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Matsubara K, Nakajima A, Hirosawa A, Yoshikawa R, Ichikawa N, Fukushima K, Fukuda A. Effect of radioprotective curtain length on the scattered dose rate distribution and endoscopist eye lens dose with an over-couch fluoroscopy system. Phys Eng Sci Med 2024; 47:691-701. [PMID: 38483784 PMCID: PMC11166833 DOI: 10.1007/s13246-024-01398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/29/2024] [Indexed: 06/12/2024]
Abstract
Sufficient dose reduction may not be achieved if radioprotective curtains are folded. This study aimed to evaluate the scattered dose rate distribution and physician eye lens dose at different curtain lengths. Using an over-couch fluoroscopy system, dH*(10)/dt was measured using a survey meter 150 cm from the floor at 29 positions in the examination room when the curtain lengths were 0% (no curtain), 50%, 75%, and 100%. The absorbed dose rates in the air at the positions of endoscopist and assistant were calculated using a Monte Carlo simulation by varying the curtain length from 0 to 100%. The air kerma was measured by 10 min fluoroscopy using optically stimulated luminescence dosimeters at the eye surfaces of the endoscopist phantom and the outside and inside of the radioprotective goggles. At curtain lengths of 50%, 75%, and 100%, the ratios of dH*(10)/dt relative to 0% ranged from 80.8 to 104.1%, 10.5 to 61.0%, and 11.8 to 24.8%, respectively. In the simulation, the absorbed dose rates at the endoscopist's and assistant's positions changed rapidly between 55 and 75% and 65% and 80% of the curtain length, respectively. At the 0%, 50%, 75%, and 100% curtain lengths, the air kerma at the left eye surface of the endoscopist phantom was 237 ± 29, 271 ± 30, 37.7 ± 7.5, and 33.5 ± 6.1 μGy, respectively. Therefore, a curtain length of 75% or greater is required to achieve a sufficient eye lens dose reduction effect at the position of the endoscopist.
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Affiliation(s)
- Kosuke Matsubara
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan.
| | - Asuka Nakajima
- Department of Radiological Technology, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
- Division of Radiology, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Ayaka Hirosawa
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
- Department of Medical Technology, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyoma, Toyama, 930-8550, Japan
| | - Ryo Yoshikawa
- Department of Radiology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Nao Ichikawa
- Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
- Department of Radiological Technology, Faculty of Health Science, Kobe Tokiwa University, 2-6-2 Otani-Cho, Nagata-Ku, Kobe, Hyogo, 653-0838, Japan
| | - Kotaro Fukushima
- Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Atsushi Fukuda
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima, Fukushima, 960-1295, Japan
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2
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Matsuya Y, Sato T, Yachi Y, Date H, Hamada N. The impact of dose rate on responses of human lens epithelial cells to ionizing irradiation. Sci Rep 2024; 14:12160. [PMID: 38802452 PMCID: PMC11130169 DOI: 10.1038/s41598-024-62679-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
The knowledge on responses of human lens epithelial cells (HLECs) to ionizing radiation exposure is important to understand mechanisms of radiation cataracts that are of concern in the field of radiation protection and radiation therapy. However, biological effects in HLECs following protracted exposure have not yet fully been explored. Here, we investigated the temporal kinetics of γ-H2AX foci as a marker for DNA double-strand breaks (DSBs) and cell survival in HLECs after exposure to photon beams at various dose rates (i.e., 150 kVp X-rays at 1.82, 0.1, and 0.033 Gy/min, and 137Cs γ-rays at 0.00461 Gy/min (27.7 cGy/h) and 0.00081 Gy/min (4.9 cGy/h)), compared to those in human lung fibroblasts (WI-38). In parallel, we quantified the recovery for DSBs and cell survival using a biophysical model. The study revealed that HLECs have a lower DSB repair rate than WI-38 cells. There is no significant impact of dose rate on cell survival in both cell lines in the dose-rate range of 0.033-1.82 Gy/min. In contrast, the experimental residual γ-H2AX foci showed inverse dose rate effects (IDREs) compared to the model prediction, highlighting the importance of the IDREs in evaluating radiation effects on the ocular lens.
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Affiliation(s)
- Yusuke Matsuya
- Faculty of Health Sciences, Hokkaido University, Kita-12 Nishi-5, Kita-ku, Sapporo, 060-0812, Japan.
- Research Group for Radiation Transport Analysis, Nuclear Science and Engineering Center, Japan Atomic Energy Agency (JAEA), 2-4 Shirakata, Tokai, Ibaraki, 319-1195, Japan.
| | - Tatsuhiko Sato
- Research Group for Radiation Transport Analysis, Nuclear Science and Engineering Center, Japan Atomic Energy Agency (JAEA), 2-4 Shirakata, Tokai, Ibaraki, 319-1195, Japan
| | - Yoshie Yachi
- Graduate School of Health Sciences, Hokkaido University, Kita-12 Nishi-5, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Hiroyuki Date
- Faculty of Health Sciences, Hokkaido University, Kita-12 Nishi-5, Kita-ku, Sapporo, 060-0812, Japan
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Chiba, 270-1194, Japan.
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Mothersill C, Seymour C, Cocchetto A, Williams D. Factors Influencing Effects of Low-dose Radiation Exposure. HEALTH PHYSICS 2024; 126:296-308. [PMID: 38526248 DOI: 10.1097/hp.0000000000001816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
ABSTRACT It is now well accepted that the mechanisms induced by low-dose exposures to ionizing radiation (LDR) are different from those occurring after high-dose exposures. However, the downstream effects of these mechanisms are unclear as are the quantitative relationships between exposure, effect, harm, and risk. In this paper, we will discuss the mechanisms known to be important with an overall emphasis on how so-called "non-targeted effects" (NTE) communicate and coordinate responses to LDR. Targeted deposition of ionizing radiation energy in cells causing DNA damage is still regarded as the dominant trigger leading to all downstream events whether targeted or non-targeted. We regard this as an over-simplification dating back to formal target theory. It ignores that last 100 y of biological research into stress responses and signaling mechanisms in organisms exposed to toxic substances, including ionizing radiation. We will provide evidence for situations where energy deposition in cellular targets alone cannot be plausible as a mechanism for LDR effects. An example is where the energy deposition takes place in an organism not receiving the radiation dose. We will also discuss how effects after LDR depend more on dose rate and radiation quality rather than actual dose, which appears rather irrelevant. Finally, we will use recent evidence from studies of cataract and melanoma induction to suggest that after LDR, post-translational effects, such as protein misfolding or defects in energy metabolism or mitochondrial function, may dominate the etiology and progression of the disease. A focus on such novel pathways may open the way to successful prophylaxis and development of new biomarkers for better risk assessment after low dose exposures.
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Affiliation(s)
- Carmel Mothersill
- Department of Biology, McMaster University, 1280 Main St., Hamilton, ON, Canada L8S 4L8
| | - Colin Seymour
- Department of Biology, McMaster University, 1280 Main St., Hamilton, ON, Canada L8S 4L8
| | - Alan Cocchetto
- The National CFIDS Foundation, 285 Beach Ave., Hull, MA 02045
| | - David Williams
- Cambridge University, The Old Schools, Trinity Lane, Cambridge CB2 1TN, United Kingdom
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4
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Masuda T, Kiguchi M, Fujioka C, Oku T, Ishibashi T, Katsunuma Y, Yoshitake T, Abe S, Awai K. Impact of beam collimation of z-overscanning on dose to the lens and thyroid gland in paediatric thoracic computed tomography imaging. Pediatr Radiol 2024; 54:758-763. [PMID: 38308740 DOI: 10.1007/s00247-024-05862-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Adaptive collimation reduces the dose deposited outside the imaged volume along the z-axis. An increase in the dose deposited outside the imaged volume (to the lens and thyroid) in the z-axis direction is a concern in paediatric computed tomography (CT). OBJECTIVE To compare the dose deposited outside the imaged volume (to the lens and thyroid) between 40-mm and 80-mm collimation during thoracic paediatric helical CT. MATERIALS AND METHODS We used anthropomorphic phantoms of newborns and 5-year-olds with 40-mm and 80-mm collimation during helical CT. We compared the measured dose deposited outside the imaged volume using optically stimulated luminescence dosimeters (OSLD) at the surfaces of the lens and thyroid and the image noise between the 40-mm and 80-mm collimations. RESULTS There were significant differences in the dose deposited outside the imaged volume (to the lens and thyroid) between the 40-mm and 80-mm collimations for both phantoms (P < 0.01). CONCLUSION Compared with that observed for 80-mm collimation in helical CT scans of the paediatric thorax, the dose deposited outside the imaged volume (to the lens and thyroid) was significantly lower in newborns and 5-year-olds with 40-mm collimation.
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Affiliation(s)
- Takanori Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima, Kurashiki, Okayama, 288701-0193, Japan.
| | - Masao Kiguchi
- Department of Radiology, Hiroshima University, Hiroshima, Japan
| | - Chikako Fujioka
- Department of Radiology, Hiroshima University, Hiroshima, Japan
| | - Takayuki Oku
- Department of Radiological Technologist, Tsuchiya General Hospital, Hiroshima, Japan
| | - Toru Ishibashi
- Department of Radiological Technologist, Tsuchiya General Hospital, Hiroshima, Japan
| | - Yasushi Katsunuma
- Department of Radiological Technology, Tokai University Oiso Hospital, Kanagawa, Japan
| | | | - Shuji Abe
- Department of Radiological Technology, Osaka College of High Technology, Osaka, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Hiroshima University, Hiroshima, Japan
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Carrothers E, Appleby M, Lai V, Kozbenko T, Alomar D, Smith BJ, Hamada N, Hinton P, Ainsbury EA, Hocking R, Yauk C, Wilkins RC, Chauhan V. AOP report: Development of an adverse outcome pathway for deposition of energy leading to cataracts. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2024. [PMID: 38644659 DOI: 10.1002/em.22594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024]
Abstract
Cataracts are one of the leading causes of blindness, with an estimated 95 million people affected worldwide. A hallmark of cataract development is lens opacification, typically associated not only with aging but also radiation exposure as encountered by interventional radiologists and astronauts during the long-term space mission. To better understand radiation-induced cataracts, the adverse outcome pathway (AOP) framework was used to structure and evaluate knowledge across biological levels of organization (e.g., macromolecular, cell, tissue, organ, organism and population). AOPs identify a sequence of key events (KEs) causally connected by key event relationships (KERs) beginning with a molecular initiating event to an adverse outcome (AO) of relevance to regulatory decision-making. To construct the cataract AO and retrieve evidence to support it, a scoping review methodology was used to filter, screen, and review studies based on the modified Bradford Hill criteria. Eight KEs were identified that were moderately supported by empirical evidence (e.g., dose-, time-, incidence-concordance) across the adjacent (directly linked) relationships using well-established endpoints. Over half of the evidence to justify the KER linkages was derived from the evidence stream of biological plausibility. Early KEs of oxidative stress and protein modifications had strong linkages to downstream KEs and could be the focus of countermeasure development. Several identified knowledge gaps and inconsistencies related to the quantitative understanding of KERs which could be the basis of future research, most notably directed to experiments in the range of low or moderate doses and dose-rates, relevant to radiation workers and other occupational exposures.
