Search Results (91)

Background/Objectives: Within the range of spread-out Bragg peak (SOBP), LET (linear energy transfer) gradually increases from proton beam entrance point toward the beam exit direction. While it is expected that the change in LET would lead to correspondent change in RBE (relative biological effectiveness) on many human cell lines, the incomplete cell killing due to low LET can result in tumor recurrence. Hence, this study aimed to assess the RBE on different cancer cell lines along low-LET proton SOBP. Methods: The clonogenicity of A549 and Panc-1 cells after irradiation was evaluated for investigating cell radiosensitivity in response to different types of radiation. The isoeffect doses of 6-MV photon and low-LET proton beams that resulted in equivalent cell surviving fractions at proton dose of 2 or 4 Gy were compared. Results: Ratios of α/β of A549 and Panc-1 cells from photon irradiation are 51.69 and −0.7747, respectively; RBE (2 Gy proton SOBP) on A549 and Panc-1 cells are 0.7403 ± 0.3324 and 1.0986 ± 0.3984, respectively. In addition, the change in RBE with proton LET was in a cell-specific and dose-dependent manner (LET-RBE linear correlations: A549 cells [r = 0.4673, p = 0.2430] vs. Panc-1 cells at 4 Gy [r = 0.7085, p = 0.0492]; Panc-1 cells at 2 Gy [r = −0.4123, p = 0.3100] vs. 4 Gy [r = 0.7085, p = 0.0492]). Conclusions: Compared with A549 cells, Panc-1 cells present greater resistance to low-LET proton beams. In addition, currently employed generic RBE value at 1.1 for proton therapy neglected the variation in cell-/tumor-specific radiobiological responses toward different dose levels of proton beams. Full article

Exposure to high-linear energy transfer (LET) heavy ions, such as ²⁸Si, poses a significant cancer risk for astronauts. While previous studies have linked high-LET radiation exposure to persistent oxidative stress and dysregulated stress responses in intestinal crypt cells with an increased risk of tumorigenesis, the relationship between IR-induced oxidative DNA damage and intestinal cancer risk remains incompletely understood. Here, we investigated the time-dependent effects of ²⁸Si-ion radiation on intestinal tumorigenesis and oxidative DNA damage in Apc^1638N/+ mice, a model for human intestinal cancer predisposition. Male Apc^1638N/+ mice were exposed to 10 cGy of either γ-rays (low-LET) or ²⁸Si-ions (high-LET), and intestinal tumor burden was assessed at 60 and 150 days post-irradiation. While both radiation groups showed modest, non-significant tumor increases at 60 days, ²⁸Si-irradiated mice exhibited an approximately 2.5-fold increase in tumor incidence by 150 days, with a higher incidence of invasive carcinomas compared to γ and sham groups. Serum 8-OxodG levels, a marker of systemic oxidative stress, were significantly elevated in the ²⁸Si-ion group, correlating with increased intestinal 8-OxodG staining. Additionally, assessment of the proliferation marker Cyclin D1 and metaplasia marker Guanylyl Cyclase C (GUCY2C) also revealed significant crypt cell hyperproliferation accompanied by increased metaplasia in ²⁸Si-exposed mouse intestines. Positive correlations between serum 8-OxodG and tumor-associated endpoints provide compelling evidence that exposure to ²⁸Si-ions induces progressive intestinal tumorigenesis through sustained oxidative DNA damage, crypt cell hyperproliferation, and metaplastic transformation. This study provides evidence in support of the radiation quality-dependent progressive increase in systemic and intestinal levels of 8-OxodG during intestinal carcinogenesis. Moreover, the progressive increase in oxidative DNA damage and simultaneous increase in oncogenic events after ²⁸Si exposure also suggest that non-targeted effects might be a significant player in space radiation-induced intestinal cancer development. The correlation between serum 8-OxodG and oncogenic endpoints supports its potential utility as a predictive biomarker of high-LET IR-induced intestinal carcinogenesis, with implications for astronaut health risk monitoring during long-duration space missions. Full article

