1
|
Lierová A, Milanová M, Pospíchal J, Novotný J, Storm J, Andrejsová L, Šinkorová Z. BIOLOGICAL EFFECTS OF LOW-DOSE RADIATION FROM CT IMAGING. RADIATION PROTECTION DOSIMETRY 2022; 198:514-520. [PMID: 36005951 DOI: 10.1093/rpd/ncac091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/21/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
The dramatic rise in diagnostic procedures, radioisotope-based scans and intervention procedures has created a very valid concern regarding the long-term biological consequences from exposure to low doses of ionizing radiation. Despite its unambiguous medical benefits, additional knowledge on the health outcome of its use is essential. This review summarizes the available information regarding the biological consequences of low-dose radiation (LDR) exposure in humans (e.g. cytogenetic changes, cancer risk and radiation-induced cataracts. However, LDR studies remain relatively new and thus an encompassing view of its biological effects and relevant mechanisms in the human body is still needed.
Collapse
Affiliation(s)
- Anna Lierová
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
- Department of Clinical Subspecialties, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - Marcela Milanová
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - Jan Pospíchal
- Department of Clinical Subspecialties, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - Jan Novotný
- Department of Clinical Subspecialties, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - Jaroslav Storm
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
- Department of Clinical Subspecialties, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - Lenka Andrejsová
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - Zuzana Šinkorová
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| |
Collapse
|
2
|
Jin Y, Yaegashi D, Shi L, Ishida M, Sakai C, Yokokawa T, Abe Y, Sakai A, Yamaki T, Kunii H, Nakazato K, Hijioka N, Awai K, Tashiro S, Takeishi Y, Ishida T. DNA Damage Induced by Radiation Exposure from Cardiac Catheterization. Int Heart J 2022; 63:466-475. [PMID: 35650148 DOI: 10.1536/ihj.22-037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Almost 40% of medical radiation exposure is related to cardiac imaging or intervention. However, the biological effects of low-dose radiation from medical imaging remain largely unknown. This study aimed to evaluate the effects of ionized radiation from cardiac catheterization on genomic DNA integrity and inflammatory cytokines in patients and operators.Peripheral mononuclear cells (MNCs) were isolated from patients (n = 51) and operators (n = 35) before and after coronary angiography and/or percutaneous coronary intervention. The expression of γH2AX, a marker for DNA double-strand breaks, was measured by immunofluorescence. Dicentric chromosomes (DICs), a form of chromosome aberrations, were assayed using a fluorescent in situ hybridization technique.In the patient MNCs, the numbers of γH2AX foci and DICs increased after cardiac catheterization by 4.5 ± 9.4-fold and 71 ± 122%, respectively (P < 0.05 for both). The mRNA expressions of interleukin (IL)-1α, IL-1β, leukemia inhibitory factor, and caspase-1 were significantly increased by radiation exposure from cardiac catheterization. The increase in IL-1β was significantly correlated with that of γH2AX, but not with the dose area product. In the operators, neither γH2AX foci nor the DIC level was changed, but IL-1β mRNA was significantly increased. The protein expression of IκBα was significantly decreased in both groups.DNA damage was increased in the MNCs of patients, but not of operators, who underwent cardiac catheterization. Inflammatory cytokines were increased in both the patients and operators, presumably through NF-κB activation. Further efforts to reduce radiation exposure from cardiac catheterization are necessary for both patients and operators.
