霍奇金淋巴瘤和弥漫性大 B 细胞淋巴瘤患者未接受放疗的放射影像学检查的累积辐射暴露。
Cumulative radiation exposure from radiological imaging in patients with Hodgkin and diffuse large b-cell lymphoma not submitted to radiotherapy.
机构信息
Medical Physics Department, University Hospital "Maggiore della Carità", Novara, Italy.
Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
出版信息
Br J Radiol. 2023 Sep;96(1149):20230106. doi: 10.1259/bjr.20230106. Epub 2023 Jul 26.
OBJECTIVE
To assess the cumulated exposure to radiation due to imaging in Hodgkin (HL) and diffuse large B-cell (DLBCL) lymphoma patients who were not submitted to radiotherapy.
METHODS
The study population included 51 and 83 adult patients with HL and DLBCL, with a follow-up duration >1 year. The cumulated exposure was expressed using patient-specific data as cumulated effective dose (CED).
RESULTS
Fifty-one HL patients (median age 47 years) were followed for a median of 3.5 years. The median total CED per subject was 104 mSv. CT and PET/CT examinations accounted for 75 and 25% of the total CED, respectively. 26 patients (49%) had a total CED ≥ 100 mSv and the maximum CED was 302 mSv. Eighty-three DLBCL patients (median age 66 years) were followed for a median of 3.7 years. The median total CED per subject over the study period was 134 mSv. CT and PET/CT for 86% and 13% of the total CED, respectively. 56 patients (67%) had a total CED ≥100 mSv. The maximum CED was 557 mSv.
CONCLUSION
Our study demonstrated the large number of imaging procedures performed for patients with lymphoma. Overall, 61% of the patients accrued a CED ≥ 100 mSv. Imaging policies were only in a partial agreement with current international guidelines.
ADVANCES IN KNOWLEDGE
The cumulated exposure radiation exposure may be of concern in HL patients and the contribution of CT procedures to the total CED is significant. The standardisation of clinical guidelines for managing patients with lymphoma is warranted.
目的
评估未接受放疗的霍奇金（HL）和弥漫性大 B 细胞（DLBCL）淋巴瘤患者因影像学检查而累积的辐射暴露。
方法
研究人群包括 51 例 HL 和 83 例 DLBCL 成年患者，随访时间＞1 年。累积暴露量采用患者特定数据表示为累积有效剂量（CED）。
结果
51 例 HL 患者（中位年龄 47 岁）中位随访时间为 3.5 年。每位患者的中位总 CED 为 104mSv。CT 和 PET/CT 检查分别占总 CED 的 75%和 25%。26 例（49%）患者的总 CED≥100mSv，最大 CED 为 302mSv。83 例 DLBCL 患者（中位年龄 66 岁）中位随访时间为 3.7 年。研究期间每位患者的中位总 CED 为 134mSv。CT 和 PET/CT 分别占总 CED 的 86%和 13%。56 例（67%）患者的总 CED≥100mSv，最大 CED 为 557mSv。
结论
本研究表明淋巴瘤患者进行了大量的影像学检查。总体而言，61%的患者累积 CED≥100mSv。影像学政策仅部分符合当前国际指南。
知识进展
HL 患者的累积辐射暴露可能令人担忧，CT 检查对总 CED 的贡献显著。有必要对管理淋巴瘤患者的临床指南进行标准化。
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