Pub Date : 2024-02-01DOI: 10.33266/1024-6177-2024-69-1-20-27
V.A. Anikina, S.S. Sorokina, A. E. Shemyakov, E. A. Zamyatina, N.R. Popova
Purpose: To evaluate the effect of local proton irradiation at a dose of 30 Gy on Balb/c and C57BL/6 mice in terms of the degree and dynamics of radiation-induced skin damage formation, changes in body weight and peripheral blood elements count. Material and methods: Experiments were performed on non-depilated male mice aged 7‒8 weeks from two strains: Balb/c and C57BL/6 (n=15). Local irradiation of the skin was carried out on the dorsal side of the animals using a scanning proton beam at an extended Bragg peak in the proton therapy complex «Prometheus» of the LPI Physico-technical Centre (Protvino) at a dose of 30 Gy with a proton energy of 87.8 MeV. During the irradiation session, animals were subjected to intraperitoneal anesthesia using a combination of Zoletil 100 (Virbac, France) and Xyla (Interchemie, Netherlands) in a previously determined ratio 1:3 (20‒40 mg/kg). Photographic documentation of radiation-induced skin damage was performed weekly for 70 days. Animals were examined daily for clinical manifestations of radiation-induced skin damage formation according to the RTOG international scale for 21 days following irradiation. The body weight dynamics of mice were evaluated one day before irradiation and then weekly for 70 days. Blood samples were collected from the tail vein by cutting the tip of the tail and analyzed using a DH36 Vet hematology analyzer (Dymind, China) one day before irradiation, one day and three days after irradiation, and weekly thereafter for 70 days. Experimental data were presented as mean ± standard deviation (M ± SD). Results: In this study, the impact of a single local exposure to proton radiation at a dose of 30 Gy on the degree and dynamics of radiation-induced skin damage formation was evaluated. It was demonstrated that Balb/c mice exhibited a higher frequency and degree of radiation-induced skin damage formation compared to the C57BL/6 mice. Analysis of body weight in mice after radiation exposure revealed no significant decrease in either mouse strain. A comparative analysis of the number of platelets, erythrocytes and hemoglobin concentration in both mouse strains did not reveal any changes, while a tendency towards a decrease in the number of leukocytes, lymphocytes, and granulocytes was observed in the irradiated Balb/c mice group compared to the control group. Conversely, in irradiated C57BL/6 mice, the number of lymphocytes was higher compared to control animals. Conclusion: In this study, Balb/c mice exhibited higher radiosensitivity compared to C57BL mice in response to a single local proton irradiation at a dose of 30 Gy.
{"title":"Comparative Assessment of the Effect of Local Proton Radiation with a Dose of 30 Gy in BALB/c and C57BL/6 Mice","authors":"V.A. Anikina, S.S. Sorokina, A. E. Shemyakov, E. A. Zamyatina, N.R. Popova","doi":"10.33266/1024-6177-2024-69-1-20-27","DOIUrl":"https://doi.org/10.33266/1024-6177-2024-69-1-20-27","url":null,"abstract":"Purpose: To evaluate the effect of local proton irradiation at a dose of 30 Gy on Balb/c and C57BL/6 mice in terms of the degree and dynamics of radiation-induced skin damage formation, changes in body weight and peripheral blood elements count. Material and methods: Experiments were performed on non-depilated male mice aged 7‒8 weeks from two strains: Balb/c and C57BL/6 (n=15). Local irradiation of the skin was carried out on the dorsal side of the animals using a scanning proton beam at an extended Bragg peak in the proton therapy complex «Prometheus» of the LPI Physico-technical Centre (Protvino) at a dose of 30 Gy with a proton energy of 87.8 MeV. During the irradiation session, animals were subjected to intraperitoneal anesthesia using a combination of Zoletil 100 (Virbac, France) and Xyla (Interchemie, Netherlands) in a previously determined ratio 1:3 (20‒40 mg/kg). Photographic documentation of radiation-induced skin damage was performed weekly for 70 days. Animals were examined daily for clinical manifestations of radiation-induced skin damage formation according to the RTOG international scale for 21 days following irradiation. The body weight dynamics of mice were evaluated one day before irradiation and then weekly for 70 days. Blood samples were collected from the tail vein by cutting the tip of the tail and analyzed using a DH36 Vet hematology analyzer (Dymind, China) one day before irradiation, one day and three days after irradiation, and weekly thereafter for 70 days. Experimental data were presented as mean ± standard deviation (M ± SD). Results: In this study, the impact of a single local exposure to proton radiation at a dose of 30 Gy on the degree and dynamics of radiation-induced skin damage formation was evaluated. It was demonstrated that Balb/c mice exhibited a higher frequency and degree of radiation-induced skin damage formation compared to the C57BL/6 mice. Analysis of body weight in mice after radiation exposure revealed no significant decrease in either mouse strain. A comparative analysis of the number of platelets, erythrocytes and hemoglobin concentration in both mouse strains did not reveal any changes, while a tendency towards a decrease in the number of leukocytes, lymphocytes, and granulocytes was observed in the irradiated Balb/c mice group compared to the control group. Conversely, in irradiated C57BL/6 mice, the number of lymphocytes was higher compared to control animals. Conclusion: In this study, Balb/c mice exhibited higher radiosensitivity compared to C57BL mice in response to a single local proton irradiation at a dose of 30 Gy.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139819330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.33266/1024-6177-2024-69-1-28-32
L.A. Romodin, E. Yashkina, A.A. Moskovskij
