Magnetic resonance imaging findings of radiation-induced breast angiosarcoma:A case report

BACKGROUND Breast conservation surgery(BCS)with adjuvant radiotherapy has become a gold standard in the treatment of early-stage breast cancer,significantly reducing the risk of tumor recurrence.However,this treatment is associated with adverse effects,including the rare but aggressive radiation-induced angiosarcoma(RIAS).Despite its rarity and nonspecific initial presentation,RIAS presents a challenging diagnosis,emphasizing the importance of imaging techniques for early detection and accurate diagnosis.CASE SUMMARY We present a case of a 48-year-old post-menopausal woman who developed skin ecchymosis on the right breast seven years after receiving BCS and adjuvant radiotherapy for breast cancer.Initial mammography and ultrasound were inconclusive,showing post-treatment changes but failing to identify the underlying angiosarcoma.Contrast-enhanced breast magnetic resonance imaging(MRI)revealed diffuse skin thickening and nodularity with distinctive enhan-cement kinetics,leading to the diagnosis of RIAS.This case highlights the crucial role of MRI in diagnosing and determining the extent of RIAS,facilitating timely and appropriate surgical intervention.CONCLUSION Breast MRI is crucial for detecting RIAS,especially when mammography and ultrasound are inconclusive.

Treatment of radiation-induced brain injury with bisdemethoxycurcumin

Radiation therapy is considered the most effective non-surgical treatment for brain tumors.However,there are no available treatments for radiation-induced brain injury.Bisdemethoxycurcumin(BDMC)is a demethoxy derivative of curcumin that has anti-proliferative,anti-inflammatory,and anti-oxidant properties.To determine whether BDMC has the potential to treat radiation-induced brain injury,in this study,we established a rat model of radiation-induced brain injury by administe ring a single 30-Gy vertical dose of irradiation to the whole brain,followed by intraperitoneal injection of 500μL of a 100 mg/kg BDMC solution every day for 5 successive weeks.Our res ults showed that BDMC increased the body weight of rats with radiation-induced brain injury,improved lea rning and memory,attenuated brain edema,inhibited astrocyte activation,and reduced oxidative stress.These findings suggest that BDMC protects against radiationinduced brain injury.

TLD calibration and absorbed dose measurement in a radiation-induced liver injury model under a linear accelerator

The application of a thermoluminescent detector(TLD) for dose detection at the liver irradiation site in mice under linear accelerator precision radiotherapy and the use of a single high dose to irradiate the mouse liver to construct a biological model of a radiation-induced liver injury(RILD) in mice were to determine the feasibility of constructing a precision radiotherapy model in small animals under a linear accelerator. A 360° arc volumetric rotational intensity-modulated radiotherapy(VMAT) plan with a prescribed dose of 2 Gy was developed for the planned target volume(PTV) at the location of the TLD within solid water to compare the difference between the measured dose of TLD and the assessed parameters in the TPS system. The TLD was implanted in the livers of mice, and VMAT was planned based on TLD to compare the measured and prescribed doses. C57BL/6 J mice were randomly divided into control and 25-Gy radiation groups and were examined daily for changes in body weight. They were euthanized at 3 and 10 weeks after radiation, and the levels of liver serum enzymes such as alanine aminotransferase(ALT), aspartate aminotransferase(AST), and alkaline phosphatase(ALP) were measured to observe any pathological histological changes in the irradiated areas of the mouse liver. The measured values of solid underwater TLD were within ± 3% of the Dmean value of the evaluation parameter in the TPS system. The mice in the 25-Gy radiation group demonstrated pathological signs of radiation-induced liver injury at the site of liver irradiation. The deviation in the measured and prescribed doses of TLD in the mouse liver ranged from-1.5 to 6%;construction of an accurate model of RILD using the VMAT technique under a linear accelerator is feasible.

A graphical user interface(GUI)for model-based radiation-induced acoustic computed tomography

Radiation-induced acoustic computed tomography(RACT)is an evolving biomedical imaging modality that aims to reconstruct the radiation energy deposition in tissues.Traditional backprojection(BP)reconstructions carry noisy and limited-view artifacts.Model-based algorithms have been demonstrated to overcome the drawbacks of BPs.However,model-based algorithms are relatively more complex to develop and computationally demanding.Furthermore,while a plethora of novel algorithms has been developed over the past decade,most of these algorithms are either not accessible,readily available,or hard to implement for researchers who are not well versed in programming.We developed a user-friendly MATLAB-based graphical user interface(GUI;RACT2D)that facilitates back-projection and model-based image reconstructions for twodimensional RACT problems.We included numerical and experimental X-ray-induced acoustic datasets to demonstrate the capabilities of the GUI.The developed algorithms support parallel computing for evaluating reconstructions using the cores of the computer,thus further accelerating the reconstruction speed.We also share the MATLAB-based codes for evaluating RACT reconstructions,which users with MATLAB programming expertise can further modify to suit their needs.The shared GUI and codes can be of interest to researchers across the globe and assist them in e±cient evaluation of improved RACT reconstructions.

