It is simple. It is non-invasive. Yet, it is not without risk. I am referring to imaging technologies, such as X-rays and computed tomography (CT) scans, that expose bodies to radiation to “see” under the skin.

What’s the risk with radiation? Well, the radiation can alter/damage DNA. Unfortunately, damaged DNA does not lead to one developing super powers despite what the comics might say. But damaged DNA can lead to cancer (ACS, 2015). And the risk only increases with repeated rounds of radiation exposure.

It’s true that the amount of radiation exposure from a simple X-ray of an extremity (e.g., an arm) is equivalent to about 3 hours of environmental radiation exposure for the typical adult (Radiological Society of North America, 2018). However, if you are subjected to many X-rays or other imaging procedures that use way more radiation over the course of your lifetime, the added radiation exposure quickly adds up. As you might expect, this extra exposure increases your cancer risk but not your Spidey senses.

What can be done to mitigate the risk? Cutting down on the number of X-rays would help. One superhero may swoop in to do just that: Researchers are pioneering the use of a simple blood sample to figure out if bones are healing.

Current monitoring of broken bones uses highly variable metrics and lacks universal standards. Researchers from Boston University set out to determine if a standardized lab test built on blood analysis could take the place of all these other approaches (Hussein et al., 2017). Using a mouse model, the researchers collected many samples and searched for different types of biomarkers. They noted that hundreds of proteins changed dramatically during the course of the bone-healing process. Optimistically, they noted that protein measurement-based blood tests may prove especially promising in monitoring human bone repair.

In a serendipitous and almost concurrent moment, an international group of researchers led by scientists from the Shriners Hospitals for Children and the Oregon Health and Science University in Portland happened upon related findings (Coghlan et al., 2017). These researchers set out to bring order to the field of monitoring how quickly children grow, which currently yields variable results, particularly in very young children. In their search, the researchers identified that the circulating levels of the protein “noncollagenous 1 domain of type X collagen” (CXM) tracked well with growth rate (specifically, the rate of bone growth). For young patients suffering from growth disorders, having a more precise way of monitoring growth rates proves crucial to gauge appropriate response to medical treatment. As for the moment of serendipity, the researchers also noted that the levels of CXM rise during the healing of broken bones.

We will likely never be able to eliminate imaging based on X-rays: It is just too useful. We may, however, be able to reduce our need for them with improved diagnostic technologies for particular uses, like monitoring bone healing. Not only will new approaches like blood analysis inevitably reduce the amount of radiation exposure, but it could be easier on the pocket book too: Just think of how many superhero comic books could be purchased for the cost of a CT scan or a standard X-ray!

 

References

American Cancer Society (ACS) medical and editorial content team. (2015, February 24). Do x-rays and gamma rays cause cancer? Retrieved from https://www.cancer.org/cancer/cancer-causes/radiation-exposure/x-rays-gamma-rays/do-xrays-and-gamma-rays-cause-cancer.html

Coghlan, R. F., Oberdorf, J. A., Sienko, S., Aiona, M. D., Boston, B. A., Connelly, K. J., . . . Horton, W. A. (2017). A degradation fragment of type X collagen is a real-time marker for bone growth velocity. Sci Transl Med, 9(419). doi:10.1126/scitranslmed.aan4669

Hussein, A. I., Mancini, C., Lybrand, K. E., Cooke, M. E., Matheny, H. E., Hogue, B. L., . . . Gerstenfeld, L. C. (2017). Serum proteomic assessment of the progression of fracture healing. J Orthop Res. doi:10.1002/jor.23754

Radiological Society of North America, Inc. (accessed February 8, 2018) Radiation Dose in X-Ray and CT Exams. Retrieved from https://www.radiologyinfo.org/en/info.cfm?pg=safety-xray