Assessment of radiological hazards from radioactivity natural of cement used in Dwellings in Rio de Janeiro, Brazil.

Brazil is the fourth largest cement consumer in the world and the largest producer in Latin America, around 1.3% of global production. The main inputs in the manufacture of cement are limestone and clay. Few studies have been carried out in the country on the risk of these materials used in civil construction. Therefore, the objective of this present work is to evaluate the radiological danger that they can present to society. Gamma spectrometry analysis on 16 samples of different brands of cement used as construction material in Rio de Janeiro (Brazil) was performed in this study, using an HPGe detector and the Genie 2000 data acquisition software. Samples were set to count for an accumulation time of 14,400 s (4 h) and all measurements were corrected to eliminate background and backscattering. Activity concentrations are determined for 226Ra was from (41.2 ± 1.6 to 174.9 ± 3.9) Bq kg-1, 232Th was from (15.7 ± 0.5 to 43.1 ± 0.7) Bq kg-1 and 40K was from (82.6 ± 7.2 to 254 ± 17) Bq kg-1. To assess radiological health risks: mean values of Radium Activity Equivalent 150.0 ± 3.4 Bq kg-1, Annual Gonadal Dose Equivalent 468 ± 11 µSv year-1 and Lifetime Excess Cancer Risk (ELCR) 2.42 ± 0.06 were calculated. Total Absorbed Dose Rates ranged from 72.2 ± 1.7 to 225.1 ± 5.2 nGy h-1. The damage to collective health was also estimated from the annual effective dose rates with an estimated total cost of damage to health of US$ 130 million. Values are generally within global limits reported by UNSCEAR.

A comprehensive value-based method for new nuclear medical service pricing: with case study of radium [223Ra] bone metastases treatment.

IMPORTANCE: Innovative nuclear medicine services offer substantial clinical value to patients. However, these advancements often come with high costs. Traditional payment strategies do not incentivize medical institutes to provide new services nor determine the fair price for payers. A shift towards a value-based pricing strategy is imperative to address these challenges. Such a strategy would reconcile the cost of innovation with incentives, foster transparent allocation of healthcare resources, and expedite the accessibility of essential medical services. OBJECTIVE: This study aims to develop and present a comprehensive, value-based pricing model for new nuclear medicine services, illustrated explicitly through a case study of the radium [223Ra] treatment for bone metastases. In constructing the pricing model, we have considered three primary value determinants: the cost of the new service, associated service risk, and the difficulty of the service provision. Our research can help healthcare leaders design an evidence-based Fee-For-Service (FFS) payment reference pricing with nuclear medicine services and price adjustments. DESIGN, SETTING AND PARTICIPANTS: This multi-center study was conducted from March 2021 to February 2022 (including consultation meetings) and employed both qualitative and quantitative methodologies. We organized focus group consultations with physicians from nuclear medicine departments in Beijing, Chongqing, Guangzhou, and Shanghai to standardize the treatment process for radium [223Ra] bone metastases. We used a specially designed 'Radium Nuclide [223Ra] Bone Metastasis Data Collection Form' to gather nationwide resource consumption data to extract information from local databases. Four interviews with groups of experts were conducted to determine the add-up ratio, based on service risk and difficulty. The study organized consultation meeting with key stakeholders, including policymakers, service providers, clinical researchers, and health economists, to finalize the pricing equation and the pricing result of radium [223Ra] bone metastases service. MAIN OUTCOMES AND MEASURES: We developed and detailed a pricing equation tailored for innovative services in the nuclear medicine department, illustrating its application through a step-by-step guide. A standardized service process was established to ensure consistency and accuracy. Adhering to best practice guidelines for health cost data analysis, we emphasized the importance of cross-validation of data, where validated data demonstrated less variation. However, it required a more advanced health information system to manage and analyze the data inputs effectively. RESULTS: The standardized service of radium [223Ra] bone metastases includes: pre-injection assessment, treatment plan, administration, post-administration monitoring, waste disposal and monitoring. The average duration for each stage is 104 min, 39 min, 25 min, 72 min and 56 min. A standardized monetary value for medical consumables is 54.94 yuan ($7.6), and the standardised monetary value (medical consumables cost plus human input) is 763.68 yuan ($109.9). Applying an agreed value add-up ratio of 1.065, the standardized value is 810.19 yuan ($116.9). Feedback from a consultation meeting with policymakers and health economics researchers indicates a consensus that the pricing equation developed was reasonable and well-grounded. CONCLUSION: This research is the first study in the field of nuclear medicine department pricing methodology. We introduce a comprehensive value-based nuclear medical service pricing method and use radium[223Ra] bone metastases treatment pricing in China as a case study. This study establishes a novel pricing framework and provides practical instructions on its implementation in a real-world healthcare setting.

