title: Clinical applications of EPR: overview and perspectives.
abstract: The development and use of in vivo techniques for strictly experimental applications in animals has been very successful, and these results now have made possible some very attractive potential clinical applications. The area with the most obvious immediate, effective and widespread clinical use is oximetry, where EPR almost uniquely can make repeated and accurate measurements of pO2 in tissues. Such measurements can provide clinicians with information that can impact directly on diagnosis and therapy, especially for oncology, peripheral vascular disease and wound healing. The other area of immediate and timely importance is the unique ability of in vivo EPR to measure clinically significant exposures to ionizing radiation 'after-the-fact', such as may occur due to accidents, terrorism or nuclear war. There are a number of other capabilities of in vivo EPR that also potentially could become extensively used in human subjects. In pharmacology the unique capabilities of in vivo EPR to detect and characterize free radicals could be applied to measure free radical intermediates from drugs and oxidative process. A closely related area of potential widespread applications is the use of EPR to measure nitric oxide. These often unique capabilities, combined with the sensitivity of EPR spectra to the immediate environment (e.g. pH, molecular motion, charge) have already resulted in some very productive applications in animals and these are likely to expand substantially in the near future. They should provide a continually developing base for extending clinical uses of in vivo EPR. The challenges for achieving full implementation include adapting the spectrometer for safe and comfortable measurements in human subjects, achieving sufficient sensitivity for measurements at the sites of the pathophysiological processes that are being measured, and establishing a consensus on the clinical value of the measurements.
authors.affiliation: Dartmouth Medical School, Hanover, NH 03755, USA. harold.swartz@dartmouth.edu
authors.forename: Harold M
authors.initials: HM
authors.lastname: Swartz
authors.forename: Nadeem
authors.initials: N
authors.lastname: Khan
authors.forename: Jay
authors.initials: J
authors.lastname: Buckey
authors.forename: Richard
authors.initials: R
authors.lastname: Comi
authors.forename: Lisa
authors.initials: L
authors.lastname: Gould
authors.forename: Oleg
authors.initials: O
authors.lastname: Grinberg
authors.forename: Alan
authors.initials: A
authors.lastname: Hartford
authors.forename: Harriet
authors.initials: H
authors.lastname: Hopf
authors.forename: Huagang
authors.initials: H
authors.lastname: Hou
authors.forename: Eugen
authors.initials: E
authors.lastname: Hug
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwasaki
authors.forename: Piotr
authors.initials: P
authors.lastname: Lesniewski
authors.forename: Ildar
authors.initials: I
authors.lastname: Salikhov
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Walczak
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D015510:Clinical Medicine / Q000295:instrumentation* / Q000379:methods* / Q000639:trends; D003238:Connective Tissue / Q000378:metabolism*; D004578:Electron Spin Resonance Spectroscopy / Q000295:instrumentation* / Q000379:methods* / Q000639:trends; D004867:Equipment Design; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000378:metabolism; D009369:Neoplasms / Q000175:diagnosis / Q000378:metabolism; D010100:Oxygen / Q000032:analysis / Q000378:metabolism*; D013673:Technology Assessment, Biomedical
chemical_list: D015415:Biomarkers; D010100:Oxygen