Risk Of Radiation Exposure Research Articles

Evaluating Factors Affecting Mean Glandular Dose in Mammography: Insights from a Retrospective Study in Dubai

Background/Objective: This study evaluates the mean glandular dose (MGD) in mammography screening for women aged 40–69 in Dubai, based on a retrospective analysis of a dose survey involving 2599 participants. Methods: MGD was calculated using the Dance formula. Results: The average MGD was 0.96 ± 0.39 mGy for mediolateral oblique (MLO) views and 0.81 ± 0.33 mGy for craniocaudal (CC) views. Weak inverse correlations were found between age and organ dose (OD) for both views, while a direct relationship was observed between breast thickness and entrance skin dose (ESD). In adjusted models, ESD was strongly associated with MGD (β = 1.04, 95% CI: 0.97, 1.09), while OD showed a moderate association (β = 0.44, 95% CI: 0.40, 0.49). Significant variations in ESD, OD, and MGD were noted across age groups and breast thicknesses. Conclusions: Lower MGD indicates reduced radiation exposure risk, while higher MGD in MLO views suggests improved imaging quality. Monitoring and optimizing MGD are essential for enhancing patient safety and screening efficacy.

HPB SO57 - Imaging in Acute Pancreatitis: Are We Getting It Right?

Abstract Background Guidelines indicate that routine use of imaging is unwarranted in patients with acute uncomplicated pancreatitis presenting with abdominal pain and increased serum amylase or lipase levels without signs of severe disease. Moreover, early CT scans may fail to accurately reflect disease severity and provide no diagnostic advantage. Method We performed a retrospective clinical audit at a district general hospital in the United Kingdom to find out the current practice regarding the use of imaging in patients presenting with acute pancreatitis. The patients were studied from January 2023 to March 2023 for the 1st cycle, and from April 2024 to May 2024 for the 2nd cycle. The list was identified by the clinical audit department – adult patients who presented to the A&E with symptoms of acute pancreatitis were included. Results Between January - March 2023, 44 patients presented to A&E with symptoms of acute pancreatitis. Of these, 25 (56%) had a CT-scan within 72-hours, with 80% showing evidence of acute pancreatitis —1 with pancreatic necrosis, 7 with intra-peritoneal fluid, & 5 with peri-pancreatic fat-stranding. The study revealed poor compliance with standards, prompting efforts to raise awareness. Findings were shared at the departmental audit meeting, & posters were displayed in A&E and GeneralSurgery departments. In the 2nd-cycle (April-May 2024), 32 patients presented, with 14 (53%) having a CT-scan within 72-hours & all had serum amylase levels checked, with 11 within normal limits. Conclusion This closed-loop clinical audit demonstrated that with appropriate measures and improved awareness of current guidelines, there can be increased compliance to the guidelines by the clinicians. This, in turn, reduces the risk of radiation exposure to patients and optimizes the use of CT scans.

Abstract 4143224: Feasibility of Left Atrial Appendage Occlusion with Dual-Seal Technology without Pre-Procedural CT: Early Single-Center Experience

Background: Left Atrial Appendage (LAA) Occlusion with Amulet has shown promising results in achieving complete closure with minimal periprocedural leak. Amulet’s dual-sealed technology and numerous sizing options provide versatility for different LAA morphologies. Pre-procedural CT is routinely recommended for pre-procedural planning. However, this brings risks including use of contrast, risk of renal failure, radiation exposure, and patient inconvenience. Here, we share initial results of our Amulet implantation protocol without pre-procedural CT: 83 cases were reviewed; number of devices used, procedural time, periprocedural bleeding complications, success in coming off oral anticoagulation, and incidences of stroke and embolism were followed. Methods: We followed 83 AF patients who underwent LAA closure with Amulet, implanted with intraprocedural TEE, intracardiac left atrial echocardiography, and intraprocedural angiography. Pre-procedural CT was not used. Patients were followed to assess safety and efficacy of this protocol. Safety endpoints included rates of procedural and bleeding complications. Efficacy endpoints included rates of stroke and embolism, and number of devices used. Results: All 83 procedures were successfully completed with no perioperative procedural complications and no documented leaks on follow-up TEE. Patients had early ambulation with closure. On average, 1.14 devices were used per case: 88% of cases required 1 device, and nine cases required 2 devices; one case required 4 devices to fit as patient was noted to have an interrupted IVC, requiring implantation via right IJV. There were no cases of stroke or embolism following implantation, and all patients were safely able to come off oral anticoagulation. Conclusions: Results demonstrate that Amulet with its dual-sealed technology can be effectively and safely implanted without pre-procedural CT. No perioperative complications were observed. 88% of cases closed with single device usage. No post-procedure leaks were noted on follow-up TEE. Safety endpoints revealed minimal adverse events, with 2 cases of late pericardial effusion managed without long-term consequences. This protocol demonstrated high efficacy, as all patients were successfully able to come off oral anticoagulation with no reported strokes or embolic events. Intraprocedural TEE, intracardiac left atrial echocardiography, and intraprocedural angiography are typically appropriate for periprocedural sizing of the device.

