Journal of Radiological Protection

Although the boundary representation (BREP) method creates detailed surface phantoms of Chinese women of childbearing age, these phantoms cannot be directly used in Monte Carlo simulations. They must first be converted into voxel phantoms, a process that may diminish some of the inherent advantages of the surface phantoms. Therefore, the aim of this study is to construct a tetrahedral mesh (TM) phantom of Chinese women of childbearing age based on the BREP phantom, incorporating micron-level structural refinements to certain organ tissues while maintaining the original model's structure. This TM phantom can be directly implemented into Monte Carlo codes to calculate the absorbed dose at different photon energies, demonstrating that both the structure and position of organ tissues affect the radiation dose. By achieving more accurate dose assessments, we can optimize radiation protection measures and reduce the potential risks to women of childbearing age.

Public living in areas contaminated by nuclear accidents is exposed to radiation in the early phase and over the long term. Even under similar accident scenarios, radiation doses and sheltering effectiveness, which is one of the protective measures, depend on meteorological conditions and the surrounding environment. Radiation doses and sheltering effectiveness in the early phase of nuclear accidents are crucial information for the public as well as national and local governments planning a nuclear emergency preparedness. In this study, we assessed radiation doses and sheltering effectiveness at sites with nuclear facilities in Japan using the Off-Site Consequence Analysis code for Atmospheric Release accidents, which is one of the level-3 probabilistic risk assessment codes, for five accident scenarios: three scenarios from past severe accident studies, a scenario defined by the Nuclear Regulation Authority in Japan, and a scenario corresponding to the Fukushima-Daiichi Nuclear Power Station accident. The sheltering effectiveness differed by up to approximately 50% among the accident scenarios at the same sites and by approximately 20%–50% among sites under the same accident scenario. Differences in the radionuclide composition among the accident scenarios and the differences in wind speeds among the sites primarily caused these differences in sheltering effectiveness.

The radium dial painters (RDPs) are a well-described group of predominantly young women who incidentally ingested ²²⁶Ra and ²²⁸Ra as they painted luminescent watch dials in the first part of the twentieth century. In 1974 pathologist Dr William D. Sharpe published complete clinical and autopsy results for 42 former RDPs evaluated in the New Jersey Radium Research Project. This was an important paper due to the completeness of the observations. Surprisingly, in this study, clinicians noted a 35.5% incidence of hearing loss, both conductive and mixed etiologies. Since the 1974 publication, there has developed a considerable literature on radiation-induced hearing loss in patients undergoing radiotherapy for head and neck cancers. It is expected that hearing loss would also be associated with systemic inflammation. Recently, the neutrophil to lymphocyte ratio (NLR) has been shown in many cancer and non-cancer studies to be a nonspecific marker of inflammation. In prior collaborative efforts with the United States Transuranium and Uranium Registries and with the NCRP Million Person Study, it has been possible to evaluate NLR from medical records of a cohort of 166 former RDPs previously evaluated at Argonne National Laboratory. In addition, NLR was available in historic medical records of the sarcoma and nasopharyngeal cancer patients described in Rowland's summary of the Argonne studies. Using elevation of the NLR as a non-specific marker of inflammation, chronic inflammation has been observed in all cohorts with significant dose. The RDP cohort has had a unique exposure to radium, but the incidence of radiation-induced hearing loss here is uncertain. Due to cosmic radiation dose to astronauts in space flight, there is a significant interest in high LET radiation dose to the brain, including the auditory system. This paper should be considered as hypothesis generating—that high LET radiation dose to the brain and auditory system may induce hearing loss.

