1.A study of PET-CT SUV range for dose verification in carbon ion radiation therapy
Lining SUN ; Weigang HU ; Songtao LAI ; Leijun SHI ; Junchao CHEN
Chinese Journal of Radiation Oncology 2017;26(7):781-785
Objective The positron generated at the dose deposition site by using high-energy carbon ions to hit the material annihilate with the negative electron in the material to release the gamma photon.The positron-emitting isotope (PEI) distributions in the target volume are activated significantly by carbon ions.Therefore, the mean values of positron emission tomography (PET) activity could be related to the delivered doses to the clinical target volume from carbon ion.This specialty can be used for the image registration fusion of the carbon ion treatment planning computed tomography (CT) and treatment verification PET-CT.After radiation in the almost same decay period, the relationship between the different target volume and the PET-CT SUV of different every single fraction dose can be found, then the range of SUV for the radiation target could be decided.So this PET-CT standardized uptake value (SUV) range can also provide a reference for the correlation and consistency in planning target dose verification and evaluation for the clinical trial.Methods The head phantom was used as a simulation of the real human body, the 1 cc, 4 cc, and 10 cc cube volume target contouring were done in the TPS, the 90 degree fixed carbon ion beams were delivered in different single fraction effective dose of 2.5 GyE, 5 GyE, and 8 GyE.After the beam delivery, later the PET-CT scanning was performed and parameters of scanning followed the trial regulation.The MIM Maestro software was used for the image processing and fusion to determine the maximum, minimum, average, and total values of SUV in the virtual clinical target volumes for the different single fraction dose.Results The results showed that for the same target volume, the SUV range of target had an approximate linear correlation with effective dose of target (P=0.000).The same effective dose for the different target volumes got the same SUV range (P>0.05).Conclusions For the carbon ion treatment plan, the SUV range from image registration and fusion of planning CT and PET-CT after treatment can be used to make an evaluation for accuracy of the dose distribution.And this method also could be used in the hyper-fraction treatment plan.In the SUV range research of different decay periods, the similar method can be performed for the exploration.
2.Relationship among cardioversion,cerebral infarction and NT-proBNP level in patients with heart fail-ure complicated atrial fibrillation
Yuhong ZHAO ; Hongfeng SUN ; Leijun WANG ; Chunxian QIAN ; Aijun CHEN ; Lei SHI ; Kaifeng CHEN ; Jing SUU
Chinese Journal of cardiovascular Rehabilitation Medicine 2015;24(5):498-501
Objective:To explore the relationship among cardioversion ,cerebral infarction (CI) and N terminal pro brain natriuretic peptide (NT‐proBNP) level in patients with heart failure (HF) complicated atrial fibrillation (AF) . Methods :A total of 150 HF + AF patients received intravenous drip of amiodarone for cardioversion therapy .Ac‐cording to cardioversion results ,they were divided into cardioversion group (n=100 ) and non‐cardioversion group (n=50) ,NT‐proBNP level change was observed in two groups before and after cardioversion .According to CI on‐set or not ,patients were divided into CI group (n=20) and non‐CI group (n= 130) ,NT‐proBNP level was com‐pared between two groups before and after onset .Results :Within 48h after administration ,a total of 100 patients (66.67% ) recovered to sinus rhythm .Compared with before cardioversion ,NT‐proBNP level significantly reduced [(967.04 ± 366.16) pg/ml vs .(496.21 ± 142.54) pg/ml] after cardioversion in cardioversion group ,and was signifi‐cantly lower than that of non‐cardioversion group (996.76 ± 351.28) pg/ml , P<0.01 all . In CI group ,compared with small size CI group ,there were significant rise in NT‐proBNP level [ (784.21 ± 231.26) pg/ml vs .(1983.24 ± 32.96) pg/ml ,(3562.19 ± 1468.32) pg/ml] in medium and large size CI group , P< 0.05 or <0.01 .Conclusion:NT‐proBNP level at hospitalization possesses predictive value for drug cardioversion effect in HF + AF patients . NT‐proBNP level is related with CI onset .After acute CI ,the higher NT‐proBNP level is ,the larger infarct size is , the poorer prognosis is .
