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Abedi R, Ghaemian N, Monfared AS, Kiapour M, Abedi-Firouzjah R, Niksirat F, Agbele AT, Gorji KE. Can leaded glasses protect the eye lens in patients undergoing neck computed tomography? J Clin Transl Res 2021; 7:428-435. [PMID: 34667888 PMCID: PMC8520700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/07/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIMS Computed tomography (CT) is one of the main sources using ionizing radiation. Considering the toxicity from this radiation, any technique that could reduce the radiosensitive organs' doses without affecting the image diagnostic quality must be considered in routine practice. In this study, the amount of eye lens dose reduction in the presence of radioprotective glasses was evaluated in neck CT examinations. METHODS Thirty adult patients (15 men and 15 women) with a mean age of 44.6 years undergoing neck CT examination participated in this study. For each patient, six thermoluminescent dosimeters (TLDs-100) were attached above the eye lens glasses surface, and another six under the glasses to assess the radioprotective effect of the glasses. The TLDs were readout and converted to Hp (3) as an indicator of eye lens dose. The obtained results from the TLD readouts as eye lens dose were compared using a paired t-test. RESULTS The TLD measurements showed the mean±standard deviation values of 2.97±0.61 mGy and 1.04±0.16 mGy for TLDs above and under the radioprotective glasses, respectively. The radioprotective glasses significantly decreased the eye lens dose by about 64.9% (P=0.001). CONCLUSIONS Due to the results, wearing radioprotective glasses for patients during neck CT scans could significantly reduce the eye lens doses. RELEVANCE FOR PATIENTS The outcome of this research shows that leaded glasses can decrease the received dose significantly in patient during neck CT scans.
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Affiliation(s)
- Reza Abedi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Naser Ghaemian
- Department of Radiology and Radiotherapy, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Ali Shabestani Monfared
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Kiapour
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Razzagh Abedi-Firouzjah
- Department of Medical Physics Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Niksirat
- Department of Medical Physics Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Kourosh Ebrahimnejad Gorji
- Department of Medical Physics Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran
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Eddy FK, Ngano SO, Jervé FA, Serge A. Optimization of the scan length of head traumas on the pediatric and adult CT scan and proposition of a new acquisition limit. Sci Rep 2021; 11:10958. [PMID: 34040095 PMCID: PMC8155083 DOI: 10.1038/s41598-021-90529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 05/10/2021] [Indexed: 11/15/2022] Open
Abstract
To propose a new method of reducing the scan length of head trauma while keeping the diagnostic efficiency of the examination in order to develop DRL in an African context. This is a retrospective single-center study including 145 patients who had cranial examinations on a 64-barettes scanner. All head trauma cases were selected. The interpretations of these CT scanners by the three radiologists of the service were noted to determine the acquisition limit. All patient acquisition lengths have been recorded. The acquisition limit for head trauma ended in clinical routine at cervical spine 4 (C4). The average scan length was 23.03 cm. Out of the CT scan results for 145 patients, only 2 (1.37%) had a C3 level cervical spine fracture and 2 (1.37%) at C4. By respecting the principles of radiation protection, this result has shown us that it is possible to limit the acquisition length of the CT scanners indicated for head trauma. The limit of the optimized scan length that we proposed is at cervical spine 2 (98.62%). Now, all head trauma are limited on cervical vertebra 2 in our hospital. The use of this new method is beneficial when the clinical indication of the examination and the type of trauma (multi-trauma) are taken into account. Based on the principles of radiation protection and the clinical indication for the examination, reducing the scan length from C4 to C2 is an effective way to reduce the dose absorbed by the patient.
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Affiliation(s)
- Fotso Kamdem Eddy
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon.
