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Estimation and comparison of the effective dose and lifetime attributable risk of thyroid cancer between males and females in routine head computed tomography scans: a multicentre study 估算和比较常规头部计算机断层扫描中男性和女性的有效剂量和终生甲状腺癌归因风险:一项多中心研究。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-12 DOI: 10.1002/jmrs.752
Daryoush Khoramian MSc, Mohammad Haghparast MSc, PhD, Adnan Honardari MSc, Ebrahim Nouri MSc, Esmail Ranjbar MSc, Razagh Abedi-Friouzjah MSc, Shiva Zarifi MSc, Choirul Anam Msc, PhD, Milad Najafzadeh MSc, PhD, Mahdieh Afkhami-Ardakni MSc

Introduction

A significant number of head computed tomography (CT) scans are performed annually. However, due to the close proximity of the thyroid gland to the radiation field, this procedure can expose the gland to ionising radiation. Consequently, this study aimed to estimate organ dose, effective dose (ED) and lifetime attributable risk (LAR) of thyroid cancer from head CT scans in adults.

Methods

Head CT scans of 74 patients (38 males and 36 females) were collected using three different CT scanners. Age, sex, and scanning parameters, including scan length, tube current–time product (mAs), pitch, CT dose index, and dose-length product (DLP) were collected. CT-Expo software was used to calculate thyroid dose and ED for each patient based on scan parameters. LARs were subsequently computed using the methodology presented in the Biologic Effects of Ionizing Radiation (BEIR) Phase VII report.

Results

Although the mean thyroid organ dose (2.66 ± 1.03 mGy) and ED (1.6 ± 0.4 mSv) were slightly higher in females, these differences were not statistically significant compared to males (mean thyroid dose, 2.52 ± 1.31 mGy; mean ED, 1.5 ± 0.4 mSv). Conversely, there was a significant difference between the mean thyroid LAR of females (0.91 ± 1.35) and males (0.20136 ± 0.29) (P = 0.001). However, the influencing parameters were virtually identical for both groups.

Conclusions

The study's results indicate that females have a higher LAR than males, which can be attributed to higher radiation sensitivity of the thyroid in females. Thus, additional care in the choice of scan parameters and irradiated scan field for female patients is recommended.

简介每年都要进行大量的头部计算机断层扫描(CT)。然而,由于甲状腺与辐射场非常接近,这一过程会使甲状腺暴露于电离辐射中。因此,本研究旨在估算成人头部 CT 扫描的器官剂量、有效剂量 (ED) 和甲状腺癌终生归因风险 (LAR)。收集了年龄、性别和扫描参数,包括扫描长度、管电流-时间乘积(mAs)、间距、CT 剂量指数和剂量-长度乘积(DLP)。使用 CT-Expo 软件根据扫描参数计算每位患者的甲状腺剂量和 ED。随后采用电离辐射的生物效应(BEIR)第七阶段报告中介绍的方法计算LAR:尽管女性的平均甲状腺器官剂量(2.66 ± 1.03 mGy)和ED(1.6 ± 0.4 mSv)略高于男性,但与男性(平均甲状腺剂量,2.52 ± 1.31 mGy;平均ED,1.5 ± 0.4 mSv)相比,这些差异并无统计学意义。相反,女性的平均甲状腺 LAR(0.91 ± 1.35)与男性(0.20136 ± 0.29)之间存在显著差异(P = 0.001)。然而,两组的影响参数几乎相同:研究结果表明,女性的 LAR 值高于男性,这可能是因为女性甲状腺的辐射敏感性更高。因此,建议女性患者在选择扫描参数和照射扫描野时多加注意。
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引用次数: 0
Barriers to radiographers' use of radiation safety principles: A qualitative perspective 放射技师使用辐射安全原则的障碍:定性视角。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-08 DOI: 10.1002/jmrs.750
Berit Møller Christensen PhD, Anna Bjällmark PhD, Irine Maghanwi Ndipen BSC, Shilan Shamon Afram BSC, May Bazzi PhD

Introduction

To minimise the risks associated with ionising radiation, it is necessary for all staff involved to employ specific techniques to reduce radiation exposure of the patient. These techniques include using compression during examinations of the pelvic region and lumbar spine, using a gonad shield, and asking women if they are pregnant. However, some staff do not use these techniques consistently. Increasing compliance requires determining why staff are non-compliant. Thus, this study aims to qualitatively investigate why radiographers do not use these techniques.

