Robatjazi Mostafa, Moayed Mahdis, Baghani Hamid Reza, Molazadeh Mikaeil, Shomoossi Nematullah
Department of Medical Physics and Radiological Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Non-Communicable Disease Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Radiat Environ Biophys. 2024 Mar;63(1):27-37. doi: 10.1007/s00411-023-01056-x. Epub 2024 Jan 7.
This study aimed to estimate lung and breast doses for individual patients using the size-specific dose estimate (SSDE) method, as well as calculating effective doses, in patients who underwent chest CT scans during the COVID-19 pandemic. Cancer risk incidence was estimated using excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) models from the Biological Effects of Ionizing Radiation Report VII (BEIR-VII). Data from about 570 patients who underwent CT scans for COVID-19 screening were utilized for this study. Using the header of the CT images in a Python script, SSDE and effective dose were calculated for each patient. The SSDE obtained by water equivalent effective diameter (wSSDE) was considered as lung and breast dose, and applied in organ-specific cancer risk estimation. The mean wSSDE value for females (13.3 mGy) was slightly higher than that for males (13.1 mGy), but the difference was not statistically significant (P value = 0.41). No significant differences were observed between males and females in terms of calculated EAR and ERR for lung cancer at 5 and 30 years after exposure (P value = 0.47, 0.46, respectively). Similarly, there was no significant difference in lung cancer LAR values between females and males (P value = 0.48). The results also indicated a decrease in LAR values for both lung and breast cancers with increasing exposure age. In accordance with the ALARA (as low as reasonably achievable) principle, it is important for medical staff and the general public to consider the benefits of CT imaging in detecting such infections. Additionally, imaging medical physicists and CT scan experts should optimize imaging protocols and strike a balance between image quality for detecting abnormalities and radiation dose, all while adhering to the ALARA principle.
本研究旨在使用特定尺寸剂量估计（SSDE）方法估算2019冠状病毒病大流行期间接受胸部CT扫描患者的肺部和乳腺剂量，并计算有效剂量。使用电离辐射生物学效应报告VII（BEIR-VII）中的超额相对风险（ERR）、超额绝对风险（EAR）和终生归因风险（LAR）模型估计癌症风险发生率。本研究使用了约570名因2019冠状病毒病筛查而接受CT扫描患者的数据。在Python脚本中利用CT图像的标题，为每位患者计算SSDE和有效剂量。通过水等效有效直径（wSSDE）获得的SSDE被视为肺部和乳腺剂量，并应用于器官特异性癌症风险估计。女性的平均wSSDE值（13.3 mGy）略高于男性（13.1 mGy），但差异无统计学意义（P值 = 0.41）。在暴露后5年和30年，男性和女性在肺癌的计算EAR和ERR方面未观察到显著差异（P值分别为0.47、0.46）。同样，女性和男性在肺癌LAR值方面也无显著差异（P值 = 0.48）。结果还表明，随着暴露年龄的增加，肺癌和乳腺癌的LAR值均降低。根据“尽可能合理达到低水平”（ALARA）原则，医护人员和公众考虑CT成像在检测此类感染中的益处非常重要。此外，影像医学物理学家和CT扫描专家应优化成像方案，在检测异常的图像质量和辐射剂量之间取得平衡，同时遵守ALARA原则。