Relevance: A number of researchers consider the study of the radioprotective properties of non-toxic or low-toxic natural substances to be a promising direction. A special place among them is occupied by antioxidants and participants in the basic reactions of metabolism. In order to avoid methodological errors when performing these studies, it is necessary to conduct a number of additional experiments. For example, in order to study the properties of various substances on cell cultures using tablet readers, it is first necessary to make sure that these substances do not affect the ability of cells to adsorb to the bottom of the wells of the tablet and do not interfere with cell proliferation. And if such an influence is detected, further experiments with these substances should be planned taking into account the information received. Purpose: To search the effect of ascorbic, malic and succinic acids on the ability of lung adenocarcinoma cells (A549) to adhere in a 96-well plate, followed by the onset of proliferation by fluorescence registration method using Hoechst-33342 fluorophore. Methodology: The experiment was carried out in a 96-well tablet. The working concentration of Hoechst-33342 was 1 μg/ml (1.62 μM). Fluorescence was recorded at a wavelength of 460 nm when the samples were excited by light with a wavelength of 355 nm. In an experiment to study the effect of ascorbate, malate and succinate on cell adhesion and proliferation, 20,000 cells and a solution of one of these substances in a working concentration of 2 mM were introduced into the cells of the tablet. The number of cells in the wells was estimated based on the fluorescence of Hoechst-33342 after a day of incubation. Result: In samples containing 2 mM succinic acid and ascorbic acid, a statistically significant decrease in the intensity of fluorescence was observed compared with a sample that did not contain the drug. This suggests that these compounds negatively affect the growth properties of the A549 culture: they inhibit cell adhesion or slow down their proliferation. Scope of the results and conclusions:The results obtained are necessary for the methodologically correct planning of the most detailed studies on the A549 cell line model using fluorescent methods, including studies on the radioprotective properties of ascorbate, malate and succinate under the influence of rare ionizing and neutron radiation.
{"title":"Fluorimetric Evaluation of the Effect of Malic, Succinic and Ascorbic Acids on the Growth Properties of A549 Cells in Culture","authors":"L.A. Romodin, E. Yashkina, A.A. Moskovskij","doi":"10.33266/1024-6177-2024-69-1-28-32","DOIUrl":"https://doi.org/10.33266/1024-6177-2024-69-1-28-32","url":null,"abstract":"Relevance: A number of researchers consider the study of the radioprotective properties of non-toxic or low-toxic natural substances to be a promising direction. A special place among them is occupied by antioxidants and participants in the basic reactions of metabolism. In order to avoid methodological errors when performing these studies, it is necessary to conduct a number of additional experiments. For example, in order to study the properties of various substances on cell cultures using tablet readers, it is first necessary to make sure that these substances do not affect the ability of cells to adsorb to the bottom of the wells of the tablet and do not interfere with cell proliferation. And if such an influence is detected, further experiments with these substances should be planned taking into account the information received. Purpose: To search the effect of ascorbic, malic and succinic acids on the ability of lung adenocarcinoma cells (A549) to adhere in a 96-well plate, followed by the onset of proliferation by fluorescence registration method using Hoechst-33342 fluorophore. Methodology: The experiment was carried out in a 96-well tablet. The working concentration of Hoechst-33342 was 1 μg/ml (1.62 μM). Fluorescence was recorded at a wavelength of 460 nm when the samples were excited by light with a wavelength of 355 nm. In an experiment to study the effect of ascorbate, malate and succinate on cell adhesion and proliferation, 20,000 cells and a solution of one of these substances in a working concentration of 2 mM were introduced into the cells of the tablet. The number of cells in the wells was estimated based on the fluorescence of Hoechst-33342 after a day of incubation. Result: In samples containing 2 mM succinic acid and ascorbic acid, a statistically significant decrease in the intensity of fluorescence was observed compared with a sample that did not contain the drug. This suggests that these compounds negatively affect the growth properties of the A549 culture: they inhibit cell adhesion or slow down their proliferation. Scope of the results and conclusions:The results obtained are necessary for the methodologically correct planning of the most detailed studies on the A549 cell line model using fluorescent methods, including studies on the radioprotective properties of ascorbate, malate and succinate under the influence of rare ionizing and neutron radiation.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139873143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.33266/1024-6177-2024-69-1-73-76
D. Kalinkin, I. Milto, Anas R. Takhauov, Lilia R. Takhauova, Yulia A. Samoilova, G. V. Gorina, Olesya V. Litvinova, R. M. Takhauov
Introduction: Uranium, which is the raw material basis of the nuclear industry, is capable of causing adverse medical and biological consequences for workers who come into contact with its compounds in the course of their professional activities. In order to study this effect and to study in detail the biomedical consequences of the effects of uranium compounds on the body of personnel of nuclear power facilities, it is necessary to form a cohort of persons engaged in work with uranium compounds. One of the key elements of the uranium conversion technology carried out within the framework of sublimation production is the production of raw uranium hexafluoride for subsequent isotopic enrichment. Purpose: To form and characterize a cohort of sublimate production of the personnel of the Siberian Chemical Plant involved in work with uranium compounds in the period 1953–2000. Material and methods: The source of information was the regional medical dosimetric register of Seversk Biophysical Research Center, containing information on all current and former employees of the Siberian Chemical Plant (about 65,000 people) from the moment of the company’s foundation to the present. Results: A cohort of Siberian Chemical Plant workers involved in work with uranium compounds in the period 1953–2000 has been formed and described. The cohort consists of 577 people (475 men and 102 women). Biomedical information and dosimetric information about the employees included in the cohort are included in the created database of the personnel of the Siberian Chemical Plant involved in working with uranium compounds in the period 1953–2000. Conclusion: The formed cohort and database will allow conducting epidemiological studies to assess the morbidity and mortality of personnel due to malignant neoplasms, as well as making scientifically sound conclusions about the role of uranium compounds in the occurrence and mortality due to malignant neoplasms.
