1
|
Laad AP, Gnanasekaran TS, Shetty SK, Vidyan SK, Chodankar SS, Nalilu SK, Radhakrishna V. Assessment of Biological Damage Induced during Multidetector Computed Tomography (MDCT) Examination. Cell Biochem Biophys 2024:10.1007/s12013-024-01345-2. [PMID: 38858307 DOI: 10.1007/s12013-024-01345-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/12/2024]
Abstract
Computed tomography (CT) is known for its non-invasiveness, fast procedure, and also for providing detailed diagnostic information to physicians. It also utilises low-dose-rate ionising radiation (X-rays) as a source for imaging. Multidetector computed tomography (MDCT) is an advanced system that uses iodinated contrast media for more accurate diagnostic results. Studies suggest using these contrasts will lead to greater radiation adsorption with significant DNA damage. No studies have been taken comparing the physical dose with the biological effect. The present study sheds light on the same by assessing the biological effect of CT with and without contrast intervention. The present study is timebound; thus, 21 participants attending for CT thorax and abdomen with no history of any cancer were included. The same participants underwent both pre-contrast and post-contrast studies. The blood sample was taken before the procedure and used as a control. Physical parameters like DLP and CTDI obtained from the instrument were compared with the MN frequency obtained (CBMN Assay). The study showed a significant increase (p-value < 0.05) in the Physical and MN frequency in the Post-Contrast group compared to the pre-contrast group. Although a positive correlation was observed between pre and post-contrast groups, the results were not found to be statistically significant (p-value < 0.05). The study confirms increased physical dose and MN frequency upon contrast intervention. This study recommends the judicial use of MDCT in disease diagnostics.
Collapse
Affiliation(s)
- Amarja Pandurang Laad
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Tamizh Selvan Gnanasekaran
- Central Research Laboratory, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Shashi Kumar Shetty
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India.
| | - Savin Kotekar Vidyan
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Sayali Satish Chodankar
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Suchetha Kumari Nalilu
- Department of Biochemistry, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Vishakh Radhakrishna
- Central Research Laboratory, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India.
| |
Collapse
|
2
|
Vinnikov V, Belyakov O. Clinical Applications of Biological Dosimetry in Patients Exposed to Low Dose Radiation Due to Radiological, Imaging or Nuclear Medicine Procedures. Semin Nucl Med 2021; 52:114-139. [PMID: 34879905 DOI: 10.1053/j.semnuclmed.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Radiation dosimetric biomarkers have found applications beyond radiation protection area and now are actively introduced into clinical practice. Cytogenetic assays appeared to be a valuable tool for individualized quantifying radiation effects in patients, with high capability for assessing genotoxicity of various medical exposure modalities and providing meaningful radiation dose estimates for prognoses of radiation-related cancer risk. This review summarized current data on the use of biological dosimetry methods in patients undergoing various medical irradiations to low doses. The highlighted topics include basic aspects of biological dosimetry and its limitations in the range of low radiation doses, and main patterns of in vivo induction of radiation biomarkers in clinical exposure scenarios, occurring in X-ray diagnostics, computed tomography, interventional radiology, low dose radiotherapy, and nuclear medicine (internally administered 131I and other radiopharmaceuticals). Additionally, several specific issues, examined by biodosimetry techniques, are analysed, such as contrast media effect, radiation response in pediatric patients, impact of magnetic resonance imaging, evaluation of radioprotectors, detection of patients' abnormal intrinsic radiosensitivity and dose estimation in persons involved in medical radiation incidents. A prognosis of possible directions for further improvements in this area includes the automation of cytogenetic analysis, introduction of molecular biodosimeters and development of multiparametric biodosimetry platforms. A potential approach to the advanced biodosimetry of internal exposure and/or low dose external irradiation is suggested; this can be a multiparametric platform based on the combination of the γ-H2AX foci, dicentric, and translocation assays, each applied in the optimum postexposure time range, with the amalgamation of the dose estimates. The study revealed the necessity of further research, which might clarify medical radiation safety concerns for patients via using stringent biodosimetry methodology.
Collapse
Affiliation(s)
- Volodymyr Vinnikov
- International Atomic Energy Agency (IAEA), Vienna, Austria; Grigoriev Institute for Medical Radiology and Oncology (GIMRO), Kharkiv, Ukraine.
| | - Oleg Belyakov
- International Atomic Energy Agency (IAEA), Vienna, Austria
| |
Collapse
|
3
|
Belmans N, Oenning AC, Salmon B, Baselet B, Tabury K, Lucas S, Lambrichts I, Moreels M, Jacobs R, Baatout S. Radiobiological risks following dentomaxillofacial imaging: should we be concerned? Dentomaxillofac Radiol 2021; 50:20210153. [PMID: 33989056 PMCID: PMC8404518 DOI: 10.1259/dmfr.20210153] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This review aimed to present studies that prospectively investigated biological effects in patients following diagnostic dentomaxillofacial radiology (DMFR). METHODS Literature was systematically searched to retrieve all studies assessing radiobiological effects of using X-ray imaging in the dentomaxillofacial area, with reference to radiobiological outcomes for other imaging modalities and fields. RESULTS There is a lot of variability in the reported radiobiological assessment methods and radiation dose measures, making comparisons of radiobiological studies challenging. Most radiological DMFR studies are focusing on genotoxicity and cytotoxicity, data for 2D dentomaxillofacial radiographs, albeit with some methodological weakness biasing the results. For CBCT, available evidence is limited and few studies include comparative data on both adults and children. CONCLUSIONS In the future, one will have to strive towards patient-specific measures by considering age, gender and other individual radiation sensitivity-related factors. Ultimately, future radioprotection strategies should build further on the concept of personalized medicine, with patient-specific optimization of the imaging protocol, based on radiobiological variables.
Collapse
Affiliation(s)
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São, Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | | | - Bjorn Baselet
- Belgian Nuclear Research Centre (SCK CEN), Radiobiology Unit, Boeretang 200, Mol, Belgium
| | | | - Stéphane Lucas
- Laboratory of Analysis by Nuclear Reaction (LARN/PMR), Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
| | - Ivo Lambrichts
- Morphology Group, Biomedical Research Institute, Hasselt University, Agoralaan Building C, Diepenbeek, Belgium
| | - Marjan Moreels
- Belgian Nuclear Research Centre (SCK CEN), Radiobiology Unit, Boeretang 200, Mol, Belgium
| | | | | |
Collapse
|
4
|
Evaluation of Calyculin A Effect on γH2AX/53BP1 Focus Formation and Apoptosis in Human Umbilical Cord Blood Lymphocytes. Int J Mol Sci 2021; 22:ijms22115470. [PMID: 34067339 PMCID: PMC8196852 DOI: 10.3390/ijms22115470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022] Open
Abstract
Dephosphorylation inhibitor calyculin A (cal A) has been reported to inhibit the disappearance of radiation-induced γH2AX DNA repair foci in human lymphocytes. However, other studies reported no change in the kinetics of γH2AX focus induction and loss in irradiated cells. While apoptosis might interplay with the kinetics of focus formation, it was not followed in irradiated cells along with DNA repair foci. Thus, to validate plausible explanations for significant variability in outputs of these studies, we evaluated the effect of cal A (1 and 10 nM) on γH2AX/53BP1 DNA repair foci and apoptosis in irradiated (1, 5, 10, and 100 cGy) human umbilical cord blood lymphocytes (UCBL) using automated fluorescence microscopy and annexin V-FITC/propidium iodide assay/γH2AX pan-staining, respectively. No effect of cal A on γH2AX and colocalized γH2AX/53BP1 foci induced by low doses (≤10 cGy) of γ-rays was observed. Moreover, 10 nM cal A treatment decreased the number of all types of DNA repair foci induced by 100 cGy irradiation. 10 nM cal A treatment induced apoptosis already at 2 h of treatment, independently from the delivered dose. Apoptosis was also detected in UCBL treated with lower cal A concentration, 1 nM, at longer cell incubation, 20 and 44 h. Our data suggest that apoptosis triggered by cal A in UCBL may underlie the failure of cal A to maintain radiation-induced γH2AX foci. All DSB molecular markers used in this study responded linearly to low-dose irradiation. Therefore, their combination may represent a strong biodosimetry tool for estimation of radiation response to low doses. Assessment of colocalized γH2AX/53BP1 improved the threshold of low dose detection.
Collapse
|
5
|
Bogdanova NV, Jguburia N, Ramachandran D, Nischik N, Stemwedel K, Stamm G, Werncke T, Wacker F, Dörk T, Christiansen H. Persistent DNA Double-Strand Breaks After Repeated Diagnostic CT Scans in Breast Epithelial Cells and Lymphocytes. Front Oncol 2021; 11:634389. [PMID: 33968734 PMCID: PMC8103218 DOI: 10.3389/fonc.2021.634389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/22/2021] [Indexed: 12/14/2022] Open
Abstract
DNA double-strand break (DSB) induction and repair have been widely studied in radiation therapy (RT); however little is known about the impact of very low exposures from repeated computed tomography (CT) scans for the efficiency of repair. In our current study, DSB repair and kinetics were investigated in side-by-side comparison of RT treatment (2 Gy) with repeated diagnostic CT scans (≤20 mGy) in human breast epithelial cell lines and lymphoblastoid cells harboring different mutations in known DNA damage repair proteins. Immunocytochemical analysis of well known DSB markers γH2AX and 53BP1, within 48 h after each treatment, revealed highly correlated numbers of foci and similar appearance/disappearance profiles. The levels of γH2AX and 53BP1 foci after CT scans were up to 30% of those occurring 0.5 h after 2 Gy irradiation. The DNA damage repair after diagnostic CT scans was monitored and quantitatively assessed by both γH2AX and 53BP1 foci in different cell types. Subsequent diagnostic CT scans in 6 and/or 12 weeks intervals resulted in elevated background levels of repair foci, more pronounced in cells that were prone to genomic instability due to mutations in known regulators of DNA damage response (DDR). The levels of persistent foci remained enhanced for up to 6 months. This “memory effect” may reflect a radiation-induced long-term response of cells after low-dose x-ray exposure.
Collapse
Affiliation(s)
- Natalia V Bogdanova
- Radiation Oncology Research Unit, Hannover Medical School, Hannover, Germany
| | - Nina Jguburia
- Radiation Oncology Research Unit, Hannover Medical School, Hannover, Germany
| | | | - Nora Nischik
- Radiation Oncology Research Unit, Hannover Medical School, Hannover, Germany.,Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Katharina Stemwedel
- Radiation Oncology Research Unit, Hannover Medical School, Hannover, Germany
| | - Georg Stamm
- Department of Radiology, Hannover Medical School, Hannover, Germany.,Department of Diagnostic and Interventional Radiology, University Medical Center, Göttingen, Germany
| | - Thomas Werncke
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Hans Christiansen
- Radiation Oncology Research Unit, Hannover Medical School, Hannover, Germany
| |
Collapse
|
6
|
Gorenberg M, Agbarya A, Groshar D, Volovik I, Avitan O, Sukhotnik I. Novel nanotech antioxidant cocktail prevents medical diagnostic procedures ionizing radiation effects. Sci Rep 2021; 11:5315. [PMID: 33674660 PMCID: PMC7935885 DOI: 10.1038/s41598-021-84596-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/11/2021] [Indexed: 11/15/2022] Open
Abstract
Ionizing radiation (IR) exposure results in oxidative damage causing cytotoxic and genotoxic effects. Double-strand breaks (DSBs) are considered the most significant DNA lesions induced by ionizing radiation. The present study evaluates the radio protective effect of a novel antioxidant cocktail through quantification of DSB in peripheral blood lymphocytes (PBL) in vivo. The study included 16 consecutive patients who were divided into 2 groups, 6 patients received the novel antioxidant cocktail and 10 control patients. Blood samples were drawn from the patients undergoing bone scan, before the injection of the 99mTc MDP tracer and 2 h after the injection. Quantification of the IR damage was done by Immunofluorescence analysis of the phosphorylated histone, γ-H2AX, used to monitor DSB induction and repair in PBL. The radiation effect of the control group was measured by 2 variables, the average DBSs foci per nucleus and the percent of the DSB bearing cells in PBL. The findings showed a significant increase in the DSBs after isotope injection with an average increment of 0.29 ± 0.13 of foci/nucleus and 17.07% ± 7.68 more DSB bearing cells (p < 0.05). The cocktail treated group showed a lower difference average of − 2.79% ± 6.13 DSB bearing cells. A paired t-test revealed a significant difference between the groups (p < 0.005) confirming the cocktail’s protective effect. The novel anti-oxidant treatment decreases the oxidative stress-induced DNA damage and can be considered as a preventative treatment before radiation exposure.