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Affiliation(s)
- Emma Carrothers
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Meghan Appleby
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Vita Lai
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Tatiana Kozbenko
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Dalya Alomar
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Benjamin J Smith
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Chiba, Japan
| | - Patricia Hinton
- Defense Research & Development Canada, Canadian Forces Environmental Medicine Establishment, Toronto, Ontario, Canada
| | - Elizabeth A Ainsbury
- Radiation, Chemical and Environmental Hazards Division, UK Health Security Agency, Birmingham, UK
- Environmental Research Group within the School of Public Health, Faculty of Medicine at Imperial College of Science, Technology and Medicine, London, UK
| | - Robyn Hocking
- Learning and Knowledge and Library Services, Health Canada, Ottawa, Ontario, Canada
| | - Carole Yauk
- Department of Biology, University of Ottawa, Ottawa, Ontario, Canada
| | - Ruth C Wilkins
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Vinita Chauhan
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
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6
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Takeya M, Takagi R, Yamamoto A, Tozawa M, Inaoka T, Terada H. [Improved Protective Equipment for NICU Portable Radiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2024; 80:166-174. [PMID: 37926521 DOI: 10.6009/jjrt.2024-1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
We have been developing protective equipment for portable radiography in neonatal intensive care units because the portable radiography's X-ray tube is in close proximity to the head of the nurse who is assisting the patient. Although our initial protective-equipment design was highly effective, there were some concerns that it obstructed the view of the patient and was difficult to handle. To overcome this problem, we have developed two new types of protective device: a narrow-type 0.13 mmPb device, 17 cm long and 45 cm wide (weight 200 g); and a wide type with a wider core material, 45 cm long and 25 cm wide (weight 300 g), both of which can be hung from the collimator cover of mobile X-ray equipment. The measured protective effectiveness was 80.6% at head height for the wide type and 76.8% for the narrow type. A survey of nurses regarding the new protective devices revealed no significant differences between the two types in terms of visibility and whether the devices would be an obstacle when assisting patients. The nurses preferred the wider type, which offered better protection. Radiological technologists also liked that both types were easy to handle because the irradiation field could be adjusted even after the device was fitted. Both types of the new protective device are thus expected to be useful in clinical practice in terms of their high protective effect and improved ease of handling.
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Affiliation(s)
- Mei Takeya
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Rei Takagi
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Akinori Yamamoto
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Mitsuyuki Tozawa
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Tsutomu Inaoka
- Department of Radiology, Toho University Sakura Medical Center
| | - Hitoshi Terada
- Department of Radiology, Toho University Sakura Medical Center
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7
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Masuda T, Kiguchi M, Fujioka C, Oku T, Ishibashi T, Katsunuma Y, Yoshitake T, Abe S, Awai K. Effectiveness of low tube voltage scan in the exposure dose for lenses during paediatric thoracic CT examination: anthropomorphic phantoms study. RADIATION PROTECTION DOSIMETRY 2024; 200:143-148. [PMID: 37987195 DOI: 10.1093/rpd/ncad284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 10/04/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
To determine whether using lower-tube voltage reduces the scattered dose for the lens during paediatric thoracic computed tomography (CT). Two paediatric anthropomorphic phantoms (ATOM Phantom, CIRS, Norfolk, Virginia, USA) representing a newborn and 5-year-old were placed on the gantry of CT scanner, and optically stimulated luminescence dosemeters were placed on the left and right lenses, in front of the left and right thyroid glands, in front of the left and right mammary glands, and in front of and behind the mammary gland level and we measured scattered dose of the optically stimulated luminescence dosemeter was compared for each phantom between 80 and 120 kVp. Significant differences were observed in the scatter doses for the lens between 80 and 120 kVp (p < 0.01). Compared with the 120 kVp scan, the scatter doses for the lens were ~15-40% lower in newborn and 5-year-olds using the 80 kVp scan during paediatric CT.
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Affiliation(s)
- Takanori Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288, Matsushima, Kurashiki, Okayama 701-0193, Japan
| | - Masao Kiguchi
- Department of Radiology, Hiroshima University, 2-3, Kasumi, Minami-ku, Hiroshima 734-0037, Japan
| | - Chikako Fujioka
- Department of Radiology, Hiroshima University, 2-3, Kasumi, Minami-ku, Hiroshima 734-0037, Japan
| | - Takayuki Oku
- Department of Radiological Technologist, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima 730-8655, Japan
| | - Toru Ishibashi
- Department of Radiological Technologist, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima 730-8655, Japan
| | - Yasushi Katsunuma
- Department of Radiological Technology, Tokai University Oiso Hospital, 143, Shimokasuya, Iseharashi, Kanagawa 259-1193, Japan
| | - Takayasu Yoshitake
- TOWCAR WORKS Co., Ltd Hoashi 233-1, Kusu-machi, Kusugun, Oita 879-4403, Japan
| | - Shuji Abe
- Department of Radiological Technologist, Osaka College of High Technology, 1-2-43, Miyahara, Yogogawa-ku, Osaka 532-0003, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Hiroshima University, 2-3, Kasumi, Minami-ku, Hiroshima 734-0037, Japan
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8
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Kleiman NJ, Edmondson EF, Weil MM, Fallgren CM, King A, Schmidt C, Hall EJ. Radiation cataract in Heterogeneous Stock mice after γ-ray or HZE ion exposure. LIFE SCIENCES IN SPACE RESEARCH 2024; 40:97-105. [PMID: 38245354 PMCID: PMC10800003 DOI: 10.1016/j.lssr.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 01/22/2024]
Abstract
Health effects of space radiation are a serious concern for astronauts on long-duration missions. The lens of the eye is one of the most radiosensitive tissues in the body and, therefore, ocular health risks for astronauts is a significant concern. Studies in humans and animals indicate that ionizing radiation exposure to the eye produces characteristic lens changes, termed "radiation cataract," that can affect visual function. Animal models of radiation cataractogenesis have previously utilized inbred mouse or rat strains. These studies were essential for determining morphological changes and dose-response relationships between radiation exposure and cataract. However, the relevance of these studies to human radiosensitivity is limited by the narrow phenotypic range of genetically homogeneous animal models. To model radiation cataract in genetically diverse populations, longitudinal cataract phenotyping was nested within a lifetime carcinogenesis study in male and female heterogeneous stock (HS/Npt) mice exposed to 0.4 Gy HZE ions (n = 609) or 3.0 Gy γ-rays (n = 602) and in unirradiated controls (n = 603). Cataractous change was quantified in each eye for up to 2 years using Merriam-Focht grading criteria by dilated slit lamp examination. Virtual Optomotry™ measurement of visual acuity and contrast sensitivity was utilized to assess visual function in a subgroup of mice. Prevalence and severity of posterior lens opacifications were 2.6-fold higher in HZE ion and 2.3-fold higher in γ-ray irradiated mice compared to unirradiated controls. Male mice were at greater risk for spontaneous and radiation associated cataracts. Risk for cataractogenesis was associated with family structure, demonstrating that HS/Npt mice are well-suited to evaluate genetic determinants of ocular radiosensitivity. Last, mice were extensively evaluated for cataract and tumor formation, which revealed an overlap between individual susceptibility to both cancer and cataract.
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Affiliation(s)
- Norman J Kleiman
- Department of Environmental Health Sciences, Eye Radiation and Environmental Research Laboratory, Columbia University, Mailman School of Public Health, 722 West 168th St., 11th Floor, New York, NY, 10032, United States.
| | - Elijah F Edmondson
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, 80523, United States; Frederick National Laboratory for Cancer Research, Frederick, Maryland, 21702, United States
| | - Michael M Weil
- Department of Environment and Radiological Health Sciences, Colorado State University, Fort Collins, CO, 80523, United States
| | - Christina M Fallgren
- Department of Environment and Radiological Health Sciences, Colorado State University, Fort Collins, CO, 80523, United States
| | - Adam King
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, 80523, United States; MedVet Chicago, Chicago, IL, 60618, United States
| | - Catherine Schmidt
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, 80523, United States; Veterinary Eye Specialists, Thornwood, NY, 10594, , United States
| | - Eric J Hall
- Center for Radiological Research, Columbia University, College of Physicians and Surgeons, 630W. 168th St., New York, NY,10032, , United States
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9
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Arao S, Masuda T, Oku T, Ono A, Okura Y. Utility of lower tube voltage scans in reducing exposure of healthcare workers within computed tomography room to scattered radiation. RADIATION PROTECTION DOSIMETRY 2023; 199:2338-2343. [PMID: 37646071 DOI: 10.1093/rpd/ncad240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/25/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023]
Abstract
The aim of this study was to estimate the effect of tube voltage on the scattered dose in a computed tomography (CT) room. To this end, we conducted experiments using anthropomorphic phantoms and a CT scanner at different tube voltages during CT. The scattered dose was measured using an electronic pocket dosemeter at 50-cm intervals from the centre of the gantry. The structure of the CT room was measured at 57 points (28 points in the front of the gantry (on the bed side), 6 points on the side of the gantry and 23 points behind the gantry) to be up to 200 cm. We compared the scattered dose distributions between 80 and 120 kVp at heights of 50, 100 and 150 cm above the floor surface. The scattered dose was reduced by ~30% when the tube voltage was reduced from 120 to 80 kVp.
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Affiliation(s)
- Shinichi Arao
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama 701-0193, Japan
| | - Takanori Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama 701-0193, Japan
| | - Takayuki Oku
- Department of Diagnostic Radiology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, Hiroshima 730-8655, Japan
| | - Atsushi Ono
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama 701-0193, Japan
| | - Yasuhiko Okura
- Department of Clinical Radiology, Faculty of Health Sciences, Hiroshima International University, 555-36 Kurosegakuendai, Higashihiroshima, Hiroshima 739-2695, Japan
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10
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Nagamoto K, Kawachino T, Suetsugu Y, Saruwatari H, Nihei SI, Kunugita N. Eye lens dose in spine surgeons during myelography procedures: a dosimetry study. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:041509. [PMID: 37944177 DOI: 10.1088/1361-6498/ad0b3a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/09/2023] [Indexed: 11/12/2023]
Abstract
To determine the eye lens dose (3 mm dose equivalent [Hp(3)]) received by spine surgeons during myelography and evaluate the effectiveness of radiation-protective glasses and x-ray tube system positioning in reducing radiation exposure. This study included spine surgeons who performed myelography using over- or under-table x-ray tube systems. Hp(3) was measured for each examination using a radio-photoluminescence glass dosimeter (GD-352M) mounted on radiation-protective glass. This study identified significantly high Hp(3) levels, especially in the right eye lens in spinal surgeons. The median Hp(3) values in the right eye were 524 (391-719) and 58 (42-83)μSv/examination for over- and under-table x-ray tube systems, respectively. Further, Hp(3)AK, which was obtained by dividing the cumulative air kerma from Hp(3), was 8.09 (6.69-10.21) and 5.11 (4.06-6.31)μSv mGy-1for the over- and under-table x-ray tube systems, respectively. Implementing radiation-protective glasses resulted in dose reduction rates of 54% (50%-57%) and 54% (51%-60%) for the over- and under-table x-ray tube systems, respectively. The use of radiation protection glasses significantly reduced the radiation dose in the eye lens during myelography, with the most effective measures being the combination of using radiation protection glasses and an under-table x-ray tube system.
