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Monte Carlo calculations of critical organ doses in radioembolization therapy of primary liver tumors via 90Y microspheres 2 2 Background: Dosimetry calculations in radioembolization therapy are known to include some uncertainties due to working assumptions. First, the microspheres used in the procedure are homogeneously distributed within the tumor volume. Second, Medical Internal Radiation Dosimetry (MIRD) method of dose calculation involves a mono-compartmental model only. To minimize the impact of these uncertainties, this study proposes Monte Carlo (MC) simulations as an alternative to MIRD method to verify the absorbed doses in the volumes of interest (tumor and its surroundings).  Material and Methods: Lung, liver, and tumor volumes of 30 radioembolization patients were defined in a mathematical whole-body phantom and MC simulations were performed using Monte Carlo N-Particle code. Absorbed doses were calculated for these tissues both in addition to stomach wall, pancreas, spleen, and kidneys which are close to the tumor volume being treated with microspheres of radioembolization therapy containing the beta-emitting 90Y radioisotope. Results: The doses absorbed by tumor, lung, and liver volumes of each patient were calculated by both MIRD methodology and MC simulations. The differences between the two methods were evaluated for normal lung tissue and tumor tissues in the liver where maximum differences were observed for tumor tissues (16.18%) and lungs (11.69%). Furthermore, it was observed through MC simulations; the organs that are close to the liver being treated were also exposed to the radiation for which absorbed doses could not be calculated by MIRD method. Conclusion: MC simulations may offer significant advantages for dose verification in radioembolization therapy. 353 360 2023/06/6 1402/3/16 2023/06/20 1402/3/30 O.M. Yildirim O.M. Yildirim Department of Bioengineering, Yildiz Technical University, 34220 Istanbul, Turkey A. Bingolbali A. Bingolbali Department of Bioengineering, Yildiz Technical University, 34220 Istanbul, Turkey ab1353@gmail.com A. Bozkurt A. Bozkurt Department of Biomedical Engineering, Akdeniz University, 07058 Antalya, Turkey C. Cafaro C. Cafaro O.M. Yildirim1, A. Bingolbali1,2*, A. Bozkurt3, C. Cafaro4, M.O. Demirkol5 1Department of Bioengineering, Yildiz Technical University, 34220 Istanbul, Turkey 2Department of Physics, University at Albany-SUNY, 12222 Albany, NY, USA 3Department of Biomedical Engineering, Akdeniz University, 07058 Antalya, Turkey 4Department of Mathematics & Physics, SUNY Polytechnic Institute, 12222 Albany, NY, USA 5Department of Nuclear Medicine & Molecular Imaging, Koç University, 34450 Istanbul, Turkey M.O. Demirkol M.O. Demirkol Department of Nuclear Medicine & Molecular Imaging, Koç University, 34450 Istanbul, Turkey Radioembolization 90-Y critical organ doses MIRD Monte Carlo simulations. 1. Kim SP, Cohalan C, Kopek N, Enger SA (2019) A guide to 90Y radioembolization and its dosimetry. Phys Medica, 68: 132-145.##Braat AJAT, Smits MLJ, Braat MNGJA, Manon NGJA, et al. (2015) 90Y Hepatic radioembolization: an update on current practice and recent developments. J Nucl Med, 56(7): 1079-87.##Dezarn WA, Cessna JT, Dewerd LA, Feng W, et al. (2011) Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies. AAPM, 38(8): 4824-45.##Cross WG, Böhm J, Charles M, Piesch E, Seltzer SM (2016) Report 56: Dosimetry of external beta rays for radiation protection. 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68-Ga-labeled NODAGA-RGD-BBN heterodimer peptide as a novel radiotracer for dual integrin and GRPR-targeted tumor imaging 2 2 Background: Due to the excellent physical and biochemical characteristics of 68Ga, 68Ga-1,4,7-triazacy–clononane–glutaric acid– 4,7 acetic acid- arginyl-glycyl-aspartic acid- bombesin (68Ga-NODAGA-RGD-BBN) was prepared as a new positron emission tomography (PET) imaging agent, and afterward, the preclinical evaluation of this labeled peptide was studied. Materials and Methods: 68Ga radioisotope was extracted from a 68Ge/68Ga generator with high radionuclide, chemical and radiochemical purities. Then; the 68Ga-NODAGA-RGD-BBN radiolabeled complex was prepared at optimized conditions. The stability of the complex was evaluated in phosphate-buffered saline (PBS) for at least 2 h. Cell studies of the radiolabeled peptide were also assessed on the gastrin releasing peptide receptor (GRPR)-expressing cell line. Finally; the biodistribution and whole-body scan imaging study of 68Ga-NODAGA-RGD-BBN was studied in normal and tumor-bearing mice. Results: The biodistribution and whole-body scan imaging of the radiolabeled compound on GRPR-expressing tumor-bearing mice demonstrated the high uptake in the tumor site at all post-injection intervals.  The biodistribution results also demonstrated the major excretion route of the complex is the urinary tract. Conclusions: 68Ga-NODAGA-RGD-BBN shows high potential for PET imaging of patients with GRPR-expressing tumors; however, more biological studies are still needed. 361 367 2023/06/62023/06/6 1402/3/16 2023/06/202023/06/20 1402/3/30 N. Amraee N. Amraee Medical Radiation Engineering Department, Science and Research Branch, Islamic Azad University (IAU), Tehran, Iran B. Alirezapour B. Alirezapour Radiation Application Research School, Nuclear Science and Technology Research Institute (NSTRI), Tehran, Iran balirezapour1358@gmail.com M. Hosntalab M. Hosntalab Medical Radiation Engineering Department, Science and Research Branch, Islamic Azad University (IAU), Tehran, Iran A. Hadadi A. Hadadi Medical Radiation Engineering Department, Science and Research Branch, Islamic Azad University (IAU), Tehran, Iran H. Yousefnia H. Yousefnia Radiation Application Research School, Nuclear Science and Technology Research Institute (NSTRI), Tehran, Iran GRPR positive tumors radiolabeling heterodimer peptide PET imaging. Ferlay J, Shin HR, Bray F, Forman D, et al. (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127(12): 2893-917.##Fischer R, Hill RM, Roland F, Diana W (1969) Effects of psychodysleptic drug psilocybin on visual perception: Changes in brightness perference. Experientia, 25: 166-169.##Nagalla SR, Brenda JB, Arnold MF, Bradford W, Gibson JE, Taylor JZ, et al. 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(2011) Comparative study of 64Cu/NOTA-[D-Tyr6, βAla11, Thi13, Nle14] BBN (6-14) monomer and dimer for breast cancer PET Imaging, 1575-1575.##Varasteh Z, Ola A, Irina V, Gunnar L, et al. (2013) In-vitro and in-vivo evaluation of a 18F-labeled high affinity NOTA conjugated bombesin antagonist as a PET ligand for GRPR-targeted tumor imaging. PloS one, 8(12).##Medical Ethics Committee, Scholl of Medical Sciences of the Tarbiat Modares University on 28th Farvardin, 1385 / 18th Rabi al-Awwal, 1427 (2006). General Principles and Guidelines for Care and Use of Experimental Animals.##Liu Z, Gang N, Fan W, Xiaoyuan C (2009) 68Ga-labeled NOTA-RGD-BBN peptide for dual integrin and GRPR-targeted tumor imaging. European journal of nuclear medicine and molecular imaging, 36(9): 1483-1494.## ##

Value of volume-rendering computed tomography for diagnosing different solitary pulmonary nodules and invasion depth in lung adenocarcinoma 2 2 Background: We aimed to analyze the value of volume rendering (VR) in diagnosing different solitary pulmonary nodules (SPNs) with diameter less than 1.0 cm and assessing invasion depth in lung adenocarcinoma. Materials and Methods: In total, 908 patients with SPN that was confirmed by postoperative pathology were included, followed by an analysis of the imaging characteristics (including microvascular sign, vascular convergence, lobulation, and spiculation) of malignant and benign SPN based on VR. Moreover, the detection rates of imaging signs of three types of malignant SPNs (pure ground grass nodule, pGGN; part-solid nodule; and solid nodule) classified by SPN density and three invasion depths of adenocarcinoma (pre-invasion lesion, PIL; micro invasive adenocarcinoma, MIA; and invasive adenocarcinoma, IAC) were also analyzed. Results: The microvascular sign detection rate was higher while vascular convergence and spiculation detection rates were lower in malignant SPN than in benign SPN. The microvascular sign possessed high sensitivity (82%) and specificity (72%) in predicting malignant and benign SPNs. The microvascular sign detection rate decreased while vascular convergence, lobulation, and spiculation detection increased with the rising density of malignant SPN. Furthermore, the detection rates of the four imaging signs all increased with the adenocarcinoma invasion depth. Microvascular sign showed good detecting ability in low density SPNs pGGN (81.8%), part-solid nodules (95.8%), and in all three invasion depths of adenocarcinoma (PIL [68.2%], MIS [95.3%], and IAC [87.2%]). Conclusion: These imaging features distinguished by VR exhibited an excellent differential diagnostic ability of various SPNs as well as invasion depth of lung adenocarcinoma. 369 375 2023/06/62023/06/62023/06/6 1402/3/16 2023/06/202023/06/202023/06/20 1402/3/30 Y. Li Y. Li Department of Respiratory, Ruijin Hospital, Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China J. Liu J. Liu Department of Medicine, Minhang Hospital, Fudan University, Shanghai 201199, China J. Zhou J. Zhou Department of Anesthesiology, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China L. Zhang L. Zhang Department of Critical Care Medicine, Minhang Hospital, Fudan University, Shanghai 201199, China X. Li X. Li Department of Critical Care Medicine, Minhang Hospital, Fudan University, Shanghai 201199, China XXang_L123@126.com Breast cancer radiotherapy lymphocytes chromosomal aberration bioindicator. 1. Smith RA, Andrews KS, Brooks D, et al. (2017) Cancer screening in the United States, 2017: a review of current American Cancer Society guidelines and current issues in cancer screening. CA: A Cancer Journal for Clinicians, 67(2): 100-121.##Wyker A and Henderson WW (2021) Solitary pulmonary nodule, in StatPearls. 2021, StatPearls Publishing: Treasure Island (FL).##Bai C Choi C-M, Chu CM, et al. (2016) Evaluation of pulmonary nodules: clinical practice consensus guidelines for Asia. Chest, 150(4): 877-893.##Wahidi MM, Govert JA, Goudar RK, et al. (2007) Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines. Chest, 132(3): 94S-107S.##Ettinger DS, Aisner DL, Wood DE, et al. (2018) NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 5.2018. 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Characterization of lung nodule malignancy using hybrid shape and appearance features. in International Conference on Medical Image Computing and Computer-Assisted Intervention. 2016. Springer.##Yue X, Liu S, Yang G, Z, et al. (2018) HRCT morphological characteristics distinguishing minimally invasive pulmonary adenocarcinoma from invasive pulmonary adenocarcinoma appearing as subsolid nodules with a diameter of ≤ 3 cm. Clinical Radiology, 73(4): 411. e7-411. e15.##Kim KH, Ryu S-Y, Lee HY, et al. (2019) Evaluating the tumor biology of lung adenocarcinoma: A multimodal analysis. Medicine, 98(29).##Travis WD, Brambilla E, Noguchi M, et al. (2011) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society:International multidisciplinary classification of lung adenocarcinoma: executive summary. 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A retrospective study on pre-operative CT-guided hook-wire localization of pulmonary nodules 2 2 Background: The Background: Currently, surgical resection of the small and sub-centimeter pulmonary nodules (< 2 cm) is quite challenging via the thoracoscopic procedure. Our retrospective study aimed to evaluate the clinical efficiency of pre-operative CT-guided hook-wire localization of targeted pulmonary nodule patients prior to video-assisted thoracoscopic surgery (VATS) or surgery. Materials and Methods: 60 patients comprising pre-operative computed tomography (CT)-guided hook-wire localization of pulmonary nodules with < 2 cm diameter were retrospectively enrolled. Herein, we evaluated clinical variables, pathological outcomes, hook-wire localization procedure-related features, and complications from targeted pulmonary nodules patients. Results: Pre-operative CT-guided hook-wire localization was carried out successfully in 60 (100%) patients with wedge resection 41 (68%), segmentectomy 10 (16.7%), and lobectomy 9 (15%). Hook-wire localization procedure had mean time of 0.91±0.29 h, and 11 (18.3%) blood loss. All pulmonary nodule patients were positive pathological diagnoses for benign or malignant lesions, such as 5 (8.3%) benign lesions, 29 (48.3%) minimal adenocarcinoma (MIA) or invasive adenocarcinoma (IAC), and 21 (33.3%) adenocarcinoma in situ (AIS) malignant lesions. The majority of patients with hook-wire localization were either asymptomatic 19 (31.7%) or shown to have mild pain 25 (41.7%) and irritable cough 7 (11.7%). Conclusion: Preoperative CT-guided hook-wire localization of pulmonary nodules is safe and effective, which can reduce the operative time of targeted pulmonary nodules, and improvise the safety and outcomes of surgery. 377 382 2023/06/62023/06/62023/06/62023/06/10 1402/3/20 2023/06/202023/06/202023/06/202023/06/20 1402/3/30 Z. Xu Z. Xu Department of Thoracic Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an223300, China Y. Ni Y. Ni Department of Thoracic Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an223300, China B. Gu B. Gu Department of Thoracic Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an223300, China H. Zhou H. Zhou Department of Thoracic Surgery, Guanyun People’s Hospital, Guanyun222299, China Y. Luo Y. Luo Department of Thoracic Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an223300, China N. Li N. Li Department of Sanatorium 1, Air Force Health Care Center for Special Service Hangzhou Sanatorium 5, Hangzhou310002, China S. Chen S. Chen Department of Thoracic Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an223300, China chenshengnj@outlook.com Pulmonary nodules computed tomography thoracoscopy. Swensen SJ, Jett JR, Hartman TE, et al. (2005) CT screening for lung cancer: five-year prospective experience. Radiology, 235(1): 259-65.##Hsu HH, Shen CH, Tsai WC, et al. (2015) Localization of nonpalpable pulmonary nodules using CT-guided needle puncture. World J Surg Oncol, 13: 248.##Rivera MP, Mehta AC, Wahidi MM (2013) Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 143(5): e142S-e165S.##Bernard A (1996) Resection of pulmonary nodules using video-assisted thoracic surgery. The Thorax Group. 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(2011) Video-assisted thoracoscopic solitary pulmonary nodule resection after CT-guided hookwire localization: 43 cases report and literature review. Surg Endosc, 25(6):1723-9.##Zhou JH, Li WT, Chen HQ, et al. (2009) CT-guided hookwire localization of small solitary pulmonary nodules in video-assisted thoracoscopic surgery. Zhonghua Zhong Liu Za Zhi, 31(7): 546-9.##Ichinose J, Kohno T, Fujimori S, et al. (2013) Efficacy and complications of computed tomography-guided hook wire localization. Ann Thorac Surg, 296(4): 1203-1208.##Suzuki K, Nagai K, Yoshida J, et al. (1999) Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest, 115(2): 563-8.##Kondo R, Yoshida K, Hamanaka K, et al. (2009) Intraoperative ultrasonographic localization of pulmonary ground-glass opacities. 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Machine learning-based radiomics for preoperative prediction of microvascular invasion in hepatocellular carcinoma 2 2 Background: Background: To evaluate the diagnostic performance of different radiomics models for preoperatively predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Materials and Methods: A total of 124 patients who had histologically confirmed HCC (training dataset: n=86; validation dataset: n=38) were included. Clinical factors (CFs) were extracted from medical data. Radiomics features were derived from the unenhanced phase, artery phase (AP), portal venous phase and delay phase CT images. The least absolute shrinkage and selection operator (LASSO) method was chosen to select the radiomics feature. Twelve models were established using three modeling methods (logistic regression [LR], support vector machine [SVM], and Bayes) with the radiomics signature. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the models. A radiomics signature that performs well was integrated with the clinical factors into a combined model. Results: AP radiomics signatures achieved the best efficiency than other radiomics models. The LR model with the AP radiomics signature as the input factor showed better performance than the SVM and Bayes models, with an area under the curve (AUC) of 0.848 in the validation datasets. When integrating the AP radiomics signatures and clinical factors, the combined model performed better and reached an AUC of 0.875 in the validation datasets. Conclusions: The radiomics model demonstrated excellent performance for preoperatively predicting MVI in patients with HCC, especially the combined model. Different modeling methods could influence the effects of the diagnostic performance. 383 390 2023/06/62023/06/62023/06/62023/06/102023/06/13 1402/3/23 2023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 L. Xiong L. Xiong Department of Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China Y. Peng Y. Peng Department of Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China Sh. Li Sh. Li Department of Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China X. Tang X. Tang Department of Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China J. Zhou J. Zhou Department of Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China L. Gong L. Gong Department of Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China gong111999@126.com Microvascular invasion radiomics hepatocellular carcinoma machine learning. 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin, 71: 209-49.##Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. (2019) Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 394: 1145-58.##Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. (2019) Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. International Journal of Cancer, 144: 1941-53.##Xie DY, Ren ZG, Zhou J, Fan J, Gao Q (2020) 2019 Chinese clinical guidelines for the management of hepatocellular carcinoma: updates and insights. Hepatobiliary Surg Nutr, 9: 452- 63.##Vitale A, Trevisani F, Farinati F, Cillo U (2020) Treatment of hepatocellular carcinoma in the precision medicine era: From treatment stage migration to therapeutic hierarchy. Hepatology, 72: 2206-18.##European Association for the Study of the Liver, European Organization for Research and Treatment of Cancer (2012) EASL-EORTC clinical practice guidelines: Management of hepatocellular carcinoma. European Journal of Cancer, 56: 908- 43.##Kulik L and El-Serag HB (2019) Epidemiology and management of hepatocellular carcinoma. Gastroenterology, 156: 477-91.e1.##Malloy PC (2019) Combination therapy in intermediate-stage hepatocellular carcinoma: Do we need to know about microvascular invasion? Radiology, 292: 248-9.##Zheng J, Seier K, Gonen M, Balachandran VP, Kingham TP, D'Angelica MI, et al. (2017) Utility of Serum Inflammatory Markers for Predicting Microvascular Invasion and Survival for Patients with Hepatocellular Carcinoma. Ann Surg Oncol, 24: 3706-14.##Zhang XP, Wang K, Wei XB, Li LQ, Sun HC, Wen TF, et al. (2019) An Eastern hepatobiliary surgery hospital microvascular invasion scoring system in predicting prognosis of patients with hepatocellular carcinoma and microvascular invasion after R0 liver resection: A large-scale, multicenter study. Oncologist, 24: e1476-88.##Wei Y, Huang Z, Tang H, Deng L, Yuan Y, Li J, et al. (2019) IVIM improves preoperative assessment of microvascular invasion in HCC. European Radiology, 29: 5403-14.##Lambin P, Leijenaar RTH, Deist TM, Peerlings J, de Jong EEC, van Timmeren J, et al. (2017) Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol, 14: 749-62.##Gillies RJ, Kinahan PE, Hricak H (2016) Radiomics: Images are more than pictures; They are data. Radiology, 278: 563-77.##Liu Z, Wang S, Dong D, Wei J, Fang C, Zhou X, et al. (2019) The Applications of radiomics in precision diagnosis and treatment of oncology: Opportunities and challenges. Theranostics, 9: 1303-22.##Bakr S, Echegaray S, Shah R, Kamaya A, Louie J, Napel S, et al. (2017) Noninvasive radiomics signature based on quantitative analysis of computed tomography images as a surrogate for microvascular invasion in hepatocellular carcinoma: a pilot study. J Med Imaging, 4: 041303.##He M, Zhang P, Ma X, He B, Fang C, Jia F (2020) Radiomic feature-based predictive model for microvascular invasion in patients with hepatocellular carcinoma. Front Oncol, 10: 574228.##Verma V, Simone CB 2nd, Krishnan S, Lin SH, Yang J, Hahn SM (2017) The rise of radiomics and implications for oncologic management. J Natl Cancer Inst, 109: page numbers??##Ma X, Wei J, Gu D, Zhu Y, Feng B, Liang M, Wang S, Zhao X, Tian J (2019) Preoperative radiomics nomogram for microvascular invasion prediction in hepatocellular carcinoma using contrast-enhanced CT. Eur Radiol, 29: 3595-3605.##Feng ST, Jia Y, Liao B, Huang B, Zhou Q, Li X, et al. (2019) Preoperative prediction of microvascular invasion in hepatocellular cancer: a radiomics model using Gd-EOB-DTPA-enhanced MRI. Eur Radiol, 29: 4648-59.##Choi JY, Lee JM, Sirlin CB (2014) CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part II. Extracellular agents, hepatobiliary agents, and ancillary imaging features. Radiology, 273: 30-50.##Thompson SM, Wells ML, Andrews JC, Ehman EC, Menias CO, Hallemeier CL, et al. 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Bystander Effect of Sonodynamic Therapy in the presence of Gold Nanoparticles: An in-vitro study 2 2 Background: Bystander (B.s) effect can influence non-irradiated cells and affect the desired effect in cancer treatment. This study was conducted to assess this effect on simultaneous administration of ultrasound (US) and Gold nanoparticles as a sonodynamic therapy (SDT) which is an important newly stimuli-responsive method in cancer treatment. Materials and Methods: Firstly, the appropriate concentration of Gold nanoparticles (GNPs) and US intensity for SDT on melanoma cancer cells (A375) were evaluated. After treatments, the target cell culture was transferred to the bystander cells and the induced bystander effects including cell viability, apoptosis, expression of P53 (a promoter of apoptosis gene) and HO-1 (an inhibitor of apoptosis gene) were examined. Results: According to the MTT results, 50 µg/ml concentration of GNPs and 1.5 W/cm2 intensity of US wave were selected. Our results revealed that SDT induced B.s effect can alter the cell viability and apoptosis up to 20% and 51.61%, respectively. Moreover, a 2.9-fold increase in p53 gene expression and a decrease in OH-1 gene expression to 0.181-fold in comparison to the control groups were observed. Conclusions: These results confirmed that B.s effect of sonodynamic can reduce the cancerous cell viability. Our finding showed that this treatment can potentially be an alternative to traditional treatment modalities. 391 398 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/14 1402/3/24 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 A. Shanei A. Shanei Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran R. Kamran Samani R. Kamran Samani Department of Medical Physics and Radiology, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran H. Akbari-Zadeh H. Akbari-Zadeh Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran M. Rezaei M. Rezaei Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran masumrezaei@yahoo.com M. Kazemi M. Kazemi Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Bystander effect sonodynamic therapy gold nanoparticles apoptosis p53 & HO-1 genes. Miller KD, Siegel RL, Lin CC, et al. (2016) Cancer treatment and survivorship statistics. CA Cancer J Clin, 66: 271-89.##Xu M, Zhou L, Zheng L, et al. (2021) Sonodynamic therapy-derived multimodal synergistic cancer therapy. Cancer Lett, 497: 229-42.##Shanei A and Akbari-Zadeh H (2019) Investigating the Sonodynamic-Radiosensitivity Effect of Gold Nanoparticles on HeLa Cervical Cancer Cells. J Korean Med Sci, 34: 1-12.