Bor-Tsung Hsieh’s research while affiliated with Central Taiwan University of Science and Technology and other places

Background: Radiotherapy plays an important role in cancer treatment today. Successful radiotherapy includes precise positioning and accurate dosimetry. Objective: To use NIPAM gel dosimeter and concentric swing machine to simulate and evaluate the feasibility of lung or upper abdominal tumor dose distribution during breathing. Methods: We used a concentric swing machine to simulate actual radiotherapy for lung or upper abdomen tumors. A 4 × 4 cm2 irradiation field area was set and MRI was performed. Next, readout analysis was performed using MATLAB and the 3 mm, 3% gamma passing rate > 95% was used as a basis for evaluation. Results: The concentric dynamic dose curve for a simulated respiratory rate of 3 seconds/breath and 4 × 4 cm2 field was compared with 4 × 4, 3 × 3, and 2 × 2 cm2 treatment planning systems (TPS), and the 3 mm, 3% gamma passing rate was 42.87%, 54.96%, and 49.92%, respectively. Pre-simulation showed that the high-dose region dose curve was similar to the 2 × 2 cm2 TPS result. After appropriate selection and comparison, we found that the 3 mm, 3% gamma passing rate was 97.92% on comparing the > 60% dose curve with the 2 × 2 cm2 TPS. Conclusions: NIPAM gel dosimeter and concentric swing machine use is feasible to simulate dose distribution during breathing and results conforming to clinical evaluation standards.

Background: The gel dosimeter is a chemical as well as a relative dosimeter. Objective: To evaluate the feasibility of using N-isopropylacrylamide (NIPAM) gel dosimeter to observe the dynamic dose effects and quantification of the respiration, and to help determine the safety margins. Methods: The NIPAM gel dosimeter combined with the dynamic phantom was used to simulate radiotherapy of lung or upper abdominal tumor. The field set to 4 × 5 cm2, simulate respiratory rate of 4 sec/cycle, and motion range 2 cm. MRI was used for reading, and MATLAB was used for analysis. The 3%/3 mm gamma passing rate > 95% was used as a clinical basis for evaluation. Results: The dynamic dose curve was compared with 4 × 5, 4 × 4, 4 × 3 cm2 TPS, and gamma passing rates were 74.32%, 54.83%, 30.18%. Gamma mapping demonstrated that the highest dose region was similar to the result of the 4 × 4 cm2 TPS. After appropriate selection and comparing that the ⩾ 60% part of the dose curve with TPS, the gamma passing rate was 96.49%. Conclusions: Using the NIPAM gel dosimeter with dynamic phantom to simulate organ motion during respiration for dynamic dose measurement and quantified the dynamic dose effect is feasible. The results are consistent with clinical evaluation standards.

Purpose: Polymer gel dosimeters provide three-dimensional absorbed dose information and have gradually become a popular tool for quality assurance in radiotherapy. This study aims to incorporate iodine into the MAGAT-based gel as radiation sensitizer and investigate whether it can be used to measure the radiation dose and slice thickness for CT scans. Methods: The nMAGAT(I) gel was doped with 0.03, 0.05, and 0.07-M iodine. The absorbed dose was delivered using a CT scanner (Alexion 16, Toshiba Medical Systems, Japan) with tube voltages of 80, 100, 120, and 135 kVp. The irradiated nMAGAT(I) gel was read using a cone beam optical CT scanner to produce dose-response curves. The nMAGAT(I) gel was used to obtain the slice sensitivity profile (SSP) and the CT dose index (CTDI) for quality assurance of CT scans. Results: The 0.07-M iodine-doped nMAGAT(I) gel exhibited maximum sensitivity with the dose enhancement ratio of 2.12. The gel was chemically stable 24 h after its preparation, and the polymerization process was completed 24-48 h after the irradiation. For CT quality assurance, the full width at half maximum measured by the nMAGAT(I) gel matched the nominal slice thickness of CT. The CTDI at center, CTDI at peripheral, and weighted CTDI obtained by the nMAGAT(I) gel differed from those obtained by the ionization chamber by -4.2%, 3.1%, and 0.7%, respectively. Conclusions: The nMAGAT(I) gel can be used to assess radiation doses and slice thickness in CT scans, thus rendering it a potential quality assurance tool for CT and other radiological diagnostic applications.

On-board cone-beam computed tomography (CBCT) was used to scan the N-isopropylacrylamide (NIPAM) gel dosimeter. A dose-response curve from 1 to 12 Gy was created. The dose profile and depth dose curve were measured, and the dose distribution acquired from CBCT was then compared with that obtained from a treatment planning system (TPS). The linearity of the dose-response curve obtained by CBCT scanning of the NIPAM gel was 0.985. The mean percent standard deviation of various doses was 12.8%. A 12- to 24-h post-irradiation time was required to achieve stable CBCT readouts. Both dose profile and depth dose were in agreement with the results of TPS. The dose difference at the isocenter between CBCT and TPS was 3.8%. The gamma evaluation under the conditions of 5% dose difference and 5 mm distance-to-agreement was performed with the pass rate of 92.6%. These results indicate that an on-board CBCT can be used for scanning gel dosimeters in clinical radiotherapy.