| | - Samba Odette Ngano
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon
- Department of Radiography, Yaoundé General Hospital, Yaoundé, Cameroon
| | - Fotue Alain Jervé
- Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Abogo Serge
- Department of Radiology, National Social Insurance Fund Hospital, Yaoundé, Cameroon
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Lu H, Ye X, Zhang H, Sun S. STUDY ON A SPECIFIC TEST METHOD FOR DOSIMETRIC CHARACTERIZATION OF ULTRA-WIDE DETECTOR COMPUTED TOMOGRAPHY. RADIATION PROTECTION DOSIMETRY 2021; 193:55-65. [PMID: 33765138 DOI: 10.1093/rpd/ncab021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 01/09/2021] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to establish a specific test method for dosimetric characterization of wide-beam computed tomography (CT). For a wide beam, the dose distribution curve and the area of the curve were obtained by using pencil-like ionization chamber, a long CT dose profiler probe, a head phantom and a body phantom. The absolute dose conversion coefficient was multiplied to obtain the total integration integral of the absolute dose distribution, and then the computed tomography dose index (CTDI) value under any wide beam condition was obtained by dividing the collimation width. It was calculated that the absolute dose conversion coefficient was 1.135 under the narrow beam of 8 mm. To a 160 mm-wide beam, the value of CTDI was 7.57 mGy/100mAs after normalized in the head 80 kV CT scanning, and it was 9.80 mGy/100mAs after normalized in the body 120 kV CT scanning. The specific test method solves the problem that the previous measurement method underestimates the CTDI value.
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Affiliation(s)
- Heqing Lu
- Department of Medical Equipment, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 201204, People's Republic of China
| | - Xiangqun Ye
- Department of Medical Equipment, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 201204, People's Republic of China
| | - Haowei Zhang
- College of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, People's Republic of China
| | - Si Sun
- College of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, People's Republic of China
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Tahmasebzadeh A, Paydar R, Soltani Kermanshahi M, Maziar A, Rezaei M, Reiazi R. PEDIATRIC REGIONAL DRL ASSESSMENT IN COMMON CT EXAMINATIONS FOR MEDICAL EXPOSURE OPTIMIZATION IN TEHRAN, IRAN. RADIATION PROTECTION DOSIMETRY 2020; 192:341-349. [PMID: 33338233 DOI: 10.1093/rpd/ncaa192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/09/2020] [Accepted: 10/27/2020] [Indexed: 06/12/2023]
Abstract
The main purpose of this pilot study was to assess the regional diagnostic reference level (RDRL) of computed tomography (CT) examinations to optimise medical exposure in five pediatric medical imaging centers in Tehran, Iran where the most frequent CT examinations were investigated. For each patient, CT volume dose indexes (CTDIvol) and dose length product (DLP) in each group were recorded and their third quartile was calculated and set as RDRL. Pediatrics were divided into four age groups (<1; 1-5; 5-10 and 10-15 years). Then, the third quartile values for head, chest and abdomen-pelvic CTs were, respectively, calculated for each group in terms of CTDIvol: 21.3, 24.4, 24.2 and 36.3 mGy; 2.9, 3.2, 3.7 and 5.7 mGy; 3.7, 5.7, 6.3 and 6.8 mGy; and in terms of DLP: 322.2, 390.1, 424.9 and 694.1 mGy.cm; 53.1, 115.2, 145.3 and 167.6 mGy.cm and 128.7, 317.7, 460.2 and 813.8 mGy.cm. Finally, RDRLs were compared with other countries and preceding data in Iran. As a result, CTDIVOL values were lower than other national and international studies except for chest and abdomen-pelvic values obtained in Europe. Moreover, this matter applied to DLP so that other formerly reported values were higher than the present study but European values for chest and abdomen-pelvic scans and also Tehran studies conducted in 2012. Variation of scan parameters (tube voltage (kVp), tube current (mAs) and scan length), CTDIvol and DLP of different procedures among different age groups were statistically significant (P-value < 0.05). The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimization of examinations relative to which this study provides helpful data.