##Ebrahiminia A, Mokhtari-dizaji M, Toliyat T (2013) Ultrasonics Sonochemistry Correlation between iodide dosimetry and terephthalic acid dosimetry to evaluate the reactive radical production due to the acoustic cavitation activity. Ultrason Sonochemistry, 20: 366-72.##Pan X, Bai L, Wang H, et al. (2018) Metal-organic‐framework‐derived carbon nanostructure augmented sonodynamic cancer therapy. Adv Mater, 30: 1800180.##https://doi.org/10.1002/adma.201870163##Samadian H, Hosseini-Nami S, Kamrava SK, et al. (2016) Folate-conjugated gold nanoparticle as a new nanoplatform for targeted cancer therapy. J Cancer Res Clin Oncol, 142: 2217-29.##Mehrabi M, Esmaeilpour P, Akbarzadeh A, et al. (2016) Efficacy of pegylated liposomal etoposide nanoparticles on breast cancer cell lines. Turkish J Med Sci, 46: 567-71.##Kosheleva OK, Lai T-C, Chen NG, et al. (2016) Selective killing of cancer cells by nanoparticle-assisted ultrasound. J Nanobiotechnology, 14: 46.##Xu T, Zhao S, Lin C, et al. (2020) Recent advances in nanomaterials for sonodynamic therapy. Nano Res, 13: 2898-908.##Heeran AB, Berrigan HP, O'Sullivan J (2019) The radiation-induced bystander effect (RIBE) and its connections with the hallmarks of cancer. Radiat Res, 192: 668-79.##Mukherjee S and Chakraborty A (2019) Radiation-induced bystander phenomenon: insight and implications in radiotherapy. Int J Radiat Biol, 95: 243-63.##Wang H, Yu KN, Hou J, et al. (2015) Radiation-induced bystander effect: early process and rapid assessment. Cancer Lett, 356: 137-44.##Bilak A, Uyetake L, Su TT. (2014) Dying cells protect survivors from radiation-induced cell death in Drosophila. PLoS Genet, 10: e1004220.##Widel M, Lalik A, Krzywon A, et al. (2015) The different radiation response and radiation-induced bystander effects in colorectal carcinoma cells differing in p53 status. Mutat Res Mol Mech Mutagen, 778: 61-70.##Rezaei M, Kamran Samani R, Kazemi M, et al. (2021) Induction of a bystander effect after therapeutic ultrasound exposure in human melanoma: In-vitro assay. Int J Radiat Res, 19: 183-9.##Marín A, Martín M, Liñán O, et al. (2015) Bystander effects and radiotherapy. Reports Pract Oncol Radiother, 20: 12-21.##Bazak J, Korytowski W, Girotti AW (2019) Bystander effects of nitric oxide in cellular models of anti-tumor photodynamic therapy. Cancers, 11: 1674.##Verma N and Tiku AB (2017) Significance and nature of bystander responses induced by various agents. Mutat Res, 773: 104-21.##Calatayud M, Asin L, Tres A, et al. (2015) Cell bystander effect induced by radiofrequency electromagnetic fields and magnetic nanoparticles. Curr Nanosci, 12: 372-7.##Daguenet E, Louati S, Wozny A-S, et al. (2020) Radiation-induced bystander and abscopal effects: Important lessons from preclinical models. Br J Cancer, 123: 339-48.##Shanei A, Akbari-Zadeh H, Fakhimikabir H, et al. (2018) Evaluation of the therapeutic effect of 6-MV X-ray radiation on HeLa cells, in the presence of nanoparticles. J Isfahan Med Sch, 36: 25-43.##Shanei A, Akbari-Zadeh H, Fakhimikabir H, et al. (2019) The role of gold nanoparticles in sonosensitization of human cervical carcinoma cell line under ultrasound irradiation: An in vitro study. J Nano Res, 59: 1-14.##Sengupta S and Balla VK (2018) A review on the use of magnetic fields and ultrasound for non-invasive cancer treatment. J Adv Res, 14: 97-111.##Kooiman K, Roovers S, Langeveld SAG, et al. (2020) Ultrasound-responsive cavitation nuclei for therapy and drug delivery. Ultrasound Med Biol, 46: 1296-325.##Shanei A, Akbari-Zadeh H, Attaran N, et al. (2019) Effect of targeted gold nanoparticles size on acoustic cavitation: An in vitro study on melanoma cells. Ultrasonics, 102: 106-120.##Kosheleva OK, Lai P, Chen NG, et al. (2015) Nanoparticle-assisted ultrasound for cancer therapy. Patent No. 9,138,476.##Brazzale C, Canaparo R, Racca L, et al. (2016) Enhanced selective sonosensitizing efficacy of ultrasound-based anticancer treatment by targeted gold nanoparticles. Nanomedicine, 11: 3053-70.##Rostami A, Toossi MTB, Sazgarnia A, et al. (2016) The effect of glucose-coated gold nanoparticles on radiation bystander effect induced in MCF-7 and QUDB cell lines. Radiat Environ Biophys, 55: 461-6.##He L-L, Wang X, Wu X-X, et al. (2015) Protein damage and reactive oxygen species generation induced by the synergistic effects of ultrasound and methylene blue. Spectrochim Acta Part A Mol Biomol Spectrosc, 134: 361-6.##Yahyapour R, Motevaseli E, Rezaeyan A, et al. (2018) Mechanisms of radiation bystander and non-targeted effects: implications to radiation carcinogenesis and radiotherapy. Curr Radiopharm, 11: 34-45.##Ma Y, Zhang L, Rong S, et al. (2013) Relation between gastric cancer and protein oxidation, DNA damage, and lipid peroxidation. 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Effect of multi-dimensional nursing combined with early postoperative activity on the prognosis of patients undergoing laparoscopic radical gastrectomy for gastric cancer 2 2 Background: To explore the impact of the combined application of multidimensional nursing and early postoperative activities on gastric cancer (GC) patients underwent laparoscopic radical gastrectomy (LRG). Materials and Methods: 156 GC patients who underwent LRG between January 2020 and December 2021 in our hospital were selected and separated into the observation group (OG) as well as the control group (CG) following the different nursing methods adopted by the patients. The CG carried out conventional nursing, while the OG adopted multidimensional nursing and early postoperative activity intervention. The pain degree, self-living ability, patient’s anxiety and depression, postoperative recovery, nursing satisfaction and adverse reactions of patients in both groups were compared. Results: After nursing intervention, pain score and anxiety and depression scores of the OG were declined relative to the CG (P<0.05), the recovery time of bowel sounds, first anal exhaust time, first feeding time, first anal defecation time as well as hospitalization time in the OG were lessened relative to the CG (P<0.05), the self-living ability score and nursing satisfaction of patients of the OG were promoted relative to the CG (P<0.05), the occurrence of adverse reaction in the OG was lower relative to the CG (P<0.05). Conclusion: Multidimensional nursing combined with early activities applied to GC patients undergoing LRG could effectively reduce postoperative pain, promote postoperative gastrointestinal function recovery and promote the self-living ability. 399 403 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/18 1402/3/28 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 C.J. Peng C.J. Peng Department of Gastrointestinal Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China T. Chen T. Chen Department of Gastrointestinal Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China CT19802008@163.com Gastric cancer laparoscope multi-dimensional nursing early activities. Teatini A, Pelanis E, Aghayan DL, et al. (2019) The effect of intraoperative imaging on surgical navigation for laparoscopic liver resection surgery. Sci Rep, 9(1): 18687.##Fretland Å A, Kazaryan AM, Bjørnbeth BA, et al. (2015) Open versus laparoscopic liver resection for colorectal liver metastases (the Oslo-CoMet Study): study protocol for a randomized controlled trial. Trials, 16: 73.##Correa P (2013) Gastric cancer: overview. Gastroenterol Clin North Am, 42(2): 211-7.##Candy B, Jones L, Vickerstaff V, et al. (2018) Mu-opioid antagonists for opioid-induced bowel dysfunction in people with cancer and people receiving palliative care. Cochrane Database Syst Rev, 6(6): Cd006332.##Ahmedzai SH, Nauck F, Bar-Sela G, et al. (2012) A randomized, double-blind, active-controlled, double-dummy, parallel-group study to determine the safety and efficacy of oxycodone/naloxone prolonged-release tablets in patients with moderate/severe, chronic cancer pain. Palliat Med, 26(1): 50-60.##Sheng S, Zhao T, Wang X (2018) Comparison of robot-assisted surgery, laparoscopic-assisted surgery, and open surgery for the treatment of colorectal cancer: A network meta-analysis. Medicine (Baltimore), 97(34): e11817.##Bull J, Wellman CV, Israel RJ, et al. (2015) Fixed-dose subcutaneous methylnaltrexone in patients with advanced illness and opioid-induced constipation: Results of a randomized, placebo-controlled study and open-label extension. J Palliat Med, 18(7): 593-600.##Dupoiron D, Stachowiak A, Loewenstein O, et al. (2017) A phase III randomized controlled study on the efficacy and improved bowel function of prolonged-release (PR) oxycodone-naloxone (up to 160/80 mg daily) vs oxycodone PR. Eur J Pain, 21(9): 1528-37.##Katakami N, Oda K, Tauchi K, et al. (2017) Phase IIb, Randomized, Double-Blind, Placebo-Controlled Study of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients With Cancer. J Clin Oncol, 35(17): 1921-8.##Portenoy RK, Thomas J, Moehl Boatwright ML, et al. (2008) Subcutaneous methylnaltrexone for the treatment of opioid-induced constipation in patients with advanced illness: a double-blind, randomized, parallel group, dose-ranging study. J Pain Symptom Manage, 35(5): 458-68.##Slatkin N, Thomas J, Lipman AG, et al. (2009) Methylnaltrexone for treatment of opioid-induced constipation in advanced illness patients. J Support Oncol, 7(1): 39-46.##Chamberlain BH, Cross K, Winston JL, et al. (2009) Methylnaltrexone treatment of opioid-induced constipation in patients with advanced illness. J Pain Symptom Manage, 38(5): 683-90.##La Sala R, Foà C, Paoli G, et al. (2015) Multi-dimensional nursing form: a novel means of approaching nurse-led secondary cardiology prevention. Acta Biomed, 86(3): 174-82.##Coronado RA, Master H, White DK, et al. (2020) Early postoperative physical activity and function: a descriptive case series study of 53 patients after lumbar spine surgery. BMC Musculoskelet Disord, 21(1): 783.##Thomas J, Karver S, Cooney GA, et al. (2008) Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med, 358(22): 2332-43.##Yin M, Li J, Wang J, et al. (2022) Observation of the effect of focused psychological intervention combined with standardized pain nursing on postoperative pain levels and depression and anxiety in patients with intestinal obstruction. Dis Markers, 2022: 2467887.##Poelaert J, Koopmans-Klein G, Dioh A, et al. (2015) Treatment with prolonged-release oxycodone/naloxone improves pain relief and opioid-induced constipation compared with prolonged-release oxycodone in patients with chronic severe pain and laxative-refractory constipation. Clin Ther, 37(4): 784-92.##Qiu J and Wang Y (2022) Effect of accelerated rehabilitation combined with enteral nutrition on gastrointestinal function recovery after hepatectomy. Support Care Cancer, 30(11): 8927-33.##Liu J, Zhang G, Xie X, et al. (2022) Effect of comprehensive nursing on quality of life of patients with cholecystolithiasis after laparoscopic surgery. Minerva Surg, 77(1): 84-6.## ##

Meta-analysis of the clinical effectiveness of abdominal aortic balloon occlusion for pelvic tumor treatment under color doppler ultrasound 2 2 Background: This paper aimed to assess the clinical effects of abdominal aortic balloon occlusion (AABO) under color Doppler ultrasound guidance in treating pelvic tumors. Materials and Methods: Various databases, which contained China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Literature Database, PubMed, Excerpta Medica Database (Embase), and Cochrane Library, were used for searching randomized controlled studies published from 2010 to present. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS). Outcome measurements included intraoperative blood loss, transfusion volume, operative time, hospital stay, recurrence, and postoperative complications. Results: Six reference articles were obtained, including 223 patients who underwent AABO and 300 patients who did not. The NOS score was greater than 7 points in both groups. Meta-analysis showed that the intraoperative blood loss, transfusion volume, and surgery duration of patients undergoing pelvic tumor resection with AABO were all reduced (95% confidence interval (CI): -1504.53~-762.10, P<0.00001; 95% CI: -902.22~-575.45, P<0.00001; 95% CI: -80.20~-26.54, P<0.0001). No difference was discovered in the occurrence of postoperative complications, including nerve injury (95% CI: 0.30~1.34, P=0.23) and urethral injury (95% CI: 0.19~1.97, P=0.41) between both groups. The incidence of wound infection was relatively low (95% CI: 0.22~0.81, P=0.010). Additionally, no difference was discovered in hospital stay (95% CI: -6.85~0.79, P=0.12) and recurrence (95% CI: 0.45~1.53, P=0.12) between both groups (P>0.05). Conclusion: AABO under color Doppler ultrasound guidance can reduce intraoperative blood loss, transfusion volume, and operative time during pelvic tumor resection and can also reduce the incidence of some postoperative complications. 405 411 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/18 1402/3/28 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 Z. Zhang Z. Zhang Department of Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P. R. China D. Wang D. Wang Department of Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P. R. China X. Zhang X. Zhang Department of Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P. R. China J. Feng J. Feng Department of Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P. R. China Q. Feng Q. Feng Department of Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P. R. China qi20150601@163.com color Doppler ultrasound abdominal aortic balloon occlusion pelvic tumor meta-analysis. 1. McMahon CJ, Rofsky NM, Pedrosa I (2010) Lymphatic metastases from pelvic tumors: anatomic classification, characterization, and staging. Radiology, 254(1): 31-46.##Wang KM, Rickards AJ, Bingham T, et al. (2022) Technical note: Evaluation of a silicone-based custom bolus for radiation therapy of a superficial pelvic tumor. J Appl Clin Med Phys, 23(4): e13538.##Ito Y, Nakayama H, Niitsu Y, et al. (2022) The first case of Veillonella atypica bacteremia in a patient with renal pelvic tumor. Anaerobe, 73: 102491.##Zoccali C, Baldi J, Attala D, et al. (2021) 3D-Printed Titanium Custom-Made Prostheses in Reconstruction after Pelvic Tumor Resection: Indications and results in a series of 14 patients at 42 months of average follow-up. J Clin Med, 10(16).##Stravitz RT, Ellerbe C, Durkalski V, et al. (2018) Bleeding complications in acute liver failure. Hepatology, 67(5): 1931-42.##Luo Y, Duan H, Min L, et al. (2014) Clinical evaluation of lower abdominal aorta balloon occlusion in pelvic or sacral tumor resection. West China Medical Journal.##Luo Y, Duan H, Liu W, et al. (2013) Clinical evaluation for lower abdominal aorta balloon occluding in the pelvic and sacral tumor resection. J Surg Oncol, 108(3): 148-51.##Xiong YQ, Song HB, Tu CQ, et al. (2012) Appling the color doppler in abdominal aortic balloon occlusion for pelvic and sacral surgery. Sichuan Da Xue Xue Bao Yi Xue Ban, 43(5):715-9.##Zhang Y, Guo W, Tang X, et al. (2018) Can aortic balloon occlusion reduce blood loss during resection of sacral tumors that extend into the lower lumber spine? Clin Orthop Relat Res, 476(3): 490-8.##Ratto N, Boffano M, Pellegrino P, et al. (2020) The intraoperative use of aortic balloon occlusion technique for sacral and pelvic tumor resections: A case-control study. Surg Oncol, 32: 69-74.##Tang X, Guo W, Yang R, et al. (2010) Use of aortic balloon occlusion to decrease blood loss during sacral tumor resection. J Bone Joint Surg Am, 92(8): 1747-53.##Wei L, Xiang Y, Zhuang J, et al. (2018) Application of abdominal aorta blockade in pelvic sacral tumor resection and reconstruction. Chinese Journal of Bone and Joint Surgery.##Iscan HZ, Unal EU, Akkaya B, et al. (2021) Color doppler ultrasound for surveillance following EVAR as the primary tool. J Card Surg, 36(1): 111-7.##Wang Y, Huang G, Jiang T, et al. (2019) Application of abdominal aortic balloon occlusion followed by uterine artery embolization for the treatment of pernicious placenta previa complicated with placenta accreta during cesarean section. J Interv Med, 2(3): 113-7.##Kong L, Yu Y, Li F, et al. (2020) Intra-aortic balloon occlusion decreases blood loss during open reduction and internal fixation for delayed acetabular fractures: A retrospective study of 43 patients. J Invest Surg, 33(5): 468-73.##Saraçoğlu A, Ezelsoy M, Saraçoğlu KT (2019) Does Transfusion of Blood and Blood Products Increase the Length of Stay in Hospital? Indian J Hematol Blood Transfus, 35(2): 313-20.##Morrissey PE, Gordon F, Shaffer D, et al. (1998) Combined liver-kidney transplantation in patients with cirrhosis and renal failure: effect of a positive cross-match and benefits of combined transplantation. Liver Transpl Surg, 4(5): 363-9.##Xing X, Zhong G, Xiang-Yang B, et al. (2013) Liver resection for the treatment of the patients with giant hepatic tumor without intraoperative blood transfusion. Journal of General Surgery for Clinicians(Electronic Version).##Liu Y, Shan N, Yuan Y, et al. (2022) The clinical evaluation of preoperative abdominal aortic balloon occlusion for patients with placenta increta or percreta. J Matern Fetal Neonatal Med, 35(25): 6084-9.##Wang YL, Su FM, Zhang HY, et al. (2017) Aortic balloon occlusion for controlling intraoperative hemorrhage in patients with placenta previa increta/percreta. J Matern Fetal Neonatal Med, 30(21): 2564-8.##Yin H and Hu R (2022) Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis. BMC Pregnancy Childbirth, 22(1): 502.## ##

Effects of high-resolution measurements between different multi-row detectors on volumetric modulated arc therapy patient-specific quality assurance  2 2 Background: This study aimed to evaluate the optimal criteria and conditions in which single-measurement (SM) and high-resolution measurement (HM) provide a similar evaluation accuracy for ArcCHECK (AC) and Octavius (OT) detectors. Materials and Methods: In the SM and HM for AC and OT, we evaluated γ-analysis pass-rate differences for various conditions (criteria, calculation grid size, and shift of the isocenter) of 20 patients who received volumetric modulated arc therapy. All results of the γ-analysis pass rate were analyzed using the Anderson–Darling normality test. Results: In the AC detector, an SM with a 1%/1 mm criterion, 1.25 mm calculation grid size, and two standard deviations (2SD) of tolerance showed an evaluation accuracy similar to that of an HM. In the OT detector, an SM with a 2%/2 mm criterion, 2.0 mm calculation grid, and 2SD of tolerance had an evaluation accuracy similar to that of an HM. The γ-pass-rate data of the OT detector for the 3%/3 mm criterion did not follow a normal distribution in both SM and HM. Conclusions: Most high γ-analysis pass rates achieved using inadequate criteria may not detect errors; therefore, accurate evaluation is necessary for optimizing the criteria settings of individual QA devices based on the characteristics and the uncertainties of array detectors. The characteristics of a detector array can be enhanced by evaluating the relationship between SM and HM, which reduces the workload of patient-specific QA.  413 419 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/18 1402/3/28 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 Y. Kunii Y. Kunii Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan Y. Tanabe Y. Tanabe Faculty of Medicine, Graduate School of Health Sciences, Okayama University, Shikata, Kita, Okayama, Japan tanabey@okayama-u.ac.jp A. Higashi A. Higashi Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan A. Nakamoto A. Nakamoto Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan K. Nishioka K. Nishioka Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan Patient-specific QA volumetric modulated arc therapy single measurement high-resolution measurement radiation treatment planning system. 1. Ezzell GA, Galvin JM, Low D, et al. (2003) Guidance document on delivery, treatment planning, and clinical implementation of IMRT: report of the IMRT Subcommittee of the AAPM Radiation Therapy Committee. Med Phys, 30(8): 2089-2115.##Zhang P, Happersett L, Hunt M, et al. (2010) Volumetric modulated arc therapy: planning and evaluation for prostate cancer cases. Int J Radiat Oncol Biol Phys, 76(5): 1456-1462.##Du W, Cho SH, Zhang X, et al. (2014) Quantification of beam complexity in intensity-modulated radiation therapy treatment plans. Med Phys, 41(2): 021716.##Park JM, Park SY, Kim H (2015) Modulation index for VMAT considering both mechanical and dose calculation uncertainties. Phys Med Biol, 60(18): 7101-7125.##Fredh A, Scherman JB, Fog LS, Munck af Rosenschöld P (2013) Patient QA systems for rotational radiation therapy: a comparative experimental study with intentional errors. Med Phys, 40(3): 031716.##Otto K (2008) Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys, 35(1): 310-317.##Yassin A, Elshahat KM, Attlah EM, et al. (2021) Dose verification and plan conformity with three different dosimeters for intensity-modulated radiation therapy plans. Int J Radiat Res, 19(3): 703-710.##Hussein M, Adams EJ, Jordan TJ, et al. (2013) A critical evaluation of the PTW 2D-ARRAY seven29 and OCTAVIUS II phantom for IMRT and VMAT verification. J Appl Clin Med Phys, 14(6): 274-292.##Feygelman V, Zhang G, Stevens C, Nelms BE (2011) Evaluation of a new VMAT QA device, or the "X" and "O" array geometries. J Appl Clin Med Phys, 12(2): 3346.##Masi L, Casamassima F, Doro R, Francescon P (2011) Quality assurance of volumetric modulated arc therapy: evaluation and comparison of different dosimetric systems. Med Phys, 38(2): 612-621.##Stelljes TS, Harmeyer A, Reuter J, Looe HK, Chofor N (2015) Dosimetric characteristics of the novel 2D ionization chamber array OCTAVIUS Detector 1500. Med Phys, 42(4): 1528-1537.##Sun Nuclear Corporation (n.d.) ArcCHECK reference guide. Sun Nuclear Corp., Melbourne, FL, USA.##Kinsella P, Shields L, McCavana P, McClean B, Langan B (2016) Determination of MLC model parameters for Monaco using commercial diode arrays. J Appl Clin Med Phys, 17(4): 37-47.##Pan Y, Yang R, Zhang S, et al. (2019) National survey of patient specific IMRT quality assurance in China. Radiat Oncol, 14(1): 69.##Miften M, Olch A, Mihailidis D, et al. (2018) Tolerance limits and methodologies for IMRT measurement-based verification QA: recommendations of AAPM Task Group No. 218. Med Phys, 45(4): e53-e83.##Low DA, Harms WB, Mutic S, Purdy JA (1998) A technique for the quantitative evaluation of dose distributions. Med Phys, 25(5): 656-661.##Park JM, Kim JI, Park SY, et al. (2018) Reliability of the gamma index analysis as a verification method of volumetric modulated arc therapy plans. Radiat Oncol, 13(1): 175.##Poppe B, Blechschmidt A, Djouguela A, et al. (2006) Two-dimensional ionization chamber arrays for IMRT plan verification. Med Phys, 33(4): 1005-1015.##Heilemann G, Poppe B, Laub W (2013) On the sensitivity of common gamma index evaluation methods to MLC misalignments in Rapidarc quality assurance. Med Phys, 40(3): 031702.##Mu G, Ludlum E, Xia P (2008) Impact of MLC leaf position errors on simple and complex IMRT plans for head and neck cancer. Phys Med Biol, 53(1): 77-88.##Chun M, Kim JI, Oh DH, et al. (2020) Effect of dose grid resolution on the results of patientspecific quality assurance for intensity-modulated radiation therapy and volumetric modulated arc therapy. Int J Radiat Res, 18(3): 521-530.##Yasui K, Saito Y, Ogawa S, Hayashi N (2021) Dosimetric characterization of a new two-dimensional diode detector array used for stereotactic radiosurgery quality assurance. Int J Radiat Res, 19(2): 281-289.##Kim JI, Choi CH, Wu HG, et al. (2016) Correlation analysis between 2D and quasi-3D gamma evaluations for both intensity-modulated radiation therapy and volumetric modulated arc therapy. Oncotarget, 8(3): 5449-5459.##Persoon LCGG, Podesta M, van Elmpt WJC, et al. (2011) A fast three-dimensional gamma evaluation using a GPU utilizing texture memory for on-the-fly interpolations. Med Phys, 38(7): 4032-4035.##Kunii Y, Tanabe Y, Nakamoto A, Nishioka K (2022) Statistical analysis of correlation of gamma passing results for two quality assurance phantoms used for patient-specific quality assurance in volumetric modulated arc radiotherapy. Med Dosim, 47(4): 329-333.##Esmaili G, Mahdavi SR, Nikoofar AR, et al. (2018) Dosimetric verification of pre-treatment intensity modulated radiation therapy in the commissioning process. Int J Radiat Res, 16(4): 493-497.##Neilson C, Klein M, Barnett R, Yartsev S (2013) Delivery quality assurance with ArcCHECK. Med Dosim, 38(1): 77-80.##Nelms BE, Zhen H, Tomé WA (2011) Per‐beam, planar IMRT QA passing rates do not predict clinically relevant patient dose errors. Med Phys, 38(2): 1037-1044.##Valdes G, Scheuermann R, Hung C, Olszanski A, et al. (2016) A mathematical framework for virtual IMRT QA using machine learning. Med Phys, 43(7): 4323-4334.##Tanabe Y, Ishida T, Eto H, et al. (2021) Patient-specific radiotherapy quality assurance for estimating actual treatment dose. Med Dosim, 46(1): e5-e10.##Osman AFI, Maalej NM, Jayesh K (2020) Prediction of the individual multileaf collimator positional deviations during dynamic IMRT delivery priori with artificial neural network. Med Phys, 47(4): 1421-1430.## ##

