Uncertainties associated with direct thyroid measurements using an NaI(Tl) survey meter: the effect of anatomical differences among individuals.

Photon detectors utilised for direct thyroid measurements to determine the radioiodine content in the thyroid are normally calibrated using a phantom that mimics the human neck, including the thyroid. However, such measurements are necessarily subject to uncertainty because of the difference between the phantom and the real human subject and also the morphological differences among individuals. In this study, personal voxel phantoms were created from magnetic resonance images of the necks of 24 adult volunteers (15 males and 9 females), and numerical simulations using these phantoms were performed to examine the variation in a conversion factor (131I kBq in the thyroid per µSv h-1) for a conventional NaI(Tl) survey meter among the individuals and also to confirm the suitability of reference Japanese voxel phantoms as a calibration standard for such measurements. As a result, it was found that the conversion factor obtained from the reference Japanese male (female) phantom was 1.29 (1.18) times larger than the average conversion factor for the male (female) subjects, suggesting that the conversion factors of the reference Japanese adult male and female phantoms would generally overestimate the 131I thyroidal contents and that the thyroid volume would be one of the factors influencing the conversion factor. This study also revealed a wide difference in the thyroid volume among individuals, which would be of concern when performing specific dose assessments for heavily exposed persons.

Chest CT Findings in Cases from the Cruise Ship Diamond Princess with Coronavirus Disease (COVID-19).

PURPOSE: To evaluate the chest CT findings in an environmentally homogeneous cohort from the cruise ship Diamond Princess with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: This retrospective study comprised 104 cases (mean age, 62 years ± 16 [standard deviation], range, 25-93 years) with COVID-19 confirmed with reverse-transcription polymerase change reaction findings. CT images were reviewed, and the CT severity score was calculated for each lobe and the entire lung. CT findings were compared between asymptomatic and symptomatic cases. RESULTS: Of 104 cases, 76 (73%) were asymptomatic, 41 (54%) of which had lung opacities on CT. Twenty-eight (27%) cases were symptomatic, 22 (79%) of which had abnormal CT findings. Symptomatic cases showed lung opacities and airway abnormalities on CT more frequently than asymptomatic cases [lung opacity; 22 (79%) vs 41 (54%), airway abnormalities; 14 (50%) vs 15 (20%)]. Asymptomatic cases showed more ground-glass opacity (GGO) over consolidation (83%), while symptomatic cases more frequently showed consolidation over GGO (41%). The CT severity score was higher in symptomatic cases than asymptomatic cases, particularly in the lower lobes [symptomatic vs asymptomatic cases; right lower lobe: 2 ± 1 (0-4) vs 1 ± 1 (0-4); left lower lobe: 2 ± 1 (0-4) vs 1 ± 1 (0-3); total score: 7 ± 5 (1-17) vs 4 ± 2 (1-11)]. CONCLUSION: This study documented a high incidence of subclinical CT changes in cases with COVID-19. Compared with symptomatic cases, asymptomatic cases showed more GGO over consolidation and milder extension of disease on CT.An earlier incorrect version appeared online. This article was corrected on April 8, 2020.© RSNA, 2020.

Erratum: Chest CT Findings in Cases from the Cruise Ship "Diamond Princess" with Coronavirus Disease 2019 (COVID-19).

[This corrects the article DOI: 10.1148/ryct.2020200110.].

MCNP SIMULATIONS WITH A PERSONALISED VOXEL PHANTOM TO VERIFY 131I CONTENT IN THYROID ESTIMATED BASED ON MEASUREMENTS WITH AN NaI(Tl) SPECTROMETER.

One of the authors (O.K.) stayed in the area located ~110 km south from the Fukushima Daiichi Nuclear Power Plant during the arrival of radioactive plumes released into the environment due to the accident in March 2011 in Japan. A previous study determined his 131I thyroid content using an NaI(Tl) spectrometer. The one remaining issue was to investigate the measurement error due to inevitable differences in the configuration (e.g. the thyroid shape and volume) between the physical phantom employed for calibration of the spectrometer and the real subject. In the present study, Monte Carlo simulations for the thyroid measurements were performed using the Monte Carlo N-Particle (MNCP) code to investigate discrepancies in peak efficiencies of the spectrometer between the personalised voxel phantom created from O.K.'s magnetic resonance images and the several typical/reference phantoms that exist. As a result, the peak efficiencies for the Oak Ridge Institute of Nuclear Studies (ORINS) phantom were found to be comparable to those for the reference voxel phantoms reproducing realistic human anatomy (the Adult Male phantom and the Japanese Male phantom). The peak efficiency for the personalised phantom, on the other hand, was fairly close to that of the other physical phantom (the Transfer phantom) actually used for the calibration of the spectrometer, suggesting that the 131I thyroid content determined for him in the previous study was sufficiently accurate. The discrepancies of peak efficiencies at the primal photon energy of 131I (365 keV) among the different phantoms were improved by extending the distance between the neck and the spectrometer; however, the appropriate measurement geometry in an actual situation will depend on the primary purpose of the measurements and should be determined accordingly.

