https://www.icrjournal.ir/ Iranian Congress of Radiology en daily 1 Sun, 01 Oct 2023 00:00:00 +0330 Sun, 01 Oct 2023 00:00:00 +0330 https://www.icrjournal.ir/article_179460.html Purpose: This study was conducted with the aim of investigating the use of pelvic ultrasound and its parameters in differentiating CPP patients from similar conditions (isolated premature thelarche (IPT) and isolated premature adrenarche (IPA)) and healthy girls. Methods: We consecutively enrolled 183 cases from 2015 to 2019 years in different groups based on the case-control method who were referred to the Endocrinology department of Ali Asghar hospital for evaluation of precocious puberty. All cases were of Persian ethnicity, classified by clinical and laboratory findings. Pelvic ultrasonography was evaluated in all groups. A one-way analysis of variance (ANOVA) was used to compare the mean of continuous variables. Finally, Receiver– operating characteristics (ROC) analysis was used to determine the best cut-off point for ultrasonography parameters Results: Among a total of 183 children, 62 were classified as the control (33.87%), 93 as the CPP group (50.81%), 16 as the IPT group (8.74%), and 12 as the IPA group (6.55%). Our study shows no significant difference in chronological age and BMI of classified groups, but CPP group showed a significantly higher bone age (107.76±19.81 month) (p<0.001) and taller height (129.53±8.97 cm) (p=0.003) against other groups. All ultrasonography parameters differ significantly between CPP and control group, also a significant difference is found between CPP compared to IPT and IPA patients in all parameters except in cervix anteroposterior diameter, and ovarian volumes. The best parameters for differentiating CPP compared to study groups were uterine volume (a cut-off of 1.40, 75.27% sensitivity,75.56% specificity), transverse diameter (a cut-off of 13.5 mm, 72.04% sensitivity, 71.11% specificity), and F/C (fundus/cervix) ratio (a cut-off of 0.98, 78.49% sensitivity, 70% specificity). Conclusion: Pelvic ultrasound parameters may improve the diagnosis of CPP patients and can play an auxiliary role in distinguishing the treatment needed from other patients. https://www.icrjournal.ir/article_179461.html   Purpose: to investigate the correlation of electroimpedance mammography findings with mammography as a screening modality. Methods: In this study 271 subjects who have been attended to Imam Khomeini hospital for screening MG, were enrolled. After screening MG and filling a written consent, patients undergone EIM for both breasts using the specific scanner (MEIK5.6, PKF SIM-Technika). EIM scans were interpreted by a specialist with 10 years of experience in reporting EIM scans. BI-RADS score and breast composition was determined in both modalities. Obtained results from MG and EIM scan were compared to find out their correlation. Statistical analysis was done using SPSS. Results: Breast conductivity of subjects were compared to the expected range according to their age. Figure1 represents the age-related electric conductivity range of the mammary gland. 84% of the subjects fell within the expected breast conductivity range (CI;5%- 95%). 9% of the subjects showed lower conductivity (<5%) and 5% of the subjects fell over the expected conductivity (>95%). Descriptive assessment of breast composition via MG and EIM is reported in table 1. After excluding missing data, MG found the breast type c (heterogeneously dense) as the most common breast composition (53%), whereas EIM reported the breast type b (scattered area of fibro-glandular density) as the most common type (81.1%). Same comparison about the reported BI-RADS in both modalities showed that both modalities report the BI-RADS score 2 (benign changes) as the most common dedicated score (MG: 60%, EIM: 50%). Using Kendal test, results represent a statistically significant (p<0.05) monotonous behaver in both modalities in breast composition recognition and determining BI-RADS score. conclusion: This study shows that EIM gives statistically significant results, correlated to MG. Electroimpedance MG evaluates the breast’s conductivity using the voltage passing through the tissue between the electrode and the scanner. The promising findings of EIM as a safe, adjunct modality should be considered in breast cancer screening programs since EIM could overcome the limitations of MG in dense breasts or the risk of ionizing radiation; furthermore, the device is cost-benefit and safe and could reduce the cost of cancer prevention and treatment across the country. https://www.icrjournal.ir/article_179462.html   Background: During the last decade, the increasing frequency of CT scans for a range of purposes, particularly pediatrics, has raised concerns regarding the population radiation exposure and subsequent chances of cancers. This study aimed to estimate the pediatrics radiation exposure from the five most common CT scans during the COVID-19 whitten three recent years in Yazd Province and to present a more tangible form of the doses by giving the risk of exposure-induced cancer death (REID) due to the performed CT scans. Methods: The risk of exposure-induced death (REID) was calculated by coupling the BEIR VII model and ICRP 103 data for the Asian population. Results. Data of patients younger than 15 years of age and adult age group were retrospectively collected from 6 educational institutions located in diverse areas of Yazd Province. Results: The median effective doses for the five most common procedures, in adult group, were as follows: 5.20 mSv for abdomen-pelvis, 3.31 mSv for routine chest, 3.00 mSv for chest HRCT, 0.76 mSv for Brain and 0.48 mSv for sinus. The highest associated risk was tied to high-resolution CT scans for women which was estimated to be 1 exposure-induced death related to 2097 scans performed on a 20-year old patient. The highest mean effective dose for younger than 15 years was estimated for the scan of abdomen-pelvis (average, 5.24 mSv) followed by chest (average, 3.66 mSv), brain (average, 1.27 mSv), and sinus (average, 0.65 mSv) scan. Moreover, the highest REID was documented for chest scan (average, 490 excess deaths in a million scans) followed by abdomen-pelvis procedure (average, 404). Conclusion: Although theeffectivedoseofCTprocedures in Yazd Province increased continuously, they were comparably lower than those reported for other countries. The radiation doses and cancer risks arising from pediatric CT scans are comparable with analogous studies, yet occurrence of high variation among patients of specific subcategorization which indicates the need for further optimization. Nevertheles, findings can represent an estimation of the hazards from CT scans for the purpose of extending the knowledge of physicians as well as those who are in charge of such procedures. Keywords: computed tomography; Cancer risk estimation; Radiation Exposure; COVID-19 FUNDING This work was supported by Shahid Sadoughi University of Medical Sciences and Health Services. (grant number: 6627 and ethical committee consent number: IR.SSU. REC.1399.067) https://www.icrjournal.ir/article_179485.html   Objective: The increasing prevalence of coronavirus has led to an increase in the use of CT scan, which is a high exposure imaging technique to follow the treatment in these patients. Therefore, this study was designed in order to estimate organ dose and effective dose to investigate the lifetime attributable risks (LARs) of cancer incidence and cancer- related mortality in patients with or suspected of covid-19. Material and Methods: A total of 600 patients with or suspected of COVID-19 participated voluntarily in this study. To estimate the cancer risk, some dosimetric parameters including dose length product(DLP), volumetric CT dose index (CTDIV), scan length, organ dose, and effective dose were used. ImPACT CT dosimetry software was also used for dose calculation i.e. organs and effective doses; and the cancer risk estimation was done based on the 2006 National Academy of Sciences Biologic Effects of Ionizing Radiation (BEIR VII) report. Results: The mean age of men and women was 41.87 ± 14.16 and 38.96 ± 13.74, respectively (40.5% males and 59.5% females). The mean of effective dose in women based on international commission radiation protection 103 (ICRP103) and ICRP60 was 2.36 ± 0.48 msv and 1.2 ± 0.28 msv, respectively. In men, this parameter was 2.31 ± 0.53 msv and 1.21 ± 0.45 msv based on ICRP103 and ICRP60, respectively. The mean of LAR, incidence, and mortality of cancer in men was 6.45 ± 2.22 and 6.25 ± 2.22, respectively, and in women, these parameters were 22.6 ± 10 and 14.32 ± 4.91 per 100000 people. Conclusion: Due to the high risk of cancer because of CT scan in people with or suspected of coronavirus, especially women due to the presence of breast tissue and thyroid sensitivity, the request of CT scan for these people should be done more carefully. Keywords: Covid-19, Effective dose, High resolution computed topography, Risk of cancer incidence, Risk of cancer mortality   https://www.icrjournal.ir/article_179486.html Purpose: In this study, a novel targeted MRI contrast agent based on polyethylene glycol (PEG) anchored on the surface of magnetite nanoparticles (Fe3O4@Au) and then decorated with Trastuzumab (TZ) was developed. Methods: The prepared system was fully characterized and relaxivity, cytotoxicity, colloidal stability, blood compatibility, in vitro cell targeting ability, cytotoxicity, and in vivo MR contrast enhancement were evaluated. Results: Cytotoxicity assay indicated that Fe3O4@Au- PEG-TZ had perfect cytocompatibility after 24 h and 48 h against both of SKBr-3 cancerous and MCF 10A normal breast cell lines. In vitro MR imaging experiments illustrated negative signal in cells affirming that the Fe3O4@Au-PEG-TZ NPs enable targeted contrast T2-weighted MR imaging of SKBr-3 as over-expressing HER-2 receptor cells. Besides, the in vivo MRI images of tumor bearing BALB/c mice indicated high tumor uptake and ability of Fe3O4@Au-PEG-TZ NPs to create negative contrast effect. Conclusion: Taken together, the developed Fe3O4@Au- PEG-TZ could be considered as an encouraging candidate for cancer diagnosis. https://www.icrjournal.ir/article_179487.html Purpose: The development of different effective multifunctional nano-probes for efficient targeted molecular imaging of tumors has presents a great challenge in medicine. Methods: Herein, we reported the in-vitro targeting of Trastuzumab (TZ) multifunctional Fe3O4 coated gold nanoparticles (Fe3O4@Au NPs) through Polyethylene glycol (PEG) linking for targeted tumor molecular computed tomography (CT) imaging method. The prepared multifunctional PEG-TZ conjugated Fe3O4@Au NPs (TZ-PEG- Fe3O4@Au NPs) were fully characterized via different procedures. MTT, hematoxylin and eosin (H&E) assays were used to evaluate the cytocompatibility of the synthesized NPs. Results: The findings showed that the synthesized TZ-PEG-Fe3O4@Au NPs, which have a size of less than 100 nm and are non-cytoxic at a specific concentration range, exhibit better X-ray attenuation intensity than iodine-based contrast agents at the same concentration. When compared to iodine at a concentration of 2000 g/ml, TZ-PEG-Fe3O4@Au NPs permit around 1.6 times more contrast per unit mass at 80 kVp. The created targeted NPs can be employed as a contrast agent for in vitro targeted CT imaging of cancer cells expressing the HER-2 receptor. At 80 kVp, the targeted cells’ CT values were higher than those of untargeted cells. https://www.icrjournal.ir/article_179488.html Purpose: Nowadays, lead shields are commonly used to protect against ionizing X-rays but based on recent studies, new composites have been introduced that are lead-free, more effective and useful for protection and dose reduction. The risk of cancer is included in the stochastic and late effects of radiation exposure. Therefore, in this study, the possibility of radiation risk with the amount of received dose from the imaging methods and how to interact to damages of these were studied. Methods: The Matrix is a Polyethylene and the filler material is a Tin metal to be used in composite shields. Certain values are prepared according to the researcher’s protocol to protect against X-rays. The risk of radiation damages was calculated in the CT scan machine and chest CT phantom along with the dosimeter embedded inside the phantom to study the received dose values. Tin-Polyethylene composite shield was used to decrease radiation risk. Results: Using the data related to the condition of the device in imaging such as kilovoltage, tube current, rotation time, collimation, type of CT scan machine and spiral pitch, equivalent and effective doses of organs such as lungs, heart, breast and the mediastinum was determined. PCXMC software was used to calculate radiation risk due to effective dose values. Conclusion: The use of Tin-polyethylene composite shield as a solution to decrease of the radiation risk and maintain the health of society was confirmed in this study. According to the principle of preferring prevention over treatment, it is recommended to use this shield especially in CT scan to reduce the risk of cancer.   https://www.icrjournal.ir/article_179490.html Introduction: Considering the increasing request for CT scan imaging due to lung and heart diseases, it is necessary to pay attention to the radiation protection of patients in CT scan. Today, lead is used as an effective protective material in imaging processes, which has a high atomic number and high attenuation coefficient. Among the disadvantages of lead protection is its toxicity and heavy weight. For this reason, researchs have been started on the production of lead-free protectives as new polymer-based materials. Therefore, in order to prevent radiation damages in CT scan, new bismuth-epoxy composite protector have been prepared in this research. Materials: Composite shields that have a polymer material as a matrix and a filler material as a reinforcement prepared according to the researcher’s protocol to protect against X-rays. In this research, bismuth metal has been used as a filler in the epoxy matrix. In order to show the difference in the conditions of using a shield and without a shield, the amount of radiation damage prevention was measured using a dosimeter. This study was used in the CT scan device and special chest CT phantom along with the dosimeter within the phantom to study the received dose values. Results: The values of radiation dose changes by calculating the mass attenuation coefficients with and without bismuth-epoxy composite protection showed the changes of dose values for preventing radiation damages. Conclusion: The reduction of dose amounts suggested the possibility of reducing the biological effects of radiation and preserving the health of the society as the practical effects of using bismuth-epoxy composite shields. According to the principle of preferring prevention over treatment, it’s recommended to use these protectors especially in CT scan. https://www.icrjournal.ir/article_179491.html   Background: Multiple sclerosis is one of the most common neurological disorders in young adults, which myelin is damaged by pathogens throughout life as high prevalance of the disease and the fact that it is the third cause of neurologic disabilities in Adults and thalamus involvement in this disease, which can cause cognitive impairment and motor disabilities and lower quality of lif. Purpose: The purpose of this study is evaluating the type of thalamus involvement, changes in volume and size, the relationship between this disease and thalamus involvement, diagnosis in the early stage of the disease, and the prognosis of symptoms and the severity of the sensory and neurological involvement Methods: In this descriptive cross-sectional study, 40patients with Multiple sclerosis were assigned consequently considering the inclusion criteria after assigning informed consent. Then, EDSS questionnaire was completed for them. Thalamus size and volume were assesed by MRI. Then, the results were analyzed by SPSS software version 24. Results: In this study, 40 subjects participated in 23 women (57.5%) and 17 men (42.5%) with a mean age of 36.3 ± 9.3. Also, 15 (37.5%) were single and Twenty-five (62.5%) were married. Bachelor’s degree and higher (32.5%) and housewives (30%), 8 (20%) were the most frequent The duration of the disease was 1.4 ± 3.5 years. In the present study, the results showed significant reverse correlation between thalamus volume and disability (P> 0.05) and thalamus size and disability (P> 0.05) and direct linear relationship Between thalamus size and thalamus volume (P> 0.05). Conclusion: Generally, it can be concluded that in patients with multiple sclerosis, decreasing the size and volume of thalamus increases the incidence of patients’ disability.     