2026-10-13T17:06:48+03:30 http://ijrr.com/browse.php?mag_id=93&slc_lang=en&sid=1

93-6848 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 G. Ramachandran M.S. Ahmad Fadzil safwanfadzil@ukm.edu.my N.A. Azmi S.H. Zuber N.M. Ung M.T. Dolah S.D. Oluwafemi N.M. Noor Background: As the complexity of radiotherapy treatments increases, ensuring the quality and safety of these interventions becomes paramount. A critical component of this quality assurance (QA) is the systematic evaluation of radiotherapy processes through audits and intercomparison protocols. This has prompted the radiation authorities to establish numerous safety protocols and audit systems, thereby forming a detailed regulatory QA landscape. The present review identifies and describes the major independent dosimetry audit organisations available worldwide. Materials and Methods: A search strategy was developed and administered to select articles on dosimetry audit systems from the PubMed, Web of Science, and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. Literature searches were done using keywords like radiotherapy incident, intercomparison, remote dosimetry audit phantom, audit organisations, and radiotherapy, with an emphasis on data relevant to the research. Results: A total of 26 articles were identified that focused on the intercomparison and dose audit in radiotherapy. The reviewed articles were detailed into several groups of information, including dose audit organisation, dosimetry audit methodologies, phantoms, and approaches to dose audit. Conclusion: The existing variability in methodologies, criteria, and benchmarks across different clinical settings poses significant challenges to the consistency and reliability of QA processes. A standardised approach enables more accurate comparisons, enhances the reproducibility of audit outcomes, and promotes the sharing of best practices across institutions. This, in turn, will contribute to the overarching goal of delivering high-quality, safe, and effective radiotherapy treatments to patients. Radiotherapy dosimetry phantoms quality assurance radiotherapy dosage. 2026 1 01 1 8 http://ijrr.com/article-1-6848-en.pdf 10.66224/ijrr.24.1.1

93-6849 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 W. Chu wei991288@163.com D. Huang Background: Ovarian cancer remains a significant challenge due to its heterogeneity and variable treatment response. Pyroptosis, an inflammatory form of programmed cell death, may influence tumor progression and treatment outcomes. Dynamic contrast-enhanced MRI (DCE-MRI) is a promising tool for monitoring treatment response in ovarian cancer. This study investigates pyroptosis-related gene (PRG) signatures and their correlation with MRI findings in ovarian cancer treatment follow-up. Materials and Methods: Differentially expressed PRGs (DE-PRGs) were identified from public datasets (e.g., GEO) and intersected with ovarian cancer gene expression data. Core PRGs were selected using LASSO regression, and their expression was correlated with DCE-MRI parameters (tumor perfusion and vascularity). Acetaminophen was evaluated as a potential therapeutic agent, with treatment effects monitored via MRI. Results: Seven core PRGs (e.g., NLRP3, TNFRSF21) were identified, showing significant correlations with tumor vascularity (r=0.71–0.77, p<0.05). DCE-MRI revealed elevated tumor perfusion (0.92±0.15 mL/min/g vs. 0.56±0.12 mL/min/g in controls, p<0.01), strongly associated with NLRP3 and TNFRSF21 expression. Acetaminophen treatment reduced tumor vascularity by 15% (p < 0.05), as observed via DCE-MRI, suggesting a potential therapeutic role. Conclusion: PRG signatures, particularly NLRP3 and TNFRSF21, are promising biomarkers for monitoring ovarian cancer treatment response. DCE-MRI effectively tracks treatment-induced changes in tumor vascularity, supporting its use in follow-up. Acetaminophen’s therapeutic potential requires further validation. Integrating PRG expression with MRI offers a novel approach to personalize ovarian cancer management. Ovarian neoplasms pyroptosis magnetic resonance imaging gene expression profiling biomarkers. 2026 1 01 9 16 http://ijrr.com/article-1-6849-en.pdf 10.66224/ijrr.24.1.2

93-6850 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 X. Zhao J.Y. Li lxlong201909@163.com C.W. Zhang L.J. Ma Y. Zhao X.H. Chen X.L. Li xaohecen20XH@163.com Background: Granulomatous mastitis (GM) often recurs, and its clinical and pathological overlap with breast malignancies is especially problematic in patients with prior radiotherapy. To identify clinical, pathological, and immunohistochemical predictors of GM recurrence and to evaluate diagnostic challenges in the context of post-radiotherapy alterations. Materials and Methods: A retrospective cohort of 206 GM patients was analyzed (58 with recurrence, 148 without). Baseline clinical factors, pathological features, and immunohistochemical markers were compared. An XGBoost algorithm was applied to construct and validate a recurrence risk model. For patients with a history of breast radiotherapy, additional subgroup analysis was performed, incorporating imaging and pathology review to differentiate GM recurrence from tumor relapse. Results: Recurrence was associated with younger age (<35 years, 41.4% vs. 18.9%, P<0.001), higher prolactin levels (32.5±8.7 vs. 24.8±6.9 ng/mL, P<0.001), and higher BMI (26.4±3.8 vs. 24.1±3.2, P=0.007). Pathological indicators included multinucleated giant cells (31.0% vs. 12.2%, P<0.001), diffuse plasma cell infiltration (82.8% vs. 62.2%, P=0.003), and elevated Ki-67 (65.5% vs. 32.4%, P<0.001). The model achieved strong predictive performance (AUC = 0.89 training, 0.85 validation, 0.83 external). In post-radiotherapy patients, fibrotic distortion and atypical immune marker expression (Ki-67, PD-L1) frequently mimicked malignancy, highlighting the need for integrated clinicopathologic assessment. Conclusion: GM recurrence is driven by hormonal imbalance, immune dysregulation, and tissue injury. Radiotherapy-associated alterations exacerbate diagnostic overlap with breast tumors, underscoring the value of multidimensional prediction models for risk stratification and differential diagnosis. Granulomatous mastitis breast neoplasms recurrence radiotherapy immunohistochemistry risk factors predictive models. 2026 1 01 17 24 http://ijrr.com/article-1-6850-en.pdf 10.66224/ijrr.24.1.3

93-6851 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 D. Kong L. Hui B. Yang J. Huang Y. Zhao K. Gu Background: This study employed Geant4 to evaluate the comparative effects of various bolus materials on dose deposition during electron beam radiotherapy. Materials and Methods: A bolus was simulated in Geant4, positioned 100 cm away from the accelerator source, with dimensions of 30 cm × 30 cm and varying thicknesses. The materials tested included water, glycerol, polystyrene, and silica gel. A tissue-equivalent phantom was positioned adjacent to the bolus, and voxels were incorporated to measure dose deposition as 6 and 9 MeV electron beams passed through it. The analysis focused on comparing maximum doses, effective therapeutic depths (ETDs), and dose distributions beyond the ETD. Results: The depth of maximum dose (dmax) showed a linear relationship with increasing bolus thickness, moving closer to the phantom surface with material-specific coefficients. The onset depth of the ETD decreased progressively until it reached the phantom surface. For equivalent bolus thicknesses where the ETD did not initial at the surface, the ETD regions exhibited similar dimensions, with onset depths in the order: silica gel < glycerol < water < polystyrene. When the ETD began at the surface, the size of the ETD regions followed the same order. The relative dose beyond the ETD generally followed the order: silica gel > water > glycerol > polystyrene. Conclusion: Bolus materials exert a significant influence on dose distribution in electron beam radiotherapy. Monte Carlo method elastomeric polymer radiation dosage electrons. 2026 1 01 25 30 http://ijrr.com/article-1-6851-en.pdf 10.66224/ijrr.24.1.4

93-6852 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 G.L. Liu W.R. Yang M. Cheng C.L. Wang M. Liu X. Zheng zhengxiao@qdu.edu.cn Background: This research was planned to disclose the clinical effect along with safety of programmed cell death protein 1/programmed death ligand-1 (PD-1/PD-L1) blockers in postoperative chemotherapy for advanced colorectal cancer. Material and Methods: From June 2019 to June 2021, 23 advanced colorectal cancer patients received apatinib treatment and 28 advanced colorectal cancer patients received PD-1 inhibitors in our hospital were included. The safety and clinical efficacy of 2 therapeutic regimens were compared. Results: Relative to apatinib group, the proportion of stable disease in patients accepting PD-1 blockers presented higher (P=0.010), the median progression-free survival (PFS) of patients accepting PD-1 blockers was longer (P=0.0209), the median PFS of patients with no liver metastasis who accepted PD-1 blockers presented longer (P<0.0001), the median PFS of Kirsten rat sarcoma viral oncogene homolog (KRAS) wild-type patients who received anti-PD-1 therapy presented longer (P=0.0288), and the median PFS of patients with left colon as primary site who received anti-PD-1 therapy presented longer (P=0.0105). Relative to the apatinib group, the incidence of adverse events in patients accepting PD-1 blockers was generally lower, but with no difference (P>0.05). Conclusion: PD-1/PD-L1 blockers possess certain clinical efficacy and tolerability in treating advanced colorectal cancer. Colorectal cancer PD-1 PD-L1 apatinib efficacy safety. 2026 1 01 31 36 http://ijrr.com/article-1-6852-en.pdf 10.66224/ijrr.24.1.5

