Efficacy of gonadal shielding in dose reduction for female pelvic radiography.

This study aimed to evaluate the dose reduction using gonad shielding (GS) during pelvic imaging. Three types of pelvic images (radiography, magnetic resonance and computed tomography) were fused to elucidate the three-dimensional relationship between the position of ovaries and GS. To estimate the dose received by the ovaries, the off-axis dose at any given depth was measured under two different imaging conditions using thermoluminescence dosemeters and a polymethyl methacrylate phantom. The mean ovarian depth was 8.4 cm. The mean estimated ovarian dose without an additional filter was 0.36 mGy without GS and 0.14 mGy with GS. The mean estimated ovarian dose with an additional filter was 0.24 mGy without GS and 0.10 mGy with GS. The efficacy of ovarian dose reduction should be evaluated based on the achieved ovarian dose, considering the ovarian depth and use of additional filtration, rather than the ovarian protection rate of GS.

Consecutive sexual maturation observed in a rock shell population in the vicinity of the Fukushima Daiichi Nuclear Power Plant, Japan.

In 2012, after the accident at the Fukushima Daiichi Nuclear Power Plant (FDNPP) that followed the Tohoku earthquake and tsunami in March 2011, no rock shell (Thais clavigera; currently recognized as Reishia clavigera; Gastropoda, Neogastropoda, Muricidae) specimens were found near the plant from Hirono to Futaba Beach (a distance of approximately 30 km). In July 2016, however, rock shells were again found to inhabit the area. From April 2017 to May 2019, we collected rock shell specimens monthly at two sites near the FDNPP (Okuma and Tomioka) and at a reference site ~ 120 km south of the FDNPP (Hiraiso). We examined the gonads of the specimens histologically to evaluate their reproductive cycle and sexual maturation. The gonads of the rock shells collected at Okuma, ~ 1 km south of the FDNPP, exhibited consecutive sexual maturation during the 2 years from April 2017 to May 2019, whereas sexual maturation of the gonads of specimens collected at Hiraiso was observed only in summer. The consecutive sexual maturation of the gonads of the specimens collected at Okuma might not represent a temporary phenomenon but rather a site-specific phenotype, possibly caused by specific environmental factors near the FDNPP.

Usefulness of an additional lead shielding device in reducing occupational radiation exposure during interventional endoscopic procedures: An observational study.

Adoption of interventional endoscopic procedures is increasing with increasing prevalence of diseases. However, medical radiation exposure is concerning; therefore, radiation protection for medical staff is important. However, there is limited information on the usefulness of an additional lead shielding device during interventional endoscopic procedures. Therefore, we aimed to determine whether an additional lead shielding device protects medical staff from radiation.An X-ray unit (CUREVISTA; Hitachi Medical Systems, Tokyo, Japan) with an over-couch X-ray system was used. Fluoroscopy-associated scattered radiation was measured using a water phantom placed at the locations of the endoscopist, assistant, nurse, and clinical engineer. For each location, measurements were performed at the gonad and thyroid gland/eye levels. Comparisons were performed between with and without the additional lead shielding device and with and without a gap in the shielding device. Additionally, a clinical study was performed with 27 endoscopic retrograde cholangiopancreatography procedures.The scattered radiation dose was lower with than without additional lead shielding at all medical staff locations and decreased by 84.7%, 82.8%, 78.2%, and 83.7%, respectively, at the gonad level and by 89.2%, 86.4%, 91.2%, and 87.0%, respectively, at the thyroid gland/eye level. Additionally, the scattered radiation dose was lower without than with a gap in the shielding device at all locations.An additional lead shielding device could protect medical staff from radiation during interventional endoscopic procedures. However, gaps in protective equipment reduce effectiveness and should be eliminated.

