Search Results (42)

Background: Computed Tomography (CT) imaging is widely recognised for its high capability in assessing multiple organs. However, concerns about patient radiation exposure, particularly in children, pose significant challenges. Objective: This study aimed to establish diagnostic reference levels (DRLs) for paediatric patients in the most common CT examinations to monitor and better control radiation doses. Methods: Dosimetry records from 5956 patients’ scans for the four most common CT imaging examinations—Head, Chest, Abdomen Pelvis (AP), and Chest Abdomen Pelvis (CAP)—were considered. The CT dosimetric quantities (CT dose-index volume (CTDI_vol) and dose-length product (DLP)), along with patient demographics (age and weight), were collected from radiology data storage systems. DRLs for CTDI_vol and DLP were determined for each imaging examination, stratified by patient age and weight groups, in accordance with ICRP recommendations. Results: The derived DRLs are presented as [median CTDI_vol (mGy): median DLP (mGy·cm)]. For (<1 yr): Head: 13:187, Chest: 0.4:7, AP: 0.9:19, CAP: 0.4:10. For (1–5 yrs): Head: 16:276, Chest: 1:22, AP: 1.5:58, CAP: 1.6:63. For (6–10 yrs): Head: 19:332, Chest: 1.4:35, AP: 1.9:74, CAP: 2:121. For (11–15 yrs): Head: 21:391, Chest: 3:86, AP: 4.1:191, CAP: 3:165. We observed that both the CTDI_vol and DLP DRL values increase with patient age. Weight-based DRLs follow similar trends for CTDI_vol, while DLP values show noticeable variations in Chest and AP examinations. Conclusions: The study findings highlight the need for review and optimisation of certain scanning protocols, particularly for chest and AP examinations. The derived DRLs are consistent with findings from other studies. The study recommends establishing national paediatric DRLs to enhance radiology practice across the country and ensure adherence to international safety standards. Full article

Prostate cancer is the second leading cause of cancer-related death in men, with metastatic castration-resistant prostate cancer (mCRPC) and bone metastases representing a critical clinical challenge. Although radium-223 (Ra-223) is approved for treating mCRPC with bone metastases, its efficacy remains limited, necessitating the development of more effective therapies. This study investigates the therapeutic potential of ¹⁷⁷Lu-PSMA-617, a PSMA-targeted radiopharmaceutical, in a murine model of prostate cancer bone metastases. To our knowledge, this is the first study to systematically evaluate ¹⁷⁷Lu-PSMA-617 in an orthotopic bone metastatic prostate cancer model, providing a clinically relevant preclinical platform to assess both imaging and therapeutic performance. We conducted comprehensive preclinical evaluations, including synthesis, stability analysis, cell binding assays, nuclear imaging, in vivo biodistribution, pharmacokinetics, and antitumor efficacy. The synthesis of ¹⁷⁷Lu-PSMA-617 demonstrated high radiochemical yield (99.2%), molar activity (25.5 GBq/μmol), and purity (>98%), indicating high product quality. Stability studies confirmed minimal release of free Lutetium-177, maintaining the compound’s integrity under physiological conditions. In vitro assays showed selective binding and internalization in PSMA-positive LNCaP prostate cancer cells, with negligible uptake in PSMA-negative PC-3 cells. In vivo biodistribution studies demonstrated efficient tumor targeting, with peak uptake in LNCaP tumors (23.31 ± 0.94 %IA/g) at 4 h post-injection. The radiopharmaceutical exhibited favorable pharmacokinetics, with high tumor-to-background ratios (tumor-to-blood, 434.4; tumor-to-muscle, 857.4). Therapeutic efficacy was confirmed by significant survival extension in treated mice (30.7% for 37 MBq and 53.8% for 111 MBq), with median survival times of 34 and 40 days, respectively, compared to 26 days in the control group. Radiation dosimetry analysis indicated a favorable safety profile with a calculated effective dose of 0.127 mSv/MBq. These findings highlight the novelty and translational relevance of using ¹⁷⁷Lu-PSMA-617 in a clinically relevant bone metastasis model, reinforcing its potential as a dual-purpose agent for both targeted therapy and molecular imaging in advanced prostate cancer. Full article