The Fricke gel dosimeter, a hydrogel-based chemical dosimeter containing dissolved ferrous sulfate, measures 3D radiation dose distributions by oxidizing Fe²⁺ to Fe³⁺ upon irradiation. This study investigates the variation in Fricke yield, G(Fe³⁺), from a radiation–chemical perspective in both standard and gel-like Fricke systems of varying viscosities, under low- and high-linear energy transfer (LET) conditions. We employed our Monte Carlo track chemistry code IONLYS-IRT, using protons of 300 MeV (LET~0.3 keV/µm) and 1 MeV (LET~25 keV/µm) as radiation sources. To assess the impact of viscosity on G(Fe³⁺), we systematically varied the diffusion coefficients of all radiolytic species in the Fricke gel, including Fe²⁺ and Fe³⁺ ions. Increasing gel viscosity reduces Fe³⁺ diffusion and stabilizes spatial dose distributions but also lowers G(Fe³⁺), compromising measurement accuracy and sensitivity—especially under high-LET irradiation. Our results show that an optimal Fricke gel dosimeter must balance these competing factors. Simulations with lower sulfuric acid concentrations (e.g., 0.05 M vs. 0.4 M) further revealed that G(Fe³⁺) values at ~100 s are nearly identical for both low- and high-LET conditions. This study underscores the utility of Monte Carlo simulations in modeling viscosity effects on Fricke gel radiolysis, guiding dosimeter optimization to maximize sensitivity and accuracy while preserving spatial dose distribution integrity. Full article

(1) Background: Generation IV supercritical water-cooled reactors (SCWRs), including small modular reactor (SCW-SMR) variants, are pivotal in nuclear technology. Operating at 300–500 °C and 25 MPa, these reactors require detailed understanding of radiation chemistry and transient species to optimize water chemistry, reduce corrosion, and enhance safety. Boron, widely used as a neutron absorber, plays a significant role in reactor performance and safety. This study focuses on the yields of radiolytic species in subcritical and supercritical water exposed to ⁴He and ⁷Li recoil ions from the ¹⁰B(n,α)⁷Li fission reaction in SCWR/SCW-SMR environments. (2) Methods: We use Monte Carlo track chemistry simulations to calculate yields (G values) of primary radicals (e⁻_aq, H^•, and ^•OH) and molecular species (H₂ and H₂O₂) from water radiolysis by α-particles and Li³⁺ recoils across 1 picosecond to 0.1 millisecond timescales. (3) Results: Simulations show substantially lower radical yields, notably e⁻_aq and ^•OH, alongside higher molecular product yields compared to low linear energy transfer (LET) radiation, underscoring the high-LET nature of ¹⁰B(n,α)⁷Li recoil nuclei. Key changes include elevated G(^•OH) and G(H₂), and a decrease in G(H^•), primarily driven during the homogeneous chemical stage of radiolysis by the reaction H^• + H₂O → ^•OH + H₂. This reaction significantly contributes to H₂ production, potentially reducing the need for added hydrogen in coolant water to mitigate oxidizing species. In supercritical conditions, low G(H₂O₂) suggests that H₂O₂ is unlikely to be a major contributor to material oxidation. (4) Conclusions: The ¹⁰B(n,α)⁷Li reaction’s yield estimates could significantly impact coolant chemistry strategies in SCWRs and SCW-SMRs. Understanding radiolytic behavior in these conditions aids in refining reactor models and coolant chemistry to minimize corrosion and radiolytic damage. Future experiments are needed to validate these predictions. Full article

A constant proton relative biological effectiveness (RBE) of 1.1 for tumor control is currently used in proton therapy treatment planning. However, in vitro, in vivo and clinical experiences indicate that proton RBE varies with kinetic energy and, therefore, tissue depth within proton Bragg peaks. A number of published RBE models capture variations in proton RBE with depth. The published models can be sub-divided into empirical (or phenomenological) and biophysical (or mechanistic-inspired) RBE models. Empirical RBE models usually characterize the beam quality through the dose-averaged linear energy transfer (${\mathrm{LET}}_{\mathrm{D}}$), while most biophysical RBE models relate RBE to the dose-averaged lineal energy ($y_{\mathrm{D}}$). In this work, an analytic microdosimetry model and the Monte Carlo damage simulation code (MCDS) were utilized for the evaluation of the ${\mathrm{LET}}_{\mathrm{D}}$ and $y_{\mathrm{D}}$ of monoenergetic proton beams in the clinically relevant energy range of 1–250 MeV. The calculated ${\mathrm{LET}}_{\mathrm{D}}$ and $y_{\mathrm{D}}$ values were then used for the estimation of the RBE for five different cell types at three dose levels (2 Gy, 5 Gy and 7 Gy). Comparisons are made between nine empirical RBE models and two biophysical models, namely, the theory of dual radiation action (TDRA) and the microdosimetric kinetic model (MKM). The results show that, at conventional dose fractions (~2 Gy) and for proton energies which correspond to the proximal and central regions of the spread-out Bragg peak (SOBP), RBE varies from 1.0 to 1.2. At lower proton energies related to the distal SOBP, we find significant deviations from a constant $\mathrm{RBE}$ of 1.1, especially for late-responding tissues (low ${(\alpha /\beta )}_R$ of ~1.5–3.5 Gy) where proton RBE may reach 1.3 to 1.5. For hypofractionated dose fractions (5–7 Gy), deviations from a constant $\mathrm{RBE}$ of 1.1 are smaller, but may still be sizeable, yielding RBE values between 1.15 and 1.3. However, large discrepancies among the different models were observed that make the selection of a variable RBE across the SOBP uncertain. Full article