Numerical Simulation Based on Individual Voxel Phantoms for a Sophisticated Evaluation of Internal Doses Mainly From 131I in Highly Exposed Workers Involved in the TEPCO Fukushima Daiichi NPP Accident.

As a response to the Tokyo Electric Power Company's Fukushima Daiichi nuclear power plant accident in 2011, seven TEPCO workers whose exposure doses were expected to be >250 mSv (a tentative dose limit stipulated by the Japanese central authority) attended Japan's National Institute for Radiological Sciences for additional internal dose measurements. The National Institute for Radiological Sciences examination revealed that these workers' internal doses came mainly from their intake of the radionuclide I during emergency operations. In this study, we performed numerical simulations based on individual volume-pixel (voxel) phantoms of six of the seven workers for a more sophisticated evaluation of their internal doses, taking into account the individual thyroid size and other specific parameters. The voxel phantoms were created from magnetic resonance imaging scan images. As a result, the individual thyroid volumes ranged from 6.5 to 28.2 cm and were considerably smaller than the reference value (~20 cm) adopted in the International Commission on Radiation Protection's dosimetric model for four of the six subjects. Compared to the original estimates of the thyroid absorbed dose, our preliminary evaluation revealed values that were increased by approximately 3-fold or decreased by 30% at maximum. A wide difference in the individual thyroid size would be one of the significant modifiers in the current dose estimation of subjects of the ongoing epidemiological study project. The present simulations also provided evidence that the direct thyroid measurements by the National Institute for Radiological Sciences to determine the workers' I thyroid contents were sufficiently accurate.

Early Intake of Radiocesium by Residents Living Near the Tepco Fukushima Dai-ichi Nuclear Power Plant After the Accident. Part 2: Relationship Between Internal Dose and Evacuation Behavior in Individuals.

The Tokyo Electric Power Company's Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident exposed members of the public to radiation. This study analyses the relation between personal behavior data obtained from 112 out of 174 subjects who underwent whole-body measurements by the National Institute of Radiological Sciences (NIRS) during the period from 27 June to 28 July 2011 and their committed effective doses (CEDs) from Cs and Cs. The whereabouts of the 112 persons living in municipalities near the FDNPP (mainly, Namie town) on several days in March 2011 are graphed on maps. It was confirmed that most subjects started evacuation promptly and had left the 20-km-radius of the FDNPP by the end of 12 March. The individual CEDs were poorly correlated with the person's distances from the FDNPP at any day in March. Meanwhile, the percentage of persons remaining within the 20-km radius of the FDNPP was 100% at 16:00 on 12 March and 42.9% at 0:00 on 15 March for those with CEDs > 0.1 mSv, whereas the corresponding values were much lower for those with CEDs ≤ 0.1 mSv. This suggests that the time of evacuation would be one of the crucial factors for the early intake; however, more personal behavior data are needed to be analyzed to clarify the relevance to the individual internal dose.

Internal thyroid doses to Fukushima residents-estimation and issues remaining.

Enormous quantities of radionuclides were released into the environment following the disastrous accident at the Fukushima Daiichi Nuclear Power Plant (FDNPP) in March 2011. It is of great importance to determine the exposure doses received by the populations living in the radiologically affected areas; however, there has been significant difficulty in estimating the internal thyroid dose received through the intake of short-lived radionuclides (mainly, (131)I), because of the lack of early measurements on people. An estimation by the National Institute of Radiological Sciences for 1 April 2012 to 31 March 2013 was thus performed using a combination of the following three sources: thyroid measurement data ((131)I) for 1080 children examined in the screening campaign, whole-body counter measurement data ((134)Cs, (137)Cs) for 3000 adults, and atmospheric transport dispersion model simulations. In this study, the residents of Futaba town, Iitate village and Iwaki city were shown to have the highest thyroid equivalent dose, and their doses were estimated to be mostly below 30 mSv. However, this result involved a lot of uncertainties and provided only representative values for the residents. The present paper outlines a more recent dose estimation and preliminary analyses of personal behavior data used in the new method.

ESTIMATION OF EARLY INTERNAL DOSES TO FUKUSHIMA RESIDENTS AFTER THE NUCLEAR DISASTER BASED ON THE ATMOSPHERIC DISPERSION SIMULATION.

Estimating the early internal doses to residents in the Fukushima Daiichi Nuclear Power Station accident is a difficult task because limited human/environmental measurement data are available. Hence, the feasibility of using atmospheric dispersion simulations created by the Worldwide version of System for Prediction of Environmental Emergency Dose Information 2nd Version (WSPEEDI-II) in the estimation was examined in the present study. This examination was done by comparing the internal doses evaluated based on the human measurements with those calculated using time series air concentration maps (131I and 137Cs) generated by WSPEEDI-II. The results showed that the latter doses were several times higher than the former doses. However, this discrepancy could be minimised by taking into account personal behaviour data that will be available soon. This article also presents the development of a prototype system for estimating the internal dose based on the simulations.