https://www.icrjournal.ir/article_179492.html   Background: Pregnancy associated breast cancer (PABC) is defined as breast cancers detected during pregnancy or in the first 12 months post- partum, or at any time during lactation. PABC is a rare but serious occurrence in young wemen. Aim: This study aims to evaluate clinic pathological and ultrasound features of patients with PABC. Materials and Methods: From September 2015 to December 2022, 32 patients with breast cancer were diagnosed that has the inclusion criteria of PABC.Our inclusion criteria was the detection of breast cancer during pregnancy or in the first year post-partum year or during lactation. The control group who had breast cancer without PABC criteria included 32 age-matched patients who had no clinical history of recent pregnancy or lactation at the time of cancer detection. The clinic pathological and ultrasound findings of PABC and non-PABC were evaluated. Findings: Most PABC cases presents with palpable mass, painful breast lump or skin edema .The analysis of ultrasound findings showed that marginal irregularity, heterogeneous internal echogenicity with cystic area and non-parallel orientation were higher in PABC group .Most cases with PABC were BI-RADS 4C or 5 in comparison with non-PABC patients . There was a significant difference in pathological grading in PABC cases comparison to non-PABC group Conclusion: Radiologists should be familiar with imaging findings of PABC the difference between imaging findings of breast lesions in PABC and non-PABC group and recommended core needle biopsy in suspected cases. https://www.icrjournal.ir/article_179493.html Introduction: Spontaneous intraparenchymal cerebral hemorrhages (SIPH) account for 10-15% of cases of acute stroke. stratication of these patients according to the risk of harboring an underlying vascular etiology would help for selecting the patients who mostly benet from multidetector CT angiography (MDCTA). The aim of this study was to Evaluate the accuracy of non-contrast brain CT (NCCT) in predicting the presence of a vascular etiology in patients with SIPH. Materials and Methods: In this retrospective study, we used NCCT criteria to predict the presence of vascular etiology in SIPH patients. Results: Of the 385 evaluated patients, 21.3% had an underlying vascular etiology. Independent predictors of the vascular etiology included age< 50 years, no history of hypertension and coagulation disorder, lobar hemorrhage, concurrent IVH or SAH, and signicant perilesional edema. We used the independent predictors of vascular etiology and NCCT classication to create a practical scoring system to predict the risk of vascular ICH (VICH). VICH score ≤4 had 76.8% Sensitivity and 90.1% Specicity for prediction of a positive MDCTA. Conclusion: The VICH score was successful in the prediction of vascular etiology in this retrospective cohort of 385 patients https://www.icrjournal.ir/article_179495.html Objectives: COVID-19 infection demonstrates characteristic findings in chest CT. The optimal timing of repeated CT scans still needs to be clarified, and the optimal time to assess imaging clearance in COVID-19 is still unknown. It is crucial to have a roadmap of the imaging course of COVID-19 pneumonia to develop guidelines for prompt diagnosis of pulmonary complications, especially fibrosis, at the earliest stage. Purpose: To assess the temporal changes of chest CT findings in patients with COVID-19 pneumonia and evaluate the rate of a complete resolution and determine the patients are at excessive risk for residual parenchymal abnormalities. Materials and Methods: This retrospective observational study included 48 patients with real-time polymerase chain reaction–confirmed COVID-19 who were admitted to three academic hospitals. These patients underwent at least one initial chest CT before or after admission and at least one follow-up CT scan four weeks or more after the onset of the symptoms. All chest CTs were categorized according to time of performance into four groups, including the first week, second week, third-fourth week, and more than 28 days. Lung involvement was categorized as predominantly alveolar (ground-glass opacity and consolidation), organizing pneumonia, and reticular patterns. The severity of involvement was also evaluated by the reader. Results: Forty-eight patients and a total of 130 chest CT scans were evaluated. The alveolar pattern showed a gradual decrease in frequency from 91% in the first week to 9% after the fourth week of the disease but the organizing pneumonia pattern gradually increased with disease progression and the frequency of reticular pattern increased significantly after third week. Complete resolution of CT findings was seen in 17 patients (13.1%) and was significantly more prevalent in patients of younger age (p value<0.001) and with lower initial CT severity scores (p value=0.048). CT severity scores in the second week were significantly higher in ICU admitted patients (p value=0.003). Conclusion: There are temporal patterns of lung abnormalities in patients with COVID-19 pneumonia. The predominant CT pattern was alveolar infiltrate in the first and second weeks of the disease, replaced with an organizing pneumonia pattern in the third and fourth weeks. Progression of lung involvement was correlated with ICU admission due to the highest CT severity score in the second and third weeks of presentation but not in the first week in patients who were admitted at ICU. Complete CT resolution was significantly more common in patients of younger age and lower initial CT severity scores.   https://www.icrjournal.ir/article_179496.html     Introduction: Despite the studies performed to characterize the clot’s features in the acute phase in non-contrast computed tomography (NCCT), no study has been conducted to evaluate the non-acute phase and the threshold density that warrants further evaluation. Herein, we assessed the temporal changes of sinus density in patients with acute CVST. Methods: In this cross-sectional study, we searched our Picture Archiving and Communicating System (PACS) of our hospital between January 2015 and September 2021. Inclusion criteria were patients older than 18-year- old with acute CVST, with available Contrast- enhanced Magnetic Resonance Venography (CE-MRV) as the gold standard for conrming the presence and location of thrombosis. The readers were asked to assess the images regarding any subjective abnormal hyper- or hypo-attenuation within the venous sinus structures. Changes in the Hounseld Unit (HU) of each venous segment during the time- course of the disease and the HU difference of affected sinus with other sinus segments were evaluated. Results: Out of 89 CT scan evaluations, 21 cases (23.6%) were performed in the acute, 38 (42.7%) presented in the subacute, and 30 (33.7%) presented in the chronic stage. In all involved venous sinuses, the mean blood density of various phases was a statistically signicant difference. The agreement of the two radiologists to report the hypodense sinus sign was reported to be 0.7.(p-value <0.001). Conclusions: The results of our study suggest that quantitative measurement and qualitative ndings of the hypodense sinus sign help to diagnose non-acute CVST better. https://www.icrjournal.ir/article_179497.html   Background: The term “hemangioma” has been incorrectly applied to a wide variety of vascular lesions. Hemangiomas are true vascular neoplasms with evidence of increased endothelial cell turnover. This case had a variety of anatomical positions meaning that every interventionist and orthopedic had a problem in treating. Case presentation: a 29-year-old man with an eight years history of a round red lesion on his buttock that progressed and become a huge mass so the orthopedic surgeon could not excise the lesion the first time. Conclusion: in this case, we had some problems with anatomy and when we occluded the main artery by CT guided interventions, a small particle detached from the artery and made the pulmonary emboli. After this intervention, the mass lesion had been excised successfully. Keywords: Hemangioma, Intramuscular, intervention   https://www.icrjournal.ir/article_179498.html Isolated fallopian tube torsion without involving ovary is a very rare condition in the pediatric population. The incidence of IFFT is approximately one in 1.5 million females. Several intrinsic or extrinsic predisposing factors have been identified in adults. However, in sexually inactive girls or adolescents, a possible factor is preexisting congenital malformations. Torsion of the right tube is much more common than left, which could be related to protective effect of sigmoid colon and mesentery, or to more frequent imaging evaluations of right pelvis pain to investigate possible appendicitis. Accompanying symptoms are very nonspecific, such as nausea, vomiting and with appendicitis-like symptoms. Because of its rarity and non-specific symptoms, it is usually misdiagnosed initially, with the expense of loss of fertility. This condition is hard to diagnose with standard imaging tests, and surgical examination is needed to make a final diagnosis. Treatment of IFTT ranges from a wait-and-see approach to total salpingectomy and early diagnosis is essential for conservative management. So it should be considered as a differential diagnosis in pediatric pelvic abdominal pain, especially if ultrasound study reveals a pelvic tubular structure without involvement of the ovary. Here, we report a very rare case of IFTT associated with hematosalpinx in a thirteen years old girl, who presented with acute abdominal pain. Gray scale, color doppler ultrasound and MRI with contrast were performed and revealed the diagnosis. Previous literature of IFTT in reproductive and pediatric age groups are reviewed and the imaging features of this patient are discussed.   https://www.icrjournal.ir/article_179500.html Diagnosing simple liver cysts seems very easy. It may be more like a myth that you consider a cyst as a simple cyst and try to drain it, but the cyst comes out after draining the hydatid. The patient is a 24-year-old soldier who was diagnosed with a simple liver cyst and was admitted to the hospital for cyst drainage under ultrasound guidance https://www.icrjournal.ir/article_179501.html Spinal dysraphism is the second most common congenital abnormality and ultrasound provides an excellent means for imaging the spine up to three to six months of age. Fusion of the bony portion of posterior elements is complete by one year of age, but since this fusion progresses from caudal to cranial, the thecal sac can be obscured by fused dorsal elements in the lumbar region as early as three months. Indications for pediatrics spines ultrasound include, those with cutaneous markers that place them at risk for dysraphism and if the cutaneous dimple is more than 2.5 cm from the anus and larger than 5 mm, it is considered at risk and those with syndromes that are associated with an increased incidence of dysraphism, including vertebral defects, cardiac anomalies, anal atresia, tracheoesophageal fistula, renal anomalies, and limb dysplasia associations The spinal cord is predominantly hypoechoic, with a “central echo complex” that is echogenic. The spinal cord is normally widest in the cervical and the lumbar spine, where large exiting nerve roots are present. Tethered Cord is a pathologic fixation of the spinal cord in an abnormal caudal location so that the cord suffers mechanical stretching, distortion and ischemia with growth and development.it is considered when, conus medullaris below L3 in a neonate and below L2/3 in older patients. Tethering may result in decreased pulsatility of the cord. Tight filum terminale syndrome is considered when it is thickened to more than 2 mm (by fibrous or lipomatous tissue) and may occur in the absence of tethering of the cord, in which case the filum is thickened but the conus is at the normal level Spinal dysraphism is a broad term given to groups of anomalies, where there are malformation in dorsum of embryo. Its types include spina bifida aperta: Dysraphism associated with a “dorsal mass that is not covered with skin” and spina bifida cystica: dorsal mass covered with skin and occult dysraphism (spina bifida occulta): dysraphism is present but there is no associated mass. meningocele is a herniation of meninges alone, without spinal cord or nerve root, into defect in spinal canal Diastematomyelia is a longitudinal split of the spinal cord and at the point of division, there may be an osseous, fibrous or cartilaginous dividing septum. hydromyelia is a fluid accumulation/ dilatation within the central canal, therefore, lined by ependyma, and syringomyelia: cavitary lesion within cord parenchyma, of any cause (there are many); located adjacent to the central canal, therefore not lined by ependymal and syringohydromyelia: a term used for either of the above, since the two may overlap and cannot be discriminated on imaging, also known as hydrosyringomyelia! keywords: ultrasound, dysraphism, Diastematomyelia, syringohydromyelia https://www.icrjournal.ir/article_179553.html Thanatophoric dysplasia type 1 (TD1) is a lethal form of osteochondral dysplasia due to mutation of FGFR3 gene. In addition to severe shortening of the limbs there is temporo- occipital lobe dysplasia along with a range of other CNS anomalies. In this report we describe the radiological and anatomical features in a fetus.We have also summarized the key distinguishing features of TD1 from other common types of osteochondral dysplasia. An accurate diagnosis is important for genetic counseling and impact on future pregnancies https://www.icrjournal.ir/article_179554.html Imaging nowadays extends beyond its traditional role of excluding neurosurgical lesions. An MR-study of a patient suspected of having dementia must be assessed in a standardized way; First of all, treatable diseases like subdural hematomas, tumors and hydrocephalus need to be excluded and Next we should look for signs of specific dementias which includes Alzheimer’s disease (AD): medial temporal lobe atrophy (MTA) and parietal atrophy and Alzheimer’s disease (FTLD): (asymmetric) frontal lobe atrophy and atrophy of the temporal pole and Vascular Dementia (VaD): global atrophy, diffuse white matter lesions, lacunes and ‘strategic infarcts’ (infarcts in regions that are involved in cognitive function) and Dementia with Lewy bodies (DLB): in contrast to other forms of dementia usually no specific abnormalities! Standardized assessment of the MR findings in a patient suspected of having a cognitive disorder includes: GCA-scale for Global Cortical Atrophy ,MTA-scale for Medial Temporal lobe Atrophy ,Koedam score for parietal atrophy, Fazekas scale for WM lesions and looking for strategic infarcts. GCA-scale is used for Global Cortical Atrophy assessment and is mean score for cortical atrophy throughout the complete cerebrum MTA-scale is used for Medial Temporal lobe Atrophy and should be rated on coronal T1-weighted images and Select a slice through the corpus of the hippocampus, at the level of the anterior pons. Fazekas scale provides an overall impression of the presence of WMH in the entire brain and best scored on transverse FLAIR or T2- weighted images. Strategic infarctions are infarctions in areas that are crucial for normal cognitive functioning of the brain Koedam score is used for Parietal lobe Atrophy and In addition to medial temporal lobe atrophy, parietal lobe atrophy also has a positive predictive value in the diagnosis of AD. keywords: dementia, MRI, Alzheimer’s disease,   Vascular                  Dementia, Strategic infarctions https://www.icrjournal.ir/article_179555.html Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) can cause various mild to severe neurologic symptoms, leading to significant morbidity and mortality. We hereby present a fatal case of a 50-year-old male health care provider, admitted due to altered mental status due to encephalopathy, cerebral edema, and fulminant cerebral vasoconstriction caused by SARS-Cov-2. Our case highlights the importance of considering SARS-Cov-2 infection in the differential diagnosis for patients with unexplained central nervous system dysfunction and cerebral edema to prevent delayed diagnosis and render rapid treatment. https://www.icrjournal.ir/article_179556.html Purpose: Pediatric congenital anomalies of spine are often encountered in pediatric centers and it is necessary for a radiologist to be familiar with these anomalies to make a correct diagnosis .it should be remembered that two or more anomalies can occur at the same time . In this article we review basic embryology of spine followed by case review of spinal anomalies Discussion: For make a definite diagnosis the radiologist must be familiar with embryology of spine and radiologic features of spinal anomalies and be aware that some anomalies can occur at the same time https://www.icrjournal.ir/article_179558.html   Aim/Introduction: The purpose of this study is to investigate the effect of Bayesian penalized likelihood (BPL) image reconstruction algorithms with different noise-controlling factor (β-values) on the FDG PET quantitative volumetric and heterogeneity features of metabolic volume (MTV) and total glycolysis (TLG). Materials and Methods: The standard National Electrical Manufacturers Association (NEMA) image quality phantom that consisted of six spheres (inner diameters of 37, 28, 22, 17, 13, and 10 mm) filed with 18F-FDG solution were used for this study. The phantom was prepared with a lesion-to-background ratio (LBR) of 4:1. All images were reconstructed using OSEM+ resolution recovery and BPL using β-values of 100, 200, 300, 400, 500. The metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured for all spheres. The relative percent error (ΔMTV and ΔTLG) with respect to true values, mean difference, standard deviation, and inter-reconstruction variabilities were quantified and evaluated. Results: The mean ΔMTV showed statistically significantchangesbetweenBPLreconstruction method in different β-values and OSEM, at LBR4 were (-1.83%, -13.80%, -0.60%, -0.34% and 0.03%) statistically significant. There was also a significant difference in the, mean ΔTLG between BPL reconstruction methods and OSEM (-4.15, -2.67, -2.21, -1.81 and 1.51, respectively) was observed (p < 0.05). Conclusion: In this study, we indicated that both volumetric and heterogeneity features of ΔMTV and ΔTLG are sensitive to reconstruction algorithms. The BPL algorithm with different noise controlling factors (β value) provided different