Intravenous Iodinated Contrast Agents Amplify DNA Radiation Damage at CT

Piechowiak, Eike Immo; Peter, Jan-Friedrich W.; Kleb, Beate; Klose, K. J.; Heverhagen, Johannes T.

doi:10.1148/radiol.14132478

Cited by 92 publications

(95 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the demonstration of LRV variations, renal venograms (25), contrast-enhanced CT (23,26,27), color Doppler US (24,28), magnetic resonance angiography (MRA) (29), and [ since it is relatively less costly, fast, easily applicable, and reliable in terms of patient compliance (31,32). However, CT has long-term risks of ionizing radiation and patients are exposed to a significant amount of iodinated intravenous contrast medium, which has potential side effects (33). Using PACS, the frequency of IVC variations and LRV variations can reliably be studied retrospectively by reevaluating the contrast-enhanced spiral abdominal CT images of the patients who readily underwent CT examination due to various abdominal problems (34).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of renal anomalies, inferior vena cava variations, and left renalvein variations by lumbar magnetic resonance imaging in 3000 patients

Dilli¹,

Ayaz²,

Karacan³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Evaluation of renal anomalies, inferior vena cava variations, and left renalvein variations by lumbar magnetic resonance imaging in 3000 patients

Dilli¹,

Ayaz²,

Karacan³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

“…However, these experiments were conducted with a very small group of subjects (n = 3), and the baseline values were higher by a factor of about 10 than otherwise published, so that the reliability of these results is uncertain in our opinion [14]. On the other hand, a current publication has confirmed an increase in DNA damage in a cohort of patients that have undergone chest CT [22]. …”

mentioning

confidence: 88%

Radiation Induced DNA Double-Strand Breaks in Radiology

Kuefner

Brand

Engert

et al. 2015

Fortschr Röntgenstr

View full text Add to dashboard Cite

Background !Shortly after the discovery of X-ray radiation, its detrimental effect on biological tissue was observed. The increasing number of X-raybased examinations in recent decades has reAbstract ! Shortly after the discovery of X-rays, their damaging effect on biological tissues was observed. The determination of radiation exposure in diagnostic and interventional radiology is usually based on physical measurements or mathematical algorithms with standardized dose simulations. γ-H2AX immunofluorescence microscopy is a reliable and sensitive method for the quantification of radiation induced DNA double-strand breaks (DSB) in blood lymphocytes. The detectable amount of these DNA damages correlates well with the dose received. However, the biological radiation damage depends not only on dose but also on other individual factors like radiation sensitivity and DNA repair capacity. Iodinated contrast agents can enhance the x-ray induced DNA damage level. After their induction DSB are quickly repaired. A protective effect of antioxidants has been postulated in experimental studies. This review explains the prinicple of the γ-H2AX technique and provides an overview on studies evaluating DSB in radiologic examinations. Key Points:▶ Radiologic examinations including CT and angiography induce DNA double-strand breaks. Even after mammography a slight but significant increase is detectable in peripheral blood lymphocytes.▶ The number of radiation induced doublestrand breaks correlates well with the radiation dose.▶ Individual factors including radiation sensitivity, DNA repair capacity and the application of iodinated contrast media has an influence on the DNA damage level. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.sulted in the heightened importance of radiation dosage and protection as clinical topics [1, 2]. Determination of dose exposure in diagnostic and interventional radiology is carried out primarily using physical methods based on standardized phantoms or relying on mathematical dosage simulations. Such estimates can determine the exposure quite well, but supply no information regarding the interaction of radiation in the patient's body. Nowadays there are indications that biological radiation damage is not solely dependent on the applied dosage, but is also related to additional individual factors that cannot be sufficiently determined using established dosimetric methods. Earlier approaches to biological dosimetry were not sensitive enough for the dosage range used in radiology [3]. Double-stand breaks (DSB) are considered the most relevant radiation-induced damage to deoxyribonucleic acid (DNA) [4]. Although such breakage is quickly repaired, defective repairs can result in mutations, causing carcinogenesis [5, 6]. An immunofluorescence microscopic approach, which is much more sensitive than previous biological processes, allows the determination of individual DNA DSB in peripheral blood lymphocytes, thus allowing an accurate estimation of the biolog...