This study presents a comprehensive dosimetric characterization and commissioning of a grid-type collimator manufactured via 3D printing using PLA-W composite filament, following an international protocol for small-field dosimetry. PLA doped with high concentrations of tungsten (>90% w/w) enables the fabrication of miniaturized collimators (<1 cm) with complex geometries, suitable for non-conventional radiotherapy applications. However, accurate assessment of spatial dose modulation is challenged by penumbra overlap between closely spaced beamlets, limiting the application of conventional instrumentation and protocols. To address this, absolute and relative dose distributions were evaluated for various radiation field configurations (number of beamlets) in both lateral and depth directions. Measurements were performed according to the IAEA TRS-483 protocol, using micro-ionization chambers and diode detectors. Additionally, long-term stability assessments were carried out to evaluate both the structural integrity and modulation performance of the printed grid over time. Point dose measurements using the same detectors were repeated after one year, and 2D surface dose distributions measured with EBT3 films were compared to SRS MapCHECK measurements two years later. The generated radiation field size of the central beamlet (FWHM) differed by less than 0.2% (15.8 mm) from the physical projection size (15.6 mm) and the lateral transmission due simultaneous beamlets resulted in FWHM variations of less than 3.8%, confirming manufacturing precision and collimator capability. Output factor measurements increased with the number of beamlets, from 0.75 for a single beamlet to 0.82 for the full beamlets configuration. No significant changes were observed in the depth of maximum dose across the different beamlets configurations (1.20 ± 0.20 cm). On the other hand, the long-term evaluations show no relevant changes in the FWHM or VPR, confirming the performance and reliability of the system. These results support the clinical feasibility and lasting performance stability of in-house manufactured grid collimators using PLA-W filaments and accessible 3D printing technology. Full article

Postmastectomy radiation therapy (PMRT) is an adjuvant treatment for breast cancer. Some mastectomized women undergoing PMRT can have breast reconstruction with expander implant reconstruction. However, the expander implant contains a magnetic metal port for its inflation, and in patients with a high risk of recurrence, the PMRT is performed before the expander replacement. The difficulties in radiation treatment near high-Z metals are mainly due to dose alterations around them. Therefore, this study proposes using a realistic breast phantom and gel dosimetry to investigate the effects of the metallic parts of the expandable prosthesis on the 3D delivery of the treatment. A conformal radiation treatment was planned and delivered to the gel phantom with the metal port. MAGIC-f gel was used with magnetic resonance imaging for dose assessment. The treatment plan dose distribution was compared to the measured dose distribution by gamma analysis (3%/3 mm/15% threshold). A significant gamma fail region was found near the metal port, corresponding to a dose reduction of approximately 5%. This underdose is within the tolerance threshold for dose heterogeneity established by the International Commission on Radiation Units (ICRU), but should be considered when treating these patients. Full article

In Internal Radiotherapy, radiopharmaceutical dosimetry provides an accurate estimation of absorbed radiation doses to organs at risk and tumours. In this paper Velocity Theranostics (Varian Medical Systems), is investigated. Its performances are compared to OLINDA 2.0 in both an anthropomorphic phantom and a group of patients. Velocity Theranostics was evaluated with a cohort of patients (15) treated with ¹⁷⁷Lu radiolabelled peptides. The absorbed doses were calculated for the liver, spleen and kidneys, separately with OLINDA 2.0 and Velocity Theranostics using the same set of images. To reduce the contribution of Time-integrated activities (TIAs) on the results and to merely compare the dose calculation algorithms, the OLINDA 2.0 absorbed doses were calculated using the TIA values calculated in Velocity Theranostics. The absorbed doses from Velocity Theranostics were found to be correlated with the doses from OLINDA 2.0 with the TIAs from Theranostics (Lin’s coefficient = 0.894 and R² = 0.9531). Absorbed doses from Velocity Theranostics are reliable at least as reliable as those for OLINDA 2.0, with many advantages regarding accuracy of calculations and robustness. In conclusion, the personalisation of dosimetry may be totally fulfilled by computational systems for absorbed dose in internal radiotherapy, equipped with a complete workflow and borrowed from external radiotherapy. Full article

