Pub Date : 2023-10-01DOI: 10.33266/1024-6177-2023-68-5-60-64
E.A. Kodintseva, A.А. Akleyev
Introduction 1. Main risk factors of radiation-induced carcinogenesis 2. Stages of an individualized approach to the formation of high-risk groups for cancer 3. Comprehensive medical examination of a patient 4. Determination of risk of radiation-induced carcinogenesis 5. Measures for prevention and (or) early diagnosis of radiation-induced malignant neoplasms 6. Monitoring of immunity indicators in persons at high risk of radiation-induced carcinogenesis Conclusion
{"title":"Individualized Approach to the Formation of High Cancer Risk Groups Based on the Assessment of Immunological Indicators in Chronically Exposed People","authors":"E.A. Kodintseva, A.А. Akleyev","doi":"10.33266/1024-6177-2023-68-5-60-64","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-5-60-64","url":null,"abstract":"Introduction 1. Main risk factors of radiation-induced carcinogenesis 2. Stages of an individualized approach to the formation of high-risk groups for cancer 3. Comprehensive medical examination of a patient 4. Determination of risk of radiation-induced carcinogenesis 5. Measures for prevention and (or) early diagnosis of radiation-induced malignant neoplasms 6. Monitoring of immunity indicators in persons at high risk of radiation-induced carcinogenesis Conclusion","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135921938","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 : 2023-10-01DOI: 10.33266/1024-6177-2023-68-5-38-43
S.A. Ryzhov, B.Ya. Narkevich, A.V. Vodovatov
Purpose: To analyze the existing in NRB-99/2009 and proposed in the journal “Medical Radiology and Radiation Safety” interpretations of the terms “dose limit” and “radiation accident” when developing a new version of this regulatory document. Material and methods: The features of the interpretation of these terms are considered both in NRB-99/2009 and in a number of domestic and international reference books and glossaries on radiation safety, including proposals published in No. 4 of the journal “Medical Radiology and Radiation Safety” for 2023. Results: The interpretation of the numerical values of the dose limits proposed in the indicated journal seems to be poorly substantiated, while their traditional interpretation remains more preferable. The addition of the concept of a radiation accident with the term “emergency” with its own explanation by the authors of the article contradicts the recommendations of the IAEA. The necessity of taking into account the specifics of radiation accidents in medicine when interpreting the term “radiation accident” is shown. Conclusions: 1. There is no need to revise the traditional interpretation of the numerical values of dose limits. 2. It is expedient to replace the wording of the concept of a radiation accident existing in NRB-99/2009 with the wording of the same concept from the IAEA glossary on radiation safety. 3. Taking into account the need for a correct interpretation of the concept of a radiation accident in medicine, the terms “radiation incident”, “unintentional (accidental) medical exposure” and “radiation accident” with their corresponding interpretations should be added to the new version of the NRB.
{"title":"To the Question of the Interpretation of the Terms “Dose Limit” and “Radiation Accident” in the Development of New Norms of Radiation Safety","authors":"S.A. Ryzhov, B.Ya. Narkevich, A.V. Vodovatov","doi":"10.33266/1024-6177-2023-68-5-38-43","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-5-38-43","url":null,"abstract":"Purpose: To analyze the existing in NRB-99/2009 and proposed in the journal “Medical Radiology and Radiation Safety” interpretations of the terms “dose limit” and “radiation accident” when developing a new version of this regulatory document. Material and methods: The features of the interpretation of these terms are considered both in NRB-99/2009 and in a number of domestic and international reference books and glossaries on radiation safety, including proposals published in No. 4 of the journal “Medical Radiology and Radiation Safety” for 2023. Results: The interpretation of the numerical values of the dose limits proposed in the indicated journal seems to be poorly substantiated, while their traditional interpretation remains more preferable. The addition of the concept of a radiation accident with the term “emergency” with its own explanation by the authors of the article contradicts the recommendations of the IAEA. The necessity of taking into account the specifics of radiation accidents in medicine when interpreting the term “radiation accident” is shown. Conclusions: 1. There is no need to revise the traditional interpretation of the numerical values of dose limits. 2. It is expedient to replace the wording of the concept of a radiation accident existing in NRB-99/2009 with the wording of the same concept from the IAEA glossary on radiation safety. 3. Taking into account the need for a correct interpretation of the concept of a radiation accident in medicine, the terms “radiation incident”, “unintentional (accidental) medical exposure” and “radiation accident” with their corresponding interpretations should be added to the new version of the NRB.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135963800","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 : 2023-10-01DOI: 10.33266/1024-6177-2023-68-5-82-87
