eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 513 519 article X. Lu 1 S. Xie xsy419848977@163.com 2 D. Mou 3 M. Peng 4 Department of Gynecology, The First People's Hospital of Zunyi, Zunyi, China Department of Gynecology, The First People's Hospital of Zunyi, Zunyi, China Department of Gynecology, The First People's Hospital of Zunyi, Zunyi, China Department of Gynecology, The First People's Hospital of Zunyi, Zunyi, China Background: To investigate the correlation between magnetic resonance imaging (MRI) imaging characteristics and serum markers carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and carbohydrate antigen 125 (CA125) levels in ovarian cancer patients. Materials and Methods: A retrospective analysis of 85 patients with ovarian cancer diagnosed by postoperative pathological results in our hospital was carried out. MRI imaging data and hematological indexes of patients were collected to analyze the relationship between imaging characteristics of ovarian cancer patients and serum CEA, CA199, CA125 levels. Results: The main morphology of ovarian cancer was irregular, with solid lesions and visible septal changes and wall nodules. After enhancement, the septal or parietal nodules also significantly enhanced, accompanied by abdominal effusion, peritoneal metastasis, and lymph node metastasis. Serum CEA (66.33±6.54) g/ml, CA199 (185.03±20.71) U/ml, CA125 (224.62±23.82) U/ml. The results of univariate analysis showed that patients with ovarian cancer wall nodules, peritoneal metastasis, and lymph node metastasis had statistically significant differences in serum CEA, CA199, and CA125 concentrations (P<0.05). Pearson's results showed that wall nodules, peritoneal metastasis, and lymph node metastasis were positively correlated with serum CEA, CA199, and CA125 levels, respectively (P<0.05). Conclusion: Ovarian cancer MRI has certain characteristics related to CEA, CA199, CA125 concentrations, which can be used to diagnose the prognosis of ovarian cancer. http://ijrr.com/article-1-6521-en.pdf Ovarian cancer magnetic resonance imaging serum tumor markers lymph node metastasis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 521 526 article N. Lei 1 Z. Li lizhenglys@126.com 2 H. Xu 3 X. Liu 4 Y. Zhou 5 S. Lei 6 X. Wang 7 Q. Wang 8 Y. Li 9 X. Cai 10 Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Department of Radiation Oncology and Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China Background: Previous research suggests that depression interventions may affect the session of radiotherapy (RT), though the causal relationship remains uncertain. This research seeks to elucidate the cause-and-effect link between treatments for depression and RT sessions through the application of two-sample Mendelian randomization (TSMR) analysis. Materials and Methods: Information on depression treatments and RT sessions was sourced from publicly available genome-wide association studies (GWAS) summary data. Genetic variations known as single nucleotide polymorphisms (SNPs) that are closely linked to depression treatments were chosen as instrumental variables (IVs). Six distinct TSMR techniques were utilized, including MR Egger, weighted median, inverse variance weighted (IVW), weighted mode, IVW with fixed effects, and MR Egger with bootstrap. The causal relationship between depression interventions and RT session was primarily assessed using the P-value from the IVW fixed effects model. Heterogeneity and pleiotropy tests were conducted to validate the findings. Results: Eight sensitive SNPs were identified for the analysis. Both the MR Egger (Q_pval=0.118>0.05) and inverse variance weighted (Q_pval=0.143>0.05) methods indicated low heterogeneity in the MR analysis. The findings remained consistent  through various sensitivity  tests. The IVW fixed effects analysis revealed a significant causal effect between depression intervention and RT session (P=0.016, OR=0.979, 95% CI: 0.961-0.996), indicating a negative causal relationship. Conclusion: Depression intervention appears to be a beneficial factor in reducing RT session, supporting its integration into treatment plans for RT patients to enhance their quality of life. http://ijrr.com/article-1-6525-en.pdf Mendelian randomization analysis radiotherapy depression genome-wide association studies. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 527 533 article T. Zhang 1 S. Hu 2 W. Yang 3 J. Zhang 4 W. Wei 5 W. Dai 6 M. Cai 7 Q. Li 8 Z. Xiao 9 L. Ma Ma 10 Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Library, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Department of Pulmonary and Critical Care Medicine, General Hospital of Western Theater Command, NO.270 Tianhui Road, Rongdu Avenue, Jinniu District, Chengdu, Sichuan Province 610083, China Background: Although combination treatment strategies have significantly improved and achieved impressive results, the 5-year survival rate of non-small cell lung cancer (NSCLC) still remains undesirable. Given the rapidly burgeoning concept of neoadjuvant and adjuvant strategies in cancer for increasing the therapeutic benefit, we aimed to explore the importance and trends of adjuvant strategies in NSCLC. Materials and Methods: We performed a visual analysis to evaluate published literature (707 papers) in the field of neoadjuvant and adjuvant strategies in NSCLC from January 1, 2013 to July 6, 2023, and acquire a comprehensive understanding of the field. VOSviewer was used to construct bibliometric networks for 707 related literatures. Results: the counts of publications and the evolution of citations concerning neoadjuvant and adjuvant strategies in NSCLC from 2013 to 2023 indicated the increasing interest and investment in the field of NSCLC neoadjuvance and adjunctive strategies. We detected that the majority of academic papers on neoadjuvant and adjuvant strategies for NSCLC were published in high-quality journals. A keyword screening of the relevant literature showed that the research on neoadjuvant and adjuvant strategies for NSCLC was mainly related to chemotherapy. China and United States were particularly influential and highly prolific in this field. Conclusion: Given this rapidly expanding realm, the neoadjuvant and adjuvant strategies may further improve the prognosis of NSCLC. The visual analysis will promote the development of research on neoadjuvant and adjuvant strategies in NSCLC and provide a reference for further research in this field. http://ijrr.com/article-1-6526-en.pdf Bibliometrics NSCLC visual analysis neoadjuvant adjuvant. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 535 542 article G. Yaprak gokhan.yaprak@sbu.edu.tr 1 Ö.Y. Doğan 2 Ö. Atasoy 3 N. Çini 4 H. Özyurt 5 D. Gedik 6 A.S. Özden 7 Istanbul Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Radiation Oncology Department, Istanbul, Turkey Istanbul Haydarpaşa Numune Training And Research Hospital, Radiation Oncology Department, Istanbul, Turkey Giresun Training And Research Hospital, Radiation Oncology Department, Istanbul, Turkey Istanbul Kartal Dr. Lütfi Kırdar City Hospital, Radiation Oncology Department, Istanbul, Turkey Istanbul Kartal Dr. Lütfi Kırdar City Hospital, Radiation Oncology Department, Istanbul, Turkey Istanbul Kartal Dr. Lütfi Kırdar City Hospital, Radiation Oncology Department, Istanbul, Turkey Background: We aimed to evaluate dosimetric, clinical parameters, and survival factors contributing to the risk of radiation pneumonia in lung cancer patients treated with volumetric-modulated arch therapy (VMAT) and helical tomotherapy (HT). Materials and Methods: Retrospective analysis of 79 lung cancer patients treated between January 2018-2020, with 54 eligible patients. Radiotherapy using HT and VMAT at a total dose of 60Gy. Lung volumes receiving >5, 10, 20 Gy, mean lung dose, and organ doses were recorded. The associations among clinical factors, dose-volume parameters, grade >3 RP, and survival outcomes (OS, LRFS, DMFS) were analyzed. Results: Median follow-up: 18.9 months (range 10.1-34.4). Median OS: 17 months, with 1- and 2-year OS rates of 71.8% and 45.2%, respectively. Univariate analysis showed significant associations with OS for mean lung dose, lung V5Gy, V10 Gy, V20Gy, mean esophagus dose, esophagus V20Gy, V60Gy, heart V40Gy, and grade >3 RP (all p<0.05). For LRFS, significant factors included PTV% 95 coverage >59Gy, PTV volume <55cm3, esophagus V20Gy, and grade>3 RP (all p<0.05). In multivariate analysis, lung V5 Gy, V10 Gy, mean esophagus dose, esophagus V20 Gy, V60 Gy, heart V40 Gy, and grade >3 RP remained significant for OS, while PTV volume was significant for LRFS. Lung volumes of V5, V10, and V20 strongly associated with grade>3 RP. Conclusion: In this study we found that low-dose lung volumes and doses to organs at risk (esophagus, heart) are not only significant for radiation pneumonitis (RP) but also play a crucial role in overall survival in arch treatments. http://ijrr.com/article-1-6527-en.pdf Lung cancer radiation therapy radiation pneumonitis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 543 549 article S. Cheng 1 T. Guan 2 L. Zhu qras510@163.com 3 Y. Zheng hddv780@163.com 4 F. Li 5 The General Hospital of Western Theater Command, Chengdu, 610000, China The General Hospital of Western Theater Command, Chengdu, 610000, China The General Hospital of Western Theater Command, Chengdu, 610000, China The General Hospital of Western Theater Command, Chengdu, 610000, China Southwest Medical University Affiliated Hospital, Luzhou, 646000, China Background: Lung adenocarcinoma exhibits considerable heterogeneity in histological subtypes, which are closely associated with prognosis. This study aimed to investigate the correlation between preoperative chest computed tomography (CT) features and histopathological subtypes of solitary invasive pulmonary adenocarcinoma, with the goal of establishing predictive imaging markers. Materials and Methods: A retrospective analysis was conducted on 187 patients with solitary invasive pulmonary adenocarcinoma (≤3.0 cm), categorized into three groups based on the 2015 WHO classification: G1 (lepidic predominant, n=77), G2 (papillary/acinar predominant, n=65), and G3 (micropapillary/solid predominant, n=45). CT characteristics—including lesion size, CT attenuation values, ground-glass opacity, solid component ratio, lobulation, spiculation, pleural traction, and vascular signs—were analyzed. Multivariate logistic regression and predictive modeling were used to identify independent imaging predictors for each subtype. Results: Significant differences were found among the three groups in CT values, lesion size, solid component proportion, spiculation, lobulation, and pleural traction (p<0.05). Vascular invasion and air space dissemination were significantly more frequent in G3 (p<0.001 and p=0.009, respectively). Multivariate analysis identified ground-glass opacity, CT value, burr sign, and lesion size as independent predictors for G1; vascular sign and size for G2; and gender (female), lobulation, and pleural traction for G3. The predictive model for G1 showed excellent diagnostic performance with an AUC of 0.986. Conclusion: Preoperative CT features correlate significantly with histopathological subtypes of lung adenocarcinoma. Distinct imaging patterns can serve as non-invasive predictors, aiding in preoperative risk stratification and individualized treatment planning for patients with pulmonary nodules. http://ijrr.com/article-1-6528-en.pdf Adenocarcinoma of lung lung neoplasms CT scan radiomics. