Systematic survey of the dose enhancement in tissue-equivalent materials facing medium- and high-Z backscatterers exposed to X-rays with energies from 5 to 250 keV.

The present study has been inspired by the results of earlier dose measurements in tissue-equivalent materials adjacent to thin foils of aluminum, copper, tin, gold, and lead. Large dose enhancements have been observed in low-Z materials near the interface when this ensemble was irradiated with X-rays of qualities known from diagnostic radiology. The excess doses have been attributed to photo-, Compton, and Auger electrons released from the metal surfaces. Correspondingly, high enhancements of biological effects have been observed in single cell layers arranged close to gold surfaces. The objective of the present work is to systematically survey, by calculation, the values of the dose enhancement in low-Z media facing backscattering materials with a variety of atomic numbers and over a large range of photon energies. Further parameters to be varied are the distance of the point of interest from the interface and the kind of the low-Z material. The voluminous calculations have been performed using the PHOTCOEF algorithm, a proven set of interpolation functions fitted to long-established Monte Carlo results, for primary photon energies between 5 and 250 keV and for atomic numbers varying over the periodic system up to Z = 100. The calculated results correlate well with our previous experimental results. It is shown that the values of the dose enhancement (a) vary strongly in dependence upon Z and photon energy; (b) have maxima in the energy region from 40 to 60 keV, determined by the K and L edges of the backscattering materials; and (c) are valued up to about 130 for "International Commission on Radiological Protection (ICRP) soft tissue" (soft tissue composition recommended by the ICRP) as the adjacent low-Z material. Maximum dose enhancement associated with the L edge occurs for materials with atomic numbers between 50 and 60, e.g., barium (Z = 56) and iodine (Z = 53). Such materials typically serve as contrast media in medical X-ray diagnostics. The gradual reduction in the dose enhancement with increasing distance from the material interface, owed to the limited ranges of the emitted secondary electrons, has been documented in detail. The discussion is devoted to practical radiological aspects of the dose enhancement phenomenon. Cytogenetic effects in cell layers closely proximate to surfaces of medium-Z materials might vary over two orders of magnitude, because the dose enhancement is accompanied by the earlier observed about twofold increase in the low-dose RBEM at a tissue-to-gold interface.

A review of the scientific basis for radiation protection of the patient.

The use of ionising radiation in medicine is the single largest man-made source of population exposure. Individual and collective doses to patients arising from the medical use of ionising radiations continue to rise significantly year on year. This is due to the increasing use of medical imaging procedures in modern healthcare systems as well as the continued development of new high dose techniques. This paper reviews the scientific basis for the principles of radiation protection as defined by the International Commission on Radiological Protection. These principles attempt to include exposures arising from both medical and non-medical applications within a common framework and have evolved over many years and changing socio-economic considerations. In particular, the concepts of justification and ALARA (doses should be as low as reasonably achievable), which underpin the principles for medical exposures are assessed in terms of their applicability to the scientific process and relevance to a rapidly changing technologically-led healthcare system. Radiation protection is an integral component of patient safety in medical practices and needs to be evidence based and amenable to the scientific process. The limitations imposed by the existing philosophy of radiation protection to the development of a quantitative framework for adequately assessing the performance of medical imaging systems are highlighted. In particular, medical practitioners will require quantitative guidance as to the risk-benefits arising from modern X-ray imaging methods if they are to make rational judgements as to the applicability of modern high-dose techniques to particular diagnostic and therapeutic tasks. At present such guidance is variable due to the lack of a rational framework for assessing the clinical impact of medical imaging techniques. The possible integration of radiation protection concepts into fundamental bio-medical imaging research activities is discussed.

[Cancer incidence rate after diagnostic X-ray exposure in 1976 - 2003 among patients of a university children's hospital]. / Inzidenz von Kinderkrebs nach Röntgendiagnostik im Patientenkollektiv der Jahre 1976 - 2003 einer Universitäts-Kinderklinik.

