Huda Walter, Ogden Kent M
Department of Radiology, Medical University of South Carolina, Charleston, SC, USA.
Pediatr Radiol. 2008 Apr;38(4):415-23. doi: 10.1007/s00247-007-0732-6. Epub 2008 Jan 15.
The computation of patient effective doses to children is of particular interest given the relatively high doses received from this imaging modality, as well as the increased utilization of CT in all areas of medicine. Current methods for computing effective doses to children are relatively complex, and it would be useful to develop a simple method of computing pediatric effective doses for clinical purposes that could be used by radiologists and technologists.
To obtain pediatric effective doses for body CT examinations by the use of adult effective doses obtained from effective dose (E) per unit dose length product (DLP) coefficients, and energy imparted to a child relative to an adult.
Adult E/DLP coefficients were obtained at 120 kV using the ImPACT CT dosimetry spreadsheet. Patients were modeled as cylinders of water, and values of energy imparted to cylinders of varying radii were generated using Monte Carlo modeling. The amounts of energy imparted to the chest and abdomen of children relative to adults (R(en)) were obtained. Pediatric effective doses were obtained using scaling factors that accounted for scan length, mAs, patient weight, and relative energy imparted (R(en)).
E/DLP values were about 16 microSv/mGy cm for males and about 19 microSv/mGy cm for females. R(en) at 120 kV for newborns was 0.35 for the chest and 0.49 for the abdomen. At constant mAs, the effective dose to 6-month-old patients undergoing chest CT examinations was found to be about 50% higher than that to adults, and for abdominal examinations about 100% higher.
Adult effective doses can be obtained using DLP data and can be scaled to provide corresponding pediatric effective doses from body examinations on the same CT scanner.
鉴于儿童通过这种成像方式接受的剂量相对较高,以及CT在医学各个领域的使用增加,计算儿童的患者有效剂量尤为重要。目前计算儿童有效剂量的方法相对复杂,开发一种简单的用于临床目的的儿童有效剂量计算方法将很有用,可供放射科医生和技术人员使用。
通过使用从单位剂量长度乘积(DLP)系数获得的成人有效剂量以及相对于成人赋予儿童的能量,来获得身体CT检查的儿童有效剂量。
使用ImPACT CT剂量测定电子表格在120 kV下获得成人E/DLP系数。将患者建模为水圆柱体,并使用蒙特卡罗建模生成赋予不同半径圆柱体的能量值。获得相对于成人赋予儿童胸部和腹部的能量量(R(en))。使用考虑扫描长度、毫安秒、患者体重和赋予的相对能量(R(en))的比例因子获得儿童有效剂量。
男性的E/DLP值约为16微希沃特/毫戈瑞·厘米,女性约为19微希沃特/毫戈瑞·厘米。120 kV时新生儿胸部的R(en)为0.35,腹部为0.49。在恒定毫安秒下,发现6个月大的患者进行胸部CT检查时的有效剂量比成人高约50%,腹部检查时高约100%。
可以使用DLP数据获得成人有效剂量,并进行缩放以提供来自同一CT扫描仪身体检查的相应儿童有效剂量。