Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland.
Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland.
Radiat Prot Dosimetry. 2024 Sep 10;200(14):1365-1371. doi: 10.1093/rpd/ncae175.
This study aims to provide radiation reference levels in orthopaedic surgery. A total of 753 procedures were collected within 1 y. Categories containing several similar procedures were created based on four criteria: same anatomical area, same level of complexity, only single procedures, and at least 10 cases per category. Exposure was defined in terms of air kerma-area product, fluoroscopy time, and air kerma at the patient entrance reference point. For common procedures, median effective doses to patient were calculated using the Monte Carlo Software PCXMC. Most irradiating procedure in this study i.e. intramedullary nailing of the proximal femur was equivalent to an air kerma at the patient entrance reference point of 37.1 mGy, which is ~50 times lower than the threshold for acute deterministic effects of radiation. Optimization remains a must to reduce the dose while maintaining the image quality and reducing the likelihood of stochastic effects.
本研究旨在提供矫形外科的辐射参考水平。在 1 年内共收集了 753 例手术。根据四个标准创建了包含多个类似手术的类别：相同解剖区域、相同复杂程度、仅单一手术和每个类别至少 10 例。暴露量根据空气比释动能-面积乘积、透视时间和患者入射参考点处的空气比释动能定义。对于常见手术，使用蒙特卡罗软件 PCXMC 计算患者的有效剂量中位数。本研究中最常见的辐射手术，即股骨近端髓内钉固定术，患者入射参考点处的空气比释动能为 37.1mGy，这大约是急性确定性辐射效应阈值的 50 倍。为了在保持图像质量和降低随机性效应的可能性的同时降低剂量，优化仍然是必须的。
