卷 68, 编号 3 (2023)
Radiation Biology
Comparative Study of Changes in the γh2AX and 53BP1 Foci Number in Human Mesenchymal Stromale Cells Incubated with 3h-thymidine or Tritiated Water
摘要
Purpose: Comparative study of changes in the number of foci of DNA (DSB) marker proteins (γH2AX and 53BP1) in human mesenchymal stromal cells (MSCs) incubated with 3H-thymidine or HTO for 24, 48, and 72 h.
Material and methods: We used the primary culture of human MSCs of passage 5–6, obtained from the collection of LLC “BioloT” (Russia). A sterile solution of 3H-thymidine or HTO with a specific activity of 100 to 400 MBq/l was added to the nutrient medium and incubated under standard conditions of a CO2 incubator for 24, 48, and 72 hours. To quantify γH2AX foci and the proportion of proliferating cells using antibodies to γH2AX, 53BP1 and Ki67 (a marker protein for cell proliferation), were used, respectively. Statistical analysis of the obtained data was carried out using the statistical software package Statistica 8.0 (StatSoft). To assess the significance of differences between samples, Student’s t-test was used.
Results: Incubation of MSCs with 3H-thymidine with a specific radioactivity of 100-400 MBq/l in the first 24 hours leads to a dose-dependent increase in the number of γH2AX and 53BP1 foci. With a further increase in the incubation time to 48 h and 72 h, a saturation effect is observed ‒ the number of foci reaches a plateau. A statistically significant increase in the number of γH2AX and 53BP1 foci in MSCs incubated with HTO was observed only in actively proliferating cells during the first 24 h of incubation in a medium with specific radioactivity of 300 and 400 MBq/l, after which, with a decrease in proliferative activity, it decreased to control values. Calculations made on the basis of the results of a quantitative analysis of γH2AX and 53BP1 foci after 24 h of incubation of MSCs with tritium compounds obtained in the course of the work show, that under the influence of 3H-thymidine ~ 6 times more DNA double-strand breaks are induced than under the influence of HTO.
5-10
Radiation Safety
Health Physics Criteria for Assessing the Radiation Situation with Changing Technology at a Nuclear Fuel Cycle Enterprise
摘要
Purpose: To select and justify health physics criteria necessary and sufficient in assessing the potential hazard for the personnel and public from the implementation of the planned activity, which can lead to deterioration in the radiation situation at the nuclear fuel cycle (NFC) enterprise.
Results: To promptly assess the feasibility of carrying out an event planned at the NFC enterprise, a methodology has been developed for assessing radiation safety and protection in case of potential deterioration in the radiation situation.
Conclusion: Each planned event that may lead to deterioration in the radiation situation at a NFC enterprise should result in neither significant changes in the radiation situation nor exceeding the established health physics criteria:
• non-exceeding main dose constraints;
• non-increasing the category of potential radiation hazard of the NFC enterprise;
• non-increasing the class of work with unsealed radiation sources;
• permissible increase in the class of working conditions of the personnel based on the findings of special assessment of working conditions.
In a comparative assessment of the competitiveness of radiation technologies, potential change in the radiation situation and the cost of implementing compensatory measures should be pre-evaluated to protect the personnel and public in case of deterioration in the radiation situation following the introduction of new technologies.
11-15
Radiation Medicine
Features of Clinical Manifestations of the Primary Reaction in Combined Radiation Injury (Radiation Exposure and Mechanical Head Injury)
摘要
Purpose: To describe, on the basis of literature data, the features of the primary reaction of a person with a combined radiation injury – radiation exposure and mechanical head injury – in order to substantiate the possibility of using the symptoms of the primary reaction to predict the severity of acute radiation sickness (ARS).
Material and methods: Analysis of literature data.
Results: Based on the literature data, the clinical symptoms of the primary reaction in human radiation damage in a different dose range, and traumatic brain injuries are described: – concussion of the brain; – mild brain injury; – moderate brain injury.
To characterize the clinical picture of the combined effects of radiation injury and mechanical head injury, the symptoms of the primary reaction were compared with the symptoms of traumatic brain injury. Such symptoms of the primary reaction as vomiting, nausea, headache, dizziness in the most severe form of traumatic brain injury – a moderate brain injury – are diagnosed somewhat more often than in acute radiation sickness. In less severe forms of traumatic brain injury – concussion, mild brain injury – the frequency and severity of these symptoms are close to ARS.
