[Consideration of Lens of the Eye Protection during Mammography with the Eyelid and the Face Guard].

PURPOSE: In 2011, the International Commissionon Radiological Protection (ICRP) recommended reducing the threshold dose for the lens. Therefore, it is important to reduce the lens exposure dose in medical exposures. In a cranio-caudal (CC) view of mammography, the patient' s lens receives scattered radiation. In this study, we investigated scatter dose around the lens during mammography and reviewed the simple and easy protection methods of the lens. METHODS: Optically stimulated luminescence (OSL) dosimeters were placed in front of the device to obtain scattered radiation intensity distribution. The human phantom was placed in the same way as the CC positioning, and BR-12 phantoms with a thickness of 40 mm was placed on the FPD. Then, the scatter dose around the lens was measured using an OSL dosimeter. In order to confirm the change in the scatter radiation dose by the face guard (FG) and eyelid, we measured and compared under the same conditions the presence of FG and adipose tissue about 1 mm thick assuming the eyelid. RESULTS: Scatter radiation intensity decreased around the FG. When the FG was installed, the scatter dose was reduced about 33%, and when the adipose tissue was pasted on the OSL dosimeter, the scatter dose was reduced about 29%. CONCLUSION: This study suggested that eye closure during mammography was effective in reducing lens exposure. In the future, we would like to expect further protective effects by increasing the thickness of FG and reviewing the materials.

[A Questionnaire Survey on the Levels of Perception and Implementation on Diagnostic Reference Levels in Japan (Japan DRLs 2015)].

In June 2015, Japanese diagnostic reference levels (Japan DRLs 2015) was released by Japan Network for Research and Information on Medical Exposures (J-RIME). After six months the release of Japan DRLs 2015, we have conducted a questionnaire and received 222 responses from hospital staff regarding their perception level, and implementation on Japan DRLs 2015 at their facilities. 131 people (59.0%) were familiar with Japan DRLs 2015, of which 56 people (29.2%) were not currently implementation of them. A total of 66 people (30.1%) understood how to implement Japan DRLs 2015. There were 35 people (18.2%) who heard of diagnostic reference levels (DRLs) for the first time through this survey. Those are the levels of perception and implementation on Japan DRLs 2015 became clear. It is necessary to compare the dose levels used at each facility with Japan DRLs 2015 to optimize patient protection during medical exposure. It is essential to continue to grow the medical community's understanding of DRLs with the expanded perception and implementation of this survey as an opinion poll across Japan.

IgG4-related disease: dataset of 235 consecutive patients.

Immunoglobulin G4-related disease (IgG4-RD) is a recently discovered systemic condition, in which various organ manifestations are linked by a similar histological appearance. Our knowledge of this condition is still fragmented, as most studies have examined only a few dozen patients or focused on a particular organ manifestation. This study was conducted to learn the demography and patient characteristics of IgG4-RD using a large cohort. A total of 235 consecutive patients with IgG4-RD, diagnosed in 8 general hospitals in the same medical district, were identified by searching the institutions' radiology database. Inclusion criteria were histology-proven IgG4-RD according to the Pathology Consensus Statement and/or definitive type 1 autoimmune pancreatitis meeting the International Consensus Diagnostic Criteria. Clinical notes and images of selected patients were retrospectively reviewed. All patients were adults (M/F = 4/1). The median age was 67 years (range 35-86). Nine tenths were diagnosed in their 50s to 70s. Among 486 manifestations identified in total, the most common was pancreatitis diagnosed in 142 patients (60%), followed by sialadenitis (34%), tubulointerstitial nephritis (23%), dacryoadenitis (23%), and periaortitis (20%). The majority of patients (95%) had at least 1 of the 5 most common manifestations. Male and female patients differed in their organ manifestations (periaortitis more common in males and sialodacryoadenitis more common in females). Serum IgG4 (normal ≤135 mg/dL) was elevated to >135 mg/dL in 208 patients (88%) and >270 mg/dL in 167 (71%). The IgG4 value was significantly higher in patients with multiorgan involvement than in those with a single manifestation (median 629 mg/dL vs 299 mg/dL, P < 0.01). Of 218 patients, for whom both IgG4 and IgG values were available, the IgG4/IgG ratio was raised to >10% in 194 (89%). Corticosteroids were effective, but the relapse rate was estimated to be 24% in the study period (median 37 months). During the follow-up, 15 malignant diseases were diagnosed in 13 patients (6%). This figure is similar to the incidence (12.9 cancers) expected from the Japanese nationwide study for cancer epidemiology (standardized incidence ratio 1.16). In conclusion, this reliable dataset could improve the characterization of IgG4-RD, particularly its unique demography and the frequency of each organ manifestation.