Radiation exposure during fluoroscopy has been of consistent interest because fluoroscopy is used not only for diagnostic purposes such as upper gastrointestinal series but for many minimally-invasive treatments in various clinical fields. In 2000, the International Commission on Radiological Protection published the important report about the avoidance of radiation injuries from medical interventional procedures, and this report defined harm during fluoroscopic-guided interventional procedure and how to reduce the radiation dose of patients and staff. Two aspects of fluoroscopy exposure differ from other types of medical radiation exposure, including computed tomography. One is that the entrance surface dose during an interventional procedure may be very high, so the deterministic effects of radiation such as skin or corneal injury should be emphasized more than stochastic effects such as cancer risk. The other is that the variation in radiation exposure is great for the same kind of procedure, so it is very difficult to generate a reference level for the radiation dose. Therefore, it is necessary to develop a guideline for the use of fluoroscopy through a nationwide survey about irradiation during fluoroscopic examinations and fluoroscopy-guided intervention procedures. In conclusion, radiation exposure by fluoroscopic guided intervention is not negligible, and the practitioner should always aim to reduce radiation exposure during interventional procedures.
Fluoroscopy ; Humans ; Radiation Dosage ; Radiation Injuries ; Radiation Monitoring ; Radiography, Interventional ; Radiology, Interventional ; Skin

PURPOSE: Radiation pneumonitis and fibrosis are common complications of radiation therapy of the chest. Sixty-six patients with lung cancer were studied to evaluate the radiation injury according to radiation dose (total and estimated single dose), time after completion of radiation, overall treatment time, and combined chemotheraphy and chest surgery. METHODS AND MATERIALS: All 66 patients received fractionated radiotherapy (180 to 300 cGy/day) to the thctax with total 1000 to 6660 cGy encompassing primary site and regional lymphatics. RESULTS: Radiation pneumonitis was developed in 40(60%) of 66 patients. Radiation pneumonitis occurred average 11 weeks after completion of therapy in 14(44%) of 32 patients below 4000 cGy, and 6 weeks in 26 (76%) of 34 patients above 4000 cGy. Radiation pneumonitis occurred more frequently when the estimated! single dose was over 1100 units than below 1100 units. Radiation pneumonitis was more frequent when the overall treatment time was over 30 days than within 30 days. All 10 patients undergone Iobectomy or pneumonectomy developed radiation pneumonitis. CONCLUSION: The incidence of radiation induced lung injury is variably dependant on radiation dose, time, from completion of radiation therapy, overall treatment time, and history of surgery such as Iobectomy or pneumonectomy before radiation therapy.
Acute Lung Injury* ; Fibrosis ; Humans ; Incidence ; Lung Injury ; Lung Neoplasms ; Pneumonectomy ; Radiation Injuries ; Radiation Pneumonitis ; Radiography, Thoracic* ; Radiotherapy ; Thorax*

Heterotopic calcification following head and neck irradiation has rarely been reported. It usually develops as a late complication of radiotherapy in patients with malignancies, including breast cancer, lymphoma, and genitourinary malignancies. The occurrence of heterotopic calcification in the prevertebral space of the cervical spine has not been described as a late complication of irradiation. Here, we report a case of prevertebral heterotopic calcification in a patient with history of chemotherapy and radiotherapy for tonsil cancer 21 years ago.
Aged ; Calcinosis/*etiology/pathology/radiography ; *Cervical Vertebrae/radiography ; Female ; Humans ; Ossification, Heterotopic/*etiology/radiography ; Radiation Injuries/complications ; Tomography, X-Ray Computed ; Tonsillar Neoplasms/*radiotherapy