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 551 556 article N. Dahdouh 1 Z. Chaoui zchaoui@univ-setif.dz 2 S. Khoudri 3 Laboratory of Optoelectronics and Devices, Physics Department, Faculty of Sciences, UFAS1, Algeria Laboratory of Optoelectronics and Devices, Physics Department, Faculty of Sciences, UFAS1, Algeria Cancer Center of Sétif, Algeria  Background: Based on recently published studies carried out in various institutions, the dosimetric evaluation was conducted to compare 5 and 7-field intensity-modulated radiation therapy (IMRT) plans. So far, dosimetric indexes have been used as the main parameters. The present study is new, it uses more sophisticated tools of evaluation based on radiobiologic indices as recommended. Materials and Methods: A comparative study of five and seven fields IMRT plans of sixteen randomly chosen prostate cancer cases has been evaluated radiobiologically. The modified Poisson model of Marsden allows us to calculate the tumor control probability (TCP) of the treated planning target volume (PTV60); The Lyman–Kutcher–Burman (LKB) model is used to calculate normal tissue complication probability (NTCP) of the organs at risk (rectal wall, bladder wall and femoral heads). We have elaborated an in-house program RADBIOFOR to calculate TCP and NTCP and use the dose volume histograms (DVH) from the treatment planning system (TPS) as input information. Results: A significant statistical difference was observed for the bladder (P-value=0.045). The statistical analysis for the rectum did not show a difference (P-value= 0.234). Meanwhile, 88% of the cases exhibited slightly lower toxicities with the 7-field compared to the 5-field. Conclusion: The present study recommends using a 7-field IMRT plan since it has proved to predict lower toxicities in the bladder and the rectum wall even though the 5-field predicts minor improvements in the local control in the tumor compared to the 7-field. http://ijrr.com/article-1-6529-en.pdf Prostate cancer IMRT fractionation TCP NTCP. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 557 562 article K. Xu 1 J. Zhou 2 H. Tu 3 Ch. Feng 4 J. Qiao 5 N. Shi 6 Y. Wang 18626326208@163.com 7 Gastroenterology Department, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China Gastroenterology Department, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China Gastroenterology Department, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China Gastroenterology Department, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China Gastroenterology Department, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China Gastroenterology Department, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China Department of Pharmacy, Affiliated Children’s Hospital of Jiangnan University, Wuxi 214000, China Background: To investigate the predictive value of Modified CT Severity Index (MCTSI) score combined with clinical indicators on the severity of early acute pancreatitis (AP). Materials and Methods: We collected 180 cases of AP patients admitted to our hospital from January 2020 to December 2023, and divided them into 32 cases of severe acute pancreatitis group (SAP group) and 148 cases of non-SAP group (non-SAP group) according to the severity of the disease. Comparing the clinical indexes of the two groups, the variables were included in logistic regression analysis to explore the independent risk factors of SAP, and were incorporated into R software to construct a predictive Nomogram model, and the predictive efficacy was evaluated by using subjects' work characteristic curves (ROC), and plotting calibration curves. Results: MCTSI score (OR=6.358, 95% CI:3.214-15.348), C-reactive protein (CRP) (OR=3.061, 95% CI:1.325-7.730), blood creatinine (Cr) (OR=1.032, 95% CI:1.020-1.041), and calcium (Ca2+) (OR=0.040, 95% CI:0.008-0.173) were independent risk factors for the occurrence of SAP (P<0.05). (95% CI:0.008-0.173) were independent risk factors for the occurrence of SAP (P<0.05). The results of ROC curve analysis showed that the Nomogram model had a high predictive value for the occurrence of SAP, with an area under the curve (AUC) of 0.910, which was significantly higher than the MCTSI score (AUC of 0.809), CRP (AUC of 0.790), Cr (AUC of 0.736), and Ca2+ (AUC of 0.781). Conclusion: The construction of a Nomogram model by combining MCTSI score, CRP, Cr, and D-D has an important application in the early prediction of AP severity. http://ijrr.com/article-1-6530-en.pdf Modified CT severity index C-reactive protein blood creatinine acute pancreatitis severity of disease. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 563 567 article F. Xu 1 P. Xu ki2233@163.com 2 Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei Province, China Background: This study focuses on analyzing the effects of three-dimensional conformal radiotherapy (3DCRT) and image-guided radiotherapy (IGRT) on the safety and prognosis of individuals with hepatocellular carcinoma (HCC). Materials and Methods: Eighty cases of HCC individuals admitted between January 2023 and December 2023 were studied; the control group received IGRT intervention with 34 cases; the research group received 3DCRT intervention with 46 cases. The safety (incidence of grade 1, 2, and 3 hepatic toxic side effects), prognosis, range of lower extremity computed tomography angiography-planned target volume (CTV-PTV) externally, and efficacy of the treatment were comparatively analyzed. Results: The data manifested that the incidence of grade 1 toxicity in the research group exceeded that in the control group, but the incidence of grade 3 toxicity in the research group was lower, and the 1-year and 2-year survival rates in the research group were greater. The median survival time in the research group was longer than that in the control group. The range of CTV-PTV exposure in the left and right, head and foot, anterior and posterior aspects was lower than that in the control group. In addition, the CR+PR rate was significantly higher in the research group. Conclusion: These outcomes revealed that IGRT is more suitable for HCC patients than 3DCRT, which not only has a certain degree of safety, but also can help to significantly improve the prognosis. http://ijrr.com/article-1-6533-en.pdf Hepatocellular carcinoma image-guided radiotherapy three-dimensional conformal radiotherapy safety prognosis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 569 576 article K. Yang 1 Z. Chen wolf0330cz.edu@hotmail.com 2 Department of General Surgery, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China Background: Colon cancer (CC) is one of the most common malignancies in the digestive tract. In this study, we analysed the diagnostic value of multislice CT (MSCT) in combination with miR-let-7 in CC and the mechanism of action of miR-let-7 in CC. Materials and Methods: A total of 108 patients with suspected CC admitted to our hospital between March 2020 and May 2022 were retrospectively analysed; 37 patients were diagnosed with CC, and the remaining 71 were determined to have benign colonic lesions. To compare the diagnostic value of MSCT, miR-let-7, and MSCT combined with miR-let-7 detection for CC, we detected the expression of miR-let-7 and high mobility group AT hook protein 2 (HMGA2) in normal human colonic epithelial FHC cells and human colonic mucosal epithelial HCT116 cells and observed the effect of miR-let-7 on the biological behaviour of CC cells. Results: Compared with the results of pathological biopsy, the diagnostic sensitivity of MSCT combined with miR-let-7 for CC was 97.30%, the specificity was 98.59%, and the accuracy was 98.15%, with a misdiagnosis rate of only 1.85%. After miR-let-7 expression was silenced, the viability of colon cancer cells increased, and the inflammatory response and oxidative stress increased. In addition, there was a targeted regulatory relationship between HMGA2 and miR-let-7, which could reverse the effect of miR-let-7 on colon cancer cells. Conclusion: The combination of MSCT and the miR-let-7 assay is accurate for the diagnosis of CC, and miR-let-7 regulates the biological behaviour of CC cells through HMGA2. http://ijrr.com/article-1-6534-en.pdf Colonic neoplasms HMGA2 protein multidetector computed tomography inflammation miR-let-7. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 577 583 article D. Zhang 1 L. Tang 2 X. Long xiejiati922465041@163.com 3 Graduate School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China Department of Radiology, 903th RD Hospital of PLA, Hangzhou, Zhejiang Province, China Department of Medical lmaging, Shanghai University Mengchao Cancer Hospital, Shanghai, China Background: multi-slice spiral computed tomography (MSCT) combined with tumor marker detection can distinguish the nature of hepatic tumors. Meanwhile, diagnosing hepatic tumors is crucial for improving the survival rates (SR) of patients. Materials and Methods: data from 98 patients with hepatic tumors who underwent radiological examinations and treated in our hospital from December 2022 to December 2023 were collected. Pathological reports were arranged for patients, and based on the results, patients were categorized into benign tumor and malignant tumor groups (BT and MT groups). Clinical information such as pathological results, gender, and medical history was recorded and compared. After MSCT examination, the imaging features of patients were documented, and tumor markers in serum were detected. The accuracy of tumor markers alone and combined examination in determining the nature of hepatic tumors was compared. Results: the positivity rate (PR) of MSCT combined with tumor markers in the MT group (89.02%) was higher to that in the BT group (64.44%). The accuracy of the combined diagnosis in judging hepatic tumor nature was 64.57%, with a sensitivity of 89.02% and specificity of 35.56%. The area Under Curve (AUC) of the combined examination was 0.813, being higher than that of MSCT or tumor marker diagnosis alone. Conclusion: MSCT combined with tumor markers exhibited remarkable clinical value in determining benign and malignant hepatic tumors, with improved diagnostic accuracy and sensitivity, enabling its widespread application in early screening of hepatic tumors. http://ijrr.com/article-1-6535-en.pdf Spiral cone-beam computed tomography tumor biomarkers liver neoplasms diagnosis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 585 591 article M.M. Yu 1 H. Sun 2 X. Jiang 3 X.S. Yang 13863966910@139.com 4 Radiology Department, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China Department of Oncology, Shandong Provincial KeyMedical and Health Discipline, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China Department of Oncology, Shandong Provincial KeyMedical and Health Discipline, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China Department of Oncology, Shandong Provincial KeyMedical and Health Discipline, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China Background: To explore the clinical value of Test Bolus (TB) scanning technology and Bolus Tracking (BT) technology in the preoperative TNM staging of gastric cancer (GC) patients and the enhanced display of perigastric arteries. Materials and Methods: A retrospective analysis was conducted on the clinical information of 107 gastric cancer patients with complete imaging and pathological diagnostic data (TB group: 30 cases, BT group: 77 cases). Chi-square tests and t-tests were used to compare baseline information between the TB and BT groups. The consistency between the diagnostic results of the TB and BT groups and pathological examination results was analyzed using Kappa tests. Results: There were no statistically significant differences between the TB and BT groups in terms of gender (P=0.499), age (P=0.419), family history of tumors (P=0.979), smoking history (P=0.269), and pain symptoms (P=0.464), while there was a statistically significant difference in alcohol consumption history (P=0.016). The imaging differences between the BT and TB groups were not statistically significant (P>0.05). Except for T staging (P=0.029), there were no statistically significant pathological differences between the BT and TB groups (P>0.05). The consistency of the TB group with pathological results was superior to that of the BT group (Kappa-T: 0.468 vs. 0.439; Kappa-N: 0.301 vs. 0.247; Kappa-M: 0.651 vs. 0.551). Conclusion: TB scanning technology can improve the staging accuracy of GC, achieving better diagnostic performance, but it cannot enhance the display of perigastric arteries. http://ijrr.com/article-1-6536-en.pdf Test bolus bolus tracking gastric cancer consistency test. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 593 600 article M.B. Adedokun madedokun@unilag.edu.ng 1 A.Z. Ibitoye 2 K.I. Ogungbemi 3 Department of Physics, Faculty of Science, University of Lagos, Akoka, Lagos, Nigeria Department of Radiation Biology, Radiotherapy, and Radiodiagnosis, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria Department of Physics, Faculty of Science, University of Lagos, Akoka, Lagos, Nigeria Background: This study evaluated the radiological risks associated with mining and living in buildings constructed with tailings. Materials and Methods: A NaI detector was used to determine the specific activity of 238U, 232Th, and 40K in tailings, and radiological hazard indices were estimated. Results: The mean specific activities of 238U, 232Th, and 40K were 84.27 ± 13.62 Bq/kg, 11.65 ± 0.69 Bq/kg, and 193.26 ± 9.98 Bq/kg, respectively. The mean values for 232Th and 40K were about 74% and 54% lower than their corresponding average world values, while that of 238U was 155% higher than its average world value. The hazards indices: radium equivalent (Raeq), absorbed dose rate (Dout and Din), annual effective dose equivalent (ADEout and ADEin), annual gonadal dose equivalent (AGDE), external hazard index (Hex), internal hazard index (Hin), and excess lifetime cancer risk (ELCRout and ELCRin) were estimated from the specific activity of the radionuclides. Their mean values were 249.74 Bq/kg, 54.03 nGy/h, 106.00 nGy/h, 66.31 µSv/y, 520.35 µSv/y, 369.78 µSv/y, 0.31, 0.54, 0.232 × 10-3 and 1.821 × 10-3 respectively. Raeq, Dout, ADEout, Hex and Hin were about 32%, 5%, 17.11%, 69%, and 46% lower, while Din, ADEin, and AGDE were about 26.19%, 24%, and 24.09% higher than their respective reference values. ELCRout is about 80%, while ELCRin is almost six times higher than the reference ELCR from all carcinogens. Conclusion: The high specific activity of 238U, Din, ADEin, AGDE, and ELCRin indicates that tailings are unsuitable for building and that there are potential radiological risks associated with artisanal mining activities in Kuru district. http://ijrr.com/article-1-6563-en.pdf Mining activities tailings building material radiation hazard indices gamma spectrometry. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 601 606 article X. Weng 1 X. Wang 2 M. Yang 3 W. Jin 4 Y. Zhu 5 L. Qiao qiaolixing@aliyun.com 6 Department of Neonatology, Binhai County People’s Hospital, Binhai, Yancheng, Jiangsu, PR China Department of Neonatology, Binhai County People’s Hospital, Binhai, Yancheng, Jiangsu, PR China Department of Neonatology, Binhai County People’s Hospital, Binhai, Yancheng, Jiangsu, PR China Department of Pediatrics, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, PR China Department of Neonatology, Binhai County People’s Hospital, Binhai, Yancheng, Jiangsu, PR China Department of Pediatrics, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, PR China Background: This research aimed to investigate imaging features of bedside ultrasound in different degrees of neonatal respiratory distress syndrome (NRDS). Materials and Methods: Eighty premature children admitted to neonatal intensive care unit (NICU) of Zhongda Hospital Affiliated to Southeast University within 6-12 hours after birth and diagnosed with NRDS by clinical and chest X-ray between January 2019 and December 2019 were selected. The children were divided into pulmonary surfactant (PS) treatment group (22 cases) and non-PS treatment group (58 cases). The lung ultrasound (LUS) score and total score of 12 regions was calculated, and score was compared with different degrees of NRDS in clinical neonates to compare ultrasound characteristics of different degrees of NRDS. Results: There was a positive correlation between 12 zone ultrasound score of double lung and grade of chest X-ray impact (r=0.872, P<0.001). The ultrasound scores were positively correlated with degree of respiratory distress (r=0.905, P<0.001). In PS administration group, the degree of respiratory distress improved from severe to mild (10 cases) and non-mild (12 cases) 2 hours after administration. Conclusion: Ultrasonography can be used as a non-invasive imaging method to diagnose condition of children with NRDS and dynamically predict prognosis of NRDS, which may offer a preliminary basis for ultrasonic-assisted clinical diagnosis and therapy. http://ijrr.com/article-1-6576-en.pdf Ultrasound Respiratory distress syndrome ultrasound imaging diagnosis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 607 612 article J.F. Liu 1 J. Qian 2 J. Ma 3 H.X. Tang 4 J.X. Ding 5 Y.Y. Tong 13965238978@163.com 6 Ultrasound Department, Tongling Municipal Hospital, Tongling, Anhui Province, China Ultrasound Department, Tongling Municipal Hospital, Tongling, Anhui Province, China Ultrasound Department, Tongling Municipal Hospital, Tongling, Anhui Province, China Ultrasound Department, Tongling Municipal Hospital, Tongling, Anhui Province, China Ultrasound Department, Tongling Municipal Hospital, Tongling, Anhui Province, China Ultrasound Department, Tongling Municipal Hospital, Tongling, Anhui Province, China Background: Thyroid nodules are common and can be benign or malignant. Ultrasound-guided fine needle aspiration cytology (USG-guided FNAC) is a new method for differentiating these nodules, but previous studies have yet to provide consistent conclusions. The aim of the study was to explore the effectiveness of USG-guided FNAC combined with ultrasonography in diagnosing benign and malignant thyroid nodules. Materials and Methods: The study involved 87 patients who underwent thyroid ultrasound and USG-guided FNAC. The results were compared with surgical and pathological findings, and the diagnostic efficiency was analyzed using ROC curves. Results: Among the 87 thyroid nodules, 22 were malignant, and 53 were benign. USG-guided FNAC alone diagnosed 34 malignant and 58 benign cases, while the combined method diagnosed 25 malignant and 63 benign cases. The ROC curve analysis showed that the combined method had a higher area under the curve (AUC) compared to ultrasound or FNAC alone, indicating better diagnostic accuracy. Conclusion: Combining USG-guided FNAC with ultrasound improves the sensitivity of preoperative differential diagnosis of benign and malignant thyroid nodules. http://ijrr.com/article-1-6577-en.pdf Thyroid nodules ultrasound-guided FNAC benign and malignant diagnostic accuracy ROC curve analysis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 613 618 article Y. Yang 1 X. Chen 2 Z. zhang 3 L. Lin llq12351@163.com 4 Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China Department of General Surgery, Fourth Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China Background: Chemotherapy is often prescribed for breast cancer treatment; however, how it affects disease-free survival, quality of life, and recurrence rates remains inadequately defined. This study aims at investigating relationships between chemotherapy and disease-free survival, quality of life, and recurrence percentages among breast cancer patients. Materials and Methods: This was a retrospective chart review of 350 breast cancer patients who underwent surgery between 2015 and 2022 at a university medical center. The participants received treatment such that the target group consisted of those receiving chemotherapy (n=105) and those not receiving chemotherapy (n=245). Comparison of demographic data such as tumor characteristics and treatment details between the two study groups will be carried out. Cox proportional hazards models as well as multivariate analysis of variance (MANOVA) and logistic regression will be used to evaluate disease-free survival, quality of life, and recurrence. Follow up assessment was done at 12 months. Results: Chemotherapy patients were significantly less likely to experience disease recurrence than those not exposed to Chemotherapy (HR=0.65, p=0.02) or local recurrence (OR=0.42, p=0.01). Patients who had chemotherapy again had lower physical and social functioning scores compared with those who were not given chemotherapy (p=0.04 and p=0.02, respectively). Chemotherapy was associated with an increased 12-month survival probability (92.5% vs 85.1%, p=0.03). Conclusion: Chemotherapy has an association with improved disease-free survival and decreased local recurrence in breast cancer patients, but it also adversely affects life quality, particularly specific aspects such as physical and social functions. These results emphasize that balance between benefit of treatment and quality of life should be carefully considered in treatment of breast cancer and that further investigations must occur for optimizing chemotherapy usage. http://ijrr.com/article-1-6580-en.pdf Radiation breast cancer neoadjuvant chemotherapy outcome. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 619 625 article L. Zhang 1 H. Li 2 C. Guo 3 T. Cheng chengtao1216@hotmail.com 4 Changzhou Cancer Hospital, Changzhou City, Jiangsu province, China Changzhou Cancer Hospital, Changzhou City, Jiangsu province, China Changzhou Cancer Hospital, Changzhou City, Jiangsu province, China Changzhou Cancer Hospital, Changzhou City, Jiangsu province, China Background: Globally, PD-1/PD-L1 inhibitors combined with bevacizumab have shown promising results in treating renal and lung cancers, but their efficacy in cervical cancer (CC) remains unclear. Superb microvascular imaging (SMI) is a novel technique for observing microcirculation in tumors. This study investigated the effectiveness and survival benefits of SMI in assessing tislelizumab combined with bevacizumab for treating CC. Materials and Methods: 86 patients with CC (2022–2023) were randomly divided into two groups: group A (bevacizumab, n=43) and group B (tislelizumab + bevacizumab, n=43). After 4 cycles of treatment, tumor volume and Adler blood-flow grades were assessed using color Doppler flow imaging (CDFI) and SMI. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of both methods in assessing treatment effects. Results: Both CDFI and SMI demonstrated significant differences in treatment effectiveness between groups (p<0.05). CDFI showed improved Adler blood-flow grades after treatment in both groups (p<0.05), but they were not significantly different between the groups (P>0.05). SMI also revealed significant improvements (p<0.01) and greater differences between groups after treatment (p<0.05). The area under the curve (AUC) for SMI in evaluating therapeutic efficacy was 0.833 (sensitivity 86.05%, specificity 69.77%), while CDFI showed an AUC of 0.816 (sensitivity 79.07%, specificity 72.09%). Conclusions: Tislelizumab combined with bevacizumab significantly improves CC treatment. SMI outperforms CDFI in evaluating tumor microvessels and provides valuable insight for the planning of early CC treatment. http://ijrr.com/article-1-6581-en.pdf Superb microvascular imaging cervical cancer monoclonal antibody tislelizumab bevacizumab. