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Behrend SJ, Giotopoulou GA, Spella M, Stathopoulos GT. A role for club cells in smoking-associated lung adenocarcinoma. Eur Respir Rev 2021; 30:30/162/210122. [PMID: 34670807 PMCID: PMC9488964 DOI: 10.1183/16000617.0122-2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/05/2021] [Indexed: 01/02/2023] Open
Abstract
The cellular origin of lung adenocarcinoma remains a focus of intense research efforts. The marked cellular heterogeneity and plasticity of the lungs, as well as the vast variety of molecular subtypes of lung adenocarcinomas perplex the field and account for the extensive variability of experimental results. While most experts would agree on the cellular origins of other types of thoracic tumours, great controversy exists on the tumour-initiating cells of lung adenocarcinoma, since this histologic subtype of lung cancer arises in the distal pulmonary regions where airways and alveoli converge, occurs in smokers as well as nonsmokers, is likely caused by various environmental agents, and is marked by vast molecular and pathologic heterogeneity. Alveolar type II, club, and their variant cells have all been implicated in lung adenocarcinoma progeny and the lineage hierarchies in the distal lung remain disputed. Here we review the relevant literature in this rapidly expanding field, including results from mouse models and human studies. In addition, we present a case for club cells as cells of origin of lung adenocarcinomas that arise in smokers. Multiple lung epithelial cells are targets of carcinogenic hits. Club cells are such cells that can metabolically activate tobacco pre-carcinogens, being thus positioned as cells of origin of lung adenocarcinomas in smokers.https://bit.ly/3iOshcy
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Affiliation(s)
- Sabine J Behrend
- Comprehensive Pneumology Center (CPC) and Institute for Lung Biology and Disease (iLBD); Helmholtz Center Munich-German Research Center for Environmental Health (HMGU) and Ludwig-Maximilian-University (LMU) Munich, Munich, Germany .,German Center for Lung Research (DZL), Giessen, Germany
| | - Georgia A Giotopoulou
- Comprehensive Pneumology Center (CPC) and Institute for Lung Biology and Disease (iLBD); Helmholtz Center Munich-German Research Center for Environmental Health (HMGU) and Ludwig-Maximilian-University (LMU) Munich, Munich, Germany.,German Center for Lung Research (DZL), Giessen, Germany
| | - Magda Spella
- Laboratory for Molecular Respiratory Carcinogenesis, Dept of Physiology, Faculty of Medicine, University of Patras, Patras, Greece
| | - Georgios T Stathopoulos
- Comprehensive Pneumology Center (CPC) and Institute for Lung Biology and Disease (iLBD); Helmholtz Center Munich-German Research Center for Environmental Health (HMGU) and Ludwig-Maximilian-University (LMU) Munich, Munich, Germany.,German Center for Lung Research (DZL), Giessen, Germany
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102
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Baran R, Marchal S, Garcia Campos S, Rehnberg E, Tabury K, Baselet B, Wehland M, Grimm D, Baatout S. The Cardiovascular System in Space: Focus on In Vivo and In Vitro Studies. Biomedicines 2021; 10:59. [PMID: 35052739 PMCID: PMC8773383 DOI: 10.3390/biomedicines10010059] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 12/13/2022] Open
Abstract
On Earth, humans are subjected to a gravitational force that has been an important determinant in human evolution and function. During spaceflight, astronauts are subjected to several hazards including a prolonged state of microgravity that induces a myriad of physiological adaptations leading to orthostatic intolerance. This review summarises all known cardiovascular diseases related to human spaceflight and focusses on the cardiovascular changes related to human spaceflight (in vivo) as well as cellular and molecular changes (in vitro). Upon entering microgravity, cephalad fluid shift occurs and increases the stroke volume (35-46%) and cardiac output (18-41%). Despite this increase, astronauts enter a state of hypovolemia (10-15% decrease in blood volume). The absence of orthostatic pressure and a decrease in arterial pressures reduces the workload of the heart and is believed to be the underlying mechanism for the development of cardiac atrophy in space. Cellular and molecular changes include altered cell shape and endothelial dysfunction through suppressed cellular proliferation as well as increased cell apoptosis and oxidative stress. Human spaceflight is associated with several cardiovascular risk factors. Through the use of microgravity platforms, multiple physiological changes can be studied and stimulate the development of appropriate tools and countermeasures for future human spaceflight missions in low Earth orbit and beyond.
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Affiliation(s)
- Ronni Baran
- Department of Biomedicine, Aarhus University, Ole Worms Allé 4, 8000 Aarhus, Denmark; (R.B.); (D.G.)
| | - Shannon Marchal
- Department of Astronomy, Catholic University of Leuven, 3000 Leuven, Belgium;
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium; (E.R.); (K.T.); (B.B.)
| | - Sebastian Garcia Campos
- Department of Microgravity and Translational Regenerative Medicine, Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany; (S.G.C.); (M.W.)
- Research Group ‘Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen’ (MARS), Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Emil Rehnberg
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium; (E.R.); (K.T.); (B.B.)
- Department of Molecular Biotechnology, Ghent University, 9000 Ghent, Belgium
| | - Kevin Tabury
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium; (E.R.); (K.T.); (B.B.)
- Department of Biomedical Engineering, University of South Carolina, Columbia, SC 29208, USA
| | - Bjorn Baselet
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium; (E.R.); (K.T.); (B.B.)
| | - Markus Wehland
- Department of Microgravity and Translational Regenerative Medicine, Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany; (S.G.C.); (M.W.)
- Research Group ‘Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen’ (MARS), Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Daniela Grimm
- Department of Biomedicine, Aarhus University, Ole Worms Allé 4, 8000 Aarhus, Denmark; (R.B.); (D.G.)
- Department of Microgravity and Translational Regenerative Medicine, Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany; (S.G.C.); (M.W.)
- Research Group ‘Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen’ (MARS), Otto von Guericke University, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Sarah Baatout
- Department of Astronomy, Catholic University of Leuven, 3000 Leuven, Belgium;
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, 2400 Mol, Belgium; (E.R.); (K.T.); (B.B.)
- Department of Molecular Biotechnology, Ghent University, 9000 Ghent, Belgium
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103
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Goula A, Chatzis A, Stamouli MA, Kelesi M, Kaba E, Brilakis E. Assessment of Health Professionals' Attitudes on Radiation Protection Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413380. [PMID: 34948989 PMCID: PMC8708066 DOI: 10.3390/ijerph182413380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Health professionals' knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals' average knowledge level and captures the beliefs, perceptions, and behaviours in a large public Greek hospital. (2) Materials and Methods: A cross-sectional study was carried out, including health professionals working in operating rooms. One hundred thirty-two staff members participated by responding to an original questionnaire. The sample consisted of nurses, radiographers and medical doctors of various specialties involved daily in surgical procedures where ionizing radiation is required. The survey was conducted from March to June 2021, and the response rate was 97%. (3) Results: The level of overall knowledge of health professionals regarding radiation protection safety was not satisfactory. Females and employees with a lower level of education had more misconceptions about radiation and radiation protection. Employees of younger ages and with less previous experience were more likely to have negative emotions towards radiation exposure. Finally, employees with fewer children tended to express physical complaints caused by their negative emotions due to radiation exposure. (4) Conclusions: Health professionals' lack of basic and specialized knowledge concerning radiation protection safety had a negative impact on the provision of health services. The continuing training of the staff seemed to be the only solution to reverse this trend. The training should highlight how radiation exposure can be minimized, safeguarding health professionals' trust and sense of security by significantly improving their working environment.
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Affiliation(s)
- Aspasia Goula
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
- Correspondence:
| | - Athanasios Chatzis
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
| | - Maria-Aggeliki Stamouli
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
| | - Martha Kelesi
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
| | - Evridiki Kaba
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
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104
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Ghorbani Z, Fardid R. Effects of Low-dose Gamma Radiation on Expression of Apoptotic Genes in Rat Peripheral Blood Lymphocyte. J Biomed Phys Eng 2021; 11:693-700. [PMID: 34904066 PMCID: PMC8649167 DOI: 10.31661/jbpe.v0i0.1166] [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: 04/21/2019] [Accepted: 05/05/2019] [Indexed: 11/26/2022]
Abstract
Background: Exposure to high-dose ionizing radiation is known as a human carcinogen factor, but our information about the effects of low-dose ionizing radiation such as occupational exposures is limited.
The main concern of scientific community is biological consequences due to low-dose radiations. Objective: This study aims to evaluate the effects of low-dose γ-radiation on expression changes of apoptotic genes (bax and bcl-2) in the rat peripheral blood lymphocytes. Material and Methods: In this experimental study, 42 adult male rats were classified into 6 groups, which was exposed to various doses values ranged from 20 mGy to 1000 mGy by γ-rays from a Co-60 source.
Blood samples were provided for analysis of gene expression 24 h after gamma radiation by relative quantitative Reverse Transcription - Polymerase Chain Reaction (RT-PCR).
Radiation sensitivity of rat lymphocytes was measured by the bax/bcl-2 ratio as a predictive marker for radio-sensitivity. Results: The results of this study showed that low dose of gamma radiation can induce down-regulation of bax in rat peripheral blood lymphocytes. Despite other mechanisms of cellular radio-protection,
changes in expression of these apoptotic genes can be the primary pathway in responses of the lymphocytes radio-protection to the exposure. Our study revealed a significant decrease
in the bax/bcl-2 ratio at 50 mGy dose compare to control and the other irradiated groups (p < 0.05). Conclusion: These results suggest that changes in the bax/bcl-2 ratio especially in radiation workers, as a key factor in apoptosis, can be considered as a biological marker in low-dose gamma radiation.
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Affiliation(s)
- Zhila Ghorbani
- MSc, Radiobiology and Radiation Protection, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Fardid
- PhD, Associate Professor of Medical Physics, Department of radiology, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- PhD, Associate Professor of Medical Physics, Ionizing and Non-Ionizing Radiation Protection Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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105
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Lala B, Shah J, Salvador TM, Ricci JA. Expanding the Utilization of Low-Dose Computed Tomography in Plastic and Reconstructive Surgery Based on Validated Practices Among Surgical Specialties. Ann Plast Surg 2021; 87:e163-e170. [PMID: 33833174 DOI: 10.1097/sap.0000000000002815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION As computed tomography (CT) usage increases, so have concerns over radiation-induced malignancy. To mitigate these risks, low-dose CT (LDCT) has emerged as a versatile alternative by other specialties, although its use in plastic surgery remains sparse. This study aimed to investigate validated uses of LDCT across surgical specialties and extrapolate these insights to expand its application for plastic surgeons. METHODS A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using search terms "low dose CT" OR "low dose computed tomography" AND "surgery," where the name of each surgical specialty was substituted for word "surgery" and each specialty term was searched separately in combination with the 2 CT terms. Data on radiation dose, outcomes, and level of evidence were collected. Validated surgical applications were correlated with similar procedures and diagnostic tests performed routinely by plastic surgeons to extrapolate potential applications for plastic surgeons. RESULTS A total of 3505 articles were identified across surgical specialties, with 27 ultimately included. Depending on the application, use of LDCT led to a 25% to 97% reduction in radiation dose and all studies reported noninferior image quality and diagnostic capability compared with standard-dose CT. Potential identified uses included the following: evaluation of soft tissue infections, preoperative and postoperative management of facial and hand fractures, flap design, 3D modeling, and surgical planning. DISCUSSION Low-dose CT is a valid imaging alternative to standard-dose CT. Expanded utilization in plastic surgery should be considered to minimize the iatrogenic effects of radiation and to promote patient safety without compromising outcomes.
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Affiliation(s)
- Brittany Lala
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center, Bronx, NY
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106
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Case JA. 3D iterative reconstruction can do so much more than reduce dose. J Nucl Cardiol 2021; 28:2633-2637. [PMID: 31376003 DOI: 10.1007/s12350-019-01827-4] [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] [Received: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
Recent advances in software and hardware for cardiac SPECT have the potential to revolutionize nuclear cardiology. It is easy to use these technologies to maintain the status quo and lower radiation dose, despite the fact there is very little evidence that lowering patient dose in already low dose imaging protocols confers any benefit to patients. Cardiac SPECT has tremendous potential for risk stratification, molecular tracers, and high temporal resolution management of patients with electrophysiological disorders. In addition, these new reconstruction techniques can offer spatial resolution that is comparable and sometimes even superior to PET. Lastly, recent research has also held out the potential for performing absolute blood flow qualification using SPECT instrumentation. As these new technologies become available, the goal should be to make images better and improve patient care first, then optimize the dose.
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Affiliation(s)
- James A Case
- Cardiovascular Imaging Technologies, 4320 Wornall Road Suite 114, Kansas City, MO, 64111, USA.
