Present levels of radiation exposure to patients and staff: how damaging are they?

International Nuclear Information System (INIS)

Dowsett, D.J.

1991-01-01

Increasing demand for diagnostic radiology is causing concern amongst radiologists and health physicists, particularly since the potential damage from low-dose radiation has been re-assessed and the risk estimates increased. The rapid introduction of CT scanning over the last 20 years, as an important diagnostic tool, has seen an ever increasing use of CT imaging, with the consequent rise in patient radiation dose. Exposure to the most radiosensitive areas: breast, red bone-marrow, gonads and the developing fetus, must be carefully controlled, since certain radiological procedures, particularly CT, are responsible for relatively high radiation doses in these areas. The balance between use of radiology and increasing radiation exposure to the population needs to be urgently addressed. (author)

Introduction to radiation transport

International Nuclear Information System (INIS)

Olson, G.L.

1998-01-01

This lecture will present time-dependent radiation transport where the radiation is coupled to a static medium, i.e., the material is not in motion. In reality, radiation exerts a pressure on the materials it propagates through and will accelerate the material in the direction of the radiation flow. This fully coupled problem with radiation transport and materials in motion is referred to as radiation-hydrodynamics (or in a shorthand notation: rad-hydro) and is beyond the scope of this lecture

Introduction to radiation hygiene

International Nuclear Information System (INIS)

Huyskens, Ch.J.

1978-08-01

This document is to introduce personnel who come into contact with any radiological activities to different aspects of radiation hygiene. The basic theory of radiation physics is given and units and dose equivalents are discussed. The biological effects of ionizing radiations are described and risk analysis is introduced. The various sources of radiation to which the population is exposed are outlined. Saftey standards and legislation regarding radiation hygiene are described and the various methods and instruments for measuring radiation are given. Dosimetry and safety precautions and measures are finally discussed. (C.F.)

Radiation Protection: Introduction

International Nuclear Information System (INIS)

Loos, M.

2007-01-01

As a federal research Centre, SCK-CEN has the statutory assignment to give priority to research related to safety, radioactive waste management, protection of man and environment, management of fissile and other strategic materials and social implications as part of the pursuit of sustainable development and to develop and gather the necessary knowledge and spread this knowledge through formation and communication. At the Division of Radiation Protection at SCK-CEN we are therefore active to maintain and enhance knowledge and expertise in each aspect of radiation protection: we study the risk of exposure - the way that radioactive materials spread in the environment and the potential for human contact - and the risk from exposure - how radiation affects human health; we perform health physics measurements; we are involved in emergency planning and preparedness and support to risk governance and decision taking. These activities are supported by radiation specific analysis and measurement techniques. These activities are not performed in isolation but in context of national and international collaborations or demands

Radiation-resistant device with tubes for the introduction of a liquid, e.g., blood into a container holding a radioactive source

International Nuclear Information System (INIS)

Rasmussen, I.

1978-01-01

The invention concerns a radiation-resistant device with tubing for the introduction/removal of a liquid (e.g. blood to and from a patient) via an at least partly curved channel into and out of a container holding a radioactive source. A break is made with the idea that it is necessary to use a circular-cylindrical tube as introduction device for the material to be irradiated. If made of materials suitable for the purpose, such tubing is safe and compressible in the longitudinal direction. The disadvantages and limitations of earlier constructions can be ascribed to this circumstance. A characteristic of the present invention is an elongated, pressure-resistant insertion ''cage'', flexible in at least one direction, used for the introduction of a minimum of one tubing into the container through the channel. The tubing enters and leaves at the same end of the insert cage. (BP)

Introduction to workshop on radiation effects in nuclear waste materials

International Nuclear Information System (INIS)

Matzke, H.

1988-01-01

The workshop consisted of an invited lecture for REI-4, treating radiation damage in nuclear fuels as well as giving an introduction to the field of damage in waste matrices, of invited and contributed lectures to the workshop and to REI as well as of discussions and round table meetings. The contributions available as manuscripts are included on the following pages of these proceedings. At the end, a short summary with recommendations for future work has been added. It is hoped that the stimulating discussions of the workshop will help to continue the work in the field of radiation effects in waste matrices in an effective way. The organizer believes that there are good reasons for this hope and he thanks all scientists who contributed to the success of the workshop, as well as members of the organizing committee of REI-4 for their help. (orig.)

Radiation and medicine: introduction

International Nuclear Information System (INIS)

Lentle, B.; Singh, H.

1984-01-01

A brief historical review is given of the development of the various nuclear medicine techniques which have been evolved since the discovery of X-rays and radioactivity. The role of various disciplines, such as radiobiology, radiation chemistry, radiation physics and computers in the application of radiation in medicine is discussed. (U.K.)

Are we failing to communicate? Internet-based patient education materials and radiation safety

International Nuclear Information System (INIS)

Hansberry, David R.; Ramchand, Tekchand; Patel, Shyam; Kraus, Carl; Jung, Jin; Agarwal, Nitin; Gonzales, Sharon F.; Baker, Stephen R.

2014-01-01

Introduction: Patients frequently turn to the Internet when seeking answers to healthcare related inquiries including questions about the effects of radiation when undergoing radiologic studies. We investigate the readability of online patient education materials concerning radiation safety from multiple Internet resources. Methods: Patient education material regarding radiation safety was downloaded from 8 different websites encompassing: (1) the Centers for Disease Control and Prevention, (2) the Environmental Protection Agency, (3) the European Society of Radiology, (4) the Food and Drug Administration, (5) the Mayo Clinic, (6) MedlinePlus, (7) the Nuclear Regulatory Commission, and (8) the Society of Pediatric Radiology. From these 8 resources, a total of 45 articles were analyzed for their level of readability using 10 different readability scales. Results: The 45 articles had a level of readability ranging from 9.4 to the 17.2 grade level. Only 3/45 (6.7%) were written below the 10th grade level. No statistical difference was seen between the readability level of the 8 different websites. Conclusions: All 45 articles from all 8 websites failed to meet the recommendations set forth by the National Institutes of Health and American Medical Association that patient education resources be written between the 3rd and 7th grade level. Rewriting the patient education resources on radiation safety from each of these 8 websites would help many consumers of healthcare information adequately comprehend such material

Are we failing to communicate? Internet-based patient education materials and radiation safety

Energy Technology Data Exchange (ETDEWEB)

Hansberry, David R., E-mail: hansbedr@njms.rutgers.edu; Ramchand, Tekchand, E-mail: ramchate@njms.rutgers.edu; Patel, Shyam, E-mail: patel288@njms.rutgers.edu; Kraus, Carl, E-mail: krauscf@njms.rutgers.edu; Jung, Jin, E-mail: jungjk@njms.rutgers.edu; Agarwal, Nitin, E-mail: nitin.agarwal@rutgers.edu; Gonzales, Sharon F., E-mail: gonzalsh@njms.rutgers.edu; Baker, Stephen R., E-mail: bakersr@njms.rutgers.edu

2014-09-15

Introduction: Patients frequently turn to the Internet when seeking answers to healthcare related inquiries including questions about the effects of radiation when undergoing radiologic studies. We investigate the readability of online patient education materials concerning radiation safety from multiple Internet resources. Methods: Patient education material regarding radiation safety was downloaded from 8 different websites encompassing: (1) the Centers for Disease Control and Prevention, (2) the Environmental Protection Agency, (3) the European Society of Radiology, (4) the Food and Drug Administration, (5) the Mayo Clinic, (6) MedlinePlus, (7) the Nuclear Regulatory Commission, and (8) the Society of Pediatric Radiology. From these 8 resources, a total of 45 articles were analyzed for their level of readability using 10 different readability scales. Results: The 45 articles had a level of readability ranging from 9.4 to the 17.2 grade level. Only 3/45 (6.7%) were written below the 10th grade level. No statistical difference was seen between the readability level of the 8 different websites. Conclusions: All 45 articles from all 8 websites failed to meet the recommendations set forth by the National Institutes of Health and American Medical Association that patient education resources be written between the 3rd and 7th grade level. Rewriting the patient education resources on radiation safety from each of these 8 websites would help many consumers of healthcare information adequately comprehend such material.

Introduction to radiation processing

International Nuclear Information System (INIS)

Kume, Tamikazu

2008-01-01

Nuclear technology such as γ-rays, electron beams and ion beams irradiation is widely used in industrial, medical and agricultural fields. The purpose of radiation application is aiming at increasing welfare and quality of our life. Radiation technology applied to medical care is widely known as X-ray diagnosis but the contribution of radiation processing to our daily life is not well known even though it is effectively used in industry and agriculture. The main radiation processing in industry is the modification of polymers, i.e. heat shrinkable tube, radial tire, plastic foam, etc. in a car, heat resistant wire and cable, semiconductor, floppy disk, etc. in a computer, and sterilization of medical devices. In Agriculture, radiation has been used in various fields such as food irradiation, sterile insect technique, mutation breeding, etc. contributing for human being to supply foods and sustainable environment. (author)

Overall response rates to radiation therapy for patients with painful uncomplicated bone metastases undergoing initial treatment and retreatment

International Nuclear Information System (INIS)

Bedard, Gillian; Hoskin, Peter; Chow, Edward

2014-01-01

Introduction: Radiation therapy has been shown to successfully palliate bone metastases. A number of systematic reviews and large clinical trials have reported response rates for initial treatment and retreatment. Objective: To determine overall response rates of patients with painful uncomplicated bone metastases undergoing initial treatment and retreatment. Methods: Intent-to-treat and evaluable patient statistics from a systematic review of palliative radiotherapy trials for initial treatment of bone metastases and a randomized clinical trial of retreatment were pooled and analyzed to determine the overall response rates for patients receiving initial treatment and retreatment. Results: In the intent-to-treat calculation, 71–73% of patients had an overall response to radiation treatment and in the evaluable patient population; 85–87% of patients did so. Response rates varied slightly whether patients underwent single or multiple fractions in initial treatment or retreatment. Conclusions: Single and multiple fraction radiation treatment yielded very similar overall response rates. Patients treated with a single fraction for both initial and repeat radiation experience almost identical overall response to those patients treated with multiple fraction treatment. It is therefore recommended that patients with uncomplicated painful bone metastases be treated with a single 8 Gy fraction of radiation at both the initial treatment and retreatment

Communication skills training for radiation therapists: preparing patients for radiation therapy.

Science.gov (United States)

Halkett, Georgia; O'Connor, Moira; Aranda, Sanchia; Jefford, Michael; Merchant, Susan; York, Debra; Miller, Lisa; Schofield, Penelope

2016-12-01

Patients sometimes present for radiation therapy with high levels of anxiety. Communication skills training may assist radiation therapists to conduct more effective consultations with patients prior to treatment planning and treatment commencement. The overall aim of our research is to examine the effectiveness of a preparatory programme 'RT Prepare' delivered by radiation therapists to reduce patient psychological distress. The purpose of this manuscript was to describe the communication skills workshops developed for radiation therapists and evaluate participants' feedback. Radiation therapists were invited to participate in two communication skills workshops run on the same day: (1) Consultation skills in radiation therapy and (2) Eliciting and responding to patients' emotional cues. Evaluation forms were completed. Radiation therapists' consultations with patients were then audio-recorded and evaluated prior to providing a follow-up workshop with participants. Nine full day workshops were held. Sixty radiation therapists participated. Positive feedback was received for both workshops with 88% or more participants agreeing or strongly agreeing with all the statements about the different components of the two workshops. Radiation therapists highlighted participating in role play with an actor, discussing issues; receiving feedback; acquiring new skills and knowledge; watching others role play and practicing with checklist were their favourite aspects of the initial workshop. The follow-up workshops provided radiation therapists with feedback on how they identified and addressed patients' psychological concerns; time spent with patients during consultations and the importance of finding private space for consultations. Communication skills training consisting of preparing patients for radiation therapy and eliciting and responding to emotional cues with follow-up workshops has the potential to improve radiation therapists' interactions with patients undergoing

Radiation therapy in old patients. Side effects and results of radiation therapy in old patients

International Nuclear Information System (INIS)

Geinitz, H.; Zimmermann, F.B.; Molls, M.

1999-01-01

Background: Despite a growing number of elderly patients receiving radiation therapy little is known about side effects and outcome of irradiation in this section of the population. Methods: In a review article epidemiologic data, aspects of radiation-biology as well as side effects and outcome of radiation therapy of elderly patients are discussed. Results: Cancer incidence rises with age and is exceeding 3.5% for males older than 85 years. With a life expectancy of more than 4 years, curative therapy is indicated even at this age. Furthermore, several retrospective studies indicate that local control and disease-Specific survival after radiation therapy of elderly patients is comparable with that of younger persons. The exception contains elderly patients with grade-III to IV gliomas or with rectal carcinoma who show a reduced survival which is perhaps caused by less aggressive combined treatment (tumor resection). Although some biological and molecular data indicate a rise in radiation sensitivity with growing age like the reduction of the capacity of some DNA-repair enzymes, there is no convincing evidence in animal studies or in retrospective clinical studies that radiation therapy is generally less well tolerated by older individuals. Some age-depending differences in organ toxicities are described in 3 large studies, which evaluate the data of patients who were enrolled in different EORTC-trials: Older patients suffer more of functional mucositis in case of radiation therapy to the head and neck, they have an increased weight loss and a higher frequency of late esophageal damage when irradiated in the thorax, and they show a higher prevalence of sexual dysfunction when treated with radiation therapy to the pelvis. On the other hand younger patients suffer more from acute toxicity like skin damage, nausea, and deterioration of the performance status during pelvic radiotherapy. When discussing the dose intensity of radiation therapy concomitant disease which

Radiation-hygienic estimation of interstitial gamma therapy conducted according to principle of subsequent introduction of radioactive sources

International Nuclear Information System (INIS)

Zamyatin, O.A.; Golikov, V.Ya.; Korenkov, I.P.; Ter-Kazar'yan, N.S.; Mindlin, G.M.

1978-01-01

A comparative study of two radiation-hygienic methods of interstitial gamma-therapy: with subsequent introduction of radioactive needles of a standard type; with subsequent manual introduction of 60 Co sources have been carried out. Chronometry-dosimetric methods of investigation and the methods of individual dosimetry underlie the studies. The obtained data showed, that doses of irradiation to which medical personnel is subjected during the use of the method of subsequent manual introduction of the active sources are 3-4 times lower, than those during the introduction of standard radioactive needles with a higher quality of the procedure performance, ensuring a good therapeutic effect. All this makes it possible to consider interstitial gamma-therapy with the use of the principle of subsequent introduction of the source to be a more perspective method than interstitial gamma-therapy with the use standard radioactive needless 60 Co

Introduction to ionizing radiation physics

International Nuclear Information System (INIS)

Musilek, L.

1979-01-01

Basic properties are described of the atom, atomic nucleus and of ionizing radiation particles; nuclear reactions, ionizing radiation sources and ionizing radiation interaction with matter are explained. (J.P.)

Incidence of primary hypothyroidism in patients exposed to therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland

Directory of Open Access Journals (Sweden)

B A Laway

2012-01-01

Full Text Available Introduction: Hypothyroidism is a known consequence of external-beam radiotherapy to the neck encompassing a part or whole of the thyroid gland. In this non-randomized prospective study, we have tried to evaluate the response of the thyroid gland to radiation by assessing thyroid function before irradiation and at regular intervals after irradiation. Aims and Objectives: The aim of this study were to assess in the cancer patients, who were exposed to the therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland: the incidence of primary hypothyroidism, the time required to become hypothyroid, any relation between the total dose for the development of hypothyroidism, and whether there are any patient or treatment-related factors that are predictive for the development of hypothyroidism, including the use of concurrent chemotherapy. Materials and Methods: This non-randomized, prospective study was conducted for a period of 2 years in which thyroid function was assessed in 59 patients (cases of head and neck cancer, breast cancer, lymphoma patients and other malignancies, who had received radiotherapy to the neck region. 59 euthyroid healthy patients (controls were also taken, who had not received the neck irradiation. These patients/controls were assessed periodically for 2 years. Results: The incidence of hypothyroidism after external beam radiation therapy (EBRT to neck where radiation portals include part or whole of the thyroid gland was 16.94%, seven cases had subclinical hypothyroidism (11.86% and three cases had clinical hypothyroidism (5.08%. Mean time for development of hypothyroidism was 4.5 months. There was no effect of age, gender, primary tumor site, radiation dose and chemotherapy, whether neoadjuvant or concurrent with the development of hypothyroidism. Conclusion: In summary, we found that thyroid dysfunction is a prevalent, yet easily treatable source of morbidity in patients

Radiation oncology: a primer for medical students.

Science.gov (United States)

Berman, Abigail T; Plastaras, John P; Vapiwala, Neha

2013-09-01

Radiation oncology requires a complex understanding of cancer biology, radiation physics, and clinical care. This paper equips the medical student to understand the fundamentals of radiation oncology, first with an introduction to cancer treatment and the use of radiation therapy. Considerations during radiation oncology consultations are discussed extensively with an emphasis on how to formulate an assessment and plan including which treatment modality to use. The treatment planning aspects of radiation oncology are then discussed with a brief introduction to how radiation works, followed by a detailed explanation of the nuances of simulation, including different imaging modalities, immobilization, and accounting for motion. The medical student is then instructed on how to participate in contouring, plan generation and evaluation, and the delivery of radiation on the machine. Lastly, potential adverse effects of radiation are discussed with a particular focus on the on-treatment patient.

Mixed messages? A comparison between the perceptions of radiation therapy patients and radiation therapists regarding patients' educational needs

International Nuclear Information System (INIS)

Bolderston, Amanda

2008-01-01

Objectives: The purpose of this study was to discover and compare radiation therapy patients' and radiation therapists' perceptions of patients' educational topics of interest and methods of information delivery during a course of radiation therapy. Methods: Using Likert-type 4-point rating scales, 42 therapists and 183 radiation therapy patients were surveyed to rate the degree of importance of 15 informational items (for example, 'What it feels like to have treatment'). In addition, therapists and patients ranked 11 methods of informational delivery (for example, 'Watching video tapes') in order of preference. Results: Results indicated several differences in therapists' and patients' perceptions of both the educational topics of interest and methods of information delivery. Among other things, patients assigned high importance to after treatment issues ('What happens after radiation therapy is finished') and how radiation therapy works, these areas were not seen as important by the studied therapists. Patients expressed a strong preference for receiving information about radiation therapy from their family doctor (ranked third), therapists ranked this source of information as the least important. Conclusion: It is vital to tailor educational interventions according to the patient's preference to optimize both understanding and compliance. This study demonstrated noteworthy differences in several areas between therapists' and patients' perceptions. Recommendations therefore include raising therapist's awareness of topics that are important to patients and meaningful informational delivery methods

Introduction and fundamentals

International Nuclear Information System (INIS)

Thomas, R.H.

1980-01-01

This introduction discusses advances in the fundamental sciences which underlie the applied science of health physics and radiation protection. Risk assessments in nuclear medicine are made by defining the conditions of exposure, identification of adverse effects, relating exposure with effect, and estimation of the overall risk for ionizing radiations

Radiation protection of patients in epiescleral brachytherapy

International Nuclear Information System (INIS)

Frutos, J.M. de; Sanchez, G.; Sendon, J.R.; Castillo, A. del; Hernando, I.

2001-01-01

Introduction. Choroidal melanoma and other ophthalmic tumors are treated with episcleral plaques. Optimisation and other criteria are necessary to avoid damage in eye and visual function preservation. Purpose. To study the dosimetric phases to apply radiation protection criteria. To determine procedures for quality assurance of applicators, sources and treatment prescription and planning. Method. We have revised treatment procedure. First, aspects shared for all the patients. Then treatment planning and applicator assembling. After that, we study insertion and treatment. Finally, we check the chart flow to modify, if necessary. It necessary consider normative and recommendations. Results and conclusions. Quality assurance of sources (calibration, autoradiography), applicator (effects, dose distribution) and treatment planning are revised. Appropriate patient data acquisition is essential due the special characteristics of tumor and eye. Treatment planning involves optimisation as a factor. Seed selection is very important to avoid misadministration. Next procedure is applicator assembling. We must care to choose the same as dosimetry and to carry out its verification. Sources insertion is a surgical procedure. It is essential in accurate placement. Desinsertion is also surgical, and must be adapted to dosimetry and prescription. Flow chart is modified adding two staff meetings to discuss about patient data and doses. (author)

Fusion: introduction

International Nuclear Information System (INIS)

Decreton, M.

2006-01-01

The article gives an overview and introduction to the activities of SCK-CEN's research programme on fusion. The decision to construct the ITER international nuclear fusion experiment in Cadarache is highlighted. A summary of the Belgian contributions to fusion research is given with particular emphasis on studies of radiation effects on diagnostics systems, radiation effects on remote handling sensing systems, fusion waste management and socio-economic studies

An introduction to radiation protection principles

International Nuclear Information System (INIS)

White, J.M.

1983-01-01

The fundamentals of radiation hazards and their control are outlined. This report is for use by all radiation workers at CRNL and copies are available for all who want one. The purposes of the document are to outline the fundamentals of radiation protection, to describe methods that enable employees to work safely with radiation and to acquaint employees with the CRNL radiation and industrial safety organization

Why do patients drop out during radiation therapy?

International Nuclear Information System (INIS)

Huh, Seung Jae; Ahn, Yong Chan; Kim, Dae Yong; Shin, Kyung Hwan; Lee, Kyu Chan; Chong, Won A; Kim, Hyun Joo; Wu, Hong Gyun

1998-01-01

This study is to see how much proportion of the patients receiving radiation therapy drop out during radiation therapy and to analyze the reason for the incomplete treatment. The base population of this study was 1,100 patients with registration numbers 901 through 2,000 at Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea. Authors investigated the incidence of incomplete radiation therapy, which was defined as less than 95% of initially planned radiation dose, and the reasons for incomplete radiation therapy. One hundred and twenty eight patients (12%) did not complete the planned radiation therapy. The performance status of the incompletely treated patients was generally poorer than that of the base population, and the aim of radiation therapy was more commonly palliative. The most common reason for not completing the planned treatment was the patients' refusal of further radiation therapy because of the distrust of radiation therapy and/or the poor economic status. Careful case selection for radiation therapy with consideration of the socioeconomic status of the patients in addition to the clinical indication would be necessary for the reduction of incomplete treatment, especially in the palliative setting

Improving patient safety in radiation oncology

International Nuclear Information System (INIS)

Hendee, William R.; Herman, Michael G.

2011-01-01

Beginning in the 1990s, and emphasized in 2000 with the release of an Institute of Medicine report, healthcare providers and institutions have dedicated time and resources to reducing errors that impact the safety and well-being of patients. But in January 2010 the first of a series of articles appeared in the New York Times that described errors in radiation oncology that grievously impacted patients. In response, the American Association of Physicists in Medicine and the American Society of Radiation Oncology sponsored a working meeting entitled ''Safety in Radiation Therapy: A Call to Action''. The meeting attracted 400 attendees, including medical physicists, radiation oncologists, medical dosimetrists, radiation therapists, hospital administrators, regulators, and representatives of equipment manufacturers. The meeting was cohosted by 14 organizations in the United States and Canada. The meeting yielded 20 recommendations that provide a pathway to reducing errors and improving patient safety in radiation therapy facilities everywhere.

Patient satisfaction in radiation oncology

International Nuclear Information System (INIS)

Zissiadis, Y.; Provis, A.; Dhaliwal, S.S.

2003-01-01

In this current economic climate where the costs of providing a good medical service are escalating, patients are demanding a higher level of service from the Radiation Oncology providers. This coupled with the rising level of patients' expectations make it absolutely paramount for Radiation Oncology providers to offer the best possible service to their patients. In order to do this, it is essential to assess the present level of patient satisfaction prior to deciding which aspects of the current service need to be changed. In this pilot study, we assess the level of patient satisfaction with aspects of the radiotherapy service and the level of patient anxiety both prior to and following radiotherapy at the Perth Radiation Oncology Centre. A questionnaire was created using a combination of the Information Satisfaction Questionnaire-1 (ISQ-1), the Very Short Questionnaire 9 (VSQ 9) and the State Trait Anxiety Index (STAI). One hundred new patients were studied, all of whom were to have radiotherapy with curative intent. The results of this study are reviewed in this presentation

An introduction to radiobiology

International Nuclear Information System (INIS)

Nias, A.H.W.; Dimbleby, R.

1990-01-01

This text provides an introduction to quantitative radiobiology with emphasis on practical aspects of the subject. Among the topics considered are reparable damage, densely ionizing radiation, normal and malignant cells, and whole body regulation. These and other aspects of radiation biology are described in detail

Measuring radiation dose to patients undergoing fluoroscopically-guided interventions

International Nuclear Information System (INIS)

Lubis, L E; Badawy, M K

2016-01-01

The increasing prevalence and complexity of fluoroscopically guided interventions (FGI) raises concern regarding radiation dose to patients subjected to the procedure. Despite current evidence showing the risk to patients from the deterministic effects of radiation (e.g. skin burns), radiation induced injuries remain commonplace. This review aims to increase the awareness surrounding radiation dose measurement for patients undergoing FGI. A review of the literature was conducted alongside previous researches from the authors’ department. Studies pertaining to patient dose measurement, its formalism along with current advances and present challenges were reviewed. Current patient monitoring techniques (using available radiation dosimeters), as well as the inadequacy of accepting displayed dose as patient radiation dose is discussed. Furthermore, advances in real-time patient radiation dose estimation during FGI are considered. Patient dosimetry in FGI, particularly in real time, remains an ongoing challenge. The increasing occurrence and sophistication of these procedures calls for further advances in the field of patient radiation dose monitoring. Improved measuring techniques will aid clinicians in better predicting and managing radiation induced injury following FGI, thus improving patient care. (paper)

Greenhouse gases, radiative forcing, global warming potential and waste management – an introduction

DEFF Research Database (Denmark)

Scheutz, Charlotte; Kjeldsen, Peter; Gentil, Emmanuel

2009-01-01

forcing (RF) and global warming potential (GWP). This paper provides a general introduction of the factors that define a GHG and explains the scientific background for estimating RF and GWP, thereby exposing the lay reader to a brief overview of the methods for calculating the effects of GHGs on climate......Management of post-consumer solid waste contributes to emission of greenhouse gases (GHGs) representing about 3% of global anthropogenic GHG emissions. Most GHG reporting initiatives around the world utilize two metrics proposed by the Intergovernmental Panel on Climate Change (IPCC): radiative...

A novel radiation protection drape reduces radiation exposure during fluoroscopy guided electrophysiology procedures.

Science.gov (United States)

Germano, Joseph J; Day, Gina; Gregorious, David; Natarajan, Venkataraman; Cohen, Todd

2005-09-01

The purpose of this study was to evaluate a novel disposable lead-free radiation protection drape for decreasing radiation scatter during electrophysiology procedures. In recent years, there has been an exponential increase in the number of electrophysiology (EP) procedures exposing patients, operators and laboratory staff to higher radiation doses. The RADPAD was positioned slightly lateral to the incision site for pectoral device implants and superior to the femoral vein during electrophysiology studies. Each patient served as their own control and dosimetric measurements were obtained at the examiner's elbow and hand. Radiation badge readings for the operator were obtained three months prior to RADPAD use and three months after introduction. Radiation dosimetry was obtained in twenty patients: 7 electrophysiology studies, 6 pacemakers, 5 catheter ablations, and 2 implantable cardioverter-defibrillators. Eleven women and nine men with a mean age of 63 +/- 4 years had an average fluoroscopy time of 2.5 +/- 0.42 minutes per case. Mean dosimetric measurements at the hand were reduced from 141.38 +/- 24.67 to 48.63 +/- 9.02 milliroentgen (mR) per hour using the protective drape (63% reduction; p < 0.0001). Measurements at the elbow were reduced from 78.78 +/- 7.95 mR per hour to 34.50 +/- 4.18 mR per hour using the drape (55% reduction; p < 0.0001). Badge readings for three months prior to drape introduction averaged 2.45 mR per procedure versus 1.54 mR per procedure for 3 months post-initiation (37% reduction). The use of a novel radiation protection surgical drape can significantly reduce scatter radiation exposure to staff and operators during a variety of EP procedures.

The MRI-Linear Accelerator Consortium: Evidence-Based Clinical Introduction of an Innovation in Radiation Oncology Connecting Researchers, Methodology, Data Collection, Quality Assurance, and Technical Development.

Science.gov (United States)

Kerkmeijer, Linda G W; Fuller, Clifton D; Verkooijen, Helena M; Verheij, Marcel; Choudhury, Ananya; Harrington, Kevin J; Schultz, Chris; Sahgal, Arjun; Frank, Steven J; Goldwein, Joel; Brown, Kevin J; Minsky, Bruce D; van Vulpen, Marco

2016-01-01

An international research consortium has been formed to facilitate evidence-based introduction of MR-guided radiotherapy (MR-linac) and to address how the MR-linac could be used to achieve an optimized radiation treatment approach to improve patients' survival, local, and regional tumor control and quality of life. The present paper describes the organizational structure of the clinical part of the MR-linac consortium. Furthermore, it elucidates why collaboration on this large project is necessary, and how a central data registry program will be implemented.

An introduction to radiation protection principles

International Nuclear Information System (INIS)

Skinner, R.W.; Kalos, F.; Bond, J.A.

1985-05-01

The purpose of the document is to outline the fundamentals of radiation protection, to describe methods that enable employees to work safely with radiation and to aquaint employees with CRNL's radiation and industrial safety organization

Maintenance hemodialysis patients have high cumulative radiation exposure.

LENUS (Irish Health Repository)

Kinsella, Sinead M

2010-10-01

Hemodialysis is associated with an increased risk of neoplasms which may result, at least in part, from exposure to ionizing radiation associated with frequent radiographic procedures. In order to estimate the average radiation exposure of those on hemodialysis, we conducted a retrospective study of 100 patients in a university-based dialysis unit followed for a median of 3.4 years. The number and type of radiological procedures were obtained from a central radiology database, and the cumulative effective radiation dose was calculated using standardized, procedure-specific radiation levels. The median annual radiation dose was 6.9 millisieverts (mSv) per patient-year. However, 14 patients had an annual cumulative effective radiation dose over 20 mSv, the upper averaged annual limit for occupational exposure. The median total cumulative effective radiation dose per patient over the study period was 21.7 mSv, in which 13 patients had a total cumulative effective radiation dose over 75 mSv, a value reported to be associated with a 7% increased risk of cancer-related mortality. Two-thirds of the total cumulative effective radiation dose was due to CT scanning. The average radiation exposure was significantly associated with the cause of end-stage renal disease, history of ischemic heart disease, transplant waitlist status, number of in-patient hospital days over follow-up, and death during the study period. These results highlight the substantial exposure to ionizing radiation in hemodialysis patients.

Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT)

OpenAIRE

Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham

2013-01-01

Introduction Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147–53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation ...

A brief introduction of the constructing work of national radiation monitoring system during the twelfth five-year

International Nuclear Information System (INIS)

Liu Hua; Zhao Yongkang; Pan Su; Zhang Jiali; Yang Bin

2013-01-01

Radiation monitoring is the technical groundwork of nuclear and radiation safety regulating. In order to overcome the challenges coming with the development of nuclear energy and technology in china, the program of constructing National Radiation Monitoring System (NRMS) was put forward in the twelfth five-year plan of nuclear safety and prevention of radiation pollution, and the view target in 2020. The implementation plan of the constructing of NRMS has been drew up by the Ministry of Environmental Protection in 2012, which including the construction of organization and human resource system, laws and standards system, quality assurance system, technical research and innovation system, and capability insurance system. A brief introduction of the implementation plan was given in the article, the achievements during the eleventh five-year were reviewed, the challenges and working points were analyzed. (authors)

Introduction to radiation chemistry of polymer

Energy Technology Data Exchange (ETDEWEB)

Mohd Dahlan, Khairul Zaman [Nuclear Energy Unit, Bangi, Selangor (Malaysia)

1994-12-31

The topics briefly discussed are 1. What are radiation chemistry 2. Type of ionising radiation 3. gamma rays versus electron beam 4. Interaction of radiation with matters 5. What is polymers 6. Techniques of crosslinking 7. Crosslinking of polymers i.e. polyethylene, ethylene copolymer, polypropylene, polyamides, polyvinyl chloride, natural rubber.

Introduction to radiation chemistry of polymer

International Nuclear Information System (INIS)

Khairul Zaman Mohd Dahlan

1994-01-01

The topics briefly discussed are 1. What are radiation chemistry 2. Type of ionising radiation 3. gamma rays versus electron beam 4. Interaction of radiation with matters 5. What is polymers 6. Techniques of crosslinking 7. Crosslinking of polymers i.e. polyethylene, ethylene copolymer, polypropylene, polyamides, polyvinyl chloride, natural rubber

Impact on quality of life of IMRT versus 3-D conformal radiation therapy in head and neck cancer patients: A case control study

Directory of Open Access Journals (Sweden)

Edvard Abel, MD

2017-07-01

Conclusions: This study further supports the hypothesis that the introduction of IMRT has improved the long-term quality of life of HN cancer patients who have been treated with radiation therapy, but might cause more acute side effects. Longer follow-up is needed to study late complications.

Internet utilization by radiation oncology patients

International Nuclear Information System (INIS)

Metz, J.M.; Devine, P.; DeNittis, A.; Stambaugh, M.; Jones, H.; Goldwein, J.; Whittington, R.

2001-01-01

Purpose: Studies describing the use of the Internet by radiation oncology patients are lacking. This multi-institutional study of cancer patients presenting to academic (AC), community (CO) and veterans (VA) radiation oncology centers was designed to analyze the use of the Internet, predictive factors for utilization, and barriers to access to the Internet. Materials and Methods: A questionnaire evaluating the use of the Internet was administered to 921 consecutive patients presenting to radiation oncology departments at AC, CO and VA Medical Centers. The study included 436 AC patients (47%), 284 CO patients (31%), and 201 VA patients (22%). A computer was available at home to 427 patients (46%) and 337 patients (37%) had Email access. The mean age of the patient population was 64 years (range=14-93). Males represented 70% of the patient population. The most common diagnoses included prostate cancer (33%), breast cancer (13%), and lung cancer (11%). Results: Overall, 265/921 patients (29%) were using the Internet to find cancer related information. The Internet was used by 42% of AC patients, 25% of CO patients and only 5% of VA patients (p<.0001). A computer was available at home in 62% AC vs. 45% CO vs. 12% VA patients (p<.0001). Patients < 60 years were much more likely to use the Internet than older patients (p<.0001). Most of the Internet users considered the information either very reliable (22%) or somewhat reliable (70%). Most patients were looking for information regarding treatment of their cancer (90%), management of side effects of treatment (74%), alternative/complementary treatments (65%) and clinical trials (51%). Unconventional medical therapies were purchased over the Internet by 12% of computer users. Products or services for the treatment or management of cancer were purchased online by 12% of Internet users. Conclusion: A significant number of cancer patients seen in radiation oncology departments at academic and community medical centers

Patient treatment in radiation accidents

International Nuclear Information System (INIS)

Tanum, G.; Bruland, Oe.S.; Hjelle, D.; Reitan, J.B.

1999-01-01

Accidental human injury due to ionizing radiation is rare. Industrial accidents are comparatively the most common. Life saving procedures should always have priority to any concern about radiation injury or contamination. The personal risks for emergency medial personnel is negligible when simple measures are taken. Repeated clinical examinations and blood lymphocyte counts should be performed on all patients with suspected radiation injury to allow a diagnosis. The radiation syndrome develops within days or weeks depending on total radiation dose, dose rate and dose distribution. Damage to the bone marrow and gut are the most important. Local radiation injuries to the hands are common in industrial accidents. The Norwegian Radiation Protection Authority should always be called when a potential ionizing radiation accident takes place within Norway

Radiation safety and care of patients

International Nuclear Information System (INIS)

Das, B.K.; Noreen Norfaraheen Lee Abdullah

2012-01-01

The objective of this chapter is to acquaint the reader with radiation safety measures which can be pursued to minimize radiation load to the patient and staff. The basic principle is that all unnecessary administration should be avoided and a number of simple techniques be used to reduce radiation dose. For example, the kidney excretes many radionuclides. Drinking plenty of fluid and frequent bladder emptying can minimize absorbed dose to the bladder. Thyroid blocking agents must be used if radioactive iodine is being administered to avoid unnecessary radiation exposure to the thyroid gland. When it is necessary to administer radioactive substances to a female of childbearing age, the radiation exposure should be minimum and information whether the patient is pregnant or not must be obtained. Alternatives techniques, which do not involve ionizing radiation, should also be considered. (author)

Introduction to renewable energy

CERN Document Server

Nelson, Vaughn C

2011-01-01

IntroductionEnergy and SocietyTypes of EnergyRenewable EnergyAdvantages/DisadvantagesEconomicsGlobal WarmingOrder of Magnitude EstimatesGrowth (Exponential)SolutionsEnergyIntroductionDefinition of Energy and PowerHeatThermodynamicsEnergy Dilemma in Light of the Laws of ThermodynamicsUse of Fossil FuelsNuclearFinite ResourceSummarySunSolar PowerElectromagnetic SpectrumEnergy Balance of the EarthEarth-Sun MotionInsolationSolar ResourceGreenhouse EffectHeat Transfer and StorageIntroductionConductionConvectionRadiationThermal MassSeasonal Heating or CoolingThermal ComfortSolar Heating and CoolingB

Radiation associated hyperthyroidism in patients with gynecological malignancies

International Nuclear Information System (INIS)

Katayama, S.; Shimaoka, K.; Piver, M.S.; Osman, G.; Tsukada, Y.; Suh, O.

1985-01-01

To determine the effect of abdominal and/or pelvic irradiation for gynecological malignancies on the later development of hyperthyroidism, 1,884 medical records of the patients diagnoses as carcinomas of cervix and corpus uteri, and of ovary were reviewed. Among 1,269 patients with radiation therapy, 5 patients developed hyperthyroidism after irradiation to the abdomen and/or pelvis. This is a statistically significant increase when compared with an epidemiological study. Radiation dose to the thyroid was estimated to be 30 to 200 rads. Two other patients who were irradiated to the nose or supraclavicular region in addition to the abdomen also developed hyperthyroidism. However, none of 581 patients without radiation therapy became hyperthyroid. The results indicate that radiation therapy for treatment of gynecological malignancy gives a significant radiation exposure with an increase in the incidence of subsequent hyperthyroidism

Radiation therapy for cancer patients

International Nuclear Information System (INIS)

Mileikowsky, C.

1987-01-01

This patent describes an apparatus for irradiating a patient comprising: a source of a radiation beam directed along a radiation axis; means mounting the source for pivotal movement about a first horizontal axis which intersects the source, is stationary with respect to the apparatus, and extends in a direction substantially normal to the radiation axis, whereby the beam is capable of an angular scan in a vertical plane; table means adapted to support a patient to be irradiated; and suspension means mounted the table means for arcuate movement to any positions angularly spaced about the first horizontal axis and for pivoting movement about a second horizontal axis displacement from and substantially parallel to the first horizontal axis. The suspension means maintain the second horizontal axis in substantially intersecting relation to the radiation axis in each of the positions while maintaining a fixed angular position of the table means with respect to the environment

On the origin of very-high-energy photons in astrophysics: a short introduction to acceleration and radiation physics

International Nuclear Information System (INIS)

Lemoine, M.; Pelletier, G.

2015-01-01

Powerful astrophysical sources produce non-thermal spectra of very-high-energy photons, with generic power-law distributions, through various radiative processes of charged particles, e.g., synchrotron radiation, inverse Compton processes, and hadronic interactions. Those charged particles have themselves been accelerated to ultra-relativistic energies in intense electromagnetic fields in the source. In many cases, the exact acceleration scheme is not known, but standard scenarios, such as Fermi mechanisms and reconnection processes are generally considered as prime suspects for the conversion of bulk kinetic or electromagnetic energy into a power law of supra-thermal particles. This paper proposes a short introduction to the various acceleration and radiative processes which shape the distributions of very-high-energy photons (E > 100 MeV) in astrophysics. (authors)

Introduction [Nuclear data for the production of therapeutic radionuclides

International Nuclear Information System (INIS)

Qaim, S.M.

2011-01-01

Radioactivity plays an important role in medical science in terms of beneficial applications in both diagnosis and therapy. The former entails the introduction of a short lived radionuclide attached to a suitable pharmaceutical into the patient, and measurement of the accumulation and movement of activity from outside. This process is called emission tomography and involves the measurement of either a single low energy γ ray (i.e. single photon computed emission tomography) or coincidences between the two 511 keV photons formed in the annihilation of a positron (i.e. positron emission tomography (PET)). The major governing principle in all diagnostic studies is that the radiation dose to the patient is as low as possible. Two modalities exist in the therapeutic use of radioactivity. The first and most commonly followed procedure involves the use of external beams of electrons, X rays and γ rays from radioactive sources (e.g. 60 Co), high energy γ rays from accelerators, and hadrons (e.g. neutrons, protons and heavy ions). The second modality involves the introduction of certain radionuclides to a given part of the body (e.g. joints, organ and tumour) either mechanically or via a biochemical pathway. Mechanical introduction is called brachytherapy, whereas the biochemical pathway is known as endoradiotherapy. External radiation therapy is outside the scope of the present studies. The concerted and collaborative efforts described here deal specifically with the production and use of radionuclides. An earlier coordinated research project (CRP) of the IAEA was devoted to diagnostic radionuclides. The present effort is related to therapeutic radionuclides.

Patient Radiation Protection in Radiotherapy

International Nuclear Information System (INIS)

Hegazy, M.

2010-01-01

The Role of Radiotherapy is treatment modalities for cancer which is generally assumed that 50 to 60% of cancer patients will benefit from radiotherapy. It constitutes a peaceful application of ionizing radiation and an essential part of cancer management. The two aims of radiation protection Prevention is of deterministic effect and Reduction of the probability of stochastic effects. The Shielding fundamentals is to limit radiation exposure of staff, patients, visitors and the public to acceptable levels it also optimize protection of patients, staff and the public. Diagnosis is important for target design and the dose required for cure or palliation while Simulator is often used twice in the radiotherapy process where Patient data acquisition - target localization, contours, outlines and Verification. The Prescription is the responsibility of individual clinicians, depending on the patient’s condition, equipment available, experience and training. An ultimate check of the actual treatment given can only be made by using in vivo dosimetry. Treatment records must be kept of all relevant aspects of the treatment – including Session and Summary Record information, Records all treatment parameters, Dose Calculations and Dose Measurements

Radiation monitoring: an introduction. Rev. ed.

International Nuclear Information System (INIS)

Hayward, P.; Arnott, D.

1987-01-01

This Greenpeace pamphlet has been produced in reponse to requests from members of the public wishing to set up monitoring groups. It lists some U.K. manufacturers of radiation monitoring equipment and the contributors have summarized information available from manufacturer's own catalogues describing the equipment, what it will and will not do and costing various programmes. Three types of monitoring are discussed: monitoring the level of background gamma radiation, monitoring radioactive contamination, (early warning systems), and monitoring food and environmental samples for very low levels of radiation. (UK)

Skin cancer in patients with chronic radiation dermatitis

International Nuclear Information System (INIS)

Davis, M.M.; Hanke, C.W.; Zollinger, T.W.; Montebello, J.F.; Hornback, N.B.; Norins, A.L.

1989-01-01

The cases of 76 patients with chronic radiation dermatitis resulting from low-dose ionizing radiation for benign disease were reviewed retrospectively for risk factors leading to the development of neoplasia. The patients were studied with respect to original hair color, eye color, sun reactive skin type, benign disease treated, area treated, age at treatment, and age at development of first skin cancer. Analysis of data showed 37% of patients had sun-reactive skin type I, 27% had type II, and 36% had type III. Types IV through VI were not represented. There appeared to be an overrepresentation of types I and II. Increased melanin pigmentation may therefore be either directly or indirectly protective against the development of skin cancers in patients who have received low-dose superficial ionizing radiation for benign disease. The sun-reactive skin type of patients with chronic radiation dermatitis may be used as a predictor of skin cancer risk when the total dose of ionizing radiation is not known

Radiation carcinogenesis

International Nuclear Information System (INIS)

Fry, R.J.M.

1976-01-01

The risk of iatrogenic tumors with radiation therapy is so outweighed by the benefit of cure that estimates of risk have not been considered necessary. However, with the introduction of chemotherapy, combined therapy, and particle radiation therapy, the comparative risks should be examined. In the case of radiation, total dose, fractionation, dose rate, dose distribution, and radiation quality should be considered in the estimation of risk. The biological factors that must be considered include incidence of tumors, latent period, degree of malignancy, and multiplicity of tumors. The risk of radiation induction of tumors is influenced by the genotype, sex, and age of the patient, the tissues that will be exposed, and previous therapy. With chemotherapy the number of cells at risk is usually markedly higher than with radiation therapy. Clearly the problem of the estimation of comparative risks is complex. This paper presents the current views on the comparative risks and the importance of the various factors that influence the estimation of risk

Patient radiation exposure in computerized tomography

Energy Technology Data Exchange (ETDEWEB)

Pavlov, V [Meditsinska Akademiya, Sofia (Bulgaria)

1980-01-01

Radiation exposure to patients undergoing axial computerized tomography as a tool of neurological X-ray diagnostics was studied. Doses thereby delivered were compared with those from routine head films at X-ray tube parameters 200 W, 70 kV, and 70 cm target-to-patient distance. Radiation exposures were analyzed with a view to improving shielding and procedural techniques. Comparisons were made using LiF TLD measurements with an Alderson phantom (standard for axial computer tomography). Skin and intracranial space doses were compared using two computers, Siretom I and Siretom 2000, for various positionings: frontal, fronto-lateral, temporal, temporo-occipital, and occipital. In addition, patient body doses with or without shielding and doses to subjects attending sick children or restless adults were examined. Achievable protection was estimated for lead shields of 0.5 mm lead equivalent. It was concluded that radiation doses delivered to neurologic patients undergoing axial computer tomography are smaller than those resulting from conventional X-ray examinations.

Unique proteomic signature for radiation sensitive patients; a comparative study between normo-sensitive and radiation sensitive breast cancer patients

Energy Technology Data Exchange (ETDEWEB)

Skiöld, Sara [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden); Azimzadeh, Omid [Institute of Radiation Biology, German Research Center for Environmental Health, Helmholtz Zentrum München (Germany); Merl-Pham, Juliane [Research Unit Protein Science, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg (Germany); Naslund, Ingemar; Wersall, Peter; Lidbrink, Elisabet [Division of Radiotherapy, Radiumhemmet, Karolinska University Hospital, Stockholm (Sweden); Tapio, Soile [Institute of Radiation Biology, German Research Center for Environmental Health, Helmholtz Zentrum München (Germany); Harms-Ringdahl, Mats [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden); Haghdoost, Siamak, E-mail: Siamak.Haghdoost@su.se [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden)

2015-06-15

Highlights: • The unique protein expression profiles were found that separate radiosensitive from normal sensitive breast cancer patients. • The oxidative stress response, coagulation properties and acute phase response suggested to be the hallmarks of radiation sensitivity. - Abstract: Radiation therapy is a cornerstone of modern cancer treatment. Understanding the mechanisms behind normal tissue sensitivity is essential in order to minimize adverse side effects and yet to prevent local cancer reoccurrence. The aim of this study was to identify biomarkers of radiation sensitivity to enable personalized cancer treatment. To investigate the mechanisms behind radiation sensitivity a pilot study was made where eight radiation-sensitive and nine normo-sensitive patients were selected from a cohort of 2914 breast cancer patients, based on acute tissue reactions after radiation therapy. Whole blood was sampled and irradiated in vitro with 0, 1, or 150 mGy followed by 3 h incubation at 37 °C. The leukocytes of the two groups were isolated, pooled and protein expression profiles were investigated using isotope-coded protein labeling method (ICPL). First, leukocytes from the in vitro irradiated whole blood from normo-sensitive and extremely sensitive patients were compared to the non-irradiated controls. To validate this first study a second ICPL analysis comparing only the non-irradiated samples was conducted. Both approaches showed unique proteomic signatures separating the two groups at the basal level and after doses of 1 and 150 mGy. Pathway analyses of both proteomic approaches suggest that oxidative stress response, coagulation properties and acute phase response are hallmarks of radiation sensitivity supporting our previous study on oxidative stress response. This investigation provides unique characteristics of radiation sensitivity essential for individualized radiation therapy.