Comparative Analysis of Multiple Comparison Tests for Radiation Exposure Subgroups Among Dental Workers At Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria

Post-hoc analysis is a crucial statistical technique employed to identify specific group differences following a significant ANOVA result. This study delves into the comparative analysis of three commonly used post-hoc tests - Tukey's HSD, LSD, and Scheffe's method - to determine significant differences in radiation exposure levels among dental workers at Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Dental professionals are routinely exposed to ionizing radiation, primarily from X-ray machines. Excessive exposure can lead to various health risks, including cancer. Hence, accurate assessment and comparison of radiation exposure levels among different categories of dental workers are essential for effective radiation protection measures. In this study, the researchers calculated the critical values for each post-hoc test at a significance level of 0.05. The results indicated that the LSD method had the smallest critical value (0.674), followed by Tukey's HSD (1.304) and Scheffe's method (1.566). A lower critical value generally implies a higher sensitivity in detecting significant differences between groups. By conducting pairwise comparisons, the study found that the LSD method was the most effective in identifying statistically significant differences in radiation exposure levels among the dental workers. This suggests that the LSD method is a suitable choice for post-hoc analysis in this specific context. The findings of this study have significant implications for radiation protection practices in dental settings. By employing appropriate post-hoc analysis methods, healthcare institutions can accurately assess radiation exposure risks and implement targeted interventions to minimize exposure and protect the health of dental workers.

Effects of Large-Scale Wildfires on the Redistribution of Radionuclides in the Chornobyl River System.

Wildfires in radiologically contaminated areas raise significant concerns due to potential radionuclides redistribution and increased public radiation exposure. This study examined the impact of the 2020 Chornobyl wildfire on the redistribution of radionuclides, specifically 137Cs and 90Sr, in the Chornobyl River system. We determined the quantities and speciation of 137Cs and 90Sr in charred residues and soil after wildfires and analyzed the riverine concentrations of these radionuclides based on long-term monitoring data. Our findings indicate that the inventories of 137Cs and 90Sr in the charred residues and soil decreased with increasing distance from the nuclear power plant, which is consistent with the initial deposition patterns. However, the transfer of 137Cs and 90Sr from soil to charred residues did not correspond to the distance, type of contamination source, or fire type. Speciation analysis revealed that the water-soluble fractions of 137Cs and 90Sr in the charred residues were significantly higher than those in the soil, implying increased mobility. Following the wildfires, no significant increase in 137Cs concentration was observed in a river catchment in Chornobyl. However, 90Sr concentrations showed a significant increase, exceeding the permissible levels in drinking water (2 Bq/L) in Ukraine. This increase is attributed to hydrologically driven mobilization processes: (1) during snowmelt in spring and (2) the transport of soluble 90Sr from charred residues and surface soil into the river during high suspended solid concentration events. Collectively, our findings highlight the importance of continuous monitoring of radionuclide dynamics in postwildfire environments to better assess potential radionuclide redistribution and radiation exposure risks. These results provide valuable insights into the behavior of 137Cs and 90Sr in river systems affected by wildfires, contributing to a more accurate understanding of their environmental impacts and potential countermeasures.