MTV and TLG values. We showed that significant differences of MTV and TLG can be obtained in low-level Beta values. https://www.icrjournal.ir/article_179559.html Purpose: CT-scan and MRI are both best of radiologic modalities with different advantages and disadvantages. In this study we aimed to evaluate and compare the features of COVID-19 pneumonia in these two modalities. Methods: Fifty three suspected COVID-19 patients who presented to our emergency ward underwent chest CT and, once various features of COVID-19 pneumonia were identified, a dedicated multi-sequence chest MRI was performed on the same day with an institutional protocol. Demographic data and the morphology, laterality and location of the lesions were recorded for each case. Results: Thirty seven males and sixteen females with the mean age of 47.49 ± 13.86 years old were present in this case series. Fifty one cases had typical CT features with ground glass opacities and consolidations, readily visible on different MRI sequences. Thirteen cases had atelectasis which were also easily seen on MRI. The comprehensive review of MRI features for each case and representative images have been illustrated. Conclusion: We can suggest MRI as an alternative choice of CT-scan for diagnosis COVID-19 pneumonia according to the revealed results, it can be a logical choice in the suspected cases. https://www.icrjournal.ir/article_179560.html Hepatoblastoma is the most common primary hepaticmalignancy in children but pedunculated hepatoblastoma is an extremely rare entity. Accurate diagnosis can be challenging due to its extrahepatic location and possibly its thin peduncle, which is not easily identified in imaging . Here, we report a case of asymptomatic giant palpable pedunculated hepatoblastoma in the LUQ of a four month old male infant, initially suspected of neuroblastoma based on abdominal ultrasound findings. the final diagnosis of giant pedunculated hepatoblastoma was made based on the abdominal CT scan and diagnosis was confirmed by percutaneous biopsy. Due to the size of the tumor, complete removal of the tumor was not initially possible. therefore, the patient was treated with several courses of chemotherapy . The tumor was shrunk and then cimpletely removed. The patient was treated and no complications were found in the 6 month follow up. The pedunculated hepatoblastoma is very rare but should be considered as a possibility in the case of a perihepatic mass in a pediatric patient . https://www.icrjournal.ir/article_179562.html Granulomatosis with polyangiitis (GPA) is chronic granulomatous necrotizing C-ANCA positive systemic vasculitis, most frequently in adults and typically involves the respiratory system and the kidneys. Few cases in children have been reported yet and CNS manifestations are also rare. Here we discuss a case of Granulomatosis with polyangiitis (Wegner) in a 12-year-old female who presented with a cough, dyspnea, fever, and high blood pressure. Pulmonary involvement showed cavitary lesions and nodules.  Lab data showed increased serum creatinine and macroscopic hematuria. patient’s C-ANCA was positive. Considering such findings renal biopsy was considered and confirmed the diagnosis of GPA. During her hospitalization, due to headache & loss of consciousness brain MR imaging was done. Evidence of Small vessel vasculitis with confluent T2 hyper signal intensity of gray- white matter junction of both parietooccipital and frontal lobes containing hemorrhagic component suggestive of Posterior reversible encephalopathy syndrome (PRES) was seen https://www.icrjournal.ir/article_179564.html Pelvic neurofibromas are benign and uncommon retroperitoneal masses. They arise from Schwann cells. One of the morphologic types of this benign tumor is solitary and sporadic and not associated with neurofibromatosis type Here we discuss a case of pelvic neurofibroma in a 20-year-old male who presented with chronic pelvic pain. He had no positive family history of genetic disorders and, on physical exam, just partly firm mass without mobility in the hypogastric region was detected. Ultrasound and Computed tomography scan showed pelvic retroperitoneal mass superior to the urinary bladder with extended of the rectovesical pouch and invasion to the posterior wall and dome of the bladder. The patient underwent laparotomy revealing an infiltrative retroperitoneal mass with the invasion of the bladder’s posterior wall, dome, and trigone. Histopathological findings show neurofibroma. https://www.icrjournal.ir/article_179566.html   Background and objective: Based on the role of radiology and radiotherapy staff in radiation optimization, this study aimed to review the level of radiation awareness of Radiation Science students as a future diagnosis and treatment team. Methods: Articles were searched in PubMed, Science direct, Embase, Cochran and Scopus databases using the keywords knowledge AND radiation AND students, awareness AND radiation AND students. The authors reviewed the abstract and full text of the articles and the relevant studies were selected for systematic review. Results: In the studies of radiation students, 69.82% were radiology technology, 30.18% were radiation therapy, the results of the reviewed studies showed that among radiation science students, the level of awareness of radiation was 61.21% on average. The higher level of knowledge was related to the radiology (65.46%) and the lower is related to the field of radiation therapy (51.3%). Conclusion: The results of the research conducted in this study showed that the level of awareness regarding radiation and its effects among students studying in radiation sciences is moderate. Keywords: Radiation, Awareness, Students https://www.icrjournal.ir/article_179569.html Newborn babies who are admitted to the intensive care unit for various disease can be diagnosed and treated under a large number of X-ray imaging The most important complication and risk of receiving too much X-rays is the increased probability of developing malignancies and cancers. Conventional radiology due to, low ratio of absorbed radiation dose per graph and also a low price is one of the most important diagnostic modality in the special care unites This study was conducted during 6 months in Ali Ibn Abi Talib Hospital in Zahedan in 2022 and 2023 in this study we are going to evaluate the amount of cumulative dose received by infants in the intensive care unit of Ali Ibn Abi Talib Hospital in Zahedan. https://www.icrjournal.ir/article_179570.html Purpose: This study investigated the correlation between Iron overload (IOL) in liver and heart as measured by Magnetic Resonance Imaging (MRI) T2* relaxation time technique and serum ferritin levels in beta thalassemia major patients in Sistan and Baluchistan province as the population of Beta thalassemia major patients is higher in this province compared to rest of Iran. Methods: This cross-sectional study was conducted at Ali Ibn Abi Taleb hospital in Zahedan, The MRI T2* data of liver and heart and ferritin serum levels were collected from 115 beta thalassemia major patients’ history. Results: There was a moderate correlation between the MRI T2* and serum ferritin levels, indicating that MRI T2* could be used to effectively monitor iron status in beta thalassemia major patients. Conclusion: The results of this study suggest that MRI T2* technique could be a valuable, non- invasive tool for monitoring iron status in the beta thalassemia major patients. https://www.icrjournal.ir/article_179571.html Background: Humans are always exposed to natural radiation. Elsewhere in the world, there are areas with high background radiation whose annual dose exceeds the standard maximum radiation dose of a resident. Radiation- related cancers are more common in the thyroid, bone, and skin systems. Since the average annual effective dose in Hamadan province exceeds the world standard. The aim of this study is to evaluate the incidence of malignancy and its relation with background radiation in Hamadan province. Material and Methods: The present study is a retrospective cross- sectional study, the records of all cancer patients related to residents of Hamadan province were provided by the Health Department during the years 2018 to 2022, and after final approval from it, the identifications like age, location, Occupation, and type of tumor were written and recorded. Results: The Spearman’s rho for all malignancies studied is not close to 1. On the other hand, the P-Value also shows a value greater than 0.05 in all cases. This relationship is not statistically significant because the high dose rate in Hamadan province does not increase any malignancies. And the radiation parameter in this case does not have a negative impact. Conclusion: The background radiation of Hamadan province is slightly higher than the world standard value, which has no effect on the incidence of malignancy, and the background dose values close to the world standard value may prevent malignancy. Keywords:       Background      Radiation, Malignancy, Radiation   https://www.icrjournal.ir/article_179572.html Purpose: Determining the relationship between spleen elastography score and spleen size with age, sex, BMI and family history of spleen disorders in healthy people. Methods: This study was conducted on 54 number of hospital staff and students of the faculty and affiliated hospitals of Islamic Azad University of Mashhad during 1400-1401, who had no history of chronic liver disease, portal hypertension and hematological disorders. Spleen shear wave-based elastography was calculated by taking the average of three valid measurements in kilopascals. Results: The results of this research show that the average score of spleen elastography in healthy people is 18.12±3.01 kilopascals, and it has no statistically significant relationship with spleen size, gender, age, and body mass index (p-value>0.05). Also, the results showed that the average size of the spleen in healthy people is 94.54 ± 13.29 mm and it has a statistically significant relationship with gender and body mass index (p-value<0.05). The average size of the spleen is greater in men than in women, and with the increase in body mass index, the size of the spleen increases. According to the correlation analysis, there is an inverse linear relationship between age and spleen size, and with increasing age, the size of the spleen decreases. Conclusion: The results of this study can be a reference point in the evaluation of spleen stiffness, especially in patients with liver disease. https://www.icrjournal.ir/article_179573.html Purpose: Densitometry is the first step in diagnosing osteoporosis. In this article, an attempt is made to review how to analyze and report Dual X-ray Absorptiometry (DXA) based on ISCD guidelines, for the hip and lumbar spine. Method: It is necessary to check the name, age, gender, and height of the patient first. Bone Mineral density (BMD) values are based on the mentioned variables which are compared with the BMD of 25 to 30-year-old young women to produce T-score. The specifications and version of the device should be mentioned since it is used in comparative In lumbar and hip DXA, the patient`s position, how to control area, BMD, and choice of suitable N., hip, and vertebrae analysis should be explained. Result: In the diagnosis section, one of the following statements should be used: - In postmenopausal women and men over 50 years old: Normal if T-score ≥ -1 Low bone mass if -2.5< T-score < -1 Osteoporosis if T-score ≤ -2.5 Severe or established osteoporosis if T-score ≤-2.5 with fragility fracture. - In premenopausal women and men younger than 50 years old: Within the expected range for age if Z-score > -2.0 Below the expected range for age if Z-score < -2.0 Z-score ≤ -2.0 must be evaluated for secondary causes. Conclusion: In conclusion, patients are divided into low- risk and high-risk. The patients with T-score ≤ -2.5, femoral fracture risk of more than 3 percent or major fracture risk of more than 20 percent, and the patients with fragility fracture should be treated. Patients with Z-score ≤ -2.5 should be also evaluated for secondary causes of bone loss. Other complementary studies done by DXA machine, like B.S, hip geometry, VFA, forearm lateral lumbar or distal femoral DXA, whole body, and body composition, should be mentioned. https://www.icrjournal.ir/article_179574.html   Background: Endometriosis is one of the most common diseases in women whose timely and accurate diagnosis can be helpful in controlling, treating and preventing recurrence. Due to the invasiveness of the laparoscopic procedure, it is necessary to consider non-invasive procedures more and more. Purpose: We aimed to investigate the correlation between diagnostic values of MRI with Laparoscopy as a gold standard for endometriosis diagnosis. Methods: A descriptive Analytic study was done on 58 women referred to private gynecology clinic who were candidate for diagnostic laparoscopy with endometriosis suspected. All woman underwent MRI imaging and laparoscopy; all images were examined by radiologist. The finding was analyzed in SPSS.V20. P value < 0/05 was considered to be significant. Results: According to this study, the frequency of endometriosis in women was 45 (77.6%) based on MRI, while the frequency of endometriosis was 48 (82.8%) based on diagnostic laparoscopy. The sensitivity of MRI to detect endometriosis was 79.17% and its specificity was 30.00%. (P = 0/527). Conclusion: According to this study MRI may be able to detect small endometrial lesions that cannot be diagnosed by laparoscopy. Keywords: Magnetic resonance imaging, Laparoscopy, Endometriosis, Diagnostic Value.   https://www.icrjournal.ir/article_179575.html Background: Ultrasound techniques during pregnancy play a very important role in evaluating fetal growth, diagnosis of retardation, intrauterine growth, determining the termination of pregnancy, determining the time of invasive diagnostic tests, amniocentesis. The cerebellum can be seen at 12 weeks of gestation and is the largest posterior part of the brain. The cerebellum cross section can be a predictive factor in determining the age of the embryo’s ultrasound pregnancy. Purpose: The aim of this study is to investigate association of measurement of the fetal transverse cerebellar diameter with gestational age. Methods: This cross-sectional study was performed on pregnant women with gestational age of 40-40 weeks. Individuals were evaluated based on gestational age in three periods (14- 20, 11-21, 30-40 weeks). Patients underwent ultrasound and then the cross section of the cerebellum in the posterior cavity was measured with butterfly properties in millimeters. The gestational age was obtained by ultrasound with a calculated value of LMP or ultrasonography before 20 weeks, and the pregnancy gestational neomagram chart was based on TCD. Data were analyzed using IBM SPSS 22.0 software. A significant level of 5% was considered significant. Results: The mean age of the mothers was 26.15 ± 0.64 years and the mean gestational age was 24.81 ± 0.60 weeks and the mean cross- sectional dimension of the cerebellum was 23.86 ± 0.54 mm. As the Pregnancy age increased, in mothers with different gestational age, body mass indexes, size of cross section of the cerebellum have increased significantly. There is also a significant relationship between the size of fetal femur length, fetal abdominal circumference, the approximate weight of the fetus and the diameter of the embryo with the gestational age. (P <0.05). Conclusion: Measuring cross section of the embryo’s cerebellum in the estimation of gestational age in the second and third trimester has a diagnostic accuracy that is approximately equivalent to measuring the fetal length of the embryo and the circumference of the abdomen and the diameter of the embryo Keywords: Cross sectional cerebellum, gestational age, Ultrasonography.   