Radiation biology Flashcards
‘Exposure’
ability of X-rays to ionize air, measured in Roentgens
concentration of radiation, in air, at a specific point
ionization produced in a specific volume of air
Absorbed Radiation dose
Radiation dose
amount of energy absorbed per unit mass at a specific point (Gy or Rads)
Gy and Rads
1 Gy = 100 Rads
Equivalent dose =
Dose x weighting factor
weighting factor based on different types of radiation
For Xrays and gamma rays = 1
alpha particles = 20
Effective dose =
Type of radiation and type of tissue
Sv
EfD = EqD x Tissue factor
Kerma
PRIMARY energy transfer (no scatter, not overall dose)
Can’t measure in body, measure at air entrance point
Entrance air kerma
Kerman and photon energy
low vs high
Low energy photon primarily PE, KERMA and entry dose roughly the same
High energy photons pass through, KERMA = MORE than absorbed dose
KAP
Kerma x beam area
thought of as total radiation used in exam more than actual dose
INDEPENDENT of source distance
Mag will increase entrance skin kerma but NOT change KAP
Entrance Kerma, KAP and collimation
KAP WILL decrease with collimation
Entrance KERMA will increase a small amount 2/2 ABC
KERMA, KAP stochastic and deterministic risks
KAP estimate/correlates with stochastic risk
Entrance Air KERMA with deterministic effects
Relative Biologic Effectiveness
RBE calc?
Capability of radiation with differing LET’s to produce a biologic reaction
Dose of 250kV x-rays/ Dose in Gy of test radiation
ex: reaction produced by 5Gy of test radiation. It takes 10Gy of 250kV x-rays to produce same effect. RBE = ?
10/5 = 2. Test radiation is twice as good at producing the biologic effect
LET and RBE
as LET increases?
directly related to a point. Above a threshold (100keV/micrometer), max damage is being done and more radiation is ‘wasted’
Oxygen Enhancement Ratio
OER at high vs low LET
relative effectiveness of radiation to produce damage at different oxygen levels
Tissue is more sensitive to damage in an oxygenated state
Only relevant at LOW LET
HIGH LET will do a lot of damage in low or high oxygenated states (OER = 1. damage without oxygen = damage with oxygen)
Direct vs Indirect ionizing radiation
Direct act Directly on DNA
Indirect if they act on water (free radical fucks up DNA later)
Syndrome with most sensitivity to x-rays
Ataxia Telangiectasia
‘Instant death of a large number of cells’
1000 Gy in a period of seconds/minute
‘Mitotic death’
When a cell dies after 1 or more divisions
(a small dose can do this)
‘Mitotic delay’
A very small dose (0.01 Gy) just before a cell divides can cause a delay or failure in the timing of the normal dividing
Most sensitive phase
overall sensitivity of phases
M phase
M > G2 > G1 > S
(G1 = variable in length)
Law of B and T
cell sensitivity
Most sensitive cells = lots of turnover, not much differentiation (Skin, blood, GI tract, reproductive)
Less sensitive, little turnover, lots of differentiation (brain, nerves, muscles)
Most sensitive part of GI tract?
small bowel
Survival curve graph
? vs ?
quasi-threshold
dose vs cell survival
repair mechanisms = quasi-threshold = shoulder on graph = sublethal damage to the cell
only exists with lower LET radiation curves
effect on blood
lymphoctyes = most sensitive
ARS
3 subtypes
4 phases
4 phases
GI - latent - syndrome/subtype - recovery/death
Bone Marrow, GI, CNS
ARS
Bone Marrow
Dose
latent period
outcome
>2Gy
1-6 weeks
possible to survive
ARS
GI
Dose
latent period
outcome
>8Gy
5-7 days
death within 2 weeks
ARS
CNS
Dose
latent period
outcome
20-50 Gy
4-6 hours
Death within 3 days
lethal dose 50/30
Dose that will kill 50% of people within 30 days
3-4 Gy without treatment
Fetus and radiation
First 2 weeks
50-100 mGy may cause fetal loss (all or nothing).
Fetus and radiation
8 - 15 weeks
8-15 weeks = MOST VULNERABLE
over 100-200 mGy a/w
reduced head diameter and retardation
Fetus and radiation
childhood leukemia
increased risk with just a few radiographs
Fetal thyroid
BEFORE week 8 does NOT take up iodine
after that = hosed
General risk of cancer
4-5% per Sv
Skin stuff
Early transient erythema
Dose
onset
2Gy
Hours
Skin stuff
Robust erythema
Dose
onset
6 Gy
1 week
Skin stuff
Telangiectasia
Dose
onset
10Gy
52 weeks
Skin stuff
Dry desquamation
Dose
onset
13 Gy
4 weeks
Skin stuff
Moist desquam/ulceration
Dose
onset
18Gy
4 weeks
Skin stuff
Secondary ulceration
Dose
onset
24 Gy skin dose
>6 weeks
Hair
temporary epilation
3Gy
21 days onset
Hair
Permanent epilation
7 Gy
21 days
Cataracts
anterior vs posterior
senile cataracts = anterior
radiation cataracts = posterior lens
Cataracts latent period
20 years after exposure
Cataracts acute exposure
2.5 Gy
cataracts annual dose rate limit
0.15 Gy/year
Sterility/infertility
female
In general younger patient, more dose required to cause sterility
female age 12 - 10 Gy
female age 45 - 2Gy
female no age given - around 6 Gy
Sterility
male
Male temporary 0.15 Gy - 2.5 Gy
Male permanent - 5 Gy
Male/Female shielding
Male
Just below symphysis
Female
1 inch medial to each palpable asis
Symptom/Dose
nausea (30% of people)
0.75 - 1.25 Gy WB
Symptom/Dose
Depress lymphocytes
0.25 Gy WB
Symptom/Dose
LD 50/60 (Marrow)
3-4 Gy WB
Symptom/Dose
LD 50/4 (GI)
8 - 10 Gy WB
Symptom/Dose
LD CNS
>20 Gy
Symptom/Dose
double normal mutation rate
1 Gy
Effective background USA dose
3mSv per year
Dose trigger for addnl F/U
15 Gy to a single exposure field
sentinel event
Exposure limits
Occupational
lens
150 mSv/year
Exposure limits
Radiation worker
50 mSv/year
Exposure limits
occupational
extremity
500mSv/year
Public exposure limits
infrequent
5mSv/year
Public exposure limits
continuous
1mSv/year
Public exposure limits
embryo/fetus via mother
5mSv/year
(1mSv to fetus directly)
Public exposure limits
fetus post declared preg
0.5mSv/month
Public exposure limits
controlled areas
50 mSv/year
Public exposure limits
uncontrolled areas
5 mSv/year
Public exposure limits
Genetically Significant dose
0.25 mSv
High yield blitz
majority of energy received by biologic material from x-rays is transferred by?
electrons
High yield blitz
60% of damage to biologic tissue is mediated by?
free radicals
High yield blitz
final number of DS DNA breaks more important than initial, some will be repaired
High yield blitz
Risk of radiation induced Ca
adult
kid
old person
4-5% per Sv adult
15% per Sv kid
1/10th that older than 50
High yield blitz
Transient erythema timing
can be seen in hours, main wave after 10 days
High yield blitz
radiation sterility in females
mimics menopause
in males no effect on libido or hormone levels, latent period
High yield blitz
Radon workers get more lung cancer
High yield blitz
highest contributor to USA effective dose
inhaled Radon, an alpha emitter, 55% of effective dose
High yield blitz
gen pop man made greatest exposure?
medical imaging