ESR investigation of joint use of dentin and tooth enamel to estimate photon and neutron dose components of a mixed field

Electron Paramagnetic Resonance (EPR) Biodosimetry with Human Teeth: A Crucial Technique for Acute and Chronic Exposure Assessment

ABSTRACT

Radiation exposure is a primary concern in emergency response scenarios and long-term health assessments. Accurate quantification of radiation doses is critical for informed decision-making and patient care. This paper reviews the dose reconstruction technique using both X- and Q-bands, with tooth enamel as a reliable dosimeter. Tooth enamel, due to its exceptional resistance to alteration over time, offers a unique opportunity for assessing both acute and chronic radiation exposures. This review delves into the principles underlying enamel dosimetry, the mechanism of radiation interactions, and dose retention in tooth enamel. We explore state-of-the-art analytical methods, such as electron paramagnetic resonance (EPR) spectroscopy, that accurately estimate low and high doses in acute and chronic exposure. Furthermore, we discuss the applicability of tooth enamel dosimetry in various scenarios, ranging from historical radiological incidents to recent nuclear events or radiological incidents. The ability to reconstruct radiation doses from dental enamel provides a valuable tool for epidemiological studies, validating the assessment of health risks associated with chronic exposures and aiding in the early detection and management of acute radiation incidents. This paper underscores the significance of tooth enamel as an essential medium for radiation dose reconstruction and its broader implications for enhancing radiation protection, emergency response, and public health preparedness. Incorporating enamel EPR dosimetry into standard protocols has the potential to transform the field of radiation assessment, ensuring more accurate and timely evaluations of radiation exposure and its associated risks.

RENEB Inter-Laboratory Comparison 2021: Inter-Assay Comparison of Eight Dosimetry Assays

Tools for radiation exposure reconstruction are required to support the medical management of radiation victims in radiological or nuclear incidents. Different biological and physical dosimetry assays can be used for various exposure scenarios to estimate the dose of ionizing radiation a person has absorbed. Regular validation of the techniques through inter-laboratory comparisons (ILC) is essential to guarantee high quality results. In the current RENEB inter-laboratory comparison, the performance quality of established cytogenetic assays [dicentric chromosome assay (DCA), cytokinesis-block micronucleus assay (CBMN), stable chromosomal translocation assay (FISH) and premature chromosome condensation assay (PCC)] was tested in comparison to molecular biological assays [gamma-H2AX foci (gH2AX), gene expression (GE)] and physical dosimetry-based assays [electron paramagnetic resonance (EPR), optically or thermally stimulated luminescence (LUM)]. Three blinded coded samples (e.g., blood, enamel or mobiles) were exposed to 0, 1.2 or 3.5 Gy X-ray reference doses (240 kVp, 1 Gy/min). These doses roughly correspond to clinically relevant groups of unexposed to low exposed (0-1 Gy), moderately exposed (1-2 Gy, no severe acute health effects expected) and highly exposed individuals (>2 Gy, requiring early intensive medical care). In the frame of the current RENEB inter-laboratory comparison, samples were sent to 86 specialized teams in 46 organizations from 27 nations for dose estimation and identification of three clinically relevant groups. The time for sending early crude reports and more precise reports was documented for each laboratory and assay where possible. The quality of dose estimates was analyzed with three different levels of granularity, 1. by calculating the frequency of correctly reported clinically relevant dose categories, 2. by determining the number of dose estimates within the uncertainty intervals recommended for triage dosimetry (±0.5 Gy or ±1.0 Gy for doses <2.5 Gy or >2.5 Gy), and 3. by calculating the absolute difference (AD) of estimated doses relative to the reference doses. In total, 554 dose estimates were submitted within the 6-week period given before the exercise was closed. For samples processed with the highest priority, earliest dose estimates/categories were reported within 5-10 h of receipt for GE, gH2AX, LUM, EPR, 2-3 days for DCA, CBMN and within 6-7 days for the FISH assay. For the unirradiated control sample, the categorization in the correct clinically relevant group (0-1 Gy) as well as the allocation to the triage uncertainty interval was, with the exception of a few outliers, successfully performed for all assays. For the 3.5 Gy sample the percentage of correct classifications to the clinically relevant group (≥2 Gy) was between 89-100% for all assays, with the exception of gH2AX. For the 1.2 Gy sample, an exact allocation to the clinically relevant group was more difficult and 0-50% or 0-48% of the estimates were wrongly classified into the lowest or highest dose categories, respectively. For the irradiated samples, the correct allocation to the triage uncertainty intervals varied considerably between assays for the 1.2 Gy (29-76%) and 3.5 Gy (17-100%) samples. While a systematic shift towards higher doses was observed for the cytogenetic-based assays, extreme outliers exceeding the reference doses 2-6 fold were observed for EPR, FISH and GE assays. These outliers were related to a particular material examined (tooth enamel for EPR assay, reported as kerma in enamel, but when converted into the proper quantity, i.e. to kerma in air, expected dose estimates could be recalculated in most cases), the level of experience of the teams (FISH) and methodological uncertainties (GE). This was the first RENEB ILC where everything, from blood sampling to irradiation and shipment of the samples, was organized and realized at the same institution, for several biological and physical retrospective dosimetry assays. Almost all assays appeared comparably applicable for the identification of unexposed and highly exposed individuals and the allocation of medical relevant groups, with the latter requiring medical support for the acute radiation scenario simulated in this exercise. However, extreme outliers or a systematic shift of dose estimates have been observed for some assays. Possible reasons will be discussed in the assay specific papers of this special issue. In summary, this ILC clearly demonstrates the need to conduct regular exercises to identify research needs, but also to identify technical problems and to optimize the design of future ILCs.

