A geographical study of thyroid cancer incidence in north-west England following the Windscale nuclear reactor fire of 1957.

The Windscale nuclear reactor fire at Sellafield, United Kingdom, in October 1957 led to an uncontrolled release of iodine-131 (radioactive half-life, 8 d) into the atmosphere. Contamination from the accident was most pronounced in the counties of Cumbria and Lancashire, north-west England. Radioiodine concentrates in the thyroid gland producing an excess risk of thyroid cancer, notably among those exposed as children, which persists into later life. For an initial investigation of thyroid cancer incidence in north-west England, data were obtained on cases of thyroid cancer among people born during 1929-1973 and diagnosed during 1974-2012 while resident in England, together with corresponding populations. Incidence rate ratios (IRRs), with Poisson 95% confidence intervals (CIs), compared thyroid cancer incidence rates in Cumbria and in Lancashire with those in the rest of England. For those aged <20 years in 1958, a statistically significantly increased IRR was found for those diagnosed during 1974-2012 while living in Cumbria (IRR = 1.29; 95% CI 1.09-1.52), but the equivalent IRR for Lancashire was marginally non-significantly decreased (IRR = 0.91; 95% CI 0.80-1.04). This pattern of IRRs was also apparent for earlier births, and the significantly increased IRR in Cumbria extended to individuals born in 1959-1963, who would not have been exposed to iodine-131 from the Windscale accident. Moreover, significant overdispersion was present in the temporal distributions of the IRRs, so that Poisson CIs substantially underestimate statistical uncertainties. Consequently, although further investigations are required to properly understand the unusual patterns of thyroid cancer IRRs in Cumbria and Lancashire, the results of this preliminary study are not consistent with an effect of exposure to iodine-131 from the Windscale accident.

Reconstructing the abundance of Dounreay hot particles on an adjacent public beach in Northern Scotland.

Following the discovery of a number of hot particles in the offshore environment of Dounreay on the North Coast of Scotland in 1997, the Dounreay site operator was required to introduce rapid and extensive beach monitoring. Since the introduction of vehicular based beach monitoring in 1999 there have been two further generations of beach monitoring equipment, developed to satisfy regulatory requirements for particle detection and in response to the recommendations of the Dounreay Particles Advisory Group (DPAG). This paper reports the results of DPAG's review of beach monitoring capabilities, evaluating the factors influencing detection capability, assessing the likely monthly particle abundance and whether there has been any real change in particle arrivals with time. The incorporation of real time kinematic GPS has enabled changes in beach elevation to be mapped, and thus allowed the assessment of whether particles detected have recently arrived or may have been buried undisturbed for extended periods of time. The results focus on Sandside Beach from which, between 1984 and December 2009, 150 particles have been recovered. This is by far the largest number of particles found on a Caithness Beach with the exception of the Foreshore of the Dounreay site. The results suggested that there is no evidence for a change in the rate of particle arrivals and DPAG estimated that there is a 1 in 20 million chance of encountering a relevant particle via contact with the skin on Sandside Beach.

Investigation of 18F-FDG 3D mode PET image quality versus acquisition time.

OBJECTIVE: Three-dimensional (3D) mode positron emission tomography (PET) is being used increasingly for clinical PET imaging. However, as yet, optimal acquisition parameters have not been established. The aim of this study was to investigate the effect of varying acquisition time on 3D image quality using standard clinical activities of F-fluorodeoxyglucose (FDG). METHODS: F-FDG phantom and patient PET images were acquired with varying acquisition times on a GE Discovery-STE PET/CT system. The NEMA Image-Quality phantom was imaged with four hot lesions in a uniform background. Images were acquired for 1, 2, 3, 4, and 5-min frames with three different lesion-to-background contrast ratios. Patient data were investigated using list mode acquisition to obtain comparable 2, 3, and 4-min frames. Qualitative analysis involved grading image quality and lesion detectability. Quantitative analysis of phantom images involved assessing the coefficient of variation (COV) of background areas as a measure of noise, and lesion over background variability as a measure of image quality. Patient data were also assessed using COV analysis of liver uptake. RESULTS: Qualitative and quantitative analysis showed no significant difference in image quality between 4 and 5-min acquisition frames for 3D mode F-FDG PET imaging with standard clinical activities. The observers noted no difference in perceived image quality. This finding was supported by COV analysis. CONCLUSION: This study shows that GE Discovery-STE acquisition frame time can be reduced to 3 min for standard 3D mode imaging at standard clinical activities of F-FDG.

