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γ-H2AX foci as biomarker for patient X-ray exposure in pediatric cardiac catheterization: are we underestimating radiation risks?

Laurence Beels UGent, Klaus Bacher UGent, Daniël De Wolf UGent, Joke Werbrouck UGent and Hubert Thierens UGent (2009) Circulation. 120(19). p.1903-1909
abstract
Background—A better knowledge of patient x-ray dose and the associated radiation risk in pediatric interventional cardiology is warranted in view of the extensive use of x-rays and the higher radiosensitivity of children. In the present study, γ-H2AX foci were used as a biomarker for radiation-induced effects. Patient-specific dose was assessed and radiation risks were estimated according to the linear-no-threshold model, commonly used in radiation protection, and the γ-H2AX foci data. Methods and Results—In 49 pediatric patients (median age, 0.75 years) with congenital heart disease who underwent cardiac catheterization procedures, blood samples were taken before and shortly after the procedure. γ-H2AX foci were determined in peripheral blood T lymphocytes. In each patient, a net increase in γ-H2AX foci, representing DNA double-strand breaks induced by interventional x-rays, was observed. In addition, a patient-specific Monte Carlo simulation of the procedure was performed, resulting in individual blood, organ, and tissue doses. Plotting of γ-H2AX foci versus blood dose indicated a low-dose hypersensitivity. Median effective doses calculated according to the International Commission on Radiological Protection 60 and 103 publications are 5.6 and 6.4 mSv, respectively. The lifetime-attributable risk of cancer mortality was calculated from the linear-no-threshold model and the gamma-H2AX foci data. This resulted in lifetime-attributable risk values of 1 per thousand and 4 per thousand, respectively, for the patient population under study. Conclusions—γ-H2AX foci as a biomarker for DNA damage indicate that radiation risk estimates according to the linear-no-threshold hypothesis are possibly underestimates. Great care should be taken to minimize and optimize patient radiation exposure.
Please use this url to cite or link to this publication:
author
organization
alternative title
radiation risk in pediatric cardiac catheterization
year
type
journalArticle (original)
publication status
published
subject
keyword
catheterization, pediatrics, radiation risk
journal title
Circulation
volume
120
issue
19
pages
1903 - 1909
Web of Science type
Article
Web of Science id
000271574600009
JCR category
CARDIAC & CARDIOVASCULAR SYSTEMS
JCR impact factor
14.816 (2009)
JCR rank
1/94 (2009)
JCR quartile
1 (2009)
ISSN
0009-7322
DOI
10.1161/CIRCULATIONAHA.109.880385
language
English
UGent publication?
yes
classification
A1
id
842744
handle
http://hdl.handle.net/1854/LU-842744
date created
2010-01-27 13:44:03
date last changed
2010-01-29 15:30:33
@article{842744,
  abstract     = {Background---A better knowledge of patient x-ray dose and the associated radiation risk in pediatric interventional
cardiology is warranted in view of the extensive use of x-rays and the higher radiosensitivity of children. In the present study, \ensuremath{\gamma}-H2AX foci were used as a biomarker for radiation-induced effects. Patient-specific dose was assessed and radiation risks were estimated according to the linear-no-threshold model, commonly used in radiation protection, and the \ensuremath{\gamma}-H2AX foci data.
Methods and Results---In 49 pediatric patients (median age, 0.75 years) with congenital heart disease who underwent
cardiac catheterization procedures, blood samples were taken before and shortly after the procedure. \ensuremath{\gamma}-H2AX foci were determined in peripheral blood T lymphocytes. In each patient, a net increase in \ensuremath{\gamma}-H2AX foci, representing DNA double-strand breaks induced by interventional x-rays, was observed. In addition, a patient-specific Monte Carlo simulation of the procedure was performed, resulting in individual blood, organ, and tissue doses. Plotting of \ensuremath{\gamma}-H2AX foci versus blood dose indicated a low-dose hypersensitivity. Median effective doses calculated according to the International Commission on Radiological Protection 60 and 103 publications are 5.6 and 6.4 mSv, respectively. The lifetime-attributable risk of cancer mortality was calculated from the linear-no-threshold model and the gamma-H2AX foci data. This resulted in lifetime-attributable risk values of 1 per thousand and 4 per thousand, respectively, for the patient population under study.
Conclusions---\ensuremath{\gamma}-H2AX foci as a biomarker for DNA damage indicate that radiation risk estimates according to the linear-no-threshold hypothesis are possibly underestimates. Great care should be taken to minimize and optimize patient radiation exposure.},
  author       = {Beels, Laurence and Bacher, Klaus and De Wolf, Dani{\"e}l and Werbrouck, Joke and Thierens, Hubert},
  issn         = {0009-7322},
  journal      = {Circulation},
  keyword      = {catheterization,pediatrics,radiation risk},
  language     = {eng},
  number       = {19},
  pages        = {1903--1909},
  title        = {\ensuremath{\gamma}-H2AX foci as biomarker for patient X-ray exposure in pediatric cardiac catheterization: are we underestimating radiation risks?},
  url          = {http://dx.doi.org/10.1161/CIRCULATIONAHA.109.880385},
  volume       = {120},
  year         = {2009},
}

Chicago
Beels, Laurence, Klaus Bacher, Daniël De Wolf, Joke Werbrouck, and Hubert Thierens. 2009. “γ-H2AX Foci as Biomarker for Patient X-ray Exposure in Pediatric Cardiac Catheterization: Are We Underestimating Radiation Risks?” Circulation 120 (19): 1903–1909.
APA
Beels, L., Bacher, K., De Wolf, D., Werbrouck, J., & Thierens, H. (2009). γ-H2AX foci as biomarker for patient X-ray exposure in pediatric cardiac catheterization: are we underestimating radiation risks? Circulation, 120(19), 1903–1909.
Vancouver
1.
Beels L, Bacher K, De Wolf D, Werbrouck J, Thierens H. γ-H2AX foci as biomarker for patient X-ray exposure in pediatric cardiac catheterization: are we underestimating radiation risks? Circulation. 2009;120(19):1903–9.
MLA
Beels, Laurence, Klaus Bacher, Daniël De Wolf, et al. “γ-H2AX Foci as Biomarker for Patient X-ray Exposure in Pediatric Cardiac Catheterization: Are We Underestimating Radiation Risks?” Circulation 120.19 (2009): 1903–1909. Print.