79 2322-3243 Dr. Hossein Mozdarani 4543 Radiation Biology After 20 years! Experiences of 20 years publication in the field of radiological sciences. The need for continued researches and global contributions Mozdarani Hossein b b Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran, 1 1 2023 21 1 1 5 02 01 2023 20 01 2023 This paper reports the 20 years non-stop efforts and experiences gained during all these years from publication of the international Journal of Radiation Research. A brief history of how the journal was established, improvement in radiological sciences since the discovery of X-rays, technological achievements in the field and also the research areas that need to be appreciated is described. The paper also indicates that why we still need to do research in the field of radiological and nuclear sciences for better radiation protection, risk assessment and better use of radiation for diagnostic and therapeutic purposes. Moreover, contribution of scientists from all over the world and use of papers published in the journal by numerous investigators in the field of radiation research is highlighted by statistics.
4563 Radiation Biology CT imaging findings and clinical correlation analysis of different clinical types of novel coronavirus pneumonia Wang G. c Zheng X. d Zou Y. e Xie H. f Wen H. g Yu F. h Yuan H. i Du H. j Liao Y. k c Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China d Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China e Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China f Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China g Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China h Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China i Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China j Department of Radiology, Affiliated Dongguan People’s Hospital, Southern Medical University, Dongguan 523059, China k GE Healthcare, Guangzhou 510623, China 1 1 2023 21 1 7 13 14 01 2023 20 01 2023 Background: To deepen the understanding of COVID-19 and provide a theoretical basis for clinical diagnosis and treatment, the clinical manifestations, laboratory test findings and chest computed tomography (CT) signs of this disease and the correlations among them were explored in this study. Materials and Methods: A total of 85 patients with confirmed cases of COVID-19 were included, and their disease courses, symptoms and laboratory test results were recorded. Results: The main characteristics of COVID-19 infection were fever (56 cases), respiratory symptoms (47 cases), normal or decreased white blood cell count (84 cases), decreased lymphocyte count (43 cases), and increased C-reactive protein (CRP) level (37 cases). There was a positive correlation between fever and each of white blood cell count, lymphocyte count, and CRP level (P<0.05). Age, disease course, fever, lymphocyte count, CRP level and CT findings were statistically correlated. In the CT-positive group, the lesions were often multiple (57 cases) and peripherally distributed (53 cases). The main manifestations included ground-glass density shadows (61 cases), grid-like changes (47 cases), abnormal pleural changes (53 cases), abnormal blood vessels (52 cases) and bronchial abnormalities (40 cases). Conclusion: Mild and common COVID-19 cases have certain characteristics, clinical manifestations and laboratory parameters are correlated with CT manifestations. The comprehensive diagnosis according to clinical manifestations, laboratory and CT characteristics can minimize the missed diagnosis rate. 4579 Radiation Biology Dosimetric and biological comparison of treatment plans between LINAC and robot systems in stereotactic body radiation therapy for localized prostate cancer Dai Z. l Zhu L. m Wang A. n Guo X. o Liu Y. p Zhuang Y. Yang P. Li N. Zhang H. Xiang Z. l National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China m Department of Radiation Oncology, Shanghai East Hospital, Tongji University, Shanghai, China n Department of Radiation Oncology, Shanghai East Hospital, Tongji University, Shanghai, China o Department of Radiation Oncology, Changhai Hospital affiliated to Navy Medical University, Shanghai, China p Department of Radiation Oncology, Changhai Hospital affiliated to Navy Medical University, Shanghai, China Department of Radiation Oncology, Shanghai East Hospital, Tongji University, Shanghai, China Department of Radiation Oncology, Shanghai East Hospital, Tongji University, Shanghai, China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China Department of Radiation Oncology, Changhai Hospital affiliated to Navy Medical University, Shanghai, China Department of Radiation Oncology, Shanghai East Hospital, Tongji University, Shanghai, China 1 1 2023 21 1 15 22 18 01 2023 20 01 2023 Background: The aim of this study was to make a comparison of plan quality between MLC-based EDGE and the cone-based CyberKnife systems in SBRT of localized prostate cancer. Materials and Methods: Ten patients with target volumes from 34.65 to 82.16 cc were included. Treatment plans were created for both systems using the same constraints. Dosimetric indices including target coverage, conformity index (CI), homogeneity index (HI), gradient index (GI) were applied for target, while the sparing of critical organs was evaluated with special dose-volume metrics and integral dose. Meanwhile, the delivery time and monitor units (MUs) were also estimated. The radiobiological indices such as equivalent uniform dose (EUD), tumor control probability (TCP) and normal tissue complication probability (NTCP) were also analyzed. Results: Both plans produced similar target coverage, HI and GI. For EDGE, more conformal dose distribution as well as reduced exposure of critical organs were obtained together with reduction of 91% delivery time and 72% MUs. EDGE plans also got lower EUD for bladder, rectum, urethra and penile bulk, which associated with reduction of NTCPs. However, higher values of EUD and TCP for tumor were obtained with CK plans.  Conclusion: It indicated that both systems were capable of producing almost equivalent plan quality and can meet clinical requirements. CyberKnife has higher target dose while EDGE system has more advantages in normal tissue sparing and delivery efficiency. 