The information about the radiation risk of non-cancer respiratory diseases is inconsistent and mainly corresponds to mortality. Previously, the cohort of workers employed at the first Russian nuclear facility Mayak Production Association who were occupationally exposed to gamma rays (externally) and to alpha-active plutonium aerosols (internally) over prolonged periods demonstrated an increased risk of chronic bronchitis (CB) incidence. Within this retrospective cohort study, we performed analyses of incidence of and mortality from CB and bronchial asthma (BA) using improved estimates of radiation doses provided by the 'Mayak Worker Dosimetry System (MWDS)—2013'. The cohort included 22 377 individuals hired in 1948–1982, and its follow-up was extended by 10 years (to the end of 2018). The excess relative risk of CB incidence per unit of accumulated lung-absorbed radiation dose (ERR/Gy) and the 95% confidence interval (95% CI) were: with the 0 year lag, ERR/Gy was 0.07 (95% CI −0.01, 0.17) for gamma exposure and 0.36 (95% CI 0.13, 0.68) for alpha exposure; with the 10 year lag, ERR/Gy was 0.15 (95% CI 0.04, 0.30) for gamma exposure and 0.54 (95% CI 0.19, 1.03) for alpha exposure. No strong evidence was found indicating that gamma and alpha exposure considerably impacted the risk of mortality from CB. The study confirmed the significant positive linear association of the CB incidence risk with gamma and alpha radiation doses from occupational chronic external and internal exposure. However, the estimates of ERR/Gy of alpha particles from internal exposure appeared to be almost three times lower than those based on the MWDS–2008 doses. The observed inconsistency requires further clarification. As for BA in Mayak workers, no association was demonstrated in the incidence and mortality risks with occupational gamma and alpha radiation exposure.

Artificial intelligence (AI) is transforming medical radiation applications by handling complex data, learning patterns, and making accurate predictions, leading to improved patient outcomes. This article examines the use of AI in optimising radiation doses for x-ray imaging, improving radiotherapy outcomes, and briefly addresses the benefits, challenges, and limitations of AI integration into clinical workflows. In diagnostic radiology, AI plays a pivotal role in optimising radiation exposure, reducing noise, enhancing image contrast, and lowering radiation doses, especially in high-dose procedures like computed tomography (CT). Deep learning (DL)-powered CT reconstruction methods have already been incorporated into clinical routine. Moreover, AI-powered methodologies have been developed to provide real-time, patient-specific radiation dose estimates. These AI-driven tools have the potential to streamline workflows and potentially become integral parts of imaging practices. In radiotherapy, AI's ability to automate and enhance the precision of treatment planning is emphasised. Traditional methods, such as manual contouring, are time-consuming and prone to variability. AI-driven techniques, particularly DL models, are automating the segmentation of organs and tumours, improving the accuracy of radiation delivery, and minimising damage to healthy tissues. Moreover, AI supports adaptive radiotherapy, allowing continuous optimisation of treatment plans based on changes in a patient's anatomy over time, ensuring the highest accuracy in radiation delivery and better therapeutic outcomes. Some of these methods have been validated and integrated into radiation treatment systems, while others are not yet ready for routine clinical use mainly due to challenges in validation, particularly ensuring reliability across diverse patient populations and clinical settings. Despite the potential of AI, there are challenges in fully integrating these technologies into clinical practice. Issues such as data protection, privacy, data quality, model validation, and the need for large and diverse datasets are crucial to ensuring the reliability of AI systems.

In 2018, the International Commission on Radiological Protection (ICRP) released Publication 138, which highlights the ethical values foundational to the system of radiological protection. Additional work, both within and beyond the ICRP, has proposed or recommended ethical values associated with applications of the system in different areas, perhaps most notably in medical, veterinary, and environmental radiological protection. There are also existing ethical frameworks not specifically related to radiological protection that are nonetheless relevant to its practice; for example, the Beauchamp and Childress principles of biomedical ethics are of particular significance when it comes to medical uses of radiation and radioactivity. At first glance, it may seem as if there are unique or isolated sets of ethical values that need to be applied depending on the circumstance. Yet while each area of application will indeed have its own unique aspects and associated value judgements, there are consistent and complementary relationships between these ethical values. This paper reviews the work of the ICRP related to ethics, including brief historical context, and highlights the similarities and differences between sets of ethical values with emphasis on medical, veterinary, and environmental applications of radiological protection.

