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为确定核医学CT的当地诊断参考水平而进行的患者剂量学审核。

Patient dosimetry audit for establishing local diagnostic reference levels for nuclear medicine CT.

作者信息

Gardner Matthew, Katsidzira Ngonidzashe M, Ross Erin, Larkin Elizabeth A

机构信息

1 RRPPS, Imaging and Medical Physics Group, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

2 Nuclear Medicine, Imaging and Medical Physics Group, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

出版信息

Br J Radiol. 2017 Mar;90(1071):20160850. doi: 10.1259/bjr.20160850. Epub 2017 Jan 19.

Abstract

OBJECTIVE

To establish a system for patient dosimetry audit and setting of local diagnostic reference levels (LDRLs) for nuclear medicine (NM) CT.

METHODS

Computed radiological information system (CRIS) data were matched with NM paper records, which provided the body region and dose mode for NMCT carried out at a large UK hospital. It was necessary to divide data in terms of the NM examination type, body region and dose mode. The mean and standard deviation dose-length products (DLPs) for common NMCT examinations were then calculated and compared with the proposed National Diagnostic Reference Levels (NDRLs). Only procedures which have 10 or more patients will be used to suggest LDRLs.

RESULTS

For most examinations, the mean DLPs do not exceed the proposed NDRLs. The bone single-photon emission CT/CT lumbar spine data clearly show the need to divide data according to the purpose of the scan (dose mode), with mean (±standard error) DLPs ranging from 51 ± 5 mGy cm (low dose) to 1086 ± 124 mGy cm (metal dose).

CONCLUSION

A system for NMCT patient dose audit has been developed, but there are non-trivial challenges which make the process labour intensive. These include limited information provided by CRIS downloads, dependence on paper records and limited number of examinations available owing to the need to subdivide data. Advances in knowledge: This article demonstrates that a system can be developed for NMCT patient dose audit, but also highlights the challenges associated with such audit, which may not be encountered with more routine audit of radiology CT.

摘要

目的

建立一个用于患者剂量测定审核以及设定核医学(NM)CT 本地诊断参考水平(LDRLs)的系统。

方法

将计算机放射信息系统(CRIS)数据与 NM 纸质记录进行匹配,这些记录提供了在英国一家大型医院进行的 NMCT 的身体部位和剂量模式。有必要根据 NM 检查类型、身体部位和剂量模式对数据进行划分。然后计算常见 NMCT 检查的平均剂量长度乘积(DLPs)和标准差,并与提议的国家诊断参考水平(NDRLs)进行比较。仅使用有 10 名或更多患者的程序来建议 LDRLs。

结果

对于大多数检查,平均 DLPs 未超过提议的 NDRLs。骨单光子发射 CT/CT 腰椎的数据清楚地表明需要根据扫描目的(剂量模式)对数据进行划分,平均(±标准误差)DLPs 范围从 51±5 mGy·cm(低剂量)到 1086±124 mGy·cm(金属剂量)。

结论

已开发出一种用于 NMCT 患者剂量审核的系统,但存在一些重大挑战,使得该过程劳动强度大。这些挑战包括 CRIS 下载提供的信息有限、对纸质记录的依赖以及由于需要细分数据而导致可用检查数量有限。知识进展:本文表明可以开发一种用于 NMCT 患者剂量审核的系统,但也突出了与此类审核相关的挑战,而这些挑战在对放射学 CT 进行更常规的审核时可能不会遇到。

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