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Over the last two decades, there has been emerging evidence suggesting that ionizing radiation exposures could be associated with elevated risks of cardiovascular disease (CVD), particularly ischemic heart disease (IHD). Excess CVD risks have been observed in a number of exposed groups, with generally similar risk estimates both at low and high radiation doses and dose rates. In 2014, we reported for the first time significantly higher risks of IHD mortality when radiation doses were delivered over a protracted period of time (an inverse dose-fractionation effect) in the Canadian Fluoroscopy Cohort Study. Here we review the current evidence on the dose-fractionation effect of radiation exposure, discuss potential implication for radiation protection policies and suggest further directions for research in this area. [ABSTRACT FROM AUTHOR]

The article offers information on radiation exposure in fluoroscopy-guided procedures. Topics discussed include fluoroscopy-guided minimally invasive procedures, amount of radiation that surgeons receive while performing routine fluoroscopy-guided procedures, and factors that reduce radiation exposure. Also mentioned is artificial intelligence in radiation protection.

This study analysed the occupational dose in Korean pressurized heavy-water reactors (PHWRs) and identified tasks involving high radiation exposure. The average individual dose was sufficiently low to be below the annual effective dose limit for radiation workers and is even lower than the dose limit for the general public. However, some workers received relatively higher doses than others. Furthermore, most PHWR workers are exposed to radiation during planned maintenance periods. In this study, the radiation dose was normalized (radiation dose per unit time) to determine the high-radiation-exposure tasks in Korean PHWRs. Consequently, end-fitting lapping, delayed neutron tube work and fuel channel fixed-end change tasks were identified as high-radiation-exposure tasks in Korean PHWRs. If appropriate radiation protection measures are prioritized for the identified high-dose exposure tasks, optimization of radiological protection will be effectively achieved by reducing the dose that is relatively higher than the average. [ABSTRACT FROM AUTHOR]

The measurements of radon concentrations in drinking water sources in and around the Main Central Thrust (MCT) region in Garhwal Himalaya, India, were carried out using the scintillation detector-based SMART RnDuo technique for radiation protection purposes. Radon values in the analyzed samples were observed between 1.1 and 183.9 Bq L−1 (AM = 19.7 Bq L−1). Radon values in 94% of the samples were found well below the World Health Organization (WHO) reference limit. The estimated radiation doses for different age groups were found higher than the WHO safe limit of 100 µSv y−1 (from all sources including radon) except for the age groups of 0–12 months infants and 1–3 years children. The results of this study may be useful for future studies on epidemiology, examining hidden faults, uranium exploration etc. [ABSTRACT FROM AUTHOR]

Aims The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey on radiation exposure in interventional echocardiography. The survey aimed to collect data on local practices for radioprotection in interventional echocardiography and to assess the awareness of echocardiography operators about radiation-related risks. Methods and results A total of 258 interventional echocardiographers from 52 different countries (48% European) responded to the survey. One hundred twenty-two (47%) participants were women. Two-thirds (76%) of interventional echocardiographers worked in tertiary care/university hospitals. Interventional echocardiography was the main clinical activity for 34% of the survey participants. The median time spent in the cath-lab for the echocardiographic monitoring of structural heart procedures was 10 (5–20) hours/month. Despite this, only 28% of interventional echocardiographers received periodic training and certification in radioprotection and 72% of them did not know their annual radiation dose. The main adopted personal protection devices were lead aprons and thyroid collars (95% and 92% of use, respectively). Dedicated architectural protective shielding was not available for 33% of interventional echocardiographers. Nearly two-thirds of responders thought that the radiation exposure of interventional echocardiographers was higher than that of interventional cardiologists and 72% claimed for an improvement in the radioprotection measures. Conclusion Radioprotection measures for interventional echocardiographers are widely variable across centres. Radioprotection devices are often underused by interventional echocardiographers, portending an increased radiation-related risk. International scientific societies working in the field should collaborate to endorse radioprotection training, promote reliable radiation dose assessment, and support the adoption of radioprotection shielding dedicated to interventional echocardiographers. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: External dose rate measurements for I-125 permanent radioactive source implantation brachytherapy for prostate cancer requires standardized external dose rate measurements and radiation safety procedures. We developed predictive models for external dose rates to ensure compliance with radiation safety guidelines. We used Monte Carlo simulation and experimental measurements to construct an external dose rate model. The model's accuracy was validated against external dose rate measurements from clinical patients. This model facilitates the calculation and minimization of family members' radiation dose, aiding in the development of personalized radiation protection strategies. This study uses Monte Carlo simulation and experimental measurements to develop a predictive model for estimating the external dose rate associated with permanent radioactive source implantation in prostate cancer patients. The objective is to estimate the accuracy of the patient's external dose rate measurement. First, I-125 radioactive sources were implanted into Mylar window water phantoms to simulate the permanent implantation of these sources in patients. Water phantom experimental measurement was combined with Monte Carlo simulation to develop predictive equations, whose performance was verified against external clinical data. The model's accuracy in predicting the external dose rate in patients with permanently implanted I-125 radioactive sources was high (R2 = 0.999). A comparative analysis of the experimental measurements and the Monte Carlo simulations revealed that the maximum discrepancy between the measured and calculated values for the water phantom was less than 5.00%. The model is practical for radiation safety assessments, enabling the evaluation of radiation exposure risks to individuals around patients with permanently implanted I-125 radioactive sources. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate patient knowledge and understanding of ionising radiation and dosage, as well as the accompanying risks related to computed tomography scans. A total of 412 outpatients who underwent computed tomography (CT) scans were surveyed to assess their understanding of radiation dose and exposure risks. CT was correctly classified as an ionising radiation by 56.8% of the respondents. More than half of the patients reported that a CT scan increases the probability of inducing cancer. Awareness of varying radiation doses in different CT exams was noted in 75.2% of patients, but only 21.4% reported having discussions with their physician about radiation dose. Gender, age and employment were significantly correlated with knowledge levels. The survey findings indicate a limited understanding of the hazards associated with ionising radiation used in CT scans, highlighting a need for increased awareness and education on radiation protection to ensure informed consent. [ABSTRACT FROM AUTHOR]

Although boron neutron capture therapy (BNCT) causes minor damage to normal cells owing to the nuclear reactions induced by neutrons with major elements of tissues such as hydrogen and nitrogen, it is useful to estimate the accurate exposure dose for radiation protection. This study aims to estimate the contribution of internal exposure in radiation exposure dose for BNCT. The study was performed by referring to clinical studies at a reactor-based BNCT facility on the basis of computational dosimetry. Five irradiation regions of head and neck were selected for the estimation. The results suggest that external exposure occurred primarily in and around the irradiation field. Furthermore, during the exposure dose estimation in BNCT, internal exposure was found to be not negligible, implying that the irradiation regions in treatment planning must be considered for avoiding damage to certain critical organs that are susceptible to internal exposure. [ABSTRACT FROM AUTHOR]