Methods

This qualitative study is based on a cross-sectional electronic survey with open-ended questions. The data were analysed using an inductive qualitative content analysis with quantification of the findings. In total, 111 radiographers from 20 hospitals in Sweden participated.

Results

Three categories appear related to barriers that could obstruct the radiographer from using compression, gonad shields and asking about pregnancy: patient characteristics, interaction between the patient and the radiographer and issues related to the situation and examination.

Conclusions

The barriers to not using radiation protection measures varied depending on the specific measure. However, the barriers were mainly related to the patient experiencing pain, communication difficulties and cultural reasons. In addition, the lack of adequate and user-friendly equipment was seen as a barrier to applying compression and using gonad shielding.

导言:为了将电离辐射的相关风险降至最低,所有相关工作人员都有必要采用特定的技术来减少病人受到的辐射。这些技术包括在检查骨盆区域和腰椎时使用压迫法、使用生殖腺屏蔽罩以及询问妇女是否怀孕。然而,有些工作人员并没有坚持使用这些技术。要提高员工的依从性,就必须确定员工不依从的原因。因此,本研究旨在对放射技师不使用这些技术的原因进行定性调查:本定性研究以横向电子调查为基础,采用开放式问题。采用归纳式定性内容分析法对数据进行分析,并对结果进行量化。共有来自瑞典 20 家医院的 111 名放射技师参加了调查:结果显示,有三类障碍可能阻碍放射技师使用压迫、生殖腺屏蔽和询问怀孕情况:患者特征、患者与放射技师之间的互动以及与检查情况和检查相关的问题:不使用辐射防护措施的障碍因具体措施而异。然而,这些障碍主要与患者感到疼痛、沟通困难和文化原因有关。此外,缺乏足够的、便于使用的设备也被认为是实施压迫和使用性腺屏蔽的障碍。
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引用次数: 0
See something, say something: the coroner's perspective 看到什么,说什么:验尸官的视角。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-04 DOI: 10.1002/jmrs.749
Kristal Lee BRadMedImag (Hons), GCAP, Kriscia Tapia PhD, MAppSc, BA, Mo'ayyad E. Suleiman PhD, MSc(IT), BSc(AppPhys), Ernest Ekpo PhD, BSc (Hons)

The communicating safely policy, publicised by the catchphrase See Something, Say Something was released by the Medical Radiation Practice Board of Australia in 2019. It was developed to support medical radiation practitioners (MRPs) upholding the obligation to communicate urgent or unexpected findings in a timely manner, when identified on medical images. Prior to this policy being part of the professional capabilities, several untimely deaths occurred—the majority of whose causal factors could have been mitigated if imaging findings were urgently communicated by MRPs. This commentary summarises three coronial inquests that involved MRPs, discusses how these coronial findings are reflected in the communicating safely policy and provides some recommendations for the profession to ensure this policy is enacted in clinical practice.

