Medical Radiology and Radiation Safety. 2024. Vol. 69. № 2

DOI:10.33266/1024-6177-2024-69-2-38-48

A.N. Koterov¹, L.N. Ushenkova¹, A.A. Wainson², I.G. Dibirgadzhiev¹,
M.V. Kalinina¹, A.Yu. Bushmanov¹

Dose Dependence for Mortality from Circulatory Diseases in Nuclear Workers (Systematic Review and Pooled Analysis):
Lack of Low Doses Effect and Confirmation of UNSCEAR and ICRP Threshold at 0.5 Gy

¹ A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

² N.N. Blokhin Russian Cancer Research Center, Moscow, Russia

Contact person: Alexey N. Koterov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Abstract

Based on the maintained database (source database) on effects in nuclear workers (NW), a selection of major studies of the relationship between mortality from diseases of the circulatory system (CVD; codes 390–459 according to ICD-9 and I00–I99 according to ICD-10) and external radiation dose. The sample included 30 papers and covered cohorts from 6 countries plus an NW cohort from 15 countries. For the sample, in most cases based on published standardized mortality rates (SMR), the relative risks (RR) of mortality from CVD were calculated for the selected dose groups with subsequent processing of the material for outliers. Initial: n = 207; final sample: n = 199; covers very low (0–10 mSv; 15.8 % of the sample), low (>10–100 mSv; 45.8 %) and moderate (>100–1000 mSv; 36.4 %) doses; data for high doses (>1000 mSv; n = 4; 2 % of the sample), due to dubiousness, were excluded.

A systematic review and pooled analysis of the RR for mortality from CVD depending on the dose on an ordinal scale was performed on the final sample. For the entire dose range (0–1000 mSv) and for moderate doses, statistically significant trends in increasing RR were found when expressed in five types of regressions (except for the logarithmic one for the entire range). Although the r values were small (0.230–0.293), the effect was clear. The ERR per 1 Gy (Sv) calculated for moderate doses using linear regression was 0.54. This value is higher than those obtained previously in meta-analyses, but should be considered as the most adequate.

No dose relationship was found for the very low + low dose range (0–100 mGy); the r coefficients for the regressions were either negligible or negative at statistical insignificance. For the subthreshold dose range for CVD mortality after exposure (according to UNSCEAR and ICRP: 500 mSv), only a weak trend towards an increase in RR was found, statistically insignificant, despite the large sample size (n = 191), while for the dose range 500–1000 mSv, the highest tendency among the pooled analyzes was revealed to increase the risk depending on the level of exposure (r = 0.297–0.423; statistically insignificant due to the small sample size: n = 8).

It is concluded that for mortality from CVD after irradiation, the threshold value of 0.5 Gy established by UNSCEAR and ICRP and confirmed in the present pooled analysis should be strictly adhered to. Due to the lack of effects of low doses, it is inappropriate to raise the issue of low dose effects in the context of these pathologies.

Keywords: diseases of the circulatory system, mortality, radiation, nuclear workers, low doses, moderate doses, effect threshold

For citation: Koterov AN, Ushenkova LN, Wainson AA, Dibirgadzhiev IG, Kalinina M, Bushmanov AYu. Dose Dependence for Morta-

lity from Circulatory Diseases in Nuclear Workers (Systematic Review and Pooled Analysis): Lack of Low Doses Effect and Confirmation of Unscear and Icrp Threshold at 0.5 Gy. Medical Radiology and Radiation Safety. 2024;69(2):38–48. (In Russian). DOI:10.33266/1024-6177-2024-69-2-38-48 

 

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 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: 20.11.2023. Accepted for publication: 27.12.2023.

