Induction of unstable and stable chromosomal aberrations by 99mTc: in-vitro and in-vivo studies

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

Radiation dosimetric biomarkers have found applications beyond radiation protection area and now are actively introduced into clinical practice. Cytogenetic assays appeared to be a valuable tool for individualized quantifying radiation effects in patients, with high capability for assessing genotoxicity of various medical exposure modalities and providing meaningful radiation dose estimates for prognoses of radiation-related cancer risk. This review summarized current data on the use of biological dosimetry methods in patients undergoing various medical irradiations to low doses. The highlighted topics include basic aspects of biological dosimetry and its limitations in the range of low radiation doses, and main patterns of in vivo induction of radiation biomarkers in clinical exposure scenarios, occurring in X-ray diagnostics, computed tomography, interventional radiology, low dose radiotherapy, and nuclear medicine (internally administered ¹³¹I and other radiopharmaceuticals). Additionally, several specific issues, examined by biodosimetry techniques, are analysed, such as contrast media effect, radiation response in pediatric patients, impact of magnetic resonance imaging, evaluation of radioprotectors, detection of patients' abnormal intrinsic radiosensitivity and dose estimation in persons involved in medical radiation incidents. A prognosis of possible directions for further improvements in this area includes the automation of cytogenetic analysis, introduction of molecular biodosimeters and development of multiparametric biodosimetry platforms. A potential approach to the advanced biodosimetry of internal exposure and/or low dose external irradiation is suggested; this can be a multiparametric platform based on the combination of the γ-H2AX foci, dicentric, and translocation assays, each applied in the optimum postexposure time range, with the amalgamation of the dose estimates. The study revealed the necessity of further research, which might clarify medical radiation safety concerns for patients via using stringent biodosimetry methodology.

Chromosome aberrations during in-vitro labeling of red blood cells with 99mTc: a study with cytokinesis block micronucleus assay in human peripheral blood lymphocytes

Radiopharmaceuticals are special medicines composed by a radionuclide and a non-radioactive compound characterized by non-pharmacodynamic effects, low prevalence of side effects, and a possible risk of oncogenesis, since its administration to patients supposes a radiation dose to organism. Over these years, radiation damage induced by diagnosis radiopharmaceuticals has been evaluated, including the radiolabeled autologous cells, a group of radiopharmaceuticals where blood cells extracted from patients are labeled in-vitro and readministered for diagnosis. There is not a consensus about the possibility of increasement of risk for malignancies associated with the radiolabeled blood cells, so for a more accurate evaluation of the potential oncogenic risk related to the administration of [Tc]Tc labeled red blood cells, radiation dose received by the cells during the labeling process is studied by means of the cytokinesis-blocked micronucleus (CBMN) assay and a dose-response curve constructed by in-vitro external irradiation of blood samples. Our work enables to establish the range of activity to be added during the in-vitro labeling of red blood cells with [Tc]Tc pertechnetate to avoid radiation damage to cells. Activities recommended for blood volume determination and angiography do not increase the risk of malignancies, whilst activities of 370 MBq show chromosome aberrations in lymphocytes. Evaluation of the radiation damage related to the in-vitro labeling is recommended to estimate the potential oncogenic risk and minimize it.

PHA stimulation may be useful for FDXR gene expression-based biodosimetry

OBJECTIVES

Nowadays, ionizing radiation (IR) has a significant contribution to the diagnostic and therapeutic medicine, and following that, health risks to individuals through unexpected exposure is greatly increased. Therefore, biological and molecular technology for estimation of dose (biodosimetry) is taken into consideration. In biodosimetry methods stimulation of cells to proliferation is routine to achieve more sensitivity of techniques. However, this concept has recently been challenged by new molecular methods such as gene expression analysis. This study aims to investigate the stimulation effects on gene expression biodosimetry.

MATERIALS AND METHODS

The blood samples were taken from15 patients who were irradiated by TC-99 MIBI, before radiopharmaceutical injection and 24 hr after injection. Lymphocytes were extracted immediately and activated by (phytohemagglutinin) PHA for 24 hr and XPA and FDXR expression levels were investigated by employing relative quantitative Real-Time PCR.

RESULTS

The results of this study show a significant increase in the FDXR expression level and a significant decrease in the XPA after stimulation of irradiated lymphocytes. Interestingly, a significant increasing trend in the FDXR expression level (at 0.05 significance level) following cell stimulation to the division was observed.

CONCLUSION

Our results suggest that the PHA activation role in gene expression-based biodosimetry is strongly depended on the target genes and the relevant protein pathways. Finally, cell stimulation looks to be useful for some specific genes, such as FDXR, due to the increasing trend in expression and improvement of sensitivity of gene expression-based biodosimetry method.