Ionizing radiation has proved to be most valuable in clinical diagnosis and radiotherapy. And also it is used very common in industries especially such as industrial radiography, atomic energy plant, inspectoring by gamma-ray, etc. However, inadvertent exposure to relatively high doses of ionizing radiation is capable of injuring and killing cells. The lungs, because of their rich vascularization, are vulnerable to radiation injury. It is now known that IL-6 is a pleiotrophic cytokine produced by various cells that regulates the immune reponses, acute phage reactions. We performed the immunohistochemical staining of IL-6 on radiation induced lung injury by duration, to clarify the role of IL-6 in tissue damage. IL-6 was strongly expressed in early phase of radiation from alveolar macrophages and damaged endothelial cells. These findings not only have important implications for increasing our understanding of mechanisms of radiation lung injury but they also have an impact on strategies for diagnosis and therapy of radiation damage.
Bacteriophages ; Diagnosis ; Endothelial Cells ; Homicide ; Interleukin-6* ; Lung Injury ; Lung* ; Macrophages, Alveolar ; Nuclear Energy ; Plants ; Radiation Injuries ; Radiation, Ionizing ; Radiography ; Radiotherapy

The aim of our study was to describe the radiologic findings of extensive acute lung injury associated with limited thoracic irradiation. Limited thoracic irradiation occasionally results in acute lung injury. In this condition, chest radiograph shows diffuse ground-glass appearance in both lungs and thin-section CT scans show diffuse bilateral ground-glass attenuation with traction bronchiectasis, interlobular septal thickening and intralobular smooth linear opacities.
Acute Disease ; Adenocarcinoma/radiotherapy ; Adenocarcinoma/pathology ; Adenocarcinoma/drug therapy ; Adenocarcinoma/complications* ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/drug therapy ; Carcinoma, Squamous Cell/complications* ; Journal Article ; Human ; Lung/radiation effects* ; Lung/pathology ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/pathology ; Lung Neoplasms/drug therapy ; Lung Neoplasms/complications* ; Male ; Middle Age ; Radiation Injuries/radiography ; Radiation Injuries/pathology ; Radiation Injuries/etiology* ; Thorax/radiation effects

OBJECTIVE: To determine the efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the detection of radiation-induced myocardial damage in beagles by comparing two pre-scan preparation protocols as well as to determine the correlation between abnormal myocardial FDG uptake and pathological findings. MATERIALS AND METHODS: The anterior myocardium of 12 beagles received radiotherapy locally with a single X-ray dose of 20 Gy. 18F-FDG cardiac PET/CT was performed at baseline and 3 months after radiation. Twelve beagles underwent two protocols before PET/CT: 12 hours of fasting (12H-F), 12H-F followed by a high-fat diet (F-HFD). Regions of interest were drawn on the irradiation and the non-irradiation fields to obtain their maximal standardized uptake values (SUVmax). Then the ratio of the SUV of the irradiation to the non-irradiation fields (INR) was computed. Histopathological changes were identified by light and electron microscopy. RESULTS: Using the 12H-F protocol, the average INRs were 1.18 +/- 0.10 and 1.41 +/- 0.18 before and after irradiation, respectively (p = 0.021). Using the F-HFD protocol, the average INRs were 0.99 +/- 0.15 and 2.54 +/- 0.43, respectively (p < 0.001). High FDG uptake in irradiation field was detected in 33.3% (4/12) of 12H-F protocol and 83.3% (10/12) of F-HFD protocol in visual analysis, respectively (p = 0.031). The pathology of the irradiated myocardium showed obvious perivascular fibrosis and changes in mitochondrial vacuoles. CONCLUSION: High FDG uptake in an irradiated field may be related with radiation-induced myocardial damage resulting from microvascular damage and mitochondrial injury. An F-HFD preparation protocol used before obtaining PET/CT can improve the sensitivity of the detection of cardiotoxicity associated with radiotherapy.
Animals ; Dogs ; Fasting ; Fluorodeoxyglucose F18/*metabolism ; Heart/*radiography ; Heart Injuries/*radiography ; Male ; Myocardium/metabolism/pathology ; Positron-Emission Tomography/*methods ; Radiation Injuries/diagnosis/*radiography ; Thoracic Neoplasms/radiotherapy ; Tomography, X-Ray Computed/*methods

