BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT: PART II - RADIATION CEREBRO/OPHTALMIC EFFECTS IN CHILDREN, PERSONS EXPOSED IN UTERO, ASTRONAUTS AND INTERVENTIONAL RADIOLOGISTS

BACKGROUND

Ionizing radiation (IR) can affect the brain and the visual organ even at low doses, while provoking cognitive, emotional, behavioral, and visual disorders. We proposed to consider the brain and the visual organ as potential targets for the influence of IR with the definition of cerebro-ophthalmic relationships as the «eye-brain axis».

OBJECTIVE

The present work is a narrative review of current experimental, epidemiological and clinical data on radiation cerebro-ophthalmic effects in children, individuals exposed in utero, astronauts and interventional radiologists.

MATERIALS AND METHODS

The review was performed according to PRISMA guidelines by searching the abstract and scientometric databases PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, published from 1998 to 2021, as well as the results of manual search of peer-reviewed publications.

RESULTS

Epidemiological data on the effects of low doses of IR on neurodevelopment are quite contradictory, while data on clinical, neuropsychological and neurophysiological on cognitive and cerebral disorders, especially in the left, dominant hemisphere of the brain, are nore consistent. Cataracts (congenital - after in utero irradiation) and retinal angiopathy are more common in prenatally-exposed people and children. Astronauts, who carry out longterm space missions outside the protection of the Earth's magnetosphere, will be exposed to galactic cosmic radiation (heavy ions, protons), which leads to cerebro-ophthalmic disorders, primarily cognitive and behavioral disorders and cataracts. Interventional radiologists are a special risk group for cerebro-ophthalmic pathology - cognitivedeficits, mainly due to dysfunction of the dominant and more radiosensitive left hemisphere of the brain, andcataracts, as well as early atherosclerosis and accelerated aging.

CONCLUSIONS

Results of current studies indicate the high radiosensitivity of the brain and eye in different contingents of irradiated persons. Further research is needed to clarify the nature of cerebro-ophthalmic disorders in different exposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.

Application of full-field organ dose modulation on cervical- thoraco-abdominopelvic contrast-enhanced computed tomography

BACKGROUND AND OBJECTIVE

To study the radiation dose and image quality on the use of full-field organ dose modulation (ODM) on cervical-thoracic-abdominal-pelvic contrast-enhanced computed tomography (CT) scanning on female chemotherapy patients.

METHODS

Eighty female chemotherapy patients undergoing cervical-thoracic-abdominal-pelvic contrast-enhanced CT were prospectively enrolled and randomly divided into two groups: group A and group B, each with 40 patients. Full-field ODM technique was used on group A and regular scanning patterns were used on group B. We calculated and recorded the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), subjective scores, mean tube currents of the anterior, left, posterior, and right aspects of the thyroid, breast, and ovary layers of all the images. The CT dose index volume (CTDIvol) and dose-length product (DLP) of each patient were recorded and the effective radiation dose (ED) was calculated. The above data were statistically analyzed.

RESULTS

There were no statistically significant differences in the SNR, CNR, and image quality scores of the thyroid, breast, and ovary layers of groups A and B during the arterial and venous phases (P > 0.05). The tube current on the anterior, left, posterior, and right aspects of the thyroid, breast, and ovary layers during the arterial and venous phases (thyroid: 324.46 ± 53.2 and 327.97 ± 61.34; breast: 243.13 ± 50.04 and 248.32 ± 60.33; ovary: 332.28 ± 71.50 and 339.78 ± 76.69; respectively) of group A were (statistically) significantly lower than those of group B (thyroid: 407.60 ± 96.81 and 402.73 ± 90.15; breast: 313.00 ± 106.68 and 315.20 ± 106.73; ovary: 457.78 ± 106.56 and 459.63 ± 106.27; respectively) (P < 0.05). The respective mean CTDIvol and DLP in group A were 22% and 24% lower than those of group B. The mean EDs of the neck, chest, and abdominal-pelvic region in group A were 19.3%, 21.4%, and 26.4% lower than those of group B, respectively (P < 0.05).

CONCLUSION

The use of ODM can reduce radiation dose of female chemotherapy patients undergoing cervical-thoracic-abdominal-pelvic contrast-enhanced CT, especially radiation-sensitive organs, while maintaining overall image quality.