Comparison of 12 surrogates to characterize CT radiation risk across a clinical population
Comparison of 12 surrogates to characterize CT radiation risk across a clinical population
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DOI：
10.1007/s00330-021-07753-9
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发表时间：
2021-02-23
影响因子：
5.9
通讯作者：
Samei, Ehsan
中科院分区：
文献类型：
--
作者：
Ria, Francesco;Fu, Wanyi;Samei, Ehsan
目的量化辐射负荷对于CT程序的合理性、优化和个性化是必不可少的，并且可以通过引起不同放射风险反映的各种风险替代物来表征。这项研究比较了如何12个这样的指标可以表征风险在patient population.Methods这项研究包括1394 CT检查（腹盆腔和胸部）。使用Monte Carlo方法计算器官剂量。考虑了以下风险替代因素：体积计算机断层扫描剂量指数（CTDIvol）、剂量长度乘积（DLP）、尺寸特异性剂量估计（SSDE）、基于DLP的有效剂量（EDk）、定义器官剂量（ODD）、基于器官剂量的有效剂量和风险指数（EDOD、RI）以及20岁患者的风险指数（RIrp）。还计算了参考ICRP-110模型的最后三个指标（ODD、0、ED 0和RI 0）。最后，受ICRP的启发，调整后的有效剂量计算为EDr = RI/RIrp x EDOD。应用线性回归评估每个指标对RI的依赖性。结果的特点是在风险敏感性指数（RSI）和风险区分指数（RDI）。结果分析报告的指标之间的显着差异与EDR显示最好的一致性与RI的RSI和RDI。在所有指标和方案中，RSI范围在0.37（SSDE）和1.29（RI 0）之间; RDI范围在0.39（EDk）和0.01（EDr）癌症x 10（3）例患者x 100 mGy.Conclusion不同的风险替代物导致不同的人群风险特征。EDR表现出人口风险的密切特征，也表现出最好的可区分性。在从应用于人群的不具代表性的风险度量中得出风险预测时，应谨慎行事。
Objectives Quantifying radiation burden is essential for justification, optimization, and personalization of CT procedures and can be characterized by a variety of risk surrogates inducing different radiological risk reflections. This study compared how twelve such metrics can characterize risk across patient populations.Methods This study included 1394 CT examinations (abdominopelvic and chest). Organ doses were calculated using Monte Carlomethods. The following risk surrogates were considered: volume computed tomography dose index (CTDIvol), dose-length product (DLP), size-specific dose estimate (SSDE), DLP-based effective dose (EDk), dose to a defining organ (ODD), effective dose and risk index based on organ doses (EDOD, RI), and risk index for a 20-year-old patient (RIrp). The last three metrics were also calculated for a reference ICRP-110model (ODD,0, ED0, and RI0). Lastly, motivated by the ICRP, an adjusted-effective dose was calculated as EDr = RI/RIrp x EDOD. A linear regression was applied to assess each metric's dependency on RI. The results were characterized in terms of risk sensitivity index (RSI) and risk differentiability index (RDI).Results The analysis reported significant differences between the metrics with EDr showing the best concordance with RI in terms of RSI and RDI. Across all metrics and protocols, RSI ranged between 0.37 (SSDE) and 1.29 (RI0); RDI ranged between 0.39 (EDk) and 0.01 (EDr) cancers x 10(3)patients x 100 mGy.Conclusion Different risk surrogates lead to different population risk characterizations. EDr exhibited a close characterization of population risk, also showing the best differentiability. Care should be exercised in drawing risk predictions from unrepresentative risk metrics applied to a population.