The effect of spleen dose-volume parameters on lymphopenia during chemoradiotherapy for pancreatic cancer 2 2 Background: We aimed to investigate the relationship between the radiation dose received by the spleen and the hematological parameters of patients who underwent chemoradiotherapy after the diagnosis of locally advanced pancreatic cancer (LAPC).Materials and Methods: Patients with LAPC who were treated with chemoradiotherapy were retrospectively reviewed. Surgical status,chemoradiotherapy details, complete blood count values (baseline, mid-treatment, and end-of-treatment), mean spleen dose, and dose-volume parameters (V5, V10, V15, V20, V25, and V30) were recorded. The relationship between spleen dose-volume parameters and the development of grade 3 lymphopenia was evaluated by Spearman's rank correlation and receiver operating characteristic (ROC) analysis. Results: All dose parameters for the spleen were significantly correlated with the mid-treatment absolute lymphocyte count. In the ROC analysis, mean spleen dose (p=0.011; area under the curve [AUC]: 0.856; 95% confidence interval [CI]: 0.675-0.995), V15 (p=0.020; AUC: 0.938; 95% CI: 0.830-0.997), and V20 (p=0.002; AUC: 0.940; 95% CI: 0.811-0.1000) were significantly associated with mid-treatment grade ≥3 lymphopenia. Conclusion: A significant correlation was found between the dose received by the spleen during chemoradiotherapy in LAPC patients and the development of lymphopenia. Contouring the spleen as an organ at risk (OAR) and documenting doses is important to establish dose limitations. 421 425 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/19 1402/3/29 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 G.A. Inan G.A. Inan Department of Radiation Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey goncaaltinisikinan@gmail.com I.P. Aral I.P. Aral Department of Radiation Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey H.F. Ozturk H.F. Ozturk Department of Radiation Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey Z. Gani Z. Gani Ankara City Hospital, Department of Radiation Oncology, Ankara, Turkey S.A. Arslan S.A. Arslan Department of Radiation Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey Y. Tezcan Y. Tezcan Department of Radiation Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey Pancreatic cancer lymphope-nia spleen radiation dose acute toxicity. Ansari D, Tingstedt B, Andersson B, Holmquist F, Sturesson C,Williamsson C, et al. (2016) Pancreatic cancer: yesterday, todayand tomorrow. Future Oncol, 12(16): 1929-46.##Badiyan SN, Molitoris JK, Chuong MD, Regine WF, Kaiser A (2017) The role of radiation therapy for pancreatic cancer in the adjuvantand neoadjuvant settings. Surg Oncol Clin N Am, 26(3): 431-53.##Pernar LIM and Tavakkoli A (2018) Anatomy and Physiology of theSpleen. Shackelford's Surgery of the Alimentary Tract, 136: 1591-1597.##Kraal G and den Haan JMM (2016) The Spleen. In Encyclopedia ofImmunobiology. Ed: Ratcliffe MJH; 1st Edition, Ch 3; 407-412.##Hey YY, Quah B, O'Neill HC (2017) Antigen-presenting capacity ofmurine splenic myeloid cells. BMC Immunol, 18(1): 4.##Sunshine GH and Mitchell TJ (1985) Antigen presentation by spleendendritic cells. J Invest Dermatol, 85(1 Suppl): 110-114.##Bronte V and Pittet MJ (2013) The spleen in local and systemicregulation of immunity. Immunity, 39(5): 806-818.##Wolfe AR, Siedow M, Nalin A, DiCostanzo D, Miller ED, Diaz DA, etal. (2021) Increasing neutrophil-to-lymphocyte ratio followingradiation is a poor prognostic factor and directly correlates withsplenic radiation dose in pancreatic cancer. Radiother Oncol, 158: 207-214.##Liu J, Zhao Q, Deng W, Lu J, Xu X, Wang R, et al. (2017). Radiation-related lymphopenia is associated with spleen irradiation doseduring radiotherapy in patients with hepatocellular carcinoma. Radiat Oncol, 12(1): 90.##Yalamanchali A, Zhang H, Huang KC, Mohan R, Lin SH, Zhu C, et al.(2020) Patient-specific lymphocyte loss kinetics as biomarker ofspleen dose in patients undergoing radiation therapy for upperabdominal malignancies. Adv Radiat Oncol, 6(1): 100545.##Alexandru M, Rodica A, Dragos-Eugen G, Mihai-Teodor G (2021) Assessing the spleen as an organ at risk in radiation therapy and itsrelationship with radiation-induced lymphopenia: A retrospectivestudy and literature review. Adv Radiat Oncol, 6(6): 100716.##Saito T, Toya R, Yoshida N, Shono T, Matsuyama T, Ninomura S, et al. (2018) Spleen dose-volume parameters as a predictor of treat-ment-related lymphopenia during definitive chemoradiotherapyfor esophageal cancer. In Vivo, 32(6):1519-1525.##Ng SP, Bahig H, Jethanandani A, Pollard C, Berends J, Sturgis EM, et al. (2020) Lymphopenia during radiotherapy in patients with oro-pharyngeal cancer. Radiother Oncol, 145: 95-100.##Balmanoukian A, Ye X, Herman J, Laheru D, Grossman SA (2012) The association between treatment-related lymphopenia andsurvival in newly diagnosed patients with resected adenocarcino-ma of the pancreas. Cancer Invest, 30(8): 571-576.##Deng W, Xu C, Liu A, van Rossum PSN, Deng W, Liao Z, et al. (2019)The relationship of lymphocyte recovery and prognosis of esopha-geal cancer patients with severe radiation-induced lymphopeniaafter chemoradiation therapy. Radiother Oncol, 133: 9-15.##De B, Ludmir EB, Messick CA, Cagley MC, Morris VK, Das P, et al.(2021) Prognostic impact of lymphopenia and neutrophil-lymphocyte ratio for patients with anal squamous cell carcinoma. J Gastrointest Oncol, 12(5): 2412-2422.##Xie X, Gong S, Jin H, Yang P, Xu T, Cai Y, et al. (2020) Radiation-induced lymphopenia correlates with survival in nasopharyngealcarcinoma: impact of treatment modality and the baseline lym-phocyte count. Radiat Oncol, 15(1): 65.##Lambin P, Lieverse RIY, Eckert F, Marcus D, Oberije C, van der WielAMA, et al. (2019) Lymphocyte-sparing radiotherapy: The rationalefor protecting lymphocyte-rich organs when combining radiothera-py with immunotherapy. Semin Radiat Oncol, 30(2): 187-193.##Arunagiri N, Kelly SM, Dunlea C, Dixon O, Cantwell J, Bhudia P, etal. (2021) The spleen as an organ at risk in pediatric radiotherapy:A SIOP-Europe Radiation Oncology Working Group report. Eur JCancer, 143: 1-10.##Chin AL, Aggarwal S, Pradhan P, et al. 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Dosimetric characteristics of tomotherapy and three-dimensional conformal radiotherapy for head and neck cancer 2 2 Background: This study aims to evaluate and compare Three-Dimensional Conformal Radiotherapy (3D-CRT) versus Helical Tomotherapy (HT) based on treatment planning and selection of the most appropriate method to reduce side effects. Materials and Methods: Treatment planning was performed on images of 20 patients with head and neck cancer with lymph node involvement by HT and 3D-CRT techniques in Seyed Al-Shohada hospital, Isfahan, Iran. The quality of target coverage, the exposure of normal tissue, and radiation delivery efficiency in two studied methods were compared. Results: Tomotherapy showed significant improvement over 3D-CRT in terms of D2%, D50% Dmean, V95%, CI (conformity index), and HI (homogeneity index) for PTV (planning target volume) and in terms of D2%, D98%, Dmean, V95%, CI and HI for PTV Nodal. The mean dose received by 98% of PTV (D98%) increased in HT compared to 3D-CRT. Whereas, higher doses received in organs at risk (OARs) in 3D-CRT compared to HT. Conclusion: Results showed improvements in target quality for HT over 3D-CRT, including dosimetric coverage of target volumes, homogeneity and conformity indices, and reduction of the volume of cold and hot spots. Tomotherapy also performed better than that of 3D-CRT in OARs. Overall, with the satisfactory results obtained here, HT technique has considerable promise for treating head and neck cancers with the involvement of regional lymph nodes. 427 434 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/19 1402/3/29 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 N. Monadi N. Monadi Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran D. Shahbazi-Gahrouei D. Shahbazi-Gahrouei Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran shahbazi@med.mui.ac.ir S. Monadi S. Monadi Department of Radiation Oncology, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran L. Mahani L. Mahani Department of Radiation Oncology, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran A. Shams A. Shams Department of Radiation Oncology, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran A. Akhavan A. Akhavan Assistant Professor of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran R. Mohammadi R. Mohammadi Department of Mathematics, Isfahan University of Technology, Isfahan, Iran Head and Neck Cancer Conformity index Homogeneity index Radiotherapy Three-Dimensional Conformal Radiation Therapy Helical Tomotherapy. Ralston SH, Penman ID, Strachan MW, Hobson R (2022) Davidson's principles and practice of medicine. E-book: Elsevier health sciences, 24th ed., ISBN: 9780702083495##Shang Q, Shen ZL, Ward MC, et al. (2015) Evolution of treatment planning techniques in external-beam radiation therapy for head and neck cancer. Applied Radiation Oncology, 4:18-25.##Andrew DV, Gregory MM, Videtic NW (2014) Handbook of treatment planning. 2nd Ed., Springer Publishing Company, New York, United States.##Moroney LB, Helios J, Ward EC, et al. (2017) Patterns of dysphagia and acute toxicities in patients with head and neck cancer undergoing helical IMRT±concurrent chemotherapy. Oral Oncology, 64:1-2.##Low DA, Moran JM, Dempsey JF, et al. (2011) Dosimetry tools and techniques for IMRT. Medical Physics, 38(3):1313-38.##Gupta T, Agarwal J, Jain S, et al. 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Investigation of the neuroprotective effect of Granisetron through SV2A and 5-HT3 modulation in a radiation-induced brain injury rat model 2 2 Background: The development of neurotoxicity in healthy, non-targeted brain tissue exposed to radiation during cranial radiotherapy (RT) is the most frequent event of radiation-induced adverse effects. The 5-hydroxytryptamine-3 (5-HT3) receptor antagonists may also have a range of neuroprotective, anti-inflammatory, and antiphlogistic properties in addition to their anti-emetic effects. Materials and Methods: Study groups were formed in the following ways: Group 2: Irradiation (IR)-only (IR+Saline); Group 1: Normal control (orally fed control); Group 3: IR+Granisetron (IR+Granisetron): whole-brain IR and Granisetron 1 mg/kg/day (Merck) administered orally. 15 days of all therapies were given. The 15 days were completed with behavioral testing. In the entire brain IR-only (placebo) group, a substantial deterioration was seen in all studied marker levels and behavioral test results. Results: Compared to the IR-only group, all of these biochemical indicators significantly improved in the granisetron group (IR+Granisetron), and levels of the control group returned to normal. In behavioral test analyses, a substantial decline in the open field and passive avoidance learning social recognition tests was seen in the IR-only group compared to the healthy control group, whereas an improvement was seen in the IR+Granisetron group. In addition, the IR-only group showed a reduction in hippocampus neurons and Purkinje neurons as well as an increase in hippocampal gliosis, whereas the IR+Granisetron group showed an improvement and a return to the normal control group counts. Conclusion: In summary, we discovered that granisetron had neuroprotective properties in a rat model of radiation-induced brain damage. 435 446 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/21 1402/3/31 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 N. Cini N. Cini Department of Radiation Oncology Clinic, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey O. Atasoy O. Atasoy Department of Radiation Oncology Clinic, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey M.A. Erdogan M.A. Erdogan Department of Physiology, Izmir Katip Çelebi University, Faculty of Medicine, Izmir, Turkey alpero86@gmail.com G. Yaprak G. Yaprak Department of Radiation Oncology Clinic, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey E. Eroglu E. 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The accuracy of infrared thermal imaging and ultrasound in evaluating knee osteoarthritis dysfunction 2 2 Background: To explore the accuracy of infrared thermal imaging and ultrasound in evaluating knee osteoarthritis (KOA) dysfunction. Materials and Methods: From November 2021 to June 2022, 50 KOA patients diagnosed by our hospital were selected. According to the results of ultrasound examination, the subjects were separated into mild group (30 cases) as well as moderate to severe group (20 cases). Pain as well as dysfunction was assessed using the visual analog Scale (VAS) and Western Ontario and McMaster osteoarthritis index (WOMAC). The forward-looking infrared (FLIR) thermal imager was used for infrared thermal imaging on the day of treatment as well as 1 month later. Results: The degree of cartilage wear detected by ultrasound was strongly correlated with the pain of knee osteoarthritis (r=0.674, P<0.05) and WOMAC osteoarthritis index (r=0.643, P <0.05). The knee temperature in the moderate to severe group was higher relative to the mild group (P<0.05, figure 2). The reliability and repeatability of the two infrared thermal imaging tests in knee were good (ICC=0.78). The knee temperature was positively correlated with the degree of cartilage wear under ultrasound (r=0.426, P<0.05, table 2). The knee temperature was positively related to pain (r=0.403, P<0.05) and WOMAC osteoarthritis index (r=0.382, P<0.05). Conclusion: Combined application of infrared thermal imaging and ultrasound in the evaluation process of knee osteoarthritis can assess the pain and dysfunction of knee osteoarthritis to a certain extent. 447 451 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/25 1402/4/4 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 B. Zhang B. Zhang Department of Department of Orthopedics, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China X. Zhao X. Zhao Department of Department of Orthopedics, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China T. Chen T. Chen Department of Department of Orthopedics, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China S. Ren S. Ren Department of Department of Orthopedics, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China Y. Lin Y. Lin Department of Department of Orthopedics, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China linyuan@ccmu.edu.cn Knee osteoarthritis dysfunction infrared thermal imaging ultrasound VAS WOMAC Osteoarthritis index. 1. Michael JW, Schlüter-Brust KU, Eysel P (2010) The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. 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Multi-slice spiral CT study on the anatomical variation of the left renal vein 2 2 Background: Background: To investigate the diagnostic value of multi-slice spiral computed tomography (MSCT) in the anatomical variation of left renal vein (LRV). Materials and Methods: The clinical and imaging data of 96 patients with LRV variation in our hospital from June 2019 to December 2022 were retrospectively analyzed, and the imaging manifestations, classification, and clinical significance were discussed in combination with the literature. Results: Among the 96 patients with LRV variation, 30 patients (30/96, 31.25%) were type I (annular aortic type), including 20 cases of type IA, 7 cases of type IB, and 3 cases of type IC. A total of 17 cases (17/96, 17.71%) were type II (complete retroaortic type), with 15 cases were type IIA and 2 cases were type IIB. There were 52 cases (52/96, 54.17%) of type III (abnormal reflux type), with 32 cases of type IIIA and 20 cases of type IIIB. There were 15 cases (15/96, 15.63%) of type IV (delayed confluence type). Taken together, 18 of the 96 patients (18/96, 18.75%) had both types of variants, including 10 cases with other types of variants accompanied by delayed confluence of the LRV, and 5 cases with other types of variants combined with abnormal reflux. Conclusion: Fully understanding the anatomical variation of renal vein before operation is of great guiding significance for the selection of renal transplant donors, and helps to formulate the best renal surgery plan, guide the correct treatment of renal vein before operation, avoid renal vein tear, bleeding, miscut and misligation, and reduce surgical complications. 453 457 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/25 1402/4/4 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 L. Wang L. Wang Department of Radiology, Daping Hospital, Army Medical University, Chongqing 400042, China R.L. Mao R.L. Mao Department of Radiology, Daping Hospital, Army Medical University, Chongqing 400042, China H. Xiang H. Xiang Department of Radiology, Daping Hospital, Army Medical University, Chongqing 400042, China C. Cheng C. Cheng Department of Radiology, Daping Hospital, Army Medical University, Chongqing 400042, China chuopingcc@163.com Variation of left renal vein multi-slice spiral CT classification vascular malformation. 1. Idhrees M and Velayudhan B (2022) Retroaortic left renal vein in open thoracoabdominal aneurysm repair: A modified approach. Eur J Cardiothorac Surg, 62(4). Ezac452.##Selberherr A, Mari M, Klinger M, et al. (2022) Left Renal Vein Division for Juxtarenal Aortic Exposure: Influence on Renal Function and Role of the Communicating Lumbar Vein. World J Surg, 46(6): 1493-9.##Lewis DS, Grimm LJ, Kim CY (2015) Left renal vein compression as cause for varicocele: prevalence and associated findings on contrast-enhanced CT. Abdom Imaging, 40(8): 3147-51.##Zhang J and Li T (2022) Stent in Left Renal Vein Stuck at the Opening of Tricuspid Valve. Ann Thorac Surg, 113(2):e91-e4.##Brancatelli G, Galia M, Finazzo M, et al. (2000) Retroaortic left renal vein joining the left common iliac vein. Eur Radiol, 10(11): 1724-5.##Kuzan TY, Kuzan BN, Telli TA, et al. (2020) Evaluation of the frequency of left renal vein variations in computed tomography and its relationship with cancer development. Folia Morphol (Warsz), 79(4): 793-8.##Yi SQ, Ueno Y, Naito M, et al. (2012) The three most common variations of the left renal vein: a review and meta-analysis. Surg Radiol Anat, 34(9): 799-804.##Heiss SG, Shifrin RY, Sommer FG (2000) Contrast-enhanced three-dimensional fast spoiled gradient-echo renal MR imaging: evaluation of vascular and nonvascular disease. Radiographics, 20(5):1341-52.##Cohen DL, Weinberg I, Uretsky S, et al. (2021) Imaging strategies for safety surveillance after renal artery denervation. Clin Res Cardiol, 110(5): 609-19.##Laurence I, Ariff B, Quest RA, et al. (2012) Is there a role for free breathing non-contrast steady-state free precession renal MRA imaging for assessing live donors? A preliminary study. Br J Radiol, 85(1016):e448-54.##Mueller-Peltzer K, Rübenthaler J, Fischereder M, et al. (2017) The diagnostic value of contrast-enhanced ultrasound (CEUS) as a new technique for imaging of vascular complications in renal transplants compared to standard imaging modalities. Clin Hemorheol Microcirc, 67(3-4): 407-13.##Liu J, Yang S, Jin H, et al. (2018) The diagnostic value of multi-slice spiral computed tomography in patients with renal carcinoma. J Cancer Res Ther, 14(4): 795-8.##Chen L, Qi L, Zhang J, et al. (2021) Neutrophil-lymphocyte ratio as a prognostic factor for minute clear cell renal cell carcinoma diagnosed using multi-slice spiral CT. Medicine (Baltimore), 100(23): e26292.##Peng N, Wang X, Zhang Z, et al. (2016) Diagnosis value of multi-slice spiral CT in renal trauma. J Xray Sci Technol, 24(5): 649-55.##Ming WD, Li XG, Xue HD, et al. (2014) Role of multi-slice computed tomography angiography in the diagnosis of visceral artery aneurysms. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 36(3): 296-9.##Haładaj R, Polguj M, Wysiadecki G, et al. (2019) Circumaortic left renal vein (circumaortic renal collar) associated with the presence of vascular anomalies: a case series and review of literature. Folia Morphol (Warsz), 78(2): 437-43.##Lopez-Lopez V, Garcia-Lopez J, Eshmuminov D, et al. (2022) Left renal vein graft and in situ hepatic perfusion in hepatectomy for complete tumor invasion of hepatic veins: hemodynamic optimization and surgical technique. Langenbecks Arch Surg, 407(4): 1-7.##Satyapal KS (1995) Classification of the drainage patterns of the renal veins. J Anat, 186 (Pt 2): 329-33.##Sonawane GB, Moorthy KH, Pillai BS (2020) Newer variants of retroaortic left renal vein. Indian J Urol, 36(2): 142-3.##Tao XF, Zhu JQ, Wu YW, et al. (2013) Dual-energy computed tomography angiography for evaluating the renal vascular variants. Chin Med J (Engl), 126(4): 650-4.##Koc Z, Ulusan S, Oguzkurt L (2007) Association of left renal vein variations and pelvic varices in abdominal MDCT. Eur Radiol, 17(5): 1267-74.##Zhu J, Zhang L, Yang Z, et al. (2015) Classification of the renal vein variations: a study with multidetector computed tomography. Surg Radiol Anat, 37(6): 667-75.##Lee HN, Hyun D, Park KB, et al. (2021) CT findings after left renal vein division during abdominal aortic surgery. Acta Radiol, 62(12): 1679-86.##Boyaci N, Karakas E, Dokumacı DS, et al. (2014) Evaluation of left renal vein and inferior vena cava variations through routine abdominal multi-slice computed tomography. Folia Morphol (Warsz), 73(2): 159-63.##Ayaz S and Ayaz ÜY (2016) Detection of retroaortic left renal vein and circumaortic left renal vein by PET/CT images to avoid misdiagnosis and support possible surgical procedures. Hell J Nucl Med, 19(2): 135-9.##Tatarano S, Enokida H, Yamada Y, et al. (2019) Anatomical Variations of the Left Renal Vein During Laparoscopic Donor Nephrectomy. Transplant Proc, 51(5):1311-3.##Dilli A, Ayaz UY, Kaplanoğlu H, et al. (2013) Evaluation of the left renal vein variations and inferior vena cava variations by means of helical computed tomography. Clin Imaging, 37(3): 530-5.##Powell AC, Plitas G, Muhs BE, et al. (2006) Left renal vein reconstruction after right nephrectomy and inadvertent left renal vein ligation: a case report and review of the literature. Vasc Endovascular Surg, 40(5): 421-4.## ##

