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Sample records for risk specific dose

  1. Patient-specific radiation dose and cancer risk for pediatric chest CT.

    Science.gov (United States)

    Li, Xiang; Samei, Ehsan; Segars, W Paul; Sturgeon, Gregory M; Colsher, James G; Frush, Donald P

    2011-06-01

    To estimate patient-specific radiation dose and cancer risk for pediatric chest computed tomography (CT) and to evaluate factors affecting dose and risk, including patient size, patient age, and scanning parameters. The institutional review board approved this study and waived informed consent. This study was HIPAA compliant. The study included 30 patients (0-16 years old), for whom full-body computer models were recently created from clinical CT data. A validated Monte Carlo program was used to estimate organ dose from eight chest protocols, representing clinically relevant combinations of bow tie filter, collimation, pitch, and tube potential. Organ dose was used to calculate effective dose and risk index (an index of total cancer incidence risk). The dose and risk estimates before and after normalization by volume-weighted CT dose index (CTDI(vol)) or dose-length product (DLP) were correlated with patient size and age. The effect of each scanning parameter was studied. Organ dose normalized by tube current-time product or CTDI(vol) decreased exponentially with increasing average chest diameter. Effective dose normalized by tube current-time product or DLP decreased exponentially with increasing chest diameter. Chest diameter was a stronger predictor of dose than weight and total scan length. Risk index normalized by tube current-time product or DLP decreased exponentially with both chest diameter and age. When normalized by DLP, effective dose and risk index were independent of collimation, pitch, and tube potential (chest CT protocols. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101900/-/DC1. RSNA, 2011

  2. Patient-specific radiation dose and cancer risk estimation in CT: Part II. Application to patients

    Energy Technology Data Exchange (ETDEWEB)

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Toncheva, Greta; Yoshizumi, Terry T.; Frush, Donald P. [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Medical Physics Graduate Program, Department of Physics, and Department of Biomedical Engineering, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 and Department of Biomedical Engineering, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Duke Radiation Dosimetry Laboratory, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Duke Radiation Dosimetry Laboratory, Department of Radiology, Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina 27705 (United States); Division of Pediatric Radiology, Department of Radiology, Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina 27710 (United States)

    2011-01-15

    Purpose: Current methods for estimating and reporting radiation dose from CT examinations are largely patient-generic; the body size and hence dose variation from patient to patient is not reflected. Furthermore, the current protocol designs rely on dose as a surrogate for the risk of cancer incidence, neglecting the strong dependence of risk on age and gender. The purpose of this study was to develop a method for estimating patient-specific radiation dose and cancer risk from CT examinations. Methods: The study included two patients (a 5-week-old female patient and a 12-year-old male patient), who underwent 64-slice CT examinations (LightSpeed VCT, GE Healthcare) of the chest, abdomen, and pelvis at our institution in 2006. For each patient, a nonuniform rational B-spine (NURBS) based full-body computer model was created based on the patient's clinical CT data. Large organs and structures inside the image volume were individually segmented and modeled. Other organs were created by transforming an existing adult male or female full-body computer model (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. A Monte Carlo program previously developed and validated for dose simulation on the LightSpeed VCT scanner was used to estimate patient-specific organ dose, from which effective dose and risks of cancer incidence were derived. Patient-specific organ dose and effective dose were compared with patient-generic CT dose quantities in current clinical use: the volume-weighted CT dose index (CTDI{sub vol}) and the effective dose derived from the dose-length product (DLP). Results: The effective dose for the CT examination of the newborn patient (5.7 mSv) was higher but comparable to that for the CT examination of the teenager patient (4.9 mSv) due to the size-based clinical CT protocols at our institution, which employ lower scan techniques for smaller

  3. Patient- and cohort-specific dose and risk estimation for abdominopelvic CT: a study based on 100 patients

    Science.gov (United States)

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

    2012-03-01

    The purpose of this work was twofold: (a) to estimate patient- and cohort-specific radiation dose and cancer risk index for abdominopelvic computer tomography (CT) scans; (b) to evaluate the effects of patient anatomical characteristics (size, age, and gender) and CT scanner model on dose and risk conversion coefficients. The study included 100 patient models (42 pediatric models, 58 adult models) and multi-detector array CT scanners from two commercial manufacturers (LightSpeed VCT, GE Healthcare; SOMATOM Definition Flash, Siemens Healthcare). A previously-validated Monte Carlo program was used to simulate organ dose for each patient model and each scanner, from which DLP-normalized-effective dose (k factor) and DLP-normalized-risk index values (q factor) were derived. The k factor showed exponential decrease with increasing patient size. For a given gender, q factor showed exponential decrease with both increasing patient size and patient age. The discrepancies in k and q factors across scanners were on average 8% and 15%, respectively. This study demonstrates the feasibility of estimating patient-specific organ dose and cohort-specific effective dose and risk index in abdominopelvic CT requiring only the knowledge of patient size, gender, and age.

  4. Microbeams, microdosimetry and specific dose

    International Nuclear Information System (INIS)

    Randers-Pehrson, H.

    2002-01-01

    Dose and its usefulness as a single parameter to describe the amount of radiation absorbed are well established for most situations. The conditions where the concept of dose starts to break down are well known, mostly from the study of microdosimetry. For low doses of high LET radiation it is noted that the process of taking the limiting value of the energy absorbed within a test volume divided by the mass within that volume yields either zero or a relatively large value. The problem is further exacerbated with microbeam irradiations where the uniformity of the energy deposition is experimentally manipulated on the spatial scale of cells being irradiated. Booz introduced a quantity to deal with these problems: the unfortunately named 'mean specific energy in affected volumes'. This quantity multiplied by the probability that a test volume has received an energy deposit is equal to dose (in situations where dose can be defined). I propose that Booz's quantity be renamed 'specific dose', that is the mean energy deposited divided by the mass within a specified volume. If we believe for instance that the nucleus of a cell is the critical volume for biological effects, we can refer to the nuclear specific dose. A microbeam experiment wherein 10 per cent of the cell nuclei were targeted with 10 alpha particles would be described as delivering a nuclear specific dose of 1.6 Gy to 10 per cent of the population. (author)

  5. WE-AB-209-08: Novel Beam-Specific Adaptive Margins for Reducing Organ-At-Risk Doses

    Energy Technology Data Exchange (ETDEWEB)

    Tsang, H; Kamerling, CP; Ziegenhein, P; Nill, S; Oelfke, U [The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2016-06-15

    Purpose: Current practice of using 3D margins in radiotherapy with high-energy photon beams provides larger-than-required target coverage. According to the photon depth-dose curve, target displacements in beam direction result in minute changes in dose delivered. We exploit this behavior by generating margins on a per-beam basis which simultaneously account for the relative distance of the target and adjacent organs-at-risk (OARs). Methods: For each beam, we consider only geometrical uncertainties of the target location perpendicular to beam direction. By weighting voxels based on its proximity to an OAR, we generate adaptive margins that yield similar overall target coverage probability and reduced OAR dose-burden, at the expense of increased target volume. Three IMRT plans, using 3D margins and 2D per-beam margins with and without adaptation, were generated for five prostate patients with a prescription dose Dpres of 78Gy in 2Gy fractions using identical optimisation constraints. Systematic uncertainties of 1.1, 1.1, 1.5mm in the LR, SI, and AP directions, respectively, and 0.9, 1.1, 1.0mm for the random uncertainties, were assumed. A verification tool was employed to simulate the effects of systematic and random errors using a population size of 50,000. The fraction of the population that satisfies or violates a given DVH constraint was used for comparison. Results: We observe similar target coverage across all plans, with at least 97.5% of the population meeting the D98%>95%Dpres constraint. When looking at the probability of the population receiving D5<70Gy for the rectum, we observed median absolute increases of 23.61% (range, 2.15%–27.85%) and 6.97% (range, 0.65%–17.76%) using per-beam margins with and without adaptation, respectively, relative to using 3D margins. Conclusion: We observed sufficient and similar target coverage using per-beam margins. By adapting each per-beam margin away from an OAR, we can further reduce OAR dose without significantly

  6. WE-AB-209-08: Novel Beam-Specific Adaptive Margins for Reducing Organ-At-Risk Doses

    International Nuclear Information System (INIS)

    Tsang, H; Kamerling, CP; Ziegenhein, P; Nill, S; Oelfke, U

    2016-01-01

    Purpose: Current practice of using 3D margins in radiotherapy with high-energy photon beams provides larger-than-required target coverage. According to the photon depth-dose curve, target displacements in beam direction result in minute changes in dose delivered. We exploit this behavior by generating margins on a per-beam basis which simultaneously account for the relative distance of the target and adjacent organs-at-risk (OARs). Methods: For each beam, we consider only geometrical uncertainties of the target location perpendicular to beam direction. By weighting voxels based on its proximity to an OAR, we generate adaptive margins that yield similar overall target coverage probability and reduced OAR dose-burden, at the expense of increased target volume. Three IMRT plans, using 3D margins and 2D per-beam margins with and without adaptation, were generated for five prostate patients with a prescription dose Dpres of 78Gy in 2Gy fractions using identical optimisation constraints. Systematic uncertainties of 1.1, 1.1, 1.5mm in the LR, SI, and AP directions, respectively, and 0.9, 1.1, 1.0mm for the random uncertainties, were assumed. A verification tool was employed to simulate the effects of systematic and random errors using a population size of 50,000. The fraction of the population that satisfies or violates a given DVH constraint was used for comparison. Results: We observe similar target coverage across all plans, with at least 97.5% of the population meeting the D98%>95%Dpres constraint. When looking at the probability of the population receiving D5<70Gy for the rectum, we observed median absolute increases of 23.61% (range, 2.15%–27.85%) and 6.97% (range, 0.65%–17.76%) using per-beam margins with and without adaptation, respectively, relative to using 3D margins. Conclusion: We observed sufficient and similar target coverage using per-beam margins. By adapting each per-beam margin away from an OAR, we can further reduce OAR dose without significantly

  7. Mutation frequencies in male mice and the estimation of genetic hazards of radiation in men: (specific-locus mutations/dose-rate effect/doubling dose/risk estimation)

    International Nuclear Information System (INIS)

    Russell, W.L.; Kelly, E.M.

    1982-01-01

    Estimation of the genetic hazards of ionizing radiation in men is based largely on the frequency of transmitted specific-locus mutations induced in mouse spermatogonial stem cells at low radiation dose rates. The publication of new data on this subject has permitted a fresh review of all the information available. The data continue to show no discrepancy from the interpretation that, although mutation frequency decreases markedly as dose rate is decreased from 90 to 0.8 R/min (1 R = 2.6 X 10 -4 coulombs/kg) there seems to be no further change below 0.8 R/min over the range from that dose rate to 0.0007 R/min. Simple mathematical models are used to compute: (a) a maximum likelihood estimate of the induced mutation frequency at the low dose rates, and (b) a maximum likelihood estimate of the ratio of this to the mutation frequency at high dose rates in the range of 72 to 90 R/min. In the application of these results to the estimation of genetic hazards of radiation in man, the former value can be used to calculate a doubling dose - i.e., the dose of radiation that induces a mutation frequency equal to the spontaneous frequency. The doubling dose based on the low-dose-rate data compiled here is 110 R. The ratio of the mutation frequency at low dose rate to that at high dose rate is useful when it becomes necessary to extrapolate from experimental determinations, or from human data, at high dose rates to the expected risk at low dose rates. The ratio derived from the present analysis is 0.33

  8. Patient-specific radiation dose and cancer risk in computed tomography examinations in some selected CT facilities in the Greater Accra Region of Ghana

    International Nuclear Information System (INIS)

    Osei, R. K.

    2012-01-01

    The effective dose and cancer risk were determined for patients undergoing seven different types of CT examinations in two CT facilities in the Greater Accra region of Ghana. The two facilities, namely; the Diagnostic Centre Ltd and Cocoa Clinic were chosen because of their significant patient throughput. The effective dose was from patient data namely age, sex, height, weight and technique factors; namely scan length, KVp (Kilovolts peak), mAs (milliamperes per second) and CTDIv from the control console of the CT machines. The effective dose was also estimated using the dose length product (DLP) and k Coefficients which is the anatomic region specific conversion factors. The cancer risk for each patient for a particular examination was determined from the effective dose, age and sex of each patient with the help of BEIR VII. In all, a total number of 800 adult patients with 400 from each of the two CT facilities were compiled. From Diagnostic Centre Ltd, the average effective dose was 5.61mSv in the range of 1.41mSv to 13.34mSv with average BMI of 26.19kg/m 2 in the range of 16.90kg/m 2 to 48.28kg/m 2 for all types of examinations. The average cancer risk was 0.0458 Sv - 1 for 400 patients in the range of 0.0001 Sv - 1 to 0.3036 Sv -1 compared with a population of 900 patients undergoing CT examination per year. From Cocoa Clinic, the average effective dose was 3.91MSv in the range of 0.54mSv to 27.32mSv with an average BMI of 25.59 kg/m 2 in the range of 17.18kg/m 2 to 35.34kg/m 2 and the average cancer risk was 0.0371 Sv - 1 in the range of 0.0001 Sv - 1 and 0.7125 Sv -1 . Some of the values were within the range of values of typical for typical effective dose for CT examinations reported by the ICRP. It was evident from this study that the variations in scanning parameters had significant impact on the effective doses to patient for similar CT examinations among the two facilities.(au)

  9. Dose-response relationship between cigarette smoking and site-specific cancer risk: protocol for a systematic review with an original design combining umbrella and traditional reviews.

    Science.gov (United States)

    Lugo, Alessandra; Bosetti, Cristina; Peveri, Giulia; Rota, Matteo; Bagnardi, Vincenzo; Gallus, Silvano

    2017-11-01

    Only a limited number of meta-analyses providing risk curve functions of dose-response relationships between various smoking-related variables and cancer-specific risk are available. To identify all relevant original publications on the issue, we will conduct a series of comprehensive systematic reviews based on three subsequent literature searches: (1) an umbrella review, to identify meta-analyses, pooled analyses and systematic reviews published before 28 April 2017 on the association between cigarette smoking and the risk of 28 (namely all) malignant neoplasms; (2) for each cancer site, an updated review of original publications on the association between cigarette smoking and cancer risk, starting from the last available comprehensive review identified through the umbrella review; and (3) a review of all original articles on the association between cigarette smoking and site-specific cancer risk included in the publications identified through the umbrella review and the updated reviews. The primary outcomes of interest will be (1) the excess incidence/mortality of various cancers for smokers compared with never smokers; and (2) the dose-response curves describing the association between smoking intensity, duration and time since stopping and incidence/mortality for various cancers. For each cancer site, we will perform a meta-analysis by pooling study-specific estimates for smoking status. We will also estimate the dose-response curves for other smoking-related variables through random-effects meta-regression models based on a non-linear dose-response relationship framework. Ethics approval is not required for this study. Main results will be published in peer-reviewed journals and will also be included in a publicly available website. We will provide therefore the most complete and updated estimates on the association between various measures of cigarette smoking and site-specific cancer risk. This will allow us to obtain precise estimates on the cancer burden

  10. Short-term Androgen-Deprivation Therapy Improves Prostate Cancer-Specific Mortality in Intermediate-Risk Prostate Cancer Patients Undergoing Dose-Escalated External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    Zumsteg, Zachary S.; Spratt, Daniel E.; Pei, Xin; Yamada, Yoshiya; Kalikstein, Abraham; Kuk, Deborah; Zhang, Zhigang; Zelefsky, Michael J.

    2013-01-01

    Purpose: We investigated the benefit of short-term androgen-deprivation therapy (ADT) in patients with intermediate-risk prostate cancer (PC) receiving dose-escalated external beam radiation therapy. Methods and Materials: The present retrospective study comprised 710 intermediate-risk PC patients receiving external beam radiation therapy with doses of ≥81 Gy at a single institution from 1992 to 2005, including 357 patients receiving neoadjuvant and concurrent ADT. Prostate-specific antigen recurrence-free survival (PSA-RFS) and distant metastasis (DM) were compared using the Kaplan-Meier method and Cox proportional hazards models. PC-specific mortality (PCSM) was assessed using competing-risks analysis. Results: The median follow-up was 7.9 years. Despite being more likely to have higher PSA levels, Gleason score 4 + 3 = 7, multiple National Comprehensive Cancer Network intermediate-risk factors, and older age (P≤.001 for all comparisons), patients receiving ADT had improved PSA-RFS (hazard ratio [HR], 0.598; 95% confidence interval [CI], 0.435-0.841; P=.003), DM (HR, 0.424; 95% CI, 0.219-0.819; P=.011), and PCSM (HR, 0.380; 95% CI, 0.157-0.921; P=.032) on univariate analysis. Using multivariate analysis, ADT was an even stronger predictor of improved PSA-RFS (adjusted HR [AHR], 0.516; 95% CI, 0.360-0.739; P<.001), DM (AHR, 0.347; 95% CI, 0.176-0.685; P=.002), and PCSM (AHR, 0.297; 95% CI, 0.128-0.685; P=.004). Gleason score 4 + 3 = 7 and ≥50% positive biopsy cores were other independent predictors of PCSM. Conclusions: Short-term ADT improves PSA-RFS, DM, and PCSM in patients with intermediate-risk PC undergoing dose-escalated external beam radiation therapy

  11. Cervical cancer: intracavitary dose specification and prescription

    International Nuclear Information System (INIS)

    Potish, R.A.; Gerbi, B.J.

    1987-01-01

    Dose and volume specifications for reporting intracavitary therapy were analyzed according to criteria recommended by the International Commission on Radiation Units and Measurements (ICRU). Ninety Fletcher-Suit radium applications were studied to examine the validity of the assumptions of the ICRU and the merit of their routine reporting. It was demonstrated that the reporting recommendations were inconsistent with clinical prescription systems and added little to dose specification. The distinction between dose specification and dose prescription was stressed

  12. Low Dose Risk, Decisions, and Risk Communication

    International Nuclear Information System (INIS)

    Flynn, James

    2002-01-01

    The overall research objective was to establish new levels of information about how people, groups, and communities respond to low dose radiation exposure. This is basic research into the social psychology of individual, group, and community responses to radiation exposures. The results of this research are directed to improving risk communication and public participation in management of environmental problems resulting from low dose radiation

  13. Radiation. Doses, effect, risk

    International Nuclear Information System (INIS)

    Vapirev, E.; Todorov, P.

    1994-12-01

    This book outlines in a popular form the topic of ionizing radiation impacts on living organisms. It contains data gathered by ICRP for a period of 35 years. The essential dosimetry terms and units are presented. Natural and artificial sources of ionizing radiation are described. Possible biological radiation effects and diseases as a consequence of external and internal irradiation at normal and accidental conditions are considered. An assessment of genetic risk for human populations is presented and the concept of 'acceptable risk' is discussed

  14. Specification of volume and dose in radiotherapy

    International Nuclear Information System (INIS)

    Levernes, S.

    1997-01-01

    As a result of a questionnaire about dose and volume specifications in radiotherapy in the Nordic countries, a group has been set up to propose common recommendations for these countries. The proposal is partly based on ICRU 50, but with major extensions. These extensions fall into three areas: patient geometry, treatment geometry, and dose specifications. For patient geometry and set-up one need alignment markings and anatomical reference points, the latter can be divided into internal and external reference points. These points are necessary to get relationships between coordinate systems related to patient and to treatment unit. For treatment geometry the main volume will be an anatomical target volume which just encompass the clinical target volume with all its variations and movements. This anatomical volume are the most suitable volume for prescription, optimization and reporting dose. A set-up margin should be added to the beam periphery in beams-eye-view to get the minimum size and shape of the beam. For dose specification the most important parameter for homogeneous dose distributions is the arithmetic mean of dose to the anatomical target volume together with its standard deviation. In addition the dose to the ICRU reference point should be reported for intercomparison, together with minimum and maximum doses or dose volume histograms for the anatomical target volume. (author)

  15. LOW DOSE RISK, DECISIONS, and RISK COMMUNICATION

    International Nuclear Information System (INIS)

    Flynn, James

    2002-01-01

    The objective of this project is to conduct basic research on how people receive, evaluate, and form positions on scientific information and its relationship to low-dose radiation exposure. There are three major areas of study in our research program. First is the development of theories, frameworks and concepts essential to guiding data collection and analysis. The second area is a program of experimental studies on risk perception, evaluation of science information, and the structure of individual positions regarding low-dose exposures. Third is the community-level studies to examine and record how the social conditions, under which science communications take place, influence the development of attitudes and opinions about: low-dose exposures, the available management options, control of radiation risks, and preferences for program and policy goals

  16. Age-specific models for evaluating dose and risk from internal exposures to radionuclides: Report of current work of the Metabolism and Dosimetry Research Group, July 1, 1985-June 30, 1987

    International Nuclear Information System (INIS)

    Leggett, R.W.; Warren, B.P.

    1987-09-01

    A projection of the health risk to a population internally exposed to a radionuclide requires explicit or implicit use of demographic, biokinetic, dosimetric, and dose-response models. Exposure guidelines have been based on models for a reference adult with a fixed life span. In this report, we describe recent efforts to develop a comprehensive methodology for estimation of radiogenic risk to individuals and to heterogeneous populations. Emphasis is on age-dependent biokinetics and dosimetry for internal emitters, but consideration also is given to conversion of age-specific doses to estimates of risk using realistic, site-specific demographic models and best available age-specific dose-response functions. We discuss how the methods described here may also improve estimates for the reference adult usually considered in radiation protection. 159 refs

  17. Age-specific models for evaluating dose and risk from internal exposures to radionuclides: Report of current work of the Metabolism and Dosimetry Research Group, July 1, 1985-June 30, 1987

    Energy Technology Data Exchange (ETDEWEB)

    Leggett, R.W.; Warren, B.P. (eds.)

    1987-09-01

    A projection of the health risk to a population internally exposed to a radionuclide requires explicit or implicit use of demographic, biokinetic, dosimetric, and dose-response models. Exposure guidelines have been based on models for a reference adult with a fixed life span. In this report, we describe recent efforts to develop a comprehensive methodology for estimation of radiogenic risk to individuals and to heterogeneous populations. Emphasis is on age-dependent biokinetics and dosimetry for internal emitters, but consideration also is given to conversion of age-specific doses to estimates of risk using realistic, site-specific demographic models and best available age-specific dose-response functions. We discuss how the methods described here may also improve estimates for the reference adult usually considered in radiation protection. 159 refs.

  18. Radiation doses and risks from internal emitters

    International Nuclear Information System (INIS)

    Harrison, John; Day, Philip

    2008-01-01

    , the same is not true of the ICRP protection quantities equivalent and effective dose (i.e. those measured in sieverts). The ICRP quantities are intended for practical application in radiological protection and the choice of radiation and tissue weighting factors used in their calculation involves simplifying assumptions regarded as acceptable for this purpose. Best estimates of doses and risks to individuals and specific population groups may be calculated using ICRP biokinetic and dosimetric approaches, but would require the use of best available information on RBE and age-, sex- and population-specific risk factors. Consideration of uncertainties is important in applications such as the assessment of the probability of cancer causation for an individual and in estimating doses in epidemiological studies. While the ICRP system of protection does not take explicit account of uncertainties, an understanding of the various contributions to uncertainty can be seen to be of value when making judgments on the optimisation of protection. (review)

  19. Dose limits cause unacceptable risk

    International Nuclear Information System (INIS)

    Collier, Sylvia.

    1985-01-01

    This paper on radiation dose limits for workers and the public discusses the following: Medical Research Council report; safety standards; risk assessment; deaths from cancers; biological radiation effects; UK legislation; low-level radiation; public concern; UKAEA staff survey; Ionising Radiations Regulations; United Nations Scientific Committee on Effects of Atomic Radiation; US studies on work force in nuclear establishments; problems of extrapolation; Japanese data from Hiroshima and Nagasaki; International Commission on Radiological Protection recommendations; studies on uranium miners; UK Health and Safety Executive; UK National Radiological Protection Board. (U.K.)

  20. Dose specification for radiation therapy: dose to water or dose to medium?

    International Nuclear Information System (INIS)

    Ma, C-M; Li Jinsheng

    2011-01-01

    The Monte Carlo method enables accurate dose calculation for radiation therapy treatment planning and has been implemented in some commercial treatment planning systems. Unlike conventional dose calculation algorithms that provide patient dose information in terms of dose to water with variable electron density, the Monte Carlo method calculates the energy deposition in different media and expresses dose to a medium. This paper discusses the differences in dose calculated using water with different electron densities and that calculated for different biological media and the clinical issues on dose specification including dose prescription and plan evaluation using dose to water and dose to medium. We will demonstrate that conventional photon dose calculation algorithms compute doses similar to those simulated by Monte Carlo using water with different electron densities, which are close (<4% differences) to doses to media but significantly different (up to 11%) from doses to water converted from doses to media following American Association of Physicists in Medicine (AAPM) Task Group 105 recommendations. Our results suggest that for consistency with previous radiation therapy experience Monte Carlo photon algorithms report dose to medium for radiotherapy dose prescription, treatment plan evaluation and treatment outcome analysis.

  1. PEGylation, increasing specific activity and multiple dosing as strategies to improve the risk-benefit profile of targeted radionuclide therapy with 177Lu-DOTA-bombesin analogues

    Science.gov (United States)

    2012-01-01

    Background Radiolabelled bombesin (BN) conjugates are promising radiotracers for imaging and therapy of breast and prostate tumours, in which BN2/gastrin-releasing peptide receptors are overexpressed. We describe the influence of the specific activity of a 177Lu-DOTA-PEG5k-Lys-B analogue on its therapeutic efficacy and compare it with its non-PEGylated counterpart. Methods Derivatisation of a stabilised DOTA-BN(7–14)[Cha13,Nle14] analogue with a linear PEG molecule of 5 kDa (PEG5k) was performed by PEGylation of the ϵ-amino group of a β3hLys-βAla-βAla spacer between the BN sequence and the DOTA chelator. The non-PEGylated and the PEGylated analogues were radiolabelled with 177Lu. In vitro evaluation was performed in human prostate carcinoma PC-3 cells, and in vivo studies were carried out in nude mice bearing PC-3 tumour xenografts. Different specific activities of the PEGylated BN analogue and various dose regimens were evaluated concerning their therapeutic efficacy. Results The specificity and the binding affinity of the BN analogue for BN2/GRP receptors were only slightly reduced by PEGylation. In vitro binding kinetics of the PEGylated analogue was slower since steady-state condition was reached after 4 h. PEGylation improved the stability of BN conjugate in vitro in human plasma by a factor of 5.6. The non-PEGylated BN analogue showed favourable pharmacokinetics already, i.e. fast blood clearance and renal excretion, but PEGylation improved the in vivo behaviour further. One hour after injection, the tumour uptake of the PEG5k-BN derivative was higher compared with that of the non-PEGylated analogue (3.43 ± 0.63% vs. 1.88 ± 0.4% ID/g). Moreover, the increased tumour retention resulted in a twofold higher tumour accumulation at 24 h p.i., and increased tumour-to-non-target ratios (tumour-to-kidney, 0.6 vs. 0.4; tumour-to-liver, 8.8 vs. 5.9, 24 h p.i.). In the therapy study, both 177Lu-labelled BN analogues significantly inhibited tumour

  2. New risk estimates at low doses

    International Nuclear Information System (INIS)

    Fry, R.J.M.

    1992-01-01

    The age of molecular radiation epidemiology may be at hand. The techniques are available to establish with the degree of precision required to determine whether agent-specific mutations can be identified consistently. A concerted effort to examine radiation-induced changes in as many relevant genes as possible appears to be justified. Cancers in those exposed to low doses of ionizing radiation should be chosen for the investigation. Parallel studies of radiation-induced cancers in experimental animals would not only complement the human studies, but perhaps reveal approaches to extrapolation of risk estimates across species. A caveat should be added to this optimistic view of what molecular studies might contribute to the knotty problem of risk estimates at low doses. The suggestions are made by one with no expertise in the field of molecular biology

  3. We can do better than effective dose for estimating or comparing low-dose radiation risks

    International Nuclear Information System (INIS)

    Brenner, D.J.

    2012-01-01

    The effective dose concept was designed to compare the generic risks of exposure to different radiation fields. More commonly these days, it is used to estimate or compare radiation-induced cancer risks. For various reasons, effective dose represents flawed science: for instance, the tissue-specific weighting factors used to calculate effective dose are a subjective mix of different endpoints; and the marked and differing age and gender dependencies for different health detriment endpoints are not taken into account. This paper suggests that effective dose could be replaced with a new quantity, ‘effective risk’, which, like effective dose, is a weighted sum of equivalent doses to different tissues. Unlike effective dose, where the tissue-dependent weighting factors are a set of generic, subjective committee-defined numbers, the weighting factors for effective risk are simply evaluated tissue-specific lifetime cancer risks per unit equivalent dose. Effective risk, which has the potential to be age and gender specific if desired, would perform the same comparative role as effective dose, be just as easy to estimate, be less prone to misuse, be more directly understandable, and would be based on solid science. An added major advantage is that it gives the users some feel for the actual numerical values of the radiation risks they are trying to control.

  4. Androgen Deprivation Therapy Use in the Setting of High-dose Radiation Therapy and the Risk of Prostate Cancer–Specific Mortality Stratified by the Extent of Competing Mortality

    Energy Technology Data Exchange (ETDEWEB)

    Rose, Brent S., E-mail: brose44@gmail.com [Harvard Radiation Oncology Program, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Chen, Ming-Hui; Wu, Jing [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Braccioforte, Michelle H.; Moran, Brian J. [Prostate Cancer Foundation of Chicago, Westmont, Illinois (United States); Doseretz, Daniel E.; Katin, Michael J.; Ross, Rudolf H.; Salenius, Sharon A. [21st Century Oncology, Inc, Fort Myers, Florida (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2016-11-15

    Purpose: The addition of androgen deprivation therapy (ADT) to radiation therapy (RT) is the standard of care for men with intermediate- and high-risk prostate cancer (PC). However, whether competing mortality (CM) affects the ability of ADT to improve, survival remains unanswered. Methods and Materials: We calculated a CM risk score using a Fine-Gray semiparametric model that included age and cardiometabolic comorbidities from a cohort of 17,669 men treated with high-dose RT with or without supplemental ADT for nonmetastatic PC. Fine and Gray competing risk regression analysis was used to assess whether ADT reduced the risk of PC-specific mortality for men with a low versus a high risk of CM among the 4550 patients within the intermediate- and high-risk cohort after adjustment for established PC prognostic factors, year of treatment, site, and ADT propensity score. Results: After a median follow-up of 8.4 years, 1065 men had died, 89 (8.36%) of PC. Among the men with a low CM score, ADT use was associated with a significant reduction in the risk of PC-specific mortality (adjusted hazard ratio 0.35, 95% confidence interval 0.14-0.87, P=.02) but was not for men with high CM (adjusted hazard ratio 1.33, 95% confidence interval 0.77-2.30, P=.30). Conclusions: Adding ADT to high-dose RT appears to be associated with decreased PC-specific mortality risk in men with a low but not a high CM score. These data should serve to heighten awareness about the importance of considering competing risks when determining whether to add ADT to RT for older men with intermediate- or high-risk PC.

  5. Androgen Deprivation Therapy Use in the Setting of High-dose Radiation Therapy and the Risk of Prostate Cancer–Specific Mortality Stratified by the Extent of Competing Mortality

    International Nuclear Information System (INIS)

    Rose, Brent S.; Chen, Ming-Hui; Wu, Jing; Braccioforte, Michelle H.; Moran, Brian J.; Doseretz, Daniel E.; Katin, Michael J.; Ross, Rudolf H.; Salenius, Sharon A.; D'Amico, Anthony V.

    2016-01-01

    Purpose: The addition of androgen deprivation therapy (ADT) to radiation therapy (RT) is the standard of care for men with intermediate- and high-risk prostate cancer (PC). However, whether competing mortality (CM) affects the ability of ADT to improve, survival remains unanswered. Methods and Materials: We calculated a CM risk score using a Fine-Gray semiparametric model that included age and cardiometabolic comorbidities from a cohort of 17,669 men treated with high-dose RT with or without supplemental ADT for nonmetastatic PC. Fine and Gray competing risk regression analysis was used to assess whether ADT reduced the risk of PC-specific mortality for men with a low versus a high risk of CM among the 4550 patients within the intermediate- and high-risk cohort after adjustment for established PC prognostic factors, year of treatment, site, and ADT propensity score. Results: After a median follow-up of 8.4 years, 1065 men had died, 89 (8.36%) of PC. Among the men with a low CM score, ADT use was associated with a significant reduction in the risk of PC-specific mortality (adjusted hazard ratio 0.35, 95% confidence interval 0.14-0.87, P=.02) but was not for men with high CM (adjusted hazard ratio 1.33, 95% confidence interval 0.77-2.30, P=.30). Conclusions: Adding ADT to high-dose RT appears to be associated with decreased PC-specific mortality risk in men with a low but not a high CM score. These data should serve to heighten awareness about the importance of considering competing risks when determining whether to add ADT to RT for older men with intermediate- or high-risk PC.

  6. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    International Nuclear Information System (INIS)

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan

    2012-01-01

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED adj ). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED adj between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED adj that differed by up to 44% from effective dose estimates that were not

  7. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    Energy Technology Data Exchange (ETDEWEB)

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan [Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States) and Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Department of Physics, Duke University, Durham, North Carolina 27710 (United States); and Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States)

    2012-11-15

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED{sub adj}). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED{sub adj} between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED{sub adj} that differed by up to 44% from effective dose

  8. Patient-specific dose estimation for pediatric chest CT

    Energy Technology Data Exchange (ETDEWEB)

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P. [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Physics, Duke University, Durham, North Carolina 27710 (United States); and Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Global Applied Science Laboratory, GE Healthcare, Waukesha, Wisconsin 53188 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham North Carolina 27710 (United States)

    2008-12-15

    dose for any other patient in the same size/protocol group who undergoes the chest scan. In summary, this work reported the first assessment of dose variations across pediatric CT patients in the same size/protocol group due to the variability of patient anatomy and body habitus and provided a previously unavailable method for patient-specific organ dose estimation, which will help in assessing patient risk and optimizing dose reduction strategies, including the development of scan protocols.

  9. Retrospective Evaluation Reveals That Long-term Androgen Deprivation Therapy Improves Cause-Specific and Overall Survival in the Setting of Dose-Escalated Radiation for High-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Feng, Felix Y.; Blas, Kevin; Olson, Karin; Stenmark, Matthew; Sandler, Howard; Hamstra, Daniel A.

    2013-01-01

    Purpose: To evaluate the role of androgen deprivation therapy (ADT) and duration for high-risk prostate cancer patients treated with dose-escalated radiation therapy (RT). Methods and Materials: A retrospective analysis of high-risk prostate cancer patients treated with dose-escalated RT (minimum 75 Gy) with or without ADT was performed. The relationship between ADT use and duration with biochemical failure (BF), metastatic failure (MF), prostate cancer-specific mortality (PCSM), non-prostate cancer death (NPCD), and overall survival (OS) was assessed as a function of pretreatment characteristics, comorbid medical illness, and treatment using Fine and Gray's cumulative incidence methodology. Results: The median follow-up time was 64 months. In men with National Comprehensive Cancer Network defined high-risk prostate cancer treated with dose-escalated RT, on univariate analysis, both metastasis (P<.0001; hazard ratio 0.34; 95% confidence interval 0.18-0.67; cumulative incidence at 60 months 13% vs 35%) and PCSM (P=.015; hazard ratio 0.41; 95% confidence interval 0.2-1.0; cumulative incidence at 60 months 6% vs 11%) were improved with the use of ADT. On multivariate analysis for all high-risk patients, Gleason score was the strongest negative prognostic factor, and long-term ADT (LTAD) improved MF (P=.002), PCSM (P=.034), and OS (P=.001). In men with prostate cancer and Gleason scores 8 to 10, on multivariate analysis after adjustment for other risk features, there was a duration-dependent improvement in BF, metastasis, PCSM, and OS, all favoring LTAD in comparison with STAD or RT alone. Conclusion: For men with high-risk prostate cancer treated with dose-escalated EBRT, this retrospective study suggests that the combination of LTAD and RT provided a significant improvement in clinical outcome, which was especially true for those with Gleason scores of 8 to 10

  10. Concentration - dose - risk computer code

    International Nuclear Information System (INIS)

    Frujinoiu, C.; Preda, M.

    1997-01-01

    Generally, the society is less willing in promoting remedial actions in case of low level chronic exposure situations. Radon in dwellings and workplaces is a case connected to chronic exposure. Apart from radon, the solely source on which the international community agreed for setting action levels, there are other numerous sources technically modified by man that can generate chronic exposure. Even if the nuclear installations are the most relevant, we are surrounded by 'man-made radioactivity' such as: mining industry, coal-fired power plants and fertilizer industry. The operating of an installation even within 'normal limits' could generate chronic exposure due to accumulation of the pollutants after a definite time. This asymptotic proclivity to a constant level define a steady-state concentration that represents a characteristic of the source's presence in the environment. The paper presents a methodology and a code package that derives sequentially the steady-state concentration, doses, detriments, as well as the costs of the effects of installation operation in a given environment. (authors)

  11. Dose and volume specification for reporting interstitial therapy

    International Nuclear Information System (INIS)

    1997-01-01

    The ICRU has previously published reports dealing with Dose Specification for Reporting External Beam Therapy with Photons and Electrons (ICRU Report 29, ICRU, 1978), Dose Specification for Reporting External Beam Therapy (ICRU Report 50, ICRU, 1993) and Dose and Volume Specification for Reporting Intracavitary Therapy in Gynecology (ICRU Report 38, ICRU, 1985). The present report addresses the problem of absorbed dose specification for report interstitial therapy. Although specific to interstitial therapy, many of the concepts developed in this report are also applicable to certain other kinds of brachytherapy applications. In particular, special cases of intraluminal brachytherapy and plesio-brachytherapy via surface molds employing x or gamma emitters are addressed in this report

  12. Recommended environmental dose calculation methods and Hanford-specific parameters

    International Nuclear Information System (INIS)

    Schreckhise, R.G.; Rhoads, K.; Napier, B.A.; Ramsdell, J.V.; Davis, J.S.

    1993-03-01

    This document was developed to support the Hanford Environmental Dose overview Panel (HEDOP). The Panel is responsible for reviewing all assessments of potential doses received by humans and other biota resulting from the actual or possible environmental releases of radioactive and other hazardous materials from facilities and/or operations belonging to the US Department of Energy on the Hanford Site in south-central Washington. This document serves as a guide to be used for developing estimates of potential radiation doses, or other measures of risk or health impacts, to people and other biota in the environs on and around the Hanford Site. It provides information to develop technically sound estimates of exposure (i.e., potential or actual) to humans or other biotic receptors that could result from the environmental transport of potentially harmful materials that have been, or could be, released from Hanford operations or facilities. Parameter values and information that are specific to the Hanford environs as well as other supporting material are included in this document

  13. Recommended environmental dose calculation methods and Hanford-specific parameters

    Energy Technology Data Exchange (ETDEWEB)

    Schreckhise, R.G.; Rhoads, K.; Napier, B.A.; Ramsdell, J.V. (Pacific Northwest Lab., Richland, WA (United States)); Davis, J.S. (Westinghouse Hanford Co., Richland, WA (United States))

    1993-03-01

    This document was developed to support the Hanford Environmental Dose overview Panel (HEDOP). The Panel is responsible for reviewing all assessments of potential doses received by humans and other biota resulting from the actual or possible environmental releases of radioactive and other hazardous materials from facilities and/or operations belonging to the US Department of Energy on the Hanford Site in south-central Washington. This document serves as a guide to be used for developing estimates of potential radiation doses, or other measures of risk or health impacts, to people and other biota in the environs on and around the Hanford Site. It provides information to develop technically sound estimates of exposure (i.e., potential or actual) to humans or other biotic receptors that could result from the environmental transport of potentially harmful materials that have been, or could be, released from Hanford operations or facilities. Parameter values and information that are specific to the Hanford environs as well as other supporting material are included in this document.

  14. Patient dose and risk in mammography

    International Nuclear Information System (INIS)

    Law, J.

    1991-01-01

    Patient dose in mammography is estimated by two methods compared and giving agreement. A mean tissue dose of about 1 mGy per film is found for a breast of 4.5 cm compressed thickness. Variables affecting dose are then considered quantitatively, including compressed breast thickness, tube potential, grids, magnification and beam collimation. The variables having the greatest effect are breast thickness and magnification. The dose estimates are combined with existing data on breast cancer induction to predict the risk of carcinogenesis in a breast screening programme. For example, in a screening centre performing 15 000 examinations per year, only one induced cancer is predicted in about 7 years of screening under average UK conditions of age and breast thickness. (author)

  15. A real time dose monitoring and dose reconstruction tool for patient specific VMAT QA and delivery

    International Nuclear Information System (INIS)

    Tyagi, Neelam; Yang Kai; Gersten, David; Yan Di

    2012-01-01

    Purpose: To develop a real time dose monitoring and dose reconstruction tool to identify and quantify sources of errors during patient specific volumetric modulated arc therapy (VMAT) delivery and quality assurance. Methods: The authors develop a VMAT delivery monitor tool called linac data monitor that connects to the linac in clinical mode and records, displays, and compares real time machine parameters with the planned parameters. A new measure, called integral error, keeps a running total of leaf overshoot and undershoot errors in each leaf pair, multiplied by leaf width, and the amount of time during which the error exists in monitor unit delivery. Another tool reconstructs Pinnacle 3 ™ format delivered plan based on the saved machine logfile and recalculates actual delivered dose in patient anatomy. Delivery characteristics of various standard fractionation and stereotactic body radiation therapy (SBRT) VMAT plans delivered on Elekta Axesse and Synergy linacs were quantified. Results: The MLC and gantry errors for all the treatment sites were 0.00 ± 0.59 mm and 0.05 ± 0.31°, indicating a good MLC gain calibration. Standard fractionation plans had a larger gantry error than SBRT plans due to frequent dose rate changes. On average, the MLC errors were negligible but larger errors of up to 6 mm and 2.5° were seen when dose rate varied frequently. Large gantry errors occurred during the acceleration and deceleration process, and correlated well with MLC errors (r= 0.858, p= 0.0004). PTV mean, minimum, and maximum dose discrepancies were 0.87 ± 0.21%, 0.99 ± 0.59%, and 1.18 ± 0.52%, respectively. The organs at risk (OAR) doses were within 2.5%, except some OARs that showed up to 5.6% discrepancy in maximum dose. Real time displayed normalized total positive integral error (normalized to the total monitor units) correlated linearly with MLC (r= 0.9279, p < 0.001) and gantry errors (r= 0.742, p= 0.005). There is a strong correlation between total integral

  16. On possible risks of low-dose irradiation

    International Nuclear Information System (INIS)

    Hug, O.; Gesellschaft fuer Strahlen- und Umweltforschung m.b.H., Neuherberg/Muenchen

    1974-01-01

    The survey on more recent experimental and epidemiological data and newer concepts for a realistic estimation of the radiation risk leads to the conclusion that for radiation late damages and possibly also for genetic damages with a chronical radiation exposure in the order of magnitude of the natural radiation exposure and probably also in the order of magnitude of the maximum permissible radiation dose, the risk is very probably lower than is to be expected based on the findings after relatively high doses and dose rates. A few less direct comparative studies have detected a time factor of 3 to 5. Considering the analysis of the RBW demely ionizing radiation which at high doses is not greater than 3, increases with decreasing dose and according to biophysical considerations, can possibly reach a value of 30, an effectiveness reduced by a factor of 10 of small doses and dose rates of loosely ionizing radiation would be even to be expected. All radiobiological knowledge on the effect of ionizing radiation allows one to expect that even smallest radiation doses can cause cellular damages due to the linear irreversable components of the radiation effect and probably that these damages can even be the starting point of a malignant tumour. Regarding this cancer-initiating effect however, the effectiveness of loosely ionizing radiation per rad in the region of natural radiation exposure lie considerably below that existing at high doses and dose rates. Whether however this initial carcinogenic effect of very small doses is at all noticeable during the average life duration in an increase of the spontaneous age-specific tumour rate is questionable if the assumption is confirmed that with decreasing dose, the time manifestation of the radiation induced tumours is delayed. (orig./LH) [de

  17. Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer.

    Science.gov (United States)

    Ecke, Thorsten H; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

    2016-11-10

    High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D'Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis ( p = 0.009), PSA on date of first HDR-BT ( p = 0.033), and PSA on date of first follow-up after one year ( p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  18. Low-Dose Risk, Decisions, and Risk Communication

    International Nuclear Information System (INIS)

    Flynn, James; Slovic, Paul

    2001-01-01

    To conduct basic research on how people receive, evaluate, and form positions on scientific information and its relationship to low-dose radiation exposure. There are three major areas of study in our research program. First is the development of theories, frameworks and concepts essential to guiding data collection and analysis. The second area is a program of experimental studies on risk perception, evaluation of science information, and the structure of individual positions regarding low dose exposures. This involves the study of existing knowledge and the evaluation of science information presented within a variety of formats, as educational information, news media stories, and alternative communication methods (personal contact, small group interaction, email and internet, etc.). Third is the community-level studies to examine and record how the social conditions, under which science communications take place, influence the development of attitudes and opinions about: low- dose exposures, the available management options, control of radiation risks, and preferences for program and policy goals

  19. Specification of absorbed dose for reporting a therapeutic irradiation

    International Nuclear Information System (INIS)

    Wambersie, A.; Chassagne, D.

    1981-01-01

    The problem of dose specification in external beam therapy with photons and electrons has been dealt with in ICRU Report 29 (1978). This problem arises from the fact that the absorbed dose distribution is usually not uniform in the target volume and that for the purpose of treatment reporting a nominal absorbed dose - which will be called target absorbed dose - has to be selected. When comparing the clinical results obtained between radiotherapy centres, the differences in the reported target absorbed doses which can be introduced by differences in the methods of dose specification often are much larger than the differences related to the dosimetric procedures themselves. This shows the importance of the problem. In this paper, some definitions of terms and concepts currently used in radiotherapy are first recalled: tumour volume, target volume, treatment volume, etc. These definitions have been proposed in ICRU Report 29 for photon and electron beams; they can be extended to any kind of irradiation. For external beam therapy with photons and electrons, the target absorbed dose is defined as the absorbed dose at selected point(s) (specification point(s)) having a meaningful relation to the target volume and/or the irradiation beams. Examples are discussed for typical cases. As far as interstitial and intracavitary therapy is concerned, the problem is more complex and no recommendations have so far been made by the ICRU Commission. A major difficulty arises from the sharp dose gradient as a function of the distance to the sources. The particular case of the treatment of cervix carcinoma is considered and some possible methods of specification are discussed: (1) the indication of the sources (in adequate units) and the duration of the application, (2) the absorbed doses at selected reference points (bladder, rectum, bony structures) and (3) the description of the tissue volume (height, width, thickness) encompassed by a given isodose surface (60Gy). (author)

  20. Risks and radiation doses due to residential radon in Germany

    International Nuclear Information System (INIS)

    Beck, T.R.

    2017-01-01

    The population-averaged risk rate and the annual average effective dose due to residential radon in Germany were calculated. The calculations were based on an epidemiological approach taking into account the age- and gender-specific lung cancer incidence rates for the German population and the excess relative risk of 0.16 per 100 Bq.m"-"3 for residential radon. In addition, the risk estimates adjusted for the smoking habits were determined. The population-averaged risk rate for the whole population was estimated with 4.1.10"-"5 y"-"1 (95% confidence interval (CI) 1.4.10"-"5 - 7.6.10"-"5 y"-"1). Residential radon causes a detriment per year of 3.3.10"-"5 y"-"1 (95% CI 1.1.10"-"5 - 6.0.10"-"5 y"-"1), which corresponds to an annual average effective dose of 0.6 mSv (95% CI 0.2-1.1 mSv). Annually, ∼3400 lung cancer incidences are attributed to residential radon. The results from the epidemiological approach exercised in this study are considerably lower than the effective dose, which would be obtained from the dose conversion coefficient calculated using biokinetic and dosimetric models. (author)

  1. Conventional patient specific IMRT QA and 3DVH verification of dose distribution for helical tomotherapy

    International Nuclear Information System (INIS)

    Sharma, Prabhat Krishna; Joshi, Kishore; Epili, D.; Gavake, Umesh; Paul, Siji; Reena, Ph.; Jamema, S.V.

    2016-01-01

    In recent years, patient-specific IMRT QA has transitioned from point dose measurements by ion chambers to films to 2D array measurements. 3DVH software has taken this transition a step further by estimating the 3D dose delivered to the patient volume from 2D diode measurements using a planned dose perturbation (PDP) algorithm. This algorithm was developed to determine, if the conventional IMRT QA though sensitive at detecting errors, has any predictive power in detecting dose errors of clinical significance related to dose to the target volume and organs at risk (OAR). The aim of this study is to compare the conventional IMRT patient specific QA and 3DVH dose distribution for patients treated with helical tomotherapy (HT)

  2. Evaluation of organ-specific peripheral doses after 2-dimensional, 3-dimensional and hybrid intensity modulated radiation therapy for breast cancer based on Monte Carlo and convolution/superposition algorithms: Implications for secondary cancer risk assessment

    International Nuclear Information System (INIS)

    Joosten, Andreas; Matzinger, Oscar; Jeanneret-Sozzi, Wendy; Bochud, François; Moeckli, Raphaël

    2013-01-01

    Background and purpose: To make a comprehensive evaluation of organ-specific out-of-field doses using Monte Carlo (MC) simulations for different breast cancer irradiation techniques and to compare results with a commercial treatment planning system (TPS). Materials and methods: Three breast radiotherapy techniques using 6MV tangential photon beams were compared: (a) 2DRT (open rectangular fields), (b) 3DCRT (conformal wedged fields), and (c) hybrid IMRT (open conformal + modulated fields). Over 35 organs were contoured in a whole-body CT scan and organ-specific dose distributions were determined with MC and the TPS. Results: Large differences in out-of-field doses were observed between MC and TPS calculations, even for organs close to the target volume such as the heart, the lungs and the contralateral breast (up to 70% difference). MC simulations showed that a large fraction of the out-of-field dose comes from the out-of-field head scatter fluence (>40%) which is not adequately modeled by the TPS. Based on MC simulations, the 3DCRT technique using external wedges yielded significantly higher doses (up to a factor 4–5 in the pelvis) than the 2DRT and the hybrid IMRT techniques which yielded similar out-of-field doses. Conclusions: In sharp contrast to popular belief, the IMRT technique investigated here does not increase the out-of-field dose compared to conventional techniques and may offer the most optimal plan. The 3DCRT technique with external wedges yields the largest out-of-field doses. For accurate out-of-field dose assessment, a commercial TPS should not be used, even for organs near the target volume (contralateral breast, lungs, heart)

  3. Volume dose of organs at risk in the irradiated volume

    International Nuclear Information System (INIS)

    Hishikawa, Yoshio; Tanaka, Shinichi; Miura, Takashi

    1984-01-01

    Absorbed dose of organs at risk in the 50% irradiated volume needs to be carefully monitored because there is high risk of radiation injury. This paper reports on the histogram of threedimensional volume dose of organs at risk, which is obtained by computer calculation of CT scans. In order to obtain this histogram, CT is first performed in the irradiation field. The dose in each pixel is then examined by the computer as to each slice. After the pixels of all slices in the organ at risk of the irradiated field are classified according to the doses, the number of pixels in the same dose class is counted. The result is expressed in a histogram. The histogram can show the differences of influence to organs at risk given by various radiation treatment techniques. Total volume dose of organs at risk after radiotherapy can also be obtained by integration of each dose of different treatment techniques. (author)

  4. Risk of cancer subsequent to low-dose radiation

    International Nuclear Information System (INIS)

    Warren, S.

    1980-01-01

    The author puts low dose irradiation risks in perspective using average background radiation doses for standards. He assailed irresponsible media coverage during the height of public interest in the Three-Mile Island Reactor incident

  5. Evaluation of effective dose and excess lifetime cancer risk from ...

    African Journals Online (AJOL)

    Evaluation of effective dose and excess lifetime cancer risk from indoor and outdoor gamma dose rate of university of Port Harcourt Teaching Hospital, Rivers State. ... Therefore, the management of University of Port Harcourt teaching hospital ...

  6. Ecosystem specific dose conversion factors for Aberg, Beberg and Ceberg

    International Nuclear Information System (INIS)

    Nordlinder, S.; Bergstroem, U.; Mathiasson, Lena

    1999-12-01

    The aim of this study was to calculate ecosystem specific dose conversion factors (EDFs) for three hypothetical sites, Aberg, Beberg and Ceberg, used in the safety analysis SR 97. The EDFs can, in combination with calculated releases of radionuclides from the geosphere, be used to illustrate relative differences in doses to the most exposed individual due to accidental leakage of radionuclides from a deep repository for spent nuclear fuel. Maps of the three sites were studied and subdivided into areas, which were characterised according to an earlier developed module system. For each of the identified modules, ecosystem transport and exposure model calculations were performed for release of 1 Bq per year during 10 000 years. 44 radionuclides contained within a deep repository for spent nuclear fuel were considered. A preliminary comparison of the EDFs for the three sites showed that the highest relative doses can be expected in Ceberg due to the high frequency of peat bog modules

  7. Computational assessment of effective dose and patient specific doses for kilovoltage stereotactic radiosurgery of wet age-related macular degeneration

    Science.gov (United States)

    Hanlon, Justin Mitchell

    Age-related macular degeneration (AMD) is a leading cause of vision loss and a major health problem for people over the age of 50 in industrialized nations. The current standard of care, ranibizumab, is used to help slow and in some cases stabilize the process of AMD, but requires frequent invasive injections into the eye. Interest continues for stereotactic radiosurgery (SRS), an option that provides a non-invasive treatment for the wet form of AMD, through the development of the IRay(TM) (Oraya Therapeutics, Inc., Newark, CA). The goal of this modality is to destroy choroidal neovascularization beneath the pigment epithelium via delivery of three 100 kVp photon beams entering through the sclera and overlapping on the macula delivering up to 24 Gy of therapeutic dose over a span of approximately 5 minutes. The divergent x-ray beams targeting the fovea are robotically positioned and the eye is gently immobilized by a suction-enabled contact lens. Device development requires assessment of patient effective dose, reference patient mean absorbed doses to radiosensitive tissues, and patient specific doses to the lens and optic nerve. A series of head phantoms, including both reference and patient specific, was derived from CT data and employed in conjunction with the MCNPX 2.5.0 radiation transport code to simulate treatment and evaluate absorbed doses to potential tissues-at-risk. The reference phantoms were used to evaluate effective dose and mean absorbed doses to several radiosensitive tissues. The optic nerve was modeled with changeable positions based on individual patient variability seen in a review of head CT scans gathered. Patient specific phantoms were used to determine the effect of varying anatomy and gaze. The results showed that absorbed doses to the non-targeted tissues were below the threshold levels for serious complications; specifically the development of radiogenic cataracts and radiation induced optic neuropathy (RON). The effective dose

  8. Consideration of the usefulness of a size-specific dose estimate in pediatric CT examination.

    Science.gov (United States)

    Tsujiguchi, Takakiyo; Obara, Hideki; Ono, Shuichi; Saito, Yoko; Kashiwakura, Ikuo

    2018-04-05

    Computed tomography (CT) has recently been utilized in various medical settings, and technological advances have resulted in its widespread use. However, medical radiation exposure associated with CT scans accounts for the largest share of examinations using radiation; thus, it is important to understand the organ dose and effective dose in detail. The CT dose index and dose-length product are used to evaluate the organ dose. However, evaluations using these indicators fail to consider the age and body type of patients. In this study, we evaluated the effective dose based on the CT examination data of 753 patients examined at our hospital using the size-specific dose estimate (SSDE) method, which can calculate the exposure dose with consideration of the physique of a patient. The results showed a large correlation between the SSDE conversion factor and physique, with a larger exposure dose in patients with a small physique when a single scan is considered. Especially for children, the SSDE conversion factor was found to be 2 or more. In addition, the patient exposed to the largest dose in this study was a 10-year-old, who received 40.4 mSv (five series/examination). In the future, for estimating exposure using the SSDE method and in cohort studies, the diagnostic reference level of SSDE should be determined and a low-exposure imaging protocol should be developed to predict the risk of CT exposure and to maintain the quality of diagnosis with better radiation protection of patients.

  9. On the use of age-specific effective dose coefficients in radiation protection of the public

    International Nuclear Information System (INIS)

    Kocher, D.C.; Eckerman, K.F.

    1998-01-01

    Current radiation protection standards for the public include a limit on effective dose in any year for individuals in critical groups. This paper considers the question of how the annual dose limit should be applied in controlling routine exposures of populations consisting of individuals of all ages. We assume that the fundamental objective of radiation protection is limitation of lifetime risk and, therefore, that standards for controlling routine exposures of the public should provide a reasonable correspondence with lifetime risk, taking into account the age dependence of intakes and doses and the variety of radionuclides and exposure pathways of concern. Using new calculations of the per capita (population-averaged) risk of cancer mortality per unit activity inhaled or ingested in the U.S. Environmental Protection Agency's Federal Guidance Report No. 13, we show that applying a limit on annual effective dose only to adults, which was the usual practice in radiation protection of the public before the development of age-specific effective dose coefficients, provides a considerably better correspondence with lifetime risk that applying the annual dose limit to the critical group of any age. (author)

  10. On the use of age-specific effective dose coefficients in radiation protection of the public

    International Nuclear Information System (INIS)

    Kocher, D.C.; Eckerman, K.F.

    1998-01-01

    Current radiation protection standards for the public include a limit on effective dose in any year for individuals in critical groups. This paper considers the question of how the annual dose limit should be applied in controlling routine exposures of populations consisting of individuals of all ages. The authors assume that the fundamental objective of radiation protection is limitation of lifetime risk and, therefore, that standards for controlling routine exposures of the public should provide a reasonable correspondence with lifetime risk, taking into account the age dependence of intakes and doses and the variety of radionuclides and exposure pathways of concern. Using new calculations of the per capita (population-averaged) risk of cancer mortality per unit activity inhaled or ingested in the US Environmental Protection Agency's Federal Guidance Report No. 13, the authors show that applying a limit on annual effective dose only to adults, which was the usual practice in radiation protection of the public before the development of age-specific effective dose coefficients, provides a considerably better correspondence with lifetime risk than applying the annual dose limit to the critical group of any age

  11. Excipient Usage Technical Risk Assessment for Generic Solid Dose Products

    Directory of Open Access Journals (Sweden)

    Ajay Babu Pazhayattil

    2017-09-01

    Full Text Available This paper proposes an assessment methodology for solid dose generic small molecule drug products. It addresses the ‘usage of the excipient’ portion of the trinomial by utilizing the systematic approach of Risk Identification, Risk Analysis and Risk Evaluation as per ICH Q9 Quality Risk Management outlined for developing risk control strategies. The assessment and maintenance of excipient risk profile is essential to minimize any potential risk associated to excipients impacting patients.

  12. Radiation dose and cancer risk to children undergoing skull radiography

    International Nuclear Information System (INIS)

    Mazonakis, Michael; Damilakis, John; Raissaki, Maria; Gourtsoyiannis, Nicholas

    2004-01-01

    Background: Limited data exist in the literature concerning the patient-effective dose from paediatric skull radiography. No information has been provided regarding organ doses, patient dose during PA skull projection, risk of cancer induction and dose to comforters, i.e. individuals supporting children during exposure. Objective: To estimate patient-effective dose, organ doses, lifetime cancer mortality risk to children and radiation dose to comforters associated with skull radiography. Materials and methods: Data were collected from 136 paediatric examinations, including AP, PA and lateral skull radiographs. Entrance-surface dose (ESD) and dose to comforters were measured using thermoluminescent dosimeters. Patients were divided into the following age groups: 0.5-2, 3-7, 8-12 and 13-18 years. The patient-effective dose and corresponding organ doses were calculated using data from the NRPB and Monte Carlo techniques. The risk for fatal cancer induction was assessed using appropriate risk coefficients. Results: For AP, PA and lateral skull radiography, effective dose ranges were 8.8-25.4, 8.2-27.3 and 8.4-22.7 μSv respectively, depending upon the age of the child. For each skull projection, the organs receiving doses above 10 μGy are presented. The number of fatal cancers was found to be less than or equal to 2 per 1 million children undergoing a skull radiograph. The mean radiation dose absorbed by the hands of comforters was 13.4 μGy. Conclusions: The current study provides detailed tabular and graphical data on ESD, effective dose, organ doses and lifetime cancer mortality risk to children associated with AP, PA and lateral skull projections at all patient ages. (orig.)

  13. Prototype Operational Advances for Atmospheric Radiation Dose Rate Specification

    Science.gov (United States)

    Tobiska, W. K.; Bouwer, D.; Bailey, J. J.; Didkovsky, L. V.; Judge, K.; Garrett, H. B.; Atwell, W.; Gersey, B.; Wilkins, R.; Rice, D.; Schunk, R. W.; Bell, D.; Mertens, C. J.; Xu, X.; Crowley, G.; Reynolds, A.; Azeem, I.; Wiltberger, M. J.; Wiley, S.; Bacon, S.; Teets, E.; Sim, A.; Dominik, L.

    2014-12-01

    effective dose rate measurements and a thermal neutron monitor to characterize Single Event Effects (SEEs) in avionics. In this presentation we describe recent ARMAS and USEWX advances that will ultimately provide operational users with real-time dose and dose rate data for human tissue and avionics exposure risk mitigation.

  14. Relationship between dose and risk, and assessment of carcinogenic risks associated with low doses of ionizing radiation

    International Nuclear Information System (INIS)

    Tubiana, M.; Aurengo, A.

    2005-01-01

    This report raises doubts on the validity of using LNT (linear no-threshold) relationship for evaluating the carcinogenic risk of low doses (< 100 mSv) and even more for very low doses (< 10 mSv). The LNT concept can be a useful pragmatic tool for assessing rules in radioprotection for doses above 10 mSv; however since it is not based on biological concepts of our current knowledge, it should not be used without precaution for assessing by extrapolation the risks associated with low and even more so, with very low doses (< 10 mSv), especially for benefit-risk assessments imposed on radiologists by the European directive 97-43. The biological mechanisms are different for doses lower than a few dozen mSv and for higher doses. The eventual risks in the dose range of radiological examinations (0.1 to 5 mSv, up to 20 mSv for some examinations) must be estimated taking into account radiobiological and experimental data. An empirical relationship which has been just validated for doses higher than 200 mSv may lead to an overestimation of risks (associated with doses one hundred fold lower), and this overestimation could discourage patients from undergoing useful examinations and introduce a bias in radioprotection measures against very low doses (< 10 mSv). Decision makers confronted with problems of radioactive waste or risk of contamination, should re-examine the methodology used for the evaluation of risks associated with very low doses and with doses delivered at a very low dose rate. This report confirms the inappropriateness of the collective dose concept to evaluate population irradiation risks

  15. Estimation of radiation risks at low dose

    International Nuclear Information System (INIS)

    1990-04-01

    The report presents a review of the effects caused by radiation in low doses, or at low dose rates. For the inheritable (or ''genetic''), as well as for the cancer producing effects of radiation, present evidence is consistent with: (a) a non-linear relationship between the frequency of at least some forms of these effects, with comparing frequencies caused by doses many times those received annually from natural sources, with those caused by lower doses; (b) a probably linear relationship, however, between dose and frequency of effects for dose rates in the region of that received from natural sources, or at several times this rate; (c) no evidence to indicate the existence of a threshold dose below which such effects are not produced, and a strong inference from the mode of action of radiation on cells at low dose rates that no such thresholds are likely to apply to the detrimental, cancer-producing or inheritable, effects resulting from unrepaired damage to single cells. 19 refs

  16. Risk management through dynamic technical specifications

    International Nuclear Information System (INIS)

    Klopp, George T.; Petersen, Thomas A.

    2004-01-01

    The wide deployment of plant specific probabilistic risk assessments for nuclear power plants has provided the means to effect a fresh risk management perspective and a fresh, risk based, regulatory outlook on nuclear power. There has been a great deal of conversation on risk based regulation within the U. S. nuclear power industry but, curiously, very little on effective risk management. This paper proposes a means to link the two subjects through the plant Technical Specifications. A revised concept for Technical Specifications is suggested which is based on deterministic analyses and probabilistic risk assessments for each plant. The revised Technical Specifications would consider, on a real-time basis, the exact state of the plant in terms of the status of key components and systems. It would depict current plant risk levels and compare those levels to the desired and limiting (alert/action) levels. It would advise the plant operator on the risk impact of proposed actions through a simple query system and illustrate the impact of such actions on plant status relative to designated risk values. The basis for the proposed approach lies in realistic deterministic plant analyses and probabilistic risk assessment (PRA) deployment tools being developed, in parallel, by a number of parties in the U.S. today. These PRAs are based primarily on the existing plant responses to Generic Letter 88-20, 'Individual Plant Examinations' (IPEs). Each of these tools allows the plant operator to input, on a real-time basis, the status of key equipment and systems. The tools then provide explicit illustrations of dependency effects; updated, 'real-time' risk status indications such as core damage frequency; and, in some cases, allow the operator to assess the risk impact of removing from service selected components for maintenance or testing. These systems generally operate on personal computers and provide nearly instantaneous responses to plant queries. Moving from these tools to

  17. Nonparametric estimation of benchmark doses in environmental risk assessment

    Science.gov (United States)

    Piegorsch, Walter W.; Xiong, Hui; Bhattacharya, Rabi N.; Lin, Lizhen

    2013-01-01

    Summary An important statistical objective in environmental risk analysis is estimation of minimum exposure levels, called benchmark doses (BMDs), that induce a pre-specified benchmark response in a dose-response experiment. In such settings, representations of the risk are traditionally based on a parametric dose-response model. It is a well-known concern, however, that if the chosen parametric form is misspecified, inaccurate and possibly unsafe low-dose inferences can result. We apply a nonparametric approach for calculating benchmark doses, based on an isotonic regression method for dose-response estimation with quantal-response data (Bhattacharya and Kong, 2007). We determine the large-sample properties of the estimator, develop bootstrap-based confidence limits on the BMDs, and explore the confidence limits’ small-sample properties via a short simulation study. An example from cancer risk assessment illustrates the calculations. PMID:23914133

  18. Effective dose and cancer risk in PET/CT exams

    International Nuclear Information System (INIS)

    Pinto, Gabriella M.; Sa, Lidia Vasconcellos de

    2013-01-01

    Due to the use of radiopharmaceutical positron-emitting in PET exam and realization of tomography by x-ray transmission in CT examination, an increase of dose with hybrid PET/CT technology is expected. However, differences of doses have been reported in many countries for the same type of procedure. It is expected that the dose is an influent parameter to standardize the protocols of PET/CT. This study aimed to estimate the effective doses and absorbed in 65 patients submitted to oncological Protocol in a nuclear medicine clinic in Rio de Janeiro, considering the risk of induction of cancer from the scan. The CT exam-related doses were estimated with a simulator of PMMA and simulated on the lmPACT resistance, which for program effective dose, were considered the weight factors of the lCRP 103. The PET exam doses were estimated by multiplying the activity administered to the patient with the ICRP dose 80 factors. The radiological risk for cancer incidence were estimated according to the ICRP 103. The results showed that the effective dose from CT exam is responsible for 70% of the effective total in a PET/CT scan. values of effective dose for the PET/CT exam reached average values of up to 25 mSv leading to a risk of 2, 57 x 10 -4 . Considering that in staging of oncological diseases at least four tests are performed annually, the total risk comes to 1,03x 10 -3

  19. Dose dependence on stochastic radiobiological effect in radiation risk estimation

    International Nuclear Information System (INIS)

    Komochkov, M.M.