澳大利亚医疗辐射执业委员会于 2019 年发布了 "安全交流政策",其口号是 "看到什么,说什么"(See Something, Say Something)。该政策旨在支持医疗放射从业人员(MRPs)履行义务,在发现医疗图像上有紧急或意外发现时及时进行沟通。在该政策成为专业能力的一部分之前,发生了多起过早死亡事件--如果医疗放射从业人员能够紧急通报影像检查结果,其中大部分的致病因素本可以得到缓解。本评论总结了涉及 MRP 的三起死因调查,讨论了这些死因调查结果如何反映在安全沟通政策中,并为该行业提供了一些建议,以确保该政策在临床实践中得以实施。
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引用次数: 0
Patient experiences and anxiety related to medical imaging: challenges and potential solutions 与医学成像相关的患者体验和焦虑:挑战和潜在解决方案。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-28 DOI: 10.1002/jmrs.748
Kristy Fakes PhD, MPH, BMedSc(Path)

Patients' experiences of medical imaging are varied. In referencing the work of Plunkett et al. https://doi.org/10.1002/jmrs.725, relating to fetal MRI, this editorial explores potential methods for increased education and support to alleviate anxiety in patients undergoing medical imaging procedures.

患者对医学成像的体验各不相同。本社论参考了 Plunkett 等人 https://doi.org/10.1002/jmrs.725 有关胎儿核磁共振成像的研究成果,探讨了加强教育和支持的潜在方法,以减轻接受医学成像程序的患者的焦虑。
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引用次数: 0
Establishing a consumer advisory group at the Australian Bragg Centre for Proton Therapy and Research 在澳大利亚布拉格质子治疗与研究中心成立消费者咨询小组。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-26 DOI: 10.1002/jmrs.746
Melanie Penfold BMRS(RT), MBA, Peter Gorayski BSc, BMBS, FRACGP, FRANZCR, Julia Green BMRP, MSc-Res, MBA(Hlth), CMPS, Kelly Skelton MCncrSC, AdvDip En

The Australian Bragg Centre for Proton Therapy and Research (ABCPTR) established the Bragg Consumer Advisory Group (BCAG) in 2023. The ABCPTR, being the first of its kind in Australia, will offer proton therapy treatment for challenging solid tumours with the potential to reduce radiation-induced side effects. With over 110 Proton Beam Therapy (PBT) centres globally, Australian patients currently can apply to access government funded treatment overseas, however, international travel for treatment presents various, significant challenges. Consumer engagement in healthcare plays a pivotal role in navigating the multifaceted journey of cancer treatment and can complement cancer control strategies by ensuring the practicalities of the cancer journey are realised. The ABCPTR aims to involve consumers in decision-making processes, especially as it prepares to open Australia's first national proton therapy centre. The aim of this commentary is to highlight the importance of involving consumers in cancer care, and to demonstrate how this was done in Australia's first proton therapy centre. To establish a consumer engagement team, ABCPTR utilised existing clinical staff. The team's formation and upskilling were integral to the project's success. The engagement framework was developed based on the five stages of commitment by the Australian Health Research Alliance and Western Australian Health Translation Network. The ABCPTR consumer engagement team successfully created a community engagement framework and upskilled in consumer engagement principles over 9–12 months. An Expression of Interest (EOI) was launched, resulting in the formation of the BCAG comprising of 10 members with diverse backgrounds and experiences. The BCAG has been actively involved in decision-making processes, with a consumer-led chair and co-chair in place. The group's feedback is expected to influence key performance indicators for the centre. The establishment of the BCAG at the ABCPTR emphasises the importance of integrating patient and community perspectives into clinical initiatives. This proactive approach ensures that processes remain patient-centred. The ongoing multi-level consumer engagement strategy aims to shape a more inclusive approach to cancer care in Australia, especially concerning PBT.