Radiation safety and radiation monitoring practices among medical radiation workers in Malaysia 2 2 Background: The Background: To assess the radiation protection and radiation monitoring practices among medical radiation workers (MRWs) in Malaysian hospitals, and to identify demographic and occupational factors influencing the consistent use of radioprotective garments and dosimeters. Materials and Methods: A link to an online survey was distributed to MRWs with the help of research coordinators at participating hospitals. A total of 387 respondents answered the online survey between April and June 2019. They reported the consistency with which they used radioprotective garments, dosimeters and other protective measures, together with the reasons for inconsistency. We then compared consistent and inconsistent groups by demographic and occupational data. Results: The respondents exhibited excellent adherence to radiation protection but showed poor adherence to radiation monitoring. The main reasons for non-use of radioprotective garments were inadequate items and the need to prioritize others. Forgetfulness and fear of losing dosimeters were the common reasons for the non-consistent use of monitoring devices. Radiologists were the most consistent group using radioprotective garments compared to other job positions (p<.050). Middle-aged respondents were more consistent in using radioprotective aprons than younger respondents (p<.005). Work schedule, institution and gender also influenced the consistency of using radioprotective garments and dosimeters. Conclusion: There is an urgent need to improve the personal dosimeter adherence rate in this country and any shortage of radioprotective garments should be tackled immediately. Ultimately, it is crucial to understand the workers’ tasks and their safety measures to avoid underestimating occupational radiation exposure and risk. 459 468 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/27 1402/4/6 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 S.F. Mohd Ridzwan S.F. Mohd Ridzwan Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia L. Fritschi L. Fritschi School of Public Health, Faculty of Health Sciences, Curtin N. Bhoo-Pathy N. Bhoo-Pathy Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia nirmala.bhoopathy@ummc.edu.my medical radiation worker radiation dosimeter radiation protection radioprotective apron thyroid shield. 1. Rose A, Uebel KE, Rae WI (2018) Interventionalists' perceptions on a culture of radiation protection. S Afr J Rad, 22(1): a1285.##Linet MS, Slovis TL, Miller DL, et al. (2012) Cancer risks associated with external radiation from diagnostic imaging procedures. CA: A Cancer Journal for Clinicians, 62: 75-100.##International Atomic Energy Agency (IAEA) (2018) Radiation protection and safety in medical uses of ionizing radiation: IAEA Safety Standards for protecting people and the environment. Specific Safety Guide Series No. SSG-46, Vienna: IAEA. https://www-pub.iaea.org/MTCD/Publications/PDF/PUB1775_web.pdf##Government of Alberta (2011) Handbook of occupational hazards and controls for personnel in diagnostic imaging and nuclear medicine. Best practices in occupational health and safety in the health care industry. Alberta, Ca. https://open.alberta.ca/dataset/21700f6d-8e42-4e71-a764-69ac10a0ffdb/resource/22bf6448-8e69-4a7e-830c-89fafe5c8863/download/ohs-wsa-handbook-diagnostic-imaging.pdf##ICRP (1991) 1990 Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann. ICRP, 21: 1-3.##Atomic Energy Licensing Act 1984 (Basic Safety Radiation Protection) Regulations 2010 (2010) P.U. (A) 46; Malaysia: PNMB. https://radia.moh.gov.my/project/new/radia/FileTransfer/downloads/files/10BSS-2010_BI.pdf##Elshami W, Abuzaid M, Piersson AD, et al. (2019) Occupational dose and radiation protection practice in UAE: a retrospective cross-sectional cohort study (2002-2016). Radiation Protection Dosimetry, 187(4): 426-37.##Abuzaid M, Elshami W, Shawki M, Salama D (2019) Assessment of compliance to radiation safety and protection at the radiology department. 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(2016) Knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in a teaching hospital in Northern Nigeria. Journal of Clinical and Diagnostic Research, 10(8): LC07-12.##Rania MA, Afaf Mohamed TE, Elsamani M, Wisal H (2015) Knowledge and performance of radiographers towards radiation protection, Taif, Saudi Arabia. IOSR Journal of Dental and Medical Sciences, 14(3):63-8.##Emmett Lynskey III G, Powell DK, et al. (2013) Radiation protection in interventional radiology: survey results of attitudes and use. J Vasc Interv Radiol, 24: 1547-51.##Adejumo SB, Irurhe NK, Olowoyeye OA, et al. (2012) Evaluation of compliance to radiation safety standard amongst radiographers in radiodiagnostic centres in South West, Nigeria. 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Four-dimensional dose reconstruction system for lung cancer VMAT treatment: a 4D phantom study 2 2 Background: Recently, volumetric modulated arc therapy (VMAT) has been applied to the treatment of moving targets, such as lung tumors. The displacement of actual tumors during treatment based on an averaged four-dimensional (4D) planning computed tomography (CT) image set induces inconsistencies between dose distribution determined during the treatment planning step and the actual irradiated dose. The present study introduces a 4D dose reconstruction system and demonstrates its feasibility based on the results of dynamic thorax phantom experiments. Materials and Methods: Linear accelerator log files of two types—dynamic beam delivery log files and DynaLog files—were used to create the DICOM-RT Plan file with multiple-field irradiation. Dose distribution corresponding to each respiratory phase was calculated by planning the corresponding CT image set, and the accumulated dose distribution was subsequently reconstructed. In the experiment conducted in this study, two types of lung-tumor motion were considered—linear motion in the craniocaudal direction and combined motion in the craniocaudal and rotational directions. Results: The dose delivered to the center of a tumor was observed to vary by up to 4.4 %, depending on the initiation time of VMAT irradiation—the proposed system estimated the administered dose with an accuracy of 1.3 % or less. In the case of two-dimensional dose distribution, the pass rate of gamma analysis with a tolerance of 3 mm/3 % exceeded 96.6 %. Conclusion: The proposed system exhibited high dose-estimation accuracy for intricately moving targets, e.g., lung tumors, undergoing combined linear and rotational motion. 469 474 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/27 1402/4/6 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 M. Hashimoto M. Hashimoto School of Allied Health Sciences, Kitasato University, Sagamihara-shi, Kanagawa, Japan Y. Ito Y. Ito Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan Y. Tanaka Y. Tanaka Graduate School of Medical Sciences, Kitasato University, Sagamihara-shi, Kanagawa, Japan M. Nakano M. Nakano Department of Radiation Oncology, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan mnakano@kitasato-u.ac.jp 4D dose reconstruction lung tumor VMAT 4D thorax phantom respiratory motion. 1. Otto K (2008) Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys, 35(1): 310-317.##Palma DA, Verbakel WFAR, Otto K, Senan S (2010) New developments in arc radiation therapy: a review. Cancer Treat Rev, 36(5): 393-399.##Teoh M, Clark CH, Wood K, Whitaker S, Nisbet A (2011) Volumetric modulated arc therapy: a review of current literature and clinical use in practice. Br J Radiol, 84: 976-996.##Bedford JL (2009) Treatment planning for volumetric modulated arc therapy. Med Phys, 36(11): 5128-5138.##Pesce GA, Clivio A, Cozzi L, Nicolini G, Richetti A, Salati E, et al. (2010) Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy. Radiat Oncol, 5(1): 54.##Holt A, Van Gestel D, Arends MP, Korevaar EW, Schuring D, Kunze-Busch MC, et al. (2013) Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study. Radiat Oncol, 8(1): 26.##Verbakel WFAR, Cuijpers JP, Hoffmans D, Bieker M, Slotman BJ, Senan S (2009) Volumetric intensity-modulated arc therapy vs. conventional IMRT in head-and-neck cancer: a comparative planning and dosimetric study. Int J Radiat Oncol Biol Phys, 74(1): 252-259.##Holt A, van Vliet-Vroegindeweij C, Mans A, Belderbos JS, Damen EMF (2011) Volumetric-modulated arc therapy for stereotactic body radiotherapy of lung tumors: a comparison with intensity-modulated radiotherapy techniques. Int J Radiat Oncol Biol Phys, 81(5): 1560-1567.##Navarria P, Ascolese AM, Mancosu P, Alongi F, Clerici E, Tozzi A, et al. (2013) Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC). Radiother Oncol, 107(3): 414-418.##Wolthaus JWH, Schneider C, Sonke J-J, van Herk M, Belderbos JSA, Rossi MMG, et al. (2006) Mid-ventilation CT scan construction from four-dimensional respiration-correlated CT scans for radiotherapy planning of lung cancer patients. Int J Radiat Oncol, 65(5): 1560-1571.##Knopf A, Nill S, Yohannes I, Graeff C, Dowdell S, Kurz C, et al. (2014) Challenges of radiotherapy: Report on the 4D treatment planning workshop 2013. Phys Medica, 30(7): 809-815.##Huang L, Park K, Boike T, Lee P, Papiez L, Solberg T, et al. (2010) A study on the dosimetric accuracy of treatment planning for stereotactic body radiation therapy of lung cancer using average and maximum intensity projection images. Radiother Oncol, 96(1): 48-54.##Berbeco RI, Pope CJ, Jiang SB. Measurement of the interplay effect in lung IMRT treatment using EDR2 films. J Appl Clin Med Phys, 7(4): 33-42.##Ong C, Verbakel WFAR, Cuijpers JP, Slotman BJ, Senan S (2011) Dosimetric Impact of Interplay Effect on RapidArc Lung Stereotactic Treatment Delivery. Int J Radiat Oncol, 79(1): 305-311.##Rao M, Wu J, Cao D, Wong T, Mehta V, Shepard D, et al. (2012) Dosimetric impact of breathing motion in lung stereotactic body radiotherapy treatment using image-modulated radiotherapy and volumetric modulated arc therapy. Int J Radiat Oncol Biol Phys, 83(2): e251-e256.##Stambaugh C, Nelms BE, Dilling T, Stevens C, Latifi K, Zhang G, et al. (2013) Experimentally studied dynamic dose interplay does not meaningfully affect target dose in VMAT SBRT lung treatments. Med Phys, 40(9): 91710.##van Zijtveld M, Dirkx MLP, de Boer HCJ, Heijmen BJM (2007) 3D dose reconstruction for clinical evaluation of IMRT pretreatment verification with an EPID. Radiother Oncol, 82(2): 201-207.##Poulsen PR, Schmidt ML, Keall P, Worm ES, Fledelius W, Hoffmann L (2012) A method of dose reconstruction for moving targets compatible with dynamic treatments. Med Phys, 39(10): 6237-6246.##Nakagawa K, Haga A, Kida S, Masutani Y, Yamashita H, Takahashi W, et al. (2013) 4D registration and 4D verification of lung tumor position for stereotactic volumetric modulated arc therapy using respiratory-correlated cone-beam CT. J Radiat Res, 54(1): 152-156.##Nakagawa K, Haga A, Sasaki K, Kida S, Masutani Y, Yamashita H, et al. (2014) Lung tumor motion reproducibility for five patients who received four-fraction VMAT stereotactic ablative body radiotherapy under constrained breathing conditions: a preliminary study. J Radiat Res, 55(6): 1199-1201.##Saitoh H (2013) Advance in dose standard and dosimetry protocol for external beam radiation therapy. Igaku Butsuri, 33(suppl.2): 1-12.##Childress NL, Rosen II (2004) Effect of processing time delay on the dose response of Kodak EDR2 film. Med Phys, 31(8): 2284.##Childress NL, Salehpour M, Dong L, Bloch C, White RA, Rosen II (2005) Dosimetric accuracy of Kodak EDR2 film for IMRT verifications. Med Phys, 32(2): 539.##Shi C, Papanikolaou N, Yan Y, Weng X, Jiang H (2006) Analysis of the sources of uncertainty for EDR2 film-based IMRT quality assurance. J Appl Clin Med Phys, 7(2): 1-8.##Lee L, Le QT, Xing L (2008) Retrospective IMRT Dose Reconstruction Based on Cone-Beam CT and MLC Log-File. Int J Radiat Oncol Biol Phys, 70(2): 634-644.##van Zijtveld M, Dirkx M, Heijmen B (2007) Correction of conebeam CT values using a planning CT for derivation of the "dose of the day." Radiother Oncol, 85(2): 195-200.##Kida S, Masutani Y, Yamashita H, Imae T, Matsuura T, Saotome N, et al. (2012) In-treatment 4D cone-beam CT with image-based respiratory phase recognition. Radiol Phys Technol, 5(2): 138-147.##28 Nenoff L, Ribeiro CO, Matter M, Hafner L, Josipovic M, Langendijk JA, et al. (2020) Deformable image registration uncertainty for inter-fractional dose accumulation of lung cancer proton therapy. Radiother Oncol, 147: 178-185.##29 Lowther NJ, Marsh SH, Louwe RJW (2020) Quantifying the dose accumulation uncertainty after deformable image registration in head-and-neck radiotherapy. Radiother Oncol, 143: 117-125.##30 Bai X, Wang B, Wang S, Wu Z, Gou C, Hou Q (2020) Radiotherapy dose distribution prediction for breast cancer using deformable image registration. Biomed Eng Online 19(1): 3.##31 Lin MH, Li J, Wang L, Koren S, Fan J, Forkal E, Ma CM (2012) 4D patient dose reconstruction using online measured EPID cine images for lung SBRT treatment validation. Med Phys, 39(10): 5949-5958.##32 Meijers A, Knopf AC, Crijns AP, Ubbels JF, Niezink AG, Langendijk JA, et al. (2020) Evaluation of interplay and organ motion effects by means of 4D dose reconstruction and accumulation. Radiother Oncol, 150: 268-274.## ##

The effect of radiotherapy and surgery on stage IIIA/B NSCLC patients treated with chemotherapy 2 2 Background: The combination of radiotherapy and surgery is used to treat locally advanced non-small cell lung cancer (NSCLC). The aim of this study was to analyze IIIA/B NSCLC patients treated with chemotherapy from the Surveillance, Epidemiology, and End Results (SEER) database to clarify whether patient prognosis correlated with surgery and radiotherapy. Materials and Methods: The IIIA/B NSCLC patients were selected from the SEER database and classified into IIIA (N0-1), IIIA (N2), IIIB (N2), and IIIB (N3). Cox analyses and Kaplan–Meier method were used to estimate the prognostic factors and lung cancer specific survival (LCSS) curves. Results: We divided 7933 cases into IIIA (N0-1), IIIA (N2), IIIB (N2), and IIIB (N3). Cox regression showed that age, sex, primary site, grade, treatment, T stage, and marriage were independent risk factors for IIIA (N0-1); age, sex, treatment, and T stage had prognostic significance for IIIA (N2); age, sex, primary site, grade, treatment, and T stage were prognostic factors for IIIB (N2); and age and primary site had effect on the prognosis of IIIB(N3). The effect of chemotherapy-surgery was better than that of chemotherapy-preoperative radiotherapy-surgery and chemotherapy-surgery-postoperative radiotherapy for IIIA (N0-1). In IIIA (N2) and IIIB, radiotherapy did not improve the LCSS. Conclusion: Surgery offered more survival benefits for IIIA (N0-1) patients. Radiotherapy did not improve the LCSS of IIIA (N2) and IIIB patients. 475 483 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/28 1402/4/7 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 Y. Zeng Y. Zeng Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China G. Wang G. Wang Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China H. Zheng H. Zheng Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China Y. Wang Y. Wang Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China G. Ma G. Ma Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China Z. Pang Z. Pang Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China J. Du J. Du Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China dujiajun@sdu.edu.cn Surgery radiotherapy NSCLC prognosis chemotherapy. 1. Torre LA, Bray F, Siegel RL, et al. (2015) Global Cancer Statistics, 2012. CA Cancer J Clin, 65(2): 87-108.##Chen W, Zheng R, Zeng H, et al. (2015) The updated incidences and mortalities of major cancers in China, 2011. Chin J Cancer, 34(11): 502-7.##Cai D, Hu C, Li L, et al. (2020) The prevalence and prognostic value of KRAS co‐mutation subtypes in Chinese stage III non‐small cell lung cancer patients. Cancer Med, 9(1): 84-93.##Schreiner W, Dudek W, Rieker RJ, et al. (2020) Major pathologic response after induction therapy has a long-term impact on survival and tumor recurrence in stage IIIA/B locally advanced NSCLC. Thorac Cardiovasc Surg, 68(7):639-645.##Li C, Hu Y, Huang J, et al. (2019) Comparison of robotic-assisted lobectomy with video-assisted thoracic surgery for stage IIB-IIIA non-small cell lung cancer. Transl Lung Cancer Res, 8(6): 820-828.##Xu GW, Xie MR, Wu HR, et al. (2020) A prospective study examining the impact of uniportal video-assisted thoracic surgery on the short-term quality of life in patients with lung cancer. Thorac Cancer, 11(3): 612-618.##Ricardi U, Badellino S, Filippi AR, et al. (2015) Stereotactic body radiotherapy for early stage lung cancer: History and updated role. Lung Cancer, 90(3):388-96.##Molina JR, Yang P, Cassivi SD, et al. (2008) Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin. Proc, 83(5):584-94.##https://doi.org/10.1016/S0025-6196(11)60735-0##Ramnath N, Dilling TJ, Harris LJ, et al. (2013) Treatment of stage III non-small cell lung cancer: diagnosis and management of lung cancer: American College of Chest Physicians evidence-based clinical practice guidelines. CHEST Journal, 143(5): e314S-40S.##Le Péchoux C (2011) Role of postoperative radiotherapy in resected non-small cell lung cancer: a reassessment based on new data. Oncologist, 16(5): 672-81.##Wisnivesky JP, Bonomi M, Henschke C, et al. (2005) Radiation therapy for the treatment of unresected stage I-II non-small cell lung cancer. Chest, 128(3): 1461-7.##Sawyer TE, Bonner JA, Gould PM, et al. (1997) Effectiveness of postoperative irradiation in stage IIIA non-small cell lung cancer according to regression tree analyses of recurrence risks. Annals of Thoracic Surgery, 64(5): 1402-7.##Machtay M, Lee JH, Shrager JB, et al. (2001) Risk of death from intercurrent disease is not excessively increased by modern postoperative radiotherapy for high-risk resected non-small-cell lung carcinoma. Journal of Clinical Oncology, 19(19): 3912-7.##Zheng G, Song K, Zhao Y, et al. (2019) Liver kinase B1 suppresses the metastasis and angiogenesis of lung cancer: involvement of the Shh signaling pathway. Neoplasma, 23: 66(3): 367-376.##Molina JR, Yang P, Cassivi SD, et al. (2008) Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin. Proc, 83(5): 584-94.##https://doi.org/10.1016/S0025-6196(11)60735-0##Siegel RL, Miller KD, Jemal A, et al. (2017) Cancer Statistics, 2017. CA-A Cancer Journal for Clinicians, 67(1): 7-30.##Noh JM, Kim JM, Ahn YC, et al. (2016) Effect of radiation therapy techniques on outcome in N3-positive IIIB non-small cell lung cancer treated with concurrent chemo radiotherapy. Cancer Research and Treatment, 48(1): 106-14.##Yan TD, Black D, Bannon PG , et al. (2009) Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video‑assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. Journal of Clinical Oncology, 27(15): 2553-62.##Na F, Wang J, Li C, et al. (2014) Primary tumor standardized uptake value measured on F18-Fluorodeoxyglucose positron emission tomography is of prediction value for survival and local control in non-small-cell lung cancer receiving radio- therapy: meta-analysis. Journal of Thoracic Oncology, 9(6): 834-42.##Rossi A, Chiodini P, Sun JM, et al. (2014) Six versus fewer planned cycles of first‑line platinum‑based chemotherapy for non-small-cell lung cancer: A systematic review and meta-analysis of individual patient data. Lancet Oncology, 15(11): 1254-62.##Duma N, Santana-Davila R, Molina JR (2019) Non-small cell lung cancer: Epidemiology, screening, diagnosis, and treatment. Mayo Clinic Proceedings, 94(8): 1623-1640.##Bryan DS and Donington JS (2019) The role of surgery in management of locally advanced non-small cell lung cancer. Current TreatmenT Options in Oncology, 20(4): 27.##Gao F, Li N, Xu Y, Yang G. (2020) Effects of postoperative radiotherapy on survival of patients with stage IIIA resected non-small cell lung cancer: analysis of the SEER database. Journal of the National Comprehensive Cancer Network, 18(6): 718-727.##Moore S, Leung B, Wu J, Ho C, et al. (2019) Real-world treatment of stage III NSCLC: The role of trimodality treatment in the era of immunotherapy. Real-world treatment of stage III NSCLC: The role of trimodality treatment in the era of immunotherapy. Journal of Thoracic Oncology, 14(8): 1430-1439.##Xu L, Xie HN, Chen XK, et al. (2021) Patient prognostic scores and association with survival improvement offered by postoperative radiotherapy for resected IIIA/N2 non-small cell lung cancer: A population-based study. Thoracic Cancer, 12(6): 760-767.##Chen D, Wang H, Song X, et al. (2018) Preoperative radiation may improve the outcomes of respectable IIIA/N2 non-small-cell lung cancer patients: A propensity score matching-based analysis from surveillance, epidemiology, and end results database. Cancer Medicine, 7(9): 4354-4360.##Steuer CE, Behera M, Ernani V, et al. (2017) Comparison of concurrent use of thoracic radiation with either carboplatin-paclitaxel or cisplatin-etoposide for patients with stage III non-small-cell lung cancer: A systematic review. JAMA Oncology, 3(8): 1120-1129.##Girard N and Mornex F (2006) Stage IIIB non-small cell lung cancer. Optimization of radiotherapy in lung cancer: some interesting questions to be solved. Revue DEs Maladies Respiratoires, 23(5- 3): 16S61-16S67.##Adizie JB, Khakwani A, Beckett P, et al. (2019) Stage III Non-small Cell Lung Cancer Management in England. Clin Oncol (R Coll Radiol), 31(10): 688-696.##Gao F, Li N, Xu Y, Yang G. (2020) Evaluation of postoperative radiotherapy effect on survival of resected stage III-N2 non-small cell lung cancer patients. Frontiers in Oncology, 10: 1135.##Wang S, Ma Z, Yang X, et al. (2017) Choice of postoperative radiation for stage IIIA pathologic N2 non-small cell lung cancer: impact of metastatic lymph node number. Radiation Oncology, 12(1): 207.## ##

The crucial role of high C-reactive protein interval and Glasgow prognostic score for predicting prognosis in esophageal cancer patients undergoing chemoradiotherapy 2 2 Background: Our aim was to draw attention to the dominant role of C-reactive protein (CRP) on prognosis by examining the effect of the high CRP interval, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS) and CAR (CRP to albumin ratio)  in patients undergoing chemoradiotherapy (CRT). Materials and Methods: 85 patients, with the diagnosis of esophageal cancer and who were scheduled for neoadjuvant or definitive CRT, were included in the study. CRP levels of each patient during the follow-up period were determined separately, and the total number of days for which serum CRP levels were > 5 mg/L was expressed as "days when CRP>5". The effects of the GPS, mGPS, CAR, and‘’days when CRP>5’’ on the prognosis and survival of these patients with esophageal cancer were analyzed in this retrospective study. Results: In the survival analysis, CAR (p=0.007), GPS (p<0.001), mGPS (p<0.001) and ‘’days when CRP > 5’’ (p=0.002) were determined to be independent predictive factors for mortality. In the long-rank test results, it was observed that the patients with GPS 0 and mGPS 0 had longer overall survival than the others (p < 0.001). In addition, with the increase in ‘’days when CRP>5’’, disease recurrence also increased significantly (p = 0.01). Similarly, in the ROC analysis, the area under the curve (AUC) was significant for the ‘’days when CRP>5’’ (AUC: 0.956, 95% CI: 0.915‒0.998; P < 0.001). Conclusions: In patients diagnosed with esophageal cancer, beginning from the pretreatment period and throughout the follow-up period, serum CRP levels are an independent factor in predicting survival, both in terms of the number of days it is high and in terms of the scoring systems it is associated with. 485 489 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/3 1402/4/12 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 N. Gurdal N. Gurdal University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey gurdalnecla@hotmail.com H. Akboru H. Akboru University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey S. Dincer S. Dincer University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey H.I. Acan H.I. Acan University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey B.A. Yildirim B.A. Yildirim University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey N. Yasar N. Yasar University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey G. Kulduk G. Kulduk University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey P.O. Nayir P.O. Nayir University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey F. Saglam F. Saglam University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey A. Alemdar A. Alemdar University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey H. Guven H. Guven University of Health Sciences, Prof Dr Cemil Tascioglu City Hospital, Department of Radiation Oncology,Istanbul,Turkey C-reactive protein High CRP Interval Glasgow prognostic score esophagus cancer. van Hagen P, Hulshof MC, van Lanschot JJ, et al. (2012) CROSS Group. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med, 366(22): 2074-84.##Torre LA, Bray F, Siegel RL, et al. (2015) Global cancer statistics, 2012. CA Cancer J Clin, 65(2): 87-108.##Forrest LM, McMillan DC, McArdle CS, et al. (2003) Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer, 89(6): 1028-30.##Numata K, Ono Y, Toda S, et al. (2020) Modified Glasgow prognostic score and carcinoembryonic antigen predict poor prognosis in elderly patients with colorectal cancer. Oncol Res Treat, 43(4): 125-133.##Lu X, Guo W, Xu W, et al. (2018) Prognostic value of the Glasgow prognostic score in colorectal cancer: a meta-analysis of 9,839 patients. Cancer Manag Res, 11: 229-249.##Petrelli F, Barni S, Coinu A, et al. (2015) The modified Glasgow prognostic score and survival in colorectal cancer: A pooled analysis of the literature. Rev Recent Clin Trials, 10(2): 135-41.##Soeters PB, Wolfe RR, Shenkin A (2019) Hypoalbuminemia: Pathogenesis and clinical significance. JPEN J Parenter Enteral Nutr, 43(2): 181-193.##Tong T, Guan Y, Xiong H, et al. (2020) A meta-analysis of glasgow prognostic score and modified Glasgow prognostic score as biomarkers for predicting survival outcome in renal cell carcinoma. Front Oncol, 10: 1541.##Chen P, Fang M, Wan Q, et al. (2017) High-sensitivity modified Glasgow prognostic score (HS-mGPS) Is superior to the mGPS in esophageal cancer patients treated with chemoradiotherapy. Oncotarget, 8(59): 99861-99870.##Urabe M, Yamashita H, Watanabe T, Seto Y (2018) Comparison of prognostic abilities among preoperative laboratory data ındices in patients with resectable gastric and esophagogastric junction adenocarcinoma. World J Surg, 42(1): 185-194.##Sakai M, Sohda M, Saito H, et al. (2020) Comparative analysis of ımmunoinflammatory and nutritional measures in surgically resected esophageal cancer: A single-center retrospective study. In-Vivo, 34(2): 881-887.##Ju SY and Ma SJ (2020) High C-reactive protein to albumin ratio and the short-term survival prognosis within 30 days in terminal cancer patients receiving palliative care in a hospital setting: A retrospective analysis. Medicine (Baltimore), 99(9): e19350.##Amano K, Maeda I, Morita T, et al. (2016). Clinical ımplications of C-reactive protein as a prognostic marker in advanced cancer patients in palliative care settings. J Pain Symptom Manage, 51(5): 860-7.##Wei XL, Wang FH, Zhang DS, et al. (2015) A novel inflammation-based prognostic score in esophageal squamous cell carcinoma: the C-Reactive protein/albumin ratio. BMC Cancer, 15: 350.##Wang Y, Li P, Li J, et al. (2019) The prognostic value of pretreatment Glasgow prognostic score in patients with esophageal cancer: A meta-analysis. Cancer Manag Res, 11: 8181-8190.##McMillan DC, Crozier JE, Canna K, et al. (2007) Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis, 22(8): 881-6.##Ibuki Y, Hamai Y, Hihara J, et al. (2017) Role of postoperative C-Reactive protein levels in predicting prognosis after surgical treatment of esophageal cancer. World J Surg, 41(6): 1558-1565.##Cui X, Jia Z, Chen D, et al. (2020) The prognostic value of the C-reactive protein to albumin ratio in cancer: An updated meta-analysis. Medicine (Baltimore), 99(14): e19165.##Tong T, Guan Y, Xiong H, et al. (2020) A meta-analysis of Glasgow prognostic score and modified Glasgow prognostic score as biomarkers for predicting survival outcome in renal cell carcinoma. Front Oncol, 10: 1541.##Wu D, Wang X, Shi G, et al. (2021) Prognostic and clinical significance of modified glasgow prognostic score in pancreatic cancer: a meta-analysis of 4,629 patients. Aging (Albany NY), 13(1): 1410-1421.##He L, Li H, Cai J, et al. (2018) Prognostic value of the Glasgow prognostic score or modified Glasgow prognostic score for patients with colorectal cancer receiving various treatments: A systematic review and meta-analysis. Cell Physiol Biochem, 51(3): 1237-1249.## ##