{"title":"The Sublimate Production Cohort of the Siberian Chemical Plant (Dosimetric Characteristics)","authors":"D. Kalinkin, I. Milto, Anas R. Takhauov, Lilia R. Takhauova, Yulia A. Samoilova, G. V. Gorina, Olesya V. Litvinova, R. M. Takhauov","doi":"10.33266/1024-6177-2024-69-1-73-76","DOIUrl":"https://doi.org/10.33266/1024-6177-2024-69-1-73-76","url":null,"abstract":"Introduction: Uranium, which is the raw material basis of the nuclear industry, is capable of causing adverse medical and biological consequences for workers who come into contact with its compounds in the course of their professional activities. In order to study this effect and to study in detail the biomedical consequences of the effects of uranium compounds on the body of personnel of nuclear power facilities, it is necessary to form a cohort of persons engaged in work with uranium compounds. One of the key elements of the uranium conversion technology carried out within the framework of sublimation production is the production of raw uranium hexafluoride for subsequent isotopic enrichment. Purpose: To form and characterize a cohort of sublimate production of the personnel of the Siberian Chemical Plant involved in work with uranium compounds in the period 1953–2000. Material and methods: The source of information was the regional medical dosimetric register of Seversk Biophysical Research Center, containing information on all current and former employees of the Siberian Chemical Plant (about 65,000 people) from the moment of the company’s foundation to the present. Results: A cohort of Siberian Chemical Plant workers involved in work with uranium compounds in the period 1953–2000 has been formed and described. The cohort consists of 577 people (475 men and 102 women). Biomedical information and dosimetric information about the employees included in the cohort are included in the created database of the personnel of the Siberian Chemical Plant involved in working with uranium compounds in the period 1953–2000. Conclusion: The formed cohort and database will allow conducting epidemiological studies to assess the morbidity and mortality of personnel due to malignant neoplasms, as well as making scientifically sound conclusions about the role of uranium compounds in the occurrence and mortality due to malignant neoplasms.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139875678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.33266/1024-6177-2023-68-6-67-72
Zh.V. Sheikh, S. Shvayko, L.G. Leonova, E. Tarachkova, E.I. Bogdanova, E.S. Stepanchenko
Despite the widespread introduction of CT into clinical practice, the diagnosis of cryptogenic organizing pneumonia is still an urgent task of modern radiology. Radiological diagnosticians and clinicians have significant difficulties in diagnosis due to rather low frequency of this disease and nonspecific clinical manifestations. Cryptogenic organizing pneumonia is a disease which sharply worsens the quality of life in case of untimely diagnosis and belongs to the group of idiopathic interstitial pneumonias. The article is devoted to the clinical case of a patient with verified cryptogenic organizing pneumonia. CT of the chest organs, along with clinical data, plays a key role in the accurate diagnosis of organizing pneumonia.
{"title":"Cryptogenic Organizing Pneumonia (Clinical Case Report, Literature Review)","authors":"Zh.V. Sheikh, S. Shvayko, L.G. Leonova, E. Tarachkova, E.I. Bogdanova, E.S. Stepanchenko","doi":"10.33266/1024-6177-2023-68-6-67-72","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-67-72","url":null,"abstract":"Despite the widespread introduction of CT into clinical practice, the diagnosis of cryptogenic organizing pneumonia is still an urgent task of modern radiology. Radiological diagnosticians and clinicians have significant difficulties in diagnosis due to rather low frequency of this disease and nonspecific clinical manifestations. Cryptogenic organizing pneumonia is a disease which sharply worsens the quality of life in case of untimely diagnosis and belongs to the group of idiopathic interstitial pneumonias. The article is devoted to the clinical case of a patient with verified cryptogenic organizing pneumonia. CT of the chest organs, along with clinical data, plays a key role in the accurate diagnosis of organizing pneumonia.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To develop a software package Virtual examination of brain perfusion by the method of SPECT/CT with 99mTc-HMPAO (Teoxime) and its practical application to study the conditions for achieving the best image quality in clinical studies of patients. Material and methods: The studies were performed using clinical data and the method of computer simulation. Clinical data of single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) with 99mTc-hexamethylpropyleneamine oxime (99mTc-Teoxime, produced by DIAMED LLC) of a patient with an ischemic stroke of the right frontal cortex were obtained on a two-detector gamma-camera NM/CT 670 DR GE Discovery (USA) using high-resolution low-energy collimators (LEHR). The measured data were processed using specialized software Q.Brain and Q.Volumetrix MI on a Xeleris 4.0 DR workstation from GE Healthcare (USA) to obtain reconstructed axial tomographic slices. To carry out simulation computer simulation of the procedure of examination of perfusion of GM by the method of SPECT/CT has developed a software package that includes a mathematical Hoffman phantom with the ability to simulate clinical cases of hypoperfusion of different localization and size (Virtual Patient), modeling the collection of “raw” projection data and an image reconstruction program based on the OSEM algorithm (Ordered Subset Expectation Maximization). An important advantage of the mathematical modeling method is the ability to assess the quality of the reconstructed image by calculating the root-mean-square error when compared with a given phantom. In numerical experiments, the dependence of the reconstruction error on the parameters of the OSEM algorithm (on the number of subgroups – subsets, and on the number of iterations) was investigated in order to determine the conditions for achieving the best image quality. A statistical stop criterion was developed and tested. Results: For the first time, a software package was developed and tested that allows us to investigate errors in the reconstruction algorithm, which is a great difficulty when using clinical research methods. A criterion for stopping iterations is proposed when using the OSEM reconstruction algorithm – minimizing the functional deviation of the chi-square function from the target value, while the detector pixels with non-zero values are combined into blocks according to the 2×2 scheme. There is a reliable good correlation between the proposed stop criterion and the minimum of the root-mean-square error of image reconstruction. This makes it possible to introduce this criterion into the clinical practice of using computational tools for reconstructing sections of the SPECT to obtain the best image. The simulation results demonstrated the possibility of reducing the time of data recording, during which the patient must remain motionless, at least twice. Conclusion: The method of computer simulation developed in this work is a practically use
