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Journal of Medical Radiation Sciences Mar 2020On this editorial, the importance of optimisation of diagnostic imaging and radiation therapy in terms of diagnostic and therapeutic tests and treatments, education and...
On this editorial, the importance of optimisation of diagnostic imaging and radiation therapy in terms of diagnostic and therapeutic tests and treatments, education and service provision are discussed.
Topics: Humans; Practice Guidelines as Topic; Radiation Dosage; Radiology
PubMed: 32153138
DOI: 10.1002/jmrs.381 -
Physica Medica : PM : An International... Nov 2020The medical radiological imaging technological evolution and wide availability has resulted in the exponential increase in utilization. Evidence for a risk of cancer... (Review)
Review
The medical radiological imaging technological evolution and wide availability has resulted in the exponential increase in utilization. Evidence for a risk of cancer arising from radiation doses of lower than 100 mSv is still limited. There is a need for patient dose optimization. A literature review was conducted to identify the reasons why optimization is important and the steps to be followed for a successful optimization process in digital radiology, Computed Tomography, interventional radiology and mammography. Based on recent literature, 5 steps for a dose optimization process are proposed. These steps are: 1) establishment of a quality assurance programme; a mistake, misuse or malfunction of an X-ray machine can potentially affect the health or life of thousands of people, 2) establishment of a dose optimization team consisting of a radiologist, medical physicist and radiation technologist, 3) determination of baseline dose levels and image quality as well as comparisons with benchmarks to decide which exam protocols should be optimized, 4) modification of protocols by the medical physicist and 5) evaluation of the optimization process and its effect on patient dose and image quality. The optimization process should include joint efforts focused on 1) equipment performance 2) exam protocol customization and 3) staff behaviour. Manufacturers should provide detailed descriptions of exam protocols and training on the use of dose reduction features. The diagnostic radiology medical physicist should emerge and take a proactive lead in the everyday clinical routine in order to promote the value of optimization process.
Topics: Humans; Radiation Dosage; Radiographic Image Enhancement; Radiography; Radiology, Interventional; Tomography, X-Ray Computed
PubMed: 33035737
DOI: 10.1016/j.ejmp.2020.09.015 -
Dysphagia Apr 2022Modified Barium Swallow Studies (MBSSs) are important tests to aid the diagnosis of swallowing impairment and guide treatment planning. Since MBSSs use ionizing...
Modified Barium Swallow Studies (MBSSs) are important tests to aid the diagnosis of swallowing impairment and guide treatment planning. Since MBSSs use ionizing radiation, it is important to understand the radiation exposure associated with the exam. This study reports the average radiation dose in routine clinical MBSSs, to aid the evidence-based decision-making of clinical providers and patients. We examined the MBSSs of 200 consecutive adult patients undergoing clinically indicated exams and used kilovoltage (kV) and Kerma Area Product to calculate the effective dose. While 100% of patients underwent the exam in the lateral projection, 72% were imaged in the upper posterior-anterior (PA) projection and approximately 25% were imaged in the middle and lower PA projection. Average kVs were 63 kV, 77 kV, 78.3 kV, and 94.3 kV, for the lateral, upper, middle, and lower PA projections, respectively. The average effective dose per exam was 0.32 ± 0.23 mSv. These results categorize a typical adult MBSS as a low dose examination. This value serves as a general estimate for adults undergoing MBSSs and can be used to compare other sources of radiation (environmental and medical) to help clinicians and patients assess the risks of conducting an MBSS. The distinction of MBSS as a low dose exam will assuage most clinician's fears, allowing them to utilize this tool to gather clinically significant information about swallow function. However, as an X-ray exam that uses ionizing radiation, the principles of ALARA and radiation safety must still be applied.
