed after complete excision of a primary tumor and its first draining lymph nodes. We describe X-ray and electrons techniques and we discuss the delivered doses according to experimental and clinical data. According to the residual disease (macroscopic or microscopic), to the healthy tissues in the target volume, and the histological type, single doses from 20 Gy to 40 Gy can be delivered. Our preliminary results are reported: 25 patients with resectable tumors of the cardia, the stomach and the pancreas, 5 patients with pelvic recurrences of colon and rectum carcinomas. Therapeutic results of the I.O.R.T. providing from the literature are discussed. The I.O.R.T. indications are defined as palliative (unresectable tumors) and curative (irradiation of tumor bed after complete excision of the tumor) [fr

  4. Intra-operative complications in sagittal and vertical ramus osteotomies

    NARCIS (Netherlands)

    van Merkesteyn, J. P.; Groot, R. H.; van Leeuwaarden, R.; Kroon, F. H.

    1987-01-01

    In orthognatic surgery of the mandibular ramus, intra-operative complications as a lesion of the inferior alveolar nerve, fractures of the osteotomised segments, incomplete sectioning, malpositioning of segments and haemorrhage may occur. In this report, intra-operative complications in 124 sagittal

  5. Perception of Nigerian anaesthetists on intra-operative death ...

    African Journals Online (AJOL)

    Perception of Nigerian anaesthetists on intra-operative death. SOA Olateju, AT Adenekan, BB Osinaike, OM Fatungase, ON Akanmu, AA Adebayo. Abstract. Background: Intra-operative death is an unusual devastating occurrence in anaesthetic practice, and it is of serious concern when it happens. Objectives: To assess the ...

  6. Accelerator-based BNCT.

    Science.gov (United States)

    Kreiner, A J; Baldo, M; Bergueiro, J R; Cartelli, D; Castell, W; Thatar Vento, V; Gomez Asoia, J; Mercuri, D; Padulo, J; Suarez Sandin, J C; Erhardt, J; Kesque, J M; Valda, A A; Debray, M E; Somacal, H R; Igarzabal, M; Minsky, D M; Herrera, M S; Capoulat, M E; Gonzalez, S J; del Grosso, M F; Gagetti, L; Suarez Anzorena, M; Gun, M; Carranza, O

    2014-06-01

    The activity in accelerator development for accelerator-based BNCT (AB-BNCT) both worldwide and in Argentina is described. Projects in Russia, UK, Italy, Japan, Israel, and Argentina to develop AB-BNCT around different types of accelerators are briefly presented. In particular, the present status and recent progress of the Argentine project will be reviewed. The topics will cover: intense ion sources, accelerator tubes, transport of intense beams, beam diagnostics, the (9)Be(d,n) reaction as a possible neutron source, Beam Shaping Assemblies (BSA), a treatment room, and treatment planning in realistic cases. © 2013 Elsevier Ltd. All rights reserved.

  7. Capturing intra-operative safety information using surgical wikis.

    Science.gov (United States)

    Edwards, Michael; Agha, Riaz; Coughlan, Jane

    2013-03-01

    Expert surgeons use a mass of intra-operative information, as well as pre- and post-operative information to complete operations safely. Trainees acquired this intra-operative knowledge at the operating table, now largely diminished by the working time directive. Wikis offer unexplored approaches to capturing and disseminating expert knowledge to further promote safer surgery for the trainee. Grafting an abdominal aortic aneurysm represents a potentially high-risk operation demanding extreme safety measures. Operative details, presented on a surgical wiki in the form of a script and content analysed to classify types of safety information. The intra-operative part of the script contained 2,743 items of essential surgical information, comprising 21 sections, 405 steps and 2,317 items of back-up information; 155 (5.7%) of them were also specific intra-operative safety checks. Best case scenarios consisted of 1,077 items of intra-operative information, 69 of which were safety checks. Worse case and rare scenarios required a further 1,666 items of information, including 86 safety checks. Wikis are relevant to surgical practice specifically as a platform for knowledge sharing and optimising the available operating time of trainees, as a very large amount of minutely detailed information essential for a safe major operation can be captured.

  8. Intra-operative cholangiography for the diagnosis of choledocholithiasis

    International Nuclear Information System (INIS)

    Raab, M.; Schroeder, A.

    1987-01-01

    521 patients with benign disorders of the extrahepatic bile duct system were examined retrospectively. Bile duct stones suspected by pre-operative intravenous cholangiography could be verified by surgery in but 41,6% of the cases. Routine intra-operative cholangiography was not performed in those cases with pre-operative indication of choledocus revision and with rare failure of cystic duct cannulation. Evaluation of 448 intra-operative cholangiographies revealed the diagnosis of choledocholithiasis to be false positive in 3,3% and false negative in 1,1%. Intra-operative X-ray examination allowed to diagnose 45 cases of choledocholithiasis subsequently verified by surgery. Most of these patients exhibited clinical signs (transient jaundice, changes in blood chemistry). Follow-up identified two patients whose bile duct stones had been overlooked. (orig.) [de

  9. Intra-operative cholangiography for the diagnosis of choledocholithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Raab, M.; Schroeder, A.

    1987-01-01

    521 patients with benign disorders of the extrahepatic bile duct system were examined retrospectively. Bile duct stones suspected by pre-operative intravenous cholangiography could be verified by surgery in but 41,6% of the cases. Routine intra-operative cholangiography was not performed in those cases with pre-operative indication of choledocus revision and with rare failure of cystic duct cannulation. Evaluation of 448 intra-operative cholangiographies revealed the diagnosis of choledocholithiasis to be false positive in 3,3% and false negative in 1,1%. Intra-operative X-ray examination allowed to diagnose 45 cases of choledocholithiasis subsequently verified by surgery. Most of these patients exhibited clinical signs (transient jaundice, changes in blood chemistry). Follow-up identified two patients whose bile duct stones had been overlooked.

  10. Appropriateness of Intra-Operative Blood Transfusion In Children at ...

    African Journals Online (AJOL)

    Background: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. Objectives :We sought therefore to determine the ...

  11. Unexpected intra-operative diagnosis of a large cystic ...

    African Journals Online (AJOL)

    draining directly into the inferior vena cava. The patient became. Unexpected intra-operative diagnosis of a large cystic phaeochromocytoma and secondary nifedipine pharmacobezoar. D N Ginther, MD, BSc. Division of General Surgery, Royal University Hospital, Saskatoon, SK, Canada. S Kriegler, MD, MB ChB, MMed, ...

  12. Comparative Study Of Intra-Operative Pelvimetry With Calipers And ...

    African Journals Online (AJOL)

    The pelvic measurement of patients who have had a caesarean section was done using Pelvic Calipers (intra-operative) and x-ray methods. In the former method, during Caesarean sections and after closure of the lower uterine segment incision, a pair of pelvic calipers was used to measure the true conjugate of the pelvis.

  13. perception of nigerian anaesthetists on intra-operative death

    African Journals Online (AJOL)

    2012-10-01

    Oct 1, 2012 ... East African Medical Journal Vol. 89 No. 10 October 2012. PERCEPTION OF NIGERIAN ANAESTHETISTS ON INTRA-OPERATIVE DEATH. S. O. A. Olateju, MBChB, DA, MPH, FMCA, FICS, Consultant Anaesthetist/Lecturer, A. T. Adenekan, MBBS, DA,. FWACS, Consultant Anaesthetist/Lecturer, ...

  14. Intra-operative parathyroid hormone measurements – experience of ...

    African Journals Online (AJOL)

    Background. Surgery is the treatment of choice for symptomatic primary hyperparathyroidism. The majority of research concerning intra-operative parathyroid hormone (ioPTH) measurements is conducted in university hospitals. Whether ioPTH measurements are feasible and useful in predicting the presence of remaining ...

  15. INEL BNCT Program

    International Nuclear Information System (INIS)

    Ackermann, A.L.; Dorn, R.V. III.

    1991-03-01

    This Bulletin presents a summary of accomplishments and highlights in the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program for March 1991. This bulletin includes information on the brain tumor and melanoma research programs, Power Burst Facility (PBF) technical support and modifications, PBF operations, a milestone summary, and animal data charts

  16. INEL BNCT Program

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, A.L. (ed.)

    1991-08-01

    This Bulletin presents a summary of accomplishments and highlights in the Idaho National Engineering Laboratory's (INEL) Boron Neutron Capture Therapy (BNCT) Program for August 1991. This bulletin includes information on the brain tumor and melanoma research programs, Power Burst Facility (PBF) technical support and modifications, PBF operations, and updates to the animal data charts.

  17. Pediatric awake craniotomy and intra-operative stimulation mapping.

    Science.gov (United States)

    Balogun, James A; Khan, Osaama H; Taylor, Michael; Dirks, Peter; Der, Tara; Carter Snead Iii, O; Weiss, Shelly; Ochi, Ayako; Drake, James; Rutka, James T

    2014-11-01

    The indications for operating on lesions in or near areas of cortical eloquence balance the benefit of resection with the risk of permanent neurological deficit. In adults, awake craniotomy has become a versatile tool in tumor, epilepsy and functional neurosurgery, permitting intra-operative stimulation mapping particularly for language, sensory and motor cortical pathways. This allows for maximal tumor resection with considerable reduction in the risk of post-operative speech and motor deficits. We report our experience of awake craniotomy and cortical stimulation for epilepsy and supratentorial tumors located in and around eloquent areas in a pediatric population (n=10, five females). The presenting symptom was mainly seizures and all children had normal neurological examinations. Neuroimaging showed lesions in the left opercular (n=4) and precentral or peri-sylvian regions (n=6). Three right-sided and seven left-sided awake craniotomies were performed. Two patients had a history of prior craniotomy. All patients had intra-operative mapping for either speech or motor or both using cortical stimulation. The surgical goal for tumor patients was gross total resection, while for all epilepsy procedures, focal cortical resections were completed without any difficulty. None of the patients had permanent post-operative neurologic deficits. The patient with an epileptic focus over the speech area in the left frontal lobe had a mild word finding difficulty post-operatively but this improved progressively. Follow-up ranged from 6 to 27 months. Pediatric awake craniotomy with intra-operative mapping is a precise, safe and reliable method allowing for resection of lesions in eloquent areas. Further validations on larger number of patients will be needed to verify the utility of this technique in the pediatric population. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Tissue-engineered heart valves: intra-operative protocol.

    Science.gov (United States)

    Gallo, Michele; Bianco, Roberto; Bottio, Tomaso; Naso, Filippo; Franci, Paolo; Zanella, Fabio; Perona, Giovanni; Busetto, Roberto; Spina, Michele; Gandaglia, Alessandro; Gerosa, Gino

    2013-08-01

    Tissue engineering of heart valves investigates the possibility to create a fully compatible and biomimetic graft able to provide host cell repopulation like the native living valve. Decellularized aortic and pulmonary valves and synthetic polymers have been used to promote the creation of a native-like scaffold suitable to be colonized by cells either in vitro, in dynamic bioreactors or in vivo using different animal models. The herein presented research provides the intra-operative protocol and details of surgical technique. Porcine aortic valve conduits were decellularized and implanted in the right ventricular outflow tract of Vietnamese pigs.

  19. Tandem electrostatic accelerators for BNCT

    International Nuclear Information System (INIS)

    Ma, J.C.

    1994-01-01

    The development of boron neutron capture therapy (BNCT) into a viable therapeutic modality will depend, in part, on the availability of suitable neutron sources compatible with installation in a hospital environment. Low-energy accelerator-based intense neutron sources, using electrostatic or radio frequency quadrupole proton accelerators have been suggested for this purpose and are underdevelopment at several laboratories. New advances in tandem electrostatic accelerator technology now allow acceleration of the multi-milliampere proton beams required to produce therapeutic neutron fluxes for BNCT. The relatively compact size, low weight and high power efficiency of these machines make them particularly attractive for installation in a clinical or research facility. The authors will describe the limitations on ion beam current and available neutron flux from tandem accelerators relative to the requirements for BNCT research and therapy. Preliminary designs and shielding requirements for a tandern accelerator-based BNCT research facility will also be presented

  20. Intra-operative radiation therapy in cancer of the pancreas

    International Nuclear Information System (INIS)

    Dubois, J.B.; Gu, S.D.; Saint-Aubert, B.; Joyeux, H.; Solassol, C.; Pujol, H.

    1991-01-01

    We report our experience concerning 22 pancreatic carcinoma bearing patients treated with intra-operative radiation therapy (IORT) after complete surgical excision: duodenopancreatectomy: 15 patients; isthmic and caudal pancreatectomy: 2 patients; total pancreatectomy: 5 patients. The dose delivered to the tumor bed was 20 Gy in 12 patients, 18 Gy in 3 patients and 15 Gy in 7 patients. Three patients died within the 1st month post-surgery from intercurrent diseases. Post-operative morbidity was not significantly modified by IORT as compared to purely surgical treated patients. Out of 19 evaluable patients, we observed local control in 16 patients (79.4%). Causes of death (15/19 patients) were: distant metastases with local control: 7 patients; in situ local failure: 3 patients; regional recurrence outside of the IORT fields: 2 patients; intercurrent diseases: 3 patients. Four patients are still alive without evolutive disease. The median overall survival is 6 months. The mean overall survival is 10.56 months. Excluding patients who died from complications and intercurrent diseases, the median survival is 10 mths and the mean survival 14.5 mths. These results emphasize the improvement in local control with IORT, but without significant improvement in survival which is dependent on local evolution and also systemic disease [fr

  1. Intra-operative blood transfusion among adult surgical patients in a ...

    African Journals Online (AJOL)

    This retrospective study was designed to audit the pattern of intra-operative whole blood transfusion among adult surgical patients over a two-year period. Data were collected on the rate of intra-operative transfusion, estimated blood loss, units of donor blood transfused, pattern of use of autologous blood and circumstances ...

  2. Intra-operative removal of chest tube in video-assisted thoracoscopic procedures

    Directory of Open Access Journals (Sweden)

    Moustafa M. El-Badry

    2017-12-01

    Conclusions: Intra-operative removal of chest tube during VATS procedures was a safe technique in well selected patients with an intra-operative successful air-leak test with radiological and clinical follow-up. This technique provided lesser post-operative pain with shorter hospital stay.

  3. BNCT of canine osteosarcoma

    International Nuclear Information System (INIS)

    Mitin, V.N.; Kulakov, V.N.; Khokhlov, V.F.

    2006-01-01

    A dog was diagnosed with osteosarcoma (8x6x5cm) in the right wing of ilium by radiography, radionuclide scintigraphy and histological study of biopsy material. The treatment plan was as follows: γ-therapy in combination with chemotherapy; prevention of hematogenous pulmonary metastases by the transfusion of 130 ml of allogenic marrow from a healthy donor; administration of 11.4g 10 B-boronphenylalanine into the right iliac artery; resection of the right iliac wing with the osteosarcoma lesion; neutron irradiation (MEPhI Reactor) of the bone fragment (dose on healthy osteocytes - 15±4 Gy (W), on tumor - 50±9 Gy (W); reimplantation and fixation of the fragment; three courses of adjuvant chemotherapy. The doses were determined in full-scale calculations of the reactor radiation fields with a model of the bone under the code RADUGA. The 10 B concentration (μg/g) in the bone was: normal tissue - 9±3, tumor - 28±5. In 24 hours post operation the dog was able to walk using the treated limb, and 6 months later it moved freely. The patient has been under observation for 30 months. The results of the research demonstrate complete cure. The use of similar treatment plans improves the therapeutic efficiency of BNCT. (author)

  4. BNCT with linac, feasibility study

    International Nuclear Information System (INIS)

    Alfuraih, A.; Ma, A.; Spyrou, N.M.; Awotwi-Pratt, Joseph

    2006-01-01

    High energy photon beams from Medical Linear Accelerators (linacs) which are used in radiotherapy produce undesirable neutrons, beside the clinically useful electron and photon beams. Neutrons are produced from the photonuclear reaction (γ,n) of high energy photons with high Z-materials which compose the accelerator head. In this paper the possible use of these undesirable neutrons for BNCT is investigated, making use of high energy linacs already installed in hospitals, primarily for high energy electron and photon therapy and applying them in the context of BNCT. The photoneutron components emitted by the accelerator is the source for Monte Carlo simulations of the interactions that take place within the head of a voxel-based phantom. The neutron flux across the phantom head is calculated using different moderator arrangements and different techniques in the aim of increasing the thermal neutron flux at the targeted site. Also, we shall test different configurations of the linac head to maximize the exposure of high-Z materials to the photon beam, including the removal of the flattening filter, so as to boost the photoneutron production in the linac head. Experimental work will be conducted in hospitals to validate the Monte Carlo simulations. To make use of linacs for BNCT will be advantageous in the sense that the setting in a hospital department is much more acceptable by the public than a reactor installation. This will mean less complications regarding patient positioning and movement with respect to the beams, additional patient transportation and management will be more cost effective. (author)

  5. Workflow Driven Decision Support Systems : A case of an intra-operative visualization system for surgeons

    NARCIS (Netherlands)

    Jalote-Parmar, A.

    2009-01-01

    Inadequate visualization during Minimally Invasive Surgeries (MIS) has led several technology research labs to develop decision support systems such as Intra-operative Visualization Systems (IVS). IVS focuses on providing surgeons with real-time imaging support to improve task visualization and

  6. Intra-Operative Amylase Concentration in Peri-Pancreatic Fluid Predicts Pancreatic Fistula After Distal Pancreatectomy

    NARCIS (Netherlands)

    Nahm, C.B.; Reuver, P.R.; Hugh, T.J.; Pearson, A.; Gill, A.J.; Samra, J.S.; Mittal, A.

    2017-01-01

    Post-operative pancreatic fistula (POPF) is a potentially severe complication following distal pancreatectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after distal pancreatectomy for the diagnosis of POPF.

  7. Photoacoustic intra-operative nodal staging using clinically approved superparamagnetic iron oxide nanoparticles

    NARCIS (Netherlands)

    Grootendorst, Diederik; Fratila, R.M.; Visscher, M.; ten Haken, Bernard; van Wezel, Richard Jack Anton; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J.M.; Oraevsky, Alexander A.; Wang, Lihong V.

    2013-01-01

    Detection of tumor metastases in the lymphatic system is essential for accurate staging of various malignancies, however fast, accurate and cost-effective intra-operative evaluation of the nodal status remains difficult to perform with common available medical imaging techniques. In recent years,

  8. l-Arginine Pathway Metabolites Predict Need for Intra-operative Shunt During Carotid Endarterectomy

    DEFF Research Database (Denmark)

    Szabo, P; Lantos, J; Nagy, L

    2016-01-01

    lactate levels were increased during reperfusion (p = .02). The median pre-operative concentration of l-arginine was lower in patients requiring an intra-operative shunt than in patients without need of shunt (median: 30.3 μmol/L [interquartile range 24.4-34.4 μmol/L] vs. 57.6 μmol/L [interquartile range...

  9. Evaluation of measures to decrease intra-operative bacterial contamination in orthopaedic implant surgery

    NARCIS (Netherlands)

    Knobben, BAS; van Horn, [No Value; van der Mei, HC; Busscher, HJ

    The aim of this study was to evaluate whether behavioural and systemic measures wilt decrease intra-operative contamination during total hip or knee replacements. The influence of these measures on subsequent prolonged wound discharge, superficial surgical site infection and deep periprosthetic

  10. Intra-operative measurement of applied forces during anterior scoliosis correction.

    Science.gov (United States)

    Fairhurst, H; Little, J P; Adam, C J

    2016-12-01

    Spinal instrumentation and fusion for the treatment of scoliosis is primarily a mechanical intervention to correct the deformity and halt further progression. While implant-related complications remain a concern, little is known about the magnitudes of the forces applied to the spine during surgery, which may affect post-surgical outcomes. In this study, the compressive forces applied to each spinal segment during anterior instrumentation were measured in a series of patients with Adolescent Idiopathic Scoliosis. A force transducer was designed and retrofit to a routinely used surgical tool, and compressive forces applied to each segment during surgery were measured for 15 scoliosis patients. Cobb angle correction achieved by each force was measured on intra-operative fluoroscope images. Relative changes in orientation of the screw within the vertebra were also measured to detect intra-operative screw plough. Intra-operative forces were measured for a total of 95 spinal segments. The mean applied compressive force was 540N (SD 230N, range 88N-1019N). There was a clear trend for higher forces to be applied at segments toward the apex of the scoliosis. Fluoroscopic evidence of screw plough was detected at 10 segments (10.5%). The magnitude of forces applied during anterior scoliosis correction vary over a broad range. These forces do reach magnitudes capable of causing intra-operative vertebral body screw plough. Surgeons should be aware there is a risk for tissue overload during correction, however the clinical implications of intra-operative screw plough remain unclear. The dataset presented here is valuable for providing realistic input parameters for in silico surgical simulations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Use of virtual slide system for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan.

    Science.gov (United States)

    Tsuchihashi, Yasunari; Takamatsu, Terumasa; Hashimoto, Yukimasa; Takashima, Tooru; Nakano, Kooji; Fujita, Setsuya

    2008-07-15

    We started to use virtual slide (VS) and virtual microscopy (VM) systems for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan. In the system we used a digital slide scanner, VASSALO by CLARO Inc., and a broadband optic fibre provided by NTT West Japan Inc. with the best effort capacity of 100 Mbps. The client is the pathology laboratory of Yamashiro Public Hospital, one of the local centre hospitals located in the south of Kyoto Prefecture, where a full-time pathologist is not present. The client is connected by VPN to the telepathology centre of our institute located in central Kyoto. As a result of the recent 15 test cases of VS telepathology diagnosis, including cases judging negative or positive surgical margins, we could estimate the usefulness of VS in intra-operative remote diagnosis. The time required for the frozen section VS file making was found to be around 10 min when we use x10 objective and if the maximal dimension of the frozen sample is less than 20 mm. Good correct focus of VS images was attained in all cases and all the fields of each tissue specimen. Up to now the capacity of best effort B-band appears to be sufficient to attain diagnosis on time in intra-operation. Telepathology diagnosis was achieved within 5 minutes in most cases using VS viewer provided by CLARO Inc. The VS telepathology system was found to be superior to the conventional still image telepathology system using a robotic microscope since in the former we can observe much greater image information than in the latter in a certain limited time of intra-operation and in the much more efficient ways. In the near future VS telepathology will replace conventional still image telepathology with a robotic microscope even in quick frozen intra-operative diagnosis.

  12. Outcome of renal transplantation with and without intra-operative diuretics.

    Science.gov (United States)

    Hanif, F; Macrae, A N; Littlejohn, M G; Clancy, M J; Murio, E

    2011-01-01

    This paper presents an e-survey of current clinical practice of use of intra-operative diuretics during renal transplantation in the United Kingdom and a study to compare outcome of renal transplants carried out with or without intra-operative diuretics in our centre. An e-mail questionnaire to renal transplant surgeons exploring their practice of renal transplantation with or without intra-operative diuretics, the type of a diuretic/s if used and the relevant doses. An observational study comparing the outcome of renal transplant recipients, group no-diuretics (GND, n = 80) carried out from 2004 to 2008 versus group diuretics (GD n = 69) renal transplant recipients who received intra-operative diuretics over a one year period is presented. Outcome measures were incidence of delayed graft function and a comparison of graft survival in both groups. Forty surgeons answered from 18 transplant centres with a response rate of 67%. 13 surgeons do not use diuretics. Mannitol is used by 10/40, Furosemide 6/40 and 11 surgeons use a combination of both. In comparative study there was no significant overall difference in one year graft survival of GD versus GND (N = 65/69, 94% and 75/80, 94% respectively, p = 0.08) and the incidence of delayed graft function was also comparable (16/69, 23% and 21/80, 26% respectively, p = 0.07). The donor characteristics in both groups were comparable. The study showed variation in clinical practice on the use of intra-operative diuretics in renal transplantation and it did not demonstrate that the use of diuretics can improve renal graft survival. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  13. Clinical results of BNCT for malignant meningiomas

    International Nuclear Information System (INIS)

    Miyatake, Shin-ichi; Tamura, Yoji; Kawabata, Shinji

    2006-01-01

    Malignant meningiomas is difficult pathology to be controlled as well as GBM. Since June of 2005, we applied BNCT for 7 cases of malignancy related meningiomas with 13 times neutron irradiation. Five were anaplastic, one was atypical meningiomas and one was sarcoma transformed from meningioma with cervical lymph node metastasis. All cases were introduced after repetitive surgeries and XRT or SRS. Follow-up images were available for 6 cases with observation duration between 2 to 9 months. We applied F-BPA-PET before BNCT in 6 out of 7 cases. One case was received methionine-PET. Five out of 6 cases who received BPA-PET study showed good BPA uptake more than 3 of T/N ratio. One atypical meningiomas cases showed 2.0 of T/N ratio. Original tumor sizes were between 9.2 to 92.7 ml. Two out of 5 anaplastic meningiomas showed CR and all six cases showed radiographic improvements. Clinical symptoms before BNCT such as hemiparesis and facial pain were improved after BNCT, except one case. An huge atypical meningiomas which arisen from tentorium and extended bilateral occipital lobes and brain stem, visual problems were worsened after repetitive BNCT with increase of peritumoral edema. Malignant meningiomas are seemed to be good candidate for BNCT. (author)

  14. Touch imprint and crash preparation intra operative cytology versus frozen section in thyroid nodule

    Directory of Open Access Journals (Sweden)

    Ali Chehrei

    2012-01-01

    Full Text Available Background: Intra operative cytology (IC, including touch imprint (TI and crash preparations (CP, in general has been demonstrated to be a diagnostic tool for many organs but its validity and reliability for diagnosis of thyroid nodules remain controversial. We evaluate the diagnostic value of frozen section, touch imprint, crash preparation and the combination of touch imprint and crash preparation and the combination of frozen section, touch imprint and crash preparation. Materials ans Methods : 55 intra operative specimens from patients with thyroid nodules who underwent thyroidectomy were evaluated at Alzahra and vali-Asr hospital laboratories. For all of the patients frozen section (FS, touch imprint (TI and crash preparation (CP was obtained and reviewed by two pathologists at the same time. Serial TI and CP, and FS, TI and CP were reviewed by the same pathologists. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and accuracy were calculated according to the permanent section as the gold standard test. Results: In our study sensitivity, specificity and accuracy for FS was 100%, 97.6% and 98.1% respectively; for TI they were 78.6%, 95% and 92.4%; for CP they were 78.6%, 92.7% and 89.9%; for serial TI and CP they were 85.7%, 92.7% and 90.9%; and for the combination of FS and TI and CP they were 100%, 97.6% and 98.18% respectively. Conclusions: Intra operative cytology (including TI and CP seems to be a useful, valuable and inexpensive method in clinics, which do not have equipment for frozen sections. Intra operative cytology combined with FS increased the overall accuracy of diagnosis. Further studies are needed to validate the obtained results of this study.

  15. Studies on the reliability of high-field intra-operative MRI in brain glioma resection

    Directory of Open Access Journals (Sweden)

    Zhi-jun SONG

    2011-07-01

    Full Text Available Objective To evaluate the reliability of high-field intra-operative magnetic resonance imaging(iMRI in detecting the residual tumors during glioma resection.Method One hundred and thirty-one cases of brain glioma(69 males and 62 females,aged from 7 to 79 years with mean of 39.6 years hospitalized from Nov.2009 to Aug.2010 were involved in present study.All the patients were evaluated using magnetic resonance imaging(MRI before the operation.The tumors were resected under conventional navigation microscope,and the high-field iMRI was used for all the patients when the operators considered the tumor was satisfactorily resected,while the residual tumor was difficult to detect under the microscope,but resected after being revealed by high-field iMRI.Histopathological examination was performed.The patients without residual tumors recieved high-field MRI scan at day 4 or 5 after operation to evaluate the accuracy of high-field iMRI during operation.Results High quality intra-operative images were obtained by using high-field iMRI.Twenty-eight cases were excluded because their residual tumors were not resected due to their location too close to functional area.Combined with the results of intra-operative histopathological examination and post-operative MRI at the early recovery stage,the sensitivity of high-field iMRI in residual tumor diagnosis was 98.0%(49/50,the specificity was 94.3%(50/53,and the accuracy was 96.1%(99/103.Conclusion High-quality intra-operative imaging could be acquired by high-field iMRI,which maybe used as a safe and reliable method in detecting the residual tumors during glioma resection.

  16. Intra-operative mapping of the atria: the first step towards individualization of atrial fibrillation therapy?

    Science.gov (United States)

    Kik, Charles; Mouws, Elisabeth M J P; Bogers, Ad J J C; de Groot, Natasja M S

    2017-07-01

    Atrial fibrillation (AF), an age-related progressive disease, is becoming a worldwide epidemic with a prevalence rate of 33 million. Areas covered: In this expert review, an overview of important results obtained from previous intra-operative mapping studies is provided. In addition, our novel intra-operative high resolution mapping studies, its surgical considerations and data analyses are discussed. Furthermore, the importance of high resolution mapping studies of both sinus rhythm and AF for the development of future AF therapy is underlined by our most recent results. Expert commentary: Progression of AF is determined by the extensiveness of electropathology which is defined as conduction disorders caused by structural damage of atrial tissue. The severity of electropathology is a major determinant of therapy failure. At present, we do not have any diagnostic tool to determine the degree of electropathology in the individual patient and we can thus not select the most optimal treatment modality for the individual patient. An intra-operative, high resolution scale, epicardial mapping approach combined with quantification of electrical parameters may serve as a diagnostic tool to stage AF in the individual patient and to provide patient tailored therapy.

  17. Bimanual, intra-operative, fluoroscopy-guided removal of nasopharyngeal migratory fish bone from carotid space.

    Science.gov (United States)

    Al-Abduwani, J A; Bhargava, D; Sawhney, S; Al-Abri, R

    2010-07-01

    We report a rare and unusual case of a patient with an ingested fishbone which migrated from the oropharynx to the anterior compartment of the retropharyngeal space and then to the deep neck space in the nasopharynx (i.e. the carotid space). This report aims to describe a successful, minimally invasive method of foreign body removal which avoided both major skull base surgery and any potential life-threatening complications. A secondary aim is to highlight the role of intra-operative fluoroscopy, an under-used tool. We present a 67-year-old man with a history of fish bone impaction but no fish bone visible on plain X-ray or flexible endoscopy. The diagnosis of fish bone lodged in the retropharyngeal space was confirmed by computed tomography. Surgical exploration of the anterior retropharyngeal space failed to locate the fish bone, as it had migrated to a new, unknown location. Intra-operative fluoroscopy was vital for the removal of the fish bone, as it was impossible to see with the naked eye and had migrated from its previously imaged position. The fish bone was finally retrieved bimanually using external pressure on the submandibular region, which displaced the fish bone, and fluoroscopic guidance, which assisted its removal from the nasopharyngeal lumen. To the best of our knowledge, this is the first reported case of bimanual, intra-operative, fluoroscopy-guided, intra-luminal removal of a migratory fish bone from the deep neck space in this region of the nasopharynx.

  18. Clinical evaluation of intra-operative radiotherapy combined with subtotal cystectomy for invasive bladder carcinoma

    International Nuclear Information System (INIS)

    Ozawa, Kazunori; Nakagomi, Kazuaki; Yonese, Junzi

    1996-01-01

    From 1981 to 1994, intra-operative radiotherapy after subtotal cystectomy was performed on 22 patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition. All the patients received 25 to 30 Gy of radiotherapy focused on trigonum and internal urethral orifice after subtotal cystectomy with uretero-cutaneostomy. Of 22 patients, 15 patients died. Five patients died of bladder cancer, one died of gastic cancer, one died of rectal cancer and the others died of pneumonia, heart failure, sepsis and senility. The five-year survival rate was 41% and the cause-specific five-year survival rate was 75%. Local recurrence was seen only in one patient, who received second intra-operative radiotherapy and recovered well in complete remission. We believe that intra-operative radiotherapy after subtotal cystectomy is useful for patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition. (author)

  19. Safe surgery: how accurate are we at predicting intra-operative blood loss?

    LENUS (Irish Health Repository)

    2012-02-01

    Introduction Preoperative estimation of intra-operative blood loss by both anaesthetist and operating surgeon is a criterion of the World Health Organization\\'s surgical safety checklist. The checklist requires specific preoperative planning when anticipated blood loss is greater than 500 mL. The aim of this study was to assess the accuracy of surgeons and anaesthetists at predicting intra-operative blood loss. Methods A 6-week prospective study of intermediate and major operations in an academic medical centre was performed. An independent observer interviewed surgical and anaesthetic consultants and registrars, preoperatively asking each to predict expected blood loss in millilitre. Intra-operative blood loss was measured and compared with these predictions. Parameters including the use of anticoagulation and anti-platelet therapy as well as intra-operative hypothermia and hypotension were recorded. Results One hundred sixty-eight operations were included in the study, including 142 elective and 26 emergency operations. Blood loss was predicted to within 500 mL of measured blood loss in 89% of cases. Consultant surgeons tended to underestimate blood loss, doing so in 43% of all cases, while consultant anaesthetists were more likely to overestimate (60% of all operations). Twelve patients (7%) had underestimation of blood loss of more than 500 mL by both surgeon and anaesthetist. Thirty per cent (n = 6\\/20) of patients requiring transfusion of a blood product within 24 hours of surgery had blood loss underestimated by more than 500 mL by both surgeon and anaesthetist. There was no significant difference in prediction between patients on anti-platelet or anticoagulation therapy preoperatively and those not on the said therapies. Conclusion Predicted intra-operative blood loss was within 500 mL of measured blood loss in 89% of operations. In 30% of patients who ultimately receive a blood transfusion, both the surgeon and anaesthetist significantly underestimate

  20. BNCT Technology Development on HANARO Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Ki Jung; Park, Kyung Bae; Whang, Seung Ryul; Kim, Myong Seop

    2007-06-15

    So as to establish the biological effects of BNCT in the HANARO Reactor, biological damages in cells and animals with treatment of boron/neutron were investigated. And 124I-BPA animal PET image, analysis technology of the boron contents in the mouse tissues by ICP-AES was established. A Standard clinical protocol, a toxicity evaluation report and an efficacy investigation report of BNCT has been developed. Based on these data, the primary permission of clinical application was acquired through IRB of our hospital. Three cases of pre-clinical experiment for boron distribution and two cases of medium-sized animal simulation experiment using cat with verifying for 2 months after BNCT was performed and so the clinical demonstration with a patient was prepared. Also neutron flux, fast neutron flux and gamma ray dose of BNCT facility were calculated and these data will be utilized good informations for clinical trials and further BNCT research. For the new synthesis of a boron compound, o-carboranyl ethylamine, o-carboranylenepiperidine, o-carboranyl-THIQ and o-carboranyl-s-triazine derivatives were synthesized. Among them, boron uptake in the cancer cell of the triazine derivative was about 25 times than that of BPA and so these three synthesized methods of new boron compounds were patented.

  1. BNCT Technology Development on HANARO Reactor

    International Nuclear Information System (INIS)

    Chun, Ki Jung; Park, Kyung Bae; Whang, Seung Ryul; Kim, Myong Seop

    2007-06-01

    So as to establish the biological effects of BNCT in the HANARO Reactor, biological damages in cells and animals with treatment of boron/neutron were investigated. And 124I-BPA animal PET image, analysis technology of the boron contents in the mouse tissues by ICP-AES was established. A Standard clinical protocol, a toxicity evaluation report and an efficacy investigation report of BNCT has been developed. Based on these data, the primary permission of clinical application was acquired through IRB of our hospital. Three cases of pre-clinical experiment for boron distribution and two cases of medium-sized animal simulation experiment using cat with verifying for 2 months after BNCT was performed and so the clinical demonstration with a patient was prepared. Also neutron flux, fast neutron flux and gamma ray dose of BNCT facility were calculated and these data will be utilized good informations for clinical trials and further BNCT research. For the new synthesis of a boron compound, o-carboranyl ethylamine, o-carboranylenepiperidine, o-carboranyl-THIQ and o-carboranyl-s-triazine derivatives were synthesized. Among them, boron uptake in the cancer cell of the triazine derivative was about 25 times than that of BPA and so these three synthesized methods of new boron compounds were patented

  2. INEL BNCT Research Program annual report 1994

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1995-11-01

    This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1994. Contributions from the principal investigators about their individual projects are included, specifically, chemistry (pituitary tumor studies, boron drug development including liposomes, lipoproteins, and carboranylalanine derivatives), pharmacology (murine screenings, toxicity testing, ICP-AES analysis of biological samples), physics (treatment planning software, neutron beam and filter design, neutron beam measurement dosimetry), and radiation biology (small and large animal models tissue studies and efficacy studies). Information on the potential toxicity of BSH and BPA is presented and results of 21 spontaneous tumor bearing dogs that have been treated with BNCT at Brookhaven National Laboratory (BNL) are discussed. Several boron carrying drugs exhibiting good tumor uptake are described. Significant progress in the potential of treating pituitary tumors is presented. Highlights from the First International Workshop on Accelerator-Based Neutron Sources for BNCT are included

  3. Production of epithermal neutron beams for BNCT

    CERN Document Server

    Bisceglie, E; Colonna, N; Paticchio, V; Santorelli, P; Variale, V

    2002-01-01

    The use of boron neutron capture therapy (BNCT) for the treatment of deep-seated tumors requires neutron beams of suitable energy and intensity. Simulations indicate the optimal energy to reside in the epithermal region, in particular between 1 and 10 keV. Therapeutic neutron beams with high spectral purity in this energy range could be produced with accelerator-based neutron sources through a suitable neutron-producing reaction. Herein, we report on different solutions that have been investigated as possible sources of epithermal neutron beams for BNCT. The potential use of such sources for a hospital-based therapeutic facility is discussed.

  4. [Intra-operative myelography in treatment of fractures of thoracolumbar spine].

    Science.gov (United States)

    Tomčovčík, L; Cuha, R; Raši, R

    2010-08-01

    The aim of this retrospective study was to evaluate the results of intra-operative myelography as the method used to assess the reduction of bone fragments from the posterior margin of the vertebral body. Forty patients with 42 comminuted fractures of the thoracolumbar spine were included in the study. The pre-operative spinal stenosis caused by bone fragments from the posterior margin of the vertebral body, as detected by CT scanning, ranged from 25 % to 85 %. Neurological deficit was due to injury in 19 patients and in one it developed post-operatively after the patient stood and walked. After ligamentotaxis and internal fixation, intra-operative myelography was used to show decompression of the spinal canal. A spinal block or severe constriction of contrast flow was an indication for hemilaminectomy (laminectomy) and direct decompression of the spinal canal. In the patients with neurological deficit and severe spinal stenosis persisting after ligamentotaxis and detectable by skiascopy, hemilaminectomy (laminectomy) and direct spinal decompression followed by intra-operative myelography were carried out. Intra-operative myelography was used 46 -times (20-times in 20 patients free from neurological deficit and 26-times in 20 patients with neurological deficit). In 38 cases (82.6 %) dural sac compression was not present (patients with neurological deficit, 13-times after ligamentotaxis, eight-times after ligamentotaxis and hemilaminectomy with direct decompression, twi- ce at repeat surgeryúúú patients without neurological deficit, 15-times). On two occasions (4.4 %) the contrast agent injected into the dural sac did not make the interior body part visible, on three occasions (6.5 %) contrast medium was injected extradurally, and dural sac compression following ligamentotaxis requiring hemilaminectomy (laminectomy) and direct decompression occurred in three cases (6.5 %). In the patients without neurological deficit, dural sac compression was not recorded. No

  5. Intra-operative maternal complications of emergency cesarean section done in advanced labor

    International Nuclear Information System (INIS)

    Nisa, M.U.

    2013-01-01

    Background: Emergency cesarean section done in advanced labor is a big challenge in obstetrics due to increased risk of intraoperative complications. In the last decade, a rapid increase in cesarean section done in advanced labor has been observed. Difficult deli-very of the fetal head during cesarean section carries a high risk of intraoperative complications like cervical and uterine tears, intra operative hemorrhage and trauma to the baby. Objectives: The purpose of this study is to find out the frequency and risk factors for intra-operative complications in emergency cesarean section done in advanced labor, so that appropriate management protocols can be planned to reduce these complications. Study Design: Prospective cohort study. Materials and Methods: This prospective study was carried out in Obstetrics and Gynecology Unit - 2 of Services Institute of Medical Sciences, Services Hospital, Lahore; from 1st January 2007 to 31st December 2007. All patients undergoing emergency cesarean sections done on laboring mothers were included in the study. The sample was divided into two groups; emergency C-section done in advanced labor as the study group and emergency C-section in early labor as the control group. Data were collected regarding age, parity, booked or unbooked status, indications for cesarean section, level of competence of operating surgeon, intra-operative complications and the risk factors for these complications. Data were recorded on a structured proforma and compared between the two groups. Statistical Analysis: Data were analyzed using computer programme SPSS Version 14 for windows applying student t-test for quantitative and chai square test for qualitative parameters. A p-value < 0.05 was used as statistically significant. Results: Out of 2064 total deliveries in the year 2007, 1290 (62.5%) were vaginal deliveries and 774 (37.5%) were C-Sections. Out of 774 C-Section, 174 (23%) were elective and 600 (77%) were emergency. Out of 600 emergency C

  6. The impact of intra-operative interruptions on surgeons' perceived workload: an observational study in elective general and orthopedic surgery.

    Science.gov (United States)

    Weigl, Matthias; Antoniadis, Sophia; Chiapponi, Costanza; Bruns, Christiane; Sevdalis, Nick

    2015-01-01

    Surgeons' intra-operative workload is critical for effective and safe surgical performance. Detrimental conditions in the operating room (OR) environment may add to perceived workload and jeopardize surgical performance and outcomes. This study aims to evaluate the impact of different intra-operative workflow interruptions on surgeons' capacity to manage their workload safely and efficiently. This was an observational study of intra-operative interruptions and self-rated workload in two surgical specialties (general, orthopedic/trauma surgery). Intra-operative interruptions were assessed via expert observation using a well-validated observation tool. Surgeons, nurses, and anesthesiologists assessed their intra-operative workload directly after case completion based on three items of the validated Surgery Task Load Index (mental demand, situational stress, distraction). A total of 56 elective cases (35 open, 21 laparoscopic) with 94 workload ratings were included. Mean intra-operative duration was 1 h 37 min. Intra-operative interruptions were on average observed 9.78 times per hour. People who entered/exited the OR (30.6 %) as well as telephone-/beeper-related disruptions (23.6 %) occurred most often. Equipment and OR environment-related interruptions were associated with highest interference with team functioning particularly in laparoscopic procedures. After identifying task and procedural influences, partial correlational analyses revealed that case-irrelevant communications were negatively associated with surgeons' mental fatigue and situational stress, whereas surgeons' reported distraction was increased by case-irrelevant communication and procedural disruptions. OR nurses' and anesthesiologists' perceived workload was also related to intra-operative interruption events. Our study documents the unique contribution of different interruptions on surgeons' workload; whereas case-irrelevant communications may be beneficial for mental fatigue and stress in routine

  7. Achieving Adequate Margins in Ameloblastoma Resection: The Role for Intra-Operative Specimen Imaging. Clinical Report and Systematic Review

    Science.gov (United States)

    Ramakrishnan, Anand; Mirkazemi, Mansoor; Baillieu, Charles; Ptasznik, Ronnie; Leong, James

    2012-01-01

    Background Ameloblastoma is a locally aggressive odontogenic neoplasm. With local recurrence rates reaching 90%, only completeness of excision can facilitate cure. Surgical clearance has widely been based on pre-operative imaging to guide operative excision margins, however use of intra-operative specimen x-ray or frozen-section has been sought to improve clearance rates, and advanced imaging technologies in this role have been proposed. This manuscript aims to quantify the evidence for evaluating intra-operative resection margins and present the current standard in this role. Method The current study comprises the first reported comparison of imaging modalities for assessing ameloblastoma margins. A case is presented in which margins are assessed with each of clinical assessment based on preoperative imaging, intra-operative specimen x-ray, intra-operative specimen computed tomography (CT) and definitive histology. Each modality is compared quantitatively. These results are compared to the literature through means of systematic review of current evidence. Results A comparative study highlights the role for CT imaging over plain radiography. With no other comparative studies and a paucity of high level evidence establishing a role for intra-operative margin assessment in ameloblastoma in the literature, only level 4 evidence supporting the use of frozen section and specimen x-ray, and only one level 4 study assesses intra-operative CT. Conclusion The current study suggests that intra-operative specimen CT offers an improvement over existing techniques in this role. While establishing a gold-standard will require higher level comparative studies, the use of intra-operative CT can facilitate accurate single-stage resection. PMID:23094099

  8. Achieving adequate margins in ameloblastoma resection: the role for intra-operative specimen imaging. Clinical report and systematic review.

    Directory of Open Access Journals (Sweden)

    Inoka De Silva

    Full Text Available BACKGROUND: Ameloblastoma is a locally aggressive odontogenic neoplasm. With local recurrence rates reaching 90%, only completeness of excision can facilitate cure. Surgical clearance has widely been based on pre-operative imaging to guide operative excision margins, however use of intra-operative specimen x-ray or frozen-section has been sought to improve clearance rates, and advanced imaging technologies in this role have been proposed. This manuscript aims to quantify the evidence for evaluating intra-operative resection margins and present the current standard in this role. METHOD: The current study comprises the first reported comparison of imaging modalities for assessing ameloblastoma margins. A case is presented in which margins are assessed with each of clinical assessment based on preoperative imaging, intra-operative specimen x-ray, intra-operative specimen computed tomography (CT and definitive histology. Each modality is compared quantitatively. These results are compared to the literature through means of systematic review of current evidence. RESULTS: A comparative study highlights the role for CT imaging over plain radiography. With no other comparative studies and a paucity of high level evidence establishing a role for intra-operative margin assessment in ameloblastoma in the literature, only level 4 evidence supporting the use of frozen section and specimen x-ray, and only one level 4 study assesses intra-operative CT. CONCLUSION: The current study suggests that intra-operative specimen CT offers an improvement over existing techniques in this role. While establishing a gold-standard will require higher level comparative studies, the use of intra-operative CT can facilitate accurate single-stage resection.

  9. Impact of intra-operative intraperitoneal chemotherapy on organ/space surgical site infection in patients with gastric cancer.

    Science.gov (United States)

    Liu, X; Duan, X; Xu, J; Jin, Q; Chen, F; Wang, P; Yang, Y; Tang, X

    2015-11-01

    Various risk factors for surgical site infection (SSI) have been identified such as age, overweight, duration of surgery, blood loss, etc. Intraperitoneal chemotherapy during surgery is a common procedure in patients with gastric cancer, yet its impact on SSI has not been evaluated. To evaluate whether intra-operative intraperitoneal chemotherapy is a key risk factor for organ/space SSI in patients with gastric cancer. All patients with gastric cancer who underwent surgery at the Department of Gastrointestinal Surgery between January 2008 and December 2013 were studied. The organ/space SSI rates were compared between patients who received intra-operative intraperitoneal chemotherapy and patients who did not receive intra-operative intraperitoneal chemotherapy, and the risk factors for organ/space SSI were analysed by univariate and multi-variate regression analyses. The microbial causes of organ/space SSI were also identified. Of the eligible 845 patients, 356 received intra-operative intraperitoneal chemotherapy, and the organ/space SSI rate was higher in these patients compared with patients who did not receive intra-operative intraperitoneal chemotherapy (9.01% vs 3.88%; P = 0.002). Univariate analysis confirmed the significance of this finding (odds ratio 2.443; P = 0.003). As a result, hospital stay was increased in patients who received intra-operative intraperitoneal chemotherapy {mean 20.91 days [95% confidence interval (CI) 19.76-22.06] vs 29.72 days (95% CI 25.46-33.99); P = 0.000}. The results also suggested that intra-operative intraperitoneal chemotherapy may be associated with more Gram-negative bacterial infections. Intra-operative intraperitoneal chemotherapy is a significant risk factor for organ/space SSI in patients with gastric cancer. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  10. INEL BNCT Program: Volume 5, No. 9

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, A.L. (ed.)

    1991-01-01

    This Bulletin presents a summary of accomplishments and highlights of the Idaho National Engineering Laboratory's (INEL) Boron Neutron Capture Therapy (BNCT) Program for September 1991. This bulletin includes information on the brain tumor and melanoma research programs, Power Burst Facility (PBF) technical support and modifications, PBF operations, and updates to the animal data charts.

  11. Introducing BNCT treatment in new treatment facilities

    International Nuclear Information System (INIS)

    Gabel, D.

    2001-01-01

    The physical and radiobiological studies that should be performed before the initiation of BNCT are discussed. The need for dose-escalation versus response studies in large animal models is questioned. These studies are time consuming, expensive and legally difficult in some countries and may be dispensable. (author)

  12. Intra-operative neurophysiological mapping and monitoring during brain tumour surgery in children: an update.

    Science.gov (United States)

    Coppola, Angela; Tramontano, Vincenzo; Basaldella, Federica; Arcaro, Chiara; Squintani, Giovanna; Sala, Francesco

    2016-10-01

    Over the past decade, the reluctance to operate in eloquent brain areas has been reconsidered in the light of the advent of new peri-operative functional neuroimaging techniques and new evidence from neuro-oncology. To maximise tumour resection while minimising morbidity should be the goal of brain surgery in children as much as it is in adults, and preservation of brain functions is critical in the light of the increased survival and the expectations in terms of quality of life. Intra-operative neurophysiology is the gold standard to localise and preserve brain functions during surgery and is increasingly used in paediatric neurosurgery. Yet, the developing nervous system has peculiar characteristics in terms of anatomical and physiological maturation, and some technical aspects need to be tailored for its use in children, especially in infants. This paper will review the most recent advances in the field of intra-operative neurophysiology (ION) techniques during brain surgery, focussing on those aspects that are relevant to the paediatric neurosurgery practice.

  13. Minimizing shoulder syndrome with intra-operative spinal accessory nerve monitoring for neck dissection.

    Science.gov (United States)

    Lee, C-H; Huang, N-C; Chen, H-C; Chen, M-K

    2013-04-01

    The objective of this study was to analyze the safety and results of intra-operative SAN (spinal accessary nerve) monitoring during selective neck dissection, with emphasis on shoulder syndrome. Twenty-five consecutive patients with head and neck cancer were studied. Selective neck dissection was performed by a single clinical fellow under the supervision of the department chief using an intra-operative SAN monitor. Electrophysiological data were recorded after initial identification of the SAN and continued until just before closure. Electromyographic evaluation was carried out to assess SAN function one month postoperatively. Shoulder disability was also evaluated at this time using a questionnaire for shoulder syndrome (shrug, flexion, abduction, winging, and pain). No patients had postoperative shoulder syndrome involving shrug, flexion, abduction, or winging. Twenty-two of the 25 (88%) patients had shoulder pain, but the average pain score was low (2.3 ± 1.3). No patients had neck recurrence during at least 1 year of follow up. By using nerve monitoring during selective neck dissection, no patient developed significant "shoulder syndrome", with the exception of slight pain.

  14. The effect of intra-operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy.

    Science.gov (United States)

    Park, C; Choi, J B; Lee, Y-S; Chang, H-S; Shin, C S; Kim, S; Han, D W

    2015-04-01

    Posterior neck pain following thyroidectomy is common because full neck extension is required during the procedure. We evaluated the effect of intra-operative transcutaneous electrical nerve stimulation on postoperative neck pain in patients undergoing total thyroidectomy under general anaesthesia. One hundred patients were randomly assigned to one of two groups; 50 patients received transcutaneous electrical nerve stimulation applied to the trapezius muscle and 50 patients acted as controls. Postoperative posterior neck pain and anterior wound pain were evaluated using an 11-point numerical rating scale at 30 min, 6 h, 24 h and 48 h following surgery. The numerical rating scale for posterior neck pain was significantly lower in the transcutaneous electrical nerve stimulation group compared with the control group at all time points (p < 0.05). There were no significant differences in the numerical rating scale for anterior wound pain at any time point. No adverse effects related to transcutaneous electrical nerve stimulation were observed. We conclude that intra-operative transcutaneous electrical nerve stimulation applied to the trapezius muscle reduced posterior neck pain following thyroidectomy. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

  15. Intra-operative 3-T MRI for paediatric brain tumours: challenges and perspectives

    International Nuclear Information System (INIS)

    Abernethy, L.J.; Avula, S.; Hughes, G.M.; Wright, E.J.; Mallucci, C.L.

    2012-01-01

    MRI is the ideal modality for imaging intracranial tumours. Intraoperative MRI (ioMRI) makes it possible to obtain scans during a neurosurgical operation that can aid complete macroscopic tumour resection - a major prognostic factor in the majority of brain tumours in children. Intra-operative MRI can also help limit damage to normal brain tissue. It therefore has the potential to improve the survival of children with brain tumours and to minimise morbidity, including neurological deficits. The use of ioMRI is also likely to reduce the need for second look surgery, and may reduce the need for chemotherapy and radiotherapy. High-field MRI systems provide better anatomical information and also enable effective utilisation of advanced MRI techniques such as perfusion imaging, diffusion tensor imaging, and magnetic resonance spectroscopy. However, high-field ioMRI facilities require substantial capital investment, and careful planning is required for optimal benefit. Safe ioMRI requires meticulous attention to detail and rigorous application of magnetic field safety precautions. Interpretation of ioMRI can be challenging and requires experience and understanding of artefacts that are common in the intra-operative setting. (orig.)

  16. Intra-operative application of optical coherence tomography with an operating microscope.

    Science.gov (United States)

    Just, T; Lankenau, E; Hüttmann, G; Pau, H W

    2009-09-01

    To introduce the use of optical coherence tomography with an operating microscope for intra-operative evaluation of the human larynx. A specially equipped operating microscope with integrated spectral domain optical coherence tomography apparatus was used during microlaryngoscopy. Technical improvements in optical coherence tomography equipment (e.g. pilot beam, variable focal distance, improved image quality and integration into an operating microscope) have enabled greater sensitivity and imaging speed and a non-contact approach. Spectral domain optical coherence tomography now enables a better correlation between optical coherence tomography images and histological findings. With this new technology, the precision of biopsy can be improved during microlaryngoscopy. Use of this new optical coherence tomography technology, integrated into an operating microscope, enables the surgeon to define the biopsy site location and resection plane precisely, while the optical zoom of the operating microscope can be used over the complete range.

  17. Intra-Operative Amylase Concentration in Peri-Pancreatic Fluid Predicts Pancreatic Fistula After Distal Pancreatectomy.

    Science.gov (United States)

    Nahm, Christopher B; de Reuver, Philip R; Hugh, Thomas J; Pearson, Andrew; Gill, Anthony J; Samra, Jaswinder S; Mittal, Anubhav

    2017-06-01

    Post-operative pancreatic fistula (POPF) is a potentially severe complication following distal pancreatectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after distal pancreatectomy for the diagnosis of POPF. Consecutive patients who underwent a distal pancreatectomy between November 2014 and September 2016 were included in the analysis. IOAC was measured, followed by drain fluid analysis for amylase on post-operative days (PODs) 1, 3, and 5. Receiver operator characteristic (ROC) analysis was performed to evaluate the discriminative capacity of IOAC as a predictor of POPF. IOAC was measured after distal pancreatectomy in 26 patients. The IOAC correlated significantly with (i) PODs 1, 3, and 5 drain amylase (p  1000 experienced a post-operative complication (OR 18.3, 95% CI 2.51-103, p pancreatectomy.

  18. A standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy

    Directory of Open Access Journals (Sweden)

    Kaska Serge C

    2010-12-01

    Full Text Available Abstract Background Intra-operative fluoroscopy for orthopaedic procedures frequently involves imaging in the horizontal plane, which requires the lower portion of the C-arm (x-ray tube to be rotated from an unsterile zone (beneath the table into the sterile field. To protect the integrity of the sterile field the C-arm must be draped repeatedly throughout the surgical case. The current, un-standardized, practice employs draping procedures which violate the Association of peri-Operative Registered Nurses (AORN Standards and Recommended Practices, waste time and material, and pose an increased risk for surgical site infection. Presentation of the hypothesis Use of a novel sterile C-arm drape (C-armor that maintains the integrity of the sterile field, will improve operating room efficiency and reduce surgical site infection risk factors. This reduction in risk factors may potentially reduce surgical site infections in orthopaedic surgical cases requiring repeated horizontal x-ray imaging. Testing the Hypothesis Savings in time and material and the reduction in surgical site infection risk factors afforded by using C-armor are intuitive to those skilled in the practice of orthopaedic surgery. Testing for a reduction in the number of microorganisms introduced to the surgical site by improved C-arm draping would be challenging due to the multiple confounding factors during a surgical operation. Determination of an absolute reduction in surgical site infections may be possible, but will require accounting for many confounding variables and a large study sample in order to achieve statistical significance. Implications of the Hypothesis Improved intraoperative workflow, healthcare savings and a reduction in surgical site infection risk factors will be achieved by utilizing a standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy.

  19. 'Sequential' Boron Neutron Capture Therapy (BNCT): A Novel Approach to BNCT for the Treatment of Oral Cancer in the Hamster Cheek Pouch Model

    International Nuclear Information System (INIS)

    Molinari, Ana J.; Pozzi, Emiliano C.C.; Hughes, Andrea Monti; Heber, Elisa M.; Garabalino, Marcela A.; Thorp, Silvia I.; Miller, Marcelo; Itoiz, Maria E.; Aromando, Romina F.; Nigg, David W.; Quintana, Jorge; Santa Cruz, Gustavo A.; Trivillin, Veronica A.; Schwint, Amanda E.

    2011-01-01

    In the present study we evaluated the therapeutic effect and/or potential radiotoxicity of the novel 'Tandem' Boron Neutron Capture Therapy (T-BNCT) for the treatment of oral cancer in the hamster cheek pouch model at RA-3 Nuclear Reactor. Two groups of animals were treated with 'Tandem BNCT', i.e. BNCT mediated by boronophenylalanine (BPA) followed by BNCT mediated by sodium decahydrodecaborate (GB-10) either 24 h (T-24h-BNCT) or 48 h (T-48h-BNCT) later. A total tumor dose-matched single application of BNCT mediated by BPA and GB-10 administered jointly ((BPA + GB-10)-BNCT) was administered to an additional group of animals. At 28 days post-treatment, T-24h-BNCT and T-48h-BNCT induced, respectively, overall tumor control (OTC) of 95% and 91%, with no statistically significant differences between protocols. Tumor response for the single application of (BPA + GB-10)-BNCT was 75%, significantly lower than for T-BNCT. The T-BNCT protocols and (BPA + GB-10)-BNCT induced reversible mucositis in dose-limiting precancerous tissue around treated tumors, reaching Grade 3/4 mucositis in 47% and 60% of the animals respectively. No normal tissue radiotoxicity was associated to tumor control for any of the protocols. 'Tandem' BNCT enhances tumor control in oral cancer and reduces or, at worst, does not increase, mucositis in dose-limiting precancerous tissue.

  20. An Accelerator Neutron Source for BNCT

    International Nuclear Information System (INIS)

    Blue, Thomas E.

    2006-01-01

    The overall goal of this project was to develop an accelerator-based neutron source (ABNS) for Boron Neutron Capture Therapy (BNCT). Specifically, our goals were to design, and confirm by measurement, a target assembly and a moderator assembly that would fulfill the design requirements of the ABNS. These design requirements were (1) that the neutron field quality be as good as the neutron field quality for the reactor-based neutron sources for BNCT, (2) that the patient treatment time be reasonable, (3) that the proton current required to treat patients in reasonable times be technologically achievable at reasonable cost with good reliability, and accelerator space requirements which can be met in a hospital, and finally (4) that the treatment be safe for the patients

  1. An Accelerator Neutron Source for BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Blue, Thomas, E

    2006-03-14

    The overall goal of this project was to develop an accelerator-based neutron source (ABNS) for Boron Neutron Capture Therapy (BNCT). Specifically, our goals were to design, and confirm by measurement, a target assembly and a moderator assembly that would fulfill the design requirements of the ABNS. These design requirements were 1) that the neutron field quality be as good as the neutron field quality for the reactor-based neutron sources for BNCT, 2) that the patient treatment time be reasonable, 3) that the proton current required to treat patients in reasonable times be technologially achievable at reasonable cost with good reliability, and accelerator space requirements which can be met in a hospital, and finally 4) that the treatment be safe for the patients.

  2. Intra-operative Ultrasound as a Tool to Assess Free Borders of Primary Vascular Aortic Tumors During Resection

    Directory of Open Access Journals (Sweden)

    R.M. Andersen

    Full Text Available : Introduction: Primary vascular tumors are rare and, in general, have a poor prognosis. Complete resection is associated with a better prognosis. Radical resection depends on safe discrimination of tumor borders. Technical summary: A 54 year old woman presented with abdominal pain. Imaging revealed a mass in the thoracic aorta, highly suspicious of angiosarcoma which was confirmed post-operatively by histological analysis. Open surgery was performed. Prior to clamping of the aorta, intra-operative ultrasound established clear delineation of the tumor borders. Conclusion: Intra-operative ultrasound was, in this case, a safe and easy method to determine the tumor borders, providing a simple guide to in toto tumor removal. Keywords: Angiosarcoma, Intra-operative ultrasound, In toto tumor removal, Fludeoxyglucose positron emission tomography/computed tomography, Magnetic resonance imaging

  3. BNCT irradiation facility at the JRR-4

    International Nuclear Information System (INIS)

    Torii, Y.; Kishi, T.; Kumada, H.; Yamamoto, K.; Sakurai, F.; Takayanagi, M.

    2000-01-01

    The JRR--4 was modified for fuel enrichment reducing and reactor equipment renewal. And also a medical irradiation facility for the Boron Neutron Capture Therapy (BNCT) was installed at the JRR--4 in that time. The medical irradiation facility has been composed of a heavy water tank, a collimator and an irradiation room. The heavy water tank has four layers of heavy water for spectrum shifter and 75cm-thickness aluminum for the shield of fast neutron. The collimator is for collimating thermal neutron and epithermal neutron using polyethylene with lithium-fluoride and shielding gamma ray by bismuth. The irradiation room has sufficient space at exit side of the beam, to accommodate a large working area for setting the patient. Both of the medical treatment room and the patient-monitoring area were prepared adjacent to the irradiation room. The medical irradiation facility in the JRR-4 is designed to permit selection of neutron energies from thermal neutron to epithermal neutron by changing the thickness of heavy water layers. Therefore it is available to continue the same kind of BNCT with thermal neutron used to perform in the JRR-2, as well as to commence the research and development of BNCT with epithermal neutron, which will make the brain tumor treatment possible at a deep part of brain. The full power operation of the JRR-4 was resumed with LEU fuel in October 1998 and currently performing some experiments to measure the neutron fluxes and physical doses for determinate characterization of the medical irradiation facility. The first medical irradiation for BNCT was carried out on 25th October 1999. The patient was treated by Tsukuba University group using thermal neutron beam included epi-thermal neutrons. (author)

  4. BNCT irradiation facility at the JRR-4

    Energy Technology Data Exchange (ETDEWEB)

    Torii, Y.; Kishi, T.; Kumada, H.; Yamamoto, K.; Sakurai, F.; Takayanagi, M. [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2000-10-01

    The JRR--4 was modified for fuel enrichment reducing and reactor equipment renewal. And also a medical irradiation facility for the Boron Neutron Capture Therapy (BNCT) was installed at the JRR--4 in that time. The medical irradiation facility has been composed of a heavy water tank, a collimator and an irradiation room. The heavy water tank has four layers of heavy water for spectrum shifter and 75cm-thickness aluminum for the shield of fast neutron. The collimator is for collimating thermal neutron and epithermal neutron using polyethylene with lithium-fluoride and shielding gamma ray by bismuth. The irradiation room has sufficient space at exit side of the beam, to accommodate a large working area for setting the patient. Both of the medical treatment room and the patient-monitoring area were prepared adjacent to the irradiation room. The medical irradiation facility in the JRR-4 is designed to permit selection of neutron energies from thermal neutron to epithermal neutron by changing the thickness of heavy water layers. Therefore it is available to continue the same kind of BNCT with thermal neutron used to perform in the JRR-2, as well as to commence the research and development of BNCT with epithermal neutron, which will make the brain tumor treatment possible at a deep part of brain. The full power operation of the JRR-4 was resumed with LEU fuel in October 1998 and currently performing some experiments to measure the neutron fluxes and physical doses for determinate characterization of the medical irradiation facility. The first medical irradiation for BNCT was carried out on 25th October 1999. The patient was treated by Tsukuba University group using thermal neutron beam included epi-thermal neutrons. (author)

  5. Present status of Accelerator-Based BNCT.

    Science.gov (United States)

    Kreiner, Andres Juan; Bergueiro, Javier; Cartelli, Daniel; Baldo, Matias; Castell, Walter; Asoia, Javier Gomez; Padulo, Javier; Suárez Sandín, Juan Carlos; Igarzabal, Marcelo; Erhardt, Julian; Mercuri, Daniel; Valda, Alejandro A; Minsky, Daniel M; Debray, Mario E; Somacal, Hector R; Capoulat, María Eugenia; Herrera, María S; Del Grosso, Mariela F; Gagetti, Leonardo; Anzorena, Manuel Suarez; Canepa, Nicolas; Real, Nicolas; Gun, Marcelo; Tacca, Hernán

    2016-01-01

    This work aims at giving an updated report of the worldwide status of Accelerator-Based BNCT (AB-BNCT). There is a generalized perception that the availability of accelerators installed in hospitals, as neutron sources, may be crucial for the advancement of BNCT. Accordingly, in recent years a significant effort has started to develop such machines. A variety of possible charged-particle induced nuclear reactions and the characteristics of the resulting neutron spectra are discussed along with the worldwide activity in suitable accelerator development. Endothermic (7)Li(p,n)(7)Be and (9)Be(p,n)(9)B and exothermic (9)Be(d,n)(10)B are compared. In addition to having much better thermo-mechanical properties than Li, Be as a target leads to stable products. This is a significant advantage for a hospital-based facility. (9)Be(p,n)(9)B needs at least 4-5 MeV bombarding energy to have a sufficient yield, while (9)Be(d,n)(10)B can be utilized at about 1.4 MeV, implying the smallest possible accelerator. This reaction operating with a thin target can produce a sufficiently soft spectrum to be viable for AB-BNCT. The machines considered are electrostatic single ended or tandem accelerators or radiofrequency quadrupoles plus drift tube Linacs. (7)Li(p,n)(7)Be provides one of the best solutions for the production of epithermal neutron beams for deep-seated tumors. However, a Li-based target poses significant technological challenges. Hence, Be has been considered as an alternative target, both in combination with (p,n) and (d,n) reactions. (9)Be(d,n)(10)B at 1.4 MeV, with a thin target has been shown to be a realistic option for the treatment of deep-seated lesions.

  6. INEL BNCT Research Program annual report 1994

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R. [ed.

    1995-11-01

    This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1994. Contributions from the principal investigators about their individual projects are included, specifically, chemistry (pituitary tumor studies, boron drug development including liposomes, lipoproteins, and carboranylalanine derivatives), pharmacology (murine screenings, toxicity testing, ICP-AES analysis of biological samples), physics (treatment planning software, neutron beam and filter design, neutron beam measurement dosimetry), and radiation biology (small and large animal models tissue studies and efficacy studies). Information on the potential toxicity of BSH and BPA is presented and results of 21 spontaneous tumor bearing dogs that have been treated with BNCT at Brookhaven National Laboratory (BNL) are discussed. Several boron carrying drugs exhibiting good tumor uptake are described. Significant progress in the potential of treating pituitary tumors is presented. Highlights from the First International Workshop on Accelerator-Based Neutron Sources for BNCT are included. Selected papers have been indexed separately for inclusion in the Energy Science and Technology Database.

  7. “Sequential” Boron Neutron Capture Therapy (BNCT): A Novel Approach to BNCT for the Treatment of Oral Cancer in the Hamster Cheek Pouch Model

    Energy Technology Data Exchange (ETDEWEB)

    Ana J. Molinari; Emiliano C. C. Pozzi; Andrea Monti Hughes; Elisa M. Heber; Marcela A. Garabalino; Silvia I. Thorp; Marcelo Miller; Maria E. Itoiz; Romina F. Aromando; David W. Nigg; Jorge Quintana; Gustavo A. Santa Cruz; Veronica A. Trivillin; Amanda E. Schwint

    2011-04-01

    In the present study we evaluated the therapeutic effect and/or potential radiotoxicity of the novel “Tandem” Boron Neutron Capture Therapy (T-BNCT) for the treatment of oral cancer in the hamster cheek pouch model at RA-3 Nuclear Reactor. Two groups of animals were treated with “Tandem BNCT”, i.e. BNCT mediated by boronophenylalanine (BPA) followed by BNCT mediated by sodium decahydrodecaborate (GB-10) either 24 h (T-24h-BNCT) or 48 h (T-48h-BNCT) later. A total tumor dose-matched single application of BNCT mediated by BPA and GB-10 administered jointly [(BPA + GB-10)-BNCT] was administered to an additional group of animals. At 28 days post-treatment, T-24h-BNCT and T-48h-BNCT induced, respectively, overall tumor control (OTC) of 95% and 91%, with no statistically significant differences between protocols. Tumor response for the single application of (BPA + GB-10)-BNCT was 75%, significantly lower than for T-BNCT. The T-BNCT protocols and (BPA + GB-10)-BNCT induced reversible mucositis in dose-limiting precancerous tissue around treated tumors, reaching Grade 3/4 mucositis in 47% and 60% of the animals respectively. No normal tissue radiotoxicity was associated to tumor control for any of the protocols. “Tandem” BNCT enhances tumor control in oral cancer and reduces or, at worst, does not increase, mucositis in dose-limiting precancerous tissue.

  8. Intra-operative nuclear imaging based on positron-emitting radiotracers

    International Nuclear Information System (INIS)

    Shakir, Dzhoshkun Ismail

    2014-01-01

    Positron-emitting radiotracers are an important part of nuclear medical imaging processes. Besides the very famous glucose analog [ 18 F]FDG, many not so well known ones exist, among them the particularly interesting amino acid-based tracers like [ 18 F]FET. Although peri-operative imaging with positron-emitting radiotracers has become state-of- the-art in cases of many types of cancer, their capability is not fully exploited in the operating room yet. In this thesis we explore two intra-operative nuclear imaging modalities exploiting different aspects of positron radiation towards quality assurance in challenging surgical treatment scenarios. The first modality freehand PET provides a tomographic image of a volume of interest and aims at minimizing invasiveness by assisting the surgeon in pinpointing target structures marked with a radiotracer. The second imaging modality epiphanography generates an image of the radiotracer distribution on a surface of interest and aims at providing a means for improving the control of tumor resection margins. The word epiphanography is a compound of the Greek words επιφανεια (epiphaneia) for surface and ζωγραφια (ographia) for image, and hence means the image of the surface similar to the compound τομοζ (tomos) for slice/volume and ζωγραφια (ographia) for image, meaning the image of the volume, i.e. tomography. To our knowledge this is the first use of the word epiphanography in the context of nuclear medical imaging. In this thesis we present our approach to modeling, developing and calibrating these two novel imaging modalities. In addition, we present our work towards their clinical integration. In the case of freehand PET, we have already acquired the first intra-operative datasets of a patient. We present this first experience in the operating room together with our phantom studies. In the case of epiphanography, we present our phantom studies with neurosurgeons towards the integration of this

  9. The studsvik BNCT project: structure and the proposed protocols

    International Nuclear Information System (INIS)

    Capala, J.; Stenstam, B.H.; Skoeld, K.; Henriksson, R.; Salford, L.; Carlsson, J.

    2000-01-01

    The BNCT facility at Studsvik is now ready for clinical trials. Scientific operations of the Studsvik BNCT project are overseen by the Scientific Advisory Board comprised of representatives of all major universities in Sweden. Furthermore, special task groups for clinical and preclinical studies have been formed to facilitate collaboration with academia and to assure the quality of the research. Proposed clinical Phase II trials for glioblastoma are sponsored by the Swedish National Neuro-Oncology Group and, initially, will involve two protocols: Protocol no.1. BNCT for glioblastoma patients who have not received any therapy other than surgery (including stereotactic biopsy only). Protocol no.2. BNCT as a palliative treatment for patients with recurrent glioblastoma following conventional therapies or BNCT. In both protocols, BPA, administered by a 6 hour i.v. infusion, will be used as the boron delivery agent. (author)

  10. Neutron beams implemented at nuclear research reactors for BNCT

    Science.gov (United States)

    Bavarnegin, E.; Kasesaz, Y.; Wagner, F. M.

    2017-05-01

    This paper presents a survey of neutron beams which were or are in use at 56 Nuclear Research Reactors (NRRs) in order to be used for BNCT, either for treatment or research purposes in aspects of various combinations of materials that were used in their Beam Shaping Assembly (BSA) design, use of fission converters and optimized beam parameters. All our knowledge about BNCT is indebted to researches that have been done in NRRs. The results of about 60 years research in BNCT and also the successes of this method in medical treatment of tumors show that, for the development of BNCT as a routine cancer therapy method, hospital-based neutron sources are needed. Achieving a physical data collection on BNCT neutron beams based on NRRs will be helpful for beam designers in developing a non-reactor based neutron beam.

  11. Lymphoscintigraphy and intra-operative gamma probe in detection of sentinel lymph node for breast cancer surgery

    International Nuclear Information System (INIS)

    Le Ngoc Ha; Le Manh Ha; Bui Quang Bieu

    2011-01-01

    Sentinel lymph node biopsy (SLNB) has been emerged as a highly accurate method of axillary staging in management of breast cancer patients. Sentinel lymph node detection (SLND) by lymphoscintigraphy and intra-operative gamma probe for SLNB have been widely used in the world. Objectives: the purpose of our study was to evaluate the result of techniques using lymphoscintigraphy and intra-operative gamma probe for SLND in breast carcinoma patients. Materials and Methods: 102 patients with early breast carcinoma were enrolled in the study. Lymphoscintigraphy using Tc-99m-human serum albumin colloid, intra-operative gamma probe were undergone for localization and SLNB. Total axillary lymph node was dissected in breast cancer surgery. Results: The success rate of lymphoscintigraphy and SLND was 98.0% (100/102 patients), mean number of sentinel lymph node (SLN)/patient was 1.56 ± 0.79 (ranged 1 - 3), number of lymphatic vessel/SLN was 1.5 ± 0.69 (ranged 1 - 4) and mean time for SLND on lymphoscintigraphy was 4.21 ± 13.4 minutes (2 - 15 minutes). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of radio-guided SLNB for axillary staging was 100%, 70.6%, 41.2%, 100% and 75.6 % respectively. Conclusions: radio-guided SLNB by lymphoscintigraphy and intra-operative gamma probe is feasible and reliable for axillary staging in early breast carcinoma patients. (author)

  12. The ultrastructure of tumor cells in patients with rectal cancer after pre-operative irradiation and intra-operative cryotherapy

    International Nuclear Information System (INIS)

    Vyinnik, Yu.O.; Kotenko, O.Je.; Nevzorov, V.P.; Chyibyisov, L.P.

    2000-01-01

    Electronic microscopy of the tumor cells was performed to confirm the efficacy of combined pre-operative gamma-therapy and intraoperative cryotherapy (CT). Pre-operative irradiation at the dose of 20 Gy accompanied by intra-operative cryotherapy caused the changes in the ultrastructure, the depth and degree of which allow to consider them destructive and irreversible

  13. Intra-operative warming with a forced-air warmer in preventing hypothermia after tourniquet deflation in elderly patients.

    Science.gov (United States)

    Kim, Y-S; Jeon, Y-S; Lee, J-A; Park, W-K; Koh, H-S; Joo, J-D; In, J-H; Seo, K-W

    2009-01-01

    This randomized, single-blind study aimed to explore the effects of intra-operative warming with a forced-air warmer in the prevention of hypothermia after tourniquet deflation in elderly patients undergoing unilateral total knee replacement arthroplasty under general anaesthesia. Patients were randomized to receive either intra-operative warming using a forced-air warmer with an upper body blanket (warming group; n = 12) or no intra-operative warming (nonwarming group; n = 12). Oesophageal temperature was measured as core body temperature. At 30 min following tourniquet inflation, the core body temperature started to increase in the warming group whereas it continued to drop in the non-warming group. This difference was statistically significant. The final core body temperature after tourniquet deflation was significantly higher in the warming group (mean +/- SD 36.1 +/- 0.2 degrees C) than in the non-warming group (35.4 +/- 0.3 degrees C). Intra-operative forced-air warming increased the core body temperature before tourniquet deflation and prevented subsequent hypothermia in elderly patients under general anaesthesia.

  14. Effects of intra-operative fluoroscopic 3D-imaging on peri-operative imaging strategy in calcaneal fracture surgery

    NARCIS (Netherlands)

    M.S.H. Beerekamp (Suzan); Backes, M. (M.); N.W.L. Schep (Niels); D.T. Ubbink (Dirk); J.S.K. Luitse; T. Schepers (Tim); J.C. Goslings (Carel)

    2017-01-01

    textabstractIntroduction: Previous studies demonstrated that intra-operative fluoroscopic 3D-imaging (3D-imaging) in calcaneal fracture surgery is promising to prevent revision surgery and save costs. However, these studies limited their focus to corrections performed after 3D-imaging, thereby

  15. Intra-operative ex vivo photoacoustic nodal staging in a rat model using a clinical superparamagnetic iron oxide nanoparticle dispersion

    NARCIS (Netherlands)

    Grootendorst, D.J.; Fratila, R.M.; Visscher, M.; Haken, B.T.; Wezel, R.J.A. van; Rottenberg, S.; Steenbergen, W. van; Manohar, S.; Ruers, T.J.M.