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Affiliation(s)
- Keisuke Nagamoto
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Tomonori Kawachino
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Yoshiki Suetsugu
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Hiromi Saruwatari
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Shun-Ichi Nihei
- Department of Emergency and Intensive Care Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Naoki Kunugita
- Department of Occupational and Community Health Nursing School of Health Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
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11
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Hamada N. Noncancer Effects of Ionizing Radiation Exposure on the Eye, the Circulatory System and beyond: Developments made since the 2011 ICRP Statement on Tissue Reactions. Radiat Res 2023; 200:188-216. [PMID: 37410098 DOI: 10.1667/rade-23-00030.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
For radiation protection purposes, noncancer effects with a threshold-type dose-response relationship have been classified as tissue reactions (formerly called nonstochastic or deterministic effects), and equivalent dose limits aim to prevent occurrence of such tissue reactions. Accumulating evidence demonstrates increased risks for several late occurring noncancer effects at doses and dose rates much lower than previously considered. In 2011, the International Commission on Radiological Protection (ICRP) issued a statement on tissue reactions to recommend a threshold of 0.5 Gy to the lens of the eye for cataracts and to the heart and brain for diseases of the circulatory system (DCS), independent of dose rate. Literature published thereafter continues to provide updated knowledge. Increased risks for cataracts below 0.5 Gy have been reported in several cohorts (e.g., including in those receiving protracted or chronic exposures). A dose threshold for cataracts is less evident with longer follow-up, with limited evidence available for risk of cataract removal surgery. There is emerging evidence for risk of normal-tension glaucoma and diabetic retinopathy, but the long-held tenet that the lens represents among the most radiosensitive tissues in the eye and in the body seems to remain unchanged. For DCS, increased risks have been reported in various cohorts, but the existence or otherwise of a dose threshold is unclear. The level of risk is less uncertain at lower dose and lower dose rate, with the possibility that risk per unit dose is greater at lower doses and dose rates. Target organs and tissues for DCS are also unknown, but may include heart, large blood vessels and kidneys. Identification of potential factors (e.g., sex, age, lifestyle factors, coexposures, comorbidities, genetics and epigenetics) that may modify radiation risk of cataracts and DCS would be important. Other noncancer effects on the radar include neurological effects (e.g., Parkinson's disease, Alzheimer's disease and dementia) of which elevated risk has increasingly been reported. These late occurring noncancer effects tend to deviate from the definition of tissue reactions, necessitating more scientific developments to reconsider the radiation effect classification system and risk management. This paper gives an overview of historical developments made in ICRP prior to the 2011 statement and an update on relevant developments made since the 2011 ICRP statement.
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Affiliation(s)
- Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Chiba, Japan
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12
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Ali F, Richardson RB. Electron, Photon, and Neutron Dose Conversion Coefficients of Lens and Non-Lens Tissues Using a Multi-Tissue Eye Model to Assess Risk of Cataracts and Retinitis. Radiat Res 2023; 200:162-175. [PMID: 37410087 DOI: 10.1667/rade-23-00023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/02/2023] [Indexed: 07/07/2023]
Abstract
Previous publications describe the estimation of the dose from ionizing radiation to the whole lens or parts of it but have not considered other eye tissues that are implicated in cataract development; this is especially critical for low-dose, low-ionizing-density exposures. A recent review of the biological mechanisms of radiation-induced cataracts showed that lenticular oxidative stress can be increased by inflammation and vascular damage to non-lens tissues in the eye. Also, the radiation oxygen effect indicates different radiosensitivities for the vascular retina and the severely hypoxic lens. Therefore, this study uses the Monte Carlo N-Particle simulations to quantify dose conversion coefficients for several eye tissues for incident antero-posterior exposure to electrons, photons, and neutrons (and the tertiary electron component of neutron exposure). A stylized, multi-tissue eye model was developed by modifying a model by Behrens etal. (2009) to include the retina, uvea, sclera, and lens epithelial cell populations. Electron exposures were simulated as a single eye, whereas photon and neutron exposures were simulated employing two eyes embedded in the ADAM-EVA phantom. For electrons and photons, dose conversion coefficients are highest for either anterior tissues for low-energy incident particles or posterior tissues for high-energy incident particles. Neutron dose conversion coefficients generally increase with increasing incident energy for all tissues. The ratio of the absorbed dose delivered to each tissue to the absorbed dose delivered to the whole lens demonstrated the considerable deviation of non-lens tissue doses from lens doses, depending on particle type and its energy. These simulations demonstrate that there are large variations in the dose to various ocular tissues depending on the incident radiation dose coefficients; this large variation will potentially impact cataract development.
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Affiliation(s)
- Fawaz Ali
- Canadian Nuclear Laboratories, Chalk River, Canada
| | - Richard B Richardson
- Canadian Nuclear Laboratories, Chalk River, Canada
- McGill University, Montreal, Canada
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13
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Takeya M, Takagi R, Ishida S, Tozawa M, Inaoka T, Terada H. [Creation of Protective Equipment for Portable Radiography in Neonatal Intensive Care Unit]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:321-330. [PMID: 36823093 DOI: 10.6009/jjrt.2023-1296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Portable imaging in the NICU requires the assistance of a nurse, and the nurse is in close proximity to the X-ray tube, In all, 64 percent of our nurses thought that additional protective equipment was needed. Therefore, a radiation protection device was created and its usefulness was verified. A protective equipment of 0.13 mmPb with a width of 38 cm and a length of 70 cm was made and hung from the mono-tank X-ray unit of the mobile X-ray unit. The position of the nurse was set at 30 cm outward from the center of the irradiation field, and the protective effect was measured at three points: (a) the patient's height, (b) 30 cm above the patient, and (c) 60 cm above the patient. For the imaging conditions, a 2-liter plastic bottle filled with water was placed in the incubator, and measurements were taken with an SID of 100 cm, irradiated field of 20.3 cm×25.4 cm, tube voltage of 58 kV, and tube current-time product of 10 mAs, which was converted to the actual imaging condition of 1 mAs. Based on the results obtained, a questionnaire survey was conducted on nurses' thoughts for the protective equipment created for them. Only 3% reduction in height of (a) where no protective equipment is reached but (b) 50% and (c) 92%, respectively. In all, 82 percent of the nurses had a favorable impression of the new protective equipment. It is expected that the protective equipment designed to control lens dose and reduce anxiety of nurses will be useful.
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Affiliation(s)
- Mei Takeya
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Rei Takagi
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Satoru Ishida
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Mitsuyuki Tozawa
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Tsutomu Inaoka
- Department of Radiology, Toho University Sakura Medical Center
| | - Hitoshi Terada
- Department of Radiology, Toho University Sakura Medical Center
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14
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Abstract
PURPOSE Cataract (opacification of the ocular lens) is a typical tissue reaction (deterministic effect) following ionizing radiation exposure, for which prevention dose limits have been recommended in the radiation protection system. Manifestations of radiation cataracts can vary among individuals, but such potential individual responses remain uncharacterized. Here we review relevant literature and discuss implications for radiation protection. This review assesses evidence for significant modification of radiation-induced cataractogenesis by age at exposure, sex and genetic factors based on current scientific literature. CONCLUSIONS In addition to obvious physical factors (e.g. dose, dose rate, radiation quality, irradiation volume), potential factors modifying individual responses for radiation cataracts include sex, age and genetics, with comorbidity and coexposures also having important roles. There are indications and preliminary data identifying such potential modifiers of radiation cataract incidence or risk, although no firm conclusions can yet be drawn. Further studies and a consensus on the evidence are needed to gain deeper insights into factors determining individual responses regarding radiation cataracts and the implications for radiation protection.
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Affiliation(s)
- Stephen G R Barnard
- UK Health Security Agency (UKHSA), Radiation, Chemical and Environmental Hazards Division (RCEHD), Didcot, UK
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
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15
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Modarai B, Haulon S, Ainsbury E, Böckler D, Vano-Carruana E, Dawson J, Farber M, Van Herzeele I, Hertault A, van Herwaarden J, Patel A, Wanhainen A, Weiss S, Esvs Guidelines Committee, Bastos Gonçalves F, Björck M, Chakfé N, de Borst GJ, Coscas R, Dias NV, Dick F, Hinchliffe RJ, Kakkos SK, Koncar IB, Kolh P, Lindholt JS, Trimarchi S, Tulamo R, Twine CP, Vermassen F, Document Reviewers, Bacher K, Brountzos E, Fanelli F, Fidalgo Domingos LA, Gargiulo M, Mani K, Mastracci TM, Maurel B, Morgan RA, Schneider P. Editor's Choice - European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Radiation Safety. Eur J Vasc Endovasc Surg 2023; 65:171-222. [PMID: 36130680 DOI: 10.1016/j.ejvs.2022.09.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023]
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16
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Takeya M, Aso M, Okano M, Ishida S, Tozawa M, Inaoka T, Terada H. [Usefulness of Radiation Protection Cloths in Fluoroscopy with Clean Areas]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:1425-1435. [PMID: 36351610 DOI: 10.6009/jjrt.2022-1276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Lowering the dose limit for the lens of the eye incorporated into the Regulation on Prevention of Ionizing Radiation Hazards, effective on April 2021, and dose reduction will become more and more important in the field of radiation. Radiation protective cloth is used as a protective equipment in fluoroscopy rooms. Although it is usually used to protect staff from radiation exposure during endoscopic retrograde cholangiopancreatography, we investigated whether there is a way to use it for procedures in clean areas. Assuming ureterostomy fistula replacement in urology, the protective cloth was suspended on the side of the patient's head and posterior aspect of the tube, and the distance between the anterior aspect of the X-ray tube and the patient's foot was 55 cm. As a result of measuring the dose rate, a 10% dose reduction was obtained for the lens of the eye of the surgeon, and the distribution of air dose rate in the examination room was significantly reduced. Although scattered radiation from the radiation protection cloth appeared in some areas, the radiation dose to the patient was reduced throughout the body, and a high degree of radiation protection was obtained, especially for the lens of the eye. It is expected that the radiation protection cloths may be useful even when the length of the cloths is limited due to the cleanliness of the area.
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Affiliation(s)
- Mei Takeya
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Masataka Aso
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Masashi Okano
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Satoru Ishida
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Mitsuyuki Tozawa
- Department of Central Radiology, Toho University Sakura Medical Center
| | - Tsutomu Inaoka
- Department of Radiology, Toho University Sakura Medical Center
| | - Hitoshi Terada
- Department of Radiology, Toho University Sakura Medical Center
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17
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Busoni S, Bruzzi M, Giomi S, Poggiali C, Quattrocchi M, Betti M, D'Urso D, Fedeli L, Mazzoni LN, Paolucci M, Rossi F, Taddeucci A, Bettarini S, Tortoli P, Belli G, Bernardi L, Gasperi C, Campanella F. Surgeon eye lens dose monitoring in interventional neuroradiology, cardiovascular and radiology procedures. Phys Med 2022; 104:123-128. [PMID: 36401940 DOI: 10.1016/j.ejmp.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This study investigated the radiation dose to surgeon eye lens for single procedure and normalised to exposure parameters for eight selected neuroradiology, cardiovascular and radiology interventional procedures. METHODS The procedures investigated were diagnostic study, Arteriovenous Malformations treatment (AVM) and aneurysm embolization for neuroradiology procedures, Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (CA-PTCA), Pacemaker and Implantable Cardioverter-Defibrillator implantation (PM-ICD), Endovascular Aortic Repair (EVAR) and Fenestrated Endovascular Aortic Repair (FEVAR) for cardiovascular and electrophysiology procedures. CT-guided lung biopsy was also monitored. All procedures were performed with table-mounted and ceiling-suspended shields (0.5 mm lead equivalent thickness), except for FEVAR and PM-ICD where only a table mounted shield was present, and CT-guided lung biopsy where no shield was used. Dose assessment was performed using a dosemeter positioned close to the most exposed eye of the surgeon, outside the protective eyewear. RESULTS The surgeon most exposed eye lens median Hp(3) equivalent dose for a single procedure, without protective eyewear contribution, was 18 μSv for neuroradiology diagnostic study, 62 μSv for AVM, 38 μSv for aneurysm embolization, 33 μSv for CA-PTCA, 39 μSv for PM-ICD, 49 μSv for EVAR, 2500 μSv for FEVAR, 153 μSv for CT-guided lung biopsy. CONCLUSIONS In interventional procedures, the 20 mSv/year dose limit for surgeon eye lens exposure might be exceeded if shields or protective eyewear are not used. Surgeon eye lens doses, normalised to single procedures and to exposure parameters, are a valuable tool for determining appropriate radiation protection measures and dedicated eye lens dosemeter assignment.
