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计算机断层扫描引导下活检程序中的患者剂量估计

Patient Dose Estimation in Computed Tomography-Guided Biopsy Procedures.

作者信息

Siomou Evangelia, Filippiadis Dimitrios K, Efstathopoulos Efstathios P, Antonakos Ioannis, Panayiotakis George S

机构信息

School of Health Sciences, University of Patras, 26504 Patras, Greece.

2nd Department of Radiology, National and Kapodistrian University of Athens, 1st Rimini St., Chaidari, 12461 Athens, Greece.

出版信息

J Imaging. 2023 Nov 30;9(12):267. doi: 10.3390/jimaging9120267.

Abstract

This study establishes typical Diagnostic Reference Levels (DRL) values and assesses patient doses in computed tomography (CT)-guided biopsy procedures. The Effective Dose (ED), Entrance Skin Dose (ESD), and Size-Specific Dose Estimate (SSDE) were calculated using the relevant literature-derived conversion factors. A retrospective analysis of 226 CT-guided biopsies across five categories (Iliac bone, liver, lung, mediastinum, and para-aortic lymph nodes) was conducted. Typical DRL values were computed as median distributions, following guidelines from the International Commission on Radiological Protection (ICRP) Publication 135. DRLs for helical mode CT acquisitions were set at 9.7 mGy for Iliac bone, 8.9 mGy for liver, 8.8 mGy for lung, 7.9 mGy for mediastinal mass, and 9 mGy for para-aortic lymph nodes biopsies. In contrast, DRLs for biopsy acquisitions were 7.3 mGy, 7.7 mGy, 5.6 mGy, 5.6 mGy, and 7.4 mGy, respectively. Median SSDE values varied from 7.6 mGy to 10 mGy for biopsy acquisitions and from 11.3 mGy to 12.6 mGy for helical scans. Median ED values ranged from 1.6 mSv to 5.7 mSv for biopsy scans and from 3.9 mSv to 9.3 mSv for helical scans. The study highlights the significance of using DRLs for optimizing CT-guided biopsy procedures, revealing notable variations in radiation exposure between helical scans covering entire anatomical regions and localized biopsy acquisitions.

摘要

本研究确立了典型的诊断参考水平(DRL)值,并评估了计算机断层扫描(CT)引导下活检程序中的患者剂量。使用相关文献得出的转换因子计算有效剂量(ED)、体表入射剂量(ESD)和特定尺寸剂量估计值(SSDE)。对五类(髂骨、肝脏、肺、纵隔和腹主动脉旁淋巴结)的226例CT引导下活检进行了回顾性分析。按照国际放射防护委员会(ICRP)第135号出版物的指南,将典型DRL值计算为中位数分布。螺旋模式CT采集的DRL设定为:髂骨活检为9.7 mGy,肝脏活检为8.9 mGy,肺部活检为8.8 mGy,纵隔肿块活检为7.9 mGy,腹主动脉旁淋巴结活检为9 mGy。相比之下,活检采集的DRL分别为7.3 mGy、7.7 mGy、5.6 mGy、5.6 mGy和7.4 mGy。活检采集的SSDE中位数在7.6 mGy至10 mGy之间,螺旋扫描的SSDE中位数在11.3 mGy至12.6 mGy之间。活检扫描的ED中位数在1.6 mSv至5.7 mSv之间,螺旋扫描的ED中位数在3.9 mSv至9.3 mSv之间。该研究强调了使用DRL优化CT引导活检程序的重要性,揭示了覆盖整个解剖区域的螺旋扫描与局部活检采集之间辐射暴露的显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd7a/10744458/2e07e91aeae8/jimaging-09-00267-g001.jpg

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