MEDIRAD project “implications of medical low-dose radiation exposure”: Enhancing the protection of patients and health professionals from exposure to low-dose medical radiation

The EC-funded project MEDIRAD addresses numerous low-dose exposure situations for patients and workers in the medical context, to further develop risk models and draw operational recommendations for improving radiation protection. The four-year project (2017–2021) relies on a 33-partner consortium from 14 European countries and is coordinated by the European Institute for Biomedical Imaging Research (EIBIR, AT). Prof. Elisabeth Cardis (ISGlobal, ES) and Prof. Guy Frija (Universit´e Paris Descartes, FR) are the scientific coordinator and the clinical coordinator, respectively. The MEDIRAD Project consists of six interdependent and complimentary Work Packages (WPs). WP1: project management and dissemination; WP2: dose evaluation and optimisation in medical imaging; WP3: impact of low-dose radiation exposure from I-131 radioiodine in thyroid cancer treatment; WP4: breast radiotherapy and secondary cardiovascular risks; WP5: possible health impact of paediatric scanning; WP6: bringing together medical and nuclear scientific communities for radiation protection purposes. The Italian National Institute of Health (ISS), thanks to its consolidated experience in the field of quality assurance in radiological sciences, will contribute to the latter issue coordinating a Working Group to develop recommendations on patient radiological protection, directed to the medical communities, considering the scientific outcomes of the MEDIRAD WPs and the stakeholders’comments

Primary squamous cell carcinoma of major salivary gland: “Sapienza Head and Neck Unit” clinical recommendations

Primary squamous cell carcinoma of salivary gland (SCG) is an extremely rare type of malignant salivary gland tumor, which in turn results in scarcity of data available regarding both its treatment and associated genetic alterations. A retrospective analysis of 12 patients with primary SCG was conducted, along with analysis of the association between treatment, clinical/pathological characteristics, and outcomes. Most patients (8) were staged IVa, with the majority of them (10) having G3 fast growing cancer. Local and systemic recurrence were reported in only three out of nine parotid cases (0 out of 2 submandibular SCGs). In two out of eight patients local relapse occurred after integrated treatment, while recurrence occurred in two out of three patients undergoing exclusive surgery. Five patients eventually died. Treatment of resectable disease must be aggressive and multimodal, with achievement of loco-regional control in order to reduce rate of recurrence and improve outcomes. Metastatic disease would require a therapeutic strategy tailored to the molecular profile in order to improve the currently disappointing results

Case study: calculation of a narrow resonance with the LIT method

The possibility to resolve narrow structures in reaction cross sections in calculations with the Lorentz integral transform (LIT) method is studied. To this end we consider a fictitious two-nucleon problem with a low-lying and narrow resonance in the $^3P_1$ nucleon-nucleon partial wave and calculate the corresponding ``deuteron photoabsorption cross section''. In the LIT method the use of continuum wave functions is avoided and one works instead with a localized function \tilde\Psi. In this case study it is investigated how far into the asymptotic region \tilde\Psi has to be determined in order to obtain a precise resolution of the artificially introduced E1 resonance. Comparing with the results of a conventional calculation with explicit neutron-proton continuum wave functions it is shown that the LIT approach leads to an excellent reproduction of the cross section in the resonance region and of further finer cross section details at higher energies. To this end, however, for \tilde\Psi one has to take into account two-nucleon distances up to at least 30 fm.Comment: 18 pages, 11 figure

Measurement results and improvements on an open EPR system

Electron spin resonance (ESR) is a spectroscopic method that allows to measure stable radicals induced by ionizing radiation. The EPR measurements can help to estimate the dose absorbed by people exposed during a nuclear disaster, detecting the number of radicals induced in their mobile phones due to the exposition [1]. Using conventional closed microwave cavities, the phone display must be fragmented in order to be introduced inside the resonator, becoming no more usable. The aim of this work is to develop a system, compatible with the spectrometer Bruker Elexys E500, able to preserve the sample integrity. The system uses an X-band resonant metallic cavity with a slit, realized on one side, for the leak of the excitation magnetic field and a Helmotz coil pair. The resonator allows measuring a sample lodged outside the cavity, while the coils produce a 100 kHz modulated field that encodes the output signal at a particular frequency and increases the SNR

Uncertainty on radiation doses estimated by biological and retrospective physical methods

