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Nicotra R, Lutz C, Messal HA, Jonkers J. Rat Models of Hormone Receptor-Positive Breast Cancer. J Mammary Gland Biol Neoplasia 2024; 29:12. [PMID: 38913216 DOI: 10.1007/s10911-024-09566-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/07/2024] [Indexed: 06/25/2024] Open
Abstract
Hormone receptor-positive (HR+) breast cancer (BC) is the most common type of breast cancer among women worldwide, accounting for 70-80% of all invasive cases. Patients with HR+ BC are commonly treated with endocrine therapy, but intrinsic or acquired resistance is a frequent problem, making HR+ BC a focal point of intense research. Despite this, the malignancy still lacks adequate in vitro and in vivo models for the study of its initiation and progression as well as response and resistance to endocrine therapy. No mouse models that fully mimic the human disease are available, however rat mammary tumor models pose a promising alternative to overcome this limitation. Compared to mice, rats are more similar to humans in terms of mammary gland architecture, ductal origin of neoplastic lesions and hormone dependency status. Moreover, rats can develop spontaneous or induced mammary tumors that resemble human HR+ BC. To date, six different types of rat models of HR+ BC have been established. These include the spontaneous, carcinogen-induced, transplantation, hormone-induced, radiation-induced and genetically engineered rat mammary tumor models. Each model has distinct advantages, disadvantages and utility for studying HR+ BC. This review provides a comprehensive overview of all published models to date.
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Affiliation(s)
- Raquel Nicotra
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- Oncode Institute, Amsterdam, Netherlands
| | - Catrin Lutz
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands.
- Oncode Institute, Amsterdam, Netherlands.
| | - Hendrik A Messal
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands.
- Oncode Institute, Amsterdam, Netherlands.
| | - Jos Jonkers
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands.
- Oncode Institute, Amsterdam, Netherlands.
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Ahmad H, Ali J, Ahmad K, Biradar G, Zaman A, Uddin Y, Sohail M, Ali S. Assessment of peripheral dose as a function of distance and depth from cobalt-60 beam in water phantom using TLD-100. J Egypt Natl Canc Inst 2024; 36:22. [PMID: 38910202 DOI: 10.1186/s43046-024-00227-1] [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: 10/26/2023] [Accepted: 05/08/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Innovations in cancer treatment have contributed to the improved survival rate of cancer patients. The cancer survival rates have been growing and nearly two third of those survivors have been exposed to clinical radiation during their treatment. The study of long-term radiation effects, especially secondary cancer induction, has become increasingly important. An accurate assessment of out-of-field/peripheral dose (PDs) is necessary to estimate the risk of second cancer after radiotherapy and the damage to the organs at risk surrounding the planning target volume. This study was designed to measure the PDs as a function of dose, distances, and depths from Telecobalt-60 (Co-60) beam in water phantom using thermoluminescent dosimeter-100 (TLD-100). METHODS The PDs were measured for Co-60 beam at specified depths of 0 cm (surface), 5 cm, 10 cm, and 15 cm outside the radiation beam at distances of 5, 10, and 13 cm away from the radiation field edge using TLD-100 (G1 cards) as detectors. These calibrated cards were placed on the acrylic disc in circular tracks. The radiation dose of 2000 mGy of Co-60 beam was applied inside 10 × 10 cm2 field size at constant source to surface distance (SSD) of 80 cm. RESULTS The results showed maximum and minimum PDs at surface and 5 cm depth respectively at all distances from the radiation field edge. Dose distributions out of the field edge with respect to distance were isotropic. The decrease in PDs at 5 cm depth was due to dominant forward scattering of Co-60 gamma rays. The increase in PDs beyond 5 cm depth was due to increase in the irradiated volume, increase in penumbra, increase in source to axis distance (SAD), and increase in field size due to inverse square factor. CONCLUSION It is concluded that the PDs depends upon depth and distance from the radiation field edge. All the measurements show PDs in the homogenous medium (water); therefore, it estimates absorbed dose to the organ at risk (OAR) adjacent to cancer tissues/planning target volume (PTV). It is suggested that PDs can be minimized by using the SAD technique, as this technique controls sources of scattered radiation like inverse square factor and effect of penumbra up-to some extent.
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Affiliation(s)
- Habib Ahmad
- Swat Institute of Nuclear Medicine, Oncology & Radiotherapy (SINOR) Cancer Hospital, Saidu Sharif Swat, KPK, Pakistan
| | - Javaid Ali
- Larkana Institute of Nuclear Medicine and Radiotherapy (LINAR) Cancer Hospital, Larkana, Sindh, Pakistan.
| | - Khalil Ahmad
- Pakistan Institute of Nuclear Science and Technology (PINSTECH), Islamabad, Pakistan
| | - Ghufran Biradar
- Swat Institute of Nuclear Medicine, Oncology & Radiotherapy (SINOR) Cancer Hospital, Saidu Sharif Swat, KPK, Pakistan
| | - Ashfaq Zaman
- Swat Institute of Nuclear Medicine, Oncology & Radiotherapy (SINOR) Cancer Hospital, Saidu Sharif Swat, KPK, Pakistan
| | - Yasir Uddin
- Royal College of Nursing, Saidu Sharif, Swat, KPK, Pakistan
| | - Muhammad Sohail
- International Collaborative Laboratory of 2D Materials for Optoelectronics Science and Technology of Ministry of Education, Institute of Microscale Optoelectronics, College of Electronics and Information Engineering, Shenzhen University, Shenzhen, 518060, China
| | - Shahid Ali
- Department of Physics, University of Peshawar (UOP), Peshawar, KPK, Pakistan
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Kjelle E, Brandsæter IØ, Andersen ER, Hofmann B. Sustainability in healthcare by reducing low-value imaging - A narrative review. Radiography (Lond) 2024; 30 Suppl 1:30-34. [PMID: 38870571 DOI: 10.1016/j.radi.2024.05.014] [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: 03/22/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES This narrative review aims to present the concept of value in imaging and explore why we conduct low-value procedures, how to reduce this wasteful use, and what we could gain from reducing low-value imaging. KEY FINDINGS Imaging of low value to the patient contributes to thousands of metric tons of CO2 emissions, costing several billion US dollars annually. With a 20% reduction in low-value imaging, we would reduce the waste of resources related to 7.2 million procedures and, at the same time, reduce the risk of incidentalomas, overdiagnosis, and overtreatment and reduce wait times for patients in need of imaging services of high value. Multi-component initiatives targeting barriers in all levels of society and healthcare are needed to reduce low-value imaging. Radiographers are key actors in medical imaging and can make substantial contributions to this effort by, together with the radiologists, referrers, and managers, ensuring that all imaging procedures conducted are sustainable along four dimensions of sustainability: value, cost, risk, and environment. CONCLUSION Efforts to secure sustainable imaging considering the four crucial dimensions (value, cost, radiation, and environment) should be made at all levels of society and healthcare, from governmental management to the individual healthcare worker. Radiographers are vital in obtaining sustainability to ensure only sustainable imaging procedures are conducted. IMPLICATIONS FOR PRACTICE When assessing the appropriateness of imaging procedures, we need to consider the environment, safety, effectiveness, and efficiency. To obtain this, we need a collective and coordinated effort locally, nationally, and internationally to deliver sustainable imaging services.
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Affiliation(s)
- E Kjelle
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway; Department of Optometry, Radiography, and Lighting Design at the University of South-Eastern Norway (USN) at Drammen, Post Office Box 4, 3199 Borre, Norway.
| | - I Ø Brandsæter
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway
| | - E R Andersen
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway
| | - B Hofmann
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway; Centre of Medical Ethics at the University of Oslo, Centre of Medical Ethics, Postbox 1130, Blindern, 0318 Oslo, Norway
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Lu C, Yao X, Yu M, He X. Medical radiation exposure in inflammatory bowel disease: an updated meta-analysis. BMC Gastroenterol 2024; 24:173. [PMID: 38762503 PMCID: PMC11102164 DOI: 10.1186/s12876-024-03264-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/14/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND There have been previous studies and earlier systematic review on the relationship between inflammatory bowel disease (IBD) and radiation exposure. With the diversification of current test methods, this study intended to conduct a meta-analysis to evaluate the IBD radiation exposure in recent years. METHODS Three databases (PUBMED, EMBASE, and MEDICINE) for relevant literature up to May 1, 2023 were searched. The statistical data meeting requirements were collated and extracted. RESULTS 20 papers were enrolled. The overall high radiation exposure rate was 15% (95% CI = [12%, 19%]) for CD and 5% (95% CI = [3%, 7%]) for UC. The pooled result found that high radiation exposure rate was 3.44 times higher in CD than in UC (OR = 3.44, 95% CI = [2.35, 5.02]). Moreover, the average radiation exposure level in CD was 12.77 mSv higher than that in UC (WMD = 12.77, 95% CI = [9.93, 15.62] mSv). Furthermore, radiation exposure level of CD after 2012 was higher than those before 2012 (26.42 ± 39.61vs. 23.76 ± 38.46 mSv, P = 0.016), while UC did not show similar result (11.99 ± 27.66 vs. 10.01 ± 30.76 mSv, P = 0.1). Through subgroup analysis, it was found that disease duration (WMD = 2.75, 95% CI = [0.10, 5.40] mSv), complications (OR = 5.09, 95% CI = [1.50, 17.29]), and surgical history (OR = 5.46, 95% CI = [1.51, 19.69]) significantly increased the proportion of high radiation exposure. CONCLUSION This study found that radiation exposure level of IBD patients was high, which revealed the radiation risk in the process of diagnosis and treatment of IBD patients. In the future, longer follow-up and prospective studies are needed to reveal the relationship between high radiation exposure and solid tumorigenesis.
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Affiliation(s)
- Chao Lu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Xin Yao
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Mosang Yu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Xinjue He
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
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Tsai YK, Lin LF, Cheng CY, Wong CYO, Wang WH, Shen DHY, Su SL, Chen ES, Chen TY, Chen IF. Simplified Assessment of Radioiodine Biokinetics for Thyroid Cancer Patients: A Practical Approach Using Continuous External Radiation Monitoring. Diagnostics (Basel) 2024; 14:1010. [PMID: 38786308 PMCID: PMC11120101 DOI: 10.3390/diagnostics14101010] [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: 04/22/2024] [Revised: 05/10/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION The biokinetics of radioiodine (RAI) in thyroid cancer patients are complex. This study aims to develop a practical approach for assessing RAI biokinetics to predict patient discharge time and estimate radiation exposure to caregivers. METHODS We retrospectively reviewed data from patients with differentiated thyroid carcinoma undergoing RAI treatment. Serial radiation dose rates were dynamically collected during hospitalization and fitted to a biexponential model to assess the biokinetic features: RAI uptake fraction of thyroid tissue (Ft) and effective half-life of extra-thyroid tissue (Tet). Correlations with 99mTc thyroid uptake ratio (TcUR), radiation retention ratio (RR), renal function, and body mass index (BMI) were analyzed. RESULTS Thirty-five patients were enrolled. The derived Ft was 0.08 ± 0.06 and Tet was 7.57 ± 1.45 h. Pearson's correlation analysis revealed a significant association between Ft and both TcUR and RR (p < 0.05), while Tet correlated with renal function and BMI (p < 0.05). CONCLUSION This novel and practical method assessing RAI biokinetics demonstrates consistency with other parameters and related studies, enhancing the model reliability. It shows promise in predicting an appropriate discharge time and estimating radiation exposure to caregivers, allowing for modifications to radiation protection precautions to follow ALARA principle and minimize the potential risks from radiation exposure.
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Affiliation(s)
- Yao-Kuang Tsai
- Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan; (Y.-K.T.); (L.-F.L.); (C.-Y.C.); (E.-S.C.); (T.-Y.C.)
- Department of Nuclear Medicine, Taichung Armed Forces General Hospital, Taichung 411228, Taiwan
- School of Medicine, National Defense Medical Center, Taipei 114201, Taiwan
| | - Li-Fan Lin
- Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan; (Y.-K.T.); (L.-F.L.); (C.-Y.C.); (E.-S.C.); (T.-Y.C.)
| | - Cheng-Yi Cheng
- Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan; (Y.-K.T.); (L.-F.L.); (C.-Y.C.); (E.-S.C.); (T.-Y.C.)
| | | | - Wei-Hsung Wang
- Radiation Safety Office, Center for Energy Studies, Louisiana State University, Baton Rouge, LA 70803, USA;
| | - Daniel Hueng-Yuan Shen
- Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan;
| | - Sui-Lung Su
- School of Public Health, National Defense Medical Center, Taipei 114201, Taiwan;
| | - En-Shih Chen
- Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan; (Y.-K.T.); (L.-F.L.); (C.-Y.C.); (E.-S.C.); (T.-Y.C.)
| | - Tzai-Yang Chen
- Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan; (Y.-K.T.); (L.-F.L.); (C.-Y.C.); (E.-S.C.); (T.-Y.C.)
| | - I-Feng Chen
- Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan; (Y.-K.T.); (L.-F.L.); (C.-Y.C.); (E.-S.C.); (T.-Y.C.)
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Waelti S, Skawran S, Sartoretti T, Schwyzer M, Gennari AG, Mader C, Treyer V, Kellenberger CJ, Burger IA, Hany T, Maurer A, Huellner MW, Messerli M. A third of the radiotracer dose: two decades of progress in pediatric [ 18F]fluorodeoxyglucose PET/CT and PET/MR imaging. Eur Radiol 2024; 34:3252-3259. [PMID: 37855853 PMCID: PMC11126459 DOI: 10.1007/s00330-023-10319-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES To assess the evolution of administered radiotracer activity for F-18-fluorodeoxyglucose (18F-FDG) PET/CT or PET/MR in pediatric patients (0-16 years) between years 2000 and 2021. METHODS Pediatric patients (≤ 16 years) referred for 18F-FDG PET/CT or PET/MR imaging of the body during 2000 and 2021 were retrospectively included. The amount of administered radiotracer activity in megabecquerel (MBq) was recorded, and signal-to-noise ratio (SNR) was measured in the right liver lobe with a 4 cm3 volume of interest as an indicator for objective image quality. Descriptive statistics were computed. RESULTS Two hundred forty-three children and adolescents underwent a total of 466 examinations. The median injected 18F-FDG activity in MBq decreased significantly from 296 MBq in 2000-2005 to 100 MBq in 2016-2021 (p < 0.001), equaling approximately one-third of the initial amount. The median SNR ratio was stable during all years with 11.7 (interquartile range [IQR] 10.7-12.9, p = 0.133). CONCLUSIONS Children have benefited from a massive reduction in the administered 18F-FDG dose over the past 20 years without compromising objective image quality. CLINICAL RELEVANCE STATEMENT Radiotracer dose was reduced considerably over the past two decades of pediatric F-18-fluorodeoxyglucose PET/CT and PET/MR imaging highlighting the success of technical innovations in pediatric PET imaging. KEY POINTS • The evolution of administered radiotracer activity for F-18-fluorodeoxyglucose (18F-FDG) PET/CT or PET/MR in pediatric patients (0-16 years) between 2000 and 2021 was assessed. • The injected tracer activity decreased by 66% during the study period from 296 megabecquerel (MBq) to 100 MBq (p < 0.001). • The continuous implementation of technical innovations in pediatric hybrid 18F-FDG PET has led to a steady decrease in the amount of applied radiotracer, which is particularly beneficial for children who are more sensitive to radiation.