Collapse
Affiliation(s)
- Yuichiro Jin
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Daiki Yaegashi
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Lin Shi
- Department of Cellular Biology, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Mari Ishida
- Department of Cardiovascular Physiology and Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Chiemi Sakai
- Department of Cardiovascular Physiology and Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tetsuro Yokokawa
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Yu Abe
- Department of Radiation Life Sciences, Fukushima Medical University
| | - Akira Sakai
- Department of Radiation Life Sciences, Fukushima Medical University
| | - Takayoshi Yamaki
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Hiroyuki Kunii
- Department of Cardiovascular Medicine, Fukushima Medical University
| | | | - Naoko Hijioka
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Kazuo Awai
- Department of Diagnostic Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Satoshi Tashiro
- Department of Cellular Biology, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | | | - Takafumi Ishida
- Department of Cardiovascular Medicine, Fukushima Medical University
| |
Collapse
|
3
|
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
|
4
|
Visweswaran S, Raavi V, Abdul Syed Basheerudeen S, Kanagaraj K, Prasad A, Selvan Gnana Sekaran T, Pattan S, Shanmugam P, Ozimuthu A, Joseph S, Perumal V. Comparative analysis of physical doses and biomarker changes in subjects underwent Computed Tomography, Positron Emission Tomography-Computed Tomography, and interventional procedures. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2021; 870-871:503404. [PMID: 34583824 DOI: 10.1016/j.mrgentox.2021.503404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/30/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
Even though the medical uses of ionizing radiation are well-acknowledged globally as vital tools for the improvement of human health, they also symbolize the major man-made sources of radiation exposure to the population. Estimation of absorbed dose and biological changes after radiation-based imaging might help to better understand the effects of low dose radiation. Because of this, we measured the Entrance Surface Dose (ESD) at different anatomical locations using Lithium tetraborate doped with manganese (Li2B4O7: Mn), recorded Dose Length Product (DLP) and Dose Area Product (DAP), analyzed Chromosomal Aberration (CA), Micronucleus (MN), gamma-H2AX (γ-H2AX), and p53ser15 proteins in the blood lymphocytes of patients (n = 267) underwent Computed Tomography (CT), Positron Emission Tomography-CT (PET/CT), and interventional procedures and healthy volunteers (n = 19). The DLP and effective doses obtained from PET/CT procedures were significantly higher (p < 0.05) when compared to CT. Fluoroscopic time and DAP were significantly higher (p < 0.05) in therapeutic compared to diagnostic interventional procedures. All the anatomical locations registered a significant amount of ESD, the ESD obtained from CT and interventional procedures were significantly (p < 0.05) higher when compared to PET/CT. Fluoroscopic time did not correlate with the ESD (eye, head, thyroid, and shoulder; R2 = 0.03). CA frequency after PET/CT was significantly higher (p < 0.001) when compared to CT and interventional procedures. MN frequency was significantly higher in 24-hs (p < 0.001) post-interventional procedure compared to 2-hs. The mean ± SD of mean fluorescence intensity of γ-H2AX and p53ser15 obtained from all subjects underwent PET/CT and interventional procedures did not show a significant difference (p > 0.05) between pre- and post-procedure. However, the relative fluorescence intensity of γ-H2AX and p53ser15 was >1 in 58.5 % and 65.8 % of subjects respectively. Large inter-individual variation and lack of correlation between physical dose and biomarkers suggest the need for robust dosimetry with a large sample size to understand the health effects of low dose radiation.
Collapse
Affiliation(s)
- Shangamithra Visweswaran
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India
| | - Venkateswarlu Raavi
- Department of Cell Biology and Molecular Genetics, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Tamaka, Kolar, Karnataka, 563 103, India
| | - Safa Abdul Syed Basheerudeen
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India
| | - Karthik Kanagaraj
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India
| | - Akshaya Prasad
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India
| | - Tamizh Selvan Gnana Sekaran
- Central Research Lab, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, 575 018, India
| | - Sudha Pattan
- Department of Radiology & Imaging Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India
| | - Panneerselvam Shanmugam
- Department of Radiology & Imaging Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India
| | - Annalakshmi Ozimuthu
- Safety, Quality & Resource Management Group, Health Safety and Environment Group, Homi Bhabha National Institute, Indira Gandhi Center for Atomic Research, Kalpakkam, Tamil Nadu, 603 102, India
| | - Santhosh Joseph
- Department of Neuro-Radiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India
| | - Venkatachalam Perumal
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600 116, India.
| |
Collapse
|
5
|
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
|
6
|
Habibi M, Karyofyllis PK, Nikolakopoulou A, Papagiannis P, Karaiskos P, Georgakilas AG, Hatzi VI, Malakos I, Kollaros N, Mastorakou I, Voudris V, Terzoudi GI. The Use of Genotoxicity Endpoints as Biomarkers of Low Dose Radiation Exposure in Interventional Cardiology. Front Public Health 2021; 9:701878. [PMID: 34368064 PMCID: PMC8342993 DOI: 10.3389/fpubh.2021.701878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022] Open
Abstract
The effect of the reportedly low ionizing radiation doses, such as those very often delivered to patients in interventional cardiology, remains ambiguous. As interventional cardiac procedures may have a significant impact on total collective effective dose, there are radiation protection concerns for patients and physicians regarding potential late health effects. Given that very low doses (<100 mSv) are expected to be delivered during these procedures, the purpose of this study was to assess the potency and suitability of current genotoxicity biomarkers to detect and quantitate biological effects essential for risk estimation in interventional cardiology. Specifically, the biomarkers γ-H2AX foci, dicentric chromosomes, and micronuclei, which underpin radiation-induced DNA damage, were studied in blood lymphocytes of 25 adult patients before and after interventional cardiac procedures. Even though the mean values of all patients as a group for all three endpoints tested show increased yields relative to baseline following medical exposure, our results demonstrate that only the γ-H2AX biomarker enables detection of statistically significant differences at the individual level (p < 0.001) for almost all patients (91%). Furthermore, 24 h after exposure, residual γ-H2AX foci were still detectable in irradiated lymphocytes. Their decline was found to vary significantly among the individuals and the repair kinetics of γ-H2AX foci was found to range from 25 to 95.6% of their maximum values obtained.
