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Kim SC. Medical-Radiation-Shielding Film Fabricated by Imitating the Layered Structure Pattern of Abalone Shell and Verification of Its Shielding Effect. Materials (Basel) 2023; 16:7700. [PMID: 38138842 PMCID: PMC10744689 DOI: 10.3390/ma16247700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Radiation-shielding clothing for medical workers must be light and thin, thus ensuring flexibility. However, controlling the thickness and weight is limited by shielding performance requirements. This study aims to improve shielding performance by considering a shielding structure that mimics the internal structure of an abalone shell. Two shields were produced: a sheet made with a carrier process using a liquid polymer and tungsten mixture, and a fillet made by compounding the same material and laminated using a heat-treatment press after the injection process. The tungsten content and thickness were the same at 85 wt% and 0.3 mm, respectively. In the high-energy region, the shielding film based on the laminated structure of abalone shells showed a shielding rate that was higher by more than 7%. Compared to that of a 0.3 mm lead plate, the shielding ratio of the shielding film was approximately 16% lower at 120 kVp, thereby confirming the radiation-shielding effect of the layered-structure shielding film. Therefore, it is concluded that the laminated structure of the shielding film, which is identical to the internal laminated structure of the abalone shell, expands the impact area of incident radiation and attenuates the energy intensity, thereby improving the medical-radiation-shielding performance.
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Affiliation(s)
- Seon-Chil Kim
- Department of Medical Informatics, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Republic of Korea;
- Department of Biomedical Engineering, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Republic of Korea
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2
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Kim SC. Metal Particle Pencil Beam Spray-Coating Method for High-Density Polymer-Resin Composites: Evaluation of Radiation-Shielding Sheet Properties. Materials (Basel) 2023; 16:6092. [PMID: 37763369 PMCID: PMC10533030 DOI: 10.3390/ma16186092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
Medical shielding suits must be lightweight and satisfy the requirements of thin films to guarantee user mobility and safety. The thin film weight is related to the density and thickness, which are associated with the particle dispersion in shielding materials. An even distribution of metal particles in a polymer can maintain the spacing among them. This paper proposes a pencil beam spray-coating method that involves spraying a constant amount of a polyethylene and tungsten mixture in a thin beam onto a nonwoven fabric at a constant speed. This technique yields higher productivity than does the electrospinning method and is expected to produce materials with better shielding performance than that of materials obtained using the calender method. The shielding performance was evaluated by manufacturing shielding sheets (thickness: 0.48-0.54 mm) using the calender and pencil beam spray-coating methods under the same conditions. The densities and performances of the sheets differed significantly. The sheet manufactured using the proposed method had an even particle dispersion and exhibited 2-4% better shielding performance than did that manufactured using the calender method. Therefore, the pencil beam spray-coating method can effectively satisfy the requirements of thin films for medical radiation-shielding materials while increasing the material flexibility.
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Affiliation(s)
- Seon-Chil Kim
- Department of Biomedical Engineering, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Republic of Korea; ; Tel.: +82-10-4803-7773
- Department of Medical Informatics, School of Medicine, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Republic of Korea
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3
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Arno MG, Stevenson N, Smith C, Donecker J. Update and Extension of Release Criteria for Canine 117m Sn Treatments. Health Phys 2023; 124:391-396. [PMID: 36749306 PMCID: PMC10063182 DOI: 10.1097/hp.0000000000001680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
ABSTRACT Tin-117 m ( 117m Sn) is used to treat dogs with osteoarthritic joints by radiosynoviorthesis. The internal conversion and Auger electrons emitted by the 117m Sn provide the therapeutic effect. Sn-117 m also emits x rays and gamma rays, of which the most significant is 158.6 keV. Accurate information regarding the interactions of a person with a treated dog is needed to determine the person's total dose and thus regulatory compliance; i.e., a time and motion study. Prior studies have characterized the radiation field emitted by a treated dog, determined the effective dose rates to a person based on those radiation fields, and evaluated dog-human interactions. These studies have been tied together to calculate the prospective dose to the owner of a treated dog. The behavior modifications needed to comply with public dose limits were identified, and a template for written instructions limiting dose was developed. Further calculations based on the written instructions were made to determine the necessary duration of the instructions. The result is guidance that may be used by veterinary practitioners to release treated dogs in accordance with the public dose limits.