Natural Radioactivity in Raw Building Materials for Underground Parking Lots and Assessment of Radiological Health Risk for the Population.

This article reports the results of an investigation into the activity concentration of natural radionuclides in raw building materials for underground parking lots, together with the assessment of the radiation hazard for the public related to exposure to ionizing radiations. To this purpose, high-purity germanium (HPGe) γ-ray spectrometry was employed in order to quantify the average specific activity of 226Ra, 232Th, and 40K natural radioisotopes. With the aim to assess any possible radiological health risk for the population, the absorbed γ-dose rate (D), the annual effective dose equivalent outdoor (AEDEout) and indoor (AEDEin), the activity concentration index (I), and the alpha index (Iα) were also estimated, resulting in values that were lower than the maximum recommended ones for humans. Finally, the extent of the correlations existing between the observed radioactivity and radiological parameters and of these parameters with the analyzed samples was quantified through statistical analyses, including Pearson's correlation, a principal component analysis (PCA), and a hierarchical cluster analysis (HCA). As a result, three clusters of the investigated samples were recognized based on their chemical composition and mineralogical nature. Noteworthily, this paper covers a certain gap in science since its topic does not appear in literature in this form. Thus, the authors underline the importance of this work to global knowledge in the environmental research and public health fields.

Assessment of NORMs (238U, 232Th, 40K) and radiation hazard indices in Beldih apatite mine region of Purulia district, West Bengal, India.

The radiation arising from naturally occurring radioactive materials (NORMs) is the foremost contributor to the collective dose received by the global population. The present study aims to measure the natural background radiation level and the associated gamma radiation dose in air in the Beldih apatite mine region of Purulia district, India. This study is primarily focused on the determination of 238U, 232Th and 40K activities in the sub-surface soil of the study area. The measurements were carried out using a High Purity Germanium (HPGe) detector-based gamma-ray spectrometer with a relative efficiency of 80%. To achieve uniformity in exposure estimations, radium equivalent activity has been calculated. Additionally, the internal hazard index, external hazard index, radioactivity level index and gamma dose rates have been evaluated to estimate the radiation hazard levels in the study area. The comparison of obtained concentrations and hazard indices with global data (UNSCEAR. (2008). Sources, effects and risks of ionizing radiation. United nations scientific committee on the effects of atomic radiation (report to the general assembly, with Annexes).) suggests that this region lies in a relatively high background radiation zone.

Using spectroscopic autoradiography of alpha particles for the quantitative mapping of 226Ra ultra-traces in geo-materials.

The measurement of 226Ra and the identification of 226Ra-bearing minerals are important for studying the behavior of radium in the environment. Various instruments for measuring 226Ra are currently used: among the radiometric techniques that measure in bulk (no spatialization), there are gamma spectrometers and alpha spectrometers. Other instruments such as SEM-EDS can map the chemical elements thus providing information on the distribution of 226Ra, but are limited for ultra-trace analyses on natural geomaterials. Finally, autoradiography techniques can locate radioactivity, but are limited to the identification of the contribution of 226Ra when the 238U series is complete. This study focuses on spectroscopic autoradiography, a method for measuring both the energy of the alpha particle emissions and their positions on the autoradiograph. A gas detector based on a parallel ionization multiplier technology was used for this purpose. Alpha particle energy is dependent on the emitting radionuclides. In order to track the 226Ra, the energy spectrum of the 238U series was studied with modeling software. It appears possible to apply a thresholding on the energy spectrum to discriminate the 226Ra from the first alpha emitters of the 238U decay chain (i.e. 238U, 234U and 230Th, all below 5 MeV). The developed method was applied to a U-mill tailing sample prepared as a thin section. The sample was heterogeneous in terms of radioactivity and was not at secular equilibrium with 238U, as expected. The 226Ra was identified and localized, and different regions of interest were also analyzed with SEM-EDS elements cartography. This revealed 226Ra-rich barite (BaSO4) phases measured at 3 ppmRa on average and containing no uranium; and uranium in siderite (FeCO3), showing a strong 226Ra deficit compared with secular equilibrium. Spectroscopic autoradiography opens up possibilities for the analysis of heterogeneous geological samples containing natural alpha emitters such as 238U and 226Ra: the 226Ra can be localized and quantified at ultra-trace content, and the method developed can also identify newly (young) uranium phases by measuring 238U/226Ra activity disequilibrium.

