Estimated Radiation Dose Research Articles

Estimated Radiation Dose to the Operator During Endovascular Aneurysm Repair

Estimated Radiation Dose to the Operator During Endovascular Aneurysm Repair

Monte Carlo Dosimetry Validation for X-Ray Guided Endovascular Procedures

Endovascular treatment is continuously gaining ground in vascular surgery procedures. However, current patient radiation dose estimation does not take into account the exact patient morphology and organs' composition. Monte Carlo (MC) simulation can accurately estimate the dose by recreating the irradiation process generated during X-ray-guided interventions. This study aimed to validate the MC simulation models by comparing simulated and measured dose distributions in endovascular aortic aneurysm repair (EVAR) procedures. We conducted a clinical study in patients treated for EVAR. Patient dose measurements were taken with passive dosimeters using Optically Stimulated Luminescence technology in 4 specific anatomical points on the skin: xiphoid process, pubic symphysis, right and left iliac crest. Dose measurements were compared to the corresponding simulated doses with the Geant4 Application for Emission Tomography (GATE) and GPU Geant4-based Monte Carlo Simulations (GGEMS) MC simulations softwares. The MC simulation took as input the computed tomography scan of the patient and the parameters of the imaging system (orientation angles, tube voltage, and aluminum filtration) and gives as output the three-dimensional (3D) dose map for each patient and angulation. A good agreement with real doses was found for doses simulated by the MC GATE method (P<0.0001; r=0.97; 95% confidence interval [CI] [0.96-0.98]), as well as for doses simulated by the GGEMS method (P<0.0001; r=0.96; 95% CI [0.94-0.97]). The mean relative error for all measurements was 5±5% in the MC GATE group and 6±5% in the GGEMS group. Process execution on GGEMS (6sec) was faster than the GATE MC simulation (5hr). Considering the current imaging settings, this study shows the potential of using the GATE and GGEMS MC simulations platforms to model the 3D dose distributions during EVAR procedures.

Effect of post-pyloric Dobhoff tube retention during gastrojejunostomy for reduction of fluoroscopic time and radiation dose.

The purpose of this study was to determine whether retention of a post-pyloric Dobhoff tube (DHT) in position to serve as a visual guide through the pylorus during gastrojejunostomy (GJ) tube placement results in a reduction in fluoroscopy time, procedure time, and estimated radiation dose. A retrospective study evaluated patients who underwent GJ tube placement or gastric to GJ conversion from January 1, 2017, to April 1, 2021. Demographic and procedural data were collected, and results were evaluated using descriptive statistics and hypothesis testing through an unpaired Student's t-test. Of the 71 GJ tube placements included for analysis, 12 patients underwent placement with a post-pyloric DHT in position, and 59 patients underwent placement without a post-pyloric DHT in position. The mean fluoroscopy time and estimated radiation dose were significantly reduced in patients who underwent GJ tube placement with a post-pyloric DHT in position compared with those without (7.08 min vs. 11.02 min, P = 0.004; 123.12 mGy vs. 255.19 mGy, P = 0.015, respectively). The mean total procedure time was also reduced in patients who underwent GJ tube placement with a post-pyloric DHT in position compared with those who had no post-pyloric DHT, but this finding lacked statistical significance (18.55 min vs. 23.15 min; P = 0.09). Post-pyloric DHT retention can be utilized during GJ tube placement to reduce radiation exposure to both the patient and interventionalist.

High-pitch CT pulmonary angiography (CTPA) with ultra-low contrast medium volume for the detection of pulmonary embolism: a comparison with standard CTPA