OBJECTIVE: To evaluate the feasibility of sinogram-affirmed iterative reconstruction (SAFIRE) and automated kV modulation (CARE kV) in reducing radiation dose without increasing image noise for abdominal CT examination. MATERIALS AND METHODS: This retrospective study included 77 patients who received CT imaging with an application of CARE kV with or without SAFIRE and who had comparable previous CT images obtained without CARE kV or SAFIRE, using the standard dose (i.e., reference mAs of 240) on an identical CT scanner and reconstructed with filtered back projection (FBP) within 1 year. Patients were divided into two groups: group A (33 patients, CT scanned with CARE kV); and group B (44 patients, scanned after reducing the reference mAs from 240 to 170 and applying both CARE kV and SAFIRE). CT number, image noise for four organs and radiation dose were compared among the two groups. RESULTS: Image noise increased after CARE kV application (p < 0.001) and significantly decreased as SAFIRE strength increased (p < 0.001). Image noise with reduced-mAs scan (170 mAs) in group B became similar to that of standard-dose FBP images after applying CARE kV and SAFIRE strengths of 3 or 4 when measured in the aorta, liver or muscle (p > or = 0.108). Effective doses decreased by 19.4% and 41.3% for groups A and B, respectively (all, p < 0.001) after application of CARE kV with or without SAFIRE. CONCLUSION: Combining CARE kV, reduction of mAs from 240 to 170 mAs and noise reduction by applying SAFIRE strength 3 or 4 reduced the radiation dose by 41.3% without increasing image noise compared with the standard-dose FBP images.
Adult ; Aged ; Aged, 80 and over ; *Algorithms ; Equipment Design ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/adverse effects/*instrumentation ; Radiation Dosage ; Radiation Injuries/etiology/*prevention & control ; Radiographic Image Interpretation, Computer-Assisted/*methods ; Radiography, Abdominal/adverse effects/*methods ; Retrospective Studies

BACKGROUNDTo evaluate the utility of rabbit ladderlike model of radiation-induced lung injury (RILI) for the future investigation of computed tomography perfusion.

METHODSA total of 72 New Zealand rabbits were randomly divided into two groups: 36 rabbits in the test group were administered 25 Gy of single fractionated radiation to the whole lung of unilateral lung; 36 rabbits in the control group were sham-radiated. All rabbits were subsequently sacrificed at 1, 6, 12, 24, 48, 72 h, and 1, 2, 4, 8,1 6, 24 weeks after radiation, and then six specimens were extracted from the upper, middle and lower fields of the bilateral lungs. The pathological changes in these specimens were observed with light and electron microscopy; the expression of tumor necrosis factor-α (TNF-a) and transforming growth factor-β₁ (TGF-β₁) in local lung tissue was detected by immunohistochemistry.

RESULTS(1) Radiation-induced lung injury occurred in all rabbits in the test group. (2) Expression of TNF-a and TGF-β₁ at 1 h and 48 h after radiation, demonstrated a statistically significant difference between the test and control groups (each P < 0.05). (3) Evaluation by light microscopy demonstrated statistically significant differences between the two groups in the following parameters (each P < 0.05): thickness of alveolar wall, density of pulmonary interstitium area (1 h after radiation), number of fibroblasts and fibrocytes in interstitium (24 h after radiation). The test group metrics also correlated well with the time of postradiation. (4) Evaluation by electron microscopy demonstrated statistically significant differences in the relative amounts of collagen fibers at various time points postradiation in the test group (P < 0.005), with no significant differences in the control group (P > 0.05). At greater than 48 h postradiation the relative amount of collagen fibers in the test groups significantly differ from the control groups (each P < 0.05), correlating well with the time postradiation (r = 0.99318).

CONCLUSIONSA consistent and reliable rabbit model of RILI can be generated in gradient using 25 Gy of high-energy X-ray, which can simulate the development and evolution of RILI.

Animals ; Disease Models, Animal ; Female ; Lung Injury ; diagnostic imaging ; etiology ; metabolism ; Male ; Rabbits ; Radiation Injuries ; diagnostic imaging ; etiology ; metabolism ; Radiography ; Transforming Growth Factor beta1 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism ; X-Rays