Collapse
Affiliation(s)
- Miguel Gorenberg
- Department of Nuclear Medicine, Bnai-Zion Medical Center, Golomb 47, P.O.B 4940, Haifa, Israel. .,Technion-Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.
| | - Abed Agbarya
- Oncology Unit, Bnai-Zion Medical Center, Haifa, Israel
| | - David Groshar
- Department of Nuclear Medicine, Belinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Ilya Volovik
- Medical Imaging Department, Bnai-Zion Medical Center, Haifa, Israel
| | - Ofir Avitan
- Urology Department, Bnai-Zion Medical Center, Haifa, Israel
| | - Igor Sukhotnik
- Department of Pediatric Surgery, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| |
Collapse
|
7
|
Potential application of γ-H2AX as a biodosimetry tool for radiation triage. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2020; 787:108350. [PMID: 34083048 DOI: 10.1016/j.mrrev.2020.108350] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 01/01/2023]
Abstract
Radiation triage and biological dosimetry are two initial steps in the medical management of exposed individuals following radiological accidents. Well established biodosimetry methods such as the dicentric (DC) assay, micronucleus (MN) assay, and fluorescence in-situ hybridization (FISH) translocation assay (for residual damage) have been used for this purpose for several decades. Recent advances in scoring methodology and networking among established laboratories have increased triage capacity; however, these methods still have limitations in analysing large sample numbers, particularly because of the ∼ 48 h minimum culture time required prior to analysis. Hence, there is a need for simple, and high throughput markers to identify exposed individuals in case of radiological/nuclear emergencies. In recent years, a few markers were identified, one being phosphorylated histone 2AX (γ-H2AX), which measured a nuclear foci or nuclear staining intensity that was found to be suitable for triage. Measurement of γ-H2AX foci formed at and around the sites of DNA double-strand breaks is a rapid and sensitive biodosimetry method which does not require culturing and is thus promising for the analysis of a large number of samples. In this review, we have summarized the recent developments of γ-H2AX assay in radiation triage and biodosimetry, focusing chiefly on: i) the importance of baseline frequency and reported values among different laboratories, ii) the influence of known and unknown variables on dose estimation, iii) quality assurance such as inter-laboratory comparison between scorers and scoring methods, and iv) current limitations and potential for future development.
Collapse
|
8
|
Lin ZX, Zhou F, Schoepf UJ, Pillai B, Zhou CS, Quan W, Bao XQ, Lu GM, Zhang LJ. Tube Voltage, DNA Double-Strand Breaks, and Image Quality in Coronary CT Angiography. Korean J Radiol 2020; 21:967-977. [PMID: 32677381 PMCID: PMC7369208 DOI: 10.3348/kjr.2019.0932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/16/2020] [Accepted: 03/05/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the effects of tube voltage on image quality in coronary CT angiography (CCTA), the estimated radiation dose, and DNA double-strand breaks (DSBs) in peripheral blood lymphocytes to optimize the use of CCTA in the era of low radiation doses. MATERIALS AND METHODS This study included 240 patients who were divided into 2 groups according to the DNA DSB analysis methods, i.e., immunofluorescence microscopy and flow cytometry. Each group was subdivided into 4 subgroups: those receiving CCTA only with different tube voltages of 120, 100, 80, or 70 kVp. Objective and subjective image quality was evaluated by analysis of variance. Radiation dosages were also recorded and compared. RESULTS There was no significant difference in demographic characteristics between the 2 groups and 4 subgroups in each group (all p > 0.05). As tube voltage decreased, both image quality and radiation dose decreased gradually and significantly. After CCTA, γ-H2AX foci and mean fluorescence intensity in the 120-, 100-, 80-, and 70-kVp groups increased by 0.14, 0.09, 0.07, and 0.06 foci per cell and 21.26, 9.13, 8.10, and 7.13 (all p < 0.05), respectively. The increase in the DNA DSB level in the 120-kVp group was higher than those in the other 3 groups (all p < 0.05), while there was no significant difference in the DSBs levels among these latter groups (all p > 0.05). CONCLUSION The 100-kVp tube voltage may be optimal for CCTA when weighing DNA DSBs against the estimated radiation dose and image quality, with further reductions in tube voltage being unnecessary for CCTA.
Collapse
Affiliation(s)
- Zhu Xiao Lin
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.,Department of Medical Imaging, Yantaishan Hospital, Yantai, China
| | - Fan Zhou
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - U Joseph Schoepf
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.,Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Balakrishnan Pillai
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Chang Sheng Zhou
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wei Quan
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xue Qin Bao
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Long Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
| |
Collapse
|
9
|
Ritt P, Jobic C, Beck M, Schmidkonz C, Kuwert T, Uder M, Brand M. Dissimilar DNA Damage to Blood Lymphocytes After 177Lu-Labeled DOTATOC or Prostate-Specific Membrane Antigen Therapy. J Nucl Med 2020; 62:379-385. [PMID: 32737244 DOI: 10.2967/jnumed.120.243782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022] Open
Abstract
DNA double-strand breaks in cells of radionuclide-treated patients are quantifiable by immunofluorescence microscopy, using phosphorylation of histone-variant H2AX (γ-H2AX) to mark radiation-induced foci (RIFs). Using this method, we compared excess RIFs side by side in recipients of 177Lu-DOTATOC or 177Lu-prostate specific membrane antigen-617 (PSMA) radioligands. We also examined relations between blood dose and dose rate, RIFs, and platelet counts. Methods: Venous blood samples were obtained from 48 patients subjected to 177Lu-labeled radioligand therapy (177Lu-DOTATOC, 26; 177Lu-PSMA, 22) to quantify blood lymphocyte RIFs and blood activity concentrations at various time points, including baseline (before injection) and postinjection readings (5 min, 30 min, 4 h, 24 h, 48 h, and 72 h). Absorbed doses and dose rates to blood were derived from sequentially assessed blood activity concentrations and γ-camera imaging. Platelet levels in routine blood tests were monitored for 3 d after injection to assess responses. Results: RIF counts averaged 0.25 ± 0.15 at baseline. Postinjection RIF counts were significantly higher than baseline values, peaking at 5 min (average, 3.93 ± 2.51 min) and declining thereafter. Compared with RIF counts of 177Lu-DOTATOC, those of 177Lu-PSMA were significantly higher at 5 min after injection and significantly lower at 72 h after injection. These differences could not be fully explained by blood doses and dose rates, which were significantly higher for 177Lu-PSMA than for 177Lu-DOTATOC treatment at every time point. RIF counts overall correlated with dose rates across all time points (Pearson r = 0.78; P < 0.01) and with absorbed dose until 4 h after injection only (Pearson r = 0.42; P < 0.01). Declines in platelet concentration correlated significantly with RIFs at 72 h after injection (Pearson r = -0.34; P < 0.05). Conclusion: Although values generated by the currently used blood dosimetry model correlated with RIF counts, the difference observed in 177Lu-DOTATOC and 177Lu-PSMA treatment groups was unexplained. Significantly more RIFs were found in 177Lu-DOTATOC recipients by comparison, despite lower dose rates and blood doses, exposing a potential limitation.
Collapse
Affiliation(s)
- Philipp Ritt
- Clinic of Nuclear Medicine, University Hospital Erlangen, Erlangen Germany; and
| | - Camille Jobic
- Clinic of Nuclear Medicine, University Hospital Erlangen, Erlangen Germany; and
| | - Michael Beck
- Clinic of Nuclear Medicine, University Hospital Erlangen, Erlangen Germany; and
| | | | - Torsten Kuwert
- Clinic of Nuclear Medicine, University Hospital Erlangen, Erlangen Germany; and
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Brand
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
| |
Collapse
|
10
|
Radiation-induced DNA double-strand breaks in peripheral leukocytes and therapeutic response of heel spur patients treated by orthovoltage X-rays or a linear accelerator. Strahlenther Onkol 2020; 196:1116-1127. [PMID: 32651595 PMCID: PMC7686210 DOI: 10.1007/s00066-020-01662-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/22/2020] [Indexed: 11/18/2022]
Abstract
Purpose Biodosimetric assessment and comparison of radiation-induced deoxyribonucleic acid (DNA) double-strand breaks (DSBs) by γH2AX immunostaining in peripheral leukocytes of patients with painful heel spur after radiation therapy (RT) with orthovoltage X‑rays or a 6-MV linear accelerator (linac). The treatment response for each RT technique was monitored as a secondary endpoint. Patients and methods 22 patients were treated either with 140-kV orthovoltage X‑rays (n = 11) or a 6-MV linac (n = 11) with two weekly fractions of 0.5 Gy for 3 weeks. In both scenarios, the dose was prescribed to the International Commission on Radiation Units and Measurements (ICRU) dose reference point. Blood samples were obtained before and 30 min after the first RT session. γH2AX foci were quantified by immunofluorescence microscopy to assess the yield of DSBs at the basal level and after radiation exposure ex vivo or in vivo. The treatment response was assessed before and 3 months after RT using a five-level functional calcaneodynia score. Results RT for painful heel spurs induced a very mild but significant increase of γH2AX foci in patients’ leukocytes. No difference between the RT techniques was observed. High and comparable therapeutic responses were documented for both treatment modalities. This trial was terminated preliminarily after an interim analysis (22 patients randomized). Conclusion Low-dose RT for painful heel spurs with orthovoltage X‑rays or a 6-MV linac is an effective treatment option associated with a very low and comparable radiation burden to the patient, as confirmed by biodosimetric measurements.
Collapse
|
11
|
Kaatsch HL, Majewski M, Schrock G, Obermair R, Seidel J, Nestler K, Abend M, Waldeck S, Port M, Ullmann R, Becker BV. CT Irradiation-induced Changes of Gene Expression within Peripheral Blood Cells. HEALTH PHYSICS 2020; 119:44-51. [PMID: 32167501 DOI: 10.1097/hp.0000000000001231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Computed tomography (CT) is a crucial element of medical imaging diagnostics. The widespread application of this technology has made CT one of the major contributors to medical radiation burden, despite the fact that doses per individual CT scan steadily decrease due to the advancement of technology. Epidemiological risk assessment of CT exposure is hampered by the fact that moderate adverse effects triggered by low doses of CT exposure are likely masked by statistical fluctuations. In light of these limitations, there is need of further insights into the biological processes induced by CT scans to complement the existing knowledge base of risk assessment. This prompted us to investigate the early transcriptomic response of ex vivo irradiated peripheral blood of three healthy individuals. Samples were irradiated employing a modern dual-source-CT-scanner with a tube voltage of 150 kV, resulting in an estimated effective dose of 9.6 mSv. RNA was isolated 1 h and 6 h after exposure, respectively, and subsequently analyzed by RNA deep sequencing. Differential gene expression analysis revealed shared upregulation of AEN, FDXR, and DDB2 6 h after exposure in all three probands. All three genes have previously been discussed as radiation responsive genes and have already been implicated in DNA damage response and cell cycle control after DNA damage. In summary, we substantiated the usefulness of AEN, FDXR, and DDB2 as RNA markers of low dose irradiation. Moreover, the upregulation of genes associated with DNA damage reminds one of the genotoxic nature of CT diagnostics even with the low doses currently applied.
Collapse
Affiliation(s)
- Hanns Leonhard Kaatsch
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Matthäus Majewski
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Gerrit Schrock
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Richard Obermair
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Jillyen Seidel
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Kai Nestler
- Bundeswehr Central Hospital Koblenz, Department of Radiology, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Stephan Waldeck
- Bundeswehr Central Hospital Koblenz, Department of Radiology, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Reinhard Ullmann
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Benjamin Valentin Becker
- Bundeswehr Central Hospital Koblenz, Department of Radiology, Rübenacher Straße 170, 56072 Koblenz, Germany
| |
Collapse
|
12
|
Bicheru NS, Haidoiu C, Călborean O, Popa A, Porosnicu I, Hertzog R. Effect of Different Antioxidants on X-ray Induced DNA Double-strand Breaks Using γ-H2AX in Human Blood Lymphocytes. HEALTH PHYSICS 2020; 119:101-108. [PMID: 32483045 DOI: 10.1097/hp.0000000000001267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Ionizing radiation exposure produces direct or indirect biological effects on genomic DNA. The latter are ionizing radiation mediated by induction of free radicals and oxygen species (ROS). The study was conducted to evaluate the dose-effect/time-effect of antioxidant treatments in reducing the induction of double-strand breaks in human blood lymphocytes. Human peripheral blood samples of 2 mL each from healthy donors were irradiated with 10 mGy after pre-incubation with different antioxidants (β-carotene, vitamin E, vitamin C, N-acetyl L-cysteine). In order to assess their efficiency as prophylactic therapy for irradiation, various concentrations and combinations of antioxidants, as well as different incubation times, have been evaluated. To assess double-strand breaks induced by ionizing radiation, the phosphorylated histone γ-H2AX has been used. A significant reduction (p < 0.001) in double-strand breaks studied with a γ-H2AX assay was observed with N-acetyl L-cysteine with a 1-h incubation time, followed by vitamin C, vitamin E, and β-carotene. The use of antioxidants, especially N-acetyl L-cysteine before irradiation, significantly decreased the occurrence of double-strand breaks, demonstrating the potential radiological protection for exposure to ionizing radiation.