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107
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Acute outcomes of three-dimensional mapping for fluoroscopy reduction in paediatric catheter ablation for supraventricular tachycardia. Cardiol Young 2021; 31:1923-1928. [PMID: 33766172 DOI: 10.1017/s1047951121001086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Catheter ablation is a safe and effective therapy for the treatment of supraventricular tachycardia in children. Current improvements in technology have allowed progressive reduction in radiation exposure associated with the procedure. To assess the impact of three-dimensional mapping, we compared acute procedural results collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry to published results from the Prospective Assessment after Pediatric Cardiac Ablation study. METHODS Inclusion and exclusion criteria from the Prospective Assessment after Pediatric Cardiac Ablation study were used as guidelines to select patient data from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry to compare acute procedural outcomes between cohorts. Outcomes assessed include procedural and fluoroscopy exposure times, success rates of procedure, and complications. RESULTS In 786 ablation procedures, targeting 498 accessory pathways and 288 atrioventricular nodal reentrant tachycardia substrates, average procedural time (156.5 versus 206.7 minutes, p < 0.01), and fluoroscopy time (1.2 versus 38.3 minutes, p < 0.01) were significantly shorter in the study group. Success rates for the various substrates were similar except for manifest accessory pathways which had a significantly higher success rate in the study group (96.4% versus 93.0%, p < 0.01). Major complication rates were significantly lower in the study group (0.3% versus 1.6%, p < 0.01). CONCLUSIONS In a large, multicentre study, three-dimensional systems show favourable improvements in clinical outcomes in children undergoing catheter ablation of supraventricular tachycardia compared to the traditional fluoroscopic approach. Further improvements are anticipated as technology advances.
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108
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Image-Based Evaluation of Irradiation Effects in Brain Tissues by Measuring Absolute Electrical Conductivity Using MRI. Cancers (Basel) 2021; 13:cancers13215490. [PMID: 34771653 PMCID: PMC8583433 DOI: 10.3390/cancers13215490] [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: 09/19/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Radiation-induced injury is damage to normal tissues caused by unintentional exposure to ionizing radiation. Image-based evaluation of tissue damage by irradiation has an advantage for the early assessment of therapeutic effects by providing sensitive information on minute tissue responses in situ. Recent magnetic resonance (MR)-based electrical conductivity imaging has shown potential as an effective early imaging biomarker for treatment response and radiation-induced injury. However, to be a tool for evaluating therapeutic effects, validation of its reliability and sensitivity according to various irradiation conditions is required. We performed MR-based electrical conductivity imaging on designed phantoms to confirm the effect of ionizing radiation at different doses and on in vivo mouse brains to distinguish tissue response depending on different doses and the elapsed time after irradiation. To quantify the irradiation effects, we measured the absolute conductivity of brain tissues and calculated relative conductivity changes based on the value of pre-irradiation. The conductivity of the phantoms with the distilled water and saline solution increased linearly with the irradiation doses. The conductivity of in vivo mouse brains showed different time-course variations and residual contrast depending on the irradiation doses. Future studies will focus on validation at long-term time points, including early and late delayed response and evaluation of irradiation effects in various tissue types.
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109
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Increasing radiation exposure from computed tomography in liver transplant recipients over time. Ir J Med Sci 2021; 191:2099-2103. [PMID: 34714492 DOI: 10.1007/s11845-021-02821-x] [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: 09/08/2021] [Accepted: 10/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate changes in radiation exposure from computed tomography (CT) among patients undergoing liver transplantation in our unit over a 10-year period. METHODS We evaluated 134 elective patients, without hepatocellular carcinoma or cholangiocarcinoma who underwent transplantation in 2007-2008 and 2017-2018. CT scans performed in our hospital up to 2 years pre transplant and 1 year post transplant were evaluated. RESULTS There was an increase in mean estimated effective radiation dose per patient in 2017-2018 compared to 2007-2008 (77.8 mSv ± 6.2 vs 56.7 mSv ± 5.9, p < 0.05). This change was mainly due to an increased number of pre-transplant CT scans per patient (2.9 ± 0.3 vs 1.4 ± 0.14, p = 0.0001). High radiation dose scan protocols were more frequently used in 2017-2018, with 4-phase liver CT accounting for a larger proportion of scans both pre-transplant (61% vs 43%, p = 0.004) and post-transplant (29% vs 13%, p = 0.002). A greater proportion of patients were exposed to > 100 mSv of ionising radiation in the 2017-2018 patients (29% vs 11%, p < 0.01). These figures are likely to be a significant under-estimate as they exclude other imaging modalities and CT scans performed at other institutions. CONCLUSION Radiation exposure from diagnostic imaging has increased among liver transplant recipients at our institution over the last decade. This appears to be due to an increase in the number of CT scans performed, and a shift towards higher dose scan protocols.
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110
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Levartovsky A, Barash Y, Ben-Horin S, Ungar B, Soffer S, Amitai MM, Klang E, Kopylov U. Machine learning for prediction of intra-abdominal abscesses in patients with Crohn's disease visiting the emergency department. Therap Adv Gastroenterol 2021; 14:17562848211053114. [PMID: 34707689 PMCID: PMC8543712 DOI: 10.1177/17562848211053114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/23/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Intra-abdominal abscess (IA) is an important clinical complication of Crohn's disease (CD). A high index of clinical suspicion is needed as imaging is not routinely used during hospital admission. This study aimed to identify clinical predictors of an IA among hospitalized patients with CD using machine learning. METHODS We created an electronic data repository of all patients with CD who visited the emergency department of our tertiary medical center between 2012 and 2018. We searched for the presence of an IA on abdominal imaging within 7 days from visit. Machine learning models were trained to predict the presence of an IA. A logistic regression model was compared with a random forest model. RESULTS Overall, 309 patients with CD were hospitalized and underwent abdominal imaging within 7 days. Forty patients (12.9%) were diagnosed with an IA. On multivariate analysis, high C-reactive protein (CRP) [above 65 mg/l, adjusted odds ratio (aOR): 16 (95% CI: 5.51-46.18)], leukocytosis [above 10.5 K/μl, aOR: 4.47 (95% CI: 1.91-10.45)], thrombocytosis [above 322.5 K/μl, aOR: 4.1 (95% CI: 2-8.73)], and tachycardia [over 97 beats per minute, aOR: 2.7 (95% CI: 1.37-5.3)] were independently associated with an IA. Random forest model showed an area under the curve of 0.817 ± 0.065 with six features (CRP, hemoglobin, WBC, age, current biologic therapy, and BUN). CONCLUSION In our large tertiary center cohort, the machine learning model identified the association of six clinical features (CRP, hemoglobin, WBC, age, BUN, and biologic therapy) with the presentation of an IA. These may assist as a decision support tool in triaging CD patients for imaging to exclude this potentially life-threatening complication.
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Affiliation(s)
| | - Yiftach Barash
- Department of Diagnostic Imaging, Sheba Medical
Center, Tel Hashomer, Tel-Aviv University, Israel,DeepVision Lab, Sheba Medical Center, Tel
Hashomer, Israel
| | - Shomron Ben-Horin
- Department of Gastroenterology, Sheba Medical
Center, Tel Hashomer, Tel-Aviv University, Israel
| | - Bella Ungar
- Department of Gastroenterology, Sheba Medical
Center, Tel Hashomer, Tel-Aviv University, Israel
| | - Shelly Soffer
- DeepVision Lab, Sheba Medical Center, Tel
Hashomer, Israel; Internal Medicine B, Assuta Medical Center, Ben-Gurion
University of the Negev, Ashdod, Israel
| | - Marianne M. Amitai
- Department of Diagnostic Imaging, Sheba Medical
Center, Tel Hashomer, Tel-Aviv University, Israel
| | - Eyal Klang
- Department of Diagnostic Imaging, Sheba Medical
Center, Tel Hashomer, Tel-Aviv University, Israel,DeepVision Lab, Sheba Medical Center, Tel
Hashomer, Israel
| | - Uri Kopylov
- Department of Gastroenterology, Sheba Medical
Center, Tel Hashomer, Tel-Aviv University, Israel
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111
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DNA damage response of haematopoietic stem and progenitor cells to high-LET neutron irradiation. Sci Rep 2021; 11:20854. [PMID: 34675263 PMCID: PMC8531011 DOI: 10.1038/s41598-021-00229-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/05/2021] [Indexed: 11/23/2022] Open
Abstract
The radiosensitivity of haematopoietic stem and progenitor cells (HSPCs) to neutron radiation remains largely underexplored, notwithstanding their potential role as target cells for radiation-induced leukemogenesis. New insights are required for radiation protection purposes, particularly for aviation, space missions, nuclear accidents and even particle therapy. In this study, HSPCs (CD34+CD38+ cells) were isolated from umbilical cord blood and irradiated with 60Co γ-rays (photons) and high energy p(66)/Be(40) neutrons. At 2 h post-irradiation, a significantly higher number of 1.28 ± 0.12 γ-H2AX foci/cell was observed after 0.5 Gy neutrons compared to 0.84 ± 0.14 foci/cell for photons, but this decreased to similar levels for both radiation qualities after 18 h. However, a significant difference in late apoptosis was observed with Annexin-V+/PI+ assay between photon and neutron irradiation at 18 h, 43.17 ± 6.10% versus 55.55 ± 4.87%, respectively. A significant increase in MN frequency was observed after both 0.5 and 1 Gy neutron irradiation compared to photons illustrating higher levels of neutron-induced cytogenetic damage, while there was no difference in the nuclear division index between both radiation qualities. The results point towards a higher induction of DNA damage after neutron irradiation in HSPCs followed by error-prone DNA repair, which contributes to genomic instability and a higher risk of leukemogenesis.
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112
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Mozzoni P, Pinelli S, Corradi M, Ranzieri S, Cavallo D, Poli D. Environmental/Occupational Exposure to Radon and Non-Pulmonary Neoplasm Risk: A Review of Epidemiologic Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10466. [PMID: 34639764 PMCID: PMC8508162 DOI: 10.3390/ijerph181910466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 12/01/2022]
Abstract
Although Radon (Rn) is a known agent for lung cancer, the link between Rn exposure and other non-pulmonary neoplasms remains unclear. The aim of this review is to investigate the role of Rn in the development of tumors other than lung cancer in both occupational and environmental exposure. Particularly, our attention has been focused on leukemia and tumors related to brain and central nervous system (CNS), skin, stomach, kidney, and breast. The epidemiologic literature has been systematically reviewed focusing on workers, general population, and pediatric population. A weak increase in leukemia risk due to Rn exposure was found, but bias and confounding factors cannot be ruled out. The results of studies conducted on stomach cancer are mixed, although with some prevalence for a positive association with Rn exposure. In the case of brain and CNS cancer and skin cancer, results are inconclusive, while no association was found for breast and kidney cancers. Overall, the available evidence does not support a conclusion that a causal association has been established between Rn exposure and the risk of other non-pulmonary neoplasms mainly due to the limited number and heterogeneity of existing studies. To confirm this result, a statistical analysis should be necessary, even if it is now not applicable for the few studies available.
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Affiliation(s)
- Paola Mozzoni
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
- Centre for Research in Toxicology (CERT), University of Parma, Via A. Gramsci 14, 43126 Parma, Italy
| | - Silvana Pinelli
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
| | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
- Centre for Research in Toxicology (CERT), University of Parma, Via A. Gramsci 14, 43126 Parma, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
| | - Delia Cavallo
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy;
| | - Diana Poli
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy;
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113
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Baratto L, Hawk KE, States L, Qi J, Gatidis S, Kiru L, Daldrup-Link HE. PET/MRI Improves Management of Children with Cancer. J Nucl Med 2021; 62:1334-1340. [PMID: 34599010 PMCID: PMC8724894 DOI: 10.2967/jnumed.120.259747] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/21/2021] [Indexed: 01/11/2023] Open
Abstract
Integrated PET/MRI has shown significant clinical value for staging and restaging of children with cancer by providing functional and anatomic tumor evaluation with a 1-stop imaging test and with up to 80% reduced radiation exposure compared with 18F-FDG PET/CT. This article reviews clinical applications of 18F-FDG PET/MRI that are relevant for pediatric oncology, with particular attention to the value of PET/MRI for patient management. Early adopters from 4 different institutions share their insights about specific advantages of PET/MRI technology for the assessment of young children with cancer. We discuss how whole-body PET/MRI can be of value in the evaluation of certain anatomic regions, such as soft tissues and bone marrow, as well as specific PET/MRI interpretation hallmarks in pediatric patients. We highlight how whole-body PET/MRI can improve the clinical management of children with lymphoma, sarcoma, and neurofibromatosis, by reducing the number of radiologic examinations needed (and consequently the radiation exposure), without losing diagnostic accuracy. We examine how PET/MRI can help in differentiating malignant tumors versus infectious or inflammatory diseases. Future research directions toward the use of PET/MRI for treatment evaluation of patients undergoing immunotherapy and assessment of different theranostic agents are also briefly explored. Lessons learned from applications in children might also be extended to evaluations of adult patients.