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Affiliation(s)
- S Busoni
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy.
| | - M Bruzzi
- Physics and Astronomy Department, University of Florence, Italy
| | - S Giomi
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy; Physics and Astronomy Department, University of Florence, Italy
| | - C Poggiali
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy; Physics and Astronomy Department, University of Florence, Italy
| | | | - M Betti
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - D D'Urso
- Health Physics Unit, AULSS 2 Marca Trevigiana, Italy
| | - L Fedeli
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - L N Mazzoni
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - M Paolucci
- Health Physics Unit, AUSL Umbria 2, Italy
| | - F Rossi
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - A Taddeucci
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - S Bettarini
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - P Tortoli
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - G Belli
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - L Bernardi
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - C Gasperi
- Health Physics Unit, AUSL Toscana Sud-Est, Italy
| | - F Campanella
- Department of Medicine, Epidemiology, Workplace and Environmental Hygiene, INAIL, Italy
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18
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Markart S, Fischer TS, Wildermuth S, Dietrich TJ, Alkadhi H, Leschka S, Guesewell S, Ditchfield MR, Oezden I, Lutters G, Waelti SL. Organ-based tube current modulation and bismuth eye shielding in pediatric head computed tomography. Pediatr Radiol 2022; 52:2584-2594. [PMID: 35836016 DOI: 10.1007/s00247-022-05410-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/23/2021] [Accepted: 05/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Exposure of the eye lens to ionizing radiation results in cataract. Several dose optimization techniques to protect the lens are available for computed tomography (CT). OBJECTIVE The radiation dose to the eye lens, volume CT dose index (CTDIvol) and image quality of various methods of dose optimization were evaluated for pediatric head CT: automated tube current modulation (ATCM), automated tube voltage selection (ATVS), organ-based tube current modulation (OBTCM) and bismuth shielding. MATERIALS AND METHODS An anthropomorphic phantom of a 5-year-old child was scanned with nine protocols: no dose optimization technique and then adding different dose optimization techniques alone and in combination. Dose to the eye, thyroid and breast were estimated using metal oxide semiconductor field effect transistor (MOSFET) dosimetry. CTDIvol, influence of timing of shield placement, image noise and attenuation values in 13 regions of interest of the head and subjective image quality were compared. RESULTS The eye shield significantly reduced the eye lens dose when used alone, to a similar degree as when using all software-based techniques together. When used in combination with software-based techniques, the shield reduced the eye lens dose by up to 45% compared to the no dose optimization technique. Noise was significantly increased by the shield, most pronounced in the anterior portion of the eye. CONCLUSION The combination of ATCM, ATVS, OBTCM and a bismuth shield, with the shield placed after acquiring the localizer image, should be considered to reduce the radiation dose to the eye lens in pediatric head CT.
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Affiliation(s)
- Stefan Markart
- Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Tim S Fischer
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Simon Wildermuth
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Tobias J Dietrich
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hatem Alkadhi
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Leschka
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sabine Guesewell
- Clinical Trials Unit, Biostatistics, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Michael R Ditchfield
- Department of Diagnostic Imaging, Monash Children's Hospital, Clayton, Australia
| | - Ismail Oezden
- Radiation Protection and Medical Physics, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Gerd Lutters
- Radiation Protection and Medical Physics, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Stephan L Waelti
- Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland.
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
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19
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Simon S, Kendall G, Bouffler S, Little M. The Evidence for Excess Risk of Cancer and Non-Cancer Disease at Low Doses and Dose Rates. Radiat Res 2022; 198:615-624. [PMID: 36136740 PMCID: PMC9797580 DOI: 10.1667/rade-22-00132.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/06/2022] [Indexed: 12/31/2022]
Abstract
The question of whether there are excess radiation-associated health risks at low dose is controversial. We present evidence of excess cancer risks in a number of (largely pediatrically or in utero exposed) groups exposed to low doses of radiation (<0.1 Gy). Moreover, the available data on biological mechanisms do not provide support for the idea of a low-dose threshold or hormesis for any of these endpoints. There are emerging data suggesting risks of cardiovascular disease and cataract at low doses, but this is less well established. This large body of evidence does not suggest and, indeed, is not statistically compatible with any very large threshold in dose (>10 mGy), or with possible beneficial effects from exposures. The presented data suggest that exposure to low-dose radiation causes excess cancer risks and quite possibly also excess risks of various non-cancer endpoints.
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Affiliation(s)
- S.L. Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (retired)
| | - G.M. Kendall
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom
| | - S.D. Bouffler
- Radiation Effects Department, UK Health Security Agency (UKHSA), Chilton, Didcot OX11 0RQ, United Kingdom
| | - M.P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-9778
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20
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Tost F, Rohrschneider K. [Radiation Cataract as an Occupational Disease Due to Cumulative Effects of Chronic Radiation Exposure in Ophthalmological Evaluation]. Klin Monbl Augenheilkd 2022. [PMID: 36368662 DOI: 10.1055/a-1947-5639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Frank Tost
- Augenklinik Universitätsmedizin, Ernst-Moritz-Arndt Universität, Greifswald, Deutschland
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21
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Hurley RJ, McCabe FJ, Turley L, Maguire D, Lucey J, Hurson CJ. Whole-body radiation exposure in Trauma and Orthopaedic surgery. Bone Jt Open 2022; 3:907-912. [DOI: 10.1302/2633-1462.311.bjo-2022-0062.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aims The use of fluoroscopy in orthopaedic surgery creates risk of radiation exposure to surgeons. Appropriate personal protective equipment (PPE) can help mitigate this. The primary aim of this study was to assess if current radiation protection in orthopaedic trauma is safe. The secondary aims were to describe normative data of radiation exposure during common orthopaedic procedures, evaluate ways to improve any deficits in protection, and validate the use of electronic personal dosimeters (EPDs) in assessing radiation dose in orthopaedic surgery. Methods Radiation exposure to surgeons during common orthopaedic trauma operations was prospectively assessed using EPDs and thermoluminescent dosimeters (TLDs). Normative data for each operation type were calculated and compared to recommended guidelines. Results Current PPE appears to mitigate more than 90% of ionizing radiation in orthopaedic fluoroscopic procedures. There is a higher exposure to the inner thigh during seated procedures. EPDs provided results for individual procedures. Conclusion PPE currently used by surgeons in orthopaedic trauma theatre adequately reduces radiation exposure to below recommended levels. Normative data per trauma case show specific anatomical areas of higher exposure, which may benefit from enhanced radiation protection. EPDs can be used to assess real-time radiation exposure in orthopaedic surgery. There may be a role in future medical wearables for orthopaedic surgeons. Cite this article: Bone Jt Open 2022;3(11):907–912.
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Affiliation(s)
- Robert J. Hurley
- Department of Trauma & Orthopaedics, St. Vincent’s University Hospital, Dublin, Ireland
| | - Fergus J. McCabe
- Department of Trauma & Orthopaedics, St. Vincent’s University Hospital, Dublin, Ireland
| | - Luke Turley
- Department of Trauma & Orthopaedics, St. Vincent’s University Hospital, Dublin, Ireland
| | - Danielle Maguire
- Medical Physics and Clinical Engineering, St. Vincent’s University Hospital, Dublin, Ireland
| | - Julie Lucey
- Medical Physics and Clinical Engineering, St. Vincent’s University Hospital, Dublin, Ireland
| | - Conor J. Hurson
- Department of Trauma & Orthopaedics, St. Vincent’s University Hospital, Dublin, Ireland
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22
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Nagamoto K, Watanabe R, Kawachino T, Ohishi Y, Yamamoto A, Moritake T, Nihei SI, Kamochi M, Kunugita N. CONTRIBUTION OF ORGAN-BASED TUBE CURRENT MODULATION TO THE REDUCTION OF LENS EXPOSURE DOSE IN HEAD 4D CT IMAGING: A PHANTOM STUDY. RADIATION PROTECTION DOSIMETRY 2022; 198:1377-1386. [PMID: 36062449 DOI: 10.1093/rpd/ncac179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/04/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
The purpose of this study was to evaluate the effectiveness of organ effect modulation (OEM) in reducing the lens dose in 4D computed tomography (CT) of the head in volume-acquisition (NVA) mode. Six radiophotoluminescent dosemeters were placed on the head of a RANDO phantom. The doses absorbed by the organs and image noise change rate were determined. The lens doses without OEM (i.e. in the OEMoff case) were higher than those with the same target standard deviation and volume-computed tomography dose index (CTDIvol) as in the OEMoff case (p < 0.01). The image noise change rate was 11%. OEM reduced the lens dose during head 4D CT imaging in the NVA mode by 18%. Furthermore, the feasibility of lens dose reduction while ensuring sufficient image quality was confirmed under the condition in which OEM was employed with the same CTDIvol as in the OEMoff case.
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Affiliation(s)
- Keisuke Nagamoto
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, Japan
| | - Ryo Watanabe
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, Japan
| | - Tomonori Kawachino
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, Japan
| | - Yoshitaka Ohishi
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, Japan
| | - Aina Yamamoto
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, Japan
| | - Takashi Moritake
- Department of Radiation Regulatory Research Group, National Institute of Radiological Sciences, Quantum Life and Medical Science Directorate, National Institute for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, Japan
| | - Shun-Ichi Nihei
- Intensive Care Unit, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Masayuki Kamochi
- Intensive Care Unit, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Naoki Kunugita
- Department of Occupational and Community Health Nursing School of Health Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, Japan
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Mikryukova L, Akleyev A. Risk of cataract of different morphological types in Urals population chronically exposed at low doses. RADIATION MEDICINE AND PROTECTION 2022. [DOI: 10.1016/j.radmp.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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24
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Drozdovitch V, Chizhov K, Chumak V, Bakhanova E, Trotsyuk N, Bondarenko P, Golovanov I, Kryuchkov V. Reliability of Questionnaire-Based Dose Reconstruction: Human Factor Uncertainties in the Radiation Dosimetry of Chernobyl Cleanup Workers. Radiat Res 2022; 198:172-180. [PMID: 35604875 PMCID: PMC9384793 DOI: 10.1667/rade-21-00207.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 05/10/2022] [Indexed: 11/03/2022]
Abstract
This original study aims to quantify the human factor uncertainties in radiation doses for Chernobyl cleanup workers that are associated with errors in direct or proxy personal interviews due to poor memory recall a long time after exposure. Two types of doses due to external irradiation during cleanup mission were calculated independently. First, a "reference" dose, that was calculated using the historical description of cleanup activities reported by 47 cleanup workers shortly after the completion of the cleanup mission. Second, a "current" dose that was calculated using information reported by 47 cleanup workers and respective 24 proxies (colleagues) nominated by cleanup workers during a personal interview conducted more recently, as part of this study, i.e., 25-30 years after their cleanup missions. The Jaccard similarity coefficient for reference and current doses was moderate: the arithmetic mean ± standard deviation was 0.29 ± 0.18 (median = 0.31) and 0.23 ± 0.18 (median = 0.22) for the cleanup worker's and proxy's interviews, respectively. The agreement between two doses was better if the cleanup worker was interviewed rather than his proxy: the median ratio of current to reference dose was 1.0 and 0.56 for cleanup workers and proxies, respectively. The present study has shown that human factor uncertainties lead to underestimation or overestimation of the "true" reference dose for most cleanup workers up to 3 times. In turn, the potential impact of these errors on radiation-related risk estimates should be assessed.
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Affiliation(s)
- Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Konstantin Chizhov
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Vadim Chumak
- National Research Centre for Radiation Medicine, Kyiv, Ukraine
| | - Elena Bakhanova
- National Research Centre for Radiation Medicine, Kyiv, Ukraine
| | | | | | - Ivan Golovanov
- State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia
| | - Victor Kryuchkov
- State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia
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25
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Akahane M, Yoshioka N, Kiryu S. Radiation Protection of the Eye Lens in Fluoroscopy-guided Interventional Procedures. INTERVENTIONAL RADIOLOGY 2022; 7:44-48. [PMID: 36196387 PMCID: PMC9527101 DOI: 10.22575/interventionalradiology.2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/25/2022] [Indexed: 11/04/2022]
Abstract
The medical staff involved in fluoroscopy-guided procedures are at potential risks of radiation-induced cataract. Therefore, proper monitoring of the lens doses is critical, and radiation protection should be provided to the maximum extent that is reasonably achievable. The collar dosimeter is necessary to avoid underestimation of the lens dose, and the third dosimeter behind the protective eyewear would be helpful for those who are likely to exceed the dose limit. The reduction of the patient doses will correspondingly reduce the staff doses. Proper placement of the ceiling-mounted shields and minimization of the face-to-glass gap are the keys to effective shielding. The optimization of procedures and devices that help maintain a distance from the irradiated area and to prevent the looking-up posture will substantially reduce the lens dose.