Topics: Adult; Barium; Barium Sulfate; Fluoroscopy; Humans; Radiation Dosage; Radiation Exposure
PubMed: 33891192
DOI: 10.1007/s00455-021-10291-7 -
JACC. Clinical Electrophysiology Feb 2021
Topics: Brain; Defibrillators; Fluoroscopy; Humans; Pacemaker, Artificial; Radiation Dosage
PubMed: 33602397
DOI: 10.1016/j.jacep.2020.09.001 -
Environment International Apr 2021
Topics: Radiation Dosage; Radiation, Ionizing
PubMed: 33309204
DOI: 10.1016/j.envint.2020.106286 -
Journal of Radiation Research Mar 2023The purpose of the present study is to evaluate the effect of curcumin as a natural compound against radiation induced γ-foci and stable chromosome aberrations. Whole...
The purpose of the present study is to evaluate the effect of curcumin as a natural compound against radiation induced γ-foci and stable chromosome aberrations. Whole blood samples form three human volunteers were pretreated with curcumin at different concentrations (0.5, 10, 20 and 100 μg/ml). After 1-hour incubation, the lymphocytes were exposed to γ-rays (0.05, 0.5, 1 and 2 Gy). Radiation induced changes in cells were quantified using γ-H2AX/53BP1 assay and FISH analysis. Our results have shown that curcumin significantly reduced the frequency of both γ-foci and translocations. We found concentration-dependent increase of curcumin protective effect on γ-H2AX/53BP1 foci formation at all radiation doses. Concerning the translocations, after 0.05 and 0.5 Gy γ-rays the values of genomic frequencies are comparable within each dose and we did not observe any impact of curcumin. The most protective effect after 1 Gy exposure was found at 100 μg/ml curcumin. At 2 Gy irradiation, the maximum protection was achieved at 0.5 and 10 μg/ml of curcumin. Concentrations of 20 and 100 μg/ml also prevent lymphocytes but to less extent. Our in vitro study indicates radioprotective efficacy of curcumin against γ-ray induced damages in human lymphocytes. This observation suggests that curcumin may play a role to protect patients undergoing radiological procedures.
Topics: Humans; Histones; Curcumin; Radiation Dosage; Lymphocytes; Chromosome Aberrations; Translocation, Genetic; Dose-Response Relationship, Radiation; Gamma Rays
PubMed: 36634350
DOI: 10.1093/jrr/rrac101 -
Annals of the ICRP Dec 2020The International Commission on Radiological Protection (ICRP) developed effective dose as a quantity related to risk for occupational and public exposure. There was a...
The International Commission on Radiological Protection (ICRP) developed effective dose as a quantity related to risk for occupational and public exposure. There was a need for a similar dose quantity linked to risk for making everyday decisions relating to medical procedures. Coefficients were developed to enable the calculation of doses to organs and tissues, and effective doses for procedures in nuclear medicine and radiology during the 1980s and 1990s. Effective dose has provided a valuable tool that is now used in the establishment of guidelines for patient referral and justification of procedures, choice of appropriate imaging techniques, and providing dose data on potential exposure of volunteers for research studies, all of which require the benefits from the procedure to be weighed against the risks. However, the approximations made in the derivation of effective dose are often forgotten, and the uncertainties in calculations of risks are discussed. An ICRP report on protection dose quantities has been prepared that provides more information on the application of effective dose, and concludes that effective dose can be used as an approximate measure of possible risk. A discussion of the way in which it should be used is given here, with applications for which it is considered suitable. Approaches to the evaluation of risk and methods for conveying information on risk are also discussed.
Topics: Humans; International Agencies; Nuclear Medicine; Radiation Dosage; Radiation Protection
PubMed: 33147998
DOI: 10.1177/0146645320927849 -
Journal of Nuclear Medicine Technology Mar 2022The diagnostic reference level (DRL) is a patient-exposure optimization tool used to evaluate and provide guidance for radiation doses in medical imaging. In the past...