In the complex clinical picture of combined radiation exposure and traumatic brain injury, the most different symptoms of the two components of combined radiation damage are the state of consciousness and the characteristics of the skin.
Conclusion: Clinical symptoms of the primary reaction to radiation exposure in conditions of combined radiation damage in the presence of head trauma lose their diagnostic significance for the early prognosis of the severity of developing ARS. In the clinical picture of combined radiation exposure and mechanical head injury, the most pronounced leading components should be the state of consciousness and the characteristics of the skin.
16-20
Radiation Epidemiology
Excess Relative Risk of Cataractogenic Lense Disordes in Nuclear Workers: Systematic Review and Meta-analysis
摘要
The lens cells are the most radiosensitive cells in the body, surpassing even lymphocytes in key parameters. Radiation damages in the lens can be observed at relatively low doses, in connection with which a number of authors attribute to these effects not a deterministic, but a stochastic nature.
Although cataractogenic consequences do not always affect visual acuity, and lens undergo successful surgical correction, when irradiating various professional groups, including workers in the nuclear industry, these consequences are regarded in importance immediately after malignant neoplasms and diseases of the circulatory system. The presented study showed that there are very few publications on the lens disorders in nuclear workers – only 20 sources were identified (1967–2022), and no data were found on the effects of low doses (0.1 Gy for low LET radiation).
When conducting a meta-analysis for ERR at 1 Gy/Sv for radiation damage in the lens of nuclear workers, three cohorts turned out to be relevant: a small group in the American study of transuranium elements processing, Mayak personnel and ROSATOM workers – liquidators of the Chernobyl accident. The sample was homogeneous, publication bias was unlikely, and, according to the results of a meta-analysis (Fixed effect model), ERR per 1 Gy/Sv was 0.30 (95 % confidence intervals: 0.25; 0.35).
Based on the earlier work (Koterov A.N. et al, 2022) of the mean cumulative dose of external exposure for nuclear workers as a world professional category, which amounted to 31.1 mSv, the calculation showed that with ERR = 0.3 per 1 Gy/Sv excess prevalence of cataracts for a group of ‘average’ workers is 0.0093. This corresponds to an increase in prevalence of 0.096 % over a background level of 10.3 % for potentially radiogenic cataracts (last value taken from a meta analysis by Hashemi H. et al., 2020). Such an increase is unlikely to have practical significance. Although for some cohorts (Sellafield, PO ‘Mayak’) there may be groups with significant cumulative doses and, therefore, with increased risks.
The importance of the risks of cataractogenic disorders in the lens in radiation workers may be due to a decrease in professional suitability, since the artificial lens, as a rule, is poorly capable of accommodation.
21-32
Incidence Rates of Malignant Neoplasms of Female Genital Organs in the Cohort of Females Occupationally Exposed to Ionizing Radiation
摘要
Purpose: To assess the association of incidence rates of malignant neoplasms of female genital organs (MNs of FGO) in women who were chronically occupationally exposed to ionizing radiation (IR) with radiation and non-radiation factors.
Material and methods: To perform the study, the cohort of females employed at the Mayak PA during 1948–1982 and followed up until 31 December 2018 was considered. All members of the considered cohort were chronically exposed to IR.
Results: 83.6 % of females were first diagnosed with a MN of FGO at age after 50 years. More than 50 % of MNs of FGO were reported during 1991–2010. Standardized rates of MNs FGO varied with the calendar period with the highest rates observed during 1996–2005. The analysis of the variation of the standardized rates with time demonstrated a significant tendency to increase by the end of the follow-up (R²=0.67, p=0.03). The incidence rates of MNs of FGO on average increased annually by 1.0 % (95 % CI 0.3–1.6). The standardized rates of MNs of FGO were significantly higher in females who had been diagnosed with endometriosis prior to MNs of FGO. The standardized rates of MNs of FGO were significantly higher in females externally exposed to gamma-rays at uterus absorbed dose of 0.2–0.5 Gy and above 0.5 Gy compared to females who had been exposed at lower doses.
MNs of the uterine body were the most common among total MNs of FGO. More than 90 % of MNs of the uterine body were registered during menopause. The standardized rate of MNs of the uterine body in females of the study cohort was 0.37 ± 0.05. The decrease in the standardized rate of the MNs of the uterine body was observed in 1986–1995 calendar period. The spline regression analysis of the variation of the standardized rate of MNs of the uterine body demonstrated the annual increment by 0.9 % (95 % CI 0.7–2.5) on average. The analysis demonstrated a tendency of the standardized rate of MNs of the uterine body to increase in the study cohort of females (R²=0.46, p=0.16). The standardized rates of MNs of the uterine body were significantly higher in females who had been diagnosed with endometriosis prior to MNs of the uterine body. Standardized rates of MNs of the uterine body were significantly higher in females externally exposed to gamma rays at the cumulative uterus absorbed dose above 0.5 Gy compared to females exposed at lower doses.
