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At least 109 records · Page 6

Impact of respiratory motion correction on SPECT myocardial perfusion imaging using a mechanically moving phantom assembly with variable cardiac defects

Background: The aim of this study was to determine the impact of respiratory motion correction on SPECT MPI and on defect detection using a phantom assembly. Methods: SPECT/CT data were acquired using an anthropomorphic phantom with inflatable lungs and with an ECG beating and moving cardiac compartment. The heart motion followed the respiratory pattern in the cranio-caudal direction to simulate normal or deep breathing. Small or large transmural defects were inserted into the myocardial wall of the left ventricle. SPECT/CT images were acquired for each of the four respiratory phases, from exhale to inhale. A respiratory motion correction was applied using an image-based method with transformation parameters derived from the SPECT data by a non-rigid registration algorithm. A report on defect detection from two physicians and a quantitative analysis on MPI data were performed before and after applying motion correction. Results: Respiratory motion correction eliminated artifacts present in the images, resulting in a uniform uptake and reduction of motion blurring, especially in the inferior and anterior regions of the LV myocardial walls. The physicians’ report after motion correction showed that images were corrected for motion. Conclusions: A combination of motion correction with attenuation correction reduces artifacts in SPECT MPI. AC-SPECT images with and without motion correction should be simultaneously inspected to report on small defects.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Assessing the use of portable air cleaners for reducing exposure to airborne diseases in a conference room with thermal stratification

The COVID-19 pandemic has highlighted the need for strategies that mitigate the risk of aerosol disease transmission in indoor environments with different ventilation strategies. It is necessary for building operators to be able to estimate and compare the relative impacts of different mitigation strategies to determine suitable strategies for a particular situation. Using a validated CFD model, this study simulates the dispersion of exhaled contaminants in a thermally stratified conference room with overhead heating. The impacts of portable air-cleaners (PACs) on the room airflow and contaminant distribution were evaluated for different PAC locations and flow rates, as well as for different room setups (socially distanced or fully occupied). To obtain a holistic view of a strategy's impacts under different release scenarios, we simultaneously model the steady-state distribution of aerosolized virus contaminants from eight distinct sources in 18 cases for a total of 144 release scenarios. The simulations show that the location of the source, the PAC settings, and the room set-up can impact the average exposure and PAC effectiveness. For this studied case, the PACs reduced the room average exposure by 31%-66% relative to the baseline case. Some occupant locations were shown to have a higher-than-average exposure, particularly those seated near the airflow outlet, and occupants closest to sources tended to see the highest exposure from said source. We found that these PACs were effective at reducing the stratification caused by overhead heating, and also identified at least one sub-optimal location for placing a PAC in this space.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

Adaptations for gas exchange enabled the elongation of lepidopteran proboscises

The extensive biodiversification of butterflies and moths (Lepidoptera) is partly attributed to their unique mouthparts (proboscis [Pr]) that can span in length from less than 1 mm to over 280mm in Darwin's sphinx moths. Lepi-doptera, similar to other insects, are believed to inhale and exhale respiratory gases only through valve-like spi-racles on their thorax and abdomen, making gas exchange through the narrow tracheae (Tr) challenging for the elongated Pr. How Lepidoptera overcome distance effects for gas transport to the Pr is an open question that is important to understanding how the Pr elongated over evolutionary time. Here, we show with scanning electron microscopy and X-ray imaging that distance effects on gas exchange are overcome by previously unreported micropores on the Pr surface and by superhydrophobic Tr that prevent water loss and entry. We find that the density of micropores decreases monotonically along the Pr length with the maxima proportional to the Pr length and that micropore diameters produce a Knudsen number at the boundary between the slip and transition flow regimes. By numerical estimation, we further show that the respiratory gas exchange for the Pr predominantly occurs via diffusion through the micropores. In conclusion, these adaptations are key innovations vital to Pr elongation, which likely facilitated lepidopteran biodiversification and the radiation of angiosperms by coevolutionary processes.