Comparison of radium-226 separation methods based on chromatographic and extraction resins for its determination by ICP-MS in drinking waters.

Over the past century, human activities have contributed to the release of 226 Ra (t½ = 1,600 y) in the environment, increasing the potential risks for human exposure and thus prompting scientists to monitor it. Inductively coupled plasma mass spectrometry (ICP-MS) is an alternative to alpha-spectrometry for the quantification of 226 Ra. However, the performances of radioanalytical procedures are rarely compared in a rigorous framework, which means that researchers may choose one on subjective factors or guesses. This article compares five published methods for the separation and preconcentration of 226 Ra in drinking waters based on chromatographic and extraction resins prior to its analysis by ICP-MS. We evaluated the turnaround time, generated wastes, and final cost of each protocol as the economic aspect can be an important criterion when selecting a method, particularly for sustainable environmental monitoring. Our results showed that 226 Ra was successfully separated and preconcentrated, yielding recoveries ranging between 84% and 105%. Method detection and quantification limits of respectively 2-7 fg L-1 (0.1-0.3 mBq L-1 ) and 6-24 fg L-1 (0.2-0.9 mBq L-1 ) were achieved when the separation method was coupled with ICP-MS. The turnaround times ranged between 6 and 21 hours, whereas the cost of the methods varied between 40 and 132 USD. This study highlights for the first time that methodologies recently published on the evaluation of 226 Ra levels in drinking water by ICP-MS have comparable figures of merit. Our results offer essential insights into the selection of the most suitable separation method.

Circulating and Imaging Biomarkers of Radium-223 Response in Metastatic Castration-Resistant Prostate Cancer.

PURPOSE: Radium-223 improves overall survival (OS) and reduces skeletal events in patients with bone metastatic castration-resistant prostate cancer (CRPC), but relevant biomarkers are lacking. We evaluated automated bone scan index (aBSI) and circulating tumor cell (CTC) analyses as potential biomarkers of prognosis and activity. PATIENTS AND METHODS: Patients with bone metastatic CRPC were enrolled on a prospective single-arm study of standard radium-223. 99mTc-MDP bone scan images at baseline, 2 months, and 6 months were quantitated using aBSI. CTCs at baseline, 1 month, and 2 months were enumerated and assessed for RNA expression of prostate cancer-specific genes using microfluidic enrichment followed by droplet digital polymerase chain reaction. RESULTS: The median OS was 21.3 months in 22 patients. Lower baseline aBSI and minimal change in aBSI (<+0.7) from baseline to 2 months were each associated with better OS (P = .00341 and P = .0139, respectively). The higher baseline CTC count of ≥5 CTC/7.5 mL was associated with worse OS (median, 10.1 v 32.9 months; P = .00568). CTCs declined at 2 months in four of 15 patients with detectable baseline CTCs. Among individual genes in CTCs, baseline expression of the splice variant AR-V7 was significantly associated with worse OS (hazard ratio, 5.20 [95% CI, 1.657 to 16.31]; P = .00195). Baseline detectable AR-V7, higher aBSI, and CTC count ≥5 CTC/7.5 mL continued to have a significant independent negative impact on OS after controlling for prostate-specific antigen or alkaline phosphatase. CONCLUSION: Quantitative bone scan assessment with aBSI and CTC analyses are prognostic markers in patients treated with radium-223. AR-V7 expression in CTCs is a particularly promising prognostic biomarker and warrants validation in larger cohorts.

Advancements in the development of radiopharmaceuticals for nuclear medicine applications in the treatment of bone metastases.