The calculation of effective doses is crucial in many medical and radiation fields in order to ensure safety and compliance with regulatory limits. Traditionally, Monte Carlo codes using detailed human body computational phantoms have been used for such calculations. Monte Carlo dose calculations can be time-consuming and require expertise in different processes when building the computational phantom and dose calculations. This study employs various machine learning (ML) algorithms to predict the organ doses and effective dose conversion coefficients (DCCs) from different anthropomorphic phantoms. A comprehensive data set comprising neutron energy bins, organ labels, masses, and densities is compiled from Monte Carlo studies, and it is used to train and evaluate the supervised ML models. This study includes a broad range of phantoms, including those from the International Commission on Radiation Protection (ICRP-110, ICRP-116 phantom), the Visible-Human Project (VIP-man phantom), and the Medical Internal Radiation Dose Committee (MIRD-Phantom), with row data prepared using numerical data and organ categorical labeled data. Extreme gradient boosting (XGB), gradient boosting (GB), and the random forest-based Extra Trees regressor are employed to assess the performance of the ML models against published ICRP neutron DCC values using the mean square error, mean absolute error, and R² metrics. The results demonstrate that the ML predictions significantly vary in lower energy ranges and vary less in higher neutron energy ranges while showing good agreement with ICRP values at mid-range energies. Moreover, the categorical data models align closely with the reference doses, suggesting the potential of ML in predicting effective doses for custom phantoms based on regional populations, such as the Saudi voxel-based model. This study paves the way for efficient dose prediction using ML, particularly in scenarios requiring rapid results without extensive computational resources or expertise. The findings also indicate potential improvements in data representation and the inclusion of larger data sets to refine model accuracy and prevent overfitting. Thus, ML methods can serve as valuable techniques for the continued development of personalized dosimetry. Full article

Background: Multimodality is required for the treatment of breast cancer. Surgery, radiation (RT), and systemic therapy were traditionally used. Pharmacotherapy includes different drug mechanisms, such as chemotherapy, hormone therapy, and targeted therapies, alone or in combination with radiotherapy. While radiation offers numerous benefits, it also has certain harmful risks. such as cardiac and pulmonary toxicity, lymphedema, and secondary cancer. Modern radiation techniques have been developed to reduce organs at risk (OAR) doses. Materials and Methods: This study is a prospective feasibility trial conducted at the Fayium Oncology Center on patients with left breast cancer receiving adjuvant locoregional radiotherapy after either breast conservative surgery (BCS) or modified radical mastectomy (MRM). This study aimed to assess the proportion of patients who are fit both physically and intellectually to undergo breast radiotherapy using the deep inspiratory breath-holding (DIBH) technique, comparing different dosimetric outcomes between the 3D dimensional conformal with DIBH and 4D-CT IMRT plans of the same patient. Results: D95 of the clinical target volume (CTV) of the target is significantly higher in the 3D DIBH plan than in the IMRT plan, with an average of 90.812% vs. 86.944%. The dosimetry of the mean heart dose (MHD) in the 4D-CT IMRT plan was significantly lower than in the 3D conformal with the DIBH plan (2.6224 vs. 4.056 Gy, p < 0.0064), and no significant difference between the two plans regarding mean left anterior descending artery (LAD) (14.696 vs. 13.492 Gy, p < 0.58), maximum LAD (39.9 vs. 43.5 Gy, p < 0.35), and V20 of the ipsilateral lung (18.66% vs. 16.306%, p < 0.88) was observed. Internal mammary chain (IMC) irradiation was better in the 4D-CT IMRT plan. Conclusions: Radiotherapy of the breast and chest wall with the 4D-CT IMRT technique appears not to be inferior to the 3D conformal with the DIBH technique and can be used as an alternative to the 3D conformal with the DIBH technique in patients meeting the exclusion criteria for performing the DIBH maneuver concerning coverage to target volumes or unacceptably high doses to OAR. Full article

P-cadherin is associated with a wide range of tumor types, making it an attractive therapeutic target. FF-21101 is a human–mouse chimeric monoclonal antibody (mAb) directed against human P-cadherin, which has been radioconjugated with indium-111 (¹¹¹In) utilizing a DOTA chelator. We investigated the biodistribution of FF-21101(¹¹¹In) in cynomolgus macaques and extrapolated the results to estimate internal radiation doses of ¹¹¹In- and yttrium-90 (⁹⁰Y)-FF-21101 for targeted radioimmunotherapy in humans. Whole-body planar and SPECT imaging were performed at 0, 2, 24, 48, 72, 96, and 120 h post-injection, using a dual-head gamma camera. Volumes of interest of identifiable source organs of radioactivity were defined on aligned reference CT and serial SPECT images. Organs with the highest estimated dose values (mSv/MBq) for FF-21101(¹¹¹In) were the lungs (0.840), spleen (0.816), liver (0.751), kidneys (0.629), and heart wall (0.451); and for FF-21101(⁹⁰Y) dose values were: lungs (10.49), spleen (8.21), kidneys (5.92), liver (5.46), and heart wall (2.61). FF-21101(¹¹¹In) exhibits favorable biodistribution in cynomolgus macaques and estimated human dosimetric characteristics. Data obtained in this study were used to support the filing of an investigational new drug application with the FDA for a Phase I clinical trial. Full article