Collapse
Affiliation(s)
- Martha Habibi
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece.,Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Aggeliki Nikolakopoulou
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece.,Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Papagiannis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Pantelis Karaiskos
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros G Georgakilas
- DNA Damage Laboratory, Department of Physics, School of Applied Mathematical and Physical Sciences, National Technical University of Athens (NTUA), Athens, Greece
| | - Vasiliki I Hatzi
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Ioannis Malakos
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | | | - Irene Mastorakou
- Imaging Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Vassilis Voudris
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | - Georgia I Terzoudi
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece
| |
Collapse
|
7
|
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
|
8
|
Lee JK, Lee MS, Moon MH, Woo H, Hong YJ, Jang S, Oh S. Translocation Frequency in Patients with Repeated CT Exposure: Comparison with CT-Naive Patients. Radiat Res 2019; 192:23-27. [DOI: 10.1667/rr15286.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | | | | | | | | | - Seongjae Jang
- Department of Laboratory of Biological Dosimetry, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Sohee Oh
- Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
9
|
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
|
10
|
Affiliation(s)
| | - Christina Stewart
- Department of Medical Physics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Nicholas W Weir
- Department of Medical Physics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - David E Newby
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
11
|
Si J, Zhou R, Zhao B, Xie Y, Gan L, Zhang J, Wang Y, Zhou X, Ren X, Zhang H. Effects of ionizing radiation and HLY78 on the zebrafish embryonic developmental toxicity. Toxicology 2019; 411:143-153. [DOI: 10.1016/j.tox.2018.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/18/2018] [Accepted: 10/11/2018] [Indexed: 01/02/2023]
|
12
|
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
|
13
|
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
|
14
|
Elsholtz FHJ, Schaafs LA, Köhlitz T, Hamm B, Niehues SM. Periradicular infiltration of the lumbar spine: testing the robustness of an interventional ultra-low-dose protocol at different body mass index levels. Acta Radiol 2017; 58:1364-1370. [PMID: 28273743 DOI: 10.1177/0284185117694508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Computed tomography (CT)-guided periradicular infiltration remains a frequent interventional procedure for treatment of low back pain. Purpose To present an interventional ultra-low-dose protocol for CT-guided periradicular infiltration therapy and assess its application at different body mass index (BMI) levels. Material and Methods Over a period of 14 months, 79 patients underwent 183 CT-guided interventions for single-site lumbar periradicular therapy using an ultra-low-dose protocol with a basic setup of 100 kV and 5 mAs. Procedures were performed via intermittent fluoroscopy. A retrospective review was performed to analyze the parameters tube current and tube voltage, dose-length product, and BMI. Results The interventional ultra-low-dose protocol allowed safe treatment of 91.1% of the patients without a need for adapting the protocol. In seven patients with a higher BMI (range, 31-38 kg/m2; mean, 34 kg/m2), the tube current had to be increased to retain sufficient image quality. Only patients with a BMI of 30 and higher showed a significant correlation between BMI and dose-length product ( P value = 0.02), resulting in a slightly increased dose ( P value = 0.002). Conclusion The protocol presented for the interventional part of CT-guided periradicular infiltration allows to safely treat patients with a median calculated effective dose of 0.045 mSv (converted from a dose-length-product of 2.26 mGy*cm). Patients with a BMI of 30 and higher required a higher calculated effective dose with just one patient slightly exceeding 0.1 mSv.
Collapse
Affiliation(s)
| | | | | | - Bernd Hamm
- Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | |
Collapse
|
15
|
Harbron R, Ainsbury EA, Bouffler SD, Tanner RJ, Eakins JS, Pearce MS. Enhanced radiation dose and DNA damage associated with iodinated contrast media in diagnostic X-ray imaging. Br J Radiol 2017; 90:20170028. [PMID: 28830201 DOI: 10.1259/bjr.20170028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A review was undertaken of studies reporting increased DNA damage in circulating blood cells and increased organ doses, for X-ray exposures enhanced by iodinated contrast media (ICM), compared to unenhanced imaging. This effect may be due to ICM molecules acting as a source of secondary radiation (Auger/photoelectrons, fluorescence X-rays) following absorption of primary X-ray photons. It is unclear if the reported increase in DNA damage to blood cells necessarily implies an increased risk of developing cancer. Upon ICM-enhancement, the attenuation properties of blood differ substantially from surrounding tissues. Increased energy deposition is likely to occur within very close proximity to ICM molecules (within a few tens of micrometres). Consequently, in many situations, damage and dose enhancement may be restricted to the blood and vessel wall only. Increased cancer risks may be possible, in cases where ICM molecules are given sufficient time to reach the capillary network and interstitial fluid at the time of exposure. In all situations, the extrapolation of blood cell damage to other tissues requires caution where contrast media are involved. Future research is needed to determine the impact of ICM on dose to cells outside the blood itself and vessel walls, and to determine the concentration of ICM in blood vessels and interstitial fluid at the time of exposure.
