再発性CT画像と,患者の放射線保護のための戦略
Antonio Jreije1, Leonid Krynke1, Birutė Gricienė2
1Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
まとめ
患者のサブセットは,頻繁に繰り返されるCTスキャンから高線量放射線を蓄積し,しばしばいくつかの検査を行う. 累積用量を効果的にモニタリングするために,36 mSvのローカル再発性曝露基準レベル (RERL) が確立されました.
科学分野:
- メディカルイマージング (医学イメージング)
- 放射線学 放射線学
- 放射線安全性について
背景:
- コンピュータトモグラフィー (CT) は,医療用放射線被曝に大きく貢献しています.
- 患者のサブセットは,高累積有効用量 (CED) を蓄積し,長期的なストキャスティックリスクをもたらします.
- 再発性曝露基準レベル (RERL) は,再発性画像患者における累積用量のモニタリングのためのベンチマークである.
研究 の 目的:
- 高等医療病院における再発性CTイメージングによる累積放射線被曝を評価する.
- 高用量値 (CED ≥100 mSv) を超える患者の割合を決定する.
- 投与量モニタリングのためのローカルRERLを確立します.
主な方法:
- ヴィルニウス大学病院サンタロスクリニコスの成人のCT検査 (2022-2024) の遡及分析.
- 定義された再発性患者は,2023年に少なくとも1回のCTと,2022年,2023年または2024年に追加のCTを持つ患者である.
- 計算されたCEDの年間および3年間の発生率は≥100 mSvであり,再発性患者の年間CEDの75パーセント位としてRERLが決定されました.
主要な成果:
- 3年間で78,258人の患者が99,865回のCT検査を受けた.
- 9,199人の再発患者の18.2%が3年以内に100mSvを超えた;68%が5回未満のCTで達成した.
- 地元のRERLは36 mSvと決定されました.
結論:
- 患者のサブセットは,頻繁なCTから高線量放射線を蓄積し,しばしば少数の検査を行う.
- 派生したRERLは欧州の研究と一致し,累積的な用量モニタリングに使用することを支持しています.
- 系統的な用量追跡と正当化/最適化原則の遵守は,リスク軽減に不可欠です.
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