{"title":"Development of Software Tools Based on Clinical Data and Phantom Studies for Mathematical Simulation Modeling to Assess Brain Perfusion and Improve Image Quality During SPECT/CT with 99mTc-GMPAO","authors":"N.V. Denisova, A.V. Nesterova, S.M. Minin, Zh.Zh. Anashbayev, S.E. Krasilnikov, W. Yu. Ussov","doi":"10.33266/1024-6177-2023-68-6-106-117","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-106-117","url":null,"abstract":"Purpose: To develop a software package Virtual examination of brain perfusion by the method of SPECT/CT with 99mTc-HMPAO (Teoxime) and its practical application to study the conditions for achieving the best image quality in clinical studies of patients. Material and methods: The studies were performed using clinical data and the method of computer simulation. Clinical data of single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) with 99mTc-hexamethylpropyleneamine oxime (99mTc-Teoxime, produced by DIAMED LLC) of a patient with an ischemic stroke of the right frontal cortex were obtained on a two-detector gamma-camera NM/CT 670 DR GE Discovery (USA) using high-resolution low-energy collimators (LEHR). The measured data were processed using specialized software Q.Brain and Q.Volumetrix MI on a Xeleris 4.0 DR workstation from GE Healthcare (USA) to obtain reconstructed axial tomographic slices. To carry out simulation computer simulation of the procedure of examination of perfusion of GM by the method of SPECT/CT has developed a software package that includes a mathematical Hoffman phantom with the ability to simulate clinical cases of hypoperfusion of different localization and size (Virtual Patient), modeling the collection of “raw” projection data and an image reconstruction program based on the OSEM algorithm (Ordered Subset Expectation Maximization). An important advantage of the mathematical modeling method is the ability to assess the quality of the reconstructed image by calculating the root-mean-square error when compared with a given phantom. In numerical experiments, the dependence of the reconstruction error on the parameters of the OSEM algorithm (on the number of subgroups – subsets, and on the number of iterations) was investigated in order to determine the conditions for achieving the best image quality. A statistical stop criterion was developed and tested. Results: For the first time, a software package was developed and tested that allows us to investigate errors in the reconstruction algorithm, which is a great difficulty when using clinical research methods. A criterion for stopping iterations is proposed when using the OSEM reconstruction algorithm – minimizing the functional deviation of the chi-square function from the target value, while the detector pixels with non-zero values are combined into blocks according to the 2×2 scheme. There is a reliable good correlation between the proposed stop criterion and the minimum of the root-mean-square error of image reconstruction. This makes it possible to introduce this criterion into the clinical practice of using computational tools for reconstructing sections of the SPECT to obtain the best image. The simulation results demonstrated the possibility of reducing the time of data recording, during which the patient must remain motionless, at least twice. Conclusion: The method of computer simulation developed in this work is a practically use","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.33266/1024-6177-2023-68-6-80-85
S. Prokhorov, N. Kochergina, A. Ryzhkov, A. Krylov, A. Bludov
Aim: To evaluate the possibilities of absolute and relative values of the apparent diffusion coefficient (ADC) in the diagnosis of metastatic lesions of skeletal bones. Material and methods: The study included 12 patients with metastatic bone lesions, before any treatment was applied. The age of the patients ranged from 38 to 73 years, 3 men, 9 women. Among the morphological forms of tumors were presented: cancers of the breast (3), prostate (1) glands, colon (1), lung (2), body (1) and cervix (1) uterus, thyroid (1) and pancreas (2). The detected changes were classified on the basis of Bone scan, SPECT/CT and standard MRI. The ADC values of unchanged bone marrow (n=360), divided by anatomical zones, metastatic foci (n=117), as well as benign changes of various nature (n=19) were analyzed. The ratio of the ADC values of each of the metastatic and benign focal formations to the normal values for each of the localizations was calculated. Results: Unchanged bone marrow, depending on anatomical localization (cervical, thoracic, lumbar spine, pelvic bones, shoulder blades, collarbones, sternum, ribs, proximal humerus and femur bones) from the point of view of ADC, showed statistically significant heterogeneity. Statistical analysis has shown that there is no connection between the groups of ADC indicators in the foci of metastatic lesions, combined depending on the anatomical localization. With a similar comparison, but by belonging to the primary tumor, an even greater intergroup difference was found. ADC values in the foci of metastatic lesions turned out to be dependent on the morphological type of the primary tumor and significantly differ both from metastases of other morphological affiliation and from normal red bone marrow parameters. The use of relative values allowed to increase the specificity from 15 to 19 %. Conclusion: This study showed that knowledge of the range of reference ADC values for unchanged red bone marrow and anomalies of various genesis is important in differential diagnosis. The differentiation of the skeleton into separate anatomical zones probably makes it possible to increase the effectiveness of the isolated application of the technique when it comes to absolute values. The morphological affiliation of metastatic foci is important in the formation of ADC values, rather than the bone marrow microenvironment, which is also supported by the low efficiency of the use of relative values.
