Optically stimulated luminescence (OSL) of dental enamel for retrospective assessment of radiation exposure

This paper briefly reviews the optically stimulated luminescence (OSL) properties of dental enamel and discusses the potential and challenges of OSL for filling the technology gap in biodosimetry required for medical triage following a radiological/nuclear accident or terrorist event. The OSL technique uses light to stimulate a radiation-induced luminescence signal from materials previously exposed to ionizing radiation. This luminescence originates from radiation-induced defects in insulating crystals and is proportional to the absorbed dose of ionizing radiation. In our research conducted to date, we focused on fundamental investigations of the OSL properties of dental enamel using extracted teeth and tabletop OSL readers. The objective was to obtain information to support the development of the necessary instrumentation for retrospective dosimetry using dental enamel in laboratory, or for in situ and non-invasive accident dosimetry using dental enamel in emergency triage. An OSL signal from human dental enamel was detected using blue, green, or IR stimulation. Blue/green stimulation associated with UV emission detection seems to be the most appropriate combination in the sense that there is no signal from un-irradiated samples and the shape of the OSL decay is clear. Improvements in the minimum detection level were achieved by incorporating an ellipsoidal mirror in the OSL system to maximize light collection. Other possibilities to improve the sensitivity and research steps necessary to establish the feasibility of the technique for retrospective assessment of radiation exposure are also discussed.     

Book Reviews

Abstract

Guidelines for Agricultural Countermeasures Following an Accidental Release of Radionuclides. (TECHNICAL REPORTS SERIES No. 363, IAEA Vienna, 1994, 115 pp.)

Handbook of Parameter Values for the Prediction of Radionuclide Transfer in Temperate Environments. (TECHNICAL REPORTS SERIES No. 364, IAEA Vienna 1994, 74 pp.)

Sources and Magnitude of Occupational and Public Exposures from Nuclear Medicine Procedures. Recommendations of the National Coouncil on Radiation Protection and Measurements. NCRP Report No. 124 Bethesda, MD, USA, 1996, 77 pp.

Deposition, Retention and Dosimetry of Inhaled Radioactive Substances. Recommendations of the National Council on Radiation Protection and Measurements. NCRP Report No. 125, 253 pp., Bethesda, MD, 1997, $40.     

Biodosimetry versus physical dosimetry for emergency dose assessment following large-scale radiological exposures

Existing data on intercomparisons involving biodosimetry or physical dosimetry methods are analyzed and the results interpreted regarding their efficacy in triage in emergency dosimetry following mass casualty radiological events. The biodosimetry technique examined is dicentric chromosome aberrations (DCA). The physical dosimetry techniques include electron paramagnetic resonance (EPR) of biological material (teeth) and physical material (smartphone screen glass), and optically stimulated luminescence (OSL) of electronic components (surface mount resistors) from mobile phones. Issues relating to calibration and interpretation of the data are discussed. An important conclusion of the analysis is that more research is critically needed to interpret the efficacy of the various methods. Included in this needed research are intercomparisons of the various methods in controlled experiments and the need to harmonize protocols.     

Protocol for emergency EPR dosimetry in fingernails

There is an increased need for after-the-fact dosimetry because of the high risk of radiation exposures due to terrorism or accidents. In case of such an event, a method is needed to make measurements of dose in a large number of individuals rapidly and with sufficient accuracy to facilitate effective medical triage. Dosimetry based on EPR measurements of fingernails potentially could be an effective tool for this purpose. This paper presents the first operational protocols for EPR fingernail dosimetry, including guidelines for collection and storage of samples, parameters for EPR measurements, and the method of dose assessment. In a blinded test of this protocol application was carried out on nails freshly sampled and irradiated to 4 and 20 Gy; this protocol gave dose estimates with an error of less than 30%.     

A Framework for Comparative Evaluation of Dosimetric Methods to Triage a Large Population Following a Radiological Event