    1999-01-01

    The analysis of the results in dose -- effect relationship observation has been carried out on the cell and organism levels, with the aim to obtain more precise data on the risk coefficients at low doses. The results are represented by two contrasting groups of dose dependence on effect: a downwards concave and a J-shaped curve. Both types of dependence are described by the equation solutions of an assumed unified protective mechanism, which comprises two components: constitutive and adaptive or inducible ones. The latest data analysis of the downwards concave dependence curves shows a considerable underestimation of radiation risk in all types of cancer, except leukemia, for a number of critical groups in a population, at low doses comparing to the ICRP recommendations. With the dose increase, the decrease of the effect value per dose unit is observed. It may be possibly related to the switching of the activity of the adaptive protective mechanism, with some threshold dose values being exceeded

  20. The gamma knife: Dose and risk evaluation

    International Nuclear Information System (INIS)

    Jones, E.D.; Alesso, H.P.; Banks, W.W.; Rathbun, P.A.

    1992-01-01

    This paper outlines a risk analysis approach designed to identify and assess most likely failure modes and high-risk, human initiated actions for nuclear medical devices. This approach is being developed under the auspices of the US Nuclear Regulatory Commission, Office of Nuclear Material Safety and Safeguards. The methodology is initiated intended to assess risk associated with the use of the Leksell Gamma Unit (LGU) or gamma knife, a gamma stereotactic radiosurgical device

  1. ANDROS: A code for Assessment of Nuclide Doses and Risks with Option Selection

    International Nuclear Information System (INIS)

    Begovich, C.L.; Sjoreen, A.L.; Ohr, S.Y.; Chester, R.O.

    1986-11-01

    ANDROS (Assessment of Nuclide Doses and Risks with Option Selection) is a computer code written to compute doses and health effects from atmospheric releases of radionuclides. ANDROS has been designed as an integral part of the CRRIS (Computerized Radiological Risk Investigation System). ANDROS reads air concentrations and environmental concentrations of radionuclides to produce tables of specified doses and health effects to selected organs via selected pathways (e.g., ingestion or air immersion). The calculation may be done for an individual at a specific location or for the population of the whole assessment grid. The user may request tables of specific effects for every assessment grid location. Along with the radionuclide concentrations, the code requires radionuclide decay data, dose and risk factors, and location-specific data, all of which are available within the CRRIS. This document is a user manual for ANDROS and presents the methodology used in this code

  2. Calculating patient specific doses in X-ray diagnostics and from radiopharmaceuticals

    International Nuclear Information System (INIS)

    Lampinen, J.

    2000-01-01

    The risk associated with exposure to ionising radiation is dependent on the characteristics of the exposed individual. The size and structure of the individual influences the absorbed dose distribution in the organs. Traditional methods used to calculate the patient organ doses are based on standardised calculation phantoms, which neglect the variance of the patient size or even sex. When estimating the radiation dose of an individual patient, patient specific calculation methods must be used. Methods for patient specific dosimetry in the fields of X-ray diagnostics and diagnostic and therapeutic use of radiopharmaceuticals were proposed in this thesis. A computer program, ODS-60, for calculating organ doses from diagnostic X-ray exposures was presented. The calculation is done in a patient specific phantom with depth dose and profile algorithms fitted to Monte Carlo simulation data from a previous study. Improvements to the version reported earlier were introduced, e.g. bone attenuation was implemented. The applicability of the program to determine patient doses from complex X-ray examinations (barium enema examination) was studied. The conversion equations derived for female and male patients as a function of patient weight gave the smallest deviation from the actual patient doses when compared to previous studies. Another computer program, Intdose, was presented for calculation of the dose distribution from radiopharmaceuticals. The calculation is based on convolution of an isotope specific point dose kernel with activity distribution, obtained from single photon emission computed tomography (SPECT) images. Anatomical information is taken from magnetic resonance (MR) or computed tomography (CT) images. According to a phantom study, Intdose agreed within 3 % with measurements. For volunteers administered diagnostic radiopharmaceuticals, the results given by Intdose were found to agree with traditional methods in cases of medium sized patients. For patients

  3. Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis

    DEFF Research Database (Denmark)

    Trauelsen, Anne Marie; Bendall, Sarah; Jansen, Jens Einar

    2015-01-01

    BACKGROUND: Reviews conclude that childhood and adolescence sexual, physical, emotional abuse and emotional and physical neglect are all risk factors for psychosis. However, studies suggest only some adversities are associated with psychosis. Dose-response effects of several adversities on risk......% of the control group. Childhood and adolescent sexual, physical, emotional abuse, and physical and emotional neglect, separation and institutionalization were about four to 17 times higher for the FEP group (all p... of psychosis have not been consistently found. The current study aimed to explore adversity specificity and dose-response effects of adversities on risk of psychosis. METHOD: Participants were 101 persons with first-episode psychosis (FEP) diagnosed with ICD-10 F20 - F29 (except F21) and 101 non-clinical...

  4. Knowledge of medical imaging radiation dose and risk among doctors

    International Nuclear Information System (INIS)

    Brown, Nicholas; Jones, Lee

    2013-01-01

    The growth of computed tomography (CT) and nuclear medicine (NM) scans has revolutionised healthcare but also greatly increased population radiation doses. Overuse of diagnostic radiation is becoming a feature of medical practice, leading to possible unnecessary radiation exposures and lifetime-risks of developing cancer. Doctors across all medical specialties and experience levels were surveyed to determine their knowledge of radiation doses and potential risks associated with some diagnostic imaging. A survey relating to knowledge and understanding of medical imaging radiation was distributed to doctors at 14 major Queensland public hospitals, as well as fellows and trainees in radiology, emergency medicine and general practice. From 608 valid responses, only 17.3% correctly estimated the radiation dose from CT scans and almost 1 in 10 incorrectly believed that CT radiation is not associated with any increased lifetime risk of developing cancer. There is a strong inverse relationship between a clinician's experience and their knowledge of CT radiation dose and risks, even among radiologists. More than a third (35.7%) of doctors incorrectly believed that typical NM imaging either does not use ionising radiation or emits doses equal to or less than a standard chest radiograph. Knowledge of CT and NM radiation doses is poor across all specialties, and there is a significant inverse relationship between experience and awareness of CT dose and risk. Despite having a poor understanding of these concepts, most doctors claim to consider them prior to requesting scans and when discussing potential risks with patients.

  5. Organ-specific external dose coefficients and protective apron transmission factors for historical dose reconstruction for medical personnel.

    Science.gov (United States)

    Simon, Steven L

    2011-07-01

    While radiation absorbed dose (Gy) to the skin or other organs is sometimes estimated for patients from diagnostic radiologic examinations or therapeutic procedures, rarely is occupationally-received radiation absorbed dose to individual organs/tissues estimated for medical personnel; e.g., radiologic technologists or radiologists. Generally, for medical personnel, equivalent or effective radiation doses are estimated for compliance purposes. In the very few cases when organ doses to medical personnel are reconstructed, the data is usually for the purpose of epidemiologic studies; e.g., a study of historical doses and risks to a cohort of about 110,000 radiologic technologists presently underway at the U.S. National Cancer Institute. While ICRP and ICRU have published organ-specific external dose conversion coefficients (DCCs) (i.e., absorbed dose to organs and tissues per unit air kerma and dose equivalent per unit air kerma), those factors have been published primarily for mono-energetic photons at selected energies. This presents two related problems for historical dose reconstruction, both of which are addressed here. It is necessary to derive conversion factor values for (1) continuous distributions of energy typical of diagnostic medical x-rays (bremsstrahlung radiation), and (2) energies of particular radioisotopes used in medical procedures, neither of which are presented in published tables. For derivation of DCCs for bremsstrahlung radiation, combinations of x-ray tube potentials and filtrations were derived for different time periods based on a review of relevant literature. Three peak tube potentials (70 kV, 80 kV, and 90 kV) with four different amounts of beam filtration were determined to be applicable for historic dose reconstruction. The probabilities of these machine settings were assigned to each of the four time periods (earlier than 1949, 1949-1954, 1955-1968, and after 1968). Continuous functions were fit to each set of discrete values of the

  6. The risk of low doses of ionising radiation and the linear no threshold relationship debate

    International Nuclear Information System (INIS)

    Tubiana, M.; Masse, R.; Vathaire, F. de; Averbeck, D.; Aurengo, A.

    2007-01-01

    The ICRP and the B.E.I.R. VII reports recommend a linear no threshold (L.N.T.) relationship for the estimation of cancer excess risk induced by ionising radiations (IR), but the 2005 report of Medicine and Science French Academies concludes that it leads to overestimate of risk for low and very low doses. The bases of L.N.T. are challenged by recent biological and animal experimental studies which show that the defence against IR involves the cell microenvironment and the immunologic system. The defence mechanisms against low doses are different and comparatively more effective than for high doses. Cell death is predominant against low doses. DNA repairing is activated against high doses, in order to preserve tissue functions. These mechanisms provide for multicellular organisms an effective and low cost defence system. The differences between low and high doses defence mechanisms are obvious for alpha emitters which show several greys threshold effects. These differences result in an impairment of epidemiological studies which, for statistical power purpose, amalgamate high and low doses exposure data, since it would imply that cancer IR induction and defence mechanisms are similar in both cases. Low IR dose risk estimates should rely on specific epidemiological studies restricted to low dose exposures and taking precisely into account potential confounding factors. The preliminary synthesis of cohort studies for which low dose data (< 100 mSv) were available show no significant risk excess, neither for solid cancer nor for leukemias. (authors)

  7. Radiation Dose Risk and Diagnostic Benefit in Imaging Investigations

    OpenAIRE

    Dobrescu, Lidia; Rădulescu, Gheorghe-Cristian

    2015-01-01

    The paper presents many facets of medical imaging investigations radiological risks. The total volume of prescribed medical investigations proves a serious lack in monitoring and tracking of the cumulative radiation doses in many health services. Modern radiological investigations equipment is continuously reducing the total dose of radiation due to improved technologies, so a decrease in per caput dose can be noticed, but the increasing number of investigations has determined a net increase ...

  8. Radiation risk factors and dose limits

    International Nuclear Information System (INIS)

    Barendsen, G.W.

    1979-01-01

    The contents of the ICRP publications 9 (1965) and 26 (1977) are outlined and the research conducted during these years considered. Expressions are derived for the frequency for induction of cancer from the most common irradiations - X rays, gamma rays and electrons. The dose limits advised by the ICRP are discussed and the first two fundamental principles are presented - that no one should be subjected to radiation without useful cause and that in those cases where irradiation is thought necessary, the medical, scientific, social and economic advantages need to be carefully considered with respect to the possible disadvantages. (C.F.)

  9. Multidisciplinary European Low Dose Initiative (MELODI). Strategic research agenda for low dose radiation risk research

    Energy Technology Data Exchange (ETDEWEB)

    Kreuzer, M. [Federal Office for Radiation Protection, BfS, Department of Radiation Protection and Health, Neuherberg (Germany); Auvinen, A. [University of Tampere, Tampere (Finland); STUK, Helsinki (Finland); Cardis, E. [ISGlobal, Barcelona Institute for Global Health, Barcelona (Spain); Durante, M. [Institute for Fundamental Physics and Applications, TIFPA, Trento (Italy); Harms-Ringdahl, M. [Stockholm University, Centre for Radiation Protection Research, Stockholm (Sweden); Jourdain, J.R. [Institute for Radiological Protection and Nuclear Safety, IRSN, Fontenay-aux-roses (France); Madas, B.G. [MTA Centre for Energy Research, Environmental Physics Department, Budapest (Hungary); Ottolenghi, A. [University of Pavia, Physics Department, Pavia (Italy); Pazzaglia, S. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome (Italy); Prise, K.M. [Queens University Belfast, Belfast (United Kingdom); Quintens, R. [Belgian Nuclear Research Centre, SCK-CEN, Mol (Belgium); Sabatier, L. [French Atomic Energy Commission, CEA, Paris (France); Bouffler, S. [Public Health England, PHE, Chilton (United Kingdom)

    2018-03-15

    MELODI (Multidisciplinary European Low Dose Initiative) is a European radiation protection research platform with focus on research on health risks after exposure to low-dose ionising radiation. It was founded in 2010 and currently includes 44 members from 18 countries. A major activity of MELODI is the continuous development of a long-term European Strategic Research Agenda (SRA) on low-dose risk for radiation protection. The SRA is intended to identify priorities for national and European radiation protection research programs as a basis for the preparation of competitive calls at the European level. Among those key priorities is the improvement of health risk estimates for exposures close to the dose limits for workers and to reference levels for the population in emergency situations. Another activity of MELODI is to ensure the availability of European key infrastructures for research activities, and the long-term maintenance of competences in radiation research via an integrated European approach for training and education. The MELODI SRA identifies three key research topics in low dose or low dose-rate radiation risk research: (1) dose and dose rate dependence of cancer risk, (2) radiation-induced non-cancer effects and (3) individual radiation sensitivity. The research required to improve the evidence base for each of the three key topics relates to three research lines: (1) research to improve understanding of the mechanisms contributing to radiogenic diseases, (2) epidemiological research to improve health risk evaluation of radiation exposure and (3) research to address the effects and risks associated with internal exposures, differing radiation qualities and inhomogeneous exposures. The full SRA and associated documents can be downloaded from the MELODI website (http://www.melodi-online.eu/sra.html). (orig.)

  10. Risk equivalent of exposure versus dose of radiation

    International Nuclear Information System (INIS)

    Bond, V.P.

    1986-01-01

    This report describes a risk analysis study of low-dose irradiation and the resulting biological effects on a cell. The author describes fundamental differences between the effects of high-level exposure (HLE) and low-level exposure (LLE). He stresses that the concept of absorbed dose to an organ is not a dose but a level of effect produced by a particular number of particles. He discusses the confusion between a linear-proportional representation of dose limits and a threshold-curvilinear representation, suggesting that a LLE is a composite of both systems

  11. Patient Doses and Risk Evaluation in Bone Mineral Densitometry

    International Nuclear Information System (INIS)

    Angelucci, M.; Borio, R.; Chiocchini, S.; Degli Esposti, P.; Dipilato, A.C.; Policani, G.

    1999-01-01

    The aim of this work was to evaluate the equipment dose to the organs and tissues and the effective dose of patients undergoing the most frequent examinations carried out in bone mineral densitometry (BMD): lumbar spine and femur. Experimental measurements of absorbed doses on a Rando phantom, allow comparison of the performances of three different photon emitter facilities. The comparison of the entrance and exit doses measured on a Rando phantom and on 50 female non-obese patients show that entrance doses on Rando can be used as 'diagnostic reference levels' for patients. A quantitative estimate of the stochastic risk due to BMD procedures was made: the results obtained show that the stochastic risk is very low and that the BMD is, at present, the most confirmed procedure for osteoporosis diagnosis and management. (author)

  12. Risk based technique for improving technical specifications

    International Nuclear Information System (INIS)

    Kim, I. S.; Jae, M. S.; Kim, B. S.; Hwang, S. W.; Kang, K. M.; Park, S. S.; Yu, Y. S.

    2001-03-01

    The objective of this study is to develop the systematic guidance for reviewing the documents associated with the changes of technical specifications. The work done in this fiscal year is the following : surveys in TS requirements, TS improvements and TS regulations in foreign countries as well as Korea, surveys on the state-of-the-art of RITSs and their use in Korea, development of a decision-making framework for both the licensee and the regulation agency, description of risk measures, assessment methodology on STI/AOT, and adverse effects caused by periodic maintenance, which are explained in appendix. The results of this study might contribute to enhancing the quality of the current technical specifications and contribute to preparing the risk informed regulation program using the decision-making framework developed in this study

  13. Using spatial information about recurrence risk for robust optimization of dose-painting prescription functions

    International Nuclear Information System (INIS)

    Bender, Edward T.

    2012-01-01

    Purpose: To develop a robust method for deriving dose-painting prescription functions using spatial information about the risk for disease recurrence. Methods: Spatial distributions of radiobiological model parameters are derived from distributions of recurrence risk after uniform irradiation. These model parameters are then used to derive optimal dose-painting prescription functions given a constant mean biologically effective dose. Results: An estimate for the optimal dose distribution can be derived based on spatial information about recurrence risk. Dose painting based on imaging markers that are moderately or poorly correlated with recurrence risk are predicted to potentially result in inferior disease control when compared the same mean biologically effective dose delivered uniformly. A robust optimization approach may partially mitigate this issue. Conclusions: The methods described here can be used to derive an estimate for a robust, patient-specific prescription function for use in dose painting. Two approximate scaling relationships were observed: First, the optimal choice for the maximum dose differential when using either a linear or two-compartment prescription function is proportional to R, where R is the Pearson correlation coefficient between a given imaging marker and recurrence risk after uniform irradiation. Second, the predicted maximum possible gain in tumor control probability for any robust optimization technique is nearly proportional to the square of R.

  14. Cardiac-Specific Conversion Factors to Estimate Radiation Effective Dose From Dose-Length Product in Computed Tomography.

    Science.gov (United States)

    Trattner, Sigal; Halliburton, Sandra; Thompson, Carla M; Xu, Yanping; Chelliah, Anjali; Jambawalikar, Sachin R; Peng, Boyu; Peters, M Robert; Jacobs, Jill E; Ghesani, Munir; Jang, James J; Al-Khalidi, Hussein; Einstein, Andrew J

    2018-01-01

    -factors for all scanners and protocols are considerably higher than the k-factor currently used to estimate ED of cardiac CT studies, suggesting that radiation doses from cardiac CT have been significantly and systematically underestimated. Using cardiac-specific factors can more accurately inform the benefit-risk calculus of cardiac-imaging strategies. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Risks to health from radiation at low dose rates

    International Nuclear Information System (INIS)

    Gentner, N.E.; Osborne, R.V.

    1997-01-01

    Our focus is on whether, using a balance-of-evidence approach, it is possible to say that at a low enough dose, or at a sufficiently low dose rate, radiation risk reduces to zero in a population. We conclude that insufficient evidence exists at present to support such a conclusion. In part this reflects statistical limitations at low doses, and in part (although mechanisms unquestionably exist to protect us against much of the damage induced by ionizing radiation) the biological heterogeneity of human populations, which means these mechanisms do not act in all members of the population at all times. If it is going to be possible to demonstrate that low doses are less dangerous than we presently assume, the evidence, paradoxically, will likely come from studies of higher dose and dose rate scenarios than are encountered occupationally. (author)

  16. Cancer risk of low dose/low dose rate radiation: a meta-analysis of cancer data of mammals exposed to low doses of radiation

    International Nuclear Information System (INIS)

    Ogata, Hiromitsu; Magae, Junji

    2008-01-01

    Full text: Linear No Threshold (LNT) model is a basic theory for radioprotection, but the adaptability of this hypothesis to biological responses at low doses or at low dose rates is not sufficiently investigated. Simultaneous consideration of the cumulative dose and the dose rate is necessary for evaluating the risk of long-term exposure to ionizing radiation at low dose. This study intends to examine several numerical relationships between doses and dose rates in biological responses to gamma radiation. Collected datasets on the relationship between dose and the incidence of cancer in mammals exposed to low doses of radiation were analysed using meta-regression models and modified exponential (MOE) model, which we previously published, that predicts irradiation time-dependent biological response at low dose rate ionizing radiation. Minimum doses of observable risk and effective doses with a variety of dose rates were calculated using parameters estimated by fitting meta-regression models to the data and compared them with other statistical models that find values corresponding to 'threshold limits'. By fitting a weighted regression model (fixed-effects meta-regression model) to the data on risk of all cancers, it was found that the log relative risk [log(RR)] increased as the total exposure dose increased. The intersection of this regression line with the x-axis denotes the minimum dose of observable risk. These estimated minimum doses and effective doses increased with decrease of dose rate. The goodness of fits of MOE-model depended on cancer types, but the total cancer risk is reduced when dose rates are very low. The results suggest that dose response curve for cancer risk is remarkably affected by dose rate and that dose rate effect changes as a function of dose rate. For scientific discussion on the low dose exposure risk and its uncertainty, the term 'threshold' should be statistically defined, and dose rate effects should be included in the risk

  17. Hiroshima and Nagasaki: New doses, risks, and their implications

    International Nuclear Information System (INIS)

    Schull, W.J.; Shimizu, Y.; Kato, H.

    1990-01-01

    This presentation summarizes the recent re-evaluations of the dose and risk of cancer among survivors of the atomic bombing of Hiroshima and Nagasaki. It addresses briefly their limitations, and describes some of their implications for the lifetime projection of the risk of a fatal cancer following exposure to ionizing radiation

  18. Collective effective dose equivalent, population doses and risk estimates from occupational exposures in Japan

    International Nuclear Information System (INIS)

    Maruyama, Takashi; Nishizawa, Kanae; Kumamoto, Yoshikazu; Iwai, Kazuo; Mase, Naomichi.

    1993-01-01

    Collective dose equivalent and population dose from occupational exposures in Japan, 1988 were estimated on the basis of a nationwide survey. The survey was conducted on annual collective dose equivalents by sex, age group and type of radiation work for about 0.21 million workers except for the workers in nuclear power stations. The data on the workers in nuclear power stations were obtained from the official report of the Japan Nuclear Safety Commission. The total number of workers including nuclear power stations was estimated to be about 0.26 million. Radiation works were subdivided as follows: medical works including dental; non-atomic energy industry; research and education; atomic energy industry and nuclear power station. For the determination of effective dose equivalent and population dose, organ or tissue doses were measured with a phantom experiment. The resultant doses were compared with the doses previously calculated using a chord length technique and with data from ICRP publications. The annual collective effective dose equivalent were estimated to be about 21.94 person·Sv for medical workers, 7.73 person·Sv for industrial workers, 0.75 person·Sv for research and educational workers, 2.48 person·Sv for atomic energy industry and 84.4 person ·Sv for workers in nuclear power station. The population doses were calculated to be about 1.07 Sv for genetically significant dose, 0.89 Sv for leukemia significant dose and 0.42 Sv for malignant significant dose. The population risks were estimated using these population doses. (author)

  19. Knowledge of medical imaging radiation dose and risk among doctors.

    Science.gov (United States)

    Brown, Nicholas; Jones, Lee

    2013-02-01

    The growth of computed tomography (CT) and nuclear medicine (NM) scans has revolutionised healthcare but also greatly increased population radiation doses. Overuse of diagnostic radiation is becoming a feature of medical practice, leading to possible unnecessary radiation exposures and lifetime-risks of developing cancer. Doctors across all medical specialties and experience levels were surveyed to determine their knowledge of radiation doses and potential risks associated with some diagnostic imaging. A survey relating to knowledge and understanding of medical imaging radiation was distributed to doctors at 14 major Queensland public hospitals, as well as fellows and trainees in radiology, emergency medicine and general practice. From 608 valid responses, only 17.3% correctly estimated the radiation dose from CT scans and almost 1 in 10 incorrectly believed that CT radiation is not associated with any increased lifetime risk of developing cancer. There is a strong inverse relationship between a clinician's experience and their knowledge of CT radiation dose and risks, even among radiologists. More than a third (35.7%) of doctors incorrectly believed that typical NM imaging either does not use ionising radiation or emits doses equal to or less than a standard chest radiograph. Knowledge of CT and NM radiation doses is poor across all specialties, and there is a significant inverse relationship between experience and awareness of CT dose and risk. Despite having a poor understanding of these concepts, most doctors claim to consider them prior to requesting scans and when discussing potential risks with patients. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

  20. Hormesis: from marginalization to mainstream A case for hormesis as the default dose-response model in risk assessment

    International Nuclear Information System (INIS)

    Calabrese, Edward J.

    2004-01-01

    The paper provides an account of how the hormetic dose response has emerged in recent years as a serious dose-response model in toxicology and risk assessment after decades of extreme marginalization. In addition to providing the toxicological basis of this dose-response revival, the paper reexamines the concept of a default dose model in toxicology and risk assessment and makes the argument that the hormetic model satisfies criteria (e.g., generalizability, frequency, application to risk assessment endpoints, false positive/negative potential, requirements for hazard assessment, reliability of estimating risks, capacity for validation of risk estimates, public health implications of risk estimates) for such a default model better than its chief competitors, the threshold and linear at low dose models. The selection of the hormetic model as the default model in risk assessment for noncarcinogens and specifically for carcinogens would have a profound impact on the practice of risk assessment and its societal implications

  1. Optimizing CT radiation dose based on patient size and image quality: the size-specific dose estimate method

    Energy Technology Data Exchange (ETDEWEB)

    Larson, David B. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2014-10-15

    The principle of ALARA (dose as low as reasonably achievable) calls for dose optimization rather than dose reduction, per se. Optimization of CT radiation dose is accomplished by producing images of acceptable diagnostic image quality using the lowest dose method available. Because it is image quality that constrains the dose, CT dose optimization is primarily a problem of image quality rather than radiation dose. Therefore, the primary focus in CT radiation dose optimization should be on image quality. However, no reliable direct measure of image quality has been developed for routine clinical practice. Until such measures become available, size-specific dose estimates (SSDE) can be used as a reasonable image-quality estimate. The SSDE method of radiation dose optimization for CT abdomen and pelvis consists of plotting SSDE for a sample of examinations as a function of patient size, establishing an SSDE threshold curve based on radiologists' assessment of image quality, and modifying protocols to consistently produce doses that are slightly above the threshold SSDE curve. Challenges in operationalizing CT radiation dose optimization include data gathering and monitoring, managing the complexities of the numerous protocols, scanners and operators, and understanding the relationship of the automated tube current modulation (ATCM) parameters to image quality. Because CT manufacturers currently maintain their ATCM algorithms as secret for proprietary reasons, prospective modeling of SSDE for patient populations is not possible without reverse engineering the ATCM algorithm and, hence, optimization by this method requires a trial-and-error approach. (orig.)

  2. Low dose diagnostic radiation does not increase cancer risk in cancer prone mice

    Energy Technology Data Exchange (ETDEWEB)

    Boreham, D., E-mail: dboreham@nosm.ca [Northern Ontario School of Medicine, ON (Canada); Phan, N., E-mail: nghiphan13@yahoo.com [Univ. of Ottawa, Ottawa, ON (Canada); Lemon, J., E-mail: lemonja@mcmaster.ca [McMaster Univ., Hamilton, ON (Canada)

    2014-07-01

    The increased exposure of patients to low dose diagnostic ionizing radiation has created concern that these procedures will result in greater risk of carcinogenesis. However, there is substantial evidence that shows in many cases that low dose exposure has the opposite effect. We have investigated whether CT scans can modify mechanisms associated with carcinogenesis in cancer-prone mice. Cancer was induced in Trp53+/- mice with an acute high dose whole-body 4 Gy γ-radiation exposure. Four weeks following the cancer-inducing dose, weekly whole-body CT scans (10 mGy/scan, 75 kVp X-rays) were given for ten consecutive weeks adding an additional radiation burden of 0.1 Gy. Short-term biological responses and subsequent lifetime cancer risk were investigated. Five days following the last CT scan, there were no detectable differences in the spontaneous levels of DNA damage in blood cells (reticulocytes). In fact, CT scanned mice had significantly lower constitutive levels of oxidative DNA damage and cell death (apoptosis), compared to non-CT scanned mice. This shows that multiple low dose radiation exposures modified the radio response and indicates protective processes were induced in mice. In mice treated with the multiple CT scans following the high cancer-inducing 4 Gy dose, tumour latency was increased, significantly prolonging lifespan. We conclude that repeated CT scans can reduce the cancer risk of a prior high-dose radiation exposure, and delay the progression of specific types of radiation-induced cancers in Trp53+/-mice. This research shows for the first time that low dose exposure long after cancer initiation events alter risk and reduce cancer morbidity. Cancer induction following low doses does not follow a linear non-threshold model of risk and this model should not be used to extrapolate risk to humans following low dose exposure to ionizing radiation. (author)

  3. Personal dosimetry statistics and specifics of low dose evaluation

    International Nuclear Information System (INIS)

    Avila, R.E.; Gómez Salinas, R.A.; Oyarzún Cortés, C.H.

    2015-01-01

    The dose statistics of a personal dosimetry service, considering 35,000+ readings, display a sharp peak at low dose (below 0.5 mSv) with skewness to higher values. A measure of the dispersion is that approximately 65% of the doses fall below the average plus 2 standard deviations, an observation which may prove helpful to radiation protection agencies. Categorizing the doses by the concomitant use of a finger ring dosimeter, that skewness is larger in the whole body, and ring dosimeters. The use of Harshaw 5500 readers at high gain leads to frequent values of the glow curve that are judged to be spurious, i.e. values not belonging to the roughly normal noise over the curve. A statistical criterion is shown for identifying those anomalous values, and replacing them with the local behavior, as fit by a cubic polynomial. As a result, the doses above 0.05 mSv which are affected by more than 2% comprise over 10% of the data base. The low dose peak of the statistics, above, has focused our attention on the evaluation of LiF(Mg,Ti) dosimeters exposed at low dose, and read with Harshaw 5500 readers. The standard linear procedure, via an overall reader calibration factor, is observed to fail at low dose, in detailed calibrations from 0.02 mSv to 1 Sv. A significant improvement is achieved by a piecewise polynomials calibration curve. A cubic, at low dose is matched, at ∼10 mSv, in value and first derivative, to a linear dependence at higher doses. This improvement is particularly noticeable below 2 mSv, where over 60% of the evaluated dosimeters are found. (author)

  4. Radiation Dose-Response Relationships and Risk Assessment

    International Nuclear Information System (INIS)

    Strom, Daniel J.

    2005-01-01

    The notion of a dose-response relationship was probably invented shortly after the discovery of poisons, the invention of alcoholic beverages, and the bringing of fire into a confined space in the forgotten depths of ancient prehistory. The amount of poison or medicine ingested can easily be observed to affect the behavior, health, or sickness outcome. Threshold effects, such as death, could be easily understood for intoxicants, medicine, and poisons. As Paracelsus (1493-1541), the 'father' of modern toxicology said, 'It is the dose that makes the poison.' Perhaps less obvious is the fact that implicit in such dose-response relationships is also the notion of dose rate. Usually, the dose is administered fairly acutely, in a single injection, pill, or swallow; a few puffs on a pipe; or a meal of eating or drinking. The same amount of intoxicants, medicine, or poisons administered over a week or month might have little or no observable effect. Thus, before the discovery of ionizing radiation in the late 19th century, toxicology ('the science of poisons') and pharmacology had deeply ingrained notions of dose-response relationships. This chapter demonstrates that the notion of a dose-response relationship for ionizing radiation is hopelessly simplistic from a scientific standpoint. While useful from a policy or regulatory standpoint, dose-response relationships cannot possibly convey enough information to describe the problem from a quantitative view of radiation biology, nor can they address societal values. Three sections of this chapter address the concepts, observations, and theories that contribute to the scientific input to the practice of managing risks from exposure to ionizing radiation. The presentation begins with irradiation regimes, followed by responses to high and low doses of ionizing radiation, and a discussion of how all of this can inform radiation risk management. The knowledge that is really needed for prediction of individual risk is presented

  5. Correlation between effective dose and radiological risk: general concepts

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Paulo Roberto; Yoshimura, Elisabeth Mateus; Nersissian, Denise Yanikian; Melo, Camila Souza, E-mail: pcosta@if.usp.br [Universidade de Sao Paulo (IF/USP), Sao Paulo, SP (Brazil). Instituto de Fisica

    2016-05-15

    The present review aims to offer an educational approach related to the limitations in the use of the effective dose magnitude as a tool for the quantification of doses resulting from diagnostic applications of ionizing radiation. We present a critical analysis of the quantities accepted and currently used for dosimetric evaluation in diagnostic imaging procedures, based on studies published in the literature. It is highlighted the use of these quantities to evaluate the risk attributed to the procedure and to calculate the effective dose, as well as to determine its correct use and interpretation. (author)

  6. Effective dose efficiency: an application-specific metric of quality and dose for digital radiography

    Energy Technology Data Exchange (ETDEWEB)

    Samei, Ehsan; Ranger, Nicole T; Dobbins, James T III; Ravin, Carl E, E-mail: samei@duke.edu [Carl E Ravin Advanced Imaging Laboratories, Department of Radiology (United States)

    2011-08-21

    The detective quantum efficiency (DQE) and the effective DQE (eDQE) are relevant metrics of image quality for digital radiography detectors and systems, respectively. The current study further extends the eDQE methodology to technique optimization using a new metric of the effective dose efficiency (eDE), reflecting both the image quality as well as the effective dose (ED) attributes of the imaging system. Using phantoms representing pediatric, adult and large adult body habitus, image quality measurements were made at 80, 100, 120 and 140 kVp using the standard eDQE protocol and exposures. ED was computed using Monte Carlo methods. The eDE was then computed as a ratio of image quality to ED for each of the phantom/spectral conditions. The eDQE and eDE results showed the same trends across tube potential with 80 kVp yielding the highest values and 120 kVp yielding the lowest. The eDE results for the pediatric phantom were markedly lower than the results for the adult phantom at spatial frequencies lower than 1.2-1.7 mm{sup -1}, primarily due to a correspondingly higher value of ED per entrance exposure. The relative performance for the adult and large adult phantoms was generally comparable but affected by kVps. The eDE results for the large adult configuration were lower than the eDE results for the adult phantom, across all spatial frequencies (120 and 140 kVp) and at spatial frequencies greater than 1.0 mm{sup -1} (80 and 100 kVp). Demonstrated for chest radiography, the eDE shows promise as an application-specific metric of imaging performance, reflective of body habitus and radiographic technique, with utility for radiography protocol assessment and optimization.

  7. Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis.

    Science.gov (United States)

    Trauelsen, Anne Marie; Bendall, Sarah; Jansen, Jens Einar; Nielsen, Hanne-Grethe Lyse; Pedersen, Marlene Buch; Trier, Christopher Høier; Haahr, Ulrik H; Simonsen, Erik

    2015-06-01

    Reviews conclude that childhood and adolescence sexual, physical, emotional abuse and emotional and physical neglect are all risk factors for psychosis. However, studies suggest only some adversities are associated with psychosis. Dose-response effects of several adversities on risk of psychosis have not been consistently found. The current study aimed to explore adversity specificity and dose-response effects of adversities on risk of psychosis. Participants were 101 persons with first-episode psychosis (FEP) diagnosed with ICD-10 F20 - F29 (except F21) and 101 non-clinical control persons matched by gender, age and parents' socio-economic status. Assessment included the Childhood Trauma Questionnaire and parts of the Childhood Experience of Care and Abuse Questionnaire. Eighty-nine percent of the FEP group reported one or more adversities compared to 37% of the control group. Childhood and adolescent sexual, physical, emotional abuse, and physical and emotional neglect, separation and institutionalization were about four to 17 times higher for the FEP group (all p<0.01). The risk of psychosis increased two and a half times for each additional adversity. All associations between specific adversities and psychosis decreased when they were adjusted for other adversities. Our findings suggest that there is a large shared effect of adversities on the risk of psychosis. Contrary to the call for further research into specific adversities, we suggest a search for mechanisms in the shared effects of traumatization. Clinical implications are thorough assessment of adversities and their possible effects. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. A comparison of dose versus risk at environmental restoration sites

    International Nuclear Information System (INIS)

    Holm-Hansen, T.; Pastor, R.S.

    1996-01-01

    This paper compares current US Environmental Protection Agency methods for completing risk assessments at radionuclide-contaminated sites with the International Council for Radiation Protection dose-based method. The two methods produce inconsistent results that could complicate cleanup decisions. Important issues include uncertainties associated with the use of carcinogenic slope factors and methods to account for institutional controls and decay of the source term for decision-making purposes. Overall, risk management at sites contaminated with radionuclides should be driven by a dose-based approach through adoption of the proposed 15 millirem cleanup standard found in Title 40 Code of Federal Regulations, Part 191

  9. Dermatologic radiotherapy and thyroid cancer. Dose measurements and risk quantification

    International Nuclear Information System (INIS)

    Goldschmidt, H.; Gorson, R.O.; Lassen, M.

    1983-01-01

    Thyroid doses for various dermatologic radiation techniques were measured with thermoluminescent dosimeters and ionization rate meters in an Alderson-Rando anthropomorphic phantom. The effects of changes in radiation quality and of the use or nonuse of treatment cones and thyroid shields were evaluated in detail. The results indicate that the potential risk of radiogenic thyroid cancer is very small when proper radiation protection measures are used. The probability of radiogenic thyroid cancer developing and the potential mortality risk were assessed quantitatively for each measurement. The quantification of radiation risks allows comparisons with risks of other therapeutic modalities and the common hazards of daily life

  10. Information from the National Institute of Radiation Protection about radiation doses and radiation risks at x-ray screening

    International Nuclear Information System (INIS)

    1975-05-01

    This report gives a specification of data concerning radiation doses and risks at x-ray investigations of lungs. The dose estimations are principally based on measurements performed in 1974 by the National Institute of Radiation Protection. The radiation doses at x-ray screening are of that magnitude that the risk for acute radiation injuries is non-existent. At these low doses it has not either been able to prove that the radiation gives long-range effects as changes in the genes or cancer of late appearance. At considerable higher doses, more than tens of thousands of millirads, a risk of cancer appearance at a small part of all irradiated persons has been proved, based on the assumption that the cancer risk is proportional to the radiation dose. Cancer can thus occure at low radiation doses too. Because of the mass radiography in Sweden 1974 about twenty cases of cancer may appear in the future. (M.S.)

  11. Dose-stress synergism in cancer risk assessment

    International Nuclear Information System (INIS)

    Pop-Jordanova, N.; Pop-Jordanov, J.

    2001-01-01

    Our hypothesis is that the relatively low risk of cancer or leukaemia from depleted uranium, as predicted by the World Health Organization and the International Atomic Energy Agency, is a result of neglecting the synergism between physico-chemical agents and psychological stress agents (here shortly denoted as dose-stress synergism). We use the modified risk assessment model that comprises a psycho-somatic extension, originally developed by us for assessing the risks of energy sources. Our preliminary meta-analysis of animal and human studies on cancers confirmed the existence of stress effects, including the amplifying synergism. Consequently, the psychological stress can increase the probability of even small toxic chemical or ionizing radiation exposure to produce malignancy. Such dose-stress synergism might influence the health risks among military personnel and the residents in the highly stressful environment in the Balkans. Further investigation is needed to estimate the order of magnitude of these combined effects in particular circumstances. (Original)

  12. Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Tianwu; Poletti, Pierre-Alexandre; Platon, Alexandra; Becker, Christoph D. [Geneva University Hospital, Department of Medical Imaging and Information Sciences, Geneva (Switzerland); Zaidi, Habib [Geneva University Hospital, Department of Medical Imaging and Information Sciences, Geneva (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland); University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, Groningen (Netherlands); University of Southern Denmark, Department of Nuclear Medicine, Odense (Denmark); Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, Geneva (Switzerland)

    2018-03-15

    This work provides detailed estimates of the foetal dose from diagnostic CT imaging of pregnant patients to enable the assessment of the diagnostic benefits considering the associated radiation risks. To produce realistic biological and physical representations of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients referred to the emergency unit of Geneva University Hospital for abdominal CT scans. The effective dose to the mother varied from 1.1 mSv to 2.0 mSv with an average of 1.6 mSv, while commercial dose-tracking software reported an average effective dose of 1.9 mSv (range 1.7-2.3 mSv). The foetal dose normalised to CTDI{sub vol} varies between 0.85 and 1.63 with an average of 1.17. The methodology for construction of personalised computational models can be exploited to estimate the patient-specific radiation dose from CT imaging procedures. Likewise, the dosimetric data can be used for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process. (orig.)

  13. Source specific risk assessment of indoor aerosol particles

    Energy Technology Data Exchange (ETDEWEB)

    Koivisto, A.J.

    2013-05-15

    In the urban environment, atmospheric aerosols consist mainly of pollutants from anthropogenic sources. The majority of these originate from traffic and other combustion processes. A fraction of these pollutants will penetrate indoors via ventilation. However, indoor air concentrations are usually predominated by indoor sources due to the small amount of dilution air. In modern societies, people spend most of their time indoors. Thus, their exposure is controlled mainly by indoor concentrations from indoor sources. During the last decades, engineering of nanosized structures has created a new field of material science. Some of these materials have been shown to be potentially toxic to human health. The greatest potential for exposure to engineered nanomaterials (ENMs) occurs in the workplace during production and handling of ENMs. In an exposure assessment, both gaseous and particulate matter pollutants need to be considered. The toxicities of the particles usually depend on the source and age. With time, particle morphology and composition changes due to their tendency to undergo coagulation, condensation and evaporation. The PM exposure risk is related to source specific emissions, and thus, in risk assessment one needs to define source specific exposures. This thesis describes methods for source specific risk assessment of airborne particulate matter. It consists of studies related to workers' ENM exposures during the synthesis of nanoparticles, packing of agglomerated TiO{sub 2} nanoparticles, and handling of nanodiamonds. Background particles were distinguished from the ENM concentrations by using different measurement techniques and indoor aerosol modelings. Risk characterization was performed by using a source specific exposure and calculated dose levels in units of particle number and mass. The exposure risk was estimated by using non-health based occupational exposure limits for ENMs. For the nanosized TiO{sub 2}, the risk was also assessed from dose

  14. Review of European research trends of low dose radiation risk

    International Nuclear Information System (INIS)

    Iwasaki, Toshiyasu; Yoshida, Kazuo

    2010-01-01

    Large research projects on low dose radiation effects in Europe and US over the past decade have provided limited scientific knowledge which could underpin the validation of radiation protection systems. Recently in Europe, there have been repeated discussions and dialogues to improve the situation, and as the consequence, the circumstances surrounding low dose radiation risks are changing. In 2009, Multidisciplinary European Low Dose Initiative (MELODI) was established as a trans-national organization capable of ensuring appropriate governance of research in the pursuit of a long term shared vision, and Low Dose Research towards Multidisciplinary Integration (DoReMi) network was launched in 2010 to achieve fairly short term results in order to prove the validity of the MELODI approach. It is expected to be very effective and powerful activities to facilitate the reduction of uncertainties in the understanding of low dose risks, but the regulatory requests rushing the reinforcement of radiological protection regulations based on the precautional principles are more increasing. To develop reasonable radiological protection systems based on scientific evidences, we need to accelerate to collect scientific evidences which could directly underpin more appropriate radiation protection systems even in Japan. For the purpose, we Japan need to develop from an independent standpoint and share as a multidisciplinary vision a long term and holistic research strategy which enables to enhance Japanese advantages such as low dose rate facilities and animal facilities, as soon as possible. (author)

  15. Equivalent dose, effective dose and risk assessment from cephalometric radiography to critical organs

    International Nuclear Information System (INIS)

    Kang, Seong Sook; Cho, Bon Hae; Kim, Hyun Ja

    1995-01-01

    In head and neck region, the critical organ and tissue doses were determined, and the risks were estimated from lateral, posteroanterial and basilar cephalometric radiography. For each cephalometric radiography, 31 TLDs were placed in selected sites (18 internal and 13 external sites) in a tissue-equivalent phantom and exposed, then read-out in the TLD reader. The following results were obtained; 1. From lateral cephalometric radiography, the highest effective dose recorded was that delivered to the salivary gland (3.6 μSv) and the next highest dose was that received by the bone marrow (3 μSv). 2. From posteroanterial cephalometric radiography, the highest effective dose recorded was that delivered to the salivary gland (2 μSv) and the next highest dose was that received by the bone marrow (1.8 μSv). 3. From basilar cephalometric radiography, the highest effective dose recorded was that delivered to the thyroid gland (31.4 μSv) and the next highest dose was that received by the salivary gland (13.3 μSv). 4. The probabilities of stochastic effect from lateral, posteroanterial and basilar cephalometric radiography were 0.72 X 10 -6 , 0.49 X 10 -6 and 3.51 X 10 -6 , respectively.

  16. Guidelines for application of chemical-specific adjustment factors in dose/concentration-response assessment

    International Nuclear Information System (INIS)

    Meek, M.E.; Renwick, A.; Ohanian, E.; Dourson, M.; Lake, B.; Naumann, B.D.; Vu, V.

    2002-01-01

    This manuscript addresses guidance in the use of kinetic and dynamic data to inform quantitatively extrapolations for interspecies differences and human variability in dose-response assessment developed in a project of the International Programme on Chemical Safety (IPCS) initiative on Harmonisation of Approaches to the Assessment of Risk from Exposure to Chemicals. The guidance has been developed and refined through a series of planning and technical meetings and larger workshops of a broad range of participants from academia, government agencies and the private sector. The guidance for adequacy of data for replacement of common defaults for interspecies differences and human variability is presented in the context of several generic categories including: determination of the active chemical species, choice of the appropriate metric (kinetic components) or endpoint (dynamic components) and nature of experimental data, the latter which includes reference to the relevance of population, route and dose and the adequacy of the number of subjects/samples. The principal objective of this guidance developed primarily as a resource for risk assessors, is to foster better understanding of the components of and criteria for adequacy of chemical-specific data to quantitate interspecies differences and human variability in kinetics and dynamics. It is anticipated that this guidance will also encourage the development of appropriate data and facilitate their incorporation in a consistent fashion in dose-response assessment for regulatory purposes (IPCS, 2001)

  17. SU-F-I-38: Patient Organ Specific Dose Assessment in Coronary CT Angiograph Using Voxellaized Volume Dose Index in Monte Carlo Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Fallal, Mohammadi Gh.; Riyahi, Alam N.; Graily, Gh. [Tehran University of Medical Scienced(TUMS), School of Medicine, Department of Nedical Physics and Biomedical Engineering, Tehran (Iran, Islamic Republic of); Paydar, R. [Iran University of Medical Sciences(IUMS), Allied Medicine Faculty, Department of radiation Sciences, Tehran (Iran, Islamic Republic of)

    2016-06-15

    Purpose: Clinical use of multi detector computed tomography(MDCT) in diagnosis of diseases due to high speed in data acquisition and high spatial resolution is significantly increased. Regarding to the high radiation dose in CT and necessity of patient specific radiation risk assessment, the adoption of new method in the calculation of organ dose is completely required and necessary. In this study by introducing a conversion factor, patient organ dose in thorax region based on CT image data using MC system was calculated. Methods: The geometry of x-ray tube, inherent filter, bow tie filter and collimator were designed using EGSnrc/BEAMnrc MC-system component modules according to GE-Light-speed 64-slices CT-scanner geometry. CT-scan image of patient thorax as a specific phantom was voxellised with 6.25mm3 in voxel and 64×64×20 matrix size. Dose to thorax organ include esophagus, lung, heart, breast, ribs, muscle, spine, spinal cord with imaging technical condition of prospectively-gated-coronary CT-Angiography(PGT) as a step and shoot method, were calculated. Irradiation of patient specific phantom was performed using a dedicated MC-code as DOSXYZnrc with PGT-irradiation model. The ratio of organ dose value calculated in MC-method to the volume CT dose index(CTDIvol) reported by CT-scanner machine according to PGT radiation technique has been introduced as conversion factor. Results: In PGT method, CTDIvol was 10.6mGy and Organ Dose/CTDIvol conversion factor for esophagus, lung, heart, breast, ribs, muscle, spine and spinal cord were obtained as; 0.96, 1.46, 1.2, 3.28. 6.68. 1.35, 3.41 and 0.93 respectively. Conclusion: The results showed while, underestimation of patient dose was found in dose calculation based on CTDIvol, also dose to breast is higher than the other studies. Therefore, the method in this study can be used to provide the actual patient organ dose in CT imaging based on CTDIvol in order to calculation of real effective dose(ED) based on organ dose

  18. Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models

    DEFF Research Database (Denmark)

    Xie, Tianwu; Poletti, Pierre-Alexandre; Platon, Alexandra

    2018-01-01

    of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients...... for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process. KEY POINTS: • In CT examinations, the absorbed dose is non-uniformly distributed within foetal organs. • This work reports, for the first time, estimates...

  19. Radiation-Induced Leukemia at Doses Relevant to Radiation Therapy: Modeling Mechanisms and Estimating Risks

    Science.gov (United States)

    Shuryak, Igor; Sachs, Rainer K.; Hlatky, Lynn; Mark P. Little; Hahnfeldt, Philip; Brenner, David J.

    2006-01-01

    Because many cancer patients are diagnosed earlier and live longer than in the past, second cancers induced by radiation therapy have become a clinically significant issue. An earlier biologically based model that was designed to estimate risks of high-dose radiation induced solid cancers included initiation of stem cells to a premalignant state, inactivation of stem cells at high radiation doses, and proliferation of stem cells during cellular repopulation after inactivation. This earlier model predicted the risks of solid tumors induced by radiation therapy but overestimated the corresponding leukemia risks. Methods: To extend the model to radiation-induced leukemias, we analyzed in addition to cellular initiation, inactivation, and proliferation a repopulation mechanism specific to the hematopoietic system: long-range migration through the blood stream of hematopoietic stem cells (HSCs) from distant locations. Parameters for the model were derived from HSC biologic data in the literature and from leukemia risks among atomic bomb survivors v^ ho were subjected to much lower radiation doses. Results: Proliferating HSCs that migrate from sites distant from the high-dose region include few preleukemic HSCs, thus decreasing the high-dose leukemia risk. The extended model for leukemia provides risk estimates that are consistent with epidemiologic data for leukemia risk associated with radiation therapy over a wide dose range. For example, when applied to an earlier case-control study of 110000 women undergoing radiotherapy for uterine cancer, the model predicted an excess relative risk (ERR) of 1.9 for leukemia among women who received a large inhomogeneous fractionated external beam dose to the bone marrow (mean = 14.9 Gy), consistent with the measured ERR (2.0, 95% confidence interval [CI] = 0.2 to 6.4; from 3.6 cases expected and 11 cases observed). As a corresponding example for brachytherapy, the predicted ERR of 0.80 among women who received an inhomogeneous low-dose

  20. Revision of risk estimates and implications for dose limits

    International Nuclear Information System (INIS)

    Clarke, R.H.

    1989-01-01

    It has been apparent for some time that our estimates of the risks associated with exposure to ionizing radiation must be increased above those values reported by UNSCEAR in 1977 an dused by ICRP to form their present recommendations. NRPB foresaw some of these changes and introduced interim advice within the UK to restrict exposures of wordkers and members of the public to levels below the existing limits. Since that advice was given, UNSCEAR has produced a 1988 report reviewing human data to provide new estimates of risks associated with exposure at high doses and high doserates. These risk figures are up to 4 times higher than when UNSCEAR reported in 1977. In this paper, the reasons for the changes in the estimates of risk will be described and the current NRPB guidelines for risk factors for protection purposes will be presented. The implications of these new risk factors for the setting of dose limits will then be discussed. (Author). 10 refs.; 2 tabs

  1. Specific gamma-ray dose constants for nuclides important to dosimetry and radiological assessment

    International Nuclear Information System (INIS)

    Unger, L.M.; Trubey, D.K.

    1982-05-01

    Tables of specific gamma-ray dose constants (the unshielded gamma-ray dose equivalent rate at 1 m from a point source) have been computed for approximately 500 nuclides important to dosimetry and radiological assessment. The half life, the mean attenuation coefficient, and thickness for a lead shield providing 95% dose equivalent attenuation are also listed

  2. The stochastic risks of radioactive radiation - risk assessment, risk proportions, dose limits

    International Nuclear Information System (INIS)

    Lindackers, K.H.

    1990-01-01

    The latest data on the delayed injury to the a-bomb survivors of Hiroshima and Nagasaki reveal that the effects of radiation are more severe than was estimated in the past. However, the application of these data to small dose rate radiation exposure over longer periods of time leads to an overestimation of the actual risk. The future supersonic aviation schemes for altitudes within 20,000 m should include early personnel check-ups for assessment of the required protective measures. (orig./DG) [de

  3. Acute Radiation Risk and BRYNTRN Organ Dose Projection Graphical User Interface

    Science.gov (United States)

    Cucinotta, Francis A.; Hu, Shaowen; Nounu, Hateni N.; Kim, Myung-Hee

    2011-01-01

    The integration of human space applications risk projection models of organ dose and acute radiation risk has been a key problem. NASA has developed an organ dose projection model using the BRYNTRN with SUM DOSE computer codes, and a probabilistic model of Acute Radiation Risk (ARR). The codes BRYNTRN and SUM DOSE are a Baryon transport code and an output data processing code, respectively. The risk projection models of organ doses and ARR take the output from BRYNTRN as an input to their calculations. With a graphical user interface (GUI) to handle input and output for BRYNTRN, the response models can be connected easily and correctly to BRYNTRN. A GUI for the ARR and BRYNTRN Organ Dose (ARRBOD) projection code provides seamless integration of input and output manipulations, which are required for operations of the ARRBOD modules. The ARRBOD GUI is intended for mission planners, radiation shield designers, space operations in the mission operations directorate (MOD), and space biophysics researchers. BRYNTRN code operation requires extensive input preparation. Only a graphical user interface (GUI) can handle input and output for BRYNTRN to the response models easily and correctly. The purpose of the GUI development for ARRBOD is to provide seamless integration of input and output manipulations for the operations of projection modules (BRYNTRN, SLMDOSE, and the ARR probabilistic response model) in assessing the acute risk and the organ doses of significant Solar Particle Events (SPEs). The assessment of astronauts radiation risk from SPE is in support of mission design and operational planning to manage radiation risks in future space missions. The ARRBOD GUI can identify the proper shielding solutions using the gender-specific organ dose assessments in order to avoid ARR symptoms, and to stay within the current NASA short-term dose limits. The quantified evaluation of ARR severities based on any given shielding configuration and a specified EVA or other mission

  4. On the genetic risk after high dose radioiodine therapy with regard to the gonadal dose

    International Nuclear Information System (INIS)

    Ehrenheim, C.; Hauswirth, C.; Fitschen, J.; Martin, E.; Oetting, G.; Hundeshagen, H.

    1997-01-01

    Aim: The genetic risk for the offspring of patients treated with high doses of radioiodine was to be assessed with special regard to the gonadal dose caused by diagnostic and therapeutic procedures. Methods: 41 young females (aged between 19 and 39 years) and four young males (aged 26 to 36 years) treated with radioiodine because of a thyroid carcinoma were interviewed by use of a questionnaire. The course of pregnancy and birth history could be documented as well as the congenital and developmental conditions of 56 children. Results: The amount of radioactivity applied for therapy and whole body scans ranged over 4,144 and 35,15 GBq I-131; the individual gonadal dose was calculated based on the MIRD model and ranged over 0,2 and 2,2 Sv (0,51 Sv at a mean). The period of time between the last radioiodine application and confinement was at least 9 months, not exceeding 14 years. As to the course of pregnancy and birth two early abortions, one extrauterine gravidity and one premature birth due to an insufficiency of the placenta were stated. In one case a chromosomal translocation 7/14 occured as a genetic defect which lead to an interruption. The children's development was unconspicuous except of two cases of neurodermatitis as well as multiple allergies and an early closure of the anterior fontanelle in one child each. Conclusion: Although the genetic risk is supposed to increase with the gonadal dose achieved (doubling dose 1 Sv) and the increased risk of any congenital anomaly was calculated as about 13% at a mean in our patients, the rate of genetic determined diseases was not elevated (1,8% or 1/57). Thus, no increase of genetic defects or congenital malformations was reported in a total of 408 children described in the literature and in our group. (orig.) [de

  5. Determination of dose equivalent and risk in thorium cycle

    International Nuclear Information System (INIS)

    Ney, C.L.V.N.

    1988-01-01

    In these report are presented the calculations of dose equivalent and risk, utilizing the dosimetric model described in publication 30 of the International Comission on Radiological Protection. This information was obtained by the workers of the thorium cycle, employed at the Praia and Santo Amaro Facilities, by assessing the quantity and concentration of thorium in the air. The samples and the number of measurements were established through design of experiments techniques, and the results were evaluated with the aid of variance analysis. The estimater of dose equivalent for internal and external radiation exposure and risk associated were compared with the maximum recommended limits. The results indicate the existence of operation areas whose values were above those limits, requiring so an improvement in the procedures and services in order to meet the requirements of the radiological protetion. (author) [pt

  6. Evaluation of organ doses and specific k effective dose of 64-slice CT thorax examination using an adult anthropomorphic phantom

    International Nuclear Information System (INIS)

    Hashim, S.; Karim, M.K.A.; Bakar, K.A.; Sabarudin, A.; Chin, A.W; Saripan, M.I.; Bradley, D.A.

    2016-01-01

    The magnitude of radiation dose in computed tomography (CT) depends on the scan acquisition parameters, investigated herein using an anthropomorphic phantom (RANDO®) and thermoluminescence dosimeters (TLD). Specific interest was in the organ doses resulting from CT thorax examination, the specific k coefficient for effective dose estimation for particular protocols also being determined. For measurement of doses representing five main organs (thyroid, lung, liver, esophagus and skin), TLD-100 (LiF:Mg, Ti) were inserted into selected holes in a phantom slab. Five CT thorax protocols were investigated, one routine (R1) and four that were modified protocols (R2 to R5). Organ doses were ranked from greatest to least, found to lie in the order: thyroid>skin>lung>liver>breast. The greatest dose, for thyroid at 25 mGy, was that in use of R1 while the lowest, at 8.8 mGy, was in breast tissue using R3. Effective dose (E) was estimated using three standard methods: the International Commission on Radiological Protection (ICRP)-103 recommendation (E103), the computational phantom CT-EXPO (E(CTEXPO)) method, and the dose-length product (DLP) based approach. E103 k factors were constant for all protocols, ~8% less than that of the universal k factor. Due to inconsistency in tube potential and pitch factor the k factors from CTEXPO were found to vary between 0.015 and 0.010 for protocols R3 and R5. With considerable variation between scan acquisition parameters and organ doses, optimization of practice is necessary in order to reduce patient organ dose. - Highlights: • Using TLD-100 dosimeters and a RANDO phantom 5 CT thorax protocol organ doses were assessed. • The specific k coefficient for effective dose estimation of protocols differed with approach. • Organ dose was observed to decrease in the order: thyroid>skin>lung>liver>breast. • E103 k factors were constant for all protocols, lower by ~8% compared to the universal k factor.

  7. Risks, radiation dose and image quality of mammography

    International Nuclear Information System (INIS)

    Menges, V.

    1979-01-01

    For some time to come, early detection of breast cancer will remain the only way to improve the therapeutical success. Mammography is an absolutely indispensible way to take advantage of this opportunity. Today, mammography is undoubtedly the most reliable method of examination for an early detection of breast cancer. Only mammography can detect carcinomas smaller than the critical tumour size of 1cm. If carried out properly and with present dose levels, it involves hardly any radiation risk. (orig.) [de

  8. Current estimates of radiation risks and implications for dose limits

    International Nuclear Information System (INIS)

    Clarke, R.H.

    1989-01-01

    The publication of the 1988 report of UNSCEAR represents a major step forward in that there is an international consensus on the estimation of risk from exposure to ionising radiation. The estimates of fatal cancers in the UNSCEAR report are up to 4 times the values in the 1977 review. This paper will describe the reasons for the increase, the remaining uncertainties and the implications for dose limits in occupational and public exposure. (author)

  9. Cancer risk from low doses of ionizing radiation

    International Nuclear Information System (INIS)

    Auvinen, A.

    1997-06-01

    The aim of the study was to estimate cancer risk from small doses of ionizing radiation from various sources, including both external and internal exposure. The types of radiation included alpha, gamma, and neutron radiation. A nationwide follow-up study covering the years up to 1992 revealed no significant association between fallout from the Chernobyl accident and incidence of childhood leukemia. An excess of eight cases or more per year could be excluded. However, some indication of an increase was evident in the most heavily affected areas. Furthermore, the risk estimates were in accordance with those reported from Hiroshima and Nagasaki, although the confidence intervals were wide. (282 refs.)

  10. Cancer risk from low doses of ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Auvinen, A

    1997-06-01

    The aim of the study was to estimate cancer risk from small doses of ionizing radiation from various sources, including both external and internal exposure. The types of radiation included alpha, gamma, and neutron radiation. A nationwide follow-up study covering the years up to 1992 revealed no significant association between fallout from the Chernobyl accident and incidence of childhood leukemia. An excess of eight cases or more per year could be excluded. However, some indication of an increase was evident in the most heavily affected areas. Furthermore, the risk estimates were in accordance with those reported from Hiroshima and Nagasaki, although the confidence intervals were wide. (282 refs.).

  11. Total Risk Management for Low Dose Radiation Exposures

    International Nuclear Information System (INIS)

    Simic, Z.; Mikulicic, V.; Sterc, D.

    2012-01-01

    Our civilization is witnessing about century of nuclear age mixed with enormous promises and cataclysmic threats. Nuclear energy seems to encapsulate both potential for pure good and evil or at least we humans are able to perceive that. These images are continuously with us and they are both helping and distracting from making best of nuclear potentials for civilization. Today with nuclear use significantly present and with huge potential to further improve our life with energy and medical use it is of enormous importance to try to have calmed, rational, and objective view on potential risks and certain benefits. Because all use of nuclear energy proved that their immediate risks are negligible (i.e., Three Mile Island and Fukushima) or much smaller than from the other alternatives (i.e., Chernobyl) it seems that the most important issue is the amount of risk from the long term effects to people from exposure to small doses of radiation. A similar issue is present in the increased use of modern computational tomography and other radiation sources use in medicine for examination and therapy. Finally, extreme natural exposures are third such potential risk sources. Definition of low doses varies depending on the way of delivery (i.e., single, multiple or continuous exposures), and for this paper usual dose of 100 mSv is selected as yearly upper amount. There are three very different scientifically supported views on the potential risks from the low doses exposure. The most conservative theory is that all radiation is harmful, and even small increments from background levels (i.e., 2-3 mSv) present additional risk. This view is called linear no threshold theory (LNT) and it is accepted as a regulatory conservative simple approach which guarantees safety. Risk is derived from the extrapolation of the measured effects of high levels of radiation. Opposite theory to LNT is hormesis which assumes that in fact small doses of radiation are helpful and they are improving our

  12. Mathematical phantoms for evaluation of age-specific internal dose

    International Nuclear Information System (INIS)

    Cristy, M.

    1980-01-01

    A series of mathematical phantoms representing children has been developed for use with photon transport codes. These phantoms, patterned after the Fisher-Snyder adult phantom, consist of simple mathematical expressions for the boundaries of the major organs and body sections. The location and shape of the organs are consistent with drawings depicting developmental anatomy, with the organ volumes assigned such that the masses at the various ages conform closely with the data presented in Reference Man. The explicit mathematical expressions for the various ages overcome the potential misrepresentation of organ sizes that occurred in phantoms derived from simple mathematical transformations of the adult phantom. Female breast tissue has been added to the phantoms, including the adult, now allowing assessment of doses to this organ

  13. Recommended environmental dose calculation methods and Hanford-specific parameters. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Schreckhise, R.G.; Rhoads, K.; Napier, B.A.; Ramsdell, J.V. [Pacific Northwest Lab., Richland, WA (United States); Davis, J.S. [Westinghouse Hanford Co., Richland, WA (United States)

    1993-03-01

    This document was developed to support the Hanford Environmental Dose overview Panel (HEDOP). The Panel is responsible for reviewing all assessments of potential doses received by humans and other biota resulting from the actual or possible environmental releases of radioactive and other hazardous materials from facilities and/or operations belonging to the US Department of Energy on the Hanford Site in south-central Washington. This document serves as a guide to be used for developing estimates of potential radiation doses, or other measures of risk or health impacts, to people and other biota in the environs on and around the Hanford Site. It provides information to develop technically sound estimates of exposure (i.e., potential or actual) to humans or other biotic receptors that could result from the environmental transport of potentially harmful materials that have been, or could be, released from Hanford operations or facilities. Parameter values and information that are specific to the Hanford environs as well as other supporting material are included in this document.

  14. Epistemological problems in assessing cancer risks at low radiation doses

    International Nuclear Information System (INIS)

    Walinder, G.

    1987-01-01

    Historically, biology has not been subjected to any epistemological analysis as has been the case with mathematics and physics. Our knowledge of the effects in biological systems of various stimuli proves to be dualistic in a complementary (although not mutually exclusive) way, which bears resemblance to the knowledge of phenomena in quantum physics. The dualistic limbs of biological knowledge are the action of stimuli and the response of the exposed, biological system. With regard to radiogenic cancer, this corresponds to the action of the ionizations and the response of the exposed mammal to that action, respectively. The following conclusions can be drawn from the present analysis: Predictions as to radiogenic cancer seem often if not always to have neglected the response variability (variations in radiosensitivity) in individuals or among individuals in populations, i.e. the predictions have been based exclusively on radiation doses and exposure conditions. The exposed individual or population, however, must be considered an open statistical system, i.e. a system in which predictions as to the effect of an agent are only conditionally possible. The knowledge is inverse to the size of the dose or concentration of the active agent. On epistemological grounds, we can not gain knowledge about the carcinogenic capacity of very low (non-dominant) radiation doses. Based on the same principle, we can not predict cancer risks at very low (non-dominant) radiation doses merely on the basis of models, or otherwise interpolated or extrapolated high-dose effects, observed under special exposure conditions

  15. Conceptus radiation dose and risk from chest screen-film radiography

    International Nuclear Information System (INIS)

    Damilakis, John; Perisinakis, Kostas; Dimovasili, Evangelia; Prassopoulos, Panos; Gourtsoyiannis, Nicholas; Varveris, Haralambos

    2003-01-01

    The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d a ) was estimated for 51 women of childbearing age from chest CT examinations. The value of d a was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10 -3 mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d a estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for

  16. Conceptus radiation dose and risk from chest screen-film radiography.

    Science.gov (United States)

    Damilakis, John; Perisinakis, Kostas; Prassopoulos, Panos; Dimovasili, Evangelia; Varveris, Haralambos; Gourtsoyiannis, Nicholas

    2003-02-01

    The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d(a)) was estimated for 51 women of childbearing age from chest CT examinations. The value of d(a) was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10(-3) mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d(a) estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for

  17. Conceptus radiation dose and risk from chest screen-film radiography

    Energy Technology Data Exchange (ETDEWEB)

    Damilakis, John; Perisinakis, Kostas; Dimovasili, Evangelia [Department of Medical Physics, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Prassopoulos, Panos; Gourtsoyiannis, Nicholas [Department of Radiology, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Varveris, Haralambos [Department of Radiotherapy, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece)

    2003-02-01

    The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d{sub a}) was estimated for 51 women of childbearing age from chest CT examinations. The value of d{sub a} was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10{sup -3} mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d{sub a} estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is

  18. High-Dose Citalopram and Escitalopram and the Risk of Out-of-Hospital Death.

    Science.gov (United States)

    Ray, Wayne A; Chung, Cecilia P; Murray, Katherine T; Hall, Kathi; Stein, C Michael

    2017-02-01

    Studies demonstrating that higher doses of citalopram (> 40 mg) and escitalopram (> 20 mg) prolong the corrected QT interval prompted regulatory agency warnings, which are controversial, given the absence of confirmatory clinical outcome studies. We compared the risk of potential arrhythmia-related deaths for high doses of these selective serotonin reuptake inhibitors (SSRIs) to that for equivalent doses of fluoxetine, paroxetine, and sertraline. The Tennessee Medicaid retrospective cohort study included 54,220 persons 30-74 years of age without cancer or other life-threatening illness who were prescribed high-dose SSRIs from 1998 through 2011. The mean age was 47 years, and 76% were female. Demographic characteristics and comorbidity for individual SSRIs were comparable. Because arrhythmia-related deaths are typically sudden and occur outside the hospital, we analyzed out-of-hospital sudden unexpected death as well as sudden cardiac deaths, a more specific indicator of proarrhythmic effects. The adjusted risk of sudden unexpected death for citalopram did not differ significantly from that for the other SSRIs. The respective hazard ratios (HRs) for citalopram versus escitalopram, fluoxetine, paroxetine, and sertraline were 0.84 (95% CI, 0.40-1.75), 1.24 (95% CI, 0.75-2.05), 0.75 (95% CI, 0.45-1.24), and 1.53 (95% CI, 0.91-2.55). There were no significant differences for sudden cardiac death or all study deaths, nor were there significant differences among high-risk patients (≥ 60 years of age, upper quartile baseline cardiovascular risk). Escitalopram users had no significantly increased risk for any study end point. We found no evidence that risk of sudden unexpected death, sudden cardiac death, or total mortality for high-dose citalopram and escitalopram differed significantly from that for comparable doses of fluoxetine, paroxetine, and sertraline. © Copyright 2016 Physicians Postgraduate Press, Inc.

