Iball Gareth R, Bebbington Natalie A, Burniston Maria, Edyvean Sue, Fraser Louise, Julyan Peter, Parkar Nasreen, Wood Tim
aLeeds Teaching Hospitals NHS Trust, Medical Physics Department, Old Medical School, Leeds General Infirmary, Leeds, LS1 3EX bUniversity Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW cSiemens Healthineers, Borupvang 9, 2750 Ballerup, Denmark dRoyal Free London NHS Foundation Trust, Pond St, London NW3 2QG eMedical (Radiation) Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards (CRCE), Public Health England, Chilton, Didcot, Oxfordshire OX11 0RQ fARSAC, Medical Exposures Group, Radiation Assessments Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 0RQ gChristie Medical Physics & Engineering, The Christie NHS Foundation Trust, Withington, Manchester, M20 4BX hRadiation Physics Department, Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Hull & East Yorkshire Hospitals NHS Trust, Castle Road, Hull, HU16 5JQ, UK iFaculty of Science, University of Hull, Cottingham Road, Hull, HU6 7RX, UK.
Nucl Med Commun. 2017 Jun;38(6):459-470. doi: 10.1097/MNM.0000000000000672.
The aim of this study was to conduct a nationwide survey of computed tomography (CT) doses for a wide range of PET-CT and single photon emission computed tomography-computed tomography (SPECT-CT) imaging procedures, with the aim of generating proposed UK national diagnostic reference levels (NDRLs).
CT protocol and dosimetry data for three PET-CT and seven SPECT-CT examinations were gathered from centres across the UK. Data were divided according to CT purpose (attenuation correction, localization or diagnostic) and third quartile values of scanner average dose metrics were used to generate suggested NDRLs for a range of examination and CT purpose combinations. Achievable doses were also established from the median of the dose distributions.
Data were obtained from 47 centres, allowing suggested NDRLs to be produced for fluorine-18-fluorodeoxyglucose half-body PET-CT, and parathyroid, post-thyroid ablation, meta-iodobenzylguanidine/octreotide, cardiac and bone SPECT-CT examinations.Variations in dose of up to a factor of 35 were observed for a given examination/CT purpose combination. For fluorine-18-fluorodeoxyglucose half-body PET-CT examination dose levels for the three CT purposes overlapped, which highlights the variability in the way in which CT purposes are interpreted across the UK. This lack of standardization is believed to be the largest contributor to the dose variations that were observed. The survey highlighted the need for targeted optimization work in many centres.
Suggested UK NDRLs and achievable doses for six common PET-CT and SPECT-CT examinations have been established as a result of this study.
本研究旨在对广泛的正电子发射断层显像-计算机断层扫描（PET-CT）和单光子发射计算机断层显像-计算机断层扫描（SPECT-CT）成像程序进行全国范围内的计算机断层扫描（CT）剂量调查，以制定英国国家诊断参考水平（NDRLs）建议值。
从英国各地的中心收集了三种PET-CT和七种SPECT-CT检查的CT协议和剂量测定数据。数据根据CT目的（衰减校正、定位或诊断）进行划分，并使用扫描仪平均剂量指标的第三四分位数来生成一系列检查和CT目的组合的建议NDRLs。还从剂量分布的中位数确定了可实现的剂量。
从47个中心获得了数据，从而能够为氟-18-氟脱氧葡萄糖半身PET-CT以及甲状旁腺、甲状腺消融术后、间碘苄胍/奥曲肽、心脏和骨骼SPECT-CT检查生成建议的NDRLs。对于给定的检查/CT目的组合，观察到剂量变化高达35倍。对于氟-18-氟脱氧葡萄糖半身PET-CT检查，三种CT目的的剂量水平有重叠，这突出了英国各地对CT目的解释方式的变异性。这种缺乏标准化被认为是观察到的剂量变化的最大原因。该调查强调了许多中心需要有针对性的优化工作。
本研究得出了英国六种常见PET-CT和SPECT-CT检查的建议NDRLs和可实现剂量。