BACKGROUND: To prepare for a possible major radiation disaster involving large numbers of potentially exposed people, it is important to be able to rapidly and accurately triage people for treatment or not, factoring in the likely conditions and available resources. To date, planners have had to create guidelines for triage based on methods for estimating dose that are clinically available and which use evidence extrapolated from unrelated conditions. Current guidelines consequently focus on measuring clinical symptoms (e.g., time-to-vomiting), which may not be subject to the same verification of standard methods and validation processes required for governmental approval processes of new and modified procedures. Biodosimeters under development have not yet been formally approved for this use. Neither set of methods has been tested in settings involving large-scale populations at risk for exposure. OBJECTIVE: To propose a framework for comparative evaluation of methods for such triage and to evaluate biodosimetric methods that are currently recommended and new methods as they are developed. METHODS: We adapt the NIH model of scientific evaluations and sciences needed for effective translational research to apply to biodosimetry for triaging very large populations following a radiation event. We detail criteria for translating basic science about dosimetry into effective multi-stage triage of large populations and illustrate it by analyzing 3 current guidelines and 3 advanced methods for biodosimetry. CONCLUSIONS: This framework for evaluating dosimetry in large populations is a useful technique to compare the strengths and weaknesses of different dosimetry methods. It can help policy-makers and planners not only to compare the methods' strengths and weaknesses for their intended use but also to develop an integrated approach to maximize their effectiveness. It also reveals weaknesses in methods that would benefit from further research and evaluation.     

Biological Dosimetry by the Triage Dicentric Chromosome Assay - Further validation of International Networking

Biological dosimetry is an essential tool for estimating radiation doses received to personnel when physical dosimetry is not available or inadequate. The current preferred biodosimetry method is based on the measurement of radiation-specific dicentric chromosomes in exposed individuals' peripheral blood lymphocytes. However, this method is labour-, time- and expertise-demanding. Consequently, for mass casualty applications, strategies have been developed to increase its throughput. One such strategy is to develop validated cytogenetic biodosimetry laboratory networks, both national and international. In a previous study, the dicentric chromosome assay (DCA) was validated in our cytogenetic biodosimetry network involving five geographically dispersed laboratories. A complementary strategy to further enhance the throughput of the DCA among inter-laboratory networks is to use a triage DCA where dose assessments are made by truncating the labour-demanding and time-consuming metaphase-spread analysis to 20 to 50 metaphase spreads instead of routine 500 to 1000 metaphase spread analysis. Our laboratory network also validated this triage DCA, however, these dose estimates were made using calibration curves generated in each laboratory from the blood samples irradiated in a single laboratory. In an emergency situation, dose estimates made using pre-existing calibration curves which may vary according to radiation type and dose rate and therefore influence the assessed dose. Here, we analyze the effect of using a pre-existing calibration curve on assessed dose among our network laboratories. The dose estimates were made by analyzing 1000 metaphase spreads as well as triage quality scoring and compared to actual physical doses applied to the samples for validation. The dose estimates in the laboratory partners were in good agreement with the applied physical doses and determined to be adequate for guidance in the treatment of acute radiation syndrome.     

Book Reviews

Nuclear Chemistry: O. Navratil, J. Hala, R. Kopunec, F. Macasek, V. Mikulaj, L. Leseticky, Translated from Czech to English by J. Hala and P. Huth, Ellis Horwood PTR Prentice Hall, New York (Physical Chemistry Series) and Academia Publishing House, Prague 1992, 389 pp.

Limitation of Exposure to Ionizing Radiation: Recommendations of the National Council on Radiation Protection and Measurements. NCRP Report No. 116, Bethesda, Maryland, 1993,88 pp.     

Electron paramagnetic resonance radiation dosimetry in fingernails

There is now an increased need for accident dosimetry due to the increased risk of significant exposure to ionizing radiation from terrorism or accidents. In such scenarios, dose measurements should be made in individuals rapidly and with sufficient accuracy to enable effective triage. Electron paramagnetic resonance (EPR) is a physical method of high potential for meeting this need, providing direct measurements of the radiation-induced radicals, which are unambiguous signatures of exposure to ionizing radiation. For individual retrospective dosimetry, EPR in tooth enamel is a proven and effective technique when isolated teeth can be obtained. There are some promising developments that may make these measurements feasible without the need to remove the teeth, but their field applicability remains to be demonstrated. However, currently it is difficult under emergency conditions to obtain tooth enamel in sufficient amounts for accurate dose measurements. Since fingernails are much easier to sample, they can be used in potentially exposed populations to determine if they were exposed to life-threatening radiation doses. Unfortunately, only a few studies have been carried out on EPR radiation-induced signals in fingernails, and, while there are some promising aspects, the reported results were generally inconclusive. In this present paper, we report the results of a systematic investigation of the potential use of fingernails as retrospective radiation dosimeters.     

