In this review, we discuss the value of biological dosimetry and electron paramagnetic resonance (EPR) spectroscopy in the medical management support of acute radiation syndrome (ARS). Medical management of an ionizing radiation scenario requires significant information. For optimal medical aid, this information has to be rapidly (< 3 days) delivered to the health-care provider. Clinical symptoms may initially enable physicians to predict ARS and initiate respective medical treatment. However, in most cases at least further verification through knowledge on radiation exposure details is necessary. This can be assessed by retrospective dosimetry techniques, if it is not directly registered by personal dosimeters. The characteristics and potential of biological dosimetry and electron paramagnetic resonance (EPR) dosimetry using human-derived specimen are presented here. Both methods are discussed in a clinical perspective regarding ARS diagnostics. The presented techniques can be used in parallel to increase screening capacity in the case of mass casualties, as both can detect the critical dose of 2 Gy (whole body single dose), where hospitalization will be considered. Hereby, biological dosimetry based on the analysis of molecular biomarkers, especially gene expression analysis, but also in vivo EPR represent very promising screening tools for rapid triage dosimetry in early-phase diagnostics. Both methods enable high sample throughput and potential for point-of-care diagnosis. In cases of higher exposure or in small-scale radiological incidents, the techniques can be used complementarily to understand important details of the exposure. Hereby, biological dosimetry can be employed to estimate the whole body dose, while EPR dosimetry on nails, bone or teeth can be used to determine partial body doses. A comprehensive assessment will support optimization of further medical treatment. Ultimately, multipath approaches are always recommended. By tapping the full potential of all diagnostic and dosimetric methods, effective treatment of patients can be supported upon exposure to radiation.

在这篇综述中，我们讨论了生物剂量学和电子顺磁共振 (EPR) 波谱在急性辐射综合征 (ARS) 的医疗管理支持中的价值。电离辐射场景的医疗管理需要大量信息。为了获得最佳的医疗援助，必须将这些信息迅速（< 3 天）传送给医疗保健提供者。临床症状最初可能使医生能够预测 ARS 并开始相应的医学治疗。然而，在大多数情况下，至少需要通过有关辐射暴露细节的知识进一步验证。如果个人剂量计没有直接记录，则可以通过追溯性剂量测定技术对其进行评估。此处介绍了使用人源标本进行生物剂量测定和电子顺磁共振 (EPR) 剂量测定的特征和潜力。这两种方法都从有关 ARS 诊断的临床角度进行了讨论。所提出的技术可以并行使用，以提高大规模伤亡情况下的筛查能力，因为两者都可以检测到 2 Gy（全身单剂量）的临界剂量，将考虑住院治疗。因此，基于分子生物标志物分析（尤其是基因表达分析）以及体内 EPR 的生物剂量学代表了非常有前途的早期诊断快速分类剂量学筛选工具。这两种方法都可以实现高样本通量和即时诊断的潜力。在较高照射或小规模放射事故的情况下，这些技术可以补充使用，以了解曝光的重要细节。因此，生物剂量学可用于估计全身剂量，而指甲、骨骼或牙齿上的 EPR 剂量学可用于确定部分身体剂量。综合评估将支持优化进一步的医疗。最终，始终建议使用多路径方法。通过充分挖掘所有诊断和剂量测定方法的潜力，可以支持对患者进行辐射照射后的有效治疗。综合评估将支持优化进一步的医疗。最终，始终建议使用多路径方法。通过充分挖掘所有诊断和剂量测定方法的潜力，可以支持对患者进行辐射照射后的有效治疗。综合评估将支持优化进一步的医疗。最终，始终建议使用多路径方法。通过充分挖掘所有诊断和剂量测定方法的潜力，可以支持对患者进行辐射照射后的有效治疗。