Effects of Kangfuxin Solution (康复新液) Combined with Low-level Laser on Cytokines and Immune Function in Patients with Radiation-induced Oral Mucositis

Objective:To investigate the effect of Kangfuxin Solution(康复新液)combined with low-level laser therapy(LLLT)on cytokines and immune function in patients with radiation-induced oral mucositis.Methods:There were 84 nasopharyngeal carcinoma patients with oral mucositis after intensity-modulated radiation therapy(IMRT)were randomly divided into the control group(CG)and the observation group(OG),with 42 cases in each group.The CG was given LLLT,and the OG was treated with Kangfuxin Solution in addition to LLLT for 10 consecutive days.The healing time of oral mucosa,mucositis grading,oral pain scores,cytokines(interleukin-6,interleukin-1βand tumor necrosis factor-α)and T lymphocyte subsets were compared between the 2 groups before and after treatment.Results:The healing time of oral mucosa in the OG was(6.8±1.4)d,which was significantly shorter than(8.6±1.9)d in the CG(t=4.943,P<0.01).After treatment,the grading of oral mucositis in the OG was better than that in the CG,with a statistically significant difference(Z=2.942,P<0.05).The oral pain scores of the OG was lower than that in the CG at different time points after treatment,and the difference was statistically significant(t=8.207,11.017,P<0.01).After treatment,the levels of IL-6,IL-1βand TNF-αin peripheral blood of the OG were significantly lower than those in the CG(t=5.217,2.775,4.053,P<0.01).There were statistically significant differences in CD4+,CD8+and CD4+/CD8+between the OG and the CG after treatment(t=5.692,6.093,3.658,P<0.01).Conclusion:Kangfuxin Solution combined with LLLT can significantly shorten the healing time of oral mucosal,reduce the grading of oral mucositis,relieve oral pain,reduce inflammatory response and improve the immune function of patients.

A Review of Radiation-Induced Oral Mucositis in Traditional Chinese and Western Medicine Research

Radiation therapy is one of the main treatments for head and neck tumors,and radiationinduced oral mucositis(RIOM)is a common serious adverse effect of radiation therapy.We summarized the pathogenesis,prevention and treatment methods of RIOM related to traditional Chinese and Western medicine in recent years.The treatment of RIOM in traditional Chinese medicine should be based on clearing heat and detoxifying,nourishing Yin and promoting fluid,tonifying spleen and stomach,cooling blood and removing blood stasis.Osteopontin,immunoglobulin A and saliva flow tests may be effective clinical indicators in the future.Through analysis,the author believes that the use of integrated intervention of traditional Chinese and western medicine can better benefit patients,and the prevention and predictive diagnostic tools of RIOM should become the future focus of attention.

Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma

Background:The increasing incidence of radiation-induced osteosarcoma of the maxilla and mandible(RIOSM) has become a significant problem that can limit long-term survival.The purpose of this study was to analyze the association of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma(NPC).Methods:We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat-sen University Cancer Center during the period August 1964 to August 2012.Of these patients,47 who developed RISOM and met inclusion criteria were included in this study.Two of these 47 patients refused treatment and were then excluded.Results:For all patients treated for NPC at Sun Yat-sen University Cancer Center during the study period,the total incidence of RIOSM after radiotherapy was 0.084%(47/53,760).Two patients(4.4%) had metastases at the diagnosis of RIOSM.Thirty-nine of the 45(86.7%) patients underwent surgery for RIOSM;most patients(24/39;61.5%) who underwent resection had gross clear margins,with 15 patients(38.5%) having either a gross or microscopic positive margin.All patients died.The 1-,2-,and 3-year overall survival(OS) rates for the entire cohort of 45 patients were 53.3%,35.6%and 13.5%,respectively.The independent prognostic factors associated with high OS rate were tumor size and treatment type.Conclusions:RISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely intervention.Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.