4565 Radiation Biology Dosimetric  comparison of the heart substructures with IMRT and VMAT techniques in left breast radiotherapy: The effect of deep inspiratory breath-hold Arslan A. Aktaş E. Eren S.K. Dengiz I. Arslan S.A. Güney Y. Kayseri City Hospital, Clinic of Radiation Oncology, Doctor, Kayseri City Hospital, Kayseri, Turkey Kayseri City Hospital, Clinic of Radiology, Doctor, Kayseri City Hospital, Kayseri, Turkey Kayseri City Hospital, Clinic of General Surgery, Doctor, Kayseri City Hospital, Kayseri, Turkey Kayseri City Hospital, Clinic of Radiation Oncology, Health Physicist, Kayseri City Hospital, Kayseri, Turkey Ankara Memorial Hospital, Clinic of Radiation Oncology, Doctor, Ankara Memorial Hospital, Ankara, Turkey Ankara Memorial Hospital, Clinic of Radiation Oncology, Doctor, Ankara Memorial Hospital, Ankara, Turkey 1 1 2023 21 1 23 30 14 01 2023 20 01 2023 Background: This study aimed to compare the doses received by the four chambers and vascular structures of the heart during adjuvant radiotherapy (RT) after left breast-conserving surgery (BCS) using intensity-modulated RT (IMRT) and volumetric-modulated arc therapy (VMAT) techniques. Material and Methods: Simulation images were taken of 14 patients who underwent left BCS with both free-breathing (FB) and deep inspiration breath-hold (DIBH) techniques. Left breast RT was planned with both IMRT and VMAT. Planned target volumes 50 and 60, homogeneity index, conformity index, and monitor unit values, as well as radiation doses received by organs at risk, were compared. Results: In IMRT compared to VMAT, in the heart (Dmean, V10, V2 ) and heart substructures (left ventricle [V5] , right ventricle [Dmean], right atrium [Dmean, Dmax], left atrium [Dmean, V5], right coronary artery [RCA; Dmean, Dmax], left artery coronary main [LACM; Dmean], and left circumflex artery [LCxA; Dmean, Dmax]), significant dose reductions were observed. When FB and DIBH results were compared, in the DIBH technique, the heart (Dmean, V25, V10, V2) and heart substructures (left ventricle [Dmean, Dmax, V23, V5], right ventricle [Dmean, Dmax], right atrium [Dmean, Dmax], left atrium [Dmean, Dmax], left anterior descending artery [Dmean, Dmax, V20], RCA [Dmax], LACM [Dmean], and LCxA [Dmean, Dmax]), doses were significantly decreased. Conclusion: In RT of patients with left BCS, significant dose reductions occurred in the lung, heart, and almost all substructures of the heart using DIBH compared to FB. 4566 Radiation Biology The effect of patients’ body mass indices on PET/CT images with 68Ga-labeled prostate-specific membrane antigen on a TruFlight PET/CT system Parlak Y. Mutevelizade G. Sezgin C. Goksoy D. Gumuser G. Sayit E. Department of Nuclear Medicine, Manisa, Turkey Department of Nuclear Medicine, Manisa, Turkey Department of Nuclear Medicine, Manisa, Turkey Department of Nuclear Medicine, Manisa, Turkey Department of Nuclear Medicine, Manisa, Turkey Department of Nuclear Medicine, Manisa, Turkey 1 1 2023 21 1 31 36 14 01 2023 20 01 2023 Background: The aim of our study was to determine the appropriate scanning time for 68Ga-labeled PSMA PET/CT imaging by using the BMI of the patients. Materials and Methods: Fifty-seven patients who were included to the study were divided into 4 groups according to their BMI. In addition to the routine imaging protocol, further imaging focused on the patient’s liver was performed. PET images were reconstructed from the reference image obtained for the images at 60, 90, 120, 180, 240, and 300 s/bp. To evaluate PET/CT with 68Ga-PSMA image quality, SNRnorm was calculated using the SNR in the liver. The correlations and differences between scanning times according to BMI were calculated. Results: The SUVmax values of the reconstructed images were obtained and the changes observed in SUVmax were statistically significant (p<0.05). Our results showed that the SUVmax in the liver decreases with increasing scan time. We calculated that SNR decreased with scan time in all groups. The SNR difference was statistically significant only for 60 and 90 s/bp (p=0.045, p=0.02, respectively). No difference in SNRnorm values was determined between the groups (p≥0.05). Conclusion: If the same amount of radioactivity is injected into patients, the liver SUVmax of the overweight patient would be expected to be higher than underweights. Since SUV calculations are standardized according to body weight, BMI and body composition may cause variability in SUV measurements. As the BMI increased, the background activity in 68Ga-PSMA PET/CT images improved. However, due to the longer imaging time, patient movement should be considered. 4567 Radiation Biology Radiotherapy related prognostic factors in brain metastasis patients who have undergone whole brain radiotherapy or with local boost and survived more than 6 months Kızıltan H.S. Coban G. Altınok P. Tekce E. Mayadagli A. Health Sciences University, Basaksehir Cam and Sakura City Hospital, Department of Radiation Oncology, Turkeye Bezmialem Vakif University, Faculty of Medicine. Department of Pathology, PC: 34093, Fatih, Turkeye Bezmialem Vakif University, Faculty of Medicine. Department of Radiation Oncology, PC: 34093, Fatih, Turkeye Bezmialem Vakif University, Faculty of Medicine. Department of Radiation Oncology, PC: 34093, Fatih, Turkeye Bezmialem Vakif University, Faculty of Medicine. Department of Radiation Oncology, PC: 34093, Fatih, Turkeye 1 1 2023 21 1 37 44 15 01 2023 20 01 2023 Background: In this study, prognostic features of radiation were investigated in cancer patients with 1-10 brain metastases (BM) who have not under surgery and survived longer than 6 months. Materials and Methods: This retrospective study included 136 patients have lung, breast, colon cancer and malign melanoma (MM) with 1-10 BM. All patients and data of BM patients who lived longer than 6 months radiotherapy (RT) related factors affecting their survival rates were examined. Patients were given only WBRT (Whole brain Radiotherapy) in 8-20 fractions with a 160-300 cGy / day fraction, or WBRT with local boost RT with an additional daily 300-350 cGy fraction. Results: When the results were evaluated analysis showed that the having CT, breast cancer, a KPS of 60% or more, daily fraction dose of RT affected survival significantly in all patients. Then subgroub analysis were obtained according to survival rates, number of metastases more than 5 affects life negatively (r=-0.435 and p=0.03) for survival longer than 6 months (SL6m) and survival shorter or equal than 6 months SS6m. The WBRT doses of 3000 cGy with 300 cGy daily fraction size negatively affected life compared to 2500 cGy with 250 cGy  (r=-0.280 and p=0.01). Conclusion: It was determined that KPS > 60 and limiting WBRT doses up to 250 / 2500 cGy daily and total in patients with BM between 1-10 was the important best prognostic factor due to RT for SL6m, which increased patient performance and survival rates. 