JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
Six issues of the journal are published per year, the volume is 13.5 conventional printed sheets, 88 printer’s sheets, 1.000 copies. The journal has an identical full-text electronic version, which, simultaneously with the printed version and color drawings, is posted on the sites of the Scientific Electronic Library (SEL) and the journal's website. The journal is distributed through the Rospechat Agency under the contract № 7407 of June 16, 2006, through individual buyers and commercial structures. The publication of articles is free.
The journal is included in the List of Russian Reviewed Scientific Journals of the Higher Attestation Commission. Since 2008 the journal has been available on the Internet and indexed in the RISC database which is placed on Web of Science. Since February 2nd, 2018, the journal "Medical Radiology and Radiation Safety" has been indexed in the SCOPUS abstract and citation database.
Brief electronic versions of the Journal have been publicly available since 2005 on the website of the Medical Radiology and Radiation Safety Journal: http://www.medradiol.ru. Since 2011, all issues of the journal as a whole are publicly available, and since 2016 - full-text versions of scientific articles. Since 2005, subscribers can purchase full versions of other articles of any issue only through the National Electronic Library. The editor of the Medical Radiology and Radiation Safety Journal in accordance with the National Electronic Library agreement has been providing the Library with all its production since 2005 until now.
The main working language of the journal is Russian, an additional language is English, which is used to write titles of articles, information about authors, annotations, key words, a list of literature.
Since 2017 the journal Medical Radiology and Radiation Safety has switched to digital identification of publications, assigning to each article the identifier of the digital object (DOI), which greatly accelerated the search for the location of the article on the Internet. In future it is planned to publish the English-language version of the journal Medical Radiology and Radiation Safety for its development. In order to obtain information about the publication activity of the journal in March 2015, a counter of readers' references to the materials posted on the site from 2005 to the present which is placed on the journal's website. During 2015 - 2016 years on average there were no more than 100-170 handlings per day. Publication of a number of articles, as well as electronic versions of profile monographs and collections in the public domain, dramatically increased the number of handlings to the journal's website to 500 - 800 per day, and the total number of visits to the site at the end of 2017 was more than 230.000.
The two-year impact factor of RISC, according to data for 2017, was 0.439, taking into account citation from all sources - 0.570, and the five-year impact factor of RISC - 0.352.
Issues journals
Medical Radiology and Radiation Safety. 2024. Vol. 69. № 3
DOI:10.33266/1024-6177-2024-69-3-57-67
A.N. Koterov1, L.N. Ushenkova1, A.A. Wainson2, I.G. Dibirgadzhiev1,
M.V. Kalinina1, A.Yu. Bushmanov1
The Mortality Risk from Main Pathologies Due to Passive Smoking is not Achieved by the Overwhelming Majority of Nuclear Workers in All Periods of Employment
1 A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia
2 N.N. Blokhin Russian Cancer Research Center, Moscow
Contact person: Alexey N. Koterov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
To date, there are about 100 meta-analyses for lung cancer and circulatory (cardiovascular) diseases (CVD) as the effects of second hand smoking (SHS). The obtained risk values (Relative Risk – RR, odds ratio – OR, etc.) are in the range of 1.2–1.3, but there are no definitively accepted estimates yet, and many estimates were not made in recent years. Both SHS and work at nuclear industry enterprises have become stereotypes in everyday and scientific everyday consciousness, meaning something harmful in everyday and professional terms. The present study compared the mortality risks from all cancers, lung cancer, and CVD for SHS and nuclear workers (NW).
At the first stage, an umbrella review (review of reviews; overview) and meta-analyses of meta-analyses (meta-meta-analyses) on the risks of mortality from these pathologies as effects of SHS were performed. Umbrella review and meta-meta-analysis are regarded as the highest level of evidence and, thus, the identified risks can be conditionally considered as ‘standard’. There were insufficient data available for all cancer mortality rates after SHS; Therefore, the results from the meta-analysis by Kim A.S. et al, 2018 were used., and meta-meta-analyses were performed for lung cancer and CVD mortality. The risk values were in the range of 1.22–1.24, which replicates previous findings.
At the second stage, the risks identified for SHS were compared with the risks of mortality from the named pathologies for NW. The sample of publications for NW, extracted from the database maintained by the authors, included the most representative cohorts in relation to nuclear installations: with maximum doses, as well as combined cohorts (14–15 countries and INWORK – 3 countries). Based on published ERRs per 1 Gy for a given NW population, the radiation doses that NW would have to accumulate to approach the mortality risks from SHS were calculated.
To achieve SHS risks for all three disease types, NWs were found to need to receive radiation doses ranging from 129–183 mSv to 1.07–6.0 Sv. There have been no cases in which the risk from SHS was equivalent to exposure to low-dose radiation (up to 100 mGy); more often, doses were localized in the range of about 300–800 mSv, up to 6 Sv. Analysis of published data on dose distributions for NW has demonstrated that such doses are received either by a relatively small or vanishingly small proportion of NW. Risks for 80–96 % of NWs from various countries, including activities since the 1940s, did not reach the harms of chronic exposure to SHS.
It is concluded that the decades-long study of risks for NW, in particular ‘low doses’, does not seem adequate without taking into account the magnitude of even weak, but poorly controlled risks of everyday life, and the data obtained once again improves the image of employment in the field of nuclear energy.