E.K. Azimova, Sh.Sh. Abdulloeva, F.N. Usov, A.D. Zikiryakhodzhaev, E.I. Egina
Purpose: To study the advantages of the technique of administering a radiopharmaceutical according to the “two-day protocol” for determining the sentinel lymph node in breast cancer. Compare the methods of introducing radiopharmaccutical according to the “two-day protocol” and the “one-day protocol”. To identify the advantages of using the “two-day protocol” method over the “one-day protocol” method. Material and methods: In order to improve the diagnosis and treatment of breast cancer by means of a sentinel lymph node biopsy (SLNB) using the technique of introducing a radiopharmaceutical a day before surgical treatment, we analyzed 76 patients with various molecular biological types and stage of breast cancer disease who underwent examination and treatment in the conditions of the P.A. Herzen Moscow State Medical Institute. This cohort of patients was divided into 2 comparable groups: 1 group of patients who underwent SLNB according to a two-day protocol (n=38), the 2nd group of patients who underwent SLNB according to a one-day protocol (n=38). The ambient equivalent dose rate of photon radiation was measured using the MKS-08P dosimeter on the day of RP administration and on the day of surgery. Results: On average, the dose rate of photon radiation 0.5 m from the injection point on the day of radiopharmaccutical administration (according to the “one-day protocol”) and on the day of surgery (according to the “two-day protocol”) was 46.9±23.1(11.0‒85.4) and 2.2±1.1(1.0‒6.4) μSv/h, respectively. The average value of thedose rate directly in the colloid injection zone two hours after administration is equal to 185.1±25.7 (138.9‒258.0) μSv/h, a day later ‒ 9.8±3.8 (6.5‒27) μSv/h. In the first group, when using the “two-day protocol”, when scanning the SPECT/CT in 34/38 (89.5 %) patients revealed 83 lymph nodes, in the second in 30/38 (78.9 %) patients – 72; the total number of removed lymph nodes ‒ 147 and 156, respectively. With an urgent cytological examination, adenogenic metastases were detected in 8 cases in the first group, in 11 cases in the second. In 11/38 (29.0 %) patients, according to the “two-day protocol”, the number of detected and removed lymph nodes is equal, “according to the one-day protocol” ‒ in 5/38 (13.2 %). The scan did not reveal any SLN in the first group – 5/38 (13.2 %), in the second – 7/38 (18.4 %). Conclusions: The advantage of using the “two-day protocol” was revealed, consisting in an 18-fold decrease in background radiation. And also, a faster and more accurate determination of the sentinel lymph node in the surgical field using a gamma detector, associated with a minimum number of cases of scattered radiation in the area of regional lymph outflow, in contrast to the weak accumulation of “sentinel” lymph nodes and strong background radiation outside the nodes when a radioisotope is injected on the day of surgery. The “two-day protocol” greatly facilitates the work of the oncologist surgeon, contributes to a more accu
{"title":"Variants of Sentinel Lymph Node Research Protocols in Breast Cancer","authors":"E.K. Azimova, Sh.Sh. Abdulloeva, F.N. Usov, A.D. Zikiryakhodzhaev, E.I. Egina","doi":"10.33266/1024-6177-2023-68-5-82-87","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-5-82-87","url":null,"abstract":"Purpose: To study the advantages of the technique of administering a radiopharmaceutical according to the “two-day protocol” for determining the sentinel lymph node in breast cancer. Compare the methods of introducing radiopharmaccutical according to the “two-day protocol” and the “one-day protocol”. To identify the advantages of using the “two-day protocol” method over the “one-day protocol” method. Material and methods: In order to improve the diagnosis and treatment of breast cancer by means of a sentinel lymph node biopsy (SLNB) using the technique of introducing a radiopharmaceutical a day before surgical treatment, we analyzed 76 patients with various molecular biological types and stage of breast cancer disease who underwent examination and treatment in the conditions of the P.A. Herzen Moscow State Medical Institute. This cohort of patients was divided into 2 comparable groups: 1 group of patients who