A survey of computed tomography dose index and dose length product level in usual computed tomography protocol.

BACKGROUND: Nowadays, the use of computed tomography (CT) as a diagnostic tool has been considerably increased. Therefore, implementation of the program to conform the protection regulations on the CT scan is necessary to reduce the detrimental effects of radiation. OBJECTIVE: This study was performed to measure weighted CT dose index (CTDIW) and dose length product (DLP) in routine CT protocols of the adult patients. METHODS: In this study, the patient dose was determined in routine CT protocols. The CT scanner used in this study was a single-slice Toshiba model. Scan parameters for each protocol were registered for 10 standard sized patients and then by applying it to the CT system, CTDIw and DLP mean values were calculated and finally the values of dose were compared with the reference dose limit. RESULTS: The mean values of CTDIw and DLP for head, para nasal sinuses, chest, abdomen, and pelvis protocols were 34.11, 19.67, 15.47, 13.95, 10.08 mGy and 362.67, 153.97, 307.33, 346.07, 189.37 mGy.cm, respectively. The mean values of CTDIW and DLP obtained in all of the protocols were less and even less than half in some of the protocols compared with the European guidelines and the UK reference values. However, mean values of CTDIw in the Chest and Abdomen protocols, were greater than IAEA reported values. CONCLUSIONS: Using lower milli Amperes and higher kilo voltage peak as well as minimizing scan area and number of slices should be considered for more reduction in patients' dose.

Prophylactic role of some plants and phytochemicals against radio-genotoxicity in human lymphocytes.

Genotoxicity in lymphocytes of cancer patients undergoing radiotherapy can lead to lymphocytopenia. Lymphocytopenia induced by radiotherapy is one of the most unfavorable prognostic biological markers in cancer patients, since it has been accepted to be associated with poor prognosis in terms of both survival time and response to cancer therapy. Therefore, reduction in lymphocytopenia may increase treatment efficiency. Research endeavors with synthetic radioprotectors in the past have met with little success primarily due to toxicity-related problems. These disadvantages have led to interest on the use of some plants and phytochemicals as radioprotector. The aim of this paper is to review protective role of some plants and phytochemicals against genotoxicity-induced by ionizing radiation in human blood lymphocytes. Therefore, current review may help the future researches to decrease lymphocytopenia in radiotherapeutic clinical trials.

Measurement of Entrance Skin Dose and Calculation of Effective Dose for Common Diagnostic X-Ray Examinations in Kashan, Iran.

The knowledge of the radiation dose received by the patient during the radiological examination is essential to prevent risks of exposures. The aim of this work is to study patient doses for common diagnostic radiographic examinations in hospitals affiliated to Kashan University of Medical sciences, Iran. The results of this survey are compared with those published by some national and international values. Entrance surface dose (ESD) was measured based on the exposure parameters used for the actual examination and effective dose (ED) was calculated by use of conversion coefficients calculated by Monte Carlo methods. The mean entrance surface dose and effective dose for examinations of the chest (PA, Lat), abdomen (AP), pelvis (AP), lumbar spine (AP, Lat) and skull (AP, Lat) are 0.37, 0.99, 2.01, 1.76, 2.18, 5.36, 1.39 and 1.01 mGy, and 0.04, 0.1, 0.28, 0,28, 0.23, 0.13, 0.01 and 0.01 mSv, respectively. The ESDs and EDs reported in this study, except for examinations of the chest, are generally lower than comparable reference dose values published in the literature. On the basis of the results obtained in this study can conclude that use of newer equipment and use of the proper radiological parameter can significantly reduce the absorbed dose. It is recommended that radiological parameter in chest examinations be revised.

Consequences of lethal-whole-body gamma radiation and possible ameliorative role of melatonin.

