Introduction: Radiation is indispensable for diagnosis and treatment and is widely used in medicine. This study aimed to determine patients’ knowledge and ability to understand radiation exposure to assess the useful...Introduction: Radiation is indispensable for diagnosis and treatment and is widely used in medicine. This study aimed to determine patients’ knowledge and ability to understand radiation exposure to assess the usefulness of providing information on radiation doses to examinees. Material and Methods: The radiation exposure literacy of mammography examinees was assessed using a new scale consisting of the following five items: “collection of information from various sources”, “selection of information necessary for oneself”, “understanding and communication of information”, “judgment of the reliability of information”, and “ability to plan and act based on information”. We analyzed the relationship of these items with examinees’ attributes and clarified the level of understanding of radiation exposure dose associated with mammography examinations by providing examinees with visual information in the form of color maps. Results: The relationship between “information collection” and several attributes of radiation exposure literacy was strong. In addition, providing visual information on radiation doses using dose distribution maps in mammography examinations could deepen the understanding of radiation doses among examinees. Conclusion: By understanding the radiation exposure literacy of examinees and comparing it with their attributes, it is possible to provide suggestions for developing methods of providing radiation dose information tailored to individual examinees. In addition, improving radiation exposure literacy will enable the development of skills necessary to provide safe medical care to medical examinees.展开更多
The effect of low voltage and low concentration contrast agent on image quality of coronary CT angiography,radiation dose and iodine intake was evaluated.A total of 121 patients with body mass index(BMI)<26 kg/m2 a...The effect of low voltage and low concentration contrast agent on image quality of coronary CT angiography,radiation dose and iodine intake was evaluated.A total of 121 patients with body mass index(BMI)<26 kg/m2 and heart rate(HR)<70 beats/min were randomly divided into four groups:group A(n=31,80 kVp,270 mgl/mL);group B(n=33,100 kVp,270 mgl/mL);group C(h=30,100 kVp,320 mgl/mL);group D(w=27,100 kVp,400 mgl/mL).The automatic current modulation system and the iterative algorithm for reconstruction were adopted in each group.The CT values and SD values of the aortic root(AR),subcutaneous fat,left coronary artery opening(LCA),and right coronary artery opening(RCA)were measured in all groups,the signalto-noise ratio(SNR)and contrast noise ratio(CNR)were calculated,and effective radiation dose and iodine intake were recorded.The subjective assessment for image quality was performed by two physicians using a 4-point scale.The results were compared using the one-way ANOVA and rank sum tests.The image quality of the four groups met the clinical diagnostic requirements.The CT values of AR in groups A,B,C,and D were 537.6±71.4,447.2±81.9,445.2±64.9 and 518.5±94.9 Hu,respectively,with no significant difference between group A and group D,or between group B and group C,while CT values in groups B and C were significantly lower than those in groups A and D(P<0.05).In groups A,B,C,and D,the LCA SNR values were 22.7±9.1,23.3±9.1,23.3±7.7 and 26.6±8.9,and the RCA CNR values were 26.9±9.&28.5±11.4,27.7土&8 and 32」±10.6,respectively.The AR visual scores in groups A,B,C and D were 3.8±0.2,3.9±0.3,3.9±0.3 and 4.0±0.3,respectively.There were no significant differences in SNR,CNR and visual score among the four groups(P>0.05).The radiation doses in groups A,B,C and D were 2.6±1.4,3.6±1.&4.9±3.5 and 4.9±2.8 mSv,respectively.The radiation dose in group A was significantly less than that in the rest three groups(P<0.05).The iodine intakes in groups A,B,C and D were 14.9±1.5,15.0±1.5,17.7±2.0 and 18.1±2.5 g,respectively.There was no significant difference in the intake of iodine between groups C and D,or between groups A and B,while iodine intake in groups A and B were significantly reduced as compared with that in groups C and D(P<0.05).It was concluded that for patients with low BMI and controlled HR,compared to 100 kVp tube voltage combined with multiple concentration contrast agents,80 kVp combined with 270 mgl/mL contrast agent is enough to ensure the quality of the images,and can reduce the radiation dose significantly,while reducing the amount of iodine intake notably,thus reducing the incidence of adverse reaction.展开更多
Objective:To analyze the radiation dose received by patients during hepatic artery infusion chemotherapy(HAIC)and transarterial chemoembolization(TACE)procedures and the related influencing factors.Methods:Data of 162...Objective:To analyze the radiation dose received by patients during hepatic artery infusion chemotherapy(HAIC)and transarterial chemoembolization(TACE)procedures and the related influencing factors.Methods:Data of 162 cases in the HAIC group and 230 cases in the TACE group were collected.The included covariates were Age(<45/45-59/≥60 years),BMI levels(underweight/normal weight/obesity),focus Dye of tumor(present/absent),lesion size(<5 cm/≥5 cm),superselection(present/absent),hepatic vascular variation(present/absent).The endpoints were postoperative dose-area product(DAP),exposure time and Air kerma(AK).Results:Of all included patients,the HAIC group patients were younger than those in the TACE group(P=0.028).The proportion of patients with large lesions in the HAIC group was higher than the TACE group(45.7%vs.33.9%,P=0.019).The proportion of patients who had superselection was lower in the HAIC group as compared to the TACE group(61.7%vs.82.2%,P<0.001).Generally,the HAIC group has lower DAP,exposure time and AK by 36.3%(P<0.001),38.2%(P<0.001),and 41.3%(P<0.001)than the TACE group,respectively.Linear regression analysis showed the procedure method(HAIC/TACE,P<0.001),type of DSA machine(Pheno/FD20,P<0.001),BMI levels(P<0.001),age(P=0.021),lesion size(<5 cm/≥5 cm,P=0.031)significantly correlated with low DAP.In the HAIC group,the type of DSA machine and BMI correlated with the radiation dose,while in the TACE group,the type of DSA machine,BMI,and lesion size correlated with the radiation dose.Conclusion:Compared with TACE,HAIC enables doctors and patients to receive lower radiation doses.Obese patients in both HAIC and TACE groups increase the radiation exposure in interventional doctors and patients,but large lesions only affect the radiation dose in the TACE procedure.展开更多
The content analysis of radioactive waste and radiation dose evaluation is considered as one of the important factors in the reactor facility design.This kind of buildings consists of the concrete for the most part an...The content analysis of radioactive waste and radiation dose evaluation is considered as one of the important factors in the reactor facility design.This kind of buildings consists of the concrete for the most part and uses it as the structure and shield of the building.Generally,the concrete has impurities such as cobalt,europium,nickel,and cesium with specific content depending on the production method or manufacturing company.Dominant radioactive nuclides generated from the fundamental components of concrete are considered that it is less contributed to the radiation dose because they are beta decay nuclides in general.Thus,impurities of irradiated concrete in the reactor facilities,are considered occasionally an important evaluation factor for induced activity.In this study,the influence on the activation of impurities in concrete was evaluated from the radiation dose and induced activity calculations.The calculation was evaluated at the bio-shield which is one of the areas with the highest neutron irradiation among the concrete structure in the reactor facility.The results show that radioactive nuclides with gamma decay were produced in these impurities.Moreover,the radiation dose of concrete with impurities was higher than concrete without impurities.The increased radiation dose was quantified through the content of impurities.展开更多
BACKGROUND Approximately 30%of patients with localized prostate cancer(PCa)who undergo radical prostatectomy will develop biochemical recurrence.In these patients,the only potentially curative treatment is postoperati...BACKGROUND Approximately 30%of patients with localized prostate cancer(PCa)who undergo radical prostatectomy will develop biochemical recurrence.In these patients,the only potentially curative treatment is postoperative radiotherapy(PORT)with or without hormone therapy.However,the optimal radiotherapy dose is unknown due to the limited data available.AIM To determine whether the postoperative radiotherapy dose influences biochemical failure-free survival(BFFS)in patients with PCa.METHODS Retrospective analysis of patients who underwent radical prostatectomy for PCa followed by PORT-either adjuvant radiotherapy(ART)or salvage radiotherapy(SRT)-between April 2002 and July 2015.From 2002 to 2010,the prescribed radiation dose to the surgical bed was 66-70 Gy in fractions of 2 Gy;from 2010 until July 2015,the prescribed dose was 70-72 Gy.Patients were grouped into three categories according to the total dose administered:66-68 Gy,70 Gy,and 72 Gy.The primary endpoint was BFFS,defined as the post-radiotherapy prostatespecific antigen(PSA)nadir+0.2 ng/mL.Secondary endpoints were overall survival(OS),cancer-specific survival(CSS),and metastasis-free survival(MFS;based on conventional imaging tests).Treatment-related genitourinary(GU)and gastrointestinal(GI)toxicity was evaluated according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.Finally,we aimed to identify