underwent SLNB according to a two-day protocol (n=38), the 2nd group of patients who underwent SLNB according to a one-day protocol (n=38). The ambient equivalent dose rate of photon radiation was measured using the MKS-08P dosimeter on the day of RP administration and on the day of surgery. Results: On average, the dose rate of photon radiation 0.5 m from the injection point on the day of radiopharmaccutical administration (according to the “one-day protocol”) and on the day of surgery (according to the “two-day protocol”) was 46.9±23.1(11.0‒85.4) and 2.2±1.1(1.0‒6.4) μSv/h, respectively. The average value of thedose rate directly in the colloid injection zone two hours after administration is equal to 185.1±25.7 (138.9‒258.0) μSv/h, a day later ‒ 9.8±3.8 (6.5‒27) μSv/h. In the first group, when using the “two-day protocol”, when scanning the SPECT/CT in 34/38 (89.5 %) patients revealed 83 lymph nodes, in the second in 30/38 (78.9 %) patients – 72; the total number of removed lymph nodes ‒ 147 and 156, respectively. With an urgent cytological examination, adenogenic metastases were detected in 8 cases in the first group, in 11 cases in the second. In 11/38 (29.0 %) patients, according to the “two-day protocol”, the number of detected and removed lymph nodes is equal, “according to the one-day protocol” ‒ in 5/38 (13.2 %). The scan did not reveal any SLN in the first group – 5/38 (13.2 %), in the second – 7/38 (18.4 %). Conclusions: The advantage of using the “two-day protocol” was revealed, consisting in an 18-fold decrease in background radiation. And also, a faster and more accurate determination of the sentinel lymph node in the surgical field using a gamma detector, associated with a minimum number of cases of scattered radiation in the area of regional lymph outflow, in contrast to the weak accumulation of “sentinel” lymph nodes and strong background radiation outside the nodes when a radioisotope is injected on the day of surgery. The “two-day protocol” greatly facilitates the work of the oncologist surgeon, contributes to a more accu","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135963803","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 : 2023-08-01DOI: 10.33266/1024-6177-2023-68-4-58-68
S. Chekin, A. Gorski, M. Maksioutov, S. Karpenko, N. V. Shchukina, E. Kochergina, O. E. Lashkova, N. S. Zelenskaya
Purpose: To assess the radiation risk of cataracts among the Chernobyl clean-up workers (liquidators), considering the impact of concomitant diseases on this risk and to determine the dose threshold for the development of cataracts. Material and methods: Radiation risks of cataract incidence were studied in the cohort of liquidators of the consequences of the accident at the Chernobyl nuclear power plant, observed in the system of the National Radiation and Epidemiological Register (NRER) from 1986 to 2021. Among the 62,828 male liquidators, 9,461 new cases of cataracts were detected. The average age of the liquidators at the beginning of exposure was 34 years, the average absorbed dose of external gamma exposure of the whole body was 0.132 Gy, the maximum dose was 1.5 Gy, and the average duration of exposure was 2.5 months. To analyze the relationships of cataract incidence with other diseases and with the dose, a statistical method of link analysis, free from the type of distribution, as well as logistic regression models, were used. Results: The radiation risk of cataracts in the cohort of liquidators who did not have diagnoses of diabetes mellitus, hypoparathyroidism, malnutrition and myotonic disorders depends on the presence of concomitant diseases in the patient: glaucoma (ICD-10 H40–H42), hyperopia (H52.0), myopia (H52.1) or presbyopia (H52.4). For liquidators with comorbidities, radiation risk is statistically significant only 15 years after exposure, with an excess relative risk of ERR/Gy=0.46 with 90 % CI (0.06; 0.90). For liquidators without comorbidities, ERR/Gy decrease over time: from 4.42 with 90 % CI (0.72; 13.41) in the first 5 years, to zero risk 15 years after exposure. Nonparametric estimates of the relative risk (RR) of cataracts for the dose groups of liquidators are consistent with the estimates of ERR/Gy in the linear non-threshold (LNT) model. The determination of the dose threshold for cataracts according to the LNT model, in accordance with the recommendations of the ICRP, leads to estimates from 1.2 Gy to 13.3 Gy, depending on the presence or absence of cataract concomitant diseases in the liquidators. Conclusions: At present, there are no epidemiological evidence for reducing the equivalent dose limit for the lens of the eye for occupational exposure in planned exposure situations at the level of 150 mSv per year, previously established by the recommendations of the ICRP in 2007 and the current Russian radiation safety standards NRB-99/2009.
