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优化PET/CT检查中的辐射防护:减少患者定位过程中的职业暴露。

Optimizing Radiation Protection in PET/CT Examinations: Reducing Occupational Exposure During Patient Positioning.

作者信息

Nagamoto Keisuke, Yoshizuka Nobuyoshi, Kawano Shoji, Nihei Shun-Ichi

机构信息

Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, JPN.

Department of Radiology, Hospital of the University of Occupational and Environmental Health, Kitakyushu, JPN.

出版信息

Cureus. 2024 Dec 3;16(12):e75052. doi: 10.7759/cureus.75052. eCollection 2024 Dec.

Abstract

Objectives The objective of this study was to evaluate the occupational radiation exposure of healthcare workers during positron emission tomography (PET)/CT examinations, focusing on patient positioning and assessing the effectiveness of different radiation protection measures. Methods Thirteen medical workers (physicians, radiological technologists, and nurses) performed PET/CT examinations on 86 patients at a major Japanese hospital from June to August 2019. Occupational doses were measured using a real-time semiconductor dosimeter: RaySafe i2 (Unfors RaySafe, Billdal, Sweden), recording the 1 cm dose equivalent (Hp(10)). Exposure during various tasks was assessed, and radiation protection measures were evaluated, including increasing the number of personnel during patient positioning, using a protective screen (3.0 mm lead equivalent; Kuraray Trading Co., Ltd., Osaka, Japan), and implementing remote patient positioning via the PET/CT operator console. Results Patient positioning and discharge (task 4) resulted in the highest occupational exposure, with a median Hp(10) of 0.66 μSv per event (interquartile range (IQR): 0.54-0.71 μSv). Increasing the number of staff during task 4 did not significantly reduce occupational dose (p=0.725). Using a protective screen reduced the median Hp(10) to 0.58 μSv per event (IQR: 0.51-0.80 μSv). Remote positioning via the operator console further reduced it to 0.49 μSv per event (IQR: 0.35-0.62 μSv), achieving a significant dose-reduction (p=0.016). The dose reduction rates were 23.7% for the protective screen and 35.5% for the operator console method. Conclusions Patient positioning is the primary source of occupational radiation exposure during PET/CT examinations. Remote positioning via the operator console significantly reduces occupational exposure and working time compared to other methods, providing an effective and cost-efficient radiation protection strategy that aligns with the As Low As Reasonably Practicable (ALARP) principle. Advances in knowledge This study demonstrates that remote patient positioning via the operator console is an effective, easily implementable radiation protection measure that enhances operational efficiency without additional costs, representing a valuable advancement in occupational safety during PET/CT examinations.

摘要

目的 本研究的目的是评估医护人员在正电子发射断层扫描(PET)/计算机断层扫描(CT)检查期间的职业辐射暴露情况,重点关注患者体位摆放,并评估不同辐射防护措施的有效性。方法 2019年6月至8月,13名医护人员(医生、放射技师和护士)在日本一家大型医院为86名患者进行了PET/CT检查。使用实时半导体剂量仪RaySafe i2(Unfors RaySafe,瑞典比尔达尔)测量职业剂量,记录1厘米剂量当量(Hp(10))。评估了各项任务期间的暴露情况,并对辐射防护措施进行了评估,包括在患者体位摆放时增加人员数量、使用防护屏(3.0毫米铅当量;日本大阪可乐丽贸易有限公司)以及通过PET/CT操作员控制台进行远程患者体位摆放。结果 患者体位摆放和出院(任务4)导致最高的职业暴露,每次事件的Hp(10)中位数为0.66微希沃特(四分位间距(IQR):0.54 - 0.71微希沃特)。在任务4期间增加工作人员数量并未显著降低职业剂量(p = 0.725)。使用防护屏使每次事件的Hp(10)中位数降至0.58微希沃特(IQR:0.51 - 0.80微希沃特)。通过操作员控制台进行远程体位摆放进一步将其降至每次事件0.49微希沃特(IQR:0.35 - 0.62微希沃特),实现了显著的剂量降低(p = 0.016)。防护屏的剂量降低率为23.7%,操作员控制台方法的剂量降低率为35.5%。结论 患者体位摆放是PET/CT检查期间职业辐射暴露的主要来源。与其他方法相比,通过操作员控制台进行远程体位摆放显著降低了职业暴露和工作时间,提供了一种符合合理可行尽量低(ALARP)原则的有效且具有成本效益的辐射防护策略。知识进展 本研究表明,通过操作员控制台进行远程患者体位摆放是一种有效且易于实施的辐射防护措施,可在不增加成本的情况下提高操作效率,是PET/CT检查期间职业安全方面的一项有价值的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db3e/11695088/d1a156c9299b/cureus-0016-00000075052-i01.jpg

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