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Affiliation(s)
- Stephan Waelti
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Stephan Skawran
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Thomas Sartoretti
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Moritz Schwyzer
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Antonio G Gennari
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Cäcilia Mader
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Christian J Kellenberger
- University of Zurich, Zurich, Switzerland
- Department of Diagnostic Imaging, University Children's Hospital Zurich, Zurich, Switzerland
| | - Irene A Burger
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, Kantonsspital Baden, Baden, Switzerland
| | - Thomas Hany
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- MRI Bahnhofplatz, Zurich, Switzerland
| | - Alexander Maurer
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
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Łysek-Gładysińska M, Wieczorek A, Walaszczyk A, Jelonek K, Pietrowska M, Widłak P, Kulik R, Gabryś D. Late Effects of Ionizing Radiation on the Ultrastructure of Hepatocytes and Activity of Lysosomal Enzymes in Mouse Liver Irradiated In Vivo. Metabolites 2024; 14:212. [PMID: 38668340 PMCID: PMC11051989 DOI: 10.3390/metabo14040212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/29/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
The study aimed to investigate late radiation-induced changes in the histology, ultrastructure, and activity of lysosomal enzymes in mouse liver exposed to ionizing radiation. The experiment was conducted on C57BL/6J male mice whose distal part of the liver was exposed occasionally to single doses of radiation (6 MV photons) during targeted heart irradiation; estimated doses delivered to analyzed tissue were 0.025 Gy, 0.25 Gy, 1 Gy, and 2 Gy. Tissues were collected 40 weeks after irradiation. We have observed that late effects of radiation have an adaptive nature and their intensity was dose-dependent. Morphological changes in hepatocytes included an increased number of primary lysosomes and autophagic vacuoles, which were visible in tissues irradiated with 0.25 Gy and higher doses. On the other hand, a significant increase in the activity of lysosomal hydrolases was observed only in tissues exposed to 2 Gy. The etiology of these changes may be multifactorial and result, among others, from unintentional irradiation of the distal part of the liver and/or functional interaction of the liver with an irradiated heart. In conclusion, we confirmed the presence of late dose-dependent ultrastructural and biochemical changes in mouse hepatocytes after liver irradiation in vivo.
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Affiliation(s)
| | - Anna Wieczorek
- Division of Medical Biology, Institute of Biology, Jan Kochanowski University, 25-406 Kielce, Poland;
| | - Anna Walaszczyk
- Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK;
| | - Karol Jelonek
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland; (K.J.); (M.P.)
| | - Monika Pietrowska
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland; (K.J.); (M.P.)
| | - Piotr Widłak
- 2nd Department of Radiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Roland Kulik
- Department of Radiotherapy Planning, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland;
| | - Dorota Gabryś
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland;
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Ali O, Kesar V, Alizadeh M, Kalachi K, Twery B, Wellnitz N, Kim RE, Goldberg E, Uradomo LT, Darwin PE. Low-dose pulsed vs standard pulsed fluoroscopy during ERCP to reduce radiation without change in image quality: Prospective randomized study. Endosc Int Open 2024; 12:E554-E560. [PMID: 38628393 PMCID: PMC11018389 DOI: 10.1055/a-2284-8656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/06/2024] [Indexed: 04/19/2024] Open
Abstract
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) poses the risk of radiation exposure (RE) to patients and staff and increases the risk of adverse biological effects such as cataracts, sterility, and cancer. Newer fluoroscopy equipment (C-Arm) provides options to limit radiation in the form of lower radiation dose and frame rate or time-limited "pulsed" settings. However, the impact of lower settings on image quality has not been assessed, and no standard protocol exists for fluoroscopy settings used during ERCP. Patients and methods This was a single-center, double-blind, prospective randomized study of consecutive adult patients undergoing standard-of-care ERCP at a tertiary academic medical center. Patients were randomized into two groups: 1) standard-dose pulsed and 2) low-dose pulsed. Pulsed mode (8 fps) was defined as x-ray exposure either in the manufacturer standard-dose or low-dose settings limited to 3 seconds each time the foot-operated switch was depressed. Results Seventy-eight patients undergoing ERCP were enrolled and randomized. No difference in age, gender, or body mass index was found between the two groups. No significant difference in image quality was found between standard-dose and low-dose fluoroscopy P = 0.925). The low-dose group was exposed to significantly less radiation when compared with standard-dose P < 0.05). Fluoroscopy time (minutes) was similar in both groups (2.0 vs 1.9), further suggesting that group assignment had no impact on image quality or procedure time. Conclusions Low-dose pulsed fluoroscopy is a reliable method that substantially reduces radiation without compromising image quality or affecting procedure or fluoroscopy times. This underscores the need for standardization in ERCP fluoroscopy settings to limit radiation exposure.
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Affiliation(s)
- Osman Ali
- Gastroenterology, University of Maryland School of Medicine, Baltimore, United States
| | - Varun Kesar
- Gastroenterology and Hepatology, Carilion Clinic, Roanoke, United States
| | - Madeline Alizadeh
- IGS, University of Maryland Institute for Genome Sciences, Silver Spring, United States
| | - Kourosh Kalachi
- Gastroenterology, University of Maryland School of Medicine, Baltimore, United States
| | - Benjamin Twery
- Gastroenterology, University of Maryland School of Medicine, Baltimore, United States
| | - Nicholas Wellnitz
- A&F Environmental Health & Safety, University of Maryland Baltimore, Baltimore, United States
| | - Raymond Eunho Kim
- Gastroenterology and Hepatology, University of Maryland Baltimore, Baltimore, United States
| | - Eric Goldberg
- Gastroenterology, University of Maryland School of Medicine, Baltimore, United States
| | - Lance T Uradomo
- Gastroeneterology, City of Hope Comprehensive Cancer Center, Duarte, United States
| | - Peter E Darwin
- Gastroenterology, University of Maryland School of Medicine, Baltimore, United States
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Wu FHW, Cheung CW, Leung YY. Neuronavigation-guided Percutaneous Rhizotomies to Trigeminal Neuralgia: A Systematic Review. Clin J Pain 2024; 40:253-266. [PMID: 38193245 DOI: 10.1097/ajp.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Neuronavigation improves intraoperative visualization of the cranial structures, which is valuable in percutaneous surgical treatments for patients with trigeminal neuralgia (TN) who are refractory to pharmacotherapy or reluctant to receive open surgery. The objective of this review was to evaluate the available neuronavigation-guided percutaneous surgical treatment modalities with cannulation of foramen ovale to TN, and their relative benefits and limitations. METHODS This review was conducted based on the PRISMA statement. An initial search was performed on electronic databases, followed by manual and reference searches. Study and patient characteristics, rhizotomy procedure and neuronavigation details, and treatment outcomes (initial pain relief and pain recurrence within 2 y, success rate of forman ovale cannulation, and complications) were evaluated. The risk of bias was assessed with a quality assessment based on the ROBINS-I tools. RESULTS Ten studies (491 operations, 403 participants) were analyzed. Three percutaneous trigeminal rhizotomy modalities identified were radiofrequency thermocoagulation rhizotomy (RFTR), percutaneous balloon compression, and glycerol rhizotomy. Intraoperative computed tomography and magnetic resonance imaging fusion-based RFTR had the highest initial pain relief rate of 97.0%. The success rate of foramen ovale cannulation ranged from 92.3% to 100% under neuronavigation. Facial hypoesthesia and masticatory muscle weakness were the most reported complications. DISCUSSION Neuronavigation-guided percutaneous trigeminal rhizotomies showed possible superior pain relief outcomes to that of conventional rhizotomies in TN, with the benefits of radiation reduction and lower complication development rates. The limitations of neuronavigation remain its high cost and limited availability. Higher-quality prospective studies and randomized clinical trials of neuronavigation-guided percutaneous trigeminal rhizotomy were lacking.
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Affiliation(s)
| | - Chi Wai Cheung
- Department of Anaesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry
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Penning D, Molendijk J, Halm JA, Schepers T. Measuring External Rotation of the Fibula and Fibular Length in Bilateral Computed Tomography Scans: How Reliable Is This Method? J Orthop Trauma 2024; 38:205-209. [PMID: 38306014 PMCID: PMC10942176 DOI: 10.1097/bot.0000000000002774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES During ankle fracture surgery, goals include accurate reduction and fixation of the fibula regarding rotation and fibular length. Bilateral postoperative computed tomography (CT) can be performed to assess fibular rotation using the talar dome angle, and fibular length. The aim of this study was to compare side-to-side differences of the fibular rotation and fibular length using bilateral CT scans of uninjured ankles. METHODS DESIGN Retrospective. SETTING Single center, Level I Academic Trauma Center. PATIENT SELECTION CRITERIA Patients with bilateral CT scans of uninjured ankles. OUTCOME MEASURES AND COMPARISONS External rotation using the Nault talar dome method and fibular length using the coronal method of Prior et al. The average, difference, and ratio (injured side/healthy side) and interobserver variability were calculated. RESULTS There were 83 patients included (166 ankles, mean age 47 years, 77.1% male). A random set of 66 ankles (33 CT scans) were used to measure interobserver variability. The mean degrees of external rotation ranged from 6.6 to 7.7, mean difference ranged from 1.4 to 3.4 degrees, mean ratio ranged from 1.1 to 1.5, and interobserver variability ranged from 0.27 to 0.65. For fibular length, the mean ranged from 24.6 to 25.8 mm, mean difference in fibular length ranged from 0.5 to 2.1 mm, mean ratio ranged from 1.0 to 1.1 mm, and interobserver variability ranged from 0.45 to 0.73. CONCLUSIONS Using bilateral ankle CT scans, mean differences in fibular rotation using the Nault talar dome method were 1.4-3.4 degrees. The distal fibular length had a mean difference between both sides of 0.5-2.1 mm. Although the intraclass correlation's were low, the interleg differences between patients were small, making them useful for clinical practice. LEVEL OF EVIDENCE Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Diederick Penning
- Trauma Unit, Department of Surgery, Amsterdam UMC location Meibergdreef, Amsterdam, the Netherlands
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11
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Saad A, Mayne A, Pagkalos J, Ollivier M, Botchu R, Davis E, Sharma A. Comparative analysis of radiation exposure in robot-assisted total knee arthroplasty using popular robotic systems. J Robot Surg 2024; 18:120. [PMID: 38492073 DOI: 10.1007/s11701-024-01896-9] [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: 01/14/2024] [Accepted: 02/28/2024] [Indexed: 03/18/2024]
Abstract
Robotic-assisted TKA (RATKA) is a rapidly emerging technique that has been shown to improve precision and accuracy in implant alignment in TKA. Robotic-assisted TKA (RATKA) uses computer software to create a three-dimensional model of the patient's knee. Different types of preoperative imaging, including radiographs and CT scans, are used to create these models, each with varying levels of radiation exposure. This study aims to determine the radiation dose associated with each type of imaging used in RATKA, to inform patients of the potential risks. A retrospective search of our clinical radiology and arthroplasty database was conducted to identify 140 knees. The patients were divided into three groups based on the type of preoperative imaging they received: (1) CT image-based MAKO Protocol, (2) Antero-posterior long leg alignment films (LLAF), (3) standard AP, lateral, and skyline knee radiographs. The dose of CT imaging technique for each knee was measured using the dose-length product (DLP) with units of mGycm2, whereas the measurement for XRAY images was with the dose area product (DAP) with units of Gycm2. The mean radiation dose for patients in the CT (MAKO protocol) image-based group was 1135 mGy.cm2. The mean radiation dose for patients in the LLAF group was 3081 Gycm2. The mean radiation dose for patients undergoing knee AP/lateral and skyline radiographs was the lowest of the groups, averaging 4.43 Gycm2. Through an ANOVA and post hoc analysis, the results between groups was statistically significant. In this study, we found a significant difference in radiation exposure between standard knee radiographs, LLAF and CT imaging. Nonetheless, the radiation dose for all groups is still within acceptable safety limits.
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Affiliation(s)
- Ahmed Saad
- Royal Orthopaedic Hospital, Birmingham, UK.
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12
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Poosiri S, Krisanachinda A, Khamwan K. Evaluation of patient radiation dose and risk of cancer from CT examinations. Radiol Phys Technol 2024; 17:176-185. [PMID: 38048023 DOI: 10.1007/s12194-023-00763-w] [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: 08/17/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023]
Abstract
Computed tomography (CT) examinations have been increasingly requested and become the major sources of patient exposure. The cancer risk from CT scans is contingent upon the amount of absorbed dose of organs. This study aims to determine the organ doses and risk of cancer incidence and mortality from CT examinations at high dose (cumulative effective dose, CED ≥ 100 mSv) in a single day to low dose (CED < 100 mSv) from common CT procedures. Data were gathered from two academic centers of patients aged 15 to 75 years old performed CT examinations during the period of 5 years. CED and organ dose were calculated using Monte Carlo simulation software. Lifetime attributable risk (LAR) was determined following Biological Effects of Ionizing Radiation (BEIR) VII report based on life table and baseline cancer rates of Thai population. At high dose, the highest LAR for breast cancer incidence in young female was 82 per 100,000 exposed patients with breast dose of 148 mGy (CT whole abdomen). The highest LAR for liver cancer incidence in male patient was 72 per 100,000 with liver dose of 133 mGy (multiple CT scans). At low dose, the highest average LAR for breast cancer incidence in young female was 23 per 100,000 while for liver cancer incidence in male patients was 22 per 100,000 (CTA whole aorta). Even though the LAR of cancer incidence and mortality was less than 100 per 100,000, they should not be neglected. The risk of cancer incidence may be increased in later life, particularly in young patients.