Gamma radiation induces the generation of free radicals, leading to serious cellular damages in biological systems. Radioprotectors act as prophylactic agents that are administered to shield normal cells and tissues from the deleterious effects of radiation. Melatonin synergistically acts as an immune-stimulator and antioxidant. We investigated the possible radioprotective role of melatonin (100 mg/kg i.p.) against lethal-whole-body radiation- (10 Gy) induced sickness, body weight loss, and mortality in rats. Results of the present study suggest that exposure to lethal-whole-body radiation incurred mortality, body weight loss, and apoptosis and it also depleted the immunity and the antioxidant status of the rats. Our results show that melatonin pretreatment provides protection against radiation induced mortality, oxidative stress, and immune-suppression. The melatonin pretreated irradiated rats showed less change in body weight as compared to radiation only group. On the other hand, melatonin appeared to have another radioprotective role, suggesting that melatonin may reduce apoptosis through a caspase-3-mediated pathway by blocking caspase-3 activity.

Can melatonin help us in radiation oncology treatments?

Nowadays, radiotherapy has become an integral part of the treatment regimen in various malignancies for curative or palliative purposes. Ionizing radiation interacts with biological systems to produce free radicals, which attack various cellular components. Radioprotectors act as prophylactic agents that are administered to shield normal cells and tissues from the harmful effects of radiation. Melatonin has been shown to be both a direct free radical scavenger and an indirect antioxidant by stimulating antioxidant enzymes and suppressing prooxidative enzymes activity. In addition to its antioxidant property, there have also been reports implicating antiapoptotic function for melatonin in normal cells. Furthermore, through its antitumor and radiosensitizing properties, treatment with melatonin may prevent tumor progression. Therefore, addition of melatonin to radiation therapy could lower the damage inflicted to the normal tissue, leading to a more efficient tumor control by use of higher doses of irradiation during radiotherapy. Thus, it seems that, in the future, melatonin may improve the therapeutic gain in radiation oncology treatments.

Evaluation of radio-protective effect of melatonin on whole body irradiation induced liver tissue damage.

OBJECTIVE: Ionizing radiation interacts with biological systems to induce excessive fluxes of free radicals that attack various cellular components. Melatonin has been shown to be a direct free radical scavenger and indirect antioxidant via its stimulatory actions on the antioxidant system.The aim of this study was to evaluate the antioxidant role of melatonin against radiation-induced oxidative injury to the rat liver after whole body irradiation. MATERIALS AND METHODS: In this experimental study,thirty-two rats were divided into four groups. Group 1 was the control group, group 2 only received melatonin (30 mg/kg on the first day and 30 mg/kg on the following days), group 3 only received whole body gamma irradiation of 10 Gy, and group 4 received 30 mg/kg melatonin 30 minutes prior to radiation plus whole body irradiation of 10 Gy plus 30 mg/kg melatonin daily through intraperitoneal (IP) injection for three days after irradiation. Three days after irradiation, all rats were sacrificed and their livers were excised to measure the biochemical parameters malondialdehyde (MDA) and glutathione (GSH). Each data point represents mean ± standard error on the mean (SEM) of at least eight animals per group. A one-way analysis of variance (ANOVA) was performed to compare different groups, followed by Tukey's multiple comparison tests (p<0.05). RESULTS: The results demonstrated that whole body irradiation induced liver tissue damage by increasing MDA levels and decreasing GSH levels. Hepatic MDA levels in irradiated rats that were treated with melatonin (30 mg/kg) were significantly decreased, while GSH levels were significantly increased, when compared to either of the control groups or the melatonin only group. CONCLUSION: The data suggest that administration of melatonin before and after irradiation may reduce liver damage caused by gamma irradiation.

Radio-protective effects of melatonin against irradiation-induced oxidative damage in rat peripheral blood.

