Efforts to assess in utero radiation doses and related quantities to the developing fetus should account for the presence of the surrounding maternal tissues. Maternal tissues can provide varying levels of protection to the fetus by shielding externally-emitted radiation or, alternatively, can become sources of internally-emitted radiation following the biokinetic uptake of medically-administered radiopharmaceuticals or radionuclides located in the surrounding environment--as in the case of the European Union's SOLO project (Epidemiological Studies of Exposed Southern Urals Populations). The University of Florida had previously addressed limitations in available computational phantom representation of the developing fetus by constructing a series of hybrid computational fetal phantoms at eight different ages and three weight percentiles. Using CT image sets of pregnant patients contoured using 3D-DOCTOR(TM), the eight 50th percentile fetal phantoms from that study were systematically combined in Rhinoceros(TM) with the UF adult non-pregnant female to yield a series of reference pregnant female phantoms at fetal ages 8, 10, 15, 20, 25, 30, 35 and 38 weeks post-conception. Deformable, non-uniform rational B-spline surfaces were utilized to alter contoured maternal anatomy in order to (1) accurately position and orient each fetus and surrounding maternal tissues and (2) match target masses of maternal soft tissue organs to reference data reported in the literature.
Purpose: Coherent scatter based imaging has shown improved contrast and molecular specificity over conventional digital mammography however the biological risks have not been quantified due to a lack of accurate information on absorbed dose. This study intends to characterize the dose distribution and average glandular dose from coded aperture coherent scatter spectral imaging of the breast. The dose deposited in the breast from this new diagnostic imaging modality has not yet been quantitatively evaluated. Here, various digitized anthropomorphic phantoms are tested in a Monte Carlo simulation to evaluate the absorbed dose distribution and average glandular dose using clinically feasible scan protocols. Methods: Geant4 Monte Carlo radiation transport simulation software is used to replicate the coded aperture coherent scatter spectral imaging system. Energy sensitive, photon counting detectors are used to characterize the x‐ray beam spectra for various imaging protocols. This input spectra is cross‐validated with the results from XSPECT, a commercially available application that yields x‐ray tube specific spectra for the operating parameters employed. XSPECT is also used to determine the appropriate number of photons emitted per mAs of tube current at a given kVp tube potential. With the implementation of the XCAT digital anthropomorphic breast phantom library, a variety of breast sizes with differing anatomical structure are evaluated. Simulations were performed with and without compression of the breast for dose comparison. Results: Through the Monte Carlo evaluation of a diverse population of breast types imaged under real‐world scan conditions, a clinically relevant average glandular dose for this new imaging modality is extrapolated. Conclusion: With access to the physical coherent scatter imaging system used in the simulation, the results of this Monte Carlo study may be used to directly influence the future development of the modality to keep breast dose to a minimum while still maintaining clinically viable image quality.
Background:The reference point cumulative air kerma (K a,r ) is a commonly used dose quantity for establishing substantial radiation dose levels (SRDLs) that can provide guidance for patient dose management actions following fluoroscopically guided procedures. However, the K a,r may not correlate well with the patient peak skin dose (D skin,max ) because the relationship between K a,r and D skin,max may vary widely due to clinical variations. Therefore, it may be prudent for institutions to establish different K a,r -based SRDL values based on the clinical procedure type. Purpose: The present study investigates the relationship between K a,r and D skin,max for different clinical services and how that variation may overestimate or underestimate the need for patient follow-up. Additionally, the study suggests a possible framework for establishing K a,r SRDLs based on the clinical data analysis. Methods: A retrospective analysis was performed for fluoroscopically guided interventions exceeding 5 Gy K a,r . For each procedure, the patient D skin,max was estimated and the ratio of D skin,max to K a,r (DKR) was calculated. Results were pooled into one of three clinical service categories: body interventions (n = 33), cardiac interventions (n = 81), or neurological (neuro) interventions (n = 44). The distributions in K a,r , D skin,max , and DKR were analyzed in aggregate and by the clinical service category. Results: The median K a,r values for procedures exceeding 5 Gy were 6.0 Gy (95% CI [5.6, 6.4]) for body interventions, 5.8 Gy (95% CI [5.5, 6.0]) for cardiac interventions, and 6.3 Gy (95% CI [5.9, 6.6]) for neuro interventions. D skin,max for the same procedure data sets were 5.0 Gy (95% CI [4.4, 5.6]) for body interventions, 5.5 Gy (95% CI [5.2, 5.8]) for cardiac interventions, and 3.7 Gy (95% CI [3.4, 4.0]) for neuro interventions. This resulted in median DKR values of 0.81 for body interventions, 0.91 for cardiac interventions, and 0.59 for neuro interventions.Conclusions: This study illustrates the need to understand the relationship between the reported K a,r and the patient D skin,max for different types of interventional procedures. This is especially important when an institution uses K a,r as the parameter for establishing an SRDL threshold to identify patients who may require clinical follow-up. The implications of this research and a guide for how to implement these findings are elaborated on in the Discussion.