Unique proteomic signature for radiation sensitive patients; a comparative study between normo-sensitive and radiation sensitive breast cancer patients

International Nuclear Information System (INIS)

Skiöld, Sara; Azimzadeh, Omid; Merl-Pham, Juliane; Naslund, Ingemar; Wersall, Peter; Lidbrink, Elisabet; Tapio, Soile; Harms-Ringdahl, Mats; Haghdoost, Siamak

2015-01-01

Highlights: • The unique protein expression profiles were found that separate radiosensitive from normal sensitive breast cancer patients. • The oxidative stress response, coagulation properties and acute phase response suggested to be the hallmarks of radiation sensitivity. - Abstract: Radiation therapy is a cornerstone of modern cancer treatment. Understanding the mechanisms behind normal tissue sensitivity is essential in order to minimize adverse side effects and yet to prevent local cancer reoccurrence. The aim of this study was to identify biomarkers of radiation sensitivity to enable personalized cancer treatment. To investigate the mechanisms behind radiation sensitivity a pilot study was made where eight radiation-sensitive and nine normo-sensitive patients were selected from a cohort of 2914 breast cancer patients, based on acute tissue reactions after radiation therapy. Whole blood was sampled and irradiated in vitro with 0, 1, or 150 mGy followed by 3 h incubation at 37 °C. The leukocytes of the two groups were isolated, pooled and protein expression profiles were investigated using isotope-coded protein labeling method (ICPL). First, leukocytes from the in vitro irradiated whole blood from normo-sensitive and extremely sensitive patients were compared to the non-irradiated controls. To validate this first study a second ICPL analysis comparing only the non-irradiated samples was conducted. Both approaches showed unique proteomic signatures separating the two groups at the basal level and after doses of 1 and 150 mGy. Pathway analyses of both proteomic approaches suggest that oxidative stress response, coagulation properties and acute phase response are hallmarks of radiation sensitivity supporting our previous study on oxidative stress response. This investigation provides unique characteristics of radiation sensitivity essential for individualized radiation therapy

Radiation-induced myocardial perfusion abnormalities in breast cancer patients following external beam radiation therapy.

Science.gov (United States)

Eftekhari, Mohammad; Anbiaei, Robabeh; Zamani, Hanie; Fallahi, Babak; Beiki, Davood; Ameri, Ahmad; Emami-Ardekani, Alireza; Fard-Esfahani, Armaghan; Gholamrezanezhad, Ali; Seid Ratki, Kazem Razavi; Roknabadi, Alireza Momen

2015-01-01

Radiation therapy for breast cancer can induce myocardial capillary injury and increase cardiovascular morbidity and mortality. A prospective cohort was conducted to study the prevalence of myocardial perfusion abnormalities following radiation therapy of left-sided breast cancer patients as compared to those with right-sided cancer. To minimize potential confounding factors, only those patients with low 10-year risk of coronary artery disease (based on Framingham risk scoring) were included. All patients were initially treated by modified radical mastectomy and then were managed by postoperative 3D Conformal Radiation Therapy (CRT) to the surgical bed with an additional 1-cm margin, delivered by 46-50 Gy (in 2 Gy daily fractions) over a 5-week course. The same dose-adjusted chemotherapy regimen (including anthracyclines, cyclophosphamide and taxol) was given to all patients. Six months after radiation therapy, all patients underwent cardiac SPECT for the evaluation of myocardial perfusion. A total of 71 patients with a mean age of 45.3±7.2 years [35 patients with leftsided breast cancer (exposed) and 36 patients with right-sided cancer (controls)] were enrolled. Dose-volume histogram (DVH) [showing the percentage of the heart exposed to >50% of radiation] was significantly higher in patients with left-sided breast cancer. Visual interpretation detected perfusion abnormalities in 42.9% of cases and 16.7% of controls (P=0.02, Odds ratio=1.46). In semiquantitative segmental analysis, only apical (28.6% versus 8.3%, P=0.03) and anterolateral (17.1% versus 2.8%, P=0.049) walls showed significantly reduced myocardial perfusion in the exposed group. Summed Stress Score (SSS) of>3 was observed in twelve cases (34.3%), while in five of the controls (13.9%),(Odds ratio=1.3). There was no significant difference between the groups regarding left ventricular ejection fraction. The risk of radiation induced myocardial perfusion abnormality in patients treated with CRT on the

Radiation-induced Pulmonary Damage in Lung Cancer Patients

International Nuclear Information System (INIS)

Chung, Su Mi; Choi, Ihl Bohng; Kang, Mi Mun; Kim, In Ah; Shinn, Kyung Sub

1993-01-01

Purpose: A retrospective analysis was performed to evaluate the incidence of radiation induced lung damage after the radiation therapy for the patients with carcinoma of the lung. Method and Materials: Sixty-six patients with lung cancer (squamous cell carcinoma 27, adenocarcinoma 14, large cell carcinoma 2, small cell carcinoma 13, unknown 10) were treated with definitive, postoperative or palliative radiation therapy with or without chemotherapy between July 1987 and December 1991. There were 50 males and 16 females with median age of 63 years(range: 33-80 years). Total lung doses ranged from 500 to 6,660 cGy (median 3960 cGy) given in 2 to 38 fractions (median 20) over a range of 2 to 150 days (median 40 days) using 6 MV or 15 MV linear accelerator. To represent different fractionation schedules of equivalent biological effect, the estimated single dose(ED) model, ED=D·N-0.377·T-0.058 was used in which D was the lung dose in cGy, N was the number of fractions, and T was the overall treatment time in days. The range of ED was 370 to 1357. The endpoint was a visible increase in lung density within the irradiated volume on chest X-ray as observed independently by three diagnostic radiologists. Patients were grouped according to ED, treatment duration, treatment modality and age, and the percent incidence of pulmonary damage for each group was determined. Result: In 40 of 66 patients, radiation induced change was seen on chest radiographs between 11 days and 314 days after initiation of radiation therapy. The incidence of radiation pneumonitis was increased according to increased ED, which was statistically significant (p=0.001). Roentgenographic charges consistent with radiation pneumonitis were seen in 100% of patients receiving radiotherapy after lobectomy or pneumonectomy, which was not statistically significant. In 32 patients who also received chemotherapy, there was no difference in the incidence of radiation induced charge between the group with radiation

Evaluation of Patient Radiation Dose during Orthopedic Surgery

International Nuclear Information System (INIS)

Osman, H; Elzaki, A.; Sam, A.K.; Sulieman, A.

2013-01-01

The number of orthopedic procedures requiring the use of the fluoroscopic guidance has increased over the recent years. Consequently the patient exposed to un avoidable radiation doses. The aim of the current study was to evaluate patient radiation dose during these procedures.37 patients under went dynamic hip screw (DHS) and dynamic cannulated screw (DCS) were evaluated using calibrated Thermolumincent Dosimeters (TLDs), under carm fluoroscopic machines ,in three centers in Khartoum-Sudan. The mean Entrance Skin Dose (ESD) was 7.9 m Gy per procedure. The bone marrow and gonad organ exposed to significant doses. No correlation was found between ESD and Body Mass Index (BMI), or patient weight. Well correlation was found between kilo voltage applied and ESD. Orthopedic surgeries delivered lower radiation dose to patients than cardiac catheterization or hysterosalpingraphy (HSG) procedures. More study should be implemented to follow radiation dose before surgery and after surgery

Introduction to IGRT and additional components

International Nuclear Information System (INIS)

Mijnheer, Ben

2008-01-01

Image-guided radiation therapy is 'Any use of planar imaging, volumetric imaging or volumetric cine imaging, marker localization, marker tracking, patient surface imaging or patient surface tracking to improve the precision of radiation-therapy delivery' , or 'Frequent imaging in the treatment room during a course of radiotherapy to guide the treatment process'. Purpose: To verify if the correct volume in a patient is irradiated by imaging the target and/or healthy tissue prior to or during treatment. Imaging modalities include: Electronic Portal Imaging Devices (EPIDs); (Portal) imaging of implanted markers; Imaging of external markers; Ultrasound; X-ray fluoroscopy; and CT (MR) scanner in treatment room. Final remarks are as follows: The introduction of various IGRT techniques allowed 3D verification of the position of target volumes and organs at risk just before or during treatment. Because the information is in 3D, or sometimes even in 4D, in principle these IGRT approaches provide more information compared to the use of 2D verification methods (e.g. EPIDs). Clinical data are becoming available to assess quantitatively for which treatment techniques IGRT approaches are advantageous compared to the use of conventional verification methods taking the additional resources (time, money, manpower) into account. (P.A.)

Introduction to radiative corrections for young experimentalists

International Nuclear Information System (INIS)

Shimizu, Y.

1985-02-01

This is an elementary lecture note on the radiative corrections indispensable for high energy e + e - colliding beam experiments. The story begins from the classical radiation theory, goes on semi-classical treatment of quantized radiation field and finally reaches to quantum field theory. All calculations are described in detail so that the readers can follow and check them. (author)

The role of radiation therapy in the multidisciplinary treatment of patients with malignant tumors. Radiation pathological stand point

International Nuclear Information System (INIS)

Niibe, Hideo

1998-01-01

Estimations suggest that about 60% of all cancer patients will require some form of radiation therapy during their lifetime. Although 40 to 50% of cancer patients in Europe and the United States receive radiation therapy, only about 20% of patients with cancer in Japan undergo such treatment. This is largely due to the lack of understanding of the role of radiation therapy by many medical personnel in Japan, as well as to ''''radiation allergy'''' among many of the general population in Japan, a country that has been undergone atomic bombing. From our perspective as specialists in radiation therapy, the chronic shortage of radiation oncologist also poses a serious problem. Although there are approximately 700 hospitals throughout Japan where radiation therapy is available, no more than half this number of medical facilities have a full-time radiation oncologist. Perhaps the reason for this is that radiation therapy is perceived as unnecessary in Japan. However, it is absolutely essential. In our experience, the 5-year relative survival rate of patients with malignant tumors who have undergone radiation therapy in our clinic is 65 percent. Thus, radiation therapy has proven very useful in the treatment of malignant tumors. Moreover, better estimates of prognosis of cancer patients treated with radiation therapy are becoming possible. This article discusses the role of radiation therapy, from a radiation pathological perspective, in a multidisciplinary approach to treatment of cancer patients. I also emphasize the critical importance of training radiation oncologists who can function as part of multidisciplinary teams that care for patients with malignant tumors. (author). 50 refs

Radiation-induced myocardial perfusion abnormalities in breast cancer patients following external beam radiation therapy

Directory of Open Access Journals (Sweden)

Mohammad Eftekhari

2015-01-01

Full Text Available Objective(s: Radiation therapy for breast cancer can induce myocardial capillary injury and increase cardiovascular morbidity and mortality. A prospective cohort was conducted to study the prevalence of myocardial perfusion abnormalities following radiation therapy of left-sided breast cancer patients as compared to those with right–sided cancer. Methods: To minimize potential confounding factors, only those patients with low 10-year risk of coronary artery disease (based on Framingham risk scoring were included. All patients were initially treated by modified radical mastectomy and then were managed by postoperative 3D Conformal Radiation Therapy (CRT to the surgical bed with an additional 1-cm margin, delivered by 46-50 Gy (in 2 Gy daily fractions over a 5-week course. The same dose-adjusted chemotherapy regimen (including anthracyclines, cyclophosphamide and taxol was given to all patients. Six months after radiation therapy, all patients underwent cardiac SPECT for the evaluation of myocardial perfusion. Results: A total of 71 patients with a mean age of 45.3±7.2 years [35 patients with leftsided breast cancer (exposed and 36 patients with right-sided cancer (controls] were enrolled. Dose-volume histogram (DVH [showing the percentage of the heart exposed to >50% of radiation] was significantly higher in patients with left-sided breast cancer. Visual interpretation detected perfusion abnormalities in 42.9% of cases and 16.7% of controls (P=0.02, Odds ratio=1.46. In semiquantitative segmental analysis, only apical (28.6% versus 8.3%, P=0.03 and anterolateral (17.1% versus 2.8%, P=0.049 walls showed significantly reduced myocardial perfusion in the exposed group. Summed Stress Score (SSS of>3 was observed in twelve cases (34.3%, while in five of the controls (13.9%,(Odds ratio=1.3. There was no significant difference between the groups regarding left ventricular ejection fraction. Conclusion: The risk of radiation induced myocardial

The role of PET/CT in radiation treatment planning for cancer patient treatment

International Nuclear Information System (INIS)

2008-10-01

Positron emission tomography (PET) and, more recently, integrated positron emission tomography/X ray computed tomography (PET/CT) have appeared as significant diagnostic imaging systems in clinical medicine. Accurate recognition of cancers in patients by means of PET scanning with Fluorine-18-fluorodeoxyglucose ( 18 F-FDG) has illustrated a need to determine a mode of therapy to achieve better prognoses. The clinical management of cancer patients has improved dramatically with the introduction of clinical PET. For treatment of cancer patients, on the other hand, radiation therapy (RT) plays an important role as a non-invasive therapy. It is crucial that cancers are encompassed by high dose irradiation, particularly in cases of curative RT. Irradiation should precisely target the entire tumour and aim to minimise the size of microscopic extensions of the cancer, as well as minimize radiation damage to normal tissues. A new imaging technique has therefore been sought to allow precise delineation of the cancer target to be irradiated. Clinical PET, combined with utilization of 18 F-FDG, may have an important role in radiation treatment planning (RTP) in lung cancer. In addition to determining if RT is appropriate and whether therapy will be given with curative or palliative intent, 18 F-FDG-PET is useful for determining therapy ports. It can be used both to limit ports to spare normal tissue and to include additional involved regions. Several studies have shown that PET has an impact on RTP in an important proportion of patients. It is to be hoped that treatment plans that include all the 18 F-FDG-avid lesions or the 18 F-FDG-avid portions of a complex mass will result in more effective local control with less unnecessary tissue being treated. The IAEA has placed emphasis on the issue of application of clinical PET for radiation treatment planning in various cancer patients. Two consultants meetings were held in 2006 and their results are summarized into this IAEA

MO-C-BRB-01: Introduction [Diagnostic radiology and radiation oncology

Energy Technology Data Exchange (ETDEWEB)

Boone, J. [University of California Davis School of Medicine (United States)

2015-06-15

Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, and the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration

Effect of introduction of electronic patient reporting on the duration of ambulance calls.

Science.gov (United States)

Kuisma, Markku; Väyrynen, Taneli; Hiltunen, Tuomas; Porthan, Kari; Aaltonen, Janne

2009-10-01

We examined the effect of the change from paper records to the electronic patient records (EPRs) on ambulance call duration. We retrieved call duration times 6 months before (group 1) and 6 months after (group 2) the introduction of EPR. Subgroup analysis of group 2 was fulfilled depending whether the calls were made during the first or last 3 months after EPR introduction. We analyzed 37 599 ambulance calls (17 950 were in group 1 and 19 649 were in group 2). The median call duration in group 1 was 48 minutes and in group 2 was 49 minutes (P = .008). In group 2, call duration was longer during the first 3 months after EPR introduction. In multiple linear regression analysis, urgency category (P introduction was noticed, reflecting adaptation process to a new way of working.

Reduction of the estimated radiation dose and associated patient risk with prospective ECG-gated 256-slice CT coronary angiography

International Nuclear Information System (INIS)

Efstathopoulos, E P; Kelekis, N L; Pantos, I; Brountzos, E; Argentos, S; Grebac, J; Ziaka, D; Seimenis, I; Katritsis, D G

2009-01-01

Computed tomography (CT) coronary angiography has been widely used since the introduction of 64-slice scanners and dual-source CT technology, but high radiation doses have been reported. Prospective ECG-gating using a 'step-and-shoot' axial scanning protocol has been shown to reduce radiation exposure effectively while maintaining diagnostic accuracy. 256-slice scanners with 80 mm detector coverage have been currently introduced into practice, but their impact on radiation exposure has not been adequately studied. The aim of this study was to assess radiation doses associated with CT coronary angiography using a 256-slice CT scanner. Radiation doses were estimated for 25 patients scanned with either prospective or retrospective ECG-gating. Image quality was assessed objectively in terms of mean CT attenuation at selected regions of interest on axial coronary images and subjectively by coronary segment quality scoring. It was found that radiation doses associated with prospective ECG-gating were significantly lower than retrospective ECG-gating (3.2 ± 0.6 mSv versus 13.4 ± 2.7 mSv). Consequently, the radiogenic fatal cancer risk for the patient is much lower with prospective gating (0.0176% versus 0.0737%). No statistically significant differences in image quality were observed between the two scanning protocols for both objective and subjective quality assessments. Therefore, prospective ECG-gating using a 'step-and-shoot' protocol that covers the cardiac anatomy in two axial acquisitions effectively reduces radiation doses in 256-slice CT coronary angiography without compromising image quality.

Ozone Therapy in the Management of Persistent Radiation-Induced Rectal Bleeding in Prostate Cancer Patients

Directory of Open Access Journals (Sweden)

Bernardino Clavo

2015-01-01

Full Text Available Introduction. Persistent radiation-induced proctitis and rectal bleeding are debilitating complications with limited therapeutic options. We present our experience with ozone therapy in the management of such refractory rectal bleeding. Methods. Patients (n=12 previously irradiated for prostate cancer with persistent or severe rectal bleeding without response to conventional treatment were enrolled to receive ozone therapy via rectal insufflations and/or topical application of ozonized-oil. Ten (83% patients had Grade 3 or Grade 4 toxicity. Median follow-up after ozone therapy was 104 months (range: 52–119. Results. Following ozone therapy, the median grade of toxicity improved from 3 to 1 (p<0.001 and the number of endoscopy treatments from 37 to 4 (p=0.032. Hemoglobin levels changed from 11.1 (7–14 g/dL to 13 (10–15 g/dL, before and after ozone therapy, respectively (p=0.008. Ozone therapy was well tolerated and no adverse effects were noted, except soft and temporary flatulence for some hours after each session. Conclusions. Ozone therapy was effective in radiation-induced rectal bleeding in prostate cancer patients without serious adverse events. It proved useful in the management of rectal bleeding and merits further evaluation.

Introduction to astronomy and astrophysics

CERN Document Server

Jain, Pankaj

2015-01-01

IntroductionOverviewScales and DimensionsNight SkyConstellationsEarth, Sun, and the Solar SystemRetrograde Motion of PlanetsSidereal TimeAstronomical Catalogs and SoftwareObservationsElectromagnetic WavesElectromagnetic SpectrumTelescopesRefractor TelescopeReflecting TelescopeObservations at Visible FrequenciesTheoretical Limit on ResolutionSeeingMounting of TelescopeEquatorial MountAzimuthal MountInterferometerObservations at Other WavelengthsAstrometryCoordinate SystemsThe Horizontal SystemEquatorial Coordinate SystemEcliptic SystemGalactic Coordinate SystemSupergalactic Coordinate SystemSpace Velocity and Proper Motion of StarsDoppler EffectParallaxAberrationCoordinate TransformationsTransformation between Equatorial and Ecliptic Coordinate SystemsPrecession of EquinoxesEquatorial Mounting of a TelescopePhotometryIntroductionFlux Density and IntensityBlackbody RadiationEnergy Density in an Isotropic Radiation FieldMagnitude ScaleApparent MagnitudeAbsolute MagnitudeThe Color IndexBolometric MagnitudeStellar...

Melatonin as Protection Against Radiation Injury

DEFF Research Database (Denmark)

Zetner, D.; Andersen, L. P H; Rosenberg, J.

2016-01-01

Introduction: Radiation is widely used in the treatment of various cancers and in radiological imaging procedures. Ionizing radiation causes adverse effects, leading to decreased quality of life in patients, by releasing free radicals that cause oxidative stress and tissue damage. The sleep......-hormone melatonin is a free radical scavenger, and induces several anti-oxidative enzymes. This review investigates the scientific literature on the protective effects of melatonin against exposure to ionizing radiation, and discusses the clinical potential of melatonin as prophylactic treatment against ionizing...... and protected against radiation enteritis. These protective effects were only documented when melatonin was administered prior to exposure to ionizing radiation. Discussion: This review documents that melatonin effectively protects animals against injury to healthy tissues from ionizing radiation. However...

Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study

Science.gov (United States)

Loy, Bryan A.; Shkedy, Clive I.; Powell, Adam C.; Happe, Laura E.; Royalty, Julie A.; Miao, Michael T.; Smith, Gary L.; Long, James W.; Gupta, Amit K.

2016-01-01

Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, ppayment model and assess implications in other populations. PMID:26870963

Radiation safety aspects pertaining to female patients and staff

International Nuclear Information System (INIS)

Patni, Nidhi

2017-01-01

Many organizations in the world are committed to gender parity. Increasing number of women is working in the fields of radiation medicine and in industries dealing with radiation. Women patients may be exposed to radiation in radiology, radiation oncology, nuclear medicine, interventional cardiology, dentistry etc. Radiation safety of women staff and women patients is different from their male counterparts because of conception and pregnancy. So, fetal health is a matter of concern in the above. Also, the excess relative risk of radiation induced cancers in females relates to higher risk of thyroid cancer and high radiosensitivity as compared to males

Heuristic introduction to gravitational waves

International Nuclear Information System (INIS)

Sandberg, V.D.

1982-01-01

The purpose of this article is to provide a rough and somewhat heuristic theoretical background and introduction to gravitational radiation, its generation, and its detection based on Einstein's general theory of relativity

Age Disparity in Palliative Radiation Therapy Among Patients With Advanced Cancer

Energy Technology Data Exchange (ETDEWEB)

Wong, Jonathan [University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii (United States); Xu, Beibei [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Yeung, Heidi N.; Roeland, Eric J. [Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Division of Palliative Medicine, Department of Internal Medicine, University of California San Diego, La Jolla, California (United States); Martinez, Maria Elena [Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Mell, Loren K. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Murphy, James D., E-mail: j2murphy@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Moores Cancer Center, University of California San Diego, La Jolla, California (United States)

2014-09-01

Purpose/Objective: Palliative radiation therapy represents an important treatment option among patients with advanced cancer, although research shows decreased use among older patients. This study evaluated age-related patterns of palliative radiation use among an elderly Medicare population. Methods and Materials: We identified 63,221 patients with metastatic lung, breast, prostate, or colorectal cancer diagnosed between 2000 and 2007 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Receipt of palliative radiation therapy was extracted from Medicare claims. Multivariate Poisson regression analysis determined residual age-related disparity in the receipt of palliative radiation therapy after controlling for confounding covariates including age-related differences in patient and demographic covariates, length of life, and patient preferences for aggressive cancer therapy. Results: The use of radiation decreased steadily with increasing patient age. Forty-two percent of patients aged 66 to 69 received palliative radiation therapy. Rates of palliative radiation decreased to 38%, 32%, 24%, and 14% among patients aged 70 to 74, 75 to 79, 80 to 84, and over 85, respectively. Multivariate analysis found that confounding covariates attenuated these findings, although the decreased relative rate of palliative radiation therapy among the elderly remained clinically and statistically significant. On multivariate analysis, compared to patients 66 to 69 years old, those aged 70 to 74, 75 to 79, 80 to 84, and over 85 had a 7%, 15%, 25%, and 44% decreased rate of receiving palliative radiation, respectively (all P<.0001). Conclusions: Age disparity with palliative radiation therapy exists among older cancer patients. Further research should strive to identify barriers to palliative radiation among the elderly, and extra effort should be made to give older patients the opportunity to receive this quality of life-enhancing treatment at the end

Release of the radioactive patient following radiation therapy

International Nuclear Information System (INIS)

Powers, J.; Cancer Board, A.

2004-01-01

Patients walk out of medical facilities containing as much as a complete therapeutic dose of radiation on a daily basis. This presents a significant challenge to the radiation protection community, as most patients have no prior education related to radiation and may not have the aptitude to assimilate such knowledge. In the case of targeted radiation therapy in which radionuclides are used to selectively target the cancer, patients are typically released only after adequate elimination and decay of the radionuclide administered. Established modalities of targeted radiotherapy include the use of iodine for thyroid cancer, strontium for bone pain, phosphorous for haematological diseases, 131I-mIBG for neuroblastoma, and most recently Y-90 labelled monoclonal antibodies for lymphoma. In the case of permanent implants, implants of encapsulated radioactive sources are left permanently in the tissues, thus patients are released containing their complete therapeutic dose. Isotopes used in permanent implants include I-125, Pd-103 and Au-198. Radiation safety considerations for both cases, the release of a patient who has received targeted radiotherapy, and the release of a patient who has received a permanent implant, will be discussed. A summary of applicable regulations will serve as a starting point for each of the following considerations; i) Security and source control ii) Instructions to patient and family members iii) Risk to the public As the incidence of cancer increases, and the popularity of targeted radiotherapy and permanent seed implants grows, the event of having an untrained person in possession of a therapeutic dose of radiation becomes more and more common. It is essential to stop and examine the risk of this practice, whether current strategies to reduce the risk to an acceptable level are indeed effective, and whether control over these sources is even feasible. (Author)

Release of the radioactive patient following radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Powers, J.; Cancer Board, A.

2004-07-01

Patients walk out of medical facilities containing as much as a complete therapeutic dose of radiation on a daily basis. This presents a significant challenge to the radiation protection community, as most patients have no prior education related to radiation and may not have the aptitude to assimilate such knowledge. In the case of targeted radiation therapy in which radionuclides are used to selectively target the cancer, patients are typically released only after adequate elimination and decay of the radionuclide administered. Established modalities of targeted radiotherapy include the use of iodine for thyroid cancer, strontium for bone pain, phosphorous for haematological diseases, 131I-mIBG for neuroblastoma, and most recently Y-90 labelled monoclonal antibodies for lymphoma. In the case of permanent implants, implants of encapsulated radioactive sources are left permanently in the tissues, thus patients are released containing their complete therapeutic dose. Isotopes used in permanent implants include I-125, Pd-103 and Au-198. Radiation safety considerations for both cases, the release of a patient who has received targeted radiotherapy, and the release of a patient who has received a permanent implant, will be discussed. A summary of applicable regulations will serve as a starting point for each of the following considerations; i) Security and source control ii) Instructions to patient and family members iii) Risk to the public As the incidence of cancer increases, and the popularity of targeted radiotherapy and permanent seed implants grows, the event of having an untrained person in possession of a therapeutic dose of radiation becomes more and more common. It is essential to stop and examine the risk of this practice, whether current strategies to reduce the risk to an acceptable level are indeed effective, and whether control over these sources is even feasible. (Author)

Radiation exposure during cardiac catheterization procedures

International Nuclear Information System (INIS)

Kicken, P.J.H.; Huyskens, C.J.; Michels, H.R.

1988-01-01

For some time there has been an increased interest in more information about radiation exposure during cardiac catheterization because of: relatively high doses to workers and patient; rapid increase of numbers of examinations; introduction of new procedure-types (e.g. Percutaneous Transluminal Coronary Angiography, PTCA) and introduction of new techniques (e.g. Digital Subtraction Angiography, DSA). This paper reports about a study on the exposure to medical personnel and patient in two major hospitals in the Netherlands. The Total number of cardiac catheterization procedures in both hospitals amounts to circa 3000 per year (approximately 10% of all cardiac procedures c.q. 20% of all PTCA procedures in the Netherlands). This study is related to 1300 cardiac examinations

Perception of radiation awareness among patients in Karnataka - a qualitative study

International Nuclear Information System (INIS)

Sukumar, Suresh; Kotian, Rahul P.; Rajagopal, K.V.

2013-01-01

Increasing concern has recently been expressed in the literature that the patients undergoing diagnostic Computer Tomography imaging and X-ray examinations have inadequate knowledge and awareness about radiation. The frequent use of Computed tomography and routine X-ray examinations for unnecessary indications is the most vital cause of increase in medical radiation exposure. Dose reduction techniques and radiation protection measures is a topic of public concern in which government should play a very important role. Radiologists and patients undergoing any radiological procedure involving ionizing radiation are becoming highly sensitized to the issue of radiation exposure from these diagnostic procedures. The attitudes and perceptions of these patients undergoing diagnostic imaging procedures that use ionizing radiation vary widely. Patients perception about radiation awareness strongly influence their consent or acceptance of any diagnostic imaging procedure. In this study we review the perceptions of radiation risk by laypersons i.e patients who have very little knowledge and awareness about the diagnostic procedure and X-ray examination for which they have been referred. Although the benefit vs risk ratio will outweigh the radiation risk involved in these X-ray and CT examinations but the patients awareness about radiation is a major concern in today's society. The purpose of this study is to understand the perception of radiation awareness among patients in the Karnataka population. Very less qualitative research work has been taken up in this field, as a result such study will gain impetus in the near future. The study was carried out in Karnataka. Qualitative case study was conducted based on Non-Probability purposive sampling and in-depth interview was conducted at the Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal among ten patients who were referred for X-ray and CT examinations. An in-depth interview among patients in

Diagnostic radiation exposure in pediatric trauma patients.

Science.gov (United States)

Brunetti, Marissa A; Mahesh, Mahadevappa; Nabaweesi, Rosemary; Locke, Paul; Ziegfeld, Susan; Brown, Robert

2011-02-01

The amount of imaging studies performed for disease diagnosis has been rapidly increasing. We examined the amount of radiation exposure that pediatric trauma patients receive because they are an at-risk population. Our hypothesis was that pediatric trauma patients are exposed to high levels of radiation during a single hospital visit. Retrospective review of children who presented to Johns Hopkins Pediatric Trauma Center from July 1, 2004, to June 30, 2005. Radiographic studies were recorded for each patient and doses were calculated to give a total effective dose of radiation. All radiographic studies that each child received during evaluation, including any associated hospital admission, were included. A total of 945 children were evaluated during the study year. A total of 719 children were included in the analysis. Mean age was 7.8 (±4.6) years. Four thousand six hundred three radiographic studies were performed; 1,457 were computed tomography (CT) studies (31.7%). Average radiation dose was 12.8 (±12) mSv. We found that while CT accounted for only 31.7% of the radiologic studies performed, it accounted for 91% of the total radiation dose. Mean dose for admitted children was 17.9 (±13.8) mSv. Mean dose for discharged children was 8.4 (±7.8) mSv (pcumulative radiation exposure can be high. In young children with relatively long life spans, the benefit of each imaging study and the cumulative radiation dose should be weighed against the long-term risks of increased exposure.

Effects of Ionizing Radiation in Atopic Patients Exposed to Radiation

International Nuclear Information System (INIS)

Radwan, N.K.A.

2014-01-01

Atopic dermatitis is a chronic relapsing inflammatory skin disease that arises most commonly during early infancy, and is characterized by severe pruritus, age-dependant skin manifestations, and a fluctuating clinical course. Hereditary, environmental and immunological factors are involved in the aetiopathogenesis of AD. Also the differentiation of helper T- cells, local cytokine profile, IgE, infectious agents and superantigens are factors identified as being involved in the pathogenesis of AD. One hundred patients with AD were selected from the outpatient clinic of the National Center for Radiation Research and Technology in Cairo, Egypt. They were divided into 2 groups; group 1 included radiation workers in the Hall of gamma irradiation unit and group 2 included workers outside controlled area and not exposed to radiation with comparable age and sex. The severity of the disease was evaluated according to the grade of atopic dermatitis. Total and specific serum IgE was measured and Complete Blood Count was also carried out. Four Malassezia species were isolated from AD patients M. globosa, M. furfur, M. sympodialis and M. obtusa. The clinical isolates consisted of two bacterial strains, S. aureus and S. epidermidis. The significant increase of AD severity seems to be more closely related to the prevalence of S. aureus and Malassezia on the skin of radiation workers. This was proved by the presence of high IgE and eosinophils in radiation workers. So, the interactions of low gamma radiation and skin seems to further complicate the risk of assessments of atopic dermatitis

Methodology for comprehensive patient, worker and public radiation protection considerations while introducing new medical procedures

International Nuclear Information System (INIS)

Neeman, E.; Keren, M.

2001-01-01

Patient protection is a major consideration while introducing new medical procedure. But protection of the workers and the public should be considered too. A methodology of combining non-patient radiation protection considerations with the introduction of new medical procedures is described. The new medical procedure was the Intracoronary Gamma Irradiation for the Prevention of Restenosis by using Iridium 192 gamma radiation sources. The usual authors' responsibility is the licensing of the use of radioactive materials while keeping public protection. According to this responsibility, the methodology's original orientation is public protection. As a result of coordination between several competent authorities, managed by the authors, the methodology was adopted for patient and worker protection too. Applicants, actually possible users (hospitals) of the new procedure, were obliged to plan medical procedures and working area according to dose limits and constrains as recommended by the International Atomic Energy Agency and local competent authorities. Exposure calculations had to consider the usual parameters as sources types and activity, dose rate and dose levels, duration and number of treatments. Special attention was given to the presence workers and public by chance presence in or near treatment area. A usual condition to give a license was the installation of continuous (during treatment) radiation monitoring systems. But a special attention was given to physical barriers and procedures in order to stop unauthorized personal to arrive near to working area. Satisfactory staff training for normal operation and emergency situations are essential, including appropriate safety procedures and the presence of safety assistance team while executing treatment. (author)

Iodine 131 therapy patients: radiation dose to staff

International Nuclear Information System (INIS)

Castronovo, F.P. Jr.; Beh, R.A.; Veilleux, N.M.

1986-01-01

Metastasis to the skeletal system from follicular thyroid carcinoma may be treated with an oral dose of 131 I-NaI. Radiation exposures to hospital personnel attending these patients were calculated as a function of administered dose, distance from the patient and time after administration. Routine or emergency patient handling tasks would not exceed occupational radiation protection guidelines for up to 30 min immediately after administration. The emergency handling of several patients presents the potential for exceeding these guidelines. (author)

Introduction to plasma dynamics

CERN Document Server

Morozov, A I

2013-01-01

As the twenty-first century progresses, plasma technology will play an increasing role in our lives, providing new sources of energy, ion-plasma processing of materials, wave electromagnetic radiation sources, space plasma thrusters, and more. Studies of the plasma state of matter not only accelerate technological developments but also improve the understanding of natural phenomena. Beginning with an introduction to the characteristics and types of plasmas, Introduction to Plasma Dynamics covers the basic models of classical diffuse plasmas used to describe such phenomena as linear and shock w

Radiation and Your Patient: A Guide for Medical Practitioners

International Nuclear Information System (INIS)

Cosset, J.M.; Liniecki, J.; Ortiz-Lopez, P.; Ringertz, H.; Sharp, C.; Mettler, F.A. Jr.; Harding, L.K.; Nakamura, H.; Rehani, M.M.; Sasaki, Y.; Ussov, W.Y.; Guiberteau, M.J.; Hiraoka, M.; Vafio, E.; Gusev, L.A.; Pinillos-Ashton, L.V.; Rosenstein, M.; Yin, W.; Mattsson, S.; Cousins, C.

2004-01-01

The medical exposures are the first cause of irradiation of populations. The benefit/risk ratio must be taken into consideration. Progress margin exists to reduce the radiation doses delivered to patients. The British people have noticed a reduction of 30% in the doses received by the patients during the last years. A better radiation protection needs a better dialogue between physicians and patients. This is the object of this ICRP guide which is a French translation of the original title 'Supporting guidance 2. Radiation and Your Patient: A Guide for Medical Practitioners', published by Pergamon (2002)

Shift in imaging modalities of the spine through 25 years and its impact on patient ionizing radiation doses

Energy Technology Data Exchange (ETDEWEB)

Borgen, Lars [Department of Radiology, Hospital of Buskerud, Dronning gaten 28, 3004 Drammen (Norway)]. E-mail: lars.borgen@sb-hf.no; Ostensen, Harald [Diagnostic Imaging and Laboratory Technology, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27 (Switzerland); Stranden, Erling [Buskerud University College, Konggate 51, 3019 Drammen (Norway); Olerud, Hilde Marie [Norwegian Radiation Protection Authority, PO Box 55, 1332 Osteras (Norway); Gudmundsen, Tor Erik [Department of Radiology, Hospital of Buskerud, Dronning gaten 28, 3004 Drammen (Norway); Buskerud University College, Konggate 51, 3019 Drammen (Norway)

2006-10-15

Study design: Retrospective. Objective: To explore the shift in modalities when diagnosing the spine in the years 1979-2003. To see how this shift, together with a radiation protective policy, have influenced on the ionizing radiation doses. Summary of background data: The shift from CT/myelography to MR when diagnosing the spine is well known. To what extent this has changed the radiation doses has to our knowledge not yet been published. Methods: Activity reports from a department of radiology have been reviewed. Relevant radiation doses estimates have been obtained from the Norwegian Radiation Protection Authority. Results: MRI was introduced in 1992 and has been used increasingly since then. Conventional X-ray to the spine has been practically unchanged. Myelography and CT decreased markedly after the introduction of MRI. The total number of examinations of the spine has increased, but the radiation doses given have decreased since 1993. Conclusions: The introduction of MRI together with a radiation protective policy have reduced the ionizing radiation doses given to this population, in spite of an increase in the total number of examinations of the spine.

An analysis of the incidence and related factors for radiation dermatitis in breast cancer patients who receive radiation therapy

International Nuclear Information System (INIS)

Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo; Lee, Heui Kwan

2010-01-01

We analyzed the incidence and related factors of radiation dermatitis; at first, to recognize whether a decrease in radiation dermatitis is possible or not in breast cancer patients who received radiation therapy. Of 338 patients, 284 with invasive breast cancer who received breast conservation surgery with radiotherapy at Chonbuk National University Hospital from January 2007 to June 2009 were evaluated. Patients who also underwent bolus, previous contralateral breast irradiation and irradiation on both breasts were excluded. For patients who appeared to have greater than moderate radiation dermatitis, the incidence and relating factors for radiation dermatitis were analyzed retrospectively. A total of 207 and 77 patients appeared to have RTOG grade 0/1 or above RTOG grade 2 radiation dermatitis, respectively. The factors found to be statistically significant for the 77 patients who appeared to have greater than moderate radiation dermatitis include the presence of lymphocele due to the stasis of lymph and lymph edema which affect the healing disturbance of radiation dermatitis (p=0.003, p=0.001). Moreover, an allergic reaction to plaster due to the immune cells of skin and the activation of cytokine and concomitant hormonal therapy were also statistically significant factors (p=0.001, p=0.025). Most of the breast cancer patients who received radiation therapy appeared to have a greater than mild case of radiation dermatitis. Lymphocele, lymphedema, an allergy to plaster and concomitant hormonal therapy which affect radiation dermatitis were found to be significant factors. Consequently, we should eliminate lymphocele prior to radiation treatment for patients who appear to have an allergic reaction to plaster. We should also instruct patients of methods to maintain skin moisture if they appear to have a greater than moderate case of radiation dermatitis.

Radiation-induced xerostomia in a patient with nasopharyngeal ...

African Journals Online (AJOL)

OBJECTIVE: This study reports a case of radiation-induced xerstomia in a patient with nasopharyngeal cancer, to emphasize the need for prompt oral care to prevent untoward effects of xerostomia and to improve patients' quality of life. CASE REPORT: A 60 year old man diagnosed of radiation-induced xerostomia, after 6 ...

Introduction of a Surgical Navigator in the Perioperative Process Improves Patient Satisfaction

Directory of Open Access Journals (Sweden)

Brett G Marshall

2017-03-01

Full Text Available Background: Patients who had received surgical services at Bellin Hospital reported anxiety with the surgical flow. This study tested the hypothesis that the introduction of a surgical navigator, someone who guided the patient and their accompanying others throughout the surgical process, would improve patient satisfaction. Methods: Ambulatory surgical patients were randomized to control and study groups. The study group patients were assigned a surgical navigator. Prior to discharge from the hospital, patients were asked to complete a patient satisfaction survey. Results: The study group had significantly higher mean scores (P value ≤ 0.026, top box scores (P value ≤ 0.021, and positive comments. Conclusion: The addition of a surgical navigator to the perioperative process significantly enhanced patient satisfaction in ambulatory surgical patients.

Radiation exposure in gastroenterology: improving patient and staff protection.

LENUS (Irish Health Repository)

Ho, Immanuel K H

2014-08-01

Medical imaging involving the use of ionizing radiation has brought enormous benefits to society and patients. In the past several decades, exposure to medical radiation has increased markedly, driven primarily by the use of computed tomography. Ionizing radiation has been linked to carcinogenesis. Whether low-dose medical radiation exposure will result in the development of malignancy is uncertain. This paper reviews the current evidence for such risk, and aims to inform the gastroenterologist of dosages of radiation associated with commonly ordered procedures and diagnostic tests in clinical practice. The use of medical radiation must always be justified and must enable patients to be exposed at the lowest reasonable dose. Recommendations provided herein for minimizing radiation exposure are based on currently available evidence and Working Party expert consensus.

Incidence of hip and knee replacement in patients with rheumatoid arthritis following the introduction of biological DMARDs

DEFF Research Database (Denmark)

Cordtz, René Lindholm; Hawley, Samuel; Prieto-Alhambra, Daniel

2018-01-01

person-years were calculated for patients with RA and GPCs in 6-month periods. Levels and trends in the pre-bDMARD (1996-2001) were compared with the bDMARD era (2003-2016) using segmented linear regression interrupted by a 1-year lag period (2002). RESULTS: We identified 30 404 patients with incident RA......OBJECTIVES: To study the impact of the introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) and associated rheumatoid arthritis (RA) management guidelines on the incidence of total hip (THR) and knee replacements (TKR) in Denmark. METHODS: Nationwide register-based cohort...... in 1996. In patients with RA, introduction of bDMARDs was associated with a decreasing incidence rate of TKR, whereas the incidence of THR had started to decrease before bDMARD introduction....

Protection of the patient in radiation therapy

International Nuclear Information System (INIS)

1991-01-01

In the ICRP report (ICRP-Pub-44) a broad picture of radiotheraphy is presented useful to all involved in the care of cancer patients, for instance to physicians, including medical oncologists, and to medical physicists, radiographers, dosimetrists, and administrators. Information is given on the general principles of radiation therapy including external beam therapy and brachytherapy; the accuracy of radiation delivery and quality assurance; the biological radiation response; the expected risk to specific organs or tissues from therapeutic irradiation; the absorbed dose to tissues inside and outside the useful radiation beams; the organization and planning of radiation oncology services; radiation therapy staff education, training and duties; and finally medical research involving the use of radiation therapy. (orig./HP) [de

Assessment of patient radiation doses during routine diagnostic radiography examinations

International Nuclear Information System (INIS)

Adam, Asim Karam Aldden Adam

2015-11-01

Medical applications of radiation represent the largest source of exposure to general population. Accounting for 3.0 mSv against an estimated 2.4 mSv from a natural back ground in United States. The association of ionizing radiation an cancer risk is assumed to be continuos and graded over the entire range of exposure, The objective of this study is to evaluate the patient radiation doses in radiology departments in Khartoum state. A total of 840 patients ? during two in the following hospitals Khartoum Teaching Hospital (260 patients), Fedail specialized hospital ( 261 patients). National Ribat University hospital ( 189 patients) and Engaz hospital (130 patients). Patient doses were measured for 9 procedures. The Entrance surface Air Kerma (ESAK) was quantified using x-ray unit output by Unifiers xi dose rate meter( Un fore inc. Billdal. Sweden) and patient exposure parameters. The mean patient age. Weight and Body Mass index (BMI) were 42.6 year 58/4 kg and 212 kg/m respectively. The mean patient doses, kv and MAS and E.q was 0.35 mGy per procedures 59.9 volt 19.8 Ampere per second 0.32 Sv . Patient doses were comparable with previous studies. Patient radiation doses showed considerable difference between hospitals due to x- ray systems exposure settings and patient weight. Patient are exposed to unnecessary radiation.(Author)

Introduction to the theory of gravitational radiation

International Nuclear Information System (INIS)

Damour, T.