Image – Based “film” dosimetry in NILPRP SSDL

This paper presents the 1D, 2D & 3D dose distribution determination method using the Real Time Dosimetry (RTD) system in NILPRP Secondary Standard Dosimetry Laboratory (SSDL). MULTIDATA has extended the RTD system to perform traditional film dosimetry tasks directly on images. Image-based film dosimetry provided the benefits of traditional film analysis in a faster, more intuitive process for commissioning, quality assurance and beam data libraries in radiation beam applications.     

Initial activities of a radiation emergency medical assistance team to Fukushima from Nagasaki

As an urgent response to serious radiological accidents in the Fukushima Daiichi nuclear power plant, the radiation emergency medical assistance team (REMAT) from Nagasaki University landed at Fukushima on March 14, 2011, two days after the initiation of radiation crisis by the hydrogen explosion at Unit-1 reactor. During a succession of unexpected disasters, REMAT members were involved in various activities for six days, such as setting the base for radiological triage at the Fukushima Medical University, considerations for administration of stable iodine, and risk communication with health care workers. This report briefly describes what happened around REMAT members and radiation doses measured during their activities.     

Retrospective and emergency dosimetry in response to radiological incidents and nuclear mass-casualty events: A review

This paper reviews recent research on the application of the physical dosimetry techniques of electron paramagnetic resonance (EPR) and luminescence (optically stimulated luminescence, OSL, and thermoluminescence, TL) to determine radiation dose following catastrophic, large-scale radiological events. Such data are used in dose reconstruction to obtain estimates of dose due to the exposure to external sources of radiation, primarily gamma radiation, by individual members of the public and by populations. The EPR and luminescence techniques have been applied to a wide range of radiological studies, including nuclear bomb detonation (e.g., Hiroshima and Nagasaki), nuclear power plant accidents (e.g., Chernobyl), radioactive pollution (e.g., Mayak plutonium facility), and in the future could include terrorist events involving the dispersal of radioactive materials. In this review we examine the application of these techniques in ‘emergency’ and ‘retrospective’ modes of operation that are conducted on two distinct timescales. For emergency dosimetry immediate action to evaluate dose to individuals following radiation exposure is required to assess deterministic biological effects and to enable rapid medical triage. Retrospective dosimetry, on the other hand, contributes to the reconstruction of doses to populations and individuals following external exposure, and contributes to the long-term study of stochastic processes and the consequential epidemiological effects. Although internal exposure, via ingestion of radionuclides for example, can be a potentially significant contributor to dose, this review is confined to those dose components arising from exposure to external radiation, which in most studies is gamma radiation.The nascent emergency dosimetry measurement techniques aim to perform direct dose evaluations for individuals who, as members of the public, are most unlikely to be carrying a dosimeter issued for radiation monitoring purposes in the event of a radiation incident. Hence attention has focused on biological or physical materials they may have in their possession that could be used as surrogate dosimeters. For EPR measurements, in particular, this includes material within the body (such as bone or tooth biopsy) requiring invasive procedures, but also materials collected non-invasively (such as clippings taken from finger- or toenails) and artefacts within their personal belongings (such as electronic devices of which smart phones are the most common). For luminescence measurements, attention has also focused on components within electronic devices, including smartphones, and a wide range of other personal belongings such as paper and other polymer-based materials (including currency, clothing, bank cards, etc.). The paper reviews progress made using both EPR and luminescence techniques, along with their current limitations.For the longer-established approach of retrospective dosimetry, luminescence has been the most extensively applied method and, by employing minerals found in construction materials, it consequently is employed in dosimetry using structures within the environment. Recent developments in its application to large-scale radiation releases are discussed, including the atomic bomb detonations at Hiroshima and Nagasaki, fallout from the Chernobyl reactor and atmospheric nuclear bomb tests within the Semipalatinsk Nuclear Test Site and fluvially transported pollution within the Techa River basin due to releases from the Mayak facility. The developments made in applying OSL and TL techniques are discussed in the context of these applications. EPR measurements with teeth have also provided benchmark values to test the dosimetry models used for Chernobyl liquidators (clean-up workers), residents of Semipalatinsk Nuclear Tests Sites and inhabitants of the Techa River basin.For both emergency and retrospective dosimetry applications, computational techniques employing radiation transport simulations based on Monte Carlo code form an essential component in the application of dose determinations by EPR and OSL to dose reconstruction problems. We include in the review examples where the translation from the physical quantity of cumulative dose determined in the sampled medium to a dose quantity that can be applied in the reconstruction of dose to individuals and/or populations; these take into account the source terms, release patterns and the movements of people in the affected areas. One role for retrospective luminescence dosimetry has been to provide benchmark dose determinations for testing the models employed in dose reconstruction for exposed populations, notably at Hiroshima and Nagasaki. The discussion is framed within the context of the well-known radiation incidents mentioned above.     