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Affiliation(s)
- Saowapark Poosiri
- Medical Physics Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
| | - Anchali Krisanachinda
- Medical Physics Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand
- Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kitiwat Khamwan
- Medical Physics Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand
- Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Broadley L, Erskine B, Marshall E, Ewert K, Picker B. Optimising image quality in intravenous cerebral cone beam computed tomography. J Med Radiat Sci 2024; 71:26-34. [PMID: 37847044 PMCID: PMC10920929 DOI: 10.1002/jmrs.735] [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: 05/31/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION The efficacy of intravenous cerebral Cone Beam Computed Tomography (IV CBCT) is well established; however, image quality has only ever been authenticated by subjective evaluation. The aim of this study was to quantify the factors pertinent to achieving consistent and optimal image quality when performing IV CBCT. METHODS Between 1 March 2021 and 30 October 2022, 79 patients received IV CBCT. These candidates were divided into three main acquisition field size categories (22/32, 42 and 48 cm) according to the clinical indication. The images were analysed using both a quantitative assessment and a subjective evaluation. Here, a comparison of Hounsfield units (HUs), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and noise index was conducted for each study and compared relative to the acquisition field size. The subjective analysis was performed in a non-blinded fashion where the diagnostic value (DV) of the exam was determined according to a graded scale. A phantom analysis for each of the acquisition field sizes was conducted and modulation transfer function (MTF) graphed. RESULTS Significantly higher HU, SNR, CNR and lower noise indices were achieved with the 42-cm protocol than the 22/32 and 48-cm protocols. Here a greater DV was also reported. The MTF demonstrates marginally improved spatial resolution for the 22-cm protocol, but this is near equivocal for the 32-, 42 and 48-cm protocols. CONCLUSION The use of larger acquisition field sizes provides improved image quality when performing IV CBCT as an alternative to intra-arterial (IA) CBCT.
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Affiliation(s)
| | | | | | - Kyle Ewert
- Alfred HospitalMelbourneVictoriaAustralia
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14
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Ylimaula S, Räsänen L, Hurskainen M, Peuna A, Julkunen P, Nieminen MT, Hanni M. X-ray scatter in projection radiography. RADIATION PROTECTION DOSIMETRY 2024; 200:120-129. [PMID: 37939724 PMCID: PMC10875324 DOI: 10.1093/rpd/ncad275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/23/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023]
Abstract
Projection radiography is the most common radiological modality, and radiation safety of it concerns both radiation workers and the public. We measured and generated a series of scattered radiation maps for projection radiography and estimated effective doses of the supporting person during exposure. Measured adult patient protocols included chest posterior-anterior, chest lateral, pelvis anterior-posterior (AP), abdomen AP and bedside chest AP. Maps concretise spatial distribution and the scattered radiation dose rates in different imaging protocols. Highest and lowest rates were measured in abdomen AP and bedside chest AP protocols, respectively. The effective dose of supporting person in abdomen AP examination at distance of 0.5 m was 300 nSv and in bedside supine chest AP examination at distance of 0.7 m was 0.5 nSv. The estimated annual effective dose of emergency unit radiographer was 0.11 mSv. The obtained effective dose values are small compared to annual dose limits of radiation workers and the public.
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Affiliation(s)
- Satu Ylimaula
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, 90220 Oulu, Finland
| | - Lasse Räsänen
- Department of Diagnostic Radiology, Oulu University Hospital, 90220 Oulu, Finland
- Terveystalo Healthcare, 00100 Helsinki, Finland
| | - Miia Hurskainen
- Department of Technical Physics, University of Eastern Finland—Kuopio Campus, 70210 Kuopio, Finland
| | - Arttu Peuna
- Department of Diagnostic Services, Hospital Nova of Central Finland, Wellbeing Services County of Central Finland, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Petro Julkunen
- Department of Technical Physics, University of Eastern Finland—Kuopio Campus, 70210 Kuopio, Finland
- Department of Clinical Neurophysiology, Kuopio University Hospital, 70200 Kuopio, Finland
| | - Miika Tapio Nieminen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, 90220 Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Matti Hanni
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, 90220 Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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Lee S, Kim HY, Lee KH, Cho J, Lee C, Kim KP, Hwang J, Park JH. Risk of hematologic malignant neoplasms from head CT radiation in children and adolescents presenting with minor head trauma: a nationwide population-based cohort study. Eur Radiol 2024:10.1007/s00330-024-10646-2. [PMID: 38358528 DOI: 10.1007/s00330-024-10646-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/06/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES The carcinogenic risks of CT radiation in children and adolescents remain debated. We aimed to assess the carcinogenic risk of CTs performed in children and adolescents with minor head trauma. METHODS In this nationwide population-based cohort study, we included 2,411,715 patients of age 0-19 with minor head trauma from 2009 to 2017. We excluded patients with elevated cancer risks or substantial past medical radiation exposure. Patients were categorized into CT-exposed or CT-unexposed group according to claim codes for head CT. The primary outcome was development of hematologic malignant neoplasms. Secondary outcomes included development of malignant solid neoplasms and benign neoplasms in the brain. We measured the incidence rate ratio (IRR) and incidence rate difference (IRD) using G-computation with Poisson regression adjusting for age, sex, hospital setting, and the type of head trauma. RESULTS Hematologic malignant neoplasms developed in 100 of 216,826 patients during 1,303,680 person-years in the CT-exposed group and in 808 of 2,194,889 patients during 13,501,227 person-years in the CT-unexposed group. For hematologic malignant neoplasms, the IRR was 1.29 (95% CI, 1.03-1.60) and the IRD was 1.71 (95% CI, 0.04-3.37) per 100,000 person-years at risk. The majority of excess hematologic malignant neoplasms were leukemia (IRR, 1.40 [98.3% CI, 1.05-1.87]; IRD, 1.59 [98.3% CI, 0.02-3.16] per 100,000 person-years at risk). There were no between-group differences for secondary outcomes. CONCLUSIONS Radiation exposure from head CTs in children and adolescents with minor head trauma was associated with an increased incidence of hematologic malignant neoplasms. CLINICAL RELEVANCE STATEMENT Our study provides a quantitative grasp of the risk conferred by CT examinations in children and adolescents, thereby providing the basis for cost-benefit analyses and evidence-driven guidelines for patient triaging in head trauma. KEY POINTS • This nationwide population-based cohort study showed that radiation exposure from head CTs in children and adolescents was associated with a higher incidence of hematologic malignant neoplasms. • The incidence rate of hematologic malignant neoplasms in the CT-exposed group was 29% higher than that in the CT-unexposed group (IRR, 1.29 [95% CI, 1.03-1.60]), and there were approximately 1.7 excess neoplasms per 100,000 person-years at risk in the CT-exposed group (IRD, 1.71 [0.04-3.37]). • Our study provides a quantified grasp of the risk conferred by CT examinations in children and adolescents, while controlling for biases observed in previous studies via specifying CT indication and excluding patients with predisposing conditions for cancer development.
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Affiliation(s)
- Seungjae Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, South Korea
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Hae Young Kim
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Kyung Hee Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, South Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, 13620, Gyeonggi-Do, South Korea
| | - Jungheum Cho
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, South Korea
| | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kwang Pyo Kim
- Department of Nuclear Engineering, Kyung Hee University, Seoul, Gyeonggi-Do, South Korea
| | - Jinhee Hwang
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, South Korea
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Ji Hoon Park
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, South Korea.
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, 13620, Gyeonggi-Do, South Korea.
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.
- Department of Medical Device Development, Seoul National University College of Medicine, Seoul, South Korea.
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16
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Wang D, Zhou Q, Yin Y, Lu D, Hu L, Richmond RH, Moon HB, Yan B, Jiang G. Implications of Fukushima's Radioactive Water Discharge on Global Environmental Sustainability. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024. [PMID: 38330250 DOI: 10.1021/acs.est.4c00955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Affiliation(s)
- Dingyi Wang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Yongguang Yin
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Dawei Lu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Ligang Hu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Robert H Richmond
- Kewalo Marine Laboratory, University of Hawaii at Manoa, Honolulu, Hawaii 96813, United States
| | - Hyo-Bang Moon
- Department of Marine Science and Convergence Engineering, Hanyang University ERICA, Ansan 15588, Republic of Korea
| | - Bing Yan
- Institute of Environmental Research at the Greater Bay Area, Key Laboratory for Water Quality and Conservation of the Pearl River Delta, Ministry of Education, Guangzhou University, Guangzhou 510006, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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Park J, Lee HJ, Han YK, Kang K, Yi JM. Identification of DNA methylation biomarkers for evaluating cardiovascular disease risk from epigenome profiles altered by low-dose ionizing radiation. Clin Epigenetics 2024; 16:19. [PMID: 38303056 PMCID: PMC10835887 DOI: 10.1186/s13148-024-01630-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Environmental exposure, medical diagnostic and therapeutic applications, and industrial utilization of radionuclides have prompted a growing focus on the risks associated with low-dose radiation (< 100 mGy). Current evidence suggests that such radiation can induce epigenetic changes. Nevertheless, whether exposure to low-dose radiation can disrupt endothelial cell function at the molecular level is unclear. Because endothelial cells play crucial roles in cardiovascular health and disease, we aimed to investigate whether low-dose radiation could lead to differential DNA methylation patterns at the genomic level in endothelial cell (EC) lines. METHODS We screened for changes in DNA methylation patterns in primary human aortic (HAECs) and coronary artery endothelial cells following exposure to low-dose ionizing radiation. Using a subset of genes altered via DNA methylation by low-dose irradiation, we performed gene ontology (GO) analysis to predict the possible biological network mediating the effect of low-dose radiation. In addition, we performed comprehensive validation using methylation and gene expression analyses, and ChIP assay to identify useful biomarkers among candidate genes for use in detecting low-dose radiation exposure in human primary normal ECs. RESULTS Low-dose radiation is sufficient to induce global DNA methylation alterations in normal EC lines. GO analysis demonstrated that these hyper- or hypo-methylated genes were linked to diverse biological pathways. Our findings indicated a robust correlation between promoter hypermethylation and transcriptional downregulation of four genes (PGRMC1, UNC119B, RERE, and FNDC3B) in response to low-dose ionizing radiation in HAECs. CONCLUSIONS Based on these findings, the identified genes can serve as potential DNA methylation biomarkers for the assessment of cardiovascular risk upon exposure to low-dose radiation.
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Affiliation(s)
- Jihye Park
- Department of Microbiology, Dankook University, Cheonan, 31116, South Korea
| | - Hae-June Lee
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, South Korea
| | - Yu Kyeong Han
- Department of Microbiology and Immunology, College of Medicine, Inje University, Busan, 47392, South Korea
| | - Keunsoo Kang
- Department of Microbiology, Dankook University, Cheonan, 31116, South Korea
| | - Joo Mi Yi
- Department of Microbiology and Immunology, College of Medicine, Inje University, Busan, 47392, South Korea.
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Xiang Y, Yuan Z, Deng Q, Xie L, Yu D, Shi J. Potential therapeutic medicines for renal fibrosis: Small-molecule compounds and natural products. Bioorg Chem 2024; 143:106999. [PMID: 38035515 DOI: 10.1016/j.bioorg.2023.106999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023]
Abstract
Renal fibrosis is the pathological change process of chronic kidney disease deteriorating continuously. When the renal organ is stimulated by external stimuli, it will trigger the damage and phenotypic changes of some intrinsic cells in the kidney. When the body's autoimmune regulation or external treatment is not prompted enough to restore the organ, the pathological process is gradually aggravating, inducing a large amount of intracellular collagen deposition, which leads to the appearance of fibrosis and scarring. The renal parenchyma (including glomeruli and tubules) begins to harden, making it difficult to repair the kidney lesions. In the process of gradual changes in the kidney tissue, the kidney units are severely damaged and the kidney function shows a progressive decline, eventually resulting in the clinical manifestation of end-stage renal failure, namely uremia. This review provides a brief description of the diagnosis, pathogenesis, and potential therapeutic inhibitors of renal fibrosis. Since renal fibrosis has not yet had a clear therapeutic target and related drugs, some potential targets and relevant inhibitors are discussed, especially pharmacological effects and interactions with targets. Some existing natural products have potential efficacy for renal fibrosis, which is also roughly summarized, hoping that this article would have reference significance for the treatment of renal fibrosis.
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Affiliation(s)
- Yu Xiang
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Zhuo Yuan
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Qichuan Deng
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Linshen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
| | - Dongke Yu
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
| | - Jianyou Shi
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
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Shao W, Lin X, Yi Y, Huang Y, Qu L, Zhuo W, Liu H. Fast prediction of patient-specific organ doses in brain CT scans using support vector regression algorithm. Phys Med Biol 2024; 69:025010. [PMID: 38086079 DOI: 10.1088/1361-6560/ad14c7] [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: 08/31/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024]
Abstract
Objectives. This study aims to develop a method for predicting patient-specific head organ doses by training a support vector regression (SVR) model based on radiomics features and graphics processing unit (GPU)-calculated reference doses.Methods. In this study, 237 patients who underwent brain CT scans were selected, and their CT data were transferred to an autosegmentation software to segment head regions of interest (ROIs). Subsequently, radiomics features were extracted from the CT data and ROIs, and the benchmark organ doses were computed using fast GPU-accelerated Monte Carlo (MC) simulations. The SVR organ dose prediction model was then trained using the radiomics features and benchmark doses. For the predicted organ doses, the relative root mean squared error (RRMSE), mean absolute percentage error (MAPE), and coefficient of determination (R2) were evaluated. The robustness of organ dose prediction was verified by changing the patient samples on the training and test sets randomly.Results. For all head organs, the maximal difference between the reference and predicted dose was less than 1 mGy. For the brain, the organ dose was predicted with an absolute error of 1.3%, and theR2reached up to 0.88. For the eyes and lens, the organ doses predicted by SVR achieved an RRMSE of less than 13%, the MAPE ranged from 4.5% to 5.5%, and theR2values were more than 0.7.Conclusions. Patient-specific head organ doses from CT examinations can be predicted within one second with high accuracy, speed, and robustness by training an SVR using radiomics features.
