Radiation Dose Does Matter: Mechanistic Insights into DNA Damage and Repair Support the Linear No-Threshold Model of Low-Dose Radiation Health Risks

Duncan, James R.; Lieber, Michael R.; Adachi, Noritaka; Wahl, Richard L.

doi:10.2967/jnumed.118.210252

Cited by 18 publications

(12 citation statements)

References 15 publications

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“…Finally, the U.S. government has recently reported that cancer incidence declined by about 1%/y, and cancer mortality declined by about 1.6%/y over recent years, whereas CT usage has expanded, in support of increasing early detection and decreasing cancer mortality. Duncan et al (1) repeat the words that ''a threshold requires processes that leave no cells harboring DNA mutations'' (3). Contradictorily, Duncan et al (1) then cite how DNA errors of EDSB repair can lead to inactivating tumor suppression genes through premalignant lesions.…”

Section: The Most Recent Report Of the Radiation Effects Researchmentioning

confidence: 99%

Mechanistic Insights Into Why Radiation Dose Matters? It Matters Most Because of Adaptive Responses at Low Radiation Doses

Pennington¹

2018

J Nucl Med

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Section: The Most Recent Report Of the Radiation Effects Researchmentioning

confidence: 99%

Mechanistic Insights Into Why Radiation Dose Matters? It Matters Most Because of Adaptive Responses at Low Radiation Doses

Pennington¹

2018

J Nucl Med

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“…Even though contrast-enhanced CT has become an important diagnostic tool, challenges still exist regarding exposure to ionising radiation and the use of iodinated CM. Exposure to ionising radiation is known to be carcinogenic and associated with an additional risk of cancer [4][5][6]. Thus, CT scanning must always be considered in accordance with the ALARA principle (as low as reasonably achievable) as regarding the radiation dose [4].…”

Section: Introductionmentioning

confidence: 99%

Impact of iodine concentration and scan parameters on image quality, contrast enhancement and radiation dose in thoracic CT

et al. 2020

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Background We investigated the impact of varying contrast medium (CM) densities and x-ray tube potentials on contrast enhancement (CE), image quality and radiation dose in thoracic computed tomography (CT) using two different scanning techniques. Methods Seven plastic tubes containing seven different CM densities ranging from of 0 to 600 HU were positioned inside a commercial chest phantom with padding, representing three different patient sizes. Helical scans of the phantom in single-source mode were obtained with varying tube potentials from 70 to 140 kVp. A constant volume CT dose index (CTDIvol) depending on phantom size and automatic dose modulation was tested. CE (HU) and image quality (contrast-to-noise ratio, CNR) were measured for all combinations of CM density and tube potential. A reference threshold of CE and kVp was defined as ≥ 200 HU and 120 kVp. Results For the medium-sized phantom, with a specific CE of 100–600 HU, the diagnostic CE (200 HU) at 70 kVp was ~ 90% higher than at 120 kVp, for both scan techniques (p < 0.001). Changes in CM density/specific HU together with lower kVp resulted in significantly higher CE and CNR (p < 0.001). When changing only the kVp, no statistically significant differences were observed in CE or CNR (p ≥ 0.094), using both dose modulation and constant CTDIvol. Conclusions For thoracic CT, diagnostic CE (≥ 200 HU) and maintained CNR were achieved by using lower CM density in combination with lower tube potential (< 120 kVp), independently of phantom size.

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“…While the linear no-threshold approach is endorsed by international regulatory documents such as the 2005 National Academy of Sciences Biologic Effects of Ionizing Radiation (BEIR) VII report as a reasonable approach for public policy purposes, its validity continues to be hotly debated. [6][7][8] The uncertainties related to the LNT theory are an important part of the discussion of this issue and were not included in the JACC review.…”

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Striking a balance in the discussion of the benefits of imaging tests and risks of radiation exposure

Thompson

2019

Journal of Nuclear Cardiology

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Diagnostic testing from ionizing radiation is an integral part of the practice of medicine. The therapeutic advances and substantial improvement in the care of patients with cardiovascular diseases would not be possible without the concomitant advances in cardiovascular imaging that have occurred. Indeed, the testing that we perform can be lifesaving, although indirectly. This point is sometimes forgotten in the consideration of risks and benefits. In the case of heart disease, there has been a dramatic improvement in patient outcome. 1 It is hard to imagine that this would have occurred without accurate diagnostic testing. Recently, a comprehensive review of the subject of the optimal use of ionizing radiation in cardiovascular imaging was published in the Journal of the American College of Cardiology. 2 There is superb content in this paper and the authors should be applauded for bringing together so much information on this complicated subject. The review serves as an effective educational tool for radiation terminology, the principals of best practice, and the various potential dangers of ionizing radiation. The American Society of Nuclear Cardiology (ASNC) was invited to be a signatory to this publication. However, the ASNC Executive Council, Board of Directors, and Quality Committee voted to refrain from endorsing the document, for 3 reasons.

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Radiation Dose Does Matter: Mechanistic Insights into DNA Damage and Repair Support the Linear No-Threshold Model of Low-Dose Radiation Health Risks

Abstract: http://jnm.snmjournals.org/content/59/7/1014 This article and updated information are available at: http://jnm.snmjournals.org/site/subscriptions/online.xhtml Information about subscriptions to JNM can be found at: http://jnm.snmjournals.org/site/misc/permission.xhtml

Cited by 18 publications

References 15 publications

Mechanistic Insights Into Why Radiation Dose Matters? It Matters Most Because of Adaptive Responses at Low Radiation Doses

Mechanistic Insights Into Why Radiation Dose Matters? It Matters Most Because of Adaptive Responses at Low Radiation Doses

Impact of iodine concentration and scan parameters on image quality, contrast enhancement and radiation dose in thoracic CT

Striking a balance in the discussion of the benefits of imaging tests and risks of radiation exposure

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