potential prognostic factors.BFFS,OS,CSS,and MFS were calculated with the Kaplan-Meier method and the log-rank test.Univariate and multivariate Cox regression models were performed to explore between-group differences in survival outcome measures.RESULTS A total of 301 consecutive patients were included.Of these,93(33.6%)received ART and 186(66.4%)SRT;22 patients were excluded due to residual macroscopic disease or local recurrence in the surgical bed.In this subgroup(n=93),43 patients(46.2%)were Gleason score(GS)≤6,44(47.3%)GS 7,and 6(6.5%)GS≥8;clinical stage was cT1 in 51(54.8%),cT2 in 35(39.3%),and cT3 in one patient(1.1%);PSA was<10 ng/mL in 58(63%)patients,10-20 ng/mL in 28(30.6%),and≥20 ng/mL in 6(6.4%)patients.No differences were found in BFFS in this patient subset versus the entire cohort of patients(P=0.66).At a median follow-up of 113 months(range,4-233),5-and 10-year BFFS rates were 78.8%and 73.7%,respectively,with OS rates of 93.3%and 81.4%.The 5-year BFFS rates in three groups were as follows:69.6%(66-68 Gy),80.5%(70 Gy)and 82.6%(72 Gy)(P=0.12):the corresponding 10-year rates were 63.9%,72.9%,and 82.6%(P=0.12),respectively.No significant between-group differences were observed in MFS,CSS,or OS.On the univariate analysis,the following variables were significantly associated with BFFS:PSA at diagnosis;clinical stage(cT1 vs cT2);GS at diagnosis;treatment indication(ART vs SRT);pre-RT PSA levels;and RT dose 66-68 Gy vs.72 Gy(HR:2.05;95%CI:1.02-4.02,P=0.04).On the multivariate analysis,the following variables remained significant:biopsy GS(HR:2.85;95%CI:1.83-4.43,P<0.001);clinical stage(HR:2.31;95%CI:1.47-4.43,P=0.01);and treatment indication(HR:4.11;95%CI:2.06-8.17,P<0.001).Acute grade(G)1 GU toxicity was observed in 11(20.4%),17(19.8%),and 3(8.3%)patients in each group(66-68 Gy,70 Gy and 72 Gy),respectively(P=0.295).Acute G2 toxicity was observed in 2(3.7%),4(4.7%)and 2(5.6%)patients,respectively(P=0.949).Acute G1 GI toxicity was observed in 16(29.6%),23(26.7%)and 2(5.6%)patients in each group,respectively(P=0.011).Acute G2 GI toxicity was observed in 2(3.7%),6(6.9%)and 1(2.8%)patients,respectively(P=0.278).No cases of acute G3 GI toxicity were observed.CONCLUSION The findings of this retrospective study suggest that postoperative radiotherapy dose intensification in PCa is not superior to conventional radiotherapy treatment.展开更多
Purpose: Children are sometimes examined with Computed Tomography protocols designed for adults, leading to radiation doses higher than necessary. Lack of optimisation could lead to image quality higher than what is n...Purpose: Children are sometimes examined with Computed Tomography protocols designed for adults, leading to radiation doses higher than necessary. Lack of optimisation could lead to image quality higher than what is needed for diagnostic purposes with associated high doses to patients. Optimising the protocols for paediatric head trauma CT imaging will reduce radiation dose. Objective: The study aimed to optimise radiation dose and assess the image quality for a set of protocols by evaluating noise, a contrast to noise ratio, modulation transfer function and noise power spectrum. Methods: Somaton Sensation 64 was used to scan the head of an anthropomorphic phantom with a set of protocols. ImageJ software was used to analyse the paediatric head image from the scanner. IMPACTSCAN dosimeter software was used to evaluate the radiation dose to the various organs in the head. MATLAB was used to analyse the Modulation Transfer Function and the Noise Power. Results: The estimated Computed Tomography Dose Index volume (CTDI<sub>vol</sub>) increased with increasing tube current and tube voltage. The high pitch of 0.9 gave a lower dose than the 0.5 pitch. The eye lens received the highest radiation dose (39.2 mGy) whiles the thyroid received the least radiation dose (13.7 mGy). There was an increase in noise (62.46) when the H60 kernel was used and a lower noise (8.829) was noticed when the H30 kernel was used. Conclusion: The results obtained show that the H30 kernel (smooth kernel) gave higher values for noise and contrast to noise ratio (CNR) than the H60 kernel (sharp kernel). The H60 kernel produced high values for the modulation transfer function (MTF) and noise power spectrum (NPS). The eye lens received the highest radiation dose.展开更多
Background: CT in pregnant patients requires careful consideration of the radiation dose and corresponding radiation risks from ionizing radiation to the unborn child. The determination of foetal dose in diagnostic ra...Background: CT in pregnant patients requires careful consideration of the radiation dose and corresponding radiation risks from ionizing radiation to the unborn child. The determination of foetal dose in diagnostic radiology is of interest as a basis for risk estimates from medical exposure of the pregnant patient. Objective: To evaluate the foetal-maternal radiation doses delivered during the CT-Pelvimetry procedure and to estimate the risk to the unborn child to develop a cancer in childhood and hereditary disease. Materials and Methods: We investigate the foetal-maternal radiation doses during CT-scan Pelvimetry in Douala (Cameroon). Data of 194 helical acquisition CT-Pelvimetry were collected between May 2017 and May 2019. An average DLP for the examination was established and the average effective dose was evaluated. The fetal dose was calculated and the FetDose V5 program was used for risk estimations. Results: The average dose length product (DLP) was 56.17 mGy·cm (range: 51.69 - 59.21 mGy·cm). The average effective dose received by women pregnant was 0.78 mSv. The mean individual fetal dose was 1.5 mGy (range: 0.76 - 1.87 mGy). The risk of Childhood Cancer calculated was: range 1 in 16,000 to 1 in 10,000 and 1 in 260,000 to 1 in 106,000 to the risk of Hereditary Disease, respectively. Conclusion: This study shows that the foetal-maternal doses delivered during CT-Pelvimetry examinations are very low and the risks of childhood cancers and hereditary diseases are derisory, the technology should be further investigated to ensure its full potential for optimal diagnostic accuracy.展开更多
Objective:To survey and analyze the radiation doses of pediatric CT in some provinces(autonomous region)or municipalities in China,and compare them with the data released by the relevant domestic and international org...Objective:To survey and analyze the radiation doses of pediatric CT in some provinces(autonomous region)or municipalities in China,and compare them with the data released by the relevant domestic and international organizations,so as to identify the current status of Chinese pediatric CT radiation doses.Methods:Radiation doses of pediatric CT were collected during August and December 2016 from 40 hospitals(including 18 children’s hospitals)in 15 provinces,municipalities or autonomous regions across the China.The procedures of head CT,chest CT and abdomen CT were selected in these hospitals,and 10 patients in each group of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were collected at random for every procedure.Weighted CT dose index(CTDI_(w)),volumetric CT dose index(CTDI_(vol))and dose length product(DLP)were used as survey quantities.An independent sample Kruskal-Wallis rank sum test was performed for CTDI and DLP for each procedure for different age groups,and pairwise comparisons were performed for intra-group data.The same statistical method was also conducted for CTDI and DLP of the same procedure and age group in different provinces or municipalities.Results:The 75th percentiles of the distribution of CTDI and DLP in different age groups of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were as follows:36.5,43.4,49.1,51.1 mGy and 488,635,723,852 mGy.cm for head,6.1,6.4,6.8,9.6 mGy and 108,136,187,293 mGy.cm for chest,10.5,10.3,11.4,13.0 mGy and 251,284,353,523 mGy.cm for abdomen.The 50th percentiles of the distribution of the radiation doses for the same procedure varied with the ages(head,CTDI_(w):H=155.66,DLP:H=212.35,P<0.05;chest,CTDI_(vol):H=85.43,DLP:H=197.36,P<0.05;abdomen:H=62.29,DLP:H=173.22,P<0.05)and with lower dose at lower age.Radiation doses were close for head between 5-<10 y and 10-<15 y groups,for chest between 1-<5 y and 5-<10 y groups and between 5-<10 y and 10-<15 y groups,and for abdomen between 0-<1 y and 1-<5 y groups,with no statistically significant difference(the adjusted P>0.05).The dose levels of different provinces or municipalities in the same procedure and age group were not consistent,and the differences were statistically significant(P<0.05).The data were different from the domestic and international values of DRL.The 75th percentiles of CTDI_(w) and DLP values of head CT were close to the data from Japan and UK(United Kingdom),higher than the data from Korea and EC(European Commission).The 75th percentiles of CTDI values of all age groups were lower than the values of Japan and UK,and larger than that of Korea and EC in chest CT and abdomen CT.Conclusions:The 75th percentile values of the distribution of the pediatric CT doses obtained from the survey were inconsistent with those released by the relevant national and international organizations.It is necessary to update the national DRLs for pediatric CT on the basis of the actual survey data.展开更多