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Affiliation(s)
- Wencheng Shao
- Institute of Radiation Medicine, Fudan University, Shanghai, People's Republic of China
| | - Xin Lin
- Institute of Radiation Medicine, Fudan University, Shanghai, People's Republic of China
| | - Yanling Yi
- Institute of Radiation Medicine, Fudan University, Shanghai, People's Republic of China
| | - Ying Huang
- Department of Nuclear Science and Technology, Institute of Modern Physics, Fudan University, Shanghai, People's Republic of China
- Key Lab of Nucl. Phys. & Ion-Beam Appl. (MOE), Fudan University, Shanghai, People's Republic of China
- Department of Radiation Oncology, Shanghai Jiao Tong University Chest Hospital Shanghai, People's Republic of China
| | - Liangyong Qu
- Department of Radiology, Shanghai Zhongye Hospital, Shanghai, People's Republic of China
| | - Weihai Zhuo
- Institute of Radiation Medicine, Fudan University, Shanghai, People's Republic of China
| | - Haikuan Liu
- Institute of Radiation Medicine, Fudan University, Shanghai, People's Republic of China
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Plasencia Martínez JM, García Santos JM. Implementing strategies to reduce the number of urgent low-value cranial CT for non-trauma reasons-where do we start fighting the hydra? Eur Radiol 2024:10.1007/s00330-023-10556-9. [PMID: 38172443 DOI: 10.1007/s00330-023-10556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Juana María Plasencia Martínez
- Department of Radiology, Servicio de Radiología, Hospital General Universitario Morales Meseguer, 1ª Planta, Avenida Marqués de los Vélez, S/N 30008, Murcia, Spain.
| | - José María García Santos
- Department of Radiology, Servicio de Radiología, Hospital General Universitario Morales Meseguer, 1ª Planta, Avenida Marqués de los Vélez, S/N 30008, Murcia, Spain
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Hasan MS, Ganni E, Liu A, Guo L, Mackie AS, Kaufman JS, Marelli AJ. CanCHD Study of Hematopoietic Cancers in Children With and Without Genetic Syndromes. J Am Heart Assoc 2024; 13:e026604. [PMID: 38156460 PMCID: PMC10863797 DOI: 10.1161/jaha.122.026604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/23/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Individuals with genetic syndromes can manifest both congenital heart disease (CHD) and cancer attributable to possible common underlying pathways. To date, reliable risk estimates of hematopoietic cancer (HC) among children with CHD based on large population-based data remain scant. This study sought to quantify the risk of HC by the presence of genetic syndrome among children with CHD. METHODS AND RESULTS Data sources were the Canadian CHD database, a nationwide database on CHD (1999-2017), and the CCR (Canadian Cancer Registry). Standardized incidence ratios were calculated for comparing HC incidences in children with CHD with the general pediatric population. A modified Kaplan-Meier curve was used to estimate the cumulative incidence of HC with death as a competing risk. A total of 143 794 children (aged 0-17 years) with CHD were followed up from birth to age 18 years for 1 314 603 person-years. Of them, 8.6% had genetic syndromes, and 898 HC cases were observed. Children with known syndromes had a substantially higher risk of incident HC than the general pediatric population (standardized incidence ratio, 13.4 [95% CI, 11.7-15.1]). The cumulative incidence of HC was 2.44% (95% CI, 2.11-2.76) among children with a syndrome and 0.79% (95% CI, 0.72-0.87) among children without a syndrome. Acute myeloid leukemia had a higher cumulative incidence during early childhood than acute lymphoblastic leukemia. CONCLUSIONS This is the first large population-based analysis documenting that known genetic syndromes in children with CHD are a significant predictor of HC. The finding could be essential in informing risk-stratified policy recommendations for cancer surveillance in children with CHD.
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Affiliation(s)
- Mohammad Sazzad Hasan
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealQuebecCanada
| | - Elie Ganni
- McGill Adult Unit for Congenital Heart Disease ExcellenceMcGill University Health CentreMontrealQuebecCanada
| | - Aihua Liu
- McGill Adult Unit for Congenital Heart Disease ExcellenceMcGill University Health CentreMontrealQuebecCanada
| | - Liming Guo
- McGill Adult Unit for Congenital Heart Disease ExcellenceMcGill University Health CentreMontrealQuebecCanada
| | - Andrew S. Mackie
- Division of Cardiology, Stollery Children’s Hospital and Department of PediatricsUniversity of AlbertaEdmontonAlbertaCanada
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealQuebecCanada
| | - Ariane J. Marelli
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealQuebecCanada
- McGill Adult Unit for Congenital Heart Disease ExcellenceMcGill University Health CentreMontrealQuebecCanada
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Heo SJ, Jee YS. Intensity-effects of strengthening exercise on thigh muscle volume, pro- or anti-inflammatory cytokines, and immunocytes in the older adults: A randomized controlled trial. Arch Gerontol Geriatr 2024; 116:105136. [PMID: 37541052 DOI: 10.1016/j.archger.2023.105136] [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: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND This study investigated the intensity-effects of strength training on thigh muscle mass, cytokines, and immunocytes in the older adults. MATERIALS AND METHODS A total of 81 participated in this study. Participants were assigned randomly to four groups: control group (CON), low- (LSE), moderate- (MSE), and high-intensity strength exercise (HSE) groups. Three exercise groups worked out for 50 min/day, 3 days/week for 12 weeks. RESULTS In the thigh volume analyzed by computed tomography, the exercise groups showed a significant increase in the muscle mass, with a clear pattern of change observed in the groups who exercised with moderate to high intensity. The lowest levels of interleukin (IL)-6 in the MSE group (-20.94%) and tumor necrosis factor-α in the HSE group (-28.75%) were observed. Notably, IL-10 showed a significant increase (35.72%) only in the MSE group. In the CON group, natural killer (NK) cells showed a decrease, while in the exercise groups, their levels increased. The highest levels of NK cells were observed in the HSE group. Similar patterns of change were observed in CD4 T cells and CD19 B cells. CD3 and CD8 T cells exhibited significant increases in the MSE and HSE groups. CONCLUSIONS This study presents evidence that engaging in moderate to high-intensity exercise may have a positive impact on cytokines and immunocytes by increasing muscle mass in older adults who may have sarcopenia. SIMPLE SUMMARY Engaging in strength training exercises is considered crucial for maintaining the health of older individuals who are susceptible to sarcopenia. When resistance exercises are performed at a moderate to strenuous intensity, it is anticipated that positive changes can occur in cytokines and immunocytes. These changes can be observed through improvements in thigh muscle volumes as measured by computed tomography.
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Affiliation(s)
- Seung-Jae Heo
- Department of Physical Education, Chungnam National University, Daehak-ro, Yuseong-gu, Daejeon, 34134, Korea
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, #1 Hanseo-ro, Haemi-myeon, Seosan, 31962, Korea.
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Wang L, Rivas R, Wilson A, Park YM, Walls S, Yu T, Miller AC. Dose-Dependent Effects of Radiation on Mitochondrial Morphology and Clonogenic Cell Survival in Human Microvascular Endothelial Cells. Cells 2023; 13:39. [PMID: 38201243 PMCID: PMC10778067 DOI: 10.3390/cells13010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
To better understand radiation-induced organ dysfunction at both high and low doses, it is critical to understand how endothelial cells (ECs) respond to radiation. The impact of irradiation (IR) on ECs varies depending on the dose administered. High doses can directly damage ECs, leading to EC impairment. In contrast, the effects of low doses on ECs are subtle but more complex. Low doses in this study refer to radiation exposure levels that are below those that cause immediate and necrotic damage. Mitochondria are the primary cellular components affected by IR, and this study explored their role in determining the effect of radiation on microvascular endothelial cells. Human dermal microvascular ECs (HMEC-1) were exposed to varying IR doses ranging from 0.1 Gy to 8 Gy (~0.4 Gy/min) in the AFRRI 60-Cobalt facility. Results indicated that high doses led to a dose-dependent reduction in cell survival, which can be attributed to factors such as DNA damage, oxidative stress, cell senescence, and mitochondrial dysfunction. However, low doses induced a small but significant increase in cell survival, and this was achieved without detectable DNA damage, oxidative stress, cell senescence, or mitochondrial dysfunction in HMEC-1. Moreover, the mitochondrial morphology was assessed, revealing that all doses increased the percentage of elongated mitochondria, with low doses (0.25 Gy and 0.5 Gy) having a greater effect than high doses. However, only high doses caused an increase in mitochondrial fragmentation/swelling. The study further revealed that low doses induced mitochondrial elongation, likely via an increase in mitochondrial fusion protein 1 (Mfn1), while high doses caused mitochondrial fragmentation via a decrease in optic atrophy protein 1 (Opa1). In conclusion, the study suggests, for the first time, that changes in mitochondrial morphology are likely involved in the mechanism for the radiation dose-dependent effect on the survival of microvascular endothelial cells. This research, by delineating the specific mechanisms through which radiation affects endothelial cells, offers invaluable insights into the potential impact of radiation exposure on cardiovascular health.
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Affiliation(s)
- Li Wang
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20889, USA; (L.W.); (R.R.); (A.W.); (S.W.)
- Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD 20889, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (Y.M.P.); (T.Y.)
| | - Rafael Rivas
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20889, USA; (L.W.); (R.R.); (A.W.); (S.W.)
| | - Angelo Wilson
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20889, USA; (L.W.); (R.R.); (A.W.); (S.W.)
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (Y.M.P.); (T.Y.)
| | - Yu Min Park
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (Y.M.P.); (T.Y.)
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Shannon Walls
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20889, USA; (L.W.); (R.R.); (A.W.); (S.W.)
| | - Tianzheng Yu
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (Y.M.P.); (T.Y.)
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Alexandra C. Miller
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20889, USA; (L.W.); (R.R.); (A.W.); (S.W.)
- Department of Radiation Science and Radiology, Uniformed Services University Health Sciences, Bethesda, MD 20889, USA
- Columbia University Irving Medical Center, Columbia University, New York, NY 10032, USA
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Ocampo Ramos JC, Carter LM, Brown JL, Marquis H, Uribe CF, Zanzonico PB, Bolch WE, Kesner AL. The risk index as a basis for risk/benefit analyses and protocol optimization in diagnostic nuclear imaging. Med Phys 2023; 50:7390-7399. [PMID: 37656137 DOI: 10.1002/mp.16696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/24/2023] [Accepted: 08/11/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Potential risk associated with low-dose radiation exposures is often expressed using the effective dose (E) quantity. Other risk-related quantities have been proposed as alternatives. The recently introduced risk index (RI) shares similarities with E but expands the metric to incorporate medical imaging-appropriate risks factors including patient-specific size, age, and sex. PURPOSE The aim of this work is to examine the RI metric for quantifying stochastic radiation risk and demonstrate its applications in nuclear imaging. The advantages in this improved metric may help the field progress toward stratified risk consideration in the course of patient management, improve efforts for procedure optimization, and support an evolution in the science of radiation risk assessment. METHODS In this study we describe, implement, and calculate RI for various diagnostic nuclear imaging scenarios using reference biokinetics published in ICRP Publication 128 for commonly utilized radiopharmaceuticals. All absorbed dose, E and RI calculations were performed using the freely available MIRDcalc nuclear medicine dosimetry software; the organ specific risk parameters used in the software are also benchmarked in this text. The resulting RI and E values are compared and various trends in RI values identified. RESULTS E and RI coefficients were calculated for 3016 use cases. Notably RI values vary depending on patient characteristics. Overall, across the population, global trends in RI values can be identified. In general, RI values were 2.15 times higher for females than males, due to higher risk coefficients and activities being distributed in smaller reference masses. The pediatric patients showed higher RIs than adults, as younger patients generally receive higher absorbed doses per administered activity, and are more radiosensitive, and have a longer projected lifespan at risk. A compendium of E and RI values is also provided in table format to serve as a reference for the community. CONCLUSIONS RI is a rational quantity that could be used for justification, risk communication and protocol optimization in medical imaging. It has some advantages when compared to the long-utilized E value with respect to personalization, since accounts for patient size, age, sex, and natural incidence of cancer risk.
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Affiliation(s)
- Juan C Ocampo Ramos
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lukas M Carter
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Justin L Brown
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA
| | - Harry Marquis
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carlos F Uribe
- Functional Imaging Department, BC Cancer, Vancouver, British Columbia, Canada
| | - Pat B Zanzonico
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Wesley E Bolch
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Adam L Kesner
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Izquierdo-Condoy JS, Simbaña-Rivera K, Nati-Castillo HA, Cassa Macedo A, Cardozo Espínola CD, Vidal Barazorda GM, Palazuelos-Guzmán I, Trejo García B, Carrington SJ, Ortiz-Prado E. How much do Latin American medical students know about radiology? Latin-American multicenter cross-sectional study. MEDICAL EDUCATION ONLINE 2023; 28:2173044. [PMID: 36722612 PMCID: PMC9897776 DOI: 10.1080/10872981.2023.2173044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/10/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Radiology is a useful tool for diagnosis and intervention in medical practice, and all the components within the teaching-learning process of this subject during undergraduate studies influence successful knowledge application. OBJECTIVE This study aimed to describe the level of knowledge in radiology of students in the last two years of medical school and curricular characteristics of their courses in seven Latin American countries. METHODS A multicenter cross-sectional study was carried out on medical students of 7 Latin American countries (Bolivia, Brazil, Colombia, Ecuador, Mexico, Paraguay, and Peru) in their final two years of medical school, using an online questionnaire validated by experts and adapted for each country that assessed knowledge and curricular characteristics in radiology subject. Scores were assigned according to the number of correct answers for the knowledge test. The T-test, and regression analysis with one-way ANOVA were used to search for relationships between the level of knowledge and other variables. RESULTS A total of 1514 medical students participated in this study. All countries had similar participation (n > 200); most participants were women 57.8%. The country with the highest knowledge score was Brazil. Male, sixth year (internship) and from public universities students had higher knowledge score (n < 0.05). Participants, who considered radiology more important, and who reported higher compliance with teaching staff with the proposed syllabus, and programmed classes, obtained better scores (n < 0.05). CONCLUSIONS Latin American medical students included in this study have a regular overall level of knowledge of Radiology, apparently influenced by curricular differences such as class and academic program compliance. Efforts to better understand and improve academic training are indispensable. LIMITATIONS The study was subject to selection bias determined by non-probability convenience sampling. The questionnaire assessed only theoretical knowledge and the evaluation system was designed by the investigators.
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Affiliation(s)
- Juan S. Izquierdo-Condoy
- OneHealth Global Research Group, Universidad de las Américas, Quito, Ecuador
- Health Management and Research Area, Universidad Internacional Iberoamericana, Arecibo, Puerto Rico
| | | | | | - Arthur Cassa Macedo
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
- Faculdade de Medicina, Universidades Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | | | | | - Brayan Trejo García
- Facultad de Medicina, Universidad Autónoma del Estado de México, Ciudad de México, México
| | | | - Esteban Ortiz-Prado
- OneHealth Global Research Group, Universidad de las Américas, Quito, Ecuador
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26
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Sohrabi M. Modern universal standardised trends in worker and public exposure monitoring and control in 21st century by Sohrabi URPS-based hypothesis. RADIATION PROTECTION DOSIMETRY 2023; 199:2160-2168. [PMID: 37934989 DOI: 10.1093/rpd/ncad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/12/2022] [Accepted: 01/12/2023] [Indexed: 11/09/2023]
Abstract
The Universal Radiation Protection System (URPS) was recently hypothesised by Sohrabi in order to address the many deficiencies of current radiation protection system. The ICRP system is currently practiced worldwide based on the linear no-threshold (LNT) model with no supporting health risk data at low effective doses. The ICRP only considers worker occupational doses and sets dose limits only on one portion of doses a worker or public receives. The URPS hypothesis equals human heath-effect risks per unit dose either from natural or man-made sources; formulates dose limits on all integrated doses an individual receives; considers worker also a member of public; conserves 'cause-effect principle' for epidemiology risk estimation; introduces dose fractionation concept in radiation protection; introduces the 'URPS Model' for bridging LNT, hormesis and threshold models; recommends establishing 'National Patient Dose Registering System'; and defines modified/new exposure terms and definitions commensurate with URPS hypothesis, as advanced since 2014.