Determination of left ventricular long-axis orientation using MRI: changes during the respiratory and cardiac cycles in normal and diseased subjects.

BACKGROUND: It has previously been shown that magnetic resonance imaging (MRI) can be used to accurately determine left ventricular (LV) long-axis orientation in healthy individuals. However, the inter- and intra-observer variability in patients with acute coronary syndrome (ACS) and chronic heart failure (CHF) has not been explored. Furthermore, the changes in LV long-axis orientation because of respiration and during the cardiac cycle remain to be determined. METHODS: LV long-axis orientation was determined by MRI in the frontal and transverse planes in 44 subjects with no cardiac disease, 20 ACS patients and 13 CHF patients. Changes in LV long-axis orientation because of respiration were assessed in a subset of 25 subjects. Changes during the cardiac cycle were assessed in six subjects from each subject group. Reproducibility was assessed by a re-examination of 17 subjects after 28 days. RESULTS: The inter- and intra-observer variability for LV long-axis orientation was low for all subject groups. The difference between the baseline and the 28 days examinations was -1.4+/-5.9 degrees and -0.8+/-4.4 degrees in the frontal and transverse planes, respectively. No significant change in LV long-axis orientation was found between end-expiration and end-inspiration (frontal plane, P=0.63 and transverse plane, P=0.42; n=25). No significant difference in change of the LV long-axis orientation during the cardiac cycle was found between the subject groups (frontal plane, chi-square 1.8, P=0.40 and transverse plane, chi-square 5.7, P=0.06). CONCLUSIONS: There is a low inter-and intra-observer variability and a high reproducibility for determining LV long-axis orientation in patients with no cardiac disease as well as in patients with ACS or CHF. There is no significant change in LV long-axis orientation due to respiration, and only small changes during the cardiac cycle in these groups.

Investigation of the effect of subcutaneous fat on image quality performance of 2D conventional imaging and tissue harmonic imaging.

Tissue harmonic imaging (THI) has been reported to improve contrast resolution, tissue differentiation and overall image quality in clinical examinations. However, a study carried out previously by the authors (Brown et al. 2004) found improvements only in spatial resolution and not in contrast resolution or anechoic target detection. This result may have been due to the homogeneity of the phantom. Biologic tissues are generally inhomogeneous and THI has been reported to improve image quality in the presence of large amounts of subcutaneous fat. The aims of the study were to simulate the distortion caused by subcutaneous fat to image quality and thus investigate further the improvements reported in anechoic target detection and contrast resolution performance with THI compared with 2D conventional imaging. In addition, the effect of three different types of fat-mimicking layer on image quality was examined. The abdominal transducer of two ultrasound scanners with 2D conventional imaging and THI were tested, the 4C1 (Aspen-Acuson, Siemens Co., CA, USA) and the C5-2 (ATL HDI 5000, ATL/Philips, Amsterdam, The Netherlands). An ex vivo subcutaneous pig fat layer was used to replicate beam distortion and phase aberration seen clinically in the presence of subcutaneous fat. Three different types of fat-mimicking layers (olive oil, lard and lard with fish oil capsules) were evaluated. The subcutaneous pig fat layer demonstrated an improvement in anechoic target detection with THI compared with 2D conventional imaging, but no improvement was demonstrated in contrast resolution performance; a similar result was found in a previous study conducted by this research group (Brown et al. 2004) while using this tissue-mimicking phantom without a fat layer. Similarly, while using the layers of olive oil, lard and lard with fish oil capsules, improvements due to THI were found in anechoic target detection but, again, no improvements were found for contrast resolution for any of the layer combinations. Therefore, it was felt that the lack of improvement in contrast resolution performance may be due to the test phantom design and not to whether a layer was present that caused beam distortion and phase aberrations.

