CT检查个体化辐射剂量估算研究现状

辐射防护 ›› 2017, Vol. 37 ›› Issue (2): 153-160.

CT检查个体化辐射剂量估算研究现状

梁保辉^1,2, 陈志¹, 徐榭¹

1.中国科学技术大学核科学技术学院,合肥 230000;
2.蚌埠医学院医学影像学系,安徽蚌埠 233030

收稿日期:2016-04-20 出版日期:2017-03-20 发布日期:2021-11-11
通讯作者: 徐榭。E-mail:xgxu@ustc.edu.cn
作者简介:梁保辉(1985—),男,2008年毕业于阜阳师范学院物理学专业,2011年毕业于苏州大学生物医学工程(医学物理方向)专业,获硕士学位,2016年毕业于中国科学技术大学核科学技术学院核科学与技术专业,获博士学位。E-mail:yxwlx@126.com
基金资助:
国家自然科学基金项目(项目编号:11375181)资助;蚌埠医学院校级科研课题(项目编号:byky1319)资助。

Progress of patient size-specific dose estimation in CT examinations

Liang Baohui^1,2, Chen Zhi¹, Xu Xie¹

1. School of Nuclear Science and Technology, University of Science and Technology of China, Hefei 230000;
2. Department of Medical Imaging, Benbu Medical College, Anhui Bengbu 233000

Received:2016-04-20 Online:2017-03-20 Published:2021-11-11

摘要/Abstract

摘要： 2011年和2014年美国医学物理学会分别发布204号和220号报告,描述基于个体体征估算CT受检者的辐射剂量。204号报告介绍应用受检者前后径和左右径等描述个体体征,220号报告介绍用水当量直径描述受检者的体型特异性,利用体型特异性的转换因子估算CT扫描受检者体型相关的辐射剂量(SSDE)。近年来,国外一系列的文章在SSDE方面进行了深入的研究,本文首先介绍两则报告的主要内容,并对SSDE在儿童和成年人群CT检查诊断参考水平的制定、CT断层图像的质量、受检者器官剂量和有效剂量的估算方面的研究现状进行综述,为开展国内SSDE相关研究和应用提供参考。

关键词: 计算机断层扫描(CT), 个体化剂量估算, 体型大小

Abstract: American Association of Physicists in Medicine (AAPM) have published Reports 204 and 220 about size-specific dose estimation (SSDE) in CT examinations in 2011 and 2014, respectively. Antero-posterior dimension (APD) and lateral dimension (LD) have been used to represent the size of patient in Report 204, while Report 220 has used water-equivalent diameter to estimate the SSDE. In recent years, many papers on thorough SSDE studies have been published. In this review, we introduced the main contents of the two Reports, followed by an overview of the applications of SSDE in CT radiation protection, such as establishment of diagnostic reference levels of CT examinations, evaluation of image quality of CT, estimation of organ dose and effective dose of the patients, which can be adopted in the research and applications of SSDE in China.

Key words: computed tomography, size-specific dose estimate, patient size

中图分类号:

TL172

梁保辉, 陈志, 徐榭. CT检查个体化辐射剂量估算研究现状[J]. 辐射防护, 2017, 37(2): 153-160.

Liang Baohui, Chen Zhi, Xu Xie. Progress of patient size-specific dose estimation in CT examinations[J]. RADIATION PROTECTION, 2017, 37(2): 153-160.