https://www.icrjournal.ir/article_179576.html   Purpose: Sternocleidomastoid muscles are one of the most important neck muscles, which play an important role in the position of the neck. Head and neck Radiotherapy is the cause of severe Sternocleidomastoid muscle contractions. The aim of this study is to present a non-invasive method based on the extraction of muscle biomechanical parameters resulting from high-frequency ultrasound images to extract muscle dose response. Methods: Sequential ultrasound images were recorded with a 14 MHz frequency imaging system. The muscle’s mechanical parameters were extracted by the motion estimation algorithm (block-matching). Reproducibility and validation of the method were done manually. Correlation between two automatic and manual methods was done with Pearson correlation analysis. The block-matching algorithm was used to estimate the muscle wall’s longitudinal movement. In this method, two blocks with specific dimensions were selected as reference blocks in the first frame. The way it works is to find the blocks in the next frames that have the most compliance with the reference blocks. The longitudinal displacement vector is the result of the difference between the two blocks in different frames. By using this algorithm, one patient with tongue cancer was examined once before the start of radiotherapy and again at the end. Results: A significant correlation between automatic and manual methods was obtained with a correlation coefficient of more than 0.79. Muscle’s shear modulus increased significantly at the end of radiotherapy which indicated an increase in muscle stiffness during the 60 Gy absorbed dose (p<0.05). Conclusion: In this study, a non-invasive method based on the extraction of muscle biomechanical parameters with processing of high-frequency ultrasound images to follow up radiation damage is concluded. The block matching algorithm is reliable for distinguishing the elasticity of Sternocleidomastoid muscle before and at the end of radiotherapy. https://www.icrjournal.ir/article_179577.html   Introduction: Despite the growing number of studies on lncRNAs, particularly in cancer biology, there is a lack of information about their specific roles. In this study, we evaluated the expression levels of LNCs after exposure to X-ray radiation and found that ANRIL was overexpressed in response to 8Gy radiation. Apoptosis, cell cycle and DNA repair-related LNCs may be promising avenues for further exploration of the effects of low-dose radiation and the cell sensitivity it may represent. https://www.icrjournal.ir/article_179578.html Diffusion Tensor Imaging (DTI) as a new imaging technique has been highly welcomed in clinical and research environments. A technique whose main purpose is imaging based on the Brownian motion of water. The two main advantages of this imaging method are examination in two scales, microscopic and macroscopic. Both the information is measured in the microscopic dimension and the information is examined in the macroscopic way such as rotation of white matter fibers. The help of this lecture is to introduce the basis of fiber routing and various methods of reconstruction and analysis of DTI images. Learning Objects: Introduction of Basic Tracking Data Pre Processing DTI Analysis Methods Region of Interest Analysis Voxel-Based Analysis Fiber Tracking and Connectivity Analysis https://www.icrjournal.ir/article_179579.html The continuing advances in computed tomographic (CT) technology in the past decades have provided ongoing opportunities to improve CT image quality and clinical practice and discover new clinical CT imaging applications. New CT technology, however, has introduced new challenges in clinical radiology practice. One of the challenges is with intravenous contrast medium administration and scan timing. In this article, contrast medium pharmacokinetics and patient, contrast medium, and CT scanning factors associated with contrast enhancement and scan timing are presented and discussed clinical considerations risks associated with contrast agents have not been eliminated, and adverse reactions of varying degree continue to occur. Consequently, it is imperative for anybody administering contrast agents to be intimately familiar with the characteristics indications, and potential side effects of these agents. They must be able to recognize adverse reactions promptly and treat them effectively and rapidly. contrast medium pharmacokinetics factors includes , osmolality and Viscosity and contrast medium factors includes rate ,concentration and volume. Patient factors are sex, age, weight and cardiac output . Risks associated with contrast agents form a simple rash to skin eruptions and form mild breathing difficulties to respiratory distress and cessation of vital signs. Keywords: CT scan ,Contrast medium ,side effect, osmolality ,cardiac output MRI Accreditation Program ACR_MRI_IMAGE_QUALITY_GUIDE https://www.icrjournal.ir/article_179580.html The American College of Radiology is the principal organization of radiologists, radiation oncologists, and clinical medical Physicists. The American College of Radiology will periodically define new practice parameters and technical standards for radiologic practice to help advance the science of radiology and to improve the quality of service to patients. Existing practice parameters and technical standards will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. ACR Practice Parameters and Technical Standards promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. The goal is to narrow the variability among radiology practices and provide guidance to achieve quality in radiology. ACR ACCREDITATION: The Gold Standard in Medical Imaging ACR Accreditation is a valuable tool for maintaining excellence in everything from operations to patient care. ACR Accreditation helps assure your patients that you provide the highest level of image quality and safety by documenting that your facility meets requirements for equipment, medical personnel and quality assurance. Goals of the ACR MRI Accreditation Program are to set quality standards for “best practice” and to help continuously improve the quality of patient care. Primary components of the ACR program are the evaluation of: Qualifications of all personnel (Physicians, Physicists and Technologists) Equipment performance Effectiveness of quality control measures Quality of clinical images This article is the introduction of ACR MRI IMAGE QUALITY GUIDE. https://www.icrjournal.ir/article_179593.html In modern life, human is under constant exposure to low dose natural or manmade sources of non-ionizing radiations (microwaves, radiowaves, mobile, etc.) and ionizing radiation used for medical or industrial purposes. Ionizing radiation (IR) is known as potent inducer of DNA damages through direct or indirect effcts on DNA molecule. Indirect effect of IR leads to water radiolysis and formation of free radicals and reactive oxygen species (ROS). ROS are a group of highly reactive molecules implicated in the oxidative damage of biological structures. There are accumulating evidences indicating that cell transformation is associated with genome instability leading to an imbalance between the mechanisms of cell-cycle control and mutation rates within the genes. Genome instability can be defined as an enhanced tendency for the genome to acquire mutations; ranging from changes to the nucleotide sequence to chromosomal gain, rearrangements or loss. ROS which gives rise to various types of DNA lesions, including single- strand breaks and double-strand breaks (DSBs), and various types of base damage as well as DNA-DNA and DNA-protein cross links. Radiation induced DSBs represent the most lethal types of DNA damage, leading to cell death, if unrepaired. However, DNA damage response mechanisms may lead to two distinct outcomes: survival and the maintenance of genomic stability. The formation of ROS produces not only DNA strand breakages, but also might act as a signaling event leading to the release of cytokines or epigenetic changes, or trigger DNA repair machinery. All primary lesions induced in the DNA are subjected to cellular repair processes; however, the unrepaired or mis-repaired lesions may give rise to gene mutations and chromosomal aberrations (CA). Although DSBs are considered as serious DNA damage, they may be repaired very effectively by either one of the two different repair mechanisms namely, homologous recombinational repair (HRR) and non-homologous end joining (NHEJ). HRR is able to restore the original sequence of DNA DSB leading to a lower risk of generation of deletions and insertions at the site of DSB. NHEJ is subject to a high risk of generation of de novo mutations at the sites of DSBs. Thus, susceptibility to mutagenesis is a direct consequence of the NHEJ system joining DNA free ends. The biological importance of genomic instability and DNA repair mechanisms in cancer development are particularly well illustrated by several heritable genetic disorders known as chromosome breakage or chromosomal instability syndromes. These chromosome breakage syndromes are characterized by various defects in DNA repair, predisposition to various forms of malignancies and increased radiosensitivity. Therefore, the consequences of genome instability might be various types of ill health such as cancer, infertility and other diseases. Moreover, upon induction of genome instability following low dose IR, other cellular responses such as inherent radiosensitivity, radio-adaptation and bystander effects might be activated which might alter cellular response to radiation. Various molecular mechanisms of genomic instability and their relevance to carcinogenesis, infertility and genetic diseases will be discussed. Keywords: Low dose ionizing radiation, Genome instability, Cancer, Genetic effects, infertility. https://www.icrjournal.ir/article_179594.html Quality assurance is the overall process which is supported by quality control activities. QA program will guarantee the whole dimensions of quality in a sophisticated process such as medical Imaging. Medical radiography needs to a comprehensive QA program to ensure medical imaging experts that final diagnosis has good accuracy and precision as well as acceptable radiation dose to patients, staff and society. This article tries to consider various aspects of quality assurance in medical radiography departments. https://www.icrjournal.ir/article_179595.html Multiple Sclerosis (MS) is a chronic autoimmune disease where the immune system wrongly attacks the central nervous and is characterized pathologically by demyelination and clinically by visual, sensory, and motor problems. This immune-mediated disease is one of the most common causes of neurological disability in young adults worldwide and currently is increasing in prevalence and incidence globally. Early and accurate diagnosis is of the utmost importance. Blood test, Spinal tap using lumbar puncture, Neurological exam and Magnetic Resonance imaging are the 4 common diagnostic tools for MS provident. MRI techniques are able to reveal a range of pathological substrates of MS lesions that include edema, inflammation, demyelination, and axonal loss. As well as being a diagnostic tool, serial MRI scanning can be useful as an objective measure to monitor lesion activity, lesion load, and response to treatment with disease modify. The problem of identifying lesions in the periventricular region, which is a common site for MS lesions, can also be addressed by suppressing the signal from CSF yet maintaining heavy T2 weighting using a fluid attenuated inversion recovery (FLAIR) sequence. This sequence is also superior at detecting cortical/juxtacortical lesions. A host of MRI techniques, which are able to monitor disease evolution, have been introduced for the assessment of MS. T1-W, T2- WI, PD-W, Fluid-attenuated inversion recovery (FLAIR), Magnetization Transfer Imaging (MTI), Susceptibility weighted imaging (SWI), Double inversion recovery (DIR), Diffusion-weighted imaging (DWI), Proton MR spectroscopy (MRS), Perfusion MRI, and ultra-high-field MRI are emerging as promising tools for improving our understanding of the pathophysiology of MS. https://www.icrjournal.ir/article_179596.html   Review on workshop Innovation in Magnetic Resonance Imaging (MRI) has been an area of increased focus in the medical industry over the past decade, with new technologies and visualization advancements emerging at a rapid pace. Artificial Intelligence (AI) and advancement in imaging technologies have been crucial to developing more accurate results, thereby improving diagnosis and patient treatment options. Besides, recent advances in MR hardware including low Field scanners, flexible radiofrequency coils, helium-free magnets, and also accessories including wireless patient monitoring, revolutionized MRI performances and workflow. In addition, the techniques of MRI have experienced rapid development and found wide applications in recent years. The technical development is marked by the improvement and optimization of conventional MR imaging techniques and the emergence of new pulse sequences with a wide range of clinical applications such as CEST-MRI (Chemical Exchange Saturation Transfer MRI) in neuroimaging. As MR new pulse sequences have matured technically primarily for neuro applications, it has also proven to be increasingly valuable for body imaging such as free-breathing techniques for abdominal imaging and pulse sequences for volumetric liver fat detection. In this workshop, we present (1)the most recent advances in AI applications including AI-base reduction of the amount of contrast media needed for contrast- enhanced MRI and AI-powered reconstruction techniques for increasing image quality. (2) we discuss the Blue Sealed magnets for addressing helium scarcity, super flex coils for improved accessibility and performance in a wide range of anatomic postures, and also MR-compatible wireless patient monitoring to allow greater flexibility for MR technicians and performance that is competitive with bedside monitoring. (3) we review the latest pulse sequences including CEST MRI for molecular imaging, synthetic MRI for generating contrast- weighted images based on measurement of tissue properties in a single acquisition, Zero TE imaging for permitting visualization of short-T2 tissues such as cortical bone, fat- quantification techniques for quantifying of fatty accumulation in the liver and also free- breathing MRI for challenging patients who may be unable to hold their breath for an extended period of time or who have irregular respiratory rates. Finally, we present our reflections on possible future developments and current availability in clinical settings. https://www.icrjournal.ir/article_179598.html MRI equipment has unique capabilities, such as human soft tissue and anatomical imaging, optimal resolution, and physiological and even functional imaging. But these desirable features must be fully assured in terms of the accuracy of the results, so the quality control of MRI equipment can be considered as a suitable solution, which is the same in practice. The help of this lecture is to provide basic information about the quality control process of MRI equipment and the goals of each of these processes. Learning objectives: Presentation of suitable quality control guidelines Presentation of quality control standard phantoms  Presentation of various quality control tests, including Magnetic Field Homogeneity (MFH) Magnetic Field Drift (MFD) Signal to Noise Ratio (SNR) Slice Thickness Geometric Distortion High Contrast Spatial Resolution Low Contrast Object Detectability Percent Signal Ghosting Ratio (PSG) Percent Image Uniformity (PIU) https://www.icrjournal.ir/article_179599.html Valve replacement by TAVI method Involved in: Heart valve disease Causes of these disease CT angiography techniques for accurate measurement of aortic valve and vessels and its branches Measurement method and parameters and required areas for measurement https://www.icrjournal.ir/article_179600.html There are several technical and physical points in regards with MRI diagnostic scanning of patients suffering from neurospine disease . it goes without saying that without taking these technical and physical points into consideration , the diagnostic procedure of the disease shall be distorted or even shall lead to fail the exposure of the disease or the defect in the worst case. Besides the adequate knowledge of the physical parameters of the scanning sequence, the appropriate application of it shall also result in the ideal protocol optimization at the end. Therefore to have even a minute knowledge about pathologies alteration or application of individual protocol is deemed necessary and inevitable. Hence through the following list the tips and tricks are designated to obtain the suitable answers to the similar related questions: Are the scanning parameters different between elderly and youngers patients? In case of positive reply which parameters should go under alteration? For better enhancement exposure resulted from contrast media injection, which parameter should be altered and what kind of parameter change shall result in contrary effect or which kind of sequences should be applied and which should be avoided? What are the individual sequences for the different pathologies like arachnoid cyst, tumors, metastases, bleeding, viruses and bacterial infections, etc? If and when the sequences are resulted in differential diagnosis in which scanning procedure they are deemed implemented? How should be the chronology of the sequences procedure? How to diagnose different kind of affective artifacts and finding a solution to tackle them? Alterations of parameters optimization for making the different contrast of image . The above mentioned questions are just part of technical points as a key to perfect scanning operation of the patient which indeed requires the knowledge of specific points for the related scanning without which the diagnostic procedure is distorted or in some cases shall be impossible.   