International Journal of Radiation Research
Volume:20 Issue: 4, Oct 2022

Radiation-induced brain injury (RIBI) is a common complication in patients with head and neck tumors. RIBI usually occurs six months to three years after therapy and is often accompanied by cognitive dysfunction, epilepsy, and other neurological dysfunctions. In severe cases, RIBI can cause a wide range of cerebral edema and herniation. A systematic search was conducted through PubMed/Medline, EMBASE, and Cochrane library databases and articles with the keywords radiation-induced brain injury, pathogenesis and protective agents were collected. The commonly known pathogenesis of RIBI includes vascular injury, immune-inflammatory response, glial cell damage, and neuronal damage. Therapeutic agents, hyperbaric oxygen, surgery, and stem cells transplantation are the most common treatment for RIBI. Tamoxifen, curcumin, and quercetin can prevent glial cell activation, proliferation, and oxidative stress caused by irradiation. Over recent years, the RIBI remission rate has gradually increased; however, there are still no effective prevention and treatment methods. This review summarized recent progress in the treatment for RIBI, as well as the pathogenesis of RIBI, including vascular injury, glial cell injury, immune-inflammatory response, and neuronal damage.

To investigate whether features of 5-mm peritumoral regions could significantly improve the predictive efficacy of a radiomics model based on solid pulmonary tumors at distinguishing lung adenocarcinoma(LAC) from granuloma(GR).

We retrospectively evaluated 167 lung tumors pathologically proven to be LAC (96) or GR (71) and divided them into training group (116) and testing (51) group. We delineated each tumor with three different measures using the tumor and its 5-mm peritumoral region. Then, we extracted 465 features from each volume of interest(VOI) and chose the optimal features to build the diagnostic models. We built four different models using different methods. Finally, we compared the performance of the four models in the test set.

The area under the curve(AUC) of each model in the test group was 0.765 (95% confidence interval(CI): 0.620–0.909), 0.797 (95%CI: 0.670–0.924), and 0.784 (95%CI: 0.647–0.920), respectively. Results of the DeLong test showed that the differences between model 2, model 3, and model 1 were not significant. Results of net reclassification improvement(NRI) showed that model 2 and model 3 had better differential diagnostic efficacy than model 1, with accuracies(ACCs) of 0.784, 0.745, and 0.686, respectively, but the differences were not significant (P>0.05). Moreover, the nomogram had good diagnostic and predictive abilities, with an AUC of 0.848 (95%CI: 0.736–0.961) and an ACC of 0.804.

Features of 5-mm peritumoral regions improved the predictive ability of the radiomics model based on the solid pulmonary tumor, but the difference was not significant.

There is an increase in pediatric Computed Tomography (CT) imaging with advancement in technology but CT radiation dose produces significant adverse effects. The objective of this experimental phantom study is to develop an age-based low-dose pediatric CT head protocol.

Polymethyl methacrylate (PMMA) pediatric head mimicking phantom scanning was performed on a CT scanner using various combinations of tube voltage (kV) and product of tube current and exposure time (mAs) setting. Images were reconstructed by iterative reconstruction iDose4 level 1-5.  Quantitative assessment of image quality (IQ) was done by calculating Signal to Noise Ratio (SNR), Contrast to Noise Ratio (CNR), and Image Noise (IN). Radiation dose indices (RDI) were measured by recording Volumetric CT Dose Index (CTDIv) and Dose length product (DLP). Figure of Merit (FOM) was calculated to study overall effects between IQ and RDI. IQ and RDI obtained using different exposure settings were compared.

Optimized age-based low-dose protocols were developed based on IQ analysis and RDI. For pediatric CT head, with age less than one year kV and mAs of 80 and 150 and for one–five years age kV and mAs of 100 and 200 with iDose4 level-3 was found to be optimum low dose protocol.