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4
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Kim SC. Performance Evaluation of Radiation-Shielding Materials and Process Technology for Manufacturing Skin Protection Cream. Materials (Basel) 2023; 16:3059. [PMID: 37109895 PMCID: PMC10146880 DOI: 10.3390/ma16083059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/03/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
Personnel using X-ray devices, the main source of radiation in medical institutions, are primarily affected by scattered rays. When interventionists use radiation for examinations/treatments, their hands may enter the radiation-generating area. The shielding gloves used for protection against these rays restrict movement and cause discomfort. Here, a shielding cream that directly adheres to the skin was developed and examined as a personal protective device; further, its shielding performance was verified. Bismuth oxide and barium sulfate were selected as shielding materials and comparatively evaluated in terms of thickness, concentration, and energy. With increasing wt% of the shielding material, the protective cream became thicker, resulting in improved protection. Furthermore, the shielding performance improved with increasing mixing temperature. Because the shielding cream is applied to the skin and has a protective effect, it must be stable on the skin and easy to remove. During manufacturing, the bubbles were removed, and the dispersion improved by 5% with increasing stirring speed. During mixing, the temperature increased as the shielding performance increased by 5% in the low-energy region. In terms of the shielding performance, bismuth oxide was superior to barium sulfate by approximately 10%. This study is expected to facilitate the mass production of cream in the future.
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Affiliation(s)
- Seon-Chil Kim
- Department of Biotechnology, Keimyung University, 1095 Dalgubeol-Daero, Daegu 42601, Republic of Korea
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5
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Yu KN, Watabe H, Zivkovic M, Krstic D, Nikezic D, Kim KM, Yamaya T, Kawachi N, Tanaka H, Haque A, Shahmohammadi Beni M. DynamicMC: An Open-source GUI Program Coupled with MCNP for Modeling Relative Dynamic Movement of Radioactive Source and ORNL Phantom in a 3-dimensional Radiation Field. Health Phys 2023; 124:301-309. [PMID: 36728190 PMCID: PMC9940830 DOI: 10.1097/hp.0000000000001670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 06/18/2023]
Abstract
ABSTRACT The present work introduces an open-source graphical user interface (GUI) computer program called DynamicMC. The present program has the ability to generate ORNL phantom input script for the Monte Carlo N-Particle (MCNP) package. The relative dynamic movement of the radiation source with respect to the ORNL phantom can be modeled, which essentially resembles the dynamic movement of source-to-target (i.e., human phantom) distance in a 3-dimensional radiation field. The present program makes the organ-based dosimetry of the human body much easier, as users are not required to write lengthy scripts or deal with any programming that many may find tedious, time consuming, and error prone. In this paper, we have demonstrated that the present program can successfully model simple and complex relative dynamic movements (i.e., those involving rotation of source and human phantom in a 3-dimensional field). The present program would be useful for organ-based dosimetry and could also be used as a tool for teaching nuclear radiation physics and its interaction with the human body.
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Affiliation(s)
- Kwan Ngok Yu
- Department of Physics, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong, China
| | - Hiroshi Watabe
- Division of Radiation Protection and Safety Control, Cyclotron and Radioisotope Center, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi 980-8578, Japan
| | | | | | - Dragoslav Nikezic
- Faculty of Science, University of Kragujevac, Serbia
- State University of Novi Pazar, Serbia
| | - Kyeong Min Kim
- Korea Institute of Radiological & Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, Korea
| | - Taiga Yamaya
- National Institutes for Quantum Science and Technology, Anagawa 4-9-1, Inage-ku, Chiba-shi, Chiba 263-8555, Japan
| | - Naoki Kawachi
- National Institutes for Quantum Science and Technology, 1233 Watanuki, Takasaki, Gunma 370-1292, Japan
| | - Hiroki Tanaka
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2-1010 Asashiro-Nishi, Kumatori-cho, Sennan-gun, Osaka 590-0494, Japan
| | - A.K.F. Haque
- Department of Physics, University of Rajshahi, Bangladesh
| | - Mehrdad Shahmohammadi Beni
- Department of Physics, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong, China
- Division of Radiation Protection and Safety Control, Cyclotron and Radioisotope Center, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi 980-8578, Japan
