全国基于适应证的诊断参考水平值在 CT 中的应用：加纳的初步研究结果。

National indication-based diagnostic reference level values in computed tomography: Preliminary results from Ghana.

机构信息

Radiography Department, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana; Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Legon, Ghana.

Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Legon, Ghana.

出版信息

Phys Med. 2021 Apr;84:274-284. doi: 10.1016/j.ejmp.2021.03.012. Epub 2021 Mar 26.

DOI:10.1016/j.ejmp.2021.03.012

PMID:33775566

Abstract

PURPOSE

This study was conducted to develop national indication-based DRL values for common indications of adult computed tomography (CT) examinations for clinical application in Ghana.

MATERIALS AND METHODS

The methodological approach recommended by the International Commission on Radiological Protection (ICRP), Publication 135, for the development of DRLs, was employed. Studies on CT infrastructure, common indications and quality control tests were first undertaken. A sample of 20 CT dose descriptor/quantity data sets were collected from each centre for each indication. Overall, 3960 data sets were collected for all identified common indications from 71.4% of the total CT scanners in Ghana (25/35). The data were collected from image folders reported and accepted by radiologists. The objective image quality was assessed through a signal to noise ratio (SNR) analysis prior to using the data and extracting DRL values.

RESULTS

Clinical indications and their respective DRL values in terms of volume weighted CT dose index (CTDI) and dose length product (DLP) were cerebrovascular accident (CVA)/stroke (77 mGy; 1313 mGy.cm), head trauma/injury (76 mGy; 1596 mGy.cm), brain tumour/space occupying lesion (SOL) (77 mGy; 2696 mGy.cm), lung tumour/cancer (12 mGy; 828 mGy.cm) and chest lesion with chronic kidney disease (CKD) (13 mGy; 467 mGy.cm). Others were abdominopelvic lesion (17 mGy; 1299 mGy.cm), kidney stones (15 mGy; 731 mGy.cm), urothelial malignancy/CT-intravenous urogram (CT-IVU) (11 mGy; 1449 mGy.cm) and pulmonary embolism (PE) (14 mGy; 942 mGy.cm).

CONCLUSION

National Indication-based DRL values developed in this study are recommended to be used to manage CT radiation dose in Ghana.

摘要

目的

本研究旨在为加纳临床应用开发成人计算机断层扫描（CT）常见适应症的基于国家指标的剂量参考水平（DRL）。

材料和方法

采用国际辐射防护委员会（ICRP）第 135 号出版物推荐的用于制定 DRL 的方法学方法。首先进行了 CT 基础设施、常见适应症和质量控制测试的研究。从每个中心的每个适应症中收集了 20 个 CT 剂量描述符/量数据集的样本。总体而言，从加纳总 CT 扫描仪的 71.4%（25/35）中收集了所有确定的常见适应症的 3960 个数据集。数据是从放射科医生报告和接受的图像文件夹中收集的。在使用数据和提取 DRL 值之前，通过信噪比（SNR）分析评估客观图像质量。

结果

以体积加权 CT 剂量指数（CTDI）和剂量长度乘积（DLP）表示的临床适应症及其各自的 DRL 值分别为：脑血管意外（CVA）/中风（77 mGy；1313 mGy·cm）、头部创伤/损伤（76 mGy；1596 mGy·cm）、脑肿瘤/占位性病变（SOL）（77 mGy；2696 mGy·cm）、肺肿瘤/癌症（12 mGy；828 mGy·cm）和慢性肾病（CKD）的胸部病变（13 mGy；467 mGy·cm）。其他适应症包括腹盆腔病变（17 mGy；1299 mGy·cm）、肾结石（15 mGy；731 mGy·cm）、尿路上皮恶性肿瘤/CT-静脉尿路造影（CT-IVU）（11 mGy；1449 mGy·cm）和肺栓塞（PE）（14 mGy；942 mGy·cm）。