The aim of this brief personal, high level review is to consider the state of the art for biological dosimetry for radiation routine and emergency response, and the potential future progress in thi... Well established and newer biodosimetric techniques show promise for a number of future dosimetry or wider research application. PCC: Premature chromosome condensation.

The aim of this review is to investigate the literature pertaining to the potential risks of low-dose ionizing radiation to Lynch syndrome patients by use of computed tomography (CT), either diagnostic CT colonography (CTC), standard staging CT or CT surveillance. Furthermore, this review explores the potential risks of using radiotherapy for treatment of rectal cancer in these patients. No data or longitudinal observational studies of the impact of radiation exposure on humans with Lynch syndrome were identified. Limited experimental studies utilizing cell lines and primary cells exposed to both low and high radiation doses have been carried out to help determine radio-sensitivity associated with DNA mismatch repair gene deficiency, the defining feature of Lynch syndrome. On balance, these studies suggest that mismatch repair deficient cells may be relatively radio-resistant (particularly for low dose rate exposures) with higher mutation rates, albeit no firm conclusions can be drawn. Mouse model studies, though, showed an increased risk of developing colorectal tumors in mismatch repair deficient mice exposed to radiation doses around 2 Gy. With appropriate ethical approval, further studies investigating radiation risks associated with CT imaging and radiotherapy relevant doses using cells/tissues derived from confirmed Lynch patients or genetically modified animal models are urgently required for future clinical guidance.

Chemical-induced premature chromosome condensation (PCC) is an alternative biodosimetry method to the gold-standard dicentric analysis for ionizing radiation. However, existing literature shows great variations in the experimental protocols which, together with the different scoring criteria applied in individual studies, result in large discrepancies in the coefficients of the calibration curves. The current study is based on an extensive review of the peer-reviewed literature on the chemical-induced ring PCC (rPCC) assay for high-dose exposure. For the first time, a simplified yet effective protocol was developed and tested in an attempt to reduce the scoring time and to increase the accuracy of dose estimation. Briefly, the protein phosphatase inhibitor, calyculin A, was selected over okadaic acid for higher efficiency. Colcemid block was omitted and only G2-PCC cells were scored. Strict scoring criteria for total rings and hollow rings only were described to minimize the uncertainty resulting from scoring ring-like artefacts. It was found that ring aberrations followed a Poisson distribution and the dose-effect relationship favored a linear fit with an α value of 0.0499 ± 0.0028 Gy–1 for total rings and 0.0361 ± 0.0031 Gy–1 for hollow rings only. The calibration curves constructed by scoring ring aberrations were directly compared between the simplified calyculin A-induced PCC protocol and that of the cell fusion-induced PCC for high-dose exposure to gamma rays. The technical practicalities of these two methods were also compared; and our blind validation tests showed that both assays were feasible for high-dose γ-ray exposure assessment even when only hollow rings in 100 PCC spreads were scored.

In previous RENEB interlaboratory comparisons based on the manual scoring of dicentric chromosomes, a tendency for systematic overestimation for doses > 2.5 Gy was found. However, these exercises included only very few doses in the high dose range, and they were heterogeneous in terms of radiation quality and evaluation mode, and comparable only to a limited extent. Here, this presumed deviation was explored by investigating three doses > 2.5 Gy. Blood samples were irradiated (2.56, 3.41 and 4.54 Gy) using a ⁶⁰Co source and sent to 14 member laboratories of the RENEB network, which performed the dicentric chromosome assay (manual and/or semi-automatic scoring) and reported dose estimates. Most participants provided estimates that agreed very well with the physical reference doses and all provided dose estimates were in the correct clinical category (> 2 Gy). The previously observed tendency for a systematic bias across all laboratories was not confirmed. However, tendencies for systematic underestimation were detected for dose estimations for reference doses given in terms of absorbed dose to blood and for some participants, a laboratory-specific trend of systematic under- or overestimation was observed. The importance of regularly performed quality checks for a broad dose range became obvious to avoid misinterpretation of results.

In the case of a radiological or nuclear event, biological dosimetry can be an important tool to support clinical decision-making. During a nuclear event, individuals might be exposed to a mixed field of neutrons and photons. The composition of the field and the neutron energy spectrum influence the degree of damage to the chromosomes. During the transatlantic BALANCE project, an exposure similar to a Hiroshima-like device at a distance of 1.5 km from the epicenter was simulated, and biological dosimetry based on dicentric chromosomes was performed to evaluate the participants ability to discover unknown doses and to test the influence of differences in neutron spectra. In a first step, calibration curves were established by irradiating blood samples with 5 doses in the range of 0–4 Gy at two different facilities in Germany (Physikalisch-Technische Bundesanstalt [PTB]) and the USA (the Columbia IND Neutron Facility [CINF]). The samples were sent to eight participating laboratories from the RENEB network and dicentric chromosomes were scored by each participant. Next, blood samples were irradiated with 4 blind doses in each of the two facilities and sent to the participants to provide dose estimates based on the established calibration curves. Manual and semiautomatic scoring of dicentric chromosomes were evaluated for their applicability to neutron exposures. Moreover, the biological effectiveness of the neutrons from the two irradiation facilities was compared. The calibration curves from samples irradiated at CINF showed a 1.4 times higher biological effectiveness compared to samples irradiated at PTB. For manual scoring of dicentric chromosomes, the doses of the test samples were mostly successfully resolved based on the calibration curves established during the project. For semiautomatic scoring, the dose estimation for the test samples was less successful. Doses >2 Gy in the calibration curves revealed nonlinear associations between dose and dispersion index of the dicentric counts, especially for manual scoring. The differences in the biological effectiveness between the irradiation facilities suggested that the neutron energy spectrum can have a strong impact on the dicentric counts.

Purpose: This study aimed to construct a calibration curve for high-dose exposure using cell fusion-induced premature chromosome condensation (PCC). Some of the associated practicalities and methodological details were also investigated. Materials and methods: Peripheral blood from two donors was used. PCC mediated by fusing mitotic CHO cells with interphase lymphocytes was carried out. Lymphocytes were irradiated with ⁶⁰Co (0-20 Gy) and held at 37 °C for 24 h post exposure. Results: The protocol for PCC induction was effective at all doses and the numbers of rings increased with increasing dose. No significant difference was found between the donors (p = 0.896) and data were pooled. Ring aberration frequencies followed a Poisson distribution and the dose-response relationship favoured a linear fitting: Y = 0.0007(±0.0004) + 0.0186(±0.001)*D. Blind tests showed that the estimated doses were all within the 95% confidence limits of the delivered doses. This study has shown that it is valid to score only 100 cells per sample in a triage mode for doses above 5 Gy and that it is valid to score only hollow rings to reduce the scoring time. Conclusion: Scoring rings in cell fusion-induced PCC assay can be a feasible and fast approach for the analysis of high-dose exposures.