| 王强,付强,林琳.胸部CT扫描所致儿童癌症风险估算研究[J].中华放射医学与防护杂志,2018,38(8):607-611 |
| 胸部CT扫描所致儿童癌症风险估算研究 |
| Cancer risk estimation in paedistric chest CT examination |
| 投稿时间：2018-02-07 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.08.009 |
| 中文关键词: CT 体型特异性评估剂量 器官剂量 终生归因风险 |
| 英文关键词:Computed tomography Size-specific dose estimation Organ dose Lifetime attributable risk |
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| 中文摘要: |
| 目的 估算1、5及10岁儿童胸部CT检查所受辐射剂量致肺癌、胃癌、肝癌、甲状腺癌、乳腺癌和白血病的终生归因风险（LAR）。方法 在医院影像归档和通信系统（PACS）中选取儿童胸部CT检查图像，在CT工作站上读取感兴趣区域（ROI）的平均CT值和面积，根据美国医学物理师协会（AAPM）推荐方法计算每个受检者的水当量直径，再结合容积CT剂量指数（CTDIvol）计算体型特异性评估剂量（SSDE），将SSDE转换为不同年龄不同性别儿童胸部CT检查时肺、胃、肝、甲状腺、乳腺和血液的平均器官剂量。以各器官剂量为基础，采用美国科学院电离辐射生物效应报告（BEIR）的癌症风险预测模型预测上述肿瘤的终生归因风险，其中白血病、肺癌、肝癌和胃癌是先经平均器官剂量计算出超额相对危险度后再计算肿瘤终生归因风险；甲状腺癌和女性乳腺癌是先计算出超额相对危险度再经平均器官剂量求得肿瘤终生归因风险。结果 由不同性别1、5及10岁儿童CT检查所受平均器官剂量可知，年龄对儿童CT检查SSDE值有显著影响（t=24.28，P<0.05），性别对儿童胸部CT检查SSDE值的影响无统计学意义（P>0.05）。不同性别1、5及10岁儿童胸部CT检查所受辐射剂量致肺癌、胃癌、肝癌、甲状腺癌、乳腺癌和白血病的终生归因风险表明，肺癌和女性乳腺癌的终生归因风险较高，女性乳腺癌1、5及10岁组的LAR分别为10.9/10万人、30.8/10万人和34.5/10万人。结论 随着新技术的引进，儿童胸部CT检查受到的辐射剂量逐渐减小，但CT检查辐射剂量相对于普通放射诊断仍然不容忽视，其引起的癌症风险仍需持续关注并应在放射诊断的正当性判断中得到充分考虑。 |
| 英文摘要: |
| Objective To estimate the lifetime attributable risk (LAR) of lung cancer, stomach cancer, liver cancer, thyroid cancer, breast cancer and leukemia for 1-, 5-and 10-year old children undergoing chest CT scan.Methods Chest CT images of children was retrieved from the picture archiving and communication system (PACS) and the average CT number and area of the region of interest (ROI) were read on the CT work station. Water equivalent diameter were calculated according to the method recommended by the American Association of Physicists in Medicine (AAPM). Furthermore, the size-specific dose estimation (SSDE) was made based on the water equivalent diameter and the volume computed tomography dose index(CTDIvol). Based on the method recommended by Caro Franck, the SSDE then was converted into average organ doses to lung, stomach, liver, thyroid, breast and blood for children at different ages and of different sex undergoing chest CT scan. On the basis of average organ dose, the cancer risk prediction model from the National Academy of Science's Biological Effects of Ionizing Radiation-Ⅶ (BEIR-Ⅶ) was used to predict the LAR for different cancers mentioned above. For lung cancer, gastric cancer, liver cancer and leukemia, the calculating sequence was from average organ dose to excess relative risk (ERR) to LAR, whereas for the thyroid cancer and breast cancer, the sequence was from ERR to average organ dose to LAR.Results The average organ dose to lung, stomach, liver, thyroid, breast and blood for children at different age and of different sex undergoing chest CT scan was obtained. The age had a statistically significant impact on the SSDE(t=24.28, P<0.05), but sex has not(P>0.05). LAR for lung cancer, gastric cancer, liver cancer, thyroid cancer, breast cancer and leukemia for 1-, 5-and 10-year old children undergoing chest CT scan was obtained, among whom the LAR for thyroid cancer and breast cancer was relatively high. The LAR for women breast cancer was 10.9 per 100 000 persons for 1 year old children, 30.8 per 100 000 persons for 5 years old and 34.5 per 100 000 persons for 10 years old.Conclusions With introduction of new technologies, the radiation dose due to chest CT scan is on the decline. But the induced radiation dose is still significant compared with general diagnostic radiography. The risk of cancer still deserves more attention and should be taken into consideration in the justification of diagnostic radiology. |
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