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Taraboletti A, Goudarzi M, Kabir A, Moon BH, Laiakis EC, Lacombe J, Ake P, Shoishiro S, Brenner D, Fornace AJ, Zenhausern F. Fabric Phase Sorptive Extraction-A Metabolomic Preprocessing Approach for Ionizing Radiation Exposure Assessment. J Proteome Res 2019; 18:3020-3031. [PMID: 31090424 PMCID: PMC7437658 DOI: 10.1021/acs.jproteome.9b00142] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The modern application of mass spectrometry-based metabolomics to the field of radiation assessment and biodosimetry has allowed for the development of prompt biomarker screenings for radiation exposure. Our previous work on radiation assessment, in easily accessible biofluids (such as urine, blood, saliva), has revealed unique metabolic perturbations in response to radiation quality, dose, and dose rate. Nevertheless, the employment of swift injury assessment in the case of a radiological disaster still remains a challenge as current sample processing can be time consuming and cause sample degradation. To address these concerns, we report a metabolomics workflow using a mass spectrometry-compatible fabric phase sorptive extraction (FPSE) technique. FPSE employs a matrix coated with sol-gel poly(caprolactone-b-dimethylsiloxane-b-caprolactone) that binds both polar and nonpolar metabolites in whole blood, eliminating serum processing steps. We confirm that the FPSE preparation technique combined with liquid chromatography-mass spectrometry can distinguish radiation exposure markers such as taurine, carnitine, arachidonic acid, α-linolenic acid, and oleic acid found 24 h after 8 Gy irradiation. We also note the effect of different membrane fibers on both metabolite extraction efficiency and the temporal stabilization of metabolites in whole blood at room temperature. These findings suggest that the FPSE approach could work in future technology to triage irradiated individuals accurately, via biomarker screening, by providing a novel method to stabilize biofluids between collection and sample analysis.
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Affiliation(s)
- Alexandra Taraboletti
- Department of Oncology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
| | - Maryam Goudarzi
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
- Lerner Research Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, United States
| | - Abuzar Kabir
- International Forensic Research Institute, Department of Chemistry and Biochemistry, Florida International University, 11200 Southwest Eighth Street, Miami, Florida 33199, United States
| | - Bo-Hyun Moon
- Department of Oncology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
| | - Evagelia C. Laiakis
- Department of Oncology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
| | - Jerome Lacombe
- Center for Applied NanoBiosience and Medicine, University of Arizona, 475 North Fifth Street, Phoenix, Arizona 85004, United States
| | - Pelagie Ake
- Department of Oncology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
| | - Sueoka Shoishiro
- Center for Applied NanoBiosience and Medicine, University of Arizona, 475 North Fifth Street, Phoenix, Arizona 85004, United States
| | - David Brenner
- Center for Radiological Research, Columbia University, 630 West 168th Street, New York, New York 10032, United States
| | - Albert J. Fornace
- Department of Oncology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Georgetown University, 3800 Reservoir Road Northwest, Washington, District of Columbia 20057, United States
| | - Frederic Zenhausern
- Center for Applied NanoBiosience and Medicine, University of Arizona, 475 North Fifth Street, Phoenix, Arizona 85004, United States
- Translational Genomics Research Institute, 445 North Fifth Street, Phoenix, Arizona 85004, United States
- Department of Basic Medical Sciences, College of Medicine Phoenix, 425 North Fifth Street, Phoenix, Arizona 85004, United States
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Boice JD. The 42nd Lauriston S. Taylor Lecture on Radiation Protection and Measurements Presented by Dr. Hans-Georg Menzel. Health Phys 2019; 116:218-219. [PMID: 30585968 DOI: 10.1097/hp.0000000000001025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- John D Boice
- National Council on Radiation, Protection and Measurements, 7910 Woodmont Avenue, Suite 400, Bethesda, MD 20814-3095
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Bushberg JT. Uses of Effective Dose: The Good, the Bad, and the Future. Health Phys 2019; 116:129-134. [PMID: 30585952 DOI: 10.1097/hp.0000000000001014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Effective dose (E) is a risk-adjusted dosimetric quantity developed by the International Commission on Radiological Protection. It is a key metric for practical management of the risk of stochastic health effects in a comprehensive radiation protection program. The International Commission on Radiological Protection and others have emphasized repeatedly that E is not intended to represent an actual radiation dose and should not be used as a risk-related metric for a specific person or population. The cancer risk uncertainties in the low-dose range and the underlying approximations, simplifications, and sex- and age-averaging used in generating E make it unsuitable for this purpose. However, in practice, medical imaging professionals and authors of peer-reviewed medical publications frequently and incorrectly use E as a surrogate for whole-body dose in order to calculate cancer risk estimates for specific patients or patient populations. This frequent misuse has popularized E for uses for which it was neither designed nor intended. Alternatives to E have been proposed that attempt to account for known age and sex differences in radiation sensitivity. E has also been proposed as a general indicator for communicating radiation risk to patients, if its limitations are kept in mind. Forthcoming guidance from the International Commission on Radiological Protection will likely clarify if, when, and how some form of E may be used as a rough indicator of the risk of a stochastic effect, possibly with some modifications for the substantial variations in risk known to exist with respect to age, sex, and population group.
