French Society of Medical Physics (SFPM), Centre Antoine Béclère, 47 Rue de la Colonie, 75013 Paris, France; Department of Adult Radiology, Necker Enfants Malades University Hospital, 149 rue de Sèvres 75743, Paris Cedex 15, France.
French Society of Medical Physics (SFPM), Centre Antoine Béclère, 47 Rue de la Colonie, 75013 Paris, France; Department of Medical Physics, ALARA Expertise, 7 Allée de l'Europe, 67960 Entzheim, France; Department of Pediatric Imaging, Armand Trousseau Hospital, APHP, The MAMUTH Hospital (University Department for Innovative Therapies in Musculoskeletal Diseases), Sorbonne Université, Paris, France.
Phys Med. 2019 May;61:18-27. doi: 10.1016/j.ejmp.2019.04.004. Epub 2019 Apr 18.
A national survey was performed to assess patient dose indicators based on clinical indication and on patient morphology for most common adult computed tomography (CT) examinations in France.
Seventeen groups of clinical indications (GCIs) for diagnostic CT in adult patients were considered based on their frequency and on image quality requirements. Data was collected for 15-30 consecutive examinations performed between 2015 and 2017, per CT scanner and GCI. Distributions of total examination Dose-Length Product (DLP) and Volume CT Dose Index (CTDI) were assessed for each GCI as a function of patient gender or patient Body Mass Index (BMI) for head/neck and trunk examinations, respectively.
6610 examinations were analysed. Median total exam DLP values were higher for men compared to women patients for head and neck examinations: difference ranged from 6% for ear trauma indication (577 vs 543 mGy·cm, p = 0.01) to 35% for brain tumour GCI (1472 vs 1093 mGy·cm, p < 0.01). For trunk examinations, total exam DLP increased consistently with patient's BMI. For normal-BMI patients, median CTDI and DLP differed significantly between different GCIs for single-phase CT of the chest (3 mGy and 112 mGy·cm, respectively, for chronic obstructive pulmonary disease group vs 5.8 mGy and 207 mGy·cm for pulmonary embolism group, p < 0.05) and of the abdomen-pelvis (5.6 mGy and 284 mGy·cm, respectively, in renal colic group vs 9.5 mGy and 463 mGy·cm in occlusive syndrome group, p < 0.05).
This study provides morphological- and clinical-based patient dose indicators in CT as a practical tool for clinical practices optimisation.
本研究通过基于临床指征和患者体型的全国性调查，评估法国最常见成人 CT 检查的患者剂量指标。
本研究共考虑了 17 组成人诊断 CT 的临床指征 (GCIs)，这些指征是基于其频率和图像质量要求确定的。根据 CT 扫描仪和 GCI，在 2015 年至 2017 年期间，对每 15-30 例连续检查进行了数据采集。分别对头颈和躯干检查，评估每个 GCI 中总检查剂量长度乘积 (DLP)和容积 CT 剂量指数 (CTDI)的分布与患者性别或患者体重指数 (BMI)的关系。
共分析了 6610 例检查。与女性患者相比，男性患者的头颈部检查总检查 DLP 值更高：差异范围从耳部创伤指征（577 比 543 mGy·cm，p=0.01）到脑肿瘤 GCI（1472 比 1093 mGy·cm，p<0.01）。对于躯干检查，随着患者 BMI 的增加，总检查 DLP 值也不断增加。对于正常 BMI 的患者，单期胸部 CT（慢性阻塞性肺疾病组分别为 3 mGy 和 112 mGy·cm，而肺栓塞组为 5.8 mGy 和 207 mGy·cm，p<0.05）和腹部-骨盆 CT（肾绞痛组分别为 5.6 mGy 和 284 mGy·cm，而阻塞综合征组为 9.5 mGy 和 463 mGy·cm，p<0.05）不同 GCI 之间的 CTDI 和 DLP 差异显著。
本研究提供了 CT 中基于形态和临床的患者剂量指标，为临床实践优化提供了实用工具。
