Medical Physics Department, University Hospital "Maggiore della Carità", Novara, Italy.
Radiology Department, University Hospital "Maggiore della Carità", Novara, Italy.
Eur Radiol. 2021 Jul;31(7):4452-4458. doi: 10.1007/s00330-020-07665-0. Epub 2021 Jan 15.
To estimate the number of patients who receive a cumulative effective dose (CED) of ≥ 100 mSv from computed tomography (CT) in a single day or episode of care.
We examined 28,870 patients who underwent 49,834 CT examinations in a tertiary care centre in Italy in 2.5 years. Radiation exposures were retrieved from the hospital's automatic exposure monitoring system. Two cohorts were identified as those who received a CED of ≥ 100 mSv in a single day and within a month starting from the first examination. Organ doses were estimated for the first cohort.
Among the 1765 (6.1%) patients who received CED ≥ 100 mSv in the observation period, 427 received a CED of ≥ 100 mSv within a month (and 70 patients in a single day). This group represented 1.5% of all patients who underwent CT exams and 24% of those who received CED ≥ 100 mSv in the observation period. The clinical indication for referral included cancer in 132 patients (31%) and non-oncological indications in 295 patients (69%). In 68/70 patients with CED > 100 mSv in a single day, at least one organ/tissue received a dose of ≥ 100 mGy.
The finding of a sizeable percentage of patients undergoing CT exams and receiving CED ≥ 100 mSv in a single episode of care points toward the need of imaging appropriateness criteria, to revise the routine protocols, to replace older machines, and to provide to the radiologist the patient's prior radiation history to facilitate an appropriate decision-making process.
• Patients can receive effective doses greater than 100 mSv in a single CT or in multiple CT examinations performed in a single episode of care in 1.5% of patients in a 2.5-year period. • In this study, the clinical indication for CT referral was non-oncological in 69% of patients. • The patient's prior radiation history should be provided to the referring physicians and the radiological medical practitioner to facilitate an appropriate decision-making process.
估算在单一就诊期间或医疗期间内，因计算机断层扫描（CT）而接受累积有效剂量（CED）≥100 mSv 的患者人数。
我们检查了意大利一家三级保健中心 2.5 年内进行的 49834 次 CT 检查的 28870 名患者。辐射暴露量从医院的自动曝光监测系统中检索到。确定了两个队列，分别为在首次检查后一天或一个月内接受 CED≥100 mSv 的患者。为第一队列估计了器官剂量。
在观察期内，1765 名（6.1%）接受 CED≥100 mSv 的患者中，427 名在一个月内接受 CED≥100 mSv（70 名在一天内）。该组占接受 CT 检查的所有患者的 1.5%和观察期内接受 CED≥100 mSv 的患者的 24%。转诊的临床指征包括 132 名患者（31%）的癌症和 295 名患者（69%）的非肿瘤指征。在 70 名 CED＞100 mSv 的患者中，至少有一个器官/组织的剂量≥100 mGy。
在单次就诊期间进行 CT 检查并接受 CED≥100 mSv 的患者比例较大，这表明需要影像学适宜性标准，修订常规方案，更换旧机器，并向放射科医生提供患者的既往辐射史，以促进做出适当的决策。
在 2.5 年内，1.5%的患者在单次 CT 或单次就诊期间进行的多次 CT 检查中接受的有效剂量超过 100 mSv。
在这项研究中，CT 转诊的临床指征在 69%的患者中是非肿瘤性的。
应向转诊医生和放射科医生提供患者的既往辐射史，以促进做出适当的决策。