The experimental phantom study concluded that with use of low kVp and mAs, radiation dose was reduced to 62% for less than 1-year age group and 51% for 1-5 year age group and also with use of iterative reconstruction technique iDose4 level-3 diagnostic image quality was maintained.

Electromagnetic fields may primarily affect cognitive functions. It has not been elucidated how electromagnetic radiation affects the brain, particularly in the young age group. We aimed to examine the cognitive function, expression of N-methyl-D-aspartate receptors (NMDA), and EEG alterations in weaned rats exposed to a 2.45 GHz electromagnetic field.

Twenty-one weaned (21 days old) male Wistar Albino rats were divided into two groups as experimental group (n=12) and control group (n=9). Animals in the experimental group were exposed to a 2.45 GHz electromagnetic field for one hour a day for more than 28 days. At the end of this period, rats were subjected to training and learning test using Morris Water Maze. After obtaining EEG records, hippocampi were removed. 2A and 2B subunits of NMDA receptors were studied in hippocampal homogenates using the Western Blot method.

There were no statistically significant differences between the two groups in measures of latency to target quadrant, time spent in the target quadrant, and average swim speed as compared in Morris water maze. However, the time to arrive at the visible platform was significantly longer in experimental animals. There were no statistically significant differences in expression of 2A and 2B subunits of NMDA receptors between the two groups. Evaluation of EEG records revealed that spike frequency was significantly higher and time to first spike was significantly shorter in the experimental group.

These results indicated that a 2.45 GHz electromagnetic field might negatively affect EEG, motivation, and attention, particularly in the young age group.

Breast cancer (BC) is a global threat to women’s health. Volumetric intensity modulated arc therapy (VMAT) is effective for the local control of BC. This study evaluated the pulmonary and cardiac radiotherapeutic dosage to provide information for estimating normal tissue complication probability (NTCP) once malignant tumors appear in patients’ left and right breasts.

We conducted a retrospective analysis of VMAT regimen of 40 patients with BC, among whom 20 patients (group 1) were diagnosed with right BC and 20 patients (group 2) with left BC. The pulmonary and cardiac dose volume histogram (DVH) parameters were acquired and compared between patients with left and right BC treated with VMAT.

Generally, the pulmonary and cardiac dosages in patients with right BC were larger than in those with left BC. For the lung, the V20 and V5 of right BC patients were significantly higher, relative to the left BC patients (P<0.05). For the heart, the V5 and V10 of right BC patients were significantly lower, compared to left BC patients, with differences of up to 20% and 10%, respectively (both P<0.05). V20, V30, and V40 as low as zero were observed for right BC patients.

When treating left BC, image guidance and respiratory management techniques should be applied to limit radiotherapy complications that occur in the heart because of patient positioning and respiratory movement.

Radiograph of hand and wrist has been widely used in children's bone age assessment (BAA). However, ionizing radiation may be harmful for children in the future. Therefore, alternative methods have been attempted for the evaluation of children's bone age. Here, we reported an automated volume scanner (AVS) in assessing the biological age of children in comparison with X-ray radiograph as the gold standard.

Total 22 children (13 male and 9 female) with short stature or precocious puberty were enrolled into this study. Their chronological age ranged from 4 to 14 years old. The children's left hand-wrist was scanned with the AVS by putting them into a water sink containing tape water. Coronal images of the left hand-wrist were reconstructed and compared with X-ray images.

The number of patients whose hand-wrist bones (except for the first metacarpal sesamoid bone and the secondary ossification center of the first metacarpal bone) identified by AVS image was not significantly different from that by X-ray image. In addition, the total number of observed bones in each patient were not significantly different between the two methods. The concordance rate (percentage of patients whose hand-wrist bone presented in both AVS image and X-ray image) was high and the inter-observer variance of BA was small.

The AVS method was highly correlated with the standard radiograph for children's bone age assessment with small inter-observer variability. This novel AVS method could be an alternative method in clinical practice for bone age assessment with higher safety and reliability.