    2013-01-01

    The ability to accurately detect tumor metastases in lymph nodes is essential for intra-operative staging of various malignancies. Histopathological assessment of nodes has the drawback of a time delay before results are available to the surgeon and a likelihood of missing metastases. Photoacoustic

  16. Intra-operative ex vivo photoacoustic nodal staging in a rat model using a clinical superparamagnetic iron oxide nanoparticle dispersion

    NARCIS (Netherlands)

    Grootendorst, Diederik; Fratila, R.M.; Visscher, M.; ten Haken, Bernard; van Wezel, Richard Jack Anton; Rottenberg, S.; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J.M.

    The ability to accurately detect tumor metastases in lymph nodes is essential for intra-operative staging of various malignancies. Histopathological assessment of nodes has the drawback of a time delay before results are available to the surgeon and a likelihood of missing metastases. Photoacoustic

  17. Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

    Science.gov (United States)

    Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

    2017-10-01

    In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

  18. Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

    Science.gov (United States)

    Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

    2017-12-01

    3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

  19. Scintigraphic techniques in primary hyperparathyroidism: from pre-operative localisation to intra-operative imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rubello, Domenico [S. Maria della Misericordia Hospital, Service of Nuclear Medicine, Rovigo (Italy); Gross, Milton D. [Department of Veterans Affairs Health System, Nuclear Medicine Service, Ann Arbor, MI (United States); Mariani, Giuliano [University of Pisa, Regional Center of Nuclear Medicine, Pisa (Italy); Al-Nahhas, Adil [Hammersmith Hospital, Department of Nuclear Medicine, London (United Kingdom)

    2007-06-15

    Primary hyperparathyroidism (PHPT) is an increasingly diagnosed disease worldwide. In most cases, PHPT is related to the presence of a solitary parathyroid adenoma (PA). Fifty percent or more of newly diagnosed PHPT patients are asymptomatic, and there is debate among endocrinologists and endocrine surgeons about whether or not such patients should be treated. Usually, in a PHPT patient with a solitary PA that is well localised pre-operatively, a parathyroidectomy with limited or minimally invasive neck exploration is offered. The diffusion of minimally invasive neck exploration procedures is a consequence of the significant improvement in the accuracy of pre-operative imaging (mainly scintigraphic) techniques; these techniques have changed the surgical strategy to PHPT, from the wide traditional bilateral neck exploration to limited neck exploration. The present review considers developments during the past 10-15 years with regard to both the accuracy of pre-operative localising imaging techniques and intra-operative minimally invasive procedures in order to provide endocrinologists and endocrine surgeons with further information about the newly available diagnostic and therapeutic tools for use in PHPT patients with a solitary PA. (orig.)

  20. Photo-acoustic imaging of blue nanoparticle targeted brain tumor for intra-operative glioma delineation

    Science.gov (United States)

    Ray, Aniruddha; Wang, Xueding; Koo Lee, Yong-Eun; Hah, HoeJin; Kim, Gwangseong; Chen, Thomas; Orrienger, Daniel; Sagher, Oren; Kopelman, Raoul

    2011-07-01

    Distinguishing the tumor from the background neo-plastic tissue is challenging for cancer surgery such as surgical resection of glioma. Attempts have been made to use visible or fluorescent markers to delineate the tumors during surgery. However, the systemic injection of the dyes requires high dose, resulting in negative side effects. A novel method to delineate rat brain tumors intra-operatively, as well as post-operatively, using a highly sensitive photoacoustic imaging technique enhanced by tumor targeting blue nanoparticle as contrast agent is demonstrated. The nanoparticles are made of polyacrylamide (PAA) matrix with covalently linked Coomassie-Blue dye. They contain 7.0% dye and the average size is 80nm. Their surface was conjugated with F3 peptide for active tumor targeting. These nanoparticles are nontoxic, chemically inert and have long plasma circulation lifetime, making them suitable as nanodevices for imaging using photoacoustics. Experiments on phantoms and rat brains tumors ex-vivo demonstrate the high sensitivity of photoacoustic imaging in delineating the tumor, containing contrast agent at concentrations too low to be visualized by eye. The control tumors without nanoparticles did not show any enhanced signal. This study shows that photoacoustic imaging facilitated with the nanoparticle contrast agent could contribute to future surgical procedures for glioma.

  1. [Inflammatory pseudotumour of the liver. Importance of intra-operative histopathology].

    Science.gov (United States)

    Onieva-González, Francisco Gabriel; Galeano-Díaz, Francisco; Matito-Díaz, María José; López-Guerra, Diego; Fernández-Pérez, Juana; Blanco-Fernández, Gerardo

    2015-01-01

    Inflammatory pseudotumour is a rare entity, considered benign, and characterised by inflammatory cell mesenchymal proliferation. The case is presented 70 year-old man with fever of unknown origin syndrome. He was diagnosed with liver abscesses (one segment IV, adjacent to gallbladder fundus and segment VI), who progressed slowly after antibiotic treatment. In the absence of a diagnosis, although fine needle puncture-aspiration and different imaging tests were performed, elective surgery was decided. The intra-operative histopathology reported the existence of an inflammatory pseudotumour. Inflammatory pseudotumours are clinically classified into different types according to their aetiology, varying therapeutic management based on the same. It is very difficult to diagnose because of the absence of symptoms, blood disorders, or specific radiological findings. Definitive diagnosis often requires histopathological confirmation, in most cases by percutaneous liver puncture, but sometimes exploratory laparotomy or even performing a hepatectomy for confirmation is necessary. The natural history of inflammatory pseudotumour is its regression; thus conservative management may be used through regular checks until resolution, or can be treated with antibiotics, anti-inflammatories and even corticosteroids. Surgical resection is indicated for persistent unresolved systemic symptoms despite medical treatment, in those situations where growth is evident, with or without symptoms, when involving the hepatic hilum, and finally, in case where the possibility of malignancy cannot be ruled out. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  2. Intra-operative radiation therapy with laser-accelerated carbon ions

    Science.gov (United States)

    Mur, P.; Bellido, P.; Seimetz, M.; Lera, R.; Ruiz-de la Cruz, A.; Galán, M.; Roso, L.; Sánchez, F.; Benlloch, J. M.

    2017-03-01

    Laser accelerators have long been proposed as beam source for hadron therapy. However, the high energies necessary for the treatment of deep-lying tumours, combined with stringent requirements on the beam quality, are still a severe challenge. In the present work, we discuss the applicability of laser-accelerated carbon ions at moderate energies (100-480 MeV) to the irradiation of superficial lesions. We propose a new therapeutic modality which combines the versatility of Intra-Operative Radiation Therapy with the advantages of carbon ions as compared to photon and electron radiation. To justify this idea a feasibility study has been carried out, focused on the uniformity of dose deposition inside the treatment volume. Physical and biological aspects characteristic to laser-accelerated carbon ion beams are considered. A GATE simulation has been performed, showing an approximately uniform depth-dose profile up to a maximum penetration depth of 5 mm for a single radiation boost of 10 GyE.

  3. Effect of intra-operative glove changing during cesarean section on post-operative complications: a randomized controlled trial.

    Science.gov (United States)

    Scrafford, Jonathan D; Reddy, Buvana; Rivard, Colleen; Vogel, Rachel Isaksson

    2018-03-19

    To compare the rates of wound-related complications among women undergoing a cesarean section when the surgical team used intra-operative glove changing versus usual care. All women undergoing a cesarean section at a single, county hospital were randomized to usual care or intra-operative glove changing prior to abdominal closure. Participants were randomized at the time of decision for cesarean section; surgeons were not blinded to the randomization arm. The primary outcome was any wound-related complication, including wound hematoma, seroma, skin separation of at least 1 cm, wound infection, or other incisional abnormality requiring treatment within 8 weeks of surgery. To detect a reduction in the primary outcome from 17% in the control group to 9% in the intervention group with 80% power, a total of 554 women (277 per group) were required. Secondary outcomes included other infectious complications including endometritis and other superficial or deep soft tissue infections. From August 2015 to November 2016, 277 women were randomized to usual care and 276 women were randomized to intra-operative glove changing. The two groups were well balanced in terms of demographic data, comorbid conditions and surgical characteristics. Intra-operative glove changing led to a significant decrease in composite wound complications from 13.6% in the control group to 6.4% in the intervention group (p = 0.008). Intra-operative glove changing prior to abdominal closure during cesarean section significantly reduced the incidence of post-operative wound complications.

  4. Agreement between pre-operative and intra-operative bacteriological samples in 85 chronic peri-prosthetic infections.

    Science.gov (United States)

    Matter-Parrat, V; Ronde-Oustau, C; Boéri, C; Gaudias, J; Jenny, J-Y

    2017-04-01

    Whether pre-operative microbiological sampling contributes to the management of chronic peri-prosthetic infection remains controversial. We assessed agreement between the results of pre-operative and intra-operative samples in patients undergoing single-stage prosthesis exchange to treat chronic peri-prosthetic infection. Agreement between pre-operative and intra-operative samples exceeds 75% in patients undergoing single-stage exchange of a hip or knee prosthesis to treat chronic peri-prosthetic infection. This single-centre retrospective study included 85 single-stage prosthesis exchange procedures in 82 patients with chronic peri-prosthetic infection at the hip or knee. Agreement between pre-operative and intra-operative sample results was evaluated. Changes to the initial antibiotic regimen made based on the intra-operative sample results were recorded. Of 149 pre-operative samples, 109 yielded positive cultures, in 75/85 cases. Of 452 intra-operative samples, 354 yielded positive cultures, in 85/85 cases. Agreement was complete in 54 (63%) cases and partial in 9 (11%) cases; there was no agreement in the remaining 22 (26%) cases. The complete agreement rate was significantly lower than 75% (P=0.01). The initial antibiotic regimen was inadequate in a single case. Pre-operative sampling may contribute to the diagnosis of peri-prosthetic infection but is neither necessary nor sufficient to confirm the diagnosis and identify the causative agent. The spectrum of the initial antibiotic regimen cannot be safely narrowed based on the pre-operative sample results. We suggest the routine prescription of a probabilistic broad-spectrum antibiotic regimen immediately after the prosthesis exchange, even when a pathogen was identified before surgery. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Carborane-containing metalloporphyrins for BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Miura, Michiko; Joel, D.D.; Nawrocky, M.M.; Micca, P.L. [and others

    1996-12-31

    For BNCT of malignant brain tumors, it is crucial that there be relatively high boron concentrations in tumor compared with normal tissues within the neutron-irradiated treatment volume. Fairchild and Bond estimated that major advances in BNCT should be possible if ratios of {sup 10}B concentrations in tumor to those in normal tissue (e.g. brain and blood) were at least 5: 1. Given that the only current boron carrier being tested clinically in the U.S., p-boronophenyl-alanine[BPA], yields tumor blood and tumor brain ratios of about 3:1, the criteria for new boronated compounds should be to at least match these ratios and maintain tumor boron concentrations greater than 30 {mu}g B/g. Although previously tested boronated porphyrins have not only matched but surpassed these ratios, it was at a cost of greater toxicity. Chemical and hematological assays of blood analytes; showed marked thrombocytopenia, a decrease to about one-tenth the normal concentration of platelets circulating in the blood, in addition to abnormalities in concentrations of circulating enzymes, that indicated liver toxicity. The physical appearance and behavior of the affected mice were different from those of mice injected with solvent only. Although thrombocytopenia and other toxic effects had disappeared after a few days, previously tested porphyrins would not be safe to infuse into patients for BNCT of potentially hemorrhagic malignant tumors in the brain such as glioblastoma multiforme and metastatic melanoma. We synthesized a different boronated porphyrin, tetracarboranylphenylporphyrin, [TCP] and inserted nickel, copper, or manganese into its coordination center. Biological studies of NiTCP in mice and of CuTCP in rats show that these compounds elicit little or no toxicity when given at potentially therapeutic doses.

  6. Clinical practice in BNCT to the brain

    International Nuclear Information System (INIS)

    Nakagawa, Y.

    2001-01-01

    Our concept of Boron Neutron Capture Therapy (BNCT) is to selectively destroy tumour cells using the high LET particles yielded from the 10B(n,α)7Li reactions. The effort of clinical investigators has concentrated on how to escalate the radiation dose at the target point. BNCT in Japan combines thermal neutrons and BSH (Na 2 B 12 H 11 SH). The radiation dose is determined by the neutron fluence at the target point and the boron concentration in the tumour tissue. According to the recent analysis, the ratio of boron concentration (BSH) in tumour tissue and blood is nearly stable at around 1.2 to 1.69. Escalation of the radiation dose was carried out by means of improving the penetration of the thermal neutron beam. Since 1968, 175 patients with glioblastoma (n=83), anaplastic astrocytoma (n=44), low grade astrocytoma (n=16) or other types of tumour (n=32) were treated by BNCT at 5 reactors (HTR n=13, JRR-3 n=1, MulTR n=98, KUR n=30, JRR-2 n=33). The retrospective analysis revealed that the important factors related to the clinical results and QOL of the patients were minimum tumour volume radiation dose, more than 18Gy of physical dose and maximum vascular radiation dose (less than 15Gy) in the normal cortex. We have planned several trials to escalate the target radiation dose. One trial makes use of a cavity in the cortex following debulking surgery of the tumour tissue to improve neutron penetration. The other trial is introduction of epithermal neutron. KUR and JRR-4 were reconstructed and developed to be able to irradiate using epithermal neutrons. The new combination of surgical procedure and irradiation using epithermal neutrons should remarkably improve the target volume dose compared to the radiation dose treated by thermal neutrons. (author)

  7. Carborane-containing metalloporphyrins for BNCT

    International Nuclear Information System (INIS)

    Miura, Michiko; Joel, D.D.; Nawrocky, M.M.; Micca, P.L.

    1996-01-01

    For BNCT of malignant brain tumors, it is crucial that there be relatively high boron concentrations in tumor compared with normal tissues within the neutron-irradiated treatment volume. Fairchild and Bond estimated that major advances in BNCT should be possible if ratios of 10 B concentrations in tumor to those in normal tissue (e.g. brain and blood) were at least 5: 1. Given that the only current boron carrier being tested clinically in the U.S., p-boronophenyl-alanine[BPA], yields tumor blood and tumor brain ratios of about 3:1, the criteria for new boronated compounds should be to at least match these ratios and maintain tumor boron concentrations greater than 30 μg B/g. Although previously tested boronated porphyrins have not only matched but surpassed these ratios, it was at a cost of greater toxicity. Chemical and hematological assays of blood analytes; showed marked thrombocytopenia, a decrease to about one-tenth the normal concentration of platelets circulating in the blood, in addition to abnormalities in concentrations of circulating enzymes, that indicated liver toxicity. The physical appearance and behavior of the affected mice were different from those of mice injected with solvent only. Although thrombocytopenia and other toxic effects had disappeared after a few days, previously tested porphyrins would not be safe to infuse into patients for BNCT of potentially hemorrhagic malignant tumors in the brain such as glioblastoma multiforme and metastatic melanoma. We synthesized a different boronated porphyrin, tetracarboranylphenylporphyrin, [TCP] and inserted nickel, copper, or manganese into its coordination center. Biological studies of NiTCP in mice and of CuTCP in rats show that these compounds elicit little or no toxicity when given at potentially therapeutic doses

  8. INEL BNCT Research Program annual report, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R. [ed.

    1993-05-01

    This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1992. Contributions from all the principal investigators about their individual projects are included, specifically, chemistry (pituitary tumor targeting compounds, boron drug development including liposomes, lipoproteins, and carboranylalanine derivatives), pharmacology (murine screenings, toxicity testing, inductively coupled plasma-atomic emission spectroscopy (ICP-AES) analysis of biological samples), physics (radiation dosimetry software, neutron beam and filter design, neutron beam measurement dosimetry), and radiation biology (small and large animal models tissue studies and efficacy studies). Information on the potential toxicity of borocaptate sodium and boronophenylalanine is presented, results of 21 spontaneous-tumor-bearing dogs that have been treated with BNCT at the Brookhaven National Laboratory (BNL) Medical Research Reactor (BMRR) are discussed, and predictions for an epithermal-neutron beam at the Georgia Tech Research Reactor (GTRR) are shown. Cellular-level boron detection and localization by secondary ion mass spectrometry, sputter-initiated resonance ionization spectroscopy, low atomization resonance ionization spectroscopy, and alpha track are presented. Boron detection by ICP-AES is discussed in detail. Several boron carrying drugs exhibiting good tumor uptake are described. Significant progress in the potential of treating pituitary tumors with BNCT is presented. Measurement of the epithermal-neutron flux at BNL and comparison to predictions are shown. Calculations comparing the GTRR and BMRR epithermal-neutron beams are also presented. Individual progress reports described herein are separately abstracted and indexed for the database.

  9. INEL BNCT Research Program annual report, 1992

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1993-05-01

    This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1992. Contributions from all the principal investigators about their individual projects are included, specifically, chemistry (pituitary tumor targeting compounds, boron drug development including liposomes, lipoproteins, and carboranylalanine derivatives), pharmacology (murine screenings, toxicity testing, inductively coupled plasma-atomic emission spectroscopy (ICP-AES) analysis of biological samples), physics (radiation dosimetry software, neutron beam and filter design, neutron beam measurement dosimetry), and radiation biology (small and large animal models tissue studies and efficacy studies). Information on the potential toxicity of borocaptate sodium and boronophenylalanine is presented, results of 21 spontaneous-tumor-bearing dogs that have been treated with BNCT at the Brookhaven National Laboratory (BNL) Medical Research Reactor (BMRR) are discussed, and predictions for an epithermal-neutron beam at the Georgia Tech Research Reactor (GTRR) are shown. Cellular-level boron detection and localization by secondary ion mass spectrometry, sputter-initiated resonance ionization spectroscopy, low atomization resonance ionization spectroscopy, and alpha track are presented. Boron detection by ICP-AES is discussed in detail. Several boron carrying drugs exhibiting good tumor uptake are described. Significant progress in the potential of treating pituitary tumors with BNCT is presented. Measurement of the epithermal-neutron flux at BNL and comparison to predictions are shown. Calculations comparing the GTRR and BMRR epithermal-neutron beams are also presented. Individual progress reports described herein are separately abstracted and indexed for the database

  10. Protecting Patients from an Unsafe System: The Etiology & Recovery of Intra-Operative Deviations in Care

    Science.gov (United States)

    Hu, Yue-Yung; Arriaga, Alexander F.; Roth, Emilie M.; Peyre, Sarah E.; Corso, Katherine A.; Swanson, Richard S.; Osteen, Robert T.; Schmitt, Pamela; Bader, Angela M.; Zinner, Michael J.; Greenberg, Caprice C.

    2012-01-01

    Objective To understand the etiology and resolution of unanticipated events in the operating room (OR). Background The majority of surgical adverse events occur intra-operatively. The OR represents a complex, high-risk system. The influence of different human, team, and organizational/environmental factors on safety and performance is unknown. Methods We video-recorded and transcribed 10 high-acuity operations, representing 43.7 hours of patient care. Deviations, defined as delays and/or episodes of decreased patient safety, were identified by majority consensus of a multidisciplinary team. Factors that contributed to each event and/or mitigated its impact were determined and attributed to the patient, providers, or environment/organization. Results Thirty-three deviations (10 delays, 17 safety compromises, 6 both) occurred – with a mean of one every 79.4 minutes. These deviations were multifactorial (mean 3.1 factors). Problems with communication and organizational structure appeared repeatedly at the root of both types of deviations. Delays tended to be resolved with vigilance, communication, coordination, and cooperation, while mediation of safety compromises was most frequently accomplished with vigilance, leadership, communication, and/or coordination. The organization/environment was not found to play a direct role in compensation. Conclusions Unanticipated events are common in the OR. Deviations result from poor organizational/environmental design and suboptimal team dynamics, with caregivers compensating to avoid patient harm. While recognized in other high risk domains, such human resilience has not yet been described in surgery and has major implications for the design of safety interventions. PMID:22750753

  11. Radiation protection for an intra-operative X-ray device.

    Science.gov (United States)

    Eaton, D J; Gonzalez, R; Duck, S; Keshtgar, M

    2011-11-01

    Therapeutic partial breast irradiation can be delivered intra-operatively using the Intrabeam 50 kVp compact X-ray device. Spherical applicators are added to the source to give an isotropic radiation dose. The low energy of this unit leads to rapid attenuation with distance, but dose rates are much greater than for diagnostic procedures. To investigate the shielding requirements for this unit, attenuation measurements were carried out with manufacturer-provided tungsten-rubber sheets, lead, plasterboard and bricks. A prospective environmental dose rate survey was also conducted in the designated theatre. As a result of isotropic geometry, the scattered dose around shielding can be 1% of primary and thus often dominates measured dose rates compared with transmission. The absorbed dose rate of the unshielded source at 1 m was 11.6 mGy h(-1) but this was reduced by 95% with the shielding sheets. Measured values for the common shielding materials were similar to reference data for the attenuation of a 50 kVp diagnostic X-ray beam. Two lead screens were constructed to shield operators remaining in the theatre and an air vent into a service corridor. A lead apron would also provide suitable attenuation, although a screen allows greater flexibility for treatment operators. With these measures, staff doses were reduced to negligible quantities. Survey measurements taken during patient treatments confirmed no additional measures were required, but the theatre should be a controlled area and access restricted. Results from this study and reference data can be used for planning other facilities.

  12. High-dose rate intra-operative radiation therapy for local advanced and recurrent colorectal cancer

    International Nuclear Information System (INIS)

    Harrison, L.B.; Mychalczak, B.; Enker, W.; Anderson, L.; Cohen, A.E.; Minsky, B.

    1996-01-01

    In an effort to improve the local control for advanced and recurrent cancers of the rectum, we have integrated high-dose rate intra-operative radiation therapy (HDR-IORT) into the treatment program. Between 11/92 and 10/95, 47 patients (pts) were treated. There were 26 males and 21 females whose ages ranged from 30-80 (median = 62) years. There were 19 pts with primary unresectable rectal cancer, and 28 pts who were treated for recurrent rectal cancer. Histology was adenocarcinoma - 45 pts, squamous cancer - 2 pts. The range of follow-up is 1-34 months (median = 14 months). The majority of primary unresectable pts received pre-operative radiation therapy (4500-5040 cGy) with chemotherapy (5-FU with Leucovorin) 4-6 weeks later, they underwent resection + HDR-IORT (1200 cGy). For the 28 pts with recurrent cancer, the majority received surgery and HDR-IORT alone because they had received prior RT. For the pts with primary unresectable disease, actuarial 2-year local control was 77%, actuarial distant metastasis-free survival was 71%, disease free survival was 66%, and overall survival was 84%. For those pts with recurrent disease, actuarial 2-year local control rate was 65%, distant metastasis-free survival was 65%, disease free survival was 47%, and overall survival was 61%. Complications occurred in 36%. There were no cases where the anatomical distribution of disease, or technical limitations prevented the adequate delivery of HDR-IORT. We conclude that this technique was most versatile, and enabled all appropriate pts to receive IORT. The preliminary data in terms of local control are encouraging, even for the poor prognostic sub-group of pts with recurrent cancer

  13. A novel intra-operative positron imager for rapid localization of tumor margins

    Science.gov (United States)

    Sabet, Hamid; Stack, Brendan C.; Nagarkar, Vivek V.

    2014-03-01

    We have developed an intra-operative and compact imaging tool for surgeons to detect PET- positive lesions. Currently, most such probes on the market are non-imaging, and provide no ancillary information of surveyed areas, such as clear delineations of malignant tissues. Our probe consists of a novel hybrid scintillator coupled to a compact silicon photomultiplier (SiPM) array with associated front-end electronics encapsulated in an ergonomic housing. Pulse shape discrimination electronics has been implemented and integrated into the downstream data acquisition system. The hybrid scintillator consists of a 0.4 mm thick layer of CsI:Tl scintillator coupled to a 1 mm thick LYSO crystal. To achieve high spatial resolution, CsI:Tl is pixelated to 0.5×0.5 mm2 pixels using laser ablation technique. While CsI:Tl act as beta-sensitive scintillator, LYSO senses the gamma radiation and can be used to navigate the probe to the locations of interest. The gamma response is also subtracted from the beta image for improved SNR and contrast. To achieve accurate centroid position estimation and uniform beta sensitivity over the entire imaging area, the LYSO thickness is optimized such that it acts as scintillation light diffuser by spreading CsI:Tl light over multiple SiPM pixels. The results show that the response of the two scintillators exposed to radiation could be easily distinguished based on their pulse shapes. The probe's spatial resolution is beta radiation even in presence of strong gamma background.

  14. Dose optimization of intra-operative high dose rate interstitial brachytherapy implants for soft tissue sarcoma

    Directory of Open Access Journals (Sweden)

    Jamema Swamidas

    2009-01-01

    Full Text Available Objective : A three dimensional (3D image-based dosimetric study to quantitatively compare geometric vs. dose-point optimization in combination with graphical optimization for interstitial brachytherapy of soft tissue sarcoma (STS. Materials and Methods : Fifteen consecutive STS patients, treated with intra-operative, interstitial Brachytherapy, were enrolled in this dosimetric study. Treatment plans were generated using dose points situated at the "central plane between the catheters", "between the catheters throughout the implanted volume", at "distances perpendicular to the implant axis" and "on the surface of the target volume" Geometrically optimized plans had dose points defined between the catheters, while dose-point optimized plans had dose points defined at a plane perpendicular to the implant axis and on the target surface. Each plan was graphically optimized and compared using dose volume indices. Results : Target coverage was suboptimal with coverage index (CI = 0.67 when dose points were defined at the central plane while it was superior when the dose points were defined at the target surface (CI=0.93. The coverage of graphically optimized plans (GrO was similar to non-GrO with dose points defined on surface or perpendicular to the implant axis. A similar pattern was noticed with conformity index (0.61 vs. 0.82. GrO were more conformal and less homogeneous compared to non-GrO. Sum index was superior for dose points defined on the surface of the target and relatively inferior for plans with dose points at other locations (1.35 vs. 1.27. Conclusions : Optimization with dose points defined away from the implant plane and on target results in superior target coverage with optimal values of other indices. GrO offer better target coverage for implants with non-uniform geometry and target volume.

  15. Relevance of intra operative radiotherapy in the treatment of uterine carcinoma - Lyon preliminary experience

    International Nuclear Information System (INIS)

    Gerard, J.P.; Braillon, G.; Gilly, F.N.; Romestaing, P.; Sentenac, I.; Rocher, F.P.; Berger, C.; Chipier, V.; Dargent, D.; Chabert, P.; Raudrant, D.; Adeleine, P.

    1994-01-01

    Aim: Retrospective analysis of Intra operative Radiotherapy (IORT) in recurrent uterine carcinoma (RUC) and prospective pilot study of IORT in advanced cervix cancer (ACC) with high risk of local failure. Patients-Treatments: (1) RUC: from 1988 to 1991, 34 patients with RUC have been treated. Primary cancer was: cervix uterus: 28, endometrium: six. Site of recurrence: centro pelvis: four, latero pelvis: 25, lombo aortic: five. Total gross resection was only possible in 12 patients. A dose of 15 to 22 Gy was given by IORT according to the residual tumour size. External beam irradiation was added in 16 patients; (2) ACC: January 1991 to November 1992, 20 patients were included in this pilot study, stage IIB: seven, stage III: 12, stage IV: 1. Preoperative retroperitoneal pelviscopy showed 13 pN1 patients and NMR imaging ten tumours of 6 cm or larger in diameter. Treatment started with concomitant pelvic irradiation (44 Gy) and one concomitant cycle of 5 Fu-CDDP, followed by a short course of high dose rate upper vagina brachytherapy (4Gy). Four weeks later a radical Wertheim operation was performed together with IORT on the lateral pelvis. Results: (1) RUC: overall survival (Kaplan Meier) at 4 years is 32% (±8). Local relapse in the field of IORT was observed in six patients. Grade 2-3 complications: six patients (radiation proctitis, neuritis, vertebral collapse, ureteral stenosis); (2) ACC: the median follow up is short (18 months). Four cases of pelvic relapse, no postoperative death. The first line radio chemotherapy was associated with two G3 early complications. Postoperative radiation complication was less than 10% G3. Discussion: promising results of IORT in RUC have been observed especially if no irradiation is given during the primary treatment. Good feasibility of the pilot study of IORT in ACC was also observed. It could be followed by a multicentric feasibility trial. (authors). 38 refs., 4 tabs., 1 fig

  16. Intra-operative parathyroid hormone monitoring through central laboratory is accurate in renal secondary hyperparathyroidism.

    Science.gov (United States)

    Vulpio, Carlo; Bossola, Maurizio; Di Stasio, Enrico; Pepe, Gilda; Nure, Eda; Magalini, Sabina; Agnes, Salvatore

    2016-05-01

    The usefulness, the methods and the criteria of intra-operative monitoring of the parathyroid hormone (ioPTH) during parathyroidectomy (PTX) for renal secondary hyperparathyroidism (rSHPT) in patients on chronic hemodialysis remain still matter of debate. The present study aimed to evaluate the ability of a low cost central-laboratory second generation PTH assay to predict an incomplete resection of parathyroid glands (PTG). The ioPTH decay was determined In 42 consecutive patients undergoing PTX (15 subtotal and 27 total without auto-transplant of PTG) for rSHPT. The ioPTH monitoring included five samples: pre-intubation, post-manipulation of PTG and at 10, 20 and 30min post-PTG excision. The patients with PTH exceeding the normal value (65pg/ml) at the first postoperative week, 6 and 12months were classified as persistent rSHPT. The concentrations of ioPTH declined significantly over time in patients who received total or subtotal PTX; however, no difference was found between the two types of PTX. Irrespective of the type of PTX and the number of PTG removed, combining the absolute and percentage of ioPTH decay at 30min after PTG excision, we found high sensitivity (100%), specificity (92%), negative predictive value (100%) and accuracy (93%) in predicting the persistence of rSHPT. The monitoring of the ioPTH decline by a low cost central-laboratory second generation assay is extremely accurate in predicting the persistence of disease in patients on maintenance hemodialysis undergoing surgery for rSHPT. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  17. Using the transverse acetabular ligament as a landmark for acetabular anteversion: an intra-operative measurement.

    Science.gov (United States)

    Inoue, Masahiro; Majima, Tokifumi; Abe, Satomi; Nakamura, Takayuki; Kanno, Taiki; Masuda, Takeshi; Minami, Akio

    2013-08-01

    PURPOSE. To measure the transverse acetabular ligament (TAL) anteversion in hips with severe deformity, using fluoroscopy-computed tomographic navigation. METHODS. 31 hips in 10 men and 19 women aged 40 to 78 (mean, 58.7) years who underwent total hip arthroplasty for primary osteoarthritis (n=6) or osteoarthritis secondary to developmental hip dysplasia (n=19) or congenital hip dislocation (n=6) were included. The severity of hip dislocation was classified according to the Crowe classification; 15 hips were grade 1, 7 were grade 2, 3 were grade 3, and 6 were grade 4. The TAL anteversion was measured using fluoroscopy-computed tomographic navigation. The difference in TAL anteversion between non-dislocated hips (Crowe grade 1, n=15) and dislocated hips (Crowe grades 2-4, n=16) was compared. RESULTS. In all 31 hips, the TAL could be visualised intra-operatively. No patient reported severe pain, early wear, loosening, or dislocation after 2 years. The mean TAL anteversion and inclination angles measured by the navigation system were 26.5 (SD, 8.9; range, 8-42) degrees and 41.5 (SD, 4.6; range, 32-49) degrees, respectively. 22 of the 31 hips were in the safe zone. TAL anteversion in non-dislocated and dislocated hips was not significantly different. Inter- and intra-observer mean absolute differences in TAL anteversion were 0.3 and 0.4 degree, respectively. CONCLUSION. The TAL is a useful anatomic landmark for total hip arthroplasty in dislocated hips.

  18. Hemodynamic effects of dexmedetomidine during intra-operative electrocorticography for epilepsy surgery

    Directory of Open Access Journals (Sweden)

    G Chaitanya

    2014-01-01

    Full Text Available Background: Dexmedetomidine, a predominant alpha-2-adrenergic agonist has been used in anesthetic practice to provide good sedation. The drug is being recently used in neuroanesthesia during awake surgery for brain tumors and in functional neurosurgery. Materials and Methods: This prospective study analyzed the hemodynamic effects of dexmedetomidine infusion during electrocorticography in patients undergoing surgery for mesial temporal sclerosis. Dexmedetomidine infusion was administered during intra-operative electrocorticography recording, 15 minutes after the end tidal MAC of N 2 O and isoflurane were decreased to zero. Anesthesia was maintained with O 2 :air mixture = 50:50, vecuronium and fentanyl. Heart rate (HR, mean arterial pressure (MAP and end tidal carbon dioxide (ETCO 2 were recorded across at induction, 2 min prior to dexmedetomidine (PreDEX, 5 min during dexmedetomidine infusion (DEX; 1 μg/kg, 5 min after stopping dexmedetomidine and 10 minutes after stopping dexmedetomidine. Results: Forty patients with mesial temporal sclerosis (M: F = 27:13, mean age = 28.15 ± 10.9 years; duration of epilepsy = 12.0 ± 7.9 years underwent anterior temporal lobe resection with amygdalohippocampectomy for drug-resistant epilepsy. Infusion of dexmedetomidine caused a transient fall in HR in 87.5% of patients and an increase in MAP in 62.5% of patients, which showed a tendency to revert back towards PreDEX values within 10 min after stopping the infusion. Sixty-five percent of the patients showed ≤25% reduction and 10% of them showed >25% reduction in HR. 47.5% of the patients showed ≤25% increase and 15% of them showed >25% increase in MAP. These changes were over a narrow range and within physiological limits. Conclusion: The infusion of dexmedetomidine for a short period causes reduction of HR and increase in MAP in patients, however the variations are within acceptable range.

  19. Imaging of spatially extended hot spots with coded apertures for intra-operative nuclear medicine applications

    Science.gov (United States)

    Kaissas, I.; Papadimitropoulos, C.; Potiriadis, C.; Karafasoulis, K.; Loukas, D.; Lambropoulos, C. P.

    2017-01-01

    Coded aperture imaging transcends planar imaging with conventional collimators in efficiency and Field of View (FOV). We present experimental results for the detection of 141 keV and 122 keV γ-photons emitted by uniformly extended 99mTc and 57Co hot-spots along with simulations of uniformly and normally extended 99mTc hot-spots. These results prove that the method can be used for intra-operative imaging of radio-traced sentinel nodes and thyroid remnants. The study is performed using a setup of two gamma cameras, each consisting of a coded-aperture (or mask) of Modified Uniformly Redundant Array (MURA) of rank 19 positioned on top of a CdTe detector. The detector pixel pitch is 350 μm and its active area is 4.4 × 4.4 cm2, while the mask element size is 1.7 mm. The detectable photon energy ranges from 15 keV up to 200 keV with an energy resolution of 3-4 keV FWHM. Triangulation is exploited to estimate the 3D spatial coordinates of the radioactive spots within the system FOV. Two extended sources, with uniform distributed activity (11 and 24 mm in diameter, respectively), positioned at 16 cm from the system and with 3 cm distance between their centers, can be resolved and localized with accuracy better than 5%. The results indicate that the estimated positions of spatially extended sources lay within their volume size and that neighboring sources, even with a low level of radioactivity, such as 30 MBq, can be clearly distinguished with an acquisition time about 3 seconds.

  20. American brain tumor patients treated with BNCT in Japan

    International Nuclear Information System (INIS)

    Laramore, G.E.; Griffin, B.R.; Spence, A.

    1995-01-01

    The purpose of this work is to establish and maintain a database for patients from the United States who have received BNCT in Japan for malignant gliomas of the brain. This database will serve as a resource for the DOE to aid in decisions relating to BNCT research in the United States, as well as assisting the design and implementation of clinical trials of BNCT for brain cancer patients in this country. The database will also serve as an information resource for patients with brain tumors and their families who are considering this form of therapy

  1. The BNCT project in the Czech Republic

    International Nuclear Information System (INIS)

    Burian, J.; Marek, M.; Rataj, J.; Honova, H.; Petruzelka, L.; Prokes, K.; Tovarys, F.; Dbaly, V.; Honzatko, J.; Tomandl, I.

    2000-01-01

    The start of clinical trials is expected before NCT Osaka 2000. The experiences from different part of project are presented. The BNCT facility at LVR-15 reactor of NRI consists of epithermal neutron beam with improved construction (6.98 x 10 8 /cm 2 s with acceptable background of fast neutrons and gammas) and irradiation and control rooms equipped by appropriate devices. Internationally-recognized software MacNCTPLAN is utilized for computational dosimetry and treatment planning. In the part of protocol the following parameters have been assessed: patient selection, BSH dosage, fractionation, starting dose, dose escalation steps. At the LVR-15, at horizontal channel, a prompt gamma ray analysis (PGRA) system has been developed and is operated for BNCT purposes. Some human blood samples were analyzed and compared with classical ICP method. During the process of licensing the experience was obtained, some notes are discussed in the paper. The first results were received for the study of biological effect of the LVR source for small animal model. (author)

  2. Intra-operative assessment of femoral antetorsion using ISO-C 3D: a cadaver study.

    Science.gov (United States)

    Hawi, Nael; Suero, Eduardo M; Liodakis, Emmanouil; Decker, Sebastian; Krettek, Christian; Citak, Musa

    2014-03-01

    The aim of this study was to check the feasibility and accuracy of measuring antetorsion during surgery using a mobile image intensifier (IF) with computed tomography (CT) function (ISO-C 3D; Siemens, Erlangen, Germany) in comparison to a conventional multi-slice CT scanner (LightSpeed QX/I CT; GE Healthcare, VA, USA). A total of 10 intact femora with intact soft tissue of five fresh frozen cadavers were used. After fixation on a surgical table, IF CT scans of the hip and knee were performed at both 190° and 120° of scanning rotation. Afterwards, a conventional CT scan was performed. Antetorsion was calculated according to the method of Jend et al. Analysis of variance (ANOVA) and Lin's concordance correlation coefficient (LCC) were used to test the agreement between the three measurement techniques. There was no significant difference in femoral antetorsion angle measurements between the different techniques (P>0.05). The mean time required to perform a scan using the ISO-C 3D was 9±3 min. The mean time required to measure antetorsion was 8±2 min. We found a high positive correlation between CT-based measurements and measurements performed using both the ISO-C 3D at 190° (LCC=0.99; mean difference=0.02°±1.8°) and the ISO-C 3D at 120° (LCC=0.99; mean difference=0.6°±1.5°), and a high positive correlation was also seen between both ISO-C 3D methods (LCC=0.99; mean difference=0.6°±1.7°). Measuring femoral antetorsion using an intra-operative IF with CT function is a feasible and accurate method. This technique could be used when there is doubt about the antetorsion angle in the operated femur and it could help decrease the need for a separate revision surgery. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. l-Arginine Pathway Metabolites Predict Need for Intra-operative Shunt During Carotid Endarterectomy.

    Science.gov (United States)

    Szabo, P; Lantos, J; Nagy, L; Keki, S; Volgyi, E; Menyhei, G; Illes, Z; Molnar, T

    2016-12-01

    Asymmetric dimethylarginine (ADMA) inhibits nitric oxide (NO) synthesis and is a marker of atherosclerosis. This study examined the correlation between pre-operative l-arginine and ADMA concentration during carotid endarterectomy (CEA), and jugular lactate indicating anaerobic cerebral metabolism, jugular S100B reflecting blood-brain barrier integrity, and with factors of surgical intervention. The concentration of l-arginine, ADMA, and symmetric dimethylarginine was measured in blood taken under regional anaesthesia from the radial artery of 55 patients prior to CEA. Blood gas parameters, concentration of lactate, and S100B were also serially measured in blood taken from both the radial artery and the jugular bulb before and after carotid clamping, and after release of the clamp. To estimate anaerobic metabolism, the jugulo-arterial ratio of CO 2 gap/oxygen extraction was calculated. Positive correlation was found between pre-operative ADMA levels and the ratio of jugulo-arterial CO 2 gap/oxygen extraction during clamp and reperfusion (p = .005 and p = .01, respectively). An inverse correlation was found between the pre-operative l-arginine concentration and jugular lactate at each time point (both p = .002). The critical pre-operative level of l-arginine was determined by receiver operator curve analysis. If l-arginine was below the cutoff value of 35 μmol/L, jugular S100B concentration was higher 24 h post-operatively (p = .03), and jugular lactate levels were increased during reperfusion (p = .02). The median pre-operative concentration of l-arginine was lower in patients requiring an intra-operative shunt than in patients without need of shunt (median: 30.3 μmol/L [interquartile range 24.4-34.4 μmol/L] vs. 57.6 μmol/L [interquartile range 42.3-74.5 μmol/L]; p = .002). High pre-operative ADMA concentration predicts poor cerebral perfusion indicated by elevated jugulo-arterial CO 2 gap/oxygen extraction. Low pre-operative l

  4. High-dose rate intra-operative radiation therapy for pediatric solid tumors

    International Nuclear Information System (INIS)

    Merchant, T.E.; Zelefsky, M.J.; Sheldon, J.M.; LaQuaglia, M.B.; Harrison, L.B.

    1996-01-01

    Fifteen pediatric patients with solid tumors received treatment on a phase I protocol designed to test the feasibility and safety of high-dose rate intra-operative radiation therapy (IORT) via a remote afterloader. Patients with Ewing's sarcoma (n=5), rhabdomyosarcoma (n=3), soft-tissue sarcoma (n=3), Wilm's tumor (n=2), osteosarcoma, and immature teratoma were included. IORT was used in the initial management of nine patients and at the time of recurrence in six. Indications for treatment included gross residual disease in four and suspected microscopic disease in eleven. The general sites treated were the abdomen (n=3), chest-wall (n=7), and pelvis (n=5). All patients were pre-treated with chemotherapy, four received prior external beam radiation therapy at the IORT site, and eight underwent an attempt at resection prior to the procedure during which IORT was performed. A minimum dose of 1200 cGy was prescribed to a depth of 0.5 cm from a multi-channel tissue-equivalent applicator. Complications ascribed to IORT included an abscess, delayed wound healing, cytopenia, and fluid loculations. Five patients received supplemental external beam radiation therapy to the IORT site without complication. At the time of IORT, three patients were known to have locally disseminated disease within the pleural cavity and one had pulmonary metastases. With a median follow-up of 18 months, the actuarial rate of local control, metastases-free and overall survival were 60%, 75%, and 50%. The patterns of failure were local (n=1), distant (n=1), and local + distant (n=1). Four patients are alive with active disease, six are alive with no evidence of disease, and the remaining five are dead from disease (n=2), other causes (n=1), or treatment (n=2). Although local failure remains a common problem in the treatment of pediatric solid tumors, the potential to improve local control with high doses of radiation must be balanced against the risk of late effects. The ability to confine the

  5. Middle cerebral artery aneurysms: aneurysm angiographic morphology and its relation to pre-operative and intra-operative rupture

    Directory of Open Access Journals (Sweden)

    Iracema Araújo Estevão

    Full Text Available ABSTRACT Objective Correlate the middle cerebral artery bifurcation aneurysm morphology with the pre-operative and intra-operative risk of rupture. Methods Forty patients with 46 middle cerebral artery bifurcation aneurysms were treated microsurgically by the same surgeon. Aneurysms were classified according to shape and the Fisher test was applied to analyze the effect of morphology on the pre-operative and intra-operative rupture. Results Pre-operative and intra-operative ruptures were observed in 8/46 patients (17.4% and 14/46 patients (30.4% respectively. Thirty-two cases (69.6% had no symptoms postoperatively, modified Rankin score (MRS of 0; 6.5% had MRS of 1 (no significant disability; 13% had MRS of 2 (slight disability; 4.3% had moderately severe disability (MRS of 4; and there were 3 deaths (6.5% post-operatively. The morphology was not directly related to the rupture rate. Conclusion In general, ruptures are not affected by the morphology or the studied variables. Larger series are needed to validate these outcomes.

  6. A case of astrocytoma, 19 year history after BNCT

    International Nuclear Information System (INIS)

    Kamano, Shuji

    2006-01-01

    A 39-year-old man had received Boron Neutron Capture Therapy (BNCT) in 1987 for a Grade II Astrocytoma. He gradually exacerbated and received a second operation in 1994. The mass taken in the second operation is almost competent with radiation necrosis. Following that, he shows no signs of recurrence. Currently, he has returned to full time employment in physical labor. This case suggests effectiveness of BNCT for rather low-grade astrocytomas. (author)

  7. INEL BNCT research program: Annual report, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R. [ed.

    1996-04-01

    This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1995. Contributions from the principal investigators about their individual projects are included, specifically, physics (treatment planning software, real-time neutron beam measurement dosimetry), and radiation biology (large animal models efficacy studies). Design of a reactor based epithermal neutron extraction facility is discussed in detail. Final results of boron magnetic resonance imagining is included for both borocaptate sodium (BSH) and boronophenylalanine (BPA) in rats, and BSH in humans. Design of an epithermal neutron facility using electron linear accelerators is presented, including a treatise on energy removal from the beam target. Information on the multiple fraction injection of BSH in rats is presented.

  8. INEL BNCT research program: Annual report, 1995

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1996-04-01

    This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1995. Contributions from the principal investigators about their individual projects are included, specifically, physics (treatment planning software, real-time neutron beam measurement dosimetry), and radiation biology (large animal models efficacy studies). Design of a reactor based epithermal neutron extraction facility is discussed in detail. Final results of boron magnetic resonance imagining is included for both borocaptate sodium (BSH) and boronophenylalanine (BPA) in rats, and BSH in humans. Design of an epithermal neutron facility using electron linear accelerators is presented, including a treatise on energy removal from the beam target. Information on the multiple fraction injection of BSH in rats is presented

  9. Beliefs and values about intra-operative teaching and learning: a case study of surgical teachers and trainees.

    Science.gov (United States)

    Ong, Caroline C P; Dodds, Agnes; Nestel, Debra

    2016-08-01

    Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient safety. Using a theoretical framework of situated learning including cognitive apprenticeship, we explored teachers' and trainees' beliefs and values about intra-operative training and reasons for any differences. A qualitative case study method was used where five teacher-trainee pairs participating in an observed teaching operation were separately interviewed about the same operation. Thematic analysis of transcribed interviews and observations was performed with iterative refinement and a reflexive approach was adopted throughout the study. We found that in all cases, teachers and trainees had shared recognition of learning about technical skills whereas they differed in three cases regarding non-technical skills such as surgical reasoning and team management. Factors contributing to teacher and trainee satisfaction with the process were successful trainee completion of operation without need for surgeon take-over, a positive learning environment and learning new things. Teaching-learning behaviours observed and discussed were modeling, coaching and scaffolding, while exploration, reflection and articulation were less common. Our study reveals differing teacher and trainee perspectives of some aspects of intra-operative training and surfaces new reasons other than amount of feedback and autonomy given. Factors contributing to different perspectives include teacher and trainee abilities, values and situational influences. Targeted teaching-learning strategies could enhance intra-operative learning.

  10. The incidence of intra-operative awareness during general anesthesia in China: a multi-center observational study.

    Science.gov (United States)

    Xu, L; Wu, A-S; Yue, Y

    2009-08-01

    The incidence of awareness in patients undergoing general anesthesia is 0.1-0.2% in Western countries. The medical literatures about awareness during general anesthesia are still rare in China, but some previous studies have reported a higher incidence (1.4-6%) of intra-operative awareness. To find out the reason why the incidence reported in China is much higher than that in Western countries, we performed a prospective, multicenter, non-randomized observational study to determine the true incidence of intra-operative awareness in China. This is a prospective, non-randomized descriptive cohort study that was conducted at 25 academic medical centers in China. Eleven thousand one hundred and eighty-five patients were interviewed by research staff for evaluation of awareness at the first and fourth day after general anesthesia with muscle relaxation. An independent blinded committee evaluated the responses and determined whether awareness occurred. Necessary data were collected for a binary logistic regression analysis. Data from 11,101 patients were presented. Forty-six cases (0.41%) were reported as definite awareness and 47 additional cases (0.41%) as possible awareness. Three hundred and fifty-five patients (3.19%) had dreams during general anesthesia. Awareness was associated with increased American Society of Anesthesiologists (ASA) physical status, a previous anesthesia, and anesthesia methods of total intravenous anesthesia. The incidence of intra-operative awareness in China is approximately 0.41%, two to three times higher than that widely cited in Western countries. Inappropriately light anesthesia, and the population proportion of surgery and general anesthesia in China may account for the difference. (ClinicalTrials.gov Identifier, NCT00693875.).

  11. Use of auditory evoked potentials for intra-operative awareness in anesthesia: a consciousness-based conceptual model.

    Science.gov (United States)

    Dong, Xuebao; Suo, Puxia; Yuan, Xin; Yao, Xuefeng

    2015-01-01

    Auditory evoked potentials (AEPs) have been used as a measure of the depth of anesthesia during the intra-operative process. AEPs are classically divided, on the basis of their latency, into first, fast, middle, slow, and late components. The use of auditory evoked potential has been advocated for the assessment of Intra-operative awareness (IOA), but has not been considered seriously enough to universalize it. It is because we have not explored enough the impact of auditory perception and auditory processing on the IOA phenomena as well as on the subsequent psychological impact of IOA on the patient. More importantly, we have seldom tried to look at the phenomena of IOP from the perspective of consciousness itself. This perspective is especially important because many of IOA phenomena exist in the subconscious domain than they do in the conscious domain of explicit recall. Two important forms of these subconscious manifestations of IOA are the implicit recall phenomena and post-operative dreams related to the operation. Here, we present an integrated auditory consciousness-based model of IOA. We start with a brief description of auditory awareness and the factors affecting it. Further, we proceed to the evaluation of conscious and subconscious information processing by auditory modality and how they interact during and after intra-operative period. Further, we show that both conscious and subconscious auditory processing affect the IOA experience and both have serious psychological implications on the patient subsequently. These effects could be prevented by using auditory evoked potential during monitoring of anesthesia, especially the mid-latency auditory evoked potentials (MLAERs). To conclude our model with present hypothesis, we propose that the use of auditory evoked potential should be universal with general anesthesia use in order to prevent the occurrences of distressing outcomes resulting from both conscious and subconscious auditory processing during

  12. Comparison and analysis of BNCT radiation dose between gold wire and JCDS measurement

    International Nuclear Information System (INIS)

    Kageji, T.; Mizobuchi, Y.; Nagahiro, S.; Nakagawa, Y.; Kumada, Hiroaki

    2006-01-01

    We compared and evaluated boron neutron capture therapy (BNCT) radiation dose between gold wire measurement and JAERI Computational Dosimetry System (JCDS). Gold wire analysis demonstrates the actual BNCT dose though it dose not reflect the real the maximum and minimum dose in tumor tissue. We can conclude that JCDS is precise and high-reliable dose planning system for BNCT. (author)

  13. The use of high-field intra-operative magnetic resonance imaging combined with language functional neuronavigation in glioma surgery

    OpenAIRE

    Yan ZHAO; Xiao-lei CHEN; Fei WANG; Guo-chen SUN; Yu-bo WANG; Zhi-jun SONG; Bai-nan XU

    2011-01-01

    Objective To explore the effect of high-field intra-operative magnetic resonance imaging(iMRI) combined with language functional neuronavigation in resection of glioma in language area of dominant hemisphere of the brain.Methods Twenty right handed patients(12 males and 8 females,aged from 20 to 61 years with mean of 43.6 years) with glioma close to arcuate fasciculus were involved in present study,and they were stratified into normal group(n=9) and aphasia group(n=11) according to the preope...

  14. Online signal processing of internal anal sphincter activity during pelvic autonomic nerve stimulation: a new method to improve the reliability of intra-operative neuromonitoring signals.

    Science.gov (United States)

    Kauff, D W; Koch, K P; Somerlik, K H; Heimann, A; Hoffmann, K P; Lang, H; Kneist, W

    2011-12-01

    Intra-operative neuromonitoring is increasingly applied in several surgical disciplines and has been introduced to facilitate pelvic autonomic nerve preservation. Nevertheless, it has been considered a questionable tool for the minimization of risk, as the results are variable and might be misleading. The aim of the present experimental study was to develop an intra-operative neuromonitoring system with improved reliability for monitoring pelvic autonomic nerve function. Fifteen pigs underwent low anterior rectal resection with pelvic autonomic nerve preservation. Intra-operative neuromonitoring was performed under autonomic nerve stimulation with observation of electromyographic signals of the internal anal sphincter and bladder manometry. As the internal anal sphincter frequency spectrum during stimulation was found to be mainly in the range of 5-20 Hz, intra-operative neuromonitoring signals were postoperatively processed by implementation of matching band pass filters. In 10 preliminary experiments, signal processing was performed offline in the postoperative analysis. Of 163 stimulations intra-operatively assessed by the surgeon as positive responses, 135 (83%) were confirmed after signal processing. In the following five consecutive experiments intra-operative online signal processing was realized and demonstrated reliable intra-operative neuromonitoring signals of internal anal sphincter activity with significant increase during pelvic autonomic nerve stimulation [0.5 μV (interquartile range = 0.3-0.7) vs 4.8 μV (interquartile range = 2.5-7.5); P signal processing of internal anal sphincter activity aids reliable identification of pelvic autonomic nerves with potential for improvement of intra-operative neuromonitoring in pelvic surgery. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  15. Validation of intra-operative parathyroid hormone and its decline as early predictors of hypoparathyroidism after total thyroidectomy: A prospective cohort study.

    Science.gov (United States)

    Gupta, Shailesh; Chaudhary, Poras; Durga, Chikkala K; Naskar, Dipankar

    2015-06-01

    Total thyroidectomy is a preferred surgical technique for benign as well as malignant thyroid pathologies, but many a times can cause hypoparathyroidism. The aim of this study is to evaluate the intra-operative parathyroid hormone (ioPTH) level and its decline as predictors for post-operative hypoparathyroidism after total thyroidectomy. In this single-centre prospective cohort study, 90 patients who underwent total thyroidectomy for benign as well as malignant pathologies of thyroid gland were studied. Intra-operative parathyroid levels and at different time intervals parathyroid hormone and serum calcium levels were measured to predict hypoparathyroidism. The data was analysed using independent sample t test and p value hypoparathyroidism. Intra-operative PTH was found to be most accurate predictor for diagnosing post-operative hypoparathyroidism (cut off was (11.3 pg/ml, calculated using ROC curves) and has maximum sum of sensitivity (91.7%) and specificity (97%). On taking cut off values of intra-operative PTH and PTH decline together, they were found to be most accurate predictor for permanent hypoparathyroidism. Early and accurate predictor of hypoparathyroidism is very important and always sought. Very early prediction during intra-operative periods can be used for auto transplantation of parathyroid gland. Intra-operative parathyroid hormone and its decline are accurate, reliable, and early predictor of hypoparathyroidism after total thyroidectomy. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  16. Accuracy of intra-operative frozen section and its role in the diagnostic evaluation of ovarian tumors.

    Science.gov (United States)

    Abudukadeer, A; Azam, S; Zunong, B; Mutailipu, A Zuoremu; Huijun, B; Qun, L

    2016-01-01

    Summary This retrospective study was undertaken to evaluate the accuracy and role of intra-operative frozen section in the diagnosis of ovarian tumors. Retrospective study of 804 ovarian frozen section results between June 2010 and June 2014 was examined to determine the accuracy of frozen section diagnosis. The intra-operative frozen section diagnosis was compared with the permanent (paraffin) section and the overall accuracy, sensitivity, specificity, and positive and negative predictive values of the frozen section were studied. The overall accuracy to determine the status of malignancy was 92.6%. There were 38 (7.4%) false negative and no false positive frozen section diagnoses.The sensitivity, specificity, and positive predictive and negative predictive values for benign ovarian tumors were 100.0%, 97.0%, 91.3%, and 100.0%, respectively; for borderline tumors they were 64.3%, 97.0%, 91.5%, and 94.0%, respectively, and for malignant tumors they were 90.0%, 100.0%, 100.0%, and 85.5%, respectively. This study concluded that frozen section appears to be an adequate technique for the histopathological diagnosis of ovarian tumors, with some limitations observed among borderline and mucinous tumors.

  17. INEEL BNCT Research Program Annual Report, CY-2000

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, James Robert

    2001-03-01

    This report is a summary of the activities conducted in conjunction with the Idaho National Engineering and Environmental Laboratory (INEEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 2000. Applications of supportive research and development, as well as technology deployment in the fields of chemistry, radiation physics and dosimetry, neutron source design and demonstration, and support the Department of Energy’s (DOE) National BNCT Program goals are the goals of this Program. Contributions from the individual contributors about their projects are included, specifically described are the following, chemistry: analysis of biological samples and an infrared blood-boron analyzer, and physics: progress in the patient treatment planning software, measurement of neutron spectra for the Argentina RA-6 reactor, and recalculation of the Finnish research reactor FiR 1 neutron spectra, BNCT accelerator technology, and modification to the research reactor at Washington State University for an epithermal-neutron beam.

  18. Proceedings of neutron irradiation technical meeting on BNCT

    International Nuclear Information System (INIS)

    2000-10-01

    The 'Neutron Irradiation Technical Meeting for Boron Neutron Capture Therapy (BNCT)' was held on March 13, 2000 at Tokai Research Establishment. The Meeting is aimed to introduce the neutron beam facility for medical irradiation at JRR-4 to Japanese researchers widely, as well as providing an opportunity for young researchers, engineers, medical representatives such surgeons and doctors of pharmacology to present their research activities and to exchange valuable information. JAERI researcher presented the performance and the irradiation technology in the JRR-4 neutron beam facility, while external researchers made various and beneficial presentations containing such accelerator-based BNCT, spectrum-shifter, biological effect, pharmacological development and so on. In this meeting, a special lecture titled 'The Dawn of BNCT and Its Development.' was given by MD, Prof. Takashi Minobe, an executive director of Japan Foundation for Emergency Medicine. The 11 of the presented papers are indexed individually. (J.P.N.)

  19. Proceedings of neutron irradiation technical meeting on BNCT

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-10-01

    The 'Neutron Irradiation Technical Meeting for Boron Neutron Capture Therapy (BNCT)' was held on March 13, 2000 at Tokai Research Establishment. The Meeting is aimed to introduce the neutron beam facility for medical irradiation at JRR-4 to Japanese researchers widely, as well as providing an opportunity for young researchers, engineers, medical representatives such surgeons and doctors of pharmacology to present their research activities and to exchange valuable information. JAERI researcher presented the performance and the irradiation technology in the JRR-4 neutron beam facility, while external researchers made various and beneficial presentations containing such accelerator-based BNCT, spectrum-shifter, biological effect, pharmacological development and so on. In this meeting, a special lecture titled 'The Dawn of BNCT and Its Development.' was given by MD, Prof. Takashi Minobe, an executive director of Japan Foundation for Emergency Medicine. The 11 of the presented papers are indexed individually. (J.P.N.)

  20. Protocols for BNCT of glioblastoma multiforme at Brookhaven: Practical considerations

    Energy Technology Data Exchange (ETDEWEB)

    Chanana, A.D.; Coderre, J.A.; Joel, D.D.; Slatkin, D.N.

    1996-12-31

    In this report we discuss some issues considered in selecting initial protocols for boron neutron capture therapy (BNCT) of human glioblastoma multiforme. First the tolerance of normal tissues, especially the brain, to the radiation field. Radiation doses limits were based on results with human and animal exposures. Estimates of tumor control doses were based on the results of single-fraction photon therapy and single fraction BNCT both in humans and experimental animals. Of the two boron compounds (BSH and BPA), BPA was chosen since a FDA-sanctioned protocol for distribution in humans was in effect at the time the first BNCT protocols were written and therapy studies in experimental animals had shown it to be more effective than BSH.

  1. IRT-Sofia BNCT beam tube optimization study.

    Science.gov (United States)

    Belousov, S; Mitev, M; Ilieva, K; Riley, K; Harling, O

    2011-12-01

    An optimization study of IRT-Sofia BNCT beam tube is presented. In the study we used the MIT/FCB experience. The enlarging of filter/moderator cross section dimensions and the decreasing of collimator length within the limits of the IRT-Sofia reactor design were analyzed. The influence of beam and reactor core axes non-coincidence on the beam properties was also evaluated. The irradiation resistance of polytetrafluoroethylene (Teflon(®)) was also evaluated. The results provide information for making decisions on the IRT-Sofia BNCT beam construction. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. A Novel Stress-Diathesis Model to Predict Risk of Post-operative Delirium: Implications for Intra-operative Management

    Directory of Open Access Journals (Sweden)

    Renée El-Gabalawy

    2017-08-01

    Full Text Available Introduction: Risk assessment for post-operative delirium (POD is poorly developed. Improved metrics could greatly facilitate peri-operative care as costs associated with POD are staggering. In this preliminary study, we develop a novel stress-diathesis model based on comprehensive pre-operative psychiatric and neuropsychological testing, a blood oxygenation level-dependent (BOLD magnetic resonance imaging (MRI carbon dioxide (CO2 stress test, and high fidelity measures of intra-operative parameters that may interact facilitating POD.Methods: The study was approved by the ethics board at the University of Manitoba and registered at clinicaltrials.gov as NCT02126215. Twelve patients were studied. Pre-operative psychiatric symptom measures and neuropsychological testing preceded MRI featuring a BOLD MRI CO2 stress test whereby BOLD scans were conducted while exposing participants to a rigorously controlled CO2 stimulus. During surgery the patient had hemodynamics and end-tidal gases downloaded at 0.5 hz. Post-operatively, the presence of POD and POD severity was comprehensively assessed using the Confusion Assessment Measure –Severity (CAM-S scoring instrument on days 0 (surgery through post-operative day 5, and patients were followed up at least 1 month post-operatively.Results: Six of 12 patients had no evidence of POD (non-POD. Three patients had POD and 3 had clinically significant confusional states (referred as subthreshold POD; ST-POD (score ≥ 5/19 on the CAM-S. Average severity for delirium was 1.3 in the non-POD group, 3.2 in ST-POD, and 6.1 in POD (F-statistic = 15.4, p < 0.001. Depressive symptoms, and cognitive measures of semantic fluency and executive functioning/processing speed were significantly associated with POD. Second level analysis revealed an increased inverse BOLD responsiveness to CO2 pre-operatively in ST-POD and marked increase in the POD groups when compared to the non-POD group. An association was also noted for

  3. Intra-operative techniques to reduce the risk of capsular contracture in patients undergoing aesthetic breast augmentation - A review.

    Science.gov (United States)

    Horsnell, J D; Searle, A E; Harris, P A

    2017-10-01

    Capsular contracture is a significant complication following aesthetic breast augmentation. Efforts to reduce this incidence have focused on the surgical approach, implant selection and IV antibiotics. Intra-operative methods to reduce the risk have had less investigation. This review focuses on these interventions and will document evidence to support pocket irrigation, nipple shields, drains and the use of an implant insertion funnel. A comprehensive review of Pubmed, Scopus and Embase was performed to identify relevant papers published since 2000. These were reviewed and pertinent papers selected. Data regarding the intervention and its impact were recorded and compared. Ten relevant studies were identified. A total of 11,772 patients were included in the studies, with a pooled capsular contracture rate of 2.54%. Six papers reported the use of antibiotic irrigation, two papers reported the use of drains, two the use of an insertion funnel, two the use of povidone-iodine and one the use of nipple shields. Antibiotic irrigation was shown to reduce capsular contracture 10 fold in two papers, have no effect in one and increase it in a further paper. However these changes did not persist after multivariate analysis. There was limited evidence to support intra-operative techniques to reduce capsular contracture rate. Where available the literature tends to support the use of antibiotic and povidone-iodine irrigation, the use of insertion funnels and nipple shields and the avoidance of drains. However due to the poor quality of the evidence these findings should be treated cautiously. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  4. Boron Neutron Capture Therapty (BNCT) in an Oral Precancer Model: Therapeutic Benefits and Potential Toxicity of a Double Application of BNCT with a Six-Week Interval

    Energy Technology Data Exchange (ETDEWEB)

    Andrea Monti Hughes; Emiliano C.C. Pozzi; Elisa M. Heber; Silvia Thorp; Marcelo Miller; Maria E. Itoiz; Romina F. Aromando; Ana J. Molinari; Marcela A. Garabalino; David W. Nigg; Veronica A. Trivillin; Amanda E. Schwint

    2011-11-01

    Given the clinical relevance of locoregional recurrences in head and neck cancer, we developed a novel experimental model of premalignant tissue in the hamster cheek pouch for long-term studies and demonstrated the partial inhibitory effect of a single application of Boron Neutron Capture Therapy (BNCT) on tumor development from premalignant tissue. The aim of the present study was to evaluate the effect of a double application of BNCT with a 6 week interval in terms of inhibitory effect on tumor development, toxicity and DNA synthesis. We performed a double application, 6 weeks apart, of (1) BNCT mediated by boronophenylalanine (BPA-BNCT); (2) BNCT mediated by the combined application of decahydrodecaborate (GB-10) and BPA [(GB-10 + BPA)-BNCT] or (3) beam-only, at RA-3 nuclear reactor and followed the animals for 8 months. The control group was cancerized and sham-irradiated. BPA-BNCT, (GB- 10 + BPA)-BNCT and beam-only induced a reduction in tumor development from premalignant tissue that persisted until 8, 3, and 2 months respectively. An early maximum inhibition of 100% was observed for all 3 protocols. No normal tissue radiotoxicity was detected. Reversible mucositis was observed in premalignant tissue, peaking at 1 week and resolving by the third week after each irradiation. Mucositis after the second application was not exacerbated by the first application. DNA synthesis was significantly reduced in premalignant tissue 8 months post-BNCT. A double application of BPA-BNCT and (GB-10 + BPA)-BNCT, 6 weeks apart, could be used therapeutically at no additional cost in terms of radiotoxicity in normal and dose-limiting tissues.

  5. INEL BNCT Program: Volume 5, No. 9. Bulletin, September 1991

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, A.L. [ed.

    1991-12-31

    This Bulletin presents a summary of accomplishments and highlights of the Idaho National Engineering Laboratory`s (INEL) Boron Neutron Capture Therapy (BNCT) Program for September 1991. This bulletin includes information on the brain tumor and melanoma research programs, Power Burst Facility (PBF) technical support and modifications, PBF operations, and updates to the animal data charts.

  6. Neutron Flux Measurement Produced by BNCT Target using Proton Beam

    International Nuclear Information System (INIS)

    Ha, Jang Ho; Kim, Yong Kyun; Chai, Jong Seo; Kim, Jong Kyung

    2005-01-01

    We are investigating neutron production target system performance for boron captured neutron therapy (BNCT). The epithermal neutron is useful for this therapy and in present study we performed a simple method to measure neutron flux and energy, which are important for the accurate cancer therapy. The simple method and result of neutron flux and energy measurement experiment are presented

  7. In vivo BNCT in experimental and spontaneous tumors at RA-1 reactor

    International Nuclear Information System (INIS)

    Trivillin, Veronica A.; Heber, Elisa M.; Itoiz, Maria E.; Schwint, Amanda E.; Nigg, David W.

    2003-01-01

    Within the search for new applications of Boron Neutron Capture Therapy (BNCT) and the basic research oriented towards the study of BNCT radiobiology to optimize its therapeutic gain, we previously proposed and validated the hamster cheek pouch oral cancer model and showed, for the first time, the success of BNCT to treat oral cancer in an experimental model. The staff of the Ra-1 Reactor (Constituyentes Atomic Center) adapted the thermal beam and physical set-up to perform in vivo BNCT of superficial tumors in small animals. We preformed a preliminary characterization of the thermal beam, performed beam only irradiation of normal and tumor bearing hamsters and in vivo BNCT of experimental oral squamous cell carcinomas in hamsters mediated by boron phenylalanine (BPA) and GB-10 (Na 2 10 B 10 H 10 ). Having demonstrated the absence of radio toxic effects in healthy tissue and a therapeutic effect of in vivo BNCT in hamster cheek pouch tumors employing the Ra-1 thermal beam, we performed a feasibility study of the treatment by BNCT of 3 terminal cases of spontaneous head and neck squamous cell carcinoma in cats following the corresponding biodistribution studies. This was the first treatment of spontaneous tumors by BNCT in our country and the first treatment by BNCT in cats worldwide. This preclinical study in terminal cases showed significant tumor control by BNCT with no damage to normal tissue. (author)

  8. An update on the clinical trial of BNCT at the BMRR

    International Nuclear Information System (INIS)

    Ma, R.; Capala, J.; Chanana, A.D.; Coderre, J.A.; Diaz, A.Z.

    1999-01-01

    Boron neutron capture therapy (BNCT) was proposed more than six decades ago. It is a binary treatment modality that requires selective delivery of a 10 B-labeled compound to a tumor and slow neutron irradiation of the tumor-bearing tissues. In order to improve the penetration of the neutron beam, an epithermal neutron beam was developed at the Brookhaven Medical Research Reactor (BMRR). This epithermal neutron beam can deliver relatively high thermal neutron fluence at depth without severe skin damage. Boronophenylalanine-fructose (BPA-F), a nontoxic boron carrier, was found to preferentially accumulate in tumor cells following intravenous infusion in patients with GBM. In preclinical BNCT studies in rats bearing 9L gliosarcoma, BPA-mediated BNCT was shown to be more efficacious than photon irradiation. In 1994, improvements in the neutron beam and in the understanding of the radiobiology of BPA-mediated BNCT led to the initiation of BNCT trials for human GBM at BMRR using BPA-F and epithermal neutrons. The primary objective of the phase I/II clinical trial of BPA-mediated BNCT at BMRR is to evaluate the safety of the BPA-F-mediated BNCT using epithermal neutrons in patients with GBM at a series of escalating BNCT doses. An incidental objective is to evaluate the therapeutic effectiveness of BNCT at each dose level. For each dose escalation group, the average brain dose (ABD) is escalated, as well as the minimum tumor dose. In summary, the BNCT procedure employed in the phase I/II clinical trial of BPA-F-mediated BNCT for GBM at BNL was found to be safe in all patients. The palliation afforded by a single session of BNCT compares favorably with palliation provided by fractionated photon therapy and adjuvant chemotherapy. If no evidence of radiation-induced brain toxicity is found in the current protocol, BNCT radiation dose will be further escalated

  9. Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents.

    Science.gov (United States)

    Siu, Joey; Maran, Nikki; Paterson-Brown, Simon

    2016-06-01

    The importance of non-technical skills in improving surgical safety and performance is now well recognised. Better understanding is needed of the impact that non-technical skills of the multi-disciplinary theatre team have on intra-operative incidents in the operating room (OR) using structured theatre-based assessment. The interaction of non-technical skills that influence surgical safety of the OR team will be explored and made more transparent. Between May-August 2013, a range of procedures in general and vascular surgery in the Royal Infirmary of Edinburgh were performed. Non-technical skills behavioural markers and associated intra-operative incidents were recorded using established behavioural marking systems (NOTSS, ANTS and SPLINTS). Adherence to the surgical safety checklist was also observed. A total of 51 procedures were observed, with 90 recorded incidents - 57 of which were considered avoidable. Poor situational awareness was a common area for surgeons and anaesthetists leading to most intra-operative incidents. Poor communication and teamwork across the whole OR team had a generally large impact on intra-operative incidents. Leadership was shown to be an essential set of skills for the surgeons as demonstrated by the high correlation of poor leadership with intra-operative incidents. Team-working and management skills appeared to be especially important for anaesthetists in the recovery from an intra-operative incident. A significant number of avoidable incidents occur during operative procedures. These can all be linked to failures in non-technical skills. Better training of both individual and team in non-technical skills is needed in order to improve patient safety in the operating room. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  10. Boron neutron capture therapy (BNCT) inhibits tumor development from precancerous tissue: An experimental study that supports a potential new application of BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Monti Hughes, A.; Heber, E.M. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Buenos Aires (Argentina); Pozzi, E. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Buenos Aires (Argentina); Department of Research and Production Reactors, Ezeiza Atomic Center, CNEA, Buenos Aires (Argentina); Nigg, D.W. [Idaho National Laboratory, Idaho Falls, Idaho (United States); Calzetta, O.; Blaumann, H.; Longhino, J. [Department of Nuclear Engineering, Bariloche Atomic Center, CNEA, Rio Negro (Argentina); Nievas, S.I. [Department of Chemistry, CNEA, Buenos Aires (Argentina); Aromando, R.F. [Department of Oral Pathology, Faculty of Dentistry, University of Buenos Aires, Buenos Aires (Argentina); Itoiz, M.E. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Buenos Aires (Argentina); Department of Oral Pathology, Faculty of Dentistry, University of Buenos Aires, Buenos Aires (Argentina); Trivillin, V.A. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Buenos Aires (Argentina); Schwint, A.E. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Buenos Aires (Argentina)], E-mail: schwint@cnea.gov.ar

    2009-07-15

    We previously demonstrated the efficacy of boron neutron capture therapy (BNCT) mediated by boronophenylalanine (BPA), GB-10 (Na{sub 2}{sup 10}B{sub 10}H{sub 10}) and (GB-10+BPA) to control tumors, with no normal tissue radiotoxicity, in the hamster cheek pouch oral cancer model. Herein we developed a novel experimental model of field-cancerization and precancerous lesions (globally termed herein precancerous tissue) in the hamster cheek pouch to explore the long-term potential inhibitory effect of the same BNCT protocols on the development of second primary tumors from precancerous tissue. Clinically, second primary tumor recurrences occur in field-cancerized tissue, causing therapeutic failure. We performed boron biodistribution studies followed by in vivo BNCT studies, with 8 months follow-up. All 3 BNCT protocols induced a statistically significant reduction in tumor development from precancerous tissue, reaching a maximum inhibition of 77-100%. The inhibitory effect of BPA-BNCT and (GB-10+BPA)-BNCT persisted at 51% at the end of follow-up (8 months), whereas for GB-10-BNCT it faded after 2 months. Likewise, beam-only elicited a significant but transient reduction in tumor development. No normal tissue radiotoxicity was observed. At 8 months post-treatment with BPA-BNCT or (GB-10+BPA)-BNCT, the precancerous pouches that did not develop tumors had regained the macroscopic and histological appearance of normal (non-cancerized) pouches. A potential new clinical application of BNCT would lie in its capacity to inhibit local regional recurrences.

  11. The use of high-field intra-operative magnetic resonance imaging combined with language functional neuronavigation in glioma surgery

    Directory of Open Access Journals (Sweden)

    Yan ZHAO

    2011-07-01

    Full Text Available Objective To explore the effect of high-field intra-operative magnetic resonance imaging(iMRI combined with language functional neuronavigation in resection of glioma in language area of dominant hemisphere of the brain.Methods Twenty right handed patients(12 males and 8 females,aged from 20 to 61 years with mean of 43.6 years with glioma close to arcuate fasciculus were involved in present study,and they were stratified into normal group(n=9 and aphasia group(n=11 according to the preoperative aphasia quotient(AQ.All the patients underwent surgical operation assisted by arcuate fasciculus navigator,and the high-field iMRI was performed with a 1.5-T magnetic resonance scanner.The 3D reconstructed arcuate fasciculus images were integrated into neuronavigation system before the operation,and used by combining with functional neuronavigation under microscope during the surgical procedure.Pre-operatirely,and 2-4 weeks,3-6 months postoperative,the patients were examined with magnetic resonance scanning and aphasia quotients examination.Results Pre-operative and intra-operative arcuate fasciculus reconstruction was completed in all the 20 patients,and neuronavigation under microscope were performed after the 3D images integrated into neuronavigation system.Patients of normal AQ(94.5±5.5 retained the normal level,except one patients who developed new conduction aphasia syndrome(AQ=81.8 2-4 weeks after operation.The AQ of aphasia group(89.4±5.8 was significantly improved than that before operation(84.9±8.7,P < 0.05,except 2 patients whose language deficit was exacerbated due to tumor recurrence.The AQ of normal group(98.3±0.5 remained at normal level,while that of aphasia group(95.2±2.6 was significantly improved 3-6 months after operation compared with that at 2-4 weeks after operation(P < 0.05.There were no other new neurologic deficits and death in both groups.Conclusion High-field iMRI combined with functional neuronavigation is a safe and

  12. Fluorocholangiography: reincarnation in the laparoscopic era-evaluation of intra-operative cholangiography in 3635 laparoscopic cholecystectomies.