  19. Risk and dose assessment methods in gamma knife QA

    International Nuclear Information System (INIS)

    Banks, W.W.; Jones, E.D.; Rathbun, P.

    1992-10-01

    Traditional methods used in assessing risk in nuclear power plants may be inappropriate to use in assessing medical radiation risks. The typical philosophy used in assessing nuclear reactor risks is machine dominated with only secondary attention paid to the human component, and only after critical machine failure events have been identified. In assessing the risk of a misadministrative radiation dose to patients, the primary source of failures seems to stem overwhelmingly, from the actions of people and only secondarily from machine mode failures. In essence, certain medical misadministrations are dominated by human events not machine failures. Radiological medical devices such as the Leksell Gamma Knife are very simple in design, have few moving parts, and are relatively free from the risks of wear when compared with a nuclear power plant. Since there are major technical differences between a gamma knife and a nuclear power plant, one must select a particular risk assessment method which is sensitive to these system differences and tailored to the unique medical aspects of the phenomena under study. These differences also generate major shifts in the philosophy and assumptions which drive the risk assessment (Machine-centered vs Person-centered) method. We were prompted by these basic differences to develop a person-centered approach to risk assessment which would reflect these basic philosophical and technological differences, have the necessary resolution in its metrics, and be highly reliable (repeatable). The risk approach chosen by the Livermore investigative team has been called the ''Relative Risk Profile Method'' and has been described in detail by Banks and Paramore, (1983)

  20. Radiation dose and cancer risk estimates in helical CT for pulmonary tuberculosis infections

    Directory of Open Access Journals (Sweden)

    Adeleye Bamise

    2017-12-01

    Full Text Available The preference for computed tomography (CT for the clinical assessment of pulmonary tuberculosis (PTB infections has increased the concern about the potential risk of cancer in exposed patients. In this study, we investigated the correlation between cancer risk and radiation doses from different CT scanners, assuming an equivalent scan protocol. Radiation doses from three 16-slice units were estimated using the CT-Expo dosimetry software version 2.4 and standard CT scan protocol for patients with suspected PTB infections. The lifetime risk of cancer for each scanner was determined using the methodology outlined in the BEIR VII report. Organ doses were significantly different (P < 0.05 between the scanners. The calculated effective dose for scanner H2 is 34% and 37% higher than scanners H3 and H1 respectively. A high and statistically significant correlation was observed between estimated lifetime cancer risk for both male (r2 = 0.943, P < 0.05 and female patients (r2 = 0.989, P < 0.05. The risk variation between the scanners was slightly higher than 2% for all ages but was much smaller for specific ages for male and female patients (0.2% and 0.7%, respectively. These variations provide an indication that the use of a scanner optimizing protocol is imperative.

  1. Radiation dose and cancer risk estimates in helical CT for pulmonary tuberculosis infections

    Science.gov (United States)

    Adeleye, Bamise; Chetty, Naven

    2017-12-01

    The preference for computed tomography (CT) for the clinical assessment of pulmonary tuberculosis (PTB) infections has increased the concern about the potential risk of cancer in exposed patients. In this study, we investigated the correlation between cancer risk and radiation doses from different CT scanners, assuming an equivalent scan protocol. Radiation doses from three 16-slice units were estimated using the CT-Expo dosimetry software version 2.4 and standard CT scan protocol for patients with suspected PTB infections. The lifetime risk of cancer for each scanner was determined using the methodology outlined in the BEIR VII report. Organ doses were significantly different (P < 0.05) between the scanners. The calculated effective dose for scanner H2 is 34% and 37% higher than scanners H3 and H1 respectively. A high and statistically significant correlation was observed between estimated lifetime cancer risk for both male (r2 = 0.943, P < 0.05) and female patients (r2 = 0.989, P < 0.05). The risk variation between the scanners was slightly higher than 2% for all ages but was much smaller for specific ages for male and female patients (0.2% and 0.7%, respectively). These variations provide an indication that the use of a scanner optimizing protocol is imperative.

  2. CANCER RISKS ATTRIBUTABLE TO LOW DOSES OF IONIZING RADIATION - ASSESSING WHAT WE REALLY KNOW?

    Science.gov (United States)

    Cancer Risks Attributable to Low Doses of Ionizing Radiation - What Do We Really Know?AbstractHigh doses of ionizing radiation clearly produce deleterious consequences in humans including, but not exclusively, cancer induction. At very low radiation doses the situatio...

  3. Research into specific risk assessment in project financing

    Directory of Open Access Journals (Sweden)

    Ivana Bestvina Bukvić

    2013-12-01

    Full Text Available An assessment of investment justification in terms of risk enables the decision maker (investor to select, among available alternatives, the one with the most favourable correlation between the expected profit and assumed risk. At the micro level, the uncertainty of business success is extremely high in production activities, which is an additional incentive for taking a comprehensive approach to the issue of investment decision-making and the development of risk assessment techniques applicable in this particular segment of industry. Given the complexity of the manufacturing process, the length of the production cycle, market conditions, and entity-specific risks (which are difficult to measure, projects in manufacturing industry require a detailed and comprehensive assessment of specific risk factors and their cost-effectiveness. Ne - vertheless, since specific risks can be diversified, investment proposal assessments in practice usually do not cover their quantification and analysis. However, the majority of business entities do not have enough active projects in various industries to be able to fully diversify their business and thus minimize the level of specific risks. The impact of specific factors becomes one of the most important elements for business success. This paper analyses how far risk assessment methods regarding specific risks are used in practice. Furthermore, it analyses the significance of specific risks for total investment risk. This study gives new insi - ghts into the significance of specific risks to the overall investment assessment and the need for permanent development of traditionally used investment assessment models.

  4. Size-specific dose estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Bria M.; Brady, Samuel L., E-mail: samuel.brady@stjude.org; Kaufman, Robert A. [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee 38105 (United States); Mirro, Amy E. [Department of Biomedical Engineering, Washington University, St Louis, Missouri 63130 (United States)

    2014-07-15

    Purpose: To investigate the correlation of size-specific dose estimate (SSDE) with absorbed organ dose, and to develop a simple methodology for estimating patient organ dose in a pediatric population (5–55 kg). Methods: Four physical anthropomorphic phantoms representing a range of pediatric body habitus were scanned with metal oxide semiconductor field effect transistor (MOSFET) dosimeters placed at 23 organ locations to determine absolute organ dose. Phantom absolute organ dose was divided by phantom SSDE to determine correlation between organ dose and SSDE. Organ dose correlation factors (CF{sub SSDE}{sup organ}) were then multiplied by patient-specific SSDE to estimate patient organ dose. The CF{sub SSDE}{sup organ} were used to retrospectively estimate individual organ doses from 352 chest and 241 abdominopelvic pediatric CT examinations, where mean patient weight was 22 kg ± 15 (range 5–55 kg), and mean patient age was 6 yrs ± 5 (range 4 months to 23 yrs). Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm; thus, showing appropriate scalability of the phantoms across the entire pediatric population in this study. IndividualCF{sub SSDE}{sup organ} were determined for a total of 23 organs in the chest and abdominopelvic region across nine weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7–1.4) and abdominopelvic region (average 0.9; range 0.7–1.3) was near unity. For organ/tissue that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1–0.4) for both the chest and abdominopelvic regions, respectively. A means to estimate patient organ dose was demonstrated. Calculated patient organ dose, using patient SSDE and CF{sub SSDE}{sup organ}, was compared to

  5. Dose and risk evaluation in digital mammography using computer modeling

    International Nuclear Information System (INIS)

    Correa, Samanda Cristine Arruda; Souza, Edmilson Monteiro de; Silva, Humberto de Oliveira; Silva, Ademir Xavier da; Lopes, Ricardo Tadeu; Magalhaes, Sarah Braga

    2010-01-01

    Digital mammography has been introduced in several countries in the last years. The new technology requires new optimising methods considering for instance the increased possibility of changing the absorbed dose, mainly in modern mammographic systems that allow the operator to choose the beam quality by varying the tube voltage, and filter and target materials. In this work, the Monte Carlo code MCNPX is used in order to investigate how the average glandular dose vary with tube voltage (23-32 kV) and anode-filter combination (Mo-Mo,Mo-Rh and Rh-Rh) in digital mammographic examinations. Furthermore, the risk of breast cancer incidence attributable to mammography exams was estimated using the Biological Effects of Ionizing Radiations (BEIR) VII Committee Report. The results show that the risk of breast cancer incidence in women younger than 30 years of age tends to decrease significantly using Rh-Rh anode-filter combination and higher tube voltage. For women older than 50 years of age the variation of tube voltage, and anode-filter combination did not influence the risk values considerably. (author)

  6. Dose and risk evaluation in digital mammography using computer modeling

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Samanda Cristine Arruda; Souza, Edmilson Monteiro de, E-mail: scorrea@nuclear.ufrj.b, E-mail: emonteiro@nuclear.ufrj.b [Centro Universitario Estadual da Zona Oeste (CCMAT/UEZO), Rio de Janeiro, RJ (Brazil); Silva, Humberto de Oliveira, E-mail: hbetorj@gmail.co [Universidade Federal do Rio de Janeiro IF/UFRJ, RJ (Brazil). Inst. de Fisica; Silva, Ademir Xavier da; Lopes, Ricardo Tadeu; Magalhaes, Sarah Braga, E-mail: ademir@nuclear.ufrj.b, E-mail: ricardo@lin.ufrj.b, E-mail: smagalhaes@nuclear.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear

    2010-07-01

    Digital mammography has been introduced in several countries in the last years. The new technology requires new optimising methods considering for instance the increased possibility of changing the absorbed dose, mainly in modern mammographic systems that allow the operator to choose the beam quality by varying the tube voltage, and filter and target materials. In this work, the Monte Carlo code MCNPX is used in order to investigate how the average glandular dose vary with tube voltage (23-32 kV) and anode-filter combination (Mo-Mo,Mo-Rh and Rh-Rh) in digital mammographic examinations. Furthermore, the risk of breast cancer incidence attributable to mammography exams was estimated using the Biological Effects of Ionizing Radiations (BEIR) VII Committee Report. The results show that the risk of breast cancer incidence in women younger than 30 years of age tends to decrease significantly using Rh-Rh anode-filter combination and higher tube voltage. For women older than 50 years of age the variation of tube voltage, and anode-filter combination did not influence the risk values considerably. (author)

  7. Mechanisms of Enhanced Cell Killing at Low Doses: Implications for Radiation Risk

    International Nuclear Information System (INIS)

    Johnston, Peter J.; Wilson, George D.

    2003-01-01

    We have shown that cell lethality actually measured after exposure to low-doses of low-LET radiation, is markedly enhanced relative to the cell lethality previously expected by extrapolation of the high-dose cell-killing response. Net cancer risk is a balance between cell transformation and cell kill and such enhanced lethality may more than compensate for transformation at low radiation doses over a least the first 10 cGy of low-LET exposure. This would lead to a non-linear, threshold, dose-risk relationship. Therefore our data imply the possibility that the adverse effects of small radiation doses (<10 cGy) could be overestimated in specific cases. It is now important to research the mechanisms underlying the phenomenon of low-dose hypersensitivity to cell killing, in order to determine whether this can be generalized to safely allow an increase in radiation exposure limits. This would have major cost-reduction implications for the whole EM program

  8. Evaluating the Application of Tissue-Specific Dose Kernels Instead of Water Dose Kernels in Internal Dosimetry : A Monte Carlo Study

    NARCIS (Netherlands)

    Moghadam, Maryam Khazaee; Asl, Alireza Kamali; Geramifar, Parham; Zaidi, Habib

    2016-01-01

    Purpose: The aim of this work is to evaluate the application of tissue-specific dose kernels instead of water dose kernels to improve the accuracy of patient-specific dosimetry by taking tissue heterogeneities into consideration. Materials and Methods: Tissue-specific dose point kernels (DPKs) and

  9. The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Joana; Paulo, Graciano [Instituto Politecnico de Coimbra, ESTESC, DMIR, Coimbra (Portugal); Foley, Shane; Rainford, Louise [University College Dublin, School of Medicine and Medical Science, Health Science Centre, Dublin 4 (Ireland); McEntee, Mark F. [The University of Sydney, Faculty of Health Sciences, Cumberland Campus, Sydney (Australia)

    2015-11-15

    The volume of CT examinations has increased with resultant increases in collective dose values over the last decade. To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations. Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed. Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693). Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings. (orig.)

  10. The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomography

    International Nuclear Information System (INIS)

    Santos, Joana; Paulo, Graciano; Foley, Shane; Rainford, Louise; McEntee, Mark F.

    2015-01-01

    The volume of CT examinations has increased with resultant increases in collective dose values over the last decade. To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations. Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed. Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693). Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings. (orig.)

  11. Low Dose Radiation Cancer Risks: Epidemiological and Toxicological Models

    Energy Technology Data Exchange (ETDEWEB)

    David G. Hoel, PhD

    2012-04-19

    The basic purpose of this one year research grant was to extend the two stage clonal expansion model (TSCE) of carcinogenesis to exposures other than the usual single acute exposure. The two-stage clonal expansion model of carcinogenesis incorporates the biological process of carcinogenesis, which involves two mutations and the clonal proliferation of the intermediate cells, in a stochastic, mathematical way. The current TSCE model serves a general purpose of acute exposure models but requires numerical computation of both the survival and hazard functions. The primary objective of this research project was to develop the analytical expressions for the survival function and the hazard function of the occurrence of the first cancer cell for acute, continuous and multiple exposure cases within the framework of the piece-wise constant parameter two-stage clonal expansion model of carcinogenesis. For acute exposure and multiple exposures of acute series, it is either only allowed to have the first mutation rate vary with the dose, or to have all the parameters be dose dependent; for multiple exposures of continuous exposures, all the parameters are allowed to vary with the dose. With these analytical functions, it becomes easy to evaluate the risks of cancer and allows one to deal with the various exposure patterns in cancer risk assessment. A second objective was to apply the TSCE model with varing continuous exposures from the cancer studies of inhaled plutonium in beagle dogs. Using step functions to estimate the retention functions of the pulmonary exposure of plutonium the multiple exposure versions of the TSCE model was to be used to estimate the beagle dog lung cancer risks. The mathematical equations of the multiple exposure versions of the TSCE model were developed. A draft manuscript which is attached provides the results of this mathematical work. The application work using the beagle dog data from plutonium exposure has not been completed due to the fact

  12. Risk-informed approach in US-APWR technical specifications

    International Nuclear Information System (INIS)

    Saji, Etsuro; Tanaka, Futoshi; Kuroiwa, Katsuya; Kawai, Katsunori

    2009-01-01

    The Risk-Managed Technical Specifications and the Surveillance Frequency Control Program have been adopted in the US-APWR Technical Specifications. These risk-informed approaches are unique among the technical specifications for the advanced light water reactor designs adopted by planned nuclear power stations in the United States. (author)

  13. Specific aspects of insurance of nuclear risks

    International Nuclear Information System (INIS)

    Angelici, C.

    1980-03-01

    The following questions are discussed in connection with the insurance of nuclear risks: insurance techniques, the nuclear operator's limitation of liability in amount and in time, its channelling, the principle of sole liability and exonerations, the insurers' position, the cover provided and state intervention beyond that amount. (NEA) [fr

  14. Radiation dose and risk in gastrointestinal roentgendiagnostic of the child

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, H; Loehr, H; Wallbaum, F [Hamburg Univ. (Germany, F.R.). Abt. fuer Roentgendiagnostik

    1978-11-01

    In gastrointestinal roentgendiagnostic of the child the exposure of the skin and the testis depends on body height and body weight. The dose grows with the age. The squaredose product (Rcm/sup 2/) and the energy absorbed by the body(integraldose, rdkg)increases comparably. On the other hand the quotient integraldosis/body weight is similar for the different age-groups. The radiation risk (the probability to die as consequence of a roentgenray induced disease) is approximately 1:100,000 to 1:10,000,000.

  15. Re-distribution of brachytherapy dose using a differential dose prescription adapted to risk of local failure in low-risk prostate cancer patients

    DEFF Research Database (Denmark)

    Rylander, Susanne; Polders, Daniel; Steggerda, Marcel J

    2015-01-01

    BACKGROUND AND PURPOSE: We investigated the application of a differential target- and dose prescription concept for low-dose-rate prostate brachytherapy (LDR-BT), involving a re-distribution of dose according to risk of local failure and treatment-related morbidity. MATERIAL AND METHODS: Our study......- and dose prescription concept of prescribing a lower dose to the whole gland and an escalated dose to the GTV using LDR-BT seed planning was technically feasible and resulted in a significant dose-reduction to urethra and bladder neck....

  16. Application of probabilistic quantitative ecological risk assessment to radiological dose

    International Nuclear Information System (INIS)

    Twining, J.; Ferris, J.; Copplestone, D.; Zinger, I.

    2004-01-01

    Probabilistic ERA is becoming more accepted and applied in evaluations of environmental impacts worldwide. In a previous paper we have shown that the process can be applied in practice to routine effluent releases from a nuclear facility. However, there are practical issues that need to be addressed prior to its regulatory application for criteria setting or for site-specific ERA. Among these issues are a) appropriate data selection for both exposure and dose-response input, because there is a need to carefully characterise and filter the available dose-response data for its ecological relevance, b) A coherent approach is required to the choice of exposure scenarios, and c) there are various questions associated with treatment of exposure to mixed nuclides. In this paper we will evaluate and discuss aspects of these issues, using an illustrative case study approach. (author)

  17. Patient absorbed dose and radiation risk in nuclear medicine

    International Nuclear Information System (INIS)

    Hetherington, E.; Cochrane, P.

    1992-01-01

    Since the introduction of technetium-99m labelled radiopharmaceuticals used as imaging agents in the nuclear medicine departments of Australian hospitals, patients have voiced concern about the effect of having radioactive materials injected into their bodies. The danger of X-ray exposure is widely known and well accepted, as is exposure to ultrasound, computed tomography scans and other imaging techniques. However, radioactivity is an unknown, and fear of the unknown can occasionally lead to patients refusing to undergo a nuclear medicine procedure. The authors emphasised that the radiation dose to a patient from a typical procedure would depend on the patient's medical history and treatment; the average dose being approximately 50 times the exposure received from the natural environmental background radiation. Furthermore, over an extended period the body can repair most minor damage caused by radiation, just as the body can repair the damage caused by sunburn resulting from too much exposure to sunlight. The risk of genetic effects as a result of a medical radiation dose is than very small

  18. Risk at Low Doses: Scientific knowledge, uncertainties and management

    International Nuclear Information System (INIS)

    Giusssani, A.; Ballarini, F.; Ottolenghi, A.

    2002-01-01

    Most of the applications of ionizing radiation in the medical field, for the exposed workers as well as the majority of patients undergoing diagnostic examinations, can be seen as low situations. Epidemiological information is however available for dose and dose rates higher than the values typical of most medical situation. Main source of information is the Life Span Study (LSS) of Japanese. A-bomb survivors, supplemented by studies of selected groups of exposed workers (uranium miners, radium painters) or radiotherapy patients with a detailed follow-up history. All of these group studies, however, suffer from one or more of the following limitations: - lack of adequate dosimetry - lack of a reliable control group for the necessary comparison - influence of concomitant factors (not always easy to find out) - influence of social conditions. In addition exposed study populations are different than the population of patients for which the risk estimates are needed in the medical situation. Recent studies aimed to evaluate the available data on the cohorts of the inhabitants of the Techa river settlements as well as of the workers of the Mayak nuclear facilities may provide in the future useful information on large populations chronically exposed to relatively low doses. (Author)

  19. Decision-Making Competence Predicts Domain-Specific Risk Attitudes

    Directory of Open Access Journals (Sweden)

    Joshua eWeller

    2015-05-01

    Full Text Available Decision Making Competence (DMC reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804 completed an online DMC measure, using a subset of the original Adult-DMC battery (A-DMC; Bruine de Bruin, Parker, & Fischhoff, 2007. Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC  expected benefits  risk-taking than the DMC  perceived riskrisk-taking path, especially for risk behaviors that may be considered more antisocial in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of the given behavior.

  20. Youth suicide attempts and the dose-response relationship to parental risk factors: a population-based study

    DEFF Research Database (Denmark)

    Christiansen, E; Goldney, R D; Beautrai, A L

    2011-01-01

    BACKGROUND: There is a lack of specific knowledge about the dose-response effect of multiple parental risk factors for suicide attempts among children and adolescents. The aim of this study was to determine the dose-response effect of multiple parental risk factors on an offspring's risk for suic......BACKGROUND: There is a lack of specific knowledge about the dose-response effect of multiple parental risk factors for suicide attempts among children and adolescents. The aim of this study was to determine the dose-response effect of multiple parental risk factors on an offspring's risk...... for suicide attempt.MethodWe designed a population-based two-generation nested case-control study and used Danish register data. A population of 403 431 individuals born between 1983 and 1989 was sampled. Among these, 3465 (0.8%) were registered as having had a suicide attempt. Twenty controls were matched...... to each case and a link to the offspring's biological parents was established. RESULTS: There was a dose-response relationship between the number of exposures and the risk of suicide attempts, with the increased risk seeming to be a multiplicative effect. Parental suicide, suicide attempt, psychiatric...

  1. Coenoses risk assessment in industry (resource specificity

    Directory of Open Access Journals (Sweden)

    Tyaglov Sergey, G.

    2015-09-01

    Full Text Available The modernization of the economic infrastructure of modern Russia is now essential, taking a natural limiter necessary momentum, which is especially important in the current conditions of global trends and taking into account the efforts taken by the State, aimed at large-scale growth of production of Russian companies. This paper discusses the direction of overcoming the problem of lack of access to financial services to business entities, due to the lack of a universal tool to identify risks in the provision of credit resources to the understanding that, despite the differences in interpretation of Russian and foreign sources, is a complex of ontological perception of researchers, proposed expanded by generally accepted phenomenon of self-organization. It is proposed to assess the risks of the enterprises on the basis of the provisions of coenoses theory, which allows using a few key parameters to determine the degree of efficiency of use of available resources, to identify the stability of the enterprise as a system and predict its dynamic changes.

  2. Radioiodine Therapy of Hyperthyroidism. Simplified patient-specific absorbed dose planning

    Energy Technology Data Exchange (ETDEWEB)

    Joensson, Helene

    2003-10-01

    Radioiodine therapy of hyperthyroidism is the most frequently performed radiopharmaceutical therapy. To calculate the activity of {sup 131}I to be administered for giving a certain absorbed dose to the thyroid, the mass of the thyroid and the individual biokinetic data, normally in the form of uptake and biologic half-time, have to be determined. The biologic half-time is estimated from several uptake measurements and the first one is usually made 24 hours after the intake of the test activity. However, many hospitals consider it time-consuming since at least three visits of the patient to the hospital are required (administration of test activity, first uptake measurement, second uptake measurement plus treatment). Instead, many hospitals use a fixed effective half-time or even a fixed administered activity, only requiring two visits. However, none of these methods considers the absorbed dose to the thyroid of the individual patient. In this work a simplified patient-specific method for treating hyperthyroidism is proposed, based on one single uptake measurement, thus requiring only two visits to the hospital. The calculation is as accurate as using the individual biokinetic data. The simplified method is as patient-convenient and time effective as using a fixed effective half-time or a fixed administered activity. The simplified method is based upon a linear relation between the late uptake measurement 4-7 days after intake of the test activity and the product of the extrapolated initial uptake and the effective half-time. Treatments not considering individual biokinetics in the thyroid result in a distribution of administered absorbed dose to the thyroid, with a range of -50 % to +160 % compared to a protocol calculating the absorbed dose to the thyroid of the individual patient. Treatments with a fixed administered activity of 370 MBq will in general administer 250 % higher activity to the patient, with a range of -30 % to +770 %. The absorbed dose to other

  3. Lung cancer risk at low doses of alpha particles

    International Nuclear Information System (INIS)

    Hofmann, W.; Katz, R.; Zhang, C.X.

    1986-01-01

    A survey of inhabitant exposures arising from the inhalation of 222 Rn and 220 Rn progeny, and lung cancer mortality has been carried out in two adjacent areas in Guangdong Province, People's Republic of China, designated as the high background and the control area. Annual exposure rates are 0.38 working level months (WLM) per year in the high background, and 0.16 WLM/yr in the control area. In 14 yr of continuous study, from 1970 to 1983, age-adjusted mortality rates were found to be 2.7 per 10(5) living persons of all ages in the high background area, and 2.9 per 10(5) living persons in the control area. From this data, we conclude that we are unable to determine excess lung cancers over the normal fluctuations below a cumulative exposure of 15 WLM. This conclusion is supported by lung cancer mortality data from Austrian and Finnish high-background areas. A theoretical analysis of epidemiological data on human lung cancer incidence from inhaled 2 ]2'' 2 Rn and 220 Rn progeny, which takes into account cell killing as competitive with malignant transformation, leads to the evaluation of a risk factor which is either a linear-exponential or a quadratic-exponential function of the alpha-particle dose. Animal lung cancer data and theoretical considerations can be supplied to support either hypothesis. Thus we conclude that at our current stage of knowledge both the linear-exponential and the quadratic-exponential extrapolation to low doses seem to be equally acceptable for Rn-induced lung cancer risk, possibly suggesting a linear-quadratic transformation function with an exponential cell-killing term, or the influence of risk-modifying factors such as repair or proliferation stimuli

  4. Gender-specific calculation of the effective dose: The example of thoracic computer tomography

    International Nuclear Information System (INIS)

    Boetticher, H. von; Lachmund, J.; Hoffmann, W.

    2003-01-01

    Systematic gender-specific differences in anatomy and physiology are mostly neglected in standard methodologies for the determination of effective doses. This paper presents and discusses three different concepts for the derivation of gender-specific effective doses. Based on the most convincing approach - especially through the influence of tissue weighting factors for the breast - the effective dose for a serial CT scan of the chest is higher for women (+11%) and lower (-11%) for men in comparison to the 'gender-neutral' average value. These differences amount to ±30% for coronary serial CT applications. (orig.) [de

  5. Customer-Specific Transaction Risk Management in E-Commerce

    Science.gov (United States)

    Ruch, Markus; Sackmann, Stefan

    Increasing potential for turnover in e-commerce is inextricably linked with an increase in risk. Online retailers (e-tailers), aiming for a company-wide value orientation should manage this risk. However, current approaches to risk management either use average retail prices elevated by an overall risk premium or restrict the payment methods offered to customers. Thus, they neglect customer-specific value and risk attributes and leave turnover potentials unconsidered. To close this gap, an innovative valuation model is proposed in this contribution that integrates customer-specific risk and potential turnover. The approach presented evaluates different payment methods using their risk-turnover characteristic, provides a risk-adjusted decision basis for selecting payment methods and allows e-tailers to derive automated risk management decisions per customer and transaction without reducing turnover potential.

  6. Toxicity risk of non-target organs at risk receiving low-dose radiation: case report

    International Nuclear Information System (INIS)

    Shueng, Pei-Wei; Lin, Shih-Chiang; Chang, Hou-Tai; Chong, Ngot-Swan; Chen, Yu-Jen; Wang, Li-Ying; Hsieh, Yen-Ping; Hsieh, Chen-Hsi

    2009-01-01

    The spine is the most common site for bone metastases. Radiation therapy is a common treatment for palliation of pain and for prevention or treatment of spinal cord compression. Helical tomotherapy (HT), a new image-guided intensity modulated radiotherapy (IMRT), delivers highly conformal dose distributions and provides an impressive ability to spare adjacent organs at risk, thus increasing the local control of spinal column metastases and decreasing the potential risk of critical organs under treatment. However, there are a lot of non-target organs at risk (OARs) occupied by low dose with underestimate in this modern rotational IMRT treatment. Herein, we report a case of a pathologic compression fracture of the T9 vertebra in a 55-year-old patient with cholangiocarcinoma. The patient underwent HT at a dose of 30 Gy/10 fractions delivered to T8-T10 for symptom relief. Two weeks after the radiotherapy had been completed, the first course of chemotherapy comprising gemcitabine, fluorouracil, and leucovorin was administered. After two weeks of chemotherapy, however, the patient developed progressive dyspnea. A computed tomography scan of the chest revealed an interstitial pattern with traction bronchiectasis, diffuse ground-glass opacities, and cystic change with fibrosis. Acute radiation pneumonitis was diagnosed. Oncologists should be alert to the potential risk of radiation toxicities caused by low dose off-targets and abscopal effects even with highly conformal radiotherapy

  7. Evaluation of risk effective STIs with specific application to diesels

    International Nuclear Information System (INIS)

    Vesely, W.E.; Samanta, P.K.; Ginzburg, T.

    1987-01-01

    From a risk standpoint, the objective of surveillance tests is to control the risk arising from failures which can occur while the component is on standby. At the same time, risks caused by the test from test-caused failures and test-caused degradations need also to be controlled. Risk-acceptable test intervals balance these risks in an attempt to achieve an acceptable low, overall risk. Risk and reliability approaches are presented which allow risk-acceptable test intervals to be determined for any component. To provide focus for the approaches, diesels are specifically evaluated, however, the approaches can be applied not only to diesels, but to any component with suitable data. Incorporation of the approaches in personal computer (PC) software is discussed, which can provide tools for the regulator or plant personnel for determining acceptable diesel test intervals for any plant specific or generic application. The FRANTIC III computer code was run to validate the approaches and to evaluate specific issues associated with determining risk effective test intervals for diesels. Using the approaches presented, diesel accident unavailability can be more effectively monitored and be controlled on a plant-specific or generic basis. Test intervals can be made more risk effective than they are now, producing more acceptable accident unavailabilities. The methods presented are one step toward performance-based technical specifications, which more directly control risks

  8. Cumulative effective dose and cancer risk for pediatric population in repetitive full spine follow-up imaging: How micro dose is the EOS microdose protocol?

    Science.gov (United States)

    Law, Martin; Ma, Wang-Kei; Lau, Damian; Cheung, Kenneth; Ip, Janice; Yip, Lawrance; Lam, Wendy

    2018-04-01

    To evaluate and to obtain analytic formulation for the calculation of the effective dose and associated cancer risk using the EOS microdose protocol for scoliotic pediatric patients undergoing full spine imaging at different age of exposure; to demonstrate the microdose protocol capable of delivering lesser radiation dose and hence of further reducing cancer risk induction when compared with the EOS low dose protocol; to obtain cumulative effective dose and cancer risk for both genders scoliotic pediatrics of US and Hong Kong population using the microdose protocol. Organ absorbed doses of full spine exposed scoliotic pediatric patients have been simulated with the use of EOS microdose protocol imaging parameters input to the Monte Carlo software PCXMC. Gender and age specific effective dose has been calculated with the simulated organ absorbed dose using the ICRP-103 approach. The associated radiation induced cancer risk, expressed as lifetime attributable risk (LAR), has been estimated according to the method introduced in the Biological Effects of Ionizing Radiation VII report. Values of LAR have been estimated for scoliotic patients exposed repetitively during their follow up period at different age for US and Hong Kong population. The effective doses of full spine imaging with simultaneous posteroanterior and lateral projection for patients exposed at the age between 5 and 18 years using the EOS microdose protocol have been calculated within the range of 2.54-14.75 μSv. The corresponding LAR for US and Hong Kong population was ranged between 0.04 × 10 -6 and 0.84 × 10 -6 . Cumulative effective dose and cancer risk during follow-up period can be estimated using the results and are of information to patients and their parents. With the use of computer simulation and analytic formulation, we obtained the cumulative effective dose and cancer risk at any age of exposure for pediatric patients of US and Hong Kong population undergoing repetitive

  9. Low dose radiation and ALARA: the potential risks to patients and staff from alpha-therapy

    International Nuclear Information System (INIS)

    Priest, N.D.

    2014-01-01

    This year a new drug containing radium-223, an alpha-emitting radionuclide, was approved for use by the US Food and Drug Administration for the palliative treatment of advanced prostate cancer metastases. Other drugs containing short-lived alpha-emitters are on clinical trial in Europe. Commonly, these employ a radionuclide attached to an antibody that specifically targets tumor cells to produce a highly localized radio-therapeutic dose to the tumor. However, normal tissues within the body will also be irradiated, albeit sometimes at low dose, and the question arises as to whether this presents a significant additional risk to the patient. Similarly, medical staff that handle these radionuclides could receive intakes of the radionuclides. What is the risk to staff? To assess the risk resulting from small tissue alpha-doses the toxicological, both human and animal, database was re-examined. The results of 20 epidemiological and toxicological studies with alpha-emitting radionuclides were analysed. In all cases a polynomial function provided a better fit to the data than a linear, no thresholds function. Also, in 19 cases a threshold dose below which no cancer is seen was indicated. The position of this threshold varied according to cancer type, but was typically in the range 0.1 to 1.0Gy of tissue dose - with a mean of 0.5Gy. It is concluded that alpha-radiation induced tumorogenesis is a threshold response and that as long as tissue doses are kept below these thresholds no additional cancers would be seen in either patients receiving alpha-therapy or in staff exposed to 'spilt' radionuclide. The presence of thresholds questions the appropriateness of current ALARA practices that are mostly used to drive occupational alpha-radiation exposures to as close to zero as possible. (author)

  10. Low dose radiation and ALARA: the potential risks to patients and staff from alpha-therapy

    Energy Technology Data Exchange (ETDEWEB)

    Priest, N.D. [Atomic Energy of Canada Limited, Chalk River, ON (Canada)

    2014-07-01

    This year a new drug containing radium-223, an alpha-emitting radionuclide, was approved for use by the US Food and Drug Administration for the palliative treatment of advanced prostate cancer metastases. Other drugs containing short-lived alpha-emitters are on clinical trial in Europe. Commonly, these employ a radionuclide attached to an antibody that specifically targets tumor cells to produce a highly localized radio-therapeutic dose to the tumor. However, normal tissues within the body will also be irradiated, albeit sometimes at low dose, and the question arises as to whether this presents a significant additional risk to the patient. Similarly, medical staff that handle these radionuclides could receive intakes of the radionuclides. What is the risk to staff? To assess the risk resulting from small tissue alpha-doses the toxicological, both human and animal, database was re-examined. The results of 20 epidemiological and toxicological studies with alpha-emitting radionuclides were analysed. In all cases a polynomial function provided a better fit to the data than a linear, no thresholds function. Also, in 19 cases a threshold dose below which no cancer is seen was indicated. The position of this threshold varied according to cancer type, but was typically in the range 0.1 to 1.0Gy of tissue dose - with a mean of 0.5Gy. It is concluded that alpha-radiation induced tumorogenesis is a threshold response and that as long as tissue doses are kept below these thresholds no additional cancers would be seen in either patients receiving alpha-therapy or in staff exposed to 'spilt' radionuclide. The presence of thresholds questions the appropriateness of current ALARA practices that are mostly used to drive occupational alpha-radiation exposures to as close to zero as possible. (author)

  11. Radiation Dose Effects into LCO in Technical Specification by Iodine in Hanul units 1,2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hye Min; Lee, Seung Chan [KHNP Central Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    This study estimates the impact of the 1-th coolant system in NPP to the LCO (Limiting Condition of Operation) limits which is in the site boundary. Dose limit is merged into the effective dose from whole body and thyroid dose limits, that is possible to combine the two LCOs to a unified LCO. To estimate the limits, the radiation dose of one of the designed accidents should be chosen to check the radiation dose response. The selected accident is based on Seung Chan Lee's study at KHNP in 2011. Using the selected accident, Iodine dose effect is reviewed depending on the LCO limiting responsibility and the specific behavior. In order to evaluate the radiation dose effect in Technical Specification of Hanul 1,2, SGTR is selected for some sensitivity analysis. From the results, in Hanul site, the case of LOOP plus ADV plus GIS is the most severe case and the dose limit margin is about 110% in LCO.

  12. Risk of low-doses in radiodiagnosis; Risque des faibles doses en radiodiagnostic. Mythes, reglementation et rationalite

    Energy Technology Data Exchange (ETDEWEB)

    Cordoliani, Y.S.; Sarrazin, J.L.; Le Frian, G.; Soulie, D.; Leveque, C. [Hopital d`Instruction des Armees du Val-de-Grace, 75 - Paris (France)

    1997-12-31

    The effect of low doses of X-rays is inferred from the indubitable effects of high doses in human carcinogenesis, Genetic and teratogenic effects are mainly inferred from animal experimentation because clinical surveys of irradiated pregnant women have failed to demonstrate such consequences in the children, except for mental retardation after Japanese atomic bombing. Since no evidence of carcinogenic effect has been produced by epidemiological studies for doses lower than 500 mSv. the estimation of the risk due to low doses has been extrapolated from the linear relation between dose and cancers at high doses. Such an extrapolation gives a maximal risk which is falsely used as a probability of cancer. The actual risk lies between zero and this maximal number, and many epidemiologic surveys in people receiving doses much higher than the mean level of background irradiation failed to demonstrate higher rate of cancer. The explanation of this fact, which is supported by the most recent biological data, is the efficacy of the DNA repair system at low level of exposure to ionizing radiations. We expose the principles of regulation of radioprotection for workers, and give estimations of the doses delivered to the patients and the personnel by diagnostic investigations, by comparing these doses with those of natural irradiation. Practical aspect for conventional and computed radiology are exposed for patients and workers. (authors)

  13. SPECIFIC METHOD OF RISK ASSESSMENT IN TOURISM ENTERPRISES

    Directory of Open Access Journals (Sweden)

    Andreea ARMEAN

    2014-12-01

    Full Text Available The objective of this paper is to present an innovative method of risk assessment for tourism businesses. The contribution to literature is the novelty of this method of following paths: is an ante-factum assessment not post-factum; risk assessment is based on perception rather than results; is based on specific risks tourism enterprises not on the overall risks. Is an asset-research methodology and consists in generating its own method of risk assessment based on the ideas summarized from the literature studied. The aim established is tourism enterprises from Romania. The data necessary for the application of this method will result from applying to top level management of tourism enterprises, a questionnaire about risk perception. The results from this study will help identify and measure the risks specific to tourism enterprises. The applicability of the results is to improve risk management in these enterprises.

  14. Cardiovascular risks associated with low dose ionizing particle radiation.

    Directory of Open Access Journals (Sweden)

    Xinhua Yan

    Full Text Available Previous epidemiologic data demonstrate that cardiovascular (CV morbidity and mortality may occur decades after ionizing radiation exposure. With increased use of proton and carbon ion radiotherapy and concerns about space radiation exposures to astronauts on future long-duration exploration-type missions, the long-term effects and risks of low-dose charged particle irradiation on the CV system must be better appreciated. Here we report on the long-term effects of whole-body proton ((1H; 0.5 Gy, 1 GeV and iron ion ((56Fe; 0.15 Gy, 1GeV/nucleon irradiation with and without an acute myocardial ischemia (AMI event in mice. We show that cardiac function of proton-irradiated mice initially improves at 1 month but declines by 10 months post-irradiation. In AMI-induced mice, prior proton irradiation improved cardiac function restoration and enhanced cardiac remodeling. This was associated with increased pro-survival gene expression in cardiac tissues. In contrast, cardiac function was significantly declined in (56Fe ion-irradiated mice at 1 and 3 months but recovered at 10 months. In addition, (56Fe ion-irradiation led to poorer cardiac function and more adverse remodeling in AMI-induced mice, and was associated with decreased angiogenesis and pro-survival factors in cardiac tissues at any time point examined up to 10 months. This is the first study reporting CV effects following low dose proton and iron ion irradiation during normal aging and post-AMI. Understanding the biological effects of charged particle radiation qualities on the CV system is necessary both for the mitigation of space exploration CV risks and for understanding of long-term CV effects following charged particle radiotherapy.

  15. Development of Organ-Specific Donor Risk Indices

    OpenAIRE

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.

    2012-01-01

    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in devel...

  16. Can we avoid high levels of dose escalation for high-risk prostate cancer in the setting of androgen deprivation?

    Science.gov (United States)

    Shakespeare, Thomas P; Wilcox, Shea W; Aherne, Noel J

    2016-01-01

    Both dose-escalated external beam radiotherapy (DE-EBRT) and androgen deprivation therapy (ADT) improve outcomes in patients with high-risk prostate cancer. However, there is little evidence specifically evaluating DE-EBRT for patients with high-risk prostate cancer receiving ADT, particularly for EBRT doses >74 Gy. We aimed to determine whether DE-EBRT >74 Gy improves outcomes for patients with high-risk prostate cancer receiving long-term ADT. Patients with high-risk prostate cancer were treated on an institutional protocol prescribing 3-6 months neoadjuvant ADT and DE-EBRT, followed by 2 years of adjuvant ADT. Between 2006 and 2012, EBRT doses were escalated from 74 Gy to 76 Gy and then to 78 Gy. We interrogated our electronic medical record to identify these patients and analyzed our results by comparing dose levels. In all, 479 patients were treated with a 68-month median follow-up. The 5-year biochemical disease-free survivals for the 74 Gy, 76 Gy, and 78 Gy groups were 87.8%, 86.9%, and 91.6%, respectively. The metastasis-free survivals were 95.5%, 94.5%, and 93.9%, respectively, and the prostate cancer-specific survivals were 100%, 94.4%, and 98.1%, respectively. Dose escalation had no impact on any outcome in either univariate or multivariate analysis. There was no benefit of DE-EBRT >74 Gy in our cohort of high-risk prostate patients treated with long-term ADT. As dose escalation has higher risks of radiotherapy-induced toxicity, it may be feasible to omit dose escalation beyond 74 Gy in this group of patients. Randomized studies evaluating dose escalation for high-risk patients receiving ADT should be considered.

  17. Active specific immunotherapy using the immune reaction of a low-dose irradiated tumor tissue

    International Nuclear Information System (INIS)

    Ogawa, Y.; Imanaka, K.; Ashida, C.; Takashima, H.; Imajo, Y.; Kimura, S.

    1983-01-01

    Active specific immunotherapy using the immune reaction of a low-dose irradiated tumor tissue was studied on the transplanted MM46 tumor of female C3H/He mice after radiotherapy. MM46 tumor cells were inoculated into the right hind paws of mice. On the 5th day, irradiation with the dose irradiated tumor tissue (2000 rad on the fifth day), were injected into the left hind paws of the tumor-bearing mice. Effectiveness of this active specific immunotherapy against tumor was evaluated by the regression of tumor and survival rate of mice. Tumor was markedly regressed and survival rate was significantly increased by the active specific immunitherapy

  18. Monte Carlo MCNP-4B-based absorbed dose distribution estimates for patient-specific dosimetry.

    Science.gov (United States)

    Yoriyaz, H; Stabin, M G; dos Santos, A

    2001-04-01

    This study was intended to verify the capability of the Monte Carlo MCNP-4B code to evaluate spatial dose distribution based on information gathered from CT or SPECT. A new three-dimensional (3D) dose calculation approach for internal emitter use in radioimmunotherapy (RIT) was developed using the Monte Carlo MCNP-4B code as the photon and electron transport engine. It was shown that the MCNP-4B computer code can be used with voxel-based anatomic and physiologic data to provide 3D dose distributions. This study showed that the MCNP-4B code can be used to develop a treatment planning system that will provide such information in a time manner, if dose reporting is suitably optimized. If each organ is divided into small regions where the average energy deposition is calculated with a typical volume of 0.4 cm(3), regional dose distributions can be provided with reasonable central processing unit times (on the order of 12-24 h on a 200-MHz personal computer or modest workstation). Further efforts to provide semiautomated region identification (segmentation) and improvement of marrow dose calculations are needed to supply a complete system for RIT. It is envisioned that all such efforts will continue to develop and that internal dose calculations may soon be brought to a similar level of accuracy, detail, and robustness as is commonly expected in external dose treatment planning. For this study we developed a code with a user-friendly interface that works on several nuclear medicine imaging platforms and provides timely patient-specific dose information to the physician and medical physicist. Future therapy with internal emitters should use a 3D dose calculation approach, which represents a significant advance over dose information provided by the standard geometric phantoms used for more than 20 y (which permit reporting of only average organ doses for certain standardized individuals)

  19. Risk of solid cancer in low dose-rate radiation epidemiological studies and the dose-rate effectiveness factor.

    Science.gov (United States)

    Shore, Roy; Walsh, Linda; Azizova, Tamara; Rühm, Werner

    2017-10-01

    Estimated radiation risks used for radiation protection purposes have been based primarily on the Life Span Study (LSS) of atomic bomb survivors who received brief exposures at high dose rates, many with high doses. Information is needed regarding radiation risks from low dose-rate (LDR) exposures to low linear-energy-transfer (low-LET) radiation. We conducted a meta-analysis of LDR epidemiologic studies that provide dose-response estimates of total solid cancer risk in adulthood in comparison to corresponding LSS risks, in order to estimate a dose rate effectiveness factor (DREF). We identified 22 LDR studies with dose-response risk estimates for solid cancer after minimizing information overlap. For each study, a parallel risk estimate was derived from the LSS risk model using matching values for sex, mean ages at first exposure and attained age, targeted cancer types, and accounting for type of dosimetric assessment. For each LDR study, a ratio of the excess relative risk per Gy (ERR Gy -1 ) to the matching LSS ERR risk estimate (LDR/LSS) was calculated, and a meta-analysis of the risk ratios was conducted. The reciprocal of the resultant risk ratio provided an estimate of the DREF. The meta-analysis showed a LDR/LSS risk ratio of 0.36 (95% confidence interval [CI] 0.14, 0.57) for the 19 studies of solid cancer mortality and 0.33 (95% CI 0.13, 0.54) when three cohorts with only incidence data also were added, implying a DREF with values around 3, but statistically compatible with 2. However, the analyses were highly dominated by the Mayak worker study. When the Mayak study was excluded the LDR/LSS risk ratios increased: 1.12 (95% CI 0.40, 1.84) for mortality and 0.54 (95% CI 0.09, 0.99) for mortality + incidence, implying a lower DREF in the range of 1-2. Meta-analyses that included only cohorts in which the mean dose was LDR data provide direct evidence regarding risk from exposures at low dose rates as an important complement to the LSS risk estimates used

  20. Determination of a site-specific reference dose for methylmercury for fish-eating populations.

    Science.gov (United States)

    Shipp, A M; Gentry, P R; Lawrence, G; Van Landingham, C; Covington, T; Clewell, H J; Gribben, K; Crump, K

    2000-11-01

    Environmental risk-management decisions in the U.S. involving potential exposures to methylmercury currently use a reference dose (RfD) developed by the U.S. Environmental Protection Agency (USEPA). This RfD is based on retrospective studies of an acute poisoning incident in Iraq in which grain contaminated with a methylmercury fungicide was inadvertently used in the baking of bread. The exposures, which were relatively high but lasted only a few months, were associated with neurological effects in both adults (primarily paresthesia) and infants (late walking, late talking, etc.). It is generally believed that the developing fetus represents a particularly sensitive subpopulation for the neurological effects of methylmercury. The USEPA derived an RfD of 0.1 microg/kg/day based on benchmark dose (BMD) modeling of the combined neurological endpoints reported for children exposed in utero. This RfD included an uncertainty factor of 10 to consider human pharmacokinetic variability and database limitations (lack of data on multigeneration effects or possible long-term sequelae of perinatal exposure). Alcoa signed an Administrative Order of Consent for the conduct of a remedial investigation/feasibility study (RI/FS) at their Point Comfort Operations and the adjacent Lavaca Bay in Texas to address the effects of historical discharges of mercury-containing wastewater. In cooperation with the Texas Natural Resource Conservation Commission and USEPA Region VI, Alcoa conducted a baseline risk assessment to assess potential risk to human health and the environment. As a part of this assessment. Alcoa pursued the development of a site-specific RfD for methylmercury to specifically address the potential human health effects associated with the ingestion of contaminated finfish and shellfish from Lavaca Bay. Application of the published USEPA RfD to this site is problematic; while the study underlying the RfD represented acute exposure to relatively high concentrations of

  1. Improvements on a patient-specific dose estimation system in nuclear medicine examination

    International Nuclear Information System (INIS)

    Chuang, K. S.; Lu, J. C.; Lin, H. H.; Dong, S. L.; Yang, H. J.; Shih, C. T.; Lin, C. H.; Yao, W. J.; Ni, Y. C.; Jan, M. L.; Chang, S. J.

    2014-01-01

    The purpose of this paper is to develop a patient-specific dose estimation system in nuclear medicine examination. A dose deposition routine to store the deposited energy of the photons during their flights was embedded in the widely used SimSET Monte Carlo code and a user-friendly interface for reading PET and CT images was developed. Dose calculated on ORNL phantom was used to validate the accuracy of this system. The ratios of S value for 99m Tc, 18 F and 131 I computed by this system to those obtained with OLINDA for various organs were ranged from 0.93 to 1.18, which were comparable to that obtained from MCNPX2.6 code (0.88-1.22). Our system developed provides opportunity for tumor dose estimation which cannot be known from the MIRD. The radiation dose can provide useful information in the amount of radioisotopes to be administered in radioimmunotherapy. (authors)

  2. Development of age-specific Japanese physical phantoms for dose evaluation in infant CT examinations

    International Nuclear Information System (INIS)

    Yamauchi-Kawaura, C.; Fujii, K.; Imai, K.; Ikeda, M.; Akahane, K.; Obara, S.; Yamauchi, M.; Narai, K.; Katsu, T.

    2016-01-01

    Secondary to the previous development of age-specific Japanese head phantoms, the authors designed Japanese torso phantoms for dose assessment in infant computed tomography (CT) examinations and completed a Japanese 3-y-old head-torso phantom. For design of age-specific torso phantoms (0, 0.5, 1 and 3 y old), anatomical structures were measured from CT images of Japanese infant patients. From the CT morphometry, it was found that rib cages of Japanese infants were smaller than those in Europeans and Americans. Radiophotoluminescence glass dosemeters were used for dose measurement of a 3-y-old head-torso phantom. To examine the validity of the developed phantom, organ and effective doses by the in-phantom dosimetry system were compared with simulation values in a web-based CT dose calculation system (WAZA-ARI). The differences in doses between the two systems were <20 % at the doses of organs within scan regions and effective doses in head, chest and abdomino-pelvic CT examinations. (authors)

  3. Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study

    DEFF Research Database (Denmark)

    Stovall, M.; Smith, S.A.; Langholz, B.M.

    2008-01-01

    PURPOSE: To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. METHODS AND MATERIALS: The study population included participants in the Women's Environmental, Cancer, and Radiation Epidemiology study: 708 cases (women...... calculated using multivariable-adjusted conditional logistic regression models. RESULTS: Across all patients, the mean radiation dose to the specific quadrant of the CB tumor was 1.1 Gy. Women 1.0 Gy of absorbed dose to the specific quadrant of the CB had a 2.5-fold greater...... risk for CB cancer than unexposed women (RR = 2.5, 95% CI 1.4-4.5). No excess risk was observed in women >40 years of age. Women 5 years had a RR of 3.0 (95% CI 1.1-8.1), and the dose response was significant (excess RR per Gy of 1.0, 95% CI 0...

  4. Performance of an automatic dose control system for CT. Specifications and basic phantom tests

    Energy Technology Data Exchange (ETDEWEB)

    Nagel, H.D. [Wissenschaft und Technik fuer die Radiolgoe, Dr. HD Nagel, Buchholz (Germany); Stumpp, P.; Kahn, T.; Gosch, D. [Universitaetsklinikum Leipzig (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2011-01-15

    Purpose: To assess the performance and to provide more detailed insight into the characteristics and limitations of devices for automatic dose control (ADC) in CT. Materials and Methods: A comprehensive study on DoseRight 2.0, the ADC system provided by Philips for its Brilliance CT scanners, was conducted. Phantom tests were carried out on a 64-slice scanner (Brilliance 64) using assorted quality control (QC) phantoms that allowed verification of the basic specifications. If feasible, the findings were verified by model calculations based on known specifications. Results: For all tests, the dose reductions and modulation characteristics fully met the values expected from the specifications. Adverse effects due to increased image noise were only moderate as a result of the 'adequate noise system' design that employs comparatively gentle modulation, and the additional use of adaptive filtration. Conclusion: Simple tests with QC phantoms allow evaluation of the most relevant characteristics of devices for ADC in CT. (orig.)

  5. Dose specification for 192Ir high dose rate brachytherapy in terms of dose-to-water-in-medium and dose-to-medium-in-medium

    International Nuclear Information System (INIS)

    Fonseca, Gabriel Paiva; Yoriyaz, Hélio; Tedgren, Åsa Carlsson; Nilsson, Josef; Persson, Maria; Reniers, Brigitte; Verhaegen, Frank

    2015-01-01

    Dose calculation in high dose rate brachytherapy with 192 Ir is usually based on the TG-43U1 protocol where all media are considered to be water. Several dose calculation algorithms have been developed that are capable of handling heterogeneities with two possibilities to report dose: dose-to-medium-in-medium (D m,m ) and dose-to-water-in-medium (D w,m ). The relation between D m,m and D w,m for 192 Ir is the main goal of this study, in particular the dependence of D w,m on the dose calculation approach using either large cavity theory (LCT) or small cavity theory (SCT). A head and neck case was selected due to the presence of media with a large range of atomic numbers relevant to tissues and mass densities such as air, soft tissues and bone interfaces. This case was simulated using a Monte Carlo (MC) code to score: D m,m, D w,m (LCT), mean photon energy and photon fluence. D w,m (SCT) was derived from MC simulations using the ratio between the unrestricted collisional stopping power of the actual medium and water. Differences between D m,m and D w,m (SCT or LCT) can be negligible (<1%) for some tissues e.g. muscle and significant for other tissues with differences of up to 14% for bone. Using SCT or LCT approaches leads to differences between D w,m (SCT) and D w,m (LCT) up to 29% for bone and 36% for teeth. The mean photon energy distribution ranges from 222 keV up to 356 keV. However, results obtained using mean photon energies are not equivalent to the ones obtained using the full, local photon spectrum. This work concludes that it is essential that brachytherapy studies clearly report the dose quantity. It further shows that while differences between D m,m and D w,m (SCT) mainly depend on tissue type, differences between D m,m and D w,m (LCT) are, in addition, significantly dependent on the local photon energy fluence spectrum which varies with distance to implanted sources. (paper)

  6. Risk equivalent of exposure versus dose of radiation

    International Nuclear Information System (INIS)

    Bond, V.P.

    1986-01-01

    Radiation is perhaps unique among all agents of interest in the Health Sciences in that it alone is both a therapeutic agent for the control of cancer and an essentially ubiquitous environmental agent with a potential for increasing the cancer rate in human populations. Therapy of tumors is accomplished with the high-level exposure (HLE) to radiation in order to effect control or a cure. Thus, it conforms to the concepts and approaches of pharmacology, toxicology, and therapeutic medicine. Only one function, that which relates the object-oriented and nonstochastic independent variable organ dose to its effect on a cancer or an organ, is needed to estimate the probability, P 2 , of a quantal response. Only P 2 is needed because P 1 , that the cancer slated for such treatment will receive some amount of the agent and be affected to some degree, is effectively unity. The health problem involving low-level exposure (LLE) to radiation, in contrast, is not at all analogous to those of pharmacology, toxicology, and medicine. Rather, it presents a public health problem in that it is a health population, albeit of cells, that is exposed in a radiation field composed of moving radiation particles with some attendant low-order carcinogenic or mutagenic risk. Thus, the concepts, quantities, and terminology applied to low-level radiation must be modified from their present orientation toward pharmacology, toxicology, medicine, and dose to conform to those of public health and accident statistics, in which both P 1 and P 2 for the exposed cells must be estimated

  7. Cohort-specific imputation of gene expression improves prediction of warfarin dose for African Americans.

    Science.gov (United States)

    Gottlieb, Assaf; Daneshjou, Roxana; DeGorter, Marianne; Bourgeois, Stephane; Svensson, Peter J; Wadelius, Mia; Deloukas, Panos; Montgomery, Stephen B; Altman, Russ B

    2017-11-24

    Genome-wide association studies are useful for discovering genotype-phenotype associations but are limited because they require large cohorts to identify a signal, which can be population-specific. Mapping genetic variation to genes improves power and allows the effects of both protein-coding variation as well as variation in expression to be combined into "gene level" effects. Previous work has shown that warfarin dose can be predicted using information from genetic variation that affects protein-coding regions. Here, we introduce a method that improves dose prediction by integrating tissue-specific gene expression. In particular, we use drug pathways and expression quantitative trait loci knowledge to impute gene expression-on the assumption that differential expression of key pathway genes may impact dose requirement. We focus on 116 genes from the pharmacokinetic and pharmacodynamic pathways of warfarin within training and validation sets comprising both European and African-descent individuals. We build gene-tissue signatures associated with warfarin dose in a cohort-specific manner and identify a signature of 11 gene-tissue pairs that significantly augments the International Warfarin Pharmacogenetics Consortium dosage-prediction algorithm in both populations. Our results demonstrate that imputed expression can improve dose prediction and bridge population-specific compositions. MATLAB code is available at https://github.com/assafgo/warfarin-cohort.

  8. Dose distribution in organs: patient-specific phantoms versus reference phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Lacerda, I.V.B., E-mail: isabelle.lacerda@ufpe.br [Universidade Federal de Pernambuco (UFPE), Recife (Brazil); Vieira, J.W. [Instituto Federal de Pernambuco (IFPE), Recife (Brazil); Oliveira, M.L.; Lima, F.R.A. [Centro Regional de Ciências Nucleares do Nordeste (CRCN-NE/CNEN-PB), Recife (Brazil)

    2017-07-01

    Discrepancies between ICRP phantoms and real patients lead to disparities on patient-dose estimations. This paper aims to compare distribution of dose in organs of male/female specific-phantoms and ICRP reference phantoms. The absorbed dose estimation was performed using the EGSnrc Monte Carlo code and a parallel source algorithm. In this work were used a patient-specific phantom for a man (1.73m/70.3kg) and another for a woman (1.63m/60.3kg) and the male and female ICRP reference phantoms. The comparison of the absorbed dose from each phantom gender was performed using the relative error. The results were expressed in terms of conversion coefficients to brain, lungs, liver and kidneys. The greatest absolute relative error between the organs of the patient-specific phantom and the reference phantom was 22.92% in the liver and 62.84% in the kidneys, respectively for man and woman. There are errors that cannot be disregarded. This paper shows the need for a specific study for each patient or for the population of each country, since there are different body types, which affects the distribution of the organ doses. (author)

  9. Cohort-specific imputation of gene expression improves prediction of warfarin dose for African Americans

    Directory of Open Access Journals (Sweden)

    Assaf Gottlieb

    2017-11-01

    Full Text Available Abstract Background Genome-wide association studies are useful for discovering genotype–phenotype associations but are limited because they require large cohorts to identify a signal, which can be population-specific. Mapping genetic variation to genes improves power and allows the effects of both protein-coding variation as well as variation in expression to be combined into “gene level” effects. Methods Previous work has shown that warfarin dose can be predicted using information from genetic variation that affects protein-coding regions. Here, we introduce a method that improves dose prediction by integrating tissue-specific gene expression. In particular, we use drug pathways and expression quantitative trait loci knowledge to impute gene expression—on the assumption that differential expression of key pathway genes may impact dose requirement. We focus on 116 genes from the pharmacokinetic and pharmacodynamic pathways of warfarin within training and validation sets comprising both European and African-descent individuals. Results We build gene-tissue signatures associated with warfarin dose in a cohort-specific manner and identify a signature of 11 gene-tissue pairs that significantly augments the International Warfarin Pharmacogenetics Consortium dosage-prediction algorithm in both populations. Conclusions Our results demonstrate that imputed expression can improve dose prediction and bridge population-specific compositions. MATLAB code is available at https://github.com/assafgo/warfarin-cohort

  10. Dose distribution in organs: patient-specific phantoms versus reference phantoms

    International Nuclear Information System (INIS)

    Lacerda, I.V.B.; Vieira, J.W.; Oliveira, M.L.; Lima, F.R.A.

    2017-01-01

    Discrepancies between ICRP phantoms and real patients lead to disparities on patient-dose estimations. This paper aims to compare distribution of dose in organs of male/female specific-phantoms and ICRP reference phantoms. The absorbed dose estimation was performed using the EGSnrc Monte Carlo code and a parallel source algorithm. In this work were used a patient-specific phantom for a man (1.73m/70.3kg) and another for a woman (1.63m/60.3kg) and the male and female ICRP reference phantoms. The comparison of the absorbed dose from each phantom gender was performed using the relative error. The results were expressed in terms of conversion coefficients to brain, lungs, liver and kidneys. The greatest absolute relative error between the organs of the patient-specific phantom and the reference phantom was 22.92% in the liver and 62.84% in the kidneys, respectively for man and woman. There are errors that cannot be disregarded. This paper shows the need for a specific study for each patient or for the population of each country, since there are different body types, which affects the distribution of the organ doses. (author)

  11. Case studies: Risk-based analysis of technical specifications

    International Nuclear Information System (INIS)

    Wagner, D.P.; Minton, L.A.; Gaertner, J.P.

    1987-01-01

    The SOCRATES computer program uses the results of a Probabilistic Risk Assessment (PRA) or a system level risk analysis to calculate changes in risk due to changes in the surveillance test interval and/or the allowed outage time stated in the technical specification. The computer program can accommodate various testing strategies (such as staggered or simultaneous testing) to allow modeling of component testing as it is carried out at a plant. The methods and computer program are an integral part of a larger decision process aimed at determining benefits from technical specification changes. These benefits can include cost savings to the utilities by reducing forced shutdowns with no adverse impacts on risk. Three summaries of case study applications are included to demonstrate the types of results that can be achieved through risk-based evaluation of technical specifications. (orig.)

  12. Risk impact of BWR technical specifications requirements during shutdown

    International Nuclear Information System (INIS)

    Staple, B.D.; Kirk, H.K.; Yakle, J.

    1994-10-01

    This report presents an application of probabilistic models and risk based criteria for determining the risk impact of the Limiting Conditions of Operations (LCOs) in the Technical Specifications (TSs) of a boiling water reactor during shutdown. This analysis studied the risk impact of the current requirements of Allowed Outage Times (AOTs) and Surveillance Test Intervals (STIs) in eight Plant Operational States (POSs) which encompass power operations, shutdown, and refueling. This report also discusses insights concerning TS action statements

  13. Development of Organ-Specific Donor Risk Indices

    Science.gov (United States)

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.

    2012-01-01

    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C-positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease disproportionately. Use of livers with high donor risk index is associated with increased hospital costs independent of recipient risk factors, and transplanting livers with high donor risk index into patients with Model for End-Stage Liver Disease scores Donor Risk Index has limited this practice. Significant regional variation in donor quality, as measured by the Liver Donor Risk Index, remains in the United States. We also review other potential indices for liver transplant, including donor-recipient matching and the retransplant donor risk index. While substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. PMID:22287036

  14. Dose specification and normal tissue reference points in the treatment of cancer cervix

    International Nuclear Information System (INIS)

    Ray, D.K.; Kumar, P.; Misra, D.K.; Das, R.; Kumar, A.; Maji, T.; Chaudhuri, P.; Sinha, T.P.

    2007-01-01

    Carcinoma of uterine cervix is one of the most common diseases among the women in India where radiotherapy is the mainstay of treatment. Most common practice of dose prescription point is the Manchester Point A. American Brachytherapy Society (ABS) recommends a point H equivalent to that used in the classical Manchester system. Many centre practices Madison point M as dose specification point which is 20 mm cephaled along the tandem from a line joining the mid dwell positions in the ovoids/ring and 20 mm lateral to the tandem. In the present study has compared the dose prescription points between Manchester Point A and Madison Point M for ring applicators and their implication in the assessment of rectal and bladder doses in patients of Carcinoma of uterine cervix

  15. Site-specific parameter values for the Nuclear Regulatory Commission's food pathway dose model

    International Nuclear Information System (INIS)

    Hamby, D.M.

    1992-01-01

    Routine operations at the Savannah River Site (SRS) in Western South Carolina result in radionuclide releases to the atmosphere and to the Savannah River. The resulting radiation doses to the off-site maximum individual and the off-site population within 80 km of the SRS are estimated on a yearly basis. These estimates are currently generated using dose models prescribed for the commercial nuclear power industry by the Nuclear Regulatory Commission (NRC). The NRC provides default values for dose-model parameters for facilities without resources to develop site-specific values. A survey of land- and water-use characteristics for the Savannah River area has been conducted to determine site-specific values for water recreation, consumption, and agricultural parameters used in the NRC Regulatory Guide 1.109 (1977) dosimetric models. These site parameters include local characteristics of meat, milk, and vegetable production; recreational and commercial activities on the Savannah River; and meat, milk, vegetable, and seafood consumption rates. This paper describes how parameter data were obtained at the Savannah River Site and the impacts of such data on off-site dose. Dose estimates using site-specific parameter values are compared to estimates using the NRC default values

  16. Computational model design specification for Phase 1 of the Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    Napier, B.A.

    1991-07-01

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation dose that individuals could have received as a result of emission from nuclear operations at Hanford since their inception in 1944. The purpose of this report is to outline the basic algorithm and necessary computer calculations to be used to calculate radiation doses specific and hypothetical individuals in the vicinity of Hanford. The system design requirements, those things that must be accomplished, are defined. The system design specifications, the techniques by which those requirements are met, are outlined. Included are the basic equations, logic diagrams, and preliminary definition of the nature of each input distribution. 4 refs., 10 figs., 9 tabs

  17. Computational model design specification for Phase 1 of the Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.

    1991-07-01

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation dose that individuals could have received as a result of emission from nuclear operations at Hanford since their inception in 1944. The purpose of this report is to outline the basic algorithm and necessary computer calculations to be used to calculate radiation doses specific and hypothetical individuals in the vicinity of Hanford. The system design requirements, those things that must be accomplished, are defined. The system design specifications, the techniques by which those requirements are met, are outlined. Included are the basic equations, logic diagrams, and preliminary definition of the nature of each input distribution. 4 refs., 10 figs., 9 tabs.