Collapse
Affiliation(s)
| | | | | | - Adrian Popa
- Military Medical Research Center, Bucharest, Romania
| | - Ioana Porosnicu
- National Institute for Laser Plasma and Radiation Physics, Bucharest, Romania
| | - Radu Hertzog
- Military Medical Research Center, Bucharest, Romania
| |
Collapse
|
13
|
Mirsch J, Hintz L, Maier A, Fournier C, Löbrich M. An Assessment of Radiation Doses From Radon Exposures Using a Mouse Model System. Int J Radiat Oncol Biol Phys 2020; 108:770-778. [PMID: 32473181 DOI: 10.1016/j.ijrobp.2020.05.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/08/2020] [Accepted: 05/18/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Radon and its progenies contribute significantly to the natural background radiation and cause several thousands of lung cancer cases per year worldwide. Moreover, patients with chronic inflammatory joint diseases are treated in radon galleries. Due to the complex nature of radon exposure, the doses associated with radon exposures are difficult to assess. Hence, there is a clear need to directly measure dose depositions from radon exposures to provide reliable risk estimates for radiation protection guidelines. OBJECTIVES We aimed to assess tissue-specific radiation doses associated with radon activity concentrations, that deposit similar dose levels as the annual natural radon exposure or radon gallery visits. METHODS We exposed mice to defined radon concentrations, quantified the number of 53BP1 foci as a measure of induced DNA damage, and compared it with the number of foci induced by known doses of reference-type radiations. An image-based analysis of the 3-dimensional foci pattern provided information about the radiation type inflicting the DNA damage. RESULTS A 1-hour exposure to 440 kBq/m3 radon-induced DNA damage corresponding to a dose of ∼10 mGy in the lung and ∼3.3 mGy in the kidney, heart, and liver. A 1-hour exposure to 44 kBq/m3 provided values consistent with a linear relationship between dose and radon concentration. Two-thirds of the dose in the lung was caused by α-particles. The dose in the kidney, heart, and liver and one-third of the dose in the lung likely resulted from β- and γ-rays. DISCUSSION We found that radon exposures mainly lead to α-particle-induced DNA damage in the lung, consistent with the lung cancer risk obtained in epidemiologic studies. Our presented biodosimetric approach can be used to benchmark risk model calculations for radiation protection guidelines and can help to understand the therapeutic success of radon gallery treatments.
Collapse
Affiliation(s)
- Johanna Mirsch
- Radiation Biology and DNA Repair, Technical University of Darmstadt, Darmstadt, Germany
| | - Lisa Hintz
- Radiation Biology and DNA Repair, Technical University of Darmstadt, Darmstadt, Germany
| | - Andreas Maier
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Claudia Fournier
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Markus Löbrich
- Radiation Biology and DNA Repair, Technical University of Darmstadt, Darmstadt, Germany.
| |
Collapse
|
14
|
Eskandari A, Mahmoudzadeh A, Shirazi A, Esmaely F, Carnovale C, Cheki M. Melatonin a Promising Candidate for DNA Double-Stranded Breaks Reduction in Patients Undergoing Abdomen-Pelvis Computed Tomography Examinations. Anticancer Agents Med Chem 2020; 20:859-864. [PMID: 32208125 DOI: 10.2174/1871521409666200324101701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/20/2019] [Accepted: 02/04/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Cancer incidence is 24% higher in children and young adults exposed to Computed Tomography (CT) scans than those unexposed. Non-repairing of ionizing radiation-induced DNA Double-Strand Breaks (DSBs) can initiate carcinogenesis. In the present study, we aimed to investigate the radioprotective potential of melatonin against DSBs in peripheral blood lymphocytes of patients undergoing abdomen-pelvis CT examinations. METHODS This double-blind, placebo-controlled clinical trial was conducted on thirty patients. These patients were divided into two groups; group one (control) patients who have undergone the CT examination received a single oral dose of placebo, while in group two, patients received a single oral dose of 100mg melatonin. In both the groups, blood samples were collected 5-10min before and 30 minutes after the CT examination. The lymphocytes from these samples were isolated and DSBs were analyzed using γH2AX immunofluorescence microscopy. RESULTS Compared to the control group, the use of melatonin 1h before the CT examination caused a significant reduction in γH2AX-foci, indicating a reduction in DSBs. In addition, no side effect was observed in patients following 100mg melatonin administration. CONCLUSION For the first time, this study has shown that melatonin has protective effects against radiationinduced genotoxicity in peripheral blood lymphocytes of patients undergoing abdomen-pelvis CT examinations. Therefore, melatonin can be considered as a promising candidate for reducing DSBs in patients undergoing abdomen-pelvis CT examinations.
Collapse
Affiliation(s)
- Ali Eskandari
- Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Aziz Mahmoudzadeh
- Department of Biosciences and Biotechnology, Malek-Ashtar University of Technology, Tehran, Iran
| | - Alireza Shirazi
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences and Health Services, Tehran, Iran
| | - Farid Esmaely
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences and Health Services, Tehran, Iran
| | - Carla Carnovale
- Department of Biomedical and Clinical Sciences L. Sacco, Unit of Clinical Pharmacology, ASST Fatebenefratelli-Sacco University Hospital, Università di Milano, Milan, Italy
| | - Mohsen Cheki
- Department of Radiologic Technology, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
15
|
Okuda K, Watanabe N, Hashimoto M, Doai M, Kawai Y, Takahashi T, Arikawa T, Ooiso K, Sunatani Y, Iwabuchi K, Kajinami K, Matoba M. Preliminary quantitative evaluation of radiation-induced DNA damage in peripheral blood lymphocytes after cardiac dual-isotope imaging. Appl Radiat Isot 2019; 154:108890. [PMID: 31525597 DOI: 10.1016/j.apradiso.2019.108890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/20/2019] [Accepted: 09/09/2019] [Indexed: 12/13/2022]
Abstract
DNA double-strand breaks (DSBs) of peripheral blood lymphocyte were prospectively assessed in 9 patients who were injected with 201Tl-chloride and 123I-beta-methyl-p-iodophenyl-pentadecanoic acid in dual-isotope imaging. Phosphorylated H2AX (γH2AX) was used as a biomarker for detecting DSBs, and the mean number of γH2AX foci per cell was measured microscopically. Mean γH2AX foci before administration of radiopharmaceuticals and at 3, 6, and 24 h following administration were 0.22 ± 0.34, 0.10 ± 0.14, 0.59 ± 0.46, and 0.52 ± 0.40, respectively (p = n.s. for all combinations).
Collapse
Affiliation(s)
- Koichi Okuda
- Department of Physics, Kanazawa Medical University, Ishikawa, 920-0293, Japan.
| | - Naoto Watanabe
- Department of Radiology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Mitsumasa Hashimoto
- Department of Physics, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Mariko Doai
- Department of Radiology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Yasuyuki Kawai
- Department of Cardiology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Tomoko Takahashi
- Department of Radiology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Tomohiro Arikawa
- Department of Biology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Kazumasa Ooiso
- Department of Radiology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Yumi Sunatani
- Department of Biochemistry I, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Kuniyoshi Iwabuchi
- Department of Biochemistry I, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Koji Kajinami
- Department of Cardiology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Munetaka Matoba
- Department of Radiology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| |
Collapse
|
16
|
Ruprecht N, Hungerbühler MN, Böhm IB, Heverhagen JT. Improved identification of DNA double strand breaks: γ-H2AX-epitope visualization by confocal microscopy and 3D reconstructed images. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:295-302. [PMID: 30799523 DOI: 10.1007/s00411-019-00778-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 01/22/2019] [Indexed: 06/09/2023]
Abstract
Currently, in the context of radiology, irradiation-induced and other genotoxic effects are determined by visualizing DSB-induced DNA repair through γ-H2AX immunofluorescence and direct counting of the foci by epifluorescence microscopy. This procedure, however, neglects the 3D nature of the nucleus. The aim of our study was to use confocal microscopy and 3D reconstructed images to improve documentation and analysis of γ-H2AX fluorescence signals after diagnostic examinations. Confluent, non-dividing MRC-5 lung fibroblasts were irradiated in vitro with a Cs-137 source and exposed to radiation doses up to 1000 mGy before fixation and staining with an antibody recognizing the phosphorylated histone variant γ-H2AX. The 3D distribution of γ-H2AX foci was visualized using confocal laser scanning microscopy. 3D reconstruction of the optical slices and γ-H2AX foci counting were performed using Imaris Image Analysis software. In parallel, γ-H2AX foci were counted visually by epifluorescence microscopy. In addition, whole blood was exposed ex vivo to the radiation doses from 200 to 1600 mGy. White blood cells (WBCs) were isolated and stained for γ-H2AX. In fibroblasts, epifluorescence microscopy alone visualized the entirety of fluorescence signals as integral, without correct demarcation of single foci, and at 1000 mGy yielded on average 11.1 foci by manual counting of 2D images in comparison to 36.1 foci with confocal microscopy and 3D reconstruction (p < 0.001). The procedure can also be applied for studies on WBCs. In contrast to epifluorescence microscopy, confocal microscopy and 3D reconstruction enables an improved identification of DSB-induced γ-H2AX foci, allowing for an unbiased, ameliorated quantification.
Collapse
Affiliation(s)
- Nico Ruprecht
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
- Department of BioMedical Research, University of Bern, Bern, Switzerland.
| | - Martin N Hungerbühler
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Ingrid B Böhm
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Johannes T Heverhagen
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| |
Collapse
|
17
|
Bryll A, Krzyściak W, Jurczak A, Chrzan R, Lizoń A, Urbanik A. Changes in the Selected Antioxidant Defense Parameters in the Blood of Patients after High Resolution Computed Tomography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091476. [PMID: 31027322 PMCID: PMC6539922 DOI: 10.3390/ijerph16091476] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 12/11/2022]
Abstract
Ionizing radiation generated during high resolution computed tomography (HRCT) scanning may have an indirect effect on the mechanisms regulating the oxidative-antioxidant balance in the human body, which is one of the necessary factors ensuring the maintenance of its homeostasis. The aim of the study was to analyze the response of antioxidant systems through the determination of the antioxidant markers in the blood of patients exposed to oxidative stress resulting from the routine HRCT examination of the chest. Blood of 35 people aged 60.77 ± 10.81 taken before and at four time points after the examination constituted the test material. The determination of the total antioxidant capacity expressed as ferric reducing ability of plasma (FRAP) and ferric reducing antioxidant activity and ascorbic acid concentration (FRASC) were performed together with an examination of catalase activity and the concentration of the reduced glutathione. The organism’s response to ionizing radiation was associated with a significant decrease in the antioxidant markers’ levels at all time-points and showed a significant negative correlation depending on the radiation dose. Visible down-regulation of these markers is a response to increased oxidative stress. In light of the obtained results, the measurement of the selected markers of antioxidant defense may be a useful parameter of oxidative stress caused by ionizing radiation.
Collapse
Affiliation(s)
- Amira Bryll
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland.
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland.
| | - Anna Jurczak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, Montelupich 4, 31-155 Krakow, Poland.
| | - Robert Chrzan
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland.
| | - Anna Lizoń
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland.
| | - Andrzej Urbanik
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland.
| |
Collapse
|
18
|
Jafarpour SM, Salimian M, Mohseni M, Talari HR, Aliasgharzadeh A, Farhood B, Moradi H, Safari H. Evaluation of Ameliorative Potential of Vitamins E and C on DNA Double Strand Break (DSB) in Patients Undergoing Computed Tomography (CT): A Clinical Study. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2019; 7:226-233. [PMID: 31516882 PMCID: PMC6709935 DOI: 10.22088/ijmcm.bums.7.4.226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 02/24/2019] [Indexed: 01/05/2023]
Abstract
Computed tomography (CT) is one of the most important diagnostic X-ray procedures which plays an important role in increasing the patient dose values. The purpose of this clinical study was to evaluate the efficacy of vitamins E and C in lowering down the level of DNA double strand break (DSB) caused by CT scan. Sixty patients for abdomen/pelvic enhanced CT scan were randomly assigned to placebo (control), vitamin C, and vitamin E groups. The patient blood samples were taken before and immediately after the CT scan. Counting the number of DSB was performed using γ-H2AX method as a sensitive biomarker. Immediately after the CT scan, the mean number of DSBs/cell increased in all three groups of control (131%, P<0.001), vitamin C (103%, P <0.001), and vitamin E (66%, P<0.001) compared to their mean before the CT scan. Furthermore, the results showed that vitamin E decreased the mean number of DSBs/cell by 22% in comparison with the control group (P =0.023), whereas vitamin C had no significant effect on reducing the DSB (<3%, P =0.741). It is concluded that the administration of vitamin E one hour before the CT scan, significantly decreases DSB levels.
