以多次计算机断层扫描为例的医疗照射辐射风险评估方法

V. V. Kashcheev, E. Pryakhin, Y. Kurashvili
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引用次数: 1

摘要

目前,诊断成像程序的应用得到了扩展。新冠肺炎疫情爆发后,放射检查数量显著增加。重复放射检查的次数也增加了。虽然单次放射扫描致癌的风险很小,但多次成像的风险尚未得到估计。需要发展评估多种放射检查的癌症风险的方法学。本文介绍了评估任何类型的多重放射学检查的辐射风险的程序。本文以多次CT检查的终身归因风险(LAR)评估为例,验证了该方法的有效性,并对结果进行了讨论。作者开发了一种方法来估计在剩余生命年中多次放射CT扫描的辐射危害。该方法基于对患者身体器官和组织的等效辐射剂量。设计了0 ~ 95岁男性和5岁女性每剂量单位的LARs值表。计算了以下癌症部位的表格:膀胱癌、乳腺癌、结肠癌、骨髓癌、肝癌、肺癌、食道癌、卵巢癌、胃癌、甲状腺癌和其他固体癌。作者估计了一名女性的癌症风险,她暴露在CT扫描的辐射中。用开发的方法评估的女性风险与用数学模型ICRP估计的辐射风险进行了比较(出版物103)。比较表明,采用该方法估算的风险与采用ICRP模型估算的风险之间的差异不超过12%。在模型中考虑了性别和年龄,还考虑了适用于俄罗斯人口的医疗和人口数据。
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Methodology for assessment of radiation risks from medical exposure on the example of multiple computed tomography
Currently the application of diagnostic imaging procedures is extended. After the COVID-19 out-break the number of radiological examinations have increased significantly. The number of re-peated radiological examinations increased as well. Although the risk of cancer from single radi-ological scanning is small, risk from multiple imaging has not been estimated yet. The develop-ment of methodology for assessment of cancer risks from multiple radiological examinations is needed. This paper presents the procedure for assessment of radiation risks from multiple radio-logical examinations of any type. The validity of the developed approach was tested on the ex-ample of assessment of lifetime attributable risk (LAR) of cancer incidence from multiple com-puted tomography (CT) examinations, the results are discussed in the paper. The authors devel-oped the method for estimating radiation detriment from multiple radiological CT scans for re-maining life years. The method is based on equivalent radiation doses to organs and tissues of a patient’s body. Tables of LARs values per dose unit for males and females within the age range 0-95 years and a step of 5 years were designed. The tables were computed for the following cancer sites: bladder, breast, colon, bone marrow, liver, lungs, esophagus, ovary, stomach, thy-roid and other solid. The authors estimated cancer risks for a female, she was exposed to radia-tion from CT scanning. The female’s risks assessed with the developed methodology were com-pared with radiation risks estimated with mathematical model ICRP (Publication 103). The com-parison showed that the difference between risks estimated with the developed method and the risks estimated with the ICRP model did not exceed 12%. In models sex and age were account-ed, medical and demographic data applicable to the Russian population were taken into account as well.
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