Background. Anecdotal reports are appearing in the scientific literature about cases of brain tumors in interventional physicians who are exposed to ionizing radiation. In response to this alarm, several designs of leaded caps have been made commercially available. However, the results reported on their efficacy are discordant. Objective. To synthesize, by means of a systematic review of the literature, the capacity of decreasing radiation levels conferred by radiation attenuating devices (RADs) at the cerebral level of interventional physicians. Methodology. A systematic review was performed including the following databases: MEDLINE, SCOPUS, EBSCO, Science Direct, Cochrane Controlled Trials Register (CENTRAL), WOS, WHO International Clinical Trials Register, Scielo and Google Scholar, considering original studies that evaluated the efficacy of RAD in experimental or clinical contexts from January 1990 to May 2023. Data selection and extraction were performed in triplicate, with a fourth author resolving discrepancies. Results. Twenty articles were included in the review from a total of 373 studies initially selected from the databases. From these, twelve studies were performed under clinical conditions encompassing 3801 fluoroscopically guided procedures, ten studies were performed under experimental conditions with phantoms, with a total of 88 procedures, four studies were performed using numerical calculations with a total of 63 procedures. The attenuation and effectiveness of provided by the caps analyzed in the present review varying from 12.3% to 99.9%, and 4.9% to 91% respectively. Conclusion. RAD were found to potentially provide radiation protection, but a high heterogeneity in the shielding afforded was found. This indicates the need for local assessment of cap efficiency according to the practice.

Biokinetic models have been employed in internal dosimetry (ID) to model the human body's time-dependent retention and excretion of radionuclides. Consequently, biokinetic models have become instrumental in modelling the body burden from biological processes from internalized radionuclides for prospective and retrospective dose assessment. Solutions to biokinetic equations have been modelled as a system of coupled ordinary differential equations (ODEs) representing the time-dependent distribution of materials deposited within the body. In parallel, several mathematical algorithms were developed for solving general kinetic problems, upon which biokinetic solution tools were constructed. This paper provides a comprehensive review of mathematical solving methods adopted by some known internal dose computer codes for modelling the distribution and dosimetry for internal emitters, highlighting the mathematical frameworks, capabilities, and limitations. Further discussion details the mathematical underpinnings of biokinetic solutions in a unique approach paralleling advancements in ID. The capabilities of available mathematical solvers in computational systems were also emphasized. A survey of ODE forms, methods, and solvers was conducted to highlight capabilities for advancing the utilization of modern toolkits in ID. This review is the first of its kind in framing the development of biokinetic solving methods as the juxtaposition of mathematical solving schemes and computational capabilities, highlighting the evolution in biokinetic solving for radiation dose assessment.

Interventional cardiology provides indisputable benefits for patients but uses a substantial amount of ionising radiation. The diagnostic reference level (DRL) is the tool recommended by the International Commission on Radiological Protection to optimise imaging procedures. In this work, a review of studies dealing with radiation dose or recommending DRL values for interventional cardiology since 2010 is presented, providing quantitative and qualitative results. There are many published papers on coronary angiography (CA) and percutaneous coronary intervention. The DRL values compiled for different continental regions are different: the DRL for CA is about 35 Gy cm² for Europe and 83 Gy cm² for North America. These differences emphasise the need to establish national DRLs considering different social and/or economic factors and the harmonisation of the survey methodology. Surveys with a large amount of data collected with the help of dose management systems provide more reliable information with less chance of statistical bias than those with a small amount of data. The complexity of procedures and improvements in technology are important factors that affect the radiation dose delivered to patients. There is a need for additional data on structural and electrophysiological procedures. The analysis of paediatric procedures is especially difficult because some studies present results split into age bands and others into weight bands. Diagnostic procedures are better described, but there is a great variety of therapeutic procedures with different DRL values (up to a factor of nine) and these require a dedicated review.

The Norwegian government has maintained a plan of action on nuclear safety and security for over 25 years. The need for such a plan grew from extensive nuclear activities during the Cold War, both civil and military, that led eventually to significant amounts of radioactive waste and nuclear material being stored in unsafe conditions in northwest Russia. As part of the program to implement the plan of action, the Norwegian Radiation and Nuclear Safety Authority has maintained a program of bilateral regulatory cooperation with corresponding authorities in countries of the former Soviet Union for over 25 years. 

This paper reviews the background to that regulatory program, identifies the main radiologically hazardous objects and the related regulatory challenges, and then documents how bilateral cooperation has contributed to the substantial progress made in risk reduction. The review then considers how bilateral work has contributed to and benefitted from sharing results and experience with international partners and draws conclusions and lessons for future work.

The primary conclusion is that bilateral regulatory cooperation has supported reduction of radiation and nuclear risks at a range of complex legacy sites and facilities in countries of the former Soviet Union. Key to this process has been a clear strategy to help build and maintain an up-to-date, robust and independent regulatory process. Only with well-coordinated regulatory bodies with clear responsibilities and functions is it possible to address the diverse threats effectively. 