Collapse
Affiliation(s)
- Seyed Masoud Jafarpour
- Department of Radiology and Medical Physics, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Morteza Salimian
- Department of Medical laboratory, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehran Mohseni
- Department of Radiology and Medical Physics, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Talari
- Department of Radiology, Kashan University of Medical Sciences, Kashan, Iran
| | - Akbar Aliasgharzadeh
- Department of Radiology and Medical Physics, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Bagher Farhood
- Department of Radiology and Medical Physics, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Habiballah Moradi
- Department of Radiology and Medical Physics, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Safari
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
19
|
Alipoor A, Fardid R, Sharifzadeh S. Evaluating Gamma-H2AX Expression as a Biomarker of DNA Damage after X-ray in Angiography Patients. J Biomed Phys Eng 2018; 8:393-402. [PMID: 30568929 PMCID: PMC6280120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 05/27/2017] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Coronary heart disease (CHD) is one of the most common diseases. Coronary angiography (CAG) is an important apparatus used to diagnose and treat this disease. Since angiography is performed through exposure to ionizing radiation, it can cause harmful effects induced by double-stranded breaks in DNA which is potentially life-threatening damage. The aim of the present study is to investigate phosphorylation of Histone H2AX in the location of double-stranded breaks in peripheral blood lymphocytes as an indication of biological effects of radiation on angiography. MATERIALS AND METHODS This method is based on the phosphorylation measurement of Histone (gamma-H2AX or γ-H2AX) levels on serine 139 after the formation of DNA double-strand break. 5 cc of blood samples from 24 patients undergoing angiography were taken pre- and post-radiation. Blood lymphocytes were extracted, fixed and stained with specific γ-H2AX antibodies. Finally, the percentage of phosphorylation of Histone H2AX as an indicator of double-strand break was measured by a cytometry technique. RESULTS An increase was observed in all patients' percentage of phosphorylated Histone H2AX (double-stranded breaks DNA) after radiation (20.15 ± 14.18) compared to pre-exposure time (1.52 ± 0.34). Also, the mean of DNA double-strand break is shown in a linear correlation with DAP. DISCUSSION Although induction of DNA double-strand breaks was associated with the radiation dose in patients, the effect of individual factors such as radio-sensitivity and regenerative capacity should not be ignored. In the future, if we are able to measure DNA damage response in every angiography patient, we will use it as a biomarker for the patient dose; this will promote public health. CONCLUSION Using flow cytometers readings done automatically is possible to detect γ-H2AX in the number of blood cells, therefore, the use of this technique could play a significant role in monitoring patients.
Collapse
Affiliation(s)
- A Alipoor
- M.Sc. Radiology Department, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - R Fardid
- Associate Professor, Radiology Department, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Ionizing and Non-Ionizing Radiation Protection Research Center (INIRPRC), School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Sharifzadeh
- Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
20
|
Lengert N, Mirsch J, Weimer RN, Schumann E, Haub P, Drossel B, Löbrich M. AutoFoci, an automated high-throughput foci detection approach for analyzing low-dose DNA double-strand break repair. Sci Rep 2018; 8:17282. [PMID: 30470760 PMCID: PMC6251879 DOI: 10.1038/s41598-018-35660-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/07/2018] [Indexed: 12/31/2022] Open
Abstract
Double-strand breaks (DSBs) are the most lethal DNA damages induced by ionising radiation (IR) and their efficient repair is crucial to limit genomic instability. The cellular DSB response after low IR doses is of particular interest but its examination requires the analysis of high cell numbers. Here, we present an automated DSB quantification method based on the analysis of γH2AX and 53BP1 foci as markers for DSBs. We establish a combination of object properties, combined in the object evaluation parameter (OEP), which correlates with manual object classification. Strikingly, OEP histograms show a bi-modal distribution with two maxima and a minimum in between, which correlates with the manually determined transition between background signals and foci. We used algorithms to detect the minimum, thus separating foci from background signals and automatically assessing DSB levels. To demonstrate the validity of this method, we analyzed over 600.000 cells to verify results of previous studies showing that DSBs induced by low doses are less efficiently repaired compared with DSBs induced by higher doses. Thus, the automated foci counting method, called AutoFoci, provides a valuable tool for high-throughput image analysis of thousands of cells which will prove useful for many biological screening approaches.
Collapse
Affiliation(s)
- Nicor Lengert
- Theory of Complex Systems, Darmstadt University of Technology, Hochschulstr. 6, 64289, Darmstadt, Germany.
| | - Johanna Mirsch
- Radiation Biology and DNA Repair, Darmstadt University of Technology, Schnittspahnstr. 13, 64287, Darmstadt, Germany
| | - Ratna N Weimer
- Radiation Biology and DNA Repair, Darmstadt University of Technology, Schnittspahnstr. 13, 64287, Darmstadt, Germany
| | - Eik Schumann
- Radiation Biology and DNA Repair, Darmstadt University of Technology, Schnittspahnstr. 13, 64287, Darmstadt, Germany
| | - Peter Haub
- Image Consulting, 68804, Altlußheim, Germany
| | - Barbara Drossel
- Theory of Complex Systems, Darmstadt University of Technology, Hochschulstr. 6, 64289, Darmstadt, Germany
| | - Markus Löbrich
- Radiation Biology and DNA Repair, Darmstadt University of Technology, Schnittspahnstr. 13, 64287, Darmstadt, Germany.
| |
Collapse
|
21
|
Solitro GF, Mainnemare F, Amirouche F, Mehta A. A novel technique with reduced computed tomography exposure to predict vertebral compression fracture: a finite element study based on rat vertebrae. Med Biol Eng Comput 2018; 57:795-805. [PMID: 30402789 DOI: 10.1007/s11517-018-1918-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 10/21/2018] [Indexed: 10/27/2022]
Abstract
Vertebral compression fractures are a significant clinical issue with an annual incidence of approximately 750,000 cases in the USA alone. Mechanical properties of vertebrae are successfully evaluated through finite element (FE) models based on vertebrae CT. However, clinical drawbacks associated to radiation transmission encouraged to explore the possibility to use selected or reduced portions of the vertebra. The objective of our study was to develop a new procedure to predict vertebral compression fracture from sub-volumes. We reconstructed rat vertebras from micro-CT of thoracic and lumbar groups. Each vertebra was partitioned into three sub-volumes of different axial thickness. FE simulating compression tests were performed on each model to evaluate their failure load and stiffness. Using a power function, a high correlation was found for stiffness and strength. The sub-volume with three fifths thickness had a failure load of 180.7 ± 19.2 N for thoracic and of 209.5 ± 27.4 N for the lumbar vertebra. These values were not significantly different from the values found for the entire vertebra (p > 0.05). Based on our findings, failure loads and stiffnesses obtained with reduced CT scans can be successfully used to predict full vertebral failure. This sub-region analysis and power relationship suggests that one can limit radiation exposure to patients when bone characterization is needed. Graphical abstract Estimated mechanical properties in relation to the extent of the computed tomography reconstruction.
Collapse
Affiliation(s)
- Giovanni F Solitro
- Department of Orthopaedics, University of Illinois at Chicago, 835 S. Wolcott Avenue, Room E270, Chicago, IL, 60612, USA.,Department of Orthopaedic Surgery, Louisiana State University Health Science Center of Shreveport, 1501 Kings Hwy, Room 3-317, Shreveport, LA, 71104, USA
| | - Florian Mainnemare
- Department of Mechanical Engineering, ENS Cachan, Université Paris-Saclay, 61 Avenue du Président Wilson, 94235, Cachan, France
| | - Farid Amirouche
- Department of Orthopaedics, University of Illinois at Chicago, 835 S. Wolcott Avenue, Room E270, Chicago, IL, 60612, USA.
| | - Ankit Mehta
- Department of Neurosurgery, University of Illinois at Chicago, 912 S Wood St, Chicago, IL, USA
| |
Collapse
|
22
|
Brand M, Wuest W, May M, Uder M, Sommer M. Influence of risk-organ-based tube current modulation on CT-induced DNA double-strand breaks in a biological phantom model. JOURNAL OF RADIATION RESEARCH 2018; 59:692-699. [PMID: 30239765 PMCID: PMC6251432 DOI: 10.1093/jrr/rry075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/01/2018] [Indexed: 06/08/2023]
Abstract
Techniques for dose reduction in computed tomography (CT) are receiving increasing attention. Lowering the tube current in front of the patient, known as risk-organ-based tube current modulation (RTM), represents a new approach. Physical dose parameters can determine the exposure but are not able to assess the biological-X-ray interactions. The purpose of this study was to establish a biological phantom model to evaluate the effect of RTM on X-ray-induced DNA double-strand breaks (DSBs). In breast phantoms and in the location of the spine in an Alderson phantom, isolated human blood lymphocytes were irradiated using a 128-slice CT scanner. A standard thoracic CT protocol (120 kV, 110 ref. mAs, anatomy-based tube current modulation, pitch 0.6, scan length 30 cm) with and without RTM was used. X-ray-induced DSBs were quantified in isolated blood lymphocytes using immunofluorescence microscopy after staining for the phosphorylated histone variant γ-H2AX. Using RTM, the resulting DNA damage reduction was 41% in superficial breast locations (P = 0.0001), 28% in middle breast locations (P = 0.0003) and 29% in lower breast locations (P = 0.0001), but we found a DNA damage increase of 36% in superficial spine locations (P = 0.0001) and of 26% in deep spine locations (P = 0.0001). In summary, we established a biological phantom model that is suitable for detecting DNA damage in distinct organs. In addition, we were able to show that, using RTM, X-ray-induced DNA damage in the breast can be significantly reduced; however, there is a significant increase in DSBs in the location of the spine.
Collapse
Affiliation(s)
- Michael Brand
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, Erlangen, Germany
| | - Wolfgang Wuest
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, Erlangen, Germany
| | - Matthias May
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, Erlangen, Germany
| | - Matthias Sommer
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, Erlangen, Germany
| |
Collapse
|
23
|
Brand M, Sommer M, Jermusek F, Fahl WE, Uder M. Reduction of X-ray-induced DNA damage in normal human cells treated with the PrC-210 radioprotector. Biol Open 2018; 7:bio.035113. [PMID: 30135082 PMCID: PMC6215412 DOI: 10.1242/bio.035113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The aim of our study was to determine the protective efficacy of the PrC-210 aminothiol radioprotector against X-ray-induced DNA damage in normal human cells and to establish dose- and time-effect models for future PrC-210 use in humans. The PrC-210 structure has a branched structure which enables scavenging of reactive oxygen species (ROS) away from DNA. Normal human blood lymphocytes, fibroblasts and naked genomic DNA were exposed to PrC-210 seconds to hours prior to irradiation. Biological (γ-H2AX foci), chemical (8-oxo-deoxyguanosine) and physical (genomic DNA electrophoretic migration) DNA damage endpoints were scored to determine the ability of PrC-210 to suppress radiation-induced DNA damage. X-ray-induced γ-H2AX foci in blood lymphocytes were reduced by 80% after irradiation with 10, 50 and 100 mGy, and DNA double-strand breaks in fibroblasts were reduced by 60% after irradiation with 20 Gy. Additionally, we observed a reduction of 8-oxo-deoxyguanosine (an ROS-mediated, DNA damage marker) in human genomic DNA to background in a PrC-210 dose-dependent manner. PrC-210 also eliminated radiation-induced cell death in colony formation assays after irradiation with 1 Gy. The protective efficacy of PrC-210 in each of these assay systems supports its development as a radioprotector for humans in multiple radiation exposure settings. Summary: A new strategy is decribed, using a new radioprotector (PrC-210) to significantly reduce radiation-induced DNA damage.