4568 Radiation Biology Effects of repeated ultraviolet-C radiation on tissues: A Guinea pig model study Ozmen O. Ipek V. Tasan S.A. Ayozger L.E.O. Altintas M. Burdur Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Pathology, Burdur, Turkey Burdur Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Pathology, Burdur, Turkey Burdur Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Pathology, Burdur, Turkey Burdur Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Pathology, Burdur, Turkey Burdur Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Pathology, Burdur, Turkey 1 1 2023 21 1 45 51 15 01 2023 20 01 2023 Background: Due to the disinfection and antibiotic resistance of microorganisms, there is a growing interest in ultraviolet-C (UV-C). UV-C has numerous advantages, and the applications of this method for fluids, surfaces, and air are rapidly expanding. However, nothing is known about how UV-C affects living bodies. This study's objective is to assess the results of 10 sessions of 10- to 20-minute UV-C exposure on healthy guinea pigs. Materials and Methods: After five days of UV-C treatment, blood and visceral organ samples were collected and analyzed. Results: Moreover, the hematological and biochemical analyses of the blood samples revealed no significant changes. According to histopathological examination, UV-C treatment did not cause any damage to internal organs. Except for the intestine, caspase-3 immunohistochemistry revealed no increase in apoptotic activity. In the UV-C-treated groups, only minor apoptotic activity was observed in intestinal goblet cells. Conclusion: This study found that repeated UV-C exposure for ten sessions lasting 10-20 minutes did not result in any pathological findings in the guinea pig model. This result suggested that UV-C could be used for barn and pen disinfection when animals are present as well as udder disinfection prior to milking. 4569 Radiation Biology Predicting radiation therapy outcome of pituitary gland in head and neck cancer using Artificial Neural Network (ANN) and radiobiological models Shahbazi S. Ferdosi R. Malekzadeh R. Egdam Zamiri R. Mesbahi A. Molecular Medicine Research Center, Institute of Biomedicine, Tabriz University of Medical Sciences, Tabriz, Iran Department of Health Information Technology, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran Department of Medical Physics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Radiation Oncology Department, Shahid Madani Hospital, Medical School, Tabriz University of Medical Sciences, Tabriz, Iran Molecular Medicine Research Center, Institute of Biomedicine, Tabriz University of Medical Sciences, Tabriz, Iran 1 1 2023 21 1 53 59 15 01 2023 20 01 2023 Background: Pituitary dysfunction is one of the complications associated with head and neck radiation therapy. Here, radiobiological and artificial neural network (ANN) models were used to estimate the normal tissue complication probability (NTCP) of the pituitary gland. Materials and Methods: Fifty-one adult patients with nasopharyngeal carcinoma and brain tumor were studied. Two radiobiological models of Lyman Kutcher Burman (LKB), log-logistic, and ANN were employed to calculate the NTCP of the pituitary gland for all patients. BIOPLAN and MATLAB softwares were used for all calculations. The necessary parameters for each radiobiological model were calculated using Bayesian methods. R2 (coefficient of determination) and root-mean-square error (RMSE) parameters were used for the ANN method to get the best estimate. The area under the receiver operating characteristic (ROC) curve (AUC) and Akaike information criterion (AIC) were used to compare the models. Results: The respective mean NTCPs for nasopharyngeal patients with LKB and log-logistic models were 54.53% and 50.83%. For brain tumors, these values were 62.23% for LKB and 53.55% for log-logistic. Furthermore, AIC and AUC values for LKB were 77.1 and 0.826 and for log-logistic were 71.9 and 0.902, respectively. AUC value for ANN was 0.92. Conclusions: It can be deduced that LKB and log-logistic methods make reliable estimations for NTCP of the pituitary gland after radiotherapy. Moreover, the ANN approach as a novel method for NTCP calculations performed better than the two conventional analytical models as its estimations were much closer to the clinical data. 4570 Radiation Biology Electromagnetic field exposed stem cells repaired Parkinson's disease symptoms in a rat model Jadidi T. Asadian N. Jadidi M. Safari M. Sameni H.R. Semnani V. Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran Department of Medical Physics, Semnan University of Medical Sciences, Semnan, Iran Department of Medical Physics, Semnan University of Medical Sciences, Semnan, Iran Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran Department of Pathology, Semnan University of Medical Sciences, Semnan, Iran 1 1 2023 21 1 61 66 15 01 2023 20 01 2023 Background: Some growth factors and electromagnetic fields (EMFs) are capable to differentiate bone marrow mesenchymal stem cells (BMMSCs) into neural cells. EMF may induce BMMSCs to differentiate into dopaminergic (DA) neurons. Our aim was to analyze the influence of EMF on BMMSCs in the treatment of rat models of Parkinson's disease. Materials and Methods: BMMSCs were extracted from the rat’s hind limbs and incubated in a cell-cultured CO2 incubator. After the third passage, the BMMSCs were exposed to sinusoidal and square waveform EMF (400 µT, 75 Hz, 1 h/day - 1 week or 7 h/1 day) and injected into the substantia nigra region of Parkinson rats. Results: The results confirmed an increased number of TH+ neurons, a reduction of activated astrocytes, and an improvement in locomotor activity (Pole test) of sinusoidal EMF groups. Conclusion: We presented a low-frequency sinusoidal EMF that increased BMMSCs’ differentiation into DA neurons. The results indicated that injection of BMMSC exposed to sinusoidal 75 Hz EMF may increase TH+ cells in SNpc and motor coordination activity in the rat model of Parkinson's disease. 