1987-01-01

In these lectures our attention is restricted to the analytical investigations of the theory of gravitational radiation. There exist already several reviews concerning this topic and, in particular, a recent detailed review, by Thorne, where gravitational radiation theory is put in a form suitable for astrophysical studies. This is why the scope of these lectures is limited to supplement the existing reviews in two ways. First, both the basic concepts of gravitational radiation theory, and the precise conditions, as well as the limitations, of validity of some of the well-known results in this theory are presented. Indeed, as these results have been, or will be, applied in astrophysics, it is important to have clearly in mind both what they mean, and when they can be legitimately applied. Second, a progress report on some of the ongoing analytical research in gravitational radiation theory is presented. 144 references

Cumulative radiation dose of multiple trauma patients during their hospitalization

International Nuclear Information System (INIS)

Wang Zhikang; Sun Jianzhong; Zhao Zudan

2012-01-01

Objective: To study the cumulative radiation dose of multiple trauma patients during their hospitalization and to analyze the dose influence factors. Methods: The DLP for CT and DR were retrospectively collected from the patients during June, 2009 and April, 2011 at a university affiliated hospital. The cumulative radiation doses were calculated by summing typical effective doses of the anatomic regions scanned. Results: The cumulative radiation doses of 113 patients were collected. The maximum,minimum and the mean values of cumulative effective doses were 153.3, 16.48 mSv and (52.3 ± 26.6) mSv. Conclusions: Multiple trauma patients have high cumulative radiation exposure. Therefore, the management of cumulative radiation doses should be enhanced. To establish the individualized radiation exposure archives will be helpful for the clinicians and technicians to make decision whether to image again and how to select the imaging parameters. (authors)

Liver late effects of ionizing radiation; Effets tardifs des radiations sur le foie

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Mornex, F.; Ramuz, O. [Centre Hospitalier Universitaire Lyon-Sud, 69 - Pierre-Benite (France); Gerard, F. [Laboratoire Marcel-Merieux, 69 - Lyon (France); Van Houtte, P. [Institut Bordet, Brussels (Belgium)

1997-12-01

Until recently, the liver was classified as a radioresistant organ, although it is in fact highly radiosensitive. The realization that the whole liver could be treated safety only with low doses of radiation led to the conclusion that radiation therapy had an extremely limited role in the treatment of intrahepatic malignancies. A resurgence of interest has been observed with the advent of conformal radiotherapy and the introduction of bone marrow transplantation with total body irradiation. The radiation-induced liver disease, often called radiation hepatitis, is a syndrome characterized by the development of anicteric ascites, approximately 2 weeks to 4 months after hepatic irradiation. Immediate tolerance is generally surprisingly good, and the subacute radiation injury is followed by a complete asymptomatic healing, although the late lesions may be associated with signs of chronic radiation hepatitis. Radiation hepatitis must be distinguished from chemo-radiation-induced-hepatitis occurring in patients undergoing bone marrow transplantation and total body irradiation. Both syndromes demonstrate the same pathological lesion: veno-occlusive disease. The main treatment for radiation hepatitis is diuretics, although soma advocate steroids for severe cases. (authors)

Combined adjuvant radiation and interferon-alpha 2B therapy in high-risk melanoma patients: the potential for increased radiation toxicity

International Nuclear Information System (INIS)

Hazard, Lisa J.; Sause, William T.; Noyes, R. Dirk

2002-01-01

Purpose: Surgically resected melanoma patients with high-risk features commonly receive adjuvant therapy with interferon-alpha 2b combined with radiation therapy; the purpose of our study was to evaluate the potential enhancement of radiation toxicity by interferon. Methods and Materials: Patients at LDS Hospital and the University of Utah Medical Center in Salt Lake City treated with interferon during radiotherapy or within 1 month of its completion were retrospectively identified, and their charts were reviewed. If possible, the patients were asked to return to the LDS Hospital radiation therapy department for follow-up. Results: Five of 10 patients receiving interferon-alpha 2b therapy during radiation therapy or within 1 month of its completion experienced severe subacute/late complications of therapy. Severe subacute/late complications included two patients with peripheral neuropathy, one patient with radiation necrosis in the brain, and two patients with radiation necrosis in the s.c. tissue. One patient with peripheral neuropathy and one patient with radiation necrosis also developed lymphedema. Conclusions: In vitro studies have identified a radiosensitizing effect by interferon-alpha on certain cell lines, which suggests the possibility that patients treated with interferon and radiation therapy may experience more severe radiation toxicities. We have observed severe subacute/late complications in five of 10 patients treated with interferon-alpha 2b during radiation therapy or within 1 month of its completion. Although an observational study of 10 patients lacks the statistic power to reach conclusions regarding the safety and complication rates of combined interferon and radiation therapy, it is sufficient to raise concerns and suggest the need for prospective studies

Audit of radiation dose to patients during coronary angiography

International Nuclear Information System (INIS)

Livingstone, Roshan S.; Chandy, Sunil; Peace, Timothy B.S.; George, Paul V.; John, Bobby; Pati, Purendra

2007-01-01

There is a widespread concern about radiation doses imparted to patients during cardiology procedures in the medical community. The current study intends to audit and optimize radiation dose to patients undergoing coronary angiography performed using two dedicated cardiovascular machines

Risk of Radiation Retinopathy in Patients With Orbital and Ocular Lymphoma

International Nuclear Information System (INIS)

Kaushik, Megha; Pulido, Jose S.; Schild, Steven E.; Stafford, Scott

2012-01-01

Purpose: Radiation retinopathy is a potential long-term complication of radiation therapy to the orbit. The risk of developing this adverse effect is dose dependent; however, the threshold is unclear. The aim of this study was to identify the risk of developing radiation retinopathy at increasing radiation doses. Methods and Materials: A 40-year retrospective review was performed of patients who received external beam radiation therapy for ocular/orbital non-Hodgkin lymphoma (NHL). Results: Sixty-seven patients who had at least one ophthalmic follow-up examination were included in this study. Most patients (52%) were diagnosed with NHL involving the orbit. Patients received external beam radiation therapy at doses between 1886 and 5400 cGy (mean, 3033 ± 782 cGy). Radiation retinopathy developed in 12% of patients, and the median time to diagnosis was 27 months (range, 15-241months). The mean prescribed radiation dose in patients with retinopathy was 3309 ± 585 cGy, and the estimated retinal dose (derived by reviewing the dosimetry) was 3087 ± 1030 cGy. The incidence of retinopathy increased with dose. The average prescribed daily fractionated dose was higher in patients who developed retinopathy than in patients who did not (mean, 202 cGy vs 180 cGy, respectively; P = .04). More patients with radiation retinopathy had comorbid diabetes mellitus type 2 than patients without retinopathy (P = .015). In our study, the mean visual acuity of the eyes that received radiation was worse than that of the eyes that did not (P = .027). Other postradiotherapy ocular findings included keratitis (6%), dry eyes (39%), and cataract (33%). Conclusions: Radiation retinopathy, a known complication of radiotherapy for orbital tumors, relates to vascular comorbidities and dose. Higher total doses and larger daily fractions (>180 cGy) appear to be related to higher rates of retinopathy. Future larger studies are required to identify a statistically significant threshold for the

Risk of Radiation Retinopathy in Patients With Orbital and Ocular Lymphoma

Energy Technology Data Exchange (ETDEWEB)

Kaushik, Megha; Pulido, Jose S. [Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota (United States); Schild, Steven E. [Division of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States); Stafford, Scott, E-mail: stafford.scott@mayo.edu [Division of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

2012-12-01

Purpose: Radiation retinopathy is a potential long-term complication of radiation therapy to the orbit. The risk of developing this adverse effect is dose dependent; however, the threshold is unclear. The aim of this study was to identify the risk of developing radiation retinopathy at increasing radiation doses. Methods and Materials: A 40-year retrospective review was performed of patients who received external beam radiation therapy for ocular/orbital non-Hodgkin lymphoma (NHL). Results: Sixty-seven patients who had at least one ophthalmic follow-up examination were included in this study. Most patients (52%) were diagnosed with NHL involving the orbit. Patients received external beam radiation therapy at doses between 1886 and 5400 cGy (mean, 3033 {+-} 782 cGy). Radiation retinopathy developed in 12% of patients, and the median time to diagnosis was 27 months (range, 15-241months). The mean prescribed radiation dose in patients with retinopathy was 3309 {+-} 585 cGy, and the estimated retinal dose (derived by reviewing the dosimetry) was 3087 {+-} 1030 cGy. The incidence of retinopathy increased with dose. The average prescribed daily fractionated dose was higher in patients who developed retinopathy than in patients who did not (mean, 202 cGy vs 180 cGy, respectively; P = .04). More patients with radiation retinopathy had comorbid diabetes mellitus type 2 than patients without retinopathy (P = .015). In our study, the mean visual acuity of the eyes that received radiation was worse than that of the eyes that did not (P = .027). Other postradiotherapy ocular findings included keratitis (6%), dry eyes (39%), and cataract (33%). Conclusions: Radiation retinopathy, a known complication of radiotherapy for orbital tumors, relates to vascular comorbidities and dose. Higher total doses and larger daily fractions (>180 cGy) appear to be related to higher rates of retinopathy. Future larger studies are required to identify a statistically significant threshold for the

Radiation-induced meningiomas in pediatric patients

International Nuclear Information System (INIS)

Moss, S.D.; Rockswold, G.L.; Chou, S.N.; Yock, D.; Berger, M.S.

1988-01-01

Radiation-induced meningiomas rarely have latency periods short enough from the time of irradiation to the clinical presentation of the tumor to present in the pediatric patient. Three cases of radiation-induced intracranial meningiomas in pediatric patients are presented. The first involved a meningioma of the right frontal region in a 10-year-old boy 6 years after the resection and irradiation of a 4th ventricular medulloblastoma. Review of our pediatric tumor cases produced a second case of a left temporal fossa meningioma presenting in a 15-year-old boy with a history of irradiation for retinoblastoma at age 3 years and a third case of a right frontoparietal meningioma in a 15-year-old girl after irradiation for acute lymphoblastic leukemia. Only three cases of meningiomas presenting in the pediatric age group after radiation therapy to the head were detected in our review of the literature

Where Do Patients With Cancer in Iowa Receive Radiation Therapy?

Science.gov (United States)

Ward, Marcia M.; Ullrich, Fred; Matthews, Kevin; Rushton, Gerard; Tracy, Roger; Goldstein, Michael A.; Bajorin, Dean F.; Kosty, Michael P.; Bruinooge, Suanna S.; Hanley, Amy; Jacobson, Geraldine M.; Lynch, Charles F.

2014-01-01

Purpose: Multiple studies have shown survival benefits in patients with cancer treated with radiation therapy, but access to treatment facilities has been found to limit its use. This study was undertaken to examine access issues in Iowa and determine a methodology for conducting a similar national analysis. Patients and Methods: All Iowa residents who received radiation therapy regardless of where they were diagnosed or treated were identified through the Iowa Cancer Registry (ICR). Radiation oncologists were identified through the Iowa Physician Information System (IPIS). Radiation facilities were identified through IPIS and classified using the Commission on Cancer accreditation standard. Results: Between 2004 and 2010, 113,885 invasive cancers in 106,603 patients, 28.5% of whom received radiation treatment, were entered in ICR. Mean and median travel times were 25.8 and 20.1 minutes, respectively, to the nearest facility but 42.4 and 29.1 minutes, respectively, to the patient's chosen treatment facility. Multivariable analysis predicting travel time showed significant relationships for disease site, age, residence location, and facility category. Residents of small and isolated rural towns traveled nearly 3× longer than urban residents to receive radiation therapy, as did patients using certain categories of facilities. Conclusion: Half of Iowa patients could reach their nearest facility in 20 minutes, but instead, they traveled 30 minutes on average to receive treatment. The findings identified certain groups of patients with cancer who chose more distant facilities. However, other groups of patients with cancer, namely those residing in rural areas, had less choice, and some had to travel considerably farther to radiation facilities than urban patients. PMID:24443730

Introduction and NASA Electronic Parts and Packaging (NEPP) Program Overview

Science.gov (United States)

LaBel, Kenneth A.; Sampson, Michael J.

2014-01-01

This presentation includes an introduction to the space radiation environment, the effects on electronics, the environment in action, flight projects, mission needs, and radiation hardness assurance (RHA).

A Kalman Filter-Based Method for Reconstructing GMS-5 Global Solar Radiation by Introduction of In Situ Data

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Yong Wang

2013-06-01

Full Text Available Solar radiation is an important input for various land-surface energy balance models. Global solar radiation data retrieved from the Japanese Geostationary Meteorological Satellite 5 (GMS-5/Visible and Infrared Spin Scan Radiometer (VISSR has been widely used in recent years. However, due to the impact of clouds, aerosols, solar elevation angle and bidirectional reflection, spatial or temporal deficiencies often exist in solar radiation datasets that are derived from satellite remote sensing, which can seriously affect the accuracy of application models of land-surface energy balance. The goal of reconstructing radiation data is to simulate the seasonal variation patterns of solar radiation, using various statistical and numerical analysis methods to interpolate the missing observations and optimize the whole time-series dataset. In the current study, a reconstruction method based on data assimilation is proposed. Using a Kalman filter as the assimilation algorithm, the retrieved radiation values are corrected through the continuous introduction of local in-situ global solar radiation (GSR provided by the China Meteorological Data Sharing Service System (Daily radiation dataset_Version 3 which were collected from 122 radiation data collection stations over China. A complete and optimal set of time-series data is ultimately obtained. This method is applied and verified in China’s northern agricultural areas (humid regions, semi-humid regions and semi-arid regions in a warm temperate zone. The results show that the mean value and standard deviation of the reconstructed solar radiation data series are significantly improved, with greater consistency with ground-based observations than the series before reconstruction. The method implemented in this study provides a new solution for the time-series reconstruction of surface energy parameters, which can provide more reliable data for scientific research and regional renewable-energy planning.

Is argon plasma coagulation an effective and safe treatment option for patients with chronic radiation proctitis after high doses of radiotherapy?

Directory of Open Access Journals (Sweden)

Eduardo Hortelano

Full Text Available Introduction: In severe cases refractory to medical treatment, APC appears to be the preferred alternative to control persistent rectal bleeding of patients with chronic radiation proctitis. Although successful outcomes have been demonstrated in patients previously treated with moderate doses of radiotherapy, there is reluctance towards its indication due to the concern of severe adverse events in patients treated with high doses of radiation. Objectives: The aim of this study was to assess the efficacy and toxicity of APC in the management of bleeding radiation-induced proctitis in patients treated with high doses of radiation for prostate cancer. Methods and materials: Data from 30 patients were treated with APC due to chronic radiation proctitis, were reviewed retrospectively. All cases had prostate cancer and 9 of them (30 % underwent previous radical prostatectomy. The median dose of conformal 3D External Beam Radiotherapy (EBRT delivered was 74 Gy (range 46-76. Median rectal D1cc and D2cc was 72.5 and 72.4 Gy respectively. Median rectal V70, V60 and V40 was 12, 39.5 and 80 %. Cardiovascular and digestive disease, diabetes, smoking behaviour, lowest haemoglobin and transfusion requirements were recorded. Indications for treatment with APC were anemia and persistent bleeding despite medical treatment. Argon gas flow was set at 1.8 l/min with an electrical power setting of 50 W. Results: Median age of all patients was 69.6 years. The median lowest haemoglobin level was 9.6 g/dL. Median time between completion of radiotherapy and first session of APC was 13 months. Ninety-four therapeutic sessions were performed (median 3 sessions. Median time follow-up was 14.5 months (range 2-61. Complete response with resolved rectal bleeding was achieved in 23 patients (77 %, partial response in 5 (16 % and no control in 2 (6 %. No patients required transfusion following therapy. Two patients developed long-term (> 6 weeks grade 2 rectal ulceration and

An introduction to radiation protection. Fourth edition

International Nuclear Information System (INIS)

Martin, A.; Harbison, S.A.

1996-01-01

This book is a comprehensive account of radiation hazards and their control. The presentation, which assumes no previous knowledge of the subject, is based on methods which the authors have found, over a number of years of teaching radiation protection at all levels, to be most easily understood by students. The book is intended to meet the requirements of a wide range of readers who are involved, either directly or indirectly, with ionizing radiation, including doctors, dentists, research workers, nuclear plant designers and operators. In particular the authors believe that the work is suitable for the health physics monitors and technicians who are concerned with the day-to-day control of radiation hazards in nuclear power stations, research establishments, hospitals and in industry. In the UK, the generally accepted standard of training in this type of work is that set by the City and Guilds of London Institute courses in Radiation Safety Practice which are held in various centers. The chapters of the book dealing with the general aspects of health physics are aimed a this standard. Later chapters dealing with particular aspects of the subject are more detailed. In the second half of the book there are individual chapters on the more specialized topics of nuclear reactor health physics, problems associated with X-rays and radiography, health physics in medicine, the disposal of radioactive waste and radiological emergencies. Chapters are also presented on legislation and on the organization of health physics

Counseling Patients Exposed to Ionizing Radiation in Diagnostic Radiology During Pregnancy

International Nuclear Information System (INIS)

Brnic, Z.; Leder, N.I.; Popic Ramac, J.; Vidjak, V.; Knezevic, Z.

2013-01-01

There are many false assumptions regarding influence of radiation on pregnant patients and fetus during diagnostic procedures in spite of scientific facts based on studies (both in general population and among physicians). These false assumptions are mostly based on the idea that every diagnostic procedure that uses ionizing radiation is a cause for serious concern and consideration for artificial abortion as a possible solution. We have analysed the data of counselling of pregnant patients exposed to ionizing radiation during diagnostic procedures in University Hospital Merkur, during a period of four years. In this period we had 26 patients come in counselling due to exposure to ionizing radiation during pregnancy. Results show that most of these patients have been exposed to radiation between 2nd and 3rd week of gestation (36 %), between 4th and 5th week - 32 %; before 2nd week - 24%; and after 6th week of gestation less than 8 %. Average doses were: up to 0.01 cGy in 46.2 % patients; 0.01 - 0.15 cGy in 19.2 % patients; 0.2 - 1 cGy in 26.9 % and 1 cGy or more in 7.7 % of patients. No one of the counselled patients had a medical indication for abortion, even though in a small percentage of patients abortion was a personal subjective decision. Considering that there are no Croatian guidelines for counselling patients exposed to ionizing radiation during pregnancy, recommendation is to use International Commission on Radiological Protection (ICRP) guidelines for management of pregnant patients exposed to ionizing radiation.(author)

The role of imaging in pediatric radiation oncology

International Nuclear Information System (INIS)

Stowe, S.M.

1985-01-01

The pediatric radiation oncologist is involved in treating a different spectrum of tumors that is generally seen by the adult radiation oncologist. More than one-third of pediatric patients with malignancies suffer from acute lymphocytic leukemia and lymphomas. Approximately one-quarter of the patients have primary tumors of the brain and central nervous system, while the remaining patients mostly present with mesenchymal sarcomas as opposed to the carcinomas more generally seen in adult practice. Pediatric tumors are frequently deep seated and therefore more difficult to evaluate by physical examination that the typical adult epithelial tumors. In the following sections, the various tumor types and locations are discussed with reference to the specific imaging requirements for each of the groups. This is preceded by a brief introduction to modern radiation oncology in order to clarify the role of these modalities

Predictors of Radiation Pneumonitis in Patients Receiving Intensity Modulated Radiation Therapy for Hodgkin and Non-Hodgkin Lymphoma

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Pinnix, Chelsea C., E-mail: ccpinnix@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Grace L.; Milgrom, Sarah; Osborne, Eleanor M.; Reddy, Jay P.; Akhtari, Mani; Reed, Valerie; Arzu, Isidora; Allen, Pamela K.; Wogan, Christine F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Fanale, Michele A.; Oki, Yasuhiro; Turturro, Francesco; Romaguera, Jorge; Fayad, Luis; Fowler, Nathan; Westin, Jason; Nastoupil, Loretta; Hagemeister, Fredrick B.; Rodriguez, M. Alma [Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); and others

2015-05-01

Purpose: Few studies to date have evaluated factors associated with the development of radiation pneumonitis (RP) in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), especially in patients treated with contemporary radiation techniques. These patients represent a unique group owing to the often large radiation target volumes within the mediastinum and to the potential to receive several lines of chemotherapy that add to pulmonary toxicity for relapsed or refractory disease. Our objective was to determine the incidence and clinical and dosimetric risk factors associated with RP in lymphoma patients treated with intensity modulated radiation therapy (IMRT) at a single institution. Methods and Materials: We retrospectively reviewed clinical charts and radiation records of 150 consecutive patients who received mediastinal IMRT for HL and NHL from 2009 through 2013. Clinical and dosimetric predictors associated with RP according to Radiation Therapy Oncology Group (RTOG) acute toxicity criteria were identified in univariate analysis using the Pearson χ{sup 2} test and logistic multivariate regression. Results: Mediastinal radiation was administered as consolidation therapy in 110 patients with newly diagnosed HL or NHL and in 40 patients with relapsed or refractory disease. The overall incidence of RP (RTOG grades 1-3) was 14% in the entire cohort. Risk of RP was increased for patients who received radiation for relapsed or refractory disease (25%) versus those who received consolidation therapy (10%, P=.019). Several dosimetric parameters predicted RP, including mean lung dose of >13.5 Gy, V{sub 20} of >30%, V{sub 15} of >35%, V{sub 10} of >40%, and V{sub 5} of >55%. The likelihood ratio χ{sup 2} value was highest for V{sub 5} >55% (χ{sup 2} = 19.37). Conclusions: In using IMRT to treat mediastinal lymphoma, all dosimetric parameters predicted RP, although small doses to large volumes of lung had the greatest influence. Patients with relapsed

Making Sense of the 'Chemical Revolution'. Patients' Voices on the Introduction of Neuroleptics in the 1950s.

Science.gov (United States)

Majerus, Benoît

2016-01-01

The so-called chemical revolution has produced a vast historiographical corpus. Yet the patient's voice remains surprisingly absent from these stories. Based on the archives of the Institut de Psychiatrie (Brussels), this paper traces the introduction of Largactil as recounted in patient letters, physician records and nurse notes. The paper thus contributes to the history of therapies from below, but also participates in the historiographical debate about whether the introduction of neuroleptics can indeed be considered a revolution.

Radiation therapy of gynecological cancer

International Nuclear Information System (INIS)

Nori, D.; Hilaris, B.S.

1987-01-01

This book consists of three parts: General Principles; Clinical Applications; and Special Topics. Some of the papers are: Introduction to Basic Radiobiology; Staging and Work-up Procedures for Patients with Gynecological Cancers; Radiation Therapy in the Treatment of Cancer of the Cervix; Role of Interstitial Implantation in Gynecological Cancer; Role of Radiocolloids in Gynecological Cancer; Radiosensitizers and Protectors; and Management of Lymphoma Associated with Pregnancy

Radiation treatment in older patients: a framework for clinical decision making.

Science.gov (United States)

Smith, Grace L; Smith, Benjamin D

2014-08-20

In older patients, radiation treatment plays a vital role in curative and palliative cancer therapy. Radiation treatment recommendations should be informed by a comprehensive, personalized risk-benefit assessment that evaluates treatment efficacy and toxicity. We review several clinical factors that distinctly affect efficacy and toxicity of radiation treatment in older patients. First, locoregional tumor behavior may be more indolent in older patients for some disease sites but more aggressive for other sites. Assessment of expected locoregional relapse risk informs the magnitude and timeframe of expected radiation treatment benefits. Second, assessment of the competing cancer versus noncancer mortality and morbidity risks contextualizes cancer treatment priorities holistically within patients' entire spectrum and time course of health needs. Third, assessment of functional reserve helps predict patients' acute treatment tolerance, differentiating those patients who are unlikely to benefit from treatment or who are at high risk for treatment complications. Potential radiation treatment options include immediate curative treatment, delayed curative treatment, and no treatment, with additional consideration given to altered radiation target, dose, or sequencing with chemotherapy and/or surgery. Finally, when cure is not feasible, palliative radiation therapy remains valuable for managing symptoms and achieving meaningful quality-of-life improvements. Our proposed decision-making framework integrates these factors to help radiation oncologists formulate strategic treatment recommendations within a multidisciplinary context. Future research is still needed to identify how advanced technologies can be judiciously applied in curative and palliative settings to enhance risk-benefit profiles of radiation treatment in older patients and more accurately quantify treatment efficacy in this group. © 2014 by American Society of Clinical Oncology.

Stereotactic body radiation therapy versus conventional radiation therapy in patients with early stage non-small cell lung cancer - An updated retrospective study on local failure and survival rates

International Nuclear Information System (INIS)

Jeppesen, Stefan S.; Schytte, Tine; Hansen, Olfred; Jensen, Henrik R.; Brink, Carsten

2013-01-01

Introduction: Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC) is now an accepted and patient friendly treatment, but still controversy exists about its comparability to conventional radiation therapy (RT). The purpose of this single-institutional report is to describe survival outcome for medically inoperable patients with early stage NSCLC treated with SBRT compared with high dose conventional RT. Material and methods: From August 2005 to June 2012, 100 medically inoperable patients were treated with SBRT at Odense Univ. Hospital. The thoracic RT consisted of 3 fractions (F) of 15-22 Gy delivered in nine days. For comparison a group of 32 medically inoperable patients treated with conventional RT with 80 Gy/35-40 F (5 F/week) in the period of July 1998 to August 2011 were analyzed. All tumors had histological or cytological proven NSCLC T1-2N0M0. Results: The median overall survival was 36.1 months versus 24.4 months for SBRT and conventional RT, respectively (p = 0.015). Local failure-free survival rates at one year were in SBRT group 93 % versus 89 % in the conventional RT group and at five years 69 % versus 66 %, SBRT and conventional RT respectively (p = 0.99). On multivariate analysis, female gender and performance status of 0-1 and SBRT predicted improved prognosis. Conclusion: In a cohort of patients with NSCLC there was a significant difference in overall survival favoring SBRT. Performance status of 0-1, female gender and SBRT predicted improved prognosis. However, staging procedure, confirmation procedure of recurrence and technical improvements of radiation treatment is likely to influence outcomes. However, SBRT seems to be as efficient as conventional RT and is a more convenient treatment for the patients

The impact of enteroclysis on patient's radiation doses

International Nuclear Information System (INIS)

Nikodemova, D.; Horvathova, M.; Prikaska, M.

2002-01-01

EU Directive 97/43 requires from Member States to ensure that appropriate quality assurance programmes are included together with quality control measures in the national legislation. On the basis of this Directive, as well as of the Basic Safety Standards although the New Act of Slovak National Council No.470/2000 Coll. improved the national system of acceptability of radiological examinations by implementation of Guidance Levels, system of education and necessity of introduction of Quality Assurance (QA) and Quality Control (QC) programmes in radiology departments. The knowledge of doses under practical conditions used for variety of diagnostic examinations, serves not only for verification of compliance with recommended guidance levels but also for stimulation of the awareness of medical staff to aspects of radiation protection of the patient, i.e. of variations in doses delivered to patients due to variations in technical conditions of the equipment used and the diagnostic procedures applied. About 14% off all radiological investigations undertaken in SR involve fluoroscopy. Because of the exposure parameters used in these examinations, particularly the screening time, they contribute a substantial proportion of the overall population dose from medical examinations. The objective of our study was to collect data on patient doses obtained during the conventional and digital fluoroscopy examinations of small intestine. In both cases the examinations were performed by the same radiologist, for excluding the individual variations in the used diagnostic methods. Two techniques for small intestine examinations were examined: the barium follow-through and enteroclysis. Our preliminary results are based on the dose-area product measurements and take into account all significant parameters influencing the irradiation dose observed during the two techniques used for diagnostic examinations

Evaluation of occupational and patient radiation doses in orthopedic surgery

International Nuclear Information System (INIS)

Sulieman, A.; Habiballah, B.; Abdelaziz, I.; Alzimami, K.; Osman, H.; Omer, H.; Sassi, S. A.

2014-08-01

Orthopedists are exposed to considerable radiation dose during orthopedic surgeries procedures. The staff is not well trained in radiation protection aspects and its related risks. In Sudan, regular monitoring services are not provided for all staff in radiology or interventional personnel. It is mandatory to measure staff and patient exposure in order to radiology departments. The main objectives of this study are: to measure the radiation dose to patients and staff during (i) Dynamic Hip Screw (Dhs) and (i i) Dynamic Cannula Screw (Dcs); to estimate the risk of the aforementioned procedures and to evaluate entrance surface dose (ESD) and organ dose to specific radiosensitive patients organs. The measurements were performed in Medical Corps Hospital, Sudan. The dose was measured for unprotected organs of staff and patient as well as scattering radiation. Calibrated Thermoluminescence dosimeters (TLD-Gr-200) of lithium fluoride (LiF:Mg, Cu,P) were used for ESD measurements. TLD signal are obtained using automatic TLD Reader model (Plc-3). The mean patients doses were 0.46 mGy and 0.07 for Dhs and Dcs procedures, respectively. The mean staff doses at the thyroid and chest were 4.69 mGy and 1.21 mGy per procedure. The mean radiation dose for staff was higher in Dhs compared to Dcs. This can be attributed to the long fluoroscopic exposures due to the complication of the procedures. Efforts should be made to reduce radiation exposure to orthopedic patients, and operating surgeons especially those with high work load. Staff training and regular monitoring will reduce the radiation dose for both patients and staff. (Author)

Evaluation of occupational and patient radiation doses in orthopedic surgery

Energy Technology Data Exchange (ETDEWEB)

Sulieman, A. [Salman bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P.O. Box 422, Alkharj (Saudi Arabia); Habiballah, B.; Abdelaziz, I. [Sudan Univesity of Science and Technology, College of Medical Radiologic Sciences, P.O. Box 1908, Khartoum (Sudan); Alzimami, K. [King Saud University, College of Applied Medical Sciences, Radiological Sciences Department, P.O. Box 10219, 11433 Riyadh (Saudi Arabia); Osman, H. [Taif University, College of Applied Medical Science, Radiology Department, Taif (Saudi Arabia); Omer, H. [University of Dammam, Faculty of Medicine, Dammam (Saudi Arabia); Sassi, S. A., E-mail: Abdelmoneim_a@yahoo.com [Prince Sultan Medical City, Department of Medical Physics, Riyadh (Saudi Arabia)

2014-08-15

Orthopedists are exposed to considerable radiation dose during orthopedic surgeries procedures. The staff is not well trained in radiation protection aspects and its related risks. In Sudan, regular monitoring services are not provided for all staff in radiology or interventional personnel. It is mandatory to measure staff and patient exposure in order to radiology departments. The main objectives of this study are: to measure the radiation dose to patients and staff during (i) Dynamic Hip Screw (Dhs) and (i i) Dynamic Cannula Screw (Dcs); to estimate the risk of the aforementioned procedures and to evaluate entrance surface dose (ESD) and organ dose to specific radiosensitive patients organs. The measurements were performed in Medical Corps Hospital, Sudan. The dose was measured for unprotected organs of staff and patient as well as scattering radiation. Calibrated Thermoluminescence dosimeters (TLD-Gr-200) of lithium fluoride (LiF:Mg, Cu,P) were used for ESD measurements. TLD signal are obtained using automatic TLD Reader model (Plc-3). The mean patients doses were 0.46 mGy and 0.07 for Dhs and Dcs procedures, respectively. The mean staff doses at the thyroid and chest were 4.69 mGy and 1.21 mGy per procedure. The mean radiation dose for staff was higher in Dhs compared to Dcs. This can be attributed to the long fluoroscopic exposures due to the complication of the procedures. Efforts should be made to reduce radiation exposure to orthopedic patients, and operating surgeons especially those with high work load. Staff training and regular monitoring will reduce the radiation dose for both patients and staff. (Author)

A study of radiation-induced cerebral vascular injury in nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis.

Directory of Open Access Journals (Sweden)

Jianhong Ye

Full Text Available To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC patients.Fifty eight NPC patients with radiation-induced temporal lobe necrosis (TLN were recruited in the study. Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT and occurrence of plaque formation. Flow velocities of bilateral middle cerebral arteries (MCAs, internal carotid arteries (ICAs and basal artery (BA were estimated through Transcranial Color Doppler (TCD. The results were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals.Significant differences in IMT, occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after radiotherapy and healthy individuals (p<0.05. IMT had positive correlation with post radiation interval (p = 0.049. Compared with results from patients without radiation-induced TLN, the mean IMT was significantly thicker in patients with TLN (p<0.001. Plaques were more common in patients with TLN than patients without TLN (p = 0.038. In addition, flow velocities of MCAs and ICAs in patients with TLN were much faster (p<0.001, p<0.001. Among patients with unilateral TLN, flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (p = 0.001.Thickening of IMT, occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy, especially in those with TLN, compared with healthy individuals.

Care of the patient receiving radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Yasko, J.M.

1982-12-01

External radiation therapy, or teletherapy, is the use of ionizing radiation to destroy cancer cells. Clinical use of ionizing radiation as treatment for cancer began with the discovery of x-rays in 1895, the identification of natural radioactivity (radium) in 1896, and the first reported cure of cancer, a basal cell epithelioma, induced by radiation in 1899. Initially, radiation was administered as a single large dose and produced severe, life-threatening side effects. The basis for the use of ionizing radiation in daily increments for a period of weeks was provided by Regaud in 1922; ten years later, Coutard clinically developed the method of dose fractionation, which remains in use today. Although the use of ionizing radiation as a treatment is over eighty years old, only in recent years have advancements in its clinical application been based on research related to the biologic effect of radiation on human cells. To effectively care for the patient prior to, during, and at the completion of external radiation therapy, the nurse must know the physical and biologic basis of external radiation therapy and its clinical application.

Care of the patient receiving radiation therapy

International Nuclear Information System (INIS)

Yasko, J.M.

1982-01-01

External radiation therapy, or teletherapy, is the use of ionizing radiation to destroy cancer cells. Clinical use of ionizing radiation as treatment for cancer began with the discovery of x-rays in 1895, the identification of natural radioactivity (radium) in 1896, and the first reported cure of cancer, a basal cell epithelioma, induced by radiation in 1899. Initially, radiation was administered as a single large dose and produced severe, life-threatening side effects. The basis for the use of ionizing radiation in daily increments for a period of weeks was provided by Regaud in 1922; ten years later, Coutard clinically developed the method of dose fractionation, which remains in use today. Although the use of ionizing radiation as a treatment is over eighty years old, only in recent years have advancements in its clinical application been based on research related to the biologic effect of radiation on human cells. To effectively care for the patient prior to, during, and at the completion of external radiation therapy, the nurse must know the physical and biologic basis of external radiation therapy and its clinical application

[Diagnostic imaging and radiation hazards].

Science.gov (United States)

Claudon, Michel; Guillaume, Luc

2015-01-01

For the last 20 years, the exposure of the population to medical radiation has been increased by 600%, mainly due to the extension of new imaging modalities such as CT or interventional radiology. The risk for radio-induced hazards is especially marked for children, because of the high sensivity of tissues to radiation especially during the first decade of the life. Two main ways allow to better control and reduce the mean effective dose per patient in diagnostic imaging: the introduction of recent technical improvement (i.e. low dose CT scans using iterative reconstruction algorithms, low dose technique for pediatric spine), and the substitution to non-radiating techniques such as ultrasound and MRI. The French National institute of Radioprotection and Nuclear Safety periodically publishes dose reference levels for conventional films and CT examinations, for both adults and pediatric patients. A close relationship between clinicians and radiologists remains essential for a better appreciation of the risk/benefit ratio of each individual examination using X-Rays.

Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study.

Directory of Open Access Journals (Sweden)

Bryan A Loy

Full Text Available Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011 and after (2013 the payment method introduction using relative risks (RR. After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05. For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008 from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20. These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study.

Science.gov (United States)

Loy, Bryan A; Shkedy, Clive I; Powell, Adam C; Happe, Laura E; Royalty, Julie A; Miao, Michael T; Smith, Gary L; Long, James W; Gupta, Amit K

2016-01-01

Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05). For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008) from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20). These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

Controlling radiation exposure during interventional procedures in childhood cancer patients

International Nuclear Information System (INIS)

Racadio, John M.

2009-01-01

Many pediatric cancer patients undergo multiple diagnostic and therapeutic radiologic procedures over the course of their illnesses and are therefore at high risk for radiation exposure. There are a variety of measures that radiologists can employ to reduce this risk. These include limiting the use of radiation whenever possible, using specific strategies to reduce radiation exposure during interventional procedures, using quality assurance programs to ensure compliance, and maintaining continuing staff radiation safety educational programs. Some of the diagnostic and therapeutic interventional radiologic procedures that are performed in pediatric oncology patients are discussed here, along with specific tips for managing radiation exposure. (orig.)

Radiation-induced ocular motor cranial nerve palsies in patients with pituitary tumor.

Science.gov (United States)

Vaphiades, Michael S; Spencer, Sharon A; Riley, Kristen; Francis, Courtney; Deitz, Luke; Kline, Lanning B

2011-09-01

Radiation therapy is often used in the treatment of pituitary tumor. Diplopia due to radiation damage to the ocular motor cranial nerves has been infrequently reported as a complication in this clinical setting. Retrospective case series of 6 patients (3 men and 3 women) with pituitary adenoma, all of whom developed diplopia following transsphenoidal resection of pituitary adenoma with subsequent radiation therapy. None had evidence of tumor involvement of the cavernous sinus. Five patients developed sixth nerve palsies, 3 unilateral and 2 bilateral, and in 1 patient, a sixth nerve palsy was preceded by a fourth cranial nerve palsy. One patient developed third nerve palsy. Five of the 6 patients had a growth hormone-secreting pituitary tumor with acromegaly. Following transsphenoidal surgery in all 6 patients (2 had 2 surgeries), 4 had 2 radiation treatments consisting of either radiosurgery (2 patients) or external beam radiation followed by radiosurgery (2 patients). Patients with pituitary tumors treated multiple times with various forms of radiation therapy are at risk to sustain ocular motor cranial nerve injury. The prevalence of acromegalic patients in this study reflects an aggressive attempt to salvage patients with recalcitrant growth hormone elevation and may place the patient at a greater risk for ocular motor cranial nerve damage.

Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

International Nuclear Information System (INIS)

Liu Hui; Zhang Xu; Vinogradskiy, Yevgeniy Y.; Swisher, Stephen G.; Komaki, Ritsuko; Chang, Joe Y.

2012-01-01

Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T 10 and mean lung dose (MLD) of the previous plan and the V 10 -V 40 and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 ≤65% before SABR (P=.012), V 20 ≥30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 ≤65%, a previous PTV spanning the bilateral mediastinum, and V 20 ≥30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

Introduction of helical computed tomography affects patient selection for V/Q lung scan

International Nuclear Information System (INIS)

Zettinig, G.; Baudrexel, S.; Leitha, Th.

2002-01-01

Aim: Retrospective analysis for determination of the effect of helical computed tomography (HCT) on utilization of V/Q lung scanning to diagnose pulmonary embolism (PE) in a large general hospital. Methods: A total number of 2676 V/Q scans of in- and out-patients referred to our department between March 1992 and December 1998 and between April 1997 and December 1998 were analyzed by an identical group of nuclear physicians. Results: Neither the total number of annually performed V/Q scans (446 ± 135) nor the mean age of patients (56 years ± 17) changed significantly since the introduction of HCT. However, the referral pattern was different. The percentage of patients with high and intermediate probability for PE decreased significantly from 15.2% to 9.4% (p <0.01) and from 10.2% to 7.3% (p <0.05), respectively. Low probability scans significantly increased from 37.8% to 42.7% (p <0.05). The percentage of normal scans did not change significantly, however, there was a highly significant increase summarizing patients with normal and low probability scans (74.6% to 83.3%; p <0.01). Conclusion: The introduction of HCT affected the selection of patients referred for V/Q lung scanning since V/Q scanning was primarily used to exclude rather to confirm PE. (orig.)

Reduction of radiation exposure for patient and examiner in interventional angiography

International Nuclear Information System (INIS)

Pecher, G.; Pecher, S.; Gosch, D.; Schulz, H.G.; Koenig, H.; Voigt, P.

1998-01-01

Purpose: In a retrospective analysis of vascular interventional procedures, relations between parameters of the examination and radiation exposure of patient and medical personnel are examined. Material and Method: 1208 vascular interventional procedures are evaluated. Interventional procedures are divided into three groups: Percutaneous transluminal angioplasty, implantation of a stent, thrombolysis. Results: Mean values of the radiation dose of patient and radiology personnel are reported for these examinations. The mean value of the radiation dose of the physician was 7 μSv (maximum 24 μSv), that of the patient 1548 cGy.cm 2 (maximum 8485 cGy.cm 2 ). Conclusion: The quantity of X-rays to the patient may be lowered by using pulsed fluoroscopy and by reducing the number of radiographs. Reduction of the number of radiographs may be achieved by using the last-image hold and the road mapping mode. The operator's dose can be decreased by using additional radiation protection systems like a MAVIG trademark -radiation protection wall. The radiation dose reduction was 61% for the physician and 17% for the patient. (orig.) [de

Radiation myelopathy in over-irradiated patients: MR imaging findings

International Nuclear Information System (INIS)

Alfonso, E.R.; Gregorio, M.A. de; Mateo, P.; Esco, R.; Bascon, N.; Morales, F.; Bellosta, R.; Lopez, P.; Gimeno, M.; Roca, M.; Villavieja, J.L.

1997-01-01

The objective of this work is to report the MRI findings in patients with radiation myelopathy due to accidental local over-irradiation syndrome. Eight patients (seven males and one female) were suffering from over-irradiation syndrome as a result of treatments from a malfunctioning linear electron accelerator. The mean accidental estimated dose was 136 Gy delivered to the ''open-neck'' (seven cases) and to the thoracic wall (one case), during a mean of 5.4 sessions (range 1-9 sessions). Paresthesia and weakness in the upper extremities were the earliest symptoms (87.5 %), with evolution to paralysis in all patients. No patient is alive (mean survival time 64 days). In all cases MRI was negative for neurologic lesions in the acute phase (< 90 days from irradiation; Radiation Therapy Oncology Group scoring system). Late signs of radiation myelitis manifested as high-intensity signals on T2-weighted images in three patients, and as Gd-DTPA enhancement of T1-weighted images in one case. Autopsies performed on four patients who died in acute phase showed morphologic alterations in white matter: edema in 75 %, and necrosis and glial reaction as well as obliterative vasculitis in all cases. In cases of over-irradiation, MRI may be normal in acute phase even if the patients have severe neurologic deficit, as positive MRI findings appear only in delayed radiation myelitis. (orig.). With 3 figs., 2 tabs

Radiation myelopathy in over-irradiated patients: MR imaging findings

Energy Technology Data Exchange (ETDEWEB)

Alfonso, E.R. [Radiology Service, Hospital Clinico Universitario, Zaragoza (Spain); Gregorio, M.A. de [Radiology Service, Hospital Clinico Universitario, Zaragoza (Spain); Mateo, P. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Esco, R. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Bascon, N. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Morales, F. [Neurology Service, Hospital Clinico Universitario, Zaragoza (Spain); Bellosta, R. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Lopez, P. [Radiation Oncology Service, Hospital Clinico Universitario, Zaragoza (Spain); Gimeno, M. [Hospital Miguel Servet, Zaragoza (Spain); Roca, M. [Radiology Service, Hospital Miguel Servet, E-50 009 Zaragoza (Spain); Villavieja, J.L. [Radiology Service, Hospital Clinico Universitario, Zaragoza (Spain)

1997-04-01

The objective of this work is to report the MRI findings in patients with radiation myelopathy due to accidental local over-irradiation syndrome. Eight patients (seven males and one female) were suffering from over-irradiation syndrome as a result of treatments from a malfunctioning linear electron accelerator. The mean accidental estimated dose was 136 Gy delivered to the ``open-neck`` (seven cases) and to the thoracic wall (one case), during a mean of 5.4 sessions (range 1-9 sessions). Paresthesia and weakness in the upper extremities were the earliest symptoms (87.5 %), with evolution to paralysis in all patients. No patient is alive (mean survival time 64 days). In all cases MRI was negative for neurologic lesions in the acute phase (< 90 days from irradiation; Radiation Therapy Oncology Group scoring system). Late signs of radiation myelitis manifested as high-intensity signals on T2-weighted images in three patients, and as Gd-DTPA enhancement of T1-weighted images in one case. Autopsies performed on four patients who died in acute phase showed morphologic alterations in white matter: edema in 75 %, and necrosis and glial reaction as well as obliterative vasculitis in all cases. In cases of over-irradiation, MRI may be normal in acute phase even if the patients have severe neurologic deficit, as positive MRI findings appear only in delayed radiation myelitis. (orig.). With 3 figs., 2 tabs.

Radiation therapy in elderly patients

International Nuclear Information System (INIS)

Durdux, C.; Boisserie, T.; Gisselbrecht, M.

2009-01-01

Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most powerful treatment against cancer. Most of published studies have demonstrated feasibility of radiotherapy in curative or palliative intent whatever cancer types are considered. Complete geriatric assessment and a multidisciplinary approach are the key points. The purpose of this review is to highlight sights of radiation oncology specifically related to aging. Particular emphasis is placed on logistic and technical aspects of radiation, as dose, irradiated volume and fractionation. (authors)

Radiation risks for patients having X rays

International Nuclear Information System (INIS)

Hale, J.; Thomas, J.W.

1985-01-01

In addition to radiation from naturally occurring radioactive materials and cosmic rays, individuals in developed countries receive radiation doses to bone marrow and gonads from the medical diagnostic use of X rays. A brief discussion of radiation epidemiology shows that deleterious effects are low even when doses are high. The concept of acceptable risk is introduced to help evaluate the small, but still existent, risks of radiation dose. Examples of bone marrow and gonadal doses for representative X-ray examinations are presented along with the current best estimates, per unit of X-ray dose, of the induction of leukemia or of genetic harm. The risk to the patient from an examination can then be compared with the normal risk of mortality from leukemia or of the occurrence of genetic defects. The risk increase is found to be very low. The risks to unborn children from radiographic examinations are also discussed. The benefit to the patient from information obtained from the examination must be balanced against the small risks

Radiation therapy for cancer in elderly patients over 80 years of age

International Nuclear Information System (INIS)

Nozaki, Miwako; Murakami, Yuko; Furuta, Masaya; Izawa, Yasuyuki; Iwasaki, Naoya

1998-01-01

The elderly population has recently increased, and the need for cancer care and treatment for the elderly is likely to grow. We report on radiation therapy for cancer in elderly patients over 80 years of age. During the period from 1985 to 1996, 90 elderly patients (54 men, 36 women) aged over 80 years were treated with radiation therapy. Many patients had primary tumors of the esophagus, head and neck, and lungs, in that order of frequency. Fifty-seven percent of the patients were treated with radical radiotherapy, and 70% were treated with radiotherapy alone. The rate of completion of radiation therapy was 90%, and the response rate was 82%. Radiation therapy played an important role in the treatment of the patients over 80 years of age. The half of our patients had concurrent medical problems, and were dependent on their home physicians both before and after radiation therapy. We consider that radiation oncologists should make an effort to form a good relationship with home physicians. (author)

Determinants of Patient Satisfaction During Receipt of Radiation Therapy

International Nuclear Information System (INIS)

Famiglietti, Robin M.; Neal, Emily C.; Edwards, Timothy J.; Allen, Pamela K.; Buchholz, Thomas A.

2013-01-01

Purpose: To evaluate the correlations and relative contributions of components of a radiation oncology-specific patient satisfaction survey to their overall satisfaction scores. Methods and Materials: From September 2006 through August 2012, we prospectively collected data from 8069 patients receiving radiation treatments with a 26-question survey. Each question was rated on a 10-point Likert scale. We analyzed the correlation between scores for each question and the overall satisfaction question. We also dichotomized the scores to reflect satisfaction versus dissatisfaction and used logistic regression to assess the relationship between items in 4 domains (the patient–provider relationship, access and environmental issues, wait times, and educational information) and overall satisfaction. Results: Scores on all questions correlated with overall patient satisfaction scores (P 2 =0.4219), followed by wait times (R 2 =0.4000), access/environment (R 2 =0.3837), and patient education (R 2 =0.3700). The specific variables with the greatest effect on patient satisfaction were the care provided by radiation therapists (odds ratio 1.91) and pain management (odds ratio 1.29). Conclusions: We found that patients' judgment of provider relationships in an outpatient radiation oncology setting were the greatest contributors to their overall satisfaction ratings. Other measures typically associated with patient satisfaction (phone access, scheduling, and ease of the check-in process) correlated less strongly with overall satisfaction. These findings may be useful for other practices preparing to assess patient ratings of quality of care

Radiation therapy for endometrial cancer in patients treated for postoperative recurrence

International Nuclear Information System (INIS)

Hart, Kimberly B.; Han, Ihn; Shamsa, Falah; Court, Wayne S.; Chuba, Paul; Deppe, Gunter; Malone, John; Christensen, Carl; Porter, Arthur T.

1998-01-01

Purpose: To retrospectively evaluate the outcome and risk factors in patients treated with radiation for endometrial cancer at time of recurrence. Materials and Methods: Three hundred ninety-nine women were treated with radiation therapy for endometrial cancer at KCI/WSU from January 1980 to December 1994. Of these, 26 patients treated primarily with surgery received radiation therapy at the time of recurrence. Median time to recurrence after surgery was 8 months, with all recurrences occurring within 24 months. Twenty-four patients had recurrences in the vaginal cuff, vagina, or pelvis. These patients received external-beam radiation to the pelvis (45.00-50.40 Gy) and periaortic lymph nodes (45.00-50.00 Gy), along with a boost given by external-beam radiation or brachytherapy (16.00-30.00 Gy). Mean follow-up was 15 months (range 1-85 months). Results: The 2-year survival was 50% and median survival was 16 months (survival range 1-85 months). Of 26 patients, 54% (14) failed locally following radiation therapy. Factors indicative of poor survival included histology (sarcoma, poorly differentiated adenocarcinoma), grade, and lymph node positivity. Histological differentiation influenced local control; lymphovascular space invasion was of borderline significance with regard to local control. Conclusion: Local control and survival for surgically treated endometrial cancer patients who receive radiation at the time of recurrence are poor, with the exception of those patients with recurrent disease limited to the vagina. Early detection of recurrence may improve outcome. Pathologic risk factors may identify those patients at risk for extrapelvic recurrence. Alternative treatment modalities need to be developed for this high-risk group of patients

Exposure of ionizing radiation to non-radiation workers from nuclear medicine patients

International Nuclear Information System (INIS)

Janssen, J.; Smart, R.C.; McKay, E.

