Enhanced radiation damage caused by iodinated contrast agents during CT examination

Abstract

The iodinated contrast agent itself can lead to an increase in the level of DSBs as assessed with γH2AX foci formation, and the application of ICA can amplify DNA damage induced by diagnostic x-ray procedures such as whole abdominal CT.

DNA Damage in Blood Leukocytes of Prostate Cancer Patients Undergoing PET/CT Examinations with [68Ga]Ga-PSMA I&T

“…Many further studies used the γ-H2AX assay both ex vivo and in vivo for investigation of DNA damage in blood lymphocytes induced during CT examinations and, in particular, to investigate the effect of iodinated contrast agents [23,[29][30][31][32][33][34][35][36]. In agreement with the results of our ex vivo study, the majority of these studies report an increase of DNA damage in the contrast media-enhanced samples.…”

“…In agreement with the results of our ex vivo study, the majority of these studies report an increase of DNA damage in the contrast media-enhanced samples. Despite the findings in some of the ex vivo studies that this increase is only significant for high concentrations of the iodinated contrast agents used (up to 50 mg mL −1 ) or high radiation doses (up to 1 Gy) but not in a range that is clinically relevant for diagnostic procedures [30,34], many patient studies show that there is an 30 to 107% increase in DNA damage when contrast agents are applied compared to non-contrast enhanced examinations [31,32,[34][35][36].…”

Effect of Iodine-based Contrast Material on Radiation Dose at CT

“…The results showed that the mean percentage increase (standard deviation) in the estimated organ dose varied across organs and was 26.3%  4.3 in lungs (the largest organ of interest in the procedure) (6). A similar investigation by Wang et al (5) showed that there was a 37.9% increase in the number of foci per cell in patients undergoing iodinated contrast-enhanced CT urography compared to patients who underwent nonenhanced abdominal CT. These effects are of the same order of magnitude.…”

“…It should be acknowledged that the estimates above do not exactly quantify the same influence; the measurements of foci per cell in the studies by Piechowiak et al (4) and Wang et al (5) were obtained in peripheral blood lymphocytes and not in organ tissues. Moreover, although the number of foci per cell is a surrogate of DSBs, the link between DSBs and subsequent cancer risk is not yet well established (7).…”

Breast Cancer Recurrence after Initial Detection with Screening US

“…It should be acknowledged that the estimates above do not exactly quantify the same influence; the measurements of foci per cell in the studies by Piechowiak et al (4) and Wang et al (5) were obtained in peripheral blood lymphocytes and not in organ tissues. Moreover, although the number of foci per cell is a surrogate of DSBs, the link between DSBs and subsequent cancer risk is not yet well established (7).…”