RELATIONSHIP OF NEUTROPHIL LYMPHOCYTE RATIO WITH APPENDICITIS INCIDENCE Review of Appendicitis Patients at Ibnu Sina Hospital, Gresik Regency in 2022-2023

This study aims to analyze the relationship between the neutrophil lymphocyte ratio (NLR) and the incidence of acute appendicitis in patients at Ibnu Sina Hospital, Gresik Regency, in the 2022-2023 period. Acute appendicitis is a frequent emergency surgical condition, especially in adolescents and young adults, with the risk of complications such as perforation and peritonitis. NLR, as an indicator of inflammatory response, is considered more practical and economical than CT scans and ultrasounds, which have limited cost, accessibility, and risk of radiation exposure. This study used an observational analytical method with a cross-sectional approach on 51 appendicitis patients who underwent appendectomy. NLR data was obtained through routine blood results, with statistical analysis using SPSS to test the normality and difference in NLR values between uncomplicated appendicitis and appendicitis with complications. There was a significant difference in the mean NLR value between patients with complementary and non-complementary appendicitis, with a p < value of 0.001. The results of the ROC Curve analysis show that NLR has a high prediction value in predicting complementary appendicitis of 97.5%. This study concludes that NLR can be an effective indicator in distinguishing cases of complementary and non-complementary appendicitis and the potential of NLR as an easy and efficient screening tool in the treatment of acute appendicitis, especially in health facilities with limited resources.

Procedural outcomes of fluoroscopy-less catheter ablation for atrial fibrillation

Abstract Background Radiofrequency catheter ablation is superior therapy to antiarrhythmic drugs for maintaining sinus rhythm in atrial fibrillation (AF) patients. Traditional fluoroscopy-guided AF ablation poses risks of prolonged radiation exposure for both patients and medical staff. Recent advancements in fluoroscopy-less catheter ablation techniques offer potential solutions, but comprehensive data on their effectiveness and safety are lacking. Purpose To evaluate the procedural outcomes and safety of fluoroscopy-less catheter ablation for AF compared to fluoroscopy-guided ablation. Methods Retrospective observational study of consecutive AF ablations (N=881) conducted at a university teaching hospital (Hamilton Health Sciences, Hamilton, Ontario) from November 2017 to September 2022. An electro-anatomical mapping system and ICE was used in all cases. Baseline characteristics and procedural outcomes between the fluoroscopy-less and fluoroscopy-guided groups were compared. Cases that used <60 seconds of fluoroscopy (occasionally used by operators during the placement of an esophageal probe) were included in the fluoroscopy-less group (N= 68). Results Mean age of individuals was 60.6 ± 11 years, 71.7% were male, 72.6% had paroxysmal AF, mean CHA2DS2-VASc score was 1.6 ± 1.4, 11.1% had prior heart failure, and mean left ventricular ejection fraction was 57.5 ± 15%. There were no significant differences in patient baseline characteristics between the fluoroscopy-less and fluoroscopy groups. Total procedure and fluoroscopy times were lower in the fluoroscopy-less group compared to the fluoroscopy-guided group (169.3 ±42 minutes vs. 192.1 ±54 minutes, p<0.0001 and 0.024 ±0.10 vs. 10.0 ±7.4 minutes , p<0.0001). Fluoroscopy-less AF ablation remained an independent predictor of lower procedure times following adjusting for the use of general anesthesia, high-power short-duration, presence of trainees, AF pattern, redo cases, and type of mapping system. Complication rates were similar between fluoroscopy-less and fluoroscopy-guided ablation (1.9% vs. 3.8%, p=0.11). Conclusion Fluoroscopy-less catheter ablation for AF appears to have similar procedural outcomes and safety than fluoroscopy-guided AF ablation.

Noise-assisted hybrid attention networks for low-dose PET and CT denoising.