show abstract

“…In practice, the contrast agents can be present in other blood vessels, which would greatly increase the radiation dose. 56 Recent findings 57,58 show that the additional secondary electrons produced when x-rays are absorbed by the contrast agents would lead to DNA damage. To investigate the effect of the dose increase on the spectrum optimization, we calculated the FOMs based on the assumption that the contrast agents are homogeneously distributed over the whole brain tissue in the head phantom.…”

Section: Discussionmentioning

confidence: 99%

Optimization of beam quality for photon-counting spectral computed tomography in head imaging: simulation study

et al. 2015

View full text Add to dashboard Cite

Abstract. Head computed tomography (CT) plays an important role in the comprehensive evaluation of acute stroke. Photon-counting spectral detectors, as promising candidates for use in the next generation of x-ray CT systems, allow for assigning more weight to low-energy x-rays that generally contain more contrast information. Most importantly, the spectral information can be utilized to decompose the original set of energy-selective images into several basis function images that are inherently free of beam-hardening artifacts, a potential advantage for further improving the diagnosis accuracy. We are developing a photon-counting spectral detector for CT applications. The purpose of this work is to determine the optimal beam quality for material decomposition in two head imaging cases: nonenhanced imaging and K-edge imaging. A cylindrical brain tissue of 16-cm diameter, coated by a 6-mm-thick bone layer and 2-mm-thick skin layer, was used as a head phantom. The imaging target was a 5-mm-thick blood vessel centered in the head phantom. In K-edge imaging, two contrast agents, iodine and gadolinium, with the same concentration (5 mg∕mL) were studied. Three parameters that affect beam quality were evaluated: kVp settings (50 to 130 kVp), filter materials (Z ¼ 13 to 83), and filter thicknesses [0 to 2 half-value layer (HVL)]. The image qualities resulting from the varying x-ray beams were compared in terms of two figures of merit (FOMs): squared signal-difference-to-noise ratio normalized by brain dose (SDNR 2 ∕BD) and that normalized by skin dose (SDNR 2 ∕SD). For nonenhanced imaging, the results show that the use of the 120-kVp spectrum filtered by 2 HVL copper (Z ¼ 29) provides the best performance in both FOMs. When iodine is used in K-edge imaging, the optimal filter is 2 HVL iodine (Z ¼ 53) and the optimal kVps are 60 kVp in terms of SDNR 2 ∕BD and 75 kVp in terms of SDNR 2 ∕SD. A tradeoff of 65 kVp was proposed to lower the potential risk of skin injuries if a relatively long exposure time is necessarily performed in the iodinated imaging. In the case of gadolinium imaging, both SD and BD can be minimized at 120 kVp filtered with 2 HVL thulium (Z ¼ 69). The results also indicate that with the same concentration and their respective optimal spectrum, the values of SDNR 2 ∕BD and SDNR 2 ∕SD in gadolinium imaging are, respectively, around 3 and 10 times larger than those in iodine imaging. However, since gadolinium is used in much lower concentrations than iodine in the clinic, iodine may be a preferable candidate for K-edge imaging.

show abstract

Intravenous Iodinated Contrast Agents Amplify DNA Radiation Damage at CT

Abstract: The application of iodinated contrast agents during diagnostic x-ray procedures, such as chest CT, leads to a clear increase in the level of radiation-induced DNA damage as assessed with γH2AX foci formation.

Cited by 92 publications

References 31 publications

Evaluation of renal anomalies, inferior vena cava variations, and left renalvein variations by lumbar magnetic resonance imaging in 3000 patients

Evaluation of renal anomalies, inferior vena cava variations, and left renalvein variations by lumbar magnetic resonance imaging in 3000 patients

Radiation Induced DNA Double-Strand Breaks in Radiology

Optimization of beam quality for photon-counting spectral computed tomography in head imaging: simulation study

Contact Info

Product

Resources

About