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Affiliation(s)
- Atefeh Tahmasebzadeh
- Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Paydar
- Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Radiation Science Department, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Soltani Kermanshahi
- Social Determinants of Health Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Asghar Maziar
- Radiation Science Department, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaei
- Department of Orthopedic, Tehran University of Medical Science, Tehran, Iran
| | - Reza Reiazi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Medical Physics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Winkelmann MT, Afat S, Walter SS, Stock E, Schwarze V, Brendlin A, Kolb M, Artzner CP, Othman AE. Diagnostic Performance of Different Simulated Low-Dose Levels in Patients with Suspected Cervical Abscess Using a Third-Generation Dual-Source CT Scanner. Diagnostics (Basel) 2020; 10:diagnostics10121072. [PMID: 33322074 PMCID: PMC7764070 DOI: 10.3390/diagnostics10121072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 01/02/2023] Open
Abstract
The aim of this study was to investigate the effects of dose reduction on diagnostic accuracy and image quality of cervical computed tomography (CT) in patients with suspected cervical abscess. Forty-eight patients (mean age 45.5 years) received a CT for suspected cervical abscess. Low-dose CT (LDCT) datasets with 25%, 50%, and 75% of the original dose were generated with a realistic simulation. The image data were reconstructed with filtered back projection (FBP) and with advanced modeled iterative reconstruction (ADMIRE) (strengths 3 and 5). A five-point Likert scale was used to assess subjective image quality and diagnostic confidence. The signal-to-noise ratio (SNR) of the sternocleidomastoid muscle and submandibular gland and the contrast-to-noise ratio (CNR) of the sternocleidomastoid muscle and submandibular glandular fat were calculated to assess the objective image quality. Diagnostic accuracy was calculated for LDCT using the original dose as the reference standard. The prevalence of cervical abscesses was high (72.9%) in the cohort; the mean effective dose for all 48 scans was 1.8 ± 0.8 mSv. Sternocleidomastoid and submandibular SNR and sternocleidomastoid muscle fat and submandibular gland fat CNR increased with higher doses and were significantly higher for ADMIRE compared to FBP, with the best results in ADMIRE 5 (all p < 0.001). Subjective image quality was highest for ADMIRE 5 at 75% and lowest for FBP at 25% of the original dose (p < 0.001). Diagnostic confidence was highest for ADMIRE 5 at 75% and lowest for FBP at 25% (p < 0.001). Patient-based diagnostic accuracy was high for all LDCT datasets, down to 25% for ADMIRE 3 and 5 (sensitivity: 100%; specificity: 100%) and lower for FBP at 25% dose reduction (sensitivity: 88.6-94.3%; specificity: 92.3-100%). The use of a modern dual-source CT of the third generation and iterative reconstruction allows a reduction in the radiation dose to 25% (0.5 mSv) of the original dose with the same diagnostic accuracy for the assessment of neck abscesses.
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Affiliation(s)
- Moritz T Winkelmann
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Saif Afat
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Sven S Walter
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Eva Stock
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Vincent Schwarze
- Department of Radiology, University Hospital LMU, 81337 Munich, Germany
| | - Andreas Brendlin
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Manuel Kolb
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Christoph P Artzner
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Ahmed E Othman
- Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
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Clinical CT underestimation of the percentage volume occupied by cysts in patients with lymphangioleiomyomatosis. Clin Imaging 2019; 59:119-125. [PMID: 31816538 DOI: 10.1016/j.clinimag.2019.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/26/2019] [Accepted: 11/14/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate the accuracy of cyst score measurements by standard high-resolution helical volume chest CT (HRCT) in patients with lymphangioleiomyomatosis (LAM), using a short z-length ultra-high resolution re-scan (UH re-scan) as the reference. In cystic lung diseases, cyst score is derived from CT scans and defined as the percentage of the total lung parenchymal volume occupied by cysts, a biomarker which measures the severity of the disease. METHODS In a prospective study of 73 LAM patients, each patient received the standard HRCT chest scan and a short z-length UH re-scan. Cyst scores were acquired from both scans using a standard FDA-approved scoring software on the CT scanner. RESULTS The limited UH re-scan resolved small cysts that were not resolved in the HRCT. The HRCT-derived cyst scores were on average 59.6% of the reference values from the UH re-scan (p = 4.7e-25). The amount of under-estimation by HRCT varied from patient to patient, with an inter-quartile range of 29.8% and standard deviation of 20.7%. The overall trend was more pronounced underestimation for patients with lower cyst scores. For patients whose reference cyst scores were below 15 (n = 29), the HRCT cyst scores were 46.9 ± 21.6% of reference values (p = 7.4e-12), while for the rest of the patients (n = 44) the HRCT cyst scores were 68.0 ± 15.3% of reference values (p = 1.2E-19). Reconstructing the HRCT images to the resolution of the UH re-scan further widened the spread of the discrepancy between HRCT and reference values due to increased image noise, and did not provide accurate cyst scores. CONCLUSION Cyst scores derived from standard high-resolution helical volume chest CT significantly underestimates the percentage lung volume occupied by cysts. This inaccuracy needs to be taken into consideration when cyst score is used as part of the CT assessment of the patient's condition.