59 BASIC BIOLOGICAL SCIENCES↗

Cigarettes vs. e-cigarettes: Passive exposure at home measured by means of airborne marker and biomarkers

Background: There is scarce evidence about passive exposure to the vapour released or exhaled from electronic cigarettes (e-cigarettes) under real conditions. The aim of this study is to characterise passive exposure to nicotine from e-cigarettes' vapour and conventional cigarettes' smoke at home among non-smokers under real-use conditions. Methods: We conducted an observational study with 54 non-smoker volunteers from different homes: 25 living at home with conventional smokers, 5 living with nicotine e-cigarette users, and 24 from control homes (not using conventional cigarettes neither e-cigarettes). We measured airborne nicotine at home and biomarkers (cotinine in saliva and urine). We calculated geometric mean (GM) and geometric standard deviations (GSD). We also performed ANOVA and Student's t tests for the log-transformed data. We used Bonferroni-corrected t-tests to control the family error rate for multiple comparisons at 5%. Results: The GMs of airborne nicotine were 0.74 μg/m{sup 3} (GSD=4.05) in the smokers’ homes, 0.13 μg/m{sup 3} (GSD=2.4) in the e-cigarettes users’ homes, and 0.02 μg/m{sup 3} (GSD=3.51) in the control homes. The GMs of salivary cotinine were 0.38 ng/ml (GSD=2.34) in the smokers’ homes, 0.19 ng/ml (GSD=2.17) in the e-cigarettes users’ homes, and 0.07 ng/ml (GSD=1.79) in the control homes. Salivary cotinine concentrations of the non-smokers exposed to e-cigarette's vapour at home (all exposed ≥2 h/day) were statistically significant different that those found in non-smokers exposed to second-hand smoke ≥2 h/day and in non-smokers from control homes. Conclusions: The airborne markers were statistically higher in conventional cigarette homes than in e-cigarettes homes (5.7 times higher). However, concentrations of both biomarkers among non-smokers exposed to conventional cigarettes and e-cigarettes’ vapour were statistically similar (only 2 and 1.4 times higher, respectively). The levels of airborne nicotine and cotinine concentrations in the homes with e-cigarette users were higher than control homes (differences statistically significant). Our results show that non-smokers passively exposed to e-cigarettes absorb nicotine. - Highlights: • This is the first study of e-cigarette exposure at home under real-use conditions. • Airborne nicotine in homes with smokers were 5.7 times higher than in e-cig homes. • Cotinine of non-smokers exposed to e-cig and conventional cigarettes was similar. • Airborne nicotine in homes with e-cig users was higher than control homes. • Cotinine of non-smokers exposed to e-cig users was higher than in those no exposed.

54 ENVIRONMENTAL SCIENCES↗

The micro-environmental impact of volatile organic compound emissions from large-scale assemblies of people in a confined space

Large-scale assemblies of people in a confined space can exert significant impacts on the local air chemistry due to human emissions of volatile organics. Variations of air-quality in such small scale can be studied by quantifying fingerprint volatile organic compounds (VOCs) such as acetone, toluene, and isoprene produced during concerts, movie screenings, and sport events (like the Olympics and the World Cup). This review summarizes the extent of VOC accumulation resulting from a large population in a confined area or in a small open area during sporting and other recreational activities. Apart from VOCs emitted directly from human bodies (e.g., perspiration and exhaled breath), those released indirectly from other related sources (e.g., smoking, waste disposal, discharge of food-waste, and use of personal-care products) are also discussed. Although direct and indirect emissions of VOCs from human may constitute <1% of the global atmospheric VOCs budget, unique spatiotemporal variations in VOCs species within a confined space can have unforeseen impacts on the local atmosphere to lead to acute human exposure to harmful pollutants.

54 ENVIRONMENTAL SCIENCES↗

Personal exposure to fine particles (PM2.5) and respiratory inflammation of common residents in Hong Kong

Highlights: • Personal PM{sub 2.5} monitoring from 46 healthy adults with up to 6 repeated measurements were conducted. • Personal PM{sub 2.5} exposures were higher than ambient levels monitored by stations. • Mixed-effects model was applied to assess the relationship between air pollutants exposure and biomarker. • Significant associations were observed for the increased FeNO with personal exposure to PM{sub 2.5} and c-PAHs. Given the lack of research on the personal exposure to fine particles (PM{sub 2.5}) in Hong Kong, we examined the association between short-term personal exposure to PM{sub 2.5} and their constituents and inflammation in exhaled breath in a sample of healthy adult residents.