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Affiliation(s)
- Jerrold T Bushberg
- Associate Chairman, Department of Radiology, Clinical Professor of Radiology and Radiation Oncology, School of Medicine, University of California, Davis, 2315 Stockton Blvd., FSSB 2500, Sacramento, CA 95817
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Abstract
Non-cancer effects and risks at low doses from ionising radiation are controversial topics within the field of radiation protection. These issues are discussed in International Commission on Radiological Protection (ICRP) Publication 118, 'ICRP statement on tissue reactions'. Both non-cancer effects and risks are expected to become increasingly important to the system of radiation protection. Before this can happen, several factors must be considered: thorough characterisation of the relationship between dose and risk; verification of the biological mechanisms for any noted excess risk; and adjustment of noted excess risks through the use of a detriment factor. It is difficult to differentiate the relatively small risks associated with radiation from other risk factors in the low-dose region of the dose-response curve. Several recent papers have indicated the possibility of a non-linear dose-response relationship for non-cancer effects. In addition, there are still many uncertainties associated with the biological mechanisms for non-cancer effects. Finally, it is essential to consider the incorporation of detriment into a well-defined system of radiological protection. Given the recent interest in non-cancer effects, it is essential to facilitate discussions in order to define dose limits more clearly within the existing system of radiation protection for both cancer and non-cancer effects.
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Affiliation(s)
- S Miyazaki
- Atomic Energy Research Institute, Kinki University, Osaka, Japan
| | - C Hill
- Stoller Nuclear News (SN3) Corporation, USA
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Stewart FA, Akleyev AV, Hauer-Jensen M, Hendry JH, Kleiman NJ, Macvittie TJ, Aleman BM, Edgar AB, Mabuchi K, Muirhead CR, Shore RE, Wallace WH. ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs--threshold doses for tissue reactions in a radiation protection context. Ann ICRP 2012; 41:1-322. [PMID: 22925378 DOI: 10.1016/j.icrp.2012.02.001] [Citation(s) in RCA: 771] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This report provides a review of early and late effects of radiation in normal tissues and organs with respect to radiation protection. It was instigated following a recommendation in Publication 103 (ICRP, 2007), and it provides updated estimates of 'practical' threshold doses for tissue injury defined at the level of 1% incidence. Estimates are given for morbidity and mortality endpoints in all organ systems following acute, fractionated, or chronic exposure. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin; and the eye. Particular attention is paid to circulatory disease and cataracts because of recent evidence of higher incidences of injury than expected after lower doses; hence, threshold doses appear to be lower than previously considered. This is largely because of the increasing incidences with increasing times after exposure. In the context of protection, it is the threshold doses for very long follow-up times that are the most relevant for workers and the public; for example, the atomic bomb survivors with 40-50years of follow-up. Radiotherapy data generally apply for shorter follow-up times because of competing causes of death in cancer patients, and hence the risks of radiation-induced circulatory disease at those earlier times are lower. A variety of biological response modifiers have been used to help reduce late reactions in many tissues. These include antioxidants, radical scavengers, inhibitors of apoptosis, anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, growth factors, and cytokines. In many cases, these give dose modification factors of 1.1-1.2, and in a few cases 1.5-2, indicating the potential for increasing threshold doses in known exposure cases. In contrast, there are agents that enhance radiation responses, notably other cytotoxic agents such as antimetabolites, alkylating agents, anti-angiogenic drugs, and antibiotics, as well as genetic and comorbidity factors. Most tissues show a sparing effect of dose fractionation, so that total doses for a given endpoint are higher if the dose is fractionated rather than when given as a single dose. However, for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease, it appears that the rate of dose delivery does not modify the low incidence. This implies that the injury in these cases and at these low dose levels is caused by single-hit irreparable-type events. For these two tissues, a threshold dose of 0.5Gy is proposed herein for practical purposes, irrespective of the rate of dose delivery, and future studies may elucidate this judgement further.