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Wilson S, Osborne D, Long M, Knowland J, Fisher DR. Practical Tools for Patient-specific Characterization and Dosimetry of Radiopharmaceutical Extravasation. Health Phys 2022; 123:343-347. [PMID: 35838538 PMCID: PMC9512231 DOI: 10.1097/hp.0000000000001600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ABSTRACT Extravasation during radiopharmaceutical injection may occur with a frequency of more than 10%. In these cases, radioactivity remains within tissue and deposits unintended radiation dose. Characterization of extravasations is a necessary step in accurate dosimetry, but a lack of free and publicly available tools hampers routine standardized analysis. Our objective was to improve existing extravasation characterization and dosimetry methods and to create and validate tools to facilitate standardized practical dosimetric analysis in clinical settings. Using Monte Carlo simulations, we calculated dosimetric values for sixteen nuclear medicine isotopes: 11 C, 64 Cu, 18 F, 67 Ga, 68 Ga, 123 I, 131 I, 111 In, 177 Lu, 13 N, 15 O, 82 Rb, 153 Sm, 89 Sr, 99m Tc, and 90 Y. We validated our simulation results against five logical alternative dose assessment methods. We then created three new characterization tools: a worksheet, a spreadsheet, and a web application. We assessed each tool by recalculating extravasation dosimetry results found in the literature and used each of the tools for patient cases to show clinical practicality. Average variation between our simulation results and alternative methods was 3.1%. Recalculation of published dosimetry results indicated an average error of 7.9%. Time required to use each characterization tool ranged from 1 to 5 min, and agreement between the three tools was favorable. We improved upon existing methods by creating new tools for characterization and dosimetry of radiopharmaceutical extravasation. These free and publicly available tools will enable standardized routine clinical analysis and benefit patient care, clinical follow-up, documentation, and event reporting.
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Affiliation(s)
- Sean Wilson
- Carilion Clinic, Roanoke VA and Blue Ridge Medical Physics, Daleville, VA
| | - Dustin Osborne
- University of Tennessee Graduate School of Medicine, Knoxville TN
| | | | | | - Darrell R. Fisher
- University of Washington Department of Radiology and Versant Medical Physics and Radiation Safety, Richland, WA
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7
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Chau M, Arruzza E, Johnson N. Simulation-based education for medical radiation students: A scoping review. J Med Radiat Sci 2022; 69:367-381. [PMID: 35178870 PMCID: PMC9442285 DOI: 10.1002/jmrs.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/30/2022] [Indexed: 11/16/2022] Open
Abstract
Simulation‐based education is a significant aspect of teaching clinical skills in tertiary medical radiation science programmes, allowing students to experience the clinical setting in a safe environment. As an educational tool, simulation exists in many valid forms including role play, interprofessional simulation and virtual reality simulation. This scoping review looks at the current literature in this field to identify the evidence surrounding simulation‐based education for medical radiation students. The purpose of this review is to provide an evidence‐based guide for educators, identify gaps in the literature and suggest areas of future research. Data extraction was performed on 33 articles where the interventions could be categorised into either role play simulation, virtual simulation, simulation videos or online learning environments. Most studies demonstrated that simulation could improve clinical competence and increase preparedness and confidence for clinical placement. Student satisfaction remained high throughout the studies; however, it is the view of many that although simulation‐based education is a valid and effective tool, it is complementary to and not a replacement for clinical placement.
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Affiliation(s)
- Minh Chau
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Elio Arruzza
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Nathan Johnson
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, South Australia, Australia
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8
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Kim SC. Tungsten-Based Hybrid Composite Shield for Medical Radioisotope Defense. Materials (Basel) 2022; 15:ma15041338. [PMID: 35207876 PMCID: PMC8880229 DOI: 10.3390/ma15041338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023]
Abstract
The shielding performance of shielding clothing is typically improved by increasing the shielding material content, but this lowers the tensile strength of the material. The weight and wearability of the shielding suit are also adversely affected. Important considerations when developing shielding fabric are thickness and flexibility to allow the wearer sufficient mobility. Insufficient thickness lowers the shielding performance, whereas excessive thickness decreases the flexibility of the garment. This study aimed to develop a composite shield that reproduces the shielding performance and meets the flexibility of the process technology. The new shield was manufactured by combining two layers: the shielding fabric fabricated from tungsten wire and a shielding sheet produced by mixing a polymer (PDMS) with tungsten powder. These two shields were bonded to develop a double hybrid composite. Compared with the existing shielding sheet (produced from lead equivalent of 0.55 mmPb), the shielding performance of the hybrid composite shield improved by approximately 17% on average and the tensile strength was 53% higher. The hybrid composite shield has a thickness of 1.35 ± 0.02 mm and delivers the same shielding performance as the lead equivalent. The new hybrid composite shield offers higher wearer mobility while shielding against radiation exposure in medical institutions.