{"title":"Assessment of Radiation Risks of Cataract Morbidity Among Liquidators of the Consequences of the Accident at the Chernobyl Nuclear Power Plant, Allowing for Impact of Concomitant Diseases","authors":"S. Chekin, A. Gorski, M. Maksioutov, S. Karpenko, N. V. Shchukina, E. Kochergina, O. E. Lashkova, N. S. Zelenskaya","doi":"10.33266/1024-6177-2023-68-4-58-68","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-4-58-68","url":null,"abstract":"Purpose: To assess the radiation risk of cataracts among the Chernobyl clean-up workers (liquidators), considering the impact of concomitant diseases on this risk and to determine the dose threshold for the development of cataracts. Material and methods: Radiation risks of cataract incidence were studied in the cohort of liquidators of the consequences of the accident at the Chernobyl nuclear power plant, observed in the system of the National Radiation and Epidemiological Register (NRER) from 1986 to 2021. Among the 62,828 male liquidators, 9,461 new cases of cataracts were detected. The average age of the liquidators at the beginning of exposure was 34 years, the average absorbed dose of external gamma exposure of the whole body was 0.132 Gy, the maximum dose was 1.5 Gy, and the average duration of exposure was 2.5 months. To analyze the relationships of cataract incidence with other diseases and with the dose, a statistical method of link analysis, free from the type of distribution, as well as logistic regression models, were used. Results: The radiation risk of cataracts in the cohort of liquidators who did not have diagnoses of diabetes mellitus, hypoparathyroidism, malnutrition and myotonic disorders depends on the presence of concomitant diseases in the patient: glaucoma (ICD-10 H40–H42), hyperopia (H52.0), myopia (H52.1) or presbyopia (H52.4). For liquidators with comorbidities, radiation risk is statistically significant only 15 years after exposure, with an excess relative risk of ERR/Gy=0.46 with 90 % CI (0.06; 0.90). For liquidators without comorbidities, ERR/Gy decrease over time: from 4.42 with 90 % CI (0.72; 13.41) in the first 5 years, to zero risk 15 years after exposure. Nonparametric estimates of the relative risk (RR) of cataracts for the dose groups of liquidators are consistent with the estimates of ERR/Gy in the linear non-threshold (LNT) model. The determination of the dose threshold for cataracts according to the LNT model, in accordance with the recommendations of the ICRP, leads to estimates from 1.2 Gy to 13.3 Gy, depending on the presence or absence of cataract concomitant diseases in the liquidators. Conclusions: At present, there are no epidemiological evidence for reducing the equivalent dose limit for the lens of the eye for occupational exposure in planned exposure situations at the level of 150 mSv per year, previously established by the recommendations of the ICRP in 2007 and the current Russian radiation safety standards NRB-99/2009.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45529766","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 : 2023-08-01DOI: 10.33266/1024-6177-2023-68-4-5-13
Yu E Kvacheva, A. Samoylov, N. Shandala
The article is dedicated to the jubilee event - the 95th anniversary of a world-famous scientist, an outstanding figure in the national medical science, one of the pioneer organizers of healthcare and the creators of the nuclear shield of our country, our Teacher – Academician Leonid Andreyevich Ilyin.
{"title":"Scientist, Innovator, Mentor, Public Figure – on the Occasion of the 95th Anniversary of Academician of the Russian Academy of Sciences L.A. Ilyin","authors":"Yu E Kvacheva, A. Samoylov, N. Shandala","doi":"10.33266/1024-6177-2023-68-4-5-13","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-4-5-13","url":null,"abstract":"The article is dedicated to the jubilee event - the 95th anniversary of a world-famous scientist, an outstanding figure in the national medical science, one of the pioneer organizers of healthcare and the creators of the nuclear shield of our country, our Teacher – Academician Leonid Andreyevich Ilyin.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43517436","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 : 2023-08-01DOI: 10.33266/1024-6177-2023-68-4-20-23
A. Simakov, V. Klochkov, Y. Abramov
The purpose of this work is to improve the Russian Radiation Safety Standards (NRB) in terms of the interpretation of the meaning of “the main limit of the annual effective dose” and the use of the concept of “emergency”. In [1], proposals were submitted to discuss the changing in new versions of NRB and the Main Health Rules for Radiation Safety (OSPORB) in terms of the interpretation of the concept of “the limit of the annual effective dose of man-caused occupational exposure” and health physics regulation of radionuclide contents in solid materials for free or limited use of these materials. The current NRB-99/2009 uses the term “radiation accident” and establishes the main limits of effective dose (Table 3.1.) for personnel and the public: ‒ for the personnel A group, the annual dose limit is 50 mSv under the mandatory condition of not exceeding the average annual value of 20 mSv for any consecutive 5 years; ‒ for the public, the annual dose limit is 5 mSv under the mandatory condition of not exceeding the average annual value of 1 mSv for any consecutive 5 years. However, in design documentation for the construction and reconstruction of nuclear facilities, in draft regulatory and methodological documents, there are periodically misinterpretations of the main dose limits for personnel and the public and an incorrect interpretation of the term “radiation accident”. In many cases, a dose of 20 mSv is called the annual dose limit for personnel, and a dose of 50 mSv/year is either not mentioned at all, or is considered only as permissible in a radiation accident. The term “radiation accident” is often treated as a synonym for “emergency”. The paper justifies the expediency of introducing relevant changes to the text of new NRB.