54 ENVIRONMENTAL SCIENCES↗

An Experimental Study of the Solubility of Rare Earth Chloride Salts (La, Nd, Er) in HCl Bearing Water Vapor from 350 – 425 °C

In this work, the solubilities of the rare earth chlorides REECl 3 , where REE = (La, Nd, Er), were measured in HCl bearing water vapor from 350 – 425°C with water partial pressures ranging from 8 – 170 bar. Solubility data were fit to the Pitzer-Pabalan quasi-chemical model in order to extract thermodynamic parameters for the formation of the gaseous REE-chloride-water clusters REECl 3 (H 2 O) n . The data show that the solubility of the REE chlorides are orders of magnitude higher than salts such as NaCl or CuCl at low water fugacities, despite their sublimation energies being substantially higher. This enhanced solubility is likely due to the high enthalpy associated with binding a single water molecule to form the species REECl 3 (H 2 O), with derived enthalpies ranging from –378 to –465 kJ/mol. Addition of further water molecules to form higher order clusters (n > 1) involves enthalpy changes of ~ -20 kJ/mol, and are in effect thermodynamically suppressed over the temperature range 350 – 425°C. Despite the enhanced solubility of small REECl 3 water clusters, simulations of boiling processes demonstrate that the REE show highly conservative behavior, partitioning strongly into the dense aqueous phase. Not surprisingly, the presence of phosphates in the system makes this effect even more pronounced, completely immobilizing the REE. This would reduce transport in both the vapor and aqueous phase to negligible levels. However, we suggest that vapor phase transport of the REE may play a significant role in systems having a relatively low partial pressure of water (below the saturation point), where the relatively high stability of the first hydrated REE chloride clusters (REECl 3 (H 2 O) and REECl 3 (H 2 O) 2 ) will give a preference for gas transport of the REE relative to other elements. This can likely happen in systems involving a gas/melt exchange in fumarolic exhalations, where water vapor discharges at relatively low (close to atmospheric) pressures.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

A Four-Dimensional Computed Tomography Analysis of Multiorgan Abdominal Motion

Purpose: To characterize and quantify multiorgan respiration-induced motion in the abdomen in liver and pancreatic cancer patients. Methods and Materials: Four-dimensional computed tomography scans were acquired for 18 patients treated for abdominal tumors. Contours of multiple abdominal organs were drawn by the radiation oncologist at one respiratory phase; these contours were propagated to other respiratory phases by deformable registration. Three-dimensional organ models were generated from the resulting contours at each phase. Motions of the bounding box and center of mass were extracted and analyzed for the clinical target volume and organs at risk. Results: On average, the center of mass motion for liver clinical target volumes was 9.7 mm (SD 5 mm) in the superior-inferior direction, with a range of 3 to 18 mm; for pancreatic tumors, the average was 5 mm (SD 1 mm) m with a range of 3 to 7 mm. Abdominal organs move in unison, but with varying amplitudes. Gating near exhale (T40-T60) reduces the range of motion by a factor of {approx}10. Conclusion: We have used deformable registration to calculate the trajectories of abdominal organs in four dimensions, based on center of mass and bounding box motion metrics. Our results are compared with previously reported studies. Possible reasons for differences are discussed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Quantification of the Variability of Diaphragm Motion and Implications for Treatment Margin Construction

Purpose: To quantify the variability of diaphragm motion during free-breathing radiotherapy of lung patients and its effect on treatment margins to account for geometric uncertainties. Methods and Materials: Thirty-three lung cancer patients were analyzed. Each patient had 5-19 cone-beam scans acquired during different treatment fractions. The craniocaudal position of the diaphragm dome on the same side as the tumor was tracked over 2 min in the projection images, because it is both easily visible and a suitable surrogate to study the variability of the tumor motion and its impact on treatment margins. Intra-acquisition, inter-acquisition, and inter-patient variability of the respiratory cycles were quantified separately, as were the probability density functions (PDFs) of the diaphragm position over each cycle, each acquisition, and each patient. Asymmetric margins were simulated using each patient PDF and compared to symmetric margins computed from a margin recipe. Results: The peak-to-peak amplitude variability (1 SD) was 3.3 mm, 2.4 mm, and 6.1 mm for the intra-acquisition, inter-acquisition, and inter-patient variability, respectively. The average PDF of each cycle was similar to the sin{sup 4} function but the PDF of each acquisition was closer to a skew-normal distribution because of the motion variability. Despite large interfraction baseline variability, the PDF of each patient was generally asymmetric with a longer end-inhale tail because the end-exhale position was more stable than the end-inhale position. The asymmetry of the PDF required asymmetric margins around the time-averaged position to account for the position uncertainty but the average difference was 1.0 mm (range, 0.0-4.4 mm) for a sharp penumbra and an idealized online setup correction protocol. Conclusion: The respiratory motion is more irregular during the fractions than between the fractions. The PDF of the respiratory motion is asymmetrically distributed. Both the intra-acquisition variability and the PDF asymmetry have a limited impact on dose distributions and inferred margins. The use of a margin recipe to account for respiratory motion with an estimate of the average motion amplitude was adequate in almost all patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Accumulated Dose in Liver Stereotactic Body Radiotherapy: Positioning, Breathing, and Deformation Effects

