This paper describes the development and testing of VirtualDose--a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the 'software as a service (SaaS)' delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose's functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT-two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations.
Visceral fat is a risk factor for non-alcoholic fatty liver disease (NAFLD). A reduction in sex hormones is associated with increased abdominal fat. Thus, we investigated whether reduced testosterone (T) or oestradiol (E2) levels in men are associated with NAFLD and central obesity. The study involved a survey of 1,882 men between 20 and 60 years of age. We detected hepatic fat infiltration by ultrasound. Early morning serum was analyzed for total testosterone (TT), E2, sex hormone-binding globulin (SHBG), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Free testosterone (FT) was calculated using the Vermeulen method. In the studied population, the prevalence of NAFLD, FSH, LH and SHBG increased with age, TT and FT declined with age, and E2 remained stable. However, in the NAFLD group, TT remained stable, FT and E2 declined, and hepatic fat infiltration increased (P < 0.001 for both). Using multivariate analysis, a correlation was found between E2 and NAFLD, with an odds ratio of 0.954 (95% confidence interval: 0.946-0.967). E2 is one of the protective factors against NAFLD in healthy men. T has no significant correlation with NAFLD. Further investigation would be required to assess the clinical consequences of reduced E2 in men with NAFLD, particularly for men whose TT remained stable.
Objectives: The aim of this study was to investigate the prevalence and epidemiological characteristics of hypertension in the Chinese She ethnic minority in Fujian province of China. After analyzing relevant risk factors of hypertension, we wanted to provide information for prevention and control of hypertension in this ethnic minority. Methods: Using the stratified and cluster methods, we randomly selected 5,350 She subjects for a questionnaire survey. Their weight, height and blood pressure were measured. Hypertension was defined as a mean systolic blood pressure of ≧140 mm Hg or a diastolic blood pressure of ≧90 mm Hg, or use of antihypertensive medication. SPSS 13.0 software was used for database building and the χ2 test for statistical analysis. Results: The number of patients with hypertension was 1,931 (prevalence 36.09%) and 71.15% of them (1,374 patients) were undiagnosed. The prevalence of hypertension increased with age and was associated with education levels, occupation, body mass index, smoking, salt intake levels and a lack of health concepts. Conclusions: The prevalence of hypertension in the She has grown rapidly, which is closely correlated with lifestyle and lack of health education of hypertension. The prevention and control of hypertension in the She is imperative, and the promotion of health education on hypertension can be improved to enhance awareness, prevention, and control of hypertension.
BackgroundComputed Tomography (CT) contributes up to 50% of the medical exposure to the United States population. Children are considered to be at higher risk of developing radiation-induced tumors due to the young age of exposure and increased tissue radiosensitivity. Organ dose estimation is essential for pediatric and adult patient cancer risk assessment. The objective of this study is to validate the VirtualDose software in comparison to currently available software and methods for pediatric and adult CT organ dose estimation.MethodsFive age groups of pediatric patients and adult patients were simulated by three organ dose estimators. Head, chest, abdomen-pelvis, and chest-abdomen-pelvis CT scans were simulated, and doses to organs both inside and outside the scan range were compared. For adults, VirtualDose was compared against ImPACT and CT-Expo. For pediatric patients, VirtualDose was compared to CT-Expo and compared to size-based methods from literature. Pediatric to adult effective dose ratios were also calculated with VirtualDose, and were compared with the ranges of effective dose ratios provided in ImPACT.ResultsIn-field organs see less than 60% difference in dose between dose estimators. For organs outside scan range or distributed organs, a five times’ difference can occur. VirtualDose agrees with the size-based methods within 20% difference for the organs investigated. Between VirtualDose and ImPACT, the pediatric to adult ratios for effective dose are compared, and less than 21% difference is observed for chest scan while more than 40% difference is observed for head-neck scan and abdomen-pelvis scan. For pediatric patients, 2 cm scan range change can lead to a five times dose difference in partially scanned organs.ConclusionsVirtualDose is validated against CT-Expo and ImPACT with relatively small discrepancies in dose for organs inside scan range, while large discrepancies in dose are observed for organs outside scan range. Patient-specific organ dose estimation is possible using the size-based methods, and VirtualDose agrees with size-based method for the organs investigated. Careful range selection for CT protocols is necessary for organ dose optimization for pediatric and adult patients.
Purpose To quantify the effects of operator head posture and different types of protective eyewear on the eye lens dose to operators in interventional radiology (IR). Methods A deformable computational human phantom, Rensselaer Polytechnic Institute (RPI) Adult Male, consisting of a high‐resolution eye model, was used to simulate a radiologist who is performing an interventional radiology procedure. The radiologist phantom was deformed to a set of different head postures. Three different protective eyewear models were incorporated into the posture‐deformed radiologist phantom. The eye lens dose of the radiologist was calculated using the Monte Carlo code, MCNP. Effects of the radiologist's head posture and different types of protective eyewear on eye lens doses were studied. The relationship between efficacy of protective eyewear and the radiologist's head posture was investigated. Effects of other parameters on efficacy of protective eyewear were also studied, including the angular position of the radiologist, the gap between the eyewear and the face of the radiologist, and the lead equivalent thickness. Results The dose to both lenses decreased by 80% as the head posture moved from looking downward to looking upward. Sports wrap glasses were found to reduce doses further than the other two studied models. The efficacy of eyewear was found to be related to radiologist's head posture as well. When the radiologist was looking up, the protective eyewear almost provided no protection to both lenses. Other factors such as the face‐to‐eyewear distance and the lead equivalent thickness were also found to have an impact on the efficacy of protective eyewear. The dose reduction factor (DRF), defined as the ratio of the dose to the lens without protection to that with protection, decreased from 4.25 to 1.07 as the face‐to‐eyewear distance increased. The DRF almost doubled when the lead equivalent thickness increased from 0.07 to 0.35 mm. However, further increase in lead equivalent thickness showed little improvement in dose reduction. Conclusion The radiologist's head posture has a significant influence on the eye lens dose in IR. Sports wrap protective eyewear which conforms to the curve of the face is essential for the radiation protection of the eye lens. However, the radiologist's head posture and other exposure parameters should be considered when evaluating the protection of the radiologist's eyes.
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