The ICRP launched in 2021 a task group (TG119) on the ‘Effects of Ionising Radiation on Diseases of the Circulatory System (DCS) and their Consideration in the System of Radiological Protection’.
It has broadly been established that high acute radiation doses as in radiotherapy cause damage to the heart and blood vessels (e.g., carotid and coronary arteries) in humans and induce an increase of DCS incidence and mortality one or two decades after exposure. Evidence for increased risks of incidence and mortality from DCS following radiation exposure at lower doses and dose rates (e.g., at atomic bombings of Hiroshima and Nagasaki, nuclear accidents, occupational exposures, diagnostic exposures) has accumulated over the recent decade. ICRP Publication 118 (2012) classified DCS as tissue reactions, with a suggested threshold due to acute and fractionated/prolonged exposures of 0.5 Gy for radiological protection purposes. However, it was acknowledged that there were uncertainties relating to the shape of the dose-response, dose threshold (if there is one), and contribution of other DCS risk factors. As the baseline rates of incidence/mortality for DCS are high, if radiation increases baseline risk in a multiplicative fashion, small increases in relative risk might imply substantial additional cases of radiation-associated disease.
Main goals of TG119 are to perform a review of current knowledge on IR-effects on DCS and to advise on the most appropriate ways to consider DCS in the evaluation of radiation-induced risks for radiological protection. TG119 will perform a comprehensive review of the recent scientific literature reporting findings of epidemiological studies of DCS incidence and mortality, including those investigating the shape of the dose-response relationship, assessing risk modification by the main known non-radiation factors for DCS, as well as results of radiobiological investigations of potential mechanisms of DCS following radiation exposure. The causal link between radiation and DCS risk will be assessed. The identification of target organs for radiation-induced DCS and of the organ absorbed radiation dose to be considered in DCS risk analyses will be refined. TG119 will examine how the information on DSC relates to the current classifications either as tissue reactions or stochastic effects, with the aim to determine if it might be appropriate to include DCS in the calculation of radiation detriment, and will assess the feasibility to do so using appropriate risk models. A report synthetizing the results of TG119 work will be open to public consultation in 2025.
Keywords: diseases of the circulatory system; low dose/dose-rate radiation exposure; radiation detriment; mechanisms; dose-response
Interesante el trabajo, será de mucha utilidad en Medicina Nuclear, ya que los estudios de perfusión de miocardio se hacen de rutina.