Bone metastases are a painful and complex condition that overwhelmingly impacts the prognosis and quality of life of cancer patients. Over the years, nuclear medicine has made remarkable progress in the diagnosis and management of bone metastases. This review aims to provide a comprehensive overview of the recent advancements in nuclear medicine for the diagnosis and management of bone metastases. Furthermore, the review explores the role of targeted radiopharmaceuticals in nuclear medicine for bone metastases, focusing on radiolabeled molecules that are designed to selectively target biomarkers associated with bone metastases, including osteocytes, osteoblasts, and metastatic cells. The applications of radionuclide-based therapies, such as strontium-89 (Sr-89) and radium-223 (Ra-223), are also discussed. This review also highlights the potential of theranostic approaches for bone metastases, enabling personalized treatment strategies based on individual patient characteristics. Importantly, the clinical applications and outcomes of nuclear medicine in osseous metastatic disease are discussed. This includes the assessment of treatment response, predictive and prognostic value of imaging biomarkers, and the impact of nuclear medicine on patient management and outcomes. The review identifies current challenges and future perspectives on the role of nuclear medicine in treating bone metastases. It addresses limitations in imaging resolution, radiotracer availability, radiation safety, and the need for standardized protocols. The review concludes by emphasizing the need for further research and advancements in imaging technology, radiopharmaceutical development, and integration of nuclear medicine with other treatment modalities. In summary, advancements in nuclear medicine have significantly improved the diagnosis and management of osseous metastatic disease and future developements in the integration of innovative imaging modalities, targeted radiopharmaceuticals, radionuclide production, theranostic approaches, and advanced image analysis techniques hold great promise in improving patient outcomes and enhancing personalized care for individuals with bone metastases.

Radium deposition in human brain tissue: A Geant4-DNA Monte Carlo toolkit study.

NASA has encouraged studies on 226Ra deposition in the human brain to investigate the effects of exposure to alpha particles with high linear energy transfer, which could mimic some of the exposure astronauts face during space travel. However, this approach was criticized, noting that radium is a bone-seeker and accumulates in the skull, which means that the radiation dose from alpha particles emitted by 226Ra would be heavily concentrated in areas close to cranial bones rather than uniformly distributed throughout the brain. In the high background radiation areas of Ramsar, Iran, extremely high levels of 226Ra in soil contribute to a large proportion of the inhabitants' radiation exposure. A prospective study on Ramsar residents with a calcium-rich diet was conducted to improve the dose uniformity due to 226Ra throughout the cerebral and cerebellar parenchyma. The study found that exposure of the human brain to alpha particles did not significantly affect working memory but was significantly associated with increased reaction times. This finding is crucial because astronauts on deep space missions may face similar cognitive impairments due to exposure to high charge and energy particles. The current study was aimed to evaluate the validity of the terrestrial model using the Geant4 Monte Carlo toolkit to simulate the interactions of alpha particles and representative cosmic ray particles, acknowledging that these radiation types are only a subset of the complete space radiation environment.

Assessment of radioactivity level and associated radiological hazard in riverbed samples within industrial areas.

Terrestrial gamma radiation is one of the major outdoor radiation exposures to the general public that varies substantially based on the type and geological properties of the soil. The objective of this study is to evaluate the naturally occurring radioactive materials (NORMs) distribution and assess the hazard parameters in the riverbank soil within various industrial zones in the densely populated Dhaka and Chattogram cities of Bangladesh. The mean activities of 226Ra (37 ± 3), 232Th (58 ± 4), and 40K (1129 ± 18) Bqkg-1 in the assessed soil samples were found to be slightly higher than the world average values 32, 35, and 420 Bqkg-1, respectively. The mean radium equivalent activity (207.49 Bqkg-1) and the external and internal hazard indices were within the recommended limits of 370 Bqkg-1 and <1, respectively. The mean absorbed dose rate (99.47 nGyhr-1), annual effective dose (0.12 mSva-1), ELCR (4.27 × 10-4), and gamma level index (1.58) exceeded the world average values 59 nGyhr-1, 0.07 mSva-1, 2.9 × 10-4, and 1 respectively. However, the studied areas are safe from a radiological viewpoint with no radiation health hazard to the people. The results of this study can be utilized to produce factual baseline data for future studies.

