Gawlitza J, Haubenreisser H, Meyer M, Hagelstein C, Sudarski S, Schoenberg S O, Henzler T
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
Eur J Radiol Open. 2016 May 7;3:95-9. doi: 10.1016/j.ejro.2016.04.003. eCollection 2016.
The aim of this study was to systematically compare organ-specific-radiation dose levels between a radiation dose optimized perfusion CT (dVPCT) protocol of the liver and a tri-phasic standard CT protocol of the liver using a Monte-Carlo-Simulation-based analysis platform.
The complete CT data of 52 patients (41 males; mean age 65 ± 12) with suspected HCC that underwent dVPCT examinations on a 3rd generation dual-source CT (Somatom Force, Siemens) with a dose optimized tube voltage of 70 kVp or 80 kVp were exported to an analysis platform (Radimetrics, Bayer). The dVPCT studies were matched with a reference group of 50 patients (35 males; mean age 65 ± 14) that underwent standard tri-phasic CT (sCT) examinations of the liver with 130 kVp using the calculated water-equivalent-diameter of the patients. The analysis platform was used for the calculation of the organ-specific effective dose (ED) as well as global radiation-dose parameters (ICRP103).
The organ-specific ED of the dVPCT protocol was statistically significantly lower when compared to the sCT in 14 of 21, and noninferior in a total of 18 of 21 examined items (all p < 0.05). The EDs of the dVPCT examinations were especially in the dose sensitive organs such as the red marrow (17.3 mSv vs 24.6 mSv, p = < 0.0001) and the liver (33.3 mSv vs 46.9 mSv, p = 0.0003) lower when compared to the sCT.
Our results suggest that dVPCT performed at 70 or 80 kVp compares favorably to sCT performed with 130 kVp with regard to effective organ dose levels, especially in dose sensitive organs, while providing additional functional information which is of paramount importance in patients undergoing novel targeted therapies.
本研究旨在使用基于蒙特卡洛模拟的分析平台，系统比较肝脏辐射剂量优化的灌注CT（dVPCT）协议与肝脏三相标准CT协议之间的器官特异性辐射剂量水平。
将52例疑似肝癌患者（41例男性；平均年龄65±12岁）在第三代双源CT（西门子Somatom Force）上进行dVPCT检查时的完整CT数据导出至分析平台（拜耳公司的Radimetrics），这些检查采用了70 kVp或80 kVp的剂量优化管电压。根据患者计算出的水等效直径，将dVPCT研究与50例患者（35例男性；平均年龄65±14岁）的参考组进行匹配，该参考组接受了130 kVp的肝脏标准三相CT（sCT）检查。分析平台用于计算器官特异性有效剂量（ED）以及总体辐射剂量参数（ICRP103）。
在21项检查项目中的14项中，dVPCT协议的器官特异性ED与sCT相比在统计学上显著更低，在总共21项检查项目中的18项中不劣于sCT（所有p<0.05）。与sCT相比，dVPCT检查的ED在诸如红骨髓（17.3 mSv对24.6 mSv，p=<0.0001）和肝脏（33.3 mSv对46.9 mSv，p=0.0003）等剂量敏感器官中尤其更低。
我们的结果表明，在有效器官剂量水平方面，70或80 kVp下进行的dVPCT与130 kVp下进行的sCT相比具有优势，尤其是在剂量敏感器官中，同时还能提供额外的功能信息，这对于接受新型靶向治疗的患者至关重要。