Recent studies confirm that current antiviral drugs are not fully effective on coronaviruses.Our research team introduced the idea of radiotherapy at low doses for coronavirus disease 2019(COVID-19)in March 2020.This ...Recent studies confirm that current antiviral drugs are not fully effective on coronaviruses.Our research team introduced the idea of radiotherapy at low doses for coronavirus disease 2019(COVID-19)in March 2020.This issue later received much attention from many scientists around the world.Low dose radiation therapy exerts modulatory effects in acute inflammation,potentiate the anti-viral immune responses,and can be localized to the organ affected by inflammatory reactions,such as lungs.The findings of the first clinical trial show that low dose radiation therapy is safe,and reveal early promise of efficacy.Moreover,plasma exchange therapy may be a rescue therapy in severe COVID-19 patients,as it can quickly eliminate the cytokines and chemokines from the circulation.Remdesivir was introduced as an anti-virus agent that prevents viral RNA synthesis and coronavirus replication and reduces the viral load.If antiviral therapy is poor,the virus has ample opportunity to mutate and increase its fitness through adaptive mutations.Given this consideration,instead a single treatment,we preferentially recommend a combination therapy using low dose radiation therapy plasma exchange and a robust antiviral agent(not yet available).This review provides a viewpoint concerning the potential synergistic effects of low dose radiation therapy,plasma exchange therapy and robust antiviral agent in severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2)-infected patients as a more effective strategy for possible treatment of severe COVID-19 patients.展开更多
Objective:To investigate the value of application of low-dose and optimized length CT scan on puncture results,complications and patients’radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules(PTN...Objective:To investigate the value of application of low-dose and optimized length CT scan on puncture results,complications and patients’radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules(PTNB).Methods:A total of 231 patients with PTNB under CT guidance were collected.Low dose scanning utilized tube current of 20 mA as compared with 40 mA in conventional dosage.Optimized length in CT is defined as intentionally narrowing the range of CT scanning just to cover 25 mm(5 layers)around the target layer during needle adjustment.According to whether low-dose scans and optimized length scans techniques were utilized,patients were divided into three groups:conventional group(conventional sequence+no optimization),optimized length group(conventional sequence+optimized length),and low-dose optimized length group(low dose sequence+optimized length).The ED(effective dose),the DLP(dose length product),the average CTDIvol(Volume CT dose index),total milliampere second between subgroups were compared.Results:Compared with the conventional group,ED,intraoperative guidance DLP,total milliseconds and operation time in the optimized length group were reduced by 18.2%(P=0.01),37%(P=0.003),17.5%(P=0.013)and13.3%(P=0.021)respectively.Compared with the optimized length group,the ED was reduced by 87%,preoperative positioning,intraoperative guidance and postoperative review DLP were also reduced by 88%,total milliampere second was reduced by 79%,with an average CTDIvol was reduced by 86%,in the low-dose optimized length group(P<0.001 for all).Conclusion:Optimizing the length during CT scanning can effectively reduce the intraoperative radiation dose and reduce the operation time compared with conventional plan;low-dose and optimized length CT scan can further reduce the total radiation dose compared with optimized length group with no differences on intraoperative complications,biopsy results and operation time.展开更多
AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients...AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point scale.RESULTS Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P < 0.001), as SD values in liver and spleen(liver 16.81 vs 14.41). Volumetric-Computed-Tomographic-Dose-Index(CTDIvol) and Dose-Length-Product(DLP) were significantly lower in low-dose CT as compared to standard-dose(DLP 1025.6 m Gy*cm vs 1429.2 m Gy*cm, P < 0.001) with overall dose reduction of 28.9%. Qualitative analysis did not reveal significant differences in image noise and diagnostic quality.CONCLUSION Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.展开更多
This study aims to measure the radiation dose over several steel-making factories in Khartoum region, Sudan. The authors used different techniques to detect the harmful Natural Occurring Radioactive Material (NORM) em...This study aims to measure the radiation dose over several steel-making factories in Khartoum region, Sudan. The authors used different techniques to detect the harmful Natural Occurring Radioactive Material (NORM) emitting through the steel-making process. While, an X-ray Diffractometer was utilized to detect the NORM in the isotopes clay elite and magnesio-ferrite over slag steel waste and soil. The worker dose was measured by using polimaster device and it was detected 56.448 mSv per year. And backpack mobile monitored the background over the waste and it was 0.048 μSv/h in accounting mode. In another hand gamma spectrometer with a high purity germanium detector detected the average of activity concentration of natural radionuclide over the slag steel waste and K-40 of it is 321 ± 3 Bq/Kg, Th-232 is 20.6 ± 5 Bq/Kg, Ra-226 is 15.2 ± 4 bq/Kg, Cs-137 is 3.33 ± 7 Bq/Kg, and over soil around the waste the concentration of K40, Ra226, Th232 was (185 ± 3, 12.6 ± 7, and 12.0 ± 5) Bq/Kg, respectively.展开更多
Background: To evaluate whether current dose reduction strategies for the CT component of hybrid Positron Emission Tomography—Computed Tomography (PET/CT) systems could reduce patient dose with maintaining adequate i...Background: To evaluate whether current dose reduction strategies for the CT component of hybrid Positron Emission Tomography—Computed Tomography (PET/CT) systems could reduce patient dose with maintaining adequate image quality for PET/CT studies. Materials and Methods: Literature survey was initially based on the selection of keywords and years of publication to identify potentially relevant articles, then the further search was conducted on the authors and references from these articles. The abstract of each article was first appraised to decide whether the content was relevant to this research question. The articles were classified into five groups: studies on dosimetry, studies on radiation-induced diseases, studies on dose reduction methods for CT-based attenuation correction (CTAC), studies on dose reduction methods for CT localization, and studies on reducing the need for a full-dose diagnostic CT in PET/CT imaging. 58 peer-reviewed articles were selected and appraised and 29 articles were used to compose this literature review. Results: The published nuclear medicine and medical physics literature were reviewed. CT dose contributed 47% - 81% of the total effective dose of a standard PET/CT study and was associated with radiation-induced diseases. The dose reduction techniques were extracted and divided into three categories: reducing the CT dose for attenuation correction (AC) and localization, selectively localizing CT use, and reducing the need for a full-dose diagnostic CT. Conclusion: Three strategies have been demonstrated, with high potential for reducing patient dose while maintaining an adequate CT image quality, used for CTCA localization and diagnosis, respectively.展开更多
Objective This study aimed to explore the feasibility of enhancing image quality in computed tomography(CT) pulmonary angiography (CTPA) and reducing radiation dose using the nonlinear blending (NLB)technique of dual-...Objective This study aimed to explore the feasibility of enhancing image quality in computed tomography(CT) pulmonary angiography (CTPA) and reducing radiation dose using the nonlinear blending (NLB)technique of dual-energy CT.Methods A total of 61 patients scheduled for CTPA were enrolled, and 30 patients underwent dual-energyscanning. Nonlinear blending images (NLB group) and three groups of linear blending images (LB group,80 kV group, and 140 kV group) were reconstructed after scanning;31 patients underwent single-energyscanning (120 kV group). The CT values and standard deviations of the pulmonary trunk, left and rightpulmonary arteries, and ipsilateral back muscle at the bifurcation level of the left and right pulmonaryarteries were measured. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the fivegroups were calculated. The subjective image quality of the five groups was assessed. The radiation dosesof the dual- and single-energy groups were recorded and calculated.Results The CNR and SNR values of blood vessels in the NLB group were significantly higher than thosein the LB, 140 kV, and 80 kV groups (CNR of pulmonary artery trunk: t = 3.50, 4.06, 7.17, all P < 0.05;SNRof pulmonary trunk: t = 3.76, 4.71, 6.92, all P < 0.05). There were no statistical differences in the CNR andSNR values between the NLB group and 120 kV group (P > 0.05). The effective radiation dose of the dualenergygroup was lower than that of the single-energy group (t = –4.52, P < 0.05). The subjective scores ofimages in the NLB group were the highest (4.28 ± 0.74).Conclusion The NLB technique of dual-energy CT can improve the image quality of CTPA and reducethe radiation dose, providing more reliable imaging data for the clinical diagnosis of pulmonary embolism.展开更多