Understanding the incidence, duration, and severity of symptoms through daily symptom monitoring among frail and non-frail older patients receiving metastatic prostate cancer treatments.

INTRODUCTION: Older adults with metastatic prostate cancer (mPC) experience high symptom burden associated with treatment. Frailty may exacerbate treatment toxicity. The aim of this study was to explore short-term treatment toxicity in patients with metastatic prostate cancer. MATERIALS AND METHODS: Older adults with metastatic prostate cancer starting chemotherapy, androgen-receptor-axis targeted therapies, or radium-223 participated in a prospective, multicentre, observational study. Participants self-reported symptoms daily using the Edmonton Symptom Assessment System for one treatment cycle via internet or telephone. The most common moderate-to-severe symptoms (score≥4), their duration, and the proportion of participants who experienced improvements in symptom severity (score<4) after reporting moderate-to-severe symptoms at baseline were determined using descriptive statistics. Once-weekly symptom questionnaires were administered and analyzed using linear mixed effect models. Symptom incidence, duration, and frailty associations were assessed using t-tests and chi-square tests. RESULTS: Ninety participants completed the study (mean age=77 years [standard deviation=6.1], 42% frail [Vulnerable Elders Survey≥3]). The most common moderate-to-severe symptoms across cohorts were fatigue (46.8%), insomnia (42.9%), poor wellbeing (41.2%), pain (37.5%), and decreased appetite (37.1%). Poor wellbeing had a higher incidence in frail participants (62.5% in frail vs. 31.4% in non-frail, p=0.039). Symptom duration varied across cohorts and between frail and non-frail participants. Among participants who reported moderate-to-severe symptoms at baseline, no more than 15% improved in any symptom. There were statistically significant improvements in weekly symptoms for fatigue, decreased appetite, and insomnia in the chemotherapy cohort only. DISCUSSION: Limitations include a short follow-up duration, lack of a control group, and few radium-223 participants. Regular symptom monitoring can help clinicians understand temporal patterns and durations of symptoms and inform supportive care approaches.

Actinium-225-PSMA radioligand therapy of metastatic castration-resistant prostate cancer (WARMTH Act): a multicentre, retrospective study.

BACKGROUND: Actinium-225 (225Ac) prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) is a novel therapy for metastatic castration-resistant prostate cancer (mCRPC). We aimed to report the safety and antitumour activity of 225Ac-PSMA RLT of mCRPC in a large cohort of patients treated at multiple centres across the world. METHODS: This retrospective study included patients treated at seven centres in Australia, India, Germany, and South Africa. We pooled data of consecutive patients of any age and Eastern Cooperative Oncology Group performance status with histopathologically confirmed adenocarcinoma of the prostate who were treated with one or more cycles of 8 MBq 225Ac-PSMA RLT administered intravenously for mCRPC. Previous lines of mCRPC treatment included taxane-based chemotherapy, androgen-receptor-axis inhibitors, lutetium-177 (177Lu) PSMA RLT, and radium-223 dichloride. The primary outcomes were overall survival and progression-free survival. FINDINGS: Between Jan 1, 2016, and May 31, 2023, 488 men with mCRPC received 1174 cycles of 225Ac-PSMA RLT (median two cycles, IQR 2-4). The mean age of the patients was 68·1 years (SD 8·8), and the median baseline prostate-specific antigen was 169·5 ng/mL (IQR 34·6-519·8). Previous lines of treatment were docetaxel in 324 (66%) patients, cabazitaxel in 103 (21%) patients, abiraterone in 191 (39%) patients, enzalutamide in 188 (39%) patients, 177Lu-PSMA RLT in 154 (32%) patients, and radium-223 dichloride in 18 (4%) patients. The median follow-up duration was 9·0 months (IQR 5·0-17·5). The median overall survival was 15·5 months (95% CI 13·4-18·3) and median progression-free survival was 7·9 months (6·8-8·9). In 347 (71%) of 488 patients, information regarding treatment-induced xerostomia was available, and 236 (68%) of the 347 patients reported xerostomia after the first cycle of 225Ac-PSMA RLT. All patients who received more than seven cycles of 225Ac-PSMA RLT reported xerostomia. Grade 3 or higher anaemia occurred in 64 (13%) of 488 patients, leukopenia in 19 (4%), thrombocytopenia in 32 (7%), and renal toxicity in 22 (5%). No serious adverse events or treatment-related deaths were recorded. INTERPRETATION: 225Ac-PSMA RLT shows a substantial antitumour effect in mCRPC and represents a viable therapy option in patients treated with previous lines of approved agents. Xerostomia is a common side-effect. Severe bone marrow and renal toxicity are less common adverse events. FUNDING: None.

