title: Advances in in vivo EPR Tooth BIOdosimetry: Meeting the targets for initial triage following a large-scale radiation event.
abstract: Several important recent advances in the development and evolution of in vivo Tooth Biodosimetry using Electron Paramagnetic Resonance (EPR) allow its performance to meet or exceed the U.S. targeted requirements for accuracy and ease of operation and throughput in a large-scale radiation event. Ergonomically based changes to the magnet, coupled with the development of rotation of the magnet and advanced software to automate collection of data, have made it easier and faster to make a measurement. From start to finish, measurements require a total elapsed time of 5 min, with data acquisition taking place in less than 3 min. At the same time, the accuracy of the data for triage of large populations has improved, as indicated using the metrics of sensitivity, specificity and area under the ROC curve. Applying these standards to the intended population, EPR in vivo Tooth Biodosimetry has approximately the same diagnostic accuracy as the purported 'gold standard' (dicentric chromosome assay). Other improvements include miniaturisation of the spectrometer, leading to the creation of a significantly lighter and more compact prototype that is suitable for transporting for Point of Care (POC) operation and that can be operated off a single standard power outlet. Additional advancements in the resonator, including use of a disposable sensing loop attached to the incisor tooth, have resulted in a biodosimetry method where measurements can be made quickly with a simple 5-step workflow and by people needing only a few minutes of training (which can be built into the instrument as a training video). In sum, recent advancements allow this prototype to meet or exceed the US Federal Government's recommended targets for POC biodosimetry in large-scale events.
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA Ann.B.Flood@Dartmouth.edu.
authors.forename: Ann Barry
authors.initials: AB
authors.lastname: Flood
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA.|Division of Radiation Oncology, Dept. of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Williams
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Wilson
authors.initials: W
authors.lastname: Schreiber
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Gaixin
authors.initials: G
authors.lastname: Du
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Wood
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Maciej M
authors.initials: MM
authors.lastname: Kmiec
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Sergey V
authors.initials: SV
authors.lastname: Petryakov
authors.affiliation: Dept. of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Eugene
authors.initials: E
authors.lastname: Demidenko
authors.affiliation: EPR Center for the Study of Viable Systems at Dartmouth, Radiology Dept., Geisel School of Medicine at Dartmouth, Hanover, NH, USA.|Division of Radiation Oncology, Dept. of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Harold M
authors.initials: HM
authors.lastname: Swartz
mesh_terms: D001681:Biological Assay / Q000379:methods*; D015415:Biomarkers / Q000032:analysis; D004578:Electron Spin Resonance Spectroscopy / Q000379:methods*; D006801:Humans; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis*; D011834:Radiation Monitoring / Q000379:methods*; D018788:Radioactive Hazard Release; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013673:Technology Assessment, Biomedical; D014070:Tooth / Q000737:chemistry* / Q000528:radiation effects*; D014218:Triage / Q000379:methods*
chemical_list: D015415:Biomarkers