Ionizing Radiation: Health Effects, Radiological Protection and Medical Applications

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Radiobiology and Nuclear Medicine".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 28228

Special Issue Editors


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Guest Editor
Italian Aerospace Research Centre (CIRA), via Maiorise s.n.c., 81043 Capua, Italy
Interests: nuclear and radiation physics; dosimetry; radioprotection; computational physics; Monte-Carlo radiation transport; radiation in space; nuclear medicine
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Advanced Biomedical Science, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
Interests: radioprotection; ionizing radiation; radioactivity; environmental radiation; radon gas; radiation detection; solid-state detection; space radiation; numerical analysis; Monte Carlo simulation; geostatistical methods; physics education; outreach; health physics
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Advanced Biomedical Science, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
Interests: radiation detection; radiation; radiation protection; metastasis; radioactivity; tumors; cancer cells; Monte Carlo simulation; laser; optics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue has been set up in the anniversary of two crucial events, the Chernobyl and Fukushima accidents, as well as in the context of exponentially rising public concern around the environmental and human health effects of ionizing radiation.

In everyday-life conditions, experimental data on the biological effects of ionizing radiations come from medical exposures, in particular those related to therapies with radioactive nuclides in nuclear medicine and with external beams in radiotherapy. An exploitation posing radiological protection issues at both population and worker level is another element to be considered within the wide spectrum of harmful effects and favorable applications of ionizing radiation.   

In accordance with the discussion above, our Special Issue is particularly devoted (even if not limited) to manuscripts covering the following topics:

  • Natural occurring radiation and radioactive isotopes distribution on Earth;
  • Radiobiology and biological effectiveness of radiations;
  • Nuclear medicine;
  • Radiotherapy;
  • Medical physics;
  • Radiological protection;
  • Radiation in space;
  • Radiation detection;
  • Radiation dosimetry;
  • Ionizing radiation physics;
  • Radioactivity monitoring;
  • Nuclear-accident-related studies;
  • Activity concentration studies.

Dr. Davide Bianco
Dr. Filomena Loffredo
Prof. Dr. Maria Quarto
Guest Editors

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Published Papers (11 papers)