Effect of radiation-induced color centers absorption in optical fibers on fiber optic gyroscope for space application

The effects of color centers＇ absorption on fibers and interferometric fiber optical gyroscopes（IFOGs） are studied in the paper. The irradiation induced attenuation（RIA） spectra of three types of polarization-maintaining fibers（PMFs）, i.e.,P-doped, Ge-doped, and pure silica, irradiated at 100 Gy and 1000 Gy are measured in a wavelength range from 1100 nm to1600 nm and decomposed according to the Gaussian model. The relationship of the color centers absorption intensity with radiation dose is investigated based on a power model. Furthermore, the effects of all color centers＇ absorption on RIA and mean wavelength shifts（MWS） at 1300 nm and 1550 nm are discussed respectively. Finally, the random walk coefficient（RWC） degradation induced from RIA and the scale factor error induced by MWS of the IFOG are simulated and tested at a wavelength of 1300 nm. This research will contribute to the applications of the fibers in radiation environments.

Rabbit model of radiation-induced lung injury

Objective:To explore the feasibility of establishing an animal model of chronic radiationinduced lung injury.Methods:Twenty-eight New Zealand white rabbits were randomly divided into 3 groups(the right lung irradiation group,the whole lung irradiation group and the control group).Animal model of radiation-induced lung injury was established b) highdoes radiotherapy in the irradiation groups,then all rabbits underwent CT and pathological examinations at 1.2.4.8.12.16 weeks,respectively after radiation.Results:Within 4 weeks of irradiation,some rabbits in the right lung irradiation group and whole lung irradiation group died. CT and pathological examinations all showed acute radiation pneumonitis.At 8-12 weeks after irradiation,CT scanning showed ground glass samples signs,patchy shadows and fibrotic stripes. Pathological examination showed the fibrosis pulmonary alveolar wall thickened obviously. Conclusions:The clinical animal model of chronic radiation-induced lung injury which corresponds to practical conditions in clinic can be successfully established.

Correlation between miR-564, TGF-β1, and radiation-induced lung injury

Objective Our study aimed to analyze the expression of miR-564 and TGF-β1 in cancer tissues and the serum of patients with radiation-induced lung injury,and to investigate the relationship between them and radiation-induced lung injury.Methods In situ hybridization and real-time fluorescence quantitative method were used to detect the expression of miR-564.Additionally,immunohistochemistry and enzyme-linked immunosorbent assay(ELISA)were performed to detect the expression of TGF-β1.Results The overall incidence of acute radiation pneumonia was 55.9%(100/179).The incidence of≥grade 2 radioactive pneumonia was 24.0%(43/179)and that of grade 1 was 31.8%(57/179).The expression of miR-564 in grade≥2 was slightly higher than that in patients without or with grade 1,but there was no statistical difference(P=0.86).The serum level and ratio of miR-564 in patients with grade≥2 were significantly higher than those without or with grade 1(P=0.005,P=0.025,respectively).The expression of TGF-β1 in grade≥2 was significantly higher than that of patients without or with grade 1(P=0.017).The serum levels of TGF-β1 in grade≥2 were significantly higher than those in patients without or with grade 1(P=0.038).Although the ratio of TGF-β1 in radiation pneumonia of grade≥2 was significantly higher than that of without or with grade 1,there was no significant difference(P=0.24).Moreover,patients with higher expression of miR-564 and lower expression of TGF-β1 had better prognosis.Conclusion MiR-564 and TGF-β1 are predictors of radiation-induced lung injury.Monitoring its changing trend can improve the accuracy of predicting radiation-induced lung injury.The levels and ratio of serum miR-564 and TGF-β1 in patients with radiation-induced lung injury are related to the severity of radiationinduced lung injury.

Radiation-induced attenuation self-compensating effect in super-fluorescent fiber source

The compact super-fluorescent fiber source （SFS） output spectra variations at different pump currents and under different dose of gamma-ray radiation were measured and compared respectively. The radiation-induced attenuation （RIA） self-compensating effect in SFS based on photo-bleaching was found and the general mathematic model of SFS output spectra variations was made. The radiation-induced background attenuation （RIBA） at the pump wavelength was identified to be the main cause of the total output power and spectra variations and the variations can then be compensated by active control of the pump power to enhance the self-compensating effect. With closed-loop feedback control of pump current, double-pass backward （DPB） configuration and spectrum re-shaping technology, an SFS prototype was made and tested. The mean-wavelength stability of about 87.4 ppm and output power instability of less than 5% were achieved under up to 200 krad （Si） gamma-ray irradiation.

