Pub Date : 2024-02-01DOI: 10.1016/j.zemedi.2023.06.005
Mark Shavers , Edward Semones , Leena Tomi , Jing Chen , Ulrich Straube , Tatsuto Komiyama , Vyacheslav Shurshakov , Chunsheng Li , Werner Rühm
The Partner Agencies of the International Space Station (ISS) maintain separate career exposure limits and shared Flight Rules that control the ionising radiation exposures that crewmembers can experience due to ambient environments throughout their space missions. In low Earth orbit as well as further out in space, energetic ions referred to as galactic cosmic radiation (GCR) easily penetrate spacecraft and spacecraft contents and consequently are always present at low dose rates. Protons and electrons that are trapped in the Earth’s geomagnetic field are encountered intermittently, and a rare energetic solar particle event (SPE) may expose crew to (mostly) energetic protons. Space radiation protection goals are to optimize radiation exposures to maintain deleterious late effects at known and acceptable levels and to prevent any early effects that might compromise crew health and mission success. The conventional radiation protection metric effective dose provides a basic framework for limiting exposures associated with human spaceflight and can be communicated to all stakeholders. Additional metrics and uncertainty analyses are required to understand more completely and to convey nuanced information about potential impacts to an individual astronaut or to a space mission. Missions to remote destinations well beyond low Earth orbit (BLEO) are upcoming and bestow additional challenges that shape design and radiation protection needs. NASA has recently adopted a more permissive career exposure limit based upon effective dose and new restrictions on mission exposures imposed by nuclear technologies. This manuscript reviews the exposure limits that apply to the ISS crewmembers. This work was performed in collaboration with the advisory and guidance efforts of International Commission on Radiological Protection (ICRP) Task Group 115 and will be summarized in an upcoming ICRP Report.
{"title":"Space agency-specific standards for crew dose and risk assessment of ionising radiation exposures for the International Space Station","authors":"Mark Shavers , Edward Semones , Leena Tomi , Jing Chen , Ulrich Straube , Tatsuto Komiyama , Vyacheslav Shurshakov , Chunsheng Li , Werner Rühm","doi":"10.1016/j.zemedi.2023.06.005","DOIUrl":"10.1016/j.zemedi.2023.06.005","url":null,"abstract":"<div><p>The Partner Agencies of the International Space Station (ISS) maintain separate career exposure limits and shared Flight Rules that control the ionising radiation exposures that crewmembers can experience due to ambient environments throughout their space missions. In low Earth orbit as well as further out in space, energetic ions referred to as galactic cosmic radiation (GCR) easily penetrate spacecraft and spacecraft contents and consequently are always present at low dose rates. Protons and electrons that are trapped in the Earth’s geomagnetic field are encountered intermittently, and a rare energetic solar particle event (SPE) may expose crew to (mostly) energetic protons. Space radiation protection goals are to optimize radiation exposures to maintain deleterious late effects at known and acceptable levels and to prevent any early effects that might compromise crew health and mission success. The conventional radiation protection metric <em>effective dose</em> provides a basic framework for limiting exposures associated with human spaceflight and can be communicated to all stakeholders. Additional metrics and uncertainty analyses are required to understand more completely and to convey nuanced information about potential impacts to an individual astronaut or to a space mission. Missions to remote destinations well beyond low Earth orbit (BLEO) are upcoming and bestow additional challenges that shape design and radiation protection needs. NASA has recently adopted a more permissive career exposure limit based upon effective dose and new restrictions on mission exposures imposed by nuclear technologies. This manuscript reviews the exposure limits that apply to the ISS crewmembers. This work was performed in collaboration with the advisory and guidance efforts of International Commission on Radiological Protection (ICRP) Task Group 115 and will be summarized in an upcoming ICRP Report.</p></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 1","pages":"Pages 14-30"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S093938892300082X/pdfft?md5=dec577eed0f7d7f58dec908ed022eeef&pid=1-s2.0-S093938892300082X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9885508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1016/j.zemedi.2023.10.003
Linda Walsh , Luana Hafner , Thomas Berger , Daniel Matthiä , Uwe Schneider , Ulrich Straube
An illustrative sample mission of a Mars swing-by mission lasting one calendar year was chosen to highlight the application of European risk assessment software to cancer (all solid cancer plus leukaemia) risks from radiation exposures in space quantified with organ dose equivalent rates from model calculations based on the quantity Radiation Attributed Decrease of Survival (RADS). The relevant dose equivalent to the colon for radiation exposures from this Mars swing-by mission were found to vary between 198 and 482 mSv. These doses depend on sex and the two other factors investigated here of: solar activity phase (maximum or minimum); and the choice of space radiation quality factor used in the calculations of dose equivalent. Such doses received at typical astronaut ages around 40 years old will result in: the probability of surviving until retirement age (65 years) being reduced by a range from 0.38% (95%CI: 0.29; 0.49) to 1.29% (95%CI: 1.06; 1.56); and the probability of surviving cancer free until retirement age being reduced by a range from 0.78% (95%CI: 0.59; 0.99) to 2.63% (95%CI: 2.16; 3.18). As expected from the features of the models applied to quantify the general dosimetric and radiation epidemiology parameters, the cancer incidence risks in terms of surviving cancer free, are higher than the cancer mortality risks in terms of surviving, the risks for females are higher than for males, and the risks at solar minimum are higher than at solar maximum.