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Affiliation(s)
- Lucia Baratto
- Department of Radiology, Stanford University, Stanford, California
| | - K Elizabeth Hawk
- Department of Radiology, Stanford University, Stanford, California
| | - Lisa States
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jing Qi
- Department of Radiology, Children's Wisconsin, Milwaukee, Wisconsin
| | - Sergios Gatidis
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany; and
| | - Louise Kiru
- Department of Radiology, Stanford University, Stanford, California
| | - Heike E Daldrup-Link
- Department of Radiology, Stanford University, Stanford, California;
- Department of Pediatrics, Stanford University, Stanford, California
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114
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Ahmad M, Tan D, Marisetty S. Assessment of the global noise algorithm for automatic noise measurement in head CT examinations. Med Phys 2021; 48:5702-5711. [PMID: 34314528 PMCID: PMC9291315 DOI: 10.1002/mp.15133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The global noise (GN) algorithm has been previously introduced as a method for automatic noise measurement in clinical CT images. The accuracy of the GN algorithm has been assessed in abdomen CT examinations, but not in any other body part until now. This work assesses the GN algorithm accuracy in automatic noise measurement in head CT examinations. METHODS A publicly available image dataset of 99 head CT examinations was used to evaluate the accuracy of the GN algorithm in comparison to reference noise values. Reference noise values were acquired using a manual noise measurement procedure. The procedure used a consistent instruction protocol and multiple observers to mitigate the influence of intra- and interobserver variation, resulting in precise reference values. Optimal GN algorithm parameter values were determined. The GN algorithm accuracy and the corresponding statistical confidence interval were determined. The GN measurements were compared across the six different scan protocols used in this dataset. The correlation of GN to patient head size was also assessed using a linear regression model, and the CT scanner's X-ray beam quality was inferred from the model fit parameters. RESULTS Across all head CT examinations in the dataset, the range of reference noise was 2.9-10.2 HU. A precision of ±0.33 HU was achieved in the reference noise measurements. After optimization, the GN algorithm had a RMS error 0.34 HU corresponding to a percent RMS error of 6.6%. The GN algorithm had a bias of +3.9%. Statistically significant differences in GN were detected in 11 out of the 15 different pairs of scan protocols. The GN measurements were correlated with head size with a statistically significant regression slope parameter (p < 10-7 ). The CT scanner X-ray beam quality estimated from the slope parameter was 3.5 cm water HVL (2.8-4.8 cm 95% CI). CONCLUSION The GN algorithm was validated for application in head CT examinations. The GN algorithm was accurate in comparison to reference manual measurement, with errors comparable to interobserver variation in manual measurement. The GN algorithm can detect noise differences in examinations performed on different scanner models or using different scan protocols. The trend in GN across patients of different head sizes closely follows that predicted by a physical model of X-ray attenuation.
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Affiliation(s)
- Moiz Ahmad
- Department of Imaging Physics ‐ Unit 1472The University of Texas MD Anderson Cancer CenterHoustonTexasUSA
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115
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Huang CS, Qiu LZ, Yue L, Wang NN, Liu H, Deng HF, Ni YH, Ma ZC, Zhou W, Gao Y. Low-dose radiation-induced demethylation of 3β-HSD participated in the regulation of testosterone content. J Appl Toxicol 2021; 42:529-539. [PMID: 34550611 DOI: 10.1002/jat.4237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 08/13/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022]
Abstract
The effects of low-dose radiation (LDR, ≤0.1 Gy) on living organisms have been the hot areas of radiation biology but do not reach a definitive conclusion yet. So far, few studies have adequately accounted for the male reproductive system responses to LDR, particularly the regulation of testosterone content. Hence, this study was designed to evaluate the effects of LDR on Leydig cells and testicular tissue, especially the ability to synthesize testosterone. We found that less than 0.2-Gy 60 Co gamma rays did not cause significant changes in the hemogram index and the body weight; also, pathological examination did not find obvious structural alterations in testis, epididymis, and other radiation-sensitive organs. Consistently, the results from in vitro showed that only more than 0.5-Gy gamma rays could induce remarkable DNA damage, cycle arrest, and apoptosis. Notably, LDR disturbed the contents of testosterone in mice serums and culture supernatants of TM3 cells and dose dependently increased the expression of 3β-HSD. After cotreatment with trilostane (Tril), the inhibitor of 3β-HSD, increased testosterone could be partially reversed. Besides, DNA damage repair-related enzymes, including DNMT1, DNMT3B, and Sirt1, were increased in irradiated TM3 cells, accompanying by evident demethylation in the gene body of 3β-HSD. In conclusion, our results strongly suggest that LDR could induce obvious perturbation in the synthesis of testosterone without causing organic damage, during which DNA demethylation modification of 3β-HSD might play a crucial role and would be a potential target to prevent LDR-induced male reproductive damage.
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Affiliation(s)
- Cong-Shu Huang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China.,School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, China
| | - Li-Zhen Qiu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China
| | - Lanxin Yue
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China
| | - Ning-Ning Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China
| | - Hong Liu
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China.,School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hui-Fang Deng
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China
| | - Yu-Hao Ni
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China
| | - Zeng-Chun Ma
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China
| | - Wei Zhou
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China
| | - Yue Gao
- Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China.,School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, China
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Tan XM, Shah MTBM, Chong SL, Ong YKG, Ang PH, Zakaria NDB, Lee KP, Pek JH. Differences in radiation dose for computed tomography of the brain among pediatric patients at the emergency departments: an observational study. BMC Emerg Med 2021; 21:106. [PMID: 34551720 PMCID: PMC8456576 DOI: 10.1186/s12873-021-00502-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/13/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Computed tomography (CT) is associated with a risk of cancer development. Strategies to reduce radiation doses vary between centers. We compared radiation doses of CT brain studies between pediatric and general emergency departments (EDs), and determine the proportion studies performed within the reference levels recommended by the International Commission on Radiological Protection (ICRP). METHODS A retrospective review was carried out in a healthcare network consisting of one pediatric ED and three general hospital EDs. Pediatric patients less than 16 years old with CT brain studies performed between 1 January 2015 and 31 December 2018 were included. Information on demographic, diagnosis, volume-averaged computed-tomography dose index and dose length product (DLP) were collected. Effective dose was then calculated from DLP using conversion factors, termed k-coefficients which were derived using a 16 cm head CT dose phantom. RESULTS Four hundred and seventy-nine CT brain studies were performed - 379 (79.1%) at the pediatric ED. Seizure (149, 31.1%), head injury (147, 30.7%) and altered mental status (44, 9.2%) were the top three ED diagnoses. The median effective dose estimates were higher in general than pediatric EDs, particularly for those aged > 3 to ≤6 years old [1.57 mSv (IQR 1.42-1.79) versus 1.93 mSv (IQR 1.51-2.28), p = 0.047], > 6 to ≤10 years old [1.43 mSv (IQR 1.27-1.67) versus 1.94 mSv (IQR 1.61-2.59), p = 0.002) and > 10 years old (1.68 mSv (IQR 1.32-1.72) versus 2.03 mSv (IQR 1.58-2.88), p < 0.001). Overall, 233 (48.6%) and 13 (2.7%) studies were within the reference levels recommended by ICRP 60 and 103 respectively. CONCLUSIONS Radiation doses for CT brain studies were significantly higher at general EDs and less than half of the studies were within the reference levels recommended by ICRP. The development of diagnostic reference levels (DRLs) as a benchmark and clinical justification for performing CT studies can help reduce the radiation risks in the pediatric population.
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Affiliation(s)
- Xi Min Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore
| | | | - Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Rd, Singapore, 229899, Singapore
| | - Yong-Kwang Gene Ong
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Rd, Singapore, 229899, Singapore
| | - Peck Har Ang
- Accident and Emergency Department, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Nur Diana Bte Zakaria
- Department of Emergency Medicine, Singapore General Hospital, Outram Rd, Singapore, 169608, Singapore
| | - Khai Pin Lee
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Rd, Singapore, 229899, Singapore
| | - Jen Heng Pek
- Department of Emergency Medicine, Sengkang General Hospital, 110 Sengkang E Way, Singapore, 544886, Singapore.
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117
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Feasibility of Cardiac Computed Tomography for the Evaluation of Ventricular Function in Postoperative Children With Congenital Heart Disease: Comparison With Cardiac Magnetic Resonance Imaging. J Comput Assist Tomogr 2021; 45:537-543. [PMID: 34519452 DOI: 10.1097/rct.0000000000001155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We explored the feasibility of cardiac computed tomography (CCT) to evaluate postoperative ventricular function in children with congenital heart disease (CHD) and evaluated the accuracy and reproducibility of CCT using cardiac magnetic resonance (CMR) as a reference. METHODS Thirty-two postoperative children with CHD (20 boys and 12 girls) who underwent CMR and CCT were enrolled. Left and right ventricular ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, and cardiac index were measured using cardiac function analysis software. Cardiac function data were compared between CMR and CCT. The agreement between the 2 modalities was assessed using a Bland-Altman analysis. Intraclass correlation coefficients were used to assess intraobserver and interobserver reproducibility in CCT functional measurements. RESULTS All functional parameters showed no significant difference (P > 0.05) and were well-correlated (r > 0.5, P < 0.05) between CMR and CCT. The mean values of all ventricular function parameters in CCT were higher compared with CMR. As indicated by 95% limits of agreement, left ventricular function parameters showed a better level of agreement compared with right ventricular function parameters between the 2 modalities. Intraobserver and interobserver reproducibility were excellent in CCT measurements for all functional parameters (intraclass correlation coefficient > 0.9). CONCLUSIONS Compared with the criterion standard of CMR, CCT is feasible for assessing postoperative ventricular function with sufficient diagnostic accuracy and reproducibility in children with CHD. In addition to its important role regarding anatomical characterization, CCT is a suitable alternative and convenient follow-up tool that can be used to functional evaluation in children who are intolerant with CMR or have contraindications to CMR.
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Döring K, Mielke D, Moerer O, Stamm G, Karsch S, Psychogios MN, Rohde V, Malinova V. Radiation Exposure in the Acute Phase after Aneurysmal Subarachnoid Hemorrhage in the Era of CT Perfusion. Clin Neuroradiol 2021; 32:123-132. [PMID: 34505910 DOI: 10.1007/s00062-021-01087-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/06/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE Aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high risk of developing multiple complications requiring further diagnostics including imaging associated with radiation exposure (RE). Since aSAH often affects younger patients, the obtained cumulative RE may have serious long-term health consequences. The aim of this study was to calculate the cumulative RE in the acute phase after aSAH and to identify contributors to RE. Additionally, we investigated whether there is a correlation of RE with outcome. METHODS A retrospective analysis of patients with aSAH treated at our department from 2012 to 2018 was performed. The radiation dose of every single cranial radiological examination was calculated for every patient. The outcome was assessed according to the modified Rankin scale (mRS) 3 months after ictus. Factors associated with high RE were evaluated and the correlation of RE with outcome was assessed. RESULTS In 268 included consecutive patients, the mean cumulative RE per patient was 39.95 mSv, ranging from 2 to 265.5 mSv. A higher RE correlated with delayed cerebral ischemia (r = 0.52, p < 0.0001), delayed infarction (r = 0.25, p < 0.0001), delayed ischemic neurological deficits (r = 0.29, p < 0.0001) and transcranial Doppler (TCD)-vasospasm (r = 0.34, p < 0.0001). Independent predictors of outcome were age (p = 0.0001), World Federation of Neurosurgical Societies (WFNS) grade (p < 0.0001) and delayed infarction (p = 0.0004), while RE did not correlate with outcome. CONCLUSION There is a considerable imaging-related RE in aSAH patients. A meticulous decision-making process and imaging protocols with lower RE for the deployment of CT-based and fluoroscopy-based imaging is indicated in order to minimize the risk for radiation-mediated heath consequences in this patient population.
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Affiliation(s)
- Katja Döring
- Department of Neurosurgery, University Medical Center Göttingen, Georg-August-University, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- Department of Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Dorothee Mielke
- Department of Neurosurgery, University Medical Center Göttingen, Georg-August-University, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Onnen Moerer
- Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
| | - Georg Stamm
- Department of Diagnostic Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Susanne Karsch
- Department of Diagnostic Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Marios-Nikos Psychogios
- Department of Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
- Department of Neuroradiology, Clinic of radiology and nuclear medicine, University Basel, Basel, Switzerland
| | - Veit Rohde
- Department of Neurosurgery, University Medical Center Göttingen, Georg-August-University, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Vesna Malinova
- Department of Neurosurgery, University Medical Center Göttingen, Georg-August-University, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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Altoukhi DH, Alaki S, El Ashiry E, Nassif O, Sabbahi D. Genotoxicity and cytotoxicity of cone beam computed tomography in children. BMC Oral Health 2021; 21:427. [PMID: 34481467 PMCID: PMC8418710 DOI: 10.1186/s12903-021-01792-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental radiographs are essential tools for diagnosis. However, there are significant concerns about the dangerous effect of radiation especially on children. The aim of this study was to evaluate genotoxicity and cytotoxicity in the exfoliated cells of buccal mucosa of children subjected to Cone Beam Computed Tomography (CBCT). METHODS The study included 18 healthy children aged (9-12 years) who were exposed to CBCT. All CBCT scans were performed with the i-CAT CBCT. Exfoliated buccal cells were scraped from the left and right cheek immediately before the exposure, after 10 ± 2 days, and after 1 month. Cells were stained using Feulgen/fast green stain and examined under light microscopy. Genotoxicity (Micronuclei) and cytotoxicity (condensed chromatin, karyorrhexis, pyknosis, and karyolysis) were scored. Statistical analysis was performed using the McNemar test, Wilcoxon Signed-Rank test, and Mann-Whitney U test at a significance level of p < 0.05. RESULTS There were statistically significant differences in the mean percentages of micronuclei, condensed chromatin, karyorrhexis, pyknosis, and karyolysis before and 10 ± 2 days after the CBCT scan (p < 0.05). There were no statistically significant differences in the frequency of micronuclei, condensed chromatin, karyorrhexis, or pyknosis before and 1 month after the exposure (p > 0.05) except for karyolysis (p < 0.05). CONCLUSIONS CBCT may induce genotoxicity and cytotoxicity in buccal mucosa cells of children. Therefore, CBCT should not be prescribed unless necessary as it cannot be considered a risk-free procedure.