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Affiliation(s)
- M Sohrabi
- Health Physics and Dosimetry Research Laboratory, Department of Energy Engineering and Physics, Amirkabir University of Technology, Tehran 1591634311, Iran
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27
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Zhao J, Liu Z, Ren Q, Nie G, Zhao D. Measurement of Hounsfield units on proximal femur computed tomography for predicting regional osteoporosis. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:90-97. [PMID: 37603067 DOI: 10.1007/s00117-023-01190-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/15/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE This study was designed to investigate the use of proximal femoral Hounsfield units (HU) in conventional abdominal and pelvic computed tomography (CT) to predict hip osteoporosis by coupling with data from quantitative CT (QCT). METHODS In this study, 315 patients who underwent routine abdominal and pelvic CT with the proximal femur included in the scanning range were also subjected to QCT of the proximal femur. Pearson correlation test was performed to analyze the correlations of the femoral head, femoral neck, proximal femur, and femoral trochanter CT HU with the femoral neck, femoral trochanter, and intertrochanteric femur bone mineral density (BMD) values from QCT. The diagnostic performance of CT HU measurement of the proximal femur for osteoporosis was analyzed using receiver operating characteristic (ROC) curves. RESULTS The CT HU of the proximal femur showed the highest correlation with the BMD value of the hip (r = 0.826; p < 0.01). The mean CT HU of the proximal femur differed significantly (all p < 0.01) for the three QCT-defined BMD categories of osteoporosis (192.23 HU vs. 188.71), of osteopenia (247.86 HU vs. 248.36 HU), and of normal individuals (308.13 HU vs. 310.41 HU) in left and right sides, respectively. In the ROC curve analysis, the area under the ROC curve values to predict osteoporosis in the left and right proximal femurs were 0.942 and 0.941, respectively. CONCLUSION The CT HU of the proximal femur was significantly associated with the BMD value of the hip measured by QCT. The CT HU of the proximal femur is highly effective in diagnosing osteoporosis and could be used for hip osteoporosis screening.
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Affiliation(s)
- Junlu Zhao
- Department of Radiology, The First Hospital of Hebei Medical University, 050031, Shijiazhuang, Hebei Province, China
| | - Zhai Liu
- Department of Radiology, The First Hospital of Hebei Medical University, 050031, Shijiazhuang, Hebei Province, China
| | - Qingyun Ren
- Department of Radiology, The First Hospital of Hebei Medical University, 050031, Shijiazhuang, Hebei Province, China.
| | - Guanwei Nie
- Operating room, The First Hospital Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Deyuan Zhao
- Department of Radiology, The First Hospital of Hebei Medical University, 050031, Shijiazhuang, Hebei Province, China
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Sioen S, Vanhove O, Vanderstraeten B, De Wagter C, Engelbrecht M, Vandevoorde C, De Kock E, Van Goethem MJ, Vral A, Baeyens A. Impact of proton therapy on the DNA damage induction and repair in hematopoietic stem and progenitor cells. Sci Rep 2023; 13:16995. [PMID: 37813904 PMCID: PMC10562436 DOI: 10.1038/s41598-023-42362-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/08/2023] [Indexed: 10/11/2023] Open
Abstract
Proton therapy is of great interest to pediatric cancer patients because of its optimal depth dose distribution. In view of healthy tissue damage and the increased risk of secondary cancers, we investigated DNA damage induction and repair of radiosensitive hematopoietic stem and progenitor cells (HSPCs) exposed to therapeutic proton and photon irradiation due to their role in radiation-induced leukemia. Human CD34+ HSPCs were exposed to 6 MV X-rays, mid- and distal spread-out Bragg peak (SOBP) protons at doses ranging from 0.5 to 2 Gy. Persistent chromosomal damage was assessed with the micronucleus assay, while DNA damage induction and repair were analyzed with the γ-H2AX foci assay. No differences were found in induction and disappearance of γ-H2AX foci between 6 MV X-rays, mid- and distal SOBP protons at 1 Gy. A significantly higher number of micronuclei was found for distal SOBP protons compared to 6 MV X-rays and mid- SOBP protons at 0.5 and 1 Gy, while no significant differences in micronuclei were found at 2 Gy. In HSPCs, mid-SOBP protons are as damaging as conventional X-rays. Distal SOBP protons showed a higher number of micronuclei in HSPCs depending on the radiation dose, indicating possible changes of the in vivo biological response.
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Affiliation(s)
- Simon Sioen
- Radiobiology, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Oniecha Vanhove
- Radiobiology, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Barbara Vanderstraeten
- Medical Physics, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent, Belgium
- Department of Radiotherapy-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Carlos De Wagter
- Medical Physics, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent, Belgium
- Department of Radiotherapy-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Monique Engelbrecht
- Separated Sector Cyclotron Laboratory, Radiation Biophysics Division, iThemba LABS (NRF), Cape Town, 7131, South Africa
| | - Charlot Vandevoorde
- Separated Sector Cyclotron Laboratory, Radiation Biophysics Division, iThemba LABS (NRF), Cape Town, 7131, South Africa
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Evan De Kock
- Separated Sector Cyclotron Laboratory, Radiation Biophysics Division, iThemba LABS (NRF), Cape Town, 7131, South Africa
| | - Marc-Jan Van Goethem
- Department of Radiation Oncology and Particle Therapy Research Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anne Vral
- Radiobiology, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Ans Baeyens
- Radiobiology, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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Nguyen MT, Kim SA, Cheng YY, Hong SH, Jin YS, Han NS. A qPCR Method to Assay Endonuclease Activity of Cas9-sgRNA Ribonucleoprotein Complexes. J Microbiol Biotechnol 2023; 33:1228-1237. [PMID: 37415091 PMCID: PMC10580886 DOI: 10.4014/jmb.2305.05010] [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: 05/10/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023]
Abstract
The CRISPR-Cas system has emerged as the most efficient genome editing technique for a wide range of cells. Delivery of the Cas9-sgRNA ribonucleoprotein complex (Cas9 RNP) has gained popularity. The objective of this study was to develop a quantitative polymerase chain reaction (qPCR)-based assay to quantify the double-strand break reaction mediated by Cas9 RNP. To accomplish this, the dextransucrase gene (dsr) from Leuconostoc citreum was selected as the target DNA. The Cas9 protein was produced using recombinant Escherichia coli BL21, and two sgRNAs were synthesized through in vitro transcription to facilitate binding with the dsr gene. Under optimized in vitro conditions, the 2.6 kb dsr DNA was specifically cleaved into 1.1 and 1.5 kb fragments by both Cas9-sgRNA365 and Cas9-sgRNA433. By monitoring changes in dsr concentration using qPCR, the endonuclease activities of the two Cas9 RNPs were measured, and their efficiencies were compared. Specifically, the specific activities of dsr365RNP and dsr433RNP were 28.74 and 34.48 (unit/μg RNP), respectively. The versatility of this method was also verified using different target genes, uracil phosphoribosyl transferase (upp) gene, of Bifidobacterium bifidum and specific sgRNAs. The assay method was also utilized to determine the impact of high electrical field on Cas9 RNP activity during an efficient electroporation process. Overall, the results demonstrated that the qPCR-based method is an effective tool for measuring the endonuclease activity of Cas9 RNP.
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Affiliation(s)
- Minh Tri Nguyen
- Brain Korea 21 Center for Bio-Health Industry, Division of Animal, Horticultural, and Food Science, Chungbuk National University, Cheongju 28644, Republic of Korea
- Faculty of Biology, Dalat University, 01- Phu Dong Thien Vuong, Dalat, Vietnam
| | - Seul-Ah Kim
- Brain Korea 21 Center for Bio-Health Industry, Division of Animal, Horticultural, and Food Science, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Ya-Yun Cheng
- Brain Korea 21 Center for Bio-Health Industry, Division of Animal, Horticultural, and Food Science, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Sung Hoon Hong
- Brain Korea 21 Center for Bio-Health Industry, Division of Animal, Horticultural, and Food Science, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Yong-Su Jin
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Nam Soo Han
- Brain Korea 21 Center for Bio-Health Industry, Division of Animal, Horticultural, and Food Science, Chungbuk National University, Cheongju 28644, Republic of Korea
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Hosseini Khameneh SM, Amani-Beni R, Ahadiat SA, Kahrizi MS, Jafari S, Seyedinnavade S, Rafie Manzelat AM, Mashatan N, Beheshtiparvar D, Moghadam Fard A, Lotfi H, Arhami H, Barati R, Hasanvand R, Boorboor S, Khodaei E, Dadashzadehasl D, Zamani F, Khorram R, Ebrahimpour M, Abdollahi Z, Shabani M, Latifi N, Vafadar R, Shah Hosseini S, Khodashenas M, Kazemi SM, Minaei Noshahr R, Ghayyem H, Farahani A, Saeidi D, Jadidi S, Goodarzy B, Farrokhi M. Diagnostic Accuracy of Ultrasonography for Identification of Elbow Fractures in Children; a Systematic Review and Meta-analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2023; 11:e62. [PMID: 37840871 PMCID: PMC10568949 DOI: 10.22037/aaem.v11i1.2078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Introduction In spite of the results of previous studies regarding the benefits of ultrasonography for diagnosis of elbow fractures in children, the exact accuracy of this imaging modality is still under debate. Therefore, in this diagnostic systematic review and meta-analysis, we aimed to investigate the accuracy of ultrasonography in this regard. Methods Two independent reviewers performed systematic search in Web of Science, Embase, PubMed, Cochrane, and Scopus for studies published from inception of these databases to May 2023. Quality assessment of the included studies was performed using Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). Meta-Disc software version 1.4 and Stata statistical software package version 17.0 were used for statistical analysis. Results A total of 648 studies with 1000 patients were included in the meta-analysis. The pooled sensitivity and specificity were 0.95 (95% CI: 0.93-0.97) and 0.87 (95% CI: 0.84-0.90), respectively. Pooled positive likelihood ratio (PLR) was 6.71 (95% CI: 3.86-11.67), negative likelihood ratio (NLR) was 0.09 (95% CI: 0.03-0.22), and pooled diagnostic odds ratio (DOR) of ultrasonography in detection of elbow fracture in children was 89.85 (95% CI: 31.56-255.8). The area under the summary receiver operating characteristic (ROC) curve for accuracy of ultrasonography in this regard was 0.93. Egger's and Begg's analyses showed that there is no significant publication bias (P=0.11 and P=0.29, respectively). Conclusion Our meta-analysis revealed that ultrasonography is a relatively promising diagnostic imaging modality for identification of elbow fractures in children. However, clinicians employing ultrasonography for diagnosis of elbow fractures should be aware that studies included in this meta-analysis had limitations regarding methodological quality and are subject to risk of bias. Future high-quality studies with standardization of ultrasonography examination protocol are required to thoroughly validate ultrasonography for elbow fractures.
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Affiliation(s)
- Seyed Mehdi Hosseini Khameneh
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University ofMedical Sciences, Tehran, Iran
| | - Reza Amani-Beni
- School ofMedicine, Isfahan University ofMedical Sciences, Isfahan, Iran
| | - Seyed-Amirabbas Ahadiat
- Department of Bimolecular and Biomedicine, University of Girona, Passeig Ave, Salt-Girona, 17190, Girona, Spain
| | | | - Sina Jafari
- Department of Prosthodontics, School of Dentistry, Iran University ofMedical Sciences, Tehran, Iran
| | | | | | - Noushin Mashatan
- Accident and Emergency Department, Southend Hospital NHS Trust,Westcliff-on-sea, United Kingdom
| | | | | | - Hamed Lotfi
- Department ofMedical Sciences, Faculty ofMedicine, Birjand University ofMedical Sciences, Birjand, Iran
| | | | - Reza Barati
- School ofMedicine, Iran University ofMedical Sciences, Tehran, Iran
| | | | | | - Elaheh Khodaei
- School ofMedicine, Tehran University ofMedical Sciences, Tehran, Iran
| | | | - Fatemeh Zamani
- Student Research Committee,Mazandaran University ofMedical Sciences, Sari, Iran
| | | | | | - Zeynab Abdollahi
- Department of Radiology, School ofMedicine, Ahvaz Jundishapur University ofMedical Sciences, Ahvaz, Iran
| | | | | | | | | | | | - Seyyed Morteza Kazemi
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University ofMedical Sciences, Tehran, Iran
| | - Reza Minaei Noshahr
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University ofMedical Sciences, Tehran, Iran
| | - Hani Ghayyem
- School ofMedicine, Shahid Beheshti University ofMedical Sciences, Tehran, Iran
| | | | - Diba Saeidi
- Students Research Committee, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University ofMedical Sciences, Isfahan, Iran
| | - Sajedeh Jadidi
- Urology and Nephrology Research Center, Department of Urology, Shahid LabbafinejadMedical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Goodarzy
- School ofMedicine, Iran University ofMedical Sciences, Tehran, Iran
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Yin H, Gao Y, Chen W, Tang C, Zhu Z, Li K, Xia S, Han C, Ding X, Ruan F, Tian H, Zhu C, Xie S, Zuo Z, Liao L, He C. Topically applied fullerenols protect against radiation dermatitis by scavenging reactive oxygen species. DISCOVER NANO 2023; 18:101. [PMID: 37581715 PMCID: PMC10427596 DOI: 10.1186/s11671-023-03869-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/04/2023] [Indexed: 08/16/2023]
Abstract
Adverse skin reactions caused by ionizing radiation are collectively called radiation dermatitis (RD), and the use of nanomedicine is an attractive approach to this condition. Therefore, we designed and large-scale synthesized fullerenols that showed free radical scavenging ability in vitro. Next, we pretreated X-ray-exposed cells with fullerenols. The results showed that pretreatment with fullerenols significantly scavenged intracellular reactive oxygen species (ROS) produced and enhanced the antioxidant capacity, protecting skin cells from X-ray-induced DNA damage and apoptosis. Moreover, we induced RD in mice by applying 30 Gy of X-ray irradiation, followed by treatment with fullerenols. We found that after treatment, the RD scores dropped, and the histological results systematically demonstrated that topically applied fullerenols could reduce radiation-induced skin epidermal thickening, collagen deposition and skin appendage damage and promote hair regeneration after 35 days. Compared with Trolamine cream, a typical RD drug, fullerenols showed superior radiation protection. Overall, the in vitro and in vivo experiments proved that fullerenols agents against RD.
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Grants
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
- Nos. XDHT2020407A and 20213160A0471 Xiamen Funano New Materials Technology Co., Ltd.