Keywords: nuclear workers, mortality from diseases of the circulatory system, radiation, low doses, moderate doses, effect threshold
For citation: Koterov AN, Ushenkova LN, Wainson AA, Dibirgadzhiev IG, Kalinina MV, Bushmanov AYu. The Mortality Risk from Main Pathologies Due to Passive Smoking is not Achieved by the Overwhelming Majority of Nuclear Workers in All Periods of Employment. Medical Radiology and Radiation Safety. 2024;69(3):57–67. (In Russian). DOI:10.33266/1024-6177-2024-69-3-57-67
References
1. Smith G.D., Egger M. The First Reports on Smoking and Lung Cancer: Why are they Consistently Ignored? Bull. World Health Organ. 2005;83;10:799–800.
2. Bachinger E.,McKee M. Tobacco Policies in Austria during the Third Reich. Int. J. Tuberc. Lung Dis. 2007;11;9:1033–1037.
3. Brawley OW, Glynn TJ, Khuri FR, et al. The First Surgeon General’s Report on Smoking and Health: the 50th Anniversary. CA Cancer J. Clin. 2014;64;1:5–8. https://doi.org/10.3322/caac.21210.
4. Koterov A.N. Causal Criteria in Medical and Biological Disciplines: History, Essence and Radiation Aspect. Report 2. Henle-Koch Postulates and Criteria for Causality of Non-Communicable Pathologies before Hill. Radiats. Biol. Radioecol. = Radiation Biology. Radioecology. 2019;59;4:341–75 (In Russ.). https://doi.org/10.1134/S0869803119040052.
5. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Smoking. A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health, DHHS Publication No. (CDC) 87-8398. USDHEW, 1986. 359 p. https://stacks.cdc.gov/view/cdc/20799 (accessed date: 2024/02/02).
6. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Washington, DC, 2006. 710 p. https://www.ncbi.nlm.nih.gov/books/NBK44324/pdf/Bookshelf_NBK44324.pdf (accessed date: 2024/02/02).
7. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the Recommendations of the Ninth Revision Conference, 1975, and Adopted by the Twenty-ninth World Health Assembly, 1975 revision. Volume I. World Health Organization: Geneva, 1980. 758 p.
8. Classification of Diseases, Functioning, and Disability. CDC. Center for Disease Control and Prevention. NCHS. National Center for Health Statistics. World Health Organization (WHO). 2021. https://www.cdc.gov/nchs/icd/index.htm (accessed date: 2024/01/25).
9. Jadad A.R., Enkin M.W. Randomized Controlled Trials. Questions, Answers, and Musings. 2nd edition. Malden, Oxford, Carlton: BMJ Books, 2007. 136 p.
10. Blettner M., Sauerbrei W., Schlehofer B., Scheuchenpflug T., Friedenreich C. Traditional Reviews, Meta-Analyses and Pooled Analyses in Epidemiology. Int. J. Epidemiol. 1999;28;1:1–9. https://doi.org/10.1093/ije/28.1.1.
11. Boderie N.W., Sheikh A., Lo E., Sheikh A., Burdorf A., Van Lenthe F.J., et al. Public Support for Smoke-Free Policies in Outdoor Areas and (Semi-)Private Places: a Systematic Review and Meta-Analysis. EClinicalMedicine. 2023;59;Article101982:15p. https://doi.org/10.1016/j.eclinm.2023.101982.
12. Germain D. Exposure to and Perceptions of the Dangers and Illnesses of Passive Smoking among Victorians: 2004.CBRC Research Paper Series No.17. Site ‘Cancer Council Victoria’. https://www.cancervic.org.au/research/behavioural/research-papers/abstract_exposure_passive_smok.html (accessed date: 2024/02/02).
13. Koterov A.N., Ushenkova L.N., Zubenkova E.S., Waynson A.A., Kalinina M.V., Biryukov A.P. Strength of Association. Report 1. Graduation of Relative Risk. Medits. Radiologiya Radiat. Bezopasnost = Medical Radiology and Radiation Safety. 2019;64(4):5–17 (In Russ.). https://doi.org/10.12737/article_5d1adb25725023.14868717.
14. Koterov A.N. Causal Criteria In Medical And Biological Disciplines: History, Essence And Radiation Aspect. Report 3, Part 1: First Five Hill’s Criteria: Use and Limitations. Radiats. Biol. Radioecol. = Radiation Biology. Radioecology. 2021;61(3):300–32 (In Russ.) https://doi:10.31857/S0869803121030085.
15. Boffetta P., Jarvholm B., Brennan P., Nyren O. Incidence of Lung Cancer in a Large Cohort of Non-Smoking Men from Sweden. Int. J. Cancer. 2001;94;4:591–593. https://doi.org/10.1002/ijc.1507.
16. Wakelee H.A., Chang E.T., Gomez S.L., Keegan T.H., Feskanich D., Clarke C.A., et al. Lung Cancer Incidence in Never Smokers. J. Clin. Oncol. 2007;25;5:472–478. https://doi.org/10.1200/JCO.2006.07.2983.
17. SDR, Diseases of Circulatory System, All Ages, per 100,000. World Health Organization. European Health Information Gateway. URL: https://gateway.euro.who.int/en/indicators/hfa_101-1320-sdr-diseases-of-circulatory-system-all-ages-per-100-000/#id=19024 (accessed date: 2024/02/02).
18. Umbrella Reviews: Evidence Synthesis with Overviews of Reviews and Meta-Epidemiologic Studies. Ed. by G. Biondi-Zoccai. 1st Edition. Springer International Publishing, Switzerland, 2016. 526 p.
19. Trinquart L, Dechartres A, Ravaud P. Commentary: Meta-Epidemiology, Meta-Meta-Epidemiology or Network Meta-Epidemiology? Int. J. Epidemiol. 2013;42;4:1131–1133. https://doi.org/10.1093/ije/dyt137.
