To assess the risk of cancer incidence after medical radiation exposure for coronary artery disease (CAD), a retrospective cohort study was conducted based on Taiwan's National Health Insurance Research Database (NHIRD). Patients with CAD were identified according to the International Classification of Diseases code, 9th Revision, Clinical Modification (ICD-9-CM), and their records of medical radiation procedures were collected from 1997 to 2010. A total of 18,697 subjects with radiation exposure from cardiac imaging or therapeutic procedures for CAD were enrolled, and 19,109 subjects receiving cardiac diagnostic procedures without radiation were adopted as the control group. The distributions of age and gender were similar between the two populations. Cancer risks were evaluated by age-adjusted incidence rate ratio (aIRR) and association with cumulative exposure were further evaluated with relative risks by Poisson regression analysis. A total of 954 and 885 subjects with various types of cancers in both cohorts after following up for over 10 years were found, with incidences of 409.8 and 388.0 per 100,000 person-years, respectively. The risk of breast cancer (aIRR=1.85, 95% confidence interval: 1.14-3.00) was significantly elevated in the exposed female subjects, but no significant cancer risk was found in the exposed males. In addition, cancer risks of the breast and lung were increased with the exposure level. The study suggests that radiation exposure from cardiac imaging or therapeutic procedures for CAD may be associated with the increased risk of breast and lung cancers in CAD patients.Keywords: Coronary artery disease (CAD) -cardiac imaging -cancer risk -incidence rate ratio (IRR)
The utilization of nuclear medicine scintigraphy with the National Health Insurance system in Taiwan has been changed considerably in the past 13 years. Both whole-body bone scan and myocardial perfusion scan were performed most often with significantly increases. The trend of nuclear medicine scintigraphy may have potential impact on making health-care policy in Taiwan.
The optimal parameters of the chitosan-coated ferrofluid under two patterns of irradiation were investigated in this study. The quality characteristics were set both to the SAR (specific absorption rate, W/g) and the particle size (nm). The control factors were chosen as the gamma irradiation dose (Gy), the quantities of chitosan (g), and the molar ratio of Fe3+to Fe2+. It shows that SAR is a better choice for determining the quality characteristic. The quantities of chitosan have a less significant impact on SAR. The optimal condition for the Fe3+/Fe2+ratio was found to be between 2.0 to 2.5 when synthesizing the magnetite Fe3O4cores. High dose (100 k Gy in this study) of gamma ray irradiation given only to the solid chitosan will have a significantly positive effect on SAR of the chitosan-coated ferrofluid for hyperthermia. However, high dose irradiation of the chitosan-coated ferrofluid tends to destroy the chitosan-magnetite cores bonds.
The numbers, frequencies, and expenses of MPS practices have increased in Taiwan during the period 2005-2009, especially for outpatients. The application rate of MPS in Taiwan was higher than that in Europe, likely because of the high accessibility to MPS procedures within the NHI system. This experience in Taiwan may serve as a reference for illustrating the trends in the use of MPS procedures in countries with a universal healthcare system.
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