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在放射性暴露后,连续葡萄糖监测系统的真实准确性
Siobhan Tellez1, Lindsey Hornung2, Emily Smith1
1Division of Endocrinology Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Pediatric diabetes
|April 30, 2025
概括
连续血糖监测器 (CGM) 的准确性不受诊断成像期间的散射辐射的影响. 在X射线或CT扫描期间留下CGM可以减少患者的负担和成本.
科学领域:
- 内分泌学 在内分泌学.
- 医疗成像医学成像
- 生物医学工程 生物医学工程
背景情况:
- 持续血糖监测 (CGM) 的使用正在增加,但制造商指南建议在诊断成像 (X射线,CT) 期间将其移除.
- 这种移除造成了财务,临床和心理社会负担,特别是对于接受全胰腺切除与小岛自身移植 (TPIAT) 的儿科患者.
- 在CGM使用中断可能会阻碍最佳的糖尿病管理.
研究的目的:
- 评估散射辐射剂量暴露对CGM精度的影响.
- 评估在诊断成像期间,在视野之外留下CGM是否会影响准确度.
- 确定这种做法是否能减轻TPIAT患者的中断和负担.
主要方法:
- 在手术后3个月内,使用胰岛素和CGM的14名儿科TPIAT患者被监测.
- 在常规的X射线或CT手术中,CGMs没有被屏蔽.
- 使用混合模型分析了CGM和葡萄糖计值之间的绝对差异;进行了克拉克错误网格分析 (EGA).
- 分散剂量暴露被追溯计算使用人形幻影.
主要成果:
- 患者接受了五次成像手术的中位数,中位数累积散射剂量为559μGy.
- 散射剂量暴露与CGM和葡萄糖计值之间的绝对差异 (p=0.17) 之间没有发现显著的关联.
- 超过98%的葡萄糖值在EGA上处于临床上可接受的区域 (A和B),不论从TPIAT分散剂量或时间.
结论:
- 诊断成像中的分散剂量暴露不会临床影响CGM的准确性.
- 在成像过程中在视野之外留下CGM组件是安全有效的.
- 这种做法减少了患者的中断,负担和成本,改善了糖尿病管理.
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