Early Intake of Radiocesium by Residents Living Near the TEPCO Fukushima Dai-Ichi Nuclear Power Plant after the Accident. Part 1: Internal Doses Based on Whole-body Measurements by NIRS.

The Tokyo Electric Power Company's Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident in 2011 resulted in a release of radionuclides into the environment (I: 142.9 PBq, Cs:12.4 PBq). This study presents the results of internal doses to 174 residents living near the FDNPP at the time of the accident based on whole-body (WB) measurements performed by the National Institute of Radiological Sciences (NIRS) during the period between 27 June and 28 July 2011. The 174 subjects consisted of 125 adults (≥18-y) and 49 children (<18-y) and included 90 persons of Namie town, one of the municipalities heavily contaminated with the radionuclides. The number of subjects with significant detection of both Cs and Cs was relatively small: 28.8% for the adults and 4.1% for the children. A significant gender difference in the Cs detection rate (males > females) was observed in the adults but not the children. In this study, the committed effective dose (CED) from Cs and Cs was calculated based on individual WB contents (Cs) corrected against body size, the observed body content ratio of Cs to Cs, and the assumed intake scenario (namely, acute inhalation of Type F compounds on 12 March 2011 when the first explosive event occurred at the site of the FDNPP). The 90th-percentile CED value for the adults was around 0.1 mSv and the maximum CED (0.63 mSv) was found in an elderly male. Comparable CED results were obtained in other WB measurements subsequently performed by the Japan Atomic Energy Agency (JAEA) in a similar manner to that of the NIRS, suggesting that the contribution of ingestion to the WB content observed would be trivial for most of the JAEA subjects. The intake ratio of I to Cs was evaluated to be 3~5 based on the I thyroid measurement data of Tokonami et al. Using the average intake ratio of 3.8, the resulting median and maximum thyroid-equivalent doses to the adult subjects of this study were estimated at 3.5 mSv and 84 mSv, respectively.

Internal radiation exposure of Ground Self-Defense Force members involved in the management of the Fukushima Nuclear Power Plant disaster.

When the Great East Japan Earthquake occurred on March 11, 2011, the Ground Self-Defense Force (GSDF) was dispatched nationally to Northeast area in Japan. The highly trained GSDF members were simultaneously assigned to various missions for the Fukushima Nuclear Power Plants disaster. The missions of GSDF terminated on August 31, 2011. Special medical examinations were conducted for the members as they returned to each military unit. GSDF members who were assigned to the nuclear power plant were at risk of radiation exposure; therefore, pocket dosimeters were used to assess external radiation exposure. A few months after the mission was terminated, measurements of internal radiation exposure were performed. This is the first report of the internal exposure of GSDF members who worked in the restricted radiation contamination area. Here, we report the amounts of internal and external exposure of and the equipment used by the GSDF members.

Identifying patients who are unsuitable for accelerated partial breast irradiation using three-dimensional external beam conformal techniques.

PURPOSE: Several recent studies reported that severe late toxicities including soft-tissue fibrosis and fat necrosis are present in patients treated with accelerated partial breast irradiation (APBI) and that these toxicities are associated with the large volume of tissue targeted by high-dose irradiation. The present study was performed to clarify which patients are unsuitable for APBI to avoid late severe toxicities. METHODS AND MATERIALS: Study subjects comprised 50 consecutive patients with Stage 0-II unilateral breast cancer who underwent breast-conserving surgery, and in whom five or six surgical clips were placed during surgery. All patients were subsequently replanned using three-dimensional conformal radiotherapy (3D-CRT) APBI techniques according to the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39 and Radiation Therapy Oncology Group (RTOG) 0413 protocol. The beam arrangements included mainly noncoplanar four- or five-field beams using 6-MV photons alone. RESULTS: Dose-volume histogram (DVH) constraints for normal tissues according to the NSABP/RTOG protocol were satisfied in 39 patients (78%). Multivariate analysis revealed that only long craniocaudal clip distance (CCD) was correlated with nonoptimal DVH constraints (p = 0.02), but that pathological T stage, anteroposterior clip distance (APD), site of ipsilateral breast (IB) (right/left), location of the tumor (medial/lateral), and IB reference volume were not. DVH constraints were satisfied in 20% of patients with a long CCD (≥5.5 cm) and 92% of those with a short CCD (p < 0.0001). Median IB reference volume receiving ≥50% of the prescribed dose (IB-V(50)) of all patients was 49.0% (range, 31.4-68.6). Multivariate analysis revealed that only a long CCD was correlated with large IB-V(50) (p < 0.0001), but other factors were not. CONCLUSION: Patients with long CCDs (≥5.5 cm) might be unsuitable for 3D-CRT APBI because of nonoptimal DVH constraints and large IB-V(50).