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Wang FA, Li Y, Zeng T. Deep Learning of radiology-genomics integration for computational oncology: A mini review. Comput Struct Biotechnol J 2024; 23:2708-2716. [PMID: 39035833 PMCID: PMC11260400 DOI: 10.1016/j.csbj.2024.06.019] [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: 03/06/2024] [Revised: 06/18/2024] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
In the field of computational oncology, patient status is often assessed using radiology-genomics, which includes two key technologies and data, such as radiology and genomics. Recent advances in deep learning have facilitated the integration of radiology-genomics data, and even new omics data, significantly improving the robustness and accuracy of clinical predictions. These factors are driving artificial intelligence (AI) closer to practical clinical applications. In particular, deep learning models are crucial in identifying new radiology-genomics biomarkers and therapeutic targets, supported by explainable AI (xAI) methods. This review focuses on recent developments in deep learning for radiology-genomics integration, highlights current challenges, and outlines some research directions for multimodal integration and biomarker discovery of radiology-genomics or radiology-omics that are urgently needed in computational oncology.
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Affiliation(s)
- Feng-ao Wang
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
| | - Yixue Li
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
- Guangzhou National Laboratory, Guangzhou, China
- GMU-GIBH Joint School of Life Sciences, The Guangdong-Hong Kong-Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Laboratory, Guangzhou Medical University, Guangzhou, China
| | - Tao Zeng
- Guangzhou National Laboratory, Guangzhou, China
- GMU-GIBH Joint School of Life Sciences, The Guangdong-Hong Kong-Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Laboratory, Guangzhou Medical University, Guangzhou, China
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2
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Valente D, Gentileschi MP, Valenti A, Burgio M, Soddu S, Bruzzaniti V, Guerrisi A, Verdina A. Cumulative Dose from Recurrent CT Scans: Exploring the DNA Damage Response in Human Non-Transformed Cells. Int J Mol Sci 2024; 25:7064. [PMID: 39000171 PMCID: PMC11241671 DOI: 10.3390/ijms25137064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open
Abstract
Recurrent computed tomography (CT) examination has become a common diagnostic procedure for several diseases and injuries. Though each singular CT scan exposes individuals at low doses of low linear energy transfer (LET) radiation, the cumulative dose received from recurrent CT scans poses an increasing concern for potential health risks. Here, we evaluated the biological effects of recurrent CT scans on the DNA damage response (DDR) in human fibroblasts and retinal pigment epithelial cells maintained in culture for five months and subjected to four CT scans, one every four weeks. DDR kinetics and eventual accumulation of persistent-radiation-induced foci (P-RIF) were assessed by combined immunofluorescence for γH2AX and 53BP1, i.e., γH2AX/53BP1 foci. We found that CT scan repetitions significantly increased both the number and size of γH2AX/53BP1 foci. In particular, after the third CT scan, we observed the appearance of giant foci that might result from the overlapping of individual small foci and that do not associate with irreversible growth arrest, as shown by DNA replication in the foci-carrying cells. Whether these giant foci represent coalescence of unrepaired DNA damage as reported following single exposition to high doses of high LET radiation is still unclear. However, morphologically, these giant foci resemble the recently described compartmentalization of damaged DNA that should facilitate the repair of DNA double-strand breaks but also increase the risk of chromosomal translocations. Overall, these results indicate that for a correct evaluation of the damage following recurrent CT examinations, it is necessary to consider the size and composition of the foci in addition to their number.
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Affiliation(s)
- Davide Valente
- Unit of Cellular Networks and Molecular Therapeutic Targets, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.V.); (M.P.G.); (S.S.)