Among the most radiologically significant sites and facilities where risk has been significantly reduced or eliminated are the Lepse spent fuel and radioactive waste storage vessel, the site for temporary storage for spent fuel and radioactive waste at Andreeva Bay, and the very large radio-isotope thermo-electric generators sources previously used in navigational devices all across the Russian arctic coastline. Noting the clear potential for transboundary impacts, this represents a substantial regional benefit.

A risk indicator that allows for the comparison of risks caused by different factors is highly useful for enhancing public understanding. The International Commission on Radiological Protection developed the concept of "detriment" to quantify radiation-related health effects at low doses. However, the detriment is specific to the radiation field and cannot be simply compared with other risks. In this study, the disability-adjusted life years (DALYs), lifetime incidence risk, and lifetime mortality risk due to radiation exposure were compared among 33 countries. These risk indicators were calculated for all solid cancers, colon cancer, lung cancer, breast cancer, thyroid cancer, and leukaemia. The values of risk indicators for all solid cancers differed by a factor of 1.5–2.0 for male and 1.2–1.5 for female among countries, with higher values observed in countries with a higher socio-demographic index (SDI). The ratios of radiation exposure indicators to the baseline indicators (R/B ratios) were 10%–15% for male and 15%–25% for female under chronic exposure to 20 mSv y−1 radiation from the age of 18 to 64 years, and 1.0%–1.5% for male and 1.5%–2.5% for female under chronic exposure to 1 mSv y−1 radiation over a lifetime. In particular, the R/B ratios under chronic exposure to 1 mSv y−1 radiation were smaller than the coefficient of variation of the baseline risk indicators. Furthermore, the trends in the values of the risk indicators for each cancer site were compared with the detriments used in the radiation field. This study indicated that DALYs should be noted as an alternative indicator to the radiation detriments when discussing the tolerability of radiation and communicating with the society.

Implementation of the novel therapeutic radiopharmaceuticals requires developing, updating, and harmonizing requirements for radiation safety in radiopharmaceutical therapy. Public exposure from patients with administered radiopharmaceutical and biological radioactive waste management can be identified as the main problems in radiopharmaceutical therapy. The aim of the study was to compare different approaches to development of patient release criteria after radiopharmaceutical therapy with different radiopharmaceuticals considering radiation exposure of members of the public in transport, biological elimination of radionuclides from a patient body and generation of biological waste. The study was performed for the following radiopharmaceuticals: 177Lu-PSMA-617, 177Lu-DOTATATE, Na131I, 131I-mIBG, 153Sm-oxabifor. Two base approaches to patient release criteria were considered. The first approach based on the radioactive decay of radionuclide and divided into groups: considering one radiopharmaceutical administration and considering several radiopharmaceutical administrations per course. The second approach based on the radioactive decay of radionuclide and biological elimination of radiopharmaceutical from the patient body (effective half-life) and divided into groups: based on 1 mSv and 5 mSv dose constrains per course. Effective dose rates from patient and sewage tank to passengers or staff in public transport were estimated for various scenarios of patient traveling after radiopharmaceutical therapy. The results demonstrated that the radiation safety of members of the public in transport should be considered while establishing the release criteria of patients after radiopharmaceutical therapy. Based on results, it is recommended to follow the approach based on the radioactive decay of radionuclide and dose constrain to members of the public in contact with patient of 1 mSv per one radiopharmaceutical administration and keep patient in the nuclear medicine department after radiopharmaceutical administration for at least 4-6 hours. Patient release criteria defined according to that approach comply with patient release criteria operated in different countries and allow maintaining radiation safety of the public.

The American radium dial worker (RDW) cohort of over 3,200 persons is being revisited as part of the Million Person Study (MPS) to include a modern approach to RDW dosimetry. An exceptional source of data and contextualization in this project is an extensive collection of electronic records (requiring 43 gigabytes (GB) of storage) digitized from existing microfilm and microfiche housed at the United States Transuranium and Uranium Registries (USTUR). Although the type, extent, and quality (e.g., legibility) of record(s) varies between individuals, the remarkable occupational, medical and demographic data include in vivo radiation measurements (e.g., radon breath, whole body counts), autopsy results, medical records (including copies of radiographs), interviews over the years, and correspondence. Of particular dosimetric interest are the details of radiation measurements. For example, there are some instances where hand-written and transcribed values are both available, along with notes providing context for why a particular measurement in a time series of measurements was chosen to assign an intake, or if there were concerns about a particular measurement. Born prior to 1935, RDW have nearly all passed away. Thus, the updated dosimetry, especially for the bone, will allow the correlation of lifetime cumulative dose with radiation risk. Here we review typical information available in this collection of historical records, highlighting some interesting finds, and discuss the relevance to current and ongoing work related to updating the dosimetry of the RDW in the Million Person Study, including providing an example of the usefulness of information contained in these records.

