Mattsson Sören, Andersson Martin, Söderberg Marcus
Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, Malmö SE-205 02, Sweden
Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, Malmö SE-205 02, Sweden.
Radiat Prot Dosimetry. 2015 Jul;165(1-4):410-5. doi: 10.1093/rpd/ncv024. Epub 2015 Mar 22.
New imaging technologies utilising X-rays and radiopharmaceuticals have developed rapidly. Clinical application of computed tomography (CT) has revolutionised medical imaging and plays an enormous role in medical care. Due to technical improvements, spatial, contrast and temporal resolutions have continuously improved. In spite of significant reduction of CT doses during recent years, CT is still a dominating source of radiation exposure to the population. Combinations with single photon emission computed tomography (SPECT) and positron emission tomography (PET) and especially the use of SPECT/CT and PET/CT, provide important additional information about physiology as well as cellular and molecular events. However, significant dose contributions from SPECT and PET occur, making PET/CT and SPECT/CT truly high dose procedures. More research should be done to find optimal activities of radiopharmaceuticals for various patient groups and investigations. The implementation of simple protocol adjustments, including individually based administration, encouraged hydration, forced diuresis and use of optimised voiding intervals, laxatives, etc., can reduce the radiation exposure to the patients. New data about staff doses to fingers, hands and eye lenses indicate that finger doses could be a problem, but not doses to the eye lenses and to the whole body.
利用X射线和放射性药物的新型成像技术发展迅速。计算机断层扫描(CT)的临床应用彻底改变了医学成像,并在医疗保健中发挥着巨大作用。由于技术改进,空间、对比度和时间分辨率不断提高。尽管近年来CT剂量大幅降低,但CT仍是人群辐射暴露的主要来源。与单光子发射计算机断层扫描(SPECT)和正电子发射断层扫描(PET)的结合,尤其是SPECT/CT和PET/CT的使用,提供了有关生理学以及细胞和分子事件的重要额外信息。然而,SPECT和PET会产生显著的剂量贡献,使得PET/CT和SPECT/CT成为真正的高剂量检查。应开展更多研究,以找到适用于不同患者群体和检查的放射性药物的最佳用量。实施简单的方案调整,包括个体化给药、鼓励饮水、强制利尿以及使用优化的排尿间隔、泻药等,可以减少患者的辐射暴露。关于工作人员手指、手部和晶状体剂量的新数据表明,手指剂量可能是个问题,但晶状体和全身剂量不是问题。