Reports of natural radioactivity measurements from the environmentally sensitive regions of Papua New Guinea are few and far between. Radiological impacts owing to exposure to radionuclides which are naturally occurring from gold-mine regions in the Wau-Bulolo district of Morobe province in Papua New Guinea were appraised. Experimental locations were selected along the Bulolo River and its tributaries.

Ambient gamma levels were measured from the locations directly using a digital gamma dosimeter and the resulting indoor and outdoor annual effective doses were estimated. Measurements in the locations along with two control points each were made for the dose assessments. Selected radionuclides other than primordial were assessed in the samples of surface soil collected from sampling sites and control points. Gamma ray spectroscopy was used to estimate the activity levels of radionuclides in the soil samples collected from the sampling and control areas.

Presence of selected radionuclides were found in the soil samples along the river flowing through the mining area. All the samples analyzed showed very low activity levels thus having negligible effect on the background radiation level and human health.

This study was designed to evaluate the matching percentage among findings of the ultrasound scans (USS) to the magnetic resonance imaging (MRI) in women with fibroids.

This descriptive, retrospective study was conducted from January 2016 to December 2018. This study includes 205 female patients referred from the Gynaecological Department to the Radiological Department in the Bahrain Defense Force Hospital for MRI and USS for fibroid evaluation. The data collected included their age, parity, and nationality. The StatsDirect software was used to analyze the fibroids according to the site, size, type, and number.

The findings of USS matched the MRI in the posterior fibroid sites in 52.5% of cases, followed by anterior (38.1%) and fundal (21.8%). For fibroid size, USS matched MRI findings in 83.3% for fibroids between >5 to ≤10 cm, 78.3% for fibroids between >2 to ≤5 cm, and 36.8% for fibroids sized ≤2 cm. Fibroids more than 10 cm in size were in agreement for 33.33% of fibroids. Submucosal fibroids matched in just 29.4% of cases, but for the subserosal fibroids, it was 44.8%. The matching score for more than four fibroids was 61.8%, followed by single fibroids (54.8%) and two fibroids (34.8%).

Results of USS and MRI were reasonably correlated in terms of fibroid location and size. USS diagnosis of posterior wall and fibroids of size less than 2 cm highly matched MRI diagnosis.

Although radioiodine-131 (131I) has been widely used for the treatment of Graves' disease (GD), radiation is a potential risk factor for mutagenic abnormalities. This retrospective clinical study mainly aimed to investigate the influence of maternal exposure to 131I used for the treatment of GD prior to pregnancy on chromosomal aberration and intellectual development of offspring in China.

In total, 69 children whose mothers received 131I for the treatment of GD during childbearing age were included. Data on the obstetric history, medical records, and the birth characteristics of the children were obtained. The thyroid function, thyroid ultrasound, chromosomal structure, and somatic and intellectual development of the children were measured.

In all 66 women, the range of the administered 131I was within 228.2 ± 70.3 MBq. The height and weight of all children were within the normal ranges, and one child was confirmed as having subclinical hypothyroidism. Two children were diagnosed with benign thyroid nodules, one child was diagnosed with thyroid cysts, and one child was confirmed as having several anechoic areas in both lobes of the thyroid gland. Chromosomal aberration was observed in one child. None of the children showed any abnormalities in somatic and/or intellectual development.

This is the first study to confirm that 131I used for the treatment of GD prior to pregnancy does not significantly increase the risk of chromosomal aberration or impair the intellectual development of offspring.

Our aims were to prepare microspheres labelled with radioactive astatine as brachytherapy seeds and to confirm the antitumor ability of these microspheres.

Chitosan-collagen composite microspheres (CCMs) were synthesized through an emulsification crosslink reaction and radiolabelled with 211At using the chloramine-T method. Radiation stability was assessed in both phosphate-buffered saline and blood serum. The in vivo distribution and therapeutic effects were evaluated in BALB/c nude mice with implanted tumours.