Targeted Radium Alpha Therapy in the Era of Nanomedicine: In Vivo Results.

Targeted alpha-particle therapy using radionuclides with alpha emission is a rapidly developing area in modern cancer treatment. To selectively deliver alpha-emitting isotopes to tumors, targeting vectors, including monoclonal antibodies, peptides, small molecule inhibitors, or other biomolecules, are attached to them, which ensures specific binding to tumor-related antigens and cell surface receptors. Although earlier studies have already demonstrated the anti-tumor potential of alpha-emitting radium (Ra) isotopes-Radium-223 and Radium-224 (223/224Ra)-in the treatment of skeletal metastases, their inability to complex with target-specific moieties hindered application beyond bone targeting. To exploit the therapeutic gains of Ra across a wider spectrum of cancers, nanoparticles have recently been embraced as carriers to ensure the linkage of 223/224Ra to target-affine vectors. Exemplified by prior findings, Ra was successfully bound to several nano/microparticles, including lanthanum phosphate, nanozeolites, barium sulfate, hydroxyapatite, calcium carbonate, gypsum, celestine, or liposomes. Despite the lengthened tumor retention and the related improvement in the radiotherapeutic effect of 223/224Ra coupled to nanoparticles, the in vivo assessment of the radiolabeled nanoprobes is a prerequisite prior to clinical usage. For this purpose, experimental xenotransplant models of different cancers provide a well-suited scenario. Herein, we summarize the latest achievements with 223/224Ra-doped nanoparticles and related advances in targeted alpha radiotherapy.

Long term studying of uranium and radium-226 activity in drinking water in some regions of Ukraine and assessment of corresponding hypotetical irradiation doses.

The article summarizes the activity concentrations data of 226Ra and the sum of uranium isotopes (∑U) in samples of drinking underground water for different regions of Ukraine studied during 1998-2023 in the radiation monitoring laboratory of the State Institution "O.M. Marzieiev Institute of Public Health National Academy of Medical Sciences of Ukraine. Arithmetic mean and standard deviations, minimum and maximum values for 226Ra and ∑U activity concentrations are presented for the entire 1240 sample set and for each region separately. Collected data show that the established state permissible level for drinking water of 1.0 Bq/l is exceeded for 226Ra in 1.1% of the studied samples, and for ∑U-in 3.9% correspondingly. The detected high levels of 226Ra and ∑U activity concentrations correspond to certain regions belonging to the Ukrainian crystalline shield territory. A comparison of the current data with the data of previous studies held during of 1989-1991 indicates a significant difference: for the previous studies the average and standard deviations are much higher. We attribute this to the fact that the centralized sampling of previous studies was random, and it was related exclusively to communal water supply systems. At the same time, the current sample set covers a much larger number of regions, different water consumers; the data set includes the results of repeated studies for a large number of sources, in particular, sources with purified water. Hypothetical exposure doses caused by consumption of 226Ra and ∑U in water for the current sample set were estimated for different age groups for each sample studied, as is, without taking into account the pattern of water consumption. The corresponding dose exceeds the WHO recommended value of 0.1 mSv per year for children under the age of one year for 220 cases (17.7%). This dose limit excess for other age groups corresponds-for children: aged 12-17 years-13.1%, aged 1-2 years-7.4%, 7-12 years old-5.6%, 2-7 years old-3.9% and for adults-4.1%.

Metastatic castration resistant prostate cancer patients' experience with Radium-223 treatment in Japan.

