Coronary artery calcification screening: estimated radiation dose and cancer risk.
Coronary artery calcification screening: estimated radiation dose and cancer risk.
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DOI：
10.1001/archinternmed.2009.162
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发表时间：
2009-07-13
影响因子：
--
通讯作者：
de Gonzalez, Amy Berrington
中科院分区：
文献类型：
--
作者：
Kim, Kwang Pyo;Einstein, Andrew J.;de Gonzalez, Amy Berrington
多探测器计算机断层扫描（MDCT）已被提出作为常规筛查工具的冠状动脉钙化（CAC）在无症状的个体。按照建议，这种筛查可能涉及数千万人，但目前还没有关于辐射剂量和辐射诱发癌症的潜在风险的详细估计。根据年龄、频率和扫描方案，我们估计了MDCT CAC筛查的器官特异性辐射剂量和相关癌症风险。成人患者的辐射剂量是根据蒙特卡洛辐射传输的一系列可行方案计算的。利用来自日本原子弹幸存者和医疗暴露队列的数据推导出的辐射风险模型用于估计辐射诱发癌症的超额终生风险。单次CAC CT扫描的辐射剂量根据治疗方案变化超过10倍（有效剂量范围=0.8至10.5毫西弗）。一般来说，较高的辐射剂量与较高的x射线管电流、较高的管电位、低间距螺旋扫描和回顾性门控有关。剂量的大变化也导致辐射诱发癌症的估计风险的大变化。假设男性从45岁至75岁，女性从55岁至75岁，每5年进行一次筛查，使用2.3毫西弗（0.8-10.5毫西弗）的中位剂量估计的超额终生癌症风险为男性42例/10万（范围14-200），女性62例/10万（范围21-300）。这些辐射风险估计值可以与筛查的潜在益处进行比较，如果有这样的估计值的话。通过使用优化方案，可以将剂量和风险降至最低。
Multi-detector computed tomography (MDCT) has been proposed as a tool for routine screening for coronary artery calcification (CAC) in asymptomatic individuals. As proposed, such screening could involve tens of millions of individuals, but detailed estimates of radiation doses and potential risk of radiation-induced cancer are not currently available. We estimated organ-specific radiation doses and associated cancer risks from CAC screening with MDCT, according to age, frequency and scan protocol. Radiation doses to adult patients were calculated from a range of available protocols using Monte Carlo radiation transport. Radiation risk models, derived using data from Japanese atomic bomb survivors and medically-exposed cohorts, were used to estimate the excess lifetime risk of radiation-induced cancer. Radiation dose from a single CAC CT scan varied more than 10-fold (effective dose range=0.8 to 10.5 mSv) depending on the protocol. In general higher radiation doses were associated with higher x-ray tube current, higher tube potential, and spiral scanning with low pitch, and retrospective gating. The wide dose variation also resulted in wide variation in estimated radiation-induced cancer risk. Assuming screening every five years from age 45-75 for men and from age 55-75 for women, the estimated excess lifetime cancer risk using the median dose of 2.3 mSv (0.8-10.5 mSv) was 42 cases/100,000 for men (range 14-200) and 62 cases/100,000 for women (range 21-300). These radiation risk estimates can be compared to potential benefits from screening, when such estimates are available. Doses and hence risks can be minimized by using optimized protocols.
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影响因子：
4.8
作者：
Flohr, TG;Schoepf, UJ;Ohnesorge, BM
通讯作者：
Ohnesorge, BM
影响因子：
19.7
作者：
Hunold, P;Vogt, FM;Barkhausen, J
通讯作者：
Barkhausen, J
影响因子：
24
作者：
Coles, DR;Smail, MA;Baumbach, A
通讯作者：
Baumbach, A
DOI：
10.1164/rccm.200704-591oc
发表时间：
2007-11-15
影响因子：
24.7
作者：
de Gonzalez, Amy Berrington;Kim, Kwang Pyo;Samet, Jonathan M.
通讯作者：
Samet, Jonathan M.
影响因子：
10.4
作者：
LAND, CE
通讯作者：
LAND, CE