Safiullah Shoaib, Patel Roshan, Uribe Brittany, Spradling Kyle, Lall Chandana, Zhang Lishi, Okhunov Zhamshid, Clayman Ralph V, Landman Jaime
1 Department of Urology, University of California , Irvine, Orange, California.
2 Division of Urology, University of Missouri , Columbia, Missouri.
J Endourol. 2017 Oct;31(10):985-990. doi: 10.1089/end.2017.0294. Epub 2017 Aug 14.
Ionizing radiation is implicated in nearly 2% of malignancies in the United States; radiation shields prevent unnecessary radiation exposure during medical imaging. Contemporary radiation shield utilization for adult patients in the United States is poorly defined. Therefore, we evaluated the prevalence of protective shielding utilization in adult patients undergoing CT scans in United States' hospitals.
An online survey was sent to established radiology departments randomly selected from the 2015 American Hospital Association Guide. Radiology departments conducting adult CT imaging were eligible; among 370 eligible departments, 215 departments accepted the study participation request. Questions focused on shielding practices during CT imaging of the eyes, thyroid, breasts, and gonads. Prevalence data were stratified per hospital location, size, and type. Main outcomes included overall protective shielding utilization, respondents' belief and knowledge regarding radiation safety, and organ-specific shielding prevalence.
Sixty-seven of 215 (31%) hospitals completed the survey; 66 (99%) reported familiarity with the ALARA (as low as reasonably achievable) principle and 56 (84%) affirmed their belief that shielding is beneficial. Only 60% of hospitals employed shielding during CT imaging; among these institutions, shielding varied based on CT study: abdominopelvic CT (13, 33%), head CT (33, 83%), or chest CT (30, 75%).
Among surveyed hospitals, 40% do not utilize CT shielding despite the majority acknowledging the ALARA principle and agreeing that shielding is a beneficial practice. Failure to address the low prevalence of protective shielding may lead to poor community health due to increased risk of radiation-related cancers.
在美国,约2%的恶性肿瘤与电离辐射有关;辐射防护屏可在医学成像过程中防止不必要的辐射暴露。目前美国成年患者辐射防护屏的使用情况尚不明确。因此,我们评估了美国医院成年患者在进行CT扫描时使用防护屏蔽的情况。
向从2015年美国医院协会指南中随机选取的放射科发送在线调查问卷。进行成人CT成像的放射科符合条件;在370个符合条件的科室中,有215个科室接受了研究参与请求。问题集中在眼部、甲状腺、乳房和性腺CT成像时的屏蔽措施。患病率数据按医院位置、规模和类型进行分层。主要结果包括总体防护屏蔽的使用情况、受访者对辐射安全的信念和知识,以及特定器官的屏蔽患病率。
215家医院中有67家(31%)完成了调查;66家(99%)报告熟悉“合理尽可能低”(ALARA)原则,56家(84%)确认他们认为屏蔽是有益的。只有60%的医院在CT成像时采用了屏蔽措施;在这些机构中,屏蔽措施因CT检查部位而异:腹部盆腔CT(13家,33%)、头部CT(33家,83%)或胸部CT(30家,75%)。
在接受调查的医院中,40%的医院未使用CT屏蔽,尽管大多数医院承认ALARA原则并认同屏蔽是一种有益的做法。由于辐射相关癌症风险增加,未能解决防护屏蔽使用率低的问题可能会导致社区健康状况不佳。