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[Supplementary Information] Increase in dicentric chromosome formation after a single CT scan in adults Yu Abe 1, Tomisato Miura 2, Mitsuaki A Yoshida 3, Risa Ujiie 1, Yumiko Kurosu 1, Nagisa Kato 1, Atsushi Katafuchi 1, Naohiro Tsuyama 1, Takashi Ohba 4, Tomoko Inamasu 4, Fumio Shishido 5, Hideyoshi Noji 6, Kazuei Ogawa 6, Hiroshi Yokouchi 7, Kenya Kanazawa 7, Takashi Ishida 7, Satoshi Muto 8, Jun Ohsugi 8, Hiroyuki Suzuki 8, Tetsuo Ishikawa 9, 11, Kenji Kamiya 10, 11 1, 11*, Akira Sakai 1 Dept. of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan 2 Dept. of Pathologic Analysis, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan 3 Dept. of Radiation Biology, Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan 4 Dept. of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan 5 Dept. of Radiology, Fukushima Medical University School of Medicine, Fukushima, Japan 6 Dept. of Cardiology & Hematology, Fukushima Medical University School of Medicine, Fukushima, Japan 7 Dept. of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan 8 Dept. of Regenerative Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan 9 Dept. of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, Fukushima, Japan 10 Dept. of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan 11 Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan *Correspondence: Akira Sakai, M.D., Ph.D. Dept. of Radiation Life Sciences Fukushima Medical University School of Medicine 1 Hikarigaoka, Fukushima, 960-1295 Japan TEL: +81-24-547-1703 FAX: +81-24-547-1704 E-mail: sakira@fmu.ac.jp

Table S1a. Analysis of DIC formation before and after the CT scan (Giemsa staining, 2,000 metaphases) Patient No. Timing of cells scored of DICs formed of cells with aberrations # DICs/cell of DIC formation DIC distribution 0 1 2 3 4 5 Before CT 2000 5 20 0.003 1995 5 0 0 0 0 1 3 / 2000 After CT 2000 8 20 0.004 1993 6 1 0 0 0 Before CT 2000 5 27 0.003 1995 5 0 0 0 0 2 4 / 2000 After CT 2000 9 25 0.005 1991 9 0 0 1 rogue cell 0 Before CT 2000 9 38 0.005 1991 9 0 0 0 2 rogue cells 3 3 / 2000 After CT 2000 12 22 0.006 1989 10 1 0 1 rogue cell 0 Before CT 2000 5 17 0.003 1995 5 0 0 0 0 4 2 / 2000 After CT 2000 7 18 0.004 1993 7 0 0 0 0 Before CT 2000 0 6 0.000 2000 0 0 0 0 0 5 4 / 2000 After CT 2000 4 24 0.002 1996 4 0 0 0 0 Before CT 2000 3 17 0.002 1997 3 0 0 0 0 6 7 / 2000 After CT 2000 10 32 0.005 1990 10 0 0 0 0 Before CT 2000 15 37 0.008 1985 15 0 0 1 rogue cell 0 7 2 / 2000 After CT 2000 17 51 0.009 1983 17 0 0 0 0 Before CT 2000 12 56 0.006 1988 12 0 0 0 0 8 2 / 2000 After CT 2000 14 56 0.007 1986 14 0 0 0 0 Before CT 2000 4 23 0.002 1997 2 1 0 0 0 9 6 / 2000 After CT 2000 10 29 0.005 1990 10 0 0 0 0 Before CT 2000 1 7 0.001 1999 1 0 0 0 0 10 0 / 2000 After CT 2000 1 7 0.001 1999 1 0 0 0 0 # Chromosomal aberrrations including dicentric, tricentric, centric ring, acentric ring, minute, and marker chromosome and fragment