Collapse
Affiliation(s)
- Richard Harbron
- 1 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.,2 Health Protection Research Unit for Chemical & Radiation Threats & Hazards, Newcastle University, Newcastle upon Tyne, UK
| | - Elizabeth A Ainsbury
- 3 Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - Simon D Bouffler
- 3 Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - Rick J Tanner
- 3 Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - Jonathan S Eakins
- 3 Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - Mark S Pearce
- 1 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.,2 Health Protection Research Unit for Chemical & Radiation Threats & Hazards, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
16
|
Wang L, Li Q, Wang XM, Hao GY, Jie-Bao, Hu S, Hu CH. Enhanced radiation damage caused by iodinated contrast agents during CT examination. Eur J Radiol 2017. [PMID: 28624023 DOI: 10.1016/j.ejrad.2017.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To access the effect of iodinate contrast agent (ICA) on DNA double-stand breaks (DSBs) in human peripheral blood lymphocytes during computed tomography (CT) examinations. MATERIALS AND METHODS This present study was approved by the institutional ethics committee; written informed patient consent was obtained from 70 patients. A total of 48 patients underwent computed tomography urography (CTU), in which only one time CT scanning was examined after injecting ICA, and 22 patients received unenhanced whole abdominal CT, among them 10 patients were selected to get ICA injection immediately after irradiation. Blood samples were taken from all patients prior to and immediately after CT scan, as well as 8min after the injection of ICA. The lymphocytes in these blood samples were separated by using density-gradient centrifugation, fixed and immunostained with γH2AX antibody. The average number of phosphorylated histone H2AX (γH2AX) foci per lymphocyte was counted under a fluorescence microscopy. Differences in the number of γH2AX-foci were statistically analyzed using independent sample t test and one way ANOVA. RESULT The three patient groups had no significant differences in the baseline foci numbers(P>0.05). The γH2AX-focus levels increased in both groups after CT scan. Patients who underwent CTU examinations had a greater DSBs level (mean±standard error of mean, 0.945±0.184 foci per cell) than those who received unenhanced whole abdominal CT scan (mean±standard error of mean, 0.700±0.112 foci per cell), increasing by about 37.9%; The ICA injected before CT scan itself had an effect on the DSBs, which increased DSBs level by approximately 90.3% (0.059±0.018vs 0.031±0.025, P<0.05), but no significant difference was found if added after irradiation, increasing DSBs level only by 3.2% approximately (0.711±0.091vs 0.689±0.108, P=0.499). CONCLUSION The iodinated contrast agent itself can lead to an increase in the level of DSBs as assessed with γH2AX foci formation, and the application of ICA can amplify DNA damage induced by diagnostic x-ray procedures such as whole abdominal CT.
Collapse
Affiliation(s)
- Ling Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188, Street of Ten Catalpa, Suzhou, 200000, China
| | - Qiang Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188, Street of Ten Catalpa, Suzhou, 200000, China; Department of Radiology, Yinzhou Hospital, Ningbo University, No. 251, East of Baizhang Road, Ningbo, 315100, China
| | - Xi-Ming Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188, Street of Ten Catalpa, Suzhou, 200000, China
| | - Guang-Yu Hao
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188, Street of Ten Catalpa, Suzhou, 200000, China
| | - Jie-Bao
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188, Street of Ten Catalpa, Suzhou, 200000, China
| | - Su Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188, Street of Ten Catalpa, Suzhou, 200000, China
| | - Chun-Hong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188, Street of Ten Catalpa, Suzhou, 200000, China.