{"title":"Radiation Safety Standards and Basic Health Rules for Radiation Safety: Proposal on the Development of New Versions","authors":"A. Simakov, V. Klochkov, Y. Abramov","doi":"10.33266/1024-6177-2023-68-4-20-23","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-4-20-23","url":null,"abstract":"The purpose of this work is to improve the Russian Radiation Safety Standards (NRB) in terms of the interpretation of the meaning of “the main limit of the annual effective dose” and the use of the concept of “emergency”. In [1], proposals were submitted to discuss the changing in new versions of NRB and the Main Health Rules for Radiation Safety (OSPORB) in terms of the interpretation of the concept of “the limit of the annual effective dose of man-caused occupational exposure” and health physics regulation of radionuclide contents in solid materials for free or limited use of these materials. The current NRB-99/2009 uses the term “radiation accident” and establishes the main limits of effective dose (Table 3.1.) for personnel and the public: ‒ for the personnel A group, the annual dose limit is 50 mSv under the mandatory condition of not exceeding the average annual value of 20 mSv for any consecutive 5 years; ‒ for the public, the annual dose limit is 5 mSv under the mandatory condition of not exceeding the average annual value of 1 mSv for any consecutive 5 years. However, in design documentation for the construction and reconstruction of nuclear facilities, in draft regulatory and methodological documents, there are periodically misinterpretations of the main dose limits for personnel and the public and an incorrect interpretation of the term “radiation accident”. In many cases, a dose of 20 mSv is called the annual dose limit for personnel, and a dose of 50 mSv/year is either not mentioned at all, or is considered only as permissible in a radiation accident. The term “radiation accident” is often treated as a synonym for “emergency”. The paper justifies the expediency of introducing relevant changes to the text of new NRB.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47342728","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 : 2023-08-01DOI: 10.33266/1024-6177-2023-68-4-81-84
A. Muravleva, V. E. Goldberg, E. Dudnikova, T. Kravchuk, R. Zelchan, A. Medvedeva, O. Bragina, E. Simolina, N. O. Popova, V. V. Vysockaja, V. A. Shatalova, A. Rybina, A. Goldberg, S. Tabakaev, V. Chernov
Purpose: To demonstrate a rare clinical case of early recurrence of verified primary genital lymphoma and the possibility of 99mTc-1-Thio-D-glucose (99mTc-TG) SPECT/CT using to brain metastasis diagnosis. Material and methods: A patient with a diagnosis of primary diffuse large B-cell genital lymphoma underwent magnetic resonance imaging (MRI) to assess the extent of the disease. Post-treatment follow-up included 18F-FDG PET/CT. To diagnose brain metastasis, 99mTc-TG SPECT/CT and MRI were performed. Results: A rare case of early recurrence of diffuse large B-cell lymphoma with a primary local lesion in the genital organs is described. The possibility of modern methods of nuclear medicine in the diagnosis of early recurrence of malignant lymphoma has been demonstrated. 99mTc-TG SPECT/CT and MRI, were useful for visualization of a high metabolic brain tumor at the outpatient stage and recommendation of high-dose therapy according to the scheme MT-R was done. Conclusion: The article presents a rare clinical case of early recurrence of diffuse large B-cell genital lymphoma. Possibilities of SPECT/CT with 99mTc-TG for visualization of lymphoma metastasis to the brain were demonstrated.
目的:探讨1例经证实的原发性生殖器淋巴瘤早期复发的临床病例，探讨99mtc -1-硫代- d -葡萄糖(99mTc-TG) SPECT/CT诊断脑转移的可能性。材料和方法:一位诊断为原发性弥漫性大b细胞生殖器淋巴瘤的患者接受了磁共振成像(MRI)来评估疾病的范围。治疗后随访包括18F-FDG PET/CT。99mTc-TG SPECT/CT及MRI诊断脑转移。结果:一例罕见的弥漫性大b细胞淋巴瘤早期复发与原发局部病变在生殖器官描述。现代核医学方法在恶性淋巴瘤早期复发诊断中的可能性已得到证实。99mTc-TG SPECT/CT和MRI对门诊期高代谢性脑肿瘤的可视化有用，并根据MT-R方案推荐高剂量治疗。结论:本文报告一例罕见的弥漫大b细胞生殖器淋巴瘤早期复发的临床病例。证实了99mTc-TG的SPECT/CT显示淋巴瘤脑转移的可能性。
{"title":"Metabolic 99mTc-1-Thio-D-Glucose SPECT/CT in the Diagnosis of Brain Metastasis of Genital Diffuse-B-Large Cell Lymphoma (Clinical Case)","authors":"A. Muravleva, V. E. Goldberg, E. Dudnikova, T. Kravchuk, R. Zelchan, A. Medvedeva, O. Bragina, E. Simolina, N. O. Popova, V. V. Vysockaja, V. A. Shatalova, A. Rybina, A. Goldberg, S. Tabakaev, V. Chernov","doi":"10.33266/1024-6177-2023-68-4-81-84","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-4-81-84","url":null,"abstract":"Purpose: To demonstrate a rare clinical case of early recurrence of verified primary genital lymphoma and the possibility of 99mTc-1-Thio-D-glucose (99mTc-TG) SPECT/CT using to brain metastasis diagnosis. Material and methods: A patient with a diagnosis of primary diffuse large B-cell genital lymphoma underwent magnetic resonance imaging (MRI) to assess the extent of the disease. Post-treatment follow-up included 18F-FDG PET/CT. To diagnose brain metastasis, 99mTc-TG SPECT/CT and MRI were performed. Results: A rare case of early recurrence of diffuse large B-cell lymphoma with a primary local lesion in the genital organs is described. The possibility of modern methods of nuclear medicine in the diagnosis of early recurrence of malignant lymphoma has been demonstrated. 99mTc-TG SPECT/CT and MRI, were useful for visualization of a high metabolic brain tumor at the outpatient stage and recommendation of high-dose therapy according to the scheme MT-R was done. Conclusion: The article presents a rare clinical case of early recurrence of diffuse large B-cell genital lymphoma. Possibilities of SPECT/CT with 99mTc-TG for visualization of lymphoma metastasis to the brain were demonstrated.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41500567","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 : 2023-08-01DOI: 10.33266/1024-6177-2023-68-4-24-27