Purpose: Intraoperative fluoroscopy use is essential during spinal fusion procedures. The amount of radiation dose should always be minimized. This study aimed to determine the feasibility of halving the frame rate from 12.5 to 6.25 frames per second (fps) and to quantify the reduction in the risk of developing radiation-induced cancer. Methods: This pilot study included 34 consecutive patients operated for open lumbar posterolateral fusion (PLF) with or without transforaminal lumbar interbody fusion (TLIF). C-arm modes were changed from half-dose (12.5 frames per second (fps), group I) to quarter-dose (6.25 fps, group II). Age, body mass index, surgical procedure, number of treated levels, and complications were collected. Kerma area product (KAP), cumulative air kerma (CAK), and fluoroscopy time were compared. Effective dose and radiation-induced cancer risk were estimated. Results: Eighteen and 16 patients were, respectively, included in group I and II. Demographic, surgical data, and fluoroscopy time were similar in both groups. However, CAK, KAP, and effective dose were significantly lower in group II, respectively, 0.56 versus 0.41 mGy (p = 0.03), 0.09 versus 0.06 Gy cm2 (p = 0.04), and 0.03 versus 0.02 mSv (p = 0.04). Radiation-induced cancer risk decreased by 47.7% from 1.49 × 10–6 to 7.77 × 10–7 after optimization. No complications were recorded in either group. Conclusion: This study demonstrates the feasibility of setting 6.25 fps for TLIF with and without PLF. By halving the fps, radiation-induced cancer risk could be almost divided by two, without compromising surgical outcome. Finally, after optimization, the risk of developing radiation-induced cancer was less than one in a million. [ABSTRACT FROM AUTHOR]

Background: Development of resistance upon exposure to small doses of ionizing radiation followed by higher doses is known as radiation-induced adaptive response (RIAR). Traditionally, the induction of the RIAR phenomenon at the cellular level has been examined in cell lines, animal models, and epidemiological studies where people live in high natural background radiation. Summary: The primary intention of the earlier studies was to corroborate the existence of RIAR and the mechanism involved in mediating the response surveyed by exposure to a low dose of radiation (<500 mGy) as priming dose toward the radiation protection point of view. However, the investigation has shifted the focus to understand the relevance of this phenomenon at clinically relevant set-ups (high doses in the order of Gy) and can be exploited during radiotherapy as RIAR is considered a mechanism for the development of radioresistance. Although the knowledge of molecular mechanisms at the cellular level has evolved significantly in multi-fractionated radiotherapy regimes, its relevance in developing radioresistance at low doses remains elusive. The authors recapitulate the existing knowledge on RIAR at cellular levels, specifically after low-dose exposure as an adaptive dose, and discussed its potential implications in clinical radiotherapy outcomes. Key Messages: Recent studies have contributed to understand the signaling molecules, pathways, and inhibitors to mitigate RIAR-mediated radiation resistance and persistent radio-tolerance at the cellular level. Monitoring the disease progression in tumor samples or liquid biopsies before, during, and after therapy with suitable biomarkers has been proposed as a strategy to translate the phenomena into clinical scenario. [ABSTRACT FROM AUTHOR]

Featured Application: It is highly unlikely that the operator would reach occupational dose limits when using iRay D3 and EZRay Air. The Epix radiographic device allows for fewer daily radiographs. This study aimed to investigate the scattered radiation dose using three portable dental radiographic units: iRay D3, EZRay Air, and Epix. The absorbed dose was measured at 0.5 and 1 m distances, every 15° in the horizontal plane, using an ionization chamber. The maximum number of radiographs per day using the portable units was calculated considering a dose limit of 50 mSv/year and 20 mSv/year. The doses were higher in the Epix unit compared to the other two devices. Anterior exposure was generally higher than the sides or posterior exposure. With a dose limit of 50 mSv/year, considering a distance of 0.5 m between the operator and the X-ray unit, a maximum of 961, 565, and 38 radiographs are permitted daily using iRay D3, EZRay Air, and Epix, respectively. Considering a dose limit of 20 mSv/year, with a distance of 0.5 m between the operator and the radiographic device, a maximum of 384, 226, and 15 radiographs are permitted daily using iRay D3, EZRay Air, and Epix portable units, respectively. It is highly unlikely that an operator would reach occupational dose limits when using iRay D3 and EZRay Air. The Epix radiographic device allows for fewer daily radiographs and should be avoided for daily use. [ABSTRACT FROM AUTHOR]

We present here the results of an experimental study assessing the influence of the diameter of the collimation window in a 3D-printed plastic object on the dose distribution of a medical electron beam. Experiments were run using a test object developed and manufactured as a rectangular parallelepiped with 12 round perforating holes with different diameters. The experiments were carried out using a medical electron beam. The radiation was delivered in such a way that the axes of the apertures were parallel to the beam axis. The distributions profiles formed by each hole were captured. The results showed that development of electron beam-shaping devices should avoid collimation apertures of diameter less than 7 mm. [ABSTRACT FROM AUTHOR]

Introduction: Computed tomography (CT) is one of the most widely used diagnostic procedures in modern medicine. Despite many technical improvements, CT still exposes patients to significantly higher doses of radiation than other methods of diagnostic imaging. The presented analysis of the number of CT scans performed in Poland in 2022 aims to designate priorities in the process of optimising radiation protection and makes it possible to identify those examinations and patient groups for which action is particularly justified. Material and methods: The data presented is based on an analysis of the National Health Fund (NHF) database of medical services reimbursed in 2022. According to the NHF data, approximately 5.1 million CT examinations were performed. The coding of reimbursed medical procedures used by the NHF in 2022 included 45 different CT procedures. Results: The highest ratio of the number of examinations performed to the number of patients was found in the age group 59-75 years (average 1.35). This ratio varied according to examination type and was closest to 1 for spine and extremities examinations (between 1.1 and 1.2 on average). Irrespective of patients' age and type of examination, the proportion of female and male patients fluctuates around 50%. Approximately 82% of head and neck examinations are single-phase CTs. Examinations with two or more phases account for about 17% and less than 1%, respectively. Conclusions: Over the past 10 years, both the number of CT scanners and the number of annually performed scans have doubled. Relative to the population size, this is a rate of about 22 scanners per one million people, an average level for European countries, ranging from a maximum of around 37 for Italy and Germany to around 20 for France, Spain, and Romania, according to Eurostat data. [ABSTRACT FROM AUTHOR]

Occupational radiation protection is an important consideration in small animal clinics world-wide. With the increased use of portable handheld X-ray devices in veterinary dentistry, concerns related to occupational radiation protection are being raised. Annual occupational dose limits for dental workers are expressed as Total Dose Equivalent (TDE) or Effective Dose. The permitted TDE can vary depending on the anatomical region, ranging from 50 millisieverts (mSv) for the external whole body exposure dose to 500 mSv for external exposure of the skin or an extremity. Although several studies have been performed in human dentistry to establish the amount of backscatter radiation produced using portable handheld X-ray devices, no similar research has been conducted in veterinary dentistry. This study aimed to determine the TDE while acquiring a full mouth intraoral radiograph set in dogs and cats and to estimate the TDE for a handheld X-ray device's operator. For this, the backscatter radiation dose recorded by three sets of monitoring dosimeters located in strategic anatomical areas of the operator was assessed after taking one hundred intraoral radiographs in each group. The study concluded that the backscatter radiation levels were far below the permitted annual occupational doses in the three patient groups of this study. Even though the portable handheld X-ray unit was demonstrated to be a safe dental radiographic unit regarding backscattering radiation, the operator's eye, ovary, and breast regions were exposed to unnecessary radiation. [ABSTRACT FROM AUTHOR]