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Affiliation(s)
- Masaaki Akahane
- Department of Radiology, School of Medicine, International University of Health and Welfare
| | - Naoki Yoshioka
- Department of Radiology, School of Medicine, International University of Health and Welfare
| | - Shigeru Kiryu
- Department of Radiology, School of Medicine, International University of Health and Welfare
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Machan L. Invited commentary: Collar Badge Lens Dose Equivalent Values among United States Physicians Performing Fluoroscopically Guided Interventional Procedures. J Vasc Interv Radiol 2022; 33:852-853. [PMID: 35777894 DOI: 10.1016/j.jvir.2022.03.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Lindsay Machan
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
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27
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Cheng KL, Huang JY, Weng JH, Chiou JY, Lan CT, Tung KC. 18F-FDG PET/CT Did Not Increase the Risk of Cataract Occurrence in Oncology Patients: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137651. [PMID: 35805310 PMCID: PMC9265417 DOI: 10.3390/ijerph19137651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/11/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the risk of cataract formation associated with radiation exposure from 18F-FDG PET/CT in oncology patients, using data from Taiwan’s National Health Insurance Research Database. The exposed group (Group E) consisted of oncology patients receiving 18F-FDG PET/CT within the first year of a cancer diagnosis. The comparison group (Group C) included subjects who had never been exposed to 18F-FDG PET/CT radiation and were propensity score-matched by date of enrolment, age, sex, cancer type, associated comorbidities, and CT utilization. Multiple Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of cataract risk due to radiation exposure, while adjusting for potential confounding factors. A total of 703 patients and 1406 matched subjects were in Groups E and C, respectively. The incidence of cataract formation was not significantly higher among subjects in Group E (adjusted HR = 1.264; 95% confidence interval [CI] = 0.845–1.891). Our results revealed that 18F-FDG PET/CT was not a significant risk factor for developing cataracts in oncology patients.
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Affiliation(s)
- Kai-Lun Cheng
- Department of Veterinary Medicine, National Chung Hsing University, 250 Kuo Kuang Road, Taichung 40227, Taiwan;
- Department of Medical Imaging, Chung Shan Medical University Hospital, 110 Jianguo North Road, Taichung 40201, Taiwan
- School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan
| | - Jing-Yang Huang
- Center for Health Data Science, Chung Shan Medical University Hospital, 110 Jianguo North Road, Taichung 40201, Taiwan;
- Institute of Medicine, College of Medicine, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan
| | - Jui-Hung Weng
- Department of Nuclear Medicine, Chung Shan Medical University Hospital, 110 Jianguo North Road, Taichung 40201, Taiwan;
- School of Medicine, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan
| | - Jeng-Yuan Chiou
- School of Health Policy and Management, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan;
| | - Chyn-Tair Lan
- Department of Anatomy, Faculty of Medicine, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan;
| | - Kwong-Chung Tung
- Department of Veterinary Medicine, National Chung Hsing University, 250 Kuo Kuang Road, Taichung 40227, Taiwan;
- Correspondence:
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28
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Sun L, Inaba Y, Sogo Y, Kunugita N, Chida K, Moritake T. Ionizing radiation reduces glutathione levels in the eye: A pilot study. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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29
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Lima TVM, Del Castillo TR, Heinrich M, Zihlmann S, Benitez RL, Roos JE. Impact of the incorrect use of lead drapes on staff and patient doses in interventional radiology. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:021505. [PMID: 35072655 DOI: 10.1088/1361-6498/ac4e13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
To evaluate the usefulness of commercially available scatter reduction drapes in mitigating staff exposure in interventional radiology and the potential harmful effects of drape malpositioning in terms of exposure levels to both patients and staff. An anthropomorphic phantom was irradiated on an angiography device under three scenarios: no drape and correct and incorrect drape positioning. Different levels of incorrect drape positioning relative to the field-of-view (FOV) were evaluated: slight, mild and severe. Real-time dosimeter systems (positioned on the operator's eye, chest and thyroid) were used to evaluate accumulative doses and dose rates. Different obstruction levels were evaluated and compared to the observer's perception. Additionally, patient exposure was evaluated for all scenarios using a dose area product (DAP). Up to a mild obstruction, by using the drape a dose reduction of up to 86% was obtained while a severe obstruction produced a 1000% increase in exposure, respectively for all dosimeter positions compared to the use of no drape. A similar order of magnitude was observed for patient exposure. Good agreement was obtained for the observer perception of the FOV obstruction up to 25% of the FOV; for larger obstructions, an overestimate of the obstruction was observed. Patient lead drapes can reduce staff doses in interventional radiology procedures even when mildly malpositioned and obscuring the FOV. Special attention to protective drape positioning is necessary, since the severe obstruction of the FOV results in a large increase in both operator and patient exposure.
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Affiliation(s)
- Thiago V M Lima
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Lucerne, Switzerland
| | | | - Mirjam Heinrich
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Stephanie Zihlmann
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Ruben Lopez Benitez
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Justus E Roos
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Lucerne, Switzerland
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Luo S, Sha Y, Wu J, Lin N, Pan Y, Zhang F, Huang W. Differentiation of malignant from benign orbital tumours using dual-energy CT. Clin Radiol 2022; 77:307-313. [PMID: 35094818 DOI: 10.1016/j.crad.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022]
Abstract
AIM To investigate the diagnostic accuracy of dual-energy computed tomography (DECT)-derived iodine concentration (IC), effective atomic number (Zeff), and spectral attenuation information for differentiating malignant and benign orbital tumours. MATERIALS AND METHODS Data from 41 patients with orbital tumours from November 2019 to March 2021 were analysed retrospectively. Each patient underwent contrast-enhanced DECT using a 128-section dual-source computed tomography (DSCT) system. Dual-energy information, including IC, normalised iodine concentration (NIC), Zeff, virtual monoenergetic images (VMIs) reconstructed from 40 to 120 keV and slope (k) value were determined. Quantitative measurement of DECT parameters was undertaken by two independent radiologists blinded to clinical data. Differences in parameters were assessed using independent sample t-test. Diagnosis performance was calculated by the receiver operating characteristic (ROC) curve analysis. Radiation doses of conventional CT and DECT were compared by paired t-tests. RESULTS Forty-one patients with histopathologically confirmed tumours were enrolled, including 10 malignant cases and 21 benign cases. Malignant orbital tumours exhibited significantly greater IC, NIC, Zeff, CT attenuation of VMIs at 40-105 keV, and k values compared to benign orbital tumours (p<0.05). In ROC analyses, 40 keV VMI demonstrated the highest diagnostic performance of single parameters (area under the ROC curve [AUC], 0.940), and combined parameters achieved the best performance (AUC, 0.971; sensitivity, 90%; specificity, 93.55%). Radiation doses were significantly reduced in DECT than conventional CT (p<0.001). CONCLUSIONS Quantitative DECT analysis can be a useful technique, which yields excellent diagnostic accuracy, in the differentiation of malignant and benign orbital tumours with low radiation dose.
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Affiliation(s)
- S Luo
- Shanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China; Department of Radiology, Eye & ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China
| | - Y Sha
- Department of Radiology, Eye & ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China.
| | - J Wu
- Siemens Healthineers, No. 399, West Haiyang Road, Shanghai, 200126, China
| | - N Lin
- Department of Radiology, Eye & ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China
| | - Y Pan
- Department of Radiology, Eye & ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China
| | - F Zhang
- Department of Radiology, Eye & ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China
| | - W Huang
- Department of Radiology, Eye & ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China
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Abstract
There has been a rapid development in the field of interventional radiology over recent years, and this has led to a rapid increase in the number of interventional radiology procedures being performed. There is, however, a growing concern regarding radiation exposure to the patients and the operators during these procedures. In this article, we review the basics of radiation exposure, radiation protection techniques, radiation protection tools available to interventional radiologists, and radiation protection during pregnancy.
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Affiliation(s)
- Tushar Garg
- Department of Interventional Radiology, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
| | - Apurva Shrigiriwar
- Department of Interventional Radiology, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
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32
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Barnard S, Uwineza A, Kalligeraki A, McCarron R, Kruse F, Ainsbury EA, Quinlan RA. Lens Epithelial Cell Proliferation in Response to Ionizing Radiation. Radiat Res 2022; 197:92-99. [PMID: 33984857 DOI: 10.1667/rade-20-00294.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/20/2021] [Indexed: 11/03/2022]
Abstract
Lens epithelial cell proliferation and differentiation are naturally well regulated and controlled, a characteristic essential for lens structure, symmetry and function. The effect of ionizing radiation on lens epithelial cell proliferation has been demonstrated in previous studies at high acute doses, but the effect of dose and dose rate on proliferation has not yet been considered. In this work, mice received single acute doses of 0.5, 1 and 2 Gy of radiation, at dose rates of 0.063 and 0.3 Gy/min. Eye lenses were isolated postirradiation at 30 min up until 14 days and flat-mounted. Then, cell proliferation rates were determined using biomarker Ki67. As expected, radiation increased cell proliferation 2 and 24 h postirradiation transiently (undetectable 14 days postirradiation) and was dose dependent (changes were very significant at 2 Gy; P = 0.008). A dose-rate effect did not reach significance in this study (P = 0.054). However, dose rate and lens epithelial cell region showed significant interactions (P < 0.001). These observations further our mechanistic understanding of how the lens responds to radiation.
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Affiliation(s)
- S Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
| | - A Uwineza
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
| | - A Kalligeraki
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
| | - R McCarron
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - F Kruse
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
- Department of Oncology, CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - E A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - R A Quinlan
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
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Park S, Lee DN, Jin YW, Cha ES, Jang WI, Park S, Seo S. Non-cancer disease prevalence and association with occupational radiation exposure among Korean radiation workers. Sci Rep 2021; 11:22415. [PMID: 34789809 PMCID: PMC8599676 DOI: 10.1038/s41598-021-01875-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/03/2021] [Indexed: 11/09/2022] Open
Abstract
Radiation-induced cancer risks have known stochastic effects; however, regarding non-cancer diseases, evidence of risk at low radiation doses remains unclear. We aimed to identify underlying characteristics concerning non-cancer disease prevalence and determine associations with radiation dose among Korean radiation workers. Using a nationwide baseline survey, 20,608 workers were enrolled. Data concerning participant demographics, occupational characteristics, lifestyle, and lifetime prevalence of non-cancer diseases were linked to a national dose registry. We compared non-cancer disease prevalences in the Korean general population with those in this cohort and undertook a dose-response analysis concerning the cumulative dose. Hyperlipidemia (10.6%), circulatory (9.6%), and respiratory (4.1%) system diseases, followed by thyroid diseases (3.5%), had the highest prevalences, with hyperlipidemia, thyroid diseases, and hepatitis prevalence being higher in the cohort than in the general population. Radiation doses were associated with elevated prevalences of most diseases; however, associations were attenuated and not significant after adjusting for confounders, except for musculoskeletal system diseases (prevalence odds ratio [POR]/10 mSv, 1.03; 95% confidence interval [CI] 1.00-1.07) and cataracts (POR/10 mSv, 1.04; 95% CI 1.00-1.07). Further studies are warranted to investigate the causality of those non-cancer diseases involving more varied confounders such as physical and psychosocial stresses and ultraviolet light.
