A study to assess the knowledge and practice of medical professionals on radiation protection in interventional radiology.

OBJECTIVE: Ionizing radiation has been extensively used in medical procedures throughout the world. Such interventional radiological procedures could result in occupational exposure that needs urgent control. Therefore, MPs (medical professionals) should receive education and appropriate training on occupational radiation protection. In this context, the present study is aimed to investigate the MPs' knowledge and practice regarding radiation protection principles during interventional radiological procedures. MATERIAL AND METHODS: A descriptive questionnaire-based study was carried out among 215 MPs involved in interventional fluoroscopy procedures. The practice of 31 MPs was studied using a checklist based on ALARA principles and ICRP guidelines. RESULTS: A total of 43.3% and 45.1% answered correctly for knowledge and practice. However, the difference between radiation protection knowledge and practice between the physicians and nurses was statistically significant. The knowledge and practice survey of MPs demonstrated that nurses rarely adhered to radiation-protection measures. CONCLUSION: The present study reflects the lack of knowledge and practice concerning radiation protection concepts among the nurses. This deficiency needs to be resolved by periodic practical radiation protection courses in the curriculum of medicine.

The Role of Single Voxel MR Spectroscopy, T2 Relaxation Time and Apparent Diffusion Coefficient in Determining the Cellularity of Brain Tumors by MATLAB Software

Introduction: Brain tumors if timely diagnosed are sure to be treated through shorter processes. MRI amongst others is of Para clinical methods greatly effective in diagnosis phase. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps provide some information that could reflect tissue cellularity. Neurosurgeons, in particular to detect the tumor cellularity, must send the specimens taken through biopsy to the pathology unit. This study is aimed at determining the tumor cellularity in brain. Materials and Methods: In this cross-sectional study, 32 patients (18 males and 14 females of the range 18 ­ 77 y/o) between April 2014 and February 2016 who were referred to the neurosurgery department of Shohada-E Tajrish Hospital of Tehran participated. Imaging was made using single voxel MR Spectroscopy, ADC and T2W Multi Echo Pulse Sequence in addition to routine pulse sequences and the images were analyzed using MATLAB software to determine the cellularity of brain tumors in comparison to the biopsy. Results: findings showed that by decreasing T2 relaxation time, the amount of ADC, N-Acetyl Aspartate (NAA) and also, increase Choline metabolite, lead to registering tumors in the lower class on the designed table and these tumors have a higher degree of consistency and cellularity. T2 Relaxation time, the tumors will stand at higher class on the designed table. Also the results indicated that 85% diagnostic weight of T2 relaxation time and 83% diagnostic weight of ADC compared with biopsy could reveal the brain tumor cellularity (P>0.05). Conclusion: some cellular metabolite changes such as NAA and Choline, ADC value and T2 relaxation time feature could effectively be used to distinguish and illustrate the degree of cellularity of brain tumors especially Intra-axial brain tumors (with about 85%. vs. biopsy). We recommend to more data should be used to increase the accuracy percentage of this technique.

Determination of intra-axial brain tumors cellularity through the analysis of T2 Relaxation time of brain tumors before surgery using MATLAB software.

INTRODUCTION: Timely diagnosis of brain tumors could considerably affect the process of patient treatment. To do so, para-clinical methods, particularly MRI, cannot be ignored. MRI has so far answered significant questions regarding tumor characteristics, as well as helping neurosurgeons. In order to detect the tumor cellularity, neuro-surgeons currently have to sample specimens by biopsy and then send them to the pathology unit. The aim of this study is to determine the tumor cellularity in the brain. METHODS: In this cross-sectional study, 32 patients (18 males and 14 females from 18-77 y/o) were admitted to the neurosurgery department of Shohada-E Tajrish Hospital in Tehran, Iran from April 2012 to February 2014. In addition to routine pulse sequences, T2W Multi echo pulse sequences were taken and the images were analyzed using the MATLAB software to determine the brain tumor cellularity, compared with the biopsy. RESULTS: These findings illustrate the need for more T2 relaxation time decreases, the higher classes of tumors will stand out in the designed table. In this study, the results show T2 relaxation time with a 85% diagnostic weight, compared with the biopsy, to determine the brain tumor cellularity (p<0.05). CONCLUSION: Our results indicate that the T2 relaxation time feature is the best method to distinguish and present the degree of intra-axial brain tumors cellularity (85% accuracy compared to biopsy). The use of more data is recommended in order to increase the percent accuracy of this techniques.

A study of the relationship between gender/age and apparent diffusion coefficient values in spleen of healthy adults using diffusion-weighted magnetic resonance imaging.

BACKGROUND: Diffusion-weighted magnetic resonance imaging (DWI) systems are very effective in detecting strokes, and they also have shown significant promise in the detection of fibrosis and cirrhosis of the liver. However, such systems have the disadvantages of poor reproducibility and noise, which can diminish the accuracy of the apparent diffusion coefficients (ADCs) provided by the DWI process. The main aim of this study was to determine the relationship between the age and gender of healthy adults in terms of the ADC values of the spleen measured by DWI. METHODS: Sixty-nine subjects selected for this study from people who were referred to the Tabesh Medical Imaging Center in Tabriz, Iran, in 2013. Each subject underwent echo-planar DWI for her or his ADC values of the spleen with b-values of 50, 400, and 800 s/mm2, and the resulting ADC values were evaluated. RESULTS: No significant differences were observed in ADC values of the spleen among the female and male participants or those from various ages (P>0.05). CONCLUSIONS: Based on the findings of this study, it was concluded that the effect of age and gender on the spleen's ADC values can be omitted from the spleen-diagnosis procedure. In other words, the spleen's ADC values are not related to the age or the gender of healthy adults.

Diffusion tensor tractography in the presurgical assessment of cerebral gliomas.

Glioma is the most common intra-axial brain tumor characterized by invasion into the surrounding white matter (WM) tracts. These tumors are usually diagnosed by conventional MRI, but this method is unable to describe the relationship between tumor and neighboring WM tracts. Diffusion tensor tractography (DTT) is a new imaging modality which can solve this problem. The current study evaluated the application of DTT imaging in the presurgical assessment of gliomas, and introduces this new modality and its importance to physicians and imaging centers in Iran. Ten patients with intra-axial brain tumor and suspicion of glioma underwent conventional brain MRI pulse sequences and DTT imaging between December 2011 and February 2013 with a 1.5 Tesla system using 64 independent diffusion encoding directions. Acquired images were assessed by the neuroradiologist and neurosurgeon. The treatment strategies were recognized and compared using data before and after the tractography. On the basis of DTT data, the treatment strategy changed from radiotherapy to the craniotomy in seven patients, and in one patient, the neurosurgeon preferred to avoid surgery. In one patient, the treatment technique did not change, and in the last one radiosurgery was replaced by craniotomy. As we can infer from this study, based on the tractography results, the treatment strategy may be changed, and the treatment technique could be devised more accurately and may lead to fewer postoperative neurological deficits and better outcomes.