93-6853 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 F. Orhan figen.kayserili@hotmail.com Y. Sahin yilmaz.sahin@atauni.edu.tr  A. Zortul A. Bastopcu Ö. Barış Background: X-rays used for diagnostic and therapeutic purposes have various effects on nosocomial pathogens. Thanks to advanced repair mechanisms, bacteria, among the earliest life forms on Earth, can survive exposure to ionizing radiation. It is important to determine the radiation threshold for nosocomial pathogens with drug resistance. In this study, we investigated the survival responses of Gram-negative bacteria, which exhibit antimicrobial resistance in the clinical setting, to different doses of ionizing radiation. Materials and Methods: Bacterial isolates obtained from pure culture and adjusted to 0.5 McFarland turbidity were exposed to radiation doses of 0 (Control), 12.5, 25, 50, and 100 Gy in an X-ray machine used in clinical treatment. The results obtained were evaluated by comparing the number of microorganisms that remained alive after exposure to X-ray radiation with the control group. Results: No significant reduction in bacterial growth was observed following exposure to 12.5 Gy and 25 Gy. At 50 Gy, 3 isolates exhibited reduced viability. Exposure to a dose of 100 Gy induced a substantial reduction in Colony-Forming Unit (CFU) counts in 14 isolates and caused complete lethality in P. mendocina. These effects followed a dose-dependent trend. Conclusions: MDR Gram-negative pathogens are resilient against radiation doses typically applied in clinical practice. Bactericidal effects were only observed at doses ≥50 Gy, levels far exceeding what is biologically tolerable for human tissues. These findings underscore the need for precise dose classification when discussing bacterial radiation responses and emphasize that such high doses are suitable only for external sterilization, not patient-based applications. Radiation tolerance drug resistance X-rays pathogens. 2026 1 01 37 42 http://ijrr.com/article-1-6853-en.pdf 10.66224/ijrr.24.1.6

93-6854 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 L.P. Zhou L.M. Chang 240612799@qq.com H. Zhao X.Y. Yang L.L. Shi Background: To analyze the correlation between epidermal growth factor receptor (EGFR) gene mutations and clinical as well as computed tomography (CT) signs in minimally invasive adenocarcinoma (MIA). Materials and Methods: A total of 118 patients with MIA treated at the Department of Thoracic Surgery, Tangshan Gongren Hospital, from December 2018 to December 2021 were included in this study. Patients were categorized into two groups based on their Epidermal Growth Factor Receptor（EGFR）mutation status: a mutation group and a wild-type group. Differences in clinical and CT features between the two groups were recorded and statistically analyzed. Results: Among the 118 patients, 69 were in the mutation group, while 49 were in the wild-type group. No significant differences were observed in gender, smoking history, age, mean nodule diameter, peripheral emphysema, air bronchogram, lobulation sign, pleural indentation sign, morphology, tumor-lung interface, peripheral fibrosis, and density between the two groups (P > 0.05). However, significant differences were noted in the spiculation sign, vacuole sign, and vascular convergence sign between the groups (P < 0.05). Logistic regression analysis identified the vacuole sign with an odds ratio (OR) of 0.410 (P > 0.05) and the spiculation sign and vascular convergence sign with ORs of 1.498 and 2.262, respectively (P < 0.05), as independent risk factors for predicting EGFR mutations. The areas under the ROC curves (AUC) for the spiculation sign and vascular convergence sign were 0.634 and 0.735, respectively, in distinguishing EGFR gene mutations in MIA. Lung adenocarcinoma CT signs epidermal growth factor receptor tomography X-ray computed. 2026 1 01 43 48 http://ijrr.com/article-1-6854-en.pdf 10.66224/ijrr.24.1.7

93-6855 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 F. Jia S. Feng T. Song X. Wang pznjiafang@163.com Background: To investigate the diagnostic efficacy of shear wave elastography (SWE) and contrast-enhanced ultrasonography (CEUS) in differentiating between metastatic and tuberculous cervical lymphadenopathy. Materials and Methods: This study included 84 patients with 91 cervical lymph nodes (LNs) that exhibited suspicious malignant features on ultrasonography (US). SWE and CEUS were sequentially performed, followed by analysis of two-dimensional SWE (2D-SWE) characteristics, maximum shear wave elastic modulus (Max-SWE), and CEUS parameters. Cervical lymphadenopathy was categorized as metastatic or tuberculous based on histopathological diagnosis. Diagnostic performance parameters including sensitivity (Se), specificity (Sp), accuracy (Acc), and area under the receiver operating characteristic curve (AUC) of conventional US, SWE, and CEUS were compared. Results: Conventional US findings showed no significant differences between the groups (P > 0.05), whereas 2D-SWE, Max-SWE, and CEUS demonstrated significant differences (all P < 0.05). CEUS, 2D-SWE, and Max-SWE demonstrated AUC values of 0.762, 0.643, and 0.605, respectively. 2D-SWE exhibited the highest specificity (Sp, 71.4%), whereas CEUS achieved superior sensitivity (Se, 81.6%) and accuracy (Acc, 75.8%). Conclusion: CEUS and SWE complement each other in differentiating metastatic lymphadenopathy from tuberculous nodes. CEUS and SWE complement each other in differentiating metastatic lymphadenopathy from tuberculous nodes. 2026 1 01 49 54 http://ijrr.com/article-1-6855-en.pdf 10.66224/ijrr.24.1.8

93-6856 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Z. Li M. Pu R. Huang P. Zhou T. Zhang Y. Zhang zhangyusui3785@hotmail.com Background: The purposes of this study were to evaluated the efficacy and changes in computed tomography (CT) imaging associated with tislelizumab combined with gemcitabine for advanced non-small cell lung cancer (NSCLC). Material and Methods: This study examined 122 patients with advanced NSCLC who were treated at our hospital between January 2021 and October 2023. Subjects were categorized into the control group (gemcitabine monotherapy) and study group (tislelizumab + gemcitabine), with 61 patients in each group. Clinical efficacy, CT imaging changes (maximum lesion diameter, CT value, short diameter of metastatic lymph nodes), serum tumor markers (CA125, CEA, NSE), quality of life (FACT-L), drug safety, and survival outcomes were compared between groups. Results: The study group showed higher rates of objective remission (42.62%) and clinical control (86.89%) compared to the control group (18.03% and 62.30%, respectively, x2=8.728, 9.731, P<0.05). CT parameters (maximum diameter, CT value, and short diameter of metastatic lymph nodes) were remarkably shorter in the study group (P<0.05). Serum CA125, CEA, and NSE levels were decreased in the study group, and their FACT-L score was higher (P<0.05). No remarkable discrepancy was found in complication rates. At the one-year follow-up, the survival rate was 70.49% in the study group and 44.26% in the control group (x2=13.571, P<0.05). Conclusion: Tislelizumab combined with gemcitabine improves short-term efficacy, reduces serum tumor markers, enhances life quality, increases survival rates in advanced NSCLC patients, and has a good safety profile. Tislelizumab gemcitabine lung neoplasms non-small-cell combined modality therapy. 2026 1 01 55 62 http://ijrr.com/article-1-6856-en.pdf 10.66224/ijrr.24.1.9

93-6857 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 N.  Kostova A.  Staynova L.  Popova-Hadjiiska D.  Georgieva H.  Hristov M.  Atanasova I.  Ivanova E.  Zaharieva H.  Tsonev R.  Hristova r.hristova@ncrrp.org Background: The Chromosomal aberrations (CAs) are among the most crucial biological effects resulting from ionizing radiation. The aim of the current study is to investigate cytogenetic effects after both short- and long-term exposure of low irradiation doses (less than100 mSv). Materials and Methods: In this study, two groups were included: 1) eighteen patients (age 54 - 90 years) undergoing fluoroscopic X-ray guided vertebroplasty for a short time (0.63 - 2.07 min) and 2) eighteen workers (age 40 - 66 years) employed in Bulgarian Nuclear Power Plant (NPP) (19 - 42 working years). Blood samples were taken from all subjects followed by culturing in RPMI-1640 medium. After cells harvesting and standard samples processing, chromosomal aberrations frequency was analyzed in Giemsa stained metaphase spreads. For patients group, blood samples were collected before and after the medical procedure. Nine healthy volunteers (from NPP administrative staff) served as reference controls in workers group. Results: The mean frequency of total CAs after vertebroplasty (0.0213 ± 0.0016 per cell) is slightly but significantly increased compared to the baseline level before the medical procedure (0.0143 ± 0.0013; P = 0.013). However, variabilities at the individual level were found. In the workers group, the total CAs yield raised 4 times relative to controls (0.0113 ± 0.0017 vs. 0.0028 ± 0.0012; P = 0.001). At the same time, no correlation was found between aberrations frequency and accumulated dose in both patients and workers. Conclusion: Low doses exposure whether acute or chronic results in deoxyribonucleic acid (DNA) damages and consequent CAs. Low-dose irradiation chromosomal aberrations vertebroplasty NPP workers. 2026 1 01 63 68 http://ijrr.com/article-1-6857-en.pdf 10.66224/ijrr.24.1.10

93-6860 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 X. Wang R. Tian K. Duan X. Zhang xuzhang0312@163.com Background: This study investigates the mechanism by which the natural flavonoid drug Nodakenin intervenes in the phenotype of non-small cell lung cancer (NSCLC) by inhibiting the aurora kinase A-C-X-C motif chemokine ligand 5 (AURKA-CXCL5) axis, and analyses its role in enhancing tumour sensitivity to radiotherapy. Materials and Methods: Human NSCLC A549 cells were classified into control group (CG), radiation group (RG), and Nodakenin group (NG). Radiotherapy was delivered at 2 Gy/day for five days using 6 MV X-rays. Nodakenin (10 μM) was applied for 24 h after irradiation. Cell proliferation and survival were assessed using the MTT assay and the colony formation assay. Apoptosis was assessed by Annexin V-FITC/PI staining and flow cytometry. Gene expression of AURKA and CXCL5 was quantified by quantitative polymerase chain reaction (qPCR), DNA damage by γ-H2AX immunofluorescence, and apoptotic proteins by Western blotting. Results: The AURKA/CXCL5 mRNA in the RG surpassed that observed in the CG (P<0.05), while the AURKA/CXCL5 mRNA in the NG was lower than RG (P<0.05). The γ-H2AX in the NG exceeded that in the RG. The cell viability in the NG was below that in the RG (P<0.05), and the apoptosis rate in the NG exceeded that in the RG (P<0.05). The quantity of cell migration and invasion in the NG was lower than RG (P<0.05). The Bax and caspase-3 proteins in the NG exceeded that in the RG (P<0.05), while the Bcl-2 was lower (P<0.05). Conclusion: Nodakenin exacerbates DNA damage and apoptosis by inhibiting the AURKA-CXCL5 axis, thereby suppressing tumor cell proliferation and invasion. Nodakenin AURKA-CXCL5 NSCLC DNA damage repair neoplastic cell phenotype aurora kinase A. 2026 1 01 69 74 http://ijrr.com/article-1-6860-en.pdf 10.66224/ijrr.24.1.11

