Optimizing the Use of Biodosimetry Tools in a Mass Casualty Incident When Surge with High Throughput is Necessary

Time for Sample Preparation

Time for biodosimetry sample preparation

---- Time for sample preparation and analysis

"Time-phased comparison of currently available dosimetry methods out to one week after detonation. Dotted lines represent time needed for sample preparation to occur before any results become available."

PCC: Premature Chromosome Condensation

CBMN: Cytokinesis Block Micronucleus

EPR: Electron Paramagnetic Resonance

"Note:

  • Some lymphocyte-based assays recommend 12 hours before drawing blood to allow lymphocyte circulation from tissues.
  • For the gamma-H2AX method, the dark green bar represents the microscopy method, and the light green bar is representative of the flow cytometry method of measurement.
  • For Premature Chromosome Condensation (PCC), the black bar represents the CHO method and the gray bar represents the chemical stimulation method."

Source: Sullivan JM et al., Assessment of Biodosimetry Methods for a Mass Casualty Radiological Incident: Medical Response and Management Considerations. Health Phys. 2013;105(6):540-554, See Figure 2. [PubMed Citation]

Dose Range

Biodosimetry dose range

Dose range in which the indicated assays are able to estimate absorbed radiation dose.

DCA: Dicentric Chromosome Assay

PCC: Premature Chromosome Condensation

LDK: Lymphocyte Depletion Kinetics

CBMN: Cytokinesis Block Micronucleus

EPR: Electron Paramagnetic Resonance

  • The dotted line represents conflicting dose estimate reports for the LDK assay that indicate the range begins at either 0.5 or 1 Gy.
  • For the gamma-H2AX method, the dark green column represents the dose range for the microscopy method, and the light green column is representative of the dose range for the flow cytometry method of measurement.

Source: Sullivan JM et al., Assessment of Biodosimetry Methods for a Mass Casualty Radiological Incident: Medical Response and Management Considerations. Health Phys. 2013;105(6):540-554, See Figure 1. [PubMed Citation]

Multiple Parameters

MethodDose Range
(Gy)		Time before sample
can be taken		Time to dose
estimate		Time period when
assay will give
results
Dicentric Chromosome Assay 0.1–5Immediately55 + h3–6+ mo
  0.5–5 (triage)52+ h
Cytokinesis Block
Micronucleus 		0.3–5Immediately3+ d6 mo –1 y
γ–H2AX Immediately24–48 h
   Microscope 0.5–54–6 h
   FACS 0.5–102 h
Lymphocyte Depletion
Kinetics Assay 		0.5/1–10Immediately for
baseline, time needed
for depletion to occur		<1 h per test.
Serial testing
requires 8-48 h.		12 h– 7 d
Premature Chromosome Condensation 0.2–20ImmediatelyCHO fusion: 2–3 h
Chemical
stimulation: 51 h		At least 1 wk, likely
6+ mo
Gene Expression 0.1–5Immediately,
depending on when
gene is upregulated		9–36 hThrough 48–72 h
EPR (tooth) 1–30Immediately5–25 minLifetime and longer

Source: Sullivan JM et al., Assessment of Biodosimetry Methods for a Mass Casualty Radiological Incident: Medical Response and Management Considerations. Health Phys. 2013;105(6):540-554, See Table 1. [PubMed Citation]