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Affiliation(s)
- Soojin Park
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Dal Nim Lee
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Young Woo Jin
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Eun Shil Cha
- grid.222754.40000 0001 0840 2678Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Won-Il Jang
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea ,grid.415464.60000 0000 9489 1588Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Sunhoo Park
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea ,grid.415464.60000 0000 9489 1588Department of Pathology, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Songwon Seo
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812, South Korea.
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Larabi-Harfouche K, Dari F, Herrati A, Medkour Ishak-Boushaki G, Ouldmouhoub-Bedak DJ, Lounis-Mokrani Z. PERFORMANCE TESTING OF EYE LENS DOSEMETER AND EVALUATION OF PERSONAL RADIOLOGICAL EXPOSITION AT DOUERA ORTHOPEDIC INTERVENTIONAL SERVICE. RADIATION PROTECTION DOSIMETRY 2021; 196:34-43. [PMID: 34435640 DOI: 10.1093/rpd/ncab124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 05/12/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
The radiological monitoring of the eye in the workplace depends on the type of dosemeter used and its performance. The dosimetric performances of Nuclear Research Center of Algiers (CRNA) developed eye lens dosemeter (Larabi-Harfouche et al. Characterization and qualification of a CRNA eye dosemeter. Perspect Sci. 12, 100402 (2019)) are investigated in this work in order to assess its ability to measure the operational quantity Hp(3) in photon fields and to check its compliance with the International Commission on Radiological Protection recommendations for professionally exposed people (ICRP. ICRP statement on tissue reactions/early and late effects of radiation in normal tissues and organs - threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Ann. ICRP 41(1/2) (2012)). Some key performance indicators including the relative response of the nonlinearity, coefficient of variation, and photon energy and angular dependence are assessed before the use of this dosemeter for eye lens monitoring of orthopedic staff in the operating room at Douera hospital. The monitoring results of this first pilot study are presented and discussed in view of supporting the recommendations of the International Organization for Standardization 15382: 2015 concerning the monitoring of the dose at lens.
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Affiliation(s)
- K Larabi-Harfouche
- Laboratory of Theoretical Physics and Radiation-Matter Interactions (LPTHIRM), USDB, Soumaa, Blida, Algeria
| | - F Dari
- Ionizing Radiation Dosimetry Department, Nuclear Research Center of Algiers, Algiers, Algeria
| | - A Herrati
- Ionizing Radiation Dosimetry Department, Nuclear Research Center of Algiers, Algiers, Algeria
| | | | - D J Ouldmouhoub-Bedak
- Service de médecine de travail, Centre Hospitalo- Universitaire (CHU), Douera, Algeria
| | - Z Lounis-Mokrani
- Ionizing Radiation Dosimetry Department, Nuclear Research Center of Algiers, Algiers, Algeria
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35
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Abstract
Data suggest that radiation-induced cataracts may form without a threshold and at low-radiation doses. Staff involved in interventional radiology and cardiology fluoroscopy-guided procedures have the potential to be exposed to radiation levels that may lead to eye lens injury and the occurrence of opacifications have been reported. Estimates of lens dose for various fluoroscopy procedures and predicted annual dosages have been provided in numerous publications. Available tools for eye lens radiation protection include accessory shields, drapes and glasses. While some tools are valuable, others provide limited protection to the eye. Reducing patient radiation dose will also reduce occupational exposure. Significant variability in reported dose measurements indicate dose levels are highly dependent on individual actions and exposure reduction is possible. Further follow-up studies of staff lens opacification are recommended along with eye lens dose measurements under current clinical practice conditions.
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Affiliation(s)
| | - Kenneth A Fetterly
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
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36
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Ainsbury EA, Barnard SGR. Sensitivity and latency of ionising radiation-induced cataract. Exp Eye Res 2021; 212:108772. [PMID: 34562436 DOI: 10.1016/j.exer.2021.108772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/26/2021] [Accepted: 09/20/2021] [Indexed: 01/29/2023]
Abstract
When managed with appropriate radiation protection procedures, ionising radiation is of great benefit to society. Opacification of the lens, and vision impairing cataract, have recently been recognised at potential effects of relatively low dose radiation exposure, on the order of 1 Gy or below. Within the last 10 years, understanding of the effects of low dose ionising radiation on the lens has increased, particularly in terms of DNA damage and responses, and how multiple radiation or other events in the lens might contribute to the overall risk of cataract. However, gaps remain, not least in the understanding of how radiation interacts with other risk factors such as aging, as well as the relative radiosensitivity of the lens compared to tissues of the body. This paper reviews the current literature in the field of low dose radiation cataract, with a particular focus on sensitivity and latency.
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Affiliation(s)
- Elizabeth A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot Oxford, OX11 ORQ, UK.
| | - Stephen G R Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot Oxford, OX11 ORQ, UK.
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37
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Moriarty HK, Clements W, Phan T, Wang S, Goh GS. Occupational radiation exposure to the lens of the eye in interventional radiology. J Med Imaging Radiat Oncol 2021; 66:34-40. [PMID: 34342393 DOI: 10.1111/1754-9485.13307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/15/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Cataract formation is a tissue reaction effected by radiation exposure. The purpose of this study was to evaluate the occupational exposure to the lens of the eye of interventional radiologists (IR's) and interventional radiology staff, with and without lead glasses. METHODS Ethical approval was provided by the hospital research and ethics committee. A prospective cohort study was performed over 1 year, doses recorded, lifetime dose (estimated at working 5 days in angiography, for 30 years) was estimated and dose compared to current guidelines. Thermoluminescent dosimeters (TLDs; Landauer, Glenwood, USA) Hp(3) were placed on both the exterior and interior side of the personal lead glasses worn by three interventional radiologists and two radiographers. They were monitored during all procedures performed within 1 year. Lead glasses (AttenuTech® Microlite® , Florida, USA) with specifications were 0.75 mm lead equivalent front shield, and Side shield 0.3 mm Pb equivalent. A control TLD was placed in the storage location of the lead glasses when not in use. Yearly dose was measured and lifetime dose was calculated from the data obtained. Calculation of dose received per day(s) spent performing procedures for both annual and lifetime exposure was performed. In addition a record of occurrence of splashes on glasses was made after each case. RESULTS Eye doses without protection were double the recommended limits for both annual and lifetime dose. For interventional radiologists working between 3 and 4 or more days in the lab per week, annual dose thresholds would be exceeded (20 mSv/year averaged over 5 years, no more than 50 mSv in 1 year). If interventional radiologists worked between 3 and 4 or more days in the lab, lifetime dose thresholds would be exceeded (500 mSv lifetime dose). Lead glasses reduced radiation exposure by an average of 79%. If lead glasses were worn no interventional radiologists would exceed annual or lifetime dose thresholds to the eyes even if working 5 days per week as the primary operator. Radiographers would not exceed annual or lifetime dose thresholds even without lead glasses. Splash incidents occurred for all interventional radiologists and one radiographer. CONCLUSION The use of lead glasses even in this small study resulted in a decreased dose of radiation to the lens of the eye. Regular use of radiation protection eyewear will reduce eye dose for primary proceduralists to well below yearly and lifetime thresholds.
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Affiliation(s)
- Heather K Moriarty
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Warren Clements
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Tuan Phan
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Sherry Wang
- University of Utah, Salt Lake City, Utah, USA
| | - Gerard S Goh
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
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38
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Burraco P, Bonzom JM, Car C, Beaugelin-Seiller K, Gashchak S, Orizaola G. Lack of impact of radiation on blood physiology biomarkers of Chernobyl tree frogs. Front Zool 2021; 18:33. [PMID: 34187507 PMCID: PMC8240299 DOI: 10.1186/s12983-021-00416-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/30/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Human actions have altered natural ecosystems worldwide. Among the many pollutants released to the environment, ionizing radiation can cause severe damage at different molecular and functional levels. The accident in the Chernobyl Nuclear Power Plant (1986) caused the largest release of ionizing radiation to the environment in human history. Here, we examined the impact of the current exposure to ionizing radiation on blood physiology biomarkers of adult males of the Eastern tree frog (Hyla orientalis) inhabiting within and outside the Chernobyl Exclusion Zone. We measured the levels of eight blood parameters (sodium, potassium, chloride, ionized calcium, total carbon dioxide, glucose, urea nitrogen, and anion gap), physiological markers of homeostasis, as well as of liver and kidney function. RESULTS Levels of blood physiology biomarkers did not vary in function of the current exposure of tree frogs to ionizing radiation within the Chernobyl Exclusion Zone. Physiological blood levels were similar in frogs inhabiting Chernobyl (both in areas with medium-high or low radiation) than in tree frogs living outside Chernobyl exposed only to background radiation levels. CONCLUSIONS The observed lack of effects of current radiation levels on blood biomarkers can be a consequence of the low levels of radiation currently experienced by Chernobyl tree frogs, but also to the fact that our sampling was restricted to active breeding males, i.e. potentially healthy adult individuals. Despite the clear absence of effects of current radiation levels on physiological blood parameters in tree frogs, more research covering different life stages and ecological scenarios is still needed to clarify the impact of ionizing radiation on the physiology, ecology, and dynamics of wildlife inhabiting radioactive-contaminated areas.
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Affiliation(s)
- Pablo Burraco
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, G12 8QQ, Glasgow, UK.
- Animal Ecology, Department of Ecology and Genetics, Evolutionary Biology Centre, Uppsala University, 75236, Uppsala, Sweden.
| | - Jean-Marc Bonzom
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-ENV/SRTE/LECO, Cadarache, 13115, Saint Paul Lez Durance, France
| | - Clément Car
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-ENV/SRTE/LECO, Cadarache, 13115, Saint Paul Lez Durance, France
| | - Karine Beaugelin-Seiller
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-ENV/SRTE/LECO, Cadarache, 13115, Saint Paul Lez Durance, France
| | - Sergey Gashchak
- Chornobyl Center for Nuclear Safety, Radioactive Waste and Radioecology, Slavutych, 07100, Ukraine
| | - Germán Orizaola
- Animal Ecology, Department of Ecology and Genetics, Evolutionary Biology Centre, Uppsala University, 75236, Uppsala, Sweden
- IMIB-Biodiversity Research Institute (Univ. Oviedo-CSIC-Princip. Asturias), University of Oviedo, 33600, Mieres, Asturias, Spain
- Zoology Unit, Department of Biology of Organisms and Systems, University of Oviedo, 33071, Oviedo, Asturias, Spain
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39
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Mizunuma K. Review of personal radiation exposure dose and history of the interventional procedure records for 40 years. Jpn J Radiol 2021; 39:1000-1008. [PMID: 34117984 PMCID: PMC8490249 DOI: 10.1007/s11604-021-01147-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022]
Abstract
Objective To inspect personal dose as an interventional radiologist for 40 years, to assess the enforcement number of interventional radiology (IR), and to check for radiation cataract. Materials and methods I evaluated my own effective dose, an equivalent dose to the lens of the eye (EDL), and the number of IR procedures between March 2019 and June 1979. I examined the lens in June 2019 as a radiologist for 40 years. Results The accumulation dose was 0 mSv in 1979–88. During 1989–93, the right crystalline lens equivalence of the value dose was measured. During 1993–96, two badge items for the head, neck, and abdomen were present. Both were distributed, but attaching to the same part and reversing occurred frequently. The EDL of the recent 5 years has exceeded 100 mSv. No association with the number of IR procedures was recognized. Posterior subcapsular vacuoles (PSV) as the early changes of the radiation cataract were recognized as four on the left and one on the right. Conclusion It is important to get accustomed to film badge wearing, and the cancelation of making a mistake in the wearing part. Radiologists should check the PSV at a stage beyond a certain constant dose.
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Affiliation(s)
- Kimiyoshi Mizunuma
- Department of the Diagnostic and Interventional Radiology, Nasu Red Cross Hospital, 1081-4, Nakadawara, Ohtawara, Tochigi, 324-8686, Japan.