To overcome chondrosarcoma’s (CHS) high chemo- and radioresistance, we used polyethylene glycol-encapsulated iron oxide nanoparticles (IONPs) for the controlled delivery of the chemotherapeutic doxorubicin (IONP_DOX) to amplify the cytotoxicity of proton radiation therapy. Human 2D CHS SW1353 cells were treated with protons (linear energy transfer (LET): 1.6 and 12.6 keV/µm) with and without IONP_DOX. Cell survival was assayed using a clonogenic test, and genotoxicity was tested through the formation of micronuclei (MN) and γH2AX foci, respectively. Morphology together with spectral fingerprints of nuclei were measured using enhanced dark-field microscopy (EDFM) assembled with a hyperspectral imaging (HI) module and an axial scanning fluorescence module, as well as scanning electron microscopy (SEM) coupled with energy-dispersive X-Ray spectroscopy (EDX). Cell survival was also determined in 3D SW3153 spheroids following treatment with low-LET protons with/without the IONP_DOX compound. IONP_DOX increased radiosensitivity following proton irradiation at both LETs in correlation with DNA damage expressed as MN or γH2AX. The IONP_DOX–low-LET proton combination caused a more lethal effect compared to IONP_DOX–high-LET protons. CHS cell biological alterations were reflected by the modifications in the hyperspectral images and spectral profiles, emphasizing new possible spectroscopic markers of cancer therapy effects. Our findings show that the proposed treatment combination has the potential to improve the management of CHS. Full article

This study conducts a comparative analysis of cystamine (RSSR), a disulfide, and cysteamine (RSH), its thiol monomer, to evaluate their efficacy as radioprotectors and antioxidants under high linear energy transfer (LET) and high-dose-rate irradiation conditions. It examines their interactions with reactive primary species produced during the radiolysis of the aqueous ferrous sulfate (Fricke) dosimeter, offering insights into the mechanisms of radioprotection and highlighting their potential to enhance the therapeutic index of radiation therapy, particularly in advanced techniques like FLASH radiotherapy. Using Monte Carlo multi-track chemical modeling to simulate the radiolytic oxidation of ferrous to ferric ions in Fricke-cystamine and Fricke-cysteamine solutions, this study assesses the radioprotective and antioxidant properties of these compounds across a variety of irradiation conditions. Concentrations were varied in both aerated (oxygen-rich) and deaerated (hypoxic) environments, simulating conditions akin to healthy tissue and tumors. Both cystamine and cysteamine demonstrate radioprotective and strong antioxidant properties. However, their effectiveness varies significantly depending on the concentration employed, the conditions of irradiation, and whether or not environmental oxygen is present. Specifically, excluding potential in vivo toxicity, cysteamine substantially reduces the adverse effects of ionizing radiation under aerated, low-LET conditions at concentrations above ~1 mM. However, its efficacy is minimal in hypoxic environments, irrespective of the concentration used. Conversely, cystamine consistently offers robust protective effects in both oxygen-rich and oxygen-poor conditions. The distinct protective capacities of cysteamine and cystamine underscore cysteamine’s enhanced potential in radiotherapeutic settings aimed at safeguarding healthy tissues from radiation-induced damage while effectively targeting tumor tissues. This differential effectiveness emphasizes the need for personalized radioprotective strategies, tailored to the specific environmental conditions of the tissue involved. Implementing such approaches is crucial for optimizing therapeutic outcomes and minimizing collateral damage in cancer treatment. Full article