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Affiliation(s)
- Doua H Altoukhi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Sumer Alaki
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eman El Ashiry
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama Nassif
- Department of Pathology, Faculty of Medicine and Hospitals, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dania Sabbahi
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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120
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Computed tomography associated radiation exposure in children with craniosynostosis. Childs Nerv Syst 2021; 37:2635-2641. [PMID: 34132893 DOI: 10.1007/s00381-021-05254-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/08/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND The role of computed tomography (CT) for diagnosis and surgical planning for craniosynostosis (CS) is well-established. The aim of this study was to quantify the cumulative medical radiation exposure from CT in patients with CS at a tertiary care children's hospital. METHODS Medical records of patients who presented at < 2 years of age and underwent surgical intervention for CS were examined for demographic information. Effective radiation dose (ERD) in mSv was calculated for each head CT. Descriptive statistics and ANOVA were performed. Mean ± SD is reported; p < 0.05 was considered significant. RESULTS Two hundred seventy-two patients met inclusion criteria: 241 nonsyndromic and 31 with syndromic diagnoses. For nonsyndromic patients, mean age at first head CT was 6.0 ± 4.9 months, mean number of CT scans obtained was 2.1 ± 1.1, and the mean total combined ERD was 9.1 ± 4.8 mSv. CT scans obtained at < 6 months of age had a significantly greater ERD than those obtained at > 6 months, 5.3 ± 1.9 versus 4.3 ± 1.4 mSv, respectively (p = 0.001). CONCLUSIONS Patients with nonsyndromic CS undergo 2 CT scans on average related to their diagnosis, with a mean total ERD of 9.1 mSv; this is equivalent to 1.5 years of the average annual background radiation dose a person living in the USA will encounter from environmental radiation, medical exposures, and consumer products. A CT obtained at < 6 months is associated with a higher ERD; thus, we recommend delaying imaging from the initial presentation to the time of pre-operative planning when possible.
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121
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Amare DE, Dagne H. Knowledge and Associated Factors of Medical Students Regarding Radiation Exposure from Common Diagnostic Imaging Procedures at the University of Gondar, Ethiopia. Ethiop J Health Sci 2021; 30:589-598. [PMID: 33897219 PMCID: PMC8054455 DOI: 10.4314/ejhs.v30i4.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Physicians’ knowledge about radiation exposure and risks was previously reported as inadequate. Therefore, the aim of this study was to assess knowledge and associated factors regarding radiation exposure among medical students from common diagnostic imaging procedures at the University of Gondar. Methods A cross-sectional study was conducted to assess knowledge and associated factors regarding radiation exposure among medical students. A total of 473 medical students (first through sixth years of study) completed a structured questionnaire. Univariate and multi-variable binary logistic regression was used to see the factors associated with knowledge of medical students on radiation sources, exposure and risks. Variables with p-value <0.2 during the bivariable binary logistic regression were tested in the multivariable binary logistic regression. P-value<0.05 was used to declare significant association at the final model. Result Response rate was 100%. Two hundred fifteen (45.5% 95% confidence interval (CI )(41.0%–50.3%)) participants had good knowledge regarding radiation exposure from diagnostic imaging procedures. Only 177(37.4%) participants correctly knew that Computer Tomography (CT) use X-ray. However, subjects incorrectly named magnetic resonance imaging (MRI) as if it used x-ray (12.1%) and source of ionizing radiation (19.5%). Being female [Adjusted-odds-ratio (AOR)=1.57,95% CI(1.05,2.36)], 18-20 years of age [AOR=2.18, 95% CI(1.26, 3.76)], and 1st to 3rd year of study [AOR=3.64, 95% CI(2.23,5.95)] were predictors of knowledge identified. Conclusion The results highlight that medical students need to be trained well with sufficient radiological education that enable them later to adhere to safe practices.
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Affiliation(s)
- Dagnachew Eyachew Amare
- Department of Environmental and Occupational Health & Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box, 196, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental and Occupational Health & Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box, 196, Gondar, Ethiopia
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Sodickson AD. Radiation concerns in frequent flyer patients: Should imaging history influence decisions about recurrent imaging? Br J Radiol 2021; 94:20210543. [PMID: 34289325 DOI: 10.1259/bjr.20210543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Radiation risks from diagnostic imaging have captured the attention of patients and medical practitioners alike, yet it remains unclear how these considerations can best be incorporated into clinical decision making. This manuscript presents a framework to consider these issues in a potentially at-risk population, the so called "frequent flyer" patients undergoing a large amount of recurrent imaging over time. Radiation risks from the low-dose exposures of diagnostic imaging are briefly reviewed, as applied to recurrent exposures. Some scenarios are then explored in which it may be helpful to incorporate knowledge of a patient's imaging history. There is no simple or uniformly applicable approach to these challenging and often nuanced clinical decisions. The complexity and variability of the underlying disease states and trajectories argues against alerting mechanisms based on a simple cumulative dose threshold. Awareness of imaging history may instead be beneficial in encouraging physicians and patients to take the long view, and to identify those populations of frequent flyers that might benefit from alternative imaging strategies.
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123
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Ye D, Sun X, Zhang C, Zhang S, Zhang X, Wang S, Fu W. In Vivo Foot and Ankle Kinematics During Activities Measured by Using a Dual Fluoroscopic Imaging System: A Narrative Review. Front Bioeng Biotechnol 2021; 9:693806. [PMID: 34350162 PMCID: PMC8327092 DOI: 10.3389/fbioe.2021.693806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022] Open
Abstract
Foot and ankle joints are complicated anatomical structures that combine the tibiotalar and subtalar joints. They play an extremely important role in walking, running, jumping and other dynamic activities of the human body. The in vivo kinematic analysis of the foot and ankle helps deeply understand the movement characteristics of these structures, as well as identify abnormal joint movements and treat related diseases. However, the technical deficiencies of traditional medical imaging methods limit studies on in vivo foot and ankle biomechanics. During the last decade, the dual fluoroscopic imaging system (DFIS) has enabled the accurate and noninvasive measurements of the dynamic and static activities in the joints of the body. Thus, this method can be utilised to quantify the movement in the single bones of the foot and ankle and analyse different morphological joints and complex bone positions and movement patterns within these organs. Moreover, it has been widely used in the field of image diagnosis and clinical biomechanics evaluation. The integration of existing single DFIS studies has great methodological reference value for future research on the foot and ankle. Therefore, this review evaluated existing studies that applied DFIS to measure the in vivo kinematics of the foot and ankle during various activities in healthy and pathologic populations. The difference between DFIS and traditional biomechanical measurement methods was shown. The advantages and shortcomings of DFIS in practical application were further elucidated, and effective theoretical support and constructive research direction for future studies on the human foot and ankle were provided.
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Affiliation(s)
- Dongqiang Ye
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xiaole Sun
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Cui Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.,Shandong Institute of Sport Science, Jinan, China
| | - Shen Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xini Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Shaobai Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Weijie Fu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.,Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
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Mondal T, Nautiyal A, Ghosh S, Loffredo CA, Mitra D, Saha C, Dey SK. An evaluation of DNA double strand break formation and excreted guanine species post whole body PET/CT procedure. JOURNAL OF RADIATION RESEARCH 2021; 62:590-599. [PMID: 34037214 PMCID: PMC8273794 DOI: 10.1093/jrr/rrab025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/10/2020] [Indexed: 06/12/2023]
Abstract
Ionizing radiation-induced oxidation and formation of deoxyribonucleic acid (DNA) double strand breaks (DSBs) are considered the exemplar of genetic lesions. Guanine bases are most prone to be oxidized when DNA and Ribonucleic acid (RNA) are damaged. The repair processes that are initiated to correct this damage release multiple oxidized guanine species into the urine. Hence, the excretion of guanine species can be related with the total repair process. Our study quantified the total DSBs formation and the amount of guanine species in urine to understand the DNA break and repair process after whole body (WB) exposure to 18F-FDG positron emission tomography/computed tomography (PET/CT). A total of 37 human participants were included with control and test groups and the average radiation dose was 27.50 ± 2.91 mSv. γ-H2AX foci assay in the collected blood samples was performed to assess the DSBs, and excreted guanine species in urine were analyzed by a competitive ELISA method. We observed a significant increase of DNA damage that correlated well with the increasing dose (p-value 0.009) and body weight (p-value 0.05). In the test group, excreted guanine species in urine sample significantly increased (from 24.29 ± 5.82 to 33.66 ± 7.20 mg/mmol creatinine). A minimum (r2 = 0.0488) correlation was observed between DSBs formation and excreted guanine species. A significant difference of DNA damage and 8-OHdG formation was seen in the test group compared to controls. Larger population studies are needed to confirm these observations, describe the fine-scale timing of changes in the biomarker levels after exposure, and further clarify any potential risks to patients from PET/CT procedures.
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Affiliation(s)
- Tanmoy Mondal
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Salt Lake, Kolkata 700064, India
| | - Amit Nautiyal
- Institute of Nuclear Medicine & Molecular Imaging, AMRI Hospitals, Dhakuria, Kolkata 700029, India
| | - Somiranjan Ghosh
- Department of Biology, Howard University, Washington, DC 20059, USA
| | | | - Deepanjan Mitra
- Institute of Nuclear Medicine & Molecular Imaging, AMRI Hospitals, Dhakuria, Kolkata 700029, India
| | - Chabita Saha
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Salt Lake, Kolkata 700064, India
| | - Subrata Kumar Dey
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Salt Lake, Kolkata 700064, India
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Khan AUH, Blimkie M, Yang DS, Serran M, Pack T, Wu J, Kang JY, Laakso H, Lee SH, Le Y. Effects of Chronic Low-Dose Internal Radiation on Immune-Stimulatory Responses in Mice. Int J Mol Sci 2021; 22:7303. [PMID: 34298925 PMCID: PMC8306076 DOI: 10.3390/ijms22147303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 12/18/2022] Open
Abstract
The Linear-No-Threshold (LNT) model predicts a dose-dependent linear increase in cancer risk. This has been supported by biological and epidemiological studies at high-dose exposures. However, at low-doses (LDR ≤ 0.1 Gy), the effects are more elusive and demonstrate a deviation from linearity. In this study, the effects of LDR on the development and progression of mammary cancer in FVB/N-Tg(MMTVneu)202Mul/J mice were investigated. Animals were chronically exposed to total doses of 10, 100, and 2000 mGy via tritiated drinking water, and were assessed at 3.5, 6, and 8 months of age. Results indicated an increased proportion of NK cells in various organs of LDR exposed mice. LDR significantly influenced NK and T cell function and activation, despite diminishing cell proliferation. Notably, the expression of NKG2D receptor on NK cells was dramatically reduced at 3.5 months but was upregulated at later time-points, while the expression of NKG2D ligand followed the opposite trend, with an increase at 3.5 months and a decrease thereafter. No noticeable impact was observed on mammary cancer development, as measured by tumor load. Our results demonstrated that LDR significantly influenced the proportion, proliferation, activation, and function of immune cells. Importantly, to the best of our knowledge, this is the first report demonstrating that LDR modulates the cross-talk between the NKG2D receptor and its ligands.
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Affiliation(s)
- Abrar Ul Haq Khan
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.U.H.K.); (D.S.Y.); (J.-Y.K.)
| | - Melinda Blimkie
- Radiobiology and Health Branch, Canadian Nuclear Laboratories Ltd., Chalk River, ON K0J 1J0, Canada; (M.B.); (M.S.); (T.P.); (J.W.); (H.L.)
| | - Doo Seok Yang
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.U.H.K.); (D.S.Y.); (J.-Y.K.)
| | - Mandy Serran
- Radiobiology and Health Branch, Canadian Nuclear Laboratories Ltd., Chalk River, ON K0J 1J0, Canada; (M.B.); (M.S.); (T.P.); (J.W.); (H.L.)
| | - Tyler Pack
- Radiobiology and Health Branch, Canadian Nuclear Laboratories Ltd., Chalk River, ON K0J 1J0, Canada; (M.B.); (M.S.); (T.P.); (J.W.); (H.L.)
| | - Jin Wu
- Radiobiology and Health Branch, Canadian Nuclear Laboratories Ltd., Chalk River, ON K0J 1J0, Canada; (M.B.); (M.S.); (T.P.); (J.W.); (H.L.)
| | - Ji-Young Kang
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.U.H.K.); (D.S.Y.); (J.-Y.K.)
| | - Holly Laakso
- Radiobiology and Health Branch, Canadian Nuclear Laboratories Ltd., Chalk River, ON K0J 1J0, Canada; (M.B.); (M.S.); (T.P.); (J.W.); (H.L.)
| | - Seung-Hwan Lee
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.U.H.K.); (D.S.Y.); (J.-Y.K.)
- Centre for Infection, The University of Ottawa, Immunity and Inflammation, Ottawa, ON K1H 8M5, Canada
| | - Yevgeniya Le
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (A.U.H.K.); (D.S.Y.); (J.-Y.K.)
