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European Radiology:儿童c臂锥形束CT中各年龄组的标准化器官辐射剂量

2022-08-23 shaosai MedSci原创

CBCT驱动的检查也可能在儿童中进行,且认为比成人更具有辐射敏感性,更有可能在一生中接受多次照射。因此,应更加注意对儿童辐射敏感器官辐射剂量的减少。

C型臂锥形束计算机断层扫描(CBCT)是一种先进的成像手段,已被整合到最新一代的数字减影血管成像(DSA)系统中。C型臂CBCT实现了对血管解剖的介入前评估、植入物定位的术中评估以及对手术结果的及时评估,减少了早期二次介入或将患者转移到标准CT室的必要。当然,在CBCT检查中需要进行辐射剂量测定。在CBCT中,剂量面积积(DAP)为衡量病人暴露的一个指标。

据我们所知,很少有研究记录了成人C型臂CBCT照射的辐射剂量结果。CBCT驱动的检查也可能在儿童中进行,且认为比成人更具有辐射敏感性,更有可能在一生中接受多次照射。因此,应更加注意对儿童辐射敏感器官辐射剂量的减少。以前文献中没有报道过小儿C型臂CBCT期间的器官剂量信息,而且缺少小儿C型臂CBCT的DAP到器官剂量的转换系数。

近日,发表在European Radiology杂志的一项研究本使用先进的剂量测定法评估了小儿体部C臂CBCT期间主要放射敏感器官的辐射剂量,并确定了标准化器官剂量(NOD)与器官剂量的转换系数。

本项研究使用了四个拟人模型,模拟了新生儿、1岁、5岁和10岁儿童的平均个体。基于蒙特卡洛(MC)的个性化剂量测定被用来估计儿童的器官剂量,这些器官剂量是在最近发布的最新一代C型臂CBCT系统上进行胸部和腹部C型臂CBCT采集的。产生了特定年龄的标准化器官剂量,并估算了胸部的皮肤、骨骼、乳房、肺、食道、胸腺、心脏以及腹部的肝脏、肾上腺、肾脏、胰腺、胃、胆囊和脾脏的器官剂量。估计的剂量与使用热释光剂量计(TLD)进行物理测量得到的相应数值进行了比较。 


图  MC计算NODCTDI的结果:方案A(a)、方案B(b)和方案C(c)的mSv/mGy值

研究结果包括了胸腔和腹部采集协议的器官剂量,大多数器官接受的剂量低于1 mSv。对于所有的年龄段,从新生儿到10岁的儿童标准化的器官剂量都有所下降。使用MC和TLD获得的器官剂量之间的差异小于8%。 

 

原文出处:

Antonios E Papadakis,John Damilakis.Organ doses and normalized organ doses for various age groups in ultralow dose pediatric C-arm cone-beam CT.DOI:10.1007/s00330-022-08767-7

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    2023-07-18 feather89
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    2022-08-24 jiyangfei
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    2022-08-23 医鸣惊人

    认真学习了

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