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Since it is not ethical to irradiate humans, animal models must be used to identify biomarkers. Injury to the female WAG\/RijCmcr rat has been well-characterized after exposure to eight doses of whole thorax irradiation: 0-, 5-, 10-, 11-, 12-, 13-, 14- and 15-Gy. End points such as SPECT imaging of the lung using molecular probes, measurement of circulating blood cells and specific miRNA have been shown to change after radiation. Our goal was to use these changes to predict lethal lung injury in the rat model, 2 weeks post-irradiation, before any symptoms manifest and after which a countermeasure can be given to enhance survival. SPECT imaging with 99mTc-MAA identified a decrease in perfusion in the lung after irradiation. A decrease in circulating white blood cells and an increase in five specific miRNAs in whole blood were also tested. Univariate analyses were then conducted on the combined dataset. The results indicated that a combination of percent change in lymphocytes and monocytes, as well as pulmonary perfusion volume could predict survival from radiation to the lungs with 88.5% accuracy (95% confidence intervals of 77.8, 95.3) with a p-value of &lt; 0.0001 versus no information rate. This study is one of the first to report a set of minimally invasive endpoints to predict lethal radiation injury in female rats. Lung-specific injury can be visualized by 99mTc-MAA as early as 2 weeks after radiation.<\/jats:p>","DOI":"10.3390\/ijms24065627","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T03:14:35Z","timestamp":1678936475000},"page":"5627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Biomarkers to Predict Lethal Radiation Injury to the Rat Lung"],"prefix":"10.3390","volume":"24","author":[{"given":"Meetha","family":"Medhora","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA"},{"name":"Department of Veterans Affairs, Research Service, Zablocki Veterans\u2019 Administration Medical Center, Milwaukee, WI 53295, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA"},{"name":"College of Dental Medicine, Midwestern University, Downers Grove, IL 60515, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Gasperetti","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayashree","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Himburg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Research Service, Zablocki Veterans\u2019 Administration Medical Center, Milwaukee, WI 53295, USA"},{"name":"Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA"},{"name":"Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne V.","family":"Clough","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Research Service, Zablocki Veterans\u2019 Administration Medical Center, Milwaukee, WI 53295, USA"},{"name":"Department of Mathematics, Statistics and Computer Science, Marquette University, Milwaukee, WI 53233, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Fish","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniko","family":"Szabo","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1088\/1361-6498\/ac0d3f","article-title":"United States medical preparedness for nuclear and radiological emergencies","volume":"41","author":"DiCarlo","year":"2021","journal-title":"J. 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