El fin de la protección gonadal en radiografía de pelvis: una revisión / The end of gonadal protection in pelvic radiography: a review

Resumen: La protección gonadal ha sido durante largo tiempo un importante factor para abordar el requisito "tan bajo como sea razonablemente posible" ALARA. El presente artículo realiza una revisión sistemática sobre la utilidad de la protección gonadal en la radiografía de pelvis en la cual se han destacado los factores que tienen que ver con su realización diaria, es decir, la dosis de radiación involucrada, la radiosensibilidad de las gónadas, la posición del protector gonadal y el factor psicológico de la población en relación con su uso. La incorporación de equipamientos modernos, con dosis y protocolo optimizados, transforma el beneficio de la protección en un tema al menos debatible. Mientras algunos siguen respaldando la medida, otros organismos y autores ya no la respaldan. Es necesario reconsiderar prácticas actuales fundadas en consensos científicos que pueden estar obsoletos y considerar el factor de cambio cultural basados en estos nuevos consensos para su implementación, sin generar mayor preocupación en la población.

Abstract: Gonadal protection has long been an important factor in addressing the ALARA "as low as reasonably possible" requirement. This article performs a systematic review on the usefulness of gonadal protection in pelvic radiography, in which the factors that have to do with its daily performance have been highlighted, that is, radiation dose involved, the radiosensitivity of the gonads, the position of the gonadal shielding and the psychological factor of the population in relation to its use. The incorporation of modern equipment, with optimized dose and protocols, transforms the benefit of gonad shielding into an issue that is at least debatable. While some continue to support the measure, other agencies and authors no longer support it. It is necessary to reconsider current practices based on scientific consensus that may be obsolete and consider the factor of cultural change based on these new consensus for its implementation, without generating major concern in the population.

Photoperiodic effects on somatic growth and gonadal maturation in Mickey Mouse platy, Xiphophorus maculatus (Gunther, 1866).

Photoperiod is important in initiation or suppression of reproductive timing and gonadal maturation which varies with species. The aim of the present study was to investigate the effect of two photoperiodic manipulating regimes, i.e., long (18L:6D) and short (10L:14D) photoperiods for a period of 60 days on somatic growth and gonadal maturation of a live-bearer ornamental fish, Mickey Mouse platy (Xiphophorus maculatus). The control fish were further kept under the laboratory environmental condition. The results showed a significant increase in weight gain, specific growth rate, and gonadosomatic index in fish under long photoperiod than those exposed to short photoperiod and control condition (P < 0.05). A condition factor showed significant variations between long photoperiod and control groups. Furthermore, a long photoperiod also induced a significant increase in the number of fish with mature embryo and middle-eyed embryo in the ovary. Similarly, histological analysis of testes of males showed an increase in the number of mature spermatid and spermatozoa under long photoperiod when compared to those of control and short photoperiod ones. Thus, it can be concluded that long-day photoperiodic manipulation may be applied for healthy growth and early gonadal maturation of live-bearer ornamental fishes.

The effective dose due to scattered radiation at patients during primary osteosynthesis; a multicenter prospective observational study.

OBJECTIVES: During osteosynthesis of a fracture patients are exposed to the primary radiation of an X-ray image and scattered (secondary) radiation. The primary objective was to measure the amount of scattered radiation at the thyroid, breast tissue, and gonads of patients undergoing primary osteosynthesis of acute fractures. The secondary objective was to calculate the effective dose caused by scattered radiation. METHODS: In this multicenter prospective observational case series patients undergoing a primary osteosynthesis of an acute fracture of hand/wrist, shoulder, ankle, knee, or hip were included. Three dosimeters were attached to the patient at the level of the thyroid, breast and gonads. Scattered radiation doses were corrected for the average background radiation per hospital per day. RESULTS: A total of 205 patients were included between March 6, 2017 and June 18, 2018; 49 (24%) had a hand/wrist fracture, 37 (18%) a shoulder fracture, 47 (23%) an ankle fracture, 35 (17%) a knee fracture, and 37 (18%) a hip fracture. In 32-39% of all patients undergoing primary osteosynthesis effective scattered doses was detected. The highest measured median effective dose was 60.43 µSv (P25-P75 33.84-100.76) at the gonads during hip osteosynthesis. CONCLUSIONS: The results of this study show that scattered radiation is detectable in a third of patients undergoing an osteosynthesis. However, both effective doses due to direct radiation and scattered radiation are low. ADVANCES IN KNOWLEDGE: This is the first study that presents that no radiation protection for patients undergoing an osteosynthesis is necessary.

Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood.

The frequency of imaging examinations requiring radiation exposure in children (especially CT) is rapidly increasing. This paper reviews the current evidence in radiation protection in pediatric imaging, focusing on the recent knowledge of the biological risk related to low doses exposure. Even if there are no strictly defined limits for patient radiation exposure, it is recommended to try to keep doses as low as reasonably achievable (the ALARA principle). To achieve ALARA, several techniques to reduce the radiation dose in radiation-sensitive patients groups are reviewed. The most recent recommendations that provide guidance regarding imaging of pregnant women are also summarized, and the risk depending on dose and phase of pregnancy is reported. Finally, the risk-benefit analysis of each examination, and careful communication of this risk to the patient, is emphasized.

Doses in eye lens, thyroid, and gonads, due to scattered radiation, during a CT radiodiagnosis study.

X-ray images used for radio-diagnosis are very useful to evaluate the progress of a treatment or to have a better diagnosis. However, during the interaction between the incoming X-ray beam and the body surface, part of the radiation is scattered out reaching other parts of the body delivering an undesirable dose. In this work the dose in eye lenses, thyroid, and gonads of a solid water phantom was measured using thermoluminescent dosimeters, while a Computer Tomography of the torso was obtained. With the measured absorbed dose the effective dose was calculated. Thus, the effective dose in the eye lens, thyroid, and gonads is approximately 57, 214 and 9 µSv respectively. The largest effective dose was on that area located nearest to the region where the radiation is scattered.

Doses in eye lens, thyroid, salivary glands, mammary glands, and gonads, due to radiation scattered in dental orthopantomography.

In the aim to support treatments and diagnostics in Dentistry the most common radiographies are the periapical radiography and the dental panoramic. In the dental panoramic the X-ray beam is addressed into a large zone of the face obtaining the image of the upper and lower jaw. In this procedure part of the X-rays are scattered reaching some other parts of the patient body. In this work the absorbed dose in the eye lens, thyroid, salivary glands, mammary glands, and gonads, was measured in patients undergoing a dental orthopantomography. Measurements were carried out with thermolmuminiscent dosimeters. With the absorbed doses the Effective dose were calculated. The highest dose was obtained in the salivary glands (30.4 µSv) and the lowest dose was obtained in thyroid (3.8 µSv).

Carryover effects of short-term UV-B radiation on fitness related traits of the sea urchin Strongylocentrotus intermedius.

Carryover effects of UV-B radiation are largely unknown in marine invertebrates, despite the ecological importance. For the first time, we investigated fitness related traits of the sea urchin Strongylocentrotus intermedius 8 weeks after short-term (1 h) UV-B radiations (0, 10 and 20 µW cm-2). Short-term UV-B radiations had significant negative effects on survival, food consumption, test diameter, test height, test height:test diameter, gonad weight and crude protein of gonads of S. intermedius, despite of the absence of UV-B radiation for 8 weeks. Survival, food consumption and crude protein of gonads were significantly lowest in S. intermedius exposed to UV-B radiation at 20 µW cm-2, highlighting that 20 µW cm-2 is a dangerous UV-B radiation intensity for the fitness of sea urchins (at least S. intermedius). Gonads were significantly more sensitive to UV-B radiation than the gut. The present study increases our understanding of carryover effects of UV-B radiations on sea urchins and provides valuable information into marine environmental safety.

Fertility preservation options in pediatric and adolescent patients with cancer.

The incidence of childhood cancer has steadily increased since the 1950s, with approximately 16,000 children diagnosed each year. However, with the advent of more effective multimodal therapies, childhood cancer survival rates have continued to improve over the past 40 years, with >80% of patients now surviving into adulthood. Fertility preservation (FP) has become an important quality-of-life issue for many survivors of childhood cancer. As a result, the therapeutic options have become less gonadotoxic over time and more patients are being offered FP options. This review examines the indications for consultation, male and female FP options both in the prepubertal patient and adolescent patient, and the unique ethical issues surrounding FP in this vulnerable population. Cancer 2018;124:1867-76. © 2018 American Cancer Society.

