考虑风险模型不确定性的计算机断层扫描医疗照射辐射风险估算方法

V. V. Kashcheev, E. Pryakhin, A. Menyajlo
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摘要

本文分析了影响计算机断层扫描(CT)辐射风险估算不确定性模型的各种因素。由测量(仪器)误差或使用的剂量估计方法、扫描区域的大小和CT扫描仪的类型引起的辐射剂量估计的不确定性。由于测量误差或剂量估计方法、扫描区域的大小和CT扫描的类型而引起的辐射剂量的不确定性也可能引起不确定性。用于计算单个器官和组织的等效剂量以及计算由于常规CT检查导致的癌症发展的终生辐射风险的数据进行了更新。DLP的转换因子是病人在胸部、腹部和头部器官的CT检查中接受的辐射剂量的量度,它被确定并用于将CT剂量转换为暴露于辐射的单个器官和组织的等效剂量。更新了15台具有不同扫描几何形状的最先进CT扫描仪的数据。寿命辐射风险的不确定性是通过估计平均剂量比例比的95%置信区间来确定的。计算了影响辐射风险估计不确定性的比剂量分布、扫描几何形状和其他因素的标准差。计算了与剂量分布、扫描几何形状和影响辐射风险评估不确定性的其他因素有关的标准差。在模拟建模过程中,确定了胸部、腹部和头部CT中受辐射最大的器官和组织。
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Methodology for estimating the radiation risk of medical exposure during computed tomography considering the uncertainties of the risk model
The paper presents analysis of different factors affecting the uncertainty model for estimating ra-diation risk from computed tomography (CT). Uncertainties in radiation doses estimates caused by measurement (instrumental) errors or used dose estimation methods, the size of the scanned area and the type of CT scanner. The uncertainty of radiation dose due to measurement errors or dose estimation methods, the size of the scanned area and type of a CT scan may cause the uncertainties as well. Data used for calculating equivalent doses in individual organs and tissues and for calculating lifetime radiation risk of cancer development due to routine CT testing were updated. Conversion factors for DLP, a measure of radiation dose a patient received during CT exams of thoracic, abdomen and head organs, were determined and used for conversion of the CT doses to equivalent doses for individual organs and tissues exposed to radiation. Data for 15 state-of-the-art CT scanners with varying scanning geometry were updated. Uncertainties in life-time radiation risk were determined by estimating 95% confidence intervals for mean dose-proportionality ratios. Standard deviations related to specific dose distribution, scanning geometry and other factors that impact on uncertainty of radiation risk estimates were calculated. The standard deviations associated with the specifics of the dose distribution, scanning geometry and other factors affecting the uncertainties of radiation risk assessments were calculated. In the course of simulation modelling, organs and tissues were identified that are most exposed to radiation during CT of the chest, abdomen and head.
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