 

 

Medical Radiology and Radiation Safety. 2024. Vol. 69. № 2

DOI:10.33266/1024-6177-2024-69-2-53-64

V. Zaichick¹, V. Kolotov²

Nuclear Physics Medical Elementology as a Section of Medical Radiology

¹ A.F. Tsyb Medical Radiological Research Centre, Obninsk, Russia

² V.I. Vernadsky Institute of Geochemistry and Analytical Chemistry of the Russian Academy of Sciences

Contact person: V. Zaichick, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

ABSTRACT

Purpose: Medical elementology and its subsection nuclear physics medical elementology, as the most important areas of biomedical science, are still insufficiently included in the arsenal of medical radiology as a fundamental basis for the development and use of new methods for diagnosing and treating various diseases, including oncological ones. For the successful establishment of nuclear physics medical elementology as a new scientific discipline, it is necessary to develop a clear methodology for its further development. 

Results: The definition of the subject of research and the main postulates of medical elementology is given. The close interrelation of knowledge about the content and metabolism of chemical elements, as well as their radioactive and stable isotopes, with the needs of medical radiology is shown. The following areas of research are considered: 1) The use of chemical elements, as well as their radioactive and stable isotopes in medicine; 2) Visualization of organs and tissues, as well as in vivo determination of the content of chemical elements in them; 3) Nuclear physical methods for determining chemical elements in samples of tissues and fluids of the human body in solving oncological problems; 4) The role of chemical elements in calculating absorbed doses during radiotherapy; 5) The use of nuclear physical methods in the formation of groups at increased risk of cancer. A range of modern nuclear physics analytical methods acceptable in clinical practice and as an adequate research tool is outlined. The need for the integrated use of nuclear physics analytical technologies to obtain reference values ​​for the content of chemical elements in various organs, tissues and fluids of the human body in normal and various pathological conditions, as well as to organize the strictest quality control of measurements and unify methodological approaches is demonstrated. The modern possibilities of using the achievements of nuclear physics medical elementology in solving the problems of medical radiology are determined and the priorities for the future are outlined.

Conclusion: The steady development of nuclear physical methods of chemical elements analysis and their implementation in medicine is constantly expanding the scope of possibilities of medical elementology. The development of this area will certainly make a significant contribution to the future successes of medical radiology.

Keywords: medical radiology, radiation-nuclear medical elementology, chemical elements, norm, pathology, extreme impacts, environment

For citation: Zaichick V, Kolotov V. Nuclear Physics Medical Elementology as a Section of Medical Radiology. Medical Radiology and Radiation Safety. 2024;69(2):53–64. (In Russian). DOI:10.33266/1024-6177-2024-69-2-53-64

 

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 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: 20.11.2023. Accepted for publication: 27.12.2023.

 

 

 

 

Medical Radiology and Radiation Safety. 2024. Vol. 69. № 2

DOI:10.33266/1024-6177-2024-69-2-49-52

I.O. Tomashevsky, O.S. Kornikova

The Importance of Radiation Methods 
in the Diagnosis of Coronary Heart Disease in a Specific Patient

Central Clinical Hospital RZD-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: Demonstrate a clinical observation in which to establish a diagnosis it was necessary to use eight methods for diagnosing coronary pathology, four of which are radiation.

Material and methods: To establish a diagnosis in a cardiac patient with suspected coronary heart disease (CHD), post-infarction cardiosclerosis, echocardiography (ECG), Holter monitoring (HM), bicycle ergometry (VE), X-ray computed tomography (X-ray computed tomography) to determine calcification of the coronary arteries, single-photon selective computer tomography (SPECT), magnetic resonance computed tomography (MRI), positron emission computed tomography (PET), coronary angiography (CAG).

Results: The sequential use of eight diagnostic methods, four from radiation, was established when observing cardiosclerosis with coronary heart disease, cardiosclerosis in the 4, 5, 10, and 11 segments of the heart, complicated by a left ventricular aneurysm in the lower and lateral walls with minor ischemia at the height of physical activity.  The need to use SPECT/CT in the complex diagnosis of coronary heart disease consists of using hybrid tomography and sequentially performing two studies in one diagnostic procedure (X-ray computed tomography and SPECT with ^99m Tc-technetril) it seems possible to obtain 26 study indicators (with X-ray computed tomography – 4 indicators assessing calcification of the coronary arteries, with SPECT – 11 indicators of perfusion and 11 indicators of myocardial function).