Purpose: Endovascular aortic repair (EAR) interventions, endovascular abdominal aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR), are associated with significant radiation exposures. We aimed to investigate the radiation doses from real-world practice and propose diagnostic reference level (DRL) for the UK. Materials and Methods: Radiation data and essential demographics were retrospectively collected from 24 vascular and interventional radiology centres in the UK for all patients undergoing EAR—standard EVAR or complex, branched/fenestrated (BEVAR/FEVAR), and TEVAR—between 2018 and 2021. The data set was further categorised according to X-ray unit type, either fixed or mobile. The proposed national DRL is the 75th percentile of the collective medians for procedure KAP (kerma area product), cumulative air kerma (CAK), fluoroscopy KAP and CAK. Results: Data from 3712 endovascular aortic procedures were collected, including 2062 cases were standard EVAR, 906 cases of BEVAR/FEVAR and 509 cases of TEVAR. The majority of endovascular procedures (3477/3712) were performed on fixed X-ray units. The proposed DRL for KAP was 162 Gy cm2, 175 Gy cm2 and 266 Gy cm2 for standard EVAR, TEVAR and BEVAR/FEVAR, respectively. Conclusion: The development of DRLs is pertinent to EAR procedures as the first step to optimise the radiation risks to patients and staff while maintaining the highest patient care and paving the way for steps to reduce radiation exposures. [ABSTRACT FROM AUTHOR]

This article presents the development, advancements, challenges and achievements of the "Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean" (OPRIPALC) program. This international initiative is led by the World Health Organization, the Pan American Health Organization and the International Atomic Energy Agency. The main objectives of OPRIPALC are to foster a culture of radiological protection in pediatric interventions, enhance these procedures' quality, and define optimization strategies such as the use of diagnostic reference levels (DRLs). Currently, 33 centers from 12 countries participate actively in the program. Significant progress has been made towards the proposed objectives, overcoming the challenges posed by the COVID-19 pandemic. Through many virtual meetings for coordination, planning, training and follow-up, a comprehensive set of DRLs for both diagnostic and therapeutic procedures, categorized by weight and age, have been established and are in use. A consensus document on good practices is in the final stage of development. The program's continuation into at least a second phase is essential to address pending issues, including the integration of automatic dose management systems, the levels of occupational radiation doses, their correlation with pediatric patient doses, and strategies to reduce them. [ABSTRACT FROM AUTHOR]

Objective: To compare the dosimetry between convex triangular fields of view (FOV) and similar dimension cylindrical FOVs of two cone-beam computed tomography (CBCT) models. Methods: Optically stimulated luminescence dosimeters (OSLDs) were placed in fiducial anatomical locations in an anthropomorphic phantom representing an adult head male for dosimetry scans. Convex triangular FOVs (100 × 80 mm/maxilla-mandible; 100 × 50 mm mandible; 100 × 50 mm/maxilla) from Veraviewepocs 3D R100 (J. Morita, Kyoto, Japan) (R100) and Veraview® X800 (J. Morita, Kyoto, Japan) (X800) and cylindrical FOVs from R100 and X800 (80 × 80 mm/maxilla-mandible; 80 × 50 mm/mandible; 80 × 50 mm/maxilla) were obtained, resulting in 12 different scan protocols. Equivalent doses for each relevant organ/tissue and the effective dose for each protocol were calculated. Mean effective doses were compared by the two-way analysis of variance (ANOVA) with Tukey's post hoc test to evaluate the effect of the FOV and device (α = 0.05). Results: The effective doses ranged between 69 and 324 μSv for the convex triangular FOVs and 76 and 332 μSv for the cylindrical FOVs. Convex triangular FOVs from the R100 device had effective doses 2.3 to 15.3% lower than their corresponding cylindrical FOVs with similar height (p < 0.05), and that difference ranged between 8.8 and 11.8% for the X800 device (p < 0.05). Conclusion: Convex triangular fields of view delivered slightly lower effective doses than the cylindrical fields of view of similar dimensions in the R100 and X800 CBCT devices. Clinical relevance: Understanding the influence of the image geometry formation in effective dose allows optimization to reduce patient dose. [ABSTRACT FROM AUTHOR]

A rise in the need of preoperative CT assessment of proximal tibial intra-articular fractures has given rise to an increased load of radiation exposure. This comparative study aims at assessing the efficacy of low dose CT scan by collating images of tibial plateau fractures produced by low dose CT scan with that of conventional dose CT scan. Furthermore, the study aims at computing the comprehensive reduction in the effective dosage of radiation when low dose CT scan is employed for assessing these fractures. The study comprise of 23 cases of proximal tibial intra-articular fractures (confirmed by initial radiographs). Low-dose CT scan of the injured limb was preceded by conventional dose CT scan for generating images that were assessed and reported independently by five (single blinded) radiologists (using Schatzker's CT based classification). Quantification of fracture was done to compare them statistically. A sensitivity of 93.94 % and positive predictive value of 93.92 % was observed on comparing images from low dose and conventional dose CT scan. An effective reduction of 89.81 % in overall dosage of radiation exposure was observed. Near equal quality images were generated by low dose CT scan as compared to conventional dose CT scan, thereby demonstrating its non-inferiority with an effective reduction of 89.81 % in overall dosage of radiation exposure. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We determined the average glandular dose (AGD) from the craniocaudally (CC) and mediolateral oblique (MLO) views of 496 breasts (247 women) at eight clinics in Sudan. The incident air kerma from the X-ray tube output values and the typical patient-specific breast exposure factors were measured. The AGD values were inferred from the measured incident air kerma and breast-specific dose-conversion coefficients. The AGD per CC and MLO projection and per woman ranged from 0.56 to 2.89 mGy (average: 1.36), 0.48 to 2.08 mGy (average: 1.19), and 2.08 to 9.94 mGy (average: 5.10). The proposed national diagnostic reference levels (mGy) for digital mammography are 1.8 and 1.6 mGy for CC and MLO projection, respectively. Establishing the proposed diagnostic reference levels is an essential step in ensuring patient protection from radiation and will help promote dose optimization for X-ray mammography at the national level and beyond. These results provide important baseline data that can be used to formulate national diagnostic reference levels. [ABSTRACT FROM AUTHOR]