Y. Udalov, T. Sharapova
Purpose: To assess the state of radiation safety at nuclear facilities of the FSCCRO. Material and methods: The Federal Scientific Clinical Center for Medical Radiology and Oncology of the FMBA of Russia has three radiation-hazardous facilities on one site, which implies the need for strict compliance with all radiation safety requirements. As a part of the study, the analysis of reports based on the Safety Guidelines for the Use of Atomic Energy, was carried out in order to comply with the requirements of regulatory documents on radiation safety when performing work on the declared types of activities, taking into account the specifics of the institution’s “closed cycle” working mode. The article also presents the annual exposure doses of the category of personnel working with technogenic sources of ionizing radiation (group A) or being under the terms works in the field of their impact (group B) for the period from 2020 to 2022. The analysis of collective and mean radiation doses of the Group A personnel is done for the specified period. Results: A three-year analysis of the state of radiation safety at the Center showed that the radiation situation at nuclear facilities meets the requirements of the current legislation of the Russian Federation in terms of radiation parameters. There were no cases of exceeding the established control levels of personnel individual radiation doses for the period 2020-2022 as of March 3, 2023. Conclusion: There are no deviations from the requirements of regulatory documents on radiation safety when performing work on the declared types of activities. The experience of the radiation safety service of the Center can be used when commissioning similar facilities on the territory of the Russian Federation.
{"title":"Features of Radiation Safety Control at the Federal State Budgetary Institution «Federal Scientific Clinical Center for Medical Radiology and Oncology» of the Federal Medical Biological Agency","authors":"Y. Udalov, T. Sharapova","doi":"10.33266/1024-6177-2023-68-4-24-27","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-4-24-27","url":null,"abstract":"Purpose: To assess the state of radiation safety at nuclear facilities of the FSCCRO. Material and methods: The Federal Scientific Clinical Center for Medical Radiology and Oncology of the FMBA of Russia has three radiation-hazardous facilities on one site, which implies the need for strict compliance with all radiation safety requirements. As a part of the study, the analysis of reports based on the Safety Guidelines for the Use of Atomic Energy, was carried out in order to comply with the requirements of regulatory documents on radiation safety when performing work on the declared types of activities, taking into account the specifics of the institution’s “closed cycle” working mode. The article also presents the annual exposure doses of the category of personnel working with technogenic sources of ionizing radiation (group A) or being under the terms works in the field of their impact (group B) for the period from 2020 to 2022. The analysis of collective and mean radiation doses of the Group A personnel is done for the specified period. Results: A three-year analysis of the state of radiation safety at the Center showed that the radiation situation at nuclear facilities meets the requirements of the current legislation of the Russian Federation in terms of radiation parameters. There were no cases of exceeding the established control levels of personnel individual radiation doses for the period 2020-2022 as of March 3, 2023. Conclusion: There are no deviations from the requirements of regulatory documents on radiation safety when performing work on the declared types of activities. The experience of the radiation safety service of the Center can be used when commissioning similar facilities on the territory of the Russian Federation.","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42968036","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 : 2023-08-01DOI: 10.33266/1024-6177-2023-68-4-35-42
I. Galstian, A. Bushmanov, N. Metlyaeva, M. Konchalovsky, V. Nugis, F. Torubarov, O. Shcherbatykh, Z. F. Zvereva, L. Yunanova
Purpose: To study the effect of the radiation dose rate on the dynamics of peripheral blood indicators in various periods of chronic radiation syndrome (CRS), which developed as a result of professional prolonged radiation exposure in a cohort of former employees of the Mayak plant who underwent inpatient examination at the clinic of the A.I. Burnazyan Federal Medical Biophysical Center of the FMBA of Russia in the period up to 1995. Material and methods: The study of the dynamics of absolute peripheral blood indices in former employees of Mayak plant who were exposed to prolonged industrial radiation with a dose rate of less than 0.001 Gy/day (25 people), 0.003‒0.007 Gy/day (12 people) and 0.008‒0.07 G/day (15 people) during the periods of formation, outcomes and immediate, as well as long-term consequences of CRS. Statistical processing of the material was performed using the IBM SPSS Statistics software