    Science.gov (United States)

    Nassar, Ahmad H M; Mirza, Ahmad; Qandeel, Haitham; Ahmed, Zubir; Zino, Samer

    2016-05-01

    The introduction of laparoscopic cholecystectomy (LC) resulted in the decline of routine intra-operative cholangiography (IOC). Common bile duct stones are being diagnosed preoperatively using magnetic resonance cholangiopancreatography (MRCP). We aim to evaluate the use and benefits of IOC during laparoscopic biliary surgery at a high-volume biliary surgery unit. Prospective data from 4088 patients undergoing LC over 22 years were analysed. Referral protocols allow one firm to receive the great majority of biliary emergencies and all suspected ductal stones. All patients with gall stones on ultrasound scanning, fit for surgery, will undergo LC during the index admission. MRCP and ERCP are not part of preoperative investigation. A four-port LC is performed with a size 5Fr ureteric catheter within an open cannula to obtain an IOC through right sub-costal port. Of 4088 patients, IOC was attempted in 3691 (90.2 %) and 3635 had a successful IOC (98.4 %). 75 % were females. The mean age was 59 years. Patients presented with one or more of the following: chronic biliary pain in 60 %, acute pain 26.7 %, acute cholecystitis 8.4 %, gallstone pancreatitis 7.8 % and jaundice with or without cholangitis in 19.2 %. A total of 1328 patients (36.5 %) had risk factors for CBD stones. The IOC was abnormal in 975 cases (26.8 %), recording 1599 abnormalities. IOC identified 774 patients with CBD stones (21.3 %), including previously unsuspected CBD stones in 4.7 %. IOC was false negative in 20 cases (0.5 %) found to have stones on basket exploration. A decision not to perform IOC in 453 cases (11 %) was made preoperatively in 74.2 % and intra-operatively in 12.3 %. IOC can be safely and routinely performed in LC. It helps to identify CBD stones, even in patients with no known risk factors, delineate bile duct anatomy and facilitate single-stage management of CBD stones.

  13. SERA -- An advanced treatment planning system for neutron therapy and BNCT

    International Nuclear Information System (INIS)

    Nigg, D.W.; Wemple, C.A.; Wessol, D.E.; Wheeler, F.J.; Albright, C.; Cohen, M.; Frandsen, M.; Harkin, G.; Rossmeier, M.

    1999-01-01

    Detailed treatment planning calculations on a patient-specific basis are required for boron neutron capture therapy (BNCT). Two integrated treatment planning systems developed specifically for BNCT have been in clinical use in the United States over the past few years. The MacNCTPLAN BNCT treatment planning system is used in the clinical BNCT trials that are underway at the Massachusetts Institute of Technology. A second system, BNCT rtpe (BNCT radiation therapy planning environment), developed independently by the Idaho national Engineering and Environmental Laboratory (INEEL) in collaboration with Montana State University (MSU), is used for treatment planning in the current series of BNCT clinical trials for glioblastoma at Brookhaven National Laboratory (BNL). This latter system is also licensed for use at several other BNCT research facilities worldwide. Although the currently available BNCT planning systems have served their purpose well, they suffer from somewhat long computation times (2 to 3 CPU-hours or more per field) relative to standard photon therapy planning software. This is largely due to the need for explicit three-dimensional solutions to the relevant transport equations. The simplifying approximations that work well for photon transport computations are not generally applicable to neutron transport computations. Greater computational speeds for BNCT treatment planning must therefore generally be achieved through the application of improved numerical techniques rather than by simplification of the governing equations. Recent efforts at INEEL and MSU have been directed toward this goal. This has resulted in a new paradigm for this type of calculation and the subsequent creation of the new simulation environment for radiotherapy applications (SERA) treatment planning system for BNCT. SERA is currently in initial clinical testing in connection with the trials at BNL, and it is expected to replace the present BNCT rtpe system upon general release

  14. Intra-operator and inter-operator reliability of manual and semiautomated measurement of fetal nuchal translucency : a cross sectional study

    NARCIS (Netherlands)

    Bakker, M.; Mulder, P.; Birnie, E.; Bilardo, C. M.

    2013-01-01

    ObjectiveThe goal of this study was to examine the intra-operator and inter-operator differences of the manual and semiautomated nuchal translucency (NT) measurements and to evaluate if these differences alter women's risk status. MethodsA cross sectional study was performed. Two operators obtained

  15. Intra-operative rapid diagnostic method based on CK19 mRNA expression for the detection of lymph node metastases in breast cancer

    NARCIS (Netherlands)

    Visser, Mike; Jiwa, Mehdi; Horstman, Anja; Brink, Antoinette A. T. P.; Pol, Rene P.; van Diest, Paul; Snijders, Peter J. F.; Meijer, Chris J. L. M.

    2008-01-01

    Staging by sentinel node (SN) biopsy is the standard procedure for clinically node-negative breast cancer patients. Intra-operative analysis of the SN allows immediate axillary lymph node (ALN) dissection in SN positive patients, but a quick, reliable and reproducible method is lacking. We tested

  16. Extended endoscopic endonasal surgery using three-dimensional endoscopy in the intra-operative MRI suite for supra-diaphragmatic ectopic pituitary adenoma.

    Science.gov (United States)

    Fuminari, Komatsu; Hideki, Atsumi; Manabu, Osakabe; Mitsunori, Matsumae

    2015-01-01

    We describe a supra-diaphragmatic ectopic pituitary adenoma that was safely removed using the extended endoscopic endonasal approach, and discuss the value of three-dimensional (3D) endoscopy and intra-operative magnetic resonance imaging (MRI) to this type of procedure. A 61-year-old-man with bitemporal hemianopsia was referred to our hospital, where MRI revealed an enhanced suprasellar tumor compressing the optic chiasma. The tumor extended on the planum sphenoidale and partially encased the right internal carotid artery. An endocrinological assessment indicated normal pituitary function. The extended endoscopic endonasal approach was taken using a 3D endoscope in the intraoperative MRI suite. The tumor was located above the diaphragma sellae and separated from the normal pituitary gland. The pathological findings indicated non-functioning pituitary adenoma and thus the tumor was diagnosed as a supra-diaphragmatic ectopic pituitary adenoma. Intra-operative MRI provided useful information to minimize dural opening and the supra-diaphragmatic ectopic pituitary adenoma was removed from the complex neurovascular structure via the extended endoscopic endonasal approach under 3D endoscopic guidance in the intra-operative suite. Safe and effective removal of a supra-diaphragmatic ectopic pituitary adenoma was accomplished via the extended endoscopic endonasal approach with visual information provided by 3D endoscopy and intra-operative MRI.

  17. Systematic Review and Meta-Analysis of Randomized Controlled Trials Evaluating Prophylactic Intra-Operative Wound Irrigation for the Prevention of Surgical Site Infections

    NARCIS (Netherlands)

    de Jonge, Stijn W.; Boldingh, Quirine J. J.; Solomkin, Joseph S.; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E. Patchen; Boermeester, Marja A.

    2017-01-01

    Surgical site infections (SSIs) are one of the most common hospital-acquired infections. To reduce SSIs, prophylactic intra-operative wound irrigation (pIOWI) has been advocated, although the results to date are equivocal. To develop recommendations for the new World Health Organization (WHO) SSI

  18. Direct evidence of the left caudate's role in bilingual control: an intra-operative electrical stimulation study.

    Science.gov (United States)

    Wang, Xin; Wang, Yin-Yan; Jiang, Tao; Wang, Yong-Zhi; Wu, Chen-Xing

    2013-01-01

    Bilinguals need control mechanisms in order to switch between languages in different communication contexts (Green, 1998, Bilingualism: Language and Cognition, 1; Price, Green, & von Studnitz, 1999, Brain, 122). There has been neural evidence showing competition to control output in L2 vs. L1 in both cortical and sub-cortical areas, when language selection is carried out (Abutalebi & Green, 2007, Journal of Neurolinguistics, 20). Here we use intra-operative direct electrical stimulation to demonstrate that the head of the left caudate is critical not only in language switching tasks but other control tasks. A bilingual Chinese-English patient was instructed to perform both language switching and switching in color-shape naming tasks during awake glioma surgery. When stimulation was applied on the left caudate, failures or difficulties in both language switching and color-shape naming were observed, with the effects greater on language switching. Stimulation to neighboring brain regions either did not affect performance or generated mild problems specific to language switching. The results provide direct evidence of the necessary role of the left caudate in language control.

  19. In vivo intra-operative breast tumor margin detection using a portable OCT system with a handheld surgical imaging probe

    Science.gov (United States)

    Erickson-Bhatt, Sarah J.; Nolan, Ryan; Shemonski, Nathan D.; Adie, Steven G.; Putney, Jeffrey; Darga, Donald; McCormick, Daniel T.; Cittadine, Andrew; Marjanovic, Marina; Chaney, Eric J.; Monroy, Guillermo L.; South, Fredrick; Carney, P. Scott; Cradock, Kimberly A.; Liu, Z. George; Ray, Partha S.; Boppart, Stephen A.

    2014-02-01

    Breast-conserving surgery is a frequent option for women with stage I and II breast cancer, and with radiation treatment, can be as effective as a mastectomy. However, adequate margin detection remains a challenge, and too often additional surgeries are required. Optical coherence tomography (OCT) provides a potential method for real-time, high-resolution imaging of breast tissue during surgery. Intra-operative OCT imaging of excised breast tissues has been previously demonstrated by several groups. In this study, a novel handheld surgical probe-based OCT system is introduced, which was used by the surgeon to image in vivo, within the tumor cavity, and immediately following tumor removal in order to detect the presence of any remaining cancer. Following resection, study investigators imaged the excised tissue with the same probe for comparison. We present OCT images obtained from over 15 patients during lumpectomy and mastectomy surgeries. Images were compared to post-operative histopathology for diagnosis. OCT images with micron scale resolution show areas of heterogeneity and disorganized features indicative of malignancy, compared to more uniform regions of normal tissue. Video-rate acquisition shows the inside of the tumor cavity as the surgeon sweeps the probe along the walls of the surgical cavity. This demonstrates the potential of OCT for real-time assessment of surgical tumor margins and for reducing the unacceptably high re-operation rate for breast cancer patients.

  20. Evaluation of Pediatric Liver Transplantation-Related Artery Complications Using Intra-Operative Multi-Parameter Ultrasonography.

    Science.gov (United States)

    Ren, Xiuyun; Guan, Junhui; Gao, Nong; Niu, Hong; Tang, Jie

    2016-11-21

    BACKGROUND This article discusses the value of using multi-parameter evaluation of intra-operative ultrasonography in evaluating pediatric liver transplantation-related arterial complications. MATERIAL AND METHODS Sixty-eight children receiving a liver transplant underwent intraoperative ultrasonography for monitoring of artery hemodynamics. The ultrasonic measurement parameters included the diameters of the hepatic artery (HA) of the donor and anastomotic stoma, peak systolic velocity (PSV), resistance index (RI), acceleration time (SAT), and blood flow volume. RESULTS After being treated immediately using surgery or other means, blood flow returned to normal in 8 cases, and did not in 3 cases, of whom 2 experienced postoperative HAT. There was a significant difference in HA diameter of the donor, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume before and after treatment of the donor in the complications group. Postoperative complications occurred in 7 of 68 recipients, including the 2 cases exhibiting complications during the surgery (complication group) and 5 without complications during the surgery (no complication group). There was a statistically significant difference (Pultrasonography parameters of HA diameter, anastomotic stoma diameter, RI, and blood flow volume. CONCLUSIONS Through intraoperative multi-parameter ultrasonic measurement, a definite diagnosis of hepatic artery complications can be made in liver transplantation patients. HA diameter of the donor, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume are important in assessing intraoperative artery complications.

  1. Intra-operative radiation therapy in cancer of the pancreas. La radiotherapie peroperatoire dans les cancers du pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Dubois, J.B.; Gu, S.D.; Saint-Aubert, B.; Joyeux, H.; Solassol, C.; Pujol, H. (Centre Regional de Lutte contre le Cancer, 34 - Montpellier (FR))

    1991-03-01

    We report our experience concerning 22 pancreatic carcinoma bearing patients treated with intra-operative radiation therapy (IORT) after complete surgical excision: duodenopancreatectomy: 15 patients; isthmic and caudal pancreatectomy: 2 patients; total pancreatectomy: 5 patients. The dose delivered to the tumor bed was 20 Gy in 12 patients, 18 Gy in 3 patients and 15 Gy in 7 patients. Three patients died within the 1st month post-surgery from intercurrent diseases. Post-operative morbidity was not significantly modified by IORT as compared to purely surgical treated patients. Out of 19 evaluable patients, we observed local control in 16 patients (79.4%). Causes of death (15/19 patients) were: distant metastases with local control: 7 patients; in situ local failure: 3 patients; regional recurrence outside of the IORT fields: 2 patients; intercurrent diseases: 3 patients. Four patients are still alive without evolutive disease. The median overall survival is 6 months. The mean overall survival is 10.56 months. Excluding patients who died from complications and intercurrent diseases, the median survival is 10 mths and the mean survival 14.5 mths. These results emphasize the improvement in local control with IORT, but without significant improvement in survival which is dependent on local evolution and also systemic disease.

  2. Intra-operative radiation therapy for malignant brain tumours: rationale, method, and treatment results of cerebral glioblastomas

    International Nuclear Information System (INIS)

    Matsutani, M.; Nakamura, O.; Nagashima, T.

    1994-01-01

    In radiation therapy for malignant brain tumours, the dose of radiation that can be safely delivered to a tumour is limited by the radiation tolerance of the adjacent normal brain tissue. Among various radiation modalities to produce local tumour eradication without unacceptable complications, we chose a large, single irradiation dose during the operation (intra-operative radiation therapy, IORT). In contrast to X-ray or Cobalt-60 gamma ray irradiation, IORT with a high-energy electron beam delivered by the Shimadzu 20 MeV betatron provides acceptable dose homogeneity with rapid fall-off of the radiation dose beyond the treatment volume. Thus, IORT has the advantage of precise demarcation of the target volume, minimum damage to surrounding normal tissues, and a high absorbed target dose (15-25 Gy in 5-10 min). On the basis of our experience with 170 patients treated by IORT, we established the treatment indications and method in patients with malignant brain tumours. IORT with a dose of 15-25 Gy was delivered to widely resected tumours followed by external radiation therapy. No acute or subacute complications were observed. Treatment results of 30 patients with glioblastoma treated by IORT (mean 18.3 Gy) combined with external radiation therapy (mean 58.5 Gy) resulted in a median survival of 119 weeks and a 2-year survival rate of 61 %. (authors)

  3. Feasibility of integrating a multi-camera optical tracking system in intra-operative electron radiation therapy scenarios

    International Nuclear Information System (INIS)

    García-Vázquez, V; Marinetto, E; Santos-Miranda, J A; Calvo, F A; Desco, M; Pascau, J

    2013-01-01

    Intra-operative electron radiation therapy (IOERT) combines surgery and ionizing radiation applied directly to an exposed unresected tumour mass or to a post-resection tumour bed. The radiation is collimated and conducted by a specific applicator docked to the linear accelerator. The dose distribution in tissues to be irradiated and in organs at risk can be planned through a pre-operative computed tomography (CT) study. However, surgical retraction of structures and resection of a tumour affecting normal tissues significantly modify the patient's geometry. Therefore, the treatment parameters (applicator dimension, pose (position and orientation), bevel angle, and beam energy) may require the original IOERT treatment plan to be modified depending on the actual surgical scenario. We propose the use of a multi-camera optical tracking system to reliably record the actual pose of the IOERT applicator in relation to the patient's anatomy in an environment prone to occlusion problems. This information can be integrated in the radio-surgical treatment planning system in order to generate a real-time accurate description of the IOERT scenario. We assessed the accuracy of the applicator pose by performing a phantom-based study that resembled three real clinical IOERT scenarios. The error obtained (2 mm) was below the acceptance threshold for external radiotherapy practice, thus encouraging future implementation of this approach in real clinical IOERT scenarios. (paper)

  4. Rapid intra-operative diagnosis of kidney cancer by attenuated total reflection infrared spectroscopy of tissue smears.

    Science.gov (United States)

    Pucetaite, Milda; Velicka, Martynas; Urboniene, Vidita; Ceponkus, Justinas; Bandzeviciute, Rimante; Jankevicius, Feliksas; Zelvys, Arunas; Sablinskas, Valdas; Steiner, Gerald

    2018-01-09

    Herein, a technique to analyze air-dried kidney tissue impression smears by means of attenuated total reflection infrared (ATR-IR) spectroscopy is presented. Spectral tumor markers-absorption bands of glycogen-are identified in the ATR-IR spectra of the kidney tissue smear samples. Thin kidney tissue cryo-sections currently used for IR spectroscopic analysis lack such spectral markers as the sample preparation causes irreversible molecular changes in the tissue. In particular, freeze-thaw cycle results in degradation of the glycogen and reduction or complete dissolution of its content. Supervised spectral classification was applied to the recorded spectra of the smears and the test spectra were classified with a high accuracy of 92% for normal tissue and 94% for tumor tissue, respectively. For further development, we propose that combination of the method with optical fiber ATR probes could potentially be used for rapid real-time intra-operative tissue analysis without interfering with either the established protocols of pathological examination or the ordinary workflow of operating surgeon. Such approach could ensure easier transition of the method to clinical applications where it may complement the results of gold standard histopathology examination and aid in more precise resection of kidney tumors. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Nuclear engineering aspects of glioma BNCT research in Italy

    International Nuclear Information System (INIS)

    Curzio, G.; Mazzini, M.

    1998-01-01

    A research project on Boron Neutron Capture Therapy (BNCZ) of gliomas has been set up in Italy, with the participation of Departments of Oncology and Mechanical and Nuclear Construction (DCMN) of the University of Pisa, as well as the Neuroscience and Physics Departments of the Universities of Roma. The specific objective of DCMN Research Unit is the study of the physical-engineering aspects related to BNCT. The paper outlines the research lines in progress at DCMN: Monte Carlo calculations of neutron dose distribution for BNCT treatment planning; measurements of neutron fluxes, spectra and doses by neutron detectors specifically set up; design of modifications to the nuclear reactors of ENEA Casaccia Center. In particular, the paper emphasizes the most original contributions on dosimetric aspects, both from informatic and experimental points of view.(author)

  6. Improvement of neutron irradiation field of research reactors for BNCT

    International Nuclear Information System (INIS)

    Aizawa, Otohiko

    1992-01-01

    The modification of research reactors for an improvement of the irradiation field for BNCT has been investigated in comparison with the field characteristics of the 'old' configuration at the Musashi reactor. The new point of this study is that the evaluation has been done by using an arrangement including both the facility structure and a whole-body phantom, and also by considering the whole-body absorbed dose. (author)

  7. Measurement and simulation of the TRR BNCT beam parameters

    Energy Technology Data Exchange (ETDEWEB)

    Bavarnegin, Elham [Nuclear Science and Technology Research Institute (NSTRI), Tehran (Iran, Islamic Republic of); Department of Physics, University of Guilan, Rasht (Iran, Islamic Republic of); Sadremomtaz, Alireza [Department of Physics, University of Guilan, Rasht (Iran, Islamic Republic of); Khalafi, Hossein [Nuclear Science and Technology Research Institute (NSTRI), Tehran (Iran, Islamic Republic of); Kasesaz, Yaser, E-mail: ykasesaz@aeoi.org.ir [Nuclear Science and Technology Research Institute (NSTRI), Tehran (Iran, Islamic Republic of); Golshanian, Mohadeseh; Ghods, Hossein; Ezzati, Arsalan; Keyvani, Mehdi; Haddadi, Mohammad [Nuclear Science and Technology Research Institute (NSTRI), Tehran (Iran, Islamic Republic of)

    2016-09-11

    Recently, the configuration of the Tehran Research Reactor (TRR) thermal column has been modified and a proper thermal neutron beam for preclinical Boron Neutron Capture Therapy (BNCT) has been obtained. In this study, simulations and experimental measurements have been carried out to identify the BNCT beam parameters including the beam uniformity, the distribution of the thermal neutron dose, boron dose, gamma dose in a phantom and also the Therapeutic Gain (TG). To do this, the entire TRR structure including the reactor core, pool, the thermal column and beam tubes have been modeled using MCNPX Monte Carlo code. To measure in-phantom dose distribution a special head phantom has been constructed and foil activation techniques and TLD700 dosimeter have been used. The results show that there is enough uniformity in TRR thermal BNCT beam. TG parameter has the maximum value of 5.7 at the depth of 1 cm from the surface of the phantom, confirming that TRR thermal neutron beam has potential for being used in treatment of superficial brain tumors. For the purpose of a clinical trial, more modifications need to be done at the reactor, as, for example design, and construction of a treatment room at the beam exit which is our plan for future. To date, this beam is usable for biological studies and animal trials. There is a relatively good agreement between simulation and measurement especially within a diameter of 10 cm which is the dimension of usual BNCT beam ports. This relatively good agreement enables a more precise prediction of the irradiation conditions needed for future experiments.

  8. Thermal hydraulic design features for the BNCT application. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Blue, T.E.; Vafai, K.

    1993-06-01

    This project report is based on our investigations for thermal design of a heat pipe for removing generated heat resulting from Proton bombardments of a Lithium target for a BNCT application. In our investigation, an integral analysis was employed to investigate the vapor an liquid flow in a flat plate heat pipe heated asymmetrically for removal of the 75 kW generated from the BNCT application. The flat plate heat pipe configuration will be used for removing the heat which is generated as a result of proton bombardment of the lithium target. The working fluid in the heat pipe occurs in two phase namely liquid and vapor. The wick contains all the liquid phase and the vapor phase is mainly in the core region. Heat is applied by an external source at the evaporator section which vaporizes the working fluid in this section. This results in a pressure difference which drives the vapor to the condenser section where condenses and releases latent heat of vaporization to a heat sink in the condense section. Due to the vaporization of liquid in the evaporator, the liquid-vapor interface enters into the wick surface and hence capillary pressure is developed there. This capillary pressure causes the condensed liquid in the condenser to be pumped back to the evaporator again. The results of our investigation have enabled us to correlate such diverse information as; the thickness of the wick, the diameter of the heat pipe, the wetting angle, the capillary radius, the surface tension, the latent heat of evaporation, the permeability and porosity of the chosen wick, the length of the heat pipe, and the viscosity and density of the two phases; with the heat removal capabilities of the heat pipe. Expressions for the pressure and velocity distributions are obtained and discussed in relation to our application to BNCT. The present design clearly shows that it is possible to attain temperatures well below the melting temperature of the lithium in the BNCT application.

  9. Optimization of the application of BNCT to undifferentiated thyroid cancer

    International Nuclear Information System (INIS)

    Dagrosa, M.A.; Thomasz, L.; Longhino, J.

    2006-01-01

    The possible increase in BNCT efficacy for undifferentiated thyroid carcinoma (UTC) using BPA plus BOPP and nicotinamide (NA) as a radiosensitizer on the BNCT reaction was analyzed. In these studies nude mice were transplanted with the ARO cells and after 14 days they were treated as follows: 1) Control; 2) NCT (neutrons alone); 3) NCT plus NA (100 mg/kg bw/day for 3 days); 4) BPA (350 mg/kg bw) + neutrons; 5) BPA+ NA+ neutrons; 6) BPA+BOPP (60 mg/kg bw) + neutrons. The flux of hyperthermal neutrons was 2.8 10 8 during 85 min. Neutrons alone or with NA caused some tumor growth delay, while in the BPA, BPA+NA and BPA+BOPP groups a 100% halt of tumor growth was observed. When the initial tumor volume was 50 mm 3 or less a complete cure was found in BPA+NA (2/2); BPA (1/4); BPA+BOPP (7/7). After 90 days of complete regression, recurrence of tumor was observed in 2/2 BPA/NA (2/2) and BPA+BOPP (1/7). Caspase 3 activity was increased in BPA+NA (p<0.05 vs controls). BPA plus NA increased tumor apoptosis but only the combination of BPA+BOPP increased significantly BNCT efficiency. (author)

  10. In vitro biological models in order to study BNCT

    International Nuclear Information System (INIS)

    Dagrosa, Maria A.; Kreimann, Erica L.; Schwint, Amanda E.; Juvenal, Guillermo J.; Pisarev, Mario A.; Farias, Silvia S.; Garavaglia, Ricardo N.; Batistoni, Daniel A.

    1999-01-01

    Undifferentiated thyroid carcinoma (UTC) lacks an effective treatment. Boron neutron capture therapy (BNCT) is based on the selective uptake of 10 B-boronated compounds by some tumours, followed by irradiation with an appropriate neutron beam. The radioactive boron originated ( 11 B) decays releasing 7 Li, gamma rays and alpha particles, and these latter will destroy the tumour. In order to explore the possibility of applying BNCT to UTC we have studied the biodistribution of BPA. In vitro studies: the uptake of p- 10 borophenylalanine (BPA) by the UTC cell line ARO, primary cultures of normal bovine thyroid cells (BT) and human follicular adenoma (FA) thyroid was studied. No difference in BPA uptake was observed between proliferating and quiescent ARO cells. The uptake by quiescent ARO, BT and FA showed that the ARO/BT and ARO/FA ratios were 4 and 5, respectively (p< 0.001). The present experimental results open the possibility of applying BNCT for the treatment of UTC. (author)

  11. A Tandem-electrostatic-quadrupole for accelerator-based BNCT

    International Nuclear Information System (INIS)

    Kreiner, A.J.; Kwan, J.W.; Burlon, A.A.; Di Paolo, H.; Henestroza, E.; Minsky, D.M.; Valda, A.A.; Debray, M.E.; Somacal, H.

    2007-01-01

    A project to develop a Tandem-electrostatic-quadrupole (TESQ) accelerator for accelerator-based boron neutron capture therapy (AB-BNCT) is described. A folded Tandem, with 1.25 MV terminal voltage, combined with an electrostatic quadrupole (ESQ) chain is being proposed. The project goal is a machine capable of delivering 30 mA of 2.5 MeV protons to be used in conjunction with a neutron production target based on the 7 Li(p, n) 7 Be reaction slightly beyond its resonance at 2.25 MeV. This machine is conceptually shown to be capable of accelerating a 30 mA proton beam to 2.5 MeV. These are the specifications needed to produce sufficiently intense and clean epithermal neutron beams, based on the 7 Li(p, n) 7 Be reaction, to perform BNCT treatment for deep-seated tumors in less than an hour. This electrostatic machine is the technologically simplest and cheapest solution for optimized AB-BNCT

  12. Medical setup of intraoperative BNCT at JRR-4

    Energy Technology Data Exchange (ETDEWEB)

    Akutsu, H.; Yamamoto, T.; Matsumura, A. [Tsukuba Univ., Ibaraki (Japan)] [and others

    2000-10-01

    Since October 1999, we have been performing clinical trials of intraoperative boron neutron capture therapy (IOBNCT) using a mixed thermal-epithermal beam at the Japan Research Reactor No. 4 (JRR-4). For immediate pre-BNCT care, including administration of a boron compound as well as post-BNCT care, a collaborating neurosurgical department of the University of Tsukuba was prepared in the vicinity of JRR-4. Following craniotomy in the treatment room, anesthetized patients were transported into the irradiation room for BNCT. The boron concentration in tissue was measured by the PGA and ICP-AES methods. The long-term follow-up was done at the University of Tsukuba Hospital. IOBNCT is a complex clinical procedure, which requires sophisticated operating team and co-medical staffs and also cooperation with physicist team. IOBNCT is a complex clinical procedure requiring a high level of cooperation among the operating team, co-medical staff, and physicists. For the safe and successful performance of IOBNCT, we have made the program including critical pathway and prepared various equipments for IOBNCT. To ensure the safe and successful performance of IOBNCT, we developed a critical pathway for use during the procedure, and prepared various apparatus for IOBNCT. (author)

  13. Pain and intra-operative amnesia evaluation with local anesthesia and sedation in patients subjected to rhinosseptoplasties

    Directory of Open Access Journals (Sweden)

    Weber, Raimar

    2010-03-01

    Full Text Available Introduction: The local anesthesia practice and sedation to rhinoplasty and others aesthetics procedures of the face are each time more frequents. In the Brazil, the Federal Council of Medicine defines it and regulate its practice. Objective: To analyze the analgesia' effectiveness and of the intro operative amnesia through analogous visual and subjective scales in the rhinosseptoplasties performed under local anesthesia and sedation, looking for associations with the medium quantities of medication utilized. Method: A retrospective study based in reports relatives to 158 aesthetic-functional rhinoplasties. The surgeon recorded in a protocol the data relatives to the use of local anesthetics and sedatives (including concentration and quantities utilized as well as the side effects. In the first return post surgery the patient quantifies the pain that he felt in the intra operative utilizing a analogous visual scale as described by Hasen and collaborators. The Amnesia considered ideal when the patient referred to remind "nothing" or "a few of the procedure. Results: The sample constituted of 80 (73,4% women and 29 26,6% men, average of age of 29,3 ± 9,5 years. The median of the pain by the analogous visual scale was 0,05; 80% under 3,35. The amnesia was ideal in 51 (46,8% surgeries. The midazolam was utilized in all the surgeries. Fentanyl in 32 (29,4% and, pethidine in 77 (70,6%. Had not statistically significants differences between the quantities of medication utilized between the groups of patients with ideal amnesia when compared with those that do not obtained satisfactory amnesia. Conclusion: Local anesthesia and sedation in rhinoplasties are comfortable and secures in the majority of the cases, even without have a satisfactory amnesia.

  14. Is intra-operative cholangiography necessary during laparoscopic cholecystectomy? A multicentre rural experience from a developing world country.

    Science.gov (United States)

    Mir, Iqbal Saleem; Mohsin, Mir; Kirmani, Omar; Majid, Tafazul; Wani, Khurshid; Hassan, Mehmood-Ul; Naqshbandi, Javed; Maqbool, Mohammed

    2007-09-07

    To evaluate the feasibility and safety of performing laparoscopic cholecystectomy (LC) in non-teaching rural hospitals of a developing country without intra-operative cholangiography (IOC). To evaluate the possibility of reduction of costs and hospital stay for patients undergoing LC. A prospective analysis of patients with symptomatic benign diseases of gall bladder undergoing LC in three non-teaching rural hospitals of Kashmir Valley from Jan 2001 to Jan 2007. The cohort represented a sample of patients requiring LC, aged 13 to 78 (mean 47.2) years. Main outcome parameters included mortality, complications, re-operation, conversion to open procedure without resorting to IOC, reduction in costs borne by the hospital, and the duration of hospital stay. Twelve hundred and sixty-seven patients (976 females/291 males) underwent laparoscopic cholecystectomy. Twenty-three cases were converted to open procedures; 12 patients developed port site infection, nobody died because of the procedure. One patient had common bile duct (CBD) injury, 4 patients had biliary leak, and 4 patients had subcutaneous emphysema. One cholecystohepatic duct was detected and managed intraoperatively, 1 patient had retained CBD stones, while 1 patient had retained cystic duct stones. Incidental gallbladder malignancy was detected in 2 cases. No long-term complications were detected up to now. LC can be performed safely even in non-teaching rural hospitals of a developing country provided proper equipment is available and the surgeons and other team members are well trained in the procedure. It is stressed that IOC is not essential to prevent biliary tract injuries and missed CBD stones. The costs to the patient and the hospital can be minimized by using reusable instruments, intracorporeal sutures, and condoms instead of titanium clips and endobags.

  15. Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Mueller, Tara C; Loos, Martin; Haller, Bernhard; Mihaljevic, André L; Nitsche, Ulrich; Wilhelm, Dirk; Friess, Helmut; Kleeff, Jörg; Bader, Franz G

    2015-02-01

    Surgical site infection (SSI) remains to be one of the most frequent infectious complications following abdominal surgery. Prophylactic intra-operative wound irrigation (IOWI) before skin closure has been proposed to reduce bacterial wound contamination and the risk of SSI. However, current recommendations on its use are conflicting especially concerning antibiotic and antiseptic solutions because of their potential tissue toxicity and enhancement of bacterial drug resistances. To analyze the existing evidence for the effect of IOWI with topical antibiotics, povidone-iodine (PVP-I) solutions or saline on the incidence of SSI following open abdominal surgery, a systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out according to the recommendations of the Cochrane Collaboration. Forty-one RCTs reporting primary data of over 9000 patients were analyzed. Meta-analysis on the effect of IOWI with any solution compared to no irrigation revealed a significant benefit in the reduction of SSI rates (OR = 0.54, 95 % confidence Interval (CI) [0.42; 0.69], p < 0.0001). Subgroup analyses showed that this effect was strongest in colorectal surgery and that IOWI with antibiotic solutions had a stronger effect than irrigation with PVP-I or saline. However, all of the included trials were at considerable risk of bias according to the quality assessment. These results suggest that IOWI before skin closure represents a pragmatic and economical approach to reduce postoperative SSI after abdominal surgery and that antibiotic solutions seem to be more effective than PVP-I solutions or simple saline, and it might be worth to re-evaluate their use for specific indications.

  16. Characterization of a microDiamond detector in high-dose-per-pulse electron beams for intra operative radiation therapy.

    Science.gov (United States)

    Di Venanzio, C; Marinelli, Marco; Tonnetti, A; Verona-Rinati, G; Falco, M D; Pimpinella, M; Ciccotelli, A; De Stefano, S; Felici, G; Marangoni, F

    2015-12-01

    To characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator. The dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.). The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors. A good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under (60)Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R50 values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes. The microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Reproducibility of a Digital Method to Evaluate Soft Tissue Modifications: A study of Inter and Intra-Operative Measurement Concordance

    Science.gov (United States)

    Rancitelli, Davide; Cicciù, Marco; Lini, Francesco; Fumagalli, Davide; Frigo, Anna Chiara; Maiorana, Carlo

    2017-01-01

    Background: The soft tissue healing and quality around dental implant is a current debated topic in the recent literature. The free gingival margin and the quantity and quality of the mucosa around teeth and surrounding dental implants still determine the hard and soft tissue healing status. Objective: The aim of this study is to assess inter and intra-operative measurement concordance of a method aimed at evaluating the apico-coronal migration of free gingival margin, using intra-oral photography. Methods: The method was tested on peri-implant tissues that were treated with a connective tissue graft on the second stage surgery. Thirty-eight measurements on 13 implants in 8 patients were recorded. An intra-oral photograph was taken for the graft and the provisional crown, which enclosed a circular landmark with a previously determined diameter. The landmark was prepared with a red-resin by the same technician. Before crown cementation, the landmark was calibrated with a digital calibrator by the main investigator, to determine the precise diameter up to two decimal numbers. Results: On the intra-oral photograph, the distance was measured from the most apical point of the determined landmark to the zenith of the gingiva, using an image-processing program designed for scientific multidimensional images (Image J). Three independent examiners took these measurements. Conclusion: The main advantage of the present non-invasive technique is that the spatial plane of the prosthetic landmarks is the same of the tooth unlike the utilization of periodontal probe, which is generally positioned on different plans in the space (generally more vestibular). PMID:28567141

  18. Building of scientific information system for sustainable development of BNCT in Bulgaria

    International Nuclear Information System (INIS)

    Mitev, M.; Ilieva, K.; Apostolov, T.

    2009-01-01

    Building a boron neutron capture therapy (BNCT) facility is foreseen within the reconstruction of the Research Reactor IRT (IRT) of the Institute for Nuclear Research and Nuclear Energy of the Bulgaria Academy of Sciences (INRNE). The development of BNCT at IRT plays a very significant role in the plan for sustainable application of the reactor. A centralized scientific information system on BNCT is being built at the INRNE with the purpose to collect and sort new information as knowledge accumulated during more than thirty years history of BNCT. This BNCT information system will help the creation and consolidation of a well informed and interconnected interdisciplinary team of physicists, chemists, biologists, and radio-oncologists for establishing BNCT cancer treatment in Bulgaria. It will strengthen more intensive development of the national network as well as its enlargement to the Balkan region countries. Furthermore, to acquaint the public at large with the opportunity for BNCT cancer treatment will be addressed. Human, social, and economics results due to BNCT for many patients from Balkan region are expected.

  19. PBF/BNCT [power burst facility/boron neutron capture therapy] program for cancer treatment

    International Nuclear Information System (INIS)

    Dorn, R.V. III.

    1989-06-01

    Highlights of the PBF/BNCT Program during June include progress within the areas of gross boron analysis in tissue, blood, and urine; analytical methodologies development for BSH (sodium borocaptate) purity determination; boron microscopic (subcellular) analytical development; noninvasive boron quantification determination; dosimetry; and analytical radiation transport and interaction modeling for BNCT

  20. Follow up of glioblastoma patients treated with BNCT using spectroscopic imaging

    International Nuclear Information System (INIS)

    Kankaanranta, L.; Haekkinen, A.M.; Kivisaari, L.; Lundbom, N.; Joensuu, H.; Seppaelae, T.

    2000-01-01

    The aim of the study was to investigate the metabolite changes of BPA-mediated BNCT on glioblastoma multiforme (GBM) and on brain white matter with proton magnetic spectroscopic imaging ( 1 H-MRSI). Four glioblastoma patients treated with BNCT were been examined with both MRI and 1 H-MRSI before BNCT and at 3-month intervals following BNCT. We found no change in the choline (Cho) of the tumors of 2 patients 3 months after BNCT, but at 6 months the choline increased in agreement with clinically observed progression of glioblastomas. No N-acetylaspartate (NAA) changes were found in the normal appearing white matter in 3 patients. Unexpectedly, choline changes were seen in both ipsi- and contralateral white matter regions. The small number of patients studied prevents making firm conclusions, but 1 H-MRSI may be a useful method in follow-up of patients treated with BNCT and deserves further study. Presence of only minimal NAA changes in some patients treated with BNCT is intriguing, and may suggest absence of marked neuronal damage within the first 6 months following BNCT treatment when average brain doses <5.2 Gy (W) are used. (author)

  1. Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients

    Directory of Open Access Journals (Sweden)

    Makita Masujiro

    2006-05-01

    Full Text Available Abstract Background A standard intra-operative procedure for assessing sentinel lymph node metastasis in breast cancer patients has not yet been established. Patients and methods One hundred and thirty-eight patients with stage I breast cancer who underwent sentinel node biopsy using both imprint cytology and frozen section were analyzed. Results Seventeen of the 138 patients had sentinel node involvement. Results of imprint cytology included nine false negative cases (sensitivity, 47.1%. In contrast, only two cases of false negatives were found on frozen section (sensitivity, 88.2%. There were two false positive cases identified by imprint cytology (specificity, 98.3%. On the other hand, frozen section had 100% specificity. Conclusion These findings suggest that frozen section is superior to imprint cytology for the intra-operative determination of sentinel lymph node metastasis in stage I breast cancer patients.

  2. Intra-Operative Surgical Irrigation of the Surgical Incision: What Does the Future Hold-Saline, Antibiotic Agents, or Antiseptic Agents?

    Science.gov (United States)

    Edmiston, Charles E; Leaper, David J

    2016-12-01

    Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure. Review of PubMed and OVID for pertinent, scientific, and clinical publications in the English language was performed. Incision irrigation was found to afford a three-fold benefit: First, to hydrate the bed; second, to assist in allowing better examination of the area immediately before closure; and finally, by removing superficial and deep incisional contamination and lowering the bioburden, expedite the healing process. The clinical practice of intra-operative peritoneal lavage is highly variable and is dependent solely on surgeon preference. By contrast, intra-operative irrigation after device-related procedures has become a standard of care for the prophylaxis of acute peri-prosthetic infection. The clinical evidence that supports the use of antibiotic irrigation is limited and based on retrospective analysis and few acceptable randomized controlled trials. The results of laboratory and animal studies using aqueous 0.05% chlorhexidine gluconate are favorable, suggesting that further studies are justified to determine its clinical efficacy. The adoption of appropriate and standardized intra-operative irrigation practices into peri-operative care bundles, which include other evidence-based strategies (weight-based antimicrobial prophylaxis, antimicrobial sutures, maintenance of normothermia, and glycemic control), offers

  3. Rotational X-ray angiography: a method for intra-operative volume imaging of the left-atrium and pulmonary veins for atrial fibrillation ablation guidance

    Science.gov (United States)

    Manzke, R.; Zagorchev, L.; d'Avila, A.; Thiagalingam, A.; Reddy, V. Y.; Chan, R. C.

    2007-03-01

    Catheter-based ablation in the left atrium and pulmonary veins (LAPV) for treatment of atrial fibrillation in cardiac electrophysiology (EP) are complex and require knowledge of heart chamber anatomy. Electroanatomical mapping (EAM) is typically used to define cardiac structures by combining electromagnetic spatial catheter localization with surface models which interpolate the anatomy between EAM point locations in 3D. Recently, the incorporation of pre-operative volumetric CT or MR data sets has allowed for more detailed maps of LAPV anatomy to be used intra-operatively. Preoperative data sets are however a rough guide since they can be acquired several days to weeks prior to EP intervention. Due to positional and physiological changes, the intra-operative cardiac anatomy can be different from that depicted in the pre-operative data. We present an application of contrast-enhanced rotational X-ray imaging for CT-like reconstruction of 3D LAPV anatomy during the intervention itself. Depending on the heart size a single or two selective contrastenhanced rotational acquisitions are performed and CT-like volumes are reconstructed with 3D filtered back projection. In case of dual injection, the two volumes depicting the left and right portions of the LAPV are registered and fused. The data sets are visualized and segmented intra-procedurally to provide anatomical data and surface models for intervention guidance. Our results from animal and human experiments indicate that the anatomical information from intra-operative CT-like reconstructions compares favorably with preacquired imaging data and can be of sufficient quality for intra-operative guidance.

  4. Spectrum shaping of accelerator-based neutron beams for BNCT

    CERN Document Server

    Montagnini, B; Esposito, J; Giusti, V; Mattioda, F; Varone, R

    2002-01-01

    We describe Monte Carlo simulations of three facilities for the production of epithermal neutrons for Boron Neutron Capture Therapy (BNCT) and examine general aspects and problems of designing the spectrum-shaping assemblies to be used with these neutron sources. The first facility is based on an accelerator-driven low-power subcritical reactor, operating as a neutron amplifier. The other two facilities have no amplifier and rely entirely on their primary sources, a D-T fusion reaction device and a conventional 2.5 MeV proton accelerator with a Li target, respectively.

  5. Fatal carotid blowout syndrome after BNCT for head and neck cancers

    International Nuclear Information System (INIS)

    Aihara, T.; Hiratsuka, J.; Ishikawa, H.; Kumada, H.; Ohnishi, K.; Kamitani, N.; Suzuki, M.; Sakurai, H.; Harada, T.

    2015-01-01

    Boron neutron capture therapy (BNCT) is high linear energy transfer (LET) radiation and tumor-selective radiation that does not cause serious damage to the surrounding normal tissues. BNCT might be effective and safe in patients with inoperable, locally advanced head and neck cancers, even those that recur at previously irradiated sites. However, carotid blowout syndrome (CBS) is a lethal complication resulting from malignant invasion of the carotid artery (CA); thus, the risk of CBS should be carefully assessed in patients with risk factors for CBS after BNCT. Thirty-three patients in our institution who underwent BNCT were analyzed. Two patients developed CBS and experienced widespread skin invasion and recurrence close to the carotid artery after irradiation. Careful attention should be paid to the occurrence of CBS if the tumor is located adjacent to the carotid artery. The presence of skin invasion from recurrent lesions after irradiation is an ominous sign of CBS onset and lethal consequences. - Highlights: • This study is fatal carotid blowout syndrome after BNCT for head and neck cancers. • Thirty-three patients in our institution who underwent BNCT were analyzed. • Two patients (2/33) developed CBS. • The presence of skin invasion from recurrent lesions after irradiation is an ominous sign of CBS. • We must be aware of these signs to perform BNCT safely.

  6. Correlation of clinical outcome to the estimated radiation dose from Boron Neutron Capture Therapy (BNCT)

    Energy Technology Data Exchange (ETDEWEB)

    Chadha, M. [Beth Israel Medical Center, NY (United States). Dept. of Radiation Oncology; Coderre, J.A.; Chanana, A.D. [Brookhaven National Lab., Upton, NY (United States)] [and others

    1996-12-31

    A phase I/II trial delivering a single fraction of BNCT using p-Boronophenylalanine-Fructose and epithermal neutrons at the the Brookhaven Medical Research Reactor was initiated in September 1994. The primary endpiont of the study was to evaluate the feasibility and safety of a given BNCT dose. The clinical outcome of the disease was a secondary endpoint of the study. The objective of this paper is to evaluate the correlation of the clinical outcome of patients to the estimated radiation dose from BNCT.

  7. Correlation of clinical outcome to the estimated radiation dose from Boron Neutron Capture Therapy (BNCT)

    International Nuclear Information System (INIS)

    Chadha, M.

    1996-01-01

    A phase I/II trial delivering a single fraction of BNCT using p-Boronophenylalanine-Fructose and epithermal neutrons at the the Brookhaven Medical Research Reactor was initiated in September 1994. The primary endpiont of the study was to evaluate the feasibility and safety of a given BNCT dose. The clinical outcome of the disease was a secondary endpoint of the study. The objective of this paper is to evaluate the correlation of the clinical outcome of patients to the estimated radiation dose from BNCT

  8. Gene transfer-applied BNCT (g-BNCT) for amelanotic melanoma in brain. Further upregulation of {sup 10}B uptake by cell modulation

    Energy Technology Data Exchange (ETDEWEB)

    Iwakura, M.; Tamaki, N. [Kobe Univ. (Japan). School of Medicine; Kondoh, H.; Mishima, Y. [Mishima Inst. for Dermatol. Res., Kobe, Hyogo (Japan); Hiratsuka, J. [Kawasaki Medical School, Dept. Radiation Oncol., Kurashiki, Okayama (Japan)

    2000-10-01

    Our success in eradicating melanoma by single BNCT with BPA led to the next urgent theme, i.e. application of such BNCT for currently uncurable melanoma metastasis in brain. In order to establish {sup 10}B-BPA-BNCT for melanoma in brain, we have investigated the pharmacokinetics of BPA which is most critical factor for successful BNCT, in melanotic and amelanotic and further tyrosinase gene-transfected amelanotic melanoma proliferating in brain having blood-brain-barrier, as compared to melanoma proliferating in skin. We have established three implanted models for melanoma in brain: 1) A1059 cells, amelanotic melanoma, 2) B16B15b cells, melanotic melanoma cells, highly metastatic to brain, and 3) TA1059 cells, with active melanogenesis induced by tyrosinase gene transfection. We would like to report the results of comparative analysis of the BPA uptake ability in these melanoma cells in both brain and skin. Based on these findings, we are further investigating to enhance {sup 10}B-BPA uptake by not only g-BNCT but also by additional melanogenesis upregulating cell modulation. (author)

  9. Gene transfer-applied BNCT (g-BNCT) for amelanotic melanoma in brain. Further upregulation of 10B uptake by cell modulation

    International Nuclear Information System (INIS)

    Iwakura, M.; Tamaki, N.; Hiratsuka, J.

    2000-01-01

    Our success in eradicating melanoma by single BNCT with BPA led to the next urgent theme, i.e. application of such BNCT for currently uncurable melanoma metastasis in brain. In order to establish 10 B-BPA-BNCT for melanoma in brain, we have investigated the pharmacokinetics of BPA which is most critical factor for successful BNCT, in melanotic and amelanotic and further tyrosinase gene-transfected amelanotic melanoma proliferating in brain having blood-brain-barrier, as compared to melanoma proliferating in skin. We have established three implanted models for melanoma in brain: 1) A1059 cells, amelanotic melanoma, 2) B16B15b cells, melanotic melanoma cells, highly metastatic to brain, and 3) TA1059 cells, with active melanogenesis induced by tyrosinase gene transfection. We would like to report the results of comparative analysis of the BPA uptake ability in these melanoma cells in both brain and skin. Based on these findings, we are further investigating to enhance 10 B-BPA uptake by not only g-BNCT but also by additional melanogenesis upregulating cell modulation. (author)

  10. Does pre-operative sampling predict intra-operative cultures and antibiotic sensitivities in knee replacements revised for infection?: a study using the NJR dataset.

    Science.gov (United States)

    Holleyman, Richard J; Deehan, David J; Charlett, Andre; Gould, Kate; Baker, Paul N

    2016-10-01

    This study examined a cohort of primary knee arthroplasties revised for peri-prosthetic infection to (1) determine whether the microorganisms isolated by sampling (up to 6 months pre-operatively) are representative of the microorganisms encountered at the time of knee revision, (2) determine whether the antibiotic sensitivity profiles of matching organisms correlate and (3) determine whether the proportion of organism and antibiotic sensitivity matches is influenced by the type of infection, timing of sample collection and the type of microorganism isolated. From the National Joint Registry database for England and Wales, a consecutive series of primary knee arthroplasties performed between 2003 and 2014 that went on to have a revision for peri-prosthetic infection were identified. Each case was then linked to a national microbiology database held by Public Health England. Following data linkage, intra-operative and pre-operative cultures were identified and compared in a group of 75 patients. Pre-operative genus matched intra-operative genus in 56 of 75 cases (75 %). Of those 56, the corresponding antimicrobial sensitivities matched in 37 (66 % of cases). Overall, 37 of 75 cases (49 %) matched for both microorganism and antimicrobial sensitivity. The proportion of matches was highest in the pure Staphylococcal genus infections (genus match 88 %, sensitivity match 62 %, genus and sensitivity match 55 %) and lowest in those patients with mixed organism infections (genus match 29 %, sensitivity match 14 %). Pre-operative joint sampling obtained by either aspiration or tissue biopsy is advocated in cases where peri-prosthetic infection is suspected and provides the only means of determining infecting organism prior to revision. Overall, only half of all pre-operative cultures matched completely the findings of intra-operative samples in terms of both the microorganism(s) encountered and their corresponding antimicrobial sensitivity profile. Clinicians should

  11. Sublingual misoprostol is as effective as intravenous oxytocin to reduce intra-operative blood loss during cesarean delivery in women living at high altitude.

    Science.gov (United States)

    Gavilanes, Patricio; Morales, Maria Fernanda; Velasco, Stiward; Teran, Enrique

    2016-01-01

    To assess the effect of sublingual misoprostol compared to intravenous oxytocin for blood loss during cesarean delivery in women living at high altitude. In a randomized trial, conducted in Quito, Ecuador (2800 m above sea level), 100 women received either sublingual misoprostol (400 µg) or intravenous oxytocin (10 IU). Bleeding in the misoprostol was no different than in the oxytocin group. Shivering was reported in 66% of women in the misoprostol group. Sublingual misoprostol might be a valid alternative to oxytocin reduce intra-operative blood loss during cesarean section in women living at high altitude.

  12. Investigation of development and management of treatment planning systems for BNCT at foreign facilities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    A new computational dosimetry system for BNCT: JCDS is developed by JAERI in order to carry out BNCT with epithermal neutron beam at present. The development and management situation of computational dosimetry system, which are developed and are used in BNCT facilities in foreign countries, were investigated in order to accurately grasp functions necessary for preparation of the treatment planning and its future subjects. In present state, 'SERA', which are developed by Idaho National Engineering and Environmental Laboratory (INEEL), is used in many BNCT facilities. Followings are necessary for development and management of the treatment planning system. (1) Reliability confirmation of system performance by verification as comparison examination of calculated value with actual experimental measured value. (2) Confirmation systems such as periodic maintenance for retention of the system quality. (3) The improvement system, which always considered relative merits and demerits with other computational dosimetry system. (4) The development of integrated system with patient setting. (author)

  13. Feasibility study to develop BNCT facility at the Indonesian research reactor

    International Nuclear Information System (INIS)

    Hastowo, H.

    2001-01-01

    A survey on the Indonesian research reactors and its supporting facilities has been done in order to check the possibility to install BNCT facility. Oncologists from several hospitals have been informing about the BNCT treatment for tumours and they give a positive response to support utilisation of the BNCT facility. Several aspects required to support the BNCT treatment have also been identified and related activities on that matter soon will be initiated. The interim result in our survey indicated that utilisation of the 30 MW Multipurpose reactor would not be possible from the technical point of view. Further study will be concentrated on the TRIGA reactor and an epithermal neutron beam facility at the thermal column of this reactor will be designed for further work. (author)

  14. Successful BNCT for patients with cutaneous and mucosal melanomas. Report of 4 cases

    International Nuclear Information System (INIS)

    Morita, Norimasa; Hiratsuka, Junichi; Kuwabara, Chiaki; Aihara, Teruhito; Harada, Tamotsu; Imajo, Yoshinari; Ono, Koji; Fukuda, Hiroshi; Kumada, Hiroaki

    2006-01-01

    Since 2003 we have conducted BNCT clinical trials on melanomas at the Kyoto University Research Reactor (KUR) and Japan Research Reactor No.4 (JRR-4). We report 4 patients given BNCT for malignant melanomas: 2 with superficial spreading types on the heel, 1 with mucosal melanoma in the nasal cavity, and 1 with a melanoma on the vulva and in the vagina. The two cutaneous melanomas and the nasal cavity mucosal melanoma showed a complete response (CR) by 6 months after BNCT. The residual melanoma showed a partial response (PR) by 3 months after treatment and no regrowth since then. Although two patients experienced normal-tissue damage that exceeded the tolerance level, all the participants were cured within a few months of treatment. BNCT was shown to be a promising treatment for mucosal, as well as for cutaneous, melanomas. (author)

  15. Physics of epi-thermal boron neutron capture therapy (epi-thermal BNCT).

    Science.gov (United States)

    Seki, Ryoichi; Wakisaka, Yushi; Morimoto, Nami; Takashina, Masaaki; Koizumi, Masahiko; Toki, Hiroshi; Fukuda, Mitsuhiro

    2017-12-01

    The physics of epi-thermal neutrons in the human body is discussed in the effort to clarify the nature of the unique radiologic properties of boron neutron capture therapy (BNCT). This discussion leads to the computational method of Monte Carlo simulation in BNCT. The method is discussed through two examples based on model phantoms. The physics is kept at an introductory level in the discussion in this tutorial review.

  16. INEEL BNCT research program. Annual report, January 1, 1996--December 31, 1996

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1997-04-01

    This report is a summary of the progress and research produced for the Idaho National Engineering and Environmental Laboratory (INEEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1996. Contributions from the individual investigators about their projects are included, specifically, physics: treatment planning software, real-time neutron beam measurement dosimetry, measurement of the Finnish research reactor epithermal neutron spectrum, BNCT accelerator technology; and chemistry: analysis of biological samples and preparation of 10 B enriched decaborane

  17. INEEL BNCT research program. Annual report, January 1, 1996--December 31, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R. [ed.

    1997-04-01

    This report is a summary of the progress and research produced for the Idaho National Engineering and Environmental Laboratory (INEEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1996. Contributions from the individual investigators about their projects are included, specifically, physics: treatment planning software, real-time neutron beam measurement dosimetry, measurement of the Finnish research reactor epithermal neutron spectrum, BNCT accelerator technology; and chemistry: analysis of biological samples and preparation of {sup 10}B enriched decaborane.

  18. Long-survivors of glioblatoma treated with boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Kageji, T.; Mizobuchi, Y.; Nagahiro, S.; Nakagawa, Y.; Kumada, H.

    2011-01-01

    The purpose of this study was to compare the radiation dose between long-survivors and non-long-survivors in patients with glioblatoma (GBM) treated with boron neutron capture therapy (BNCT). Among 23 GBM patients treated with BNCT, there were five patients who survived more than three years after diagnosis. The physical and weighted dose of the minimum gross tumor volume (GTV) of long-survivors was much higher than that of non-long survivors with significant statistical differences.

  19. Complexion of Boric Acid with 2-Deoxy-D-glucose (DG) as a novel boron carrier for BNCT

    OpenAIRE

    Akan, Zafer; Demiroglu, Hasan; Avcibasi, Ugur; Oto, Gokhan; Ozdemir, Hulya; Deniz, Sabahattin; Basak, Ali Sadi

    2014-01-01

    Objective: Boron neutron capture therapy (BNCT) is an intensive research area for cancer researchers. Especially the side effects and inabilities of conventional therapies in some cases, directs researchers to find out a new cancer therapy methods such as BNCT. One of three important problem of BNCT is targeting of boron to tumor tissue. Borono Phenyl Alanine (BPA) and Borono Sodium Borocaptate (BSH) are already using in clinical studies as boron carriers. New boron carriers are searching fo...

  20. INEL BNCT Research Program, January/February 1993

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R. [ed.

    1993-04-01

    This report presents summaries for two months of current research of the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murine screening experiments of low-density lipoprotein, carboranyl alanine, and liposome boron containing compounds. Pituitary tumor cell culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronophenylaianine (BPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, and noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed.

  1. TIDBIT - the INEL database of BNCT information and treatment

    International Nuclear Information System (INIS)

    Mancuso, C.A.

    1995-01-01

    The INEL Database of BNCT Information and Treatment (TIDBIT) has been under development for several years. Late in 1993, a new software development team took over the project and did and assessment of the current implementation status, and determined that the user interface was unsatisfactory for the expected users and that the data structures were out of step with the current state of reality. The team evaluated several tools that would improve the user interface to make the system easier to use. Uniface turned out to be the product of choice. During 1994, TIDBIT got its name, underwent a complete change of appearance, had a major overhaul to the data structures that support the application, and system documentation was begun. A prototype of the system was demonstrated in September 1994

  2. INEL BNCT Research Program, May/June 1992

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1992-09-01

    This report presents summaries for two months of current research of the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murine screening experiments of low-density lipoprotein, carboranyl alanine, and liposome boron containing compounds. Pituitary tumor cell culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronophenylaianine (IBPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, and noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed

  3. INEL BNCT Research Program, September--October 1992

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1992-12-01

    This report presents summaries for two months of current research of the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murine screening experiments of low-density lipoprotain. carboranyl alanine, and liposome boron containing compounds. Pituitary tumor call culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronophonylalanine (BPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, and noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed

  4. INEL BNCT Research Program, September--October 1992

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R.

    1992-12-01

    This report presents summaries for two months of current research of the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murine screening experiments of low-density lipoprotain. carboranyl alanine, and liposome boron containing compounds. Pituitary tumor call culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronophonylalanine (BPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, and noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed.

  5. INEL BNCT Research Program, January/February 1993

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1993-04-01

    This report presents summaries for two months of current research of the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murine screening experiments of low-density lipoprotein, carboranyl alanine, and liposome boron containing compounds. Pituitary tumor cell culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronophenylaianine (BPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, and noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed

  6. INEL BNCT Research Program, March/April 1992

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R.

    1992-09-01

    This report presents summaries for two months of current research for the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murino screening experiments of low-density lipoprotein, carboranyl alanine, and liposome boron containing compounds. Pituitary tumor call culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronopheoylalanine (BPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, and noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed.

  7. Boron neutron capture therapy (BNCT) for glioblastoma multiforme using the epithermal neutron beam at the Brookhaven Medical Research Reactor

    International Nuclear Information System (INIS)

    Capala, J.; Diaz, A.Z.; Chadha, M.

    1997-01-01

    The abstract describes evaluation of boron neutron capture therapy (BNCT) for two groups of glioblastoma multiforme patients. From September 1994 to February 1996 15 patients have been treated. In September 1997 another 34 patients were examined. Authors determined a safe starting dose for BNCT using epithermal neutrons and BPA-F. They have also evaluated adverse effects of BNCT at this starting dose. Therapeutic effectiveness of this starting dose has been evaluated. No significant side effects from BPA-F infusion or BNCT treatment were observed in normal brains

  8. Boron neutron capture therapy (BNCT) for glioblastoma multiforme using the epithermal neutron beam at the Brookhaven Medical Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Capala, J. [Brookhaven National Lab., Upton, NY (United States); Diaz, A.Z.; Chadha, M. [Univ. Hospital, State Univ. of New York, NY (United States)] [and others

    1997-12-31

    The abstract describes evaluation of boron neutron capture therapy (BNCT) for two groups of glioblastoma multiforme patients. From September 1994 to February 1996 15 patients have been treated. In September 1997 another 34 patients were examined. Authors determined a safe starting dose for BNCT using epithermal neutrons and BPA-F. They have also evaluated adverse effects of BNCT at this starting dose. Therapeutic effectiveness of this starting dose has been evaluated. No significant side effects from BPA-F infusion or BNCT treatment were observed in normal brains.

  9. Fracture Surgery of the extremities with the intra-operative use of 3D-RX: A randomized multicenter trial (EF3X-trial

    Directory of Open Access Journals (Sweden)

    Marmor Meir

    2011-07-01

    Full Text Available Abstract Background Posttraumatic osteoarthritis can develop after an intra-articular extremity fracture, leading to pain and loss of function. According to international guidelines, anatomical reduction and fixation are the basis for an optimal functional result. In order to achieve this during fracture surgery, an optimal view on the position of the bone fragments and fixation material is a necessity. The currently used 2D-fluoroscopy does not provide sufficient insight, in particular in cases with complex anatomy or subtle injury, and even an 18-26% suboptimal fracture reduction is reported for the ankle and foot. More intra-operative information is therefore needed. Recently the 3D-RX-system was developed, which provides conventional 2D-fluoroscopic images as well as a 3D-reconstruction of bony structures. This modality provides more information, which consequently leads to extra corrections in 18-30% of the fracture operations. However, the effect of the extra corrections on the quality of the anatomical fracture reduction and fixation as well as on patient relevant outcomes has never been investigated. The objective of this study protocol is to investigate the effectiveness of the intra-operative use of the 3D-RX-system as compared to the conventional 2D-fluoroscopy in patients with traumatic intra-articular fractures of the wrist, ankle and calcaneus. The effectiveness will be assessed in two different areas: 1 the quality of fracture reduction and fixation, based on the current golden standard, Computed Tomography. 2 The patient-relevant outcomes like functional outcome range of motion and pain. In addition, the diagnostic accuracy of the 3D-RX-scan will be determined in a clinical setting and a cost-effectiveness as well as a cost-utility analysis will be performed. Methods/design In this protocol for an international multicenter randomized clinical trial, adult patients (age > 17 years with a traumatic intra-articular fracture of the

  10. Boron Neutron Capture Therapy (BNCT) in an experimental model of lung metastases in BDIX rats

    International Nuclear Information System (INIS)

    Trivillin, V.A.; Garabalino, M.A.; Colombo, L.L.

    2013-01-01

    Boron Neutron Capture Therapy (BNCT) in an experimental model of lung metastases in BDIX rats Introduction: Boron Neutron Capture Therapy (BNCT) is based on selective tumor uptake of boron compounds, followed by neutron irradiation. BNCT was proposed for the treatment of unresectable, diffuse lung metastases. The aim of the present study was to perform BNCT studies in an experimental model of lung metastases. Materials and Methods: 3 x 106/0.5 ml colon carcinoma cells (DHD/K12/TRb) were injected iv in syngeneic BDIX rats. Three weeks post-inoculation, rats with diffuse lung metastases were used for in vivo BNCT studies in the RA-3 Nuclear Reactor. Based on previous biodistribution studies and computational dosimetry with Monte Carlo simulation, 2 doses were prescribed, i.e. 4 Gy and 8 Gy minimum absorbed dose to tumor. The animals were assigned to 5 experimental groups (n= 4 to 8) at each dose level: T0 (euthanized pre-treatment), BPA-BNCT, Comb-BNCT (BPA+GB-10), Beam only (background dose) and Sham (same manipulation, no treatment). Boron concentration was measured in a blood sample taken pre-irradiation to verify that the value was in the range established in previous biodistribution studies. The animals were followed clinically for 2 weeks after neutron irradiation and then euthanized to assess the response of tumor and normal lung, macroscopically and histologically. To date we have evaluated the end-point weight of lung (normal lung + metastases) and % lung weight/body weight as an indicator of tumor growth. Results: The statistical analysis (ANOVA) of % lung weight/body weight showed statistically significant differences (p<0.05) between groups T0 (0.79 ± 0.38) and Sham (1.87 ± 0.91). No statistically significant differences were observed between the Beam only groups (at both dose levels) and Sham. Similar and statistically significant tumor control was induced in the groups BPA-BNCT Low dose (LD) (0.56 ± 0.11), BPA-BNCT High dose (HD) (0.80 ± 0.16), Comb-BNCT

  11. First clinical results on the finnish study on BPA-mediated BNCT in glioblastoma

    International Nuclear Information System (INIS)

    Kankaanranta, L.; Seppaelae, T.; Kallio, M.

    2000-01-01

    An open phase I dose-escalation boron neutron capture therapy (BNCT) study on glioblastoma multiforme (GBM) was initiated at the BNCT facility FiR 1, Espoo, Finland, in May 1999. The aim of the study is to investigate the safety of boronophenylalanine (BPA)-mediated BNCT. Ten GBM patients were treated with a 2-field treatment plan using one fraction. BPA-F was used as the 10 B carrier infused as a fructose solution 290 mg BPA/kg over 2-hours prior to irradiation with epithermal neutrons. Average doses to the normal brain, contrast enhancing tumour, and the target ranged from 3.0 to 5.6 Gy (W), from 35.1 to 66.7 Gy (W), and from 29.6 to 53.6 Gy (W), respectively. BNCT was associated with acceptable toxicity. The median follow-up is 9 months (range, 3 to 16 months) post diagnosis in July 2000. Seven of the 10 patients have recurrent or persistent GBM, and the median time to progression is 8 months. Only one patient has died, and the estimated 1-year overall survival is 86%. Five of the recurrent tumours were treated with external beam photon radiation therapy to the total dose of 30-40 Gy with few acute side-effects. These preliminary findings suggest that acute toxicity of BPA-mediated BNCT is acceptable when average brain doses of 5.6 Gy (W) or less are used. The followup time is too short to evaluate survival, but the estimated 1-year survival of 86% achieved with BNCT followed by conventional photon irradiation at the time of tumour progression is encouraging and emphasises the need of further investigation of BPA-mediated BNCT. (author)

  12. Intra-operative Vector Flow Imaging Using Ultrasound of the Ascending Aorta among 40 Patients with Normal, Stenotic and Replaced Aortic Valves

    DEFF Research Database (Denmark)

    Hansen, Kristoffer Lindskov; Møller-Sørensen, Hasse; Kjaergaard, Jesper

    2016-01-01

    Stenosis of the aortic valve gives rise to more complex blood flows with increased velocities. The angleindependent vector flow ultrasound technique transverse oscillation was employed intra-operatively on the ascending aorta of (I) 20 patients with a healthy aortic valve and 20 patients with aor...... replacement corrects some of these changes. Transverse oscillation may be useful for assessment of aortic stenosis and optimization of valve surgery. (E-mail: lindskov@gmail.com) 2016 World Federation for Ultrasound in Medicine & Biology...... with aortic stenosis before (IIa) and after (IIb) valve replacement. The results indicate that aortic stenosis increased flow complexity (p , 0.0001), induced systolic backflow (p , 0.003) and reduced systolic jet width (p , 0.0001). After valve replacement, the systolic backflow and jet width were normalized...

  13. Accelerator based-boron neutron capture therapy (BNCT)-clinical QA and QC

    International Nuclear Information System (INIS)

    Suzuki, Minoru; Tanaka, Hiroki; Sakurai, Yoshinori; Yong, Liu; Kashino, Genro; Kinashi, Yuko; Masunaga, Shinichiro; Ono, Koji; Maruhashi, Akira

    2009-01-01

    Alpha-particle and recoil Li atom yielded by the reaction ( 10 B, n), due to their high LET properties, efficiently and specifically kill the cancer cell that has incorporated the boron. Efficacy of this boron neutron capture therapy (BNCT) has been demonstrated mainly in the treatment of recurrent head/neck and malignant brain cancers in Kyoto University Research Reactor Institute (KUR). As the clinical trial of BNCT is to start from 2009 based on an accelerator (not on the Reactor), this paper describes the tentative outline of the standard operation procedure of BNCT for its quality assurance (QA) and quality control (QC) along the flow of its clinical practice. Personnel concerned in the practice involve the attending physician, multiple physicians in charge of BNCT, medical physicists, nurses and reactor stuff. The flow order of the actual BNCT is as follows: Pre-therapeutic evaluation mainly including informed consent and confirmation of the prescription; Therapeutic planning including setting of therapy volume, and of irradiation axes followed by meeting for stuffs' agreement, decision of irradiating field in the irradiation room leading to final decision of the axis, CT for the planning, decision of the final therapeutic plan according to Japan Atomic Energy Agency-Computational Dosimetry System (JCDS) and meeting of all related personnel for the final confirmation of therapeutic plan; and BNCT including the transport of patient to KUR, dripping of boronophenylalanine, setting up of the patient on the machine, blood sampling for pharmacokinetics, boron level measurement for decision of irradiating time, switch on/off of the accelerator, confirmation of patient's movement in the irradiated field after the neutron irradiation, blood sampling for confirmation of the boron level, and patient's leave from the room. The QA/QC check is principally to be conducted with the two-person rule. The purpose of the clinical trial is to establish the usefulness of BNCT

  14. Analysis of radiation risk to patients from intra-operative use of the mobile X-ray system (C-arm

    Directory of Open Access Journals (Sweden)

    Yang-Sub Lee

    2015-01-01

    Full Text Available Background: The aim of this study was to investigate clinical applications of mobile C-arms and consequent radiation risk, to increase medical attention on radiation protection, and to provide basic data for safe radiation use in the operating room. Materials and Methods: In this study, a total of 374 surgical operations, conducted using a portable fluoroscopic X-ray system from January to March of 2013, were analyzed. Dose summaries produced by the General Electric C-arm and data elements in digital imaging and communications in the medicine header of Ziehm C-arm, fluoroscopy time were used to obtain dose-area product (DAP and effective dose. Corresponding mean and maximum values were calculated, and the resulting data on the frequency of application, fluoroscopy time, DAP, and effective dose were compared and analyzed in terms of surgical specialty and operation types. Results: Orthopedic surgery was the most frequent with 165 cases (44.1%. The highest DAP value and effective dose were found in liver transplant among surgical specialty fields, with mean values of 2.90 ± 3.76 mGy∙m 2 and 58 ± 75.2 mSv, respectively (P = 0.0001. The highest DAP value and effective dose were observed in intra-operative mesenteric portography among types of surgery, showing mean values of 2.90 ± 3.81 mGy∙m 2 and 58.03 ± 76.24 mSv, respectively (P = 0.0001. Conclusion: Because DAP varies significantly across surgical specialties and types of operation, aggressive efforts to understand the effects of radiation dose is critical for radiation protection from intra-operative use of mobile C-arms.

  15. Biocompatibility of functionalized boron phosphate (BPO4) nanoparticles for boron neutron capture therapy (BNCT) application.

    Science.gov (United States)

    Achilli, Cesare; Grandi, Stefania; Ciana, Annarita; Guidetti, Gianni F; Malara, Alessandro; Abbonante, Vittorio; Cansolino, Laura; Tomasi, Corrado; Balduini, Alessandra; Fagnoni, Maurizio; Merli, Daniele; Mustarelli, Piercarlo; Canobbio, Ilaria; Balduini, Cesare; Minetti, Giampaolo

    2014-04-01

    Boron neutron capture therapy (BNCT) is a radiotherapy treatment based on the accumulation in the tumor of a (10)B-containing drug and subsequent irradiation with low energy neutrons, which bring about the decay of (10)B to (7)Li and an α particle, causing the death of the neoplastic cell. The effectiveness of BNCT is limited by the low delivery and accumulation of the used boron-containing compounds. Here we report the development and the characterization of BPO4 nanoparticles (NPs) as a novel possible alternative drug for BNCT. An extensive analysis of BPO4 NP biocompatibility was performed using both mature blood cells (erythrocytes, neutrophils and platelets) and a model of hematopoietic progenitor cells. A time- and concentration-dependent cytotoxicity study was performed on neoplastic coloncarcinoma and osteosarcoma cell lines. BPO4 functionalization with folic acid, introduced to improve the uptake by tumor cells, appeared to effectively limit the unwanted effects of NPs on the analyzed blood components. Boron neutron capture therapy (BNCT) is a radiotherapy treatment modality based on the accumulation of a (10)B-containing drug and subsequent irradiation with low energy neutrons, inducing the decay of (10)B to (7)Li and an α particle, causing neoplastic cell death. This team of authors reports on a folic acid functionalized BPO4 nanoparticle with improved characteristics compared with conventional BNCT approaches, as demonstrated in tumor cell lines, and hopefully to be followed by translational human studies. © 2014.

  16. Fission reactor based epithermal neutron irradiation facilities for routine clinical application in BNCT-Hatanaka memorial lecture

    International Nuclear Information System (INIS)

    Harling, Otto K.

    2009-01-01

    Based on experience gained in the recent clinical studies at MIT/Harvard, the desirable characteristics of epithermal neutron irradiation facilities for eventual routine clinical BNCT are suggested. A discussion of two approaches to using fission reactors for epithermal neutron BNCT is provided. This is followed by specific suggestions for the performance and features needed for high throughput clinical BNCT. An example of a current state-of-the-art, reactor based facility, suited for routine clinical use is discussed. Some comments are provided on the current status of reactor versus accelerator based epithermal neutron sources for BNCT. This paper concludes with a summary and a few personal observations on BNCT by the author.

  17. Assessment of the learning curves for photoselective vaporization of the prostate using GreenLight™ 180-Watt-XPS laser therapy: defining the intra-operative parameters within a prospective cohort.

    Science.gov (United States)

    Misraï, Vincent; Faron, Matthieu; Guillotreau, Julien; Bruguière, Eric; Bordier, Benoit; Shariat, Shahrokh F; Rouprêt, Morgan

    2014-04-01

    To assess the learning curves for the intra-operative parameters of the GreenLight™ 180-W XPS for photoselective vaporization of the prostate (PVP). A prospective study was conducted on 200 men who underwent PVP using the GreenLight™ 180-W XPS over 20 months. The population was divided into four consecutive equal groups. Evolution of lasing parameters was the main endpoint to reach an average energy of 5 kJ per prostate volume and to reach a lasing time/operative time (LT/OT) ratio of 66-80 %. Changes in the IPSS and prostate volume were also evaluated 12 weeks later. Total energy delivered (energy/ml of prostate) and the LT/OT ratio significantly increased over time (p learning curves within multiple intra-operative parameters. The PVP learning curves required at least 120 procedures until it met all intra-operative parameters of experts in this field.

  18. BNCT clinical trials of skin melanoma patients in Argentina

    International Nuclear Information System (INIS)

    Roth, Berta M.; Bonomi, Marcelo R.; Gonzalez, Sara J.

    2006-01-01

    The clinical outcome of six skin melanoma BNCT irradiations is presented. Three patients (A, B and C), with multiple subcutaneous skin metastases progressed to chemotherapy were infused with ∼14 g/m 2 of boronophenylalanine ( 10 BPA)-fructose and irradiated in the hyperthermal neutron beam of the RA-6 reactor. Patient A received two one fraction irradiations in different areas of the leg, B received one fraction and C was irradiated in three consecutive fields at the calf, heel and foot sole. The maximum prescribed dose to normal skin ranged from 16.5 to 24 Gy-Eq. With a minimum follow-up of 10 months there was a G1 acute epithelitis in A and B and a G3 in C. No late toxicity was observed. Due to the in-field tumor-growth-delay and the absence of severe acute and/or late toxicity observed during the follow-up period, a dose-escalation trial is ongoing. (author)

  19. Liquid Li based neutron source for BNCT and science application.

    Science.gov (United States)

    Horiike, H; Murata, I; Iida, T; Yoshihashi, S; Hoashi, E; Kato, I; Hashimoto, N; Kuri, S; Oshiro, S

    2015-12-01

    Liquid lithium (Li) is a candidate material for a target of intense neutron source, heat transfer medium in space engines and charges stripper. For a medical application of BNCT, epithermal neutrons with least energetic neutrons and γ-ray are required so as to avoid unnecessary doses to a patient. This is enabled by lithium target irradiated by protons at 2.5 MeV range, with utilizing the threshold reaction of (7)Li(p,n)(7)Be at 1.88 MeV. In the system, protons at 2.5 MeV penetrate into Li layer by 0.25 mm with dissipating heat load near the surface. To handle it, thin film flow of high velocity is important for stable operation. For the proton accelerator, electrostatic type of the Schnkel or the tandem is planned to be employed. Neutrons generated at 0.6 MeV are gently moderated to epithermal energy while suppressing accompanying γ-ray minimum by the dedicated moderator assembly. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. The Idaho Power Burst Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program overview

    International Nuclear Information System (INIS)

    Dorn, R.V. III; Griebenow, M.L.; Ackermann, A.L.; Miller, L.G.; Miller, D.L.; Wheeler, F.J.; Bradshaw, K.M.; Wessol, D.E.; Harker, Y.D.; Nigg, D.W.; Randolph, P.D.; Bauer, W.F.; Gavin, P.R.; Richards, T.L.

    1992-01-01

    The Power Burst Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program has been funded since 1988 to evaluate brain tumor treatment using Na 2 B 12 H 11 SH (borocaptate sodium or BSH) and epithermal neutrons. The PBF/BNCT Program pursues this goal as a comprehensive, multidisciplinary, multiorganizational endeavor applying modern program management techniques. The initial focus was to: (1) establish a representative large animal model and (2) develop the generic analytical and measurement capabilities require to control treatment repeatability and determine critical treatment parameters independent of tumor type and body location. This paper will identify the PBF/BNCT Program elements and summarize the status of some of the developed capabilities

  1. Subcellular boron and fluorine distributions with SIMS ion microscopy in BNCT and cancer research

    Energy Technology Data Exchange (ETDEWEB)

    Subhash Chandra

    2008-05-30

    The development of a secondary ion mass spectrometry (SIMS) based technique of Ion Microscopy in boron neutron capture therapy (BNCT) was the main goal of this project, so that one can study the subcellular location of boron-10 atoms and their partitioning between the normal and cancerous tissue. This information is fundamental for the screening of boronated drugs appropriate for neutron capture therapy of cancer. Our studies at Cornell concentrated mainly on studies of glioblastoma multiforme (GBM). The early years of the grant were dedicated to the development of cryogenic methods and correlative microscopic approaches so that a reliable subcellular analysis of boron-10 atoms can be made with SIMS. In later years SIMS was applied to animal models and human tissues of GBM for studying the efficacy of potential boronated agents in BNCT. Under this grant the SIMS program at Cornell attained a new level of excellence and collaborative SIMS studies were published with leading BNCT researchers in the U.S.