Micronuclei formation in rainbow trout cells exposed to multiple stressors: Morpholine, heat shock, and ionizing radiation.

Discharges from industrial cooling water systems can include low levels of morpholine (a chemical pH regulator and corrosion inhibitor), as well as transiently higher temperature effluent water which present a potential source of environmental impact to aquatic biota. The effects of environmental levels of morpholine or heat shock (HS) treatment alone and in combination with a challenge high-dose of 137Cs ionizing radiation were studied using the cytokinesis block micronucleus assay in a rainbow trout cell line (RTG-2). Morpholine treatment of 10 or 100mgL-1 alone produced no significant effects, and no interaction was observed in combination with 7.75Gy radiation. A 9°C magnitude HS treatment alone significantly increased micronuclei formation. A synergistic response was observed when 9°C HS was combined with 7.75Gy radiation, with 15% more cells containing 3 or more micronuclei than the sum of each individual stressor. A synergistic increase in the average number of micronuclei was observed when morpholine and a 9°C HS were co-treated. These results indicate that morpholine at environmentally-relevant levels does not impact micronuclei formation or cell cycle progression however 9°C HS may be of potential concern both alone and in combination with other stressor treatments.

Poor Utility of Gonadal Shielding for Pediatric Pelvic Radiographs.

Plain pelvic radiographs are commonly used for a variety of pediatric orthopedic disorders. Lead shielding is typically placed over the gonads to minimize radiation exposure to these sensitive tissues. However, misplaced shielding can sabotage efforts to protect patients from excessive radiation exposure either by not covering radiosensitive tissues or by obscuring anatomic areas of interest, prompting repeat radiographic examinations. The goal of this study was to determine the incidence of misplaced shielding for pelvic radiographs obtained for pediatric orthopedic evaluation. Children 8 to 16 years old who had an anteroposterior or frog lateral pelvic radiograph between 2008 and 2014 were included. A total of 3400 patients met the inclusion criteria, and 84 boys and 84 girls were randomly selected for review. For both boys and girls, the percentage of incorrectly positioned or missing shields was calculated. Chi-square testing was used to compare the frequency of missing or incorrectly placed shields between sexes and age groups. Pelvic shields were misplaced in 49% of anteroposterior and 63% of frog lateral radiographs. Shielding was misplaced more frequently for girls than for boys on frog lateral radiographs (76% vs 51%; P<.05). Pelvic bony landmarks were often obscured by pelvic shielding, with a frequency of 7% to 43%, depending on the specific landmark. The femoral head and acetabulum were obscured by shielding in up to 2% of all images. The findings suggest that accepted pelvic shielding protocols are ineffective. Consideration should be given to alternative protocols or abandonment of this practice. [Orthopedics. 2017; 40(4):e623-e627.].

Gonad dose in AP pelvis radiography: Impact of anode heel orientation.

PURPOSE: For antero posterior (AP) pelvis radiographic examination, determine the impact of anode heel orientation on female/male gonad dose. METHODS: High sensitivity thermo-luminescent dosimeters (TLDs) were used with an ATOM dosimetry phantom; the phantom was positioned for AP pelvis. TLDs were placed into the testes and ovaries. Radiation dose received by these organs was measured with the feet toward anode and feet toward the cathode. kVp, mAs and SID were manipulated to generate a range of exposures. A dose profile was also generated using Unfors Mult-O-Meter 401 along the long axis of the phantom. RESULTS: A decrease in dose from the central ray toward the anode was noted, with a marked increase toward the cathode. A significant reduction in dose was received by the testes with feet towards the anode compared with feet towards cathode (P˂0.001). No difference was seen for ovarian dose (P˃0.05). kVp, mAs and SID all have an effect on male and female gonad dose. CONCLUSION: For male pelvis imaging, placing feet towards the anode can be used as a simple dose reduction method.

Gonad Shielding during Pelvic Radiography: A Systematic Review and Meta-analysis.

