Clinical Applications of Biological Dosimetry in Patients Exposed to Low Dose Radiation Due to Radiological, Imaging or Nuclear Medicine Procedures

Extending culture time to improve Mitotic Index for cytogenetic dosimetry

PURPOSE

To analyze the effects of extending lymphocyte cultivation time on the Mitotic Index, frequency of first-division cells, and dose estimation after irradiating blood samples with different doses of radiation.

MATERIALS AND METHODS

Blood samples from two healthy male volunteers were separately irradiated with three doses (3, 5, and 6 Gy) using a 60Co gamma source (average dose rate: 1.48 kGy.h-1) and cultivated in vitro for conventional (48 h) and extended (56, 68, and 72 h) amounts of time. Colcemid (0.01 µg.mL-1) was added at the beginning of the culture period. Cells were fixed, stained with fluorescence plus Giemsa (FPG), and analyzed under a light microscope. The effects of prolonged culture duration on the Mitotic Index (MI), frequency of first-division cells (M1 cells), and the First-Division Mitotic Index (FDMI) were investigated. The estimation of delivered doses was conducted using a conventional 48h-culture calibration curve.

RESULTS

Overall, cells presented higher MI (up to 12-fold) with the extension of culture, while higher radiation doses led to lower MI values (up to 80% reduction at 48 h). Cells irradiated with higher doses (5 and 6 Gy) had the most significant increase (5- to 12-fold) of MI as the cultivation was prolonged. The frequency of M1 cells decreased with the prolongation of culture for all doses (up to 75% reduction), while irradiated cells presented higher frequencies of M1 cells than non-irradiated ones. FDMI increased for all irradiated cultures but most markedly in those irradiated with higher doses (up to 10-fold). The conventional 48h-culture calibration curve proved adequate for assessing the delivered dose based on dicentric frequency following a 72-hour culture.

CONCLUSION

Compared to the conventional 48-hour protocol, extending the culture length to 72 hours significantly increased the Mitotic Index and the number of first-division metaphases of irradiated lymphocytes, providing slides with a better scorable metaphase density. Extending the culture time to 72 hours, combined with FPG staining to score exclusively first-division metaphases, improved the counting of dicentric chromosomes. The methodology presented and discussed in this study can be a powerful tool for dicentric-based biodosimetry, especially when exposure to high radiation doses is involved.

Low-dose radiation from CT examination induces DNA double-strand breaks and detectable changes of DNA methylation in peripheral blood cells

BACKGROUND

Radiation burden from CT examinations increases rapidly with the increased clinical use frequency. Previous studies have disclosed the association between radiation exposure and increased double-strand breaks (DSBs) and changes in DNA methylation. However, whether the induced DSBs by CT examination recover within 24h and whether a CT examination induces detectable gene-specific methylation changes are still unclear. The aim of the present study was to analyze γ-H2AX in the peripheral blood lymphocyte (PBL) of healthy adults before and after CT examination and to discover the differentially methylated positions (DMPs) along with an analysis of DNA methylation changes caused by CT examination.

MATERIALS AND METHODS

Peripheral blood samples of 4 ml were drawn from 20 healthy volunteers at three time points: before CT examination, after CT examination 1h, and after CT examination 24h. γ-H2AX immunofluorescence and Illumina Infinium Human Methylation EPIC BeadChip (850k BeadChip) were used respectively for the test of DSBs and the epigenome-wide DNA methylation analysis. Linear mixed-effect (LME) models were used to evaluate the impacts of doses represented by different parameters and foci on genome-wide DNA methylation.

RESULTS

The number of γ-H2AX foci per cell at 1h showed linear dose-responses for the radiation doses represented by CT index volume (CTDIvol), dose length product (DLP), and blood absorbed dose, respectively. Residual γ-H2AX foci was observed after CT examination at 24h (p < .001). DMPs and γ-H2AX foci changes could be found within 1h. One CpG site related to PAX5 was significantly changed by using most of the parameters in LME models and did not recover till 24h.

CONCLUSIONS

Residual γ-H2AX foci exist after CT examination at 24h. The DNA methylation changes induced by CT examination may not recover within 24h. The DNA methylation had been changed as early as at 1h. The PAX5-related CpG site may be a potential biomarker of low-dose radiation.

CLINICAL RELEVANCE

The biological effects and the cancer risks of CT examination are still unclear. The present study is an effort to document the CT scan-induced events in 24h in vivo. The CT scanning area should be strictly limited, and non-essential repeated operations shouldn't be performed within 24h.

Revision of cytogenetic dosimetry in the IAEA manual 2011 based on data about radio-sensitivity and dose-rate findings contributing

In order to achieve the goal of rapid response, effective controland protection of life inlarge-scale radiation events, the IAEA Manual 2011 has been revised based on the data of radio-sensitivity, dose-rate findings. Analyze individual differences in radiation sensitivity using ⁶⁰ Co radiation (0.27 Gy/min). Chromosomal aberrations with different irradiation dose rates were used to establish the biological dose curve and analyze the excess of the "dicentric + ring" caused by the dose rate at each dose point; DAPI-images and Metafer 4 were used to capture metaphase images and make further analysis. The data were collected in 2020, Dicentric + ring/100 Cells was 17.5-43.8, the average value was28.32 ± 6.98. The mean value of Dicentric + ring/100 Cells was 31.37 in males while 25.27 in females, there are significant differences (p < .01). The irradiation dose is dominant, At each dose point, the value of"(dicentric chromosome + centric rings)/cell" is proportional to "dose rate", that is, Y = kx + b, within the dose range of 1-5 Gy, "(dicentric chromosome + centric rings)/Cell" holds a quadratic linear relationship with dose rate, that is, y = ax²  + bx + c; The DAPI-images might give you more hints than those of conventional Giemsa-stain. The authors recommend that the IAEA Manual 2011 could be revised based on data of radio-sensitivity and dose-rate, which may contribute to the establishment of a unified dose-response calibration curve and stimulation of potential for automation in cytogenetic biodosimetry. (1) Individual differences of radiosensitivity are very large. (2) At each dose point, "(dicentric chromosome + centric rings)/cell" is proportional to "dose rate", that is, Y = kx + b. (3) "(dicentric chromosome + centric rings)/Cell" is a quadratic linear relationship with dose rate, that is, y = ax²  + bx + c. (4) We created a "Unity Standard Curve of Biological Dose Estimation". Creating a Unity Standard Curve of Biological Dose, under these circumstances, we can form a joint and rapid response to a nuclear and radiological accident.