Long-lived radiopharmaceuticals: dispensing from multidose vials.

We report the use of broth simulation as a means of validating the practice of sub-dispensing from stock vials of long-lived sterile radiopharmaceuticals. 'Matched' vials of nutrient broth accompanied the stock vials of long-lived sterile radiopharmaceuticals during their time in use and were subject to the same handling and storage procedures. At the end of the life of each radiopharmaceutical stock vial, the matching broth residue was sent for incubation and reporting. The results to date have yielded no reports of microbial contamination in any of the simulated broths (0 in 256).

Validation of a sensitivity performance index test protocol and evaluation of colour Doppler sensitivity for a range of ultrasound scanners.

The ability to detect flow is the most crucial aspect of an ultrasound (US) system because, if flow cannot be detected, no other aspect of performance matters. The objectives of this study were to validate a Doppler "sensitivity performance index," a figure of merit, and to determine if it could be used to differentiate colour Doppler sensitivity performance in scanners of varying complexity. The sensitivity performance index was developed to give a combined measure of related aspects of sensitivity, such as the lowest detectable velocity, the vessel size and the penetration depth. The colour Doppler sensitivity was evaluated objectively as the lowest detectable velocity signal from the deepest achievable point within the Doppler sensitivity phantom free from extraneous noise in a small diameter vessel (3.2 mm inner diameter). The effect of vessel size and mean velocity on the sensitivity performance index were investigated and it was found that the index was not proportional to vessel size, but this may be accounted for by considering the effect of the acoustic properties of the vessel material, the clutter filter and beam shape. The results obtained using flow phantoms with vessel sizes different from those used in this study are, therefore, not directly comparable to the results found in this study; however, a similar trend should be found in the results for the effect of control settings and a similar range of US scanners. It was found that the Doppler sensitivity performance index was a robust challenging test because none of the US scanners evaluated was capable of achieving the highest sensitivity performance index score, which would be limited by the lowest pump velocity and the deepest point of the vessel within the flow phantom. Therefore, this suggests that this method of determining Doppler sensitivity performance is valuable in the absence of other suitable methods, despite the fact that the relationship between the sensitivity performance index and vessel size is not proportional. Furthermore, use of the Doppler sensitivity performance index for the evaluation of a range of scanners demonstrated that curvilinear transducers have higher sensitivity performance indices than higher-frequency linear transducers, due to the higher achievable penetration depth. The effect of instrument settings was assessed for two transducers, the 4C3 curvilinear general-purpose transducer (Aspen) and the PVM375AT curvilinear general-purpose transducer (Nemio). The colour Doppler sensitivity performance was found to be significantly dependent on the clutter filter setting and the output power setting for both transducers tested. Users need to be aware of the effect of these settings on the colour Doppler sensitivity performance of their US scanner when interpreting the clinical significance of the colour Doppler information.

Objective measurements of image quality.

Tissue harmonic imaging (THI) and compound imaging have been reported clinically to improve contrast resolution, tissue differentiation and overall image quality. However, there have been limited studies to date to quantify objectively the improvements in image quality achieved with these new imaging techniques. The aim of this study was to quantify differences in image quality that exist between conventional B-mode imaging, harmonic imaging, compound imaging and harmonic compound imaging. An ATL HDI 5000 scanner with three probes (C5-2, L7-4 and L12-5) was tested with two different types of test object, the Gammex-RMI model 404 GS LE and the Gammex-RMI 403 GS LE. The measurement limitations associated with subjective analysis methods were not present in this study because an automated image analysis program was used to determine the image quality parameters. Therefore, subtle differences between the four imaging modes could be detected. Significant improvements in lateral resolution and slice thickness as a function of depth were found with THI. Contrast resolution and anechoic target detection improved with compound imaging, and harmonic compound imaging improved lateral resolution, slice thickness as a function of depth and contrast resolution.