https://www.icrjournal.ir/article_179601.html Interviewing is an important step in the employee selection process. If done effectively, the interview enables the employer to determine if an applicant’s skills, experience and personality meet the job’s requirements. If you’re a human resources professional, learning about the importance of recruiting and interviewing may help you support your company more effectively. Understanding why interviews are essential and recognizing key components of a successful interview can help your company find the right candidates. Assisting your company in hiring effective employees can also reflect positively on you and may help you advance your career. Moreover, Companies that use KPI tools effectively can foster employee and company growth. This is because it can identify improvement areas and help a company discover continuous improvement initiatives. Additionally, it can show employees’ skills they can develop to help improve their work performance. KPIs should not be used in isolation to assess the individual value or contribution of your employees. Performance appraisals depend on a broad application of qualitative and quantitative feedback, which don’t just focus on productivity. Your employees’ worth cannot be reduced down to a number, and that is not the purpose of using KPIs. These employee KPIs are purely intended as high-level markers to indicate overall employee productivity. They allow businesses to quickly identify potential problems, which are often the result of wider operational issues, resource availability and workflow bottlenecks. https://www.icrjournal.ir/article_179602.html One in every 7 men is diagnosed with prostate cancer, and approximately 27,500 deaths per year are attributed to this disease. Prostate cancer represents a broad spectrum of diseases ranging from the indolent to the highly aggressive but, in general, tends to be slower growing than most other solid cancers. The methods based on serum prostate- specific antigen (PSA) followed by random biopsies tend to overdiagnose small indolent tumors, which begin appearing in men at a young age at autopsy and are found throughout the prostates in men ages 50 years and older.This combination of PSA screening and random biopsy has yielded disappointing clinical outcomes. Prostate MRI has seen increasing interest in recent years. Multiparametric MRI (mpMRI) prostate allows accurate anatomical and functional imaging of the prostate gland and diagnosis of significant (intermediate and high risk) prostate cancer. mpMRI can also be utilised in active surveillance for patients with low- and intermediate-risk prostate cancer and guide targeted prostate biopsies. The    quality   of    the    multiparametric sequences employed depends not only on the hardware   and   software   utilised   and scanning parameters selected, but also on patient-related factors. The radiology community is continuously working on new MRI techniques and sequences to improve PCa diagnosis. https://www.icrjournal.ir/article_179603.html The   radiation  therapy  simulator  is   a diagnostic x-ray machine Mounted on a rotating gantry, which provides geometric identical with those found on megavoltage therapy machines. Formerly the use ofconventionalradiography for treatment Planing is predominant. The first appearance of simulator was at 1970s. The procedure in which we used simulator is called simulation in the most general sense, the term simulation defines the Procedure. We are trying to “simulate” the therapy setup before Treatment actually begins. The specific of this process depends heavily on the reasons for which it is under taken. The most common Reasons are firstly, for accuracy of radiotherapy, it can be increased because of the ability to image the location and extension of the disease and/or normal tissues relative to the treatment fields. Also the ability to more easily mark the patient externally. Secondly, the Simulation process often serves as a focal point for the planning of a Patient’s and technical staff which all data pertaining to the particular patient. The last reasons that the simulator may increase the efficiency of the radiotherapy units because it allows questions of setup and planning to be resolved without actually using the Machines. The use of ionizing radiation for cancer treatment has undergone extraordinary development during the past hundred years. The advancement of medical imaging has been critical in helping to achieve this change. The invention of computed tomography (CT) was pivotal in the development of treatment planning. Despite some disadvantages, CT remains the only three-dimensional imaging modality used for dose calculation. Newer image modalities, such as magnetic resonance (MR) imaging and positron emission tomography (PET), are also used secondarily in the treatment-planning process. MR, with its better tissue contrast and resolution than those of CT, improves tumor definition compared with CT planning alone. PET also provides metabolic information to supplement the CT and MR anatomical information. With emerging molecular imaging techniques, the ability to visualize and characterize tumors with regard to their metabolic profile, active pathways, and genetic markers, both across different tumors and within individual, heterogeneous tumors, will inform clinicians regarding the treatment options most likely to benefit a patient and to detect at the earliest time possible if and where a chosen therapy is working. https://www.icrjournal.ir/article_179604.html Protocols and Technique MRI of the liver is routinely performed in imaging centers to diagnose benign and malignant liver diseases. The use of a contrast agent makes lesions better visible and better distinguished from normal tissue, and the use of appropriate timing is very important in obtaining different phases of dynamic liver MRI. Two factors the cooperation of the patient and the skill of the technologist in using MR protocols are very important in obtaining the appropriate image of the liver according to the clinical conditions of the patient. Patient’s breathing movements are one of the important challenges of liver imaging, which can be solved and minimized with different methods. The optimality of the imaging parameters in the pulse sequence used in MRI of the abdomen and liver is of special importance, which should be given more attention in the specific imaging methods of the liver, so that the use of TR, TE, FA and b value is appropriate in Along with many other details, it is very important for a liver MRI. Various liver MRI methods such as dynamic, diffusion, MRCP, perfusion, etc., expression and pulse sequences and their effective parameters are investigated. https://www.icrjournal.ir/article_179605.html Discovery of X-ray in 1895 by Roentgen established a new branch of medicine named as Radiology. Transmission and absorption of X-rays are main parameters to make image contrast in diagnostic radiology. Image contrast is introduced by x-ray absorption difference between two regions. However sometimes that difference is too small to get a reasonable contrast. That could lead a diagnostic failure. Scientists has been studying a variety of methods to solve abovementioned problem like phase contrast imaging especially after 1965. X-ray intraction with matter could make coherent x-ray scattering and reflected photons. Those radiations could have interferences in two types as follows: Constructive interferences: Waves interfere in same phases causing constructive integration of amplitudes. Destructive interferences: Waves interfere in different phases causing reduction of the resulted amplitudes, even in full opposition those will get zero. Abovementioned amplitudes are modulated to densities that their differences make contrast. Phase contrast imaging improve the image contrast in comparison with ordinary radiology especially for soft tissues like breast, however it leaves high patient radiation dose as a big challenge. https://www.icrjournal.ir/article_179607.html Diagnosis   of    tumours  has   improved considerably due to the introduction of new imaging CT and MRI techniques. These techniques, and the contrast medium in particular, provide anatomical and structural information    about  brain   tumours,        and information about the physiology, metabolism, and haemodynamics of individual tumours. Advanced magnetic resonance techniques in neuroradiology evaluate changes at the microvascular, haemodynamic, and cellular levels of brain tumours, and in addition to structural changes, evaluate changes at the metabolic and biochemical levels DTI is an advanced magnetic resonance technique that allows visualization of white matter tracts, and describes the movement of water molecules by using two parameters, mean diffusivity (MD) and fractional anisotropy (FA), which represent the directionality of water diffusion. With PWI it is possible to determine tumour grading non-invasively. In general, high-grade tumours have higher CBV values than low- grade tumours. PWI is also used for localization of the parts of a tumour with a high degree of vascularity for the purpose of stereotactic biopsy. PWI helps to define the edge of a tumour, which is important in planning surgical treatment radiotherapy. PWI is also used to monitor the effect of treatment on patients. MRS is a non-invasive method and currently is part of the advanced diagnostic protocol in neuroradiology. MRS can determine pathological changes in brain tissue long before conventional techniques. Presently, in tumour imaging, fMRI is used predominantly for the preoperative localization of eloquent cortical regions that may have been displaced, distorted or compressed by the tumour. Neuronavigation is a common method of preoperative localization of brain tumours. It uses imaging materials of preoperative MRI examinations, 3D sequences and DTI and fMRI data, that are transferred to a computer database of a neuronavigation device. DSA is used to detect the blood vessels supplying the brain tumours, and also tocontrol the hypervascular tumour embolization. https://www.icrjournal.ir/article_179608.html Purpose: The aim of this study was to evaluate the regional (i.e. myocardial segments) variability as well as the overall image quality of cardiac T2 maps in systolic and diastolic phase, using gradient- and spin-echo (GRASE) sequence. Furthermore, fat suppression (FS) technique was activated in this sequence and T2 values were measured. Methods: T2 maps were acquired using GRASE technique at 1.5 T (Philips Ingenia) in 6 wolunteer and 10 patients with cardiac disease. Diastolic and systolic T2-mapping were done with and without FS. The image quality and motion artefact were measured in four sequences. Results: In both healthy volunteers and patients, systolic readout increased the thickness of myocardium, compared to the diastolic readout. The effect of time delay (TD) was not significant on T2 values in both groups (p > 0.05), with slightly less T2 values in systole compared to diastole (< 5 ms). The FS technique significantly increased T2 values in both systolic and diastolic phases in both groups (p = 0.000) and no significant differences was shown between them (p > 0.05). All T2 maps were of moderate quality due to being a spin echo based sequence, but systolic TD were associated with higher variability in segmental T2 values. In tachyarrhythmia patients, systolic acquisitions produced consistently excellent T2 maps (median R (2) = 0.993). Conclusions: GRASE technique showed more T2 variability and less T2 values, compared to diastolic readout. Slightly shorter T2 values with more variablity in systole are mostly explained by blood motion artefact due to changing double inversion recovery (DIR) as a black blood technique to TE preparation with spoiler gradient to be able to perform this technique in systolic phase. In patients with tachyarrhythmia, systolic T2-mapping is feasible, circumvents mistriggering and produces good quality T2 maps. This extends its clinical applicability to challenging rhythms (such as rapid atrial fibrillation) and aids the investigation of thinner myocardial segments. With further validation, systolic T2-mapping may become a new and convenient standard for myocardial T2-mapping. Keywords: T2 mapping, GRASE technique, cardiac magnetic resonance imaging, systolic phase, diastolic phase. https://www.icrjournal.ir/article_179610.html Dual energy CT,also known as spectral CT, is a computed tomography technique that uses two separate x-ray photon energy spectra, allowing the interrogation of materials that have different attenuation properties at different energies.One source-based approach for dual- energy imaging is through implementation of a dual-source system, in which two independent source-detector pairs are mounted to the same gantry at about a 90° offset. While one X-ray tube operates at a low tube potential, the other tube operates at a high tube potential (e.g., 70 kV vs. 120 kV). This scanner design has several notable advantages for dual-energy imaging.In general, unenhanced images can be avoided by using DECT for body and neurological applications; iodine can be removed from the image, and a virtual, non-contrast (water) image can be obtained. Neuroradiological applications allow for the removal of bone and calcium from the carotid and brain CT angiography. Thorax applications include perfusion imaging in patients with pulmonary thromboemboli and other chest diseases, xenon ventilation-perfusion imaging and solitary nodule characterization. Cardiac applications include dual-energy cardiac perfusion, viability and cardiac iron detection. Abdominal applications include the detection and characterization of liver and pancreas masses, the diagnosis of steatosis and iron overload, DECT colonoscopy and CT cholangiography. Urinary system applications are urinary calculi characterization (uric acid vs. non-uric acid), renal cyst characterization and mass characterization. Musculoskeletal applications permit the differentiation of gout from pseudogout and a reduction of metal artifacts. Recent introduction of iterative reconstruction techniques can increase the use of DECT techniques DECT is a promising technique with potential clinical applications.   https://www.icrjournal.ir/article_179611.html In COMAPUTED TOMOGRAPHY, each pixel is assigned in the reconstituted image. This CT number also depends on the linear attenuation coefficient of the tissues in each section. In image reconstruction, the information collected by the detectors should be displayed as 2-D images. The process of using RAW DATA and creating an image is called IMAGE RECONSTRUCTION. IN CT we have 3 main reconstruction Methods: Back-Projection Iterative Methods Analytical Methods Nowadays, by using new Methods of image reconstruction it is even possible to reduce the Dose of the patient without reducing the quality of the image. Recently, new algorithms for reducing noise with factors for less radiation used and in this case the quality of the image or spatial resolution and low contrast detection are maintained, and artifacts caused by metals or beam hardening and photon deficiency are reduced. https://www.icrjournal.ir/article_179612.html Machine learning is a technique for recognizing patterns that can be applied to medical images. Machine learning has been used in medical imaging and will have a greater influence in the future. Those working in medical imaging must be aware of how machine learning works. Here we introduce the new strategies that reduce time scan with remaining good sufficient and reproducible quality in imaging the body and head region .deep resolve and deep gain with deep learning reconstruction is a very active field for researchers, demonstrating great potential for the future of MR image reconstruction, including denoising, artifact reduction, and possibly even the reconstruction of multiple contrasts from one single acquisition. These technologies enable us to reduce acquisition times and improve image quality simultaneously Compressed sensing (CS) is a mathematical framework that reconstructs missing data from highly undersampled measurements. CS has been applied to MRI to achieve higher acceleration factors by incoherent k-space undersampling.we discuss this workflow and see who the time will be reduced in MRI examinations. https://www.icrjournal.ir/article_179613.html Magnetic resonance angiography–also called MRA is a type of MRI developed for studying the arterial and venous systems. The benefits of an MRA in comparison to traditional angiography is that it is noninvasive, it lacks ionizing radiation exposure, it has the potential for a non-contrast examination and it has the ability of high-resolution volumetric images. MRA used to evaluate an aneurysm or weakness in the wall of an artery ,a narrowing of the aorta, or aortic coarctation ,bleeding in and along the wall of the aorta ,or aortic dissection ,to find the cause of a stroke ,signs of heart disease ,narrowing or blockage of the vessels in the arms or legs ,renal artery stenosis, a narrowing of the blood vessels in the kidneys that can lead to high blood pressure and even renal failure. MRA is a term that groups various imaging techniques based on different physical principles and is employed for diverse diagnostic purposes .MRA methods can be divided into two broad categories depending on whether they produce dark blood or bright blood. Bright blood techniques are further subdivided according to whether they are performed with or without gadolinium contrast. Contrast-enhanced MR angiography (MRA) is a technique involving 3D spoiled gradient- echo (GE) sequences, with administration of gadolinium-based contrast agents . It can be used to assess vascular structures of almost any part of the body. Its key features are: 1.T1 weighted spoiled gradient-echo sequence 2.Central k-space acquisition corresponding to arterial phase of the study maximizes preferential visualization of arteries3.use of gadolinium contrast to shorten T1 interval of the blood which appears bright as a result. Non Contrast Enhanced MR Angiography is performed in several ways including: 1. time of flight angiography (TOF) 2. phase contrast angiography (PCA) 3.Three-dimensional(3D) electrocardiograph-triggered half-Fourier fast spin echo. Generally, these techniques are time-consuming as compared with contrast enhanced MR angiography. https://www.icrjournal.ir/article_179614.html Background Ionizing radiation (IR) is regarded as one of the most commonly used methods for diagnostic and treating diseases including cancers; which may lead to various complications despite its many medical uses. Radiation therapy, as one of the most effective modality, plays an important role in treatment and prevention of cancer recurrence or metastasis. Due to different radiosensitivity of healthy tissues around the tumor, variable responses to IR could be obtained; which may terminate in several detrimental effects. Therefore, the acute and late toxicity of radiation therapy in healthy tissues can be expressed as a major limitation for radiation dose delivery to