- Institute of Molecular Biology and Pathology (IBPM), National Research Council (CNR), c/o Sapienza University, 00185 Rome, Italy
| | - Maria Pia Gentileschi
- Unit of Cellular Networks and Molecular Therapeutic Targets, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.V.); (M.P.G.); (S.S.)
| | - Alessandro Valenti
- Unit of Radiology and Diagnostic Imaging, Department of Clinical and Dermatological Research, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy; (A.V.); (M.B.)
| | - Massimo Burgio
- Unit of Radiology and Diagnostic Imaging, Department of Clinical and Dermatological Research, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy; (A.V.); (M.B.)
| | - Silvia Soddu
- Unit of Cellular Networks and Molecular Therapeutic Targets, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.V.); (M.P.G.); (S.S.)
| | - Vicente Bruzzaniti
- Unit of Medical Physics and Expert Systems, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Antonino Guerrisi
- Unit of Radiology and Diagnostic Imaging, Department of Clinical and Dermatological Research, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy; (A.V.); (M.B.)
| | - Alessandra Verdina
- Unit of Cellular Networks and Molecular Therapeutic Targets, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.V.); (M.P.G.); (S.S.)
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3
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Ma Y, Guo L, Fang L, Hou D, Chen R, Wang X, Mao X, Zhao Z, Chen Y. Assessment of radiation doses and DNA damage in pediatric patients undergoing interventional procedures for vascular anomalies. MUTATION RESEARCH. GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2023; 889:503653. [PMID: 37491112 DOI: 10.1016/j.mrgentox.2023.503653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/07/2023] [Accepted: 06/22/2023] [Indexed: 07/27/2023]
Abstract
Interventional procedures (IPs) have been widely used to treat vascular anomalies (VA) in recent years. However, patients are exposed to low-dose X-ray ionizing radiation (IR) during these fluoroscopy-guided IPs. We collected clinical information and IR doses during IPs and measured biomarkers including γ-H2AX, chromosome aberrations (CA), and micronuclei (MN), which underpin radiation-induced DNA damage, from 74 pediatric patients before and after IPs. For the 74 children, the range of dose-area product (DAP) values was from 1.2 to 1754.6 Gy∙cm2, with a median value of 27.1 Gy∙cm2. DAP values were significantly higher in children with lesions in the head and neck than in the limbs and trunk; the age and weight of children revealed a strong positive correlation with DAP values. The treated patients as a group demonstrated an increase in all three endpoints relative to baseline following IPs. Children with vascular tumors have a higher risk of dicentric chromosome + centric ring (dic+r) and cytokinesis-block micronucleus (CBMN) after IPs than children with vascular malformations. The younger the patient, the greater the risk of CA after IPs. Moreover, rogue cells (RCs) were found in five children (approximately 10%) after IPs, and the rates of dic+r and CBMN were significantly higher than those of other children (Z = -3.576, p < 0.001). These results suggest that there may be some children with VA who are particularly sensitive to IR, but more data and more in-depth experiments will be needed to verify this in the future.
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Affiliation(s)
- Ya Ma
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Lei Guo
- Jinan Children's Hospital, No. 23976 Jingshi Road, Jinan 250022, PR China
| | - Lianying Fang
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Dianjun Hou
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Rui Chen
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Xiaoshan Wang
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Xuesong Mao
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Zihan Zhao
- High School Attached to Shandong Normal University, No. 3 Shanshi North Street, Jinan 250014, PR China
| | - Yingmin Chen
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China.
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López-Riego M, Płódowska M, Lis-Zajęcka M, Jeziorska K, Tetela S, Węgierek-Ciuk A, Sobota D, Braziewicz J, Lundholm L, Lisowska H, Wojcik A. The DNA damage response to radiological imaging: from ROS and γH2AX foci induction to gene expression responses in vivo. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2023:10.1007/s00411-023-01033-4. [PMID: 37335333 DOI: 10.1007/s00411-023-01033-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/03/2023] [Indexed: 06/21/2023]
Abstract
Candidate ionising radiation exposure biomarkers must be validated in humans exposed in vivo. Blood from patients undergoing positron emission tomography-computed tomography scan (PET-CT) and skeletal scintigraphy (scintigraphy) was drawn before (0 h) and after (2 h) the procedure for correlation analyses of the response of selected biomarkers with radiation dose and other available patient information. FDXR, CDKN1A, BBC3, GADD45A, XPC, and MDM2 expression was determined by qRT-PCR, DNA damage (γH2AX) by flow cytometry, and reactive oxygen species (ROS) levels by flow cytometry using the 2', 7'-dichlorofluorescein diacetate test in peripheral blood mononuclear cells (PBMC). For ROS experiments, 0- and 2-h samples were additionally exposed to UVA to determine whether diagnostic irradiation conditioned the response to further oxidative insult. With some exceptions, radiological imaging induced weak γH2AX foci, ROS and gene expression fold changes, the latter with good coherence across genes within a patient. Diagnostic imaging did not influence oxidative stress in PBMC successively exposed to UVA. Correlation analyses with patient characteristics led to low correlation coefficient values. γH2AX fold change, which correlated positively with gene expression, presented a weak positive correlation with injected activity, indicating a radiation-induced subtle increase in DNA damage and subsequent activation of the DNA damage response pathway. The exposure discrimination potential of these biomarkers in the absence of control samples as frequently demanded in radiological emergencies, was assessed using raw data. These results suggest that the variability of the response in heterogeneous populations might complicate identifying individuals exposed to low radiation doses.
