Gawlitza Joshua, Henzler Thomas, Trinkmann Frederik, Nekolla Elke, Haubenreisser Holger, Brix Gunnar
Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, 66424 Homburg, Germany.
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68159 Mannheim, Germany.
Diagnostics (Basel). 2020 Dec 18;10(12):1106. doi: 10.3390/diagnostics10121106.
As stated by the Fleischner Society, an additional computed tomography (CT) scan in expiration is beneficial in patients with chronic obstructive pulmonary disease (COPD). It was thus the aim of this study to evaluate the radiation risk of a state-of-the-art paired inspiratory-expiratory chest scan compared to inspiration-only examinations. Radiation doses to 28 organs were determined for 824 COPD patients undergoing routine chest examinations at three different CT systems-a conventional multi-slice CT (MSCT), a 2nd generation (2nd-DSCT), and 3rd generation dual-source CT (3rd-DSCT). Patients examined at the 3rd-DSCT received a paired inspiratory-expiratory scan. Organ doses, effective doses, and lifetime attributable cancer risks (LAR) were calculated. All organ and effective doses were significantly lower for the paired inspiratory-expiratory protocol (effective doses: 4.3 ± 1.5 mSv (MSCT), 3.0 ± 1.2 mSv (2nd-DSCT), and 2.0 ± 0.8 mSv (3rd-DSCT)). Accordingly, LAR was lowest for the paired protocol with an estimate of 0.025 % and 0.013% for female and male patients (50 years) respectively. Image quality was not compromised. Paired inspiratory-expiratory scans can be acquired on 3rd-DSCT systems at substantially lower dose and risk levels when compared to inspiration-only scans at conventional CT systems, offering promising prospects for improved COPD diagnosis.
正如弗莱施纳学会所述，呼气时进行额外的计算机断层扫描（CT）对慢性阻塞性肺疾病（COPD）患者有益。因此，本研究的目的是评估与仅吸气检查相比，先进的配对吸气-呼气胸部扫描的辐射风险。对在三种不同CT系统——传统多层CT（MSCT）、第二代双源CT（2nd-DSCT）和第三代双源CT（3rd-DSCT）——上接受常规胸部检查的824例COPD患者的28个器官的辐射剂量进行了测定。在3rd-DSCT上检查的患者接受了配对的吸气-呼气扫描。计算了器官剂量、有效剂量和终生归因癌症风险（LAR）。配对吸气-呼气方案的所有器官和有效剂量均显著较低（有效剂量：MSCT为4.3±1.5 mSv，2nd-DSCT为3.0±1.2 mSv，3rd-DSCT为2.0±0.8 mSv）。相应地，配对方案的LAR最低，估计女性和男性患者（50岁）分别为0.025%和0.013%。图像质量未受影响。与传统CT系统的仅吸气扫描相比，在3rd-DSCT系统上进行配对吸气-呼气扫描时，辐射剂量和风险水平显著降低，为改善COPD诊断提供了广阔前景。