Purpose: To investigate the accumulated dose deviations to tumors and normal tissues in liver stereotactic body radiotherapy (SBRT) and investigate their geometric causes. Methods and Materials: Thirty previously treated liver cancer patients were retrospectively evaluated. Stereotactic body radiotherapy was planned on the static exhale CT for 27-60 Gy in 6 fractions, and patients were treated in free-breathing with daily cone-beam CT guidance. Biomechanical model-based deformable image registration accumulated dose over both the planning four-dimensional (4D) CT (predicted breathing dose) and also over each fraction's respiratory-correlated cone-beam CT (accumulated treatment dose). The contribution of different geometric errors to changes between the accumulated and predicted breathing dose were quantified. Results: Twenty-one patients (70%) had accumulated dose deviations relative to the planned static prescription dose >5%, ranging from -15% to 5% in tumors and -42% to 8% in normal tissues. Sixteen patients (53%) still had deviations relative to the 4D CT-predicted dose, which were similar in magnitude. Thirty-two tissues in these 16 patients had deviations >5% relative to the 4D CT-predicted dose, and residual setup errors (n = 17) were most often the largest cause of the deviations, followed by deformations (n = 8) and breathing variations (n = 7). Conclusion: The majority of patients had accumulated dose deviations >5% relative to the static plan. Significant deviations relative to the predicted breathing dose still occurred in more than half the patients, commonly owing to residual setup errors. Accumulated SBRT dose may be warranted to pursue further dose escalation, adaptive SBRT, and aid in correlation with clinical outcomes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Management of Respiration-Induced Motion With 4-Dimensional Computed Tomography (4DCT) for Pancreas Irradiation

Purpose: The purposes of this study were to quantify respiration-induced organ motions for pancreatic cancer patients and to explore strategies to account for these motions. Methods and Materials: Both 3-dimensional computed tomography (3DCT) and 4-dimensional computed tomography (4DCT) scans were acquired sequentially for 15 pancreatic cancer patients, including 10 randomly selected patients and 5 patients selected from a subgroup of patients with large tumor respiratory motions. 3DCTs were fused with 2 sets of 4DCT data at the end of exhale phase (50%) and the end of inhale phase (0%). The target was delineated on the 50% and 0% phase CT sets, and the organs at risk were drawn on the 3DCT. These contours were populated to the CT sets at other respiratory phases based on deformable image registration. Internal target volumes (ITV) were generated by tracing the target contours of all phases (ITV{sub 10}), 3 phases of 0%, 20% and 50% (ITV{sub 3}), and 2 phases of 0% and 50% (ITV{sub 2}). ITVs generated from phase images were compared using percentage of volume overlap, Dice coefficient, geometric centers, and average surface distance. Results: Volume variations of pancreas, kidneys, and liver as a function of respiratory phases were small (<5%) during respiration. For the 10 randomly selected patients, peak-to-peak amplitudes of liver, left kidney, right kidney, and the target along the superior-inferior (SI) direction were 7.9 ± 3.2 mm, 7.1 ± 3.1 mm, 5.7 ± 3.2 mm, and 5.9 ± 2.8 mm, respectively. The percentage of volume overlap and Dice coefficient were 92% ± 1% and 96% ± 1% between ITV{sub 10} and ITV{sub 2} and 96% ± 1% and 98% ± 1% between ITV{sub 10} and ITV{sub 3}, respectively. The percentage of volume overlap between ITV{sub 10} and ITV{sub 3} was 93.6 ± 1.1 for patients with tumor motion >8 mm. Conclusions: Appropriate motion management strategies are proposed for radiation treatment planning of pancreatic tumors based on magnitudes of tumor respiratory motions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A Comparison of Amplitude-Based and Phase-Based Positron Emission Tomography Gating Algorithms for Segmentation of Internal Target Volumes of Tumors Subject to Respiratory Motion