After the Fukushima Daiichi Nuclear Power Station accident, various information about radiation circulated throughout Japan, leading to diverse perceptions regarding the situation in Fukushima. These perceptions contributed to the social challenges faced by the residents of Fukushima at the time, including prejudice and discrimination. This heightened concern about radiation exposure, particularly among younger generations who were considering marriage or starting families. In the present study, we aimed to investigate the present status of radiation risk perception among university students in Japan and the factors associated with radiation risk perception among these students. A questionnaire survey was administered to university students throughout Japan. We collected demographic information as well as queried their perception of radiation risk (delayed health effects and genetic effects). The results showed that approximately 60% and 40% of respondents believed that delayed effects and genetic effects would occur among residents of Fukushima, respectively. Additionally, having a university major other than studying radiation techniques and living in western Japan were associated with these perceptions of risk. In the future, enhancing risk communication, especially among young populations in western Japan, is necessary to dispel anxiety about the risks from radiation exposure.

Epidemiological studies of nuclear industry workers are of substantial importance to understanding the risk of cancer consequent to low-level exposure to radiation, and these studies should provide vital evidence for the construction of the international system of radiological protection. Recent studies involve large numbers of workers and include health outcomes for workers who accumulated moderate (and even high) doses over prolonged periods while employed during the earlier years of the nuclear industry. The interpretation of the findings of these recent studies has proved to be disappointingly difficult. There are puzzling patterns of results involving the period of first employment and monitoring for radionuclide intakes, depending on the particular study examined. Explaining these patterns is crucial for a reliable understanding of results in terms of occupational radiation exposure. In this paper, an updated review of nuclear worker studies is presented in the context of these patterns of results, making use of the latest relevant results. It is apparent that the strikingly raised risks for mortality from solid cancers for workers hired in later years reported from the International Nuclear Workers Study (INWORKS) is effectively confined to workers at five nuclear facilities in the USA, and that the notable variation of risks in INWORKS between workers monitored or not for radionuclide intakes is driven by UK workers. These are the areas where effort must be concentrated before a confident derivation of radiation risk estimates can be obtained from these nuclear worker studies.

Historically, radiation exposure to mineral sands workers arose primarily from intake of thorium associated with monazite dust generated in mineral separation plants. Research investigations in the 1990s provided greater insight into the characteristics of inhaled thorium ore dust and bioassay studies inferred that some workers had accumulated significant lung burdens of thorium. Recent changes to biokinetic models have increased the radiation dose assessed to arise from thorium intake, raising questions on the appropriateness of current assumptions used in exposure assessment and feasibility of further bioassay research. Past radiation research undertaken in the Western Australian mineral sands industry is summarised and findings from contemporary research relevant to thorium ore dust exposure, thorium health effects and the associated assessment of internal radiation dose are reviewed and analysed. Radiation exposures in the industry have reduced substantially in the last two decades, however current workplace exposure measurement regimes may not reflect the actual intake of monazite-bearing dusts on an individual basis. Past research indicated that thorium associated with monazite dust is relatively insoluble and avidly retained in the lung. There is a paucity of published research on thorium retention and excretion by mine workers over the last 20 years, however significant advances have been made in the detection of thorium in biospecimens. Improvements in measurement technology should make periodic bioassay measurements feasible for selected long-term workers involved in the mining and processing of naturally occurring radioactive materials. Past worker dose estimates require re-evaluation following recent updates to biokinetic models and long-term follow up of the health of workers chronically exposed to thorium ore dusts is recommended.