- CANDU Owners Group Inc., Toronto, ON M5G 2K4, Canada
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Dammerer D, VAN Beeck A, Schneeweiss V, Schwabegger A. Follow-up Strategies for Primary Extremity Soft-tissue Sarcoma in Adults: A Systematic Review of the Published Literature. In Vivo 2021; 34:3057-3068. [PMID: 33144410 DOI: 10.21873/invivo.12140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 01/22/2023]
Abstract
AIM Follow-up strategies for primary extremity soft-tissue sarcomas (eSTS) in adults were evaluated in a systematic review of the published literature. MATERIAL AND METHODS The published literature was reviewed using PubMed. Of 136,646 studies published between 1985 and 2019, 78 original articles met the inclusion criteria. Articles were selected on the basis of the PRISMA guidelines. The selected articles were then cross-searched to identify further publications. August 1, 2019 was used as the concluding date of publication. RESULTS A variety of follow-up schedules have been reported in recently published literature. Two official guidelines have been approved by international societies. The guidelines distinguish between high- and low-grade STS, but mention a wide range of follow-up intervals. Established tools of follow-up include computed tomograph, X-rays of the chest, and magnetic resonance imaging of the primary tumor site in addition to clinical observation and physical examination. CONCLUSION Further research will be needed to establish evidence-based guidelines and schedules for follow-up strategies in patients with eSTS.
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Affiliation(s)
- Dietmar Dammerer
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Viktoria Schneeweiss
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anton Schwabegger
- Department of Plastic Surgery, Medical University of Innsbruck, Innsbruck, Austria
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Chang VC, Cotterchio M, De P, Tinmouth J. Risk factors for early-onset colorectal cancer: a population-based case-control study in Ontario, Canada. Cancer Causes Control 2021; 32:1063-1083. [PMID: 34120288 PMCID: PMC8416813 DOI: 10.1007/s10552-021-01456-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 05/30/2021] [Indexed: 02/06/2023]
Abstract
Purpose There has been an alarming increase in colorectal cancer (CRC) incidence among young adults aged < 50 years, and factors driving this upward trend are unknown. This study investigated associations between various medical, lifestyle, and dietary factors and risk of early-onset CRC (EO-CRC). Methods A population-based case–control study was conducted in Ontario, Canada during 2018–2019. EO-CRC cases aged 20–49 years (n = 175) were identified from the Ontario Cancer Registry; sex- and age group-matched controls (n = 253) were recruited through random digit dialing. Data on potential a priori risk factors were collected using a web-based self-reported questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression. Results Family history of CRC in a first- or second-degree relative (OR 2.37; 95% CI 1.47–3.84), longer sedentary time (≥ 10 vs. < 5 h/day, OR 1.93; 95% CI 1.02–3.65), greater consumption of sugary drinks (≥ 7 vs. < 1 drinks/week, OR 2.99; 95% CI 1.57–5.68), and a more Westernized dietary pattern (quartile 4 vs. 1, OR 1.92; 95% CI 1.01–3.66) were each associated with an increased risk of EO-CRC. Conversely, calcium supplement use (OR 0.53; 95% CI 0.31–0.92), history of allergy or asthma (OR 0.62; 95% CI 0.39–0.98), and greater parity in females (≥ 3 vs. nulliparity, OR 0.29; 95% CI 0.11–0.76) were each associated with a reduced risk. Conclusion Modifiable factors, particularly sedentary behavior and unhealthy diet including sugary drink consumption, may be associated with EO-CRC risk. Our findings, if replicated, may help inform prevention strategies targeted at younger persons. Supplementary Information The online version contains supplementary material available at 10.1007/s10552-021-01456-8.
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Affiliation(s)
- Vicky C Chang
- Prevention and Cancer Control, Clinical Institutes and Quality Programs, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Michelle Cotterchio
- Prevention and Cancer Control, Clinical Institutes and Quality Programs, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Prithwish De
- Prevention and Cancer Control, Clinical Institutes and Quality Programs, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
| | - Jill Tinmouth
- Prevention and Cancer Control, Clinical Institutes and Quality Programs, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
- Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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128
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Zahnreich S, Schmidberger H. Childhood Cancer: Occurrence, Treatment and Risk of Second Primary Malignancies. Cancers (Basel) 2021; 13:cancers13112607. [PMID: 34073340 PMCID: PMC8198981 DOI: 10.3390/cancers13112607] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 12/14/2022] Open
Abstract
Cancer represents the leading cause of disease-related death and treatment-associated morbidity in children with an increasing trend in recent decades worldwide. Nevertheless, the 5-year survival of childhood cancer patients has been raised impressively to more than 80% during the past decades, primarily attributed to improved diagnostic technologies and multiagent cytotoxic regimens. This strong benefit of more efficient tumor control and prolonged survival is compromised by an increased risk of adverse and fatal late sequelae. Long-term survivors of pediatric tumors are at the utmost risk for non-carcinogenic late effects such as cardiomyopathies, neurotoxicity, or pneumopathies, as well as the development of secondary primary malignancies as the most detrimental consequence of genotoxic chemo- and radiotherapy. Promising approaches to reducing the risk of adverse late effects in childhood cancer survivors include high precision irradiation techniques like proton radiotherapy or non-genotoxic targeted therapies and immune-based treatments. However, to date, these therapies are rarely used to treat pediatric cancer patients and survival rates, as well as incidences of late effects, have changed little over the past two decades in this population. Here we provide an overview of the epidemiology and etiology of childhood cancers, current developments for their treatment, and therapy-related adverse late health consequences with a special focus on second primary malignancies.
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129
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Cwikel J, Sheiner E, Sergienko R, Slusky D, Quastel M. Hospitalizations Among Chernobyl-Exposed Immigrants to the Negev of Israel, 1992-2017: A Historical Follow-Up Study. J Immigr Minor Health 2021; 24:469-480. [PMID: 33974176 DOI: 10.1007/s10903-021-01202-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/26/2022]
Abstract
On April 26th, 1986 the nuclear reactor at Chernobyl, Ukraine exploded, causing the worst radiation disaster in history. The aim was to estimate hospitalization rates among exposed civilians who later immigrated to Israel. We conducted a historical follow-up study, among persons exposed to Chernobyl (n = 1128) using linked hospitalization records from Soroka University Medical Center (SUMC), compared with immigrants from other areas of the Former Soviet Union (FSU) (n = 11,574), immigrants not from FSU (n = 11,742) and native-born Israelis (n = 8351), matched on age and gender (N = 32,795). Hospitalizations for specific ICD-10 coded diagnostic groups were analyzed by exposure and comparison groups by gender and age at accident. In addition, the rate of hospitalization, and the duration of hospital days and the number of hospitalizations for these selected diagnostic groups was also calculated. Hospitalizations for specific ICD-10 coded diagnostic groups and for any hospitalization in these diagnostic groups in general were analyzed by exposure and comparison groups and by covariates (gender and age at accident). The rate of any hospitalization for the selected diagnostic groups was elevated in the low exposure Chernobyl group (51.1%), which was significantly higher than the immigrant (41.6%) and the Israel-born comparison group (35.1%) (p < .01) but did not differ from either the high exposure group (46.9%) or the FSU comparison group (46.4%), according to the post-hoc tests. The total number of hospitalizations in the low exposure Chernobyl group (2.35) differed from the immigrant (1.73) and Israel comparison group (1.26) (p < .01) but did not differ from the FSU comparison group (1.73) or the high exposure group (2.10). Low exposure women showed higher rates of circulatory hospitalizations (33.8%) compared to immigrants (22.8%) and Israeli born (16.5%), while high exposure women (27.5%) only differed from Israelis (p < .01). Neither exposure group differed from FSU immigrant women on the rate of circulatory hospitalizations. Post-hoc tests showed that among women in the low exposure group, there was a significant difference in rate of hospitalizations for neoplasms (28.6%) compared to the three comparison groups; FSU (18.6%), immigrants (15.7%) and Israel (13.1) (p < .01). Those among the low exposure group who were over the age of 20 at the time of the accident showed the higher rates of circulatory (51.2%) and neoplasm hospitalizations (33.3%), compared to the other immigrant groups (p < .01). When controlling for both age at accident and gender, hospitalizations for neoplasms were higher among Chernobyl-exposed populations (RR = 1.65, RR = 1.77 for high and low-exposure groups, respectively) compared to other FSU immigrants (RR = 1.31) other immigrants (RR = 1.11) and Israeli born (RR = 1.0) after controlling for gender and age at accident. High RRs attributable to Chernobyl exposure were also found for circulatory diseases compared to other immigrants and Israeli born (RRs = 1.50, 1.47 for high and low exposure compared to 1.11. and 1.0, other immigrants and Israeli born, respectively). Endocrine problems and disorders of the eye also showed elevated RR compared to the immigrant comparison groups. Respiratory and mental disorders did not show any consistent association with Chernobyl exposure. The findings support unique Chernobyl morbidity associations only in some diagnostic groups, particularly for low exposure women. General immigration effects on hospitalizations compared to the Israeli born population were found on all diagnostic groups. There is a need to improve the services and medical follow-up for these Chernobyl exposed groups in specific diagnostic groups.
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Affiliation(s)
- Julie Cwikel
- Chilewich Family Chair in Studies in Social Integration, Spitzer Department of Social Work, & BGU Center for Women's Health Studies and Promotion, POB 653, 84105, Beer Sheva, Israel.
| | - Eyal Sheiner
- OB-GYN (Women's B Ward), Soroka University Medical Center, Beer Sheva, Israel
| | - Ruslan Sergienko
- Department of Epidemiology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | - Michael Quastel
- Nuclear Medicine, Soroka University Medical Center (retired), Beer Sheva, Israel
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130
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An TJ, Tabari A, Gee MS, McCarthy CJ. Factors influencing cumulative radiation dose from percutaneous intra-abdominal abscess drainage in the setting of inflammatory bowel disease. Abdom Radiol (NY) 2021; 46:2195-2202. [PMID: 33237341 DOI: 10.1007/s00261-020-02864-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Patients with inflammatory bowel disease (IBD) are at risk for intra-abdominal abscesses requiring CT-guided drainage. These patients are at baseline risk of high cumulative radiation exposure from imaging, which may be exacerbated by CT-guided drainage. This study aimed to determine the radiation dose associated with percutaneous drainage in the setting of IBD and identify risk factors associated with high exposure. METHODS An IRB-approved single-center retrospective study was performed to identify patients with IBD who underwent percutaneous abscess drainage over a 5-year period. An episode of drainage was defined from drain placement to removal, with all intervening procedures and diagnostic CT scans included in the cumulative radiation dose. RESULTS The mean cumulative effective dose for a drainage episode was 47.50 mSv. The mean duration of a drainage episode was 68.7 days. Patients with a cumulative dose greater than 50 mSv required higher number of follow-up visits compared to patients with less than 50 mSv (6.9 vs. 3.5, p = 0.003*). Patients with higher cumulative dose were also more likely to require drain upsize (54% vs. 13%, p = 0.01*) or additional drain placement (63% vs 24%, p = 0.03*) compared to patients with lower dose. CONCLUSION Intra-abdominal abscess drainage may be associated with significant cumulative radiation exposure. Requirement of drain upsizing or additional drain placement were associated with higher cumulative radiation dose, which may be related to more severe underlying inflammatory bowel disease.
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Affiliation(s)
- Thomas J An
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Azadeh Tabari
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Colin J McCarthy
- Department of Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX, 77030, USA.
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Chatzis A, Brilakis E, Papadopoulou D, Giannouli V, Stamouli MA, Goula A, Sarris M, Soulis S. Beliefs and behaviours of radiographers and other health professionals concerning radiation protection safety in a high-volume Greek public hospital. Development of a new measuring instrument. Radiography (Lond) 2021; 27:1038-1043. [PMID: 33933361 DOI: 10.1016/j.radi.2021.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The use of fluoroscopy-assisted surgical procedures has been increasing recently. The extensive use of fluoroscopy, combined with the lack of knowledge about radiation risks among operating room (OR) personnel (surgeons, anaesthetists, nurses, and radiographers), may lead to misconceptions. The perceptions and beliefs of any health professional concerning radiation protection safety (RPS) may affect their behaviour during surgery, leading to negative outcomes. The aim of this study was to construct a new, original, reliable, and valid instrument to record the beliefs, perceptions, and behaviours of health professionals during surgery, which reflects the established culture of RPS. METHODS A questionnaire was designed, consisting of 95 questions grouped into six coherent sections. The study was performed at a Greek public hospital with a high workload in terms of fluoroscopically guided surgical operations. RESULTS It was distributed among 136 people, and 132 completed questionnaires were collected (response rate 97%). Exploratory factor analysis was performed separately for each scale studied and Cronbach's Alpha reliability analysis was also performed. The reliability of the greater part of the new measurement tool ranged from very good to acceptable. CONCLUSION The questionnaire developed in this study is a valid and reliable option for recording health professionals' perceptions, beliefs, and behaviours concerning the RPS culture. IMPLICATIONS FOR PRACTICE This study helps clinical radiographers to understand a possible knowledge gap about RPS and locates the specific fields that the OR personnel misunderstand. It also can support and establish local learning organisations with regular targeted staff training for health professionals, thereby leading to a generally improved RPS culture.
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Affiliation(s)
- A Chatzis
- General Hospital "Asklepieio Voulas", Voula, Greece; Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - E Brilakis
- Associate Director of 3rd Orthopaedic Department of Hygeia Hospital, Athens, Greece.
| | | | - V Giannouli
- Department of Business Administration, University of West Attica, Egaleo, Greece; Attica Psychiatric Hospital "Dafni", Dafni, Greece.
| | - M-A Stamouli
- Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - A Goula
- Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - M Sarris
- Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - S Soulis
- Department of Business Administration, University of West Attica, Egaleo, Greece.