PURPOSE: Although the carcinogenic effect of ionizing radiation is well known, knowledge gaps persist on the health effects of low-dose radiation, especially in children. The cancer incidence rate in a cohort of 92,957 children diagnosed using X-rays in the years 1976 - 2003 in the radiology department of a large university clinic was studied. MATERIALS AND METHODS: Individual radiation doses per examination were reconstructed using an algorithm taking into account the dose area product and other exposure parameters together with conversion factors computed specifically for the equipment and protocols used in the radiology department. Incident cancer cases in the period 1980 - 2006 were identified via record linkage to the German Childhood Cancer Registry using pseudonymized data. RESULTS: A total of 87 cancers occurred in the cohort between 1980 and 2006: 33 leukemia, 13 lymphoma, 10 brain tumors, and 31 other tumors. The standardized incidence ratio (SIR) for all cancers was 0.99 (95 % CI: 0.79 1.22). A dose-response relationship was not observed for all cancers, leukemia and lymphoma or solid tumors. The cancer risks for boys and girls did not differ. CONCLUSION: No increase in the cancer incidence risk in relation to very low doses of diagnostic ionizing radiation was observed in this study. However, the results are compatible with a broad range of risk estimates.

[Radiation exposure of children in pediatric radiology. Part 7: conversion factors for reconstruction of organ dose during thoracoabdominal babygrams]. / Zur Strahlenexposition von Kindern in der pädiatrischen Radiologie. Teil 7: Konversionsfaktoren zur Rekonstruktion von Organdosen beim thorakoabdominalen Babygramm.

PURPOSE: Calculation of conversion coefficients for the reconstruction of organ doses from entrance doses for thoracoabdominal babygrams of premature neonates with a gestational age of 23 and 27 weeks and of mature neonates. MATERIALS AND METHODS: Using the commercially available personal computer program PCXMC developed by the Finnish Centre for Radiation and Nuclear Safety (Säteilyturvakeskus STUK), conversion coefficients for conventional thoracoabdominal babygrams were calculated with Monte Carlo simulations in mathematical hermaphrodite phantom models describing patients of different ages. RESULTS: Conversion coefficients for the reconstruction of organ doses in approximately 40 organs and tissues of the human body from measured entrance doses during thoracoabdominal babygrams were calculated for the standard sagittal beam projections and the standard focus film distance of 100 cm. CONCLUSION: The conversion coefficients presented in this paper may be used for organ dose assessments from entrance doses measured during thoracoabdominal babygrams especially in patients in special care baby units.

[Radiation exposure of children in pediatric radiology. Part 6: conversion factors for reconstruction of organ dose in abdominal radiography]. / Zur Strahlenexposition von Kindern in der pädiatrischen Radiologie. Teil 6: Konversionsfaktoren zur Rekonstruktion von Organdosen bei Abdomenaufnahmen.

PURPOSE: Calculation of conversion coefficients for the reconstruction of organ doses from entrance doses for abdomen radiographs of 0, 1, 5, 10, 15, and 30-year-old patients in conventional pediatric radiology for the radiographic settings recommended by the German and European guidelines for quality management in diagnostic radiology. MATERIALS UND METHOD: Using the commercially available personal computer program PCXMC developed by the Finnish Center for Radiation and Nuclear Safety (Säteilyturvakeskus STUK), conversion coefficients for conventional abdomen radiographs were calculated performing Monte Carlo simulations in mathematical hermaphrodite phantom models describing patients of different ages. The possible clinical variation of beam collimation was taken into consideration by defining optimal and suboptimal radiation fields on the phantoms' surfaces. RESULTS: Conversion coefficients for the reconstruction of organ doses in about 40 organs and tissues of the human body from measured entrance doses during abdomen radiographs for 0, 1, 5, 10, 15, and 30-year-old pediatric patients were calculated for the standard sagittal and lateral beam projections and the standard focus film distances of 100 cm and 115 cm. CONCLUSION: The conversion coefficients presented in this paper may be used for organ dose assessments from entrance doses measured during abdomen radiographs of patients of all age groups and all beam collimations within the optimal and suboptimal standard beam collimations.

