Georgia Health Sciences University scientists have devised a way to reduce lung cancer cells’ ability to repair the lethal double-strand DNA breaks caused by radiation therapy.

“Radiation is a great therapy – the problem is the side effects,” said Dr. William S. Dynan, biochemist and Associate Director of Research and Chief, Nanomedicine and Gene Regulation at the GHSU Institute of Molecular Medicine and Genetics. “We think this is a way to get the same amount of cancer cell death with less radiation or use the same amount and maybe cure a patient that could not be cured before.”

Radiation therapy capitalizes on radiation’s ability to kill cells by causing double-strand breaks in DNA. But the fact that varying levels of radiation are essentially everywhere – food, air, the ground, etc. – means all cells, including cancer cells, have internal mechanisms to prevent the lethal breakage.

GHSU scientists are targeting the natural defense mechanisms by packaging a piece of an antibody against one of them with folate, which has easy access to most cells, particularly cancer cells. Many cancers, including the lung cancer cells they studied, have large numbers of folate receptors so that cancer cells get a disproportionate share of the package.

Previous efforts to destroy cancer cells’ ability to avoid radiation damage have focused on receptors on their surface, said Dr. Shuyi Li, molecular biologist, pediatrician and corresponding author on the study in the International Journal of Radiation Oncology.

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Scientists may be able to double efficacy of radiation therapy

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The study compared organ doses to the breast, lungs and pelvis using commonly used protocols and found a change in protocol could decrease breast radiation dose by more than 50 percent. “The highest doses to the breast skin and parenchyma were found with our standard thoracic CT protocol (120 kVp, variable 120-320 mA) and the protocol we use to assess for pulmonary embolism in the general population (120kVp, variable 200-394 mA),” said Dr. Diana Litmanovich of Harvard Medical School in Boston, and the lead author of the study.

“We found the dose was reduced by more than half when we used our protocol for assessing pulmonary embolism in pregnant or young patients,” (100 kVP, fixed 200 mA), said Dr. Litmanovich.

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Consider the breast and lungs when determining thoracic imaging protocols

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The above advisory no 1/FSSAI/2011 is based on the discussion in a meeting held under the Chairmanship of Sh P.I Suvrathan, Chairperson, FSSAI. A meeting was called by FSSAI to review the situation arising out of radioactive incidents in nuclear power plants in Japan and possible contamination of Japanese food being imported into India. After detailed discussions, it was concluded that since the radiation is spreading/expanding horizontally in other parts of Japan, it may result in further radioactive contamination in the supply chain of food exports from Japan.

Representatives/experts from Board of Radiation & Isotope Technology (BRIT), Bhabha Atomic Research Institute (BARC), Atomic Energy Regulatory Board (AERB), Indian Institute of Toxicology Research (IITR), Central Board of Excise & Customs (CBEC) and Shriram Institute for Industrial Research participated in the meeting.

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“To improve radiotherapy for lung cancer cells, we are studying the potential of natural non-toxic components of soybeans, called soy isoflavones, to augment the effect of radiation against the tumor cells and at the same time protect normal lung against radiation injury,” said Dr. Gilda Hillman, an associate professor in the Department of Radiation Oncology at Wayne State University’s School of Medicine and the Karmanos Cancer Institute in Detroit.

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Dose optimization workshop helps reduce radiation dose associated with MDCT scans

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The U.S. Food and Drug Administration has announced an initiative to reduce unnecessary radiation exposure from three types of medical imaging procedures: computed tomography (CT), nuclear medicine studies, and fluoroscopy. These procedures are the greatest contributors to total radiation exposure within the U.S. population and use much higher radiation doses than other radiographic procedures, such as standard X-rays, dental X-rays, and mammography.

CT, nuclear medicine, and fluoroscopic imaging have led to early diagnosis of disease, improved treatment planning, and image-guided therapies that help save lives every day. The FDA continues to support a strong dialogue between patients and physicians over the medical necessity and risk associated with these types of imaging studies.

