Multinational data on cumulative radiation exposure of patients from recurrent radiological procedures: call for action
Multinational data on cumulative radiation exposure of patients from recurrent radiological procedures: call for action
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DOI：
10.1007/s00330-019-06528-7
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发表时间：
2019-12-02
影响因子：
5.9
通讯作者：
Rehani, Madan M.
中科院分区：
文献类型：
--
作者：
Brambilla, Marco;Vassileva, Jenia;Rehani, Madan M.
目的了解CT成像的重复使用情况，以了解对个体患者的累积有效剂量（CED）可能超过100 mSv的水平，在该水平下，器官剂量通常处于辐射影响令人担忧的范围内。方法国际原子能机构于2019年召开了一次会议，与会者来自26个国家，来自各组织的代表以及放射学，医学物理学，辐射生物学和流行病学。要求参与者在会议前收集累积辐射剂量数据，以评估超过规定CED水平的患者数量。结果观察到CED >= 100 mSv的患者数量比以前已知或预期的要多得多。会议上介绍了来自约320万名患者的研究数据，这些患者在不同医院接受了1至5年的成像程序。全球每年可能还有90万患者达到CED >= 100 mSv。所有利益攸关方都需要采取紧急行动，解决患者受到的高累积辐射剂量问题。这些行动包括由专业协会为需要反复进行成像检查的患者制定适当性标准/转诊指南，由制造商开发辐射剂量低于目前的CT机，以及由风险管理组织制定政策以提高患者辐射安全。应在剂量监测系统中设置并引入患者累积辐射照射的警报值。
Objectives To have a global picture of the recurrent use of CT imaging to a level where cumulative effective dose (CED) to individual patients may be exceeding 100 mSv at which organ doses typically are in a range at which radiation effects are of concern Methods The IAEA convened a meeting in 2019 with participants from 26 countries, representatives of various organizations, and experts in radiology, medical physics, radiation biology, and epidemiology. Participants were asked to collect data prior to the meeting on cumulative radiation doses to assess the magnitude of patients above a defined level of CED. Results It was observed that the number of patients with CED >= 100 mSv is much larger than previously known or anticipated. Studies were presented in the meeting with data from about 3.2 million patients who underwent imaging procedures over periods of between 1 and 5 years in different hospitals. It is probable that an additional 0.9 million patients reach the CED >= 100 mSv every year globally. Conclusions There is a need for urgent actions by all stakeholders to address the issue of high cumulative radiation doses to patients. The actions include development of appropriateness criteria/referral guidelines by professional societies for patients who require recurrent imaging studies, development of CT machines with lower radiation dose than today by manufacturers, and development of policies by risk management organizations to enhance patient radiation safety. Alert values for cumulative radiation exposures of patients should be set up and introduced in dose monitoring systems.