Canadian biodosimetry capacity for response to radiation emergencies

In December 2001, Canada's response to the international political climate was launched by the creation of the Chemical, Biological, Radiological/Nuclear Research & Technology Initiative (CRTI). The National Biological Dosimetry Response Plan (NBDRP), established through partnering the expertise of three federal departments and one university, was created in response to this initiative. The NBDRP objectives were to develop a network of laboratories with expertise to perform biological dosimetry by cytogenetics and to investigate new technologies that may be applicable in the development of the new biodosimetry program. Since the creation of the NBDRP, Canada has made significant progress in enhancing expertise and resources to be better prepared for radiological/nuclear events. Through participation in exercises, the existing capacities were tested and recommendations for improvements were made. This paper describes the results from two exercises. The first exercise was designed to test the culturing, analysis, and reporting procedures within a single laboratory, and the second exercise was intended to test the capacity of the NBDRP. Future exercises will further challenge the network resulting in an improved national response capability.     

Comparison of phantom materials for use in quality assurance of microbeam radiation therapy

Microbeam radiation therapy (MRT) is a promising radiotherapy modality that uses arrays of spatially fractionated micrometre‐sized beams of synchrotron radiation to irradiate tumours. Routine dosimetry quality assurance (QA) prior to treatment is necessary to identify any changes in beam condition from the treatment plan, and is undertaken using solid homogeneous phantoms. Solid phantoms are designed for, and routinely used in, megavoltage X‐ray beam radiation therapy. These solid phantoms are not necessarily designed to be water‐equivalent at low X‐ray energies, and therefore may not be suitable for MRT QA. This work quantitatively determines the most appropriate solid phantom to use in dosimetric MRT QA. Simulated dose profiles of various phantom materials were compared with those calculated in water under the same conditions. The phantoms under consideration were RMI457 Solid Water (Gammex‐RMI, Middleton, WI, USA), Plastic Water (CIRS, Norfolk, VA, USA), Plastic Water DT (CIRS, Norfolk, VA, USA), PAGAT (CIRS, Norfolk, VA, USA), RW3 Solid Phantom (PTW Freiburg, Freiburg, Germany), PMMA, Virtual Water (Med‐Cal, Verona, WI, USA) and Perspex. RMI457 Solid Water and Virtual Water were found to be the best approximations for water in MRT dosimetry (within ±3% deviation in peak and 6% in valley). RW3 and Plastic Water DT approximate the relative dose distribution in water (within ±3% deviation in the peak and 5% in the valley). PAGAT, PMMA, Perspex and Plastic Water are not recommended to be used as phantoms for MRT QA, due to dosimetric discrepancies greater than 5%.     

Introduction to dosimetry and risk estimation of second cancer induction following radiotherapy

This brief review of dosimetry in second cancer dosimetry introduces work carried out by Working Group 9 (Radiation Protection Dosimetry in Medicine) of the European Radiation Dosimetry Group (EURADOS). The work described in the following papers in this edition was presented at a Workshop on Dosimetry for Second Cancer Risk Estimation given at the EURADOS Annual meeting in Vienna on February 8th 2012. The work concentrates on the measurement of out-of-field doses in water tanks and BOMAB-like phantoms using a variety of dosimeters to measure photon and neutron doses. These include optically stimulated luminescence (OSL), radiophotoluminescence (RPL) and thermoluminescence (TLD) dosimeters for photon dosimetry (together with ion chambers for reference measurements traceable to primary standards) and track etch and bubble detectors for neutron measurements. A discussion of the various phantoms available for these measurements is presented together with a brief introduction to a model for the relationship between organ doses and the risk of induction of second cancers. The estimation of second cancer risks is not trivial and involves processes which are currently incompletely understood. However, progress in this field requires a robust foundation and methodology for the measurement or calculation of organ doses following radiotherapy, so that risks can be placed in perspective, algorithms for out-of-field doses can be compared with measured data, and future epidemiological studies may have a reliable foundation of organ dosimetry for retrospective dosimetry studies.     

Analysis of MIR-18 results for physical and biological dosimetry: radiation shielding effectiveness in LEO.