  2. Radiation shielding design of BNCT treatment room for D-T neutron source.

    Science.gov (United States)

    Pouryavi, Mehdi; Farhad Masoudi, S; Rahmani, Faezeh

    2015-05-01

    Recent studies have shown that D-T neutron generator can be used as a proper neutron source for Boron Neutron Capture Therapy (BNCT) of deep-seated brain tumors. In this paper, radiation shielding calculations have been conducted based on the computational method for designing a BNCT treatment room for a recent proposed D-T neutron source. By using the MCNP-4C code, the geometry of the treatment room has been designed and optimized in such a way that the equivalent dose rate out of the treatment room to be less than 0.5μSv/h for uncontrolled areas. The treatment room contains walls, monitoring window, maze and entrance door. According to the radiation protection viewpoint, dose rate results of out of the proposed room showed that using D-T neutron source for BNCT is safe. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Characterisation of an accelerator-based neutron source for BNCT versus beam energy

    CERN Document Server

    Agosteo, S; D'Errico, F; Nath, R; Tinti, R

    2002-01-01

    Neutron capture in sup 1 sup 0 B produces energetic alpha particles that have a high linear energy transfer in tissue. This results in higher cell killing and a higher relative biological effectiveness compared to photons. Using suitably designed boron compounds which preferentially localize in cancerous cells instead of healthy tissues, boron neutron capture therapy (BNCT) has the potential of providing a higher tumor cure rate within minimal toxicity to normal tissues. This clinical approach requires a thermal neutron source, generally a nuclear reactor, with a fluence rate sufficient to deliver tumorcidal doses within a reasonable treatment time (minutes). Thermal neutrons do not penetrate deeply in tissue, therefore BNCT is limited to lesions which are either superficial or otherwise accessible. In this work, we investigate the feasibility of an accelerator-based thermal neutron source for the BNCT of skin melanomas. The source was designed via MCNP Monte Carlo simulations of the thermalization of a fast ...

  4. Might iodomethyl-{alpha}-tyrosine be a surrogate for BPA in BNCT?

    Energy Technology Data Exchange (ETDEWEB)

    Miura, Michiko; Micca, P.L.; Nawrocky, M.M.; Slatkin, D.N.

    1996-12-31

    A single-photon emission computed tomography [SPECT] imaging agent that is an analogue of a boron carrier for boron neutron-capture therapy [BNCT] of cerebral gliomas would be useful for assessing the kinetics of boron uptake in tumors and in the surrounding brain tissues noninvasively. BNCT is based on the interaction of thermalized neutrons with {sup 10}B nuclei in the targeted tumor. For BNCT of brain tumors, it is crucial that {sup 10}B concentrations in radiosensitive regions of the brain be minimal since malignant cells and vital brain tissues are often inter-mingled at the margins of the tumor. Currently, boronophenylalanine [BPA]-mediated BNCT is undergoing preliminary clinical study for postoperative radiotherapy of glioblastorna multiforme at Brookhaven National Laboratory. Investigators in Japan are developing {sup 18}F-fluoroboronophenylaianine [FBPA] as a positron {sup 18}F (T{sub 1/2} = 110 min), which is usually emission tomography [PET] surrogate for BPA. generated at a cyclotron dedicated to PET, is generally a minimally perturbing substitute for the 2-H on the aromatic ring because of its small size and the strong covalent bond it forms with carbon. However, SPECT has potential advantages over PET: (1) SPECT is clinically more widely available at lower cost; (2) most radioisotopes for the synthesis of SPECT agents can be purchased; (3) SPECT is less difficult to implement. It is thought that the quality of images derived from the two techniques would each be sufficiently informative for BNCT treatment planning purposes, provided that the SPECT and PET agents being considered were both pharmacokinetic surrogates for BPA. This study evaluated the use of {sup 123}I alpha methyltyrosine as a surrogate for BPA in BNCT.

  5. Might iodomethyl-α-tyrosine be a surrogate for BPA in BNCT?

    International Nuclear Information System (INIS)

    Miura, Michiko; Micca, P.L.; Nawrocky, M.M.; Slatkin, D.N.

    1996-01-01

    A single-photon emission computed tomography [SPECT] imaging agent that is an analogue of a boron carrier for boron neutron-capture therapy [BNCT] of cerebral gliomas would be useful for assessing the kinetics of boron uptake in tumors and in the surrounding brain tissues noninvasively. BNCT is based on the interaction of thermalized neutrons with 10 B nuclei in the targeted tumor. For BNCT of brain tumors, it is crucial that 10 B concentrations in radiosensitive regions of the brain be minimal since malignant cells and vital brain tissues are often inter-mingled at the margins of the tumor. Currently, boronophenylalanine [BPA]-mediated BNCT is undergoing preliminary clinical study for postoperative radiotherapy of glioblastorna multiforme at Brookhaven National Laboratory. Investigators in Japan are developing 18 F-fluoroboronophenylaianine [FBPA] as a positron 18 F (T 1/2 = 110 min), which is usually emission tomography [PET] surrogate for BPA. generated at a cyclotron dedicated to PET, is generally a minimally perturbing substitute for the 2-H on the aromatic ring because of its small size and the strong covalent bond it forms with carbon. However, SPECT has potential advantages over PET: (1) SPECT is clinically more widely available at lower cost; (2) most radioisotopes for the synthesis of SPECT agents can be purchased; (3) SPECT is less difficult to implement. It is thought that the quality of images derived from the two techniques would each be sufficiently informative for BNCT treatment planning purposes, provided that the SPECT and PET agents being considered were both pharmacokinetic surrogates for BPA. This study evaluated the use of 123 I alpha methyltyrosine as a surrogate for BPA in BNCT

  6. Liposome and co-spray-dried PVP / o-carborane formulations for BNCT treatment of cancer

    OpenAIRE

    Olusanya, Temidayo; Stich, Theresia; Higgins, Samantha Caroline; Lloyd, Rhiannon Eleanor Iris; Pilkington, Geoffrey John; Fatouros, Dimitrios; Calabrese, Gianpiero; Smith, James Richard; Tsibouklis, John

    2015-01-01

    Purpose: Boron neutron capture therapy (BNCT) is a method for selectively destroying malignant (normally glioma) cells whilst sparing normal tissue. Irradiation of 10B (large neutron capture cross-section) with thermal neutrons effects the nuclear fission reaction: 10B + 1n → → 7Li+ + α + γ; where the penetration of α-particles and 7Li+ is only 8 and 5 µm, respectively, i.e., within a single cell thickness. Poor selectivity is the main reason why BNCT has not become a mainstream cancer therap...

  7. The Boron Neutron Capture Therapy (BNCT) Project at the TRIGA Reactor in Mainz, Germany

    DEFF Research Database (Denmark)

    Hampel, G.; Grunewald, C.; Schütz, C.

    2011-01-01

    The thermal column of the TRIGA reactor in Mainz is being used very effectively for medical and biological applications. The BNCT (boron neutron capture therapy) project at the University of Mainz is focussed on the treatment of liver tumours, similar to the work performed at Pavia (Italy) a few...... have also been initiated to investigate radiobiological effects of radiation generated during BNCT. For both experiments and treatment, a reliable dosimetry system is necessary. From work elsewhere, the use of alanine detectors appear to be an appropriate dosimetry technique....

  8. Experimental study on the performance of an epithermal neutron flux monitor for BNCT.

    Science.gov (United States)

    Guan, Xingcai; Manabe, Masanobu; Tamaki, Shingo; Liu, Shuangtong; Sato, Fuminobu; Murata, Isao; Wang, Tieshan

    2016-07-01

    The performance of an epithermal neutron (0.5eVflux monitor designed for boron neutron capture therapy (BNCT) was experimentally studied by using a prototype monitor in an appropriate neutron field at the intense deuterium-tritium neutron source facility OKTAVIAN of Osaka University, Japan. It was convinced from the experimental results that the developed monitor worked well and the epithermal neutron fluxes in BNCT neutron sources can be measured within 5% by the monitor. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Study of the potential of using 9B(p,n) for BNCT clinical trials

    International Nuclear Information System (INIS)

    Stone, N.; Bleuel, D.; Donahue, R.; Ludewigt, B.A.; Chu, W.T.

    2000-01-01

    The potential of using a 30-MeV proton accelerator utilizing the 9 Be(p,n) 9 B reaction as a neutron source for BNCT (Boron Neutron Capture Therapy) was investigated. MCNPX (Monte Carlo Neutron Photon-transport code X) was used to calculated neutron spectra and yields for comparison against existing experimental data and for the moderator optimization. Moderator performance was assessed using MCNPX and clinical efficacy was assessed using BNCT-RTPE to estimate in-phantom dose distributions and neutron fluences. The optimized source and moderator gave comparable tumor doses and treatment times to the clinical trials recently completed at the Brookhaven Medical Research Reactor (BMRR). (author)

  10. Towards a new therapy protocol for liver metastases. Effect of boron compounds and BNCT on normal liver regeneration

    International Nuclear Information System (INIS)

    Cardoso, Jorge E.; Heber, Elisa M.; Trivillin, Veronica A.

    2006-01-01

    The Taormina project developed a new method for BNCT treatment of multifocal unresectable liver metastases based on whole liver autograft. The Roffo Institute liver surgeons propose a new technique based on partial liver autograft that would pose less risk to the patient but would require significant healthy liver regeneration following BNCT. The aim of the present study was to assess the effect of BPA, GB-10 (Na 2 10 B 10 H 10 ) and (GB-10 + BPA) and of BNCT mediated by these boron compounds on normal liver regeneration in the Wistar rat. Normal liver regeneration, body weight, hemogram, liver and kidney function were assessed following partial hepatectomy post administration of BPA, GB-10 or (GB-10 + BPA) and post in vivo BNCT at the RA-6 Reactor. These end-points were evaluated 9 days following partial hepatectomy, the time at which complete liver regeneration occurs in untreated controls. The corresponding biodistribution studies were conducted to perform dosimetric calculations. BPA, GB-10 and (GB-10 + PBA) and in vivo BNCT mediated by these boron compounds in dose ranges compatible with therapy did not cause alterations in the outcome of normal liver regeneration, and did not induce alterations in body weight, hemogram, liver or kidney function. The experimental data available to date support the development of a new BNCT protocol for the treatment of liver metastases that requires the regeneration of normal liver past-BNCT. (author)

  11. Abscopal effect of boron neutron capture therapy (BNCT). Proof of principle in an experimental model of colon cancer

    Energy Technology Data Exchange (ETDEWEB)

    Trivillin, Veronica A.; Monti Hughes, Andrea; Schwint, Amanda E. [Comision Nacional de Energia Atomica (CNEA), Department of Radiobiology, B1650KNA San Martin, Provincia Buenos Aires (Argentina); Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Pozzi, Emiliano C.C.; Curotto, Paula [Centro Atomico Ezeiza, Comision Nacional de Energia Atomica (CNEA), Department of Research and Production Reactors, Provincia Buenos Aires (Argentina); Colombo, Lucas L. [Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Instituto de Oncologia Angel H. Roffo, Ciudad Autonoma de Buenos Aires (Argentina); Thorp, Silvia I.; Farias, Ruben O. [Comision Nacional de Energia Atomica (CNEA), Department of Instrumentation and Control, Provincia Buenos Aires (Argentina); Garabalino, Marcela A. [Comision Nacional de Energia Atomica (CNEA), Department of Radiobiology, B1650KNA San Martin, Provincia Buenos Aires (Argentina); Gonzalez, Sara J. [Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Comision Nacional de Energia Atomica (CNEA), Department of Instrumentation and Control, Provincia Buenos Aires (Argentina); Santa Cruz, Gustavo A. [Comision Nacional de Energia Atomica (CNEA), Department of Boron Neutron Capture Therapy, Provincia Buenos Aires (Argentina); Carando, Daniel G. [Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Universidad de Buenos Aires, Faculty of Exact and Natural Sciences, Ciudad Autonoma de Buenos Aires (Argentina)

    2017-11-15

    The aim of the present study was to evaluate, for the first time, the abscopal effect of boron neutron capture therapy (BNCT). Twenty-six BDIX rats were inoculated subcutaneously with 1 x 10{sup 6} DHD/K12/TRb syngeneic colon cancer cells in the right hind flank. Three weeks post-inoculation, the right leg of 12 rats bearing the tumor nodule was treated with BPA-BNCT (BPA-Boronophenylalanine) at the RA-3 nuclear reactor located in Buenos Aires, Argentina, at an absorbed dose of 7.5 Gy to skin as the dose-limiting tissue. The remaining group of 14 tumor-bearing rats were left untreated and used as control. Two weeks post-BNCT, 1 x 10{sup 6} DHD/K12/TRb cells were injected subcutaneously in the contralateral left hind flank of each of the 26 BDIX rats. Tumor volume in both legs was measured weekly for 7 weeks to determine response to BNCT in the right leg and to assess a potential influence of BNCT in the right leg on tumor development in the left leg. Within the BNCT group, a statistically significant reduction was observed in contralateral left tumor volume in animals whose right leg tumor responded to BNCT (post-treatment/pre-treatment tumor volume <1) versus animals who failed to respond (post/pre ≥1), i.e., 13 ± 15 vs 271 ± 128 mm{sup 3}. In addition, a statistically significant reduction in contralateral left leg tumor volume was observed in BNCT-responsive animals (post/pre <1) vs untreated animals, i.e., 13 ± 15 vs 254 ± 251 mm{sup 3}. The present study performed in a simple animal model provides proof of principle that the positive response of a tumor to BNCT is capable of inducing an abscopal effect. (orig.)

  12. Abscopal effect of boron neutron capture therapy (BNCT). Proof of principle in an experimental model of colon cancer

    International Nuclear Information System (INIS)

    Trivillin, Veronica A.; Monti Hughes, Andrea; Schwint, Amanda E.; Pozzi, Emiliano C.C.; Curotto, Paula; Colombo, Lucas L.; Thorp, Silvia I.; Farias, Ruben O.; Garabalino, Marcela A.; Gonzalez, Sara J.; Santa Cruz, Gustavo A.; Carando, Daniel G.

    2017-01-01

    The aim of the present study was to evaluate, for the first time, the abscopal effect of boron neutron capture therapy (BNCT). Twenty-six BDIX rats were inoculated subcutaneously with 1 x 10 6 DHD/K12/TRb syngeneic colon cancer cells in the right hind flank. Three weeks post-inoculation, the right leg of 12 rats bearing the tumor nodule was treated with BPA-BNCT (BPA-Boronophenylalanine) at the RA-3 nuclear reactor located in Buenos Aires, Argentina, at an absorbed dose of 7.5 Gy to skin as the dose-limiting tissue. The remaining group of 14 tumor-bearing rats were left untreated and used as control. Two weeks post-BNCT, 1 x 10 6 DHD/K12/TRb cells were injected subcutaneously in the contralateral left hind flank of each of the 26 BDIX rats. Tumor volume in both legs was measured weekly for 7 weeks to determine response to BNCT in the right leg and to assess a potential influence of BNCT in the right leg on tumor development in the left leg. Within the BNCT group, a statistically significant reduction was observed in contralateral left tumor volume in animals whose right leg tumor responded to BNCT (post-treatment/pre-treatment tumor volume <1) versus animals who failed to respond (post/pre ≥1), i.e., 13 ± 15 vs 271 ± 128 mm 3 . In addition, a statistically significant reduction in contralateral left leg tumor volume was observed in BNCT-responsive animals (post/pre <1) vs untreated animals, i.e., 13 ± 15 vs 254 ± 251 mm 3 . The present study performed in a simple animal model provides proof of principle that the positive response of a tumor to BNCT is capable of inducing an abscopal effect. (orig.)

  13. The efficacy, safety and cost-effectiveness of intra-operative cell salvage in high-bleeding-risk cardiac surgery with cardiopulmonary bypass: a prospective randomized and controlled trial.

    Science.gov (United States)

    Xie, Yihong; Shen, Sheliang; Zhang, Jun; Wang, Wenyuan; Zheng, Jiayin

    2015-01-01

    Intra-operative cell salvage (CS) was reported to be ineffective, safe and not cost-effective in low-bleeding-risk cardiac surgery with cardiopulmonary bypass (CPB), but studies in high-bleeding-risk cardiac surgery are limited. The objective of this study is to evaluate the efficacy, safety and cost-effectiveness of intra-operative CS in high-bleeding-risk cardiac surgery with CPB. One hundred and fifty patients were randomly assigned to either with intra-operative CS group (Group CS) or without intra-operative CS group (Group C). Study endpoints were defined as perioperative allogeneic red blood cell (RBC) transfusion, perioperative impairment of blood coagulative function, postoperative adverse events and costs of transfusion-related. Both the proportion and quantity of perioperative allogeneic RBC transfusion were significantly lower in Group CS than that in Group C (p=0.0002, operative CS in high-bleeding-risk cardiac surgery with CPB is effective, generally safe, and cost-effective in developed countries but not in China.

  14. Intra-operative defibrillation testing and clinical shock efficacy in patients with implantable cardioverter-defibrillators: the NORDIC ICD randomized clinical trial.

    Science.gov (United States)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan; Bode, Frank; Svendsen, Jesper Hastrup; Táborský, Miloš; Kuster, Stefan; Blomström-Lundqvist, Carina; Felk, Angelika; Hauser, Tino; Suling, Anna; Wegscheider, Karl

    2015-10-01

    This trial was designed to test the hypothesis that shock efficacy during follow-up is not impaired in patients implanted without defibrillation (DF) testing during first implantable cardioverter-defibrillator (ICD) implantation. Between February 2011 and July 2013, 1077 patients were randomly assigned (1 : 1) to first time ICD implantation with (n = 540) or without (n = 537) DF testing. The intra-operative DF testing was standardized across all participating centres, and all ICD shocks were programmed to 40 J irrespective of DF test results. The primary end point was the average first shock efficacy (FSE) for all true ventricular tachycardia and fibrillation (VT/VF) episodes during follow-up. The secondary end points included procedural data, serious adverse events, and mortality. During a median follow-up of 22.8 months, the model-based FSE was found to be non-inferior in patients with an ICD implanted without a DF test, with a difference in FSE of 3.0% in favour of the no DF test [confidence interval (CI) -3.0 to 9.0%, Pnon-inferiority Defibrillation efficacy during follow-up is not inferior in patients with a 40 J ICD implanted without DF testing. Defibrillation testing during first time ICD implantation should no longer be recommended for routine left-sided ICD implantation. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  15. Anti-tumor effects of cold atmospheric pressure plasma on vestibular schwannoma demonstrate its feasibility as an intra-operative adjuvant treatment.

    Science.gov (United States)

    Yoon, Yeo Jun; Suh, Michelle J; Lee, Hyun Young; Lee, Hae June; Choi, Eun Ha; Moon, In Seok; Song, Kiwon

    2018-02-01

    Vestibular schwannoma (VS), although a benign intracranial tumor, causes morbidities by brainstem compression. Since chemotherapy is not very effective in most Nf2-negative schwannomas, surgical removal or radiation therapy is required. However, depending on the size and site of the tumor, these approaches may cause loss of auditory or vestibular functions, and severely decrease the post-surgical wellbeing. Here, we examined the feasibility of cold atmospheric pressure plasma (CAP) as an intra-operative adjuvant treatment for VS after surgery. Cell death was efficiently induced in both human HEI-193 and mouse SC4 VS cell lines upon exposure to CAP for seven minutes. Interestingly, both apoptosis and necroptosis were simultaneously induced by CAP treatment, and cell death was not completely inhibited by pan-caspase and receptor-interacting serine/threonine-protein kinase 1 (RIK1) inhibitors. Upon CAP exposure, cell death phenotype was similarly observed in patient-derived primary VS cells and tumor mass. In addition, CAP exposure after the surgical removal of primary tumor efficiently inhibited tumor recurrence in SC4-grafted mouse models. Collectively, these results strongly suggest that CAP should be developed as an efficient adjuvant treatment for VS after surgery to eliminate the possible remnant tumor cells, and to minimize the surgical area in the brain for post-surgical wellbeing. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. "Sequential” Boron Neutron Capture Therapy (BNCT): A Novel Approach to BNCT for the Treatment of Oral Cancer in the Hamster Cheek Pouch Model

    Energy Technology Data Exchange (ETDEWEB)

    Ana J. Molinari; Andrea Monti Hughes; Elisa M. Heber; Marcela A. Garabalino; Veronica A. Trivillin; Amanda E. Schwint; Emiliano C. C. Pozzi; Maria E. Itoiz; Silvia I. Thorp; Romina F. Aromando; David W. Nigg; Jorge Quintana; Gustavo A. Santa Cruz

    2011-04-01

    Boron Neutron Capture Therapy (BNCT) is a binary treatment modality that involves the selective accumulation of 10B carriers in tumors followed by irradiation with a thermal or epithermal neutron beam. The minor abundance stable isotope of boron, 10B, interacts with low energy (thermal) neutrons to produce high linear energy transfer (LET) a-particles and 7Li ions. These disintegration products are known to have a high relative biological effectiveness (RBE). Their short range (<10 {micro}m) would limit the damage to cells containing 10B (1,2). Thus, BNCT would target tumor tissue selectively, sparing normal tissue. Clinical trials of BNCT for the treatment of glioblastoma multiforme and/or melanoma and, more recently, head and neck tumors and liver metastases, using boronophenylalanine (BPA) or sodium mercaptoundecahydrododecaborane (BSH) as the 10B carriers, have been performed or are underway in Argentina, Japan, the US and Europe (e.g. 3-8). To date, the clinical results have shown a potential, albeit inconclusive, therapeutic advantage for this technique. Contributory translational studies have been carried out employing a variety of experimental models based on the implantation of tumor cells in normal tissue (e.g. 5).

  17. 2-O-α-glucopytanosyl L-ascorbic acid reduced mutagenicity at HPRT locus of mouse splenocytes following BNCT

    International Nuclear Information System (INIS)

    Kinashi, Yuko; Masunaga, Shin-ichiro; Suzuki, Minoru; Nagata, Kanji; Ono, Koji

    2006-01-01

    In boron neutron capture therapy (BNCT), normal tissue surrounding the tumor cells sometimes take up boron compounds resulting in radiation-induced damage to normal tissue. We have previously reported the evidence for increased the mutagenicity of thermal neutron in the presence of boron. In addition, we described the biological radio-protective effects of the ascorbic acid for mutation induction following BNCT in vitro. Here, we investigated these radio-protective effects of ascorbic acid for mutation induction in mouse splenocytes on HPRT locus following a BNCT study in vivo. (author)

  18. Tumor blood vessel "normalization" improves the therapeutic efficacy of boron neutron capture therapy (BNCT) in experimental oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    D. W. Nigg

    2012-01-01

    We previously demonstrated the efficacy of BNCT mediated by boronophenylalanine (BPA) to treat tumors in a hamster cheek pouch model of oral cancer with no normal tissue radiotoxicity and moderate, albeit reversible, mucositis in precancerous tissue around treated tumors. It is known that boron targeting of the largest possible proportion of tumor cells contributes to the success of BNCT and that tumor blood vessel normalization improves drug delivery to the tumor. Within this context, the aim of the present study was to evaluate the effect of blood vessel normalization on the therapeutic efficacy and potential radiotoxicity of BNCT in the hamster cheek pouch model of oral cancer.

  19. Boron biodistribution for BNCT in the hamster cheek pouch oral cancer model: Combined administration of BSH and BPA

    Energy Technology Data Exchange (ETDEWEB)

    D.W. Nigg; William Bauer; Various Others

    2014-06-01

    Sodium mercaptoundecahydro-closo-dodecaborate (BSH) is being investigated clinically for BNCT. We examined the biodistribution of BSH and BPA administered jointly in different proportions in the hamster cheek pouch oral cancer model. The 3 assayed protocols were non-toxic, and showed preferential tumor boron uptake versus precancerous and normal tissue and therapeutic tumor boron concentration values (70–85 ppm). All 3 protocols warrant assessment in BNCT studies to contribute to the knowledge of (BSH+BPA)-BNCT radiobiology for head and neck cancer and optimize therapeutic efficacy.

  20. Radiobiology studies for the evaluation of epithermal neutron beams used for BNCT

    International Nuclear Information System (INIS)

    Green, S.; Jones, B.; Mill, A.J.

    2006-01-01

    This paper outlines our plans for a study to establish the radiobiological effectiveness of the various mixes of radiation components present in an epithermal neutron beam designed for BNCT and to incorporate these data into clinical protocols for the treatment of malignant glioma. This is a description of work which is funded and just now beginning in Birmingham so no results can be presented. Our project will involve a combination of experimental measurements carried out in Birmingham and in Boston and mathematical modelling carried out in Birmingham. Despite all the extant in-vitro and in-vivo work, there is no widely accepted method to determine biological effect by accounting for variations in beam component mix, dose rate and treatment fractionation for disparate from the various BNCT centres. The objectives of this study are: To develop a cell-based radiobiology protocol to provide essential data on safety and efficacy of beams for Boron Neutron Capture Therapy (BNCT) in advance of clinical trials. To exploit the facilities at Massachusetts Institute of Technology for variable dose-rate epithermal irradiations to validate the above protocol. To develop mathematical models of this radiobiological system that can be used to inform decisions on dose selection, fractionation schedules, BNCT use as supplementary boosts or for re-treatment of recurrent cancers. To provide fundamental data relevant to the understanding of the radiobiology of simultaneous mixed high-and low-LET radiations over a clinically relevant dose-range. (author)

  1. Time factor of BSH from intravenous infusion to neutron irradiation for BNCT in patients with glioblastoma

    International Nuclear Information System (INIS)

    Kageji, T.; Nagahiro, S.; Kitamura, K.; Nakagawa, Y.; Hatanaka, H.; Haritz, D.; Grochulla, F.; Haselsberger, K.; Gabel, D.

    2000-01-01

    The present report evaluates the time factor of BSH from infusion to irradiation in patients with glioblastoma as a cooperative study in Europe and Japan. For BNCT with BSH after intravenous infusion, this work confirms that the planned neutron irradiation after intravenous BSH infusion appears to be optimal around 12-19 hours after the infusion. (author)

  2. Radiobiology of BNCT mediated by GB-10 and GB-10+BPA in experimental oral cancer

    International Nuclear Information System (INIS)

    Trivillin, Veronica A.; Heber, Elisa M.; Itoiz, Maria E.; Nigg, David; Calzetta, Osvaldo; Blaumann, Herman; Longhino, Juan; Schwint, Amanda E.

    2004-01-01

    We previously reported biodistribution and pharmacokinetic data for GB-10 (Na 2 10 B 10 H 10 ) and the combined administration of GB-10 and boronophenylalanine (BPA) as boron delivery agents for boron neutron capture therapy (BNCT) in the hamster cheek pouch oral cancer model. The aim of the present study was to assess, for the first time, the response of hamster cheek pouch tumors, precancerous tissue and normal tissue to BNCT mediated by GB-10 and BNCT mediated by GB-10 and BPA administered jointly using the thermalized epithermal beam of the RA-6 Reactor at the Bariloche Atomic Center. GB-10 exerted 75.5% tumor control (partial+complete remission) with no damage to precancerous tissue around tumor or to normal tissue. Thus, GB-10 proved to be a therapeutically efficient boron agent in this model despite the fact that it is not taken up selectively by oral tumor tissue. GB-10 exerted a selective effect on tumor blood vessels leading to significant tumor control with a sparing effect on normal tissue. BNCT mediated by the combined administration of GB-10 and BPA resulted in a reduction in the dose to normal tissue and would thus allow for significant escalation of dose to tumor without exceeding normal tissue tolerance

  3. First tomographic image of neutron capture rate in a BNCT facility

    Energy Technology Data Exchange (ETDEWEB)

    Minsky, D.M., E-mail: minsky@tandar.cnea.gov.ar [Gerencia de Investigacion y Aplicaciones, CAC, CNEA, Av. Gral. Paz 1499 (B1650KNA), San Martin, Prov. Bs. As. (Argentina)] [Escuela de Ciencia y Tecnologia, , UNSAM, M. de Irigoyen 3100 (1650), San Martin, Prov. Bs. As. (Argentina)] [Conicet, Av. Rivadavia 1917 (C1033AAJ), Buenos Aires (Argentina); Valda, A.A. [Gerencia de Investigacion y Aplicaciones, CAC, CNEA, Av. Gral. Paz 1499 (B1650KNA), San Martin, Prov. Bs. As. (Argentina)] [Escuela de Ciencia y Tecnologia, , UNSAM, M. de Irigoyen 3100 (1650), San Martin, Prov. Bs. As. (Argentina); Kreiner, A.J. [Gerencia de Investigacion y Aplicaciones, CAC, CNEA, Av. Gral. Paz 1499 (B1650KNA), San Martin, Prov. Bs. As. (Argentina)] [Escuela de Ciencia y Tecnologia, , UNSAM, M. de Irigoyen 3100 (1650), San Martin, Prov. Bs. As. (Argentina)] [Conicet, Av. Rivadavia 1917 (C1033AAJ), Buenos Aires (Argentina); Green, S.; Wojnecki, C. [School of Physics and Astronomy, University of Birmingham, B15 2 TT (United Kingdom)] [Department of Medical Physics, University Hospital Birmingham, Birmingham B15 2TH (United Kingdom); Ghani, Z. [Department of Medical Physics, University Hospital Birmingham, Birmingham B15 2TH (United Kingdom)

    2011-12-15

    This work discusses the development of online dosimetry of the boron dose via Single Photon Emission Computed Tomography (SPECT) during a BNCT treatment irradiation. Such a system will allow the online computation of boron dose maps without the large current uncertainties in the assessment of the boron concentration in different tissues. The first tomographic boron dose image with a SPECT prototype is shown.

  4. Logic Estimation of the Optimum Source Neutron Energy for BNCT of Brain Tumors

    International Nuclear Information System (INIS)

    Dorrah, M.A.; Gaber, F.A.; Abd Elwahab, M.A.; Kotb, M.A.; Mohammed, M.M.

    2012-01-01

    BNCT is very complicated technique; primarily due to the complexity of element composition of the brain. Moreover; numerous components contributes to the over all radiation dose both to normal brain and to tumor. Simple algebraic summation cannot be applied to these dose components, since each component should at first be weighed by its relative biological effectiveness (RBE) value. Unfortunately, there is no worldwide agreement on these RBE values. For that reason, the parameters required for accurate planning of BNCT of brain tumors located at different depths in brain remained obscure. The most important of these parameters is; the source neutron energy. Thermal neutrons were formerly employed for BNCT, but they failed to prove therapeutic efficacy. Later on; epithermal neutrons were suggested proposing that they would be enough thermalized while transporting in the brain tissues. However; debate aroused regarding the source neutrons energy appropriate for treating brain tumors located at different depths in brain. Again, the insufficient knowledge regarding the RBE values of the different dose components was a major obstacle. A new concept was adopted for estimating the optimum source neutrons energy appropriate for different circumstances of BNCT. Four postulations on the optimum source neutrons energy were worked out, almost entirely independent of the RBE values of the different dose components. Four corresponding condition on the optimum source neutrons energy were deduced. An energy escalation study was carried out investigating 65 different source neutron energies, between 0.01 eV and 13.2 MeV. MCNP4B Monte C arlo neutron transport code was utilized to study the behavior of neutrons in the brain. The deduced four conditions were applied to the results of the 65 steps of the neutron energy escalation study. A source neutron energy range of few electron volts (eV) to about 30 keV was estimated to be the most appropriate for BNCT of brain tumors located at

  5. Development of cancer therapy facility of Hanaro and medical research in BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Byung Jin; Kim, M. S.; Kim, M. J.; Park, S. J. [KAERI, Taejon (Korea, Republic of); Lee, C. H.; Kwack, H. S.; Kim, M. S. [Korea Inst. of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, J. K.; Park, S. H.; Shin, C. H. [Hanyang Univ., Seoul (Korea, Republic of)

    2003-05-01

    In order to support the domestic research on the Boron Neutron Capture Therapy(BNCT) which is a promising treatment method for tumor in principle, a neutron irradiation facility and a Prompt Gamma Neutron Activation Analysis (PGNAA) equipment for the boron concentration measurement are developed and installed at Hanaro. Meanwhile basic research has been performed to develop BNCT medical technology using above Hanaro facilities when they are ready. The Hanaro BNCT facility gives almost pure thermal neutron beam, it can be applied to all level of BNCT research from the cell culture and animal study to clinical trials by focussed irradiation, and its use does not cause any interference with other utilization. It can also be used for other purposes such as standard thermal neutron field and a dynamic neutron radiography with excellent features. The PGNAA equipment will be used not only for the boron concentration measurement but also for the general multi-element simultaneous analyses. The medical research for BNCT covers basic research on dose evaluation, boron compound behaviour and new compound development. Technologies for neutron and gamma transport calculation and their measurement, and micro dosimetry are developed. While import of a dose planning program has been pushed, domestic development of the program has been tried. Imaging technologies for boron distribution using SPECT or PET are developed by labeling I-123 or F-18 to BPA. Data for the BPA accumulation into the brain tumor are produced by clinical trials of the technology. A general and versatile method for the synthesis of o-carborane clusters containing of their important biological activities as neurotransmitter, antipsychotic or anticancer is developed. We found three promising compounds of which accumulation into B-16 melanoma cell is about 10 times of BPA.

  6. A clinical trial protocol for second line treatment of malignant brain tumors with BNCT at University of Tsukuba

    Energy Technology Data Exchange (ETDEWEB)

    Aiyama, H. [Department of Neurosurgery, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan); Nakai, K., E-mail: knakai@Neurosurg-tsukuba.com [Department of Neurosurgery, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan); Yamamoto, T. [Department of Neurosurgery, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan)] [Department of Radiation Oncology, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan); Nariai, T. [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyouku (Japan); Kumada, H. [Department of Radiation Oncology, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan); Ishikawa, E. [Department of Neurosurgery, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan); Isobe, T. [Department of Radiation Oncology, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan); Endo, K.; Takada, T.; Yoshida, F.; Shibata, Y.; Matsumura, A. [Department of Neurosurgery, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba (Japan)

    2011-12-15

    We have evaluated the efficacy and safety of boron neutron capture therapy (BNCT) for recurrent glioma and malignant brain tumor using a new protocol. One of the two patients enrolled in this trial is a man with recurrent glioblastoma and the other is a woman with anaplastic meningioma. Both are still alive and no severe adverse events have been observed. Our findings suggest that NCT will be safe as a palliative therapy for malignant brain tumors. - Highlights: Black-Right-Pointing-Pointer Boron neutron capture therapy (BNCT) for recurrent glioma and malignant brain tumor. Black-Right-Pointing-Pointer Two cases with recurrent glioblastoma and anaplastic meningioma. Black-Right-Pointing-Pointer No severe adverse events have been observed using BNCT. Black-Right-Pointing-Pointer BNCT has a possibility of a safe palliative therapy for malignant brain tumors.

  7. Simulated versus realistic intra operative radiation therapy (I.O.R.T.) treatment in operating room: from knowledge of stray radiation to action

    International Nuclear Information System (INIS)

    Andreoli, S.; Moretti, R.; Catalano, M.; Locatelli, F.

    2006-01-01

    Intra-Operative Radiation Therapy (I.O.R.T.) is carried out with electron beams produced by a Linac (Linear Accelerator) generally used for conventional radiotherapy with external beam, or by dedicated accelerators that can be employed directly into an operating room. I.O.R.T. refers to the application of radiation during a surgical intervention, after the removal of a neoplastic mass. I.O.R.T. uses on the tumour area a direct irradiation, for the possible localisation of sub-clinic illness or macroscopic residue in the case of non-radical resection. Intra-Operative Radiotherapy foresees a single session only, generally preceded or followed by radiotherapy with external beam. It allows the achievement of a selective radiation boost on the tumour volume. In some cases, it can also be used as a one-time/stand alone treatment in initial cancer of small volume, or in unresectable malignancies for palliative purpose. The technical advantages of I.O.R.T. consist in the direct visual control of the target volume, and in the possibility to protect the healthy tissues by moving them away from the path of the radiation beam. The use of electron beams allows the administration of a homogeneous dose to a selected layer of tissues surrounding the tumour. The following professional staff forms the Operative Group: radiation oncologist, surgeon, anaesthetist, medical physicist, radiation technologist, nurse.The choice of a simulation geometry very similar to the clinical situation allows to evaluate radioprotection data very close to the real situation. For a fixed layout, an anthropomorphic phantom was positioned on the operating bed and a breast I.O.R.T. treatment was simulated positioning all the accessories of the operating room in their typical positions. A detailed dose mapping was performed with a Victoreen 450P ionisation chamber and with environment film-dosimeter on the walls of the operating room during the simulation of the clinical treatment. The simulation appears

  8. Pre-operative and intra-operative detection of axillary lymph node metastases in 108 patients with invasive lobular breast cancer undergoing mastectomy.

    Science.gov (United States)

    Novak, Jerica; Besic, Nikola; Dzodic, Radan; Gazic, Barbara; Vogrin, Andrej

    2018-02-05

    Despite the recent changes in the treatment of the axilla in selected breast cancer patient, positive sentinel lymph node (SLN) in patients undergoing mastectomy still necessitates axillary lymph node dissection (ALND). In invasive lobular carcinoma (ILC), pre-operative detection of the lymph node metastasis may be demanding due to its unique morphology. The aim of this study was to examine the benefit of preoperative axillary ultrasound (AUS), ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and intra-operative imprint cytology (IIC), in order to avoid two-stage axillary surgery in patients with ILC undergoing mastectomy. The object of this study were 102 patients (median age 52, range 34-73 years) with clinically non-suspicious axilla in whom 108 mastectomies were performed after a pre-operative AUS investigation. Whenever a metastasis was detected in a sentinel lymph node, ALND was done. Reports of the pre-operative AUS investigation, US-FNAB, and IIC were compared with definitive histopathological reports of surgical specimens. In 46 cases lymph node metastases were diagnosed. AUS suspicious lymph nodes were found in 29/108 cases and histopathology confirmed metastases in 22/30 cases. US-FNAB was performed in 29 cases with AUS suspicious lymph nodes. Cytology proved metastases in 11/29 cases. Histopathology confirmed metastases in 10/11 cases with only isolated tumor cells found in one case. IIC investigation was performed in 63 cases and in 10/27 cases metastases were confirmed by histopathology. Pre-operative AUS, US-FNAB, and/or IIC investigation enabled ALND during a single surgical procedure in 20/46 patients with metastases in lymph nodes. Pre-operative AUS, US-FNAB, and/or IIC are/is beneficial in patients with ILC planned for mastectomy in order to decrease the number of two stage axillary procedures.

  9. Focused parathyroidectomy without intra-operative parathormone monitoring: The value of PTH assay in preoperative ultrasound guided fine needle aspiration washout.

    Science.gov (United States)

    Kuzu, Fatih; Arpaci, Dilek; Cakmak, Guldeniz Karadeniz; Emre, Ali Ugur; Elri, Tarik; Ilikhan, Sevil Uygun; Bahadir, Burak; Bayraktaoglu, Taner

    2016-03-01

    The accurate identification of hyperfunctioning parathyroid (HP) gland is the only issue for definitive surgical treatment in primary hyperparathyroidism (pHPT). Various imaging and operative techniques have been proposed to confirm the localization of the diseased gland. Nevertheless, none of these methods proved to be the gold standard. The presented study aimed to assess the value of parathyroid hormone assay in preoperative ultrasound guided fine needle aspiration (FNA)-PTH washout fluid to verify the correct localisation for focused parathyroidectomy without intra-operative PTH monitoring. The retrospective analysis of 57 patients with pHPT who underwent FNA-PTH was conducted from a prospective database. Biochemical assessment together with radiological (ultrasonography) and nuclear (MIBI scan) imaging was reviewed. Associations between FNA-PTH washout values and localization technics were evaluated and compared in terms of operative findings. Focused parathyroidectomy without intraoperative PTH monitoring was performed to 45 patients with high FNA-PTH values. The median largest diameter of the target parathyroid lesion identified by ultrasonography was 13 mm (range, 6 to 36). The median serum PTH level was 190 pg/mL (range, 78 to 1709; reference range, 15 to 65) whereas the median washout PTH was 2500 pg/mL (range, 480 to 3389). According to operative findings high FNA-PTH levels correctly identified parathyroid adenoma in 40 cases (89% of sensitivity and 100% of specificity and positive predictive value) whereas MIBI scan localized the lesion in 36 of these cases (80% of sensitivity). The higher level of PTH in preoperative ultrasound guided FNA washout is a considerable data to predict the correct localization of HP, particularly in circumstances of greater values than the serum PTH level. However, although its specificity is high, in cases of coexisting nodular thyroid disease, associated additional HP might be missed at focused parathyroidectomy

  10. Dual phase helical CT versus portal venous phase CT for the detection of colorectal liver metastases: Correlation with intra-operative sonography, surgical and pathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Scott, D. John; Guthrie, J. Ashley; Arnold, Paul; Ward, Janice; Atchley, Julian; Wilson, Daniel; Robinson, Philip J

    2001-03-01

    AIM: To assess whether dual phase helical computed tomography (DPCT) of the liver improves the detection of colorectal liver metastases compared with portal venous phase (PVP) imaging alone. MATERIALS AND METHODS: DPCT was performed in 33 consecutive patients before laparotomy for resection of colorectal liver metastases. CT comprised 8-mm slice collimation with a pitch of 1 to 1.25; imaging was commenced 20-25 and 65-70 s after the start of injection of 150 ml of contrast medium at 5 ml/s to coincide with hepatic arterial phase (HAP) and PVP contrast enhancement, respectively. Four blinded observers independently reviewed the HAP, PVP and DPCT images recording the site and size of all lesions. Alternative-free response receiver operating characteristic (AFROC) methodology was used to analyse the results, which were correlated with surgery, intra-operative ultrasound and histology. RESULTS: The mean observer sensitivities for malignant lesion detection were 75.3% for DPCT, 69.7% for PVP imaging and 66.7% for HAP imaging alone. There was a statistically significant improvement in malignant lesion detection using DPCT when compared with PVP imaging alone (P < 0.05). The mean areas under the AFROC curves were 0.84 for DPCT and 0.82 for PVP (P < 0.03) imaging alone. CONCLUSION: The detection of colorectal liver metastases was marginally better with DPCT than with PVP imaging alone, but the discovery of additional lesions did not affect the management of any of the patients in this study. Scott, D.J. et al. (2001)

  11. Intra-Operative Inspired Fraction of Oxygen and the Risk of Surgical Site Infections in Patients with Type 1 Surgical Incisions.

    Science.gov (United States)

    Wanta, Brendan T; Hanson, Kristine T; Hyder, Joseph A; Stewart, Thomas M; Curry, Timothy B; Berbari, Elie F; Habermann, Elizabeth B; Kor, Daryl J; Brown, Michael J

    2018-04-02

    Whether the fraction of inspired oxygen (F I O 2 ) influences the risk of surgical site infection (SSI) is controversial. The World Health Organization and the World Federation of Societies of Anesthesiologists offer conflicting recommendations. In this study, we evaluate simultaneously three different definitions of F I O 2 exposure and the risk of SSI in a large surgical population. Patients with clean (type 1) surgical incisions who developed superficial and deep organ/space SSI within 30 days after surgery from January 2003 through December 2012 in five surgical specialties were matched to specialty-specific controls. Fraction of inspired oxygen exposure was defined as (1) nadir F I O 2 , (2) percentage of operative time with F I O 2 greater than 50%, and (3) cumulative hyperoxia exposure, calculated as the area under the curve (AUC) of F I O 2 by time for the duration in which F I O 2 greater than 50%. Stratified univariable and multivariable logistic regression models tested associations between F I O 2 and SSI. One thousand two hundred fifty cases of SSI were matched to 3,248 controls. Increased oxygen exposure, by any of the three measures, was not associated with the outcome of any SSI in a multivariable logistic regression model. Elevated body mass index (BMI; 35+ vs. operative oxygen exposure was associated with higher odds of SSI in the neurosurgical and spine populations. Increased intra-operative inspired fraction of oxygen was not associated with a reduction in SSI. These findings do not support the practice of increasing F I O 2 for the purpose of SSI reduction in patients with clean surgical incisions.

  12. Systematic Review and Meta-Analysis of Randomized Controlled Trials Evaluating Prophylactic Intra-Operative Wound Irrigation for the Prevention of Surgical Site Infections.

    Science.gov (United States)

    de Jonge, Stijn W; Boldingh, Quirine J J; Solomkin, Joseph S; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E Patchen; Boermeester, Marja A

    Surgical site infections (SSIs) are one of the most common hospital-acquired infections. To reduce SSIs, prophylactic intra-operative wound irrigation (pIOWI) has been advocated, although the results to date are equivocal. To develop recommendations for the new World Health Organization (WHO) SSI prevention guidelines, a systematic literature review and a meta-analysis were conducted on the effectiveness of pIOWI using different agents as a means of reducing SSI. The PUBMED, Embase, CENTRAL, CINAHL, and WHO databases were searched. Randomized controlled trials (RCTs) comparing either pIOWI with no pIOWI or with pIOWI using different solutions and techniques were retrieved with SSI as the primary outcome. Meta-analyses were performed, and odds ratios (OR) and the mean difference with 95% confidence intervals (CI) were extracted and pooled with a random effects model. Twenty-one studies were suitable for analysis, and a distinction was made between intra-peritoneal, mediastinal, and incisional wound irrigation. A low quality of evidence demonstrated a statistically significant benefit for incisional wound irrigation with an aqueous povidone-iodine (PVP-I) solution in clean and clean contaminated wounds (OR 0.31; 95% CI 0.13-0.73; p = 0.007); 50 fewer SSIs per 1,000 procedures (from 19 fewer to 64 fewer)). Antibiotic irrigation had no significant effect in reducing SSIs (OR 1.16; 95% CI 0.64-2.12; p = 0.63). Low-quality evidence suggests considering the use of prophylactic incisional wound irrigation to prevent SSI with an aqueous povidone-iodine solution. Antibiotic irrigation does not show a benefit and therefore is discouraged.

  13. Comparison of surgical outcomes after anterior cervical discectomy and fusion: does the intra-operative use of a microscope improve surgical outcomes.

    Science.gov (United States)

    Adogwa, Owoicho; Elsamadicy, Aladine; Reiser, Elizabeth; Ziegler, Cole; Freischlag, Kyle; Cheng, Joseph; Bagley, Carlos A

    2016-03-01

    The primary aim of this study was to assess and compare the complications profile as well as long-term clinical outcomes between patients undergoing an Anterior Cervical Discectomy and Fusion (ACDF) procedure with and without the use of an intra-operative microscope. One hundred and forty adult patients (non-microscope cohort: 81; microscope cohort: 59) undergoing ACDF at a major academic medical center were included in this study. Enrollment criteria included available demographic, surgical and clinical outcome data. All patients had prospectively collected patient-reported outcomes measures and a minimum 2-year follow-up. Patients completed the neck disability index (NDI), short-form 12 (SF-12) and visual analog pain scale (VAS) before surgery, then at 3, 6, 12, and 24 months after surgery. Clinical outcomes and complication rates were compared between both patient cohorts. Baseline characteristics were similar between both cohorts. The mean ± standard deviation duration of surgery was longer in the microscope cohort (microscope: 169±34 minutes vs. non-microscope: 98±42 minutes, Pmicroscope and non-microscope cohorts demonstrated similar improvement from base line in NDI (microscope: 13.52±25.77 vs. non-microscope: 19.51±27.47, Pmicroscope: 4.15±26.39 vs. non-microscope: 11.98±22.96, Pmicroscope: 9.47±32.38 vs. non-microscope: 16.19±30.44, Pmicroscope: 2.22±4.00 vs. non-microscope: 3.69±3.61, Pmicroscope does not improve overall surgery-related outcomes, nor does it lead to superior long-term outcomes in pain and functional disability, 2 years after index surgery.

  14. Dual phase helical CT versus portal venous phase CT for the detection of colorectal liver metastases: Correlation with intra-operative sonography, surgical and pathological findings

    International Nuclear Information System (INIS)

    Scott, D. John; Guthrie, J. Ashley; Arnold, Paul; Ward, Janice; Atchley, Julian; Wilson, Daniel; Robinson, Philip J.

    2001-01-01

    AIM: To assess whether dual phase helical computed tomography (DPCT) of the liver improves the detection of colorectal liver metastases compared with portal venous phase (PVP) imaging alone. MATERIALS AND METHODS: DPCT was performed in 33 consecutive patients before laparotomy for resection of colorectal liver metastases. CT comprised 8-mm slice collimation with a pitch of 1 to 1.25; imaging was commenced 20-25 and 65-70 s after the start of injection of 150 ml of contrast medium at 5 ml/s to coincide with hepatic arterial phase (HAP) and PVP contrast enhancement, respectively. Four blinded observers independently reviewed the HAP, PVP and DPCT images recording the site and size of all lesions. Alternative-free response receiver operating characteristic (AFROC) methodology was used to analyse the results, which were correlated with surgery, intra-operative ultrasound and histology. RESULTS: The mean observer sensitivities for malignant lesion detection were 75.3% for DPCT, 69.7% for PVP imaging and 66.7% for HAP imaging alone. There was a statistically significant improvement in malignant lesion detection using DPCT when compared with PVP imaging alone (P < 0.05). The mean areas under the AFROC curves were 0.84 for DPCT and 0.82 for PVP (P < 0.03) imaging alone. CONCLUSION: The detection of colorectal liver metastases was marginally better with DPCT than with PVP imaging alone, but the discovery of additional lesions did not affect the management of any of the patients in this study. Scott, D.J. et al. (2001)

  15. Simultaneous multi-scale microscopy as a potential dedicated tool for intra-operative parathyroid identification during thyroid surgery (Conference Presentation)

    Science.gov (United States)

    De Montigny, Étienne; Goulamhoussen, Nadir; Madore, Wendy-Julie; Strupler, Mathias; Maniakas, Anastasios; Ayad, Tareck; Boudoux, Caroline

    2016-02-01

    While thyroidectomy is considered a safe surgery, dedicated tools facilitating tissue identification during surgery could improve its outcome. The most common complication following surgery is hypocalcaemia, which results from iatrogenic removal or damage to parathyroid glands. This research project aims at developing and validating an instrument based on optical microscopy modalities to identify tissues in real time during surgery. Our approach is based on a combination of reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) to obtain multi-scale morphological contrast images. The orthogonal field of views provide information to navigate through the sample. To allow simultaneous, synchronized video-rate imaging in both modalities, we designed and built a dual-band wavelength-swept laser which scans a 30 nm band centered at 780 nm and a 90 nm band centered at 1310 nm. We built an imaging setup integrating a custom-made objective lens and a double-clad fibre coupler optimized for confocal microscopy. It features high resolutions in RCM (2µm lateral and 20 µm axial) in a 500 µm x 500 µm field-of-view and a larger field-of-view of 2 mm (lateral) x 5 mm (axial) with 20 µm lateral and axial resolutions in OCT. Imaging of ex vivo animal samples is demonstrated on a bench-top system. Tissues that are visually difficult to distinguish from each other intra-operatively such as parathyroid gland, lymph nodes and adipose tissue are imaged to show the potential of this approach in differentiating neck tissues. We will also provide an update on our ongoing clinical pilot study on patients undergoing thyroidectomy.

  16. Cross talk experiment with two-element CdTe detector and collimator for BNCT-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Manabe, Masanobu; Ohya, Ryosuke; Saraue, Nobuhide; Sato, Fuminobu; Murata, Isao [Osaka University, Osaka (Japan)

    2016-12-15

    Boron Neutron Capture Therapy (BNCT) is a new radiation therapy. In BNCT, there exists some very critical problems that should be solved. One of the severest problems is that the treatment effect cannot be known during BNCT in real time. We are now developing a SPECT (single photon emission computed tomography) system (BNCT-SPECT), with a cadmium telluride (CdTe) semiconductor detector. BNCT-SPECT can obtain the BNCT treatment effect by measuring 478 keV gamma-rays emitted from the excited state of 7Li nucleus created by 10B(n,α) 7Li reaction. In the previous studies, we investigated the feasibility of the BNCT-SPECT system. As a result, the S/N ratio did not meet the criterion of S/N >1 because deterioration of the S/N ratio occurred caused by the influence of Compton scattering especially due to capture gamma-rays of hydrogen. We thus produced an arrayed detector with two CdTe crystals to test cross talk phenomenon and to examine an anti-coincidence detection possibility. For more precise analysis for the anti-coincidence detection, we designed and made a collimator having a similar performance to the real BNCT-SPECT. We carried out experiments with the collimator to examine the effect of cross talk of scattering gamma-rays between CdTe elements more practically. As a result of measurement the coincidence events were successfully extracted. We are now planning to carry out evaluation of coincidence rate from the measurement and comparison of it with the numerical calculations.

  17. The effect of post-traumatic-stress-disorder on intra-operative analgesia in a veteran population during cataract procedures carried out using retrobulbar or topical anesthesia: a retrospective study.

    Science.gov (United States)

    Rapoport, Yuna; Wayman, Laura L; Chomsky, Amy S

    2017-06-07

    A growing proportion of veterans treated at the Veterans Health Administration (VA) have a history of post-traumatic-stress-disorder (PTSD), and there exists a higher rate of PTSD amongst veterans than the general population. The purpose of this study is to determine the correlation between PTSD and intra-operative analgesia, intra-operative time, and anesthesia type for cataract surgery in a veteran population. Secondary objectives are to determine if patient age, and first or second eye surgery affect intra-operative pain control or are correlated with type of anesthesia modality. A retrospective study of 330 cataract surgeries performed by resident physicians between January and September 2012 at the Veterans Affairs Medical Center Tennessee Valley Healthcare System, Nashville and Murfreesboro Campuses was completed. Three hundred and thirty veteran patients were selected if their cataract surgery was performed between January and September 2012. Combined cases were excluded. The primary outcome evaluated was intra-operative analgesia. Secondary outcomes included history of post-traumatic-stress-disorder, anesthesia type, first or second eye, pain control, intra-operative heart rate and blood pressure, age, and case complexity. Data was analyzed using an unpaired two-sample Welch's t-test assuming unequal variance and Z test of comparison of proportions. Patients with post-traumatic-stress-disorder reported higher pain scores, had longer operative times, and were more likely to have received a retrobulbar block. Operative time was not associated with an increased pain score, irrespective of anesthesia type, when controlled for PTSD. Complex cases had longer operative times, more sedation, and higher pain scores. P Post-traumatic stress disorder and anxiety are more prevalent in the veteran population. Our data suggests that a history of post-traumatic-stress-disorder was correlated with higher pain scores, longer operative times, and with having received a

  18. Prediction of boron concentration in blood from low dose infusion for the patients of BNCT at JAERI

    International Nuclear Information System (INIS)

    Shibata, Y.; Matsumura, A.; Yamamoto, T.

    2000-01-01

    It is difficult to measure boron concentration in blood during neutron irradiation in BNCT. We have investigated the predictability of boron concentration in blood from the data at 1st craniotomy after low dose BSH infusion. Two patients entered BNCT at JRR2 in 1995/1996, and 5 patients entered BNCT at JRR4 in 1992/2000. The patients include 2 male and 5 female and their age ranged from 20 to 66. In 5 patients 1 g of BSH was infused before 1st tumor removal operation and boron concentrations in blood were examined around this operation. All patients were infused 100 mg/kg of BSH at 12 hours prior to BNCT and boron concentrations were examined before and after BNCT using prompt gamma ray analysis or ICP-AES. Each results showed biphasic pharmacokinetic profile. Personal variations of the pharmacokinetics of BSH were small. Final and 1 g data were well correlated and final boron concentrations at BNCT were predictable from 1 g studies. (author)

  19. Prediction of boron concentration in blood from low dose infusion for the patients of BNCT at JAERI

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, Y.; Matsumura, A.; Yamamoto, T. [University of Tsukuba, Department of Neurosurgery, Tsukuba, Ibaraki (JP)] [and others

    2000-10-01

    It is difficult to measure boron concentration in blood during neutron irradiation in BNCT. We have investigated the predictability of boron concentration in blood from the data at 1st craniotomy after low dose BSH infusion. Two patients entered BNCT at JRR2 in 1995/1996, and 5 patients entered BNCT at JRR4 in 1992/2000. The patients include 2 male and 5 female and their age ranged from 20 to 66. In 5 patients 1 g of BSH was infused before 1st tumor removal operation and boron concentrations in blood were examined around this operation. All patients were infused 100 mg/kg of BSH at 12 hours prior to BNCT and boron concentrations were examined before and after BNCT using prompt gamma ray analysis or ICP-AES. Each results showed biphasic pharmacokinetic profile. Personal variations of the pharmacokinetics of BSH were small. Final and 1 g data were well correlated and final boron concentrations at BNCT were predictable from 1 g studies. (author)

  20. Therapeutic efficacy and toxicity of a single and double application of boron neutron capture therapy (BNCT) in a hamster cheek pouch oral precancer model

    International Nuclear Information System (INIS)

    Monti Hughes, A; Pozzi, E C C; Thorp, S; Garabalino, M A; Farias, R O; Gonzalez, S J; Heber, E M; Itoiz, M E; Aromando, R F; Molinari, A J; Miller, M; Nigg, D W; Curotto, P; Trivillin, V A; Schwint, A E

    2012-01-01

    Tumor development from tissue with potentially malignant disorders (PMD) gives rise to second primary tumors. We previously demonstrated the partial inhibitory effect on tumor development of Boron Neutron Capture Therapy (BNCT) mediated by the boron compounds BPA (boronophenylalanine) and decahydrodecaborate (GB-10) in a hamster pouch oral precancer model. Seeking to optimize BNCT, the aim of the present study was to contribute to the knowledge of BNCT radiobiology for oral precancer and assess new BNCT protocols in terms of inhibition of tumor development and radiotoxicity. Groups of cancerized hamsters were locally exposed to single or double applications (2 weeks apart) of BPA-BNCT or (GB-10 + BPA)-BNCT at a total dose of 8Gy to tissue with PMD; to a single application of BPA-BNCT at 6Gy and to a double application (4 weeks apart) of BPA-BNCT or (BPA + GB-10)-BNCT at a total dose of 10Gy. Cancerized, sham-irradiated hamsters served as controls. Clinical status, tumor development from tissue with PMD and mucositis were followed for 8 months. The marked therapeutic efficacy of single applications of BNCT at 6 and 8Gy were associated to severe radiotoxicity. Dose fractionation into 2 applications reduced mucositis but also reduced therapeutic efficacy, depending on dose and interval between applications. A double application (4 weeks apart) of (GB-10 + BPA)-BNCT at a total dose of 10Gy rendered the best therapeutic advantage, i.e. 63% - 100% inhibition of tumor development with only slight mucositis in 67% of cases. The data reported herein show that issues such as dose levels and dose fractionation, interval between applications, and choice of boron compounds are pivotal to therapeutic advantage and must be tailored for a particular pathology and anatomic site. The present study determined treatment conditions that would contribute to optimize BNCT for precancer and that would warrant cautious assessment in a clinical scenario (author)

  1. Incremental value of combined 99MTc tetrofosmin parathyroid scintigraphy, rapid intra operative PTH assays and minimally invasive radio-guided surgery (MIRS) in optimizing parathyroidectomies

    International Nuclear Information System (INIS)

    Padma, S.; Kumar, S.; Babu, T.; Kumar, H.; Nair, V.; Nair, G.K.

    2004-01-01

    Objective: Aim of our study was to evaluate incremental diagnostic value of 99mTc Tetrofosmin parathyroid SPECT (TPSPECT), rapid intra operative quick parathyroid hormone measurement (QPTH) combined with radio guidance provided by scintillation probe (Minimally Invasive Radio guided Surgery MIRS) in parathyroid surgeries. While TPSPECT is an established investigation in preoperative workup of hyperparathyroidism patients , MIRS is a relatively new concept in Indian subcontinent. Methods: 29 pts (M: F = 18: 11), age range 16- 65 yrs (mean 41+ 9 yrs) having clinical and biochemical hyperparathyroidism underwent TPSPECT between Jan 02 -04, using 20 mci IV 99mTc Tetrofosmin. Pts with familial hyperparathyroidism , previous nodular goiters and previous neck irradiation were excluded from study. Scintigraphy comprised of immediate, delayed planar and SPECT imaging of neck and chest. Imagewise abnormal, persistent tracer uptake was considered positive for adenoma and diffuse uptake for hyperplasia. 26 pts underwent exploration (22 adenomas and 4 hyperplasias).18 pts had benefit of intraoperative QPTH. A select group (after Dec 2003) i.e. 9 pts got the assistance of radioguided probing. Peroperatively NM physician used cordless handheld gamma probe (Gamma Finder, World of Medicine, Germany) in neck and mediastinum to detect parathyroid adenoma / hyperplasias. A five fold increase in radioactive counts perceived by probe when compared to background was considered positive for parathyroid adenoma / hyperplasia. If PTH levels fell from baseline by at least 50%, the surgery was concluded as complete. Results: In all 22 pts suspected to have primary hyperparathyroidism TPSPECT identified adenomas (100 % sensitivity). While planar imaging had a sensitivity of 90.1% (20/22 pts), SPECT identified the adenoma in all pts. Interestingly only 3/22 pts had ectopic glands while 5 had more than one adenomas. The most commonly involved gland was left inferior. In secondary

  2. Towards the final BSA modeling for the accelerator-driven BNCT facility at INFN LNL

    Energy Technology Data Exchange (ETDEWEB)

    Ceballos, C. [Centro de Aplicaciones Tecnlogicas y Desarrollo Nuclear, 5ta y30, Miramar, Playa, Ciudad Habana (Cuba); Esposito, J., E-mail: juan.esposito@lnl.infn.it [INFN, Laboratori Nazionali di Legnaro (LNL), via dell' Universita, 2, I-35020 Legnaro (PD) (Italy); Agosteo, S. [Politecnico di Milano, Dipartimento di Energia, Piazza Leonardo da Vinci 32, 20133 Milano (Italy)] [INFN, Sezione di Milano, via Celoria 16, 20133 Milano (Italy); Colautti, P.; Conte, V.; Moro, D. [INFN, Laboratori Nazionali di Legnaro (LNL), via dell' Universita, 2, I-35020 Legnaro (PD) (Italy); Pola, A. [Politecnico di Milano, Dipartimento di Energia, Piazza Leonardo da Vinci 32, 20133 Milano (Italy)] [INFN, Sezione di Milano, via Celoria 16, 20133 Milano (Italy)

    2011-12-15

    Some remarkable advances have been made in the last years on the SPES-BNCT project of the Istituto Nazionale di Fisica Nucleare (INFN) towards the development of the accelerator-driven thermal neutron beam facility at the Legnaro National Laboratories (LNL), aimed at the BNCT experimental treatment of extended skin melanoma. The compact neutron source will be produced via the {sup 9}Be(p,xn) reactions using the 5 MeV, 30 mA beam driven by the RFQ accelerator, whose modules construction has been recently completed, into a thick beryllium target prototype already available. The Beam Shaping Assembly (BSA) final modeling, using both neutron converter and the new, detailed, Be(p,xn) neutron yield spectra at 5 MeV energy recently measured at the CN Van de Graaff accelerator at LNL, is summarized here.

  3. Radioprotective agents to reduce BNCT (Boron Neutron Capture Therapy) induced mucositis in the hamster cheek pouch

    International Nuclear Information System (INIS)

    Monti Hughes, A.; Pozzi, E.C.C.; Thorp, S.

    2013-01-01

    Introduction: BNCT is based on the capture reaction between boron, selectively targeted to tumor tissue, and thermal neutrons which gives rise to lethal, short-range high linear energy transfer particles that selectively damage tumor tissue, sparing normal tissue. We previously evidenced a remarkable therapeutic success of BNCT mediated by boronophenylalanine (BPA) in the hamster cheek pouch oral cancer and pre cancer model. Despite therapeutic efficacy, mucositis induced in premalignant tissue was dose limiting and favored, in some cases, tumor development. In a clinical scenario, oral mucositis limits the dose administered to head and neck tumors. Aim: Our aim was to evaluate the effect of the administration of different radioprotective agents, seeking to reduce BNCT-induced mucositis to acceptable levels in dose-limiting premalignant tissue; without compromising therapeutic effect evaluated as inhibition on tumor development in premalignant tissue; without systemic or local side effects; and without negative effects on the biodistribution of the boron compound used for treatment. Materials and methods: Cancerized hamsters with DMBA (dimethylbenzanthracene) were treated with BPA-BNCT 5 Gy total absorbed dose to premalignant tissue, at the RA-3 Nuclear Reactor, divided into different groups: 1-treated with FLUNIXIN; 2- ATORVASTATIN; 3-THALIDOMIDE; 4-HISTAMINE (two concentrations: Low -1 mg/ml- and High -5 mg/ml-); 5-JNJ7777120; 6-JNJ10191584; 7-SALINE (vehicle). Cancerized animals without any treatment (neither BNCT nor radioprotective therapy) were also analyzed. We followed the animals during one month and evaluated the percentage of animals with unacceptable/severe mucositis, clinical status and percentage of animals with new tumors post treatment. We also performed a preliminary biodistribution study of BPA + Histamine “low” concentration to evaluate the potential effect of the radioprotector on BPA biodistribution. Results: Histamine

  4. Four cases of facial melanoma treated by BNCT with {sup 10}B-p-boronophenylalanine

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, H. [Tohoku Univ., IDAC, Sendai, Miyagi (Japan); Mishima, Y. [Mishima Institute for Dermatological Research, Kobe, Hyogo (Japan); Hiratsuka, J. [Kawasaki Medical School, Kurashiki, Okayama (Japan); Kobayashi, T. [Kyoto Univ., Kyoto (Japan); Karashima, H. [Mitsubishi Ind. Co. Ltd. (Japan); Yoshino, K. [Shinshu Univ., Matsumoto, Nagano (Japan); Tsuru, K.; Araki, K.; Ichihashi, M. [Kobe Univ., Kobe, Hyogo (Japan)

    2000-10-01

    We treated four cases of facial melanoma by BNCT with {sup 10}B-paraboronophenylalanine {center_dot} fructose complex (BPA). The patients received 180 to 200 mg BPA/kg-BW intravenously for 3 to 5 hours. One to two hours after the end of BPA administration, they were irradiated with a thermal neutron beam at the Kyoto University Reactor (KUR). The local control of the tumors was good and complete regression was achieved in all cases. The acute and subacute skin reactions ranged from dry desquamation to erosion and were within tolerable limits. After 2 to 3 months, the skin recovered from damage with slight pigmentation or depigmentation and without serious functional or cosmetic problems. Our results indicate BNCT of facial melanoma is promising not only for tumor cure but also for good QOL of the patients, although surgery is the standard and first choice for the treatment of malignant melanoma. (author)

  5. Monte Carlo simulations of the cellular S-value, lineal energy and RBE for BNCT

    International Nuclear Information System (INIS)

    Liu Chingsheng; Tung Chuanjong

    2006-01-01

    Due to the non-uniform uptake of boron-containing pharmaceuticals in cells and the short-ranged alpha and lithium particles, microdosimetry provides useful information on the cellular dose and response of boron neutron capture therapy (BNCT). Radiation dose and quality in BNCT may be expressed in terms of the cellular S-value and the lineal energy spectrum. In the present work, Monte Carlo simulations were performed to calculate these microdosimetric parameters for different source-target configurations and sizes in cells. The effective relative biological effectiveness (RBE) of the Tsing Hua Open-pool Reactor (THOR) epithermal neutron beam was evaluated using biological weighting functions that depended on the lineal energy. RBE changes with source-target configurations and sizes were analyzed. (author)

  6. Hyaluronic acid as a potential boron carrier for BNCT: Preliminary evaluation.

    Science.gov (United States)

    Zaboronok, A; Yamamoto, T; Nakai, K; Yoshida, F; Uspenskii, S; Selyanin, M; Zelenetskii, A; Matsumura, Akira

    2015-12-01

    Hyaluronic acid (HA), a nonimmunogenic, biocompatible polymer found in different biological tissues, has the potential to attach to CD44 receptors on the surface of certain cancer cells, where the receptor is overexpressed compared with normal cells. Boron-hyaluronic acid (BHA) was tested for its feasibility as a potential agent for BNCT. BHA with low-viscosity 30 kDa HA could be administered by intravenous injection. The compound showed a certain degree of cytotoxicity and accumulation in C6 rat glioma cells in vitro. Instability of the chelate bonds between boron and HA and/or insufficient specificity of CD44 receptors on C6 cells to BHA could account for the insufficient in vitro accumulation. To ensure the future eligibility of BHA for BNCT experiments, using alternative tumor cell lines and chemically securing the chelate bonds or synthesizing BHA with boron covalently attached to HA might be required. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Boron analysis and boron imaging in biological materials for Boron Neutron Capture Therapy (BNCT).

    Science.gov (United States)

    Wittig, Andrea; Michel, Jean; Moss, Raymond L; Stecher-Rasmussen, Finn; Arlinghaus, Heinrich F; Bendel, Peter; Mauri, Pier Luigi; Altieri, Saverio; Hilger, Ralf; Salvadori, Piero A; Menichetti, Luca; Zamenhof, Robert; Sauerwein, Wolfgang A G

    2008-10-01

    Boron Neutron Capture Therapy (BNCT) is based on the ability of the stable isotope 10B to capture neutrons, which leads to a nuclear reaction producing an alpha- and a 7Li-particle, both having a high biological effectiveness and a very short range in tissue, being limited to approximately one cell diameter. This opens the possibility for a highly selective cancer therapy. BNCT strongly depends on the selective uptake of 10B in tumor cells and on its distribution inside the cells. The chemical properties of boron and the need to discriminate different isotopes make the investigation of the concentration and distribution of 10B a challenging task. The most advanced techniques to measure and image boron are described, both invasive and non-invasive. The most promising approach for further investigation will be the complementary use of the different techniques to obtain the information that is mandatory for the future of this innovative treatment modality.

  8. On line local measurement of thermal neutron flux on BNCT patient using SPND

    International Nuclear Information System (INIS)

    Miller, M.E.; Sztejnberg Goncalves-Carralves, M.L.; Gonzalez, S.J.

    2006-01-01

    The first on-line neutron flux measurement on a patient using a self-powered neutron detector (SPND) was assessed during the fourth clinical trial of the Boron Neutron Capture Therapy (BNCT) Project carried out at the National Atomic Energy Commission of Argentina (CNEA) and the medical center Angel H. Roffo. The SPND was specially developed and assembled for BNCT by CNEA. Its small size, 1 cm sensible length and 1.9 mm diameter, allowed performing a localized measurement. Since the treated tumors were cutaneous melanomas of nodular type, the SPND was located on the patient's skin. The patient was exposed to three different and consecutive fields and in each of them the SPND was used to measure local thermal neutron fluxes at selected dosimetric reference points. The values of the measured fluxes agreed with the ones estimated by calculation. This trial also demonstrated the usefulness of the SPND for assessing flux on-line. (author)

  9. The Phase I/II BNCT Trials at the Brookhaven medical research reactor: Critical considerations

    International Nuclear Information System (INIS)

    Diaz, A.Z.

    2001-01-01

    A phase I/II clinical trial of boronophenylalanine-fructose (BPA-F) mediated boron neutron capture therapy (BNCT) for Glioblastoma Multiforme (GBM) was initiated at Brookhaven National Laboratory (BNL) in 1994. Many critical issues were considered during the design of the first of many sequential dose escalation protocols. These critical issues included patient selection criteria, boron delivery agent, dose limits to the normal brain, dose escalation schemes for both neutron exposure and boron dose, and fractionation. As the clinical protocols progressed and evaluation of the tolerance of the central nervous system (CNS) to BPA-mediated BNCT at the BMRR continued new specifications were adopted. Clinical data reflecting the progression of the protocols will be presented to illustrate the steps taken and the reasons behind their adoption. (author)

  10. Thermally optimized lithium neutron producing target design for accelerator-based BNCT

    International Nuclear Information System (INIS)

    Park Shane; Joo Hyeong Min; Jang Byeong Ill; Jeun, Gyoodong; Kim Jong Kyung; Chai, Jong Seo

    2006-01-01

    In accelerator-based Boron Neutron Capture Therapy (BNCT), 7 Li(p,n) 7 Be reaction is prevalently used as a neutron source. However, lithium has a very low melting point and poor thermal conductivity. Thus lithium target needs an efficient cooling. In this study, ways of increasing proton beam diameter and slanting target are proposed to reduce the heat density of lithium target. Thermal analysis on the lithium target design shows that water cooling is feasible if the proton beam diameter and target slopes are in the available range of the contour plots generated from this study. On the basis of the thermal analysis, the prototype of target system was designed and manufactured. Full-model thermal analysis and temperature measuring experiment were subsequently performed. The calculated temperature distribution coincided with the contour plots and the experimental results. These results will be used in the manufacture of the prototype accelerator-based BNCT facility at Hanyang University. (author)

  11. A colorimetric determination of boron in biological sample for boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Camillo, M.A.P.; Tomac Junior, U.

    1990-01-01

    The boron neutron capture therapy (BNCT) has shown better prognosis in the treatment of glyemas and gluoblastomas grade III and IV than other therapies. During the treatment the levels of Na 2 10 B 12 H 11 SH must be known in several compartiments of the organism and with this purpose the method of colorimetric determination of boron using curcumine was established. This method is simple, reprodutible and adequate sensitivity for this control. (author) [pt

  12. Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT.

    Science.gov (United States)

    Herrera, M S; González, S J; Burlon, A A; Minsky, D M; Kreiner, A J

    2011-12-01

    Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Treatment optimization of a brain tumor in BNCT by Monte Carlo method

    International Nuclear Information System (INIS)

    Nejat, S.; Binesh, A.; Karimian, A.

    2012-01-01

    Brain cancers are one of the most important diseases. BNCT (Boron Neutron Capture Therapy) is used to brain tumor treatment. In this method the 1 0B (n,α) 7 Li reaction is used. The purpose of this study is absorbed dose evaluation of tumoral and healthy parts of brain. To achieve this aim the brain was simulated by a cylindrical phantom with the dimensions of 20 cm in diameter and height. In BNCT treatment the BSH (Na 2 B 12 H 11 SH) is injected to the human body and absorbed in the healthy and tumoral parts by the ratios of 18 and 65 ppm respectively. So in this research the absorption of BSH in tumoral and healthy parts of brain was considered as the mentioned ratio. Then the neutron with the energy range of 50 eV - 10 keV was exposed to the brain and maximum absorbed dose in healthy and tumoral parts of brain were calculated for a cylindrical tumor with the thickness of about 1 cm which was considered in 5.5 cm depth of brain. This research showed the suitable energy to treat this tumor by BNCT is interval 4 keV- 6keV. The average of dose which is met with healthy and tumor tissue was gained for 6 keV energy of brain 1.18x10 -12 cGy/n and 5.98x10 -12 cGy/n respectively. Maximum of dose which is met with healthy tissue was 4.3 Gy which is much less than standard amount 12.6 Gy. Therefore BNCT method is known as an effective way in the therapy of this kind of tumor. (authors)

  14. Retrospective review of the clinical BNCT trial at Brookhaven National Laboratory

    International Nuclear Information System (INIS)

    Diaz, A.Z.; Chanana, A.D.; Coderre, J.A.; Ma, R.

    2000-01-01

    The primary objective of the phase I/II dose escalation studies was to evaluate the safety of the boronophenylalanine-fructose (BPA-F) mediated boron neutron capture therapy (BNCT) in subjects with glioblastoma multiforme (GBM). A secondary objective was to retrospectively assess the palliation of GBM by BNCT. Fifty-three subjects with GBM were treated under multiple dose escalation protocols at the Brookhaven Medical Research Reactor (BMRR). Twenty-six subjects were treated using one field, 17 subjects were treated using 2 fields and 10 subjects were treated using 3 fields. BPA-F related toxicity was not observed. The maximum radiation dose to a volume of approximately 1 cc of the normal brain varied from 8.9 to 15.9 gray-equivalent (Gy-Eq). The volume-weighted average radiation dose to normal brain varied from 1.9 to 9.5 Gy-Eq. Six RTOG (Radiation Therapy Oncology Group) grade 3 or 4 toxicities were attributed to BNCT. Four of the 53 subjects are still alive with 3 of them free of recurrent disease with over two years follow-up. The median times to progression and median survival time from diagnosis were 28.4 weeks and 12.8 months respectively. (author)

  15. Quality assurance for BNCT at nuclear facilities. A necessary burden or the unavoidable seal of approval

    International Nuclear Information System (INIS)

    Moss, R.; Morrissey, J.; Sauerwein, W.; Hideghety, K.; Rassow, J.; Stecher-Rasmussen, F.