Background: The PET/CT imaging studies have two doses components the dose from the PET radiopharmaceutical and the other from the low dose CT used for PET images attenuation correction. We have one PET/CT scanner at o...Background: The PET/CT imaging studies have two doses components the dose from the PET radiopharmaceutical and the other from the low dose CT used for PET images attenuation correction. We have one PET/CT scanner at our institution a Philips Time of Flight scanner. Our local patient’s radiation protection rules requires continuous assessment of radiation doses delivered to our patients. Purposes: The objectives of this study are to develop a weight- based facility DRLs for paediatric F-18-FDG PET-CT imaging for oncology in a large tertiary hospital and to determine whether the calculated DRLs compares with internationally published DRLs. Materials & Methods: Radiation dose data and patient demographics of two-hundreds and sixteen paediatric PET-CT oncology patients imaging procedures from one large tertiary hospital were selected and analysed in order to establish a facility paediatric DRLs. Statistical analysis was performed. Results: The PET dose reference levels ranged between [62 - 525] MBq of injected activity for a range of pediatric age groups. The CTDI<sub>vol</sub> values were between 3.5 and 16.5 mGy for all age groups. Comparison with current EANM and SNMMI recommendations of patient’s dose are discussed. Conclusion: Our pediatric PET/CT reference levels are higher than the ones reported internationally with notable variations. .展开更多
Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 1...Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 154 consecutive trauma patients with the need for chest CT scan were included. Two different BMI-adjusted CT protocols at a fixed voltage tube and the same scan length were applied. Dose estimation parameters like CT dose index (CTDI), dose length product (DLP) and effective breast dose were calculated. Breast surface dose was obtained by using thermoluminescence dosimeters (TLDs) and eventually, the life attributable risk (LAR) of cancer incidence was estimated. The mean effective dose was 4.87 ± 2.3 mSv and 5.12 ± 2.8 mSv for patients who were scanned with tube currents of 120 mAs and 200 mAs, respectively. There was no significant difference between organ surface doses for females but in males it was notable. The risk of cancer incidence is lower for protocol 1 in comparison with protocol 2. Optimizing tube current of 120 mAs reduced breast surface dose up to 50% in comparison with the tube current of 200 mAs. In trauma patients, using lower tube current based on BMI has notable impact on the absorbed dose in the breast and can reduce the breast cancer risk by nearly 33.6% for women.展开更多
Background: Magnetic resonance(MR)-guided ultra-hypofractionated radiotherapy with whole-pelvic irradiation(UHF-WPRT)is a novel approach to radiotherapy for patients with high-risk(HR)and very high-risk(VHR)prostate c...Background: Magnetic resonance(MR)-guided ultra-hypofractionated radiotherapy with whole-pelvic irradiation(UHF-WPRT)is a novel approach to radiotherapy for patients with high-risk(HR)and very high-risk(VHR)prostate cancer(PCa).However,the inherent complexity of adaptive UHF-WPRT might inevitably result in longer on-couch time.We aimed to estimate the delivered dose,study the feasibility and safety of adaptive UHF-WPRT on a 1.5-Tesla MR-Linac.Methods: Ten patients with clinical stage T3a-4N0-1M0-1c PCa,who consecutively received UHF-WPRT,were enrolled prospectively.The contours of the target and organ-at-risks on the position verification-MR(PV-MR),beam-on 3D-MR(Bn-MR),and post-MR(after radiotherapy delivery)were derived from the pre-MR data by deformable image registration.The physician then manually adjusted them,and dose recalculation was performed accordingly.GraphPad Prism 9(GraphPad Prism Software Inc.)was utilized for conducting statistical analyses.Results: In total,we collected 188 MR scans(50 pre-MR,50 PV-MR,44 Bn-MR,and 44 post-MR scans).With median 59 min,the mean prostate clinical target volume(CTV)-V_(100%)was 98.59%±2.74%,and the mean pelvic CTVp-V_(100%)relative percentages of all scans was 99.60%±1.18%.The median V29 Gy change in the rectal wall was−2%(−18%to 20%).With a median follow-up of 9 months,no patient had acute Common Terminology Criteria for Adverse Events(CTCAE)grade 2 or more severe genitourinary(GU)or gastrointestinal(GI)toxicities(0%).Conclusion: UHF-RT to the prostate and the whole pelvis with concomitant boost to positive nodes using an Adapt-To-Shape(ATS)workflow was technically feasible for patients with HR and VHR PCa,presenting only mild GU and GI toxicities.The estimated target dose during the beam-on phase was clinically acceptable based on the 3D-MR-based dosimetry analysis.Clinical trial registration Chinese Clinical Trial Registry ChiCTR2000033382.展开更多
Computed tomography(CT)has seen a rapid increase in use in recent years.Radiation from CT accounts for a significant proportion of total medical radiation.However,given the known harmful impact of radiation exposure t...Computed tomography(CT)has seen a rapid increase in use in recent years.Radiation from CT accounts for a significant proportion of total medical radiation.However,given the known harmful impact of radiation exposure to the human body,the excessive use of CT in medical environments raises concerns.Concerns over increasing CT use and its associated radiation burden have prompted efforts to reduce radiation dose during the procedure.Therefore,low-dose CT has attracted major attention in the radiology,since CT-associated x-ray radiation carries health risks for patients.The reduction of the CT radiation dose,however,compromises the signal-to-noise ratio,which affects image quality and diagnostic performance.Therefore,several denoising methods have been developed and applied to image processing technologies with the goal of reducing image noise.Recently,deep learning applications that improve image quality by reducing the noise and artifacts have become commercially available for diagnostic imaging.Deep learning image reconstruction shows great potential as an advanced reconstruction method to improve the quality of clinical CT images.These improvements can provide significant benefit to patients regardless of their disease,and further advances are expected in the near future.展开更多
We successfully obtained 3 D skeletal images of Hyla suweonensis, employing a nondestructive method by applying appropriate anesthesia and limiting the radiation dose. H. suweonensis is a tree frog endemic to Korea an...We successfully obtained 3 D skeletal images of Hyla suweonensis, employing a nondestructive method by applying appropriate anesthesia and limiting the radiation dose. H. suweonensis is a tree frog endemic to Korea and is on the list of endangered species. Previous studies have employed caliper-based measurements and two-dimensional(2 D) X-ray imaging for anatomical analyses of the skeletal system or bone types of H. suweonensis. In this work we reconstructed three-dimensional(3 D) skeletal images of H. suweonensis, utilizing a nondestructive micro-computed tomography(micro-CT) with a short scan and low radiation dose(i.e. 4 min and 0.16 Gy). Importantly, our approach can be applied to the imaging of 3 D skeletal systems of other endangered frog species, allowing both versatile and high contrast images of anatomical structures without causing any significant damages to the living animal.展开更多
Background:As molecular advances have deepened the knowledge on low-grade glioma(LGG),we investigated the effect of higher radiation dose on the survival of IDH-wildtype(IDHwt)LGG.Methods:In the current study,52 IDHwt...Background:As molecular advances have deepened the knowledge on low-grade glioma(LGG),we investigated the effect of higher radiation dose on the survival of IDH-wildtype(IDHwt)LGG.Methods:In the current study,52 IDHwt LGG patients who received radiotherapy were enrolled from the Chinese Glioma Genome Atlas dataset.Radiation doses>54 Gy were defined as high-dose,whereas doses≤54 Gy were defined as low-dose.We performed univariate and multivariate survival analyses to examine the prognostic role of high-dose radiotherapy.Results:In total,the radiation dose ranged from 48.6 Gy to 61.2 Gy,with a median of 55.8 Gy,and 31 patients were grouped into high-dose radiation.Univariate survival analysis indicated that high-dose radiotherapy(p=0.015),tumors located in the frontal lobe(p=0.009),and pathology of astrocytoma(p=0.037)were significantly prognostic factors for overall survival.In multivariate survival analysis,high-dose radiotherapy(p=0.028)and tumors located in the frontal lobe(p=0.016)were independently associated with better overall survival.Conclusions:In conclusion,high-dose radiotherapy independently improved the survival of IDHwt LGG.This can guide treatments for glioma with known molecular characteristics.展开更多
文摘Introduction: Radiation is indispensable for diagnosis and treatment and is widely used in medicine. This study aimed to determine patients’ knowledge and ability to understand radiation exposure to assess the usefulness of providing information on radiation doses to examinees. Material and Methods: The radiation exposure literacy of mammography examinees was assessed using a new scale consisting of the following five items: “collection of information from various sources”, “selection of information necessary for oneself”, “understanding and communication of information”, “judgment of the reliability of information”, and “ability to plan and act based on information”. We analyzed the relationship of these items with examinees’ attributes and clarified the level of understanding of radiation exposure dose associated with mammography examinations by providing examinees with visual information in the form of color maps. Results: The relationship between “information collection” and several attributes of radiation exposure literacy was strong. In addition, providing visual information on radiation doses using dose distribution maps in mammography examinations could deepen the understanding of radiation doses among examinees. Conclusion: By understanding the radiation exposure literacy of examinees and comparing it with their attributes, it is possible to provide suggestions for developing methods of providing radiation dose information tailored to individual examinees. In addition, improving radiation exposure literacy will enable the development of skills necessary to provide safe medical care to medical examinees.