Assessment of image quality of two cone-beam computed tomography of the Varian Linear accelerators: Comparison with spiral CT simulator 2 2 Background: To assess and compare image quality characteristics of x-ray computed tomography (CT) and cone beam (CBCT) imaging systems of the Varian linear accelerator. Materials and Methods: The CatPhan®504, was examined on the CT simulator (SOMATOM Definition AS, VA48A) and two CBCTs (TrueBeam™ and Clinac® iX linear accelerators) attached to Varian linear accelerator. Image quality parameters including pixel value stability, spatial linearity, pixel size verification, uniformity, noise, spatial resolution, low contrast resolution, and contrast-to-noise ratio (CNR) were assessed using different scanning protocols. Results: The mean pixel values of regions of interest were stable for CT, TB, and iX-CBCT imaging. Noise on CT was slightly lower and was seen to decrease with increasing mAs, while CNR increased with CT mAs and two CBCTs. For all schemes, the Modulation Transfer Function (MTF) of the reconstructed image was limited by the pixel size. Low contrast targets for TB-CBCT were visible, with up to 6 and 2 targets for 1% and 0.5% for contrast, respectively. However, up to 4 targets of 1% contrast on iX-CBCT images are visible for the low-contrast objectives. Also, up to 8, 4, and 1 targets of 1%, 0.5%, and 0.3% contrast were visible for the low-contrast targets on CT images. Conclusions: CT and CBCT image quality parameters have been quantified and compared for clinical protocols in different mAs conditions. Selecting the right protocol will boost contrast, based on image quality criteria. The mAs can be decreased to minimize patient dosage. 491 497 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/4 1402/4/13 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 H. Ragab H. Ragab Department of Radiation Oncology, Warith International Cancer Institute (WICI), University of Warith Al. Anbiyaa, Karbala, Iraq D.M. Abdelaziz D.M. Abdelaziz Department of Radiation Oncology, Baheya hospital for early detection and treatment of breast cancer, Giza, Egypt M.M. Khalil M.M. Khalil Department of Physics, Faculty of Science, Helwan University, Cairo, Egypt M.N. Yasein Elbakry M.N. Yasein Elbakry Department of Physics, Faculty of Science, Helwan University, Cairo, Egypt Cone-beam computed tomography image quality TB-CBCT iX-CBCT. Jaffray DA, Siewerdsen JH, Wong JW, Martinez AA (2002) Flat-panel cone-beam computed tomography for image-guided radiation therapy. Int J Radiat Oncol, 53(5): 1337-49.##Elstrøm U V, Wysocka BA, Muren LP, et al. (2010) Cone-beam CT and deformable image registration as a method for studying dosimetric consequences of anatomic changes in adaptive IMRT of head and neck cancer. Acta Oncol (Madr), 49(7): 1101-8.##Dawson LA and Jaffray DA (2007) Advances in image-guided radiation therapy. J Clin Oncol, 25(8): 938-46.##Verellen D, Ridder M De, Storme GA (2008) Short history of image-guided radiotherapy. Radiother Oncol, 86(1): 4-13.##Kim S, Yoo S, Yin F-F, et al. (2010) Kilovoltage cone-beam CT: Comparative dose and image quality evaluations in partial and full-angle scan protocols. Med Phys, 37(7Part1): 3648-59.##Elstrøm U V, Muren LP, Petersen JBB, Grau C (2011) Evaluation of image quality for different kV cone-beam CT acquisition and reconstruction methods in the head and neck region. Acta Oncol (Madr), 50(6): 908-17.##Bissonnette J-P, Moseley DJ, Jaffray DA (2008) A quality assurance program for image quality of cone-beam CT guidance in radiation therapy. [Internet] Med Phys, 35(5):1807-15.##Kamath S, Song W, Chvetsov A, Li J, et al. (2011) An image quality comparison study between XVI and OBI CBCT systems. Med Phys, 35(6): 2648.##Miura H, Ozawa S, Hayata M, et al. (2017) Evaluation of cone-beam computed tomography image quality assurance for Vero4DRT system. [Internet] Reports Pract Oncol Radiother, 22(3): 258-63.##Zhang J, Bao ZR, Huang XT, et al. (2019) Methods to evaluate the performance of kilovoltage cone-beam computed tomography in the three-dimensional reconstruction space. Int J Radiat Res, 17(2):189-202.##Chen L, Shaw CC, Mustafa C, et al. (2008) Spatial resolution properties in cone beam CT: A simulation study. Med Phys, 35(2): 724-34.##Endo M, Tsunoo T, Nakamori N, Yoshida K (2001) Effect of scattered radiation on image noise in cone beam CT. Med Phys, 28(4): 469-74.##Jaffray DA and Siewerdsen JH (2000) Cone-beam computed tomography with a flat-panel imager: Initial performance characterization. Med Phys, 27(6): 1311-23.##Yang K, Kwan ALC, Huang S-Y, et al. (2008) Noise power properties of a cone-beam CT system for breast cancer detection. Med Phys, 35(12): 5317-27.##Shepherd J (2014) Applications of linac-mounted kilovoltage Cone-beam Computed Tomography in modern radiation therapy: A review. Polish J Radiol, 79: 181-93.##The Phantom Laboratory (2013) Catphan ® 504 Manual CTP504. 2013.##EFOMP-ESTRO-IAEA (2019) Quality control in cone-beam computed tomography (CBCT) EFOMP-ESTRO-IAEA protocol. 2019.##IAEA (2012) Quality Assurance Programme for Computed Tomography: Diagnostic and Therapy Applications, Human Health Series No. 19. Vienna; 2012.##Droege RT and Morin RL (1982) A practical method to measure the MTF of CT scanners. Med Phys, 9(5): 758-60.##Gulliksrud K, Stokke C, Trægde Martinsen AC (2014) How to measure CT image quality: Variations in CT-numbers, uniformity and low contrast resolution for a CT quality assurance phantom. Phys Medica, 30(4): 521-6.##Roa AMA, Andersen HK, Martinsen ACT (2015) CT image quality over time: comparison of image quality for six different CT scanners over a six-year period. 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Application of portable vaginal irrigator in patients with cervical cancer undergoing external irradiation combined with intracavitary brachytherapy 2 2 Background: To probe the impact of portable vaginal irrigator in patients with cervical cancer undergoing radiotherapy. Materials and Methods: A total of 100 patients with advanced cervical cancer who received radiotherapy in our hospital from January 2021 to December 2022 were chosen and separated into control group (CG, n=50) and research group (RG, n=50). After radiotherapy, patients in the CG control group adopted extrusion balloon irrigator for vaginal irrigation, while patients in the RG adopted portable vaginal irrigator for vaginal irrigation. The cleanliness, vaginal length, vaginal width, comfort ratio, patient satisfaction, and occurrence of complications in both groups were compared. Results: The number of patients with a white blood cell count of 15-30 in the RG was less than that of the CG (P<0.05). The number of patients in cleanliness degree I in the RG was higher relative to the CG (P<0.05), while the number of patients in cleanliness degree III in the RG was lower compared to the CG (P<0.05). Three months after radiotherapy, the vaginal length and vaginal width of the RG were higher relative to the CG (P<0.05). The comfort ratio and satisfaction of patients in the RG was higher compared to the CG (P<0.05). The occurrence of complications in the RG was declined compared to the CG (P<0.05). Conclusion: The use of portable vaginal irrigation device realizes the comfortable feeling of patients in the process of use, improves the effect of vaginal irrigation, reduces the occurrence of complications after radiotherapy, which is worthy of clinical promotion. 499 503 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/10 1402/4/19 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 H. Zhang H. Zhang Department of Radiation Oncology, and Department of Laboratory Medicine, Shanghai Sixth People's Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China J. Qian J. Qian Department of Radiation Oncology, and Department of Laboratory Medicine, Shanghai Sixth People's Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China J. Lin J. Lin Department of Radiation Oncology, and Department of Laboratory Medicine, Shanghai Sixth People's Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China yqyysj116@163.com Cervical cancer radiotherapy portable vaginal irrigator cleanliness complications. 1. Johnson CA, James D, Marzan A, et al. (2019) Cervical Cancer: An Overview of Pathophysiology and Management. Semin Oncol Nurs, 35(2): 166-74.##Vu M, Yu J, Awolude OA, et al. (2018) Cervical cancer worldwide. Curr Probl Cancer, 42(5):457-65.##Burd EM. (2003) Human papillomavirus and cervical cancer. Clin Microbiol Rev, 16(1): 1-17.##Moore DH. (2006) Cervical cancer. Obstet Gynecol, 107(5): 1152-61.##Olusola P, Banerjee HN, Philley JV, et al. (2019) Human Papilloma Virus-Associated Cervical Cancer and Health Disparities. Cells, 8(6). 622.##Cohen PA, Jhingran A, Oaknin A, et al. (2019) Cervical cancer. Lancet, 393(10167): 169-82.##Mayadev JS, Ke G, Mahantshetty U, et al. (2022) Global challenges of radiotherapy for the treatment of locally advanced cervical cancer. Int J Gynecol Cancer, 32(3): 436-45.##Chargari C, Peignaux K, Escande A, et al. (2022) Radiotherapy of cervical cancer. Cancer Radiother, 6(1-2): 298-308.##Shelley CE, Barraclough LH, Nelder CL, et al. (2021) Adaptive Radiotherapy in the Management of Cervical Cancer: Review of Strategies and Clinical Implementation. Clin Oncol (R Coll Radiol), 33(9): 579-90.##Kokka F, Bryant A, Olaitan A, et al. (2022) Hysterectomy with radiotherapy or chemotherapy or both for women with locally advanced cervical cancer. Cochrane Database Syst Rev, 8(8): Cd010260.##Hamoonga TE, Olowski P, Musonda P (2019) Vaginal douching in Zambia: a risk or benefit to women in the fight against cervical cancer: a retrospective cohort study. BMC Womens Health, 19(1): 135.##Cottrell BH (2003) Vaginal douching. J Obstet Gynecol Neonatal Nurs, 32(1): 12-8.##Phongsavan K, Phengsavanh A, Wahlström R, et al. (2010) Women's perception of cervical cancer and its prevention in rural Laos. Int J Gynecol Cancer, 20(5): 821-6.##Musunuru HB, Pifer PM, Mohindra P, et al. (2021) Advances in management of locally advanced cervical cancer. Indian J Med Res, 154(2): 248-61.##Vordermark D (2016) Radiotherapy of cervical cancer. Oncol Res Treat, 39(9): 516-20.##Naga Ch P, Gurram L, Chopra S, et al. (2018) The management of locally advanced cervical cancer. Curr Opin Oncol, 30(5): 323-9.##Tan Mbbs Mrcp Frcr Md LT, Tanderup Ph DK, Kirisits Ph DC, et al. (2019) Image-guided Adaptive Radiotherapy in Cervical Cancer. 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Gamma analysis of patient specific quality assurance by hybrid acceptance criterion method 2 2 Background: Gamma analysis is an effective tool used to verify treatment plan accuracy with regard to patient specific quality assurance. In this method, accuracy is validated through the major parameters presented in the acceptance criterion (AC). The Hybrid AC (HAC) method has been proposed and validated via the Traditional AC (TAC) method of comparison. Materials and Methods: The performance of the HAC method was investigated through one-dimensional (1D) relative dose profile and clinical planar dose distribution. By employing the HAC method, Gamma values were observed at different regions of the profile as well as at the different treatment sites of clinical planar dose distribution. Both results were compared by employing the TAC method, but only planar dose distribution was analyzed by 95% confidence interval of statistics. Results: The results of the HAC method indicate higher Gamma values at the penumbra of the dose profile when compared with the results of the TAC method. In low dose and high dose areas, both methods produced comparable results. In terms of planar dose distribution, the proposed method demonstrated a higher degree of sensitivity than the TAC method by indicating low values for the Gamma passing rate at all treatment sites. Conclusion: The HAC method could effectively increase the sensitivity of the tool at a high dose gradient of planar dose distribution, whereas it had no impact on the area of the low dose gradient. Therefore, this method could be an alternative option for evaluation of treatment planning accuracy in clinical practice. 505 512 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/11 1402/4/20 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 A. Watcharawipha A. Watcharawipha Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand I. Chitapanarux I. Chitapanarux Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand imjai@hotmail.com Gamma index gamma analysis patient specific quality assurance acceptance criterion dose distribution. 1. Ozturk N, Ozbek N, Depboylu B (2022) Dosimetric comparison of IMRT, VMAT and HYBRID treatment methods in radical radiation therapy of prostate cancer. Int J Radiat Res, 20(2): 411-416.##Trivedi G, Oinam A, Singh YB, Vasudeva T (2021) Dosimetric comparison of three different radiotherapy techniques (3DCRT, ECOMP & VMAT) for breast irradiation. Int J Radiat Res, 19(2): 371-379.##Guo M, Zhao X, Huang Y, et al. (2022) The dosimetric and clinical comparison between helical tomotherapy and fixed-field intensity-modulated radiotherapy in radical irradiation for cervical cancer. Int J Radiat Re, 20(2): 377-382.##Kongsa A, Chitapanarux I, Watcharawipha A, et al. (2023) Improvement of matching fields using coplanar field border method in postmastectomy radiotherapy. Journal of Radiotherapy in Practice, 22(e8): 1-8.##Low DA, Harms WB, Mutic S, et al. (1998) A technique for the quantitative evaluation of dose distributions. Med Phys, 25(5): 656-661.##Klunklin P, Manoharn T, Wanwilairat S, et al. (2021) Analysis of the planned, delivered dose distributions and quality assurance for helical tomotherapy and volumetric modulated arc therapy in locally advanced non-small cell lung cancer. Rep Pract Oncol Radiother, 26(6): 939-947.##Varatharaj C, Ravikumar M, Sathiyan S, et al. (2010) Dosimetric verification of brain and head and neck intensity-modulated radiation therapy treatment using EDR2 films and 2D ion chamber array matrix. J Cancer Res Ther, 6(2): 179-184.##Szczurek L, Juszkat R, Szczurek J, et al. (2019) Pre-treatment 2D and 3D dosimetric verification of volumetric arc therapy. A correlation study between gamma index passing rate and clinical dose volume histogram. PLoS ONE, 14(8): e0221086.##Agazaryan N, Solberg TD, DeMarco JJ (2003) Patient specific quality assurance for the delivery of intensity modulated radiotherapy. J Appl Clin Med Phys, 4(1): 40-50.##Pal B, Pal A, Bag S, Ali MA, Das S, Palit, et al. (2021) Comparative performance analysis of 2D and 3D gamma metrics for patient specific QA in VMAT using Octavius 4D with 2D-Array 1500. Physica Medica, 91: 18-27.##Ezzell GA, Burmeister JW, Dogan N, et al. (2009) IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119. Med Phys, 36(11): 5359-5373.##Miften M, Olch A, Mihailidis D, Moran J, et al. (2018) Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations of AAPM Task Group No.218. Med Phys, 45(4): e53-e83.##Saminathan S, Manickam R, Chandraraj V (2011) Plan evaluation and dosimetric comparison of IMRT using AAPM TG119 test suites and recommendations. Australas Phys Eng Sci Med, 34(1): 55-61.##Park JM, Kim Ji, Park SY, et al. (2018) Reliability of the gamma index analysis as a verification method of volumetric modulated arc therapy plans. Radiat Oncol, 13: 175.##Garcia Q, Solis C, Salazar V, Ramos C (2022) Evaluation of the impact of parameters on the gamma index for breast cancer treatments. Rev Mex Fis, 67(6): 1-6.##Song JH, Kim MJ, Park SH, et al. (2015) Gamma analysis dependence on specified low-dose thresholds for VMAT QA. J Appl Clin Med Phys, 16(6): 263-272.##Heilemann G, Poppe B, Laub W (2013) On the sensitivity of common gamma-index evaluation methods to MLC misalignments in Rapidarc quality assurance. Med Phys, 40(3): 031702.##Van Dyk J, Barnett RB, Cygler JE, Shragge PC (1993) Commissioning and quality assurance of treatment planning computers. Int J Radiat Oncol Biol Phys, 26(2): 261-273.##International Commission on Radiation Units and measurements. (2012) The ICRU Report 83: prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT). Strahlenther Onkol, 188(1): 97-99.##Yu L, Tang TLS, Cassim N, et al. 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Imaging features of intestinal metastasis from pulmonary sarcomatoid carcinoma 2 2 Background: The aim of this study was to examine the imaging features of patients diagnosed with pulmonary sarcoma (PSC) exhibiting small bowel metastases, utilizing magnetic resonance imaging (MRI) and computed tomography (CT), and to report the clinical outcomes of surgical resection in conjunction with duvacizumab drug therapy.  Materials and Methods: Clinical data and CT imaging markers of patients with pathologically confirmed primary pulmonary sarcoma from January 2020 to April 2021 were retrospectively assessed. Results: Immunohistochemical analysis of lung tissue samples indicated Galectin-3(+), PAS(-), Myoglobin(-), F8(-), CD31(-), TTF(+), P40(-), D2-40(-), HMB45(-), AE1/AE3(+), MC(-), and CD68(-). PD-L1 positive cell count, as determined through immunohistochemical evaluation, was 50%. Immunohistochemical findings of the patient's small intestine tissue revealed AE1/AE3(+), CD117(-), CD34(-), Desmin(-), SMA(-), Vimentin(+), S-100(-), CK7(-), CK20(-), CEA(-), EMA(-), PAS(-), CD45(-), with a Ki-67 positivity rate of approximately 40%. Following 11 cycles of duvacizumab drug therapy, the volume of the patient's left upper lung mass decreased from 7.1 cm × 5.7 cm to 2.8 cm x 3.3 cm. Conclusion: The combination of surgical resection and duvacizumab drug therapy demonstrated clinical efficacy in patients with PSC and holds promise as a potential treatment option for patients suffering from PSC. 513 519 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/11 1402/4/20 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 H. Wu H. Wu Department of Oncology, Department of General Surgery, The People's Hospital of Shifang, Sichuan, China 937089375@qq.com  T. Tang T. Tang Department of Oncology, Department of General Surgery, The People's Hospital of Shifang, Sichuan, China L.B. Yi L.B. Yi Department of Oncology, Department of General Surgery, The People's Hospital of Shifang, Sichuan, China Pulmonary sarcomatoid carcinoma neoplasm metastasis computed tomography surgical resection durvalumab. Guo H, Li B, Diao L, et al. (2021) An immune-based risk-stratification system for predicting prognosis in pulmonary sarcomatoid carcinoma (PSC). Oncoimmunology, 10(1): 1947665.##Yendamuri S, Caty L, Pine M, et al. (2012) Outcomes of sarcomatoid carcinoma of the lung: a Surveillance, Epidemiology, and End Results Database analysis. Surgery, 152(3): 397-402.##Schrock AB, Li SD, Frampton GM, et al. (2017) Pulmonary sarcomatoid carcinomas commonly harbor either potentially targetable genomic alterations or high tumor mutational burden as observed by comprehensive genomic profiling. Journal of Thoracic Oncology: Official publication of the International Association for the Study of Lung Cancer, 12(6): 932-942.##Pécuchet N, Vieira T, Rabbe N, et al. (2017) Molecular classification of pulmonary sarcomatoid carcinomas suggests new therapeutic opportunities. Annals of Oncology: Official journal of the European Society for Medical Oncology, 28(7): 1597-1604.##Maneenil K, Xue Z, Liu M, et al. (2018) Sarcomatoid Carcinoma of the Lung: The Mayo Clinic Experience in 127 Patients. Clinical Lung Cancer, 19(3): e323-e333.##Bae HM, Min HS, Lee SH, et al. (2007) Palliative chemotherapy for pulmonary pleomorphic carcinoma. (Amsterdam, Netherlands) Lung Cancer, 58(1): 112-115.##Lee J, Jung HA, Kim Y, et al. (2018) Efficacy of mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) in patients with advanced pulmonary pleomorphic carcinoma. (Amsterdam, Netherlands) Lung Cancer, 122: 160-164.##Hegde PS and Chen DS (2020) Top 10 Challenges in Cancer Immunotherapy. Immunity, 52(1): 17-35.##O'Donnell JS, Teng MWL, Smyth MJ (2019) Cancer immunoediting and resistance to T cell-based immunotherapy. Nature reviews. Clinical Oncology, 16(3): 151-167.##Liu X, Wang F, Xu C, et al. (2021) Genomic origin and intratumor heterogeneity revealed by sequencing on carcinomatous and sarcomatous components of pulmonary sarcomatoid carcinoma. Oncogene, 40(4): 821-832.##Vieira T, Antoine M, Hamard C, et al. (2016). Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) and strong immune-cell infiltration by TCD3 cells and macrophages. (Amsterdam, Netherlands) Lung Cancer, 98: 51-58.##Antonia SJ, Villegas, A, Daniel D, et al., PACIFIC Investigators (2017). Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer. The New England Journal of Medicine, 377(20): 1919-1929.##Paz-Ares L, Dvorkin M, Chen Y, et al., CASPIAN investigators (2019). Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. 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Annals of Surgical Oncology, 18(10): 2952-2960.##Berg KB and Churg A (2017) GATA3 immunohistochemistry for distinguishing sarcomatoid and desmoplastic mesothelioma from sarcomatoid carcinoma of the lung. The American Journal of Surgical Pathology, 41(9): 1221-1225.