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利用患者特定的计算模型评估胎儿和孕妇的 CT 剂量。

Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models.

机构信息

Department of Medical Imaging and Information Sciences, Geneva University Hospital, Geneva, Switzerland.

Geneva Neuroscience Center, Geneva University, Geneva, Switzerland.

出版信息

Eur Radiol. 2018 Mar;28(3):1054-1065. doi: 10.1007/s00330-017-5000-z. Epub 2017 Sep 8.

DOI:10.1007/s00330-017-5000-z
PMID:28887589
Abstract

PURPOSE

This work provides detailed estimates of the foetal dose from diagnostic CT imaging of pregnant patients to enable the assessment of the diagnostic benefits considering the associated radiation risks.

MATERIALS AND METHODS

To produce realistic biological and physical representations of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients referred to the emergency unit of Geneva University Hospital for abdominal CT scans.

RESULTS

The effective dose to the mother varied from 1.1 mSv to 2.0 mSv with an average of 1.6 mSv, while commercial dose-tracking software reported an average effective dose of 1.9 mSv (range 1.7-2.3 mSv). The foetal dose normalised to CTDI varies between 0.85 and 1.63 with an average of 1.17.

CONCLUSION

The methodology for construction of personalised computational models can be exploited to estimate the patient-specific radiation dose from CT imaging procedures. Likewise, the dosimetric data can be used for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process.

KEY POINTS

• In CT examinations, the absorbed dose is non-uniformly distributed within foetal organs. • This work reports, for the first time, estimates of foetal organ-level dose. • The foetal brain and skeleton doses present significant correlation with gestational age. • The conceptus dose normalised to CTDI varies between 0.85 and 1.63. • The developed methodology is adequate for patient-specific CT radiation dosimetry.

摘要

目的

本研究旨在详细估算孕妇诊断性 CT 成像的胎儿剂量,以便在考虑相关辐射风险的情况下评估诊断获益。

材料与方法

为了对孕妇和胎儿进行真实的生物和物理建模,我们开发了一种基于现有标准化混合计算孕妇模型的个体化基于体素计算人体模型构建方法。我们对转诊至日内瓦大学医院急诊科行腹部 CT 扫描的 30 名孕妇进行了母体吸收剂量和胎儿器官剂量的估算。

结果

母亲的有效剂量范围为 1.1 mSv 至 2.0 mSv,平均为 1.6 mSv,而商业剂量跟踪软件报告的平均有效剂量为 1.9 mSv(范围 1.7 至 2.3 mSv)。胎儿剂量与 CTDI 的比值范围为 0.85 至 1.63,平均值为 1.17。

结论

个体化计算模型的构建方法可用于估算 CT 成像过程中的患者特定辐射剂量。同样,剂量学数据可用于评估不同 CT 扫描方案对孕妇和胎儿的辐射风险,从而指导决策过程。

关键点

  1. 在 CT 检查中,胎儿器官内的吸收剂量分布不均匀。

  2. 本研究首次报告了胎儿器官水平剂量的估算值。

  3. 胎儿脑和骨骼剂量与胎龄呈显著相关。

  4. 胎儿剂量与 CTDI 的比值范围为 0.85 至 1.63。

  5. 所开发的方法适用于个体化 CT 辐射剂量学。

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Comparing different methods for estimating radiation dose to the conceptus.比较不同方法估算胎儿辐射剂量。
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