ObjectiveTo investigate the feasibility and image quality of high-pitch CT pulmonary angiography (CTPA) with reduced iodine volume in normal weight patients.MethodsIn total, 81 normal weight patients undergoing CTPA for suspected pulmonary arterial embolism were retrospectively included: 41 in high-pitch mode with 20 mL of contrast medium (CM); and 40 with normal pitch and 50 mL of CM. Subjective image quality was assessed and rated on a 3-point scale. For objective image quality, attenuation and noise values were measured in all pulmonary arteries from the trunk to segmental level. Contrast-to-noise ratio (CNR) was calculated. Radiation dose estimations were recorded.ResultsThere were no statistically significant differences in patient and scan demographics between high-pitch and standard CTPA. Subjective image quality was rated good to excellent in over 90% of all exams with no significant group differences (p = 0.32). Median contrast opacification was lower in high-pitch CTPA (283.18 [216.06–368.67] HU, 386.81 [320.57–526.12] HU; p = 0.0001). CNR reached a minimum of eight in all segmented arteries, but was lower in high-pitch CTPA (8.79 [5.82–12.42], 11.01 [9.19–17.90]; p = 0.005). Median effective dose of high-pitch CTPA was lower (1.04 [0.72–1.27] mSv/mGy·cm; 1.49 [1.07–2.05] mSv/mGy·cm; p < 0.0001).ConclusionHigh-pitch CTPA using ultra-low contrast volume (20 mL) rendered diagnostic images for the detection of pulmonary arterial embolism in most instances. Compared to standard CTPA, the high-pitch CTPA exams with drastically reduced contrast medium volume had also concomitantly reduced radiation exposure. However, objective image quality of high-pitch CTPA was worse, though likely still within acceptable limits for confident diagnosis.Clinical relevanceThis study provides valuable insights on the performance of a high-pitch dual-source CTPA protocol, offering potential benefits in reducing contrast medium and radiation dose while maintaining sufficient image quality for accurate diagnosis in patients suspected of pulmonary embolism.Key Points• High-pitch CT pulmonary angiography (CTPA) with ultra-low volume of contrast medium and reduced radiation dose renders diagnostic examinations with comparable subjective image quality to standard CTPA in most patients.• Objective image quality of high-pitch CTPA is reduced compared to standard CTPA, but contrast opacification and contrast-to-noise ratio remain above diagnostic thresholds.• Challenges of high-pitch CTPA may potentially be encountered in patients with severe heart failure or when performing a Valsalva maneuver during the examination.

Comparison of typical radiation doses and risks using an anthropomorphic 'bone fracture' phantom for commonly performed X-ray projections in a 5-year-old.

Diagnostic reference levels (DRLs) are typical dose levels for medical imaging examinations for groups of standard-sized patients or standard phantoms for broadly defined types of equipment used as a tool to aid optimisation of protection for medical exposures. Currently, there are no paediatric DRLs for conventional radiography (i.e. general X-rays) published in Australia. The aim of this study was to establish typical radiation doses and risks that are representative of those delivered for commonly performed X-ray projections for a 5-year-old/20 kg child using a 5-year-old anthropomorphic 'bone fracture' phantom in three dedicated paediatric radiology departments in Victoria. A total of 20 projection images were acquired for a standard 5-year-old/20 kg phantom using digital radiography X-ray equipment. The air kerma-area product (KAP) measured at each centre by a KAP metre, which was calibrated to a national primary standard, was considered to represent the median value for that centre for each X-ray projection. Organ doses and effective dose were estimated using PCXMC software, and risks of radiation-induced cancer and radiation-induced death were calculated based on the BEIR VII report. The typical doses for the individual X-ray projections ranged from 3 mGy•cm2 to 86 mGy•cm2 , whilst the effective doses ranged from 0.00004 to 0.07 mSv. The radiation risks were 'minimal' to 'negligible'. The estimation of typical radiation doses and associated risks for a 5-year-old/20 kg phantom study provides reference values for guidance and is a first step in assisting optimisation at other institutions until national DRLs, based on patient data from the clinical setting, are published.

Dose reconstruction for plutonium-239 intakes at the Rocky Flats Plant

Purpose The Rocky Flats (RF) Plant was a weapons manufacturing facility that operated from the early 1950s to 1989. Its primary missions were the production of plutonium (Pu) pits for thermonuclear weapons and the processing of retired weapons for Pu recovery. The purpose of this study was to estimate radiation doses to a cohort of 4499 RF workers from an intake of 239Pu, the primary plutonium isotope handled at the site. Materials and methods The latest biokinetic models of the International Commission on Radiological Protection, or site-specific variations of those models, were used to estimate 239Pu intakes for each worker based on model fits to bioassay data often coupled with lung measurements. Results Urinary excretion and lung retention data for most 239Pu intakes could be fit reasonably well by a mixture of Pu dioxide and moderately soluble material. For some workers, better fits were obtained by application of other absorption types including Type S, 239Pu nitrate, or pure 239Pu dioxide, or by assuming intake via a wound. The lungs typically received the highest tissue doses, with fifty-year committed equivalent doses in the range of 0.5–1 Sv for 275 workers, 1–5 Sv for 115 workers, and greater than 5 Sv for 12 workers. Conclusions RF was a unique site regarding a large number of lung measurements available for determining the appropriate absorption types for inhaled material. This provided higher confidence in reconstructed 239Pu doses than is generally gained from urinary data alone.