This study measured 99mTc-MDP bone scintigraphy radiation risks, as low-dose radiation exposure is a growing concern. Dosimeter measurements were taken at four positions (left lateral, right lateral, anterior, and posterior) around the patients at 30, 60, 100, and 200 cm at 0, 1.5, and 3 h. The highest dose rates were recorded from 51% of the patients, who emitted ≥ 25 µSv/h up to 49.00 µSv/h at the posterior location at a distance of 30 cm. Additionally, at the anterior location at a distance of 30 cm, 42% of patients emitted ≥ 25 µSv/h up to 38.00 µSv/h. Furthermore, at 1.5 h after the tracer injection, 7% of the dose rates exceeded 25 µSv/h. There was a significant reduction in mean dose rates for all positions as distance and time increased (p-value < 0.05). As a result, radiation levels decreased with increased distance and time as a result of radiation decay, biological clearance, and distance from the source. In addition, increasing the distance from the patient for all positions reduced the radiation dose, as was substantiated via exponential regression analysis. Additionally, after completing the bone scintigraphy, the patients' dose rates on discharge were within the current guidelines, and the mean radiation doses from 99mTc-MDP were below occupational limits. Thus, medical staff received less radiation than the recommended 25 μSv/h. On discharge and release to public areas, the patients' mean dose rates were as follows: 1.13 µSv/h for the left lateral position, 1.04 µSv/h for the right lateral, 1.39 µSv/h for the anterior, and 1.46 µSv/h for the posterior. This confirms that if an individual was continuously present in an unrestricted area, the dose from external sources would not exceed 20 µSv/h. Furthermore, the patients' radiation doses were below the public exposure limit on discharge. [ABSTRACT FROM AUTHOR]

Radiation doses in dentomaxillofacial imaging are typically very low. However, diagnostic and follow-up protocols in orthognathic surgery result in a patient-specific risk in effective dose. Estimating the cancer risks from these exposures remains abstract for many maxillofacial surgeons. In this study, 40 orthognathic patients were randomly sampled and their cumulative effective dose (ED) calculated. The lifetime attributable risk of cancer (LAR) was calculated based on the standard radiological protocol for orthognathic surgery follow-up using methods described in the BEIR VII report and RadRAT. The mean cumulative ED of the 40 sampled patients at the end of their 2-year follow-up period was 1.91 ± 0.58 mSv. The LAR at the end of follow-up was 17.65 (90% confidence interval 6.46–32.90) per 100,000 person-years for male orthognathic patients and 13.93 (90% confidence interval 6.27–25.24) per 100,000 person-years for female orthognathic patients. This represents 0.70% and 0.68%, respectively, of the baseline cancer risk for oral, thyroid, and brain cancer combined. Although theoretical, these results provide a framework for interpreting radiation doses and cancer risks in patients undergoing orthognathic surgery. Considering the increased radiation sensitivity in children and adolescents, indication-oriented and patient-specific imaging protocols should be advised. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate radiation doses from handheld X-ray devices, specifically NOMAD Pro 2TM (DvcN), Rextar X (DvcRX), and Diox 602 (DvcD), targeting operator and patient's critical organs and tissues. Calibrated TLD-100H dosimeters were placed on a mannequin and phantom head, focusing on the eyes, thyroid, gonads, hands, and salivary glands. Using a TLD reader, absorbed equivalent doses post irradiation were assessed. Conventional systems yielded higher radiation doses than phosphor plates and digital systems. Notably, implementing protective measures resulted in significant (p < 0.05) dose reductions to the operator. Peak measurements without protection included: gonad 24.4 (DvcN) μGy; thyroid 30.5 (DvcN) μGy; right eye 31.9 (DvcN) μGy; left eye 27.9 (DvcN) μGy; right hand 111.6 (DvcRX) μGy; and left hand 71.7 (DvcD) μGy. Radiation dose reductions ranged from 11.49% to 93.25%, depending on the region and device. It is imperative to adhere to radiological protection protocols, particularly when employing handheld X-ray devices; optimally, these should be used with digital systems. [ABSTRACT FROM AUTHOR]

The Ionising Radiation Regulations 2017 requires prior risk assessment calculations and regular environmental monitoring of radiation doses. However, the accuracy of prior risk assessments is limited by assumptions and monitoring only provides retrospective evaluation. This is particularly challenging in nuclear medicine for areas surrounding radionuclide therapy patient bathroom wastewater pipework. Machine learning (ML) is a technique that could be applied to patient booking records to predict environmental radiation dose rates in these areas to aid prospective risk assessment calculations, which this proof-of-concept work investigates. 540 days of a dosimeters historical daily average dose rate measurements and the corresponding period of department therapy booking records were used to train six different ML models. Predicted versus measured daily average dose rates for the following 60 days were analysed to assess and compare model performance. A wide range in prediction errors was observed across models. The gradient boosting regressor produced the best accuracy (root mean squared error = 1.10 µ Sv.hr−1, mean absolute error = 0.87 µ Sv.hr−1, mean absolute percentage error = 35% and maximum error = 3.26 µ Sv.hr−1) and goodness of fit (R 2 = 0.411). Methods to improve model performance and other scenarios where this approach could prove more accurate were identified. This work demonstrates that ML can predict temporal fluctuations in environmental radiation dose rates in the areas surrounding radionuclide therapy wastewater pipework and indicates that it has the potential to play a role in improving legislative compliance, the accuracy of radiation safety and use of staff time and resources. [ABSTRACT FROM AUTHOR]

Background: Ionizing radiation is extensively employed in diverse diagnostic procedures, playing a pivotal role in diagnosing various diseases. The escalating use of such investigations underscores the importance of judicious and careful application to mitigate associated risks and hazards. This study aims to assess doctors' knowledge regarding radiation hazards and doses in commonly used diagnostic procedures. Methods: Between July 1 and July 31, 2019, a questionnaire comprising 20 questions was distributed among doctors across various departments in a tertiary care hospital. The questionnaire, divided into three sections, covered topics such as radiological procedures employing ionizing radiation, equivalent dose units, estimation of radiation doses for common procedures, and awareness of risks linked to radiation exposure. Results: A total of 200 questionnaires were returned, representing diverse specialties. Responses from radiology (11), surgery (53), orthopedics (2), medicine (84), eye (6), ENT (4), pediatrics (9), and gynecology/obstetrics (31) were included. The assessment of doctors' knowledge in each section revealed suboptimal scores, with average correct responses of 64.1%, 21.8%, and 64.5% for the three sections, respectively. Notably, 21.3% of doctors underestimated doses, and 28% had no idea about estimated doses. Additionally, 49% and 12% of participants incorrectly categorized Magnetic Resonance Imaging (MRI) and ultrasonography as procedures involving ionizing radiation. Conclusion: This study exposes significant knowledge gaps among doctors regarding radiation doses and hazards. The findings underscore an urgent necessity for implementing institutional educational programs on radiation protection at both undergraduate and postgraduate levels. [ABSTRACT FROM AUTHOR]