4571 Radiation Biology Can dynamic wedges reduce thyroid dose in breast radiotherapy compared to physical wedges? Joya M. Kordane T. Karimi A.H. Geraily G. Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Department of Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 1 1 2023 21 1 67 72 15 01 2023 20 01 2023 Background: In breast radiotherapy, enhanced dynamic wedge (EDW) and physical wedges are used to improve the homogeneity of the dose. Scattered photons are the major factor in the off-field organs' unwanted dose. In breast radiotherapy, the thyroid is a critical off-field organ at risk for scattered photons. This study was performed to compare the unwanted dose and the secondary fatal cancer risk to the thyroid in breast radiotherapy between EDW and physical wedge. Material and Methods: The 6-MV Varian 2100 C/D linac was used to irradiate the breast of a thorax phantom under two opposite tangential fields. The unwanted dose that reached the thyroid was estimated using Eclipse Treatment Planning System and Gafchromic film dosimetry. Corresponding fatal secondary cancer risks were also assessed according to the NCRP report 116 recommendations. Results: The measured dose for thyroid using a physical wedge and enhanced dynamic wedge were measured as 2.1 and 0.735 cGy, which are approximately 1% and 0.37% of the prescribed dose to the breast (2 Gy), respectively. In the case of radiotherapy with the physical wedge, the lifetime risk of secondary fatal cancer attributed to the thyroid is 0.0480 and 0.0504 % using TPS and measured data, respectively. In the case of the dynamic wedge, the above values were reduced to 0.0168 and 0.0176 %, respectively. Conclusions: Using an enhanced dynamic wedge in breast radiotherapy reduced the thyroid dose by about 65% compared to the physical wedge technique. As a result, it was concluded that the application of EDW is safer than the physical wedge in breast radiotherapy. 4572 Radiation Biology Immunomodulatory effects of ionizing radiation on peripheral blood mononuclear cells Öztürk N. Karlıtepe A. Depboylu B. Kılıç Eren M. Aydın Adnan Menderes University, Faculty of Medicine, Department of Radiation Oncology, Aytepe Campus, Aydin, Turkey Aydın Adnan Menderes University, Faculty of Medicine, Department of Medical Biology, Aytepe Campus, Aydin, Turkey Aydın Adnan Menderes University, Faculty of Medicine, Department of Radiation Oncology, Aytepe Campus, Aydin, Turkey Aydın Adnan Menderes University, Faculty of Medicine, Department of Medical Biology, Aytepe Campus, Aydin, Turkey 1 1 2023 21 1 73 78 15 01 2023 20 01 2023 Background: Avoiding exposure to ionizing radiation due to environmental factors is almost inevitable in daily life. Here, we aimed to investigate the possible immunomodulatory effects of ionizing radiation on NK and T cell activation using Peripheral Blood Mononuclear Cells (PBMC). We measured the pro-inflammatory cytokines INFγ, IL-2 and TNFα, as well as Granzyme B. In addition, we determined the expression levels of CD28, NKG2D (CD314) receptors, which play a key role in the activation of T and NK cells, respectively. Materials and Methods: 20 ml peripheral blood samples were taken from healthy volunteer donors and exposed to radiation doses of 0, 1, 3 and 5 Gy. ELISA analysis was used to measure Granzyme B, INFy, TNFα and IL2. Expression of CD28, NKG2D (CD314) receptors was measured by qRT-PCR analysis. Apoptosis and necrosis were measured by AnnexinV/7AAD analysis. Catalase activity was measured using hemolysates from irradiated blood samples. Results: Here we show that IR exposure induces necrotic cell death in PBMCs as the main response. IR exposure significantly induced secretions of Granzyme B, TNFα, IL2, and INFγ in a dose-dependent manner. In addition, mRNA levels of CD28 and NKG2D expressions were increased by 3 Gy IR exposure, but decreased by 5 Gy, while catalase activity increases with 1 Gy IR treatment, 3 and 5 Gy decreases. Conclusions: Our results suggest that not only high doses but even low doses of radiation can modulate the immune response through cytokine secretion and activation of T and NK cell receptors. 4573 Radiation Biology Novel polyethylene/tungsten oxide/bismuth trioxide/barium sulfate/graphene oxide nanocomposites for shielding against X-ray radiations Abdolahzadeh T. Morshedian J. Ahmadi S. Department of Polymer Processing, Iran Polymer and Petrochemical Institute (IPPI), P.O. Box 14975/112, Tehran, Iran Department of Polymer Processing, Iran Polymer and Petrochemical Institute (IPPI), P.O. Box 14975/112, Tehran, Iran Department of Polymer Processing, Iran Polymer and Petrochemical Institute (IPPI), P.O. Box 14975/112, Tehran, Iran 1 1 2023 21 1 79 87 15 01 2023 20 01 2023 Background: High-energy beams, such as gamma rays and X-rays, have many applications in nuclear power plants, healthcare, aerospace, and medicine. Therefore, appropriate radiation protection of living bodies in nuclear science and industries is essential to shield humans against the aforementioned radiation. Utilizing shielding materials is a practical method to protect individuals from harmful radiation. Materials and Methods: High-density polyethylene (HDPE)-based nanocomposites were prepared to perform as a shield against X-ray radiation by using various weight fractions of the tungsten oxide, barium sulfate, and bismuth trioxide (10, 15, 20, and 25% wt). Samples’ shielding properties were experimentally studied with an X-ray tube at 50, 60, 80, and 120 kVp. Results: The recorded results showed that with increasing the number of nanoparticles, the transmission factor and HVL values were decreased and the linear attenuation coefficient was increased significantly. SEM, EDX analysis, and TEM evaluated the morphological properties of the fabricated samples. Results revealed that the particle size of the used nanoparticles was in the 25-50 nm range. Thermal study of the prepared nanocomposites including ΔHm, crystalline percentage (Xc), melting point (Tm) as well as the thermal stability of the nanocomposites were determined by using DSC, and TGA, respectively. Conclusion: Samples including 20% ​​and 25% wt of Bismuth trioxide, and Tungsten trioxide loaded on graphene oxide reached 12% and 10% transmission factor values, respectively. 