The extent of unnecessary tooth loss due to extractions prior to radiotherapy based on radiation field and dose in patients with head and neck cancer

Background and purposePrior to radiotherapy (RT), teeth with poor prognosis that pose a risk for post-RT osteoradionecrosis (ORN) are removed. To allow enough time for adequate wound healing prior to RT, decisions are made based on the estimated radiation dose. This study aimed to gain insight into (1) the overall number of teeth extracted and (2) the patient and tumor characteristics associated with the number of redundantly extracted teeth. Materials and methodsPatients with head and neck cancer (HNC), treated with RT between 2015 and 2019, were included in this cross-sectional study. For each extracted tooth the radiation dose was calculated retrospectively. The cut-off point for valid extraction was set at ≥ 40 Gy in accordance with the national protocol. Potential factors for doses ≥ 40 Gy were identified, including age, sex, tumor location, tumor (T) and nodal stage (N), overall tumor stage and number of teeth extracted. ResultsA total of 1759 teeth were removed from 358 patients. Of these 1759 teeth, 1274 (74%) appeared to have been removed redundantly, based on the mean dose (Dmean) of < 40 Gy. Using the maximum dose (Dmax) of < 40 Gy, 1080 teeth (61%) appeared to have been removed redundantly. Tumor location and N-classification emerged as the most important associative variables in the multivariable regression analysis. ConclusionTo our knowledge this is the first study to provide insight into the amount of teeth redundantly extracted prior to RT and represents a step forward in de-escalating the damage to the masticatory system prior to RT.

Recall of residential history and dietary habits during pregnancy and lactation in the distant past: reliability of questionnaire-based radiation doses for persons exposed in utero and early life.

This study evaluates the reliability of information obtained by standardized questionnaires used in by personal interviews for estimation of radiation thyroid doses of 1065 individuals in the Belarusian cohort of individuals who were exposed in utero and early life following the Chernobyl accident in April 1986. Data from two interviews conducted in 2012-2017 and in 2018-2022 with mothers, who were pregnant or gave birth shortly after the Chernobyl accident, were analysed. The most reliable answers dealt with various attributes related to residential history. In contrast, the reliability of answers regarding consumption rates of milk from privately owned cows or trade network was moderate, while the agreement in responses for consumption of milk products and leafy vegetables was fair. Information from the two interviews was used to calculate thyroid doses received by the cohort members. Specifically, 'model-based' thyroid doses due to 131I were estimated using input data on individual residential history and food consumption reported during the personal interviews and ecological data (131I ground deposition in the corresponding settlements). In addition, for a subset of cohort subjects (n = 205) whose mothers were measured for 131I thyroid activity, 'measurement-based' thyroid doses were calculated by adjusting the model-based dose using a scaling factor that is defined as the ratio of measured 131I thyroid activity to model-based 131I thyroid activity calculated for the date of measurement. A moderate agreement was observed for total (prenatal and postnatal) model-based thyroid doses due to 131I intake, the arithmetic mean ± standard deviation for the Jaccard similarity coefficient ([Formula: see text]) was 0.45 ± 0.34 (median = 0.39), while measurement-based doses showed a much better agreement with a [Formula: see text] of 0.78 ± 0.29 (median = 0.93). For model-based thyroid doses from external irradiation and from ingestion of 134Cs and 137Cs, [Formula: see text] was 0.82 ± 0.23 (median = 0.90) and 0.84 ± 0.24 (median = 0.96), respectively. Measurement-based doses due to ingestion of radiocaesium isotopes resulted in an almost perfect agreement, [Formula: see text] was 0.91 ± 0.19 (median = 1.0). The present findings suggest that long-term memory recall can be reliable, if a person is asked about unique or important life events, such as pregnancy and childbirth occurring around the time of a nuclear reactor accident. However, the substantial difference (more than 10 times) observed for model-bases doses calculated using the two questionnaires represents an important source of human factor uncertainties that needs to be considered in any dose response analyses. Other lessons learned from this study are that (i) individual measurements of radionuclides in the human body are the most valuable source of information for estimating radiation doses, and (ii) whenever a radiation accident occurs, a sample of affected people should be asked to keep a diary, if at all possible.