Purpose: To assess accuracy, the frequency of hemorrhagic complications and computed tomography (CT) radiation dose parameters in pediatric patients undergoing landmark-guided external ventricular drain (EVD) placement in an emergency setting. Methods: Retrospective analysis comprised 36 EVD placements with subsequent CT control scans in 29 patients (aged 0 to 17 years) in our university hospital from 2008 to 2022. The position of the EVD as well as the presence and extension of bleeding were classified according to previously established grading schemes. Dose length product (DLP), volume-weighted CT dose index (CTDIvol) and scan length were extracted from the radiation dose reports and compared to the diagnostic reference values (DRLs) issued by the German Federal Office for Radiation Protection. Results: After the initial EVD placement, optimal positioning of the catheter tip into the ipsilateral frontal horn or third ventricle (Grade I), or a functional positioning in the contralateral lateral ventricle or the non-eloquent cortex (Grade II), was achieved in 28 and 8 cases, respectively. In 32 of 36 procedures, no evidence of hemorrhage was present in the control CT scan. Grade 1 (<1 mL) and Grade 2 (≥1 to 15 mL) bleedings were detected after 3 and 1 placement(s), respectively. For control scans after EVD placements, CTDIvol (median [25%; 75% quartile]) was 39.92 [30.80; 45.55] mGy, DLP yielded 475.50 [375.00; 624.75] mGy*cm and the scan length result was 136 [120; 166] mm. Exceedances of the DRL values were observed in 14.5% for CTDIvol, 12.7% for DLP and 65.6% for the scan length. None of these values was in the range requiring a report to the national authorities. Conclusion: Landmark-based emergency EVD placement in pediatric patients yielded an optimal position in most cases already after the initial insertion. Complications in terms of secondary hemorrhages are rare. CT dose levels associated with the intervention are below the reportable threshold of the national DRLs in Germany. [ABSTRACT FROM AUTHOR]

Purpose: It's postulated that hybrid techniques (HT) with lower weighting of IMRT/VMAT component would improve lung dose-volume parameters despite some disadvantage in PTV homogeneity index (HI) and target coverage (TC). Material and Methods: Conformal plans were prepared using 6-10-15 MV-X photon energies while IMRT/VMAT plans of HTs were prepared using 6MV-X. Four HTs were developed having two different ratios (10% and 50%) of IMRT/VMAT component (h-IMRT1, h-IMRT2 and h-VMAT1, h-VMAT2, respectively). HTs were compared with 3D-CRT in terms of HI and TC for PTV, and total lung (TL) and contralateral lung (CL) V5Gy, V10Gy, V20Gy and mean lung dose (MLD). Results: All HTs were advantageous for HI and TC, while disadvantageous for TL and CL-V5Gy. H-IMRT2 provided better TC than h-IMRT1, and so did h-VMAT2 compared to h-VMAT1. Lower weighting of IMRT/VMAT decreased TL and CL-V5Gy in HTs. In addition, h-IMRT1 decreased TL and CL-MLD and CLV20Gy compared to h-IMRT2, while h-VMAT2 decreased TL-V20Gy and CL-MLD compared to h-VMAT2. Conclusion: In the RT of lung tumors close to vertebra, it may be appropriate to suggest a ratio of IMRT/VMAT component approximately 10% in order to decrease the low and intermediate dose-wash lung volume, if HI and TC values are acceptable. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To provide radiologists and physicists with methodological tools to improve patient management after vascular fluoroscopically guided intervention (FGI) by providing optimized thresholds (OT) values that could be used as a surrogate to the thresholds classically proposed by the National Council on Radiation Protection (NCRP) or could be useful to adapt their own substantial radiation dose levels (SRDL) values. Methods: PSD of 2000–4000 mGy after FGI were calculated for 258 patients with dedicated software. Overall, the kerma and KAP 3D-ROC curves were used to assess the sensitivity (SEN) and specificity (SPE) of NCRP thresholds and OT for each PSD. Kiviat diagram and density curves were plotted for the best SEN/SPE pair of 3D-ROC curves and compared to the NCRP thresholds. Results: OT for both kerma and KAP generating the best SEN/SPE couple for PSD of 2000–4000 mGy were obtained. The SEN/SPE couple of each OT was always better than that obtained using NCRP ones. The best OT among all those calculated providing the highest SEN/SPE values for kerma (3020.5 mGy) and KAP (741.02 Gy.cm2) were obtained when PSD was equal to 3300 mGy. Conclusions: We have calculated OT in terms of kerma and KAP based on 3D-ROC curves analysis and peak skin dose calculations that can be obtained to better predict high skin dose. The use of OT that predicted PSD greater than 3000 mGy is likely to improve patient follow-up. The methodology developed in this work could be adapted to other institutions in order to better define their own SRDL. Key Points: • Optimized dose thresholds in terms of kerma and KAP based on 3D-ROC curves analysis and peak skin dose calculations between 2000 and 4000 mGy can be obtained to better predict high skin dose. • Patients receiving a peak skin dose between 2000 and 4000 mGy have their follow-up enhanced by using the optimized thresholds instead of the NCRP thresholds. • The best-optimized thresholds, corresponding to 3020.5 mGy and 741.02 Gy.cm2 for kerma and KAP respectively can be used instead of NRCP ones to trigger patient follow-up after fluoroscopically guided vascular interventions. [ABSTRACT FROM AUTHOR]

Scatter radiation from portable and pediatric X-rays could pose a risk to radiographers, nearby patients, and caretakers. We aim to evaluate the spatial scatter radiation distribution to the radiographers, nearby patients, and caretakers during common projections in portable and pediatric X-rays. We evaluated the three-dimensional scatter dose profiles of four and three commonly used portable and pediatric X-ray projections, respectively, by anthropomorphic phantoms and scatter probes. For portable X-ray, the AP abdomen had the highest scatter radiation dose recorded. Radiographer scatter radiation doses were 177 ± 8 nGy (longest cord extension) and 14 ± 0 nGy (hiding behind the portable X-ray machine). Nearby patient scatter radiation doses were 3323 ± 28 nGy (40 cm bed distance), 1785 ± 50 nGy (80 cm bed distance), and 580 ± 42 nGy (160 cm bed distance). The AP chest and abdomen had the highest scatter radiation dose in pediatric X-rays. Caretaker scatter radiation doses were 33 ± 1 nGy (50 cm height) and 659 ± 7 nGy (140 cm height). Although the estimated lens doses were all within safe levels, the use of shielding and caution on dose estimation by inverse square law is suggested to achieve the ALARA principle and dose optimization. [ABSTRACT FROM AUTHOR]

BACKGROUND: Few contemporary studies have assessed physicians' knowledge of radiation exposure associated with common imaging studies, especially in trauma care. The purpose of this study was to assess the knowledge of physicians involved in caring for trauma patients regarding the effective radiation doses of musculoskeletal (MSK) imaging studies routinely utilized in the trauma setting. METHODS: An electronic survey was distributed to United States orthopaedic surgery, general surgery, and emergency medicine (EM) residency programs. Participants were asked to estimate the radiation dose for common imaging modalities of the pelvis, lumbar spine, and lower extremity, in terms of chest X-ray (CXR) equivalents. Physician estimates were compared to the true effective radiation doses. Additionally, participants were asked to report the frequency of discussing radiation risk with patients. RESULTS: A total of 218 physicians completed the survey; 102 (46.8%) were EM physicians, 88 (40.4%) were orthopaedic surgeons, and 28 (12.8%) were general surgeons. Physicians underestimated the effective radiation doses of nearly all imaging modalities, most notably for pelvic computed tomaography (CT) (median 50 CXR estimation vs. 162 CXR actual) and lumbar CT (median 50 CXR estimation vs. 638 CXR actual). There was no difference between physician specialties regarding estimation accuracy (P=0.133). Physicians who regularly discussed radiation risks with patients more accurately estimated radiation exposure (P=0.007). CONCLUSION: The knowledge among orthopaedic and general surgeons and EM physicians regarding the radiation exposure associated with common MSK trauma imaging is lacking. Further investigation with larger scale studies is warranted, and additional education in this area may improve care. [ABSTRACT FROM AUTHOR]