  18. Risk-based technical specifications program: Site interview results

    International Nuclear Information System (INIS)

    Andre, G.R.; Baker, A.J.; Johnson, R.L.

    1991-08-01

    The Electric Power Research Institute and Pacific Gas and Electric Company are sponsoring a program directed at improving Technical Specifications using risk-based methods. The major objectives of the program are to develop risk-based approaches to improve Technical Specifications and to develop an Interactive Risk Advisor (IRA) prototype. The IRA is envisioned as an interactive system that is available to plant personnel to assist in controlling plant operation. Use of an IRA is viewed as a method to improve plant availability while maintaining or improving plant safety. In support of the program, interviews were conducted at several PWR and BWR plant sites, to elicit opinions and information concerning risk-based approaches to Technical Specifications and IRA requirements. This report presents the results of these interviews, including the functional requirements of an IRA. 2 refs., 6 figs., 2 tabs

  19. Methodology for risk-based analysis of technical specifications

    International Nuclear Information System (INIS)

    Vesely, W.E.; Gaertner, J.P.; Wagner, D.P.

    1985-01-01

    Part of the effort by EPRI to apply probabilistic risk assessment methods and results to the solution of utility problems involves the investigation of methods for risk-based analysis of technical specifications. The culmination of this investigation is the SOCRATES computer code developed by Battelle's Columbus Laboratories to assist in the evaluation of technical specifications of nuclear power plants. The program is designed to use information found in PRAs to re-evaluate risk for changes in component allowed outage times (AOTs) and surveillance test intervals (STIs). The SOCRATES program is a unique and important tool for technical specification evaluations. The detailed component unavailability model allows a detailed analysis of AOT and STI contributions to risk. Explicit equations allow fast and inexpensive calculations. Because the code is designed to accept ranges of parameters and to save results of calculations that do not change during the analysis, sensitivity studies are efficiently performed and results are clearly displayed

  20. Can we avoid high levels of dose escalation for high-risk prostate cancer in the setting of androgen deprivation?

    Directory of Open Access Journals (Sweden)

    Shakespeare TP

    2016-05-01

    Full Text Available Thomas P Shakespeare,1,2 Shea W Wilcox,1 Noel J Aherne1,2 1Department of Radiation Oncology, North Coast Cancer Institute, 2Rural Clinical School, Faculty of Medicine, University of New South Wales, Coffs Harbour, NSW, Australia Aim: Both dose-escalated external beam radiotherapy (DE-EBRT and androgen deprivation therapy (ADT improve outcomes in patients with high-risk prostate cancer. However, there is little evidence specifically evaluating DE-EBRT for patients with high-risk prostate cancer receiving ADT, particularly for EBRT doses >74 Gy. We aimed to determine whether DE-EBRT >74 Gy improves outcomes for patients with high-risk prostate cancer receiving long-term ADT. Patients and methods: Patients with high-risk prostate cancer were treated on an institutional protocol prescribing 3–6 months neoadjuvant ADT and DE-EBRT, followed by 2 years of adjuvant ADT. Between 2006 and 2012, EBRT doses were escalated from 74 Gy to 76 Gy and then to 78 Gy. We interrogated our electronic medical record to identify these patients and analyzed our results by comparing dose levels. Results: In all, 479 patients were treated with a 68-month median follow-up. The 5-year biochemical disease-free survivals for the 74 Gy, 76 Gy, and 78 Gy groups were 87.8%, 86.9%, and 91.6%, respectively. The metastasis-free survivals were 95.5%, 94.5%, and 93.9%, respectively, and the prostate cancer-specific survivals were 100%, 94.4%, and 98.1%, respectively. Dose escalation had no impact on any outcome in either univariate or multivariate analysis. Conclusion: There was no benefit of DE-EBRT >74 Gy in our cohort of high-risk prostate patients treated with long-term ADT. As dose escalation has higher risks of radiotherapy-induced toxicity, it may be feasible to omit dose escalation beyond 74 Gy in this group of patients. Randomized studies evaluating dose escalation for high-risk patients receiving ADT should be considered. Keywords: radiotherapy, IMRT, dose

  1. Dose-specific transcriptional responses in thyroid tissue in mice after 131I administration

    International Nuclear Information System (INIS)

    Rudqvist, Nils; Schüler, Emil; Parris, Toshima Z.; Langen, Britta; Helou, Khalil; Forssell-Aronsson, Eva

    2015-01-01

    Introduction: In the present investigation, microarray analysis was used to monitor transcriptional activity in thyroids in mice 24 h after 131 I exposure. The aims of this study were to 1) assess the transcriptional patterns associated with 131 I exposure in normal mouse thyroid tissue and 2) propose biomarkers for 131 I exposure of the thyroid. Methods: Adult BALB/c nude mice were i.v. injected with 13, 130 or 260 kBq of 131 I and killed 24 h after injection (absorbed dose to thyroid: 0.85, 8.5, or 17 Gy). Mock-treated mice were used as controls. Total RNA was extracted from thyroids and processed using the Illumina platform. Results: In total, 497, 546, and 90 transcripts were regulated (fold change ≥ 1.5) in the thyroid after 0.85, 8.5, and 17 Gy, respectively. These were involved in several biological functions, e.g. oxygen access, inflammation and immune response, and apoptosis/anti-apoptosis. Approximately 50% of the involved transcripts at each absorbed dose level were dose-specific, and 18 transcripts were commonly detected at all absorbed dose levels. The Agpat9, Plau, Prf1, and S100a8 gene expression displayed a monotone decrease in regulation with absorbed dose, and further studies need to be performed to evaluate if they may be useful as dose-related biomarkers for 131I exposure. Conclusion: Distinct and substantial differences in gene expression and affected biological functions were detected at the different absorbed dose levels. The transcriptional profiles were specific for the different absorbed dose levels. We propose that the Agpat9, Plau, Prf1, and S100a8 genes might be novel potential absorbed dose-related biomarkers to 131 I exposure of thyroid. Advances in knowledge: During the recent years, genomic techniques have been developed; however, they have not been fully utilized in nuclear medicine and radiation biology. We have used RNA microarrays to investigate genome-wide transcriptional regulations in thyroid tissue in mice after low

  2. Application and inspiration of risk control in dose control in Fukushima nuclear accident

    International Nuclear Information System (INIS)

    Yu Shaoqing; Chen Yan; Chai Jianshe; Zhang Chunming

    2013-01-01

    The article introduced the basic concept of risk and risk control methods. Using the risk control methods, we analyzed and evaluated the actions to control dose of public and occupational radiation exposure in the Fukushima Dai-ichi nuclear power plant accident, especially found out the weak points of these actions, and finally discussed the application of the risk control methods in dose management during nuclear accidents. (authors)

  3. An overview of measuring and modelling dose and risk from ionising radiation for medical exposures

    International Nuclear Information System (INIS)

    Tootell, Andrew; Szczepura, Katy; Hogg, Peter

    2014-01-01

    Purpose: This paper gives an overview of the methods that are used to calculate dose and risk from exposure to ionizing radiation as a support to other papers in this special issue. Background: The optimization of radiation dose is a legal requirement in medical exposures. This review paper aims to provide the reader with knowledge of dose by providing definitions and concepts of absorbed, effective and equivalent dose. Criticisms of the use of effective dose to infer the risk of an exposure to an individual will be discussed and an alternative approach considering the lifetime risks of cancer incidence will be considered. Prior to any dose or risk calculation, data concerning the dose absorbed by the patient needs to be collected. This paper will describe and discuss the main concepts and methods that can be utilised by a researcher in dose assessments. Concepts behind figures generated by imaging equipment such as dose-area-product, computed tomography dose index, dose length product and their use in effective dose calculations will be discussed. Processes, advantages and disadvantages in the simulation of exposures using the Monte Carlo method and direct measurement using digital dosimeters or thermoluminescent dosimeters will be considered. Beyond this special issue, it is proposed that this paper could serve as a teaching or CPD tool for personnel working or studying medical imaging

  4. The Effects of Metal on Size Specific Dose Estimation (SSDE) in CT: A Phantom Study

    Science.gov (United States)

    Alsanea, Maram M.

    Over the past number of years there has been a significant increase in the awareness of radiation dose from use of computed tomography (CT). Efforts have been made to reduce radiation dose from CT and to better quantify dose being delivered. However, unfortunately, these dose metrics such as CTDI vol are not a specific patient dose. In 2011, the size-specific dose estimation (SSDE) was introduced by AAPM TG-204 which accounts for the physical size of the patient. However, the approach presented in TG-204 ignores the importance of the attenuation differences in the body. In 2014, a newer methodology that accounted for tissue attenuation was introduced by the AAPM TG-220 based on the concept of water equivalent diameter, Dw. One of the limitation of TG-220 is that there is no estimation of the dose while highly attenuating objects such as metal is present in the body. The purpose of this research is to evaluate the accuracy of size-specific dose estimates in CT in the presence of simulated metal prostheses using a conventional PMMA CTDI phantom at different phantom diameter (body and head) and beam energy. Titanium, Cobalt- chromium and stainless steel alloys rods were used in the study. Two approaches were used as introduced by AAPM TG-204 and 220 utilizing the effective diameter and the Dw calculations. From these calculations, conversion factors have been derived that could be applied to the measured CTDIvol to convert it to specific patient dose, or size specific dose estimate, (SSDE). Radiation dose in tissue (f-factor = 0.94) was measured at various chamber positions with the presence of metal. Following, an average weighted tissue dose (AWTD) was calculated in a manner similar to the weighted CTDI (CTDIw). In general, for the 32 cm body phantom SSDE220 provided more accurate estimates of AWTD than did SSDE204. For smaller patient size, represented by the 16 cm head phantom, the SSDE204 was a more accurate estimate of AWTD that that of SSDE220. However, as the

  5. Risk of Developing Second Cancer From Neutron Dose in Proton Therapy as Function of Field Characteristics, Organ, and Patient Age

    International Nuclear Information System (INIS)

    Zacharatou Jarlskog, Christina; Paganetti, Harald

    2008-01-01

    Purpose: To estimate the risk of a second malignancy after treatment of a primary brain cancer using passive scattered proton beam therapy. The focus was on the cancer risk caused by neutrons outside the treatment volume and the dependency on the patient's age. Methods and Materials: Organ-specific neutron-equivalent doses previously calculated for eight different proton therapy brain fields were considered. Organ-specific models were applied to assess the risk of developing solid cancers and leukemia. Results: The main contributors (>80%) to the neutron-induced risk are neutrons generated in the treatment head. Treatment volume can influence the risk by up to a factor of ∼2. Young patients are subject to significantly greater risks than are adult patients because of the geometric differences and age dependency of the risk models. Breast cancer should be the main concern for females. For males, the risks of lung cancer, leukemia, and thyroid cancer were significant for pediatric patients. In contrast, leukemia was the leading risk for an adult. Most lifetime risks were <1% (70-Gy treatment). The only exceptions were breast, thyroid, and lung cancer for females. For female thyroid cancer, the treatment risk can exceed the baseline risk. Conclusion: The risk of developing a second malignancy from neutrons from proton beam therapy of a brain lesion is small (i.e., presumably outweighed by the therapeutic benefit) but not negligible (i.e., potentially greater than the baseline risk). The patient's age at treatment plays a major role

  6. A method to adjust radiation dose-response relationships for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane Lindegaard; Vogelius, Ivan R

    2012-01-01

    Several clinical risk factors for radiation induced toxicity have been identified in the literature. Here, we present a method to quantify the effect of clinical risk factors on radiation dose-response curves and apply the method to adjust the dose-response for radiation pneumonitis for patients...

  7. Risk factors of non-specific spinal pain in childhood.

    Science.gov (United States)

    Szita, Julia; Boja, Sara; Szilagyi, Agnes; Somhegyi, Annamaria; Varga, Peter Pal; Lazary, Aron

    2018-05-01

    Non-specific spinal pain can occur at all ages and current evidence suggests that pediatric non-specific spinal pain is predictive for adult spinal conditions. A 5-year long, prospective cohort study was conducted to identify the lifestyle and environmental factors leading to non-specific spinal pain in childhood. Data were collected from school children aged 7-16 years, who were randomly selected from three different geographic regions in Hungary. The risk factors were measured with a newly developed patient-reported questionnaire (PRQ). The quality of the instrument was assessed by the reliability with the test-retest method. Test (N = 952) and validity (N = 897) datasets were randomly formed. Risk factors were identified with uni- and multivariate logistic regression models and the predictive performance of the final model was evaluated using the receiver operating characteristic (ROC) method. The final model was built up by seven risk factors for spinal pain for days; age > 12 years, learning or watching TV for more than 2 h/day, uncomfortable school-desk, sleeping problems, general discomfort and positive familiar medical history (χ 2  = 101.07; df = 8; p < 0.001). The probabilistic performance was confirmed with ROC analysis on the test and validation cohorts (AUC = 0.76; 0.71). A simplified risk scoring system showed increasing possibility for non-specific spinal pain depending on the number of the identified risk factors (χ 2  = 65.0; df = 4; p < 0.001). Seven significant risk factors of non-specific spinal pain in childhood were identified using the new, easy to use and reliable PRQ which makes it possible to stratify the children according to their individual risk. These slides can be retrieved under Electronic Supplementary Material.

  8. Age-specific inhalation radiation dose commitment factors for selected radionuclides

    International Nuclear Information System (INIS)

    Strenge, D.L.; Peloquin, R.A.; Baker, D.A.

    1982-08-01

    Inhalation dose commitment factors are presented for selected radionuclides for exposure of individuals in four age groups: infant, child, teen and adult. Radionuclides considered are 35 S, 36 Cl, 45 Ca, 67 Ga, 75 Se, 85 Sr, 109 Cd, 113 Sn, 125 I, 133 Ba, 170 Tm, 169 Yb, 182 Ta, 192 Ir, 198 Au, 201 Tl, 204 Tl, and 236 Pu. The calculational method is based on the human metabolic model of ICRP as defined in Publication 2 (ICRP 1959) and as used in previous age-specific dose factor calculations by Hoenes and Soldat (1977). Dose commitment factors are presented for the following organs of reference: total body, bone, liver, kidney, thyroid, lung and lower large intestine

  9. Allergen-specific immunotherapy and risk of autoimmune disease

    DEFF Research Database (Denmark)

    Linneberg, Allan; Madsen, Flemming; Skaaby, Tea

    2012-01-01

    After 100 years of experience with allergen-specific immunotherapy (SIT), an issue that is still unresolved is whether SIT can act as a trigger of, or as a risk factor for, autoimmune disease. We searched the literature for evidence on this topic.......After 100 years of experience with allergen-specific immunotherapy (SIT), an issue that is still unresolved is whether SIT can act as a trigger of, or as a risk factor for, autoimmune disease. We searched the literature for evidence on this topic....

  10. Optimizing fluorescently tethered Hsp90 inhibitor dose for maximal specific uptake by breast tumors

    Science.gov (United States)

    Crouch, Brian T.; Duer, Joy; Wang, Roujia; Gallagher, Jennifer; Hall, Allison; Soo, Mary Scott; Hughes, Philip; Haystead, Timothy A. J.; Ramanujam, Nirmala

    2018-03-01

    Despite improvements in surgical resection, 20-40% of patients undergoing breast conserving surgery require at least one additional re-excision. Leveraging the unique surface expression of heat shock protein 90 (Hsp90), a chaperone protein involved in several key hallmarks of cancer, in breast cancer provides an exciting opportunity to identify residual disease during surgery. We developed a completely non-destructive strategy using HS-27, a fluorescently-tethered Hsp90 inhibitor, to assay surface Hsp90 expression on intact tissue specimens using a fluorescence microendoscope with a field of view of 750 μm and subcellular resolution of 4 μm. HS-27 consists of an FDA approved Hsp90 inhibitor tethered to fluorescein isothiocyanate (EX 488nm, EM 525nm). Here, we optimized ex vivo HS-27 administration in pre-clinical breast cancer models and validated our approach on 21 patients undergoing standard of care ultrasound guided core needle biopsy. HS-27 administration time was fixed at 1- minute to minimize imaging impact on clinical workflow. HS-27 and HS-217 (non-specific control) doses were modulated from 1 μM up to 100 μM to identify the dose maximizing the ratio of specific uptake (HS-27 fluorescence) to non-specific uptake (HS-217 fluorescence). The specificity ratio was maximized at 100 μM and was significantly greater than all other doses (pcancer makes this technology attractive for assessing tumor margins, as one agent can be used for all subtypes.

  11. Tensit - a simulation tool for migration, risk and dose calculations

    International Nuclear Information System (INIS)

    Jones, J.; Kautsky, U.; Vahlund, C.F.

    2004-01-01

    During the next years the Swedish Nuclear Fuel and Waste Management Co (SKB) performs site investigations for a future repository of spent nuclear fuel. The repository will be situated in crystalline rock at a depth of approximately 500 m. Novel methods based on systems and landscape ecology are developed to understand the interacting mechanisms and finally, to model radionuclide migration in the biosphere using site specific data. These models and methods are later used as part of the overall safety assessment for the repository where also migration in the near field and in the bedrock is considered. In the present paper, a newly developed probabilistic simulation package, TENSIT, is presented. The package is based on pre-existing codes (Matlab, Simulink and the probabilistic engine-at-risk) and is capable of performing radionuclide migration calculations both for the repository and the biosphere. Hence, a platform independent, transparent (well documented and intuitive on a model scale), thoroughly supported, efficient and user friendly (graphical interface for the modeler) code can be developed at a fairly low cost. Comparisons with other codes used for compartment based biosphere modelling and the PSACOIN Level 1B exercise shows on a good agreement on the application scale. Moreover, by basing the package on continuously maintained, pre-existing codes, potential risks associated with a less spread software may be avoided. In addition to the compartment based models based on transfer factors, TENSIT is also able to handle the more complex ecosystem models (based on flow of carbon and nutrients) either separately or in combination with the compartment models. Within the project, biosphere migration calculations have been performed using TENSIT for a watershed in the Forsmark area (one of the studied sites). In this simulation, data from the ongoing site investigation program has been used to define the based model. (author)

  12. Development of organ-specific donor risk indices.

    Science.gov (United States)

    Akkina, Sanjeev K; Asrani, Sumeet K; Peng, Yi; Stock, Peter; Kim, W Ray; Israni, Ajay K

    2012-04-01

    Because of the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival with various combinations of donor and recipient characteristics. Here we review the kidney donor risk index (KDRI) and the liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The KDRI has a potential role in developing new kidney allocation algorithms. The LDRI allows a greater appreciation of the importance of donor factors, particularly for hepatitis C virus-positive recipients; as the donor risk index increases, the rates of allograft and patient survival among these recipients decrease disproportionately. The use of livers with high donor risk indices is associated with increased hospital costs that are independent of recipient risk factors, and the transplantation of livers with high donor risk indices into patients with Model for End-Stage Liver Disease scores indices for liver transplantation, including donor-recipient matching and the retransplant donor risk index. Although substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. Copyright © 2012 American Association for the Study of Liver Diseases.

  13. Determination of dose ranges of gamma rays to induce specific changes in three ornamental species

    International Nuclear Information System (INIS)

    Gonzalez J, J.

    2011-11-01

    In order to confirming the possibility of to settle a dose range that takes place directly and not at random, a specific effect independently of the species that is were produced several similar organisms to three ornamental species took place via meristems cultivation: Petunia hybrid, Impatiens walleriana and Sprekelia formosissima, same that were irradiated in an irradiator Gamma cell 220, to different dose: 0, 3.5, 5.0, 7.5, 10, 12.5, 15, 17.5 and 20 Gy. Later on, of the plants treated via in vitro the subsequent generations were obtained until the M 4 . To determine the DL 50 and the possible good doses, the survival parameters, development, morphogenesis and height were evaluated during 8 weeks, interpreting based on them, the possible physiologic and genetic alterations induced by the radiation. The established DL 50 were: 7.5 Gy (Petunia), 19.0 Gy (Impatiens) and 12.0 Gy (Sprekelia). Based on the DL 50 of each species, a range of coincident dose settled down that produces a similar effect in the three species: a range of DL 23 to the DL 50 induces and alteration in the cytokinins production affecting directly in the leaves number, buds and plants taken place by meristem, also a range of DL 32 - DL 50 impacts in the auxins production altering to the radicule system. However, when being superimposed the dose is considered that the investigation should continue. (Author)

  14. Technical specification of the NRPB thermoluminescent dosemeter used for the measurement of body dose and skin dose

    CERN Document Server

    Shaw, K B

    1977-01-01

    This report specifies the NRPB thermoluminescent dosemeter used for the measurement of radiation dose in tissue at a depth of 700 mg cm sup - sup 2 (body dose) and at a depth of 5-10 mg cm sup - sup 2 (skin dose).

  15. Measurement of specific parameters for dose calculation after inhalation of aerols containing transuranium elements

    International Nuclear Information System (INIS)

    Ramounet-le Gall, B.; Fritsch, P.; Abram, M.C.; Rateau, G.; Grillon, G.; Guillet, K.; Baude, S.; Berard, P.; Ansoborlo, E.; Delforge, J.

    2002-01-01

    A review on specific parameter measurements to calculate doses per unit of incorporation according to recommendations of the International Commission of Radiological Protection has been performed for inhaled actinide oxides. Alpha activity distribution of the particles can be obtained by autoradiography analysis using aerosol sampling filters at the work places. This allows us to characterize granulometric parameters of 'pure' actinide oxides, but complementary analysis by scanning electron microscopy is needed for complex aerosols. Dissolution parameters with their standard deviation are obtained after rat inhalation exposure, taking into account both mechanical lung clearance and actinide transfer to the blood estimated from bone retention. In vitro experiments suggest that the slow dissolution rate might decrease as a function of time following exposure. Dose calculation software packages have been developed to take into account granulometry and dissolution parameters as well as specific physiological parameters of exposed individuals. In the case of poorly soluble actinide oxides, granulometry and physiology appear as the main parameters controlling dose value, whereas dissolution only alters dose distribution. Validation of these software packages are in progress. (author)

  16. Dose-response characteristics of low- and intermediate-risk prostate cancer treated with external beam radiotherapy

    International Nuclear Information System (INIS)

    Cheung, Rex; Tucker, Susan L.; Lee, Andrew K.; Crevoisier, Renaud de; Dong Lei; Kamat, Ashish; Pisters, Louis; Kuban, Deborah

    2005-01-01

    Purpose: In this era of dose escalation, the benefit of higher radiation doses for low-risk prostate cancer remains controversial. For intermediate-risk patients, the data suggest a benefit from higher doses. However, the quantitative characterization of the benefit for these patients is scarce. We investigated the radiation dose-response relation of tumor control probability in low-risk and intermediate-risk prostate cancer patients treated with radiotherapy alone. We also investigated the differences in the dose-response characteristics using the American Society for Therapeutic Radiology and Oncology (ASTRO) definition vs. an alternative biochemical failure definition. Methods and materials: This study included 235 low-risk and 387 intermediate-risk prostate cancer patients treated with external beam radiotherapy without hormonal treatment between 1987 and 1998. The low-risk patients had 1992 American Joint Committee on Cancer Stage T2a or less disease as determined by digital rectal examination, prostate-specific antigen (PSA) levels of ≤10 ng/mL, and biopsy Gleason scores of ≤6. The intermediate-risk patients had one or more of the following: Stage T2b-c, PSA level of ≤20 ng/mL but >10 ng/mL, and/or Gleason score of 7, without any of the following high-risk features: Stage T3 or greater, PSA >20 ng/mL, or Gleason score ≥8. The logistic models were fitted to the data at varying points after treatment, and the dose-response parameters were estimated. We used two biochemical failure definitions. The ASTRO PSA failure was defined as three consecutive PSA rises, with the time to failure backdated to the mid-point between the nadir and the first rise. The second biochemical failure definition used was a PSA rise of ≥2 ng/mL above the current PSA nadir (CN + 2). The failure date was defined as the time at which the event occurred. Local, nodal, and distant relapses and the use of salvage hormonal therapy were also failures. Results: On the basis of the

  17. High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Keisei Okamoto

    2017-02-01

    Full Text Available Purpose : To evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR brachytherapy in combination with external beam radiotherapy (EBRT and short-term androgen deprivation therapy (ADT. Material and methods : From 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT. The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%, 61 patients with 2 high-risk factors (43%, and 22 patients with 3 high-risk factors (15% including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition. Results : Six patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS rate of 97.2%, and an overall survival (OS rate of 95.5%. Conclusions : High-dose (BED ≥ 220 Gy radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further.

  18. Imaging dose in breast radiotherapy: does breast size affect the dose to the organs at risk and the risk of secondary cancer to the contralateral breast?

    International Nuclear Information System (INIS)

    Batumalai, Vikneswary; Quinn, Alexandra; Jameson, Michael; Delaney, Geoff; Holloway, Lois

    2015-01-01

    Correct target positioning is crucial for accurate dose delivery in breast radiotherapy resulting in utilisation of daily imaging. However, the radiation dose from daily imaging is associated with increased probability of secondary induced cancer. The aim of this study was to quantify doses associated with three imaging modalities and investigate the correlation of dose and varying breast size in breast radiotherapy. Planning computed tomography (CT) data sets of 30 breast cancer patients were utilised to simulate the dose received by various organs from a megavoltage computed tomography (MV-CT), megavoltage electronic portal image (MV-EPI) and megavoltage cone-beam computed tomography (MV-CBCT). The mean dose to organs adjacent to the target volume (contralateral breast, lungs, spinal cord and heart) were analysed. Pearson correlation analysis was performed to determine the relationship between imaging dose and primary breast volume and the lifetime attributable risk (LAR) of induced secondary cancer was calculated for the contralateral breast. The highest contralateral breast mean dose was from the MV-CBCT (1.79 Gy), followed by MV-EPI (0.22 Gy) and MV-CT (0.11 Gy). A similar trend was found for all organs at risk (OAR) analysed. The primary breast volume inversely correlated with the contralateral breast dose for all three imaging modalities. As the primary breast volume increases, the likelihood of a patient developing a radiation-induced secondary cancer to the contralateral breast decreases. MV-CBCT showed a stronger relationship between breast size and LAR of developing a radiation-induced contralateral breast cancer in comparison with the MV-CT and MV-EPI. For breast patients, imaging dose to OAR depends on imaging modality and treated breast size. When considering the use of imaging during breast radiotherapy, the patient's breast size and contralateral breast dose should be taken into account

  19. Derivation of Accident-Specific Material-at-Risk Equivalency Factors

    Energy Technology Data Exchange (ETDEWEB)

    Jason P. Andrus; Dr. Chad L. Pope

    2012-05-01

    A novel method for calculating material at risk (MAR) dose equivalency developed at the Idaho National Laboratory (INL) now allows for increased utilization of dose equivalency for facility MAR control. This method involves near-real time accounting for the use of accident and material specific release and transport. It utilizes all information from the committed effective dose equation and the five factor source term equation to derive dose equivalency factors which can be used to establish an overall facility or process MAR limit. The equivalency factors allow different nuclide spectrums to be compared for their respective dose consequences by relating them to a specific quantity of an identified reference nuclide. The ability to compare spectrums to a reference limit ensures that MAR limits are in fact bounding instead of attempting to establish a representative or bounding spectrum which may lead to unintended or unanalyzed configurations. This methodology is then coupled with a near real time material tracking system which allows for accurate and timely material composition information and corresponding MAR equivalency values. The development of this approach was driven by the complex nature of processing operations in some INL facilities. This type of approach is ideally suited for facilities and processes where the composition of the MAR and possible release mechanisms change frequently but in well defined fashions and in a batch-type nature.

  20. Context specificity in the assessment of psychosocial risk at work

    DEFF Research Database (Denmark)

    Camerino, Donatella; Conway, Paul Maurice; Fattori, Alice

    2014-01-01

    Background: Following EU requirements, in recent years standard procedures for the assessment of work-related stress have been developed in Italy. However, while such standardization has facilitated the spread and use of these procedures, it has brought a lack of specificity in risk assessment...

  1. Twin Specific Risk Factors in Primary School Achievements

    NARCIS (Netherlands)

    de Zeeuw, L.E.J.; van Beijsterveldt, C.E.M.; de Geus, E.J.C.; Boomsma, D.I.

    2012-01-01

    The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational

  2. Machine learning-based patient specific prompt-gamma dose monitoring in proton therapy

    Science.gov (United States)

    Gueth, P.; Dauvergne, D.; Freud, N.; Létang, J. M.; Ray, C.; Testa, E.; Sarrut, D.

    2013-07-01

    Online dose monitoring in proton therapy is currently being investigated with prompt-gamma (PG) devices. PG emission was shown to be correlated with dose deposition. This relationship is mostly unknown under real conditions. We propose a machine learning approach based on simulations to create optimized treatment-specific classifiers that detect discrepancies between planned and delivered dose. Simulations were performed with the Monte-Carlo platform Gate/Geant4 for a spot-scanning proton therapy treatment and a PG camera prototype currently under investigation. The method first builds a learning set of perturbed situations corresponding to a range of patient translation. This set is then used to train a combined classifier using distal falloff and registered correlation measures. Classifier performances were evaluated using receiver operating characteristic curves and maximum associated specificity and sensitivity. A leave-one-out study showed that it is possible to detect discrepancies of 5 mm with specificity and sensitivity of 85% whereas using only distal falloff decreases the sensitivity down to 77% on the same data set. The proposed method could help to evaluate performance and to optimize the design of PG monitoring devices. It is generic: other learning sets of deviations, other measures and other types of classifiers could be studied to potentially reach better performance. At the moment, the main limitation lies in the computation time needed to perform the simulations.

  3. Machine learning-based patient specific prompt-gamma dose monitoring in proton therapy

    International Nuclear Information System (INIS)

    Gueth, P; Freud, N; Létang, J M; Sarrut, D; Dauvergne, D; Ray, C; Testa, E

    2013-01-01

    Online dose monitoring in proton therapy is currently being investigated with prompt-gamma (PG) devices. PG emission was shown to be correlated with dose deposition. This relationship is mostly unknown under real conditions. We propose a machine learning approach based on simulations to create optimized treatment-specific classifiers that detect discrepancies between planned and delivered dose. Simulations were performed with the Monte-Carlo platform Gate/Geant4 for a spot-scanning proton therapy treatment and a PG camera prototype currently under investigation. The method first builds a learning set of perturbed situations corresponding to a range of patient translation. This set is then used to train a combined classifier using distal falloff and registered correlation measures. Classifier performances were evaluated using receiver operating characteristic curves and maximum associated specificity and sensitivity. A leave-one-out study showed that it is possible to detect discrepancies of 5 mm with specificity and sensitivity of 85% whereas using only distal falloff decreases the sensitivity down to 77% on the same data set. The proposed method could help to evaluate performance and to optimize the design of PG monitoring devices. It is generic: other learning sets of deviations, other measures and other types of classifiers could be studied to potentially reach better performance. At the moment, the main limitation lies in the computation time needed to perform the simulations. (paper)

  4. Radiation dose and second cancer risk in patients treated for cancer of the cervix

    International Nuclear Information System (INIS)

    Boice, J.D. Jr.; Engholm, G.; Kleinerman, R.A.

    1988-01-01

    The risk of cancer associated with a broad range of organ doses was estimated in an international study of women with cervical cancer. Among 150,000 patients reported to one of 19 population-based cancer registries or treated in any of 20 oncology clinics, 4188 women with second cancers and 6880 matched controls were selected for detailed study. Radiation doses for selected organs were reconstructed for each patient on the basis of her original radiotherapy records. Very high doses, on the order of several hundred gray, were found to increase the risk of cancers of the bladder [relative risk (RR) = 4.0], rectum (RR = 1.8), vagina (RR = 2.7), and possibly bone (RR = 1.3), uterine corpus (RR = 1.3), cecum (RR = 1.5), and non-Hodgkin's lymphoma (RR = 2.5). For all female genital cancers taken together, a sharp dose-response gradient was observed, reaching fivefold for doses more than 150 Gy. Several gray increased the risk of stomach cancer (RR = 2.1) and leukemia (RR = 2.0). Although cancer of the pancreas was elevated, there was no evidence of a dose-dependent risk. Cancer of the kidney was significantly increased among 15-year survivors. A nonsignificant twofold risk of radiogenic thyroid cancer was observed following an average dose of only 0.11 Gy. Breast cancer was not increased overall, despite an average dose of 0.31 Gy and 953 cases available for evaluation (RR = 0.9); there was, however, a weak suggestion of a dose response among women whose ovaries had been surgically removed. Doses greater than 6 Gy to the ovaries reduced breast cancer risk by 44%. A significant deficit of ovarian cancer was observed within 5 years of radiotherapy; in contrast, a dose response was suggested among 10-year survivors

  5. Radiation doses and cause-specific mortality among workers at a nuclear materials fabrication plant

    International Nuclear Information System (INIS)

    Checkoway, H.; Pearce, N.; Crawford-Brown, D.J.; Cragle, D.L.

    1988-01-01

    A historical cohort mortality study was conducted among 6781 white male employees from a nuclear weapons materials fabrication plant for the years 1947-1979. Exposures of greatest concern are alpha and gamma radiation emanating primarily from insoluble uranium compounds. Among monitored workers, the mean cumulative alpha radiation dose to the lung was 8.21 rem, and the mean cumulative external whole body penetrating dose from gamma radiation was 0.96 rem. Relative to US white males, the cohort experienced mortality deficits from all causes combined, cardiovascular diseases, and from most site-specific cancers. Mortality excesses of lung and brain and central nervous system cancers were seen from comparisons with national and state rates. Dose-response trends were detected for lung cancer mortality with respect to cumulative alpha and gamma radiation, with the most pronounced trend occurring for gamma radiation among workers who received greater than or equal to 5 rem of alpha radiation. These trends diminished in magnitude when a 10-year latency assumption was applied. Under a zero-year latency assumption, the rate ratio for lung cancer mortality associated with joint exposure of greater than or equal to 5 versus less than 1 rem of both types of radiation is 4.60 (95% confidence limits (CL) 0.91, 23.35), while the corresponding result, assuming a 10-year latency, is 3.05 (95% CL 0.37, 24.83). While these rate ratios, which are based on three and one death, respectively, lack statistical precision, the observed dose-response trends indicate potential carcinogenic effects to the lung of relatively low-dose radiation. There are no dose-response trends for mortality from brain and central nervous system cancers

  6. Dose and volume specification for reporting NCT. An ICRU-IAEA initiative

    International Nuclear Information System (INIS)

    Wambersie, A.; Gahbauer, R.A.; Whitmore, G.; Levin, C.V.

    2000-01-01

    The present recommendations result from of an ICRU-IAEA initiative for harmonization of reporting NCT (Neutron Capture Therapy). As stated by the ISNCT, harmonization of reporting is required to understand what has actually been done and interpret the clinical results on the basis of reliable information. Prescription of a treatment remains the responsibility of the radiation oncologist in charge of the patient. Complete oncological data should be reported, including Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) as well as Planning Target Volume (PTV), Treated Volume and Organs/Structures at Risk. A reference point for reporting dose should be selected in the central part of the PTV/CTV. At each point of interest, the four components contributing to the absorbed dose and the weighting factors applied to take account of the RBE (Relative Biological Effectiveness) differences should be specified. (author)

  7. Equivalent dose, effective dose and risk assessment from panoramic radiography to the critical organs of head and neck region

    International Nuclear Information System (INIS)

    Cho, Bong Hae; Nah, Kyung Soo; Lee, Ae Ryeon

    1995-01-01

    The purpose of this study was to evaluate the equivalent and effective dose, and estimate radiation risk to the critical organs of head and neck region from the use of adult and child mode in panoramic radiography. The results were as follows. 1. The salivary glands showed the highest equivalent and effective dose in adult and child mode. The equivalent and effective dose in adult mode were 837 μSv and 20.93 μSv, those in child mode were 462 μSv and 11.54 μSv, respectively. 2. Total effective doses to the critical head and neck organs were estimated 34.2l μSv in adult mode, 20.14 μSv in child mode. From these data, the probabilities of stochastic effect from adult and child mode were 2.50xl0 -6 and 1.47x10 -6 3. The other remainder showed the greatest risk of fatal cancer. The risk estimate were 4.5 and 2.7 fatal malignancies in adult and child mode from million examinations. The bone marrow and thyroid gland showed about 0.1 fatal cancer in adult. and child mode from these examinations.

  8. Risk of radiation-induced cancer at low doses and low dose rates for radiation protection purposes

    International Nuclear Information System (INIS)

    1995-01-01

    The aim of this report is to provide an updated, comprehensive review of the data available for assessing the risk of radiation-induced cancer for radiation protection purposes. Particular emphasis is placed on assessing risks at low doses and low dose rates. The review brings together the results of epidemiological investigations and fundamental studies on the molecular and cellular mechanisms involved in radiation damage. Additionally, this information is supplemented by studies with experimental animals which provide further guidance on the form of the dose-response relationship for cancer induction, as well as on the effect of dose rate on the tumour yield. The emphasis of the report is on cancer induction resulting from exposure to radiations with a low linear energy transfer (LET). The work was performed under contract for the Institut de Protection et de Surete Nucleaire, Fontenay-aux-Roses, Paris, France, whose agreement to publish is gratefully ackowledged. It extends the advice on radiation risks given in Documents of the NRPB, 4 No. 4 (1993). (Author)

  9. Breast dose reduction for chest CT by modifying the scanning parameters based on the pre-scan size-specific dose estimate (SSDE)

    Energy Technology Data Exchange (ETDEWEB)

    Kidoh, Masafumi; Utsunomiya, Daisuke; Oda, Seitaro; Nakaura, Takeshi; Yuki, Hideaki; Hirata, Kenichiro; Namimoto, Tomohiro; Sakabe, Daisuke; Hatemura, Masahiro; Yamashita, Yasuyuki [Kumamoto University, Department of Diagnostic Radiology, Faculty of Life Sciences, Honjo, Kumamoto (Japan); Funama, Yoshinori [Kumamoto University, Department of Medical Physics, Faculty of Life Sciences, Honjo, Kumamoto (Japan)

    2017-06-15

    To investigate the usefulness of modifying scanning parameters based on the size-specific dose estimate (SSDE) for a breast-dose reduction for chest CT. We scanned 26 women with a fixed volume CT dose index (CTDI{sub vol}) (15 mGy) and another 26 with a fixed SSDE (15 mGy) protocol (protocol 1 and 2, respectively). In protocol 2, tube current was calculated based on the patient habitus obtained on scout images. We compared the mean breast dose and the inter-patient breast dose variability and performed linear regression analysis of the breast dose and the body mass index (BMI) of the two protocols. The mean breast dose was about 35 % lower under protocol 2 than protocol 1 (10.9 mGy vs. 16.8 mGy, p < 0.01). The inter-patient breast dose variability was significantly lower under protocol 2 than 1 (1.2 mGy vs. 2.5 mGy, p < 0.01). We observed a moderate negative correlation between the breast dose and the BMI under protocol 1 (r = 0.43, p < 0.01); there was no significant correlation (r = 0.06, p = 0.35) under protocol 2. The SSDE-based protocol achieved a reduction in breast dose and in inter-patient breast dose variability. (orig.)

  10. Ontology-based specification, identification and analysis of perioperative risks.

    Science.gov (United States)

    Uciteli, Alexandr; Neumann, Juliane; Tahar, Kais; Saleh, Kutaiba; Stucke, Stephan; Faulbrück-Röhr, Sebastian; Kaeding, André; Specht, Martin; Schmidt, Tobias; Neumuth, Thomas; Besting, Andreas; Stegemann, Dominik; Portheine, Frank; Herre, Heinrich

    2017-09-06

    Medical personnel in hospitals often works under great physical and mental strain. In medical decision-making, errors can never be completely ruled out. Several studies have shown that between 50 and 60% of adverse events could have been avoided through better organization, more attention or more effective security procedures. Critical situations especially arise during interdisciplinary collaboration and the use of complex medical technology, for example during surgical interventions and in perioperative settings (the period of time before, during and after surgical intervention). In this paper, we present an ontology and an ontology-based software system, which can identify risks across medical processes and supports the avoidance of errors in particular in the perioperative setting. We developed a practicable definition of the risk notion, which is easily understandable by the medical staff and is usable for the software tools. Based on this definition, we developed a Risk Identification Ontology (RIO) and used it for the specification and the identification of perioperative risks. An agent system was developed, which gathers risk-relevant data during the whole perioperative treatment process from various sources and provides it for risk identification and analysis in a centralized fashion. The results of such an analysis are provided to the medical personnel in form of context-sensitive hints and alerts. For the identification of the ontologically specified risks, we developed an ontology-based software module, called Ontology-based Risk Detector (OntoRiDe). About 20 risks relating to cochlear implantation (CI) have already been implemented. Comprehensive testing has indicated the correctness of the data acquisition, risk identification and analysis components, as well as the web-based visualization of results.

  11. Study on the evaluation of radiation doses in dental radiography. Doses and risks due to dental full mouth examination

    Energy Technology Data Exchange (ETDEWEB)

    Sugimoto, K [Kanagawa Dental Coll., Yokosuka (Japan)

    1980-09-01

    Radiation doses and possible biological risks due to dental full mouth examination (adult: 10-film technique, child: 6-film technique) were evaluated based on preliminary experiments and statistical surveillance of patients' records. Dosimetrical studies were performed by using head and neck phantoms and a dental x-ray tube. Radiation doses were measured by x-ray films and thermoluminescence dosimeters. For the obtained doses of skin, eyes, thyroid gland and bone marrow, the biological risk of leukemia and thyroid cancer was discussed on the statistical basis of patients at Kanagawa Dental College Hospital. The major findings were as follows: The total number of patients who recieved full mouth x-ray examination at Kanagawa Dental College Hospital in 1978 was 1,099. The number of male patients was 382 (3,804 films) and that of female patients was 717 (7,138 films). In both sexes, the number of patients was the greatest in the group of 8 - 14 years of age. The collective doses of bone marrow due to full mouth 10-film examination performed at Kanagawa Dental College Hospital in 1978 were approximately 6.0 rad, which could induce leukemia with a probability of 1/8,000. The collective doses of thyroid gland were approximately 13 rad, which could induce lethal thyroid cancer with a probability of 1/15,000. The radiation dose due to the dental radiography for examination at Kanagawa Dental College Hospital was proved to be apparently below the level that could actually induce radiation injuries. But the collective radiation doses due to dental examination in Japan as a whole were approximately 8,000 times greater than that in Kanagawa Dental College Hospital.

  12. Estimation of outdoor and indoor effective dose and excess lifetime cancer risk from Gamma dose rates in Gonabad, Iran

    Energy Technology Data Exchange (ETDEWEB)

    Jafaria, R.; Zarghania, H.; Mohammadia, A., E-mail: rvzreza@gmail.com [Paramedical faculty, Birjand University of Medical Sciences, Birjand (Iran, Islamic Republic of)

    2017-07-01

    Background gamma irradiation in the indoor and outdoor environments is a major concern in the world. The study area was Gonabad city. Three stations and buildings for background radiation measurement of outdoor and indoor were randomly selected and the Geiger-Muller detector (X5C plus) was used. All dose rates on display of survey meter were recorded and mean of all data in each station and buildings was computed and taken as measured dose rate of that particular station. The average dose rates of background radiation were 84.2 nSv/h for outdoor and 108.6 nSv/h for indoor, maximum and minimum dose rates were 88.9 nSv/h and 77.7 nSv/h for outdoor measurements and 125.4 nSv/h and 94.1 nSv/h for indoor measurements, respectively. Results show that the annual effective dose is 0.64 mSv, which compare to global level of the annual effective dose 0.48 mSv is high. Estimated excess lifetime cancer risk was 2.24×10{sup -3} , indicated that it is large compared to the world average value of 0.25×10{sup -3}. (author)

  13. Out-of-field organ doses and associated radiogenic risks from para-aortic radiotherapy for testicular seminoma

    Energy Technology Data Exchange (ETDEWEB)

    Mazonakis, Michalis, E-mail: mazonak@med.uoc.gr; Berris, Theocharis; Damilakis, John [Department of Medical Physics, Faculty of Medicine, University of Crete, P. O. Box 2208, 71003 Iraklion, Crete (Greece); Varveris, Charalambos; Lyraraki, Efrossyni [Department of Radiotherapy and Oncology, University Hospital of Iraklion, 71110 Iraklion, Crete (Greece)

    2014-05-15

    Purpose: The aims of this study were to (a) calculate the radiation dose to out-of-field organs from radiotherapy for stage I testicular seminoma and (b) estimate the associated radiogenic risks. Methods: Monte Carlo methodology was employed to model radiation therapy with typical anteroposterior and posteroanterior para-aortic fields on an anthropomorphic phantom simulating an average adult. The radiation dose received by all main and remaining organs that defined by the ICRP publication 103 and excluded from the treatment volume was calculated. The effect of field dimensions on each organ dose was determined. Additional therapy simulations were generated by introducing shielding blocks to protect the kidneys from primary radiation. The gonadal dose was employed to assess the risk of heritable effects for irradiated male patients of reproductive potential. The lifetime attributable risks (LAR) of radiotherapy-induced cancer were estimated using gender- and organ-specific risk coefficients for patient ages of 20, 30, 40, and 50 years old. The risk values were compared with the respective nominal risks. Results: Para-aortic irradiation to 20 Gy resulted in out-of-field organ doses of 5.0–538.6 mGy. Blocked field treatment led to a dose change up to 28%. The mean organ dose variation by increasing or decreasing the applied field dimensions was 18.7% ± 3.9% and 20.8% ± 4.5%, respectively. The out-of-field photon doses increased the lifetime intrinsic risk of developing thyroid, lung, bladder, prostate, and esophageal cancer by (0.1–1.4)%, (0.4–1.1)%, (2.5–5.4)%, (0.2–0.4)%, and (6.4–9.2)%, respectively, depending upon the patient age at exposure and the field size employed. A low risk for heritable effects of less than 0.029% was found compared with the natural incidence of these defects. Conclusions: Testicular cancer survivors are subjected to an increased risk for the induction of bladder and esophageal cancer following para-aortic radiotherapy. The

  14. Occupational radiation dose assessment for a non site specific spent fuel storage facility

    International Nuclear Information System (INIS)

    Hadley, J.; Eble, R.G. Jr.

    1997-01-01

    To expedite the licensing process of the non site specific Centralized Interim Storage Facility (CISF) the Department of Energy has completed a phase I CISF Topical Safety Analysis Report (TSAR). The TSAR will be used in licensing the phase I CISF if a site is designated. An occupational radiation does assessment of the facility operations is performed as part of the phase I CISF design. The first phase of the CISF has the capability to receive, transfer, and store SNF in dual-purpose cask/canister systems (DPC's). Currently there are five vendor technologies under consideration. The preliminary dose assessment is based on estimated occupational exposures using traditional power plant ISFSI and transport cask handling processes. The second step in the process is to recommend ALARA techniques to reduce potential exposures. A final dose assessment is completed implementing the ALARA techniques and a review is performed to ensure that the design is in compliance with regulatory criteria. The dose assessment and ALARA evaluation are determined using the following input information: Dose estimates from vendor SAR's; ISFSI experience with similar systems; Traditional methods of operations; Expected CISF cask receipt rates; and feasible ALARA techniques. 5 refs., 1 tab

  15. Low-dose aspirin and risk of intracranial bleeds

    DEFF Research Database (Denmark)

    Cea Soriano, Lucía; Gaist, David; Soriano-Gabarró, Montse

    2017-01-01

    cohort of nonusers of low-dose aspirin at baseline were followed (maximum 14 years, median 5.4 years) to identify incident cases of ICB, with validation by manual review of patient records or linkage to hospitalization data. Using 10,000 frequency-matched controls, adjusted rate ratios (RRs) with 95...

  16. Low-dose tryptophan depletion in recovered depressed women induces impairments in autobiographical memory specificity.

    Science.gov (United States)

    Haddad, Anneke D M; Williams, J Mark G; McTavish, Sarah F B; Harmer, Catherine J

    2009-12-01

    Depressed patients perform poorly on tests of autobiographical memory specificity (AMS); this may have negative consequences for other important cognitive abilities, delays recovery from mood episodes, and, in recovered patients, may mediate vulnerability to future episodes. Although the cognitive mechanisms underlying AMS deficits are beginning to be understood, the neurobiological mechanisms remain unclear. Serotonin is implicated in both depression and long-term memory; therefore, temporary lowering of brain serotonin function via acute tryptophan depletion (ATD) offers a means of studying the role of serotonin in autobiographical memory specificity. In this study, 24 previously depressed women underwent low-dose ATD or sham depletion and completed tests of initial and delayed memory, recollection- and familiarity-based recognition, and AMS. ATD did not differentially affect state mood. Compared with sham depletion, ATD impaired immediate recall on the Auditory Verbal Learning Test. Although ATD did not differentially impair recollection- and familiarity-based recognition, it did slow recognition of positive words. ATD also reduced autobiographical memory specificity in response to negative cue words. The results confirm previous findings that low-dose ATD can reinstate depression-congruent biases in cognition without causing depressive mood in vulnerable populations. The ATD-induced reduction in memory specificity suggests that serotonergic dysfunction may mediate depressive deficits in autobiographical memory; the interaction of cognitive and neurobiological vulnerability mechanisms is discussed.

  17. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Gestaut, Matthew M.; Cai, Wendi; Vyas, Shilpa; Patel, Belur J.; Hasan, Salman A.; MunozMaldonado, Yolanda; Deb, Niloyjyoti; Swanson, Gregory

    2017-01-01

    Purpose: Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Methods and Materials: Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. Results: A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression–free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (P<.0001). The 5-year bPFS rate was 70.0% (LRC), 51.4% (IRC), 89.4% (LRB), and 89.7% (IRB). The bPFS rate was significantly different between brachytherapy and cryotherapy for low- and intermediate-risk groups (P<.05). The mean nadir temperature reached for cryotherapy patients was −35°C (range, −96°C to −6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Conclusions: Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with

  18. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer.

    Science.gov (United States)

    Gestaut, Matthew M; Cai, Wendi; Vyas, Shilpa; Patel, Belur J; Hasan, Salman A; MunozMaldonado, Yolanda; Deb, Niloyjyoti; Swanson, Gregory

    2017-05-01

    Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression-free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (Pcryotherapy for low- and intermediate-risk groups (Pcryotherapy patients was -35°C (range, -96°C to -6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with low- to intermediate-risk prostate cancer. Patient selection criteria for consideration of cryotherapy and brachytherapy are similar in terms of anesthesia candidacy. Therefore, cryotherapy would not be recommended as a first-line local therapy for this particular

  19. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gestaut, Matthew M., E-mail: Matthew.Gestaut@BSWHealth.org [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); Cai, Wendi [Department of Biostatistics, Baylor Scott and White Health, Temple, Texas (United States); Vyas, Shilpa [Department of Radiation Oncology, Swedish Cancer Institute, Seattle, Washington (United States); Patel, Belur J. [Department of Urology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); Hasan, Salman A. [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); MunozMaldonado, Yolanda [Department of Biostatistics, Baylor Scott and White Health, Temple, Texas (United States); Deb, Niloyjyoti; Swanson, Gregory [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States)

    2017-05-01

    Purpose: Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Methods and Materials: Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. Results: A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression–free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (P<.0001). The 5-year bPFS rate was 70.0% (LRC), 51.4% (IRC), 89.4% (LRB), and 89.7% (IRB). The bPFS rate was significantly different between brachytherapy and cryotherapy for low- and intermediate-risk groups (P<.05). The mean nadir temperature reached for cryotherapy patients was −35°C (range, −96°C to −6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Conclusions: Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with

  20. Cancer incidence after retinoblastoma - Radiation dose and sarcoma risk

    NARCIS (Netherlands)

    Wong, FL; Boice, JD; Abramson, DH; Tarone, RE; Kleinerman, RA; Stovall, M; Goldman, MB; Seddon, JM; Tarbell, N; Fraumeni, JF; Li, FP

    1997-01-01

    Context.-There is a substantial risk of a second cancer for persons with hereditary retinoblastoma, which is enhanced by radiotherapy. Objective.-To examine long-term risk of new primary cancers in survivors of childhood retinoblastoma and quantify the role of radiotherapy in sarcoma development.

  1. Radiation dose to testes and risk of infertility from radiotherapy for rectal cancer.

    Science.gov (United States)

    Mazonakis, Michalis; Damilakis, John; Varveris, Haris; Gourtsouiannis, Nicholas

    2006-03-01

    This study aims to provide the means for testicular dose estimation from radiotherapy for rectal cancer. Rectal irradiation was simulated on a humanoid phantom using a 6 MV photon beam. The effect of field size, distance from irradiated area, wedge introduction into lateral beams, tissue thickness along the beam axis and use of gonad shields on the testicular dose was examined. Testicular dose was measured in five patients undergoing radiotherapy for rectal carcinoma. For a 4500 cGy tumour dose, testicular dose was 32-216 cGy depending upon the field dimensions and the distance from the field isocenter. The presence of wedges increased the testicular dose by a factor up to 2.2. The increase of irradiated tissue thickness increased the gonadal dose up to 40% whereas the use of the appropriate gonad shield reduced the dose by >66%. A simple method was developed to estimate testicular dose. The mean difference between the in vivo gonadal doses and the doses calculated using the proposed method was 5.8%. Testicular dose can exceed the value of 100 cGy, which permits a complete recovery of spermatogenesis. The presented data can be used to estimate the gonadal dose and the associated risk of infertility attributable to rectal irradiation.

  2. Economics of site-specific and variable-dose herbicide application

    DEFF Research Database (Denmark)

    Ørum, Jens Erik; Kudsk, Per; Jensen, Peter Kryger

    2017-01-01

    Site-specific application of pesticides has so far focused mainly on herbicides. The purpose of precision farming technologies in relation to herbicide use is to reduce herbicide cost and environmental impact from spraying, but at the same time to achieve acceptable weed control. Another purpose...... is to increase the spraying capacity, to reduce the number of sprayer refills, and finally to minimize time spent on weed monitoring. In this chapter the relevance and profitability of four precision herbicide application technologies, two weed detection technologies and a low dose decision support system (DSS......) is analysed. With a low dose herbicide, cost can be reduced by 20–50%. It requires, however, proper monitoring of weeds, which can be a time-consuming task that again requires that the farmer is able to identify the dominant weed species. The current development of high-speed camera and software systems can...

  3. Improvement of quantification of somatic radiation risks at low doses

    International Nuclear Information System (INIS)

    Jacobi, W.; Paretzke, H.G.; Henrichs, K.; Hettig, H.; Jacob, P.; Merkle, W.; Messerer, P.; Schindel, F.

    1985-10-01

    In this research contract several selected topics of basic relevancy for assessment models of radiological consequences of hypothetical reactor accidents have been considered. The investigations focussed on the following areas: 1) Age dependent dose conversion factors for members of the public and their variability for radioisotopes of iodine, strontium, and caesium, - improvement of the accuracy of dose calculations for external gamma irradiation from cloud- and ground-shine; 2) analysis of data and models relevant for the assessment of exposure-time-effect relationships for lethal somatic late effects of lung and breast cancer and of leukemia; 3) analysis of various health status indices (e.g. ''loss of healthy life span'') with respect to their usefulness in addition to incidence, mortality, etc. for the evaluation of the magnitude of a health detriment due to a previous radiation exposure. (orig./HP) [de

  4. Dose-response relationship analysis for cancer and circulatory system disease mortality risks among uranium miners

    International Nuclear Information System (INIS)

    Drubay, Damien

    2015-01-01

    The relation between lung cancer risk and radon exposure has been clearly established, especially from the studies on uranium miner cohorts. But the association between radon exposure and extrapulmonary cancers and non-cancer diseases remains not well known. Moreover, the health risks associated with the other mining-related ionizing radiation exposures are still under consideration. The aim of this thesis is to contribute to the estimation of the radio-induced health risks at low-doses through the analysis of the kidney cancer and Circulatory System Disease (CSD) mortality risks among uranium miners. Kidney cancer mortality risk analyses were performed from the French cohort of uranium miners (n=5086; follow-up period: 1946-2007), the post-55 cohort (n=3,377; follow-up period: 1957-2007) and the German cohort of the Wismut (n=58,986; follow-up period: 1946-2003) which included 24, 11 and 174 deaths from kidney cancer, respectively. The exposures to radon and its short-lived progeny (expressed in Working Level Month WLM), to uranium ore dust (kBqh.m -3 ) and to external gamma rays (mSv) were estimated for each miners and the equivalent kidney dose was calculated. The dose-response relation was refined considering two responses: the instantaneous risk of kidney cancer mortality (corresponding to the classical analysis, Cause specific Hazard Ratio (CSHR) estimated with the Cox model) and its occurrence probability during the followup (Sub-distribution Hazard Ratio (SHR) estimated with the Fine and Gray model). An excess of kidney cancer mortality was observed only in the French cohort (SMR = 1.62 CI95%[1.04; 2.41]). In the Wismut cohort, a decrease of the kidney cancer mortality was observed (0.89 [0.78; 0.99]). For these three cohorts, the occupational radiological exposures (or the equivalent kidney dose) were significantly associated neither with the risk of kidney cancer mortality (e.g. CSHRWismut-radon/100 WLM=1.023 [0.993; 1.053]), nor with its occurrence

  5. Second International MELODI Workshop on Low Dose Risk Research - Slides of the presentations

    International Nuclear Information System (INIS)

    Repussard, J.; Weiss, W.; Quintana Trias, O.; Rosario Perez, M. del; Andersen, M.; Rudiger Trott, K.; Ottolenghi, A.; Smyth, V.; Graw, J.; Little, M.P.; Yonai, S.; Barcellos-Hoff, M.H.; Bouffler, S.; Chevillard, S.; Jeggo, P.; Sabatier, L.; Baatout, S.; Niwa, O.; Oesch, F.; Atkinson, M.; Averbeck, D.; Lloyd, D.; O'Neill, P.

    2011-01-01

    The MELODI (Multidisciplinary European Low Dose Initiative) mission is to impulse low dose risk research in Europe through a strategic research agenda (SRA) and road-map of priorities. The last presentation is dedicated to the SRA and its preference research programs. The other presentations deal principally with the low-dose exposure in medical uses of ionizing radiations, radiosensitivity, radiation-induced cataracts, or epidemiology and radiobiology of cardiovascular disease. This document is composed of the slides of the presentations

  6. Thyroid Radiation Dose and Other Risk Factors of Thyroid Carcinoma Following Childhood Cancer.

    Science.gov (United States)

    de Vathaire, Florent; Haddy, Nadia; Allodji, Rodrigue S; Hawkins, Mike; Guibout, Catherine; El-Fayech, Chiraz; Teinturier, Cécile; Oberlin, Odile; Pacquement, Hélène; Diop, Fara; Kalhouche, Amar; Benadjaoud, Mohamedamine; Winter, David; Jackson, Angela; Bezin Mai-Quynh, Giao; Benabdennebi, Aymen; Llanas, Damien; Veres, Cristina; Munzer, Martine; Nguyen, Tan Dat; Bondiau, Pierre-Yves; Berchery, Delphine; Laprie, Anne; Deutsch, Eric; Lefkopoulos, Dimitri; Schlumberger, Martin; Diallo, Ibrahima; Rubino, Carole

    2015-11-01

    Thyroid carcinoma is a frequent complication of childhood cancer radiotherapy. The dose response to thyroid radiation dose is now well established, but the potential modifier effect of other factors requires additional investigation. This study aimed to investigate the role of potential modifiers of the dose response. We followed a cohort of 4338 5-year survivors of solid childhood cancer treated before 1986 over an average of 27 years. The dose received by the thyroid gland and some other anatomical sites during radiotherapy was estimated after reconstruction of the actual conditions in which irradiation was delivered. Fifty-five patients developed thyroid carcinoma. The risk of thyroid carcinoma increased with a radiation dose to the thyroid of up to two tenths of Gy, then leveled off for higher doses. When taking into account the thyroid radiation dose, a surgical or radiological splenectomy (>20 Gy to the spleen) increased thyroid cancer risk (relative risk [RR] = 2.3; 95% confidence interval [CI], 1.3-4.0), high radiation doses (>5 Gy) to pituitary gland lowered this risk (RR = 0.2; 95% CI, 0.1-0.6). Patients who received nitrosourea chemotherapy had a 6.6-fold (95% CI, 2.5-15.7) higher risk than those who did not. The excess RR per Gy of radiation to the thyroid was 4.7 (95% CI, 1.7-22.6). It was 7.6 (95% CI, 1.6-33.3) if body mass index at time of interview was equal or higher than 25 kg/m(2), and 4.1 (95% CI, 0.9-17.7) if not (P for interaction = .1). Predicting thyroid cancer risk following childhood cancer radiation therapy probably requires the assessment of more than just the radiation dose to the thyroid. Chemotherapy, splenectomy, radiation dose to pituitary gland, and obesity also play a role.

  7. Estimates of radiation doses and cancer risk from food intake in Korea

    International Nuclear Information System (INIS)

    Moon, Eun Kyeong; Lee, Won Jin; Ha, Wi Ho; Seo, Song Won; Jin, Young Woo; Jeong, Kyu Hwan; Yoon, Hae Jung; Kim, Hyoung Soo; Hwang, Myung Sil; Choi, Hoon

    2016-01-01

    After the Fukushima Daiichi nuclear power plant accident, a widespread public concern for radiation exposure through the contamination of domestic or imported food has continued worldwide. Because the internal exposure from contaminated food is an important consideration for human health effect, some studies for estimating radiation doses and cancer risk from the Fukushima nuclear accident have been conducted in several countries (1). The aims of the study is to estimate internal radiation dose and lifetime risks of cancer from food ingestion in Korean population. Our findings suggest no discernible increase n radiation doses or excess fatal cancer risk from food ingestion at this stage in Korea, and provide scientific evidence of the risk communication with general public associated with low-dose radiation exposure.

  8. Estimates of radiation doses and cancer risk from food intake in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Eun Kyeong; Lee, Won Jin [Korea University, Seoul (Korea, Republic of); Ha, Wi Ho; Seo, Song Won; Jin, Young Woo [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Jeong, Kyu Hwan [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Yoon, Hae Jung; Kim, Hyoung Soo; Hwang, Myung Sil [Ministry of Food and Drug Safety, Cheongju (Korea, Republic of); Choi, Hoon [Wonkwang University, Iksan (Korea, Republic of)

    2016-04-15

    After the Fukushima Daiichi nuclear power plant accident, a widespread public concern for radiation exposure through the contamination of domestic or imported food has continued worldwide. Because the internal exposure from contaminated food is an important consideration for human health effect, some studies for estimating radiation doses and cancer risk from the Fukushima nuclear accident have been conducted in several countries (1). The aims of the study is to estimate internal radiation dose and lifetime risks of cancer from food ingestion in Korean population. Our findings suggest no discernible increase n radiation doses or excess fatal cancer risk from food ingestion at this stage in Korea, and provide scientific evidence of the risk communication with general public associated with low-dose radiation exposure.

  9. Risks Associated with High-Dose Lactobacillus rhamnosus in an Escherichia coli Model of Piglet Diarrhoea

    DEFF Research Database (Denmark)

    Li, Xiao-Qiong; Zhu, Yao-Hong; Zhang, Hong-Fu

    2012-01-01

    might be more effective than a high dose at ameliorating diarrhoea. There is a risk that high-dose L. rhamnosus pretreatment may negate the preventative effects, thus decreasing the prophylactic benefits against potential enteric pathogens. Our data suggest a safe threshold for preventative use...

  10. Patient doses and radiation risks in film-screen mammography in Finland

    International Nuclear Information System (INIS)

    Servomaa, A.; Parviainen, T.; Komppa, T.

    1995-01-01

    Screen-film mamography is the most sensitive method for the early detection of breast cancer. Breast doses in mamography should be measured for several reasons, especially for the evaluation of patient risk in a screening programme, but also for the assessment and comparison of imaging techniques and equipment performance. In this study, the factors affecting patient doses were assessed by making performance and patient dose measurements; about 50 mammographic units used for screening were included in the study. The lifetime risk as a function of age at exposure was calculated using the average glandular dose, the relative risk model shown in the BEIR V report, and the breast cancer mortality in Finland. The mean surface dose of a 4.5 cm thick phantom was 6.3 mGy, and the mean glandular dose 1.0 mGy. Analysis of the surface dose with respect to film optical density, relative speed of film processing, sensitivity of image receptors, and antiscatter grid showed that the mean surface dose could be decreased by more than 50%. For the screened age group of 50 to 59 years, the risk of exposure-induced death (REID) of breast cancer is about 1.4 x 10 -6 mSv -1 , and the average loss of life expectancy due to the radiation-induced breast cancer deaths (LLE/REID) is about 9.5 years. (Author)

  11. Dose-response relationships and risk estimates for the induction of cancer due to low doses of low-LET radiation

    International Nuclear Information System (INIS)

    Elaguppillai, V.

    1981-01-01

    Risk estimates for radiation-induced cancer at low doses can be obtained only by extrapolation from the known effects at high doses and high dose rates, using a suitable dose-response model. The applicability of three different models, linear, sublinear and supralinear, are discussed in this paper. Several experimental studies tend to favour a sublinear dose-response model (linear-quadratic model) for low-LET radiation. However, human epidemiological studies do not exclude any of the dose-response relationships. The risk estimates based on linear and linear quadratic dose-response models are compared and it is concluded that, for low-LET radiation, the linear dose-response model would probably over-estimate the actual risk of cancer by a factor of two or more. (author)

  12. Regional and site-specific absolute humidity data for use in tritium dose calculations

    International Nuclear Information System (INIS)

    Etnier, E.L.

    1980-01-01

    Due to the potential variability in average absolute humidity over the continental U.S., and the dependence of atmospheric 3 H specific activity on absolute humidity, availability of regional absolute humidity data is of value in estimating the radiological significance of 3 H releases. Most climatological data are in the form of relative humidity, which must be converted to absolute humidity for dose calculations. Absolute humidity was calculated for 218 points across the U.S., using the 1977 annual summary of U.S. Climatological Data, and is given in a table. Mean regional values are shown on a map. (author)

  13. Radiation dose, reproductive history, and breast cancer risk among Japanese A-bomb survivors

    International Nuclear Information System (INIS)

    Land, C.E.