{"title":"European astronaut radiation related cancer risk assessment using dosimetric calculations of organ dose equivalents","authors":"Linda Walsh , Luana Hafner , Thomas Berger , Daniel Matthiä , Uwe Schneider , Ulrich Straube","doi":"10.1016/j.zemedi.2023.10.003","DOIUrl":"10.1016/j.zemedi.2023.10.003","url":null,"abstract":"<div><p>An illustrative sample mission of a Mars swing-by mission lasting one calendar year was chosen to highlight the application of European risk assessment software to cancer (all solid cancer plus leukaemia) risks from radiation exposures in space quantified with organ dose equivalent rates from model calculations based on the quantity Radiation Attributed Decrease of Survival (RADS). The relevant dose equivalent to the colon for radiation exposures from this Mars swing-by mission were found to vary between 198 and 482 mSv. These doses depend on sex and the two other factors investigated here of: solar activity phase (maximum or minimum); and the choice of space radiation quality factor used in the calculations of dose equivalent. Such doses received at typical astronaut ages around 40 years old will result in: the probability of surviving until retirement age (65 years) being reduced by a range from 0.38% (95%CI: 0.29; 0.49) to 1.29% (95%CI: 1.06; 1.56); and the probability of surviving cancer free until retirement age being reduced by a range from 0.78% (95%CI: 0.59; 0.99) to 2.63% (95%CI: 2.16; 3.18). As expected from the features of the models applied to quantify the general dosimetric and radiation epidemiology parameters, the cancer incidence risks in terms of surviving cancer free, are higher than the cancer mortality risks in terms of surviving, the risks for females are higher than for males, and the risks at solar minimum are higher than at solar maximum.</p></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 1","pages":"Pages 92-99"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0939388923001198/pdfft?md5=f5d1b79a1e969f259ce4038b52a8588d&pid=1-s2.0-S0939388923001198-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1016/j.zemedi.2023.10.005
Mark R. Shavers , Edward J. Semones , Vyacheslav Shurshakov , Mikhail Dobynde , Tatsuhiko Sato , Tatsuto Komiyama , Leena Tomi , Jing Chen , Samy El-Jaby , Ulrich Straube , Chunsheng Li , Werner Rühm
The International Partner Agencies of the International Space Station (ISS) present a comparison of the ionizing radiation absorbed dose and risk quantities used to characterize example missions in lunar space. This effort builds on previous collaborative work that characterizes radiation environments in space to support radiation protection for human spaceflight on ISS in low-Earth orbit (LEO) and exploration missions beyond (BLEO). A “shielded” ubiquitous galactic cosmic radiation (GCR) environment combined with––and separate from––the transient challenge of a solar particle event (SPE) was modelled for a simulated 30-day mission period. Simple geometries of relatively thin and uniform shields were chosen to represent the space vehicle and other available shielding, and male or female phantoms were used to represent the body’s self-shielding. Absorbed dose in organs and tissues and the effective dose were calculated for males and females. Risk parameters for cancer and other outcomes are presented for selected organs. The results of this intracomparison between ISS Partner Agencies itself provide insights to the level of agreement with which space agencies can perform organ dosimetry and calculate effective dose. This work was performed in collaboration with the advisory and guidance efforts of the International Commission on Radiological Protection (ICRP) Task Group 115 and will be presented in an ICRP Report