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40
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Van Schelt J. Lens dose to standing patients treated with electrons to the hand. Med Dosim 2021; 46:e7-e10. [PMID: 34053855 DOI: 10.1016/j.meddos.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
Patients receiving radiotherapy to the hand are sometimes treated standing, with their heads beside and potentially facing an electron applicator. This raises the possibility of consequential lens dose from scattered electrons, which this study investigates. This study measures the dose beside an applicator at a depth of 3 mm in a phantom as an estimate of lens dose for such patients. The lens dose is investigated as a function of height, distance, beam energy, applicator size, and cutout fill on a Varian Trilogy linear accelerator. The effect of the potential mitigation strategies of turning the head or shielding with lead sheets is also investigated. Measurement found that a typical hand setup may result in the lens receiving 0.15% of the treatment dose, which would deliver a cumulative dose above the demonstrated threshold dose for cataract risk for some courses. Large applicators and close facial proximity to the applicator separately enhance dose by factors of 3 and 5 respectively, raising the possibility of multiple gray to the lens for patients in unfavorable setups. Simple and effective mitigation strategies are available: Turning the patient's head to the side or placing 1-2 mm of lead on glasses reduced lens dose by a factor of 3-4, and covering the side of the applicator with 1 mm of lead or turning the head completely away effectively eliminated lens dose. The lens dose can be consequential but is readily mitigated.
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Affiliation(s)
- Jonathon Van Schelt
- Department of Radiation Oncology, Rush University Medical Center, Chicago, IL 60612-3833, USA.
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41
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McCarron RA, Barnard SGR, Babini G, Dalke C, Graw J, Leonardi S, Mancuso M, Moquet JE, Pawliczek D, Pazzaglia S, De Stefano I, Ainsbury EA. Radiation-Induced Lens Opacity and Cataractogenesis: A Lifetime Study Using Mice of Varying Genetic Backgrounds. Radiat Res 2021; 197:57-66. [PMID: 33984859 DOI: 10.1667/rade-20-00266.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/20/2021] [Indexed: 11/03/2022]
Abstract
Recent epidemiological findings and reanalysis of historical data suggest lens opacities resulting from ionizing radiation exposures are likely induced at lower doses than previously thought. These observations have led to ICRP recommendations for a reduction in the occupational dose limits for the eye lens, as well as subsequent implementation in EU member states. The EU CONCERT LDLensRad project was initiated to further understand the effects of ionizing radiation on the lens and identify the mechanism(s) involved in radiation-induced cataract, as well as the impact of dose and dose-rate. Here, we present the results of a long-term study of changes to lens opacity in male and female adult mice from a variety of different genetic (radiosensitive or radioresistant) backgrounds, including mutant strains Ercc2 and Ptch1, which were assumed to be susceptible to radiation-induced lens opacities. Mice received 0.5, 1 and 2 Gy 60Co gamma-ray irradiation at dose rates of 0.063 and 0.3 Gy min-1. Scheimpflug imaging was used to quantify lens opacification as an early indicator of cataract, with monthly observations taken postirradiation for an 18-month period in all strains apart from 129S2, which were observed for 12 months. Opacification of the lens was found to increase with time postirradiation (with age) for most mouse models, with ionizing radiation exposure increasing opacities further. Sex, dose, dose rate and genetic background were all found to be significant contributors to opacification; however, significant interactions were identified, which meant that the impact of these factors was strain dependent. Mean lens density increased with higher dose and dose rate in the presence of Ercc2 and Ptch1 mutations. This project was the first to focus on low (<1 Gy) dose, multiple dose rate, sex and strain effects in lens opacification, and clearly demonstrates the importance of these experimental factors in radiobiological investigations on the lens. The results provide insight into the effects of ionizing radiation on the lens as well as the need for further work in this area to underpin appropriate radiation protection legislation and guidance.
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Affiliation(s)
- R A McCarron
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - S G R Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom.,Durham University, School of Biosciences, Durham, United Kingdom
| | - G Babini
- Department of Physics, University of Pavia, Pavia, Italy.,Department of Woman and Child Health, Fondazione Policlinico A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - C Dalke
- Helmholtz Zentrum München GmbH, German Research Centre for Environmental Health, Neuherberg, Germany
| | - J Graw
- Helmholtz Zentrum München GmbH, German Research Centre for Environmental Health, Neuherberg, Germany
| | - S Leonardi
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - M Mancuso
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - J E Moquet
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - D Pawliczek
- Helmholtz Zentrum München GmbH, German Research Centre for Environmental Health, Neuherberg, Germany
| | - S Pazzaglia
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - I De Stefano
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - E A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
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42
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Ota J, Kawakami Y, Sada T, Irie R, Chida K, Masuda Y. [Calculation of Lens Exposure Reduction Using Organ-effective Modulation in Pediatric Head CT]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:326-334. [PMID: 33883366 DOI: 10.6009/jjrt.2021_jsrt_77.4.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE Using a pediatric head phantom constructed in our department, we examined a method to reduce exposure by using organ-effective modulation (OEM; Toshiba Medical Systems Corporation, Tochigi) to tilt the gantry during pediatric head computed tomography (CT) scanning. METHOD The radiation reduction and CT image standard deviation (SD) were measured at gantry angles at which the orbit was slightly irradiated, partially irradiated, and completely irradiated. The OEM incident surface dose reduction rate was measured using an automatic exposure control (AEC) phantom with a diameter of 6-18 cm. RESULTS The lens surface dose reduction rate using OEM was 21.2%. When the gantry was tilted and the orbit was completely out of the scanning range, the rate of reduction was 47.8%. OEM incident surface dose reduction rates were 27.4% for a phantom diameter of 18 cm, 22.0% for that of 16 cm, 17.8% for that of 14 cm, 17.2% for that of 12 cm, 8.4% for that of 10 cm, and 0% for that of 8 cm and 6 cm. OEM effectiveness decreased with decreasing phantom diameter. The use of OEM increased the rate of change of SD by 1.25´ when the gantry inclination was 0°, 1.27´ when the gantry inclination was 10°, and 1.27´ when the gantry inclination was 20°in the 12 o'clock position. CONCLUSION The degree of reduction in exposure dose to the lens in pediatric head CT imaging was 47.8% by completely removing the lens from the irradiation range using gantry tilt and 21.2% by using OEM. The effect of OEM changed in proportion to tube current. The exposure reduction effect of the OEM decreases with decreasing head size, indicating its reduced effectiveness in head CT scans of smaller infants.
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Affiliation(s)
- Joji Ota
- Department of Radiology, Chiba University Hospital.,Department of Health Science, Tohoku University Graduate School of Medicine
| | | | | | - Ryosuke Irie
- Department of Radiology, Chiba University Hospital
| | - Koichi Chida
- Department of Health Science, Tohoku University Graduate School of Medicine
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43
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Lo Giudice G, Angelini E, Bini S, Candian T, Crudeli C, Galan A. Outcome of cataract surgery in children affected by malignancies other than retinoblastoma with eye-lens radiation exposure. Eur J Ophthalmol 2021; 32:11206721211009445. [PMID: 33843295 DOI: 10.1177/11206721211009445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe, retrospectively, the visual outcome, feasibility, and safety of cataract surgery in a pediatric population affected by iatrogenic cataract, secondary to systemic oncological treatment for malignancies other than retinoblastoma. METHODS Young patients, affected by radiation-induced cataract, who were referred to the San Paolo Ophthalmic Center in Padova between 2010 and 2017, were included in the study. All patients had previously received radiotherapy and/or chemotherapy treatment for malignancies, between 2004 and 2013. All medical records of infants who underwent cataract surgery were accurately reviewed. RESULTS Eighteen eyes out of 11 patients included in the study underwent cataract surgery. The mean age at surgery was 9.7 ± 3.6 years. The interval between tumor diagnosis and cataract development was around 3 years. Mean follow-up after surgery was 15.4 ± 6.3 months. All eyes underwent posterior chamber intraocular lens implantation, posterior capsulotomy, and anterior vitrectomy in one time surgery. No intraoperative complications were shown. Post-operatively, only one eye received laser capsulotomy due to posterior capsule opacification. At the end of follow up, best-corrected visual acuity was 20/20 (LogMAR 0) in all eyes and significantly improved (p < 0.01) compared to baseline. CONCLUSIONS Iatrogenic-cataract surgery in pediatric oncological patients is a safe and effective way to improve visual acuity. Posterior capsulotomy and anterior vitrectomy at the time of surgery reduce the rate of posterior lens opacification and guarantee an excellent visual acuity in these patients.
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Affiliation(s)
- Giuseppe Lo Giudice
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Edoardo Angelini
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Silvia Bini
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Tommaso Candian
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Clorinda Crudeli
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Alessandro Galan
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
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44
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Little MP, Azizova TV, Hamada N. Low- and moderate-dose non-cancer effects of ionizing radiation in directly exposed individuals, especially circulatory and ocular diseases: a review of the epidemiology. Int J Radiat Biol 2021; 97:782-803. [PMID: 33471563 PMCID: PMC10656152 DOI: 10.1080/09553002.2021.1876955] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/24/2020] [Accepted: 01/09/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE There are well-known correlations between high and moderate doses (>0.5 Gy) of ionizing radiation exposure and circulatory system damage, also between radiation and posterior subcapsular cataract. At lower dose correlations with circulatory disease are emerging in the Japanese atomic bomb survivors and in some occupationally exposed groups, and are still to some extent controversial. Heterogeneity in excess relative risks per unit dose in epidemiological studies at low (<0.1 Gy) and at low-moderate (>0.1 Gy, <0.5 Gy) doses may result from confounding and other types of bias, and effect modification by established risk factors. There is also accumulating evidence of excess cataract risks at lower dose and low dose rate in various cohorts. Other ocular endpoints, specifically glaucoma and macular degeneration have been little studied. In this paper, we review recent epidemiological findings, and also discuss some of the underlying radiobiology of these conditions. We briefly review some other types of mainly neurological nonmalignant disease in relation to radiation exposure. CONCLUSIONS We document statistically significant excess risk of the major types of circulatory disease, specifically ischemic heart disease and stroke, in moderate- or low-dose exposed groups, with some not altogether consistent evidence suggesting dose-response non-linearity, particularly for stroke. However, the patterns of risk reported are not straightforward. We also document evidence of excess risks at lower doses/dose-rates of posterior subcapsular and cortical cataract in the Chernobyl liquidators, US Radiologic Technologists and Russian Mayak nuclear workers, with fundamentally linear dose-response. Nuclear cataracts are less radiogenic. For other ocular endpoints, specifically glaucoma and macular degeneration there is very little evidence of effects at low doses; radiation-associated glaucoma has been documented only for doses >5 Gy, and so has the characteristics of a tissue reaction. There is some evidence of neurological detriment following low-moderate dose (∼0.1-0.2 Gy) radiation exposure in utero or in early childhood.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Ozyorsk Chelyabinsk Region, Russia
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Komae, Tokyo, Japan
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45
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Pawliczek D, Fuchs H, Gailus-Durner V, de Angelis MH, Quinlan R, Graw J, Dalke C. On the Nature of Murine Radiation-Induced Subcapsular Cataracts: Optical Coherence Tomography-Based Fine Classification, In Vivo Dynamics and Impact on Visual Acuity. Radiat Res 2021; 197:7-21. [PMID: 33631790 DOI: 10.1667/rade-20-00163.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/05/2021] [Indexed: 11/03/2022]
Abstract
Ionizing radiation is widely known to induce various kinds of lens cataracts, of which posterior subcapsular cataracts (PSCs) have the highest prevalence. Despite some studies regarding the epidemiology and biology of radiation-induced PSCs, the mechanism underscoring the formation of this type of lesions and their dose dependency remain uncertain. Within the current study, our team investigated the in vivo characteristics of PSCs in B6C3F1 mice (F1-hybrids of BL6 × C3H) that received 0.5-2 Gy γ-ray irradiation after postnatal day 70. For purposes of assessing lenticular damages, spectral domain optical coherence tomography was utilized, and the visual acuity of the mice was measured to analyze their levels of visual impairment, and histological sections were then prepared in to characterize in vivo phenotypes. Three varying in vivo phenotype anterior and posterior lesions were thus revealed and correlated with the applied doses to understand their marginal influence on the visual acuity of the studied mice. Histological data indicated no significantly increased odds ratios for PSCs below a dose of 1 Gy at the end of the observation time. Furthermore, our team demonstrated that when the frequencies of the posterior and anterior lesions were calculated at early time points, their responses were in accordance with a deterministic model, whereas at later time points, their responses were better described via a stochastic model. The current study will aid in honing the current understanding of radiation-induced cataract formation and contributes greatly to addressing the fundamental questions of lens dose response within the field of radiation biology.