    1992-01-01

    Excess risk of female breast cancer is among the most comprehensively documented late effects of exposure to substantial doses of ionizing radiation, based on studies of medically irradiated populations and the survivors of the A-bombings of Hiroshima and Nagasaki. This study looks at the interaction of dose with epidemiological factors like age at first full-term pregnancy and family history of breast cancer, most closely associated with risk in epidemiological studies of non-irradiatied populations. 1 fig., 2 tabs

  14. Risk of a second malignant neoplasm after cancer in childhood treated with radiotherapy: correlation with the integral dose

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, F.; Rubino, C.; Guerin, S.; de Vathaire, F. [National Institute of Public Health and Medical Research (INSERM) Unit 605, Institut Gustave-Roussy, Villejuif (France); Diallo, I.; Samand, A. [National Institute of Public Health and Medical Research (INSERM) Unit 605, Institut Gustave-Roussy, Villejuif, (France); Medical Physics and Radiotherapy Departments, Institut Gustave-Roussy, Villejuif (France); Hawkins, M. [Centre for Childhood Cancer Survivor Studies, University of Birmingham, Birmingham (United Kingdom); Oberlin, O. [Paediatrics Department, Institut Gustave-Roussy, Villejuif (France); Lefkopoulos, D. [Medical Physics and Radiotherapy Departments, Institut Gustave-Roussy, Villejuif (France)

    2006-07-01

    In the cohort, among patients who had received radiotherapy, only those who had received the highest integral dose had a higher risk. Among the other patients, including 80% of the variability of the integral dose, no increased risk was evidenced. Thus, the integral dose in the study cannot be considered as a good predictor of later risk. (N.C.)

  15. Risk of a second malignant neoplasm after cancer in childhood treated with radiotherapy: correlation with the integral dose

    International Nuclear Information System (INIS)

    Nguyen, F.; Rubino, C.; Guerin, S.; de Vathaire, F.; Diallo, I.; Samand, A.; Hawkins, M.; Oberlin, O.; Lefkopoulos, D.

    2006-01-01

    In the cohort, among patients who had received radiotherapy, only those who had received the highest integral dose had a higher risk. Among the other patients, including 80% of the variability of the integral dose, no increased risk was evidenced. Thus, the integral dose in the study cannot be considered as a good predictor of later risk. (N.C.)

  16. Determinations of dose mean of specific energy for conventional x-rays by variance-measurements

    International Nuclear Information System (INIS)

    Forsberg, B.; Jensen, M.; Lindborg, L.; Samuelson, G.

    1978-05-01

    The dose mean value (zeta) of specific energy of a single event distribution is related to the variance of a multiple event distribution in a simple way. It is thus possible to determine zeta from measurements in high dose rates through observations of the variations in the ionization current from for instance an ionization chamber, if other parameters contribute negligibly to the total variance. With this method is has earlier been possible to obtain results down to about 10 nm in a beam of Co60-γ rays, which is one order of magnitude smaller than the sizes obtainable with the traditional technique. This advantage together with the suggestion that zeta could be an important parameter in radiobiology make further studies of the applications of the technique motivated. So far only data from measurements in beams of a radioactive nuclide has been reported. This paper contains results from measurements in a highly stabilized X-ray beam. The preliminary analysis shows that the variance technique has given reasonable results for object sizes in the region of 0.08 μm to 20 μm (100 kV, 1.6 Al, HVL 0.14 mm Cu). The results were obtained with a proportional counter except for the larger object sizes, where an ionization chamber was used. The measurements were performed at dose rates between 1 Gy/h and 40 Gy/h. (author)

  17. Risk of Low Dose/Low Dose Rate Ionizing Radiation to Humans Symposium Annual Meeting of the Environmental Mutagen Society: Agenda and Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    Veigl, Martina L. [Environmental Mutagen Society (EMS), Reston, VA (United States); Case Western Reserve Univ., Cleveland, OH (United States). Case Comprehensive Cancer Center; Morgan, William F. [Univ. of Maryland, College Park, MD (United States); Schwartz, Jeffrey L. [Univ. of Washington, Seattle, WA (United States)

    2009-11-11

    The low dose symposium thoughtfully addressed controversy of risk from low dose radiation exposure, hormesis and radon therapy. The stem cell symposium cogently considered the role of DNA damage and repair in hematopoietic stem cells underlying aging and malignancy and provocatively presented evidence that stem cells may have distinct morphologies and replicative properties, as well as special roles in cancer initiation. In the epigenetics symposium, studies illustrated the long range interaction of epigenetic mechanisms, the roles of CTCF and BORIS in region/specific regulation of epigenetic processes, the impact of DNA damage on epigenetic processes as well as links between epigenetic mechanisms and early nutrition and bystander effects. This report shows the agenda and abstracts for this symposium.

  18. Comfrey: assessing the low-dose health risk.

    Science.gov (United States)

    Abbott, P J

    The regular use of comfrey as part of the diet or for medicinal purposes may be a potential health risk as a result of the presence of naturally-occurring pyrrolizidine alkaloids. The majority of these alkaloids are hepatotoxic in both animals and humans, and some have been shown to induce tumours in experimental animals. In this article, the toxic properties of pyrrolizidine alkaloids are reviewed briefly, with particular reference to their presence in comfrey. The acute and long-term health risks at the normally-low levels of comfrey consumption are evaluated and discussed. On the basis of the data that are available currently, the small but significant long-term risk that is associated with the consumption of comfrey justifies the need to limit its intake. This is being achieved by controls under various state Poisons Acts, but also requires further education on the potential dangers of naturally-occurring chemicals of plant origin.

  19. Radiation dose and cancer risk among pediatric patients undergoing interventional neuroradiology procedures

    International Nuclear Information System (INIS)

    Thierry-Chef, Isabelle; Simon, Steven L.; Miller, Donald L.

    2006-01-01

    During interventional neuroradiology procedures, patients can be exposed to moderate to high levels of radiation. Special considerations are required to protect children, who are generally more sensitive to the short- and long-term detrimental effects of radiation exposure. Estimates of dose to the skin of children from certain interventional procedures have been published elsewhere, but we are not aware of data on dose to the brain or on the long-term risk of cancer from brain radiation. Our goals were to estimate radiation doses to the brain in 50 pediatric patients who had undergone cerebral embolization and to assess their lifetime risks of developing radiation-related brain cancer. Entrance-peak skin dose and various assumptions on conditions of exposure were used as input for dosimetric calculations to estimate the spatial pattern of dose within the brain and the average dose to the whole brain for each child. The average dose and the age of the child at time of exposure were used to estimate the lifetime risk of developing radiation-related brain cancer. Among the 50 patients, average radiation doses to the brain were estimated to vary from 100 mGy to 1,300 mGy if exposed to non-collimated fields and from 20 mGy to 160 mGy for collimated, moving fields. The lifetime risk of developing brain cancer was estimated to be increased by 2% to 80% as a result of the exposure. Given the very small lifetime background risk of brain tumor, the excess number of cases will be small even though the relative increase might be as high as 80%. ALARA principles of collimation and dose optimization are the most effective means to minimize the risk of future radiation-related cancer. (orig.)

  20. Element-specific and constant parameters used for dose calculations in SR-Site

    International Nuclear Information System (INIS)

    Norden, Sara; Avila, Rodolfo; De la Cruz, Idalmis; Stenberg, Kristofer; Grolander, Sara

    2010-12-01

    The report presents Best Estimate (BE) values and Probability Distribution Functions (PDFs) of Concentration Ratios (CR) for different types of terrestrial and aquatic biota and distribution coefficients (K d ) for organic and inorganic deposits, as well as for suspended matter in freshwater and marine ecosystems. The BE values have been used in deterministic simulations for derivation of Landscape Dose Factors (LDF) applied for dose assessments in SR-Site. The PDFs have been used in probabilistic simulations for uncertainty and sensitivity analysis of the LDFs. The derivation of LDFs for SR-Site is described in /Avila et al. 2010/. The CR and K d values have been derived using both site-specific data measured at Laxemar and Forsmark during the site investigation program and literature data. These two data sources have been combined using Bayesian updating methods, which are described in detail in an Appendix, along with the input data used in the statistical analyses and the results obtained. The report also describes a kinetic-allometric model that was applied for deriving values of CR for terrestrial herbivores in cases when site and literature data for an element were missing. In addition, the report presents values for a number of other parameters used in the SR-Site Radionuclide Model for the biosphere: radionuclide decay-ingrowth data, elemental diffusivities, fractions of element content released during decomposition processes, ingestion of food, water and soil by cattle, elements retention fraction on plant surfaces during irrigation. The report also presents parameter values used in calculation of doses to a reference man: dose coefficients for inhalation, ingestion and external exposure, inhalation rates, ingestion rates of food and water

  1. Element-specific and constant parameters used for dose calculations in SR-Site

    Energy Technology Data Exchange (ETDEWEB)

    Norden, Sara (Svensk Kaernbraenslehantering AB (Sweden)); Avila, Rodolfo; De la Cruz, Idalmis; Stenberg, Kristofer; Grolander, Sara (Facilia AB (Sweden))

    2010-12-15

    The report presents Best Estimate (BE) values and Probability Distribution Functions (PDFs) of Concentration Ratios (CR) for different types of terrestrial and aquatic biota and distribution coefficients (K{sub d}) for organic and inorganic deposits, as well as for suspended matter in freshwater and marine ecosystems. The BE values have been used in deterministic simulations for derivation of Landscape Dose Factors (LDF) applied for dose assessments in SR-Site. The PDFs have been used in probabilistic simulations for uncertainty and sensitivity analysis of the LDFs. The derivation of LDFs for SR-Site is described in /Avila et al. 2010/. The CR and K{sub d} values have been derived using both site-specific data measured at Laxemar and Forsmark during the site investigation program and literature data. These two data sources have been combined using Bayesian updating methods, which are described in detail in an Appendix, along with the input data used in the statistical analyses and the results obtained. The report also describes a kinetic-allometric model that was applied for deriving values of CR for terrestrial herbivores in cases when site and literature data for an element were missing. In addition, the report presents values for a number of other parameters used in the SR-Site Radionuclide Model for the biosphere: radionuclide decay-ingrowth data, elemental diffusivities, fractions of element content released during decomposition processes, ingestion of food, water and soil by cattle, elements retention fraction on plant surfaces during irrigation. The report also presents parameter values used in calculation of doses to a reference man: dose coefficients for inhalation, ingestion and external exposure, inhalation rates, ingestion rates of food and water

  2. Use of doubling doses for the estimation of genetic risks

    International Nuclear Information System (INIS)

    Searle, A.G.

    1977-01-01

    Doubling dose estimates derived from radiation experiments in mice are proving of great value for the assessment of genetic hazards to man from extra radiation exposure because they allow the latest information on mutation frequencies and the incidence of genetic disease in man to be used in the assessment process. The similarity in spectra of 'spontaneous' and induced mutations increases coincidence in the validity of this approach. Data on rates of induction of dominant and recessive mutations, translocations and X-chromosome loss are used to derive doubling doses for chronic exposures to both low and high-LET radiations. Values for γ and X-rays, derived from both male and female germ-cells, fall inside a fairly small range and it is felt that the use of an overall figure of 100 rads is justifiable for protection purposes. Values for neutrons and α-particles, obtained from male germ-cells, varied according to neutron energy etc. but clustered around a value of 5 rads for fission neutrons

  3. [Radon risk in healthcare facilities: environmental monitoring and effective dose].

    Science.gov (United States)

    Cammarota, B; Cascone, Maria Teresa; De Paola, L; Schillirò, F; Del Prete, U

    2009-01-01

    Radon, the second cause of lung cancer after smoking (WHO- IARC), is a natural, radioactive gas, which originates from the soil and pollutes indoor air, especially in closed or underground spaces. The purpose of this study was to determine the concentration of radon gas, its effective dose, and the measurement of microclimatic degrees C; U.R. % and air velocity in non-academic intensive care units of public hospitals in the Naples area. The annual average concentrations of radon gas were detected with EIC type ionization electret chambers, type LLT with exposure over four 3-month periods. The concentrations varied for all health facilities between 186 and 1191 Bq/m3. Overall, the effective dose of exposure to radon gas of 3mSv/a recommended by Italian legislation was never exceeded. The concentration of radon gas showed a decreasing trend starting from the areas below ground level to those on higher floors; such concentrations were also influenced by natural and artificial ventilation of the rooms, building materials used for walls, and by the state of maintenance and improvements of the building (insulation of floors and walls). The data obtained confirmed the increased concentration of radionuclides in the yellow tuff of volcanic origin in the Campania Region and the resulting rate of release of radon gas, whereas the reinforced concrete structure (a hospital located on the hillside), which had the lowest values, proved to provide good insulation against penetration and accumulation of radon gas.

  4. Radiometric surveying for the assessment of radiation dose and radon specific exhalation in underground environment

    Science.gov (United States)

    Bochiolo, M.; Verdoya, M.; Chiozzi, P.; Pasquale, V.

    2012-08-01

    We performed a radiometric survey for evaluating the natural radioactivity and the related potential hazard level both outdoor and indoor a mine tunnel. The mine is located in a zone of uranium enrichment in the Western Alps (Italy). At first, a γ-ray spectrometry survey of the area surrounding the mine was carried out to define the extent of the ore deposit. Then, spectrometric measurements were performed in the tunnel and rock samples were collected for laboratory analyses. The results point to significant heterogeneity in uranium concentration and consequently in the absorbed dose rate spatial distribution. Spectrometric results in situ and in the laboratory, together with radon air concentration measurements, were used to infer the radon specific exhalation and flow from the mine rocks. The specific exhalation is positively related to the activity concentration of uranium.

  5. A comparison study of size-specific dose estimate calculation methods

    Energy Technology Data Exchange (ETDEWEB)

    Parikh, Roshni A. [Rainbow Babies and Children' s Hospital, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Department of Radiology, Cleveland, OH (United States); University of Michigan Health System, Department of Radiology, Ann Arbor, MI (United States); Wien, Michael A.; Jordan, David W.; Ciancibello, Leslie; Berlin, Sheila C. [Rainbow Babies and Children' s Hospital, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Department of Radiology, Cleveland, OH (United States); Novak, Ronald D. [Rainbow Babies and Children' s Hospital, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Department of Radiology, Cleveland, OH (United States); Rebecca D. Considine Research Institute, Children' s Hospital Medical Center of Akron, Center for Mitochondrial Medicine Research, Akron, OH (United States); Klahr, Paul [CT Clinical Science, Philips Healthcare, Highland Heights, OH (United States); Soriano, Stephanie [Rainbow Babies and Children' s Hospital, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Department of Radiology, Cleveland, OH (United States); University of Washington, Department of Radiology, Seattle, WA (United States)

    2018-01-15

    The size-specific dose estimate (SSDE) has emerged as an improved metric for use by medical physicists and radiologists for estimating individual patient dose. Several methods of calculating SSDE have been described, ranging from patient thickness or attenuation-based (automated and manual) measurements to weight-based techniques. To compare the accuracy of thickness vs. weight measurement of body size to allow for the calculation of the size-specific dose estimate (SSDE) in pediatric body CT. We retrospectively identified 109 pediatric body CT examinations for SSDE calculation. We examined two automated methods measuring a series of level-specific diameters of the patient's body: method A used the effective diameter and method B used the water-equivalent diameter. Two manual methods measured patient diameter at two predetermined levels: the superior endplate of L2, where body width is typically most thin, and the superior femoral head or iliac crest (for scans that did not include the pelvis), where body width is typically most thick; method C averaged lateral measurements at these two levels from the CT projection scan, and method D averaged lateral and anteroposterior measurements at the same two levels from the axial CT images. Finally, we used body weight to characterize patient size, method E, and compared this with the various other measurement methods. Methods were compared across the entire population as well as by subgroup based on body width. Concordance correlation (ρ{sub c}) between each of the SSDE calculation methods (methods A-E) was greater than 0.92 across the entire population, although the range was wider when analyzed by subgroup (0.42-0.99). When we compared each SSDE measurement method with CTDI{sub vol,} there was poor correlation, ρ{sub c}<0.77, with percentage differences between 20.8% and 51.0%. Automated computer algorithms are accurate and efficient in the calculation of SSDE. Manual methods based on patient thickness provide

  6. Implications of effects ''adaptive response'', ''low-dose hypersensitivity'' und ''bystander effect'' for cancer risk at low doses and low dose rates

    International Nuclear Information System (INIS)

    Jacob, P

    2006-01-01

    A model for carcinogenesis (the TSCE model) was applied in order to examine the effects of ''Low-dose hypersensitivity (LDH)'' and the ''Bystander effect (BE)'' on the derivation of radiation related cancer mortality risks. LDH has been discovered to occur in the inactivation of cells after acute exposure to low LET radiation. A corresponding version of the TSCE model was applied to the mortality data on the Abomb survivors from Hiroshima and Nagasaki. The BE has been mainly observed in cells after exposure to high LET radiation. A Version of the TSCE model which included the BE was applied to the data on lung cancer mortality from the workers at the Mayak nuclear facilities who were exposed to Plutonium. In general an equally good description of the A-bomb survivor mortality data (for all solid, stomach and lung tumours) was found for the TSCE model and the (conventional) empirical models but fewer parameters were necessary for the TSCE model. The TSCE model which included the effects of radiation induced cell killing resulted in non-linear dose response curves with excess relative risks after exposure at young ages that were generally lower than in the models without cell killing. The main results from TSCE models which included cell killing described by either conventional survival curves or LDH were very similar. A sub multiplicative effect from the interaction of smoking and exposure to plutonium was found to result from the analysis of the Mayak lung cancer mortality data. All models examined resulted in the predominant number of Mayak lung cancer deaths being ascribed to smoking. The interaction between smoking and plutonium exposures was found to be the second largest effect. The TSCE model resulted in lower estimates for the lung cancer excess relative risk per unit plutonium dose than the empirical risk model, but this difference was not found to be statistically significant. The excess relative risk dose responses were linear in the empirical model and

  7. Geographical distribution of radiation risk unaccountable by direct exposure dose in hiroshima A-bomb victims

    International Nuclear Information System (INIS)

    Tonda, Tetsuji; Satoh, Kenichi; Ohani, Keiko

    2012-01-01

    Death risks due to solid cancer were estimated from region to region where the A-bomb survivors had been actually exposed, to visualize the risk distribution on the map, which resulting in risk regional difference that had been unaccountable by direct exposure dose estimation. Analysis was performed with 3 hazard models of the previous one, + direct exposed dose as a confounding factor and, further, + spatial distance from the explosion point. Subjects were 37,382 A-bomb survivors at Jan. 1, 1970 with known positional coordinate at explosion, followed until Dec. 31, 2009, whose endpoint was set by 4,371 deaths due to cancer except leukemia, cancers of thyroid and breast. Confounding factors in the previous hazard model were sex, age at the exposure, dose and shielding. With the previous model, risk distribution was observed in a concentric circular region around the hypocenter and in an additional west to northwestern suburbs. The latter risk distribution was also seen with the second model in the same region, where dose decreased with -7 powers of the distance. When adjusted with -3 powers of the distance with the third model, the actual risk distribution was found best fitted, indicating the presence of distance-dependent risk. It was suggested that the region exposed to additional dose possibly derived from fallout had been the actual black rainfall area as those regions agreed with each other. (T.T.)

  8. Impact of shutdown risk on risk-based assessment of technical specifications

    International Nuclear Information System (INIS)

    Deriot, S.

    1992-10-01

    This paper describes the current work performed by the Research and Development Division of EDF concerning risk-based assessment of Operating Technical Specifications (OTS). The current risk-based assessment of OTS at EDF is presented. Then, the level 1 Probabilistic Safety Assessment of unit 3 of the Paluel nuclear power station (called PSA 1300) is described. It is fully computerized and takes into account the risk in shutdown states. A case study is presented. It shows that the fact of considering shutdown risk suggests that the current OTS should be modified

  9. Dose to the Contralateral Breast From Radiotherapy and Risk of Second Primary Breast Cancer in the WECARE Study

    International Nuclear Information System (INIS)

    Stovall, Marilyn; Smith, Susan A.; Langholz, Bryan M.; Boice, John D.; Shore, Roy E.; Andersson, Michael; Buchholz, Thomas A.; Capanu, Marinela; Bernstein, Leslie; Lynch, Charles F.; Malone, Kathleen E.; Anton-Culver, Hoda; Haile, Robert W.; Rosenstein, Barry S.

    2008-01-01

    Purpose: To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. Methods and Materials: The study population included participants in the Women's Environmental, Cancer, and Radiation Epidemiology study: 708 cases (women with asynchronous bilateral breast cancer) and 1399 controls (women with unilateral breast cancer) counter-matched on radiation treatment. Participants were 1.0 Gy of absorbed dose to the specific quadrant of the CB had a 2.5-fold greater risk for CB cancer than unexposed women (RR = 2.5, 95% CI 1.4-4.5). No excess risk was observed in women >40 years of age. Women 5 years had a RR of 3.0 (95% CI 1.1-8.1), and the dose response was significant (excess RR per Gy of 1.0, 95% CI 0.1-3.0). Conclusions: Women 1.0 Gy to the CB had an elevated, long-term risk of developing a second primary CB cancer. The risk is inversely related to age at exposure and is dose dependent

  10. Low-dose total skin electron beam therapy for cutaneous lymphoma : Minimal risk of acute toxicities.

    Science.gov (United States)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor

    2017-12-01

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T‑cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses.

  11. Alternative approaches to risk-based technical specifications

    International Nuclear Information System (INIS)

    Atefi, B.; Gallagher, D.W.; Liner, R.T.; Lofgren, E.V.

    1987-01-01

    Four alternative risk-based approaches to Technical Specifications are identified. These are: a Probabilistic Risk Assessment (PRA) oriented approach; a reliability goal-oriented approach; an approach based on configuration control; a data-oriented approach. Based on preliminary results, the PRA-oriented approach, which has been developed further than the other approaches, seems to offer a logical, quantitative basis for setting Allowed Outage Times (AOTs) and Surveillance Test Intervals (STIs) for some plant components and systems. The most attractive feature of this approach is that it directly links the AOTs and STIs with the risk associated with the operation of the plant. This would focus the plant operator's and the regulatory agency's attention on the most risk-significant components of the plant. A series of practical issues related to the level of detail and content of the plant PRAs, requirements for the review of these PRAs, and monitoring cf the plant's performance by the regulatory agency must be resolved before the approach could be implemented. Future efforts will examine the other three approaches and their practicality before firm conclusions are drawn regarding the viability of any of these approaches

  12. Age- and gender-specific estimates of cumulative CT dose over 5 years using real radiation dose tracking data in children

    International Nuclear Information System (INIS)

    Lee, Eunsol; Goo, Hyun Woo; Lee, Jae-Yeong

    2015-01-01

    It is necessary to develop a mechanism to estimate and analyze cumulative radiation risks from multiple CT exams in various clinical scenarios in children. To identify major contributors to high cumulative CT dose estimates using actual dose-length product values collected for 5 years in children. Between August 2006 and July 2011 we reviewed 26,937 CT exams in 13,803 children. Among them, we included 931 children (median age 3.5 years, age range 0 days-15 years; M:F = 533:398) who had 5,339 CT exams. Each child underwent at least three CT scans and had accessible radiation dose reports. Dose-length product values were automatically extracted from DICOM files and we used recently updated conversion factors for age, gender, anatomical region and tube voltage to estimate CT radiation dose. We tracked the calculated CT dose estimates to obtain a 5-year cumulative value for each child. The study population was divided into three groups according to the cumulative CT dose estimates: high, ≥30 mSv; moderate, 10-30 mSv; and low, <10 mSv. We reviewed clinical data and CT protocols to identify major contributors to high and moderate cumulative CT dose estimates. Median cumulative CT dose estimate was 5.4 mSv (range 0.5-71.1 mSv), and median number of CT scans was 4 (range 3-36). High cumulative CT dose estimates were most common in children with malignant tumors (57.9%, 11/19). High frequency of CT scans was attributed to high cumulative CT dose estimates in children with ventriculoperitoneal shunt (35 in 1 child) and malignant tumors (range 18-49). Moreover, high-dose CT protocols, such as multiphase abdomen CT (median 4.7 mSv) contributed to high cumulative CT dose estimates even in children with a low number of CT scans. Disease group, number of CT scans, and high-dose CT protocols are major contributors to higher cumulative CT dose estimates in children. (orig.)

  13. Modified Exponential (MOE) Models: statistical Models for Risk Estimation of Low dose Rate Radiation

    International Nuclear Information System (INIS)

    Ogata, H.; Furukawa, C.; Kawakami, Y.; Magae, J.

    2004-01-01

    Simultaneous inclusion of dose and dose-rate is required to evaluate the risk of long term irradiation at low dose-rates, since biological responses to radiation are complex processes that depend both on irradiation time and total dose. Consequently, it is necessary to consider a model including cumulative dose,dose-rate and irradiation time to estimate quantitative dose-response relationship on the biological response to radiation. In this study, we measured micronucleus formation and (3H) thymidine uptake in U2OS, human osteosarcoma cell line, as indicators of biological response to gamma radiation. Cells were exposed to gamma ray in irradiation room bearing 50,000 Ci 60Co. After irradiation, they were cultured for 24h in the presence of cytochalasin B to block cytokinesis, and cytoplasm and nucleus were stained with DAPI and propidium iodide. The number of binuclear cells bearing a micronucleus was counted under a florescence microscope. For proliferation inhibition, cells were cultured for 48 h after the irradiation and (3h) thymidine was pulsed for 4h before harvesting. We statistically analyzed the data for quantitative evaluation of radiation risk at low dose/dose-rate. (Author)

  14. SU-E-T-316: The Design of a Risk Index Method for 3D Patient Specific QA

    Energy Technology Data Exchange (ETDEWEB)

    Cho, W; Wu, H [Seoul National University Hospital, Seoul (Korea, Republic of); Xing, L [Stanford University, Stanford, CA (United States); Suh, T [Catholic UniversityMedical College, Seoul (Korea, Republic of)

    2014-06-01

    Purpose: To suggest a new guidance for the evaluation of 3D patient specific QA, a structure-specific risk-index (RI) method was designed and implemented. Methods: A new algorithm was designed to assign the score of Pass, Fail or Pass with Risk to all 3D voxels in each structure by improving a conventional Gamma Index (GI) algorithm, which implied the degree of the risk of under-dose to the treatment target or over-dose to the organ at risks (OAR). Structure-specific distance to agreement (DTOA), dose difference and minimum checkable dose were applied to the GI algorithm, and additional parameters such as dose gradient factor and dose limit of structures were used to the RI method. Maximum passing rate (PR) and minimum PR were designed and calculated for each structure with the RI method. 3D doses were acquired from a spine SBRT plan by simulating the shift of beam iso-center, and tested to show the feasibility of the suggested method. Results: When the iso-center was shifted by 1 mm, 2 mm, and 3 mm, the PR of conventional GI method between shifted and non-shifted 3D doses were 99.9%, 97.4%, and 89.7% for PTV, 99.8%, 84.8%, and 63.2% for spinal cord, and 100%, 99.5%, 91.7% for right lung. The minimum PRs from the RI method were 98.9%, 96.9%, and 89.5% for PTV, and 96.1%, 79.3%, 57.5% for spinal cord, and 92.5%, 92.0%, 84.4% for right lung, respectively. The maximum PRs from the RI method were equal or less than the PRs from the conventional GI evaluation. Conclusion: Designed 3D RI method showed more strict acceptance level than the conventional GI method, especially for OARs. The RI method is expected to give the degrees of risks in the delivered doses, as well as the degrees of agreements between calculated 3D doses and measured (or simulated) 3D doses.

  15. SU-E-T-316: The Design of a Risk Index Method for 3D Patient Specific QA

    International Nuclear Information System (INIS)

    Cho, W; Wu, H; Xing, L; Suh, T

    2014-01-01

    Purpose: To suggest a new guidance for the evaluation of 3D patient specific QA, a structure-specific risk-index (RI) method was designed and implemented. Methods: A new algorithm was designed to assign the score of Pass, Fail or Pass with Risk to all 3D voxels in each structure by improving a conventional Gamma Index (GI) algorithm, which implied the degree of the risk of under-dose to the treatment target or over-dose to the organ at risks (OAR). Structure-specific distance to agreement (DTOA), dose difference and minimum checkable dose were applied to the GI algorithm, and additional parameters such as dose gradient factor and dose limit of structures were used to the RI method. Maximum passing rate (PR) and minimum PR were designed and calculated for each structure with the RI method. 3D doses were acquired from a spine SBRT plan by simulating the shift of beam iso-center, and tested to show the feasibility of the suggested method. Results: When the iso-center was shifted by 1 mm, 2 mm, and 3 mm, the PR of conventional GI method between shifted and non-shifted 3D doses were 99.9%, 97.4%, and 89.7% for PTV, 99.8%, 84.8%, and 63.2% for spinal cord, and 100%, 99.5%, 91.7% for right lung. The minimum PRs from the RI method were 98.9%, 96.9%, and 89.5% for PTV, and 96.1%, 79.3%, 57.5% for spinal cord, and 92.5%, 92.0%, 84.4% for right lung, respectively. The maximum PRs from the RI method were equal or less than the PRs from the conventional GI evaluation. Conclusion: Designed 3D RI method showed more strict acceptance level than the conventional GI method, especially for OARs. The RI method is expected to give the degrees of risks in the delivered doses, as well as the degrees of agreements between calculated 3D doses and measured (or simulated) 3D doses

  16. A comparison of mantle versus involved-field radiotherapy for Hodgkin's lymphoma: reduction in normal tissue dose and second cancer risk

    International Nuclear Information System (INIS)

    Koh, Eng-Siew; Paul, Narinder; Hodgson, David C; Tran, Tu Huan; Heydarian, Mostafa; Sachs, Rainer K; Tsang, Richard W; Brenner, David J; Pintilie, Melania; Xu, Tony; Chung, June

    2007-01-01

    Hodgkin's lymphoma (HL) survivors who undergo radiotherapy experience increased risks of second cancers (SC) and cardiac sequelae. To reduce such risks, extended-field radiotherapy (RT) for HL has largely been replaced by involved field radiotherapy (IFRT). While it has generally been assumed that IFRT will reduce SC risks, there are few data that quantify the reduction in dose to normal tissues associated with modern RT practice for patients with mediastinal HL, and no estimates of the expected reduction in SC risk. Organ-specific dose-volume histograms (DVH) were generated for 41 patients receiving 35 Gy mantle RT, 35 Gy IFRT, or 20 Gy IFRT, and integrated organ mean doses were compared for the three protocols. Organ-specific SC risk estimates were estimated using a dosimetric risk-modeling approach, analyzing DVH data with quantitative, mechanistic models of radiation-induced cancer. Dose reductions resulted in corresponding reductions in predicted excess relative risks (ERR) for SC induction. Moving from 35 Gy mantle RT to 35 Gy IFRT reduces predicted ERR for female breast and lung cancer by approximately 65%, and for male lung cancer by approximately 35%; moving from 35 Gy IFRT to 20 Gy IFRT reduces predicted ERRs approximately 40% more. The median reduction in integral dose to the whole heart with the transition to 35 Gy IFRT was 35%, with a smaller (2%) reduction in dose to proximal coronary arteries. There was no significant reduction in thyroid dose. The significant decreases estimated for radiation-induced SC risks associated with modern IFRT provide strong support for the use of IFRT to reduce the late effects of treatment. The approach employed here can provide new insight into the risks associated with contemporary IFRT for HL, and may facilitate the counseling of patients regarding the risks associated with this treatment

  17. SU-E-J-10: Imaging Dose and Cancer Risk in Image-Guided Radiotherapy of Cancers

    International Nuclear Information System (INIS)

    Zhou, L; Bai, S; Zhang, Y; Deng, J

    2015-01-01

    Purpose: To systematically evaluate imaging doses and cancer risks to organs-at-risk as a Result of cumulative doses from various radiological imaging procedures in image-guided radiotherapy (IGRT) in a large cohort of cancer patients. Methods: With IRB approval, imaging procedures (computed tomography, kilo-voltage portal imaging, megavoltage portal imaging and kilo-voltage cone-beam computed tomography) of 4832 cancer patients treated during 4.5 years were collected with their gender, age and circumference. Correlations between patient’s circumference and Monte Carlo simulated-organ dose were applied to estimate organ doses while the cancer risks were reported as 1+ERR using BEIR VII models. Results: 80 cGy or more doses were deposited to brain, lungs and RBM in 273 patients (maximum 136, 278 and 267 cGy, respectively), due largely to repetitive imaging procedures and non-personalized imaging settings. Regardless of gender, relative cancer risk estimates for brain, lungs, and RBM were 3.4 (n = 55), 2.6 (n = 49), 1.8 (n = 25) for age group of 0–19; 1.2 (n = 87), 1.4 (n = 98), 1.3 (n = 51) for age group of 20–39; 1.0 (n = 457), 1.1 (n = 880), 1.8 (n=360) for age group of 40–59; 1.0 (n = 646), 1.1 (n = 1400), 2.3 (n = 716) for age group of 60–79 and 1.0 (n = 108),1.1 (n = 305),1.6 (n = 147) for age group of 80–99. Conclusion: The cumulative imaging doses and associated cancer risks from multi-imaging procedures were patient-specific and site-dependent, with up to 2.7 Gy imaging dose deposited to critical structures in some pediatric patients. The associated cancer risks in brain and lungs for children of age 0 to 19 were 2–3 times larger than those for adults. This study indicated a pressing need for personalized imaging protocol to maximize its clinical benefits while reducing associated cancer risks. Sichuan University Scholarship

  18. Site-Specific ecological risk assessment. Case-study 2

    DEFF Research Database (Denmark)

    Jensen, John

    “Development of a decision support system for sustainable management of contaminated land by linking bioavailability, ecological risk and ground water pollution of organic pollutants”or in short “LIBERATION”. The presentation includes examples on how to scale and integrate the results from various scientific......The decision supporting and integrating assessment tool, TRIAD, is used site-specific on PAH- and heavy metal contaminated sites in Denmark. The various aspects of the TRIAD approach are used on a set of chemistry-, ecotoxicology- and ecology related data collected among others in the EU project...

  19. Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

    International Nuclear Information System (INIS)

    Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

    2014-01-01

    Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI vol and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose metrics

  20. Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yakun [Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Li, Xiang [Medical Physics Graduate Program, Department of Physics, Cleveland State University, Cleveland, Ohio 44115 (United States); Segars, W. Paul [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Samei, Ehsan, E-mail: samei@duke.edu [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Departments of Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University Medical Center, Durham, North Carolina 27705 (United States)

    2014-02-15

    Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI{sub vol} and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose

  1. Experimental study on active specific immunotherapy utilizing the immune reaction of low-dose irradiated tumor tissue, 4

    International Nuclear Information System (INIS)

    Imanaka, Kazufumi; Ogawa, Yasuhiro; Gose, Kyuhei; Imajo, Yoshinari; Kimura, Shuji

    1982-01-01

    We have already reported that the effectiveness of active specific immunotherapy using low-dose irradiated tumor cells and infiltrating mononuclear cells. The present study was designed to investigate the effect of non-specific immunopotentiator combined with the active specific immunotherapy. Twelve-week-aged female C3H/He mice transplanted with MM46 tumor were received local radiotherapy with the dose of 3,000 rads by high energy electron beam on the sixth day after inoculation. Active specific immunotherapy was performed on the 13th day, and daily dose of 1.0 KE of OK-432 was injected intraperitoneally from the 13th day to the 17th day. The inhibition of the tumor growth and the elongation of survival period were noted in the group which received active specific immunotherapy combined with non-specific immunopotentiator, OK-432 compared with that active specific immunotherapy alone. (author)

  2. Low-dose extrapolation of radiation health risks: some implications of uncertainty for radiation protection at low doses.

    Science.gov (United States)

    Land, Charles E

    2009-11-01

    Ionizing radiation is a known and well-quantified human cancer risk factor, based on a remarkably consistent body of information from epidemiological studies of exposed populations. Typical examples of risk estimation include use of Japanese atomic bomb survivor data to estimate future risk from radiation-related cancer among American patients receiving multiple computed tomography scans, persons affected by radioactive fallout, or persons whose livelihoods involve some radiation exposure, such as x-ray technicians, interventional radiologists, or shipyard workers. Our estimates of radiation-related risk are uncertain, reflecting statistical variation and our imperfect understanding of crucial assumptions that must be made if we are to apply existing epidemiological data to particular situations. Fortunately, that uncertainty is also highly quantifiable, and can be presented concisely and transparently. Radiation protection is ultimately a political process that involves consent by stakeholders, a diverse group that includes people who might be expected to be risk-averse and concerned with plausible upper limits on risk (how bad could it be?), cost-averse and concerned with lower limits on risk (can you prove there is a nontrivial risk at current dose levels?), or combining both points of view. How radiation-related risk is viewed by individuals and population subgroups also depends very much on perception of related benefit, which might be (for example) medical, economic, altruistic, or nonexistent. The following presentation follows the lead of National Council on Radiation Protection and Measurements (NCRP) Commentary 14, NCRP Report 126, and later documents in treating radiation protection from the viewpoint of quantitative uncertainty analysis.

  3. QUANTITATION OF MOLECULAR ENDPOINTS FOR THE DOSE-RESPONSE COMPONENT OF CANCER RISK ASSESSMENT

    Science.gov (United States)

    Cancer risk assessment involves the steps of hazard identification, dose-response assessment, exposure assessment and risk characterization. The rapid advances in the use of molecular biology approaches has had an impact on all four components, but the greatest overall current...

  4. Effective doses and standardised risk factors from paediatric diagnostic medical radiation exposures: Information for radiation risk communication

    International Nuclear Information System (INIS)

    Bibbo, Giovanni

    2018-01-01

    In the paediatric medical radiation setting, there is no consistency on the radiation risk information conveyed to the consumer (patient/carer). Each communicator may convey different information about the level of risk for the same radiation procedure, leaving the consumer confused and frustrated. There is a need to standardise risks resulting from medical radiation exposures. In this study, paediatric radiographic, fluoroscopic, CT and nuclear medicine examination data have been analysed to provide (i) effective doses and radiation induced cancer risk factors from common radiological and nuclear medicine diagnostic procedures in standardised formats, (II) awareness of the difficulties that may be encountered in communicating risks to the layperson, and (iii) an overview of the deleterious effects of ionising radiation so that the risk communicator can convey with confidence the risks resulting from medical radiation exposures. Paediatric patient dose data from general radiographic, computed tomography, fluoroscopic and nuclear medicine databases have been analysed in age groups 0 to <5 years, 5 to <10 years, 10 to <15 years and 15 to <18 years to determine standardised risk factors. Mean, minimum and maximum effective doses and the corresponding mean lifetime risks for general radiographic, fluoroscopic, CT and nuclear medicine examinations for different age groups have been calculated. For all examinations, the mean lifetime cancer induction risk is provided in three formats: statistical, fraction and category. Standardised risk factors for different radiological and nuclear medicine examinations and an overview of the deleterious effects of ionising radiation and the difficulties encountered in communicating the risks should facilitate risk communication to the patient/carer.

  5. Estimation of breast dose and cancer risk in chest and abdomen CT procedures

    International Nuclear Information System (INIS)

    Eltahir, Suha Abubaker Ali

    2013-05-01

    The use of CT in medical diagnosis delivers radiation doses to patents that are higher than those from other radiological procedures. Lack of optimized protocols be an additional source of increased dose in developing countries. The aims of this study are first, to measure patient doses during CT chest and abdomen procedures, second, to estimate the radiation dose to the breast, and third to quantify the radiation risks during the procedures. Patient doses from two common CT examinations were obtained from four hospitals in Khartoum.The patient doses were estimated using measurement of CT dose indexes (CTDI), exposure-related parameters, and the IMPACT spreadsheet based on NRPB conversion factors. A large variation of mean organ doses among hospitals was observed for similar CT examinations. These variations largely originated from different CT scanning protocols used in different hospitals and scanner type. The largest range was found for CT of the chest, for which the dose varied from 2.3 to 47 (average 24.7) mSv and for abdomen CT, it was 1.6 to 18.8 (average 10.2) mSv. Radiation dose to the breast ranged from 1.6 to 32.9 mSv for the chest and 1.1 to 13.2 mSv for the abdomen. The radiation risk per procedure was high. The obtained values were mostly higher than the values of organ doses reported from the other studies. It was concluded that current clinical chest and abdomen protocols result in variable radiation doses to the breast. The magnitude of exposure may have implications for imaging strategies.(Author)

  6. European Academy of Allergy and Clinical Immunology task force report on 'dose-response relationship in allergen-specific immunotherapy'

    DEFF Research Database (Denmark)

    Calderón, M A; Larenas, D; Kleine-Tebbe, J

    2011-01-01

    For a century, allergen-specific immunotherapy (SIT) has proven to be an effective treatment for allergic rhinitis, asthma, and insect sting allergy. However, as allergen doses are frequently adapted to the individual patient, there are few data on dose-response relationship in SIT. Allergen prod...

  7. Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors

    NARCIS (Netherlands)

    van Eggermond, Anna M.; Schaapveld, Michael; Janus, Cécile Pm; de Boer, Jan Paul; Krol, Augustinus Dg; Zijlstra, Josée M.; van der Maazen, Richard Wm; Kremer, Leontien C.; van Leerdam, Monique E.; Louwman, Marieke Wj; Visser, Otto; de Bruin, Marie L.; Aleman, Berthe Mp; van Leeuwen, Flora E.

    2017-01-01

    Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. In a Dutch cohort of 3121

  8. Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors

    NARCIS (Netherlands)

    Eggermond, A.M. van; Schaapveld, M.; Janus, C.P.; Boer, J.P. de; Krol, A.D.; Zijlstra, J.M.; Maazen, R.W.M. van der; Kremer, L.C.; Leerdam, M.E. van; Louwman, M.W.; Visser, O; Bruin, M.L. De; Aleman, B.M.; Leeuwen, F.E. van

    2017-01-01

    BACKGROUND: Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. METHODS: In a

  9. Post-operative high dose rate brachytherapy in patients with low to intermediate risk endometrial cancer

    International Nuclear Information System (INIS)

    Pearcey, R.G.; Petereit, D.G.

    2000-01-01

    This paper investigates the outcome using different dose/fractionation schedules in high dose rate (HDR) post-operative vaginal vault radiotherapy in patients with low to intermediate risk endometrial cancer. The world literature was reviewed and thirteen series were analyzed representing 1800 cases. A total of 12 vaginal vault recurrences were identified representing an overall vaginal control rate of 99.3%. A wide range of dose fractionation schedules and techniques have been reported. In order to analyze a dose response relationship for tumor control and complications, the biologically effective doses to the tumor and late responding tissues were calculated using the linear quadratic model. A threshold was identified for complications, but not vaginal control. While dose fractionation schedules that delivered a biologically effective dose to the late responding tissues in excess of 100 Gy 3 (LQED = 60 Gy) predicted for late complications, dose fractionation schedules that delivered a modest dose to the vaginal surface (50 Gy 10 or LQED = 30 Gy) appeared tumoricidal with vaginal control rates of at least 98%. By using convenient, modest dose fractionation schedules, HDR vaginal vault - brachytherapy yields very high local control and extremely low morbidity rates. (author)

  10. Evaluation of the impact of organ-specific dose reduction on image quality in pediatric chest computed tomography

    International Nuclear Information System (INIS)

    Boos, Johannes; Kroepil, Patric; Klee, Dirk; Heusch, Philipp; Schimmoeller, Lars; Schaper, Joerg; Antoch, Gerald; Lanzman, Rotem S.

    2014-01-01

    Organ-specific dose reduction significantly reduces the radiation exposure of radiosensitive organs. The purpose of this study was to assess the impact of a novel organ-specific dose reduction algorithm on image quality of pediatric chest CT. We included 28 children (mean age 10.9 ± 4.8 years, range 3-18 years) who had contrast-enhanced chest CT on a 128-row scanner. CT was performed at 100 kV using automated tube current modulation and a novel organ-specific dose-reduction algorithm (XCare trademark; Siemens, Forchheim, Germany). Seven children had a previous chest CT performed on a 64-row scanner at 100 kV without organ-specific dose reduction. Subjective image quality was assessed using a five-point scale (1-not diagnostic; 5-excellent). Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were assessed in the descending aorta. Overall mean subjective image quality was 4.1 ± 0.6. In the subgroup of the seven children examined both with and without organ-specific dose reduction, subjective image quality was comparable (score 4.4 ± 0.5 with organ-specific dose reduction vs. 4.4 ± 0.7 without it; P > 0.05). There was no significant difference in mean signal-to-noise ratio and contrast-to-noise ratio with organ-specific dose reduction (38.3 ± 10.1 and 28.5 ± 8.7, respectively) and without the reduction (35.5 ± 8.5 and 26.5 ± 7.8, respectively) (P > 0.05). Volume computed tomography dose index (CTDI vol ) and size-specific dose estimates did not differ significantly between acquisitions with the organ-specific dose reduction (1.7 ± 0.8 mGy) and without the reduction (1.7 ± 0.8 mGy) (P > 0.05). Organ-specific dose reduction does not have an impact on image quality of pediatric chest CT and can therefore be used in clinical practice to reduce radiation dose of radiosensitive organs such as breast and thyroid gland. (orig.)

  11. Noninvasive non Doses Method for Risk Stratification of Breast Diseases

    Directory of Open Access Journals (Sweden)

    I. A. Apollonova

    2014-01-01

    Full Text Available The article concerns a relevant issue that is a development of noninvasive method for screening diagnostics and risk stratification of breast diseases. The developed method and its embodiment use both the analysis of onco-epidemiologic tests and the iridoglyphical research.Widely used onco-epidemiologic tests only reflect the patient’s subjective perception of her own life history and sickness. Therefore to confirm the revealed factors, modern objective and safe methods are necessary.Iridoglyphical research may be considered as one of those methods, since it allows us to reveal changes in iris’ zones in real time. As these zones are functionally linked with intern organs and systems, in this case mammary glands, changes of iris’ zones may be used to assess risk groups for mammary gland disorders.The article presents results of research conducted using a prototype of the hardwaresoftware complex to provide screening diagnostics and risk stratification of mammary gland disorders.Research has been conducted using verified materials, provided by the Biomedical Engineering Faculty and the Scientific Biometry Research and Development Centre of Bauman Moscow State Technical University, the City of Moscow’s GUZ Clinical and Diagnostic Centre N°4 of the Western Administrative District and the First Mammology (Breast Care Centre of the Russian Federation’s Ministry of Health and Social Development.The information, obtained as a result of onco-epidemiological tests and iridoglyphical research, was used to develop a procedure of quantitative diagnostics aimed to assess mammary gland cancer risk groups. The procedure is based on Bayes conditional probability.The task of quantitative diagnostics may be formally divided into the differential assessment of three states. The first, D1, is the norm, which corresponds to the population group with a lack of risk factors or changes of the mammary glands. The second, D2, is the population group

  12. Entyvio lengthen dose-interval study: lengthening vedolizumab dose interval and the risk of clinical relapse in inflammatory bowel disease.

    Science.gov (United States)

    Chan, Webber; Lynch, Nicole; Bampton, Peter; Chang, Jeff; Chung, Alvin; Florin, Timothy; Hetzel, David J; Jakobovits, Simon; Moore, Gregory; Pavli, Paul; Radford-Smith, Graham; Thin, Lena; Baraty, Brandon; Haifer, Craig; Yau, Yunki; Leong, Rupert W L

    2018-07-01

    Vedolizumab (VDZ), an α4β7 anti-integrin antibody, is efficacious in the induction and maintenance of remission in ulcerative colitis (UC) and Crohn's disease (CD). In the GEMINI long-term safety study, enrolled patients received 4-weekly VDZ. Upon completion, patients were switched to 8-weekly VDZ in Australia. The clinical success rate of treatment de-escalation for patients in remission on VDZ has not been described previously. To determine the proportion of patients who relapsed after switching from 4 to 8-weekly VDZ, the mean time to relapse, and the recapture rate when switching back to 8-weekly dosing. This was a retrospective, observational, multicenter study of patients previously recruited into GEMINI long-term safety in Australia. Data on the demographics and biochemical findings were collected. There were 34 patients [23 men, mean age 49.1 (±13.1) years] and their mean disease duration was 17.6 (±8.5) years. The mean 4-weekly VDZ infusion duration was 286.5 (±48.8) weeks. A total of five (15%) patients relapsed on dose-interval increase (4/17 UC, 1/17 CD) at a median duration from dose interval lengthening to flare of 14 weeks (interquartile range=6-25). Eighty percent (4/5) of patients re-entered remission following dose-interval decrease back to 4-weekly. No clinical predictors of relapse could be determined because of the small cohort size. The risk of patients relapsing when switching from 4 to 8-weekly VDZ ∼15% and is similar between CD and UC. Dose-interval decrease recaptures 80% of patients who relapsed. Therapeutic drug monitoring of VDZ may be of clinical relevance.

  13. Thyroid doses and risk to paediatric patients undergoing neck CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Spampinato, Maria Vittoria; Tipnis, Sameer; Huda, Walter [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Tavernier, Joshua [Medical University of South Carolina, College of Medicine, Charleston, SC (United States)

    2015-07-15

    To estimate thyroid doses and cancer risk for paediatric patients undergoing neck computed tomography (CT). We used average CTDI{sub vol} (mGy) values from 75 paediatric neck CT examinations to estimate thyroid dose in a mathematical anthropomorphic phantom (ImPACT Patient CT Dosimetry Calculator). Patient dose was estimated by modelling the neck as mass equivalent water cylinder. A patient size correction factor was obtained using published relative dose data as a function of water cylinder size. Additional correction factors included scan length and radiation intensity variation secondary to tube-current modulation. The mean water cylinder diameter that modelled the neck was 14 ± 3.5 cm. The mathematical anthropomorphic phantom has a 16.5-cm neck, and for a constant CT exposure, would have thyroid doses that are 13-17 % lower than the average paediatric patient. CTDI{sub vol} was independent of age and sex. The average thyroid doses were 31 ± 18 mGy (males) and 34 ± 15 mGy (females). Thyroid cancer incidence risk was highest for infant females (0.2 %), lowest for teenage males (0.01 %). Estimated absorbed thyroid doses in paediatric neck CT did not significantly vary with age and gender. However, the corresponding thyroid cancer risk is determined by gender and age. (orig.)

  14. Cancer risk at low doses of ionizing radiation. Artificial neural networks inference from atomic bomb survivors

    International Nuclear Information System (INIS)

    Sasaki, Masao S.; Tachibana, Akira; Takeda, Shunichi

    2014-01-01

    Cancer risk at low doses of ionizing radiation remains poorly defined because of ambiguity in the quantitative link to doses below 0.2 Sv in atomic bomb survivors in Hiroshima and Nagasaki arising from limitations in the statistical power and information available on overall radiation dose. To deal with these difficulties, a novel nonparametric statistics based on the ‘integrate-and-fire’ algorithm of artificial neural networks was developed and tested in cancer databases established by the Radiation Effects Research Foundation. The analysis revealed unique features at low doses that could not be accounted for by nominal exposure dose, including (1) the presence of a threshold that varied with organ, gender and age at exposure, and (2) a small but significant bumping increase in cancer risk at low doses in Nagasaki that probably reflects internal exposure to 239 Pu. The threshold was distinct from the canonical definition of zero effect in that it was manifested as negative excess relative risk, or suppression of background cancer rates. Such a unique tissue response at low doses of radiation exposure has been implicated in the context of the molecular basis of radiation–environment interplay in favor of recently emerging experimental evidence on DNA double-strand break repair pathway choice and its epigenetic memory by histone marking. (author)

  15. Why we need new approaches to low-dose risk modeling

    International Nuclear Information System (INIS)

    Alvarez, J.L.; Seiler, F.A.

    1996-01-01

    The linear no-threshold model for radiation effects was introduced as a conservative model for the design of radiation protection programs. The model has persisted not only as the basis for such programs, but has come to be treated as a dogma and is often confused with scientific fact. In this examination a number of serious problems with the linear no-threshold model of radiation carcinogenesis were demonstrated, many of them invalidating the hypothesis. It was shown that the relative risk formalism did not approach 1 as the dose approaches zero. When morality ratios were used instead, the data in the region below 0.3 Sv were systematically below the predictions of the linear model. It was also shown that the data above 0.3 Sv were of little use in formulating a model at low doses. In addition, these data are valid only for doses accumulated at high dose rates, and there is no scientific justification for using the model in low-dose, low-dose-rate extrapolations for purposes of radiation protection. Further examination of model fits to the Japanese survivor data were attempted. Several such models were fit to the data including an unconstrained linear, linear-square root, and Weibull, all of which fit the data better than the relative risk, linear no-threshold model. These fits were used to demonstrate that the linear model systematically over estimates the risk at low doses in the Japanese survivor data set. It is recommended here that an unbiased re-analysis of the data be undertaken and the results used to construct a new model, based on all pertinent data. This model could then form the basis for managing radiation risks in the appropriate regions of dose and dose rate

  16. Sensitivity analysis of specific activity model parameters for environmental transport of 3H and dose assessment

    International Nuclear Information System (INIS)

    Rout, S.; Mishra, D.G.; Ravi, P.M.; Tripathi, R.M.

    2016-01-01

    Tritium is one of the radionuclides likely to get released to the environment from Pressurized Heavy Water Reactors. Environmental models are extensively used to quantify the complex environmental transport processes of radionuclides and also to assess the impact to the environment. Model parameters exerting the significant influence on model results are identified through a sensitivity analysis (SA). SA is the study of how the variation (uncertainty) in the output of a mathematical model can be apportioned, qualitatively or quantitatively, to different sources of variation in the input parameters. This study was designed to identify the sensitive model parameters of specific activity model (TRS 1616, IAEA) for environmental transfer of 3 H following release to air and then to vegetation and animal products. Model includes parameters such as air to soil transfer factor (CRs), Tissue Free Water 3 H to Organically Bound 3 H ratio (Rp), Relative humidity (RH), WCP (fractional water content) and WEQp (water equivalent factor) any change in these parameters leads to change in 3 H level in vegetation and animal products consequently change in dose due to ingestion. All these parameters are function of climate and/or plant which change with time, space and species. Estimation of these parameters at every time is a time consuming and also required sophisticated instrumentation. Therefore it is necessary to identify the sensitive parameters and freeze the values of least sensitive parameters at constant values for more accurate estimation of 3 H dose in short time for routine assessment

  17. Systematic review on physician's knowledge about radiation doses and radiation risks of computed tomography

    International Nuclear Information System (INIS)

    Krille, Lucian; Hammer, Gael P.; Merzenich, Hiltrud; Zeeb, Hajo

    2010-01-01

    Background: The frequent use of computed tomography is a major cause of the increasing medical radiation exposure of the general population. Consequently, dose reduction and radiation protection is a topic of scientific and public concern. Aim: We evaluated the available literature on physicians' knowledge regarding radiation dosages and risks due to computed tomography. Methods: A systematic review in accordance with the Cochrane and PRISMA statements was performed using eight databases. 3091 references were found. Only primary studies assessing physicians' knowledge about computed tomography were included. Results: 14 relevant articles were identified, all focussing on dose estimations for CT. Overall, the surveys showed moderate to low knowledge among physicians concerning radiation doses and the involved health risks. However, the surveys varied considerably in conduct and quality. For some countries, more than one survey was available. There was no general trend in knowledge in any country except a slight improvement of knowledge on health risks and radiation doses in two consecutive local German surveys. Conclusions: Knowledge gaps concerning radiation doses and associated health risks among physicians are evident from published research. However, knowledge on radiation doses cannot be interpreted as reliable indicator for good medical practice.

  18. Foetal Radiation Dose and Risk from Diagnostic Radiology Procedures: A Multinational Study

    International Nuclear Information System (INIS)

    Osei, Ernest K.; Darko, Johnson

    2012-01-01

    In diagnostic radiology examinations there is a benefit that the patient derives from the resulting diagnosis. Given that so many examinations are performed each year, it is inevitable that there will be occasions when an examination(s) may be inadvertently performed on pregnant patients or occasionally it may become clinically necessary to perform an examination(s) on a pregnant patient. In all these circumstances it is necessary to request an estimation of the foetal dose and risk. We initiated a study to investigate fetal doses from different countries. Exposure techniques on 367 foetuses from 414 examinations were collected and investigated. The FetDoseV4 program was used for all dose and risk estimations. The radiation doses received by the 367 foetuses ranges: <0.001–21.9 mGy depending on examination and technique. The associated probability of induced hereditary effect ranges: <1 in 200000000 (5 × 10 −9 ) to 1 in 10000 (1 × 10 −4 ) and the risk of childhood cancer ranges <1 in 12500000 (8 × 10 −8 ) to 1 in 500 (2 × 10 −3 ). The data indicates that foetal doses from properly conducted diagnostic radiology examinations will not result in any deterministic effect and a negligible risk of causing radiation induced hereditary effect in the descendants of the unborn child

  19. Testicular dose and associated risk from inverted-Y field irradiation in patients with Hodgkin's disease.

    Science.gov (United States)

    Mazonakis, Michalis; Kokona, Georgiana; Damilakis, John; Varveris, Haris; Gourtsoyiannis, Nicholas

    This study aims to estimate testicular dose and the associated risks for infertility and hereditary effects from inverted-Y field irradiation Radiotherapy was simulated on a humanoid phantom using a 6 MV photon beam. Testicular dose was measured for various field sizes and tissue thicknesses along beam axis using an ionization chamber. Gonadal dose was reduced by placing lead cups around the testes supplemented by a field edge block. For a tumor dose of 40 Gy, testicular dose was 0.56-6.52 Gy depending upon the field size and the distance from the inferior field edge. The corresponding dose to shielded testes was 0.12-1.96 Gy. The increase of tissue thickness in reased the testicular dose up to 40%. An excess risk of hereditary disorders of (7-391) per 10000 births was calculated. The treatment parameters, the presence of gonad shield and the somatometric characteristics determine whether testicular dose can exceed 1 Gy which allows a complete recovery of spermatogenesis.

  20. Role of prostate dose escalation in patients with greater than 15% risk of pelvic lymph node involvement

    International Nuclear Information System (INIS)

    Jacob, Rojymon; Hanlon, Alexandra L.; Horwitz, Eric M.; Movsas, Benjamin; Uzzo, Robert G.; Pollack, Alan

    2005-01-01

    Purpose: To determine whether the radiation dose is a determinant of clinical outcome in patients with a lymph node risk of >15% treated using whole pelvic (WP), partial pelvic (PP), or prostate only (PO) fields. Methods and materials: A total of 420 patients with prostate cancer treated with three-dimensional conformal radiotherapy with or without short-term androgen deprivation (STAD) between June 1989 and July 2000 were included in this study. Patients had an initial pretreatment prostate-specific antigen level of 15% in the patient population studied. These data suggest that the primary tumor takes precedence over lymph node coverage or the use of STAD. Doses >70 Gy are of paramount importance in such intermediate- and high-risk patients

  1. TH-A-19A-06: Site-Specific Comparison of Analytical and Monte Carlo Based Dose Calculations

    International Nuclear Information System (INIS)

    Schuemann, J; Grassberger, C; Paganetti, H; Dowdell, S

    2014-01-01

    Purpose: To investigate the impact of complex patient geometries on the capability of analytical dose calculation algorithms to accurately predict dose distributions and to verify currently used uncertainty margins in proton therapy. Methods: Dose distributions predicted by an analytical pencilbeam algorithm were compared with Monte Carlo simulations (MCS) using TOPAS. 79 complete patient treatment plans were investigated for 7 disease sites (liver, prostate, breast, medulloblastoma spine and whole brain, lung and head and neck). A total of 508 individual passively scattered treatment fields were analyzed for field specific properties. Comparisons based on target coverage indices (EUD, D95, D90 and D50) were performed. Range differences were estimated for the distal position of the 90% dose level (R90) and the 50% dose level (R50). Two-dimensional distal dose surfaces were calculated and the root mean square differences (RMSD), average range difference (ARD) and average distal dose degradation (ADD), the distance between the distal position of the 80% and 20% dose levels (R80- R20), were analyzed. Results: We found target coverage indices calculated by TOPAS to generally be around 1–2% lower than predicted by the analytical algorithm. Differences in R90 predicted by TOPAS and the planning system can be larger than currently applied range margins in proton therapy for small regions distal to the target volume. We estimate new site-specific range margins (R90) for analytical dose calculations considering total range uncertainties and uncertainties from dose calculation alone based on the RMSD. Our results demonstrate that a reduction of currently used uncertainty margins is feasible for liver, prostate and whole brain fields even without introducing MC dose calculations. Conclusion: Analytical dose calculation algorithms predict dose distributions within clinical limits for more homogeneous patients sites (liver, prostate, whole brain). However, we recommend

  2. TH-A-19A-06: Site-Specific Comparison of Analytical and Monte Carlo Based Dose Calculations

    Energy Technology Data Exchange (ETDEWEB)

    Schuemann, J; Grassberger, C; Paganetti, H [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Dowdell, S [Illawarra Shoalhaven Local Health District, Wollongong (Australia)

    2014-06-15

    Purpose: To investigate the impact of complex patient geometries on the capability of analytical dose calculation algorithms to accurately predict dose distributions and to verify currently used uncertainty margins in proton therapy. Methods: Dose distributions predicted by an analytical pencilbeam algorithm were compared with Monte Carlo simulations (MCS) using TOPAS. 79 complete patient treatment plans were investigated for 7 disease sites (liver, prostate, breast, medulloblastoma spine and whole brain, lung and head and neck). A total of 508 individual passively scattered treatment fields were analyzed for field specific properties. Comparisons based on target coverage indices (EUD, D95, D90 and D50) were performed. Range differences were estimated for the distal position of the 90% dose level (R90) and the 50% dose level (R50). Two-dimensional distal dose surfaces were calculated and the root mean square differences (RMSD), average range difference (ARD) and average distal dose degradation (ADD), the distance between the distal position of the 80% and 20% dose levels (R80- R20), were analyzed. Results: We found target coverage indices calculated by TOPAS to generally be around 1–2% lower than predicted by the analytical algorithm. Differences in R90 predicted by TOPAS and the planning system can be larger than currently applied range margins in proton therapy for small regions distal to the target volume. We estimate new site-specific range margins (R90) for analytical dose calculations considering total range uncertainties and uncertainties from dose calculation alone based on the RMSD. Our results demonstrate that a reduction of currently used uncertainty margins is feasible for liver, prostate and whole brain fields even without introducing MC dose calculations. Conclusion: Analytical dose calculation algorithms predict dose distributions within clinical limits for more homogeneous patients sites (liver, prostate, whole brain). However, we recommend

  3. Computation of thyroid doses and carcinogenic radiation risks to patients undergoing neck CT examinations

    International Nuclear Information System (INIS)

    Huda, W.; Spampinato, M. V.; Tipnis, S. V.; Magill, D.

    2013-01-01

    The aim of the study was to investigate how differences in patient anatomy and CT technical factors in neck CT impact on thyroid doses and the corresponding carcinogenic risks. The CTDI vol and dose-length product used in 11 consecutive neck CT studies, as well as data on automatic exposure control (AEC) tube current variation(s) from the image DICOM header, were recorded. For each CT image that included the thyroid, the mass equivalent water cylinder was estimated based on the patient cross-sectional area and average relative attenuation coefficient (Hounsfield unit, HU). Patient thyroid doses were estimated by accounting for radiation intensity at the location of the patient's thyroid, patient size and the scan length. Thyroid doses were used to estimate thyroid cancer risks as a function of patient demographics using risk factors in BEIR VII. The length of the thyroid glands ranged from 21 to 54 mm with an average length of 42±12 mm. Water cylinder diameters corresponding to the central slice through the patient thyroid ranged from 18 to 32 cm with a mean of 25±5 cm. The average CTDI vol (32-cm phantom) used to perform these scans was 26±6 mGy, but the use of an AEC increased the tube current by an average of 44 % at the thyroid mid-point. Thyroid doses ranged from 29 to 80 mGy, with an average of 55±19 mGy. A 20-y-old female receiving the highest thyroid dose of 80 mGy would have a thyroid cancer risk of nearly 0.1 %, but radiation risks decreased very rapidly with increasing patient age. The key factors that affect thyroid doses in neck CT examinations are the radiation intensity at the thyroid location and the size of the patient. The corresponding patient thyroid cancer risk is markedly influenced by patient sex and age. (authors)

  4. Automation of PCXMC and ImPACT for NASA Astronaut Medical Imaging Dose and Risk Tracking

    Science.gov (United States)

    Bahadori, Amir; Picco, Charles; Flores-McLaughlin, John; Shavers, Mark; Semones, Edward

    2011-01-01

    To automate astronaut organ and effective dose calculations from occupational X-ray and computed tomography (CT) examinations incorporating PCXMC and ImPACT tools and to estimate the associated lifetime cancer risk per the National Council on Radiation Protection & Measurements (NCRP) using MATLAB(R). Methods: NASA follows guidance from the NCRP on its operational radiation safety program for astronauts. NCRP Report 142 recommends that astronauts be informed of the cancer risks from reported exposures to ionizing radiation from medical imaging. MATLAB(R) code was written to retrieve exam parameters for medical imaging procedures from a NASA database, calculate associated dose and risk, and return results to the database, using the Microsoft .NET Framework. This code interfaces with the PCXMC executable and emulates the ImPACT Excel spreadsheet to calculate organ doses from X-rays and CTs, respectively, eliminating the need to utilize the PCXMC graphical user interface (except for a few special cases) and the ImPACT spreadsheet. Results: Using MATLAB(R) code to interface with PCXMC and replicate ImPACT dose calculation allowed for rapid evaluation of multiple medical imaging exams. The user inputs the exam parameter data into the database and runs the code. Based on the imaging modality and input parameters, the organ doses are calculated. Output files are created for record, and organ doses, effective dose, and cancer risks associated with each exam are written to the database. Annual and post-flight exposure reports, which are used by the flight surgeon to brief the astronaut, are generated from the database. Conclusions: Automating PCXMC and ImPACT for evaluation of NASA astronaut medical imaging radiation procedures allowed for a traceable and rapid method for tracking projected cancer risks associated with over 12,000 exposures. This code will be used to evaluate future medical radiation exposures, and can easily be modified to accommodate changes to the risk

  5. Low-Dose Aspirin Reduces Breast Cancer Risk in Women with Diabetes: A Nationwide Retrospective Cohort Study in Taiwan.

    Science.gov (United States)

    Yang, Yi-Sun; Kornelius, Edy; Chiou, Jeng-Yuan; Lai, Yung-Rung; Lo, Shih-Chang; Peng, Chiung-Huei; Huang, Chien-Ning

    2017-12-01

    Low-dose aspirin is commonly used for preventing cardiovascular disease in people with diabetes, but its association with cancer remains controversial. This study used a nationwide population-based reimbursement database to investigate the relationship between low-dose aspirin use and breast cancer incidence in women with diabetes. This retrospective cohort study was conducted using data retrieved from the National Health Insurance Research Database in Taiwan from January 1, 1998 to December 31, 2011. Women diagnosed as having diabetes with low-dose aspirin use (75-165 mg daily) were identified as the study population, whereas those without low-dose aspirin use were selected as the comparison group. We analyzed 148,739 patients with diabetes. Their mean age (standard deviation) was 63.3 (12.8) years. A total of 27,378 patients were taking aspirin. Overall, the use of aspirin in patients with diabetes reduced the risk of breast cancer by 18% (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.71-0.94) after adjustment for potential confounders, namely age and comorbidities. Specifically, a cumulative dose of aspirin exceeding 88,900 mg was observed to reduce the risk of breast cancer by 47% (HR, 0.53, 95% CI, 0.43-0.67); however, low (aspirin did not reduce the risk of breast cancer. Our findings suggest that a cumulative aspirin dosage of more than 88,900 mg daily was associated with a reduced risk of breast cancer in women with diabetes. However, additional studies are necessary to confirm these findings.

  6. Dose and risk assessment for intrusion into mixed waste disposal sites

    International Nuclear Information System (INIS)

    Kennedy, W.E. Jr.; Aaberg, R.L.