| |
Collapse
|
17
|
Hosseinimehr SJ, Fathi M, Ghasemi A, Shiadeh SNR, Pourfallah TA. Celecoxib mitigates genotoxicity induced by ionizing radiation in human blood lymphocytes. Res Pharm Sci 2017; 12:82-87. [PMID: 28255318 PMCID: PMC5333484 DOI: 10.4103/1735-5362.199051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Ionizing radiation causes DNA damage and chromosome abbreviations on normal cells. The radioprotective effect of celecoxib (CLX) was investigated against genotoxicity induced by ionizing radiation in cultured human blood lymphocytes. Peripheral blood samples were collected from human volunteers and were incubated at different concentrations at 1, 5, 10 and 50 μM of CLX for two hours. At each dose point, the whole blood was exposed in vitro to 150 cGy of X-ray, and then the lymphocytes were cultured with mitogenic stimulation to determine the micronucleus frequency in cytokinesis blocked binucleated lymphocytes. Incubation of the whole blood with CLX exhibited a significant decrease in the incidence of micronuclei in lymphocytes induced by ionizing radiation, as compared with similarly irradiated lymphocytes without CLX treatment. The maximum reduction on the frequency of micronuclei was observed at 50 μM of CLX (65% decrease). This data may have an important possible application for the protection of human lymphocytes from the genetic damage induced by ionizing irradiation in human exposed to radiation.
Collapse
Affiliation(s)
- Seyed Jalal Hosseinimehr
- Department of Radiopharmacy, Faculty of Pharmacy, Pharmaceutical Sciences Research Center, Mazandaran University of Medical Sciences, Sari, I.R. Iran
| | - Mahdieh Fathi
- Department of Radiopharmacy, Faculty of Pharmacy, Pharmaceutical Sciences Research Center, Mazandaran University of Medical Sciences, Sari, I.R. Iran
| | - Arash Ghasemi
- Department of Radiology and Radiation Oncology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, I.R. Iran
| | - Seyedeh Nesa Rezaeian Shiadeh
- Department of Radiopharmacy, Faculty of Pharmacy, Pharmaceutical Sciences Research Center, Mazandaran University of Medical Sciences, Sari, I.R. Iran
| | - Tayyeb Allahverdi Pourfallah
- Department of Biochemistry and Biophysics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, I.R. Iran
| |
Collapse
|
18
|
Abdollahi H, Shiri I, Salimi Y, Sarebani M, Mehdinia R, Deevband MR, Mahdavi SR, Sohrabi A, Bitarafan-Rajabi A. Radiation dose in cardiac SPECT/CT: An estimation of SSDE and effective dose. Eur J Radiol 2016; 85:2257-2261. [PMID: 27842674 DOI: 10.1016/j.ejrad.2016.10.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 10/11/2016] [Accepted: 10/19/2016] [Indexed: 12/21/2022]
Abstract
AIMS The dose levels for Computed Tomography (CT) localization and attenuation correction of Single Photon Emission Computed Tomography (SPECT) are limited and reported as Volume Computed Tomography Dose Index (CTDIvol) and Dose-Length Product (DLP). This work presents CT dose estimation from Cardiac SPECT/CT based on new American Association of Physicists in Medicine (AAPM) Size Specific Dose Estimation (SSDE) parameter, effective dose, organ doses and also emission dose from nuclear issue. MATERIAL AND METHODS Myocardial perfusion SPECT/CT for 509 patients was included in the study. SSDE, effective dose and organ dose were calculated using AAPM guideline and Impact-Dose software. Data were analyzed using R and SPSS statistical software. Spearman-Pearson correlation test and linear regression models were used for finding correlations and relationships among parameters. RESULTS The mean CTDIvol was 1.34 mGy±0.19 and the mean SSDE was 1.7 mGy±0.16. The mean±SD of effective dose from emission, CT and total dose were 11.5±1.4, 0.49±0.11 and 12.67±1.73 (mSv) respectively. The mean±SD of effective dose from emission, CT and total dose were 11.5±1.4, 0.49±0.11 and 12.67±1.73 (mSv) respectively. The spearman test showed that correlation between body size and organ doses is significant except thyroid and red bone marrow. CTDIvol was strongly dependent on patient size, but SSDE was not. Emission dose was strongly dependent on patient weight, but its dependency was lower to effective diameter. CONCLUSION The dose parameters including CTDIvol, DLP, SSDE, effective dose values reported here are very low and below the reference level. This data suggest that appropriate CT acquisition parameters in SPECT/CT localization and attenuation correction are very beneficial for patients and lowering cancer risks.
