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使用J45怀孕女性体模系列的胎儿和母体原子弹幸存者剂量测定:与DS02系统比较时对跪姿和躺姿的考量

Fetal and Maternal Atomic Bomb Survivor Dosimetry Using the J45 Pregnant Female Phantom Series: Considerations of the Kneeling and Lying Posture with Comparisons to the DS02 System.

作者信息

Domal Sean J, Correa-Alfonso Camilo M, Paulbeck Colin J, Griffin Keith T, Sato Tatsuhiko, Funamoto Sachiyo, Cullings Harry M, Egbert Stephen D, Endo Akira, Hertel Nolan E, Lee Choonsik, Bolch Wesley E

机构信息

Medical Physics Program, College of Medicine, University of Florida, Gainesville, FL.

Department of Radiology, Johns Hopkins University, Baltimore, MD.

出版信息

Health Phys. 2023 Oct 1;125(4):245-259. doi: 10.1097/HP.0000000000001710. Epub 2023 Jun 23.

DOI:10.1097/HP.0000000000001710
PMID:37358430
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11789001/
Abstract

Organ dosimetry data of the atomic bomb survivors and the resulting cancer risk models derived from these data are currently assessed within the DS02 dosimetry system developed through the Joint US-Japan Dosimetry Working Group. In DS02, the anatomical survivor models are limited to three hermaphroditic stylized phantoms-an adult (55 kg), a child (19.8 kg), and an infant (9.7 kg)-that were originally designed for the preceding DS86 dosimetry system. As such, organ doses needed for assessment of in-utero cancer risks to the fetus have continued to rely upon the use of the uterine wall in the adult non-pregnant stylized phantom as the dose surrogate for all fetal organs regardless of gestational age. To address these limitations, the Radiation Effects Research Foundation (RERF) Working Group on Organ Dose (WGOD) has established the J45 (Japan 1945) series of high-resolution voxel phantoms, which were derived from the UF/NCI series of hybrid phantoms and scaled to match mid-1940s Japanese body morphometries. The series includes male and female phantoms-newborn to adult-and four pregnant female phantoms at gestational ages of 8, 15, 25, and 38 wk post-conception. In previous studies, we have reported organ dose differences between those reported by the DS02 system and those computed by the WGOD using 3D Monte Carlo radiation transport simulations of atomic bomb gamma-ray and neutron fields for the J45 phantoms series in their traditional "standing" posture, with some variations in their facing direction relative to the bomb hypocenter. In this present study, we present the J45 pregnant female phantoms in both a "kneeling" and "lying" posture and assess the dosimetric impact of these more anatomically realistic survivor models in comparison to current organ doses given by the DS02 system. For the kneeling phantoms facing the bomb hypocenter, organ doses from bomb source photon spectra were shown to be overestimated by the DS02 system by up to a factor of 1.45 for certain fetal organs and up to a factor of 1.17 for maternal organs. For lying phantoms with their feet in the direction of the hypocenter, fetal organ doses from bomb source photon spectra were underestimated by the DS02 system by factors as low as 0.77, while maternal organ doses were overestimated by up to a factor of 1.38. Organs doses from neutron contributions to the radiation fields exhibited an increasing overestimation by the DS02 stylized phantoms as gestational age increased. These discrepancies are most evident in fetal organs that are more posterior within the mother's womb, such as the fetal brain. Further analysis revealed that comparison of these postures to the original standing posture indicate significant dose differences for both maternal and fetal organ doses depending on the type of irradiation. Results from this study highlight the degree to which the existing DS02 system can differ from organ dosimetry based upon 3D radiation transport simulations using more anatomically realistic models of those survivors exposed during pregnancy.

摘要

目前,通过美日剂量测定联合工作组开发的DS02剂量测定系统,正在评估原子弹幸存者的器官剂量数据以及从这些数据得出的癌症风险模型。在DS02中,解剖学幸存者模型仅限于三个雌雄同体的理想化体模——一个成人(55千克)、一个儿童(19.8千克)和一个婴儿(9.7千克),这些体模最初是为之前的DS86剂量测定系统设计的。因此,评估胎儿宫内癌症风险所需的器官剂量,一直依赖于将成年未孕理想化体模中的子宫壁用作所有胎儿器官的剂量替代物,而不考虑胎龄。为解决这些局限性,辐射效应研究基金会(RERF)器官剂量工作组(WGOD)建立了J45(日本1945)系列高分辨率体素体模,该系列体模源自UF/NCI系列混合体模,并按比例缩放以匹配20世纪40年代中期日本人的身体形态测量数据。该系列包括男性和女性体模——从新生儿到成人——以及四个孕龄分别为受孕后8周、15周、25周和38周的怀孕女性体模。在之前的研究中,我们报告了DS02系统报告的器官剂量与WGOD使用原子弹伽马射线和中子场的3D蒙特卡罗辐射传输模拟为J45体模系列计算的器官剂量之间的差异,这些体模处于传统的“站立”姿势,其面对炸弹爆心的方向存在一些变化。在本研究中,我们展示了处于“跪着”和“躺着”姿势的J45怀孕女性体模,并评估了这些更符合解剖学实际情况的幸存者模型与DS02系统给出的当前器官剂量相比的剂量测定影响。对于面对炸弹爆心的跪着的体模,DS02系统对某些胎儿器官的炸弹源光子光谱器官剂量高估了1.45倍,对母体器官高估了1.17倍。对于脚朝爆心方向躺着的体模,DS02系统对炸弹源光子光谱的胎儿器官剂量低估了0.77倍,而母体器官剂量高估了1.38倍。随着胎龄增加,DS02理想化体模对辐射场中子贡献的器官剂量高估程度不断增加。这些差异在母亲子宫内更靠后的胎儿器官中最为明显,比如胎儿大脑。进一步分析表明,将这些姿势与原始站立姿势进行比较表明,根据照射类型的不同,母体和胎儿器官剂量存在显著的剂量差异。这项研究的结果突出了现有DS02系统与基于3D辐射传输模拟的器官剂量测定之间的差异程度,后者使用了怀孕期间受照者更符合解剖学实际情况的模型。

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本文引用的文献

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Specific absorbed fractions for a revised series of the UF/NCI pediatric reference phantoms: internal photon sources.修订版 UF/NCI 儿科参考模型的特定吸收分数:内部光子源。
Phys Med Biol. 2021 Jan 26;66(3):035006. doi: 10.1088/1361-6560/abc708.
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