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Affiliation(s)
- Milagrosa López-Riego
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden.
| | - Magdalena Płódowska
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
| | - Milena Lis-Zajęcka
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
| | - Kamila Jeziorska
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
| | - Sylwia Tetela
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
| | - Aneta Węgierek-Ciuk
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
| | - Daniel Sobota
- Department of Medical Physics, Institute of Biology, Jan Kochanowski University, Kielce, Poland
| | - Janusz Braziewicz
- Department of Medical Physics, Institute of Biology, Jan Kochanowski University, Kielce, Poland
- Department of Nuclear Medicine With Positron Emission Tomography (PET) Unit, Holy Cross Cancer Centre, Kielce, Poland
| | - Lovisa Lundholm
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Halina Lisowska
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
| | - Andrzej Wojcik
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
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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.
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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
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6
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Evans AC, Setzkorn T, Edmondson DA, Segelke H, Wilson PF, Matthay KK, Granger MM, Marachelian A, Haas-Kogan DA, DuBois SG, Coleman MA. Peripheral Blood Transcript Signatures after Internal 131I-mIBG Therapy in Relapsed and Refractory Neuroblastoma Patients Identifies Early and Late Biomarkers of Internal 131I Exposures. Radiat Res 2022; 197:101-112. [PMID: 34673986 PMCID: PMC8870530 DOI: 10.1667/rade-20-00173.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/23/2021] [Indexed: 02/03/2023]
Abstract
131I-metaiodobenzylguanidine (131I-mIBG) is a targeted radiation therapy developed for the treatment of advanced neuroblastoma. We have previously shown that this patient cohort can be used to predict absorbed dose associated with early 131I exposure, 72 h after treatment. We now expand these studies to identify gene expression differences associated with 131I-mIBG exposure 15 days after treatment. Total RNA from peripheral blood lymphocytes was isolated from 288 whole blood samples representing 59 relapsed or refractory neuroblastoma patients before and after 131I-mIBG treatment. We found that several transcripts predictive of early exposure returned to baseline levels by day 15, however, selected transcripts did not return to baseline. At 72 h, all 17 selected pathway-specific transcripts were differentially expressed. Transcripts CDKN1A (P < 0.000001), FDXR (P < 0.000001), DDB2 (P < 0.000001), and BBC3 (P < 0.000001) showed the highest up-regulation at 72 h after 131I-mIBG exposure, with mean log2 fold changes of 2.55, 2.93, 1.86 and 1.85, respectively. At day 15 after 131I-mIBG, 11 of the 17 selected transcripts were differentially expressed, with XPC, STAT5B, PRKDC, MDM2, POLH, IGF1R, and SGK1 displaying significant up-regulation at 72 h and significant down-regulation at day 15. Interestingly, transcripts FDXR (P = 0.01), DDB2 (P = 0.03), BCL2 (P = 0.003), and SESN1 (P < 0.0003) maintained differential expression 15 days after 131I-mIBG treatment. These results suggest that transcript levels for DNA repair, apoptosis, and ionizing radiation-induced cellular stress are still changing by 15 days after 131I-mIBG treatment. Our studies showcase the use of biodosimetry gene expression panels as predictive biomarkers following early (72 h) and late (15 days) internal 131I exposure. Our findings also demonstrate the utility of our transcript panel to differentiate exposed from non-exposed individuals up to 15 days after exposure from internal 131I.