During radiotherapy, ionizing irradiation interacts with biological systems to produce free radicals, which attacks various cellular components. The hematopoietic system is well-known to be radiosensitive and its damage may be life-threatening. Melatonin synergistically acts as an immunostimulator and antioxidant. In this study we used a total of 120 rats with 20 rats in each group. Group 1 did not receive melatonin or irradiation (Control group), Group 2 received only 10 mg/kg melatonin (Mel group), Group 3 exposed to dose of 2 Gy irradiation (2 Gy Rad group), Group 4 exposed to 8 Gy irradiation (8 Gy Rad group), Group 5 received 2 Gy irradiation plus 10 mg/kg melatonin (Mel +2 Gy Rad group) and Group 6 received 8 Gy irradiation plus 10 mg/kg melatonin (Mel+8 Gy Rad group). Following exposure to radiation, five rats from each group were sacrificed at 4, 24, 48 and 72 h. Exposure to different doses of irradiation resulted in a dose-dependent decline in the antioxidant enzymes activity and lymphocyte count (LC) and an increase in the nitric oxide (NO) levels of the serum. Pre-treatment with melatonin (10 mg/kg) ameliorates harmful effects of 2 and 8 Gy irradiation by increasing lymphocyte count(LC) as well as antioxidant enzymes activity and decreasing NO levels at all time-points. In conclusion 10 mg/kg melatonin is likely to be a threshold concentration for significant protection against lower dose of 2 Gy gamma irradiation compared to higher dose of 8 Gy. Therefore, it seems that radio-protective effects of melatonin are dose-dependent.

Melatonin may play a role in modulation of bax and bcl-2 expression levels to protect rat peripheral blood lymphocytes from gamma irradiation-induced apoptosis.

The close relationship between free radicals effects and apoptosis process has been proved. Melatonin has been reported as a direct free radical scavenger. We investigated the capability of melatonin in the modification of radiation-induced apoptosis and apoptosis-associated upstream regulators expression in rat peripheral blood lymphocytes. Rats were irradiated with a single whole body Cobalt 60-gamma radiation dose of 8Gy at a dose rate of 101cGy/min with or without melatonin pretreatments at different concentrations of 10 and 100mg/kg body weight. The rats were divided into eight groups of control, irradiation-only, vehicle-only, vehicle plus irradiation, 10mg/kg melatonin alone, 10mg/kg melatonin plus irradiation, 100mg/kg melatonin alone and 100mg/kg melatonin plus irradiation. Rats were given an intraperitoneal (IP) injection of melatonin or the same volume of vehicle alone 1h prior to irradiation. Blood samples were taken 4, 24, 48 and 72h after irradiation for evaluation of flow cytometric analysis of apoptotic lymphocytes using Annexin V/PI assay and measurement of bax and bcl-2 expression using quantitative real-time PCR (RT(2)qPCR). Irradiation-only and vehicle plus irradiation showed an increase in the percentage of apoptotic lymphocytes significantly different from control group (P<0.01), while melatonin pretreatments in a dose-dependent manner reduced it as compared with the irradiation-only and vehicle plus irradiation groups (P<0.01) in all time points. This reduced apoptosis by melatonin was related to the downregulation of bax, upregulation of bcl-2, and therefore reduction of bax/bcl-2 ratio. Our results suggest that melatonin in these doses may provide modulation of bax and bcl-2 expression as well as bax/bcl-2 ratio to protect rat peripheral blood lymphocytes from gamma irradiation-induced apoptosis.

Radio-protective role of antioxidant agents.

Ionizing radiation interacts with biological systems to produce reactive oxygen species and reactive nitrogen species which attack various cellular components. Radio-protectors act as prophylactic agents to shield healthy cells and tissues from the harmful effects of radiation. Past research on synthetic radio-protectors has brought little success, primarily due to the various toxicity-related problems. Results of experimental research show that antioxidant nutrients, such as vitamin E and herbal products and melatonin, are protective against the damaging effects of radiation, with less toxicity and side effects. Therefore, we propose that in the future, antioxidant radio-protective agents may improve the therapeutic index in radiation oncology treatments.