Pravatà Emanuele, Presilla Stefano, Roccatagliata Luca, Cianfoni Alessandro
Department of Neuroradiology, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, Via Tesserete, 46, 6900, Lugano, Switzerland.
Medical Physics Unit, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland.
Clin Neurol Neurosurg. 2018 Oct;173:105-109. doi: 10.1016/j.clineuro.2018.08.015. Epub 2018 Aug 9.
To perform a pilot study to quantify the radiation dose incident on operators during CT-guided interventional spine procedures, and provide a quick method to approximate it based on the total amount of radiation reported by the CT scanner.
Data retrospectively obtained from 26 consecutive CT-guided spine procedures, encompassing a variety of interventions. Intermittent low-dose limited-coverage CT-scanning performed using a "step and shoot" mode to visualize needle advancement. The operator wore an electronic direct dosimeter to record the dose measured above the operator's lead apron [μGy] for each procedure. Total amount of radiation used for CT-guidance quantified by the Dose-Length Product (DLP) [mGy-cm] provided by the CT scanner. The relationship between the operator's dose and the DLP was assessed.
Average and median operator's dose were 2.3 and 1.9 μGy, respectively, with half of these values ranging between 0.7 and 2.5 μGy. Average and median DLP values used to perform the CT-guided procedure were 58 and 54 mGy-cm respectively, and half of these values ranged between 38 and 68 mGy-cm. There was a statistically significant correlation between the operator's dose and the DLP used to perform CT-guidance (r = 0.61), with an operator's dose-DLP conversion factor of 0.04 μGy / 1 mGy-cm (range: 0.006-0.083 μGy / 1 mGy-cm).
In our series, the average amount of radiation used during CT guided procedures was about 50 mGy-cm (DLP), and the corresponding average operator's dose was about 2 μGy. We showed how an approximate estimate of the operator's dose could be obtained right after each procedure, based on the CT-scanner DLP output.
开展一项初步研究，以量化CT引导下脊柱介入手术期间术者所受的辐射剂量，并基于CT扫描仪报告的总辐射量提供一种快速估算该剂量的方法。
回顾性收集连续26例CT引导下脊柱手术的数据，涵盖多种介入操作。采用“步进式扫描”模式进行间歇性低剂量有限覆盖CT扫描，以观察穿刺针的推进情况。术者佩戴电子直读剂量仪，记录每次手术中术者铅衣外测得的剂量[微戈瑞（μGy）]。CT引导所用的总辐射量通过CT扫描仪提供的剂量长度乘积（DLP）[毫戈瑞-厘米（mGy-cm）]进行量化。评估术者剂量与DLP之间的关系。
术者剂量的平均值和中位数分别为2.3 μGy和1.9 μGy，其中一半数值介于0.7至2.5 μGy之间。用于CT引导手术的DLP平均值和中位数分别为58 mGy-cm和54 mGy-cm，其中一半数值介于38至68 mGy-cm之间。术者剂量与用于CT引导的DLP之间存在统计学显著相关性（r = 0.61），术者剂量-DLP转换系数为0.04 μGy / 1 mGy-cm（范围：0.006 - 0.083 μGy / 1 mGy-cm）。
在我们的研究系列中，CT引导手术期间所用的平均辐射量约为50 mGy-cm（DLP），相应的术者平均剂量约为2 μGy。我们展示了如何根据CT扫描仪的DLP输出，在每次手术后立即获得术者剂量的近似估算值。