Impact of Single-Time-Point Estimates of 177Lu-PRRT Absorbed Doses on Patient Management: Validation of a Trained Multiple-Linear-Regression Model in 159 Patients and 477 Therapy Cycles.

Dosimetry after 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) enables estimation of radiation doses absorbed by normal organs and target lesions. This process is time-consuming and requires multiple posttreatment studies on several subsequent days. In a previous study, we described a newly developed multiple-linear-regression model to predict absorbed doses (ADs) from a single-time-point (STP) posttreatment study acquired 168 h after the first infusion and 24 h after the following ones, with similar results to the standard multiple-time-point (MTP) protocol. The present study aimed to validate this model in a large patient cohort and to assess whether STP dosimetry affects patient management decisions compared with our MTP protocol. Methods: Quantitative 177Lu-DOTATATE SPECT/CT post-PRRT data from 159 consecutive patients (172 therapies, 477 therapy cycles) were retrospectively analyzed. ADs obtained from an STP model were compared with those obtained using an MTP model. We evaluated the impact of the STP model on the decision on whether PRRT should be stopped because of an expected kidney AD exceeding the safety threshold. We hypothesized that patient management based on the STP model does not differ from that based on the MTP model in at least 90% of the cases. Results: There was no difference in management decisions between the MTP and STP models in 170 of 172 therapies (98.8%). A Fisher χ2 test for combined probabilities produced a composite P value of 0.0003. Mean cumulative AD relative differences between the STP and MTP models were 0.8% ± 8.0%, -7.7% ± 4.8%, 0.0% ± 11.4%, -2.8% ± 6.3%, and -2.1% ± 18.4% for kidneys, bone marrow, liver, spleen, and tumors, respectively (Pearson r = 0.99 for all), for patients who underwent 4 therapy cycles. Similar results were obtained with fewer therapy cycles. Conclusion: Estimated radiation ADs and patient management decisions were similar with the STP and MTP models. The STP model can simplify the dosimetry process while also reducing scanner and staff time and improving patient comfort.

Estimation of radiation dose due to ingestion of radon in water samples of Garhwal Himalaya, India

Estimation of radiation dose due to ingestion of radon in water samples of Garhwal Himalaya, India

Impact of bowel space contouring variability on radiation dose and volume assessments in treatment planning for gynaecologic cancers.

Correlations between radiation dose/volume measures and small bowel (SB) toxicity are inconsistent in the medical literature. We assessed the impact of inter-provider variation in bowel bag contouring technique on estimates of radiation dose received by the SB during pelvic radiotherapy. Ten radiation oncologists contoured rectum, bladder and bowel bags on treatment planning computed tomography (CT) scans of two patients receiving adjuvant radiation for endometrial cancer. A radiation plan was generated for each patient and used to determine the radiation dose/volume for each organ. Kappa statistics were applied to assess the inter-provider contouring agreement, and Levene test evaluated the homogeneity of variance for radiation dose/volume metrics, including the V45Gy (cm3 ). The bowel bag showed greater variation in radiation dose/volume estimates compared to the bladder and rectum. The V45Gy ranged from 163 to 384 cm3 for data set A and 109 to 409 cm3 for dataset B. Kappa values were 0.82/0.83, 0.92/0.92 and 0.94/0.86 for the bowel bag, rectum, and bladder on data sets A/B, demonstrating lower inter-provider agreement for bowel bag compared with bladder and rectum. Inter-provider contouring variability is more significant for the bowel bag than the rectum and bladder, with an associated greater variability in dose and volume estimates during radiation planning.

Radiation doses to non-human species after the Fukushima accident and comparison with ICRP’s DCRLs: A systematic qualitative review

This study reviewed publications on radiation dose estimations for non-human species after the 2011 Fukushima nuclear power plant accident and discussed the accident’s potential effects on the environment. Articles published from 2011 to December 2022 in online database were manually searched, and 27 eligible articles were identified. The estimated doses were summarized according to reference animals and plants and derived consideration reference levels (DCRLs) from ICRP Publication 108. Most estimated dose rates were on or below DCRL bands, but several greatly exceeded the DCRLs, mainly immediately after the accident. Half of the articles focused on dose estimation, but 13 also contained assessments of radiation effects. Effects such as chromosomal aberrations, morphological abnormalities, and population decline, were observed and the observed effects corresponding to estimated dose rates were implied in agreement with DCRL. Although a broader integration of knowledge is needed to obtain more robust data on environmental effects and improve environmental protection systems, our review contributes to refining the objectives of the environmental radiological protection approach.