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Research

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10 pages, 1639 KiB  
Article
Radioprotection for Astronauts’ Missions: Numerical Results on the Nomex Shielding Effectiveness
by Filomena Loffredo, Emanuele Vardaci, Davide Bianco, Antonio Di Nitto and Maria Quarto
Life 2023, 13(3), 790; https://doi.org/10.3390/life13030790 - 15 Mar 2023
Cited by 1 | Viewed by 1679
Abstract
Space missions with humans expose the crews to ionizing radiation, mainly due to the galactic cosmic radiation (GCR). All radiation protection programs in space aim to minimize crews’ exposure to radiation. The radiation protection of astronauts can be achieved through the use of [...] Read more.
Space missions with humans expose the crews to ionizing radiation, mainly due to the galactic cosmic radiation (GCR). All radiation protection programs in space aim to minimize crews’ exposure to radiation. The radiation protection of astronauts can be achieved through the use of shields. The shields could serve as a suit to reduce GCR exposure and, in an emergency, as a radiation shelter to perform necessary interventions outside the space habitat in case of a solar proton event (SPE). A space radiation shielding that is suitable for exploration during space missions requires particular features and a proper knowledge of the radiation type. This study shows the results of numerical simulations performed with the Geant4 toolkit-based code DOSE. Calculations to evaluate the performance of Nomex, an aramidic fiber with high mechanical resistance, in terms of dose reduction to crews, were performed considering the interaction between protons with an energy spectrum ranging from 50 to 1100 MeV and a target slab of 20 g/cm2. This paper shows the properties of secondary products obtained as a result of the interaction between space radiation and a Nomex target and the properties of the secondary particles that come out the shield. The results of this study show that Nomex can be considered a good shield candidate material in terms of dose reductions. We also note that the secondary particles that provide the greatest contribution to the dose are protons, neutrons and, in a very small percentage, α-particles and Li ions. Full article
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12 pages, 1005 KiB  
Article
Initial Testing of an Approximated, Fast Calculation Procedure for Personalized Dosimetry in Radionuclide Therapy Based on Planar Whole-Body Scan and Monte-Carlo Specific Dose Rates from the OpenDose Project
by Davide Bianco, Carmela Nappi, Leandra Piscopo, Fabio Volpe, Mariarosaria Manganelli, Federica Volpicelli, Filomena Loffredo, Pasquale Totaro, Maria Quarto, Alberto Cuocolo and Michele Klain
Life 2022, 12(9), 1303; https://doi.org/10.3390/life12091303 - 25 Aug 2022
Cited by 2 | Viewed by 1635
Abstract
Individualized dosimetry in nuclear medicine is currently at least advisable in order to obtain the best risk–benefit balance in terms of the maximal dose to lesions and under-threshold doses to radiosensitive organs. This article aims to propose a procedure for fast dosimetric calculations [...] Read more.
Individualized dosimetry in nuclear medicine is currently at least advisable in order to obtain the best risk–benefit balance in terms of the maximal dose to lesions and under-threshold doses to radiosensitive organs. This article aims to propose a procedure for fast dosimetric calculations based on planar whole-body scintigraphy (WBS) images and developed to be employed in everyday clinical practice. Methods: For simplicity and legacy reasons, the method is based on planar imaging dosimetry, complemented with some assumptions on the radiopharmaceutical kinetics empirically derived from single-photon emission tomography/computed tomography (SPECT/CT) image analysis. The idea is to exploit a rough estimate of the time-integrated activity as has been suggested for SPECT/CT dosimetry but using planar images. The resulting further reduction in dose estimation accuracy is moderated by the use of a high-precision Monte-Carlo S-factor, such as those available within the OpenDose project. Results: We moved the problem of individualized dosimetry to a transformed space where comparing doses was imparted to the ICRP Average Male/Female computational phantom, resulting from an activity distribution related to patient’s pharmaceutical uptake. This is a fast method for the personalized dosimetric evaluation of radionuclide therapy, bearing in mind that the resulting doses are meaningful in comparison with thresholds calculated in the same framework. Conclusion: The simplified scheme proposed here can help the community, or even the single physician, establish a quantitative guide-for-the-eye approach to individualized dosimetry. Full article
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10 pages, 465 KiB  
Article
COVID-19 and the Additional Radiological Risk during the Lockdown Period in the Province of Naples City (South Italy)
by Giuseppe La Verde, Valeria Artiola, Marco La Commara, Vittoria D’Avino, Leopoldo Angrisani, Giuseppe Sabatino and Mariagabriella Pugliese
Life 2022, 12(2), 246; https://doi.org/10.3390/life12020246 - 7 Feb 2022
Cited by 9 | Viewed by 1712
Abstract
The lockdown restrictions, as a first solution to contain the spread of the COVID-19 pandemic, have affected everyone’s life and habits, including the time spent at home. The latter factor has drawn attention to indoor air quality and the impact on human health, [...] Read more.
The lockdown restrictions, as a first solution to contain the spread of the COVID-19 pandemic, have affected everyone’s life and habits, including the time spent at home. The latter factor has drawn attention to indoor air quality and the impact on human health, particularly for chemical pollutants. This study investigated how the increasing time indoor influenced exposure to natural radioactive substances, such as radon gas. To calculate the radiological risk, we considered the most consolidated indices used for radiation protection: annual effective dose, excess lifetime cancer risk, and the lung cancer case. Furthermore, two different exposure times were considered: pre-lockdown and post-lockdown. The lockdown increased the indoor exposure time by 4% and, consequently, the radiological risk factors by 9%. Furthermore, the reference value of 300 Bq/m3, considered acceptable for human radiation protection, may need to be lowered further in the case of conditions similar to those of the lockdown period. Full article
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9 pages, 924 KiB  
Article
Assessment of Fetal Dose and Health Effect to the Fetus from Breast Cancer Radiotherapy during Pregnancy
by Pattarakan Suwanbut, Thiansin Liamsuwan, Danupon Nantajit, Wilai Masa-nga and Chirapha Tannanonta
Life 2022, 12(1), 84; https://doi.org/10.3390/life12010084 - 7 Jan 2022
Cited by 5 | Viewed by 2530 | Correction
Abstract
Decision for radiotherapy during the first trimester of pregnancy may occur, as patients may not realize their pregnancy at the very early stage. Since radiation dose can affect fetal development, the aim of this study was to evaluate fetal dose and associated deterministic [...] Read more.
