Trattner Sigal, Chelliah Anjali, Prinsen Peter, Ruzal-Shapiro Carrie B, Xu Yanping, Jambawalikar Sachin, Amurao Maxwell, Einstein Andrew J
1 Department of Medicine, Cardiology Division, Columbia University Medical Center, New York, NY.
2 Department of Pediatrics, Pediatric Cardiology Division, New York-Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY.
AJR Am J Roentgenol. 2017 Mar;208(3):585-594. doi: 10.2214/AJR.15.15908. Epub 2017 Jan 17.
The purpose of this study is to determine the conversion factors that enable accurate estimation of the effective dose (ED) used for cardiac 64-MDCT angiography performed for children.
Anthropomorphic phantoms representative of 1- and 10-year-old children, with 50 metal oxide semiconductor field-effect transistor dosimeters placed in organs, underwent scanning performed using a 64-MDCT scanner with different routine clinical cardiac scan modes and x-ray tube potentials. Organ doses were used to calculate the ED on the basis of weighting factors published in 1991 in International Commission on Radiological Protection (ICRP) publication 60 and in 2007 in ICRP publication 103. The EDs and the scanner-reported dose-length products were used to determine conversion factors for each scan mode. The effect of infant heart rate on the ED and the conversion factors was also assessed.
The mean conversion factors calculated using the current definition of ED that appeared in ICRP publication 103 were as follows: 0.099 mSv · mGy · cm, for the 1-year-old phantom, and 0.049 mSv · mGy · cm, for the 10-year-old phantom. These conversion factors were a mean of 37% higher than the corresponding conversion factors calculated using the older definition of ED that appeared in ICRP publication 60. Varying the heart rate did not influence the ED or the conversion factors.
Conversion factors determined using the definition of ED in ICRP publication 103 and cardiac, rather than chest, scan coverage suggest that the radiation doses that children receive from cardiac CT performed using a contemporary 64-MDCT scanner are higher than the radiation doses previously reported when older chest conversion factors were used. Additional up-to-date pediatric cardiac CT conversion factors are required for use with other contemporary CT scanners and patients of different age ranges.
本研究旨在确定能准确估算儿童心脏64层螺旋CT血管造影术有效剂量(ED)的转换系数。
使用50个金属氧化物半导体场效应晶体管剂量计置于器官内,制作代表1岁和10岁儿童的仿真人体模型,采用64层螺旋CT扫描仪,以不同常规临床心脏扫描模式和X射线管电压进行扫描。根据1991年国际放射防护委员会(ICRP)第60号出版物及2007年ICRP第103号出版物公布的权重因子,用器官剂量计算有效剂量。利用有效剂量和扫描仪报告的剂量长度乘积确定每种扫描模式的转换系数。还评估了婴儿心率对有效剂量及转换系数的影响。
根据ICRP第103号出版物中有效剂量的当前定义计算出的平均转换系数如下:1岁人体模型为0.099 mSv·mGy·cm,10岁人体模型为0.049 mSv·mGy·cm。这些转换系数比根据ICRP第60号出版物中有效剂量的旧定义计算出的相应转换系数平均高37%。心率变化对有效剂量及转换系数无影响。
根据ICRP第103号出版物中有效剂量的定义及心脏而非胸部扫描范围确定的转换系数表明,儿童使用当代64层螺旋CT扫描仪进行心脏CT检查时所接受的辐射剂量高于使用旧的胸部转换系数时先前报告的辐射剂量。还需要其他最新的儿科心脏CT转换系数,以用于其他当代CT扫描仪及不同年龄范围的患者。