[Radiation exposure of children in pediatric radiology--part 2: the PAEDOS algorithm for computer-assisted dose reconstruction in pediatric radiology and results for X-ray examinations of the skull]. / Zur Strahlenexposition von Kindern in der pädiatrischen Radiologie--Teil 2: der PADOS-Algorithmus zur rechnergestützten Dosisrekonstruktion in der Kinderradiologie am Beispiel der Röntgenuntersuchung des Schädels.

PURPOSE: Development of an algorithm for computer-assisted dose reconstruction using exposure data from a very large electronic database of a university children's hospital. Radiation dose values and new conversion factors for pediatric radiology were calculated and selected results for skull X-rays of 5-year-old patients will be presented. MATERIALS AND METHODS: Since 1976 all relevant data from daily routine X-ray examinations performed in Dr. von Hauner's Kinderspital (children's hospital of the university of Munich, DvHK) have been stored electronically in a database. This database now encompasses basic personal patient data, type of radiological procedure, individual radiographic/fluoroscopic settings, dose measurements (dose area product), individual referral criteria and radiological diagnosis. After 30 years of data gathering, the database now includes 305 434 radiological examinations (radiographs and fluoroscopies) of all age groups, from newborns to adolescents. With a computer program, called PADOS, a specific algorithm was created to calculate radiation doses using the individual dose area product values and other known exposure parameters extracted from the databases. The dose reconstruction procedure is based on the conversion factor concept. By means of the PCXMC program developed by the Finnish Center for Radiation and Nuclear Safety (STUK, Helsinki), Monte Carlo simulations were performed to calculate new conversion factors for pediatric radiology based on the radiographic technique used in the DvHK. RESULTS: The entrance dose values of skull X-rays showed a very good correlation with the changes of examination technique in the last 30 years. In our sample, the measured dose values for skull X-rays were far below the reference dose levels set by the Bundesamt für Strahlenschutz (BfS) in 2003. Conversion factors for 28 different radiographic procedures, 6 age groups, 40 reference organs, 3 beam projections, 12 voltage settings and 3 total filtration levels were calculated. The influence of collimation on the organ doses of radiosensitive organs, e. g. thyroid, bone marrow, in all age groups, especially in the very young, was able to be demonstrated. CONCLUSION: The PADOS algorithm seems to be suitable for the handling of very large and heterogeneous radiological databases and allows the reconstruction of various dose entities.

[Radiation exposure of children in pediatric radiology. Part 3: Conversion coefficients for reconstruction of organ doses achieved during chest X-ray examinations]. / Zur Strahlenexposition von Kindern in der pädiatrischen Radiologie. Teil 3: Konversionsfaktoren zur Rekonstruktion von Organdosen bei Thoraxaufnahmen.

PURPOSE: Calculation of conversion coefficients for the reconstruction of organ doses from entrance doses for chest radiographs of 0, 1, 5, 10, 15, and 30-year-old patients in conventional pediatric radiology for the radiographic settings recommended by the German and European guidelines for quality management in diagnostic radiology. MATERIALS AND METHODS: The conversion coefficients for pediatric chest radiographs were calculated using the commercially available personal computer program PCXMC developed by the Finnish Centre for Radiation and Nuclear Safety (Säteilyturvakeskus STUK). PCXMC is a Monte Carlo program for computing organ and effective doses in about 40 organs of mathematical hermaphrodite phantom models describing patients of different ages. The possible clinical variation of beam collimation was taken into consideration by defining optimal and suboptimal radiation fields on the phantoms' surfaces. RESULTS: Conversion coefficients for the reconstruction of organ doses from measured entrance doses during chest radiographs for 0, 1, 5, 10, 15, and 30-year-old pediatric patients were presented. Conversion coefficients were calculated for the standard sagittal and lateral beam projections and the standard focus film distances of 100 cm, 115 cm, and 150 cm using the standard radiation qualities according to the recommendations of the German and European guidelines for quality management in diagnostic radiology. These conversion coefficients allow the reconstruction of the absorbed dose in about 40 organs and tissues of the human body for optimal and suboptimal radiation field collimations. CONCLUSION: The conversion coefficients presented in this paper may be used for organ dose assessments from entrance doses measured during chest radiographs of patients of all age groups with all beam collimations within optimal and suboptimal standard beam collimations. While the influence of the beam collimation on organ doses of organs localized near the center of the beam is expectedly low, the radiation exposure of organs and tissues near the boundaries of the radiation field can be considerably reduced by an optimal beam collimation. The conversion coefficients calculated for the STUK phantoms are in good conformity with values published for the GSF phantoms "Adam", "Golem" and "Visible Human".