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 627 633 article W. Zhao 1 Y. Liu 2 X. Li 3 G. Chen 819136262@qq.com 4 Department of Ultrasound, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China 445000 Department of Ultrasound, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China 445000 Department of Ultrasound, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China 445000 Department of Ultrasound, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China 445000 Background: To assess the effectiveness and safety of combining ultrasound-guided interventional therapy with radiotherapy (RT) in treating Hepatocellular Carcinoma (HCC). Materials and Methods: Literature was searched in PubMed, Coghlan's database and Web of Science (WOS) up to November 2024 without language restriction. Outcome indicators included complete response (CR), partial response (PR), stable disease (SD), disease progression (PD), 1-year survival rate, and adverse events (AEs). The Cochrane Collaboration tool was utilized to evaluate the risk of bias in the included studies. Statistical analysis was performed based on revman software, and P<0.05 was considered statistically significant. Results: Five studies were included in the analysis, and the overall quality of the studies was high. The combination therapy group demonstrated statistically significant differences compared to the control group in PR (OR=2.14, 95% CI: 1.32–3.48, P=0.002), PD (OR=0.45, 95% CI: 0.27–0.76, P=0.003), and AEs (OR=0.54, 95% CI: 0.35–0.82, P=0.004). No statistically significant differences were observed between the two groups in terms of CR (OR=1.31, 95% CI: 0.24–7.01, P=0.760), SD (OR=0.88, 95% CI: 0.50–1.55, P=0.670), and one-year survival rate (OR=1.62, 95% CI: 0.85–3.09, P=0.140). Conclusion: Ultrasound-guided interventional therapy combined with RT demonstrates certain clinical advantages in the treatment of HCC, particularly in improving PR, reducing PD, and managing AEs. Additional studies are required to confirm its long-term effectiveness and safety. http://ijrr.com/article-1-6592-en.pdf Hepatocellular carcinoma ultrasound-guided radiotherapy synergistic treatment meta-analysis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 635 641 article D.W. Kim 1 H. Jeon 2 Y. Ki apex7171@hanmail.net 3 J.H. Joo 4 W. Kim 5 D. Kim 6 J. Nam 7 D. Park 8 Department of Radiation Oncology and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea Department of Radiation Oncology and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea Department of Radiation Oncology and Research Institute, Pusan National University Yangsan Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Research Institute, Pusan National University Yangsan Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Background: Due to the complicated dose calculations, in volumetric modulated arc therapy (VMAT), treatment errors may occur with changes around the lesion due to changes in the patient volume. The head and neck contain many major organs at risks (OAR)s increasing the likelihood of volume changes in OARs due to the effects of radiotherapy. Materials and Methods: The dose distribution and effects according to the changes in patient volume were analyzed while maintaining the same beam and irradiation conditions as in the initial treatment plan. The volume was extracted to quantify the volume change by setting the region of interest (ROI) of a fan-shaped area formed tangentially to the planning target volume (PTV), with the spinal cord as the center in the transverse plane. Results: As the radiation treatment progressed, the head and neck volume changes accelerated. As the volume change increased, the target's low-dose distribution area, the incident dose to the spinal cord and parotid gland, and the incident dose to the target periphery increased. In particular, an increase in the target's cold spot and the incident dose to the parotid gland can cause late effects as well as insufficient treatment. Conclusion: The alteration in dose distribution can be anticipated by monitoring the shift in patient volume using the ROI extraction method outlined in this study. http://ijrr.com/article-1-6593-en.pdf Intensity-Modulated Radiotherapy Cancer of Head and Neck Anatomic Variation Radiation Dose-Response Relationship. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 643 650 article J. Ruan 1 Z-z. Qin 2 P. Chen 3 Y. Chen 4 J. Fang 5 H. Tang tanghaoth@126.com 6 Department of Hematology, CR & WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China Department of Hematology, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Department of Hematology, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Department of Hematology, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Department of Hematology, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Department of Cardiovascular Surgery, Zhongnan Hospital, Wuhan University, Wuhan, China Background: The blockade of both VEGF / VEGFR and angiopoietin/TEK receptor tyrosine kinase (Tie-2) pathways can be considered an attractive approach to inhibition of angiogenesis in glioblastomas. Paeonol (Pae), a natural compound, has been identified to possess evidence of antitumor activity. Materials and Methods: In this study, the impact of Pae combined with radiotherapy on the glioblastoma angiogenesis pathways was investigated in vitro. For this purpose, effects of various doses of Pae alone or in combination of 2 Gy radiation was assessed using various endpoints such as gene expression, ᵧH2AX and apoptosis in glioblastoma cells. Results: Results indicated that Pae could induce the down-regulation of VEGF at the protein level and inhibit the mRNA and protein level of VEGFR1/2 in EA.hy926 cells. Pae and radiation co-treatment inhibited the protein levels of ANG1 and ANG2 in U251 cells and of Tie-2 in EA.hy926 cells. Notably, the combination therapy disrupted endothelial tube formation more effectively than Pae or radiation alone, reducing tubule length by 65% (p<0.001). However, we found that Pae had reduced the phosphorylation of Erk pathway in these cells. Pae enhanced radiation-induced DNA damage, as evidenced by increased γ-H2AX foci formation (p<0.01). The results further elucidate the multifaceted effects of Pae on tumor cell proliferation and angiogenesis in glioblastoma. Conclusion: Obtained results might imply that Pae might inhibit glioblastoma angiogenesis by the VEGF/VEGFR and ANG/Tie-2 pathways, with the Erk pathway potentially serving as a key mechanism. Our findings propose that Pae acts as a radiosensitizer while concurrently suppressing angiogenic signaling. http://ijrr.com/article-1-6609-en.pdf Paeonol radiation tumor angiogenesis ANG1/2 Tie-2 glioblastoma. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 651 658 article F. Gu drgufen48050@hotmail.com 1 M. Deng 2 Y. Zhao 3 X. Chen 4 L. An 5 Z. Zhao zhao900803zhen@hotmail.com 6 Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Changle West Road, Xi’an, Shaanxi Province, China Department of Ultrasound, Yuncheng Central Hospital, Shanxi Medical University, Hedong East Street, Yanhu District, Yuncheng, Shanxi Province, China Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Changle West Road, Xi’an, Shaanxi Province, China Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Changle West Road, Xi’an, Shaanxi Province, China Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Changle West Road, Xi’an, Shaanxi Province, China Avic Xi’an Aircraft Industry Group Company Ltd, No.1 Xifei Avenue, Yanliang District, Xi’an, Shaanxi Province, China Background: Rotator cuff injuries are common musculoskeletal conditions that impair shoulder function and quality of life. Conventional therapies often fail to address the biological and mechanical deficiencies of these injuries. This study evaluated the clinical efficacy of ultrasound-guided hypertonic glucose injections combined with blood flow restriction (BFR) training in managing rotator cuff injuries. Materials and Methods: A randomized controlled trial involving 120 patients with rotator cuff injuries was conducted. Participants were assigned to an experimental group (ultrasound-guided glucose injections with BFR training, n=60) or a control group (standard physical therapy, n=60). Pain, shoulder function, tendon thickness, range of motion (ROM), muscle strength, and patient-reported outcomes were assessed over 12 weeks using ultrasound imaging and validated scales (visual analog scale (VAS), Constant–Murley score (CMS), shoulder disability index (SDI), and American Shoulder and Elbow Surgeons (ASES) score). Results: The experimental group showed significant improvements compared to the control group, including reduced pain (VAS: -3.0, p<0.001), enhanced function (CMS: +29.5, p<0.001), increased ROM (+25°, p<0.001), decreased tendon thickness (-1.7 mm, p<0.001), and improved muscle strength (+2.8 kg, p<0.001). Patient-reported satisfaction and functionality (ASES: +33.4, p<0.001) were also higher in the experimental group. Conclusion: The combination of hypertonic glucose injections and BFR training is an effective approach for treating rotator cuff injuries. It provides significant pain relief, functional recovery, and structural improvements, which highlight its potential as a better alternative to conventional treatments. Further research is recommended to assess the long-term efficacy and refine the treatment protocols. http://ijrr.com/article-1-6610-en.pdf Rotator Cuff Injuries hypertonic glucose blood flow restriction training ultrasound-guided musculoskeletal rehabilitation. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 659 664 article D.W. Kim 1 H. Jeon 2 Y. Ki apex7171@hanmail.net 3 J.H. Joo 4 W. Kim 5 D. Kim 6 J. Nam 7 D. Park 8 Department of Radiation Oncology and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea Department of Radiation Oncology and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea Department of Radiation Oncology and Research Institute, Pusan National University Yangsan Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Research Institute, Pusan National University Yangsan Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Department of Radiation Oncology and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Yangsan, South Korea Background: Deep-inspiration breath-hold (DIBH) is a helpful technique during radiation therapy (RT) for breast cancer that can protect vital organs and deliver a more accurate treatment dose to the target. A laser sensor-based position monitoring system is developed to measure the absolute position of an object and achieve high accuracy and reproducibility during DIBH. Materials and Methods: A laser distance sensor (LDS) was fabricated to be mounted on a commercially available breast board and configured to provide real-time monitoring to assist with respiratory control. DIBH was measured in 10 volunteers with and without self-monitoring. Using an anthropomorphic phantom, we calculated the change in dose distribution due to DIBH error. We estimated the change in dose to target, the heart, and left lung due to DIBH error from the volunteer data. Results: With monitoring, the DIBH error was within 2 mm; without monitoring, the DIBH error increased to approximately 5 mm. Some of the volunteers who did not perform self-monitoring had large DIBH errors. This resulted in suboptimal dose distributions to the target, heart, and left lung, due to unintended alterations in the intended dose distribution. Conclusion: A self-monitoring system using LDS can greatly assist in the reproducibility of DIBH, thus helping to maintain the planned prescribed dose. http://ijrr.com/article-1-6611-en.pdf Breath-holding laser distance sensor breast neoplasms cardiac sparing radiotherapy. