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Radiation Protection Dosimetry Oct 2021Some of the ethically most sensitive issues in radiation protection arise at imaging of pregnant-and potentially pregnant-patients and of newborn. This article reviews... (Review)
Review
Some of the ethically most sensitive issues in radiation protection arise at imaging of pregnant-and potentially pregnant-patients and of newborn. This article reviews the current literature and recommendations on imaging during pregnancy and breastfeeding. Risks related to alternative non-ionizing radiation methods are also considered. With few exceptions, exposure of the fetus through radiography, computed tomography (CT) and nuclear medicine imaging can be limited to safe levels, although studies such as abdominal-pelvic CT cannot avoid significant exposure to fetuses. Eight to 10 weeks post-conception, the fetus has a thyroid which starts to concentrate iodide having crossed the placenta barrier resulting in unacceptably high doses to the fetal thyroid after administration of 131I- and even 123I-iodide and other radiopharmaceuticals with a high content of free radioiodine. Many radiopharmaceuticals are excreted through breast milk. Breastfeeding interruption recommendations should be followed to keep the effective dose to the infant below 1 mSv.
Topics: Breast Feeding; Female; Fetus; Humans; Infant, Newborn; Iodine Radioisotopes; Molecular Imaging; Pregnancy; Radiation Dosage; Radiography; X-Rays
PubMed: 33855370
DOI: 10.1093/rpd/ncab041 -
Pediatric Radiology Apr 2021
Topics: Child; Humans; Radiation Dosage; Radiology
PubMed: 33743035
DOI: 10.1007/s00247-020-04838-3 -
Pediatric Radiology Apr 2023Paediatric computed tomography (CT) imaging has always been associated with challenges. Although the technical background of CT imaging is complex, it is worth... (Review)
Review
Paediatric computed tomography (CT) imaging has always been associated with challenges. Although the technical background of CT imaging is complex, it is worth considering the baseline aspects of radiation exposure to prevent unwanted excess radiation in paediatric patients. In this review, we discuss the most relevant factors influencing radiation exposure, and provide a simplified and practical approach to optimise paediatric CT.
Topics: Child; Humans; Radiation Dosage; Tomography, X-Ray Computed; Radiation Exposure
PubMed: 36333494
DOI: 10.1007/s00247-022-05526-0 -
Physica Medica : PM : An International... Apr 2022Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New...
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control (AEC) systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
Topics: Child; Consensus; Humans; Radiation Dosage; Radiography; Radiology; Radiology Department, Hospital; Tomography, X-Ray Computed
PubMed: 34955383
DOI: 10.1016/j.ejmp.2021.12.006 -
Radiography (London, England : 1995) May 2022Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New...
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control (AEC) systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
Topics: Child; Consensus; Humans; Radiation Dosage; Radiography; Radiology; Tomography, X-Ray Computed
PubMed: 34953726
DOI: 10.1016/j.radi.2021.12.003 -
Nihon Hoshasen Gijutsu Gakkai Zasshi 2022
Topics: Radiation Exposure; Radiation Dosage
PubMed: 36403968
DOI: 10.6009/jjrt.2022-2115 -
Journal of Medical Radiation Sciences Mar 2023
Topics: Radiation Dosage; Tomography, X-Ray Computed
PubMed: 36680354
DOI: 10.1002/jmrs.656 -
Radiology Feb 2020
Topics: Humans; Medical Staff; Radiation Dosage; Radiation Protection; Radiometry
PubMed: 31770079
DOI: 10.1148/radiol.2019192414 -
Journal of the National Cancer Institute Nov 2023Immunotherapy combinations are being investigated to expand the benefit of immune checkpoint blockade across many cancer types. Radiation combinations, in particular...
Immunotherapy combinations are being investigated to expand the benefit of immune checkpoint blockade across many cancer types. Radiation combinations, in particular using stereotactic body radiotherapy, are of keen interest because of underlying mechanistic rationale, safety, and availability as a standard of care in certain cancers. In addition to direct tumor cytotoxicity, radiation therapy has immunomodulatory effects such as induction of immunogenic cell death, enhancement of antigen presentation, and expansion of the T-cell receptor repertoire as well as recruitment and increased activity of tumor-specific effector CD8+ cells. Combinations of radiation with cytokines and/or chemokines and anti-programmed death 1 and anticytotoxic T-lymphocyte antigen 4 therapies have demonstrated safety and feasibility, as well as the potential to improve long-term outcomes and possibly induce out of irradiated field or abscopal responses. Novel immunoradiotherapy combinations represent a promising therapeutic approach to overcome radioresistance and further enhance systemic immunotherapy. Potential benefits include reversing CD8+ T-cell exhaustion, inhibiting myeloid-derived suppressor cells, and reversing M2 macrophage polarization as well as decreasing levels of colony-stimulating factor-1 and transforming growth factor-β. Here, we discuss current data and mechanistic rationale for combining novel immunotherapy agents with radiation therapy.
Topics: Humans; Radioimmunotherapy; Combined Modality Therapy; Neoplasms; Immunotherapy; Radiation Dosage
PubMed: 37348864
DOI: 10.1093/jnci/djad118 -
RoFo : Fortschritte Auf Dem Gebiete Der... Sep 2019
Topics: Guideline Adherence; Humans; Infant; Infant, Newborn; Radiation Dosage; Radiation Injuries; Radiation Protection
PubMed: 31430783
DOI: 10.1055/a-0943-1526