The diagnostic reference level (DRL) is a patient-exposure optimization tool used to evaluate and provide guidance for radiation doses in medical imaging. In the past few decades, there has been a global increase in the number of diagnostic imaging procedures, including nuclear medicine procedures, and consequently in patient radiation exposure. This increase has encouraged international and national health-care organizations to take action and keep up with such changes to meet the expectation of increasing use of ionizing radiation in medicine. DRLs in Kuwait were established by investigating the administered activity of radiopharmaceuticals and CT radiation doses in hybrid imaging systems. The DRLs were determined on the basis of the 75th percentile of radiopharmaceutical administered activity distribution as recommended by the International Commission on Radiological Protection. The DRLs determined in Kuwait agree well with other published DRLs in Europe, Japan, Korea, Australia, and the United States. This study presents the establishment process and the results of the first national DRLs for nuclear medicine procedures in Kuwait as a way to optimize radiation exposure.
Topics: Diagnostic Reference Levels; Humans; Kuwait; Multimodal Imaging; Nuclear Medicine; Radiation Dosage; Reference Values
PubMed: 34583955
DOI: 10.2967/jnmt.121.262175 -
Tomography (Ann Arbor, Mich.) Jan 2023Lung cancer screening (LCS) programs through low-dose Computed Tomography (LDCT) are being implemented in several countries worldwide. Radiation exposure of healthy... (Review)
Review
Lung cancer screening (LCS) programs through low-dose Computed Tomography (LDCT) are being implemented in several countries worldwide. Radiation exposure of healthy individuals due to prolonged CT screening rounds and, eventually, the additional examinations required in case of suspicious findings may represent a concern, thus eventually reducing the participation in an LCS program. Therefore, the present review aims to assess the potential radiation risk from LDCT in this setting, providing estimates of cumulative dose and radiation-related risk in LCS in order to improve awareness for an informed and complete attendance to the program. After summarizing the results of the international trials on LCS to introduce the benefits coming from the implementation of a dedicated program, the screening-related and participant-related factors determining the radiation risk will be introduced and their burden assessed. Finally, future directions for a personalized screening program as well as technical improvements to reduce the delivered dose will be presented.
Topics: Humans; Radiation Dosage; Early Detection of Cancer; Lung Neoplasms; Tomography, X-Ray Computed; Radiation Exposure
PubMed: 36828367
DOI: 10.3390/tomography9010015 -
Journal of the American Dental... Sep 2023The American Academy of Oral and Maxillofacial Radiology established an ad hoc committee to draft evidence-based recommendations and clinical guidance for the...
BACKGROUND
The American Academy of Oral and Maxillofacial Radiology established an ad hoc committee to draft evidence-based recommendations and clinical guidance for the application of patient contact shielding during dentomaxillofacial imaging.
TYPES OF STUDIES REVIEWED
The committee reviewed monographs and reports from radiation protection organizations and studies that reported radiation dose to gonads, breasts, and thyroid gland from dentomaxillofacial imaging.
RESULTS
Considering the absence of radiation-induced heritable effects in humans and the negligible dose to the gonads and fetus from dentomaxillofacial imaging, the committee recommends discontinuing shielding of the gonads, pelvic structures, and fetuses during all dentomaxillofacial radiographic imaging procedures. On the basis of radiation doses from contemporaneous maxillofacial imaging, the committee considered that the risks from thyroid cancer are negligible and recommends that thyroid shielding not be used during intraoral, panoramic, cephalometric, and cone-beam computed tomographic imaging.
PRACTICAL IMPLICATIONS
This position statement informs and educates the reader on evolving radiation protection practices and provides simple, unequivocal guidance to dental personnel to implement these guidelines. State and local authorities should be contacted to update regulations to reflect these recommendations.
Topics: Humans; Radiation Dosage; Radiography, Dental; Radiography, Panoramic; Radiology; Cone-Beam Computed Tomography
PubMed: 37530694
DOI: 10.1016/j.adaj.2023.06.015