Villoing Daphnée, Drozdovitch Vladimir, Simon Steven L, Kitahara Cari M, Linet Martha S, Melo Dunstana R
*Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD; ‡Melohill Technology LLC, Rockville, MD.
Health Phys. 2017 Dec;113(6):474-518. doi: 10.1097/HP.0000000000000721.
Ionizing radiation exposure to the general U.S. population nearly doubled between 1980 and 2006, due almost entirely to the significant increase in the number of radiologic and nuclear medicine procedures performed. Significant changes in the types of procedures and radionuclides used in nuclear medicine, as well as in detection technology, have led to notable changes over time in absorbed doses to specific organs. This study is the first to estimate per-procedure organ doses to nuclear medicine patients and trends in doses over five decades. Weighted average organ doses per examination to 14 organs of interest were calculated for 17 examination types over 10 5-y time periods (1960-2010) as the product of the percentage of use of each radiopharmaceutical in those diagnostic procedures based on comprehensive literature review, the administered activity, and ICRP dose coefficients; doses per radiopharmaceutical were also provided for each organ, procedure, and time period. The weighted doses to adult nuclear medicine patients from cardiac procedures increased to all organs of interest between 1960 and 2010 except for the urinary bladder wall. From high radiation doses for most other procedures in the 1960s, with up to 0.7 Gy in the specific case of radioiodinated thyroid scans, organ-absorbed doses generally decreased from 1960 to 1990. In contrast, during the 1990s and 2000s, the weighted doses were gradually increased for some procedures, such as brain and skeleton scans. The increasing number of nuclear medicine procedures, specifically cardiac scans and changes in weighted doses, underscore the need to monitor exposure levels and radiation-related disease risks in nuclear medicine patients.
1980年至2006年间，美国普通人群的电离辐射暴露量几乎翻了一番，这几乎完全归因于放射学和核医学检查数量的显著增加。核医学中所使用的检查类型、放射性核素以及检测技术都发生了重大变化，随着时间的推移，特定器官的吸收剂量也出现了显著变化。本研究首次估算了核医学患者每次检查的器官剂量以及五十年来的剂量趋势。基于全面的文献综述，计算了10个5年时间段（1960 - 2010年）内17种检查类型针对14个感兴趣器官的每次检查加权平均器官剂量，其为那些诊断程序中每种放射性药物的使用百分比、给药活度以及国际放射防护委员会（ICRP）剂量系数的乘积；还提供了每个器官、程序和时间段每种放射性药物的剂量。1960年至2010年间，除膀胱壁外，心脏检查给予成年核医学患者的加权剂量在所有感兴趣器官中均有所增加。从20世纪60年代大多数其他检查的高辐射剂量，如放射性碘甲状腺扫描的特定情况下高达0.7 Gy，器官吸收剂量在1960年至1990年间总体呈下降趋势。相比之下，在20世纪90年代和21世纪初，某些检查（如脑部和骨骼扫描）的加权剂量逐渐增加。核医学检查数量的增加，特别是心脏扫描以及加权剂量的变化，凸显了监测核医学患者暴露水平和辐射相关疾病风险的必要性。