tumors. Protection against the biological effects of IR could be implemented by both physical and chemical approaches. The basis of physical protection is illustrated as the use of appropriate radiation field and lead protectors or shields, radiation dose proportional to the target, reduction in duration of irradiation, and increase in the distance from the radiation source. Chemical protection is elucidated as reducing the detrimental effects of IR by natural and synthetic compounds of chemical or plant origin; which can be used orally, injectably or topically. Presence of these compounds at the moment of irradiation and free radical’s production, can reduce or prevent the adverse effects of IR by distinct mechanisms. In addition to protecting patients in medical applications, radioprotectors are utilized to protect workers during occupational exposure and public members via accidental exposure. Peculiarities of an ideal radioprotector could be categorized as; 1) selective differentiation of healthy cells from tumoral 2) protecting healthy tissues, while not protecting tumoral ones, 3) optimal stability, 4) administration suitable method (preferably oral), 5) lack of drug interactions, 6) easily penetration into the cells, 7) minimum degree of toxicity and 8) accessibility and reasonable price. However, despite huge bulk of studies, non-toxic and effective radioprotector for human use has not yet been officially ascertained. One of the known radioprotector agents is melatonin, which is a fat-soluble compound derived from the amino acid tryptophan. Melatonin (N-acetyl-5-methoxytryptamine) by molecular formula C13H16N2O2, is a hormone that is secreted at night in the absence of light by the pineal gland behind the third ventricle of the brain of all mammals, including humans. Accumulating evidence demonstrated that melatonin is a strong antioxidant, indicating its properties both in a direct (scavenging free radicals) and indirect strategies (stimulating the activation of antioxidant enzymes). The investigations exhibited by researchers reported that melatonin could alleviate the deleterious complications caused by IR in different tissues of animals such as lung, colon, eye, spleen and spinal cord. Moreover, enough published papers have manifested the radio sensitivity effect of melatonin on cancer cells through increasing cell apoptosis. Results & Conclusion Melatonin with several features including stimulation the activity of antioxidant enzymes (e.g. glutathione) and free radicals scavengering, inhibition of the activity of pro- oxidant enzymes, increasing the expression of anti-apoptotic genes and decreasing the expression of pro-apoptotic genes in healthy tissue, easily penetration, accumulation with the highest concentration in different parts of the cell, low toxicity, no proof of adverse effects, suitable administration method (oral), availability and cheap price could be considered as a promising radioprotector. Noteworthy to mention that the presence of two properties of radioprotection and radiosensitization simultaneously can confirm the role of melatonin as a strong unique compound. More confirming research and clinical trials could clarify the ambiguity and uncertainty of clinical use of this compound. https://www.icrjournal.ir/article_179772.html With the advance of technology and the emergence of multi-slice CT scans (MDCT), the use of CT scans in medical diagnosis has increased significantly. On the other hand, the installation of CT scanners has also increased. Therefore, considering that the highest radiation dose received by the public from medical sources is related to CT scan and also stochastic effects caused by radiation such as cancer, it is important to pay attention to dose management in CT and optimization of protocols. CTDI & DLP are the two main indexes of dose expression in CT scan, and scan parameters such as kVp, tube current (mAs), Pitch factor, scan length, and the use of automatic exposure control (AEC) affect the dose by influencing these two indicators. And finally, with the use of these indices and coefficients related to tissue radiation sensitivity, the effective dose from CT examination can be calculated and compared with other imaging modalities. The image quality indicators that should be included in a proper imaging are parameters such as Noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). In CT scan protocols, scan parameters must be carefully selected so that these indicators are at an optimal level. The optimal limit of these indicators will be different according to the diagnostic application of CT scan. Of course, according to the optimization and justification principles, a compromise should always be made between the image quality and the radiation dose, so that both diagnostic quality and radiation protection are considered.   https://www.icrjournal.ir/article_179773.html Introduction: Pulmonary embolism occurs when a blood clot gets stuck in an artery in the lung, blocking blood flow to part of the lung. Because of its associated risks and because CT pulmonary angiography offers similar or better information, direct pulmonary angiography is now rarely performed, except in the patient who may undergo pulmonary embolectomy. CT pulmonary angiography (CTPA) is known as the gold standard for the diagnosis of pulmonary embolism. Although development of multi-slice scanners with higher speed, lower radiation dose, bolus tracking, and test bolus has increased the quality of images and resolves the many of previous challenges; However, radiology technologists have many challenges for performing this procedure in practice. This challenges refer to patient physiopathology conditions (e.g heart output, kidney disease, breath holding problems and etc.), contrast medium (low/high Iodine concentration, dye temperature), scanner’s speed an equipment with angiographic applications (Blus tracking or test bolus), type of injector (dual or single head), using low- dose protocols, and type of catheter (central or peripheral venous) will be discussed. Firstly, the fundamental principles of CTPA from the patient educations to the multi-planar reconstructions were discussed in summary. Finally, the clinical solutions were provided to decreasing the dye volume at the lowest, obtaining the best delay time, optimizing the protocol parameters, with considering the patients’ safety based on the recent studies. Results and Discussions: Although, the patient weight is recommended for determining the contrast medium (CM) volume for CTPA, however vessels diameter and patient height must be included for calculating the contrast medium volume. Also, using dual head injector and test bolus (instead of bolus tracking) can decrease the total contrast volume to 35 mL. Temperature can increase the contrast medium viscosity and have inverse effect on the choosing the injection rate in patient with unstable veins. Using a test bolus to determine CM arrival time at two locations (i.e., ascending aorta and pulmonary trunk) can be performed to better determine the arrival time of the diagnostic CM in the target vessel of choice, especially in patient with heart failure. Using the bolus tracking instead of test bolus can be more useful in some patient with urgency condition or for double rule-out study (CTA for Pulmonary Embolus and thoracic aorta). Craniocaudal CT pulmonary angiography is suggested in recent 16-slice scanners with short scan time equal to the patient breath holding (5-10 s). Craniocaudal had a similar degree of respiratory motion artifact to caudocranial scanning, in contrast, cause to better peak contrast enhancement in the distal pulmonary branches. Inserting the region of interest (ROI) in the nearest place to the beginning of scan is necessary, especially in scanners with high diagnostic delay time. In this way, there is not necessary to starting the scan from top of lung. Thus inserting the ROI in 1-2 cm upper than aortic arch helps to decrease the diagnostic delay and decreasing the patient radiation dose. Although, using lowest rotation time is necessary for tracking the bolus to increasing the accuracy of determining the peak contrast enhancement; however, decreasing the scan speed is more helpful in patient with insufficient heart output (high time of peak enhancement) and with tall lung. In this cases, the contrast medium has enough time to arrival to the distal pulmonary branches. The tube voltage decreasing instead of tube current should be considered in low- dose protocols. Recent studies are shown that using the lower tube voltage (80-100 kVp) can allow the lower contrast medium usage with same diagnostic value for patient with medium size. Maximum intensity reconstruction (MIP) can’t be useful when the pulmonary veins are enhanced because of inappropriate timing. https://www.icrjournal.ir/article_179775.html MR mammography, also known as breast MRI, is a non-invasive imaging technique used to examine breast tissue. MR mammography is typically used in conjunction with other imaging techniques such as mammography and ultrasound and is often recommended for women who are at high risk for breast cancer or who have dense breast tissue that may be difficult to image using other methods. MR mammography is a valuable tool in the early detection and diagnosis of breast cancer and can be an important part of a woman’s breast health screening routine. To obtain the most accurate results, MR Mammography usually involves the use of a gadolinium-based contrast agent, which is administered intravenously during the exam. There have been studies that have shown that breast MRI without the contrast agent has no diagnostic value. Kinetic analysis of the Dynamic Contrast-Enhanced (DCE) MRI reflects perfusion of the lesion, which can help in the differentiation of the lesions. Diffusion-weighted imaging (DWI) has emerged as both a complementary and potentially alternative technique to evaluate the breast. The combination of DCE and DWI increased specificity along with sensitivity and maximized diagnostic accuracy. The combination of DCE and DWI increased the specificity and sensitivity of the breast MRI. Although currently, DWI is not part of the BI-RADS lexicon, the inclusion of DWI is encouraged by different communities. In this presentation, we will discuss some technical pitfalls of the DCE and DWI in breast MRI.     https://www.icrjournal.ir/article_179776.html Learning Objectives: Upon completion of this presentation, participants will be able to: Recognize common sign and symptoms of Contrast media Familiarize with first steps of physical and medical management of patients Presentation Summary: Contrast agents are substances that are used to enhance the visibility of certain lesions or tissue during medical imaging procedures such as X-rays, CT scans, MRI scans, and ultrasound. They work by altering the way that electromagnetic radiation or sound waves interact with the body’s tissues, making it easier for Radiologists and clinicians to see and diagnose abnormalities. While contrast agents are generally safe and well-tolerated by most patients, there is a risk of adverse reactions in some cases. These reactions can range from mild to severe and may include symptoms such as nausea, vomiting, itching, hives, difficulty breathing, and even anaphylaxis (a life-threatening allergic reaction). To minimize the risk of adverse reactions to contrast agents, it is important for medical imaging technologists to carefully screen patients for any allergies or other medical conditions that may increase their risk. Patients should also be informed about the potential risks and benefits of contrast agents before undergoing any imaging procedures. If a patient does experience an adverse reaction to a contrast agent, prompt treatment is essential. This may involve administering medications such as antihistamines or steroids to alleviate symptoms or pacing patient in special positioning or providing emergency care in cases of severe reactions. In conclusion, while contrast agents are an important tool in modern medical imaging, it is crucial for radiation technologists to be aware of the potential risks and take appropriate measures to ensure patient safety. By staying informed about the latest research and guidelines on contrast agent use and management of adverse reactions, which we will expalin them in this presentation. Keywords: Contrast Media, Adverse effects, Computed Tomography (CT-Scan), Radiology, Magnetic Resonance Imaging (MRI) https://www.icrjournal.ir/article_179777.html Purpose: Evaluation of the resting-state brain networks map in Alzheimer’s disease, amnestic mild cognitive impairment, and normal aging subjects. Methods: The resting-state functional Magnetic Resonance Imaging data of 13 patients with Alzheimer’s disease, 16 patients with amnestic mild cognitive impairment, and 14 normal aging subjects were evaluated using functional connectivity analysis. Preprocessing steps were realignment, slice timing correction, segmentation, co-registration, normalization, and functional smoothing. In the second-level measurement, ROI-ROI/seed-based analysis using bivariate correlation coefficient and Fisher z-transformation was performed. Results: Using parametric statistics (cluster threshold: p < 0.05 p-False Discovery Rate corrected; voxel threshold: p < 0.001 p-uncorrected) group differences were found between Alzheimer’s disease and normal aging and also between Alzheimer’s disease and amnestic mild cognitive impairment. Using parametric multivariate statistics (cluster threshold: p < 0.05 p-False Discovery Rate corrected; connection threshold: p < 0.05 p-uncorrected), differences were found in the map of the three groups. No significant difference was found between the two groups of normal and amnestic mild cognitive impairment. Conclusions: The map of statistical correlation in the resting-state brain network (matrix display) of the three groups was different (The number of positive and negative correlations and the strength of connections between the nodes of the resting-state networks differed). Also, seed- based functional connectivity analysis and the resulting spatial map showed differences between Alzheimer’s disease - amnestic mild cognitive impairment and Alzheimer’s disease - normal aging groups.   https://www.icrjournal.ir/article_179778.html Purposes: the purpose of this study is to investigate the diagnostic value of different diffusion parameters, especially the MK parameter, and compare it with the results of MRS and pathology as a standard for distinguishing true recurrence of glioblastoma from pseudoprogression. Methods: 19 glioblastoma patients who had a new lesion with absorption of contrast material after surgery and radiotherapy were subjected to conventional MRI, DKI and multivoxel MRS imaging. Based on pathology findings and radiologist’s opinion, 13 patients had true recurrence and 6 patients had pseudoprogression of glioblastoma. FA, MD and MKparametersbasedontheareaswithabsorption of contrast material in T1 images after injection, once in voxels with a volume of approximately 2.34 cm3 and corresponding to the MRS voxel and again in a smaller voxel with a volume of 0.004 cm3 was calculated. The mean differences of diffusion parameters between true recurrence and pseudoprogression of glioblastoma were compared using the Mann-Whitney test. The receiver operating characteristic curve was used to evaluate the differential detection efficiency of each parameter. Findings and conclusions: MK parameter between these two groups was significant with p-value=0.01. ROC analysis showed that MK parameter with AUC=0.93 with sensitivity of 69% and specificity of 100%, also FA with AUC=0.67 and sensitivity of 67% and specificity of 69.2% and MD with AUC=0.64 with sensitivity of 83.3% and specificity of 53.8% It is able to distinguish between the true recurrence of glioblastoma and its false recurrence. The result of MK parameter in 78% of patients was consistent with MRS and pathology results. This value for MD and FA parameters was 63 and 53%, respectively. MK parameter has more sensitivity, specificity, accuracy, NPV and PPV than other studied diffusion parameters in differentiating true recurrence from pseudoprogression of glioblastoma. https://www.icrjournal.ir/article_179779.html Purpose: Water equivalent diameter (WED) is related to the computed tomography (CT) number. Lung lesions change the tissue attenuation properties in the COVID-19 patients. Thus, these lesions can change the CT number and affect the WED, conversion factors (CFs), and size-specific dose estimation (SSDE). We evaluated the effect of lung infection on the radiation dose in the CT scans of COVID-19 patients. Methods: One hundred eighty-six chest CT scans of adult COVID-19 patients were obtained from PACS under a retrospective study. All patients were categorised into five categories based on total severity score (TSS). The effective diameter (Deff), WED (Dw), conversion factor, CTDIv, and SSDE are calculated for all slices based on AAPM TG-220. One-way ANOVA test following Tukey’s post hoc test is used to compare the mean of Deff, CFeff, Dw, CFw, (SSDEw ) and computed tomography dose index (CTDIv) among all pairwise TSS groups. The correlation among mentioned parameters with TSS is determined by the Spearman’s correlation coefficient. Results: Although there was no difference for Deff and CF among all TSS groups but the Dw, CFs, and PDIF were significantly higher for COVID-19 patients than healthy cases. Furthermore, our study showed that TSS is correlated with Dw (r = 0.29, P-value = 0.001), and CFs (r = - 0.29, P-value = 0.001). (SSDE_w ) was significantly different among all pairwise groups when fixed tube current (FTC) was used. We found A significant difference for (SSDEw ) (On-ATCM) between healthy-moderate (P-value = 0.006) and healthy-mild (P-value = 0.04) TSS groups. Conclusion: Lung lesions change the Dw and CFw, which can affect the patient’s radiation dose in COVID-19 paients. Increasing TSS causes a decrease in CFw and (SSDEw ) when low-dose protocol with FTC was performed. Moreover, in some TSS groups, the lung lesions can affect the (SSDEw) when ATCM is used. It seems some pathologies can affect the cancer risk from CT scan exposure. https://www.icrjournal.ir/article_179780.html Purpose: Currently, different imaging methods are used for diseases diagnosing which have their own advantages and disadvantages. Virtual reality (VR) is an innovative technology that uses a computer to create an artificial 3D environment in which the user can receive visual and tactile stimuli using special sensors and interact with them. VR with its unique feature has been used for different radiological procedures such as virtual angiography, cystoscopy and colonoscopy. The aim of this study was to investigate the current trends of VR in radiology. Methods: The articles were obtained through searching “virtual reality”, “radiology”, “virtual angiography”, “virtual cystoscopy” and “virtual colonoscopy” from the databases of Google Scholar, PubMed, and ScienceDirect. Then, the results were summarized. Results: Applications of virtual reality in radiology are as following: Overcoming the limitation of 2D images and appropriately viewing a 3D image from different angles Performing complex medical procedures and deeper understanding of the complex structure such as tumors and vessels Improving physician knowledge to early detection and treatment of diseases Improving interventional radiology procedures lead to patient comfort from less painful process Increasing the accuracy and efficiency of interventional radiology procedures and reducing errors lead to overall cost reduction Conclusion: VR is a promising technology for improving radiological procedures that can be widely used in future. Keywords: Virtual reality, Radiology, Virtual angiography, Virtual cystoscopy, Virtual colonoscopy https://www.icrjournal.ir/article_179781.html Purpose: Glioma is the most common malignant type of brain tumor. Magnetic resonance imaging (MRI) is used as one of the first techniques for imaging and diagnosing of glioma. Despite inherent soft tissue contrast of MRI, it has limitations such as the inability to grade the tumor, determine tumor changes after treatment, and show tumor recurrence. On the other hand, positron emission tomography (PET) can provide useful biochemical and molecular information. By combining these two imaging modalities, we can use both methods advantages. This study aims to review PET-MRI hybrid imaging in the diagnosis of glioma. Methods: We searched various keywords such as PET- MRI, hybrid imaging, glioma, and brain tumors in search engines such as Web of Science, PubMed, and Google Scholar. The data from the extracted articles related to the topic were reviewed. Results: PET-MRI provides the excellent soft tissue contrast of MRI and the information on the metabolism and activity of tumors from PET imaging. Hybrid imaging by combining PET and MRI has a better function in diagnosing glioma and determining the spread of the tumor than contrast-enhanced MRI. PET-MRI shows a higher accuracy in the diagnosis of glioma than the single imaging modalities. PET-MRI reduces the need for invasive methods for the tumor diagnosis and provides supplementary information to differentiate between high- grade and low-grade glioma. Conclusion: PET-MRI is a promising technique in diagnosing glioma and reducing the invasive methods, which gives us the benefits of both imaging modalities. Keywords: PET-MRI, Hybrid imaging, Glioma, Brain tumors   https://www.icrjournal.ir/article_179782.html Purpose: One of the common algorithms nowadays for the segmentation of Diffusion Tensor images is the clustering method, one of the techniques of which is the QuickBundles method. Its biggest capabilities are the analysis of images using different features and metrics so that many of these features and metrics can be introduced and distributed as desired. Of course, their implementation will require the use of open-source programming languages. In this study, some of the most important features of the QuickBundles method have been implemented and compared with each other using Python. Materials and Methods: Necessary information for Tractography was collected from 10 completely healthy patients according to the standard conditions for all patients. After data preprocessing, Python libraries were used to perform Tractography analysis. Four features namely center of mass, middle point, arc length, and end points between the directions vectors were analyzed by the QuickBundles method on all patients. Then, anatomically and clinically, all calculated streamlines were compared with each other. Results: The streamlines obtained in terms of computing time are variable according to the number of streamlines so that the implementation of the center of mass feature has the least computing time. In all four features, the route map in color has been appropriate in terms of anatomical comparison, and the radiologist has reported it as acceptable. Conclusion: One of the most important features of the implementation of features in DTI data analysis is the appropriate speed of the QuickBundles method, especially when implemented in environments such as Python. It seems that the implementation of each feature can well express the expected results from the implementation of data analysis, such that the feature of the center of mass and the middle point to show the spatial position of the streamlines, the length of the arc to show the length of a streamline and the endpoints between the vectors to the amount of rotation of a streamline. They are very suitable for examining the mentioned features.   https://www.icrjournal.ir/article_179783.html introduction: Coronary artery disease(CAD) is the situation of narrowing or blockage of your heart supplying arteries lumen caused by fatty material build-up called plaque leading to impairment in oxygen delivery to the myocardium. The standard diagnostic tool for CAD is still conventional coronary angiography which takes advantage of high resolution and identifies the presence and extent of CAD which is followed by risks and specific complications. Computed tomography angiography(CTA) is a certified non-invasive imaging tool used as the main alternative to conventional coronary angiography for coronary artery disease assessment which is increasingly gaining importance. This procedure benefits from high sensitivity and specificity for CAD detection while, has the disadvantage of high radiation dose that due to potential cancer risk remains a non- negligible concern for physicians and radiologists so lots of strategies have been developed to reduce radiation dose-encompassing dose modulation techniques with retrospective and prospective ECG triggering and FLASH (a prospective ECG triggered data. This study was intended to compare radiation dose and image quality across three groups of patients undergoing different CCTA methods, including prospective, retrospective, and FLASH. Material and Method: A dual-source scanner (384 slice, Siemens) was used for data acquisition in both FLASH and Pros/Retrospective CTA. The two major parameters of radiation dose assessment are CT dose index(CTDI) and Dose Length Product(DLP) which are used to calculate the SSDE (Size Specific Dose Estimation). A python-based software was developed by our team to read the required data including CTDI and DLP from the DICOM header and automatically calculate the effective diameter which can be used to determine the desired conversion factor and result in the geometrical measurement of SSDE. Results: Different parameters for radiation dose assessment, including wSSDE, gSSDE, effective dose, and exposure obtained for the three CCTA methods, including prospective, retrospective, and FLASH methods. A comparison of the CCTA methods for the same parameter reveals a significant difference in the radiation dose received by the patient. The prospective protocol is known as the standard protocol for cardiac imaging and increasing pitch value is used to reduce radiation dose with good diagnostic accuracy. prospective ECG-triggered data acquisition with very high pitch values (FLASH) provides images with high image quality for patients with a heartbeat of less than 60 and also a sharp depreciation in radiation dose received by the patient. the Retrospective protocol offers a high amount of radiation dose in comparison with others and also not a good image quality in compare with prospective which is probably due to severe motion artifact. Conclusion: 384-slice CTA enables us to visualize the coronary arteries using 3 different protocols that are selected to be performed based on the patient’s heartbeats. Prospective ECG Triggered data acquisition for heartbeats<60 offers an acceptable image quality with a sharp depreciation In radiation dose. For heartbeats, more than 60 to 75 prospective scannings represent the first choice. If the heartbeat goes over 75, the retrospective is considered as the final alternative, dose reduction using a relatively low tube voltage and using tube modulation would be necessary. https://www.icrjournal.ir/article_179784.html Background and Purpose: The effect of radiation in increasing the risk of cancer and its other harmful effects has been proven. The possibility of chromosomal damage and the creation of genetic mutations has also been proven as a result of damage to DNA, and it is one of the most important and fundamental damages of radiation. Gonads in men are among the most vulnerable parts when exposed to radiation. The present study was conducted to measure the absorbed dose of gonads in prostate cancer radiotherapy. Methodology: This study was an experimental scientific study in which the dose reached to the gonads in radiotherapy treatments for prostate cancer was investigated and calculated. The method of measuring the radiation transmission coefficient is to measure the absorbed dose of radiation at a certain point, with and without a shield, and this coefficient is obtained by dividing the value read with the shield by the one without the shield. The amount of 70 times of radiation in this study was done with the medical linear accelerator device available (Varian X linear accelerator with MV18 photon energy), 40 times of which was by TLD chips and 30 times by the ionization chamber. Farmer type was used. Findings: The radiation passing through cedar blocks that was measured in this research was equal to 4%. The absorbed dose resulting from the scattering of the collimator on the head of the patient’s body, etc., which in this research was between 3 and 5% in different conditions. The target was 4 to 6 percent. Conclusion: In the treatments of the abdominal region, the testicle is not in the radiotherapy field. But a significant absorbed dose of scattered rays reaches the testicle, which is up to 9.5%. Keywords: radiation therapy; gonads; Prostate Cancer; Linear accelerator. https://www.icrjournal.ir/article_179785.html Today, Dynamic Contrast Enhancement is known as the standard MRI technique method for breast lesions imaging and breast masses screening. Despite the many advances that have been made in this method and its high capability in diagnosing and differentiating breast lesions, it can still be problematic and challenging DCE to perform. Also, this method has low specificity. In addition, due to the injection of contrast material in this method, it is not recommended for young patients and people who are allergic to MRI contrast materials. Diffusion Weighted Imaging is a technique based on the diffusion of water molecules in tissues. Tissues in which the diffusion of water molecules is restricted in this method have abnormal signals. Due to the presence of many membrane structures Pathological tissues have limited diffusion, therefore appear as high signal in DWI images. Another ability of this method is to quantitatively set ADC values in tissues using ADC map images. Using DWI, the morphological structure and microstructures of the tissue can be quantitatively and qualitatively evaluated. This technique can be used to differentiate between benign and malignant masses. To quantitative assessment of ADC value and differentiate between malignant and benign lesions, it’s necessary a cutoff point of ADC value determine. According to cutoff value, different values of sensitivity are obtained. Unfortunately, the cutoff value of ADC for differentiation between benign and malignant lesions has not been standardized and its determination requires more studies in different centers and patients. In this article, we evaluate the different diagnosis and differentiation methods for breast lesions and compare them. Also, we evaluate and compare DCE and DWI techniques in breast lesions diagnosis and differentiation and try to provide suggestions for the cutoff value of ADC. https://www.icrjournal.ir/article_179786.html Multiple Sclerosis (MS) is a chronic autoimmune disease where the immune system wrongly attacks the central nervous and  is  characterized  pathologically  by demyelination and clinically by visual, sensory, and motor problems. This immune-mediated disease is one of the most common causes of neurological disability in young adults worldwide and currently is increasing in prevalence and incidence globally1. Early and accurate diagnosis is of the utmost importance. Blood test, Spinal tap using lumbar puncture, Neurological exam and Magnetic Resonance imaging are the 4 common diagnostic tools for MS provident. MRI has a major role and is the most important available tool that supports the diagnosis and monitoring of MS. This review study was   aimed to evaluate different sequences for MS diagnosis and discuss each protocol hallmark. Sequences contain Spin-Echo sequences, gradient echo    sequences,                  Susceptibility sequences, Magnetic Resonance Spectroscopy, Magnetization transfer imaging, Diffusion Weighted imaging, USPIO sequences, and some other modern sequences. We discussed about characteristic hallmarks and each sequence-specific application https://www.icrjournal.ir/article_179787.html Today, accurate diagnosis of breast cancer is very important due to the growing trend of breast cancer. And the most important stage of accurate diagnosis of breast lumps is biopsy from suspicious lumps in the breast with vacuum biopsy methods under mammography or ultrasound guidance and core needle biopsy. In this educational review article, the latest biopsy methods under the tomosynthesis guide and the training of methods, techniques and related tips and tricks and troubleshooting are described. In the attached file, a translation of the 20th chapter of Mammographic lmaging (fourth edition) written by shelly L.Lille and wendy J.Marshall , which the presenters of this review article contributed to its translation, is provided. In this review article, the points raised in this file have been used. A summary of the topics presented in this educational review article is given below, the full description of which will be presented in PowerPoint. Biopsy Modalities Clinical Guidance Ultrasound-Guided Biopsy (Sonographic) Stereotactic Guidance and Overview of the Stereotactic Procedure positioning for stereotactic biopsy Acquisition and Display of the Planar Images Principles and instrumentation of core biopsy Digital breast tomosynthesis (DBT) and Benefits of DBT-guided breast biopsy DBT-guided biopsy     procedure    and technique Complications (vasovagal      reaction, bleeding, infection) , troubleshooting conclusion And finally, a brief introduction to the methods and images of breast tomography with injection https://www.icrjournal.ir/article_179788.html Introduction: currently, mammography is one of the best methods for breast cancer screening. One of the most important factors in breast cancer risk, as well as the dose and sensitivity of mammography is breast tissue composition and another effective factor in breast dose is thickness and size the breast. This study was designed to investigate the relationship between glandular dose and breast tissue composition and thickness. Method: This cross-sectional study was performed on 286 clients in a period of six months in the second half of 2020 - 21 and demographic information, history of surgery, chemotherapy and radiotherapy through a questionnaire and information about the composition of breast tissue with a, b, c , d level According to reports, mammography images were collected by a radiologist, as well as information about the received dose of each breast and its thickness by examining digital mammography images on 1132 images. Multivariate linear regression was used to analyze the data Findings: Based on the results, there is a significant relationship between glandular dose and type of breast tissue (a, b, c, d) Type a has a lower absorption dose and type d has a higher absorption dose. (P <0/05) Also, the amount of absorbed dose of the patient has a significant relationship with the thickness and size of breast tissue, which increases with    increasing       thickness,                  the amount of absorbed dose of the patient and in MLO images due to increasing thickness, the amount of absorbed dose is higher than CC images of breast.