Aim: We aimed to determine Japanese metastatic castration resistant prostate cancer (CRPC) patients' Ra-223 treatment experience. Patients & methods: Patients answered the Cancer Therapy Satisfaction Questionnaire (CTSQ domains: Satisfaction with Therapy [SWT], Expectations of Therapy [ET], Feelings about Side Effects [FSE]), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and the FACT-Bone Pain (FACT-BP) Questionnaire at baseline, during (vists 3 and 5) and after treatment (end of observation; EOO). Results: Data from 72 patients were included. Baseline median CTSQ scores SWT: 66.1 (IQR19.7), ET: 75.0 (IQR45), and FSE 68.8 (IQR 34.4) were unchanged during vists 3 and 5, but the SWT (-3.57 [IQR17.9]) and ET (-5.0 [IQR30]) decreased while FSE was unchanged (0.0 [IQR31.25]) at EOO. The median MAX-PC (18.0 [IQR 49]) score was unchanged (0.0, IQR 6) while the median FACT BP (54.0 [IQR13]) score decreased by -1.0 (IQR 8) at EOO. Conclusion: Japanese metastatic castration resistant prostate cancer patients' experience is stable during Ra-223 treatment.

What is this study about? We wanted to know the treatment experience with Radium-223 (Ra-223) among Japanese prostate cancer patients. Ra-223 is a radioactive molecule used for the treatment of metastatic castration resistant prostate cancer. We asked patients to answer different questionnaires on treatment satisfaction, anxiety and quality of life before, during, and after treatment with Ra-223. What were the results? Based on the patients' answers to our questionnaires, treatment satisfaction, anxiety and quality of life remain stable while the patients undergo treatment with Ra-223, but in some aspects may decline after treatment. What do the results mean? The results mean that patients' experience during Ra-223 treatment is stable but patients should share any concerns they have about their treatment with their doctors.

The radiopharmaceutical radium-223 has immunomodulatory effects in patients and facilitates anti-programmed death receptor-1 therapy in murine models of bone metastatic prostate cancer.

BACKGROUND & PURPOSE: Radium-223 (Ra223) improves survival in metastatic prostate cancer (mPC), but its impact on systemic immunity is unclear, and biomarkers of response are lacking. We examined markers of immunomodulatory activity during standard clinical Ra223 and studied the impact of Ra223 on response to immune checkpoint inhibition (ICI) in preclinical models. MATERIALS & METHODS: We conducted a single-arm biomarker study of Ra223 in 22 bone mPC patients. We measured circulating immune cell subsets and a panel of cytokines before and during Ra223 therapy and correlated them with overall survival (OS). Using two murine mPC models-orthotopic PtenSmad4-null and TRAMP-C1 grafts in syngeneic immunocompetent mice-we tested the efficacy of combining Ra223 with ICI. RESULTS: Above-median level of IL-6 at baseline was associated with a median OS of 358 versus 947 days for below levels; p = 0.044, from the log-rank test. Baseline PlGF and PSA inversely correlated with OS (p = 0.018 and p = 0.037, respectively, from the Cox model). Ra223 treatment was associated with a mild decrease in some peripheral immune cell populations and a shift in the proportion of MDSCs from granulocytic to myeloid. In mice, Ra223 increased the proliferation of CD8+ and CD4+ helper T cells without leading to CD8+ T cell exhaustion in the mPC lesions. In one of the models, combining Ra223 and anti-PD-1 antibody significantly prolonged survival, which correlated with increased CD8+ T cell infiltration in tumor tissue. CONCLUSION: The inflammatory cytokine IL-6 and the angiogenic biomarker PlGF at baseline were promising outcome biomarkers after standard Ra223 treatment. In mouse models, Ra223 increased intratumoral CD8+ T cell infiltration and proliferation and could improve OS when combined with anti-PD-1 ICI.

Assessment of radioactivity in sand samples from eastern Nepal in perspective of radiological hazards.

This study was conducted to investigate the activity concentrations of 226Ra, 232Th and 40K in the sand samples and the health hazards associated with them utilizing a NaI (Tl) gamma spectrometer. The average activity concentrations of 226Ra, 232Th and 40K were found to be 24.8 ± 10.1, 39.8 ± 16.4 and 531.3 ± 52.8 Bq kg-1, respectively. The calculated radiological hazard parameters, including radium equivalent activity, absorbed gamma dose and effective dose rate, were found to be 122.7 ± 34.0 Bq kg-1, 57.7 ± 14.9 nGy h-1 and 0.3 ± 0.1 mSv y-1, respectively. Notably, these results were observed to be below the recommended thresholds. Other measured hazard indices were also lower than the prescribed values. From a radiological perspective, the present study concludes that the sand samples do not pose any threat to human health when utilized as a building material.