{"title":"The Apparent Diffusion Coefficient in the Diagnosis of Metastatic Lesions of Skeletal Bones","authors":"S. Prokhorov, N. Kochergina, A. Ryzhkov, A. Krylov, A. Bludov","doi":"10.33266/1024-6177-2023-68-6-80-85","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-80-85","url":null,"abstract":"Aim: To evaluate the possibilities of absolute and relative values of the apparent diffusion coefficient (ADC) in the diagnosis of metastatic lesions of skeletal bones. Material and methods: The study included 12 patients with metastatic bone lesions, before any treatment was applied. The age of the patients ranged from 38 to 73 years, 3 men, 9 women. Among the morphological forms of tumors were presented: cancers of the breast (3), prostate (1) glands, colon (1), lung (2), body (1) and cervix (1) uterus, thyroid (1) and pancreas (2). The detected changes were classified on the basis of Bone scan, SPECT/CT and standard MRI. The ADC values of unchanged bone marrow (n=360), divided by anatomical zones, metastatic foci (n=117), as well as benign changes of various nature (n=19) were analyzed. The ratio of the ADC values of each of the metastatic and benign focal formations to the normal values for each of the localizations was calculated. Results: Unchanged bone marrow, depending on anatomical localization (cervical, thoracic, lumbar spine, pelvic bones, shoulder blades, collarbones, sternum, ribs, proximal humerus and femur bones) from the point of view of ADC, showed statistically significant heterogeneity. Statistical analysis has shown that there is no connection between the groups of ADC indicators in the foci of metastatic lesions, combined depending on the anatomical localization. With a similar comparison, but by belonging to the primary tumor, an even greater intergroup difference was found. ADC values in the foci of metastatic lesions turned out to be dependent on the morphological type of the primary tumor and significantly differ both from metastases of other morphological affiliation and from normal red bone marrow parameters. The use of relative values allowed to increase the specificity from 15 to 19 %. Conclusion: This study showed that knowledge of the range of reference ADC values for unchanged red bone marrow and anomalies of various genesis is important in differential diagnosis. The differentiation of the skeleton into separate anatomical zones probably makes it possible to increase the effectiveness of the isolated application of the technique when it comes to absolute values. The morphological affiliation of metastatic foci is important in the formation of ADC values, rather than the bone marrow microenvironment, which is also supported by the low efficiency of the use of relative values.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.33266/1024-6177-2023-68-6-92-98
T. Malivanova, T. Astrelina, I. Kobzeva, V. Nikitina, Y. Suchkova, A.I. Golovkova, A. S. Ostashkin, D. Usupzhanova, V. Brunchukov, A. Rastorgueva, E. I. Dobrovolskaya, A. Kirilchev, M. Sukhova, O.G. Mikhadarkina, N.V. Sokolova, A. Samoilov
Background: Adjuvant radiation therapy (ART), an integral part of locoregional breast cance (BC) therapy, acting not only locally, but also systemically and leads to a shift in homeostasis, which is reflected in routine general clinical tests. Tumor necrosis factor (TNF) is a proinflammatory cytokine, the production of which can be influenced by the single-nucleotide substitution -308(G/A)TNF. The minor allele -308A can be included in the stable inherited haplotype AH8.1 of the HLA gene complex. At the same time, the carriage of the -308A without the AH8.1 haplotype is associated with a poor prognosis in patients with BC. The aim of the study was to evaluate the features of the systemic response to the course of ART in carriers of TNF-associated genotypes with BC. Material and methods: The sample is represented by 147 BC patients who underwent a course of ART (2 Gy in 25 fractions). Clinical and morphological characteristics and data of general clinical blood analysis were obtained from medical histories. Venous blood samples for the study were obtained at the beginning and at the end of the ART course. Alleles -308(G/A)TNF and marker alleles of haplotype AH8.1 (HLA-A×01, HLA-B×08 and HLA-DRB1×03) were determined by allele-specific PCR. sTNF concentrations were determined by the ELISA in 102 blood plasma samples. Results: TNF-associated comparison groups were identified based on genotyping: (1) 114 carriers -308GG of the TNF gene, regardless of the AH8.1 haplotype (77,6 %); (2) 23 carrier -308A(AH8.1pos) had at least one AH8.1 marker allele (15.6 %); (3) 10 carriers -308A(AH8.1neg) did not have any AH8.1 marker allele (6.8 %). In the -308A(AH8.1neg) group the average concentration of sTNF both at the beginning and at the end of ART was significantly higher and, unlike other comparison groups, did not significantly decrease at the end of the ART course. A significant decrease in absolute values was revealed during ART in a number of cases for leukocytes, platelets and lymphocytes, however within the reference values. In the group -308A(AH8.1neg) correlation analysis revealed a high strength of positive connections between sTNF and leukocytes (r=0.71; p=0.027), platelets (r=0.67; p=0.04), neutrophils (r=0.70; p=0.027) only at the end of ART, whereas at the beginning ART these correlations were weak (r≤0.3) and statistically unreliable. For other genetic groups, the revealed correlations were not strong enough. Conclusion: The revealed features of the systemic response to ART for carriers of a prognostically unfavorable genotype -308A(AH8.1neg) – a high concentration of sTNF and a positive correlation with the content of leukocytes (probably due to neutrophils) and platelets – can be considered as targets of individualized therapy.