参考文献

[1] Boone MJ, Strauss KJ, Cody DD, et al. Size-specific dose estimates (SSDE) in pediatric and adult body CT examinations[R]. AAPM Report 204. 2011.
[2] DeMarco JJ, Cagnon CH, Cody DD, et al. Estimating radiation doses from multidetector CT using Monte Carlo simulations: effects of different size voxelized patient models on magnitudes of organ and effective dose[J]. Phys Med Biol, 2007, (52):2 583-2 597.
[3] McCollough C, Bakalyar DM, Bostani M, et al. Use of water equivalent diameter for calculating patient size.and Size-Specific Dose Estimates (SSDE) in CT[R]. AAPM Task Group 220. 2014.
[4] 张晓东,郭小超,王霄英. 体型特异性剂量估计的概念和方法[J]. 放射学实践, 2013, 28(3):312-314.
[5] Wang J, Duan X, Christner JA, et al. Attenuation-based estimation of patient size for the purpose of size specific dose estimation in CT:Part I. Developmentand validation of methods using the CT image[J]. Med Phys, 2012, 39 (11):6 764-6 772.
[6] Ikuta I, Warden GI, Andriole KP, et al. Estimating patient dose from X-ray Tube output metrics: automated measurement of patient size from CT images enables largescale size-specific dose estimates[J]. Radiology, 2014, 270(2):472-480.
[7] Wang J, Christner JA, Duan X, et al. Attenuation-based estimation of patient size for the purpose of size specific dose estimation in CT: Part II. Implementation on abdomenand thorax phantoms using cross sectional CT images and scanned projection radiograph images[J]. Med Phys, 2012, 39 (11):6 772-6 778.
[8] Christner JA, Braun NN, Jacobsen MC, et al. Size-specific dose estimates for adult patients at CT of the Torso[J]. Radiology, 2012, 265(3):841-848.
[9] Valeri G, Cegna S, Mari A, et al. Evaluating the appropriateness of dosimetric indices in body CT[J]. Radiol Med, 2015, (120):466-473.
[10] Figueira C, Di Maria S, Baptista M, et al. Paediatric CT exposures: Comparison between CTDI_vol and SSDE methods using measurements and Monte Carlo simulations[J]. Radiation Protection Dosimetry, 2015,165(1-4):210-215.
[11] 刘长安,陈肖华. 放射诊疗中的辐射防护[M]. 北京:军事医学出版社,2014:9.
[12] Imai R, Miyazaki O, Horiuchi T, et al. Local diagnostic reference level based on size-specific dose estimates: Assessment of pediatric abdominal/pelvic computedtomography at a Japanese national children's hospital[J]. Pediatr Radiol, 2015,45(3):345-353.
[13] Granata C, Origgi D, Palorini F, et al. Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey[J]. Pediatr Radiol, 2015, (45):695-705.
[14] Goske MJ, StraussmKJ, Coombs LP, et al. Diagnostic reference ranges for Pediatric abdominal CT[J]. Radiology, 2013,268(1):208-218.
[15] Jackson D, Atkin K, Bettenay F, et al. Paediatric CT dose: a multicentre audit of subspecialty practice in Australia and New Zealand[J]. Eur Radiol, 2015,(3):1-14.
[16] 江苏省疾病预防控制中心. GBZ 165—2012 X射线计算机断层摄影放射防护要求[S]. 北京:中国标准出版社,2012.
[17] 彭建亮,党磊,刘长安. CT诊断参考水平的制定及进展[J]. 中国医学影像技术, 2014,30(10):1 583-1 586.
[18] Ogden K, Huda W, Scalzetti EM, et al. Patient size and X-ray transmission in body CT[J]. Health Physics, 2004, 86(4):397-406.
[19] Brady SL, Kaufman RA. Investigation of American association of physicists in medicine report 204 size-specific dose estimates for pediatric CT implementation[J]. Radiology, 2012, 265(3): 832-841.
[20] Noferini L, Fulcheri C, Taddeucci A, et al. Considerations on the practical application of the size-specific dose estimation (SSDE) method of AAPM Report 204[J]. Radiol Phys Technol, 2014, (7):296-302.
[21] Christianson O, Li X, Frush D, et al. Automated size-specific CT dose monitoring program: Assessing variability in CT dose[J]. Med Phys, 2012,39 (11): 7 131-7 139.
[22] Cheng PM. Automated estimation of abdominal effective diameter for body size normalization of CT dose[J]. J Digit Imaging, 2013, (26):406-411.