The staff of the Radiation Protection Service of a European clinical center measured the radiation dose by type-tested thermoluminescent dosemeter systems to which the medical staff was exposed, to assess the effectiveness of current procedures and equipment for optimalisation prompted by the requirements EU Basic Safety Standard 2013. There were three participating sites, the Site 1 was an external hospital, whereas Sites 2 and 3 are part of the same clinical center, who provided data regarding their personnel, from technologists, nurses and medical doctors. In this preliminary study, only a low number of cases were available and used to establish a new, more realistic yearly dose constraint, namely 6 (from two) mSv for whole-body effective dose, 15 (from two) mSv for eye lens dose and 300 (from 50) mSv for extremity dose. Furthermore, the state of safety culture and protection equipment was assessed. Collection of the sufficient amount of data for statistical evaluation is ongoing. [ABSTRACT FROM AUTHOR]

Background: Ionizing radiation is being used more frequently in medicine, which has been linked to recognized biological effects such as cancer and mortality. Radiology services are becoming more widely available in Ethiopian health facilities but there is no compiled record of worker's radiation dose. So, assessing the magnitude and identifying the associated factors of occupational radiation exposure dose among radiology personnel help to design strategies for radiation protection. Objective: The study was designed to assess the occupational radiation exposure dose and associated factors among radiology personnel in eastern Amhara, northeast Ethiopia, 2021. Methods: Cross-sectional study was conducted from March 25 to April 30, 2021, in 57 health institutions among 198 radiology personnel. The study comprised all eligible radiology personnel. The data were collected using an electronic-based (Google form) self-administered questionnaire, and document review. The data were entered into an excel spread sheet and then, exported to Stata 14 software. Linear regression model was used to analyse the data after checking its assumptions. Variables with a p-value < 0.25 were entered into a multiple linear regression analysis, and those with a p-value < 0.05 were judged significant. VIF was used to check for multi-collinearity. Coefficient of determination was used to check the model fitness. Results: The mean (± SD) annual shallow and deep dose equivalents of radiology personnel were 1.20 (± 0.75) and 1.02 (± 0.70) mSv, respectively. Body mass index (β = 0.104, 95% CI: 0.07, 0.14), practice of timing (β = -0.43, 95% CI: -0.73, -0.13), working experience (β = -0.04, 95% CI: -0.048, -0.032), and practice of distancing (β = -0.26, 95% CI: -0.49, -0.17) were found to be statistically significant factors of annual deep dose equivalent. In addition, body mass index (β = 0.113, 95% CI: 0.08, 0.15), practice of timing (β = -0.62 95% CI: -0.93, -0.31) and, working experience (β = -0.044, 95% CI: -0.053, -0.036 had statistically significant associations with annual shallow dose equivalent. Conclusion: The annual dose equivalents were two times higher than the global average of annual per caput effective dose due to medical exposure. Body mass index, practice of timing, working experience, and practice of distancing were factors of occupational radiation exposure dose. Strategies focusing on increasing the skill, experience, and lifestyle of radiology personnel would be supreme important means to reduce occupational radiation exposure dose. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the image quality of deep learning–based reconstruction (DLR), model-based (MBIR), and hybrid iterative reconstruction (HIR) algorithms for lower-dose (LD) unenhanced head CT and compare it with those of standard-dose (STD) HIR images. Methods: This retrospective study included 114 patients who underwent unenhanced head CT using the STD (n = 57) or LD (n = 57) protocol on a 320-row CT. STD images were reconstructed with HIR; LD images were reconstructed with HIR (LD-HIR), MBIR (LD-MBIR), and DLR (LD-DLR). The image noise, gray and white matter (GM-WM) contrast, and contrast-to-noise ratio (CNR) at the basal ganglia and posterior fossa levels were quantified. The noise magnitude, noise texture, GM-WM contrast, image sharpness, streak artifact, and subjective acceptability were independently scored by three radiologists (1 = worst, 5 = best). The lesion conspicuity of LD-HIR, LD-MBIR, and LD-DLR was ranked through side-by-side assessments (1 = worst, 3 = best). Reconstruction times of three algorithms were measured. Results: The effective dose of LD was 25% lower than that of STD. Lower image noise, higher GM-WM contrast, and higher CNR were observed in LD-DLR and LD-MBIR than those in STD (all, p ≤ 0.035). Compared with STD, the noise texture, image sharpness, and subjective acceptability were inferior for LD-MBIR and superior for LD-DLR (all, p < 0.001). The lesion conspicuity of LD-DLR (2.9 ± 0.2) was higher than that of HIR (1.2 ± 0.3) and MBIR (1.8 ± 0.4) (all, p < 0.001). Reconstruction times of HIR, MBIR, and DLR were 11 ± 1, 319 ± 17, and 24 ± 1 s, respectively. Conclusion: DLR can enhance the image quality of head CT while preserving low radiation dose level and short reconstruction time. Key Points: • For unenhanced head CT, DLR reduced the image noise and improved the GM-WM contrast and lesion delineation without sacrificing the natural noise texture and image sharpness relative to HIR. • The subjective and objective image quality of DLR was better than that of HIR even at 25% reduced dose without considerably increasing the image reconstruction times (24 s vs. 11 s). • Despite the strong noise reduction and improved GM-WM contrast performance, MBIR degraded the noise texture, sharpness, and subjective acceptance with prolonged reconstruction times relative to HIR, potentially hampering its feasibility. [ABSTRACT FROM AUTHOR]

Objectives: Commercial intraoral rectangular collimators are available for collimating to size 2 image receptor. The benefits of reducing the x-ray beam to match the area of the image detector in adult intraoral radiography are endorsed internationally. However, in pediatric dentistry the image receptor can be further decreased to size 1 and 0. Method and materials: For this study size 1 and 0 rectangular collimators were fabricated using 1.65-mm lead sheets (Rotometals). The custom-fabricated collimators were fixed to the plastic body of a Rinn (Dentsply) Universal Collimator attachment. Aperture sizes were extrapolated based on the active imaging area of size 1 and 0 digital image receptors. A dose area product (DAP) measuring device was used to determine the change in radiation absorbed dose as a function of the imaging field of view. Results: DAP measurements were evaluated in the 31.7 cm² conventional round collimation, Rinn 12.0 cm² Universal rectangular collimator, and in the manufactured size 1 (8.25 cm²) and size 0 (5.72 cm²) rectangular collimators. The size 1 collimator had a 32% DAP reduction from the size 2, and a 53% reduction for the size 0. Conclusion: Size 1 and size 0 rectangular collimators can be independently manufactured and utilized in pediatric dentistry. This study suggests that a considerable radiation dose reduction is possible in pediatric intraoral imaging when using the size 1 and 0 matched collimation. Since the pediatric population is vulnerable to radiation exposure, any measurable reduction has a potential for long-term health benefits and is therefore clinically significant. [ABSTRACT FROM AUTHOR]