In oncology, tremendous research has been conducted on the use of alternative minimally invasive techniques for cancer treatment and diagnosis. The use of biophotonic techniques as a standalone treatment or together with conventional imaging techniques has gained interest among researchers in recent years, while biophotonic therapies such as photothermal and photodynamic therapies tend to bring the use of non-ionizing radiation in therapy back into the spotlight due to the progressive development of optical instrumentation, enhancement agents, molecular probes, light sources and nanocarriers. Thus, the coupling of non-ionizing with ionizing radiation (IR) and the combination of nanomedicine with nuclear medicine procedures are considered to be revolutionary strategies to optimize the therapeutic efficacy of biophotonic modalities and to develop theranostic applications for the better diagnosis and treatment of cancer. Recently, the low-intensity Cerenkov light emitted by tissues as a byproduct of the IR–biostructure interaction has been suggested as an effective internal light source that can trigger phototherapy and guide radiotherapy dosimetry using Cerenkov imaging. This review also provides an overview of in vitro and in vivo studies regarding the use of Cerenkov radiation produced by X-rays or radionucleotides and combined with nanoparticles as a hybrid method to induce enhanced photothermal and photodynamic therapies. Full article

(1) Background: The IVIscan is a commercially available scintillating fiber detector designed for quality assurance and in vivo dosimetry in computed tomography (CT). In this work, we investigated the performance of the IVIscan scintillator and associated method in a wide range of beam width from three CT manufacturers and compared it to a CT chamber designed for Computed Tomography Dose Index (CTDI) measurements. (2) Methods: We measured weighted CTDI (CTDIw) with each detector in accordance with the requirements of regulatory tests and international recommendations for the minimum, maximum and the most used beam width in clinic and investigated the accuracy of the IVIscan system based on the assessment of the CTDIw deviation from the CT chamber. We also investigated the IVIscan accuracy for the whole range of the CT scans kV. (3) Results: We found excellent agreement between the IVIscan scintillator and the CT chamber for the whole range of beam widths and kV, especially for wide beams used on recent technology of CT scans. (4) Conclusions: These findings highlight that the IVIscan scintillator is a relevant detector for CT radiation dose assessments, and the method associated with calculating the CTDIw saves a significant amount of time and effort when performing tests, especially with regard to new CT technologies. Full article

A comparative investigation of amino acids (proline, cysteine, and alanine) as dosimetric materials using electron paramagnetic resonance (EPR) spectroscopy in the absorbed dosage range of 1–25 kGy is presented. There were no signals in the EPR spectra of the samples before irradiation. After irradiation, the complex spectra were recorded. These results showed that the investigated amino acids were sensitive to radiation. In the EPR spectrum of cysteine after irradiation, RS• radicals dominated. The effects of the microwave power on the saturation of the EPR signals showed the presence of at least three different types of free radicals in proline. It was also found out that the DL-proline and cysteine had stable free radicals after irradiation and represented a linear dosage response up to 10 kGy. On the other hand, the amino acid alanine has been accepted by the International Atomic Energy Agency as a transfer standard dosimetry system. In view of this, the obtained results of the proline and cysteine studies have been compared with those of the alanine studies. The results showed that the amino acids proline and cysteine could be used as alternative dosimetric materials in lieu of alanine in a dosage range of 1–10 kGy of an absorbed dose of γ-rays using EPR spectroscopy. Regarding the radiation sensitivity, the following order of decreased dosage responses was determined: alanine > DL-proline > cysteine > L-proline. Full article