93-6861 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 A.N. Hmood N.I. Ashour nabeel.ashoor@uokerbala.edu.iq M.N. Hammood A.K. Hashim A.S. Musa Background: Natural radioactive nuclei in the earth's geology are being increasingly studied worldwide due to their potential public health implications. This research is crucial, as legumes, which are a primary food source for many people, commonly contain such radionuclides. The study aimed to evaluate the background radiation in legumes and grains collected from an Iraqi market using two techniques: a scintillation detector system and a CN-85 detector. Materials and Methods: As discussed in the first part of this work, after samples were collected, they were dried at 70 °C, ground up, weighed, and stored in Marlin beakers for four weeks to reach equilibrium before 222Rn and 226Ra. NaI (Tl) scintillation detectors were used. The samples were then sealed in test tubes for four weeks to ensure further balance. Detectors were used to measure alpha release for 79 days before the samples were treated with 2.5N NaOH at 60 °C for 3 hours. All samples were then placed in a water bath, washed with distilled water, and dried, and the nuclear detector effects were calculated using microscopy. Results: The 238U emissions ranged from 5.86±0.15 to 1.3±0.12 Bq/kg, while the 232Th was between 3.82±0.14 and1.1±0.11 Bq/kg; 40K was between 59.53±2.21and 414.16±3.81 Bq/kg. The Ca in the airspace between the samples and the detector ranged between 288.766 and 656.643 Bq/m3, while the CRn in the samples ranged between 4,827.885 and 10978.440 Bq/m3. Conclusion: The results closely aligned with or slightly exceeded those of previous studies. All results fell within UNSCEAR 2000 internationally permitted limits, however, suggesting that such produce offers no danger to human life or health from radioactivity. Natural radioactivity gamma spectroscopy sealed can technique foods. 2026 1 01 75 81 http://ijrr.com/article-1-6861-en.pdf 10.66224/ijrr.24.1.12

93-6862 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 N. Nasir S.S. Nair sarathshyam007@gmail.com Sh. Shambhavi S. Lewis J. Nagesh S.S. Nair S. Hussain A. Singh Background: Studying the influence of multi-criterial optimization (MCO) on dosimetry in stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma patients, utilizing Flattening Filter Free (FFF) photon energies through Monte Carlo (MC) algorithm. Materials and Methods: Hepatocellular carcinoma SBRT plans were generated at a prescribed dose of 35 Gy in 5 fractions, with Standard Direct Machine Optimization (SDMO) and multi-criteria optimization for two energies of 6 and 10 MV FFF using MC algorithm in Monaco Planning Station. These plans were compared within and across the groups based on various plan quality metrics such as target coverage, Conformity Index (CI), Homogeneity Index (HI), Monitor Unit (MU) and Organ at Risk (OAR) dose. Results: Using MCO technique, plans with comparable target outcome measures and slightly improved OAR sparing are produced, with the consequence of increased MU for both energies (p=0.030 & p=0.002 respectively). In the case of 6 MV FFF plans using MCO, the degree of CI within the target showed a statistical significance (p=0.013) and provided plans with better OAR sparing and for 10 MV FFF energy showed no observable statistical significance for any target outcome measures such as CI, HI or V95%. Conclusion: With efficient treatment planning time, MCO is a valuable tool for providing optimal SBRT plans, however it results in longer treatment times due to increase in MU. Out of the SBRT plans generated the MCO plan using 6 MV FFF energy shows little superiority than others, with a better balance in target coverage and OAR sparing. Multi-criterial optimization standard direct machine optimization stereotactic body radiotherapy Monte Carlo flattening filter free. 2026 1 01 83 90 http://ijrr.com/article-1-6862-en.pdf 10.66224/ijrr.24.1.13

93-6863 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Q. Jing L. Zhao zhaolihong741256@163.com R. Yang N. Hu D. Wu Z. Zhang K. Qiu X. Zhong Background: To assess the degree of gastric dilatation in patients undergoing abdominal contrast-enhanced computer tomography (CT) and to identify factors associated with gastric dilatation. Materials and Methods: This study adopted a cross-sectional design. Participants ingested water to distend the stomach 10 minutes prior to CT examination.  After baseline assessment, participants self-administered the STAI under research assistant supervision. The degree of gastric dilation positively correlated with image clarity score (scale 1~5). Ordinal logistic regression analysis was used to identify influencing factors. Results: A gastric dilation score of 5 (indicating maximal dilation) was recorded in 14.0% of case, with median oral contrast volume reaching 1000ml. Ordinal logistic regression analysis confirmed five independent predictors of gastric dilation quality: education (OR=1.534, 95%CI=1.056-5.138, P=0.008), BMI（OR=4.025, 95%CI=2.284-7-092, P<0.001, water intake (OR=13.317, 95%CI 5.681-11.565, P<0.001), fasting status (OR=1.544, 95%CI=1.323-1.916, P=0.022) and ethnicity (OR=1.679, 95%CI=1.311-1.916, P=0.023). Inter-reader agreement was excellent (ICC=0.943). Conclusions: In individuals who underwent abdominal contrast-enhanced CT, the general state of stomach filling was poor. The education level, dietary intake, the consumed amount of water, BMI and ethnicity contributed to gastric dilatation. Gastric dilatation multi-detector computed tomography diagnostic imaging contrast agent. 2026 1 01 91 96 http://ijrr.com/article-1-6863-en.pdf 10.66224/ijrr.24.1.14

93-6870 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Z. Wu Y. Pang J. Wang P. Gao W. Yin Y. Xia yizherenx5555@163.com Background: To observe the effect of quantitative parameters of intravoxel incoherent motion-diffusion weighted imaging (IVIM-DWI) in the evaluation of transcatheter arterial chemoembolization (TACE) combined with 3-dimensional conformal radiation therapy (3D-CRT) treatment effect. Materials and Methods: Research subjects were selected from 80 cases of patients with primary liver cancer (PLC) from May 2021 to October 2022. According to the judgment criteria of treatment effect of solid tumors, the patients were divided into complete remission (CR)/partial remission (PR) group (n=37) and stable disease (SD)/progressive disease (PD) group (n=43) after TACE combined with 3D-CRT treatment. The quantitative parameters of IVIM-DWI [F value, D* value, D value and apparent diffusion coefficient (ADC) value] in the two groups were compared. Results: The value of D*, F, D and ADC of IVIM-DWI quantitative parameters in the SD/PD group were all higher‌ (P<0.05). The receiver operating characteristic (ROC) curve indicated that the area under curve (AUC) of the value of D*, F, D and ADC in IVIM-DWI quantitative parameters of patients with PLC to predict the effect of TACE combined with 3D-CRT in patients were 0.827, 0.777, 0.827, 0.863 and 0.923, and the AUC of the combination prediction was the largest. The sensitivity and specificity of combined prediction were 92.3% and 81.1% (Youden index 0.896), respectively. Conclusion: The value of D*, F, D and ADC in IVIM-DWI quantitative parameters are feasible to evaluate the treatment effect of TACE combined with 3D-CRT in patients with PLC. Hepatocellular carcinomas multiparametric magnetic resonance imaging radiotherapy chemoembolization therapeutic ROC Curve. 2026 1 01 97 102 http://ijrr.com/article-1-6870-en.pdf 10.66224/ijrr.24.1.15

93-6885 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 X. Zhang X. Wu G. Wang becky.shaw133049@yahoo.com Background: We aimed to analyze the significance of multi-slice spiral computed tomography (CT) combined with carcinoembryonic antigen (CEA) and Wnt pathway inhibitor (DKK1) for the diagnosis of early-stage lung carcinoma. Materials and Methods: Subjects (102 in total) were selected from patients with suspected early-stage lung carcinoma receiving treatment in the hospital. Multi-slice spiral CT was performed on all subjects, CEA and DKK1 levels in the serum were detected, and the diagnostic efficiency of multi-slice spiral CT for early-stage lung cancer was analyzed. Results: The sensitivity of 94.25% (82/87), Youden index of 0.743, specificity of 80.00% (12/15), accuracy of 92.16% (94/102), positive diagnostic value of 96.47% (82/85), and negative diagnostic value of 70.59% (12/17) were obtained for multi-slice spiral CT in diagnosing early-stage lung cancer. As revealed by receiver operating characteristic curve analysis results, multi-slice spiral CT parameters combined with CEA and DKK1 had an area under the curve of 0.954, sensitivity of 95.22% and specificity of 86.17% in the diagnosis of early-stage lung carcinoma, significantly superior to multi-slice spiral CT parameters, CEA or DKK1 alone (P<0.05). Conclusion: The combination of CEA and DKK1 with multi-slice spiral CT can improve the diagnostic efficiency for early-stage lung cancer. Carcinoembryonic antigen diagnosis lung neoplasms CT. 2026 1 01 103 108 http://ijrr.com/article-1-6885-en.pdf 10.66224/ijrr.24.1.16