4574 Radiation Biology Radioprotective effect of Nigella sativa Oil (NSO) against radiation-induced hepatic toxicity and haematological alteration in irradiated albino mice Mohammed Amin S.S. Mohammed L. MA. Faiq A.B. Salih S.S. Saeed Z.Y. Muhammed Salih T.F. Abdullah Rashid D. Anaesthesia Department, College of Health & Medical Technology, Sulaimani Polytechnic University, Sulaimaniyeh, Iraq Medical Laboratory Department, College of Health & Medical Technology, Sulaimani Polytechnic University, Sulaimaniyeh, Iraq Medical Laboratory Department, College of Health & Medical Technology, Sulaimani Polytechnic University, Sulaimaniyeh, Iraq Medical Laboratory Department, College of Health & Medical Technology, Sulaimani Polytechnic University, Sulaimaniyeh, Iraq Zhianawa Cancer Center, Sulaimaniyeh, Iraq Nursing Department, College of Health & Medical Technology, Sulaimani Polytechnic University, Sulaimaniyeh, Iraq Biology Department, College of Basic Education, University of Sulaimani, Sulaimaniyeh, Iraq 1 1 2023 21 1 89 95 15 01 2023 20 01 2023 Background: In this study, an attempt was made to estimate to what degree Nigella sativa oil (NSO) could reduce the destruction produced by irradiation on the haematopoietic system, liver function and histopathological changes of liver tissues, and malondialdehyde MDA level in albino mice exposed to whole-body x-radiation. Materials and Methods: the mice were divided into four different groups. Group I (negative control group) received deionized water. Group II (6 Gy group) was exposed to whole-body X-irradiation at 6 Gy. Group III (NSO) received NSO orally (10 ml/kg). Group IV (NSO+6 Gy) received NSO orally (10 ml/kg) for 5 days prior to irradiation. Results: The results of the group exposed to 6 Gy X-irradiation showed a decrease in red blood cell count, haemoglobin, hematocrit, mean corpuscular volume and mean corpuscular haemoglobin (all with P ≤ 0.05), while for the group that received NSO before irradiation, all the mentioned parameters were ameliorated and shifted toward normal values. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzyme levels were showed to be affected: they both increased during irradiation in the (6 Gy) group and decreased in the (NSO + 6 Gy) group. Histopathological alterations were also observed when the liver was irradiated in the (6 Gy) group. However, the (NSO+6 Gy) group demonstrated a lowering of the incidence of histopathological changes in liver tissues. Conclusion: it is clear that mice treated with NSO oil prior to X-irradiation had reduced alteration in the haematological parameters, hepatocyte lipid peroxidation and the histology of the liver. 4575 Radiation Biology Dose assessment of 137-Cs in agricultural surface soil in Selangor, Malaysia Muthu H. Ramesh K. Ramesh S. Bashir S. Centre for Ionics University of Malaya, Department of Physics, Faculty of Science, University Malaya, 50603, Kuala Lumpur, Malaysia Centre for Ionics University of Malaya, Department of Physics, Faculty of Science, University Malaya, 50603, Kuala Lumpur, Malaysia Centre for Ionics University of Malaya, Department of Physics, Faculty of Science, University Malaya, 50603, Kuala Lumpur, Malaysia Centre for Ionics University of Malaya, Department of Physics, Faculty of Science, University Malaya, 50603, Kuala Lumpur, Malaysia 1 1 2023 21 1 97 103 15 01 2023 20 01 2023 Background: The activity concentration (AC) of cesium-137 (137Cs) in the agricultural soil was measured in this study to set reference data and an indicator of the radionuclide fallout especially in Malaysia. Materials and Method: Using the High Purity Germanium (HPGe) gamma-ray spectrometer, the AC of 137Cs was employed to determine the radiological hazards to the public. Results: Results revealed that the AC of 137Cs in the soil samples ranged between 0.34 ± 0.09 to 3.21 ± 0.17 Bqkg-1. Dose rate computed from the corresponding value of AC ranged from 0.01 to 0.10 nGyh-1. The annual effective dose rate ranged between 1.25 to 11.8 µSv y-1. The values of Excessive lifetime cancer risk, ELCR ranged between 0.47 × 10-5 to 4.45 × 10-5  is lesser than the safety threshold of 0. 29 × 10−3. The analysis of variance of this parameter is found to be at p<0.05 which is statistically significant in this study. Conclusion: The outcomes from this study show that the analysed values are below than the recommended values by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNCSEAR) and The International Commission on Radiological Protection (ICRP) and do not cause any radiological hazards to the general population. 4580 Radiation Biology Fixed field technique for hippocampal avoidance whole-brain radiotherapy: A feasibility study using Elekta system Vysakh R. Ganapathi Raman R. Muhammed S.O. Puzhakkkal N. Department of Physics, Noorul Islam Centre for Higher Education, Kumaracoil- 629 180, Kanyakumari District, Tamil Nadu, India Department of Medical Physics, MVR Cancer Centre & Research Institute, Calicut, India Department of Medical Physics, Anna University, Chennai, India Department of Physics, Noorul Islam Centre for Higher Education, Kumaracoil- 629 180, Kanyakumari District, Tamil Nadu, India 1 1 2023 21 1 105 109 18 01 2023 20 01 2023 Background: Treatment planning for Hippocampal avoidance whole-brain radiotherapy (ha-WBRT) is demanding and time-consuming due to the position of the Hippocampus and low dose tolerances. This study evaluates the feasibility of fixed field volumetric modulated arc therapy (fVMAT) for ha-WBRT using the Elekta Agility™ collimator system and Monaco treatment planning system. Materials and Methods: Fifteen patients treated for WBRT were subjected to fVMAT and conventional VMAT (cVMAT) planning with similar optimisation criteria. Jaws were restricted above and below the Hippocampus for the fVMAT plans with isocenter positioned at the brain's center, dividing the brain target into two. In contrast, Jaws were not restricted for cVMAT plans. Plans were compared in terms of dose constraints, dose conformity, and dose homogeneity. Plan complexity was compared in terms of modulation degree (MD), and delivery efficiency was checked by performing patient-specific quality assurance. Results: Both plans met the RTOG-0933 dose requirements. The fVMAT plans showed statistically significant improved target coverage (D98%, V30Gy), target homogeneity, and conformity. There was no statistically significant change in hippocampus doses between the two plans. The fVMAT plans showed lesser plan complexity with average MD of 3.34±0.5 compared to cVMAT plans (average MD of 4.21±0.4, p=0.00011). The increased plan complexity was reflected in the delivery efficiency as cVMAT showed higher average gamma failure for patient3.84%(p=0.0004) and a target volume 7.13% (p=0.0359) structures. Conclusions: According to the obtained results, the Elekta Agility™ collimator system and Monaco treatment planning system can generate better ha-WBRT plans using the fVMAT technique. 