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制定常见 CT 检查可接受的辐射剂量标准:阿联酋多中心聚焦研究。

Development of acceptable quality radiation dose levels for common computed tomography examinations: A focused multicenter study in United Arab Emirates.

机构信息

Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.

Department of Radiology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria.

出版信息

Front Public Health. 2022 Sep 23;10:964104. doi: 10.3389/fpubh.2022.964104. eCollection 2022.

Abstract

PURPOSE

Diagnostic Reference Level (DRL) is a practical tool for radiation dose optimization, yet it does not indicate the patient size or image quality. The Acceptable Quality Dose (AQD) introduced to address the limitations of the DRLs and it is based on image quality, radiation dose, and patient weight. The aim of this study is to establish the AQD for adult patients' undergoing Computed Tomography (CT) examinations (Head, chest, abdomen).

METHODS

This study is conducted in the four main hospitals at the Ministry of Health and Prevention. Patient information and exposure parameters were extracted. All the acceptable images are scored for their quality assessments. Data is classified as seven weight groups, <50, 50-59, 60-69, 70-79, 80-89, 90-99, and ≥100 kg. The mean ± SD, median, and 75th are calculated for the CTDIvol and DLP for each weight group per examination.

RESULTS

Out of 392, 358 CT examinations are scored with acceptable quality. The median CTDIvol values for the weight groups are obtained as 24.6, 25.4, 25.4, 25.0, 26.0, 27.0, and 29.0 mGy. Moreover, median DLP values are obtained as 576.7, 601.0, 616.5, 636.1, 654.0, 650.0, 780.0, and 622.5 mGy.cm, respectively, for head CT without Contrast Media (CM). Similar calculation for head CT with (CM), chest without CM, abdomen without CM, and chest and abdomen (with and without CM) CTs are presented.

CONCLUSION

Images with bad, unacceptable and higher than necessary qualities contribute to increasing patient dose and increasing the DRLs. The AQD for the selected examinations were lower than the proposed DRLs in the United Arab Emirates. The integration of image quality and patients size in the assessment of the AQD values provide effective model to compare radiation dose indices within facility and compare with others. The obtained results may be useful in terms of improving dose and the diagnostic quality in the national and international levels.

摘要

目的

诊断参考水平(DRL)是辐射剂量优化的实用工具,但它不能指示患者的体型或图像质量。为了解决 DRL 的局限性,引入了可接受质量剂量(AQD),它基于图像质量、辐射剂量和患者体重。本研究的目的是为接受 CT(头部、胸部、腹部)检查的成年患者建立 AQD。

方法

本研究在卫生部和预防部的四家主要医院进行。提取患者信息和曝光参数。对所有可接受的图像进行质量评估评分。数据分为七个体重组,<50、50-59、60-69、70-79、80-89、90-99 和≥100kg。计算每个体重组每个检查的 CTDIvol 和 DLP 的平均值±标准差、中位数和 75 百分位数。

结果

392 次 CT 检查中有 358 次评分达到可接受的质量。体重组的 CTDIvol 中位数值分别为 24.6、25.4、25.4、25.0、26.0、27.0 和 29.0mGy。此外,头部 CT 无对比剂(CM)的中位数 DLP 值分别为 576.7、601.0、616.5、636.1、654.0、650.0、780.0 和 622.5mGy.cm,头部 CT 有 CM、胸部无 CM、腹部无 CM 和胸部和腹部(有和无 CM)CT 也分别进行了类似的计算。

结论

质量差、不可接受和高于必要的图像会导致患者剂量增加和 DRL 增加。选定检查的 AQD 低于阿拉伯联合酋长国提出的 DRL。在评估 AQD 值时,将图像质量和患者体型结合起来,可以提供一种在设施内比较辐射剂量指数并与其他设施进行比较的有效模型。获得的结果在提高国家和国际层面的剂量和诊断质量方面可能是有用的。

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Dose surveys and DRLs: critical look and way forward.剂量调查与药物参考剂量:批判性审视与未来方向
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