93-6889 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 X. Lai G. Gao L. Lin 15988699773@163.com Background: Dual-specificity phosphatase 1 (DUSP1) plays a critical role in cellular stress responses, but its function in hepatitis B virus (HBV)-associated hepatocellular carcinoma (LCC) and radiation therapy remains unclear. This study investigates the effects of DUSP1 on HBV replication, tumor progression, and radiation response in LIC. Materials and Methods: Fifteen HBV-LIC patients and 10 radiation-treated liver tumor patients (20–50 Gy) were included. HepG2.2.15 cells were used to establish DUSP1-overexpressing and control groups. DUSP1 expression was assessed via Western blot and quantitative polymerase chain reaction (qPCR). HBV replication markers (HBsAg, HBeAg) were measured by enzyme-linked immunosorbent assay (ELISA). Cell proliferation cell counting Kit-8 (CCK-8), migration/invasion (Transwell), and miR-21 expression were evaluated. Statistical analysis was performed using SPSS 22.0. Results: DUSP1 was significantly downregulated in LIC tissues (P < 0.001) and further suppressed in irradiated patients (P = 0.002). DUSP1 overexpression reduced HBV replication (HBsAg: P = 0.008; HBeAg: P = 0.008) and enhanced radiosensitivity. Overexpression inhibited proliferation, migration, and invasion (P < 0.001) and attenuated radiation-induced miR-21 upregulation (P = 0.004). Conclusion: DUSP1 suppresses HBV replication and tumor progression while enhancing radiation response in LIC, suggesting its potential as a therapeutic target for HBV-associated hepatocellular carcinoma. pecificity phosphatases hepatitis B virus hepatocellular carcinoma radiotherapy microRNA-21 signal transduction. 2026 1 01 109 114 http://ijrr.com/article-1-6889-en.pdf 10.66224/ijrr.24.1.17

93-6890 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 F. Geyikoglu G.Y. Deniz gulsah.ydeniz@gmail.com M.N.G. Demir M. Arslan B. Erdemci Background: Irradiation at the high dose may attenuate renal hemodynamics while retaining the therapeutic effect on cancer cells and thus can life-threatening. Hence the effects on kidneys of irradiation become increasingly crucial. This study aimed to examine oxidative stress, inflammatory response, vascular injury, apoptotis and deoxyribonucleic acid (DNA)DNA damage induced acute high dose ionising radiation in rat kidney and to investigate whether umbelliferone (UMB) has protective effect on radiation-induced renal damage and dysfunction. Materials and Methods: Rats were randomly allocated into eight groups (n = 7): the control group, given physiological saline; the model group, exposured radiation (whole body irradiated with single high dose of 12 Gy of gamma rays) to induce radiation damage in renal tissue; UMB groups, received UMB (30, 60 and 90 mg/kg) alone and treatment groupsreceived orally UMB for 5 days before radiation exposure. Animals were divided groups; control,  group whole body irradiated with single dose 12 Gy, groups receiving umbelliferone alone and groups receiving umbelliferone for 5 days before irradiated. Results: Radiation-induced pathological findings and functional disorders were significantly ameliorated in UMBumbelliferone-treated groups. Our results revealed that umbelliferone pretreatment in the kidney plays an important role in the regulation of blood pressure in irradiation-induced renal injury. UMB increases the antioxidant activity and decreases inflammatory response in kidney tissue against radiation toxicity. Notably, it exhibits anti-apoptotic and anti-genotoxic actions in damaged renal cells. It also ameliorates the blood urea nitrogen (BUN) and creatinine values. Conclusion: In conclusion, UMBumbelliferone from coumarin compounds is a targeted and promising drug to prevent kidney necrosis and dysfunction due to radiation therapy. 8-hydroxy-2'-deoxyguanosine (8-OHdG)DNA damage ıonizing Rradiation renal dysfunctioninjury umbelliferone thromboxane B2 (TXB2)Vascular injury. 2026 1 01 115 122 http://ijrr.com/article-1-6890-en.pdf 10.66224/ijrr.24.1.18

93-6891 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 J. Duan Z. Gao Z. Yang W. Huang X. Guan Y. Wang 15043210800@163.com Background: To investigate the clinical value of combining the expression of circular RNA ubiquitin associated protein 2 (circRNA-UBAP2) and chemokine receptor 4 (CXCR4) messenger RNA（mRNA） with endoscopic ultrasonography for the diagnosis of colorectal cancer (CRC). Materials and Methods: A retrospective study was conducted. 104 patients with CRC and 87 patients with colorectal adenoma who were admitted to the hospital from May 2022 to May 2024 were enrolled in the study. The expression levels of circRNA-UBAP2 and CXCR4 mRNA in samples were detected. The relationship between the expression of circRNA-UBAP2 and CXCR4 mRNA and clinicopathological features of patients with CRC was analyzed, and the diagnostic efficacy of circRNA-UBAP2 and CXCR4 mRNA combined with endoscopic ultrasonography for CRC were evaluated. Results: The expression levels of circRNA-UBAP2 and CXCR4 mRNA in cancer tissues of patients with CRC were higher than those in adjacent tissues (P<0.05). Statistically significant differences in the expression levels of circRNA-UBAP2 and CXCR4 mRNA were observed among patients with different differentiation degrees, TNM stages, and lymph node metastasis status (P<0.05). The accuracy of endoscopic ultrasonography in diagnosing CRC was 87.96% (kappa value=0.758). The AUC (95% CI) of joint diagnosis was 0.980 (0.958-1.000), which was larger than that of separate diagnosis (P<0.05). Conclusion: circRNA-UBAP2 and CXCR4 mRNA are highly expressed in patients with CRC, and are associated with differentiation degree, TNM staging, and lymph node metastasis. The two are helpful in distinguishing CRC from colorectal adenoma, and their combination with endoscopic ultrasonography can improve diagnostic efficacy. Colorectal cancer endoscopic ultrasonography ubiquitin associated protein 2 chemokine receptor 4. 2026 1 01 123 128 http://ijrr.com/article-1-6891-en.pdf 10.66224/ijrr.24.1.19

93-6892 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 E.S. Akovalı eminesedef88@gmail.com G. Can S. Karaçam D.Ç. Öksüz Background: The aim of this study was to evaluate interfractional esophageal motions using kilovoltage cone-beam computed tomography (kV-CBCT) in patients who underwent chemoradiotherapy for esophageal cancer. Materials and Methods: Sixteen patients treated with intensity modulated radiation therapy or volume modulated arc therapy were included. For each patient, one kV-CBCT per week was used for the assessments. Upper, middle, distal thoracic esophagus and abdominal esophagus was contoured on planning CT (pCT) and each kV-CBCT images. Each kV-CBCTs was fused with the  pCT after automatic vertebrae-matching rigid registration, thus only esophageal motion was taken into account. The displacement of the esophageal center points was calculated on the left-right (LR), anterior-posterior (AP), cranio-caudal (CC) directions. It was investigated whether the outer contour of the esophagus remained within the 95% isodose line in the treatment plan. Results: The interfractional displacement of the abdominal esophagus in all directions was found statistically significantly higher than other part of the esophagus. The minimum PTV  margin of 1.03 cm for AP, 1.03 cm for CC and 1.05 cm for LR direction was required. The minimum margin needed for covering 95% of the tumor motion in LR, AP, CC directions, respectively, were 0.8, 0.8 and 0.7 cm for the abdominal esophagus. Isodose coverage of 95% were similar for all esophageal segments in pCT and combined kV-CBCT volume. Conclusion: Interfractional position changes were largest in all directions in the abdominal esophagus. Reducing of PTV margin for the distal thoracic and abdominal esophagus may not be suitable for clinical practice. Esophageal cancer interfractional esophageal motion CBCT. 2026 1 01 129 134 http://ijrr.com/article-1-6892-en.pdf 10.66224/ijrr.24.1.20

93-6893 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 S.H. Zuber N.I.A. Mohd Hijas M.F.R. Abdul Hadi N.A.A. Hashikin hashikin@usm.my Background: This study aimed to assess the equivalent and effective doses received by medical personnel during an interventional radiology procedure. Materials and Methods: Monte Carlo GATE was used to obtain the radiation doses. The protection provided by two protective garments was also investigated. Results: The effective doses at LLAT and RAO30 projections were found to contribute high doses to the medical personnel, with rates varying between 0.5 to 2.0 μSv. On the other hand, PA projection produced the lowest effective dose, between 0.04 to 0.6 μSv. In the simulation, a 0.5 mm-thick protective garment reduced the effective dose to more than three times. At LLAT and RAO30 projections, the effective dose with no protection increased with variations of 3 to 9 μSv, while PA projection increased the effective dose with variations of 1 to 3 μSv per procedure. Conclusion: A higher overall effective dose was observed for unshielded medical personnel. This work demonstrates the potential of Monte Carlo GATE in validating the doses received by medical personnel during interventional procedures. occupational exposure personnel Monte Carlo method interventional radiology protective devices. 2026 1 01 135 142 http://ijrr.com/article-1-6893-en.pdf 10.66224/ijrr.24.1.21

93-6894 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 L. Zhang Y. Liu P. Zhang Y. Zhang M. Xie X. Zhang H. Li Y. Duan Duanyulong191960@126.com Background: Benign and malignant thyroid nodules (BMTDs) often show lymph-node metastasis in the neck and impose great physical and psychological burdens. Therefore, early diagnosis and treatment BMTD are essential. The objective of this study was to analyze the effectiveness and safety of ultrasound-guided microwave ablation therapy for BMTDs of different sizes. Materials and Methods: The study examined 180 patients with solitary BMTD from Shijiazhuang People’s Hospital between June 2022 and June 2024. Patients with BMTD diameter larger than 1 cm were assigned to group A (60 patients), and those with diameters of 0.5–1 cm were assigned to group B (60 patients). Group C comprised those with BMTD diameters smaller than <0.5 cm (60 patients). All patients were treated with conventional thyroid ultrasound, ultrasonography, and ultrasound-guided microwave ablation. The primary assessments were the change in transverse and longitudinal diameters of the thyroid nodules, volume reduction rate (VRR), and cure rate at months 1, 3, 6, and 9 post-treatment. The secondary outcomes were quality-of-life scores, incidence of adverse effects, complications, and recurrence rates. Results: After treatment, all indicators improved in all groups. Group C had greater improvements in nodule diameter, VRR, cure rate, cosmetic score, adverse reactions, and complications than group A and group B. Thyroid biochemical indicators showed greater improvement in groups B and C than group A (P<0.05). No groups showed any recurrence (P>0.05). Conclusion: Ultrasound-guided microwave ablation can treat BMTD and is particularly suitable for solitary thyroid nodules with diameter <0.5 cm, which showed the highest cure rate. Microwave Ablation ultrasonography thyroid nodule nodule size therapeutic efficacy. 2026 1 01 143 150 http://ijrr.com/article-1-6894-en.pdf 10.66224/ijrr.24.1.22