Positron emission tomography (PET) and computed tomography (CT) play a vital role in tumor-related medical diagnosis, assessment, and treatment planning. However, full-dose PET and CT pose the risk of excessive radiation exposure to patients, whereas low-dose images compromise image quality, impacting subsequent tumor recognition and diseasediagnosis. To solve such problems, we propose a Noise-Assisted Hybrid Attention Network (NAHANet) to reconstruct full-dose PET and CT images from low-dose PET (LDPET) and CT (LDCT) images to reduce patient radiation risks while ensuring the performance of subsequent tumor recognition. NAHANet contains two branches: the noise feature prediction branch (NFPB) and the cascaded reconstruction branch. Among them, NFPB providing noise features for the cascade reconstruction branch. The cascaded reconstruction branch comprises a shallow feature extraction module and a reconstruction module which contains a series of cascaded noise feature fusion blocks (NFFBs). Among these, the NFFB fuses the features extracted from low-dose images with the noise features obtained by NFPB to improve the feature extraction capability. To validate the effectiveness of the NAHANet method, we performed experiments using two public available datasets: the Ultra-low Dose PET Imaging Challenge dataset and Low Dose CT Grand Challengedataset. As a result, the proposed NAHANet achieved higher performance on common indicators. For example, on the CT dataset, the PSNR and SSIM indicators were improved by 4.1dB and 0.06 respectively, and the rMSE indicator was reduced by 5.46 compared with the LDCT; on the PET dataset, the PSNR and SSIM was improved by 3.37dB and 0.02, and the rMSE was reduced by 9.04 compared with theLDPET. This paper proposes a transformer-based denoising algorithm, which utilizes hybrid attention to extract high-level features of low dose images and fuses noise features to optimize the denoising performance of the network, achieving good performance improvements on low-dose CT and PETdatasets.

Awareness of Interventional Radiology and The Associated Radiation Exposure Risk Among The Public Population and Primary Care Physicians in Saudi Arabia

Introduction: The imperative for healthcare professionals to possess a comprehensive understanding of radiation doses and the associated risks of the diagnostic imaging processes they recommend is underscored by the evolving landscape of medical diagnostics and treatment. Interventional radiology (IR) plays a crucial role in modern medicine, offering minimally invasive alternatives to traditional surgery. However, public and healthcare practitioner awareness of IR and its associated radiation risks remains inadequately explored, particularly in regions like Saudi Arabia. Purpose: This study aimed to evaluate the awareness of interventional radiology (IR) and the associated risks of radiological procedures among the general public and healthcare practitioners in Saudi Arabia, identify knowledge gaps, and inform future educational initiatives. Methods: Participants undergoing radiological procedures were selected using a random sampling technique, with stratification based on gender, age, nationality, and education level. The survey, conducted in Saudi Arabia, comprised 48 questions in yes-or-no and multiple-choice formats, covering demographic information, comprehension of interventional radiology, and awareness of radiation exposure risks. Results: Out of 625 respondents, 62.7% had no prior knowledge of IR, and 94.2% had never undergone IR procedures. A significant proportion (55%) lacked information about the radiation exposure associated with IR, and 57.9% perceived risks from radiation in imaging devices. In the post-educational video, 88.2% favoured IR over traditional treatment methods, with 57.8% expressing a willingness to undergo IR procedures in the future. Conclusion: The study reveals a substantial lack of awareness and knowledge about interventional radiology and radiation risks among the Saudi Arabian population and healthcare practitioners. There is a critical need to enhance public and professional understanding of IR to ensure informed decision-making and patient consent, necessitating targeted educational programs to bridge these knowledge gaps.

Congenital solitary functioning kidney: evaluations to do which, when, and how

Congenital solitary functioning kidney (CSFK) is characterized by an anatomical or functional absence of one kidney from birth. When suspected on perinatal ultrasonography (US), repeat US after birth should be performed for confirmation. Although postnatal 99mTc-dimercaptosuccinic acid scintigraphy (DMSA scan) is the gold standard for confirming CSFK, it carries the risk of radiation exposure; US alone is sufficient when performed by an experienced radiologist. One-third of patients with CSFK have additional congenital anomalies of the kidney and urinary tract at the solitary functioning kidney, the most common of which is vesicoureteral reflux. As evidence regarding vesicoureteral reflux with normal kidney US is correlated with significant urinary tract infection is lacking, voiding cystourethrogram may be considered in patients with CSFK with abnormal US findings. Furthermore, approximately 30% of patients with CSFK have extrarenal malformations. Moreover, up to 10% of them have syndromic features. In particular, examining for female genitalia malformations, which can have potential for complications from untreated obstructive malformations, is important. In conclusion, DMSA scan and voiding cystourethrogram are not necessary for all patients with CSFK, and the risk of each patient should be assessed to determine which test is needed during follow-up. The presence of extrarenal manifestations should also always be considered.