20. Sturmberg J.P. Evidence-Based Medicine – Not a Panacea for the Problems of a Complex Adaptive World. J. Eval. Clin. Pract. 2019;25;5:706–716. https://doi.org/10.1111/jep.13122.
21. Koterov A.N., Ushenkova L.N., Waynson A.A. Nuclear Workers — on the Question of Unification of Russian-Language Terminology (Brief Report). Medits. Radiologiya i Radiat. Bezopasnost = Medical Radiology and Radiation Safety. 2023;68;3:80–84 (In Russ.) https://doi.org/10.33266/1024-6177-2023-68-3-80-84.
22. ICRP Publication 118. ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs – Threshold Doses for Tissue Reactions in a Radiation Protection Context. Annals of the ICRP. Ed. by C.H. Clement. Amsterdam – New York: Elsevier, 2012. 325 p.
23. Koterov A.N., Ushenkova L.N., Kalinina M.V., Biryukov A.P. Brief Review of World Researches of Radiation and Non-Radiation Effects in Nuclear Industry Workers. Mediko-biologicheskiye Problemy Zhiznedeyatel’nosti = Medical and Biological Problems of Life Activity (Gomel). 2020;1:17–31 (In Russ.). https://doi.org/10.33266/2070-1004-2021-3-34-41.
24. Koterov A.N., Ushenkova L.N., Kalinina M.V., Biryukov A.P. Comparison of the Risk of Mortality from Solid Cancers after Radiation Incidents and Occupational Exposures. Meditsina Katastrof = Disaster Medicine. 2021;3:34–41 (In Russ.). https://doi.org/10.33266/2070-1004-2021-3-34-41.
25. Koterov A.N., Tukov A.R., Ushenkova L.N., Kalinina M.V., Biryukov A.P. Average Accumulated Radiation Doses for World Nuclear Workers: Low Doses, Low Effects. Comparison with Doses for Medical Radiologists. Radiatsionnaya Biologiya. Radioekologiya = Radiation biology. Radioecology. 2022;62;3:227–239. (In Russ.). https://doi.org/10.31857/S0869803122030043.
26. Koterov A.N., Tukov A.R., Ushenkova L.N., Kalinina M.V., Biryukov A.P. Average Accumulated Radiation Doses for Global Nuclear Workers: Low Doses, Low Effects, and Comparison with Doses For Medical Radiologists. Biology Bulletin. 2022;49;12:2475–2485. https://doi.org/10.1134/S106235902212007X.
27. Koterov A.N., Ushenkova L.N., Dibirgadzhiev I.G., Waynson A.A., Kalinina M.V., Biryukov A.P. Excess Relative Risk of Cataractogenic Lense Disorders in Nuclear Workers: Systematic Review and Meta-Analysis. Medits. Radiologiya i Radiat. Bezopasnost = Medical Radiology and Radiation Safety. 2023;68;3:21–32 (In Russ.). https://doi.org/10.33266/1024-6177-2023-68-3-21-32.
28. Koterov A.N., Ushenkova L.N., Kalinina M.V., Biryukov A.P. The ‘Healthy Worker Effect’ on Indexes of Total Mortality and Malignant Neoplasms Mortality for Nuclear and Chemical Workers: Meta-Analysis. Medits. Radiologiya i Radiat. Bezopasnost = Medical Radiology and Radiation Safety. 2023;68;4:43–50 (In Russ.). https://doi.org/10.33266/1024-6177-2023-68-4-43-50.
29. IARC 2004. Tobacco Smoke and Involuntary Smoking. Vol. 83. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. France, Lyon, 2004. 1473 p.
30. Webb P, Bain C. Essential Epidemiology. An Introduction for Students and Health Professionals. 2nd Edition. Cambridge etc.: Cambridge University Press, 2011. 445 p.
31. Higgins J.P., Thompson S.G., Deeks J.J., Altman D.G. Measuring Inconsistency in Meta-Analyses. Brit. Med. J. 2003;327;7414:557–560. https://doi.org/10.1136/bmj.327.7414.557.
32. Egger M, Davey Smith G, Schneider M, Minder C. Bias in Meta-Analysis Detected by a Simple, Graphical Test. Brit. Med. J. 1997;315;7109:629–34. https://doi.org/10.1136/bmj.315.7109.629.
33. Sterne J.A.C., Egger M. Funnel Plots for Detecting Bias in Meta-Analysis: Guidelines on Choice of Axis. J. Clin. Epidemiol. 2001;54;10:1046–1055. https://doi.org/10.1016/s0895-4356(01)00377-8.
34. Kokunin V.A. Statistical Processing of Data from a Small Number of Experiments. Ukr. Biokhim. Zh. = Ukrainian Journal of Biochemistry. 1975;47;6:776–791 (In Russ.).
35. Higgins J.P.T., Li T., Deeks J.J. Chapter 6: Choosing Effect Measures and Computing Estimates of Effect. 6.3 Extracting Estimates of Effect Directly. 6.3.1 Obtaining Standard Errors from Confidence Intervals and P Values: Absolute (Difference) Measures. Cochrane Handbook for Systematic Reviews of Interventions, 2nd Edition. Ed. by J.P.T. Higgins, T. James, J. Chandler, M. Cumpston, T. Li, M.J. Page, V.A. Welch. 2019. https://doi.org/10.1002/9781119536604. https://training.cochrane.org/handbook/current/chapter-06/ (accessed date: 2024/02/02).
36. Lv X., Sun J., Bi Y., Xu M., Lu J., Zhao L., Xu Y. Risk of All-Cause Mortality and Cardiovascular Disease Associated with Secondhand Smoke Exposure: a Systematic Review and Meta-Analysis. Int. J. Cardiol. 2015;199:106–115. https://doi.org/10.1016/j.ijcard.2015.07.011.
