Sullivan C J, Murphy K P, McLaughlin P D, Twomey M, O'Regan K N, Power D G, Maher M M, O'Connor O J
Department of Radiology, Cork and Mercy University Hospitals, Wilton, Cork, Ireland.
Eur Radiol. 2015 Apr;25(4):1005-13. doi: 10.1007/s00330-014-3507-0. Epub 2014 Dec 13.
Risks associated with high cumulative effective dose (CED) from radiation are greater when imaging is performed on younger patients. Testicular cancer affects young patients and has a good prognosis. Regular imaging is standard for follow-up. This study quantifies CED from diagnostic imaging in these patients.
Radiological imaging of patients aged 18-39 years, diagnosed with testicular cancer between 2001 and 2011 in two tertiary care centres was examined. Age at diagnosis, cancer type, dose-length product (DLP), imaging type, and frequency were recorded. CED was calculated from DLP using conversion factors. Statistical analysis was performed with SPSS.
In total, 120 patients with a mean age of 30.7 ± 5.2 years at diagnosis had 1,410 radiological investigations. Median (IQR) surveillance was 4.37 years (2.0-5.5). Median (IQR) CED was 125.1 mSv (81.3-177.5). Computed tomography accounted for 65.3 % of imaging studies and 98.3 % of CED. We found that 77.5 % (93/120) of patients received high CED (>75 mSv). Surveillance time was associated with high CED (OR 2.1, CI 1.5-2.8).
Survivors of testicular cancer frequently receive high CED from diagnostic imaging, mainly CT. Dose management software for accurate real-time monitoring of CED and low-dose CT protocols with maintained image quality should be used by specialist centres for surveillance imaging.
• CT accounted for 98.3 % of CED in patients with testicular cancer. • Median CED in patients with testicular cancer was 125.1 mSv • High CED (>75 mSv) was observed in 77.5 % (93/120) of patients. • Dose tracking and development of low-dose CT protocols are recommended.
对年轻患者进行成像检查时，辐射累积有效剂量（CED）过高带来的风险更大。睾丸癌患者多为年轻患者，且预后良好。定期成像检查是随访的标准做法。本研究对这些患者诊断性成像的CED进行了量化。
对2001年至2011年期间在两家三级医疗中心确诊为睾丸癌的18至39岁患者的放射影像学检查进行了分析。记录诊断时的年龄、癌症类型、剂量长度乘积（DLP）、成像类型和频率。使用转换因子根据DLP计算CED。采用SPSS进行统计分析。
共有120例患者，诊断时平均年龄为30.7±5.2岁，共接受了1410次放射学检查。中位（四分位间距）随访时间为4.37年（2.0 - 5.5年）。中位（四分位间距）CED为125.1 mSv（81.3 - 177.5 mSv）。计算机断层扫描（CT）占成像检查的65.3%，占CED的98.3%。我们发现77.5%（93/120）的患者接受了高CED（>75 mSv）。随访时间与高CED相关（比值比2.1，可信区间1.5 - 2.8）。
睾丸癌幸存者经常因诊断性成像检查，主要是CT检查，而接受高CED。专科中心在进行监测成像时应使用剂量管理软件，以准确实时监测CED，并采用能保持图像质量的低剂量CT方案。
• CT占睾丸癌患者CED的98.3%。• 睾丸癌患者的中位CED为125.1 mSv。• 77.5%（93/120）的患者观察到高CED（>75 mSv）。• 建议进行剂量跟踪并制定低剂量CT方案。
