Siegfried A. Schwab, Presenter: Nothing to Disclose

Michael Andreas Kuefner, Abstract Co-Author: Nothing to Disclose

Susanne Brunner, Abstract Co-Author: Nothing to Disclose

Christoph D Garlichs, Abstract Co-Author: Nothing to Disclose

Markus Loebrich, Abstract Co-Author: Nothing to Disclose

Michael Uder MD, Abstract Co-Author: Speakers Bureau, Bracco Group Speakers Bureau, Bayer AG Research Consultant, Insight Agent Research Consultant, General Electric Company Research grant, Siemens AG Research grant, Koninklijke Philips Electronics NV

During coronary angiography patients are exposed to rather high X-ray doses. Furthermore interventional cardiologists are exposed to scattered radiation. Physical dose parameters can determine exposition, but do not adequately evaluate dose deposition in the patient. DNA double-strand breaks (DSBs) are among the most significant genetic lesions introduced by ionizing radiation. The aim of this study was to adapt a novel method for determination of DSBs in patients undergoing coronary angiography and to determine biological dose in patients and interventional cardiologists.

Blood samples were taken from 42 patients undergoing coronary angiography before and after the examinations. Furthermore samples were taken and from 3 interventional cardiologists during a normal working day. DSBs in blood lymphocytes were visualized using immunofluorescence microscopy after staining against the phosphorylated histone variant gamma-H2AX. Radiation dose to the blood was estimated by relating in-vivo number of DSBs to those of individual in-vitro irradiated samples (50 mGy).

Dose area product (DAP) ranged from 707 to 12448 µGy*m². Fluoroscopy time and total examination time was 1.3 to 14.4 and 6 to 57 minutes respectively. In all patients, an irradiation induced increase of DSBs was detected. Number of DSBs at the end of fluoroscopy ranged from 0.04 to 1.08 per cell, thereafter a rapid loss of foci was observed. Radiation dose to the blood ranged from 23.4 to 56.4 mGy. A good correlation between DSBs and DAP at similar examination durations was seen (r=0.59-0.99). In cardiologists, no significant increase of DSBs during a working day was found.

Gamma-H2AX immunofluorescence microscopy is suitable for biological dose estimation in coronary angiography. The damage levels in patients are dependent on the dose deposed, the examination duration, and the fractionation of the x-ray exposure. After a working day in interventional cardiologists no biological X-ray effects due to scattered irradiation could be detected.

Gamma-H2AX immunofluorescence microscopy enables to assess the biological effects of ionizing radiation in patients undergoing coronary angiography.

Schwab, S, Kuefner, M, Brunner, S, Garlichs, C, Loebrich, M, Uder, M, Determination of X-ray Induced DNA Double Strand Breaks in Patients and Interventional Cardiologists after Coronary Angiography.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012370.html