CCMs showed ideal morphological characteristics (diameter of 7.5-15 μm) and acceptable radiation stability (73.99% in PBS and 72.56% in serum after 16 hours). The in vivo biodistribution analysis demonstrated that 211At-CCMs were highly localized in tumour tissue. The therapeutic efficacy of 211At-CCMs when intratumorally injected into a cervical tumour model was assessed. Fourteen days after a single-dose treatment with 211At-CCMs, significantly retarded tumour volume growth was observed.

211At-CCM brachytherapy has the potential to provide an alternative solution for tumour treatment.

This study targeted to conclude the effect of cherry juice and fractionated dose γ-irradiation on the fertility of elderly rats.

Male and female rats were assigned to five groups: young adult control, old adult control, old adult irradiated using 137Cs, source (0.3 Gy*3), old adult cherry juice and cherry irradiated group. Cherry juice was administered orally at the dose 5ml/kg b.w. Follicle stimulating hormone (FSH), estradiol (E2), 8-hydroxy-2-deoxyguanosine (8-OHdG), and insulin-Like Growth Factor 1 (IGF-1) were estimated in the serum of female rats. Serum testosterone (T), FSH, and testicular steroidogenic acute regulatory (STAR) gene expression were evaluated in male rats. Metallothionine (MT), malondialdehyde (MDA) and glutathione (GSH) were estimated in the uterus and testes.

Co-treatments of old adult male and female rats with cherry juice and fractionated doses of γ-irradiation developed a significant decrease in MDA in uterus and testes, parallel with an increase in the level of uterus MT and testes GSH as compared with young rats. A significant increase in the levels of female E2, IGF-1, and male T along with a decrease in FSH in both sexes was observed. Additionally, STAR gene expression in male was up regulated.

Fractionated dose of gamma radiation (0.3 Gy*3) has no effect on tested reproductive hormones, while Cherry juice stimulates the secretion of E2, and T, and elevates GSH. Tart cherry juice can improve reproductive ability, especially for those undergoing radiotherapy Thus, cherry juice may be a potential candidate to ameliorate the effect of aging on reproductive ability.

The main purpose of the present study was to evaluate the safety and efficiency of concurrent administration of hydroxychloroquine (HCQ) and whole brain radiation therapy (WBRT) in patients with brain metastases. Based on numerous preclinical reports, inhibition of autophagy by HCQ can significantly enhance the efficacy of DNA-damaging therapies improving results of radiation therapy. The primary end point of this study was response to treatment and complications, determined by the National Cancer Institute Common Toxic Criteria for Adverse Events (CTCAE) scale V5.0.

Patients with pathologically-confirmed primary solid malignancies together with single or multiple brain metastases on magnetic resonance imaging (MRI) were enrolled in the study (n=64). Treatment with HCQ (200 mg/P.O. once daily) was begun concurrent with WBRT (total dose of 30 Grays (Gy) in 10 daily fractions) in case group. Control group received the standard regimen.

Analysis of complications and response rate at each follow up points revealed no statistically significant differences between the case and control groups. Although, median brain metastasis specific Progression Free Survival (PFS) was non-significantly longer in HCQ group compared to control. No grade 3 or more severe toxicities were reported during therapy in both groups of the study.

Although concurrent administration of HCQ with WBRT in patients who suffers from brain metastases was well tolerated, this combination did not meaningfully improve outcomes in comparison to WBRT alone.

To evaluate the predictive value of the 18F-FDG PET/CT parameters on the histopathological features, receptor expression status, and molecular proliferation markers in breast cancer. Also, to assess the effect of the normal breast parenchymal uptake (BPU) on primary breast cancer.

287 patients were included, 198 patients with breast cancer (BC) and 89 patients with the healthy breast control group (CG). The metabolic parameters of breast carcinoma were compared with immunohistochemical subtypes, Ki-67 expression status, tumor size, axillary nodal involvement, and distant organ metastasis. We also analyzed the BPU using a 1.5 cm3 volume of interest (VOI) in the BC and CG groups.