93-6895 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 T. Li Li ty13841402@hotmail.com B. Han Q. Dong D. Ji Background: Locally advanced non-small cell lung cancer (NSCLC) is often associated with unfavorable clinical outcomes. This study aims to examine the association between peripheral immuno-inflammatory biomarkers, the effectiveness of radiotherapy, and 1-year survival rates in stage III NSCLC. Materials and Methods: This study reviewed 180 stage III NSCLC patients treated with radical radiotherapy from 2020 to 2024. Pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and lymphocyte-to-monocyte ratio (LMR) levels were measured and compared with healthy controls. Biomarker differences were analyzed across clinical subgroups and between radiotherapy response groups. Using median values as cutoffs, one-year survival data were assessed, with Cox regression determining prognostic factors. Results: Patients with NSCLC had significantly higher NLR, PLR, and SII and lower LMR than the control group (P<0.05). The good-response group had lower NLR, PLR, and SII and higher LMR (P<0.05). Higher NLR, PLR, and SII were associated with worse 1-year survival, while higher LMR predicted better outcomes (P<0.05). Cox analysis confirmed that all four markers were independent prognostic factors (P<0.05). Conclusion: The peripheral blood markers NLR, PLR, SII, and LMR are closely associated with radiotherapy efficacy and 1-year survival in stage III NSCLC. Carcinoma non-small-cell lung inflammatory markers radiotherapy survival rate stage III neoplasms. 2026 1 01 151 157 http://ijrr.com/article-1-6895-en.pdf 10.66224/ijrr.24.1.23

93-6896 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 T. Huang AmonUhn8286@hotmail.com Background: Folate metabolism is essential in cancer progression and therapeutic response by supporting DNA synthesis, repair, and methylation. However, the differential impact of systemic folate (RBC Folate) versus local folate (Follicular Fluid Folate, FFF) on radiotherapy outcomes in cancer patients remains unclear. Materials and Methods: A cross-sectional study was conducted on 280 female patients with reproductive tract cancers undergoing pelvic radiotherapy. Blood and follicular fluid samples were collected before radiotherapy. RBC Folate and FFF concentrations were quantified. Radiotherapy outcomes-including tumor shrinkage (assessed via imaging), DNA damage repair (γ-H2AX assay), and clinical treatment response-were analyzed using Pearson correlation and multiple linear regression. Results: Higher FFF levels were significantly associated with enhanced DNA repair and increased tumor persistence (β = 0.02171, P = 0.0363), indicating a potential protective effect on tumor cells. Conversely, elevated RBC Folate was negatively correlated with radiotherapy response (β = -0.002011, P = 0.0015). Tumor shrinkage and DNA repair parameters were the strongest predictors of treatment success. Age and tumor type also influenced the outcomes negatively. Conclusion: Local and systemic folate levels exhibit opposing effects on radiotherapy response in gynecological cancer patients. Elevated FFF may enhance tumor resilience, whereas higher RBC Folate may reduce treatment efficacy. Folate profiling could guide personalized strategies to optimize radiotherapy outcomes. Neoplasms radiotherapy. folate red blood cell count follicular fluid DNA repair tumor microenvironment. 2026 1 01 159 165 http://ijrr.com/article-1-6896-en.pdf 10.66224/ijrr.24.1.24

93-6897 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Y. Li Z. Xie J. Liu J. Piao 13578945886@163.com Background: To delve into the association between preoperative immune-related markers and lymphovascular space invasion (LVSI) in patients with endometrial cancer (EC). Materials and Methods: According to the 7:3 allocation, 411 EC patients were analyzed. Clinical and pathological data were collected, and imaging histologic features were extracted from contrast-enhanced T1-weighted imaging (CE-T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps, the related factors affecting LVSI were analyzed. Subsequently, a backward step-wise selection approach was adopted to select the most relevant variables for incorporation into the nomogram. Results: In the training cohort, independent predictors for LVSI were identified as systemic immune-inflammation index (SII), depth of myometrial invasion (MI), and carbohydrate antigen 125 (CA125) levels. The nomogram was used to predict the probability of LVSI, and the area under the ROC curve was 0.7813. Conclusion: LVSI positivity in EC patients is strongly associated with elevated SII, MI≥1/2, and high CA125 levels. The SII-based nomogram provides a reliable tool for predicting LVSI status in EC patients. Endometrial cancer nomogram magnetic resonance imaging diagnosis risk modeling. 2026 1 01 167 171 http://ijrr.com/article-1-6897-en.pdf 10.66224/ijrr.24.1.25

93-6898 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 S. Tong Z. Liu Q. Wen X. Zhang C. Zheng onrx855@163.com Background: To evaluate the clinical effectiveness of autologous peripheral blood hematopoietic stem cell transplantation (Auto-HSCT) as a therapeutic approach for patients with both refractory systemic sclerosis (SSc) and cancer undergoing radiotherapy. Materials and Methods: Eleven patients with refractory SSc and concurrent cancer received Auto-HSCT following peripheral blood stem cell mobilization. Standardized radiotherapy protocols were applied based on cancer type. Preconditioning regimens included combinations of cyclophosphamide, melphalan, rituximab, and bendamustine. Post-transplant assessments focused on hematopoietic recovery, SSc disease activity, and tumor response. Results: A mean of 3.87 × 106/kg CD34+ cells were collected. All patients achieved hematopoietic reconstitution, with neutrophil and platelet recovery occurring in 9 ± 3 and 14 ± 7 days, respectively. At a median follow-up of 14.6 months, improvements in modified Rodnan skin scores (mRSS), digital ulcers, Raynaud’s phenomenon, and pulmonary fibrosis were observed. Eight patients showed sustained improvement in SSc and cancer response. Three patients relapsed and required additional immunotherapy. Conclusion: Auto-HSCT appears to be a feasible and effective option for patients with both refractory SSc and cancer undergoing radiotherapy. It improved autoimmune disease control, enhanced hematopoietic recovery, and supported cancer treatment with manageable toxicity. Systemic Sclerosis Neoplasms Radiotherapy Hematopoietic Stem Cell Transplantation Autologous CD34 Antigen. 2026 1 01 173 178 http://ijrr.com/article-1-6898-en.pdf 10.66224/ijrr.24.1.26

93-6899 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Y. Zhou meizipo0725592032@163.com G. Wang Z. He Y. Zhang Y. Zhou H. Li Q. Jing J. Qian Q. Sun X. Zhang H. Jiang Background: Nasopharyngeal carcinoma (NPC) is a radiosensitive tumor located in a complex anatomical region, necessitating highly conformal radiotherapy. Spiral tomotherapy (TOMO), an advanced form of intensity-modulated radiotherapy (IMRT), integrates dose-guided and image-guided delivery to improve tumor targeting. This study aimed to compare the clinical efficacy, toxicity, and dosimetric advantages of spiral TOMO versus conventional IMRT in NPC patients. Materials and Methods: A total of 80 NPC patients treated between September 2017 and February 2019 were retrospectively reviewed. Patients were assigned to either spiral TOMO (n = 40) or IMRT (n = 40) groups. Radiotherapy doses ranged from 50.7 to 71.1 Gy, delivered over 6–6.5 weeks. Clinical response was assessed using RECIST criteria, while treatment toxicity was graded according to the standards of the American Society for Radiation Oncology. Dosimetric evaluation included target coverage and organ-at-risk (OAR) sparing parameters. Results: Spiral TOMO achieved a total short-term efficacy rate of 97.5%, compared to 95.0% for IMRT. Although myelosuppression rates were comparable (P>0.05), the TOMO group showed significantly lower rates of acute skin reactions (12.5% vs. 60%) and acute dry mouth (10% vs. 45%) (P<0.05). Dosimetric analysis confirmed improved dose conformity and reduced exposure to OARs such as the parotid glands and spinal cord in the TOMO group. Conclusion: Spiral TOMO demonstrated superior short-term efficacy and lower toxicity compared to IMRT in the treatment of NPC. Its advantages in dose distribution and organ preservation support its clinical use as an effective radiotherapy technique for nasopharyngeal carcinoma. Nasopharyngeal carcinoma spiral tomotherapy IMRT radiotherapy efficacy Toxicity reduction. 2026 1 01 179 184 http://ijrr.com/article-1-6899-en.pdf 10.66224/ijrr.24.1.27

93-6902 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 N.K. Bawalia S. Degra S.K. Gupta R. Malviya R.K. Meena V. Yadav V. Vishal Y.K. Saini N. Naskar P. Meena D. Meena dalpat11phdmeena@gmail.com Background: Environmental accumulation of naturally occurring radioactive substances and their decay products may harm local populations' health. In this investigation, soil samples collected from many sites in Shrimadhopur, Rajasthan, India, were examined for the specific activities of radioisotopes and their potential health risks. Materials and Methods: Ten samples of soil were collected from various parts of Shrimadhopur. The samples were prepared and analysed for activity concentrations of 226Ra, 232Th, and 40K using a p-type High Purity Germanium (HPGe) detector, and the activity concentrations were calculated by the comparative approach; radiation hazard parameters were also evaluated. Results: The mean activity concentrations were determined to be 20.23, 34.17, and 335.09 Bq kg-1 for 226Ra,232Th, and 40K, respectively. The Radium equivalent activity varies between 44.27 and 138.19 Bq kg-1 with an average of 84.91 Bq kg-1. It was discovered that hazard parameters like Hex, Hin, ??, and ?? were below the safe limit of unity. The average absorbed gamma dose rate was measured at 127.92 nGy h-1, while the average total annual effective dose equivalent was 0.024 mSv. Furthermore, the average excess lifetime cancer risk is 0.086 × 10-3. Conclusion: These findings suggest that no substantial health hazards are associated with the radiological characteristics of the soil samples. Gamma ray spectroscopy HPGe detector comparative method radiological hazard soil. 2026 1 01 185 192 http://ijrr.com/article-1-6902-en.pdf 10.66224/ijrr.24.1.28

