Reply: The murky world of effective dose for cardiovascular CT.
Reply: The murky world of effective dose for cardiovascular CT.
复制标题
回复：心血管CT有效剂量的黑暗世界。
DOI：
10.1016/j.jacc.2014.06.1156
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发表时间：
2014
影响因子：
24
通讯作者：
Shaw,LesleeJ
中科院分区：
文献类型：
--
作者：
Einstein,AndrewJ;Halliburton,SandraS;Gerber,ThomasC;Shaw,LesleeJ
DLP。无论如何，辐射剂量难以估计并不意味着不应与患者公开讨论，特别是因为这是一个公众关注的问题。我们目前正在研究一种更准确的方法，用于估计几乎所有当代扫描仪的冠状动脉CTA的DLP有效剂量，我们论文的目标之一是激发人们对涉及电离辐射的所有心血管手术中DRL需求的认识，其中冠状动脉CTA是一个重要的例子。这是一个心脏病学领域已经落后于其他领域（例如，儿科放射学）的领域。个体检查的DRL通常以特定人群中患者剂量分布的第75百分位数为基础。然而，正如Castellano和Nicol博士指出的那样，由于中心间变异性如此之高，需要仔细思考制定此类参考水平的最具建设性的方法。如果统一使用基于人群的第75百分位数阈值，则在某些实验室中，大多数患者将被标记为超过DRL;因此，DRL的概念对患者辐射防护几乎没有用处。
DLP. In any event, just because radiation dose is difficult to estimate does not mean that it should not be openly discussed with patients, especially because it is a public concern. We are currently working on a more accurate approach for estimation of effective dose from DLP for coronary CTA for virtually all contemporary scanners.One of the goals of our paper was to stimulate awareness of the need for DRLs in all cardiovascular procedures involving ionizing radiation, of which coronary CTA is an important example. This is an area in which the cardiology community has fallen behind other fields (eg, pediatric radiology). DRLs for individual examinations are often framed in terms of the 75th percentile of the distribution of patient doses in a particular population. However, with such high between-center variability, as pointed out by Drs. Castellano and Nicol, careful thought is needed for the most constructive approach to developing such reference levels. If a population-based 75th percentile threshold were used uniformly, most patients would be flagged as exceeding the DRL in some laboratories; consequently, the concept of DRL could be rendered of little use for patient radiation protection.