There was a positive correlation between primary tumor SUVmax and tumor size (p=0.001), high Ki-67 expression (p<0.001), axillary nodal involvement (p<0,001), distant organ metastases (p=0.026), ER and PR negativity, and HER2 positivity (p=0.000, 0.001, and 0.021, respectively). Furthermore, the change in mean SUVmax in molecular subtypes was statistically significant (p<0.001). In addition, the SUVmax measured 0.5 cm from the tumor in the same quadrant is higher than the opposite quadrant and contralateral breast, suggesting that the distance to the tumor increases, the FDG uptake decreases (p<0.001 and 0.001, respectively).

Strong relationships were detected between the ER and PR negativity, HER2-positivity, high Ki-67 expression, tumor size, axillary lymph node involvement, distant organ metastases, and SUVmax values. Therefore, we believe that metabolic parameters obtained with 18F-FDG PET/CT may provide relevant information about breast cancer tumor biology and suggest a potential role in identifying more aggressive behavior.

PSMA is known as a suitable marker for imaging and targeted therapy of malignant tumors, especially prostate cancer. While; 177Lu-labeled PSMA is recognized as a promising compound for the treatment of metastatic castration-resistant prostate cancer patients, deployment of radionuclides with higher beta energy, including 188Re, can be useful for larger-sized tumors. However, the absorbed dose of the PSMA radiolabeled compound is substantial according to the considerable accumulation in the kidney.

In this study; the biodistribution of 188Re-HYNIC-PSMA was studied in Wistar rats. ANACOMP software was utilized for compartmental modeling. The human absorbed dose of this new agent was assessed according to the rats’ biodistribution data using the RADAR method.

The highest accumulation of activity in Wistar rats’ organs were observed in the kidney. The human organs that received the highest absorbed dose were the kidneys and bladder wall with 0.69 and 0.46 mSv/MBq, respectively.

The absorbed dose of 188Re-PSMA-617 in critical organs is comparable to the values of 177Lu-PSMA-617. 188Re-HYNIC-PSMA can be considered a safe compound for the treatment of PSMA expressing tumors.

the aim of this study was to investigate the role of choline glycerophosphate (GPC) either alone or combined with silymarin in modulating whole body gamma irradiation-induced brain and intestinal injuries in rats.

Rats were irradiated with 7Gy then subjected to GPC and/ or silymarin for two weeks. At the end of the experiment, the animals were sacrificed then, brain and intestine samples were removed for biochemical, molecular and histopathological examinations.

it has been detected that GPC alone or combined with silymarin ameliorated the adverse effects of radiation as revealed by the inhibition of oxidative stress, apoptotic and inflammatory markers [Malondialdehyde (MDA), Caspase-3 Tumors necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and nuclear factor kappa-B (NF-kB)]. However, Total antioxidant capacity (TAC), anti-inflammatory marker, Interleukin-10 (IL-10) and inhibitor of Nuclear factor kappa-Ba (IkBa) mRNA were increased. This was also accompanied by a significant increase in the Acetylcholine (ACh) level, Choline Acetyltransferase (ChAT) activity and Alpha-7 nicotinic receptor (α7nAChR), mRNA-expression and a significant decrease in the activity of Acetylcholine esterase (AChE) as compared with the corresponding values of the irradiated group. Moreover, a reduction in the tissue lesions was observed in brain and intestinal tissues.

Choline glycerolphosphate and silymarin exhibited modulating effect against detrimental effects of gamma-radiation via cholinergic anti-inflammatory pathway.

Our study was to evaluate the value of contrast-enhanced ultrasonography (CEUS) and contrast-enhanced magnetic resonance imaging (CE-MRI) in analyzing the blood vessels associated with ovarian tumors.

A total of 100 patients with ovarian tumors underwent CEUS and CE-MRI before surgery. After surgery, the resected ovarian tissues were evaluated via immunohistochemistry to calculate the tumor microvessel density (MVD), and the correlation between the parameters of CEUS and CE-MRI and MVD in ovarian tumors was determined.