EPR dosimetry with tooth enamel: A review

When tooth enamel is exposed to ionizing radiation, radicals are formed, which can be detected using electron paramagnetic resonance (EPR) techniques. EPR dosimetry using tooth enamel is based on the (presumed) correlation between the intensity or amplitude of some of the radiation-induced signals with the dose absorbed in the enamel. In the present paper a critical review is given of this widely applied dosimetric method. The first part of the paper is fairly fundamental and deals with the main properties of tooth enamel and some of its model systems (e.g., synthetic apatites). Considerable attention is also paid to the numerous radiation-induced and native EPR signals and the radicals responsible for them. The relevant methods for EPR detection, identification and spectrum analyzing are reviewed from a general point of view. Finally, the needs for solid-state modelling and studies of the linearity of the dose response are investigated. The second part is devoted to the practical implementation of EPR dosimetry using enamel. It concerns specific problems of preparation of samples, their irradiation and spectrum acquisition. It also describes how the dosimetric signal intensity and dose can be retrieved from the EPR spectra. Special attention is paid to the energy dependence of the EPR response and to sources of uncertainties. Results of and problems encountered in international intercomparisons and epidemiological studies are also dealt with. In the final section the future of EPR dosimetry with tooth enamel is analyzed.

Study of materials for mixed field dosimetry by EPR spectroscopy

EPR dose reconstruction after accidental photon exposure based on materials irradiated in the vicinity of the victim (sucrose, medicine tablets, etc.) was used successfully in several cases referenced in the literature. However, accidental exposure may also occur with a neutron component such as in the Tokai-Mura criticality accident. The aim of this work is to investigate the potentiality of EPR dosimetry for mixed photon and neutron field exposure with different organic materials already used for photon exposure (sucrose) or with potential dosimetric properties (ascorbic acid, sorbitol, glucose, galactose, fructose, lactose and mannose). To assess the neutron sensitivity, the materials were exposed to a mixed radiation field of an experimental reactor with different neutron to photon ratios. The relative neutron sensitivity was found to range from 12 to 43% according to the materials. The potentiality of these materials for mixed field EPR dosimetry is discussed.

EPR properties of intact and deproteinated dentin

The effect of sample preparation on dentin electron paramagnetic resonance (EPR) spectra was investigated. The analysis was performed on dentin samples prepared by pure mechanical treatment or by an alkaline deproteination method. It was observed that (1) mechanical treatment induces both stable and transient signals, depending on the specific mechanical operation applied; and (2) sodium hydroxide deproteination removes the native signal, but at the same time introduces new confounding signals in the EPR spectrum. Also, it increases the radiation sensitivity of dentin. These findings suggest that attention must be paid to dentin sample preparation.