4581 Radiation Biology The effect of feeding state on the level of detections of plasma metabolites in rats after irradiation Li R. Cai J. Wang Y. Fu C. Hu B. Department of Radiation Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China Department of Radiation Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China Department of Radiation Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China Department of Radiation Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China Department of Radiation Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China 1 1 2023 21 1 111 116 18 01 2023 20 01 2023 Background: The existence of correlates between radiation and plasma metabolites in rats might be affected by feeding conditions. Materials and Methods: The rats were kept without food and water for a certain time before the blood was harvested on the seventh day after X-ray irradiation at doses of 0 and 8 Gy. The plasma metabolites were tested using Enzyme-Linked Immunosorbent Assay (ELISA). Results: Our results showed that abrosia for 2 h before blood harvesting could increase the level of detections of both interleukin-6 (IL-6) and glycine (Gly) in rats. Furthermore, abrosia and meanwhile water deprivation for 2-4 h increased better the level of detections of IL-6 and Gly in rats. Conclusion: The level of detections of biomarkers in the blood may be more authentic and can better reflect the changes in the experimental animals after stress when they are treated by both abrosia and water deprivation for 2 h before blood harvesting. 4590 Radiation Biology Radioactive heat production rate and excess lifetime cancer risk of sand from two major rivers in India – A comparative study Murugesan S. Ravichandran S. Department of Physics, Sathyabama Institute of Science and Technology, Chennai – 600119, Tamilnadu, India Department of Physics, Sathyabama Institute of Science and Technology, Chennai – 600119, Tamilnadu, India 1 1 2023 21 1 117 124 22 01 2023 20 01 2023 Background: Rivers are having a major role in crop cultivation, power generation, and sand used for mining and construction. Materials and Methods: The gamma ray spectrometer was used to estimate uranium, thorium, and potassium (238U, 232Th, 40K), and its average is tabulated. Related parameters like absorbed dose (D), Annual Effective Dose Equivalent (AE), and also hazard indices (H) to assess radiation exposure. Additional parameters like radium equivalent (Req), radioactive heat production (RHP), Excess Lifetime Cancer Risk (ELCR), Alpha (Iα), and Gamma Index (Ig), Annual Gonadal dose (AGD) are computed and correlated with the related parameters to understand radioactive penetration to the living things. Results: This study exhibits the radioactive contaminants in Cauvery are in control by comparing to the world average except for C20. The average radiological risk of the Palar river is slightly higher and site no.6 shows three times the world average. Conclusion: This radioactive pollution can cause serious health effects for the people living in and around those two sites (C20 and P7) who are highly exposed to radiation, which leads to harmful effects on living things. 4597 Radiation Biology Soil radioactivity levels, radiation hazard assessment and cancer risk in Al-Sadr City, Baghdad Governorate, Iraq Al-Alawy I.T. Taher W.I. Mzher O.A. Physics Department, College of Science, Mustansiriyah University, Baghdad, Iraq Directorates of Radioactive Waste Treatments and Management, Ministry of Science and Technology, Baghdad, Iraq 1 1 2023 21 1 125 130 25 01 2023 20 01 2023 Background: Natural radioactivity concentrations of 238U, 232Th, and 40K in surface soil specimens from various sectors in Sadr City were collected and measured by HPGe detector. Materials and Methods: Twenty specimens were collected from selected sites in the study district. The total average activity concentrations of radionuclides 238U, 232Th and 40K were 15.35±0.82 Bq/kg, 13.31±0.79 Bq/Kg, and 315.39±18.05 Bq/kg, respectively. Correlations between these radionuclides demonstrate a secular equilibrium in the examined soil. Results: It was found that the average rate of absorbed dose is 87.510±21.555 nGy/h which is below the maximum limit except for specimens S13 and S14, where their values are close to the permissible limit. The indoor gamma-ray absorbed dose rate exceeds the permissible limit in the soil specimens S13 and S14. Radium equivalent activities, external and internal hazard indices, representative, with respect to the examined soil, do not override the global limits.  Conclusions: Average concentrations of the radioactive elements were lower than the worldwide mean values. 40K concentration and lifetime cancer risk ELCRin  and ELCRtatal in soil specimens S13, S14, and S20 were above the recommended limit, while total annual effective dose equivalent AEDEtatal is very close to the permissible limits provided by UNSCEAR and ICRP. 4599 Radiation Biology Simulation based analysis of 4He, 7Li, 8Be and 10B ions for heavy ion therapy Ekinci F. Bostanci E. Güzel M.S. Dagli O. Ankara University, Institute of Nuclear Sciences, Besevler 10. Yıl Campus, Tandogan Ankara, Turkey Ankara University, Computer Engineering Department, Golbasi, Ankara, Turkey Ankara University, Computer Engineering Department, Golbasi, Ankara, Turkey Gazi University, Faculty of Medicine, Department of Neurosurgery Gamma Knife Unit, Ankara, Turkey 1 1 2023 21 1 131 137 28 01 2023 20 01 2023 Background: The therapeutic usage of heavy ions has received much attention due to its advantageous physical and radiobiological assets compared to photon-based therapy. Thanks to these unique properties of heavy ion radiotherapy, it