Lebanon NH

DMS researchers will lead group developing practical tool to detect radiation levels in disaster survivors

With a fresh infusion of federal support, researchers at Geisel School of Medicine at Dartmouth will join General Electric, the Dana-Farber Cancer Institute, the Medical College of Wisconsin, and two overseas universities, Hokkaido University (Sapporo, Japan) and The Jagiellonian University (Krakow, Poland) in product development of readily-deployable devices to measure radiation dose levels in survivors of radiological and nuclear catastrophies, including terror attacks.

Over the next five years, if all options are exercised, the Biomedical Advanced Research and Development Authority (BARDA)will fund the collaborative $28.9 million to improve the speed, accuracy, in-the-field portability, and user-friendliness of the dosimeter that DMS radiologist Harold Swartz, MD, PhD, MSPH, invented to detect levels of radiation in teeth. In mid-August, the medical school signed the contract with BARDA.

This will be a very specific, very focused development leading to a Food and Drug Administration (FDA)-approved device ,says Swartz, a DMS professor of radiology, radiation oncology, physiology, and community and family medicine.Making this easy to use is an audacious undertaking, but it seems completely feasible.

In 2010, the National Institutes of Health (NIH) found Swartz's research (Dartmouth Medicine Magazine) in electronic paramagnetic resonance (EPR) feasible enough to award $16.6 million over five years to EPR Center at Geisel School of Medicine at Dartmouth , to form the Biodosimetry Center for Medical Countermeasures Against Radiation (Dart-Dose CMCR). Dart-Dose CMCR is one of seven centers nationwide focusing on one or more aspects of medical response to large-scale incidents.(CMCR Scientigic Program Description)

Under the BARDA agreement, Swartz expects his Dartmouth team ,now at 30 members and growing ,to spend the first 18 month base period of performance on research and development, with GE experts helping to amass data in support of an eventual submission for clearance of a diagnostic device to the Food and Drug Administration (FDA). Subsequently if the first option is exercised, the DMS team would spend the next 18 month period improving the components of the device particularly the resonator that goes on the tooth of a patient ,while GE starts manufacturing prototypes.

Hal's research offers a convenient way to test radiation levels in the general population in the event of damage to a nuclear reactor,says Wiley (Chip) Souba, MD, ScD, MBA, dean of Dartmouth Medical School and vice president for health affairs at Dartmouth College. The device is portable, reliable, and non-invasive. Its ease of use makes it most practical.

In collaboration with Dana Farber, Swartz's team will test each iteration of the dosimeter prototype in development for the BARDA contract on healthy volunteers as well as on people undergoing treatments involving radiation ,including candidates for bone-marrow transplants under the guidelines of the Food and Drug Administration (FDA).

Coordinating the efforts of the team are the two co-directors for both the CMCR grant and the BARDA contract. While Benjamin B. Williams, PhD, a research assistant professor of radiology at DMS, focuses on the dosimeter for teeth, Ann Barry Flood, PhD, a professor of community and family medicine and of radiology at DMS and a professor at The Dartmouth Institute of Health Policy and Clinical Practice (TDI), oversees testing in human subjects and their models, and directs pilot programs for the Dart-Dose CMCR.

Since 2005, Swartz and the EPR Center have been developing, improving, and testing EPR techniques with the support of NIAID, as part of one of the initial CMCR Centers. On August 19, 2010, NIAID announced the funding of the second round of CMCRs, this time with DMS as its own center devoted to physical biodosimetry. Other CMCRs receiving NIAID support are at Columbia University, the Albert Einstein College of Medicine, Duke University, the University of California-Los Angeles, the University of Pittsburgh Medical Center, and the University of Rochester (N.Y.) Medical Center.

Swartz pioneered research in this field during his tenure with the Army medical corps in the 1960s. In a 1968 paper, he showed that EPR could measure radiation exposure through the teeth of patients and, potentially, in their fingernails. He continued his research at the Medical College of Wisconsin and at the University of Illinois at Urbana-Champaign before coming to Dartmouth in 1992.

The CMCRs are part of NIAID's larger program of medical countermeasures. In addition to continuing its research, the CMCR at Dartmouth annually supports up to 10 pilot studies, at $50,000 each, for research that complements the Dart-Dose theme of physical biodosimetry and other studies relevant to the overall mission of the CMCRs.

I would be very disappointed and surprised if we didnot come through, Swartz says of the BARDA-funded project. It is going to take a lot of work and a lot of dedication. It is not going to take luck.