With the International Commission on Radiological Protection (ICRP) lowering the annual dose limit for the eye lens to 20 mSv, precise monitoring of eye lens exposure has become essential. The personal dose equivalent at a depth of 3 mm, H_p(3), is the measurement method for monitoring the dose to the lens of the eye. Usual dosemeter type-test irradiations at non-normal angles of radiation incidence (α ≠ 0°) primarily use lateral radiation exposure scenarios, where radiation approaches from the left or right, necessitating rotation of the dosemeter-phantom setup around a vertical axis. However, this method does not adequately account for bottom-to-top radiation exposures which are common in real-world situations (such as radiation scattered by a patient reaching medical staff). This study examines oblique radiation exposure conditions using a typical eye lens thermoluminescent dosemeter (TLD), Eye-D, placed on a cylindrical phantom to assess dose response at different angles and exposure energies. The study employs both low-energy (N-30 radiation quality with a mean photon energy of 25 keV) and medium-energy (N-100 radiation quality with a mean photon energy of 83 keV) x-rays at irradiation angles of −60°, 0°, and +60°, measured along the vertical and horizontal rotation axes of the dosemeter-phantom setup. The results show no significant difference between horizontal and vertical (polar and radial) rotation orientations of the dosemeter-phantom setup: recorded relative doses stayed well within ± 1 %, i.e. by far within the attributed combined uncertainty of ± 2 %.

In this submission we opine on India adopting a rather stringent maximum single year dose limit, instead of harmonizing with international standards. We explore how dose limits evolved, why India has opted for a lower maximum effective dose limit of 30 mSv for a single year and argue that raising this limit to at least 50 mSv, in line with International Commission on Radiological Protection (ICRP) recommendations, would not only contribute to upcoming revised ICRP publications but also support the realization of India's nuclear ambitions.

In short terms, a society's available resources are finite and must be prioritised. The more resources that are spent on radiological protection, the lesser resources are available for other needs. The ALARA principle states that exposure of ionising radiation should be kept as low as reasonably achievable, taking into account economic and societal factors. In practice, one of several approaches to determine what is considered as reasonably achievable is cost-benefit analysis. A demanding part of cost-benefit analysis is to decide on an α value, which stipulates the value of radiological protection. There are different conversion methods on how to convert societal costs into an α value. However, with the assistance of recent developments within both health economics and radiological protection room for improvements was found. Therefore, the aims of the present study were to develop a new conversion method (on how to convert societal costs into an α value) and to provide recommendations of α values for each member country of The Organisation for Economic Co-operation and Development (OECD). With the help of systematic reviews of societal costs (the value of a statistical life, productivity losses and healthcare costs) and discount rates, as well as Monte Carlo simulations of the number of years between exposure and cancer diagnosis, a new conversion method and recommendations of α values could be presented. The new conversion method was expressed as a discounted nominal risk of exposure with a median (interquartile range) of 175 (136–222) per 10 000 persons per Sv for the public and 169 (134–207) per 10 000 persons per Sv for workers. For OECD in general, recommendations of α values were determined to be $56–170 per man.mSv for the public and $61–162 per man.mSv for workers (2023-USD).

Since 1968, the United States Transuranium and Uranium Registries (USTUR) has studied the biokinetics and tissue dosimetry of uranium and transuranium elements in nuclear workers. As part of the USTUR collaboration with the Million Person Study of Low-Dose Health Effects, radiation dose to different parts of the human heart is being estimated for workers with documented intakes of ²³⁹Pu or ²²⁶Ra. The study may be expanded for workers with intakes of ²³⁸U and other radionuclides. The distribution of radionuclides, expressed in terms of concentration (Bq per kg of tissue) serves as an important parameter for estimating radiation dose. Based on available organs from workers who donated their bodies or tissues for research, nine undissected hearts were selected: seven from USTUR registrants with plutonium exposure (males) and two individuals with radium intakes (female and male). For the plutonium workers, estimated ²³⁹Pu systemic deposition ranged from <74 Bq to 1765 Bq. Estimated ²²⁶Ra 'initial systemic intakes' were 10.1 MBq and 14.8 kBq for the female patient and male worker, respectively. Organ dissection was based on a heart model published by Borrego et al (2019 J. Radiol. Prot. 39 950–65). This model includes nine cardiac substructures: aorta, left main coronary artery, left atrium, left anterior descending artery, left circumflex artery, left ventricle, right atrium, right coronary artery, and right ventricle. In addition, heart valves, fat attached to epicardium, fluids, and a coronary bypass graft were collected resulting in 111 samples that are currently undergoing radiochemical analyses and mass-spectrometric measurements. The ²³⁹Pu and ²²⁶Ra evaluations are not completed. The results of this study are intended to support radiation worker health studies by improving associated dosimetric and epidemiological models.