A novel means of applying radiotherapy in cancer treatment is the application of a radiation dose at a very high intensity for a very short time in FLASH radiotherapy (FLASH-RT). This technique involves the exposure of tumors to >40 Gy/s, usually for less than one second. Studies conducted in cell and preclinical models suggest that FLASH-RT seems less damaging to normal tissues from adverse effects relative to the same overall dose of radiation administered in conventional therapy (CONV-RT), which involves the administration of lower levels of radiation repeated intermittently over a protracted period. In contrast, the susceptibility of tumor tissues to FLASH-RT is not diminished relative to CONV-RT. Within solid tumors, both modes of dispensation of radiation produce an equivalent degree of cell damage. The differential treatment between normal and malignant material has been found in isolated tissues, animal studies and, more recently, in clinical trials. However, the classic radiation concept is that high-energy linear transfer radiation (LET) is more damaging than the equivalent total dose of low LET. Thus, the susceptibility of cells should be greater after short-term exposure to high LET. This article discusses the potential reasons that may account for this discrepancy. While the relative protection given to untransformed tissues by FLASH-RT relative to tumor tissue is a major step forward in radiation therapy for cancer, the processes that lie behind this phenomenon are incompletely understood and are considered here. Full article

Chondrosarcoma is a rare malignant tumor that forms in bone and cartilage. The primary treatment involves surgical removal of the tumor with a margin of healthy tissue. Especially if complete surgical removal is not possible, radiation therapy and chemotherapy are used in conjunction with surgery, but with a generally low efficiency. Ongoing researches are focused on understanding the genetic and molecular basis of chondrosarcoma following high linear energy transfer (LET) irradiation, which may lead to treatments that are more effective. The goal of this study is to evaluate the differential effects of DNA damage repair inhibitors and high LET irradiation on chondrosarcoma versus chondrocyte cells and the LET-dependency of the effects. Two chondrosarcoma cell lines with different IDH mutation status and one chondrocyte cell line were exposed to low LET (X-ray) and high LET (carbon ion) irradiation in combination with an Olaparib PARP inhibitor. Cell survival and DNA repair mechanisms were investigated. High LET irradiation drastically reduced cell survival, with a biological efficiency three times that of low LET. Olaparib significantly inhibited PARylation in all the tested cells. A significant reduction in cell survival of both chondrosarcoma and chondrocyte cells was observed following the treatment combining Olaparib and X-ray. PARP inhibition induced an increase in PARP-1 expression and a reduced effect on the cell survival of WT IDH chondrosarcoma cells. No radiosensitizing effect was observed in cells exposed to Olaparib paired with high LET irradiation. NHEJ was activated in response to high LET irradiation, neutralizing the PARP inhibition effect in both chondrosarcoma cell lines. When high LET irradiation is not available, PARP inhibition could be used in combination with low LET irradiation, with significant radiosensitizing effects on chondrosarcoma cells. Chondrocytes may be affected by the treatment combination too, showing the need to preserve normal tissues from radiation fields when this kind of treatment is suggested. Full article

Epidemiological, experimental, and ecological data have indicated the controversial effect of in utero chronic low dose rate (<6 mGy/h) with accumulative low (≤100 mGy) or high (>100 mGy) dose radiation exposure. Our main goal of this study was to examine if different low dose rates of chronic pre- and/or post-natal radiation exposure with accumulative high doses could induce hippocampal cellular, mRNA, and miRNA changes leading to neuropsychiatric disorders. The comprehensive mouse phenotypic traits, organ weight, pathological, and blood mRNA and miRNA changes were also studied. Using different approaches including SmithKline, Harwell, Imperial College, Royal Hospital, Phenotype Assessment (SHIRPA), neurobehavioral tests, pathological examination, immunohistochemistry, mRNA and miRNA sequencing, and real-time quantitative polymerase chain reaction (qRT-PCR) validation, we found that in prenatally irradiated (100 mGy/d for 18 days with an accumulative dose of 1.8 Gy) 1-year-old mice, no cellular changes, including immature neurons in the subgranular zone, mature neurons and glial cells in the hilus of the dentate gyrus and development of cognitive impairment, neuropsychiatric disorders, occurred. However, a significant reduction in body weight and mass index (BMI) was indicated by the SHIRPA test. A reduced exploratory behavior was shown by an open field test. Organ weights showed significant reductions in the testes, kidneys, heart, liver and epididymides with no abnormal pathology. mRNA and miRNA sequencing and qRT-PCR validation revealed the upregulation of Rubcnl and Abhd14b, and downregulation of Hspa1b, P4ha1, and Banp genes in both the hippocampus and blood of mice prenatally irradiated with 100 mGy/d. Meanwhile, downregulation of miR-448-3p and miR1298-5p in the hippocampus, miR-320-3p, miR-423-5p, miR-486b-5p, miR-486b-3p, miR-423-3p, miR-652-3p, miR-324-3p, miR-181b-5p, miR-let-7b, and miR-6904-5p in the blood was induced. The target scan revealed that Rubcnl is one of the miR-181b-5p targets in the blood. We, therefore, concluded that prenatal chronic irradiation with a low dose rate of 100 mGy/d and accumulative dose of 1.8 Gy or below might not induce significant adverse health effects on the offspring. Further study of different low dose rate radiation exposures with accumulative high doses may provide threshold doses for authorities or regulators to set new radiation safety guidelines to replace those extrapolated from acute high dose/dose rate irradiation to reduce unnecessary emergency evacuation or spending once a nuclear accident or leakage occurs. Full article