We compare models of radiation transport and biological response to physical and biological dosimetry results from astronauts on the Mir space station. Transport models are shown to be in good agreement with physical measurements and indicate that the ratio of equivalent dose from the Galactic Cosmic Rays (GCR) to protons is about 3/2:1 and that this ratio will increase for exposures to internal organs. Two biological response models are used to compare to the Mir biodosimetry for chromosome aberration in lymphocyte cells; a track-structure model and the linear-quadratic model with linear energy transfer (LET) dependent weighting coefficients. These models are fit to in vitro data for aberration formation in human lymphocytes by photons and charged particles. Both models are found to be in reasonable agreement with data for aberrations in lymphocytes of Mir crew members: however there are differences between the use of LET dependent weighting factors and track structure models for assigning radiation quality factors. The major difference in the models is the increased effectiveness predicted by the track model for low charge and energy ions with LET near 10 keV/micrometers. The results of our calculations indicate that aluminum shielding, although providing important mitigation of the effects of trapped radiation, provides no protective effect from the galactic cosmic rays (GCR) in low-earth orbit (LEO) using either equivalent dose or the number of chromosome aberrations as a measure until about 100 g/cm 2 of material is used.     

An initial limited biodosimetry inter-comparison exercise: FOI and DRDC Ottawa

While biodosimetry is a valuable tool in radiation dose assessment, the dicentric assay, which is the most validated method to date, requires some degree of technical competence. Recently published ISO guidelines indicate the need for documenting competence and establishment of quality control programs. Inter-laboratory comparisons are required to document the ability to perform reproducible and accurate assessments. FOI and DRDC Ottawa have conducted an initial limited biodosimetry exercise inter-comparison for quality assurance purposes. The exercise involved blinded exchange of three previously prepared slides from each laboratory from samples that had been evaluated for each lab's dose–response curve. Approximately 100 cells from each slide were evaluated and aberration frequencies reported and compared to the expected frequencies. The limited number of cells evaluated for each sample could not permit statistically distinguishing a 20% difference in all the samples. However, the results indicated reasonable agreement in analyses for all samples for triage purposes. Comparison of aberration frequencies, rather than dose estimates, further illustrates consistent scoring criteria between the two laboratories. The exercise conducted by FOI and DRDC Ottawa provided an efficient means of documenting expertise. Such cooperation further establishes the international biodosimetry network and ensures our readiness for emergency response.     

BiodosEPR-2006 consensus committee report on biodosimetric methods to evaluate radiation doses at long times after exposure

The requirements for biodosimetric techniques used at long times after exposure, i.e., 6 months to more than 50 years, are unique compared to the requirements for methods used for immediate dose estimation. In addition to the fundamental requirement that the assay measures a physical or biologic change that is proportional to the energy absorbed, the signal must be highly stable over time to enable reasonably precise determinations of the absorbed dose decades later. The primary uses of these biodosimetric methods have been to support long-term health risk (epidemiologic) studies or to support compensation (damage) claims. For these reasons, the methods must be capable of estimating individual doses, rather than group mean doses. Even when individual dose estimates can be obtained, inter-individual variability remains as one of the most difficult problems in using biodosimetry measurements to rigorously quantify individual exposures. Other important criteria for biodosimetry methods include obtaining samples with minimal invasiveness, low detection limits, and high precision. Cost and other practical limitations generally prohibit biodosimetry measurements on a large enough sample to replace analytical dose reconstruction in epidemiologic investigations. However, these measurements can be extremely valuable as a means to corroborate analytical or model-based dose estimates, to help reduce uncertainty in individual doses estimated by other methods and techniques, and to assess bias in dose reconstruction models. There has been extensive use of three biodosimetric techniques in irradiated populations: EPR (using tooth enamel), FISH (using blood lymphocytes), and GPA (also using blood); these methods have been supplemented with luminescent methods applied to building materials and artifacts. A large number of investigations have used biodosimetric methods many years after external and, to a lesser extent, internal exposure to reconstruct doses received from accidents, from occupational exposures, from environmental releases of radioactive materials, and from medical exposures. In most applications, the intent has been to either identify highly exposed persons or confirmed suspected exposures. Improvements in methodology, however, have led many investigators to attempt quantification of whole-body doses received, or in a few instances, to estimate organ doses. There will be a continued need for new and improved biodosimetric techniques not only to assist in future epidemiologic investigations but to help evaluate the long-term consequences following nuclear accidents or events of radiologic terrorism.