Comparing Virtual Reality and Traditional Training in Radiation Safety Practices Over Three Years Among Cardiologists and Scrub Nurses

PurposeThis study evaluated the effectiveness of virtual reality (VR) training versus traditional methods in enhancing radiation safety practices among cardiologists and scrub nurses. Developed by Virtual Medical Coaching, VR training simulates radiation safety scenarios in cardiac catheterization laboratories (Cath Labs). MethodsA three-year crossover study was conducted with 150 healthcare professionals (in this study, healthcare professionals are defined as cardiologists and scrub nurses who work in Cath Labs) at five urban hospitals. These professionals are key personnel in fluoroscopy-guided interventional procedures, where radiation safety is a critical concern.Participants, stratified by profession, were randomly assigned to initially receive either VR (virtual medical coaching) or traditional training, followed by a year-long washout period before switching training modalities. Primary outcomes measured changes in radiation exposure via dosimeters, whereas secondary outcomes assessed knowledge retention. ResultsVR training significantly reduced radiation exposure, resulting in a 30% greater decrease in radiation dose than traditional methods do. Cardiologists in Group A (VR training) experienced a mean reduction of 3.37 (p < 0.001), whereas scrub nurses experienced a mean reduction of 2.89 (p < 0.001). In contrast, participants in Group B (traditional training) exhibited a smaller reduction of 1.75 for cardiologists (p < 0.001) and 1.49 for scrub nurses (p < 0.001). The participants transitioning from traditional to VR training demonstrated enhanced retention and application of safety protocols, as reflected by improved knowledge and observed structured clinical examinations (OSCE) scores. The integration of VR into training notably improved procedural knowledge and skills without the risk of radiation exposure, making VR an effective tool for radiation safety education. ConclusionThis study highlights the superiority of VR training in reducing radiation exposure and enhancing practical skills among medical professionals. Virtual medical coaching’s specialized VR modules effectively simulate real-world scenarios, making them valuable components in radiation safety training. The findings advocate the integration of VR into medical education curricula to improve safety standards and training efficacy.

Clinical usability and efficacy of a robotic bone fracture reduction system: A pilot animal study

Challenges in minimally invasive surgeries, such as intramedullary nailing for long bone fractures, include radiation overexposure for patients and surgeons, potential malreduction, and physical burden on surgeons in maintaining the reduction status. A robotic bone fracture reduction system was developed in this study to address these problems. The system consists of a hexapod with six degrees of freedom, with a fracture reduction device and a master device. This study aimed to evaluate the novel system in a preclinical setting. The length of the six axes in the system can be adjusted to precisely control the length, angle, and rotation so that no additional traction is required. Fluoroscopic images can be remotely examined to reduce the risk of radiation exposure for surgeons. In this study, alignment accuracy and radiation exposure were measured using 32 bovine bone fracture models, and these surgical outcomes were compared to those of conventional manual surgery to verify the clinical usability and effectiveness of the system. The alignment accuracy was assessed by analyzing length, angulation, and rotation. The four surgeons participating in this study were divided into two groups (expert and novice) according to their clinical experience. All parameters in robotic surgery significantly decreased by approximately 4 mm and 8° on average (p≤0.05) compared to conventional surgery. The mean radiation exposure in robot-assisted surgery was 0.11 mSv, showing a significant decrease compared to conventional surgery (p<0.05). Reduction accuracy was higher in robotic surgery performed by the novice group than in conventional surgery performed by the expert group; however, standard deviation values were inversed. In conclusion, the bone fracture reduction robot system increased the alignment accuracy through precise control while reducing radiation exposure in surgeons, as the surgery was performed remotely. The use of this system is predicted to improve the accuracy and reproducibility of the surgery and the safety of medical staff.11Abbreviations: CT, computed tomography; FRD, fracture reduction device; FRMD, fracture reduction master device; SD, standard deviation

Assessing Ionizing Radiation Exposure Risks to Human Health in Wadi-B, Jere Oil Exploration Areas, Borno State, Nigeria

Assessing Ionizing Radiation Exposure Risks to Human Health in Wadi-B, Jere Oil Exploration Areas, Borno State, Nigeria

Assessment of Radioactivity Levels in Bottled Drinking Water Consumed by Different Age Groups of People in Kampala City, Uganda

