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

Lookup NU author(s): Dr Richard Harbron, Professor Mark PearceORCiD


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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.

Publication metadata

Author(s): Harbron R, Ainsbury EA, Bouffler SD, Tanner RJ, Eakins JS, Pearce MS

Publication type: Review

Publication status: Published

Journal: The British Journal of Radiology

Year: 2017

Volume: 90

Issue: 1079

Online publication date: 17/10/2017

Acceptance date: 07/08/2017

ISSN (print): 0007-1285

ISSN (electronic): 1748-880X


DOI: 10.1259/bjr.20170028

PubMed id: 28830201