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 665 675 article S. Zhou 1 H. Ren 2 K. Zhu 3 S. Cheng slcheng@njmu.edu.cn 4 The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China 310052 The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China 310052 The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China 310052 Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China 310052 Background: One of the most widespread forms of cancer in males across the globe is prostate cancer (PC), which is seeing an upward trend in illness and death. The use of Prostate-Specific Membrane Antigen Positron Emission Tomography-Computed Tomography (PSMA PET-CT) is gaining traction as a valuable imaging strategy that shows potential for diagnosing and monitoring PC. Nevertheless, existing studies on how PSMA PET-CT parameters influence patient outcomes show varying results, highlighting the need for definitive evidence to validate their predictive capabilities. Materials and Methods: The objective of this thorough examination and structured evaluation was to assess the predictive capacity of parameters derived from PSMA PET-CT in PC patients. The databases PubMed, EMBASE, Cochrane Library, and Web of Science were accessed to find research on the link between metrics generated from PSMA PET-CT and survival rates in PC patients. The meta-analysis utilized Stata version 14.0. To determine whether publication bias existed among the studies, Egger’s test was employed. Results: Seventeen research investigations that included 1,103 individuals were combined. The findings from the meta-analysis indicated that TV-PSMA emerged as a crucial factor in forecasting overall survival (OS) for PC patients (HR=1.69, 95% CI 1.24-2.29), while parameters related to SUV showed no meaningful association with OS or progression-free survival (PFS). Conclusion: The PSMA PET-CT-derived TV-PSMA parameters serve as reliable predictors of OS in PC patients, while SUV-related parameters and TL-PSMA each show no significant performance in prognostic predictions. Future research should seek to validate these findings in a broader population, and these parameters should be effectively incorporated into clinical decision-making to enhance patient outcomes. http://ijrr.com/article-1-6616-en.pdf Prostate cancer prostate-specific membrane antigen PET-CT prognosis meta-analysis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 677 682 article J. Zeng 1 L. Lu 2 X.Y. Liu 3 C.R. Hu 4 J. Hong 5 F.B. Guo gfb803@fjmu.edu.cn 6 Y. Guo gyi@mail.ustc.edu.cn 7 Department of Radiotherapy, Cancer center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China Department of Radiotherapy, Cancer center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China Department of Radiotherapy, Cancer center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China Department of Radiotherapy, Cancer center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China Department of Radiotherapy, Cancer center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China Department of Radiotherapy, Cancer center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China Background: This study investigates the dosimetric response of the Delta4 system to varying field sizes and assesses its accuracy in dose verification. Materials and Methods: Output factors for fields ranging from 1 × 1 cm² to 20 × 20 cm² were measured using PTW 60019 detector, PTW 60018 detector, and the Delta4 system. The PTW 60019 measurements were considered the gold standard and were compared with those from the other two detectors. Two test plans were developed to compare the dose verification results of the Delta4 system, both with and without output factor correction. Results: The PTW 60018 and IBA CC13 detector measurements, using the daisy-chaining method, demonstrated strong agreement with the gold standard. However, the Delta4 system showed an underestimation in the output factor of the 1×1 cm² field, with deviations of -2.259% for the 6 MV flattening filter (FF) beam and -3.343% for the 6 MV flattening filter free (FFF) beam. After correcting the output factor, the gamma passes rate (3%/2mm) for test plan 2 featuring 1 × 1 cm² sub-fields improved from 67.3% to 95.7% for the 6 MV FF beam. Conclusions: The Delta4 system exhibits a dosimetric response issue when managing small fields. Output factor corrections are recommended for Delta4 dose verification results when dealing with field sizes less than 4 cm and a high number of sub-fields. http://ijrr.com/article-1-6639-en.pdf Radiometry radiation dosage Delta4 small field. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 683 690 article Z.A. Ismail Alsudani Zahraa A. Ismail Alsudani 1 Department of Physics, College of Science, Misan University, Misan, Iraq Background: The city of Ali Al-Gharbi in Misan province, Iraq, is known for its agricultural activities, raising concerns about potential soil contamination due to industrial activities, waste disposal, and the use of fertilizers and pesticides. Understanding soil radioactivity levels is essential for assessing health risks to the environment and the local population. Materials and Methods: A High-Purity Germanium detector was employed to assess the radioactivity of both artificial and natural radionuclides within the soil obtained from twenty-three localities in Ali Al-Gharbi city, Misan. The soil was prepared, dried, and analyzed in the lab. Radiological hazard indices (RHI): annual gonadal dose equivalent (AGDE), radium equivalent activity (Raeq), absorbed dose rate (D), gamma index (Iγ), external and internal hazard indices (Hex & Hin), excess lifetime cancer risk (ELCR), and outdoor annual effective dose equivalent (AEDE), were computed using established formulas. Statistical analysis provided insights into the radiological risks in the region. Results:  226Ra,232Th, 40K, and 137Cs were found to be 32.676±3.684 Bq/kg, 18.150±1.562 Bq/kg, 377.376±15.266 Bq/kg, and 1.906±0.422 Bq/kg, respectively. Radiological hazard parameters, including excess ELCR, Iγ, D, Raeq, (Hex & Hin), AGDE, and AEDEout were found to be 87.091±17.476 Bq/kg, 0.235±0.047, 0.323±0.073, 0.323±0.062, 41.543±8.107 nGy/h, 50.948±9.943 µSv/y, 293.587±56.174 µSv/y, and 1.783±0.348 ×10-4, respectively. The findings showed that the 226Ra, 232Th, 40K, and 137Cs were below the recommended value by the UNSCEAR. Conclusions: Moreover, all estimated radiation hazard parameters from natural radionuclides were below the recommended limits, suggesting no health risk from radioactivity in the study area. http://ijrr.com/article-1-6640-en.pdf Radioactivity gamma spectrometry soil radiological hazard Ali Al- Gharbi. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 691 695 article N. Dahdouh narimane.dahdouh@univ-setif.dz 1 Z. Chaoui 2 S. Khoudri 3 Department of Laboratory of Optoelectronics and Devices, Physics Department, Faculty of Sciences, UFAS1; Algeria Department of Laboratory of Optoelectronics and Devices, Physics Department, Faculty of Sciences, UFAS1; Algeria Cancer Center of Setif, Algeria Background: Our new present study uses biological indices to predict NTCP (normal tissue complications probability) and TCP (tumor control probability) in breast cancer patients undergoing mastectomy planned with MIT (monoisocentric technique) and DIT (dual isocentric technique) in the 3DCRT (three-dimensional conformal radiotherapy). Materials and Methods: This study involved using DVH (dose-volume histograms) from randomly selected patients to calculate the NTCP and TCP with our in-house program, RADBIOFOR. We focused on specific parameters related to pneumonitis in the lungs, pericarditis in the heart, and tumor control for the targeted area. Results: The incidence of clinical symptomatic pneumonitis grade 2 is lower for MIT than DIT, with a mean  difference of 6.86%, 1.39% for symptomatic radiation pneumonitis grade 2, 1.17% and 0.82% for radiation pneumonitis grade 2. Both techniques produced comparable results, with MIT showing slightly better control than DIT, resulting in a mean difference of 0.18%. Our study suggests that the mean lung dose significantly affects the incidence of radiation pneumonitis. Conclusion: MIT outperforms DIT and offers better lung and heart protection with a lower incidence of radiation complications. Similar local control rates in the chest wall and lymph node region. http://ijrr.com/article-1-6643-en.pdf Monoisocentric technique dual isocentric technique TCP NTCP pneumonitis 3DCRT. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 697 705 article Y. Shi 1 B. Ding 2 J. Zhao 3 Z. Liu 4 L. Wang 5 Sh. Wang 6 H. Zhao zhaohongtao2019@163.com 7 Y. Liu 8 G. Wei 9 P. Zhang 10 Harbin Engineering University, College of Physics and Optoelectronic Engineering, Key Laboratory of In-Fiber Integrated Optics of Ministry of Education, Harbin, China Heilongjiang Institute of Atomic Energy, Key Laboratory of Nuclear Technology Application, Harbin, China Harbin Engineering University, College of Nuclear Science and Technology, Harbin, China Heilongjiang Institute of Atomic Energy, Key Laboratory of Nuclear Technology Application, Harbin, China Heilongjiang Institute of Atomic Energy, Key Laboratory of Nuclear Technology Application, Harbin, China Heilongjiang Institute of Atomic Energy, Key Laboratory of Nuclear Technology Application, Harbin, China Harbin Engineering University, College of Physics and Optoelectronic Engineering, Key Laboratory of In-Fiber Integrated Optics of Ministry of Education, Harbin, China Harbin Engineering University, College of Physics and Optoelectronic Engineering, Key Laboratory of In-Fiber Integrated Optics of Ministry of Education, Harbin, China Heilongjiang Institute of Atomic Energy, Key Laboratory of Nuclear Technology Application, Harbin, China Heilongjiang Institute of Atomic Energy, Key Laboratory of Nuclear Technology Application, Harbin, China Background: Underground transportation is increasingly becoming the preferred mode of daily commuting. However, radon can accumulate in the relatively enclosed underground environments of subway stations, posing ionizing radiation exposure risk for staff and the public. Therefore, monitoring and assessment are essential. Materials and Methods: An FD216 environmental radon measurement device was used to monitor the air radon concentrations in 66 underground stations in a Chinese city, including ticket offices, security checkpoints, and platforms. The personal exposure dose was estimated and potential health effects were evaluated. Multivariate statistical analysis was conducted and frequency distribution, Pearson correlation analysis, box plots, and cluster analysis were used to assess the distribution patterns and relationships among radiological parameters. Results: The 222Rn concentrations ranged from 20.1 to 78.4 Bq/m3, with an average of 51.5 Bq/m3, which is below the Chinese standard limit. The annual effective dose and excess lifetime cancer risk for underground station staff due to inhalation of indoor radon were 0.48 mSv and 1.69×10-3, respectively, compared to 0.12 