The activity concentrations of natural radionuclides in drinking water may be enhanced depending on the geological strata from which it is extracted. The demand and consumption of bottled drinking water is increasing every year in Uganda mainly in Kampala city. Therefore, the study was purposed to assess the levels of natural radioactivity using a gamma spectrometer in commonly bottled drinking water in Kampala City. The mean specific activities for Ra-226, Th-232, and K-40 in bottled drinking water were 4.45±0.20, 1.32±0.27, and 46.33±0.24 Bq/l respectively which exceeded the specific World Health Organization recommended guidance level of 1.0 Bq/l except for K-40. The mean activity concentrations were however comparable to the mean concentration of tap water used in Kampala City, that is 4.00±0.16, 1.4±0.19, and 47.05±0.21 Bq/l for Ra-226, Th-232, and K-40 respectively. The annual effective dose contributed by two radionuclides of Ra-226 and Th-232 in the bottled water exceeded the maximum dose limit of 0.1 mSv/y recommended by the World Health Organization (WHO). The mean estimated excess lifetime cancer risk due to Ra-226 (0.00177) exceeded the recommended limit of 0.001 while that due to Th-232 (0.0001) was below the recommended limit. Therefore, the main contributor to the total annual ingestion dose was Ra-226. Due to the high solubility and toxicity of Ra-226, there is a significant concern warranting further investigation. Finally, the results from the study revealed that there was not any trace of contamination from artificial radionuclides in the bottled drinking water manufactured and consumed within Kampala City. With the growing populational demand for bottled drinking water, it's recommended that radioactivity levels comply with the WHO recommended radioactivity levels. Therefore, this study contributes to the revision of standards and development of regulations for radiological protection of the public and the environment from risks of radiation exposure associated with bottled drinking water.

56Fe-ion Exposure Increases the Incidence of Lung and Brain Tumors at a Similar Rate in Male and Female Mice.

The main deterrent to long-term space travel is the risk of Radiation Exposure Induced Death (REID). The National Aeronautics and Space Administration (NASA) has adopted Permissible Exposure Levels (PELs) to limit the probability of REID to 3% for the risk of death due to radiation-induced carcinogenesis. The most significant contributor to current REID estimates for astronauts is the risk of lung cancer. Recently updated lung cancer estimates from Japan's atomic bomb survivors showed that the excess relative risk of lung cancer by age 70 is roughly fourfold higher in females compared to males. However, whether sex differences may impact the risk of lung cancer due to exposure to high charge and energy (HZE) radiation is not well studied. Thus, to evaluate the impact of sex differences on the risk of solid cancer development after HZE radiation exposure, we irradiated Rbfl/fl, Trp53fl/+ male and female mice infected with Adeno-Cre with various doses of 320 kVp X rays or 600 MeV/n 56Fe ions and monitored them for any radiation-induced malignancies. We conducted complete necropsy and histopathology of major organs on 183 male and 157 female mice after following them for 350 days postirradiation. We observed that lung adenomas/carcinomas and esthesioneuroblastomas (ENBs) were the most common primary malignancies in mice exposed to X rays and 56Fe ions, respectively. In addition, 1 Gy 56Fe-ion exposure compared to X-ray exposure led to a significantly early incidence of lung adenomas/carcinomas (P = 0.02) and ENBs (P < 0.0001) in mice. However, we did not find a significantly higher incidence of any solid malignancies in female mice as compared to male mice, regardless of radiation quality. Furthermore, gene expression analysis of ENBs suggested a distinct gene expression pattern with similar hallmark pathways altered, such as MYC targets and MTORC1 signaling, in ENBs induced by X rays and 56Fe ions. Thus, our data revealed that 56Fe-ion exposure significantly accelerated the development of lung adenomas/carcinomas and ENBs compared to X rays, but the rate of solid malignancies was similar between male and female mice, regardless of radiation quality.

The Future of Health Physics: Trends, Challenges, and Innovation.