{"title":"Comparison of dose and risk estimates between ISS Partner Agencies for a 30-day lunar mission","authors":"Mark R. Shavers , Edward J. Semones , Vyacheslav Shurshakov , Mikhail Dobynde , Tatsuhiko Sato , Tatsuto Komiyama , Leena Tomi , Jing Chen , Samy El-Jaby , Ulrich Straube , Chunsheng Li , Werner Rühm","doi":"10.1016/j.zemedi.2023.10.005","DOIUrl":"10.1016/j.zemedi.2023.10.005","url":null,"abstract":"<div><p>The International Partner Agencies of the International Space Station (ISS) present a comparison of the ionizing radiation absorbed dose and risk quantities used to characterize example missions in lunar space. This effort builds on previous collaborative work that characterizes radiation environments in space to support radiation protection for human spaceflight on ISS in low-Earth orbit (LEO) and exploration missions beyond (BLEO). A “shielded” ubiquitous galactic cosmic radiation (GCR) environment combined with––and separate from––the transient challenge of a solar particle event (SPE) was modelled for a simulated 30-day mission period. Simple geometries of relatively thin and uniform shields were chosen to represent the space vehicle and other available shielding, and male or female phantoms were used to represent the body’s self-shielding. Absorbed dose in organs and tissues and the effective dose were calculated for males and females. Risk parameters for cancer and other outcomes are presented for selected organs. The results of this intracomparison between ISS Partner Agencies itself provide insights to the level of agreement with which space agencies can perform organ dosimetry and calculate effective dose. This work was performed in collaboration with the advisory and guidance efforts of the International Commission on Radiological Protection (ICRP) Task Group 115 and will be presented in an ICRP Report</p></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 1","pages":"Pages 31-43"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0939388923001216/pdfft?md5=31f7430d986940c92142e5bd471f10e0&pid=1-s2.0-S0939388923001216-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1016/j.zemedi.2023.08.002
Alexander Ulanowski , Nobuhiko Ban , Kotaro Ozasa , Werner Rühm , Edward Semones , Mark Shavers , Ludovic Vaillant
Task Group 115 of the International Commission on Radiological Protection is focusing on mission-related exposures to space radiation and concomitant health risks for space crew members including, among others, risk of cancer development. Uncertainties in cumulative radiation risk estimates come from the stochastic nature of the considered health outcome (i.e., cancer), uncertainties of statistical inference and model parameters, unknown secular trends used for projections of population statistics and unknown variability of survival properties between individuals or population groups. The variability of survival is usually ignored when dealing with large groups, which can be assumed well represented by the statistical data for the contemporary general population, either in a specific country or world averaged. Space crew members differ in many aspects from individuals represented by the general population, including, for example, their lifestyle and health status, nutrition, medical care, training and education. The individuality of response to radiation and lifespan is explored in this modelling study. Task Group 115 is currently evaluating applicability and robustness of various risk metrics for quantification of radiation-attributed risks of cancer for space crew members. This paper demonstrates the impact of interpopulation variability of survival curves on values and uncertainty of the estimates of the time-integrated radiation risk of cancer.
