Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK.
Br J Radiol. 2013 Jul;86(1027):20130173. doi: 10.1259/bjr.20130173. Epub 2013 May 9.
Diagnostic and therapeutic radiation technology has developed dramatically in recent years, and its use has increased significantly, bringing clinical benefit. The use of diagnostic radiology has become widespread in modern society, particularly in paediatrics where the clinical benefit needs to be balanced with the risk of leukaemia and brain cancer increasing after exposure to low doses of radiation. With improving long-term survival rates of radiotherapy patients and the ever-increasing use of diagnostic and interventional radiology procedures, concern has risen over the long-term risks and side effects from such treatments. Biomarker development in radiology and radiotherapy has progressed significantly in recent years to investigate the effects of such use and optimise treatment. Recent biomarker development has focused on improving the limitations of established techniques by the use of automation, increasing sensitivity and developing novel biomarkers capable of quicker results. The effect of low-dose exposure (0-100 mGy) used in radiology, which is increasingly linked to cancer incidences, is being investigated, as some recent research challenges the linear-no-threshold model. Radiotherapy biomarkers are focused on identifying radiosensitive patients, determining the treatment-associated risk and allowing for a tailored and more successful treatment of cancer patients. For biomarkers in any of these areas to be successfully developed, stringent criteria must be applied in techniques and analysis of data to reduce variation among reports and allow data sets to be accurately compared. Newly developed biomarkers can then be used in combination with the established techniques to better understand and quantify the individual biological response to exposures associated with radiology tests and to personalise treatment plans for patients.
近年来，诊断和治疗辐射技术有了显著的发展，其应用也显著增加，带来了临床效益。诊断放射学在现代社会得到了广泛应用，特别是在儿科，需要平衡临床效益与因暴露于低剂量辐射而导致白血病和脑癌风险增加的问题。随着放射治疗患者长期生存率的提高和诊断及介入放射学程序的使用不断增加，人们对这些治疗的长期风险和副作用越来越关注。近年来，放射学和放射治疗中的生物标志物开发取得了显著进展，以研究这种应用的影响并优化治疗。最近的生物标志物开发集中于通过使用自动化、提高灵敏度和开发能够更快获得结果的新型生物标志物来改善现有技术的局限性。目前正在研究放射科中越来越多与癌症发病率相关的低剂量暴露（0-100 mGy）的影响，因为一些最近的研究对线性无阈值模型提出了挑战。放射治疗生物标志物的重点是识别辐射敏感的患者，确定与治疗相关的风险，并为癌症患者提供个性化和更成功的治疗。为了成功开发任何这些领域的生物标志物，必须在技术和数据分析中应用严格的标准，以减少报告之间的差异，并允许准确比较数据集。然后，可以将新开发的生物标志物与既定技术结合使用，以更好地了解和量化与放射学测试相关的个体生物对暴露的反应，并为患者制定个性化的治疗计划。
