Smith-Bindman Rebecca, Moghadassi Michelle, Wilson Nicole, Nelson Thomas R, Boone John M, Cagnon Christopher H, Gould Robert, Hall David J, Krishnam Mayil, Lamba Ramit, McNitt-Gray Michael, Seibert Anthony, Miglioretti Diana L
From the Department of Radiology and Biomedical Imaging, University of California-San Francisco, 350 Parnassus Ave, Suite 307C, San Francisco, CA 94143-0336 (R.S.B., M.M., N.W., R.G.); Department of Epidemiology and Biostatistics and the Philip R. Lee Institute for Health Policy Studies, University of California-San Francisco, San Francisco, Calif (R.S.B.); Department of Radiology, University of California-San Diego, San Diego, Calif (T.R.N., D.J.H.); Department of Radiology (J.M.B., R.L., A.S.) and Division of Biostatistics, Department of Public Health Sciences (D.L.M.), University of California-Davis, Davis, Calif; Department of Radiology, University of California-Los Angeles, Los Angeles, Calif (C.H.C., M.M.G.); Department of Radiological Sciences, University of California-Irvine, Irvine, Calif (M.K.); and Group Health Research Institute, Group Health Cooperative, Seattle, Wash (D.L.M.).
Radiology. 2015 Oct;277(1):134-41. doi: 10.1148/radiol.2015142728. Epub 2015 May 19.
To summarize data on computed tomographic (CT) radiation doses collected from consecutive CT examinations performed at 12 facilities that can contribute to the creation of reference levels.
The study was approved by the institutional review boards of the collaborating institutions and was compliant with HIPAA. Radiation dose metrics were prospectively and electronically collected from 199 656 consecutive CT examinations in 83 181 adults and 3871 consecutive CT examinations in 2609 children at the five University of California medical centers during 2013. The median volume CT dose index (CTDIvol), dose-length product (DLP), and effective dose, along with the interquartile range (IQR), were calculated separately for adults and children and stratified according to anatomic region. Distributions for DLP and effective dose are reported for single-phase examinations, multiphase examinations, and all examinations.
For adults, the median CTDIvol was 50 mGy (IQR, 37-62 mGy) for the head, 12 mGy (IQR, 7-17 mGy) for the chest, and 12 mGy (IQR, 8-17 mGy) for the abdomen. The median DLPs for single-phase, multiphase, and all examinations, respectively, were as follows: head, 880 mGy · cm (IQR, 640-1120 mGy · cm), 1550 mGy · cm (IQR, 1150-2130 mGy · cm), and 960 mGy · cm (IQR, 690-1300 mGy · cm); chest, 420 mGy · cm (IQR, 260-610 mGy · cm), 880 mGy · cm (IQR, 570-1430 mGy · cm), and 550 mGy · cm (IQR 320-830 mGy · cm); and abdomen, 580 mGy · cm (IQR, 360-860 mGy · cm), 1220 mGy · cm (IQR, 850-1790 mGy · cm), and 960 mGy · cm (IQR, 600-1460 mGy · cm). Median effective doses for single-phase, multiphase, and all examinations, respectively, were as follows: head, 2 mSv (IQR, 1-3 mSv), 4 mSv (IQR, 3-8 mSv), and 2 mSv (IQR, 2-3 mSv); chest, 9 mSv (IQR, 5-13 mSv), 18 mSv (IQR, 12-29 mSv), and 11 mSv (IQR, 6-18 mSv); and abdomen, 10 mSv (IQR, 6-16 mSv), 22 mSv (IQR, 15-32 mSv), and 17 mSv (IQR, 11-26 mSv). In general, values for children were approximately 50% those for adults in the head and 25% those for adults in the chest and abdomen.
These summary dose data provide a starting point for institutional evaluation of CT radiation doses.
总结从12家机构连续进行的计算机断层扫描（CT）检查中收集到的辐射剂量数据，这些数据有助于制定参考水平。
本研究经各合作机构的机构审查委员会批准，并符合《健康保险流通与责任法案》（HIPAA）。2013年期间，在加利福尼亚大学的五家医学中心，前瞻性地以电子方式收集了83181名成人的199656次连续CT检查以及2609名儿童的3871次连续CT检查的辐射剂量指标。分别计算成人和儿童的中位容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）和有效剂量以及四分位数间距（IQR），并按解剖区域进行分层。报告单相检查、多相检查和所有检查的DLP和有效剂量分布情况。
对于成人，头部的中位CTDIvol为50 mGy（IQR，37 - 62 mGy），胸部为12 mGy（IQR，7 - 17 mGy），腹部为12 mGy（IQR，8 - 17 mGy）。单相、多相和所有检查的中位DLP分别如下：头部，880 mGy·cm（IQR，640 - 1120 mGy·cm）、1550 mGy·cm（IQR，1150 - 2130 mGy·cm）和960 mGy·cm（IQR，690 - 1300 mGy·cm）；胸部，420 mGy·cm（IQR，260 - 610 mGy·cm）、880 mGy·cm（IQR，570 - 1430 mGy·cm）和550 mGy·cm（IQR 320 - 830 mGy·cm）；腹部，580 mGy·cm（IQR，360 - 860 mGy·cm）、1220 mGy·cm（IQR，850 - 1790 mGy·cm）和960 mGy·cm（IQR，600 - 1460 mGy·cm）。单相、多相和所有检查的中位有效剂量分别如下：头部，2 mSv（IQR，1 - 3 mSv）、4 mSv（IQR，3 - 8 mSv）和2 mSv（IQR，2 - 3 mSv）；胸部，9 mSv（IQR，5 - 13 mSv）、18 mSv（IQR，12 - 29 mSv）和11 mSv（IQR，6 - 18 mSv）；腹部，10 mSv（IQR，6 - 16 mSv）、22 mSv（IQR，15 - 32 mSv）和17 mSv（IQR，11 - 26 mSv）。一般来说，儿童头部的值约为成人的50%，胸部和腹部的值约为成人的25%。
这些总结剂量数据为机构评估CT辐射剂量提供了一个起点。
