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γ-H2AX foci as in vivo effect biomarker in children emphasize the importance to minimize x-ray doses in paediatric CT imaging

(2015) EUROPEAN RADIOLOGY. 25(3). p.800-811
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Abstract
Objectives: Investigation of DNA damage induced by CT x-rays in paediatric patients versus patient dose in a multicentre setting. Methods: From 51 paediatric patients (median age, 3.8 years) who underwent an abdomen or chest CT examination in one of the five participating radiology departments, blood samples were taken before and shortly after the examination. DNA damage was estimated by scoring gamma-H2AX foci in peripheral blood T lymphocytes. Patient-specific organ and tissue doses were calculated with a validated Monte Carlo program. Individual lifetime attributable risks (LAR) for cancer incidence and mortality were estimated according to the BEIR VII risk models. Results: Despite the low CT doses, a median increase of 0.13 gamma-H2AX foci/cell was observed. Plotting the induced gamma-H2AX foci versus blood dose indicated a low-dose hypersensitivity, supported also by an in vitro dose-response study. Differences in dose levels between radiology centres were reflected in differences in DNA damage. LAR of cancer mortality for the paediatric chest CT and abdomen CT cohort was 0.08 and 0.13% respectively. Conclusion: CT x-rays induce DNA damage in paediatric patients even at low doses and the level of DNA damage is reduced by application of more effective CT dose reduction techniques and paediatric protocols.
Keywords
Double-strand DNA breaks, X-ray computed tomography, Radiobiology, gammaH2AX protein, Paediatrics, DOUBLE-STRAND BREAKS, RADIATION-EXPOSURE, COMPUTED-TOMOGRAPHY, IONIZING-RADIATION, BLOOD-LYMPHOCYTES, WHOLE-BLOOD, CANCER, REPAIR, REDUCTION, PROTOCOLS

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Chicago
Vandevoorde, Charlot, Caro Franck, Klaus Bacher, Luc Breysem, Maria Helena Smet, Adelard De Backer, Kris Van De Moortele, Peter Smeets, and Hubert Thierens. 2015. “γ-H2AX Foci as in Vivo Effect Biomarker in Children Emphasize the Importance to Minimize X-ray Doses in Paediatric CT Imaging.” European Radiology 25 (3): 800–811.
APA
Vandevoorde, C., Franck, C., Bacher, K., Breysem, L., Smet, M. H., De Backer, A., Van De Moortele, K., et al. (2015). γ-H2AX foci as in vivo effect biomarker in children emphasize the importance to minimize x-ray doses in paediatric CT imaging. EUROPEAN RADIOLOGY, 25(3), 800–811.
Vancouver
1.
Vandevoorde C, Franck C, Bacher K, Breysem L, Smet MH, De Backer A, et al. γ-H2AX foci as in vivo effect biomarker in children emphasize the importance to minimize x-ray doses in paediatric CT imaging. EUROPEAN RADIOLOGY. 2015;25(3):800–11.
MLA
Vandevoorde, Charlot, Caro Franck, Klaus Bacher, et al. “γ-H2AX Foci as in Vivo Effect Biomarker in Children Emphasize the Importance to Minimize X-ray Doses in Paediatric CT Imaging.” EUROPEAN RADIOLOGY 25.3 (2015): 800–811. Print.
@article{5919101,
  abstract     = {Objectives: Investigation of DNA damage induced by CT x-rays in paediatric patients versus patient dose in a multicentre setting. 
Methods: From 51 paediatric patients (median age, 3.8 years) who underwent an abdomen or chest CT examination in one of the five participating radiology departments, blood samples were taken before and shortly after the examination. DNA damage was estimated by scoring gamma-H2AX foci in peripheral blood T lymphocytes. Patient-specific organ and tissue doses were calculated with a validated Monte Carlo program. Individual lifetime attributable risks (LAR) for cancer incidence and mortality were estimated according to the BEIR VII risk models. 
Results: Despite the low CT doses, a median increase of 0.13 gamma-H2AX foci/cell was observed. Plotting the induced gamma-H2AX foci versus blood dose indicated a low-dose hypersensitivity, supported also by an in vitro dose-response study. Differences in dose levels between radiology centres were reflected in differences in DNA damage. LAR of cancer mortality for the paediatric chest CT and abdomen CT cohort was 0.08 and 0.13\% respectively. 
Conclusion: CT x-rays induce DNA damage in paediatric patients even at low doses and the level of DNA damage is reduced by application of more effective CT dose reduction techniques and paediatric protocols.},
  author       = {Vandevoorde, Charlot and Franck, Caro and Bacher, Klaus and Breysem, Luc and Smet, Maria Helena and De Backer, Adelard and Van De Moortele, Kris and Smeets, Peter and Thierens, Hubert},
  issn         = {0938-7994},
  journal      = {EUROPEAN RADIOLOGY},
  keyword      = {Double-strand DNA breaks,X-ray computed tomography,Radiobiology,gammaH2AX protein,Paediatrics,DOUBLE-STRAND BREAKS,RADIATION-EXPOSURE,COMPUTED-TOMOGRAPHY,IONIZING-RADIATION,BLOOD-LYMPHOCYTES,WHOLE-BLOOD,CANCER,REPAIR,REDUCTION,PROTOCOLS},
  language     = {eng},
  number       = {3},
  pages        = {800--811},
  title        = {\ensuremath{\gamma}-H2AX foci as in vivo effect biomarker in children emphasize the importance to minimize x-ray doses in paediatric CT imaging},
  url          = {http://dx.doi.org/10.1007/s00330-014-3463-8},
  volume       = {25},
  year         = {2015},
}

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