Decision for radiotherapy during the first trimester of pregnancy may occur, as patients may not realize their pregnancy at the very early stage. Since radiation dose can affect fetal development, the aim of this study was to evaluate fetal dose and associated deterministic effects and risks to the fetus from breast cancer radiotherapy of an 8-week pregnant patient. PHITS (Particle and Heavy Ion Transport code System) Monte Carlo simulation and the J-45 computational pregnancy phantom were used to simulate breast cancer radiotherapy from a 6 MV TrueBeam linear accelerator using the three dimensional-conformal radiotherapy (3D-CRT) technique with a prescribed dose to the planning target volume (PTV) of 50 Gy. Once the fetal dose was evaluated, the occurrence of the deterministic effects and risks for developing stochastic effects in the fetus were assessed using the recommendations of NCRP Report No. 174, AAPM Report No. 50, and ICRP Publication 84. The fetal dose was evaluated to be 3.37 ± 2.66 mGy, suggesting that the fetus was expected to have no additional deterministic effects, while the risks for developing cancer and malfunctions were similar to that expected from exposure to background radiation. The comparison with the other studies showed that accurate consideration of fetal position and size was important for dose determination in the fetus, especially at the early pregnancy stage when the fetus is very small. Full article
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11 pages, 681 KiB  
Article
Comparison of Dosimetry Protocols for Electron Beam Radiotherapy Calibrations and Measurement Uncertainties
by Fawzia E. M. Elbashir, Wassim Ksouri, Mohamed Hassan Eisa, Sitah Alanazi, Farouk Habbani, Abdelmoneim Sulieman, David A. Bradley and Ibrahim I. Suliman
Life 2022, 12(1), 31; https://doi.org/10.3390/life12010031 - 26 Dec 2021
Cited by 2 | Viewed by 2919
Abstract
This paper presents guidelines for the calibration of radiation beams that were issued by the International Atomic Energy Agency (IAEA TRS 398), the American Association of Physicists in Medicine (AAPM TG 51) and the German task group (DIN 6800-2). These protocols are based [...] Read more.
This paper presents guidelines for the calibration of radiation beams that were issued by the International Atomic Energy Agency (IAEA TRS 398), the American Association of Physicists in Medicine (AAPM TG 51) and the German task group (DIN 6800-2). These protocols are based on the use of an ionization chamber calibrated in terms of absorbed dose to water in a standard laboratory’s reference quality beam, where the previous protocols were based on air kerma standards. This study aims to determine uncertainties in dosimetry for electron beam radiotherapy using internationally established high-energy radiotherapy beam calibration standards. Methods: Dw was determined in 6-, 12- and 18 MeV electron energies under reference conditions using three cylindrical and two plane-parallel ion chambers in concert with the IAEA TRS 398, AAPM TG 51 and DIN 6800-2 absorbed dose protocols. From mean measured Dw values, the ratio TRS 398/TG 51 was found to vary between 0.988 and 1.004, while for the counterpart TRS 398/DIN 6800-2 and TG 51/DIN 6800-2, the variation ranges were 0.991–1.003 and 0.997–1.005, respectively. For the cylindrical chambers, the relative combined uncertainty (k = 1) in absorbed dose measurements was 1.44%, while for the plane-parallel chambers, it ranged from 1.53 to 1.88%. Conclusions: A high degree of consistency was demonstrated among the three protocols. It is suggested that in the use of the presently determined dose conversion factors across the three protocols, dose intercomparisons can be facilitated between radiotherapy centres. Full article
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11 pages, 257 KiB  
Article
Individual Radiosensitivity as a Risk Factor for the Radiation-Induced Acute Radiodermatitis
by Juras Kišonas, Jonas Venius, Olga Sevriukova, Mindaugas Grybauskas, Daiva Dabkevičienė, Arvydas Burneckis and Ričardas Rotomskis
Life 2022, 12(1), 20; https://doi.org/10.3390/life12010020 - 23 Dec 2021
Cited by 3 | Viewed by 2604
Abstract
Background: Up to 95% of irradiated patients suffer from ionizing radiation (IR) induced early skin reaction, acute radiation dermatitis (ARD). Some experts think that additional skin hydration can reduce acute skin reactions. Individual radiosensitivity (IRS) determined from lymphocytes may help to predict acute [...] Read more.
Background: Up to 95% of irradiated patients suffer from ionizing radiation (IR) induced early skin reaction, acute radiation dermatitis (ARD). Some experts think that additional skin hydration can reduce acute skin reactions. Individual radiosensitivity (IRS) determined from lymphocytes may help to predict acute radiation toxicity. The purpose of this study is to evaluate the clinical manifestation of ARD in different skincare groups during whole breast radiotherapy depending on IRS and other risk factors. Methods: A total of 108 early-stage breast cancer patients were randomized into best supportive care (BSC) and additional skincare (ASC) groups. IRS was evaluated using a G2 assay modified with caffeine-induced G2 checkpoint arrest. All patients received a 50 Gy dose to the breast planning target volume (PTV). Clinical assessment of ARD symptoms according to the CTCAE grading scale was performed once a week. Results: IRS was successfully determined for 91 out of 108 patients. A total of 10 patients (11%) had normal IRS, 47 patients (52%) were categorized as radiosensitive, and 34 (37%) as highly radiosensitive. There was no significant difference in the manifestation of ARD between patient groups by skincare or IRS. According to logistic regression, patients with bigger breasts were prone to more severe ARD (p = 0.002). Conclusions: The additional skincare did not improve skin condition during RT. A total of 89% of patients had increased radiosensitivity. IRS determined before RT did not show the predictive value for the manifestation of ARD. Logistic regression revealed that breast volume was the most significant risk factor for the manifestation of ARD. Full article
15 pages, 2155 KiB  
Article
The Effect of High-Dose-Rate Pulsed Radiation on the Survival of Clinically Relevant Radioresistant Cells
by Shingo Terashima, Hironori Yoshino, Yoshikazu Kuwahara, Hiro Sakuraba and Yoichiro Hosokawa
Life 2021, 11(12), 1295; https://doi.org/10.3390/life11121295 - 25 Nov 2021
Cited by 1 | Viewed by 2112
Abstract
We demonstrated that low dose pulsed radiation (0.25 Gy) at a high-dose-rate, even for very short intervals (10 s), decreases cell survival to a greater extent than single exposure to a similar total dose and dose rate. The objective of this study was [...] Read more.
We demonstrated that low dose pulsed radiation (0.25 Gy) at a high-dose-rate, even for very short intervals (10 s), decreases cell survival to a greater extent than single exposure to a similar total dose and dose rate. The objective of this study was to clarify whether high-dose-rate pulsed radiation is effective against SAS-R, a clinically relevant radioresistant cell line. Cell survival following high-dose-rate pulsed radiation was evaluated via a colony assay. Flow cytometry was utilized to evaluate γH2AX, a molecular marker of DNA double-strand breaks and delayed reactive oxygen species (ROS) associated with radiation-induced apoptosis. Increased cytotoxicity was observed in SAS-R and parent SAS cells in response to high dose rate pulsed radiation compared to single dose, as determined by colony assays. Residual γH2AX in both cells subjected to high-dose-rate pulsed radiation showed a tendency to increase, with a significant increase observed in SAS cells at 72 h. In addition, high-dose-rate pulsed radiation increased delayed ROS more than the single exposure did. These results indicate that high-dose-rate pulsed radiation was associated with residual γH2AX and delayed ROS, and high-dose-rate pulsed radiation may be used as an effective radiotherapy procedure against radioresistant cells. Full article
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Review