Collapse
Affiliation(s)
- Michael Brand
- Department of Radiology, Maximiliansplatz 3, University of Erlangen, 91054 Erlangen, Germany
| | - Matthias Sommer
- Department of Radiology, Maximiliansplatz 3, University of Erlangen, 91054 Erlangen, Germany
| | - Frank Jermusek
- Wisconsin Institutes of Medical Research, University of Wisconsin-Madison, Madison, Wisconsin 53705 USA
| | - William E Fahl
- Wisconsin Institutes of Medical Research, University of Wisconsin-Madison, Madison, Wisconsin 53705 USA
| | - Michael Uder
- Department of Radiology, Maximiliansplatz 3, University of Erlangen, 91054 Erlangen, Germany
| |
Collapse
|
24
|
Virag P, Hedesiu M, Soritau O, Perde-Schrepler M, Brie I, Pall E, Fischer-Fodor E, Bogdan L, Lucaciu O, Belmans N, Moreels M, Salmon B, Jacobs R. Low-dose radiations derived from cone-beam CT induce transient DNA damage and persistent inflammatory reactions in stem cells from deciduous teeth. Dentomaxillofac Radiol 2018; 48:20170462. [PMID: 30168750 DOI: 10.1259/dmfr.20170462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Cone-beam CT (CBCT), a radiographic tool for diagnosis, treatment, and follow-up in dental practice, was introduced also in pediatric radiology, especially orthodontics. Such patients subjected to repetitive X-rays examinations may receive substantial levels of radiation doses. Ionizing radiation (IR), a recognized carcinogenic factor causing DNA double-strand breaks (DSBs) could be harmful to undifferentiated cells such as dental pulp stem cells (DPSCs) since inaccurately repaired or unrepaired DSBs may lead to malignant transformation. The H2AX and MRE11 proteins generated following DSBs formation and pro-inflammatory cytokines (CKs) secreted after irradiation are relevant candidates to monitor the cellular responses induced by CBCT. METHODS DPSCs were extracted from human exfoliated deciduous teeth and their phenotype was assessed by immunocytochemistry and flow-cytometry. Cells were exposed to IR doses: 5.4-107.7 mGy, corresponding to 0.5-8 consecutive skull exposures, respectively. H2AX and MRE11 were detected in whole cells, while IL-1α, IL-6, IL-8, TNFα in supernatants, using enzyme-linked immunosorbent assay (ELISA) at different time points after exposure. RESULTS The phosphorylation level of H2AX in DPSCs increased considerably at 0.5 h after exposure (p < 0.001 for 3, 5, 8 skull exposures and p < 0.05 for 1 skull exposure, respectively). MRE11 response could only be detected for the highest IR dose (p < 0.001) in the same interval. CKs secretion increased upon CBCT exposure according to doses and time. CONCLUSIONS The DPSCs exposure to CBCT induces transient DNA damage and persistent inflammatory reaction in DPSCs drawing the attention on the potential risks of IR exposures and on the importance of dose monitoring in pediatric population.
Collapse
Affiliation(s)
- Piroska Virag
- The Oncology Institute "Prof.Dr.Ion Chiricuta", Laboratory of Radiotherapy, Radiobiology and Tumor Biology, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Oral and Maxillofacial Radiology, Cluj-Napoca, Romania
| | - Olga Soritau
- The Oncology Institute "Prof.Dr.Ion Chiricuta", Laboratory of Radiotherapy, Radiobiology and Tumor Biology, Cluj-Napoca, Romania
| | - Maria Perde-Schrepler
- The Oncology Institute "Prof.Dr.Ion Chiricuta", Laboratory of Radiotherapy, Radiobiology and Tumor Biology, Cluj-Napoca, Romania
| | - Ioana Brie
- The Oncology Institute "Prof.Dr.Ion Chiricuta", Laboratory of Radiotherapy, Radiobiology and Tumor Biology, Cluj-Napoca, Romania
| | - Emoke Pall
- University of Agricultural Sciences and Veterinary Medicine, Cluj- Napoca, Romania
| | - Eva Fischer-Fodor
- The Oncology Institute "Prof.Dr.Ion Chiricuta", Laboratory of Radiotherapy, Radiobiology and Tumor Biology, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Medfuture Research Center for Advanced Medicine, Cluj-Napoca, Romania
| | - Loredana Bogdan
- Radiation Hygiene Department, National Institute of Public Health, Regional Center of Public Health Cluj-Napoca, Cluj-Napoca, Romania
| | - Ondine Lucaciu
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Oral and Maxillofacial Radiology, Cluj-Napoca, Romania
| | - Niels Belmans
- Faculty of Medicine and Life Sciences, Biomedical Research Institute, Hasselt University, Hasselt, Belgium.,Radiobiology Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre, SCK·CEN, Boeretang, Belgium
| | - Marjan Moreels
- Radiobiology Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre, SCK·CEN, Boeretang, Belgium
| | - Benjamin Salmon
- EA2496, Orofacial Pathologies, Imaging and Biotherapies, Dental School Paris Descartes University, Sorbonne Paris Cité, France.,Department of Odontology, AP-HP, Nord Val de Seine Hospital (Bretonneau), Paris, France
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, University of Leuven, Leuven, Belgium
| |
Collapse
|
25
|
Tao SM, Li X, Schoepf UJ, Nance JW, Jacobs BE, Zhou CS, Gu HF, Lu MJ, Lu GM, Zhang LJ. Comparison of the effect of radiation exposure from dual-energy CT versus single-energy CT on double-strand breaks at CT pulmonary angiography. Eur J Radiol 2018; 101:92-96. [PMID: 29571808 DOI: 10.1016/j.ejrad.2018.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/19/2017] [Accepted: 02/03/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare the effect of dual-source dual-energy CT versus single-energy CT on DNA double-strand breaks (DSBs) in blood lymphocytes at CT pulmonary angiography (CTPA). METHODS AND MATERIALS Sixty-two patients underwent either dual-energy CTPA (Group 1: n = 21, 80/Sn140 kVp, 89/38 mAs; Group 2: n = 20, 100/Sn140 kVp, 89/76 mAs) or single-energy CTPA (Group 3: n = 21, 120 kVp, 110 mAs). Blood samples were obtained before and 5 min after CTPA. DSBs were assessed with fluorescence microscopy and Kruskal-Walls tests were used to compare DSBs levels among groups. Volume CT dose index (CTDIvol), dose length product (DLP) and organ radiation dose were compared using ANOVA. RESULTS There were increased excess DSB foci per lymphocyte 5 min after CTPA examinations in three groups (Group 1: P = .001; Group 2: P = .001; Group 3: P = .006). There were no differences among groups regarding excess DSB foci/cell and percentage of excess DSBs (Group 1, 23%; Group 2, 24%; Group 3, 20%; P = .932). CTDIvol, DLP and organ radiation dose in Group 1 were the lowest among the groups (all P < .001). CONCLUSION DSB is increased following dual-source and single-source CTPA, while dual-source dual-energy CT protocols do not increase the estimated radiation dose and also do not result in a higher incidence of DNA DSBs in patients undergoing CTPA.
Collapse
Affiliation(s)
- Shu Min Tao
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Xie Li
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - U Joseph Schoepf
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr. Charleston, SC 29401, United States
| | - John W Nance
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr. Charleston, SC 29401, United States
| | - Brian E Jacobs
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr. Charleston, SC 29401, United States
| | - Chang Sheng Zhou
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Hai Feng Gu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Meng Jie Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Long Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China.
| |
Collapse
|
26
|
DNA double-strand breaks in blood lymphocytes induced by two-day 99mTc-MIBI myocardial perfusion scintigraphy. Eur Radiol 2018; 28:3075-3081. [PMID: 29383524 DOI: 10.1007/s00330-017-5239-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/29/2017] [Accepted: 12/05/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To investigate DNA double-strand breaks (DSBs) in blood lymphocytes induced by two-day 99mTc-MIBI myocardial perfusion scintigraphy (MPS) using y-H2AX immunofluorescence microscopy and to correlate the results with 99mTc activity in blood samples. METHODS Eleven patients who underwent two-day MPS were included. DSB blood sampling was performed before and 5min, 1h and 24h after the first and second radiotracer injections. 99mTc activity was measured in each blood sample. For immunofluorescence microscopy, distinct foci representing DSBs were quantified in lymphocytes after staining for the phosphorylated histone variant y-H2AX. RESULTS The 99mTc-MIBI activity measured on days one and two was similar (254±25 and 258±27 MBq; p=0.594). Compared with baseline DSB foci (0.09±0.05/cell), a significant increase was found at 5min (0.19±0.04/cell) and 1h (0.18±0.04/cell) after the first injection and at 5min and 1h after the second injection (0.21±0.03 and 0.19±0.04/cell, respectively; p=0.003 for both). At 24h after the first and second injections, the number of DSB foci had returned to baseline (0.06±0.02 and 0.12±0.05/cell, respectively). 99mTc activity levels in peripheral blood samples correlated well with DSB counts (r=0.451). CONCLUSIONS DSB counts reflect 99mTc-MIBI activity after injection for two-day MPS, and might allow individual monitoring of biological effects of cardiac nuclear imaging. KEY POINTS • Myocardial perfusion scintigraphy using 99mTc induces time-dependent double-strand breaks (DSBs) • γ-H2AX immunofluorescence microscopy shows DSB as an early response to radiotracer injection • Activity measurements of 99mTc correlate well with detected DSB • DSB foci induced by 99mTc return to baseline 24h after radiotracer injection.
Collapse
|
27
|
Fasshauer M, Krüwel T, Zapf A, Stahnke VC, Rave-Fränk M, Staab W, Sohns JM, Steinmetz M, Unterberg-Buchwald C, Schuster A, Ritter C, Lotz J. Absence of DNA double-strand breaks in human peripheral blood mononuclear cells after 3 Tesla magnetic resonance imaging assessed by γH2AX flow cytometry. Eur Radiol 2017; 28:1149-1156. [DOI: 10.1007/s00330-017-5056-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 08/19/2017] [Accepted: 09/04/2017] [Indexed: 12/15/2022]
|
28
|
Khattab M, Walker DM, Albertini RJ, Nicklas JA, Lundblad LK, Vacek PM, Walker VE. Frequencies of micronucleated reticulocytes, a dosimeter of DNA double-strand breaks, in infants receiving computed tomography or cardiac catheterization. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2017; 820:8-18. [DOI: 10.1016/j.mrgentox.2017.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/10/2017] [Accepted: 05/12/2017] [Indexed: 12/18/2022]
|
29
|
Hasan Basri IK, Yusuf D, Rahardjo T, Nurhayati S, Tetriana D, Ramadhani D, Alatas Z, Purnami S, Kisnanto T, Lusiyanti Y, Syaifudin M. Study of γ-H2AX as DNA double strand break biomarker in resident living in high natural radiation area of Mamuju, West Sulawesi. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2017; 171:212-216. [PMID: 28282532 DOI: 10.1016/j.jenvrad.2017.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 12/16/2016] [Accepted: 02/15/2017] [Indexed: 06/06/2023]
Abstract
High expression of phospho histone γ-H2AX, a sensitive marker of double stranded DNA damage, is believed to be an indication of defective DNA repair pathway or genomic instability that may cause mutations and ultimately cancer. DNA damage can be caused by ionizing radiation exposure. Beside in medical treatment/diagnosis or industry, ionizing radiation exposure can also be found in naturally in regions of high natural back ground radiation. In this study we collect the blood from 45 volunteers living in Mamuju, a region with highest natural radiation in Indonesia (dose of ∼7 mSv/year). Subjects were grouped as high natural background area (HNBA) (n = 37) and control area (n = 8). The expression γ-H2AX foci were evaluated by one of researcher fluorescence microscope examination. Our results show that the average foci numbers per cell were in the normal range. While not statistical different, the average of γ-H2AX foci in exposed area higher in the exposed compared to the control area, 0.31 versus 0.13 (p > 0.05), respectively. Moreover, there was also no statistical difference of average γ-H2AX foci between man and woman, old and young people in exposed and control area (p > 0.05). In this preliminary study we find that γ-H2AX foci (and thus DNA double strand break) frequency in residents living in the HNBA of Mamuju, West Sulawesi, show a trend towards higher (albeit not significant) average values relative to the control area. More research is needed to further scrutinize these observations.
