The spread of the novel coronavirus infection (COVID-19) in Moscow has led to a significant increase in the number of chest CT scans performed on patients as part of the diagnosis and assessment of the effectiveness of therapy. The change in the structure of radiation diagnostics in Moscow associated with COVID-19 leads to changes in the magnitude and structure of the collective dose of the population of Moscow, while the process of changing the collective dose is multidirectional. Since at the moment there is no reliable information on changes in the structure of radiation diagnostics and the levels of exposure of the population of Moscow in connection with the COVID-19 epidemic, this work was carried out to change the current situation.
The basic capabilities of patient dose monitoring software (DMS) available on the world market were studied. The main technical requirements for the software functional needed in practical work were defined. Modern DMS has wide range of possibilities for automated collection, storage and control of patient radiation exposure data in radiology departments. DMS increases the quality of healthcare services, provides patient safety and optimizes workflow of medical organization.
Background. The implementation of tyrosine kinase inhibitors into clinical practice improved treatment outcomes in patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC). Lenvatinib is recommended as a first-line drug for these patients. The study objective is to analyze clinical experience with lenvatinib in patients with RR-DTC in the Russian Federation. Materials and methods. The data from 18 clinical sites in Russia was analyzed for the period December 2015 and September 2019. Seventyseven patients with histologically verified DTC, proven resistance to radioactive iodine therapy, and tumor progression (according to the Response Evaluation Criteria In Solid Tumors 1.1 criteria) were included in the study. Results.Median progression-free survival in patients included into analysis (n = 72) was 26.1 months. In patients who responded to therapy (including those with partial and complete response), median progression-free survival reached 36.2 months, which is higher than that reported in the updated results of the SELECT study (33.1 months). Lenvatinib-associated adverse events (AEs) were observed in 87 % of patients. Severe AEs were registered in 18.2 % of participants. In 6.5 % of cases, AEs lead to lenvatinib cessation; in 74 % of cases, AEs required dose reduction.Conclusion. Our findings suggest high efficacy and good tolerability of lenvatinib in patients with RR-DTC in routine clinical practice in the Russian Federation.
Purpose. Comparative evaluation of effective doses to patients calculated using various methods for the most common X-ray examinations performed on general-purpose digital X-ray machines. Materials and methods. Data collection on parameters of examinations was performed for seven digital X-ray machines located in several Moscow medical facilities. Parameters for the most common X-ray examinations were collected for 120 standard patients from October to December 2019. Results. For all X-ray machines, significant reliable discrepancies were revealed between effective doses from the protocols of accredited laboratories (calculated based on radiation output) and effective doses determined by the authors based on the collected values of the dose-area product. The differences, on average, did not exceed ± 100%. However, the discrepancies for the thoracic spine and chest X-ray on some devices were even more significant. Limitations. Lack of a unified, standardised methodology for collecting parameters of radiological studies. Conclusion. The parameters of standard X-ray studies, collected by accredited laboratories and presented in the current methodological guidelines for monitoring patients’ effective doses, significantly differ from the studies’ parameters obtained from our data collection results. The existing methods for calculating effective doses require to be updated and revised. It makes sense to give up using transition coefficients and specialised software that calculates the effective dose, taking into account the geometry of patients’ exposure and physical and technical parameters of the study.
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