can allow dose increase in tumors while reducing the radiation dose in adjacent normal tissues. Materials and Methods: The main aim of this study is to analyze the LET, recoils, lateral scattering, and phonon energies of selected 4He, 7Li, 8Be and 10B heavy ions in the water phantom in the therapeutic energy range. This analysis was performed by using MC based TRIM simulation method of interactions. Results: The main innovation that this study will provide to the literature is not only ionization but also the calculation of recoils, lateral scattering and phonon oscillation resulting from all interactions. According to the calculation results, the largest recoils peak value was found to be 7.957 eV/A-ion×103 in the B ion, and it was observed that it formed an average of 88% more recoil peaks than He ion, 53% on average than Li ion and 24% more than Be ion on average. In the lateral scattering, the greatest value occurred in the He ion. It should be noted that He ion produced 42%, 57% and 71% more lateral scattering than Li, Be and B ions respectively. As a result of all these interactions, 32% of the phonon and 68% of the phonon were formed respectively by the recoil interactions. Conclusion: This study includes ionization and all particle-based target interactions. 4600 Radiation Biology Postoperative intensity-modulated radiotherapy and chemotherapy in patients with high-grade glioma: analysis of efficacy and prognostic factors Zhu H. Luo J. Department of Radiation Oncology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China Department of Radiotherapy, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213003, China 1 1 2023 21 1 139 145 28 01 2023 20 01 2023 Background: To determine the treatment efficacy and prognostic factors for high-grade glioma (HGG) patients treated with postoperative intensity-modulated radiotherapy (IMRT). Materials and Methods: An analysis of 86 HGG patients who underwent surgery, radiotherapy (total dose: 54-60 Gy), and chemotherapy was performed retrospectively. The primary endpoint was Overall survival (OS), while the secondary endpoint was progression-free survival (PFS). Patient factors, tumor characteristics, and treatments were examined for their prognostic value. Results: Among the enrolled patients, there were 22 patients of grade III and 64 patients of grade IV. At the end of the study, 48 cases had died, and 66 cases had relapsed. The median OS was 24 months, while the median PFS was just 9 months. The mean OS of patients with grade III and IV glioma was 41 months and 16 months, respectively. Patients had relative survival rates of 73.2%, 46.6%, and 27.0% at 1, 2, and 5 years. The most common type of tumor recurrence was relapse within the radiation field. Univariate analysis indicated that sex, age, Karnofsky Performance Scale score (KPS), Pathological grade, tumor location, surgical approach, and adjuvant chemotherapy cycles were predictive factors for OS (P< 0.05). In contrast, sex, age, pathological grade, number of lesions, surgical approach, and adjuvant chemotherapy cycles were predictive factors for PFS (P < 0.05). According to multivariate analysis indicated that pathological grade, surgical approach, and adjuvant chemotherapy cycles were associated with longer OS and PFS (P< 0.05). Conclusions: Grade III gliomas, total surgical resection, and adjuvant chemotherapy for more than six cycles were associated with more favorable survival outcomes in this study. 4601 Radiation Biology Effectiveness of oesophageal gastric junction tumour motion with and without a pneumatic abdominal compression belt in the era of precise image-guided radiation therapy Li N. Li T-T Xiang X-Y Liu X-D Tang Y. Li Y-X Shi J-M Liu W-Y Ren H. Fang H. Tang Y. Chen B. Lu N-N Hao J. Qi S-N Wang S-L Liu Y-P Song Y-W Jin J. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China 1 1 2023 21 1 147 151 28 01 2023 20 01 2023 Background: To investigate the effect of a pneumatic abdominal compression belt (PACB) on suppressing the movement of primary lesions in the oesophageal gastric junction (EGJ). Materials and Methods: Titanium clips A and B were placed on the upper and lower edges of the tumour grossly in 10 patients by using gastroscopy before preoperative chemoradiotherapy. Four sets of images of clips were obtained by 4DCT in each patient with and without PACB. Nine sets of CBCT images were obtained from each patient for analysis. Paired t tests and independent t tests were used to test for differences. Results: In the cranio-caudal (CC) directions, the internal motion of clip B was smaller with PACB than without PACB (P=0.000). The interfraction motion of clip B in the left-right (LR), anterior-posterior (AP) and CC directions was smaller with than without PACB (P=0.002, 0.002 and 0.005). We determined that 0.9, 0.9 and 0.9 cm ITV margins in the LR, AP and CC directions are suggested for EGJ lesions with PACB to better cover the tumour movements. Conclusion: A pneumatic abdominal compression belt can reduce the intra- and interfraction movements of EGJ tumours during preoperative radiotherapy. 4603 Radiation Biology 3D printed customized bolus for intensity-modulated radiotherapy in a patient with nasal radiotherapy Song R. Li W. Department of Radiotherapy, Tianmen First People’s Hospital, Tianmen 431700, Hubei, China Department of Radiotherapy, Tianmen First People’s Hospital, Tianmen 431700, Hubei, China 1 1 2023 21 1 153 157 29 01 2023 20 01 2023 Background: The aim of the study was to compare the dose differences between 3D-printed bolus, commercial bolus (wax), thermoplastic mask bolus and bolus-free head phantoms simulating nose radiotherapy. Materials and Methods: We used 3D printing technology to make a 3D-printed bolus. To evaluate the clinical feasibility, intensity-modulated radiation therapy (IMRT) plans were created for head phantoms that were 3D-printed bolus, commercial bolus (wax), thermoplastic mask bolus or bolus-free. Dosimetry differences were compared in simulating nose radiotherapy. Results: For the PTV of all the plans, 3D-printed bolus, commercial bolus (wax) and thermoplastic masks bolus had lower Dmax and D1% than the plan without the bolus; for Dmean and D95%, the results were the opposite. For V90%, V95%, V100% and HI, the plan with the 3D-printed bolus was better than the others, and the plan without the bolus was the worst. Conclusions: The dosimetric differences of 3D-printed bolus, commercial bolus (wax), thermoplastic mask bolus and bolus-free were compared in head phantoms simulating nose radiotherapy. The 3D-printed bolus was good for fit, had a high level of comfort and repeatability, and also had better dose parameters in IMRT plans. 