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Mamourian A, O'Shea M, Maidment ADA. Cumulative radiation dose in patients with aneurysmal subarachnoid hemorrhage. AJNR Am J Neuroradiol 2010; 31:E87-8; author reply E89. [PMID: 20966050 DOI: 10.3174/ajnr.a2260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Gialousis G, Yiakoumakis EN, Makri TK, Papadoupoulou D, Karlatira M, Karaiskos P, Papaodysseas S, Evlogias N, Dimitriou PA, Georgiou EK. Comparison of dose from radiological examination for scoliosis in children among two pediatric hospitals by Monte Carlo simulation. Health Phys 2008; 94:471-478. [PMID: 18403968 DOI: 10.1097/01.hp.0000303105.91168.ea] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The radiation exposures of children undergoing full spine radiography were investigated in two pediatric hospitals in Greece. Entrance surface kerma (Ka,e) was assessed by thermoluminescence dosimetry and patient's effective dose (E) was estimated by Monte Carlo simulation. All required information regarding patient age and sex, the irradiation geometry, the x-ray spectra, and other exposure parameters (tube voltage and current) were registered as well. Values of Ka,e were measured to range from 0.22 mGy to 2.12 mGy, while E was estimated to range from 0.03 mSv to 0.47 mSv. In general, all values were greater in one of the two hospitals, as higher tube currents and exposure times were used in the examinations because of the difference in radiographers' training and practice. Moreover, dose to red bone marrow was found to be between 0.01 to 0.23 mSv and dose to breast ranged between 0.02 and 1.05 mSv depending on the age, projection, and hospital. These values are comparable with literature sources.
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Affiliation(s)
- G Gialousis
- Medical Physics Department, Medical School, University of Athens, 75 Mikras Asias Str., Goudi 11527, Athens, Greece.
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Abstract
To investigate the interaction of low frequency electric and magnetic fields with pregnant women and in particular with the fetus, an anatomical voxel model of an 89 kg woman at week 30 of pregnancy was developed. Intracorporal electric current density distributions due to exposure to homogeneous 50 Hz electric and magnetic fields were calculated and results were compared with basic restrictions recommended by ICNIRP guidelines. It could be shown that the basic restriction is met within the central nervous system (CNS) of the mother at exposure to reference level of either electric or magnetic fields. However, within the fetus the basic restriction is considerably exceeded. Revision of reference levels might be necessary.
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Affiliation(s)
- R Cech
- Institute of Clinical Engineering, Graz University of Technology, Inffeldgasse 18, 8010 Graz, Austria.