Neuron-specific enolase expression in a rat model of radiation-induced brain injury following vascular endothelial growth factor-modified neural stem cell transplantation

BACKGROUND： Previous studies have shown that transplantation of vascular endothelial growth factor （VEGF）-modified neural stem cells （NSC） provides better outcomes, compared with neural stem cells, in the treatment of brain damage. OBJECTIVE： To compare the effects of VEGF-modified NSC transplantation and NSC transplantation on radiation-induced brain injury, and to determine neuron-specific enolase （NSE） expression in the brain. DESIGN, TIME, AND SETTING： The randomized, controlled study was performed at the Linbaixin Experimental Center, Second Affiliated Hospital, Sun Yat-sen University, China from November 2007 to October 2008. MATERIALS： VEGF-modified C17.2 NSCs were supplied by Harvard Medical School, USA. Streptavidin-biotin-peroxidase-complex kit （Boster, China） and 5, 6-carboxyfluorescein diacetate succinimidyl ester （Fluka, USA） were used in this study. METHODS： A total of 84 Sprague Dawley rats were randomly assigned to a blank control group （n = 20）, model group （n = 20）, NSC group （n = 20）, and a VEGF-modified NSC group （n = 24）. Rat models of radiation-induced brain injury were established in the model, NSC, and VEGF-modified NSC groups. At 1 week following model induction, 10 pL （5 ×10^4 cells/μL） VEGF-modified NSCs or NSCs were respectively infused into the striatum and cerebral cortex of rats from the VEGF-modified NSC and NSC groups. A total of 10μL saline was injected into rats from the blank control and model groups. MAIN OUTCOME MEASURES： NSE expression in the brain was detected by immunohistochemistry following VEGF-modified NSC transplantation. RESULTS： NSE expression was significantly decreased in the brains of radiation-induced brain injury rats （P 〈 0.05）. The number of NSE-positive neurons significantly increased in the NSC and VEGF-modified NSC groups, compared with the model group （P 〈 0.05）. NSE expression significantly increased in the VEGF-modified NSC group, compared with the NSC group, at 6 weeks following transplantation （P 〈 0.05）. CONCLUSION： VEGF-modified NSC transplantation increased NSE expression in rats with radiation-induced brain injury, and the outcomes were superior to NSC transplantation.

Radiation-induced brain injury after a conventional dose of intensity-modulated radiotherapy for nasopharyngeal carcinoma:a case report and literature review

A 61-year-old female nasopharyngeal carcinoma patient was admitted to the hospital with sudden cognitive dysfunction one month after Volumetric Intensity Modulated Arc Therapy(VMAT)conventional dose radiotherapy,and the initial diagnosis was radiation-induced brain injury(RBI).After comprehensive treatment with steroid hormones,the patient’s condition rapidly improved.Typically,in nasopharyngeal carcinoma patients treated with VMAT,the incidence of RBI is extremely low when the temporal lobe dose is less than 65 Gy or 1%of the volume is less than 65 Gy.When this limit is exceeded,RBI may occur in varying degrees.However,in this case,even though the temporal lobe dose was under the prescribed limit,the patient still experienced RBI.The rare observations in this case can be used as a reference,and clinicians should seriously consider the possibility of RBI in similar cases.

Adsorbent for Arsenic(V) Removal Synthesized by Radiation-Induced Graft Polymerization onto Nonwoven Cotton Fabric

A fibrous adsorbent for arsenic (As) removal was synthesized with nonwoven cotton fabric as a trunk polymer. 2-hydroxyethyl methacrylate phosphoric acid monomer which composed of phosphoric acid mono (50%) and di (50%) ethyl methacrylate ester was introduced with radiation-induced graft polymerization onto nonwoven cotton fabric. The degree of grafting of 130% was obtained at irradiation dose of 20 kGy with 5% of monomer solution for 2 hours reaction time at 40?C reaction temperature. After the grafted material was contacted with 10 mmol/L of zirconium (Zr) solution at pH 1, 0.38 mmol/g of Zr was loaded on phosphoric units as a functional group for As(V) removal. The resulting adsorbent was evaluated by column mode adsorption with 1 mg/L of As(V) solution at various pH with space velocity 200 h–1. The maximum capacity of As(V) adsorption was 0.1 mmol/g at pH 2.

Radiation-induced reduction of chromium(VI) in aqueous solution by γ-irradiation in a laboratory-scale

Radiation-induced reduction of chromium（Ⅵ）（Cr（Ⅵ） by ,γ-irradiation was studied with an initial concentration of 42 mg/L in aqueous solutions. Several factors which might affect the reduction of Cr（Ⅵ） to Cr（Ⅲ） were examined, pH of aqueous solution affects the reduction efficiency significantly. Acidic condition of aqueous solution accelerates the process. At pH 2, a reduction of 86.2% was achieved with the absorbed dose of 15 kGy, while, with the same dose, at pH 5 and 7, the reduction ofCr （Ⅵ） were only 36.3% and 22.2%, respectively. Ethanol （0.1% in V：V） and sodium carbonate （1 mmol/L） were added into the solution respectively as relatively non-toxic hydroxyl radical scavengers. Reduction rate increased greatly in the presence of ethanol at each pH. Reduction efficiency of Cr（Ⅵ） was enhanced in neutral condition with the addition of sodium carbonate, however, no enhancement was found in acidic condition. The reduction of Cr（Ⅵ） was restrained when the solution was saturated with oxygen; however, the restraint was not significant.