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10 pages, 911 KiB  
Review
Very-Low-Dose Radiation and Clinical Molecular Nuclear Medicine
by Chi-Jung Tsai, Kang-Wei Chang, Bang-Hung Yang, Ping-Hsiu Wu, Ko-Han Lin, Ching Yee Oliver Wong, Hsin-Lun Lee and Wen-Sheng Huang
Life 2022, 12(6), 912; https://doi.org/10.3390/life12060912 - 17 Jun 2022
Cited by 4 | Viewed by 5303
Abstract
Emerging molecular and precision medicine makes nuclear medicine a de facto choice of imaging, especially in the era of target-oriented medical care. Nuclear medicine is minimally invasive, four-dimensional (space and time or dynamic space), and functional imaging using radioactive biochemical tracers in evaluating [...] Read more.
Emerging molecular and precision medicine makes nuclear medicine a de facto choice of imaging, especially in the era of target-oriented medical care. Nuclear medicine is minimally invasive, four-dimensional (space and time or dynamic space), and functional imaging using radioactive biochemical tracers in evaluating human diseases on an anatomically configured image. Many radiopharmaceuticals are also used in therapies. However, there have been concerns over the emission of radiation from the radionuclides, resulting in wrongly neglecting the potential benefits against little or any risks at all of imaging to the patients. The sound concepts of radiation and radiation protection are critical for promoting the optimal use of radiopharmaceuticals to patients, and alleviating concerns from caregivers, nuclear medicine staff, medical colleagues, and the public alike. Full article
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Other