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Affiliation(s)
- Seon-Chil Kim
- Department of Biomedical Engineering, School of Medicine, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Korea
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9
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Abstract
ABSTRACT Yttrium-90 (90Y)-polymer composite (RadioGel™) is a new cancer therapeutic agent for treating solid tumors by direct interstitial injection. The 90Y-composite comprises insoluble, microscopic yttrium-phosphate particles carried by a sterile, injectable water-polymer (hydrogel) solution that can be placed directly by needle injection into solid tumors. The yttrium-90-RadioGel™ agent was designed to provide a safe, effective, localized, high-dose beta radiation for treating solid tumors. The properties of 90Y-RadioGel™ also make it a relatively safe agent for health care personnel who prepare, handle, and administer the material. The purpose of this work was to demonstrate and characterize radiation safety of the injectable 90Y-RadioGel™ therapeutic agent. Safety in the patient is defined by its ability to target precisely and remain confined within tumor tissue so that radiation doses are imparted to the tumor and not to normal organs and tissues. Radiation safety for health care personnel is defined by the low radiation doses received by persons who prepare and administer the agent. These safety features were demonstrated during experiments, first involving laboratory rabbits and second in cat and dog animal patients that were treated clinically for sarcoma tumors. This paper focuses mainly on the rabbit tissue biodistribution study; follow-on clinical application in cat and dog subjects confirmed the rabbit results. Implanted VX2 liver tumors in the hind limbs of 26 New Zealand White rabbits were treated using tracer amounts of either (a) 90Y-RadioGel™ or (b) 90Y-microparticles in phosphate-buffered saline (PBS) without the gel carrier. Tumor and margin injections were interstitial. Rabbits were euthanized at 48 h or 10 d following injection. Blood and tissues (tumor or tumor margins, liver, lymph nodes, rib bone, kidney, spleen) were collected for liquid scintillation counting using wet-ash procedures. Biodistribution was also analyzed at 10 d post-injection using micro-computed tomography. Thirteen cat and dog subjects were also treated clinically for sarcomas. Liquid scintillation counting at 48 h post-injection of tumors or margins with 90Y-RadioGel™ showed that significant radioactivity was measurable only at the site of administration and that radioactivity above detector background was not found in blood or peripheral organs and tissues. At 10 d post-injection, microCT showed that yttrium phosphate microparticles were confined to the injection site. Yttrium-90 remained where placed and did not migrate away in significant amounts from the injection site. Radiation doses were confined mainly to tumors and margin tissues. During preparation and administration, radiation doses to hands and body of study personnel were negligible. This work showed that 90Y-RadioGel™ can be safely prepared and administered and that radiation doses to cancer patients are confined to tumor and margin tissues rather than to critical normal organs and tissues.
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Affiliation(s)
- Darrell R. Fisher
- Department of Pharmaceutical Sciences, Washington State University, Richland, WA 99354
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10
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Choi K, Choi J. Investigation of Radiation Safety Pictogram Recognition in Daily Life. Int J Environ Res Public Health 2021; 18:2166. [PMID: 33672145 DOI: 10.3390/ijerph18042166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/01/2021] [Accepted: 02/19/2021] [Indexed: 11/28/2022]
Abstract
After the Fukushima Daiichi nuclear accident of 2011, interest regarding radiation safety in everyday life has increased considerably. This study investigates the general public’s current level of awareness of six warning pictograms in regard to medical and natural radiation safety utilized under ISO 7010, as per Korea industrial regulations. Namely, it tests whether survey respondents can recognize pictograms related to radiation safety according to their purpose, as their inability to do so poses a serious safety problem. The empirical analysis results regarding the awareness levels for radiation safety pictograms are as follows. First, 63.3% of the respondents were unable to correctly identify the pictograms; that is, their level of understandings of the six pictograms related to everyday radiation were low. Second, the mean score for the correct responses to the question of what the six pictograms indicated in relation to everyday radiation safety was also relatively low, with a mean score of 2.79 and a standard deviation of 1.447. The primary reasons for the low awareness and understanding levels were identified to be insufficient education related to radiation safety in schools. Additionally, it is necessary to revise and rectify current warning pictograms established by the Korea Industrial Standards and ISO 7010. This study is thus significant in that it identifies the level of understanding of the pictograms and suggests the need for improvement as a diversified effort toward improving everyday radiation safety.