However, like all medical procedures, CT, nuclear medicine, and fluoroscopy pose risks. These types of imaging exams expose patients to ionizing radiation, a type of radiation that can increase a person’s lifetime cancer risk. Accidental exposure to very high amounts of radiation also can cause injuries, such as skin burns, hair loss and cataracts. Health care decisions made by patients and their physicians should include discussions of the medical need and associated risks for each procedure.

“The amount of radiation Americans are exposed to from medical imaging has dramatically increased over the past 20 years,” said Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health. “The goal of FDA’s initiative is to support the benefits associated with medical imaging while minimizing the risks.”

While there is some disagreement over the extent of the cancer risk associated with exposure to radiation from medical imaging, there is broad agreement that steps can and should be taken to reduce unnecessary radiation exposure.

For example, the radiation dose associated with a CT abdomen scan is the same as the dose from approximately 400 chest X-rays. In comparison, a dental X-ray calls for approximately one-half the radiation dose of a chest X-ray. Both diagnostics serve important, sometimes critical, public health needs.

Through the FDA’s regulatory oversight of medical imaging devices, such as CT scanners, and through collaboration with other federal agencies and health care professional groups, the FDA is advocating the adoption of two principles of radiation protection: appropriate justification of the radiation procedure and optimization of the radiation dose used during each procedure.

“Working together,” said Shuren, “the FDA and other organizations hope to help patients get the right imaging exam, at the right time, with the right radiation dose.”

The three-pronged initiative the FDA is announcing will promote the safe use of medical imaging devices, support informed clinical decision-making, and increase patient awareness of their own exposure.

The FDA intends to issue targeted requirements for manufacturers of CT and fluoroscopic devices to incorporate important safeguards into the design of their machines to develop safer technologies and to provide appropriate training to support safe use by practitioners. The agency intends to hold a public meeting on March 30-31, 2010, to solicit input on what requirements to establish.

Examples could include a requirement that these devices display, record, and report equipment settings and radiation dose, an alert for users when the dose exceeds a diagnostic reference level (the optimal dose for most patients), training for users, and a requirement that devices be able to capture and transmit radiation dose information to a patient’s electronic medical record and to national dose registries.

In addition, the FDA and the Centers for Medicare and Medicaid Services are collaborating to incorporate key quality assurance practices into the mandatory accreditation and conditions of participation survey processes for imaging facilities and hospitals. These quality assurance practices will improve the quality of oversight and promote the safe use of advanced imaging technologies in those facilities.

The FDA recommends that health care professional organizations continue to develop, in collaboration with the agency, diagnostic radiation reference levels for medical imaging procedures, and increase efforts to develop one or more national registries for radiation doses.

A dose registry would pool data from many imaging facilities nationwide, capturing dose information from a variety of imaging studies. This registry will help define diagnostic reference levels where they do not yet exist, validate levels that do exist, and provide benchmarks for health care facilities to use in individual imaging studies.

In a bid to empower patients and increase awareness, the FDA is collaborating with other organizations to develop and disseminate a patient medical imaging history card. This tool, which will be available on the FDA’s Web site, will allow patients to track their own medical imaging history and share it with their physicians, especially when it may not be included in their medical records.

Source: U.S. Food and Drug Administration

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Sources at the Foreign Affairs ministry indicate that the aim is to put the final touches to a draft bill to provide for protection against risks associated with exposure to ionizing radiation, for the security of radiation sources and for the setting up of a Radiation Protection Authority.

The sources add that in this context, the International Atomic Energy Agency (IAEA), has sent an expert from its Office of Legal Affairs together with a consultant to help run the sessions.

Also the sources aver that the IAEA has indicated that it will also provide technical advice on the regulations for the proposed legislation.

The meetings are being attended by stakeholders from various ministries and agencies including the Attorney-General’s Office, Employment, Foreign Affairs, Defense, Police, Environment and Transport, and the National Assembly.

Seychelles joined the IAEA as a member in 2002 and have benefited from several projects and programs, including projects for eradicating the melon fly.

The IAEA has also helped the islands develop better nutrient management practices using nuclear-related techniques to enhance agricultural productivity, and assessing groundwater resources in several parts of the country.