This paper offers a comprehensive exploration of the future trajectory of health physics, examining influential factors in external and internal dimensions. External factors include an in-depth analysis of low-dose (10-100 mSv) measurement challenges and priorities, highlighting the transformative potential of biomarkers in solving radiation susceptibility following low-dose exposures. Cutting-edge technologies are at the forefront, with insights into emerging radiation detection tools like plastic scintillators with triple discrimination capabilities and sensors based on plastic scintillation microspheres (PSm) for estimating α and β emitting radionuclides in environmental samples. Remote detection systems using drones, robot dogs, and quantum sensors boasting heightened sensitivity and precision also are discussed. Integrating artificial intelligence (AI) and data analytics emerges as a pivotal element, promising to redefine health physics by minimizing radiation exposure risks. The exploration includes innovative materials for radiation shielding, advancements in virtual reality applications, preparation for radiological protection during armed conflicts, and the ever-evolving landscape of decommissioning health physics. Examining health effects from non-ionizing radiation and analyzing broader contextual factors such as regulatory shifts, geopolitics, and socioeconomic influences adds depth to understanding the external forces leading to the future of health physics. Internally, the paper focuses on the transformative dynamics of health physics education and training, encompassing expanded educational horizons, innovative delivery methods, targeted student outreach strategies, and insights into navigating health physics careers amid a dynamically evolving job market. The discussion unfolds further, focusing on new risk communication strategies, the collaborative potential of interdisciplinary approaches, and the significance of health physics summer schools and consortia for transformative educational paradigms. The objective of this paper is not only to unravel the multifaceted factors shaping the future of health physics but also to foster dialogue and collaboration for the unpredictable yet exciting journey ahead.

Assessing the Reliability of Postoperative Cross-Table Radiographs Compared to CT Scans for Measuring Acetabular Anteversion Angle Following Total Hip Arthroplasty.

This study aimed to evaluate acetabular anteversion following total hip arthroplasty (THA) using cross-table lateral radiographs and CT scans and to determine the reliability of cross-table lateral radiographs compared to computed tomography (CT) scans for measuring acetabular anteversion. We conducted a cross-sectional study of patients undergoing THA at Justice K.S. Hegde Charitable Hospital, Deralakatte, Mangalore, from January 2020 to June 2021. Radiographs are typically taken in both anteroposterior (AP) and lateral views after THA. However, for this study, a cross-table lateral view was used instead of the usual lateral radiograph to measure the angle of anteversion. The anteversion was calculated using the method described by Woo and Morrey. Additionally, CT scans were performed on all patients as part of the study protocol. The anteversion measured in these scans was compared to that in the cross-table radiographs to assess the latter's reliability for routine use. The risk of radiation exposure from CT scans was minimized by adhering to the ALARA (As Low as Reasonably Achievable) principle, with only axial sections of the acetabular cup being scanned. The results show that the radiographic acetabular anteversion and CT scan measurements have a mean difference of 0.3036. There is a positive correlation between these measurements. The p-value is not statistically significant (p=0.698). Therefore, the measurements are correlated with each other with a linear relationship (r=0.919). For anteversion measurements using the X-ray method, the mean was 27.16 degrees with a standard deviation of ±9.49. The median was 27.26 degrees, ranging from 10.27 to 42.58 degrees. In comparison, the CT method yielded a mean anteversion of 27.40 degrees with a standard deviation of ±8.50 degrees. The median was 27.64 degrees, ranging from 12.35 to 43.11 degrees. Cross-table lateral radiographs are a reliable and comparable method to CT scans for measuring acetabular anteversion following total hip arthroplasty.

An interplay between orthopaedic trauma and pregnancy—A case series of 42 patients