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Wendt RE, Selting KA, Lattimer JC, Wong J, Simón J, Stevenson NR, Stearns SD. Radiation Safety Considerations in the Treatment of Canine Skeletal Conditions Using 153Sm, 90Y, and 117mSn. Health Phys 2020; 118:702-710. [PMID: 32167498 PMCID: PMC7192767 DOI: 10.1097/hp.0000000000001222] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The treatment of pets, service animals, and pre-clinical research subjects with radionuclides raises concern for the safety of the people who interact with the animals after their treatment. Three treatments of skeletal conditions in dogs are considered in this study: Sm-1,4,7,10-tetraazacylcododecanetetramethylenephosphonic acid, which is a bone-seeking radiopharmaceutical; unencapsulated Y permanent interstitial implants, which are sometimes called "liquid brachytherapy"; and Sn radiosynoviorthesis, which is also called radiosynovectomy. External exposure rate readings of the Sm and Sn treatments, and Monte Carlo simulations of Sn at a distance of 1 m and of all three in direct contact with tissue were analyzed for doses. Dogs that have received any of these treatments using typically administered activities may be released from radiation safety isolation immediately after treatment from the standpoint of external exposure. People should avoid prolonged close proximity, such as sleeping with a treated dog, for three weeks following an Y interstitial implant or for a month following Sn radiosynoviorthesis. No such avoidance is necessary after treatment with Sm-1,4,7,10-tetraazacylcododecanetetramethylenephosphonic acid.
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Affiliation(s)
- Richard E Wendt
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Kimberly A Selting
- College of Veterinary Medicine, The University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; formerly in the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, The University of Missouri, Columbia, Missouri 65211
| | - Jimmy C Lattimer
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, The University of Missouri, Columbia, Missouri 65211
| | - Janine Wong
- The University of Texas Health Science Center School of Public Health, Houston, Texas 77030; formerly in the Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Jaime Simón
- IsoTherapeutics Group, LLC, Angleton, Texas 77515
| | - Nigel R Stevenson
- Exubrion Therapeutics, Inc., Buford, Georgia 30518; formerly with Serene, LLC, The Woodlands, Texas 77381
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12
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Chau M. Cultural Diversity and the Importance of Communication, Cultural Competence, and Uncertainty in Radiography. J Med Imaging Radiat Sci 2020; 51:S17-S22. [PMID: 32439284 DOI: 10.1016/j.jmir.2020.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
Cultural diversity has been well-recognized as a challenge for health care providers in many countries, thereby stressing the importance of effective and sufficient communications between patients and health care staff. Culturally competent care is a key to day-to-day practice, and we must strive to provide optimum care despite personal differences. If the health care service is to provide culturally competent care, our radiographers are vulnerable and prone to errors because effective communication requires both cultural competence and knowledge of the language. An understanding in effective communication, cultural competence, and uncertainty is important in the profession of radiographers.
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Affiliation(s)
- Minh Chau
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
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13
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Chew SY, Ang IWL, Lim DXY, Tan MQS, Wee ZY. Assessment of knowledge and perceptions of medical radiation among caregivers and adolescent patients in the paediatric emergency department. Singapore Med J 2020; 62:582-587. [PMID: 32349196 DOI: 10.11622/smedj.2020071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to assess understanding of the potential risks associated with medical imaging among caregivers and adolescent patients in a paediatric emergency department (PED) in Singapore. METHODS A prospective convenience sample survey was performed involving adolescents and caregivers presenting to our PED from December 2015 to May 2016. The questionnaire examined demographic data, knowledge of imaging procedures and radiation risks, and expectations regarding information provided about medical radiation. RESULTS A total of 349 questionnaires were returned (caregivers 82.5%, adolescents 17.5%). A mean of 6.2 ± 2.4 (out of 11) questions were correctly answered. Those who had tertiary education fared better than those who did not (36.4% vs. 17.2% scoring above the mean, p = 0.001). Age, gender, history of previous imaging and imaging performed during the visit did not affect the score. Two-thirds of the participants did not associate medical radiation with any negative lifetime risk of cancers or know that different scans entailed differing amounts of radiation. Most were unaware that the radiation dose in medical imaging is adjusted to a child's size. Among patients who underwent imaging, 90.1% received explanations on the need for scans, and 26.5% were informed of the risks involved. Almost all participants wished to be informed of imaging indications and risks. More preferred to learn this from physicians (75.6%) or technicians (51.6%) rather than through educational pamphlets (34.4%) or Internet resources (22.9%). CONCLUSION Awareness regarding medical radiation needs to be improved in our patient population. A mismatch exists between caregiver expectations and the actual procedure of disclosure of the risk associated with radiation.