{"title":"Time-integrated radiation risk metrics and interpopulation variability of survival","authors":"Alexander Ulanowski , Nobuhiko Ban , Kotaro Ozasa , Werner Rühm , Edward Semones , Mark Shavers , Ludovic Vaillant","doi":"10.1016/j.zemedi.2023.08.002","DOIUrl":"10.1016/j.zemedi.2023.08.002","url":null,"abstract":"<div><p>Task Group 115 of the International Commission on Radiological Protection is focusing on mission-related exposures to space radiation and concomitant health risks for space crew members including, among others, risk of cancer development. Uncertainties in cumulative radiation risk estimates come from the stochastic nature of the considered health outcome (i.e., cancer), uncertainties of statistical inference and model parameters, unknown secular trends used for projections of population statistics and unknown variability of survival properties between individuals or population groups. The variability of survival is usually ignored when dealing with large groups, which can be assumed well represented by the statistical data for the contemporary general population, either in a specific country or world averaged. Space crew members differ in many aspects from individuals represented by the general population, including, for example, their lifestyle and health status, nutrition, medical care, training and education. The individuality of response to radiation and lifespan is explored in this modelling study. Task Group 115 is currently evaluating applicability and robustness of various risk metrics for quantification of radiation-attributed risks of cancer for space crew members. This paper demonstrates the impact of interpopulation variability of survival curves on values and uncertainty of the estimates of the time-integrated radiation risk of cancer.</p></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 1","pages":"Pages 64-82"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0939388923000910/pdfft?md5=957caec7a052d20a9597624238b43d94&pid=1-s2.0-S0939388923000910-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1016/j.zemedi.2023.10.002
Tabea Pfuhl , Uli Weber , Felix Horst , Marco Durante , Christoph Schuy
The generation of space radiation on Earth is essential to study and predict the effects of radiation on space travelers, electronics, or materials during future long-term space missions. Next to the heavy ions of the galactic cosmic rays, solar particle events play a major role concerning the radiation risk in space, which consist of intermediate-energy protons with broad spectra and energies up to a few hundred MeV. This work describes an approach for the ground-based generation of solar particle events. As a proof of principle, a passive beam modulator with a specific funnel-shaped periodic structure was designed and is used to convert a monoenergetic proton beam into a spectral proton energy distribution, mimicking a solar particle event from August 1972, which is known as one of the strongest recorded SPE events. The required proton beam of 220 MeV can be generated at many existing particle accelerators at research or particle therapy facilities. The planning, manufacturing and testing of the modulator is described step by step. Its correct manufacturing and the characteristics of the solar particle event simulator are tested experimentally and by means of Monte Carlo simulations. Future modulators will follow the same concept with minor adjustments such as a larger lateral extension. As of now, the presented beam modulator is available to the research community to conduct experiments at GSI for exposure under solar particle event conditions. In addition, researchers can use and apply the described concept to design and print their individualized modulator to reproduce any desired solar particle event spectrum or request the presented modulator geometry from the authors.
{"title":"Ground-based passive generation of Solar Particle Event spectra: Planning and manufacturing of a 3D-printed modulator","authors":"Tabea Pfuhl , Uli Weber , Felix Horst , Marco Durante , Christoph Schuy","doi":"10.1016/j.zemedi.2023.10.002","DOIUrl":"10.1016/j.zemedi.2023.10.002","url":null,"abstract":"<div><p>The generation of space radiation on Earth is essential to study and predict the effects of radiation on space travelers, electronics, or materials during future long-term space missions. Next to the heavy ions of the galactic cosmic rays, solar particle events play a major role concerning the radiation risk in space, which consist of intermediate-energy protons with broad spectra and energies up to a few hundred MeV. This work describes an approach for the ground-based generation of solar particle events. As a proof of principle, a passive beam modulator with a specific funnel-shaped periodic structure was designed and is used to convert a monoenergetic proton beam into a spectral proton energy distribution, mimicking a solar particle event from August 1972, which is known as one of the strongest recorded SPE events. The required proton beam of 220 MeV can be generated at many existing particle accelerators at research or particle therapy facilities. The planning, manufacturing and testing of the modulator is described step by step. Its correct manufacturing and the characteristics of the solar particle event simulator are tested experimentally and by means of Monte Carlo simulations. Future modulators will follow the same concept with minor adjustments such as a larger lateral extension. As of now, the presented beam modulator is available to the research community to conduct experiments at GSI for exposure under solar particle event conditions. In addition, researchers can use and apply the described concept to design and print their individualized modulator to reproduce any desired solar particle event spectrum or request the presented modulator geometry from the authors.</p></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 1","pages":"Pages 153-165"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0939388923001186/pdfft?md5=a6f5e78f640321e98de05544aa403b06&pid=1-s2.0-S0939388923001186-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71524005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-29DOI: 10.1016/j.zemedi.2023.10.004
Pascal Wodtke, Martin Grashei, Franz Schilling
Over the last two decades, hyperpolarized 13C MRI has gained significance in both preclinical and clinical studies, hereby relying on technologies like PHIP-SAH (ParaHydrogen-Induced Polarization-Side Arm Hydrogenation), SABRE (Signal Amplification by Reversible Exchange), and dDNP (dissolution Dynamic Nuclear Polarization), with dDNP being applied in humans. A clinical dDNP polarizer has enabled studies across 24 sites, despite challenges like high cost and slow polarization. Parahydrogen-based techniques like SABRE and PHIP offer faster, more cost-efficient alternatives but require molecule-specific optimization. The focus has been on imaging metabolism of hyperpolarized probes, which requires long T1, high polarization and rapid contrast generation. Efforts to establish novel probes, improve acquisition techniques and enhance data analysis methods including artificial intelligence are ongoing. Potential clinical value of hyperpolarized 13C MRI was demonstrated primarily for treatment response assessment in oncology, but also in cardiology, nephrology, hepatology and CNS characterization. In this review on biomedical hyperpolarized 13C MRI, we summarize important and recent advances in polarization techniques, probe development, acquisition and analysis methods as well as clinical trials. Starting from those we try to sketch a trajectory where the field of biomedical hyperpolarized 13C MRI might go.
