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      Comparative dosimetry of radiography device, MSCT device and two CBCT devices in the elbow region

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          Abstract

          The aim of the study was to estimate and to compare effective doses in the elbow region resulting from four different x‐ray imaging modalities. Absorbed organ doses were measured using 11 metal oxide field effect transistor (MOSFET) dosimeters that were placed in a custom‐made anthropomorphic elbow RANDO phantom. Examinations were performed using Shimadzu FH‐21 HR radiography device, Siemens Sensation Open 24‐slice MSCT‐device, NewTom 5G CBCT device, and Planmed Verity CBCT device, and the effective doses were calculated according to ICRP 103 recommendations. The effective dose for the conventional radiographic device was 1.5 µSv. The effective dose for the NewTom 5G CBCT ranged between 2.0 and 6.7 µSv, for the Planmed Verity CBCT device 2.6 µSv and for the Siemens Sensation MSCT device 37.4 µSv. Compared with conventional 2D radiography, this study demonstrated a 1.4–4.6 fold increase in effective dose for CBCT and 25‐fold dose for standard MSCT protocols. When compared with 3D CBCT protocols, the study showed a 6‐19 fold increase in effective dose using a standard MSCT protocol. CBCT devices offer a feasible low‐dose alternative for elbow 3D imaging when compared to MSCT.

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          Most cited references50

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          Estimated risks of radiation-induced fatal cancer from pediatric CT.

          In light of the rapidly increasing frequency of pediatric CT examinations, the purpose of our study was to assess the lifetime cancer mortality risks attributable to radiation from pediatric CT. Organ doses as a function of age-at-diagnosis were estimated for common CT examinations, and estimated attributable lifetime cancer mortality risks (per unit dose) for different organ sites were applied. Standard models that assume a linear extrapolation of risks from intermediate to low doses were applied. On the basis of current standard practice, the same exposures (milliampere-seconds) were assumed, independent of age. The larger doses and increased lifetime radiation risks in children produce a sharp increase, relative to adults, in estimated risk from CT. Estimated lifetime cancer mortality risks attributable to the radiation exposure from a CT in a 1-year-old are 0.18% (abdominal) and 0.07% (head)-an order of magnitude higher than for adults-although those figures still represent a small increase in cancer mortality over the natrual background rate. In the United States, of approximately 600,000 abdominal and head CT examinations annually performed in children under the age of 15 years, a rough estimate is that 500 of these individuals might ultimately die from cancer attributable to the CT radiation. The best available risk estimates suggest that pediatric CT will result in significantly increased lifetime radiation risk over adult CT, both because of the increased dose per milliampere-second, and the increased lifetime risk per unit dose. Lower milliampere-second settings can be used for children without significant loss of information. Although the risk-benefit balance is still strongly tilted toward benefit, because the frequency of pediatric CT examinations is rapidly increasing, estimates that quantitative lifetime radiation risks for children undergoing CT are not negligible may stimulate more active reduction of CT exposure settings in pediatric patients.
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            The frequency and epidemiology of hand and forearm fractures in the United States.

            The purpose of this study was to estimate the frequency and describe the epidemiology of hand and forearm fractures in the United States. We extracted cases with ICD-9-CM diagnostic codes of 813.0 to 817.1 from the 1998 National Hospital Ambulatory Medical Care Survey. In 1998 there were 1,465,874 estimated cases of hand/forearm fractures, accounting for 1.5% of all emergency department cases. Radius and/or ulna fractures comprised the largest proportion of fractures (44%). The most affected age group was 5 to 14 years of age (26%). Private insurance paid for 49% of the cases. Most of the fractures occurred at home (30%); the street/highway was the second most likely fracture location (14%). Accidental falls caused the majority (47%) of fractures. Large database analysis provides important information that can be used to target interventions toward vulnerable populations and to allocate adequate resources for treating upper extremity fractures.
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              EANM Dosimetry Committee guidelines for bone marrow and whole-body dosimetry.

              The level of administered activity in radionuclide therapy is often limited by haematological toxicity resulting from the absorbed dose delivered to the bone marrow. The purpose of these EANM guidelines is to provide advice to scientists and clinicians on data acquisition and data analysis related to bone-marrow and whole-body dosimetry. The guidelines are divided into sections "Data acquisition" and "Data analysis". The Data acquisition section provides advice on the measurements required for accurate dosimetry including blood samples, quantitative imaging and/or whole-body measurements with a single probe. Issues specific to given radiopharmaceuticals are considered. The Data analysis section provides advice on the calculation of absorbed doses to the whole body and the bone marrow. The total absorbed dose to the bone marrow consists of contributions from activity in the bone marrow itself (self-absorbed dose) and the cross-absorbed dose to the bone marrow from activity in bone, larger organs and the remainder of the body. As radionuclide therapy enters an era where patient-specific dosimetry is used to guide treatments, accurate bone-marrow and whole-body dosimetry will become an essential element of treatment planning. We hope that these guidelines will provide a basis for the optimization and standardization of the treatment of cancer with radiopharmaceuticals, which will facilitate single- and multi-centre radionuclide therapy studies.
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                Author and article information

                Contributors
                juha.koivisto@planmeca.com
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                03 April 2021
                May 2021
                : 22
                : 5 ( doiID: 10.1002/acm2.v22.5 )
                : 128-138
                Affiliations
                [ 1 ] Department of Physics University of Helsinki Helsinki Finland
                [ 2 ] Department of Oral and Maxillofacial Surgery/Oral Pathology VU University Medical Center Amsterdam The Netherlands
                [ 3 ] University of North Carolina Adams School of Dentistry Chapel Hill NC USA
                [ 4 ] International Docrates Cancer Center Helsinki Finland
                [ 5 ] Section of Oral Maxillofacial Radiology Department of Clinical Dentistry Faculty of Medicine and Dentistry University of Bergen Bergen Norway
                [ 6 ] Department of Oral Maxillofacial Surgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
                [ 7 ] Division of Regenerative Orofacial Medicine Hamburg Germany
                Author notes
                [*] [* ] Author to whom correspondence should be addressed. Juha Koivisto

                E‐mail: juha.koivisto@ 123456planmeca.com .

                Article
                ACM213245
                10.1002/acm2.13245
                8130242
                33811787
                7c19af1e-934a-4ef5-8f68-2b289a943a02
                © 2021 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 March 2021
                : 11 December 2019
                : 17 March 2021
                Page count
                Figures: 5, Tables: 6, Pages: 11, Words: 8373
                Categories
                Medical Imaging
                Medical Imaging
                Custom metadata
                2.0
                May 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.2 mode:remove_FC converted:18.05.2021

                cbct,effective dose,elbow,x‐ray radiation
                cbct, effective dose, elbow, x‐ray radiation

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