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Affiliation(s)
- Angela C. Evans
- Department of Radiation Oncology, University of California Davis, Sacramento, California;,Lawrence Livermore National Laboratory, Livermore, California
| | - Tim Setzkorn
- Technical University of Munich, School of Medicine, Germany
| | | | - Haley Segelke
- Lawrence Livermore National Laboratory, Livermore, California
| | - Paul F. Wilson
- Department of Radiation Oncology, University of California Davis, Sacramento, California
| | - Katherine K. Matthay
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco California
| | | | - Araz Marachelian
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Daphne A. Haas-Kogan
- Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Steven G. DuBois
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Matthew A. Coleman
- Department of Radiation Oncology, University of California Davis, Sacramento, California;,Lawrence Livermore National Laboratory, Livermore, California;,Address for correspondence: Department of Radiation Oncology, University of California Davis, Sacramento, CA;
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7
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Li W, Zhou S, Jia M, Li X, Li L, Wang Q, Qi Z, Zhou P, Li Y, Wang Z. Early Biomarkers Associated with P53 Signaling for Acute Radiation Injury. LIFE (BASEL, SWITZERLAND) 2022; 12:life12010099. [PMID: 35054492 PMCID: PMC8778477 DOI: 10.3390/life12010099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 01/18/2023]
Abstract
Accurate dose assessment within 1 day or even 12 h after exposure through current methods of dose estimation remains a challenge, in response to a large number of casualties caused by nuclear or radiation accidents. P53 signaling pathway plays an important role in DNA damage repair and cell apoptosis induced by ionizing radiation. The changes of radiation-induced P53 related genes in the early stage of ionizing radiation should compensate for the deficiency of lymphocyte decline and γ-H2AX analysis as novel biomarkers of radiation damage. Bioinformatic analysis was performed on previous data to find candidate genes from human peripheral blood irradiated in vitro. The expression levels of candidate genes were detected by RT-PCR. The expressions of screened DDB2, AEN, TRIAP1, and TRAF4 were stable in healthy population, but significantly up-regulated by radiation, with time specificity and dose dependence in 2–24 h after irradiation. They are early indicators for medical treatment in acute radiation injury. Their effective combination could achieve a more accurate dose assessment for large-scale wounded patients within 24 h post exposure. The effective combination of p53-related genes DDB2, AEN, TRIAP1, and TRAF4 is a novel biodosimetry for a large number of people exposed to acute nuclear accidents.
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Affiliation(s)
- Weihong Li
- Graduate Collaborative Training Base of Academy of Military Sciences, Hengyang Medical School, University of South China, Hengyang 421001, China;
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Shixiang Zhou
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Meng Jia
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Xiaoxin Li
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Lin Li
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Qi Wang
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Zhenhua Qi
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Pingkun Zhou
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
| | - Yaqiong Li
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
- Correspondence: (Y.L.); (Z.W.); Tel.: +86-10-66930294 (Y.L.); +86-10-66930248 (Z.W.)
| | - Zhidong Wang
- Graduate Collaborative Training Base of Academy of Military Sciences, Hengyang Medical School, University of South China, Hengyang 421001, China;
- Beijing Key Laboratory for Radiobiology, Department of Radiobiology, Beijing Institute of Radiation Medicine, Beijing 100850, China; (S.Z.); (M.J.); (X.L.); (L.L.); (Q.W.); (Z.Q.); (P.Z.)
- Correspondence: (Y.L.); (Z.W.); Tel.: +86-10-66930294 (Y.L.); +86-10-66930248 (Z.W.)