The MVD level between ovarian tumors was significantly different (p = 0.03); the peak intensity (PI) and area under the curve (AUC) of CEUS parameters in malignant tumors were significantly higher than those in benign tumors (p = 0.03, p = 0.03); and were significantly positively correlated with MVD (r = 0.57, p = 0.00; r = 0.50, p = 0.00). The Ktrans and Ve of CE-MRI parameters in malignant tumors were significantly higher than those in benign tumors (p = 0.01 and p = 0.04), and were also significantly positively correlated with MVD (r = 0.66, p = 0.00; r = 0.55, p = 0.00). Moreover, there was no significant difference between CEUS and CE-MRI in terms of sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) in malignant ovarian tumors (p > 0.05).

Both CEUS and CE-MRI parameters can reflect the MVD level in ovarian tumors; therefore, CEUS is expected to become a viable alternative approach for evaluating ovarian tumors.

With the advent of Intensity Modulated Radiotherapy (IMRT) and recently, Volumetric Modulated Arc Therapy (VMAT), treatment planning using Flattening Filter Free (FFF) beams can meet all of the energy requirements in radiation therapy clinics. Manufacturers of linear accelerators no longer need to install a flattening filter (FF) in gantry head. This study aims to provide evidence of the superiority of FFF to FF through both dosimetric measurements and clinical treatment plans.

A 50×50×50cm3 water phantom was created in the RayStation treatment planning system (TPS) for dosimetry comparisons. Flat beam profiles were generated using FFF beam through an optimization process for 10×10 to 30×30cm2 field sizes. Next, a comparison of treatment plans was made using 21 Head and Neck and 14 Lung/Mediastinum treatment sites using 6MV and 6MV-FFF beams.

Using FFF beams, profiles with flatness and symmetry identical to or better than those of the flattened beams were produced. At the very edge of the optimized plans for FFF beams, horns had the highest gamma index deviation <1.5% of the normalized dose. For clinical plans evaluated, most of the mean doses to organs-at-risk (OAR) volumes receiving 5% to 30% of the prescription dose were reduced with FFF beams.

These results indicate the feasibility of delivering flat beams with FFF quality and producing treatment plans with equal or higher qualities in PTV coverage while achieving better sparing of OAR which will allow escalation of target dose if desired. Plus, removing FF will simplify the gantry head and reduces quality assurance and machine maintenance efforts.

Cardiotoxicity is one of the most serious complications of radiation. Nanoparticles, has gained increasing attention as therapeutic agents. This work aims to evaluate the beneficial effect of zinc oxide nanoparticles (ZnONPs) on the cardiotoxicity induced by ionizing radiation.

Twenty eight male rats were included in the study. Animals were categorized into four groups (n=7),  group I: (control), group II: rats were irradiated with a single dose of ɤ radiation (6Gy), group III: rats injected with ZnONPs (10mg /Kg b.wt), intrapritoneally for two weeks (5days/week), group IV (treated):  irradiated rats received ZnONPs intrapritoneally with the same dose for two weeks after 24hr of irradiation.

γ-irradiation caused a significant elevation in the levels of creatine phosphokinase, creatine kinase, lactate dehydrogenase, troponin I, fibrinogen and C-reactive protein. Additionally, a noticeable increase in the lipid content including cholesterol, triglycerides and low density lipoprotein with concomitant decline in high density lipoprotein and finally, a marked decrease in hematological parameters as compared to the control group. These changes manifested good amelioration in the groups injected with ZnONPs.

Based on these findings, it can be argued that treatment with ZnONPs reduces the extent of radiation damage by providing significant hypolipidemic, anti-inflammatory and antioxidant effects in irradiated rats.