Collapse
Affiliation(s)
- Hamid Abdollahi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Isaac Shiri
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Yazdan Salimi
- Biomedical Engineering and Medical Physics Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maghsoud Sarebani
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Mehdinia
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Deevband
- Biomedical Engineering and Medical Physics Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seied Rabi Mahdavi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Sohrabi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Bitarafan-Rajabi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Department of Nuclear Medicine, Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
19
|
DNA damage in lymphocytes induced by cardiac CT and comparison with physical exposure parameters. Eur Radiol 2016; 27:1660-1666. [PMID: 27510626 DOI: 10.1007/s00330-016-4519-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 07/13/2016] [Accepted: 07/19/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate whether physical exposure parameters such as the dose index (CTDI), dose length product (DLP), and size-specific dose estimate (SSDE) are predictive of DNA damage. METHODS In vitro, we scanned a phantom containing blood samples from five volunteers at CTDI 50, 100, and 150 mGy. One sample was not scanned. We also scanned samples in three different-size phantoms at CTDI 100 mGy. In vivo, we enrolled 45 patients and obtained blood samples before and after cardiac CT. The γ-H2AX foci were counted. RESULTS In vitro, in the control and at CTDI 50, 100, and 150 mGy, the number of γ-H2AX was 0.94 ± 0.24 (standard error, SE), 1.28 ± 0.30, 1.91 ± 0.47, and 2.16 ± 0.20. At SSDE 180, 156, and 135 mGy, it was 2.41 ± 0.20, 1.91 ± 0.47, and 1.42 ± 0.20 foci/cell. The γ-H2AX foci were positively correlated with the radiation dose and negatively correlated with the body size. In vivo, the γ-H2AX foci were significantly increased after CT (from 1.21 ± 0.19 to 1.92 ± 0.22 foci/cell) and correlated with CTDI, DLP, and SSDE. CONCLUSIONS DNA damage was induced by cardiac CT. There was a correlation between the physical exposure parameters and γ-H2AX. KEY POINTS • DNA damage was induced by radiation exposure from cardiac CT. • The γ-H2AX foci number was correlated with the CT radiation dose. • Physical exposure parameters reflect the DNA damage by CT radiation exposure.
Collapse
|
20
|
Abe Y, Miura T, Yoshida MA, Ujiie R, Kurosu Y, Kato N, Katafuchi A, Tsuyama N, Kawamura F, Ohba T, Inamasu T, Shishido F, Noji H, Ogawa K, Yokouchi H, Kanazawa K, Ishida T, Muto S, Ohsugi J, Suzuki H, Ishikawa T, Kamiya K, Sakai A. Analysis of chromosome translocation frequency after a single CT scan in adults. JOURNAL OF RADIATION RESEARCH 2016; 57:220-6. [PMID: 26874116 PMCID: PMC4915535 DOI: 10.1093/jrr/rrv090] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/03/2015] [Indexed: 05/04/2023]
Abstract
We recently reported an increase in dicentric chromosome (DIC) formation after a single computed tomography (CT) scan (5.78-60.27 mSv: mean 24.24 mSv) and we recommended analysis of 2000 metaphase cells stained with Giemsa and centromere-FISH for dicentric chromosome assay (DCA) in cases of low-dose radiation exposure. In the present study, we analyzed the frequency of chromosome translocations using stored Carnoy's-fixed lymphocyte specimens from the previous study; these specimens were from 12 patients who were subject to chromosome painting of Chromosomes 1, 2 and 4. Chromosomes 1, 2 and 4 were analyzed in ∼5000 cells, which is equivalent to the whole-genome analysis of almost 2000 cells. The frequency of chromosome translocation was higher than the number of DICs formed, both before and after CT scanning. The frequency of chromosome translocations tended to be higher, but not significantly higher, in patients with a treatment history compared with patients without such a history. However, in contrast to the results for DIC formation, the frequency of translocations detected before and after the CT scan did not differ significantly. Therefore, analysis of chromosome translocation may not be a suitable assay for detecting chromosome aberrations in cases of low-dose radiation exposure from a CT scan. A significant increase in the frequency of chromosome translocations was not likely to be detected due to the high baseline before the CT scan; the high and variable frequency of translocations was probably due to multiple confounding factors in adults.