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8
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Kaatsch HL, Schneider J, Brockmann C, Brockmann MA, Overhoff D, Becker BV, Waldeck S. Radiation exposure during angiographic interventions in interventional radiology - risk and fate of advanced procedures. Int J Radiat Biol 2022; 98:865-872. [PMID: 34982640 DOI: 10.1080/09553002.2021.2020362] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Advanced angiographic procedures in interventional radiology are becoming more important and are more frequently used, especially in the treatment of several acute life-threatening diseases like stroke or aortic injury. In recent years, technical advancement has led to a broader spectrum of interventions and complex procedures with longer fluoroscopy times. This involves the risk of higher dose exposures, which, in rare cases, may cause deterministic radiation effects, e.g. erythema in patients undergoing angiographic procedures. Against this background, these procedures recently also became subject to national and international regulations regarding radiation protection. At the same time, individual risk assessment of possible stochastic radiation effects for each patient must be weighed up against the anticipated benefits of the therapy itself. Harmful effects of the administered dose are not limited to the patient but can also affect the radiologist and the medical staff. In particular, the development of cataracts in interventionalists is a rising matter of concern. Furthermore, long-term effects of repeated and prolonged x-ray exposure have long been neglected by radiologists but have come into focus in the past years. CONCLUSIONS With all this in mind, this review discusses different efforts to reduce radiation exposition levels for patients and medical staff by means of technical, personal as well as organizational measures.
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Affiliation(s)
| | - Julian Schneider
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Koblenz, Germany
| | - Carolin Brockmann
- Department of Neuroradiology, University Medical Center Mainz, Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center Mainz, Mainz, Germany
| | - Daniel Overhoff
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Koblenz, Germany
| | | | - Stephan Waldeck
- Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Koblenz, Germany
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9
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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.
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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.
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Low Dose Ionising Radiation-Induced Hormesis: Therapeutic Implications to Human Health. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11198909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The concept of radiation-induced hormesis, whereby a low dose is beneficial and a high dose is detrimental, has been gaining attention in the fields of molecular biology, environmental toxicology and radiation biology. There is a growing body of literature that recognises the importance of hormetic dose response not only in the radiation field, but also with molecular agents. However, there is continuing debate on the magnitude and mechanism of radiation hormetic dose response, which could make further contributions, as a research tool, to science and perhaps eventually to public health due to potential therapeutic benefits for society. The biological phenomena of low dose ionising radiation (LDIR) includes bystander effects, adaptive response, hypersensitivity, radioresistance and genomic instability. In this review, the beneficial and the detrimental effects of LDIR-induced hormesis are explored, together with an overview of its underlying cellular and molecular mechanisms that may potentially provide an insight to the therapeutic implications to human health in the future.
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Roser P, Birkhold A, Preuhs A, Ochs P, Stepina E, Strobel N, Kowarschik M, Fahrig R, Maier A. XDose: toward online cross-validation of experimental and computational X-ray dose estimation. Int J Comput Assist Radiol Surg 2021; 16:1-10. [PMID: 33274400 PMCID: PMC7822800 DOI: 10.1007/s11548-020-02298-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE As the spectrum of X-ray procedures has increased both for diagnostic and for interventional cases, more attention is paid to X-ray dose management. While the medical benefit to the patient outweighs the risk of radiation injuries in almost all cases, reproducible studies on organ dose values help to plan preventive measures helping both patient as well as staff. Dose studies are either carried out retrospectively, experimentally using anthropomorphic phantoms, or computationally. When performed experimentally, it is helpful to combine them with simulations validating the measurements. In this paper, we show how such a dose simulation method, carried out together with actual X-ray experiments, can be realized to obtain reliable organ dose values efficiently. METHODS A Monte Carlo simulation technique was developed combining down-sampling and super-resolution techniques for accelerated processing accompanying X-ray dose measurements. The target volume is down-sampled using the statistical mode first. The estimated dose distribution is then up-sampled using guided filtering and the high-resolution target volume as guidance image. Second, we present a comparison of dose estimates calculated with our Monte Carlo code experimentally obtained values for an anthropomorphic phantom using metal oxide semiconductor field effect transistor dosimeters. RESULTS We reconstructed high-resolution dose distributions from coarse ones (down-sampling factor 2 to 16) with error rates ranging from 1.62 % to 4.91 %. Using down-sampled target volumes further reduced the computation time by 30 % to 60 %. Comparison of measured results to simulated dose values demonstrated high agreement with an average percentage error of under [Formula: see text] for all measurement points. CONCLUSIONS Our results indicate that Monte Carlo methods can be accelerated hardware-independently and still yield reliable results. This facilitates empirical dose studies that make use of online Monte Carlo simulations to easily cross-validate dose estimates on-site.