1999-01-01

Full text: Occasionally, patients are required to have several tests in one day. They may be injected with radio-isotopes in the morning, have other investigations during the absorption period and then return to nuclear medicine for imaging later in the day. Recently, the NSW Department of Health issued a circular concerning exposure to sonographers from ionizing radiation emitted from nuclear medicine patients. The object of this study is to establish a model of emissions from nuclear medicine patients and to measure the exposure to other health workers who may be in close contact with these patients. Dose rate measurements were acquired for patients injected with 99 Tc m and 67 Ga for the following studies: heart, thyroid, lung, bone, biliary and lymphoma. Measurements were taken at 10 cm increments to 1 m and at time intervals of 0,1,2 and 24 h post-injection. In addition, 5 sonographers were issued with TLDs to be worn on the waist and fingers for a period of 3 months. The dose limit for a non-radiation worker is 1000 μSv (ICRP 60). The external dose rate measurements indicate that, assuming a sonographer is seated approximately 30 cm from a patient injected with 800 MBq 99 Tc m -HDP for a bone scan, 1 h post-injection, the sonographer would receive a dose of 11 μSv for a 30 min ultrasound scan. In practice, only 4 nuclear medicine patients were scanned in the ultrasound department during the 5 week monitoring period and the sonographers' TLDs recorded no radiation dose. In conclusion, the average exposure to sonographers from nuclear medicine patients is well within the limits recommended by the ICRP. However, in accordance with the ALARA principle where practicable, any ultrasound examination should be performed prior to nuclear medicine studies

Radiation and your patient: A guide for medical practitioners

International Nuclear Information System (INIS)

Valentin, Jack; )

2002-01-01

This didactic text is devoted to patients' protection against unnecessary exposure to ionizing radiation. There are obvious benefits to health from medical uses of radiation, i.e. in X-ray diagnostics, in interventional radiology, nuclear medicine and radiotherapy. However, there are well-established risks from improperly applied high doses of radiation (therapy, interventional radiology) and possible deleterious effects from small radiation doses used in diagnostics). Appropriate use of large doses prevents serious harm from therapy, but low doses carry a risk that cannot be entirely eliminated. Diagnostic use of radiation requires therefore such methodology that would secure high diagnostic gains while limiting the possible harm to the lowest possible level. The text provides ample information on opportunities to minimize the doses, and therefore the risk from diagnostic uses of radiation. This objective may be reached by avoiding unnecessary (unjustified) examinations, and optimizing the applied procedures both from the standpoint of diagnostic quality and of reduction of the excessive doses to patients. Optimization of patient protection in radiotherapy must depend on maintaining sufficiently high doses to irradiated tumours, securing a high cure rate, while protecting the healthy tissues to the largest extent possible. Problems related to special protection of human embryo and foetus in course of diagnostic and therapeutic uses of radiation are presented and respective practical solutions are recommended

Introduction to radiological physics and radiation dosimetry

CERN Document Server

Attix, Frank Herbert

2004-01-01

A straightforward presentation of the broad concepts underlying radiological physics and radiation dosimetry for the graduate-level student. Covers photon and neutron attenuation, radiation and charged particle equilibrium, interactions of photons and charged particles with matter, radiotherapy dosimetry, as well as photographic, calorimetric, chemical, and thermoluminescence dosimetry. Includes many new derivations, such as Kramers X-ray spectrum, as well as topics that have not been thoroughly analyzed in other texts, such as broad-beam attenuation and geometrics, and the reciprocity theorem

Survey of Michigan dentists and radiation oncologists on oral care of patients undergoing head and neck radiation therapy.

Science.gov (United States)

Patel, Yoshita; Bahlhorn, Hannah; Zafar, Saniya; Zwetchkenbaum, Samuel; Eisbruch, Avraham; Murdoch-Kinch, Carol Anne

2012-07-01

Oral complications of radiation therapy for head and neck cancer (HNC) are associated with a significant decline in oral health-related quality of life (OHQOL). The dentist, working with the radiation oncologist and the rest of the health care team, plays an important role in the prevention and management of these complications, but patients do not always receive care consistent with current guidelines. This study investigated barriers to recommended care. There is variability in knowledge and practice among dentists and radiation oncologists regarding the dental management of patients treated with head and neck radiotherapy (HNRT), and inadequate communication and collaboration between members of the patient's health care team contribute to inconsistencies in application of clinical care guidelines. There is on interest and need for continuing dental (CDE) and medical education (CME) on this topic. A questionnaire was developed to assess dentists' knowledge and practice of dental management of HNC patients and their interest in CDE on this topic. All members of the Michigan Dental Association (MDA) with email addresses were asked to complete the survey online, and a random sample of MDA members without email addresses was invited to complete a paper version of the same survey. All Michigan members of the American Society for Radiation Oncology (ASTRO) were invited to complete an online version of the survey modified for radiation oncologists. The response rate for dentists was 47.9% and radiation oncologists was 22.3%. Of the dentists who responded, 81% reported that a major barrier to providing dental treatment before radiotherapy was a lack of time between initial dental consultation and the start of radiation; inadequate communication between health care providers was blamed most frequently for this. Ten percent of the dentists and 25% of the radiation oncologists reported that they did not treat HNC patients because they lacked adequate training, and 55% of

Sexuality in gynecological patients undergoing radiation therapy treatments

International Nuclear Information System (INIS)

Dolan, M.E.

1987-01-01

The gynecology patient undergoing radiation therapy treatments may experience physiological and psychological problems related to sexuality. The needs of this group must be met by the radiation oncology staff by their being informed, interested, and experienced in dealing with sexual problems created by radiation therapy treatments. Opportunities to obtain information and for discussion about how the disease and its treatments will affect sexual functioning must be provided for the patient and partner. It is important to remember that the ability to seek and preserve gratifying sexual function is of great importance to almost all women, regardless of age. The patient may feel much personal distress related to the disease, the treatments, and how they affect the way she feels as a sexual human being. Opportunities must be provided to share the feelings created by the treatment process and trained therapists should be available when intensive sexual counseling is needed

An introduction to medical physics

CERN Document Server

2017-01-01

This book begins with the basic terms and definitions and takes a student, step by step, through all areas of medical physics. The book covers radiation therapy, diagnostic radiology, dosimetry, radiation shielding, and nuclear medicine, all at a level suitable for undergraduates. This title not only describes the basics concepts of the field, but also emphasizes numerical and mathematical problems and examples.Students will find An Introduction to Medical Physics to be an indispensible resource in preparations for further graduate studies in the field.

Radiation exposure in the young level 1 trauma patient: a retrospective review.

Science.gov (United States)

Gottschalk, Michael B; Bellaire, Laura L; Moore, Thomas

2015-01-01

Computed tomography (CT) has become an increasingly popular and powerful tool for clinicians managing trauma patients with life-threatening injuries, but the ramifications of increasing radiation burden on individual patients are not insignificant. This study examines a continuous series of 337 patients less than 40 years old admitted to a level 1 trauma center during a 4-month period. Primary outcome measures included number of scans; effective dose of radiation from radiographs and CT scans, respectively; and total effective dose from both sources over patients' hospital stays. Several variables, including hospital length of stay, initial Glasgow Coma Scale score, and Injury Severity Score, correlated with greater radiation exposure. Blunt trauma victims were more prone to higher doses than those with penetrating or combined penetrating and blunt trauma. Location and mechanism of injury were also found to correlate with radiation exposure. Trauma patients as a group are exposed to high levels of radiation from X-rays and CT scans, and CT scans contribute a very high proportion (91.3% ± 11.7%) of that radiation. Certain subgroups of patients are at a particularly high risk of exposure, and greater attention to cumulative radiation dose should be paid to patients with the above mentioned risk factors.

Patient radiation exposure and dose tracking: a perspective.

Science.gov (United States)

Rehani, Madan M

2017-07-01

Much of the emphasis on radiation protection about 2 decades ago accrued from the need for protection of radiation workers and collective doses to populations from medical exposures. With the realization that individual patient doses were rising and becoming an issue, the author had propagated the concept of a smart card for radiation exposure history of individual patients. During the last 7 years, much has happened wherein radiation exposure and the dose history of individual patients has become a reality in many countries. In addition to dealing with overarching questions, such as "Why track, what to track, and how to track?," this review elaborates on a number of points such as attitudes toward tracking, review of practices in large parts of the world, description of various elements for exposure and dose tracking, how to use the information available from tracking, achievements and stumbling blocks in implementation to date, templates for implementation of tracking at different levels of health care, the role of picture archiving and communication systems and eHealth, the role of tracking in justification and optimization of protection, comments on cumulative dose, how referrers can use this information, current provisions in international standards, and future actions.

Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

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Rong, X.; Tang, Y.; Lu, K.; Peng, Y. [Sun Yat-sen Memorial Hospital, Guangzhou (China). Dept. of Neurology; Chen, M. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Nasopharyngeal Carcinoma

2012-03-15

The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

International Nuclear Information System (INIS)

Rong, X.; Tang, Y.; Lu, K.; Peng, Y.; Chen, M.

2012-01-01

The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

Health physics limitations for radiation protection of patients and medical staff

International Nuclear Information System (INIS)

Golikov, V.Ya.; Ermolina, E.P.

1997-01-01

Norm-setting documents regulating the requirements to radiation safety during medical x-ray and radiological procedures are reviewed. Besides the Federal Law On Radiation Safety of the Population and Radiation Safety Norms-96, the authors comment on the norm-setting documents issued later and supplementing the above documents. The authors emphasize the obligatory licensing during medical use of ionizing radiation sources. Effective dose is introduced as the criterion of radiation safety of the patients and staff during prophylactic x-ray examinations. Principles of normsetting, validation, and optimization of medical exposures and criteria of radiation safety of patients are discussed

Radiation hazards

International Nuclear Information System (INIS)

Rausch, L.

1979-01-01

On a scientific basis and with the aid of realistic examples, the author gives a popular introduction to an understanding and judgment of the public discussion over radiation hazards: Uses and hazards of X-ray examinations, biological radiation effects, civilisation risks in comparison, origins and explanation of radiation protection regulations. (orig.) [de

Dental extractions in relation to radiation therapy of 224 patients

International Nuclear Information System (INIS)

Makkonen, T.A.; Kiminki, A.; Makkonen, T.K.; Nordman, E.

1987-01-01

The case histories of 224 patients treated with radiation therapy for head and neck malignancies at the Radiotherapy Clinic of the Univesity Central Hospital in Turku during the years 1974-77 are reviewed. Of the 92 patients surviving for 5 years, 90 were available for re-examination. The median radiation dosage was 61 Gy in 6 to 8 weeks in patients with squamous cell carcinoma and othe solid tumours and 43 Gy in 5 weeks in patients with lymphoma. The oral status of the patients was examined clinically and radiographically. From these pationts 45 teeth had been extracted before irradiation and 94 after irradiation. In no case had this resulted in osteoradionecrosis of the jaws. It is evident that the repairing of patient's teeth before radiation treatment, coupled with continuous preventive care of caries, will prevent serious complications from arising. (author)

Radiation-induced changes in taste acuity in cancer patients

International Nuclear Information System (INIS)

Mossman, K.L.; Henkin, R.I.

1978-01-01

Changes in taste acuity were measured in 27 patients with various forms of cancer who received radiation to the head and neck region. In 9 of these patients (group I), measurements of taste acuity were made more than 1 year after completion of radiation therapy. In the other 18 patients (group II), taste measurements were made before, during, and approximately 1 month after radiation therapy. Taste acuity was measured for four taste qualities (salt, sweet, sour, and bitter) by a forced choice-three stimulus drop technique which measured detection and recognition thresholds and by a forced scaling technique which measured taste intensity responsiveness. In group II patients, impaired acuity, as indicated by elevated detection and recognition thresholds, was observed approximately 3 weeks after initiation of radiotherapy. The bitter and salt qualities showed the earliest and greatest impairment and the sweet quality the least. Taste intensity responsiveness also was impaired in group II patients. As for thresholds, scaling impairment was most severe for bitter and salt taste qualities. Scaling impairment occurred before changes in either detection or recognition thresholds. Detection and recognition thresholds determined in group I patients also showed salt and bitter qualities were affected more severely than either sweet or sour qualities. Zinc administration to group I patients in an uncontrolled study suggested that zinc therapy may be useful in ameliorating taste impairment in some patients. These results suggest that taste loss may be a factor in the anorexia and weight loss that is observed commonly in patients who have undergone radiation treatment. Correction of this abnormality may be useful in aiding the nutritional status of these patients

Radiation oncology: An Irish hospitals approach to supporting patients

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Miller, Caragh [Cork University Hospital (Ireland)], E-mail: caragh.miller@tcd.ie

2009-02-15

Despite advances in medical technology, cancer is still one of the leading causes of death globally, leaving many patients to deal with the emotional and psychological aspects associated with cancer and its treatment [Department of Health and Children. A strategy for cancer control in Ireland. National Cancer Forum. Dublin; 2006]. The recognition and management of psychological conditions are an integral part of comprehensive cancer care. As a result, the Health Services Executive as part of the continuing expansion of Cork Radiation Oncology Department created the role of Information and Support Radiation Therapist. This post was specially created during June 2005 to facilitate the smooth entry into the treatment for patients and family members experiencing radiotherapy for the first time. Working alongside the oncology nurses and other health professionals the Information and Support Radiation Therapist aims to provide vital education/information and support to patients and their families. The provision of this new service for patients enables departments to adopt a holistic approach to treatment. This research identifies the cancer services and psychological support services in Ireland. Up-to-date audits of the new patient services established in the Cork Radiation Oncology Department and their psychological contribution towards cancer development and treatment are also discussed.

Radiation oncology: An Irish hospitals approach to supporting patients

International Nuclear Information System (INIS)

Miller, Caragh

2009-01-01

Despite advances in medical technology, cancer is still one of the leading causes of death globally, leaving many patients to deal with the emotional and psychological aspects associated with cancer and its treatment [Department of Health and Children. A strategy for cancer control in Ireland. National Cancer Forum. Dublin; 2006]. The recognition and management of psychological conditions are an integral part of comprehensive cancer care. As a result, the Health Services Executive as part of the continuing expansion of Cork Radiation Oncology Department created the role of Information and Support Radiation Therapist. This post was specially created during June 2005 to facilitate the smooth entry into the treatment for patients and family members experiencing radiotherapy for the first time. Working alongside the oncology nurses and other health professionals the Information and Support Radiation Therapist aims to provide vital education/information and support to patients and their families. The provision of this new service for patients enables departments to adopt a holistic approach to treatment. This research identifies the cancer services and psychological support services in Ireland. Up-to-date audits of the new patient services established in the Cork Radiation Oncology Department and their psychological contribution towards cancer development and treatment are also discussed

A study of smart card for radiation exposure history of patient.

Science.gov (United States)

Rehani, Madan M; Kushi, Joseph F

2013-04-01

The purpose of this article is to undertake a study on developing a prototype of a smart card that, when swiped in a system with access to the radiation exposure monitoring server, will locate the patient's radiation exposure history from that institution or set of associated institutions to which it has database access. Like the ATM or credit card, the card acts as a secure unique "token" rather than having cash, credit, or dose data on the card. The system provides the requested radiation history report, which then can be printed or sent by e-mail to the patient. The prototype system is capable of extending outreach to wherever the radiation exposure monitoring server extends, at county, state, or national levels. It is anticipated that the prototype shall pave the way for quick availability of patient exposure history for use in clinical practice for strengthening radiation protection of patients.

Determinants of Patient Satisfaction During Receipt of Radiation Therapy

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Famiglietti, Robin M., E-mail: rfamigli@mdanderson.org; Neal, Emily C.; Edwards, Timothy J.; Allen, Pamela K.; Buchholz, Thomas A.

2013-09-01

Purpose: To evaluate the correlations and relative contributions of components of a radiation oncology-specific patient satisfaction survey to their overall satisfaction scores. Methods and Materials: From September 2006 through August 2012, we prospectively collected data from 8069 patients receiving radiation treatments with a 26-question survey. Each question was rated on a 10-point Likert scale. We analyzed the correlation between scores for each question and the overall satisfaction question. We also dichotomized the scores to reflect satisfaction versus dissatisfaction and used logistic regression to assess the relationship between items in 4 domains (the patient–provider relationship, access and environmental issues, wait times, and educational information) and overall satisfaction. Results: Scores on all questions correlated with overall patient satisfaction scores (P<.0001). Satisfaction with patient–provider relationships had the greatest influence on overall satisfaction (R{sup 2}=0.4219), followed by wait times (R{sup 2}=0.4000), access/environment (R{sup 2}=0.3837), and patient education (R{sup 2}=0.3700). The specific variables with the greatest effect on patient satisfaction were the care provided by radiation therapists (odds ratio 1.91) and pain management (odds ratio 1.29). Conclusions: We found that patients' judgment of provider relationships in an outpatient radiation oncology setting were the greatest contributors to their overall satisfaction ratings. Other measures typically associated with patient satisfaction (phone access, scheduling, and ease of the check-in process) correlated less strongly with overall satisfaction. These findings may be useful for other practices preparing to assess patient ratings of quality of care.

Radiation risk index for pediatric CT. A patient-derived metric

International Nuclear Information System (INIS)

Samei, Ehsan; Tian, Xiaoyu; Paul Segars, W.; Frush, Donald P.

2017-01-01

There is a benefit in characterizing radiation-induced cancer risk in pediatric chest and abdominopelvic CT: a singular metric that represents the whole-body radiation burden while also accounting for age, gender and organ sensitivity. To compute an index of radiation risk for pediatric chest and abdominopelvic CT. Using a protocol approved by our institutional review board, 42 pediatric patients (age: 0-16 years, weight: 2-80 kg) were modeled into virtual whole-body anatomical models. Organ doses were estimated for clinical chest and abdominopelvic CT examinations of the patients using validated Monte Carlo simulations of two major scanner models. Using age-, size- and gender-specific organ risk coefficients, the values were converted to normalized effective dose (by dose length product) (denoted as the k factor) and a normalized risk index (denoted as the q factor). An analysis was performed to determine how these factors are correlated with patient age and size for both males and females to provide a strategy to better characterize individualized risk. The k factor was found to be exponentially correlated with the average patient diameter. For both genders, the q factor also exhibited an exponential relationship with both the average patient diameter and with patient age. For both factors, the differences between the scanner models were less than 8%. The study defines a whole-body radiation risk index for chest and abdominopelvic CT imaging, that incorporates individual estimated organ dose values, organ radiation sensitivity, patient size, exposure age and patient gender. This indexing metrology enables the assessment and potential improvement of chest and abdominopelvic CT performance through surveillance of practice dose profiles across patients and may afford improved informed communication. (orig.)

Radiation risk index for pediatric CT. A patient-derived metric

Energy Technology Data Exchange (ETDEWEB)

Samei, Ehsan [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Duke University Medical Center, Department of Biomedical Engineering, Electrical and Computer Engineering, Durham, NC (United States); Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Tian, Xiaoyu [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Paul Segars, W. [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Frush, Donald P. [Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Duke University Medical Center, Division of Pediatric Radiology, Department of Radiology, Durham, NC (United States)

2017-12-15

There is a benefit in characterizing radiation-induced cancer risk in pediatric chest and abdominopelvic CT: a singular metric that represents the whole-body radiation burden while also accounting for age, gender and organ sensitivity. To compute an index of radiation risk for pediatric chest and abdominopelvic CT. Using a protocol approved by our institutional review board, 42 pediatric patients (age: 0-16 years, weight: 2-80 kg) were modeled into virtual whole-body anatomical models. Organ doses were estimated for clinical chest and abdominopelvic CT examinations of the patients using validated Monte Carlo simulations of two major scanner models. Using age-, size- and gender-specific organ risk coefficients, the values were converted to normalized effective dose (by dose length product) (denoted as the k factor) and a normalized risk index (denoted as the q factor). An analysis was performed to determine how these factors are correlated with patient age and size for both males and females to provide a strategy to better characterize individualized risk. The k factor was found to be exponentially correlated with the average patient diameter. For both genders, the q factor also exhibited an exponential relationship with both the average patient diameter and with patient age. For both factors, the differences between the scanner models were less than 8%. The study defines a whole-body radiation risk index for chest and abdominopelvic CT imaging, that incorporates individual estimated organ dose values, organ radiation sensitivity, patient size, exposure age and patient gender. This indexing metrology enables the assessment and potential improvement of chest and abdominopelvic CT performance through surveillance of practice dose profiles across patients and may afford improved informed communication. (orig.)

Acupuncture treatment of patients with radiation-induced xerostomia

International Nuclear Information System (INIS)

Blom, M.; Dawidson, I.; Johnson, G.; Angmar-Maansson, B.; Fernberg, J.-O.

1996-01-01

Xerostomia is a common and usually irreversible side effect in patients receiving radiation therapy (>50 Gy) for head and neck cancer. Of 38 patients with radiation-induced xerostomia, 20 in the experimental group were treated with classical acupuncture and 18 patients in the control group received superficial acupuncture as placebo. Within both groups the patients showed significantly increased salivary flow rates after the acupuncture treatment. In the experimental group 68% and in the control group 50% of the patients had increased salivary flow rates at the end of the observation period. Among those patients who had had all their salivary glands irradiated, 50% in both groups showed increased salivary flow rates (>20%) by the end of the observation period of 1 year. The study indicates that among the patients who had increased salivary flow rates already after the first 12 acupuncture sessions, the majority had high probability of continual improvement after the completion of acupuncture treatment. (Author)

Acupuncture treatment of patients with radiation-induced xerostomia

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Blom, M.; Dawidson, I.; Johnson, G.; Angmar-Maansson, B. [Karolinska Inst., Huddinge (Sweden). Dept. of Cardiology; Fernberg, J.-O. [Karolinska Hospital, Stockholm (Sweden). Dept. of General Oncology

1996-05-01

Xerostomia is a common and usually irreversible side effect in patients receiving radiation therapy (>50 Gy) for head and neck cancer. Of 38 patients with radiation-induced xerostomia, 20 in the experimental group were treated with classical acupuncture and 18 patients in the control group received superficial acupuncture as placebo. Within both groups the patients showed significantly increased salivary flow rates after the acupuncture treatment. In the experimental group 68% and in the control group 50% of the patients had increased salivary flow rates at the end of the observation period. Among those patients who had had all their salivary glands irradiated, 50% in both groups showed increased salivary flow rates (>20%) by the end of the observation period of 1 year. The study indicates that among the patients who had increased salivary flow rates already after the first 12 acupuncture sessions, the majority had high probability of continual improvement after the completion of acupuncture treatment. (Author).

Radiation pneumonitis in a patient exposed to asbestos

International Nuclear Information System (INIS)

Ashford, R.F.U.; Maher, J.; Drury, A.; Pickering, D.

1981-01-01

A case report is presented of a 58 year old man who had for many years run an asbestos importing and fibreizing plant. He developed radiation pneumonitis following radiotherapy to a squamous cell carcinoma of the middle 3rd of the oesophagus. Detailed lung studies at autopsy revealed asbestos bodies associated with macrophages in many alveoli and areas of subpleural fibrosis typical of asbestos exposure. This was the most florid case of radiation seen in the Westminster Hospital for some years and the first seen in patients treated for carcinoma of the oesophagus using a three field technique. It is suggested that when planning radiotherapy to an asbestos-exposed patient, a possible increase in lung sensitivity to radiation should be considered when planning dosage. (U.K.)

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

International Nuclear Information System (INIS)

Aizer, Ayal A.; Chen, Ming-Hui; Parekh, Arti; Choueiri, Toni K.; Hoffman, Karen E.; Kim, Simon P.; Martin, Neil E.; Hu, Jim C.; Trinh, Quoc-Dien; Nguyen, Paul L.

2014-01-01

Purpose: Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. Methods and Materials: We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. Results: In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Conclusions: Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

Energy Technology Data Exchange (ETDEWEB)

Aizer, Ayal A., E-mail: aaaizer@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Parekh, Arti [Boston University School of Medicine, Boston, Massachusetts (United States); Choueiri, Toni K. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kim, Simon P. [Department of Urology, Mayo Clinic, Rochester, Minnesota (United States); Martin, Neil E. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Hu, Jim C. [Department of Urology, University of California, Los Angeles, California (United States); Trinh, Quoc-Dien [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec (Canada); Nguyen, Paul L. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States)

2014-07-15

Purpose: Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. Methods and Materials: We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. Results: In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Conclusions: Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life

Incidence of Second Malignancies Among Patients Treated With Proton Versus Photon Radiation

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Chung, Christine S., E-mail: chungc1@sutterhealth.org [Department of Radiation Oncology, Alta Bates Summit Medical Center, Berkeley, California (United States); Yock, Torunn I. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Nelson, Kerrie [Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts (United States); Xu, Yang [Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (United States); Keating, Nancy L. [Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (United States); Department of General Internal Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Tarbell, Nancy J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Office of the Executive Dean, Harvard Medical School, Boston, Massachusetts (United States)

2013-09-01

Purpose: Proton radiation, when compared with photon radiation, allows delivery of increased radiation dose to the tumor while decreasing dose to adjacent critical structures. Given the recent expansion of proton facilities in the United States, the long-term sequelae of proton therapy should be carefully assessed. The objective of this study was to compare the incidence of second cancers in patients treated with proton radiation with a population-based cohort of matched patients treated with photon radiation. Methods and Materials: We performed a retrospective cohort study of 558 patients treated with proton radiation from 1973 to 2001 at the Harvard Cyclotron in Cambridge, MA and 558 matched patients treated with photon therapy in the Surveillance, Epidemiology, and End Results (SEER) Program cancer registry. Patients were matched by age at radiation treatment, sex, year of treatment, cancer histology, and site. The main outcome measure was the incidence of second malignancies after radiation. Results: We matched 558 proton patients with 558 photon patients from the Surveillance, Epidemiology, and End Results registry. The median duration of follow-up was 6.7 years (interquartile range, 7.4) and 6.0 years (interquartile range, 9.3) in the proton and photon cohorts, respectively. The median age at treatment was 59 years in each cohort. Second malignancies occurred in 29 proton patients (5.2%) and 42 photon patients (7.5%). After we adjusted for sex, age at treatment, primary site, and year of diagnosis, proton therapy was not associated with an increased risk of second malignancy (adjusted hazard ratio, 0.52 [95% confidence interval, 0.32-0.85]; P=.009). Conclusions: The use of proton radiation therapy was not associated with a significantly increased risk of secondary malignancies compared with photon therapy. Longer follow-up of these patients is needed to determine if there is a significant decrease in second malignancies. Given the limitations of the study

Incidence of Second Malignancies Among Patients Treated With Proton Versus Photon Radiation

International Nuclear Information System (INIS)

Chung, Christine S.; Yock, Torunn I.; Nelson, Kerrie; Xu, Yang; Keating, Nancy L.; Tarbell, Nancy J.

2013-01-01

Purpose: Proton radiation, when compared with photon radiation, allows delivery of increased radiation dose to the tumor while decreasing dose to adjacent critical structures. Given the recent expansion of proton facilities in the United States, the long-term sequelae of proton therapy should be carefully assessed. The objective of this study was to compare the incidence of second cancers in patients treated with proton radiation with a population-based cohort of matched patients treated with photon radiation. Methods and Materials: We performed a retrospective cohort study of 558 patients treated with proton radiation from 1973 to 2001 at the Harvard Cyclotron in Cambridge, MA and 558 matched patients treated with photon therapy in the Surveillance, Epidemiology, and End Results (SEER) Program cancer registry. Patients were matched by age at radiation treatment, sex, year of treatment, cancer histology, and site. The main outcome measure was the incidence of second malignancies after radiation. Results: We matched 558 proton patients with 558 photon patients from the Surveillance, Epidemiology, and End Results registry. The median duration of follow-up was 6.7 years (interquartile range, 7.4) and 6.0 years (interquartile range, 9.3) in the proton and photon cohorts, respectively. The median age at treatment was 59 years in each cohort. Second malignancies occurred in 29 proton patients (5.2%) and 42 photon patients (7.5%). After we adjusted for sex, age at treatment, primary site, and year of diagnosis, proton therapy was not associated with an increased risk of second malignancy (adjusted hazard ratio, 0.52 [95% confidence interval, 0.32-0.85]; P=.009). Conclusions: The use of proton radiation therapy was not associated with a significantly increased risk of secondary malignancies compared with photon therapy. Longer follow-up of these patients is needed to determine if there is a significant decrease in second malignancies. Given the limitations of the study

Refusal of curative radiation therapy and surgery among patients with cancer.

Science.gov (United States)

Aizer, Ayal A; Chen, Ming-Hui; Parekh, Arti; Choueiri, Toni K; Hoffman, Karen E; Kim, Simon P; Martin, Neil E; Hu, Jim C; Trinh, Quoc-Dien; Nguyen, Paul L

2014-07-15

Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (PRefusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; Prefuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life-saving care. Copyright © 2014 Elsevier Inc. All rights reserved.

KERMA-based radiation dose management system for real-time patient dose measurement

Science.gov (United States)

Kim, Kyo-Tae; Heo, Ye-Ji; Oh, Kyung-Min; Nam, Sang-Hee; Kang, Sang-Sik; Park, Ji-Koon; Song, Yong-Keun; Park, Sung-Kwang

2016-07-01

Because systems that reduce radiation exposure during diagnostic procedures must be developed, significant time and financial resources have been invested in constructing radiation dose management systems. In the present study, the characteristics of an existing ionization-based system were compared to those of a system based on the kinetic energy released per unit mass (KERMA). Furthermore, the feasibility of using the KERMA-based system for patient radiation dose management was verified. The ionization-based system corrected the effects resulting from radiation parameter perturbations in general radiography whereas the KERMA-based system did not. Because of this difference, the KERMA-based radiation dose management system might overestimate the patient's radiation dose due to changes in the radiation conditions. Therefore, if a correction factor describing the correlation between the systems is applied to resolve this issue, then a radiation dose management system can be developed that will enable real-time measurement of the patient's radiation exposure and acquisition of diagnostic images.

Radiation ulcers in patients with cancer of the torgue after 252Cf therapy

International Nuclear Information System (INIS)

Galantseva, G.F.; Guseva, L.I.; Plichko, V.I.

1984-01-01

Interstitial therapy with 252 Cf was conducted for 57 patients with cancer of the tongue. It was established that clinical course of radiation tungue ulcers after interstitial therapy with 252 Cf doesn't differ sufficiently from the course of radiation injuries, occurring after γ-radiation application. Radiation ulcers are often observed in patients after the treatment of recurrent and residual tumors with 252 Cf (in 33% of patients); the ulcers appeared in 15% of cases in patients after the treatment of initial ulcers tumors. Conservative treatment provide the cure of radiation tongUe ulcers after interstitial therapy with 252 Cf

Analytical signals from cancer patients following radiation treatment

International Nuclear Information System (INIS)

Wielopolski, L.; Meek, A.G.; Reinstein, L.E.

1986-01-01

Cancer patients are treated with high energy (8 to 30 MeV) gamma radiation. This treatment modality provides better depth dose distribution than more conventional low-energy gamma treatments, in particular for deeply located tumors. A by-product of the high-energy treatment is gamma-induced activity in the treatment volume following photonuclear reactions. These reactions are endogenic and require that the gamma radiation energy be above threshold value in order for the reaction to take place. For most elements, the threshold value is above 8 MeV; however, for low Z elements, this threshold may reach 18 MeV as is the case for oxygen. The cross sections for the (γ, n) reactions are few millibarns for low Z elements and increases up to few hundreds of millibarns for the heavy elements. The radionuclides resulting from photonuclear reaction are typically positron emitter or decay by electron capture. Thus, it is possible to monitor either the annihilation radiation (511 KeV) or the characteristic gamma radiation. The present work demonstrates that the activity induced in cancer patients following a single treatment (300 rad) enables the monitoring of nitrogen and phosphorus in the irradiated volume. The results from measurements in phantom, cadavers, and cancer patients from different regions in the body are presented. The hypothesis to be tested is whether there are local changes in these two elements during the course of radiation treatment which might correlate with the efficacy of the treatment

Radiation protection of the patient during medical uses of ionizing radiation in the GDR

International Nuclear Information System (INIS)

Arndt, D.

1987-01-01

Section 18 of the new Radiation Protection Ordinance of the GDR defines basic principles for the radiation protection of patients undergoing diagnostic examinations or treatments with ionizing radiation, including, for example, the requirements that necessary exposures should be justifiable in terms of the benefit to be expected and that doses administered should be limited to as low an amount as possible. An outline is given of these principles, their importance and enforcement. (author)

Radiation exposure around patients after 201Tl-myocardial scintigraphy

International Nuclear Information System (INIS)

Kurtaran, A.; Preitfellner, J.; Kohoutek, D.; Tousek, A.; Virgolini, I.; Havlik, E.

1997-01-01

Aim: It was the aim of the study to assess the additional radiation exposure to patients, attendents and nurses by patients who are undergoing nuclear medicine investigations (myocardial scintigraphy) with 201 Tl-chloride ( 201 Tl-Cl). Methode: In 16 cases the dose rates at 0.5, 1 and 2 m distance from patients were measured at 0.5, 1.5, 3-4 and 24, in some cases until 370 h after administration of 100±10 MBq 201 Tl-Cl. From the time courses of the dose rates around the patients the possible radiation exposure of other persons were estimated. Results: The initial values of the dose rate were 3.82 μSv/h at 0.5 m, 1.18 μSv/h at 1 m and 0.30 μSv/h at 2 m distance from the patients respectively. The dose rates were decreasing following a monoexponential course with an effective half-life of 60 h. The maximum doses to other persons at 1 m distance from the patients were determined by considering three scenarios. The values were 13 μSv in the waiting room, 26 μSv for nurses working in the ward and 105 μSv for persons living in the same household. Conclusion: Even at very restrictive assumptions the doses were far below the maximum permissible dose to non-radiation workers set by radiation protection regulations (1.5 mSv per year). (orig.) [de

Differential gene expression before and after ionizing radiation of subcutaneous fibroblasts identifies breast cancer patients resistant to radiation-induced fibrosis

DEFF Research Database (Denmark)

Alsner, Jan; Rødningen, Olaug K.; Overgaard, Jens

2007-01-01

BACKGROUND AND PURPOSE: Differentially gene expression between patients with either very low or very high risk of radiation-induced fibrosis (RIF) in patient-derived fibroblasts after irradiation has previously been reported. In the present study, we are investigating the robustness of radiation...... and changes in radiation-induced gene expression in fibroblasts. MATERIAL AND METHODS: Gene expression was analysed by quantitative real-time PCR before and after a fractionated scheme with 3x3.5Gy/3 days in fibroblasts derived from 26 patients with breast cancer treated with post-mastectomy radiotherapy....... RESULTS: Robust radiation-induced changes in gene expression were observed, with differential gene expression between low and high risk patients being most pronounced for the fold induction level ('after' value divided by 'before' value for each patient). When including patients with intermediate risk...

Patient radiation exposure during different kyphoplasty techniques.

Science.gov (United States)

Panizza, Denis; Barbieri, Massimo; Parisoli, Francesco; Moro, Luca

2014-01-01

The scope of this study was to quantify patient radiation exposure during two different techniques of kyphoplasty (KP), which differ by a cement delivery method, in order to assess whether or not one of the two used methods can reduce the patient dose. Twenty patients were examined for this investigation. One X-ray fluoroscopy unit was used for localization, navigation and monitoring of cement delivery. The patient biometric data, the setting of the fluoroscope, the exposure time and the kerma-area product (KAP) were monitored in all the procedures for anteroposterior (AP) and lateral (LL) fluoroscopic projections in order to assess the range of radiation doses imparted to the patient. Theoretical entrance skin dose (ESD) and effective dose (E) were calculated from intraoperatively measured KAP. An average ET per procedure was 1.5±0.5 min for the manual injection technique (study A) and 1.4±0.4 min for the distance delivery technique (study B) in the AP plane, while 3.2±0.7 and 5.1±0.6 min in the lateral plane, respectively. ESD was estimated as an average of 0.10±0.06 Gy for study A and 0.13±0.13 Gy for study B in the AP or/and 0.59±0.46 and 1.05±0.36 Gy in the lateral view, respectively. The cumulative mean E was 1.9±1.0 mSv procedure(-1) for study A and 3.6±0.9 mSv procedure(-1) for study B. Patient radiation exposure and associated effective dose from KP may be considerable. The technique of distance cement delivery appears to be slower than the manual injection technique and it requires a more protracted fluoroscopic control in the lateral projection, so that this system entails a higher amount of dose to the patient.

Patients radiation protection in medical imaging. Conference proceedings

International Nuclear Information System (INIS)

2011-12-01

This document brings together the available presentations given at the conference organised by the French society of radiation protection about patients radiation protection in medical imaging. Twelve presentations (slides) are compiled in this document and deal with: 1 - Medical exposure of the French population: methodology and results (Bernard Aubert, IRSN); 2 - What indicators for the medical exposure? (Cecile Etard, IRSN); 3 - Guidebook of correct usage of medical imaging examination (Philippe Grenier, Pitie-Salpetriere hospital); 4 - Radiation protection optimization in pediatric imaging (Hubert Ducou-Le-Pointe, Aurelien Bouette (Armand-Trousseau children hospital); 5 - Children's exposure to image scanners: epidemiological survey (Marie-Odile Bernier, IRSN); 6 - Management of patient's irradiation: from image quality to good practice (Thierry Solaire, General Electric); 7 - Dose optimization in radiology (Cecile Salvat (Lariboisiere hospital); 8 - Cancer detection in the breast cancer planned screening program - 2004-2009 era (Agnes Rogel, InVS); 9 - Mammographic exposures - radiobiological effects - radio-induced DNA damages (Catherine Colin, Lyon Sud hospital); 10 - Breast cancer screening program - importance of non-irradiating techniques (Anne Tardivon, Institut Curie); 11 - Radiation protection justification for the medical imaging of patients over the age of 50 (Michel Bourguignon, ASN); 12 - Search for a molecular imprint for the discrimination between radio-induced and sporadic tumors (Sylvie Chevillard, CEA)

Radiation Protection in Medical Physics : Proceedings of the NATO Advanced Study Institute on Radiation Protection in Medical Physics Activities

CERN Document Server

Lemoigne, Yves

2011-01-01

This book introduces the fundamental aspects of Radiation Protection in Medical Physics and covers three main themes: General Radiation Protection Principles; Radiobiology Principles; Radiation Protection in Hospital Medical Physics. Each of these topics is developed by analysing the underlying physics principles and their implementation, quality and safety aspects, clinical performance and recent advances in the field. Some issues specific to the individual techniques are also treated, e.g. calculation of patient dose as well as that of workers in hospital, optimisation of equipment used, shielding design of radiation facilities, radiation in oncology such as use of brachytherapy in gynecology or interventional procedures. All topics are presented with didactical language and style, making this book an appropriate reference for students and professionals seeking a comprehensive introduction to the field as well as a reliable overview of the most recent developments.

Patient dosimetry in intravascular radiation therapy

International Nuclear Information System (INIS)

Putte, S. van de; Thierens, H.; Taeymans, Y.

2001-01-01

Percutaneous transluminal coronary angioplasty is a well-accepted method for nonsurgical myocardial revascularization. However, the long-term success of this method is limited by the occurrence of restenosis. Endovascular brachytherapy has been put forward as a means to avoid restenosis. Since this technique involves the placement of a radioactive source in a catheter in the patient's arteries, the possible radiation risk should be considered. In this paper the effective dose of the patient associated with the use of Iridium-192 for IRT treatment has been calculated using Monte Carlo techniques. To put the results into perspective the effective dose form the PTCA procedure was also calculated using the same techniques. Calculations were based on the measurement of DAP (Dose Area Product) for the procedure. We found a mean effective dose of 9 mSv for both the PTCA procedures as for the IRT treatment. Thus leading to the conclusion that, from the perspective of radiation burden, the elimination of one PTCA procedure through the use of IRT is a benefit for the patient. (author)

Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

Science.gov (United States)

Wang, Chu

Patients undergoing cardiac catheterization are potentially at risk of radiation-induced health effects from the interventional fluoroscopic X-ray imaging used throughout the clinical procedure. The amount of radiation exposure is highly dependent on the complexity of the procedure and the level of optimization in imaging parameters applied by the clinician. For cardiac catheterization, patient radiation dosimetry, for key organs as well as whole-body effective, is challenging due to the lack of fixed imaging protocols, unlike other common X-ray based imaging modalities. Pediatric patients are at a greater risk compared to adults due to their greater cellular radio-sensitivities as well as longer remaining life-expectancy following the radiation exposure. In terms of radiation dosimetry, they are often more challenging due to greater variation in body size, which often triggers a wider range of imaging parameters in modern imaging systems with automatic dose rate modulation. The overall objective of this dissertation was to develop a comprehensive method of radiation dose estimation for pediatric patients undergoing cardiac catheterization. In this dissertation, the research is divided into two main parts: the Physics Component and the Clinical Component. A proof-of-principle study focused on two patient age groups (Newborn and Five-year-old), one popular biplane imaging system, and the clinical practice of two pediatric cardiologists at one large academic medical center. The Physics Component includes experiments relevant to the physical measurement of patient organ dose using high-sensitivity MOSFET dosimeters placed in anthropomorphic pediatric phantoms. First, the three-dimensional angular dependence of MOSFET detectors in scatter medium under fluoroscopic irradiation was characterized. A custom-made spherical scatter phantom was used to measure response variations in three-dimensional angular orientations. The results were to be used as angular dependence

Oral care of the cancer patient receiving radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Holtzhausen, T [Medical Univ. of Southern Africa, Pretoria (South Africa). Dept. of Community Dentistry

1982-07-01

Radiation therapy is frequently being used for the patient with oral cancer. The survival rate is increasing, due to more effective treatment technique. The question of whether any teeth should be extracted, the mode of therapy and the side effects of radiation like Xerostomia, caries, stomatitis, trismus and osteo-radionecrosis and also post radiation care are discussed.

Radiation Protection and Dosimetry An Introduction to Health Physics

CERN Document Server

Stabin, Michael G

2007-01-01

This comprehensive text provides an overview of all relevant topics in the field of radiation protection (health physics). Radiation Protection and Dosimetry serves as an essential handbook for practicing health physics professionals, and is also ideal as a teaching text for courses at the university level. The book is organized to introduce the reader to basic principles of radiation decay and interactions, to review current knowledge and historical aspects of the biological effects of radiation, and to cover important operational topics such as radiation shielding and dosimetry. In addition to presenting the most up to date treatment of the topics and references to the literature, most chapters contain numerical problems with their solutions for use in teaching or self assessment. One chapter is devoted to Environmental Health Physics, which was written in collaboration with leading professionals in the area.

Radiation induced chromosomal instability in lymphocytes of cancer patients

International Nuclear Information System (INIS)

Sudo, H.; Sagara, M.; Ban, S.; Noda, S.; Iwakawa, M.; Harada, Y.; Imai, T.; Cologne, J.B.

2003-01-01

Full text: Cytokinesis-blocked micronucleus (CBMN) assay has been extensively used to evaluate the radiation sensitivity of human individuals. Using the CBMN assay, Scott et al (1998, 1999) demonstrated that a fraction of radiosensitive individuals in breast cancer case population was larger than in normal individual population. However, Vral et al were very skeptical about the Scott et al's findings (2002). Under the approval from the ethical committee of NIRS, peripheral blood was obtained from 46 normal healthy females, 131 breast cancer patients, 32 cervical cancer patients and 7 female head and neck cancer patients. Radiosensitivity of T-lymphocytes was assessed by using a CBMN assay. The frequencies of MN per binucleated cell in healthy donors were 0.031(±0.010) and 0.151(±0.066) for cells treated before and after X-ray-irradiation (2Gy), respectively. Spontaneous MN frequencies in cancer patients were significantly higher than healthy donors (p < 0.001). Radiation sensitivities of breast- and head and neck-cancer patients were significantly higher than normal individuals (p < 0.001). Cervical cancer patients were more resistant to irradiation than healthy donors, though the number of cases for statistical analysis was small. (p < 0.001). We are considering that the HPV infection affected the radiosensitivity of cervical cancer cases. Because it is widely believed that one key mechanism which leads to spontaneous micronucleus formation involves an imbalance of chromosomal segregation and a chromosomal instability in patients' lymphocytes might be greater than that in normal individuals' lymphocytes. Recently, Kuschel et al (2002) demonstrated that ratios in two SNPs on XRCC3 were significantly different between cancer patients and healthy females. Then, we can suppose that the radiation-related genes with low penetrance may be involved in tumorigenesis of mammary- and head and neck-cells, and also, in patients' radiation susceptibility

Central Nervous System Disease, Education, and Race Impact Radiation Refusal in Pediatric Cancer Patients.

Science.gov (United States)

Patel, Chirayu G; Stavas, Mark; Perkins, Stephanie; Shinohara, Eric T

2017-07-01

To investigate the determinants of radiation therapy refusal in pediatric cancer, we used the Surveillance, Epidemiology, and End Results registry to identify 24,421 patients who met the eligibility criteria, diagnosed between 1974 and 2012. Patients had any stage of cancer, were aged 0 to 19, and received radiation therapy or refused radiation therapy when it was recommended. One hundred twenty-eight patients (0.52%) refused radiation therapy when it was recommended. Thirty-two percent of patients who refused radiation therapy ultimately died from their cancer, at a median of 7 months after diagnosis (95% confidence interval, 3-11 mo), as compared with 29.0% of patients who did not refuse radiation therapy died from their cancer, at a median of 17 months after diagnosis (95% confidence interval, 17-18 mo). On multivariable analysis, central nervous system (CNS) site, education, and race were associated with radiation refusal. The odds ratio for radiation refusal for patients with CNS disease was 1.62 (P=0.009) as compared with patients without CNS disease. For patients living in a county with ≥10% residents having less than ninth grade education, the odds ratio for radiation refusal was 1.71 (P=0.008) as compared with patients living in a county with education. Asian, Pacific Islander, Alaska Native, and American Indian races had an odds ratio of 2.12 (P=0.002) for radiation refusal as compared with black or white race. Although the radiation refusal rate in the pediatric cancer population is low, we show that CNS site, education level, and race are associated with a significant difference in radiation refusal.

Oncology Patient Perceptions of the Use of Ionizing Radiation in Diagnostic Imaging.

Science.gov (United States)

Steele, Joseph R; Jones, Aaron K; Clarke, Ryan K; Giordano, Sharon H; Shoemaker, Stowe

2016-07-01

To measure the knowledge of oncology patients regarding use and potential risks of ionizing radiation in diagnostic imaging. A 30-question survey was developed and e-mailed to 48,736 randomly selected patients who had undergone a diagnostic imaging study at a comprehensive cancer center between November 1, 2013 and January 31, 2014. The survey was designed to measure patients' knowledge about use of ionizing radiation in diagnostic imaging and attitudes about radiation. Nonresponse bias was quantified by sending an abbreviated survey to patients who did not respond to the original survey. Of the 48,736 individuals who were sent the initial survey, 9,098 (18.7%) opened it, and 5,462 (11.2%) completed it. A total of 21.7% of respondents reported knowing the definition of ionizing radiation; 35.1% stated correctly that CT used ionizing radiation; and 29.4% stated incorrectly that MRI used ionizing radiation. Many respondents did not understand risks from exposure to diagnostic doses of ionizing radiation: Of 3,139 respondents who believed that an abdominopelvic CT scan carried risk, 1,283 (40.9%) believed sterility was a risk; 669 (21.3%) believed heritable mutations were a risk; 657 (20.9%) believed acute radiation sickness was a risk; and 135 (4.3%) believed cataracts were a risk. Most patients and caregivers do not possess basic knowledge regarding the use of ionizing radiation in oncologic diagnostic imaging. To ensure health literacy and high-quality patient decision making, efforts to educate patients and caregivers should be increased. Such education might begin with information about effects that are not risks of diagnostic imaging. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Introduction to radiation protection practical knowledge for handling radioactive sources

CERN Document Server

Grupen, Claus

2010-01-01

The book presents an accessible account of the sources of ionising radiation and the methods of radiation protection. The basics of nuclear physics which are directly related to radiation protection are briefly discussed. The book describes the units of radiation protection, the measurement techniques, biological effects of radiation, environmental radiation, and many applications of radiation. For each chapter there is a problem section with full solutions. A detailed glossary and many useful information in appendixes complete the book. The author has addressed the issue of internationality to make sure that the text and, in particular, the complicated regulations can be easily interpreted not only in Europe and the United States but also in other countries. The subject of radiation protection requires a certain amount of mathematics. For those who have forgotten the basic rules of calculus a short refresher course in the form of a mathematical appendix is added.