    1991-10-01

    Sites previously used for disposal of radioactive and hazardous chemical materials have resulted in situations that pose a potential threat to humans from inadvertent intrusion. An example generic scenario analysis was developed to demonstrate the evaluation of potential exposure to either cleanup workers or members of the public who intrude into buried waste containing both radioactive and hazardous chemical contaminants. The example scenarios consist of a collection of exposure routes (or pathways) with specific modeling assumptions for well-drilling and for excavation to construct buildings. These scenarios are used to describe conceptually some potential patterns of activity by non-protected human beings during intrusion into mixed-waste disposal sites. The dose from exposure to radioactive materials is calculated using the GENII software system and converted to risk by using factors from ICRP Publication 60. The hazard assessment for nonradioactive materials is performed using recent guidelines from the US Environmental Protection Agency (EPA). The example results are in the form of cancer risk for carcinogens and radiation exposure

  7. Pediatric radiation dose and risk from bone density measurements using a GE Lunar Prodigy scanner.

    Science.gov (United States)

    Damilakis, J; Solomou, G; Manios, G E; Karantanas, A

    2013-07-01

    Effective radiation doses associated with bone mineral density examinations performed on children using a GE Lunar Prodigy fan-beam dual-energy X-ray absorptiometry (DXA) scanner were found to be comparable to doses from pencil-beam DXA devices, i.e., lower than 1 μSv. Cancer risks associated with acquisitions obtained in this study are negligible. No data were found in the literature on radiation doses and potential risks following pediatric DXA performed on GE Lunar DXA scanners. This study aimed to estimate effective doses and associated cancer risks involved in pediatric examinations performed on a GE Lunar Prodigy scanner. Four physical anthropomorphic phantoms representing newborn, 1-, 5-, and 10-year-old patients were employed to simulate DXA exposures. All acquisitions were carried out using the Prodigy scanner. Dose measurements were performed for spine and dual femur using the phantoms simulating the 5- and 10-year-old child. Moreover, doses associated with whole-body examinations were measured for the four phantoms used in the current study. The gender-average effective dose for spine and hip examinations were 0.65 and 0.36 μSv, respectively, for the phantom representing the 5-year-old child and 0.93 and 0.205 μSv, respectively, for the phantom representing the 10-year-old child. Effective doses for whole-body examinations were 0.25, 0.22, 0.19, and 0.15 μSv for the neonate, 1-, 5-, and 10-year old child, respectively. The estimated lifetime cancer risks were negligible, i.e., 0.02-0.25 per million, depending on the sex, age, and type of DXA examination. A formula is presented for the estimation of effective dose from examinations performed on GE Lunar Prodigy scanners installed in other institutions. The effective doses and potential cancer risks associated with pediatric DXA examinations performed on a GE Lunar Prodigy fan-beam scanner were found to be comparable to doses and risks reported from pencil-beam DXA devices.

  8. Low-dose aspirin or other nonsteroidal anti-inflammatory drug use and prostate cancer risk

    DEFF Research Database (Denmark)

    Skriver, Charlotte; Dehlendorff, Christian; Borre, Michael

    2016-01-01

    PURPOSE: Increasing evidence suggests that aspirin use may protect against prostate cancer. In a nationwide case-control study, using Danish high-quality registry data, we evaluated the association between the use of low-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs......) and the risk of prostate cancer. METHODS: We identified 35,600 patients (cases) with histologically verified prostate cancer during 2000-2012. Cases were matched to 177,992 population controls on age and residence by risk-set sampling. Aspirin and nonaspirin NSAID exposure was defined by type, estimated dose......, duration, and consistency of use. We used conditional logistic regression to estimate odds ratios (ORs), with 95 % confidence intervals (CIs), for prostate cancer associated with low-dose aspirin (75-150 mg) or nonaspirin NSAID use, adjusted for potential confounders. RESULTS: Use of low-dose aspirin...

  9. Landslide susceptibility and risk assessment: specificities for road networks

    Science.gov (United States)

    Pellicani, Roberta; Argentiero, Ilenia; Parisi, Alessandro; Spilotro, Giuseppe

    2017-04-01

    A regional-scale assessment of landslide susceptibility and risk along the main road corridors crossing the provincial territory of Matera (Basilicata Region, Southern Italy) was carried out. The entire provincial road network extends for about 1,320 km through a territory, of which represents the main connection infrastructure among thirty-one municipalities due to the lack of an efficient integrated transportation system through the whole regional territory. For this reason, the strategic importance of these roads consists in their uniqueness in connecting every urban center with the socio-economic surrounding context. These roads and their vehicular traffic are continuously exposed to instability processes (about the 40% of the total length is disrupted by landslides), characterized both by high intensity and low frequency and by low intensity and high frequency. This last typology, consisting in small shallow landslides, is particularly hazardous for the roads since it is widespread along the road network, its occurrence is connected to rainfalls and determines high vulnerability conditions for the road in terms of interruption of vehicular traffic. A GIS-based heuristic-bivariate statistical predictive model was performed to assess and map the landslide susceptibility in the study area, by using a polynomial function of eight predisposing factors, weighted according to their influence on the landslide phenomena, recognized and collected in an inventory. Susceptibility associated to small shallow phenomena was assessed by using a polynomial function of specific factors, such as slope angle and aspect, lithological outcrops, rainfalls, etc. In absence of detailed input data, the spatial distribution of landslide risk along the road corridors was assessed and mapped using a qualitative hazard-consequence matrix approach, by which risk is obtained by combining hazard categories with consequence classes pairwise in a two-dimensional table or matrix. Landslide

  10. Average annual doses, lifetime doses and associated risk of cancer death for radiation workers in various fuel fabrication facilities in India

    International Nuclear Information System (INIS)

    Iyer, P.S.; Dhond, R.V.

    1980-01-01

    Lifetime doses based on average annual doses are estimated for radiation workers in various fuel fabrication facilities in India. For such cumulative doses, the risk of radiation-induced cancer death is computed. The methodology for arriving at these estimates and the assumptions made are discussed. Based on personnel monitoring records from 1966 to 1978, the average annual dose equivalent for radiation workers is estimated as 0.9 mSv (90 mrem), and the maximum risk of cancer death associated with this occupational dose as 1.35x10 -5 a -1 , as compared with the risk of death due to natural causes of 7x10 -4 a -1 and the risk of death due to background radiation alone of 1.5x10 -5 a -1 . (author)

  11. European Academy of Allergy and Clinical Immunology task force report on 'dose-response relationship in allergen-specific immunotherapy'.

    Science.gov (United States)

    Calderón, M A; Larenas, D; Kleine-Tebbe, J; Jacobsen, L; Passalacqua, G; Eng, P A; Varga, E M; Valovirta, E; Moreno, C; Malling, H J; Alvarez-Cuesta, E; Durham, S; Demoly, P

    2011-10-01

    For a century, allergen-specific immunotherapy (SIT) has proven to be an effective treatment for allergic rhinitis, asthma, and insect sting allergy. However, as allergen doses are frequently adapted to the individual patient, there are few data on dose-response relationship in SIT. Allergen products for SIT are being increasingly required to conform to regulatory requirements for human medicines, which include the need to demonstrate dose-dependent effects. This report, produced by a Task Force of the EAACI Immunotherapy Interest Group, evaluates the currently available data on dose-response relationships in SIT and aims to provide recommendations for the design of future studies. Fifteen dose-ranging studies fulfilled the inclusion criteria and twelve reported a dose-response relationship for clinical efficacy. Several studies also reported a dose-response relationship for immunological and safety endpoints. Due to the use of different reference materials and methodologies for the determination of allergen content, variations in study design, and choice of endpoints, no comparisons could be made between studies and, as a consequence, no general dosing recommendations can be made. Despite recently introduced guidelines on the standardization of allergen preparations and study design, the Task Force identified a need for universally accepted standards for the measurement of allergen content in SIT preparations, dosing protocols, and selection of clinical endpoints to enable dose-response effects to be compared across studies. © 2011 John Wiley & Sons A/S.

  12. No-threshold dose-response curves for nongenotoxic chemicals: Findings and applications for risk assessment

    International Nuclear Information System (INIS)

    Sheehan, Daniel M.

    2006-01-01

    We tested the hypothesis that no threshold exists when estradiol acts through the same mechanism as an active endogenous estrogen. A Michaelis-Menten (MM) equation accounting for response saturation, background effects, and endogenous estrogen level fit a turtle sex-reversal data set with no threshold and estimated the endogenous dose. Additionally, 31 diverse literature dose-response data sets were analyzed by adding a term for nonhormonal background; good fits were obtained but endogenous dose estimations were not significant due to low resolving power. No thresholds were observed. Data sets were plotted using a normalized MM equation; all 178 data points were accommodated on a single graph. Response rates from ∼1% to >95% were well fit. The findings contradict the threshold assumption and low-dose safety. Calculating risk and assuming additivity of effects from multiple chemicals acting through the same mechanism rather than assuming a safe dose for nonthresholded curves is appropriate

  13. Risk of a Second Kidney Carcinoma Following Childhood Cancer: Role of Chemotherapy and Radiation Dose to Kidneys.

    Science.gov (United States)

    de Vathaire, Florent; Scwhartz, Boris; El-Fayech, Chiraz; Allodji, Rodrigue Sètchéou; Escudier, Bernard; Hawkins, Mike; Diallo, Ibrahima; Haddy, Nadia

    2015-11-01

    Kidney carcinoma is a rare second malignancy following childhood cancer. We sought to quantify risk and assess risk factors for kidney carcinoma following treatment for childhood cancer. We evaluated a cohort of 4,350 patients who were 5-year cancer survivors and had been treated for cancer as children in France and the United Kingdom. Patients were treated between 1943 and 1985, and were followed for an average of 27 years. Radiation dose to the kidneys during treatment was estimated with dedicated software, regardless of the site of childhood cancer. Kidney carcinoma developed in 13 patients. The cumulative incidence of kidney carcinoma was 0.62% (95% CI 0.27%-1.45%) at 40 years after diagnosis, which was 13.3-fold higher (95% CI 7.1-22.3) than in the general population. The absolute excess risk strongly increased with longer duration of followup (p kidney carcinoma was 5.7-fold higher (95% CI 1.4-14.7) if radiotherapy was not performed or less than 1 Gy had been absorbed by the kidney but 66.3-fold higher (95% CI 23.8-142.5) if the radiation dose to the kidneys was 10 to 19 Gy and 14.5-fold higher (95% CI 0.8-63.9) for larger radiation doses to the kidney. Treatment with chemotherapy increased the risk of kidney carcinoma (RR 5.1, 95% CI 1.1-22.7) but we were unable to identify a specific drug or drug category responsible for this effect. Moderate radiation dose to the kidneys during childhood cancer treatment increases the risk of a second kidney carcinoma. This incidence will be further increased when childhood cancer survivors reach old age. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Experimental study on active specific immunotherapy utilizing the immune reaction of low-dose irradiated tumor tissue, 5

    International Nuclear Information System (INIS)

    Ogawa, Yasuhiro; Imanaka, Kazufumi; Gose, Kyuhei; Imajo, Yoshinari; Kimura, Shuji

    1982-01-01

    We have already reported the remarkable effect of the active specific immunotherapy utilizing cryopreserved tumor cells and infiltrating mononuclear cells prepared from a low-dose irradiated tumor tissue after cytoreductive radiotherapy. In the present study, the effect of a biological response modifier, OK-432 combined with this active specific immunotherapy was investigated. Twelve-week-aged female C3H/He mice transplanted with MM46 tumor cells were received local radiotherapy with the dose of 3,000 rads by high energy electron beam on the sixth day after inoculation. This active specific immunotherapy was performed on the thirteenth day, and daily dose of 1.0 KE of OK-432 was injected intraperitoneally from the thirteenth day to the seventeenth day. The inhibition of the tumor growth was observed in the group which received this active specific immunotherapy combined with a biological response modifier, OK-432 compared with that received this active specific immunotherapy alone. (author)

  15. Low-dose aspirin use and the risk of ovarian cancer in Denmark

    DEFF Research Database (Denmark)

    Baandrup, Lone; Kjaer, S K; Olsen, J H

    2015-01-01

    BACKGROUND: A comprehensive body of evidence has shown that aspirin has cancer-preventive effects, particularly against gastrointestinal cancer, but its effects on the risk of ovarian cancer are less well established. This nationwide case-control study examined the association between low......-dose aspirin and the risk of ovarian cancer. PATIENTS AND METHODS: We identified all patients in the Danish Cancer Registry aged 30-84 years old with a histologically verified first diagnosis of epithelial ovarian cancer during 2000-2011. Each patient was sex- and age-matched to 15 population controls using...... risk-set sampling. Prescription use, comorbidity, reproductive history, and demographic characteristics data were obtained from nationwide registries. The use of low-dose (75-150 mg) aspirin was defined according to the dose as well as the duration and consistency of use. Conditional logistic...

  16. Three-dimensional dose-response models of risk for radiation injury carcinogenesis

    International Nuclear Information System (INIS)

    Raabe, O.G.

    1988-01-01

    The use of computer graphics in conjunction with three-dimensional models of dose-response relationships for chronic exposure to ionizing radiation dramaticly clarifies the separate and interactive roles of competing risks. The three dimensions are average dose rate, exposure time, and risk. As an example, the functionally injurious and carcinogenic responses after systemic uptake of Ra-226 by beagles, mice and people with consequent alpha particle irradiation of the bone are represented by three-dimensional dose-rate/time/response surfaces that demonstrate the contributions with the passage of time of the competing deleterious responses. These relationships are further evaluated by mathematical stripping with three-dimensional illustrations that graphically show the resultant separate contribution of each effect. Radiation bone injury predominates at high dose rates and bone cancer at intermediate dose rates. Low dose rates result in spontaneous deaths from natural aging, yielding a type of practical threshold for bone cancer induction. Risk assessment is benefited by the insights that become apparent with these three-dimensional models. The improved conceptualization afforded by them contributes to planning and evaluating epidemiological analyses and experimental studies

  17. Reference computations of public dose and cancer risk from airborne releases of uranium and Class W plutonium

    International Nuclear Information System (INIS)

    Peterson, V.L.

    1995-01-01

    This report presents ''reference'' computations that can be used by safety analysts in the evaluations of the consequences of postulated atmospheric releases of radionuclides from the Rocky Flats Environmental Technology Site. These computations deal specifically with doses and health risks to the public. The radionuclides considered are Class W Plutonium, all classes of Enriched Uranium, and all classes of Depleted Uranium. (The other class of plutonium, Y, was treated in an earlier report.) In each case, one gram of the respirable material is assumed to be released at ground leveL both with and without fire. The resulting doses and health risks can be scaled to whatever amount of release is appropriate for a postulated accident being investigated. The report begins with a summary of the organ-specific stochastic risk factors appropriate for alpha radiation, which poses the main health risk of plutonium and uranium. This is followed by a summary of the atmospheric dispersion factors for unfavorable and typical weather conditions for the calculation of consequences to both the Maximum Offsite Individual and the general population within 80 km (50 miles) of the site

  18. [Specific iatrogenic risks to patients with HIV infection].

    Science.gov (United States)

    De Tournemire, R; Yeni, P

    1994-01-01

    Human immunodeficiency virus-infected patients are exposed to more or less specific iatrogenic diseases. The main characteristics of the risks encountered in this field are described: drug intolerance, mostly to sulfamethoxazole-trimethoprim, is extremely frequent; nucleoside analogue antiviral toxicity is reminiscent of that of chemotherapy; nosocomial infections, in general, are more prominent than in HIV-non infected patients. Intravenous line infections are particularly frequent, but these devices are necessary for prolonged intravenous therapies such as anti-CMV treatment of parenteral nutrition. An improved understanding of different etiopathogenic mechanisms and a better approach of the toxicity/efficacy ratio for each treatment would allow to reduce the excessive morbidity due to iatrogenicity.

  19. Radiation exposure to examiners and patients during therapeutic ERCP: Dose optimisation and risk estimation

    International Nuclear Information System (INIS)

    Sulieman, A.; Kappas, K.; Theodorou, K.; Paroutoglou, G.; Kapatenakis, A.; Kapsoritakis, A.; Potamianos, S.; Vlychou, M.; Fezoulidis, I.

    2008-01-01

    Aim: This study intended to optimise the radiation dose during therapeutic ERCP, and to estimate the risk for examiners and patients, to compare the doses based on available data obtained by other researchers and reference levels recommended by international organizations, and to evaluate the technique applied in order to reduce patient and examiners doses. Materials and Methods: 153 patients were studied in two Gastroenterology Departments, (group A, 111; group B, 42). Thermoluminescent dosimeters (TLD) were used to measure the staff and patients entrance surface dose (ESD) at different body sites. Results: The mean ESD, exit and thyroid surface dose per procedure was estimated to be 68.75 mGy, 3.45 mGy and 0.67 mGy, respectively. The mean patient effective dose was 3.44 mSv, and the cancer risk per procedure was estimated to be 190 x10 -6 . The effective dose for the first, second and third examiner was 0.4 μSv, 0.2 μSv and 5.0 μSv, respectively. Conclusion: The patient dose can be optimized by the presence of two experienced examiners and reduction of radiographic images. The examiners should use a wrap around lead apron since the highest dose originating from the X-ray tube, is incident on their side and back. The current formulae, which exist, underestimate the effective dose to the examiners, when they are applied for ERCP procedures. For both patients and examiners, our results were up to 60% lower compared to the lowest values found in previous studies. (authors)

  20. Lifetime attributable risk as an alternative to effective dose to describe the risk of cancer for patients in diagnostic and therapeutic nuclear medicine

    Science.gov (United States)

    Andersson, Martin; Eckerman, Keith; Mattsson, Sören

    2017-12-01

    The aim of this study is to implement lifetime attributable risk (LAR) predictions of cancer for patients of various age and gender, undergoing diagnostic investigations or treatments in nuclear medicine and to compare the outcome with a population risk estimate using effective dose and the International Commission on Radiological Protection risk coefficients. The radiation induced risk of cancer occurrence (incidence) or death from four nuclear medicine procedures are estimated for both male and female between 0 and 120 years. Estimations of cancer risk are performed using recommended administered activities for two diagnostic (18F-FDG and 99mTc-phosphonate complex) and two therapeutic (131I-iodide and 223Ra-dichloride) radiopharmaceuticals to illustrate the use of cancer risk estimations in nuclear medicine. For 18F-FDG, the cancer incidence for a male of 5, 25, 50 and 75 years at exposure is 0.0021, 0.0010, 0.0008 and 0.0003, respectively. For 99mTc phosphonates complex the corresponding values are 0.000 59, 0.000 34, 0.000 27 and 0.000 13, respectively. For an 131I-iodide treatment with 3.7 GBq and 1% uptake 24 h after administration, the cancer incidence for a male of 25, 50 and 75 years at exposure is 0.041, 0.029 and 0.012, respectively. For 223Ra-dichloride with an administration of 21.9 MBq the cancer incidence for a male of 25, 50 and 75 years is 0.31, 0.21 and 0.09, respectively. The LAR estimations are more suitable in health care situations involving individual patients or specific groups of patients than the health detriment based on effective dose, which represents a population average. The detriment consideration in effective dose adjusts the cancer incidence for suffering of non-lethal cancers while LAR predicts morbidity (incidence) or mortality (cancer). The advantages of these LARs are that they are gender and age specific, allowing risk estimations for specific patients or subgroups thus better representing individuals in health care

  1. Bleeding Risk with Long-Term Low-Dose Aspirin: A Systematic Review of Observational Studies

    Science.gov (United States)

    García Rodríguez, Luis A.; Martín-Pérez, Mar; Hennekens, Charles H.; Rothwell, Peter M.; Lanas, Angel

    2016-01-01

    Background Low-dose aspirin has proven effectiveness in secondary and primary prevention of cardiovascular events, but is also associated with an increased risk of major bleeding events. For primary prevention, this absolute risk must be carefully weighed against the benefits of aspirin; such assessments are currently limited by a lack of data from general populations. Methods Systematic searches of Medline and Embase were conducted to identify observational studies published between 1946 and 4 March 2015 that reported the risks of gastrointestinal (GI) bleeding or intracranial hemorrhage (ICH) with long-term, low-dose aspirin (75–325 mg/day). Pooled estimates of the relative risk (RR) for bleeding events with aspirin versus non-use were calculated using random-effects models, based on reported estimates of RR (including odds ratios, hazard ratios, incidence rate ratios and standardized incidence ratios) in 39 articles. Findings The incidence of GI bleeding with low-dose aspirin was 0.48–3.64 cases per 1000 person-years, and the overall pooled estimate of the RR with low-dose aspirin was 1.4 (95% confidence interval [CI]: 1.2–1.7). For upper and lower GI bleeding, the RRs with low-dose aspirin were 2.3 (2.0–2.6) and 1.8 (1.1–3.0), respectively. Neither aspirin dose nor duration of use had consistent effects on RRs for upper GI bleeding. The estimated RR for ICH with low-dose aspirin was 1.4 (1.2–1.7) overall. Aspirin was associated with increased bleeding risks when combined with non-steroidal anti-inflammatory drugs, clopidogrel and selective serotonin reuptake inhibitors compared with monotherapy. By contrast, concomitant use of proton pump inhibitors decreased upper GI bleeding risks relative to aspirin monotherapy. Conclusions The risks of major bleeding with low-dose aspirin in real-world settings are of a similar magnitude to those reported in randomized trials. These data will help inform clinical judgements regarding the use of low-dose aspirin

  2. Twin specific risk factors in primary school achievements.

    Science.gov (United States)

    de Zeeuw, Eveline L; van Beijsterveldt, Catherina E M; de Geus, Eco J C; Boomsma, Dorret I

    2012-02-01

    The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational achievement was compared between twins and their nontwin siblings in a within-family design. Data were obtained from parents and teachers of approximately 10,000 twins and their nontwin siblings registered with the Netherlands Twin Register. Teachers rated the proficiency of the children on arithmetic, language, reading, and physical education, and reported a national educational achievement test score (CITO). Structural equation modeling showed that gestational age, birth weight, and sex were significant predictors of educational achievement, even after correction for socioeconomic status. Mode of delivery and zygosity did not have an effect, while parental age only influenced arithmetic. Mode of conception, incubator time, and birth complications negatively affected achievement in physical education. The comparison of educational achievement of twins and singletons showed significantly lower ratings on arithmetic, reading, and language in twins, compared to their older siblings, but not compared to their younger siblings. Low gestational age and low birth weight were the most important risk factors for lower educational achievement of twins in primary school. It seems that the differences observed between twins and their nontwin siblings in educational achievement can largely be explained by birth order within the family.

  3. Three-dimensional dose-response models of competing risks and natural life span

    International Nuclear Information System (INIS)

    Raabe, O.G.

    1987-01-01

    Three-dimensional dose-rate/time/response surfaces for chronic exposure to carcinogens, toxicants, and ionizing radiation dramatically clarify the separate and interactive roles of competing risks. The three dimensions are average dose rate, exposure time, and risk. An illustration with computer graphics shows the contributions with the passage of time of the competing risks of death from radiation pneumonitis/fibrosis, lung cancer, and natural aging consequent to the inhalation of plutonium-239 dioxide by beagles. These relationships are further evaluated by mathematical stripping with three-dimensional illustrations that graphically show the resultant separate contribution of each fatal effect. Radiation pneumonitis predominates at high dose rates and lung cancer at intermediate dose rates. Low dose rates result in spontaneous deaths from natural aging, yielding a type of practical threshold for lung cancer induction. Risk assessment is benefited by the insights that become apparent with these three-dimensional models. The improved conceptualization afforded by them contributes to the planning and evaluation of epidemiological analyses and experimental studies involving chronic exposure to toxicants

  4. The role of uncertainty analysis in dose reconstruction and risk assessment

    International Nuclear Information System (INIS)

    Hoffman, F.O.; Simon, S.L.; Thiessen. K.M.

    1996-01-01

    Dose reconstruction and risk assessment rely heavily on the use of mathematical models to extrapolate information beyond the realm of direct observation. Because models are merely approximations of real systems, their predictions are inherently uncertain. As a result, full disclosure of uncertainty in dose and risk estimates is essential to achieve scientific credibility and to build public trust. The need for formal analysis of uncertainty in model predictions was presented during the nineteenth annual meeting of the NCRP. At that time, quantitative uncertainty analysis was considered a relatively new and difficult subject practiced by only a few investigators. Today, uncertainty analysis has become synonymous with the assessment process itself. When an uncertainty analysis is used iteratively within the assessment process, it can guide experimental research to refine dose and risk estimates, deferring potentially high cost or high consequence decisions until uncertainty is either acceptable or irreducible. Uncertainty analysis is now mandated for all ongoing dose reconstruction projects within the United States, a fact that distinguishes dose reconstruction from other types of exposure and risk assessments. 64 refs., 6 figs., 1 tab

  5. Soy food intake and risk of gastric cancer: A dose-response meta-analysis of prospective studies.

    Science.gov (United States)

    Weng, Ke-Gui; Yuan, Ya-Ling

    2017-08-01

    Epidemiological studies were inconsistent on the association between soy food intake and risk of gastric cancer (GC). This study aimed to determine the role of soy food intake in the development of GC.A systematic search was conducted in PubMed and Web of Science to identify all relevant studies. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model, and the dose-response relationship between soy food intake and GC risk was also assessed.Thirteen prospective studies were identified with a total of 517,106 participants and 5800 cases. Among 11 types of soy food, high intake of total soy food (the highest vs the lowest category: RR: 0.78, 95% CI: 0.62-0.98) and nonfermented soy food (RR: 0.63, 95% CI: 0.50-0.79) were inversely associated with GC risk, while high intake of miso soup was associated with the risk in male (RR: 1.17, 95% CI: 1.02-1.36). In dose-response meta-analysis, total soy food intake (0-150 g/day) showed no significant association with GC risk, while high intake of nonfermented soy food was inversely related, especially an intake of more than 100 g/day. In male, miso soup intake (1-5 cups/day) was significantly associated with GC risk.High intake of nonfermented soy food might reduce the risk of GC, while miso soup intake might increase the risk in male.

  6. Radiation dose and radiation risk to foetuses and newborns during X-ray examinations

    Energy Technology Data Exchange (ETDEWEB)

    Kettunen, A. [Oulu Univ. (Finland)

    2004-05-01

    The purpose of this study is to determine the way in which the demands set by degree 423/2000 by the Ministry of Social Affairs and Health are fulfilled with respect to the most radiosensitive groups, the foetus and the child, by estimating the radiation dose and radiation risk to the foetus from x-ray examinations of an expectant mother's pelvic region, finding out the practice involved in preventing doses to embryos and foetuses and assessing dose practices in cases where an embryo or foetus is or shall be exposed, and by estimating radiation dose and risk due to the radiation received by a new-born being treated in a paediatric intensive care unit. No statistics are available in Finland to indicate how many x-ray examinations of the pelvic region and lower abdomen are made to pregnant patients or to show the dose and risk to the foetus due these examinations. In order to find out the practices in radiological departments concerning the pelvic x-ray examination of fertile woman and the number of foetuses exposed, a questionnaire was sent to all radiation safety officers responsible for the safe use of radiation (n = 290). A total of 173 questionnaires were returned. This study recorded the technique and Dose-Area Product of 118 chest examinations of newborns in paediatric intensive care units. Entrance surface doses and effective doses were calculated separately to each newborn. Based on the patient records, the number of all x-ray examinations during the study was calculated and the effective doses were estimated retrospectively to each child. The radiation risk was estimated both for the foetuses and for the newborns. According to this study, it is rare in Finland to expose a pregnant woman to radiation. On the other hand, with the exception of pelvimetry examinations, there are no compiled statistics concerning the number of pelvic x-ray examinations of a pregnant woman. There was no common practice on how to exclude the possibility of pregnancy. The dose

  7. Radiation dose and radiation risk to foetuses and newborns during X-ray examinations

    International Nuclear Information System (INIS)

    Kettunen, A.

    2004-05-01

    The purpose of this study is to determine the way in which the demands set by degree 423/2000 by the Ministry of Social Affairs and Health are fulfilled with respect to the most radiosensitive groups, the foetus and the child, by estimating the radiation dose and radiation risk to the foetus from x-ray examinations of an expectant mother's pelvic region, finding out the practice involved in preventing doses to embryos and foetuses and assessing dose practices in cases where an embryo or foetus is or shall be exposed, and by estimating radiation dose and risk due to the radiation received by a new-born being treated in a paediatric intensive care unit. No statistics are available in Finland to indicate how many x-ray examinations of the pelvic region and lower abdomen are made to pregnant patients or to show the dose and risk to the foetus due these examinations. In order to find out the practices in radiological departments concerning the pelvic x-ray examination of fertile woman and the number of foetuses exposed, a questionnaire was sent to all radiation safety officers responsible for the safe use of radiation (n = 290). A total of 173 questionnaires were returned. This study recorded the technique and Dose-Area Product of 118 chest examinations of newborns in paediatric intensive care units. Entrance surface doses and effective doses were calculated separately to each newborn. Based on the patient records, the number of all x-ray examinations during the study was calculated and the effective doses were estimated retrospectively to each child. The radiation risk was estimated both for the foetuses and for the newborns. According to this study, it is rare in Finland to expose a pregnant woman to radiation. On the other hand, with the exception of pelvimetry examinations, there are no compiled statistics concerning the number of pelvic x-ray examinations of a pregnant woman. There was no common practice on how to exclude the possibility of pregnancy. The dose to a

  8. Vrancea earthquakes. Specific actions to mitigate seismic risk

    International Nuclear Information System (INIS)

    Marmureanu, Gheorghe; Marmureanu, Alexandru

    2005-01-01

    natural disasters given by earthquakes, there is a need to reverse trends in seismic risk mitigation to future events. Main courses of specific action to mitigate the seismic risks from strong deep Vrancea earthquakes should be considered as key to future development projects, including: - Early warning system for industrial facilities; - Short and long term prediction program of strong Vrancea earthquakes; - Seismic hazard map of Romania; - Seismic microzonation of large populated cities; - Shake map; - Seismic tomography of dams for avoiding disasters. The quality of life and the security of infrastructure (including human services, civil and industrial structures, financial infrastructure, information transmission and processing systems) in every nation are increasingly vulnerable to disasters caused by events that have geological, atmospheric, hydrologic, and technological origins. As UN Secretary General Kofi Annan pointed out, 'Building a culture of prevention is not easy. While the costs of prevention have to be paid in the present, its benefits lie in a distant future'. In other words: Prevention pays off. This may not always become apparent immediately, but, in the long run, the benefits from prevention measures will always outweigh their costs by far. Romania is an earthquake prone area and these main specific actions are really contributing to seismic risk mitigation. These specific actions are provided for in Law nr. 372/March 18,2004 -'The National Program of Seismic Risk Management'. (authors)

  9. SU-E-T-120: Analytic Dose Verification for Patient-Specific Proton Pencil Beam Scanning Plans

    International Nuclear Information System (INIS)

    Chang, C; Mah, D

    2015-01-01

    Purpose: To independently verify the QA dose of proton pencil beam scanning (PBS) plans using an analytic dose calculation model. Methods: An independent proton dose calculation engine is created using the same commissioning measurements as those employed to build our commercially available treatment planning system (TPS). Each proton PBS plan is exported from the TPS in DICOM format and calculated by this independent dose engine in a standard 40 x 40 x 40 cm water tank. This three-dimensional dose grid is then compared with the QA dose calculated by the commercial TPS, using standard Gamma criterion. A total of 18 measured pristine Bragg peaks, ranging from 100 to 226 MeV, are used in the model. Intermediate proton energies are interpolated. Similarly, optical properties of the spots are measured in air over 15 cm upstream and downstream, and fitted to a second-order polynomial. Multiple Coulomb scattering in water is approximated analytically using Preston and Kohler formula for faster calculation. The effect of range shifters on spot size is modeled with generalized Highland formula. Note that the above formulation approximates multiple Coulomb scattering in water and we therefore chose not use the full Moliere/Hanson form. Results: Initial examination of 3 patient-specific prostate PBS plans shows that agreement exists between 3D dose distributions calculated by the TPS and the independent proton PBS dose calculation engine. Both calculated dose distributions are compared with actual measurements at three different depths per beam and good agreements are again observed. Conclusion: Results here showed that 3D dose distributions calculated by this independent proton PBS dose engine are in good agreement with both TPS calculations and actual measurements. This tool can potentially be used to reduce the amount of different measurement depths required for patient-specific proton PBS QA

  10. Estimating doses and risks associated with decontamination and decommissioning activities using the CRRIS

    International Nuclear Information System (INIS)

    Miller, C.W.; Sjoreen, A.L.; Cotter, S.J.

    1986-01-01

    The Computerized Radiological Risk Investigation System (CRRIS) is applicable to determining doses and risks from a variety of decontamination and decommissioning activities. For example, concentrations in air from resuspended radionuclides initially deposited on the ground surface and the concentrations of deposited radionuclides in various soil layers can be obtained. The CRRIS will estimate exposure to radon and its progeny in terms of working-level months, and will compute the resulting health risks. The CRRIS consists of seven integrated computer codes that stand alone or are run as a system to calculate environmental transport, doses, and risks. PRIMUS output provides other CRRIS codes the capability to handle radionuclide decay chains. ANEMOS and RETADD-II calculate atmospheric dispersion and deposition for local and regional distances, respectively. Multiple ANEMOS runs for sources within a small area are combined on a master grid by SUMIT. MLSOIL is used to estimate effective ground surface concentrations for dose computations. TERRA calculates food chain transport, and ANDROS calculates individual or population exposures, doses, and risks. Applications of the CRRIS to decontamination problems are discussed. 16 refs., 1 fig

  11. Assessing doses of radiotherapy with the risk of developing cancer in the head and neck

    International Nuclear Information System (INIS)

    Yu, Cheng-Ching; Hsu, Fang-Yuh; Yu, Wan-Hsuan; Liu, Mu-Tai; Huang, Sheng-Shien

    2011-01-01

    Radiation is known to be a major cause of cancer in normal tissue. After treatment with radiotherapy, for young patients or the patients can survive for a long time, the radiation-induced cancer risk is noteworthy. This research investigated the dose delivered by the treatment of intensity modulated radiation therapy (IMRT) for head and neck cancer, such as NPC and oral cancer, and assessed the risk of developing radiation-induced secondary cancer in non-targeted normal tissues. A Rando phantom was used to simulate a patient with NPC or oral cancer, and thermoluminescent dosimeter (TLD) chips were placed inside the phantom to estimate the doses delivered by IMRT. In summary, the risks to patients with NPC was somewhat higher than for those with oral cancer, because the region of the PTV was lower, requiring larger field sizes be used for cases of NPC. The smaller the field size used, the less the risk was of developing secondary cancer. In addition, the higher the value of MU used, the higher the dose delivered to normal tissues was. The risk of radiation-induced secondary cancer was proportional to the delivered dose.

  12. Radiation therapy for stage IIA and IIB testicular seminoma: peripheral dose calculations and risk assessments

    Science.gov (United States)

    Mazonakis, Michalis; Berris, Theocharris; Lyraraki, Efrossyni; Damilakis, John

    2015-03-01

    This study was conducted to calculate the peripheral dose to critical structures and assess the radiation risks from modern radiotherapy for stage IIA/IIB testicular seminoma. A Monte Carlo code was used for treatment simulation on a computational phantom representing an average adult. The initial treatment phase involved anteroposterior and posteroanaterior modified dog-leg fields exposing para-aortic and ipsilateral iliac lymph nodes followed by a cone-down phase for nodal mass irradiation. Peripheral doses were calculated using different modified dog-leg field dimensions and an extended conventional dog-leg portal. The risk models of the BEIR-VII report and ICRP-103 were combined with dosimetric calculations to estimate the probability of developing stochastic effects. Radiotherapy for stage IIA seminoma with a target dose of 30 Gy resulted in a range of 23.0-603.7 mGy to non-targeted peripheral tissues and organs. The corresponding range for treatment of stage IIB disease to a cumulative dose of 36 Gy was 24.2-633.9 mGy. A dose variation of less than 13% was found by altering the field dimensions. Radiotherapy with the conventional instead of the modern modified dog-leg field increased the peripheral dose up to 8.2 times. The calculated heart doses of 589.0-632.9 mGy may increase the risk for developing cardiovascular diseases whereas the testicular dose of more than 231.9 mGy may lead to a temporary infertility. The probability of birth abnormalities in the offspring of cancer survivors was below 0.13% which is much lower than the spontaneous mutation rate. Abdominoplevic irradiation may increase the lifetime intrinsic risk for the induction of secondary malignancies by 0.6-3.9% depending upon the site of interest, patient’s age and tumor dose. Radiotherapy for stage IIA/IIB seminoma with restricted fields and low doses is associated with an increased morbidity. These data may allow the definition of a risk-adapted follow-up scheme for long

  13. Risk group dependence of dose-response for biopsy outcome after three-dimensional conformal radiation therapy of prostate cancer

    International Nuclear Information System (INIS)

    Levegruen, Sabine; Jackson, Andrew; Zelefsky, Michael J.; Venkatraman, Ennapadam S.; Skwarchuk, Mark W.; Schlegel, Wolfgang; Fuks, Zvi; Leibel, Steven A.; Ling, C. Clifton

    2002-01-01

    Background and purpose: We fit phenomenological tumor control probability (TCP) models to biopsy outcome after three-dimensional conformal radiation therapy (3D-CRT) of prostate cancer patients to quantify the local dose-response of prostate cancer. Materials and methods: We analyzed the outcome after photon beam 3D-CRT of 103 patients with stage T1c-T3 prostate cancer treated at Memorial Sloan-Kettering Cancer Center (MSKCC) (prescribed target doses between 64.8 and 81 Gy) who had a prostate biopsy performed ≥2.5 years after end of treatment. A univariate logistic regression model based on D mean (mean dose in the planning target volume of each patient) was fit to the whole data set and separately to subgroups characterized by low and high values of tumor-related prognostic factors T-stage ( 6), and pre-treatment prostate-specific antigen (PSA) (≤10 ng/ml vs. >10 ng/ml). In addition, we evaluated five different classifications of the patients into three risk groups, based on all possible combinations of two or three prognostic factors, and fit bivariate logistic regression models with D mean and the risk group category to all patients. Dose-response curves were characterized by TCD 50 , the dose to control 50% of the tumors, and γ 50 , the normalized slope of the dose-response curve at TCD 50 . Results: D mean correlates significantly with biopsy outcome in all patient subgroups and larger values of TCD 50 are observed for patients with unfavorable compared to favorable prognostic factors. For example, TCD 50 for high T-stage patients is 7 Gy higher than for low T-stage patients. For all evaluated risk group definitions, D mean and the risk group category are independent predictors of biopsy outcome in bivariate analysis. The fit values of TCD 50 show a clear separation of 9-10.6 Gy between low and high risk patients. The corresponding dose-response curves are steeper (γ 50 =3.4-5.2) than those obtained when all patients are analyzed together (γ 50 =2

  14. Burden of upper gastrointestinal symptoms in patients receiving low-dose acetylsalicylic acid for cardiovascular risk management

    DEFF Research Database (Denmark)

    Bytzer, Peter; Pratt, Stephen; Elkin, Eric

    2013-01-01

    Continuous low-dose acetylsalicylic acid (aspirin; ASA) is a mainstay of cardiovascular (CV) risk management. It is well established, however, that troublesome upper gastrointestinal (GI) symptoms are commonly experienced among low-dose ASA users.......Continuous low-dose acetylsalicylic acid (aspirin; ASA) is a mainstay of cardiovascular (CV) risk management. It is well established, however, that troublesome upper gastrointestinal (GI) symptoms are commonly experienced among low-dose ASA users....

  15. Genetic radiation risks: a neglected topic in the low dose debate

    Directory of Open Access Journals (Sweden)

    Inge Schmitz-Feuerhake

    2016-01-01

    Full Text Available Objectives To investigate the accuracy and scientific validity of the current very low risk factor for hereditary diseases in humans following exposures to ionizing radiation adopted by the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Commission on Radiological Protection. The value is based on experiments on mice due to reportedly absent effects in the Japanese atomic bomb (Abomb survivors. Methods To review the published evidence for heritable effects after ionising radiation exposures particularly, but not restricted to, populations exposed to contamination from the Chernobyl accident and from atmospheric nuclear test fallout. To make a compilation of findings about early deaths, congenital malformations, Down’s syndrome, cancer and other genetic effects observed in humans after the exposure of the parents. To also examine more closely the evidence from the Japanese A-bomb epidemiology and discuss its scientific validity. Results Nearly all types of hereditary defects were found at doses as low as one to 10 mSv. We discuss the clash between the current risk model and these observations on the basis of biological mechanism and assumptions about linear relationships between dose and effect in neonatal and foetal epidemiology. The evidence supports a dose response relationship which is non-linear and is either biphasic or supralinear (hogs-back and largely either saturates or falls above 10 mSv. Conclusions We conclude that the current risk model for heritable effects of radiation is unsafe. The dose response relationship is non-linear with the greatest effects at the lowest doses. Using Chernobyl data we derive an excess relative risk for all malformations of 1.0 per 10 mSv cumulative dose. The safety of the Japanese A-bomb epidemiology is argued to be both scientifically and philosophically questionable owing to errors in the choice of control groups, omission of internal exposure effects and

  16. Donor-specific cell-based assays in studying sensitivity to low-dose radiation: a population-based perspective

    Directory of Open Access Journals (Sweden)

    Dora eIl'yasova

    2014-11-01

    Full Text Available Currently, a linear no-threshold model is used to estimate health risks associated with exposure to low-dose radiation, a prevalent exposure in the general population, because the direct estimation from epidemiological studies suffers from uncertainty. This model has been criticized based on unique biology of low-dose radiation. Whether the departure from linearity is toward increased or decreased risk is intensely debated. We present an approach based on individual radiosensitivity testing and discuss how individual radiosensitivity can be assessed with the goal to develop a quantifiable measure of cellular response that can be conducted via high-throughput population testing.

  17. Association between tea consumption and risk of cognitive disorders: A dose-response meta-analysis of observational studies.

    Science.gov (United States)

    Liu, Xueying; Du, Xiaoyuan; Han, Guanying; Gao, Wenyuan

    2017-06-27

    The epidemiological evidence for a dose-response relationship between tea consumption and risk of cognitive disorders is sparse. The aim of the study was to summarize the evidence for the association of tea consumption with risk of cognitive disorders and assess the dose-response relationship. We searched electronic databases of Pubmed, Embase, and Cochrane Library (from 1965 to Jan 19, 2017) for eligible studies that published in the international journals. A random-effects model was used to pool the most adjusted odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Seventeen studies involving 48,435 participants were included in our study. The meta-analysis showed that a higher tea consumption was associated with a significant reduction in the risk of cognitive disorders (OR=0.73, 95% CI: 0.65-0.82). When considering the specific types of tea consumption, the significantly inverse association is only found in green tea consumption (OR=0.64, 95% CI: 0.53-0.77) but not in black/oolong tea consumption (OR=0.75, 95% CI: 0.55-1.01). Dose-response meta-analysis indicated that tea consumption is linearly associated with a reduced risk of cognitive disorders. An increment of 100 ml/day, 300 ml/day, and 500 ml/day of tea consumption was associated with a 6% (OR=0.94, 95% CI: 0.92-0.96), 19% (OR=0.81, 95% CI: 0.74-0.88), and 29% (OR=0.71, 95% CI: 0.62-0.82) lower risk of cognitive disorders. Tea consumption is inversely and linearly related to the risk of cognitive disorders. More studies are needed to further confirm our findings.

  18. Overview of Graphical User Interface for ARRBOD (Acute Radiation Risk and BRYNTRN Organ Dose Projection)

    Science.gov (United States)

    Kim, Myung-Hee Y.; Hu, Shaowen; Nounu, Hatem N.; Cucinotta, Francis A.

    2010-01-01

    Solar particle events (SPEs) pose the risk of acute radiation sickness (ARS) to astronauts, because organ doses from large SPEs may reach critical levels during extra vehicular activities (EVAs) or lightly shielded spacecraft. NASA has developed an organ dose projection model of Baryon transport code (BRYNTRN) with an output data processing module of SUMDOSE, and a probabilistic model of acute radiation risk (ARR). BRYNTRN code operation requires extensive input preparation, and the risk projection models of organ doses and ARR take the output from BRYNTRN as an input to their calculations. With a graphical user interface (GUI) to handle input and output for BRYNTRN, these response models can be connected easily and correctly to BRYNTRN in a user friendly way. The GUI for the Acute Radiation Risk and BRYNTRN Organ Dose (ARRBOD) projection code provides seamless integration of input and output manipulations required for operations of the ARRBOD modules: BRYNTRN, SUMDOSE, and the ARR probabilistic response model. The ARRBOD GUI is intended for mission planners, radiation shield designers, space operations in the mission operations directorate (MOD), and space biophysics researchers. Assessment of astronauts organ doses and ARS from the exposure to historically large SPEs is in support of mission design and operation planning to avoid ARS and stay within the current NASA short-term dose limits. The ARRBOD GUI will serve as a proof-of-concept for future integration of other risk projection models for human space applications. We present an overview of the ARRBOD GUI product, which is a new self-contained product, for the major components of the overall system, subsystem interconnections, and external interfaces.

  19. Radioactive contamination in the Arctic--sources, dose assessment and potential risks

    International Nuclear Information System (INIS)

    Strand, P.; Howard, B.J.; Aarkrog, A.; Balonov, M.; Tsaturov, Y.; Bewers, J.M.; Salo, A.; Sickel, M.; Bergman, R.; Rissanen, K.

    2002-01-01

    Arctic residents, whose diets comprise a large proportion of traditional terrestrial and freshwater foodstuffs, have received the highest radiation exposures to artificial radionuclides in the Arctic. Doses to members of both the average population and selected indigenous population groups in the Arctic depend on the rates of consumption of locally-derived terrestrial and freshwater foodstuffs, including reindeer/caribou meat, freshwater fish, goat cheese, berries, mushrooms and lamb. The vulnerability of arctic populations, especially indigenous peoples, to radiocaesium deposition is much greater than for temperate populations due to the importance of terrestrial, semi-natural exposure pathways where there is high radiocaesium transfer and a long ecological half-life for this radionuclide. In contrast, arctic residents with diets largely comprising marine foodstuffs have received comparatively low radiation exposures because of the lower levels of contamination of marine organisms. Using arctic-specific information, the predicted collective dose is five times higher than that estimated by UNSCEAR for temperate areas. The greatest threats to human health and the environment posed by human and industrial activities in the Arctic are associated with the potential for accidents in the civilian and military nuclear sectors. Of most concern are the consequences of potential accidents in nuclear power plant reactors, during the handling and storage of nuclear weapons, in the decommissioning of nuclear submarines and in the disposal of spent nuclear fuel from vessels. It is important to foster a close association between risk assessment and practical programmes for the purposes of improving monitoring, formulating response strategies and implementing action plans

  20. Influence of Comorbidity on the Risk of Mortality in Men With Unfavorable-Risk Prostate Cancer Undergoing High-Dose Radiation Therapy Alone

    Energy Technology Data Exchange (ETDEWEB)

    Huynh, Mai Anh, E-mail: mahuynh@lroc.harvard.edu [Harvard Radiation Oncology Program, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Chen, Ming-Hui; Wu, Jing [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Braccioforte, Michelle H.; Moran, Brian J. [Prostate Cancer Foundation of Chicago, Westmont, Illinois (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Brigham and Women' s Hospital–Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2016-07-15

    Purpose: To explore whether a subgroup of men with unfavorable-risk prostate cancer (PC) exists in whom high-dose radiation therapy (RT) alone is sufficient to avoid excess PC death due to competing risk from cardiometabolic comorbidity. Methods and Materials: This was a cohort study of 7399 men in whom comorbidity (including congestive heart failure, diabetes mellitus, or myocardial infarction) was assessed and recorded with T1-3NxM0 PC treated with brachytherapy with or without neoadjuvant RT, October 1997 to May 2013 at a single providing institution. Cox and competing risks regression analyses were used to assess whether men with unfavorable–intermediate/high-risk versus favorable–intermediate/low-risk PC were at increased risk of PC-specific, all-cause, or other-cause mortality (PCSM, ACM, OCM), adjusting for number of comorbidities, age at and year of brachytherapy, RT use, and an RT treatment propensity score. Results: After a median follow-up of 7.7 years, 935 men died: 80 of PC and 855 of other causes. Among men with no comorbidity, PCSM risk (adjusted hazard ratio [AHR] 2.74 [95% confidence interval (CI) 1.49-5.06], P=.001) and ACM risk (AHR 1.30 [95% CI 1.07-1.58], P=.007) were significantly increased in men with unfavorable–intermediate/high-risk PC versus favorable–intermediate/low-risk PC, with no difference in OCM (P=.07). Although PCSM risk was increased in men with 1 comorbidity (AHR 2.87 [95% CI 1.11-7.40], P=.029), ACM risk was not (AHR 1.03 [95% CI 0.78-1.36], P=.84). Neither PCSM risk (AHR 4.39 [95% CI 0.37-51.98], P=.24) or ACM risk (AHR 1.43 [95% CI 0.83-2.45], P=.20) was increased in men with 2 comorbidities. Conclusions: To minimize death from PC, high-dose RT alone may be sufficient treatment in men with 2 or more cardiometabolic comorbidities and unfavorable–intermediate- and high-risk PC.

  1. Operational specification and forecasting advances for Dst, LEO thermospheric densities, and aviation radiation dose and dose rate

    Science.gov (United States)

    Tobiska, W. Kent

    Space weather’s effects upon the near-Earth environment are due to dynamic changes in the energy transfer processes from the Sun’s photons, particles, and fields. Of the space environment domains that are affected by space weather, the magnetosphere, thermosphere, and even troposphere are key regions that are affected. Space Environment Technologies (SET) has developed and is producing innovative space weather applications. Key operational systems for providing timely information about the effects of space weather on these domains are SET’s Magnetosphere Alert and Prediction System (MAPS), LEO Alert and Prediction System (LAPS), and Automated Radiation Measurements for Aviation Safety (ARMAS) system. MAPS provides a forecast Dst index out to 6 days through the data-driven, redundant data stream Anemomilos algorithm. Anemomilos uses observational proxies for the magnitude, location, and velocity of solar ejecta events. This forecast index is used by satellite operations to characterize upcoming geomagnetic storms, for example. In addition, an ENLIL/Rice Dst prediction out to several days has also been developed and will be described. LAPS is the SET fully redundant operational system providing recent history, current epoch, and forecast solar and geomagnetic indices for use in operational versions of the JB2008 thermospheric density model. The thermospheric densities produced by that system, driven by the LAPS data, are forecast to 72-hours to provide the global mass densities for satellite operators. ARMAS is a project that has successfully demonstrated the operation of a micro dosimeter on aircraft to capture the real-time radiation environment due to Galactic Cosmic Rays and Solar Energetic Particles. The dose and dose-rates are captured on aircraft, downlinked in real-time via the Iridium satellites, processed on the ground, incorporated into the most recent NAIRAS global radiation climatology data runs, and made available to end users via the web and

  2. Prostate-specific antigen bounce after high-dose rate brachytherapy with external beam radiation therapy for prostate cancer patients

    International Nuclear Information System (INIS)

    Sakamoto, Naotaka; Kakinoki, Hiroaki; Tsutsui, Akio; Yoshikawa, Masahiro; Iguchi, Atsushi; Matsunobu, Toru; Uehara, Satoru

    2008-01-01

    Prostate-specific antigen (PSA) bounce after high-dose rate (HDR) brachytherapy with external beam radiation therapy (EBRT) for prostate cancer patients was evaluated. Sixty-one patients treated with HDR-brachytherapy followed by EBRT had a minimum follow-up of 12 months (median, 24 months) in our institute. A PSA bounce was defined as a rise of at least 0.1 ng/ml greater than a previous PSA level, with a subsequent decline equal to, or less than, the initial nadir. A PSA bounce was noted in 16 (26.2%) of 61 patients (one patient had a PSA bounce twice). Median time to develop a PSA bounce was 18 months, but 23.5% developed a PSA bounce after 24 months. Median duration of PSA bounce was 6 months and 11.8% had increased PSA within a period of 12 months. Median bounce height was 0.2 ng/ml (range, 0.1 to 3.39 ng/ml). A bounce height of gerater than 2 ng/ml was seen in 11.8%. Clinical characteristics (age, prostate volume, neoadjuvant endocrine therapy, risk classification, stage, pretreatment PSA, Gleason score) do not predict whether or not there will be a PSA bounce. In patients treated with HDR-brachytherapy followed by EBRT, the incidence and characteristics of PSA bounce were similar to those in patients treated with low-dose rate brachytherapy. Physicians should be aware of the possibility of PSA bounce following HDR-brachytherapy with EBRT. (author)

  3. Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Mehta, Niraj H.; Kamrava, Mitchell; Wang, Pin-Chieh; Steinberg, Michael; Demanes, Jeffrey

    2013-01-01

    Purpose: To characterize the magnitude and kinetics of prostate-specific antigen (PSA) bounces after high-dose-rate (HDR) monotherapy and determine relationships between certain clinical factors and PSA bounce. Methods and Materials: Longitudinal PSA data and various clinical parameters were examined in 157 consecutive patients treated with HDR monotherapy between 1996 and 2005. We used the following definition for PSA bounce: rise in PSA ≥threshold, after which it returns to the prior level or lower. Prostate-specific antigen failure was defined per the Phoenix definition (nadir +2 ng/mL). Results: A PSA bounce was noted in 67 patients (43%). The number of bounces per patient was 1 in 45 cases (67%), 2 in 19 (28%), 3 in 2 (3%), 4 in 0, and 5 in 1 (1%). The median time to maximum PSA bounce was 1.3 years, its median magnitude was 0.7, and its median duration was 0.75 years. Three patients (2%) were noted to have PSA failure. None of the 3 patients who experienced biochemical failure exhibited PSA bounce. In the fully adjusted model for predicting each bounce, patients aged <55 years had a statistically significant higher likelihood of experiencing a bounce (odds ratio 2.22, 95% confidence interval 1.38-3.57, P=.001). There was also a statistically significant higher probability of experiencing a bounce for every unit decrease in Gleason score (odds ratio 1.52, 95% confidence interval 1.01-2.04, P=.045). Conclusions: A PSA bounce occurs in a significant percentage of patients treated with HDR monotherapy, with magnitudes varying from <1 in 28% of cases to ≥1 in 15%. The median duration of bounce is <1 year. More bounces were identified in patients with lower Gleason score and age <55 years. Further investigation using a model to correlate magnitude and frequency of bounces with clinical variables are under way

  4. Concomitant Imaging Dose and Cancer Risk in Image Guided Thoracic Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yibao; Wu, Hao [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Chen, Zhe [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Knisely, Jonathan P.S. [Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York (United States); Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Feng, Zhongsu [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Bao, Shanglian [Beijing Key Laboratory of Medical Physics and Engineering, Peking University, Beijing (China); Deng, Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States)

    2015-11-01

    Purpose: Kilovoltage cone beam computed tomography (CT) (kVCBCT) imaging guidance improves the accuracy of radiation therapy but imposes an extra radiation dose to cancer patients. This study aimed to investigate concomitant imaging dose and associated cancer risk in image guided thoracic radiation therapy. Methods and Materials: The planning CT images and structure sets of 72 patients were converted to CT phantoms whose chest circumferences (C{sub chest}) were calculated retrospectively. A low-dose thorax protocol on a Varian kVCBCT scanner was simulated by a validated Monte Carlo code. Computed doses to organs and cardiac substructures (for 5 selected patients of various dimensions) were regressed as empirical functions of C{sub chest}, and associated cancer risk was calculated using the published models. The exposures to nonthoracic organs in children were also investigated. Results: The structural mean doses decreased monotonically with increasing C{sub chest}. For all 72 patients, the median doses to the heart, spinal cord, breasts, lungs, and involved chest were 1.68, 1.33, 1.64, 1.62, and 1.58 cGy/scan, respectively. Nonthoracic organs in children received 0.6 to 2.8 cGy/scan if they were directly irradiated. The mean doses to the descending aorta (1.43 ± 0.68 cGy), left atrium (1.55 ± 0.75 cGy), left ventricle (1.68 ± 0.81 cGy), and right ventricle (1.85 ± 0.84 cGy) were significantly different (P<.05) from the heart mean dose (1.73 ± 0.82 cGy). The blade shielding alleviated the exposure to nonthoracic organs in children by an order of magnitude. Conclusions: As functions of patient size, a series of models for personalized estimation of kVCBCT doses to thoracic organs and cardiac substructures have been proposed. Pediatric patients received much higher doses than did the adults, and some nonthoracic organs could be irradiated unexpectedly by the default scanning protocol. Increased cancer risks and disease adverse events in the

  5. Task-based measures of image quality and their relation to radiation dose and patient risk

    International Nuclear Information System (INIS)

    Barrett, Harrison H; Kupinski, Matthew A; Myers, Kyle J; Hoeschen, Christoph; Little, Mark P

    2015-01-01

    The theory of task-based assessment of image quality is reviewed in the context of imaging with ionizing radiation, and objective figures of merit (FOMs) for image quality are summarized. The variation of the FOMs with the task, the observer and especially with the mean number of photons recorded in the image is discussed. Then various standard methods for specifying radiation dose are reviewed and related to the mean number of photons in the image and hence to image quality. Current knowledge of the relation between local radiation dose and the risk of various adverse effects is summarized, and some graphical depictions of the tradeoffs between image quality and risk are introduced. Then various dose-reduction strategies are discussed in terms of their effect on task-based measures of image quality. (topical review)

  6. Patient-specific IMRT verification using independent fluence-based dose calculation software: experimental benchmarking and initial clinical experience

    International Nuclear Information System (INIS)

    Georg, Dietmar; Stock, Markus; Kroupa, Bernhard; Olofsson, Joergen; Nyholm, Tufve; Ahnesjoe, Anders; Karlsson, Mikael

    2007-01-01

    Experimental methods are commonly used for patient-specific intensity-modulated radiotherapy (IMRT) verification. The purpose of this study was to investigate the accuracy and performance of independent dose calculation software (denoted as 'MUV' (monitor unit verification)) for patient-specific quality assurance (QA). 52 patients receiving step-and-shoot IMRT were considered. IMRT plans were recalculated by the treatment planning systems (TPS) in a dedicated QA phantom, in which an experimental 1D and 2D verification (0.3 cm 3 ionization chamber; films) was performed. Additionally, an independent dose calculation was performed. The fluence-based algorithm of MUV accounts for collimator transmission, rounded leaf ends, tongue-and-groove effect, backscatter to the monitor chamber and scatter from the flattening filter. The dose calculation utilizes a pencil beam model based on a beam quality index. DICOM RT files from patient plans, exported from the TPS, were directly used as patient-specific input data in MUV. For composite IMRT plans, average deviations in the high dose region between ionization chamber measurements and point dose calculations performed with the TPS and MUV were 1.6 ± 1.2% and 0.5 ± 1.1% (1 S.D.). The dose deviations between MUV and TPS slightly depended on the distance from the isocentre position. For individual intensity-modulated beams (total 367), an average deviation of 1.1 ± 2.9% was determined between calculations performed with the TPS and with MUV, with maximum deviations up to 14%. However, absolute dose deviations were mostly less than 3 cGy. Based on the current results, we aim to apply a confidence limit of 3% (with respect to the prescribed dose) or 6 cGy for routine IMRT verification. For off-axis points at distances larger than 5 cm and for low dose regions, we consider 5% dose deviation or 10 cGy acceptable. The time needed for an independent calculation compares very favourably with the net time for an experimental approach

  7. Specification of carbon ion dose at the National Institute of Radiological Sciences (NIRS)

    International Nuclear Information System (INIS)

    Matsufuji, Naruhiro; Nakai, Tatsuaki; Kanematsu, Nobuyuki

    2007-01-01

    The clinical dose distributions of therapeutic carbon beams, currently used at National Institute of Radiological Sciences (NIRS) Heavy Ion Medical Accelerator in Chiba (HIMAC), are based on in-vitro Human Salivary Gland (HSG) cell survival response and clinical experience from fast neutron radiotherapy. Moderate radiosensitivity of HSG cells is expected to be a typical response of tumours to carbon beams. At first, the biological dose distribution is designed so as to cause a flat biological effect on HSG cells in the spread-out Bragg peak (SOBP) region. Then, the entire biological dose distribution is evenly raised in order to attain a RBE (relative biological effectiveness)=3.0 at a depth where dose-averaged LET (linear energy transfer) is 80 keV/μm. At that point, biological experiments have shown that carbon ions can be expected to have a biological effect identical to fast neutrons, which showed a clinical RBE of 3.0 for fast neutron radiotherapy at NIRS. The resulting clinical dose distribution in this approximation is not dependent on dose level, tumour type or fractionation scheme and thus reduces the unknown parameters in the analysis of the clinical results. The width SOBP and the clinical/physical dose at the center of SOBP specify the dose distribution. The clinical results analyzed in terms of tumor control probability (TCP) were found to show good agreement with the expected RBE value at higher TCP levels. The TCP analysis method was applied for the prospective dose estimation of hypofractionation. (author)

  8. Low-dose aspirin and risk of intracranial bleeds: An observational study in UK general practice.

    Science.gov (United States)

    Cea Soriano, Lucía; Gaist, David; Soriano-Gabarró, Montse; Bromley, Susan; García Rodríguez, Luis A

    2017-11-28

    To quantify the risk of intracranial bleeds (ICBs) associated with new use of prophylactic low-dose aspirin using a population-based primary care database in the United Kingdom. A cohort of new users of low-dose aspirin (75-300 mg; n = 199,079) aged 40-84 years and a 1:1 matched cohort of nonusers of low-dose aspirin at baseline were followed (maximum 14 years, median 5.4 years) to identify incident cases of ICB, with validation by manual review of patient records or linkage to hospitalization data. Using 10,000 frequency-matched controls, adjusted rate ratios (RRs) with 95% confidence intervals (CIs) were calculated for current low-dose aspirin use (0-7 days before the index date [ICB date for cases, random date for controls]); reference group was never used. There were 1,611 cases of ICB (n = 743 for intracerebral hemorrhage [ICH], n = 483 for subdural hematoma [SDH], and n = 385 for subarachnoid hemorrhage [SAH]). RRs (95% CI) were 0.98 (0.84-1.13) for all ICB, 0.98 (0.80-1.20) for ICH, 1.23 (0.95-1.59) for SDH, and 0.77 (0.58-1.01) for SAH. No duration of use or dose-response association was apparent. RRs (95% CI) for ≥1 year of low-dose aspirin use were 0.90 (0.72-1.13) for ICH, 1.20 (0.91-1.57) for SDH, and 0.69 (0.50-0.94) for SAH. Low-dose aspirin is not associated with an increased risk of any type of ICB and is associated with a significantly decreased risk of SAH when used for ≥1 year. © 2017 American Academy of Neurology.

  9. Radiation dose and cancer risk from pediatric CT examinations on 64-slice CT: A phantom study

    International Nuclear Information System (INIS)

    Feng Shiting; Law, Martin Wai-Ming; Huang Bingsheng; Ng, Sherry; Li Ziping; Meng Quanfei; Khong, Pek-Lan

    2010-01-01

    Objective: To measure the radiation dose from CT scans in an anthropomorphic phantom using a 64-slice MDCT, and to estimate the associated cancer risk. Materials and methods: Organ doses were measured with a 5-year-old phantom and thermoluminescent dosimeters. Four protocols; head CT, thorax CT, abdomen CT and pelvis CT were studied. Cancer risks, in the form of lifetime attributable risk (LAR) of cancer incidence, were estimated by linear extrapolation using the organ radiation doses and the LAR data. Results: The effective doses for head, thorax, abdomen and pelvis CT, were 0.7 mSv, 3.5 mSv, 3.0 mSv, 1.3 mSv respectively. The organs with the highest dose were; for head CT, salivary gland (22.33 mGy); for thorax CT, breast (7.89 mGy); for abdomen CT, colon (6.62 mGy); for pelvis CT, bladder (4.28 mGy). The corresponding LARs for boys and girls were 0.015-0.053% and 0.034-0.155% respectively. The organs with highest LARs were; for head CT, thyroid gland (0.003% for boys, 0.015% for girls); for thorax CT, lung for boys (0.014%) and breast for girls (0.069%); for abdomen CT, colon for boys (0.017%) and lung for girls (0.016%); for pelvis CT, bladder for both boys and girls (0.008%). Conclusion: The effective doses from these common pediatric CT examinations ranged from 0.7 mSv to 3.5 mSv and the associated lifetime cancer risks were found to be up to 0.16%, with some organs of higher radiosensitivity including breast, thyroid gland, colon and lungs.

  10. Risk Factors and Dose-Effect Relationship for Mandibular Osteoradionecrosis in Oral and Oropharyngeal Cancer Patients

    International Nuclear Information System (INIS)

    Lee, Ik Jae; Koom, Woong Sub; Lee, Chang Geol; Kim, Yong Bae; Yoo, Sei Whan; Keum, Ki Chang; Kim, Gwi Eon; Choi, Eun Chang; Cha, In Ho

    2009-01-01

    Purpose: To analyze risk factors and the dose-effect relationship for osteoradionecrosis (ORN) of the mandible after radiotherapy of oral and oropharyngeal cancers. Materials and Methods: One-hundred ninety-eight patients with oral (45%) and oropharyngeal cancer (55%) who had received external radiotherapy between 1990 and 2000 were retrospectively reviewed. All patients had a dental evaluation before radiotherapy. The median radiation dose was 60 Gy (range, 16-75 Gy), and the median biologically effective dose for late effects (BED late ) in bone was 114 Gy 2 (range, 30-167 Gy 2 ). Results: The frequency of ORN was 13 patients (6.6%). Among patients with mandibular surgery, eight had ORN at the surgical site. Among patients without mandibular surgery, five patients had ORN on the molar area of the mandible. The median time to ORN was 22 months (range, 1-69 months). Univariate analysis revealed that mandibular surgery and Co-60 were significant risk factors for ORN (p = 0.01 and 0.04, respectively). In multivariate analysis, mandibular surgery was the most important factor (p = 0.001). High radiation doses over BED 102.6 Gy 2 (conventional dose of 54 Gy at 1.8 Gy/fraction) were also a significant factor for ORN (p = 0.008) and showed a positive dose-effect relationship in logistic regression (p = 0.04) for patients who had undergone mandibular surgery. Conclusions: Mandibular surgery was the most significant risk factor for ORN of mandible in oral and oropharyngeal cancers patients. A BED of 102.6 Gy 2 or higher to the mandible also significantly increases the risk of ORN.

  11. Psychosocial Risks Generated By Assets Specific Design Software

    Science.gov (United States)

    Remus, Furtună; Angela, Domnariu; Petru, Lazăr

    2015-07-01

    The human activity concerning an occupation is resultant from the interaction between the psycho-biological, socio-cultural and organizational-occupational factors. Tehnological development, automation and computerization that are to be found in all the branches of activity, the level of speed in which things develop, as well as reaching their complexity, require less and less physical aptitudes and more cognitive qualifications. The person included in the work process is bound in most of the cases to come in line with the organizational-occupational situations that are specific to the demands of the job. The role of the programmer is essencial in the process of execution of ordered softwares, thus the truly brilliant ideas can only come from well-rested minds, concentrated on their tasks. The actual requirements of the jobs, besides the high number of benefits and opportunities, also create a series of psycho-social risks, which can increase the level of stress during work activity, especially for those who work under pressure.