Biological and physical retrospective dosimetry are recognised as key techniques to provide individual estimates of dose following unplanned exposures to ionising radiation. Whilst there has been a relatively large amount of recent development in the biological and physical procedures, development of statistical analysis techniques has failed to keep pace. The aim of this paper is to review the current state of the art in uncertainty analysis techniques across the ‘EURADOS Working Group 10— Retrospective dosimetry’ members, to give concrete examples of implementation of the techniques recommended in the international standards, and to further promote the use of Monte Carlo techniques to support characterisation of uncertainties. It is concluded that sufficient techniques are available and in use by most laboratories for acute, whole body exposures to highly penetrating radiation, but further work will be required to ensure that statistical analysis is always wholly sufficient for the more complex exposure scenarios

The Top-Implart Proton Linear Accelerator: Interim Characteristics of the 35 Mev Beam

In the framework of the Italian TOP-IMPLART project (Regione Lazio), ENEA-Frascati, ISS and IFO are developing and constructing the first proton linear accelerator based on an actively scanned beam for tumor radiotherapy with final energy of 150 MeV. An important feature of this accelerator is modularity: an exploitable beam can be delivered at any stage of its construction, which allows for immediate characterization and virtually continuous improvement of its performance. Currently, a sequence of 3 GHz accelerating modules combined with a commercial injector operating at 425 MHz delivers protons up to 35 MeV. Several dosimetry systems were used to obtain preliminary characteristics of the 35-MeV beam in terms of stability and homogeneity. Short-term stability and homogeneity better than 3% and 2.6%, respectively, were demonstrated; for stability an improvement with respect to the respective value obtained for the previous 27 MeV beam

Threshold 3He and 3H Transverse Electron Scattering Response Functions

The threshold transverse response functions R_T(q,omega) for 3He and 3H are calculated using the AV18 nucleon-nucleon potential, the UrbanaIX three-body force, and the Coulomb potential. Final states are completely taken into account via the Lorentz integral transform technique. Consistent two-body pi- and rho-meson exchange currents as deduced using the Arenh\"ovel-Schwamb technique are included. The convergence of the method is shown and a comparison of the corresponding MEC contribution is made to that of a consistent MEC for the meson theoretical r-space BonnA potential. The response R_T is calculated in the threshold region at q=174, 324, and 487 MeV/c and compared with available data. The strong MEC contributions in the threshold region are nicely confirmed by the data at q=324 and 487 MeV/c although some differences between theoretical and experimental results remain. A comparison is also made with other calculations, where the same theoretical input is used. The agreement is generally rather good, but leaves also some space for further improvement.Comment: 16 pages, 5 figure

Realising the European network of biodosimetry: RENEB-status quo

Creating a sustainable network in biological and retrospective dosimetry that involves a large number of experienced laboratories throughout the European Union (EU) will significantly improve the accident and emergency response capabilities in case of a large-scale radiological emergency. A well-organised cooperative action involving EU laboratories will offer the best chance for fast and trustworthy dose assessments that are urgently needed in an emergency situation. To this end, the EC supports the establishment of a European network in biological dosimetry (RENEB). The RENEB project started in January 2012 involving cooperation of 23 organisations from 16 European countries. The purpose of RENEB is to increase the biodosimetry capacities in case of large-scale radiological emergency scenarios. The progress of the project since its inception is presented, comprising the consolidation process of the network with its operational platform, intercomparison exercises, training activities, proceedings in quality assurance and horizon scanning for new methods and partners. Additionally, the benefit of the network for the radiation research community as a whole is addressed

Integration of new biological and physical retrospective dosimetry methods into EU emergency response plans : joint RENEB and EURADOS inter-laboratory comparisons

Purpose: RENEB, 'Realising the European Network of Biodosimetry and Physical Retrospective Dosimetry,' is a network for research and emergency response mutual assistance in biodosimetry within the EU. Within this extremely active network, a number of new dosimetry methods have recently been proposed or developed. There is a requirement to test and/or validate these candidate techniques and inter-comparison exercises are a well-established method for such validation. Materials and methods: The authors present details of inter-comparisons of four such new methods: dicentric chromosome analysis including telomere and centromere staining; the gene expression assay carried out in whole blood; Raman spectroscopy on blood lymphocytes, and detection of radiation induced thermoluminescent signals in glass screens taken from mobile phones. Results: In general the results show good agreement between the laboratories and methods within the expected levels of uncertainty, and thus demonstrate that there is a lot of potential for each of the candidate techniques. Conclusions: Further work is required before the new methods can be included within the suite of reliable dosimetry methods for use by RENEB partners and others in routine and emergency response scenarios

CMS physics technical design report : Addendum on high density QCD with heavy ions

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