{"title":"Quo Vadis Hyperpolarized 13C MRI?","authors":"Pascal Wodtke, Martin Grashei, Franz Schilling","doi":"10.1016/j.zemedi.2023.10.004","DOIUrl":"https://doi.org/10.1016/j.zemedi.2023.10.004","url":null,"abstract":"<p>Over the last two decades, hyperpolarized <sup>13</sup>C MRI has gained significance in both preclinical and clinical studies, hereby relying on technologies like PHIP-SAH (ParaHydrogen-Induced Polarization-Side Arm Hydrogenation), SABRE (Signal Amplification by Reversible Exchange), and dDNP (dissolution Dynamic Nuclear Polarization), with dDNP being applied in humans. A clinical dDNP polarizer has enabled studies across 24 sites, despite challenges like high cost and slow polarization. Parahydrogen-based techniques like SABRE and PHIP offer faster, more cost-efficient alternatives but require molecule-specific optimization. The focus has been on imaging metabolism of hyperpolarized probes, which requires long <em>T<sub>1</sub></em>, high polarization and rapid contrast generation. Efforts to establish novel probes, improve acquisition techniques and enhance data analysis methods including artificial intelligence are ongoing. Potential clinical value of hyperpolarized <sup>13</sup>C MRI was demonstrated primarily for treatment response assessment in oncology, but also in cardiology, nephrology, hepatology and CNS characterization. In this review on biomedical hyperpolarized <sup>13</sup>C MRI, we summarize important and recent advances in polarization techniques, probe development, acquisition and analysis methods as well as clinical trials. Starting from those we try to sketch a trajectory where the field of biomedical hyperpolarized <sup>13</sup>C MRI might go.</p>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"21 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139068000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-15DOI: 10.1016/j.zemedi.2023.11.001
Martin P. Pichotka, Moritz Weigt, Mukesch J. Shah, Maximilian F. Russe, Thomas Stein, T. Billoud, Jürgen Beck, Jakob Straehle, Christopher L. Schlett, Dominik v. Elverfeldt, Marco Reisert
<h3>Objectives</h3><p>Despite their life-saving capabilities, cerebrospinal fluid (CSF) shunts exhibit high failure rates, with a large fraction of failures attributed to the regulating valve. Due to a lack of methods for the detailed analysis of valve malfunctions, failure mechanisms are not well understood, and valves often have to be surgically explanted on the mere suspicion of malfunction.</p><p>The presented pilot study aims to demonstrate radiological methods for comprehensive analysis of CSF shunt valves, considering both the potential for failure analysis in design optimization, and for future clinical in-vivo application to reduce the number of required shunt revision surgeries. The proposed method could also be utilized to develop and support in situ repair methods (e.g. by lysis or ultrasound) of malfunctioning CSF shunt valves.</p><h3>Materials and methods</h3><p>The primary methods described are contrast-enhanced radiographic time series of CSF shunt valves, taken in a favorable projection geometry at low radiation dose, and the machine-learning-based diagnosis of CSF shunt valve obstructions. Complimentarily, we investigate CT-based methods capable of providing accurate ground truth for the training of such diagnostic tools. Using simulated test and training data, the performance of the machine-learning diagnostics in identifying and localizing obstructions within a shunt valve is evaluated regarding per-pixel sensitivity and specificity, the Dice similarity coefficient, and the false positive rate in the case of obstruction free test samples.</p><h3>Results</h3><p>Contrast enhanced subtraction radiography allows high-resolution, time-resolved, low-dose analysis of fluid transport in CSF shunt valves. Complementarily, photon-counting micro-CT allows to investigate valve obstruction mechanisms in detail, and to generate valid ground truth for machine learning-based diagnostics.</p><p>Machine-learning-based detection of valve obstructions in simulated radiographies shows promising results, with a per-pixel sensitivity >70%, per-pixel specificity >90%, a median Dice coefficient >0.8 and <10% false positives at a detection threshold of 0.5.</p><h3>Conclusions</h3><p>This ex-vivo study demonstrates obstruction detection in cerebro-spinal fluid shunt valves, combining radiological methods with machine learning under conditions compatible to future in-vivo application.</p><p>Results indicate that high-resolution contrast-enhanced subtraction radiography, possibly including time-series data, combined with machine-learning image analysis, has the potential to strongly improve the diagnostics of CSF shunt valve failures. The presented method is in principle suitable for in-vivo application, considering both measurement geometry and radiological dose. Further research is needed to validate these results on real-world data and to refine the employed methods.</p><p>In combination, the presented methods enable comprehensive analysis