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Affiliation(s)
- Su Yah Chew
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Ivy Wei Ling Ang
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Department of Paediatrics, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Desiree Xin Ying Lim
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Zi Ying Wee
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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14
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Oakley PA, Harrison DE. Are Restrictive Medical Radiation Imaging Campaigns Misguided? It Seems So: A Case Example of the American Chiropractic Association's Adoption of "Choosing Wisely". Dose Response 2020; 18:1559325820919321. [PMID: 32425722 PMCID: PMC7218311 DOI: 10.1177/1559325820919321] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/12/2020] [Accepted: 03/20/2020] [Indexed: 12/18/2022] Open
Abstract
Since the 1980s, increased utilization of medical radiology, primarily computed tomography, has doubled medically sourced radiation exposures. Ensuing fear-mongering media headlines of iatrogenic cancers from these essential medical diagnostic tools has led the public and medical professionals alike to display escalating radiophobia. Problematically, several campaigns including Image Gently, Image Wisely, and facets of Choosing Wisely propagate fears of all medical radiation, which is necessary for the delivery of effective and efficient health care. Since there are no sound data supporting the alleged risks from low-dose radiation and since there is abundant evidence of health benefits from low-doses, these imaging campaigns seem misguided. Further, thresholds for cancer are 100 to 1000-fold greater than X-rays, which are within the realm of natural background radiation where no harm has ever been validated. Here, we focus on radiographic imaging for use in spinal rehabilitation by manual therapists, chiropractors, and physiotherapists as spinal X-rays represent the lowest levels of radiation imaging and are critical in the diagnosis and management of spine-related disorders. Using a case example of a chiropractic association adopting "Choosing Wisely," we argue that these campaigns only fuel the pervasive radiophobia and continue to constrain medical professionals, attempting to deliver quality care to patients.
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15
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Deng J, Fan S, Wang T, Hao S, Liu X, Guo W, Sun Q. Trends and Distribution Analysis of Occupational Exposure From Medical Practices in China (2010-2016). Health Phys 2019; 117:656-660. [PMID: 31348020 PMCID: PMC6837351 DOI: 10.1097/hp.0000000000001118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Occupational exposure to ionizing radiation from medical practices in China has been collected for a 7 y period between 2010 and 2016 from roughly 220 individual monitoring service providers through the Chinese Registry of Radiation Workers. Statistical dose distributions and characteristic tendencies are presented based on the evaluation in terms of six occupational categories. A reduction can be seen in average annual effective dose for interventional radiology, nuclear medicine, diagnostic radiology, radiotherapy, dental radiology, and others by 52%, 47%, 46%, 34%, 69%, and 31%, respectively, for the 7 y period. More than 94.5% of radiation workers received annual doses less than the public dose limit (1 mSv) in 2016. Workers engaged in nuclear medicine and interventional radiology activities were found to receive relatively more dose than the other fields of practice. Diagnostic radiology makes the dominant contribution of 68% to the collective effective dose of 73,641.3 person mSv received by 211,613 radiation workers in medical practices in 2016. The observation of workers in medical practices receiving well below the recommended occupational dose limit (20 mSv) could be a result of an improvement in radiation protection practices in the medical field in China. However, it is still necessary to control and manage the workplace and radiation workers to avoid unnecessary exposures, in particular for the workers engaged in nuclear medicine and interventional radiology activities.
