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, 34 (30), 2340-5

Impact of Cardiac Magnetic Resonance Imaging on Human Lymphocyte DNA Integrity

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Impact of Cardiac Magnetic Resonance Imaging on Human Lymphocyte DNA Integrity

Michael Fiechter et al. Eur Heart J.

Abstract

Aims: Magnetic resonance (MR) imaging is widely used for diagnostic imaging in medicine as it is considered a safe alternative to ionizing radiation-based techniques. Recent reports on potential genotoxic effects of strong and fast switching electromagnetic gradients such as used in cardiac MR (CMR) have raised safety concerns. The aim of this study was to analyse DNA double-strand breaks (DSBs) in human blood lymphocytes before and after CMR examination.

Methods and results: In 20 prospectively enrolled patients, peripheral venous blood was drawn before and after 1.5 T CMR scanning. After density gradient cell separation of blood samples, DNA DSBs in lymphocytes were quantified using immunofluorescence microscopy and flow cytometric analysis. Wilcoxon signed-rank testing was used for statistical analysis. Immunofluorescence microscopic and flow cytometric analysis revealed a significant increase in median numbers of DNA DSBs in lymphocytes induced by routine 1.5 T CMR examination.

Conclusion: The present findings indicate that CMR should be used with caution and that similar restrictions may apply as for X-ray-based and nuclear imaging techniques in order to avoid unnecessary damage of DNA integrity with potential carcinogenic effect.

Keywords: Cardiac MRI; DNA damage; Flow cytometry; Immunofluorescence microscopy; γ-H2AX.

Figures

Figure 1
Figure 1
Visualization of double-strand breaks (DSBs) in nuclei (arrow heads) of human lymphocytes of two patients before and after cardiac magnetic resonance scans by immunofluorescence microscopy. DSBs (foci, white arrows) are detected by γ-H2AX staining (green).
Figure 2
Figure 2
Amount of double-strand breaks before and after cardiac magnetic resonance (CMR) scan by immunofluorescence microscopy. After CMR scanning, there was a significant increase (*P < 0.05) in γ-H2AX foci per lymphocyte by immunofluorescence microscopy. Bars indicate median values with median absolute deviation (left panel) and individual values are interconnected with a line (right panel).
Figure 3
Figure 3
Flow cytometric analysis of double-strand breaks (γ-H2AXpositive T-lymphocytes) before and after cardiac magnetic resonance (CMR) scan. T-lymphocytes were readily identified by representative dot plots and histograms (lymphocytes, DAPI, and CD3). The shift of the left curve (red, before CMR) to the right curve (blue, after CMR) in the presented overlay indicates an increase in double-strand breaks (γ-H2AXpositive T-lymphocytes). SSC-A: side scatter channel area. FSC-A: forward scatter channel area. DAPI: 4′,6-diamidino-2-phenylindole, counterstaining cell nuclei. CD3: mouse-anti-human CD3-APC antibody counterstaining specifically the T-lymphocytes.
Figure 4
Figure 4
Amount of double-strand breaks before and after cardiac magnetic resonance scan by flow cytometry of γ-H2AXpositive T-lymphocytes using geometric mean fluorescence intensity (MFI). The median MFI increased significantly after cardiac magnetic resonance scanning (*P < 0.005, left panel). Individual values are interconnected with a line (right panel).

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