37. Boffetta P., Tredaniel J., Greco A. Risk of Childhood Cancer and Adult Lung Cancer after Childhood Exposure to Passive Smoke: a Meta-Analysis. Environ. Health Perspect. 2000;108;1:73–82. https://doi.org/10.1289/ehp.0010873.
38. Wang Y.T., Hu K.R., Zhao J., Ai F.L., Shi Y.L., Wang X.W., et al. The Association Between Exposure to Second-Hand Smoke and Disease in the Chinese population: a Systematic Review and Meta-Analysis. Biomed. Environ Sci. 2023;36;1:24–37. https://doi.org/10.3967/bes2023.003.
39. Kim A.S., Ko H.J., Kwon J.H., Lee J.M. Exposure to Secondhand Smoke and Risk of Cancer in Never Smokers: a Meta-Analysis of Epidemiologic Studies. Int. J. Environ. Res. Public. Health. 2018;15;9;Article E1981:17 p. https://doi.org/10.3390/ijerph15091981.
40. Chuang S.C., Gallo V., Michaud D., Overvad K., Tjonneland A., Clavel-Chapelon F., et al. Exposure to Environmental Tobacco Smoke in Childhood and Incidence of Cancer in Adulthood in Never Smokers in the European Prospective Investigation into Cancer and Nutrition. Cancer Causes Control. 2011;22;3:487–494. https://doi.org/10.1007/s10552-010-9723-2.
41. Borenstein M., Hedges L.V., Higgins J.P.T., Rothstein H.R. Introduction to Meta-Analysis. John Wiley & Sons, Ltd, 2009. 421 p.
42. LeVois M.E., Layard M.W. Publication Bias in The Environmental Tobacco Smoke/Coronary Heart Disease Epidemiologic Literature. Regul. Toxicol. Pharmacol. 1995;21;1:184–191. https://doi.org/10.1006/rtph.1995.1023.
43. Wing S., Richardson D.B. Age at Exposure to Ionising Radiation and Cancer Mortality among Hanford Workers: Follow up through 1994. Occup. Environ. Med. 2005;62;7:465–472. https://doi.org/10.1136/oem.2005.019760.
44. Cardis E., Vrijheid M., Blettner M., Gilbert E., Hakama M., Hill C., et al. The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: Estimates of Radiation-Related Cancer Risks. Radiat. Res. 2007;167;4:396–416. https://doi.org/10.1667/RR0553.1.
45. Wakeford R. Nuclear Worker Studies: Promise and Pitfalls. Br. J. Cancer. 2014;110;1:1–3. https://doi.org/10.1038/bjc.2013.713.
46. Daniels R.D., Bertke S.J., Richardson D.B., et al. Examining Temporal Effects on Cancer Risk in the International Nuclear Workers’ Study. Int. J. Cancer. 2017;140;6:1260–1269. https://doi.org/10.1002/ijc.30544.
47. Richardson D.B., Cardis E., Daniels R.D., et al. Risk of Cancer from Occupational Exposure to Ionising Radiation: Retrospective Cohort Study of Workers in France, the United Kingdom, and the United States (INWORKS). Br. Med. J. 2015;351;Articleh5359. https://doi.org/10.1136/bmj.h5359.
48. Azizova T.V., Batistatou E., Grigorieva E.S., McNamee R., Wakeford R., Liu H., et al. An Assessment of Radiation-Associated Risks of Mortality from Circulatory Disease in the Cohorts of Mayak and Sellafield Nuclear Workers. Radiat. Res. 2018;189;4:371–388. https://doi.org/10.1667/RR14468.1.
49. McGeoghegan D., Binks K. The Mortality and Cancer Morbidity Experience of Employees at the Chapelcross Plant of British Nuclear Fuels plc, 1955–95. J. Radiol. Prot. 2001;21;3:221–250. https://doi.org/10.1088/0952-4746/21/3/302.
50. Zablotska L.B., Lane R.S., Frost S.E. Mortality (1950–1999) and Cancer Incidence (1969–1999) of Workers in the Port Hope Cohort Study Exposed to a Unique Combination of Radium, Uranium and γ-Ray Doses. BMJ Open. 2013;3;2;Article e002159:19p. https://doi.org/10.1136/bmjopen-2012-002159.
51. Vrijheid M., Cardis E., Ashmore P., Auvinen A., Bae JM., Engels H., et al. Mortality from Diseases other than Cancer Following Low Doses of Ionizing Radiation: Results from the 15-Country Study of Nuclear Industry Workers. Int. J. Epidemiol. 2007;36;5:1126–1135. https://doi.org/10.1093/ije/dym138.
52. Koterov A.N. From Very Low to Very Large Doses of Radiation: New Data on Ranges Definitions and its Experimental and Epidemiological Basing. Medits. Radiologiya i Radiat. Bezopasnost = Medical Radiology and Radiation Safety. 2013;58;2:5–21 (In Russ.).
53. Koterov AN, Waynson AA. Conjunctural Approach to the Concept of Low Dose Radiation Range with Low Let in Foreign Review Sources: No Changes for 18 Years. Medits. Radiologiya i Radiat. Bezopasnost = Medical Radiology and Radiation Safety. 2022;67;5:33–40. (In Russ.). https://doi.org/10.33266/1024-6177-2022-67-5-33-40.
54. Koterov A.N., Ushenkova L.N., Waynson A.A., Dibirgadzhiev I.G., Biryukov A.P. Excess Relative Risk of Mortality from Disease of the Circulation System after Irradiation. Report 1. Overview of Reviews and Meta-Analysis Declared Effects of Low Doses. Radiatsionnaya Biologiya. Radioekologiya = Radiation Biology. Radioecology. 2022;63;1:3–33 (In Russ.). https://doi.org/10.31857/S0869803123010095.