An objective measure of response on whole-body MRI in metastatic hormone sensitive prostate cancer treated with androgen deprivation therapy, external beam radiotherapy, and radium-223.

OBJECTIVES: The aim of this study was to generate an objective method to describe MRI data to assess response in the vertebrae of patients with metastatic hormone sensitive prostate cancer (mHSPC), treated with external beam radiation therapy and systemic therapy with Radium-223 and to correlate changes with clinical outcomes. METHODS: Three sets of whole-body MRI (WBMRI) images were utilized from 25 patients from the neo-adjuvant Androgen Deprivation Therapy pelvic Radiotherapy and RADium-223 (ADRRAD) clinical trial: MRI1 (up to 28 days before Radium-223), MRI2, and MRI3 (2 and 6 months post completion of Radium-223). Radiological response was assessed based on post baseline MRI images. Vertebrae were semi-automatically contoured in the sagittal T1-weighted (T1w) acquisitions, MRI intensity was measured, and spinal cord was used to normalize the measurements. The relationship between MRI intensity vs time to biochemical progression and radiology response was investigated. Survival curves were generated and splitting measures for survival and biochemical progression investigated. RESULTS: Using a splitting measure of 1.8, MRI1 was found to be a reliable quantitative indicator correlating with overall survival (P = 0.023) and biochemical progression (P = 0.014). MRI (3-1) and MRI (3-2) were found to be significant indicators for patients characterized by progressive/non-progressive disease (P = 0.021, P = 0.004) and biochemical progression within/after 12 months (P = 0.007, P = 0.001). CONCLUSIONS: We have identified a potentially useful objective measure of response on WBMRI of vertebrae containing bone metastases in mHSPC which correlates with survival/progression (prognostic) and radiology response (predictive). ADVANCES IN KNOWLEDGE: Measurements of T1w WBMRI normalized intensity may allow identifying potentially useful response biomarkers correlating with survival, radiological response and biochemical progression.

Assessment of gamma absorbed doses and radiological risk indexes from soil radioactivity around the phosphate area in south Tunisia.

Human beings are constantly exposed to the radiations coming from the environment. This work assesses the radiological hazards of natural radioactivity in soil samples taken at four locations around the phosphate area in south Tunisia. Concentrations of primordial radionuclides were measured by gamma spectrometer using an HPGe detector. The overall mean values of 40K, 226Ra and 232Th concentrations were 264, 27 and 13 Bq kg-1, respectively. From the radioactivity measurements, radiation hazard indices specified by the United Nation Scientific Committee on the Effect of Atomic Radiation such as radium equivalent activity (Raeq), absorbed dose rates ($ {\dot{\text D}} $) and annual effective dose (AED) to the population for outdoor environment were determined. The mean values for the abovementioned parameters were 64 Bq kg-1, 33 nGy h-1 and 40 µSv y-1, respectively.

A preliminary study on determination of radioactivity levels and estimation of the annual effective dose in dried fruits consumed in Albania.

This work aimed to support Albania's food safety monitoring regime. In this context, the natural and artificial radioactivity was measured in 20 samples of dried fruits collected randomly in different markets of Tirana. The activity concentration of 40K, 226Ra, 232Th and 137Cs was determined by using the high-purity germanium detector. The maximum values of activity concentration in dried fruits were calculated as 517 ± 22 Bq kg-1 for 40K, 11.10 ± 0.93 Bq kg-1 for 226Ra, 4.38 ± 0.26 Bq kg-1 for 232Th and 0.83 ± 0.14 Bq kg-1 for 137Cs. The average values of activity concentration of 40K and 226Ra were 269and 6.05 Bq kg-1 and the average effective dose to individuals from the intake of the dried fruits was 44 µSv y-1. All average values in this study were lower than recommended values by reports United Nations Scientific Committee on the Effect of Atomic Radiation, World Health Organization and International Commission on Radiological Protection for all age groups. Therefore, all dried fruit samples in this study are safe for consumption with acceptable radiological risk and none of them pose any significant radiological impact. The obtained data in this paper and information for levels of radioactivity and ingestion absorbed dose from dried fruits can be used to be the basic data for future comparative analysis of the other studies.