Dosimetric and radiation cancer risk evaluation of high resolution thorax CT during COVID-19 outbreak

Purpose: The aim of this work was to evaluate the dosimetric impact of high-resolution thorax CT during COVID-19 outbreak in the University Hospital of Parma. In two months we have performed a huge number of thorax CT scans collecting effective and equivalent organ doses and evaluating also the lifetime attributable risk (LAR) of lung and other major cancers. Materials and Method: From February 24th to April 28th, 3224 high-resolution thorax CT were acquired. For all patients we have examined the volumetric computed tomography dose index (CTDIvol), the dose length product (DLP), the size-specific dose estimate (SSDE) and effective dose (E103) using a dose tracking software (Radimetrics Bayer HealthCare). From the equivalent dose to organs for each patient, LAR for lung and major cancers were estimated following the method proposed in BEIR VII which considers age and sex differences. Results: Study population included 3224 patients, 1843 male and 1381 female, with an average age of 67 years. The average CTDIvol, SSDE and DLP, and E103 were 6.8 mGy, 8.7 mGy, 239 mGy·cm and 4.4 mSv respectively. The average LAR of all solid cancers was 2.1 cases per 10,000 patients, while the average LAR of leukemia was 0.2 cases per 10,000 patients. For both male and female the organ with a major cancer risk was lung. Conclusions: Despite the impressive increment in thoracic CT examinations due to COVID-19 outbreak, the high resolution low dose protocol used in our hospital guaranteed low doses and very low risk estimation in terms of LAR

Measurements of metaphase and interphase chromosome aberrations transmitted through early cell replication rounds in human lymphocytes exposed to low-LET protons and high-LET 12C ions

Inheritable chromosome aberrations (CA) are of concern because cytogenetic damage may trigger the carcinogenic process. Moreover, stability of radiation-induced CA is a prerequisite for meaningful biological dosimetry. CA inheritability arguably depends on the aberration structure, with symmetrical exchanges being favoured over asymmetrical rearrangements, but it is also affected by radiation quality. CA induced by low-LET protons and high-LET 12C ions in G0 peripheral blood lymphocytes were measured in first- , second- and third-generation by combined FISH/harlequin staining of metaphase as well as prematurely condensed interphase chromosomes 1 and 2. As expected, the frequency of non-transmissible (NT) aberrations declined through replication rounds. A radiation-induced arrest occurred prior to first post-irradiation mitosis that prevalently affected aberrant cells. Aberrant cells incurred cycle delays also at subsequent cycles following proton-irradiation but not 12C ion-irradiation. As expected, the frequency of reciprocal translocations remained fairly stable while that of dicentrics was halved at each mitotic round. A significant fraction of complex-type exchanges was found in third-generation cells following both irradiations and appeared to be transmitted relatively more efficiently after protons than 12C ions. A low but stably transmitted frequency of transmissible (T)-type insertions were detected after 12C ions but not after low LET-irradiation. Our data support a differential ability by aberrant cells to progress through post-irradiation mitoses that is influenced by the aberration burden and radiation quality

Measurements of metaphase and interphase chromosome aberrations transmitted through early cell replication rounds in human lymphocytes exposed to low-LET protons and high-LET 12C ions.

Inheritable chromosome aberrations (CA) are of concern because cytogenetic damage may trigger the carcinogenic process. Moreover, stability of radiation-induced CA is a prerequisite for meaningful biological dosimetry. CA inheritability arguably depends on the aberration structure, with symmetrical exchanges being favoured over asymmetrical rearrangements, but it is also affected by radiation quality. CA induced by low-LET protons and high-LET 12C ions in G0 peripheral blood lymphocytes were measured in first- , second- and third-generation by combined FISH/harlequin staining of metaphase as well as prematurely condensed interphase chromosomes 1 and 2. As expected, the frequency of non-transmissible (NT) aberrations declined through replication rounds. A radiation-induced arrest occurred prior to first post-irradiation mitosis that prevalently affected aberrant cells. Aberrant cells incurred cycle delays also at subsequent cycles following proton-irradiation but not 12C ion-irradiation. As expected, the frequency of reciprocal translocations remained fairly stable while that of dicentrics was halved at each mitotic round. A significant fraction of complex-type exchanges was found in third-generation cells following both irradiations and appeared to be transmitted relatively more efficiently after protons than 12C ions. A low but stably transmitted frequency of transmissible (T)-type insertions were detected after 12C ions but not after low LET-irradiation. Our data support a differential ability by aberrant cells to progress through post-irradiation mitoses that is influenced by the aberration burden and radiation quality