We determined radiotoxic 210Po in roasted coffee beans from different regions worldwide, the beverages, and tried to create the prediction model of 210Po content based on its growth location. Additionally, the experiments on 210Po losses and extraction were performed to describe the actual exposure to 210Po. 210Po concentrations in coffee beans and brews tuned out low (maximally of 0.20 Bq∙kg−1 and 2.31 Bq∙L−1, respectively). We assessed the impact of the roasting process on 210Po content and its losses at a maximum of 56.7%. During infusion experiments, we estimated the extraction of 210Po to the coffee brew at a maximum of 40.6%. The amount of 210Po in the coffee brew depended on the infusion style and water type. We calculated the effective radiation doses from the coffee drink ingestion. Coffee drinking does not contribute significantly to the annual effective radiation dose worldwide. [ABSTRACT FROM AUTHOR]

The radiation damage effect is relatively serious during spacecraft operation in orbit. To know the real cumulative dose in orbit accurately, a radiation dose detector is carried on the FY-4B satellite. It comprises one electric control unit and three dose detectors, with a total of four payloads. Each dose detector includes five dose-monitoring points corresponding to different shielding thicknesses, which are mainly used for the measurement of the dose depth. Three dose detectors with the same function are installed in the X, Y and Z positions and can detect the total dose in different directions during the operation of the satellite. Each detector has the characteristics of small size, high integration and low power consumption. At present, the FY-4B satellite is in orbit. The detectors have been working normally since they were started up, and good preliminary detection results have been obtained. From the power-up of the detectors to April 2022, the maximum dose has reached 2.7 × 103 rad(Si). We conducted a preliminary analysis of the relationship between total dose and shielding thickness. In addition, the relationship between daily average dose and shielding thickness was further analyzed. These studies have application value for radiation protection design. [ABSTRACT FROM AUTHOR]

The article presents answers to questions related to lutetium-177-PSMA-617 therapy for metastatic castration-resistant prostate cancer based on a randomized controlled trial.

After the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, individual exposure doses to residents have been assessed by many municipalities, governments and research institutes. Various methods including measurements with personal dosimeters and simulations have been used for this evaluation depending on purposes, but the information of assessments and methods has not been systematically organized. A comprehensive review of the knowledge and experiences of individual exposure doses assessments accumulated so far and understanding the characteristics of the assessment methods will be very useful for radiation protection and risk communication, following to governmental policy planning. We reviewed the efforts made by the Japanese government and research institutes to assess radiation doses to residents after the FDNPS accident in Part 1. On the other hand, each method of assessing individual exposure doses includes uncertainties and points to be considered for the appropriate assessment. These knowledge and experiences are important for the assessment implementation and applying the assessment results to the governmental policy planning, and are summarized in Part 2 of this article. [ABSTRACT FROM AUTHOR]

Although the Diagnostic Reference Levels (DRLs) have been shown to be an important tool for optimising patient radiation protection, there are still difficulties related to the methodology that should be used to establish and use local DRL values. This statement represents the current view of the EuroSafe Imaging 'Clinical DRLs' working group formed with the purpose to produce scientific and educational material on DRLs and promote the concept of local DRLs. Guidelines on how to establish and how to use local DRLs presented herein can be implemented using a multidisciplinary team approach. Local DRLs are easy to determine and implement and they reflect local equipment performance and local clinical needs. They can be updated more frequently than the national DRLs, especially if a dose management system is available. To establish local DRLs, a practical approach could be to collect a reasonable set, i.e., at least 20–30 procedures, of data for well-defined clinical indications and calculate the 3rd quartile values. The median values of the distribution can be set to define the 'typical values'. The International Commission of Radiological Protection (ICRP) suggests setting 'typical values' for newer technologies that enable decreased amounts of radiation exposure for a similar level of image quality. Local DRLs should be similar or lower to the national DRLs. They could be higher only if the clinical benefits for some medical indications are fully explained and reported. Local DRLs may be used as a quality benchmark to track outliers and can be also used as alert values. Key points: Guidelines on how to establish and use local DRLs are presented. Local DRLs are easy to determine and implement and can be updated frequently Additionally, local DRLs can be used to track outliers. [ABSTRACT FROM AUTHOR]

This prospective study sought to evaluate potential savings of radiation dose to medical staff using real‐time dosimetry coupled with visual radiation dose feedback during angiographic interventions. For this purpose, we analyzed a total of 214 angiographic examinations that consisted of chemoembolizations and several other types of therapeutic interventions. The Unfors RaySafe i2 dosimeter was worn by the interventionalist at chest height over the lead protection. A total of 110 interventions were performed with real‐time radiation dosimetry allowing the interventionalist to react upon higher x‐ray exposure and 104 examinations served as the comparative group without real‐time radiation monitoring. By using the real‐time display during interventions, the overall mean operator radiation dose decreased from 3.67 (IQR, 0.95–23.01) to 2.36 μSv (IQR, 0.52–12.66) (−36%; p = 0.032) at simultaneously reduced operator exposure time by 4.5 min (p = 0.071). Dividing interventions into chemoembolizations and other types of therapeutic interventions, radiation dose decreased from 1.31 (IQR, 0.46‐3.62) to 0.95 μSv (IQR, 0.53‐3.11) and from 24.39 (IQR, 12.14‐63.0) to 10.37 μSv (IQR, 0.85‐36.84), respectively, using live‐screen dosimetry (p ≤ 0.005). Radiation dose reductions were also observed for the participating assistants, indicating that they could also benefit from real‐time visual feedback dosimetry during interventions (−30%; p = 0.039). Integration of real‐time dosimetry into clinical processes might be useful in reducing occupational radiation exposure time during angiographic interventions. The real‐time visual feedback raised the awareness of interventionalists and their assistants to the potential danger of prolonged radiation exposure leading to the adoption of radiation‐sparing practices. Therefore, it might create a safer environment for the medical staff by keeping the applied radiation exposure as low as possible. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether route of access, transradial or transfemoral, leads to any discernible differences in patient radiation or contrast medium exposure as well as procedure time in elective prostate artery embolization (PAE). Methods: This retrospective study included sixty patients in total: n = 30 in the radial PAE group, and n = 30 in the femoral PAE group. All procedures were performed in a single angiography suite between May 2018 and January 2021, using a standard kit for each type of vascular access, the same microcatheter/wire combination and embolic agent to super-selectively target and embolize one or both prostate arteries. Outcome measures included dose area product (DAP, µGym 2), air kerma (mGy), fluoroscopy time (mins), procedure time (mins) and volume of contrast medium used (mL). Adverse events were also recorded. Results: The radial and femoral groups were matched for age (73.2 ± 7.5 vs 71.3 ± 10.14, P =.41) and body mass index (27.53 ± 5.08 vs 26.41 ± 3.93, P =.38). No significant difference in dose area product, air kerma, fluoroscopy time, procedure time or volume of contrast medium used was found between radial and femoral PAE. No adverse events occurred in either group. Conclusion: Radial PAE is safe and comparable to femoral PAE with respect to patient radiation exposure, contrast medium usage, and procedure duration. Radial access is a useful skill to add to the armament of the interventional radiologist in elective PAE. [ABSTRACT FROM AUTHOR]

