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基于全身计算机断层扫描后的蒙特卡罗模拟计算有效剂量和恶性肿瘤风险的个体计算。

Individual Calculation of Effective Dose and Risk of Malignancy Based on Monte Carlo Simulations after Whole Body Computed Tomography.

机构信息

Department of Radiology, University Hospital Erlangen, Erlangen, Germany.

Institute of Medical Microbiology and Hygiene, University of Technology Dresden, Dresden, Germany.

出版信息

Sci Rep. 2020 Jun 11;10(1):9475. doi: 10.1038/s41598-020-66366-2.

DOI:10.1038/s41598-020-66366-2
PMID:32528028
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7289876/
Abstract

Detailed knowledge about radiation exposure is crucial for radiology professionals. The conventional calculation of effective dose (ED) for computed tomography (CT) is based on dose length product (DLP) and population-based conversion factors (k). This is often imprecise and unable to consider individual patient characteristics. We sought to provide more precise and individual radiation exposure calculation using image based Monte Carlo simulations (MC) in a heterogeneous patient collective and to compare it to phantom based MC provided from the National Cancer Institute (NCI) as academic reference. Dose distributions were simulated for 22 patients after whole-body CT during Positron Emission Tomography-CT. Based on MC we calculated individual Lifetime Attributable Risk (LAR) and Excess Relative Risk (ERR) of cancer mortality. ED was compared to ED and ED. ED (13.2 ± 4.5 mSv) was higher compared to ED (9.8 ± 2.1 mSv) and ED (11.6 ± 1.5 mSv). Relative individual differences were up to -48% for ED and -44% for ED compared to ED. Matching pair analysis illustrates that young age and gender are affecting LAR and ERR significantly. Because of these uncertainties in radiation dose assessment automated individual dose and risk estimation would be desirable for dose monitoring in the future.

摘要

详细的辐射暴露知识对放射科专业人员至关重要。传统的计算机断层扫描（CT）有效剂量（ED）计算是基于剂量长度乘积（DLP）和基于人群的转换系数（k）。这种方法通常不够精确，无法考虑个体患者的特征。我们试图使用基于图像的蒙特卡罗模拟（MC）在异质患者群体中提供更精确和个体化的辐射暴露计算，并将其与国家癌症研究所（NCI）提供的基于体模的 MC 进行比较，作为学术参考。对 22 名接受正电子发射断层扫描-CT 全身 CT 的患者进行了剂量分布模拟。基于 MC，我们计算了个体的终生归因风险（LAR）和癌症死亡率的超额相对风险（ERR）。ED 与 ED 和 ED 进行了比较。ED（13.2±4.5mSv）高于 ED（9.8±2.1mSv）和 ED（11.6±1.5mSv）。与 ED 相比，ED 的个体差异相对高达-48%，ED 的个体差异相对高达-44%。配对分析表明，年龄和性别对 LAR 和 ERR 有显著影响。由于辐射剂量评估中的这些不确定性，未来的剂量监测需要自动化的个体剂量和风险估计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/61b5e5b1c707/41598_2020_66366_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/2b61aa65cb6e/41598_2020_66366_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/c8484b479641/41598_2020_66366_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/79f243e2a1b1/41598_2020_66366_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/76f5061d0947/41598_2020_66366_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/62aba13fa255/41598_2020_66366_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/c958b3748e2e/41598_2020_66366_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/61b5e5b1c707/41598_2020_66366_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/2b61aa65cb6e/41598_2020_66366_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/c8484b479641/41598_2020_66366_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/79f243e2a1b1/41598_2020_66366_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/76f5061d0947/41598_2020_66366_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/62aba13fa255/41598_2020_66366_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/c958b3748e2e/41598_2020_66366_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/7289876/61b5e5b1c707/41598_2020_66366_Fig7_HTML.jpg

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