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Zinsser D, Maurer M, Do PL, Weiß J, Notohamiprodjo M, Bamberg F, Othman AE. Reduced scan range abdominopelvic CT in patients with suspected acute appendicitis - impact on diagnostic accuracy and effective radiation dose. BMC Med Imaging 2019; 19:4. [PMID: 30635023 PMCID: PMC6329115 DOI: 10.1186/s12880-019-0304-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/02/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To evaluate a reduced range CT protocol in patients with suspected acute appendicitis as compared to standard abdominal CT regarding diagnostic performance, effective radiation dose and organ doses. METHODS In this study, we retrospectively included 90 patients (43 female, mean age 56.7 ± 17 years) with suspected acute appendicitis who underwent CT of abdomen and pelvis. From those CTs, we reconstructed images with a reduced scan range from L1 to the the pubic symphysis. Full range and reduced range datasets were assessed by two radiologists for i) coverage of the Appendix, ii) presence/absence of appendicitis and iii) presence of differential diagnoses. Furthermore, effective radiation doses as well as organ doses were calculated using a commercially available dose management platform (Radimetrics, Bayer HealthCare). RESULTS The Appendix was covered by the reduced range CT in all cases. In 66 patients CT confirmed the presence of appendicitis. In 14 patients, other relevant differential diagnoses were identified by CT, whereas in 10 patients no relevant findings were detected. Both readers identified all patients with appendicitis on both full and reduced range CT. For reduced range CT, total effective dose was 39% lower than for full range CT (reduced range: 4.5 [1.9-11.2] vs. full range: 7.4 [3.3-18.8] mSv; p ≤ 0.001). Notably, a remarkable reduction of organ dose in the female breasts by 97% (0.1 [0.1-0.6] vs. 3.8 [0.5-18.8] mSv; p ≤ 0.001) and in the testicles in males by 81% (3.4 [0.7-32.7] vs. 17.6 [5.4-52.9] mSv; p ≤ 0.001) was observed for reduced range CT compared to full range CT. CONCLUSIONS In patients with suspected acute appendicitis, reduced range abdominopelvic CT results in a comparable diagnostic performance with a remarkable reduction of total effective radiation dose and organ doses (especially breast dose in female and testicle dose in male patients) as compared to full range CT.
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Affiliation(s)
- Dominik Zinsser
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
| | - Michael Maurer
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - Phuong-Linh Do
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - Jakob Weiß
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - Mike Notohamiprodjo
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - Ahmed E Othman
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
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Performance of sparse-view CT reconstruction with multi-directional gradient operators. PLoS One 2019; 14:e0209674. [PMID: 30615635 PMCID: PMC6322781 DOI: 10.1371/journal.pone.0209674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/09/2018] [Indexed: 01/21/2023] Open
Abstract
To further reduce the noise and artifacts in the reconstructed image of sparse-view CT, we have modified the traditional total variation (TV) methods, which only calculate the gradient variations in x and y directions, and have proposed 8- and 26-directional (the multi-directional) gradient operators for TV calculation to improve the quality of reconstructed images. Different from traditional TV methods, the proposed 8- and 26-directional gradient operators additionally consider the diagonal directions in TV calculation. The proposed method preserves more information from original tomographic data in the step of gradient transform to obtain better reconstruction image qualities. Our algorithms were tested using two-dimensional Shepp–Logan phantom and three-dimensional clinical CT images. Results were evaluated using the root-mean-square error (RMSE), peak signal-to-noise ratio (PSNR), and universal quality index (UQI). All the experiment results show that the sparse-view CT images reconstructed using the proposed 8- and 26-directional gradient operators are superior to those reconstructed by traditional TV methods. Qualitative and quantitative analyses indicate that the more number of directions that the gradient operator has, the better images can be reconstructed. The 8- and 26-directional gradient operators we proposed have better capability to reduce noise and artifacts than traditional TV methods, and they are applicable to be applied to and combined with existing CT reconstruction algorithms derived from CS theory to produce better image quality in sparse-view reconstruction.
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