55. Koterov A.N., Ushenkova L.N., Waynson A.A., Dibirgadzhiev I.G., Biryukov A.P. Excess Relative Risk of Mortality from Diseases of the Circulation System after Irradiation: Report 1. Overview of Reviews and Meta-Analysis Declared Effects of Low Doses. Biology Bulletin. 2023;50;12:3155–3183. https://doi.org/10.1134/S1062359023120142.
56. Moher D., Liberati A., Tetzlaff J., Altman D.G. (PRISMA Group). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. PLoS Med. 2009;6;7;Article e1000097:6p. https://doi.org/10.1371/journal.pmed.1000097.
57. Omel’yanovskiy V.V., Avksentyeva M.V., Sura M.V., Khachatryan G.R., Fedyaeva V.K. Guidelines for Conducting a Meta-Analysis. Moscow Publ., 2017. 28 p. (In Russ.).
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.01.2024. Accepted for publication: 27.02.2024.
Medical Radiology and Radiation Safety. 2024. Vol. 69. № 3
DOI:10.33266/1024-6177-2024-69-3-68-71
M.V. Chernykh, T.A. Krylova
Clinical Audits Methodology of the Radiotherapy Departments
in Russian Federation Based on IAEA Audits Principles
N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
Contact person: T.A. Krylova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: To describe the essence, tasks and algorithm of comprehensive audit in radiotherapy departments of medical institutions in Rus
sian Federation. The methodology of audits conducted by the International Atomic Energy Agency (IAEA) and adapted for its further application, was used as a model. The global goal of the audit project is to standardize and harmonize procedures to ensure safety and quality control of treatment of cancer patients in different institutions, to enable comparison of radiation therapy results among participating institutions, to conduct interclinical studies and, possibly, to create a unified data register.
Material and methods: One of the main aspects of clinical audits is the harmonization of standards between different departments. Clinical audits in radiotherapy can be an important tool for interclinical quality assurance (QA) program, effectiveness and safety of radiotherapy, and treatment protocols synchronization. Audits allow an in-depth analysis of the procedures and processes governing patient care in a particular clinic. Such clinical audits cover the whole chain of patients care, the organization of structural units, the infrastructure, clinical, physics and technical aspects underlying the radiotherapy department. This audit is a peer review process conducted by an audit team consisting of a radiation oncologist (RO), medical physicist (MP) and radiation technologist (RTT) and is known as QUATRO and stands for Quality Assurance Team in Radiation Oncology).
Possible audit tools include:
1. Saff interviewing.
2. Examination of the structure of the entire department.
3. Review and evaluation of procedures and all relevant documentation, including analysis of patient charts.
4. Conducting independent measurements of absorbed doses and other methods of local procedures monitoring, where relevant and appropriate.
5. Observation of the practical implementation of operating procedures.
Results: It was decided to use the IAEA QUATRO methodology for clinical audits and to adapt it to the specifics of radiotherapy in Russian Federation. One of the advantages of such a clinical audit is that the formalism and algorithm of this approach will be identically applied in all departments, which will allow comparing and analyzing the results. In order to obtain structured information, a detailed research protocol, which is a questionnaire, has been developed. The questions in the questionnaire allow to assess key aspects of the radiotherapy process that affect clinical outcomes and treatment efficiency.
Keywords: radiation therapy, audit, quality assurance, protocol, quality standards
For citation: Chernykh MV, Krylova TA. Clinical Audits Methodology of the Radiotherapy Departments in Russian Federation Based on IAEA Audits Principles. Medical Radiology and Radiation Safety. 2024;69(3):68–71. (In Russian). DOI:10.33266/1024-6177-2024-69-3-68-71
References
1. Всесторонние аудиты практики лучевой терапии: средство для повышения качества. Вена, Международное агентство по атомной энергии, 2008. [Comprehensive Audits of Radiotherapy Practice: a Tool for Improving Quality. Vienna, International Atomic Energy Agency Publ., 2008 (In Russ.)].
2. Vaandering Aude, Lievens Yolande, Scalliet Pierre. Feasibility and Impact of National Peer Reviewed Clinical Audits in Radiotherapy Departments. Radiotherapy and Oncology. 2020;144: 218–223.
3. On-Site Visits to Radiotherapy Centres: Medical Physics Procedures. IAEA-TECDOC-1543. 2007; March.
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.01.2024. Accepted for publication: 27.02.2024.
Medical Radiology and Radiation Safety. 2024. Vol. 69. № 3
DOI:10.33266/1024-6177-2024-69-3-77-80
I.O. Tomashevsky, O.S. Kornikova
The Importance of SPECT/CT in Simultaneous Assessment
of Calcinosis of Coronary Arteries, Perfusion and Contractile Function of the Myocardium among Men’s with Coronary Heart Disease
Central Clinical Hospital “Russian Railways–Medicine, Moscow, Russia
Contact person: I.O. Tomashevsky, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: To study the frequency of calcinosis of coronary arteries and its effect on myocardial perfusion and contractile function among men’s with coronary heart disease (CHD).
Material and methods: A survey was conducted among 1175 men’s aged 30 to 83 years with coronary artery disease (CHD): simultaneous assessment of coronary artery calcinosis, perfusion and contractile function with 99m Tc-MIBI using SPECT/CT with ECG-synchronization and X-ray radiation attenuation correction, as well as comparison of data with the results of electrocardiography (ECG), echocardiography (ECHO-CG), clinical and biochemical blood tests.
