Yang Fanqiaochu, Gao Linfeng
School of Public Health, Fudan University, Shanghai, People's Republic of China.
Shanghai Municipal Center for Disease Control & Prevention, Shanghai, People's Republic of China.
J Radiol Prot. 2024 Apr 23;44(2). doi: 10.1088/1361-6498/ad3ce5.
Computed tomography (CT) is extensively utilised in medical diagnostics due to its notable radiographic superiority. However, the cancer risk associated with CT examinations, particularly in children, is of significant concern. The assessment of cancer risk relies on the radiation dose to examinees. Diagnostic reference levels (DRLs) and achievable doses (ADs) were used to assess the level of radiation dose in CT examinations widely. Although the national DRLs of paediatric CT have been explored in China, few local DRLs at the city level have been assessed. To set up the local DRLs and ADs of paediatric CT, we investigated the radiation dose level for paediatric CT in Shanghai. In this survey, a total of 3061 paediatric CT examinations underwent in Shanghai in 2022 were selected by stratified sampling, and the dose levels in terms of volume CT dose index (CTDI) and the dose-length product (DLP) were analysed by 4 age groups. The DRLs and ADs were set at the 75th and 50th percentile of the distribution and compared with the previous studies at home and abroad. The survey results revealed that, for head scan, the DRLs of CTDIwere from 25 to 46 mGy, and the levels of DLP were from 340 to 663 mGy·cm. For chest, the DRLs of CTDIwere from 2.2 to 8.3 mGy, and the levels of DLP were from 42 to 223 mGy·cm. For abdomen, the DRLs of CTDIwere from 6.3 to 16 mGy, and the levels of DLP were from 181 to 557 mGy·cm. The ADs were about 60% lower than their corresponding DRLs. The levels of radiation doses in children-based hospitals were higher than those in other medical institutions (< 0.001). In conclusion, there was still potential for reducing radiation dose of paediatric CT, emphasising the urgent need for optimising paediatric CT dose in Shanghai.
计算机断层扫描（CT）因其显著的放射学优势而在医学诊断中得到广泛应用。然而，与CT检查相关的癌症风险，尤其是在儿童中，备受关注。癌症风险的评估依赖于受检者所接受的辐射剂量。诊断参考水平（DRLs）和可达到剂量（ADs）被广泛用于评估CT检查中的辐射剂量水平。尽管中国已对儿科CT的国家DRLs进行了探索，但很少有城市层面的本地DRLs被评估。为了建立儿科CT的本地DRLs和ADs，我们调查了上海儿科CT的辐射剂量水平。在本次调查中，通过分层抽样选取了2022年在上海进行的3061例儿科CT检查，并按4个年龄组分析了容积CT剂量指数（CTDI）和剂量长度乘积（DLP）方面的剂量水平。DRLs和ADs分别设定为分布的第75百分位数和第50百分位数，并与国内外先前的研究进行比较。调查结果显示，对于头部扫描，CTDI的DRLs为25至46 mGy，DLP水平为340至663 mGy·cm。对于胸部，CTDI的DRLs为2.2至8.3 mGy，DLP水平为42至223 mGy·cm。对于腹部，CTDI的DRLs为6.3至16 mGy，DLP水平为181至557 mGy·cm。ADs比其相应的DRLs低约60%。儿童医院的辐射剂量水平高于其他医疗机构（<0.001）。总之，儿科CT的辐射剂量仍有降低的潜力，这凸显了上海优化儿科CT剂量的迫切需求。
