Department of Clinical Physics and Bio-engineering, University of Glasgow, Health Physics, Gartnavel Royal Hospital, Glasgow G12 0XH, UK.
Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Didcot, Oxon OX11 0RQ, UK.
Phys Med. 2020 Nov;79:87-92. doi: 10.1016/j.ejmp.2020.10.020. Epub 2020 Nov 13.
Effective dose (E) has been developed by the International Commission on Radiological Protection (ICRP) as a dose quantity with a link to risks of health detriment, mainly cancer. It is based on reference phantoms representing average individuals, but this is often forgotten in its application to medical exposures, for which its use sometimes goes beyond the intended purpose. There has been much debate about issues involved in the use of E in medicine and ICRP is preparing a publication with more information on this application. This article aims to describe the development of E and explain how it should be used in medicine. It discusses some of the issues that arise when E is applied to medical exposures and provides information on how its use might evolve in the future. The article concludes with responses to some frequently asked questions about uses of E that are in line with the forthcoming ICRP publication. The main use of E in medicine is in meaningful comparison of doses from different types of procedure not possible with measurable dose quantities. However, it can be used, with appropriate care, as a measure of possible cancer risks. When considering E to individual patients, it is important to note that the dose received will differ from that assessed for reference phantoms, and the risk per Sv is likely to be greater on average in children and less in older adults. Newer techniques allow the calculation of patient-specific E which should be distinguished from the reference quantity.
有效剂量（E）是由国际辐射防护委员会（ICRP）开发的，作为与健康损害风险（主要是癌症）相关的剂量量。它基于代表平均个体的参考体模，但在将其应用于医疗照射时，这一点常常被遗忘，其用途有时超出了预期目的。在医学中使用 E 涉及到许多问题，ICRP 正在准备一份关于该应用的出版物，其中包含更多信息。本文旨在描述 E 的发展，并解释如何在医学中使用它。它讨论了在将 E 应用于医疗照射时出现的一些问题，并提供了有关其未来使用方式可能如何演变的信息。本文最后回答了一些关于 E 的常见问题，这些问题符合即将发布的 ICRP 出版物。E 在医学中的主要用途是在不同类型的程序之间进行有意义的剂量比较，而这些程序无法用可测量的剂量来进行。然而，只要小心使用，它也可以作为衡量癌症风险的一种手段。在考虑 E 对个体患者的影响时，需要注意的是，患者所接受的剂量与参考体模评估的剂量不同，而且儿童的每 Sv 风险平均而言可能更大，而老年人的风险则更小。新技术允许计算患者特定的 E，应将其与参考量区分开来。