BACKGROUND: Gonad shielding has been extensively advocated during pelvic radiography at or below reproductive ages. The popular practice of gonad shielding is placement of a lead shield in the midline of the pelvis. The aim of this study was to address the prevalence of gonad shielding and find out whether the current practice of gonad shielding can be considered as an effective method to reduce radiation exposure in patients undergoing pelvic radiography. METHODS: National and international electronic databases, including PubMed, MEDLIN, EMBASE, and Google-Scholar, were searched up to January 2016. The database searches were supplemented with manual searches of reference lists. Two authors independently assessed the eligibility of all studies and extracted data. RESULTS: The searches yielded a total of 243 publications. After assessing each identified study against specific inclusion exclusion criteria, 18 studies were deemed as relevant for this review. The total prevalence rate of gonad shielding was estimated at 58% (95% CI: 40 to 74%). It was estimated that only 34% (95% CI: 25 to 44%) of the radiographs had correct positioning of the shield. Also, incorrect positioning of the shield was statistically significantly higher in females than males (85% vs. 52 %; P-value < 0.001). CONCLUSIONS: Our study demonstrates that the current practice of gonad shielding during female pelvic radiography should be no longer considered as an effective method to reduce radiation exposure. Training the best qualified radiographers is the key to accurate positioning of the shield in male subjects.

Skin entrance dose with and without lead apron in digital panoramic radiography for selected sensitive body regions.

PURPOSE: The aim of this study was to compare the dose at skin level at five significant anatomical regions for panoramic radiography devices with and without lead apron by means of a highly sensitive dosimeter. MATERIALS AND METHODS: A female RANDO-phantom was exposed in five different digital panoramic radiography systems, and the dose at skin level was assessed tenfold for each measurement region by means of a highly sensitive solid-state-dosimeter. The five measurement regions selected were the thyroid, both female breasts, the gonads, and a central region in the back of the phantom. For each panoramic machine, the measurements were performed in two modes: with and without a commercial lead apron specifically designed for panoramic radiography. Reproducibility of the measurements was expressed by absolute differences and the coefficient of variation. Values between shielded and unshielded doses were pooled for each region and compared by means of the paired Wilcoxon tests (p ≤ 0.05). RESULTS: Reproducibility as represented by the mean CV was 22 ± 52 % (median 2.3 %) with larger variations for small dose values. Doses at skin level ranged between 0.00 µGy at the gonads and 85.39 µGy at the unshielded thyroid (mean ± SD 15 ± 24 µGy). Except for the gonads, the dose in all the other regions was significantly lower (p < 0.001) when a lead apron was applied. Unshielded doses were between 1.02-fold (thyroid) and 112-fold (at the right breast) higher than those with lead apron shielding (mean: 14-fold ± 18-fold). CONCLUSION: Although the doses were entirely very low, we observed a significant increase in dose in the radiation-sensitive female breast region when no lead apron was used. Future discussions on shielding requirements for panoramic radiography should focus on these differences in the light of the linear non-threshold (LNT) theory which is generally adopted in medical imaging.

Fertility in childhood cancer survivors following cranial irradiation for primary central nervous system and skull base tumors.

Recent advances in pediatric cancer treatment have improved disease control and survival outcomes for childhood cancers survivors, including those treated for primary central nervous system and skull base malignancies. Future research in this population will focus on identifying risk factors for infertility, novel screening techniques and recommendations, and quality-of-life outcomes improvement. The purpose of this review is to define the infertility complications observed in pediatric cancer survivors who receive cranial irradiation for central nervous system and skull base malignancies.

[Radiation-induced DNA fragmentation in cells of somatic and generative tissues of Drosophila melanogaster].

The levels of DNA fragmentation (using a neutral version of the "Comet assay" method) in the cells of somatic (brain ganglia) and generative (male gonad) tissues of the inbred individuals of the Drosophila wild-type developing in different conditions of a chronic irradiation were estimated. It was found that the radiobiological effect depends on the genotype and cytotype. Irradiation at low doses (0.42 mGy/h) induces the DNA damage in somatic cells of all the studied lines Drosophila in the same way. With the increase in the intensity of chronic irradiation (3.5mGy/h) a significant level of DNA breaks in neuroblasts was observed only for Harwich and Oregon-R stocks, in the cells of male gonad--for all the studied genotypes.