93-6903 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 W. Junwu wangjunwudf@163.com L. Yi T. Lidong L. Qichao Background: To analyze the value of quantitative parameters of magnetic resonance imaging (MRI) combined with circulating tumor cells (CTC) in predicting the prognosis of neoadjuvant chemotherapy (NAC) for breast cancer. Materials and Methods: Ninety-eight breast cancer patients treated with NAC from January 2022 to January 2024 at our institution were collected. Pathological complete remission (pCR) was evaluated 2 weeks after the end of NAC. According to pCR, the patients were divided into pCR group (n=34) and non-pCR group (n=64). The volume transfer constant (Ktrans), extravascular extracellular space volume ratio (Ve), rate constant (Kep), and positive rate of CTC were compared between the two groups before and after treatment. The area under the receiver operating characteristic (ROC) curve (AUC) was used to express the prognostic value. Results: Among the 98 patients, 34 patients achieved pCR, with a rate of 34.69%. After treatment, Ktrans, Kep, and positive rate of CTC were lower than those before treatment (P<0.05), and were lower in the pCR group than in the non-pCR group (P<0.05). Ktrans, Kep, and positive rate of CTC were positively correlated with TNM staging (P<0.05). The AUCs of Ktrans, Kep, and positive rate of CTC joint prediction for predicting pCR after NAC for breast cancer was 0.847, which was larger than separate prediction. The sensitivity and specificity of joint prediction were 67.65% and 90.38%. Conclusion: The quantitative MRI indexes combined with blood CTC can effectively predict NAC prognosis in breast cancer patients. Breast neoplasms neoadjuvant therapy magnetic resonance imaging circulating tumor cell. 2026 1 01 193 198 http://ijrr.com/article-1-6903-en.pdf 10.66224/ijrr.24.1.29

93-6904 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Y. Lin T-F. Qu S. Li J-U Xu H-Q. Jin Background: To evaluate the effectiveness of ultrasound-guided paravertebral nerve block (PVB) in reducing radiotherapy-associated pain in pediatric patients with mediastinal tumors. Materials and Methods: Thirty children (ages 1-16) receiving radiotherapy after mediastinal tumor surgery were randomly assigned to two groups: control (routine analgesia, n=15) and observation (ultrasound-guided PVB, n=15). Radiotherapy was delivered to the mediastinal region using conventional fractionated external beam protocols (2 Gy per fraction, total dose 40-60 Gy). Pain intensity was assessed by Visual Analogue Scale (VAS) at 0-, 12-, 24-, and 48-hours post-radiotherapy. Analgesic consumption, time to first rescue analgesic, incidence of radiotherapy-related side effects (skin irritation, fatigue), recovery time, and adverse reactions were compared between groups. Results: The observation group had significantly lower VAS scores at all time points compared to controls (p<0.05). Time to first rescue analgesic was longer (7.61±0.64 vs. 4.35±0.52 h, p<0.01), and overall analgesic use was reduced in the PVB group (p<0.05). Radiotherapy-related side effects, including skin irritation (13.3% vs. 40%) and fatigue (26.6% vs. 53.3%), were less frequent in the PVB group (p<0.05). Recovery outcomes were also improved, with shorter ICU stays and earlier resumption of daily activities (p<0.05). Conclusion: Ultrasound-guided PVB is an effective adjunct for managing radiotherapy-induced pain in pediatric mediastinal tumor patients. It reduces pain scores, prolongs analgesia, lowers radiotherapy-related side effects, and accelerates recovery, providing a safer and more effective approach to pediatric pain management. Radiotherapy Mediastinal Neoplasms Pain Management Ultrasonography Pediatric Patients. 2026 1 01 199 204 http://ijrr.com/article-1-6904-en.pdf 10.66224/ijrr.24.1.30

93-6905 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 H. Fei H. He FHL08496@hotmail.com Background: To evaluate the effectiveness and safety of rehabilitation strategies for rectal cancer patients undergoing chemotherapy or radiotherapy via meta-analysis. Materials and Methods: We searched PubMed, Web of Science, Embase, and Cochrane Library for English-language studies from inception to April 2025. Eligible studies were screened, quality-assessed using Cochrane and CASP tools, and meta-analyzed with RevMan 5.4. Results: A total of eighteen studies were included, all of which were of acceptable quality. The meta-analysis showed that in most outcome measures, such as health-related physical fitness, body indices, and exercise questionnaire scores, there were no significant differences between the exercise group and the usual care group (P>0.05). When compared to the usual care group, the exercise group had a higher VO₂ at the anaerobic threshold (AT), with a pooled OR of 2.65 (95% CI: 0.71, 4.59). In the assessment of quality of life, the Short Form-36 (SF-36) showed that after exercise, there were significant improvements in role - physical function (OR=9.10, 95% CI: 3.24, 14.97) and social function (OR=7.04, 95% CI: 0.33, 13.75) compared to the levels before exercise. There were no significant differences in the incidence of adverse events between the two groups (OR=1.57, 95% CI: 0.54, 4.57). Conclusion: Rehabilitation strategies incorporating exercise for patients with rectal cancer undergoing chemotherapy enhance VO2 at AT and specific quality-of-life indicators, with safety comparable to usual care. Rectal neoplasms chemotherapy adjuvant radiotherapy adjuvant rehabilitation meta-analysis. 2026 1 01 205 214 http://ijrr.com/article-1-6905-en.pdf 10.66224/ijrr.24.1.31

93-6906 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 J. Yang P. Guo D. Zhou L. Ding P. Jiang hgszxyycgzs201106@163.com Background: To observe the expression of serum vascular endothelial growth factor receptor-3 (VEGFR-3) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters in patients with lung adenocarcinoma (AOL) mediastinal lymph node metastasis (MLNM), and analyze the relationship between the above parameter and MLNM of AOL. Materials and Methods: One hundred patients with AOL, they were divided into MLNM group and non-MLNM group. Two groups were compared in the DCE-MRI quantitative parameters [Rate constant (Kep), volume transfer constant (Ktrans), extravascular extracellular volume fraction (Ve), and apparent diffusion coefficient (ADC)] and serum VEGFR-3 expression, and the relationship between the above index parameters and MLNM in patients with AOL was analyzed. Results: Compared with the non-MLNM group, the Ktrans, Kep, Ve value and expression of serum VEGFR-3 in the MLNM group were higher, the ADC value was lower (P<0.05). Logistics regression analysis showed that preoperative fasting serum VEGFR-3 expression was related to MLNM in patients with AOL, and high VEGFR-3 expression might be a risk factor for MLNM in patients with AOL (OR>1, P<0.05). The ROC curve showed that the AUC of VEGFR-3 and DCE-MRI quantitative parameters to predict MLNM in patients with AOL was greater than 0.70. Conclusion: The DCE-MRI quantitative parameters combined with serum VEGFR-3 expression has a certain value in the preoperative assessment of MLNM in patients with AOL. Adenocarcinoma of lung magnetic resonance imaging vascular endothelial growth factor receptor-3 lymphatic metastasis diagnosis. 2026 1 01 215 219 http://ijrr.com/article-1-6906-en.pdf 10.66224/ijrr.24.1.32

93-6909 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Z. Zhang Background: Cataract surgery requires accurate prediction of the effective lens position (ELP) to optimize refractive outcomes. Both axial length (AL) and prior ocular tissue changes, including radiotherapy exposure, can influence postoperative results. Materials and Methods: This longitudinal study included 285 patients (312 eyes) undergoing phacoemulsification with intraocular lens implantation. Among them, 27 patients (29 eyes) had a documented history of orbital or periocular radiotherapy, delivered with external beam therapy (median cumulative dose 45 Gy, range 30-60 Gy) for ocular adnexal or head and neck malignancies. Preoperative AL was measured using partial coherence interferometry, and postoperative ELP was determined via anterior segment optical coherence tomography (AS-OCT). Refractive error and best-corrected visual acuity were evaluated at 1, 3, 6, and 12 months. Statistical analyses were performed using SPSS with bivariate correlation and subgroup comparisons. Results: Short AL eyes (<22.0 mm) demonstrated a mean ELP of 4.50 mm (SD ± 0.35), while long AL eyes (>24.5 mm) had a shallower mean ELP of 4.00 mm (SD ± 0.40) (p < 0.001). Eyes with prior radiotherapy exhibited a significant posterior displacement of the ELP (mean reduction 0.18 mm, p = 0.042) and a higher incidence of hyperopic shift. Despite overall visual improvement across all groups, radiotherapy-treated and long AL eyes showed greater refractive variability, with slower stabilization within ±0.4 D. Conclusion: Both axial length and prior radiotherapy independently affect postoperative ELP and refractive predictability. Careful surgical planning is essential in these high-risk groups to optimize visual outcomes. Axial length cataract extraction lens implantation intraocular radiotherapy. 2026 1 01 221 227 http://ijrr.com/article-1-6909-en.pdf 10.66224/ijrr.24.1.33

