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在剂量管理系统支持下改进介入操作诊断参考水平区域性项目(OPRIPALC)以保护患者和工作人员。

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff.

机构信息

Servicio de Fisica Médica, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.

Radiology Department, Complutense University, 28040 Madrid, Spain.

出版信息

J Radiol Prot. 2024 Jun 12;44(2). doi: 10.1088/1361-6498/ad53d8.

Abstract

Interventional radiology is a clinical practice with important benefits for patients, but which involves high radiation doses. The optimisation of radiation protection (RP) for paediatric interventional cardiology is a priority for both patients and staff. The use of diagnostic reference levels (DRLs) has been proposed by the International Commission on Radiological Protection to improve RP in imaging procedures. Dose management systems (DMSs) allow the automatic collection of dosimetric, geometric and technical data to assist the optimisation process, with a continuous audit of the procedures, generating alerts to implement corrective actions when necessary. Patient dose indicators may be analysed individually and for different radiation events (fluoroscopy and cine runs). Occupational doses per procedure may be analysed (if electronic dosimeters are available) and linked with patient doses for an integrated approach to RP. Regional optimisation programmes require data collection and processing from several countries to set and periodically update the DRLs. Patient data is anonymised, and each participating hospital has access to their data in a central computer server. Using DMSs may be one of the best ways to support these programs in the collection and analysis of data, raising alerts about high patient and occupational doses and suggesting optimisation actions.

摘要

介入放射学是一种具有重要临床效益的实践,但涉及到高剂量的辐射。优化儿科介入心脏病学的放射防护(RP)是患者和工作人员的首要任务。国际放射防护委员会(ICRP)建议使用诊断参考水平(DRLs)来改进成像程序中的 RP。剂量管理系统(DMS)允许自动收集剂量学、几何和技术数据,以协助优化过程,并对程序进行持续审核,在必要时生成警报以采取纠正措施。可以单独和针对不同的辐射事件(透视和电影运行)分析患者剂量指标。可以分析每次手术的职业剂量(如果有电子剂量计),并将其与患者剂量相关联,以实现 RP 的综合方法。区域优化计划需要从多个国家收集和处理数据,以制定和定期更新 DRL。患者数据是匿名的,每个参与的医院都可以在中央计算机服务器上访问其数据。使用 DMS 可能是支持这些计划在数据收集和分析中使用的最佳方法之一,提醒注意高患者和职业剂量,并建议优化措施。

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