4604 Radiation Biology Natural radionuclides and radiological hazards in sediment samples of the Euphrates River in Al Diwaniyah governorate, Iraq Riyadh M. Al-Hamzawi A.A. Department of Physic, College of Education, University of Al-Qadisiyah, Diwaniyah, Iraq Department of Physic, College of Education, University of Al-Qadisiyah, Diwaniyah, Iraq 1 1 2023 21 1 159 162 29 01 2023 20 01 2023 Background: The radionuclide concentrations of 226Ra, 232Th and 40K were measured in the sediments samples of the Euphrates River in Al-Diwaniyah city, Iraq. Materials and Methods: Effective technique of high purity germanium (HPGe) detector based on a high-resolution gamma spectrometry system was used to determine the specific activity of natural and artificial radionuclide in sediments samples. Results: The present investigated showed that the average values of specific activities of (226Ra, 232Th, and 40K) were 86.015, 48.446, and 764.661 Bq/Kg, respectively. The averages values of the radiological hazards radium equivalent (Raeq), absorbed dose rate (DR) and external hazard index (Hex) were 211.3 Bq/kg, 100.9 nGy/h, and 0.56 respectively. Specific activity of 137Cs appeared in some sediment samples, which indicates the presence of industrial pollution in those areas. Conclusion: According to these values, the results of the current study exceeded the global permissible values of the natural radionuclides. 4605 Radiation Biology Effective management of a patient with secondary male breast cancer after neck radiotherapy for tonsillar lymphoma Tramacere F. Pisani A.R. Maggiulli E. Moschetta M. Sardaro A. Altini C. Sciacqua A. Portaluri M. Section of radiotherapy, A. Perrino Hospital, 72100 Brindisi, Italy Section of Nuclear Medicine, DIM, University “Aldo Moro”, 70124 Bari, Italy Medical Physics, ASL Brindisi, 72100 Brindisi, Italy Division of Diagnostic Imaging, Department of Emergency and Organ Transplantation (DETO), Aldo Moro University, Medical School, Bari, Italy Section of radiotherapy, DIM, University “Aldo Moro”, 70124 Bari, Italy Section of Nuclear Medicine, DIM, University “Aldo Moro”, 70124 Bari, Italy Section of Nuclear Medicine, DIM, University “Aldo Moro”, 70124 Bari, Italy Section of radiotherapy, A. Perrino Hospital, 72100 Brindisi, Italy 1 1 2023 21 1 163 167 29 01 2023 20 01 2023 Recent advances in surgical techniques, chemotherapy and radiotherapy led to significant increase in the number of long-term cancer survivors, but on other hand with increased probability of adverse effects, including the development of a secondary malignant neoplasm. This is especially important to consider when there is the need to provide treatment recommendations for patients undergoing radiotherapy keeping in mind the potential risks of toxicity associated with possession of specific genetic variants. We reported the clinical case of a patient in whom rare malignancies associated to genetic mutation have been treated and managed in the best way thanks to the support of radiotherapist. In particular a male patient with positive family history of BRCA2 mutation, developed breast cancer after radiotherapy for a rare tonsillar non-Hodgkin Lymphoma. We highlight that the knowledge of all aspects of the diseases, of all treatments secondary effects, in particular of ionizing radiation in patients with potential genetic risk of toxicity, allowed an optimal management of the case. 4607 Radiation Biology PET/CT Imaging of disseminated peritoneal leiomyomatosis: Cases reports Ye D. Yin H. Geng C. Department of Radiology, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, Jiangsu Province, China Department of Radiology, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, Jiangsu Province, China Department of Radiology, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, 214044, Jiangsu Province, China 1 1 2023 21 1 169 171 29 01 2023 20 01 2023 Disseminated Peritoneal Leiomyomatosis (DPL) is a rare benign illness characterized by numerous smooth muscle nodules over the peritoneal surface of the abdomen and pelvis. It mostly occurs in women of reproductive age, seldom in the postmenopausal women and men. We herein report two DPL cases and both of them took 18F-FDG PET/CT (Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography) examination. On PET/CT images, all DPL nodules presented low to moderate metabolism, and the range of SUVmax (standard uptake value) was 1.9 to 4.4. An unusual diagnosis of DPL was difficult to make. 4608 Radiation Biology Osteomalacia mimicking skeletal metastasis induced by antacid and sucralfate: An interesting image on bone scintigraphy Chuang Y-W Chan H-P Lin C-Y Huang Y-F Hsu C-C Chang C-C Shen D. H-Y Chuang K-P Yang M-H Tyan Y-C Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, 912, Taiwan Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan 1 1 2023 21 1 173 176 29 01 2023 20 01 2023 Phosphate absorption can be blocked by over-the-counter antacids, such as calcium- magnesium-, and aluminum-containing products. Although it is rare to see hypophosphatemia induced by aluminum-containing antacids, the combination treatment using two kinds of aluminum-containing agents may significantly increase the risk of hypophosphatemia in clinical settings. We present a case of hepatocellular carcinoma, showing multiple hot spots while being investigated for metastatic cancer in a routine bone scan. Initial laboratory studies showed hypophosphatemia. Long-term treatment for upper gastrointestinal bleeding with antacids and sucralfate was remarkable in the patient’s past history. Compared with corresponding radiographic findings, multiple areas of increased uptake on the bone scan are consistent with osteomalacia and microfractures. This case demonstrates that antacid and sucralfate-induced osteomalacia can mimic bony metastasis in a hepatocellular carcinoma patient on bone scintigraphy. Additional imaging modality, laboratory surveillance or follow-up bone scintigraphy may be recommended for accurate diagnosis or an appropriate treatment plan for the patient.