Table S1b. Analysis of DIC formation before and after the CT scan (Centromere-FISH, 2,000 metaphases) Patient No. Timing of cells scored of DICs formed of cells with aberrations # DICs/cell of DIC formation DIC distribution 0 1 2 3 4 5 Before CT 2000 2 15 0.001 1998 2 0 0 0 0 1 3 / 2000 After CT 2000 5 27 0.003 1995 5 0 0 0 0 Before CT 2000 3 14 0.002 1997 3 0 0 0 0 2 2 / 2000 After CT 2000 5 16 0.003 1995 5 0 0 0 0 Before CT 2000 5 24 0.003 1995 5 0 0 0 0 3 4 / 2000 After CT 2000 9 36 0.005 1991 9 0 0 0 0 Before CT 2000 3 32 0.002 1997 3 0 0 0 0 4 1 / 2000 After CT 2000 4 20 0.002 1996 4 0 0 0 0 Before CT 2000 3 26 0.002 1997 3 0 0 0 0 5 3 / 2000 After CT 2000 6 24 0.003 1994 6 0 0 0 0 Before CT 2000 2 10 0.001 1998 2 0 0 0 0 6 6 / 2000 After CT 2000 8 26 0.004 1992 8 0 0 0 0 Before CT 2000 11 29 0.006 1989 11 0 0 0 0 7 4 / 2000 After CT 2000 15 42 0.008 1985 15 0 0 0 0 Before CT 2000 13 51 0.007 1987 13 0 0 0 0 8 1 / 2000 After CT 2000 14 52 0.007 1986 14 0 0 0 0 Before CT 2000 2 12 0.001 1998 2 0 0 0 0 9 6 / 2000 After CT 2000 8 25 0.004 1992 8 0 0 0 0 Before CT 2000 0 4 0.000 2000 0 0 0 0 0 10 1 / 2000 After CT 2000 1 7 0.001 1999 1 0 0 0 0 # Chromosomal aberrrations including dicentric, tricentric, centric ring, acentric ring, minute, and marker chromosome and fragment

Table S2a. Analysis of DIC formation (Giemsa staining, 1,000 metaphases) Patient No. DICs formed/metaphase Before CT After CT of DIC formation 1 3 5 2/1000 2 5 5 0/1000 3 7 11 4/1000 4 4 4 0/1000 5 0 2 2/1000 6 2 4 2/1000 7 9 11 2/1000 8 5 9 4/1000 9 2 5 3/1000 10 1 0-1/1000 Table S2b. Analysis of DIC formation (Centromere-FISH, 1,000 metaphases) Patient No. DICs formed/metaphase Before CT After CT of DIC formation 1 2 2 0/1000 2 1 2 1/1000 3 2 5 3/1000 4 2 2 0/1000 5 2 2 0/1000 6 1 5 4/1000 7 5 7 2/1000 8 7 8 1/1000 9 1 4 3/1000 10 0 1 1/1000

(a) (b) of DIC formation 8 6 4 2 0 y = 6E-05x + 3.1465 R² = 0.002 0 2000 4000 6000 of DIC formation 8 6 4 2 0 y = 0.0002x + 2.667 R² = 0.0204 0 2000 4000 6000 DLP (mgy cm) DLP (mgy cm) Figure S1.

Effective radiation dose (msv) WAZA-ARI 70 60 50 40 30 20 10 0 y = 0.0072x + 4.5664 R² = 0.5231 0 1000 2000 3000 4000 5000 6000 DLP (mgy cm) Figure S2.

Supplementary Information Table S1a. Analysis of DIC formation before and after the CT scan (Giemsa staining, 2,000 metaphases) Table S1b. Analysis of DIC formation before and after the CT scan (Centromere-FISH, 2,000 metaphases) Table S2a. Analysis of DIC formation (Giemsa staining, 1,000 metaphases) Table S2b. Analysis of DIC formation (Centromere-FISH, 1,000 metaphases) Figure S1. Relationship between the increment of DIC formation and DLP in analysis of 2,000 metaphases using either Giemsa staining or Centromere-FISH. No correlation was observed with the results of either Giemsa staining (R 2 = 0.00197) (a) or Centromere-FISH (R 2 = 0.02036) (b). Figure S2. Relationship between DLP and the effective radiation dose, as calculated using WAZA- ARI. A correlation was observed between them (R 2 = 0.52312).