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Affiliation(s)
- Hanying Yin
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - You Gao
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Weiguang Chen
- School of Medicine and School of Biomedical Sciences, Huaqiao University, Xiamen, Fujian, China
| | - Chen Tang
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Zihan Zhu
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Kun Li
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Siyu Xia
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Changshun Han
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Xiaoyan Ding
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Fengkai Ruan
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Hanrui Tian
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, 361005, China
| | - Changfeng Zhu
- Xiamen Funano New Materials Technology Co., Ltd., Xiamen, China
| | - Suyuan Xie
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, 361005, China
| | - Zhenghong Zuo
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China
| | - Lixin Liao
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China.
| | - Chengyong He
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Faculty of Medicine and Life Sciences, The Plastic and Aesthetic Burn Department, The First Affiliated Hospital, Xiamen University, Xiamen, People's Republic of China.
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Averbeck D. Low-Dose Non-Targeted Effects and Mitochondrial Control. Int J Mol Sci 2023; 24:11460. [PMID: 37511215 PMCID: PMC10380638 DOI: 10.3390/ijms241411460] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Non-targeted effects (NTE) have been generally regarded as a low-dose ionizing radiation (IR) phenomenon. Recently, regarding long distant abscopal effects have also been observed at high doses of IR) relevant to antitumor radiation therapy. IR is inducing NTE involving intracellular and extracellular signaling, which may lead to short-ranging bystander effects and distant long-ranging extracellular signaling abscopal effects. Internal and "spontaneous" cellular stress is mostly due to metabolic oxidative stress involving mitochondrial energy production (ATP) through oxidative phosphorylation and/or anaerobic pathways accompanied by the leakage of O2- and other radicals from mitochondria during normal or increased cellular energy requirements or to mitochondrial dysfunction. Among external stressors, ionizing radiation (IR) has been shown to very rapidly perturb mitochondrial functions, leading to increased energy supply demands and to ROS/NOS production. Depending on the dose, this affects all types of cell constituents, including DNA, RNA, amino acids, proteins, and membranes, perturbing normal inner cell organization and function, and forcing cells to reorganize the intracellular metabolism and the network of organelles. The reorganization implies intracellular cytoplasmic-nuclear shuttling of important proteins, activation of autophagy, and mitophagy, as well as induction of cell cycle arrest, DNA repair, apoptosis, and senescence. It also includes reprogramming of mitochondrial metabolism as well as genetic and epigenetic control of the expression of genes and proteins in order to ensure cell and tissue survival. At low doses of IR, directly irradiated cells may already exert non-targeted effects (NTE) involving the release of molecular mediators, such as radicals, cytokines, DNA fragments, small RNAs, and proteins (sometimes in the form of extracellular vehicles or exosomes), which can induce damage of unirradiated neighboring bystander or distant (abscopal) cells as well as immune responses. Such non-targeted effects (NTE) are contributing to low-dose phenomena, such as hormesis, adaptive responses, low-dose hypersensitivity, and genomic instability, and they are also promoting suppression and/or activation of immune cells. All of these are parts of the main defense systems of cells and tissues, including IR-induced innate and adaptive immune responses. The present review is focused on the prominent role of mitochondria in these processes, which are determinants of cell survival and anti-tumor RT.
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Affiliation(s)
- Dietrich Averbeck
- Laboratory of Cellular and Molecular Radiobiology, PRISME, UMR CNRS 5822/IN2P3, IP2I, Lyon-Sud Medical School, University Lyon 1, 69921 Oullins, France
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Najjar R. Radiology's Ionising Radiation Paradox: Weighing the Indispensable Against the Detrimental in Medical Imaging. Cureus 2023; 15:e41623. [PMID: 37435015 PMCID: PMC10331516 DOI: 10.7759/cureus.41623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 07/13/2023] Open
Abstract
Ionising radiation stands as an indispensable protagonist in the narrative of medical imaging, underpinning diagnostic evaluations and therapeutic interventions across an array of medical conditions. However, this protagonist poses a paradox - its inestimable service to medicine coexists with an undercurrent of potential health risks, primarily DNA damage and subsequent oncogenesis. The narrative of this comprehensive review unfurls around this intricate enigma, delicately balancing the indispensable diagnostic utility against the non-negotiable commitment to patient safety. In this critical discourse, the intricacies of ionising radiation are dissected, illuminating not only its sources but also the associated biological and health hazards. The exploration delves into the labyrinth of strategies currently deployed to minimise exposure and safeguard patients. By casting light on the scientific nuances of X-rays, computed tomography (CT), and nuclear medicine, it traverses the complex terrain of radiation use in radiology, to promote safer medical imaging practices, and to facilitate an ongoing dialogue about diagnostic necessity and risk. Through a rigorous examination, the pivotal relationship between radiation dose and dose response is elucidated, unravelling the mechanisms of radiation injury and distinguishing between deterministic and stochastic effects. Moreover, protection strategies are illuminated, demystifying concepts such as justification, optimisation, the As Low As Reasonably Achievable (ALARA) principle, dose and diagnostic reference levels, along with administrative and regulatory approaches. With an eye on the horizon, promising avenues of future research are discussed. These encompass low-radiation imaging techniques, long-term risk assessment in large patient cohorts, and the transformative potential of artificial intelligence in dose optimisation. This exploration of the nuanced complexities of radiation use in radiology aims to foster a collaborative impetus towards safer medical imaging practices. It underscores the need for an ongoing dialogue around diagnostic necessity and risk, thereby advocating for a continual reassessment in the narrative of medical imaging.
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Affiliation(s)
- Reabal Najjar
- Medical Imaging, Canberra Hospital, Australian Capital Territory (ACT) Health, Canberra, AUS
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Chen Y, Gutierrez V, Morris L, Marti JL. Diagnostic Scrutiny and Patterns of Elevated Cancer Risk: Uncovering Overdiagnosis Through Standardized Incidence Ratios. Cureus 2023; 15:e42439. [PMID: 37637595 PMCID: PMC10447997 DOI: 10.7759/cureus.42439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Certain medical diagnoses and environmental or occupational exposures may be associated with elevated risk of cancer diagnosis, either through causal mechanisms or via increased detection of a subclinical reservoir through increased diagnostic scrutiny (overdiagnosis). The present study aimed to investigate the distribution of elevated cancer risks associated with different diagnoses and exposures. A systematic literature search was conducted to identify studies published in the last 30 years that examined the standardized incidence ratio (SIR) associated with exposures and risk factors. Meta-SIRs for each cancer type were calculated. The distribution of elevated cancer risks was then compared between cancer types previously reported to be susceptible to overdiagnosis and those that have not been associated with overdiagnosis. The review of 108 studies identified four patterns: SIR generally elevated for 1) only overdiagnosis-susceptible cancer types, 2) both overdiagnosed and non-overdiagnosed cancer types, 3) select cancers in accordance with risk factor or exposure, and 4) SIRs that did not exhibit a distinct increase in any cancer type. The distribution of elevated cancer risks may serve as a signature of whether the underlying risk factor or exposure is a carcinogenic process or a mechanism of increased diagnostic scrutiny uncovering clinically occult diseases. The identification of increased cancer risk should be viewed with caution, and analyzing the pattern of elevated cancer risk distribution can potentially reveal conditions that appear to be cancer risk factors but are in fact the result of exposure to medical surveillance or other healthcare activities that lead to the detection of indolent tumors.
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Affiliation(s)
- Yunchan Chen
- Department of Surgery, Weill Cornell Medicine, New York, USA
| | | | - Luc Morris
- Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Jennifer L Marti
- Division of Breast Surgical Oncology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, USA
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Laurier D, Billarand Y, Klokov D, Leuraud K. The scientific basis for the use of the linear no-threshold (LNT) model at low doses and dose rates in radiological protection. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:024003. [PMID: 37339605 DOI: 10.1088/1361-6498/acdfd7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/20/2023] [Indexed: 06/22/2023]
Abstract
The linear no-threshold (LNT) model was introduced into the radiological protection system about 60 years ago, but this model and its use in radiation protection are still debated today. This article presents an overview of results on effects of exposure to low linear-energy-transfer radiation in radiobiology and epidemiology accumulated over the last decade and discusses their impact on the use of the LNT model in the assessment of radiation-related cancer risks at low doses. The knowledge acquired over the past 10 years, both in radiobiology and epidemiology, has reinforced scientific knowledge about cancer risks at low doses. In radiobiology, although certain mechanisms do not support linearity, the early stages of carcinogenesis comprised of mutational events, which are assumed to play a key role in carcinogenesis, show linear responses to doses from as low as 10 mGy. The impact of non-mutational mechanisms on the risk of radiation-related cancer at low doses is currently difficult to assess. In epidemiology, the results show excess cancer risks at dose levels of 100 mGy or less. While some recent results indicate non-linear dose relationships for some cancers, overall, the LNT model does not substantially overestimate the risks at low doses. Recent results, in radiobiology or in epidemiology, suggest that a dose threshold, if any, could not be greater than a few tens of mGy. The scientific knowledge currently available does not contradict the use of the LNT model for the assessment of radiation-related cancer risks within the radiological protection system, and no other dose-risk relationship seems more appropriate for radiological protection purposes.
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Affiliation(s)
- Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Yann Billarand
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Dmitry Klokov
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Klervi Leuraud
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
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Koarashi J, Atarashi-Andoh M, Nishimura S. Effect of soil organic matter on the fate of 137Cs vertical distribution in forest soils. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115177. [PMID: 37354569 DOI: 10.1016/j.ecoenv.2023.115177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023]
Abstract
Understanding the fate of the vertical distribution of radiocesium (137Cs) in Japanese forest soils is key to assessing the radioecological consequences of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. The 137Cs behavior in mineral soil is known to be primarily governed by interaction with clay minerals; however, some observations suggest the role of soil organic matter (SOM) in enhancing the mobility of 137Cs. Here we hypothesized that soil organic carbon (SOC) concentration profile determines the ultimate vertical pattern of 137Cs distribution in Japanese forest soils. In testing this hypothesis, we obtained soil samples that were collected before the FDNPP accident at four forest sites with varying SOC concentration profiles and quantified the detailed vertical profile of 137Cs inventory in the soils roughly half a century after global fallout in the early 1960 s. Results showed that the higher the SOC concentration in the soil profile, the deeper the 137Cs downward penetration. On the basis of the data for surface soils (0-10 cm), the 137Cs retention ratio for each of the 2-cm thick layers was evaluated as the ratio of 137Cs inventory in the target soil layer to the total 137Cs inventory in and below the soil layer. A negative correlation was found between the ratio and SOC concentration of the layer across all soils and depths. This indicates that the ultimate fate of 137Cs vertical distribution can be predicted as a function of SOC concentration for Japanese forest soils, and provides further evidence for SOM effects on the mobility and bioavailability of 137Cs in soils.
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Affiliation(s)
- Jun Koarashi
- Nuclear Science and Engineering Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan.
| | - Mariko Atarashi-Andoh
- Nuclear Science and Engineering Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
| | - Syusaku Nishimura
- Nuclear Science and Engineering Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan; Nuclear Fuel Cycle Engineering Laboratories, Japan Atomic Energy Agency, Ibaraki 319-1194, Japan
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Chai W, Kong Y, Escalona MB, Hu C, Balajee AS, Huang Y. Evaluation of Low-dose Radiation-induced DNA Damage and Repair in 3D Printed Human Cellular Constructs. HEALTH PHYSICS 2023; Publish Ahead of Print:00004032-990000000-00091. [PMID: 37294952 DOI: 10.1097/hp.0000000000001709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
ABSTRACT DNA double-strand breaks (DSBs) induced by ionizing radiation (IR) are considered to be the most critical lesion that when unrepaired or misrepaired leads to genomic instability or cell death depending on the radiation exposure dose. The potential health risks associated with exposures of low-dose radiation are of concern since they are being increasingly used in diverse medical and non-medical applications. Here, we have used a novel human tissue-like 3-dimensional bioprint to evaluate low-dose radiation-induced DNA damage response. For the generation of 3-dimensional tissue-like constructs, human hTERT immortalized foreskin fibroblast BJ1 cells were extrusion printed and further enzymatically gelled in a gellan microgel-based support bath. Low-dose radiation-induced DSBs and repair were analyzed in the tissue-like bioprints by indirect immunofluorescence using a well-known DSB surrogate marker, 53BP1, at different post-irradiation times (0.5 h, 6 h, and 24 h) after treatment with various doses of γ rays (50 mGy, 100 mGy, and 200 mGy). The 53BP1 foci showed a dose dependent induction in the tissue bioprints after 30 min of radiation exposure and subsequently declined at 6 h and 24 h in a dose-dependent manner. The residual 53BP1 foci number observed at 24 h post-irradiation time for the γ-ray doses of 50 mGy, 100 mGy, and 200 mGy was not statistically different from mock treated bioprints illustrative of an efficient DNA repair response at these low-dose exposures. Similar results were obtained for yet another DSB surrogate marker, γ-H2AX (phosphorylated form of histone H2A variant) in the human tissue-like constructs. Although we have primarily used foreskin fibroblasts, our bioprinting approach-mimicking a human tissue-like microenvironment-can be extended to different organ-specific cell types for evaluating the radio-response at low-dose and dose-rates of IR.
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Affiliation(s)
- Wenxuan Chai
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611
| | - Yunfan Kong
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611
| | - Maria B Escalona
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Center/Training Site, Oak Ridge Associated Universities, 1299 Bethel Valley Road, Oak Ridge, TN 37830
| | - Chunshan Hu
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611
| | - Adayabalam S Balajee
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Center/Training Site, Oak Ridge Associated Universities, 1299 Bethel Valley Road, Oak Ridge, TN 37830
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Spadafora M, Sannino P, Mansi L, Mainolfi C, Capasso R, Di Giorgio E, Fiordoro S, Imbimbo S, Masone F, Evangelista L. Algorithm for Reducing Overall Biological Detriment Caused by PET/CT: an Age-Based Study. Nucl Med Mol Imaging 2023; 57:137-144. [PMID: 37181801 PMCID: PMC10172419 DOI: 10.1007/s13139-023-00788-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/16/2023] [Accepted: 01/28/2023] [Indexed: 02/09/2023] Open
Abstract
Purpose This study is to use a simple algorithm based on patient's age to reduce the overall biological detriment associated with PET/CT. Materials and Methods A total of 421 consecutive patients (mean age 64 ± 14 years) undergoing PET for various clinical indications were enrolled. For each scan, effective dose (ED in mSv) and additional cancer risk (ACR) were computed both in a reference condition (REF) and after applying an original algorithm (ALGO). The ALGO modified the mean dose of FDG and the PET scan time parameters; indeed, a lower dose and a longer scan time were reported in the younger, while a higher dose and a shorter scan time in the older patients. Moreover, patients were classified by age bracket (18-29, 30-60, and 61-90 years). Results The ED was 4.57 ± 0.92 mSv in the REF condition. The ACR were 0.020 ± 0.016 and 0.0187 ± 0.013, respectively, in REF and ALGO. The ACR for the REF and ALGO conditions were significantly reduced in males and females, although it was more evident in the latter gender (all p < 0.0001). Finally, the ACR significantly reduced from the REF condition to ALGO in all three age brackets (all p < 0.0001). Conclusion Implementation of ALGO protocols in PET can reduce the overall ACR, mainly in young and female patients.