93-6910 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 H. Zhao M. Jiang Z. Li L. Mao J. Miao W. Wang Y. Sun 365845111@qq.com Background: This study explores the association between C3AR1 gene polymorphisms and sepsis susceptibility and prognosis in colorectal cancer patients undergoing radiotherapy, aiming to enhance genetic insights and clinical management. Materials and Methods: We enrolled 100 colorectal cancer patients with sepsis during radiotherapy and 80 healthy controls. DNA was extracted from blood samples, and serum CEA and VEGF levels were measured pre- and post-radiotherapy. Four C3AR1 polymorphisms (rs11567806, rs190043630, rs113825556, rs147364229) were genotyped. Hardy-Weinberg equilibrium, χ² tests, and logistic regression were used for analysis. Radiotherapy included 2 Gy daily fractions for 5 weeks. Results: The sepsis and non-sepsis groups were similar in age, gender, BMI, WBC count, infection site, and smoking history (P>0.05). The sepsis group had higher APACHE II scores (14.65±4.23 vs. 12.90±3.87, P=0.006) and PCT levels (45.87±9.76 g/L vs. 8.92±2.73 g/L, P<0.01). C3AR1 polymorphisms showed no significant association with sepsis susceptibility. However, the CC genotype of rs190043630 was linked to poorer prognosis (P=0.044). Post-radiotherapy, CEA (22.3±7.5 to 12.4±6.1 ng/mL, P<0.001) and VEGF (123.4±42.5 to 54.2±28.1 pg/mL, P<0.01) levels decreased significantly in the ACD + radiotherapy group. Conclusion: C3AR1 polymorphisms rs11567806 and rs190043630 are not linked to sepsis susceptibility, but the rs190043630 CC genotype predicts poorer prognosis. Radiotherapy enhances biomarker reduction, suggesting a synergistic effect with chemotherapy. C3AR1 polymorphism sepsis colorectal cancer radiotherapy prognosis CEA VEGF. 2026 1 01 229 236 http://ijrr.com/article-1-6910-en.pdf 10.66224/ijrr.24.1.34

93-6913 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Z. Lin R. Ma Z. Wang X. Fu H. Jiao D. Wang J. Yu J. Wang Y. An X. Yu 18999223109@163.com Background: This study investigates the impact of novel anticoagulants on bleeding risk and thrombosis in critically ill patients, with a special focus on those who are exposed to radiation therapy. We compare the safety and efficacy of rivaroxaban and apixaban to traditional anticoagulants to assess their role in radiation-induced coagulopathies. Materials and Methods: A total of 400 critically ill patients requiring anticoagulation were included. Patients were divided into two groups: the experimental group received novel anticoagulants, and the control group received traditional anticoagulants (heparin or low molecular weight heparin). Radiotherapy was administered based on standard protocols to patients with various cancers, including breast, lung, gastrointestinal, and head and neck cancers. Various bleeding and coagulation parameters, including activated partial thromboplastin time (aPTT) and prothrombin time (PT), were measured to assess thrombotic and bleeding risks. Results: The experimental group showed a significant reduction in the incidence of thromboembolic events compared to the control group. The novel anticoagulants demonstrated significantly fewer bleeding complications and a more favorable safety profile. Radiological imaging used to assess pulmonary embolism or deep vein thrombosis also suggested lower follow-up requirements in the experimental group, hinting at the efficiency of novel anticoagulation strategies in reducing the need for radiation-based diagnostics. Conclusion: The use of novel anticoagulants in critically ill patients exposed to radiotherapy appears to effectively balance the anticoagulation benefit with a reduced bleeding risk, offering a potential alternative to traditional therapies. Their ability to manage radiation-induced coagulopathies and reduce complications could enhance the overall care and outcomes of radiation-exposed patients. Novel anticoagulants radiotherapy bleeding risk Rivaroxaban Apixaban coagulopathies. 2026 1 01 237 244 http://ijrr.com/article-1-6913-en.pdf 10.66224/ijrr.24.1.35

93-6914 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Y. Zhou meizipo0725592032@163.com G. Wang Z. He Y. Zhang Y. Zhou H. Li Q. Jing J. Qian Q. Sun X. Zhang H. Jiang Background: Nasopharyngeal carcinoma (NPC) is a radiosensitive tumor located in a complex anatomical region, necessitating highly conformal radiotherapy. Spiral tomotherapy (TOMO), an advanced form of intensity-modulated radiotherapy (IMRT), integrates dose-guided and image-guided delivery to improve tumor targeting. This study aimed to compare the clinical efficacy, toxicity, and dosimetric advantages of spiral TOMO versus conventional IMRT in NPC patients. Materials and Methods: A total of 80 NPC patients treated between September 2017 and February 2019 were retrospectively reviewed. Patients were assigned to either spiral TOMO (n = 40) or IMRT (n = 40) groups. Radiotherapy doses ranged from 50.7 to 71.1 Gy, delivered over 6–6.5 weeks. Clinical response was assessed using RECIST criteria, while treatment toxicity was graded according to the standards of the American Society for Radiation Oncology. Dosimetric evaluation included target coverage and organ-at-risk (OAR) sparing parameters. Results: Spiral TOMO achieved a total short-term efficacy rate of 97.5%, compared to 95.0% for IMRT. Although myelosuppression rates were comparable (P>0.05), the TOMO group showed significantly lower rates of acute skin reactions (12.5% vs. 60%) and acute dry mouth (10% vs. 45%) (P<0.05). Dosimetric analysis confirmed improved dose conformity and reduced exposure to OARs such as the parotid glands and spinal cord in the TOMO group. Conclusion: Spiral TOMO demonstrated superior short-term efficacy and lower toxicity compared to IMRT in the treatment of NPC. Its advantages in dose distribution and organ preservation support its clinical use as an effective radiotherapy technique for nasopharyngeal carcinoma. Nasopharyngeal carcinoma spiral tomotherapy IMRT radiotherapy efficacy Toxicity reduction. 2026 1 01 245 250 http://ijrr.com/article-1-6914-en.pdf 10.66224/ijrr.24.1.36

93-6915 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 H. Mozdarani mozdarani@modares.ac.ir S. Mozdarani E. Samei S. Mozdarani F. Pakniat H. Nosrati Background: The use of radioprotectors to ameliorate the deleterious effects of radiation could be an option to reduce normal tissue radiotoxicity. In this study, melatonin as an efficient naturally occurring antioxidant was used to explore its modulating effects on radiation induced cytogenetic damages at G0 and G2-lymphocytes of control and breast cancer (BC) patients. Materials and Methods: Whole blood samples were collected from 20 BC patients, and also 10 healthy individuals. Lymphocyte culture was initiated, irradiation was applied in G0-lymphocytes 1 hour before culture initiation using a 6 MV linear accelerator at dose of 3Gy and 4 hours before harvesting for G2-lymphocytes at a dose of 1Gy in the presence or absence of melatonin (800 µg/ml). Cytogenetic damages were assessed using cytochalasin-B blocked micronucleus (CBMN) assay and chromosomal aberrations were analyzed using G2-assay according to standard methods. Data were statistically analyzed and P-value <0.05 was considered as significant difference. Results: Results obtained for G0-irradiated lymphocytes in the presence of melatonin, showed a profound reduction in the frequency of CBMN in both lymphocytes of normal control and BC patients compared to radiation alone (p<0.05). Conversely, a significant increase in the frequency of radiation induced chromosomal aberrations was observed in both groups (p<0.05). Conclusion: Apparently melatonin exerts its modifying effect on radiation induced cytogenetic damages in a cell-cycle dependent manner. It acts as a radioprotector when lymphocytes have been irradiated in G0-phase of the cell cycle. Conversely it acts as radiosensitizer when used for lymphocytes exposed at G2-phase of the cell cycle. Breast cancer lymphocytes antioxidants ionizing radiation radioprotector radiosensitizer cell cycle. 2026 1 01 251 257 http://ijrr.com/article-1-6915-en.pdf 10.66224/ijrr.24.1.37

93-6916 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 M. Yasir F. Siddique F. Andleeb G. Gilanie H. Ullah hafeezullah@iub.edu.pk Background: Brain tumor segmentation is an important aspect of medical image processing. Timely detection of brain tumors can increase a patient's survival rate significantly. Doctors use traditional manual techniques for diagnosis, but these techniques are tedious and require intricate programming. Materials and Methods: New developments of automatic and semi-automatic approaches for image processing have been applied. MRI images are characterized using segmentation and registration Toolkit (ITK-SNAP) software to find and demarcate boundaries and assess brain tumor volume from MRI images. This study included six untreated brain tumor patients (aged 35-75) to explore the feasibility of using semi-automated MRI techniques for tumor segmentation. Despite the small sample size, the method showed promising accuracy, highlighting its potential for clinical use. Results: Our findings revealed accurate diagnosis of primary brain tumors, 3D tumor size, tumor edges, and metastatic brain tumors based on MRI images. ITK-SNAP proved to be more effective for diagnosing metastatic and secondary brain tumors than conventional techniques. The importance of effective and accurate segmentation, particularly discrimination among primary and metastatic tumors, was highlighted. Conclusion: On the contrary, completely automatic approaches tend to be imprecise. Tailoring the ITK-SNAP tool for brain tumor segmentation maximizes efficiency with improved accuracy for differentiating tumor categories. Primary brain tumors metastatic brain tumors MRI semi-automated segmentation computer-assisted image interpretation. 2026 1 01 259 265 http://ijrr.com/article-1-6916-en.pdf 10.66224/ijrr.24.1.38

93-6917 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 C.F. Cao onrx855@163.com L. Zhang W. Liu Background: Radiotherapy (RT) is a critical modality for ovarian cancer treatment, yet its integration with culturally sensitive practices to enhance patient outcomes remains underexplored. This study investigates the impact of culturally integrated practices, such as Traditional Chinese Medicine (TCM) and culturally inspired hospital designs, on patient trust, satisfaction, and emotional well-being in RT settings. Materials and Methods: A phenomenological study involved semi-structured interviews with 15 healthcare leaders from Chinese hospitals specializing in RT for ovarian cancer. Data were analyzed using NVIVO software to identify themes. Results: Culturally integrated practices, including TCM (e.g., acupuncture, herbal medicine) and designs like healing gardens, improved patient trust by 78% and satisfaction by 82%, based on leader-reported patient feedback. Emotional well-being increased in 73% of patients, enhancing treatment adherence by 65%. Financial returns were modest, contributing 5–10% to RT department revenue, with primary benefits in reputation and loyalty. Conclusion: Culturally integrated practices in RT enhance patient-centered outcomes, offering a competitive edge despite limited financial gains. These findings support broader adoption in RT for ovarian cancer. Radiotherapy Ovarian Cancer Cultural Integration Traditional Chinese Medicine Patient Satisfaction. 2026 1 01 267 272 http://ijrr.com/article-1-6917-en.pdf 10.66224/ijrr.24.1.39