NatuAt present, radioactive seed implantation is a common treatment for prostate cancer, the TPS (treatment planning system) calculates the dose by adding the dose attributed to each source. However, the interseed attenuation effect would result in a difference between the actual dose and the calculated dose. The aim of this study was to identify the factors influencing the interseed attenuation effect.

I-125 seed sources were selected, and MC (Monte Carlo) method was used to simulate the dose distribution around seed sources. The results obtained from the linear addition of a single-source dose were compared with those obtained considering the interseed attenuation effect. The effects of the medium, source arrangement and source number on the dose were evaluated.

The MC simulation results for multiple seed sources are lower than those for linear additive doses in most areas. In different medium, the mean error caused by interseed attenuation effect is the smallest in adipose tissue (0.52%) and the largest in bone (1.41%). Taking four sources as examples, the maximum error is 9.34%, appearing in the plane where the source is located. The error decreases to 1.3% when the source is located 2 mm away from the source plane. The more scattered the sources are in space, the smaller the error will be.

A high atomic number and high-density medium will cause a high error. The area with a high error is mainly observed in the plane where the sources are located, the edge error of the source distribution area is larger.

To investigate the clinical efficacy of hyperthermic intraperitoneal chemotherapy in combination with the malignant ascites in gastric cancer following the Intensive preoperative radiotherapy for radical surgery of tumor.

We selected a total of 112 gastric cancer patients who had been operated on for radical surgery of tumor in this hospital as subjects that were randomized into the control group and the observation group, with 56 patients in each group. Patients in the control group took the abdominal aspiration in combination with the intravenous chemotherapy, while those in the observation group underwent the hyperthermic intraperitoneal chemotherapy. After treatment, we compared the effectiveness rate, levels of tumor markers, incidence rates of adverse reactions, and  Karnofsky (KPS) scores between the two groups.

In the observation group and the control group, the effectiveness rates of patients were 71.43% and 44.64%, showing the statistical significance of the difference (P < 0.05); after treatment, the levels of CEA, CA125, and CA199, tumor markers, were decreased compared to before treatment (P < 0.05). The incidence rates of adverse reactions were 75.00% and 82.14%, showing no statistical significance of difference (P > 0.05). Following the treatment, the KPS scores were improved in two groups compared to before treatment (P < 0.05).

For gastric cancer patients with malignant ascites, hyperthermic intraperitoneal chemotherapy excels in the clinical efficacy by decreasing the level of tumor markers, to improve the life quality of patients, but with no increase in the incidence rate of adverse reactions.

It is generally accepted that smokers are more prone to lung cancers, however non-smokers also are at high risk if they are exposed to higher concentration of radon. Radon has been the major source of this alpha particle.

The use of water in day to day activities has immensely increase the rate of exposure to radon in indoor. Therefore, 42 water samples (30 well and 12 borehole water) use for such domestics activities were systemically collected from different places for radon probing with the aid of an electronic active detector RAD7 produced by Durridge USA. The annual inhalation and ingestion were also estimated from the water samples.

After probing the radon in the water samples, the obtained results ranged for well and borehole water samples were 0.08 to 14.8 Bq/l and 0.004 to 5.41 Bq/l respectively. Statistical analysis results confirmed that there is a significant difference between the mean value of radon concentration in different sources of water from both well and borehole, (p=0.000). The estimated inhalation and ingestion doses were lower than the world average reference level.

The areas with higher radon concentration in their water samples should take necessary actions to avoid consequences from exposure to higher radon. The total annual effective dose due to inhalation and ingestion were estimated to be 10.0 µSv/y for well water and 8.579 µSv/y for bore hole water which were lower than the recommended action level of 0.1 mSvy-1 set by WHO.

Computed tomography (CT) is a highly effective imaging technique for abdominopelvic pathologies. Nonetheless, radiation concerns arise due to patients receiving a significant effective dose (ED). Thus, patient dose evaluation is critical to ensure that benefits compensate for the projected cancer risk. The current study aimed to assess abdominopelvic CT radiation exposure.