(1) Background: Supercritical water-cooled reactors (SCWRs) and their smaller modular variants (SMRs) are part of the ‘Generation IV International Forum’ (GIF) on advanced nuclear energy systems. These reactors operate beyond the critical point of water (t_c = 373.95 °C and P_c = 22.06 MPa), which introduces specific technical challenges that need to be addressed. The primary concerns involve the effects of intense radiation fields—including fast neutrons, recoil protons/oxygen ions, and γ rays—on the chemistry of the coolant fluid and the integrity of construction materials. (2) Methods: This study employs Monte Carlo simulations of radiation track chemistry to investigate the yields of radiolytic species in SCWRs/SMRs exposed to 2 MeV neutrons. In our calculations, only the contributions from the first three recoil protons with initial energies of 1.264, 0.465, and 0.171 MeV were considered. Our analysis was conducted at both subcritical (300 and 350 °C) and supercritical temperatures (400–600 °C), maintaining a constant pressure of 25 MPa. (3) Results: Our simulations provide insights into the radiolytic formation of chemical species such as e⁻_aq, H^●, H₂, ^●OH, and H₂O₂ from ~1 ps to 1 ms. Compared to data from radiation with low linear energy transfer (LET), the G(e⁻_aq) and G(^●OH) values obtained for fast neutrons show a similar temporal dependence but with smaller amplitude—a result demonstrating the high LET nature of fast neutrons. A notable outcome of our simulations is the marked increase in G(^●OH) and G(H₂), coupled with a corresponding reduction in G(H^●), observed during the homogeneous chemical stage of radiolysis. This evolution is attributed to the oxidation of water by the H^● atom according to the reaction H^● + H₂O → ^●OH + H₂. This reaction acts as a significant source of H₂, potentially reducing the need to add extra hydrogen to the reactor’s coolant water to suppress the net radiolytic production of oxidizing species. Unlike in subcritical water, our simulations also indicate that G(H₂O₂) remains very low in low-density SCW throughout the interval from ~1 ps to 1 ms, suggesting that H₂O₂ is less likely to contribute to oxidative stress under these conditions. (4) Conclusions: The results of this study could significantly impact water-chemistry management in the proposed SCWRs and SCW-SMRs, which is crucial for assessing and mitigating the corrosion risks to reactor materials, especially for long-term operation. Full article

The combination of high and low LET radionuclides has been tested in several patient studies to improve treatment response. Radionuclide mixtures can also be released in nuclear power plant accidents or nuclear bomb deployment. This study investigated the DNA damage response and DNA double-strand break (DSB) repair in peripheral blood mononuclear cells (PBMCs) after internal exposure of blood samples of 10 healthy volunteers to either no radiation (baseline) or different radionuclide mixtures of the α- and β-emitters [²²³Ra]RaCl₂ and [¹⁷⁷Lu]LuCl₃, i.e., 25 mGy/75 mGy, 50 mGy/50 mGy and 75 mGy/25 mGy, respectively. DSB foci and γ-H2AX α-track enumeration directly after 1 h of exposure or after 4 h or 24 h of repair revealed that radiation-induced foci (RIF) and α-track induction in 100 cells was similar for mixed α/β and pure internal α- or β-irradiation, as were the repair rates for all radiation qualities. In contrast, the fraction of unrepaired RIF (Q_β) in PBMCs after mixed α/β-irradiation (50% ²²³Ra & 50% ¹⁷⁷Lu: Q_β = 0.23 ± 0.10) was significantly elevated relative to pure β-irradiation (50 mGy: Q_{β, pure} = 0.06 ± 0.02), with a similar trend being noted for all mixtures. This α-dose-dependent increase in persistent foci likely relates to the formation of complex DNA damage that remains difficult to repair. Full article