    2000-01-01

    The BNCT clinical trial at the HFR Petten is performed on a completely multi-national basis. The irradiation facility is located in one country (The Netherlands), is operated by an international team of experts under the leadership of a radiotherapist from another country (Germany) and treats patients coming from different European countries. In gaining the necessary approval, it became apparent, especially in the many discussions with the (Dutch) Health authorities that Quality Assurance (QA) would be and is a critical aspect. This is even more so, in the case of BNCT, where it was not only a (relatively) new experimental treatment (in 1996/97) about to be performed for the first time in Europe, but it was to be performed in a non-hospital environment and furthermore in a nuclear research reactor. It was necessary therefore to comply, as closely as possible, with similarly accepted practices in conventional radiotherapy. Despite QA being a sometimes burdensome task, this paper nevertheless raises the issue as to whether it is necessary or whether it is the seal of approval for BNCT as an acceptable mode of treatment in mainstream radiotherapy. (author)

  16. An accelerator neutron source for BNCT. Technical progress report, 1 June 1993--31 May 1994

    International Nuclear Information System (INIS)

    Blue, T.E.; Vafai, K.

    1994-02-01

    This is the progress report for the project entitled, ''An Accelerator Neutron Source for BNCT.'' The progress report is for the period from July 1, 1993 to date. The overall objective of our research project is to develop an Accelerator Epithermal Neutron Irradiation Facility (AENIF) for Boron Neutron Capture Therapy (BNCT). The AENIF consists of a 2.5 MeV high current proton accelerator, a lithium target to produce source neutrons, and a moderator/reflector assembly to obtain from the energetic source neutrons an epithermal neutron field suitable for BNCT treatments. Our project goals are to develop the non-accelerator components of the AENIF, and to specifically include in our development: (1) design, numerical simulation, and experimental verification of a target assembly which is capable of removing 75 kW of beam power; (2) re-optimization of the moderator assembly design based on in-phantom dose assessments using neutron spectra calculated in phantom and an energy-dependent neutron Relative Biological Effectiveness (RBE); (3) construction of a prototype moderator assembly and confirmation of its design by measurements; (4) design of the shielding of the accelerator and treatment rooms for an AENIF; and (5) design of a high energy beam transport system which is compatible with the shielding design and the thermal-hydraulic design

  17. In vivo tyrosinase mini-gene transfer enhances killing effect of BNCT on amelanotic melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Kondoh, H.; Mishima, Y. [Mishima Institute for Dermatological Research, Kobe, Hyogo (Japan); Hiratsuka, J. [Kawasaki Medical School, Dept. of Radiation Oncology, Kurashiki, Okayama (Japan); Iwakura, M. [Kobe Univ. (Japan). School of Medicine

    2000-10-01

    Using accentuated melanogenesis principally occurring within melanoma cells, we have successfully treated human malignant melanoma (Mm) with {sup 10}B-BPA BNCT. Despite this success, there are still remaining issues for poorly melanogenic Mm and further non-pigment cell tumors. We found the selective accumulation of {sup 10}B-BPA to Mm is primarily due to the complex formation of BPA and melanin-monomers activity synthesized within Mm cells. Then, we succeeded in transferring the tyrosinase gene into amelanotic to substantially produce melanin monomers. These cells has demonstrated increased boron accumulation and enhanced killing effect of BNCT. Further, transfection of TRP-2 (DOPAchrome tautomerase) gene into poorly eumelanotic and slightly phenomelanotic Mm cells in culture cell systems also led to increased BPA accumulation. Thereafter, we studied in vivo gene transfer. We transferred the tyrosinase mini-gene by intra-tumor injection into poorly melanotic Mm proliferating subcutaneously in hamster skin, and performed BNCT. Compared to control tumors, gene-transferred tumors showed increased BPA accumulation leading to enhanced killing effect. (author)

  18. FiR 1 reactor in service for boron neutron capture therapy (BNCT) and isotope production

    International Nuclear Information System (INIS)

    Auterinen, I.; Salmenhaara, S.E.J. . Author

    2004-01-01

    The FiR 1 reactor, a 250 kW Triga reactor, has been in operation since 1962. The main purpose for the existence of the reactor is now the Boron Neutron Capture Therapy (BNCT), but FiR 1 has also an important national role in providing local enterprises and research institutions in the fields of industrial measurements, pharmaceuticals, electronics etc. with isotope production and activation analysis services. In the 1990's a BNCT treatment facility was built at the FiR 1 reactor located at Technical Research Centre of Finland. A special new neutron moderator material Fluental TM (Al+AlF3+Li) developed at VTT ensures the superior quality of the neutron beam. Also the treatment environment is of world top quality after a major renovation of the whole reactor building in 1997. Recently the lithiated polyethylene neutron shielding of the beam aperture was modified to ease the positioning of the patient close to the beam aperture. Increasing the reactor power to 500 kW would allow positioning of the patient further away from the beam aperture. Possibilities to accomplish a safety analysis for this is currently under considerations. Over thirty patients have been treated at FiR 1 since May 1999, when the license for patient treatment was granted to the responsible BNCT treatment organization, Boneca Corporation. Currently three clinical trial protocols for tumours in the brain as well as in the head and neck region are recruiting patients. (author)

  19. Hyaluronic acid as a potential boron carrier for BNCT: Preliminary evaluation

    International Nuclear Information System (INIS)

    Zaboronok, A.; Yamamoto, T.; Nakai, K.; Yoshida, F.; Uspenskii, S.; Selyanin, M.; Zelenetskii, A.; Matsumura, Akira

    2015-01-01

    Hyaluronic acid (HA), a nonimmunogenic, biocompatible polymer found in different biological tissues, has the potential to attach to CD44 receptors on the surface of certain cancer cells, where the receptor is overexpressed compared with normal cells. Boron–hyaluronic acid (BHA) was tested for its feasibility as a potential agent for BNCT. BHA with low-viscosity 30 kDa HA could be administered by intravenous injection. The compound showed a certain degree of cytotoxicity and accumulation in C6 rat glioma cells in vitro. Instability of the chelate bonds between boron and HA and/or insufficient specificity of CD44 receptors on C6 cells to BHA could account for the insufficient in vitro accumulation. To ensure the future eligibility of BHA for BNCT experiments, using alternative tumor cell lines and chemically securing the chelate bonds or synthesizing BHA with boron covalently attached to HA might be required. - Highlights: • Hyaluronic acid (HA) is a nonimmunogenic, biocompatible polymer. • Boron–HA (BHA) acid can contain a large number of boron atoms for BNCT. • Active targeting can be realized with CD44 and other HA receptors on tumor cells. • BHA showed a certain degree of toxicity against C6 tumor cells and V79 fibroblasts. • BHA was injected into rats via the tail vein, boron was detected in tumors in vivo.

  20. Some recent developments in treatment planning software and methodology for BNCT

    International Nuclear Information System (INIS)

    Nigg, D.W.; Wheeler, F.J.; Wessol, D.E.; Wemple, C.A.; Babcock, R.; Capala, J.

    1996-01-01

    Over the past several years/the Idaho National Engineering Laboratory (INEL) has led the development of a unique, internationally-recognized set of software modules (BNCT rtpe) for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT). The computational capability represented by this software is essential to the proper administration of all forms of radiotherapy for cancer. Such software addresses the need to perform pretreatment computation and optimization of the radiation dose distribution in the target volume. This permits the achievement of the optimal therapeutic ratio (tumor dose relative to critical normal tissue dose) for each individual patient via a systematic procedure for specifying the appropriate irradiation parameters to be employed for a given treatment. These parameters include angle of therapy beam incidence, beam aperture and shape,and beam intensity as a function of position across the beam front. The INEL software is used for treatment planning in the current series of human glioma trials at Brookhaven National Laboratory (BNL) and has also been licensed for research and developmental purposes to several other BNCT research centers in the US and in Europe

  1. Some recent developments in treatment planning software and methodology for BNCT

    International Nuclear Information System (INIS)

    Nigg, D.W.; Wheeler, F.J.; Wessol, D.E.

    1996-01-01

    Over the past several years the Idaho National Engineering Laboratory (INEL) has led the development of a unique, internationally-recognized set of software modules (BNCT-rtpe) for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT). The computational capability represented by this software is essential to the proper administration of all forms of radiotherapy for cancer. Such software addresses the need to perform pretreatment computation and optimization of the radiation dose distribution in the target volume. This permits the achievement of the optimal therapeutic ratio (tumor dose relative to critical normal tissue dose) for each individual patient via a systematic procedure for specifying the appropriate irradiation parameters to be employed for a given treatment. These parameters include angle of therapy beam incidence, beam aperture and shape, and beam intensity as a function of position across the beam front. The INEL software is used for treatment planning in the current series of human glioma trials at Brookhaven National Laboratory (BNL) and has also been licensed for research and developmental purposes to several other BNCT research centers in the US and in Europe

  2. Optimization of the irradiation beam in the BNCT research facility at IEA-R1 reactor

    International Nuclear Information System (INIS)

    Castro, Vinicius Alexandre de

    2014-01-01

    Boron Neutron Capture Therapy (BNCT) is a radiotherapeutic technique for the treatment of some types of cancer whose useful energy comes from a nuclear reaction that occurs when thermal neutron impinges upon a Boron-10 atom. In Brazil there is a research facility built along the beam hole number 3 of the IEA-R1 research reactor at IPEN, which was designed to perform BNCT research experiments. For a good performance of the technique, the irradiation beam should be mostly composed of thermal neutrons with a minimum as possible gamma and above thermal neutron components. This work aims to monitor and evaluate the irradiation beam on the sample irradiation position through the use of activation detectors (activation foils) and also to propose, through simulation using the radiation transport code, MCNP, new sets of moderators and filters which shall deliver better irradiation fields at the irradiation sample position In this work, a simulation methodology, based on a MCNP card, known as wwg (weight window generation) was studied, and the neutron energy spectrum has been experimentally discriminated at 5 energy ranges by using a new set o activation foils. It also has been concluded that the BNCT research facility has the required thermal neutron flux to perform studies in the area and it has a great potential for improvement for tailoring the irradiation field. (author)

  3. Monitoring total boron in blood for BNCT by a novel atomic emission method

    International Nuclear Information System (INIS)

    Laakso, J.; Kulvik, M.; Ruokonen, I.; Vaehaetalo, J.; Faerkkilae, M.; Kallio, M.; Zilliacus, R.

    2000-01-01

    In BNCT the duration and timing of the is adjusted by 10 B concentrations in whole blood. Time-frame for determinations is less than 20 minutes. Therefore fast and accurate boron determinations are a prerequisite for BNCT. We present a method based on ICP-AES instrument for whole blood and plasma boron determinations with protein precipitation with trichloroacetic acid as sample pre-treatment and beryllium as an internal standard. The method was compared to established but tedious ICP-mass spectrometric method with wet ashing as a sample pre-treatment. The ICP-AES method is in good agreement (correlation coefficient 0.99) the ICP-MS. Within-day and between-day imprecisions were less than 3,5% CV for whole blood samples. Samples taken during and after BPA-F infusion (290 mg/kg) revealed an uneven distribution between plasma and erythrocytes. The present method is feasible and one of the fastest currently available for BNCT. Our results indicate that BPA-F or its metabolites do not seem to be tightly bound to plasma proteins. It also seems that determination of boron in plasma sample may be preferable than measuring boron in whole blood. (author)

  4. Reprint of Application of BNCT to the treatment of HER2+ breast cancer recurrences: Research and developments in Argentina

    International Nuclear Information System (INIS)

    Gadan, M.A.; González, S.J.; Batalla, M.; Olivera, M.S.; Policastro, L.; Sztejnberg, M.L.

    2015-01-01

    In the frame of the Argentine BNCT Project a new research line has been started to study the application of BNCT to the treatment of locoregional recurrences of HER2+ breast cancer subtype. Based on former studies, the strategy considers the use of immunoliposomes as boron carriers nanovehicles to target HER2 overexpressing cells. The essential concerns of the current stage of this proposal are the development of carriers that can improve the efficiency of delivery of boron compounds and the dosimetric assessment of treatment feasibility. For this purpose, an specific pool of clinical cases that can benefit from this application was determined. In this work, we present the proposal and the advances related to the different stages of current research. - Highlights: • A new proposal of BNCT for HER2+ breast cancer treatment is introduced. • The proposal considers development of immunoliposomes as boron carrier nanovehicles. • Locoregional recurrences after treatment were identified as candidates for initial BNCT studies. • First analysis show acceptable neutron flux distributions provided by RA-6 BNCT facility.

  5. A preclinical study of boron neutron capture therapy (BNCT) of spontaneous tumors in cats at RA-6 in Argentina

    International Nuclear Information System (INIS)

    Trivillin, Veronica A.; Heber, Elisa M.; Itoiz, Maria E.; Schwint, Amanda E.; Calzetta, Osvaldo A.; Blaumann, Hernan R.; Longhino, J.; Rao, Monica; Cantarelli, Maria de los A.

    2005-01-01

    BNCT is a binary treatment modality that combines irradiation with a thermal or epithermal neutron beam with tumor-seeking, boron containing drugs to produce selective irradiation of tumor tissue. Having demonstrated that BNCT mediated by boronophenylalanine (BPA) induced control of experimental squamous cell carcinomas (SCC) of the hamster cheek pouch mucosa with no damage to normal tissue we explored the feasibility and safety of treating spontaneous head and neck tumors, with particular focus on SCC, of terminal feline patients with low dose BPA-BNCT employing the thermal beam of RA-1. Having demonstrated partial tumor control with no radio toxic effects, the aim of the present study was to evaluate the effect of BPA-BNCT on tumor and normal tissue in 3 cases of spontaneous SCC in feline patients employing a higher neutron fluence than in the previous study. The present study was performed at RA-6 with the thermalized epithermal neutron beam. All three irradiations were successful. Except for an initial, moderate and reversible mucositis, no significant radio toxic effects were observed in terms of clinical follow-up, histological examination, biochemical analysis and assessment of autopsy material. Partial tumor control was evidenced in terms of growth inhibition and partial necrosis and improvement in the quality of life during the survival period. Optimization of the therapeutic efficacy of BNCT would require improvement in boron tumor targeting and strategies to increase in-depth dose in large tumors. (author)

  6. Early phase II study on BNCT in metastatic malignant melanoma using the boron carrier BPA (EORTC protocol 11011)

    International Nuclear Information System (INIS)

    Wittig, Andrea; Sauerwein, Wolfgang; Moss, Raymond

    2006-01-01

    The aim of the trial is to examine the clinical response of metastatic melanoma following BNCT with BPA. The trial contains an optional biodistribution sub-study, which is done if operable metastases are removed prior BNCT. BNCT is applied in 2 fractions at the HFR in Petten. In cases of diffuse brain metastases the whole brain is irradiated homogeneously using 5 irradiation beams from different directions. Up to now 4 patients suffering from multiple brain metastases (more than 20) have been included. In all cases we observed a partial response or no change in the irradiated volume. However, none of the patients survived more than 3 months. The pharmacokinetic of the BPA can be predicted very precisely using a two-compartment model. The treatment can be performed safety. (author)

  7. The hamster cheek pouch (HCP) as an experimental model of oral cancer for BNCT: biodistribution and pharmacokinetics of BPA

    Energy Technology Data Exchange (ETDEWEB)

    Kreimann, E.; Itoiz, M.E.; Dagrosa, A.; Garavaglia, R.; Farias, S.; Batistoni, D.; Schwint, A.E. [National Atomic Energy Commission (Argentina)

    2000-10-01

    We propose and validate the HCP model of oral cancer for BNCT studies. This model serves to explore new applications of the technique, study the biology of BNCT and assess Boron uptake in clinically relevant oral tissues. Tumors are induced by a process that mimics spontaneous malignant transformation instead of by the growth of implanted tumor cells. Syrian hamsters were submitted to tumor induction with a chemical carcinogenesis protocol and then used for biodistribution and pharmacokinetic studies of BPA. The data reveal selective uptake by tumor and, to a lesser degree, by precancerous tissue. Boron concentration in oral tissues and skin was higher than in blood, an issue of clinical relevance given that these tissues may be dose-limiting. Absolute and relative values of Boron concentration would be potentially therapeutic. Boron concentration exhibited a linear relationship with percentage of viable tissue in HCP tumors. The HCP model would provide a novel, contributory approach to BNCT research. (author)

  8. The use of positron emission tomography in BNCT treatment planning for metastatic malignant melanoma and glioblastoma multiforme

    International Nuclear Information System (INIS)

    Kabalka, G.; Nichols, T.; Smith, G.; Miller, L.; Kahn, M.

    2000-01-01

    Positron emission tomography (PET) evaluations of six glioblastoma multiforme (GBM) and one metastatic melanoma (MM) patient have been carried out utilizing fluorine-18 labeled p-boronophenylalanine. Four of the GBM patients were imaged both prior to and post BNCT. In one GBM patient, biopsy derived boron distribution data compared favorably to the PET derived data. The PET data have been used as input to dosimetry calculations and the results vary from those obtained using current protocols. In addition, PET images of the thorax would indicate that the utility of PET for staging tumors for BNCT may extend beyond the brain. However, higher than anticipated levels of activity in the lungs (as also seen in salivary glands) indicate the more effective BNCT agents will be required. (author)

  9. Tight intra-operative blood pressure control versus standard care for patients undergoing hip fracture repair - Hip Fracture Intervention Study for Prevention of Hypotension (HIP-HOP) trial: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Moppett, Iain Keith; White, Stuart; Griffiths, Richard; Buggy, Donal

    2017-07-25

    Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control. We are conducting a three-centre, randomised, double-blinded pilot study in three hospitals in the United Kingdom. The sample size will be 75 patients (25 from each centre). Randomisation will be done using computer-generated concealed tables. Both participants and investigators will be blinded to group allocation. Participants will be aged >70 years, cognitively intact (Abbreviated Mental Test Score 7 or greater), able to give informed consent and admitted directly through the emergency department with a fractured neck of the femur requiring operative repair. Patients randomised to tight blood pressure control or avoidance of intra-operative hypotension will receive active treatment as required to maintain both of the following: systolic arterial blood pressure >80% of baseline pre-operative value and mean arterial pressure >75 mmHg throughout. All participants will receive standard hospital care, including spinal or general anaesthesia, at the discretion of the clinical team. The primary outcome is a composite of the presence or absence of defined cardiovascular, renal and delirium morbidity within 7 days of surgery (myocardial injury, stroke, acute kidney injury, delirium). Secondary endpoints will include the defined individual morbidities, mortality, early mobility and discharge to usual residence. This is a small-scale pilot study investigating the feasibility of a trial of tight intra-operative blood pressure control in a frail elderly patient group with known high morbidity

  10. Effects of intra-operative end-tidal carbon dioxide levels on the rates of post-operative complications in adults undergoing general anesthesia for percutaneous nephrolithotomy: A clinical trial

    Directory of Open Access Journals (Sweden)

    Mahmoud Saghaei

    2014-01-01

    Full Text Available Background: A retrospective study has shown lesser days of hospital stay in patients with increased levels of intra-operative end-tidal carbon dioxide (ETCO 2 . It is probable that hypercapnia may exert its beneficial effects on patients′ outcome through optimization of global hemodynamic and tissue oxygenation, leading to a lower rate of post-operative complications. This study was designed to test the hypothesis that higher values of intra-operative ETCO 2 decrease the rate of post-operative complications. Materials and Methods: In this randomized, double-blind clinical trial, 78 adult patients scheduled for percutaneous nephrolithotomy (PCNL were prospectively enrolled and randomly divided into three groups. ETCO 2 was set and maintained throughout the procedure at 31-33, 37-39 and 43-45 mmHg in the hypocapnia, normocapnia and hypercapnia groups, respectively. The rates of post-operative complications were compared among the three groups. Results: Seventy-five patients completed the study (52 male and 23 female. Ten (38.5%, four (16% and two (8.3% patients developed post-operative vomiting in the hypocapnia, normocapnia and hypercapnia groups, respectively (P = 0.025. The nausea score was significantly lower in the hypercapnic group compared with the other groups (3.9 ± 1.8, 3.2 ± 2.1 and 1.3 ± 1.8 in the hypocapnia, normocapnia and hypercapnia groups, respectively; P = 0.000. Time to return of spontaneous respiration and awakening were significantly decreased in the hypercapnia group compared with the other groups (P < 0.01. Conclusion: Mild intra-operative hypercapnia has a protecting effect against the development of post-operative nausea and vomiting and decreases the duration of emergence and recovery from general anesthesia.

  11. OPTIMIZATION OF A NEUTRON BEAM SHAPING ASSEMBLY DESIGN FOR BNCT AND ITS DOSIMETRY SIMULATION BASED ON MCNPX

    Directory of Open Access Journals (Sweden)

    I Made Ardana

    2017-10-01

    OPTIMASI DESAIN KOLIMATOR NEUTRON UNTUK SISTEM BNCT DAN UJI DOSIMETRINYA MENGGUNAKAN PROGRAM MCNPX. Telah dilakukan penelitian tentang sistem BNCT yang meliputi dua tahapan simulasi dengan menggunakan program MCNPX yaitu uji simulasi untuk optimasi desain kolimator neutron untuk sistem BNCT berbasis Siklotron 30 MeV dan uji simulasi untuk menghitung fluks neutron dan dosimetri radiasi pada kanker sarkoma jaringan lunak pada leher dan kepala. Tujuan simulasi untuk mendapatkan desain kolimator yang paling optimal dalam memoderasi fluks neutron cepat yang dihasilkan dari sistem target berilium sehingga dapat dihasilkan fluks neutron yang sesuai untuk sistem BNCT. Uji optimasi dilakukan dengan cara memvariasikan bahan dan ketebalan masing-masing komponen dalam kolimator seperi reflektor, moderator, filter neutron cepat, filter neutron thermal, filter radiasi gamma dan lubang keluaran. Desain kolimator yang diperoleh dari hasil optimasi tersusun atas moderator berbahan Al dengan ketebalan 39 cm, filter neutron cepat berbahan LiF2 setebal 8,2 cm, dan filter neutron thermal berbahan B4C setebal 0,5 cm. Untuk reflektor, filter radiasi gamma dan lubang keluaran masing-masing menggunakan bahan PbF2, Pb dan Bi. Fluks neutron epithermal yang dihasilkan dari kolimator yang didesain adalah sebesar 2,83 x 109 n/s cm-2 dan telah memenuhi seluruh parameter fluks neutron yang sesuai untuk sistem BNCT. Selanjutnya uji simulasi dosimetri pada kanker sarkoma jaringan lunak pada leher dan kepala dilakukan dengan cara memvariasikan konsentrasi senyawa boron pada model phantom leher manusia (ORNL. Selanjutnya model phantom tersebut diiradiasi dengan fluks neutron yang berasal dari kolimator yang telah didesain sebelumnya. Hasilnya, fluks neutron thermal mencapai nilai tertinggi pada kedalaman 4,8 cm di dalam model phantom leher ORNL dengan laju dosis tertinggi terletak pada area jaringan kanker. Untuk masing-masing variasi konsentrasi senyawa boron pada model phantom leher ORNL supaya

  12. Co-registration of the BNCT treatment planning images for clinical practice

    International Nuclear Information System (INIS)

    Salli, Eero; Seppaelae, Tiina; Kankaanranta, Leena; Asikainen, Sami; Savolainen, Sauli; Koivunoro, Hanna

    2006-01-01

    We have co-registered MRI, CT and FBPA-PET images for BNCT in clinical practice. Co-registration improves the spatial accuracy of the treatment planning by enabling use of information from all the co-registered modalities. The multimodal co-registration has been implemented as a service product provided by the Imaging Center of Helsinki University Central Hospital to other departments. To increase the accuracy of co-registration and patient positioning in the head area BNCT, a patient-specific fixation mask suitable for PET, MRI and CT was developed. The goal of the fixation mask is to normalize the orientation of the patient's head and neck. Co-registration is performed at the image processing unit by using a rigid body model, mutual-information based algorithms and partly in-house developed software tools. The accuracy of co-registration is verified by comparing the locations of the external skin markers and anatomical landmarks in different modalities. After co-registration, the images are transformed and covered into a format required by the BNCT dose-planning software and set to the dose-planning unit of the hospital. So far co-registration has been done for 22 patients. The co-registration protocol has proved to be reliable and efficient. Some registration errors are seen on some patients in the neck area because the rigid-body model used in co-registration is not fully valid for the brain-neck entity. The registration accuracy in this area could likely be improved by implementing a co-registration procedure utilizing a partly non-rigid body model. (author)

  13. Dosimetric analysis of BNCT - Boron Neutron Capture Therapy - coupled to 252Cf brachytherapy

    International Nuclear Information System (INIS)

    Brandao, Samia F.; Campos, Tarcisio P.R.

    2009-01-01

    The incidence of brain tumors is increasing in world population; however, the treatments employed in this type of tumor have a high rate of failure and in some cases have been considered palliative, depending on histology and staging of tumor. Its necessary to achieve the control tumor dose without the spread irradiation cause damage in the brain, affecting patient neurological function. Stereotactic radiosurgery is a technique that achieves this; nevertheless, other techniques that can be used on the brain tumor control must be developed, in order to guarantee lower dose on health surroundings tissues other techniques must be developing. The 252 Cf brachytherapy applied to brain tumors has already been suggested, showing promising results in comparison to photon source, since the active source is placed into the tumor, providing greater dose deposition, while more distant regions are spared. BNCT - Boron Neutron Capture Therapy - is another technique that is in developing to brain tumors control, showing theoretical superiority on the rules of conventional treatments, due to a selective irradiation of neoplasics cells, after the patient receives a borate compound infusion and be subjected to a epithermal neutrons beam. This work presents dosimetric studies of the coupling techniques: BNCT with 252 Cf brachytherapy, conducted through computer simulation in MCNP5 code, using a precise and well discretized voxel model of human head, which was incorporated a representative Glioblastoma Multiform tumor. The dosimetric results from MCNP5 code were exported to SISCODES program, which generated isodose curves representing absorbed dose rate in the brain. Isodose curves, neutron fluency, and dose components from BNCT and 252 Cf brachytherapy are presented in this paper. (author)

  14. Monte Carlo based protocol for cell survival and tumour control probability in BNCT.

    Science.gov (United States)

    Ye, S J

    1999-02-01

    A mathematical model to calculate the theoretical cell survival probability (nominally, the cell survival fraction) is developed to evaluate preclinical treatment conditions for boron neutron capture therapy (BNCT). A treatment condition is characterized by the neutron beam spectra, single or bilateral exposure, and the choice of boron carrier drug (boronophenylalanine (BPA) or boron sulfhydryl hydride (BSH)). The cell survival probability defined from Poisson statistics is expressed with the cell-killing yield, the 10B(n,alpha)7Li reaction density, and the tolerable neutron fluence. The radiation transport calculation from the neutron source to tumours is carried out using Monte Carlo methods: (i) reactor-based BNCT facility modelling to yield the neutron beam library at an irradiation port; (ii) dosimetry to limit the neutron fluence below a tolerance dose (10.5 Gy-Eq); (iii) calculation of the 10B(n,alpha)7Li reaction density in tumours. A shallow surface tumour could be effectively treated by single exposure producing an average cell survival probability of 10(-3)-10(-5) for probable ranges of the cell-killing yield for the two drugs, while a deep tumour will require bilateral exposure to achieve comparable cell kills at depth. With very pure epithermal beams eliminating thermal, low epithermal and fast neutrons, the cell survival can be decreased by factors of 2-10 compared with the unmodified neutron spectrum. A dominant effect of cell-killing yield on tumour cell survival demonstrates the importance of choice of boron carrier drug. However, these calculations do not indicate an unambiguous preference for one drug, due to the large overlap of tumour cell survival in the probable ranges of the cell-killing yield for the two drugs. The cell survival value averaged over a bulky tumour volume is used to predict the overall BNCT therapeutic efficacy, using a simple model of tumour control probability (TCP).

  15. Development of a tandem-electrostatic-quadrupole accelerator facility for BNCT.

    Science.gov (United States)

    Kreiner, A J; Thatar Vento, V; Levinas, P; Bergueiro, J; Di Paolo, H; Burlon, A A; Kesque, J M; Valda, A A; Debray, M E; Somacal, H R; Minsky, D M; Estrada, L; Hazarabedian, A; Johann, F; Suarez Sandin, J C; Castell, W; Davidson, J; Davidson, M; Giboudot, Y; Repetto, M; Obligado, M; Nery, J P; Huck, H; Igarzabal, M; Fernandez Salares, A

    2009-07-01

    In this work we describe the present status of an ongoing project to develop a tandem-electrostatic-quadrupole (TESQ) accelerator facility for accelerator-based (AB) BNCT at the Atomic Energy Commission of Argentina in Buenos Aires. The project final goal is a machine capable of delivering 30 mA of 2.4 MeV protons to be used in conjunction with a neutron production target based on the (7)Li(p,n)(7)Be reaction slightly beyond its resonance at 2.25 MeV. These are the specifications needed to produce sufficiently intense and clean epithermal neutron beams, based on the (7)Li(p,n)(7)Be reaction, to perform BNCT treatment for deep-seated tumors in less than an hour. An electrostatic machine is the technologically simplest and cheapest solution for optimized AB-BNCT. The machine being designed and constructed is a folded TESQ with a high-voltage terminal at 1.2 MV intended to work in air. Such a machine is conceptually shown to be capable of transporting and accelerating a 30 mA proton beam to 2.4 MeV. The general geometric layout, its associated electrostatic fields, and the acceleration tube are simulated using a 3D finite element procedure. The design and construction of the ESQ modules is discussed and their electrostatic fields are investigated. Beam transport calculations through the accelerator are briefly mentioned. Likewise, work related to neutron production targets, strippers, beam shaping assembly and patient treatment room is briefly described.

  16. Application of HVJ envelope system to boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Nakai, Kei; Kurooka, Masaaki; Kaneda, Yasufumi; Yamamoto, Tetsuya; Matsumura, Akira; Asano, Tomoyuki

    2006-01-01

    Boron Neutron Capture Therapy (BNCT) has been used clinically for the treatment of malignant tumors. Two drugs, p-boronophenylalanine (BPA) and sulfhydral borane (BSH), have been used as boron delivery agents. These drugs seem to be taken up preferentially in solid tumors, but it is uncertain whether therapeutic quantities of boron atoms are taken up by micro-invasive or distant tumor cells. High accumulation and high selective delivery of boron into tumor tissues are the most important requirements to achieve efficient BNCT for malignant tumor. The HVJ envelope (HVJ-E) vector system is a novel fusion-mediated gene delivery system based on inactivated hemagglutinating virus of Japan (HVJ; Sendai virus). Although we developed this vector system for gene transfer, it can also deliver proteins, synthetic oligonucleotides, and drugs. HVJ-liposome, which is liposome fused with HVJ-E, has higher boron trapping efficiency than HVJ-E alone. We report the boron delivery into cultured cells with HVJ-liposome systems. The cellular 10 B concentration after 60 min incubation with HVJ-E containing BSH was 24.9 μg/g cell pellet for BHK-21 cells (baby hamster kidney cells) and 19.4 μg/g cell pellet for SCC VII cells (murine squamous cell carcinoma). These concentrations are higher than that of 60 min incubated cells with BSH containing (100μg 10 B/ml) medium. These results indicate the HVJ-E fused with tumor cell membrane and rapidly delivered boron agents, and that the HVJ-E-mediated delivery system could be applicable to BNCT. Plans are underway to begin neutron radiation experiments in vivo and in vitro. (author)

  17. High neutronic efficiency, low current targets for accelerator-based BNCT applications

    International Nuclear Information System (INIS)

    Powell, J.R.; Ludewig, H.; Todosow, M.

    1998-01-01

    The neutronic efficiency of target/filters for accelerator-based BNCT applications is measured by the proton current required to achieve a desirable neutron current at the treatment port (10 9 n/cm 2 /s). In this paper the authors describe two possible targeyt/filter concepts wihch minimize the required current. Both concepts are based on the Li-7 (p,n)Be-7 reaction. Targets that operate near the threshold energy generate neutrons that are close tothe desired energy for BNCT treatment. Thus, the filter can be extremely thin (∼ 5 cm iron). However, this approach has an extremely low neutron yield (n/p ∼ 1.0(-6)), thus requiring a high proton current. The proposed solutino is to design a target consisting of multiple extremely thin targets (proton energy loss per target ∼ 10 keV), and re-accelerate the protons between each target. Targets operating at ihgher proton energies (∼ 2.5 MeV) have a much higher yield (n/p ∼ 1.0(-4)). However, at these energies the maximum neutron energy is approximately 800 keV, and thus a neutron filter is required to degrade the average neutron energy to the range of interest for BNCT (10--20 keV). A neutron filter consisting of fluorine compounds and iron has been investigated for this case. Typically a proton current of approximately 5 mA is required to generate the desired neutron current at the treatment port. The efficiency of these filter designs can be further increased by incorporating neutron reflectors that are co-axial with the neutron source. These reflectors are made of materials which have high scattering cross sections in the range 0.1--1.0 MeV

  18. Dose rate distribution calculation of elaborate head phantom for BNCT based on repeated structure card

    International Nuclear Information System (INIS)

    Li Xiaohua; Yu Tao; Xue Qing

    2009-01-01

    Because of cursory character of the head geometry phantom which adopted in BNCT for glioma cure, filling the head by using Universe card and Fill card of MCNP code is performed, and subtle description of head phantom is accomplished in this paper. Then, dose distribution calculation in head injected with boron and without boron is implemented with fast, super-thermal and thermal neutrons respectively. Finally, the curve of dose rate and depth in head is acquired. The calculation result is consistent with the related reference report, which proves that elaborate head phantom constructed in this paper is correct. (authors)

  19. Collimator and shielding design for boron neutron capture therapy (BNCT) facility at TRIGA MARK II reactor

    International Nuclear Information System (INIS)

    Mohd Rafi Mohd Solleh; Abdul Aziz Tajuddin; Abdul Aziz Mohamed; Eid Mahmoud Eid Abdel Munem; Mohamad Hairie Rabir; Julia Abdul Karim; Yoshiaki, Kiyanagi

    2011-01-01

    The geometry of reactor core, thermal column, collimator and shielding system for BNCT application of TRIGA MARK II Reactor were simulated with MCNP5 code. Neutron particle lethargy and dose were calculated with MCNPX code. Neutron flux in a sample located at the end of collimator after normalized to measured value (Eid Mahmoud Eid Abdel Munem, 2007) at 1 MW power was 1.06 x 10 8 n/ cm 2 / s. According to IAEA (2001) flux of 1.00 x 10 9 n/ cm 2 / s requires three hours of treatment. Few modifications were needed to get higher flux. (Author)

  20. Design of a beam shaping assembly for an accelerator-based BNCT system

    International Nuclear Information System (INIS)

    Stichelbaut, F.; Forton, E.; Jongen, Y.

    2006-01-01

    A complete BNCT system based on a high-intensity proton accelerator is developed by the IBA company. The neutron beam is produced via the 7 Li(p,n) 7 Be reaction using a solid lithium target. The neutron energy spectrum is tailored with a beam shaping assembly surrounding the target. This device is the object of an extensive R and D project and is fully designed with the Monte Carlo simulation code MCNPX. The emphasis is put on the treatment quality, notably the radiation dose at the skin level, and the achievable neutron flux. (author)

  1. Development of the patient setting system for BNCT at JRR-4

    International Nuclear Information System (INIS)

    Kumada, H.; Yamamoto, K.; Torii, Y.

    2000-01-01

    A new treatment planning software: Computational Dosimetry System (JCDS) is in progress its development for BNCT with epithermal neutron beam in JAERI. Irradiation conditions such as beam angle to a patient are calculated by JCDS. In order to implement these conditions, it is necessary to precisely set the patient to actual irradiation position simulated by JCDS beforehand. Therefore, the Patient Setting System, which accurately and quickly sets the patient to the irradiation position, is being developed with JCDS concurrently. In this report, the current status of the development of JCDS and the Patient Setting System in JAERI will be described. (author)

  2. Spectrum shaping assessment of accelerator-based fusion neutron sources to be used in BNCT treatment

    Science.gov (United States)

    Cerullo, N.; Esposito, J.; Daquino, G. G.

    2004-01-01

    Monte Carlo modelling of an irradiation facility, for boron neutron capture therapy (BNCT) application, using a set of advanced type, accelerator based, 3H(d,n) 4He (D-T) fusion neutron source device is presented. Some general issues concerning the design of a proper irradiation beam shaping assembly, based on very hard energy neutron source spectrum, are reviewed. The facility here proposed, which represents an interesting solution compared to the much more investigated Li or Be based accelerator driven neutron source could fulfil all the medical and safety requirements to be used by an hospital environment.

  3. Beam shaping assembly optimization for (7)Li(p,n)(7)Be accelerator based BNCT.

    Science.gov (United States)

    Minsky, D M; Kreiner, A J

    2014-06-01

    Within the framework of accelerator-based BNCT, a project to develop a folded Tandem-ElectroStatic-Quadrupole accelerator is under way at the Atomic Energy Commission of Argentina. The proposed accelerator is conceived to deliver a proton beam of 30mA at about 2.5MeV. In this work we explore a Beam Shaping Assembly (BSA) design based on the (7)Li(p,n)(7)Be neutron production reaction to obtain neutron beams to treat deep seated tumors. © 2013 Elsevier Ltd. All rights reserved.

  4. Calculational evaluations of the proposal for a reference dosimetric phantom for BNCT

    International Nuclear Information System (INIS)

    Bjugg, H.; Seppaelae, T.; Auterinen, I.; Kotiluoto, P.; Savolainen, S.

    2001-01-01

    Standard dosimetric phantoms are used in radiotherapy to compare irradiations under standard conditions. They provide volumes of tissue substitute for the measurement of absorbed dose and are large enough to ensure that full contribution to the absorbed dose from scattered radiation is received at the point of measurement. Aim of this study was to find out a recommendation for the boundary values of size of a reference phantom. These reference conditions for the reference measurement methods are created for 'A code of practise for dosimetry, of BNCT in Europe' project. The major objective of the project is to prepare detailed guidelines for the dosimetry of epithermal neutron beams to be used for treatment of cancer patients by Boron Neutron Capture Therapy (BNCT) at European research reactors and accelerators. For this objective Monte Carlo simulations have been carried out with MCNP 4B code in three different cubic phantoms for studying effect of different phantom sizes in important radiation components. These three phantoms are the proposed reference (measurement) phantom (20*20*20 cm), a phantom that was assumed to model an infinite phantom, and a smaller (15*15*15 cm) cubic phantom which exists in Petten BNCT facility in Netherlands. Function of the smallest phantom was to study acceptable lower limit to the phantom size to still reach the reference conditions. All the simulated phantoms were cubic water phantoms with one 0.5 cm thick (beam side) wall and three 1 cm thick walls of PMMA (polymethyl-methacrylate). The comparisons were done with calculations of the thermal, epithermal and fast neutron fluence rates in analogous points. The source specification of the MCNP runs were accordance of 250 kW FiR 1 research reactor neutron beam with 14 cm beam aperture. In order to minimise the statistical error of the Monte Carlo calculations, over 60*106 source particles were simulated for infinite and reference phantom cases. Calculation results were in good

  5. In vitro studies of the cellular response to boron neutron capture therapy (BNCT) in thyroid carcinoma

    International Nuclear Information System (INIS)

    Rodriguez, C; Carpano, M; Perona, M; Thorp, S; Curotto, P; Pozzi, E; Casal, M; Juvenal, G; Pisarev, M; Dagrosa, A

    2012-01-01

    Background: Previously, we have started to study the mechanisms of DNA damage and repair induced by BNCT in thyroid carcinoma some years ago. We have shown different genotoxic patterns for tumor cells irradiated with gamma rays, neutrons alone or neutrons plus different compounds, boronophenylalanine (BPA) or α, β - dihydroxyethyl)-deutero-porphyrin IX (BOPP). In the present study we analyzed the expression of Ku70, Rad51 and Rad54 components of non homologous end-joing (NHEJ) and homologous recombination repair (HRR) pathways, respectively, induced by BNCT in human cells of thyroid carcinoma. Methods: A human cell line of follicular thyroid carcinoma (WRO) in exponential growth phase was distributed into the following groups: 1) Gamma Radiation, 2) Radiation with neutrons beam (NCT), 3) Radiation with n th in presence of BPA (BNCT). A control group for each treatment was added. The cells were irradiated in the thermal column facility of the RA-3 reactor (flux= 1.10 10 n/cm 2 sec) or with a source of 60 Co. The irradiations were performed during different lapses in order to obtain a total physical dose of 3 Gy (±10%). The mRNA expressions of Ku70, Rad 51 and Rad 54 were analysed by reverse transcription-polymerase chain reaction (RT-PCR) at different times post irradiation (2, 4, 6, 24 and 48 h). DNA damage was evaluated by immunofluorescence using an antibody against the phosphorylation of histone H2AX, which indicates double strand breaks in the DNA. Results: The expression of Rad51 increased at 2 h post-irradiation and it lasted until 6 h only in the neutron and neutron + BPA groups (p<0.05). Rad54 showed an up-regulation from 2 to 24 h in both groups irradiated with the neutron beam (with and without BPA) (p<0.05). On the other hand, Ku70 mRNA did not show a modification of its expression in the irradiated groups respect to the control group. Conclusion: these results would indicate an activation of the HRR pathway in the thyroid carcinoma cells treated by

  6. Tumor control induced by Boron Neutron Capture Therapy (BNCT) as a function of dose in an experimental model of liver metastases at 5 weeks follow-up

    International Nuclear Information System (INIS)

    Pozzi, E C C; Trivillin, V A; Colombo, L L; Monti Hughes, A; Thorp, S; Cardoso, J E; Garabalino, M A; Molinari, A J; Heber, E M; Curotto, Paula; Miller, M; Itoiz, M E; Aromando, R F; Nigg, D W; Schwint, A E

    2012-01-01

    BNCT has been proposed for the treatment of multifocal, non-resectable, bilobar colorectal liver metastases that do not respond to chemotherapy. We recently reported that BNCT mediated by boronophenylalanine (BPA) induced significant remission of experimental colorectal tumor nodules in rat liver at 3 weeks follow-up with no contributory liver toxicity (Pozzi et al.,2012). The aim of the present study was to evaluate tumor control and potential liver toxicity of BPA-BNCT at 5 weeks follow-up. Prescribed dose was retrospectively evaluated based on blood boron values, allowing for assessment of response over a range of delivered dose values (author)

  7. Evaluation of BPA uptake in clear cell sarcoma (CCS) in vitro and development of an in vivo model of CCS for BNCT studies

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, T., E-mail: fujitaku@hp.pref.hyogo.jp [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Andoh, T. [Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Sudo, T. [Section of Translational Research, Hyogo Cancer Center, Akashi 673-0021 (Japan); Fujita, I.; Imabori, M. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Moritake, H. [Division of Pediatrics, University of Miyazaki, Miyazaki 889-1692 (Japan); Sugimoto, T. [Department of Pediatrics, Saiseikai Shigaken Hospital, Ritto 520-3046 (Japan); Sakuma, Y. [Department of Pathology, Hyogo Cancer Center, Akashi 673-0021 (Japan); Takeuchi, T. [Department of Pathology, Kochi Medical School, Nangoku 783-8505 (Japan); Sonobe, H. [Department of Pathology, Chugoku Central Hospital, Fukuyama 720-0001 (Japan); Epstein, Alan L. [Department of Pathology, Keck School of Medicine,University of Southern California, Los Angeles,CA 90033 (United States); Akisue, T. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Kirihata, M. [Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Sakai 599-8531 (Japan); Kurosaka, M. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Fukumori, Y.; Ichikawa, H. [Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan)

    2011-12-15

    Clear cell sarcoma (CCS), a rare malignant tumor with a predilection for young adults, is of poor prognosis. Recently however, boron neutron capture therapy (BNCT) with the use of p-borono-L-phenylalanine (BPA) for malignant melanoma has provided good results. CCS also produces melanin; therefore, the uptake of BPA is the key to the application of BNCT to CCS. We describe, for the first time, the high accumulation of boron in CCS and the CCS tumor-bearing animal model generated for BNCT studies.

  8. Radiation field characterization of a BNCT research facility using Monte Carlo method - code MCNP-4B

    International Nuclear Information System (INIS)

    Hernandez, Antonio Carlos

    2002-01-01

    Boron Neutron Capture Therapy - BNCT - is a selective cancer treatment and arises as an alternative therapy to treat cancer when usual techniques - surgery, chemotherapy or radiotherapy - show no satisfactory results. The main proposal of this work is to project a facility to BNCT studies. This facility relies on the use of an Am Be neutron source and on a set of moderators, filters and shielding which will provide the best neutron/gamma beam characteristic for these Becton studies, i.e., high intensity thermal and/or epithermal neutron fluxes and with the minimum feasible gamma rays and fast neutrons contaminants. A computational model of the experiment was used to obtain the radiation field in the sample irradiation position. The calculations have been performed with the MCNP 4B Monte Carlo Code and the results obtained can be regarded as satisfactory, i.e., a thermal neutron fluencyN T = 1,35x10 8 n/cm , a fast neutron dose of 5,86x10 -10 Gy/N T and a gamma ray dose of 8,30x10 -14 Gy/N T . (author)

  9. A phase-I clinical trial for cranial BNCT at Harvard-MIT

    International Nuclear Information System (INIS)

    Busse, P.M.; Palmer, M.R.; Harling, O.K.

    2000-01-01

    Phase I trial designed to determine the maximum tolerable dose to normal tissue for cranial BNCT (Boron Neutron Capture Therapy) irradiations was recently completed at Harvard Medical School and MIT. Twenty-two subjects diagnosed with either glioblastoma multiforme or intracranial melanoma were treated between 1996 and 1999. Subjects received either one or two administrations of boronophenylalanine intravenously at doses between 250 and 350 mg/kg body weight, then exposed in one, two or three fields to epithermal neutrons at the MIT Research Reactor in one or two fractions. Over the course of the study, the maximum normal tissue dose target was increased from 8.8 to 14.2 RBE (Relative Biological Effectiveness) Gy in 10% increments. Subjects have been followed clinically and radiographically. Of those patients surviving beyond six months, no MRI (Magnetic Resonance Image) white-matter changes were observed and no long-term complications attributable to BNCT were evident. Tumor responses were observed, particularly with the melanoma subjects. With increasing doses, difficulties arose from long irradiation times (approximately 3 hours) and the emergence of acute reactions in the skin and mucosa. The trial was stopped in May 1999. Future trials will be initiated with the new high intensity, low background fission converter beam at MIT. (author)

  10. Calculation of neutron flux distributions in BNCT using removal-diffusion theory

    Energy Technology Data Exchange (ETDEWEB)

    Niemkiewicz, J.; Blue, T.E.; Gupta, N.

    1994-12-31

    Boron neutron capture therapy (BNCT) is under investigation as a treatment modality for brain tumors. Successful routine use of BNCT will require a knowledge of the radiation dose distribution in a patient`s head prior to treatment. This will allow optimization of the treatment to fit the needs of individual patients. Determination of the dose distribution begins with calculation of the neutron flux distribution in the head. Most efforts to date have relied on Monte Carlo or discrete ordinates techniques to calculate this flux distribution. Use of removal-diffusion theory has the advantage of a relatively short computer time to complete a calculation. Previous work by our group has shown good agreement between neutron flux distributions calculated using removal-diffusion theory and Monte Carlo methods for parallel incident neutrons and a rectangular parallelepiped water phantom. This work compares neutron flux distributions calculated using removal-diffusion theory and Monte Carlo methods for a homogeneous ellipsoidal water phantom that models the human head.

  11. Optimization of beam shaping assembly based on D-T neutron generator and dose evaluation for BNCT

    Science.gov (United States)

    Naeem, Hamza; Chen, Chaobin; Zheng, Huaqing; Song, Jing

    2017-04-01

    The feasibility of developing an epithermal neutron beam for a boron neutron capture therapy (BNCT) facility based on a high intensity D-T fusion neutron generator (HINEG) and using the Monte Carlo code SuperMC (Super Monte Carlo simulation program for nuclear and radiation process) is proposed in this study. The Monte Carlo code SuperMC is used to determine and optimize the final configuration of the beam shaping assembly (BSA). The optimal BSA design in a cylindrical geometry which consists of a natural uranium sphere (14 cm) as a neutron multiplier, AlF3 and TiF3 as moderators (20 cm each), Cd (1 mm) as a thermal neutron filter, Bi (5 cm) as a gamma shield, and Pb as a reflector and collimator to guide neutrons towards the exit window. The epithermal neutron beam flux of the proposed model is 5.73 × 109 n/cm2s, and other dosimetric parameters for the BNCT reported by IAEA-TECDOC-1223 have been verified. The phantom dose analysis shows that the designed BSA is accurate, efficient and suitable for BNCT applications. Thus, the Monte Carlo code SuperMC is concluded to be capable of simulating the BSA and the dose calculation for BNCT, and high epithermal flux can be achieved using proposed BSA.

  12. Biodistribution of Boron compounds in an experimental model of liver metastases for Boron Neutron Capture (BNCT) Studies

    International Nuclear Information System (INIS)

    Garabalino, Marcela A.; Monti Hughes, Andrea; Molinari, Ana J.; Heber, Elisa M.; Pozzi, Emiliano C.C.; Itoiz, Maria E.; Trivillin, Veronica A.; Schwint, Amanda E.; Nievas, Susana; Aromando, Romina F.

    2009-01-01

    Boron Neutron Capture Therapy (BNCT) is a binary treatment modality that involves the selective accumulation of 10 B carriers in tumors followed by irradiation with thermal or epithermal neutrons. The high linear energy transfer alpha particles and recoiling 7 Li nuclei emitted during the capture of a thermal neutron by a 10 B nucleus have a short range and a high biological effectiveness. Thus, BNCT would potentially target neoplastic tissue selectively. In previous studies we demonstrated the therapeutic efficacy of different BNCT protocols in an experimental model of oral cancer. More recently we performed experimental studies in normal rat liver that evidenced the feasibility of treating liver metastases employing a novel BNCT protocol proposed by JEC based on ex-situ treatment and partial liver auto-transplant. The aim of the present study was to perform biodistribution studies with different boron compounds and different administration protocols to determine the protocols that would be therapeutically useful in 'in vivo' BNCT studies at the RA-3 Nuclear Reactor in an experimental model of liver metastases in rats. Materials and Methods. A total of 70 BDIX rats (Charles River Lab., MA, USA) were inoculated in the liver with syngeneic colon cancer cells DH/DK12/TRb (ECACC, UK) to induce the development of subcapsular metastatic nodules. 15 days post-inoculation the animals were used for biodistribution studies. A total of 11 protocols were evaluated employing the boron compounds boronophenylalanine (BPA) and GB-10 (Na 2 10 B 1 -0H 10 ), alone or combined employing different doses and administration routes. Tumor, normal tissue and blood samples were processed for boron measurement by ICP-OES. Results. Several protocols proved potentially useful for BNCT studies in terms of absolute boron concentration in tumor and preferential uptake of boron by tumor tissue, i.e. BPA 15.5 mg 10 B/kg iv + GB-10 50 mg 10 B/kg iv; BPA 46.5 mg 10 B/kg ip; BPA 46.5 mg 10 B/kg ip

  13. The therapeutic ratio in BNCT: Assessment using the Rat 9L gliosarcoma brain tumor and spinal cord models

    International Nuclear Information System (INIS)

    Coderre, J.A.; Micca, P.L.; Nawrocky, M.M.; Fisher, C.D.; Bywaters, A.; Morris, G.M.; Hopewell, J.W.

    1996-01-01

    During any radiation therapy, the therapeutic tumor dose is limited by the tolerance of the surrounding normal tissue within the treatment volume. The short ranges of the products of the 10 B(n,α) 7 Li reaction produced during boron neutron capture therapy (BNCT) present an opportunity to increase the therapeutic ratio (tumor dose/normal tissue dose) to levels unprecedented in photon radiotherapy. The mixed radiation field produced during BNCT comprises radiations with different linear energy transfer (LET) and different relative biological effectiveness (RBE). The short ranges of the two high-LET products of the 'B(n,a)'Li reaction make the microdistribution of the boron relative to target cell nuclei of particular importance. Due to the tissue specific distribution of different boron compounds, the term RBE is inappropriate in defining the biological effectiveness of the 10 B(n,α) 7 Li reaction. To distinguish these differences from true RBEs we have used the term open-quotes compound biological effectivenessclose quotes (CBE) factor. The latter can be defined as the product of the true, geometry-independent, RBE for these particles times a open-quotes boron localization factorclose quotes, which will most likely be different for each particular boron compound. To express the total BNCT dose in a common unit, and to compare BNCT doses with the effects of conventional photon irradiation, multiplicative factors (RBEs and CBEs) are applied to the physical absorbed radiation doses from each high-LET component. The total effective BNCT dose is then expressed as the sum of RBE-corrected physical absorbed doses with the unit Gray-equivalent (Gy-Eq)

  14. The effect of ionizing radiation on the blood-brain-barrier (BBB): Considerations for the application of boron neutron capture therapy (BNCT) of brain tumors

    International Nuclear Information System (INIS)

    Dorn, R.V. III; Spickard, J.H.; Griebenow, M.L.

    1988-01-01

    All methods of boron neutron capture therapy (BNCT) in use or envisioned for treatment of brain tumors have, as an inseparable component, an element of ionizing radiation. This paper reviews data on the effects of ionizing radiation on the blood-brain-barrier (BBB) and the blood-tumor-barrier (BTB) and the potential impact of the effects on the delivery techniques of BNCT. This paper has the following objectives: review the available technique for BNCT of brain tumors; review the literature on experimental and human studies regarding the effects of ionizing radiation on the BBB; discuss the impact of these effects on the fractionization question for BNCT; and draw conclusions from that information

  15. Dosimetry and radiobiology at the new RA-3 reactor boron neutron capture therapy (BNCT) facility: Application to the treatment of experimental oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pozzi, E. [Research and Production Reactors, National Atomic Energy Commission, Ezeiza Atomic Center (Argentina); Department of Radiobiology, National Atomic Energy Commission, Constituyentes Atomic Center (Argentina)], E-mail: epozzi@cnea.gov.ar; Nigg, D.W. [Idaho National Laboratory, Idaho Falls (United States); Miller, M.; Thorp, S.I. [Instrumentation and Control Department, National Atomic Energy Commission, Ezeiza Atomic Center (Argentina); Heber, E.M. [Department of Radiobiology, National Atomic Energy Commission, Constituyentes Atomic Center (Argentina); Zarza, L.; Estryk, G. [Research and Production Reactors, National Atomic Energy Commission, Ezeiza Atomic Center (Argentina); Monti Hughes, A.; Molinari, A.J.; Garabalino, M. [Department of Radiobiology, National Atomic Energy Commission, Constituyentes Atomic Center (Argentina); Itoiz, M.E. [Department of Radiobiology, National Atomic Energy Commission, Constituyentes Atomic Center (Argentina); Department of Oral Pathology, Faculty of Dentistry, University of Buenos Aires (Argentina); Aromando, R.F. [Department of Oral Pathology, Faculty of Dentistry, University of Buenos Aires (Argentina); Quintana, J. [Research and Production Reactors, National Atomic Energy Commission, Ezeiza Atomic Center (Argentina); Trivillin, V.A.; Schwint, A.E. [Department of Radiobiology, National Atomic Energy Commission, Constituyentes Atomic Center (Argentina)

    2009-07-15

    The National Atomic Energy Commission of Argentina (CNEA) constructed a novel thermal neutron source for use in boron neutron capture therapy (BNCT) applications at the RA-3 research reactor facility located in Buenos Aires. The aim of the present study was to perform a dosimetric characterization of the facility and undertake radiobiological studies of BNCT in an experimental model of oral cancer in the hamster cheek pouch. The free-field thermal flux was 7.1x10{sup 9} n cm{sup -2} s{sup -1} and the fast neutron flux was 2.5x10{sup 6} n cm{sup -2} s{sup -1}, indicating a very well-thermalized neutron field with negligible fast neutron dose. For radiobiological studies it was necessary to shield the body of the hamster from the neutron flux while exposing the everted cheek pouch bearing the tumors. To that end we developed a lithium (enriched to 95% in {sup 6}Li) carbonate enclosure. Groups of tumor-bearing hamsters were submitted to BPA-BNCT, GB-10-BNCT, (GB-10+BPA)-BNCT or beam only treatments. Normal (non-cancerized) hamsters were treated similarly to evaluate normal tissue radiotoxicity. The total physical dose delivered to tumor with the BNCT treatments ranged from 6 to 8.5 Gy. Tumor control at 30 days ranged from 73% to 85%, with no normal tissue radiotoxicity. Significant but reversible mucositis in precancerous tissue surrounding tumors was associated to BPA-BNCT. The therapeutic success of different BNCT protocols in treating experimental oral cancer at this novel facility was unequivocally demonstrated.

  16. Analysis of accelerator based neutron spectra for BNCT using proton recoil spectroscopy

    International Nuclear Information System (INIS)

    Wielopolski, L.; Ludewig, H.; Powell, J.R.; Raparia, D.; Alessi, J.G.; Lowenstein, D.I.

    1998-01-01

    Boron Neutron Capture Therapy (BNCT) is a promising binary treatment modality for high-grade primary brain tumors (glioblastoma multiforme, GM) and other cancers. BNCT employs a boron-10 containing compound that preferentially accumulates in the cancer cells in the brain. Upon neutron capture by 10 B energetic alpha particles and triton released at the absorption site kill the cancer cell. In order to gain penetration depth in the brain Fairchild proposed, for this purpose, the use of energetic epithermal neutrons at about 10 keV. Phase I/II clinical trials of BNCT for GM are underway at the Brookhaven Medical Research Reactor (BMRR) and at the MIT Reactor, using these nuclear reactors as the source for epithermal neutrons. In light of the limitations of new reactor installations, e.g. cost, safety and licensing, and limited capability for modulating the reactor based neutron beam energy spectra alternative neutron sources are being contemplated for wider implementation of this modality in a hospital environment. For example, accelerator based neutron sources offer the possibility of tailoring the neutron beams, in terms of improved depth-dose distributions, to the individual and offer, with relative ease, the capability of modifying the neutron beam energy and port size. In previous work new concepts for compact accelerator/target configuration were published. In this work, using the Van de Graaff accelerator the authors have explored different materials for filtering and reflecting neutron beams produced by irradiating a thick Li target with 1.8 to 2.5 MeV proton beams. However, since the yield and the maximum neutron energy emerging from the Li-7(p,n)Be-7 reaction increase with increase in the proton beam energy, there is a need for optimization of the proton energy versus filter and shielding requirements to obtain the desired epithermal neutron beam. The MCNP-4A computer code was used for the initial design studies that were verified with benchmark experiments

  17. 2.5 MeV CW 4-vane RFQ accelerator design for BNCT applications

    Science.gov (United States)

    Zhu, Xiaowen; Wang, Hu; Lu, Yuanrong; Wang, Zhi; Zhu, Kun; Zou, Yubin; Guo, Zhiyu

    2018-03-01

    Boron Neutron Capture Therapy (BNCT) promises a bright future in cancer therapy for its highly selective destruction of cancer cells, using the 10B +n→7Li +4 He reaction. It offers a more satisfactory therapeutic effect than traditional methods for the treatment of malignant brain tumors, head and neck cancer, melanoma, liver cancer and so on. A CW 4-vane RFQ, operating at 162.5 MHz, provides acceleration of a 20 mA proton beam to 2.5 MeV, bombarding a liquid lithium target for neutron production with a soft neutron energy spectrum. The fast neutron yield is about 1.73×1013 n/s. We preliminarily develop and optimize a beam shaping assembly design for the 7Li(p, n)7Be reaction with a 2.5 MeV proton beam. The epithermal neutron flux simulated at the beam port will reach up to 1 . 575 ×109 n/s/cm2. The beam dynamics design, simulation and benchmark for 2.5 MeV BNCT RFQ have been performed with both ParmteqM (V3.05) and Toutatis, with a transmission efficiency higher than 99.6% at 20 mA. To ease the thermal management in the CW RFQ operation, we adopt a modest inter-vane voltage design (U = 65 kV), though this does increase the accelerator length (reaching 5.2 m). Using the well-developed 3D electromagnetic codes, CST MWS and ANSYS HFSS, we are able to deal with the complexity of the BNCT RFQ, taking the contribution of each component in the RF volume into consideration. This allows us to optimize the longitudinal field distribution in a full-length model. Also, the parametric modeling technique is of great benefit to extensive modifications and simulations. In addition, the resonant frequency tuning of this RFQ is studied, giving the tuning sensitivities of vane channel and wall channel as -16.3 kHz/°C and 12.4 kHz/°C, respectively. Finally, both the multipacting level of this RFQ and multipacting suppressing in the coaxial coupler are investigated.

  18. Microwave digestion techniques applied to determination of boron by ICP-AES in BNCT program

    International Nuclear Information System (INIS)

    Farias, Silvia S.; Di Santo, Norberto R.; Garavaglia, Ricardo N.; Pucci, Gladys N.; Batistoni, Daniel A.; Schwint, Amanda E.

    1999-01-01

    Recently, boron neutron capture therapy (BNCT) has merged as an interesting option for the treatment of some kind of tumors where established therapies show no success. A molecular boronated species, enriched in 10 B is administrated to the subject; it localizes in malignant tissues depending the kind of tumor and localization. Therefore, a very important fact in BNCT research is the detection of boron at trace or ultra trace levels precisely and accurately. This is extremely necessary as boronated species do localize in tumoral tissue and also localize in liver, kidney, spleen, skin, membranes. By this way, before testing a boronated species, it is mandatory to determine its biodistribution in a statistically meaning population, that is related with managing of a great number of samples. In the other hand, it is necessary to exactly predict when to begin the irradiation and to determine the magnitude of radiation to obtain the desired radiological dose for a specified mean boron concentration. This involves the determination of boron in whole blood, which is related with boron concentration in the tumor object of treatment. The methodology selected for the analysis of boron in whole blood and tissues must join certain characteristics: it must not be dependant of the chemical form of boron, it has to be fast and capable to determine boron accurately and precisely in a wide range of concentrations. The design and validation of experimental models involving animals in BNCT studies and the determination of boron in blood of animals and subjects upon treatment require reliable analytical procedures to determine boron quantitatively in those biologic materials. Inductively coupled plasma-atomic emission spectrometry (ICP-AES) using pneumatic nebulization is one of the most promising methods for boron analysis, but the sample must be liquid and have low solid concentration. In our case, biological tissues and blood, it is mandatory to mineralize and/or dilute samples

  19. Comparison of the radiobiological effects of Boron neutron capture therapy (BNCT) and conventional Gamma Radiation

    International Nuclear Information System (INIS)

    Dagrosa, Maria A.; Carpano, Marina; Perona, Marina; Thomasz, Lisa; Juvenal, Guillermo J.; Pisarev, Mario; Pozzi, Emiliano; Thorp, Silvia

    2009-01-01

    BNCT is an experimental radiotherapeutic modality that uses the capacity of the isotope 10 B to capture thermal neutrons leading to the production of 4 He and 7 Li, particles with high linear energy transfer (LET). The aim was to evaluate and compare in vitro the mechanisms of response to the radiation arising of BNCT and conventional gamma therapy. We measured the survival cell fraction as a function of the total physical dose and analyzed the expression of p27/Kip1 and p53 by Western blotting in cells of colon cancer (ARO81-1). Exponentially growing cells were distributed into the following groups: 1) BPA (10 ppm 10 B) + neutrons; 2) BOPP (10 ppm 10 B) + neutrons; 3) neutrons alone; 4) gamma-rays. A control group without irradiation for each treatment was added. The cells were irradiated in the thermal neutron beam of the RA-3 (flux= 7.5 10 9 n/cm 2 sec) or with 60 Co (1Gy/min) during different times in order to obtain total physical dose between 1-5 Gy (±10 %). A decrease in the survival fraction as a function of the physical dose was observed for all the treatments. We also observed that neutrons and neutrons + BOPP did not differ significantly and that BPA was the more effective compound. Protein extracts of irradiated cells (3Gy) were isolated to 24 h and 48 h post radiation exposure. The irradiation with neutrons in presence of 10 BPA or 10 BOPP produced an increase of p53 at 24 h maintain until 48 h. On the contrary, in the groups irradiated with neutrons alone or gamma the peak was observed at 48 hr. The level of expression of p27/Kip1 showed a reduction of this protein in all the groups irradiated with neutrons (neutrons alone or neutrons plus boron compound), being more marked at 24 h. These preliminary results suggest different radiobiological response for high and low let radiation. Future studies will permit establish the role of cell cycle in the tumor radio sensibility to BNCT. (author)

  20. Randomised study on single stage laparo-endoscopic rendezvous (intra-operative ERCP procedure versus two stage approach (Pre-operative ERCP followed by laparoscopic cholecystectomy for the management of cholelithiasis with choledocholithiasis

    Directory of Open Access Journals (Sweden)

    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Introduction : The ′Rendezvous′ technique consists of laparoscopic cholecystectomy (LC standards with intra-operative cholangiography followed by endoscopic sphincterotomy. The sphincterotome is driven across the papilla through a guidewire inserted by the transcystic route. In this study, we intended to compare the two methods in a prospective randomised trial. Materials And Methods: From 2005 to 2012, we enrolled 83 patients with a diagnosis of cholecysto-choledocolithiasis. They were randomised into two groups. In ′group-A′,41 patients were treated with two stages management, first by pre-operative endoscopic retrograde cholangiopancreatography (ERCP and common bile duct (CBD clearance and second by LC. In ′group-B′, 42 patients were treated with LC and intra-operative cholangiography; and when diagnosis of choledocholithiasis was confirmed, patients had undergone one stage management of by Laparo-endoscopic Rendezvous technique. Results: In arm-A and arm-B groups, complete CBD clearance was achieved in 29 and 38 patients, respectively. Failure of the treatment in arm-A was 29% and in arm-B was 9.5%. In arm-A, selective CBD cannulation was achieved in 33 cases (80.5% and in arm-B in 39 cases (93%. In arm-Agroup, post-ERCP hyperamylasia was presented in nine patients (22% and severe pancreatitis in five patients (12% versus none of the patients (0% in arm-B group, respectively. Mean post-operative hospital stay in arm-A and arm-B groups are 10.9 and 6.8 days, respectively. Conclusion: One stage laparo-endoscopic rendezvous approach increases selective cannulation of CBD, reduces post-ERCP pancreatitis, reduces days of hospital stay, increases patient′s compliance and prevents unnecessary intervention to CBD.

  1. Boron neutron capture therapy (BNCT) for liver metastasis in an experimental model: dose–response at five-week follow-up based on retrospective dose assessment in individual rats

    Energy Technology Data Exchange (ETDEWEB)

    Emiliano C. C. Pozzi; Veronica A. Trivilin; Lucas L. Colombo; Andrea Monti Hughes; Silvia I. Thorp; Jorge E. Cardoso; Marcel A. Garabalino; Ana J. Molinari; Elisa M. Heber; Paula Curotto; Marcelo Miller; Maria E. Itoiz; Romina F. Aromando; David W. Nigg; Amanda E. Schwint

    2013-11-01

    Boron neutron capture therapy (BNCT) was proposed for untreatable colorectal liver metastases. Employing an experimental model of liver metastases in rats, we recently demonstrated that BNCT mediated by boronophenylalanine (BPA-BNCT) at 13 Gy prescribed to tumor is therapeutically useful at 3-week follow-up. The aim of the present study was to evaluate dose–response at 5-week follow-up, based on retrospective dose assessment in individual rats. BDIX rats were inoculated with syngeneic colon cancer cells DHD/K12/TRb. Tumor-bearing animals were divided into three groups: BPA-BNCT (n = 19), Beam only (n = 8) and Sham (n = 7) (matched manipulation, no treatment). For each rat, neutron flux was measured in situ and boron content was measured in a pre-irradiation blood sample for retrospective individual dose assessment. For statistical analysis (ANOVA), individual data for the BPA-BNCT group were pooled according to absorbed tumor dose, BPA-BNCT I: 4.5–8.9 Gy and BPA-BNCT II: 9.2–16 Gy. At 5 weeks post-irradiation, the tumor surface area post-treatment/pre-treatment ratio was 12.2 +/- 6.6 for Sham, 7.8 +/- 4.1 for Beam only, 4.4 +/- 5.6 for BPA-BNCT I and 0.45 +/- 0.20 for BPA-BNCT II; tumor nodule weight was 750 +/- 480 mg for Sham, 960 +/- 620 mg for Beam only, 380 +/- 720 mg for BPA-BNCT I and 7.3 +/- 5.9 mg for BPA-BNCT II. The BPA-BNCT II group exhibited statistically significant tumor control with no contributory liver toxicity. Potential threshold doses for tumor response and significant tumor control were established at 6.1 and 9.2 Gy, respectively.

  2. Measurement of dose rate components of the BNCT beam at THOR using paired ionization chambers

    International Nuclear Information System (INIS)

    Tsai Wenchyi; Chen Angyu; Liu Yuanhao; Jiang Shianghuei; Liu Yenwan Hsueh; Liu Hongming

    2006-01-01

    Paired ionization chambers were used in this work to measure the neutron and gamma-ray dose rates of the BNCT epithermal neutron beam at THOR along the beam axis free-in-air and in the water phantom. The position dependent and kerma rate weighted neutron sensitivities of the TE(TE) chamber were adopted in the measurements. Monte Carlo calculations of the neutron fluence rates and neutron kerma rates using the MCNP4C code were used to support the measurements and compare with the measured results. It concludes that the relative neutron sensitivity of the Mg(Ar) chamber warrants a detailed investigation to improve the accuracy of the dose rate measurement using paired ionization chambers in a mixed field. (author)

  3. Neutron therapy coupling brachytherapy and boron neutron capture therapy (BNCT) techniques

    International Nuclear Information System (INIS)

    Chaves, Iara Ferreira.

    1994-12-01

    In the present dissertation, neutron radiation techniques applied into organs of the human body are investigated as oncologic radiation therapy. The proposal treatment consists on connecting two distinct techniques: Boron Neutron Capture Therapy (BNCT) and irradiation by discrete sources of neutrons, through the brachytherapy conception. Biological and radio-dosimetrical aspects of the two techniques are considered. Nuclear aspects are discussed, presenting the nuclear reactions occurred in tumoral region, and describing the forms of evaluating the dose curves. Methods for estimating radiation transmission are reviewed through the solution of the neutron transport equation, Monte Carlo methodology, and simplified analytical calculation based on diffusion equation and numerical integration. The last is computational developed and presented as a quickly way to neutron transport evaluation in homogeneous medium. The computational evaluation of the doses for distinct hypothetical situations is presented, applying the coupled techniques BNTC and brachytherapy as an possible oncologic treatment. (author). 78 refs., 61 figs., 21 tabs

  4. Monte Carlo dose calculations for BNCT treatment of diffuse human lung tumours

    International Nuclear Information System (INIS)

    Altieri, S.; Bortolussi, S.; Bruschi, P.

    2006-01-01

    In order to test the possibility to apply BNCT in the core of diffuse lung tumours, dose distribution calculations were made. The simulations were performed with the Monte Carlo code MCNP.4c2, using the male computational phantom Adam, version 07/94. Volumes of interest were voxelized for the tally requests, and results were obtained for tissues with and without Boron. Different collimated neutron sources were tested in order to establish the proper energies, as well as single and multiple beams to maximize neutron flux uniformity inside the target organs. Flux and dose distributions are reported. The use of two opposite epithermal neutron collimated beams insures good levels of dose homogeneity inside the lungs, with a substantially lower radiation dose delivered to surrounding structures. (author)

  5. Effects of secondary interactions on the dose calculation in treatments with Boron Neutron Capture Therapy (BNCT)

    International Nuclear Information System (INIS)

    Monteiro, E.

    2004-01-01

    The aimed of this work consists of evaluating the influence of the secondary contributions of dose (thermal neutrons dose, epithermal neutrons dose, fast neutrons dose and photon dose) in treatment planning with BNCT. MCNP4B Code was used to calculate RBE-Gy doses through the irradiation of the modified Snyder head head phantom.A reduction of the therapeutical gain of monoenergetic neutron beans was observed in non invasive treatments, provoked for the predominance of the fast neutron dose component in the skin, showing that the secondary contributions of dose can contribute more in the direction to raise the dose in the fabric healthy that in the tumor, thus reducing the treatment efficiency. (author)

  6. Study on high speed lithium jet for neutron source of boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Takahashi, Minoru; Kobayashi, Tooru; Zhang, Mingguang; Mak, Michael; Stefanica, Jiri; Dostal, Vaclav; Zhao Wei

    2012-01-01

    The feasibility study of a liquid lithium type proton beam target was performed for the neutron source of the boron neutron capture therapy (BNCT). As the candidates of the liquid lithium target, a thin sheet jet and a thin film flow on a concave wall were chosen, and a lithium flow experiment was conducted to investigate the hydrodynamic stability of the targets. The surfaces of the jets and film flows with a thickness of 0.5 mm and a width of 50 mm were observed by means of photography. It has been found that a stable sheet jet and a stable film flow on a concave wall can be formed up to certain velocities by using a straight nozzle and a curved nozzle with the concave wall, respectively. (author)

  7. Synthesis and in-vivo detection of boronated compounds for use in BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Kabalka, G.W.

    1992-01-01

    The primary objective of the DOE program at The University of Tennessee Graduate School of Medicine is the development of effective molecular medicine for use in neutron-capture therapy (NCT). The research focuses primarily on the preparation of new boron-rich NCT agents and the technology to detect them in-vivo. The detection technology involves the development of effective magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques for verifying and measuring NCT agents in-vivo. The synthetic program is directed toward the design of novel boron NCT (BNCT) agents which are targeted to the cell nucleus and gadolinium liposomes targeted to the liver. The UT-DOE program is unique in that it has access to both state-of-the-art whole-body and microscopy MRI instruments.

  8. A core laboratory offering full evaluation of new boron compounds. A service to the BNCT community

    International Nuclear Information System (INIS)

    Zamenhof, R.G.; Patel, H.; Palmer, M.R.; Lin, H.C.; Busse, P.M.; Harling, O.; Binns, P.J.; Riley, K.J.; Bernard, J.

    2000-01-01

    A joint project by the Beth Israel Deaconess Medical Center at Harvard Medical School and The Nuclear Reactor Laboratory of the Massachusetts Institute of Technology is proposed which would provide a core laboratory for the evaluation of new boron compounds. Federal agency funding has been applied for to support such a facility. The facility's evaluation of candidate boron compounds will include: quantitative cellular boron uptake; cell survival curve analysis (using a thermal neutron beam); small or large animal pharmacokinetic analysis; macro- and micro boron distribution analysis using high-resolution autoradiography, prompt gamma analysis and ICP-AES; small or large animal in vivo tumor control studies (using thermal or epithermal neutron beams); and pharmacological in vivo toxicity evaluation. The laboratory will include small and large animal surgical facilities and resources for additional boron compound chemistry as required by the evaluation procedure. This facility will be open to the BNCT research community. (author)

  9. PhoNeS: A novel approach to BNCT with conventional radiotherapy accelerators

    International Nuclear Information System (INIS)

    Bevilacqua, R.; Giannini, G.; Calligaris, F.; Fontanarosa, D.; Longo, F.; Scian, G.; Totaro, P.; Vittor, K.; Vallazza, E.; Severgnini, M.; Vidimari, R.; Bartesaghi, G.; Conti, V.; Mascagna, V.; Perboni, C.; Prest, M.; Gambarini, G.; Gay, S.; Valente, M.A.; Mozzanica, A.; Monti, A.; Ostinelli, A.; Azario, L.; Fidanzio, A.; Piermattei, A.; Borla, O.; Elisabetta Durisi; Fasolo, F.; Nastasi, U.; Perosino, E.; Zanini, A.; Tommasino, L.

    2007-01-01

    PhoNeS (Photo Neutron Source) is an INFN project devoted to the optimization of the neutron production and moderation in radiotherapy linear accelerators. LinAcs producing high energy (15-25MeV) photon beams are becoming widespread. At this energy neutron photo-production is unavoidable and the neutron dose must be controlled and reduced during normal radiotherapy. A technique known as BNCT (Boron Neutron Capture Therapy) uses neutrons for radiotherapic treatments: the cells are given a drug containing B10 which undergoes fission after neutron capture, inducing heavy damages to the DNA of the cell itself. This paper will describe the moderator developed by PhoNeS and the results in terms of neutron flux and spectrum and photon contamination of the measurements performed on several radiotherapy accelerators

  10. Gel dosimeters as useful dose and thermal-fluence detectors in Boron Neutron Capture Therapy (BNCT)

    International Nuclear Information System (INIS)

    Gambarini, G.; Valente, M.; Moss, R.L.; Daquino, G.G.; Nievaart, V.A.; Mariani, M.; Vanossi, E.; Carrara, M.

    2006-01-01

    The dosimetry method based on Fricke-Xylenol-Orange-infused gels in form of layers has shown noticeable potentiality for in-phantom or in-free-beam dose and thermal flux profiling and imaging in the high fluxes of thermal or epithermal neutrons utilised for boron neutron capture therapy (BNCT). Gel-dosimeters in form of layers give the possibility not only of obtaining spatial dose distributions but also of achieving measurements of each dose contribution in neutron fields. The discrimination of the various dose components is achieved by means of pixel-to-pixel manipulations of pairs of images obtained with gel-dosimeters having different isotopic composition. It is possible to place large dosimeters, detecting in such a way large dose images, because the layer geometry of dosimeters avoids sensitive variation of neutron transport due to the gel isotopic composition. Some results obtained after the last improvements of the method are reported. (Author)

  11. Tumor development in field-cancerized tissue is inhibited by a double application of Boron neutron capture therapy (BNCT) without exceeding radio-tolerance

    International Nuclear Information System (INIS)

    Monti Hughes, Andrea; Heber, Elisa M.; Itoiz, Maria E.; Molinari, Ana J.; Garabalino, Marcela A.; Trivillin, Veronica A.; Schwint, Amanda E.; Aromando, Romina F.