文摘The effect of low voltage and low concentration contrast agent on image quality of coronary CT angiography,radiation dose and iodine intake was evaluated.A total of 121 patients with body mass index(BMI)<26 kg/m2 and heart rate(HR)<70 beats/min were randomly divided into four groups:group A(n=31,80 kVp,270 mgl/mL);group B(n=33,100 kVp,270 mgl/mL);group C(h=30,100 kVp,320 mgl/mL);group D(w=27,100 kVp,400 mgl/mL).The automatic current modulation system and the iterative algorithm for reconstruction were adopted in each group.The CT values and SD values of the aortic root(AR),subcutaneous fat,left coronary artery opening(LCA),and right coronary artery opening(RCA)were measured in all groups,the signalto-noise ratio(SNR)and contrast noise ratio(CNR)were calculated,and effective radiation dose and iodine intake were recorded.The subjective assessment for image quality was performed by two physicians using a 4-point scale.The results were compared using the one-way ANOVA and rank sum tests.The image quality of the four groups met the clinical diagnostic requirements.The CT values of AR in groups A,B,C,and D were 537.6±71.4,447.2±81.9,445.2±64.9 and 518.5±94.9 Hu,respectively,with no significant difference between group A and group D,or between group B and group C,while CT values in groups B and C were significantly lower than those in groups A and D(P<0.05).In groups A,B,C,and D,the LCA SNR values were 22.7±9.1,23.3±9.1,23.3±7.7 and 26.6±8.9,and the RCA CNR values were 26.9±9.&28.5±11.4,27.7土&8 and 32」±10.6,respectively.The AR visual scores in groups A,B,C and D were 3.8±0.2,3.9±0.3,3.9±0.3 and 4.0±0.3,respectively.There were no significant differences in SNR,CNR and visual score among the four groups(P>0.05).The radiation doses in groups A,B,C and D were 2.6±1.4,3.6±1.&4.9±3.5 and 4.9±2.8 mSv,respectively.The radiation dose in group A was significantly less than that in the rest three groups(P<0.05).The iodine intakes in groups A,B,C and D were 14.9±1.5,15.0±1.5,17.7±2.0 and 18.1±2.5 g,respectively.There was no significant difference in the intake of iodine between groups C and D,or between groups A and B,while iodine intake in groups A and B were significantly reduced as compared with that in groups C and D(P<0.05).It was concluded that for patients with low BMI and controlled HR,compared to 100 kVp tube voltage combined with multiple concentration contrast agents,80 kVp combined with 270 mgl/mL contrast agent is enough to ensure the quality of the images,and can reduce the radiation dose significantly,while reducing the amount of iodine intake notably,thus reducing the incidence of adverse reaction.
基金supported by grants from National Natural Science Foundation of China(No.81801804)。
文摘Objective:To analyze the radiation dose received by patients during hepatic artery infusion chemotherapy(HAIC)and transarterial chemoembolization(TACE)procedures and the related influencing factors.Methods:Data of 162 cases in the HAIC group and 230 cases in the TACE group were collected.The included covariates were Age(<45/45-59/≥60 years),BMI levels(underweight/normal weight/obesity),focus Dye of tumor(present/absent),lesion size(<5 cm/≥5 cm),superselection(present/absent),hepatic vascular variation(present/absent).The endpoints were postoperative dose-area product(DAP),exposure time and Air kerma(AK).Results:Of all included patients,the HAIC group patients were younger than those in the TACE group(P=0.028).The proportion of patients with large lesions in the HAIC group was higher than the TACE group(45.7%vs.33.9%,P=0.019).The proportion of patients who had superselection was lower in the HAIC group as compared to the TACE group(61.7%vs.82.2%,P<0.001).Generally,the HAIC group has lower DAP,exposure time and AK by 36.3%(P<0.001),38.2%(P<0.001),and 41.3%(P<0.001)than the TACE group,respectively.Linear regression analysis showed the procedure method(HAIC/TACE,P<0.001),type of DSA machine(Pheno/FD20,P<0.001),BMI levels(P<0.001),age(P=0.021),lesion size(<5 cm/≥5 cm,P=0.031)significantly correlated with low DAP.In the HAIC group,the type of DSA machine and BMI correlated with the radiation dose,while in the TACE group,the type of DSA machine,BMI,and lesion size correlated with the radiation dose.Conclusion:Compared with TACE,HAIC enables doctors and patients to receive lower radiation doses.Obese patients in both HAIC and TACE groups increase the radiation exposure in interventional doctors and patients,but large lesions only affect the radiation dose in the TACE procedure.
基金This work was supported by the R&D program throughout the National Fusion Research Institute(NFRI)funded by the Ministry of Science of the Republic of Korea(Project No.:201800000002652),and Innovative Technology Center for Radiation Safety(ITRS).
文摘The content analysis of radioactive waste and radiation dose evaluation is considered as one of the important factors in the reactor facility design.This kind of buildings consists of the concrete for the most part and uses it as the structure and shield of the building.Generally,the concrete has impurities such as cobalt,europium,nickel,and cesium with specific content depending on the production method or manufacturing company.Dominant radioactive nuclides generated from the fundamental components of concrete are considered that it is less contributed to the radiation dose because they are beta decay nuclides in general.Thus,impurities of irradiated concrete in the reactor facilities,are considered occasionally an important evaluation factor for induced activity.In this study,the influence on the activation of impurities in concrete was evaluated from the radiation dose and induced activity calculations.The calculation was evaluated at the bio-shield which is one of the areas with the highest neutron irradiation among the concrete structure in the reactor facility.The results show that radioactive nuclides with gamma decay were produced in these impurities.Moreover,the radiation dose of concrete with impurities was higher than concrete without impurities.The increased radiation dose was quantified through the content of impurities.