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Rusin M, Ghobrial N, Takacs E, Willey JS, Dean D. Changes in ionizing radiation dose rate affect cell cycle progression in adipose derived stem cells. PLoS One 2021; 16:e0250160. [PMID: 33905436 PMCID: PMC8078807 DOI: 10.1371/journal.pone.0250160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 04/01/2021] [Indexed: 01/08/2023] Open
Abstract
Biomedical use of radiation is utilized in effective diagnostic and treatment tools, yet can introduce risks to healthy tissues. High energy photons used for diagnostic purposes have high penetration depth and can discriminate multiple tissues based on attenuation properties of different materials. Likewise, the ability to deposit energy at various targets within tumors make the use of photons effective treatment for cancer. Radiation focused on a tumor will deposit energy when it interacts with a biological structure (e.g. DNA), which will result in cell kill should repair capacity of the tissue be overwhelmed. Likewise, damage to normal, non-cancerous tissues is a consequence of radiation that can lead to acute or late, chronic toxicity profiles. Adipose derived stem cells (ADSCs) are mesenchymal stem cells that have been proven to have similar characteristics to bone marrow derived stem cells, except that they are much easier to obtain. Within the body, ADSCs act as immunomodulators and assist with the maintenance and repair of tissues. They have been shown to have excellent differentiation capability, making them an extremely viable option for stem cell therapies and regenerative medicine applications. Due to the tissue ADSCs are derived from, they are highly likely to be affected by radiation therapy, especially when treating tumors localized to structures with relatively high ADSC content (eg., breast cancer). For this reason, the purpose behind this research is to better understand how ADSCs are affected by doses of radiation comparable to a single fraction of radiation therapy. We also measured the response of ADSCs to exposure at different dose rates to determine if there is a significant difference in the response of ADSCs to radiation therapy relevant doses of ionizing radiation. Our findings indicate that ADSCs exposed to Cesium (Cs 137)-gamma rays at a moderate dose of 2Gy and either a low dose rate (1.40Gy/min) or a high dose rate (7.31Gy/min) slow proliferation rate, and with cell cycle arrest in some populations. These responses ADSCs were not as marked as previously measured in other stem cell types. In addition, our results indicate that differences in dose rate in the Gy/min range typically utilized in small animal or cell irradiation platforms have a minimal effect on the function of ADSCs. The potential ADSCs have in the space of regenerative medicine makes them an ideal candidate for study with ionizing radiation, as they are one of the main cell types to promote tissue healing.
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Affiliation(s)
- Matthew Rusin
- Bioengineering Department, Clemson University, Clemson, South Carolina, United States of America
| | - Nardine Ghobrial
- Bioengineering Department, Clemson University, Clemson, South Carolina, United States of America
| | - Endre Takacs
- Physics and Astronomy Department, Clemson University, Clemson, South Carolina, United States of America
| | - Jeffrey S. Willey
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Delphine Dean
- Bioengineering Department, Clemson University, Clemson, South Carolina, United States of America
- * E-mail:
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Gilbert CR, Jackson AS, Wilshire CL, Horslen LC, Chang SC, Bograd AJ, Vallieres E, Gorden JA. Cumulative radiation dose incurred during the management of complex pleural space infection. BMC Pulm Med 2021; 21:132. [PMID: 33892685 PMCID: PMC8063294 DOI: 10.1186/s12890-021-01486-7] [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: 01/15/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Complex pleural space infections are commonly managed with antibiotics, pleural drainage, intrapleural fibrinolytic therapy, and surgery. These strategies often utilize radiographic imaging during management, however little data is available on cumulative radiation exposure received during inpatient management. We aimed to identify the type and quantity of radiographic studies along with the resultant radiation exposure during the management of complex pleural space infections. METHODS Retrospective review of community network healthcare system from January 2015 to July 2018. Patients were identified through billing databases as receiving intrapleural fibrinolytic therapy and/or surgical intervention. Patient demographics, clinical outcomes, and inpatient radiographic imaging was collected to calculate cumulative effective dose. RESULTS A total of 566 patients were identified with 7275 total radiographic studies performed and a median cumulative effective dose of 16.9 (IQR 9.9-26.3) mSv. Multivariable linear regression analysis revealed computed tomography use was associated with increased cumulative dose, whereas increased age was associated with lower cumulative dose. Over 74% of patients received more than 10 mSv, with 7.4% receiving more than 40 mSv. CONCLUSIONS The number of radiographic studies and overall cumulative effective dose in patients hospitalized for complex pleural space infection was high with the median cumulative effective dose > 5 times normal yearly exposure. Ionizing radiation and modern radiology techniques have revolutionized medical care, but are likely not without risk. Additional study is warranted to identify the frequency and imaging type needed during complex pleural space infection management, attempting to keep ionizing radiation exposure as low as reasonably possible.
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Affiliation(s)
- Christopher R Gilbert
- Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104, USA.
| | - Anee S Jackson
- Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, USA
| | - Candice L Wilshire
- Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104, USA
| | - Leah C Horslen
- Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104, USA
| | - Shu-Ching Chang
- Medical Data Research Center, Providence St. Joseph Health, Portland, OR, USA
| | - Adam J Bograd
- Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104, USA
| | - Eric Vallieres
- Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104, USA
| | - Jed A Gorden
- Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104, USA
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Hadi YB, Khan AA, Naqvi SFZ, Khan S, Thompson J, Kupec JT. Are We Overradiating Patients with Irritable Bowel Syndrome? Inflamm Intest Dis 2021; 6:32-37. [PMID: 33850837 DOI: 10.1159/000511105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/24/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Protracted exposures to small doses of radiation, even cumulative effective doses (CED) as low as 50-100 mSv, may increase the risk for malignancy. Medical radiation exposure has not been rigorously examined for patients with irritable bowel syndrome (IBS). We examined medical radiation exposure in patients with IBS at a tertiary care center in the USA. Methods Patients diagnosed with IBS at our institute from 2009 to 2018 were included in a retrospective cohort study. Medical charts were examined to calculate total and annual CED. Results 221 patients were included; mean CED was 40.32 mSv (SD: 54.36). Fifty-nine participants (26.7%) received >50 mSv of CED with 27 participants (12.2%) exceeding 100 mSv. Conventional imaging, nuclear medicine, and fluoroscopy accounted for 74.08, 12.93, and 12.98% of total CED, respectively. CT scans contributed to 66.61% of total CED. Outpatient orders accounted for 37.96% of total CED, while 31.4% of total CED was ordered in the emergency department. Population-specific high total CED was calculated as 105.65 mSv. Multivariable binomial logistic regression model found that comorbid anxiety, chronic pain medication use, and diarrhea-predominant IBS were independently positively associated with population-specific high CED exposure. No significant temporal trend in peri-diagnostic mean CED was found. Conclusion Patients with IBS receive high amounts of medical radiation, with 1 in 4 patients reaching at-risk levels of 50 mSv or more. Usage of pain medication at home, comorbid anxiety, and IBS-D are independently linked to an increased risk of high CED.
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Affiliation(s)
- Yousaf B Hadi
- Internal Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Adnan Aman Khan
- Internal Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Syeda F Z Naqvi
- Internal Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Salman Khan
- Internal Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Jesse Thompson
- Internal Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Justin T Kupec
- Internal Medicine, West Virginia University, Morgantown, West Virginia, USA
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Snelling PJ, Keijzers G, Byrnes J, Bade D, George S, Moore M, Jones P, Davison M, Roan R, Ware RS. Bedside Ultrasound Conducted in Kids with distal upper Limb fractures in the Emergency Department (BUCKLED): a protocol for an open-label non-inferiority diagnostic randomised controlled trial. Trials 2021; 22:282. [PMID: 33853650 PMCID: PMC8048294 DOI: 10.1186/s13063-021-05239-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Children frequently present to the emergency department (ED) with forearm injuries and often have x-rays to determine if there is a fracture. Bedside ultrasound, also known as point-of-care ultrasound (POCUS), is an alternative diagnostic test used to rapidly diagnose a fracture at the time of examination, without exposing children to ionising radiation. Prospective studies have demonstrated high agreement between POCUS and x-ray findings. However, whether the initial imaging modality affects the patient's medium-term physical function is unknown. METHODS This is a multicentre, open-label, non-inferiority randomised controlled trial conducted in Australian EDs. Recruitment will continue until 112 children with distal forearm injuries (including 48 buckle fractures) per trial arm have achieved the primary outcome measure. Patients aged 5-15 years presenting with an isolated, acute, clinically non-angulated, distal forearm injury with suspected fracture will have their initial diagnostic approach randomised to either POCUS, performed by a credentialled practitioner, or x-ray imaging. If a cortical breach fracture is identified on POCUS, the patient will receive x-rays and have usual care. If a buckle fracture is identified, the patient will have their forearm placed in a splint and be discharged home. Patients will be followed up at 1, 4 and 8 weeks. The primary outcome is upper limb physical function at 4 weeks, as determined by the Pediatric Upper Extremity Short Patient-Reported Outcomes Measurement Information System (PROMIS) tool. Secondary outcomes include healthcare costs, satisfaction, pain, complications, rates of imaging, ED length of stay and diagnostic accuracy. DISCUSSION If POCUS is non-inferior to x-ray in terms of patient's medium-term physical function, it may have an effect on overall health care resource use, including the number of x-ray performed and earlier ED discharge. Although prospective studies have confirmed the accuracy of POCUS, this will be the first RCT to assess non-inferiority of functional outcomes of POCUS to diagnose non-angulated paediatric distal forearm injuries, compared to x-ray. POCUS may be of particular importance in settings where access to x-ray imaging can be limited either during or after-hours, as it can aid the triaging and management of patients. TRIAL REGISTRATION Prospectively registered with the ANZCTR on 29 May 2020 ( ACTRN12620000637943 ).
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Affiliation(s)
- Peter J. Snelling
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, Queensland Australia
- Department of Emergency Medicine, Gold Coast University Hospital, Southport, Queensland Australia
- Sonography Innovation and Research Group (Sonar Group), Southport, Queensland Australia
- Child Health Research Centre, University of Queensland, Brisbane, Queensland Australia
| | - Gerben Keijzers
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, Queensland Australia
- Department of Emergency Medicine, Gold Coast University Hospital, Southport, Queensland Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, School of Medicine, Griffith University, Southport, Queensland Australia
| | - David Bade
- Department of Orthopaedics, Queensland Children’s Hospital, South Brisbane, Queensland Australia
| | - Shane George
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, Queensland Australia
- Department of Emergency Medicine, Gold Coast University Hospital, Southport, Queensland Australia
- Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Mark Moore
- Department of Emergency Medicine, Queensland Children’s Hospital, South Brisbane, Queensland Australia
| | - Philip Jones
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, Queensland Australia
- Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital, Herston, Queensland Australia
| | - Michelle Davison
- Department of Emergency Medicine, Sunshine Coast University Hospital, Birtinya, Queensland Australia
| | - Rob Roan
- Department of Emergency Medicine, Ipswich Hospital, Ipswich, Queensland Australia
| | - Robert S. Ware
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, Queensland Australia
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Novak KL, Nylund K, Maaser C, Petersen F, Kucharzik T, Lu C, Allocca M, Maconi G, de Voogd F, Christensen B, Vaughan R, Palmela C, Carter D, Wilkens R. Expert Consensus on Optimal Acquisition and Development of the International Bowel Ultrasound Segmental Activity Score [IBUS-SAS]: A Reliability and Inter-rater Variability Study on Intestinal Ultrasonography in Crohn's Disease. J Crohns Colitis 2021; 15:609-616. [PMID: 33098642 PMCID: PMC8023841 DOI: 10.1093/ecco-jcc/jjaa216] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Intestinal ultrasound [IUS] is an accurate, patient-centreed monitoring tool that objectively evaluates Crohn's disease [CD] activity. However no current, widely accepted, reproducible activity index exists to facilitate consistent IUS identification of inflammatory activity. The aim of this study is to identify key parameters of CD inflammation on IUS, evaluate their reliability, and develop an IUS index reflecting segmental activity. METHODS There were three phases: [1] expert consensus Delphi method to derive measures of IUS activity; [2] an initial, multi-expert case acquisition and expert interpretation of 20 blinded cases, to measure inter-rater reliability for individual measures; [3] refinement of case acquisition and interpretation by 12 international experts, with 30 blinded case reads with reliability assessment and development of a segmental activity score. RESULTS Delphi consensus: 11 experts representing seven countries identified four key parameters including: [1] bowel wall thickness [BWT]; [2] bowel wall stratification; [3] hyperaemia of the wall [colour Doppler imaging]; and [4] inflammatory mesenteric fat. Blind read: each variable exhibited moderate to substantial reliability. Optimal, standardised image and cineloop acquisition were established. Second blind read and score development: intra-class correlation coefficient [ICC] for BWT was almost perfect at 0.96 [0.94-0.98]. All four parameters correlated with the global disease activity assessment and were included in the final International Bowel Ultrasound Segmental Activity Score with almost perfect ICC (0.97 [0.95-0.99, p <0.001]). CONCLUSIONS Using expert consensus and standardised approaches, identification of key activity measurements on IUS has been achieved and a segmental activity score has been proposed, demonstrating excellent reliability.