{"title":"Features of the Systemic Response to Adjuvant Radiation Therapy in Carriers of Polymorphism -308(G/A)TNF in Breast Cancer Patients","authors":"T. Malivanova, T. Astrelina, I. Kobzeva, V. Nikitina, Y. Suchkova, A.I. Golovkova, A. S. Ostashkin, D. Usupzhanova, V. Brunchukov, A. Rastorgueva, E. I. Dobrovolskaya, A. Kirilchev, M. Sukhova, O.G. Mikhadarkina, N.V. Sokolova, A. Samoilov","doi":"10.33266/1024-6177-2023-68-6-92-98","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-92-98","url":null,"abstract":"Background: Adjuvant radiation therapy (ART), an integral part of locoregional breast cance (BC) therapy, acting not only locally, but also systemically and leads to a shift in homeostasis, which is reflected in routine general clinical tests. Tumor necrosis factor (TNF) is a proinflammatory cytokine, the production of which can be influenced by the single-nucleotide substitution -308(G/A)TNF. The minor allele -308A can be included in the stable inherited haplotype AH8.1 of the HLA gene complex. At the same time, the carriage of the -308A without the AH8.1 haplotype is associated with a poor prognosis in patients with BC. The aim of the study was to evaluate the features of the systemic response to the course of ART in carriers of TNF-associated genotypes with BC. Material and methods: The sample is represented by 147 BC patients who underwent a course of ART (2 Gy in 25 fractions). Clinical and morphological characteristics and data of general clinical blood analysis were obtained from medical histories. Venous blood samples for the study were obtained at the beginning and at the end of the ART course. Alleles -308(G/A)TNF and marker alleles of haplotype AH8.1 (HLA-A×01, HLA-B×08 and HLA-DRB1×03) were determined by allele-specific PCR. sTNF concentrations were determined by the ELISA in 102 blood plasma samples. Results: TNF-associated comparison groups were identified based on genotyping: (1) 114 carriers -308GG of the TNF gene, regardless of the AH8.1 haplotype (77,6 %); (2) 23 carrier -308A(AH8.1pos) had at least one AH8.1 marker allele (15.6 %); (3) 10 carriers -308A(AH8.1neg) did not have any AH8.1 marker allele (6.8 %). In the -308A(AH8.1neg) group the average concentration of sTNF both at the beginning and at the end of ART was significantly higher and, unlike other comparison groups, did not significantly decrease at the end of the ART course. A significant decrease in absolute values was revealed during ART in a number of cases for leukocytes, platelets and lymphocytes, however within the reference values. In the group -308A(AH8.1neg) correlation analysis revealed a high strength of positive connections between sTNF and leukocytes (r=0.71; p=0.027), platelets (r=0.67; p=0.04), neutrophils (r=0.70; p=0.027) only at the end of ART, whereas at the beginning ART these correlations were weak (r≤0.3) and statistically unreliable. For other genetic groups, the revealed correlations were not strong enough. Conclusion: The revealed features of the systemic response to ART for carriers of a prognostically unfavorable genotype -308A(AH8.1neg) – a high concentration of sTNF and a positive correlation with the content of leukocytes (probably due to neutrophils) and platelets – can be considered as targets of individualized therapy.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138622949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.33266/1024-6177-2023-68-6-86-91
O. Gribova, Z. Startseva, E. Choynzonov, V. A. Novikov, A. Ryabova, V. Shtin
The purpose: To evaluate the efficiency of combined treatment of patients with salivary gland cancer using neutron therapy. Material and methods: The study included 130 patients with salivary gland cancer who underwent combined treatment with adjuvant neutron or standard photon radiotherapy. Neutron therapy was performed on a cyclotron U-120. The average energy of fast neutrons was 6.3 MeV. Results: There was observed a significant decrease in the frequency of relapses in the group of patients who received a postoperative course of NT compared with the control group (21.1 % vs. 45 %, p<0.05). The five-year overall survival in the study group was 73.8±9.5 %, in the control group ‒ 43.2±9.4% (p<0.05). The value of five-year relapse-free survival in the study group was 65.6±7.5 %, in the control group ‒ 34.8±9.1 % (p<0.05). Erythema of the skin in the irradiation area (grade I) was the most frequent type of local acute radiation reaction and was observed in 60 % of patients in the study group and in 25 % of patients in the control group. The most frequent late complication in both groups of patients was skin atrophy and subcutaneous fibrosis (grade I on the RTOG/EORTC scale). In the study group, this indicator was 34.4 %, in the control group ‒ 20 % (p>0.05). Conclusion: Thus, the study confirmed the high effectiveness of fast neutron therapy against malignant tumors of the salivary glands. Neutron therapy does not cause serious complications, encourages to increase of patients life expectancy and to decrease the number of relapses after combined treatment in comparison with standard methods of treatment.
