Konstantopoulio General Hospital, Agias Olgas 3-5, 14233, Nea Ionia, Athens, Greece.
School of Medicine, University of Crete, Iraklion, Crete, Greece.
Eur Radiol. 2021 Jul;31(7):4459-4469. doi: 10.1007/s00330-020-07652-5. Epub 2021 Jan 15.
The objective of this study was to investigate the feasibility of defining diagnostic reference levels (DRLs) on a European basis for specific clinical indications (CIs), within the context of the European Clinical DRLs (EUCLID) European Commission project.
A prospective, multicenter, industry-independent European study was performed to provide data on 10 CIs (stroke, chronic sinusitis, cervical spine trauma, pulmonary embolism, coronary calcium scoring, coronary angiography, lung cancer, hepatocellular carcinoma, colic/abdominal pain, and appendicitis) via an online survey that included information on patient clinical, technical, and dosimetric parameters. Data from at least 20 patients per CI were requested from each hospital. To establish DRLs, a methodology in line with the International Commission on Radiological Protection (ICRP) Report 135 good practice recommendations was followed.
Data were collected from 19 hospitals in 14 European countries on 4299 adult patients and 10 CIs to determine DRLs. DRLs differ considerably between sites for the same CI. Differences were attributed mainly to technical protocol and variable number of phases/scan lengths. Stroke and hepatocellular carcinoma were the CIs with the highest DRLs. Coronary calcium scoring had the lowest DRL value. Comparison with published literature was limited, as there was scarce information on DRLs based on CI.
This is the first study reporting on feasibility of establishing CT DRLs based on CI using European data. Resulting values will serve as a baseline for comparison with local radiological practice, national authorities when DRLs are set/updated, or as a guideline for local DRL establishment.
• First study reporting on the feasibility of establishing CT diagnostic reference levels based on clinical indication using data collected across Europe. • Only one-fourth of the hospitals had CT machines less than 5 years old. • Large dose variations were observed among hospitals and CT protocols were quite different between hospitals.
本研究旨在探讨在欧洲临床诊断参考水平（EUCLID）项目背景下，针对特定临床指征（CI），定义诊断参考水平（DRLs）的可行性。
一项前瞻性、多中心、独立于行业的欧洲研究，通过在线调查收集了 10 个 CI（中风、慢性鼻窦炎、颈椎创伤、肺栓塞、冠状动脉钙化评分、冠状动脉造影、肺癌、肝细胞癌、腹痛/腹痛、阑尾炎）的数据，其中包括患者临床、技术和剂量参数信息。每个医院至少需要提供每个 CI 20 名以上患者的数据。为了制定 DRLs，遵循了符合国际辐射防护委员会（ICRP）报告 135 项良好实践建议的方法。
从 14 个欧洲国家的 19 家医院收集了 4299 名成年患者和 10 个 CI 的数据，以确定 DRLs。对于同一 CI，不同站点的 DRL 差异很大。差异主要归因于技术方案和不同数量的相位/扫描长度。中风和肝细胞癌是 DRLs 最高的 CI。冠状动脉钙化评分的 DRL 值最低。由于基于 CI 的 DRL 信息稀缺，与已发表文献的比较有限。
这是第一项使用欧洲数据报告基于 CI 建立 CT DRLs 可行性的研究。得出的数值将作为与当地放射实践、国家当局制定/更新 DRL 时的比较基准，或作为当地 DRL 制定的指南。
• 第一项使用欧洲数据报告基于临床指征建立 CT 诊断参考水平的可行性的研究。• 只有四分之一的医院拥有不到 5 年历史的 CT 机。• 医院之间的剂量差异很大，医院之间的 CT 方案差异也很大。