  12. Age-specific radiation dose commitment factors for a one-year chronic intake

    International Nuclear Information System (INIS)

    Hoenes, G.R.; Soldat, J.K.

    1977-11-01

    During the licensing process for nuclear facilities, radiation doses and dose commitments must be calculated for people in the environs of a nuclear facility. These radiation doses are determined by examining characteristics of population groups, pathways to people, and radionuclides found in those pathways. The pertinent characteristics, which are important in the sense of contributing a significant portion of the total dose, must then be analyzed in depth. Dose factors are generally available for adults, see Reference 1 for example, however numerous improvements in data on decay schemes and half-lives have been made in recent years. In addition, it is advisable to define parameters for calculation of the radiation dose for ages other than adults since the population surrounding nuclear facilities will be composed of various age groups. Further, since infants, children, and teens may have higher rates of intake per unit body mass, it is conceivable that the maximally exposed individual may not be an adult. Thus, it was necessary to develop new radiation-dose commitment factors for various age groups. Dose commitment factors presented in this report have been calculated for a 50-year time period for four age groups

  13. Minimizing Patient-Specific Tracer Dose in Myocardial Perfusion Imaging Using CZT SPECT

    NARCIS (Netherlands)

    van Dijk, Joris David; Jager, Pieter L.; Ottervanger, Jan Paul; Slump, Cornelis H.; de Boer, Jaep; Oostdijk, Adrianus H.J.; van Dalen, Jorn A.

    Myocardial perfusion imaging (MPI) with SPECT is widely adopted in clinical practice but is associated with a relatively high radiation dose. The aim of this study was to determine the minimum product of tracer dose and scan time that will maintain diagnostic value for cadmium zinc telluride (CZT)

  14. Software requirements specification for the program analysis and control system risk management module

    International Nuclear Information System (INIS)

    SCHAEFER, J.C.

    1999-01-01

    TWR Program Analysis and Control System Risk Module is used to facilitate specific data processes surrounding the Risk Management program of the Tank Waste Retrieval environment. This document contains the Risk Management system requirements of the database system

  15. Youth's perceptions of HIV infection risk: a sex-specific test of two ...

    African Journals Online (AJOL)

    Youth's perceptions of HIV infection risk: a sex-specific test of two risk models. ... The analysis is based on data from the 2003 Demographic and Health survey ... multiple partners, Nigeria, risk perception, sexual behaviour, vulnerability to HIV ...

  16. Can we avoid dose escalation for intermediate-risk prostate cancer in the setting of short-course neoadjuvant androgen deprivation?

    Science.gov (United States)

    Shakespeare, Thomas P; Wilcox, Shea W; Aherne, Noel J

    2016-01-01

    Both dose-escalated external beam radiotherapy (DE-EBRT) and androgen deprivation therapy (ADT) improve the outcomes in patients with intermediate-risk prostate cancer. Despite this, there are only few reports evaluating DE-EBRT for patients with intermediate-risk prostate cancer receiving neoadjuvant ADT, and virtually no studies investigating dose escalation >74 Gy in this setting. We aimed to determine whether DE-EBRT >74 Gy improved the outcomes for patients with intermediate-risk prostate cancer who received neoadjuvant ADT. In our institution, patients with intermediate-risk prostate cancer were treated with neoadjuvant ADT and DE-EBRT, with doses sequentially increasing from 74 Gy to 76 Gy and then to 78 Gy between 2006 and 2012. We identified 435 patients treated with DE-EBRT and ADT, with a median follow-up of 70 months. For the 74 Gy, 76 Gy, and 78 Gy groups, five-year biochemical disease-free survival rates were 95.0%, 97.8%, and 95.3%, respectively; metastasis-free survival rates were 99.1%, 100.0%, and 98.6%, respectively; and prostate cancer-specific survival rate was 100% for all three dose levels. There was no significant benefit for dose escalation either on univariate or multivariate analysis for any outcome. There was no benefit for DE-EBRT >74 Gy in our cohort of intermediate-risk prostate cancer patients treated with neoadjuvant ADT. Given the higher risks of toxicity associated with dose escalation, it may be feasible to omit dose escalation in this group of patients. Randomized studies evaluating dose de-escalation should be considered.

  17. Experimental study on active specific immunotherapy utilizing the immune reaction of low-dose irradiated tumor tissue, 7

    International Nuclear Information System (INIS)

    Ogawa, Yasuhiro; Maeda, Tomoho; Yoshida, Shoji; Yamamoto, Yoichi; Morita, Masaru

    1983-01-01

    We have already reported the remarkable effect of the active specific immunotherapy utilizing cryopreserved tumor cells and infiltrating mononuclear cells prepared from a lowdose irradiated tumor tissue after cytoreductive radiotherapy. In the present study, the effect of a biological response modifier, PSK combined with this active specific immunotherapy was investigated. Twelve-week-aged female C3H/He mice transplanted with MM46 tumor cells were received local radiotherapy with the dose of 3,000 rads by high energy electron beam on the fifth day after tumor inoculation. This active specific immunotherapy was performed on the twelveth day, and daily dose of 200 mg/kg of PSK was injected intraperitoneally from the sixth day to the tenth day. The more inhibition of the tumor growth was observed in the group which received this active specific immunotherapy combined with a biological response modifier, PSK compared with that received this active specific immunotherapy alone. (author)

  18. Study of dose and relative risk of occupationally exposed individuals in interventional procedures

    International Nuclear Information System (INIS)

    Silveira Filho, Jose A.M.; Reis, Charlene O.; Taniguti, Lana T.; Pacifico, Leonardo C.; SaintYves, Thalis L.A.; Mecca, Fernando A.

    2012-01-01

    This paper estimates the occupational effective dose and the relative risk of leukemia and cancers of the digestive tract mortality through dose study of the most radiosensitive anatomical regions (lens, thyroid, chest and gonads) of the professionals involved in interventional gonad procedures. It was considered a cumulative exposure time of 10,000 hours, which is the occupational exposure time of an IOE in throughout his professional life. It was also considered that they always use Personal Protective Equipment (PPE). Mathematical models derived from epidemiological data contained in the BEIR V and in the IAEA’s TECDOC 870 are used to estimate the relative risk. The results show a significant increase in mortality risk for these types of cancer for individuals occupationally exposed to three different distances from the x-ray beam, and reinforces that radiation protection measures are essential. (author)

  19. Minimising the risk: reducing breast tissue dose in an adolescent female

    International Nuclear Information System (INIS)

    Thompson, Ann; Toe, Aimee; Ungureanu, Elena; Wolf, M.; Wirth, Andrew

    2005-01-01

    Breast cancer is amongst the leading radiation-associated, second malignancies that develop in patients after treatment for Hodgkin's disease. This risk is affected by two main factors: 1. The age of the patient at the time of radiotherapy; and 2. The dose received by the breast tissue The adolescent female thus faces an exceptionally high risk, as breast tissue at this age is undergoing rapid developmental growth and small doses of radiation exposure could be carcinogenic. This case report of a fifteen-year-old girl who received radiotherapy for Hodgkin's disease demonstrates how radiation therapists worked together with the radiation oncologists and medical physicists to provide an optimal treatment plan for a high-risk patient. Copyright (2005) Australian Institute of Radiography

  20. Effect of Radiotherapy Volume and Dose on Secondary Cancer Risk in Stage I Testicular Seminoma

    International Nuclear Information System (INIS)

    Zwahlen, Daniel R.; Martin, Jarad M.; Millar, Jeremy L.; Schneider, Uwe

    2008-01-01

    Purpose: To estimate and compare the secondary cancer risk (SCR) due to para-aortic (PA), dogleg field (DLF), or extensive field (EF) radiotherapy (RT) at different dose levels for Stage I testicular seminoma. Methods and Materials: The organ equivalent dose concept with a linear, plateau, and linear-exponential dose-response model was applied to the dose distributions to estimate the SCR. The dose distributions were calculated in a voxel-based anthropomorphic phantom. Three different three-dimensional plans were computed: PA, DLF, and EF. The plans were calculated with 6-MV photons and two opposed fields, using 20 Gy in 10 fractions. Results: The estimated cumulative SCR for a 75-year-old patient treated with PA-RT at age 35 was 23.3% (linear model), 20.9% (plateau model), and 20.8% (linear-exponential model) compared with 19.8% for the general population. Dependent on the model, PA-RT compared with DLF-RT reduced the SCR by 48-63% or 64-69% when normalized to EF-RT. For PA-RT, the linear dose-response model predicted a decrease of 45% in the SCR, using 20 Gy instead of 30 Gy; the linear-exponential dose-response model predicted no change in SCR. Conclusion: Our model suggested that the SCR after PA-RT for Stage I testicular seminoma is reduced by approximately one-half to two-thirds compared with DLF-RT, independent of the dose-response model. The SCR is expected to be equal or lower with 20 Gy than with 30 Gy. In the absence of mature patient data, the organ equivalent dose concept offers the best potential method of estimating the SCR when discussing treatment options with patients

  1. Long term results of a prospective dose escalation phase-II trial: Interstitial pulsed-dose-rate brachytherapy as boost for intermediate- and high-risk prostate cancer

    International Nuclear Information System (INIS)

    Lettmaier, Sebastian; Lotter, Michael; Kreppner, Stephan; Strnad, Annedore; Fietkau, Rainer; Strnad, Vratislav

    2012-01-01

    Purpose: We reviewed our seven year single institution experience with pulsed dose rate brachytherapy dose escalation study in patients with intermediate and high risk prostate cancer. Materials and methods: We treated a total of 130 patients for intermediate and high risk prostate cancer at our institution between 2000 and 2007 using PDR-brachytherapy as a boost after conformal external beam radiation therapy to 50.4 Gy. The majority of patients had T2 disease (T1c 6%, T2 75%, T3 19%). Seventy three patients had intermediate-risk and 53 patients had high-risk disease according to the D’Amico classification. The dose of the brachytherapy boost was escalated from 25 to 35 Gy – 33 pts. received 25 Gy (total dose 75 Gy), 63 pts. 30 Gy (total dose 80 Gy) and 34 pts. 35 Gy, (total dose 85 Gy) given in one session (dose per pulse was 0.60 Gy or 0.70 Gy/h, 24 h per day, night and day, with a time interval of 1 h between two pulses). PSA-recurrence-free survival according to Kaplan–Meier using the Phoenix definition of biochemical failure was calculated and also late toxicities according to Common Toxicity Criteria scale were assessed. Results: At the time of analysis with a median follow-up of 60 months biochemical control was achieved by 88% of patients – only 16/130 patients (12.3%) developed a biochemical relapse. Biochemical relapse free survival calculated according to Kaplan–Meier for all patients at 5 years was 85.6% (83.9% for intermediate-risk patients and 84.2% for high-risk patients) and at 9 years’ follow up it was 79.0%. Analysing biochemical relapse free survival separately for different boost dose levels, at 5 years it was 97% for the 35 Gy boost dose and 82% for the 25 and 30 Gy dose levels. The side effects of therapy were negligible: There were 18 cases (15%) of grade 1/2 rectal proctitis, one case (0.8%) of grade 3 proctitis, 18 cases (15%) of grade 1/2 cystitis, and no cases (0%) with dysuria grade 3. No patient had a bulbourethral

  2. Radioactivity Risk Assessment of Radon and Gamma Dose at One Uranium Tailings Pond in China

    Science.gov (United States)

    Lou, Yalong; Liu, Yong; Peng, Guowen; Zhao, Guodong; Zhang, Yan; Yang, Zhu

    2018-01-01

    A year-long monitoring of gamma radiation effective dose rate and radon concentration had been done in the reservoir area of one uranium tailings pond in Hunan province (The monitoring area included indoor and outdoor area of residential buildings and workshops, tailings dam slope). Afterwards, the annual effective radiation dose of the people in that radiation environment had been calculated based on the results of monitoring, as well as a radiation risk assessment. According to the assessment, gamma radiation effective dose rate and radon concentration in the monitoring area were low, and the annual effective radiation dose was far below the international standard (30mSv), which showed that the radiation would not put the people’s health at risk. However, the annual effective radiation dose of gamma was far above that of radon in the area of uranium tailings pond; therefore, it’s advisable to take quarantine measures in in the area of uranium tailings pond to keep the surrounding residents away from unnecessary ionizing radiation.

  3. Concord Grape Juice Polyphenols and Cardiovascular Risk Factors: Dose-Response Relationships

    Science.gov (United States)

    Blumberg, Jeffrey B.; Vita, Joseph A.; Chen, C. -Y. Oliver

    2015-01-01

    Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice flavonoids to these outcomes. Utilizing the results of clinical trials testing single doses, we have analyzed data from studies of 100% Concord grape juice by placing its flavonoid content in the context of results from randomized clinical trials of other polyphenol-rich foods and beverages describing the same outcomes but covering a broader range of intake. We selected established biomarkers determined by similar methods for measuring flow-mediated vasodilation (FMD), blood pressure, platelet aggregation, and the resistance of low density lipoprotein cholesterol (LDL) to oxidation. Despite differences among the clinical trials in the treatment, subjects, and duration, correlations were observed between the dose and FMD. Inverse dose-response relationships, albeit with lower correlation coefficients, were also noted for the other outcomes. These results suggest a clear relationship between consumption of even modest serving sizes of Concord grape juice, flavonoid intake, and effects on risk factors for cardiovascular disease. This approach to dose-response relationships may prove useful for testing other individual foods and beverages. PMID:26633488

  4. On the use of biomathematical models in patient-specific IMRT dose QA

    Energy Technology Data Exchange (ETDEWEB)

    Zhen Heming [UT Southwestern Medical Center, Dallas, Texas 75390 (United States); Nelms, Benjamin E. [Canis Lupus LLC, Merrimac, Wisconsin 53561 (United States); Tome, Wolfgang A. [Department of Radiation Oncology, Division of Medical Physics, Montefiore Medical Center and Institute of Onco-Physics, Albert Einstein College of Medicine, Bronx, New York 10461 (United States)

    2013-07-15

    Purpose: To investigate the use of biomathematical models such as tumor control probability (TCP) and normal tissue complication probability (NTCP) as new quality assurance (QA) metrics.Methods: Five different types of error (MLC transmission, MLC penumbra, MLC tongue and groove, machine output, and MLC position) were intentionally induced to 40 clinical intensity modulated radiation therapy (IMRT) patient plans (20 H and N cases and 20 prostate cases) to simulate both treatment planning system errors and machine delivery errors in the IMRT QA process. The changes in TCP and NTCP for eight different anatomic structures (H and N: CTV, GTV, both parotids, spinal cord, larynx; prostate: CTV, rectal wall) were calculated as the new QA metrics to quantify the clinical impact on patients. The correlation between the change in TCP/NTCP and the change in selected DVH values was also evaluated. The relation between TCP/NTCP change and the characteristics of the TCP/NTCP curves is discussed.Results:{Delta}TCP and {Delta}NTCP were summarized for each type of induced error and each structure. The changes/degradations in TCP and NTCP caused by the errors vary widely depending on dose patterns unique to each plan, and are good indicators of each plan's 'robustness' to that type of error.Conclusions: In this in silico QA study the authors have demonstrated the possibility of using biomathematical models not only as patient-specific QA metrics but also as objective indicators that quantify, pretreatment, a plan's robustness with respect to possible error types.

  5. On the use of biomathematical models in patient-specific IMRT dose QA

    International Nuclear Information System (INIS)

    Zhen Heming; Nelms, Benjamin E.; Tomé, Wolfgang A.

    2013-01-01

    Purpose: To investigate the use of biomathematical models such as tumor control probability (TCP) and normal tissue complication probability (NTCP) as new quality assurance (QA) metrics.Methods: Five different types of error (MLC transmission, MLC penumbra, MLC tongue and groove, machine output, and MLC position) were intentionally induced to 40 clinical intensity modulated radiation therapy (IMRT) patient plans (20 H and N cases and 20 prostate cases) to simulate both treatment planning system errors and machine delivery errors in the IMRT QA process. The changes in TCP and NTCP for eight different anatomic structures (H and N: CTV, GTV, both parotids, spinal cord, larynx; prostate: CTV, rectal wall) were calculated as the new QA metrics to quantify the clinical impact on patients. The correlation between the change in TCP/NTCP and the change in selected DVH values was also evaluated. The relation between TCP/NTCP change and the characteristics of the TCP/NTCP curves is discussed.Results:ΔTCP and ΔNTCP were summarized for each type of induced error and each structure. The changes/degradations in TCP and NTCP caused by the errors vary widely depending on dose patterns unique to each plan, and are good indicators of each plan's “robustness” to that type of error.Conclusions: In this in silico QA study the authors have demonstrated the possibility of using biomathematical models not only as patient-specific QA metrics but also as objective indicators that quantify, pretreatment, a plan's robustness with respect to possible error types

  6. Estimation of effective dose and lifetime attributable risk from multiple head CT scans in ventriculoperitoneal shunted children

    International Nuclear Information System (INIS)

    Aw-Zoretic, J.; Seth, D.; Katzman, G.; Sammet, S.

    2014-01-01

    Purpose: The purpose of this review is to determine the averaged effective dose and lifetime attributable risk factor from multiple head computed tomography (CT) dose data on children with ventriculoperitoneal shunts (VPS). Method and materials: A total of 422 paediatric head CT exams were found between October 2008 and January 2011 and retrospectively reviewed. The CT dose data was weighted with the latest IRCP 103 conversion factor to obtain the effective dose per study and the averaged effective dose was calculated. Estimates of the lifetime attributable risk were also calculated from the averaged effective dose using a conversion factor from the latest BEIR VII report. Results: Our study found the highest effective doses in neonates and the lowest effective doses were observed in the 10–18 years age group. We estimated a 0.007% potential increase risk in neonates and 0.001% potential increased risk in teenagers over the base risk. Conclusion: Multiple head CTs in children equates to a slight potential increase risk in lifetime attributable risk over the baseline risk for cancer, slightly higher in neonates relative to teenagers. The potential risks versus clinical benefit must be assessed

  7. Dose-to-dose variations with single packages of counterfeit medicines and adulterated dietary supplements as a potential source of false negatives and inaccurate health risk assessments.

    Science.gov (United States)

    Venhuis, B J; Zwaagstra, M E; Keizers, P H J; de Kaste, D

    2014-02-01

    In this report, we show three examples of how the variability in dose units in single packages of counterfeit medicines and adulterated dietary supplements may contribute to a false negative screening result and inaccurate health risk assessments. We describe a counterfeit Viagra 100mg blister pack and a box of an instant coffee both containing dose units with and without an active pharmaceutical ingredient (API). We also describe a purportedly herbal slimming product with capsules that mutually differed in API and impurities. The adulterated dietary supplements contained sibutramine, benzyl-sibutramine, N-desmethyl-sibutramine (DMS), N,N-didesmethyl-sibutramine (DDMS) and several other related impurities. Counterfeit medicines and adulterated dietary supplements are a health risk because their quality is unreliable. Health risks are even greater when such unreliability extends to fundamental differences between dose units in one package. Because dose-to-dose variability for these products is unpredictable, the confidence interval of a sample size is unknown. Consequently, the analyses of a selection of dose units may not be representative for the package. In the worst case, counterfeit or unauthorised medicines are not recognised as such or a health risk is not identified. In order to reduce erroneous results particular care should be taken when analysing a composite of dose units, when finding no API in a dietary supplement and when finding conformity in a suspect counterfeit medicine. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. A long-term risk-benefit analysis of low-dose aspirin in primary prevention.

    Science.gov (United States)

    Wu, I-Chen; Hsieh, Hui-Min; Yu, Fang-Jung; Wu, Meng-Chieh; Wu, Tzung-Shiun; Wu, Ming-Tsang

    2016-02-01

    The long-term risk-benefit effect of occasional and regular use of low-dose aspirin (≤ 100 mg per day) in primary prevention of vascular diseases and cancers was calculated. One representative database of 1 000 000 participants from Taiwan's National Health Insurance scheme in 1997-2000 was used. The potential study subjects were those aged 30-95 years, were found not to have been prescribed aspirin before 1 January 2000, but to have first been prescribed low-dose aspirin (≤ 100 mg per day) after that date and were followed up to 31 December 2009. Participants prescribed low-dose aspirin risk. A total of 1720 pairs were analysed. During the study period, haemorrhage and ischaemia occurred in 25 (1·45%) and 67 participants (3·90%) in occasional users and 69 (4·01%) and 100 participants (5·81%) in regular users, whereas cancer occurred in 32 participants (1·86%) in occasional users and 26 participants (1·51%) in regular users. The crude and adjusted net clinical risks of low-dose aspirin use between the two frequency of users (≥ 80% vs. prevention against major vascular diseases and cancer. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  9. Analysis of dose and risk associated with the use of backscatter vans

    International Nuclear Information System (INIS)

    Correa, Samanda C.A.; Aquino, Josilto O.; Silva, Ademir X.

    2011-01-01

    In recent years, imaging technology using radiation has been gaining in importance for the screening of persons for security reasons and in order to detect contraband. And currently, new X-ray detection technologies have been introduced such as the Backscatter Van. The Backscatter Van is used in port and border security, force protection, urban surveillance, and other critical security applications in order to seize drugs, explosives, and more. The system is mobile, affordable and the faster, more effective, and less expensive than any mobile screening solution in the marketplace. However, although the application of this equipment in the national security area is indeed relevant, its use has caused a great deal of controversy, especially with regard to the doses absorbed and to the cancer induction risk associated with these exposures. The aim of this study is to use the Monte Carlo MCNPX code and the male adult voxel (MAX) and female adult voxel (FAX) phantoms, to evaluate the absorbed dose, effective dose and cancer induction risk values associated with the exposures of individuals submitted to Backscatter Van. The effective dose values were calculated as recommended by the new ICRP 103 and the cancer induction risk values were estimated through the BEIR VII document. (author)

  10. Analysis of dose and risk associated with the use of backscatter vans

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Samanda C.A.; Aquino, Josilto O., E-mail: scorrea@cnen.gov.b, E-mail: josilto@cnen.gov.b [Comissao Nacional de Energia Nuclear (DIAPI/CGMI/CNEN), Rio de Janeiro, RJ (Brazil). Coordenacao Geral de Instalacoes Medicas e Industriais. Div. de Aplicacoes Industriais; Souza, Edmilson M., E-mail: emonteiro@nuclear.ufrj.b [Centro Universitario Estadual da Zona Oeste (CAPI/UEZO), Rio de Janeiro, RJ (Brazil); Silva, Ademir X., E-mail: ademir@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear

    2011-07-01

    In recent years, imaging technology using radiation has been gaining in importance for the screening of persons for security reasons and in order to detect contraband. And currently, new X-ray detection technologies have been introduced such as the Backscatter Van. The Backscatter Van is used in port and border security, force protection, urban surveillance, and other critical security applications in order to seize drugs, explosives, and more. The system is mobile, affordable and the faster, more effective, and less expensive than any mobile screening solution in the marketplace. However, although the application of this equipment in the national security area is indeed relevant, its use has caused a great deal of controversy, especially with regard to the doses absorbed and to the cancer induction risk associated with these exposures. The aim of this study is to use the Monte Carlo MCNPX code and the male adult voxel (MAX) and female adult voxel (FAX) phantoms, to evaluate the absorbed dose, effective dose and cancer induction risk values associated with the exposures of individuals submitted to Backscatter Van. The effective dose values were calculated as recommended by the new ICRP 103 and the cancer induction risk values were estimated through the BEIR VII document. (author)

  11. Vrancea earthquakes. Courses for specific actions to mitigate seismic risk

    International Nuclear Information System (INIS)

    Marmureanu, Gheorghe; Marmureanu, Alexandru

    2005-01-01

    Earthquakes in the Carpathian-Pannonian region are confined to the crust, except the Vrancea zone, where earthquakes with focal depth down to 200 Km occur. For example, the ruptured area migrated from 150 km to 180 km (November 10,1940, M w = 7.7) from 90 km to 110 km (March 4, 1977, M w 7.4), from 130 km to 150 km (August 30, 1986, M w = 7.1) and from 70 km to 90 km (May 30, 1990, M w = 6.9) depth. The depth interval between 110 km and 130 km remains not ruptured since 1802, October 26, when it was the strongest earthquake occurred in this part of Central Europe. The magnitude is assumed to be M w = 7.9 - 8.0 and this depth interval is a natural candidate for the next strong Vrancea event. While no country in the world is entirely safe, the lack of capacity to limit the impact of seismic hazards remains a major burden for all countries and while the world has witnessed an exponential increase in human and material losses due to natural disasters given by earthquakes, there is a need to reverse trends in seismic risk mitigation to future events. Main courses for specific actions to mitigate the seismic risk given by strong deep Vrancea earthquakes should be considered as key for development actions: - Early warning system for industrial facilities. Early warning is more than a technological instrument to detect, monitor and submit warnings. It should become part of a management information system for decision-making in the context of national institutional frameworks for disaster management and part of national and local strategies and programmers for risk mitigation; - Prediction program of Vrancea strong earthquakes of short and long term; - Hazard seismic map of Romania. The wrong assessment of the seismic hazard can lead to dramatic situations as those from Bucharest or Kobe. Before the 1977 Vrancea earthquake, the city of Bucharest was designed to intensity I = VII (MMI) and the real intensity was I = IX1/2-X (MMI); - Seismic microzonation of large populated

  12. Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners.

    Science.gov (United States)

    Stratis, Andreas; Zhang, Guozhi; Lopez-Rendon, Xochitl; Politis, Constantinus; Hermans, Robert; Jacobs, Reinhilde; Bogaerts, Ria; Shaheen, Eman; Bosmans, Hilde

    2017-09-01

    To calculate organ doses and estimate the effective dose for justification purposes in patients undergoing orthognathic treatment planning purposes and temporal bone imaging in dental cone beam CT (CBCT) and Multidetector CT (MDCT) scanners. The radiation dose to the ICRP reference male voxel phantom was calculated for dedicated orthognathic treatment planning acquisitions via Monte Carlo simulations in two dental CBCT scanners, Promax 3D Max (Planmeca, FI) and NewTom VGi evo (QR s.r.l, IT) and in Somatom Definition Flash (Siemens, DE) MDCT scanner. For temporal bone imaging, radiation doses were calculated via MC simulations for a CBCT protocol in NewTom 5G (QR s.r.l, IT) and with the use of a software tool (CT-expo) for Somatom Force (Siemens, DE). All procedures had been optimized at the acceptance tests of the devices. For orthognathic protocols, dental CBCT scanners deliver lower doses compared to MDCT scanners. The estimated effective dose (ED) was 0.32mSv for a normal resolution operation mode in Promax 3D Max, 0.27mSv in VGi-evo and 1.18mSv in the Somatom Definition Flash. For temporal bone protocols, the Somatom Force resulted in an estimated ED of 0.28mSv while for NewTom 5G the ED was 0.31 and 0.22mSv for monolateral and bilateral imaging respectively. Two clinical exams which are carried out with both a CBCT or a MDCT scanner were compared in terms of radiation dose. Dental CBCT scanners deliver lower doses for orthognathic patients whereas for temporal bone procedures the doses were similar. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. SU-E-T-602: Patient-Specific Online Dose Verification Based On Transmission Detector Measurements

    International Nuclear Information System (INIS)

    Thoelking, J; Yuvaraj, S; Jens, F; Lohr, F; Wenz, F; Wertz, H; Wertz, H

    2015-01-01

    Purpose: Intensity modulated radiotherapy requires a comprehensive quality assurance program in general and ideally independent verification of dose delivery. Since conventional 2D detector arrays allow only pre-treatment verification, there is a debate concerning the need of online dose verification. This study presents the clinical performance, including dosimetric plan verification in 2D as well as in 3D and the error detection abilities of a new transmission detector (TD) for online dose verification of 6MV photon beam. Methods: To validate the dosimetric performance of the new device, dose reconstruction based on TD measurements were compared to a conventional pre-treatment verification method (reference) and treatment planning system (TPS) for 18 IMRT and VMAT treatment plans. Furthermore, dose reconstruction inside the patient based on TD read-out was evaluated by comparing various dose volume indices and 3D gamma evaluations against independent dose computation and TPS. To investigate the sensitivity of the new device, different types of systematic and random errors for leaf positions and linac output were introduced in IMRT treatment sequences. Results: The 2D gamma index evaluation of transmission detector based dose reconstruction showed an excellent agreement for all IMRT and VMAT plans compared to reference measurements (99.3±1.2)% and TPS (99.1±0.7)%. Good agreement was also obtained for 3D dose reconstruction based on TD read-out compared to dose computation (mean gamma value of PTV = 0.27±0.04). Only a minimal dose underestimation within the target volume was observed when analyzing DVH indices (<1%). Positional errors in leaf banks larger than 1mm and errors in linac output larger than 2% could clearly identified with the TD. Conclusion: Since 2D and 3D evaluations for all IMRT and VMAT treatment plans were in excellent agreement with reference measurements and dose computation, the new TD is suitable to qualify for routine treatment plan

  14. SU-E-T-602: Patient-Specific Online Dose Verification Based On Transmission Detector Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Thoelking, J; Yuvaraj, S; Jens, F; Lohr, F; Wenz, F; Wertz, H; Wertz, H [University Medical Center Mannheim, University of Heidelberg, Mannheim, Baden-Wuerttemberg (Germany)

    2015-06-15

    Purpose: Intensity modulated radiotherapy requires a comprehensive quality assurance program in general and ideally independent verification of dose delivery. Since conventional 2D detector arrays allow only pre-treatment verification, there is a debate concerning the need of online dose verification. This study presents the clinical performance, including dosimetric plan verification in 2D as well as in 3D and the error detection abilities of a new transmission detector (TD) for online dose verification of 6MV photon beam. Methods: To validate the dosimetric performance of the new device, dose reconstruction based on TD measurements were compared to a conventional pre-treatment verification method (reference) and treatment planning system (TPS) for 18 IMRT and VMAT treatment plans. Furthermore, dose reconstruction inside the patient based on TD read-out was evaluated by comparing various dose volume indices and 3D gamma evaluations against independent dose computation and TPS. To investigate the sensitivity of the new device, different types of systematic and random errors for leaf positions and linac output were introduced in IMRT treatment sequences. Results: The 2D gamma index evaluation of transmission detector based dose reconstruction showed an excellent agreement for all IMRT and VMAT plans compared to reference measurements (99.3±1.2)% and TPS (99.1±0.7)%. Good agreement was also obtained for 3D dose reconstruction based on TD read-out compared to dose computation (mean gamma value of PTV = 0.27±0.04). Only a minimal dose underestimation within the target volume was observed when analyzing DVH indices (<1%). Positional errors in leaf banks larger than 1mm and errors in linac output larger than 2% could clearly identified with the TD. Conclusion: Since 2D and 3D evaluations for all IMRT and VMAT treatment plans were in excellent agreement with reference measurements and dose computation, the new TD is suitable to qualify for routine treatment plan

  15. Dose related risk and effect assessment model (DREAM) -- A more realistic approach to risk assessment of offshore discharges

    International Nuclear Information System (INIS)

    Johnsen, S.; Furuholt, E.

    1995-01-01

    Risk assessment of discharges from offshore oil and gas production to the marine environment features determination of potential environmental concentration (PEC) levels and no observed effect concentration (NOEC) levels. The PEC values are normally based on dilution of chemical components in the actual discharge source in the recipient, while the NOEC values are determined by applying a safety factor to acute toxic effects from laboratory tests. The DREAM concept focuses on realistic exposure doses as function of contact time and dilution, rather than fixed exposure concentrations of chemicals in long time exposure regimes. In its present state, the DREAM model is based on a number of assumptions with respect to the link between real life exposure doses and effects observed in laboratory tests. A research project has recently been initiated to develop the concept further, with special focus on chronic effects of different chemical compounds on the marine ecosystem. One of the questions that will be addressed is the link between exposure time, dose, concentration and effect. Validation of the safety factors applied for transforming acute toxic data into NOEC values will also be included. The DREAM model has been used by Statoil for risk assessment of discharges from new and existing offshore oil and gas production fields, and has been found to give a much more realistic results than conventional risk assessment tools. The presentation outlines the background for the DREAM approach, describes the model in its present state, discusses further developments and applications, and shows a number of examples on the performance of DREAM

  16. Metformin decreases lung cancer risk in diabetic patients in a dose-dependent manner.

    Science.gov (United States)

    Tsai, Ming-Ju; Yang, Chih-Jen; Kung, Ya-Ting; Sheu, Chau-Chyun; Shen, Yu-Ting; Chang, Pi-Yu; Huang, Ming-Shyan; Chiu, Herng-Chia

    2014-11-01

    Higher risk of lung cancer has been noted in patients with type 2 diabetes mellitus (DM). Some observational studies have shown a reduced risk of lung cancer in DM patients taking metformin, but a dose-response relationship has never been reported. The aim of this study is to exam the association between the dose of metformin and the incidence of lung cancer in a Chinese population. The dataset used for this nationwide population-based study is a cohort of 1 million subjects randomly sampled from individuals enrolled in the Taiwan National Health Insurance system. We enrolled all subjects with newly diagnosed type 2 DM between 1997 and 2007. Subjects with a diagnosis of neoplasm before DM diagnosis, those using metformin before DM diagnosis, those with polycystic ovary syndrome, and those with a DM diagnosis before their 15 years of age were excluded. The demographic data and duration, cumulative dose and intensity of metformin use were compared between patients developing lung cancer and those without lung cancer. Totally, 47,356 subjects were identified. After adjusting for age, gender, and modified Charlson Comorbidity Index score, the utilization of metformin was an independent protecting factor, and the risk of developing lung cancer decreased progressively with either the higher cumulative dose or the higher intensity of metformin use. This study revealed that the use of metformin decreased the risk of lung cancer in a dose-dependent manner in patients with type 2 DM. The chemo-preventive effect of metformin deserves further study. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Gender-Specific Differences in Low-Dose Haloperidol Response for Prevention of Postoperative Nausea and Vomiting: A Register-Based Cohort Study.

    Science.gov (United States)

    Brettner, Florian; Janitza, Silke; Prüll, Kathrin; Weninger, Ernst; Mansmann, Ulrich; Küchenhoff, Helmut; Jovanovic, Alexander; Pollwein, Bernhard; Chappell, Daniel; Zwissler, Bernhard; von Dossow, Vera

    2016-01-01

    Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after general anesthesia and surgery, with young non-smoking females receiving postoperative opioids being high-risk patients. This register-based study aims to evaluate the effect of low-dose haloperidol (0.5 mg intravenously) directly after induction of general anesthesia to reduce the incidence of PONV in the postoperative anesthesiological care unit (PACU). Multivariable regression models were used to investigate the association between low-dose haloperidol and the occurrence of PONV using a patient registry containing 2,617 surgical procedures carried out at an university hospital. Haloperidol 0.5 mg is associated with a reduced risk of PONV in the total collective (adjusted odds ratio = 0.75, 95% confidence interval: [0.56, 0.99], p = 0.05). The results indicate that there is a reduced risk in male patients (adjusted odds ratio = 0.45, 95% confidence interval: [0.28, 0.73], p = 0.001) if a dose of 0.5 mg haloperidol was administered while there seems to be no effect in females (adjusted odds ratio = 1.02, 95% confidence interval: [0.71, 1.46], p = 0.93). Currently known risk factors for PONV such as female gender, duration of anesthesia and the use of opioids were confirmed in our analysis. This study suggests that low-dose haloperidol has an antiemetic effect in male patients but has no effect in female patients. A confirmation of the gender-specific effects we have observed in this register-based cohort study might have major implications on clinical daily routine.

  18. Low Birth Weight, Cumulative Obesity Dose, and the Risk of Incident Type 2 Diabetes

    OpenAIRE

    Feng, Cindy; Osgood, Nathaniel D.; Dyck, Roland F.

    2018-01-01

    Background. Obesity history may provide a better understanding of the contribution of obesity to T2DM risk. Methods. 17,634 participants from the 1958 National Child Development Study were followed from birth to 50 years. Cumulative obesity dose, a measure of obesity history, was calculated by subtracting the upper cut-off of the normal BMI from the actual BMI at each follow-up and summing the areas under the obesity dose curve. Hazard ratios (HRs) for diabetes were calculated using Cox regre...

  19. The risk equivalent of an exposure to-, versus a dose of radiation

    International Nuclear Information System (INIS)

    Bond, V.P.

    1986-01-01

    The long-term potential carcinogenic effects of low-level exposure (LLE) are addressed. The principal point discussed is linear, no-threshold dose-response curve. That the linear no-threshold, or proportional relationship is widely used is seen in the way in which the values for cancer risk coefficients are expressed - in terms of new cases, per million persons exposed, per year, per unit exposure or dose. This implies that the underlying relationship is proportional, i.e., ''linear, without threshold''. 12 refs., 9 figs., 1 tab

  20. Lifetime radiation risks from low-dose rate radionuclides in beagles

    International Nuclear Information System (INIS)

    Goldman, M.; Rosenblatt, L.S.

    1985-01-01

    One of the largest, long-term (25-yr) animal studies on the effects of low-dose internal irradiation is almost completed. Some 335 beagles were given continuous exposure to graded 90 Sr [low linear energy transfer (LET)] in their diets (D-dogs) through adulthood. A second group (R-dogs) was given fractionated doses of 225 Ra (high LET) as young adults. A third group of 44 was given a single injection of 90 Sr as adults (S-dogs) to compare single to continuous dosages. All dogs were followed through their lifetimes. Only one of the 848 dogs is still alive. The animals were whole-body counted over their entire life span and were examined frequently for assessment of medical status. There were no acute radiation lethalities. Analyses of the large data base from these dogs have begun and preliminary indications are that 90 Sr, which was tested over a 1500-fold skeletal dose rate range, does not cause significant life shortening at average accumulation skeletal doses of ∼2500 rads (25 Gy) and that a curvilinear dose response curve for life shortening was seen at higher accumulation doses. The data will be discussed in terms of modern epidemiological concepts and quantifications will be related to certain parameters of human risk from acute or chronic radiation exposures

  1. Risk ratios for use in establishing dose limits for occupational exposure to radiation

    International Nuclear Information System (INIS)

    Metcalf, P.E.; Winkler, B.C.

    1980-01-01

    Dose limits for occupational exposure to radiation may be established by comparing the associated mortality risk with apparently accepted levels of industrial mortality risk due to conventional hazards. Average levels of industrial mortality risk rates are frequently quoted and used in such comparisons. However, within particular occupations or industries certain groups of workers will be exposed to higher levels of risk than the average, again an apparently accepted situation. A study has been made of the ratios of maximum to average industrial mortality risk currently experienced in some South African industries. Such a ratio may be used to assess the acceptability of maximum individual-to-average exposures in particular groups of exposed individuals. (author)

  2. Effective dose and cancer risk in PET/CT exams; Dose efetiva e risco de cancer em exames de PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Gabriella M.; Sa, Lidia Vasconcellos de, E-mail: montezano@ird.gov.br, E-mail: Iidia@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2013-07-01

    Due to the use of radiopharmaceutical positron-emitting in PET exam and realization of tomography by x-ray transmission in CT examination, an increase of dose with hybrid PET/CT technology is expected. However, differences of doses have been reported in many countries for the same type of procedure. It is expected that the dose is an influent parameter to standardize the protocols of PET/CT. This study aimed to estimate the effective doses and absorbed in 65 patients submitted to oncological Protocol in a nuclear medicine clinic in Rio de Janeiro, considering the risk of induction of cancer from the scan. The CT exam-related doses were estimated with a simulator of PMMA and simulated on the lmPACT resistance, which for program effective dose, were considered the weight factors of the lCRP 103. The PET exam doses were estimated by multiplying the activity administered to the patient with the ICRP dose 80 factors. The radiological risk for cancer incidence were estimated according to the ICRP 103. The results showed that the effective dose from CT exam is responsible for 70% of the effective total in a PET/CT scan. values of effective dose for the PET/CT exam reached average values of up to 25 mSv leading to a risk of 2, 57 x 10{sup -4}. Considering that in staging of oncological diseases at least four tests are performed annually, the total risk comes to 1,03x 10{sup -3}.

  3. Lack of benefit for the addition of androgen deprivation therapy to dose-escalated radiotherapy in the treatment of intermediate- and high-risk prostate cancer.

    LENUS (Irish Health Repository)

    Krauss, Daniel

    2012-02-01

    PURPOSE: Assessment of androgen deprivation therapy (ADT) benefits for prostate cancer treated with dose-escalated radiotherapy (RT). METHODS AND MATERIALS: From 1991 to 2004, 1,044 patients with intermediate- (n = 782) or high-risk (n = 262) prostate cancer were treated with dose-escalated RT at William Beaumont Hospital. Patients received external-beam RT (EBRT) alone, brachytherapy (high or low dose rate), or high dose rate brachytherapy plus pelvic EBRT. Intermediate-risk patients had Gleason score 7, prostate-specific antigen (PSA) 10.0-19.9 ng\\/mL, or Stage T2b-T2c. High-risk patients had Gleason score 8-10, PSA >\\/=20, or Stage T3. Patients were additionally divided specifically by Gleason score, presence of palpable disease, and PSA level to further define subgroups benefitting from ADT. RESULTS: Median follow-up was 5 years; 420 patients received ADT + dose-escalated RT, and 624 received dose-escalated RT alone. For all patients, no advantages in any clinical endpoints at 8 years were associated with ADT administration. No differences in any endpoints were associated with ADT administration based on intermediate- vs. high-risk group or RT modality when analyzed separately. Patients with palpable disease plus Gleason >\\/=8 demonstrated improved clinical failure rates and a trend toward improved survival with ADT. Intermediate-risk patients treated with brachytherapy alone had improved biochemical control when ADT was given. CONCLUSION: Benefits of ADT in the setting of dose-escalated RT remain poorly defined. This question must continue to be addressed in prospective study.

  4. Dose to the Developing Dentition During Therapeutic Irradiation: Organ at Risk Determination and Clinical Implications

    International Nuclear Information System (INIS)

    Thompson, Reid F.; Schneider, Ralf A.; Albertini, Francesca; Lomax, Antony J.; Ares, Carmen; Goitein, Gudrun; Hug, Eugen B.

    2013-01-01

    Purpose: Irradiation of pediatric facial structures can cause severe impairment of permanent teeth later in life. We therefore focused on primary and permanent teeth as organs at risk, investigating the ability to identify individual teeth in children and infants and to correlate dose distributions with subsequent dental toxicity. Methods and Materials: We retrospectively reviewed 14 pediatric patients who received a maximum dose >20 Gy(relative biological effectiveness, RBE) to 1 or more primary or permanent teeth between 2003 and 2009. The patients (aged 1-16 years) received spot-scanning proton therapy with 46 to 66 Gy(RBE) in 23 to 33 daily fractions for a variety of tumors, including rhabdomyosarcoma (n=10), sarcoma (n=2), teratoma (n=1), and carcinoma (n=1). Individual teeth were contoured on axial slices from planning computed tomography (CT) scans. Dose-volume histogram data were retrospectively obtained from total calculated delivered treatments. Dental follow-up information was obtained from external care providers. Results: All primary teeth and permanent incisors, canines, premolars, and first and second molars were identifiable on CT scans in all patients as early as 1 year of age. Dose-volume histogram analysis showed wide dose variability, with a median 37 Gy(RBE) per tooth dose range across all individuals, and a median 50 Gy(RBE) intraindividual dose range across all teeth. Dental follow-up revealed absence of significant toxicity in 7 of 10 patients but severe localized toxicity in teeth receiving >20 Gy(RBE) among 3 patients who were all treated at <4 years of age. Conclusions: CT-based assessment of dose distribution to individual teeth is feasible, although delayed calcification may complicate tooth identification in the youngest patients. Patterns of dental dose exposure vary markedly within and among patients, corresponding to rapid dose falloff with protons. Severe localized dental toxicity was observed in a few patients receiving the

  5. Assessing the reliability of dose coefficients for exposure to radioiodine by members of the public, accounting for dosimetric and risk model uncertainties.

    Science.gov (United States)

    Puncher, M; Zhang, W; Harrison, J D; Wakeford, R

    2017-06-26

    Assessments of risk to a specific population group resulting from internal exposure to a particular radionuclide can be used to assess the reliability of the appropriate International Commission on Radiological Protection (ICRP) dose coefficients used as a radiation protection device for the specified exposure pathway. An estimate of the uncertainty on the associated risk is important for informing judgments on reliability; a derived uncertainty factor, UF, is an estimate of the 95% probable geometric difference between the best risk estimate and the nominal risk and is a useful tool for making this assessment. This paper describes the application of parameter uncertainty analysis to quantify uncertainties resulting from internal exposures to radioiodine by members of the public, specifically 1, 10 and 20-year old females from the population of England and Wales. Best estimates of thyroid cancer incidence risk (lifetime attributable risk) are calculated for ingestion or inhalation of 129 I and 131 I, accounting for uncertainties in biokinetic model and cancer risk model parameter values. These estimates are compared with the equivalent ICRP derived nominal age-, sex- and population-averaged estimates of excess thyroid cancer incidence to obtain UFs. Derived UF values for ingestion or inhalation of 131 I for 1 year, 10-year and 20-year olds are around 28, 12 and 6, respectively, when compared with ICRP Publication 103 nominal values, and 9, 7 and 14, respectively, when compared with ICRP Publication 60 values. Broadly similar results were obtained for 129 I. The uncertainties on risk estimates are largely determined by uncertainties on risk model parameters rather than uncertainties on biokinetic model parameters. An examination of the sensitivity of the results to the risk models and populations used in the calculations show variations in the central estimates of risk of a factor of around 2-3. It is assumed that the direct proportionality of excess thyroid cancer

  6. Dose and risk evaluation to the thyroid gland in intra-oral dental radiology

    International Nuclear Information System (INIS)

    Souza, Edmilson M.; Lima, Marco A.F.; Kelecom, Alphonse; Correa, Samanda C.A.; Silva, Ademir X.; Brito, Alan

    2008-01-01

    Intra-oral technique is one of the most frequently used procedures of dental radiology, allowing the detection of a variety of dental anomalies such as caries, dental trauma and periodontal lesions, while exposing patients to relatively low doses of radiation. However, although the adverse effects of doses generated by dental radiology are essentially stochastic, a number of epidemiological studies have provided evidence of an increased risk of thyroid tumors for dental radiography. Many studies have measured doses of radiation for dental radiography, but only a few have estimated thyroid dose. Furthermore, most of the studies on dose evaluation in dental radiology are based on standardized calculation phantoms, which neglect the variance of the patient size or even sex. The purpose of this study is to use the Monte Carlo code MCNPX and the FAX (Female Adult voXel) and MAX (Male Adult voXel) phantoms to investigate how absorbed doses to the thyroid gland in intraoral dental examinations vary in female and male patients. The lifetime cancer incidence attributable to dental examinations were estimated using the Biological Effects of Ionizing Radiations (BEIR) VII Committee Report. The phantoms study proved a useful trial for detecting the radiation dose to the thyroid gland and conclusively supported that the anatomy may be regarded as an influencing factor in radiation dose received during dental examination. Finally, the results have also confirmed that the association of the MCNPX code and the MAX and FAX phantoms is very useful in dosimetric studies on radiographic examinations of female and male patients. (author)

  7. Development of Graphical User Interface for ARRBOD (Acute Radiation Risk and BRYNTRN Organ Dose Projection)

    Science.gov (United States)

    Kim, Myung-Hee; Hu, Shaowen; Nounu, Hatem N.; Cucinotta, Francis A.

    2010-01-01

    The space radiation environment, particularly solar particle events (SPEs), poses the risk of acute radiation sickness (ARS) to humans; and organ doses from SPE exposure may reach critical levels during extra vehicular activities (EVAs) or within lightly shielded spacecraft. NASA has developed an organ dose projection model using the BRYNTRN with SUMDOSE computer codes, and a probabilistic model of Acute Radiation Risk (ARR). The codes BRYNTRN and SUMDOSE, written in FORTRAN, are a Baryon transport code and an output data processing code, respectively. The ARR code is written in C. The risk projection models of organ doses and ARR take the output from BRYNTRN as an input to their calculations. BRYNTRN code operation requires extensive input preparation. With a graphical user interface (GUI) to handle input and output for BRYNTRN, the response models can be connected easily and correctly to BRYNTRN in friendly way. A GUI for the Acute Radiation Risk and BRYNTRN Organ Dose (ARRBOD) projection code provides seamless integration of input and output manipulations, which are required for operations of the ARRBOD modules: BRYNTRN, SUMDOSE, and the ARR probabilistic response model. The ARRBOD GUI is intended for mission planners, radiation shield designers, space operations in the mission operations directorate (MOD), and space biophysics researchers. The ARRBOD GUI will serve as a proof-of-concept example for future integration of other human space applications risk projection models. The current version of the ARRBOD GUI is a new self-contained product and will have follow-on versions, as options are added: 1) human geometries of MAX/FAX in addition to CAM/CAF; 2) shielding distributions for spacecraft, Mars surface and atmosphere; 3) various space environmental and biophysical models; and 4) other response models to be connected to the BRYNTRN. The major components of the overall system, the subsystem interconnections, and external interfaces are described in this

  8. Prostate-Specific Antigen (PSA) Bounce After Dose-Escalated External Beam Radiation Therapy Is an Independent Predictor of PSA Recurrence, Metastasis, and Survival in Prostate Adenocarcinoma Patients.

    Science.gov (United States)

    Romesser, Paul B; Pei, Xin; Shi, Weiji; Zhang, Zhigang; Kollmeier, Marisa; McBride, Sean M; Zelefsky, Michael J

    2018-01-01

    To evaluate the difference in prostate-specific antigen (PSA) recurrence-free, distant metastasis-free, overall, and cancer-specific survival between PSA bounce (PSA-B) and non-bounce patients treated with dose-escalated external beam radiation therapy (DE-EBRT). During 1990-2010, 1898 prostate adenocarcinoma patients were treated with DE-EBRT to ≥75 Gy with ≥5 years follow-up. Patients receiving neoadjuvant/concurrent androgen-deprivation therapy (n=1035) or with fewer than 4 PSA values obtained 6 months or more after post-EBRT completion (n=87) were excluded. The evaluable 776 patients were treated (median, 81.0 Gy). Prostate-specific antigen bounce was defined as a ≥0.2-ng/mL increase above the interval PSA nadir, followed by a decrease to nadir or below. Prostate-specific antigen relapse was defined as post-radiation therapy PSA nadir + 2 ng/mL. Median follow-up was 9.2 years (interquartile range, 6.9-11.3 years). One hundred twenty-three patients (15.9%) experienced PSA-B after DE-EBRT at a median of 24.6 months (interquartile range, 16.1-38.5 months). On multivariate analysis, younger age (P=.001), lower Gleason score (P=.0003), and higher radiation therapy dose (P=.0002) independently predicted PSA-B. Prostate-specific antigen bounce was independently associated with decreased risk for PSA relapse (hazard ratio [HR] 0.53; 95% confidence interval [CI] 0.33-0.85; P=.008), distant metastatic disease (HR 0.34; 95% CI 0.12-0.94; P=.04), and all-cause mortality (HR 0.53; 95% CI 0.29-0.96; P=.04) on multivariate Cox analysis. Because all 50 prostate cancer-specific deaths in patients without PSA-B were in the non-bounce cohort, competing-risks analysis was not applicable. A nonparametric competing-risks test demonstrated that patients with PSA-B had superior cancer-specific survival compared with patients without PSA-B (P=.004). Patients treated with dose-escalated radiation therapy for prostate adenocarcinoma who experience posttreatment PSA-B have

  9. Radiation doses and risks to neonates undergoing common radiographic examinations in the neonatal intensive care unit

    International Nuclear Information System (INIS)

    McParland, B.J.; Lee, R.

    1996-01-01

    Neonates in the-Neonatal Intensive Care Unit (NICU) can receive large numbers of radiographs owing to the clinical conditions they may present. More neonatal radiation dosimetry data are required for three fundamental reasons: (1.) to aid in the establishment of reference dose levels for interinstitutional comparisons; (2.) to improve childhood cancer risk estimates following neonatal exposure; and (3.) to indicate appropriate directions for dose reduction. This paper describes an investigation of two different NICU radiological techniques with significantly different neonate doses. While patient-matched images taken with both techniques were assessed in a blind review, this component of the study is beyond the scope of this paper and is not discussed here. (author)

  10. Intensity-Modulated Radiotherapy for Craniospinal Irradiation: Target Volume Considerations, Dose Constraints, and Competing Risks

    International Nuclear Information System (INIS)

    Parker, William; Filion, Edith; Roberge, David; Freeman, Carolyn R.

    2007-01-01

    Purpose: To report the results of an analysis of dose received to tissues and organs outside the target volume, in the setting of spinal axis irradiation for the treatment of medulloblastoma, using three treatment techniques. Methods and Materials: Treatment plans (total dose, 23.4 Gy) for a standard two-dimensional (2D) technique, a three-dimensional (3D) technique using a 3D imaging-based target volume, and an intensity-modulated radiotherapy (IMRT) technique, were compared for 3 patients in terms of dose-volume statistics for target coverage, as well as organ at risk (OAR) and overall tissue sparing. Results: Planning target volume coverage and dose homogeneity was superior for the IMRT plans for V 95% (IMRT, 100%; 3D, 96%; 2D, 98%) and V 107% (IMRT, 3%; 3D, 38%; 2D, 37%). In terms of OAR sparing, the IMRT plan was better for all organs and whole-body contour when comparing V 10Gy , V 15Gy , and V 20Gy . The 3D plan was superior for V 5Gy and below. For the heart and liver in particular, the IMRT plans provided considerable sparing in terms of V 10Gy and above. In terms of the integral dose, the IMRT plans were superior for liver (IMRT, 21.9 J; 3D, 28.6 J; 2D, 38.6 J) and heart (IMRT, 9 J; 3D, 14.1J; 2D, 19.4 J), the 3D plan for the body contour (IMRT, 349 J; 3D, 337 J; 2D, 555 J). Conclusions: Intensity-modulated radiotherapy is a valid treatment option for spinal axis irradiation. We have shown that IMRT results in sparing of organs at risk without a significant increase in integral dose

  11. Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization.

    Science.gov (United States)

    Hill, Kevin D; Wang, Chu; Einstein, Andrew J; Januzis, Natalie; Nguyen, Giao; Li, Jennifer S; Fleming, Gregory A; Yoshizumi, Terry K

    2017-04-01

    To quantify the impact of image optimization on absorbed radiation dose and associated risk in children undergoing cardiac catheterization. Various imaging and fluoroscopy system technical parameters including camera magnification, source-to-image distance, collimation, antiscatter grids, beam quality, and pulse rates, all affect radiation dose but have not been well studied in younger children. We used anthropomorphic phantoms (ages: newborn and 5 years old) to measure surface radiation exposure from various imaging approaches and estimated absorbed organ doses and effective doses (ED) using Monte Carlo simulations. Models developed in the National Academies' Biological Effects of Ionizing Radiation VII report were used to compare an imaging protocol optimized for dose reduction versus suboptimal imaging (+20 cm source-to-image-distance, +1 magnification setting, no collimation) on lifetime attributable risk (LAR) of cancer. For the newborn and 5-year-old phantoms, respectively ED changes were as follows: +157% and +232% for an increase from 6-inch to 10-inch camera magnification; +61% and +59% for a 20 cm increase in source-to-image-distance; -42% and -48% with addition of 1-inch periphery collimation; -31% and -46% with removal of the antiscatter grid. Compared with an optimized protocol, suboptimal imaging increased ED by 2.75-fold (newborn) and fourfold (5 years old). Estimated cancer LAR from 30-min of posteroanterior fluoroscopy using optimized versus suboptimal imaging, respectively was 0.42% versus 1.23% (newborn female), 0.20% versus 0.53% (newborn male), 0.47% versus 1.70% (5-year-old female) and 0.16% versus 0.69% (5-year-old male). Radiation-related risks to children undergoing cardiac catheterization can be substantial but are markedly reduced with an optimized imaging approach. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. [Doses to organs at risk in conformational radiotherapy and stereotaxic irradiation: The heart].

    Science.gov (United States)

    Vandendorpe, B; Servagi Vernat, S; Ramiandrisoa, F; Bazire, L; Kirova, Y M

    2017-10-01

    Radiation therapy of breast cancer, Hodgkin lymphoma, lung cancer and others thoracic irradiations induce an ionizing radiation dose to the heart. Irradiation of the heart, associated with patient cardiovascular risk and cancer treatment-induced cardiotoxicity, increase cardiovascular mortality. The long survival after breast or Hodgkin lymphoma irradiation requires watching carefully late treatment toxicity. The over-risk of cardiac events is related to the dose received by the heart and the irradiated cardiac volume. The limitation of cardiac irradiation should be a priority in the planning of thoracic irradiations. Practices have to be modified, using modern techniques to approach of the primary objective of radiotherapy which is to optimize the dose to the target volume, sparing healthy tissues, in this case the heart. We have reviewed the literature on cardiac toxicity induced by conformational tridimensional radiation therapy, intensity-modulated radiation therapy or stereotactic body radiation therapy, in order to evaluate the possibilities to limit cardiotoxicity. Finally, we summarise the recommendations on dose constraints to the heart and coronary arteries. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  13. Development of PC based Monte Carlo simulations for the calculation of scanner-specific normalized organ doses from CT

    International Nuclear Information System (INIS)

    Jansen, J. T. M.; Shrimpton, P. C.; Zankl, M.

    2009-01-01

    This paper discusses the simulation of contemporary computed tomography (CT) scanners using Monte Carlo calculation methods to derive normalized organ doses, which enable hospital physicists to estimate typical organ and effective doses for CT examinations. The hardware used in a small PC-cluster at the Health Protection Agency (HPA) for these calculations is described. Investigations concerning optimization of software, including the radiation transport codes MCNP5 and MCNPX, and the Intel and PGI FORTRAN compilers, are presented in relation to results and calculation speed. Differences in approach for modelling the X-ray source are described and their influences are analysed. Comparisons with previously published calculations at HPA from the early 1990's proved satisfactory for the purposes of quality assurance and are presented in terms of organ dose ratios for whole body exposure and differences in organ location. Influences on normalized effective dose are discussed in relation to choice of cross section library, CT scanner technology (contemporary multi slice versus single slice), definition for effective dose (1990 and 2007 versions) and anthropomorphic phantom (mathematical and voxel). The results illustrate the practical need for the updated scanner-specific dose coefficients presently being calculated at HPA, in order to facilitate improved dosimetry for contemporary CT practice. (authors)

  14. Analysis of the risk factors for exposure of the lung to low irradiation doses

    International Nuclear Information System (INIS)

    Hogeweg, B.

    1986-02-01

    In this report a description is presented of the risk factors for induction of lungtumours. The contribution of natural radioactivity from uranium and thorium to the lungs is mainly caused by inhalation of alpha-emitting radon and thorium daughter products. Apart from exposure by inhalation the lungs are also exposed to external radiation. For internal as well as external exposure a value of 10 -3 lungcancers per Sv lung dose equivalence is found to be acceptable for the riskfactor. (Auth.)

  15. Low doses of ionizing radiation and risk of cardiovascular disease: A review of epidemiological studies

    International Nuclear Information System (INIS)

    Metz-Flamant, C.; Bonaventure, A.; Tirmarche, M.; Laurier, D.; Bernier, M.O.; Milliat, F.

    2009-01-01

    Background While cardiovascular risks associated with high level of ionizing radiation are well-established, long-term effects of low and medium levels of exposure, between 0 and 5 gray (Gy), on the cardiovascular system are debated. Methods Available literature was reviewed considering various populations, such as survivors of atomic bombs, nuclear workers, Chernobyl liquidators, radiologists and radiological technologists and patients exposed for medical reasons. Results A significant increased risk of cardiovascular diseases associated with low doses of ionizing radiation was observed in 13 studies among the 27 analyzed. The ischemic heart diseases risk was detailed in 16 studies and seven of them showed a significant increase. The cerebrovascular risk was significantly increased in five studies among the 12 considered. Conclusion Some epidemiological and experimental data are clearly in favour of an increased cardiovascular risk associated with exposure to low doses. However, given the multi-factorial origin of cardiovascular diseases and the lack of a clear pathophysiologic mechanism, epidemiological results have to be carefully interpreted. Further research should be conducted in this area. (authors)

  16. Dose and risk assessment approach for the Fernald CERCLA D ampersand D Project

    International Nuclear Information System (INIS)

    Throckmorton, J.D.; Clark, T.R.; Waligora, S.J. Jr.; Haaker, R.F.

    1994-01-01

    At the Fernald Environmental Management Project (FEMP) the uranium processing facilities used from the 1952 through 1989 are near or beyond their intended design life. These current conditions present an increasing probability for future releases of hazardous substances to the environment. To support a decision by the U.S. Department of Energy (DOE) and the Environmental Protection Agency (EPA) to remediate the buildings, a dose and risk assessment was performed to determine the extent of exposure that would be associated with the controlled decontamination and dismantlement (D ampersand D) of the Fernald facilities. A conceptual risk assessment model was developed, with exposure mechanisms and associated pathways for each potential receptor. The three receptor groups were defined as: the remediation workers, other on-site workers (those not performing D ampersand D), and off-site residents. For use in the conceptual model, an airborne source term was developed through process knowledge, other historical information and data, and air sample data from within the facilities. Individual and collective doses and risks were developed for each receptor and for each population group. The risk assessment demonstrated that all exposures resulting from the action would be within the acceptable DOE administrative control level of 2.0 rem per year for occupational workers and the acceptable EPA risk range from 10 -6 to 10 -4 for the general public

  17. Quantifying the dose-response of walking in reducing coronary heart disease risk: meta-analysis.

    Science.gov (United States)

    Zheng, Henry; Orsini, Nicola; Amin, Janaki; Wolk, Alicja; Nguyen, Van Thi Thuy; Ehrlich, Fred

    2009-01-01

    The evidence for the efficacy of walking in reducing the risk of and preventing coronary heart disease (CHD) is not completely understood. This meta-analysis aimed to quantify the dose-response relationship between walking and CHD risk reduction for both men and women in the general population. Studies on walking and CHD primary prevention between 1954 and 2007 were identified through Medline, SportDiscus and the Cochrane Database of Systematic Reviews. Random-effect meta-regression models were used to pool the relative risks from individual studies. A total of 11 prospective cohort studies and one randomized control trial study met the inclusion criteria, with 295,177 participants free of CHD at baseline and 7,094 cases at follow-up. The meta-analysis indicated that an increment of approximately 30 min of normal walking a day for 5 days a week was associated with 19% CHD risk reduction (95% CI = 14-23%; P-heterogeneity = 0.56; I (2) = 0%). We found no evidence of heterogeneity between subgroups of studies defined by gender (P = 0.67); age of the study population (P = 0.52); or follow-up duration (P = 0.77). The meta-analysis showed that the risk for developing CHD decreases as walking dose increases. Walking should be prescribed as an evidence-based effective exercise modality for CHD prevention in the general population.

  18. Image quality and dose differences caused by vendor-specific image processing of neonatal radiographs

    International Nuclear Information System (INIS)

    Sensakovic, William F.; O'Dell, M.C.; Letter, Haley; Kohler, Nathan; Rop, Baiywo; Cook, Jane; Logsdon, Gregory; Varich, Laura

    2016-01-01

    Image processing plays an important role in optimizing image quality and radiation dose in projection radiography. Unfortunately commercial algorithms are black boxes that are often left at or near vendor default settings rather than being optimized. We hypothesize that different commercial image-processing systems, when left at or near default settings, create significant differences in image quality. We further hypothesize that image-quality differences can be exploited to produce images of equivalent quality but lower radiation dose. We used a portable radiography system to acquire images on a neonatal chest phantom and recorded the entrance surface air kerma (ESAK). We applied two image-processing systems (Optima XR220amx, by GE Healthcare, Waukesha, WI; and MUSICA"2 by Agfa HealthCare, Mortsel, Belgium) to the images. Seven observers (attending pediatric radiologists and radiology residents) independently assessed image quality using two methods: rating and matching. Image-quality ratings were independently assessed by each observer on a 10-point scale. Matching consisted of each observer matching GE-processed images and Agfa-processed images with equivalent image quality. A total of 210 rating tasks and 42 matching tasks were performed and effective dose was estimated. Median Agfa-processed image-quality ratings were higher than GE-processed ratings. Non-diagnostic ratings were seen over a wider range of doses for GE-processed images than for Agfa-processed images. During matching tasks, observers matched image quality between GE-processed images and Agfa-processed images acquired at a lower effective dose (11 ± 9 μSv; P < 0.0001). Image-processing methods significantly impact perceived image quality. These image-quality differences can be exploited to alter protocols and produce images of equivalent image quality but lower doses. Those purchasing projection radiography systems or third-party image-processing software should be aware that image processing

  19. Image quality and dose differences caused by vendor-specific image processing of neonatal radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Sensakovic, William F.; O' Dell, M.C.; Letter, Haley; Kohler, Nathan; Rop, Baiywo; Cook, Jane; Logsdon, Gregory; Varich, Laura [Florida Hospital, Imaging Administration, Orlando, FL (United States)

    2016-10-15

    Image processing plays an important role in optimizing image quality and radiation dose in projection radiography. Unfortunately commercial algorithms are black boxes that are often left at or near vendor default settings rather than being optimized. We hypothesize that different commercial image-processing systems, when left at or near default settings, create significant differences in image quality. We further hypothesize that image-quality differences can be exploited to produce images of equivalent quality but lower radiation dose. We used a portable radiography system to acquire images on a neonatal chest phantom and recorded the entrance surface air kerma (ESAK). We applied two image-processing systems (Optima XR220amx, by GE Healthcare, Waukesha, WI; and MUSICA{sup 2} by Agfa HealthCare, Mortsel, Belgium) to the images. Seven observers (attending pediatric radiologists and radiology residents) independently assessed image quality using two methods: rating and matching. Image-quality ratings were independently assessed by each observer on a 10-point scale. Matching consisted of each observer matching GE-processed images and Agfa-processed images with equivalent image quality. A total of 210 rating tasks and 42 matching tasks were performed and effective dose was estimated. Median Agfa-processed image-quality ratings were higher than GE-processed ratings. Non-diagnostic ratings were seen over a wider range of doses for GE-processed images than for Agfa-processed images. During matching tasks, observers matched image quality between GE-processed images and Agfa-processed images acquired at a lower effective dose (11 ± 9 μSv; P < 0.0001). Image-processing methods significantly impact perceived image quality. These image-quality differences can be exploited to alter protocols and produce images of equivalent image quality but lower doses. Those purchasing projection radiography systems or third-party image-processing software should be aware that image

  20. Interindividual variability in the dose-specific effect of dopamine on carotid chemoreceptor sensitivity to hypoxia

    Science.gov (United States)

    Limberg, Jacqueline K.; Johnson, Blair D.; Holbein, Walter W.; Ranadive, Sushant M.; Mozer, Michael T.