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Affiliation(s)
- Jun Deng
- 1Key Laboratory of Radiological Protection and Nuclear Emergency, China CDC and National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China
| | | | | | | | | | | | - Quanfu Sun
- Key Laboratory of Radiological Protection and Nuclear Emergency, China CDC and National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China
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Shi L, Tashiro S. Estimation of the effects of medical diagnostic radiation exposure based on DNA damage. J Radiat Res 2018; 59:ii121-ii129. [PMID: 29518207 PMCID: PMC5941141 DOI: 10.1093/jrr/rry006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/12/2018] [Indexed: 05/29/2023]
Abstract
X-rays are widely applied in the medical field for the diagnosis and treatment of diseases. Among the uses of X-rays in diagnosis, computed tomography (CT) has been established as one of the most informative diagnostic radiology examinations. Moreover, recent advances in CT scan technology have made this examination much easier and more informative and increased its application, especially in Japan. However, the radiation dose of CT scans is higher than that of simple X-ray examinations. Therefore, the health risk of a CT scan has been discussed in various studies, but is still controversial. Consequently, the biological and cytogenetic effects of CT scans are being analyzed. Here, we summarize the recent findings concerning the biological and cytogenetic effects of ionizing radiation from a CT scan, by focusing on DNA damage and chromosome aberrations.
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Affiliation(s)
- Lin Shi
- Department of Cellular Biology, Research Institute for Radiation Biology Medicine, Hiroshima University, Kasumi 1-2-3, Minamiku, Hiroshima 734-8553, Japan
| | - Satoshi Tashiro
- Department of Cellular Biology, Research Institute for Radiation Biology Medicine, Hiroshima University, Kasumi 1-2-3, Minamiku, Hiroshima 734-8553, Japan
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Johansen C, Schüz J, Andreasen AMS, Dalton SO. Study designs may influence results: the problems with questionnaire-based case-control studies on the epidemiology of glioma. Br J Cancer 2017; 116:841-848. [PMID: 28267708 PMCID: PMC5379153 DOI: 10.1038/bjc.2017.46] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 01/30/2017] [Accepted: 02/02/2017] [Indexed: 12/27/2022] Open
Abstract
Glioma is a rare brain tumour with a very poor prognosis and the search for modifiable factors is intense. We reviewed the literature concerning risk factors for glioma obtained in case-control designed epidemiological studies in order to discuss the influence of this methodology on the observed results. When reviewing the association between three exposures, medical radiation, exogenous hormone use and allergy, we critically appraised the evidence from both case-control and cohort studies. For medical radiation and hormone replacement therapy (HRT), questionnaire-based case-control studies appeared to show an inverse association, whereas nested case-control and cohort studies showed no association. For allergies, the inverse association was observed irrespective of study design. We recommend that the questionnaire-based case-control design be placed lower in the hierarchy of studies for establishing cause-and-effect for diseases such as glioma. We suggest that a state-of-the-art case-control study should, as a minimum, be accompanied by extensive validation of the exposure assessment methods and the representativeness of the study sample with regard to the exposures of interest. Otherwise, such studies cannot be regarded as 'hypothesis testing' but only 'hypothesis generating'. We consider that this holds true for all questionnaire-based case-control studies on cancer and other chronic diseases, although perhaps not to the same extent for each exposure-outcome combination.
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Affiliation(s)
- Christoffer Johansen
- Oncology Clinic, Finsen Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark
- Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | | | - Susanne Oksbjerg Dalton
- Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
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International Commission on Non-Ionizing Radiation Protection (ICNIRP). ICNIRP Statement on Diagnostic Devices Using Non-ionizing Radiation: Existing Regulations and Potential Health Risks. Health Phys 2017; 112:305-21. [PMID: 28121732 DOI: 10.1097/HP.0000000000000654] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Use of non-ionizing radiation (NIR) for diagnostic purposes allows non-invasive assessment of the structure and function of the human body and is widely employed in medical care. ICNIRP has published previous statements about the protection of patients during medical magnetic resonance imaging (MRI), but diagnostic methods using other forms of NIR have not been considered. This statement reviews the range of diagnostic NIR devices currently used in clinical settings; documents the relevant regulations and policies covering patients and health care workers; reviews the evidence around potential health risks to patients and health care workers exposed to diagnostic NIR; and identifies situations of high NIR exposure from diagnostic devices in which patients or health care workers might not be adequately protected by current regulations. Diagnostic technologies were classified by the types of NIR that they employ. The aim was to describe the techniques in terms of general device categories which may encompass more specific devices or techniques with similar scientific principles. Relevant legally-binding regulations for protection of patients and workers and organizations responsible for those regulations were summarized. Review of the epidemiological evidence concerning health risks associated with exposure to diagnostic NIR highlighted a lack of data on potential risks to the fetus exposed to MRI during the first trimester, and on long-term health risks in workers exposed to MRI. Most of the relevant epidemiological evidence that is currently available relates to MRI or ultrasound. Exposure limits are needed for exposures from diagnostic technologies using optical radiation within the body. There is a lack of data regarding risk of congenital malformations following exposure to ultrasound in utero in the first trimester and also about the possible health effects of interactions between ultrasound and contrast media.