Objective: To present patient dose levels for different CBCT scanners, acquired by a dose monitoring tool in a University Hospital, as a function of field of view (FOV), operation mode, and patient age. Methods: An integrated dose monitoring tool was used to collect radiation exposure data [type of CBCT unit, dose-area product (DAP), FOV size, and operation mode] and patient demographic information (age, referral department) performed on a 3D Accuitomo 170 and a Newtom VGI EVO unit. Effective dose conversion factors were calculated and implemented into the dose monitoring system. For each CBCT unit, the frequency of examinations, clinical indications, and effective dose levels were obtained for different age and FOV groups, and operation modes. Results: A total of 5163 CBCT examinations were analyzed. Surgical planning and follow-up were the most frequent clinical indications. For the standard operation mode, effective doses ranged from 35.1 to 300 µSv and 9.26-117 µSv using 3D Accuitomo 170 and Newtom VGI EVO, respectively. In general, effective doses decreased with increasing age and FOV size reduction. Conclusions: Effective dose levels varied notably between systems and operation modes. Operation mode selection and FOV size were indication-oriented, with larger FOV sizes election serving surgical planning and follow-up. Seeing the influence of FOV size on effective dose levels, manufacturers could be advised to move toward patient-specific collimation and dynamic FOV selection. Systematically monitoring patient doses could be recommended for steering future CBCT optimization. [ABSTRACT FROM AUTHOR]

Early implant migration is an indicator of the long-term survival/failure of implants. CT-based radio-stereometric analysis (CT-RSA) is a precise method for measuring and visualizing implant migration in vivo using image processing of CT scans. This makes the method widely applicable to orthopedic researcher. Since its development in the early 2000s, CT-RSA has benefited from breakthroughs in CT and computing technology. These advancements have allowed for the acquisition of images with higher resolution at a much lower radiation dose. As a result, the measurement precision of CT-RSA is now comparable to that of the current gold standard technology while still compatible with most ethical considerations regarding radiation exposure. In this review we present bests practices for the successful execution of CT-RSA research projects. These practices are based on experience from projects on the hip, knee, shoulder, lower back, cervical spine, foot, pelvis, and wrist. [ABSTRACT FROM AUTHOR]

A ‘Cyclotron’ is a proton particle accelerator, broadly used for short-lived isotopes (like F-18) production for imaging in radiation oncology. In Pakistan, Fluorine (F-18) is being produced by the cyclotrons installed in various hospitals. F-18 emits two gamma photons through the annihilation phenomenon, having 511 keV energy each. F-18 has converted into (18F) Fluorodeoxyglucose (FDG) through the synthesis process. This high-intensity gamma photon may be dangerous to radiation workers if radiation safety regulations are not followed. A study was conducted for the measurement of ambient radiation levels in the controlled areas and supervised areas of cyclotron facilities using Thermoluminescent Dosimeters (TLDs). The results obtained from TLDs were formulated and evaluated. All measured values were meeting the criteria of classification of areas i.e., the radiation doses will receive greater than 6mSv/year in a Controlled area and the radiation dose will receive greater than 1mSv/year in a Supervised area as mentioned in Pakistan Nuclear Regulatory Authority (PNRA’s) Regulations on Radiation Protection (PAK/904). It is concluded that all workers received radiation doses within limits and the facilities had implemented clause 26 of PNRA Regulations through effective shielding in the design of the cyclotron facilities, and dose monitoring. The effective implementation of PNRA regulations is verified through regulatory oversight and through such type of cross-verification in the country. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Radiation safety training remains variable among gastroenterologists performing endoscopic retrograde cholangiopancreatography (ERCP). This study sought to ascribe dosimeter readings to various real-world ERCP scenarios to provide data supporting the 3 pillars of radiation safety: distance, time, and shielding. METHODS: An ERCP fluoroscopy unit was used to generate radiation scatter from 2 differently sized anthropomorphic phantoms. Radiation scatter was measured at various distances from the emitter, with and without a lead apron, and at various frame rates (measured in frames per second, fps) and degrees of fluoroscopy pedal actuation. An image quality phantom was used to assess resolution at various frame rates and air gaps. RESULTS: Increasing the distance resulted in a decrease in measured scatter (from 0.75 mR/h at 1.5 ft to 0.15 mR/h at 9 ft with the average phantom and from 50 mR/h at 1.5 ft to 3.06 mR/h at 9 ft with the large phantom). Depressing the fluoroscopy pedal less frequently, or decreasing the frame rate (ie, increasing the time per frame), resulted in a linear decrease in scatter (from 55 mR/h at 8 fps to 24.5 mR/h at 4 fps and 13.60 mR/h at 2 fps). Providing shielding through the presence of a 0.5-mm lead apron reduced scatter (from 4.10 to 0.11 mR/h with the average phantom; from 15.30 mR/h to 0.43 mR/h with the large phantom). However, decreasing the frame rate from 8 fps to 2 fps did not change the number of line pairs identified on the image phantom. A greater air gap increased the number of line pairs resolved. CONCLUSIONS: Implementing the 3 pillars of radiation safety led to a quantifiable, clinically significant decrease in radiation scatter. The authors hope that these findings spark greater implementation of radiation safety measures among practitioners utilizing fluoroscopy. [ABSTRACT FROM AUTHOR]

The purpose of this study is to show the actual recommendations for dose management and provide an overview of the available options for dose tracking and dose optimization. The legal institutions that supervise the radiological exposure of patients and their most important directives are presented. A literature review of existing diagnostic reference levels for computed tomography (CT), interventional radiology, radiography, paediatric radiography, mammography, and fluoroscopy in Europe and Poland was carried out. It has been shown that, in Poland, it is necessary to verify and determine the new diagnostic reference levels (DRLs) for each imaging modality because the existing ones are adapted from other countries and are not determined on the basis of data from Polish hospitals. They have not been updated for 11-17 years, although it is recommended to update them every 3-5 years. Many countries in Europe have already determined DRLs based on the analysis of their own dosage data (e.g. Austria and Germany). Analysing the existing DRLs for CT in Poland, it was noticed that they concern only a single anatomical region. It is necessary to determine the DRLs for multi-region CT (i.e. chest-abdomen-pelvis and neck-chest-abdomen-pelvis) examinations because these examinations account for about 60% of all oncological CT examinations-based on data collected from The Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw. [ABSTRACT FROM AUTHOR]

The evacuation order areas established due to the accident at the Tokyo Electric Power Company Holdings' (TEPCO) Fukushima Daiichi Nuclear Power Plant (FDNPP) have been reorganized according to the decrease in ambient dose rates and the decontamination progress. The Japanese government decided to decontaminate the difficult-to-return areas and lift the evacuation order by 2030. This radiation protection strategy can be optimized by examining emergency exposure situations to date and the existing exposure after the accident. This article reviews the methods that can determine the individual radiation doses of residents who should return to their homes when the evacuation order is lifted in the specific reconstruction reproduction base area and the difficult-to-return areas outside this base area and summarizes the points to be considered when implementing these methods. In Part 1 of this article, we review the efforts made by the Japanese government and research institutes to assess radiation doses to residents after the FDNPP accident. [ABSTRACT FROM AUTHOR]