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Affiliation(s)
- Daniel Pawliczek
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Helmut Fuchs
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Valerie Gailus-Durner
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Martin Hrabê de Angelis
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany.,Chair of Experimental Genetics, School of Life Science Weihenstephan, Technische Universität München, Freising, Germany.,German Center for Diabetes Research (DZB), Neuherberg, Germany
| | - Roy Quinlan
- Department of Biosciences, School of Biological and Medical Sciences, University of Durham, Durham, United Kingdom
| | - Jochen Graw
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
| | - Claudia Dalke
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany
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46
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Arefpour AM, Bahrami M, Haghparast A, Khoshgard K, Aryaei Tabar H, Farshchian N. Evaluating Dose-response of Cataract Induction in Radiotherapy of Head and Neck Cancers Patients. J Biomed Phys Eng 2021; 11:9-16. [PMID: 33564635 PMCID: PMC7859376 DOI: 10.31661/jbpe.v0i0.834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 11/16/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Head and neck cancers are currently the most common types of cancers. 3D-conformal radiation therapy is the most common dose delivery technique for head and neck cancers. Eye Lens is a radio sensitive structure and cataract formation as a visual disorder associated with exposure to ionizing radiation which is documented. OBJECTIVE Determining the radiation dose to eye lens during head and neck radiography and estimating the probability of cataract induction are essential. MATERIAL AND METHODS This experimental study was performed on 14 patients with head and neck cancers through experimental study analysis. The maximum opacity of the eyes lens were measured by pentacamTM before radiation therapy. CT data of patients were transmitted to Isogray treatment planning Software, and dose calculations for each patient was performed. At the end of radiation treatment, 3 and 6 months after radiotherapy, the eye lens opacity of the patients was assessed. RESULTS Overall, 28 lenses were studied. Statistical one sample K- S test proved normality of obtained data. Using repeated measures test, the relation before and 3 months after radiotherapy, as well as the relationship before and 6 months after radiotherapy proved a significant relationship. CONCLUSION The opacity caused by radiation in eyes is a non-statistical and linear-quadratic response curve with no threshold. This opacity can also appear within 3 months after completion of radiation therapy.
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Affiliation(s)
- A M Arefpour
- MD, Department of Radiation Oncology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - M Bahrami
- MSc, Department of Medical Physics, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - A Haghparast
- PhD, Department of Medical Physics, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - K Khoshgard
- PhD, Department of Medical Physics, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - H Aryaei Tabar
- MD, Departments of Ophthalmology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - N Farshchian
- MD, Department of Radiation Oncology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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47
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Harrison JD, Balonov M, Bochud F, Martin C, Menzel HG, Ortiz-Lopez P, Smith-Bindman R, Simmonds JR, Wakeford R. ICRP Publication 147: Use of Dose Quantities in Radiological Protection. Ann ICRP 2021; 50:9-82. [PMID: 33653178 DOI: 10.1177/0146645320911864] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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48
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Hiramatsu N, Nagai N, Kondo M, Imaizumi K, Sasaki H, Yamamoto N. Morphological comparison between three-dimensional structure of immortalized human lens epithelial cells and Soemmering's ring. Med Mol Morphol 2021; 54:216-226. [PMID: 33458799 DOI: 10.1007/s00795-021-00280-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/03/2021] [Indexed: 01/01/2023]
Abstract
The incidence rate of post-cataract surgery posterior capsule opacification (PCO) and lens turbidity is about 20% in 5 years. Soemmering's ring, which is a type of PCO also called a regenerated lens with similar tissue structure to that of a human lens, is an important proxy for elucidating the mechanism of lens regeneration and maintenance of transparency. The authors created new human immortalized crystalline lens epithelial cells (iHLEC-NY1s) with excellent differentiation potential, and as a result of culturing the cells by static and rotation-floating methods, succeeded in producing a three-dimensional cell structure model (3D-iHLEC-NY1s) which is similar to Soemmering's ring in tissue structure and expression characteristics of αA-crystalline, βB2-crystalline, vimentin proteins. 3D-iHLEC-NY1s is expected to be a proxy in vitro experimental model of Soemmering's ring to enable evaluation of drug effects on suppression of cell aggregate formation and transparency. By further improving the culture conditions, we aim to control the cell sequence and elucidate the mechanism underlying the maintenance of lens transparency.
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Affiliation(s)
- Noriko Hiramatsu
- Center for Clinical Trial and Research Support, Fujita Health University Research Promotion and Support Headquarters, Toyoake, Aichi, 470-1192, Japan
- Graduate School of Medicine, Fujita Health University, Toyoake, Aichi, 470-1192, Japan
| | - Noriaki Nagai
- Faculty of Pharmacy, Kindai University, Higashiosaka, Osaka, 577-8502, Japan
| | - Masashi Kondo
- Center for Clinical Trial and Research Support, Fujita Health University Research Promotion and Support Headquarters, Toyoake, Aichi, 470-1192, Japan
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan
| | - Kazuyoshi Imaizumi
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, 920-0293, Japan
| | - Naoki Yamamoto
- Department of Ophthalmology, Kanazawa Medical University, Kahoku, Ishikawa, 920-0293, Japan.
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Ainsbury EA, Dalke C, Hamada N, Benadjaoud MA, Chumak V, Ginjaume M, Kok JL, Mancuso M, Sabatier L, Struelens L, Thariat J, Jourdain JR. Radiation-induced lens opacities: Epidemiological, clinical and experimental evidence, methodological issues, research gaps and strategy. ENVIRONMENT INTERNATIONAL 2021; 146:106213. [PMID: 33276315 DOI: 10.1016/j.envint.2020.106213] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/11/2020] [Accepted: 08/25/2020] [Indexed: 06/12/2023]
Abstract
In 2011, the International Commission on Radiological Protection (ICRP) recommended reducing the occupational equivalent dose limit for the lens of the eye from 150 mSv/year to 20 mSv/year, averaged over five years, with no single year exceeding 50 mSv. With this recommendation, several important assumptions were made, such as lack of dose rate effect, classification of cataracts as a tissue reaction with a dose threshold at 0.5 Gy, and progression of minor opacities into vision-impairing cataracts. However, although new dose thresholds and occupational dose limits have been set for radiation-induced cataract, ICRP clearly states that the recommendations are chiefly based on epidemiological evidence because there are a very small number of studies that provide explicit biological and mechanistic evidence at doses under 2 Gy. Since the release of the 2011 ICRP statement, the Multidisciplinary European Low Dose Initiative (MELODI) supported in April 2019 a scientific workshop that aimed to review epidemiological, clinical and biological evidence for radiation-induced cataracts. The purpose of this article is to present and discuss recent related epidemiological and clinical studies, ophthalmic examination techniques, biological and mechanistic knowledge, and to identify research gaps, towards the implementation of a research strategy for future studies on radiation-induced lens opacities. The authors recommend particularly to study the effect of ionizing radiation on the lens in the context of the wider, systemic effects, including in the retina, brain and other organs, and as such cataract is recommended to be studied as part of larger scale programs focused on multiple radiation health effects.
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Affiliation(s)
- Elizabeth A Ainsbury
- Public Health England (PHE) Centre for Radiation, Chemical and Environmental Hazards, Oxon, United Kingdom.
| | - Claudia Dalke
- Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Germany.
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan.
| | - Mohamed Amine Benadjaoud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP 17, 31 avenue de la division Leclerc, Fontenay-aux-Roses, France.
| | - Vadim Chumak
- National Research Centre for Radiation Medicine, Ukraine.
| | | | - Judith L Kok
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Mariateresa Mancuso
- Laboratory of Biomedical Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, (ENEA), Rome, Italy.
| | - Laure Sabatier
- Commissariat à l'Energie Atomique et aux Energies Alternatives, Saclay, France.
| | | | - Juliette Thariat
- Laboratoire de physique corpusculaire IN2P3/ENSICAEN -UMR6534 - Unicaen - Normandie University, France
| | - Jean-René Jourdain
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP 17, 31 avenue de la division Leclerc, Fontenay-aux-Roses, France.
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Nagamoto K, Moritake T, Nakagami K, Morota K, Matsuzaki S, Nihei SI, Kamochi M, Kunugita N. Occupational radiation dose to the lens of the eye of medical staff who assist in diagnostic CT scans. Heliyon 2021; 7:e06063. [PMID: 33553745 PMCID: PMC7851788 DOI: 10.1016/j.heliyon.2021.e06063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/08/2020] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We investigated occupational dose to the lens of the eye for CT-assisting personnel for diagnostic purposes using a radio-photoluminescent glass dosimeter (RPLD) and evaluate compliance with the new equivalent dose limit for the lens of the eye (20 mSv/year). Further, we proposed the implementation of "multiple protective measures" and estimated its effect. METHOD An eye lens dosimeter clip was developed specifically to attach RPLDs inside radiation safety glasses in an L-shape. Using a total of six RPLDs attached to the radiation safety glasses, the 3-mm dose-equivalent (Hp(3)) to the lens of the eye for medical staff (n = 11; 6 intensive care physicians, 2 pediatricians, 3 radiological technologists) who assisted patients during CT scan for "diagnostic" purpose (n = 91) was measured. We evaluated the dose reduction efficiencies with radiation safety glasses and bag-valve-mask extension tube. We also estimated the protection efficiency with radiation protection curtain introduced in front of the staff's face via the phantom experiment. RESULTS Without wearing radiation safety glasses, Hp(3) to the lens of the eye was greatest for intensive care physicians (0.49 mSv/procedure; allowing 40 procedures to be performed annually), followed by pediatricians (0.30 mSv/procedure; 66 procedures annually) and radiological technologists (0.28 mSv/procedure; 71 procedures annually). Use of each type of protective tools: radiation safety glasses (0.07-mm-Pb), bag-valve-mask extension tube (20 cm) and radiation protective curtain (0.25-mm-Pb), reduced Hp(3) to the lens of the eye by 51%, 31% and 61%, respectively. CONCLUSION Intensive care physicians perform most assisted ventilations with the bag-valve-mask during "diagnostic" CT scans, and may exceed the equivalent dose limit for the lens of the eye if radiation safety glasses are not worn. If "multiple protective measures" are implemented, compliance with the equivalent dose limit for the lens of the eye should be achievable without placing significant burdens on physicians or medical institutions.
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Affiliation(s)
- Keisuke Nagamoto
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Takashi Moritake
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Koichi Nakagami
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Koichi Morota
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Department of Radiology, Shinkomonji Hospital, 2-5 Dairishinmachi, Moji-ku, Kitakyushu, Fukuoka, Japan
| | - Satoru Matsuzaki
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Department of Radiology, Shinkomonji Hospital, 2-5 Dairishinmachi, Moji-ku, Kitakyushu, Fukuoka, Japan
| | - Shun-ichi Nihei
- Intensive Care Unit, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Masayuki Kamochi
- Intensive Care Unit, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Naoki Kunugita
- Department of Occupational and Community Health Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
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