Collapse
Affiliation(s)
- Iin Kurnia Hasan Basri
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia.
| | - Darlina Yusuf
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Tur Rahardjo
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Siti Nurhayati
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Devita Tetriana
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Dwi Ramadhani
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Zubaidah Alatas
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Sofiati Purnami
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Teja Kisnanto
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Yanti Lusiyanti
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| | - Mukh Syaifudin
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Jl. Lebakbulus Raya No. 49, Jakarta Indonesia
| |
Collapse
|
30
|
Lee WH, Nguyen PK, Fleischmann D, Wu JC. DNA damage-associated biomarkers in studying individual sensitivity to low-dose radiation from cardiovascular imaging. Eur Heart J 2016; 37:3075-3080. [PMID: 27272147 PMCID: PMC6279211 DOI: 10.1093/eurheartj/ehw206] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 04/10/2016] [Accepted: 05/04/2016] [Indexed: 12/29/2022] Open
Affiliation(s)
- Won Hee Lee
- Department of Medicine, Division of Cardiology
- Department of Radiology
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Patricia K Nguyen
- Department of Medicine, Division of Cardiology
- Department of Radiology
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Dominik Fleischmann
- Department of Radiology
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Joseph C Wu
- Department of Medicine, Division of Cardiology
- Department of Radiology
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
31
|
Schaller F, Sedlmair M, Raupach R, Uder M, Lell M. Noise Reduction in Abdominal Computed Tomography Applying Iterative Reconstruction (ADMIRE). Acad Radiol 2016; 23:1230-8. [PMID: 27318787 DOI: 10.1016/j.acra.2016.05.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 05/24/2016] [Accepted: 05/27/2016] [Indexed: 12/11/2022]
Abstract
RATIONALE AND OBJECTIVES The study aimed to compare image quality of filtered back projection (FBP) and iterative reconstruction (advanced modeled iterative reconstruction, ADMIRE) in contrast-enhanced computed tomography (CT) of the abdomen, and to assess the differences of reconstructions according to these methods. It also aimed to investigate the potential for noise reduction of ADMIRE for different reconstructed slice thicknesses. MATERIALS AND METHODS CT data of the abdomen and pelvis were acquired using a 128-slice single-source CT system using automated kV selection and tube current adaption based on patients' anatomy. Raw data sets from patients scanned at 100 kV were selected, and images were reconstructed with slice thicknesses of 1 mm, 3 mm, and 5 mm, both with FBP and ADMIRE. Filter strength F1, F3, and F5 of the ADMIRE algorithm and the corresponding reconstruction kernels were used. In total, 58 raw data sets from 17 patients were used to reconstruct from the same raw data FBP and ADMIRE images, representing identical body regions. Identical regions of interest were placed at the same position of up to four images and image noise was measured. Differences of reconstructed images and detail preservation were tested using an image subtraction technique, and subjective image quality was assessed using a 5-point Likert scale. RESULTS On average, for 1-mm slice thickness, noise reduction was 9.15% ± 2.4% with filter strength level F1, 30.2% ± 3.4% with F3, and 54.4% ± 7.0% with F5 as compared to FBP. For a slice thickness of 3 mm, noise reduction was 8.5% ± 3.7% with F1, 28.6% ± 3.9% with F3, and 52.2% ± 9.1% with F5. For 5 mm, the corresponding values are 8.9% ± 2.7%, 31.4% ± 2.8%, and 52.7% ± 7.7%. On subtraction images, edge information of tissue classes with a high attenuation gradient was found, but structures with small differences in attenuation were not detectable on subtraction images, confirming that no relevant details were lost in the iterative reconstruction process. CONCLUSIONS ADMIRE is able to reduce image noise considerably (up to 50%) without any obvious negative impact on lesion depiction as assessed visually. Noise reduction of ADMIRE seems to be independent of slice thickness.
Collapse
|
32
|
Popp HD, Meyer M, Brendel S, Prinzhorn W, Naumann N, Weiss C, Seifarth W, Schoenberg SO, Hofmann WK, Henzler T, Fabarius A. Leukocyte DNA damage after reduced and conventional absorbed radiation doses using 3rd generation dual-source CT technology. Eur J Radiol Open 2016; 3:134-7. [PMID: 27437433 PMCID: PMC4939318 DOI: 10.1016/j.ejro.2016.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 06/22/2016] [Indexed: 01/10/2023] Open
Abstract
Purpose Computed tomography (CT) scans are an important source of ionizing irradiation (IR) in medicine that can induce a variety of DNA damage in human tissues. With technological improvements CT scans at reduced absorbed doses became feasible presumably lowering genotoxic side effects. Materials and methods For measuring DNA damage we performed γH2AX foci microscopy in peripheral blood mononuclear cells (PBMC) after exposure to reduced and conventional absorbed radiation doses using 3rd generation dual-source CT (DSCT) technology. Results CT scans performed at reduced absorbed doses of 3 mGy induced significant lower levels (p < 0.0001) of DNA damage (0.05 focus per cell ± 0.01 [mean ± standard error of mean]) at 5 min after IR compared to conventional absorbed doses of 15 mGy (0.30 focus per cell ± 0.03). With ongoing DNA repair background γH2AX foci levels (0.05 focus per cell) were approached at 24 h after CT with both protocols. Conclusion Our results provide evidence that reduced absorbed doses mediated by adjusted tube current in 3rd generation DSCT induce lower levels of DNA damage in PBMC compared to conventional absorbed doses suggesting a lower genotoxic risk for state-of-the-art tube current reduced CT protocols.
Collapse
Affiliation(s)
- Henning D Popp
- Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Mathias Meyer
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Susanne Brendel
- Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Wiltrud Prinzhorn
- Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Nicole Naumann
- Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Christel Weiss
- Department of Statistical Analysis, Medical Faculty Mannheim of the University of Heidelberg, Ludolf-Krehl-Strasse 13-17, 68167 Mannheim, Germany
| | - Wolfgang Seifarth
- Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Wolf-K Hofmann
- Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Thomas Henzler
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Alice Fabarius
- Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| |
Collapse
|
33
|
Lopez Perez R, Best G, Nicolay NH, Greubel C, Rossberger S, Reindl J, Dollinger G, Weber KJ, Cremer C, Huber PE. Superresolution light microscopy shows nanostructure of carbon ion radiation-induced DNA double-strand break repair foci. FASEB J 2016; 30:2767-76. [PMID: 27166088 DOI: 10.1096/fj.201500106r] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/12/2016] [Indexed: 12/13/2022]
Abstract
Carbon ion radiation is a promising new form of radiotherapy for cancer, but the central question about the biologic effects of charged particle radiation is yet incompletely understood. Key to this question is the understanding of the interaction of ions with DNA in the cell's nucleus. Induction and repair of DNA lesions including double-strand breaks (DSBs) are decisive for the cell. Several DSB repair markers have been used to investigate these processes microscopically, but the limited resolution of conventional microscopy is insufficient to provide structural insights. We have applied superresolution microscopy to overcome these limitations and analyze the fine structure of DSB repair foci. We found that the conventionally detected foci of the widely used DSB marker γH2AX (Ø 700-1000 nm) were composed of elongated subfoci with a size of ∼100 nm consisting of even smaller subfocus elements (Ø 40-60 nm). The structural organization of the subfoci suggests that they could represent the local chromatin structure of elementary DSB repair units at the DSB damage sites. Subfocus clusters may indicate induction of densely spaced DSBs, which are thought to be associated with the high biologic effectiveness of carbon ions. Superresolution microscopy might emerge as a powerful tool to improve our knowledge of interactions of ionizing radiation with cells.-Lopez Perez, R., Best, G., Nicolay, N. H., Greubel, C., Rossberger, S., Reindl, J., Dollinger, G., Weber, K.-J., Cremer, C., Huber, P. E. Superresolution light microscopy shows nanostructure of carbon ion radiation-induced DNA double-strand break repair foci.
Collapse
Affiliation(s)
- Ramon Lopez Perez
- Clinical Cooperation Unit and Molecular Radiation Oncology, German Cancer Research Center, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany;
| | - Gerrit Best
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany; Kirchhoff-Institute for Physics, Heidelberg University, Heidelberg, Germany
| | - Nils H Nicolay
- Clinical Cooperation Unit and Molecular Radiation Oncology, German Cancer Research Center, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Greubel
- Institut für Angewandte Physik und Messtechnik, Universität der Bundeswehr München, Neubiberg, Germany; and
| | - Sabrina Rossberger
- Kirchhoff-Institute for Physics, Heidelberg University, Heidelberg, Germany
| | - Judith Reindl
- Institut für Angewandte Physik und Messtechnik, Universität der Bundeswehr München, Neubiberg, Germany; and
| | - Günther Dollinger
- Institut für Angewandte Physik und Messtechnik, Universität der Bundeswehr München, Neubiberg, Germany; and
| | - Klaus-Josef Weber
- Clinical Cooperation Unit and Molecular Radiation Oncology, German Cancer Research Center, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Cremer
- Kirchhoff-Institute for Physics, Heidelberg University, Heidelberg, Germany; Superresolution Microscopy of Functional Nuclear Nanostructure, Institute of Molecular Biology, Mainz, Germany
| | - Peter E Huber
- Clinical Cooperation Unit and Molecular Radiation Oncology, German Cancer Research Center, Heidelberg University Hospital, Heidelberg, Germany; Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany;
| |
Collapse
|
34
|
Berrington de Gonzalez A, Kleinerman RA, McAreavey D, Rajaraman P. Cardiac MR Imaging and the Specter of Double-Strand Breaks. Radiology 2016; 277:329-31. [PMID: 26492020 DOI: 10.1148/radiol.2015151943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Amy Berrington de Gonzalez
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, 6120 Executive Blvd, Bethesda, MD 20892 (A.B.d.G., R.A.K., P.R.); and Department of Cardiology, National Institutes of Health Clinical Center, Bethesda, Md (D.M.)
| | - Ruth A Kleinerman
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, 6120 Executive Blvd, Bethesda, MD 20892 (A.B.d.G., R.A.K., P.R.); and Department of Cardiology, National Institutes of Health Clinical Center, Bethesda, Md (D.M.)
| | - Dorothea McAreavey
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, 6120 Executive Blvd, Bethesda, MD 20892 (A.B.d.G., R.A.K., P.R.); and Department of Cardiology, National Institutes of Health Clinical Center, Bethesda, Md (D.M.)
| | - Preetha Rajaraman
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, 6120 Executive Blvd, Bethesda, MD 20892 (A.B.d.G., R.A.K., P.R.); and Department of Cardiology, National Institutes of Health Clinical Center, Bethesda, Md (D.M.)
| |
Collapse
|
35
|
Affiliation(s)
- Philipp A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, Ramistr 100 (NUK D 6), CH-8091 Zurich, Switzerland
| |
Collapse
|
36
|
Schnarr K, Carter TF, Gillis D, Webber C, Lemon JA, Dayes I, Dolling JA, Gulenchyn K, Boreham DR. Biological Response of Positron Emission Tomography Scan Exposure and Adaptive Response in Humans. Dose Response 2015; 13:1559325815611904. [PMID: 26740810 PMCID: PMC4679193 DOI: 10.1177/1559325815611904] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The biological effects of exposure to radioactive fluorodeoxyglucose (18F-FDG) were investigated in the lymphocytes of patients undergoing positron emission tomography (PET) procedures. Low-dose, radiation-induced cellular responses were measured using 3 different end points: (1) apoptosis; (2) chromosome aberrations; and (3) γH2AX foci formation. The results showed no significant change in lymphocyte apoptosis, or chromosome aberrations, as a result of in vivo 18F-FDG exposure, and there was no evidence the PET scan modified the apoptotic response of lymphocytes to a subsequent 2 Gy in vitro challenge irradiation. However, lymphocytes sampled from patients following a PET scan showed an average of 22.86% fewer chromosome breaks and 39.16% fewer dicentrics after a subsequent 2 Gy in vitro challenge irradiation. The effect of 18F-FDG exposure on phosphorylation of histone H2AX (γH2AX) in lymphocytes of patients showed a varied response between individuals. The relationship between γH2AX foci formation and increasing activity of 18F-FDG was not directly proportional to dose. This variation is most likely attributed to differences in the factors that combine to constitute an individual’s radiation response. In summary, the results of this study indicate18F-FDG PET scans may not be detrimental but can elicit variable responses between individuals and can modify cellular response to subsequent radiation exposures.
Collapse
Affiliation(s)
- Kara Schnarr
- Department of Radiation Oncology, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Timothy F Carter
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Daniel Gillis
- School of Computer Science, University of Guelph, Guelph, Ontario,Canada
| | - Colin Webber
- Department of Nuclear Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada; Deceased
| | - Jennifer A Lemon
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Ian Dayes
- Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada
| | - Joanna A Dolling
- Genetics Laboratory, Health Sciences North, Sudbury, Ontario, Canada
| | - Karen Gulenchyn
- Department of Nuclear Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Douglas R Boreham
- Department of Medical Sciences, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| |
Collapse
|
37
|
Direct measurement of the 3-dimensional DNA lesion distribution induced by energetic charged particles in a mouse model tissue. Proc Natl Acad Sci U S A 2015; 112:12396-401. [PMID: 26392532 DOI: 10.1073/pnas.1508702112] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Charged particles are increasingly used in cancer radiotherapy and contribute significantly to the natural radiation risk. The difference in the biological effects of high-energy charged particles compared with X-rays or γ-rays is determined largely by the spatial distribution of their energy deposition events. Part of the energy is deposited in a densely ionizing manner in the inner part of the track, with the remainder spread out more sparsely over the outer track region. Our knowledge about the dose distribution is derived solely from modeling approaches and physical measurements in inorganic material. Here we exploited the exceptional sensitivity of γH2AX foci technology and quantified the spatial distribution of DNA lesions induced by charged particles in a mouse model tissue. We observed that charged particles damage tissue nonhomogenously, with single cells receiving high doses and many other cells exposed to isolated damage resulting from high-energy secondary electrons. Using calibration experiments, we transformed the 3D lesion distribution into a dose distribution and compared it with predictions from modeling approaches. We obtained a radial dose distribution with sub-micrometer resolution that decreased with increasing distance to the particle path following a 1/r2 dependency. The analysis further revealed the existence of a background dose at larger distances from the particle path arising from overlapping dose deposition events from independent particles. Our study provides, to our knowledge, the first quantification of the spatial dose distribution of charged particles in biologically relevant material, and will serve as a benchmark for biophysical models that predict the biological effects of these particles.