A cross-sectional analytical design was conducted for 130 abdominopelvic CT procedures. The WAZA-ARI version 2 CT dosimetry system, which is web-based, open Monte Carlo simulation software for CT dose computations was used to calculate organ doses. Lifetime attributable risk (LAR) of cancer induction was calculated for dual-phase abdominopelvic CT through the website “Xrayrisk.com”.

Results revealed that the mean ED was slightly lower in females compared to males (13.9±2.9 mSv vs. 15.5±2.7 mSv). The mean EDs for male patients in the arterial and venous phases were 6.2±1.08 mSv and 9.3±1.62, respectively, while the corresponding mean EDs  for female patients were 5.56±1.16 mSv and 8.34±1.74. The highest organ equivalent doses for both genders and among all exams were gonads (males 32.55, females 28.76 mSv); small intestine (males 30.26, females 26.66 mSv); colon (males 29.79, females 26.33 mSv), and stomach (males 28.55, females 25.23 mSv).

Variations among organ doses and assumptions regarding negligible risk of malignancy inform current hospital policy.  Our findings suggest that achieving the balance between diagnostic benefits and radiation risk requires careful attention.

Natural Cat scratch disease is caused by the infection of Bartonella henselae after a cat scratch, bite, or close contact, and mainly presents with skin lesions and swollen lymph nodes in the drainage area. Herein, we report a 71-year-old female cat scratch disease patient who initially presented with low fever and enlarged lymph nodes on the left side of her neck, who underwent fluorine-18 labeled fluorodeoxyglucose positron emission tomography/computed tomography for suspected lymphoma. As increased fluorodeoxyglucose uptake can indicate inflammation or tumor, and lymph node enlargement accompanied by abnormal metabolism can mimic lymphoma or other diseases, the diagnosis of cat scratch disease is difficult. Its diagnosis should be indicated when unilateral lymphadenopathy is accompanied by abnormally high metabolic uptake of fluorodeoxyglucose.

Epithelioid sarcoma (ES) is a rare soft tissue tumor that mainly occurs under the skin of the extremities. ES in the groin area may be easily misdiagnosed with undifferentiated pleomorphic sarcoma, leiomyosarcoma, rhabdomyosarcoma, and other mesenchymal tumors. Herein, we reported a single case of a patient with proximal-type epithelioid sarcoma of the groin, including its clinical and imaging findings. We also discussed some previously reported similar cases.

Our ES patient was a 24-year-old male who developed a subcutaneous nodule in the groin area 1 year before admission. After careful clinical and pathological examination, the patient was diagnosed with ES. He received chemotherapy (doxorubicin, ifosfamide plus cisplatin) and, later on, surgery. His symptoms improved, and he is still being followed up. In addition, we conducted a review of the literature and compared our data with 12 previously reported similar cases (including 17 patients with ES involving the groin).

ES is a highly invasive tumor prone to metastasis and postoperative recurrence. Surgery seems to be the most effective treatment for ES. The effectiveness of auxiliary and radiotherapy needs to be confirmed by a large amount of data. A systematic understanding of the clinical and imaging features of ES in the groin area may help clinical and imaging doctors to correctly diagnose the disease.

Pulmonary ventilation/perfusion (V/Q) scintigraphy is often used for the diagnosis of pulmonary embolism. However, it should be noted that the perfusion defect shown by pulmonary perfusion imaging is not the only manifestation of pulmonary embolism. Any disease that causes pulmonary vasculature stenosis and occlusion can cause pulmonary blood flow perfusion impaired. We report a case of fibrosing mediastinitis (FM) with pulmonary hypertension as a complication of pulmonary artery and pulmonary vein stenosis. Based on clinical symptoms, laboratory test and multiple radiographic findings, the diagnosis of FM was established. The patient underwent balloon dilation and stent implantation of right upper lobe pulmonary vein, as well as balloon dilatation of right upper lobe pulmonary artery, whose symptoms was immediately improved during the following investigation.