澳大利亚布拉格质子治疗与研究中心(ABCPTR)于2023年成立了布拉格消费者咨询小组(BCAG)。澳大利亚布拉格质子治疗与研究中心是澳大利亚首家质子治疗中心,将为具有挑战性的实体瘤提供质子治疗,有望减少辐射引起的副作用。目前,全球有超过110家质子束治疗(PBT)中心,澳大利亚患者可以申请到海外接受政府资助的治疗,但国际旅行治疗带来了各种重大挑战。消费者参与医疗保健在多方面的癌症治疗过程中发挥着关键作用,并能通过确保实现癌症治疗过程中的实际需求来补充癌症控制策略。澳大利亚质子治疗中心(ABCPTR)旨在让消费者参与决策过程,尤其是在准备开设澳大利亚首个国家质子治疗中心之际。本评论旨在强调让消费者参与癌症治疗的重要性,并展示澳大利亚首家质子治疗中心是如何做到这一点的。为了建立消费者参与团队,澳大利亚质子治疗中心利用了现有的临床工作人员。该团队的组建和技能提升是项目成功不可或缺的因素。参与框架是根据澳大利亚健康研究联盟(Australian Health Research Alliance)和西澳大利亚健康翻译网络(Western Australian Health Translation Network)的五个承诺阶段制定的。在 9-12 个月的时间里,ABCPTR 消费者参与团队成功创建了社区参与框架,并掌握了消费者参与原则。意向书(EOI)发布后,成立了由 10 名具有不同背景和经验的成员组成的 BCAG。该小组积极参与决策过程,并由消费者担任主席和联合主席。该小组的反馈意见有望影响中心的主要绩效指标。ABCPTR BCAG 的成立强调了将患者和社区观点纳入临床举措的重要性。这种积极主动的方法可确保各项流程始终以患者为中心。目前正在实施的多层次消费者参与战略旨在为澳大利亚的癌症治疗,尤其是肺结核治疗提供更具包容性的方法。
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引用次数: 0
A multi-centre survey of New Zealand cancer patients' preferences for radiation treatment information 新西兰癌症患者对放射治疗信息偏好的多中心调查。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-22 DOI: 10.1002/jmrs.745
Alannah Flockton BRT (Hons), Aidan Leong MHealSc, Daniel Gilfillan PGCertHealSc (MedTech), Peter Larsen PhD

Introduction

Patients undergoing radiation therapy have a diverse range of information needs, however, there is a lack of data specific to the needs of New Zealand patients. This cross-sectional survey captured New Zealand cancer patients' preferences for radiation treatment information. Preferences were assessed regarding the scope of information needs and the satisfaction with which these needs were being met.

Methods

A custom survey was offered to 275 eligible patients undergoing radiation treatment at six of 10 departments across New Zealand over a 2-day period. The survey captured patient demographics as well as information needs and satisfaction across five distinct domains using Likert scales and one free-text question. Responses were analysed using descriptive statistics and directed content analysis.

Results

Over 80% of participants rated all information domains as extremely or very important. Over 90% of participants were extremely satisfied or very well satisfied in four of the five domains. Information on what happens after radiation treatment had the lowest satisfaction at 78%. No demographic subcategories were clearly associated with differences in information needs or satisfaction. 59% of participants indicated their willingness to engage in online education. The qualitative analysis strongly corroborated the quantitative results.

Conclusion

The New Zealand cancer patients surveyed in this study demonstrated high levels of importance and satisfaction with the information provided during radiation treatment. Information on what happens after completing radiation treatment had the lowest satisfaction. These findings support further exploration of New Zealand cancer patients' information needs following radiation treatment as well as strategies to address them.