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Affiliation(s)
| | | | - Luigi Mansi
- CIRPS, Interuniversity Research Center for Sustainability, Rome, Italy
- IOS–Medicina Futura, Acerra, Naples, Italy
| | - Ciro Mainolfi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | | | | | | | | | - Laura Evangelista
- Nuclear Medicine Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128 Padua, Italy
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Zhao L, Tang A, Long F, Mi D, Sun Y. Modeling of ionizing radiation-induced chromosome aberration and tumor prevalence based on two classes of DNA double-strand breaks clustering in chromatin domains. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 259:115038. [PMID: 37229870 DOI: 10.1016/j.ecoenv.2023.115038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/24/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
There has been some controversy over the use of radiobiological models when modeling the dose-response curves of ionizing radiation (IR)-induced chromosome aberration and tumor prevalence, as those curves usually show obvious non-targeted effects (NTEs) at low doses of high linear energy transfer (LET) radiation. The lack of understanding the contribution of NTEs to IR-induced carcinogenesis can lead to distinct deviations of relative biological effectiveness (RBE) estimations of carcinogenic potential, which are widely used in radiation risk assessment and radiation protection. In this work, based on the initial pattern of two classes of IR-induced DNA double-strand breaks (DSBs) clustering in chromatin domains and the subsequent incorrect repair processes, we proposed a novel radiobiological model to describe the dose-response curves of two carcinogenic-related endpoints within the same theoretical framework. The representative experimental data was used to verify the consistency and validity of the present model. The fitting results indicated that, compared with targeted effect (TE) and NTE models, the current model has better fitting ability when dealing with the experimental data of chromosome aberration and tumor prevalence induced by multiple types of IR with different LETs. Notably, the present model without introducing an NTE term was adequate to describe the dose-response curves of IR-induced chromosome aberration and tumor prevalence with NTEs in low-dose regions. Based on the fitting parameters, the LET-dependent RBE values were calculated for three given low doses. Our results showed that the RBE values predicted by the current model gradually decrease with the increase of doses for the endpoints of chromosome aberration and tumor prevalence. In addition, the calculated RBE was also compared with those evaluated from other models. These analyses show that the proposed model can be used as an alternative tool to well describe dose-response curves of multiple carcinogenic-related endpoints and effectively estimate RBE in low-dose regions.
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Affiliation(s)
- Lei Zhao
- Institute of Environmental Systems Biology, College of Environmental Science and Engineering, Dalian Maritime University, Dalian 116026, Liaoning, China.
| | - Aiping Tang
- College of Science, Dalian Maritime University, Dalian 116026, Liaoning, China
| | - Fei Long
- Institute of Environmental Systems Biology, College of Environmental Science and Engineering, Dalian Maritime University, Dalian 116026, Liaoning, China
| | - Dong Mi
- College of Science, Dalian Maritime University, Dalian 116026, Liaoning, China.
| | - Yeqing Sun
- Institute of Environmental Systems Biology, College of Environmental Science and Engineering, Dalian Maritime University, Dalian 116026, Liaoning, China.
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Anderson AB, Rivera JA, Mullin EP, Harrington CJ, Potter BK, Forsberg JA, Tintle SM. Is the Lifetime Malignancy Risk in United States Military Personnel Sustaining Combat-related Trauma Increased Because of Radiation Exposure From Diagnostic Imaging? Clin Orthop Relat Res 2023; 481:1040-1046. [PMID: 36480057 PMCID: PMC10097560 DOI: 10.1097/corr.0000000000002488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/17/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients with complex polytrauma in the military and civilian settings are often exposed to substantial diagnostic medical radiation because of serial imaging studies for injury diagnosis and subsequent management. This cumulative radiation exposure may increase the risk of subsequent malignancy. This is particularly true for combat-injured servicemembers who receive care at a variety of facilities worldwide. Currently, there is no coordinated effort to track the amount of radiation exposure each servicemember receives, nor a surveillance program to follow such patients in the long term. It is important to assess whether military servicemembers are exposed to excessive diagnostic radiation to mitigate or prevent such occurrences and monitor for carcinogenesis, when necessary. The cumulative amount of radiation exposure for combat-wounded and noncombat-wounded servicemembers has not been described, and it remains unknown whether diagnostic radiation exposure meets thresholds for an increased risk of carcinogenesis. QUESTIONS/PURPOSES We performed this study to (1) quantify the amount of exposure for combat-wounded servicemembers based on medical imaging in the first year after injury and compare those exposures with noncombat-related trauma, and (2) determine whether the cumulative dose of radiation correlates to the Injury Severity Score (ISS) across the combat-wounded and noncombat-wounded population combined. METHODS We performed a retrospective study of servicemembers who sustained combat or noncombat trauma and were treated at Walter Reed National Military Medical Center from 2005 to 2018. We evaluated patients using the Department of Defense Trauma Registry. After consolidating redundant records, the dataset included 3812 unique servicemember encounters. Three percent (104 of 3812) were excluded because of missing radiation exposure data in the electronic medical record. The final cohort included 3708 servicemembers who had combat or noncombat injury trauma, with a mean age at the time of injury of 26 ± 6 years and a mean ISS of 18 ± 12. The most common combat trauma mechanisms of injury were blast (in 65% [2415 of 3708 patients]), followed by high-velocity gunshot wounds (in 22% [815 of 3708 patients]). We calculated the cumulative diagnostic radiation dose exposure at 1 year post-traumatic injury in patients with combat-related trauma and those with noncombat trauma. We did this by multiplying the number of imaging studies by the standardized effective radiation dose for each imaging study type. We then performed analysis of variance for four data subsets (battle combat trauma, nonbattle civilian trauma, high ISS, and high radiation exposure [> 50 mSv]) independently. To evaluate whether the total number of imaging studies, radiation exposure, and ISS values differed between battle-wounded and nonbattle-wounded patients, we performed a pairwise t-test. RESULTS The mean radiation exposure for combat-related injuries was 35 ± 26 mSv while the mean radiation exposure for noncombat-related injuries was 22 ± 33 mSv in the first year after injury. In the first year after trauma, 44% of patients (1626 of 3708) were exposed to high levels of radiation that were greater than 20 mSv, and 23% (840 of 3708) were exposed to very high levels of radiation that were greater than 50 mSv. Servicemembers with combat trauma-related injuries had eight more imaging studies than those who sustained noncombat injuries. Servicemembers with combat trauma injuries (35 ± 26 mSv) were exposed to more radiation (approximately 4 mSv) than patients treated for noncombat injuries (22 ± 33 mSv) (p = 0.01). We found that servicemembers with combat injuries had a higher ISS than servicemembers with noncombat trauma (p < 0.001). We found a positive correlation between radiation exposure and ISS for servicemembers. The positive relationship between radiation exposure and ISS held for combat trauma (r 2 = 0.24; p < 0.001), noncombat trauma (r 2 = 0.20; p < 0.001), servicemembers with a high ISS (r 2 = 0.10; p < 0.001), and servicemembers exposed to high doses of radiation (r 2 = 0.09; p < 0.001). CONCLUSION These data should be used during clinical decision-making and patient counseling at military treatment facilities and might provide guidance to the Defense Health Agency. These recommendations will help determine whether the benefits of further imaging outweigh the risk of carcinogenesis. If not, we need to develop interdisciplinary clinical practice guidelines to reduce or minimize radiation exposure. It is important for treating physicians to seriously weigh the risk and benefits of every imaging study ordered because each test does not come without a cumulative risk. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Ashley B. Anderson
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD, USA
- Department of Orthopaedic Surgery, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Julio A. Rivera
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Edmund P. Mullin
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, TX, USA
| | - Collin J. Harrington
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD, USA
| | - Benjamin K. Potter
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD, USA
| | - Jonathan A. Forsberg
- Department of Orthopaedic Surgery, Johns Hopkins University Hospital, Baltimore, MD, USA
| | - Scott M. Tintle
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Division of Orthopaedics, Department of Surgery, Walter Reed National Military Center, Bethesda, MD, USA
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Keenen TL, Demirel S, Gheen A, Casabarro B, Fleishman D. Intraoperative Fluoroscopy Radiation Using OEC 9900 Elite C-arm: Risk and Method for Decreasing Exposure. HEALTH PHYSICS 2023; 124:380-390. [PMID: 36880954 DOI: 10.1097/hp.0000000000001679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
ABSTRACT The use of intraoperative fluoroscopy in surgery produces scattered radiation that can expose all operating room personnel to measurable and, in some cases, substantial radiation doses. The goal of this work is to assess and document potential radiation doses to various staff positions in a simulated standard operating room environment. Adult-sized mannequins wearing standard lead protective aprons were placed at seven positions around large and small BMI cadavers. Doses were recorded in real time at thyroid level with Bluetooth-enabled dosimeters for a variety of fluoroscope settings and imaging views. A total of 320 images were acquired, resulting in 2,240 dosimeter readings from the seven mannequins. Doses were compared to cumulative air kerma (CAK) calculations provided by the fluoroscope. There was a strong correlation between the CAK and the recorded scattered radiation doses ( P < 0.001). Radiation doses could be reduced by manipulating C-arm manual technique settings [e.g., turning off the automatic exposure control (AEC) and using pulse (PULSE) or low dose (LD) settings]. Staff position and patient size also affected the recorded doses. The highest radiation doses were recorded across all settings for the mannequin positioned immediately adjacent to the C-arm x-ray tube. The larger BMI cadaver generated greater scattered radiation than the smaller BMI cadaver for all views and settings. This work provides suggestions for reducing exposure to operating room personnel beyond standard techniques of reducing beam-on time, increasing the distance from the radiation source, and use of shielding. Simple changes in C-arm settings (turning AEC off, avoiding DS setting, use of PULSE or LD settings) can markedly reduce dose to staff.
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Affiliation(s)
- Timothy L Keenen
- Oregon Health and Sciences University, Dept of Orthopedics and Rehabilitation, Portland, OR
| | | | | | - Benjamin Casabarro
- Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd., Indianapolis, IN 46202
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Wang YR(J, Qu L, Sheybani ND, Luo X, Wang J, Hawk KE, Theruvath AJ, Gatidis S, Xiao X, Pribnow A, Rubin D, Daldrup-Link HE. AI Transformers for Radiation Dose Reduction in Serial Whole-Body PET Scans. Radiol Artif Intell 2023; 5:e220246. [PMID: 37293349 PMCID: PMC10245181 DOI: 10.1148/ryai.220246] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/30/2023] [Accepted: 04/12/2023] [Indexed: 06/10/2023]
Abstract
Purpose To develop a deep learning approach that enables ultra-low-dose, 1% of the standard clinical dosage (3 MBq/kg), ultrafast whole-body PET reconstruction in cancer imaging. Materials and Methods In this Health Insurance Portability and Accountability Act-compliant study, serial fluorine 18-labeled fluorodeoxyglucose PET/MRI scans of pediatric patients with lymphoma were retrospectively collected from two cross-continental medical centers between July 2015 and March 2020. Global similarity between baseline and follow-up scans was used to develop Masked-LMCTrans, a longitudinal multimodality coattentional convolutional neural network (CNN) transformer that provides interaction and joint reasoning between serial PET/MRI scans from the same patient. Image quality of the reconstructed ultra-low-dose PET was evaluated in comparison with a simulated standard 1% PET image. The performance of Masked-LMCTrans was compared with that of CNNs with pure convolution operations (classic U-Net family), and the effect of different CNN encoders on feature representation was assessed. Statistical differences in the structural similarity index measure (SSIM), peak signal-to-noise ratio (PSNR), and visual information fidelity (VIF) were assessed by two-sample testing with the Wilcoxon signed rank t test. Results The study included 21 patients (mean age, 15 years ± 7 [SD]; 12 female) in the primary cohort and 10 patients (mean age, 13 years ± 4; six female) in the external test cohort. Masked-LMCTrans-reconstructed follow-up PET images demonstrated significantly less noise and more detailed structure compared with simulated 1% extremely ultra-low-dose PET images. SSIM, PSNR, and VIF were significantly higher for Masked-LMCTrans-reconstructed PET (P < .001), with improvements of 15.8%, 23.4%, and 186%, respectively. Conclusion Masked-LMCTrans achieved high image quality reconstruction of 1% low-dose whole-body PET images.Keywords: Pediatrics, PET, Convolutional Neural Network (CNN), Dose Reduction Supplemental material is available for this article. © RSNA, 2023.
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Kessara A, Buyukcizmeci N, Gedik GK. CANCER RISK ESTIMATION FOR PATIENTS UNDERGOING WHOLE-BODY PET/CT SCANS. RADIATION PROTECTION DOSIMETRY 2023; 199:509-518. [PMID: 36856709 DOI: 10.1093/rpd/ncad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 01/23/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
The objective of this paper was to compute the effective dose, as well as the lifetime attributable risk (LAR) of cancer related to whole-body positron emission tomography (PET)/computed tomography (CT) scan for 193 adult patients. The mean effective dose for all patients from a single PET/CT scan was 20.6 mSv. For males aged 40 y, a single PET/CT scan is associated with a LAR of cancer incidence of 0.169%. This risk increased to 0.85% if an annual surveillance protocol for 5 y was performed. For female patients aged 40 y, the LAR of cancer mortality increased from 0.126 to 0.63% if an annual surveillance protocol for 5 y was performed. Since PET/CT scans are associated with a high dose and a risk of developing cancer, it was important to balance the advantages and risks before conducting any scans. This is especially important for younger patients and those who are overweight.