An improvement of the computational effective diameter measurement in thoracic computed tomography examinations

A method to calculate a corrected effective diameter (DMIL) to more accurately estimate the dose received by a patient in chest computed tomography (CT) examination had been previously proposed. However, the discrepancy between DMIL and water-equivalent diameter (Dw) is still relatively high (i.e. about 6%). Furthermore, the method is still performed manually, so it is laborious and time-consuming. This study aims to improve the corrected effective diameter with bone correction (Deffcorr) and to automatically calculate it. The automated Deffcorr was calculated as the square root of the product of these corrected AP and LAT diameters. The approach was implemented on 30 patients who had undergone chest CT examination with the standard protocol. The results show that the correlation between the Deffcorr and Dw is R2=0.93 with no statistical difference (p&amp;gt;0.05). The automated Deffcorr is 3.1% lower than Dw. While the DMIL is 10.5% higher than Dw and both are statistically different (p&amp;lt;0.05). In conclusion, the new Deffcorr was introduced and the result obtained was closer to Dw than DMIL. This method is simple enough to be used as an alternative method to accurately estimate Dw for radiation dose estimation in clinical chest CT scanning.

Estimation of radiation dose and cancer risk from ingestion of natural radionuclides in groundwater of Ekiti State, Southwest Nigeria

Groundwater contains natural radionuclides in varying concentrations and its consumption may present a risk to human health. To evaluate the radiation dose due to the ingestion of the radionuclides in groundwater, 100 groundwater samples from wells used for drinking purposes were obtained spatially across Ekiti State. The concentrations of 226Ra, 232Th, and 40K were measured using a calibrated thallium-doped sodium iodide scintillation detector. The average values of the radionuclide concentrations in the drinking water samples are 4.1 ± 3.4 BqL−1, 3.4 ± 1.6 BqL−1, and 62.6 ± 44.0 BqL−1 for 226Ra, 232Th, and 40K respectively. Most of the groundwater samples have radionuclide concentrations above the WHO guidance level for the three radionuclides. The estimated average radiation dose due to ingestion of radionuclides in the groundwater to adults, children, and infants are 971.48 μSvy−1, 680.03 μSvy−1, and 291.44 μSvy−1 respectively. The lifetime cancer risk values of 1.05×10−3 and 1.10×10−3 due to ingestion of radionuclides in groundwater were evaluated for male and female respectively. These risk values are considered to be significant. Remedial actions may be necessary to ensure the safe consumption of groundwater in the area.

Estimated Radiation Dose to the Lens During Endourologic Procedures: The Role of Leaded Glasses and the ALARA Protocol-An ESU/ESUT-YAU Endourology Group Collaboration.

Purpose: On February 6, 2018, the European Atomic Energy Community reduced the annual equivalent dose limit for the lens from 150 to 20 mSv/year, because of its association with cataracts at low radiation doses. Our aim was to estimate the radiation doses received by the lens during endourologic procedures that require fluoroscopy. Materials and Methods: Multicenter study including prospective data of annual eye dosimeters between 2017 and 2020. Four endourologists used an eye dosimeter in endourologic procedures that require fluoroscopy (ureteroscopy, retrograde intrarenal surgery, and percutaneous nephrolithotomy). Surgeons 1 and 2 wore leaded glasses; surgeon 1 also used the as low as reasonably achievable (ALARA) protocol. Descriptive statistical analysis using SPSS 25.0 was conducted. Results: Surgeons 1, 2, 3, and 4 performed a median of 159, 586, 102, and 129 endourologic procedures per year, respectively, for a total of 641, 2340, 413, and 350 procedures between 2017 and 2020. The median annual dose of lens radiation exposure was 0.16, 1.18, 3.79, and 1.42 mSv per year, respectively, which corresponds to 0.001, 0.009, 0.024, and 0.012 mSv per procedure. The two surgeons who used leaded glasses registered a lower radiation dose per procedure (0.001 vs 0.027). Similarly, the urologist who used the ALARA protocol registered the lowest lens radiation dose compared with the three surgeons who did not use it (0.001 vs 0.023). Conclusions: The endourologists who participated in this study effectively comply with current guidelines on radiation exposure to the lens. Registered eye lens radiation does not seem to be related to the number of procedures but rather to the use of leaded glasses and the ALARA protocol.