( P <0/05) In general, the absorbed dose is higher in patients with denser tissue and greater thickness, to whom radiation management is important. Keywords: Digital mammography, Breast tissue composition, Glandular absorption dose, Breast tissue thickness https://www.icrjournal.ir/article_179790.html Introduction: Nowadays CT scan plays an important role in medical imaging and, as pediatrics is in the most sensitive group to radiation, optimizing radiation dose became an important issue for them. Materials and Methods: In this study, we examined the risk of cancer due to the common procedures of CT scan in children less than 15 years of age in children’s imaging centers in Tehran province. First, by entering the desired information to measure the dose of organs as a result of CT scan of head, chest, abdomen and pelvic in NCICT dosimetry software, dose of organs and also the effective dose was measured and the value of CTDIvol, DLP and were introduced as local DRL in Tehran province and were compared with other studies conducted in other provinces and countries. Then, using the second phase of BEIR VII report, we examined the risk of cancer in research. Results: The results of RDRL werecompared with other countries and previous data in Iran, CTDIVOL values were lower than the other national and international studies compared with except chest and abdomen-pelvic in European study, and in case of DLP, European values except cest and abdomen-pelvic scans, Tehran studies conducted in 2012, and abdomen and pelvic exams in UK ,Thailand and mazandaran studies, the others were higher than this study, also by examining the LAR value we concluded that the rate of breast, lung and colon cancers due to radiation was significant, also cancer incidence didn’t show a significant differences among boys and girls(P-value>0.05), but considering the total average of all cancers, it is generally understood that the risk of cancer is higher in females in all age groups and this difference decreases by age. As a result due to the importance and significant role of CT scans in medical diagnosis its use should be with caution. https://www.icrjournal.ir/article_179791.html Purpose: Thyroid cancer is one of the most common cancers in the endocrine system. Imaging methods for diagnosis of thyroid cancer include ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET), and radioiodine scan. Several treatment methods including surgery, radiotherapy, and chemotherapy have been used to treat thyroid cancer. On the other hand, optical imaging and therapy by use of light and its optical properties can be utilized for both diagnosis and treatment of thyroid cancer. This study aims to investigate the advantages of optical imaging and therapy in the thyroid cancer diagnosis and treatment. Methods: The search was done using the keywords of optical imaging, thyroid cancer, diagnosis, and treatment in PubMed, Google scholar, and ScienceDirect databases during 2018-2022 to identify appropriate studies. Results: Optical imaging is used in the diagnosis before, during, and after thyroid cancer treatment and increases diagnostic accuracy. Also, the optical property can be used to improve surgeons’ vision during tumor resection which leads to reduced wrong damage to the thyroid and surrounding tissues. The following advantages can be mentioned for optical imaging and therapy of thyroid cancer: Non-invasive and non-ionizing radiation method leads to high safety Real-time imaging and feedback capability lead to excellent controllability Ease of   implementation  with   simple equipment Cost efficiency Conclusion: Optical imaging and therapy can be considered as accurate and safe diagnostic and therapeutic method for thyroid cancer detection and treatment. Keywords: Optical imaging, Thyroid cancer, Diagnosis, Treatment https://www.icrjournal.ir/article_179792.html   Purpose: Eye cancer describes various types of tumors in different regions of the eye. The cancer treatment methods must have the least side effects on eye function and visual acuity. Currently, different treatment methods such as radiotherapy (external beam or brachytherapy), chemotherapy, surgery, and enucleation are used to treat eye tumors. Photodynamic therapy (PDT) is another cancer treatment process in which a photosensitizer is applied locally or systemically and it is selectively absorbed by the malignant tissue, then the tissue is irradiated locally. Successful PDT applications in the treatment of eye tumors have been reported. This study aims to review the role of photodynamic therapy in the treatment of eye cancer. Methods: The articles published during 2017-2022 were identified via searching in Google Scholar, PubMed, and Science Direct using keywords including Photodynamic therapy, eye cancer, tumor, and treatment method. After the selection of the related studies, the required data were extracted and summarized. Results: Based on the review results, PDT showed the following advantages for eye cancer treatment: A safe treatment method with few side effects compared to other treatment methods A localized method has the least destructive impact on other parts of the eye, leading to the least effect on reducing visual acuity Non-invasive treatment without significant pain Easily accessible treatment with lower costs compared to other treatment methods An outpatient or ambulatory treatment modality without using general anesthesia It can be used in combination with chemotherapy, radiotherapy, and surgery Conclusion: PDT is considered to be a safe and tolerable treatment method for eye cancer with high local control rates and an excellent visual prognosis for most patients. Keywords: Photodynamic therapy, Eye cancer, Tumor, Treatment method https://www.icrjournal.ir/article_179793.html Purpose: Schizophrenia is one of the acute mental disordersthatdisturbpatients’cognition,behavior and emotion. Its clinical diagnosis is usually based on fulfilling criteria of phenotypical features, which is time-consuming. Therefore, using the methods for early diagnosis of schizophrenia and faster therapeutic interventions is essential. Machine learning algorithms have shown good performance for schizophrenia classification, but due to the limitation in manual feature selection, they may not fully represent the neural differences associated with schizophrenia. On the other hand, deep learning algorithms, especially convolutional neural networks (CNN), can learn the fully automatic features related to schizophrenia. The aim of this study is to determine the accuracy of the deep learning algorithms in the classification of schizophrenia patients using MRI images. Methods: We searched the articles published in 2018-2022 in PubMed, Google Scholar, and AltaVista databases using the keywords of schizophrenia, classification, deep learning algorithms, and magnetic resonance imaging. Among the searched articles, the most relevant ones were reviewed. Result: According to the findings, various deep learning algorithms such as pre-trained 2D CNN, 3D Naïve CNN, modified 3D VGG with squeeze excitation (SE) and batch normalization (BN) model (SE-VGG-11BN), and 2D convolutional Autoencoder (CNN-AE) have been used for the classification of schizophrenia using structural, diffusion, and functional MRI images. The reviewed articles results showed an accuracy of 72-97% for classifying schizophrenia in MRI images using these algorithms. Conclusion: Deep learning algorithms showed high accuracy for the classification of schizophrenia patients using MRI images. Keywords: Schizophrenia, Classification, Deep learning algorithms, Magnetic resonance imaging https://www.icrjournal.ir/article_179794.html Purpose: Ovarian cancer is the deadliest of women’s cancers diagnosed in the late stages, and therefore, it has a high mortality rate. There are several imaging methods for the diagnosis of ovarian tumors such as transvaginal ultrasound (TVU), positron emission tomography (PET), computed tomography (CT), and magnetic resonance imaging (MRI). Photoacoustic imaging (PAI) is a hybrid noninvasive imaging modality in which photoacoustic waves are produced as a result of thermoelastic expansion and contraction of irradiated tissue with laser light. Successful applications of PAI in the diagnosis of ovarian tumors have been reported. The purpose of this study is to investigate the efficacy of PAI in the early diagnosis of ovarian cancer. Methods: The articles used for this study were published from 2016 to 2022, and were obtained by searching the keywords of “photoacousticimaging”, “hybrid imaging” , “ovarian cancer”, and “diagnosis” in the databases of PubMed, Google Scholar, and ScienceDirect. Results: Photoacoustic imaging can be used as a complementary method along with other imaging modalities such as TVU for better management of ovarian cancer in the early stages.Photoacousticimagingisasafediagnostic method without using ionizing radiation that provides real-time detection of the tissue’s functional and molecular information. It has a high sensitivity to detect cancer metastases and a good penetration depth. Conclusion: Photoacoustic imaging is a complementary diagnostic method for early, efficient and safe diagnosis of ovarian cancer. Keywords: Photoacoustic imaging, Hybrid imaging, ovarian cancer, Diagnosis https://www.icrjournal.ir/article_179796.html Background and Purpose: Due to the prevalence of breast cancer and the importance of early detection As a result of the need to use its screening methods in the society and the importance and role of women teachers, The present study aims to determine the level of awareness, The attitude and behavior of female teachers in Zahedan city about breast cancer screening has been done. Methodology: This research is a descriptive and analytical study, the population of which is 300 female teachers of Zahedan schools in 1401, who will be randomly selected, and the collected information will be analyzed using statistical software such as spss. Findings: According to the studies we reviewed, it is expected that the level of knowledge of teachers about breast cancer and screening methods is average and their attitude is positive, but most of them do not use these methods. Therefore, in this research, the information of 300 female teachers of Zahedan schools will be collected, and after checking, it will be compared with similar studies. Conclusion: Women teachers due to the importance of their role in society; In order to increase their level of awareness and attitude towards breast cancer and screening programs and as a result to increase their participation in these screenings, they need to provide the necessary training in the field of breast cancer screening methods. Keywords: Breast cancer, screening, consciousness, attitude. https://www.icrjournal.ir/article_179797.html Purpose: Ovarian cancer is one of the malignancies of women that usually has no symptoms in the early stages and causes late diagnosis and even death in some cases. Although different imaging modalities are used to diagnose ovarian cancer, its early diagnosis and effective treatment are limited. Nanotheranostics are nanoscale materials that include diagnostic and therapeutic portions in a single platform. This study aims to investigate the role of nanotheranostic systems in the diagnosis and treatment of ovarian cancer. Methods: We searched the keywords “ovarian cancer”, “nanotheranostic systems”, “diagnosis” and “treatment” using Google Scholar, PubMed, Web of Science, and AltaVista search engines. Among the extracted articles, we reviewed the most related ones. Results: Different  imaging  modalities  such as MRI, fluorescent, and photoacoustic imaging, and treatment methods such as photothermal therapy, photodynamic therapy and chemotherapy were used to diagnose and treatment of ovarian cancer by different nanotheranostics. The diagnostic part of these nanotheranostics included the components such as iron oxide and gadolinium oxide nanoparticles for MRI and CuS quantum dots for fluorescent imaging. Based on the findings, human epidermal growth factor receptor 2 (HER2) targeted iron oxide nanoparticles showed a high ability to deliver the chemotherapy drug cisplatin to the ovary’s primary tumor and inhibited the tumor’s growth. Additionally, CuS-MnS2 nanotheranostic presented high potential in creating necroptosis in ovarian cancer cells by photothermal therapy. Also, the resolution of photoacoustic images was increased with the use of gold nanoparticles coated with reduced graphene oxide, providing more accurate information about the size and location of the tumor. Conclusion: Nanotheranostic systems can play a significant role in the diagnosis and treatment of ovarian cancer. Keywords:Ovariancancer, Nanotheranostic systems, Diagnosis, Treatment https://www.icrjournal.ir/article_179800.html Purpose: One of the challenges in DW imaging is the presence of noise, which reduces SNR. The presence of noise can definitely cause incorrect quantitative calculations, and especially in DT imaging where we need accurate calculations of the connections of brain white fiber structures, low SNR will be very troublesome. In this study, several noise reduction methods have been implemented on Diffusion-Weighted MR images of brain and compared with each other. Materials and Methods: DW images of 10 patients were initially used in a self-supervised method to denoise. This method, which uses an entire volume to learn a full-rank local linear eliminator for that volume, can separate structure from noise without requiring an explicit model for each, using q-space oversampled DWI data. Then three conventional methods of Non- Local Means and PCA with experimental thresholding and PCA by Marcenko-Pastur method are performed on all the images. In order to compare the success rate of denoise, the SNR value in the corpus callosum region was measured on all images. Results: According to the calculation of SNR in each direction, the average of all directions for each method was calculated in all images. The average SNR for self-supervised, non-local means, PCA with experimental thresholding, and PCA by Marcenko-Pastur method were 24.8, 23.4, 23.7, and 23.2, respectively. Conclusion: It seems that the self-supervised method is more successful than other methods in denoise DW images. Unlike other methods that assume certain properties in the signal structure, this method does not make such an assumption about the signal, instead, it uses the fact that the noise in the 3D volumes of the DWI signal originates from random fluctuations in the acquired signal, which is closer to the reality of the noise event. https://www.icrjournal.ir/article_179803.html Background: This study aimed to investigate the potential relationship between diffusion kurtosis imaging (DKI)- derived parameters and lymphovascular space invasion (LVSI) in patients with cervical carcinoma. Patients and Methods: This prospective study included 30 patients with cervical carcinoma. The patients underwent MRI, diffusion-weighted imaging (DWI), and DKI prior to surgery. The surgical pathology results were accepted as the reference standard for determining the LVSI status. The DKI-derived parameters, including mean diffusivity (MD) and mean kurtosis (MK), were measured. The apparent diffusion coefficient (ADC) value was also assessed. Results: The MD value of LVSI positive cervical carcinomas was significantly lower than LVSI negative carcinomas (p-value = 0.01). MK value was significantly higher in LVSI positive tumors (p-value = 0.01). However, the ADC value did not show a significant difference between LVSI positive and LVSI negative tumors (p-value = 0.2). MD and MK parameters showed similar diagnostic accuracy in identifying the LVSI status, with the area under the curve of 0.77 and 0.78, respectively. Conclusion: In this study, DKI-derived parameters were associated with the LVSI status in cervical carcinomas. Further studies with larger sample size are required to confirm these results. https://www.icrjournal.ir/article_179806.html Introduction: Gadolinium-based T1-weighted MRI sequence is the gold standard for the detection of active multiple sclerosis (MS) lesions. The performance of machine learning (ML) models in the classification of active and non- active MS lesions from the non-contrasted T2- weighted MRI images has been investigated in this study. Methods: 108 Features of 75 active and 100 non- active MS lesions was extracted by using SegmentEditor and Radiomics modules of 3D slicer software. 18 ML models have been made using the 5-fold cross-validation method and each model with its special optimized parameters has been trained by using the training-validation data sets. Performance models in test data set has been evaluated by metric parameters of accuracy, precision, sensitivity, specificity, AUC, and F1 score. Results: The highest values of accuracy (91.9%), precision (95.5%), sensitivity (85%), specificity (95.8%), AUC (94.2%), and F1 score (89.5%) have been seen in LogisticRegression model. Conclusion: The performance of ML models in the classification of active and non-active MS lesions was evaluated. The results of this study show that the LogesticRegression model is the best and reliable ML model for this purpose. Keywords: Multiple Sclerosis, Machine Learning, https://www.icrjournal.ir/article_179807.html   in kyphosis and lordosis measurement. It is Scoliosis radiography is useful in identifying the degree of the scoliosis curvature (major/ minor or primary/compensatory curves), as well as observe its progression to determine the best method of treatment The vertebral centroid angle is considered an alternative to the Cobb angle especially considered less susceptible to variations in the vertebral end-plate architecture Evaluation of spinal deviation measurement methods in lateral view and ap representation in Kyphosis and Scoliosis