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Affiliation(s)
- Aida Kessara
- Department of Physics, Institute of Science, University of Selcuk, 42130 Konya, Türkiye
| | | | - Gonca Kara Gedik
- Department of Nuclear Medicine, Medical Faculty, Selcuk University, 42131 Konya, Türkiye
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Wang YRJ, Wang P, Adams LC, Sheybani ND, Qu L, Sarrami AH, Theruvath AJ, Gatidis S, Ho T, Zhou Q, Pribnow A, Thakor AS, Rubin D, Daldrup-Link HE. Low-count whole-body PET/MRI restoration: an evaluation of dose reduction spectrum and five state-of-the-art artificial intelligence models. Eur J Nucl Med Mol Imaging 2023; 50:1337-1350. [PMID: 36633614 PMCID: PMC10387227 DOI: 10.1007/s00259-022-06097-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/24/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE To provide a holistic and complete comparison of the five most advanced AI models in the augmentation of low-dose 18F-FDG PET data over the entire dose reduction spectrum. METHODS In this multicenter study, five AI models were investigated for restoring low-count whole-body PET/MRI, covering convolutional benchmarks - U-Net, enhanced deep super-resolution network (EDSR), generative adversarial network (GAN) - and the most cutting-edge image reconstruction transformer models in computer vision to date - Swin transformer image restoration network (SwinIR) and EDSR-ViT (vision transformer). The models were evaluated against six groups of count levels representing the simulated 75%, 50%, 25%, 12.5%, 6.25%, and 1% (extremely ultra-low-count) of the clinical standard 3 MBq/kg 18F-FDG dose. The comparisons were performed upon two independent cohorts - (1) a primary cohort from Stanford University and (2) a cross-continental external validation cohort from Tübingen University - in order to ensure the findings are generalizable. A total of 476 original count and simulated low-count whole-body PET/MRI scans were incorporated into this analysis. RESULTS For low-count PET restoration on the primary cohort, the mean structural similarity index (SSIM) scores for dose 6.25% were 0.898 (95% CI, 0.887-0.910) for EDSR, 0.893 (0.881-0.905) for EDSR-ViT, 0.873 (0.859-0.887) for GAN, 0.885 (0.873-0.898) for U-Net, and 0.910 (0.900-0.920) for SwinIR. In continuation, SwinIR and U-Net's performances were also discreetly evaluated at each simulated radiotracer dose levels. Using the primary Stanford cohort, the mean diagnostic image quality (DIQ; 5-point Likert scale) scores of SwinIR restoration were 5 (SD, 0) for dose 75%, 4.50 (0.535) for dose 50%, 3.75 (0.463) for dose 25%, 3.25 (0.463) for dose 12.5%, 4 (0.926) for dose 6.25%, and 2.5 (0.534) for dose 1%. CONCLUSION Compared to low-count PET images, with near-to or nondiagnostic images at higher dose reduction levels (up to 6.25%), both SwinIR and U-Net significantly improve the diagnostic quality of PET images. A radiotracer dose reduction to 1% of the current clinical standard radiotracer dose is out of scope for current AI techniques.
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Affiliation(s)
- Yan-Ran Joyce Wang
- Department of Radiology, School of Medicine, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
- Department of Biomedical Data Science, Stanford University, Stanford, CA, 94304, USA.
| | - Pengcheng Wang
- Department of Electronic Engineering and Information Science, University of Science and Technology of China, Hefei, China
| | - Lisa Christine Adams
- Department of Radiology, School of Medicine, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA
| | - Natasha Diba Sheybani
- Department of Biomedical Data Science, Stanford University, Stanford, CA, 94304, USA
| | - Liangqiong Qu
- Department of Biomedical Data Science, Stanford University, Stanford, CA, 94304, USA
| | - Amir Hossein Sarrami
- Department of Radiology, School of Medicine, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA
| | - Ashok Joseph Theruvath
- Department of Radiology, School of Medicine, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA
| | - Sergios Gatidis
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Tina Ho
- Department of Radiology, School of Medicine, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA
| | - Quan Zhou
- Department of Radiology, School of Medicine, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA
| | - Allison Pribnow
- Department of Pediatrics, Pediatric Oncology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94304, USA
| | - Avnesh S Thakor
- Department of Pediatrics, Pediatric Oncology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94304, USA
| | - Daniel Rubin
- Department of Biomedical Data Science, Stanford University, Stanford, CA, 94304, USA
- Department of Pediatrics, Pediatric Oncology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94304, USA
| | - Heike E Daldrup-Link
- Department of Radiology, School of Medicine, Stanford University, 725 Welch Road, Stanford, CA, 94304, USA.
- Department of Pediatrics, Pediatric Oncology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94304, USA.
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Brandsæter IØ, Andersen ER, Hofmann BM, Kjelle E. Drivers for low-value imaging: a qualitative study of stakeholders' perspectives in Norway. BMC Health Serv Res 2023; 23:295. [PMID: 36978092 PMCID: PMC10044073 DOI: 10.1186/s12913-023-09328-4] [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: 10/25/2022] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND One kind of overutilization of diagnostic imaging is low-value imaging, i.e., imaging that does not lead to altered clinical pathways or improved health outcomes. Despite having well-documented extension and consequences, low-value imaging is still widespread. The objective of this study was to identify the drivers for the use of low-value imaging in the Norwegian healthcare services. METHODS We conducted individual, semi-structured interviews among representatives from the health authorities, general practitioners, specialists working in hospitals, radiologists, radiographers, and managers of imaging departments. Data analysis was carried out in line with framework analysis consisting of five steps: Familiarization, indexing, charting, mapping, and interpretation. RESULTS The analysis included 27 participants and resulted in two themes. The stakeholders identified drivers in the healthcare system and in the interaction between radiologists, referrers, and patients. The identified drivers were categorized in sub-themes, such as organization, communication, competence, expectations, defensive medicine, roles and responsibilities, and referral quality and time constraints. The drivers interact with each other and may strengthen the effect of other drivers. CONCLUSIONS Several drivers for low-value imaging in Norway were identified at all levels of the healthcare system. The drivers work simultaneously and synergistically. To free resources for high-value imaging, drivers should be targeted by appropriate measures at several levels to reduce low-value imaging.
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Affiliation(s)
- Ingrid Øfsti Brandsæter
- Department of Health Sciences Gjøvik, Norwegian University of Science and Technology (NTNU), NTNU Gjøvik, PB 191, 2802, Gjøvik, Norway.
| | - Eivind Richter Andersen
- Department of Health Sciences Gjøvik, Norwegian University of Science and Technology (NTNU), NTNU Gjøvik, PB 191, 2802, Gjøvik, Norway
| | - Bjørn Morten Hofmann
- Department of Health Sciences Gjøvik, Norwegian University of Science and Technology (NTNU), NTNU Gjøvik, PB 191, 2802, Gjøvik, Norway
- Centre for Medical Ethics, University of Oslo, Blindern, PB 1130, 0318, Oslo, Norway
| | - Elin Kjelle
- Department of Health Sciences Gjøvik, Norwegian University of Science and Technology (NTNU), NTNU Gjøvik, PB 191, 2802, Gjøvik, Norway
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Mainprize JG, Yaffe MJ, Chawla T, Glanc P. Effects of ionizing radiation exposure during pregnancy. Abdom Radiol (NY) 2023; 48:1564-1578. [PMID: 36933026 PMCID: PMC10024285 DOI: 10.1007/s00261-023-03861-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE To review the effects of ionizing radiation to the conceptus and the relationship to the timing of the exposure during pregnancy. To consider strategies that would mitigate potential harms associated with exposure to ionizing radiation during pregnancy. METHODS Data reported in the peer-reviewed literature on entrance KERMA received from specific radiological examinations were combined with published results from experiment or Monte Carlo modeling of tissue and organ doses per entrance KERMA to estimate total doses that could be received from specific procedures. Data reported in the peer-reviewed literature on dose mitigation strategies, best practices for shielding, consent, counseling and emerging technologies were reviewed. RESULTS For procedures utilizing ionizing radiation for which the conceptus is not included in the primary radiation beam, typical doses are well below the threshold for causing tissue reactions and the risk of induction of childhood cancer is low. For procedures that include the conceptus in the primary radiation field, longer fluoroscopic interventional procedures or multiphase/multiple exposures potentially could approach or exceed thresholds for tissue reactions and the risk of cancer induction must be weighed against the expected risk/benefit of performing (or not) the imaging examination. Gonadal shielding is no longer considered best practice. Emerging technologies such as whole-body DWI/MRI, dual-energy CT and ultralow dose studies are gaining importance for overall dose reduction strategies. CONCLUSION The ALARA principle, considering potential benefits and risks should be followed with respect to the use of ionizing radiation. Nevertheless, as Wieseler et al. (2010) state, "no examination should be withheld when an important clinical diagnosis is under consideration." Best practices require updates on current available technologies and guidelines.
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Affiliation(s)
- James G. Mainprize
- Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave., Rm S632/S657, Toronto, ON M4N 3M5 Canada
| | - Martin J. Yaffe
- Physical Sciences Platform, Sunnybrook Research Institute, 2075 Bayview Ave., Rm S632/S657, Toronto, ON M4N 3M5 Canada
- Departments of Medical Biophysics and Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave., Rm S657, Toronto, ON M4N 3M5 Canada
| | - Tanya Chawla
- Joint Department of Medical Imaging, Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON M5G 1X5 Canada
| | - Phyllis Glanc
- Departments Medical Imaging, Obstetrics & Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Rm MG 160, Toronto, ON M4N 3M5 Canada
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Paithankar JG, Gupta SC, Sharma A. Therapeutic potential of low dose ionizing radiation against cancer, dementia, and diabetes: evidences from epidemiological, clinical, and preclinical studies. Mol Biol Rep 2023; 50:2823-2834. [PMID: 36595119 PMCID: PMC9808703 DOI: 10.1007/s11033-022-08211-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2023]
Abstract
The growing use of ionizing radiation (IR)-based diagnostic and treatment methods has been linked to increasing chronic diseases among patients and healthcare professionals. However, multiple factors such as IR dose, dose-rate, and duration of exposure influence the IR-induced chronic effects. The predicted links between low-dose ionizing radiation (LDIR) and health risks are controversial due to the non-availability of direct human studies. The studies pertaining to LDIR effects have importance in public health as exposure to background LDIR is routine. It has been anticipated that data from epidemiological and clinical reports and results of preclinical studies can resolve this controversy and help to clarify the notion of LDIR-associated health risks. Accumulating scientific literature shows reduced cancer risk, cancer-related deaths, curtailed neuro-impairments, improved neural functions, and reduced diabetes-related complications after LDIR exposure. In addition, it was found to alter evolutionarily conserved stress response pathways. However, the picture of molecular signaling pathways in LDIR responses is unclear. Besides, there is limited/no information on biomarkers of epidemiological LDIR exposure. Therefore, the present review discusses epidemiological, clinical, and preclinical studies on LDIR-induced positive effects in three chronic diseases (cancer, dementia, and diabetes) and their associated molecular mechanisms. The knowledge of LDIR response mechanisms may help to devise LDIR-based therapeutic modalities to stop disease progression. Modulation of these pathways may be helpful in developing radiation resistance among humans. However, more clinical evidence with additional biochemical, cellular, and molecular data and exploring the side effects of LDIR are the major areas of future research.
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Affiliation(s)
- Jagdish Gopal Paithankar
- Nitte (Deemed to Be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Environmental Health and Toxicology, Kotekar-Beeri Road, Deralakatte, Mangaluru, 575018, India
| | - Subash Chandra Gupta
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, 221005, India. .,Department of Biochemistry, All India Institute of Medical Sciences, Guwahati, 781001, India.
| | - Anurag Sharma
- Nitte (Deemed to Be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Environmental Health and Toxicology, Kotekar-Beeri Road, Deralakatte, Mangaluru, 575018, India.
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Keller G, Grünwald L, Springer F. Ultra-low-dose CT is feasible for torsion measurement of the lower limb in patients with metal implants. Br J Radiol 2023; 96:20220495. [PMID: 36728237 PMCID: PMC10078873 DOI: 10.1259/bjr.20220495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Patients who need torsion measurement of the lower limb often have metal implants hindering e.g. MRI. A new ultra-low-dose (ULD-)CT protocol might be feasible for torsion measurement at cost of relatively low radiation exposure. METHODS We retrospectively included all patients with clinically indicated torsion measurement in the period July 2019 to June 2021 and metal implants in the scanning field. The ULD-CT protocol comprised automated tube current time product and automated tube voltage with reference settings of 100kV/20mAs (hip), 80kV/20mAs (knee) and 80kV/10mAs (ankle). Femoral neck anteversion, tibial, intra-articular knee and overall leg torsion measurements were performed by two radiologists independently. Diagnostic confidence regarding the delineation of the relevant cortical bone was rated on a 5-point Likert scale (1 = non-diagnostic, 5 = excellent). RESULTS 102 consecutive patients could be included (BMI 27.38 ± 5.85) with 154 metal implants. Median total dose length product of the ULD-CT-torsion measurement was 16.5mGycm [11-39]. Both readers showed high agreement with a maximum torsional difference of 4.1°. Diagnostic confidence was rated best (5/5) in 92.2% (reader 1) and 93.1% (reader 2) with a worst rating of 3/5. CONCLUSION The new ULD-CT protocol is feasible for torsion measurement of the lower limb - even in patients with metal implants. ADVANCES IN KNOWLEDGE Metal implants are not an obstacle for ULD-CT torsion measurements of the lower limb.
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Affiliation(s)
- Gabriel Keller
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str, Tübingen, Germany
| | - Leonard Grünwald
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Schnarrenberg-Str, Tübingen, Germany
| | - Fabian Springer
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str, Tübingen, Germany
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Synthesis and Characterization of Supermagnetic Nanocomposites Coated with Pluronic F127 as a Contrast Agent for Biomedical Applications. Pharmaceutics 2023; 15:pharmaceutics15030740. [PMID: 36986601 PMCID: PMC10053918 DOI: 10.3390/pharmaceutics15030740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/09/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Nanomedicine has garnered significant interest owing to advances in drug delivery, effectively demonstrated in the treatment of certain diseases. Here, smart supermagnetic nanocomposites based on iron oxide nanoparticles (MNPs) coated with Pluronic F127 (F127) were developed for the delivery of doxorubicin (DOX) to tumor tissues. The XRD patterns for all samples revealed peaks consistent with Fe3O4, as shown by their indices (220), (311), (400), (422), (511), and (440), demonstrating that the structure of Fe3O4 did not change after the coating process. After loading with DOX, the as-prepared smart nanocomposites demonstrated drug-loading efficiency and drug-loading capacity percentages of 45 ± 0.10 and 17 ± 0.58% for MNP-F127-2-DOX and 65 ± 0.12 and 13 ± 0.79% for MNP-F127-3-DOX, respectively. Moreover, a better DOX release rate was observed under acidic conditions, which may be credited to the pH sensitivity of the polymer. In vitro analysis demonstrated the survival rate of approximately 90% in HepG2 cells treated with PBS and MNP-F127-3 nanocomposites. Furthermore, after treatment with MNP-F127-3-DOX, the survival rate decreased, confirming cellular inhibition. Hence, the synthesized smart nanocomposites showed great promise for drug delivery in liver cancer treatment, overcoming the limitations of traditional therapies.
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The why, who, how, and what of communicating CT radiation risks to patients and healthcare providers. ABDOMINAL RADIOLOGY (NEW YORK) 2023; 48:1514-1525. [PMID: 36799998 DOI: 10.1007/s00261-022-03778-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 02/18/2023]
Abstract
Computed tomography (CT) has witnessed tremendous growth in utilization. Despite its immense benefits, there is a growing concern from the general public and the medical community about the detrimental consequences of ionizing radiation from CT. Anxiety from the perceived risks associated with CT can deter referring physicians from ordering clinically indicated CT scans and patients from undergoing medically necessary exams. This article discusses various strategies for educating patients and healthcare providers on the benefits and risks of CT scanning and salient techniques for effective communication.
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