    2015-01-01

    Human studies use varying levels of low-dose (1-4 μg·kg−1·min−1) dopamine to examine peripheral chemosensitivity, based on its known ability to blunt carotid body responsiveness to hypoxia. However, the effect of dopamine on the ventilatory responses to hypoxia is highly variable between individuals. Thus we sought to determine 1) the dose response relationship between dopamine and peripheral chemosensitivity as assessed by the ventilatory response to hypoxia in a cohort of healthy adults, and 2) potential confounding cardiovascular responses at variable low doses of dopamine. Young, healthy adults (n = 30, age = 32 ± 1, 24 male/6 female) were given intravenous (iv) saline and a range of iv dopamine doses (1–4 μg·kg−1·min−1) prior to and throughout five hypoxic ventilatory response (HVR) tests. Subjects initially received iv saline, and after each HVR the dopamine infusion rate was increased by 1 μg·kg−1·min−1. Tidal volume, respiratory rate, heart rate, blood pressure, and oxygen saturation were continuously measured. Dopamine significantly reduced HVR at all doses (P HVR in the high group only (P HVR in the low group (P > 0.05). Dopamine infusion also resulted in a reduction in blood pressure (3 μg·kg−1·min−1) and total peripheral resistance (1–4 μg·kg−1·min−1), driven primarily by subjects with low baseline chemosensitivity. In conclusion, we did not find a single dose of dopamine that elicited a nadir HVR in all subjects. Additionally, potential confounding cardiovascular responses occur with dopamine infusion, which may limit its usage. PMID:26586909

  1. Interindividual variability in the dose-specific effect of dopamine on carotid chemoreceptor sensitivity to hypoxia.

    Science.gov (United States)

    Limberg, Jacqueline K; Johnson, Blair D; Holbein, Walter W; Ranadive, Sushant M; Mozer, Michael T; Joyner, Michael J

    2016-01-15

    Human studies use varying levels of low-dose (1-4 μg·kg(-1)·min(-1)) dopamine to examine peripheral chemosensitivity, based on its known ability to blunt carotid body responsiveness to hypoxia. However, the effect of dopamine on the ventilatory responses to hypoxia is highly variable between individuals. Thus we sought to determine 1) the dose response relationship between dopamine and peripheral chemosensitivity as assessed by the ventilatory response to hypoxia in a cohort of healthy adults, and 2) potential confounding cardiovascular responses at variable low doses of dopamine. Young, healthy adults (n = 30, age = 32 ± 1, 24 male/6 female) were given intravenous (iv) saline and a range of iv dopamine doses (1-4 μg·kg(-1)·min(-1)) prior to and throughout five hypoxic ventilatory response (HVR) tests. Subjects initially received iv saline, and after each HVR the dopamine infusion rate was increased by 1 μg·kg(-1)·min(-1). Tidal volume, respiratory rate, heart rate, blood pressure, and oxygen saturation were continuously measured. Dopamine significantly reduced HVR at all doses (P HVR in the high group only (P HVR in the low group (P > 0.05). Dopamine infusion also resulted in a reduction in blood pressure (3 μg·kg(-1)·min(-1)) and total peripheral resistance (1-4 μg·kg(-1)·min(-1)), driven primarily by subjects with low baseline chemosensitivity. In conclusion, we did not find a single dose of dopamine that elicited a nadir HVR in all subjects. Additionally, potential confounding cardiovascular responses occur with dopamine infusion, which may limit its usage. Copyright © 2016 the American Physiological Society.

  2. Development of Monte Carlo simulations to provide scanner-specific organ dose coefficients for contemporary CT

    Science.gov (United States)

    Jansen, Jan T. M.; Shrimpton, Paul C.

    2016-07-01

    The ImPACT (imaging performance assessment of CT scanners) CT patient dosimetry calculator is still used world-wide to estimate organ and effective doses (E) for computed tomography (CT) examinations, although the tool is based on Monte Carlo calculations reflecting practice in the early 1990’s. Subsequent developments in CT scanners, definitions of E, anthropomorphic phantoms, computers and radiation transport codes, have all fuelled an urgent need for updated organ dose conversion factors for contemporary CT. A new system for such simulations has been developed and satisfactorily tested. Benchmark comparisons of normalised organ doses presently derived for three old scanners (General Electric 9800, Philips Tomoscan LX and Siemens Somatom DRH) are within 5% of published values. Moreover, calculated normalised values of CT Dose Index for these scanners are in reasonable agreement (within measurement and computational uncertainties of  ±6% and  ±1%, respectively) with reported standard measurements. Organ dose coefficients calculated for a contemporary CT scanner (Siemens Somatom Sensation 16) demonstrate potential deviations by up to around 30% from the surrogate values presently assumed (through a scanner matching process) when using the ImPACT CT Dosimetry tool for newer scanners. Also, illustrative estimates of E for some typical examinations and a range of anthropomorphic phantoms demonstrate the significant differences (by some 10’s of percent) that can arise when changing from the previously adopted stylised mathematical phantom to the voxel phantoms presently recommended by the International Commission on Radiological Protection (ICRP), and when following the 2007 ICRP recommendations (updated from 1990) concerning tissue weighting factors. Further simulations with the validated dosimetry system will provide updated series of dose coefficients for a wide range of contemporary scanners.

  3. Age-specific doses of lormetazepam as a night sedative in cases of chronic sleep disturbance.

    Science.gov (United States)

    Jovanović, U J; Ott, H; Heidrich, H; Stephan, K; Schratzer, M

    1980-01-01

    Lormetazepam, a new benzodiazepine derivative, was tested under double blind conditions in order to find the optimal dosage for different age groups of out-patients. 120 patients suffering from chronic sleep disturbance were included in the study: a younger group (age 20 to 55) and an older group (age 56 to 85 years). Four different doses were given to each age group: 0.5, 1.0, 2.0, and 3.0 mg to the younger group and 0.5, 1.0, 1.5, and 2.0 mg to the older group. A pre-placebo week (i.e. when all patients received placebo) in which baseline data were recorded preceded the two verum weeks, and these were followed by a post-placebo or withdrawal week (again all patients receiving placebo). The level of significance accepted for statistical decisions was alpha = 0.05. No differences in effects between the different doses were observed with regard to sleep pattern variables (sleep latency, sleep duration, frequency of awakenings, sleep quality, occurrence of 'bad' dreams) with the exception of sleep quality which was better in the older group than in the younger group after 0.5 mg in week 2. Considerable differences with regard to hangover feelings the next morning and during the next day (morning feelings, tranquility, alertness, and concentration), comparison of the effects of discontinuing therapy upon the above-mentioned sleep pattern variables and small differences in side effects--which were few--led to the following conclusion: --0.5 mg stood out as the best dose for the older group. --None of the dosages given to the younger group emerged clearly as superior. However, it would seem that the 1 mg dose should be the dose recommended, since fewer unfavourable scores and side effects appeared after this dose.

  4. A method to dynamically balance intensity modulated radiotherapy dose between organs-at-risk

    International Nuclear Information System (INIS)

    Das, Shiva K.

    2009-01-01

    The IMRT treatment planning process typically follows a path that is based on the manner in which the planner interactively adjusts the target and organ-at-risk (OAR) constraints and priorities. The time-intensive nature of this process restricts the planner from fully understanding the dose trade-off between structures, making it unlikely that the resulting plan fully exploits the extent to which dose can be redistributed between anatomical structures. Multiobjective Pareto optimization has been used in the past to enable the planner to more thoroughly explore alternatives in dose trade-off by combining pre-generated Pareto optimal solutions in real time, thereby potentially tailoring a plan more exactly to requirements. However, generating the Pareto optimal solutions can be nonintuitive and computationally time intensive. The author presents an intuitive and fast non-Pareto approach for generating optimization sequences (prior to planning), which can then be rapidly combined by the planner in real time to yield a satisfactory plan. Each optimization sequence incrementally reduces dose to one OAR at a time, starting from the optimization solution where dose to all OARs are reduced with equal priority, until user-specified target coverage limits are violated. The sequences are computationally efficient to generate, since the optimization at each position along a sequence is initiated from the end result of the previous position in the sequence. The pre-generated optimization sequences require no user interaction. In real time, a planner can more or less instantaneously visualize a treatment plan by combining the dose distributions corresponding to user-selected positions along each of the optimization sequences (target coverage is intrinsically maintained in the combination). Interactively varying the selected positions along each of the sequences enables the planner to rapidly understand the nature of dose trade-off between structures and, thereby, arrive at a

  5. The current state of knowledge on the use of the benchmark dose concept in risk assessment.

    Science.gov (United States)

    Sand, Salomon; Victorin, Katarina; Filipsson, Agneta Falk

    2008-05-01

    This review deals with the current state of knowledge on the use of the benchmark dose (BMD) concept in health risk assessment of chemicals. The BMD method is an alternative to the traditional no-observed-adverse-effect level (NOAEL) and has been presented as a methodological improvement in the field of risk assessment. The BMD method has mostly been employed in the USA but is presently given higher attention also in Europe. The review presents a number of arguments in favor of the BMD, relative to the NOAEL. In addition, it gives a detailed overview of the several procedures that have been suggested and applied for BMD analysis, for quantal as well as continuous data. For quantal data the BMD is generally defined as corresponding to an additional or extra risk of 5% or 10%. For continuous endpoints it is suggested that the BMD is defined as corresponding to a percentage change in response relative to background or relative to the dynamic range of response. Under such definitions, a 5% or 10% change can be considered as default. Besides how to define the BMD and its lower bound, the BMDL, the question of how to select the dose-response model to be used in the BMD and BMDL determination is highlighted. Issues of study design and comparison of dose-response curves and BMDs are also covered. Copyright (c) 2007 John Wiley & Sons, Ltd.

  6. Effect of multiple honey doses on non-specific acute cough in children. An open randomised study and literature review.

    Science.gov (United States)

    Miceli Sopo, S; Greco, M; Monaco, S; Varrasi, G; Di Lorenzo, G; Simeone, G

    2015-01-01

    Honey is recommended for non-specific acute paediatric cough by the Australian guidelines. Current available randomised clinical trials evaluated the effects of a single evening dose of honey, but multiple doses outcomes have never been studied. To evaluate the effects of wildflower honey, given for three subsequent evenings, on non-specific acute paediatric cough, compared to dextromethorphan (DM) and levodropropizine (LDP), which are the most prescribed over-the-counter (OTC) antitussives in Italy. 134 children suffering from non-specific acute cough were randomised to receive for three subsequent evenings a mixture of milk (90ml) and wildflower honey (10ml) or a dose of DM or LDP adjusted for the specific age. The effectiveness was evaluated by a cough questionnaire answered by parents. Primary end-point efficacy was therapeutic success. The latter was defined as a decrease in cough questionnaire score greater than 50% after treatment compared with baseline values. Three children were excluded from the study, as their parents did not complete the questionnaire. Therapeutic success was achieved by 80% in the honey and milk group and 87% in OTC medication group (p=0.25). Milk and honey mixture seems to be at least as effective as DM or LDP in non-specific acute cough in children. These results are in line with previous studies, which reported the health effects of honey on paediatric cough, even if placebo effect cannot be totally excluded. Copyright © 2014 SEICAP. Published by Elsevier Espana. All rights reserved.

  7. Feasibility assessment of a risk-based approach to technical specifications

    International Nuclear Information System (INIS)

    Atefi, B.; Gallagher, D.W.

    1991-05-01

    To assess the potential use of risk and reliability techniques for improving the effectiveness of the technical specifications to control plant operational risk, the Technical Specifications Branch of the Nuclear Regulatory Commission initiated an effort to identify and evaluate alternative risk-based approaches that could bring greater risk perspective to these requirements. In the first phase four alternative approaches were identified and their characteristics were analyzed. Among these, the risk-based approach to technical specifications is the most promising approach for controlling plant operational risk using technical specifications. The second phase of the study concentrated on detailed characteristics of the real time risk-based approach. It is concluded that a real time risk-based approach to technical specifications has the potential to improve both plant safety and availability. 33 figs., 5 figs., 6 tabs

  8. Estimation of pneumonitis risk in three-dimensional treatment planning using dose-volume histogram analysis

    International Nuclear Information System (INIS)

    Oetzel, Dieter; Schraube, Peter; Hensley, Frank; Sroka-Perez, Gabriele; Menke, Markus; Flentje, Michael

    1995-01-01

    Purpose: Investigations to study correlations between the estimations of biophysical models in three dimensional (3D) treatment planning and clinical observations are scarce. The development of clinically symptomatic pneumonitis in the radiotherapy of thoracic malignomas was chosen to test the predictive power of Lyman's normal tissue complication probability (NTCP) model for the assessment of side effects for nonuniform irradiation. Methods and Materials: In a retrospective analysis individual computed-tomography-based 3D dose distributions of a random sample of (46(20)) patients with lung/esophageal cancer were reconstructed. All patients received tumor doses between 50 and 60 Gy in a conventional treatment schedule. Biological isoeffective dose-volume histograms (DVHs) were used for the calculation of complication probabilities after applying Lyman's and Kutcher's DVH-reduction algorithm. Lung dose statistics were performed for single lung (involved ipsilateral and contralateral) and for the lung as a paired organ. Results: In the lung cancer group, about 20% of the patients (9 out of 46) developed pneumonitis 3-12 (median 7.5) weeks after completion of radiotherapy. For the majority of these lung cancer patients, the involved ipsilateral lung received a much higher dose than the contralateral lung, and the pneumonitis patients had on average a higher lung exposure with a doubling of the predicted complication risk (38% vs. 20%). The lower lung exposure for the esophagus patients resulted in a mean lung dose of 13.2 Gy (lung cancer: 20.5 Gy) averaged over all patients in correlation with an almost zero complication risk and only one observed case of pneumonitis (1 out of 20). To compare the pneumonitis risk estimations with observed complication rates, the patients were ranked into bins of mean ipsilateral lung dose. Particularly, in the bins with the highest patient numbers, a good correlation was achieved. Agreement was not reached for the lung functioning as

  9. Can we avoid dose escalation for intermediate-risk prostate cancer in the setting of short-course neoadjuvant androgen deprivation?

    Directory of Open Access Journals (Sweden)

    Shakespeare TP

    2016-03-01

    Full Text Available Thomas P Shakespeare,1,2 Shea W Wilcox,1 Noel J Aherne1,2 1Department of Radiation Oncology, North Coast Cancer Institute, 2Faculty of Medicine, Rural Clinical School, The University of New South Wales, Coffs Harbour, New South Wales, Australia Background: Both dose-escalated external beam radiotherapy (DE-EBRT and androgen deprivation therapy (ADT improve the outcomes in patients with intermediate-risk prostate cancer. Despite this, there are only few reports evaluating DE-EBRT for patients with intermediate-risk prostate cancer receiving neoadjuvant ADT, and virtually no studies investigating dose escalation >74 Gy in this setting. We aimed to determine whether DE-EBRT >74 Gy improved the outcomes for patients with intermediate-risk prostate cancer who received neoadjuvant ADT. Findings: In our institution, patients with intermediate-risk prostate cancer were treated with neoadjuvant ADT and DE-EBRT, with doses sequentially increasing from 74 Gy to 76 Gy and then to 78 Gy between 2006 and 2012. We identified 435 patients treated with DE-EBRT and ADT, with a median follow-up of 70 months. For the 74 Gy, 76 Gy, and 78 Gy groups, five-year biochemical disease-free survival rates were 95.0%, 97.8%, and 95.3%, respectively; metastasis-free survival rates were 99.1%, 100.0%, and 98.6%, respectively; and prostate cancer-specific survival rate was 100% for all three dose levels. There was no significant benefit for dose escalation either on univariate or multivariate analysis for any outcome. Conclusion: There was no benefit for DE-EBRT >74 Gy in our cohort of intermediate-risk prostate cancer patients treated with neoadjuvant ADT. Given the higher risks of toxicity associated with dose escalation, it may be feasible to omit dose escalation in this group of patients. Randomized studies evaluating dose de-escalation should be considered. Keywords: radiotherapy, IMRT, dose, dose escalation, dose de-escalation, androgen deprivation therapy

  10. Dose-Specific Adverse Drug Reaction Identification in Electronic Patient Records: Temporal Data Mining in an Inpatient Psychiatric Population

    DEFF Research Database (Denmark)

    Eriksson, Robert; Werge, Thomas; Jensen, Lars Juhl

    2014-01-01

    patient-specific adverse events (AEs) and links these to specific drugs and dosages in a temporal manner, based on integration of text mining results and structured data. The structured data contained precise information on drug identity, dosage and strength.When applying the method to the 3,394 patients...... all indication areas.The aim of this study was to take advantage of techniques for temporal data mining of EPRs in order to detect ADRs in a patient- and dose-specific manner.We used a psychiatric hospital’s EPR system to investigate undesired drug effects. Within one workflow the method identified...

  11. Low-dose total skin electron beam therapy for cutaneous lymphoma. Minimal risk of acute toxicities

    Energy Technology Data Exchange (ETDEWEB)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor [University Hospital of Muenster, Department of Radiation Oncology, Muenster (Germany)

    2017-12-15

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T-cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P < 0.001). A lower grade 3 AE rate was also observed in patients who had received the low-dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses. (orig.) [German] Eine niedrigdosierte Ganzhautelektronenbestrahlung (TSEBT) wird vermehrt zur effektiven palliativen Behandlung von Patienten mit primaer kutanen T-Zell-Lymphomen (pCTCL) eingesetzt. In dieser Studie vergleichen wir die Toxizitaetsprofile verschiedener Dosiskonzepte. Untersucht wurden 60 zwischen 2000 und 2016 am Universitaetsklinikum Muenster mittels TSEBT

  12. Estimation of organ doses and risk of cancer associated with CT examination

    International Nuclear Information System (INIS)

    Ahmed, Nagla Nooraldaim

    2017-11-01

    The purpose of this study to estimate the organ closes and risk of cancer associated with CT examinations in Khartoum state, where the study conducted in three hospitals; Alzytouna , royal scan and Royal Care. From April to November 2017, and the data collected from 120 patients, 40 patents from each hospital undergoing CT brain and abdomen examinations. The data were entered to CT - Expo version 2.4 software for calculation the effective dose and organ dose and by Xray risk web site for calculate the risk factor associated with CT examinations. Results have shown the values of effective dose that found 9.73 mSv for all patients and for female and male 9.9 mSv respectively. The effective dose from Brain examinations in three hospitals Alzytouna Royal scan and Royal Care was 16.9 mSv, 3.7 mSv, 3.8 mSv respectively, and from abdomen examinations was 4.2 mSv, 7.6 mSv, 22.2 mSv respectively. Comparing te effective dose from the hospitals, for Ct. Brain in Alzytouna hospital was higher than other hospitals; and for CT Abdomen in Royal Care hospital was higher than other hospitals, but still under the risk levels according to the ICRP report. For organ doses results, the most organs exposed from CT. brain was brain, salivary gland, thyroid gland, Bone marrow, Bone surface, Extra thoracic tissue, Eye lens and oral mucosa received ( 70,2, 66.4,15.04, 10.9, 24.9, 14.8,89.5,65.07) mSv respectively. The most organs exposed from CT. Abdomen were liver, stomach, low, Large intestine, Bladder, Bone surface, upper , Large intestine, spleen, kidney, small intestine and prostate received (16.53, 12.8, 33.43, 41.01,20.5, 38.4, 14.7, 28.9, 37.5,30.5 ) mSv respectively. This study found that te ability of cancer induced i the female was higher from the male; dut to body component of the female. (Author)

  13. IMRT implementation and patient specific dose verification with film and ion chamber array detectors

    International Nuclear Information System (INIS)

    Saminathan, S.; Manickam, R.; Chandraraj, V.; Supe, S. S.; Keshava, S. L.

    2009-01-01

    Implementation of Intensity Modulation Radiotherapy (IMRT) and patient dose verification was carried out with film and I'mariXX using linear accelerator with 120-leaf Millennium dynamic multi leaf collimator (dMLC). The basic mechanical and electrical commissioning and quality assurance tests of linear accelerator were carried out. The leaf position accuracy and leaf position repeatability checks were performed for static MLC positions. Picket fence test and garden fence test were performed to check the stability of the dMLC and the reproducibility of the gap between leaves. The radiation checks were performed to verify the position accuracy of MLCs in the collimator system. The dMLC dosimetric checks like output stability, average leaf transmission and dosimetric leaf separation were also investigated. The variation of output with gravitation at different gantry angles was found to be within 0.9%. The measured average leaf transmission for 6 MV was 1.6% and 1.8% for 18 MV beam. The dosimetric leaf separation was found to be 2.2 mm and 2.3 mm for 6 MV and 18 MV beams. In order to check the consistency of the stability and the precision of the dMLC, it is necessary to carryout regular weekly and monthly checks. The dynalog files analysis for Garden fence, leaf gap width and step wedge test patterns carried out weekly were in good agreement. Pretreatment verification was performed for 50 patients with ion chamber and I'matiXX device. The variations of calculated absolute dose for all treatment fields with the ion chamber measurement were within the acceptable criterion. Treatment Planning System (TPS) calculated dose distribution pattern was comparable with the I'matriXX measured dose distribution pattern. Out of 50 patients for which the comparison was made, 36 patients were agreed with the gamma pixel match of>95% and 14 patients were with the gamma pixel match of 90-95% with the criteria of 3% delta dose (DD) and 3 mm distance-to-agreement (DTA). Commissioning and

  14. Reducing uncertainty in risk assessment by using specific knowledge to replace default options.

    Science.gov (United States)

    McClellan, R O

    1996-01-01

    This paper has advocated the development of specific scientific information, especially information on the mechanisms of action of chemicals, to use in place of default options in assessing human cancer risks. Four examples have been discussed that build largely on information from the CIIT research program. These four examples are worthy of consideration as a group, with a view to developing insights for increasing the effectiveness and efficiency of obtaining such data in the future and, most of all, to increase their acceptance for use instead of default options. In my view, key features of all four examples are that the data are framed within an exposure-dose-response paradigm and that there is a clear linkage to the end point of concern-cancer. As the number of techniques available for making observations at the cellular and molecular levels continues to increase at a rapid pace, linking these observations to the health end points of concern such as cancer is going to be increasingly important, especially in enhancing the value of the observations for risk assessment purposes. Equally as important, the mechanistic observations must be linked to realistic exposures and associated tissue dose that can be related to realistic human exposure scenarios. In my opinion, the likelihood of obtaining information of value for risk assessment purposes using the most sophisticated of molecular and cellular techniques will be of limited value if the exposures or doses are not realistically linked to those likely to be encountered by humans. The mechanism of alpha 2u-globulin nephropathy and its association with kidney tumors in male rats and the conclusion that the male rat kidney tumor findings are not applicable to assessing human cancer risk is an example of a qualitative decision. I suspect this may be a somewhat unusual case. As one looks across the various mammalian species used for experimentation and makes comparisons with humans, a unifying theme is the relative

  15. High-dose anti-histamine use and risk factors in children with urticaria.

    Science.gov (United States)

    Uysal, Pınar; Avcil, Sibelnur; Erge, Duygu

    2016-12-01

    The drugs of choice in the treatment of urticaria in children are H1-antihistamines. The aim of the study was to evaluate children with urticaria and define risk factors for requirement of high-dose H1-antihistamines in children with urticaria. The medical data of children who were diagnosed as having urticaria admitted to our outpatient clinic between January 2014 and January 2016 were searched. The medical histories, concomitant atopic diseases, parental atopy histories, medications, treatment responses, blood eosinophil and basophil counts, and serum total IgE levels were recorded. In addition, the urticaria activity score for seven days, autoimmune antibody tests, and skin prick test results were evaluated in children with chronic urticaria. The numbers of the children with acute and chronic urticaria were 138 and 92, respectively. The age of the children with chronic urticaria was higher than that of those with acute urticaria (p0.05). There was a negative correlation between blood eosinophil count and the UAS7 score in children with chronic urticaria (r=-0.276, p=0.011). Chronic urticaria and requirement of high dose H1-antihistamines were significant in children aged ≥10 years (p<0.001, p=0.015). High UAS7 score (OR: 1.09; CI 95%: [1.03-1.15]) and basopenia (OR: 6.77; CI 95%: [2.01-22.75]) were associated with the requirement of high-dose H1-AH in children with chronic urticaria. The requirement of high-dose H1-antihistamines was higher with children's increasing age. Disease severity and basopenia were risk factors for the requirement of high-dose H1-antihistamines.

  16. Doses and risk estimates to the human conceptus due to internal prenatal exposure to radioactive caesium

    International Nuclear Information System (INIS)

    Kalef-Ezra, J.A.

    1997-01-01

    The 1986 nuclear reactor accident at Chernobyl resulted in widespread internal contamination by radioactive caesium. The aim of the present study was to estimate the doses to embryos/fetus in Greece attributed to maternal 134 Cs and 137 Cs intake and the consequent health risks to their offspring. In pregnant women the concentration of total-body caesium (TBCs) was lower than in age-matched non-pregnant women measured during the same month. A detailed study of intake and retention in the members of one family carried out during the three years that followed the accident indicated that the biological half-time of caesium in the women decreased by a factor of two shortly after conception. Then at partus, there was an increase in the biological half-time, reaching a value similar to that before conception. The total-body potassium concentration was constant over the entire period. Doses to the embryo/fetus due to maternal intake was estimated to be about 150 μGy maximally in those conceived between November 1986 and March 1987. When conception took place later, the prenatal dose followed an exponential reduction with a half-time of about 170 d. These prenatal doses do not exceed the doses from either the natural internal potassium, or from the usual external background sources. The risks attributed to maternal 134 Cs and 137 Cs intake were considerably lower than levels that would justify consideration of termination of a pregnancy. In the absence of these data however, 2500 otherwise wanted pregnancies in Greece were terminated following the Chernobyl accident. (author)

  17. "The Dose Makes the Poison": Informing Consumers About the Scientific Risk Assessment of Food Additives.

    Science.gov (United States)

    Bearth, Angela; Cousin, Marie-Eve; Siegrist, Michael

    2016-01-01

    Intensive risk assessment is required before the approval of food additives. During this process, based on the toxicological principle of "the dose makes the poison,ˮ maximum usage doses are assessed. However, most consumers are not aware of these efforts to ensure the safety of food additives and are therefore sceptical, even though food additives bring certain benefits to consumers. This study investigated the effect of a short video, which explains the scientific risk assessment and regulation of food additives, on consumers' perceptions and acceptance of food additives. The primary goal of this study was to inform consumers and enable them to construct their own risk-benefit assessment and make informed decisions about food additives. The secondary goal was to investigate whether people have different perceptions of food additives of artificial (i.e., aspartame) or natural origin (i.e., steviolglycoside). To attain these research goals, an online experiment was conducted on 185 Swiss consumers. Participants were randomly assigned to either the experimental group, which was shown a video about the scientific risk assessment of food additives, or the control group, which was shown a video about a topic irrelevant to the study. After watching the video, the respondents knew significantly more, expressed more positive thoughts and feelings, had less risk perception, and more acceptance than prior to watching the video. Thus, it appears that informing consumers about complex food safety topics, such as the scientific risk assessment of food additives, is possible, and using a carefully developed information video is a successful strategy for informing consumers. © 2015 Society for Risk Analysis.

  18. Radiation Dose and Subsequent Risk for Stomach Cancer in Long-term Survivors of Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kleinerman, Ruth A., E-mail: kleinerr@mail.nih.gov [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Rockville, Maryland (United States); Smith, Susan A. [Department of Radiation Physics, University of Texas M D Anderson Cancer Center, Houston, Texas (United States); Holowaty, Eric [Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario (Canada); Hall, Per [Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm (Sweden); Pukkala, Eero [Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki (Finland); Vaalavirta, Leila [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Stovall, Marilyn; Weathers, Rita [Department of Radiation Physics, University of Texas M D Anderson Cancer Center, Houston, Texas (United States); Gilbert, Ethel [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Rockville, Maryland (United States); Aleman, Berthe M.P. [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Kaijser, Magnus [Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm (Sweden); Andersson, Michael [Department of Oncology, Copenhagen University Hospital, Copenhagen (Denmark); Storm, Hans [Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen (Denmark); Joensuu, Heikki [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Lynch, Charles F. [Department of Epidemiology, University of Iowa, Iowa City, Iowa (United States); and others

    2013-08-01

    Purpose: To assess the dose–response relationship for stomach cancer after radiation therapy for cervical cancer. Methods and Materials: We conducted a nested, matched case–control study of 201 cases and 378 controls among 53,547 5-year survivors of cervical cancer diagnosed from 1943 to 1995, from 5 international, population-based cancer registries. We estimated individual radiation doses to the site of the stomach cancer for all cases and to corresponding sites for the matched controls (overall mean stomach tumor dose, 2.56 Gy, range 0.03-46.1 and after parallel opposed pelvic fields, 1.63 Gy, range 0.12-6.3). Results: More than 90% of women received radiation therapy, mostly with external beam therapy in combination with brachytherapy. Stomach cancer risk was nonsignificantly increased (odds ratio 1.27-2.28) for women receiving between 0.5 and 4.9 Gy to the stomach cancer site and significantly increased at doses ≥5 Gy (odds ratio 4.20, 95% confidence interval 1.41-13.4, P{sub trend}=.047) compared with nonirradiated women. A highly significant radiation dose–response relationship was evident when analyses were restricted to the 131 cases (251 controls) whose stomach cancer was located in the middle and lower portions of the stomach (P{sub trend}=.003), whereas there was no indication of increasing risk with increasing dose for 30 cases (57 controls) whose cancer was located in the upper stomach (P{sub trend}=.23). Conclusions: Our findings show for the first time a significant linear dose–response relationship for risk of stomach cancer in long-term survivors of cervical cancer.

  19. Radiation Dose and Subsequent Risk for Stomach Cancer in Long-term Survivors of Cervical Cancer

    International Nuclear Information System (INIS)

    Kleinerman, Ruth A.; Smith, Susan A.; Holowaty, Eric; Hall, Per; Pukkala, Eero; Vaalavirta, Leila; Stovall, Marilyn; Weathers, Rita; Gilbert, Ethel; Aleman, Berthe M.P.; Kaijser, Magnus; Andersson, Michael; Storm, Hans; Joensuu, Heikki; Lynch, Charles F.

    2013-01-01

    Purpose: To assess the dose–response relationship for stomach cancer after radiation therapy for cervical cancer. Methods and Materials: We conducted a nested, matched case–control study of 201 cases and 378 controls among 53,547 5-year survivors of cervical cancer diagnosed from 1943 to 1995, from 5 international, population-based cancer registries. We estimated individual radiation doses to the site of the stomach cancer for all cases and to corresponding sites for the matched controls (overall mean stomach tumor dose, 2.56 Gy, range 0.03-46.1 and after parallel opposed pelvic fields, 1.63 Gy, range 0.12-6.3). Results: More than 90% of women received radiation therapy, mostly with external beam therapy in combination with brachytherapy. Stomach cancer risk was nonsignificantly increased (odds ratio 1.27-2.28) for women receiving between 0.5 and 4.9 Gy to the stomach cancer site and significantly increased at doses ≥5 Gy (odds ratio 4.20, 95% confidence interval 1.41-13.4, P trend =.047) compared with nonirradiated women. A highly significant radiation dose–response relationship was evident when analyses were restricted to the 131 cases (251 controls) whose stomach cancer was located in the middle and lower portions of the stomach (P trend =.003), whereas there was no indication of increasing risk with increasing dose for 30 cases (57 controls) whose cancer was located in the upper stomach (P trend =.23). Conclusions: Our findings show for the first time a significant linear dose–response relationship for risk of stomach cancer in long-term survivors of cervical cancer

  20. Physicians' knowledge about radiation dose and possible risks of common medical tests: a survey in Iran

    International Nuclear Information System (INIS)

    Zakeri, Farideh; Mianji, Fereidoun; Shakeri, Mahsa; Rajabpour, Mohammad Reza; Farshidpour, Mohammad Reza

    2016-01-01

    Recent data suggest that knowledge of radiation exposures among physicians is inadequate. This study, therefore, aimed to evaluate their knowledge of the radiation doses their patients received and awareness of associated biological risks of radiation exposure. A questionnaire in multiple-choice format consisted of four sections with a total of 10 questions based on the literature review. A total of 136 questionnaires were returned from 69 general practitioners and 67 physicians in various specialties from 10 different hospitals in the capital city of Tehran, Iran. Fifty-four percent of general practitioners and twenty-five percent of specialties declared that they are not aware of biological risks of radiation exposure. Fifty-six percent of physicians did not know the correct definition of absorbed dose. Only 33% of physicians knew the dose exposure of a chest X-ray and only 31% knew the approximate doses of various procedures relative to a chest X-ray. Forty-seven percent of physicians incorrectly distinguished the stochastic effects of radiation from the deterministic effects, and thirty-eight of physicians did not know the organs of the body that are most sensitive to ionizing radiation. Only 23.5% of physicians were aware of the one in 2000 risk of induction of fatal carcinoma from computed tomography of the abdomen. Seventy-nine percent of physicians incorrectly underestimated the contribution of nuclear and radiological tests in exposure of an average person. The mean score of the specialties trended toward being more accurate than general practitioners (4.18 ± 1.28 vs. 3.89 ± 1.46, respectively, from a potential accurate total score of 9), but these differences were not statistically significant. Among specialists, orthopedics had the highest scores. The present study demonstrated the limited knowledge of radiation exposures among general practitioners and specialists and a need to improve their knowledge by means of targeted training and re

  1. Dose conformity of gamma knife radiosurgery and risk factors for complications

    International Nuclear Information System (INIS)

    Nakamura, Jean L.; Verhey, Lynn J.; Smith, Vernon; Petti, Paula L.; Lamborn, Kathleen R.; Larson, David A.; Wara, William M.; McDermott, Michael W.; Sneed, Penny K.

    2001-01-01

    Purpose: To quantitatively evaluate dose conformity achieved using Gamma Knife radiosurgery, compare results with those reported in the literature, and evaluate risk factors for complications. Methods and Materials: All lesions treated at our institution with Gamma Knife radiosurgery from May 1993 (when volume criteria were routinely recorded) through December 1998 were reviewed. Lesions were excluded from analysis for reasons listed below. Conformity index (the ratio of prescription volume to target volume) was calculated for all evaluable lesions and for lesions comparable to those reported in the literature on conformity of linac radiosurgery. Univariate Cox regression models were used to test for associations between treatment parameters and toxicity. Results: Of 1612 targets treated in 874 patients, 274 were excluded, most commonly for unavailability of individual prescription volume data because two or more lesions were included within the same dose matrix (176 lesions), intentional partial coverage for staged treatment of large arteriovenous malformations (AVMs) (33 lesions), and missing target volume data (26 lesions). The median conformity indices were 1.67 for all 1338 evaluable lesions and 1.40-1.43 for lesions comparable to two linac radiosurgery series that reported conformity indices of 1.8 and 2.7, respectively. Among all 651 patients evaluable for complications, there were one Grade 5, eight Grade 4, and 27 Grade 3 complications. Increased risk of toxicity was associated with larger target volume, maximum lesion diameter, prescription volume, or volume of nontarget tissue within the prescription volume. Conclusions: Gamma Knife radiosurgery achieves much more conformal dose distributions than those reported for conventional linac radiosurgery and somewhat more conformal dose distributions than sophisticated linac radiosurgery techniques. Larger target, nontarget, or prescription volumes are associated with increased risk of toxicity

  2. Maternal age-specific risk of non-chromosomal anomalies

    NARCIS (Netherlands)

    Loane, M.; Dolk, H.; Morris, Joan K.

    To determine the excess risk of non-chromosomal congenital anomaly (NCA) among teenage mothers and older mothers. Population-based prevalence study using data from EUROCAT congenital anomaly registers in 23 regions of Europe in 15 countries, covering a total of 1.75 million births from 2000 to 2004.

  3. Maternal age-specific risk of non-chromosomal anomalies

    DEFF Research Database (Denmark)

    Loane, M; Dolk, H; Morris, J K

    2009-01-01

    OBJECTIVES: To determine the excess risk of non-chromosomal congenital anomaly (NCA) among teenage mothers and older mothers. DESIGN AND SETTING: Population-based prevalence study using data from EUROCAT congenital anomaly registers in 23 regions of Europe in 15 countries, covering a total of 1.7...

  4. Measuring time and risk preferences: Reliability, stability, domain specificity

    NARCIS (Netherlands)

    Wölbert, E.M.; Riedl, A.M.

    2013-01-01

    To accurately predict behavior economists need reliable measures of individual time preferences and attitudes toward risk and typically need to assume stability of these characteristics over time and across decision domains. We test the reliability of two choice tasks for eliciting discount rates,

  5. Polycystic ovary syndrome: cardiovascular risk factors according to specific phenotypes.

    Science.gov (United States)

    Aziz, Mubeena; Sidelmann, Johannes J; Faber, Jens; Wissing, Marie-Louise M; Naver, Klara V; Mikkelsen, Anne-Lis; Nilas, Lisbeth; Skouby, Sven O

    2015-10-01

    Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance. The objective of this cross-sectional study was to investigate the impact of insulin resistance and body mass index (BMI) on inflammatory and hemostatic variables associated with long-term risk of cardiovascular disease in women with PCOS. 149 premenopausal women with PCOS were recruited consecutively from April 2010 to February 2012 at three Danish University Hospitals. The study was conducted at the Department of Gynecology and Obstetrics, Herlev University Hospital, Denmark. PCOS was diagnosed in accordance with the Rotterdam criteria and the women were classified into four phenotypes according to BMI and insulin resistance measured by the homeostasis model assessment of insulin resistance index. Body composition was determined by dual-energy X-ray absorptiometry. Main outcome measures were the biomarkers C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and von Willebrand factor antigen. Normal weight insulin-resistant PCOS women were characterized by abdominal obesity and elevated levels of plasma PAI-1. Overweight/obese insulin-resistant PCOS women had increased levels of both PAI-1 and CRP. Of the three Rotterdam criteria, only hyperandrogenemia was significantly associated with the hemostatic risk marker of long-term cardiovascular disease risk. Surrogate risk markers for cardiovascular disease are elevated in women with PCOS, especially insulin-resistant and overweight/obese women. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  6. Effects of long-term low dose radiation. Epstein-Barr virus-specific antibodies in radiological technologists

    Energy Technology Data Exchange (ETDEWEB)

    Kumagai, Etsuko; Higashida, Yoshiharu; Onomichi, Mitsukazu; Nakamura, Ikuo; Tanoue, Shozo; Tanaka, Ryuji; Kumagai, Takashi; Katsuki, Takato; Sawada, Shozo.

    1988-09-01

    To clarify the long-term effects of occupational exposure to low doses of radiation, Epstein-Barr virus (EBV)-specific antibody titers in sera from 104 radiological technologists (R.T.) and 118 controls in Kumamoto prefecture were measured by the immunofluorescence method. Antibody titers to viral capsid antigen (VCA)-IgG increased with the years of experience as R.T., and the prevalence of abnormal antibody titers to both VCA-IgG and early antigen (EA)-IgG were significantly higher in R.T. with over 15 years of experience or 30 rads of cumulative radiation dose than in the controls. However, there was no correlation between exposure and the frequency of abnormal EBV-associated nuclear antigen (EBNA) antibody titers. The EBV-specific antibody titers of 24 Hiroshima atomic-bomb survivors were also measured. They were similar to those of the R.T. with over 30 years of experience. The EBV-specific antibody titers of R.T. suggest that there may be an impairment of immunologic competence after continuous long-term exposure to low doses of radiation. Also, the correlation of EBV-specific antibody titers and frequency of cells with chromosome aberrations in 53 R.T. was studied. Some correlations were found between the antibody titers to both of the VCA-IgG and EBNA and the frequency of cells with chromosome aberrations.

  7. Experimental study on active specific immunotherapy utilizing the immune reaction of low-dose irradiated tumor tissue, 9

    International Nuclear Information System (INIS)

    Ogawa, Yasuhiro; Maeda, Tomoho; Yoshida, Shoji

    1983-01-01

    We have already reported the remarkable effect of an active specific immunotherapy using cryopreserved tumor cells and infiltrating mononuclear cells prepared from a low-dose irradiated tumor tissue after cytoreductive radiotherapy. In the present study, the effect of a biological response modifier, OK-432 combined with the active specific immunotherapy was investigated. Twelve-week-aged female C3H/He mice transplanted with MM 46 tumor cells were received local radiotherapy with a dose of 3,000 rads by high energy electron beams on the fifth day after inoculation. The tumor cells and infiltrating mononuclear cells cryopreserved for two months were thawed and treated with mitomycin-C at concentration of 20 μg/10 7 cells at 37 0 C for 30 min. Then, these cells were injected subcutaneously into the left hind paws as a mitomycin C-treated, cryopreserved active specific immunotherapy on the thirteenth day, and daily dose of 1 KE of OK-432 was injected intraperitoneally from the sixth to the tenth days. The inhibition of the tumor growth was similarly observed in the group which received this active specific immunotherapy combined with a biological response modifier, OK-432. (author)

  8. Image quality and dose differences caused by vendor-specific image processing of neonatal radiographs.

    Science.gov (United States)

    Sensakovic, William F; O'Dell, M Cody; Letter, Haley; Kohler, Nathan; Rop, Baiywo; Cook, Jane; Logsdon, Gregory; Varich, Laura

    2016-10-01

    Image processing plays an important role in optimizing image quality and radiation dose in projection radiography. Unfortunately commercial algorithms are black boxes that are often left at or near vendor default settings rather than being optimized. We hypothesize that different commercial image-processing systems, when left at or near default settings, create significant differences in image quality. We further hypothesize that image-quality differences can be exploited to produce images of equivalent quality but lower radiation dose. We used a portable radiography system to acquire images on a neonatal chest phantom and recorded the entrance surface air kerma (ESAK). We applied two image-processing systems (Optima XR220amx, by GE Healthcare, Waukesha, WI; and MUSICA(2) by Agfa HealthCare, Mortsel, Belgium) to the images. Seven observers (attending pediatric radiologists and radiology residents) independently assessed image quality using two methods: rating and matching. Image-quality ratings were independently assessed by each observer on a 10-point scale. Matching consisted of each observer matching GE-processed images and Agfa-processed images with equivalent image quality. A total of 210 rating tasks and 42 matching tasks were performed and effective dose was estimated. Median Agfa-processed image-quality ratings were higher than GE-processed ratings. Non-diagnostic ratings were seen over a wider range of doses for GE-processed images than for Agfa-processed images. During matching tasks, observers matched image quality between GE-processed images and Agfa-processed images acquired at a lower effective dose (11 ± 9 μSv; P < 0.0001). Image-processing methods significantly impact perceived image quality. These image-quality differences can be exploited to alter protocols and produce images of equivalent image quality but lower doses. Those purchasing projection radiography systems or third-party image-processing software should be aware that image

  9. Optimal density assignment to 2D diode array detector for different dose calculation algorithms in patient specific VMAT QA

    International Nuclear Information System (INIS)

    Park, So Yeon; Park, Jong Min; Choi, Chang Heon; Chun, MinSoo; Han, Ji Hye; Cho, Jin Dong; Kim, Jung In

    2017-01-01

    The purpose of this study is to assign an appropriate density to virtual phantom for 2D diode array detector with different dose calculation algorithms to guarantee the accuracy of patient-specific QA. Ten VMAT plans with 6 MV photon beam and ten VMAT plans with 15 MV photon beam were selected retrospectively. The computed tomography (CT) images of MapCHECK2 with MapPHAN were acquired to design the virtual phantom images. For all plans, dose distributions were calculated for the virtual phantoms with four different materials by AAA and AXB algorithms. The four materials were polystyrene, 455 HU, Jursinic phantom, and PVC. Passing rates for several gamma criteria were calculated by comparing the measured dose distribution with calculated dose distributions of four materials. For validation of AXB modeling in clinic, the mean percentages of agreement in the cases of dose difference criteria of 1.0% and 2.0% for 6 MV were 97.2%±2.3%, and 99.4%±1.1%, respectively while those for 15 MV were 98.5%±0.85% and 99.8%±0.2%, respectively. In the case of 2%/2 mm, all mean passing rates were more than 96.0% and 97.2% for 6 MV and 15 MV, respectively, regardless of the virtual phantoms of different materials and dose calculation algorithms. The passing rates in all criteria slightly increased for AXB as well as AAA when using 455 HU rather than polystyrene. The virtual phantom which had a 455 HU values showed high passing rates for all gamma criteria. To guarantee the accuracy of patent-specific VMAT QA, each institution should fine-tune the mass density or HU values of this device

  10. Optimal density assignment to 2D diode array detector for different dose calculation algorithms in patient specific VMAT QA

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Yeon; Park, Jong Min; Choi, Chang Heon; Chun, MinSoo; Han, Ji Hye; Cho, Jin Dong; Kim, Jung In [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2017-03-15

    The purpose of this study is to assign an appropriate density to virtual phantom for 2D diode array detector with different dose calculation algorithms to guarantee the accuracy of patient-specific QA. Ten VMAT plans with 6 MV photon beam and ten VMAT plans with 15 MV photon beam were selected retrospectively. The computed tomography (CT) images of MapCHECK2 with MapPHAN were acquired to design the virtual phantom images. For all plans, dose distributions were calculated for the virtual phantoms with four different materials by AAA and AXB algorithms. The four materials were polystyrene, 455 HU, Jursinic phantom, and PVC. Passing rates for several gamma criteria were calculated by comparing the measured dose distribution with calculated dose distributions of four materials. For validation of AXB modeling in clinic, the mean percentages of agreement in the cases of dose difference criteria of 1.0% and 2.0% for 6 MV were 97.2%±2.3%, and 99.4%±1.1%, respectively while those for 15 MV were 98.5%±0.85% and 99.8%±0.2%, respectively. In the case of 2%/2 mm, all mean passing rates were more than 96.0% and 97.2% for 6 MV and 15 MV, respectively, regardless of the virtual phantoms of different materials and dose calculation algorithms. The passing rates in all criteria slightly increased for AXB as well as AAA when using 455 HU rather than polystyrene. The virtual phantom which had a 455 HU values showed high passing rates for all gamma criteria. To guarantee the accuracy of patent-specific VMAT QA, each institution should fine-tune the mass density or HU values of this device.

  11. Fast patient-specific Monte Carlo brachytherapy dose calculations via the correlated sampling variance reduction technique

    Energy Technology Data Exchange (ETDEWEB)

    Sampson, Andrew; Le Yi; Williamson, Jeffrey F. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)

    2012-02-15

    Purpose: To demonstrate potential of correlated sampling Monte Carlo (CMC) simulation to improve the calculation efficiency for permanent seed brachytherapy (PSB) implants without loss of accuracy. Methods: CMC was implemented within an in-house MC code family (PTRAN) and used to compute 3D dose distributions for two patient cases: a clinical PSB postimplant prostate CT imaging study and a simulated post lumpectomy breast PSB implant planned on a screening dedicated breast cone-beam CT patient exam. CMC tallies the dose difference, {Delta}D, between highly correlated histories in homogeneous and heterogeneous geometries. The heterogeneous geometry histories were derived from photon collisions sampled in a geometrically identical but purely homogeneous medium geometry, by altering their particle weights to correct for bias. The prostate case consisted of 78 Model-6711 {sup 125}I seeds. The breast case consisted of 87 Model-200 {sup 103}Pd seeds embedded around a simulated lumpectomy cavity. Systematic and random errors in CMC were unfolded using low-uncertainty uncorrelated MC (UMC) as the benchmark. CMC efficiency gains, relative to UMC, were computed for all voxels, and the mean was classified in regions that received minimum doses greater than 20%, 50%, and 90% of D{sub 90}, as well as for various anatomical regions. Results: Systematic errors in CMC relative to UMC were less than 0.6% for 99% of the voxels and 0.04% for 100% of the voxels for the prostate and breast cases, respectively. For a 1 x 1 x 1 mm{sup 3} dose grid, efficiency gains were realized in all structures with 38.1- and 59.8-fold average gains within the prostate and breast clinical target volumes (CTVs), respectively. Greater than 99% of the voxels within the prostate and breast CTVs experienced an efficiency gain. Additionally, it was shown that efficiency losses were confined to low dose regions while the largest gains were located where little difference exists between the homogeneous and

  12. SU-F-I-12: Region-Specific Dictionary Learning for Low-Dose X-Ray CT Reconstruction

    International Nuclear Information System (INIS)

    Xu, Q; Han, H; Xing, L

    2016-01-01

    Purpose: Dictionary learning based method has attracted more and more attentions in low-dose CT due to the superior performance on suppressing noise and preserving structural details. Considering the structures and noise vary from region to region in one imaging object, we propose a region-specific dictionary learning method to improve the low-dose CT reconstruction. Methods: A set of normal-dose images was used for dictionary learning. Segmentations were performed on these images, so that the training patch sets corresponding to different regions can be extracted out. After that, region-specific dictionaries were learned from these training sets. For the low-dose CT reconstruction, a conventional reconstruction, such as filtered back-projection (FBP), was performed firstly, and then segmentation was followed to segment the image into different regions. Sparsity constraints of each region based on its dictionary were used as regularization terms. The regularization parameters were selected adaptively according to different regions. A low-dose human thorax dataset was used to evaluate the proposed method. The single dictionary based method was performed for comparison. Results: Since the lung region is very different from the other part of thorax, two dictionaries corresponding to lung region and the rest part of thorax respectively were learned to better express the structural details and avoid artifacts. With only one dictionary some artifact appeared in the body region caused by the spot atoms corresponding to the structures in the lung region. And also some structure in the lung regions cannot be recovered well by only one dictionary. The quantitative indices of the result by the proposed method were also improved a little compared to the single dictionary based method. Conclusion: Region-specific dictionary can make the dictionary more adaptive to different region characteristics, which is much desirable for enhancing the performance of dictionary learning

  13. SU-F-I-12: Region-Specific Dictionary Learning for Low-Dose X-Ray CT Reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Q; Han, H; Xing, L [Stanford University School of Medicine, Stanford, CA (United States)

    2016-06-15

    Purpose: Dictionary learning based method has attracted more and more attentions in low-dose CT due to the superior performance on suppressing noise and preserving structural details. Considering the structures and noise vary from region to region in one imaging object, we propose a region-specific dictionary learning method to improve the low-dose CT reconstruction. Methods: A set of normal-dose images was used for dictionary learning. Segmentations were performed on these images, so that the training patch sets corresponding to different regions can be extracted out. After that, region-specific dictionaries were learned from these training sets. For the low-dose CT reconstruction, a conventional reconstruction, such as filtered back-projection (FBP), was performed firstly, and then segmentation was followed to segment the image into different regions. Sparsity constraints of each region based on its dictionary were used as regularization terms. The regularization parameters were selected adaptively according to different regions. A low-dose human thorax dataset was used to evaluate the proposed method. The single dictionary based method was performed for comparison. Results: Since the lung region is very different from the other part of thorax, two dictionaries corresponding to lung region and the rest part of thorax respectively were learned to better express the structural details and avoid artifacts. With only one dictionary some artifact appeared in the body region caused by the spot atoms corresponding to the structures in the lung region. And also some structure in the lung regions cannot be recovered well by only one dictionary. The quantitative indices of the result by the proposed method were also improved a little compared to the single dictionary based method. Conclusion: Region-specific dictionary can make the dictionary more adaptive to different region characteristics, which is much desirable for enhancing the performance of dictionary learning

  14. NIRS methods of specifying carbon ion dose verification of RBE and tumour specific radiosensitivity

    International Nuclear Information System (INIS)

    Matsufuji, Naruhiro; Kanai, Tatsuaki; Kanematsu, Nobuyuki

    2006-01-01

    Clinical dose distribution of therapeutic carbon beams, currently used at National Institute of Radiological Sciences (NIRS) Heavy Ion Medical Accelerator in Chiba (HIMAC), is designed based on in-vitro Human Salivary Gland (HSG) cell survival response and clinical experiences of fast neutron radiotherapy. At first, the biological dose distribution is designed so as to cause a flat biological effect on HSG cells in spread-out Bragg peak (SOBP) region. Then, the entire biological dose distribution is evenly raised in order to attain relative biological effectiveness (RBE)=3.0 at a depth where dose-averaged linear energy transfer (LET) is 80 keV/μm. A retrospective analysis was made to examine appropriateness on the estimation of the biological effectiveness of carbon-ion radiotherapy using resultant data of clinical trials at HIMAC. Using this RBE system, over 2,700 patients have been treated by carbon beams. As a part of these patient data, local control rate of non-small lung cancer, were analysed to verify the clinical RBE of the carbon beam. The local control rate was compared with those for published by groups of Gunma University and Massachusetts General Hospital. Using a simplified tumour control probability (TCP) model, clinical RBE values were obtained for different level of the tumour control probability. For the 50% level of the clinical TCP, the RBE values nearly coincide with those of in-vitro human salivary gland cell survival at 10%. For the higher level of the clinical TCP, the RBE values approach closer to those adapted in clinical trials at HIMAC. The approach was also applied for those of chordoma, bone and soft tissue sarcoma and rectal cancer. Difference in radiosensitivity is observed for the tumours. (author)

  15. Developing patient-specific dose protocols for a CT scanner and exam using diagnostic reference levels

    International Nuclear Information System (INIS)

    Strauss, Keith J.

    2014-01-01

    The management of image quality and radiation dose during pediatric CT scanning is dependent on how well one manages the radiographic techniques as a function of the type of exam, type of CT scanner, and patient size. The CT scanner's display of expected CT dose index volume (CTDI vol ) after the projection scan provides the operator with a powerful tool prior to the patient scan to identify and manage appropriate CT techniques, provided the department has established appropriate diagnostic reference levels (DRLs). This paper provides a step-by-step process that allows the development of DRLs as a function of type of exam, of actual patient size and of the individual radiation output of each CT scanner in a department. Abdomen, pelvis, thorax and head scans are addressed. Patient sizes from newborns to large adults are discussed. The method addresses every CT scanner regardless of vendor, model or vintage. We cover adjustments to techniques to manage the impact of iterative reconstruction and provide a method to handle all available voltages other than 120 kV. This level of management of CT techniques is necessary to properly monitor radiation dose and image quality during pediatric CT scans. (orig.)

  16. Organ-specific radiation-induced cancer risk estimates due to radiotherapy for benign pigmented villonodular synovitis

    Science.gov (United States)

    Mazonakis, Michalis; Tzedakis, Antonis; Lyraraki, Efrossyni; Damilakis, John

    2016-09-01

    Pigmented villonodular synovitis (PVNS) is a benign disease affecting synovial membranes of young and middle-aged adults. The aggressive treatment of this disorder often involves external-beam irradiation. This study was motivated by the lack of data relating to the radiation exposure of healthy tissues and radiotherapy-induced cancer risk. Monte Carlo methodology was employed to simulate a patient’s irradiation for PVNS in the knee and hip joints with a 6 MV photon beam. The average radiation dose received by twenty-two out-of-field critical organs of the human body was calculated. These calculations were combined with the appropriate organ-, age- and gender-specific risk coefficients of the BEIR-VII model to estimate the lifetime probability of cancer development. The risk for carcinogenesis to colon, which was partly included in the treatment fields used for hip irradiation, was determined with a non-linear mechanistic model and differential dose-volume histograms obtained by CT-based 3D radiotherapy planning. Risk assessments were compared with the nominal lifetime intrinsic risk (LIR) values. Knee irradiation to 36 Gy resulted in out-of-field organ doses of 0.2-24.6 mGy. The corresponding range from hip radiotherapy was 1.2-455.1 mGy whereas the organ equivalent dose for the colon was up to 654.9 mGy. The organ-specific cancer risks from knee irradiation for PVNS were found to be inconsequential since they were at least 161.5 times lower than the LIRs irrespective of the patient’s age and gender. The bladder and colon cancer risk from radiotherapy in the hip joint was up to 3.2 and 6.6 times smaller than the LIR, respectively. These cancer risks may slightly elevate the nominal incidence rates and they should not be ignored during the patient’s treatment planning and follow-up. The probabilities for developing any other solid tumor were more than 20 times lower than the LIRs and, therefore, they may be considered as small.

  17. Rat skin carcinogenesis as a basis for estimating risks at low doses and dose rates of various types of radiation

    International Nuclear Information System (INIS)

    Burns, F.J.; Vanderlaan, M.; Strickland, P.; Albert, R.E.

    1976-01-01

    The recovery rate, age dependence and latent period for tumor induction in rat skin were measured for single and split doses of radiation, and the data were analyzed in terms of a general model in an attempt to estimate the expected tumor response for various types of radiation given at low dose rates for long periods of time. The dorsal skin of male rats was exposed to electrons, x rays, or protons in either single or split doses for several doses and the tumor responses were compared during 80 weeks of observation. A two stage model incorporating a reversible or recoverable mode was developed and various parameters in the model, including recovery rate, dose-response coefficients, and indices of age sensitivity, were evaluated experimentally. The measured parameters were then utilized to calculate expected tumor responses for exposure periods extending for duration of life. The calculations indicated that low dose rates could be markedly ( 1 / 100 to 1 / 1000 ) less effective in producing tumors than the same dose given in a short or acute exposure, although the magnitude of the reduction in effectiveness declines as the dose declines

  18. Experimental study on active specific immunotherapy utilizing the immune reaction of low-dose irradiated tumor tissue, 8

    International Nuclear Information System (INIS)

    Imanaka, Kazufumi; Gose, Kyuhei; Ichiyanagi, Akihiro

    1983-01-01

    The effectiveness of active specific immunotherapy prepared from a low-dose irradiated tumor tissue has already reported. The present study was designed to investigate the effect of Mitomycin C-treated active specific immunotherapy. Twelve-week-aged female C3H/He mice transplanted with MM 46 tumors were exposed to local electron radiotherapy with a dose of 3,000 rad on the 5th day after tumor inoculation. Tumor cells prepared for active specific immunotherapy were pretreated with Mitomycin C at concentration of 20 μg/10 7 cells in Eagle MEM Earle containing 100 IU/ml penicillin. The cell suspension was incubated at 37 0 C for 15 minutes. Mitomycin C-treated active specific immunotherapy was performed on the 12th day. Antitumor effect was evaluated by the regression of the tumor and survival curve. The remarkable regression of the tumor and significant elongation of the survival period were observed in the group which received Mitomycin C-treated active specific immunotherapy and the group which received active specific immunotherapy without the treatment of Mitomycin C. (author)

  19. Causes of Mortality After Dose-Escalated Radiation Therapy and Androgen Deprivation for High-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Tendulkar, Rahul D.; Hunter, Grant K.; Reddy, Chandana A.; Stephans, Kevin L.; Ciezki, Jay P.; Abdel-Wahab, May; Stephenson, Andrew J.; Klein, Eric A.; Mahadevan, Arul; Kupelian, Patrick A.

    2013-01-01

    Purpose: Men with high-risk prostate cancer have other competing causes of mortality; however, current risk stratification schema do not account for comorbidities. We aim to identify the causes of death and factors predictive for mortality in this population. Methods and Materials: A total of 660 patients with high-risk prostate cancer were treated with definitive high-dose external beam radiation therapy (≥74 Gy) and androgen deprivation (AD) between 1996 and 2009 at a single institution. Cox proportional hazards regression analysis was conducted to determine factors predictive of survival. Results: The median radiation dose was 78 Gy, median duration of AD was 6 months, and median follow-up was 74 months. The 10-year overall survival (OS) was 60.6%. Prostate cancer was the leading single cause of death, with 10-year mortality of 14.1% (95% CI 10.7-17.6), compared with other cancers (8.4%, 95% CI 5.7-11.1), cardiovascular disease (7.3%, 95% CI 4.7-9.9), and all other causes (10.4%, 95% CI 7.2-13.6). On multivariate analysis, older age (HR 1.55, P=.002) and Charlson comorbidity index score (CS) ≥1 (HR 2.20, P<.0001) were significant factors predictive of OS, whereas Gleason score, T stage, prostate-specific antigen, duration of AD, radiation dose, smoking history, and body mass index were not. Men younger than 70 years of age with CS = 0 were more likely to die of prostate cancer than any other cause, whereas older men or those with CS ≥1 more commonly suffered non-prostate cancer death. The cumulative incidences of prostate cancer-specific mortality were similar regardless of age or comorbidities (P=.60). Conclusions: Men with high-risk prostate cancer are more likely to die of causes other than prostate cancer, except for the subgroup of men younger than 70 years of age without comorbidities. Only older age and presence of comorbidities significantly predicted for OS, whereas prostate cancer- and treatment-related factors did not

  20. Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors

    DEFF Research Database (Denmark)

    van Eggermond, Anna M; Schaapveld, Michael; Janus, Cécile Pm

    2017-01-01

    incidence ratios (SIR) was 2.4-fold increased (95% confidence interval (95%CI) 1.8-3.2), leading to 5.7 excess cases per 10 000 patient-years. Risk was still increased 30 years after HL treatment (SIR: 2.8; 95%CI: 1.6-4.6). The highest (SIR: 6.5, 95%CI: 3.3-11.3) was seen for transverse colon cancer (15......BACKGROUND: Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. METHODS...... a hazard ratio of 6.8 (95%CI: 3.0-15.6) compared with patients receiving neither treatment, which is significantly higher than an additive joint effect (Padditivity=0.004). CONCLUSIONS: Colorectal cancer surveillance should be considered for HL survivors who received Infradiaphragmatic radiotherapy...

  1. Organ doses, effective doses, and risk indices in adult CT: Comparison of four types of reference phantoms across different examination protocols

    International Nuclear Information System (INIS)

    Zhang Yakun; Li Xiang; Paul Segars, W.; Samei, Ehsan

    2012-01-01

    Purpose: Radiation exposure from computed tomography (CT) to the public has increased the concern among radiation protection professionals. Being able to accurately assess the radiation dose patients receive during CT procedures is a crucial step in the management of CT dose. Currently, various computational anthropomorphic phantoms are used to assess radiation dose by different research groups. It is desirable to better understand how the dose results are affected by different choices of phantoms. In this study, the authors assessed the uncertainties in CT dose and risk estimation associated with different types of computational phantoms for a selected group of representative CT protocols. Methods: Routinely used CT examinations were categorized into ten body and three neurological examination categories. Organ doses, effective doses, risk indices, and conversion coefficients to effective dose and risk index (k and q factors, respectively) were estimated for these examinations for a clinical CT system (LightSpeed VCT, GE Healthcare). Four methods were used, each employing a different type of reference phantoms. The first and second methods employed a Monte Carlo program previously developed and validated in our laboratory. In the first method, the reference male and female extended cardiac-torso (XCAT) phantoms were used, which were initially created from the Visible Human data and later adjusted to match organ masses defined in ICRP publication 89. In the second method, the reference male and female phantoms described in ICRP publication 110 were used, which were initially developed from tomographic data of two patients and later modified to match ICRP 89 organ masses. The third method employed a commercial dosimetry spreadsheet (ImPACT group, London, England) with its own hermaphrodite stylized phantom. In the fourth method, another widely used dosimetry spreadsheet (CT-Expo, Medizinische Hochschule, Hannover, Germany) was employed together with its associated

  2. Organ doses, effective doses, and risk indices in adult CT: Comparison of four types of reference phantoms across different examination protocols

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Yakun; Li Xiang; Paul Segars, W.; Samei, Ehsan [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke University, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States) and Department of Radiology, Duke University, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University, Durham, North Carolina 27705 (United States) and Departments of Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University, Durham, North Carolina 27705 (United States)

    2012-06-15

    Purpose: Radiation exposure from computed tomography (CT) to the public has increased the concern among radiation protection professionals. Being able to accurately assess the radiation dose patients receive during CT procedures is a crucial step in the management of CT dose. Currently, various computational anthropomorphic phantoms are used to assess radiation dose by different research groups. It is desirable to better understand how the dose results are affected by different choices of phantoms. In this study, the authors assessed the uncertainties in CT dose and risk estimation associated with different types of computational phantoms for a selected group of representative CT protocols. Methods: Routinely used CT examinations were categorized into ten body and three neurological examination categories. Organ doses, effective doses, risk indices, and conversion coefficients to effective dose and risk index (k and q factors, respectively) were estimated for these examinations for a clinical CT system (LightSpeed VCT, GE Healthcare). Four methods were used, each employing a different type of reference phantoms. The first and second methods employed a Monte Carlo program previously developed and validated in our laboratory. In the first method, the reference male and female extended cardiac-torso (XCAT) phantoms were used, which were initially created from the Visible Human data and later adjusted to match organ masses defined in ICRP publication 89. In the second method, the reference male and female phantoms described in ICRP publication 110 were used, which were initially developed from tomographic data of two patients and later modified to match ICRP 89 organ masses. The third method employed a commercial dosimetry spreadsheet (ImPACT group, London, England) with its own hermaphrodite stylized phantom. In the fourth method, another widely used dosimetry spreadsheet (CT-Expo, Medizinische Hochschule, Hannover, Germany) was employed together with its associated

  3. Dose-stochastic radiobiological effect relationship in model of two reactions and estimation of radiation risk

    International Nuclear Information System (INIS)

    Komochkov, M.M.

    1997-01-01

    The model of dose-stochastic effect relationship for biological systems capable of self-defence under danger factor effect is developed. A defence system is realized in two forms of organism reaction, which determine innate μ n and adaptive μ a radiosensitivities. The significances of μ n are determined by host (inner) factors; and the significances of μ a , by external factors. The possibilities of adaptive reaction are determined by the coefficient of capabilities of the defence system. The formulas of the dose-effect relationship are the solutions of differential equations of assumed process in the defence system of organism. The model and formulas have been checked both at cell and at human levels. Based on the model and personal monitoring data, the estimation of radiation risk at the Joint Institute for Nuclear Research is done

  4. Polycystic ovary syndrome: Cardiovascular risk factors according to specific phenotypes

    DEFF Research Database (Denmark)

    Aziz, Mubeena; Sidelmann, Johannes Jakobsen; Faber, Jens

    2015-01-01

    INTRODUCTION: Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance. The objective of this cross-sectional study was to investigate the impact of insulin resistance and body mass index (BMI) on inflammatory and hemostatic variables associated with long-term risk...... of cardiovascular disease in women with PCOS. MATERIAL AND METHODS: 149 premenopausal women with PCOS were recruited consecutively from April 2010 to February 2012 at three Danish University Hospitals. The study was conducted at the Department of Gynecology and Obstetrics, Herlev University Hospital, Denmark. PCOS...

  5. The risk of childhood cancer from low doses of ionizing radiation received in utero

    International Nuclear Information System (INIS)

    Wakeford, R.; Doll, R.; Bithell, J.F.

    1997-01-01

    Radiological protection is based upon the assumption that any additional exposure to ionising radiation leads to an increased risk of stochastic adverse health effects. The validity of this assumption is supported by the epidemiological association between childhood cancer and X-ray exposure of the fetus in utero for diagnostic purposes. Evidence for a direct causal interpretation of this association is compelling: the association has high statistical significance, it is consistent across many case-control studies carried out worldwide, and an appropriate dose-response relationship is indicated. Evidence against bias and confounding as alternative explanations is strong. Nonetheless, objections to causality have been raised. Four grounds for controversy are examined in detail, with the conclusion that they do not provide persuasive evidence against a cause and effect relationship. We conclude that acute doses of the order of 10 mGy received by the fetus in utero cause a subsequent increase in the risk of cancer in childhood, and that, in these circumstances, the excess absolute risk coefficient for childhood cancer incidence is 6-12% per Gy. (author)