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Geng L, Osusky K, Konjeti S, Fu A, Hallahan D. Radiation-guided drug delivery to tumor blood vessels results in improved tumor growth delay. J Control Release 2005; 99:369-81. [PMID: 15451595 DOI: 10.1016/j.jconrel.2004.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2004] [Accepted: 07/16/2004] [Indexed: 11/24/2022]
Abstract
Tumor blood vessels are biological targets for cancer therapy. In this study, a tumor vasculature targeting system that consisted of liposomes and lectin (WGA) was built. Liposomes were used to carry a number of liposome-friendly anti-tumoral agents along with WGA, a lectin which posseses a specific affinity for binding to inflamed endothelial cells. In order to target tumor vasculature, inflammation of endothelial cells was induced by radiation. Because ionizing radiation induces an inflammatory response in tumor vasculature, lectin-conjugates were utilized to determine whether radiation can be used to target drug delivery to tumor vessels. Wheat germ agglutinin (WGA) is one such lectin that binds to inflamed microvasculature. WGA was conjugated to liposomes containing cisplatin and administered to tumor bearing mice. Tumor growth delay was used to analyze the efficacy of cytotoxicity. FITC-conjugated WGA accumulated within irradiated tumor microvasculature. WGA was conjugated to liposomes and labeled with 111In. This demonstrated radiation-inducible tumor-selective binding. WGA-liposome-conjugates were loaded with Cisplatin and administered to mice bearing irradiated tumors. Tumors treated with a combination of liposome encapsulated cisplatin together with radiation showed a significant increase in tumor growth delay as compared to radiation alone. These findings demonstrate that ionizing radiation can be used to guide drug delivery to tumor microvasculature.
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Affiliation(s)
- Ling Geng
- Department of Radiation Oncology, Vanderbilt University, Nashville, TN 37232, USA
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Abstract
In image-guided radiation therapy, megavoltage computerized tomography (MVCT) delivers higher dose to the patient for lower image quality than diagnostic kilovoltage CT (kVCT). One way to reduce the mean imaging dose is to reduce the imaging volume, which is often sufficient for registration and dosimetry purposes. The filtered back projection using truncated data causes artefacts that degrade the image quality. Those artefacts can be effectively reduced by wavelet-based multi-resolution analysis (WMRA), in which the detail and approximate information are reconstructed separately to bypass the non-locality of filtered back projection. In this study, WMRA was used to reconstruct local images from both very low-dose kVCT scans from a bench-top tomotherapy unit and MVCT scans from helical tomotherapy. Results show that mean imaging dose can be significantly reduced by imaging a small region of interest. In simulation, the root-mean-square error brought by the truncation is smaller than 1-2% and depends on the level of dose reduction. On the other hand, the same mean dose that would have been delivered by a low-quality global CT can be conformed to a smaller volume to improve the visibility of low-contrast organs and fine structures using WMRA. Organs at risk can be avoided during repeated daily CT imaging when irregular-shaped reconstruction areas are used. WMRA does not involve computationally expensive iterations and is suitable for image-guided radiation therapy where imaging speed is essential. Compared with extrapolation methods, errors are further reduced to improve the detection of low contrast and fine structures.
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Affiliation(s)
- Ke Sheng
- Radiation Oncology Department, University of Virginia, VA, USA
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Abstract
Although IMRT has been shown clinically to increase skin doses for some patients, it has also been shown that intensity modulated delivery does not, of itself, increase skin doses. The reason for this apparent difference is that inverse planning can result in solutions that give high fluence to tangential beam segments near the skin surface, in an attempt to counter the build-up region. In cases where the clinical target volume (CTV) stops short of the skin surface, but the planning target volume (PTV) does not, there is no clinical reason to treat the skin. The CTV-PTV margin exists purely to ensure that fields are large enough to allow for geometrical uncertainties. With an objective function based on the doses to the PTV, it is possible for a plan that gives excess fluence to the skin to have a lower objective function, and hence to be preferred in an optimization. We describe a technique of plan evaluation, based on analysis of a plan by recalculating several plans in which the isocentre has been offset by a distance equal to the CTV-PTV margin. We demonstrate that changes to a plan that reduce a PTV-based objective can give a worse dose distribution to the CTV when systematic and random set-up errors are accounted for, and increase skin dose. Several possible strategies for avoiding this problem are discussed, including the use of the skin as an organ at risk, modification of the PTV to avoid the skin, and the use of 'pretend bolus' applied in planning but not in treatment. The latter gave the best results. The possibility of using the evaluation method itself, as the basis of an objective function for optimization, is discussed.