##Husain AN, Colby, TV, Ordóñez NG, et al. (2018) Guidelines for pathologic diagnosis of malignant mesothelioma 2017 update of the consensus statement from the international mesothelioma interest group. Archives of Pathology & Laboratory Medicine, 142(1): 89-108.##Lin Y, Yang H, Cai Q, et al. (2016) Characteristics and prognostic analysis of 69 patients with pulmonary sarcomatoid carcinoma. American Journal of Clinical Oncology, 39(3): 215-222.##Zeng Q, Li J, Sun N, et al. (2021) Preoperative systemic immune-inflammation index predicts survival and recurrence in patients with resected primary pulmonary sarcomatoid carcinoma. Translational Lung cancer Research, 10(1): 18-31.##Chen M, Yang Q, Xu Z, et al. 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The determination of virtual source position using convergent arcCOS method for scanning-passive scatter beam in carbon ion therapy 2 2 Background: We developed a convergent arcCOS (cACOS) technique capable of dealing with the virtual source position delivered by different carbon ion energies from the pattern of scanning-passive scatter beam in this study. Materials and Methods: A homemade large-format CMOS sensor and Gaf Chromic EBT3 films were used for the virtual source position measurement. The Gaf films were embedded in a self-designed rectangular plastic frame to tighten the films and set up on a treatment couch for irradiation in the air with the film perpendicular to the carbon ion beam at the point of nominal source-axis-distance (SAD) as well as upstream and downstream from the SAD. The horizontal carbon ion beam with 5 energies at a machine opening field size was carried out in this study. The virtual source position was determined with a convergent arcCOS method and compared with the linear regression by back projecting the FWHM to zero at a distance upstream from the various point of source-film distance. Results: The determination of virtual source position using convergent arcCOS method agrees with the method by back projecting the FWHM to zero, and for higher carbon ion energy has an obvious longer distance from the SAD since the more carbon ion beam energy, the less spreading affected by the horizontal and vertical magnetism, therefore, the distance of virtual source positions is decreased from SAD with high to low energy. Conclusion: We have developed a technique capable of dealing with the virtual source position with a convergent arcCOS method to avoid any manual measurement mistakes in scanning-passive scatter carbon ion beam. The method for investigating the virtual source position in the carbon ion beam in this study can also be used for external electrons and the proton. 521 530 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/11 1402/4/20 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 Y. Qi Y. Qi Heavy Ion Center of Wuwei Cancer Hospital, Gansu Wuwei Academy of Medical Sciences, Gansu Wuwei Tumor Hospital, Wuwei city, Gansu province, China Y-S. Zhang Y-S. Zhang Heavy Ion Center of Wuwei Cancer Hospital, Gansu Wuwei Academy of Medical Sciences, Gansu Wuwei Tumor Hospital, Wuwei city, Gansu province, China Y-C. Ye Y-C. Ye Heavy Ion Center of Wuwei Cancer Hospital, Gansu Wuwei Academy of Medical Sciences, Gansu Wuwei Tumor Hospital, Wuwei city, Gansu province, China 13830510999@163.com T-F. Lee T-F. Lee Medical Physics and Informatics Laboratory of Electronic Engineering, National Kaohsiung University of Science and Technology, Kaohsiung 80778, Taiwan J-M. Wu J-M. Wu Heavy Ion Center of Wuwei Cancer Hospital, Gansu Wuwei Academy of Medical Sciences, Gansu Wuwei Tumor Hospital, Wuwei city, Gansu province, China jiaming.wu@chmsc.com Carbon ion beams virtual source position scanning-passive scatter beam. Sawkey DL and Faddegon BA (2009) Determination of electron energy, spectral width, and beam divergence at the exit window for clinical megavoltage X-ray beams. Med. Phys, 36: 698-707.##Sham E, Seuntjens J, Devic S (2008) Influence of focal spot on characteristics of very small diameter radiosurgical beams. Med Phys, 35: 3317-3330.##Knöös T, Wieslander E, Cozzi L (2006) Comparison of dose calculation algorithms for treatment planning in external photon beam therapy for clinical situation. Phys Med Biol, 51: 5785-5807.##Sterpin E, Tomsej M, De Smedt B (2007) Monte Carlo evaluation of the AAA treatment planning algorithm in a heterogeneous multilayer phantom and IMRT clinical treatments for an Elekta SL25 linear accelerator Med Phys, 34: 1665-1677.##Bortfeld T and Schlegel W (2007) An analytical approximation of depth-dose distributions for theraputic proton beams. Phys Med Biol, 41: 1331-9.##Chetty IJ, Curran B, Cygler JE (2007) Report of the AAPM task group No. 105: Issues associated with clinical implementation of Monte Carlo-based photon and electron external beam treatment planning. Med Phys, 34: 4818-4853.##Kooy H, Rosenthal S, Engelsman M (2005) The prediction of output factors for spread-out proton Bragg peak fields in clinical practice Phys Med Biol, 50: 5847-56.##Kooy H, Schaefer M, Rosenthal S (2003) Monitor unit calculations for range-modulated spread-out Bragg peak fields Phys Med Biol, 48: 2797-808.##Petti PL (1992) Differential-pencil-beam dose calculation for charged particles. Med Phys, 19: 137-49.##Verhaegen F and Seuntjens J (2003) Monte Carlo modeling of external radiotherapy photon beams. Phys Med Biol, 48: R107-R164.##Russell KR, Isacsson U, Saxner M (2000) Implementation of pencil kernel and depth penetration algorithms for treatment planning of proton beams. Phys Med Biol, 45: 9-27.##Reynaert N, van der Marck SC, Schaart DR (2007) Monte Carlo treatment planning for photon and electron beams. Radiat Phys Chem, 76: 643-686.##Dreind R ,Georg D, Stock M ( 2014) Radiochromic film dosimetry: considerations on precision and accuracy for EBT2 and EBT3 type films. Med Phys, 24(2):153-163.##Kamomae T, Miyabe Y, Sawada A (2011) Simulation for improvement of system sensitivity of radiochromic film dosimetry with different band-pass filters and scanner light intensities. Radiol Phys Technol, 4(2): 140-147.##García-Garduño OA, Lárraga-Gutiérrez JM, Rodríguez-Villafuerte M (2016) Effect of correction methods of radiochromic EBT2 films on the accuracy of IMRT QA. App Radi Isot, 107:121-126.##Barbara S (2008) Proton dose calculation based on in-air fluence measurements, Phys Med Biol 53:1545-1562.##Wu JM, Lee TF, Kuo CM (2012) A light field-based method to adjust rounded leaf end MLC position for split shape dose calculation correction in a radiation therapy treatment planning system, J Appl Clin Med Phys, 13(6): 3-18.## ##

Selection of kilovolt based on body mass index reduced radiation dose for computed tomography-guided radiofrequency ablation of liver tumors 2 2 Background: To explore the effect of kilovolt (kV) selection based on body mass index (BMI) on reducing the radiation dose of radiofrequency ablation (RFA) in liver tumours under computed tomography (CT) guidance. Materials and Methods: This study retrospectively reviewed CT-guided RFA of liver tumours performed between 1 January 2019 and 31 December 2019. The radiation dose received by the patients was recorded after the planning, execution and surgery. The RFA protocol for liver tumours was subsequently modified according to the patients’ BMI. Changes in tube voltage and tube current were recorded for the RFA protocol based on BMI. The image quality and overall operator satisfaction were recorded for each case based on the BMI-modified protocol. The radiation dose received by the patients was also recorded, and the degree of dose reduction adjusted based on BMI was calculated. Results: The results showed that the mean (± SD) overall CT dose index (CTDI) of CT-guided RFA was 12.83 ± 3.78 mGy. Following protocol modification, the mean CTDI decreased to 3.84 ± 2.24 mGy, a 70.07% reduction overall. The image quality was slightly lower compared with before the modification, but the image quality in both stages met the needs of CT-guided RFA for liver tumours. Electrode needle display and operator confidence satisfaction showed no significant difference between the groups (P > 0.05). Conclusion: Modification of the BMI-based kV protocol could significantly reduce the radiation dose received by patients during CT-guided ablation of liver tumours. Furthermore, the image quality was not significantly compromised. 531 535 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/17 1402/4/26 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 J. Zhao J. Zhao Department of Radiology, The First Hospital of Hebei Medical University, ShiJiaZhuang 050031, China G. Nie G. Nie Operating room, The First Hospital of Hebei Medical University, ShiJiaZhuang 050031, China Z. Liu Z. Liu Department of Radiology, The First Hospital of Hebei Medical University, ShiJiaZhuang 050031, China liuzhanhuizz@163.com Y. Zhao Y. Zhao Department of Radiology, The First Hospital of Hebei Medical University, ShiJiaZhuang 050031, China D. Zhao D. Zhao Department of Radiology, The First Hospital of Hebei Medical University, ShiJiaZhuang 050031, China L. Zheng L. Zheng Department of Radiology, The First Hospital of Hebei Medical University, ShiJiaZhuang 050031, China Radiofrequency ablation liver tumour radiation dose low kV body mass index. Tian Z, Hong B, Chen J, Tang Z (2022) Combination of Radiofrequency Ablation With Resiquimod to Treat Hepatocellular Carcinoma Inflammation of Tumor Immune Microenvironment and Suppression of Angiogenesis. Front Oncol, 12: 891724.##Jarosova J, Macinga P, Krupickova L, et al. (2022) Impact of endoluminal radiofrequency ablation on immunity in pancreatic cancer and cholangiocarcinoma. Biomedicines, 10(6): 1331.##Yuan, Q Zheng L, Hou J, et al. (2022) Total thyroidectomy versus hemithyroidectomy with intraoperative radiofrequency ablation for unilateral thyroid cancer with contralateral nodules: A propensity score matching study. Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et de Chirurgie Cervico-faciale, 51(1): 26.##Abdalla M, Collings AT Dirks R, et al. (2022) Surgical approach to microwave and radiofrequency liver ablation for hepatocellular carcinoma and colorectal liver metastases less than 5 cm: a systematic review and meta-analysis. Surgical Endoscopy, 37(5): 3340-3353.##Bazaga Pérez de Rozas S, Gallardo Ramírez MA, García-Alonso FJ, et al. (2019) Endoscopic ultrasound-guided radiofrequency ablation for management of gastric gastrointestinal stromal tumor. Endoscopy, 51(8): E223-E224.##Koethe Y, Wilson N, Narayanan G (2022) Irreversible electroporation for colorectal cancer liver metastasis: a review. International Journal of Hyperthermia : the Official Journal of European Society For Hyperthermic Oncology, North American Hyperthermia Group, 39(1): 682-687.##Fegrachi S, Walma MS, de Vries JJJ, et al. (2019) Safety of radiofrequency ablation in patients with locally advanced, unresectable pancreatic cancer: A phase II study. European Journal of Surgical Oncology: Eur J Surg Oncol, 45(11): 2166-2172.##Ahmed T, Portnoy R, Chachati G, et al. (2022) Correlation of body mass index with recanalization risk after endovenous thermal ablation. Journal of Vascular Surgery. Venous and Lymphatic Disorders, 10(1): 82-86.##Budzianowski J, Hiczkiewicz J, Łojewska K, et al. (2021) Predictors of early-recurrence atrial fibrillation after catheter ablation in women and men with abnormal body weight. Journal of Clinical Medicine, 10(12).##Liu JQ, Cheng Y, Chen LJ (2021) Optimization of scanning parameters for pulmonary nodules using different CT scanner:a comparative phantom study. Radiology Practice, 36(12): 1577-1581.##Zhao HB, Luo HJ, Liao MZ (2019) Comparative study on 70 and 120 kV dual-source CT image quality with different CARE Dose 4D preset values. Medical and Health Equipment, 40(2): 56-59.##Yu HS, Shen YL, Liu YK (2018) Application of double-low technique to aortic MSCTA. Chinese Medical Equipment Journal, 48(2): 76-79.##Herts BR, Baker ME, Obuchowski N, et al. (2013) Dose reduction for abdominal and pelvic MDCT after change to graduated weight-based protocol for selecting quality reference tube current, peak kilovoltage, and slice collimation. AJR. American Journal of Roentgenology, 200(6): 1298-1303.##Bongartz G, Golding SJ, Jurik AG (2106) European guidelines on quality criteria for computed tomography. www.drs.dk/guidelines /ct/quality /htmlindex.htm. Danish Society of Radiology website.##Luan X, Gao Z, Sun J, et al. (2022) Feasibility of an ultra-low dose contrast media protocol for coronary CT angiography. Clinical Radiology, 77(9): e705-e710.##Sliwicka O, Swiderska-Chadaj Z, Snoeren M, et al. (2022) Multireader image quality evaluation of dynamic myocardial computed tomography perfusion imaging with a novel four-dimensional noise reduction filter. (Stockholm, Sweden: 1987)##Acta Radiologica, 2022: 2841851221108804.##Quality Management and Safety Management Group of Radiology Branch of Chinese Medical Association. Expert consensus on reference level of CT radiation dose diagnosis (2017). Chinese Journal of Radiology, 51(11): 817-822.##Sarti M, Brehmer WP, Gay SB (2012) Low-dose techniques in CT-guided interventions. Radiographics, 32(4): 1109-19.##Cao ZT, Huo X, Liu TJ (2021) Application value of low-dose CT angiography combined with iterative reconstruction colon examination. Chinese Medical Equipment Journal, 42(1): 53-56.##Liu CP, Pan ZY, Yan YC (2022) The application of noise index in CT localization lung puncture biopsy. Journal of Modern Oncology, 30(1): 117-120.##Huo XH, Yang SL, Guo ZT (2020) The clinical application study of low-dose CT-guided thoracic puncture biopsy. Journal of Medical Imaging, 30(12): 2228-2231.##Fang D, Cui SC, Li JH (2016) The CT dosage optimal control of CT-guided microwave ablation in patients with hepatocellular carcinoma. Journal of Medical Imaging, 26(10): 1837-1840.##Zhu GS, Xiao HJ, Dong XM (2021) Comparison of low-dose coronary CT angiography in patients with high heart rate using third-generation dual-source CT. Journal of China Clinic Medical Imaging, 32(1): 52-55.##Ma GN, Jiang QQ, Han P (2018) The clinical application of SAFIRE reconstruction combined with CARE kV in aortic low-dose CT angiography. Journal of Clinical Radiology, 37(10): 1755-1759.## ##

Significance of magnetic resonance zoomed imaging with parallel transmission intravoxel incoherent motion imaging, ultrasonography and dual-energy computed tomography imaging in the differential diagnosis of benign thyroid nodule and papillary thyroid carcinoma 2 2 Background: To assess the use of computed tomography (CT), ultrasonography and magnetic resonance imaging (MRI) in distinguishing papillary thyroid cancer (PTC) from benign thyroid nodules. Materials and Methods: A total of 45 cases with benign thyroid nodules and 75 cases with papillary thyroid cancer were included from our hospital from March 2020 to December 2021. All patients were examined by MRI, ultrasonography and dual-energy CT. The outcomes of the two groups' MRI, CT and ultrasonography scans were compared. Results: The benign nodule group had significantly higher pure diffusion coefficient (D) (1.38±0.32 vs 0.95±0.12), perfusion fraction (F) values (17.13±4.35 vs 12.83±2.93) and iodine concentration (IC) plain scan scores (0.96±0.44 vs 0.56±0.37), whereas it had lower IC artery scores (2.65±1.11 vs 3.92±1.22) than those of the PTC group (p<0.001 for all). The Emax value of the PTC group was substantially greater than that of the benign nodule group (62.53±37.93 vs 25.37±8.38, p<0.001), and the percentage of nodules with aspect ratio ≥ 1 was higher in the PTC group than in the benign nodule group (48.0% vs 22.2%, p=0.005). The area under the curve (AUC) for MRI in the diagnosis of PTC patients was 0.885, which was substantially higher than those for ultrasonography (AUC=0.705) and CT exams (AUC=0.753) (p<0.001). Conclusion: MRI, ultrasonography and CT examinations are essential for discriminating between benign thyroid nodules and PTC. MRI has better diagnostic accuracy than the other two tests. 537 543 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/17 1402/4/26 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 Y. He Y. He Department of Radiology, Ma’anshan People's Hospital, Maanshan, Anhui, 243000, China yongshenghe1431@163.com X. Qi X. Qi Department of Radiology, Ma’anshan People's Hospital, Maanshan, Anhui, 243000, China X. Luo X. Luo Department of Radiology, Ma’anshan People's Hospital, Maanshan, Anhui, 243000, China W. Wang W. Wang Department of Radiology, Ma’anshan People's Hospital, Maanshan, Anhui, 243000, China H. Yang H. Yang Department of Radiology, Ma’anshan People's Hospital, Maanshan, Anhui, 243000, China M. Xu M. Xu Department of Radiology, Ma’anshan People's Hospital, Maanshan, Anhui, 243000, China X. Wu X. Wu Department of Radiology, Ma’anshan People's Hospital, Maanshan, Anhui, 243000, China W. Fan W. Fan School of graduate, Wan’nan Medical College, Wuhu, 241000, China Papillary thyroid carcinoma benign thyroid nodules ZOOMit IVIM imaging ultrasonography dual-energy CT imaging. Chinese Society of Endocrinology, Chinese Medical Association Surgery Branch Endocrinology Group, China Anti-cancer Association, Chinese Society of Nuclear Medicine. (2013) Guidelines for diagnosis and treatment of thyroid nodules and differentiated thyroid carcinoma. 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Oral Oncol, 88: 75-83.##Bonjoc KJ, Young H, Warner S, et al. (2020) Thyroid cancer diagnosis in the era of precision imaging. J Thorac Dis, 12(9): 5128-5139.##Li M, Zheng X, Gao F, et al. (2016) Spectral CT imaging of intranodular hemorrhage in cases with challenging benign thyroid nodules. Radiol Med, 121(4): 279-290.##Le Bihan D, Breton E, Lallemand D, et al. (1986) MRimaging of intravoxel incoherent motions: application to diffusion and perfusion inneurologic disorders. Radiology, 161(2): 401-7.##Sim KC, Park BJ, Han NY, et al. (2020) Efficacy of ZOOMit coronal diffusion-weighted imaging and MR texture analysis for differentiating between benign and malignant distal bile duct strictures. Abdom Radiol (NY), 45(8): 2418-2429.##Ai ZD, Hou J, Li FP, et al. (2017) Intravoxel incoherent motion diffusion weighted magnetic resonance imaging for differentiation between benign and malignant thyroid nodules. 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An assessment of the usefulness of handheld X-ray devices in general radiography based on a performance evaluation experiment 2 2 Background: Light and portable handheld X-ray devices are being used more often for diagnosis because they allow radiography procedures to be performed on patients in settings where there may not be stationary X-ray devices, such as islands or mountainous regions. In this study, the performances of handheld X-ray devices (HXD) and stationary X-ray devices (SXD) were compared to determine whether the handheld device could produce diagnostically acceptable image quality outside of hospitals, particularly during a global pandemic. Materials and Methods: For performance evaluation, the accuracy of tube voltage, reproducibility of X-ray dose, linearity, leakage dose, and accuracy of focal spot size were obtained. The accuracy of the tube voltage and the reproducibility and linearity of the X-ray dose were measured to reduce the frequency of patient reimaging as a performance evaluation of the devices. Results: After conducting various experiments, it was found that the percentage average error (PAE) value of the tube voltage was -0.01% for the HXD, and the error of the tube voltage was 0.01% for the SXD, which is lower than the standard 10%. Additionally, when using an HXD according to these standards, medical staff is considered safe from exposure to leakage dose because the leakage dose is 0.26 mSv/year without the use of a partition. Conclusion: Our results provide evidence that images of appropriate quality can be taken with an HXD, offering comparable diagnostic value. It was concluded that the leakage radiation dose would be safe at 0.26 mSv/year without using a radiation shielding partition. 545 551 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/18 1402/4/27 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 E. Kim E. Kim Department of Health and Safety Convergence Science, Korea University, Seoul, Republic of Korea H. Park H. Park Department of Health and Safety Convergence Science, Korea University, Seoul, Republic of Korea H. Choi H. Choi Department of Health and Safety Convergence Science, Korea University, Seoul, Republic of Korea J. Kim J. Kim Department of Health and Safety Convergence Science, Korea University, Seoul, Republic of Korea minbogun@korea.ac.kr Handheld X-ray device portable X-ray device performance evaluation image quality scatter radiation dose. 1. Benmalek E, Elmhamdi J, Jilbab A (2021) Comparing CT scan and chest X-ray imaging for COVID-19 diagnosis. Biomed Eng Adv, 1: 1-6.##Kim EH, Choi YS, Park HM, Na CY, Kim JM, Kim JS, Han TH (2021) Assessment of radiation dose of mobile computed tomography in intensive care units, Radiat Prot Dosim, 196 (1-2): 60-70.##Venkategowda P, Rao S, Mutkule D, Taggu A (2014) Unexpected events occurring during the intra-hospital transport of critically ill ICU patients. Indian J Crit Care Med, 18 (6): 354-7.##Parmer H, Lim TC, Goh J, Tan J, Sitoh Y, Hui F (2004) Providing optimal radiology service in the severe acute respiratory syndrome outbreak: use of mobile CT. 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(2010) The use of a portable head CT scanner in the intensive care unit. J Neurosci Nurs, 42(2): 109-116.##Gance CP, Pahade JK, Gortopassi I, et al. (2020). Social distancing with portable chest radiographs during the COVID-19 pandemic: assessment of radiograph technique and image quality obtained at 6 feet and through glass. Radiology, 2(6): 1-7.##Sawicka BD (1995), Portable digital electronic radiography system. Candu Maintenance Conference, Ontario, Canada, 71-77.##Jacobi A, Chung M, Bernheim A, Eber C (2020) Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review. Clin Imaging, 64: 35-42.##Eisenhauber E, Schaefer-Prokop CM, Prosch H, Schima W (2012) Bedside chest radiography. Respir Care, 57(3): 427-443.##Cohen MD, Long B, Cory DA, Broderick NJ, Smith JA (1989) Digital imaging of the newborn chest. Clin Radiol, 40: 365-368.##Hong DH, Lim CH, Kim YM, et al. (2021) Necessity of mandatory records on radiological examination. 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Effect of collimator scatter factors on dose calculation of different breast cancer cases in radiotherapy 2 2 Background: The present study aims to estimate the effect of collimator, phantom and Multi-Leaf Collimator (MLC) scatters on dose calculation in different breast cancer cases using acrylic, brass build-up caps and acrylic mini-phantom in the measurements. Materials and Methods: Collimator scatter factors (Sc), phantom scatter factors (Sp) and MLC transmission factors for different field sizes ranging from 1 × 1 cm2 to 40 × 40 cm2  for energies 6 MV and 15 MV  were measured using acrylic mini-phantom (PTW and local mini-phantom), acrylic build up cap and brass build up cap where the farmer ionization chamber was used as detector in this study and semiflex detector was used but only with small field sizes from 1 × 1 cm2  to 4 × 4 cm2 and scatter effect on the dose calculation in different breast cancer cases was evaluated. Results: The results in this study show that there is no significant difference between MLC transmission factors using acrylic mini-phantom and brass build-up cap with energy 6 MV where the transmission factor value is 0.007 and 0.0071 with acrylic mini-phantom and brass build- up cap, respectively.  Also it is clear that brass build-up cap gives the highest collimator scatter factors results where collimator scatter factors start at value 0.963 at field size 4 × 4 cm2 then increase gradually to end at point value 1.049 at field size 40 × 40 cm2. In breast cancer cases, there is sharp increase in organ at risk doses with brass build-up cap. Conclusion: From this study it is evident that almost there is large variation between the acrylic build-up cap, acrylic mini-phantom and brass build-up cap where brass build-up achieve higher results in most measurements. 