    2009-01-01

    Introduction: BNCT is based on the capture reaction between boron, selectively targeted to tumor tissue, and thermal neutrons which gives rise to lethal, short-range high linear energy transfer particles that selectively damage tumor tissue, sparing normal tissue. We previously evidenced a remarkable therapeutic success of a 'single' application of boron neutron capture therapy (BNCT) mediated by boronophenylalanine (BPA), GB-1(Na 2 10 B 10 H 10 ) or (GB-10+BPA) to treat hamster cheek pouch tumors with no normal tissue radiotoxicity. Based on these results, we developed a model of precancerous tissue in the hamster cheek pouch for long-term studies. Employing this model we evaluated the long-term potential inhibitory effect on the development of second primary tumors from precancerous tissue and eventual radiotoxicity of a single application of BNCT mediated by BPA, GB-10 or (GB-10+BPA), in the RA-6. The clinical rationale of this study was to search for a BNCT protocol that is therapeutic for tumor, not radio-toxic for the normal tissue that lies in the neutron beam path, and exerts the desired inhibitory effect on the development of second primary tumors, without exceeding the radio-tolerance of precancerous tissue, the dose limiting tissue in this case. Second primary tumors that arise in precancerous tissue (also called locoregional recurrences) are a frequent cause of therapeutic failure in head and neck tumors. Aim: Evaluate the radiotoxicity and inhibitory effect of a 'double' application of the same BNCT protocols that were proved therapeutically successful for tumor and precancerous tissue, with a long term follow up (8 months). A 'double' application of BNCT is a potentially useful strategy for the treatment of tumors, in particular the larger ones, but the cost in terms of side-effects in dose-limiting tissues might preclude its application and requires cautious evaluation. Materials and methods: We performed a double application of 1) BPA-BNCT; 2) (GB

  12. Confirmation of a realistic reactor model for BNCT dosimetry at the TRIGA Mainz

    Energy Technology Data Exchange (ETDEWEB)

    Ziegner, Markus, E-mail: Markus.Ziegner.fl@ait.ac.at [AIT Austrian Institute of Technology GmbH, Vienna A-1220, Austria and Institute of Atomic and Subatomic Physics, Vienna University of Technology, Vienna A-1020 (Austria); Schmitz, Tobias; Hampel, Gabriele [Institut für Kernchemie, Johannes Gutenberg-Universität, Mainz DE-55128 (Germany); Khan, Rustam [Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad PK-44000 (Pakistan); Blaickner, Matthias [AIT Austrian Institute of Technology GmbH, Vienna A-1220 (Austria); Palmans, Hugo [Acoustics and Ionising Radiation Division, National Physical Laboratory, Teddington TW11 0LW, United Kingdom and Medical Physics Group, EBG MedAustron GmbH, Wiener Neustadt A-2700 (Austria); Sharpe, Peter [Acoustics and Ionising Radiation Division, National Physical Laboratory, Teddington TW11 0LW (United Kingdom); Böck, Helmuth [Institute of Atomic and Subatomic Physics, Vienna University of Technology, Vienna A-1020 (Austria)

    2014-11-01

    Purpose: In order to build up a reliable dose monitoring system for boron neutron capture therapy (BNCT) applications at the TRIGA reactor in Mainz, a computer model for the entire reactor was established, simulating the radiation field by means of the Monte Carlo method. The impact of different source definition techniques was compared and the model was validated by experimental fluence and dose determinations. Methods: The depletion calculation code ORIGEN2 was used to compute the burn-up and relevant material composition of each burned fuel element from the day of first reactor operation to its current core. The material composition of the current core was used in a MCNP5 model of the initial core developed earlier. To perform calculations for the region outside the reactor core, the model was expanded to include the thermal column and compared with the previously established ATTILA model. Subsequently, the computational model is simplified in order to reduce the calculation time. Both simulation models are validated by experiments with different setups using alanine dosimetry and gold activation measurements with two different types of phantoms. Results: The MCNP5 simulated neutron spectrum and source strength are found to be in good agreement with the previous ATTILA model whereas the photon production is much lower. Both MCNP5 simulation models predict all experimental dose values with an accuracy of about 5%. The simulations reveal that a Teflon environment favorably reduces the gamma dose component as compared to a polymethyl methacrylate phantom. Conclusions: A computer model for BNCT dosimetry was established, allowing the prediction of dosimetric quantities without further calibration and within a reasonable computation time for clinical applications. The good agreement between the MCNP5 simulations and experiments demonstrates that the ATTILA model overestimates the gamma dose contribution. The detailed model can be used for the planning of structural

  13. Dynamic infrared imaging of cutaneous melanoma and normal skin in patients treated with BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Santa Cruz, G.A. [Dpto. de Instrumentacion y Control, Comision Nacional de Energia Atomica, Av. del Libertador 8250 (1429), Buenos Aires (Argentina)], E-mail: santacr@cnea.gov.ar; Bertotti, J.; Marin, J. [Universidad Favaloro, Solis 453 (1078), Buenos Aires (Argentina); Gonzalez, S.J. [Dpto. de Instrumentacion y Control, Comision Nacional de Energia Atomica, Av. del Libertador 8250 (1429), Buenos Aires (Argentina); CONICET, Avda. Rivadavia 1917 (1033), Buenos Aires (Argentina); Gossio, S. [FCEyN, Pabellon II, Ciudad Universitaria (1428), Buenos Aires (Argentina); Alvarez, D. [Fundacion Favaloro, Av. Belgrano 1746 (1093), Buenos Aires (Argentina); Roth, B.M.C.; Menendez, P. [Instituto de Oncologia Angel H. Roffo, Av. San Martin 5481 (1417), Buenos Aires (Argentina); Pereira, M.D. [Agencia Nacional de Promocion Cientifica y Tecnologica, PAV 22393 (Argentina); Albero, M.; Cubau, L.; Orellano, P. [INVAP S.E., F.P. Moreno 1089 (R8400AMU), S.C. de Bariloche, Rio Negro (Argentina); Liberman, S.J. [Dpto. de Instrumentacion y Control, Comision Nacional de Energia Atomica, Av. del Libertador 8250 (1429), Buenos Aires (Argentina)

    2009-07-15

    We recently initiated a program aimed to investigate the suitability of dynamic infrared imaging for following-up nodular melanoma patients treated with BNCT. The reason that makes infrared imaging attractive is the fact that it constitutes a functional and non-invasive imaging method, providing information on the normal and abnormal physiologic response of the nervous and vascular systems, as well as the local metabolic rate and inflammatory processes that ultimately appear as differences in the skin temperature. An infrared camera, with a focal plane array of 320x240 uncooled ferroelectric detectors is employed, which provides a video stream of the infrared emission in the 7-14 {mu}m wavelength band. A double blackbody is used as reference for absolute temperature calibration. After following a protocol for patient preparation and acclimatization, a basal study is performed. Subsequently, the anatomic region of interest is subjected to a provocation test (a cold stimulus), which induces an autonomic vasoconstriction reflex in normal structures, thus enhancing the thermal contrast due to the differences in the vasculature of the different skin regions. Radiation erythema reactions and melanoma nodules possess typically a faster temperature recovery than healthy, non-irradiated skin. However, some other non-pathological structures are also detectable by infrared imaging, (e.g. scars, vessels, arteriovenous anastomoses and injuries), thus requiring a multi-study comparison in order to discriminate the tumor signal. Besides the superficial nodules, which are readily noticeable by infrared imaging, we have detected thermal signals that are coincident with the location of non-palpable nodules, which are observable by CT and ultrasound. Diffuse regions of fast temperature recovery after a cold stimulus were observed between the third and sixth weeks post-BNCT, concurrent with the clinical manifestation of radiation erythema. The location of the erythematous visible and

  14. Dynamic infrared imaging of cutaneous melanoma and normal skin in patients treated with BNCT

    International Nuclear Information System (INIS)

    Santa Cruz, G.A.; Bertotti, J.; Marin, J.; Gonzalez, S.J.; Gossio, S.; Alvarez, D.; Roth, B.M.C.; Menendez, P.; Pereira, M.D.; Albero, M.; Cubau, L.; Orellano, P.; Liberman, S.J.

    2009-01-01

    We recently initiated a program aimed to investigate the suitability of dynamic infrared imaging for following-up nodular melanoma patients treated with BNCT. The reason that makes infrared imaging attractive is the fact that it constitutes a functional and non-invasive imaging method, providing information on the normal and abnormal physiologic response of the nervous and vascular systems, as well as the local metabolic rate and inflammatory processes that ultimately appear as differences in the skin temperature. An infrared camera, with a focal plane array of 320x240 uncooled ferroelectric detectors is employed, which provides a video stream of the infrared emission in the 7-14 μm wavelength band. A double blackbody is used as reference for absolute temperature calibration. After following a protocol for patient preparation and acclimatization, a basal study is performed. Subsequently, the anatomic region of interest is subjected to a provocation test (a cold stimulus), which induces an autonomic vasoconstriction reflex in normal structures, thus enhancing the thermal contrast due to the differences in the vasculature of the different skin regions. Radiation erythema reactions and melanoma nodules possess typically a faster temperature recovery than healthy, non-irradiated skin. However, some other non-pathological structures are also detectable by infrared imaging, (e.g. scars, vessels, arteriovenous anastomoses and injuries), thus requiring a multi-study comparison in order to discriminate the tumor signal. Besides the superficial nodules, which are readily noticeable by infrared imaging, we have detected thermal signals that are coincident with the location of non-palpable nodules, which are observable by CT and ultrasound. Diffuse regions of fast temperature recovery after a cold stimulus were observed between the third and sixth weeks post-BNCT, concurrent with the clinical manifestation of radiation erythema. The location of the erythematous visible and

  15. Neutron generator for BNCT based on high current ECR ion source with gyrotron plasma heating.

    Science.gov (United States)

    Skalyga, V; Izotov, I; Golubev, S; Razin, S; Sidorov, A; Maslennikova, A; Volovecky, A; Kalvas, T; Koivisto, H; Tarvainen, O

    2015-12-01

    BNCT development nowadays is constrained by a progress in neutron sources design. Creation of a cheap and compact intense neutron source would significantly simplify trial treatments avoiding use of expensive and complicated nuclear reactors and accelerators. D-D or D-T neutron generator is one of alternative types of such sources for. A so-called high current quasi-gasdynamic ECR ion source with plasma heating by millimeter wave gyrotron radiation is suggested to be used in a scheme of D-D neutron generator in the present work. Ion source of that type was developed in the Institute of Applied Physics of Russian Academy of Sciences (Nizhny Novgorod, Russia). It can produce deuteron ion beams with current density up to 700-800 mA/cm(2). Generation of the neutron flux with density at the level of 7-8·10(10) s(-1) cm(-2) at the target surface could be obtained in case of TiD2 target bombardment with deuteron beam accelerated to 100 keV. Estimations show that it is enough for formation of epithermal neutron flux with density higher than 10(9) s(-1) cm(-2) suitable for BNCT. Important advantage of described approach is absence of Tritium in the scheme. First experiments performed in pulsed regime with 300 mA, 45 kV deuteron beam directed to D2O target demonstrated 10(9) s(-1) neutron flux. This value corresponds to theoretical estimations and proofs prospects of neutron generator development based on high current quasi-gasdynamic ECR ion source. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Radiation field characterization of a BNCT research facility using Monte Carlo Method - Code MCNP-4B; Caracterizacao do campo de radiacao numa instalacao para pesquisa em BNCT o metodo de Monte Carlo Codigo - MCNP-4B

    Energy Technology Data Exchange (ETDEWEB)

    Hernandes, Antonio Carlos

    2002-07-01

    Boron Neutron Capture Therapy - BNCT- is a selective cancer treatment and arises as an alternative therapy to treat cancer when usual techniques - surgery, chemotherapy or radiotherapy - show no satisfactory results. The main proposal of this work is to project a facility to BNCT studies. This facility relies on the use of an AmBe neutron source and on a set of moderators, filters and shielding which will provide the best neutron/gamma beam characteristic for these BNCT studies, i.e., high intensity thermal and/or epithermal neutron fluxes and with the minimum feasible gamma rays and fast neutrons contaminants. A computational model of the experiment was used to obtain the radiation field in the sample irradiation position. The calculations have been performed with the MCNP 4B Monte Carlo Code and the results obtained can be regarded as satisfactory, i.e., a thermal neutron fluency {Nu}{sub {Tau}} = 1,35x10{sup 8} n/cm{sup 2}, a fast neutron dose of 5,86x{sup -1}0 Gy/{Nu}{sub {Tau}} and a gamma ray dose of 8,30x{sup -14} Gy/{Nu}{sub {Tau}}. (author)

  17. Artificial neural networks to evaluate the boron concentration decreasing profile in Blood-BPA samples of BNCT patients

    International Nuclear Information System (INIS)

    García-Reiriz, Alejandro; Magallanes, Jorge; Zupan, Jure; Líberman, Sara

    2011-01-01

    For the prediction of decay concentration profiles of the p-boronophenylalanine (BPA) in blood during BNCT treatment, a method is suggested based on Kohonen neural networks. The results of a model trained with the concentration profiles from the literature are described. The prediction of the model was validated by the leave-one-out method. Its robustness shows that it is mostly independent on small variations. The ability to fit retrospective experimental data shows an uncertainty lower than the two compartment model used previously. - Highlights: ► We predicted decaying concentration profiles of BPA in blood during BNCT therapy. ► Is suggested a method based on Kohonen neural networks. ► The results show that it is very robust and mostly independent of small variations. ► It has a better ability to fit retrospective experimental data. ► The model could be progressively improved by adding new data to the training matrix.

  18. Feasibility of sealed D-T neutron generator as neutron source for liver BNCT and its beam shaping assembly.

    Science.gov (United States)

    Liu, Zheng; Li, Gang; Liu, Linmao

    2014-04-01

    This paper involves the feasibility of boron neutron capture therapy (BNCT) for liver tumor with four sealed neutron generators as neutron source. Two generators are placed on each side of the liver. The high energy of these emitted neutrons should be reduced by designing a beam shaping assembly (BSA) to make them useable for BNCT. However, the neutron flux decreases as neutrons pass through different materials of BSA. Therefore, it is essential to find ways to increase the neutron flux. In this paper, the feasibility of using low enrichment uranium as a neutron multiplier is investigated to increase the number of neutrons emitted from D-T neutron generators. The neutron spectrum related to our system has a proper epithermal flux, and the fast and thermal neutron fluxes comply with the IAEA recommended values. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. AB-BNCT beam shaping assembly based on {sup 7}Li(p,n){sup 7}Be reaction optimization

    Energy Technology Data Exchange (ETDEWEB)

    Minsky, D.M., E-mail: minsky@tandar.cnea.gov.ar [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral Paz 1499 (B1650KNA), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. de Irigoyen 3100 (1650), San Martin (Argentina)] [CONICET, Av. Rivadavia 1917 (C1033AAJ), Buenos Aires (Argentina); Kreiner, A.J. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral Paz 1499 (B1650KNA), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. de Irigoyen 3100 (1650), San Martin (Argentina)] [CONICET, Av. Rivadavia 1917 (C1033AAJ), Buenos Aires (Argentina); Valda, A.A. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral Paz 1499 (B1650KNA), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. de Irigoyen 3100 (1650), San Martin (Argentina)

    2011-12-15

    A numerical optimization of a Beam Shaping Assembly (BSA) for Accelerator Based-Boron Neutron Capture Therapy (AB-BNCT) has been performed. The reaction {sup 7}Li(p,n){sup 7}Be has been considered using a proton beam on a lithium fluoride target. Proton energy and the dimensions of a simple BSA geometry have been varied to obtain a set of different configurations. The optimal configuration of this set is shown.

  20. Boron neutron capture therapy (BNCT) for glioblastoma multiforme (GBM), using the epithermal neutron beam at the Brookhaven National Laboratory

    International Nuclear Information System (INIS)

    Chadha, Manjeet; Capala, Jacek; Coderre, Jeffrey A.; Elowitz, Eric H.; Joel, Darrel D.; Hungyuan, B. Liu; Slatkin, Daniel N.; Chanana, Arjun D.

    1996-01-01

    Objective: BNCT is a binary treatment modality based on the nuclear reactions that occur when boron ( 10 B) is exposed to thermal neutrons. Preclinical studies have demonstrated the therapeutic efficacy of p-boronophenylalanine (BPA)-based BNCT. The objective of the Phase I/II trial was to evaluate BPA-fructose (BPA-F) as a boron delivery agent for GBM and to study the feasibility and safety of a single-fraction of BNCT. Materials and Methods: The trial design required i) a BPA-F biodistribution study performed at the time of craniotomy; and ii) BNCT within 4 weeks of the craniotomy. From September 94 to July 95, 10 patients with biopsy proven GBM were treated. All but 1 patient underwent a biodistribution study receiving IV BPA-F at the time of craniotomy. Multiple tissue samples and concurrent blood and urine samples were collected for evaluation of the boron concentration and clearance kinetics. For BNCT all patients received 250 mg/kgm of BPA-F (IV infusion over 2 hrs) followed by neutron irradiation. The blood 10 B concentration during irradiation was used to calculate the time of neutron exposure. The 3D treatment planning was done using the BNCT treatment planning software developed at the Idaho National Engineering Laboratory. The BNCT dose is expressed as the sum of the physical dose components corrected for both the RBE and the 10 B localization factor with the unit Gy-Eq. The photon-equivalent dose, where the thermal neutron fluence reaches a maximum, is the peak-dose equivalent. A single-fraction of BNCT was delivered prescribing 10.5 Gy-Eq (9 patients) and 13.8 Gy-Eq (1 patient) as the peak dose-equivalent to the normal brain. The peak dose rate was kept below 27 cGy-Eq/min. Results: Biodistribution data: The maximum blood 10 B concentration was observed at the end of the infusion and scaled as a linear function of the administered dose. The 10 B concentration in the scalp and in the GBM tissue was higher than in blood by 1.5 x and at least 3.5 x

  1. Development of An Epi-thermal Neutron Field for Fundamental Researches for BNCT with A DT Neutron Source

    Directory of Open Access Journals (Sweden)

    Osawa Yuta

    2017-01-01

    Full Text Available Boron Neutron Capture Therapy (BNCT is known to be a new promising cancer therapy suppressing influence against normal cells. In Japan, Accelerator Based Neutron Sources (ABNS are being developed for BNCT. For the spread of ABNS based BNCT, we should characterize the neutron field beforehand. For this purpose, we have been developing a low-energy neutron spectrometer based on 3He position sensitive proportional counter. In this study, a new intense epi-thermal neutron field was developed with a DT neutron source for verification of validity of the spectrometer. After the development, the neutron field characteristics were experimentally evaluated by using activation foils. As a result, we confirmed that an epi-thermal neutron field was successfully developed suppressing fast neutrons substantially. Thereafter, the neutron spectrometer was verified experimentally. In the verification, although a measured detection depth distribution agreed well with the calculated distribution by MCNP, the unfolded spectrum was significantly different from the calculated neutron spectrum due to contribution of the side neutron incidence. Therefore, we designed a new neutron collimator consisting of a polyethylene pre-collimator and boron carbide neutron absorber and confirmed numerically that it could suppress the side incident neutrons and shape the neutron flux to be like a pencil beam.

  2. Capability of NIPAM polymer gel in recording dose from the interaction of 10B and thermal neutron in BNCT

    International Nuclear Information System (INIS)

    Khajeali, Azim; Reza Farajollahi, Ali; Kasesaz, Yaser; Khodadadi, Roghayeh; Khalili, Assef; Naseri, Alireza

    2015-01-01

    The capability of N-isopropylacrylamide (NIPAM) polymer gel to record the dose resulting from boron neutron capture reaction in BNCT was determined. In this regard, three compositions of the gel with different concentrations of 10 B were prepared and exposed to gamma radiation and thermal neutrons. Unlike irradiation with gamma rays, the boron-loaded gels irradiated by neutron exhibited sensitivity enhancement compared with the gels without 10 B. It was also found that the neutron sensitivity of the gel increased by the increase of concentration of 10 B. It can be concluded that NIPAM gel might be suitable for the measurement of the absorbed dose enhancement due to 10 B and thermal neutron reaction in BNCT. - Highlights: • Three compositions of NIPAM gel with different concentration of 10 B have been exposed by gamma and thermal neutron. • The vials containing NIPAM gel have been irradiated by an automatic system capable of providing for dose uniformity. • Suitability of NIPAM polymer gel in measuring radiation doses in BNCT has been investigated.

  3. Considerations for boron neutron capture therapy studies; Consideracoes sobre o estudo da BNCT (terapia de captura neutronica por boro)

    Energy Technology Data Exchange (ETDEWEB)

    Faria Gaspar, P. de

    1994-12-31

    Radiotherapy is indispensable as a mean to eradicate deeply or infiltrating tumor tissue that can not be removed surgically. Therefore, it is not selective and may also kill the surrounding health tissue. The principle of BNCT (Boron Neutron Capture Therapy) consist in targeting a tumor selectively with a boron-10 compound. This nuclide has a large capture cross section for thermal neutrons and the nuclear reaction and the delivered energy in locus will selective the tumor. Since its initial proposal in 1963 BNCT has made much progress, however it is not used in a routine treatment. In this work it was approached some complex procedures, as the obtention of selective boron compounds, the adequate set up of neutron beams, the biodistribution, the in vivo and in vitro studies, and also human patients treatments. This work provide fundamentals about BNCT to professional of different areas of knowledge since it comprises multidisciplinary study. It includes appendixes for the ones not related to the field for a better comprehension of the many aspects involved. It is also presented a glossary containing technical and basic aspects involved. It is also presented a glossary containing technical and basic terms referred in the work. (author). 174 refs, 1 fig, 12 apps.

  4. First clinical results from the EORTC phase I Trial ''postoperative treatment of glioblastoma with BNCT at the Petten irradiation facility''

    International Nuclear Information System (INIS)

    Sauerwein, W.; Hideghety, K.; Rassow, J.; Devries, M.J.; Goetz, C.; Paquis, P.; Grochulla, F.; Wolbers, J.G.; Haselsberger, K.; Turowski, B.; Moss, R.L.; Stecher-Rasmussen, F.; Touw, D.; Wiestler, O.D.; Frankhauser, H.; Gabel, D.

    2001-01-01

    Based on the pre-clinical work of the European Collaboration on Boron Neutron Capture Therapy a study protocol was prepared in 1995 to initiate Boron Neutron Capture Therapy (BNCT) in patients at the High Flux Reactor (HFR) in Petten. Bio-distribution and pharmacokinetics data of the boron drug Na 2 B 12 H 11 SH (BSH) as well as the radiobiological effects of BNCT with BSH in healthy brain tissue of dogs were considered in designing the strategy for this clinical Phase I trial. The primary goal of the radiation dose escalation study is the investigation of possible adverse events due to BNCT; i.e. to establish the dose limiting toxicity and the maximal tolerated dose. The treatment is delivered in 4 fractions at a defined average boron concentration in blood. Cohorts of 10 patients are treated per dose group. The starting dose was set at 80% of the dose at which neurological symptoms occurred in preclinical dog experiments following a single fraction. After an observation period of at least 6 months, the dose is increased by 10% for the next cohort if less then three severe side effects related to the treatment occurred. The results of the first cohort are presented here. The evaluated dose level can be considered safe. (author)

  5. Boron neutron capture therapy (BNCT) translational studies in the hamster cheek pouch model of oral cancer at the new ''B2'' configuration of the RA-6 nuclear reactor

    Energy Technology Data Exchange (ETDEWEB)

    Monti Hughes, Andrea; Trivillin, Veronica A.; Schwint, Amanda E. [Constituyentes Atomic Center, National Atomic Energy Commission (CNEA), Department of Radiobiology, San Martin, Province Buenos Aires (Argentina); National Research Council (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Longhino, Juan; Boggio, Esteban [Bariloche Atomic Center, CNEA, Department of Nuclear Engineering, San Carlos de Bariloche, Province Rio Negro (Argentina); Medina, Vanina A.; Martinel Lamas, Diego J. [National Research Council (CONICET), Ciudad Autonoma de Buenos Aires (Argentina); Pontifical Catholic University of Argentina (UCA), Laboratory of Tumoral Biology and Inflammation, School of Medical Sciences, Institute for Biomedical Research (BIOMED CONICET-UCA), Ciudad Autonoma de Buenos Aires (Argentina); Garabalino, Marcela A.; Heber, Elisa M.; Pozzi, Emiliano C.C. [Constituyentes Atomic Center, National Atomic Energy Commission (CNEA), Department of Radiobiology, San Martin, Province Buenos Aires (Argentina); Itoiz, Maria E. [Constituyentes Atomic Center, National Atomic Energy Commission (CNEA), Department of Radiobiology, San Martin, Province Buenos Aires (Argentina); UBA, Department of Oral Pathology, Faculty of Dentistry, Ciudad Autonoma de Buenos Aires (Argentina); Aromando, Romina F. [UBA, Department of Oral Pathology, Faculty of Dentistry, Ciudad Autonoma de Buenos Aires (Argentina); Nigg, David W. [Idaho National Laboratory, Idaho Falls (United States)

    2017-11-15

    Boron neutron capture therapy (BNCT) is based on selective accumulation of B-10 carriers in tumor followed by neutron irradiation. We demonstrated, in 2001, the therapeutic effect of BNCT mediated by BPA (boronophenylalanine) in the hamster cheek pouch model of oral cancer, at the RA-6 nuclear reactor. Between 2007 and 2011, the RA-6 was upgraded, leading to an improvement in the performance of the BNCT beam (B2 configuration). Our aim was to evaluate BPA-BNCT radiotoxicity and tumor control in the hamster cheek pouch model of oral cancer at the new ''B2'' configuration. We also evaluated, for the first time in the oral cancer model, the radioprotective effect of histamine against mucositis in precancerous tissue as the dose-limiting tissue. Cancerized pouches were exposed to: BPA-BNCT; BPA-BNCT + histamine; BO: Beam only; BO + histamine; CONTROL: cancerized, no-treatment. BNCT induced severe mucositis, with an incidence that was slightly higher than in ''B1'' experiments (86 vs 67%, respectively). BO induced low/moderate mucositis. Histamine slightly reduced the incidence of severe mucositis induced by BPA-BNCT (75 vs 86%) and prevented mucositis altogether in BO animals. Tumor overall response was significantly higher in BNCT (94-96%) than in control (16%) and BO groups (9-38%), and did not differ significantly from the ''B1'' results (91%). Histamine did not compromise BNCT therapeutic efficacy. BNCT radiotoxicity and therapeutic effect at the B1 and B2 configurations of RA-6 were consistent. Histamine slightly reduced mucositis in precancerous tissue even in this overly aggressive oral cancer model, without compromising tumor control. (orig.)

  6. Pre- and/or Intra-Operative Prescription of Diuretics, but Not Renin-Angiotensin-System Inhibitors, Is Significantly Associated with Acute Kidney Injury after Non-Cardiac Surgery: A Retrospective Cohort Study.

    Science.gov (United States)

    Tagawa, Miho; Ogata, Ai; Hamano, Takayuki

    2015-01-01

    Pre- and/or intra-operative use of diuretics, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARB) constitutes a potentially modifiable risk factor for postoperative acute kidney injury (AKI). It has been studied whether use of these drugs predicts AKI after cardiac surgery. The objective of this study was to examine whether administration of these agents was independently associated with AKI after non-cardiac surgery. This was a retrospective observational study. Inclusion criteria were adult patients (age ≥ 18) who underwent non-cardiac surgery under general anesthesia from 2007 to 2009 at Kyoto Katsura Hospital. Exclusion criteria were urological surgery, missing creatinine values, and preoperative dialysis. The exposures of interest were pre- and/or intra-operative use of diuretics or ACE-I/ARB. Outcome variables were postoperative AKI as defined by the AKI Network (increase in creatinine ≥ 0.3 mg/dL or 150% within 48 hours, or urine output 6 hours). Multivariable logistic regression analyses were conducted and adjusted for potential confounders. Propensity scores (PS) for receiving diuretics or ACE-I/ARB therapy were estimated and PS adjustment, PS matching, and inverse probability weighting were performed. There were 137 AKI cases (5.0%) among 2,725 subjects. After statistical adjustment for patient and surgical characteristics, odds (95% CI) of postoperative AKI were 2.07 (1.10-3.89) (p = 0.02) and 0.89 (0.56-1.42) (p = 0.63) in users of diuretics and ACE-I/ARB, respectively, compared with non-users. PS adjustment, PS matching, and inverse probability weighting yielded similar results. The effect size of diuretics was significantly greater in the patients with lower propensity for diuretic use (p for interaction diuretics, but not ACE-I/ARB, was independently associated with postoperative AKI after non-cardiac surgery, especially in patients with low propensity for diuretic use. It might be reasonable to withhold

  7. Boron Neutron Capture Therapy at the TRIGA Mark II of Pavia, Italy - The BNCT of the diffuse tumours

    International Nuclear Information System (INIS)

    Altieri, S.; Bortolussi, S.; Stella, S.; Bruschi, P.; Gadan, M.A.

    2008-01-01

    The selectivity based on the B distribution rather than on the irradiation field makes Boron neutron Capture Therapy (BNCT) a valid option for the treatment of the disseminated tumours. As the range of the high LET particles is shorter than a cell diameter, the normal cells around the tumour are not damaged by the reactions occurring in the tumoral cells. PAVIA 2001: first treatment of multiple hepatic metastases from colon ca by BNCT and auto-transplantation technique: TAOrMINA project. The liver was extracted after BPA infusion, irradiated in the Thermal Column of the Pavia TRIGA Mark II reactor, and re-implanted in the patient. Two patients were treated, demonstrating the feasibility of the therapy and the efficacy in destroying the tumoral nodules sparing the healthy tissues. In the last years, the possibility of applying BNCT to the lung tumours using epithermal collimated neutron beams and without explanting the organ, is being explored. The principal obtained results of the BNCT research are presented, with particular emphasis on the following aspects: a) the project of a new thermal column configuration to make the thermal neutron flux more uniform inside the explanted liver, b) the Monte Carlo study by means of the MCNP code of the thermal neutron flux distribution inside a patient's thorax irradiated with epithermal neutrons, and c) the measurement of the boron concentration in tissues by (n,α) spectroscopy and neutron autoradiography. The dose distribution in the thorax are simulated using MCNP and the anthropomorphic model ADAM. To have a good thermal flux distribution inside the lung epithermal neutrons must be used, which thermalize crossing the first tissue layers. Thermal neutrons do not penetrate and the obtained uniformity is poor. In the future, the construction of a PGNAA facility using a horizontal channel of the TRIGA Mark II is planned. With this method the B concentration can be measured also in liquid samples (blood, urine) and in those

  8. Evaluation of neutron irradiation fields for BNCT by using absorbed dose in a phantom

    International Nuclear Information System (INIS)

    Aizawa, O.

    1993-01-01

    In a previous paper, the author defined the open-quotes irradiation timeclose quotes as the time of irradiation in which the maximum open-quotes total background doseclose quotes becomes 2,500 RBE-cGy. In this paper, he has modified the definition a little as the time of irradiation in which the maximum open-quotes lμg/g B-10 doseclose quotes becomes 3,000 RBE-cGy, because he assumed that normal tissue contained 1μg/g B-10. Moreover, he has modified the dose criteria for BNCT as follows: The open-quotes eye doseclose quotes, open-quotes total body doseclose quotes and open-quotes except-head doseclose quotes should be less that 200, 100 and 50 RBE-cGy, respectively. He has added one more criterion for BNCT that the thermal neutron fluence at the tumor position should be over 2.5x10 12 n/cm 2 at the open-quotes irradiation timeclose quotes. The distance from the core side to the irradiation port in the open-quotes old configurationclose quotes of the Musashi reactor (TRIGA-II, 100kW) was 160 cm. He is now planning to design an eccentric core and to move the reactor core nearer to the irradiation port, distance between the core side and the irradiation port to be 140, 130 and 120cm. The other assumptions used in this paper are as follows: (1) The B-10 concentrations in tumor are 30 and/or 10μg/g. (2) The depth of the tumor is 5.0 cm to 5.5 cm from the surface. (3) The RBE values used are 1.0 for all gamma rays and 2.3 for B 10 (n,α) reaction products. (4) The RBE values for neutrons are the following three cases: the first case is using 1.6 for all neutrons; the second one is using 3.2 for non-thermal neutrons and 1.6 for thermal neutrons; the third case is using 4.8 for fast neutrons, 3.2 for faster epithermal and epithermal neutrons, and 1.6 for thermal neutrons

  9. Intra-Operative Dosimetry in Prostate Brachytherapy

    Science.gov (United States)

    2006-11-01

    insufficient to correctly match the seeds, while a third image renders the matching problem to be of nonpolynomial complexity. We utilize the special... subpixel precision. Projected point features have a high segmentation error25 1–2 pixel but make the pose estimation problem very well constrained.27...in Eq. 2 uniquely. In this framework, the exact solution is rendered nonlin- ear and we use the iterative Newton’s optimization method to solve it

  10. Initial Experimental Verification of the Neutron Beam Modeling for the LBNL BNCT Facility

    International Nuclear Information System (INIS)

    Bleuel, D.L.; Chu, W.T.; Donahue, R.J.; Ludewigt, B.A.; McDonald, R.J.; Smith, A.R.; Stone, N.A.; Vuji, J.

    1999-01-01

    In preparation for future clinical BNCT trials, neutron production via the 7Li(p,n) reaction as well as subsequent moderation to produce epithermal neutrons have been studied. Proper design of a moderator and filter assembly is crucial in producing an optimal epithermal neutron spectrum for brain tumor treatments. Based on in-phantom figures-of-merit,desirable assemblies have been identified. Experiments were performed at the Lawrence Berkeley National Laboratory's 88-inch cyclotron to characterize epithermal neutron beams created using several microampere of 2.5 MeV protons on a lithium target. The neutron moderating assembly consisted of Al/AlF3 and Teflon, with a lead reflector to produce an epithermal spectrum strongly peaked at 10-20 keV. The thermal neutron fluence was measured as a function of depth in a cubic lucite head phantom by neutron activation in gold foils. Portions of the neutron spectrum were measured by in-air activation of six cadmium-covered materials (Au, Mn, In, Cu, Co, W) with high epithermal neutron absorption resonances. The results are reasonably reproduced in Monte Carlo computational models, confirming their validity

  11. An automated method for breathing frequency determination for rat lung radiobiology in BNCT

    International Nuclear Information System (INIS)

    Kiger, J.L.; Coderre, J.A.; Kiger, W.S. III

    2006-01-01

    Whole-body plethysmography was used to the measure the breathing rate in rats as a functional indication of radiation-induced lung damage, either weekly or bi-weekly for a period of 180 days following thorax irradiations in a BNCT radiobiology study. A three-minute digital breathing signal was collected in each measurement. Software has been developed to automatically discriminate against large-amplitude noise due to animal movement. After segmenting the signal into consecutive, overlapping and circular blocks, the mean frequency spectrum of the processed signal was calculated using the Fast Fourier Transform (FFT). The breathing rate was defined as the primary frequency of the spectrum and the standard deviation was estimated using the bootstrap method. The mean standard deviation of all measurements in the data set (n=4269) was 2.4%. The improved accuracy with low standard deviation of the measurements ensures good sensitivity and a low threshold for detection of responding animals; breathing rates more than 20% (∼3 σ) above the control mean were considered responding. (author)

  12. Monte Carlo simulation to study the doses in an accelerator BNCT treatment

    International Nuclear Information System (INIS)

    Burlon, Alejandro A.; Valda, Alejandro A.; Somacal, Hector R.; Kreiner, Andres J.; Minsky, Daniel M.

    2003-01-01

    In this work the 7 Li(p, n) 7 Be reaction has been studied as a neutron source for accelerator-based BNCT (Boron Neutron Capture Therapy). In order to optimize the design of the neutron production target and the beam shaping assembly, extensive MCNP simulations have been performed. These simulations include a thick Li metal target, a whole-body phantom, a moderator-reflector assembly (Al/AlF 3 as moderator and graphite as reflector) and the treatment room. The doses were evaluated for two proton bombarding energies of 1.92 MeV (near to the threshold of the reaction) and 2.3 MeV (near to the resonance of the reaction) and for three Al/ALF 3 moderator thicknesses (18, 26 and 34 cm). To assess the doses, a comparison using a Tumor Control Probability (TCP) model was done. In a second instance, the effect of the specific skin radiosensitivity (an RBE of 2.5 for the 10 B(n,α) 7 Li reaction) and a 10 B uptake of 17 ppm was considered for the scalp. Finally, the simulations show the advantage of irradiating with near-resonance-energy protons (2.3 MeV) because of the high neutron yield at this energy, leading to the lowest treatment times. Moreover, the 26 cm Al/AlF 3 moderator has shown the best performance among the studied cases. (author)

  13. BDTPS The BNCT Treatment Planning System jointly developed at DIMNP and JRC/IE

    CERN Document Server

    Daquino, G G; Mazzini, M; Moss, R; Muzi, L; International Workshop on "Neutron Capture Therapy: State of the art"

    2003-01-01

    The idea to couple the Treatment Planning System (TPS) to the information on the real boron distribution in the patient is the main added value of the new methodology set-up at DIMNP of University of Pisa, in collaboration with the JRC of Petten (NL). The methodology has been implemented in the new TPS, called BDTPS (Boron Distribution Treatment Planning System), which takes into account the actual boron distribution in the patient brain, while the standard TPS assumes a uniform boron distribution, absolutely far from the reality. Nowadays, Positron Emission Tomography (PET) is able to provide this in vivo information. The new TPS, based on the Monte Carlo technique, has been validated comparing the main BNCT parameters (thermal flux, boron dose, etc.) as measured during the irradiation of a special heterogeneous boron phantom (HEBOM), ad hoc designed, as calculated by the BDTPS and by the standard TPS SERA. An evident SERA overestimation of the thermal neutron flux, as well as the boron dose, has been detect...

  14. The BNCT facility at the HFR Petten: Quality assurance for reactor facilities in clinical trials

    International Nuclear Information System (INIS)

    Moss, R.; Watkins, P.; Vroegindeweij, C.; Stecher-Rasmussen, F.; Huiskamp, R.; Ravensberg, K.; Appelman, K.; Sauerwein, W.; Hideghety, K.; Gabel, D.

    2001-01-01

    The first clinical trial in Europe of Boron Neutron Capture Therapy (BNCT) for the treatment of glioblastoma was opened in July 1997. The trial is a Phase I study with the principal aim to establish the maximum tolerated radiation dose and the dose limiting toxicity under defined conditions. It is the first time that a clinical application could be realised on a completely multi-national scale. The treatment takes place at the High Flux Reactor (HFR) in Petten, the Netherlands, is operated by an international team of experts under the leadership of a German radiotherapist, and treats patients coming from different European countries. It has therefore been necessary to create a very specialised organisation and contractual structure with the support of administrations from different countries, who had to find and adapt solutions within existing laws that had never foreseen such a situation. Furthermore, the treatment does not take place in an hospital environment and even more so, the facility is at a nuclear research reactor. Hence, special efforts were made on quality assurance, in order that the set-up at the facility and the personnel involved complied, as closely as possible, with similar practices in conventional radiotherapy departments. (author)

  15. Dosimetric study of varying aperture-surface distance at the Finnish BNCT facility

    International Nuclear Information System (INIS)

    Uusi-Simola, Jouni; Seppaelae, Tiina; Nieminen, Katja; Kotiluoto, Petri; Seren, Tom; Auterinen, Iiro; Kortesniemi, Mika; Savolainen, Sauli

    2006-01-01

    Comparison of experimental and calculated dosimetric values in a water phantom was performed at the Finnish BNCT facility at the FiR 1 research reactor. The purpose was to study the effect of changing aperture to surface distance (ASD) to radiation dose and to verify the accuracy of the treatment planning and to provide data for comparison of the methods. A magnesium ionisation chamber flushed with argon gas was used to measure absorbed photon dose rate. Diluted manganese (Mn) and gold (Au) foils and Mn wires were used to determine Mn and Au activation reaction rates. Computer simulations with both SERA and MCNP programs were used to independently calculate the corresponding values. Photon dose and activation reaction rate depth profiles at beam central axis an axial profiles at 2.5 and 6 cm depths were measured and calculated for 11 and 14 and 17 cm diameter apertures. Depth profiles for activation reaction rates were determined for the clinically used 11 and 14 cm diameter apertures for 0, 5, and 10 cm ASD. In addition, the optional 17 cm beam was characterised at 0 and 5 cm ASD. The beam intensity decreases by approximately 20% and 40% when ASD is increased to 5 cm or 10 cm, respectively. The shape of the 55 Mn activation reaction rate depth profile and photon depth radial profile did not vary more than 5% for the 14 cm beam when the ASD was increased from 0 cm to 10 cm. (author)

  16. Detailed dosimetry and clinical outcome analysis for the argentine BNCT trials of cutaneous nodular melanomas

    International Nuclear Information System (INIS)

    Gonzalez, S.J.; Santa Cruz, G.A.; Casal, M.R.

    2006-01-01

    Three female patients with biopsy-proven nodular melanoma were treated to six separate sites as part of the Phase I/II BNCT clinical trial conducted at the Comision Nacional de Energia Atomica (CNEA) and the Instituto A. Roffo, Argentina. This work reports on the detailed dosimetry for the clinical trials, and presents a preliminary analysis to investigate the possible influence of tumor size and total equivalent dose on the observed local tumor response. Also, the appropriateness of applying 3.5 tumor-to-blood 10 B concentration ratio for the BPA compound in nodular melanoma cases is discussed. The statistical analysis showed that tumor response depends not only on the dose but also, and highly, on the tumor size. For these three patients, there was no significant difference between minimum and mean equivalent doses as explicative for tumor response. The collection of sixteen experimental-based tumor-to-blood ratios determined by CNEA in nodular melanoma patients derived an average value and standard deviation of 2.5 ± 0.6. This result suggests that a lower ratio could be more suitable for estimating the clinical dosimetry. It is also consistent with the worse tumor control rate in nodular melanomas observed by other researchers. (author)

  17. Synthesis and in-vivo detection of boronated compounds for use in BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Kabalka, G.W.

    1991-02-01

    The primary objectives of the DOE Program at the University of Tennessee Biomedical Imaging Center are the development of new boron-neutron-capture agents as well as the technology to detect boron compounds in-vivo. The detection technology focuses on the development of effective magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques for verifying and measuring BNCT agents in-vivo. A significant portion of the effort is directed toward the design of boron-containing neutron-capture-therapy agents. The UT -- DOE program is unique in that it has access to two state-of-the-art multinuclear magnetic resonance imaging units housed in the Biomedical Imaging Center at the University of Tennessee Medical Center at Knoxville. In addition the UT -- DOE researchers actively collaborate with colleagues at other DOE facilities (Brookhaven National Laboratory, Oak Ridge National Laboratory, Los Alamos National Laboratory and Oak Ridge Associated Universities). An important goal of the DOE program at UT is to provide training for students (predoctoral and postdoctoral). The University of Tennessee is one of the very few institutions in the world where students have hands-on'' access to both modern scientific equipment and medical imaging modalities such as the clinical MRI units. The academic nature of the program facilitates collaborative interactions with other DOE programs and helps to insure the continued availability of skilled scientists dedicated to the advancement of diagnostic medical procedures. 14 refs., 3 figs.

  18. Simulation of the BNCT of Brain Tumors Using MCNP Code: Beam Designing and Dose Evaluation

    Directory of Open Access Journals (Sweden)

    Fatemeh Sadat Rasouli

    2012-09-01

    Full Text Available Introduction BNCT is an effective method to destroy brain tumoral cells while sparing the healthy tissues. The recommended flux for epithermal neutrons is 109 n/cm2s, which has the most effectiveness on deep-seated tumors. In this paper, it is indicated that using D-T neutron source and optimizing of Beam Shaping Assembly (BSA leads to treating brain tumors in a reasonable time where all IAEA recommended criteria are met. Materials and Methods The proposed BSA based on a D-T neutron generator consists of a neutron multiplier system, moderators, reflector, and collimator. The simulated Snyder head phantom is used to evaluate dose profiles in tissues due to the irradiation of designed beam. Monte Carlo Code, MCNP-4C, was used in order to perform these calculations.   Results The neutron beam associated with the designed and optimized BSA has an adequate epithermal flux at the beam port and neutron and gamma contaminations are removed as much as possible. Moreover, it was showed that increasing J/Φ, as a measure of beam directionality, leads to improvement of beam performance and survival of healthy tissues surrounding the tumor. Conclusion According to the simulation results, the proposed system based on D-T neutron source, which is suitable for in-hospital installations, satisfies all in-air parameters. Moreover, depth-dose curves investigate proper performance of designed beam in tissues. The results are comparable with the performances of other facilities.

  19. A novel design of beam shaping assembly to use D-T neutron generator for BNCT.

    Science.gov (United States)

    Kasesaz, Yaser; Karimi, Marjan

    2016-12-01

    In order to use 14.1MeV neutrons produced by d-T neutron generators, two special and novel Beam Shaping Assemblies (BSA), including multi-layer and hexagonal lattice have been suggested and the effect of them has been investigated by MCNP4C Monte Carlo code. The results show that the proposed BSA can provide the qualified epithermal neutron beam for BNCT. The final epithermal neutron flux is about 6e9 n/cm2.s. The final proposed BSA has some different advantages: 1) it consists of usual and well-known materials (Pb, Al, Fluental and Cd); 2) it has a simple geometry; 3) it does not need any additional gamma filter; 4) it can provide high flux of epithermal neutrons. As this type of neutron source is under development in the world, it seems that they can be used clinically in a hospital considering the proposed BSA. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Development of a treatment planning system for BNCT based on positron emission tomography data: preliminary results

    Science.gov (United States)

    Cerullo, N.; Daquino, G. G.; Muzi, L.; Esposito, J.

    2004-01-01

    Present standard treatment planning (TP) for glioblastoma multiforme (GBM - a kind of brain tumor), used in all boron neutron capture therapy (BNCT) trials, requires the construction (based on CT and/or MRI images) of a 3D model of the patient head, in which several regions, corresponding to different anatomical structures, are identified. The model is then employed by a computer code to simulate radiation transport in human tissues. The assumption is always made that considering a single value of boron concentration for each specific region will not lead to significant errors in dose computation. The concentration values are estimated "indirectly", on the basis of previous experience and blood sample analysis. This paper describes an original approach, with the introduction of data on the in vivo boron distribution, acquired by a positron emission tomography (PET) scan after labeling the BPA (borono-phenylalanine) with the positron emitter 18F. The feasibility of this approach was first tested with good results using the code CARONTE. Now a complete TPS is under development. The main features of the first version of this code are described and the results of a preliminary study are presented. Significant differences in dose computation arise when the two different approaches ("standard" and "PET-based") are applied to the TP of the same GBM case.

  1. A new approach to determine tumor-to-blood 10B concentration ratios from the clinical outcome of a BNCT treatment

    International Nuclear Information System (INIS)

    Gonzalez, S.J.; Carando, D.G.; Bonomi, M.R.

    2004-01-01

    A new approach to determine the tumor-to-blood 10 B concentration ratio in boron neutron capture therapy (BNCT) is introduced. It is a statistical method, which uses maximum likelihood estimation on the clinical outcome of a BNCT treatment. Its performance is shown in a clinical case of cutaneous multiple nodular melanomas. The calculations involve a detailed dosimetry analysis, the determination of tumor control probabilities for the different nodules, the maximum likelihood estimation itself, and a parametric bootstrap to obtain confidence intervals for the tumor-to-blood ratio. The obtained ratio is 3.05±0.46 with a 95%-confidence interval. These results are consistent with those found in literature. Moreover, a single patient with multiple nodules proves enough to get statistically relevant results. The proposed method does not involve surgery and can be performed after a BNCT treatment without being invasive for the patient

  2. Neutron field characterization in the installation for BNCT study in the IEA-R1 reactor; Caracterizacao do campo de neutrons na instalacao para estudo em BNCT no reator IEA-R1

    Energy Technology Data Exchange (ETDEWEB)

    Carneiro Junior, Valdeci

    2008-07-01

    This work aims to characterize the mixed neutron and gamma field, in the sample irradiation position, in a research installation for Boron Neutron Capture Therapy (BNCT), in the IPEN IEA-R1 reactor. The BNCT technique has been studied as a safe and selective option in the treatment of resistant cancerigenous tumors or considered non-curable by the conventional techniques, for example, the Glioblastoma Multiform - a brain cancerigenous tumor. Neutron flux measurements were carried out: thermal, resonance and fast, as well as neutron and gamma rays doses, in the sample position, using activation foils detectors and thermoluminescent dosimeters. For the determination of the neutron spectrum and intensity, a set of different threshold activation foils and gold foils covered and uncovered with cadmium irradiated in the installation was used, analyzed by a high Pure Germanium semiconductor detector, coupled to an electronic system suitable for gamma spectrometry. The results were processed with the SAND-BP code. The doses due to gamma and neutron rays were determined using thermoluminescent dosimeters TLD 400 and TLD 700 sensitive to gamma and TLD 600, sensitive to neutrons. The TLDs were selected and used for obtaining the calibration curves - dosimeter answer versus dose - from each of the TLD three types, which were necessary to calculate the doses due to neutron and gamma, in the sample position. The radiation field, in the sample irradiation position, was characterized flux for thermal neutrons of 1.39.10{sup 8} {+-} 0,12.10{sup 8} n/cm{sup 2}s the doses due to thermal neutrons are three times higher than those due to gamma radiation and confirm the reproducibility and consistency of the experimental findings obtained. Considering these results, the neutron field and gamma radiation showed to be appropriated for research in BNCT. (author)

  3. PET pharmacokinetic analysis to estimate boron concentration in tumor and brain as a guide to plan BNCT for malignant cerebral glioma

    Energy Technology Data Exchange (ETDEWEB)

    Nariai, Tadashi [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan)], E-mail: nariai.nsrg@tmd.ac.jp; Ishiwata, Kiichi [Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1, Nakacho, Itabashi-ku, Tokyo (Japan); Kimura, Yuichi [Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba (Japan); Inaji, Motoki; Momose, Toshiya [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan); Yamamoto, Tetsuya; Matsumura, Akira [Department of Neurosurgery, University of Tsukuba, Tennodai, Tsukuba, Igaraki (Japan); Ishii, Kenji [Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1, Nakacho, Itabashi-ku, Tokyo (Japan); Ohno, Kikuo [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan)

    2009-07-15

    Introduction: To plan the optimal BNCT for patients with malignant cerebral glioma, estimation of the ratio of boron concentration in tumor tissue against that in the surrounding normal brain (T/N ratio of boron) is important. We report a positron emission tomography (PET) imaging method to estimate T/N ratio of tissue boron concentration based on pharmacokinetic analysis of amino acid probes. Methods: Twelve patients with cerebral malignant glioma underwent 60 min dynamic PET scanning of brain after bolus injection of {sup 18}F-borono-phenyl-alanine (FBPA) with timed arterial blood sampling. Using kinetic parameter obtained by this scan, T/N ratio of boron concentration elicited by one-hour constant infusion of BPA, as performed in BNCT, was simulated on Runge-Kutta algorithm. {sup 11}C-methionine (MET) PET scan, which is commonly used in worldwide PET center as brain tumor imaging tool, was also performed on the same day to compare the image characteristics of FBPA and that of MET. Result: PET glioma images obtained with FBPA and MET are almost identical in all patients by visual inspection. Estimated T/N ratio of tissue boron concentration after one-hour constant infusion of BPA, T/N ratio of FBPA on static condition, and T/N ratio of MET on static condition showed significant linear correlation between each other. Conclusion: T/N ratio of boron concentration that is obtained by constant infusion of BPA during BNCT can be estimated by FBPA PET scan. This ratio can also be estimated by MET-PET imaging. As MET-PET study is available in many clinical PET center, selection of candidates for BNCT may be possible by MET-PET images. Accurate planning of BNCT may be performed by static images of FBPA PET. Use of PET imaging with amino acid probes may contribute very much to establish an appropriate application of BNCT for patients with malignant glioma.

  4. PET pharmacokinetic analysis to estimate boron concentration in tumor and brain as a guide to plan BNCT for malignant cerebral glioma

    International Nuclear Information System (INIS)

    Nariai, Tadashi; Ishiwata, Kiichi; Kimura, Yuichi; Inaji, Motoki; Momose, Toshiya; Yamamoto, Tetsuya; Matsumura, Akira; Ishii, Kenji; Ohno, Kikuo

    2009-01-01

    Introduction: To plan the optimal BNCT for patients with malignant cerebral glioma, estimation of the ratio of boron concentration in tumor tissue against that in the surrounding normal brain (T/N ratio of boron) is important. We report a positron emission tomography (PET) imaging method to estimate T/N ratio of tissue boron concentration based on pharmacokinetic analysis of amino acid probes. Methods: Twelve patients with cerebral malignant glioma underwent 60 min dynamic PET scanning of brain after bolus injection of 18 F-borono-phenyl-alanine (FBPA) with timed arterial blood sampling. Using kinetic parameter obtained by this scan, T/N ratio of boron concentration elicited by one-hour constant infusion of BPA, as performed in BNCT, was simulated on Runge-Kutta algorithm. 11 C-methionine (MET) PET scan, which is commonly used in worldwide PET center as brain tumor imaging tool, was also performed on the same day to compare the image characteristics of FBPA and that of MET. Result: PET glioma images obtained with FBPA and MET are almost identical in all patients by visual inspection. Estimated T/N ratio of tissue boron concentration after one-hour constant infusion of BPA, T/N ratio of FBPA on static condition, and T/N ratio of MET on static condition showed significant linear correlation between each other. Conclusion: T/N ratio of boron concentration that is obtained by constant infusion of BPA during BNCT can be estimated by FBPA PET scan. This ratio can also be estimated by MET-PET imaging. As MET-PET study is available in many clinical PET center, selection of candidates for BNCT may be possible by MET-PET images. Accurate planning of BNCT may be performed by static images of FBPA PET. Use of PET imaging with amino acid probes may contribute very much to establish an appropriate application of BNCT for patients with malignant glioma.

  5. Physical and biological dosimetry at the RA-3 facility for small animal irradiation: preliminary BNCT studies in an experimental model of oral cancer

    International Nuclear Information System (INIS)

    Pozzi, Emiliano; Miller, Marcelo; Thorp, Silvia I.; Heber, Elisa M.; Trivillin, Veronica A.; Zarza, Leandro; Estryk, Guillermo; Schwint, Amanda E.; Nigg, David W.

    2007-01-01

    Boron Neutron Capture Therapy (BNCT) is a binary treatment modality based on the capture reaction that occurs between thermal neutrons and boron-10 atoms that accumulate selectively in tumor tissue, emitting high linear energy transfer (LET), short range (5-9 microns) particles (alpha y 7 Li). Thus, BNCT would potentially target tumor tissue selectively, sparing normal tissue. Herein we evaluated the feasibility of treating experimental oral mucosa tumors with BNCT at RA-3 (CAE) employing the hamster cheek pouch oral cancer model and characterized the irradiation field at the RA-3 facility. We evaluated the therapeutic effect on tumor of BNCT mediated by BPA in the hamster cheek pouch oral cancer model and the potential radio toxic effects in normal tissue. We evidenced a moderate biological response in tumor, with no radio toxic effects in normal tissue following irradiations with no shielding for the animal body. Given the sub-optimal therapeutic response, we designed and built a 6 Li 2 CO 3 shielding for the body of the animal to increase the irradiation dose to tumor, without exceeding normal tissue radio tolerance. The measured absolute magnitude of thermal neutron flux and the characterization of the beam with and without the shielding in place, suggest that the irradiation facility in the thermal column of RA-3 would afford an excellent platform to perform BNCT studies in vitro and in vivo in small experimental animals. The present findings must be confirmed and extended by performing in vivo BNCT radiobiological studies in small experimental animals, employing the shielding device for the animal body. (author) [es

  6. Performance testing of the neutron flux monitors from 10keV to 1MeV developed for BNCT: A preliminary study.

    Science.gov (United States)

    Guan, Xingcai; Manabe, Masanobu; Tamaki, Shingo; Sato, Fuminobu; Murata, Isao; Wang, Tieshan

    2017-07-01

    The neutron flux monitors from 10keV to 1MeV designed for boron neutron capture therapy (BNCT) were experimentally tested with prototype monitors in an appropriate neutron field produced at the intense deuterium-tritium neutron source facility OKTAVIAN of Osaka University, Japan. The experimental test results and related analysis indicated that the performance of the monitors was good and the neutron fluxes from 10keV to 1MeV of practical BNCT neutron sources can be measured within 10% by the monitors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Proximal translation of > 1 mm within the first two years of revision total hip arthroplasty correctly predicts whether or not an acetabular component is loose in 80% of cases: a case-control study with confirmed intra-operative outcomes.

    Science.gov (United States)

    Kim, Y S; Abrahams, J M; Callary, S A; De Ieso, C; Costi, K; Howie, D W; Solomon, L B

    2017-04-01

    The purpose of this study was to determine the sensitivity, specificity and predictive values of previously reported thresholds of proximal translation and sagittal rotation of cementless acetabular components used for revision total hip arthroplasty (THA) at various times during early follow-up. Migration of cementless acetabular components was measured retrospectively in 84 patients (94 components) using Ein-Bild-Rontgen-Analyse (EBRA-Cup) in two groups of patients. In Group A, components were recorded as not being loose intra-operatively at re-revision THA (52 components/48 patients) and Group B components were recorded to be loose at re-revision (42 components/36 patients). The mean proximal translation and sagittal rotation were significantly higher in Group B than in Group A from three months onwards (p 1.0 mm within 24 months had a positive predictive value (PPV) of 90% and a specificity of 94%, but a sensitivity of 64%. Proximal translation > 1.0 mm within the first 24 months correctly identified 76 of 94 (81%) of components to be either loose or not loose. However, ten components in Group B (24%) did not migrate proximally above 1.0 mm within the first 60 months. The high PPV of EBRA-Cup measurements of proximal translation (90%) shows that this can be used in early follow-up to identify patients at risk of aseptic loosening. The absence of proximal translation within the first 60 months indicates a component is not likely to be loose at re-revision THA although it does not exclude late aseptic loosening as a cause of failure. Cite this article: Bone Joint J 2017;99-B:465-74. ©2017 The British Editorial Society of Bone & Joint Surgery.

  8. Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy.

    Science.gov (United States)

    Sarmento, Sandra; Costa, Filipa; Pereira, Alexandre; Lencart, Joana; Dias, Anabela; Cunha, Luís; Sousa, Olga; Silva, José Pedro; Santos, Lúcio

    2015-01-09

    Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT. CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber. Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR (192)Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT. The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR (192)Ir brachytherapy.

  9. Intracellular targeting of mercaptoundecahydrododecaborate (BSH) to malignant glioma by transferrin-PEG liposomes for boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Doi, Atsushi; Miyatake, Shin-ichi; Iida, Kyouko

    2006-01-01

    Malignant glioma is one of the most difficult tumor to control with usual therapies. In our institute, we select boron neutron capture therapy (BNCT) as an adjuvant radiation therapy after surgical resection. This therapy requires the selective delivery of high concentration of 10 B to malignant tumor tissue. In this study, we focused on a tumor-targeting 10 B delivery system (BDS) for BNCT that uses transferrin-conjugated polyethylene-glycol liposome encapsulating BSH (TF-PEG liposome-BSH) and compared 10 B uptake of the tumor among BSH, PEG liposome-BSH and TF-PEG liposome-BSH. In vitro, we analyzed 10 B concentration of the cultured human U87Δ glioma cells incubated in medium containing 20 μg 10 B/ml derived from each BDS by inductively coupled plasma atomic emission spectrometry (ICP-AES). In vivo, human U87Δ glioma-bearing nude mice were administered with each BDS (35mg 10 B/kg) intravenously. We analyzed 10 B concentration of tumor, normal brain and blood by ICP-AES. The TF-PEG liposome-BSH showed higher absolute concentration more than the other BDS. Moreover, TF-PEG liposome-BSH decreased 10 B concentration in blood and normal tissue while it maintained high 10 B concentration in tumor tissue for a couple of days. This showed the TF-PEG liposome-BSH caused the selective delivery of high concentration of 10 B to malignant tumor tissue. The TF-PEG liposome-BSH is more potent BDS for BNCT to obtain absolute high 10 B concentration and good contrast between tumor and normal tissue than BSH and PEG liposome-BSH. (author)

  10. A study of computational dosimetry and boron biodistribution for ex – situ lung BNCT at RA-3 Reactor

    International Nuclear Information System (INIS)

    Garabalino, M.A.; Trivillin, V. A.; Monti Hughes, A.; Pozzi, E.C.C.; Thorp, S.; Curotto, P; Miller, M.; Santa Cruz, G.A.; Saint Martin, G.; Schwint, A.E.; González, S.J.; Farías, R.O; Portu, A.; Ferraris, S.; Santa María, J.; Lange, F.; Bortolussi, S.; Altieri, S.

    2013-01-01

    Within the context of the preclinical ex-situ BNCT Project for the treatment of diffuse lung metastases, we performed boron biodistribution studies in a sheep model and computational dosimetry studies in human lung to evaluate the potential therapeutic efficacy of the proposed technique. Herein we report preliminary data that supports the use of the sheep model as an adequate human surrogate in terms of boron kinetics and uptake in clinically relevant tissues. Furthermore, the estimation of the potential therapeutic efficacy of the proposed treatment in humans, based on boron uptake values in the large animal model, yields promising tumor control probability values even in the most conservative scenario considered. (author)

  11. Mock-up experiment at Birmingham University for BNCT project of Osaka University--Neutron flux measurement with gold foil.

    Science.gov (United States)

    Tamaki, S; Sakai, M; Yoshihashi, S; Manabe, M; Zushi, N; Murata, I; Hoashi, E; Kato, I; Kuri, S; Oshiro, S; Nagasaki, M; Horiike, H

    2015-12-01

    Mock-up experiment for development of accelerator based neutron source for Osaka University BNCT project was carried out at Birmingham University, UK. In this paper, spatial distribution of neutron flux intensity was evaluated by foil activation method. Validity of the design code system was confirmed by comparing measured gold foil activities with calculations. As a result, it was found that the epi-thermal neutron beam was well collimated by our neutron moderator assembly. Also, the design accuracy was evaluated to have less than 20% error. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Functional and histological assessment of the radiobiology of normal rat lung in BNCT

    International Nuclear Information System (INIS)

    Kiger, J.L.; Riley, K.J.; Binns, P.J.; Harling, O.K.; Coderre, J.A.; Kiger, W.S. III; Patel, H.

    2006-01-01

    This study investigated the radiobiology and sensitivity of the normal rat lung to Boron Neutron Capture Therapy (BNCT) radiation. Rat thorax irradiations were carried out with x-rays or with neutrons in the presence or absence of p-boronophenylalanine (BPA). Lung damage were assessed functionally with breathing rate measurement up to 180 days after irradiation and then histologically. Breathing rates 20% (∼3 σ) above the control group (sham-irradiated rats) mean were considered as positive responses to lung radiation damage. Though most responding animals demonstrated radiation induced pneumonitis (≤110 days) as well as pulmonary fibrosis (>110 days), some animals receiving neutrons plus BPA showed only the latter. The breathing rate dose response data were fit using probit analysis. The ED 50 values measured for x-rays, neutron beam only, and neutrons plus BPA were 11.5±0.4 Gy, 9.2±0.5 Gy, and 6.7±0.4 Gy, respectively. The biological weighting factors for the neutron beam (n+γ), the thermal neutron dose component, and the 10 B dose component were determined to be 1.2±0.1, 2.2±0.4, and 2.3±0.3, respectively. The histological dose response curves were linear. Consistent with the functional assay, the weighting factors measured histologically were 1.2±0.1 for the thermal neutron beam and 1.9±0.2 for the 10 B dose component. (author)

  13. Biodistribution of a new boron compound for BNCT in an experimental model of oral cancer

    International Nuclear Information System (INIS)

    Kreimann, Erica L.; Itoiz, Maria E.; Schwint, Amanda E.; Miura, M.; Coderre, J.A.; Garavaglia, Ricardo; Batistoni, Daniel A.

    2000-01-01

    We have proposed and validated the HCP carcinogenesis model of oral cancer, a model that mimics spontaneous malignant transformation, for BNCT research in a separate study. We herein perform a biodistribution study of a lipophilic carborane-containing tetraphenylporphyrin, CuTCPH, in this model. This compound was previously tested in a model of mice bearing subcutaneously transplanted mammary carcinomas. In the present study CuTCPH was administered as a single i.p. injection at a dose of 32 μg/g b.w. (10 μg B/g b.w.) or as 4 i.p. injections over 2 days at a dose of 32 μg/g b.w. per injection. Blood (Bl) and tissue, i.e. tumor (T), precancerous tissue surrounding tumor (P), normal pouch (N), skin, tongue, cheek and palate mucosa, liver, spleen, parotid gland and brain were sampled 3, 6, 12, 24, 48 and 72 hs post-administration in the single dose protocol and 1-4 days after the last injection in the multidose protocol. Boron (B) analysis was performed by ICP-AES. The maximum ratio of B concentration for the single dose protocol was 32.7:1 for T:N and 31.8:1 for T:Bl. The B value in tumor reached a maximum of 43.8 ppm. However, the mean value of 16 ± 14.3 ppm fell short of therapeutically useful levels. The multidose protocol yielded maximum ratios of 53.33:1 for T:N and 3633.3:1 for T:Bl. The maximum absolute B value in tumor reached 106.40 ppm. The mean value in tumor 3 days post-administration was 68.02 ± 25.02. Absolute and relative maximum and average B values markedly exceeded the therapeutic threshold values. (author)

  14. Radiation field characterization of a BNCT research facility using Monte Carlo method - code MCNP-4B; Caracterizacao do campo de radiacao numa instalacao para pesquisa em BNCT utilizando o metodo de Monte Carlo - codigo MCNP-4B

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, Antonio Carlos

    2002-07-01

    Boron Neutron Capture Therapy - BNCT - is a selective cancer treatment and arises as an alternative therapy to treat cancer when usual techniques - surgery, chemotherapy or radiotherapy - show no satisfactory results. The main proposal of this work is to project a facility to BNCT studies. This facility relies on the use of an Am Be neutron source and on a set of moderators, filters and shielding which will provide the best neutron/gamma beam characteristic for these Becton studies, i.e., high intensity thermal and/or epithermal neutron fluxes and with the minimum feasible gamma rays and fast neutrons contaminants. A computational model of the experiment was used to obtain the radiation field in the sample irradiation position. The calculations have been performed with the MCNP 4B Monte Carlo Code and the results obtained can be regarded as satisfactory, i.e., a thermal neutron fluencyN{sub T} = 1,35x10{sup 8} n/cm , a fast neutron dose of 5,86x10{sup -10} Gy/N{sub T} and a gamma ray dose of 8,30x10{sup -14} Gy/N{sub T}. (author)

  15. Neutron intensity monitor with activation foil for p-Li neutron source for BNCT--Feasibility test of the concept.

    Science.gov (United States)

    Murata, Isao; Otani, Yuki; Sato, Fuminobu

    2015-12-01

    Proton-lithium (p-Li) reaction is being examined worldwide as a candidate nuclear production reaction for accelerator based neutron source (ABNS) for BNCT. In this reaction, the emitted neutron energy is not so high, below 1 MeV, and especially in backward angles the energy is as low as about 100 keV. The intensity measurement was thus known to be difficult so far. In the present study, a simple method was investigated to monitor the absolute neutron intensity of the p-Li neutron source by employing the foil activation method based on isomer production reactions in order to cover around several hundreds keV. As a result of numerical examination, it was found that (107)Ag, (115)In and (189)Os would be feasible. Their features found out are summarized as follows: (107)Ag: The most convenient foil, since the half life is short. (115)In: The accuracy is the best at 0°, though it cannot be used for backward angles. And (189)Os: Suitable nuclide which can be used in backward angles, though the gamma-ray energy is a little too low. These would be used for p-Li source monitoring depending on measuring purposes in real BNCT scenes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Meeting the challenge of homogenous boron targeting of heterogeneous tumors for effective boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Heber, Elisa M.; Trivillin, Veronica A.; Itoiz, Maria E.; Rebagliati, J. Raul; Batistoni, Daniel; Kreimann, Erica L.; Schwint, Amanda E.; Nigg, David W.; Gonzalez, Beatriz N.

    2006-01-01

    BNCT is a tumor cell targeted radiation therapy. Inadequately boron targeted tumor populations jeopardize tumor control. Meeting the to date unresolved challenge of homogeneous targeting of heterogeneous tumors with effective boron carriers would contribute to therapeutic efficacy. The aim of the present study was to evaluate the degree of variation in boron content delivered by boronophenylalanine (BPA), GB-10 (Na 2 10 B 10 H 10 ) and the combined administration of (BPA+GB-10) in different portions of tumor, precancerous tissue around tumor and normal pouch tissue in the hamster cheek pouch oral cancer model. Boron content was evaluated by ICP-AES. The degree of homogeneity in boron targeting was assessed in terms of the coefficient of variation ([S.D./Mean]x100) of boron values. Statistical analysis of the results was performed by one-way ANOVA and the least significant difference test. GB-10 and GB-10 plus BPA achieved respectively a statistically significant 1.8-fold and 3.3-fold increase in targeting homogeneity over BPA. The combined boron compound administration protocol contributes to homogeneous targeting of heterogeneous tumors and would increase therapeutic efficacy of BNCT by exposing all tumor populations to neutron capture reactions in boron. (author)

  17. Artificial neural networks to evaluate the boron concentration decreasing profile in Blood-BPA samples of BNCT patients

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Reiriz, Alejandro, E-mail: garciareiriz@gmail.com [Department of Analytical Chemistry, Faculty of Biochemical and Pharmaceutical Sciences, National University of Rosario, Rosario Institute of Chemistry (IQUIR-CONICET), Suipacha 531, Rosario S2002LRK (Argentina); Magallanes, Jorge [Comision Nacional de Energia Atomica, Av. Gral. Paz 1499, San Martin, B1650KNA, Buenos Aires (Argentina); Zupan, Jure [National Institute of Chemistry, Hajdrihova 19, SLO-1000 Ljubljana, Eslovenia (Slovenia); Liberman, Sara [Comision Nacional de Energia Atomica, Av. Gral. Paz 1499, San Martin, B1650KNA, Buenos Aires (Argentina)

    2011-12-15

    For the prediction of decay concentration profiles of the p-boronophenylalanine (BPA) in blood during BNCT treatment, a method is suggested based on Kohonen neural networks. The results of a model trained with the concentration profiles from the literature are described. The prediction of the model was validated by the leave-one-out method. Its robustness shows that it is mostly independent on small variations. The ability to fit retrospective experimental data shows an uncertainty lower than the two compartment model used previously. - Highlights: Black-Right-Pointing-Pointer We predicted decaying concentration profiles of BPA in blood during BNCT therapy. Black-Right-Pointing-Pointer Is suggested a method based on Kohonen neural networks. Black-Right-Pointing-Pointer The results show that it is very robust and mostly independent of small variations. Black-Right-Pointing-Pointer It has a better ability to fit retrospective experimental data. Black-Right-Pointing-Pointer The model could be progressively improved by adding new data to the training matrix.

  18. Stability of high-speed lithium sheet jets for the neutron source in Boron Neutron Capture Therapy (BNCT)

    International Nuclear Information System (INIS)

    Nakagawa, Masamichi; Takahashi, Minoru; Aritomi, Masanori; Kobayashi, Toru

    2014-01-01

    The stability of high-speed liquid lithium sheet jets was analytically studied for the neutron source in Boron Neutron Capture Therapy (BNCT), which makes cancers and tumors curable with cell-level selections and hence high QOL. The object of our research is to realize the thin and high-speed plane sheet jets of liquid lithium in a high-vacuum as an accelerator target. Linear analysis approach is made to the stability on thin plane sheet jets of liquid lithium in a high-vacuum, and then our analytical results were compared with the previous experimental ones. We proved that the waves of surface tension on thin lithium sheet jets in a high-vacuum are of supercritical flows and neutral stable under about 17.4 m/s in flow velocity and that the fast non-dispersive anti-symmetric waves are more significant than the very slow dispersive symmetric waves. We also formulated the equation of shrinking angle in isosceles-triangularly or isosceles-trapezoidal shrinking sheet jets corresponding to the Mach angle of supersonic gas flows. This formula states universally the physical meaning of Weber number of sheet jets on the wave of surface tension in supercritical flows. We obtained satisfactory prospects (making choice of larger flow velocity U and larger thickness of sheet a) to materialize a liquid target of accelerator in BNCT. (author)

  19. An accelerator-based Boron Neutron Capture Therapy (BNCT) facility based on the 7Li(p,n)7Be

    Science.gov (United States)

    Musacchio González, Elizabeth; Martín Hernández, Guido

    2017-09-01

    BNCT (Boron Neutron Capture Therapy) is a therapeutic modality used to irradiate tumors cells previously loaded with the stable isotope 10B, with thermal or epithermal neutrons. This technique is capable of delivering a high dose to the tumor cells while the healthy surrounding tissue receive a much lower dose depending on the 10B biodistribution. In this study, therapeutic gain and tumor dose per target power, as parameters to evaluate the treatment quality, were calculated. The common neutron-producing reaction 7Li(p,n)7Be for accelerator-based BNCT, having a reaction threshold of 1880.4 keV, was considered as the primary source of neutrons. Energies near the reaction threshold for deep-seated brain tumors were employed. These calculations were performed with the Monte Carlo N-Particle (MCNP) code. A simple but effective beam shaping assembly (BSA) was calculated producing a high therapeutic gain compared to previously proposed facilities with the same nuclear reaction.

  20. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Directory of Open Access Journals (Sweden)

    Samia de Freitas Brandao

    2013-07-01

    Full Text Available Objective Comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and Methods Simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results Intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h-1.p-1.s, respectively, on the healthy tissue, on the balloon periphery and on the I 1 and I 2 tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h-1.p-1.s, respectively on the healthy tissue, on the target tumor and on the I 1 and I 2 infiltration zones. Conclusion Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones.