Cold season dose rate contributions from gamma, radon, thoron or progeny in legacy mines with high natural background radiation.

In areas with high natural background radiation, underground cavities tend to have high levels of airborne radionuclides. Within mines, occupancy may involve significant exposure to airborne radionuclides like radon (222Rn), thoron (220Rn) and progeny. The Fen carbonatite complex in Norway has legacy mines going through bedrock with significantly elevated levels of uranium (238U) and especially thorium (232Th), and significant levels of their progeny 222Rn and 220Rn. There are also significantly elevated levels of gamma radiation in these mines. These mines are naturally chimney ventilated and release large volumes of air to the outdoors giving a large local outdoor impact. We placed alpha track detectors at several localities within these mines to measure airborne radionuclides and measured gamma radiation of bedrock at each locality. The bedrock within the mines shows levels up to 1900Bqkg-1 for 238U, 12000Bqkg-1 for 232Th and gamma dose rates up to 11μSvh-1. Maximum levels of airborne radionuclides were 45000Bqm-3 for 220Rn and 6900Bqm-3 for 222Rn. In addition, we measured levels of thoron progeny (TnP). In order to estimate radiation dose contribution, TnP should be assessed rather than 220Rn, but deposition-based detectors may be biased by the airflow of mine-draft. We present dose rate contributions using UNSCEAR dose conversion factors, and correcting for airflow bias, finding a combined cold season dose rate within these mines of 17-24μSvh-1. Interestingly, fractional dose rate contributions vary from 0.02 to 0.6 for gamma, 0.33 to 0.95 for radon and 0.1 to 0.25 for TnP.

Radiotherapy and cardiac implantable electronic devices: a nurse-based protocol in a single centre experience

Abstract Funding Acknowledgements Type of funding sources: None. Background An increasing number of patients need cardiac implantable electronic devices (CIED) for bradycardia or to prevent sudden cardiac death. At the same time many patients require radiotherapy for oncologic reasons. Interaction between CIEDs and ionizing radiations may cause several dysfunctions: electromagnetic interferences due to oversensing, CIED reset, drainage of the battery, hardware damage to the pulse generator and to the lead-tissue interface. Purpose An adequate planning is expected to guarantee the safety of CIED patients, reducing the potential complications. We describe our protocol in use and its application. Methods In 2016 an internal protocol was written to standardize the approach to CIED patients undergoing radiotherapy. Cardiology Department, Radiotherapy Unit and Medical Physics were involved in the draft. We stratified patients in high and low risk groups according to the CIED characteristics (ICD vs pacemaker), electro-dependency (yes vs no), and the estimated radiation dose (&amp;lt; 2 Gy: 2-10 Gy, &amp;gt; 10 Gy). Low risk group: - Non pacemaker (PM) dependent patients, estimated dose &amp;lt; 10 Gy - PM dependent patients, estimated dose &amp;lt; 2 Gy High risk group: - PM dependent patients, estimated dose &amp;gt; 2 Gy - Non-PM dependent patients estimated dose &amp;gt;10 Gy - ICD patients Two EHRA certificated nurses followed up the patients before, during and after the radiotherapy. Low risk patients received weekly in office evaluation during radiotherapy course. High risk patients were scheduled for daily in office check plus monitoring during each radiotherapy session, ICD therapy was temporarily switched off during each radiotherapy session. An in office evaluation was planned 1, 3, 6 and 12 months after the end of radiotherapy course until 2019, since 2020 all patients were given remote monitoring for accurate follow up. Results Between 2016 and November 2022 101 patients with CIED underwent radiotherapy in our facility. Clinical characteristics of the patients are described in Table 1. EHRA certificated nurses managed 1282 radiotherapy sessions without any complication. A transient underestimation of ICD longevity was the only software error occurred. Conclusions The reported protocol assured a safe radiotherapy course for all our CIED patients. Given the limited data available about the interaction between the newest CIEDs and radiotherapy, we opted for a high safety profile. The EHRA certified nurse’s involvement allowed to optimize personnel resources.

Radiological assessment of irrigation water used in Rustenburg, South Africa.