Average glandular dose conversion coefficients for segmented breast voxel models.

For 8 voxel models of a compressed breast (4-7 cm thickness and two orientations for each thickness) and 14 radiation qualities commonly used in mammography (HVL 0.28-0.50 mm Al), tissue dose conversion coefficients were calculated for a focus-to-film distance of 60 cm using Monte Carlo methods. The voxel models were segmented from a high-resolution (slice thickness of 1 mm) computed tomography data set of an ablated breast specimen fixated while being compressed. The contents of glandular tissues amounted to 2.6%, and were asymmetrically distributed with regard to the midplane of the model. The calculated tissue dose conversion coefficients were compared with the recent literature values. These earlier tissue dose conversion coefficients were also calculated using Monte Carlo methods and breast models of various thickness, but these consist of homogeneous mixtures of glandular and adipose tissues embedded in 5 mm pure adipose tissue both at the entrance and exit sides. The results show that the new glandular tissue dose conversion coefficients agree well with the literature values for those cases where the glandular tissue is predominantly concentrated in the upper part of the model. In the opposite case, they were lower by up to 40%. These findings reveal a basic problem in patient dosimetry for mammography: glandular dose is not only governed by the average breast composition, which could be derived from the breast thickness, but also by the local distribution of glandular tissue within the breast, which is not known.

RADIUS--closing the circle on the assessment of imaging performance.

The RADIUS (Radiological Imaging Unification Strategy) project addresses the assessment of image quality in terms of both physical and clinically relevant measures. The aim is to unify our understanding of both types of measure as well as the numerous underlying factors that play a key role in the assessments of imaging performance. In this way it is expected to provide a solid basis for the improvement in radiological safety management, where not only radiation risks are considered but also diagnostic risks of incorrect clinical outcomes (i.e. false positive/false negative). The project has applied a variety of relevant experimental and theoretical methods to this problem, which is generic to medical imaging as a whole. Digital radiography of the chest and the breast has been employed as the clinical imaging domain vehicles for the study. The project addressed the problem from the following directions: role and relevance of pathology, human observer studies including receiver operating characteristics, image quality criteria analysis, structural noise analysis, physical measurements on clinical images, physical measurements on imaging system, modelling of imaging system, modelling of visual processes, modelling of doses delivered and IT-based scientific support strategies. This paper presents an overview of the main outcomes from this project and highlights how the research outcomes actually apply to the real world. In particular, attention will be focused on new and original findings and methods and techniques that have been developed within the framework of the project. The relevance of the project's outcomes to future European research will also be presented.

Parameters affecting EPR dose reconstruction in teeth.

The aim of this paper is to analyze the lower limit of detection (LLD), linearity of dose response, variation of radiation sensitivity between different tooth enamel samples, and time/temperature stability of EPR biodosimetry in tooth enamel. The theoretical LLD is shown to be 0.46 mGy, which is far lower than the measured value of about 30 mGy. The main issues to lowering LLD are the differentiation of the radiation-induced component against the total EPR spectrum and the complex nature of the dose dependence of the EPR signal. The following questions are also discussed in detail: need for exfoliated or extracted teeth from persons of interest, accounting for background radiation contribution; conversion of tooth enamel absorbed dose to effective dose; accounting for internal exposure specifically from bone-seeking radionuclides. Conclusions on future development of EPR retrospective biodosimetry are made.