Radiation exposure in diagnostic medicine

International Nuclear Information System (INIS)

Haehnel, S.; Michalczak, H.; Reinoehl-Kompa, S.

1995-01-01

This volume includes the manuscripts of the papers read at the conference as well as a summary and assessment of its results. The scientific discussions were centred upon the following issues: - International surveys and comparisons of rdiation exposures in diagnostic radiology and nuclear medicine, frequency of the individual diagnostic procedures and age distribution of patients examined; - policies and regulations for the radiation protection of patients, charcteristic dosimetric values and practical usefulness of the effective dose concept during medical examinations; - assessments of the relative benefits and risks and measures to reduce the radiation exposure in the light of quality assurance aspects. The main objective of this conference not only was to evaluate the risks from diagnostic radiology and nuclear medicine but also to encourgage a critical analysis and adjustment of examination routines followed in everyday practice. Among the measures recommended were quality assurance, maintenace of international standards, development of guidelines, introduction of standard doses, improved training and professional education of personnel as well as surveys and analyses of certain examination procedures associated with substantial radiation exposure. (orig./MG) [de

Radiation dose to the patient in radionuclide studies

International Nuclear Information System (INIS)

Roedler, H.D.

1981-01-01

In medical radionuclide studies, the radiation risk has to be considered in addition to the general risk of administering a pharmaceutical. As radiation exposure is an essential factor in radiation risk estimation, some aspects of internal dose calculation, including radiation risk assessments, are treated. The formalism of current internal dose calculation is presented. The input data, especially the residence time and the absorbed dose per transformation, their origin and accuracy are discussed. Results of internal dose calculations for the ten most frequently used radionuclide studies are presented as somatically effective dose equivalents. The accuracy of internal dose calculation is treated in detail by considering the biokinetics of the radiopharmaceutical, the phantoms used for dose calculations, the absorbed dose per transformation, the administered activity, and the transfer of the dose, calculated for a phantom, to the patient. The internal dose calculated for a reference phantom may be assumed to be in accordance with the actual patient dose within a range described by a factor of about two to three. Finally, risk estimates for nuclear medicine procedures are quantified, being generally of sixth order. The radiation risk from the radioiodine test is comparably higher, but probably lower than calculated according to the UNSCEAR risk coefficients. However, further studies are needed to confirm these preliminary results and to improve the quantification of the radiation risk from the medical use of radionuclides. (author)

Radiation exposure from diagnostic imaging among patients with gastrointestinal disorders.

LENUS (Irish Health Repository)

Desmond, Alan N

2012-03-01

There are concerns about levels of radiation exposure among patients who undergo diagnostic imaging for inflammatory bowel disease (IBD), compared with other gastrointestinal (GI) disorders. We quantified imaging studies and estimated the cumulative effective dose (CED) of radiation received by patients with organic and functional GI disorders. We also identified factors and diagnoses associated with high CEDs.

Molecular mechanisms in radiation carcinogenesis: introduction

International Nuclear Information System (INIS)

Setlow, R.B.

1975-01-01

Molecular studies of radiation carcinogenesis are discussed in relation to theories for extrapolating from cellular and animal models to man. Skin cancer is emphasized because of sunlight-induced photochemical damage to DNA. It is emphasized that cellular and animal models are needed as well as molecular theories for quantitative evaluation of hazardous environmental agents. (U.S.)

An introduction to nuclear physics, with applications in medicine and biology

International Nuclear Information System (INIS)

Dyson, N.A.

1981-01-01

A concise account of the applications of nuclear physics to medical and biological science is given. Half the book is devoted to the basic aspects of nuclear and radiation physics such as interactions between radiation and matter, nuclear reactions and the production of isotopes, an introduction to α, β and γ-radiation detectors and finally the radiation from nuclear decay. Information is then given on the applications of radioisotopes and neutrons and other accelerator-based applications in medicine and biology. The book is aimed at not only those undergraduates and postgraduates who are devoting their main effort to medical physics, but also to those students who are looking primarily for an introduction to nuclear physics together with an account of some of the ways in which it impinges on the work of other scientists. (U.K.)

The role of radiation therapy in malignant pleural mesothelioma: A systematic review

International Nuclear Information System (INIS)

Ung, Yee C.; Yu, Edward; Falkson, Conrad; Haynes, Adam E.; Stys-Norman, Denise; Evans, William K.

2006-01-01

Introduction: Radiation therapy may offer patients presenting with malignant pleural mesothelioma (MPM) symptom palliation and improvements in quality of life. This systematic review will address the role of radiation therapy in the management of MPM. Methods: A thorough systematic search of the literature was conducted for published articles and conference proceedings for applicable abstracts. Relevant trials were selected and assessed. Results: Three small randomized controlled trials compared prophylactic external beam radiation therapy to no radiation therapy for patients with thoracic tracts caused by drainage tubes or diagnostic procedures. None of those trials reported any serious adverse effects. A pooled analysis found no significant reduction in the frequency of procedure tract metastases. Four non-comparative studies have shown that hemithoracic irradiation alone resulted in significant toxicity, including radiation-induced pulmonary fibrosis, radiation pneumonitis, and bronchopleural fistula, without any survival benefit. Few of the identified studies reported on symptom control, and no studies included formal measures of quality of life. Conclusion: There is limited evidence for the role of radiotherapy in the management of patients with MPM. Future studies including radiotherapy for the treatment of such patients should include formal measures of quality of life and symptom control

Optical Tracking Technology in Stereotactic Radiation Therapy

International Nuclear Information System (INIS)

Wagner, Thomas H.; Meeks, Sanford L.; Bova, Frank J.; Friedman, William A.; Willoughby, Twyla R.; Kupelian, Patrick A.; Tome, Wolfgang

2007-01-01

The last decade has seen the introduction of advanced technologies that have enabled much more precise application of therapeutic radiation. These relatively new technologies include multileaf collimators, 3-dimensional conformal radiotherapy planning, and intensity modulated radiotherapy in radiotherapy. Therapeutic dose distributions have become more conformal to volumes of disease, sometimes utilizing sharp dose gradients to deliver high doses to target volumes while sparing nearby radiosensitive structures. Thus, accurate patient positioning has become even more important, so that the treatment delivered to the patient matches the virtual treatment plan in the computer treatment planning system. Optical and image-guided radiation therapy systems offer the potential to improve the precision of patient treatment by providing a more robust fiducial system than is typically used in conventional radiotherapy. The ability to accurately position internal targets relative to the linac isocenter and to provide real-time patient tracking theoretically enables significant reductions in the amount of normal tissue irradiated. This report reviews the concepts, technology, and clinical applications of optical tracking systems currently in use for stereotactic radiation therapy. Applications of radiotherapy optical tracking technology to respiratory gating and the monitoring of implanted fiducial markers are also discussed

Radiation dose exposure in patients affected by lymphoma undergoing repeat CT examinations: how to manage the radiation dose variability.

Science.gov (United States)

Paolicchi, Fabio; Bastiani, Luca; Guido, Davide; Dore, Antonio; Aringhieri, Giacomo; Caramella, Davide

2018-03-01

To assess the variability of radiation dose exposure in patients affected by lymphoma undergoing repeat CT (computed tomography) examinations and to evaluate the influence of different scan parameters on the overall radiation dose. A series of 34 patients (12 men and 22 women with a median age of 34.4 years) with lymphoma, after the initial staging CT underwent repeat follow-up CT examinations. For each patient and each repeat examination, age, sex, use of AEC system (Automated Exposure Control, i.e. current modulation), scan length, kV value, number of acquired scans (i.e. number of phases), abdominal size diameter and dose length product (DLP) were recorded. The radiation dose of just one venous phase was singled out from the DLP of the entire examination. All scan data were retrieved by our PACS (Picture Archiving and Communication System) by means of a dose monitoring software. Among the variables we considered, no significant difference of radiation dose was observed among patients of different ages nor concerning tube voltage. On the contrary the dose delivered to the patients varied depending on sex, scan length and usage of AEC. No significant difference was observed depending on the behaviour of technologists, while radiologists' choices had indirectly an impact on the radiation dose due to the different number of scans requested by each of them. Our results demonstrate that patients affected by lymphoma who undergo repeat whole body CT scanning may receive unnecessary overexposure. We quantified and analyzed the most relevant variables in order to provide a useful tool to manage properly CT dose variability, estimating the amount of additional radiation dose for every single significant variable. Additional scans, incorrect scan length and incorrect usage of AEC system are the most relevant cause of patient radiation exposure.

Radiation exposure to patients during extracorporeal shock wave lithotripsy

International Nuclear Information System (INIS)

Van Swearingen, F.L.; McCullough, D.L.; Dyer, R.; Appel, B.

1987-01-01

Extracorporeal shock wave lithotripsy is rapidly becoming an accepted treatment of renal calculi. Since fluoroscopy is involved to image the stones it is important to know how much radiation the patient receives during this procedure. Surface radiation exposure to the patient was measured in more than 300 fluoroscopic and radiographic procedures using thermoluminescent dosimeters. Initial results showed an average skin exposure of 10.1 rad per procedure for each x-ray unit, comparing favorably with exposure rates for percutaneous nephrostolithotomy and other routine radiological procedures. Factors influencing exposure levels include stone characteristics (location, size and opacity), physician experience and number of shocks required. Suggestions are given that may result in a 50 per cent reduction of radiation exposure

Radiation protection in BNCT patients

International Nuclear Information System (INIS)

Blaumann, Hernan R.; Scharnichia, E.; Levanon, I.; Fernandez, C.; Facchini, Guillermo; Longhino, J.; Calzetta, Osvaldo; Pereira, M.

2008-01-01

Full text: Boron Neutron Capture Therapy (BNCT) is a technique that selectively targets cancer cells while sparing normal tissues by virtue of the differential uptake of a 10 B carrier compound in tumor. The National Atomic Energy Commission (CNEA) and the Oncology Institute 'Angel H. Roffo' (IOAR) began a BNCT programme in 2003 for treating cutaneous skin melanomas in extremities. The neutron beam used is the hyperthermal one developed at the RA-6 Reactor of the Bariloche Atomic Centre (CAB). The prescribed dose is delivered in one fraction and therefore patient positioning and knowledge of the dose received by normal tissue are crucial. 10 irradiations have been done since 2003, all of them in legs and feet and the dose prescription was determined by the maximum tolerable skin dose. Due to the characteristics of this treatment the patient body might be exposed not only to the primary beam but also to the secondary photon beam produced by neutron capture at the target itself. Thus a patient radiation-monitoring plan was implemented in order to evaluate the gamma dose delivered to sensible organs of each patient. An acrylic water-filled whole body phantom was used for preliminary gamma dose and thermal neutron flux measurements at positions related to patient's body sensible organs considering tentative patient positions. The beam port shielding was, in this way, optimized. TLD-700 and Manganese foils were used for gamma and thermal neutron detection. The TLD-700 thermal neutron response was previously evaluated by using the in-phantom beam dosimetry characterization. In-vivo dosimetry with TLD is routinely implemented in order to evaluate gamma dose to sensible organs of each patient. These organs are chosen depending on its distance from the zone to be irradiated and its radio-sensibility. All TLDs have been positioned well outside the irradiation field. Maximum gamma dose received outside the radiation field in healthy tissues was well below tolerance dose for

Tamoxifen with and without radiation after partial mastectomy in patients with involved nodes

Energy Technology Data Exchange (ETDEWEB)

Cooke, Andrew L; Perera, Francisco; Fisher, Barbara; Opeitum, Abiola; Yu, Norman

1995-02-15

Purpose: To determine the effect of tamoxifen on local control after partial mastectomy with and without adjuvant breast irradiation. Methods and Materials: A retrospective study of 97 node positive patients identified from the records of the London Regional Cancer Center included 44 patients who received tamoxifen and breast irradiation (40 or 50 Gy plus booster dose) after partial mastectomy, and 53 patients who received tamoxifen only after partial mastectomy. Base line characteristics of the two groups were similar. Results: At 39 months actuarial follow-up there was a breast tumor recurrence (BTR) in 5% vs. 21% of patients when radiation was omitted (p = 0.0388), but there was no difference in the cause-specific mortality of the two treatment groups. Cox Regression analysis (on only 10 BTR) showed age and adjuvant radiation as significant predictors of BTR. In patients not receiving radiation, no BTR was seen in 22 patients {>=}70 years of age at diagnosis vs. 8 BTR in 31 patients <70 years (p = 0.0130). All BTR occurred while patients were receiving tamoxifen. Conclusion: Tamoxifen alone with omission of radiation after partial mastectomy provides inferior breast tumor control in node positive patients. This is especially true for patients under 70 years of age. Patients aged 70 years or older at the time of diagnosis of breast cancer who receive tamoxifen have a low rate of breast tumor recurrence when radiation is omitted. These patients represent a group for whom radiation might not be necessary.

Introduction to radiation and human health

International Nuclear Information System (INIS)

Anon.

1981-01-01

This introductory chapter presents an overview of topics that are examined throughout the book. There are brief discussions on basic scientific notation, epidemiology, risk assessment, and the use of assumptions and approximations in scientific research. The book presents evidence that ionizing radiation causes a variety of human health hazards. The health hazards evaluated in detail are cancer and chromosomal damage

Multifocal atherosclerosis in patient after acute first degree radiation sickness.

Directory of Open Access Journals (Sweden)

Metlyaeva N.A.

2014-12-01

Full Text Available Purpose: assessment the heavy psychosomatic and all-somatic cardiovascular and cerebrovascular pathology of patient, transferred an acute I degree radiation sickness, from the general evenly gamma-beta radiation. Conclusions. The subdepressive and disturbing-depressive syndrome of patient, transferred an acute radiation sickness (ARS of I degree, from the general evenly gamma-beta radiation, was independent risk factor of development of multifocal atherosclerosis; Features of development of all-somatic and psychosomatic pathology of patient are based on a combination of genetic prerequisites, environment influences (the stress caused by accident on the ChNPP and social factors, influencing on him during a course of life, especially during early socialization. Thus at development of psychosomatic frustration the combination of feature of the mental reaction connected with the personal characteristic and special relationship between mental (stress and physiological (somatic by aspects of reaction which led to metabolism violation, to aging, decrease in adaptation opportunities of an organism and development age — dependent pathology took place.

Survey of sexual educational needs in radiation oncology patients

International Nuclear Information System (INIS)

Chen, L.; Sweeney, P.; Wallace, G.; Neish, P.; Vijayakumar, S.

1997-01-01

Purpose: To assess the knowledge of and need for education about sexuality in oncology patients treated with radiation therapy. Methods and Materials: Patients who received radiation therapy for any disease site were given a self-assessment survey to complete to determine their opinions on sexuality and needs for sexual education. The surveys were given to patients on follow-up visit seen approximately 6 months to 2 years after radiation therapy. All patients were diagnosed with a malignancy and asked to participate on a voluntary basis; confidentiality was ensured by excluding any identifying patient information on the survey form. Respondents were polled with a survey that consisted of 17 questions about their sexual activity. Questions were broadly categorized into the following: definition of sexual activity, frequency of sexual activity prior to and after diagnosis and treatment of cancer, perception of sexual attractiveness, sexual satisfaction in the relationship, patient perception of partner's sexual satisfaction in the relationship, educational needs with regard to sexuality after therapy for cancer, and demographic information. Results: All patients were over age 18, and received radiation therapy as part of the treatment. Patients with all disease sites were included in the survey, regardless of stage or diagnosis. A total of 28 patients completed the survey form, which was approved by our institutional review board. Forty-three percent of patients felt that the cancer diagnosis or treatment effect was the cause of not engaging in sexual intercourse. Fifty percent reported not having the same sexual desire as before the diagnosis of cancer, while 46% reported having the same sexual desire as prior to the diagnosis of cancer. Forty-six percent felt less attractive than before the diagnosis of cancer, while 43% felt the same as before diagnosis. Thirty-six percent of patients received no information with regards to sexuality and cancer, while 18% received

Vocal changes in patients undergoing radiation therapy for glottic carcinoma

International Nuclear Information System (INIS)

Miller, S.; Harrison, L.B.; Solomon, B.; Sessions, R.B.

1990-01-01

A prospective evaluation of vocal changes in patients receiving radiation therapy for T1 and T2 (AJC) glottic carcinoma was undertaken in January 1987. Vocal analysis was performed prior to radiotherapy and at specific intervals throughout the radiation treatment program. The voicing ratio was extrapolated from a sustained vowel phonation using the Visipitch interfaced with the IBM-PC. Preliminary observations suggested three distinct patterns of vocal behavior: 1. reduced voicing ratio with precipitous improvement within the course of treatment, 2. high initial voicing ratio with reduction secondary to radiation induced edema, with rapid improvement in the voicing component after the edema subsided, and 3. fluctuating voicing ratio during and following treatment. Enrollment of new patients and a 2-year follow-up of current patients was undertaken

Outcome of radiation therapy for patients with Kasabach-Merritt syndrome

International Nuclear Information System (INIS)

Mitsuhashi, Norio; Furuta, Masaya; Sakurai, Hideyuki; Takahashi, Takeo; Kato, Shingo; Nozaki, Miwako; Saito, Yoshihiro; Hayakawa, Kazushige; Niibe, Hideo

1997-01-01

Purpose: The efficacy of radiation therapy for Kasabach-Merritt syndrome, which is characterized by a huge hemangioma with consumption coagulopathy, remains controversial. In this study, we retrospectively investigated the treatment outcome of radiation therapy for seven neonates with Kasabach-Merritt syndrome. Methods and Materials: During the past 25 years we have seen seven children with Kasabach-Merritt syndrome who were treated with radiation therapy. Their ages ranged from 1 day to 5 months, with a median age of 1 month. The hemangioma was located in the extremities in four of seven children. Tumor sizes ranged from 70 cm to more than 150 cm in greatest diameter. Initial platelet counts were all less than 40,000/mm 3 except for one patient. In principle, the total dose applied to the hemangioma was 8-10 Gy, with a daily dose of 1 Gy five times a week. Results: Four of seven hemangiomas responded dramatically, with a concomitant rise of the platelet count to radiation therapy. Although the remaining three hemangiomas, all of which were ill circumscribed by widespread overlying shiny, dusky purple skin, became less tense during radiation therapy. Disseminated intravascular coagulopathy was not improved, but they have responded favorably to two or three courses of radiation therapy with an extended radiation field by 1.5 years of age. As a result, all seven patients are now surviving with no evidence of hemangioma or hematological abnormalities. Shortening of the extremity was observed in three patients who received multiple courses of radiation therapy. Conclusions: Radiation therapy appears to be one of the effective treatment options for Kasabach-Merritt syndrome despite the risk of growth delay and malignancy

Relationship Between Low Hemoglobin Levels and Outcomes After Treatment With Radiation or Chemoradiation in Patients With Cervical Cancer: Has the Impact of Anemia Been Overstated?

International Nuclear Information System (INIS)

Bishop, Andrew J.; Allen, Pamela K.; Klopp, Ann H.; Meyer, Larissa A.; Eifel, Patricia J.

2015-01-01

Purpose: Previous reports have suggested that anemia increases rates of recurrence after radiation therapy for cervical cancer. However, these studies may not have fully corrected for confounding risk factors. Using a well-characterized cohort of cervical cancer patients, we examined the association between anemia and outcomes before and after the introduction of chemoradiation as standard of care. Methods and Materials: We reviewed the records of 2454 patients who underwent definitive radiation therapy from 1980 through 2011. Minimum hemoglobin level (Hgb min ) was recorded for 2359 patients (96%). Endpoints included freedom from central recurrence (FFCR), freedom from distant metastasis (FFDM), and disease-specific survival (DSS). Results: For the entire cohort, hemoglobin concentrations of 9, 10, and 12 g/dL before and during radiation were all significantly associated with FFCR, FFDM, and DSS (all P<.001) on univariate analysis. However, on multivariate analysis, only Hgb min less than 10 g/dL during RT (RT-Hgb <10 ) remained significant, and it was correlated with lower DSS (P=.02, hazard ratio [HR] = 1.28) and FFDM (P=.03, HR = 1.33) but not with FFCR. In a subset analysis of patients receiving chemoradiation (n=678), RT-Hgb <10 was associated only with DSS (P=.008, HR = 1.49), not with FFCR or FFDM. In this subgroup, despite an association between RT-Hgb <10 and DSS, the use of transfusion was not correlated with benefit. Conclusions: No evidence was found supporting anemia as an independent predictor of central recurrence in patients treated with definitive radiation therapy with or without chemotherapy. Less emphasis on correcting anemia in cervical cancer patients may be warranted

Relationship Between Low Hemoglobin Levels and Outcomes After Treatment With Radiation or Chemoradiation in Patients With Cervical Cancer: Has the Impact of Anemia Been Overstated?

Energy Technology Data Exchange (ETDEWEB)

Bishop, Andrew J.; Allen, Pamela K.; Klopp, Ann H. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Meyer, Larissa A. [Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Eifel, Patricia J., E-mail: peifel@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2015-01-01

Purpose: Previous reports have suggested that anemia increases rates of recurrence after radiation therapy for cervical cancer. However, these studies may not have fully corrected for confounding risk factors. Using a well-characterized cohort of cervical cancer patients, we examined the association between anemia and outcomes before and after the introduction of chemoradiation as standard of care. Methods and Materials: We reviewed the records of 2454 patients who underwent definitive radiation therapy from 1980 through 2011. Minimum hemoglobin level (Hgb{sub min}) was recorded for 2359 patients (96%). Endpoints included freedom from central recurrence (FFCR), freedom from distant metastasis (FFDM), and disease-specific survival (DSS). Results: For the entire cohort, hemoglobin concentrations of 9, 10, and 12 g/dL before and during radiation were all significantly associated with FFCR, FFDM, and DSS (all P<.001) on univariate analysis. However, on multivariate analysis, only Hgb{sub min} less than 10 g/dL during RT (RT-Hgb{sub <10}) remained significant, and it was correlated with lower DSS (P=.02, hazard ratio [HR] = 1.28) and FFDM (P=.03, HR = 1.33) but not with FFCR. In a subset analysis of patients receiving chemoradiation (n=678), RT-Hgb{sub <10} was associated only with DSS (P=.008, HR = 1.49), not with FFCR or FFDM. In this subgroup, despite an association between RT-Hgb{sub <10} and DSS, the use of transfusion was not correlated with benefit. Conclusions: No evidence was found supporting anemia as an independent predictor of central recurrence in patients treated with definitive radiation therapy with or without chemotherapy. Less emphasis on correcting anemia in cervical cancer patients may be warranted.

Radiation protection in radionuclide investigations

International Nuclear Information System (INIS)

Taylor, D.M.

1985-01-01

The subject is covered in sections: introduction; radiation and radioactivity; alpha particles; beta particles; neutrons; electromagnetic radiation; units of radioactivity and radiation; biological effects of radiation; the philosophy of radiation protection (ALARA principle); practical aspects of radiation protection; work with unsealed radiation sources; radionuclide studies in experimental animals; radiation safety during clinical investigations; legislative control of radiation work; radioactive waste disposal; emergency procedures; conclusion. (U.K.)

Patient radiation exposure during different kyphoplasty techniques

International Nuclear Information System (INIS)

Panizza, D.; Barbieri, M.; Parisoli, F.; Moro, L.

2014-01-01

The scope of this study was to quantify patient radiation exposure during two different techniques of kyphoplasty (KP), which differ by a cement delivery method, in order to assess whether or not one of the two used methods can reduce the patient dose. Twenty patients were examined for this investigation. One X-ray fluoroscopy unit was used for localization, navigation and monitoring of cement delivery. The patient bio-metric data, the setting of the fluoroscope, the exposure time and the kerma-area product (KAP) were monitored in all the procedures for anteroposterior (AP) and lateral (LL) fluoroscopic projections in order to assess the range of radiation doses imparted to the patient. Theoretical entrance skin dose (ESD) and effective dose (E) were calculated from intraoperatively measured KAP. An average ET per procedure was 1.5±0.5 min for the manual injection technique (study A) and 1.4±0.4 min for the distance delivery technique (study B) in the AP plane, while 3.2±0.7 and 5.1±0.6 min in the lateral plane, respectively. ESD was estimated as an average of 0.10±0.06 Gy for study A and 0.13±0.13 Gy for study B in the AP or/and 0.59±0.46 and 1.05±0.36 Gy in the lateral view, respectively. The cumulative mean E was 1.9±1.0 mSv procedure -1 for study A and 3.6±0.9 mSv procedure -1 for study B. Patient radiation exposure and associated effective dose from KP may be considerable. The technique of distance cement delivery appears to be slower than the manual injection technique and it requires a more protracted fluoroscopic control in the lateral projection, so that this system entails a higher amount of dose to the patient. (authors)

Radiation Protection of Patients program (Argentina)

International Nuclear Information System (INIS)

Touzet, R.; Perez, M. R.; Buzzi, A.; Andisco, D.

2006-01-01

After an initial period of conviction for installing an active discussion on Radiation Protection of Patients inside the medical community, there were organized working groups in Radiodiagnosis, Radiotherapy, Nuclear Medicine and on radiation protection of pregnant women. These groups began systematical activities, which received a strong institutional support of the Argentine Society of Radiology, toward the implementation of a Program of RPP that is being put nowadays into practice. This program has three aims and a series of targets to be fulfilled in successive stages: Basic aims and short term targets: 1) To guarantee the Justification. First goal: Development of the Prescription Guide (achieve) 2) To optimize the radioprotection: First goal: Development of a Manual of Procedures (achieved) 3) To prevent potential exposures. First goal: Design of a Basic Quality System in Health (achieved) The effective participation of the professional's and technician's associations in the development of the program of radiological protection of the patient is a key aspect for the success. (Author)

Doses from Medical Radiation Sources

Science.gov (United States)

... Medical Radiation Sources Michael G. Stabin, PhD, CHP Introduction Radiation exposures from diagnostic medical examinations are generally ... of exposure annually to natural background radiation. Plain Film X Rays Single Radiographs Effective Dose, mSv Skull ( ...

Radiation port cutaneous metastases: Reports of two patients whose recurrent visceral cancers presented as skin lesions at the site of previous radiation and literature review

Directory of Open Access Journals (Sweden)

Brian Spencer Hoyt

2014-01-01

Full Text Available Radiation therapy is associated with a variety of complications, including the development of primary skin cancers in the radiated region. However, it is rare for patients with visceral cancers who are treated with radiation therapy to subsequently develop cutaneous metastasis within the radiation port. We describe two patients with internal malignancies who developed cutaneous metastases within their radiation ports following radiotherapy. In addition, we used PubMed to perform an extensive literature review and identify additional reports of cutaneous metastasis within a radiation port. We excluded patients who developed melanoma or primary skin cancers in the radiation port. We also excluded patients with non-solid organ malignancies. Herein, we summarize the characteristics of 23 additional patients who experienced radiation port cutaneous metastases and explore possible mechanisms for the occurrence of radiation port cutaneous metastases.

Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations

International Nuclear Information System (INIS)

Prabhu, Arpan V.; Hansberry, David R.; Agarwal, Nitin; Clump, David A.; Heron, Dwight E.

2016-01-01

Purpose: Physicians encourage patients to be informed about their health care options, but much of the online health care–related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Methods: Radiation oncology–related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, (RadiologyInfo.org), and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. Results: When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Conclusion: Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each

Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations

Energy Technology Data Exchange (ETDEWEB)

Prabhu, Arpan V. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Hansberry, David R. [Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania (United States); Agarwal, Nitin [Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Clump, David A. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Heron, Dwight E., E-mail: herond2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

2016-11-01

Purpose: Physicians encourage patients to be informed about their health care options, but much of the online health care–related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Methods: Radiation oncology–related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, (RadiologyInfo.org), and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. Results: When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Conclusion: Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment

Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations.

Science.gov (United States)

Prabhu, Arpan V; Hansberry, David R; Agarwal, Nitin; Clump, David A; Heron, Dwight E

2016-11-01

Physicians encourage patients to be informed about their health care options, but much of the online health care-related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Radiation oncology-related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, RadiologyInfo.org, and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each physician-patient interaction more productive

Radiation exposure of nursing personnel to brachytherapy patients

International Nuclear Information System (INIS)

Cobb, P.D.; Kase, K.R.; Bjaerngard, B.E.

1978-01-01

The radiation exposure of nursing personnel to brachytherapy patients has been analyzed from data collected during the years 1973-1976, at four different hospitals. The average annual dose per exposed nurse ranged between 25 and 150 mrem. The radiation exposure per nurse was found to be proportional to the total potential exposure and was uncorrelated with the size of the nursing staff. (author)

Benefits of adopting good radiation practices in reducing the whole body radiation dose to the nuclear medicine personnel during (18)F-fluorodeoxyglucose positron emission tomography/computed tomography imaging.

Science.gov (United States)

Verma, Shashwat; Kheruka, Subhash Chand; Maurya, Anil Kumar; Kumar, Narvesh; Gambhir, Sanjay; Kumari, Sarita

2016-01-01

Positron emission tomography has been established as an important imaging modality in the management of patients, especially in oncology. The higher gamma radiation energy of positron-emitting isotopes poses an additional radiation safety problem. Those working with this modality may likely to receive higher whole body doses than those working only in conventional nuclear medicine. The radiation exposure to the personnel occurs in dispensing the dose, administration of activity, patient positioning, and while removing the intravenous (i.v.) cannula. The estimation of radiation dose to Nuclear Medicine Physician (NMP) involved during administration of activity to the patient and technical staff assisting in these procedures in a positron emission tomography/computed tomography (PET/CT) facility was carried out. An i.v access was secured for the patient by putting the cannula and blood sugar was monitored. The activity was then dispensed and measured in the dose calibrator and administered to the patient by NMP. Personnel doses received by NMP and technical staff were measured using electronic pocket dosimeter. The radiation exposure levels at various working locations were assessed with the help of gamma survey meter. The radiation level at working distance while administering the radioactivity was found to be 106-170 μSv/h with a mean value of 126.5 ± 14.88 μSv/h which was reduced to 4.2-14.2 μSv/h with a mean value of 7.16 ± 2.29 μSv/h with introduction of L-bench for administration of radioactivity. This shows a mean exposure level reduction of 94.45 ± 1.03%. The radiation level at working distance, while removing the i.v. cannula postscanning was found to be 25-70 μSv/h with a mean value of 37.4 ± 13.16 μSv/h which was reduced to 1.0-5.0 μSv/h with a mean value of 2.77 ± 1.3 μSv/h with introduction of L-bench for removal of i.v cannula. This shows a mean exposure level reduction of 92.85 ± 1.78%. This study shows that good radiation practices are

Significant fibrosis after radiation therapy in a patient with Marfan Syndrome

International Nuclear Information System (INIS)

Suarez, Eva M.; Knackstedt, Rebecca J.; Jenrette, Joseph M.

2014-01-01

Marfan syndrome is one of the collagen vascular diseases that theoretically predisposes patients to excessive radiation-induced fibrosis yet there is minimal published literature regarding this clinical scenario. We present a patient with a history of Marfan syndrome requiring radiation for a diagnosis of a right brachial plexus malignant nerve sheath tumor. It has been suggested that plasma transforming growth factor beta 1 (TGF-beta1) can be monitored as a predictor of subsequent fibrosis in this population of high risk patients. We therefore monitored the patient's TGF-beta1 level during and after treatment. Despite maintaining stable levels of plasma TGF-beta1, our patient still developed extensive fibrosis resulting in impaired range of motion. Our case reports presents a review of the literature of patients with Marfan syndrome requiring radiation therapy and the limitations of serum markers on predicting long-term toxicity.

Significant fibrosis after radiation therapy in a patient with Marfan Syndrome

Energy Technology Data Exchange (ETDEWEB)

Suarez, Eva M.; Knackstedt, Rebecca J.; Jenrette, Joseph M. [Medical University of South Carolina, Charleston (United States)

2014-09-15

Marfan syndrome is one of the collagen vascular diseases that theoretically predisposes patients to excessive radiation-induced fibrosis yet there is minimal published literature regarding this clinical scenario. We present a patient with a history of Marfan syndrome requiring radiation for a diagnosis of a right brachial plexus malignant nerve sheath tumor. It has been suggested that plasma transforming growth factor beta 1 (TGF-beta1) can be monitored as a predictor of subsequent fibrosis in this population of high risk patients. We therefore monitored the patient's TGF-beta1 level during and after treatment. Despite maintaining stable levels of plasma TGF-beta1, our patient still developed extensive fibrosis resulting in impaired range of motion. Our case reports presents a review of the literature of patients with Marfan syndrome requiring radiation therapy and the limitations of serum markers on predicting long-term toxicity.

Protection of persons occupationally exposed to radiation and of patients

International Nuclear Information System (INIS)

Stieve, F.E.

1976-01-01

The experiences of the last ten years have shown that the measures of the First Radiation Protection Ordinance generally proved to be sufficient for the protection of the employed or of the patients. They had to be amended in so far as the exposure to radiation for those occupationally exposed can be reduced. This results in changes to the regulations so that certain groups of persons can also be effectively controlled. The recognition that medical supervision for radiation protection reasons is reasonable only if exposure has occurred should be additionally utilized in the regulations if the Euratom standards make this possible. The protection of patients attains some new rules which can be derived from handling and from therapeutical use. In this case too experience resulted in a more reasonable application of ionizing radiation and radioactive materials than was expected when the First Radiation Protection Ordinance was issued. (orig.) [de

Ceiling art in a radiation therapy department: its effect on patient treatment experience

International Nuclear Information System (INIS)

Bonett, Jotham

2015-01-01

A new initiative has been implemented at the Sunshine Hospital Radiation Therapy Centre, to provide a calming and comforting environment for patients attending radiation therapy treatment. As part of this initiative, the department's computed tomography (CT) room and radiation therapy bunkers were designed to incorporate ceiling art that replicates a number of different visual scenes. The study was undertaken to determine if ceiling art in the radiation therapy treatment CT and treatment bunkers had an effect on a patient's experience during treatment at the department. Additionally, the study aimed to identify which of the visuals in the ceiling art were most preferred by patients. Patients were requested to complete a 12-question survey. The survey solicited a patient's opinion/perception on the unit's unique ceiling display with emphasis on aesthetic appeal, patient treatment experience and the patient's engagement due to the ceiling display. The responses were dichotomised to ‘positive’ or ‘negative’. Every sixth patient who completed the survey was invited to have a general face-to-face discussion to provide further information about their thoughts on the displays. The results demonstrate that the ceiling artwork solicited a positive reaction in 89.8% of patients surveyed. This score indicates that ceiling artwork contributed positively to patients’ experiences during radiation therapy treatment. The study suggests that ceiling artwork in the department has a positive effect on patient experience during their radiation therapy treatment at the department

Ceiling art in a radiation therapy department: its effect on patient treatment experience

Energy Technology Data Exchange (ETDEWEB)

Bonett, Jotham [Sunshine Hospital Radiation Therapy Centre, Melbourne, Vic. (Australia)

2015-09-15

A new initiative has been implemented at the Sunshine Hospital Radiation Therapy Centre, to provide a calming and comforting environment for patients attending radiation therapy treatment. As part of this initiative, the department's computed tomography (CT) room and radiation therapy bunkers were designed to incorporate ceiling art that replicates a number of different visual scenes. The study was undertaken to determine if ceiling art in the radiation therapy treatment CT and treatment bunkers had an effect on a patient's experience during treatment at the department. Additionally, the study aimed to identify which of the visuals in the ceiling art were most preferred by patients. Patients were requested to complete a 12-question survey. The survey solicited a patient's opinion/perception on the unit's unique ceiling display with emphasis on aesthetic appeal, patient treatment experience and the patient's engagement due to the ceiling display. The responses were dichotomised to ‘positive’ or ‘negative’. Every sixth patient who completed the survey was invited to have a general face-to-face discussion to provide further information about their thoughts on the displays. The results demonstrate that the ceiling artwork solicited a positive reaction in 89.8% of patients surveyed. This score indicates that ceiling artwork contributed positively to patients’ experiences during radiation therapy treatment. The study suggests that ceiling artwork in the department has a positive effect on patient experience during their radiation therapy treatment at the department.

Radiation therapy patient education using VERT: combination of technology with human care.

Science.gov (United States)

Jimenez, Yobelli A; Lewis, Sarah J

2018-05-13

The Virtual Environment for Radiotherapy Training (VERT) system is a recently available tool for radiation therapy education. The majority of research regarding VERT-based education is focused on students, with a growing area of research being VERT's role in patient education. Because large differences in educational requirements exist between students and patients, focused resources and subsequent evaluations are necessary to provide solid justification for the unique benefits and challenges posed by VERT in a patient education context. This commentary article examines VERT's role in patient education, with a focus on salient visual features, VERT's ability to address some of the spatial challenges associated with RT patient education and how to combine technology with human care. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Primary beam ionizing radiation for patients during coronary cineangiography

International Nuclear Information System (INIS)

Ramirez, Alfredo; Leyton, Fernando; Gamarra, Jorge; Oyarzun C, Carlos; Silva, Ana Maria; Ugalde, Hector; Dussaillant, Gaston

2001-01-01

Current cardiology practice incorporates hemodynamic and angiographic studies as normal procedures. Clinical actions have to be taken in interventionist cardiology that demand prolonged exposure times to radiation, which implies submitting patients to quantitatively significant doses. This work is a preliminary phase for clinical studies involving long procedures in hemodynamic and electrophysiological interventionist cardiology to show the magnitude of the radiation doses received by the patients after a proper diagnosis. The aim is to improve the patient's radiological protection as well as that of the staff involved. The study group consisted of 18 patients who underwent coronary angiography procedures with Siemens Angioskop D equipment and a Siemens Polidoros 80 generator. Four TLD Crystal detectors were used for the patient's dosimetry, which were located in the dorsal region along the left para scapular line, on the mid line of the thyroid region and a detector on the mid point between the umbilical zone and the pubis symphysis. For procedure times of 14±4.3 min., with fluoroscope times of 3.6±2.5 min., connection techniques of 87±15 kV. and 126±24 mA, the radiations recorded in the left inter scapular and right inter scapular regions were 215±199 mGy (1-710 mGy range) and 255±212 mGy ( 22 - 791mGy range ). The radiations in the pubic and thyroid regions were 0.23±0.07 mGy and 3.62±2.44 mGy, respectively (CO)

Introduction to EMC

CERN Document Server

Scott, John

1997-01-01

This is the clear guide for non-specialists to electromagnetic compatability (EMC), the effects of electromagnetic radiation and the European EMC Directive which is now in force. This book helps by explaining the basic principles of EMC, how it may be controlled in practice through filtering, shielding, appropriate printed circuit board design, and other means. Electrostatic discharge (ESD) and surge protection are discussed. The growing concern about the effects of electromagnetic waves and fields on health are examined in detail.This introduction provides beginners, technical and

Psychology and quality of life in cancer patients on radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Yang, Jong Chul; Chung, Woong Ki [Chonnam National University Hospital, Gwangju (Korea, Republic of)

2004-12-15

The object of this study is to investigate sociodemographic and clinical characteristics, psychology, self-esteem and quality of life in cancer patients on radiation therapy and to provide useful information for therapeutic approach to cancer patients on radiation therapy. The subjects were 36 patients who had been treated with radiation therapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients on radiation therapy were investigated, and symptom checklist-90-revised, Rosenberg Self-esteem Scale for self esteem, World Health Organization Quality of Life Assessment Instrument for quality of life were administered to subjects. And Spearman's correlation analysis was used among these. The tendency of somatization, depression, anxiety and hostility in cancer group were significantly higher than normal group. Self esteem and quality of life in cancer group were significantly lower than normal group. No significant difference was found in comparison of psychology, self esteem and quality of life according to sociodemographic variables. Among clinical characteristics, in the presence of metastasis in cancer patients, the scores of anxiety, phobia and paranoid ideation were higher. In patients with pain, the score of somatization was higher. And in case of weight loss, the score of somatization was higher. The higher score of depression, anxiety and hostility were significantly associated with lower self-esteem. And higher score of somatization, depression, anxiety and hostility were significantly associated with lower quality of life. Understanding and management of psychological symptoms, such as somatization, depression, anxiety, and hostility, and pain control are necessary to improve quality of life in cancer patients on radiation therapy.

Psychology and quality of life in cancer patients on radiation therapy

International Nuclear Information System (INIS)

Yang, Jong Chul; Chung, Woong Ki

2004-01-01

The object of this study is to investigate sociodemographic and clinical characteristics, psychology, self-esteem and quality of life in cancer patients on radiation therapy and to provide useful information for therapeutic approach to cancer patients on radiation therapy. The subjects were 36 patients who had been treated with radiation therapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients on radiation therapy were investigated, and symptom checklist-90-revised, Rosenberg Self-esteem Scale for self esteem, World Health Organization Quality of Life Assessment Instrument for quality of life were administered to subjects. And Spearman's correlation analysis was used among these. The tendency of somatization, depression, anxiety and hostility in cancer group were significantly higher than normal group. Self esteem and quality of life in cancer group were significantly lower than normal group. No significant difference was found in comparison of psychology, self esteem and quality of life according to sociodemographic variables. Among clinical characteristics, in the presence of metastasis in cancer patients, the scores of anxiety, phobia and paranoid ideation were higher. In patients with pain, the score of somatization was higher. And in case of weight loss, the score of somatization was higher. The higher score of depression, anxiety and hostility were significantly associated with lower self-esteem. And higher score of somatization, depression, anxiety and hostility were significantly associated with lower quality of life. Understanding and management of psychological symptoms, such as somatization, depression, anxiety, and hostility, and pain control are necessary to improve quality of life in cancer patients on radiation therapy

Impact of digital imaging on radiation doses to the patient during X-ray examination of the urinary tract.

Science.gov (United States)

Sjöholm, B; Geijer, H; Persliden, J

2005-10-01

To compare radiation doses given to patients undergoing IVU (intravenous urography) before and after digitalization of our X-ray department. IVU examinations were monitored with dose area product meters before and after the X-ray department changed to digital techniques. The first step was a change from film-screen to storage phosphor plates, while the second step involved changing to a flat panel detector. Forty-two patients were included for the film-screen situation, 69 when using the storage phosphor plates, and 70 using the flat panel detector. A dose reduction from 41.8 Gycm2 to 31.5 Gycm2 was achieved with the first step when the film-screen system was replaced with storage phosphor plates. A further reduction to 12.1 Gycm2 was achieved using the flat panel detector. The introduction of the flat panel detectors made a considerable dose reduction possible.

Patient radiation dose in conventional and xerographic cephalography

International Nuclear Information System (INIS)

Copley, R.L.; Glaze, S.A.; Bushong, S.C.; West, D.C.

1979-01-01

A comparison of the radiation doses for xeroradiographic and conventional film screen cephalography was made. Alderson tissue-equivalent phantoms were used for patient simulation. An optimum technique in terms of patient dose and image quality indicated that the dose for the Xerox process ranged from five to eleven times greater than that for the conventional process for entrance and exit exposures, respectively. This dose, however, falls within an acceptable range for other dental and medical radiation doses. It is recommended that conventional cephalography be used for routine purposes and that xeroradiography be reserved for situations requiring the increased image quality that the process affords

The long-term effects of radiation therapy on patients with ovarian dysgerminoma

International Nuclear Information System (INIS)

Mitchell, M.F.; Gershenson, D.M.; Soeters, R.P.; Eifel, P.J.; Delclos, L.; Wharton, J.T.

1991-01-01

A retrospective chart review and questionnaire study was undertaken to look at the long-term effects of radiation therapy in ovarian dysgerminoma patients. Forty-three patients and 55 controls responded to a questionnaire that detailed bowel, bladder, thyroid, menstrual, reproductive, sexual, and growth function. Statistically significant differences in the number of bowel movements were noticed when comparing patients with controls. The authors noticed no significant differences between cases and controls in bladder function. No thyroid disorders were attributable to mediastinal radiation therapy. Most patients with intact uteri bleed monthly on hormonal replacement. Three patients with a remaining ovary and uterus resumed menstrual function after substantial doses of abdominopelvic radiation therapy. No patients have conceived. The authors noticed a slight increase in dyspareunia in the treated group, but most patients were satisfied with their sexual function. One premenarchal patient exhibited a growth disorder

Introduction to heat transfer

CERN Document Server

SUNDÉN, B

2012-01-01

Presenting the basic mechanisms for transfer of heat, Introduction to Heat Transfer gives a deeper and more comprehensive view than existing titles on the subject. Derivation and presentation of analytical and empirical methods are provided for calculation of heat transfer rates and temperature fields as well as pressure drop. The book covers thermal conduction, forced and natural laminar and turbulent convective heat transfer, thermal radiation including participating media, condensation, evaporation and heat exchangers.

Radiation ulcers in patients with cancer of the tongue after /sup 252/Cf therapy

Energy Technology Data Exchange (ETDEWEB)

Galantseva, G.F.; Guseva, L.I.; Plichko, V.I. (Akademiya Meditsinskikh Nauk SSSR, Obninsk. Nauchno-Issledovatel' skij Inst. Meditsinskoj Radiologii)

1984-01-01

Interstitial therapy with /sup 252/Cf was conducted for 57 patients with cancer of the tongue. It was established that clinical course of radiation tungue ulcers after interstitial therapy with /sup 252/Cf doesn't differ sufficiently from the course of radiation injuries, occurring after ..gamma..-radiation application. Radiation ulcers are often observed in patients after the treatment of recurrent and residual tumors with /sup 252/Cf (in 33% of patients); the ulcers appeared in 15% of cases in patients after the treatment of initial ulcers tumors. Conservative treatment provide the cure of radiation tongue ulcers after interstitial therapy with /sup 252/Cf.

Environmental law in Thuringia. Text collection with introduction. Pt. 1. Waste law, nuclear, radiation and energy law, soil protection law and land reparcelling, forestry law, fishing and hunting law

International Nuclear Information System (INIS)

Schneider, Matthias Werner

2015-01-01

The volume 1 of the collection on the Thuringian Environmental Law contains additional to a detailed introduction: - Waste management - Nuclear, radiation and energy law - Soil protection law and land reparcelling - Forestry, fishery and hunting law. [de

Cumulative total effective whole-body radiation dose in critically ill patients.