Water is an essential input in agricultural production, which is why it plays an important role in food security. According to the World Bank, water irrigated agriculture represents about 20% of the total cultivated land and 40% of the total food produced globally. This makes water a direct and indirect route of radiation exposure to humans via contact, ingestion and consumption of agricultural products. Radiological assessment of irrigation water around Rustenburg, one of the mining and industrial cities in South Africa, is investigated in this study. The activity concentrations of 238U, 232Th and 40K in irrigation water samples were determined using the total mass elemental concentrations of uranium, thorium and potassium, measured using inductively coupled plasma mass spectroscopy. The activity concentrations of 238U and 40K range from 1.24×10-04 to 1.09×10-02Bq/l, and 7.07×1000 to 1.32×10+01Bq/l, with mean activity concentrations of 2.78×10-03 and 1.16×10+01Bq/l, respectively. The activity concentration of 232Th was found below the detection level in all sampled irrigation water. Estimated annual effective dose because of ingestion because of 238U and 40K was also found to be below 120μSv/y for 238U and 232Th, 170μSv/y for 40K and a total of 290μSv/y by the United Nations Scientific Committee on the Effects of Atomic Radiation. The estimated radiation dose and lifetime cancer risk indices indicate insignificant radiological risk, making the irrigation water safe for domestic and agriculture purposes.

Improving radiation dosimetry with an automated micronucleus scoring system: correction of automated scoring errors

Radiation dose estimations performed by automated counting of micronuclei (MN) have been studied for their utility for triage following large-scale radiological incidents; although speed is essential, it also is essential to estimate radiation doses as accurately as possible for long-term epidemiological follow-up. Our goal in this study was to evaluate and improve the performance of automated MN counting for biodosimetry using the cytokinesis-block micronucleus (CBMN) assay. We measured false detection rates and used them to improve the accuracy of dosimetry. The average false-positive rate for binucleated cells was 1.14%; average false-positive and -negative MN rates were 1.03% and 3.50%, respectively. Detection errors seemed to be correlated with radiation dose. Correction of errors by visual inspection of images used for automated counting, called the semi-automated and manual scoring method, increased accuracy of dose estimation. Our findings suggest that dose assessment of the automated MN scoring system can be improved by subsequent error correction, which could be useful for performing biodosimetry on large numbers of people rapidly, accurately, and efficiently.

Improved accuracy of the biodistribution and internal radiation dosimetry of 13 N-ammonia using a total-body PET/CT scanner.

Conventional short-axis PET typically utilizes multi-bed multi-pass acquisition to produce quantitative whole-body dynamic images and cannot record all the uptake information simultaneously, resulting in errors when fitting the time-activity curves (TACs) and calculating radiation doses. The aim of this study is to evaluate the 13 N-ammonia biodistribution and the internal radiation doses using a 194cm long total-body PET/CT scanner (uEXPLORER), and make a comparison with the previous short-axis PET results. Ten subjects (age 40-74years) received 13 N-NH3 injection (418.1-670.81 MBq) and were under a dynamic scan for about 60min with using a 3-dimensional whole-body protocol. ROIs were drawn visually on 11 major organs (brain, thyroid, gallbladder, heart wall, kidneys, liver, pancreas, spleen, lungs, bone marrow, and urinary bladder content) for each subject. TACs were generated using Pmod and the absorbed radiation doses were calculated using Olinda 2.2. To compare with the conventional PET/CT, five points were sampled on uEXPLORER's TACs to mimic the result of a short-axis PET/CT (15cm axial FOV, consisted of 9 or 10 bed positions). Then the TACs were obtained using the multi-exponential fitting method, and the residence time and radiation dose were also calculated and compared with uEXPLORER. The highest absorbed organ doses were the pancreas, thyroid, spleen, heart wall, and kidneys for the male. For the female, the first five highest absorbed organ dose coefficients were the pancreas, heart wall, spleen, lungs, and kidneys. The lowest absorbed dose was found in red marrow both for male and female. The simulated short-axis PET can fit TACs well for the gradually-changed uptake organs but typically underestimated for the rapid-uptake organs during the first-10min, resulting in errors in the calculated radiation dose. uEXPLORER PET/CT can measure 13 N-ammonia's TACs simultaneously in all organs of the whole body, which can provide more accurate biodistribution and radiation dose estimation compared with the conventional short-axis scanners.