In 2011, the International Commission on Radiological Protection (ICRP) recommended a significant reduction in the lens-equivalent radiation dose limit, thus from an average of 150 to 20 mSv/year over 5 years. In recent years, the occupational dose has been rising with the increased sophistication of interventional radiology (IVR); management of IVR staff radiation doses has become more important, making real-time radiation monitoring of such staff desirable. Recently, the i3 real-time occupational exposure monitoring system (based on RaySafe^TM) has replaced the conventional i2 system. Here, we compared the i2 and i3 systems in terms of sensitivity (batch uniformity), tube-voltage dependency, dose linearity, dose-rate dependency, and angle dependency. The sensitivity difference (batch uniformity) was approximately 5%, and the tube-voltage dependency was <±20% between 50 and 110 kV. Dose linearity was good (R² = 1.00); a slight dose-rate dependency (~20%) was evident at very high dose rates (250 mGy/h). The i3 dosimeter showed better performance for the lower radiation detection limit compared with the i2 system. The horizontal and vertical angle dependencies of i3 were superior to those of i2. Thus, i3 sensitivity was higher over a wider angle range compared with i2, aiding the measurement of scattered radiation. Unlike the i2 sensor, the influence of backscattered radiation (i.e., radiation from an angle of 180°) was negligible. Therefore, the i3 system may be more appropriate in areas affected by backscatter. In the future, i3 will facilitate real-time dosimetry and dose management during IVR and other applications. Full article

The goal of this study is to introduce an implantable haptic feedback device that allows a user to obtain better interactions and feedback from various sensory modules. A thorough analysis of the design of the sensor is provided in this work. The implantable nature increases the user’s ability to integrate the vibrations into a more natural sense over time. Conscious training associating the vibrations with their meaning and the natural neuroplastic capacity of the brain will allow a user to have an intuitive and integrated understanding of the linked device. By using a standardized external battery module, design constraints surrounding internal power storage are avoided and present an opportunity for modular sensor packages. Current applications include blood glucose monitoring, radiation dosimetry, and pseudo-echolocation using an array of implants. Full article

This study addressed an important but not yet thoroughly investigated topic regarding human exposure to radio-frequency electromagnetic fields (RF-EMF) generated by vehicular connectivity. In particular, the study assessed, by means of computational dosimetry, the RF-EMF exposure in road users near a car equipped with vehicle-to-vehicle (V2V) communication antennas. The exposure scenario consisted of a 3D numerical model of a car with two V2V antennas, each fed with 1 W, operating at 5.9 GHz and an adult human model to simulate the road user near the car. The RF-EMF dose absorbed by the human model was calculated as the specific absorption rate (SAR), that is, the RF-EMF power absorbed per unit of mass. The highest SAR was observed in the skin of the head (34.7 mW/kg) and in the eyes (15 mW/kg); the SAR at the torso (including the genitals) and limbs was negligible or much lower than in the head and eyes. The SAR over the whole body was 0.19 mW/kg. The SAR was always well below the limits of human exposure in the 100 kHz–6 GHz band established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). The proposed approach can be generalized to assess RF-EMF exposure in different conditions by varying the montage/number of V2V antennas and considering human models of different ages. Full article

Neutrons constitute a significant component of the secondary cosmic rays and are one of the most important contributors to natural cosmic ray radiation background dose. The study of the cosmic ray neutrons’ contribution to the dose equivalent received by humans is an interesting and challenging task for the scientific community. In addition, international regulations demand assessing the biological risk due to radiation exposure for both workers and the general population. Because the dose rate due to cosmic radiation increases significantly with altitude, the objective of this work was to characterize the thermoluminescent dosimeter (TLDs) from the perspective of exposing them at high altitudes for longtime neutron dose monitoring. The pair of TLD-700 and TLD-600 is amply used to obtain the information on gamma and neutron dose in mixed neutron-gamma fields due to the present difference in 6Li isotope concentration. A thermoluminescence dosimeter system based on pair of TLD-600/700 was characterized to enable it for neutron dosimetry in the thermal energy range. The system was calibrated in terms of neutron ambient dose equivalent in an experimental setup using a 241Am-B radionuclide neutron source coated by a moderator material, polyethylene, creating a thermalized neutron field. Afterward, the pair of TLD-600/700 was exposed at the CERN-EU High-Energy Reference Field (CERF) facility in Geneva, which delivers a neutron field with a spectrum similar to that of secondary cosmic rays. The dosimetric system provided a dose value comparable with the calculated one demonstrating a good performance for neutron dosimetry. Full article