Schnell-Inderst P, Hacker M, Nosske D, Weiss M, Stamm-Meyer A, Brix G, Hahn K
Klinik und Poliklinik für Nuklearmedizin, Klinikum der Universität München, Munich.
Nuklearmedizin. 2004 Mar;43(2):45-56. doi: 10.1267/nukl04020045.
A pilot study for estimation of radiation exposure due to diagnostic procedures in nuclear medicine using routine data of hospitals and practices in Germany.
Hospitals and practices willing to participate in the study supplied data of one year (1997), containing information on patients' identification number, age, sex, type of diagnostic procedure, radiopharmaceutical, administered activity, type of health insurance (private/public), inpatient/outpatient status, and so-called Leistungsziffer, which describes the type of medical performances in Germany. The effective dose per examination was calculated according to ICRP 80. Mean, standard deviation, median, 5th and 95th percentiles of the effective dose were calculated, stratified by type of organ system and also by sex and age, including patients of > or = 18 years.
82,039 examinations from patients of 9 hospitals and practices were analyzed. The median (5-95(th) percentiles) of the effective dose per examination for all patients was 2.9 mSv (0.4-8.5 mSv); 1.2 examinations per patient and year were performed on average. The three most frequent examinations were bone scans (median 3.4 mSv; 2.9-5.1), thyroid (0.9 mSv; 0.4-2.2) and cardiovascular studies (7.3 mSv; 3.8-20.2). The median effective dose for 18 to 40 years old women was 1.0 mSv (0.4-5.8), for women between 41 and 65 years 2.2 mSv (0.4-7.3) and for women older than 65 years 2.4 mSv (0.5-7.6). The corresponding values for men were 2.6 mSv (0.3-7.6); 3.3 mSv (0.4-9.1), and 3.4 mSv (0.5-8.8).
It was possible to gain an accurate determination of radiation exposure of diagnostic procedures in nuclear medicine by routine data.
利用德国医院和诊所的常规数据，开展一项关于核医学诊断程序辐射剂量估算的初步研究。
愿意参与研究的医院和诊所提供了1997年一整年的数据，包括患者的身份证号码、年龄、性别、诊断程序类型、放射性药物、给药剂量、医疗保险类型（私人/公共）、住院/门诊状态以及所谓的Leistungsziffer（用于描述德国医疗服务类型）。根据国际辐射防护委员会（ICRP）第80号出版物计算每次检查的有效剂量。计算有效剂量的均值、标准差、中位数、第5和第95百分位数，并按器官系统类型、性别和年龄进行分层，纳入年龄大于或等于18岁的患者。
分析了9家医院和诊所82039例患者的检查数据。所有患者每次检查有效剂量的中位数（第5 - 95百分位数）为2.9毫希沃特（0.4 - 8.5毫希沃特）；平均每名患者每年接受1.2次检查。最常见的三项检查为骨扫描（中位数3.4毫希沃特；2.9 - 5.1）、甲状腺检查（0.9毫希沃特；0.4 - 2.2）和心血管检查（7.3毫希沃特；3.8 - 20.2）。18至40岁女性的有效剂量中位数为1.0毫希沃特（0.4 - 5.8），41至65岁女性为2.2毫希沃特（0.4 - 7.3），65岁以上女性为2.4毫希沃特（0.5 - 7.6）。男性的相应数值分别为2.6毫希沃特（0.3 - 7.6）、3.3毫希沃特（0.4 - 9.1）和3.4毫希沃特（0.5 - 8.8）。
通过常规数据能够准确确定核医学诊断程序的辐射剂量。