Conclusion: MNs of FGO were associated with both known non-radiation factors (age, calendar period, endometriosis) and the cumulative uterus absorbed dose from chronic occupational exposure to ionizing radiation.
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Radiation Diagnostics
An Innovative Approach to Magnetic Resonance Imaging of the Wrist
摘要
Purpose: Determination of the diagnostic capabilities of a specialized metadevice designed to detect magnetic resonance signs of pathological changes in the hands (including early ones) in patients with rheumatoid arthritis.
Material and methods: The study considered a metadevice for imaging of hands with magnetic induction 1.5 T. 26 people were examined, 10 of whom were studied using a standard coil for examining the knee joint and 16 using a metadevice, magnetic resonance images T1-VI, T2-VI, PD FS-VI were obtained. The images were evaluated by radiologists on a 5-point scale Likert.
Results: The images acquired using the metadevice had acceptable and peer-reviewed absolute and relative signal-to-noise ratios with images obtained using a standard pattern at the same resolution deviation and measuring input power at an average of 18 times for 1.5 T. In terms of image quality criteria for the presence/absence of arthritis, the average score for the metadevice (4.33) is slightly higher than the score for the specialized coil (4.25). The lower score of the standard coil, including on the issue of artifacts, indicates a lower susceptibility of the metadevice to various factors that give artifacts on MRI.
Discussion: The analysis of the collected assessments of independent experts indicates that the diagnostic characteristics of magnetic resonance images of the hand obtained using wire-based metadevices (for 1.5 T) are of good and average levels, and are comparable, and also surpass the standard approaches in all criteria.
Conclusions/Conclusion: The assessment of the quality of the obtained images demonstrates the acceptable quality of imaging and reflects the possibility of their application in clinical practice, taking into account ongoing improvements and optimization of the entire set of pulse sequences for MRI of the hand.
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Choise of Statistical Processing Methods for the Results of Radcomic Analysis of CT Images of Head and Neck Tumors
摘要
Purpose: Selection of the optimal method for statistical processing of the results of texture analysis of conventional CT images in patients with head and neck tumors.
Material and methods: A total of 118 patients aged from 4 to 80 years with a verified diagnosis of 37 benign and 81 malignant head and neck tumors were studied. Texture analysis was performed using LIFEx program, version 7.10, with statistical processing using SPSS, MedCalc, XLSTAT, R.
Results: The 39 texture indicators extracted from CT images were subjected to statistical processing by different methods, including Mann-Whitney U test, correlation matrix, factor analysis, LASSO-regression, ending with the development of a logistic classification model. Of the multiple processing methods, LASSO-regression followed by logistic model was optimal; according to its results, the percentage of correct classification of benign and malignant patient groups was – 81.3 %, area under the ROC curve was 0.902±0.029 (p<0.0001), sensitivity – 82.7 %, specificity – 87.5 %.
Conclusion: Texture analysis of medical images allows non-invasive prediction of benign or malignant nature of the imaged head and neck mass. The choice of the correct method for statistical processing of texture analysis results is critical to assess and classify patients according to the nature of the tumor.
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Radiation Therapy
Radiation Therapy for Breast Cancer pT1-3N0-1M0 after Mastectomy or Subcutaneous/Skin-Preserving Mastectomy with Reconstruction. Literature Review
摘要
Purpose: The literature review analyzes publications over the past decades on the need for radiation therapy after mastectomy or subcutaneous/skin-preserving mastectomy with reconstruction.
Results: Risk factors for breast cancer recurrence were analyzed. The effect of radiation therapy on the recurrence of breast cancer after mastectomy, subcutaneous and skin-preserving mastectomy with reconstruction was evaluated depending on the stage, lymph node lesions, and the presence of unfavorable molecular biological types. Indications for radiation therapy are described. The effect of radiation therapy on early and late complications of the reconstructed breast and options for reducing the percentage of complications were analyzed.