文摘BACKGROUND Approximately 30%of patients with localized prostate cancer(PCa)who undergo radical prostatectomy will develop biochemical recurrence.In these patients,the only potentially curative treatment is postoperative radiotherapy(PORT)with or without hormone therapy.However,the optimal radiotherapy dose is unknown due to the limited data available.AIM To determine whether the postoperative radiotherapy dose influences biochemical failure-free survival(BFFS)in patients with PCa.METHODS Retrospective analysis of patients who underwent radical prostatectomy for PCa followed by PORT-either adjuvant radiotherapy(ART)or salvage radiotherapy(SRT)-between April 2002 and July 2015.From 2002 to 2010,the prescribed radiation dose to the surgical bed was 66-70 Gy in fractions of 2 Gy;from 2010 until July 2015,the prescribed dose was 70-72 Gy.Patients were grouped into three categories according to the total dose administered:66-68 Gy,70 Gy,and 72 Gy.The primary endpoint was BFFS,defined as the post-radiotherapy prostatespecific antigen(PSA)nadir+0.2 ng/mL.Secondary endpoints were overall survival(OS),cancer-specific survival(CSS),and metastasis-free survival(MFS;based on conventional imaging tests).Treatment-related genitourinary(GU)and gastrointestinal(GI)toxicity was evaluated according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.Finally,we aimed to identify potential prognostic factors.BFFS,OS,CSS,and MFS were calculated with the Kaplan-Meier method and the log-rank test.Univariate and multivariate Cox regression models were performed to explore between-group differences in survival outcome measures.RESULTS A total of 301 consecutive patients were included.Of these,93(33.6%)received ART and 186(66.4%)SRT;22 patients were excluded due to residual macroscopic disease or local recurrence in the surgical bed.In this subgroup(n=93),43 patients(46.2%)were Gleason score(GS)≤6,44(47.3%)GS 7,and 6(6.5%)GS≥8;clinical stage was cT1 in 51(54.8%),cT2 in 35(39.3%),and cT3 in one patient(1.1%);PSA was<10 ng/mL in 58(63%)patients,10-20 ng/mL in 28(30.6%),and≥20 ng/mL in 6(6.4%)patients.No differences were found in BFFS in this patient subset versus the entire cohort of patients(P=0.66).At a median follow-up of 113 months(range,4-233),5-and 10-year BFFS rates were 78.8%and 73.7%,respectively,with OS rates of 93.3%and 81.4%.The 5-year BFFS rates in three groups were as follows:69.6%(66-68 Gy),80.5%(70 Gy)and 82.6%(72 Gy)(P=0.12):the corresponding 10-year rates were 63.9%,72.9%,and 82.6%(P=0.12),respectively.No significant between-group differences were observed in MFS,CSS,or OS.On the univariate analysis,the following variables were significantly associated with BFFS:PSA at diagnosis;clinical stage(cT1 vs cT2);GS at diagnosis;treatment indication(ART vs SRT);pre-RT PSA levels;and RT dose 66-68 Gy vs.72 Gy(HR:2.05;95%CI:1.02-4.02,P=0.04).On the multivariate analysis,the following variables remained significant:biopsy GS(HR:2.85;95%CI:1.83-4.43,P<0.001);clinical stage(HR:2.31;95%CI:1.47-4.43,P=0.01);and treatment indication(HR:4.11;95%CI:2.06-8.17,P<0.001).Acute grade(G)1 GU toxicity was observed in 11(20.4%),17(19.8%),and 3(8.3%)patients in each group(66-68 Gy,70 Gy and 72 Gy),respectively(P=0.295).Acute G2 toxicity was observed in 2(3.7%),4(4.7%)and 2(5.6%)patients,respectively(P=0.949).Acute G1 GI toxicity was observed in 16(29.6%),23(26.7%)and 2(5.6%)patients in each group,respectively(P=0.011).Acute G2 GI toxicity was observed in 2(3.7%),6(6.9%)and 1(2.8%)patients,respectively(P=0.278).No cases of acute G3 GI toxicity were observed.CONCLUSION The findings of this retrospective study suggest that postoperative radiotherapy dose intensification in PCa is not superior to conventional radiotherapy treatment.
文摘Purpose: Children are sometimes examined with Computed Tomography protocols designed for adults, leading to radiation doses higher than necessary. Lack of optimisation could lead to image quality higher than what is needed for diagnostic purposes with associated high doses to patients. Optimising the protocols for paediatric head trauma CT imaging will reduce radiation dose. Objective: The study aimed to optimise radiation dose and assess the image quality for a set of protocols by evaluating noise, a contrast to noise ratio, modulation transfer function and noise power spectrum. Methods: Somaton Sensation 64 was used to scan the head of an anthropomorphic phantom with a set of protocols. ImageJ software was used to analyse the paediatric head image from the scanner. IMPACTSCAN dosimeter software was used to evaluate the radiation dose to the various organs in the head. MATLAB was used to analyse the Modulation Transfer Function and the Noise Power. Results: The estimated Computed Tomography Dose Index volume (CTDI<sub>vol</sub>) increased with increasing tube current and tube voltage. The high pitch of 0.9 gave a lower dose than the 0.5 pitch. The eye lens received the highest radiation dose (39.2 mGy) whiles the thyroid received the least radiation dose (13.7 mGy). There was an increase in noise (62.46) when the H60 kernel was used and a lower noise (8.829) was noticed when the H30 kernel was used. Conclusion: The results obtained show that the H30 kernel (smooth kernel) gave higher values for noise and contrast to noise ratio (CNR) than the H60 kernel (sharp kernel). The H60 kernel produced high values for the modulation transfer function (MTF) and noise power spectrum (NPS). The eye lens received the highest radiation dose.
文摘Background: CT in pregnant patients requires careful consideration of the radiation dose and corresponding radiation risks from ionizing radiation to the unborn child. The determination of foetal dose in diagnostic radiology is of interest as a basis for risk estimates from medical exposure of the pregnant patient. Objective: To evaluate the foetal-maternal radiation doses delivered during the CT-Pelvimetry procedure and to estimate the risk to the unborn child to develop a cancer in childhood and hereditary disease. Materials and Methods: We investigate the foetal-maternal radiation doses during CT-scan Pelvimetry in Douala (Cameroon). Data of 194 helical acquisition CT-Pelvimetry were collected between May 2017 and May 2019. An average DLP for the examination was established and the average effective dose was evaluated. The fetal dose was calculated and the FetDose V5 program was used for risk estimations. Results: The average dose length product (DLP) was 56.17 mGy·cm (range: 51.69 - 59.21 mGy·cm). The average effective dose received by women pregnant was 0.78 mSv. The mean individual fetal dose was 1.5 mGy (range: 0.76 - 1.87 mGy). The risk of Childhood Cancer calculated was: range 1 in 16,000 to 1 in 10,000 and 1 in 260,000 to 1 in 106,000 to the risk of Hereditary Disease, respectively. Conclusion: This study shows that the foetal-maternal doses delivered during CT-Pelvimetry examinations are very low and the risks of childhood cancers and hereditary diseases are derisory, the technology should be further investigated to ensure its full potential for optimal diagnostic accuracy.
