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确定CT扫描所致电离辐射暴露的变化率:来自一家医院的数据库分析

Determining the rate of change in exposure to ionizing radiation from CT Scans: a database analysis from one hospital.

作者信息

Rayo Michael F, Patterson Emily S, Liston Beth W, White Susan, Kowalczyk Nina

机构信息

School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio.

School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio.

出版信息

J Am Coll Radiol. 2014 Jul;11(7):703-8. doi: 10.1016/j.jacr.2013.12.005. Epub 2014 Mar 19.

Abstract

PURPOSE

Cancer risks associated with radiation from CT procedures have recently received increased attention. An important question is whether the combined impact of CT volume and dose reduction strategies has reduced radiation exposure to adult patients undergoing CT examinations. The aim of this study was to determine differences in radiation exposure from 2008 to 2012 to patients receiving CT scans of the abdomen, head, sinus, and lumbar spine at a midwestern academic medical center that implemented dose reduction strategies.

METHODS

Data were collected from two internal data sets from 2008 to 2012 for general medicine and intensive care unit patients. These data were used to calculate annual CT volume, rate, average effective dose, radiation exposure, and estimated cancer risk.

RESULTS

A 37% reduction in abdominal CT volume was found from 2008 to 2012. However, no volume reductions were found for CT examinations of the head or lumbar spine, and the decrease in sinus imaging was minimal. Dose reduction strategies resulted in 30% to 52% decreases in radiation exposure for the targeted body areas. The combined reduction in volume and dose per procedure reduced estimated induced cancers by 63%.

CONCLUSIONS

Exposure to ionizing radiation from these examinations was reduced at one institution because of reduced volumes of procedures and the reduction of each procedure's effective dose through new protocols and technologies. Although both the volume reduction and dose reduction strategies contributed to the reduced exposure, it seems that investments in implementing the protocols and new technology had the greatest effect on future cancer risk.

摘要

目的

CT检查辐射相关的癌症风险近来受到更多关注。一个重要问题是,CT扫描量与剂量降低策略的综合影响是否降低了接受CT检查的成年患者的辐射暴露。本研究的目的是确定2008年至2012年期间,在一家实施了剂量降低策略的中西部学术医疗中心,接受腹部、头部、鼻窦和腰椎CT扫描的患者的辐射暴露差异。

方法

从2008年至2012年两个内部数据集收集普通内科和重症监护病房患者的数据。这些数据用于计算年度CT扫描量、扫描率、平均有效剂量、辐射暴露以及估计的癌症风险。

结果

2008年至2012年期间,腹部CT扫描量减少了37%。然而,头部或腰椎的CT检查扫描量未减少,鼻窦成像的减少幅度也很小。剂量降低策略使目标身体部位的辐射暴露减少了30%至52%。每次检查的扫描量和剂量的综合减少使估计的诱发癌症减少了63%。

结论

在一家机构中,这些检查的电离辐射暴露减少,这是因为检查量减少,以及通过新方案和新技术降低了每次检查的有效剂量。虽然扫描量减少和剂量降低策略都有助于减少暴露,但似乎实施方案和新技术的投入对未来癌症风险的影响最大。

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