BackgroundPregnancy and trauma are complex situations with significant implications for maternal and fetal health. Physical and psychological trauma during pregnancy can lead to pre-term labor, abruptio-placenta, and fetal injury or death. Management of trauma is challenging due to physiological and anatomical changes, which can affect fracture management and the risk of radiation exposure. A multidisciplinary approach is beneficial for patient care. This study aimed to determine the impact of orthopaedic trauma on pregnancy and its outcome, and influence of pregnancy on fracture management. Methods and materialA retrospective-study was conducted at a Level-1 trauma-care-center, focusing on 54 pregnant women who sustained trauma between January 2015 and December 2022. The study included patients with closed or open fractures, but excluded those without fractures. Forty-two patients were available with minimum 1 year follow-up. Data was collected from hospital records and PACS, including demographic details, emergency care, and laboratory parameters. Changes made in protocol in fracture management due to pregnancy (primary definitive fixation vs staged management), and impact of trauma on pregnancy outcome; mode-of-delivery, maternal and fetal loss were evaluated. ResultsThe mean age was 30-years (range: 21–43years). Road-traffic-collision was most-common mode-of-injury (66.7 %). 38.1 % were in the first-trimester, 35.7 % in second, and 26.2 % in third-trimester. Eight patients had polytrauma, seven had multiple-injuries, and 27 had isolated-injuries. The maternal-mortality-rate was 0.45 %. Three polytraumatized patients ended up with intrauterine death, two polytrauma patients underwent elective abortion, one patient presented with spontaneous-abortion, and fetal loss was 14.3 % (6-of-42). Out of 42 patients, 10 had open-injuries and 32 had closed-injuries. Nine patients underwent LSCS(lower-segment-caesarean-section), six of them were planned for elective-LSCS due to injury and associated fractures (two patients with pelvic injuries, two neck femur fracture patients, one open distal femur fracture, and one ankle fracture dislocation). ConclusionOrthopaedic trauma during pregnancy can significantly affect pregnancy outcomes and is associated with a notably higher risk of fetal loss. An elective-caesarean-section is recommended for patients with polytrauma, pelvic-injuries, and those who are immobilized for longer-duration. During the third-trimester and in polytraumatized patients, external-fixator-application for lower-limb-injuries is a safe strategy, and definitive fixation could be performed post-delivery.

Accurate Whole-Brain Image Enhancement for Low-Dose Integrated PET/MR Imaging Through Spatial Brain Transformation.

Positron emission tomography/magnetic resonance imaging (PET/MRI) systems can provide precise anatomical and functional information with exceptional sensitivity and accuracy for neurological disorder detection. Nevertheless, the radiation exposure risks and economic costs of radiopharmaceuticals may pose significant burdens on patients. To mitigate image quality degradation during low-dose PET imaging, we proposed a novel 3D network equipped with a spatial brain transform (SBF) module for low-dose whole-brain PET and MR images to synthesize high-quality PET images. The FreeSurfer toolkit was applied to derive the spatial brain anatomical alignment information, which was then fused with low-dose PET and MR features through the SBF module. Moreover, several deep learning methods were employed as comparison measures to evaluate the model performance, with the peak signal-to-noise ratio (PSNR), structural similarity (SSIM) and Pearson correlation coefficient (PCC) serving as quantitative metrics. Both the visual results and quantitative results illustrated the effectiveness of our approach. The obtained PSNR and SSIM were 41.96 ± 4.91 dB (p < 0.01) and 0.9654 ± 0.0215 (p < 0.01), which achieved a 19% and 20% improvement, respectively, compared to the original low-dose brain PET images. The volume of interest (VOI) analysis of brain regions such as the left thalamus (PCC = 0.959) also showed that the proposed method could achieve a more accurate standardized uptake value (SUV) distribution while preserving the details of brain structures. In future works, we hope to apply our method to other multimodal systems, such as PET/CT, to assist clinical brain disease diagnosis and treatment.

Towards accurate dose assessment for emergency industrial radiography source retrieval operations: A preliminary study of 4D Monte Carlo dose calculations

The exposure devices utilizing high-activity gamma radiation sources for industrial radiography frequently encounter issues such as stuck or disconnected sources, posing a substantial risk of radiation exposure to the workers executing emergency source retrieval operations, emphasizing the importance of accurate dose assessment. In the present study, the radiation dose to the main worker during the process of source retrieval was calculated and compared for five emergency source retrieval procedures to retrieve stuck or disconnected sources, using 4D Monte Carlo dose calculation and a mesh-type reference computational phantom. For a stuck source, the dose values of the two source retrieval procedures (i.e., repair and cut methods) were found to be relatively small, which indicates that the worker might select either method based on personal preference or situational convenience. Conversely, for a disconnected source, the dose values of the three source retrieval procedures (i.e., fishing, connect/push, and hot stick methods) were much larger and show significant differences. Notably, the fishing method was associated with the lowest dose, whereas the hot stick method resulted in significantly higher doses, differences being as large as ∼5 times. These results underscore the fishing method as a preferable option, particularly over the hot stick method.