Biological effects of low-dose radiation from computed tomography scanning

Ma, Shumei; Kong, Boyu; Liu, Bing; Liu, Xiaodong

doi:10.3109/09553002.2013.756595

Cited by 35 publications

(21 citation statements)

References 63 publications

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“…Breast cancer was also expected to be higher in HHT patients: As for any discipline in which screening and treatment modalities include exposure to ionising radiation, there are discussions about the degree to which health benefits may be offset by an increase in cancer rates [57-61]. In HHT, this is particularly true for brain, lung and breast tissues which lie within the radiation exposure fields for CT scans and angiographic studies that are essential to treat HHT cerebral and pulmonary AVMs respectively.…”

Section: Discussionmentioning

confidence: 99%

Specific cancer rates may differ in patients with hereditary haemorrhagic telangiectasia compared to controls

Hosman

Devlin

Silva

et al. 2013

Orphanet J Rare Dis

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BackgroundHereditary haemorrhagic telangiectasia (HHT) is inherited as an autosomal dominant trait, affects ~1 in 5,000, and causes multi-systemic vascular lesions and life-limiting complications. Life expectancy is surprisingly good, particularly for patients over 60ys. We hypothesised that individuals with HHT may be protected against life-limiting cancers.MethodsTo compare specific cancer rates in HHT patients and controls, we developed a questionnaire capturing data on multiple relatives per respondent, powered to detect differences in the four most common solid non skin cancers (breast, colorectal, lung and prostate), each associated with significant mortality. Blinded to cancer responses, reports of HHT-specific features allowed assignment of participants and relatives as HHT-subjects, unknowns, or controls. Logistic and quadratic regressions were used to compare rates of specific cancer types between HHT subjects and controls.Results1,307 participants completed the questionnaire including 1,007 HHT-subjects and 142 controls. The rigorous HHT diagnostic algorithm meant that 158 (12%) completed datasets were not assignable either to HHT or control status. For cancers predominantly recognised as primary cancers, the rates in the controls generally matched age-standardised rates for the general population. HHT subjects recruited through the survey had similar demographics to controls, although the HHT group reported a significantly greater smoking habit. Combining data of participants and uniquely-reported relatives resulted in an HHT-arm of 2,161 (58% female), and control-arm of 2,817 (52% female), with median ages of 66ys [IQR 53–77] and 77ys [IQR 65–82] respectively. In both crude and age-adjusted regression, lung cancers were significantly less frequent in the HHT arm than controls (age-adjusted odds ratio 0.48 [0.30, 0.70], p = 0.0012). Breast cancer prevalence was higher in HHT than controls (age-adjusted OR 1.52 [1.07, 2.14], p = 0.018). Overall, prostate and colorectal cancer rates were equivalent, but the pattern of colorectal cancer was modified, with a higher prevalence in younger HHT patients than controls.ConclusionsThese preliminary survey data suggest clinically significant differences in the rates of lung, breast and colorectal cancer in HHT patients compared to controls. For rare diseases in which longitudinal studies take decades to recruit equivalent datasets, this type of methodology provides a good first-step method for data collection.

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Section: Discussionmentioning

confidence: 99%

Specific cancer rates may differ in patients with hereditary haemorrhagic telangiectasia compared to controls

Hosman

Devlin

Silva

et al. 2013

Orphanet J Rare Dis

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“…CT scanning provides more thorough diagnostic details than X-ray but at the cost of patient exposure to a higher radiation dose, estimated at 15-30 mGy (compared with 0.01-0.15 mGy from X-ray imaging) (47). Cumulative CT-related low-dose IR has been correlated with detrimental biological effects such as DNA damage, bystander effects, tissue injury, and, in some cases, carcinogenesis (218). The biological consequences of low-dose IR have been recently reviewed (218), and illustrate that although CT is a valuable diagnostic tool, excessive exposure, especially in children, may lead to cancer and should be limited (241,263).…”

Section: Fundamentalsmentioning

confidence: 99%

Effects of Ionizing Radiation on Biological Molecules—Mechanisms of Damage and Emerging Methods of Detection

Reisz

Bansal²,

Qian³

et al. 2014

Antioxidants & Redox Signaling

650

447

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“…Radioadaptive dosing, where cells are pre-primed with a low dose, can reduce vulnerability to subsequent exposure to higher doses, also producing a neuroprotective effect. Otsuka et al [123] demonstrated that animals primed with pre-exposure to doses of 0.5 Gy gamma radiation developed increased resistance to DNA damage after subsequent exposure to a higher challenge dose of 1.6 Gy, compared to mice irradiated with the higher dose alone [123], indicative of a radioadaptive response [22], [124]. In terms of inflammation, decreases in pro-inflammatory markers in the mouse hippocampus and cortex were present only in animals primed with a 0.1 Gy dose prior to subsequent exposure to 2 Gy, suggesting that early exposure to low doses can prevent the upregulation of inflammation by higher doses [100].…”

Section: The Impact Of Low Dose Ionising Radiation On the Cnsmentioning

confidence: 99%

“…Mitochondrial redox balance and microglial responses are also critical in modulating responses to low dose irradiation, largely through the stimulation of antioxidant defences [7]. Whilst some evidence still points to a linear dose-response pattern, there is significant evidence to suggest that lower doses can confer protection to cell functioning, molecular structures, synapses, and key brain mechanisms such as neurogenesis, and induce reparative mechanisms in the face of CNS pathology [10], [22]. Based on guidelines by regulatory bodies, as well as data generated by low dose radiation research programs, a low dose is considered to be acute exposure to less than 100mSv, or 0.1 Gy [23], [24].…”

Section: Introductionmentioning

confidence: 99%

The impact of high and low dose ionising radiation on the central nervous system

et al. 2016

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Responses of the central nervous system (CNS) to stressors and injuries, such as ionising radiation, are modulated by the concomitant responses of the brains innate immune effector cells, microglia. Exposure to high doses of ionising radiation in brain tissue leads to the expression and release of biochemical mediators of ‘neuroinflammation’, such as pro-inflammatory cytokines and reactive oxygen species (ROS), leading to tissue destruction. Contrastingly, low dose ionising radiation may reduce vulnerability to subsequent exposure of ionising radiation, largely through the stimulation of adaptive responses, such as antioxidant defences. These disparate responses may be reflective of non-linear differential microglial activation at low and high doses, manifesting as an anti-inflammatory or pro-inflammatory functional state. Biomarkers of pathology in the brain, such as the mitochondrial Translocator Protein 18 kDa (TSPO), have facilitated in vivo characterisation of microglial activation and ‘neuroinflammation’ in many pathological states of the CNS, though the exact function of TSPO in these responses remains elusive. Based on the known responsiveness of TSPO expression to a wide range of noxious stimuli, we discuss TSPO as a potential biomarker of radiation-induced effects.

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Biological effects of low-dose radiation from computed tomography scanning

Cited by 35 publications

References 63 publications

Specific cancer rates may differ in patients with hereditary haemorrhagic telangiectasia compared to controls

Specific cancer rates may differ in patients with hereditary haemorrhagic telangiectasia compared to controls

Effects of Ionizing Radiation on Biological Molecules—Mechanisms of Damage and Emerging Methods of Detection

The impact of high and low dose ionising radiation on the central nervous system

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