Purpose: To quantitatively compare the accuracy of tumor volume segmentation in amplitude-based and phase-based respiratory gating algorithms in respiratory-correlated positron emission tomography (PET). Methods and Materials: List-mode fluorodeoxyglucose-PET data was acquired for 10 patients with a total of 12 fluorodeoxyglucose-avid tumors and 9 lymph nodes. Additionally, a phantom experiment was performed in which 4 plastic butyrate spheres with inner diameters ranging from 1 to 4 cm were imaged as they underwent 1-dimensional motion based on 2 measured patient breathing trajectories. PET list-mode data were gated into 8 bins using 2 amplitude-based (equal amplitude bins [A1] and equal counts per bin [A2]) and 2 temporal phase-based gating algorithms. Gated images were segmented using a commercially available gradient-based technique and a fixed 40% threshold of maximum uptake. Internal target volumes (ITVs) were generated by taking the union of all 8 contours per gated image. Segmented phantom ITVs were compared with their respective ground-truth ITVs, defined as the volume subtended by the tumor model positions covering 99% of breathing amplitude. Superior-inferior distances between sphere centroids in the end-inhale and end-exhale phases were also calculated. Results: Tumor ITVs from amplitude-based methods were significantly larger than those from temporal-based techniques (P=.002). For lymph nodes, A2 resulted in ITVs that were significantly larger than either of the temporal-based techniques (P<.0323). A1 produced the largest and most accurate ITVs for spheres with diameters of ≥2 cm (P=.002). No significant difference was shown between algorithms in the 1-cm sphere data set. For phantom spheres, amplitude-based methods recovered an average of 9.5% more motion displacement than temporal-based methods under regular breathing conditions and an average of 45.7% more in the presence of baseline drift (P<.001). Conclusions: Target volumes in images generated from amplitude-based gating are larger and more accurate, at levels that are potentially clinically significant, compared with those from temporal phase-based gating.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Intrafraction Variability and Deformation Quantification in the Breast

Purpose: To evaluate intrafraction variability and deformation of the lumpectomy cavity (LC), breast, and nearby organs. Methods and Materials: Sixteen left-sided postlumpectomy and 1 bilateral breast cancer cases underwent free-breathing CT (FBCT) and 10-phase 4-dimensional CT (4DCT). Deformable image registration was used for deformation analysis and contour propagation of breast, heart, lungs, and LC between end-exhale and end-inhale 4DCT phases. Respiration-induced motion was calculated via centroid analysis. Two planning target volumes (PTVs) were compared: PTV{sub FBCT} from the FBCT volume with an isotropic 10 mm expansion (5 mm excursion and 5 mm setup error) and PTV{sub 4DCT} generated from the union of 4DCT contours with isotropic 5 mm margin for setup error. Volume and geometry were evaluated via percent difference and bounding box analysis, respectively. Deformation correlations between breast/cavity, breast/lung, and breast/heart were evaluated. Associations were tested between cavity deformation and proximity to chest wall and breast surface. Results: Population-based 3-dimensional vector excursions were 2.5 ± 1.0 mm (range, 0.8-3.8 mm) for the cavity and 2.0 ± 0.8 mm (range, 0.7-3.0 mm) for the ipsilateral breast. Cavity excursion was predominantly in the anterior and superior directions (1.0 ± 0.8 mm and −1.8 ± 1.2 mm, respectively). Similarly, for all cases, LCs and ipsilateral breasts yielded median deformation values in the superior direction. For 14 of 17 patients, the LCs and breast interquartile ranges tended toward the anterior direction. The PTV{sub FBCT} was 51.5% ± 10.8% larger (P<.01) than PTV{sub 4DCT}. Bounding box analysis revealed that PTV{sub FBCT} was 9.8 ± 1.2 (lateral), 9.0 ± 2.2 (anterior–posterior), and 3.9 ± 1.8 (superior–inferior) mm larger than PTV{sub 4DCT}. Significant associations between breast and cavity deformation were found for 6 of 9 axes. No dependency was found between cavity deformation and proximity to chest wall or breast surface. Conclusions: Lumpectomy cavity and breast deformation and motion demonstrated large variability. A PTV{sub 4DCT} approach showed value in patient-specific margins, particularly if robust interfraction setup analysis can be performed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Multi-institutional Validation Study of Commercially Available Deformable Image Registration Software for Thoracic Images