package 23.0 using the Kruskal–Wallis criteria and the Mann–Whitney U-test for independent samples. The results obtained were considered statistically reliable at p < 0.05. Results: In a group of patients irradiated with a dose rate of 0.008‒0.07 Gy/day during the periods of formation, as well as the outcomes and immediate consequences of CRS, platelet-, leuco- and deep neutropenia were noted. A decrease in the number of erythrocytes and hemoglobin was detected only in the period of outcomes and immediate consequences. The development of agranulocytosis and anemic syndrome are signs that distinguish the course of CRS in this group of patients from the clinical picture of typical CRS. In the period of long-term consequences, 60 % of patients (9 out of 15) developed oncohematological diseases. At an irradiation power of 0.003‒0.007 Gy/day anemic syndrome was found in 4 out of 12 patients. Leukopenia was observed in the periods of outcomes and immediate consequences. Granulocytopenia was detected in all three periods of the course of CRS. In the long term, 2 patients from this group developed oncohematological diseases At an irradiation power of less than 0.001 Gy/day shallow thrombocytopenia and neutropenia are noted in the periods of outcomes and immediate consequences of CRS. In the period of long-term consequences, all the average values of peripheral blood indicators correspond to normal levels. Conclusions: With prolonged irradiation of a person with a dose rate of 0.008‒0.07 Gy/ day or more, with the accumulation of a total dose of 1.7‒9.6 Gy and a contact duration of 6‒96 months, one can expect the development of CRS with a peculiar subacute clinical course of bone marrow syndrome (BMS), manifested by the defeat of all three hematopoietic sprouts, the development of agranulocytosis, anemia and, probably, in 60 % of cases of leukemia development with an unfavorable prognosis for the patient’s life. The main factor determining this feature of the course of BMC CRS is the dose rate, which exceeds 0.008 Gy / day (2 Gr/year). At a dose rate of
{"title":"Dynamics Of Peripheral Blood Parameters in Different Periods of Chronic Radiation Syndrome after Chronic Exposure with Different Dose Rates","authors":"I. Galstian, A. Bushmanov, N. Metlyaeva, M. Konchalovsky, V. Nugis, F. Torubarov, O. Shcherbatykh, Z. F. Zvereva, L. Yunanova","doi":"10.33266/1024-6177-2023-68-4-35-42","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-4-35-42","url":null,"abstract":"Purpose: To study the effect of the radiation dose rate on the dynamics of peripheral blood indicators in various periods of chronic radiation syndrome (CRS), which developed as a result of professional prolonged radiation exposure in a cohort of former employees of the Mayak plant who underwent inpatient examination at the clinic of the A.I. Burnazyan Federal Medical Biophysical Center of the FMBA of Russia in the period up to 1995. Material and methods: The study of the dynamics of absolute peripheral blood indices in former employees of Mayak plant who were exposed to prolonged industrial radiation with a dose rate of less than 0.001 Gy/day (25 people), 0.003‒0.007 Gy/day (12 people) and 0.008‒0.07 G/day (15 people) during the periods of formation, outcomes and immediate, as well as long-term consequences of CRS. Statistical processing of the material was performed using the IBM SPSS Statistics software package 23.0 using the Kruskal–Wallis criteria and the Mann–Whitney U-test for independent samples. The results obtained were considered statistically reliable at p < 0.05. Results: In a group of patients irradiated with a dose rate of 0.008‒0.07 Gy/day during the periods of formation, as well as the outcomes and immediate consequences of CRS, platelet-, leuco- and deep neutropenia were noted. A decrease in the number of erythrocytes and hemoglobin was detected only in the period of outcomes and immediate consequences. The development of agranulocytosis and anemic syndrome are signs that distinguish the course of CRS in this group of patients from the clinical picture of typical CRS. In the period of long-term consequences, 60 % of patients (9 out of 15) developed oncohematological diseases. At an irradiation power of 0.003‒0.007 Gy/day anemic syndrome was found in 4 out of 12 patients. Leukopenia was observed in the periods of outcomes and immediate consequences. Granulocytopenia was detected in all three periods of the course of CRS. In the long term, 2 patients from this group developed oncohematological diseases At an irradiation power of less than 0.001 Gy/day shallow thrombocytopenia and neutropenia are noted in the periods of outcomes and immediate consequences of CRS. In the period of long-term consequences, all the average values of peripheral blood indicators correspond to normal levels. Conclusions: With prolonged irradiation of a person with a dose rate of 0.008‒0.07 Gy/ day or more, with the accumulation of a total dose of 1.7‒9.6 Gy and a contact duration of 6‒96 months, one can expect the development of CRS with a peculiar subacute clinical course of bone marrow syndrome (BMS), manifested by the defeat of all three hematopoietic sprouts, the development of agranulocytosis, anemia and, probably, in 60 % of cases of leukemia development with an unfavorable prognosis for the patient’s life. The main factor determining this feature of the course of BMC CRS is the dose rate, which exceeds 0.008 Gy / day (2 Gr/year). At a dose rate of ","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41779587","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 : 2023-08-01DOI: 10.33266/1024-6177-2023-68-4-14-19