Collapse
Affiliation(s)
- Yu Abe
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Tomisato Miura
- Department of Pathologic Analysis, Hirosaki University Graduate School of Health Sciences, Hirosaki, 036-8564, Japan
| | - Mitsuaki A Yoshida
- Department of Radiation Biology, Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, 036-8564, Japan
| | - Risa Ujiie
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Yumiko Kurosu
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Nagisa Kato
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Atsushi Katafuchi
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Naohiro Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Fumihiko Kawamura
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Takashi Ohba
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Tomoko Inamasu
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Fumio Shishido
- Department of Radiology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hideyoshi Noji
- Department of Cardiology and Hematology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Kazuei Ogawa
- Department of Cardiology and Hematology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hiroshi Yokouchi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Takashi Ishida
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Satoshi Muto
- Department of Regenerative Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Jun Ohsugi
- Department of Regenerative Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hiroyuki Suzuki
- Department of Regenerative Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Tetsuo Ishikawa
- Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Akira Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| |
Collapse
|
21
|
Vandevoorde C, Gomolka M, Roessler U, Samaga D, Lindholm C, Fernet M, Hall J, Pernot E, El-Saghire H, Baatout S, Kesminiene A, Thierens H. EPI-CT: in vitro assessment of the applicability of the γ-H2AX-foci assay as cellular biomarker for exposure in a multicentre study of children in diagnostic radiology. Int J Radiat Biol 2015; 91:653-63. [PMID: 25968559 DOI: 10.3109/09553002.2015.1047987] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To conduct a feasibility study on the application of the γ-H2AX foci assay as an exposure biomarker in a prospective multicentre paediatric radiology setting. MATERIALS AND METHODS A set of in vitro experiments was performed to evaluate technical hurdles related to biological sample collection in a paediatric radiology setting (small blood sample volume), processing and storing of blood samples (effect of storing blood at 4°C), the reliability of foci scoring for low-doses (merge γ-H2AX/53BP1 scoring), as well as the impact of contrast agent administration as potential confounding factor. Given the exploratory nature of this study and the ethical constraints related to paediatric blood sampling, blood samples from adult volunteers were used for these experiments. In order to test the feasibility of pooling the γ-H2AX data when different centres are involved in an international multicentre study, two intercomparison studies in the low-dose range (10-500 mGy) were performed. RESULTS Determination of the number of X-ray induced γ-H2AX foci is feasible with one 2 ml blood sample pre- and post-computed tomography (CT) scan. Lymphocyte isolation and fixation on slides is necessary within 5 h of blood sampling to guarantee reliable results. The possible enhancement effect of contrast medium on the induction of DNA DSB in a patient study can be ruled out if radiation doses and the contrast agent concentration are within diagnostic ranges. The intercomparison studies using in vitro irradiated blood samples showed that the participating laboratories, executing successfully the γ-H2AX foci assay in lymphocytes, were able to rank blind samples in order of lowest to highest radiation dose based on mean foci/cell counts. The dose response of all intercomparison data shows that a dose point of 10 mGy could be distinguished from the sham-irradiated control (p = 0.006). CONCLUSIONS The results demonstrate that it is feasible to apply the γ-H2AX foci assay as a cellular biomarker of exposure in a multicentre prospective study in paediatric CT imaging after validating it in an in vivo international pilot study on paediatric patients.
Collapse
Affiliation(s)
| | - Maria Gomolka
- b Federal Office for Radiation Protection , BfS , Germany
| | - Ute Roessler
- b Federal Office for Radiation Protection , BfS , Germany
| | - Daniel Samaga
- b Federal Office for Radiation Protection , BfS , Germany
| | | | | | - Janet Hall
- e Centre de Recherche en Cancérologie de Lyon - UMR Inserm 1052 - CNRS 5286 , France
| | - Eileen Pernot
- f Centre for Research in Environmental Epidemiology , CREAL , Spain
- g Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- h CIBER Epidemiología y salud P ublica (CIBERESP) , Barcelona , Spain
| | | | - Sarah Baatout
- i Radiobiology Unit, Belgian Nuclear Research Centre, SCK-CEN , Belgium
| | | | | |
Collapse
|
22
|
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
|
23
|
Schächinger V, Nef H, Achenbach S, Butter C, Deisenhofer I, Eckardt L, Eggebrecht H, Kuon E, Levenson B, Linke A, Madlener K, Mudra H, Naber C, Rieber J, Rittger H, Walther T, Zeus T, Kelm M. Leitlinie zum Einrichten und Betreiben von Herzkatheterlaboren und Hybridoperationssälen/Hybridlaboren. KARDIOLOGE 2015. [DOI: 10.1007/s12181-014-0631-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
24
|
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
|
25
|
Kuon E, Felix SB, Weitmann K, Büchner I, Hummel A, Dörr M, Reffelmann T, Riad A, Busch MC, Empen K. ECG-gated coronary angiography enables submillisievert imaging in invasive cardiology. Herz 2014; 40 Suppl 3:247-53. [PMID: 25277222 DOI: 10.1007/s00059-014-4153-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The median dose area products (DAP) and effective doses (ED) of patients arising from coronary angiography (CA) are considerable: According the 2013 National German Registry, they amount to 19.8 Gy × cm(2) and 4.0 mSv, respectively. METHODS We investigated the feasibility of prospective electrocardiogram (ECG)-gated coronary angiography (CA)-a novel technique in invasive cardiology-with respect to possible reduction in irradiation effects. Instead of universally fix-rated radiographic acquisition within 7.5-15 frames/s, one single frame/heartbeat was triggered toward the diastolic moment immediately before atrial contraction (77 % of ECG-RR interval) most likely to provide motion-free and hence optimized resolution of the coronary tree. For 200 patients (body mass index 27.8 kg/m(2), age 67.5 years, male 55 %, 68 bpm) undergoing ECG-gated CA, we measured various median (interquartile range) parameters for radiation exposure. RESULTS The total DAP was 0.64 (0.46-1.00), radiographic fraction was 0.30 (0.19-0.43), and fluoroscopic fraction was 0.35 (0.21-0.57) Gy × cm(2). Radiographic imaging occurred within 21.7 s (17.1-26.3), with 25 frames (20-30) over the course of 7 runs (6-8). Fluoroscopy time was 119 s (94-141). Radiographic DAP was 12.6 mGy × cm(2)/frame and 13.8 mGy × cm(2)/s. Fluoroscopic DAP was 0.8 mGy × cm(2)/pulse and 3.1 mGy × cm(2)/s. Patient reference point air kerma was 17.0 mGy (11.1-28.1) and contrast volume was 70 ml (60-85). CONCLUSION In conclusion, invasive ECG-gated coronary imaging is feasible in clinical routine and enables patient EDs of approx. 3 % of typical values in invasive cardiology: 0.13 mSv (0.09-0.20).