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Affiliation(s)
- Philipp Roser
- Pattern Recognition Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, 91058, Erlangen, Germany.
- Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander Universität Erlangen-Nürnberg, 91052, Erlangen, Germany.
| | - Annette Birkhold
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Alexander Preuhs
- Pattern Recognition Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - Philipp Ochs
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Elizaveta Stepina
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Norbert Strobel
- Institute of Medical Engineering Schweinfurt, University of Applied Sciences Würzburg-Schweinfurt, 97421, Schweinfurt, Germany
| | - Markus Kowarschik
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Rebecca Fahrig
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, 91301, Forchheim, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, 91058, Erlangen, Germany
- Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander Universität Erlangen-Nürnberg, 91052, Erlangen, Germany
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12
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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.
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13
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Shin JH. Recent Radiation Reduction Strategies for Neurointerventionists. Neurointervention 2020; 15:167-170. [PMID: 33080665 PMCID: PMC7608495 DOI: 10.5469/neuroint.2020.00346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/06/2020] [Indexed: 01/10/2023] Open
Affiliation(s)
- Jae Ho Shin
- Department of Radiology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
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14
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Shin E, Lee S, Kang H, Kim J, Kim K, Youn H, Jin YW, Seo S, Youn B. Organ-Specific Effects of Low Dose Radiation Exposure: A Comprehensive Review. Front Genet 2020; 11:566244. [PMID: 33133150 PMCID: PMC7565684 DOI: 10.3389/fgene.2020.566244] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/07/2020] [Indexed: 12/16/2022] Open
Abstract
Ionizing radiation (IR) is a high-energy radiation whose biological effects depend on the irradiation doses. Low-dose radiation (LDR) is delivered during medical diagnoses or by an exposure to radioactive elements and has been linked to the occurrence of chronic diseases, such as leukemia and cardiovascular diseases. Though epidemiological research is indispensable for predicting and dealing with LDR-induced abnormalities in individuals exposed to LDR, little is known about epidemiological markers of LDR exposure. Moreover, difference in the LDR-induced molecular events in each organ has been an obstacle to a thorough investigation of the LDR effects and a validation of the experimental results in in vivo models. In this review, we summarized the recent reports on LDR-induced risk of organ-specifically arranged the alterations for a comprehensive understanding of the biological effects of LDR. We suggested that LDR basically caused the accumulation of DNA damages, controlled systemic immune systems, induced oxidative damages on peripheral organs, and even benefited the viability in some organs. Furthermore, we concluded that understanding of organ-specific responses and the biological markers involved in the responses is needed to investigate the precise biological effects of LDR.
