Incidence, management, and outcome of incidental meningioma: what has happened in 10 years?

PURPOSE: The aim of this study was to study the use of brain scanning, and the subsequent findings of presumed incidental meningioma in two time periods, and to study differences in follow-up, treatment, and outcome. METHODS: Records of all performed CT and MRI of the brain during two time periods were retrospectively reviewed in search of patients with presumed incidental meningioma. These patients were further analyzed using medical health records, with the purpose to study clinical handling and outcome during a 3 year follow up. RESULTS: An identical number of unique patients underwent brain imaging during the two time periods (n = 22 259 vs. 22 013). In 2018-2019, 25% more incidental meningiomas were diagnosed compared to 2008-2009 (n = 161 vs. 129, p = 0.052). MRI was used more often in 2018-2019 (26.1 vs. 12.4%, p = 0.004), and the use of contrast enhancement, irrespective of modality, also increased (26.8 vs. 12.2%, p < 0.001). In the most recent cohort, patients were older (median 79 years vs. 73 years, p = 0.03). Indications showed a significant increase of cancer without known metastases among scanned patients. 29.5 and 35.4% of patients in the cohorts were deceased 3 years after diagnosis for causes unrelated to their meningioma. CONCLUSIONS: Despite the same number of unique patients undergoing brain scans in the time periods, there was a trend towards more patients diagnosed with an incidental asymptomatic meningioma in the more recent years. This difference may be attributed to more contrast enhanced scans and more scans among the elderly but needs to be further studied. Patients in the cohort from 2018 to 2019 more often had non-metastatic cancer, with their cause of scan screening for metastases. There was no significant difference in management decision at diagnosis, but within 3 years of follow up significantly more patients in the latter cohort had been re-scanned. Almost a third of all patients were deceased within 3 years after diagnosis, due to causes other than their meningioma.

The impact of the Fukushima nuclear accident on marine biota: retrospective assessment of the first year and perspectives.

An international study under the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) was performed to assess radiological impact of the nuclear accident at the Fukushima-Daiichi Nuclear Power Station (FDNPS) on the marine environment. This work constitutes the first international assessment of this type, drawing upon methodologies that incorporate the most up-to-date radioecological models and knowledge. To quantify the radiological impact on marine wildlife, a suite of state-of-the-art approaches to assess exposures to Fukushima derived radionuclides of marine biota, including predictive dynamic transfer modelling, was applied to a comprehensive dataset consisting of over 500 sediment, 6000 seawater and 5000 biota data points representative of the geographically relevant area during the first year after the accident. The dataset covers the period from May 2011 to August 2012. The method used to evaluate the ecological impact consists of comparing dose (rates) to which living species of interest are exposed during a defined period to critical effects values arising from the literature. The assessed doses follow a highly variable pattern and generally do not seem to indicate the potential for effects. A possible exception of a transient nature is the relatively contaminated area in the vicinity of the discharge point, where effects on sensitive endpoints in individual plants and animals might have occurred in the weeks directly following the accident. However, impacts on population integrity would have been unlikely due to the short duration and the limited space area of the initially high exposures. Our understanding of the biological impact of radiation on chronically exposed plants and animals continues to evolve, and still needs to be improved through future studies in the FDNPS marine environment.

Application of an environmental impact assessment methodology to a site discharging low levels of radioactivity to a freshwater environment in Norway.

Significant shifts in opinion regarding environmental protection from ionising radiation have resulted in the development and availability of bespoke approaches for the assessment of impacts on wildlife from radioactive contaminants. The application of such assessment methodologies to actual situations, however, remains relatively limited. This paper describes the implementation of the ERICA Integrated Approach and associated tools within the context of routine discharges of radioactive materials to a freshwater environment. The article follows the implementation through its relevant stages and discusses strengths and weaknesses of the approach in relation to the case study. For current discharge levels, 137Cs and 60Co constitute the main dose contributors to the majority of reference organisms studied, although 241Am and 3H are the main contributors for the phyto- and zooplankton categories. Patterns are observed depending on whether the reference organism is sediment-associated or not. At current discharge levels, none of the reference organisms exceeded or approached the selected screening level, and impacts on biota could be regarded as negligible.

Overview of dose assessment developments and the health of riverside residents close to the "Mayak" PA facilities, Russia.

The Norwegian Radiation Protection Authority (NRPA) has been involved in studies related to the Mayak PA and the consequences of activities undertaken at the site for a number of years. This paper strives to present an overview of past and present activities at the Mayak PA and subsequent developments in the quantification of health effects on local populations caused by discharges of radioactive waste into the Techa River. Assessments of doses to affected populations have relied on the development of dose reconstruction techniques for both external and internal doses. Contamination levels are typically inhomogeneous and decrease with increasing distance from the discharge point. Citations made in this paper give a comprehensive, though not exhaustive, basis for further reading about this topic.

Assessment of current exposure of the population living in the Techa River basin from radioactive releases of the Mayak facility.

Current doses arising from external and internal pathways have been estimated for the residents of two villages, Muslumovo and Brodokalmak, alongside the Techa River, which was contaminated by radioactive releases from the Mayak production facility. The dose estimates are based on numerous environmental measurements supplemented by further human whole body measurements and studies on occupational and dietary habits of Slavic and Turkish ethnic groups. Estimated doses arise mainly from use of the contaminated floodplains alongside the Techa River. The current average annual effective dose attributable to Cs and Sr in the environment, under conditions where restrictions on some river-related activities are in place, may exceed the Russian national action level of 1 mSv only in the hypothetical critical group of herdsmen in Muslumovo. The dose to this critical group in Brodokalmak is assessed to be 3 times less than that in Muslumovo and 2 fold below the action level. The external and internal exposures give comparable contributions to the total dose in both settlements and population groups: 47% and 53% in Muslumovo and 40% and 60% in Brodokalmak, respectively. About one quarter to one half of the internal dose in adults arises from the intake of Sr. In order to avoid substantial increases in the dose received by Muslumovo residents, it is expedient to prolong the current policy of restriction of some river-related population activities in this village.