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Affiliation(s)
- Kerri L Novak
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, AB, Canada
| | - Kim Nylund
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Institute of Clinical Medicine, University in Bergen, Klinisk institutt 1, Bergen, Norway
| | - Christian Maaser
- Outpatient Department of Gastroenterology, Department of Geriatric Medicine, University Teaching Hospital Lueneburg, Lueneburg, Germany
| | - Frauke Petersen
- Department of Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg, Germany
| | - Torsten Kucharzik
- Department of Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg, Germany
| | - Cathy Lu
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, AB, Canada
| | - Mariangela Allocca
- Humanitas Clinical and Research Centre, Rozzano, Italy
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - Giovanni Maconi
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences. FBF- L.Sacco University Hospital, Milan. Italy
| | - Floris de Voogd
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Britt Christensen
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, VIC Australia
| | - Rose Vaughan
- Department of Gastroenterology, Royal Melbourne Hospital, Parkville, VIC Australia
| | - Carolina Palmela
- Division of Gastroenterology, Department of General Surgery, Hospital Beatriz Ângelo, Loures, Portugal
| | - Dan Carter
- Department of Gastroenterology, Chaim Sheba Medical Centre, Tel Hashomer, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rune Wilkens
- Gastrounit, Division of Medicine, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
- Copenhagen Centre for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Copenhagen, Denmark
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Marcu LG, Chau M, Bezak E. How much is too much? Systematic review of cumulative doses from radiological imaging and the risk of cancer in children and young adults. Crit Rev Oncol Hematol 2021; 160:103292. [DOI: 10.1016/j.critrevonc.2021.103292] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/20/2021] [Accepted: 02/27/2021] [Indexed: 01/18/2023] Open
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Magnetic resonance imaging versus computed tomography and ultrasound for the diagnosis of female pelvic pathology. Emerg Radiol 2021; 28:789-796. [PMID: 33730220 DOI: 10.1007/s10140-021-01923-4] [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: 12/14/2020] [Accepted: 02/25/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We sought to determine the diagnostic accuracy of magnetic resonance (MR) imaging compared with computed tomography (CT) and ultrasound (US) when evaluating for five common pelvic pathologies among women presenting to the emergency department (ED) with right lower quadrant abdominal pain. METHODS This prospective, single-center study was conducted at an academic ED as a sub-analysis of a direct comparison of the diagnostic accuracy of CT and MR in the evaluation of appendicitis. Patients were eligible for participation in the parent study if they were at least 12 years old and had a CT performed for evaluation of possible appendicitis. In the current study, only female patients who also underwent pelvic US were included. Three radiologists independently interpreted each MR examination specifically for the presence of pelvic pathology, knowing that patients had initially undergone imaging evaluation for possible appendicitis. The determination of an independent expert panel of two radiologists and one emergency physician based on surgical pathology, comprehensive chart review, clinical information, and follow-up phone calls served as the reference standard. Test characteristics of MR, CT, and US were calculated based on this; the main outcome measure was the summary sensitivity and specificity of MR versus CT and US. RESULTS Forty-one participants were included with a mean age of 27.6 ± 10.8 years. The MR consensus interpretation had an overall sensitivity and specificity of 57.1% (CI 38.8-75.5%) and 97.2% (CI 94.7-99.6%) respectively, for detecting any of the five pelvic pathologies. By comparison, CT exhibited sensitivity and specificity of 66.7% (CI 50.0-83.5%) and 98.3% (CI 96.4-100.0%) while it was 64.3% (CI 46.5-82.0%) and 97.7% (CI 95.6-99.9%) for US, respectively. No significant differences were identified when comparing these modalities. Overall, Fleiss' kappa interrater reliability value for MR interpretation was 0.75, corresponding to substantial agreement between the three readers. CONCLUSIONS In women who might otherwise undergo multiple imaging tests to evaluate gastrointestinal versus pelvic pathologies, our data suggest that MR may be an acceptable first-line imaging test.
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Nicolan B, Greffier J, Dabli D, de Forges H, Arcis E, Al Zouabi N, Larbi A, Beregi JP, Frandon J. Diagnostic performance of ultra-low dose versus standard dose CT for non-traumatic abdominal emergencies. Diagn Interv Imaging 2021; 102:379-387. [PMID: 33714689 DOI: 10.1016/j.diii.2021.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE The purpose of this study was to compare the diagnostic performance of ultra-low dose (ULD) to that of standard (STD) computed tomography (CT) for the diagnosis of non-traumatic abdominal emergencies using clinical follow-up as reference standard. MATERIALS AND METHODS All consecutive patients requiring emergency abdomen-pelvic CT examination from March 2017 to September 2017 were prospectively included. ULD and STD CTs were acquired after intravenous administration iodinated contrast medium (portal phase). CT acquisitions were performed at 125mAs for STD and 55mAs for ULD. Diagnostic performance was retrospectively evaluated on ULD and STD CTs using clinical follow-up as a reference diagnosis. RESULTS A total of 308 CT examinations from 308 patients (145 men; mean age 59.1±20.7 (SD) years; age range: 18-96 years) were included; among which 241/308 (78.2%) showed abnormal findings. The effective dose was significantly lower with the ULD protocol (1.55±1.03 [SD] mSv) than with the STD (3.67±2.56 [SD] mSv) (P<0.001). Sensitivity was significantly lower for the ULD protocol (85.5% [95%CI: 80.4-89.4]) than for the STD (93.4% [95%CI: 89.4-95.9], P<0.001) whereas specificities were similar (94.0% [95%CI: 85.1-98.0] vs. 95.5% [95%CI: 87.0-98.9], respectively). ULD sensitivity was equivalent to STD for bowel obstruction and colitis/diverticulitis (96.4% [95%CI: 87.0-99.6] and 86.5% [95%CI: 74.3-93.5] for ULD vs. 96.4% [95%CI: 87.0-99.6] and 88.5% [95%CI: 76.5-94.9] for STD, respectively) but lower for appendicitis, pyelonephritis, abscesses and renal colic (75.0% [95%CI: 57.6-86.9]; 77.3% [95%CI: 56.0-90.1]; 90.5% [95%CI: 69.6-98.4] and 85% [95%CI: 62.9-95.4] for ULD vs. 93.8% [95%CI: 78.6-99.2]; 95.5% [95%CI: 76.2-100.0]; 100.0% [95%CI: 81.4-100.0] and 100.0% [95%CI: 80.6-100.0] for STD, respectively). Sensitivities were significantly different between the two protocols only for appendicitis (P=0.041). CONCLUSION In an emergency context, for patients with non-traumatic abdominal emergencies, ULD-CT showed inferior diagnostic performance compared to STD-CT for most abdominal conditions except for bowel obstruction and colitis/diverticulitis detection.
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Affiliation(s)
- Basien Nicolan
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France
| | - Joël Greffier
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France
| | - Djamel Dabli
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France
| | - Hélène de Forges
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France
| | - Elise Arcis
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France
| | - Nadir Al Zouabi
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France
| | - Ahmed Larbi
- ISERIS imagerie médicale, 34000 Montpellier, France
| | - Jean-Paul Beregi
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France
| | - Julien Frandon
- Department of Medical Imaging, Nîmes University Hospital, University of Montpellier, Medical Imaging Group Nîmes, EA 2415, 30000 Nîmes, France.
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Committed effective dose and lifetime cancer risk due to ingestion of natural radionuclides in grains grown in an area of high background radiation. Appl Radiat Isot 2021; 172:109656. [PMID: 33667931 DOI: 10.1016/j.apradiso.2021.109656] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/12/2021] [Accepted: 02/19/2021] [Indexed: 11/22/2022]
Abstract
The current study aimed at estimating committed effective dose and cancer risk due to the intake of K-40, Ra-226, Ra-228 and Th-228 present in grains grown in an HBRA. The highest activity concentrations found were (606.2 ± 25.13), (8.07 ± 6.37), (10.01 ± 1.45), (43.97 ± 5.54) Bq.kg-1 for K-40, Ra-226, Ra-228 and Th-228, respectively. The committed effective dose estimated was 0.5 mSv.y-1, and the estimated cancer risk suggested that uninterrupted and unrestricted consumption of beans grown in this HBRA is not desirable.
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Kim K, Eun D, Jee YS. Higher Impulse Electromyostimulation Contributes to Psychological Satisfaction and Physical Development in Healthy Men. ACTA ACUST UNITED AC 2021; 57:medicina57030191. [PMID: 33668740 PMCID: PMC7996253 DOI: 10.3390/medicina57030191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/02/2022]
Abstract
Background and Objectives: This study investigated the various impulse effects of whole-body electromyostimulation (WB-EMS) on psychophysiological responses and adaptations. Materials and Methods: The participants included fifty-four men between 20 and 27 years of age who practiced isometric exercises for 20 min, three days a week, for 12 weeks while wearing WB-EMS suits, which enabled the simultaneous activation of eight muscle groups with three types of impulse intensities. Participants were allocated to one of four groups: control group (CON), low-impulse-intensity group (LIG), mid-impulse-intensity group (MIG), and high-impulse-intensity group (HIG). Psychophysiological conditions were measured at week 0, week 4, week 8, and week 12. Results: Compared with the CON, (1) three psychological conditions in LIG, MIG, and HIG showed positive tendencies every four weeks, and the analysis of covariance (ANCOVA) test revealed that body image (p = 0.004), body shape (p = 0.007), and self-esteem (p = 0.001) were significantly different among the groups. (2) Body weight, fat mass, body mass index, and percent fat in the CON showed decreasing tendencies, whereas those in LIG, MIG, and HIG showed a noticeable decrease, which revealed that there were significant differences among the groups. Specifically, a higher impulse intensity resulted in a greater increase in muscle mass. (3) Although there was no interaction effect in the abdominal visceral fat area, there were significant interactions in the abdominal subcutaneous fat (ASF) and total fat (ATF) areas. Both the ASF and ATF in the CON showed decreasing tendencies, whereas those in other groups showed a noticeable decrease. The ANCOVA revealed that the ASF (p = 0.002) and ATF (p = 0.001) were significantly different among the groups. In particular, the higher the impulse intensity, the greater the decrease in abdominal fat. Conclusions: This study confirmed that high-impulse-intensity EMS can improve psychophysiological conditions. In other words, healthy young adults felt that the extent to which their body image, body shape, and self-esteem improved depended on how intense their EMS impulse intensities were. The results also showed that higher levels of impulse intensity led to improved physical conditions.
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Subedi P, Gomolka M, Moertl S, Dietz A. Ionizing Radiation Protein Biomarkers in Normal Tissue and Their Correlation to Radiosensitivity: A Systematic Review. J Pers Med 2021; 11:jpm11020140. [PMID: 33669522 PMCID: PMC7922485 DOI: 10.3390/jpm11020140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/05/2021] [Accepted: 02/14/2021] [Indexed: 12/16/2022] Open
Abstract
Background and objectives: Exposure to ionizing radiation (IR) has increased immensely over the past years, owing to diagnostic and therapeutic reasons. However, certain radiosensitive individuals show toxic enhanced reaction to IR, and it is necessary to specifically protect them from unwanted exposure. Although predicting radiosensitivity is the way forward in the field of personalised medicine, there is limited information on the potential biomarkers. The aim of this systematic review is to identify evidence from a range of literature in order to present the status quo of our knowledge of IR-induced changes in protein expression in normal tissues, which can be correlated to radiosensitivity. Methods: Studies were searched in NCBI Pubmed and in ISI Web of Science databases and field experts were consulted for relevant studies. Primary peer-reviewed studies in English language within the time-frame of 2011 to 2020 were considered. Human non-tumour tissues and human-derived non-tumour model systems that have been exposed to IR were considered if they reported changes in protein levels, which could be correlated to radiosensitivity. At least two reviewers screened the titles, keywords, and abstracts of the studies against the eligibility criteria at the first phase and full texts of potential studies at the second phase. Similarly, at least two reviewers manually extracted the data and accessed the risk of bias (National Toxicology Program/Office for Health Assessment and Translation—NTP/OHAT) for the included studies. Finally, the data were synthesised narratively in accordance to synthesis without meta analyses (SWiM) method. Results: In total, 28 studies were included in this review. Most of the records (16) demonstrated increased residual DNA damage in radiosensitive individuals compared to normo-sensitive individuals based on γH2AX and TP53BP1. Overall, 15 studies included proteins other than DNA repair foci, of which five proteins were selected, Vascular endothelial growth factor (VEGF), Caspase 3, p16INK4A (Cyclin-dependent kinase inhibitor 2A, CDKN2A), Interleukin-6, and Interleukin-1β, that were connected to radiosensitivity in normal tissue and were reported at least in two independent studies. Conclusions and implication of key findings: A majority of studies used repair foci as a tool to predict radiosensitivity. However, its correlation to outcome parameters such as repair deficient cell lines and patients, as well as an association to moderate and severe clinical radiation reactions, still remain contradictory. When IR-induced proteins reported in at least two studies were considered, a protein network was discovered, which provides a direction for further studies to elucidate the mechanisms of radiosensitivity. Although the identification of only a few of the commonly reported proteins might raise a concern, this could be because (i) our eligibility criteria were strict and (ii) radiosensitivity is influenced by multiple factors. Registration: PROSPERO (CRD42020220064).