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Affiliation(s)
- Eunguk Shin
- Department of Integrated Biological Science, Pusan National University, Busan, South Korea
| | - Sungmin Lee
- Department of Integrated Biological Science, Pusan National University, Busan, South Korea
| | - Hyunkoo Kang
- Department of Integrated Biological Science, Pusan National University, Busan, South Korea
| | - Jeongha Kim
- Department of Integrated Biological Science, Pusan National University, Busan, South Korea
| | - Kyeongmin Kim
- Department of Integrated Biological Science, Pusan National University, Busan, South Korea
| | - HyeSook Youn
- Department of Integrative Bioscience and Biotechnology, Sejong University, Seoul, South Korea
| | - Young Woo Jin
- Laboratory of Low Dose Risk Assessment, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, South Korea
| | - Songwon Seo
- Laboratory of Low Dose Risk Assessment, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, South Korea
| | - BuHyun Youn
- Department of Integrated Biological Science, Pusan National University, Busan, South Korea.,Department of Biological Sciences, Pusan National University, Busan, South Korea
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15
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Visweswaran S, Joseph S, Dhanasekaran J, Paneerselvam S, Annalakshmi O, Jose MT, Perumal V. Exposure of patients to low doses of X-radiation during neuro-interventional imaging and procedures: Dose estimation and analysis of γ-H2AX foci and gene expression in blood lymphocytes. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2020; 856-857:503237. [PMID: 32928370 DOI: 10.1016/j.mrgentox.2020.503237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/19/2022]
Abstract
Radiation has widespread applications in medicine. However, despite the benefits of medical radiation exposures, adverse long-term health effects are cause for concern. Protein and gene biomarkers are early indicators of cellular response after low-dose exposure. We examined DNA damage by quantifying γ-H2AX foci and expression of twelve candidate genes in the blood lymphocytes of patients exposed to low doses of X-radiation during neuro-interventional procedures. Entrance surface dose (ESD; 10.92-1062.55 mGy) was measured by thermoluminescence dosimetry (TLD). Absorbed dose was estimated using γ-H2AX focus frequency and gene expression, with in vitro dose-response curves generated for the same biomarkers. γ-H2AX foci in post-exposure samples were significantly higher than in pre-exposure samples. Among the genes analysed, FDXR, ATM, BCL2, MDM2, TNFSF9, and PCNA showed increased expression; CDKN1A, DDB2, SESN1, BAX, and TNFRSF10B showed unchanged or decreased expression. Absorbed dose, estimated based on γ-H2AX focus frequency and gene expression changes, did not show any correlation with measured ESD. Patients undergoing interventional procedures receive considerable radiation doses, resulting in DNA damage and altered gene expression. Medical procedures should be carried out using the lowest radiation doses possible without compromising treatment.
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Affiliation(s)
- Shangamithra Visweswaran
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - Santhosh Joseph
- Department of Neuro-Radiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - Jagadeesan Dhanasekaran
- Department of Neuro-Radiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - S Paneerselvam
- Department of Neuro-Radiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - O Annalakshmi
- Radiation Safety Division Unit, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, 603102, Tamil Nadu, India
| | - M T Jose
- Radiation Safety Division Unit, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, 603102, Tamil Nadu, India
| | - Venkatachalam Perumal
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India.
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16
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Patient dosimetry in neurointerventional procedures. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2020.108962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Fang L, Li J, Li W, Mao X, Ma Y, Hou D, Zhu W, Jia X, Qiao J. Assessment of Genomic Instability in Medical Workers Exposed to Chronic Low-Dose X-Rays in Northern China. Dose Response 2019; 17:1559325819891378. [PMID: 31819742 PMCID: PMC6883363 DOI: 10.1177/1559325819891378] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/27/2019] [Accepted: 10/29/2019] [Indexed: 01/08/2023] Open
Abstract
The increasing use of ionizing radiation (IR) in medical diagnosis and treatment
has caused considerable concern regarding the effects of occupational exposure
on human health. Despite this concern, little information is available regarding
possible effects and the mechanism behind chronic low-dose irradiation. The
present study assessed potential genomic damage in workers occupationally
exposed to low-dose X-rays. A variety of analyses were conducted, including
assessing the level of DNA damage and chromosomal aberrations (CA) as well as
cytokinesis-block micronucleus (CBMN) assay, gene expression profiling, and
antioxidant level determination. Here, we report that the level of DNA damage,
CA, and CBMN were all significantly increased. Moreover, the gene expression and
antioxidant activities were changed in the peripheral blood of men exposed to
low-dose X-rays. Collectively, our findings indicated a strong correlation
between genomic instability and duration of low-dose IR exposure. Our data also
revealed the DNA damage repair and antioxidative mechanisms which could result
in the observed genomic instability in health-care workers exposed to chronic
low-dose IR.
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Affiliation(s)
- Lianying Fang
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Jieqing Li
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Weiguo Li
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Xuesong Mao
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Ya Ma
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Dianjun Hou
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Wei Zhu
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Ximing Jia
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Jianwei Qiao
- Institute of Radiation Medicine, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
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