[23] Cheng PM, Vachon LA, Duddalwar VA. Automated pediatric abdominal effective diameter measurements versus age-predicted body size for normalization of CT dose[J]. J Digit Imaging, 2013, 26:1 151-1 155.
[24] Gabusi M, Riccardi L, Aliberti C, et al. Radiation dose in chest CT: Assessment of size-specific dose estimates based on water-equivalent correction[J]. Physica Medica, 2016, (32 ): 393–397.
[25] Bostani M, McMillan K, Lu P, et al. Attenuation-based size metric for estimating organ dose to patients undergoing tube current modulated CT exams[J]. Med Phys, 2015, 42 (2): 958-969.
[26] Leng S, Shiung M, Duan X, et al. Size-specific dose estimates in chest, abdomen, and pelvis CT: impact of intra-patient variability in water equivalent diameter[J]. Radiology, 2015, 276(1): 184-190.
[27] Larson DB. Optimizing CT radiation dose based on patient size and image quality: the size-specific dose estimate method[J]. Pediatr Radiol, 2014, 44 (Supply 3):S501-S505.
[28] Larson DB, Wang LL, Podberesky DJ, et al. System for verifiable CT radiation dose optimization based on image quality: Part I. Optimization Model[J]. Radiology, 2013, 269(1):167-176.
[29] Larson DB, Malarik RJ, Hall SM, et al. System for verifiable CT radiation dose optimization based on image quality: Part II. Process Control System[J]. Radiology, 2013, 269(1) : 177-185.
[30] 石明国. CT技术发展进入低剂量成像时代[J]. 中国医疗设备, 2012, 27(1)39-42.
[31] Tian Xiaoyu, Li Xiang, W Paul Segars,et al. Dose coefficients in pediatric and adult abdominopelvic CT based on 100 patient models[J]. Phys Med Biol, 2013, (58):8 755-8 768.
[32] Tian Xiaoyu, Li Xiang, W Paul Segars, et al. Pediatric chest andabdominopelvic CT: Organ doseestimation based on 42 patient models[J]. Radiology, 2014, 270(2):535-547.
[33] Westra SJ, Li X, Gulati K, et al. Entrance skin dosimetry and size-specific dose estimate from pediatric chest CTA[J]. J Cardiovasc Comput Tomogr, 2014, 8(2):97-107.
[34] Mueller JW, Vining DJ, Jones AK, et al. In vivo CT dosimetry during CT colonography[J]. AJR, 2014, 202: 703-710.
[35] Sinclair L, Griglock TK, Mench A, et al. Determining organ doses from CT with direct measurements in postmortem subjects: Part 2—Correlations with patient-specific parameters[J]. Radiology, 2015, 227(2):471-476.
[36] Moore BM, Brady SL, Mirro AE, et al. Size-specific dose estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations[J]. Med Phys, 2014, 41 (7):071917.
[37] 国际放射防护委员会. 多排探测器计算机 X线体层摄影患者剂量控制[M]//岳保荣,牛延涛,等译. 国际放射防护委员会第102号出版物. 北京:人民军医出版社,2011:2.
[38] Brady SL, Kaufman RA. Investigation of American association of physicists in medicine report 204 size-specific dose estimates for pediatric CT implementation[J]. Radiology, 2012, 265(3): 832-841.
[39] Huda W, Tipnis SV. Doses metrics and patient age in CT[J]. Radiation Protection Dosimetry, 2016, 168(3):374-380.
[40] Brink JA, Morin RL. Size-specific dose estimation for CT: how should it be used and what does it mean?[J]. Radiology, 2012, 265(3):666-669.
[41] 刘海宽,卓维海,陈波,等. CT扫描所致受检者器官剂量的体模实验研究[J]. 中华放射医学与防护杂志, 2009, 29(2):221-225.
[42] 潘羽晞, 邱睿, 郑钧正,等. 利用蒙特卡罗建模及估算儿童X-CT 检查受照剂量[J]. 辐射防护, 2016, 36(3):129-125.
[43] 李纬,朱绍成,史大鹏. 体质量指数指导扫描条件降低体部 CT 剂量的可行性研究[J]. 中华放射医学与防护杂志, 2011, 31(2):241-242.
[44] 应援宁,张立仁,徐冬生,等. 宝石CT冠状动脉成像低剂量扫描方案临床应用研究[J]. 中华放射医学与防护杂志, 2014,34(4):310-313.
[45] 舒荣宝, 何永胜, 仝开军,等. 腹部CT个体化扫描参数的临床研究和剂量优化[J]. 中华放射医学与防护杂志, 2013,33(2):204-206.
[46] 崔燕海, 黄美萍, 李景雷,等. 基于胸围的管电流调制技术在冠状动脉CT造影应用的可行性探讨[J]. 中华放射医学与防护杂志, 2014, 34(10):783-786.
[47] 程香,何玲,陈欣. 管电流自动调节技术在儿童腹部CT中的应用[J]. 中国医学影像技术, 2015, 31(2):294-297.
[48] 许轶群, 孟名柱, 钱农,等. 智能最佳管电压技术降低胸部 CT辐射剂量的前瞻性研究[J].中华放射医学与防护杂志, 2013,33(6):664-667.
[49] 陈惠娟,祁丽,赵艳娥,等. 基于BMI调节管电压的前瞻性大螺距CT冠状动脉成像研究[J]. 医学研究生学报,2015,28(3):272-276.
[50] 曹新鸣,郭小超,王霄英,等. 适应性统计迭代重建在头颅CT检查中的应用研究[J]. 放射学实践, 2013,28(5):486-488.