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Developments in Biodosimetry Methods for Triage With a Focus on X-band Electron Paramagnetic Resonance In Vivo Fingernail Dosimetry

Swarts, Steven, G.1; Sidabras, Jason, W.2; Grinberg, Oleg3; Tipikin, Dmitriy, S.3; Kmiec, Maciej, M.3; Petryakov, Sergey, V.3; Schreiber, Wilson3; Wood, Victoria, A.3; Williams, Benjamin, B.3; Flood, Ann, Barry3; Swartz, Harold, M.3

doi: 10.1097/HP.0000000000000874

Instrumentation and application methodologies for rapidly and accurately estimating individual ionizing radiation dose are needed for on-site triage in a radiological/nuclear event. One such methodology is an in vivo X-band, electron paramagnetic resonance, physically based dosimetry method to directly measure the radiation-induced signal in fingernails. The primary components under development are key instrument features, such as resonators with unique geometries that allow for large sampling volumes but limit radiation-induced signal measurements to the nail plate, and methodological approaches for addressing interfering signals in the nail and for calibrating dose from radiation-induced signal measurements. One resonator development highlighted here is a surface resonator array designed to reduce signal detection losses due to the soft tissues underlying the nail plate. Several surface resonator array geometries, along with ergonomic features to stabilize fingernail placement, have been tested in tissue-equivalent nail models and in vivo nail measurements of healthy volunteers using simulated radiation-induced signals in their fingernails. These studies demonstrated radiation-induced signal detection sensitivities and quantitation limits approaching the clinically relevant range of ≤ 10 Gy. Studies of the capabilities of the current instrument suggest that a reduction in the variability in radiation-induced signal measurements can be obtained with refinements to the surface resonator array and ergonomic features of the human interface to the instrument. Additional studies are required before the quantitative limits of the assay can be determined for triage decisions in a field application of dosimetry. These include expanded in vivo nail studies and associated ex vivo nail studies to provide informed approaches to accommodate for a potential interfering native signal in the nails when calculating the radiation-induced signal from the nail plate spectral measurements and to provide a method for calibrating dose estimates from the radiation-induced signal measurements based on quantifying experiments in patients undergoing total-body irradiation or total-skin electron therapy.

1Department of Radiation Oncology, University of Florida, P.O. Box 100385, Gainesville, FL 32610 USA;

2Max Planck Institute for Chemical Energy Conversion, Biophysical Chemistry, Stiftstr. 34–36, 45470 Mülheim, Germany;

3Geisel School of Medicine, HB 7785 Dartmouth College, Hanover, NH 03755 USA.

Conflicts of interest and source of funding: Harold M. Swartz and Ann Barry Flood are owners of Clin-EPR, LLC (278 River Road, Lyme, NH 03768 USA) which manufactures EPR instruments designed for in vivo clinical applications for investigational use only. For the remaining authors, no conflicts of interest were declared.

For correspondence contact: Steven G. Swarts, Department of Radiation Oncology, University of Florida, 2033 Mowry Road, P.O. Box 103633, Gainesville, FL 32610, or email at

(Manuscript accepted 21 February 2018)

© 2018 by the Health Physics Society