文摘Objective:To survey and analyze the radiation doses of pediatric CT in some provinces(autonomous region)or municipalities in China,and compare them with the data released by the relevant domestic and international organizations,so as to identify the current status of Chinese pediatric CT radiation doses.Methods:Radiation doses of pediatric CT were collected during August and December 2016 from 40 hospitals(including 18 children’s hospitals)in 15 provinces,municipalities or autonomous regions across the China.The procedures of head CT,chest CT and abdomen CT were selected in these hospitals,and 10 patients in each group of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were collected at random for every procedure.Weighted CT dose index(CTDI_(w)),volumetric CT dose index(CTDI_(vol))and dose length product(DLP)were used as survey quantities.An independent sample Kruskal-Wallis rank sum test was performed for CTDI and DLP for each procedure for different age groups,and pairwise comparisons were performed for intra-group data.The same statistical method was also conducted for CTDI and DLP of the same procedure and age group in different provinces or municipalities.Results:The 75th percentiles of the distribution of CTDI and DLP in different age groups of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were as follows:36.5,43.4,49.1,51.1 mGy and 488,635,723,852 mGy.cm for head,6.1,6.4,6.8,9.6 mGy and 108,136,187,293 mGy.cm for chest,10.5,10.3,11.4,13.0 mGy and 251,284,353,523 mGy.cm for abdomen.The 50th percentiles of the distribution of the radiation doses for the same procedure varied with the ages(head,CTDI_(w):H=155.66,DLP:H=212.35,P<0.05;chest,CTDI_(vol):H=85.43,DLP:H=197.36,P<0.05;abdomen:H=62.29,DLP:H=173.22,P<0.05)and with lower dose at lower age.Radiation doses were close for head between 5-<10 y and 10-<15 y groups,for chest between 1-<5 y and 5-<10 y groups and between 5-<10 y and 10-<15 y groups,and for abdomen between 0-<1 y and 1-<5 y groups,with no statistically significant difference(the adjusted P>0.05).The dose levels of different provinces or municipalities in the same procedure and age group were not consistent,and the differences were statistically significant(P<0.05).The data were different from the domestic and international values of DRL.The 75th percentiles of CTDI_(w) and DLP values of head CT were close to the data from Japan and UK(United Kingdom),higher than the data from Korea and EC(European Commission).The 75th percentiles of CTDI values of all age groups were lower than the values of Japan and UK,and larger than that of Korea and EC in chest CT and abdomen CT.Conclusions:The 75th percentile values of the distribution of the pediatric CT doses obtained from the survey were inconsistent with those released by the relevant national and international organizations.It is necessary to update the national DRLs for pediatric CT on the basis of the actual survey data.
文摘Recent studies confirm that current antiviral drugs are not fully effective on coronaviruses.Our research team introduced the idea of radiotherapy at low doses for coronavirus disease 2019(COVID-19)in March 2020.This issue later received much attention from many scientists around the world.Low dose radiation therapy exerts modulatory effects in acute inflammation,potentiate the anti-viral immune responses,and can be localized to the organ affected by inflammatory reactions,such as lungs.The findings of the first clinical trial show that low dose radiation therapy is safe,and reveal early promise of efficacy.Moreover,plasma exchange therapy may be a rescue therapy in severe COVID-19 patients,as it can quickly eliminate the cytokines and chemokines from the circulation.Remdesivir was introduced as an anti-virus agent that prevents viral RNA synthesis and coronavirus replication and reduces the viral load.If antiviral therapy is poor,the virus has ample opportunity to mutate and increase its fitness through adaptive mutations.Given this consideration,instead a single treatment,we preferentially recommend a combination therapy using low dose radiation therapy plasma exchange and a robust antiviral agent(not yet available).This review provides a viewpoint concerning the potential synergistic effects of low dose radiation therapy,plasma exchange therapy and robust antiviral agent in severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2)-infected patients as a more effective strategy for possible treatment of severe COVID-19 patients.
基金supported by grants from National Natural Science Foundation of China(No.81801804).
文摘Objective:To investigate the value of application of low-dose and optimized length CT scan on puncture results,complications and patients’radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules(PTNB).Methods:A total of 231 patients with PTNB under CT guidance were collected.Low dose scanning utilized tube current of 20 mA as compared with 40 mA in conventional dosage.Optimized length in CT is defined as intentionally narrowing the range of CT scanning just to cover 25 mm(5 layers)around the target layer during needle adjustment.According to whether low-dose scans and optimized length scans techniques were utilized,patients were divided into three groups:conventional group(conventional sequence+no optimization),optimized length group(conventional sequence+optimized length),and low-dose optimized length group(low dose sequence+optimized length).The ED(effective dose),the DLP(dose length product),the average CTDIvol(Volume CT dose index),total milliampere second between subgroups were compared.Results:Compared with the conventional group,ED,intraoperative guidance DLP,total milliseconds and operation time in the optimized length group were reduced by 18.2%(P=0.01),37%(P=0.003),17.5%(P=0.013)and13.3%(P=0.021)respectively.Compared with the optimized length group,the ED was reduced by 87%,preoperative positioning,intraoperative guidance and postoperative review DLP were also reduced by 88%,total milliampere second was reduced by 79%,with an average CTDIvol was reduced by 86%,in the low-dose optimized length group(P<0.001 for all).Conclusion:Optimizing the length during CT scanning can effectively reduce the intraoperative radiation dose and reduce the operation time compared with conventional plan;low-dose and optimized length CT scan can further reduce the total radiation dose compared with optimized length group with no differences on intraoperative complications,biopsy results and operation time.
文摘AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point scale.RESULTS Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P < 0.001), as SD values in liver and spleen(liver 16.81 vs 14.41). Volumetric-Computed-Tomographic-Dose-Index(CTDIvol) and Dose-Length-Product(DLP) were significantly lower in low-dose CT as compared to standard-dose(DLP 1025.6 m Gy*cm vs 1429.2 m Gy*cm, P < 0.001) with overall dose reduction of 28.9%. Qualitative analysis did not reveal significant differences in image noise and diagnostic quality.CONCLUSION Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.
文摘This study aims to measure the radiation dose over several steel-making factories in Khartoum region, Sudan. The authors used different techniques to detect the harmful Natural Occurring Radioactive Material (NORM) emitting through the steel-making process. While, an X-ray Diffractometer was utilized to detect the NORM in the isotopes clay elite and magnesio-ferrite over slag steel waste and soil. The worker dose was measured by using polimaster device and it was detected 56.448 mSv per year. And backpack mobile monitored the background over the waste and it was 0.048 μSv/h in accounting mode. In another hand gamma spectrometer with a high purity germanium detector detected the average of activity concentration of natural radionuclide over the slag steel waste and K-40 of it is 321 ± 3 Bq/Kg, Th-232 is 20.6 ± 5 Bq/Kg, Ra-226 is 15.2 ± 4 bq/Kg, Cs-137 is 3.33 ± 7 Bq/Kg, and over soil around the waste the concentration of K40, Ra226, Th232 was (185 ± 3, 12.6 ± 7, and 12.0 ± 5) Bq/Kg, respectively.
文摘Background: To evaluate whether current dose reduction strategies for the CT component of hybrid Positron Emission Tomography—Computed Tomography (PET/CT) systems could reduce patient dose with maintaining adequate image quality for PET/CT studies. Materials and Methods: Literature survey was initially based on the selection of keywords and years of publication to identify potentially relevant articles, then the further search was conducted on the authors and references from these articles. The abstract of each article was first appraised to decide whether the content was relevant to this research question. The articles were classified into five groups: studies on dosimetry, studies on radiation-induced diseases, studies on dose reduction methods for CT-based attenuation correction (CTAC), studies on dose reduction methods for CT localization, and studies on reducing the need for a full-dose diagnostic CT in PET/CT imaging. 58 peer-reviewed articles were selected and appraised and 29 articles were used to compose this literature review. Results: The published nuclear medicine and medical physics literature were reviewed. CT dose contributed 47% - 81% of the total effective dose of a standard PET/CT study and was associated with radiation-induced diseases. The dose reduction techniques were extracted and divided into three categories: reducing the CT dose for attenuation correction (AC) and localization, selectively localizing CT use, and reducing the need for a full-dose diagnostic CT. Conclusion: Three strategies have been demonstrated, with high potential for reducing patient dose while maintaining an adequate CT image quality, used for CTCA localization and diagnosis, respectively.
基金Supported by a grant from the Science and Technology Plan of Sichuan Province(No.2021YFS0225)the Science and Technology Plan of Chengdu(No.2021-YF05-01507-SN).
文摘Objective This study aimed to explore the feasibility of enhancing image quality in computed tomography(CT) pulmonary angiography (CTPA) and reducing radiation dose using the nonlinear blending (NLB)technique of dual-energy CT.Methods A total of 61 patients scheduled for CTPA were enrolled, and 30 patients underwent dual-energyscanning. Nonlinear blending images (NLB group) and three groups of linear blending images (LB group,80 kV group, and 140 kV group) were reconstructed after scanning;31 patients underwent single-energyscanning (120 kV group). The CT values and standard deviations of the pulmonary trunk, left and rightpulmonary arteries, and ipsilateral back muscle at the bifurcation level of the left and right pulmonaryarteries were measured. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the fivegroups were calculated. The subjective image quality of the five groups was assessed. The radiation dosesof the dual- and single-energy groups were recorded and calculated.Results The CNR and SNR values of blood vessels in the NLB group were significantly higher than thosein the LB, 140 kV, and 80 kV groups (CNR of pulmonary artery trunk: t = 3.50, 4.06, 7.17, all P < 0.05;SNRof pulmonary trunk: t = 3.76, 4.71, 6.92, all P < 0.05). There were no statistical differences in the CNR andSNR values between the NLB group and 120 kV group (P > 0.05). The effective radiation dose of the dualenergygroup was lower than that of the single-energy group (t = –4.52, P < 0.05). The subjective scores ofimages in the NLB group were the highest (4.28 ± 0.74).Conclusion The NLB technique of dual-energy CT can improve the image quality of CTPA and reducethe radiation dose, providing more reliable imaging data for the clinical diagnosis of pulmonary embolism.