{"title":"Pilot study on high-resolution radiological methods for the analysis of cerebrospinal fluid (CSF) shunt valves","authors":"Martin P. Pichotka, Moritz Weigt, Mukesch J. Shah, Maximilian F. Russe, Thomas Stein, T. Billoud, Jürgen Beck, Jakob Straehle, Christopher L. Schlett, Dominik v. Elverfeldt, Marco Reisert","doi":"10.1016/j.zemedi.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.zemedi.2023.11.001","url":null,"abstract":"<h3>Objectives</h3><p>Despite their life-saving capabilities, cerebrospinal fluid (CSF) shunts exhibit high failure rates, with a large fraction of failures attributed to the regulating valve. Due to a lack of methods for the detailed analysis of valve malfunctions, failure mechanisms are not well understood, and valves often have to be surgically explanted on the mere suspicion of malfunction.</p><p>The presented pilot study aims to demonstrate radiological methods for comprehensive analysis of CSF shunt valves, considering both the potential for failure analysis in design optimization, and for future clinical in-vivo application to reduce the number of required shunt revision surgeries. The proposed method could also be utilized to develop and support in situ repair methods (e.g. by lysis or ultrasound) of malfunctioning CSF shunt valves.</p><h3>Materials and methods</h3><p>The primary methods described are contrast-enhanced radiographic time series of CSF shunt valves, taken in a favorable projection geometry at low radiation dose, and the machine-learning-based diagnosis of CSF shunt valve obstructions. Complimentarily, we investigate CT-based methods capable of providing accurate ground truth for the training of such diagnostic tools. Using simulated test and training data, the performance of the machine-learning diagnostics in identifying and localizing obstructions within a shunt valve is evaluated regarding per-pixel sensitivity and specificity, the Dice similarity coefficient, and the false positive rate in the case of obstruction free test samples.</p><h3>Results</h3><p>Contrast enhanced subtraction radiography allows high-resolution, time-resolved, low-dose analysis of fluid transport in CSF shunt valves. Complementarily, photon-counting micro-CT allows to investigate valve obstruction mechanisms in detail, and to generate valid ground truth for machine learning-based diagnostics.</p><p>Machine-learning-based detection of valve obstructions in simulated radiographies shows promising results, with a per-pixel sensitivity >70%, per-pixel specificity >90%, a median Dice coefficient >0.8 and <10% false positives at a detection threshold of 0.5.</p><h3>Conclusions</h3><p>This ex-vivo study demonstrates obstruction detection in cerebro-spinal fluid shunt valves, combining radiological methods with machine learning under conditions compatible to future in-vivo application.</p><p>Results indicate that high-resolution contrast-enhanced subtraction radiography, possibly including time-series data, combined with machine-learning image analysis, has the potential to strongly improve the diagnostics of CSF shunt valve failures. The presented method is in principle suitable for in-vivo application, considering both measurement geometry and radiological dose. Further research is needed to validate these results on real-world data and to refine the employed methods.</p><p>In combination, the presented methods enable comprehensive analysis ","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"21 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138679829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1016/j.zemedi.2023.09.003
{"title":"Acknowledgements to the Consulting Editorial Board and the Reviewers","authors":"","doi":"10.1016/j.zemedi.2023.09.003","DOIUrl":"10.1016/j.zemedi.2023.09.003","url":null,"abstract":"","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"33 4","pages":"Pages I-III"},"PeriodicalIF":2.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0939388923001150/pdfft?md5=2b5ae1a5b25c34fa9d41b4390507bf07&pid=1-s2.0-S0939388923001150-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}