Science.gov (United States)

Rohner, Deborah J; Bennett, Suzanne; Samaratunga, Chandrasiri; Jewell, Elizabeth S; Smith, Jeffrey P; Gaskill-Shipley, Mary; Lisco, Steven J

2013-11-01

Uncertainty exists about a safe dose limit to minimize radiation-induced cancer. Maximum occupational exposure is 20 mSv/y averaged over 5 years with no more than 50 mSv in any single year. Radiation exposure to the general population is less, but the average dose in the United States has doubled in the past 30 years, largely from medical radiation exposure. We hypothesized that patients in a mixed-use surgical ICU (SICU) approach or exceed this limit and that trauma patients were more likely to exceed 50 mSv because of frequent diagnostic imaging. Patients admitted into 15 predesignated SICU beds in a level I trauma center during a 30-day consecutive period were prospectively observed. Effective dose was determined using Huda's method for all radiography, CT imaging, and fluoroscopic examinations. Univariate and multivariable linear regressions were used to analyze the relationships between observed values and outcomes. Five of 74 patients (6.8%) exceeded exposures of 50 mSv. Univariate analysis showed trauma designation, length of stay, number of CT scans, fluoroscopy minutes, and number of general radiographs were all associated with increased doses, leading to exceeding occupational exposure limits. In a multivariable analysis, only the number of CT scans and fluoroscopy minutes remained significantly associated with increased whole-body radiation dose. Radiation levels frequently exceeded occupational exposure standards. CT imaging contributed the most exposure. Health-care providers must practice efficient stewardship of radiologic imaging in all critically ill and injured patients. Diagnostic benefit must always be weighed against the risk of cumulative radiation dose.

Radiation recall gastritis secondary to erlotinib in a patient with pancreatic cancer.

Science.gov (United States)

Graziani, Casey; Hegde, Sanjay; Saif, Muhammad Wasif

2014-12-01

Radiation recall refers to chemotherapy-triggered inflammation in healthy areas previously exposed to irradiation. Chemotherapeutics known to be associated with radiation recall phenomenon include anthracyclines, taxanes and antimetabolites, such as gemcitabine and capecitabine. Case reports detailing radiation recall dermatitis and pneumonitis associated with erlotinib have been previously described in the literature, however, there are no reported cases describing radiation gastritis associated with erlotinib. We report a patient with pancreatic cancer who developed gastrointestinal bleeding secondary to radiation recall gastritis related to erlotinib exposure. A 57-year-old Hispanic male with pancreatic cancer initially received 7 cycles of FOLFIRINOX followed by capecitabine with radiation therapy for 28 fractions for a total of 5,040 cGy. Re-staging with computed tomography demonstrated stable disease. The patient was then treated with erlotinib and capecitabine for approximately two months before restaging demonstrated progressive disease. Shortly after discontinuing erlotinib and capecitabine, the patient reported maroon colored stools. Laboratory studies demonstrated a precipitous drop in hemoglobin and hematocrit from pre-treatment baseline, ultimately requiring transfusion with packed red blood cells. Subsequent esophagogastroduodenoscopy demonstrated findings consistent with radiation gastritis, with oozing in the gastric body and antrum, which was treated therapeutically with argon plasma coagulation. The patient's gastrointestinal bleed was difficult to control. Over the course of a two-month period - the patient required multiple admissions, repeat therapeutic esophagogastroduodenoscopies and transfusions. Radiation recall from erlotinib is rare but can potentially arise in any site that has been previously irradiated. There may be an association between the pathogenesis of radiation recall and erlotinib's up-regulation of the angiogenic growth factor

Surgical techniques in radiation induced temporal lobe necrosis in nasopharyngeal carcinoma patients.

Science.gov (United States)

Alfotih, Gobran Taha Ahmed; Zheng, Mei Guang; Cai, Wang Qing; Xu, Xin Ke; Hu, Zhen; Li, Fang Cheng

2016-01-01

Radiation induced brain injury ranges from acute reversible edema to late, irreversible radiation necrosis. Radiation induced temporal lobe necrosis is associated with permanent neurological deficits and occasionally progresses to death. We present our experience with surgery on radiation induced temporal lobe necrosis (RTLN) in nasopharyngeal carcinoma (NPC) patients with special consideration of clinical presentation, surgical technique, and outcomes. This retrospective study includes 12 patients with RTLN treated by the senior author between January 2010 and December 2014. Patients initially sought medical treatment due to headache; other symptoms were hearing loss, visual deterioration, seizure, hemiparesis, vertigo, memory loss and agnosia. A temporal approach through a linear incision was performed for all cases. RTLN was found in one side in 7 patients, and bilaterally in 5. 4 patients underwent resection of necrotic tissue bilaterally and 8 patients on one side. No death occurred in this series of cases. There were no post-operative complications, except 1 patient who developed aseptic meningitis. All 12 patients were free from headache. No seizure occurred in patients with preoperative epilepsy. Other symptoms such as hemiparesis and vertigo improved in all patients. Memory loss, agnosia and hearing loss did not change post-operatively in all cases. The follow-up MR images demonstrated no recurrence of necrotic lesions in all 12 patients. Neurosurgical intervention through a temporal approach with linear incision is warranted in patients with radiation induced temporal lobe necrosis with significant symptoms and signs of increased intracranial pressure, minimum space occupying effect on imaging, or neurological deterioration despite conservative management. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Increased seroreactivity to glioma-expressed antigen 2 in brain tumor patients under radiation.

Directory of Open Access Journals (Sweden)

Sabrina M Heisel

Full Text Available BACKGROUND: Surgery and radiation are the mainstays of therapy for human gliomas that are the most common primary brain tumors. Most recently, cell culture and animal studies provided the first convincing evidence that radiation not only eliminates tumor cells, but also modulates the immune response and likely improves anti-tumor immunotherapy. METHODOLOGY/PRINCIPAL FINDINGS: We present an in vivo study that analyzes the effects of radiation on the immune response in tumor patients. As readout system, we utilized the reactivity of glioma patients' sera against antigen GLEA2 as the most frequent antigen immunogenic in glioblastoma patients. We established an ELISA assay to analyze reactivity of 24 glioblastoma patients over a period of several months. As control we used 30 sera from healthy donors as well as 30 sera from lung cancer patients. We compared the course of GLEA2 seroreactivity at different times prior, during and after radiation. The GLEA2 seroreactivity was increased by the time of surgery, decreased after surgery, increased again under radiation, and slightly decreased after radiation. CONCLUSIONS/SIGNIFICANCE: Our results provide in vivo evidence for an increased antibody response against tumor antigens under radiation. Antigens that become immunogenic with an increased antibody response as result of radiation can serve as ideal targets for immunotherapy of human tumors.

Ovarian cancer: contribution of radiation therapy to patient management: Erskine Memorial Lecture, 1983

International Nuclear Information System (INIS)

Bush, R.S.

1984-01-01

Ovarian cancer may be treated with radiation therapy, surgery, chemotherapy, or a combination. To evaluate the contribution of radiation therapy to patient management the cure rate must be estimated; data are presented suggesting that the 5-year survival rate provides a reasonable estimate of the cure rate. A study of patients treated since 1971 showed that stage and postoperative residuum could be used to divide patients into two subgroups, a poor prognosis group and a good prognosis group; a multifactorial grouping of patients in the good prognosis group who were treated postoperatively with radiation therapy only was further able to divide patients into low-risk, intermediate-risk, and high-risk groups. Studies of radiation therapy for different subgroups are discussed; abdominopelvic irradiation has been shown to improve survival for approximately one-third of patients with cancer of the ovary

A phase I trial of tocoferol monoglucoside in patients undergoing hemi-body radiation

Directory of Open Access Journals (Sweden)

Huilgol N

2005-01-01

Full Text Available Purpose: To evaluate Tocoferol monoglucoside (TMG, a water soluble vit. E. in a phase I trial, as a radiation protector in those undergoing hemi-body radiation for disseminated disease. Materials and Methods: Patients scheduled to receive modified hemi-body radiation were accrued for the study. Patients not only had disseminated skeletal disease but, were heavily pretreated Seven patients were accrued for the study. Patients received 1 and 2 gms of TMG. 30-40 minutes before hemibody radiation. A dose of 600 cGy was delivered on telecobalt equipment at mid plane. Immediate Toxicities were evaluated as well as response to pain. Results: All the seven patients underwent radiation uneventfully. There was no drug related toxicity. Pain relief was adequate. Conclusion: Tocoferol monoglucoside an effective antioxidant with no significant acute toxicity, when administered in a dose of 1 or 2 gms per oral route. TMG being water-soluble can have global antioxidant and radio protective effects. This needs further clinical evaluation.

Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

International Nuclear Information System (INIS)

Gunther, Jillian R.; Sato, Mariko; Chintagumpala, Murali; Ketonen, Leena; Jones, Jeremy Y.; Allen, Pamela K.; Paulino, Arnold C.; Okcu, M. Fatih; Su, Jack M.; Weinberg, Jeffrey; Boehling, Nicholas S.; Khatua, Soumen; Adesina, Adekunle; Dauser, Robert; Whitehead, William E.; Mahajan, Anita

2015-01-01

Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem

Correlation factor analysis between radiation pneumonitis and chemo-radiotherapy in breast cancer patients

International Nuclear Information System (INIS)

Li Huiping; Wang Junjie; Ma Liwen; Zhang Shulan; Deng Huijing; Jia Tingzhen

2004-01-01

Objective: To investigate the relationship between radiotherapy-induced lung injury and chemotherapy agents as well as other factors. Methods: A total of 85 breast cancer patients received radiotherapy with sequential or concurrent chemotherapy after surgery were analysed for radiation dose, chemotherapy schedule, age, and lung disease history. Results: Five patients had clinical symptoms of radiation pneumonitis, one of them was necessary to treat and 16 patients developed radiological changes (18.8%). Close relationship was noted between incidence of radiation pneumonitis and radiation dose, timing and drugs used in chemotherapy and lung disease history. Conclusion: High irradiation dose, concurrent chemotherapy, and lung disease history can increase the rate of radiotherapy-induced pulmonary injury in breast cancer patients. (authors)

Radiation dosimetry predicts IQ after conformal radiation therapy in pediatric patients with localized ependymoma

International Nuclear Information System (INIS)

Merchant, Thomas E.; Kiehna, Erin N.; Li Chenghong; Xiong Xiaoping; Mulhern, Raymond K.

2005-01-01

Purpose: To assess the effects of radiation dose-volume distribution on the trajectory of IQ development after conformal radiation therapy (CRT) in pediatric patients with ependymoma. Methods and Materials: The study included 88 patients (median age, 2.8 years ± 4.5 years) with localized ependymoma who received CRT (54-59.4 Gy) that used a 1-cm margin on the postoperative tumor bed. Patients were evaluated with tests that included IQ measures at baseline (before CRT) and at 6, 12, 24, 36, 48, and 60 months. Differential dose-volume histograms (DVH) were derived for total-brain, supratentorial-brain, and right and left temporal-lobe volumes. The data were partitioned into three dose intervals and integrated to create variables that represent the fractional volume that received dose over the specified intervals (e.g., V 0-20Gy , V 20-40Gy , V 40-65Gy ) and modeled with clinical variables to develop a regression equation to estimate IQ after CRT. Results: A total of 327 IQ tests were performed in 66 patients with infratentorial tumors and 20 with supratentorial tumors. The median follow-up was 29.4 months. For all patients, IQ was best estimated by age (years) at CRT; percent volume of the supratentorial brain that received doses between 0 and 20 Gy, 20 and 40 Gy, and 40 and 65 Gy; and time (months) after CRT. Age contributed significantly to the intercept (p > 0.0001), and the dose-volume coefficients were statistically significant (V 0-20Gy , p = 0.01; V 20-40Gy , p 40-65Gy , p = 0.04). A similar model was developed exclusively for patients with infratentorial tumors but not supratentorial tumors. Conclusion: Radiation dosimetry can be used to predict IQ after CRT in patients with localized ependymoma. The specificity of models may be enhanced by grouping according to tumor location

Acute neurocognitive impairment during cranial radiation therapy in patients with intracranial tumors

International Nuclear Information System (INIS)

Welzel, Grit; Mai, Sabine K.; Hermann, Brigitte; Kraus-Tiefenbacher, Uta; Wenz, Frederik; Fleckenstein, Katharina; Duke University Medical Center Durham, NC

2008-01-01

The objective of the current study was to evaluate the acute effects of cranial radiation therapy (CNS-RT) using different radiation doses (0, 1.8, 2, 3, ≤ 20 Gy) on cognitive function with special emphasis on memory. We assessed patients with and without intracranial tumors to distinguish between direct and indirect radiation effects on brain tissue. Eighty-two patients were evaluated with neuropsychological testing before and acutely after radiotherapy (RT). Sixty-four patients received RT to the brain (55 with, 9 without intracranial tumor). Eighteen patients treated with RT to the breast served as controls. Patients with intracranial tumor demonstrated attention (19-38th percentile) and verbal memory scores (34-46th percentile) below the population average at baseline. The average Verbal Memory score was significantly different between patients with intracranial tumor and controls both at baseline (38th vs. 58th percentile) and after irradiation (27th vs. 52th percentile). Patients with preexisting peritumoral edema performed worse than patients without edema and controls. Radiation dose-related deficits were seen for working memory performance in patients with intracranial tumor. Our data indicate no measurable impairment of cognitive functioning acutely after prophylactic cranial irradiation. Patients with intracranial tumor show a deterioration of almost all memory functions with a dose-dependent impairment in working memory. Patients with preexisting peritumoral brain edema show the strongest deterioration. (orig.)

Acute neurocognitive impairment during cranial radiation therapy in patients with intracranial tumors

Energy Technology Data Exchange (ETDEWEB)

Welzel, Grit; Mai, Sabine K.; Hermann, Brigitte; Kraus-Tiefenbacher, Uta; Wenz, Frederik [University Medical Center Mannheim, Heidelberg Univ. (Germany). Dept. of Radiation Oncology; Fleckenstein, Katharina [University Medical Center Mannheim, Heidelberg Univ. (Germany). Dept. of Radiation Oncology]|[Duke University Medical Center Durham, NC (United States). Dept. of Radiation Oncology

2008-12-15

The objective of the current study was to evaluate the acute effects of cranial radiation therapy (CNS-RT) using different radiation doses (0, 1.8, 2, 3, {<=} 20 Gy) on cognitive function with special emphasis on memory. We assessed patients with and without intracranial tumors to distinguish between direct and indirect radiation effects on brain tissue. Eighty-two patients were evaluated with neuropsychological testing before and acutely after radiotherapy (RT). Sixty-four patients received RT to the brain (55 with, 9 without intracranial tumor). Eighteen patients treated with RT to the breast served as controls. Patients with intracranial tumor demonstrated attention (19-38th percentile) and verbal memory scores (34-46th percentile) below the population average at baseline. The average Verbal Memory score was significantly different between patients with intracranial tumor and controls both at baseline (38th vs. 58th percentile) and after irradiation (27th vs. 52th percentile). Patients with preexisting peritumoral edema performed worse than patients without edema and controls. Radiation dose-related deficits were seen for working memory performance in patients with intracranial tumor. Our data indicate no measurable impairment of cognitive functioning acutely after prophylactic cranial irradiation. Patients with intracranial tumor show a deterioration of almost all memory functions with a dose-dependent impairment in working memory. Patients with preexisting peritumoral brain edema show the strongest deterioration. (orig.)

Acupuncture in the rehabilitation of patients with radiation fibrosis ans secondary neuritis

International Nuclear Information System (INIS)

Subova, N.D.; Bardychev, M.S.; Guseva, L.I.

1980-01-01

Acupuncture application experience as effective method of rehabilitation of patients with radiation fibrosis and neuritis is presented. Acupuncture results are more efficient in patients with treatment course after irradiation not more than 3 years, that is why its inclusion in the complex of medicaleasures of presentive treatment of patients with delayed radiation injuries should be considered advisable

Radiation therapy in patients with hematologic diseases

International Nuclear Information System (INIS)

Hennequin, C.; Maylin, C.

1995-01-01

Radiation therapy has a significant place in the treatment of hematologic diseases. Irradiation is a key component of the treatment strategy for Hodgkin's disease and has benefited from clinical studies aimed at improving its therapeutic index. There have been many recent improvements, in particular with regard to accuracy of techniques, imagery, dosimetry, and implementation of quality-control procedures. In localized non-Hodgkin's lymphoma, the gold-standard treatment is radiation therapy coupled with a short course of chemotherapy. In contrast, the place of irradiation in disseminated lymphomas remains to be defined. Prophylactic irradiation of the brain is still used in patients with acute lymphoblastic leukemia. Radiation therapy is of value as palliative treatment of bone lesions of myeloma, in chemo-resistant lymphomas, and in relapses of leukemia. Total body irradiation is a cumbersome but irreplaceable method, which has also benefited from recent clinical and biological studies. Optimal radiation therapy with the best possible therapeutic index requires adequate technological and human resources. (authors). 30 refs., 1 tab

An introduction to heat transfer. 2. rev. ed.

International Nuclear Information System (INIS)

Hell, F.

1979-01-01

This book represents a fundamental introduction to heat transfer. Practical problems and tables make the book useful for engeneers and students. The chapters include detailed informations together with exercises of convection, radiat heat transfer, thermal conduction and condensation. (CDS)

The infrared radiation spectrum of acupoint taiyuan (LU 9) in asthma patients.

Science.gov (United States)

Zhou, Yu; Shen, Xue-yong; Wang, Li-zhen; Wei, Jian-zi; Cheng, Ke

2012-06-01

To analyze the distinctive pathological characteristics in the spectrums of spontaneous infrared radiation at the Taiyuan (LU 9) acupoint in patients with asthma. A highly sensitive infrared spectrum detecting device was used to detect the spectrums of spontaneous infrared radiation at Taiyuan (LU 9) in 37 asthma patients and 34 healthy volunteers. Asthma patients had significantly lower infrared intensity than that of the healthy volunteers (P>0.01). Asthma patients had significantly lower overall infrared radiation intensity at the left Taiyuan (LU 9) than that of healthy volunteers (P > 0.05), but there was no significant difference between healthy volunteers and asthma patients at the right Taiyuan (LU 9) (P > 0.05). The infrared radiation intensity of 17 wavelength spots at the left Taiyuan (LU 9) and 4 wavelength spots at the right Taiyuan (LU 9) in asthma patients were significantly lower than those of healthy volunteers (P > 0.05). At 2 microm, the infrared radiation intensity of asthma patients was significantly stronger than that of healthy volunteers (P > 0.05). At 19 wavelength spots in the healthy volunteers and at 4 wave-length spots in the asthma patients, the left Taiyuan (LU 9) showed a significantly stronger intensity than that of the right Taiyuan (LU 9) (P > 0.05S). By Pearson's chi2 test, healthy volunteers had more wavelength spots that were significantly different between the left and right Taiyuan (LU 9) than the asthma patients (P > 0.01). Changes in the infrared spectrum at the Taiyuan (LU 9) acupoint in asthma patients may reflect distinct pathological changes. Certain acupuncture points may be related to specific organs.

Vitamin D Deficiency Is Associated With the Severity of Radiation-Induced Proctitis in Cancer Patients

International Nuclear Information System (INIS)

Ghorbanzadeh-Moghaddam, Amir; Gholamrezaei, Ali; Hemati, Simin

2015-01-01

Purpose: Radiation-induced injury to normal tissues is a common complication of radiation therapy in cancer patients. Considering the role of vitamin D in mucosal barrier hemostasis and inflammatory responses, we investigated whether vitamin D deficiency is associated with the severity of radiation-induced acute proctitis in cancer patients. Methods and Materials: This prospective observational study was conducted in cancer patients referred for pelvic radiation therapy. Serum concentration of 25-hydroxyvitamin D was measured before radiation therapy. Vitamin D deficiency was defined as 25-hydroxyvitamin D concentrations of <35 nmol/L and <40 nmol/L in male and female patients, respectively, based on available normative data. Acute proctitis was assessed after 5 weeks of radiation therapy (total received radiation dose of 50 Gy) and graded from 0 to 4 using Radiation Therapy Oncology Group (RTOG) criteria. Results: Ninety-eight patients (57.1% male) with a mean age of 62.8 ± 9.1 years were studied. Vitamin D deficiency was found in 57 patients (58.1%). Symptoms of acute proctitis occurred in 72 patients (73.4%) after radiation therapy. RTOG grade was significantly higher in patients with vitamin D deficiency than in normal cases (median [interquartile range] of 2 [0.5-3] vs 1 [0-2], P=.037). Vitamin D deficiency was associated with RTOG grade of ≥2, independent of possible confounding factors; odds ratio (95% confidence interval) = 3.07 (1.27-7.50), P=.013. Conclusions: Vitamin D deficiency is associated with increased severity of radiation-induced acute proctitis. Investigating the underlying mechanisms of this association and evaluating the effectiveness of vitamin D therapy in preventing radiation-induced acute proctitis is warranted

Vitamin D Deficiency Is Associated With the Severity of Radiation-Induced Proctitis in Cancer Patients

Energy Technology Data Exchange (ETDEWEB)

Ghorbanzadeh-Moghaddam, Amir [Medical Student' s Research Center, Isfahan University of Medical Sciences, Isfahan (Iran, Islamic Republic of); Gholamrezaei, Ali, E-mail: Gholamrezaei@med.mui.ac.ir [Medical Student' s Research Center, Isfahan University of Medical Sciences, Isfahan (Iran, Islamic Republic of); Poursina Hakim Research Institution, Isfahan (Iran, Islamic Republic of); Hemati, Simin [Department of Radiotherapy Oncology, Isfahan University of Medical Sciences, Isfahan (Iran, Islamic Republic of)

2015-07-01

Purpose: Radiation-induced injury to normal tissues is a common complication of radiation therapy in cancer patients. Considering the role of vitamin D in mucosal barrier hemostasis and inflammatory responses, we investigated whether vitamin D deficiency is associated with the severity of radiation-induced acute proctitis in cancer patients. Methods and Materials: This prospective observational study was conducted in cancer patients referred for pelvic radiation therapy. Serum concentration of 25-hydroxyvitamin D was measured before radiation therapy. Vitamin D deficiency was defined as 25-hydroxyvitamin D concentrations of <35 nmol/L and <40 nmol/L in male and female patients, respectively, based on available normative data. Acute proctitis was assessed after 5 weeks of radiation therapy (total received radiation dose of 50 Gy) and graded from 0 to 4 using Radiation Therapy Oncology Group (RTOG) criteria. Results: Ninety-eight patients (57.1% male) with a mean age of 62.8 ± 9.1 years were studied. Vitamin D deficiency was found in 57 patients (58.1%). Symptoms of acute proctitis occurred in 72 patients (73.4%) after radiation therapy. RTOG grade was significantly higher in patients with vitamin D deficiency than in normal cases (median [interquartile range] of 2 [0.5-3] vs 1 [0-2], P=.037). Vitamin D deficiency was associated with RTOG grade of ≥2, independent of possible confounding factors; odds ratio (95% confidence interval) = 3.07 (1.27-7.50), P=.013. Conclusions: Vitamin D deficiency is associated with increased severity of radiation-induced acute proctitis. Investigating the underlying mechanisms of this association and evaluating the effectiveness of vitamin D therapy in preventing radiation-induced acute proctitis is warranted.

Intraoperative radiation therapy for patients with pancreatic carcinoma

International Nuclear Information System (INIS)

Abe, Tetsuo; Itoh, Kei; Agawa, Senichiro; Ishihara, Yukio; Konishi, Toshiro

2001-01-01

We studied the efficacy and complications of intraoperative radiation therapy (IORT) in 40 subjects with unresected pancreatic carcinoma (Group A) and 8 with resected pancreatic carcinoma (Group B). These 2 groups were compared to groups not treated by IORT; 59 subjects with unresected pancreatic carcinoma (Group C) and 55 with resected pancreatic carcinoma (Group D). The 6-month survival in Group A was 55%, and 1-year survival 26% compared to 20% 6-month survival and 9% 1-year survival in Group C with a median survival of 7 months in Group A and 4 months in group C; all statistically significant. Pain control was 81.8% in Group A, reduction in tumor size was 50% and reduction of tumor marker, CA19-9 was 56.3% in Group A. Survival in Groups B and D did not differ significantly. The histological efficacy of IORT in Group A was confirmed in autopsy of fibrosis and scar formation in radiation fields of the pancreas. Two patients in Group B had major morbidity leading to death; 1 from leakage in the pancreatojejunal anastomosis accompanied by pancreatic necrosis and the other from duodenal perforation with rupture of the portal vein and hepatic artery. This study demonstrates the efficacy of IORT in patients with unresected pancreatic carcinoma. Prophylactic bypass and shielding of the residual pancreas with lead or reducing the IORT or external beam radiation therapy (EBRT) dose should be considered in patients with unresected or resected pancreatic carcinoma, however, to prevent serious complications due to radiation injury of the duodenum and pancreas. (author)

Carcinoma of the anal canal: Intensity modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3DCRT)

Science.gov (United States)

Sale, Charlotte; Moloney, Phillip; Mathlum, Maitham

2013-01-01

Introduction Patients with anal canal carcinoma treated with standard conformal radiotherapy frequently experience severe acute and late toxicity reactions to the treatment area. Roohipour et al. (Dis Colon Rectum 2008; 51: 147–53) stated a patient's tolerance of chemoradiation to be an important prediction of treatment success. A new intensity modulated radiation therapy (IMRT) technique for anal carcinoma cases has been developed at the Andrew Love Cancer Centre aimed at reducing radiation to surrounding healthy tissue. Methods A same-subject repeated measures design was used for this study, where five anal carcinoma cases at the Andrew Love Cancer Centre were selected. Conformal and IMRT plans were generated and dosimetric evaluations were performed. Each plan was prescribed a total of 54 Gray (Gy) over a course of 30 fractions to the primary site. Results The IMRT plans resulted in improved dosimetry to the planning target volume (PTV) and reduction in radiation to the critical structures (bladder, external genitalia and femoral heads). Statistically there was no difference between the IMRT and conformal plans in the dose to the small and large bowel; however, the bowel IMRT dose–volume histogram (DVH) doses were consistently lower. Conclusion The IMRT plans were superior to the conformal plans with improved dose conformity and reduced radiation to the surrounding healthy tissue. Anecdotally it was found that patients tolerated the IMRT treatment better than the three-dimensional (3D) conformal radiation therapy. This study describes and compares the planning techniques. PMID:26229623

Patient-centered image and data management in radiation oncology

International Nuclear Information System (INIS)

Steil, Volker; Schneider, Frank; Kuepper, Beate; Wenz, Frederik; Lohr, Frank; Weisser, Gerald

2009-01-01

Background: recent changes in the radiotherapy (RT) workflow through the introduction of complex treatment paradigms such as intensity-modulated radiotherapy (IMRT) and, recently, image-guided radiotherapy (IGRT) with their increase in data traffic for different data classes have mandated efforts to further integrate electronic data management for RT departments in a patient- and treatment-course-centered fashion. Methods: workflow in an RT department is multidimensional and multidirectional and consists of at least five different data classes (RT/machine data, patient-related documents such as reports and letters, progress notes, DICOM (Digital Imaging and Communications in Medicine) image data, and non-DICOM image data). Data has to be handled in the framework of adaptive feedback loops with increasing frequency. This is in contrast to a radiology department where mainly DICOM image data and reports have to be widely accessible but are dealt with in a mainly unidirectional manner. When compared to a diagnostic Radiology Information System (RIS)/Picture Archiving and Communication System (PACS), additional legal requirements have to be conformed to when an integrated electronic RT data management system is installed. Among these are extended storage periods, documentation of treatment plan approval by physicians and physicist, documentation of informed consent, etc. Conclusion: since the transition to a paper- and filmless environment in medicine and especially m radiation ''neology is unavoidable this review discusses these issues and suggests a possible hardware and organizational architecture of an RT department information system under control of a Hospital Information System (HIS), based on combined features of genuine RT Record and Verify (R and V) Systems, PACS, and Electronic Medical Records (EMR). (orig.)

The effects and control of radiation

International Nuclear Information System (INIS)

Saunders, P.A.H.

1982-12-01

The subject is discussed under the headings: introduction; ionising radiation (alpha and beta particles, gamma- and X-radiation, neutrons, half-life, sources of radiation); biological effects; risk estimates (somatic) (early effects, delayed effects); risk estimates (hereditary); control of radiation; risk estimates (accidents). (U.K.)

Reversal of cerebral radiation necrosis with bevacizumab treatment in 17 Chinese patients

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Wang Yang

2012-08-01

Full Text Available Abstract Background Bevacizumab has been suggested as a new treatment modality for cerebral radiation necrosis due to its ability to block the effects of vascular endothelial growth factor (VEGF in leakage-prone capillaries, though its use still remains controversial in clinical practice. Methods The use of bevacizumab in 17 patients with symptomatic cerebral radiation necrosis poorly controlled with dexamethasone steroid treatments was examined between March 2010 and January 2012. Bevacizumab therapy was administered for a minimum of two cycles (7.5 mg/kg, at two-week interval with a median of four bevacizumab injections. Changes in bi-dimensional measurements of the largest radiation necrosis lesions were observed by gadolinium-enhanced and T2-weighted magnetic resonance imaging (MRI. Additionally, dexamethasone dosage, Karnofsky performance status (KPS, adverse event occurrence and associated clinical outcomes were recorded for each patient. Results MRI analysis revealed that the average reduction was 54.9% and 48.4% in post-gadolinium and T2-weighted sequence analysis, respectively. Significant clinical neurological improvements were expressed in 10 patients according to KPS values. Dexamethasone reduction was achieved four weeks after initiation of bevacizumab in all patients, with four patients successfully discontinuing dexamethasone treatment. Mild to moderate bevacizumab-related adverse events, such as fatigue, proteinuria and hypertension were observed in three patients. Upon follow-up at 4 to 12 months, 10 patients showed clinical improvement, and 7 patient deaths occurred from tumor progression (5 patients, recurrent necrosis (1 patient, and uncontrolled necrosis-induced edema (1 patient. Conclusions These findings suggest bevacizumab as a promising treatment for cerebral radiation necrosis induced by common radiation therapies, including external beam radiotherapy (EBRT, stereotactic radiosurgery (SRS, and fractionated stereotactic

Radiation exposure and dosimetry in transplant patients due to Nuclear Medicine studies

International Nuclear Information System (INIS)

El-Maghraby, T. A. F.; Cairo Univ., Cairo; Camps, J. A. J.; Geleyns, J.; Pauwels, E. K. J.

2000-01-01

Organ transplantation is now an accepted method of therapy for treating patients with end stage failure of kidneys, liver, heart or lung. Nuclear Medicine may provide functional data and semi-quantitative parameters. However, one serious factor that hampers the use of nuclear medicine procedures in transplant patients is the general clinical concern about radiation exposure to the patient. This lead the researcher to discuss the effective doses and radiation dosimetry associated with radionuclide procedures used in the management and follow-up of transplant patients. A simple way to place the risk associated with Nuclear Medicine studies in an appropriate context is to compare the dose with that received from more familiar source of exposure such as from a diagnostic X-ray procedure. The radiation dose for the different radiopharmaceuticals used to study transplant organ function ranges between 0.1 and 5.3 mSv which is comparable to X-ray procedures with the exception of 201 Tl and 111 In-antimyosin. Thus Nuclear Medicine studies do not bear a higher radiation risk than the often used X-ray studies in transplant patients

Medical management of irradiated patients in a radiation accident in Jining, Shandong province

International Nuclear Information System (INIS)

Ai Huisheng; Yu Changlin; Qiao Jianhui; Zhang Shi; Guo Mei; Zhang Xignag; Wang Danhong; Sun Qiyun; Niu Wenkai; Li Guang; Yao Bo; Zhou Zhenshan; Luo Weidong; Liu Sugang; He Yaozhong; Chen Jiankui; Li Xiaobing; Hu Kaixun; Chen Ying; Wu Ke; Yang Guoshan; Liu Ying

2007-01-01

Objective: To summarize the experience of diagnosis and treatment from the extremely severe bone marrow form of acute radiation sickness and intestinal form of acute radiation sickness. Methods: A nuclear accident occurred in China on October 21st, 2004. Two individuals were accidentally irradiated by a 60 Co source. The two patients were estimated at more than 20-25 Gy and 9-15 Gy of γ-rays exposures, respectively, and were diagnosed as the intestinal form of acute radiation sickness (patient A) and the extremely severe bone marrow form of acute radiation sickness (patient B), respectively. After urgent preparative regimen based on low- dose fludarabine, antilymphocyte globulin and cyclophosphamide, the two patients received HLA-haploidentical (patient A) or HLA-identical (patient B) peripheral blood stem cell transplantation (PBSCT), respectively. Cyclosporin A combined mycophenolate mofetil regimen was used for the prevention of graft-versus-host disease (GVHD). Bone marrow mesenchymal stem cells from donor were injected to bone marrow of patient A additionally. Results: Both peripheral blood and bone marrow examinations showed hemopoietic recovery after PBSCT. Neither of the two patients showed obvious clinical signs specific to GVHD. Patient A died of septicemia and multi-organ failure on the 33rd day after exposure, while patient B died of multi-organ failure with predominant heart failure on the 75th day after exposure. Conclusions: Chromosome analysis of bone marrow and peripheral blood, and electron spin resonance measurement of tooth enamel play a very important role in diagnosis of the very high dose radiation disease. It is possible and feasible to treat acute radiation sickness using HLA-haploidentical or HLA-identical PBSCT. The death of patients is mainly due to infection and multi-organ failure. (authors)

Stereotactic Body Radiation Therapy for Locally Progressive and Recurrent Pancreatic Cancer after Prior Radiation

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Philip Sutera

2018-03-01

Full Text Available IntroductionPancreatic adenocarcinoma is an aggressive malignancy that has consistently demonstrated poor outcomes despite aggressive treatments. Despite multimodal treatment, local disease progression and local recurrence are common. Management of recurrent or progressive pancreatic carcinomas proves a further challenge. In patients previously treated with radiation therapy, stereotactic body radiation therapy (SBRT is a promising modality capable of delivering high dose to the tumor while limiting dose to critical structures. We aimed to determine the feasibility and tolerability of SBRT for recurrent or local pancreatic cancer in patients previously treated with external beam radiation therapy (EBRT.Materials and methodsPatients treated with EBRT who developed recurrent or local pancreatic ductal adenocarcinoma treated with SBRT reirradiation at our institution, from 2004 to 2014 were reviewed. Our primary endpoints included overall survival (OS, local control, regional control, and late grade 3+ radiation toxicity. Endpoints were analyzed with the Kaplan–Meier method. The association of these survival endpoints with risk factors was studied with univariate Cox proportional hazards models.ResultsWe identified 38 patients with recurrent/progressive pancreatic cancer treated with SBRT following prior radiation therapy. Prior radiation was delivered to a median dose of 50.4 Gy in 28 fractions. SBRT was delivered to a median dose of 24.5 Gy in 1–3 fractions. Surgical resection was performed on 55.3% of all patients. Within a median follow-up of 24.4 months (inter-quartile range, 14.9–32.7 months, the median OS from diagnosis for the entire cohort was 26.6 months (95% CI: 20.3–29.8 with 2-year OS of 53.0%. Median survival from SBRT was 9.7 months (95% CI, 5.5–13.8. The 2-year freedom from local progression and regional progression was 58 and 82%, respectively. For the entire cohort, 18.4 and 10.5% experienced late grade 2

New patient-controlled abdominal compression method in radiography: radiation dose and image quality.

Science.gov (United States)

Piippo-Huotari, Oili; Norrman, Eva; Anderzén-Carlsson, Agneta; Geijer, Håkan

2018-05-01

The radiation dose for patients can be reduced with many methods and one way is to use abdominal compression. In this study, the radiation dose and image quality for a new patient-controlled compression device were compared with conventional compression and compression in the prone position . To compare radiation dose and image quality of patient-controlled compression compared with conventional and prone compression in general radiography. An experimental design with quantitative approach. After obtaining the approval of the ethics committee, a consecutive sample of 48 patients was examined with the standard clinical urography protocol. The radiation doses were measured as dose-area product and analyzed with a paired t-test. The image quality was evaluated by visual grading analysis. Four radiologists evaluated each image individually by scoring nine criteria modified from the European quality criteria for diagnostic radiographic images. There was no significant difference in radiation dose or image quality between conventional and patient-controlled compression. Prone position resulted in both higher dose and inferior image quality. Patient-controlled compression gave similar dose levels as conventional compression and lower than prone compression. Image quality was similar with both patient-controlled and conventional compression and was judged to be better than in the prone position.

Impact of Digital Imaging on Radiation Doses to the Patient During X-ray Examination of the Urinary Tract

International Nuclear Information System (INIS)

Sjoeholm, B.; Geijer, H.; Persliden, J.

2005-01-01

Purpose: To compare radiation doses given to patients undergoing IVU (intravenous urography) before and after digitalization of our X-ray department. Material and Methods: IVU examinations were monitored with dose area product meters before and after the X-ray department changed to digital techniques. The first step was a change from film-screen to storage phosphor plates, while the second step involved changing to a flat panel detector. Forty-two patients were included for the film-screen situation, 69 when using the storage phosphor plates, and 70 using the flat panel detector. Results: A dose reduction from 41.8 Gycm 2 to 31.5 Gycm 2 was achieved with the first step when the film-screen system was replaced with storage phosphor plates. A further reduction to 12.1 Gycm 2 was achieved using the flat panel detector. Conclusion: The introduction of the flat panel detectors made a considerable dose reduction possible Digital radiography, dosimetry, urinary

Impact of Digital Imaging on Radiation Doses to the Patient During X-ray Examination of the Urinary Tract

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Sjoeholm, B. [Oerebro Univ. Hospital (Sweden). Depts. of Medical Physics and Radiology; Geijer, H. [Oerebro Univ. (Sweden). Dept. of Physics; Persliden, J. [Linkoeping Univ. (Sweden). Dept. of Radiation Physics

2005-10-01

Purpose: To compare radiation doses given to patients undergoing IVU (intravenous urography) before and after digitalization of our X-ray department. Material and Methods: IVU examinations were monitored with dose area product meters before and after the X-ray department changed to digital techniques. The first step was a change from film-screen to storage phosphor plates, while the second step involved changing to a flat panel detector. Forty-two patients were included for the film-screen situation, 69 when using the storage phosphor plates, and 70 using the flat panel detector. Results: A dose reduction from 41.8 Gycm{sup 2} to 31.5 Gycm{sup 2} was achieved with the first step when the film-screen system was replaced with storage phosphor plates. A further reduction to 12.1 Gycm{sup 2} was achieved using the flat panel detector. Conclusion: The introduction of the flat panel detectors made a considerable dose reduction possible Digital radiography, dosimetry, urinary.

Optimization and radiation protection of the patient in medical exposure

International Nuclear Information System (INIS)

Mwambinga, S.A.

2012-04-01

Radiography has been an established imaging modality for over a century, continuous developments have led to improvements in technique resulting in improved image quality at reduced patient dose. If one compares the technique used by Roentgen with the methods used today, one finds that a radiograph can now be obtained at a dose which is smaller. The International Atomic Energy Agency (IAEA) has a statutory responsibility to establish standards for the protection of people against exposure to ionising radiation and to provide for the worldwide application of those standards. A fundamental requirement of the International Basic Safety Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources (BSS) is the optimization of radiological protection of patients undergoing medical exposure. By using technique such as added filtration, use of high kVp techniques, low mAs, use of appropriate screen-film combination and making sure that all practices and any exposure to patient are justified, using ALARA principles and diagnostic Reference Levels, patient protection can be optimised. (author)

Detection of nuclear radiations

International Nuclear Information System (INIS)

Tanarro Sanz, A.

1959-01-01

A summary of the lectures about the ordinary detectors of nuclear radiations given by the author in the Courses of Introduction to Nuclear Engineering held at the JEN up to the date of publication is given. Those lectures are considered to be a necessary introduction to Nuclear Instrumentation and Applied electronics to Nuclear Engineering so it has been intent to underline those characteristics of radiation detectors that must be taken in consideration in choosing or designing the electronic equipment associated to them in order to take advantage of each detector possibilities. (Author) 8 refs

X-ray and radium gamma radiation injuries

International Nuclear Information System (INIS)

Fokkema, R.E.

1993-05-01

During the period 1896-1939 a number of maxima could be distinguished in the incidence of X-ray and radium gamma ray injuries in patients. An explanation for these fluctuations is investigated in this study. The first distinguishable maximum in the number of reported cases of X-ray injuries can be found in the period 1896-1897 and mainly concerns skin lesions, caused by the lack of shielding and ignorance of the effects. In the period 1904-1905 there was once again an apparent prevalence of radiation injuries to patients. After 1905 the incidence of radiation injuries decreased due to a wider use of dosimetric methods. The third phase of increased injuries may be subdivided into three components. In diagnostic roentgenology from 1896 to 1926 a number of causes of roentgen burns persisted: multiple or long exposures, the use of a short focus-skin-distance and a lack of suitable dosimetric methods. The reduction of complications after 1923 can be attributed to several factors: systematic training of physics who wished to become roentgenologists, greater care of doctors, the use of an alternative method of radiotherapy according to Coutard's method, the introduction of dosimetry with ionization chambers (after 1924), the consensus reached over the roentgen as a unit of applied dosage (in 1928), and the introduction of absorption curves for radiation quality (in 1933). Around 1920 a high complication rate arose as a result of exposure to radiation emitted by radium. In 1922 the first reliable radium dosimetry method came available. This applied to external radium therapy by regular shaped applicators. After 1938 reliable dosimetry was achieved in the field of interstitial radium therapy (brachytherapy). Injuries from radium therapy, however, persisted till about 1940, caused not only by the delayed availability of radium dosimetry, but also to the use of radium therapy by poorly trained radium therapists. 28 figs., 5 tabs

A prospective study of quality of life in breast cancer patients undergoing radiation therapy

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Canhua Xiao, PhD, RN

2016-01-01

Conclusions: Radiation therapy did not worsen QOL in breast cancer patients. However, pre-radiation therapy patient characteristics including BMI and perceived stress may be used to identify women who may experience decreased physical and mental function during and up to 1 year after radiation therapy.

Experiences of 23 patients ≥ 90 years of age treated with radiation therapy

International Nuclear Information System (INIS)

Oguchi, Masahiko; Ikeda, Hiroshi; Watanabe, Toshikazu; Shikama, Naoto; Ohata, Takeo; Okazaki, Youichi; Kiyono, Kunihiro; Sone, Shusuke

1998-01-01

Purpose: To present 23 patients ≥ 90 years old treated with radiotherapy, and to retrospectively evaluate the results of radiotherapy and tolerance in these patients. Methods and Materials: The clinical records of 27 patients over 90 years of age who were treated with radiotherapy at the Department of Radiology, Shinshu University Hospital, and eight affiliated general hospitals from 1990 until 1995 were reviewed. The strategy of radiotherapy was individually planned depending on the stage of the disease and performance status (PS) of the patient; however, it was not modified, based solely on chronologic age. The overall survival rate and disease-free survival rate were determined using the Kaplan-Meier method. The Radiation Therapy Oncology Group scoring criteria of acute and late reactions of radiation therapy were used. Results: This group of patients accounted for 0.37% of all patients treated with radiotherapy in these hospitals. Of these, 23 patients in whom cancer was pathologically confirmed and whose follow-up data were available for retrospective analysis were included in the final evaluation of data. The age of the 23 patients ranged from 90 to 96 years (median 93). Tumor was untreated and in the early stage in five patients, locoregionally advanced in 13, recurrent in four, and systemic in one. Definitive radiation therapy was administered in 12 patients (13 sites), preoperative intent in one, and palliative intent in 10. The period of observation ranged from 2.5 to 6 years (median 18 months). Seven patients were alive for 15-67 months. Fourteen patients died because of intercurrent diseases or senility associated with active cancer, and two because of senility without evidence of cancer. The overall and relapse-free survival rates were 65% and 30% at 1 year and 30% and 21% at 2 years, respectively. Definitive radiation therapy was completed in 13 of 13 patients (100%), and local control was attained in 9 of 13 patients at 6 months (62%). Palliative

Radiation-induced cancer in laryngectomized patients

International Nuclear Information System (INIS)

Miyahara, Hiroshi; Tsuruta, Yoshihiro; Sato, Takeo; Yoshino, Kunitoshi; Umatani, Katunori

1991-01-01

Three patients developed hypopharyngo-cervical esophageal carcinoma, 6.5, 13, and 12 years after total laryngectomy. The first patient had received irradiation (60 Gy) for hypopharyngeal carcinoma. The recurrent tumor was removed with total pharyngolaryngoesophagectomy and reconstruction was performed with a local skin flap. After 6 years and 6 months, she developed progressive dysphagia. A new cervical esophageal skin cancer was diagnosed by pharyngoesophagography and treated. The second patient had had total laryngectomy for laryngeal carcinoma and received irradiation (100 Gy) post-operatively. After 13 years, he developed progressive dysphagia. Pharyngoesophagography revealed cervical esophageal carcinoma. The third patient had received irradiation for laryngeal carcinoma (60 Gy) and underwent total laryngectomy because of recurrence. After 12 years she developed dysphagia, and was treated for hypopharyngeal carcinoma. These three patients seemed to have radiation-induced carcinoma. Patients treated with total laryngectomy and irradiation who later complain of progressive dysphagia should be examined carefully to differentiate between postoperative stenosis due to scarring and a new carcinoma. (author)

Effects of the new radiation protection act on the radiation protection register and the monitoring of occupational radiation exposure

International Nuclear Information System (INIS)

Frasch, G.

2016-01-01

The implementation of DIRECTIVE 2013/59 / EURATOM (EURATOM Basic Safety Standards) is via the new radiation protection law and brings in the monitoring of occupational radiation among others two significant new features and changes: - Introduction of a unique personal identifier, - update of the occupational categories. Both require technical and organizational changes in the data transmission of the licensees to the dosimetry services and the radiation protection register.

Improved radiation protection for physicians performing cardiac catheterization

International Nuclear Information System (INIS)

Gertz, E.W.; Wisneski, J.A.; Gould, R.G.; Akin, J.R.

