Journal ArticleDOI
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
F A Stewart,A V Akleyev,Martin Hauer-Jensen,Jolyon H Hendry,N J Kleiman,Thomas J. MacVittie,B M Aleman,Angela B. Edgar,K Mabuchi,C R Muirhead,Roy E. Shore,William Wallace +11 more
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Estimates of ‘practical’ threshold doses for tissue injury defined at the level of 1% incidence are provided and it appears that the rate of dose delivery does not modify the low incidence for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease.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.read more
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Patient radiation biological risk in computed tomography angiography procedure
TL;DR: The overall patient risk from CTA procedures ranged between 15 and 36 cancer risks per 1 million procedures, and special concern should be provided to the lens of the eye and thyroid during brain and abdomen procedures.
Journal ArticleDOI
Leaded eyeglasses substantially reduce radiation exposure of the surgeon's eyes during acquisition of typical fluoroscopic views of the hip and pelvis.
Sean Burns,Raymond H. Thornton,Lawrence T. Dauer,Brian T. Quinn,Daniel Miodownik,David J. Hak +5 more
TL;DR: In this article, the authors used anthropomorphic patient and surgeon phantoms to measure the radiation dose at the surgeon's lens with and without leaded glasses during fluoroscopic acquisition of sixteen common pelvic and hip views.
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Comparing Vessel Imaging: Noncontrast Computed Tomography/Computed Tomographic Angiography Should Be the New Minimum Standard in Acute Disabling Stroke
TL;DR: This review will consider characteristics important for evaluating and comparing the 3 modalities as the diagnostic tool of choice for acute stroke assessment and treatment decision making.
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Radiation and cataract risk: Impact of recent epidemiologic studies on ICRP judgments.
TL;DR: There is currently no compelling evidence for diminished cataractogenic effects at low dose rates, i.e., the data are compatible with a dose-rate effectiveness factor (DREF) of unity but the uncertainties are large enough that other values of DREF cannot be ruled out.
Journal ArticleDOI
Ionizing radiation sensitivity of the ocular lens and its dose rate dependence.
TL;DR: Mounting biological evidence indicates that the lens cells are not necessarily radiosensitive to cell killing, and the high radiosensitivity of the lens thus appears to be attributable to other mechanisms, including excessive proliferation, abnormal differentiation, a slow repair of DNA double-strand breaks, telomere, senescence, crystallin changes and inflammation.
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