文摘Background: The PET/CT imaging studies have two doses components the dose from the PET radiopharmaceutical and the other from the low dose CT used for PET images attenuation correction. We have one PET/CT scanner at our institution a Philips Time of Flight scanner. Our local patient’s radiation protection rules requires continuous assessment of radiation doses delivered to our patients. Purposes: The objectives of this study are to develop a weight- based facility DRLs for paediatric F-18-FDG PET-CT imaging for oncology in a large tertiary hospital and to determine whether the calculated DRLs compares with internationally published DRLs. Materials & Methods: Radiation dose data and patient demographics of two-hundreds and sixteen paediatric PET-CT oncology patients imaging procedures from one large tertiary hospital were selected and analysed in order to establish a facility paediatric DRLs. Statistical analysis was performed. Results: The PET dose reference levels ranged between [62 - 525] MBq of injected activity for a range of pediatric age groups. The CTDI<sub>vol</sub> values were between 3.5 and 16.5 mGy for all age groups. Comparison with current EANM and SNMMI recommendations of patient’s dose are discussed. Conclusion: Our pediatric PET/CT reference levels are higher than the ones reported internationally with notable variations. .
文摘Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 154 consecutive trauma patients with the need for chest CT scan were included. Two different BMI-adjusted CT protocols at a fixed voltage tube and the same scan length were applied. Dose estimation parameters like CT dose index (CTDI), dose length product (DLP) and effective breast dose were calculated. Breast surface dose was obtained by using thermoluminescence dosimeters (TLDs) and eventually, the life attributable risk (LAR) of cancer incidence was estimated. The mean effective dose was 4.87 ± 2.3 mSv and 5.12 ± 2.8 mSv for patients who were scanned with tube currents of 120 mAs and 200 mAs, respectively. There was no significant difference between organ surface doses for females but in males it was notable. The risk of cancer incidence is lower for protocol 1 in comparison with protocol 2. Optimizing tube current of 120 mAs reduced breast surface dose up to 50% in comparison with the tube current of 200 mAs. In trauma patients, using lower tube current based on BMI has notable impact on the absorbed dose in the breast and can reduce the breast cancer risk by nearly 33.6% for women.
基金This work was supported by the Non-profit Central Research Institute Fund of the Chinese Academy of Medical Sciences,Longevity and Health Project,2021-JKCS-003.
文摘Background: Magnetic resonance(MR)-guided ultra-hypofractionated radiotherapy with whole-pelvic irradiation(UHF-WPRT)is a novel approach to radiotherapy for patients with high-risk(HR)and very high-risk(VHR)prostate cancer(PCa).However,the inherent complexity of adaptive UHF-WPRT might inevitably result in longer on-couch time.We aimed to estimate the delivered dose,study the feasibility and safety of adaptive UHF-WPRT on a 1.5-Tesla MR-Linac.Methods: Ten patients with clinical stage T3a-4N0-1M0-1c PCa,who consecutively received UHF-WPRT,were enrolled prospectively.The contours of the target and organ-at-risks on the position verification-MR(PV-MR),beam-on 3D-MR(Bn-MR),and post-MR(after radiotherapy delivery)were derived from the pre-MR data by deformable image registration.The physician then manually adjusted them,and dose recalculation was performed accordingly.GraphPad Prism 9(GraphPad Prism Software Inc.)was utilized for conducting statistical analyses.Results: In total,we collected 188 MR scans(50 pre-MR,50 PV-MR,44 Bn-MR,and 44 post-MR scans).With median 59 min,the mean prostate clinical target volume(CTV)-V_(100%)was 98.59%±2.74%,and the mean pelvic CTVp-V_(100%)relative percentages of all scans was 99.60%±1.18%.The median V29 Gy change in the rectal wall was−2%(−18%to 20%).With a median follow-up of 9 months,no patient had acute Common Terminology Criteria for Adverse Events(CTCAE)grade 2 or more severe genitourinary(GU)or gastrointestinal(GI)toxicities(0%).Conclusion: UHF-RT to the prostate and the whole pelvis with concomitant boost to positive nodes using an Adapt-To-Shape(ATS)workflow was technically feasible for patients with HR and VHR PCa,presenting only mild GU and GI toxicities.The estimated target dose during the beam-on phase was clinically acceptable based on the 3D-MR-based dosimetry analysis.Clinical trial registration Chinese Clinical Trial Registry ChiCTR2000033382.
文摘Computed tomography(CT)has seen a rapid increase in use in recent years.Radiation from CT accounts for a significant proportion of total medical radiation.However,given the known harmful impact of radiation exposure to the human body,the excessive use of CT in medical environments raises concerns.Concerns over increasing CT use and its associated radiation burden have prompted efforts to reduce radiation dose during the procedure.Therefore,low-dose CT has attracted major attention in the radiology,since CT-associated x-ray radiation carries health risks for patients.The reduction of the CT radiation dose,however,compromises the signal-to-noise ratio,which affects image quality and diagnostic performance.Therefore,several denoising methods have been developed and applied to image processing technologies with the goal of reducing image noise.Recently,deep learning applications that improve image quality by reducing the noise and artifacts have become commercially available for diagnostic imaging.Deep learning image reconstruction shows great potential as an advanced reconstruction method to improve the quality of clinical CT images.These improvements can provide significant benefit to patients regardless of their disease,and further advances are expected in the near future.
基金supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (grant numbers: NRF-2015R1C1A1A01052498 and NRF2014R1A1A1006010)
文摘We successfully obtained 3 D skeletal images of Hyla suweonensis, employing a nondestructive method by applying appropriate anesthesia and limiting the radiation dose. H. suweonensis is a tree frog endemic to Korea and is on the list of endangered species. Previous studies have employed caliper-based measurements and two-dimensional(2 D) X-ray imaging for anatomical analyses of the skeletal system or bone types of H. suweonensis. In this work we reconstructed three-dimensional(3 D) skeletal images of H. suweonensis, utilizing a nondestructive micro-computed tomography(micro-CT) with a short scan and low radiation dose(i.e. 4 min and 0.16 Gy). Importantly, our approach can be applied to the imaging of 3 D skeletal systems of other endangered frog species, allowing both versatile and high contrast images of anatomical structures without causing any significant damages to the living animal.
基金This work was supported by The National Natural Science Foundation of China(Grant Numbers:82001778)The Capital Medical Development Research Fund(Grant Numbers:2020-2-1072).
文摘Background:As molecular advances have deepened the knowledge on low-grade glioma(LGG),we investigated the effect of higher radiation dose on the survival of IDH-wildtype(IDHwt)LGG.Methods:In the current study,52 IDHwt LGG patients who received radiotherapy were enrolled from the Chinese Glioma Genome Atlas dataset.Radiation doses>54 Gy were defined as high-dose,whereas doses≤54 Gy were defined as low-dose.We performed univariate and multivariate survival analyses to examine the prognostic role of high-dose radiotherapy.Results:In total,the radiation dose ranged from 48.6 Gy to 61.2 Gy,with a median of 55.8 Gy,and 31 patients were grouped into high-dose radiation.Univariate survival analysis indicated that high-dose radiotherapy(p=0.015),tumors located in the frontal lobe(p=0.009),and pathology of astrocytoma(p=0.037)were significantly prognostic factors for overall survival.In multivariate survival analysis,high-dose radiotherapy(p=0.028)and tumors located in the frontal lobe(p=0.016)were independently associated with better overall survival.Conclusions:In conclusion,high-dose radiotherapy independently improved the survival of IDHwt LGG.This can guide treatments for glioma with known molecular characteristics.