Collapse
|
38
|
Brand M, Ellmann S, Sommer M, May MS, Eller A, Wuest W, Engert C, Achenbach S, Kuefner MA, Baeuerle T, Lell M, Uder M. Influence of Cardiac MR Imaging on DNA Double-Strand Breaks in Human Blood Lymphocytes. Radiology 2015. [PMID: 26225451 DOI: 10.1148/radiol.2015150555] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the ability of magnetic resonance (MR) imaging to induce deoxyribonucleic acid (DNA) damage in patients who underwent cardiac MR imaging in daily routine by using γ-H2AX immunofluorescence microscopy. MATERIALS AND METHODS This study complies with the Declaration of Helsinki and was performed according to local ethics committee approval. Informed patient consent was obtained. Blood samples from 45 patients (13 women, 32 men; mean age, 50.3 years [age range, 20-89 years]) were obtained before and after contrast agent-enhanced cardiac MR imaging. MR imaging-induced double-strand breaks (DSBs) were quantified in isolated blood lymphocytes by using immunofluorescence microscopy after staining the phosphorylated histone variant γ-H2AX. Twenty-nine patients were examined with a myocarditis protocol (group A), 10 patients with a stress-testing protocol (group B), and six patients with flow measurements and angiography (group C). Paired t test was performed to compare excess foci before and after MR imaging. RESULTS The mean baseline DSB level before MR imaging and 5 minutes after MR imaging was, respectively, 0.116 DSB per cell ± 0.019 (standard deviation) and 0.117 DSB per cell ± 0.019 (P = .71). There was also no significant difference in DSBs in these subgroups (group A: DSB per cell before and after MR imaging, respectively, 0.114 and 0.114, P = .91; group B: DSB per cell before and after MR imaging, respectively, 0.123 and 0.124, P = .78; group C: DSB per cell before and after MR imaging, respectively, 0.114 and 0.115, P = .36). CONCLUSION By using γ-H2AX immunofluorescence microscopy, no DNA DSBs were detected after cardiac MR imaging.
Collapse
Affiliation(s)
- Michael Brand
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Stephan Ellmann
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Matthias Sommer
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Matthias S May
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Achim Eller
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Wolfgang Wuest
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Christina Engert
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Stephan Achenbach
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Michael A Kuefner
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Tobias Baeuerle
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Michael Lell
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| | - Michael Uder
- From the Department of Radiology, University Hospital Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany (M.B., S.E., M.S., M.S.M., A.E., W.W., C.E., M.A.K., T.B., M.L., M.U.); and Department of Cardiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany (S.A.)
| |
Collapse
|
39
|
Nguyen PK, Lee WH, Li YF, Hong WX, Hu S, Chan C, Liang G, Nguyen I, Ong SG, Churko J, Wang J, Altman RB, Fleischmann D, Wu JC. Assessment of the Radiation Effects of Cardiac CT Angiography Using Protein and Genetic Biomarkers. JACC Cardiovasc Imaging 2015. [PMID: 26210695 DOI: 10.1016/j.jcmg.2015.04.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate whether radiation exposure from cardiac computed tomographic angiography (CTA) is associated with deoxyribonucleic acid (DNA) damage and whether damage leads to programmed cell death and activation of genes involved in apoptosis and DNA repair. BACKGROUND Exposure to radiation from medical imaging has become a public health concern, but whether it causes significant cell damage remains unclear. METHODS We conducted a prospective cohort study in 67 patients undergoing cardiac CTA between January 2012 and December 2013 in 2 U.S. medical centers. Median blood radiation exposure was estimated using phantom dosimetry. Biomarkers of DNA damage and apoptosis were measured by flow cytometry, whole genome sequencing, and single cell polymerase chain reaction. RESULTS The median dose length product was 1,535.3 mGy·cm (969.7 to 2,674.0 mGy·cm). The median radiation dose to the blood was 29.8 mSv (18.8 to 48.8 mSv). Median DNA damage increased 3.39% (1.29% to 8.04%, p < 0.0001) and median apoptosis increased 3.1-fold (interquartile range [IQR]: 1.4- to 5.1-fold, p < 0.0001) post-radiation. Whole genome sequencing revealed changes in the expression of 39 transcription factors involved in the regulation of apoptosis, cell cycle, and DNA repair. Genes involved in mediating apoptosis and DNA repair were significantly changed post-radiation, including DDB2 (1.9-fold [IQR: 1.5- to 3.0-fold], p < 0.001), XRCC4 (3.0-fold [IQR: 1.1- to 5.4-fold], p = 0.005), and BAX (1.6-fold [IQR: 0.9- to 2.6-fold], p < 0.001). Exposure to radiation was associated with DNA damage (odds ratio [OR]: 1.8 [1.2 to 2.6], p = 0.003). DNA damage was associated with apoptosis (OR: 1.9 [1.2 to 5.1], p < 0.0001) and gene activation (OR: 2.8 [1.2 to 6.2], p = 0.002). CONCLUSIONS Patients exposed to >7.5 mSv of radiation from cardiac CTA had evidence of DNA damage, which was associated with programmed cell death and activation of genes involved in apoptosis and DNA repair.
Collapse
Affiliation(s)
- Patricia K Nguyen
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Veterans Administration Palo Alto, Palo Alto, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California.
| | - Won Hee Lee
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California
| | - Yong Fuga Li
- Department of Genetics, Stanford University School of Medicine, Stanford, California
| | - Wan Xing Hong
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California
| | - Shijun Hu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California
| | - Charles Chan
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Grace Liang
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California
| | - Ivy Nguyen
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California
| | - Sang-Ging Ong
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California
| | - Jared Churko
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California
| | - Jia Wang
- Environmental Health and Safety, Stanford University School of Medicine, Stanford, California
| | - Russ B Altman
- Department of Genetics, Stanford University School of Medicine, Stanford, California
| | - Dominik Fleischmann
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California; Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, California; Department of Radiology, Stanford University School of Medicine, Stanford, California.
| |
Collapse
|
40
|
Reddig A, Fatahi M, Friebe B, Guttek K, Hartig R, Godenschweger F, Roggenbuck D, Ricke J, Reinhold D, Speck O. Analysis of DNA Double-Strand Breaks and Cytotoxicity after 7 Tesla Magnetic Resonance Imaging of Isolated Human Lymphocytes. PLoS One 2015; 10:e0132702. [PMID: 26176601 PMCID: PMC4503586 DOI: 10.1371/journal.pone.0132702] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/17/2015] [Indexed: 01/25/2023] Open
Abstract
The global use of magnetic resonance imaging (MRI) is constantly growing and the field strengths increasing. Yet, only little data about harmful biological effects caused by MRI exposure are available and published research analyzing the impact of MRI on DNA integrity reported controversial results. This in vitro study aimed to investigate the genotoxic and cytotoxic potential of 7 T ultra-high-field MRI on isolated human peripheral blood mononuclear cells. Hence, unstimulated mononuclear blood cells were exposed to 7 T static magnetic field alone or in combination with maximum permissible imaging gradients and radiofrequency pulses as well as to ionizing radiation during computed tomography and γ-ray exposure. DNA double-strand breaks were quantified by flow cytometry and automated microscopy analysis of immunofluorescence stained γH2AX. Cytotoxicity was studied by CellTiter-Blue viability assay and [3H]-thymidine proliferation assay. Exposure of unstimulated mononuclear blood cells to 7 T static magnetic field alone or combined with varying gradient magnetic fields and pulsed radiofrequency fields did not induce DNA double-strand breaks, whereas irradiation with X- and γ-rays led to a dose-dependent induction of γH2AX foci. The viability assay revealed a time- and dose-dependent decrease in metabolic activity only among samples exposed to γ-radiation. Further, there was no evidence for altered proliferation response after cells were exposed to 7 T MRI or low doses of ionizing radiation (≤ 0.2 Gy). These findings confirm the acceptance of MRI as a safe non-invasive diagnostic imaging tool, but whether MRI can induce other types of DNA lesions or DNA double-strand breaks during altered conditions still needs to be investigated.
Collapse
Affiliation(s)
- Annika Reddig
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- * E-mail:
| | - Mahsa Fatahi
- Department of Biomedical Magnetic Resonance, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Björn Friebe
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Karina Guttek
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Roland Hartig
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Frank Godenschweger
- Department of Biomedical Magnetic Resonance, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Dirk Roggenbuck
- Medipan GmbH, Dahlewitz/Berlin, Germany
- Faculty of Natural Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Jens Ricke
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Dirk Reinhold
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Oliver Speck
- Department of Biomedical Magnetic Resonance, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- German Center for Neurodegenerative Disease, Magdeburg, Germany
| |
Collapse
|
41
|
Brand M, Sommer M, Ellmann S, Wuest W, May MS, Eller A, Vogt S, Lell MM, Kuefner MA, Uder M. Influence of Different Antioxidants on X-Ray Induced DNA Double-Strand Breaks (DSBs) Using γ-H2AX Immunofluorescence Microscopy in a Preliminary Study. PLoS One 2015; 10:e0127142. [PMID: 25996998 PMCID: PMC4440758 DOI: 10.1371/journal.pone.0127142] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/13/2015] [Indexed: 11/19/2022] Open
Abstract
Background Radiation exposure occurs in X-ray guided interventional procedures or computed tomography (CT) and γ-H2AX-foci are recognized to represent DNA double-strand breaks (DSBs) as a biomarker for radiation induced damage. Antioxidants may reduce the induction of γ-H2AX-foci by binding free radicals. The aim of this study was to establish a dose-effect relationship and a time-effect relationship for the individual antioxidants on DSBs in human blood lymphocytes. Materials and Methods Blood samples from volunteers were irradiated with 10 mGy before and after pre-incubation with different antioxidants (zinc, trolox, lipoic acid, ß-carotene, selenium, vitamin E, vitamin C, N-acetyl-L-cysteine (NAC) and Q 10). Thereby, different pre-incubation times, concentrations and combinations of drugs were evaluated. For assessment of DSBs, lymphocytes were stained against the phosphorylated histone variant γ-H2AX. Results For zinc, trolox and lipoic acid regardless of concentration or pre-incubation time, no significant decrease of γ-H2AX-foci was found. However, ß-carotene (15%), selenium (14%), vitamin E (12%), vitamin C (25%), NAC (43%) and Q 10 (18%) led to a significant reduction of γ-H2AX-foci at a pre-incubation time of 1 hour. The combination of different antioxidants did not have an additive effect. Conclusion Antioxidants administered prior to irradiation demonstrated the potential to reduce γ-H2AX-foci in blood lymphocytes.
Collapse
Affiliation(s)
- Michael Brand
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
- * E-mail:
| | - Matthias Sommer
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Stephan Ellmann
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Wolfgang Wuest
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias S. May
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Achim Eller
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Sabine Vogt
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Michael M. Lell
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Michael A. Kuefner
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany
| |
Collapse
|
42
|
Elgart SR, Bostani M, Mok KC, Adibi A, Ruehm S, Enzmann D, McNitt-Gray M, Iwamoto KS. Investigation of DNA Damage Dose-Response Kinetics after Ionizing Radiation Schemes Similar to CT Protocols. Radiat Res 2015; 183:701-7. [PMID: 25950819 DOI: 10.1667/rr13752.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Although there has been extensive research done on the biological response to doses of ionizing radiation relevant to radiodiagnostic procedures, very few studies have examined radiation schemes similar to those frequently utilized in CT exams. Instead of a single exposure, CT exams are often made up of a series of scans separated on the order of minutes. DNA damage dose-response kinetics after radiation doses and schemes similar to CT protocols were established in both cultured (ESW-WT3) and whole blood lymphocytes and compared to higher dose exposures. Both the kinetics and extent of H2AX phosphorylation were found to be dose dependent. Damage induction and detection showed a clear dose response, albeit different, at all time points and differences in the DNA repair kinetics of ESW-WT3 and whole blood lymphocytes were characterized. Moreover, using a modified split-dose in vitro experiment, we show that phosphorylation of H2AX is significantly reduced after exposure to CT doses fractionated over a few minutes compared to the same total dose delivered as a single exposure. Because the split-dose exposures investigated here are more similar to those experienced during a CT examination, it is essential to understand why and how these differences occur. This work provides compelling evidence supporting differential biological responses not only between high and low doses, but also between single and multiple exposures to low doses of ionizing radiation.