Artificial intelligence (AI) is transforming medical radiation applications by handling complex data, learning patterns, and making accurate predictions, leading to improved patient outcomes. This article examines the use of AI in optimising radiation doses for x-ray imaging, improving radiotherapy outcomes, and briefly addresses the benefits, challenges, and limitations of AI integration into clinical workflows. In diagnostic radiology, AI plays a pivotal role in optimising radiation exposure, reducing noise, enhancing image contrast, and lowering radiation doses, especially in high-dose procedures like computed tomography (CT). Deep learning (DL)-powered CT reconstruction methods have already been incorporated into clinical routine. Moreover, AI-powered methodologies have been developed to provide real-time, patient-specific radiation dose estimates. These AI-driven tools have the potential to streamline workflows and potentially become integral parts of imaging practices. In radiotherapy, AI's ability to automate and enhance the precision of treatment planning is emphasised. Traditional methods, such as manual contouring, are time-consuming and prone to variability. AI-driven techniques, particularly DL models, are automating the segmentation of organs and tumours, improving the accuracy of radiation delivery, and minimising damage to healthy tissues. Moreover, AI supports adaptive radiotherapy, allowing continuous optimisation of treatment plans based on changes in a patient's anatomy over time, ensuring the highest accuracy in radiation delivery and better therapeutic outcomes. Some of these methods have been validated and integrated into radiation treatment systems, while others are not yet ready for routine clinical use mainly due to challenges in validation, particularly ensuring reliability across diverse patient populations and clinical settings. Despite the potential of AI, there are challenges in fully integrating these technologies into clinical practice. Issues such as data protection, privacy, data quality, model validation, and the need for large and diverse datasets are crucial to ensuring the reliability of AI systems.

Paediatric patients with congenital heart disease often undergo cardiac catheterisation procedures and are exposed to considerable ionising radiation early in life. This study aimed to develop a method for estimating the dose area product (P_KA) from paediatric cardiac catheterisation procedures (1975–1989) at a national centre for paediatric cardiology and to evaluate trends in P_KA and exposure parameters until 2021. Data from 2200 catheterisation procedures on 1685 patients (1975–1989) and 4184 procedures on 2139 patients (2000–2021) under 18 years of age were retrospectively collected. P_KA values were missing for 1975–1989 but available from 2000 onward. The missing P_KA was estimated from air kerma and beam area, based on exposure records and input from clinicians working at that time. P_KA trends were analysed over time and age. There was a 71% reduction in median P_KA from the period 1975–1989 (median 6.63 Gy cm²) to 2011–2021 (1.91 Gy cm²). The P_KA increases significantly (p = 0.0001) with patient age, which was associated with body weight. Approximately 80% of the total P_KA was from cine acquisition in 1975–1989, while 20% was from fluoroscopy. The P_KA estimate during 1975–1989 was considerably impacted by the assumptions of missing parameters such as tube filtration, focus-to-heart distance, beam area, and number of cine series. The decreasing trend in P_KA values was attributed to advancements in both technologies and clinical practices. The high contribution of cine acquisition to the total dose during 1975–1989 was due to factors such as a high frame rate, multiple acquisitions, and high tube current. The estimated P_KA values for the period 1975–1989 are of importance for the dose reconstruction and risk assessments in the EU epidemiology project Health Effects of Cardiac Fluoroscopy and Modern Radiotherapy in Pediatrics(HARMONIC).

This study examines the effect of paediatric mesh-type reference computational phantoms on organ S values resulting from radioiodine (¹³¹I) intake. Using Geant4, we estimated ¹³¹I S values for 30 radiosensitive target tissues due to emission from the thyroid (Target ← Thyroid) in these phantoms. Our results show that S values differ between male and female phantoms of the same age and S values also decrease as phantom age increases. The male-to-female S value ratio typically varies within 10%, with larger differences observed for the esophagus, extra-thoracic regions, muscles, bladder, and sex organs. On average, S values for mesh phantoms are approximately 17% higher than those for voxel phantoms, with larger discrepancies for organs remodelled separately in mesh phantoms. The study provides organ S values for the paediatric population due to ¹³¹I exposure from the thyroid, based on the reference mesh-type computational phantoms, enhancing organ dose estimation in emergency situations and during radioiodine treatment.