Comparison of formation and evolution of radiation-induced defects in pure Ni and Ni-Co-Fe medium-entropy alloy

High-entropy alloys(HEAs)and medium-entropy alloys(MEAs)have attracted a great deal of attention for developing nuclear materials because of their excellent irradiation tolerance.Herein,formation and evolution of radiation-induced defects in Ni Co Fe MEA and pure Ni are investigated and compared using molecular dynamics simulation.It is observed that the defect recombination rate of ternary Ni Co Fe MEA is higher than that of pure Ni,which is mainly because,in the process of cascade collision,the energy dissipated through atom displacement decreases with increasing the chemical disorder.Consequently,the heat peak phase lasts longer,and the recombination time of the radiation defects(interstitial atoms and vacancies)is likewise longer,with fewer deleterious defects.Moreover,by studying the formation and evolution of dislocation loops in Ni-Co-Fe alloys and Ni,it is found that the stacking fault energy in Ni-Co-Fe decreases as the elemental composition increases,facilitating the formation of ideal stacking fault tetrahedron structures.Hence,these findings shed new light on studying the formation and evolution of radiation-induced defects in MEAs.

Time-dependent Changes in CT of Radiation-induced Liver Injury:A Preliminary Study in Gastric Cancer Patients

In this study, the time-dependent changes on dynamic computed tomograph (CT) of radiation-induced liver injury in gastric cancer patients was examined.The CT images of 52 gastric cancer patients who had received chemoradiotherapies were reviewed on the PACS system.Dynamic CT scan was performed in all the subjects.Our results showed that 18 patients were found to have radiation-induced liver injury.The CT findings of radiation-induced liver injury in gastric cancer patients tend to show up one month after radiation treatment.The damaged area was of low density on all three phases, and then it was enhanced on portal vein phase or delay phase.The focal radiation reaction of liver without basic disease vanished 9-11 months later after treatment.We are led to conclude that dynamic CT is of help in the diagnosis of CRT-induced liver injury, and it may be the method of choice for following up the whole course of the CRT-induced liver injury, i.e., form hepatic damage to healing.The classification of CT findings we recommend can avoid the influence of technological factors, and thereby serve as a better guide for treatment of CRT-induced liver injury.

Metastatic peritoneal sarcomatosis from radiation-induced osteosarcoma in a patient with previously treated pelvic Ewing’s sarcoma: Report of a case

Metastatic peritoneal sarcomatosis most commonly occurs from primary soft tissue sarcomas arising either within the abdomen or extremities. Metastatic peritoneal sarcomatosis from an osteosarcoma is extremely rare;only six cases have previously been reported. We report the first case of metastatic peritoneal sarcomatosis originating from radiation-induced osteoblastic osteosarcoma in a 22-year-old woman who had previously been treated for pelvic Ewing’s sarcoma. Abdominal computed tomography, bone scintigraphy and FDG PET/CT demonstrated extensive finely nodular disseminated peritoneal lesions. Histopathologic examination of these peritoneal lesions revealed osteosarcomatosis. In summary, we describe an unusual case of metastatic peritoneal sar comatosis from secondary osteosarcoma arising in a previously irradiated pelvicEwing’s sarcoma.

Prevention and treatment of radiation-induced lung injury by hydroxypiperquin phosphate: a clinical and experimental study

Objective: To evaluate the hydroxypiperquin phosphate (HPQP) as a modifier of radiation-induced injury in human and rat lungs. Methods: Sixty-five patients with lung cancer treated with conventional radiotherapy were divided into 2 groups randomly: Thirty cases were treated with HPQP and the others were in a control group. The changes of X - ray manifestation before, after and during taking drug were compared. An animal model of radiation-induced fibrosis of lungs was also established. Hydroxyproling (HP) content in lung tissue and the pathological changes in rat lungs were checked with microscope and electron microscope after 4 months and 6 months respectively. Results: The changes of lung X-ray manifestation in treatment group were much lighter than that in control group. The HP content and the change of pathology in the lungs of those rats with HPQP treatment were obviously less than that in control group. Conclusion: HPQP plays an important role in prevention and treatment of radiation-induced injury in lungs.