mSv and 0.42×10-3 for the public, which are below the limits established by the International Commission on Radiological Protection. Radon levels within underground stations do not pose a threat to the health of people. http://ijrr.com/article-1-6644-en.pdf Radon occupational exposure radioactivity multivariate analysis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 707 713 article R. Lin Linruiying@mjc-edu.cn 1 G. Xiao 2 W. Xiu 3 S. Cai 4 Department of Radiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001,Fujian Province, China Department of Radiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001,Fujian Province, China Department of Radiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001,Fujian Province, China Department of Radiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001,Fujian Province, China Background: It aimed to compare the efficacy of digital mammography and magnetic resonance imaging (MRI) used alone and in combination in the diagnosis of ductal carcinoma in situ (DCIS). Material and Methods: 78 patients with pathologically confirmed DCIS were enrolled in this retrospective study. All patients underwent digital mammography and MRI. The imaging results were graded using the Breast Imaging Reporting and Data System (BI-RADS), and the diagnostic sensitivity (Sen), specificity (Spe), and accuracy (Acc) of the two methods, both individually and in combination, were calculated. Results: imaging findings were classified as highly suspicious (BI-RADS grade 4 and above) or not highly suspicious (BI-RADS grade 3 and below). The Sen, Spe, and Acc of digital mammography in the diagnosis of DCIS were 68.97%, 60%, and 66.67%, respectively. The Sen, Spe, and Acc of MRI were 77.5%, 70%, and 75.64%, respectively. When the two techniques were combined, the Sen was increased to 87.93%, the Spe was 75%, and the Acc was 84.62%. There were visible distinctions in Sen and Acc between the combined use and single mammography detection (P<0.05). Conclusion: the combined use of digital mammography and MRI shows high Sen and Acc in the diagnosis of DCIS, which is more effective than single method. This article supports the use of multimodal diagnostic strategies in clinical practice to improve the diagnostic efficiency of DCIS. http://ijrr.com/article-1-6645-en.pdf Ductal carcinoma in situ mammography magnetic resonance imaging sensitivity specificity diagnostic accuracy. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 715 720 article M.A. Boroumand 1 R. Azmoonfar 2 F. MadadiZadeh 3 K. Saber korosh.iut@gmail.com 4 N. Hamzian hamzian.nima@gmail.com 5 Clinical Oncology Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Radiology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran Biostatistics and Epidemiology Departments, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Medical Physics, School of Medical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran Medical Physics Department, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Background: Radiation therapy is one of the most important methods of breast cancer treatment that can cause complications that affect the patient's quality of life. The aim of this study was a dosimetric comparison of skin complications after hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) in breast cancer patients. Materials and Methods: In this cross-sectional study between November 2021 and July 2022, 55 patients were reviewed. Thirty-six patients received CFRT (50Gy in 25 fractions), and 19 patients received HFRT (42. 5Gy in 16 fractions). Skin complications during treatment and 40 days after radiotherapy were evaluated and compared for these two procedures. Results: The incidence of grade 1, 2, and 3 skin complications up to 40 days after CFRT was 100%, 88.8%, and 22.2%, respectively; also, in HFRT, the incidence of grade 1, 2, and 3 skin complications was 89.4%, 36.8%, and zero, respectively. The results show that the incidence of skin complications is significantly higher with the CFRT than with the HFRT (P<0.05). Conclusion: In this clinical study, both in terms of complications and dosimetry, it was shown that patients undergoing radiation therapy with the hypofractionation technique had fewer skin complications compared to those treated with the conventional technique. http://ijrr.com/article-1-6655-en.pdf Breast cancer radiotherapy dermatitis. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 721 730 article W. Li 1 J. Zhang 2 Y. Li 3 L. Xu 4 Q. Son 12299079@qq.com 5 J. Wang jiewang_CH@163.com 6 Department of Oncology, General Hospital of Central Theater Command, Wuhan, 430070, Hubei Province, China Department of Oncology, General Hospital of Central Theater Command, Wuhan, 430070, Hubei Province, China Department of Oncology, General Hospital of Central Theater Command, Wuhan, 430070, Hubei Province, China Department of Oncology, General Hospital of Central Theater Command, Wuhan, 430070, Hubei Province, China Department of Oncology, General Hospital of Central Theater Command, Wuhan, 430070, Hubei Province, China Department of Cardiothoracic Surgery, Taikang Tongji (Wuhan) Hospital, Wuhan, 430050, Hubei Province, China Background: Pancreatic ductal adenocarcinoma (PDAC) is recognized as an exceptionally aggressive malignancy with limited treatment options. Radiotherapy, particularly creotactic body radiotherapy, plays a vital role in cancer management but faces challenges due to the complex microenvironment of tumors and intrinsic resistance mechanisms. Materials and Methods: Transcriptomic data from PDAC tissue samples were analyzed pre- and post-stereotactic body radiotherapy to identify variations in the expression of  lncRNAs and mRNAs. Additionally, bioinformatics approaches were used to explore their interactions, focusing on the effects on p53-mediated apoptosis and immune cell dynamics, and to assess their potential as biomarkers for radiotherapy outcomes. Results: Genes linked to p53-driven apoptosis and DNA damage response showed significant upregulation after stereotactic body radiotherapy, highlighting the cytotoxic effects of radiotherapy. Conversely, immune-related genes were downregulated, indicating an immunosuppressive tumor microenvironment following radiotherapy. Meanwhile, co-expression analysis revealed a regulatory network between lncRNAs and mRNAs that influence radiotherapy-induced cytotoxicity and immunosuppression. Lastly, a risk model was constructed by incorporating three mRNAs (HSPA1L, MT-CYB, PMAIP1) and five lncRNAs (AC018816.3, RP11-147L13.2, CTD-2651B20.6, RP11-422P24.10, AC067945.4) to predict radiotherapy outcomes. Conclusion: This study uncovers the intricate interaction between lncRNAs and mRNAs in PDAC, especially in the context of radiotherapy. Our results demonstrated that the lncRNA-mRNA network significantly impacts the tumor microenvironment and radiotherapy response by regulating pathways involved in cell death and immunosuppression. Thus, targeting this network could enhance radiotherapy efficacy and mitigate its immunosuppressive effects, offering novel strategies to improve the treatment outcomes of PDAC. http://ijrr.com/article-1-6664-en.pdf Pancreatic neoplasms stereotactic body radiotherapy long noncoding RNA apoptosis immune evasion. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 731 736 article S. Monica 1 C. Bindhu 2 P.J. Jojo panakal.jojo@pnguot.ac.pg 3 Department of Physics, St. Joseph’s College for Women, Alappuzha, Kerala, India Department of Physics, Fatima Mata National College (Autonomous), Kollam, India Department of Physics, Fatima Mata National College (Autonomous), Kollam, India Background: Prognostic models and specific data are the basics of radiation dosimetry.  Inhalation is the major pathway of radiation exposure to man. Precise data of progeny concentration status is important for all dose assessments owing to Radon (222Rn) and Thoron (220Rn). Materials and Methods: The measurements of unbound (unattached) and bound (attached) short lived Radon and Thoron daughters were carried out in selected dwellings of coastal regions of Thiruvananthapuram district, Kerala. For the precise assessment of fraction of bound and unbound fraction of radon / thoron progeny, progeny sensors with wire mesh capped progeny sensors were used. The method makes use of radon thoron progeny discrimination using proper barriers and wire mesh helps to segregate bound against unbound fractions of progeny. Results: Overall (bound and unbound) equilibrium equivalent concentrations of 222Rn (EECRA+U) and similar quantity for 220Rn concentration (EECTA+U) were found to differ from 6.31± 0.9 to 7.98 ± 1.1 Bqm-3 and 0.35 ± 1.1 to 0.61 ± 0.1 Bqm-3, respectively. Conclusions: The volume specific quantities of bound progeny nuclides for both Radon and Thoron were found superior than the unbound daughter nuclides in the residences of the study area. The unattached (unbound) equilibrium equivalent concentrations of 222Rn and 220Rn did not demonstrate any notable relationship with ventilation conditions. It was found that there is a positive relationship between the progeny attachment rate and aerosol concentration for radon. http://ijrr.com/article-1-6665-en.pdf Attached and unattached progeny aerosol concentrations attachment rate deposition-based progeny sensors wire-mesh capped sensors. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 737 742 article S. Chen 1 R. Huang hrisheng@126.com 2 J. Chen 3 H. Lin 4 L. Lu 5 S. Zhang 6 Z. Jiang 7 Department of Radiology, Quanzhou First Hospital, Quanzhou, Fujian, China Department of Radiology, Quanzhou First Hospital, Quanzhou, Fujian, China Department of Radiology, Quanzhou First Hospital, Quanzhou, Fujian, China Department of Radiology, Quanzhou First Hospital, Quanzhou, Fujian, China Department of Radiotherapy, Quanzhou First Hospital, Quanzhou, Fujian, China Department of Radiology, Quanzhou First Hospital, Quanzhou, Fujian, China Department of Neurosurgery, Quanzhou First Hospital, Quanzhou, Fujian, China Background: This research attempted to elucidate amide proton transfer (APT) role in combination with relative cerebral blood volume (rCBV) in grading adult diffuse glioma and predicting isocitrate dehydrogenase (IDH) gene mutation status. Materials and Methods: A retrospective analysis was implemented on 70 patients with adult diffuse glioma in our hospital from September 2022 to October 2023. All patients underwent Dynamic Susceptibility Contrast Perfusion Weighted Imaging (DSC-PWI) and APT-weighted magnetic resonance imaging examination. The values of rCBVmax and APTmean in differentiating the classification of glioma and IDH gene mutation status were analyzed. Results: The rCBVmax and APTmean value were reduced in grade II patients than in grade III patients (P<0.01). The AUC of rCBVmax value combined with APTmean value was 0.9330, with a 95% CI of 0.8962-0.9697, which was higher than single rCBVmax value or APTmean value (P<0.001). The rCBVmax value and APTmean were higher in IDH wild-type glioma patients than in IDH mutant-type glioma patients (P<0.01). The AUC of rCBVmax value combined with APTmean value was 0.8808, with a 95% CI of 0.8233-0.9383, which was higher than single rCBVmax value or APTmean value (P<0.001). Conclusion: The combined diagnosis of APT and rCBV can improve the value of differentiating grade I and II glioma as well as IDH genotyping, which is worth of promoting in clinical practice. http://ijrr.com/article-1-6666-en.pdf Glioma grade isocitrate dehydrogenase gene. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 743 750 article Y. Lei 1 Y. Liu 2 W. Zhang zhangweiguo0906@sina.com 3 F. Chu 4 T. Guo 5 Radiology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Chenggong District, Kunming, Yunnan Province, China Radiology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China College of Aerospace and Civil Engineering, Harbin Engineering University, Harbin, Heilongjiang Province, China Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Chenggong District, Kunming, Yunnan Province, China Background: Medical Titanium (Ti) alloys have been widely used in the fields of wound repair and orthopedic treatment because of their high strength, good resistance to physiological corrosion and excellent biomechanics properties. However, similar withto other metal materials, Medical Ti alloys may also be damaged with potentially suffer from damages of various extentvarying degrees under proton radiation condition and environment. Materials and Methods: As theSince traditional investigation methods are limited on time and space size to some extent, Molecular Dynamic (MD) simulations are generally applied to uncover the entire proton radiation process, and the simulatedsimulation models are concentrated on β type medical Ti alloys. Results: Firstly, when the proton struck withe a constant velocity of 2000 Å/ps impact with Primary Knock-on Atom (PKA) at a constant velocity of 2,000 Å/ps, the kinetic energy of 24,451.7 eV will would be transferred, and PKA willwould leave its original site and further transfer the kinetic energy, until reaching the equilibrium site, but accompanied by . This process also leave a plenty ofsignificant micro-structure damages. Secondly, by adjusting the velocity of proton to be in the range of 1,500 Å/ps ~ 2,500 Å/ps, damage zone could be expanded by increasing the kinetic energy of proton. through adjusting the velocity of proton between 1500 and 2500 Å/ps, it seems that the addition of proton kinetic energy could enlarge the damage zone. However, the increase of increased Ti alloy matrix temperature did not have a great impact on the velocity of proton. could not show the same effect with proton velocity. Thirdly, the multi-proton effect on horizontal mode is more obviouspronounced than that on vertical mode. Conclusions: It is kinetic energy, but not rather than potential energy, that contributes to the formation of micro-structure in Ti alloys. The influence of temperature can be ignored in practical applications, In the practice environment, effects of temperature can be ignored, but the velocity and density of incident proton ought to be considered. http://ijrr.com/article-1-6667-en.pdf Radiology molecular dynamic simulation titanium nanoparticles. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 751 756 article F. Song 1 J. Che 2 H. Li 3 G. Zhu 4 M. Huang 5 D. Xu 632533054@qq.com 6 Department of Minimally Invasive Intervention, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650118, China Department of Minimally Invasive Intervention, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650118, China Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650118, China Department of Minimally Invasive Intervention, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650118, China Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650118, China Department of Medical Laboratory, Pingbian County People's Hospital, Pingbian 661200, Yunnan, China Background: Iodine-125 (125I) brachytherapy is an effective strategy for treating human tumors. The current study aimed to discover the mechanisms underlying the therapeutic action of 125I radiation in lung cancer, with a focus on its impact on the epithelial-mesenchymal transition (EMT). Materials and Methods: A549 cells, a human lung adenocarcinoma cell line, were treated with transforming growth factor β1 (TGF-β1) and/or 125I (control, TGF-β1, 125I, and TGF-β1 + 125I groups) to evaluate the effects of 125I on TGF-β1-induced EMT. After treatment, the viability of A549 cells was detected using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The expression of E-cadherin, N-cadherin, Vimentin, Smad3, and Snai1 markers and pathway molecules was measured. Results: 125I radiation inhibited the viability of A549 cells, both with and without TGF-β1 treatment. TGF-β1 intervention promoted the EMT of A549 cells, as demonstrated by the morphological transition from a polygonal shape to a spindle shape, reduced E-cadherin levels, and elevated Vimentin and N-cadherin expression. Notably, TGF-β1-activated EMT was significantly weakened by 125I radiation. Moreover, 125I radiation reversed TGF-β1-induced upregulation of Smad3 and Snai1 in A549 cells. Conclusion: 125I radiation suppresses the EMT by blocking TGF-β1/Smad3/Snai1 signaling, contributing to the treatment of lung cancer. http://ijrr.com/article-1-6668-en.pdf Lung neoplasms iodine-125 epithelial-mesenchymal transition transforming growth factor beta1 smad3 protein. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 757 769 article G. Chen 1 S. Jiang 2 L. Kong 3 T. Yang 4 X. Sun 5 T. Xu 6 L. Fan 7 Q. Xie xieqingrjh@163.com 8 H. Zhao zhaohong1968qd@163.com 9 Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025 Shanghai, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Background: Digestive tract cancers, including esophageal, gastric, colorectal, liver, pancreatic, gastrointestinal stromal tumors (GISTs), and digestive blastomas, accounted for 26% of cancer cases and 38% of cancer-related deaths worldwide in 2020. Managing these malignancies is challenging due to frequent advanced-stage diagnosis, complicating treatment and resulting in poor prognoses. Radiotherapy has evolved from a palliative approach to a curative treatment for several digestive tract cancers, with advances in techniques like three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and stereotactic body radiotherapy (SBRT) improving precision and efficacy. Materials and Methods: PubMed was searched from inception to September 2024 using various keywords with Boolean modifiers and operators. The abstracts were screened, and any relevant articles were imported into a reference manager. Additionally, the references of the selected articles were further screened for any further relevant articles. Results: This literature review examines the integration of radiotherapy into multimodal treatments, such as neoadjuvant chemoradiation for esophageal and gastric cancers, as demonstrated by the CROSS study. Challenges include resistance to therapy, often mediated by molecular mechanisms involving non-coding RNAs, and significant side effects like gastrointestinal toxicity and fatigue. The emerging role of the gut microbiome in influencing radiotherapy efficacy and side effects is also highlighted. Conclusion: Despite successes, overcoming resistance and reducing side effects remain significant challenges. Advances in radiotherapy techniques, combined with a deeper understanding of molecular biology and the gut microbiome offer promising avenues for enhancing efficacy and tolerability. http://ijrr.com/article-1-6678-en.pdf Digestive tract cancer radiotherapy neoadjuvant therapy radiotherapy side effects. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 771 782 article L. Shi 1 X. Sun 2 X. Wang 3 H. Zhao zhaohong1968qd@163.com 4 Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266042, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266042, China Department of General Surgery, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266042, China Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266042, China This review article explores the key targets and mechanisms of radiotherapy (RT)-induced gastrointestinal mucositis (RIGIM) development and progression. RIGIM is a frequent and potentially disabling side effect of radiation therapy, impacting the mucosal lining of the gastrointestinal tract. The pathophysiology of RIGIM is complex, involving oxidative stress, inflammatory pathways, DNA damage, changes in the gut microbiota, and disruption of the mucosal barrier’s integrity. The clinical presentation of RIGIM varies, ranging from mild inflammation to severe ulceration, significantly impacting patients’ quality of life, nutrition, and treatment adherence. This article discusses the risk factors, symptoms, and clinical manifestations of RIGIM, as well as current and potential therapeutic strategies. These strategies include pharmacological interventions, microbiome modulation, and supportive care, aimed at preventing, mitigating, or treating RIGIM and ultimately improving the lives of cancer patients undergoing RT. http://ijrr.com/article-1-6679-en.pdf Gastrointestinal tract mucositis radiation ionizing inflammation gastrointestinal microbiome radiotherapy. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 783 796 article K.M. Sergieva ksergieva@medfac.mu-sofia.bg 1 L.L. Traikov 2 T.G. Bogdanov 3 E.S. Stoyanova 4 R. Tafraddjiiska-Hadjiolova 5 V.H. Hadzhiyska 6 Medical University Sofia, Faculty of Medicine, Department of Nuclear Medicine, Radiotherapy and Medical Oncology, Sofia, Bulgaria Medical University Sofia, Faculty of Medicine, Center of Biomedical Sciences-CBS, Department of Medical Physics and Biophysics, Sofia, Bulgaria Medical University Sofia, Faculty of Medicine, Center of Biomedical Sciences-CBS, Department of Medical Physics and Biophysics, Sofia, Bulgaria Medical University Sofia, Faculty of Medicine, Center of Biomedical Sciences-CBS, Department of Medical Physics and Biophysics, Sofia, Bulgaria Medical University Sofia, Faculty of Medicine, Center of Biomedical Sciences-CBS, Department of Medical Physiology and Pathophysiology, Sofia, Bulgaria Medical University Sofia, Faculty of Medicine, Department of Nuclear Medicine, Radiotherapy and Medical Oncology, Sofia, Bulgaria Radiotherapy has been the modality for treating cancer patients worldwide for more than 100 years. Radiation dose to patients is delivered through different techniques using high-energy photon beams generated by the linear accelerators. Radiotherapy techniques are developing at a speed never seen before. For continuous improvement, safe and effective radiotherapy delivery requires implementing adapted quality assurance (QA) programs and integral quality management (QM) systems. A key step in any QA program is the dosimetry audit. It provides an effective tool to improve the accuracy of patients’ treatments. In the global panorama, dosimetry audit programs are conducted by various institutions. Still, the largest of them is the International Atomic Energy Agency (IAEA) in Vienna, Austria, the Imaging and Radiation Oncology Core (IROC-H) Houston QA Center in the USA, and EQUAL (European Quality Laboratory) Laboratory in the framework of the ESTRO (European Society for Therapeutic Radiology and Oncology) ESTRO – EQUAL Laboratory in Villejuif Cedex, France. http://ijrr.com/article-1-6680-en.pdf Radiotherapy radiation dosimetry thermoluminescent dosimetry film dosimetry radio photoluminescent dosimetry. