Radiology Department, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Eur Radiol. 2021 May;31(5):3065-3070. doi: 10.1007/s00330-020-07458-5. Epub 2020 Nov 12.
To identify a patient cohort who received ≥ 100 mSv during a single computed tomography (CT)-guided intervention and analyze clinical information.
Using the dose-tracking platform Radimetrics that collects data from all CT scanners in a single hospital, a patient-level search was performed retrospectively by setting a threshold effective dose (E) of 100 mSv for the period from January 2013 to December 2017. Patients who received ≥ 100 mSv in a single day during a single CT-guided intervention were then identified. Procedure types were identified, and medical records were reviewed up to January 2020 to identify patients who developed short- and/or medium-term (up to 8 years) medical consequences.
Of 8952 patients with 100 mSv+, there were 33 patients who underwent 37 CT-guided interventions each resulting in ≥ 100 mSv. Procedures included ablations (15), myelograms (8), drainages (7), biopsies (6), and other (1). The dose for individual procedures was 100.2 to 235.5 mSv with mean and median of 125.7 mSv and 111.8 mSv, respectively. Six patients (18 %) were less than 50 years of age. During the study period of 0.2 to 7 years, there were no deterministic or stochastic consequences identified in this study cohort.
While infrequent, CT-guided interventions may result in a single procedure dose of ≥ 100 mSv. Awareness of the possibility of such high doses and potential for long-term deleterious effects, especially in younger patients, and consideration of alternative imaging guidance and/or further dose optimization should be strongly considered whenever feasible.
• Although not so frequent, CT-guided interventions may result in a single procedure dose of ≥ 100 mSv • Procedures with potential for high dose includes ablations, myelograms, drainages, and biopsies.
确定在单次计算机断层扫描（CT）引导介入治疗中接受≥100mSv 的患者队列，并分析其临床信息。
使用 Radimetrics 剂量跟踪平台，该平台从单个医院的所有 CT 扫描仪中收集数据，通过为 2013 年 1 月至 2017 年 12 月期间设定 100mSv 的有效剂量（E）阈值，进行了回顾性患者水平搜索。然后确定在单次 CT 引导介入治疗中每天接受≥100mSv 的患者。识别出治疗类型，并查阅病历至 2020 年 1 月，以确定发生短期和/或中期（最长 8 年）医疗后果的患者。
在 8952 名 100mSv+的患者中，有 33 名患者进行了 37 次 CT 引导介入治疗，每次治疗的剂量均≥100mSv。治疗包括消融术（15 例）、脊髓造影术（8 例）、引流术（7 例）、活检术（6 例）和其他（1 例）。个别手术的剂量为 100.2 至 235.5mSv，平均剂量和中位数分别为 125.7mSv 和 111.8mSv。6 名患者（18%）年龄小于 50 岁。在 0.2 至 7 年的研究期间，在本研究队列中未发现确定性或随机性后果。
尽管不常见，但 CT 引导介入治疗可能导致单次手术剂量≥100mSv。当可行时，应强烈考虑对这种高剂量的可能性以及对长期有害影响的认识，尤其是在年轻患者中，并考虑替代成像引导和/或进一步剂量优化。
• 尽管不常见，但 CT 引导介入治疗可能导致单次手术剂量≥100mSv。
• 消融术、脊髓造影术、引流术和活检术等有潜在高剂量的治疗方法。