Collapse
Affiliation(s)
- E Kuon
- Department of Cardiology, Klinik Fraenkische Schweiz, Feuersteinstr. 2, 91320, Ebermannstadt, Germany,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Kuon E, Weitmann K, Hoffmann W, Dörr M, Reffelmann T, Hummel A, Riad A, Busch MC, Empen K, Felix SB. Efficacy of a Minicourse in Radiation-Reducing Techniques in Invasive Cardiology. JACC Cardiovasc Interv 2014; 7:382-90. [DOI: 10.1016/j.jcin.2013.11.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 10/26/2013] [Accepted: 11/07/2013] [Indexed: 10/25/2022]
|
27
|
Deinzer CKW, Danova D, Kleb B, Klose KJ, Heverhagen JT. Influence of different iodinated contrast media on the induction of DNA double-strand breaks afterin vitroX-ray irradiation. CONTRAST MEDIA & MOLECULAR IMAGING 2014; 9:259-67. [DOI: 10.1002/cmmi.1567] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 07/02/2013] [Accepted: 07/25/2013] [Indexed: 11/11/2022]
Affiliation(s)
| | - Daniela Danova
- Department of Diagnostic and Interventional Radiology; Philipps University; Marburg Germany
| | - Beate Kleb
- Department of Diagnostic and Interventional Radiology; Philipps University; Marburg Germany
| | - Klaus J. Klose
- Department of Diagnostic and Interventional Radiology; Philipps University; Marburg Germany
| | - Johannes T. Heverhagen
- Department of Diagnostic and Interventional Radiology; Philipps University; Marburg Germany
- Department of Diagnostic; Interventional and Pediatric Radiology; University Hospital Inselspital; Bern Switzerland
| |
Collapse
|
28
|
Latest-generation catheterization systems enable invasive submillisievert coronary angiography. Herz 2013; 40 Suppl 3:233-9. [PMID: 24317020 DOI: 10.1007/s00059-013-4015-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/05/2013] [Accepted: 10/28/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND The radiation risk of patients undergoing invasive cardiology remains considerable and includes skin injuries and cancer. To date, submillisievert coronary angiography has not been considered feasible. PATIENTS AND METHODS In 2011, we compared results from 100 consecutive patients undergoing elective coronary angiography using the latest-generation flat-panel angiography system (FPS) with results from examinations by the same operator using 106 historic controls with a conventional image-intensifier system (IIS) that was new in 2002. RESULTS The median patient exposure parameters were measured as follows: dose-area product (DAP) associated with radiographic cine acquisitions (DAP(R)) and fluoroscopy (DAP(F)) scenes, radiographic frames and runs, and cumulative exposure times for radiography and fluoroscopy. On the FPS as compared to the traditional IIS, radiographic detector entrance dose levels were reduced from 164 to 80 nGy/frame and pulse rates were lowered from 12.5/s to 7.5/s during radiography and from 25/s to 4/s during fluoroscopy. The cardiologist's performance patterns remained comparable over the years: fluoroscopy time was constant and radiography time even slightly increased. Overall patient DAP decreased from 7.0 to 2.4 Gy × cm(2); DAP(R), from 4.2 to 1.7 Gy × cm(2); and DAP(F), from 2.8 to 0.6 Gy × cm(2). Time-adjusted DAP(R)/s decreased from 436 to 130 mGy × cm(2) and DAP(F)/s, from 21.6 to 4.4 mGy × cm(2). Cumulative patient skin dose with the FPS amounted to 67 mGy, and the median (interquartile range) of effective dose was 0.5 (0.3 … 0.7) mSv. CONCLUSION Consistent application of radiation-reducing techniques with the latest-generation flat-panel systems enables submillisievert coronary angiography in invasive cardiology.
Collapse
|