Collapse
Affiliation(s)
| | - Maryam Bostani
- b Radiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | | | - Ali Adibi
- b Radiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Stefan Ruehm
- b Radiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Dieter Enzmann
- b Radiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Michael McNitt-Gray
- b Radiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | | |
Collapse
|
43
|
Zwicker F, Swartman B, Roeder F, Sterzing F, Hauswald H, Thieke C, Weber KJ, Huber PE, Schubert K, Debus J, Herfarth K. In vivo measurement of dose distribution in patients' lymphocytes: helical tomotherapy versus step-and-shoot IMRT in prostate cancer. JOURNAL OF RADIATION RESEARCH 2015; 56:239-247. [PMID: 25361548 PMCID: PMC4380044 DOI: 10.1093/jrr/rru096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 09/07/2014] [Accepted: 09/13/2014] [Indexed: 06/04/2023]
Abstract
In radiotherapy, in vivo measurement of dose distribution within patients' lymphocytes can be performed by detecting gamma-H2AX foci in lymphocyte nuclei. This method can help in determining the whole-body dose. Options for risk estimations for toxicities in normal tissue and for the incidence of secondary malignancy are still under debate. In this investigation, helical tomotherapy (TOMO) is compared with step-and-shoot IMRT (SSIMRT) of the prostate gland by measuring the dose distribution within patients' lymphocytes. In this prospective study, blood was taken from 20 patients before and 10 min after their first irradiation fraction for each technique. The isolated leukocytes were fixed 2 h after radiation. DNA double-stranded breaks in lymphocyte nuclei were stained immunocytochemically using anti-gamma-H2AX antibodies. Gamma-H2AX foci distribution in lymphocytes was determined for each patient. Using a calibration line, dose distributions in patients' lymphocytes were determined by studying the gamma-H2AX foci distribution, and these data were used to generate a cumulative dose-lymphocyte histogram (DLH). Measured in vivo (DLH), significantly fewer lymphocytes indicated low-dose exposure (<40% of the applied dose) during TOMO compared with SSIMRT. The dose exposure range, between 45 and 100%, was equal with both radiation techniques. The mean number of gamma-H2AX foci per lymphocyte was significantly lower in the TOMO group compared with the SSIMRT group. In radiotherapy of the prostate gland, TOMO generates a smaller fraction of patients' lymphocytes with low-dose exposure relative to the whole body compared with SSIMRT. Differences in the constructional buildup of the different linear accelerator systems, e.g. the flattening filter, may be the cause thereof. The influence of these methods on the incidence of secondary malignancy should be investigated in further studies.
Collapse
Affiliation(s)
- Felix Zwicker
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Benedict Swartman
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Falk Roeder
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Florian Sterzing
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Henrik Hauswald
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Christian Thieke
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Klaus-Josef Weber
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Peter E Huber
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kai Schubert
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| |
Collapse
|
44
|
Abstract
Several radiation-related professional societies have concluded that carcinogenic risks associated with doses below 50-100 mSv are either too small to be detected, or are nonexistent. This is especially important in the context of doses from medical imaging. Radiation exposure to the public from medical imaging procedures is rising around the world, primarily due to increased utilization of computed tomography. Professional societies and advisory bodies consistently recommend against multiplying small doses by large populations to predict excess radiation-induced cancers, in large part because of the potential for sensational claims of health impacts which do not adequately take the associated uncertainties into account. Nonetheless, numerous articles have predicted thousands of future cancers as a result of CT scanning, and this has generated considerable concern among patients and parents. In addition, some authors claim that we now have direct epidemiological evidence of carcinogenic risks from medical imaging. This paper critically examines such claims, and concludes that the evidence cited does not provide direct evidence of low-dose carcinogenicity. These claims themselves have adverse public health impacts by frightening the public away from medically justified exams. It is time for the medical and scientific communities to be more assertive in responding to sensational claims of health risks.
Collapse
Affiliation(s)
- Brant A. Ulsh
- Principal Health Physicist, M.H. Chew & Associates, Livermore, CA
| |
Collapse
|
45
|
Kuefner MA, Brand M, Andreassi MG, Braga L, Uder M. Chemoprevention of Radiation-Induced DNA Double-Strand Breaks with Antioxidants. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-014-0081-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
46
|
Vandevoorde C, Franck C, Bacher K, Breysem L, Smet MH, Ernst C, De Backer A, Van De Moortele K, Smeets P, Thierens H. γ-H2AX foci as in vivo effect biomarker in children emphasize the importance to minimize x-ray doses in paediatric CT imaging. Eur Radiol 2014; 25:800-11. [PMID: 25354556 PMCID: PMC4328121 DOI: 10.1007/s00330-014-3463-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/16/2014] [Accepted: 10/01/2014] [Indexed: 11/26/2022]
Abstract
Objectives Investigation of DNA damage induced by CT x-rays in paediatric patients versus patient dose in a multicentre setting. Methods From 51 paediatric patients (median age, 3.8 years) who underwent an abdomen or chest CT examination in one of the five participating radiology departments, blood samples were taken before and shortly after the examination. DNA damage was estimated by scoring γ-H2AX foci in peripheral blood T lymphocytes. Patient-specific organ and tissue doses were calculated with a validated Monte Carlo program. Individual lifetime attributable risks (LAR) for cancer incidence and mortality were estimated according to the BEIR VII risk models. Results Despite the low CT doses, a median increase of 0.13 γ-H2AX foci/cell was observed. Plotting the induced γ-H2AX foci versus blood dose indicated a low-dose hypersensitivity, supported also by an in vitro dose–response study. Differences in dose levels between radiology centres were reflected in differences in DNA damage. LAR of cancer mortality for the paediatric chest CT and abdomen CT cohort was 0.08 and 0.13 ‰ respectively. Conclusion CT x-rays induce DNA damage in paediatric patients even at low doses and the level of DNA damage is reduced by application of more effective CT dose reduction techniques and paediatric protocols. Key Points • CT induces a small, significant number of double-strand DNA breaks in children. • More effective CT dose reduction results in less DNA damage. • Risk estimates based on the LNT hypothesis may represent underestimates.
Collapse
Affiliation(s)
- C Vandevoorde
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, 9000, Gent, Belgium,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Schwab SA, Brand M, Schlude IK, Wuest W, Meier-Meitinger M, Distel L, Schulz-Wendtland R, Uder M, Kuefner MA. X-ray induced formation of γ-H2AX foci after full-field digital mammography and digital breast-tomosynthesis. PLoS One 2013; 8:e70660. [PMID: 23936236 PMCID: PMC3723730 DOI: 10.1371/journal.pone.0070660] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 06/20/2013] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To determine in-vivo formation of x-ray induced γ-H2AX foci in systemic blood lymphocytes of patients undergoing full-field digital mammography (FFDM) and to estimate foci after FFDM and digital breast-tomosynthesis (DBT) using a biological phantom model. MATERIALS AND METHODS The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. For in-vivo tests, systemic blood lymphocytes were obtained from 20 patients before and after FFDM. In order to compare in-vivo post-exposure with pre-exposure foci levels, the Wilcoxon matched pairs test was used. For in-vitro experiments, isolated blood lymphocytes from healthy volunteers were irradiated at skin and glandular level of a porcine breast using FFDM and DBT. Cells were stained against the phosphorylated histone variant γ-H2AX, and foci representing distinct DNA damages were quantified. RESULTS Median in-vivo foci level/cell was 0.086 (range 0.067-0.116) before and 0.094 (0.076-0.126) after FFDM (p = 0.0004). In the in-vitro model, the median x-ray induced foci level/cell after FFDM was 0.120 (range 0.086-0.140) at skin level and 0.035 (range 0.030-0.050) at glandular level. After DBT, the median x-ray induced foci level/cell was 0.061 (range 0.040-0.081) at skin level and 0.015 (range 0.006-0.020) at glandular level. CONCLUSION In patients, mammography induces a slight but significant increase of γ-H2AX foci in systemic blood lymphocytes. The introduced biological phantom model is suitable for the estimation of x-ray induced DNA damages in breast tissue in different breast imaging techniques.
Collapse
Affiliation(s)
- Siegfried A Schwab
- Institute of Radiology, University Erlangen/Nuremberg, Erlangen, Bavaria, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Kuefner MA, Brand M, Engert C, Kappey H, Uder M, Distel LV. The effect of calyculin A on the dephosphorylation of the histone γ-H2AX after formation of X-ray-induced DNA double-strand breaks in human blood lymphocytes. Int J Radiat Biol 2013; 89:424-32. [PMID: 23363014 DOI: 10.3109/09553002.2013.767991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effect of calyculin A on the number of γ-H2AX foci (phosphorylated histone variant 2AX) in lymphocytes after in vitro and in vivo irradiation with rather low doses as they are used in diagnostic and interventional radiology. MATERIALS AND METHODS For in vitro experiments blood samples of 14 healthy volunteers were irradiated with different doses (10, 50, 100 mGy) and incubated with (0.01, 0.1, 1, 10 nM) or without calyculin A for up to 2 hours. Non-irradiated samples with and without calyculin A served as controls. For in vivo evaluation blood samples were collected from seven patients undergoing computed tomography (CT) both with 1 nM calyculin A containing vials and vials without calyculin A. Foci were quantified in isolated lymphocytes using γ-H2AX immunofluorescence microscopy. RESULTS 1 nM calyculin A led to a complete inhibition of γ-H2AX foci loss in irradiated samples whereas no inhibition of p53 binding protein 1 (53 BP1) foci was found. Lower concentrations of the phosphatase inhibitor did not have a sufficient effect on foci decrease. Calyculin A did not affect foci levels in non-irradiated samples. If no calyculin A was added into the vial before the blood draws detectable CT-induced foci levels were lower in all patients with a reduction of the medians of 35%. CONCLUSIONS Using γ-H2AX immunofluorescence microscopy calyculin A can be a useful tool to mark the induced γ-H2AX foci after low dose irradiation and to avoid an underestimation of the real deoxyribonucleic acid (DNA) damage in in vitro and in vivo experiments.
Collapse
Affiliation(s)
- Michael A Kuefner
- Department of Radiology, University Hospital of Erlangen-Nürnberg, Maximiliansplatz 1, Erlangen, Germany.
| | | | | | | | | | | |
Collapse
|
49
|
Valdiglesias V, Giunta S, Fenech M, Neri M, Bonassi S. γH2AX as a marker of DNA double strand breaks and genomic instability in human population studies. Mutat Res 2013; 753:24-40. [PMID: 23416207 DOI: 10.1016/j.mrrev.2013.02.001] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/30/2013] [Accepted: 02/04/2013] [Indexed: 10/27/2022]
Abstract
DNA double strand breaks (DSB) are the gravest form of DNA damage in eukaryotic cells. Failure to detect DSB and activate appropriate DNA damage responses can cause genomic instability, leading to tumorigenesis and possibly accelerated aging. Phosphorylated histone H2AX (γH2AX) is used as a biomarker of cellular response to DSB and its potential for monitoring DNA damage and repair in human populations has been explored in this review. A systematic search was conducted in PubMed for articles, in English, on human studies reporting γH2AX as a biomarker of either DNA repair or DNA damage. A total of 68 publications were identified. Thirty-four studies (50.0%) evaluated the effect of medical procedures or treatments on γH2AX levels; 20 (29.4%) monitored γH2AX in specific pathological conditions with a case/control or case/case design; 5 studies (7.4%) evaluated the effect of environmental genotoxic exposures, and 9 (13.2%) were descriptive studies on cancer and aging. Peripheral blood lymphocytes (44.6%) or biopsies/tissue specimens (24.3%) were the most commonly used samples. γH2AX was scored by optical microscopy as immunostained foci (78%), or by flow cytometry (16%). Critical features affecting the reliability of the assay, including protocols heterogeneity, specimen, cell cycle, kinetics, study design, and statistical analysis, are hereby discussed. Because of its sensitivity, efficiency and mechanistic relevance, the γH2AX assay has great potential as a DNA damage biomarker; however, the technical and epidemiological heterogeneity highlighted in this review infer a necessity for experimental standardization of the assay.
Collapse
Affiliation(s)
- Vanessa Valdiglesias
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Roma, Italy
| | - Simona Giunta
- CSIRO Preventative Health Flagship, Adelaide 5000, Australia
| | - Michael Fenech
- CSIRO Preventative Health Flagship, Adelaide 5000, Australia
| | - Monica Neri
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Roma, Italy
| | - Stefano Bonassi
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Roma, Italy.
| |
Collapse
|
50
|
Reinke G, Halbfaß J, Dittrich S, Banckwitz R, Köhler C, Achenbach S, Rompel O, Glöckler M. Three-Dimensional Rotational Angiography in Congenital Heart Disease: Estimation of Radiation Exposure. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojrad.2013.33020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|