Biological and biophysical techniques to assess radiation exposure: a perspective

Percutaneous Balloon Compression for Trigeminal Neuralgia. A Comparative Study Between the Fluoroscope Guided and Neuronavigated Technique

Percutaneous balloon compression (PBC) is a safe and effective procedure in the treatment of trigeminal neuralgia (TN) due to its simplicity, low cost and the possibility of being repeated in case of pain recurrence. Foramen ovale (FO) cannulation is accomplished with the assistance of intraoperative C-arm fluoroscopy. Recently, several authors have reported successful application of intraoperative CT navigation as well. The reported advantages of CT navigation are linked to better spatial orientation and the low rate of attempts for FO cannulation. However, these advantages should be considered in the face of concerns regarding increased radiation dose to the patient and its possible adverse effects. Here we compared the fluoroscopic guided and neuronavigated PBC techniques in terms of efficacy and radiological exposure. We retrospectively analyzed 37 patients suffering for TN and submitted to PBC. We observed a significant improvement of pain at 1 month FU compared with the pre-operative in both groups (p < 0.0001 and p < 0.0001, respectively). A significant increase in radiation exposure was found in the neuronavigated group compared with the fluoroscopy group (p < 0.0001). We suggest the use of neuronavigated PBC only in selected cases, such as patients with multiple previous operations, in whom a difficult access can be pre-operatively hypothesized.

Frequency of gamma H2AX foci in healthy volunteers and health workers occupationally exposed to X-irradiation and its relevance in biological dosimetry

Gamma-H2AX (γ-H2AX) assay is a marker to measure double-strand breaks in the deoxyribonucleic acid. Variables such as age, oxidative stress, temperature, genetic factors and inter-individual variation have been reported to influence the baseline γ-H2AX focus levels. Therefore, knowledge on baseline frequency of γ-H2AX foci in a targeted population would facilitate reliable radiation triage and dose estimation. The objective of the present study was to establish the baseline data using blood samples from healthy volunteers (n = 130) differing in age, occupation and lifestyle as well as from occupationally exposed health workers (n = 20). The γ-H2AX focus assay was performed using epifluorescence microscopy. In vitro dose-response curve for γ-H2AX foci was constructed in blood samples (n = 3) exposed to X-rays (30 min post-exposure). The mean γ-H2AX focus frequency obtained in healthy volunteers was 0.042 ± 0.001 and showed an age-related increase (p < 0.001). Significantly higher (p < 0.005) focus frequencies were observed in health workers (0.066 ± 0.005) than in healthy volunteers. A sub-group analysis did not show a significant (p > 0.1) difference in γ-H2AX focus frequency among sexes. Blood exposed in vitro to X-rays showed dose-dependent increase in γ-H2AX foci frequency (Y = 0.1902 ± 0.1363 + 2.9020 ± 0.3240 * D). Baseline frequency of γ-H2AX foci obtained from different age groups showed a significant (p < 0.01) influence on the dose-response coefficients. The overall results demonstrated that the γ-H2AX assay can be used as a reliable biomarker for radiation triage and estimating the radiation absorbed dose by considering variables such as age, occupation and lifestyle factors.

Biomarkers of space radiation risk

Radiation risk estimates are based on epidemiological data obtained on Earth for cohorts exposed predominantly to acute doses of gamma rays, and the extrapolation to the space environment is highly problematic and error-prone. The uncertainty can be reduced if risk estimates are compared directly to space radiation-induced biological alterations, i.e. by detecting biomarkers in astronauts. Chromosomal aberrations in peripheral blood lymphocytes are the only biomarker that can provide simultaneous information on dose, dose equivalent and risk, and they have been measured extensively in astronauts during the past 10 years. Individual relative risks calculated from chromosomal aberration measurements in crew members after single space missions in low-Earth orbit fall in the same range as the estimates derived from physical dosimetry, suggesting that the current system for radiogenic risk evaluation is essentially sound. However, the output of the biomarker test is dependent upon the sampling time. Recent results show a fast time-dependent decay of chromosomal aberrations in blood lymphocytes after space flight and a lack of correlation between translocations and cumulative dose in astronauts involved in two to five space missions. This "time factor" may reflect individual variability and time dependence in the risk produced by exposure to cosmic radiation during the flight. Biomarkers may be superior to dose in predicting space radiation risk, pending technical improvements in sensitivity, and validation by epidemiological studies.

Membrane solubilization in erythrocytes as a measure of radiation exposure to fast neutrons

Membrane solubilization and osmotic fragility of rat erythrocytes irradiated in vivo with fast neutron fluences ranging from 10(6) to 5 x 10(7) n cm(-2) using a 252Cf source were measured instantaneously using a light scattering technique. The solubilization of erythrocyte membrane by a non-ionic detergent, octylglucoside (OG), was found to exhibit a two stage transition from vesicular form to mixed micellar form in the range of detergent concentrations 1.5-7.8 mM. The coexistence phase, vesicular/mixed micellar, was shifted towards higher detergent concentrations with increase in the neutron fluence, indicating increasing membrane resistance to the detergent and hence change in the natural membrane permeation properties. The technique shows an adequate sensitivity in detecting membrane damage in erythrocytes and has potential as a biophysical marker of radiation exposure. The osmotic fragility of irradiated erythrocytes shows a decreasing trend with increasing irradiation fluence measured directly and two weeks post-irradiation. Blood films photographed two weeks post-irradiation show developed elliptocytosis and crenated cell anaemia.

Preliminary study of dose equivalent evaluation for residents in radioactivity contaminated rebar buildings

It has recently been found that several resident and office buildings in Taiwan were constructed with 60Co-contaminated reinforcing steel bar (rebar). Both governmental officials and the residents of such buildings have been concerned about this finding. In order to respond to the situation, the government has adopted a number of remedial measures, including full-scale radiation survey, dose evaluation and physical examinations of residents. This article presents three methods for evaluating the dose equivalents of the residents living in the contaminated rebar buildings by means of gamma-ray survey, necklace-type thermoluminescence dosimeters (TLDs) and the human lymphocyte chromosome aberration analyses. The results reveal that the dose evaluation by gamma-ray survey is rather conservative. Generally for the residents whose annual dose equivalents are greater than 5 mSv (0.5 rem) by gamma-ray survey, the dose equivalents from necklace-type TLDs are only within the range of 20 to 50% of the evaluated values mentioned above. For chromosome analyses, at least 500 lymphocyte cells were scored and analyzed for each resident. Most of the chromosome analysis data show that the dose equivalents received by residents are lower than the detection limit of the method (100 mSv) and quite different from the estimated dose obtained from either gamma-ray survey or necklace-type TLD measurements.