Oxidative stress-mediated biomolecular damage is a characteristic feature of ionizing radiation (IR) injury, leading to genomic instability and chronic health implications. Specifically, a dose- and linear energy transfer (LET)-dependent persistent increase in oxidative DNA damage has been reported in many tissues and biofluids months after IR exposure. Contrary to low-LET photon radiation, high-LET IR exposure is known to cause significantly higher accumulations of DNA damage, even at sublethal doses, compared to low-LET IR. High-LET IR is prevalent in the deep space environment (i.e., beyond Earth’s magnetosphere), and its exposure could potentially impair astronauts’ health. Therefore, the development of biomarkers to assess and monitor the levels of oxidative DNA damage can aid in the early detection of health risks and would also allow timely intervention. Among the recognized biomarkers of oxidative DNA damage, 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-OxodG) has emerged as a promising candidate, indicative of chronic oxidative stress. It has been reported to exhibit differing levels following equivalent doses of low- and high-LET IR. This review discusses 8-OxodG as a potential biomarker of high-LET radiation-induced chronic stress, with special emphasis on its potential sources, formation, repair mechanisms, and detection methods. Furthermore, this review addresses the pathobiological implications of high-LET IR exposure and its association with 8-OxodG. Understanding the association between high-LET IR exposure-induced chronic oxidative stress, systemic levels of 8-OxodG, and their potential health risks can provide a framework for developing a comprehensive health monitoring biomarker system to safeguard the well-being of astronauts during space missions and optimize long-term health outcomes. Full article

Introduction: Decellularized extracellular matrix (ECM) bioscaffolds have emerged as a promising three-dimensional (3D) model, but so far there are no data concerning their use in radiobiological studies. Material and Methods: We seeded two well-known radioresistant cell lines (HMV-II and PANC-1) in decellularized porcine liver-derived scaffolds and irradiated them with both high- (Carbon Ions) and low- (Photons) Linear Energy Transfer (LET) radiation in order to test whether a natural 3D-bioscaffold might be a useful tool for radiobiological research and to achieve an evaluation that could be as near as possible to what happens in vivo. Results: Biological scaffolds provided a favorable 3D environment for cell proliferation and expansion. Cells did not show signs of dedifferentiation and retained their distinct phenotype coherently with their anatomopathological and clinical behaviors. The radiobiological response to high LET was higher for HMV-II and PANC-1 compared to the low LET. In particular, Carbon Ions reduced the melanogenesis in HMV-II and induced more cytopathic effects and the substantial cell deterioration of both cell lines compared to photons. Conclusions: In addition to offering a suitable 3D model for radiobiological research and an appropriate setting for preclinical oncological analysis, we can attest that bioscaffolds seemed cost-effective due to their ease of use, low maintenance requirements, and lack of complex technology Full article

Recurrent computed tomography (CT) examination has become a common diagnostic procedure for several diseases and injuries. Though each singular CT scan exposes individuals at low doses of low linear energy transfer (LET) radiation, the cumulative dose received from recurrent CT scans poses an increasing concern for potential health risks. Here, we evaluated the biological effects of recurrent CT scans on the DNA damage response (DDR) in human fibroblasts and retinal pigment epithelial cells maintained in culture for five months and subjected to four CT scans, one every four weeks. DDR kinetics and eventual accumulation of persistent-radiation-induced foci (P-RIF) were assessed by combined immunofluorescence for γH2AX and 53BP1, i.e., γH2AX/53BP1 foci. We found that CT scan repetitions significantly increased both the number and size of γH2AX/53BP1 foci. In particular, after the third CT scan, we observed the appearance of giant foci that might result from the overlapping of individual small foci and that do not associate with irreversible growth arrest, as shown by DNA replication in the foci-carrying cells. Whether these giant foci represent coalescence of unrepaired DNA damage as reported following single exposition to high doses of high LET radiation is still unclear. However, morphologically, these giant foci resemble the recently described compartmentalization of damaged DNA that should facilitate the repair of DNA double-strand breaks but also increase the risk of chromosomal translocations. Overall, these results indicate that for a correct evaluation of the damage following recurrent CT examinations, it is necessary to consider the size and composition of the foci in addition to their number. Full article