1982-01-01

Physicians and their assistants performing diagnostic angiography must be concerned with the radiation exposure they receive. The introduction of hemiaxial projections for imaging has increased diagnostic accuracy but has also greatly increased the physicians' exposure to scattered radiation. This increase is especially critical for the eyes and thyroid of the physician who routinely performs these procedures. To reduce such exposure a ceiling-suspended shield (60 x 45 cm), made of 6.4 mm glass with a 19.5 kg/m2 (4 lb/ft2) lead equivalency, was developed. During procedures the shield is interposed between the physician and the region of the patient acting as the source of scattered radiation. The degree of radiation protection to the operator was assessed by measuring the distribution of scattered radiation in the vicinity of the operator with and without the shield. The effectiveness of the shield was determined in the 30 degrees right anterior oblique (RAO), 5 degrees left anterior oblique (LAO), 35 degrees LAO, and 50 degrees LAO-15 degrees cranial angulations. At critical heights such as the level of the eyes and thyroid, scattered radiation levels were reduced by 85% or greater in all angulations. Without interfering with the physician's ability to observe the patient or manipulate the catheter, this shield can significantly reduce the physician's exposure to radiation

Evaluation of radiation dose to patients in intraoral dental radiography using Monte Carlo Method

International Nuclear Information System (INIS)

Park, Il; Kim, Kyeong Ho; Oh, Seung Chul; Song, Ji Young

2016-01-01

The use of dental radiographic examinations is common although radiation dose resulting from the dental radiography is relatively small. Therefore, it is required to evaluate radiation dose from the dental radiography for radiation safety purpose. The objectives of the present study were to develop dosimetry method for intraoral dental radiography using a Monte Carlo method based radiation transport code and to calculate organ doses and effective doses of patients from different types of intraoral radiographies. Radiological properties of dental radiography equipment were characterized for the evaluation of patient radiation dose. The properties including x-ray energy spectrum were simulated using MCNP code. Organ doses and effective doses to patients were calculated by MCNP simulation with computational adult phantoms. At the typical equipment settings (60 kVp, 7 mA, and 0.12 sec), the entrance air kerma was 1.79 mGy and the measured half value layer was 1.82 mm. The half value layer calculated by MCNP simulation was well agreed with the measurement values. Effective doses from intraoral radiographies ranged from 1 μSv for maxilla premolar to 3 μSv for maxilla incisor. Oral cavity layer (23⁓82 μSv) and salivary glands (10⁓68 μSv) received relatively high radiation dose. Thyroid also received high radiation dose (3⁓47 μSv) for examinations. The developed dosimetry method and evaluated radiation doses in this study can be utilized for policy making, patient dose management, and development of low-dose equipment. In addition, this study can ultimately contribute to decrease radiation dose to patients for radiation safety

Evaluation of radiation dose to patients in intraoral dental radiography using Monte Carlo Method

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Park, Il; Kim, Kyeong Ho; Oh, Seung Chul; Song, Ji Young [Dept. of Nuclear Engineering, Kyung Hee University, Yongin (Korea, Republic of)

2016-11-15

The use of dental radiographic examinations is common although radiation dose resulting from the dental radiography is relatively small. Therefore, it is required to evaluate radiation dose from the dental radiography for radiation safety purpose. The objectives of the present study were to develop dosimetry method for intraoral dental radiography using a Monte Carlo method based radiation transport code and to calculate organ doses and effective doses of patients from different types of intraoral radiographies. Radiological properties of dental radiography equipment were characterized for the evaluation of patient radiation dose. The properties including x-ray energy spectrum were simulated using MCNP code. Organ doses and effective doses to patients were calculated by MCNP simulation with computational adult phantoms. At the typical equipment settings (60 kVp, 7 mA, and 0.12 sec), the entrance air kerma was 1.79 mGy and the measured half value layer was 1.82 mm. The half value layer calculated by MCNP simulation was well agreed with the measurement values. Effective doses from intraoral radiographies ranged from 1 μSv for maxilla premolar to 3 μSv for maxilla incisor. Oral cavity layer (23⁓82 μSv) and salivary glands (10⁓68 μSv) received relatively high radiation dose. Thyroid also received high radiation dose (3⁓47 μSv) for examinations. The developed dosimetry method and evaluated radiation doses in this study can be utilized for policy making, patient dose management, and development of low-dose equipment. In addition, this study can ultimately contribute to decrease radiation dose to patients for radiation safety.

Use of combutec 2 for the treatment of patients with radiation injuries

International Nuclear Information System (INIS)

Selezneva, L.G.; Barabanova, A.V.; Adamyan, A.A.; Drobysh, S.V.; Kochergina, L.D.; Chechetkin, P.I.; Golovanova, N.M.; Makarova, L.R.; Tuzova, N.N.

1991-01-01

A high activity of combutec 2, prepared on the basis of soluble collagen, was demonstrated in patients with radiation injuries of the skin after the accident at Chernobyl. Combutec 2 can be recommended for local therapy of patients with skin radiation injuries in all periods of development of these changes

Incidence and predictors of Lhermitte’s sign among patients receiving mediastinal radiation for lymphoma

International Nuclear Information System (INIS)

Youssef, Bassem; Shank, JoAnn; Reddy, Jay P.; Pinnix, Chelsea C.; Farha, George; Akhtari, Mani; Allen, Pamela K.; Fanale, Michelle A.; Garcia, John A.; Horace, Patricia H.; Milgrom, Sarah; Smith, Grace Li; Nieto, Yago; Arzu, Isadora; Wang, He; Fowler, Nathan; Rodriguez, Maria Alma; Dabaja, Bouthaina

2015-01-01

To prospectively examine the risk of developing Lhermitte’s sign (LS) in patients with lymphoma treated with modern-era chemotherapy followed by consolidation intensity-modulated radiation therapy. We prospectively interviewed all patients with lymphoma who received irradiation to the mediastinum from July 2011 through April 2014. We extracted patient, disease, and treatment-related variables from the medical records of those patients and dosimetric variables from treatment-planning systems and analyzed these factors to identify potential predictors of LS with Pearson chi-square tests. During the study period 106 patients received mediastinal radiation for lymphoma, and 31 (29 %) developed LS. No correlations were found between LS and any of the variables examined, including total radiation dose, maximum point dose to the spinal cord, volume receiving 105 % of the dose, and volumes receiving 5 or 15 Gy. In this group of patients, treatment with chemotherapy followed by intensity-modulated radiation therapy led to 29 % developing LS; this symptom was independent of radiation dose and seemed to be an idiosyncratic reaction. This relatively high incidence could have resulted from prospective use of a structured interview

The role of intraoperative radiation therapy in patients with pancreatic cancer.

Science.gov (United States)

Palta, Manisha; Willett, Christopher; Czito, Brian

2014-04-01

Intraoperative radiation therapy (IORT) techniques allow for the delivery of high doses of radiation therapy while excluding part or all of the nearby dose-limiting sensitive structures. Therefore, the effective radiation dose is increased and local tumor control potentially improved. This is pertinent in the case of pancreatic cancer because local failure rates are as high as 50%-80% in patients with resected and locally advanced disease. Available data in patients receiving IORT after pancreaticoduodenectomy reveal an improvement in local control, though overall survival benefit is unclear. Series of patients with locally advanced pancreatic cancer also suggest pain relief, and in select studies, improved survival associated with the inclusion of IORT. At present, no phase III data clearly supports the use of IORT in the management of pancreatic cancer. © 2013 Published by Elsevier Inc.

Radiation exposure to patients and personnel during percutaneous renal calculus extraction

International Nuclear Information System (INIS)

Khandelwal, K.C.; Kooka, D.M.; Dagaonkar, S.S.; Supe, S.J.

1990-01-01

Radiation exposure to the patient, radiologist and other personnel was measured during 20 percutaneous renal calculus extractions. Thermoluminescent dosimeters were used. The average skin dose for patient at the level of the testis was 80 mrem, and at the level of the kidney, 17.2 rem. Radiation exposure to the personnel was measured at the levels of forehead, thyroid, chest and testis. The average dose to these regions ranged between 0.20 mrem and 2.5 mrem. The radiologist's hand received on average radiation of 88.8 mrems. The patient skin surface exposure at the nephrostomy site are comparable to skin doses from standard procedures. The exposure to the radiologist is similar to that from other interventional fluoroscopic procedures and is within acceptable limits. (author). 10 refs., 3 tabs

Introduction to the special issue of Radiation Protection Dosimetry

International Nuclear Information System (INIS)

Anon.

2016-01-01

This special issue is a collection of peer-reviewed articles derived from presentations at the fourth EPR BioDose Meeting, held in Hanover, NH, USA in 4-8 October 2015. Organised by The International Association of Biological and EPR Radiation Dosimetry (IABERD), this meeting was held in combination with two international conferences (The International Symposium on EPR Dosimetry and Dating and The International Conference on Biodosimetry) and a symposium (The International EPR Society). The primary focus of this conference was on medical response to events in which large numbers of individuals may be exposed to significant levels of ionising radiation; topics included biodosimetry techniques, radiation mitigators, model systems to develop countermeasures, new data from different exposure events and the implication of these methods in a radiological emergency or in terrorist attack scenarios. (authors)

Patients Undergoing Radiation Therapy Are at Risk of Financial Toxicity: A Patient-based Prospective Survey Study.

Science.gov (United States)

Palmer, Joshua D; Patel, Tejash T; Eldredge-Hindy, Harriet; Keith, Scott W; Patel, Tapas; Malatesta, Theresa; DiNome, Jessie; Lowther, Anne; Ferguson, Linda; Wagenborg, Sally; Smyles, John; Babaria, Usha; Stabile, Richard; Gressen, Eric; Rudoler, Shari; Fisher, Scot A

2018-06-01

Little is known about the financial burden experienced by patients receiving radiation therapy. Furthermore, currently, no financial toxicity screening tools have been validated for use in radiation oncology. Physician surveys were used to gauge provider understanding of treatment costs and their willingness to adopt the use of financial toxicity screening tools. Post-treatment patient surveys were used to investigate the covariates of treatment-induced financial risk. Of the 210 radiation oncologists who completed our survey, 53% reported being "very concerned" with treatment-related costs negatively affecting their patients, and 80% believed that a financial toxicity screening tool would be useful in practice. An analysis of patient surveys using logistic regression found age and cancer site to be the most important variables associated with financial toxicity. Thirty-four patients (22%) experienced financial toxicity related to treatment. The financial toxicities experienced were loss of job (28%), loss of income (24%), difficulty paying their rent or mortgage (20%), difficulty paying for transportation (15%), and difficulty paying for meals (13%). Financial toxicity is an important measure for patients and providers and is experienced by approximately one quarter of patients. Further studies to improve models to predict financial toxicity and how financial toxicity is related to patient outcomes and quality of life are warranted. Copyright © 2018 Elsevier Inc. All rights reserved.

What do Patients Want From Their Radiation Oncologist? Initial Results From a Prospective Trial

International Nuclear Information System (INIS)

Bhatnagar, Ajay K.; Land, Stephanie R.; Shogan, Alyson; Rodgers, Edwin E.; Heron, Dwight E.; Flickinger, John C.

2007-01-01

Purpose: To assess patients' initial physician preferences using a newly developed instrument. Methods and Materials: A total of 182 patients with a primary diagnosis of prostate, breast, or lung cancer referred for consultation to University of Pittsburgh Cancer Institute Department of Radiation Oncology enrolled in our institutional review board-approved protocol. All patients completed patient preference instrument surveys before meeting their radiation oncologist. Survey responses to 10 statements were categorized into three groups (agree, neutral, or disagree), and the association of survey responses by cancer site was tested with chi-squared tests. Results: Ninety-nine percent of all patients preferred to be addressed by their first name in encounters with their radiation oncologist. There were significant associations of Item 3 (hand holding) with gender (p = 0.039) and education (p = 0.028). The responses to Item 5, a statement that patients would feel uncomfortable if the radiation oncologist offered to hug them at the end of treatment, was significantly associated with disease site (p < 0.0001). Further analysis was performed for Item 5 and revealed that the male lung cancer patients had a much higher rate of disagreement with Item 5 compared with prostate cancer patients (37% vs. 18%). Conclusions: Results of this study may afford greater insight and foster better understanding of what patients want from their radiation oncologist. For breast, lung, and prostate cancer patients, initial preferences for their radiation oncologist are generally similar, according to this tool. However, there are important difference among cancer sites (and gender) regarding physical contact at the end of treatment

Radiation dose associated with CT-guided drain placement for pediatric patients

Energy Technology Data Exchange (ETDEWEB)

Schwartz, Cody J.; Isaacson, Ari J.; Fordham, Lynn Ansley; Ivanovic, Marija; Dixon, Robert G. [University of North Carolina at Chapel Hill, Department of Radiology, UNC Health Care, Chapel Hill, NC (United States); Taylor, J.B. [University of North Carolina at Chapel Hill, Environment, Health and Safety, Chapel Hill, NC (United States)

2017-05-15

To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary. (orig.)

Radiation dose associated with CT-guided drain placement for pediatric patients

International Nuclear Information System (INIS)

Schwartz, Cody J.; Isaacson, Ari J.; Fordham, Lynn Ansley; Ivanovic, Marija; Dixon, Robert G.; Taylor, J.B.

2017-01-01

To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary. (orig.)

Patient radiation dose during mammography procedures

International Nuclear Information System (INIS)

Mohamed, Swsan Awd Elkriem

2015-11-01

The objectives of this study were to estimate the patient dose in term of mean glandular dose and assist in optimization of radiation protection in mammographic procedures in Sudan. A total number of 107 patients were included. Four mammographic units were participated. Only one center was using automatic exposure control (AEC). The mean doses in (mGy) for the CC projection were 3.13, 1.24, 2.45 and 0.98 and for the MLO projection was 2.13, 1.26, 1.99 and 1.02 for centers A, B, C, and D, respectively. The total mean dose per breast from both projections was 5.26, 2.50, 4.44 and 1.99 mGy for centers A, B, C and D, respectively. The minimum mean glandular dose was found between the digital system which was operated under AEC and one of the manual selected exposure factors systems, this highlight possible optimization of radiation protection in the other manual selected systems. The kilo volt and the tube current time products should be selected correctly according to the breast thickness in both centers A and C. (author)

Patient-Physician Communication About Complementary and Alternative Medicine in a Radiation Oncology Setting

International Nuclear Information System (INIS)

Ge Jin; Fishman, Jessica; Vapiwala, Neha; Li, Susan Q.; Desai, Krupali; Xie, Sharon X.; Mao, Jun J.

2013-01-01

Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients’ discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.

Theoretical astrophysics an introduction

CERN Document Server

Bartelmann, Matthias

2013-01-01

A concise yet comprehensive introduction to the central theoretical concepts of modern astrophysics, presenting hydrodynamics, radiation, and stellar dynamics all in one textbook. Adopting a modular structure, the author illustrates a small number of fundamental physical methods and principles, which are sufficient to describe and understand a wide range of seemingly very diverse astrophysical phenomena and processes. For example, the formulae that define the macroscopic behavior of stellar systems are all derived in the same way from the microscopic distribution function. This function it

Radiation exposure of patient and surgeon in minimally invasive kidney stone surgery.

Science.gov (United States)

Demirci, A; Raif Karabacak, O; Yalçınkaya, F; Yiğitbaşı, O; Aktaş, C

2016-05-01

Percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) are the standard treatments used in the endoscopic treatment of kidney stones depending on the location and the size of the stone. The purpose of the study was to show the radiation exposure difference between the minimally invasive techniques by synchronously measuring the amount of radiation the patients and the surgeon received in each session, which makes our study unique. This is a prospective study which included 20 patients who underwent PNL, and 45 patients who underwent RIRS in our clinic between June 2014 and October 2014. The surgeries were assessed by dividing them into three steps: step 1: the access sheath or ureter catheter placement, step 2: lithotripsy and collection of fragments, and step 3: DJ catheter or re-entry tube insertion. For the PNL and RIRS groups, mean stone sizes were 30mm (range 16-60), and 12mm (range 7-35); mean fluoroscopy times were 337s (range 200-679), and 37s (range 7-351); and total radiation exposures were 142mBq (44.7 to 221), and 4.4mBq (0.2 to 30) respectively. Fluoroscopy times and radiation exposures at each step were found to be higher in the PNL group compared to the RIRS group. When assessed in itself, the fluoroscopy time and radiation exposure were stable in RIRS, and the radiation exposure was the highest in step 1 and the lowest in step 3 in PNL. When assessed for the 19 PNL patients and the 12 RIRS patients who had stone sizes≥2cm, the fluoroscopy time in step 1, and the radiation exposure in steps 1 and 2 were found to be higher in the PNL group than the RIRS group (PPNL because it has short fluoroscopy time and the radiation exposure is low in every step. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Trends in Radiation Doses to Patients from Medical X-ray Examinations in Romania

Energy Technology Data Exchange (ETDEWEB)

Olga Iacob; Irina Anca Popescu [Institute of Public Health, Iassy (Romania); Mihai Radu Iacob [University ' Al. I. Cuza' Iassy (Romania)

2006-07-01

Even if the doses received by patients during 2005 survey are lower than those estimated in the 2000 national survey on diagnostic medical radiation exposure by 27 percent, on average, their values still indicate an urgent need to develop radiation protection and optimization activities for X ray examinations, especially in pediatrics radiology. The increasing attention given in last years to radiation protection for conventional examinations, with development of national patient dosimetry protocols and reference doses, new radiation protection legislation and norms have played a significant part in this substantial reduction in effective doses. (N.C.)

Radiation-Induced Esophagitis is Mitigated by Soy Isoflavones

Directory of Open Access Journals (Sweden)

Matthew D Fountain

2016-11-01

Full Text Available Introduction: Lung cancer patients receiving radiotherapy present with acute esophagitis and chronic fibrosis, as a result of radiation injury to esophageal tissues. We have shown that soy isoflavones alleviate pneumonitis and fibrosis caused by radiation toxicity to normal lung. The effect of soy isoflavones on esophagitis histopathological changes induced by radiation was investigated. Methods: C57BL/6 mice were treated with 10 Gy or 25 Gy single thoracic irradiation and soy isoflavones for up to 16 weeks. Damage to esophageal tissues was assessed by H&E, Masson’s Trichrome and Ki-67 staining at 1, 4, 10, 16 weeks after radiation. The effects on smooth muscle cells and leukocyte infiltration were determined by immunohistochemistry using anti-αSMA and anti-CD45 respectively. Results: Radiation caused thickening of esophageal tissue layers that was significantly reduced by soy isoflavones. Major radiation alterations included hypertrophy of basal cells in mucosal epithelium and damage to smooth muscle cells in muscularis mucosae as well as disruption of collagen fibers in lamina propria connective tissue with leukocyte infiltration. These effects were observed as early as one week after radiation and were more pronounced with a higher dose of 25 Gy. Soy isoflavones limited the extent of tissue damage induced by radiation both at 10 and 25 Gy.Conclusions: Soy isoflavones have a radioprotective effect on the esophagus, mitigating the early and late effects of radiation injury in several esophagus tissue layers. Soy could be administered with radiotherapy to decrease the incidence and severity of esophagitis in lung cancer patients receiving thoracic radiation therapy.

Radiation-induced abnormal cortical thickness in patients with nasopharyngeal carcinoma after radiotherapy

Directory of Open Access Journals (Sweden)

Jiabao Lin

2017-01-01

Full Text Available Conventional MRI studies showed that radiation-induced brain necrosis in patients with nasopharyngeal carcinoma (NPC in years after radiotherapy (RT could involve brain gray matter (GM and impair brain function. However, it is still unclear the radiation-induced brain morphological changes in NPC patients with normal-appearing GM in the early period after RT. In this study, we acquired high-resolution brain structural MRI data from three groups of patients, 22 before radiotherapy (pre-RT NPC patients with newly diagnosed but not yet medically treated, 22 NPC patients in the early-delayed stage after radiotherapy (post-RT-ED, and 20 NPC patients in the late-delayed stage after radiotherapy (post-RT-LD, and then analyzed the radiation-induced cortical thickness alteration in NPC patients after RT. Using a vertex-wise surface-based morphometry (SBM approach, we detected significantly decreased cortical thickness in the precentral gyrus (PreCG in the post-RT-ED group compared to the pre-RT group. And the post-RT-LD group showed significantly increased cortical thickness in widespread brain regions, including the bilateral inferior parietal, left isthmus of the cingulate, left bank of the superior temporal sulcus and left lateral occipital regions, compared to the pre-RT group, and in the bilateral PreCG compared to the post-RT-ED group. Similar analysis with ROI-wise SBM method also found the consistent results. These results indicated that radiation-induced brain injury mainly occurred in the post-RT-LD group and the cortical thickness alterations after RT were dynamic in different periods. Our findings may reflect the pathogenesis of radiation-induced brain injury in NPC patients with normal-appearing GM and an early intervention is necessary for protecting GM during RT.

Osteoradionecrosis and Radiation Dose to the Mandible in Patients With Oropharyngeal Cancer

International Nuclear Information System (INIS)

Tsai, Chiaojung Jillian; Hofstede, Theresa M.; Sturgis, Erich M.; Garden, Adam S.; Lindberg, Mary E.; Wei Qingyi; Tucker, Susan L.; Dong Lei

2013-01-01

Purpose: To determine the association between radiation doses delivered to the mandible and the occurrence of osteoradionecrosis (ORN). Methods and Materials: We reviewed the records of 402 oropharyngeal cancer patients with stage T1 or T2 disease treated with definitive radiation between January 2000 and October 2008 for the occurrence of ORN. Demographic and treatment variables were compared between patients with ORN and those without. To examine the dosimetric relationship further, a nested case-control comparison was performed. One to 2 ORN-free patients were selected to match each ORN patient by age, sex, radiation type, treatment year, and cancer subsite. Detailed radiation treatment plans for the ORN cases and matched controls were reviewed. Mann-Whitney test and conditional logistic regression were used to compare relative volumes of the mandible exposed to doses ranging from 10 Gy-60 Gy in 10-Gy increments. Results: In 30 patients (7.5%), ORN developed during a median follow-up time of 31 months, including 6 patients with grade 4 ORN that required major surgery. The median time to develop ORN was 8 months (range, 0-71 months). Detailed radiation treatment plans were available for 25 of the 30 ORN patients and 40 matched ORN-free patients. In the matched case-control analysis, there was a statistically significant difference between the volumes of mandible in the 2 groups receiving doses between 50 Gy (V50) and 60 Gy (V60). The most notable difference was seen at V50, with a P value of .02 in the multivariate model after adjustment for the matching variables and dental status (dentate or with extraction). Conclusions: V50 and V60 saw the most significant differences between the ORN group and the comparison group. Minimizing the percent mandibular volume exposed to 50 Gy may reduce ORN risk.

Relative efficacy for radiation reducing methods in scoliotic patients

International Nuclear Information System (INIS)

Aikenhead, J.; Triano, J.; Baker, J.

1989-01-01

Radiation dosages to sensitive organs in full spine radiography have in recent years been a concern of physicians as well as the general public. The spine is the prime target for exposure in scoliosis radiography, though the exposure usually necessitates irradiation of several radio-sensitive organs. In recent studies, various protection techniques have been used including various lead and aluminum filtration systems, altered patient positioning and varied tube-film distances. The purpose of this study was to evaluate the efficiency for radiation dosage reduction of three filtration systems used frequently in the chiropractic profession. The systems tested were the Nolan Multiple X-ray Filters, the Clear-Pb system and the Sportelli Wedge system. These systems were tested in seven configurations varying breast shielding, distance and patient positioning. All systems tested demonstrated significant radiation reductions to organs, especially breast tissue. The Clear-Pb system appeared to be the most effective for all organs except the breast, and the Sportelli Wedge system demonstrated the greatest reduction to breast tissue

Radiation protection

International Nuclear Information System (INIS)

Koelzer, W.

1976-01-01

The lecture is divided into five sections. The introduction deals with the physical and radiological terms, quantities and units. Then the basic principles of radiological protection are discussed. In the third section attention is paid to the biological effects of ionizing radiation. The fourth section deals with the objectives of practical radiological protection. Finally the emergency measures are discussed to be taken in radiation accidents. (HP) [de

Radiation reactions and care of the patient

International Nuclear Information System (INIS)

Lochhead, J.N.M.

1983-01-01

Many of the radiation reactions which may occur in patients following radiotherapy and the care of these reactions are described. These include the systemic reaction, reactions of the blood and skin, reactions occurring after treatment of the breast and chest wall, reactions after irradiation of the mouth and throat, intrathoracic tumours, the abdominal alimentary tract and pelvis, bone, the CNS and the eye. Patient care during the treatment of children and also during treatment using small sealed sources is also described. (U.K.)

Radiation therapy induced changes in male sex hormone levels in rectal cancer patients

International Nuclear Information System (INIS)

Dueland, Svein; Groenlie Guren, Marianne; Rune Olsen, Dag; Poulsen, Jan Peter; Magne Tveit, Kjell

2003-01-01

Background and purpose:To determine the effect of curative radiation therapy (46-50 Gy) on the sex hormone levels in male rectal cancer patients. Materials and methods:Twenty-five male rectal cancer patients (mean age 65 years), receiving pelvic radiation therapy (2 Gyx23-25 fractions in 5 weeks) were included. Serum testosterone, FSH and LH were determined before start of treatment, at the 10th and 25th fractions, and 4-6 weeks after completed radiotherapy. The testicular dose was determined by thermoluminescent dosimetry. Results:Five weeks of radiation therapy (46-50 Gy) resulted in a 100% increase in serum FSH, a 70% increase in LH, and a 25% reduction in testosterone levels. After treatment, 35% of the patients had serum testosterone levels below lower limit of reference. The mean radiation dose to the testicles was 8.4 Gy. A reduction in testosterone values was observed already after a mean dose of 3.3 Gy (10th fraction). Conclusion:Radiation therapy (46-50 Gy) for rectal cancer resulted in a significant increase in serum FSH and LH and a significant decrease in testosterone levels, indicating that sex hormone production is sensitive to radiation exposure in patients with a mean age of 65 years

Course for monitored education at distance: 'Introduction to basic aspects of radiation physics in NM'

International Nuclear Information System (INIS)

Lopez, Adlin; Palau, Aley; Petrirena, Gregorio; Cardenas, Ana Ivis

2008-01-01

Full text: Nuclear Medicine became a multimodality speciality, related with a lot of personnel not specialized in NM techniques: who have not training in radiation aspects. These projects try to evaluate the use of specialized multimedia product for a monitored education at distance of personnel who start to be related with Nuclear Medicine Techniques like nurses, surgeons, rheumatologists, etc. The multimedia product included two items: Introduction to Nuclear Medicine Techniques and Basic aspects of radiation physics. Each item contents an audio-visual conference (Power Point) and a charter (PDF): with theoretic aspects, understand verification questions and self-evaluation activities. The product need only a PC compatible with window 98 (or more advanced version), and 130MBy of memory spaced for archive. In order to verify the effectiveness of the distance course, we tested it in 10 students: 1 nurse, 1 radio-pharmacist, 1 cardiologist, 1 neurologist, 6 technologists. After consult and clarify their doubts, a final test was applied in order to check the knowledge acquired. With 100 point of maximum store and 60 point minimum to pass, the test contented 2 types of questions: true or false choice (with 50 aspects to verify 1.5 point/ correct answer) and many correct choices (5 questions, 5 point/correct answer). The average result was 85.6 points/ students: 6 -Excellent (90-100 points) , 3 -Very good (80-89 points) and 1 -Good (70-79 points). The course was polled about the quality of the material and their comprehension degree, asking the student to make suggestions if were needed. The average evaluation was 94 points (91-95 points). The suggestions made were: increase the number of examples and practical sequences, the understand verification questions and include monitored practical exercise. Conclusion: the product can be useful for a monitored education at distance of personnel who start to be related with Nuclear Medicine Techniques. Recommendation: The

Differential gene expression before and after ionizing radiation of subcutaneous fibroblasts identifies breast cancer patients resistant to radiation-induced fibrosis

International Nuclear Information System (INIS)

Alsner, Jan; Rodningen, Olaug K.; Overgaard, Jens

2007-01-01

Background and purpose: Differentially gene expression between patients with either very low or very high risk of radiation-induced fibrosis (RIF) in patient-derived fibroblasts after irradiation has previously been reported. In the present study, we are investigating the robustness of radiation-induced changes in gene expression in fibroblasts, whether differential expression is more pronounced when looking at the fold induction levels, taking into account the differences in background expression levels between patients, and whether there is a linear correlation between individual risk of RIF and changes in radiation-induced gene expression in fibroblasts. Material and methods: Gene expression was analysed by quantitative real-time PCR before and after a fractionated scheme with 3 x 3.5 Gy/3 days in fibroblasts derived from 26 patients with breast cancer treated with post-mastectomy radiotherapy. Results: Robust radiation-induced changes in gene expression were observed, with differential gene expression between low and high risk patients being most pronounced for the fold induction level ('after' value divided by 'before' value for each patient). When including patients with intermediate risk, there was no linear correlation between individual risk of RIF and differential expression of the genes investigated. Rather, differential gene expression could divide patients into two clearly separated groups, a larger, sensitive group and a smaller resistant group. Conclusions: Differential gene expression in irradiated fibroblasts might be an important tool in the identification of differences in the genetic background between patients with variable risk of RIF, and in the identification of new targets for prevention and intervention of the fibrotic process

Effects of radiation therapy on neuropsychological functioning in patients with nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Lee, P.W.H.; Hung, B.K.M.; Woo, E.K.W.; Tai, P.T.H.; Choi, D.T.K.

1989-01-01

Sixteen patients who had a nasopharyngeal carcinoma (NPC) who were treated with radiation therapy were followed up after a median duration of 5.5 years and given a battery of neuropsychological tests. Results were compared with a comparable group of newly diagnosed NPC patients awaiting radiation therapy. The irradiated group was significantly poorer in overall IQ, non-verbal memory recall, and reported a substantially greater number of memory related complaints. These results contrast with the complacent general assumption that radiation therapy has a negligible effect on adult functioning. (author)

Radiation therapy in patients with electric cardiac pacemakers

International Nuclear Information System (INIS)

Bisping, H.J.; Stockberg, H.; Meyer, J.; Frik, W.; Technische Hochschule Aachen

1977-01-01

In the course of radiation therapy and connected diagnostic measures ionizing radiation and other sources of disturbance may interfere with the function of permanent pacemakers. The conditions of such hazards are investigated in theory and practice making allowance for the different susceptibility to trouble of various models of permanent pacemakers. It appears that no extension of long-term follow-up of the cardiac pacemaker's function is needed with regard to possible late effects of ionizing radiation, but that the follow-up of pacemaker-patients during their first period of treatment should not be neglected, since other sources of electronic interference may be present. Routine checks at radiotherapy installations should also include possible sources of disturbance to electronic pacemakers. (orig.) [de

Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing. Retrospective analysis of 29 medulloblastoma patients

International Nuclear Information System (INIS)

Scobioala, Sergiu; Kittel, Christopher; Ebrahimi, Fatemeh; Wolters, Heidi; Eich, Hans Theodor; Parfitt, Ross; Matulat, Peter; Am Zehnhoff-Dinnesen, Antoinette

2017-01-01

To analyze the incidence and degree of sensorineural hearing loss (SNHL) resulting from different radiation techniques, fractionation dose, mean cochlear radiation dose (D mean ), and total cisplatin dose. In all, 29 children with medulloblastoma (58 ears) with subclinical pretreatment hearing thresholds participated. Radiotherapy (RT) and cisplatin had been applied sequentially according to the HIT MED Guidance. Audiological outcomes up to the latest follow-up (median 2.6 years) were compared. Bilateral high-frequency SNHL was observed in 26 patients (90%). No significant differences were found in mean hearing threshold between left and right ears at any frequency. A significantly better audiological outcome (p < 0.05) was found after tomotherapy at the 6 kHz bone-conduction threshold (BCT) and left-sided 8 kHz air-conduction threshold (ACT) than after a combined radiotherapy technique (CT). Fraction dose was not found to have any impact on the incidence, degree, and time-to-onset of SNHL. Patients treated with CT had a greater risk of SNHL at high frequencies than tomotherapy patients even though D mean was similar. Increase in severity of SNHL was seen when the total cisplatin dose reached above 210 mg/m 2 , with the highest abnormal level found 8-12 months after RT regardless of radiation technique or fraction dose. The cochlear radiation dose should be kept as low as possible in patients who receive simultaneous cisplatin-based chemotherapy. The risk of clinically relevant HL was shown when D mean exceeds 45 Gy independent of radiation technique or radiation regime. Cisplatin ototoxicity was shown to have a dose-dependent effect on bilateral SNHL, which was more pronounced in higher frequencies. (orig.) [de

Introduction of functionalizable groups via radiation grafting into polymer electrolyte membranes for fuel cells

International Nuclear Information System (INIS)

Buchmueller, Y.; Scherer, G.G.; Wokaun, A.; Gubler, L.

2011-01-01

Complete text of publication follows. Our work is focused on the introduction of functionalizable groups, so called linkers, to polymer electrolyte membranes. The aim is to attach antioxidant groups to the linkers to enhance the durability of the proton conducting membrane in a fuel cell. The synthetic route we chose is radiation cografting of functionalizable monomers and precursor monomers of a protogenic group into ETFE base film (thickness 25 μm) with subsequent amination. Typically, we performed cografting of styrene with different linkers, such as acryloyl chloride, vinylbenzyl chloride, and glycidyl methacrylate. Styrene is readily sulfonated to introduce proton conductivity. The cografting behavior of the linkers and styrene was investigated to target the desired molar fraction of the monomers in the grafted polymer. All films were characterized by Fourier transform infrared (FTIR) spectroscopy and elemental analysis. Using these data the graft polymerization kinetics of these systems have been determined. The cografted films were first functionalized with amines, such as thyramine and dopamine, and then sulfonated or vice-versa, depending on the stability of the compounds in acidic environment. The synthesized membranes were characterized for conductivity and ion exchange capacity (IEC). Promising membranes were tested in a fuel cell.

Radiation creep of graphite. An introduction

Energy Technology Data Exchange (ETDEWEB)

Blackstone, R [Commission of the European Communities, Petten (Netherlands). Joint Nuclear Research Center

1977-03-01

Graphite, a class of materials with many unique and unusual properties, shows a remarkably high creep ductility under irradiation. As this behaviour compensates to some extent some of the more worrying radiation effects, such as dimensional changes and their strong temperature dependence, it is a property of large technological interest. There are various ways of observing and measuring in-pile creep of graphite, varying in degree of sophistication and in cost, in accuracy and in the type of data that is generated. This paper attempts to review briefly the various experimental methods, and the knowledge generated so far. An indication is given of the areas in which further knowledge is wanted.

Radiation creep of graphite. An introduction

International Nuclear Information System (INIS)

Blackstone, R.

1977-01-01

Graphite, a class of materials with many unique and unusual properties, shows a remarkably high creep ductility under irradiation. As this behavior compensates to some extent some of the more worrying radiation effects, such as dimensional changes and their strong temperature dependence, it is a property of large technological interest. There are various ways of observing and measuring in-pile creep of graphite, varying in degree of sophistication and in cost, in accuracy and in the type of data that is generated. This paper attempts to review briefly the various experimental methods, and the knowledge generated so far. An indication is given of the areas in which further knowledge is wanted

Ionizing radiation used in medical diagnostics as a source of radiation exposure of the patient with occupational diseases. Analysis and problems

International Nuclear Information System (INIS)

Apostolova, D.B.; Paskalev, Z.D.

2001-01-01

X-rays in medical diagnostic are the major source of Bulgarian population exposure to ionizing radiations. Diagnostic X-ray is the most diagnostic application and is used in a wide variety of examinations. The modern concept for radiation protection of patients in diagnostic radiology is based on two main principles: justification of the examinations and radiation protection optimization. It is pointed out that the collective effective dose of radiation may be considerably reduced by decreasing the number of clinically unwarranted X-ray examination of storage and delivery of diagnostic information and adopting a system for physical and technical quality control of the X-ray equipment. The aim of this investigation is assessment of the collective effective doses for the patients with occupational diseases exposed to ionizing radiation by radiological diagnostics. The study covers the period of 1990 through 1999. A total of 3293 patients, treated in the Department of Occupational Toxicology, Clinic of Occupational Diseases, Medical University - Sofia, were examined with X-ray and KT (cervical and lumbar spine, chest, skull, stomach, extremities, pelvis, brain). Most of the observed patients were with predominantlyheavy metals poisonings and a few with other chemical agents poisonings. Number of patients with radiological examinations was 1938, number of examination per capita was 0,59 and the total number of radiological examinations was 2536. The average number of radiological examination for one patient was 1,36, the most number of radiological examinations for one patient was 4. The collective effective dose for an examined patient was 1803 man.mSv. Our results shown the essential of the raising ensure that the medical exposure of patients be the minimum necessary to achieve the required diagnostic objective. (author)

XRCC3 polymorphisms are associated with the risk of developing radiation-induced late xerostomia in nasopharyngeal carcinoma patients treated with intensity modulation radiated therapy.

Science.gov (United States)

Zou, Yan; Song, Tao; Yu, Wei; Zhao, Ruping; Wang, Yong; Xie, Ruifei; Chen, Tian; Wu, Bo; Wu, Shixiu

2014-03-01

The incidence of radiation-induced late xerostomia varies greatly in nasopharyngeal carcinoma patients treated with radiotherapy. The single-nucleotide polymorphisms in genes involved in DNA repair and fibroblast proliferation may be correlated with such variability. The purpose of this paper was to evaluate the association between the risk of developing radiation-induced late xerostomia and four genetic polymorphisms: TGFβ1 C-509T, TGFβ1 T869C, XRCC3 722C>T and ATM 5557G>A in nasopharyngeal carcinoma patients treated with Intensity Modulation Radiated Therapy. The severity of late xerostomia was assessed using a patient self-reported validated xerostomia questionnaire. Polymerase chain reaction-ligation detection reaction methods were performed to determine individual genetic polymorphism. The development of radiation-induced xerostomia associated with genetic polymorphisms was modeled using Cox proportional hazards, accounting for equivalent uniform dose. A total of 43 (41.7%) patients experienced radiation-induced late xerostomia. Univariate Cox proportional hazard analyses showed a higher risk of late xerostomia for patients with XRCC3 722 TT/CT alleles. In multivariate analysis adjusted for clinical and dosimetric factors, XRCC3 722C>T polymorphisms remained a significant factor for higher risk of late xerostomia. To our knowledge, this is the first study that demonstrated an association between genetic polymorphisms and the risk of radiation-induced late xerostomia in nasopharyngeal carcinoma patients treated with Intensity Modulation Radiated Therapy. Our findings suggest that the polymorphisms in XRCC3 are significantly associated with the risk of developing radiation-induced late xerostomia.

Radiation-related pericardial effusions in patients with Hodgkin's disease

International Nuclear Information System (INIS)

Ruckdeschel, J.C.; Chang, P.; Martin, R.G.; Byhardt, R.W.; O'Connell, M.J.; Sutherland, J.C.; Wiernik, P.H.

1975-01-01

Pericardial effusions following radiotherapy for Hodgkins Disease have previously been described as infrequent and related to the total dose of radiation received. Analysis of all chest x-rays on 81 patients who received upper-mantle radiotherapy for Hodgkins Disease at the Baltimore Cancer Research Center between 1968 and 1972 disclosed an incidence of pericardial effusions of 30.9% (25 of 81), with 13.6% (11 of 81) requiring limitation of activity (5) or pericardiectomy (6). Clinical presentation of radiation-related pericardial effusions was subtle, with signs and symptoms a late finding if they occurred. Radiotherapy data was reviewed and no difference in total dose (rads) or time-dose relationships (rets) was found between the groups who did or did not develop effusions. Analysis of multiple pre-treatment clinical and pathological characteristics disclosed four parameters that were felt to be related to the development of pericardial effusions; elevated ESR, normal absolute lymphocyte count, initial presence of extensive mediastinal adenopathy and the addition of adjuvant chemotherapy. The presence of increasing combinations of these pretreatment 'risk factors' led to an increasing likelihood of developing a radiation-related pericardial effusion such that six of seven patients with all four 'risk factors' developed a pericardial effusion. Nine of 13 clinically significanteffusions were associated with the addition of adjuvant chemotherapy. Possible pathogenetic mechanisms that include factors other than radiation dosage and the clinical management of radiation-related pericardial effusions are discussed

An Introduction to Atmospheric Radiation: Review for the Bulletin of AMS

Science.gov (United States)

Marshak, Alexander

2003-01-01

Whether you like a certain geophysical book or not, largely depends on your background. The field of radiative transfer and atmospheric radiation, in particular, combines people with a wide range of mathematical skills: from theoretical astrophysicists and nuclear physicists to meteorologists and ecologists. There is always a delicate balance between physical explanations and their mathematical interpretations. This balance is very personal and is based on your background. I came to the field of atmospheric radiative transfer as a mathematician with little knowledge of atmospheric physics. After being in the field for more than a decade, I still have gaps in my atmospheric science education. Thus I assess a radiative transfer book fi-om two main criteria: how well does it describe the material that is familiar to me (the radiative transfer equation and its numerical solutions) and how well does it help me to fill the gaps in my personal knowledge. So I present this review fi-om the perspective of a former mathematician working in the field of atmospheric radiation. . After being asked to review the book, my first intention was to compare the new edition with the previous one (Liou, 1980). In doing so, you can clearly follow the progress made in the field of atmospheric radiation over the past two decades. If there are few changes (as in Fundamental Radiative Transfer) or no changes at all (as in the Maxwell s equations), then the field has not seen much development. To the contrary, many differences between the two editions illustrate areas of major progress in the field, such as evidenced in Thermal Ineared Radiative Transfer and even in the creations of completely new fields like Three-Dimensional Radiative Transfer or Light Scattering by Nonspherical Particles. Obviously, the major changes happened not in the theory, which is at least half a century old, but in data quality and completely new measurements (mostly due to new satellite data) with higher accuracy

Introduction of Functional Structures in Nano-Scales into Engineering Polymer Films Using Radiation Technique

Energy Technology Data Exchange (ETDEWEB)

Maekawa, Y., E-mail: maekawa.yasunari@jaea.go.jp [Japan Atomic Energy Agency (JAEA), Quantum Beam Science Directorate, High Performance Polymer Group, 1233 Watanuki-Machi, Takasaki, Gunma-ken 370-1292 (Japan)

2010-07-01

Introduction of functional regions in nanometer scale in polymeric films using γ-rays, EB, and ion beams are proposed. Two approaches to build nano-scale functional domains in polymer substrates are proposed: 1) Radiation-induced grafting to transfer nano-scale polymer crystalline structures (morphology), acting as a nano-template, to nano-scale graft polymer regions. The obtained polymers with nano structures can be applied to high performance polymer membranes. 2) Fabrication of nanopores and functional domains in engineering plastic films using ion beams, which deposit the energy in very narrow region of polymer films. Hydrophilic grafting polymers are introduced into hydrophobic fluorinated polymers, cross-linked PTFE (cPTFE) and aromatic hydrocarbon polymer, poly(ether ether ketone (PEEK), which is known to have lamella and crystallite in the polymer films. Then, the hierarchical structures of graft domains are analyzed by a small angle neutron scattering (SANS) experiment. From these analyses, the different structures and the different formation of graft domains were observed in fluorinated and hydrocarbon polymer substrates. the grafted domains in the cPTFE film, working as an ion channel, grew as covering the crystallite and the size of domain seems to be similar to that of crystallite. On the other hand, the PEEK-based PEM has a smaller domain size and it seems to grow independently on the crystallites of PEEK substrate. For nano-fabrication of polymer films using heavy ion beams, the energy distribution in radial direction, which is perpendicular to ion trajectory, is mainly concerned. For penumbra, we re-estimated effective radius of penumbra, in which radiation induced grafting took place, for several different ion beams. We observed the different diameters of the ion channels consisting of graft polymers. The channel sizes were quite in good agreement with the effective penumbra which possess the absorption doses more than 1 kGy. (author)

Introduction of Functional Structures in Nano-Scales into Engineering Polymer Films Using Radiation Technique

International Nuclear Information System (INIS)

Maekawa, Y.

2010-01-01

Introduction of functional regions in nanometer scale in polymeric films using γ-rays, EB, and ion beams are proposed. Two approaches to build nano-scale functional domains in polymer substrates are proposed: 1) Radiation-induced grafting to transfer nano-scale polymer crystalline structures (morphology), acting as a nano-template, to nano-scale graft polymer regions. The obtained polymers with nano structures can be applied to high performance polymer membranes. 2) Fabrication of nanopores and functional domains in engineering plastic films using ion beams, which deposit the energy in very narrow region of polymer films. Hydrophilic grafting polymers are introduced into hydrophobic fluorinated polymers, cross-linked PTFE (cPTFE) and aromatic hydrocarbon polymer, poly(ether ether ketone (PEEK), which is known to have lamella and crystallite in the polymer films. Then, the hierarchical structures of graft domains are analyzed by a small angle neutron scattering (SANS) experiment. From these analyses, the different structures and the different formation of graft domains were observed in fluorinated and hydrocarbon polymer substrates. the grafted domains in the cPTFE film, working as an ion channel, grew as covering the crystallite and the size of domain seems to be similar to that of crystallite. On the other hand, the PEEK-based PEM has a smaller domain size and it seems to grow independently on the crystallites of PEEK substrate. For nano-fabrication of polymer films using heavy ion beams, the energy distribution in radial direction, which is perpendicular to ion trajectory, is mainly concerned. For penumbra, we re-estimated effective radius of penumbra, in which radiation induced grafting took place, for several different ion beams. We observed the different diameters of the ion channels consisting of graft polymers. The channel sizes were quite in good agreement with the effective penumbra which possess the absorption doses more than 1 kGy. (author)

Radiation medicine

International Nuclear Information System (INIS)

1991-01-01

This booklet has been produced by UKAEA and the Marie Curie Memorial Foundation to give some basic information about what radiation is and how it is used in day to day diagnosis and treatment. It will be of interest to people undergoing treatment, their relatives and friends, and anyone who wants to know more about this important area. After a brief historical introduction the booklet explains what radiation is, the natural and man-made sources of radiation, how it is produced and how X-rays are used in medical diagnosis and treatment. The radiation protection measures taken and safety standards followed are mentioned. (author)

Evaluation of occupational and patient radiation doses in orthopedic surgery

International Nuclear Information System (INIS)

Sulieman, A.; Alzimami, K.; Habeeballa, B.; Osman, H.; Abdelaziz, I.; Sassi, S.A.; Sam, A.K.

2015-01-01

This study intends to measure the radiation dose to patients and staff during (i) Dynamic Hip Screw (DHS) and (ii) Dynamic Cannula Screw (DCS) and to evaluate entrance surface Air kerma (ESAK) dose and organ doses and effective doses. Calibrated Thermoluminescence dosimeters (TLD-GR200A) were used. The mean patients’ doses were 0.46 mGy and 0.07 mGy for DHS and DCS procedures, respectively. The mean staff doses at the thyroid and chest were 4.69 mGy and 1.21 mGy per procedure. The mean organ and effective dose for patients and staff were higher in DHS compared to DCS. Orthopedic surgeons were exposed to unnecessary radiation doses due to the lack of protection measures. The radiation dose per hip procedure is within the safety limit and less than the previous studies

Pre-Radiation dental considerations and management for head and neck cancer patients.

Science.gov (United States)

Kufta, Kenneth; Forman, Michael; Swisher-McClure, Samuel; Sollecito, Thomas P; Panchal, Neeraj

2018-01-01

Treatment of head and neck cancer (HNC) is accompanied by a high rate of morbidity, and complications can have a lifelong, profound impact on both patients and caregivers. Radiation-related injury to the hard and soft tissue of the head and neck can significantly decrease patients' quality of life. The purpose of this study is to provide patent-specific guidelines for managing the oral health and related side effects of HNC patients treated with radiation therapy. Based on reviewed articles retrieved on the PubMed database, guidelines for management of the oral health of this patient population were organized into three separate categories: cancer, patient, and dentition. The location, type, and staging of the cancer, along with the radiation used to treat the cancer significantly impact dental treatment. Several unique patient characteristics such as motivation, presence of support system, socioeconomic status, nutrition, and race have all been found to affect outcomes. Dental disease and available supportive dental management was found to significantly impact treatment and quality of life in this patient population. By comprehensively assessing unique cancer, patient, and dental-related factors, this review provides individualized evidence-based guidelines on the proper management of this complex and vulnerable patient population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Topical Mitomycin C and Radiation Induce Conjunctival DNA-Polyploidy

Directory of Open Access Journals (Sweden)

Olaf Cartsburg

2001-01-01

Full Text Available Introduction: Atypical cell changes often occur following treatment of premalignant or malignant conjunctival neoplasias with topical mitomycin C (MMC and/or radiation. These reactive, non‐neoplastic alterations of the conjunctival epithelium can be a differential diagnostic problem. Our aim was to investigate changes in the nuclear DNA‐distribution of conjunctival epithelial cells after MMC‐ and radiation therapy by DNA‐image‐cytometry. Methods: Conjunctival brush smears were obtained from 13 patients (13 eyes with squamous cell carcinomas and six patients (6 eyes with conjunctival malignant melanomas in situ before, during and after treatment. The patients were treated with MMC‐drops (0.02% or 0.04% alone (n=12, with radiation therapy (n=3 or both (n=4. At first, the obtained brush smears were evaluated by cytology. Secondly, after Feulgen restaining, the DNA content of reactively changed cells was determined using the AutoCyte‐QUIC‐DNA® workstation. Results: We observed euploid DNA‐polyploidy and cytomorphological changes in all patients (19/19. We considered these alterations as reactive to treatment. Four patients showed their greatest DNA‐stemline at 4c and 15 patients at 8c. This effect was observed during and following MMC‐drops and/or radiation and remained stable in 94% of all patients after a mean follow‐up of 22.5 months (SD 15.4. In five cases image cytometry additionally demonstrated DNA‐stemline aneuploidy as an evidence of tumor recurrence. Conclusion: Measurements of DNA‐content revealed euploid polyploidisation of morphological suspicious but benign squamous cells which is the biologic correlate of well known secondary morphologic changes following topical chemotherapy and/or radiation. DNA‐image‐cytometry is a useful tool in the differention of euploid polyploidization as a sign of reactive cell changes following treatment and tumor recurrences.