553 560 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/18 1402/4/27 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 M.A. Eid M.A. Eid Radiotherapy Department, Nasser Institute, Cairo, Egypt mohamedahmed@gstd.sci.cu.edu.eg H.S. Mohammed H.S. Mohammed Biophysics Department, Faculty of Science, Cairo University, Egypt A.M. Abdelaal A.M. Abdelaal Radiotherapy Department, Nasser Institute, Cairo, Egypt S. Taha S. Taha Biophysics Department, Faculty of Science, Cairo University, Egypt Collimator scatter factor mini-phantom build-up cap brass MLC transmission. Podgorsak EB (2005) Radiation oncology physics. Vienna: International Atomic Energy Agency 123-271.##Bjärngard B (1980) Thermoluminescence dosimetry in the μGy range, by P. Spanne. Medical Physics, 7: 267-267.##Jursinic PA (2006) Measurement of head scatter factors of linear accelerators with columnar miniphantoms. Medical physics, 33(6-1): 1720-1728.‌##McKerracher C and Thwaites DI (2007) Head scatter actors for small MV photon fields. Part II: the effects of source size and detector. Radio ther Oncol, 85: 286-91.##Jursinic PA (2006) Measurement of head scatter factors of linear accelerators with columnar miniphantoms. Med linear accelerators with columnar miniphantoms. 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Medical Dosimetry, 13(1): 23-24.##Khan FM, Sewchand W, Lee J, Williamson JF (1980) Revision of tissue‐maximum ratio and scatter‐maximum ratio concepts for cobalt 60 and higher energy X‐ray beams. Medical physics, 7(3): 230-237.##Jursinic PA and Thomadsen BR (1999) Measurements of head‐scatter factors with cylindrical build‐up caps and columnar miniphantoms. Medical physics, 26(4): 512-517.##Weber L, Nilsson P, Ahnesjö A (1997) Build-up cap materials for measurement of photon head-scatter factors. Physics in Medicine & Biology, 42(10), 1875.##Fogliata A, et al. (2018) "Collimator scatter factor: Monte Carlo and in-air measurements approaches. Radiation Oncology, 13(1): 126.##Yang Y, Xing L, Li JG, et al. (2003) Independent dosimetric calculation with inclusion of head scatter and MLC transmission for IMRT. Medical physics, 30(11): 2937-2947.‌##Alongi F, Clerici E, Pentimalli S, et al. (2012) Initial experience of hypofractionated radiation retreatment with true beam and flattening filter free beam in selected case reports of recurrent nasopharyngeal carcinoma. Reports of Practical Oncology and Radiotherapy, 17(5): 262-268.‌##Klein EE, Harms WB, Low DA, et al. (1995) Clinical implementation of a commercial multileaf collimator: dosimetry, networking, simulation, and quality assurance. Int J Radiat Oncol, Biol Phys, 33(5): 1195-1208.‌##Birgani Tahmasebi MJ, Chegeni N, Behrooz MA, et al. (2017) An analytical method to calculate phantom scatter factor for photon beam accelerators. Electronic Physician, 9(1): 3523.##‌Fogliata A, Stravato A, Reggiori G, et al. (2018) Collimator scatter factor: Monte Carlo and in-air measurements approaches. Radiation Oncology, 13(1): 1-10.‌##Li J and Zhu TC (2006) Measurement of in-air output ratios using different miniphantom materials. Physics in Medicine & Biology, 51(15): 3819.##Olofsso J, Nyholm T, Georg, D, et al. (2006). Evaluation of uncertainty predictions and dose output for model‐based dose calculations for megavoltage photon beams. Medical physics, 33(7-1), 2548-2556.##Iftikhar A (2012) Measurements of output factors using different ionization chambers and build-up caps. Int J Radiat Res, 10(2): 95-98.##Berris T, Mazonakis M, Stratakis J, et al. (2013) Calculation of organ doses from breast cancer radiotherapy: a Monte Carlo study. Journal of Applied Clinical Medical Physics, 14(1): 133146.##Zurl B, Stranzl H, Winkler P, Kapp KS (2013) Quantification of contralateral breast dose and risk estimate of radiation-induced contralateral breast cancer among young women using tangential fields and different modes of breathing. Int J Radiat Oncol Biol Phys, 85(2), 500-505.## ##

Dosimetric comparison of volumetric-modulated arc therapy (VMAT) and fixed field intensity-modulated radiotherapy (IMRT) in patients with nasal tumor: a meta-analysis 2 2 Background: In recent years, volumetric-modulated arc therapy (VMAT) and fixed field intensity-modulated radiotherapy (IMRT) have been used as the two mainstream radiotherapy techniques for the treatment of nasal tumors. In this study, we compared effectiveness of these two radiotherapy techniques in the treatment of nasal tumors through analysis of relevant literature and meta-analysis. Materials and Methods: A search was performed on PubMed, Web of Science, Embase, and Cochrane Library databases on April 2022 to identify all related literature in line with pre-determined eligibility criteria. The included/excluded studies were screened manually and relevance data were extracted. Forest plots were plotted and analyze, Egger’s asymmetry tests and sensitivity analysis were conducted using software Stata 16.0. Results: Eight studies were included in the meta-analysis. We found no significant difference in D2% and D98% of the Planning Target Volumes (PTV) between VMAT and IMRT. In contrast, the conformity index (CI) and the homogeneity index (HI) were significantly different between the two groups. Further analysis revealed no significant differences in dose sparing for all analyzed organs at risk (OARs) between VMAT and IMRT techniques. In addition, the monitor unit (MUs) of VMAT plan was significantly lower than that of the IMRT plan. Conclusions: VMAT has better local tumor control rate compared with IMRT, but it does not significantly reduce maximum dose (Dmax) or mean dose (Dmean) of OARs. We suggest that VMAT plan may be a better radiation therapy technology in the treatment of nasal tumors. 561 569 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/19 1402/4/28 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 W.G. Feng W.G. Feng Department of Radiotherapy, Gansu Provincial Hospital, Lanzhou, Gansu 73000, China W. Ma W. Ma Department of Radiotherapy, Gansu Provincial Hospital, Lanzhou, Gansu 73000, China Sh.P. Li Sh.P. Li Department of Radiotherapy, Gansu Provincial Hospital, Lanzhou, Gansu 73000, China Y.X. Guo Y.X. Guo Department of Radiotherapy, Gansu Provincial Hospital, Lanzhou, Gansu 73000, China W. Du W. Du Department of Radiotherapy, Gansu Provincial Hospital, Lanzhou, Gansu 73000, China H.Y. Cai H.Y. Cai Department of Radiotherapy, Gansu Provincial Hospital, Lanzhou, Gansu 73000, China gschy333@163.com Nasal tumor VMAT IMRT meta-analysis. Katz TS, Mendenhall WM, Morris CG, et al. (2002) Malignant tumors of the nasal cavity and paranasal sinuses. Head & Neck, 24(9): 821-829.##Japan Lymphoma Radiation Therapy Group (2001) Localized aggressive non- Hodgkin's lymphoma a of the nasal cavity a survey by the Japan Lymphonma a Radiation Therapy Group. Int J Radiat Oncol Biol Phys, 51(5): 1228-1233.##Yao B, Li YX, Fang H, et al. (2006) Prognostic factors and treament outcome in early stage nasal NK/T cell lymphoma. Chin J Hematol, 27(4): 222-225.##Li H, Wang ChS, Wang XD (2014) Meta Analysis of Treatment for Stage IE~IIE Extranodal Natural Killer /T Cell Lymphomas in China. Asian Pacific Journal of Cancer Prevention, 15: 2297-2302.##Tomita N, Kodaira T, Tachibana H, et al. (2009) A comparison of radiation treatment plans using IMRT with helical tomotherapy and 3D conformal radiotherapy for nasal natural killer/T-cell lymphoma. Br J Radiol, 82(981): 756-763.##Mock U, Georg D, Bogner J, et al. (2004) Treatment planning comparison of conventional, 3D conformal, and intensity-modulated photon (IMRT) and proton therapy for paranasal sinus carcinoma. Int J Radiat Oncol Biol Phys, 58(1): 147-154.##Liu X, Huang E, Wang Y, et al. (2017) Dosimetric comparison of helical tomotherapy, VMAT, fixed-field IMRT and 3D-conformal radiotherapy for stage I-II nasal natural killer T-cell lymphoma. Radiat Oncol, 12(1): 76.##Paelinck L, Smedt BD, Reynaert N, et al. (2006) Comparison of dose-volume histograms of IMRT treatment plans for ethmoid sinus cancer computed by advanced treatment planning systems including Monte Carlo. Radiother Oncol, 81(3): 250-256.##Liu X, Yang Y, Jin F, et al. (2016) A comparison of volumetric modulated arc therapy and sliding-window intensity-modulated radiotherapy in the treatment of Stage I-II nasal natural killer/T-cell lymphoma. Med Dosim, 41(1): 42-46.##Ren W, Gao ShB, Yan J, et al. (2011) Comparison of the dosimetry of conventional three dimentional conformal intensity modulated radiation therapy for patients with nasal NK/T cell lymphoma. Chinese Clinical Oncology, 16(7): 644-647.##Lomax AJ, Goitein M, Adams J (2003) Intensity modulation in radiotherapy: photons versus protons in the paranasal sinus. Radiotherapy and Oncology, 66: 11-18.##Dirix P, Vanstraelen B, Jorissen M, et al. (2010) Intensity-modulated radiotherapy for sinonasal cancer: improved outcome compared to conventional radiotherapy. Int J Radiat Oncol Biol Phys, 78(4): 998-1004.##Hounsell AR, Sharrock PJ, Moore CJ, et al. (1992) Computer-assisted generation of multi-leaf collimator settings for conformation therapy. The British Journal of Radiology, 65: 321-326.##Chin LM, Kijewski PK, Svensson GK, Bjärngard BE (1983) Dose optimisation with computer-controlled gantry rotation, collimator motion and dose-rate variation. Int J Radiat Oncol Biol Phys, 9(5): 723-729.##Sankaralingam M, Glegg M, Smith S, et al. (2012) Quantitative comparison of volumetric modulated arc therapy and intensity modulated radiotherapy plan quality in sino-nasal cancer. Journal of Medical Physics, 37(1): 8-13.##Kathirvel M; Subramani V, Subramanian VS, et al.(2017) Dosimetric comparison of head and neck cancer patients planned with multivendor volumetric modulated arc therapy technology. Journal of Canser Research and Therapeutics, 13: 122-130.##Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 6(7): e1000097.##https://doi.org/10.1093/ptj/89.9.873##https://doi.org/10.1016/j.jclinepi.2009.06.005##https://doi.org/10.1371/journal.pmed.1000097##https://doi.org/10.7326/0003-4819-151-4-200908180-00135##https://doi.org/10.3736/jcim20090918##Ning ZH, Jiang JT, Li XD, et al. (Published online 2014) (2015) Coplanar VMAT vs. noncoplanar VMAT in the treatment of sinonasal cancer. Strahlentherapie und Onkologie, 191(1): 34-42.##Sang Y, Shan G, Shao K, et al. (2020) Radiotherapy for maxillary sinus carcinoma: dosimetric comparison of volumetric modulated arc therapy with 0° and 90° collimator intensity modulated radiation therapy. Journal of Radiation Oncology, 9: 53-58.##Raturi VP, Motegi A, Zenda S, et al. (2021) Comparison of a Hybrid IMRT/VMAT technique with non-coplanar VMAT and non-coplanar IMRT for unresectable olfactory neuroblastoma using the RayStation treatment planning system-EUD, NTCP and planning study. 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Acceptance test for fan beam CT linac treatment planning system using AAPM TG 119 test cases 2 2 Background: To assess accurately the URT treatment planning system from the United Imaging Healthcare, the American Academy of Pain Medicine (AAPM) TG 119 test plans for Intensity-Modulated Radiation Therapy (IMRT) and Volumetric-Modulated Arc Therapy (VMAT) were used. Materials and Methods: Based on the URT-Linac 506C, the plans were sent to the phantom. The overall accuracy was tested and examined using five geometry tests supplied in TG 119 for various treatment modes of IMRT and VMAT, with three types of beams using the Flattening Filter modality, estimated using the URT-TPS Monte Carlo algorithm. Moreover, a Farmer-type ion chamber was used to measure the point values, and a film was used to measure the fluence. Results: The disparities between the measured point doses and the anticipated doses for the FF photon beams for static MLC, dynamic MLC, and VMAT were within 2.16%, 1.89%, and 1.89%, respectively. The TG 119 report confidence limits were all met, and SMLC, DMLC, and VMAT had gamma passing rates greater than 99.80%, 99.60%, and 99.70%, respectively. Conclusion: The URT treatment planning system and the URT-Linac 506C have correctly commissioned IMRT and VMAT processes, according to this analysis, which was completed following the recommendations given by TG 119. 571 576 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/192023/07/19 1402/4/28 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 T. Wang T. Wang Department of Radiotherapy, Internal Medicine, Radiology Department, Medical Imaging Department, Qingdao West Coast New Area People's Hospital, Qingdao 266400, China P. Guo P. Guo Department of Radiotherapy, Internal Medicine, Radiology Department, Medical Imaging Department, Qingdao West Coast New Area People's Hospital, Qingdao 266400, China M. Li M. Li Department of Radiotherapy, Internal Medicine, Radiology Department, Medical Imaging Department, Qingdao West Coast New Area People's Hospital, Qingdao 266400, China Q. Wang Q. Wang Department of Radiotherapy, Internal Medicine, Radiology Department, Medical Imaging Department, Qingdao West Coast New Area People's Hospital, Qingdao 266400, China 15166616377@163.com TG 119 linac 506C URT-TPS flattening filter intensity-modulated radiation therapy volumetric-modulated arc therapy. 1. Boyer AL, Butler EB, Dipetrillo TA (2001) Intensity modulated radiation therapy collaborative working group. Intensity-modulated radiotherapy: current status and issues of interest. Int J Radiat Oncol Biol Phys, 51(4): 880-914.##Michael JZ, Zvi F, Laura H, et al. (2000) Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer. Radiotherapy and Oncology, 55(3): 241-249.##Lorenzo L, Fabrizio B, Gabriele S, et al. (2010) Accelerated partial breast irradiation with IMRT: new technical approach and interim analysis of acute toxicity in a phase III randomized clinical trial. Int J Radiat Oncol Biol Phys, 77(2): 509-515.##Nishi T, Nishimura Y, Shibata T, et al. (2013) Volume and dosimetric changes and initial clinical experience of a two-step adaptive intensity modulated radiation therapy (IMRT) scheme for head and neck cancer. Radiotherapy and Oncology, 106(1): 85-89.##Mackie TR, Holmes T, Swerdloff S, et al. (1993) Tomotherapy: a new concept for the delivery of dynamic conformal radiotherapy. Medical Physics, 20(6): 1709-1719.##Vulpen MV, Field C, Raaijmakers CP, et al. (2005) Comparing step-and-shoot IMRT with dynamic helical tomotherapy IMRT plans for head-and-neck cancer. Int J Radiat Oncol Biol Phys, 62(5): 1535-1539.##Sharma SD, Upreti RR, Laskar S, et al. (2008) Estimation of risk of radiation-induced carcinogenesis in adolescents with nasopharyngeal cancer treated using sliding window IMRT. Radiother Oncol, 86(2): 177-81.##Otto K (2008) Volumetric modulated arc therapy: IMRT in a single gantry arc. Medical Physics, 35(1): 310-317.##Wolff D, Stieler F, Welzel G, et al. (2009) Volumetric modulated arc therapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer. Radiother Oncol, 93(2): 226-33.##Van Benthuysen L, Hales L, Podgorsak MB (2011) Volumetric modulated arc therapy vs. IMRT for the treatment of distal esophageal cancer. Medical Dosimetry, 36(4): 404-409.##Sharma S, Subramani V, Kumar P, et al. (2017) EP-1498: IMRT and VMAT commissioning for Versa HD linear accelerator using AAPM TG-119. Radiotherapy and Oncology, 123: S803-S804.##Nelms BE, Chan MF, Jarry G, et al. (2013) Evaluating IMRT and VMAT dose accuracy: practical examples of failure to detect systematic errors when applying a commonly used metric and action levels. Med Phys, 40(11): 111722.##Ezzell GA, Burmeister JW, Dogan N, et al. (2009) IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119. Med Phys, 36(11): 5359-73.##Knill C and Snyder M (2011) An analysis of confidence limit calculations used in AAPM Task Group No. 119[J]. Med Phys, 38(4): 1779-1784.##Mynampati DK, Yaparpalvi R, Hong L, et al. (2012) Application of AAPM TG 119 to volumetric arc therapy (VMAT). J Appl Clin Med Phys, 13(5): 3382.##Wen N, Zhao B, Kim J, et al. (2014) Imrt and rapidarc commissioning of a truebeam linear accelerator using tg-119 protocol cases. 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Efficacy and safety of ultrasound-guided percutaneous laser ablation in the treatment of unifocal papillary thyroid microcarcinoma 2 2 Background: Ultrasound-guided percutaneous laser ablation (US-PLA), as a minimally invasive ablation method, has been widely used in the treatment of benign and malignant tumors. The objective of the current study was to determine the efficacy and safety of US-PLA for unifocal papillary thyroid microcarcinoma (PTMC). Materials and Methods: Totally 18 PTMC patients underwent US-PLA at our hospital were selected. Tumor location, tumor volume and thyroid function of patients were examined before percutaneous laser ablation (PLA). Contrast-enhanced ultrasound (CEUS) was performed immediately after PLA treatment. Complications, thyroid function, ablation area size and volume, tumor recurrence rate and metastasis rate were recorded. Results: Eighteen nodules were completely ablated in 18 patients, and postoperative CEUS showed no contrast fill in the ablated areas. Fifteen patients underwent single needle and single PLA ablation, and 3 cases underwent a second ablation due to incomplete ablation as confirmed by CEUS. All patients tolerated and completed ablation with no serious complications. The maximum diameter and volume of the ablation zones at 6, 12, 18, and 24 months after PLA were significantly smaller than the preoperative nodules (P<0.05). The number of tumors that completely disappeared at 6, 12, 18, and 24 months was 1 (5.7%), 6 (38.9%), 4 (61.1%), and 2 (72.2%), respectively. No local tumor recurrence, lymph node metastasis and distant metastasis occurred. Conclusion: US-PLA is a safe and effective technique for unifocal PTMC treatment, which may provide a new therapeutic option for PTMC patients who are not eligible or unwilling to receive surgery. 577 584 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/192023/07/192023/07/24 1402/5/2 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/30 1402/4/9 J. Gu J. Gu Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215006, PR China X. Fan X. Fan Department of Ultrasonography, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou 215000, Jiangsu Province, PR China X. Sun X. Sun Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China Z. Yu Z. Yu Department of Ultrasonography, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu Province 215001, PR China X. Zhu X. Zhu Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215006, PR China zhuxiaoli90@163.com Papillary thyroid microcarcinoma percutaneous laser ablation ultrasound efficacy safety. 1. Holt EH (2021) Current Evaluation of Thyroid Nodules. Med Clin North Am, 105(6): 1017-31.##Cho BY, Choi HS, Park YJ, et al. (2013) Changes in the clinicopathological characteristics and outcomes of thyroid cancer in Korea over the past four decades. Thyroid, 23(7): 797-804.##Coca-Pelaz A, Shah JP, Hernandez-Prera JC, et al. (2020) Papillary Thyroid Cancer-Aggressive Variants and Impact on Management: A Narrative Review. Adv Ther, 37(7): 3112-28.##Ito Y, Miyauchi A, Oda H (2018) Low-risk papillary microcarcinoma of the thyroid: A review of active surveillance trials. Eur J Surg Oncol, 44(3): 307-15.##Min Y, Wang X, Chen H, et al. (2020) Thermal Ablation for Papillary Thyroid Microcarcinoma: How Far We Have Come? Cancer Manag Res, 12: 13369-79.##Mauri G, Orsi F, Carriero S, et al. (2020) Image-Guided Thermal Ablation as an Alternative to Surgery for Papillary Thyroid Microcarcinoma: Preliminary Results of an Italian Experience. Front Endocrinol (Lausanne), 11: 575152.##Xu B, Zhou NM, Cao WT, et al. (2018) Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma. World J Clin Cases, 6(15): 936-43.##Cao XJ, Yu MA, Zhu YL, et al. (2021) Ultrasound-guided thermal ablation for papillary thyroid microcarcinoma: a multicenter retrospective study. Int J Hyperthermia, 38(1): 916-22.##Ito Y, Miyauchi A, Inoue H, et al. (2010) An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg, 34(1): 28-35.##Tong M, Li S, Li Y, et al. (2019) Efficacy and safety of radiofrequency, microwave and laser ablation for treating papillary thyroid microcarcinoma: a systematic review and meta-analysis. Int J Hyperthermia, 36(1): 1278-86.##Cho SJ, Baek JH, Chung SR, et al. (2019) Thermal Ablation for Small Papillary Thyroid Cancer: A Systematic Review. Thyroid, 29(12): 1774-83.##Bo XW, Lu F, Xu HX, et al. (2020) Thermal Ablation of Benign Thyroid Nodules and Papillary Thyroid Microcarcinoma. Front Oncol, 10: 580431.##Mauri G, Nicosia L, Della Vigna P, et al. (2019) Percutaneous laser ablation for benign and malignant thyroid diseases. 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A systematic review and meta-analysis of clinical trials of thyroids hormone using ultrasound based datasets 2 2 Background: Thyroid nodules account for 10-15 % of thyroid cancers or malignancies and ultrasound (US) is the most accurate technique for evaluating thyroid nodules.  Ultrasound-based datasets aid in detecting malignancy risk and avoiding Fine Needle Aspiration (FNA) biopsy. There are several guidelines for determining thyroid nodules, and ACR-TIRADS (American College of Radiology Thyroid Imaging Reporting and Data Systems) is the most accurate and widely used. However, very few or no studies have compared various grades of ACR-TIRADS based on benign and malignant nodules. Therefore, this study aimed to investigate the predictive risk of malignant cancer in thyroid nodules obtained from an ultrasound dataset based on the ACR-TIRADS classification. Materials and Methods: PubMed, Medline, EMBASE (Excerpta Medica dataBASE), Google Scholar, Cochrane Library, and Web of Science were searched for articles published between Jan 2018 to 30 June, 2022, and ultrasound-based datasets were obtained for benign and malignant thyroid nodules based on ACR-TIRADS. Results: Ten articles were included with 12723 total cases of thyroid ultrasound dataset for benign and malignant thyroid nodule classification. The total number of benign was 6641 and the total number of malignant thyroid nodules was 6082 respectively (95 % CI=1.14, 0.75-1.74) with P=0.53. The number of TR4 and TR5 malignancies were 1397 and 3733 respectively (95 % CI=0.42, 0.22-0.83) with P=0.01. Conclusion: The TR4 and TR5 grading of the ACR-TIRADS represents an excellent stratification system for classifying thyroid lesions thereby avoiding biopsies performed on benign nodules. 585 592 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/192023/07/192023/07/242023/07/23 1402/5/1 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/302023/06/20 1402/3/30 J. Niu J. Niu Department of Department of Ultrasound, First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming City, Yunnan Province, 650032, China H. Chen H. Chen Department of Department of Ultrasound, First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming City, Yunnan Province, 650032, China J. Peng J. Peng Department of Department of Ultrasound, First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming City, Yunnan Province, 650032, China H. Yuan H. Yuan Department of Department of Ultrasound, First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming City, Yunnan Province, 650032, China dryuanh@sina.com Thyroids hormone ultrasound benign malignant. 1. Beynon ME and Pinneri K (2016) An overview of the thyroid gland and thyroid-related deaths for the forensic pathologist. 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Rev Endocr Metab Disord, 22(2): 453-460.##Papini E, Guglielmi R, Bizzarri G (2007) Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid, 17: 229 -235.##Kwak JY, Han KH, Yoon JH, et al. (2011) Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology, 260: 892-899.##Wells SA Jr, Asa SL, Dralle H, et al. (2015) American thyroid association guidelines task force on medullary thyroid carcinoma. Revised American Thyroid association guidelines for the management of medullary thyroid carcinoma. Thyroid, 25(6): 567-610.##Shin JH, Baek JH, Chung J, et al. (2016) Korean society of thyroid radiology (KSThR) and Korean society of radiology. (2016) Ultrasonography diagnosis and imaging-based management of thyroid nodules: Revised Korean society of thyroid radiology consensus statement and recommendations. Korean J Radiol, 17(3): 370-95.##Russ G, Bonnema SJ, Erdogan MF, et al. (2017) European thyroid association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: The EU-TIRADS. Eur Thyroid J, 6(5): 225-237.