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 797 807 article A. Hosseinpour 1 A. Piranfar 2 T. Harati 3 S. Veyseh 4 M. Soltani msoltani@uwaterloo.ca 5 Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran Generative Adversarial Networks (GANs) have emerged as powerful tools within the realm of deep learning, particularly in the synthesis of artificial images, a capability that holds immense promise in the field of medical image-to-image translation. Recent years have witnessed significant strides in GAN development tailored for cross-domain image translation, largely driven by the availability of extensive datasets containing meticulously annotated medical images. Nonetheless, the process of annotating these images poses a formidable challenge, demanding a substantial number of specialized experts for supervised methods. To surmount this obstacle, cross-modality synthesis techniques have gained traction, offering an efficient approach to mitigate the complexities and costs associated with acquiring paired training data. This paper serves as an introductory exploration into the diverse array of GAN variants employed in image-to-image translation, subsequently delving into their applications within medical imaging. Specifically, it investigates the realms of cross-modality synthesis and conditional image synthesis, shedding light on their potential to revolutionize diagnostic precision and streamline the intricacies of medical imaging processes. http://ijrr.com/article-1-6681-en.pdf Generative adversarial networks image-to-image translation synthetic medical imaging cross-modality synthesis conditional GANs. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 809 812 article H. Ahmadpour 1 A. Mohammadkarim mohammadkarim.medphys@gmail.com 2 A. Kazemian 3 G. Geraily 4 P. Hejazi 5 M. Yadollahi 6 M. Najafi 7 N. Gorjizadeh 8 Department of Medical Physics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran Radiation Sciences Research Center (RSRC), Aja University of Medical Sciences, Tehran, Iran Radiation Oncology Research Center (RORC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Department of Medical Physics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Radiation Oncology, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran Department of Radiation Oncology, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran Background: External radiotherapy procedures as an important tool for curing nasopharyngeal carcinoma (NPC) are commonly performed with one of the well-known techniques, three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT). Materials and Methods: In this study, the therapeutically dosimetric parameters including conformity index (CI), homogeneity index (HI), and tumor control probability (TCP) were extracted from the dose volume histogram (DVH) curves of fifteen patients in two designed treatment plans including, 3D-CRT and IMRT. 3D-CRT plans were performed in three phases by considering the mixed photon-electron beams in the second phase with a total dose of 70 Gy in 35 fractions. The prescribed dose of IMRT plans was 70 Gy in 33 fractions by employing 9 fields of photon beams. Results: A significant statistical difference was observed in TCP and CI between 3D-CRT and IMRT plans. The average value of TCP in IMRT is 5.65 times that of 3D-CRT. Also, IMRT showed a 123% increase in the average value of CI compared with 3D-CRT.There were no significant statistical changes in HI between the two treatments. Conclusion: Although the IMRT procedure is more effective than 3D-CRT in the dose delivery process, 3D-CRT with mixed photon-electron beams can create dose homogeneity. http://ijrr.com/article-1-6682-en.pdf Nasopharyngeal carcinoma conformal radiotherapy intensity-modulated radiotherapy tumor control probability. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 813 817 article M. Zhang 1 M. Lei 2 F. Lin 3 Y. Chen 4 Y. Xie 5 J. Liu 6 J. Chen 7 H. Wang 8 M. Xiao xmqzhuhai@163.com 9 Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Guizhou Medical University, Grade 2022 Imaging medicine major, Gouzhou City, Gouzhou Province, China Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China Background: This study aims to compare the image quality and effective dose (ED) of deep learning algorithm computer tomography (DLA-CT) with standard CT (SD-CT) in managing ankle trauma. Materials and Methods: In this prospective study, 88 patients underwent random allocation to either the SD-CT group (utilizing a tube voltage of 120KV and an automatic tube current milliampere setting) or the DLA-CT group (employing automatic tube voltage and current adjustments). Senior radiologists assessed objective image quality using parameters such as noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The influence of subjective image quality and its impact on treatment plans were evaluated using a 5-point Likert scale, with scores of 3 or higher indicating acceptable image quality and adherence to treatment plan requirements. Dose length product (DLP) (mGy×cm) was automatically recorded by the scanner software, DLP×k. Results: Objective image quality with DLA-CT was found to be inferior to that obtained with SD-CT (P<0.001). No significant differences were noted in subjective image quality scores between the two groups (P =0.60). Additionally, both subjective image quality scores and the effect of image quality on treatment decisions were scored at 3 or higher. The ED was significantly reduced by 48.83% in the DLA-CT group compared to the SD-CT group (21.42±2.62 µSv and 10.96±1.12 µSv, respectively, P=0.001). Conclusion: DLA-CT proves effective in the management of ankle trauma, significantly reducing ED while meeting clinical diagnostic and treatment standards. http://ijrr.com/article-1-6683-en.pdf Deep learning algorithm ankle fracture computer tomography low radiation dose. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 819 822 article M. Bahador 1 S. Soltani Nejad 2 S. Yazdani yazdani_ph70@yahoo.com 3 Department of Radiation Oncology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran Department of Radiation Oncology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran Department of Medical Physics, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran Background: The aim of this study was to determine the radiation dose to the thyroid and spinal cord using different gantry angles for the supraclavicular field in breast cancer patients. Materials and Methods: Fifty patients treated with opposing tangential fields for chest wall and ipsilateral supraclavicular (SCV) field were enrolled. On the planning computed tomography (CT) scans of patients receiving 50 Gray (Gy) of radiation in daily fractions of 2 Gy, the volumes of the thyroid, spinal cord, and supraclavicular (SCV) nodes were contoured. A comparison of the dosimetric parameters between three different gantry angles (0°, 5°, and 10°) of the SCV field was performed. Moreover, the percentage volumes of absorbed dose by the thyroid at low (V15) and high (V45) doses were compared. The maximum dose to the spinal cord was also compared between the angles. Results: Differences between mean dose (Dmean) of thyroid, spinal cord, V15, and V45 values using different gantry angles were statistically significant (p <0.05). When the gantry angle increased, the Dmean of the thyroid and spinal cord significantly decreased. Conclusions: Gantry angle adjustment can reduce the dose to the thyroid. Therefore, contouring the thyroid as an organ at risk and utilizing an appropriate gantry angle during radiation is beneficial in minimizing the dose received by the thyroid. Nevertheless, the dose distribution of SCV lymph nodes and SCV field should be considered. http://ijrr.com/article-1-6684-en.pdf Breast neoplasms radiotherapy thyroid gland. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 823 827 article A. Mehta 1 P. Kumar rtbareilly@gmail.com 2 S. Navitha 3 N.S. Silambarasan 4 Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Manipal Academy of Higher Education, Manipal, Karnataka, India Department of Radiation Oncology, Shri Ram Murti Institute of Medical Sciences Bareilly, India Department of Radiation Oncology, Shri Ram Murti Institute of Medical Sciences Bareilly, India Department of Radiation Oncology, Shri Ram Murti Institute of Medical Sciences Bareilly, India Background: The elective irradiation of internal mammary nodes (IMN) has not been preferred, attributable to the low incidental doses delivered and the effect of systemic therapies. This study analyzed the incidental dose delivered to IMN using routine planning techniques. Materials and Methods: Twenty post-MRM patients who received adjuvant radiotherapy were selected. The CTV included the chest wall with axillary/supraclavicular lymph nodes if indicated, and a 5mm expansion was taken (PTV-planning). For study purposes, IMRT and 3DCRT plans were generated for each patient. Retrospectively, IMN was delineated, and a margin of 5 mm was taken (PTV-IMN). The dosimetry of the two techniques was compared. Results: An average of 65.03% (SD - 12.45) volume of the PTV-IMN was overlapping with PTV_planning. No significant difference between 3DCRT and IMRT was found in any of the dose parameters of PTV-IMN. The volume of PTV-IMN included inside the PTV_planning had a significant correlation with the mean dose of PTV-IMN for both 3DCRT (r=0.46, p=0.04) and IMRT (r=0.62, p=0.004). A weak positive correlation was observed between the Dmean of PTV-IMN and PTV-planning (r=0.025) and the Dmean of PTV-IMN and heart (r=0.33). The IMRT technique led to improved coverage of PTV-planning, while the heart dose favoured the 3DCRT technique. Conclusion: The treatment technique did not impact the incidental IMN doses. The IMRT led to better coverage of target volume, as reflected by a few of the dose parameters, but this did not impact the IMN doses. http://ijrr.com/article-1-6685-en.pdf Intensity modulated radiotherapy three dimensional conformal radiotherapy internal mammary nodes. eng Dr. Hossein Mozdarani International Journal of Radiation Research 2322-3243 2345-4229 2025-07 23 3 829 831 article H. Hou 1 Q. Huang 2 X. Su 3 G. Zhang 4 M. Zhang zms75@163.com 5 Department of Oncology, the Fifth Hospital of Wuhan, No.122, Xianzheng Street, Wuhan 430050, Hubei, P.R. China Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Wuhan 430030, Hubei, P.R. China Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Wuhan 430030, Hubei, P.R. China Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Wuhan 430030, Hubei, P.R. China Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Wuhan 430030, Hubei, P.R. China Background: Globally, primary liver cancer is a common tumor and patients generally have a poor prognosis. Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. In most cases, the diagnosis of HCC relies on imaging. Case presentation: This study reports on a male patient diagnosed with primary HCC who went into remission after hepatectomy, chemotherapy, and splenic embolization. In the 4th year of follow-up, elevated alpha-fetoprotein was detected (325 ng/mL). However, neither computed tomography (CT) nor magnetic resonance imaging (MRI) revealed significant abnormalities. To clarify the diagnosis, 2-deoxy-2-18F-fluoro-D-glucose integrated positron emission tomography/computed tomography (18F-FDG-PET/CT) was used for initial diagnosis. However, no significant FDG uptake was seen in multiple nodules of the liver. Further examination was performed using 68Ga-fibroblast activation protein inhibitor positron emission tomography/computed tomography (68Ga-FAPI PET/CT), which showed intense FAPI uptake in multiple lesions in the liver, providing direct evidence for the diagnosis of potential HCC recurrence. Finally, the lesions were completely resected and the diagnosis of hepatocellular carcinoma (HCC) was confirmed. Conclusion: Previous studies have shown that 68Ga-FAPI PET/CT is more sensitive than 18F-FDG for the detection of HCC. This study suggests that 68Ga-FAPI PET/CT is a new option for patients with recurrent HCC who are not sensitive to 18F-FDG. http://ijrr.com/article-1-6686-en.pdf HCC recurrence 18-F-FDG PET/CT 68-Ga-FAPI PET/CT case report.