Nuclear Medicine & Radiation Therapy

ISSN: 2155-9619

Open Access

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    Research Article Pages: 1 - 7

    Evaluation of Doses to Organ at Risk with Deep Inspiratory Breath Hold Compared to Free Breathing in Left Sided Breast Cancer and Assessment of Patient Related Anatomical Factors

    Tabinda Sadaf*, Samaha Nawaz, Asma Rashid, Aqueel Shahid, Amna Munawar, Raheel Mukhtar, Sana Mazhar and Muhammad Abubakar

    DOI: 10.37421/2155-9619.2023.14.526

    Introduction: With the improvement in prognosis for patients with breast cancer, reducing long-term toxicity from treatment has become increasingly important. Left breast Radiotherapy (RT usually results in higher dose delivery to the heart and lungs, which are treated as Organs at Risk (OAR. Heart irradiation increases the risk of radiation induced heart disease and major coronary artery disease in long term survivors.

    Material and methods: After obtaining informed consent, 50 patients were enrolled in the study between October 2020 and February 2021. Two scans were performed on each patient, one in Free Breathing (FB) and one using Deep Inspiratory Breath Hold technique (DIBH). Contouring of target volume and Organ at Risk (OAR) were performed on both scans. Dose Volume Histograms (DVH) was generated for both scans for plan evaluation. Dose parameters were calculated and compared to assess doses to heart and lungs. In addition, anatomical parameters including Maximum Heart Distance (MHD), Haller Index (HI), Central Long Distance (CLD), chest wall separation (CWS), Heart Chest Distance (HCD), Lung Volume Difference (LVD), and Cardiac Contact Distance (CCD) in axial and parasagittal planes were also studied for impact on doses to heart and lung.

    Results: The reduction in mean doses using DIBH was statistically significant for both heart and lung. Overall, the mean heart dose in FB was 5.60 ± 2.20 and in DIBH it is 2.50 ± 1.24 leading to a difference of 3.4 Gy.

    About 17 patients (34% failed to attain a difference of ≥2 Gy with DIBH scans. This difference was persistent and significant in V10, V30, V35 of heart. Similarly, mean left lung dose reduction of 4.89 Gy was seen from 9.42 ± 2.80 in FB to 4.53 ± 2.20 using DIBH scan with statistically significant (p value=<0.05. Overall, V20 V5 and V10 of both lungs showed no statistical difference in either group (FB and DIBH, respectively. On contrary to this, the impact of DIBH dose reduction was more pronounced in V20 and V30 of left lung and less marked in V5 and V10. The mean differences in different anatomical parameters between FB and DIBH scan were significant for all stated parameters except chest wall separation (FB=20.35 cm, DIBH=20.55 cm, p-value=0.68. The moderate correlation between the anatomical parameters and mean heart dose reduction was statically significant for CLD (r=-0.36, p- value 0.01, MHD (r=-0.40, p-value=0.007, HCD (r=0.50, p-value=0.001, CCDps (r=-0.43, p-value=0.002 while the rest of the parameters including CCDax, LVD, CWS and Haller index showed weak correlation with outcome variable. The Multivariate regression analysis concluded HCD (β=2.02 (CI=1.14-2.89),p -value=0.001)a nd CLD (β-1.499 (CI=-2.448-0.549),p - value=0.003 two variables that independently predict mean heart dose reduction for patients undergoing DIBH based left sided breast radiotherapy.

    Conclusion: DIBH is a sublime technique and it is cost effective if used in suitable cohorts of patients. To improve selection criteria, HCD and CLD can be used as suitable anatomical predictors for reduction in mean doses to organs at risk.

      Mini Review Pages: 1 - 3

      You Have 3 Minutes Radiologic Technologist

      Julie Ostrowski*

      DOI: 10.37421/2155-9619.2023.14.556

      The question for the radiologic technologist is: What does a radiologic technologist do when it is time for them to clock in but they have a million things on their mind? How do they deal with the chaos in their mind from the morning chaos? What if they lack the motivation to do their job and they have an 8-hour shift staring them in the face? The answer is simple: They have 3 minutes. Three minutes to get it together before they start their shift, 3 minutes to get their professional demeaner on and 3 minutes to leave it all behind and focus on the patient. This article will discuss exactly how to do that exact thing, by utilizing three items in the radiologic technologist toolbox: A good attitude, professionalism and education. When utilized correctly, these items will help the radiologic technologist prepare for their upcoming shift and assist them in leaving the drama off the clock and patient care in focus.