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Abstract
With the average age of radiation therapy patients decreasing and the advent of more complex treatment options comes the concern that the incidences of radiation-induced cancer might increase in the future. The carcinogenic effects of radiation are not well understood for the entire dose range experienced in radiation therapy. Longer epidemiologic studies are needed to improve current risk models and reduce uncertainties of current risk model parameters. On the other hand, risk estimations are needed today to judge the risks versus benefits of modern radiation therapy techniques. This paper describes the current state-of-the-art in risk modeling for radiation-induced malignancies in radiation therapy, distinguishing between two volumes: first, the organs within the main radiation field receiving low or intermediate doses (typically between 0.1 and 50 Gy); and second, the organs far away from the treatment volume receiving low doses mainly due to scattered and secondary radiation (typically below 0.1 Gy). The dosimetry as well as the risk model formalisms are outlined. Furthermore, example calculations and results are presented for intensity-modulated photon therapy versus proton therapy.
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Affiliation(s)
- Harald Paganetti
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114, USA.
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Gledo I, Pranjic N, Drljević K, Prasko S, Drljevic I, Brzeziński P. Female breast cancer in relation to exposure to medical iatrogenic diagnostic radiation during life. Contemp Oncol (Pozn) 2012; 16:551-6. [PMID: 23788943 DOI: 10.5114/wo.2012.32489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 07/28/2012] [Accepted: 08/02/2012] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY Exposure to radiation and aging are the leading causes of breast cancer among female patients. We aimed to investigate and assess the relationship between exposure to medical, diagnostic and iatrogenic radiation and breast cancer using a questionnaire among 100 newly diagnosed female breast cancer patients and 100 control female subjects without cancer. MATERIAL AND METHODS A case control study using a family ambulatory based survey was conducted among 200 female patients from all municipalities of Zenica-Doboj Canton. New cases of breast cancer among subjects of experimental groups (n = 100) were diagnosed between 1 January 2003 and 31 December 2007 using the institutional clinical procedure for breast cancer diagnosis. Data were obtained using a self-rated questionnaire on radiation as a breast carcinogen. Data analysis was performed using SPSS version 19.0. RESULTS There were no significant differences between the two groups and their subgroups for individual data and demographics except for prevalence of decreased family financial situation (practical poverty) among subjects with breast cancer in relation to control subjects (31%: 17% among control subjects; p = 0.001). Female patients who are exposed to iatrogenic radiation before the 3(rd) year of life (OR = 1.29; 95% CI: 0.839-1.985) and those who are exposed to CT more than twice per year are more than twice as likely to have breast carcinoma (OR = 2.02; 95% CI: 1.254-3.261) compared to control subjects. Poverty and low family income are vulnerability factors associated with elevated levels of breast carcinoma. This result is not in accordance with prior study results. CONCLUSIONS It is necessary to develop an adequate registration system of iatrogenic exposure to radiation for each patient of any age, particularly for children aged < 3 years and for CT iatrogenic exposure.
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Abstract
When x-rays were first discovered, the harmful effects of radiation had to be manifest in the early users before they were known. Today, radiation protection and safety have been established and the effects of radiation, as well as its risks, are known. Even so, medical radiation, in particular the growth in the use of computed tomography (CT), has resulted in soaring radiation doses received by the population in general. Inappropriate use has resulted in overuse, overdose and, perhaps, overdiagnosis, especially when used in screening. In the quest to control and curb the use of procedures involving radiation, however, we must be careful not to provoke a pandemic of irrational fear of radiation. Overreaction to the overuse and overdose of radiation might deter patients from life-saving procedures.
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