A. Samoylov, O. Kochetkov, V. Klochkov, V. Barchukov, S. Shinkarev
Purpose: To justify the necessity to update the radiation safety standards in our country and to propose the main directions for revising the Russian regulatory framework in the field of radiation safety. Material and methods: This paper considers the phases of development of the radiation safety regulation system in Russia. It is noted that for the first time a full-fledged three-level system of radiation safety regulation was created in Russia in the early 2000s. A generalized analysis of new international documents in the field of radiation safety system, which are worth using in the Russian regulatory framework, is presented. Results: The main directions of the revision of the Russian regulatory framework in the field of radiation safety are: introduction of new concepts and current terminology; introduction of “soft” standards, which are reference levels and the so-called “dose constraints” (it is desirable to give this term a different Russian name); updating the principles and standards of emergency response; updating the dose coefficients taking into account new biokinetic models, extension of the list of radionuclides and pathways; introduction of special approaches in the field of internal dosimetry and regulation of radiation protection of workers under management of radionuclides with a long effective half-life of clearance from the human body (isotopes of plutonium and 90Sr); use of principles and standards according to the concept of exclusion, exemption, and clearance to justify the criteria for classifying various media as radioactive waste and waste with a high content of radionuclides; development of standards and rules for maintaining the radiation safety of workers and the public during the decommissioning of radiation facilities and the rehabilitation of contaminated areas. Conclusion: For the successful implementation of the work to be done, it is important to combine the efforts of the Russian scientists and practitioners who have accumulated extensive experience in the field of radiation safety. The high potential of the Russian specialists makes it possible to carry out this work in a short time. A necessary condition for the implementation of these works is the introduction of amendments to the Federal Law of 09.01.1996 No. 3-FL «On Radiation Safety of the Public».
{"title":"The Main Directions of Improving the Current Standards and Rules to Provide Radiation Safety. Part 1. Scale of the Problem and Ways to Solve It","authors":"A. Samoylov, O. Kochetkov, V. Klochkov, V. Barchukov, S. Shinkarev","doi":"10.33266/1024-6177-2023-68-4-14-19","DOIUrl":"https://doi.org/10.33266/1024-6177-2023-68-4-14-19","url":null,"abstract":"Purpose: To justify the necessity to update the radiation safety standards in our country and to propose the main directions for revising the Russian regulatory framework in the field of radiation safety. Material and methods: This paper considers the phases of development of the radiation safety regulation system in Russia. It is noted that for the first time a full-fledged three-level system of radiation safety regulation was created in Russia in the early 2000s. A generalized analysis of new international documents in the field of radiation safety system, which are worth using in the Russian regulatory framework, is presented. Results: The main directions of the revision of the Russian regulatory framework in the field of radiation safety are: introduction of new concepts and current terminology; introduction of “soft” standards, which are reference levels and the so-called “dose constraints” (it is desirable to give this term a different Russian name); updating the principles and standards of emergency response; updating the dose coefficients taking into account new biokinetic models, extension of the list of radionuclides and pathways; introduction of special approaches in the field of internal dosimetry and regulation of radiation protection of workers under management of radionuclides with a long effective half-life of clearance from the human body (isotopes of plutonium and 90Sr); use of principles and standards according to the concept of exclusion, exemption, and clearance to justify the criteria for classifying various media as radioactive waste and waste with a high content of radionuclides; development of standards and rules for maintaining the radiation safety of workers and the public during the decommissioning of radiation facilities and the rehabilitation of contaminated areas. Conclusion: For the successful implementation of the work to be done, it is important to combine the efforts of the Russian scientists and practitioners who have accumulated extensive experience in the field of radiation safety. The high potential of the Russian specialists makes it possible to carry out this work in a short time. A necessary condition for the implementation of these works is the introduction of amendments to the Federal Law of 09.01.1996 No. 3-FL «On Radiation Safety of the Public».","PeriodicalId":37358,"journal":{"name":"Medical Radiology and Radiation Safety","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45731114","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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