导言:接受放射治疗的患者对信息的需求多种多样,然而,目前还缺乏专门针对新西兰患者需求的数据。这项横断面调查收集了新西兰癌症患者对放射治疗信息的偏好。调查评估了患者对信息需求范围的偏好以及对这些需求得到满足的满意度:在为期 2 天的时间里,新西兰 10 个部门中的 6 个部门向 275 名符合条件的放射治疗患者进行了定制调查。调查采用李克特量表和一个自由文本问题,收集了患者的人口统计数据以及五个不同领域的信息需求和满意度。调查采用描述性统计和定向内容分析法对答复进行了分析:超过 80% 的参与者将所有信息领域评为 "极其重要 "或 "非常重要"。超过 90% 的参与者对五个领域中的四个领域表示非常满意或非常满意。关于放射治疗后会发生什么的信息满意度最低,仅为 78%。人口统计子类别与信息需求或满意度的差异没有明显关联。59% 的参与者表示愿意参与在线教育。定性分析有力地证实了定量分析的结果:本研究中接受调查的新西兰癌症患者对放射治疗期间所提供信息的重视程度和满意度都很高。对放射治疗结束后的信息满意度最低。这些结果支持进一步探讨新西兰癌症患者在放射治疗后的信息需求以及解决这些需求的策略。
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引用次数: 0
Meaningful consumer engagement in medical radiation sciences: enhancing quality improvement and research projects 让消费者切实参与医疗辐射科学:加强质量改进和研究项目。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-20 DOI: 10.1002/jmrs.747
Amy Brown PhD, MAppSc (Research), BAppSc (MRT-RT), Brianna McCoola BAppSc (MRT-RT), GCert(AdolHlthWelb), Yovanna Funnell BRadTherapy, GDip(AdolHlthWelb), Catriona Hargrave PhD, MAppSc (Research), BAppSc (MRT-RT)

Consumer engagement and partnership are increasingly recognised as a significant component of healthcare planning, provision, quality improvement and research. This article provides an overview of consumer engagement embedded in two different projects: a quality improvement project and a research project. The considerations and steps taken to effectively engage and partner with consumers throughout both projects will be discussed such as the prompt for consumer engagement, how the consumer/s were recruited and their specific contributions. The commonly reported advantages and challenges as well as reflections on what we might do differently with the benefit of hindsight are presented, including time required by both consumers and health professionals; funding and remuneration; and reporting findings to the wider community. In demonstrating consumer engagement and our learnings, we aim to encourage further consumer engagement activities amongst medical radiation professionals.

越来越多的人认识到,消费者参与和伙伴关系是医疗保健规划、提供、质量改进和研究的重要组成部分。本文将概述消费者参与两个不同项目的情况:一个质量改进项目和一个研究项目。文章将讨论在这两个项目中有效吸引消费者参与并与之合作的注意事项和步骤,例如吸引消费者参与的动机、如何招募消费者以及他们的具体贡献。此外,还将介绍通常报告的优势和挑战,以及我们在事后可能会采取的不同做法,包括消费者和医疗专业人员所需的时间、资金和报酬,以及向更广泛的社区报告研究结果。通过展示消费者参与情况和我们的经验教训,我们旨在鼓励医疗辐射专业人员进一步开展消费者参与活动。
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引用次数: 0
Continuing Professional Development – Answers 持续专业发展 - 答案
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-12 DOI: 10.1002/jmrs.731

Maximise your CPD by reading the selected article and answer the five questions. Please remember to self-claim your CPD and retain your supporting evidence. Answers are available online at www.asmirt.org/news-and-publications/jmrs.

阅读所选文章并回答五个问题,最大限度地提高您的持续专业发展能力。请记住,请自行申请 CPD 并保留您的支持证据。答案可从 www.asmirt.org/news-and-publications/jmrs 在线获取。
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引用次数: 0
The rationale for a carbon ion radiation therapy facility in Australia 在澳大利亚建立碳离子放射治疗设施的理由
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-07 DOI: 10.1002/jmrs.744
David I. Thwaites PhD, Dale A. Prokopovich PhD, Richard F. Garrett PhD, Annette Haworth PhD, Anatoly Rosenfeld PhD, Verity Ahern MBBS, FRANZCR

Australia has taken a collaborative nationally networked approach to achieve particle therapy capability. This supports the under-construction proton therapy facility in Adelaide, other potential proton centres and an under-evaluation proposal for a hybrid carbon ion and proton centre in western Sydney. A wide-ranging overview is presented of the rationale for carbon ion radiation therapy, applying observations to the case for an Australian facility and to the clinical and research potential from such a national centre.

