PMID- 34564862
OWN - NLM
STAT- MEDLINE
DCOM- 20211117
LR  - 20220731
IS  - 2473-4209 (Electronic)
IS  - 0094-2405 (Print)
IS  - 0094-2405 (Linking)
VI  - 48
IP  - 11
DP  - 2021 Nov
TI  - Potential increase in radiation-induced DNA double-strand breaks with higher 
      doses of iodine contrast during coronary CT angiography.
PG  - 7526-7533
LID - 10.1002/mp.15253 [doi]
AB  - PURPOSE: To investigate the contrast media iodine dose dependency of 
      radiation-induced DNA double-strand breaks (DSBs) during a coronary computed 
      tomography angiography (CCTA) scan. METHODS: This prospective patient study was 
      approved by the ethical committee. Between November 2018 and July 2019, 50 
      patients (31 males and 19 females, mean age 64 years) were included in the study, 
      45 CCTA and five noncontrast-enhanced (NCE) cardiac computed tomography (CT) 
      patients. A single-heartbeat scan protocol with a patient-tailored contrast media 
      injection protocol was used, administering a patient-specific iodine dose. DNA 
      double-strand breaks were quantified using a gammaH2AX foci assay on peripheral blood 
      lymphocytes. The net amount of gammaH2AX/cell was normalized to the individual 
      patient CT dose by the size-specific dose estimate (SSDE). Correlation between 
      the administered and blood-iodine dose and the SSDE normalized amount of DNA DSBs 
      was investigated using a Pearson correlation test. RESULTS: CCTA patients were 
      scanned with a mean CTDI(vol) of 10.6 +/- 5.6 mGy, corresponding to a mean SSDE of 
      11.3 +/- 5.3 mGy while the NCE cardiac CT patients were scanned with a mean 
      CTDI(vol) of 6.00 +/- 1.8 mGy, corresponding to a mean SSDE of 6.6 +/- 2.7 mGy. The 
      administered iodine dose ranged from 16.5 to 34.0 gI in the CCTA patients, 
      resulting in a blood-iodine dose range from 5.1 to 15.0 gI in the exposed blood 
      volume. A significant linear relationship (r = 0.79, p-value < 0.001) was 
      observed between the blood iodine dose and SSDE normalized radiation-induced DNA 
      DSBs. A similar significant linear relationship (r = 0.62, p-value < 0.001) was 
      observed between the administered iodine dose and SSDE normalized 
      radiation-induced DNA DSBs. CONCLUSIONS: This study shows that contrast media 
      iodine dose increases the level of radiation-induced DNA DSBs in peripheral blood 
      lymphocytes in a linear dose-dependent manner with CCTA. Importantly, the level 
      of DNA DSBs can be reduced by lowering the administered iodine dose.
CI  - (c) 2021 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf 
      of American Association of Physicists in Medicine.
FAU - Van Cauteren, Toon
AU  - Van Cauteren T
AD  - Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
FAU - Tanaka, Kaoru
AU  - Tanaka K
AD  - Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
FAU - Belsack, Dries
AU  - Belsack D
AD  - Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
FAU - Van Gompel, Gert
AU  - Van Gompel G
AD  - Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
FAU - Kersemans, Veerle
AU  - Kersemans V
AD  - Department of Oncology, CRUK/MRC Institute for Radiation Oncology, University of 
      Oxford, Oxford, UK.
FAU - Jochmans, Kristin
AU  - Jochmans K
AD  - Department of Hematology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
FAU - Droogmans, Steven
AU  - Droogmans S
AD  - Department of Cardiology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
FAU - de Mey, Johan
AU  - de Mey J
AD  - Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
FAU - Buls, Nico
AU  - Buls N
AD  - Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair 
      Ziekenhuis Brussels (UZB), Brussels, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20211013
PL  - United States
TA  - Med Phys
JT  - Medical physics
JID - 0425746
RN  - 0 (Contrast Media)
RN  - 9007-49-2 (DNA)
RN  - 9679TC07X4 (Iodine)
SB  - IM
MH  - Computed Tomography Angiography
MH  - Contrast Media
MH  - Coronary Angiography
MH  - DNA
MH  - *DNA Breaks, Double-Stranded
MH  - Female
MH  - Humans
MH  - *Iodine
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Radiation Dosage
PMC - PMC9293077
OTO - NOTNLM
OT  - DNA double-strand breaks
OT  - computed tomography angiography
OT  - contrast media
OT  - patient safety
COIS- The authors declare that there is no conflict of interest regarding the 
      publication of this article. None of the authors has a relationship with 
      industry.
EDAT- 2021/09/27 06:00
MHDA- 2021/11/18 06:00
PMCR- 2022/07/18
CRDT- 2021/09/26 21:13
PHST- 2021/06/25 00:00 [revised]
PHST- 2021/02/04 00:00 [received]
PHST- 2021/09/14 00:00 [accepted]
PHST- 2021/09/27 06:00 [pubmed]
PHST- 2021/11/18 06:00 [medline]
PHST- 2021/09/26 21:13 [entrez]
PHST- 2022/07/18 00:00 [pmc-release]
AID - MP15253 [pii]
AID - 10.1002/mp.15253 [doi]
PST - ppublish
SO  - Med Phys. 2021 Nov;48(11):7526-7533. doi: 10.1002/mp.15253. Epub 2021 Oct 13.