  1. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Samia de Freitas, E-mail: samiabrandao@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Campos, Tarcisio Passos Ribeiro de [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2013-06-15

    Objective: comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and methods: simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results: intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively, on the healthy tissue, on the balloon periphery and on the /{sub 1} and /{sub 2} tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively on the healthy tissue, on the target tumor and on the /{sub 1} and /{sub 2} infiltration zones. Conclusion: Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones. (author)

  2. Rhodium self-powered neutron detector as a suitable on-line thermal neutron flux monitor in BNCT treatments

    International Nuclear Information System (INIS)

    Miller, Marcelo E.; Sztejnberg, Manuel L.; Gonzalez, Sara J.; Thorp, Silvia I.; Longhino, Juan M.; Estryk, Guillermo

    2011-01-01

    Purpose: A rhodium self-powered neutron detector (Rh SPND) has been specifically developed by the Comision Nacional de Energia Atomica (CNEA) of Argentina to measure locally and in real time thermal neutron fluxes in patients treated with boron neutron capture therapy (BNCT). In this work, the thermal and epithermal neutron response of the Rh SPND was evaluated by studying the detector response to two different reactor spectra. In addition, during clinical trials of the BNCT Project of the CNEA, on-line neutron flux measurements using the specially designed detector were assessed. Methods: The first calibration of the detector was done with the well-thermalized neutron spectrum of the CNEA RA-3 reactor thermal column. For this purpose, the reactor spectrum was approximated by a Maxwell-Boltzmann distribution in the thermal energy range. The second calibration was done at different positions along the central axis of a water-filled cylindrical phantom, placed in the mixed thermal-epithermal neutron beam of CNEA RA-6 reactor. In this latter case, the RA-6 neutron spectrum had been well characterized by both calculation and measurement, and it presented some marked differences with the ideal spectrum considered for SPND calibrations at RA-3. In addition, the RA-6 neutron spectrum varied with depth in the water phantom and thus the percentage of the epithermal contribution to the total neutron flux changed at each measurement location. Local (one point-position) and global (several points-positions) and thermal and mixed-field thermal neutron sensitivities were determined from these measurements. Thermal neutron flux was also measured during BNCT clinical trials within the irradiation fields incident on the patients. In order to achieve this, the detector was placed on patient's skin at dosimetric reference points for each one of the fields. System stability was adequate for this kind of measurement. Results: Local mixed-field thermal neutron sensitivities and global

  3. Biodistribution study with combined administration of BPA and BSH for BNCT in the hamster cheek pouch oral cancer model

    International Nuclear Information System (INIS)

    Garabalino, M A; Heber, E M; Monti Hughes, A; Pzzi, E C C; Molinari, A J; Niggg, D W; Bauer, W; Trivillin, V A; Schwint, A E

    2012-01-01

    We previously proved the therapeutic potential of the chemically non-selective boron compound decahydrodecaborate (GB-10) as a stand-alone boron carrier for BNCT in the hamster cheek pouch oral cancer model with no toxic effects in normal or precancerous tissue. Although GB-10 is not taken up selectively by oral tumor tissue, selective tumor lethality would result from selective aberrant tumor blood vessel damage. Furthermore, BNCT efficacy was enhanced when GB-10 and boronophenylalanine (BPA) were administered jointly. The fact that sodium mercaptoundecahydro-closo-dodecaborate (BSH) is being investigated clinically as a stand-alone boron agent for BNCT of brain tumors and in combination with BPA for recurrent head and neck malignancies makes it a particularly interesting boron compound to explore. Based on the working hypothesis that BSH would conceivably behave similarly to GB-10 in oral cancer, we previously performed biodistribution studies with BSH alone in the hamster cheek pouch oral cancer model. The aim of the present study was to perform biodistribution studies of BSH + BPA administered jointly in the hamster cheek pouch oral cancer model as a starting point to contribute to the knowledge of (BSH+BPA)-BNCT radiobiology and optimize therapeutic efficacy. The right cheek pouch of Syrian hamsters was subjected to topical administration of a carcinogen twice a week for 12 weeks. Once the exophytic tumors, i.e. squamous cell carcinomas, had developed, the animals were used for biodistribution studies with BSH + BPA. Three administration protocols with different proportions of each of the compounds were assessed: 1. BSH, 50 mg 10 B/kg, iv + BPA, 15.5 mg 10 B/kg, ip; 2. BSH, 34.5 mg 10 B/kg, iv + BPA, 31 mg 10 B/kg, ip; 3. BSH, 20 mg 10 B/kg, iv + BPA, 46.5 mg 10 B/kg, ip. Groups of animals were euthanized 4 h after the administration of BSH and 3 h after the administration of BPA. Samples of blood, tumor, precancerous and normal pouch and other tissues with

  4. Rhodium self-powered neutron detector as a suitable on-line thermal neutron flux monitor in BNCT treatments.

    Science.gov (United States)

    Miller, Marcelo E; Sztejnberg, Manuel L; González, Sara J; Thorp, Silvia I; Longhino, Juan M; Estryk, Guillermo

    2011-12-01

    A rhodium self-powered neutron detector (Rh SPND) has been specifically developed by the Comisión Nacional de Energía Atómica (CNEA) of Argentina to measure locally and in real time thermal neutron fluxes in patients treated with boron neutron capture therapy (BNCT). In this work, the thermal and epithermal neutron response of the Rh SPND was evaluated by studying the detector response to two different reactor spectra. In addition, during clinical trials of the BNCT Project of the CNEA, on-line neutron flux measurements using the specially designed detector were assessed. The first calibration of the detector was done with the well-thermalized neutron spectrum of the CNEA RA-3 reactor thermal column. For this purpose, the reactor spectrum was approximated by a Maxwell-Boltzmann distribution in the thermal energy range. The second calibration was done at different positions along the central axis of a water-filled cylindrical phantom, placed in the mixed thermal-epithermal neutron beam of CNEA RA-6 reactor. In this latter case, the RA-6 neutron spectrum had been well characterized by both calculation and measurement, and it presented some marked differences with the ideal spectrum considered for SPND calibrations at RA-3. In addition, the RA-6 neutron spectrum varied with depth in the water phantom and thus the percentage of the epithermal contribution to the total neutron flux changed at each measurement location. Local (one point-position) and global (several points-positions) and thermal and mixed-field thermal neutron sensitivities were determined from these measurements. Thermal neutron flux was also measured during BNCT clinical trials within the irradiation fields incident on the patients. In order to achieve this, the detector was placed on patient's skin at dosimetric reference points for each one of the fields. System stability was adequate for this kind of measurement. Local mixed-field thermal neutron sensitivities and global thermal and mixed

  5. First evaluation of the biologic effectiveness factors of boron neutron capture therapy (BNCT) in a human colon carcinoma cell line.

    Science.gov (United States)

    Dagrosa, Maria Alejandra; Crivello, Martín; Perona, Marina; Thorp, Silvia; Santa Cruz, Gustavo Alberto; Pozzi, Emiliano; Casal, Mariana; Thomasz, Lisa; Cabrini, Romulo; Kahl, Steven; Juvenal, Guillermo Juan; Pisarev, Mario Alberto

    2011-01-01

    DNA lesions produced by boron neutron capture therapy (BNCT) and those produced by gamma radiation in a colon carcinoma cell line were analyzed. We have also derived the relative biologic effectiveness factor (RBE) of the neutron beam of the RA-3- Argentine nuclear reactor, and the compound biologic effectiveness (CBE) values for p-boronophenylalanine ((10)BPA) and for 2,4-bis (α,β-dihydroxyethyl)-deutero-porphyrin IX ((10)BOPP). Exponentially growing human colon carcinoma cells (ARO81-1) were distributed into the following groups: (1) BPA (10 ppm (10)B) + neutrons, (2) BOPP (10 ppm (10)B) + neutrons, (3) neutrons alone, and (4) gamma rays ((60)Co source at 1 Gy/min dose-rate). Different irradiation times were used to obtain total absorbed doses between 0.3 and 5 Gy (±10%) (thermal neutrons flux = 7.5 10(9) n/cm(2) sec). The frequency of micronucleated binucleated cells and the number of micronuclei per micronucleated binucleated cells showed a dose-dependent increase until approximately 2 Gy. The response to gamma rays was significantly lower than the response to the other treatments (p irradiations with neutrons alone and neutrons + BOPP showed curves that did not differ significantly from, and showed less DNA damage than, irradiation with neutrons + BPA. A decrease in the surviving fraction measured by 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazolium bromide (MTT) assay as a function of the absorbed dose was observed for all the treatments. The RBE and CBE factors calculated from cytokinesis block micronucleus (CBMN) and MTT assays were, respectively, the following: beam RBE: 4.4 ± 1.1 and 2.4 ± 0.6; CBE for BOPP: 8.0 ± 2.2 and 2.0 ± 1; CBE for BPA: 19.6 ± 3.7 and 3.5 ± 1.3. BNCT and gamma irradiations showed different genotoxic patterns. To our knowledge, these values represent the first experimental ones obtained for the RA-3 in a biologic model and could be useful for future experimental studies for the application of BNCT to colon carcinoma

  6. BNCT of intracerebral melanoma. Enhanced survival and cure following Cereport mediated opening of the blood-brain barrier

    International Nuclear Information System (INIS)

    Barth, R.F.; Yang, W.; Bartus, R.T.; Rotaru, J.H.; Ferketich, A.K.; Moeschberger, M.L.; Nawrocky, M.M.; Coderre, J.A.

    2000-01-01

    Cereport is a bradykinin analogue that produces a transient, pharmacologically mediated opening of the blood-brain barrier (BBB). The present study was designed to determine if Cereport could enhance the delivery of BPA and the efficacy of BNCT in nude rats bearing intracerebral implants of the human MRA 27 melanoma. Animals that received intracarotid (i.c.) injection of Cereport and i.c. BPA had a mean survival time of 115 d compared to 82 d without Cereport, 42 d for i.v. BPA with Cereport and 31 d for irradiated controls. The combination of i.c. Cereport and BPA produced a 400% increase in the life span with 35% long-term survivors (>180 d). (author)

  7. Exploring new labelling strategies for boronated compounds: towards fast development and efficient assessment of BNCT drug candidates

    OpenAIRE

    Gona, Kiran Babu

    2016-01-01

    208 p. La terapia por captura de neutrones (BNCT o Boron Neutron Capture Therapy), fue descrita por primera vez por Locher en 1936 y es una modalidad terapéutica binaria para el tratamiento del cáncer que se basa en la captura de neutrones térmicos por medio de átomos de 10B, previamente acumulados en las células tumorales. La captura del neutrón térmico resulta en la formación de un núcleo de 11B, que fisiona para generar dos iones altamente energéticos: 4He2+ y 7Li3+. El daño y la poster...

  8. Depth-dose evaluation for lung and pancreas cancer treatment by BNCT using an epithermal neutron beam

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Tetsuo; Fukushima, Yuji [Musashi Institute of Technology, Atomic Energy Research Laboratory, Kawasaki, Kanagawa (Japan)

    2000-10-01

    The depth-dose distributions were evaluated for possible treatment of both lung and pancreas cancers using an epithermal neutron beam. The MCNP calculations showed that physical dose in tumors were 6 and 7 Gy/h, respectively, for lung and pancreas, attaining an epithermal neutron flux of 5x10{sup 8} ncm{sup -2}s{sup -1}. The boron concentrations were assumed at 100 ppm and 30 ppm, respectively, for lung and pancreas tumors and normal tissues contains 1/10 tumor concentrations. The dose ratios of tumor to normal tissue were 2.5 and 2.4, respectively, for lung and pancreas. The dose evaluation suggests that BNCT could be applied for both lung and pancreas cancer treatment. (author)

  9. Development of cancer therapy facility of HANARO and medical research in BNCT; development of the technique for boron concentration analysis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hee Dong; Byun, Soo Hyun; Sun, Gwang Min; Kim, Suk Kwon; Kim, In Jung; Park, Chang Su [Seoul National University, Seoul (Korea)

    2002-03-01

    Objective and Necessity of the Project- Development of a boron concentration analysis facility used for BNCT. - Development of the technique for boron concentration analysis. Contents and Scopes of the Project - Construction of the boron concentration analysis facility based on PGAA. Estimation of the neutron beam characteristics. -Establishment of the technique for the boron concentration analysis. - Estimation of the reliability for the boron analysis. Results of the Project -Installation of the boron concentration analysis facility at Hanaro. - Neutron beam characteristics are the sample position (neutron flux : 7.9 x 10{sup 7} n/cm{sup 2}s, Cd-ratio : 266) Technique for the boron concentration analysis. - Boron detection sensitivity and limit (detection sensitivity : 2, 131 cps/mg-B, detection limit : 67 ng for 10,000 sec). 63 refs., 37 figs., 13 tabs. (Author)

  10. A sensitivity study on neutron flux variation due to 10B concentration in dose calculation for BNCT

    International Nuclear Information System (INIS)

    Jung, Sang Hoon

    2006-02-01

    The effects of inclusion of 10 B concentration on neutron flux and dose in dose calculation were studied. In order to provide the quantitative effects of inclusion of 10 B concentrations on depressions of neutron and photon flux and dose, the fluxes and doses with voxel head phantoms for various 10 B concentrations homogeneously distributed were calculated by using MCNPX simulations. A lithium target system and beam shaping assembly, which have been developed at the Hanyang University, were used as epithermal neutron beam. The calculation results show that the neutron flux at the center of the head phantom decreases by approximately 5.4% per 10 ppm of 10 B concentration in comparison with the neutron flux in the case of boron-free. It was also observed that the tissue dose at the center of the head phantom is depressed by approximately 4.7% per 10 ppm of the 10 B concentration and the tumor dose by approximately 5.3% per 10 ppm. According to depth of tumors, it was observed that the depressions of the doses in the tumors are ranged in 3.7 ∼ 9.2%. The dose calculations in the case of boron-free show that it is overestimated in comparison with the dose calculations in the cases of the inclusion of 10 B concentrations for the normal tissue and the tumors. Therefore, in dose calculation for BNCT, the depressions of neutron flux and dose should be considered. The results in this study are available to setting up the depression ratios which can be used for converting neutron and gamma fluxes and doses in phantom with boron free into the fluxes and doses in phantom with inclusion of 10 B concentrations in treatment. It is expected that the depression ratios is practicable to dose evaluation for BNCT

  11. Investigating a multi-purpose target for electron linac based photoneutron sources for BNCT of deep-seated tumors

    International Nuclear Information System (INIS)

    Masoudi, S. Farhad; Rasouli, Fatemeh S.

    2015-01-01

    Recent studies in BNCT have focused on investigating appropriate neutron sources as alternatives for nuclear reactors. As the most prominent facilities, the electron linac based photoneutron sources benefit from two consecutive reactions, (e, γ) and (γ, n). The photoneutron sources designed so far are composed of bipartite targets which involve practical problems and are far from the objective of achieving an optimized neutron source. This simulation study deals with designing a compact, optimized, and geometrically simple target for a photoneutron source based on an electron linac. Based on a set of MCNPX simulations, tungsten is found to have the potential of utilizing as both photon converter and photoneutron target. Besides, it is shown that an optimized dimension for such a target slows-down the produced neutrons toward the desired energy range while keeping them economy, which makes achieving the recommended criteria for BNCT of deep-tumors more available. This multi-purpose target does not involve complicated designing, and can be considered as a significant step toward finding application of photoneutron sources for in-hospital treatments. In order to shape the neutron beam emitted from such a target, the beam is planned to pass through an optimized arrangement of materials composed of moderators, filters, reflector, and collimator. By assessment with the recommended in-air parameters, it is shown that the designed beam provides high intensity of desired neutrons, as well as low background contamination. The last section of this study is devoted to investigate the performance of the resultant beam in deep tissue. A typical simulated liver tumor, located within a phantom of human body, was subjected to the irradiation of the designed spectrum. The dosimetric results, including evaluated depth-dose curves and carried out in-phantom parameters show that the proposed configuration establishes acceptable agreement between the appropriate neutron intensity, and

  12. Measurement of the 33S(n,α) cross-section at n_TOF(CERN): Applications to BNCT

    Science.gov (United States)

    Sabaté-Gilarte, Marta; Praena, Javier; Porras, Ignacio; Quesada, José Manuel; Mastinu, Pierfrancesco

    2016-01-01

    Aim The main purpose of this work is to present a new (n,α) cross-section measurement for a stable isotope of sulfur, 33S, in order to solve existing discrepancies. Background 33S has been studied as a cooperating target for Boron Neutron Capture Therapy (BNCT) because of its large (n,α) cross-section in the epithermal neutron energy range, the most suitable one for BNCT. Although the most important evaluated databases, such as ENDF, do not show any resonances in the cross-section, experimental measurements which provided data from 10 keV to 1 MeV showed that the lowest-lying and strongest resonance of 33S(n,α) cross-section occurs at 13.5 keV. Nevertheless, the set of resonance parameters that describe such resonance shows important discrepancies (more than a factor of 2) between them. Materials and methods A new measurement of the 33S(n,α)30Si reaction cross-section was proposed to the ISOLDE and Neutron Time-of-Flight Experiments Committee of CERN. It was performed at n_TOF(CERN) in 2012 using MicroMegas detectors. Results In this work, we will present a brief overview of the experiment as well as preliminary results of the data analysis in the neutron energy range from thermal to 100 keV. These results will be taken into account to calculate the kerma-fluence factors corresponding to 33S in addition to 10B and those of a standard four-component ICRU tissue. Conclusions MCNP simulations of the deposited dose, including our experimental data, shows an important kerma rate enhancement at the surface of the tissue, mainly due to the presence of 33S. PMID:26933393

  13. Measurement of the (33)S(n,α) cross-section at n_TOF(CERN): Applications to BNCT.

    Science.gov (United States)

    Sabaté-Gilarte, Marta; Praena, Javier; Porras, Ignacio; Quesada, José Manuel; Mastinu, Pierfrancesco

    2016-01-01

    The main purpose of this work is to present a new (n,α) cross-section measurement for a stable isotope of sulfur, (33)S, in order to solve existing discrepancies. (33)S has been studied as a cooperating target for Boron Neutron Capture Therapy (BNCT) because of its large (n,α) cross-section in the epithermal neutron energy range, the most suitable one for BNCT. Although the most important evaluated databases, such as ENDF, do not show any resonances in the cross-section, experimental measurements which provided data from 10 keV to 1 MeV showed that the lowest-lying and strongest resonance of (33)S(n,α) cross-section occurs at 13.5 keV. Nevertheless, the set of resonance parameters that describe such resonance shows important discrepancies (more than a factor of 2) between them. A new measurement of the (33)S(n,α)(30)Si reaction cross-section was proposed to the ISOLDE and Neutron Time-of-Flight Experiments Committee of CERN. It was performed at n_TOF(CERN) in 2012 using MicroMegas detectors. In this work, we will present a brief overview of the experiment as well as preliminary results of the data analysis in the neutron energy range from thermal to 100 keV. These results will be taken into account to calculate the kerma-fluence factors corresponding to (33)S in addition to (10)B and those of a standard four-component ICRU tissue. MCNP simulations of the deposited dose, including our experimental data, shows an important kerma rate enhancement at the surface of the tissue, mainly due to the presence of (33)S.

  14. Studies for the application of Boron neutron capture therapy (BNCT) to the treatment of differentiated thyroid cancer (CDT)

    International Nuclear Information System (INIS)

    Carpano, Marina; Thomasz, Lisa; Perona, Marina; Juvenal, Guillermo J.; Pisarev, Mario; Dagrosa, Maria A.; Nievas, Susana I.; Pozzi, Emiliano; Thorp, Silvia

    2009-01-01

    Boron neutron capture therapy (BNCT) is a high linear energy transfer (LET) radiotherapy for cancer, which it is based on the nuclear reaction that occurs when boron-10 that it is a non radioactive isotope of the natural elemental boron, is irradiated with low energy thermal neutrons to produce an alpha particle and a nucleus of lithium-7. Both particles have a range smaller than the diameter of a cell causing cell tumor death without significant damage to the surrounding normal tissues. In previous studies we have shown that BNCT can be a possibility for the treatment of undifferentiated thyroid cancer (UTC). However, more than 80 % of patients with thyroid neoplasm present differentiated carcinoma (CDT). These carcinomas are treated by surgery followed by therapy with 131 I and mostly these forms are well controlled. But in some patients recurrence of the tumor is observed. BNCT can be an alternative for these patients in who the tumor lost the capacity to concentrate iodide. The aim of these studies was to evaluate the possibility of treating differentiated thyroid cancer by BNCT. Materials and Methods: The human cell lines of follicular (WRO) and papillary carcinomas (TPC-1) were grown in RPMI and modified DMEM medium respectively. Both supplemented with 10 % of SFB. The cell line of thyroid rat, FRTL-5, used as control normal, was cultured in DMEM/F12. The uptakes of 125 I and p-borophenylalanine BPA (6.93mM) were studied. The intracellular boron concentration was measured by inductively coupled plasma optical emission spectroscopy (ICP-OES) at 2 hr post incubation. The NIH strain of male nude mice, aged 6 to 8 weeks and weighing 20 to 25 g were implanted (s.c) in the back right flank with different concentrations of tumor cells. The size of the tumors was measured with a caliper twice or three times a week and the volume was calculated according the following formulae: A 2 x B/2 (were A is the width and B is the length). To evaluate the BPA uptake, animals

  15. A micro-PET/CT approach using O-(2-[{sup 18}F]fluoroethyl)-L-tyrosine in an experimental animal model of F98 glioma for BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Menichetti, L., E-mail: luca.menichetti@ifc.cnr.it [CNR Institute of Clinical Physiology, Pisa (Italy); Petroni, D.; Panetta, D. [CNR Institute of Clinical Physiology, Pisa (Italy); Burchielli, S. [Fondazione CNR/Regione Toscana G. Monasterio, Pisa (Italy); Bortolussi, Silva [Dept. Theoretical and Nuclear Physics, University of Pavia, Pavia (Italy); Matteucci, M. [Scuola Superiore Sant' Anna, Pisa (Italy); Pascali, G.; Del Turco, S. [CNR Institute of Clinical Physiology, Pisa (Italy); Del Guerra, A. [Department of Physics, University of Pisa, Pisa (Italy); Altieri, S. [Dept. Theoretical and Nuclear Physics, University of Pavia, Pavia (Italy); Salvadori, P.A. [CNR Institute of Clinical Physiology, Pisa (Italy)

    2011-12-15

    The present study focuses on a micro-PET/CT application to be used for experimental Boron Neutron Capture Therapy (BNCT), which integrates, in the same frame, micro-CT derived anatomy and PET radiotracer distribution. Preliminary results have demonstrated that {sup 18}F-fluoroethyl-tyrosine (FET)/PET allows the identification of the extent of cerebral lesions in F98 tumor bearing rat. Neutron autoradiography and {alpha}-spectrometry on axial tissues slices confirmed the tumor localization and extraction, after the administration of fructose-boronophenylalanine (BPA). Therefore, FET-PET approach can be used to assess the transport, the net influx, and the accumulation of FET, as an aromatic amino acid analog of BPA, in experimental animal model. Coregistered micro-CT images allowed the accurate morphological localization of the radiotracer distribution and its potential use for experimental BNCT.

  16. Selective enhancement of boron accumulation with boron-entrapped water-in-oil-water emulsion in VX-2 rabbit hepatic cancer model for BNCT

    International Nuclear Information System (INIS)

    Yanagie, Hironobu; Higashi, Shushi; Ikushima, Ichiro

    2006-01-01

    Tumor cell destruction in boron neutron-capture therapy (BNCT) is due to the nuclear reaction between 10 B and thermal neutrons. It is necessary for effective BNCT therapy to accumulate 10 B atoms in the tumor cells without affecting adjacent healthy cells. Water-in-oil-water (WOW) emulsion was used as the carrier of anti-cancer agents on arterial injections in clinical cancer treatment. In this study, we prepared 10 BSH entrapped WOW emulsion for selective arterial infusion for the treatment of hepatocellular carcinoma. WOW emulsion was administrated by arterial injections via proper hepatic artery. The anti-tumor activity of the emulsion was compared with 10 BSH-Lipiodol mix emulsion or 10 BSH solutions on VX-2 rabbit hepatic tumor models. The 10 B concentrations in VX-2 tumor on delivery with WOW emulsion was superior to those by conventional lipiodol mix emulsion. Electro-microscopic figures of WOW emulsion delineated the accumulation of fat droplets of WOW emulsion in the tumor site, but there was no accumulation of fat droplets in lipiodol emulsion. These results indicate that 10 B entrapped WOW emulsion is most useful carrier for arterial delivery of boron agents on BNCT to cancer. (author)

  17. Boron delivery with liposomes for boron neutron capture therapy (BNCT): biodistribution studies in an experimental model of oral cancer demonstrating therapeutic potential

    International Nuclear Information System (INIS)

    Nigg, David W.

    2012-01-01

    Boron neutron capture therapy (BNCT) combines selective accumulation of 10B carriers in tumor tissue with subsequent neutron irradiation. We previously demonstrated the therapeutic efficacy of BNCT in the hamster cheek pouch oral cancer model. Optimization of BNCT depends largely on improving boron targeting to tumor cells. Seeking to maximize the potential of BNCT for the treatment for head and neck cancer, the aim of the present study was to perform boron biodistribution studies in the oral cancer model employing two different liposome formulations that were previously tested for a different pathology, i.e., in experimental mammary carcinoma in BALB/c mice: (1) MAC: liposomes incorporating K(nido-7-CH3(CH2)15-7,8-C2B9H11) in the bilayer membrane and encapsulating a hypertonic buffer, administered intravenously at 6 mg B per kg body weight, and (2) MAC-TAC: liposomes incorporating K(nido-7-CH3(CH2)15-7,8-C2B9H11) in the bilayer membrane and encapsulating a concentrated aqueous solution of the hydrophilic species Na3 (ae-B20H17NH3), administered intravenously at 18 mg B per kg body weight. Samples of tumor, precancerous and normal pouch tissue, spleen, liver, kidney, and blood were taken at different times post-administration and processed to measure boron content by inductively coupled plasma mass spectrometry. No ostensible clinical toxic effects were observed with the selected formulations. Both MAC and MAC-TAC delivered boron selectively to tumor tissue. Absolute tumor values for MAC-TAC peaked to 66.6 ± 16.1 ppm at 48 h and to 43.9 ± 17.6 ppm at 54 h with very favorable ratios of tumor boron relative to precancerous and normal tissue, making these protocols particularly worthy of radiobiological assessment. Boron concentration values obtained would result in therapeutic BNCT doses in tumor without exceeding radiotolerance in precancerous/normal tissue at the thermal neutron facility at RA-3.

  18. Boron delivery with liposomes for boron neutron capture therapy (BNCT): biodistribution studies in an experimental model of oral cancer demonstrating therapeutic potential

    Energy Technology Data Exchange (ETDEWEB)

    David W. Nigg

    2012-05-01

    Boron neutron capture therapy (BNCT) combines selective accumulation of 10B carriers in tumor tissue with subsequent neutron irradiation. We previously demonstrated the therapeutic efficacy of BNCT in the hamster cheek pouch oral cancer model. Optimization of BNCT depends largely on improving boron targeting to tumor cells. Seeking to maximize the potential of BNCT for the treatment for head and neck cancer, the aim of the present study was to perform boron biodistribution studies in the oral cancer model employing two different liposome formulations that were previously tested for a different pathology, i.e., in experimental mammary carcinoma in BALB/c mice: (1) MAC: liposomes incorporating K[nido-7-CH3(CH2)15-7,8-C2B9H11] in the bilayer membrane and encapsulating a hypertonic buffer, administered intravenously at 6 mg B per kg body weight, and (2) MAC-TAC: liposomes incorporating K[nido-7-CH3(CH2)15-7,8-C2B9H11] in the bilayer membrane and encapsulating a concentrated aqueous solution of the hydrophilic species Na3 [ae-B20H17NH3], administered intravenously at 18 mg B per kg body weight. Samples of tumor, precancerous and normal pouch tissue, spleen, liver, kidney, and blood were taken at different times post-administration and processed to measure boron content by inductively coupled plasma mass spectrometry. No ostensible clinical toxic effects were observed with the selected formulations. Both MAC and MAC-TAC delivered boron selectively to tumor tissue. Absolute tumor values for MAC-TAC peaked to 66.6 {+-} 16.1 ppm at 48 h and to 43.9 {+-} 17.6 ppm at 54 h with very favorable ratios of tumor boron relative to precancerous and normal tissue, making these protocols particularly worthy of radiobiological assessment. Boron concentration values obtained would result in therapeutic BNCT doses in tumor without exceeding radiotolerance in precancerous/normal tissue at the thermal neutron facility at RA-3.

  19. SU-E-J-100: Reconstruction of Prompt Gamma Ray Three Dimensional SPECT Image From Boron Neutron Capture Therapy(BNCT)

    International Nuclear Information System (INIS)

    Yoon, D; Jung, J; Suh, T

    2014-01-01

    Purpose: Purpose of paper is to confirm the feasibility of acquisition of three dimensional single photon emission computed tomography (SPECT) image from boron neutron capture therapy (BNCT) using Monte Carlo simulation. Methods: In case of simulation, the pixelated SPECT detector, collimator and phantom were simulated using Monte Carlo n particle extended (MCNPX) simulation tool. A thermal neutron source (<1 eV) was used to react with the boron uptake region (BUR) in the phantom. Each geometry had a spherical pattern, and three different BURs (A, B and C region, density: 2.08 g/cm3) were located in the middle of the brain phantom. The data from 128 projections for each sorting process were used to achieve image reconstruction. The ordered subset expectation maximization (OSEM) reconstruction algorithm was used to obtain a tomographic image with eight subsets and five iterations. The receiver operating characteristic (ROC) curve analysis was used to evaluate the geometric accuracy of reconstructed image. Results: The OSEM image was compared with the original phantom pattern image. The area under the curve (AUC) was calculated as the gross area under each ROC curve. The three calculated AUC values were 0.738 (A region), 0.623 (B region), and 0.817 (C region). The differences between length of centers of two boron regions and distance of maximum count points were 0.3 cm, 1.6 cm and 1.4 cm. Conclusion: The possibility of extracting a 3D BNCT SPECT image was confirmed using the Monte Carlo simulation and OSEM algorithm. The prospects for obtaining an actual BNCT SPECT image were estimated from the quality of the simulated image and the simulation conditions. When multiple tumor region should be treated using the BNCT, a reasonable model to determine how many useful images can be obtained from the SPECT could be provided to the BNCT facilities. This research was supported by the Leading Foreign Research Institute Recruitment Program through the National Research

  20. BNCT enhanced fast neutron therapy: in vitro studies for preparing a clinical trial at the Essen cyclotron

    International Nuclear Information System (INIS)

    Wittig, A.; Sauerwein, W.; Hideghety, K.; Poeller, F.; Pignol, J.P.; Mueller, W.

    2000-01-01

    At the University Hospital Essen a cyclotron producing d(14)+Be fast neutrons is used routinely for patient treatment. Fast neutrons have demonstrated their potential to sterilize glioblastoma but could not show a clinical benefit because of lethal damages to healthy brain. At depth, fast neutrons are thermalized allowing neutron capture reactions, which can be used to enhance the applied dose. A selective increase of the dose to the tumor cells by BNCT may offer a chance to an effective treatment. In order to prepare a clinical trial in vitro experiments were performed. MeWo cells were irradiated in a tissue equivalent phantom at a depth of 6.5 cm. 91% 10 B enriched BSH was used to generate BNC effects. For a total dose of 1 Gy the thermal fluence rate was 3.4x10 10 cm -2 . An amount of 960 ppm 10 B present in the cell medium during irradiation led to a reduction of the cell survival from 3.6% (neutron alone) to 0.2%. If the irradiation was performed after incubation of the cells in BSH, but in a medium without BSH the survival was 1.6%. The in vitro set up demonstrates the capacity of BSH to considerably increase the biological effects of the neutron irradiation and add arguments for the opening of a clinical trial. (author)

  1. Tumor control and normal tissue complications in BNCT treatment of nodular melanoma: A search for predictive quantities

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, S.J. [Comision Nacional de Energia Atomica, Av. del Libertador 8250, (1429) Cdad. de Buenos Aires (Argentina); CONICET, Avda. Rivadavia 1917, (1033) Cdad. de Buenos Aires (Argentina)], E-mail: srgonzal@cnea.gov.ar; Casal, M. [Instituto de Oncologia Angel H. Roffo, Av. San Martin 5481, (1417) Cdad. de Buenos Aires (Argentina); Pereira, M.D. [Instituto de Oncologia Angel H. Roffo, Av. San Martin 5481, (1417) Cdad. de Buenos Aires (Argentina); Agencia Nacional de Promocion Cientifica y Tecnologica, PAV 22393 (Argentina); Santa Cruz, G.A. [Comision Nacional de Energia Atomica, Av. del Libertador 8250, (1429) Cdad. de Buenos Aires (Argentina); Carando, D.G. [CONICET, Avda. Rivadavia 1917, (1033) Cdad. de Buenos Aires (Argentina); Dpto. de Matematica, Pab. I Ciudad Universitaria, UBA, (1428) Cdad. de Buenos Aires (Argentina); Blaumann, H. [Comision Nacional de Energia Atomica, Av. del Libertador 8250, (1429) Cdad. de Buenos Aires (Argentina); Bonomi, M. [CONICET, Avda. Rivadavia 1917, (1033) Cdad. de Buenos Aires (Argentina); Calzetta Larrieu, O.; Feld, D.; Fernandez, C. [Comision Nacional de Energia Atomica, Av. del Libertador 8250, (1429) Cdad. de Buenos Aires (Argentina); Gossio, S. [FCEyN, Pab. II Ciudad Universitaria, UBA, (1428) Cdad. de Buenos Aires (Argentina); Jimenez Rebagliatti, R.; Kessler, J.; Longhino, J. [Comision Nacional de Energia Atomica, Av. del Libertador 8250, (1429) Cdad. de Buenos Aires (Argentina); Menendez, P. [Instituto de Oncologia Angel H. Roffo, Av. San Martin 5481, (1417) Cdad. de Buenos Aires (Argentina); Nievas, S. [Comision Nacional de Energia Atomica, Av. del Libertador 8250, (1429) Cdad. de Buenos Aires (Argentina); Roth, B.M.C [Instituto de Oncologia Angel H. Roffo, Av. San Martin 5481, (1417) Cdad. de Buenos Aires (Argentina); Liberman, S.J. [Comision Nacional de Energia Atomica, Av. del Libertador 8250, (1429) Cdad. de Buenos Aires (Argentina)

    2009-07-15

    A previous work concerning tumor control and skin damage in cutaneous melanoma treatments with BNCT has been extended to include doses, volumes and responses of 104 subcutaneous lesions from all patients treated in Argentina. Acute skin reactions were also scored for these patients, and cumulative dose-area histograms and dose-based figures of merit for skin were calculated. Broadening the tumor response analysis with the latest data showed that the (minimum or mean) tumor dose is not a good predictor of the observed clinical outcome by itself. However, when the tumor volume was included in the model as second explicative variable, the dose increases its significance and becomes a critical variable jointly with the volume (p-values<0.05). A preliminary analysis to estimate control doses for two groups of tumor sizes revealed that for small tumor volumes (< 0.1 cm{sup 3}) doses greater than 20 Gy-Eq produce a high tumor control (> 80%). However, when tumor volumes are larger than 0.1 cm{sup 3}, control is moderate (< 40%) even for minimum doses up to 40 Gy-Eq. Some quantities based on skin doses, areas and complication probabilities were proposed as candidates for predicting the severity of the early skin reactions. With the current data, all the evaluated figures of merit derived similar results: ulceration is present among the cases for which these quantities take the highest values.

  2. Tumor control and normal tissue complications in BNCT treatment of nodular melanoma: A search for predictive quantities

    International Nuclear Information System (INIS)

    Gonzalez, S.J.; Casal, M.; Pereira, M.D.; Santa Cruz, G.A.; Carando, D.G.; Blaumann, H.; Bonomi, M.; Calzetta Larrieu, O.; Feld, D.; Fernandez, C.; Gossio, S.; Jimenez Rebagliatti, R.; Kessler, J.; Longhino, J.; Menendez, P.; Nievas, S.; Roth, B.M.C; Liberman, S.J.

    2009-01-01

    A previous work concerning tumor control and skin damage in cutaneous melanoma treatments with BNCT has been extended to include doses, volumes and responses of 104 subcutaneous lesions from all patients treated in Argentina. Acute skin reactions were also scored for these patients, and cumulative dose-area histograms and dose-based figures of merit for skin were calculated. Broadening the tumor response analysis with the latest data showed that the (minimum or mean) tumor dose is not a good predictor of the observed clinical outcome by itself. However, when the tumor volume was included in the model as second explicative variable, the dose increases its significance and becomes a critical variable jointly with the volume (p-values 3 ) doses greater than 20 Gy-Eq produce a high tumor control (> 80%). However, when tumor volumes are larger than 0.1 cm 3 , control is moderate (< 40%) even for minimum doses up to 40 Gy-Eq. Some quantities based on skin doses, areas and complication probabilities were proposed as candidates for predicting the severity of the early skin reactions. With the current data, all the evaluated figures of merit derived similar results: ulceration is present among the cases for which these quantities take the highest values.

  3. Application of 10BSH entrapped transferrin-PEG-liposome to boron neutron-capture therapy (BNCT) for solid tumor

    International Nuclear Information System (INIS)

    Maruyama, K.; Ishida, O.; Iwatsuru, M.; Yanagie, H.; Eriguchi, M.; Kobayashi, H.

    2000-01-01

    The successful treatment of cancer by BNCT requires the selective concentration of 10 B within malignant tumor cells. Intracellular targeting ability and cytotoxic effects of 10 B entrapped TF-PEG-liposomes, in which TF is covalently linked to the distal terminal of PEG chains on the external surface of PEG-liposomes, were examined in Colon 26 tumor-bearing mice. TF-PEG-liposomes readily bound to tumor cells in vivo, and were internalized by receptor-mediated endocytosis. 10 B-PEG-liposomes and 10 B-TF-PEG-liposomes showed prolonged residence time in the circulation and low RES uptake in tumor-bearing mice, resulting in enhanced extravasation of the liposomes into the solid tumor tissue and reached high level of 10 B content in tumor. After thermal neutron irradiation of mice injected with 10 B-PEG-liposomes or 10 B-TF-PEG-liposome, tumor growth was suppressed relative to controls. These results suggest that intravenous injection of 10 B TF-PEG-liposome can increase the intracellular retention of 10 B atoms, which were introduced by receptor mediated endocytosis after binding, causing tumor growth suppression in vivo upon thermal neutron irradiation. (author)

  4. Neutron flux and gamma dose measurement in the BNCT irradiation facility at the TRIGA reactor of the University of Pavia

    Science.gov (United States)

    Bortolussi, S.; Protti, N.; Ferrari, M.; Postuma, I.; Fatemi, S.; Prata, M.; Ballarini, F.; Carante, M. P.; Farias, R.; González, S. J.; Marrale, M.; Gallo, S.; Bartolotta, A.; Iacoviello, G.; Nigg, D.; Altieri, S.

    2018-01-01

    University of Pavia is equipped with a TRIGA Mark II research nuclear reactor, operating at a maximum steady state power of 250 kW. It has been used for many years to support Boron Neutron Capture Therapy (BNCT) research. An irradiation facility was constructed inside the thermal column of the reactor to produce a sufficient thermal neutron flux with low epithermal and fast neutron components, and low gamma dose. In this irradiation position, the liver of two patients affected by hepatic metastases from colon carcinoma were irradiated after borated drug administration. The facility is currently used for cell cultures and small animal irradiation. Measurements campaigns have been carried out, aimed at characterizing the neutron spectrum and the gamma dose component. The neutron spectrum has been measured by means of multifoil neutron activation spectrometry and a least squares unfolding algorithm; gamma dose was measured using alanine dosimeters. Results show that in a reference position the thermal neutron flux is (1.20 ± 0.03) ×1010 cm-2 s-1 when the reactor is working at the maximum power of 250 kW, with the epithermal and fast components, respectively, 2 and 3 orders of magnitude lower than the thermal component. The ratio of the gamma dose with respect to the thermal neutron fluence is 1.2 ×10-13 Gy/(n/cm2).

  5. The BNCT resistant fraction of cancer cells. An in vitro morphologic and cytofluorimetric study on a rat coloncarcinoma cell line

    International Nuclear Information System (INIS)

    Ferrari, C.; Clerici, A.M.; Mazzini, G.

    2006-01-01

    Given the high efficacy of the BNCT treatment, recurrences reasonably depends on the failure of a cell fraction to uptake and retain adequate levels of boronated compounds. Aim of this study is to identify, quantify and characterize the resistant cell fraction relative to the delivered boron concentration. Experiments were performed on the DHD/K12/TRb line by means of cytofluorimetric DNA analysis, plating efficiency and morphologic observations. Cells were incubated with p-boronophenylalanine (BPA) concentrations ranging from 10 to 40 ppm for 18 h. Following neutron exposure, cells were reseeded for subsequent morphologic observations, counting and DNA analysis. Samples of irradiated cells not BPA enriched and non-irradiated cells with and without boron were compared with them. After 24 hs there were no differences among the four conditions, in terms of number of recovered cells, morphology and cell cycle distribution. Starting from 48 hs and up to 7 days BPA irradiated cells showed growth in dimensions, important cell number reduction and multiclonal DNA profile worsening with time. After 9 days normally sized cell clones appeared confirming the presence of a resistant cell fraction able to restore the original cell population after 21 days. The incidence of surviving cells turned out to be in the range 0,026-0,05%. (author)

  6. Neutron-photon mixed field dosimetry by TLD-700 glow curve analysis and its implementation in dose monitoring for Boron Neutron Capture Therapy (BNCT) treatments

    Energy Technology Data Exchange (ETDEWEB)

    Boggio, E. F.; Longhino, J. M. [Centro Atomico Bariloche, Departamento de Fisica de Reactores y Radiaciones / CNEA, Av. E. Bustillo Km 9.5, R8402AGP San Carlos de Bariloche (Argentina); Andres, P. A., E-mail: efboggio@cab.cnea.gov.ar [Centro Atomico Bariloche, Division Proteccion Radiologica / CNEA, Av. E. Bustillo Km 9.5, R8402AGP San Carlos de Bariloche (Argentina)

    2015-10-15

    BNCT is a cancerous cells selective, non-conventional radiotherapy modality to treat malignant tumors such as glioblastoma, melanoma and recurrent head and neck cancer. It consists of a two-step procedure: first, the patient is injected with a tumor localizing drug containing a non-radioactive isotope (Boron-10) with high slow neutron capture cross-section. In a second step, the patient is irradiated with neutrons, which are absorbed by the Boron-10 agent with the subsequently nuclear reaction B- 10(n,a)Li-7, thereby resulting in dose at cellular level due to the high-Let particles. The neutron fields suitable for BNCT are characterized by high neutron fluxes and low gamma dose. Determination of each component is not an easy task, especially when the volume of measurement is quite small or inaccessible for a miniature ionization chamber, for example. A method of measuring the photon and slow neutron dose(mainly by N-14 and B-10) from the glow curve (GC) analysis of a single {sup 7}LiF thermoluminescence detector is evaluated. This method was suggested by the group headed by Dr. Grazia Gambarini. The dosemeters used were TLD-600 ({sup 6}LiF:Mg,Ti with 95.6% {sup 6}Li) and TLD-700 ({sup 7}LiF:Mg,Ti with 99.9% {sup 7}LiF) from Harshaw. Photon dose measurement using the GC analysis method with TLD-700 in mixed fields requires the relation of the two main peaks of a TLD-600 GC shape obtained from an exposition to the same neutron field, and a photon calibrated GC with TLD-700. The requirements for slow neutron dose measurements are similar. In order to properly apply the GC analysis method at the Ra-6 Research Reactor BNCT facility, measurements were carried out in a standard water phantom, fully characterized on the BNCT beam by conventional techniques (activation detectors and paired ionization chambers technique). Next, the method was implemented in whole body dose monitoring of a patient undergoing a BNCT treatment, using a Bo MAb (Bottle Manikin Absorption) phantom

  7. Sodium borocaptate (BSH) for Boron Neutron Capture Therapy (BNCT) in the hamster cheek pouch oral cancer model: boron biodistribution at 9 post administration time-points

    International Nuclear Information System (INIS)

    Garabalino, M.A.; Heber, E.M.; Monti, Hughes A.; Molinari, A.J.; Pozzi, E.C.C.; Trivillin, V.A.; Schwint, Amanda E.

    2011-01-01

    The therapeutic success of Boron Neutron Capture Therapy (BNCT) depends centrally on boron concentration in tumor and healthy tissue. We previously demonstrated the therapeutic efficacy of boronophenylalanine (BPA) and sodium decahydrodecaborate (GB-10) as boron carriers for BNCT in the hamster cheek pouch oral cancer model. Given the clinical relevance of sodium mercaptoundecahydro-closo-dodecaborate (BSH) as a boron carrier, the aim of the present study was to expand the ongoing BSH biodistribution studies in the hamster cheek pouch oral cancer model. In particular, we studied 3 additional post-administration time-points and increased the sample size corresponding to the time-points evaluated previously, to select more accurately the post-administration time at which neutron irradiation would potentially confer the greatest therapeutic advantage. BSH was dissolved in saline solution in anaerobic conditions to avoid the formation of the dimer BSSB and its oxides which are toxic. The solution was injected intravenously at a dose of 50 mg 10 B/kg (88 mg BSH / kg). Different groups of animals were killed humanely at 7, 8, and 10 h after administration of BSH. The sample size corresponding to the time-points 3, 4, 6, 9 and 12 h was increased. Samples of blood, tumor, precancerous tissue, normal pouch tissue, cheek mucosa, parotid gland, palate, skin, tongue, spinal cord marrow, brain, liver, kidney, spleen and lung were processed for boron measurement by Optic Emission Spectroscopy (ICP-OES). Boron concentration in tumor peaked to 24-34 ppm, 3-10 h post-administration of BSH, with a spread in values that resembled that previously reported in other experimental models and human subjects. The boron concentration ratios tumor/normal pouch tissue and tumor/blood ranged from 1.3 to 1.8. No selective tumor uptake was observed at any of the time points evaluated. The times post-administration of BSH that would be therapeutically most useful would be 5, 7 and 9 h. The

  8. A method to build an analytic model of the 10B(n,alpha)7Li reaction rate space distribution for boron neutron capture therapy (BNCT).

    Science.gov (United States)

    Morand, Josselin; Moss, Raymond; Hachem, Sabet; Sauerwein, Wolfgang

    2009-07-01

    This work provides the basis of a methodology to build a deterministic model for the spatial distribution of the (10)B(n,alpha)(7)Li reaction rate in boron neutron capture therapy (BNCT), as a function of space variables, boron concentration and beam incidence angle in homogeneous isotropic environments but also in different heterogeneous environments. Building the analytic function in a simple homogeneous environment with numerical methods leads to a mathematical formulation of the (10)B(n,alpha)(7)Li reactions rate.

  9. Design and construction of shoulder recesses into the beam aperture shields for improved patient positioning at the FiR 1 BNCT facility

    International Nuclear Information System (INIS)

    Auterinen, I.; Kotiluoto, P.; Hippelaeinen, E.; Kortesniemi, M.; Seppaelae, T.; Seren, T.; Mannila, V.; Poeyry, P.; Kankaanranta, L.; Collan, J.; Kouri, M.; Joensuu, H.; Savolainen, S.

    2004-01-01

    Improvements have been made at the FiR 1 BNCT facility to ease the positioning of the patient with a tumor in the head and neck region into a lateral neutron beam. Shoulder recesses were constructed horizontally on both sides of the beam aperture. When shoulder recesses are not needed, they are filled with neutron attenuating filling blocks. MCNP simulations using an anthropomorphic human model BOMAB phantom showed that the main contribution to the increase in the effective dose to the patient's body due to the shoulder recesses was from the neutron dose of the arm. In a position when one arm is inside the shoulder recess, the maximal effective dose of the patient was estimated to be 0.7 Sv/h. Dose measurements using the twin ionization chamber technique showed that the neutron dose increased on the sides as predicted by the MCNP model but there was no noticeable change in the gamma doses. When making the recesses into the lithium containing neutron shield material tritium contamination was confined using an underpressurized glove box and machine tools with local exhaust. The shoulder recesses give space for more flexible patient positioning and can be considered as a significant improvement of the Finnish BNCT facility

  10. Study of a neutron producing target via the 7Li(p,n)7Be reaction near its energy threshold for BNCT (boron neutron capture therapy)

    International Nuclear Information System (INIS)

    Burlon, Alejandro; Kreiner, Andres J.; Debray, Mario E.; Stoliar, Pablo; Kesque, Jose M.; Naab, Fabian; Ozafran, Mabel J.; Schuff, Juan; Vazquez, Monica; Caraballo, Maria E.; Valda, Alejandro; Somacal, Hector; Davidson, Miguel; Davidson, Jorge

    2000-01-01

    In the framework of Accelerator Based BNCT (AB-BNCT) the 7 Li(p,n) 7 Be reaction near its energy threshold is one of the most promising. In this work a thick LiF target irradiated with a proton beam was studied as a neutron source. The 1.88-2.0 MeV proton beam was produced by the tandem accelerator TANDAR at CNEA's facilities in Buenos Aires. A water-filled phantom, containing a boron sample was irradiated with the resulting neutron beam. The boron neutron capture reaction produces a 0.478 MeV gamma ray in 94 % of the cases. The neutron yield was monitored by detecting this gamma ray using a germanium detector with an 'anti-Compton' shield. Moreover, the thermal neutron flux was evaluated at different depths inside the phantom using bare and Cd-covered gold foils. A maximum neutron thermal flux of 1.4 x 10 8 1/(cm 2 -s-mA) was obtained at 4.2 cm from the phantom surface. (author)

  11. Design and optimization of a beam-shaping assembly (BSA) for BNCT based on a neutron generator located at CEADEN, Havana, Cuba

    International Nuclear Information System (INIS)

    Padilla Cabal, F.; Martin, G.; Abrahantes, A.

    2007-01-01

    A monoenergetic neutron beam simulation study is carried out to determine the most suitable neutron energy for treatment of shallow and deep-seated brain tumors in the context of Boron Neutron Capture Therapy (BNCT). Two figures-of-merit, i.e. the absorbed dose for healthy tissue and the absorbed tumor dose at a given depth in the brain are used to measure the neutron beam quality. Also irradiation time, therapeutic gain and the power generated in the target are utilized as beam assessment parameters. Moderators, reflectors and delimiters are designed and optimized to moderate the high-energy neutrons from the fusion reactions 2 H(d;n) 3 He and 3 H(d;n) 4 Hedown to a suitable energy spectrum. Metallic uranium and manganese are successfully tested for fast-to-epithermal neutron moderation as well as Fluental TM for the neutron spectrum shifting. A semi spherical target is proposed in order to dissipate twice the amount of power generated in the target, and decrease all the dimensions of the BSA. The cooling system of the target is also included in the calculations. Calculations are performed using the MCNP code. After the optimization of our beam-shaper a study of the dose distribution in the head had been made. The therapeutic gain is increased in 9% while the current required for one hour treatment is decreased in comparison with the trading prototypes of NG used for BNCT. (Author)

  12. Design and optimization of a beam-shaping assembly (BSA) for BNCT based on a neutron generator located at CEADEN, Havana, Cuba

    International Nuclear Information System (INIS)

    Padilla Cabal, F.; Martin, G; Abrahantes, A.

    2007-01-01

    A monoenergetic neutron beam simulation study is carried out to determine the most suitable neutron energy for treatment of shallow and deep-seated brain tumors in the context of Boron Neutron Capture Therapy (BNCT). Two figures-of-merit, i.e. the absorbed dose for healthy tissue and the absorbed tumor dose at a given depth in the brain are used to measure the neutron beam quality. Also irradiation time, therapeutic gain and the power generated in the target are utilized as beam assessment parameters. Moderators, reflectors and delimiters are designed and optimized to moderate the high-energy neutrons from the fusion reactions 2 H(d;n) 3 He and 3 H(d;n) 4 He down to a suitable energy spectrum. Metallic uranium and manganese are successfully tested for fast-to-epithermal neutron moderation as well as Fluental TM for the neutron spectrum shifting. A semispherical target is proposed in order to dissipate twice the amount of power generated in the target, and decrease all the dimensions of the BSA. The cooling system of the target is also included in the calculations. Calculations are performed using the MCNP code. After the optimization of our beam-shaper a study of the dose distribution in the head had been made. The therapeutic gain is increased in 9% while the current required for one hour treatment is decreased in comparison with the trading prototypes of NG used for BNCT. (Author)

  13. Manufacturing of thin films of boron for the measurement of the {sup 10}B(n, {alpha}){sup 7} Li reaction used in BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Smilgys, Barbara; Oliveira, Sandro Guedes de; Hadler Neto, Julio Cesar; Vellame, Igor Alencar [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Inst. de Fisica Gleb Wataghin; Soares, Cleber Jose; Salim, Leonardo Alfredo [Universidade Estadual Paulista (UNESP), Rio Claro, SP (Brazil). Inst. de Geociencias e Ciencias Exatas; Coelho, Paulo Rogerio Pinto [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Centro de Engenharia Nuclear

    2011-07-01

    Full text: The Boron Neutron Capture Therapy (BNCT) is considered to be a possible treatment for different types of aggressive cancers located in areas of difficult access or which already have metastasis. The working principle of this therapy is the selective delivery of a greater amount of boron to the tumor cells than to the healthy ones, followed by the neutron irradiation that will induce the emission of {alpha} particles through the {sup 10}B(n, {alpha}){sup 7} Li reaction used in BNCT reaction. The high energy deposition of the product particles causes the death of the cells and this therapy becomes much effective if the healthy tissue is less exposed to this radiation. The objective of this work is to develop a method for measuring the rate of this reaction by using thin films of boron. We have manufactured thin films with different concentrations of boron deposited on mica and the thin films were exposed to different irradiation time intervals at the reactor IEA-R1 located at IPEN, Sao Paulo. Here we show our first results on the density and uniformity of the thin films, where the detection of the particles is made using plastic track detectors (CR-39) which have their structures damaged by the passage of ions. (author)

  14. Application of an octa-anionic 5,10,15,20-tetra[3,5-(nido-carboranylmethyl)phenyl]porphyrin (H2OCP) as dual sensitizer for BNCT and PDT

    Science.gov (United States)

    The applications of the octa-anionic 5,10,15,20-tetra[3,5-(nidocarboranylmethyl) phenyl]porphyrin (H2OCP) as a boron delivery agent in boron neutron capture therapy (BNCT) and a photosensitizer in photodynamic therapy (PDT) have been investigated. Using F98 Rat glioma cells, we evaluated the cytotox...

  15. Design of a model for BSA to meet free beam parameters for BNCT based on multiplier system for D–T neutron source

    International Nuclear Information System (INIS)

    Rasouli, Fatemeh S.; Farhad Masoudi, S.; Kasesaz, Yaser

    2012-01-01

    Highlights: ► The possibility of using natural uranium as a neutron multiplier for D–T neutron generator is examined. ► To optimize output neutron beam, a moderator/filter/reflector arrangement was designed. ► The MCNP4C code has been used for BSA optimization and other simulations. ► The results show that using this system the BNCT in-air recommended parameters are met. - Abstract: Extensive research has recently been carried out for the development of high-energy D–T neutron generators as neutron sources for BNCT. The energy of these high-energy neutrons must be reduced by designing a Beam Shaping Assembly (BSA) to make them usable for BNCT. However, the neutron flux decreases drastically as neutrons pass through different materials of BSA. Therefore, it is very important to find ways to treat the neutrons economically. In this paper the possibility of using natural uranium as a neutron multiplier is investigated in order to increase the number of neutrons emitted from D–T neutron generator. According to the simulations and performed calculations, a sphere containing natural uranium as neutron multiplier was used to increase the number of neutrons generated by the D–T neutron generator. The energy of fast neutrons that are generated by D–T fusion reaction and amplified by neutron multiplier system is decreased using proper materials as moderators and fast neutron filters in BSA. The gamma rays which are generated as a result of neutron interaction with moderators are removed from neutron spectrum using bismuth as the gamma filter. Also, a thermal neutron absorber omits undesired low-energy neutrons which lead to a high radiation dose for the skin and soft tissues. The results show that passing neutrons through such a BSA causes the establishment of free beam parameters yet the reduction of the output beam intensity is unavoidable. The neutron spectrum related to our BSA has a proper epithermal flux and the fast and thermal neutron fluxes are

  16. Experimental Studies of Boronophenylalanine ({sup 10}BPA) Biodistribution for the Individual Application of Boron Neutron Capture Therapy (BNCT) for Malignant Melanoma Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Carpano, Marina; Perona, Marina; Rodriguez, Carla [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); Nievas, Susana; Olivera, Maria; Santa Cruz, Gustavo A. [Department of Boron Neutron Capture Therapy, National Atomic Energy Commission, San Martín (Argentina); Brandizzi, Daniel; Cabrini, Romulo [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); School of Dentistry, University of Buenos Aires, Buenos Aires (Argentina); Pisarev, Mario [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina); Department of Human Biochemistry, School of Medicine, University of Buenos Aires, Buenos Aires (Argentina); Juvenal, Guillermo Juan [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina); Dagrosa, Maria Alejandra, E-mail: dagrosa@cnea.gov.ar [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina)

    2015-10-01

    Purpose: Patients with the same histopathologic diagnosis of cutaneous melanoma treated with identical protocols of boron neutron capture therapy (BNCT) have shown different clinical outcomes. The objective of the present studies was to evaluate the biodistribution of boronophenilalanina ({sup 10}BPA) for the potential application of BNCT for the treatment of melanoma on an individual basis. Methods and Materials: The boronophenilalanine (BPA) uptake was evaluated in 3 human melanoma cell lines: MEL-J, A375, and M8. NIH nude mice were implanted with 4 10{sup 6} MEL-J cells, and biodistribution studies of BPA (350 mg/kg intraperitoneally) were performed. Static infrared imaging using a specially modified infrared camera adapted to measure the body infrared radiance of small animals was used. Proliferation marker, Ki-67, and endothelial marker, CD31, were analyzed in tumor samples. Results: The in vitro studies demonstrated different patterns of BPA uptake for each analyzed cell line (P<.001 for MEL-J and A375 vs M8 cells). The in vivo studies showed a maximum average boron concentration of 25.9 ± 2.6 μg/g in tumor, with individual values ranging between 11.7 and 52.0 μg/g of {sup 10}B 2 hours after the injection of BPA. Tumor temperature always decreased as the tumors increased in size, with values ranging between 37°C and 23°C. A significant correlation between tumor temperature and tumor-to-blood boron concentration ratio was found (R{sup 2} = 0.7, rational function fit). The immunohistochemical studies revealed, in tumors with extensive areas of viability, a high number of positive cells for Ki-67, blood vessels of large diameter evidenced by the marker CD31, and a direct logistic correlation between proliferative status and boron concentration difference between tumor and blood (R{sup 2} = 0.81, logistic function fit). Conclusion: We propose that these methods could be suitable for designing new screening protocols applied before melanoma BNCT

  17. Desain Beam Shaping Assembly (BSA berbasis D-D Neutron Generator 2,45 MeV untuk Uji Fasilitas BNCT

    Directory of Open Access Journals (Sweden)

    Desman P. Gulo

    2015-12-01

    Full Text Available Boron Neutron Capture Therapy (BNCT is one of the cancer treatments that are being developed in nowadays. In order to support BNCT treatment for cancer that exists in underneath skin like breast cancer, the facility needs a generator that is able to produce epithermal neutron. One of the generator that is able to produce neutron is D-D neutron generator with 2.45 MeV energy. Based on the calculation of this paper, we found that the total production of neutron per second (neutron yield from Neutron Generator (NG by PSTA-BATAN Yogyakarta is 2.55×1011 n/s. The energy and flux that we found is in the range of quick neutron. Thus, it needs to be moderated to the level of epithermal neutron which is located in the interval energy of 1 eV to 10 KeV with 109 n/cm2s flux. This number is the recommendation standard from IAEA. Beam Shaping Assembly (BSA is needed in order to moderate the quick neutron to the level of epithermal neutron. One part of BSA that has the responsibility in moderating the quick neutron to epithermal neutron is the moderator. The substance of moderator used in this paper is MgF2 and A1F3. The thickness of moderator has been set in in such a way by using MCNPX software in order to fulfill the standard of IAEA. As the result of optimizing BSA moderator, the data obtain epithermal flux with the total number of 4.64×108 n/cm2/s for both of moderators with the thickness of moderator up to 15 cm. At the end of this research, the number of epithermal flux does not follow the standard of IAEA. This is because the flux neutron that is being produced by NG is relatively small. In conclusion, the NG from PSTA-BATAN Yogyakarta is not ready to be used for the BNCT treatment facility for the underneath skin cancer like breast cancer.

  18. Employment of MCNP in the study of TLDS 600 and 700 seeking the implementation of radiation beam characterization of BNCT facility at IEA-R1

    International Nuclear Information System (INIS)

    Cavalieri, Tassio Antonio

    2013-01-01

    Boron Neutron Capture Therapy, BNCT, is a bimodal radiotherapy procedure for cancer treatment. Its useful energy comes from a nuclear reaction driven by impinging thermal neutron upon Boron 10 atoms. A BNCT research facility has been constructed in IPEN at the IEA-R1 reactor, to develop studies in this area. One of its prime experimental parameter is the beam dosimetry which is nowadays made by using activation foils, for neutron measurements, and TLD 400, for gamma dosimetry. For mixed field dosimetry, the International Commission on Radiation Units and Measurements, ICRU, recommends the use of pair of detectors with distinct responses to the field components. The TLD 600/ TLD 700 pair meets this criteria, as the amount of 6 Li, a nuclide with high thermal neutron cross section, greatly differs in their composition. This work presents a series of experiments and simulations performed in order to implement the mixed field dosimetry based on the use of TLD 600/TLD 700 pair. It also intended to compare this mixed field dosimetric methodology to the one so far used by the BNCT research group of IPEN. The response of all TLDs were studied under irradiations in different irradiation fields and simulations, underwent by MCNP, were run in order to evaluate the dose contribution from each field component. Series of repeated irradiations under pure gamma field and mixed field neutron/gamma field showed differences in the TLD individual responses which led to the adoption of a Normalization Factor. It has allowed to overcome TLD selection. TLD responses due to different field components and spectra were studied. It has shown to be possible to evaluate the relative gamma/neutron fluxes from the relative responses observed in the two Regions of Interest, ROIs, from TLD 600 and TLD 700. It has also been possible to observe the TLD 700 response to neutron, which leads to a gamma dose overestimation when one follows the ICRU recommended mixed field dosimetric procedure. Dose

  19. Unexpected intra-operative diagnosis of a large cystic ...

    African Journals Online (AJOL)

    crampy abdominal pain, hypercalcaemia, and postprandial nausea and vomiting suggestive of intermittent bowel obstruction. Her medical history included hypothyroidism and hypertension. There was no prior surgical history of note. Her medications included nifedipine XL, losartan, hydrochlorothiazide and levothyroxine.

  20. Intra-operative RF ablation in the atria.

    Science.gov (United States)

    Swanson, David; Panescu, Dorin

    2004-01-01

    We examined two methods of creating atrial linear transmural lesions for an epicardial approach. In a monopolar approach, radiofrequency (RF) ablation was applied to a multiple coil electrode probe with internal cooling to create linear and transmural lesions from the epicardium. Compared to no cooling, internal cooling enables faster and deeper lesion formation. In vitro experiments showed that with internal cooling epicardial RF energy applications time requirements could be reduced from longer than 3 min to 45 seconds to achieve transmural lesions despite convective endocardial cooling produced by blood flow. In vivo experimentation in five sheep confirmed atrial transmural lesions were achieved using 120 seconds of RF application times at set temperatures of 80 degrees C. In a bipolar clamp approach, RF ablation was applied from multiple coil electrodes mounted on one jaw of the clamp to coil electrodes mounted on the opposing jaw of the clamp. In vitro experiments showed that lesions could be made reliably through tissues up to 1-cm thick using RF energy applied for 30 seconds with a set temperature of 80 degrees C. Animal experiments confirmed that pulmonary veins (PV) could be isolated in an electrophysiological (EP) sense from the left atrium by creating an encircling lesion in a cuff of tissue surrounding the PV using the bipolar ablating clamp technique.

  1. aging hypotension and intra-operative cardiac arres

    African Journals Online (AJOL)

    Initiate CPR. Call for defibrillator. Instruct surgeon to deliver foetus. All to follow instructions. Can ask: “what must I do?” *Times given are approximate values for ..... Functioning of operating table. 4. 4. 4. Neonatal equipment. Indicate that neonatal equipment must be checked. 0. 3. 4. Preoperative assessment. Medical and ...

  2. Broken Heart Syndrome – An intra operative complication

    Directory of Open Access Journals (Sweden)

    Zara Wani

    2018-03-01

    Full Text Available We report a case of Broken Heart Syndrome in a 56 year old Postmenopausal woman suffered while undergoing simple biopsy procedure for vocal cord polyp that lead to physical, mental and financial burden both for the patient as well as the doctors. A team of cardiologists based on clinical and echocardiographic findings made the diagnosis of this case.

  3. Intra-Operational Area Coordination: The Zone EOC Concept

    Science.gov (United States)

    2015-09-01

    critical infrastructure, including regional mass transportation corridors, as well as gas, electric , fuel, and water utility lines.5 Any earthquakes ...more effective alternate model and offers an alternative, multilateral collaborative model solution—the zone EOC concept. Designed to enable...Operations Center (DOC), operational area, emergency response coordination, mutual aid, catastrophic disasters, earthquake , geographic regions, emergency

  4. aging hypotension and intra-operative cardiac arres

    African Journals Online (AJOL)

    class correlation coefficient of 0.983. Conclusions: The scoring tool was shown to be valid and reliable. It offers a standardised assessment process and may be used to refine institutional intern training programmes, with a view to improving ...

  5. Intra-operative pneumatic tourniquet - perceptions of use and ...

    African Journals Online (AJOL)

    Fifty-four per cent of respondents personally checked the calibration of the pneumatic tourniquet, although 76% of respondents believe that the apparatus needs to be checked at least once per month. More respondents who did not check the tourniquet apparatus than respondents who did check it believe that applied ...

  6. Intra-operative pneumatic tourniquet - perceptions of use and ...

    African Journals Online (AJOL)

    applied pressure alone or excessive applied pressure caused by use of faulty equipment. It needs to be emphasised to these surgeons that regular checking of the pneumatic tourniquet apparatus is necessary in order. MRC/UCT Bioenergetics of Exercise Research Unit, Department of. Physiology. University of Cape Town.

  7. Intra-operative hearing monitoring methods in middle ear surgeries

    Directory of Open Access Journals (Sweden)

    Wei Ren

    2016-12-01

    Full Text Available Hearing loss is a condition affecting millions of people worldwide. Conductive hearing loss (CHL is mainly caused by middle ear diseases. The low frequency area is the pivotal part of speech frequencies and most frequently impaired in patients with CHL. Among various treatments of CHL, middle ear surgery is efficient to improve hearing. However, variable success rates and possible needs for prolonged revision surgery still frustrate both surgeons and patients. Nowadays, increasing numbers of researchers explore various methods to monitor the efficacy of ossicular reconstruction intraoperatively, including electrocochleography (ECochG, auditory brainstem response (ABR, auditory steady state response (ASSR, distortion product otoacoustic emissions (DPOAE, subjective whisper test, and optical coherence tomography (OCT. Here, we illustrate several methods used clinically by reviewing the literature.

  8. Intra-operative parathyroid hormone measurements – experience of ...

    African Journals Online (AJOL)

    These patients remained normocalcaemic during follow-up. The 'uncured' patient was operated on by means of a targeted approach to the left lower parathyroid, based on the result of the sestamibi scan. His medical history comprised previous thy- roid gland surgery. After removal of what appeared to be thyroid tissue, the ...

  9. The incidence and risk factors for intra-operative hypothermia ...

    African Journals Online (AJOL)

    ... at the Kenyatta National Hospital is 30%. Gender (male), lower body temperature at induction, use of caudal block and the volume of intravenous fluids infused were significant independent predictors of core hypothermia. The most significant predictor was body temperature at the time of induction of general anaesthesia.

  10. Brain effects observed in the canine healthy tissue tolerance studies for BNCT with borocaptate sodium at the epithermal neutron beam of the HFR, Petten

    International Nuclear Information System (INIS)

    Siefert, A.; Casado, J.; Moss, R.L.; Philipp, K.; Huiskamp, R.; Gavin, P.R.; Duehmke, E.

    1993-01-01

    Before the first clinical trails of BNCT with borocaptate sodium (BSH) on patients suffering from malignant brain tumours can be performed at the epithermal neutron bean of the HFR Petten, the tolerance of healthy tissue exposed to this beam has to be determined. Therefore irradiation experiments are currently being performed on beagle dogs at different mean blood 10 B concentrations. To monitor radiation induced brain damage after irradiation, a method has to be employed which provides sufficient sensitivity for detecting radiation induced damage to tissue. Magnetic Resonance Imaging (MRI) is a non-invasive method which yields excellent discrimination between grey and white matter. Information on the integrity of the blood-brain-barrier can be obtained by using paramagnetic contrast agents like Gadolinium-DTPA (Gd-DTPA). This paper summarizes the results of the MRI's performed on the irradiated beagle dogs up to August 1992 and compares these results with the findings of histopathology

  11. Measurement of gamma-ray emission from p-Li, p-Be, and d-Be reactions for accelerator-based BNCT

    International Nuclear Information System (INIS)

    Miyamaru, Hiroyuki; Murata, Isao; Ootera, Yasutaka; Kitamura, Akira

    2006-01-01

    Gamma-ray emission for each p-Li, p-Be, and d-Be nuclear reaction was investigated for accelerator-based BNCT. Measured gamma-ray energy spectra were analyzed and gamma-ray yield for a thick target was evaluated as a function of incident beam energy. Two intense gamma rays at 429 and 477 keV were observed in the p-Li reaction. The gamma ray at 477 keV was specified to be mainly due from the reaction of 7 Li(p,p') 7 Li * . In the p-Be reaction, a Doppler-broadened peak was observed at 3.56 MeV, resulting from the 9 Be(p,α) 6 Li * reaction. Four gamma peaks identified were from the transition of 10 B * generated by the d-Be reaction. Gamma-ray emission characteristics for each reaction are summarized. (author)

  12. Synthesis and in-vivo detection of boronated compounds for use in BNCT. Comprehensive progress report, August 1, 1989--July 31, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Kabalka, G.W.

    1992-01-01

    The primary objective of the DOE program at The University of Tennessee Graduate School of Medicine is the development of effective molecular medicine for use in neutron-capture therapy (NCT). The research focuses primarily on the preparation of new boron-rich NCT agents and the technology to detect them in-vivo. The detection technology involves the development of effective magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques for verifying and measuring NCT agents in-vivo. The synthetic program is directed toward the design of novel boron NCT (BNCT) agents which are targeted to the cell nucleus and gadolinium liposomes targeted to the liver. The UT-DOE program is unique in that it has access to both state-of-the-art whole-body and microscopy MRI instruments.

  13. A Study on Optimized Neutron Beam Generation by Analysis of Neutron Angular Distribution from 7Li(p,n)7Be Reaction for Accelerator-Based BNCT

    International Nuclear Information System (INIS)

    Kim, Kyung O

    2008-02-01

    Perpendicular neutrons (i.e., solid angle bin of 50-150 .deg. ) among ones generated from 7 Li(p,n) 7 Be reaction, which are focused on the relative low energy regions, was used to produce optimized epithermal neutron beam for Accelerator-based BNCT. By this time, most of the studies for generating the therapeutic neutron beam have used the neutrons emitted to the collinear with the incoming proton. However, it is very difficult to produce the high quantity of epithermal neutrons due to the relative high energy neutrons to be used. In this study, it was found that perpendicular neutrons (solid angle 50-150 .deg. ) include about two times as many neutrons in the energy range of 100 - 300 keV as the existing studies. In particular, epithermal neutron beam from the dual beam port assembly was simulated by MCNPX: this assembly was designed for using the neutrons in optimized neutron angle bin (solid angle 50-150 .deg. ). As the results of the IAEA recommendations for all parameters, and moderation length could be reduced. The advantage depth (AD) and dose rate in the mathematical phantom are calculated to evaluate the dosimetric characterization of the designed epithermal neutron beams. It was recognized that the tumor positioned at the maximum depth of 70 mm from skin could be treated, and tumor at 60 mm depth is approximately taken with only a treatment of a few minutes by using the beam from the dual beam port assembly. It is therefore expected that the neutrons emitted into the solid angle bin of 50 - 150 .deg. from 7 Li(p,n) 7 Be reaction are very effective to produce epithermal neutron beam for BNCT. The new dual beam port assembly which is possible to generate the therapeutic neutron beam satisfies with the IAEA recommendations at each beam port and can be used for reference study of epithermal neutron beam design

  14. Development of liquid-lithium film jet-flow for the target of (7)Li(p,n)(7)Be reactions for BNCT.

    Science.gov (United States)

    Kobayashi, Tooru; Miura, Kuniaki; Hayashizaki, Noriyosu; Aritomi, Masanori

    2014-06-01

    A feasibility study on liquid lithium target in the form of a flowing film was performed to evaluate its potential use as a neutron generation target of (7)Li(p,n)(7)Be reaction in BNCT. The target is a windowless-type flowing film on a concave wall. Its configuration was adapted for a proton beam which is 30mm in diameter and with energy and current of up to 3MeV and 20mA, respectively. The flowing film of liquid lithium was 0.6mm in thickness, 50mm in width and 50mm in length. The shapes of the nozzle and concave back wall, which create a stable flowing film jet, were decided based on water experiments. A lithium hydrodynamic experiment was performed to observe the stability of liquid lithium flow behavior. The flowing film of liquid lithium was found to be feasible at temperatures below the liquid lithium boiling saturation of 342°C at the surface pressure of 1×10(-3)Pa. Using a proto-type liquid lithium-circulating loop for BNCT, the stability of the film flow was confirmed for velocities up to 30m/s at 220°C and 250°C in vacuum at a pressure lower than 10(-3) Pa. It is expected that for practical use, a flowing liquid lithium target of a windowless type can solve the problem of radiation damage and target cooling. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Morphometric and immunocytochemical analysis of melanoma samples for individual optimization of therapy for boron neutron capture (BNCT)

    International Nuclear Information System (INIS)

    Carpano, M; Dagrosa, A; Brandizzi, D; Nievas, S; Olivera, M S; Perona, M; Rodriguez, C; Cabrini, R; Juvenal, G; Pisarev, M

    2012-01-01

    Introduction: Tumors from different patients with the same histological diagnosis can show different responses to ionizing radiation including BNCT. Further knowledge about individual tumor characteristics is needed in order to optimize the individual application of this therapy. In previous studies we have shown different patterns of boron intracellular concentration in three human melanoma cell lines. When we performed xenografts with these cell lines in nude mice a wide range of boron concentrations in tumor was observed. We also evaluated the tumor temperature obtained by thermography. Objectives: The aim of this study was to evaluate the differences in the BPA uptake related to different histological and thermal characteristics of each tumor in nude mice bearing human melanoma. We also studied the proliferation and the vasculature in tumors by immunohistochemical studies and the relationship with the BPA uptake. Materials and Methodos: NIH nude mice of 6-8 weeks were implanted (s.c.) into the back right flank with 3.106 human melanoma cells (MELJ). To evaluate the BPA uptake, animals were injected at a dose of 350 mg/Kg b.w. (ip) and sacrificed 2 h post administration. Each sample of tumor was divided into two equal parts, one for uptake of B and another for histological studies. Boron measurements in tissues were performed by ICP-OES. For the histological studies, samples from the tumors were fixed in buffered 10% formaldehyde, embedded in paraffin and stained with hematoxylin and eosin (HE). Infrared imaging studies were performed the day before the biodistribution, measuring the tumor and body temperatures. Immunohistochemical studies were performed with antibodies Ki-67 and CD31. The first one is a marker of proliferative rate and the second one is a specific marker of endothelial cells which allows to identify the vasculature. Formaldehyde-fixed paraffin-embedded tissues and avidin biotin complex immunostaining were used. Results: Tumor BPA uptake showed

  16. Employment of MCNP in the study of TLDS 600 and 700 seeking the implementation of radiation beam characterization of BNCT facility at IEA-R1; Emprego do MCNP no estudo dos TLDS 600 e 700 visando a implementacao da caracterizacao do feixe de irradiacao da instalacao de BNCT do IEA-R1

    Energy Technology Data Exchange (ETDEWEB)

    Cavalieri, Tassio Antonio

    2013-07-01

    Boron Neutron Capture Therapy, BNCT, is a bimodal radiotherapy procedure for cancer treatment. Its useful energy comes from a nuclear reaction driven by impinging thermal neutron upon Boron 10 atoms. A BNCT research facility has been constructed in IPEN at the IEA-R1 reactor, to develop studies in this area. One of its prime experimental parameter is the beam dosimetry which is nowadays made by using activation foils, for neutron measurements, and TLD 400, for gamma dosimetry. For mixed field dosimetry, the International Commission on Radiation Units and Measurements, ICRU, recommends the use of pair of detectors with distinct responses to the field components. The TLD 600/ TLD 700 pair meets this criteria, as the amount of {sup 6}Li, a nuclide with high thermal neutron cross section, greatly differs in their composition. This work presents a series of experiments and simulations performed in order to implement the mixed field dosimetry based on the use of TLD 600/TLD 700 pair. It also intended to compare this mixed field dosimetric methodology to the one so far used by the BNCT research group of IPEN. The response of all TLDs were studied under irradiations in different irradiation fields and simulations, underwent by MCNP, were run in order to evaluate the dose contribution from each field component. Series of repeated irradiations under pure gamma field and mixed field neutron/gamma field showed differences in the TLD individual responses which led to the adoption of a Normalization Factor. It has allowed to overcome TLD selection. TLD responses due to different field components and spectra were studied. It has shown to be possible to evaluate the relative gamma/neutron fluxes from the relative responses observed in the two Regions of Interest, ROIs, from TLD 600 and TLD 700. It has also been possible to observe the TLD 700 response to neutron, which leads to a gamma dose overestimation when one follows the ICRU recommended mixed field dosimetric procedure. Dose

  17. Comparison of three experimental protocols in pre clinical studies for thyroid cancer treatment using sodium butyrate in combination with boron neutron capture therapy (BNCT)

    International Nuclear Information System (INIS)

    Perona, M; Rodriguez, C; Carpano, M; Majdalani E; Nievas, S; Olivera, M; Pisarev, M; Cabrini, R; Juvenal, G; Dagrosa A

    2012-01-01

    Background: We have shown that boron neutron capture therapy (BNCT) could be an alternative for the treatment of poorly differentiated (PDTC) and undifferentiated thyroid carcinoma (UTC). However new strategies are being assayed in order to optimize its application. Histone de acetylase inhibitors (HDAC-I) like sodium butyrate (NaB), are emerging as a new class of chemotherapeutic agents which target the epigenome. Since histone hyper acetylation mediates changes in chromatin conformation, HDAC-I are involved in different epigenetically controlled activities like apoptosis, proliferation, cell differentiation, induction of cell cycle arrest and motility. The purpose of the present studies was to analyze different treatment regimens of combination of NaB and boronophenylalanine (BPA) uptake in animals bearing transplants of a human thyroid carcinoma Methods: NIH nude mice of 6-8 weeks were implanted (s.c.) with 10 6 of human follicular thyroid carcinoma cells (WRO). Three regimens were evaluated in 48 animals after 15 days when tumors had a size between 50 and 100 mm 3 . Group 1 (n=10): BPA and NaB (50 mM) via i.p. at a dose of 110 mg/kg b.w. 24 h before boron compound administration; group 2 (n=10): BPA and NaB 3.4% in the water ad libitum during a month after 15 days post-implantation; group 3 (n=10): BPA alone. In all the groups BPA was injected at a dose of 350 mg/Kg b.w. (i.p.) and the animals were sacrificed at 2 h post-administration. Boron measurements in tissues and blood were performed by ICP-OES. A control group without NaB (n=6) for each regimen was included. The tumor growth and the body weight were determined twice a week during a month. Results: The administration of NaB 3.4% during a month previous to BNCT did not modify the body weight of the mice and decreased the tumor growth compared to its control group (p<0.01). The biodistribution studies showed a tumor boron concentration of 32.6 ± 1.4 ppm for group 1 (NaB 50 mM plus BPA), of 16.9 ± 3.7 ppm

  18. Enhanced tumor cell killing following BNCT with hyperosmotic mannitol-induced blood-brain barrier disruption and intracarotid injection of boronophenylalanine

    International Nuclear Information System (INIS)

    Hsieh, C.H.; Hwang, J.J.; Chen, F.D.; Liu, R.S.; Liu, H.M.; Hsueh, Y.W.; Kai, J.J.