93-6918 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 H. Çetinkaya hcetinkaya@gmail.com N.H.N. Alabboodi Background: Nuts are nutrient-rich foods and are recommended to be promoted to the public for their immense health benefits. The radioactivity content of 8 different types of nuts consumed in Kütahya, Turkey, was determined in 2024. Materials and Methods: Fourteen nut samples collected from local markets and supermarkets in Kütahya province were pulverized and dried, then waited in a 1 L Marinelli container for 30 days to attain equilibrium between Ra-226 and Th-232, their daughter products, finally sample content is determined using Canberra 3x3 NaI (Tl) detector. In addition, the samples' Annual Effective Ingestion Dose values were estimated. Results: K-40, Ra-226 and Th-232 concentrations of the samples were measured between 173.8 ± 2.7 and 305.0 ± 3.6 Bq kg-1, <MDA (2.6) and 3.1 ± 0.7 Bq kg-1, < MDA (2.6) and 3.3 ± 0.7 Bq kg-1, respectively. Conclusions: The annual effective ingestion dose resulting from nut consumption was calculated assuming that an adult consumes 20 g of dried nuts daily and found between 9.1 and 19.0 µSv y-1, with a mean of 13.9 µSv y-1. A comparison of radioactivity levels and ingestion dose results with the limits presented in the UNSCEAR report shows that they were below the safety limits. Nuts radioactivity ingestion Kütahya Turkey. 2026 1 01 273 276 http://ijrr.com/article-1-6918-en.pdf 10.66224/ijrr.24.1.40

93-6919 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 S. Zhang M. Xu X. Shen J. Ke kejuying@zjsmyy.com Background: Upper airway cough syndrome (UACS) is a common condition marked by chronic cough, nasal congestion, and throat irritation. Standard treatments-including antihistamines, decongestants, and corticosteroids-often yield limited relief. Sinus Negative Pressure Exchange (SNPE) technology has emerged as a novel approach that may enhance sinonasal drainage and mucociliary function. CT imaging provides structural insights and may aid in the detection of sinus tumors. Materials and Methods: This retrospective study evaluated patients with UACS treated using SNPE technology. Symptom severity-cough frequency, nasal blockage, and throat discomfort-was assessed before and after treatment. CT scans were used to assess anatomical changes and to identify any incidental sinus tumors. Logistic regression was used to explore factors associated with clinical response. Results: Patients undergoing SNPE therapy showed significant improvement in cough and nasal congestion. CT scans demonstrated better sinus aeration and drainage post-treatment, supporting the physiological benefits of SNPE. In several cases, clearer imaging enabled incidental detection of sinus tumors, suggesting a potential diagnostic advantage. Regression analysis confirmed a strong association between SNPE use and symptom relief, influenced by baseline severity and comorbidities. Conclusion: SNPE technology shows promise as a dual-purpose intervention for UACS—offering both symptomatic relief and improved radiologic visualization. These findings support SNPE's potential role in managing UACS and facilitating incidental sinus tumor detection. Larger prospective studies are recommended to confirm these outcomes and assess broader clinical implications. Cough upper respiratory tract diseases negative-pressure therapy CT imaging sinus neoplasms treatment outcomes. 2026 1 01 277 282 http://ijrr.com/article-1-6919-en.pdf 10.66224/ijrr.24.1.41

93-6920 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Y. Tian X. Peng L. Yang yanglan_zn163.com H. Liu hbzkznyy@163.com Background: This study compares treatment plans for gastric cancer patients generated using the Varian IX linear accelerator (linac) and the uRT-Linac 506C. Materials and Methods: A retrospective analysis was performed on ten gastric cancer patients. Treatment plans were initially created using Varian Eclipse v13.5 treatment planning system (TPS) and uRT-TPS for intensity-modulated radiation therapy (IMRT), respectively; all plans were developed by an experienced physicist and determined to be clinically acceptable. Dosimetric parameters were compared for the planning target volume (PTV) and organs at risk (OARs), including the conformity index (CI), homogeneity index (HI), and monitor unit (MU) efficiency. The delivery accuracy of both accelerator systems was assessed using gamma index analysis. Results: Results indicated that the uRT-Linac 506C provided superior dose conformity and target volume coverage compared to the Varian IX linac, as evidenced by a higher V45/% parameter for the uRT-Linac 506C. For the left kidney, the Varian IX linac had a significantly lower maximum dose (Dmax); however, its mean dose (Dmean), V10, and V20 were significantly higher than those of the uRT-Linac 506C. Similar trends were observed for the right kidney and liver, where the Varian IX linac exhibited significantly higher doses and volumes for specific parameters. Conclusion: In conclusion, both linacs can achieve clinical requirements for gastric cancer radiotherapy; however, the uRT-Linac 506C demonstrated improved dose conformity and target coverage in this study. Further research is warranted to validate these findings and investigate potential clinical implications. Gastric cancer intensity modulated radiotherapy treatment plans dosimetric parameters. 2026 1 01 283 287 http://ijrr.com/article-1-6920-en.pdf 10.66224/ijrr.24.1.42

93-6921 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 A. Saeed Shah shahsaeed2002@yahoo.com Gh. Ghaus Shah U. Siddique Umer H. Abid Background: The Computed Tomography is a major contributor to patient radiation exposure in diagnostic radiology. This study aimed to establish facility-specific CT Diagnostic Reference Levels for head, chest and abdomen examinations to optimize radiation doses while maintaining diagnostic image quality. The diagnostic reference levels serve as benchmarks to enhance radiation protection by adjusting scanning parameters. The establishment of facility diagnostic reference levels provide a base line for future dose reduction strategies. Materials and Methods: Adult patient data for head, chest, and abdomen scans were collected from the facility’s 128-slice CT scanner. The facility volumetric computed dose index and dose-length product data was recorded on Microsoft excel sheet. The first, second and third quartile values were determined, and the facility diagnostic reference levels were established as the third quartile of the median volume CT dose index and dose-length product values for head, chest and abdomen examination. Results: The determined median volumetric computed dose index for head, chest and abdomen was 41.9 mGy (IQR: 41.9-46.35 mGy), 29.5 mGy (IQR: 28.3-29.5 mGy) and 29.5 mGy (IQR: 29.5-42.98 mGy) respectively. The corresponding median dose-length product values were 810mGy·cm (IQR: 768.5-931.6 mGy·cm) for head, 1220 mGy·cm (IQR: 1031.45-1312.9 mGy·cm) for chest, and 1694.5 mGy·cm (IQR: 1529.68–2247 mGy·cm) for abdomen. Conclusion: The study findings support the development of local and national benchmarking databases for CT radiation doses.   The evaluated F facility diagnostic reference levels provide a base line for future dose reduction strategies used for standardization and radiation doses optimization in CT imaging. Optimization computed tomography dose reference levels volumetric computed dose index dose length product. 2026 1 01 289 292 http://ijrr.com/article-1-6921-en.pdf 10.66224/ijrr.24.1.43

93-6922 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 Y. Qin S-r. Liu G-l. Wu L. Jiang S. Tan Background: Cutaneous Rosai-Dorfman disease (CRDD) is an uncommon histiocytic proliferative disorder localized to the skin, representing merely 3% of all reported cases of Rosai-Dorfman disease (RDD). Despite numerous investigations into the clinical and pathological attributes of CRDD, there are few works on its ultrasonic manifestations, with the majority of studies being limited to individual case reports. Case presentation: This paper presents the case of a 66-year-old female who exhibited red nodules on the skin of her face, accompanied by pruritus, which persisted for 2 years and notably affected her quality of sleep. Clinical assessment substantiated a diagnosis of CRDD, and subsequent ultrasound imaging revealed a low-echo nodule. The nodule (2.4 cm by 0.4 cm) was identified within the skin of the right eyebrow and exhibited pronounced blood flow. Following multiple sessions of targeted treatment, there was a notable improvement in the lesion, and no recurrence was detected during subsequent follow-up evaluations. Conclusion: This case exemplifies the typical ultrasound features associated with CRDD and underscores the limitations inherent in ultrasound diagnostics, thereby highlighting the vital importance of histopathological assessment. Ultrasound cutaneous Rosai-Dorfman disease color Doppler. 2026 1 01 293 295 http://ijrr.com/article-1-6922-en.pdf 10.66224/ijrr.24.1.44

93-6923 2026-10-13 10.1002

International Journal of Radiation Research Int J Radiat Res 2322-3243 2345-4229 10.66224/ijrr 2026 24 1 A. Baskar baskarmdrd@gmail.com V. Indiran V. Vignesh I. Rajkumar Background: Congenital anomalies of the internal carotid artery (ICA), such as agenesis, aplasia, and hypoplasia, are considerably rare, occurring in less than 0.01% of the population. Recognition of these anomalies is critical, as they may alter cerebral hemodynamics and impact clinical management. Case Presentation: We report a rare case of unilateral agenesis of the right ICA in an adult, incidentally detected during Magnetic resonance imaging (MRI). This anomaly was associated with several unusual vascular features: hypoplasia of the right common carotid artery, aberrant origin of the right subclavian artery from the aortic arch, and a hypoplastic right vertebral artery. Intracranial findings included basilar artery bifurcation supplying the right middle cerebral artery, fetal origin of the left posterior cerebral artery, and an anomalous origin of the right ophthalmic artery from the cavernous segment of the left ICA. Despite these extensive vascular variations, the patient was asymptomatic. Conclusion: Early diagnosis and knowledge of this unusual constellation of findings in patients with ICA agenesis are crucial for the optimization of clinical treatment and planning of possible surgical treatment in the future. Carotid arteries cerebral arteries CT scan MRI congenital anomalies. 2026 1 01 297 300 http://ijrr.com/article-1-6923-en.pdf 10.66224/ijrr.24.1.45