Spectra of scattered photons in large absorbers and their importance for the values of radiation weighting factor wR.

In its review of the present values of radiation weighting factor w(R) and of possible revisions of this factor, the German Radiation Protection Commission has recommended to maintain the approach of ICRP 60 to base the selection of the w(R) value for a given radiation (e.g. fission neutrons) on observed values of the relative biological effectiveness (RBE) of this radiation 'regardless of whether the reference radiation is X rays or gamma rays'. The physical background of the German recommendation is the buildup of a strong field of energy-degraded Compton scattered photons in the human body if exposed to an external field of high-energy photons, so that the total radiation field inside the body is a mixture comprising low and high photon energies. Therefore, it is appropriate that the selection of the w(R) value of the given radiation is guided by RBE values averaged over X rays and gamma rays as the reference radiations. In support of this rationale, the present paper provides a sample of Monte Carlo calculated scattered photon spectra in large absorbers exposed to high-energy photons. Depth-dependent fractional dose contributions of the scattered photons are tabulated for incident energies from 1 to 10 MeV, and estimates of the influence of their degraded energies on the biological effectiveness of the incoming radiation are presented. Accordingly, we point out that it is appropriate to use, for the purposes of 'risk projection', RBE values averaged over X and gamma reference radiations.

Adult female voxel models of different stature and photon conversion coefficients for radiation protection.

This paper describes the construction of three adult female voxel models, two whole-body and one from head to thighs, from computed tomographic data of 3 women of different stature. Voxel models (also called phantoms) are human models based on computed tomographic or magnetic resonance images obtained from high resolution continuous scans of a single individual. The gray-scale data or information content of the medical images are interpreted into tissues (i.e., organs), a process known as segmentation. The phantoms, consisting of millions of volume elements, called voxels, provide a three-dimensional representation of the human body and the spatial form of its constituent organs and structures. They were initially developed for radiation protection purposes to estimate the organ and effective doses and hence the risk to a person or population due to an irradiation. This paper also presents conversion coefficients for idealized geometries of external photon exposures of energies 10 keV-1 MeV for the three female models, calculated with a Monte Carlo code. Until now there were not any published data on conversion coefficients for explicit female voxel models. Such sets of conversion coefficients exist for voxel adult males or for MIRD-type male, female, and hermaphrodite models. Numerical differences of the calculated conversion coefficients for the voxel female models and MIRD-type models can amount up to 60% or more for external exposures and are due to the improved anatomical realism of the voxel models. The size of the model also has an effect on the conversion coefficients, particularly for deeper lying organs and energies below 200 keV. The three separate sets of conversion coefficients allow one to choose the most suitable model according to the size of the individual as well as to study the dosimetric variations due to the size of the model.

The application of voxel phantoms to the internal dosimetry of radionuclides.

Extensive calculations of specific absorbed fractions (SAFs) for monoenergetic photon sources were performed using a Monte Carlo photon transport code together with seven male and female adult voxel models based on computed tomographic data of real persons. These models offer greater realism with respect to organ topology than the mathematical phantoms commonly used in the past. Due to individual anatomical differences, large variations in photon SAFs between the voxel models were found that can amount to orders of magnitude for very low photon energies. However, in many cases, the larger differences were found between MIRD-type and voxel models, since the inter-organ distances tend to be larger in the MIRD-type phantoms than in reality, due to over-simplification of organ shapes. Furthermore, organ absorbed doses per incorporated activity were evaluated for two selected radiopharmaceuticals. Although a method was found to largely eliminate the influence of organ mass on SAFs for organ self-absorption, the absorbed dose coefficients varied by several tens of per cent between the individual voxel models, thus indicating a significant influence of individual photon SAFs for organ cross-fire on organ absorbed dose. Again, 43% of the MIRD organ dose values were outside the range of doses spanned by the voxel models. Effective dose showed a variation of only up to 26% between the single voxel models for the radiopharmaceuticals considered.