Background/aim: An injectable chitosan-based co-cross-linking thermosensitive hydrogel combining 188Re- and doxorubicin-encapsulated liposomes (C/GP/GE/188Re-LIPO-DOX) was developed for the prevention of locoregional recurrence after mastectomy. Materials and methods: The hydrogel properties, in vitro drug release characteristics, and in vivo scintigraphy imaging attributes were investigated. Results: The gelation time of the hydrogels can be controlled to be within 5 min. Results from Fourier-transform infrared spectroscopy, scanning electron microscopy, and dynamic mechanical analysis showed that a covalent cross-linking reaction between chitosan and genipin occurred and that the hydrogel's mechanical strength and chemical stability were improved. In vitro drug release studies showed that the hydrogel can prolong the release of doxorubicin by several weeks (51.5%±5.3% at 21 days). In addition, in vivo scintigraphy results suggested high retention rates (43.1%±1.0% at 48 h) of the radiopharmaceutical compound at the tumor injection site. Conclusion: The preliminary results indicated that the C/GP/GE/188Re-LIPO-DOX radiopharmaceutical hydrogel is a potential candidate for further in vivo therapeutic evaluation.

Aim: To assess the correlation between advanced non-small cell lung cancer (NSCLC) with or without pulmonary lymphangitic carcinomatosis (PLC) and fluorodeoxyglucose (FDG) uptake and its effect on survival outcomes. Patients and methods: We retrospectively reviewed 157 patients with NSCLC. The mean and maximum standardized uptake values (SUVmean and SUVmax, respectively), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were evaluated for their effect on overall survival (OS) and progression-free survival (PFS). Results: The PLC group included 55 patients and the non-PLC group included 102 patients. The SUVmean, SUVmax, MTV and TLG values were lower in the non-PLC group. In the PLC group, primary lung tumor TLG was a significant predictor of PFS, while whole-body TLG was found to be a significant predictor in non-PLC patients. Conclusion: Primary lung tumor TLG was a good predictor in PLC patients. Whole-body TLG could be a useful predictor only in patients without PLC.

With advances in therapeutic instruments and techniques, three-dimensional dose delivery has been widely used in radiotherapy. The verification of dose distribution in a small field becomes critical because of the obvious dose gradient within the field. The study investigates the dose distributions of various field sizes by using NIPAM polymer gel dosimeter. The dosimeter consists of 5% gelatin, 5% monomers, 3% cross linkers, and 5 mM THPC. After irradiation, a 24 to 96 hour delay was applied, and the gel dosimeters were read by a cone beam optical computed tomography (optical CT) scanner. The dose distributions measured by the NIPAM gel dosimeter were compared to the outputs of the treatment planning system using gamma evaluation. For the criteria of 3%/3 mm, the pass rates for 5 × 5, 3 × 3, 2 × 2, 1 × 1, and 0.5 × 0.5 cm2 were as high as 91.7%, 90.7%, 88.2%, 74.8%, and 37.3%, respectively. For the criteria of 5%/5 mm, the gamma pass rates of the 5 × 5, 3 × 3, and 2 × 2 cm2 fields were over 99%. The NIPAM gel dosimeter provides high chemical stability. With cone-beam optical CT readouts, the NIPAM polymer gel dosimeter has potential for clinical dose verification of small-field irradiation.

This study aimed to investigate the dosimetric characteristics of intensity-modulated radiation therapy (IMRT) and RapidArc therapy by using 3D N-isopropylacrylamide (NIPAM) polymer gel. Optical computed tomography, specifically OCTOPUSTM-10X fast optical computed tomography scanner, was used as a readout tool. Two cylindrical acrylic phantoms (10 cm in diameter, 10 cm in height, and 3 mm in thickness) were filled with NIPAM gel and used for IMRT and RapidArc irradiation by using the Clinac iX treatment machine. The irradiation energies for IMRT and RapidArc® were set as 6 MV photons, but their irradiation angles and dose rates differed during irradiation. The irradiation angles of IMRT were 120°, 155°, 180°, 215°, and 245°, and the dose rate was fixed at 400 cGy/min. RapidArc® rotated continuously during irradiation, and the dose rate varied from 330 cGy/min to 400 cGy/min. The pass rates were 98.02% and 97.48% for IMRT and RapidArc®, respectively, and the rejected area appeared at the edge of the irradiated region. The isodose lines of IMRT and RapidArc® were consistent with those of TPS in most regions. Scattering and edge enhancement effects are main factors that cause dose inaccuracy in the edge region and reduced pass rates. Considering dose rate dependence, we used variable dose rates during irradiation with RapidArc®. Results showed that the dose distribution of NIPAM gel was consistent with that of TPS. The pass rates were also the same for IMRT and RapidArc® irradiation. This study proposes a preliminary profile of dosimetric characteristics of IMRT and RapidArc® by using a NIPAM gel dosimeter.

NIPAM dosimeter is widely accepted and recommended for its 3D distribution and accurancy in dose absorption. Up to the moment, most research on dose measurement are based on a fixed irradiation target without the consideration of the effect from physiological motion. We present a study to construct a respiratory motion simulating patient anatomical and dosimetry model for the study of dosimetic effect of organ motion. The dose on fixed and motion targets were measured by MRI after a dose adminstration of 1,2,5,8,10 Gy from Linear accelerator. Comparison of two situations. The average sensitivity of fixed NIPAM was 0.1356 s−1/Gy linearity R2= 0.998, The average sensitivity of movement NIPAM was 0.1366 s−1/Gy linearity R2= 0.998 only 0.001 of the sensitivity difference. The difference between the two based on dose rate dependency, position and depth were not significant. There was thus no apparent impact on NIPAM dosimeter from physiological motion. The high sensitivity, linearity and stability of NIPAM dosimeter prove to be an ideal apparatus in the dose measurement in these circumstances.