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14 pages, 1786 KiB  
Systematic Review
Low-Dose Chest CT Protocols for Imaging COVID-19 Pneumonia: Technique Parameters and Radiation Dose
by Ibrahim I. Suliman, Ghada A. Khouqeer, Nada A. Ahmed, Mohamed M. Abuzaid and Abdelmoneim Sulieman
Life 2023, 13(4), 992; https://doi.org/10.3390/life13040992 - 12 Apr 2023
Cited by 7 | Viewed by 3009
Abstract
Chest computed tomography (CT) plays a vital role in the early diagnosis, treatment, and follow-up of COVID-19 pneumonia during the pandemic. However, this raises concerns about excessive exposure to ionizing radiation. This study aimed to survey radiation doses in low-dose chest CT (LDCT) [...] Read more.
Chest computed tomography (CT) plays a vital role in the early diagnosis, treatment, and follow-up of COVID-19 pneumonia during the pandemic. However, this raises concerns about excessive exposure to ionizing radiation. This study aimed to survey radiation doses in low-dose chest CT (LDCT) and ultra-low-dose chest CT (ULD) protocols used for imaging COVID-19 pneumonia relative to standard CT (STD) protocols so that the best possible practice and dose reduction techniques could be recommended. A total of 564 articles were identified by searching major scientific databases, including ISI Web of Science, Scopus, and PubMed. After evaluating the content and applying the inclusion criteria to technical factors and radiation dose metrics relevant to the LDCT protocols used for imaging COVID-19 patients, data from ten articles were extracted and analyzed. Technique factors that affect the application of LDCT and ULD are discussed, including tube current (mA), peak tube voltage (kVp), pitch factor, and iterative reconstruction (IR) algorithms. The CTDIvol values for the STD, LDCT, and ULD chest CT protocols ranged from 2.79–13.2 mGy, 0.90–4.40 mGy, and 0.20–0.28 mGy, respectively. The effective dose (ED) values for STD, LDCT, and ULD chest CT protocols ranged from 1.66–6.60 mSv, 0.50–0.80 mGy, and 0.39–0.64 mSv, respectively. Compared with the standard (STD), LDCT reduced the dose reduction by a factor of 2–4, whereas ULD reduced the dose reduction by a factor of 8–13. These dose reductions were achieved by applying scan parameters and techniques such as iterative reconstructions, ultra-long pitches, and fast spectral shaping with a tin filter. Using LDCT, the cumulative radiation dose of serial CT examinations during the acute period of COVID-19 may have been inferior or equivalent to that of conventional CT. Full article
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1 pages, 160 KiB  
Correction
Correction: Suwanbut et al. Assessment of Fetal Dose and Health Effect to the Fetus from Breast Cancer Radiotherapy during Pregnancy. Life 2022, 12, 84
by Pattarakan Suwanbut, Thiansin Liamsuwan, Danupon Nantajit, Wilai Masa-nga and Chirapha Tannanonta
Life 2023, 13(2), 285; https://doi.org/10.3390/life13020285 - 19 Jan 2023
Viewed by 951
Abstract
In the original publication [...] Full article
8 pages, 3195 KiB  
Case Report
Intramedullary Spinal Cord Metastases from Differentiated Thyroid Cancer, a Case Report
by Fabio Volpe, Leandra Piscopo, Mariarosaria Manganelli, Maria Falzarano, Federica Volpicelli, Carmela Nappi, Massimo Imbriaco, Alberto Cuocolo and Michele Klain
Life 2022, 12(6), 863; https://doi.org/10.3390/life12060863 - 9 Jun 2022
Cited by 3 | Viewed by 1822
Abstract
Intramedullary spinal cord metastases (ISCM) are uncommon metastases of the spinal cord. Magnetic resonance (MR) plays an important role in surgical planning when ISCM is suspected in the differential diagnosis. The incidence of ISCM is expected to increase due to the longer survival [...] Read more.
Intramedullary spinal cord metastases (ISCM) are uncommon metastases of the spinal cord. Magnetic resonance (MR) plays an important role in surgical planning when ISCM is suspected in the differential diagnosis. The incidence of ISCM is expected to increase due to the longer survival of cancer patients as well as the widespread use of MR in the diagnosis of neurological syndromes. The management of these patients is controversial because of the multiple clinical presentations and lack of controlled studies on the efficacy of different therapeutic approaches. Increased awareness of this rare entity may lead to an earlier diagnosis with novel imaging approaches at a stage when neurological deficits are reversible. A case of ISCM in a 49-year-old patient with differentiated thyroid cancer is reported. Full article
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