澳大利亚采取了全国协作的网络化方法来实现粒子治疗能力。这将支持阿德莱德正在建设的质子治疗设施,其他潜在的质子中心以及西悉尼碳离子和质子混合中心的评估提案。对碳离子放射治疗的基本原理进行了广泛的概述,将观察结果应用于澳大利亚设施的案例以及这样一个国家中心的临床和研究潜力。
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引用次数: 0
Effects of body part thickness on low-contrast detail detection and radiation dose during adult chest radiography 人体部位厚度对成人胸片低对比度细节检测和辐射剂量的影响。
IF 2.1 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-04 DOI: 10.1002/jmrs.741
Sadeq Al-Murshedi PhD, Kholoud Alzyoud PhD, Mohamed Benhalim PhD, Nadi Alresheedi, Stamatia Papathanasiou PhD, Andrew England PhD

Introduction

Differences in patient size often provide challenges for radiographers, particularly when choosing the optimum acquisition parameters to obtain radiographs with acceptable image quality (IQ) for diagnosis. This study aimed to assess the effect of body part thickness on IQ in terms of low-contrast detail (LCD) detection and radiation dose when undertaking adult chest radiography (CXR).

Methods

This investigation made use of a contrast detail (CD) phantom. Polymethyl methacrylate (PMMA) was utilised to approximate varied body part thicknesses (9, 11, 15 and 17 cm) simulating underweight, standard, overweight and obese patients, respectively. Different tube potentials were tested against a fixed 180 cm source to image distance (SID) and automatic exposure control (AEC). IQ was analysed using bespoke software thus providing an image quality figure inverse (IQFinv) value which represents LCD detectability. Dose area product (DAP) was utilised to represent the radiation dose.

Results

IQFinv values decreased statistically (P = 0.0001) with increasing phantom size across all tube potentials studied. The highest IQFinv values were obtained at 80 kVp for all phantom thicknesses (2.29, 2.02, 1.8 and 1.65, respectively). Radiation dose increased statistically (P = 0.0001) again with increasing phantom thicknesses.

Conclusion

Our findings demonstrate that lower tube potentials provide the highest IQFinv scores for various body part thicknesses. This is not consistent with professional practice because radiographers frequently raise the tube potential with increased part thickness. Higher tube potentials did result in radiation dose reductions. Establishing a balance between dose and IQ, which must be acceptable for diagnosis, can prevent the patient from receiving unnecessary additional radiation dose.

患者体型的差异通常给放射技师带来挑战,特别是在选择最佳采集参数以获得可接受的图像质量(IQ)用于诊断的x线片时。本研究旨在从低对比度细节(LCD)检测和成人胸部x线摄影(CXR)时的辐射剂量两方面评估身体部位厚度对智商的影响。方法:本研究采用对比细节(CD)假体。聚甲基丙烯酸甲酯(PMMA)分别用于模拟体重过轻、标准、超重和肥胖患者的不同身体部位厚度(9、11、15和17厘米)。在180 cm固定光源下,对不同的电子管电位进行了成像距离(SID)和自动曝光控制(AEC)测试。使用定制软件分析IQ,从而提供图像质量数字逆(IQFinv)值,代表LCD可检测性。剂量面积积(DAP)表示辐射剂量。结果:在所研究的所有管电位中,IQFinv值随着幻影尺寸的增加而统计学上下降(P = 0.0001)。在80 kVp时,所有模体厚度的IQFinv值最高(分别为2.29、2.02、1.8和1.65)。随着幻膜厚度的增加,辐射剂量再次增加(P = 0.0001)。结论:我们的研究结果表明,对于不同的身体部位厚度,较低的管电位提供了最高的IQFinv评分。这与专业实践是不一致的,因为放射线技师经常会随着零件厚度的增加而提高管电位。较高的管电位确实导致了辐射剂量的减少。在剂量和智商之间建立一个平衡,这必须是诊断可以接受的,可以防止病人接受不必要的额外辐射剂量。
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引用次数: 0
期刊
Journal of Medical Radiation Sciences
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