Radiation Dose Index of Renal Colic Protocol CT Studies in the United States: A Report from the American College of Radiology National Radiology Data Registry
Radiation Dose Index of Renal Colic Protocol CT Studies in the United States: A Report from the American College of Radiology National Radiology Data Registry
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DOI：
10.1148/radiol.14131601
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发表时间：
2014-05-01
期刊：
影响因子：
19.7
通讯作者：
Moore, Christopher L.
中科院分区：
文献类型：
--
作者：
Lukasiewicz, Adam;Bhargavan-Chatfield, Mythreyi;Moore, Christopher L.
目的：确定在美国根据肾绞痛方案进行计算机断层扫描 (CT) 的辐射剂量指数，包括减少剂量技术的使用频率以及与高或低剂量指数相关的任何机构层面因素。材料和方法：剂量成像登记处 (DIR) 收集参与机构进行的 CT 去识别化 CT 数据，包括检查类型和剂量指数；因此，该研究的 DIR 部分无需获得机构审查委员会的批准，并且符合 HIPAA 要求。截至 2013 年 1 月，在机构层面对采用肾绞痛方案进行 CT 的机构进行了检查，截至 2013 年 1 月，这些机构至少向注册机构贡献了 10 项研究。此外，对在单一机构接受肾绞痛 CT 治疗的患者（经机构审查委员会批准并获得前瞻性受试者的知情同意和放弃回顾性受试者的同意）进行了研究，以检查个体肾绞痛 CT 剂量指数模式，并探索患者习惯、人口统计学和剂量指数之间的关系。采用描述性统计分析剂量指标，并采用线性回归和Spearman相关性检验剂量指标与机构因素之间的关系。结果：2011年5月至2013年1月期间，93个机构共进行了49 903例肾绞痛方案CT检查。平均年龄+/-标准差为49岁+/-18岁，其中53.9%的患者为女性。机构贡献的 CT 研究中位数为 268 项（四分位数范围，77-699）。总体平均机构剂量长度乘积 (DLP) 为 746 mGy.cm（有效剂量，11.2 mSv），平均 DLP 范围为 307-1497 mGy.cm（有效剂量，4.6-22.5 mSv）。只有 2% 的研究采用 200 mGy.cm 或更低（“降低剂量”）（有效剂量，3 mSv）的 DLP 进行，并且只有 10% 的机构对至少 50% 的患者将 DLP 保持在 400 mGy.cm（有效剂量，6 mSv）或更低。结论：减少剂量肾脏方案 CT 在美国很少使用。平均剂量指数高于之前报道的水平，并且机构差异很大。 (C) 北美放射学会，2014
Purpose: To determine radiation dose indexes for computed tomography (CT) performed with renal colic protocols in the United States, including frequency of reduced-dose technique usage and any institutional-level factors associated with high or low dose indexes.Materials and Methods: The Dose Imaging Registry (DIR) collects deidentified CT data, including examination type and dose indexes, for CT performed at participating institutions; thus, the DIR portion of the study was exempt from institutional review board approval and was HIPAA compliant. CT dose indexes were examined at the institutional level for CT performed with a renal colic protocol at institutions that contributed at least 10 studies to the registry as of January 2013. Additionally, patients undergoing CT for renal colic at a single institution (with institutional review board approval and informed consent from prospective subjects and waiver of consent from retrospective subjects) were studied to examine individual renal colic CT dose index patterns and explore relationships between patient habitus, demographics, and dose indexes. Descriptive statistics were used to analyze dose indexes, and linear regression and Spearman correlations were used to examine relationships between dose indexes and institutional factors.Results: There were 49 903 renal colic protocol CT examinations conducted at 93 institutions between May 2011 and January 2013. Mean age +/- standard deviation was 49 years +/- 18, and 53.9% of patients were female. Institutions contributed a median of 268 (interquartile range, 77-699) CT studies. Overall mean institutional dose-length product (DLP) was 746 mGy.cm (effective dose, 11.2 mSv), with a range of 307-1497 mGy.cm (effective dose, 4.6-22.5 mSv) for mean DLPs. Only 2% of studies were conducted with a DLP of 200 mGy.cm or lower (a "reduced dose") (effective dose, 3 mSv), and only 10% of institutions kept DLP at 400 mGy.cm (effective dose, 6 mSv) or less in at least 50% of patients.Conclusion: Reduced-dose renal protocol CT is used infrequently in the United States. Mean dose index is higher than reported previously, and institutional variation is substantial. (C) RSNA, 2014