Purpose: To assess the accuracy of the commercially available deformable image registration (DIR) software for thoracic images at multiple institutions. Methods and Materials: Thoracic 4-dimensional (4D) CT images of 10 patients with esophageal or lung cancer were used. Datasets for these patients were provided by DIR-lab ( (dir-lab.com)) and included a coordinate list of anatomic landmarks (300 bronchial bifurcations) that had been manually identified. Deformable image registration was performed between the peak-inhale and -exhale images. Deformable image registration error was determined by calculating the difference at each landmark point between the displacement calculated by DIR software and that calculated by the landmark. Results: Eleven institutions participated in this study: 4 used RayStation (RaySearch Laboratories, Stockholm, Sweden), 5 used MIM Software (Cleveland, OH), and 3 used Velocity (Varian Medical Systems, Palo Alto, CA). The ranges of the average absolute registration errors over all cases were as follows: 0.48 to 1.51 mm (right-left), 0.53 to 2.86 mm (anterior-posterior), 0.85 to 4.46 mm (superior-inferior), and 1.26 to 6.20 mm (3-dimensional). For each DIR software package, the average 3-dimensional registration error (range) was as follows: RayStation, 3.28 mm (1.26-3.91 mm); MIM Software, 3.29 mm (2.17-3.61 mm); and Velocity, 5.01 mm (4.02-6.20 mm). These results demonstrate that there was moderate variation among institutions, although the DIR software was the same. Conclusions: We evaluated the commercially available DIR software using thoracic 4D-CT images from multiple centers. Our results demonstrated that DIR accuracy differed among institutions because it was dependent on both the DIR software and procedure. Our results could be helpful for establishing prospective clinical trials and for the widespread use of DIR software. In addition, for clinical care, we should try to find the optimal DIR procedure using thoracic 4D-CT data.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Impact of Real-Time Image Gating on Spot Scanning Proton Therapy for Lung Tumors: A Simulation Study

Purpose: To investigate the effectiveness of real-time-image gated proton beam therapy for lung tumors and to establish a suitable size for the gating window (GW). Methods and Materials: A proton beam gated by a fiducial marker entering a preassigned GW (as monitored by 2 fluoroscopy units) was used with 7 lung cancer patients. Seven treatment plans were generated: real-time-image gated proton beam therapy with GW sizes of ±1, 2, 3, 4, 5, and 8 mm and free-breathing proton therapy. The prescribed dose was 70 Gy (relative biological effectiveness)/10 fractions to 99% of the target. Each of the 3-dimensional marker positions in the time series was associated with the appropriate 4-dimensional computed tomography phase. The 4-dimensional dose calculations were performed. The dose distribution in each respiratory phase was deformed into the end-exhale computed tomography image. The D99 and D5 to D95 of the clinical target volume scaled by the prescribed dose with criteria of D99 >95% and D5 to D95 <5%, V20 for the normal lung, and treatment times were evaluated. Results: Gating windows ≤ ±2 mm fulfilled the CTV criteria for all patients (whereas the criteria were not always met for GWs ≥ ±3 mm) and gave an average reduction in V20 of more than 17.2% relative to free-breathing proton therapy (whereas GWs ≥ ±4 mm resulted in similar or increased V20). The average (maximum) irradiation times were 384 seconds (818 seconds) for the ±1-mm GW, but less than 226 seconds (292 seconds) for the ±2-mm GW. The maximum increased considerably at ±1-mm GW. Conclusion: Real-time-image gated proton beam therapy with a GW of ±2 mm was demonstrated to be suitable, providing good dose distribution without greatly extending treatment time.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Total and regional deposition of inhaled aerosols in supine healthy subjects and subjects with mild-to-moderate COPD