        Full Length Research Paper Pages: 1 - 3

        Evaluating the Radiation Dose Hazardous Indexes Using Hpge Detector in Sekota, Ethiopia

        Baye Zinabe Kebede*

        This research paper desired to illustrate the presence of naturally occurring radioactive minerals concentration and the way how naturally occurring radioactive minerals were identified in Wag-himra iron ore deposit soil site. The deposit area covers five Kebelles of the border of Sekota wereda, Ziquale and Abergelle wereda. We were used HPGe detector to identify the presence of natural occurring radioactivity concentration in iron ore/alloy deposit soil, and applied appropriate research methodology particularly experimental design were more preferable. The researcher was collected samples from ten places across iron ore deposit area by using critical sampling techniques and prepared as a desirable manner. The chosen sample was sealed for four weeks in order to obtain secular equilibrium, wherein the rate of decay of the daughters’ equivalent that of the parent. Radium equivalent activity, external hazard index and representative gamma index of the sample were 56.19 Bq/kg,0.1515 Bq/kg,0.804 Bq/kg,0.408Bq/kg,0.00011 Bq/kg respectively. However, internal hazard index was slightly approaching to recommended value and it may cause the significant radiation hazard through long dwelling to the area.

          Research Article Pages: 1 - 4

          Sarepaka V Ramana Murthy*

          Introduction: Technologists working in Nuclear Medicine are exposed to radiation when doing tasks such as labeling/synthesis of radiopharmaceuticals, radiopharmaceutical administration, scan acquisition, and radiation survey. When working with therapeutic radiopharmaceuticals, the radiation dose could be significantly higher. The radiation dosage to the technologist in this study involved synthesis of Lu-177-DOTATATE (DOTA-Tyr3-octreotate) and PSMA-617(Prostate specific membrane Antigen) was estimated.

          Aim: The purpose of this study is to calculate the whole-body radiation dose to a technologist who is involved in the labelling of two different Lu-177 labelled compounds, namely Lu-177 DOTATATE and Lu-177- PSMA, and to compare the occupational burden to the dose limits recommended by India's Atomic Energy Regulatory Board.

          Materials and methods: A survey meter cum contamination monitor was used to detect radiation levels before the start of the labelling in the Hot lab by maintaining it at the area where the technologist generally stands during synthesis. An instant personal monitoring device like electronic pocket dosimeter was used by the technologist at chest level, performing the labelling of Lu177 (135mci to 520mci) received fortnightly by our department. Data were collected for 16 syntheses of Lu-177 DOTATATE and13 syntheses of Lu-177 PSMA-617 followed by the quality control. Mean time required to complete synthesis of Lu-177 DOTATATE and Lu-177 PSMA-617 was 52.68min and 52.39min respectively. Mean whole body radiation dose was 0.041 ± 0.004 mSv and 0.037±0.002mSv. Higher dose was obtained during the synthesis of Lu-177 DOTATATE.

          Conclusion: Data suggest that during the manual radio labelling of Lu -177 compounds, the whole-body radiation exposure to technologist is within the limits prescribed by AERB.

            Research Article Pages: 1 - 4

            The Value of 18F-FDG PET/CT in Detecting Local Recurrence or Distant Metastases in Patients with Renal Cell Carcinoma Who Underwent Radical Nephrectomy

            Ai-ka Abneh Awad* and Attieh Ola

            Aim: The aim of this study is to detect the value of 18F-FDG PET/CT in detecting local recurrence or distant metastases in patient who underwent radical nephrectomy for renal cell carcinoma.

            Materials and Methods: This retrospective study includes 88 patients diagnosed to have renal cell carcinoma underwent radical nephrectomy. Both 18F-FDG PET/CT and CT scan were done in the post-operative period for follow up. Sites of the relapse were categorized into local recurrence and distant metastasis. The final diagnosis of disease status was made on subsequent follow up by conventional imaging CT and 18F-FDG PET/CT with histopathology confirmation for all of the cases.

            Results: PET/CT was positive and detected recurrence in 48/88 patients, of which confirmed to be recurrence via biopsy 46/48 and was negative in 40/88 patients, 3 of them were falsely negative. 11/48 had local renal bed recurrence and 35/48 patients had distant metastases. PET/CT classified: 46/48 of cases to be true-positive, 2/48 false-positive and 3/40 false-negatives. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 93.9%, 94.9%, 94.3%, 95.8%, and 92.5%, respectively.

            Conclusion: 18F-FDG PET/CT scan proved its efficiency in post-surgical renal cell carcinoma patients as a follow up tool in local recurrence and distant metastasis. In particular detection of renal bed recurrence and bone metastasis. This can be considered as a base for future studies with larger population number.

              Research Article Pages: 1 - 9

              Radioprotective Efficacy of Marine Algae

              Subhashini Swaminathan* and Shweta Kailash Pal

              Radiation and radiation technology has risen too much from the last few years, hence the chances of radiation contamination increased over the past few years. The need to study radiation protection has become necessary. Commercially available chemical radioprotectors having too many side effects and hence limiting the use. Since the last decade, the study on marine algae has gained impact through the experimental studies marine algae is considered to have many Radioprotective phytochemicals, such as phlorotannins, polysaccharides, carotenoids and other compounds. Chemical radioprotectors having many side effects of the human hence limiting the use. Natural radioprotectors can be used in place of artificial to reduce the side effect and can be used in the long run. Marine algae exhibiting a broad spectrum of antioxidant properties can be used widely as radioprotectors.

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