Enhanced radiation dose and DNA damage associated with iodinated contrast media in diagnostic X-ray imaging

Richard Harbron*, Elizabeth Ainsbury, Simon Bouffler, Richard Tanner, Jonathan Eakins, Mark S. Pearce

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

12 Citations (Scopus)

Abstract

A review was undertaken of studies reporting increased DNA damage in circulating blood cells and increased organ doses, for X-ray exposures enhanced by iodinated contrast media (ICM), compared to unenhanced imaging. This effect may be due to ICM molecules acting as a source of secondary radiation (Auger/photoelectrons, fluorescence X-rays) following absorption of primary X-ray photons. It is unclear if the reported increase in DNA damage to blood cells necessarily implies an increased risk of developing cancer. Upon ICM-enhancement, the attenuation properties of blood differ substantially from surrounding tissues. Increased energy deposition is likely to occur within very close proximity to ICM molecules (within a few tens of micrometres). Consequently, in many situations, damage and dose enhancement may be restricted to the blood and vessel wall only. Increased cancer risks may be possible, in cases where ICM molecules are given sufficient time to reach the capillary network and interstitial fluid at the time of exposure. In all situations, the extrapolation of blood cell damage to other tissues requires caution where contrast media are involved. Future research is needed to determine the impact of ICM on dose to cells outside the blood itself and vessel walls, and to determine the concentration of ICM in blood vessels and interstitial fluid at the time of exposure.

Original languageEnglish
Article number20170028
JournalBritish Journal of Radiology
Volume90
Issue number1079
DOIs
Publication statusPublished - 2017

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