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Supplemental material, sj-docx-1-tam-10.1177_17588359221119370 for Immunogenicity of SARS-CoV-2 vaccines in patients with breast cancer by Elyssa Denault, Erika Nakajima, Vivek Naranbhai, Jennifer A. Hutchinson, Lindsey Mortensen, Elizabeth Neihoff, Caroline Barabell, Amy Comander, Dejan Juric, Irene Kuter, Theresa Mulvey, Jeffrey Peppercorn, Aron S. Rosenstock, Jennifer Shin, Neelima Vidula, Seth A. Wander, Beverly Moy, Leif W. Ellisen, Steven J. Isakoff, A. John Iafrate, Justin F. Gainor, Aditya Bardia and Laura M. Spring in Therapeutic Advances in Medical Oncology

Supplemental material, sj-docx-1-tam-10.1177_17588359221119370 for Immunogenicity of SARS-CoV-2 vaccines in patients with breast cancer by Elyssa Denault, Erika Nakajima, Vivek Naranbhai, Jennifer A. Hutchinson, Lindsey Mortensen, Elizabeth Neihoff, Caroline Barabell, Amy Comander, Dejan Juric, Irene Kuter, Theresa Mulvey, Jeffrey Peppercorn, Aron S. Rosenstock, Jennifer Shin, Neelima Vidula, Seth A. Wander, Beverly Moy, Leif W. Ellisen, Steven J. Isakoff, A. John Iafrate, Justin F. Gainor, Aditya Bardia and Laura M. Spring in Therapeutic Advances in Medical Oncology

Purpose Recently, digital X-ray tomosynthesis using flat panel detectors (FPD) has been used to diagnose the inner ears of pediatric patients. This imaging provides intermediate functionality between X-ray photographs and X-ray computer tomography (CT) scans. However, during inner ear diagnosis, digital X-ray tomosynthesis includes the eye lens in its field of view; an organ sensitive to X-ray doses. The purpose of this research is to evaluate the X-ray dosage upon the eye lens during inner ear diagnosis using digital tomosynthesis and to compare this dosage with X-ray CT exposure. Methods Small optically stimulated luminescence (OSL) dosimeters (nanodot: Nagase Landauer, Ltd.) were positioned on the eye lens of a phantom and on the bed of an X-ray TV device to measure the kinetic energy released per unit mass of air (air kerma). We performed tomosynthesis, assuming the conditions for an inner ear examination of an infant. The irradiant conditions were a tube voltage of 60–110 kV, an added filter of 0.1 mmCu, a swing angle θ of ± 20 °, and 76 photographs of a flame. The absorbed dose for the eye lens was calculated using the mass energy absorption coefficient ratio of the eye lens and air. In addition, the eye lens absorbed dose was compared with an X-ray CT scan. Results As the tube voltage increased, the absorbed dose increased. Moreover, when placed in a posterior-anterior (PA) position, as the phantom thickness increased, the absorbed dose decreased. On the contrary, when in an anterior-posterior (AP) position, as phantom thickness increased, the absorbed dose increased. Conclusions The eye lens absorbed dose in the PA position decreased by 90% compared to AP-positioning when using digital tomosynthesis for inner ear diagnosis of pediatric patients. Additionally, the eye lens absorbed dose in PA-positioned digital tomosynthesis decreased 93% compared to X-ray CT scans. Therefore, it is useful to reduce the exposure dose of the eye lens during inner ear diagnosis of pediatric patients via the use of digital tomosynthesis imaging.

Purpose The diagnostic reference level (DRLs) was proposed to a patient dose as a tool for optimization by diagnostic X-ray examination. The purpose of this study was to estimate the entrance surface dose for the different types of X-ray examinations of the hospital. In this study, a novel calculation system was developed for estimating the entrance surface doses and the result of the local survey about the patient dose of the local area was reanalyzed. Methods The entrance surface dose by novel calculation system (call estimation patient dose calculation system: EPD) is calculated using the parameter of an X-ray output (tube voltage, current time product, filtration, focus-skin distance, field size, etc.). The coefficient which standardized the output in each conditions based on the measurement result of a standard air kerma is used for this calculation system. Although the standard body thickness according to types of X-ray examination, exposure field size, etc. are used in initial setting, modification is also possible respectively. The entrance surface dose by means of survey continuously conducted by the Ibaraki Association of Radiologic Technologists from 1988 to the hospital in Ibaraki Prefecture was re-analyzed using this calculation system. Results As for the calculation result, a maximum of +20% of difference was confirmed to the measurement result of an ionization chamber type dosimeter (DC300: Wellhofer). However, it is proper as an estimate to the survey for attaining rationalization of a dose. There is a limit in accurate dose estimate by the range of 40–150 kV tube voltage, the difference in filtration, etc. Although the dose was a decline tendency on the whole in the re-analysis result of the patient dose by the novel dose calculation system, transition is trifling in recent years. Conclusions A novel calculation system was developed for estimating the entrance surface dose and the result of the local survey about the patient dose of the area was reanalyzed. The accuracy of dose estimation was investigated and the usefulness was confirmed. The transition of the level of the patient doses in a local area has been grasped.