{"title":"Combined Treatment of Salivary Gland Cancer Patients with the Use of High-Let Radiation","authors":"O. Gribova, Z. Startseva, E. Choynzonov, V. A. Novikov, A. Ryabova, V. Shtin","doi":"10.33266/1024-6177-2023-68-6-86-91","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-86-91","url":null,"abstract":"The purpose: To evaluate the efficiency of combined treatment of patients with salivary gland cancer using neutron therapy. Material and methods: The study included 130 patients with salivary gland cancer who underwent combined treatment with adjuvant neutron or standard photon radiotherapy. Neutron therapy was performed on a cyclotron U-120. The average energy of fast neutrons was 6.3 MeV. Results: There was observed a significant decrease in the frequency of relapses in the group of patients who received a postoperative course of NT compared with the control group (21.1 % vs. 45 %, p<0.05). The five-year overall survival in the study group was 73.8±9.5 %, in the control group ‒ 43.2±9.4% (p<0.05). The value of five-year relapse-free survival in the study group was 65.6±7.5 %, in the control group ‒ 34.8±9.1 % (p<0.05). Erythema of the skin in the irradiation area (grade I) was the most frequent type of local acute radiation reaction and was observed in 60 % of patients in the study group and in 25 % of patients in the control group. The most frequent late complication in both groups of patients was skin atrophy and subcutaneous fibrosis (grade I on the RTOG/EORTC scale). In the study group, this indicator was 34.4 %, in the control group ‒ 20 % (p>0.05). Conclusion: Thus, the study confirmed the high effectiveness of fast neutron therapy against malignant tumors of the salivary glands. Neutron therapy does not cause serious complications, encourages to increase of patients life expectancy and to decrease the number of relapses after combined treatment in comparison with standard methods of treatment.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138610916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.33266/1024-6177-2023-68-6-60-66
A. Tukov, I. Shafransky, O. Prokhorova, A.M. Mikhailenko, M. Ziyatdinov
Summary: Investigation purposes Diabetes mellitus (DM) occupies the largest share in the structure of endocrine system diseases, nutritional disorders and metabolic disorders, which is currently one of the important priorities of national health systems. Research on certain groups of the population with their own harmful occupational risk factors is relevant. Analysis of the incidence of diabetes mellitus of the second type - T2DM (ICD 10: E11-E11.9) of liquidators of the consequences of the Chernobyl accident ‒ workers of nuclear industry enterprises for 30 years of observation and assessment of the radiation risk of its occurrence. Material and methods: The study includes data from the Industry register of persons exposed to radiation as a result of the Chernobyl accident over a thirty-year period, having a verified dose of external radiation received during work in the 30 km zone of the Chernobyl nuclear power plant, men – 12663 people, 1327, of whom have data on the dose of occupational irradiation. The Poisson process with an intensity parameter was chosen as a statistical model of morbidity. Results: The incidence of T2DM in liquidators of the consequences of the Chernobyl accident was estimated by age and sex groups. On the basis of the obtained file of individual unstratified data, an analytical likelihood function for the Poisson process was constructed and the value of the excess relative risk (ERR) of T2DM incidence was calculated and the nature of the dose dependence of RR was investigated. A cohort epidemiological study of a group of liquidators in 1986–1990 was carried out. over a thirty-year period, depending on the dose, both received during the liquidation of the consequences of the Chernobyl accident, and during professional work with radioactive substances (RS) and sources of ionizing radiation (IRS). Direct estimates of the radiogenic risk of diabetes mellitus are given. Different values of risk were noted when using doses from different types of radiation. There was no significant increase in the risk of disease per dose unit (ERR / Sv). Conclusion: With the aging of the cohort of liquidators, an increase in the incidence of T2DM was noted in both men and women. The results obtained on the assessment of the radiation risk of T2DM at this stage are taken as preliminary, since the use of radiation risk in the development of radiation safety regulations requires a total dose from all types of exposure (professional, emergency, medical, natural).
{"title":"Diabetes Mellitus Incidence and the Risk of its Occurrence in Liquidators of the Chnpp Accident Consequences including Nuclear Industry Workers","authors":"A. Tukov, I. Shafransky, O. Prokhorova, A.M. Mikhailenko, M. Ziyatdinov","doi":"10.33266/1024-6177-2023-68-6-60-66","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-60-66","url":null,"abstract":"Summary: Investigation purposes Diabetes mellitus (DM) occupies the largest share in the structure of endocrine system diseases, nutritional disorders and metabolic disorders, which is currently one of the important priorities of national health systems. Research on certain groups of the population with their own harmful occupational risk factors is relevant. Analysis of the incidence of diabetes mellitus of the second type - T2DM (ICD 10: E11-E11.9) of liquidators of the consequences of the Chernobyl accident ‒ workers of nuclear industry enterprises for 30 years of observation and assessment of the radiation risk of its occurrence. Material and methods: The study includes data from the Industry register of persons exposed to radiation as a result of the Chernobyl accident over a thirty-year period, having a verified dose of external radiation received during work in the 30 km zone of the Chernobyl nuclear power plant, men – 12663 people, 1327, of whom have data on the dose of occupational irradiation. The Poisson process with an intensity parameter was chosen as a statistical