Source African Press Agency

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Marcel Olitte, Responsible Officer for the Radiation Protection Authority, indicated here that in this context, the Ministry of Renewable Energy is promulgating the Radiation Protection (Registration of Radiation Sources and Facilities) Regulations 2009.

He added that the aim of the regulations will be to compel all the owners of equipments that emit ionizing rays and all institutions and department that use radiation sources to register these sources within 30 days from the date the equipments are being used or the institutions are operational.

Olitte declared that once the registration has become effective, a Registration certificate will be issued.

Also Olitte stated that the sectors that are most concerned are the health sectors which are using various apparatus including X-Ray, radioscopy, radiotherapy machines and scanners.

He averred that in the industrial sector, the majority of apparatus that emit radiation are to be found in the welding industry.

And Olitte said that these rays are beneficial to human beings when they are used judiciously, but can be dangerous in the long term and can even cause death in case users are exposed to them for a long time.

Source African Press Agency

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Writing in the article, Dr. Giedd comments, “Adolescence is a time of substantial neurobiological and behavioral change, but the teen brain is not a broken or defective adult brain. The adaptive potential of the overproduction/selective elimination process, increased connectivity and integration of disparate brain functions, changing reward systems and frontal/limbic balance, and the accompanying behaviors of separation from family of origin, increased risk taking, and increased sensation seeking have been highly adaptive in our past and may be so in our future. These changes and the enormous plasticity of the teen brain make adolescence a time of great risk and great opportunity.”

In an accompanying editorial, Elizabeth R. McAnarney MD, Department of Pediatrics, University of Rochester Medical Center, comments, “Finally neuroscientists are able to go under the ‘…leathery membrane, surrounded by a protective moat of fluid, and completely encased in bone…’ to provide new insights into brain development. Changes in the brain during childhood and adolescent development that are being documented through exquisite imaging by Giedd and others hold the promise for the development of hypotheses about the potential origins of behaviors that we have observed clinically for years….”

“Novelty seeking/sensation seeking and risk taking,” Dr. McAnarney continues, “is the basis for considerable growth during adolescence, as well as for the seemingly reckless behavior of some adolescents. Novelty seeking/sensation seeking and risk taking are topics of growing interest as adolescent brain development is defined better and as morbidity from adolescent risk taking mounts….The implication of our growing knowledge of brain–behavior mechanisms of adolescent conditions should provide insights into the risk of particular adolescents for morbidity and mortality. Preliminary data are promising so that as we begin to understand the complexity of and specificity of each of these conditions, we shall be able to diagnose and treat conditions earlier.”

The NIMH Longitudinal Brain Imaging Project began in 1989. Participants visit the NIMH at approximately two-year intervals for brain imaging, neuropsychological and behavioral assessment and collection of DNA. As of September 2007, approximately 5000 scans from 2000 subjects have been acquired. Of these, 387 subjects, aged 3 to 27 years, have remained free of any psychopathology and serve as the models for typical brain development.

Three themes have emerged from this and other studies in this new era of adolescent neuroscience. The first is functional and structural increases in connectivity and integrative processing as distributed brain modules become more and more integrated. Using a literary metaphor, maturation would not be the addition of new letters but rather of combining earlier formed letters into words, and then words into sentences and then sentences into paragraphs.

The second is a general pattern of childhood peaks of gray matter (frontal lobe, parietal lobe, temporal lobe and occipital lobe) followed by adolescent declines. As parts of the brain are overdeveloped and then discarded, the structure of the brain becomes more refined.

The third theme is a changing balance between limbic/subcortical and frontal lobe functions that extends well into young adulthood as different cognitive and emotional systems mature at different rates. The cognitive and behavioral changes taking place during adolescence may be understood from the perspective of increased “executive” functioning, a term encompassing a broad array of abilities, including attention, response inhibition, regulation of emotion, organization and long-range planning.

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The article is “The Teen Brain: Insights from Neuroimaging” by Jay N. Giedd, MD. The editorial is “Adolescent Brain Development: Forging New Links”” by Elizabeth R. McAnarney, MD. Both appear in the Journal of Adolescent Health, Volume 42, Issue 4 (April 2008) published by Elsevier.

Source: Elsevier Health Sciences

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