Results: Of the 1175 men examined using SPECT/CT, coronary artery calcification was detected in 426 (35 %): in the age group over 55 years old – in 142 (12 %), in the age group 46−55 years old – in 200 (17 %), in the age group 27–45 years old – in 74 (6 %). The interval of calcium index indicators in accordance with the Agatston scale was established as follows: at the maximum degree > 400 units – in 87 males (7 % of all examined); at 101−400 units – at 121 (10 %); at 11−100 units – at 162 (14 %); at 1−10 units – in 46
(4 %); with a minimum degree − of 0 units – in 759 men (65 % of all examined). In 34 men of whom 15 had coronary calcification and 19 did not have it, perfusion index (SPB) was either normal or corresponded to the initial degree of decrease in perfusion, and contractile function was slightly impaired, the ejection fraction was not reduced.
Conclusion: The use of SPECT/CT technology with ECG-synchronization and CT-attenuation correction of radiation, in 1175 men with CHD made it possible to detect coronary calcification in 35 %: at the age of 55 years in 12 %, at the age of 46–55 years in 17 %, at the age of 27–45 years – in 6 %. In men with CHD without acute coronary events, both with and without coronary calcinosis, SPB was either normal or corresponded to the initial degree of reduced perfusion, and contractile function was slightly impaired, EF was not reduced. Three years later, in men whose coronary artery calcification was moderate despite its increase to a high degree, the perfusion (SPB) and contractile function indicators did not significantly change, and such indicators did not significantly change in the absence of coronary artery calcification.
Keywords: heart, SPECT/CT, calcinosis of coronary arteries, perfusion, contractile function of the myocardium
For citation: Tomashevsky IO, Kornikova OS. The Importance of SPECT/CT in Simultaneous Assessment of Calcinosis of Coronary Arteries, Perfusion and Contractile Function of the Myocardium among Men’s with Coronary Heart Disease. Medical Radiology and Radiation Safety. 2024;69(3):77–80. (In Russian). DOI:10.33266/1024-6177-2024-69-3-77-80
References
1. Ansheles A.A., Sergienko V.B. Nuclear Cardiology. Moscow Publ., 2021. P. 75-125 (In Russ.).
2. Ansheles A.A., Shulgin D.N., Solomyanyy V.V., Sergienko V.B. Comparison of the Results of Stress Tests, Data of Single-Photon Emission Computed Tomography of Myocardium And Coronarography in Patients with Ischemic Heart Disease. Cardiologicheskiy Vestnik. 2012;VII;2(XIX):10-16 (In Russ.).
3. Rudoy A.S., Zagashvili I.V. Microvascular Angina. Voennaya Meditsina = Military Medicine. 2012;(1):143–8 (In Russ.).
4. Zhuravlev K.N., Vasilyeva E.Yu., Sinitsin V.E., Spector A.V. Calcium Score as a Screening Method for Cardiovascular Disease Diagnosis. Rossiyskiy Kardiologicheskiy Zhurnal = Russian Journal of Cardiology. 2019;12:153-161 (In Russ.) .
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. I.O. Tomashevsky took part in the development of the concept, design, theoretical basis, modification of research methods. O. Kornikova took part in the collection and analysis of literary material, statistical data processing, writing and scientific editing of the text.
Article received: 20.01.2024. Accepted for publication: 27.02.2024.
Medical Radiology and Radiation Safety. 2024. Vol. 69. № 3
DOI:10.33266/1024-6177-2024-69-3-72-76
O.D. Bragina1, 2, M.E. Borodina4, V.I. Chernov1, 2, S.M. Deyev2, 3,
M.A. Vostrikova1, A.A. Romanova1
Assessment of Acute Toxicity of the 99mTc(CO)3-(HE)3-DARPinG3 in Breast Cancer Patients
1 National Research Medical Center, Tomsk, Russian
2 Research Center “Oncotheranostics”, National Research Tomsk Polytechnic University, Tomsk, Russia
3 M.M. Shemyakin & Yu.A. Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russia
4 National Medical Research Radiological Centre, Moscow, Russia
Contact person: O.D. Bragina, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: Study the acute toxicity of the radiopharmaceutical [99mTc]Tc-(HE)3-G3 in breast cancer patients.
Material and Methods: The study included 10 breast cancer patients (T1-4N0-2M0) with different HER2/neu expression before systemic/surgical treatment, who were injected with 1000 μg of DARPinG3 protein labeled with technetium-99m ([99mTc]Tc-(HE)3-G3). Throughout the study (48 hours), patients were monitored by medical personnel, during which complaints were assessed, heart rate, blood pressure and body temperature were measured before injection of the radiopharmaceutical, as well as 2, 4, 6, 24 and 48 hours after injection. Additionally, laboratory tests such as general and biochemical blood tests and general urine analysis were performed before injection, 48 hours and 7 days later.
Results: The presence of complaints, as well as the detection of adverse reactions in breast cancer patients included in the study at the time of injection of the radiopharmaceutical [99mTc]Tc-(HE)3-G3, as well as 2, 4, 6, 24, 48 hours and 7 days after injection were not detected. The measurement of heart rate, body temperature, and blood pressure also showed no pathological abnormalities. According to general and biochemical blood analysis, general urine analysis and ECG results, no abnormalities were found 2, 4, 6, 24 and 48 hours, as well as 7 days after of the radiopharmaceutical [99mTc]Tc-(HE)3-G3.
Conclusion: The performed studies fully demonstrate the safety of the clinical use of the radiopharmaceutical [99mTc]Tc-(HE)3-G3 for radionuclide diagnosis of breast cancer patients. The data obtained were confirmed both by the subjective sensations of the patients directly included in the analysis, and by the data of clinical quantitative parameters before the start, as well as 2, 4, 6, 24 and 48 hours after injection of the radiopharmaceutical [99mTc]Tc-(HE)3-G3.