The maximum low-dose RBE of 17.4 and 40 keV monochromatic X rays for the induction of dicentric chromosomes in human peripheral lymphocytes.

Schmid et al. recently reported on the maximum low-dose RBE for mammography X rays (29 kV) for the induction of dicentrics in human lymphocytes. To obtain additional information on the RBE for this radiation quality, experiments with monochromatized synchrotron radiation were performed. Monochromatic 17.4 keV X rays were chosen for comparison with the diagnostic mammography X-ray spectrum to evaluate the spectral influence, while monochromatic 40 keV X rays represent a higher-energy reference radiation, within the experiment. The induction of dicentric chromosomes in human lymphocytes from one blood donor irradiated in vitro with 17.4 keV and 40 keV monochromatic X rays resulted in alpha coefficients of (3.44 +/- 0.87) x 10(-2) Gy(-1) and (2.37 +/- 0.93) x 10(-2) Gy(-1), respectively. These biological effects are only about half of the alpha coefficients reported earlier for exposure of blood from the same donor with the broad energy spectra of 29 kV X rays (mean energy of 17.4 keV) and 60 kV X rays (mean energy of 48 keV). A similar behavior is evident in terms of RBEM. Relative to weakly filtered 220 kV X rays, the RBEM for 17.4 and 40 keV monochromatic X rays is 0.86 +/- 0.23 and 0.59 +/- 0.24, respectively, which is in contrast to the RBEM of 1.64 +/- 0.27 for 29 kV X rays and 1.10 +/- 0.19 for 60 kV X rays. It is evident that the monochromatic radiations are less effective in inducing dicentric chromosomes than broad-spectrum X rays with the corresponding mean energy value. Therefore, it can be assumed that, for these X-ray qualities with broad energy spectra, a large fraction of the effects should be attributed predominantly to photons with energies well below the mean energy.

RBE of nearly monoenergetic neutrons at energies of 36 keV-14.6 MeV for induction of dicentrics in human lymphocytes.

We examined the induction of dicentric chromosomes in human lymphocytes irradiated in vitro with nearly monoenergetic neutrons at energies in the range of 36 keV-15.0 MeV. For the assessment of the relative biological effectiveness (RBE) both 220 kV x-rays and (60)Co gamma-rays were used as reference radiations. To avoid potential confounding factors that would influence the outcome of the experiments, only blood from one individual was used. The neutron RBE culture conditions ensured that the chromosome analysis could be performed exclusively in metaphases of the first cell cycle in vitro. For the reference radiation of 220 kV x-rays, the values of RBE(M) were found to increase from 16.6 (E(n)=36 keV) to the maximum value of 23.4 (E(n)=385 keV). For (60)Co gamma-rays utilized as the reference radiation, the corresponding RBE(M) values were found to be higher by a factor of 4. These results agree well with the previously published large data sets of three laboratories on dose-response relationships for dicentrics or dicentrics plus centric rings. They show a similar dependence of RBE on neutron energy.

An adaptive algorithm for the detection of microcalcifications in simulated low-dose mammography.

This paper uses the task of microcalcification detection as a benchmark problem to assess the potential for dose reduction in x-ray mammography. We present the results of a newly developed algorithm for detection of microcalcifications as a case study for a typical commercial film-screen system (Kodak Min-R 2000/2190). The first part of the paper deals with the simulation of dose reduction for film-screen mammography based on a physical model of the imaging process. Use of a more sensitive film-screen system is expected to result in additional smoothing of the image. We introduce two different models of that behaviour, called moderate and strong smoothing. We then present an adaptive, model-based microcalcification detection algorithm. Comparing detection results with ground-truth images obtained under the supervision of an expert radiologist allows us to establish the soundness of the detection algorithm. We measure the performance on the dose-reduced images in order to assess the loss of information due to dose reduction. It turns out that the smoothing behaviour has a strong influence on detection rates. For moderate smoothing. a dose reduction by 25% has no serious influence on the detection results. whereas a dose reduction by 50% already entails a marked deterioration of the performance. Strong smoothing generally leads to an unacceptable loss of image quality. The test results emphasize the impact of the more sensitive film-screen system and its characteristics on the problem of assessing the potential for dose reduction in film-screen mammography. The general approach presented in the paper can be adapted to fully digital mammography.