##Zhou J, Yin L, Wei X, et al. (2020) Superficial organ and vascular ultrasound group of the society of ultrasound in medicine of the Chinese medical association##Chinese artificial intelligence alliance for thyroid and breast ultrasound. 2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: the C-TIRADS. Endocrine, 70(2): 256-279.##Tessler FN, Middleton WD, Grant EG, et al. (2017) ACR thyroid imaging, reporting and data system (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 14(5):587-595.##Yuan H, Niu J, Chen H (2015) Diagnostic value of real-time ultrasound elastography in parotid mass. 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Changes in some hematological parameters in radiology unit workers during the Covid-19 pandemic: Retrospective study 2 2 Background: The purpose of this study is to retrospectively compare annual changes (between 2019 and 2022 years) in selected hematological parameters in radiology workers during the COVİD-19 pandemic. Material and Methods: A total of sixteen radiology unit workers, seven male and nine female, aged 18-40 years, working in Ataturk University Faculty of Medicine, Department of Radiology in 2019-2022, were included in this retrospective study. The annual changes (between 2019-2022) of the participants in selected hematological parameters such as white blood cell (WBC), hemoglobin (HGB) and red blood cell (RBC) during the COVID-19 pandemic were compared. Results: There was a statistically significant difference when comparing the annual changes in WBC value during the COVID-19 pandemic (F(3, 36)=3.141, p=.037, ηp2= .207). It was observed that WBC decreased significantly in 2022 compared to 2021 (p<0.05). Moreover, a statistically significant difference was found in the comparison of the annual changes in the RBC value during the COVID-19 pandemic (F(3, 36)=25.370, p=.000, ηp2= .712). It was found that RBC diminished significantly in 2020, 2021, and 2022 compared to 2019. Additionally, a statistically significant difference was detected when comparing the annual changes in HGB value during the COVID-19 pandemic (F(3, 36)=26.794, p=.000, ηp2= .691). It was determined that HGB decreased significantly in 2022 compared to 2020 and 2022 compared to 2021 (p<0.05). Conclusion: It is known that radiology workers are exposed to more and more prolonged radiation due to the increase in patient density and the length of their working hours during the COVID-19 pandemic period. Radiation also has harmful acute and chronic effects on human health. In this process, it is seen that exposure to both COVID-19 and Ionizing Radiation (IR) increases the sensitivity of hematological parameters. 593 596 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/192023/07/192023/07/242023/07/232023/07/23 1402/5/1 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/302023/06/202023/06/20 1402/3/30 D. Ozturk D. Ozturk Health Services Vocational School, Ataturk University, Erzurum, Turkey Y. Sahin Y. Sahin Health Services Vocational School, Ataturk University, Erzurum, Turkey yilmazsahin86@gmail.com E. Meletlioglu E. Meletlioglu Faculty of Engineering, Department of Mechanical Engineering, Ataturk University, Erzurum, Turkey COVID-19 radiation hematology radiology workers. Basak T, Uzun S, Arslan F (2008) Taf Preventive Medicine Bulletin, 7(6): 547-54.##Radyasyon Güvenliği Yönetmeliği. In: Kurumu Tae, Editor.: Türkiye Atom Enerjisi Kurumu; 2000.##Radyasyon Çeşitleri: Türkiye Atom Enerjisi Kurumu. Cited 2015 30.07.2015]. Available From: Http://Www.Taek.Gov.Tr/Ogrenci/R02.Htm.##Tubiana M and Dutreix J (1990) Introduction to radiobiology. Paris, France: Taylor & Francis,1990. pp. 24-99.##Saygin M, Yasar S, Kayan M, et al. (2014) Effects of ionizing radiation on respiratory function tests and blood parameters in radiology staff. The West Indian Medical Journal, 63(1): 40-45.##Mattiuzzi C and Lippi G (2020) Which lessons shall we learn from the 2019 novel coronavirus outbreak? Ann Transl Med, 8(3): 48.##Kara Rogers, Ed., Blood: Physiology And Circulation (The Human Body), 1th ed.##Buttarello M (2016) Laboratory diagnosis of anemia: are the old and new red cell parameters useful in classification and treatment, how?. International Journal of Laboratory Hematology, 38: 123-132.##“Guyton and Hall Textbook of Medical Physiology.” 12th ed. Saunders,2003,http://avaxho.me/blogs/ChrisRedfield.##El-Shanshoury H, El-Shanshoury G, Abaza A (2016) Evaluation of low dose ionizing radiation effect on some blood components in animal model. J Radiat Res Appl Sci, 9(3): 282-293.##NRC Nuclear Regulatory Commission "Backgrounder on Biological Effects of Radiation," 2008,Office of Public Affairs. Protecting People and the Environment.##Harris C, Carson G, Baillie JK, et al. (2020) An evidence-based framework for priority clinical research questions for COVID-19. J Glob Health, 10(1): 011001.##Kahn JS and McIntosh K (2005) History and recent advances in coronavirus discovery, Pediatr. Infect Dis J, 24(11): S223-S227.##Cheng S-C, Chang Y-C, Chiang Y-L-F et al. (2020) First case of coronavirus disease 2019 (COVID-19) pneumonia in Taiwan. J Formos Med Assoc, 119(3): 747-751.##Li B et al. (1018) Identification of retinoic acid receptor agonists as potent hepatitis B virus ınhibitors via a drug repurposing screen. Antimicrob. Agents Chemother, 62(12): 10.1128/AAC.##Tezer H and Bedir DT (2020) Novel coronavirus disease (COVID-19) in children. Turkish J Med Sci, 50(SI-1): 592-603.##Federal Register (1991) Code of Federal Regulations. 10 CFR 20.1201. Standards for Protection Against Radiation: 1991; Occupational dose limits for adults. Washington, DC: U.S. Government Printing Office.##Bushong S (2012) Radiologic Science for Technologists Physics, Biology and Protection, Tenth Edition, Mosby.##Zheng Y, Zhang Y, Chi H, et al. (2020) The hemocyte counts as a potential biomarker for predicting disease progression in COVID-19: a retrospective study. Clin Chem Lab Med, 58: 1106-15.##Wu H, Zhu H, Yuan C, et al. (2020) Clinical and immune features of hospitalized pediatric patients with coronavirus disease 2019 (COVID-19) in Wuhan, China. JAMA Netw Open, 3: e2010895.##Taneri PE, Gómez-Ochoa SA, Llanaj E, et al. (2020) Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis. Eur J Epidemiol, 35(8):763-773.##Bergamaschi G, Borrelli de Andreis F, Aronico N, et al. (2021) Internal medicine Covid-19 collaborators. Anemia in patients with Covid-19: pathogenesis and clinical significance. Clin Exp Med, 21(2): 239-246.##Amgalan A and Othman M (2020) Hemostatic laboratory derangements in COVID-19 with a focus on platelet count. Platelets, 31(6): 740-745.##Ardestani A and Azizi Z (2021) Targeting glucose metabolism for treatment of COVID-19. Signal Transduct Target Ther,6(1): 112.##Mo P, Xing Y, Xiao Y, et al. (2021). Clinical Characteristics of Refractory Coronavirus Disease 2019 in Wuhan, China. Clin Infect Dis, 73(11): e4208-e4213.##Sun S, Cai X, Wang H, et al. (2020) Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clinica Chimica Acta, 507: 174-180.##Yang AP, Liu JP, Tao WQ, Li HM (2020) The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol, 84: 106504.## ##

Measurement of radioactivity levels of liquid milk samples in Kütahya, Turkey 2 2 Background: Milk is a fundamental part of the human daily diet, so radioactivity concentrations in milk must have been controlled regularly. In this study, radiation activities were measured in 12 ultra-high temperature (UHT) milk samples collected in Kütahya, Turkey, in August 2021. Materials and Methods: Radium (Ra-226), thorium (Th-232) and potassium (K-40) values were determined by using the Canberra 3x3 NaI(Tl) gamma spectroscopy method in 8 samples, and Radon (Rn-222) activity measurements have been conducted in 12 samples using the E-perm method. Results: Radium (Ra-226), thorium (Th-232) and potassium (K-40) levels are measured as < MDA (2.28 Bq/kg), < MDA (2.53 Bq/kg), 40.43 ± 2.25 to 53.31 ± 2.30 Bq/kg, respectively. Radon (Rn-222) concentrations were determined by the E-perm system between 0.46 ± 0.02 and 2.01 ± 0.05 Bq/l with an average of 1.11 ±  0.03 Bq/l. Conclusions: Annual ingested radiation doses were calculated using radioactivity levels for different age groups as a result of milk consumption. Ingestion dose levels are below the worldwide average values given in the UNSCEAR report. It has been observed that the results are below the safety limits. 597 600 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/192023/07/192023/07/242023/07/232023/07/232023/07/23 1402/5/1 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/302023/06/202023/06/202023/06/20 1402/3/30 M. Biçer M. Biçer Department of Physics, Dumlupınar University, Faculty of Arts and Sciences, Kütahya, Turkey mustafa.bicer@dpu.edu.tr H. Çetinkaya H. Çetinkaya Department of Physics, Dumlupınar University, Faculty of Arts and Sciences, Kütahya, Turkey Annual effective dose milk radon gamma spectrometry natural radioactivity. 1. UNSCEAR (United Nations Scientific Committee on the Effect of Atomic radiation) (2000) United Nations General Assembly Vol. 1 Annex B United Nations, New York##Duong VH, Nguyen TD, Hegedűs M, et al. (2021) Assessment of 232Th, 226Ra, 137Cs, and 40 K concentrations and annual effective dose due to the consumption of Vietnamese fresh milk. J Radioanal Nucl Chem, 328: 1399-1404.##Yii MW (2019) Measurement of activity concentrations in powdered milk and estimation of the corresponding annual effective dose. J Radioanal Nucl Chem, 320: 193-199.##TUIK (Turkish Statistical Institute) (2022) Milk and milk dairy production report number: 45747 Date: 14.02.2022 https://data.tuik.gov.tr/Bulten/Index?p=Sut-ve-Sut-Urunleri-Uretimi-Aralik-2021-45747 access date: 21.04.2022##Hashim AK, Abbas RH, Naser MA, et al. (2021) Comparison study of CR-39 and CN-85 detectors to evaluate the alpha radioactivity of some samples of drinks in Iraq. Applied Radiation and Isotopes, 167: 109410.##Pereira WS, Lopes JM, Kelecom A, et al. (2021) Lifetime cancer risk increase due to consumption of some foods from a High Background Radiation Area. Appl Radiat Isot, 176: 109855.##Silva C, Amaral R, Amaral A, et al. (2006) 226Ra in milk of the dairy cattle from the rural region of Pernambuco, Brazil. J Radioanal Nucl Chem, 270: 237-241.##Machraoui S, Mohan M P, Naregundi K, Labidi S (2019) Baseline studies on radionuclide concentration in food materials and estimation of the committed radiation dose around the phosphate industrial area of south Tunisia. Radiation Protection Dosimetry, 184(2): 263-273.##Kamenova-Totzeva RM, Totzev AV, Kotova RM, Badulin VM (2017) Radionuclides Content in Pasteurized Cow Milk: Dose Estimation. Radiation Protection Dosimetry, 174(4): 464-470.##Kırıs E, Baltas H, Damla N, Ertugral B, Cevik U (2013) Radioactivity levels in some cow milks consumed in Eastern Black Sea Region of Turkey. Batman Üniversitesi Yaşam Bilimleri Dergisi, 3(2): 29-38.##Agbalagba EO, Agbalagba HO, Avwiri GO (2016) Cost-benefit analysis approach to risk assessment of natural radioactivity in powdered and liquid milk products consumed in Nigeria. Environmental Forensics, 17(3): 191-202.##Al-Kinani AT (2006) Depleted uranium in the food chain at south of Iraq. Int J Radiat Res, 4(3) :143-148.##Çetinkaya H and Biçer M (2021) Radon and radium measurements of Eskişehir Spa waters. Radiation Protection Dosimetry, 194(2-3): 82-89.##Çetinkaya H, Manisa K, Işık U (2022) Radioactivity Content of Building Materials Used in Kutahya Province, Turkey. Radiation Protection Dosimetry, 198(3): 167-174.##Jodłowski P (2006) Self-absorption correction in gamma-ray spectrometry of environmental samples - an overview of methods and correction values obtained for the selected geometries. Nukleonika, 51(2): 21-25.##Patra AC, Mohapatra S, Sahoo SK, et al. (2013) Age-dependent dose and health risk due to intake of uranium in drinking water from Jaduguda, India. Radiation Protection Dosimetry, 155(2): 210-216.## ##

Micronucleus assay in the blood of residents in Mamuju, West Sulawesi, Indonesia, a high background radiation area 2 2 Background: Mamuju is regarded as a high background radiation location (HBRA). The local population's cells may be harmed by the high ionizing radiation dosage in this region. Micronuclei (MN), nucleoplasmic bridges (NPB), nuclear buds (NBUD), and 8-shaped blood cells can be used to detect cytogenetic abnormalities. By comparing blood samples from HBRA to control site samples, this study focused on determining the impacts of high-risk levels of natural radiation in the cells. Material and Methods: The study employed a cytokinesis-block micronucleus cytome (CBMN Cyt) test. Results: In comparison to the control group, the study group had a higher nuclear division index (NDI) and a higher frequency of all abnormalities. The formation of MN and 8-shaped nuclei was significantly influenced by high natural radiation, whereas levels of NPB and NBUD were not significantly affected. Cytogenetic abnormalities were within normal limits and did not correlate with age or gender. Conclusion: Chronic high background radiation exposure impacted human lymphocyte cell growth and the levels of certain biomarkers. 601 604 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/192023/07/192023/07/242023/07/232023/07/232023/07/232023/07/23 1402/5/1 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/302023/06/202023/06/202023/06/202023/06/20 1402/3/30 N. Khoirunnisa N. Khoirunnisa Faculty of Science and Technology, Islamic State University of Syarif Hidayatullah, Jakarta, Indonesia S. Purnami S. Purnami Research Center for Safety, Metrology, and Nuclear Quality Technology, Research Organization for Nuclear Energy (ORTN), National Research and Innovation Agency (BRIN), Jakarta, Indonesia D. Tetriana D. Tetriana Research Center for Safety, Metrology, and Nuclear Quality Technology, Research Organization for Nuclear Energy (ORTN), National Research and Innovation Agency (BRIN), Jakarta, Indonesia D. Dasumiati D. Dasumiati Faculty of Science and Technology, Islamic State University of Syarif Hidayatullah, Jakarta, Indonesia D. Ramadhani D. Ramadhani Research Center for Radioisotopes, Radiopharmaceuticals and Biodosimetry Technology, Research Organization for Nuclear Energy (ORTN), National Research and Innovation Agency (BRIN), Tangerang Selatan, Banten, Indonesia H.N.E. Surniyantoro H.N.E. Surniyantoro Research Center for Radioisotopes, Radiopharmaceuticals and Biodosimetry Technology, Research Organization for Nuclear Energy (ORTN), National Research and Innovation Agency (BRIN), Tangerang Selatan, Banten, Indonesia harr005@brin.go.id M. Syaifudin M. Syaifudin Research Center for Radioisotopes, Radiopharmaceuticals and Biodosimetry Technology, Research Organization for Nuclear Energy (ORTN), National Research and Innovation Agency (BRIN), Tangerang Selatan, Banten, Indonesia CBMN cyt assay cytogenetic abnormalities high background radiation area Mamuju residents Ayua TJ, Tyovenda AA, Igyuse IS, Ejegwoya OP (2017) Determination of ionizing radiation exposure levels within four local mining sites selected from Sardauna Local Government Area of Taraba State - Nigeria. Int J Phys, 5(5): 157-161.##Aliyu AS and Ramli AT (2015) The world's high background natural radiation areas (HBNRAs) revisited: A broad overview of the dosimetric, epidemiological and radiobiological issues. Radiat Measur, 73: 51-59.##Vaiserman A, Koliada A, Zabuga O, Socol Y (2018) Health impacts of low-dose ionizing radiation: current scientific debates and regulatory issues. Dose Response, 16(3): 1-27.##Syaeful H, Sukadana IG, Sumaryanto A (2014) Radiometric mapping for naturally occurring radioactive materials (NORM) assessment in Mamuju, West Sulawesi. Atom Indonesia, 40(1):33-39.##Nugraha ED, Hosoda M, Kusdiana K, et al. (2021) Comprehensive exposure assessments from the viewpoint of health in a unique high natural background radiation area, Mamuju, Indonesia. Sci Rep, 11: 1-16.##Kiang JG and Olabisi AO (2019) Radiation: a poly-traumatic hit leading to multi-organ injury. Cell Biosci, 9: 1-15.##Fenech M (2007) Cytokinesis-block micronucleus assay evolves into a "cytome" assay of chromosomal instability, mitotic dysfunction, and cell death. Mutat Res, 600: 58-66.##Tian XL, Lu X, Cai TJ, Lyu YM, Tian M, Liu QJ (2021) Cytogenetic monitoring of peripheral blood lymphocytes from medical radiation professionals occupationally exposed to low-dose ionizing radiation. Mutat Res Genet Toxicol Environ Mutagen, 867: 503370.##Torres-Bugarin O, Covarrubias-Bugarin R, Zamora-Perez AL, et al. (2007) Anabolic androgenic steroids induce micronuclei in buccal mucosa cells of bodybuilders. Br J Sports Med, 41(9): 592-596.##Ramadhani D, Sardini S, Lubis M, Syaifudin M (2016) Evaluation of lymphocytes proliferation in Botteng village (a high background radiation area) inhabitants using binucleate index. J Appl Isot Radiat, 12(2): 107-112.##Kravtsov V, Livanova A, Starkova Y (2017) Nuclear abnormalities of lymphocytes as the simplest markers for bioindication test in case of mass casualty events involving radiation exposure. Emerg Med (Los Angel), 7(4): 1-6.##Wodarz D, Sorace R, Komarova NL (2014) Dynamics of cellular responses to radiation. PloS Comput Biol, 10(4): 1-11.##Purnami S, Lubis M, Suryadi, Syaifudin M (2020) The assessment of mitotic and nuclear division indexes as biomarkers for estimating the risk on the health of residents exposed to the high natural radiation of Mamuju, West Sulawesi. J Phys: Conf Ser, 1436: 1-8.##Sinitsky MY and Druzhinin VG (2014) The application of the cytokinesis-block micronucleus assay on peripheral blood lymphocytes for the assessment of genome damage in long-term residents of areas with high radon concentration. J Radiat Study, 55(1): 61-66.##Syaifudin M, Ramadhani D, Purnami S, et al. (2022) The evaluation of frequencies of cytogenetic biomarkers in lymphocyte of residents from high natural radiation area in West Sulawesi, Indonesia. Int J Adv Sci Eng Inf Technol, 12(1): 263-269.##Lindberg HK, Wang X, Jarventaus H, et al. (2007) Origin of nuclear buds and micronuclei in normal and folate-deprived human lymphocytes. Mutat Res, 617: 33-45.##Mortazavi S, Mosleh-Shirazi M, Tavassoli A, et al. (2011) A comparative study on the increased radioresistance to lethal doses of gamma rays after exposure to microwave radiation and oral intake of flaxseed oil. Int J Radiat Res, 9: 9-14.##Syaifudin M, Defiyandra VP, Nurhayati S, et al. (2018) Micronucleus assay-based evaluation of radiosensitivity of lymphocytes among inhabitants living in high background radiation area of Mamuju, West Sulawesi, Indonesia. Genome Integr, 9(2): 1-5.##Karuppasamy CV, Ramachandran EN, Kumar VA, et al. (2016) Peripheral blood lymphocyte micronucleus frequencies in men from areas of Kerala, India, with high vs. normal levels of natural background ionizing radiation. Mutat Res Genet Toxicol Environ Mutagen, 800: 40-45.##Salimi M and Mozdarani H (2015) Different aspects of cytochalasin B Blocked micronucleus cytome (CBMN cyt) assay as a comprehensive measurement tool for radiobiological studies, biological dosimetry, and genome instability. Int J Radiat Res, 13(2): 100-126.## ##

Isolated scapular metastasis from breast carcinoma 2 2 Breast cancer is the most common cancer in women and the most common cause of cancer-related death in women worldwide. Distant metastases in breast cancer occur in the bones, lungs, liver, and brain. Surgical treatment is recommended because the resection of primary tumor in breast cancer has a positive effect on prognosis and survival. The importance of ablative therapy has increased with the development of systemic treatments for a small number of organ metastases, which are referred to as oligometastases. Patients with isolated bone metastases have better prognosis than those with other visceral metastases. In single bone metastases, systemic and local treatments are preferred using a multidisciplinary approach. This case report presents a breast cancer patient with contralateral isolated scapula glenoid metastases, which have not been reported in the literature. 605 608 2023/06/62023/06/62023/06/62023/06/102023/06/132023/06/142023/06/182023/06/182023/06/182023/06/192023/06/192023/06/212023/06/252023/06/252023/06/272023/06/272023/06/282023/07/32023/07/42023/07/102023/07/112023/07/112023/07/112023/07/172023/07/172023/07/182023/07/182023/07/192023/07/192023/07/242023/07/232023/07/232023/07/232023/07/232023/07/23 1402/5/1 2023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/202023/06/302023/06/202023/06/202023/06/202023/06/202023/06/20 1402/3/30 H. Baysal H. Baysal Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital, General Surgery, Istanbul, Turkey hakanbaysal_tr@yahoo.com B. Baysal B. Baysal Istanbul Medeniyet University Faculty of Medicine, Radiology, Istanbul, Turkey M. Tarik Tatoglu M. Tarik Tatoglu Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital Nuclear Medicine, Istanbul, Turkey O. Alimoglu O. Alimoglu H. Baysal1*, B. Baysal2, M. Tarik Tatoglu3, O. Alimoglu4 1Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital, General Surgery, Istanbul, Turkey 2Istanbul Medeniyet University Faculty of Medicine, Radiology, Istanbul, Turkey 3Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital Nuclear Medicine, Istanbul, Turkey 4Istanbul Medeniyet University Faculty of Medicine General Surgery, Istanbul, Turkey Breast cancer metastases scapula. 1. Riggio AI, Varley KE, Welm AL (2021) The lingering mysteries of metastatic recurrence in breast cancer. British Journal of Cancer, 124(1): 13-26.##Wang R, Zhu Y, Liu X, Liao X, He J, Niu L (2019) The Clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer. BMC Cancer, 19(1): 1091.##https://doi.org/10.21203/rs.2.11765/v4##https://doi.org/10.21203/rs.2.11765/v3##https://doi.org/10.21203/rs.2.11765/v2##https://doi.org/10.21203/rs.2.11765/v1##Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, et al. SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER website, April 2018.##Pulido C, Vendrell I, Ferreira AR, Casimiro S, Mansinho A, Alho I, et al. (2017) Bone metastasis risk factors in breast cancer. Ecancermedicalscience, 11: 715.##Harris E, Barry M, Kell MR (2013) Meta-analysis to determine if surgical resection of the primary tumour in the setting of stage IV breast cancer impacts on survival. Annals of surgical oncology, 20(9): 2828-2834.##Song X, Wei C, Li X (2022) The Signaling Pathways Associated With Breast Cancer Bone Metastasis. Front Oncol, 12: 855609.##Wu X, Li F, Dang L, Liang C, Lu A, Zhang G (2020) RANKL/RANK System-Based Mechanism for Breast Cancer Bone Metastasis and Related Therapeutic Strategies. Frontiers in Cell and Developmental Biology, 8: 76.##Marazzi F, Orlandi A, Manfrida S, Masiello V, Di Leone A, Massaccesi M, et al. (2020) Diagnosis and Treatment of Bone Metastases in Breast Cancer: Radiotherapy, Local Approach and Systemic Therapy in a Guide for Clinicians. Cancers, 12(9): 2390.##Clézardin P, Coleman R, Puppo M, Ottewell P, Bonnelye E, Paycha F, et al. (2021) Bone metastasis: mechanisms, therapies, and biomarkers. Physiol Rev. 101(3): 797-855.##Wang L, Fang D, Xu J, Luo R (2020) Various pathways of zoledronic acid against osteoclasts and bone cancer metastasis: a brief review. BMC Cancer, 20(1): 1059.##van der Velden J, Willmann J, Spałek M, Oldenburger E, Brown S, Kazmierska J, et al. (2022) ESTRO ACROP guidelines for external beam radiotherapy of patients with uncomplicated bone metastases. Radiother Oncol. 173: 197-206.##Kraus KM, Winter J, Zhang Y, Ahmed M, Combs SE, Wilkens JJ, et al. (2022) Treatment Planning Study for Microbeam Radiotherapy Using Clinical Patient Data. Cancers, 14(3): 685.##Rich SE, Chow R, Raman S, Liang Zeng K, Lutz S, Lam H, et al. (2018) Update of the systematic review of palliative radiation therapy fractionation for bone metastases. Radiother Oncol. 126(3): 547-557. Erratum in: Radiother Oncol. 2019 Jun; 135:201.##Sit D, Zhao B, Chen KT, Lohrisch C, Olson R, Nichol A, et al. (2022) The Effect of Breast Cancer Subtype on Symptom Improvement Following Palliative Radiotherapy for Bone Metastases. Clinical Oncology (Royal College of Radiologists (Great Britain)), 34(4): 267-273.##Pielkenrood BJ, van der Velden JM, van der Linden YM, Bartels MMT, Kasperts N, Verhoeff JJC, et al. (2021) Pain Response After Stereotactic Body Radiation Therapy Versus Conventional Radiation Therapy in Patients With Bone Metastases-A Phase 2 Randomized Controlled Trial Within a Prospective Cohort. Int J Radiat Oncol Biol Phys. 110(2): 358-367.## ##