使用第三代双源多探测器及光谱整形技术的全身低剂量计算机断层扫描:方案优化与文献综述

Whole Body Low Dose Computed Tomography Using Third-Generation Dual-Source Multidetector With Spectral Shaping: Protocol Optimization and Literature Review.

作者信息

Baldi Dario, Tramontano Liberatore, Alfano Vincenzo, Punzo Bruna, Cavaliere Carlo, Salvatore Marco

机构信息

IRCCS SDN, Naples, Italy.

出版信息

Dose Response. 2020 Dec 29;18(4):1559325820973131. doi: 10.1177/1559325820973131. eCollection 2020 Oct-Dec.

Abstract

For decades, the main imaging tool for multiple myeloma (MM) patient's management has been the conventional skeleton survey. In 2014 international myeloma working group defined the advantages of the whole-body low dose computed tomography (WBLDCT) as a gold standard, among imaging modalities, for bone disease assessment and subsequently implemented this technique in the MM diagnostic workflow. The aim of this study is to investigate, in a group of 30 patients with a new diagnosis of MM, the radiation dose (CT dose index, dose-length product, effective dose), the subjective image quality score and osseous/extra-osseous findings rate with a modified WBLDCT protocol. Spectral shaping and third-generation dual-source multidetector CT scanner was used for the assessment of osteolytic lesions due to MM, and the dose exposure was compared with the literature findings reported until 2020. Mean radiation dose parameters were reported as follows: CT dose index 0.3 ± 0.1 mGy, Dose-Length Product 52.0 ± 22.5 mGy*cm, effective dose 0.44 ± 0.19 mSv. Subjective image quality was good/excellent in all subjects. 11/30 patients showed osteolytic lesions, with a percentage of extra-osseous findings detected in 9/30 patients. Our data confirmed the advantages of WBLDCT in the diagnosis of patients with MM, reporting an effective dose for our protocol as the lowest among previous literature findings.

摘要

几十年来,用于多发性骨髓瘤(MM)患者管理的主要成像工具一直是传统的骨骼检查。2014年,国际骨髓瘤工作组将全身低剂量计算机断层扫描(WBLDCT)定义为骨病评估成像方式中的金标准,并随后在MM诊断流程中采用了该技术。本研究的目的是在一组30例新诊断的MM患者中,采用改良的WBLDCT方案,研究辐射剂量(CT剂量指数、剂量长度乘积、有效剂量)、主观图像质量评分以及骨/骨外发现率。使用光谱整形和第三代双源多探测器CT扫描仪评估MM引起的溶骨性病变,并将剂量暴露与截至2020年报道的文献结果进行比较。平均辐射剂量参数报告如下:CT剂量指数0.3±0.1 mGy,剂量长度乘积52.0±22.5 mGy*cm,有效剂量0.44±0.19 mSv。所有受试者的主观图像质量均为良好/优秀。30例患者中有11例显示溶骨性病变,30例患者中有9例检测到骨外发现。我们的数据证实了WBLDCT在MM患者诊断中的优势,报告我们方案的有效剂量是以往文献结果中最低的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff9b/7783892/8e723bec43b3/10.1177_1559325820973131-fig1.jpg

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