    2006-01-01

    The delivery of boronophenylalanine (BPA) by means of intracarotid injection combined with opening the blood-brain barrier (BBB) have been shown significantly enhanced the tumor boron concentration and the survival time of glioma-bearing rats. However, no direct evidence demonstrates whether this treatment protocol can enhance the cell killing of tumor cells or infiltrating tumor cells and the magnitude of enhanced cell killing. The purpose of the present study was to determine if the tumor cell killing of boron neutron capture therapy could be enhanced by hyperosmotic mannitol-induced BBB disruption using BPA-Fr as the capture agent. F98 glioma-bearing rats were injected intravenously or intracarotidly with BPA at doses of 500 mg/kg body weight (b.w.) and with or without mannitol-induced hyperosmotic BBB disruption. The rats were irradiated with an epithermal neutron beam at the reactor of National Tsing-Hua University (THOR). After neutron beam irradiation, the rats were euthanized and the ipsilateral brains containing intracerebral F98 glioma were removed to perform in vivo/in vitro soft agar clonogenic assay. The results demonstrate BNCT with optimizing the delivery of BPA by means of intracarotid injection combined with opening the BBB by infusing a hyperosmotic solution of mannitol significantly enhanced the cell killing of tumor cells and infiltrating tumor cells, the tumor boron concentration and the boron ratio of tumor to normal brain tissues. (author)

  19. DOSE EFFECT OF THE 33S(n,α) 30SI REACTION IN BNCT USING THE NEW n_TOF-CERN DATA.

    Science.gov (United States)

    Sabaté-Gilarte, M; Praena, J; Porras, I; Quesada, J M

    2017-09-23

    33S is a stable isotope of sulphur which is being studied as a potential cooperative target for Boron Neutron Capture Therapy (BNCT) in accelerator-based neutron sources because of its large (n,α) cross section in the epithermal neutron energy range. Previous measurements resolved the resonances with a discrepant description of the lowest-lying and strongest one (at 13.5 keV). However, the evaluations of the major databases do not include resonances, except EAF-2010 which shows smaller values in this range than the experimental data. Furthermore, the glaring lack of data below 10 keV down to thermal (25.3 meV) has motivated a new measurement at n_TOF at CERN in order to cover the whole energy range. The inclusion of this new 33S(n,α) cross section in Monte Carlo simulations provides a more accurate estimation of the deposited kerma rate in tissue due to the presence of 33S. The results of those simulations represent the goal of this work. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Synthesis and in-vivo detection of boronated compounds for use in BNCT. Final progress report, August 1, 1989--April 30, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Kabalka, G.W.

    1993-08-01

    Carboranes contain ten boron atoms in a three-dimensional space equivalent to a benzene ring; consequently, the carborane isomers can be utilized to prepare a variety of boron-rich agents for potential use in boron-neutron capture therapy. We developed synthetic methodology suitable for use with carboranes preparing amino acids and other physio-logically active compounds of potential use in BNCT. The methodology involves the conversion of simple carboranes into more complex, reactive organometallic reagents which can then be utilized to prepare agents which will target the nuclei of tumor cells. Specific examples include the projected syntheses of boron analogs of known intercolators such as Diazaquone (AZQ) which have been proven effectiveness in chemotherapy. We have also synthesized and carried out biodistribution studies of gadolinium labeled liposomes (GLL) which were developed in our laboratory. Gadolinium like boron-10, has an excellent neutron cross section and is considered to be of potential use in neutron capture therapy. GLL are constructed by adding gadolinium based amphiphiles.

  1. Design and optimization of a beam shaping assembly for BNCT based on D-T neutron generator and dose evaluation using a simulated head phantom.

    Science.gov (United States)

    Rasouli, Fatemeh S; Masoudi, S Farhad

    2012-12-01

    A feasibility study was conducted to design a beam shaping assembly for BNCT based on D-T neutron generator. The optimization of this configuration has been realized in different steps. This proposed system consists of metallic uranium as neutron multiplier, TiF(3) and Al(2)O(3) as moderators, Pb as reflector, Ni as shield and Li-Poly as collimator to guide neutrons toward the patient position. The in-air parameters recommended by IAEA were assessed for this proposed configuration without using any filters which enables us to have a high epithermal neutron flux at the beam port. Also a simulated Snyder head phantom was used to evaluate dose profiles due to the irradiation of designed beam. The dose evaluation results and depth-dose curves show that the neutron beam designed in this work is effective for deep-seated brain tumor treatments even with D-T neutron generator with a neutron yield of 2.4×10(12) n/s. The Monte Carlo Code MCNP-4C is used in order to perform these calculations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Quantitative evaluation of boron neutron capture therapy (BNCT) drugs for boron delivery and retention at subcellular scale resolution in human glioblastoma cells with imaging secondary ion mass spectrometry (SIMS)

    Science.gov (United States)

    Chandra, S.; Ahmad, T.; Barth, R. F.; Kabalka, G. W.

    2014-01-01

    Boron neutron capture therapy (BNCT) of cancer depends on the selective delivery of a sufficient number of boron-10 (10B) atoms to individual tumor cells. Cell killing results from the 10B (n, α)7Li neutron capture and fission reactions that occur if a sufficient number of 10B atoms are localized in the tumor cells. Intranuclear 10B localization enhances the efficiency of cell killing via damage to the DNA. The net cellular content of 10B atoms reflects both bound and free pools of boron in individual tumor cells. The assessment of these pools, delivered by a boron delivery agent, currently cannot be made at subcellular scale resolution by clinically applicable techniques such as PET and MRI. In this study, secondary ion mass spectrometry (SIMS) based imaging instrument, a CAMECA IMS 3f ion microscope, capable of 500 nm spatial resolution was employed. Cryogenically prepared cultured human T98G glioblastoma cells were evaluated for boron uptake and retention of two delivery agents. The first, L-p-boronophenylalanine (BPA), has been used clinically for BNCT of high grade gliomas, recurrent tumors of the head and neck region and melanomas. The second, a boron analogue of an unnatural amino acid, 1-amino-3-borono-cyclopentanecarboxylic acid (cis-ABCPC), has been studied in rodent glioma and melanoma models by quantification of boron in the nucleus and cytoplasm of individual tumor cells. The bound and free pools of boron were assessed by exposure of cells to boron-free nutrient medium. Both BPA and cis-ABCPC delivered almost 70% of the pool of boron in the free or loosely bound form to the nucleus and cytoplasm of human glioblastoma cells. This free pool of boron could be easily mobilized out of the cell and was in some sort of equilibrium with extracellular boron. In the case of BPA, the intracellular free pool of boron also was affected by the presence of phenylalanine in the nutrient medium. This suggests that it might be advantageous if patients were placed on a

  3. Quantitative evaluation of boron neutron capture therapy (BNCT) drugs for boron delivery and retention at subcellular-scale resolution in human glioblastoma cells with imaging secondary ion mass spectrometry (SIMS).

    Science.gov (United States)

    Chandra, S; Ahmad, T; Barth, R F; Kabalka, G W

    2014-06-01

    Boron neutron capture therapy (BNCT) of cancer depends on the selective delivery of a sufficient number of boron-10 ((10)B) atoms to individual tumour cells. Cell killing results from the (10)B (n, α)(7) Li neutron capture and fission reactions that occur if a sufficient number of (10)B atoms are localized in the tumour cells. Intranuclear (10)B localization enhances the efficiency of cell killing via damage to the DNA. The net cellular content of (10)B atoms reflects both bound and free pools of boron in individual tumour cells. The assessment of these pools, delivered by a boron delivery agent, currently cannot be made at subcellular-scale resolution by clinically applicable techniques such as positron emission tomography and magnetic resonance imaging. In this study, a secondary ion mass spectrometry based imaging instrument, a CAMECA IMS 3f ion microscope, capable of 500 nm spatial resolution was employed. Cryogenically prepared cultured human T98G glioblastoma cells were evaluated for boron uptake and retention of two delivery agents. The first, L-p-boronophenylalanine (BPA), has been used clinically for BNCT of high-grade gliomas, recurrent tumours of the head and neck region and melanomas. The second, a boron analogue of an unnatural amino acid, 1-amino-3-borono-cyclopentanecarboxylic acid (cis-ABCPC), has been studied in rodent glioma and melanoma models by quantification of boron in the nucleus and cytoplasm of individual tumour cells. The bound and free pools of boron were assessed by exposure of cells to boron-free nutrient medium. Both BPA and cis-ABCPC delivered almost 70% of the pool of boron in the free or loosely bound form to the nucleus and cytoplasm of human glioblastoma cells. This free pool of boron could be easily mobilized out of the cell and was in some sort of equilibrium with extracellular boron. In the case of BPA, the intracellular free pool of boron also was affected by the presence of phenylalanine in the nutrient medium. This

  4. Models for estimation of the 10B concentration after BPA-fructose complex infusion in patients during epithermal neutron irradiation in BNCT

    International Nuclear Information System (INIS)

    Ryynaenen, Paeivi M.; Kortesniemi, Mika; Coderre, Jeffrey A.; Diaz, Aidnag Z.; Hiismaeki, Pekka; Savolainen, Sauli E.

    2000-01-01

    Purpose: To create simple and reliable models for clinical practice for estimating the blood 10 B time-concentration curve after p-boronophenylalanine fructose complex (BPA-F) infusion in patients during neutron irradiation in boron neutron capture therapy (BNCT). Methods and Materials: BPA-F (290 mg BPA/kg body weight) was infused i.v. during two hours to 10 glioblastoma multiforme patients. Blood samples were collected during and after the infusion. Compartmental models and bi-exponential function fit were constructed based on the 10 B blood time-concentration curve. The constructed models were tested with data from six additional patients who received various amounts of infused BPA-F and data from one patient who received a one-hour infusion of 170 mg BPA/kg body weight. Results: The resulting open two-compartment model and bi-exponential function estimate the clearance of 10 B after 290 mg BPA/kg body weight infusion from the blood with satisfactory accuracy during the first irradiation field (1 ppm, i.e., 7%). The accuracy of the two models in predicting the clearance of 10 B during the second irradiation field are for two-compartment model 1.0 ppm (8%) and 0.2 ppm (2%) for bi-exponential function. The models predict the average blood 10 B concentration with an increasing accuracy as more data points are available during the treatment. Conclusion: By combining the two models, a robust and practical modeling tool is created for the estimation of the 10 B concentration in blood after BPA-F infusion

  5. Comparative study of two boron compounds (BPA and BOPP) for the application of BNCT to an animal model of undifferentiated thyroid cancer

    International Nuclear Information System (INIS)

    Dagrosa, Maria A.; Viaggi, Mabel; Juvenal, Guillermo; Pisarev, Mario A.

    2003-01-01

    Boron neutron capture therapy (BNCT) is based on the selective uptake of certain boron compounds by tumors. Once the uptake, relative to normal tissues, is equal of greater than 3, the tumoral area is irradiated with an appropriate neutron beam. The 10 B is then converted into 11 B and this decays releasing an atom of Li, gamma rays and alpha particles. These latter have a high linear energy transfer (LET) and will cause local damage, eventually killing the tumoral cells. At the present time several clinical trials are being conducted in different countries to treat patients with glioblastoma multiform and melanomas. So far the results obtained, specially with this last disease, are quite encouraging. Undifferentiated thyroid cancer (UTC) is a very aggressive tumor which does not respond to the therapies available at the present. Usually it has a very bad prognosis with a very short survival period. We have previously shown that the human UTC cell line ARO has an uptake of borophenylanine (BPA) significantly greater than normal thyroid or than human follicular adenoma cells in culture. Moreover, an animal model for UTC was developed in our laboratory by transplanting the human ARO cells into nude mice. This model closely resembles the evolution of human disease and even produces lung metastasis, like the human. In the present studies we have compared the uptake of two boron compounds: BPA and boronated porphyrin (BOPP). BPA was administered via ip in a dose of 600 mg/kg body weight, while BOPP was given either ip or iv, in doses of 10 and 100 mg/kg body weight. The animals were sacrificed at different times after the injection: up to 150 min for BPA and after 24 h with BOPP. The concentration of boron was determined by ICP-AES. The results obtained showed that the uptake of BPA was significantly greater in the tumoral area and in the infiltrated surrounding skin than in the other organs examined (liver, kidney, lung, mice thyroid, blood, spleen and distal skin

  6. Comparison of the image-derived radioactivity and blood-sample radioactivity for estimating the clinical indicators of the efficacy of boron neutron capture therapy (BNCT): 4-borono-2-18F-fluoro-phenylalanine (FBPA) PET study.

    Science.gov (United States)

    Isohashi, Kayako; Shimosegawa, Eku; Naka, Sadahiro; Kanai, Yasukazu; Horitsugi, Genki; Mochida, Ikuko; Matsunaga, Keiko; Watabe, Tadashi; Kato, Hiroki; Tatsumi, Mitsuaki; Hatazawa, Jun

    2016-12-01

    In boron neutron capture therapy (BNCT), positron emission tomography (PET) with 4-borono-2- 18 F-fluoro-phenylalanine (FBPA) is the only method to estimate an accumulation of 10 B to target tumor and surrounding normal tissue after administering 10 B carrier of L-paraboronophenylalanine and to search the indication of BNCT for individual patient. Absolute concentration of 10 B in tumor has been estimated by multiplying 10 B concentration in blood during BNCT by tumor to blood radioactivity (T/B) ratio derived from FBPA PET. However, the method to measure blood radioactivity either by blood sampling or image data has not been standardized. We compared image-derived blood radioactivity of FBPA with blood sampling data and studied appropriate timing and location for measuring image-derived blood counts. We obtained 7 repeated whole-body PET scans in five healthy subjects. Arterialized venous blood samples were obtained from the antecubital vein, heated in a heating blanket. Time-activity curves (TACs) of image-derived blood radioactivity were obtained using volumes of interest (VOIs) over ascending aorta, aortic arch, pulmonary artery, left and right ventricles, inferior vena cava, and abdominal aorta. Image-derived blood radioactivity was compared with those measured by blood sampling data in each location. Both the TACs of blood sampling radioactivity in each subject, and the TACs of image-derived blood radioactivity showed a peak within 5 min after the tracer injection, and promptly decreased soon thereafter. Linear relationship was found between blood sampling radioactivity and image-derived blood radioactivity in all the VOIs at any timing of data sampling (p radioactivity measured in the left and right ventricles 30 min after injection showed high correlation with blood radioactivity. Image-derived blood radioactivity was lower than blood sampling radioactivity data by 20 %. Reduction of blood radioactivity of FBPA in left ventricle after 30 min of FBPA

  7. Design and characterization of a novel neutron shield for BNCT in an experimental model of oral cancer in the hamster cheek pouch at RA-3

    International Nuclear Information System (INIS)

    Pozzi, E.C.C.; Curotto, P.; Monti Hughes, A.; Nigg, D.W.; Schwint, A.E.; Trivillin, V.A.; Thorp, S.I.

    2013-01-01

    Our research group at the Radiation Pathology Division of the Department of Radiobiology (National Atomic Energy Commission) has previously demonstrated the therapeutic efficacy of different BNCT protocols to treat oral cancer in an experimental hamster cheek pouch model. In particular, to perform studies in this experimental model at the thermal facility constructed at RA-3, we designed and constructed a shielding device for thermal neutrons, to be able to expose the cheek pouch while minimizing the dose to the rest of the body. This device allowed for the irradiation of one animal at a time. Given the usage rate of the device, the aim of the present study was to design and construct an optimized version of the existing shielding device that would allow for the simultaneous irradiation of 2 animals at the thermal facility of RA-3. Taking into account the characteristics of the neutron source and preliminary biological assays, we designed the shielding device for the body of the animal, i.e. a rectangular shaped box with double acrylic walls. The space between the walls contains a continuous filling of 6Li 2 CO 3 (95% enriched in 6Li), approximately 6 mm thick. Two small windows interrupt the shield at one end of the box through which the right pouch of each hamster is everted out onto an external acrylic shelf for exposure to the neutron flux. The characterization of the shielding device showed that the neutron flux was equivalent at both irradiation positions confirming that we were able to design and construct a new shielding device that allows for the irradiation of 2 animals at the same time at the thermal facility of RA-3. This new version of the shielding device will reduce the number of interventions of the reactor operators, reducing occupational exposure to radiation and will make the procedure more efficient for researchers. In addition, we addressed the generation of tritium as a product of the capture reaction in lithium. It was considered as a

  8. Optimization of a neutron production target and a beam shaping assembly based on the 7Li( p, n) 7Be reaction for BNCT

    Science.gov (United States)

    Burlon, A. A.; Kreiner, A. J.; Valda, A. A.; Minsky, D. M.; Somacal, H. R.; Debray, M. E.; Stoliar, P.

    2005-02-01

    In this work a thick LiF target was studied through the 7Li( p, n) 7Be reaction as a neutron source for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) to provide a testing ground for numerical simulations aimed at producing an optimized neutron production target and beam shaping assembly design. Proton beams in the 1.88-2.0 MeV energy range were produced with the tandem accelerator TANDAR ( TANDem ARgentino) at the Comisión Nacional de Energía Atómica (CNEA) in Buenos Aires, Argentina. A cylindrical water-filled head-phantom, containing a boric acid sample, was irradiated to study the resulting neutron flux. The dose deposited in the boric acid sample was inferred through the Compton-suppressed detection of the gamma radiation produced from the 10B( n, αγ) 7Li capture reaction. The thermal neutron flux was evaluated using bare and Cd-covered activation gold foils. In all cases, Monte Carlo simulations have been done showing good agreement with the experimental results. Extensive MCNP simulation trials have then been performed after the preliminary calculation tool validation in order to optimize a neutron beam shaping assembly. These simulations include a thick Li metal target (instead of LiF), a whole-body phantom, two different moderator-reflector assemblies (Al/AlF 3/LiF, Fluental ®, as moderator and lead as reflector and a combination of Al, PTFE (polytetrafluoroethylene) and LiF as moderator and lead as reflector) and the treatment room. The doses were evaluated for proton bombarding energies of 1.92 MeV (near to the threshold of the reaction), 2.0 MeV, 2.3 MeV (near the reaction resonance) and 2.5 MeV, and for three Fluental ® and Al/PTFE/LiF moderator thicknesses (18, 26 and 34 cm). In a later instance, the effect of the specific skin radiosensitivity (an RBE of 2.5 for the 10B( n, α) 7Li reaction) and a 10B uptake 50% greater than the healthy tissue one, was considered for the scalp. To evaluate the doses in the phantom, a comparison of

  9. Recombination chambers for BNCT dosimetry

    International Nuclear Information System (INIS)

    Tulik, Piotr

    2006-01-01

    Parallel plate recombination ionization chambers are known as the detectors which can be used for determination of gamma and high-LET dose components and for characterization of radiation quality of mixed radiation fields. Specially designed chambers can operate correctly even at dose rates of therapeutic beams. In this work the investigations were extended to a set of cylindrical chambers including a TE chamber and three graphite chambers filled with different gases - CO 2 , N 2 and 10 BF 3 , in order to determine the thermal neutrons, 14 N capture, gamma, and fast neutron dose components. The separation of the dose components is based on differences of the shape of the saturation curve, in dependence on LET spectrum of the investigated radiation. The measurements using all the chambers and a parallel plate recombination chamber were performed in a reactor beam of NRI Rez (Czech Republic). The gamma component was determined with accuracy of about 5%, while the variations of its value could be monitored with accuracy of about 0.5%. Relative changes of the beam components could be detected with accuracy of about 5% using the parallel plate chamber. The use of the chambers filled with different gases considerably improved the resolution of the method. (author)

  10. Estimation and comparison of intra operative blood loss in patients with and without venous thromboembolism prophylaxis

    International Nuclear Information System (INIS)

    Ahsin, S.; Bashir, A.; Faiz, S.A.; Tahir, J.; Ijaz, A.

    2014-01-01

    To estimate and compare intraoperative blood loss in surgical patients with and without deep vein thrombosis (DVT) prophylaxis using unfractionated heparin Study Design: Clinical Trial Place and Duration: Surgery Department of Fauji Foundation Hospital and Physiology Department Foundation University Medical College from October 2011 to August 2012 Patients and Methodology: Patients were selected by non probability purposive sampling. Patients fulfilling the inclusion criteria were divided into 2 groups 25 each on the basis of order of presentation at Fauji Foundation Hospital until cohort numbers were reached. Group I received no heparin whereas group II received heparin. Written informed consent was taken from the patient after explaining the procedure of the study. Coagulation profile was done for both groups before the planned surgery. Heparin in a dose of 5000 units was administered subcutaneously to group II on the morning of the planned surgery and it was stopped 24 hours post operatively. Blood loss was estimated in both groups by weighing cotton swabs pre and post operatively. Data was analyzed by SPSS version 17. Results: Demographic data and surgical procedure time between the two groups did not differ. Blood loss between the two groups did not show any statistically significant difference. Conclusion: DVT prophylaxis using unfractionated heparin did not lead to any significant overt blood loss when compared with those without it. (author)

  11. Intra-operative hyperthermia in a cat with a fatal outcome.

    Science.gov (United States)

    Thomson, Sarah M; Burton, Carolyn A; Armitage-Chan, Elizabeth A

    2014-05-01

    A four year old male neutered Domestic Short Hair cat presented for general anaesthesia for hind limb orthopaedic surgery. The cat had been anaesthetized four days previously with propofol and isoflurane and made an uneventful recovery. On pre-anaesthetic examination the cat had a temperature of 38.9 °C and was otherwise healthy. After a premedication of acepromazine and pethidine, anaesthesia was induced with thiopental and maintained with isoflurane in oxygen 50% and nitrous oxide 50%. Increases in heart rate, respiratory rate, end tidal carbon dioxide tension and temperature were observed, occurring sequentially, from 110 to 175 minutes after anaesthetic induction. Despite ceasing all warming measures and attempting to cool the patient, body temperature continued to rapidly rise, reaching 42.5 °C and limb rigidity was observed. Isoflurane administration was stopped and esmolol was administered. Cardiac arrest occurred. Cardio-pulmonary cerebral resuscitation was commenced and a lateral thoracotomy was performed to allow cardiac compressions and internal defibrillation. Atropine, adrenaline, glucose and dopamine were administered and cold saline was instilled into the thoracic cavity. Resuscitation was unsuccessful and the cat died. A presumptive diagnosis of malignant hyperthermia was made. Malignant hyperthermia should be considered, even if prior exposure to volatile inhalational anaesthesia was uneventful, and prompt and aggressive therapy instituted. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  12. Characteristics and quality of intra-operative cell salvage in paediatric scoliosis surgery.

    Science.gov (United States)

    Perez-Ferrer, A; Gredilla-Díaz, E; de Vicente-Sánchez, J; Navarro-Suay, R; Gilsanz-Rodríguez, F

    2016-02-01

    To determine the haematological and microbiological characteristics of blood recovered by using a cell saver with a rigid centrifuge bowl (100ml) in paediatric scoliosis surgery and to determine whether it conforms to the standard expected in adult patients. A cross-sectional, descriptive cohort study was performed on 24 consecutive red blood cell (RBC) units recovered from the surgical field and processed by a Haemolite® 2+ (Haemonetics Corp., Braintree, MA, EE. UU.) cell saver. Data were collected regarding age, weight, surgical approach (anterior or posterior), processed shed volume and volume of autologous RBC recovered, full blood count, and blood culture obtained from the RBC concentrate, and incidence of fever after reinfusion. The processed shed volume was very low (939±569ml) with high variability (coefficient of variation=0.6), unlike the recovered volume 129±50ml (coefficient of variation=0.38). A statistically significant correlation between the processed shed volume and recovered RBC concentrate haematocrit was found (Pearson, r=.659, P=.001). Haematological parameters in the recovered concentrate were: Hb 11±5.3g dl(-1); haematocrit: 32.1±15.4% (lower than expected); white cells 5.34±4.22×103 ul(-)1; platelets 37.88±23.5×103 ul(-1) (mean±SD). Blood culture was positive in the RBC concentrate recovered in 13 cases (54.2%) in which Staphylococcus coagulase (-) was isolated. Cell salvage machines with rigid centrifuge bowls (including paediatric small volume) do not obtain the expected haematocrit if low volumes are processed, and therefore they are not the best choice in paediatric surgery. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Intra-Operative Indocyanine Green-Videoangiography (ICG-VA) in ...

    African Journals Online (AJOL)

    Methods: Fifteen consecutive patients with anterior circulation aneurysms who underwent craniotomy and clipping of the aneurysms were included in this study. Intraoperative ICG-VA was performed in all cases after exposure of the aneurysm and the branches in the vicinity of the aneurysm or the parent vessel before ...

  14. SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

    International Nuclear Information System (INIS)

    Williams, C; Crowley, E; Wolfgang, J

    2016-01-01

    Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on software development with the IntraOp Medical Corporation.

  15. An evaluation of intra-operative and post-operative blood loss in ...

    African Journals Online (AJOL)

    Background: Total knee replacement is a rewarding and reliable procedure, producing a lasting relief to severe knee pains. However, significant blood loss usually in the post-operative period may be a challenge, necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this ...

  16. The influence of transoesophageal echocardiography on intra-operative decision making - A European multicentre study

    NARCIS (Netherlands)

    Kolev, N; Brase, R; Swanevelder, J; Oppizzi, M; Riesgo, MJ; van der Maaten, JMAA; Abiad, MG; Guarracino, F; Zimpfer, M

    The role of transoesophageal echocardiography (TOE) in anaesthesia remains controversial because it is a rapidly evolving technique with few proven benefits and considerable cost. Recently, the Society of Cardiovascular Anaesthesiologists has published practice guidelines for the use of

  17. Evaluation of accuracy of intra operative imprint cytology for detection of breast lesions

    International Nuclear Information System (INIS)

    Mahmood, Z.; Shahbaz, A.; Qureshi, A.; Aziz, N.; Niazi, S.; Qureshi, S.; Bukhari, M.H.

    2010-01-01

    Objective: To determine the accuracy of imprint cytology as an intraoperative diagnostic procedure for breast lesions with histopathological correlation. Materials and Methods: This was a descriptive study on 40 cases of breast lesions comprising of inflammatory, benign and malignant lesions including their margins etc. It was conducted at King Edward Medical University, Lahore in collaboration with all Surgical Departments of Mayo Hospital. Relevant clinical data was recorded in a proforma. Both touch and scrape imprints were prepared from all the lesions and stained with May-Grunwaled Giemsa and Haematoxylin and Eosin stains. The imprints were subsequently compared with histopathology sections. Results: When we used atypical cases as negative both touch and scrape imprints gave sensitivity, specificity, positive predictive value, negative predictive value and accuracy at 100%. However when we used cases with atypia as positive, sensitivity and negative predictive value were 100% with both touch and scrape imprints. Specificity, positive predictive value and accuracy were 71%, 86%, 85.5% respectively with touch imprints and 78%, 89%, 89% respectively with scrape imprints. No diagnostic difference was noted between the results of both stains. All the imprints were well correlated with histopathological diagnosis. Conclusion: Imprint cytology is an accurate and simple intraoperative method for diagnosing breast lesions. It can provide the surgeons with information regarding immediate clinical and surgical interventions. (author)

  18. The relationship between intra-operative entropy of the EEG and ...

    African Journals Online (AJOL)

    Adele

    Background. Entropy is based on the extent of order in both the cortical EEG and facial EMG (FEMG) signals, measured from the patient's forehead. Order equals regularity of the EEG signal. In an awake patient, the. EEG is very irregular and the entropy high. As the level of anesthesia deepens, the EEG becomes more ...

  19. Intra-operative Cerenkov Imaging for Guiding Breast Cancer Surgery and Assessing Tumor Margins

    Science.gov (United States)

    2014-03-01

    Parallel code is also harder to debug and maintain. Last, large computer clus- ters are not always available at a medical institution for running...with a 5% milk/95% water mixture.34 The phantom properties were set as follows: the absorption and scatter coefficients were µa = 0.0025 cm−1 and µs...1 min 54 s for the MC-HP timeline. Waste denotes speculative execution. In a last experiment, 100 million photon packets were simu- lated with MC-HP

  20. Intra-operative colloid administration increases the clearance of a post-operative fluid load

    DEFF Research Database (Denmark)

    Borup, Tine; Hahn, Robert; Holte, K

    2009-01-01

    using volume kinetics based on the plasma dilution alone. The pre-operative plasma clearance was compared with the post-operative plasma clearance and patients served as their own control. RESULTS: The urinary excretion averaged 350 ml for the pre-operative infusion and 612 ml post-operatively, which...

  1. Broken Heart Syndrome – An intra operative complication

    African Journals Online (AJOL)

    Zara Wani

    2017-03-09

    Mar 9, 2017 ... diomyopathy, Stress Cardiomyopathy1 is an acute reversible left ventricular dysfunction in the absence ... acute coronary syndrome with charac- teristics features of typical chest pain, pulmonary edema, ... Beta-blockers5 and intensive care is the prime mode of treatment, which provides good recovery and ...

  2. Intra-operative defibrillation testing and clinical shock efficacy in patients with implantable cardioverter-defibrillators

    DEFF Research Database (Denmark)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan

    2015-01-01

    AIMS: This trial was designed to test the hypothesis that shock efficacy during follow-up is not impaired in patients implanted without defibrillation (DF) testing during first implantable cardioverter-defibrillator (ICD) implantation. METHODS AND RESULTS: Between February 2011 and July 2013, 107...

  3. SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Williams, C [Brigham and Women’s Hospital & Dana Farber Cancer Institute, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Crowley, E; Wolfgang, J [Harvard Medical School, Boston, MA (United States); Massachusetts General Hospital, Boston, MA (United States)

    2016-06-15

    Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on software development with the IntraOp Medical Corporation.

  4. Reconstruction accuracy of a dedicated localiser for filmless planning in intra-operative brachytherapy

    International Nuclear Information System (INIS)

    Kolkman-Deurloo, Inger-Karine K.; Visser, Andries G.; Idzes, Marjolein H.M.; Levendag, Peter C.

    1997-01-01

    Background and purpose: With the use of HDR and PDR afterloaders containing a single stepping source, brachytherapy dose distributions can be optimised by varying the source dwell time. With the goal of implementing 'conformal brachytherapy', i.e. ensuring that the dose distribution conforms as accurately as possible to the target volume, we evaluated a set-up which enabled on-line implant localisation and dose planning during implantation. Materials and methods: The set-up, designated as an integrated brachytherapy unit (IBU), consists of a shielded operating room equipped with an HDR afterloader and a dedicated brachytherapy localiser connected to a treatment planning computer. The localiser is isocentric and has an extra degree of freedom in comparison to conventional simulators (i.e. an L-arm in combination with a C-arm) and enables viewing of the implant from any direction. A reconstruction algorithm which takes into account both rotation axes, i.e. the L-arm and C-arm angle, was developed for the localiser. The reconstruction procedure was tested by using the IBU localiser to measure the reconstruction accuracy with a phantom (containing 25 markers at well defined positions) and using reconstruction from radiographs. These results were compared to simulations where the accuracy of reconstruction was determined as a function of the reconstruction angle and the accuracy of read-outs of the localiser settings. On-line localisation and dose planning during implantation is based on filmless planning, i.e. fluoroscopy images and the corresponding localiser settings are imported into the treatment planning computer during implantation. The accuracy of filmless planning was determined using fluoroscopy images in the same set-up as for the experiments with the radiographs. The effect of reconstruction inaccuracies on the total irradiation time and the dose in target or normal tissue points was elucidated for clinically relevant implant geometries. The treatment plans of two phantoms based on reconstruction from films as well as fluoroscopy images were compared with plans for implants defined by exact co-ordinates. Results: The average reconstruction error due to the accuracy of the read-out of the localiser settings varied between -0.18 and 0.24 mm, with a standard deviation (arising from digitisation errors) ranging from 0.11 to 0.22 mm. Using filmless reconstruction and the 10 inch field of view of the image intensifier (without applying correction for the geometric distortions) the average reconstruction error ranged from 0.01 to 0.65 mm, and the standard deviation ranged from 0.40 to 0.73 mm. These errors arose as a consequence of the finite pixel size and geometric distortions. These limited errors did not influence the treatment time for clinical implant geometries and had only a minor effect (<1%) on the dose in markers during filmless planning. Conclusion: This IBU set-up, with a dedicated brachytherapy localiser, allows for a rapid and accurate filmless planning procedure based on implant localisation from fluoroscopy images

  5. The Use of Patient-Specific Intra-Operative Guides for Total Knee Arthroplasty (TKA

    Directory of Open Access Journals (Sweden)

    Hendrik P. Delport

    2012-08-01

    Conclusions: We conclude that this novel technique hereby described has major benefits: less operative time and proper implant positioning, but more prospective studies are mandatory. [Arch Clin Exp Surg 2012; 1(4.000: 206-212

  6. Is intra-operative gamma probe detection really necessary for inguinal sentinel lymph node biopsy?

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira Filho, Renato Santos de; Santos, Ivan Dunshe Abranches Oliveira; Ferreira, Lydia Massako; Almeida, Fernando Augusto de; Simoes, Milvia Maria; Enokihara, Silvia; Barbieri, Antonio; Tovo Filho, Reinaldo [Universidade Federal de Sao Paulo (UNIFESP - EPM), SP (Brazil). Disciplina de Cirurgia Plastica

    2000-11-01

    Sentinel node (SN) biopsy has changed the surgical treatment of malignant melanoma. The literature has emphasized the importance of gamma probe detection (GPD) of the SN. Our objective was to evaluate the efficacy of patent blue dye (PBD) and GPD for SN biopsy in different lymphatic basins. Patients with cutaneous malignant melanoma in stages I and II were submitted to biopsy of the SN, identified by PBD and GPD, as part of a research project. Patients were seen at Hospital Sao Paulo by a multidisciplinary group (Plastic Surgery Tumor Branch, Nuclear Medicine and Pathology). 64 patients with localized malignant melanoma were studied. The median age was 46.5 years. The primary tumor was located in the neck, trunk or extremities. Preoperative lymphoscintigraphy, lymphatic mapping with PBD and intraoperative GPD were performed on all patients. The SN was examined by conventional and immuno-histological staining. If the SN was not found or contained micrometastases, only complete lymphadenectomy was performed. The SN was identified by PBD if it was blue-stained, and by GPD if demonstrated activity five times greater than the adipose tissue of the neighborhood. Seventy lymphatic basins were explored. Lymphoscintigraphy showed ambiguous drainage em 7 patients. GPD identified the SN in 68 basins (97%) and PBD in 53 (76%). PBD and GPD identified SN in 100% of the inguinal basins. For the remaining basins both techniques were complementary. A metastatic SN was found in 10 basins. Three patients with negative SN had recurrence (median follow-up=11 months). Although both GPD and PBD are useful and complementary, PBD alone identified the SN in 100% of the inguinal lymphatic basins. (author)

  7. the incidence and risk factors for intra-operative hypothermia among ...

    African Journals Online (AJOL)

    2013-08-01

    Aug 1, 2013 ... 99.9 ± 83.9min, that reported by Abelha et al. (5) was. 218 ± 108min while the patients in this study had an average length of general anaesthesia of 79 ± 42min. Unfortunately the studies quoted did not report their ambient theatre temperatures and comparisons cannot be drawn. The incidence of 30% is ...

  8. Intra-operative prostate motion tracking using surface markers for robot-assisted laparoscopic radical prostatectomy

    Science.gov (United States)

    Esteghamatian, Mehdi; Sarkar, Kripasindhu; Pautler, Stephen E.; Chen, Elvis C. S.; Peters, Terry M.

    2012-02-01

    Radical prostatectomy surgery (RP) is the gold standard for treatment of localized prostate cancer (PCa). Recently, emergence of minimally invasive techniques such as Laparoscopic Radical Prostatectomy (LRP) and Robot-Assisted Laparoscopic Radical Prostatectomy (RARP) has improved the outcomes for prostatectomy. However, it remains difficult for the surgeons to make informed decisions regarding resection margins and nerve sparing since the location of the tumor within the organ is not usually visible in a laparoscopic view. While MRI enables visualization of the salient structures and cancer foci, its efficacy in LRP is reduced unless it is fused into a stereoscopic view such that homologous structures overlap. Registration of the MRI image and peri-operative ultrasound image using a tracked probe can potentially be exploited to bring the pre-operative information into alignment with the patient coordinate system during the procedure. While doing so, prostate motion needs to be compensated in real-time to synchronize the stereoscopic view with the pre-operative MRI during the prostatectomy procedure. In this study, a point-based stereoscopic tracking technique is investigated to compensate for rigid prostate motion so that the same motion can be applied to the pre-operative images. This method benefits from stereoscopic tracking of the surface markers implanted over the surface of the prostate phantom. The average target registration error using this approach was 3.25+/-1.43mm.

  9. Intra-operative Assessment of the Spinal Cord Function: Awakening Compared to Ankle Clonus Test

    International Nuclear Information System (INIS)

    Amin, Wafik A.; Tealab, Ayman I.; Ei-Gendy, Eslah H.; Esmat, Hesham A.

    2006-01-01

    The spinal cord is at high risk of injury during special procedures such as correction of scoliosis. Recovery from impairement is directly proportional to the time of removal of the instrumentations. For this, methods used to detect the neurologic injury should be continuous, fast, sensitive and specific. The present study was performed to evaluate the ankle clonus as a test for the integrity of the spinal cord function intraoperatively. Twenty eight scoliotic patients were included in the study. The ankle clonus was tested before, during and after the correction and fixation followed by the wake-up test to correlate the results of both rests. The haemodynamics changes at the time of the two tests were compared. It was found out that, the ankle clonus test correlated well with the wake-up test, with only two false positive results. No false negative results were recorded which was an important finding. The haemodynamic changes were better during the ankle clonus test than during the wake-up test. It was concluded that the ankle clonus test is reliable, safe, and faster than the wake-up test. It is recommended to use the test to evaluate the integrity of the spinal cord during the operations with potential risk to the cord. In case the result of the ankle clonus is positive, the wake-up test should be done before an attempt to release or remove the instrumentations. (author)

  10. Near-infrared laparoscopy for real-time intra-operative arterial and lymphatic perfusion imaging.

    LENUS (Irish Health Repository)

    Cahill, R A

    2012-02-01

    Multimodal laparoscopic imaging systems possessing the capability for extended spectrum irradiation and visualization within a unified camera system are now available to provide enhanced intracorporeal operative anatomic and dynamic perfusion assessment and potentially augmented patient outcome. While ultraviolet-range energies have limited penetration and hence are probably more useful for endoscopic mucosal interrogation, the near-infrared (NIR) spectrum is of greater potential utility for the purposes of examining inducible fluorescence in abdominopelvic tissue that can be achieved by administration of specific tracer agents, either directly into the circulation (e.g. for anastomotic perfusion assessment at the time of stapling) or into the lymphatic system (e.g. for lymph basin road-mapping and\\/or focussed target nodal assessment). This technology is also capable of supplementing anatomic recognition of the biliary system while implantable fibres can also be inserted intraoperatively for the purpose of safeguarding vital structures such as the oesphagus and ureters especially in difficult reoperations. It is likely that this technological capability will find a clear and common indication in colorectal specialist and general surgical departments worldwide in the near future.

  11. Comparação entre o teste de despertar e a monitoração neurofisiológica intra-operatória com potencial evocado somato-sensitivo nas cirurgias de escoliose Comparación entre el teste de despertar y la monitorización neurofisiológica intraoperatoria con potencial evocado somato sensorial en las cirugías de escoliosis Comparison between the wake-up test and the intra-operative neurophysiologic monitoring with somato-sensitive evoked potentials in surgery for scoliosis

    Directory of Open Access Journals (Sweden)

    Eduardo Barros Puertas

    2009-03-01

    , entre el período de enero de 1985 ha mayo de 2001. Los procedimientos fueron divididos en dos grupos, siendo 80 pacientes operados sin monitoración intra-operatória, utilizado la prueba del despertar, en el período de enero de 1985 a enero de 1998. A partir de mayo de 1998 las cirugías comenzaron a ser supervisadas con monitoración del potencial evocado somato-sensitivo (PESS para la prevención de lesión neurológica, formando así un segundo grupo de 31 pacientes. RESULTADOS: en el primer grupo, un paciente presento lesión neurológica irreversible y cuatro pacientes tuvieron lesión neurológica reversible. Entre los 31 pacientes, com monitoración neurofisiológica somato sensitiva, ocho pacientes presentaron lesión neurológica reversible evidenciada en el intra-operatório, sin ninguna repercusión clínica después del procedimiento. CONCLUSIÓN: los actuales resultados sugieren la eficacia de la monitoración intra-operatória, con el potencial evocado somato-sensitivo, para la prevención de lesiones neurológicas, en las cirugías correctivas de curvas rígidas de escoliosis idiopática.OBJECTIVE: the objective of this study is to compare the incidence of neurological injuries in corrective surgeries for rigid curves of idiopathic scoliosis using only the wake-up test and using the intraoperative neurophysiologic monitoring with somato sensitive evoked potentials. METHODS: we performed 111 surgeries to correct idiopathic scoliosis, with rigid curves through instrumentation and posterior fusion in the period January 1985 to May 2001. The procedures were divided into two groups, with 80 patients operated without the intra-operative monitoring, using only the wake-up test, from January 1985 to January 1998. From May 1998 the surgeries began to be monitored with somato-sensitive evoked potential (PESS for prevention of neurological damage, forming a second group of 31 patients. RESULTS: in the first group, one patient had irreversible neurological damage

  12. INEL BNCT Research Program Annual Report 1993

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R.

    1994-08-01

    This report is a summary of the progress and research produced for the Idaho National Engineering Laboratory Boron Neutron Capture Therapy Research Program for calendar year 1993. Contributions from all the principal investigators are included, covering chemistry (pituitary tumor studies, boron drug development including liposomes, lipoproteins, and carboranylalanine derivatives), pharmacology (murine screenings, toxicity testing, boron drug analysis), physics (radiation dosimetry software, neutron beam and filter design, neutron beam measurement dosimetry), and radiation biology (tissue and efficacy studies of small and large animal models). Information on the potential toxicity of borocaptate sodium and boronophenylalanine is presented. Results of 21 spontaneous-tumor-bearing dogs that have been treated with boron neutron capture therapy at the Brookhaven National Laboratory are updated. Boron-containing drug purity verification is discussed in some detail. Advances in magnetic resonance imaging of boron in vivo are discussed. Several boron-carrying drugs exhibiting good tumor uptake are described. Significant progress in the potential of treating pituitary tumors is presented. Measurement of the epithermal-neutron flux of the Petten (The Netherlands) High Flux Reactor beam (HFB11B), and comparison to predictions are shown.

  13. Chlorin derivatives for potential use in BNCT

    International Nuclear Information System (INIS)

    Osterloh, J.; Neumann, M.; Ruf, S.; Gabel, D.

    2000-01-01

    A series of BSH containing alkyl ether homologues of pytropheophorbide a has been prepared. Cellular uptake studies show that is possible to accumulate 2.2 mg of the heptyl ether after 2 h of incubation with a 0.04 mM solution. That means a boron amount of 330 μg per gram cell mass. Cytotoxicity studies allow radiobiological experiments. The patterns of subcellular localisation visualised by fluorescence microscopy and CLSM show that much of the chlorins is located close to the nucleus and in the nucleus membrane. However, no chlorin was found in the nucleus. (author)

  14. Boron-rich oligomers for BNCT

    International Nuclear Information System (INIS)

    Gula, M.; Perleberg, O.; Gabel, D.

    2000-01-01

    The synthesis of two BSH derivatives is described, which can be used for oligomerization in DNA-synthesizers. Synthesis pathways lead to final products in five and six steps, respectively. Because of chirality interesting results were expected. NMR-measurements confirm this expectation. Possible oligomers with high concentrations of boron can be attached to biomolecules. These oligomers can be explored with several imaging methods (EELS, PEM) to determine the lower detection limit of boron with these methods. (author)

  15. INEL BNCT research program publications, 1993

    International Nuclear Information System (INIS)

    1994-05-01

    This document is a collection of the published reports describing research supporting the Idaho National Engineering Laboratory Boron Neutron Capture Therapy Research Program for calendar year 1993. Contributions from the principal investigators are included, covering chemistry (pituitary tumor studies, boron drug development including liposomes, lipoproteins, and carboranylalanine derivatives), pharmacology (murine screenings, toxicity testing, ICP-AES analysis of biological samples), physics (radiation dosimetry software, neutron beam and filter design, neutron beam measurement dosimetry), and radiation biology (tissue and efficacy studies of small and large animal models). These reports have previously appeared in the book: Advances in Neutron Capture Therapy, edited by A. H. Soloway, R. F. Barth, D. E. Carpenter, Plenum Press, 1993. Reports have also appeared in three journals: Angewandte Chemie, Strahlentherapie und Onkologie, and Nuclear Science and Engineering. This individual papers have been indexed separately elsewhere

  16. Intra-operative remifentanil might influence pain levels in the immediate postoperative period after major abdominal surgery

    DEFF Research Database (Denmark)

    Hansen, EG; Duedahl, Tina H; Rømsing, Janne

    2005-01-01

    Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had...... any impact on post-operative pain and opioid consumption after major abdominal surgery....

  17. Intra-operative dosimetry of trans-rectal ultrasound guided 125I prostate implants using C-arm fluoroscopic images

    Directory of Open Access Journals (Sweden)

    Ravindran Paul

    2006-01-01

    Full Text Available Permanent implantation of radioactive seeds is a viable and effective therapeutic option widely used today for early-stage prostate cancer. The implant technique has improved considerably during the recent years due to the use of image guidance; however, real-time dose distributions would allow potential cold spots to be assessed and additional seeds added. In this study, we investigate the use of a conventional C-arm fluoroscopy unit for image acquisition and evaluation of dose distribution immediately after the implant. The phantom study indicates that it is possible to obtain seed positions within ±2 mm. A pilot study carried out with three patients indicated that it is possible to obtain seed positions and calculate the dose distribution with C-arm fluoroscopy and about 95% of the seeds were reconstructed within ±2 mm. The results could be further improved with better digital imaging.

  18. Limb-saving surgery by intra-operative irradiation on malignant soft tissue tumors in the foot

    International Nuclear Information System (INIS)

    Inoue, Osamu; Ibaraki, Kunio; Shimabukuro, Hiroyuki; Niigaki, Norisada; Motohana, Tetsu; Nakano, Masao

    1990-01-01

    Limb-saving surgery with combined intraoperative irradiation and intralesional resection was performed in two patients. A 10-year-old boy with recurrent desmoplastic fibroma in the right foot received intraoperative irradiation with 40 Gy. Because radiation ulcer occurred in the foot, it was covered with free flap of the musculi latissimus dorsi. In a 23-year-old man, synoviosarcoma involved in the root of the left foot was removed as soon as possible, and was exposed to electron beams of 40 Gy. Similarly, radiation ulcer was covered with free flap of the outer arm muscle. The patient remains free of local recurrence, and is able to live without any tool in the house. Care should be taken to prevent skin injury by selecting electron beams according to the depth of lesions in intraoperative irradiation of the foot. (N.K.)

  19. Intra-Operative Airway Management in Patients with Maxillofacial Trauma having Reduction and Immobilization of Facial Fractures.

    Science.gov (United States)

    Osinaike, Babatunde Babasola; Gbolahan, Olalere O; Olusanya, Adeola A

    2015-01-01

    Despite advancements in airway management, treatment of fractures in the maxillofacial region under general anesthesia remains a unique anesthetic challenge. We reviewed the pattern of airway management in patients with maxillofacial fractures and assessed those challenges associated with the different airway management techniques employed. The anesthetic chart, theatre and maxillofacial operations records of patients who had reduction and immobilization of various maxillofacial fractures over a 2-year period were reviewed. Information obtained included the patient demographics, mechanisms of injury, types of fractures and details about airway management. Statistical Package for Social Sciences, SPSS version 17.0 was utilized for all data analysis. Fifty-one patients were recruited during the 2-year study period. Mask ventilation was easy in 80-90% of the patients, 80% had Mallampati three or four, while 4 (7.8%) had laryngoscopy grading of 4. There was no statistically significant difference between the fracture groups in terms of the laryngoscopy grading (P = 0.153) but there was statistical significant difference in the technique of airway management (P = 0.0001). Nasal intubation following direct laryngoscopy was employed in 64.7% of the patients, fiber-optic guided nasal intubation was utilized in only 7.8%. None of the patients had tracheostomy either before or during operative management. Laryngoscopic grading and not adequacy of mouth opening predicted difficult intubation in this group of patients in the immediate preoperative period. Despite the distortions in the anatomy of the upper airway that may result from maxillofacial fractures, nasal intubation following direct laryngoscopy may be possible in many patients with maxillofacial fractures.

  20. Theoretical characterization of the spatial resolution intra-operative probes; Caracterizacion teorica de la resolucion espacial de sondas intraoperatorias

    Energy Technology Data Exchange (ETDEWEB)

    Agramunt Chaler, S.; Jurado Bruggeman, D.; Munoz Montplet, C.

    2013-07-01

    This work intends to check that the characterization of the spatial profiles obtained by a an intraoperative probe in the presence of a point source is possible enough making use only of the parameters down time sensitivity and opening of the collimator. (Author)

  1. Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities

    Directory of Open Access Journals (Sweden)

    S Rajasekaran

    2010-01-01

    Full Text Available Background: Cervical pedicle screw fixation is challenging due to the small osseous morphometrics and the close proximity of neurovascular elements. Computer navigation has been reported to improve the accuracy of pedicle screw placement. There are very few studies assessing its efficacy in the presence of deformity. Also cervical pedicle screw insertion in children has not been described before. We evaluated the safety and accuracy of Iso-C 3D-navigated pedicle screws in the deformed cervical spine. Materials and Methods: Thirty-three patients including 15 children formed the study group. One hundred and forty-five cervical pedicle screws were inserted using Iso-C 3D-based computer navigation in patients undergoing cervical spine stabilization for craniovertebral junction anomalies, cervico-thoracic deformities and cervical instabilities due to trauma, post-surgery and degenerative disorders. The accuracy and containment of screw placement was assessed from postoperative computerized tomography scans. Results: One hundred and thirty (89.7% screws were well contained inside the pedicles. Nine (6.1% Type A and six (4.2% Type B pedicle breaches were observed. In 136 levels, the screws were inserted in the classical description of pedicle screw application and in nine deformed vertebra, the screws were inserted in a non-classical fashion, taking purchase of the best bone stock. None of them had a critical breach. No patient had any neurovascular complications. Conclusion: Iso-C navigation improves the safety and accuracy of pedicle screw insertion and is not only successful in achieving secure pedicle fixation but also in identifying the best available bone stock for three-column bone fixation in altered anatomy. The advantages conferred by cervical pedicle screws can be extended to the pediatric population also.

  2. Relationship Between Cervical Disc Herniation and Posterior Longitudinal Ligament in Intra-operative Microscope-Guided 468 ACDF

    Directory of Open Access Journals (Sweden)

    LI Ze-qing

    2016-12-01

    Full Text Available Objective: To observe the relationship between cervical disc herniation (CDH and posterior longitudinal ligament (PLL under microscope-guided anterior cervical decompression and fusion (ACFD, with intention to provide the basis for PLL surgery resection.Methods: Totally 325 patients with CDH (468 levels were performed with microscope-guided ACFD. During the procedure, integrity of annulus, PLL, and dural sac were observed. Meanwhile, the position of the protruded mass was recorded. The actual exploratory results under microscope were documented and compared with preoperative magnetic resonance imaging (MRI presentation.Results: According to disc-posterior anatomic layers and findings under the intraoperative microscope, 468 levels of CDH were classified into five sites. Site I: disc with tearing annulus but intact outmost layer (in 47 levels; Site Ⅱ: ruptured annulus with intact PLL (in 202 levels;Site Ⅲ: herniated mass within or through PLL (in 107 levels; Site Ⅳ: free and sequestered mass posterior to PLL (in 105 levels; Site V: intradural CDH (in 7 levels.Conclusion: This observation of CDH reveals the chronic and dynamic progress of the disease. Though MRI is considered a powerful and sensitive technique for the assessment of CDH, it may not provide the proof for the relationship between CDH and PLL. To ensure the complete anterior decompression, the PLL should be resected routinely to explore if there is free disc mass under PLL.

  3. Beliefs and Values about Intra-Operative Teaching and Learning: A Case Study of Surgical Teachers and Trainees

    Science.gov (United States)

    Ong, Caroline C.; Dodds, Agnes; Nestel, Debra

    2016-01-01

    Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient…

  4. The detection of intra-operative myocardial ischaemia. Preliminary experience with the right-sided precordial lead

    NARCIS (Netherlands)

    de Hert, S. G.; de Jongh, R. F.; van den Bossche, A. O.; de Maere, P. L.; Adriaensen, H. F.

    1989-01-01

    The value of monitoring the right precordial lead, V4R, to detect peri-operative ischaemic events during coronary artery surgery was studied in 60 patients. Thirty-four patients had only left-sided coronary disease (Group 1). The other 26 patients had both left-sided occlusive coronary artery

  5. Design considerations and initial performance of a 1.2 cm/sup 2/ beta imaging intra-operative probe

    Science.gov (United States)

    Tornai, M. P.; MacDonald, L. R.; Levin, C. S.; Siegel, S.; Hoffman, E. J.

    1996-08-01

    A novel small area beta (/spl beta//sup /spl plusmn//) detector is under development for nuclear emission imaging of surgically exposed, radiolabeled tumor beds. The imaging device front-end consists of a 0.5 mm thick by 1.25 cm diameter CaF/sub 2/(Eu) scintillator disk coupled to a rigid bundle of 2 mm diameter double clad optical fibers through a polystyrene light diffuser. The detector area (1.2 cm/sup 2/) was determined by the requirement of introducing the probe into small cavities, e.g. during neuro-surgical lesion resection, but large enough to produce images of clinical significance. Flexible back-end optical fibers (1.9 m long) were coupled to the front-end components allowing /spl sim/75 photo-electrons to be detected for mean beta energies of 250 keV, indicating that sufficient signal can be obtained with clinical beta emitters (e.g. /sup 18/F, /sup 131/I). The long flexible fibers guide the scintillation light to a Philips XP1700 series, fiber optic faceplate, Multi-Channel PMT. The parallel MC-PMT outputs are fed into a variable gain, charge divider network and an i-V pre-amplifier/line driver network, whose resulting four outputs are digitized and histogrammed with standard Anger positioning logic. The various components in the imaging chain were evaluated and optimized by both simulations and measurements. Line spread functions measured in the 10.8 mm FOV were 0.50 mm /spl plusmn/0.038 mm and 0.55 mm /spl plusmn/0.065 mm FWHM in X and Y, respectively. A 20% variation in pulse height and minimal variation in spatial resolution was observed. The differential image uniformity was measured to be /spl plusmn/15.6% with /spl sim/150 cts/pixel. Preliminary images show excellent reproduction of phantom activity distributions.

  6. Intra-operative on-line discrimination of kidney cancer from normal tissue by IR ATR spectroscopy of extracellular fluid

    Science.gov (United States)

    Urboniene, V.; Velicka, M.; Ceponkus, J.; Pucetaite, M.; Jankevicius, F.; Sablinskas, V.; Steiner, G.

    2016-03-01

    Determination of cancerous and normal kidney tissues during partial, simple or radical nephrectomy surgery was performed by using differences in the IR absorption spectra of extracellular fluid taken from the corresponding tissue areas. The samples were prepared by stamping of the kidney tissue on ATR diamond crystal. The spectral measurements were performed directly in the OR during surgery for 58 patients. It was found that intensities of characteristic spectral bands of glycogen (880-1200 cm-1) in extracellular fluid are sensitive to the type of the tissue and can be used as spectral markers of tumours. Characteristic spectral band of lactic acid (1730 cm-1) - product of the anaerobic glycolysis, taking place in the cancer cells is not suitable for use as a spectral marker of cancerous tissue, since it overlaps with the band of carbonyl stretch in phospholipids and fatty acids. Results of hierarchical cluster analysis of the spectra show that the spectra of healthy and tumour tissue films can be reliably separated into two groups. On the other hand, possibility to differentiate between tumours of different types and grades remains in question. While the fluid from highly malignant G3 tumour tissue contains highly pronounced glycogen spectral bands and can be well separated from benign and G1 tumours by principal component analysis, the variations between spectra from sample to sample prevent from obtaining conclusive results about the grouping between different tumour types and grades. The proposed method is instant and can be used in situ and even in vivo.

  7. Limb-saving surgery by intra-operative irradiation on malignant soft tissue tumors in the foot

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Osamu; Ibaraki, Kunio; Shimabukuro, Hiroyuki; Niigaki, Norisada; Motohana, Tetsu; Nakano, Masao (University of the Rhukyus, Nishihara, Okinawa (Japan). School of Medicine)

    1990-09-01

    Limb-saving surgery with combined intraoperative irradiation and intralesional resection was performed in two patients. A 10-year-old boy with recurrent desmoplastic fibroma in the right foot received intraoperative irradiation with 40 Gy. Because radiation ulcer occurred in the foot, it was covered with free flap of the musculi latissimus dorsi. In a 23-year-old man, synoviosarcoma involved in the root of the left foot was removed as soon as possible, and was exposed to electron beams of 40 Gy. Similarly, radiation ulcer was covered with free flap of the outer arm muscle. The patient remains free of local recurrence, and is able to live without any tool in the house. Care should be taken to prevent skin injury by selecting electron beams according to the depth of lesions in intraoperative irradiation of the foot. (N.K.).

  8. Effects of pressure support ventilation mode on emergence time and intra-operative ventilatory function: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Xavier Capdevila

    Full Text Available We tested the hypothesis that pressure-support ventilation (PSV allows a reduction in emergence time and laryngeal mask airway (LMA removal time after general anesthesia compared to volume-controlled mechanical ventilation (CMV. Because spontaneous breathing (SB is often used with LMA under general anesthesia, patients were allocated randomly to three groups (CMV, SB and PSV. Thirty-six consecutive ASA I-II patients scheduled for knee arthroscopic surgery under general anesthesia with a LMA and breathing throughout the ventilator circuit were included. Hemodynamic and ventilatory variables were recorded before and 10-min after general anesthesia-induction, at the surgical incision, at the end of anaesthetic drugs infusion and when the patient was totally awake (which defines emergence time. LMA removal time, drug consumption were recorded at the end of the surgical procedure. Leak fraction around the LMA was also evaluated. LMA removal time was significantly higher in the CMV-group (18 ± 6 min compared to both SB (8 ± 4 min and PSV (7 ± 4 min, P < 0.05 groups as well as for emergence time: CMV-group (32 ± 12 min, SB (17 ± 7 min and PSV (13 ± 6 min, P < 0.05 groups. Total propofol consumption was significantly lower in the PSV-group (610 ± 180 mg than in both CMV (852 ± 330 mg and SB (734 ± 246 mg, P < 0.05 groups. Air leaks around the LMA was significantly higher in the CMV-group than in the SB and PSV groups (16% vs 3% and 7%, all P<0.05. In conclusion, in knee arthroscopic surgery, in comparison to CMV, PSV use during general anesthesia in unparalyzed patients decreases LMA removal time, propofol consumption and leaks around LMA while improving ventilatory variables without adverse effects.Controlled-Trials.com ISRCTN17382426.

  9. McConnell's sign in intra-operative acute right ventricle ischaemia: An under-recognized aetiology.

    Science.gov (United States)

    Longo, S A; Echegaray, A; Acosta, C M; Rinaldi, L I; Cabrera Schulmeyer, M C; Olavide Goya, I

    2016-11-01

    Transoesophageal echocardiography (TEE) has become a fundamental tool in modern cardiothoracic anaesthesia. It has an indisputable role in coronary valve surgery and revascularisations with severe impairment of ventricle function. It helps in making diagnoses that can optimise the surgical strategy and to minimal invasively dynamically monitor volaemia and cardiac function during the post-operative period, detecting complications unobservable by other methods. The McConnell sign, visualised using TEE as an akinesis of the right ventricular free wall, with a normal apex motility and enlargement of the right cavities, is characteristic of right ventricular (RV) dysfunction. This sign has a 77% sensitivity and 94% specificity for the diagnosis of acute pulmonary embolism (APE). The case is presented of a 53-year-old man scheduled for aortic valve and ascending aorta replacement surgery, with a history of severe valve aortic stenosis, aortic root and arch aneurysm, and with normal coronary arteries. Post-cardiopulmonary bypass (CBP), the patient presented with haemodynamic instability, with the TEE showing a typical image of the McConnell sign, with no pulmonary hypertension. This enabled making an early diagnosis of acute RV ischaemia, that led to a change in the surgical plan, the performing of coronary revascularisation surgery. As a result, the McConnell sign, which describes the characteristics of RV dysfunction, led to making a differential diagnosis between APE, RV infarction and acute myocardial ischaemia. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Intra-operative cell salvage and sickle cell trait in liver transplantation: time to re-consider?

    Science.gov (United States)

    Loh, P S; Gilder, F; Klinck, J

    2018-04-19

    Sickle cell trait (SCT), characterized by the sickle hemoglobin (HbS) gene in a heterozygous state is the most common hemoglobinopathy worldwide that is typically asymptomatic in affected individuals [1]. In Europe, migration has increased the prevalence, raising concerns about its clinical impact [1]. For example, the use of intraoperative cell salvage may induce sickling because of hypoxia during processing [2]. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Intra-operative remifentanil might influence pain levels in the immediate post-operative period after major abdominal surgery

    DEFF Research Database (Denmark)

    Hansen, E G; Duedahl, T H; Rømsing, J

    2005-01-01

    Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had...... any impact on post-operative pain and opioid consumption after major abdominal surgery....

  12. Evaluation of superparamagnetic iron oxide nanoparticles (Endorem®) as a photoacoustic contrast agent for intra-operative nodal staging

    NARCIS (Netherlands)

    Grootendorst, Diederik J.; Jose, Jithin; Fratila, Raluca M.; Visscher, Martijn; Velders, Aldrik H.; ten Haken, Bennie; van Leeuwen, Ton G.; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J. M.

    2013-01-01

    Detection of tumor metastases in the lymphatic system is essential for accurate staging of malignancies. Commercially available superparagmagnetic nanoparticles (SPIOs) accumulate in normal lymph tissue after injection at a tumor site, whereas less or no accumulation takes place in metastatic nodes,

  13. Evaluation of superparamagnetic iron oxide nanoparticles (Endorem) as a photoacoustic contrast agent for intra-operative nodal staging

    NARCIS (Netherlands)

    Grootendorst, Diederik; Jose, J.; Fratila, R.M.; Visscher, M.; Velders, Aldrik; ten Haken, Bernard; van Leeuwen, Ton; Steenbergen, Wiendelt; Manohar, Srirang; Ruers, Theo J.M.

    2013-01-01

    Detection of tumor metastases in the lymphatic system is essential for accurate staging of malignancies. Commercially available superparagmagnetic nanoparticles (SPIOs) accumulate in normal lymph tissue after injection at a tumor site, whereas less or no accumulation takes place in metastatic nodes,

  14. Unexpected refractory intra-operative hypotension during non-cardiac surgery: Diagnosis and management guided by trans-oesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Sundara Reddy

    2014-01-01

    Full Text Available We present a case of severe refractory hypotension in a patient undergoing de-bulking liver resection for massive polycystic liver disease. Emergent trans-oesophageal echocardiography (TOE revealed dynamic left ventricular outflow tract (LVOT obstruction with systolic anterior motion (SAM of the anterior mitral leaflet (AML. Notably, he had a structurally normal heart on pre-operative trans-thoracic echocardiography (TTE. Diagnosis of SAM by TOE, possible mechanisms and specific management of refractory hypotension in this context are discussed.

  15. Pre-operative planning and intra-operative guidance in modern neurosurgery: a review of 300 cases.

    Science.gov (United States)

    Wadley, J.; Dorward, N.; Kitchen, N.; Thomas, D.

    1999-01-01

    Operative neurosurgery has recently entered an exciting era of image guided surgery or neuronavigation and application of this novel technology is beginning to have a significant impact in many ways in a variety of intracranial procedures. In order to fully assess the advantages of image guided techniques over conventional planning and surgery in selected cases, detailed prospective evaluation has been carried out during the advanced development of an optically tracked neuronavigation system. Over a 2-year period, 300 operative neurosurgical procedures have been performed with the assistance of interactive image guidance, as well as the development of new software applications and hardware tools. A broad range of intracranial neurosurgical procedures were seen to benefit from image guidance, including 163 craniotomies, 53 interactive stereotactic biopsies, 7 tracked neuroendoscopies and 37 complex skull base procedures. The most common pathological diagnoses were cerebral glioma in 98 cases, meningioma in 64 and metastasis in 23. Detailed analysis of a battery of postoperative questions revealed benefits in operative planning, appreciation of anatomy, lesion location, safety of surgery and greatly enhanced surgical confidence. The authors believe that image guided surgical technology, with new developments such as those described, has a significant role to play in contemporary neurosurgery and its widespread adoption in practice will be realised in the near future. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:10615186

  16. Intra-operative periprosthetic fractures associated with press fit stems in revision total knee arthroplasty: incidence, management, and outcomes.

    Science.gov (United States)

    Cipriano, Cara A; Brown, Nicholas M; Della Valle, Craig J; Moric, Mario; Sporer, Scott M

    2013-09-01

    The purpose of this study is to report the incidence, management, and outcomes of periprosthetic fractures associated with the insertion of press-fit stems during revision total knee arthroplasty (TKA). Immediate and six week post-operative radiographs from 634 stemmed implants (307 femoral, 327 tibial) from 420 consecutive revision TKAs were reviewed. Sixteen tibial (4.9%) and 3 femoral (1%) fractures (combined incidence 3.0%) were identified. All healed uneventfully without operative intervention, with no evidence of implant loosening at a mean of 23 months (range 12 to 47 months). The technique of tightly press fitting stems into the diaphysis is associated with a small rate (3%) of periprosthetic fractures; most were non or minimally displaced, all healed uneventfully with non-operative management and were not associated with implant loosening. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Diagnosis of pelvic inflammatory disease (PID): intra-operative findings and comparison of vaginal and intra-abdominal cultures.

    Science.gov (United States)

    Schindlbeck, Christian; Dziura, Dominik; Mylonas, Ioannis

    2014-06-01

    Pelvic inflammatory disease (PID) is frequent in adolescents and younger women. Diagnosis is usually based on the clinical findings, and the threshold for empiric antibiotic therapy should be low. However, at least in cases of resistance toward therapy or deterioration of symptoms, laparoscopic evaluation can be helpful. We searched the hospital charts for in-house patients who were treated for PID or tubo-ovarian abscess between 2007 and 2010. In cases with both vaginal and intra-abdominal bacterial cultures, results of those were compared. 73 patients with suspected PID or tubo-ovarian abscess were included. Median patients' age was 40 years (18-88), 18 of 73 (24.7 %) patients had an IUD at the time of consultation. 58 patients underwent laparoscopy or laparotomy. In 41 patients (70.7 %) tubo-ovarian abscess could be confirmed, four patients had differential gynecologic diagnoses, and two patients appendicitis. In vaginal swabs, most frequent bacteria were Streptococcus sp. (28.5 %), Escherichia coli (22.2 %), Enterococcus faecalis (15.9 %), and Staphylococcus sp. (9.5 %). In eight patients (11 %) Chlamydia trachomatis could be found, there was no case of Neisseria gonorrhea. In 33 patients both vaginal and abdominal cultures were available. In nine cases (27.3 %), identical bacteria could be found, however, 11 cases (33.3 %) showed different results. In severe cases of PID, laparoscopic evaluation and taking an intra-abdominal bacterial culture are helpful for the confirmation of diagnosis, accurate microbiologic testing and specific therapy.

  18. Spindle cell oncocytoma of the adenohypophysis: 2 case reports of unusual radiological and intra-operative findings

    Directory of Open Access Journals (Sweden)

    Nasir M. Rafiq

    2017-12-01

    Conclusion: SCO is a rare entity, difficult to identify on clinical basis alone, but with different radiological and surgical operative features compared to typical pituitary adenomas. This tumour should be suspected preoperatively if an isointense and well delineated pituitary mass is identified, or unusually during resection when a hard consistency is noted.

  19. Intra-operative Patient-Controlled Sedation (PCS:Propofol versus Midazolam Supplementation During Epidural Analgesia (Clinical and Hormonal Study

    Directory of Open Access Journals (Sweden)

    Hassan S Al-khayat

    2008-01-01

    Full Text Available This study was done on sixty adult males scheduled to have an epidural analgesia for elective inguinal hernia repair. The study was designed to compare propofol and midazolam with regard to their suitability for the patient-controlled sedation (PCS technique during epidural analgesia. Patients were divided into three equal groups and premedicated with 0.2mg.kg -1 oral midazolam. Group I (G1 served as control. Using PCS technique, the pump was programmed to deliver on demand a bolus dose of 0.5 mg.kg- 1 of propofol in Group II (G2 or 0.1mg.kg -1 midazolam in Group III(G3. Patient′s sedation status was assessed by sedation score, comfort scale and by psychometric testing. The total delivered dose of each tested drug was calculated. Serum concentrations of propfol and midazolam, plasma cortisol and free fatty acids were measured. Propofol and midazolam PCS technique produced excellent and easily controllable sedation. The dose needed to produce steady state sedation was 2.8±1.42 and 0.11±0.6 mg.kg -1 .h- 1 for propofol and midazolam respectively. Propofol was more suitable than midazolam for PCS because of its rapid onset, favorable recovery profile and low side effects. PCS proved to be a stress-free and acceptable technique.

  20. INEL BNCT Research Program, March/April 1993

    International Nuclear Information System (INIS)

    Venhuizen, J.R.

    1993-06-01

    This report presents summaries for two months of current research of the Idaho National Engineering Laboratory Boron Neutron Capture Therapy Program. Information is presented on development and murine screening experiments of low-density lipoprotein, carboranyl alanine, and liposome boron containing compounds. Pituitary tumor cell culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium and boronophenylalanine are described. Treatment protocol development via the large animal (canine) modal studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, and noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed

  1. Spontaneous canine oral melanoma: A large animal model for BNCT

    International Nuclear Information System (INIS)

    Gavin, P.R.; Kraft, S.L.; DeHaan, C.E.; Sande, R.D.; Papageorges, M.; Bauer, W.F.

    1992-01-01

    Oral melanomas in dogs are the most common malignant neoplasm of the oral cavity. Prevalence has been recorded at 127 per 100,000 dogs/year. There is a predilection for the gingiva of male dogs with heavy pigmentation. The tumors are resistant to treatment with conventional radiation and chemotherapy. The tumors are very aggressive and have generally metastasized to the regional lymph nodes at the time of initial diagnosis. Distant metastases occur in approximately 85% of patients. Metastatic sites include lungs, kidneys, liver, brain, skeleton, and gastrointestinal (GI) tract. Fifteen (15) dogs with oral lesions biopsied and diagnosed as malignant melanoma were entered in the study. A thorough diagnostic regimen was performed in an attempt to detect the regional spread and distant metastases of the tumor

  2. Uranium target for electron accelerator based neutron source for BNCT

    International Nuclear Information System (INIS)

    Tonchev, A.P.; Harmon, F.; Collens, T.J.; Kennedy, K.; Sabourov, A.; Harker, Y.D.; Nigg, D.W.; Jones, J.L.

    2001-01-01

    Calculations of the epithermal-neutron yield of photoneutrons from a uranium-beryllium converter using a 27 MeV electron linear accelerator have been investigated. In this concept, relativistic electron beams from a 30 MeV LINAC impinge upon a small uranium sphere surrounded by a cylindrical tank of circulating heavy water (D 2 O) nested in a beryllium cube. The photo-fission neutron spectrum from the uranium sphere is thermalized in deuterium and beryllium, filtered and moderated in special material (AlF 3 /Al/LiF), and directed to the patient. The results of these calculations demonstrate that photoneutron devices could offer a promising alternative to nuclear reactors for the production of epithermal neutrons for Neutron Capture Therapy. The predicted parameter for the epithermal flux is more than 10 8 n.cm -2 .mA -1

  3. Intra-pelvic migration of femoral head trial in total hip arthroplasty, a rare intra-operative complication: a systematic literature review.

    Science.gov (United States)

    Abouel-Enin, S; Fraig, H; Griffiths, J; Latham, J

    2016-08-01

    Trial reduction while performing total hip replacement is an essential step of the procedure. This is to check the stability of the hip joint with the selected implant sizes and to assess the leg length to avoid discrepancy. Disengagement of the femoral head trial from the femoral rasp stem with subsequent migration of the trial head into the pelvic cavity is a rare occurrence, but can be a very frustrating complication to both the surgeon and occasionally the patient. We present our experience with this exceptional situation and different management options, together with systematic review of the literature.

  4. Uso do 5-fluorouracil no intra-operatório da cirurgia do pterígio Intra-operative use of 5-fluorouracil in pterygium surgery

    Directory of Open Access Journals (Sweden)

    Silvana A. Schellini

    2000-04-01

    Full Text Available Objetivo: Avaliar a efetividade e as complicações com a aplicação do 5- fluorouracil (5-FLU no intra-operatório da cirurgia do pterígio. Método: Foram avaliados 28 olhos de 26 indivíduos quanto ao tipo e tamanho do pterígio, cirurgias prévias e a resposta ao tratamento cirúrgico (no 7º , 21º , 60º e 90º dia de pós-operatório. Logo após a exerese do pterígio, aplicou-se 5-FLU (25 mg/ml no leito cirúrgico, durante cinco minutos; a seguir, realizou-se a técnica de deslizamento de retalho conjuntival. Resultados: A maioria dos pacientes tinha mais de 50 anos de idade e apresentava pterígio primário (70,0%, grau II (60,7%, do tipo involutivo (60,7%. No pós-operatório observaram-se: isquemia (10,7%, deiscência da conjuntiva (7,1%, ceratite (3,5%, conjuntivite (3,5% e recidiva da lesão em 1 olho (3,5%.Conclusão: O 5-FLU se mostrou droga segura e efetiva na prevenção das recidivas, podendo ser usado como coadjuvante no tratamento do pterígio para prevenir recidivas.Purpose: To evaluate the effectiveness and the complications on intraoperative application of 5-fluorouracil (5FLU in pterygium surgery. Method: We studied 28 eyes of 26 patients with pterygium, evaluating the type and size of the pterygium, previous surgeries and the response to surgical treatment (on the 7th, 21st, 60th, 90th postoperative day. The application of 5-FLU (25 mg/ml was done soon after resection, for five minutes, followed by the sliding flap technique.Results: Most of the patients were more than 50 years old, presented with primary (70.0%, degree II (60.7%, involu-tionary type (60.7% pterygium. After surgery ischemic area (10.7%, conjunctival deiscence (7.1%, keratitis (3.5%, conjunctivitis (3.5% and lesion relapse (3.5% were observed.Conclusion: 5-FLU is a safe and effective drug and could be of help in the treatment of pterygium to prevent relapse.

  5. A novel approach for evaluating acceptable intra-operative correction of lower limb alignment in femoral and tibial malunion using the deviation angle of the normal contralateral knee.

    Science.gov (United States)

    Wu, Chi-Chuan

    2014-03-01

    A simple and appropriate approach for evaluating an acceptable alignment of bone around the knee during operation has not yet been reported. Thirty-five men and 35 women presenting with nonunion or malunion of the unilateral femoral shaft were included in the first study. Using the standing scanograph, the contralateral normal lower extremity was measured to determine the normal deviation angle (DA) of the medial malleolus when the medial aspect of the knee was placed in the midline of the body. In the second study, the normal DA from individual patients was used as a reference to evaluate knee alignment during operation in 40 other patients presenting with distal femoral or proximal tibial nonunion or malunion. The clinical and knee functional outcomes of these 40 patients were investigated. The average normal DA was 4.2° in men and 6.0° in women (palignment was maintained in all 30 patients with fracture union. Satisfactory function of the knee was achieved in 28 patients (82%, palignment of bone around the knee during operation. Level IV, Case series. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Three-dimensional echocardiography: assessment of inter- and intra-operator variability and accuracy in the measurement of left ventricular cavity volume and myocardial mass

    Energy Technology Data Exchange (ETDEWEB)

    Nadkarni, S.K.; Drangova, M. [Advanced Imaging Research Laboratories, John P Robarts Research Institute, PO Box 5015, 100 Perth Drive, London, Ontario N6A 5K8 (Canada); Department of Medical Biophysics, Medical Sciences Building, University of Western Ontario, L