Radiation Safety Section, OHS Department, Hamad Medical Corporation, Doha, Qatar.
Webster Center for Quality and Safety, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Phys Med. 2020 Nov;79:1-15. doi: 10.1016/j.ejmp.2020.08.020. Epub 2020 Sep 25.
In the last few years there has been an increasing interest on radiation dose to patients undergoing various diagnostic or therapeutic procedures with the use of ionizing radiation. Especially for CT examinations and interventional procedures, where it is known that patient doses are much higher than conventional radiography, new norms have been published that require to have appropriate radiation dose indices registered in the patient medical record. Because of these demands, dose monitoring has been recommended and adopted into many clinical practices as a routine procedure for every patient and every examination. Dedicated dose monitoring systems (DMS) that facilitate data collection and processing, statistical comparisons, reporting and management of radiation dose related information have been devised and are being used worldwide. In this review paper, a brief flashback to the reasons that necessitated dose monitoring in radiology will be first presented. Furthermore, since the focus of this manuscript is on CT, the CT dosimetry principles and metrics will be summarized. The limitations of these metrics will be also discussed, so that DMS users are aware of the semantics of the parameters shown in the DMS reports. The operation of DMS systems will be outlined to make users aware of functions, limitations, and available options of DMS systems. Furthermore, the usefulness of DMS systems as an optimization tool will be presented and discussed. Finally, information about the DMS solutions available in the market and relevant links will be presented.
在过去的几年中，人们对接受各种诊断或治疗程序的患者的辐射剂量越来越感兴趣，这些程序都用到了电离辐射。特别是对于 CT 检查和介入性程序，已知患者的剂量远高于常规射线照相，因此已经发布了新的规范，要求在患者的病历中记录适当的辐射剂量指数。由于这些要求，剂量监测已被推荐并采用为许多临床实践中的常规程序，适用于每个患者和每次检查。已经设计并在全球范围内使用了专用的剂量监测系统（DMS），以方便数据收集和处理、统计比较、报告以及管理与辐射剂量相关的信息。在这篇综述论文中，首先将简要回顾一下需要在放射科进行剂量监测的原因。此外，由于本文的重点是 CT，因此将总结 CT 剂量学原理和指标。还将讨论这些指标的局限性，以便 DMS 用户了解 DMS 报告中显示的参数的语义。将概述 DMS 系统的操作，以使用户了解 DMS 系统的功能、局限性和可用选项。此外，还将介绍和讨论 DMS 系统作为优化工具的用处。最后，将提供有关市场上可用的 DMS 解决方案的信息和相关链接。