The effect of 29 kV X rays on the dose response of chromosome aberrations in human lymphocytes.

The induction of chromosome aberrations in human lymphocytes irradiated in vitro with X rays generated at a tube voltage of 29 kV was examined to assess the maximum low-dose RBE (RBE(M)) relative to higher-energy X rays or 60Co gamma rays. Since blood was taken from the same male donor whose blood had been used for previous irradiation experiments using widely varying photon energies, the greatest possible accuracy was available for such an estimation of the RBE(M), avoiding the interindividual variations in sensitivity or differences in methodology usually associated with interlaboratory comparisons. The magnitude of the linear coefficient alpha of the linear-quadratic dose-effect relationship obtained for the production of dicentric chromosomes by 29 kV X rays (alpha = 0.0655 +/- 0.0097 Gy(-1)) confirms earlier observations of a strong increase in alpha with decreasing photon energy. Relating this value to previously published values of alpha for the dose-effect curves for dicentrics obtained in our own laboratory, RBE(M) values of 1.6 +/- 0.3 in comparison with weakly filtered 220 kV X rays, 3.0 +/- 0.7 compared to heavily filtered 220 kV X rays, and 6.1 +/- 2.5 compared to 60Co gamma rays have been obtained. These data emphasize that the choice of the reference radiation is of fundamental importance for the RBE(M) obtained. A special survey of the RBE(M) values obtained by different investigators in the narrow quality range from about 30 to 350 kV X rays indicates that the present RBE is in fairly good agreement with previously published findings for the induction of chromosome aberrations or micronuclei in human lymphocytes but differs from recently published findings for neoplastic transformation in a human hybrid cell line.

Enhanced values of the RBE and H ratio for cytogenetic effects induced by secondary electrons from an X-irradiated gold gurface.

The low-energy secondary electrons emerging from the entrance surface of an X-irradiated gold foil increase the dose to cells in contact with or at micrometer distances from this surface (Radiat. Res. 150, 92-100, 1998). We examined the effect of the spectrum of these low-energy electrons on the RBE for cytogenetic effects and showed that this RBE was increased. A monolayer of surface-attached human T lymphocytes was exposed to 60 kV X rays in the absence or presence of a gold foil positioned immediately behind the cell layer or separated from it by a Mylar foil 0.9 or 2 microm thick. The enhancement of dose in the cell nuclei caused by the photoelectrons and Auger electrons emerging from the entrance surface of the gold foil was measured by TSEE dosimetry. Dose enhancement factors of 55.7, 46.6 and 37.5 were obtained with 0, 0.9 and 2 microm of Mylar inserted between the gold surface and the cell layer. This large enhancement results from the photoelectric effect in the gold foil, as shown by the accompanying Monte Carlo calculations of the secondary electron spectra at the gold surface. Auger electrons from the gold foil generally were not able to penetrate into the cell nuclei except for that fraction of the cells that had a very thin (< 0.7 microm) layer of cytoplasm and membranes between gold surface and cell nucleus. The dose-yield curves for dicentric chromosomes plus centric rings and for acentric fragments obtained after exposures without or with the gold foil were linear-quadratic. The coefficient alpha, the slope of the linear yield component, was increased in the presence of the gold foil and showed RBE values ranging from 1.7 to 2.2 compared to exposures in absence of the gold foil. The ratio of the yield of interstitial deletions and dicentrics (H ratio) was significantly increased from about 0.17 in the absence of the gold foil to about 0.22 in the presence of the gold foil. The increases in the RBE and the H ratio are interpreted in microdosimetric terms: The preferred occurrence of electron track ends in the vicinity of the gold surface causes an increase in the dose-mean restricted linear energy transfer in cell nuclei exposed to the photoelectrons and Auger electrons.