Intensity-Modulated Radiation Therapy with Noncoplanar Beams for Treatment of Prostate Cancer in Patients with Bilateral Hip Prosthesis-A Case Study

International Nuclear Information System (INIS)

Brooks, Chris; Cheung, Rex Min; Kudchadker, Rajat J.

2010-01-01

Megavoltage photon intensity-modulated radiation therapy (IMRT) is typically used in the treatment of prostate cancer at our institution. Approximately 1% to 2% of patients with prostate cancer have hip prostheses. The presence of the prosthesis usually complicates the planning process because of dose perturbation around the prosthesis, radiation attenuation through the prosthesis, and the introduction of computed tomography artifacts in the planning volume. In addition, hip prostheses are typically made of materials of high atomic number, which add uncertainty to the dosimetry of the prostate and critical organs in the planning volume. When the prosthesis is bilateral, treatment planning is further complicated because only a limited number of beam angles can be used to avoid the prostheses. In this case study, we will report the observed advantages of using noncoplanar beams in the delivery of IMRT to a prostate cancer patient with bilateral hip prostheses. The treatment was planned for 75.6 Gy using a 7-field coplanar approach and a noncoplanar arrangement, with all fields avoiding entrance though the prostheses. Our results indicate that, compared with the coplanar plan, the noncoplanar plan delivers the prescribed dose to the target with a slightly better conformality and sparing of rectal tissue versus the coplanar plan.

Dental radiographic units - radiation safety and patient doses

International Nuclear Information System (INIS)

Nagpal, J.S.; Varadharajan, Geetha

2001-01-01

Three models of dental radiographic machines have been examined for radiation safety. Using TL dosemeters, doses received by the patients at chest level and the gonads have been estimated. Care should be taken to shield gonads during dental radiographic examinations. (author)

Clinical Usefulness of serum total cholesterol as an index of hypothyroidism in patients after cervical radiation

International Nuclear Information System (INIS)

Iguma, Yoko; Iwai, Chikako; Okuyama, Masako; Futami, Takahiro; Inui, Ken-ichi; Asato, Ryo

2003-01-01

Cervical radiation therapy is often applied to patients with head and neck cancers because radiation has a high sensitivity to these cancers and permits the preservation of functions and physical form. However, it has been shown that various complications can result from radiation therapy. We have encountered some patients who showed hypercholesterolemia resulting from cervical radiation. Therefore, we have paid close attention to the relationship between hypercholesterolemia after cervical radiation and hypothyroidism. Thyroid hormone tests in these patients with hypercholesterolemia after cervical radiation showed high thyroid stimulating hormone (TSH) and low free thyroxine (fT 4 ), indicating the presence of hypothyroidism. After administration of levothyroxine Na, their fT 4 levels increased and both TSH levels and serum total cholesterol levels decreased. In conclusion, in patients who have received cervical radiation, we recommend monitoring serum total cholesterol periodically to detect hypothyroidism easily before the appearance of its symptoms. (author)

Clinical Usefulness of serum total cholesterol as an index of hypothyroidism in patients after cervical radiation

Energy Technology Data Exchange (ETDEWEB)

Iguma, Yoko; Iwai, Chikako; Okuyama, Masako; Futami, Takahiro; Inui, Ken-ichi [Kyoto Univ. (Japan). Hospital; Asato, Ryo [Kyoto Univ. (Japan). Graduate School of Medicine

2003-02-01

Cervical radiation therapy is often applied to patients with head and neck cancers because radiation has a high sensitivity to these cancers and permits the preservation of functions and physical form. However, it has been shown that various complications can result from radiation therapy. We have encountered some patients who showed hypercholesterolemia resulting from cervical radiation. Therefore, we have paid close attention to the relationship between hypercholesterolemia after cervical radiation and hypothyroidism. Thyroid hormone tests in these patients with hypercholesterolemia after cervical radiation showed high thyroid stimulating hormone (TSH) and low free thyroxine (fT{sub 4}), indicating the presence of hypothyroidism. After administration of levothyroxine Na, their fT{sub 4} levels increased and both TSH levels and serum total cholesterol levels decreased. In conclusion, in patients who have received cervical radiation, we recommend monitoring serum total cholesterol periodically to detect hypothyroidism easily before the appearance of its symptoms. (author)

Analysis of radiation doses to patients from diagnostic department of nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Lepej, L; Messingerova, M [F.D. Rosvelt Hospital, Banska Bystrica (Slovakia). Dept. of Nuclear Medicine; Ftacnikova, S [Inst. of Preventive and Clinical Medicine, Bratislava (Slovakia)

1996-12-31

In this paper the values of mean effective dose equivalents per unit activity (H{sub E/1Bq}) were used for the calculation of mean effective dose equivalents for one examination (H{sub E}). The collective effective dose equivalents for each radiopharmaceutical and type of examination (S{sub ER}) and global collective effective dose equivalent for department for all radiopharmaceuticals (S{sub E}) during evaluated period were defined. The data for years from 1992 to 1994 were evaluated and compared with results in literature. The evaluation of radiation doses in nuclear medicine department is useful parameter for internal quality control. Using this method, the radiation dose in this laboratory was changed to minimum (under mean value of Slovak Republic). Unfortunately, the real data of patients radiation doses are different from the calculated one. Due to different kinetic of radiopharmaceuticals in individual patients (influenced by pathology, age, etc.) the evaluation of radiation burden to nuclear medicine patients is problematic. But this approach enable the relative comparison of the changes in values of H{sub E} and S{sub E} during the observed period. The evaluation of individual (minimal) effective dose equivalent - (H{sub min}) which represents dose calculated under physiologic conditions can be useful for indication of diagnostic examination by physicians. Therefore the systematic registration of H{sub min} from all examinations - patient`s radiation history. This is specially important in the case of children and young people. The importance of the proposed method, is in regulation of radiation dose from nuclear medicine diagnostic examinations, not only be the control of number and type of examinations, but also by selection of used radiopharmaceuticals and by the way how to use them. (J.K.) 1 fig., 2 refs.

Program of radiation protection of patients (Argentina)

International Nuclear Information System (INIS)

Touzet, Rodolfo E.; Buzzi, Alfredo; Rojas, Roberto; Andisco Daniel

2008-01-01

After an initial period of conviction for installing an active discussion on Radiation Protection of Patients inside the medical community, there were organized 'working groups' in Radiodiagnosis, Radiotherapy, Nuclear Medicine and on radiation protection of pregnant women. These groups began systematical activities, which received a strong institutional support of the Argentine Society of Radiology, toward the implementation of a 'Program of RPP' that is being put nowadays into practice. The rapid advances which are present in medicine today, both in equipment and work protocol, determine that 'norms and regulations never arrive on time' which is why it is paramount that health services have 'systems of dynamic quality' and 'continual improvement' that can be adapted quickly to changes. This program has 6 principal aims and a series of targets to be fulfilled in successive stages: Basic aims and short term targets: 1) To guarantee the Justification. First goal: Development of the 'Prescription Guide' (achieved); 2) To optimize the radioprotection: First goal: Development of a 'Manual of Procedures' (In process); 3) To prevent potential exposures. First goal: Design of a 'Basic Quality System' in Health (achieved); 4) To achieve a qualification of the professionals by means of a process of certification and re-certification (In process); 5) To spread PRP's criteria by means of chats, meetings and the use of the media and graphical means. (Partially fulfilled); 6) To establish criteria for the protection of patient and operators in Interventional Radiology by creating a referral service. Strategies to cope with different interests within society are described. Main problems, failures and difficulties are also described. The effective participation of the professional and technicians' associations in the development of the program for radiation protection of the patient is a key aspect for the success of the whole national programme. (author)

Central dose data management and analysis in IT-driven radiation protection strategies

International Nuclear Information System (INIS)

Ward, M.; Hughes, D.; Connolly, P.; Moores, B. M.

2005-01-01

The applications of information technology in health care are now widespread and continue to grow. Medical imaging is at the forefront of this revolution and the introduction of digital detection methods to replace film is now addressing the diagnostic X-ray market, the most routinely employed imaging modality. The introduction of picture archiving and communication systems, hospital and radiology information systems is well underway, and the integration of radiation protection initiatives into these developments is desirable. In north-west UK, a project aimed at developing and implementing IT-driven radiation protection strategies has been underway for the past 10 y. Such strategies are geared towards the support of European Commission patient dose directive 97/43 EURATOM, in particular the need to implement clinical audit, patient dose audit and to establish dose reference levels. This paper demonstrates the national and local requirements for establishing a central dose data management system for use in radiation protection strategies. In particular, such a system can help develop and support the role of a medical physics expert in optimisation. The scientific requirements for such an approach are presented in this paper, and a prototype system is described. Preliminary results obtained with the central data management facility are also presented and the implication for analysing multiple site dose data in optimisation strategies for digital radiographic technology is highlighted. (authors)

Three-dimensional radiation treatment planning

International Nuclear Information System (INIS)

Mohan, R.

1989-01-01

A major aim of radiation therapy is to deliver sufficient dose to the tumour volume to kill the cancer cells while sparing the nearby health organs to prevent complications. With the introduction of devices such as CT and MR scanners, radiation therapy treatment planners have access to full three-dimensional anatomical information to define, simulate, and evaluate treatments. There are a limited number of prototype software systems that allow 3D treatment planning currently in use. In addition, there are more advanced tools under development or still in the planning stages. They require sophisticated graphics and computation equipment, complex physical and mathematical algorithms, and new radiation treatment machines that deliver dose very precisely under computer control. Components of these systems include programs for the identification and delineation of the anatomy and tumour, the definition of radiation beams, the calculation of dose distribution patterns, the display of dose on 2D images and as three dimensional surfaces, and the generation of computer images to verify proper patient positioning in treatment. Some of these functions can be performed more quickly and accurately if artificial intelligence or expert systems techniques are employed. 28 refs., figs

Implanted Cardiac Defibrillator Care in Radiation Oncology Patient Population

International Nuclear Information System (INIS)

Gelblum, Daphna Y.; Amols, Howard

2009-01-01

Purpose: To review the experience of a large cancer center with radiotherapy (RT) patients bearing implantable cardiac defibrillators (ICDs) to propose some preliminary care guidelines as we learn more about the devices and their interaction with the therapeutic radiation environment. Methods and Materials: We collected data on patients with implanted ICDs treated with RT during a 2.5-year period at any of the five Memorial Sloan-Kettering clinical campuses. Information regarding the model, location, and dose detected from the device, as well as the treatment fields, fraction size, and treatment energy was collected. During this time, a new management policy for these patients had been implemented requiring treatment with low-energy beams (6 MV) and close surveillance of the patients in partnership with their electrophysiologist, as they received RT. Results: During the study period, 33 patients were treated with an ICD in place. One patient experienced a default of the device to its initial factory setting that was detected by the patient hearing an auditory signal from the device. This patient had initially been treated with a 15-MV beam. After this episode, his treatment was replanned to be completed with 6-MV photons, and he experienced no further events. Conclusion: Patients with ICDs and other implanted computer-controlled devices will be encountered more frequently in the RT department, and proper management is important. We present a policy for the safe treatment of these patients in the radiation oncology environment.

Radiation Protection of Patients in Croatian Legislative

International Nuclear Information System (INIS)

Novakovic, M.; Molnar, M.; Kozuh, D.

2001-01-01

Full text: The value of radiological examinations has been established over the last 100 years by custom and practice. Problem often occurs when scientific initiatives affect usual philosophy and tradition. At present, to many X-ray examinations are performed which are not clinically justified. In some counties in Croatia there are about 1000 examinations per 1000 inhabitants. Whereas in others, as well as in developed countries, it is at the 500 - 600 level. There is still a need to know what is the desirable level of radiological practice. Subsidiary is often used as an excuse not to take any action at all. Criteria are needed for deciding on the optimum number for particular procedures like CT or the length of time for fluoroscopy. Europe has repeatedly been the scene for harmonised improvements in medical exposure through introduction of its Medical Exposure Directive (1997). To be in a line Croatian authorities issued Regulation on Patient Protection (1999) based on this Directive and ICRP Publication 73. This Regulation includes a number of issues which have potential to improve the safety and quality of medical use of ionising radiation. Introduced diagnostic dose reference values are related to clinical questions and radiographic techniques as recommended in European or similar guidelines. These are supplementary to clinical judgement on image quality. Quality assurance programmes should be in place and these should be audited. There should be inspections of X-ray departments by the competent authorities and there should be clinical evaluation of the outcomes of various radiological examinations. Equipment must be quality assured on a regular basis. It must be capable of producing satisfactory images within reference levels set down at national level. Every effort should be made to avoid high and unnecessary exposures.(author)

Proceedings of workshop on surface finishing by radiation curing technology: radiation curing for better finishing

International Nuclear Information System (INIS)

1993-01-01

This book compiled the paper presented at this workshop. The papers discussed are 1. Introduction to radiation curing, 2. Radiation sources -ultraviolet and electron beams, 3. UV/EB curing of surface coating - wood and nonwood substrates, 4. Development of EPOLA (epoxidised palm oil products acrylate) and its application, 5. Development of radiation-curable resin based natural rubber

Proceedings of workshop on surface finishing by radiation curing technology: radiation curing for better finishing

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-31

This book compiled the paper presented at this workshop. The papers discussed are 1. Introduction to radiation curing, 2. Radiation sources -ultraviolet and electron beams, 3. UV/EB curing of surface coating - wood and nonwood substrates, 4. Development of EPOLA (epoxidised palm oil products acrylate) and its application, 5. Development of radiation-curable resin based natural rubber.

Radiation creep of graphite. An introduction

International Nuclear Information System (INIS)

Blackstone, R.

1977-01-01

Graphite, a class of materials with many unique and unusual properties, shows a remarkably high creep ductility under irradiation. As this behaviour compensates to some extent some of the more worrying radiation effects, such as dimensional changes and their strong temperature dependence, it is a property of large technological interest. There are various ways of observing and measuring in-pile creep of graphite, varying in degree of sophistication and in cost, in accuracy and in the type of data that is generated. This paper attempts to review briefly the various experimental methods, and the knowledge generated so far. An indication is given of the areas in which further knowledge is wanted. (Auth.)

Applications of synchrotron radiation in Biophysics

International Nuclear Information System (INIS)

Bemski, G.

1983-01-01

A short introduction to the generation of the synchrotron radiation is made. Following, the applications of such a radiation in biophysics with emphasis to the study of the hemoglobin molecule are presented. (L.C.) [pt

IAEA calls for enhanced radiation protection of patients. Safety specialists warn against overuse of new imaging devices

International Nuclear Information System (INIS)

2009-01-01

Advances in medical imaging techniques are allowing doctors to detect hidden diseases and make ever more accurate diagnoses. But radiation safety experts at the International Atomic Energy Agency (IAEA) say that overuse of high-tech scanning procedures may unnecessarily expose patients to increased radiation levels. The IAEA, in collaboration with other international organizations, is developing a series of measures aimed at strengthening patient protection. The focus of recent efforts is a Smart Card project, to log how much radiation a person receives in the course of a lifetime. Concern surrounds procedures such as computed tomography (CT) scans because they deliver higher doses of radiation to patients in comparison to conventional X-rays (radiographs). It's been estimated that the average radiation dose of one CT scan is equal to roughly 500 chest X-rays. And that can increase a patient's lifetime risk of cancer, particularly if CT scans are repeated. The IAEA is one of the key international players in the field of patient radiation protection. A unit dedicated to the Radiological Protection of Patients (RPoP) was established in 2001. The IAEA's activities in radiation protection of patients include training, knowledge sharing and capacity building in the medical use of radiation. Extensive, up-to-date training material for health professionals is freely available on the RPoP website. An International Action Plan on the Radiological Protection of Patients that has been established together with leading international organizations such as the World Health Organization (WHO), UNSCEAR, the International Commission on Radiological Protection (ICRP) and others to identify strategies for strengthening radiation protection of patients. Coordinating and managing technical cooperation projects with Member States on patient dose assessment. The aim is to identify the factors that contribute to unnecessary radiation dose to patients, provide guidance on dealing with

The results of palliative radiation therapy in patients with unresectable advanced pancreatic cancer

International Nuclear Information System (INIS)

Ryu, Mi Ryeong; Yoon, Sei Chul; Kim, Yeon Sil; Chung, Su Mi

2006-01-01

To evaluate the treatment results and prognostic factors of palliative radiation therapy in the patients with unresectable advanced pancreatic cancer. Thirty-seven evaluable patients with unresectable advanced pancreatic cancer who were treated by palliative radiation therapy for pain relief at the Department of Radiation Oncology, Kangnam St. Mary's hospital, the Catholic University of Korea between March 1984 and February 2005 were analysed retrospectively. There were 22 men and 15 women. Age at diagnosis ranged from 30 to 80 (median 57) years. Twelve patients (32.4%) had liver metastases and 22 patients (59.5%) had lymph node metastases. Radiation therapy was delivered to primary tumor and regional lymph nodes with 1 ∼ 2 cm margin, and total dose was 3,240 ∼ 5,580 cGy (median 5,040 cGy). Chemotherapy with radiotherapy was delivered in 30 patients (81%) with 5-FU alone (21 patients) or gemcitabine (9 patients). The follow-up period ranged from 1 to 44 months. Survival and prognostic factors were analysed using Kaplan-Meier method and log-rank test respectively. Overall mean and median survival were 11 and 8 months and 1-year survival rate was 20%. Among 33 patients who were amenable for response evaluation, 7 patients had good response and 22 patients had fail response with overall response rate of 87.9%. Mild to moderate toxicity were observed in 14 patients with nausea, vomiting, and indigestion, but severe toxicity requiring interruption of treatment were not observed. Chemotherapy didn't influence the survival and symptomatic palliation, but the group containing gemcitabine showed a tendency of longer survival (median 12 months) than 5-FU alone group (median 5.5 months) without statistical significance (ρ > 0.05). The significant prognostic factors were Karnofsky performance status and liver metastasis (ρ 0.05). Radiation therapy was effective for symptomatic palliation in the patients with unresectable advanced pancreatic cancer and would play an

Impact of view reduction in CT on radiation dose for patients

International Nuclear Information System (INIS)

Parcero, E.; Flores, L.; Sánchez, M.G.; Vidal, V.; Verdú, G.

2017-01-01

Iterative methods have become a hot topic of research in computed tomography (CT) imaging because of their capacity to resolve the reconstruction problem from a limited number of projections. This allows the reduction of radiation exposure on patients during the data acquisition. The reconstruction time and the high radiation dose imposed on patients are the two major drawbacks in CT. To solve them effectively we adapted the method for sparse linear equations and sparse least squares (LSQR) with soft threshold filtering (STF) and the fast iterative shrinkage-thresholding algorithm (FISTA) to computed tomography reconstruction. The feasibility of the proposed methods is demonstrated numerically. - Highlights: • A method for CT reconstruction is proposed: LSQR-STF-FISTA. • Our method achieve good results in reconstruction of few-view CT. • The reconstruction of projections with Gaussian noise is possible. • Our reconstruction process allows a reduction of time in the data acquisition process. • Our reconstruction process allows a reduction in the radiation exposure in the patients.

Radiation therapy in old patients. Side effects and results of radiation therapy in old patients; Strahlentherapie des alten Patienten. Vertraeglichkeit und Ergebnisse der Strahlentherapie aelterer Personen

Energy Technology Data Exchange (ETDEWEB)

Geinitz, H.; Zimmermann, F.B.; Molls, M. [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany)

1999-03-01

Background: Despite a growing number of elderly patients receiving radiation therapy little is known about side effects and outcome of irradiation in this section of the population. Methods: In a review article epidemiologic data, aspects of radiation-biology as well as side effects and outcome of radiation therapy of elderly patients are discussed. Results: Cancer incidence rises with age and is exceeding 3.5% for males older than 85 years. With a life expectancy of more than 4 years, curative therapy is indicated even at this age. Furthermore, several retrospective studies indicate that local control and disease-Specific survival after radiation therapy of elderly patients is comparable with that of younger persons. The exception contains elderly patients with grade-III to IV gliomas or with rectal carcinoma who show a reduced survival which is perhaps caused by less aggressive combined treatment (tumor resection). Although some biological and molecular data indicate a rise in radiation sensitivity with growing age like the reduction of the capacity of some DNA-repair enzymes, there is no convincing evidence in animal studies or in retrospective clinical studies that radiation therapy is generally less well tolerated by older individuals. Some age-depending differences in organ toxicities are described in 3 large studies, which evaluate the data of patients who were enrolled in different EORTC-trials: Older patients suffer more of functional mucositis in case of radiation therapy to the head and neck, they have an increased weight loss and a higher frequency of late esophageal damage when irradiated in the thorax, and they show a higher prevalence of sexual dysfunction when treated with radiation therapy to the pelvis. On the other hand younger patients suffer more from acute toxicity like skin damage, nausea, and deterioration of the performance status during pelvic radiotherapy. When discussing the dose intensity of radiation therapy concomitant disease which

Late radiation side-effects in three patients undergoing parotid irradiation for benign disease.

Science.gov (United States)

Armour, A; Ghanna, P; O'Rielly, B; Habeshaw, T; Symonds, P

2000-01-01

We report three patients in whom standard radiation therapy was given and serious late radiation damage was seen. The first patient suffered recurrent parotiditis and a parotid fistula. He was treated initially with 20 Gy in ten fractions via a 300 kV field. Further irradiation was required 1 year later and 40 Gy was given in 2 Gy fractions by an oblique anterior and posterior wedged photon pair. Ten years later he developed localized temporal bone necrosis. The second patient, with pleomorphic salivary adenoma, developed localized temporal bone necrosis 6 years after 60 Gy had been given using standard fractionation and technique. The third patient received 55 Gy in 25 fractions for a pleomorphic salivary adenoma and after 3 years developed temporal bone necrosis. Sixteen years later the same patient developed cerebellar and brainstem necrosis. All patients developed chronic persistent infection during or shortly after the radiation therapy, which increased local tissue sensitivity to late radiation damage. As a result, severe bone, cerebellar and brainstem necrosis was observed at doses that are normally considered safe. We therefore strongly recommend that any infection in a proposed irradiated area should be treated aggressively, with surgical debridement if necessary, before radiotherapy is administered, or that infection developing during or after irradiation is treated promptly.

Scatter Dose in Patients in Radiation Therapy

International Nuclear Information System (INIS)

Schmidt, W. F. O.

2003-01-01

Patients undergoing radiation therapy are often treated with high energy radiation (bremsstrahlung) which causes scatter doses in the patients from various sources as photon scatter coming from collimator, gantry, patient, patient table or room (walls, floor, air) or particle doses resulting from gamma-particle reactions in the atomic nucleus if the photon energies are above 8 MeV. In the last years new treatment techniques like IMRT (esp the step-and-shoot- or the MIMIC-techniques) have increased interest in these topics again. In the lecture an overview about recent measurements on scatter doses resulting from gantry, table and room shall be given. Scatter doses resulting from the volume treated in the patient to other critical parts of the body like eyes, ovarii etc. have been measured in two diploma works in our institute and are compared with a program (PERIDOSE; van der Giessen, Netherlands) to estimate them. In some cases these scatter doses have led to changes of treatment modalities. Also an overview and estimation of doses resulting from photon-particle interactions is given according to a publication from Gudowska et al.(Gudowska I, Brahme A, Andreo P, Gudowski W, Kierkegaard J. Calculation of absorbed dose and biological effectiveness from photonuclear reactions in a bremsstrahlung beam of end point 50 MeV. Phys Med Biol 1999; 44(9):2099-2125.). Energy dose has been calculated with Monte Carlo-methods and is compared with analytical methods for 50 MV bremsstrahlung. From these data biologically effective doses from particles in different depths of the body can be estimated also for energies used in normal radiotherapy. (author)

Radiation therapy for patients with obstructive jaundice caused by carcinoma of the extrahepatic biliary system

International Nuclear Information System (INIS)

Kawamura, Masashi; Nakagawa, Hirofumi; Kataoka, Masaaki

1992-01-01

From February 1980 through September 1990, 92 patients with obstructive jaundice resulting from biliary tract cancer were registered at Shikoku Cancer Center Hospital or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of these patients (30 with carcinoma of the extrahepatic bile duct, excluding ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38 patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39 with carcinoma of the extrahepatic bile duct and eight with carcinoma of the gallbladder) were not treated by RT. All jaundiced patients received external and/or internal biliary drainage of some kind. Among patients undergoing biliary drainage with a catheter, 21 patients who underwent RT (four with IORT) survived significantly longer than 19 patients who did not (generalized Wilcoxon test: p<0.05). There were no significant differences in survival between 7 patients with recanalization and 11 patients with no recanalization. Concerning the survival of laparotomized patients, excluding those with complete resection or perioperative death, eight patients treated with postoperative ERT survived longer than 12 patients who did not have postoperative ERT (not significant). Eleven patients underwent IORT. A patient with unresectable carcinoma of the hilar bile duct survived 2 years and 3 months after a combination treatment of ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II were observed (Oboshi and Shimosato's evaluation system for the histological effects of radiation therapy). Our experience suggests that RT is effective in patients with obstructive jaundice caused by carcinoma of the biliary system. (author)

Radiation protection of patients in X-ray diagnostic techniques

International Nuclear Information System (INIS)

Gerhardt, P.

1975-01-01

The author states as a result that the care taken by the physician and the technical assistant is the most important factor in reducing the radiation exposure of patients. A fair relation between efficiency and possible unnecessary exposure is provided by careful and conscientious work which has to be based on sound knowledge of the effects of ionizing radiation on the organism and of the possibilities of reducing the doses responsible for these effects. (orig./AK) [de

Introduction to the theory of free electron lasers

International Nuclear Information System (INIS)

Krinsky, S.

1985-01-01

We present an introduction to some fundamental aspects of the theory of free electron lasers. Spontaneous radiation emitted by electrons traversing a wiggler magnet is briefly reviewed, and stimulated emission in the low-gain regime is discussed using Colson's pendulum equations and Madey's theorems. The high-gain regime is treated by an extention of the work of Bonifacio, Pellegrini, and Narducci. We introduce dynamical variables to describe the radiation field, and a Hamiltonian formulation of Maxwell's equations is employed. A canonical transformation to the interaction representation factors out the fast time variation of the radiation field, and the slow time dependence is determined by linearized equations for the appropriate collective variables. As an application of this technique we consider self-amplified spontaneous radiation, and we comment upon the relationship between our approach and the use of coupled Vlasov-Maxwell equations

Postoperative radiation therapy after hip replacement in high-risk patients for development of heterotopic bone formation

International Nuclear Information System (INIS)

Hashem, R.; Rene, N.; Souhami, L.; Tanzer, M.; Evans, M.

2011-01-01

Purpose. - To report the results of postoperative radiation therapy in preventing the development of heterotopic bone formation after hip replacement surgery in high-risk patients. Patients and methods. - Between 1991 and 2007, 44 patients were preventively treated with postoperative RT after total hip replacement. In total, 47 hips were treated. All patients were considered at high risk for developing heterotopic bone formation. Most patients (63.5%) were treated because of a history of severe osteoarthritis or ankylosing spondylitis. All patients were treated with shaped parallel-opposed fields with a single fraction of 7 Gy using 6 or 18 MV photons. Most patients (94%) received radiation therapy within 72 hours postoperative and in only three patients radiation therapy was delivered after 72 hours post-surgery (5-8 days). Results. - Minimum follow-up was 1 year. There were 18 females and 26 males. Median age was 63 years (range: 18-80). Treatments were well tolerated and no acute toxicity was seen post-radiation therapy. Only one of the 47 hips (2%) developed heterotopic bone formation. This patient received postoperative radiation therapy to both hips but only developed heterotopic bone formation in one of them. None of the three patients treated beyond 72 hours failed. To date no late toxicity has been observed. Conclusion. - The use of postoperative radiation therapy was an effective and safe treatment in the prevention of heterotopic bone formation in a high-risk group of patients undergoing total hip replacement. (authors)

Dental management for head and neck cancer patients undergoing radiation therapy: comprehensive patient based planning--a case report.

Science.gov (United States)

Higham, Paola; Quek, Samuel; Cohen, Harold V

2009-01-01

Medical management of the head and neck cancer patient (HNCP) most often will include radiation therapy to the head and neck region. HNCPs with malignant disease require judicious dental treatment planning prior to radiation therapy (RT) and/or chemotherapy. RT can result in a multitude of adverse effects, both reversible and irreversible. We report a case of a patient with squamous cell carcinoma of the throat above the larynx (supraglottic), who did not adhere to dental treatment recommendations for both pre- and post radiation dental management. The focus of this case report is to create awareness within the clinician that, in addition to evaluating the patient for the disease related issues that may affect the oral cavity and dentition, a total management plan should include factors beyond the structural oral problems related to the cancer. Final treatment plans for the HNCP should include medical assessment of past dental history, oral hygiene, potential compliance, or lack of, to dental care recommendations, the emotional state of the patient, socio-economic status of the patient (lifestyle, cost of care), future quality of life, the medical and/or life prognosis of the patient.

Emergency preparedness of Research Center for Radiation medicine and its hospital to admit and treat the patients with signs of acute radiation sickness

International Nuclear Information System (INIS)

Belyi, D. A.; Khomenko, V. I.; Bebeshko, V. G.

2009-01-01

After the Chernobyl accident, the Research Center for Radiation Medicine (RCRM) was established in Kiev (Ukraine). Its main task was to maintain a high level of emergency preparedness and be ready to examine and treat patients who suffer as a result of hypothetical radiation accident. Based on the previous experience, this institution's specialists worked out new diagnostic criteria and drug treatment schemata for acute radiation sickness, created a database on 75 patients with this diagnosis and improved educational programmes for medical students and physicians working in the field of radiation medicine. RCRM collaborates fruitfully with western partners through the joint research projects and connects with the World Health Organisation's Radiation Emergency Medical Preparedness and Assistance Network centre. Collaboration with Kiev Center for Bone Marrow Transplantation allows RCRM to use aseptic wards having highly filtered air for the treatment of most severely irradiated patients. (authors)

Analysis of radiation doses to patients from diagnostic department of nuclear medicine

International Nuclear Information System (INIS)

Lepej, L.; Messingerova, M.

1995-01-01

In this paper the values of mean effective dose equivalents per unit activity (H E/1Bq ) were used for the calculation of mean effective dose equivalents for one examination (H E ). The collective effective dose equivalents for each radiopharmaceutical and type of examination (S ER ) and global collective effective dose equivalent for department for all radiopharmaceuticals (S E ) during evaluated period were defined. The data for years from 1992 to 1994 were evaluated and compared with results in literature. The evaluation of radiation doses in nuclear medicine department is useful parameter for internal quality control. Using this method, the radiation dose in this laboratory was changed to minimum (under mean value of Slovak Republic). Unfortunately, the real data of patients radiation doses are different from the calculated one. Due to different kinetic of radiopharmaceuticals in individual patients (influenced by pathology, age, etc.) the evaluation of radiation burden to nuclear medicine patients is problematic. But this approach enable the relative comparison of the changes in values of H E and S E during the observed period. The evaluation of individual (minimal) effective dose equivalent - (H min ) which represents dose calculated under physiologic conditions can be useful for indication of diagnostic examination by physicians. Therefore the systematic registration of H min from all examinations - patient's radiation history. This is specially important in the case of children and young people. The importance of the proposed method, is in regulation of radiation dose from nuclear medicine diagnostic examinations, not only be the control of number and type of examinations, but also by selection of used radiopharmaceuticals and by the way how to use them. (J.K.) 1 fig., 2 refs

Nuclei and particles. An introduction to nuclear and subnuclear physics

International Nuclear Information System (INIS)

Serge, E.

1977-01-01

A broad introduction is given to nuclear and subnuclear physics. Major divisions of the book include radiation and tools for studying the nucleus, elements of the structure, properties, and reactions of nuclei, and a semiphenomenological approach to elementary particles

Ionizing radiation-induced DNA injury and damage detection in patients with breast cancer

Energy Technology Data Exchange (ETDEWEB)

Borrego-Soto, Gissela; Ortiz-Lopez, Rocio; Rojas-Martinez, Augusto, E-mail: arojasmtz@gmail.com, E-mail: augusto.rojasm@uanl.mx [Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León (Mexico)

2015-10-15

Breast cancer is the most common malignancy in women. Radiotherapy is frequently used in patients with breast cancer, but some patients may be more susceptible to ionizing radiation, and increased exposure to radiation sources may be associated to radiation adverse events. This susceptibility may be related to deficiencies in DNA repair mechanisms that are activated after cell-radiation, which causes DNA damage, particularly DNA double strand breaks. Some of these genetic susceptibilities in DNA-repair mechanisms are implicated in the etiology of hereditary breast/ovarian cancer (pathologic mutations in the BRCA 1 and 2 genes), but other less penetrant variants in genes involved in sporadic breast cancer have been described. These same genetic susceptibilities may be involved in negative radiotherapeutic outcomes. For these reasons, it is necessary to implement methods for detecting patients who are susceptible to radiotherapy-related adverse events. This review discusses mechanisms of DNA damage and repair, genes related to these functions, and the diagnosis methods designed and under research for detection of breast cancer patients with increased radiosensitivity. (author)

Lacunar infarction in brain tumor patients. Chronic stage complication after radiation therapy

International Nuclear Information System (INIS)

Nakazaki, Kiyoshi; Titoku, Shirou; Ota, Shinzou; Sato, Mitiyoshi; Kobanawa, Satoshi; Tutida, Kazuyuki; Tanaka, Yasue; Goto, Katsuya; Ota, Taisei

2007-01-01

The authors reported two relatively young adults with lacunar infarction that took place many years after radiation therapy. The first case was that of a 41-year-old male presenting with a slight decrease in consciousness and right hemiparesis of sudden occurrence. MRI revealed a lacunar infarction in the left internal capsule. This patient had received radiation therapy and chemotherapy for a right basal ganglia germinoma when he was 24 years old. The tumor completely disappeared and he was able to return to work. The second case was a 24-year-old female presenting with dysesthesia in the right upper extremity and nausea of sudden occurrence. MRI disclosed a lacunar infarct in the right corona radiata. The patient had received radiation therapy for a suprasellar tumor when she was 11 years old. The tumor considerably decreased in size and the patient conducted normal social life thereafter. MRI showed a lacunar infarction in the right corona radiata. Review of the literature was made and the possibility of radiation therapy as a causative factor of the lacunar infarction in relatively young adults was discussed. (author)

Radiation doses and radiation risk in foreign nuclear objects

International Nuclear Information System (INIS)

Tvehlov, Yu.

2001-01-01

Data on levels of irradiation on NPP operating in different regions of the world obtained from the data of the International Information System ISOE created by IAEA in association with the Nuclear Energetic Agency OECD are performed. Effect of commissioning new NPP, sacrifice of radiation situation at the Ignalina NPP in 1996, importance of the development and introduction of programs on perfecting of radiation protection and culture of safety are noted [ru

Nuclear radiation in warfare

International Nuclear Information System (INIS)

Rotblat, J.

1986-01-01

The subject is covered in chapters, entitled: introduction; digest of nuclear weaponry (characteristics of nuclear weapons; effects of nuclear weapons other than ionizing radiation (fire-ball, fall-out, thermal radiation, blast wave, electromagnetic pulse); the nuclear arms race; war scenarios; biological effects of radiations on man (radiation doses; natural sources of radiation; acute effects of radiation; long-term somatic effects; genetic effects; factors affecting the biological response to radiation; internal exposure; synergistic effects; protection against radiation effects); radiations from nuclear explosions (initial radiation; fall-out; effects of fall-out on animal and plant life; contamination of water and food supplies by fall-out); radiation casualties in a nuclear war; effectiveness of civil defence; other warlike uses of radiation (attacks on civilian nuclear power installations; radiological warfare; terrorist activities); conclusion. (orig./HP) [de

Nuclear radiation in warfare

International Nuclear Information System (INIS)

Rotblat, J.

1981-01-01

The subject is covered in chapters, entitled: introduction; digest of nuclear weaponry (characteristics of nuclear weapons; effects of nuclear weapons other than ionizing radiation (fire-ball, fall-out, thermal radiation, blast wave, electromagnetic pulse); the nuclear arms race; war scenarios); biological effects of radiations on man (radiation doses; natural sources of radiation; acute effects of radiation; long-term somatic effects; genetic effects; factors affecting the biological response to radiation; internal exposure; synergistic effects; protection against radiation effects); radiations from nuclear explosions (initial radiation; fall-out; effects of fall-out on animal and plant life; contamination of water and food supplies by fall-out); radiation casualties in a nuclear war; effectiveness of civil defence; other warlike uses of radiation (attacks on civilian nuclear power installations; radiological warfare; terrorist activities); conclusion. (U.K.)

Does introduction of a Patient Data Management System (PDMS) improve the financial situation of an intensive care unit?

Science.gov (United States)

Castellanos, Ixchel; Schüttler, Jürgen; Prokosch, Hans-Ulrich; Bürkle, Thomas

2013-09-16

Patient Data Management Systems (PDMS) support clinical documentation at the bedside and have demonstrated effects on completeness of patient charting and the time spent on documentation. These systems are costly and raise the question if such a major investment pays off. We tried to answer the following questions: How do costs and revenues of an intensive care unit develop before and after introduction of a PDMS? Can higher revenues be obtained with improved PDMS documentation? Can we present cost savings attributable to the PDMS? Retrospective analysis of cost and reimbursement data of a 25 bed Intensive Care Unit at a German University Hospital, three years before (2004-2006) and three years after (2007-2009) PDMS implementation. Costs and revenues increased continuously over the years. The profit of the investigated ICU was fluctuating over the years and seemingly depending on other factors as well. We found a small increase in profit in the year after the introduction of the PDMS, but not in the following years. Profit per case peaked at 1039 € in 2007, but dropped subsequently to 639 € per case. We found no clear evidence for cost savings after the PDMS introduction. Our cautious calculation did not consider additional labour costs for IT staff needed for system maintenance. The introduction of a PDMS has probably minimal or no effect on reimbursement. In our case the observed increase in profit was too small to amortize the total investment for PDMS implementation.This may add some counterweight to the literature, where expectations for tools such as the PDMS can be quite unreasonable.

Evaluation of the knowledge of physicians prescribing CT examinations on the radiation protection of patients

International Nuclear Information System (INIS)

Gervaise, A.; Pernin, M.; Naulet, P.; Portron, Y.; Lapierre-Combes, M.; Esperabe-Vignau, F.

2011-01-01

Purpose: To evaluate the knowledge of physicians prescribing CT examinations on the radiation protection of patients. Materials and methods: A questionnaire was distributed to all clinicians on medical staff who prescribe CT examinations. Several questions related to their prescription pattern and their knowledge of radiation protection. Results: Forty-four questionnaires were analyzed. While 70% of physicians claimed that they considered the risks from exposure to ionizing radiation when prescribing a CT examination, only 25% informed their patients about those risks. Knowledge of the radiation dose delivered during CT evaluation of the abdomen and pelvis was poorly understood and the risks related to small doses of radiation were grossly underestimated. Finally, only a third of clinicians had received training with regards to radiation protection. Conclusion: While most clinicians claim that they consider the risks from exposure to ionizing radiation when prescribing a CT examination, the risks are either not well known or not known at all. Increased formation of clinicians with regards to the radiation protection of patients, maybe through a dedicated clinical rotation while in medical school, could be a solution to improve the knowledge of hospital clinicians with regards to radiation protection. (authors)

Do prostate cancer patients want to choose their own radiation treatment?

NARCIS (Netherlands)

Tol-Geerdink, J.J. van; Stalmeier, P.F.M.; Lin, E.N.J.T. van; Schimmel, E.C.; Huizenga, H.; Daal, W.A.J. van; Leer, J.W.H.

2006-01-01

Purpose: The aims of this study were to investigate whether prostate cancer patients want to be involved in the choice of the radiation dose, and which patients want to be involved. Methods and Materials: This prospective study involved 150 patients with localized prostate cancer treated with

Radiation exposure estimation from patient treated by I-131

International Nuclear Information System (INIS)

Lahfi, Y.; Anjak, O.

2012-09-01

Radioactive iodine is the main radiopharmaceutical substance in the nuclear medicine field which used in diagnosis and treatment of patients suffering from thyroid cancer; thus it can be considered as the main source of the public and patient relative exposure. In this study, 192 patients were selected randomly and their radiation dose rate was measured at different levels of the patient's body (thyroid, knee, bladder) after one, twenty four and forty eight hours from availing the prescript quantity of the I-131. The collected data may serve in estimating the worker and public exposure related to the patient treated by I-131. (authors)

The ICRP principles applied to radiation protection of the patient in diagnostic radiology

International Nuclear Information System (INIS)

Carlsson, S.; Mattsson, S.

1994-01-01

The International Commission on Radiation Protection (ICRP) has published new recommendations in Publication 60. These take account of the new biological information and trends in the setting of radiation protection standards since 1977. The main principle for radiation protection of the patient is that the exposure should be justified not only at a broad level but also with respect to the individual patient. Protection arrangements should be optimised using reference dose levels as an upper bound of the optimisation process. The reference levels should be applied with flexibility and based on sound clinical judgement. (authors)

Radiation therapy for malignant tumors in patients 80 years of age or older

International Nuclear Information System (INIS)

Mitsuhashi, Norio; Niibe, Hideo; Hayakawa, Kazushige; Takahashi, Mitsuhiro; Nozaki, Miwako; Yamakawa, Michitaka

1992-01-01

We report here, results of investigation of changes in the condition of elderly patients, 80 years of age or older (EP-80), treated with radiation, and analysis of the results of radiotherapy to assess the value of radiotherapy in treating the elderly. Between 1970 and 1989, 294 EP-80 with various malignant tumors received radiation therapy at the Department of Radiology, Gunma University Hospital. The number of EP-80 treated has increased recently to about thirty per year, and their incidence among newly registered patients has also increased to over 5%. The 5-year cause specific survival rates for male and female were 14% and 32%, respectively. There was a significant difference between the survival rates for male and female (x 2 =11.89, p=0.00056) because of inclusion of a significant proportion of female patients with gynecological malignancies. The 5-year survival rate for patients in the curative radiotherapy group (CRG) was 30%, whereas no patient of the palliative radiotherapy group (PRG) has survived for 5 years (x 2 =90.23, p=0.00000). In the CRG, the survival rate for females was significantly higher than that for males (x 2 =11.48, p=0.00070). Thirty-one patients survived for 5 year. Head and neck cancer and uterine lervix cancer were the most common tumors in 5 year survivors. Age was not a significant prognostic factor in the elderly patients treated with radiation. It is considered that radiation therapy is as valuable in elderly patients as in the younger patient population. (author)

Terminological problems in radiation diagnosis

International Nuclear Information System (INIS)

Rozenfel'd, L.G.

1991-01-01

It was noted the necessity of regulation of medical termonilogy. The introduction of terms radiation diagnosis, radiation therapy was justified, usage of terms xeroroentgenography, reconstructive tomography was recommended. In author's opinion it was expedient to exclude from utilization the terms diagnostic radiology, skiagraphy, electroroentgenography, computerized tomography

Delayed radiation necrosis of the central nervous system in patients irradiated for pituitary tumours

International Nuclear Information System (INIS)

Grattan-Smith, P.J.; Morris, J.G.; Langlands, A.O.

1992-01-01

Four cases of delayed radiation necrosis involving the CNS were found in a group of 46 patients irradiated for pituitary tumours over a six year period. This occurred in three of 11 patients with Cushing's disease representing an incidence of 27% in this group. There were no cases among 11 patients with acromegaly or among seven with prolactinomas. One case (6%) was found in the 17 patients with chromophobe adenomas. Standard doses of radiation were delivered to these patients and the findings support suggestions that the metabolic disturbances of Cushing's disease may reduce tolerance to radiation. Our results and a literature review indicate that if radiotherapy is used to treat Cushing's disease, the total dose should be less than 50 Gy at 2 Gy per day fractionation. (Author)

Delayed radiation necrosis of the central nervous system in patients irradiated for pituitary tumours

Energy Technology Data Exchange (ETDEWEB)

Grattan-Smith, P.J.; Morris, J.G.; Langlands, A.O. (Westmead Hospital, Sydney (Australia))

1992-10-01

Four cases of delayed radiation necrosis involving the CNS were found in a group of 46 patients irradiated for pituitary tumours over a six year period. This occurred in three of 11 patients with Cushing's disease representing an incidence of 27% in this group. There were no cases among 11 patients with acromegaly or among seven with prolactinomas. One case (6%) was found in the 17 patients with chromophobe adenomas. Standard doses of radiation were delivered to these patients and the findings support suggestions that the metabolic disturbances of Cushing's disease may reduce tolerance to radiation. Our results and a literature review indicate that if radiotherapy is used to treat Cushing's disease, the total dose should be less than 50 Gy at 2 Gy per day fractionation. (Author).

Critical evaluation of the role of nutritional support for radiation therapy patients

International Nuclear Information System (INIS)

Pezner, R.; Archambeau, J.O.

1985-01-01

Nutritional intake or absorption may be compromised by radiation therapy (RT) when large portions of the gastrointestinal tract are treated. Dietary counseling, oral supplements, tube feedings and intravenous hyperalimentation (IVH) have been employed to limit weight loss and lessen intestinal RT side effects. Unfortunately, no prospective study reviewed has shown improved tumor control or patient survival. Special diets and IVH have also been employed in select patients to relieve chronic malabsorption from severe radiation enteritis

Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy

Science.gov (United States)

2017-10-01

AWARD NUMBER: W81XWH-15-1-0681 TITLE: Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy PRINCIPAL...TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1-0681Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated...effects, urinary morbidity, rectal injury, sexual dysfunction 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF

Program for radiation protection of the patient (Argentina)

International Nuclear Information System (INIS)

Touzet, Rodolfo E.; Perez, Maria del R.; Alfredo Buzzi; Andisco, Daniel

2006-01-01

After an initial period of conviction for installing an active discussion on radiation protection of patients inside the medical community, there were organized 'working groups' in radiodiagnosis, radiotherapy, nuclear medicine and on radiation protection of pregnant women. These groups began systematical activities, which received a strong institutional support of the Argentine Society of Radiology, toward the implementation of a 'Program of RPP' that is being put nowadays into practice. This program has three aims and a series of targets to be fulfilled in successive stages: basic aims and short term targets: 1) To guarantee the justification: first goal: development of the 'Prescription Guide' (achieved); 2) To optimize the radioprotection: first goal: Development of a 'Manual of Procedures' (achieved); 3) To prevent potential exposures: first goal: Design of a 'Basic quality system' in Health (achieved). The effective participation of the professional's and technician's associations in the development of the program of radiological protection of the patient is a key aspect for the success. (author) [es