Conclusion: A clinical observation of the diagnosis of coronary artery disease with post-infarction cardiosclerosis and left ventricular aneurysm was demonstrated in which eight diagnostic technologies were used (ECG, CM, VE, CT, SPECT, MRI, PET, and CAG), four of which relate to radiation diagnostics (X-ray CT, SPECT, PET, and KAG). A feature of sequential hybrid tomography (X-ray CT and SPECT with ^99mTc-technitrile) is that this technology allows you to obtain 26 research indicators.

Keywords: radiation diagnostics, heart, x-ray computed tomography, SPECT/CT, ischemic disease

For citation: Tomashevsky IO, Kornikova OS. The Importance of Radiation Methods in the Diagnosis of Coronary Heart Disease in a Specific Patient. Medical Radiology and Radiation Safety. 2024;69(2):49–52. (In Russian). DOI:10.33266/1024-6177-2024-69-2-49-52

 

References

1. Tomashevskiy I.O., Kornikova O.S. Hybrid Simultaneous ECG-Synchronized Emission and X-Ray Tomography in Assessing the Effect of Coronary Artery Calcinosis on Myocardial Perfusion, as Well as Function, in the Diagnosis of Cardiac Ischemia. Materialy XYII Vserossiyskogo Natsionalnogo Kongressa Luchevykh Diagnostov i Terapevtov «Radiolgiya-2023» = The Collection of Materials of the XYII All-Russian National Congress of Radiation Diagnostics and Therapists “Radiologla-2023”. Moscow Publ., P. 131. ISBN 978-5-906484-71-0 (In Russ.).

2. Khachirova E.A. State of Myocardial Perfusion and Diastolic Function in Patients with Stenocardia and Unchanged Coronary Arteries (According to Hybrid Single-Photon Emission Computed Tomography with ^99mTc-MIBI. Thesis PhD Med. Moscow Publ., 2020 (In Russ.). 

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 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: 20.11.2023. Accepted for publication: 27.12.2023.

 

 

Medical Radiology and Radiation Safety. 2024. Vol. 69. № 2

DOI:10.33266/1024-6177-2024-69-2-65-72

S.M. Rodneva¹, D.V. Guryev^{1, 2}

Theoretical Analysis of the Radiation Quality and the Relative Biological Efficiency of Tritium

¹ A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

² N.N. Semenov Federal Research Center for Chemical Physics, Moscow, Russia

Contact person: Sofya Mikhailovna Rodneva, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

CONTENTS

 

Introduction

1. Tritium and reference radiation

1.1 Tritium isotope and its energy spectrum

1.2 Reference radiation

2. Methods for determining the quality of radiation and RBE

2.1 Radiation quality in microdosimetry

2.2 RBE by the number of DNA double-strand breaks

2.3 RBE by fraction of secondary low-energy electrons

3. Analysis of calculations of radiation quality and tritium RBE

3.1 Estimation of tritium emission quality factors

3.2 Evaluation of the RBE of tritium radiation during its action on DNA

3.3 Estimation of the RBE of tritium from the fraction of secondary low-energy electrons

3.4 Quality factors and RBE of tritium with respect to reference emissions

Conclusion

Keywords: ionizing radiation, tritium, electrons, DNA breaks, Monte Carlo simulation, RBE

For citation: Rodneva SM, Guryev DV. Theoretical Analysis of the Radiation Quality and the Relative Biological Efficiency of Tritium. Medical Radiology and Radiation Safety. 2024;69(2):65–72. (In Russian). DOI:10.33266/1024-6177-2024-69-2-65-72

 

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 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: 20.11.2023. Accepted for publication: 27.12.2023.