3.Prevention value of different blood pressure levels in H‐type hypertensive patients for stroke/
Yuhong ZHAO ; Hao YANG ; Lei SHI ; Hongfeng SUN ; Leijun WANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2019;28(6):23-27
To explore target blood pressure (BP) for lower incidence rate of stroke and better prognosis in patients with H‐type hypertension .Methods :A total of 600 patients with H‐type hypertension according to BP were divided into low level group (< 120/90mmHg or DBP < 90mmHg , n = 200 ) , medium level group (120 ~ 130/90mmHg or DBP<90mmHg ,n= 200 ) and high level group (130~140/90mmHg or DBP< 90mmHg ,n= 200 ) , three groups were treated for two years .Levels of BP ,serum homocysteine (Hcy) ,carotid intima‐media thickness (CIMT) were measured and compared among three groups before and after treatment ,and incidence rates of ad‐verse events were recorded in three groups during follow‐up .Results :During follow‐up ,there were gradual signifi‐cant reductions in serum Hcy level and CIMT in three groups ,P<0.05 or <0. 01. After four‐week follow‐up ,com‐pared with low level group ,there were significant rise in levels of BP and Hcy in medium and high level group ,and SBP of high level group was significantly higher than that of medium level group ,CIMT was significantly higher than the other two groups , P=0.001 all ;after eight‐week and two‐year follow‐up ,compared with low level group , there were significant rise in levels of BP ,Hcy and CIMT in medium and high level group ,SBP and CIMT of high level group were significantly higher than those of medium level group ;and Hcy level of medium level group was sig‐nificantly higher than that of high level group after two‐year follow‐up , P<0.05 or <0.01. After two‐year follow‐up ,recurrence rate of stroke ,incidence rates of cardiovascular diseases and adverse reactions in high level group were significantly higher than those of low and medium level group ,and recurrence rate of stroke in medium level group was significantly lower than that of low level group , P<0.05 or <0.01. Conclusion :Total therapeutic effect of low level group is significantly better than those of medium and high level group .It can more significantly reduce Hcy level ,further reduce recurrence rate of stroke and mortality and more comprehensively control risk factors of cardiovascular diseases .
4.Experimental study of range verification of proton radiotherapy using off-line PET/CT
Jiangang ZHANG ; Junyu ZHANG ; Yan LU ; Yinxiangzi SHENG ; Wei REN ; Leijun SHI ; Yun SUN ; Yingjian ZHANG ; Wenchien HSI ; Rong ZHOU ; Guoliang JIANG ; Jiade LU ; Jingyi CHENG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2020;40(10):603-608
Objective:To test the usefulness of PET-range verification (RV) method for proton radiation accuracy verification in poly (methyl methacrylate) (PMMA) phantom using off-line PET/CT scanning.Methods:Proton irradiation dose of 2 Gy and 4 Gy were delivered in PMMA phantom. Given the difference of clinical target volume (CTV), 7 subgroups with different depth (5.0, 7.5, 10.0, 12.5, 15.0, 17.5, 20.0 cm) were set for each dose (14 radiation plans or radiation fields). PET/CT scan was performed 10 min after irradiation of 48-221 MeV proton beam. A co-registration between CT from treatment planning system and PET/CT was performed, as well as the smoothing and normalization of PET/CT data. The region of interest (ROI) and profile lines were drawn with the Raystation PET-RV software. The predictive induced radioactivity and the measured induced radioactivity profile lines were analyzed to evaluate the Δ R50, namely, the error at the position corresponding to 50% of the maximum predictive induced radioactivity at the end of both curves. Results:The size of each ROI was 5.0 cm×5.0 cm×2.5 cm. Profile lines were evenly distributed with the interval of 3 mm, and totally 289 pairs of profile lines were drew. The 2 Gy- and 4 Gy-dose groups yielded similar mean depth errors (Δ R50 between 1 mm and -1 mm with a standard deviation <1 mm). Conclusions:The off-line PET/CT scanning of PMMA phantom reveals a good agreement between predicted and measured PET data, with error of ±1 mm. The PET-RV method can be extended to clinical cases′ verification in human body treatment with further investigation.