在全身计算机断层扫描成像中使用自动曝光控制和造影剂时年轻睾丸癌患者的辐射负担过量问题

Excess of Radiation Burden for Young Testicular Cancer Patients using Automatic Exposure Control and Contrast Agent on Whole-body Computed Tomography Imaging.

作者信息

Niiniviita Hannele, Kulmala Jarmo, Pölönen Tuukka, Määttänen Heli, Järvinen Hannu, Salminen Eeva

机构信息

Department of Medical Physics, Turku University Hospital, Turku, Finland.

Department of Diagnostic Radiology, University of Turku, Turku, Finland.

出版信息

Radiol Oncol. 2017 Feb 26;51(2):235-240. doi: 10.1515/raon-2017-0012. eCollection 2017 Jun.

DOI:10.1515/raon-2017-0012

PMID:28740460

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5514665/

Abstract

BACKGROUND

The aim of the study was to assess patient dose from whole-body computed tomography (CT) in association with patient size, automatic exposure control (AEC) and intravenous (IV) contrast agent.

PATIENTS AND METHODS

Sixty-five testicular cancer patients (mean age 28 years) underwent altogether 279 whole-body CT scans from April 2000 to April 2011. The mean number of repeated examinations was 4.3. The GE LightSpeed 16 equipped with AEC and the Siemens Plus 4 CT scanners were used for imaging. Whole-body scans were performed with (216) and without (63) IV contrast. The ImPACT software was used to determine the effective and organ doses.

RESULTS

Patient doses were independent (p < 0.41) of patient size when the Plus 4 device (mean 7.4 mSv, SD 1.7 mSv) was used, but with the LightSpeed 16 AEC device, the dose (mean 14 mSv, SD 4.6 mSv) increased significantly (p < 0.001) with waist cirfumference. Imaging with the IV contrast agent caused significantly higher (13% Plus 4, 35% LightSpeed 16) exposure than non-contrast imaging (p < 0.001).

CONCLUSIONS

Great caution on the use of IV contrast agent and careful set-up of the AEC modulation parameters is recommended to avoid excessive radiation exposure on the whole-body CT imaging of young patients.

摘要

背景

本研究旨在评估全身计算机断层扫描（CT）的患者剂量与患者体型、自动曝光控制（AEC）和静脉注射（IV）造影剂之间的关系。

患者与方法

2000年4月至2011年4月期间，65例睾丸癌患者（平均年龄28岁）共接受了279次全身CT扫描。重复检查的平均次数为4.3次。使用配备AEC的GE LightSpeed 16和西门子Plus 4 CT扫描仪进行成像。全身扫描分为使用（216次）和不使用（63次）静脉造影剂两种情况。使用ImPACT软件确定有效剂量和器官剂量。

结果

使用Plus 4设备时（平均7.4 mSv，标准差1.7 mSv），患者剂量与患者体型无关（p < 0.41），但使用LightSpeed 16 AEC设备时，剂量（平均14 mSv，标准差4.6 mSv）随腰围显著增加（p < 0.001）。使用静脉造影剂成像导致的辐射暴露显著高于未使用造影剂成像（Plus 4设备为13%，LightSpeed 16设备为35%）（p < 0.001）。