Keywords: radionuclide diagnostics, scaffold proteins, 99mTc-DARPinG3, breast cancer, HER2/neu
For citation: Bragina OD, Borodina ME, Chernov VI, Deyev SM, Vostrikova MA, Romanova AA. Assessment of Acute Toxicity of the 99mTc(CO)3-(HE)3-DARPinG3 in Breast Cancer Patients. Medical Radiology and Radiation Safety. 2024;69(3):72–76. (In Russian). DOI:10.33266/1024-6177-2024-69-3-72-76
References
1. Bragina O, Deyev SM, Chernov VI, Tolmachev VM. The Evolution of Targeted Radionuclide Diagnosis of HER2-Positive Breast Cancer Acta Naturae. 2022;Apr-Jun;14(2):4–15. DOI: 10.32607/actanaturae.11611. PMID:35923562.
2. Hricak H, Abdel-Wahab M, Atun R, Lette MM, Paez D, Brink JA, Donoso-Bach L, Frija G, Hierath M, Holmberg O, Khong PL, Lewis JS, McGinty G, Oyen WJG, Shulman LN, Ward ZJ, Scott AM. Medical Imaging and Nuclear Medicine: a Lancet Oncology Commission. Lancet Oncol. 2021;Apr;22(4):136-172. DOI: 10.1016/S1470-2045(20)30751-8. PMID: 33676609.
3. Bodei L, Herrmann K, Schöder H, Scott AM, Lewis JS. Radiotheranostics in Oncology: Current Challenges and Emerging Opportunities. Nat Rev Clin Oncol. 2022;Aug;19(8):534-550. DOI: 10.1038/s41571-022-00652-y. PMID: 35725926.
4. Giordano SH, Franzoi MAB, Temin S, Anders CK, Chandarlapaty S, Crews JR, Kirshner JJ, Krop IE, Lin NU, Morikawa A, Patt DA, Perlmutter J, Ramakrishna N, Davidson NE. Systemic Therapy for Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: ASCO Guideline Update. J Clin Oncol. 2022;Aug 10;40(23):2612-2635. DOI: 10.1200/JCO.22.00519. PMID: 35640077.
5. Wolff AC, Hammond ME, Hicks DG, Dowsett M, McShane LM, Allison KH, Allred DC, Bartlett JM, Bilous M, Fitzgibbons P, Hanna W, Jenkins RB, Mangu PB, Paik S, Perez EA, Press MF, Spears PA, Vance GH, Viale G, Hayes DF. Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology. College of American Pathologists Clinical Practice Guideline Update. J Clin Oncol. 2013;31:3997-4013. DOI: 10.1200/JCO.2013.50.9984. PMID: 24101045.
6. Tolmachev V, Orlova A, Sorensen J. The Emerging Role of Radionuclide Molecular Imaging of Her2 Expression in Breast Cancer. Semin Cancer Biol. 2021;72:185-197. DOI: 10.1016/j.semcancer.2020.10.005. PMID: 33465471.
7. Брагина О.Д., Чернов В.И., Гарбуков Е.Ю., Дорошенко А.В., Воробьева А.Г., Орлова А.М., Толмачев В.М. Возможности радионуклидной диагностики HER2-позитивного рака молочной железы с использованием меченных технецием-99m таргетных молекул: первый опыт клинического применения // Бюллетень сибирской медицины. 2021. Т. 20. №1. С. 23–30. https://doi.org: 10.20538/1682-0363-2021-1-23-30. [Bragina OD, Chernov VI, Garbukov EYu, Doroshenko AV, Vorobyeva AG, Orlova AM, Tolmachev VM. Possibilities of Radionuclide Diagnostics of Her2-Positive Breast Cancer Using Technetium-99m-Labeled Target Molecules: the First Experience of Clinical Use. Bulletin of Siberian Medicine. 2021;20(1):23–30. https://doi.org: 10.20538/1682-0363-2021-1-23-30. (In Russ.)].
8. Tolmachev V, Bodenko V, Oroujeni M, Deyev S, Konovalova E, Schulga AS, Hober S, Bragina OA, Vorobyeva A. Direct in Vivo Comparison of 99mTc-Labeled Scaffold Proteins DARPin G3 and ADAPT6 for Visualization of HER2 Expression and Monitoring of Early Response for Trastuzumab Therapy. International Journal of Molecular Sciences. 2022;Dec;2;23(23):15181. DOI: 10.3390/ijms232315181. PMID: 36499504.
9. Bragina O, Chernov V, Schulga A, Konovalova E, Hober S, Deyev S, Sörensen J, Tolmachev V. Direct Intra-Patient Comparison of Scaffold Protein-Based Tracers, [99mTc]Tc ADAPT6 and [99mTc]Tc-(HE)3-G3, for Imaging of HER2-Positive Breast Cancer. Cancers. 2023;15(12):3149. https://doi.org/10.3390/cancers15123149.
10. Bragina O, von Witting E, Garousi J, Zelchan R, Sandström M, Orlova A, Medvedeva A, Doroshenko A, Vorobyeva A, Lindbo S, Borin J, Tarabanovskaya N, Sörensen J, Hober S, Chernov V, Tolmachev V. Phase I Study of 99mTc-ADAPT6, a Scaffold Protein-Based Probe for Visualization of HER2 Expression in Breast Cancer. J Nucl Med. 2021;Apr;62(4):493-499. DOI: 10.2967/jnumed.120.248799. PMID: 32817142.
