中华放射医学与防护杂志

李宁,姚忠强,杨志,杨鸿宇,何正中,廖光星,肖国有.PET-CT检查致前列腺癌患者辐射剂量研究[J].中华放射医学与防护杂志,2019,39(6):465-470

PET-CT检查致前列腺癌患者辐射剂量研究

Research on radiation dose to prostate cancer patients from PET-CT examinations

投稿时间：2018-10-10

DOI：10.3760/cma.j.issn.0254-5098.2019.06.012

英文关键词:PET-CT Prostate cancer Effective dose Organ dose

基金项目:广西医疗卫生适宜技术开发与推广应用项目（S201633）；广西教育厅中青年教师基础能力提升项目（KY2016LX025）；广西高等教育本科教学改革工程立项项目（2016JGB186）

作者	单位	E-mail
李宁	广西医科大学附属肿瘤医院核医学科, 南宁 530021
姚忠强	广西医科大学附属肿瘤医院核医学科, 南宁 530021
杨志	广西医科大学附属肿瘤医院核医学科, 南宁 530021
杨鸿宇	广西医科大学附属肿瘤医院核医学科, 南宁 530021
何正中	广西医科大学附属肿瘤医院核医学科, 南宁 530021
廖光星	广西医科大学附属肿瘤医院核医学科, 南宁 530021
肖国有	广西医科大学附属肿瘤医院核医学科, 南宁 530021	xgy725@aliyun.com

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中文摘要:

目的评估¹⁸F-Choline、¹¹C-Choline和⁶⁸Ga-PSMA PET-CT检查致前列腺癌患者的有效剂量和器官剂量。方法回顾性研究2017年5月至2018年6月广西医科大学附属肿瘤医院接受PET-CT检查的150例前列腺癌患者，按照注射正电子放射性药物类型分为3组，每组50例。CT定位扫描电压和电流分别为120 kV和35 mA，全身CT扫描电和电流分别为120 kV和（135.6±9.4） mA。PET部分的剂量利用基于医学内照射剂量（MIRD）计算方法的OLINDA/EXM （version 1.1）软件行计算。利用有效剂量转换因子和ImPACT （version 1.0.4） CT剂量计算器计算CT部分剂量，CT剂量指数（CTDI）利用标准体模测量和ImPACT CT计算，组织权重因子取自国际放射防护委员会（ICRP）103号报告，PET和CT剂量之和为患者总有效剂量。结果注射¹⁸F-Choline、¹¹C-Choline和⁶⁸Ga-PSMA的活度分别为（279.2±13.2）、（350.2±39.9）和（186.8±19.4） MBq，有效剂量分别为（5.0±0.2）、（1.6±0.2）和（3.0±0.3） mSv，差异有统计学意义（F=837.0，P<0.001）。CT有效剂量为（11.4±0.2） mSv。3组总有效剂量分别为（16.4±0.3）、（13.0±0.3）和（14.4±0.4） mSv。PET检查3组器官当量剂量平均值比较，差异有统计学意义（F=381.2~1 637.7，P<0.001）。¹⁸F-Choline和⁶⁸Ga-PSMA PET-CT检查器官当量剂量最高为肾脏，而¹¹C-Choline PET-CT检查最高为甲状腺。结论 PET-CT检查致前列腺癌患者的有效剂量为13.0~16.4 mSv，其中绝大部分的剂量来自CT扫描。¹¹C-Choline PET-CT检查致患者的辐射剂量最低，有望成为潜在的前列腺癌PET显像药物。

英文摘要:

Objective To estimate effective and organ doses to prostate cancer patients result ing from the whole-body ¹⁸F-Choline,¹¹C-Choline and ⁶⁸Ga-PSMA PET-CT examinations. Methods A total of 150 prostate cancer patients who underwent PET-CT scanning from May 2017 to June 2018 were retrospectively analyzed. They were divided into three groups, each with 50 patients, according to the type of positron radiopharmaceuticals injected. All patients used the same PET-CT scan protocol. PET component dose was calculated by using OLINDA/EXM (version 1.1) software which was based on the MIRD method. The CTDI values were measured by the standard CT phantoms and computed by ImPACT (version 1.0.4) CT, and ImPACT was used for dose calculation from CT. The tissue weighting factors according to ICRP Report 103 were used for effective dose calculation. Results The effective dose and organ equivalent dose from ¹⁸F/¹¹C-Choline and ⁶⁸Ga-PSMA PET/CT examinations were estimated. The voltage and current of Topogram scan were 120 kV and 35 mA, respectively, as well as 120 kV and (135.6±9.4) mA for low-dose CT scan. The injected activity of ¹⁸ F-Choline,¹¹C-Choline and⁶⁸Ga-PSMA was (279.2±13.2), (350.2±39.9) and (186.8±19.4) MBq, respectively. The effective dose was (5.0±0.2), (1.6±0.2) and (3.0±0.3) mSv, respectively (F=837.0, P<0.001). The CT effective dose was (11.4±0.2) mSv. The total effective dose for three groups were (16.4±0.3), (13.0±0.3) and (14.4±0.4) mSv, respectively. The mean organ equivalent doses were statistically significantly different among groups (F=381.2-1 637.7, P<0.001). The highest organ equivalent dose was to kidney for ¹⁸F-Choline and ⁶⁸Ga-PSMA PET/CT scans and thyroid for ¹¹C-Choline PET/CT scan. Conclusions The effective dose to the prostate cancer patients who underwent PET-CT scanning was from 13.0 to 16.4 mSv, with vast majority of these doses coming from CT scans. The lowest radiation dose to the patients was caused by ¹¹C-Choline PET-CT examination, suggesting that it would be a potential prostate cancer PET radiotracer.

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