title: Physically-based biodosimetry using in vivo EPR of teeth in patients undergoing total body irradiation.
abstract: OBJECTIVE
  The ability to estimate individual exposures to radiation following a large attack or incident has been identified as a necessity for rational and effective emergency medical response. In vivo electron paramagnetic resonance (EPR) spectroscopy of tooth enamel has been developed to meet this need.
  
  
  METHODS
  A novel transportable EPR spectrometer, developed to facilitate tooth dosimetry in an emergency response setting, was used to measure upper incisors in a model system, in unirradiated subjects, and in patients who had received total body doses of 2 Gy.
  
  
  RESULTS
  A linear dose response was observed in the model system. A statistically significant increase in the intensity of the radiation-induced EPR signal was observed in irradiated versus unirradiated subjects, with an estimated standard error of dose prediction of 0.9 ± 0.3 Gy.
  
  
  CONCLUSIONS
  These results demonstrate the current ability of in vivo EPR tooth dosimetry to distinguish between subjects who have not been irradiated and those who have received exposures that place them at risk for acute radiation syndrome. Procedural and technical developments to further increase the precision of dose estimation and ensure reliable operation in the emergency setting are underway. With these developments EPR tooth dosimetry is likely to be a valuable resource for triage following potential radiation exposure of a large population.
authors.affiliation: Department of Diagnostic Radiology, Dartmouth Physically-based Biodosimetry Center for Medical Countermeasures against Radiation, Dartmouth Medical School, Hanover, New Hampshire, USA. Benjamin.B.Williams@dartmouth.edu
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Williams
authors.forename: Ruhong
authors.initials: R
authors.lastname: Dong
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Nicolalde
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Matthews
authors.forename: David J
authors.initials: DJ
authors.lastname: Gladstone
authors.forename: Eugene
authors.initials: E
authors.lastname: Demidenko
authors.forename: Bassem I
authors.initials: BI
authors.lastname: Zaki
authors.forename: Ildar K
authors.initials: IK
authors.lastname: Salikhov
authors.forename: Piotr N
authors.initials: PN
authors.lastname: Lesniewski
authors.forename: Harold M
authors.initials: HM
authors.lastname: Swartz
mesh_terms: D001681:Biological Assay / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D011832:Radiation Injuries / Q000175:diagnosis* / Q000209:etiology; D011834:Radiation Monitoring / Q000295:instrumentation*; D018788:Radioactive Hazard Release; D011868:Radioisotopes / Q000032:analysis*; D014070:Tooth / Q000737:chemistry*; D014916:Whole-Body Irradiation / Q000009:adverse effects*
chemical_list: D011868:Radioisotopes