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Affiliation(s)
- Simon J Thomas
- Department of Medical Physics, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
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Scarantino CW, Ruslander DM, Rini CJ, Mann GG, Nagle HT, Black RD. An implantable radiation dosimeter for use in external beam radiation therapy. Med Phys 2004; 31:2658-71. [PMID: 15487749 DOI: 10.1118/1.1778809] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
An implantable radiation dosimeter for use with external beam therapy has been developed and tested both in vitro and in canines. The device uses a MOSFET dosimeter and is polled telemetrically every day during the course of therapy. The device is designed for permanent implantation and also acts as a radiographic fiducial marker. Ten dogs (companion animals) that presented with spontaneous, malignant tumors were enrolled in the study and received an implant in the tumor CTV. Three dogs received an additional implant in collateral normal tissue. Radiation therapy plans were created for the animals and they were treated with roughly 300 cGy daily fractions until completion of the prescribed cumulative dose. The primary endpoints of the study were to record any adverse events due to sensor placement and to monitor any movement away from the point of placement. No adverse events were recorded. Unacceptable device migration was experienced in two subjects and a retention mechanism was developed to prevent movement in the future. Daily dose readings were successfully acquired in all subjects. A rigorous in vitro calibration methodology has been developed to ensure that the implanted devices maintain an accuracy of +/-3.5% relative to an ionization chamber standard. The authors believe that an implantable radiation dosimeter is a practical and powerful tool that fosters individualized patient QA on a daily basis.
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Voisin P, Barquinero F, Blakely B, Lindholm C, Lloyd D, Luccioni C, Miller S, Palitti F, Prasanna PGS, Stephan G, Thierens H, Turai I, Wilkinson D, Wojcik A. Towards a standardization of biological dosimetry by cytogenetics. Cell Mol Biol (Noisy-le-grand) 2002; 48:501-4. [PMID: 12146703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
When individuals are accidentally overexposed to ionising radiations, follow-up investigations may include dose assessment by cytogenetics. Scoring of unstable chromosome aberrations (dicentrics, centric rings and acentrics) in peripheral blood lymphocytes is regarded as the most specific method to estimate the exposure dose. It has acquired, in some countries, a medico-legal recognition. Paradoxically, there is no universally adopted technique and so important variations occur in methods and these may influence the quality of results. The only published documents supplying some standardization background are International Atomic Energy Agency (IAEA) Technical Reports No 260 (1986) and 405 (2001). Even they do not address crucial areas such as the organization of service laboratories and the need for quality assurance programmes. The significant role of biological dosimetry in many countries has proved the need for a standardized technique that is compatible with national radiological protection programmes. Thus, an International Standards Organization working group for the standardization of biological dosimetry by cytogenetics was created. This group comprises 13 scientists from 11 countries plus an IAEA representative. On the basis of a group consensus, a text defining minimal constraints on all the steps of the process was proposed. A working draft was submitted to ISO in 2001 and its structure is presented here.
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Affiliation(s)
- P Voisin
- Institute of Protection and Nuclear Safety IPSN, Fontenay-aux-Roses, France.
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Blower PJ, Gardin I. A place for cellular dosimetry in risk assessment. Nucl Med Commun 1997; 18:989-91. [PMID: 9423198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Cerletty JM. Irradiation-related thyroid cancer. Wis Med J 1976; 75:S88-9. [PMID: 969556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Fitzgerald PH. Radiation, chromosomes and man. N Z Med J 1971; 73:147-54. [PMID: 5280738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
MESH Headings
- Chromosome Aberrations/etiology
- Chromosome Disorders
- Chromosomes/radiation effects
- Chromosomes, Human, 1-3/radiation effects
- Chromosomes, Human, 13-15/radiation effects
- Chromosomes, Human, 16-18/radiation effects
- Chromosomes, Human, 19-20/radiation effects
- Chromosomes, Human, 21-22 and Y/radiation effects
- Chromosomes, Human, 4-5/radiation effects
- Chromosomes, Human, 6-12 and X/radiation effects
- Humans
- Karyotyping
- Male
- Radiation Injuries
- Radiometry/adverse effects
- Radiotherapy/adverse effects
- Radiotherapy Dosage/adverse effects
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