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Yamagishi M, Tamaki N, Akasaka T, Ikeda T, Ueshima K, Uemura S, Otsuji Y, Kihara Y, Kimura K, Kimura T, Kusama Y, Kumita S, Sakuma H, Jinzaki M, Daida H, Takeishi Y, Tada H, Chikamori T, Tsujita K, Teraoka K, Nakajima K, Nakata T, Nakatani S, Nogami A, Node K, Nohara A, Hirayama A, Funabashi N, Miura M, Mochizuki T, Yokoi H, Yoshioka K, Watanabe M, Asanuma T, Ishikawa Y, Ohara T, Kaikita K, Kasai T, Kato E, Kamiyama H, Kawashiri M, Kiso K, Kitagawa K, Kido T, Kinoshita T, Kiriyama T, Kume T, Kurata A, Kurisu S, Kosuge M, Kodani E, Sato A, Shiono Y, Shiomi H, Taki J, Takeuchi M, Tanaka A, Tanaka N, Tanaka R, Nakahashi T, Nakahara T, Nomura A, Hashimoto A, Hayashi K, Higashi M, Hiro T, Fukamachi D, Matsuo H, Matsumoto N, Miyauchi K, Miyagawa M, Yamada Y, Yoshinaga K, Wada H, Watanabe T, Ozaki Y, Kohsaka S, Shimizu W, Yasuda S, Yoshino H. JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases. Circ J 2021; 85:402-572. [PMID: 33597320 DOI: 10.1253/circj.cj-19-1131] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine Graduate School
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School
| | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | | | | | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School
| | | | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School
| | | | - Hiroshi Tada
- Department of Cardiovascular Medicine, University of Fukui
| | | | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | | | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa Universtiy
| | | | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Atsushi Nohara
- Division of Clinical Genetics, Ishikawa Prefectural Central Hospital
| | | | | | - Masaru Miura
- Department of Cardiology, Tokyo Metropolitan Children's Medical Center
| | | | | | | | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Toshihiko Asanuma
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School
| | - Yuichi Ishikawa
- Department of Pediatric Cardiology, Fukuoka Children's Hospital
| | - Takahiro Ohara
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Tokuo Kasai
- Department of Cardiology, Uonuma Kinen Hospital
| | - Eri Kato
- Department of Cardiovascular Medicine, Department of Clinical Laboratory, Kyoto University Hospital
| | | | - Masaaki Kawashiri
- Department of Cardiovascular and Internal Medicine, Kanazawa University
| | - Keisuke Kiso
- Department of Diagnostic Radiology, Tohoku University Hospital
| | - Kakuya Kitagawa
- Department of Advanced Diagnostic Imaging, Mie University Graduate School
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School
| | | | | | | | - Akira Kurata
- Department of Radiology, Ehime University Graduate School
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
| | - Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama Nagayama Hospital
| | - Akira Sato
- Department of Cardiology, University of Tsukuba
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Kyoto University Graduate School
| | - Junichi Taki
- Department of Nuclear Medicine, Kanazawa University
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of the University of Occupational and Environmental Health, Japan
| | | | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | - Ryoichi Tanaka
- Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University
| | | | | | - Akihiro Nomura
- Innovative Clinical Research Center, Kanazawa University Hospital
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Hospital
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University
| | | | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Naoya Matsumoto
- Division of Cardiology, Department of Medicine, Nihon University
| | | | | | | | - Keiichiro Yoshinaga
- Department of Diagnostic and Therapeutic Nuclear Medicine, Molecular Imaging at the National Institute of Radiological Sciences
| | - Hideki Wada
- Department of Cardiology, Juntendo University Shizuoka Hospital
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University
| | - Yukio Ozaki
- Department of Cardiology, Fujita Medical University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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144
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Zhang D, Jones RR, James P, Kitahara CM, Xiao Q. Associations between artificial light at night and risk for thyroid cancer: A large US cohort study. Cancer 2021; 127:1448-1458. [PMID: 33554351 DOI: 10.1002/cncr.33392] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Light at night (LAN) inhibits nighttime secretion of melatonin and may cause circadian disruption, which may be a risk factor for cancer. Recent studies have linked high LAN exposure with elevated breast cancer risk. Given that breast cancer may share a common hormone-dependent etiology with thyroid cancer and that circadian rhythms play a role in regulating thyroid function, the authors hypothesized that exposure to LAN is positively associated with thyroid cancer incidence. METHODS This study examined the association between LAN and thyroid cancer incidence in the National Institutes of Health-American Association of Retired Persons Diet and Health Study. LAN exposure was estimated from satellite data and was linked to residential addresses at the baseline. Incident thyroid cancer cases were ascertained via linkage to state cancer registries. Cox regression was used to determine the relationship between LAN and thyroid cancer risk, with adjustments made for sociodemographic, lifestyle, and other environmental factors. RESULTS Among 464,371 participants, a positive association was found between LAN and thyroid cancer risk. Specifically, in comparison with the lowest quintile of LAN, the highest quintile was associated with a 55% increase in risk (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.18-2.02). The association was primarily driven by papillary thyroid cancer and was stronger in women (HR, 1.81; 95% CI, 1.26-2.60) than men (HR, 1.29; 95% CI, 0.86-1.94). In women, the association was stronger for localized cancer, whereas in men, the association was stronger for a more advanced stage. Results were consistent across different tumor sizes. CONCLUSIONS LAN was positively associated with thyroid cancer risk. Future studies are needed to confirm this association and identify underlying biological mechanisms.
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Affiliation(s)
- Dong Zhang
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
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145
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Experimental verification of consistency of micro-silica glass bead thermoluminescent detectors for mixed gamma/neutron irradiation. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2020.109210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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146
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Wang YRJ, Baratto L, Hawk KE, Theruvath AJ, Pribnow A, Thakor AS, Gatidis S, Lu R, Gummidipundi SE, Garcia-Diaz J, Rubin D, Daldrup-Link HE. Artificial intelligence enables whole-body positron emission tomography scans with minimal radiation exposure. Eur J Nucl Med Mol Imaging 2021; 48:2771-2781. [PMID: 33527176 DOI: 10.1007/s00259-021-05197-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/10/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE To generate diagnostic 18F-FDG PET images of pediatric cancer patients from ultra-low-dose 18F-FDG PET input images, using a novel artificial intelligence (AI) algorithm. METHODS We used whole-body 18F-FDG-PET/MRI scans of 33 children and young adults with lymphoma (3-30 years) to develop a convolutional neural network (CNN), which combines inputs from simulated 6.25% ultra-low-dose 18F-FDG PET scans and simultaneously acquired MRI scans to produce a standard-dose 18F-FDG PET scan. The image quality of ultra-low-dose PET scans, AI-augmented PET scans, and clinical standard PET scans was evaluated by traditional metrics in computer vision and by expert radiologists and nuclear medicine physicians, using Wilcoxon signed-rank tests and weighted kappa statistics. RESULTS The peak signal-to-noise ratio and structural similarity index were significantly higher, and the normalized root-mean-square error was significantly lower on the AI-reconstructed PET images compared to simulated 6.25% dose images (p < 0.001). Compared to the ground-truth standard-dose PET, SUVmax values of tumors and reference tissues were significantly higher on the simulated 6.25% ultra-low-dose PET scans as a result of image noise. After the CNN augmentation, the SUVmax values were recovered to values similar to the standard-dose PET. Quantitative measures of the readers' diagnostic confidence demonstrated significantly higher agreement between standard clinical scans and AI-reconstructed PET scans (kappa = 0.942) than 6.25% dose scans (kappa = 0.650). CONCLUSIONS Our CNN model could generate simulated clinical standard 18F-FDG PET images from ultra-low-dose inputs, while maintaining clinically relevant information in terms of diagnostic accuracy and quantitative SUV measurements.
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Affiliation(s)
- Yan-Ran Joyce Wang
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA
| | - Lucia Baratto
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA
| | - K Elizabeth Hawk
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA
| | - Ashok J Theruvath
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA
| | - Allison Pribnow
- Department of Pediatrics, Pediatric Oncology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94304, USA
| | - Avnesh S Thakor
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA
| | - Sergios Gatidis
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Rong Lu
- Quantitative Sciences Unit, School of Medicine, Stanford University, Stanford, CA, 94304, USA
| | - Santosh E Gummidipundi
- Quantitative Sciences Unit, School of Medicine, Stanford University, Stanford, CA, 94304, USA
| | - Jordi Garcia-Diaz
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA
| | - Daniel Rubin
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA. .,Department of Pediatrics, Pediatric Oncology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94304, USA.
| | - Heike E Daldrup-Link
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 725 Welch Road, CA, 94304, Stanford, USA. .,Department of Pediatrics, Pediatric Oncology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94304, USA.
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147
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Bo YMD, Peng HMD, Yukun LMD, Mingbo ZMD. Feasibility and Efficacy of the Segmental Localization of Lumbar Vertebrae by Ultrasound vs X-ray Examination: A Prospective Comparative Study. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2021. [DOI: 10.37015/audt.2021.200062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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148
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Yushkova E, Bashlykova L. Transgenerational effects in offspring of chronically irradiated populations of Drosophila melanogaster after the Chernobyl accident. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2021; 62:39-51. [PMID: 33233025 DOI: 10.1002/em.22416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 06/11/2023]
Abstract
The zone of the Chernobyl nuclear disaster represents the largest area of chronic low-intensity radioactive impact on the natural ecosystems. The effects of chronic low-dose irradiation for natural populations of organisms and their offspring are unknown. The natural populations of Drosophila melanogaster sampled in 2007 in Chernobyl sites with different levels of radiation contamination were investigated. The offspring of specimens from these populations were studied under laboratory conditions to assess the effects of parental irradiation on the mutation process and survival of the offspring. Transgenerational effects of radioactive contamination were observed at the level of gross chromosomal rearrangements (dominant lethal mutations). The frequency of point/gene mutations (recessive sex-linked lethal mutations) of the offspring of the irradiated parents corresponded to the actual level of spontaneous mutations. The survival rate of offspring decreased over 160 generations and significantly correlated with the dominant lethal mutation levels. Our results provide a compelling evidence that other factors (distance from the Chernobyl Nuclear Power Plant, time after the initial exposure, selection site and origin of population) can affect the changes in the levels of the studied parameters along with the parental radiation exposure. They can also make a significant contribution to the health of the offspring of animals exposed to radioactive contamination. These data should be useful for future radioecological studies which will clarify the true mechanisms of transgenerational inheritance and generation of mutations to the offspring of chronically irradiated animals and their reactions to the interaction of various environmental factors.
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Affiliation(s)
- Elena Yushkova
- Institute of Biology of Komi Scientific Centre of the Ural Branch of the Russian Academy of Science, Syktyvkar, Russia
| | - Ludmila Bashlykova
- Institute of Biology of Komi Scientific Centre of the Ural Branch of the Russian Academy of Science, Syktyvkar, Russia
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149
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Dutta B, Asami T, Imatomi T, Igarashi K, Nagata K, Watanabe-Asaka T, Yasuda T, Oda S, Shartl M, Mitani H. Strain difference in transgene-induced tumorigenesis and suppressive effect of ionizing radiation. JOURNAL OF RADIATION RESEARCH 2021; 62:12-24. [PMID: 33231252 PMCID: PMC7779347 DOI: 10.1093/jrr/rraa103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/30/2020] [Indexed: 06/11/2023]
Abstract
Transgenic expression in medaka of the Xiphophorus oncogene xmrk, under a pigment cell specific mitf promoter, induces hyperpigmentation and pigment cell tumors. In this study, we crossed the Hd-rR and HNI inbred strains because complete genome information is readily available for molecular and genetic analysis. We prepared an Hd-rR (p53+/-, p53-/-) and Hd-rR HNI hybrid (p53+/-) fish-based xmrk model system to study the progression of pigment cells from hyperpigmentation to malignant tumors on different genetic backgrounds. In all strains examined, most of the initial hyperpigmentation occurred in the posterior region. On the Hd-rR background, mitf:xmrk-induced tumorigenesis was less frequent in p53+/- fish than in p53-/- fish. The incidence of hyperpigmentation was more frequent in Hd-rR/HNI hybrids than in Hd-rR homozygotes; however, the frequency of malignant tumors was low, which suggested the presence of a tumor suppressor in HNI genetic background fish. The effects on tumorigenesis in xmrk-transgenic immature medaka of a single 1.3 Gy irradiation was assessed by quantifying tumor progression over 4 consecutive months. The results demonstrate that irradiation has a different level of suppressive effect on the frequency of hyperpigmentation in purebred Hd-rR compared with hybrids.
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Affiliation(s)
- Bibek Dutta
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Taichi Asami
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Tohru Imatomi
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Kento Igarashi
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Kento Nagata
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Tomomi Watanabe-Asaka
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Takako Yasuda
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Shoji Oda
- Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 277-8562, Kashiwa, Japan
| | - Manfred Shartl
- University of Wuerzburg, Physiological Chemistry, Biocenter, 97074 Wuerzburg, Germany and the Xiphophorus Genetic Stock Center, Department of Chemistry and Biochemistry, Texas State University, San Marcos, Texas, 78666, USA
| | - Hiroshi Mitani
- Corresponding author. Laboratory of Genome Stability, Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha 277-8562, Kashiwa, Japan. Tel: +81(4) 7136-3670; Fax:+81(4)7136-3669;
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150
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Pediatric Molecular Imaging. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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