11. Bragina O, Chernov V, Larkina M, Rybina A, Zelchan R, Garbukov E, Oroujeni M, Loftenius A, Orlova A, Sörensen J, Frejd FY, Tolmachev V. Phase I Clinical Evaluation of 99mTc-labeled Affibody Molecule for Imaging HER2 Expression in Breast Cancer. Theranostics. 2023;Sep;4;13(14):4858-4871. DOI: 10.7150/thno.86770. PMID: 37771776.
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The work was carried out within the framework of the Russian Science Foundation grant No. 22-15-00169 on the topic “Phenotype of BRCA-like tumors in the process of carcinogenesis and treatment.”
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.01.2024. Accepted for publication: 27.02.2024.
Medical Radiology and Radiation Safety. 2024. Vol. 69. № 3
DOI:10.33266/1024-6177-2024-69-3-81-85
Muaayed F. Al-Rawi, Izz K. Abboud, and Nasir A. Al-Awad
Novel Approach Using Transfer Deep Learning for Brain Tumor Prediction
College of Engineering, Mustansiriyah University, Baghdad, Iraq
Contact person: Muaayed F. Al-Rawi, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract:
A brain tumor refers to an abnormal collection or aggregation of cells in the brain that has the potential to be life-threatening owing to the cells’ capacity to penetrate and metastasize to organs that are nearby. It is possible to save lives by making a correct diagnosis of this potentially fatal condition. Within the last several years, there has been a noticeable increase in the functionality of deep learning applications. As a result, improving the module’s architecture leads to better approximations in the monitored configuration. Through the provision of trustworthy datasets, the categorization of tumors via the use of deep learning algorithms has successfully achieved significant progress. The purpose of this article is to use transfer module algorithms for the prediction of brain tumors. These modules include MobileNet, VGG19, InceptionResNetV2, Inception, and DenseNet201. The suggested module uses three main optimizers: Adam, SGD, and RMSprop. The simulation findings indicate that the pre-trained MobileNet module with the RMSprop optimizer outperformed all other evaluated modules. In addition to having the shortest amount of time required for computing, it obtained an accuracy of 99.6 %, a sensitivity of 99.4 %, and a specificity of 100 %.
Keywords: medical images, brain tumor, machine and deep learning, computer vision, MRI
For citation: Muaayed F. Al-Rawi, Izz K. Abboud, and Nasir A. Al-Awad. Novel Approach Using Transfer Deep Learning for Brain Tumor Prediction. Medical Radiology and Radiation Safety. 2024;69(3):81–85. (In Russian). DOI:10.33266/1024-6177-2024-69-3-81-85
References
1. Mzoughi H., et al. Deep Multi-Scale 3d Convolutional Neural Network (CNN) for MRI Gliomas Brain Tumor Classifcation. J. Digit. Imaging. 2020;33;903–915.
2. Muhammad Sjjad, Salman Khan, Khan Muhammad, Wanqing Wu, Amin Ullah, Sung Wook Baik. Multigrade Brain Tumor Classification Using Deep CNN with Extensive Data Augmentation. Elsevier. Journal of Computational Science. 2019;30:174-182.
3. Amin Kabir Anaraki, Moosa Ayati, Foad Kazemi. Magnetic Resonance Imaging-Based Brain Tumor Grades Classification and Grading Via Convolutional Neural Networks and Genetic Algorithms. Elsevier. Biocybergenetics and Biomedical Engineering. 2019;39:63-74.
4. Deepak P.M. Ameer. Brain Tumor Classification Using Deep CNN Features Via Transfer Learning. Elsevier. Computers in Biology and Medicine. 2019;111:1-7.
5. R.Vimal Kurup, V.Sowmya, K.P.Soman. Effect of Data Pre-processing on Brain Tumor Classification Using Capsulenet. Springer. ICICCT System Reliability, Quality Control, Safety, Maintenance and Management. 2019:110-119.
6. Zar Nawab Khan Swati, Qinghua Zhao, Muhammad Kabir, Farman Ali, Zakir Ali, Saeed Ahmed, Jianfeng Lu. Brain Tumor Classification for MR Images Using Transfer Learning and Finetuning. Elsevier. Computerized Medical Imaging and Graphics. 2019;75:34-46.
7. Nyoman Abiwinanda, Muhammad Hanif, S. TafwidaHesaputra, Astri Handayani, Tati Rajab Mengko. Brain Tumor Classification Using Convolutional Neural Network. Springer. World Congress on Medical Physics and Biomedical Engineering. 2018:183-189.
8. F.P.Polly, S.K.Shil, M.A.Hossain, A.Ayman, Y.M.Jang. Detection and Classification of HGG and LGG Brain Tumor Using Machine Learning. IEEE. International Conference on Information Networking (ICOIN), 2018.
9. Heba Mohsen, El-Sayed A.El-Dahshan, El-Sayed M.El-Horbaty, Abdel-Badeeh M.Salem. Classification Using Deep Learning Neural Networks for Brain Tumors. Elsevier. Future Computing and Informatics Journal. 2018;3:68-71.
10. Garima Singh, Dr M.A.Ansari. Efficient Detection of Brain Tumor from MRIs Using K-Means Segmentation and Normalized Histogram. IEEE. 1st India International Conference on Information Processing (IICIP), 2016.
11. Parnian Afshar, Konstantinos N. Plantaniotis, Arash Mohammadi. Capsule Networks for Brain Tumor Classification Based on MRI Images Coarse Tumor Boundaries. IEEE. International Conference on Acoustics, Speech and Signal Processing, 2019.
12. https://www.kaggle.com/datasets/ahmedhamada0/braintumor-detection.
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.01.2024. Accepted for publication: 27.02.2024.