Conclusion: The exclusion of radiation therapy from the breast cancer treatment plan is a decrease in the percentage of complications caused by radiation therapy, for example, during implant reconstruction – a decrease in capsular contractures. And, as a result, improving the quality of life of patients, reducing repeated operations in case of complications, which means it is economically profitable. In recent years, due to the increasing need for various breast reconstruction options, the surgeon and radiotherapist have faced the task of choosing the optimal sequence of breast reconstruction, as well as reducing the risk of post-radiation complications. Radiation therapy, along with reducing the risk of relapse of the disease, increases the risk of complications after breast reconstruction, and vice versa, the reconstructed mammary gland can cause difficulties for the radiologist to correctly deliver the required dose of radiation. Minimizing the frequency and severity of complications after radiation therapy on the reconstructed gland without compromising oncological or cosmetic results is an important and common interdisciplinary goal for oncologists and radiotherapists.
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Nuclear Medicine
The Efficacy of Radionuclide Therapy for Bone Metastasis
摘要
Purpose: Development of a methodology for evaluating the effectiveness of radionuclide therapy for bone metastases based on dosimetric and clinical and laboratory criteria.
Material and methods: A comparative analysis of the functionality of various criteria for assessing the long-term and short-term effectiveness of radionuclide therapy of bone metastases was carried out. Focal absorbed doses of internal exposure are considered as one of the criteria, for the determination of which a simplified method for their calculation is proposed based on quantitative data from SPECT/CT scanning of an X-ray phantom and a real patient who has been injected with a β-γ-emitting therapeutic radiopharmaceutical.
Results: On a clinical example of radionuclide therapy with 177Lu-PSMA-617 in a patient with stage 4 prostate cancer, dose estimates of internal irradiation of foci with β-particles were obtained. Calculations were made for bone metastases of 7 localizations in dynamics for each of the 5 fractions of the course of radionuclide therapy. It is shown that the total focal doses for 5 fractions of internal exposure vary from 70.6 to 116.8 Gy for different foci, which corresponds to the literature data obtained by more accurate methods of dosimetry of internal exposure. The obtained dosimetric data were compared with efficacy estimates based on metabolic, hematological, hormonal and biochemical parameters, as well as on the tumor marker PSA.
Conclusion: The main criterion for assessing the antitumor efficacy of radionuclide therapy is the metabolic activity of bone foci, while data on the accumulated focal doses of internal β-irradiation are of an auxiliary nature. Hematological indicators should be the criteria for assessing radiotoxicity and used to adjust the course of radionuclide therapy.
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SAPHO Syndrome: Difficulties of Diagnosis in the Clinical Case. Radiology Imaging
摘要
Purpose: Demonstrate the possible manifestations of SAPHO syndrome.
Material and methods: 38-year-old woman with suspected SAPHO syndrome were performed scintigraphy and SPECT/CT for evaluate the localization and abundance of the process.
Results: Osteosclerosis and hyperostosis of the left clavicle, osteosclerosis of the L1 vertebra and other, less pronounced changes, accompanied by active accumulation of the 99mTc-MDP, were revealed.
Conclusion: It is important to remember the specific complex of symptoms of this nosological entity and the possible isolated onset of individual manifestations, which was also observed in our case.
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Development of Methodological Documents Regulating the Clinical Trials of New Radiopharmaceutical Drugs
摘要
Introduction
The forms of radiopharmaceutical drugs clinical trial protocols
The forms of the researcher’s brochure for clinical studies of radiopharmaceutical drugs
The forms of reports on the results of clinical trials for radiopharmaceutical drugs
Conclusion
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Review
Review of Roshydromet Recommendations R 52.18.787-2013 "Methodology for assessing radiation risks based on radiation monitoring data" and R 52.18.923-2022 "Procedure for assessing the risk of radioactive contamination of the environment based on radiation monitoring data"
78-79
Letters to the editor
Nuclear Workers - on the Question of Unification of Russian-Language Terminology (Brief Report)
摘要
The issue of terminology is considered when searching for sources for analytical and synthetic studies of effects among workers in the nuclear industry (nuclear fuel cycle for the production of nuclear weapons components and fuel for power or transport installations). It is noted that if there are relatively few English-language names of this professional group (only four were found) with the absolute prevalence of the term ‘nuclear workers’, then for Russian-language sources there is a wide variety of names (various combinations with ‘atomic’ and ‘nuclear’ ‘industry’ or ‘industry’ etc.) without a hint of specificity. It is concluded that in the Russian-language literature it is most appropriate to use the term ‘workers in the nuclear industry’ [=nuclear workers], given that the name ‘nuclear industry’ is official.
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