<div>Abstract<p>While immune checkpoint blockade elicits efficacious responses in many patients with cancer, it also produces a diverse and unpredictable number of immune-related adverse events (IRAE). Mechanisms driving IRAEs are generally unknown. Because CTLA-4 blockade leads to proliferation of circulating T cells, we examined in this study whether ipilimumab treatment leads to clonal expansion of tissue-reactive T cells. Rather than narrowing the T-cell repertoire to a limited number of clones, ipilimumab induced greater diversification in the T-cell repertoire in IRAE patients compared with patients without IRAEs. Specifically, ipilimumab triggered increases in the numbers of clonotypes, including newly detected clones and a decline in overall T-cell clonality. Initial broadening in the repertoire occurred within 2 weeks of treatment, preceding IRAE onset. IRAE patients exhibited greater diversity of CD4<sup>+</sup> and CD8<sup>+</sup> T cells, but showed no differences in regulatory T-cell numbers relative to patients without IRAEs. Prostate-specific antigen responses to ipilimumab were also associated with increased T-cell diversity. Our results show how rapid diversification in the immune repertoire immediately after checkpoint blockade can be both detrimental and beneficial for patients with cancer. <i>Cancer Res; 77(6); 1322–30. ©2016 AACR</i>.</p></div>
<p>The supplementary file contains 3 supplemental figures. Supplementary Figure S1 shows the kinetics of Ki67 expression by CD4 and CD8 T cells following treatment with ipilimumab. Supplementary Figure S2 shows the change in TCR clonality over time following treatment with ipilimumab. Supplementary Figure S3 shows the changes in clonotype frequencies of sorted CD4+ and CD8+ T cells with ipilimumab.</p>
<p>The supplementary file contains 3 supplemental figures. Supplementary Figure S1 shows the kinetics of Ki67 expression by CD4 and CD8 T cells following treatment with ipilimumab. Supplementary Figure S2 shows the change in TCR clonality over time following treatment with ipilimumab. Supplementary Figure S3 shows the changes in clonotype frequencies of sorted CD4+ and CD8+ T cells with ipilimumab.</p>
Background: To investigate the impact of radiation exposure from a computed tomography (CT) scanner on the functional integrity of a wearable insulin delivery system. Methods: A total of 160 Omnipods and four personal diabetes managers (PDMs) were evenly divided into four groups: (1) control group (no radiation exposure), (2) typical radiation exposure group, (3) 4× typical radiation exposure group, and (4) scatter radiation group. Pods were attached to an anthropomorphic torso phantom on the abdomen (direct irradiation) or shoulder (scatter radiation) region. A third-generation dual-source CT scanner was used to scan the pods using either a typical exposure (used for routine CT abdominal study of a median size patient) or 4× typical exposure. A manufacturer-recommended 20-step functionality test was performed for all 160 Omnipods. Results: The radiation dose (measured in volume CT Dose index) was 16 mGy for a typical exposure, and 64 mGy for 4× typical exposure. The scatter radiation is less than 0.1 mGy. All Pods passed the functionality test except one pod in the scatter radiation group, which sounded an alarm due to occlusion. The blockage to the fluid was due to a kink in the soft cannula, a mechanical issue not caused by the radiation exposure. Conclusions: This study suggests X-ray exposure levels used in radiological imaging procedures do not negatively impact the functional integrity of Omnipods. This finding may support the potential for the manufacturer to remove the warning that patients should remove the Pod for X-ray imaging procedures, which will have a huge impact on patient care.
Purpose: To optimize collimation and shielding for a deuterium‐deuterium (DD) neutron generator for an inexpensive and compact clinical neutron imaging system. The envisioned application is cancer diagnosis through Neutron Stimulated Emission Computed Tomography (NSECT). Methods: Collimator designs were tested with an isotropic 2.5 MeV neutron source through GEANT4 simulations. The collimator is a 52×52×52 cm3 polyethylene block coupled with a 1 cm lead sheet in sequence. Composite opening was modeled into the collimator to permit passage of neutrons. The opening varied in shape (cylindrical vs. tapered), size (1–5 cm source‐side and target‐side openings) and aperture placements (13–39 cm from source‐side). Spatial and energy distribution of neutrons and gammas were tracked from each collimator design. Parameters analyzed were primary beam width (FWHM), divergence, and efficiency (percent transmission) for different configurations of the collimator. Select resultant outputs were then used for simulated NSECT imaging of a virtual breast phantom containing a 2.5 cm diameter tumor to assess the effect of the collimator on spatial resolution, noise, and scan time. Finally, composite shielding enclosure made of polyethylene and lead was designed and evaluated to block 99.99% of neutron and gamma radiation generated in the system. Results: Analysis of primary beam indicated the beam‐width is linear to the aperture size. Increasing source‐side opening allowed at least 20% more neutron throughput for all designs relative to the cylindrical openings. Maximum throughput for all designs was 364% relative to cylindrical openings. Conclusion: The work indicates potential for collimating and shielding a DD neutron generator for use in a clinical NSECT system. The proposed collimator designs produced a well‐defined collimated neutron beam that can be used to image samples of interest with millimeter resolution. Balance in output efficiency, noise reduction, and scan time should be considered to determine the optimal design for specific NSECT applications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.