model of morbidity. Results: The incidence of T2DM in liquidators of the consequences of the Chernobyl accident was estimated by age and sex groups. On the basis of the obtained file of individual unstratified data, an analytical likelihood function for the Poisson process was constructed and the value of the excess relative risk (ERR) of T2DM incidence was calculated and the nature of the dose dependence of RR was investigated. A cohort epidemiological study of a group of liquidators in 1986–1990 was carried out. over a thirty-year period, depending on the dose, both received during the liquidation of the consequences of the Chernobyl accident, and during professional work with radioactive substances (RS) and sources of ionizing radiation (IRS). Direct estimates of the radiogenic risk of diabetes mellitus are given. Different values of risk were noted when using doses from different types of radiation. There was no significant increase in the risk of disease per dose unit (ERR / Sv). Conclusion: With the aging of the cohort of liquidators, an increase in the incidence of T2DM was noted in both men and women. The results obtained on the assessment of the radiation risk of T2DM at this stage are taken as preliminary, since the use of radiation risk in the development of radiation safety regulations requires a total dose from all types of exposure (professional, emergency, medical, natural).","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To estimate the potential of imaging methods in the diagnosis of non-alcoholic fatty liver disease (NAFLD) based on the example of a clinical case. Material and methods: A 42 years-old man with suspected of NAFLD, by the clinical and laboratory tests results, underwent a quantitative assessment of fatty hepatosis using radiodiagnosis imaging methods. We used US “liver protocol” with attenuation imaging technique (ATI), shear wave elastography (SWE), shear wave dispersion imaging (SWD), computed tomography (CT) with quantitative and qualitative assessment using the liver-spleen index (CTL-S); MRI with application that provides volumetric whole-liver fat fraction (FF) measurements by proton density (PDFF), on the basis of IDEAL IQ program. The morphological verification of liver biopsy was also performed. Results: All imaging method used in this clinical case showed severe degree of fatty hepathosis, that correlated with biopsy of liver. In repeated studies, on the background of treatment, the quantitative indicators of all imaging methods had a similar dynamics of reduction of the degree of fatty hepatosis. Conclusion: The clinical case of verified acute steatohepatitis shows the possibilities of its diagnostics by means of the radiation modalities. We used US with ATI, SWE и SWD, CT with CTL-S, MRI with FF that demonstrated high diagnostic efficiency for determination fatty hepatosis and the possibility of its quantification. These technologies are suitable for widespread implementation into clinical practice providing good diagnostic accuracy. CT associated with higher doses of radiation is not considered to be the basic method of choice for diagnosing NAFLD, but still may provide a physician with necessary information to determine further treatment strategy.
目的:通过对非酒精性脂肪性肝病(NAFLD)的临床分析，探讨影像学诊断的潜力。材料和方法:一名42岁男性疑似NAFLD，通过临床和实验室检查结果，采用放射诊断成像方法对脂肪肝进行定量评估。我们采用美国“肝脏方案”，结合衰减成像技术(ATI)、横波弹性成像(SWE)、横波色散成像(SWD)、计算机断层扫描(CT)，利用肝脾指数(CTL-S)进行定量和定性评估;MRI与应用程序，提供体积全肝脂肪分数(FF)测量的质子密度(PDFF)，在IDEAL IQ程序的基础上。同时进行肝活检的形态学验证。结果:本病例所有影像学检查均显示脂肪肝病变严重程度，与肝活检相关。在反复的研究中，在治疗的背景下，所有影像学方法的定量指标都具有相似的降低脂肪肝程度的动态。结论:经证实的急性脂肪性肝炎的临床病例显示了放射诊断的可能性。我们采用US联合ATI, SWE / SWD, CT联合CTL-S, MRI联合FF，对脂肪肝的诊断效率高，并有可能量化脂肪肝。这些技术适合广泛应用于临床实践，提供良好的诊断准确性。CT与高剂量的辐射不被认为是诊断NAFLD的基本方法，但仍然可以为医生提供必要的信息，以确定进一步的治疗策略。
{"title":"Modern Possibilities of Imaging Diagnosis Methods in Assessing the Severity of Fatty Hepatosis in Non-Alcoholic Fatty Liver Disease (Clinical Case)","authors":"E.I. Matkevich, A. Bashkov, E.A. Ionova, A.U. Veselkova, V.S. Rudakov, O.V. Parinov, V.V. Kapustin","doi":"10.33266/1024-6177-2023-68-6-73-79","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-6-73-79","url":null,"abstract":"Purpose: To estimate the potential of imaging methods in the diagnosis of non-alcoholic fatty liver disease (NAFLD) based on the example of a clinical case. Material and methods: A 42 years-old man with suspected of NAFLD, by the clinical and laboratory tests results, underwent a quantitative assessment of fatty hepatosis using radiodiagnosis imaging methods. We used US “liver protocol” with attenuation imaging technique (ATI), shear wave elastography (SWE), shear wave dispersion imaging (SWD), computed tomography (CT) with quantitative and qualitative assessment using the liver-spleen index (CTL-S); MRI with application that provides volumetric whole-liver fat fraction (FF) measurements by proton density (PDFF), on the basis of IDEAL IQ program. The morphological verification of liver biopsy was also performed. Results: All imaging method used in this clinical case showed severe degree of fatty hepathosis, that correlated with biopsy of liver. In repeated studies, on the background of treatment, the quantitative indicators of all imaging methods had a similar dynamics of reduction of the degree of fatty hepatosis. Conclusion: The clinical case of verified acute steatohepatitis shows the possibilities of its diagnostics by means of the radiation modalities. We used US with ATI, SWE и SWD, CT with CTL-S, MRI with FF that demonstrated high diagnostic efficiency for determination fatty hepatosis and the possibility of its quantification. These technologies are suitable for widespread implementation into clinical practice providing good diagnostic accuracy. CT associated with higher doses of radiation is not considered to be the basic method of choice for diagnosing NAFLD, but still may provide a physician with necessary information to determine further treatment strategy.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138623734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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