Evidence map›Paper›PMID 27082782›Full record

Trial reportRadiology2016

Effects of Breast Shielding during Heart Imaging on DNA Double-Strand-Break Levels: A Prospective Randomized Controlled Trial.

Michael K Cheezum, Christophe E Redon, Allison S Burrell, Anthony S Kaviratne, Jody Bindeman, Daisuke Maeda, Houria Balmakhtar, Ashly Pezel, Piotr Wisniewski, Panfilo Delacruz and 3 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Radiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02617888 (The HEART BREAK Study), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02617888 nacompletednot on this map

The HEART BREAK Study: Effects of Heart Imaging Radiation on DNA Double-Stranded Breaks in Blood Lymphocytes and Hair Follicle Cells

TypeinterventionalSponsorWalter Reed National Military Medical CenterRan2011 to 2015Enrolled228ConditionsCoronary Artery Disease, Chest PainArmsCCTA ~ BREAST SHIELDS
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Michael K CheezumFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Christophe E RedonFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Allison S BurrellFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Anthony S KaviratneFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Jody BindemanFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Daisuke MaedaFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Houria BalmakhtarFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Ashly PezelFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Piotr WisniewskiFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Panfilo DelacruzFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Binh NguyenFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
William M BonnerFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Todd C VillinesFrom the Department of Medicine (Cardiology Service) (M.K.C., A.S.K., J.B., T.C.V.) and Department of Radiology (B.N.), Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889; Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Md (C.E.R., A.S.B., D.M., H.B., W.M.B.); Institute of Biomedical Sciences, The George Washington University, Washington, DC (A.S.B.); George Mason University, Fairfax, Va (H.B.); Uniformed Services University of Health Sciences, Bethesda, Md (A.P., P.W.); and Department of Medicine, San Antonio Military Medical Center, San Antonio, Tex (P.D.).
Walter Reed National Military Medical Center · USCenter for Cancer Research · USUniformed Services University of the Health Sciences · USGeorge Washington University · USSan Antonio Military Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose To examine the effect of breast shielding on blood lymphocyte deoxyribonucleic acid (DNA) double-strand-break levels resulting from in vivo radiation and ex vivo radiation at breast-tissue level, and the effect of breast shielding on image quality. Materials and Methods The study was approved by institutional review and commpliant with HIPAA guidelines. Adult women who underwent 64-section coronary computed tomographic (CT) angiography and who provided informed consent were prospectively randomized to the use (n = 50) or absence (n = 51) of bismuth breast shields. Peripheral blood samples were obtained before and 30 minutes after in vivo radiation during CT angiography to compare DNA double-strand-break levels by γ-H2AX immunofluorescence in blood lymphocytes. To estimate DNA double-strand-break induction at breast-tissue level, a blood sample was taped to the sternum for ex vivo radiation with or without shielding. Data were analyzed by linear regression and independent sample t tests. Results Breast shielding had no effect on DNA double-strand-break levels from ex vivo radiation of blood samples under shields at breast-tissue level (unadjusted regression: β = .08; P = .43 versus no shielding), or in vivo radiation of circulating lymphocytes (β = -.07; P = .50). Predictors of increased DNA double-strand-break levels included total radiation dose, increasing tube potential, and tube current (P < .05). With current radiation exposures (median, 3.4 mSv), breast shielding yielded a 33% increase in image noise and 19% decrease in the rate of excellent quality ratings. Conclusion Among women who underwent coronary CT angiography, breast shielding had no effect on DNA double-strand-break levels in blood lymphocytes exposed to in vivo radiation, or ex vivo radiation at breast-tissue level. At present relatively low radiation exposures, breast shielding contributed to an increase in image noise and a decline in image quality. The findings support efforts to minimize radiation by primarily optimizing CT settings. (©) RSNA, 2016 Clinical trial registration no. NCT02617888 Online supplemental material is available for this article.

Indexed as

Computed Tomography AngiographyCoronary AngiographyBreastDNA Breaks, Double-StrandedFemaleHeart DiseasesHumansMiddle AgedProspective StudiesRadiation DosageRadiation ProtectionRadiographic Image Interpretation, Computer-Assisted

Identifiers

PMID27082782
PMCPMC5047130
OpenAlexW2339192269

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.