Despite substantial development of sophisticated subject-specific computational models of aerosol transport and deposition in human lungs, experimental validation of predic- tions from these new models is sparse. We collected aerosol retention and exhalation profiles in seven healthy volunteers and six subjects with mild-to-moderate COPD (FEV1 ¼ 50–80%predicted) in the supine posture. Total deposition was measured during continuous breathing of 1 and 2.9 mm-diameter particles (tidal volume of 1 L, flow rate of 0.3 L/s and 0.75 L/s). Bolus inhalations of 1 mm particles were performed to penetration volumes of 200, 500 and 800 mL (flow rate of 0.5 L/s). Aerosol bolus dispersion (H), deposition, and mode shift (MS) were calculated from these data. There was no significant difference in total deposition between healthy subjects and those with COPD. Total deposition increased with increasing particle size and also with increasing flow rate. Similarly, there was no significant difference in aerosol bolus deposition between subject groups. Yet, the rate of increase in dispersion and of decrease in MS with increasing penetration volume was higher in subjects with COPD than in healthy volunteers (H: 0.79870.205 vs. 0.52770.122 mL/mL, p¼ 0.01; MS: - 0.27170.129 vs. - 0.145 70.076 mL/mL, p¼ 0.05) indicating larger ventilation inhomogeneities (based on H) and increased flow sequencing (based on MS) in the COPD than in the healthy group. In conclusion, in the supine posture, deposition appears to lack sensitivity for assessing the effect of lung morphology and/or ventilation distribution alteration induced by mild-to- moderate lung disease on the fate of inhaled aerosols. However, other parameters such as aerosol bolus dispersion and mode shift may be more sensitive parameters for evaluating models of lungs with moderate disease.

54 ENVIRONMENTAL SCIENCES↗

YC-1 potentiates cAMP-induced CREB activation and nitric oxide production in alveolar macrophages

Alveolar macrophages play significant roles in the pathogenesis of several inflammatory lung diseases. Increases in exhaled nitric oxide (NO) are well documented to reflect disease severity in the airway. In this study, we investigated the effect of 3-(5′-hydroxymethyl-2′-furyl)-1-benzyl indazole (YC-1), a known activator of soluble guanylyl cyclase, on prostaglandin (PG)E{sub 1} (a stable PGE{sub 2} analogue) and forskolin (a adenylate cyclase activator) induced NO production and inducible NO synthase (iNOS) expression in rat alveolar macrophages (NR8383). YC-1 did not directly cause NO production or iNOS expression, but drastically potentiated PGE{sub 1}- or forskolin-induced NO production and iNOS expression in NR8383 alveolar macrophages. Combination treatment with YC-1 and PGE{sub 1} significantly increased phosphorylation of the cAMP response element-binding protein (CREB), but not nuclear factor (NF)-κB activation. The combined effect on NO production, iNOS expression, and CREB phosphorylation was reversed by a protein kinase (PK)A inhibitor (H89), suggesting that the potentiating functions were mediated through a cAMP/PKA signaling pathway. Consistent with this, cAMP analogues, but not the cGMP analogue, caused NO release, iNOS expression, and CREB activation. YC-1 treatment induced an increase in PGE{sub 1}-induced cAMP formation, which occurred through the inhibition of cAMP-specific phosphodiesterase (PDE) activity. Furthermore, the combination of rolipram (an inhibitor of PDE4), but not milronone (an inhibitor of PDE3), and PGE{sub 1} also triggered NO production and iNOS expression. In summary, YC-1 potentiates PGE{sub 1}-induced NO production and iNOS expression in alveolar macrophages through inhibition of cAMP PDE activity and activation of the cAMP/PKA/CREB signaling pathway. Highlights: ► YC-1 potentiated PGE1-induced iNOS expression in alveolar macrophages. ► The combination of YC-1 and PGE1 increased CREB but not NFκB activation. ► The combined effects were reversed by H89. ► The combination of rolipram and PGE1 triggered NO production and iNOS expression. ► Effect of YC-1 occurred through inhibition of cAMP-specific PDE.

60 APPLIED LIFE SCIENCES↗

Structural Changes in Films of Pulmonary Surfactant Induced by Surfactant Vesicles

When compressed by the shrinking alveolar surface area during exhalation, films of pulmonary surfactant in situ reduce surface tension to levels, at which surfactant monolayers collapse from the surface in vitro. Vesicles of pulmonary surfactant added below these monolayers slow collapse. X-ray scattering here determined the structural changes that improve stability. Grazing incidence X-ray diffraction on monolayers of extracted calf surfactant detected an ordered phase. Mixtures of dipalmitoyl phosphatidylcholine and cholesterol, but not the phospholipid alone, mimic that structure. At concentrations that stabilize the monolayers, vesicles in the subphase had no effect on the unit cell, and the film remained monomolecular. The added vesicles, however, produced a concentration-dependent increase in the diffracted intensity. These results suggest that the enhanced resistance to collapse results from components of an ordered interfacial phase which partition from subphase to the surface, increasing the area of the ordered structure.

60 APPLIED LIFE SCIENCES↗