Nuclear Physics Enterprises, Marlton, New Jersey
U.S. Food and Drug Administration (retired), Green Valley, Arizona.
J Nucl Med. 2017 Jun;58(6):865-868. doi: 10.2967/jnumed.117.195263. Epub 2017 May 10.
A debate exists within the medical community on whether the linear no-threshold model of ionizing radiation exposure accurately predicts the subsequent incidence of radiogenic cancer. In this article, we evaluate evidence refuting the linear no-threshold model and corollary efforts to reduce radiation exposure from CT and nuclear medicine imaging in accord with the as-low-as-reasonably-achievable principle, particularly for children. Further, we review studies demonstrating that children are not, in fact, more radiosensitive than adults in the radiologic imaging dose range, rendering dose reduction for children unjustifiable and counterproductive. Efforts to minimize nonexistent risks are futile and a major source of persistent radiophobia. Radiophobia is detrimental to patients and parents, induces stress, and leads to suboptimal image quality and avoidance of imaging, thus increasing misdiagnoses and consequent harm while offering no compensating benefits.
医学领域存在着一个争议，即线性无阈值模型是否能准确预测电离辐射暴露后放射性癌症的发生率。在本文中，我们评估了一些证据，这些证据反驳了线性无阈值模型以及为了符合合理可行尽量低原则而减少 CT 和核医学成像辐射暴露的努力，特别是针对儿童。此外，我们还回顾了一些研究，这些研究表明，在放射影像学剂量范围内，儿童的辐射敏感性实际上并不高于成年人，因此，为儿童减少剂量是不合理且适得其反的。为了最小化不存在的风险而努力是徒劳的，而且是持续的辐射恐惧症的主要来源。辐射恐惧症对患者和家长都有害，会引起压力，并导致图像质量不佳和避免成像，从而增加误诊和随之而来的伤害，而没有任何补偿的好处。
