| Hu Yanjun,Wei Xuan,Zhao Pengfei,et al.Propensity score matching-based study on radiation risk of low-dose chest CT[J].Chinese Journal of Radiological Medicine and Protection,2026,46(1):77-83 |
| Propensity score matching-based study on radiation risk of low-dose chest CT |
| Received:April 18, 2025 |
| DOI：10.3760/cma.j.cn112271-20250418-00145 |
| KeyWords:Propensity score matching Low dose CT Chest CT Radiation dose Lifetime attributable risk Secondary malignancies |
| FundProject:国家自然科学基金(82271988) |
| Author Name | Affiliation | E-mail | | Hu Yanjun | Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China | | | Wei Xuan | Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China | | | Zhao Pengfei | Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China | | | Su Yinping | Key Laboratory of Radiological Protection and Nuclear Emergency, ChinaCDC, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China | | | Qiu Rui | Key Laboratory of Particle & Radiation Imaging, Ministry of Education, Department of Engineering Physics, Tsinghua University, Beijing 100084, China | | | Tian Xin | Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China | ytniu163vip@163.com | | Wang Likun | Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China | | | Niu Yantao | Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China | |
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| Abstract:: |
| Objective To compare radiation doses and carcinogenic risks between low-dose chest CT (LDCT) and standard chest CT (STD) using propensity score matching. Methods Data on chest CT scans (non-contrast-enhanced) were retrospectively collected from January 2022 to December 2023 using a standardized protocol on a single scanner. The dataset was first stratified by gender into male and female subgroups; patients were then categorized into LDCT and STD groups based on scanning protocols; propensity score matching (PSM) was subsequently applied to each gender subgroup using covariates (patient age, patient diameter, scan length), yielding balanced LDCT and STD cohorts for comparative analysis. The Mann-Whitney U test were conducted to evaluate differences in radiation metrics (DLP, effective dose E, lung organ dose, breast organ dose for females) and lifetime attributable risks (LAR) for lung cancer and breast cancer between the two groups. Results The study included 25 634 male patients and 36 463 female patients. After PSM, 10 082 matched pairs were formed in the male cohort, and 14 124 matched pairs were formed in the female cohort. In males, the differences in DLP, E, lung organ dose, lung cancer incidence LAR, and lung cancer mortality LAR between the STD and LDCT groups were statistically significant (Z = -120.6, -122.4, -122.3, -118.6, -119.8, P<0.01).In females, in addition to the aforementioned indicators (Z = -140.7, -144.1, -144.3, -142.0, -142.7, P<0.01), the differences in breast organ dose, breast cancer incidence LAR, and breast cancer mortality LAR between the STD and LDCT groups were also statistically significant (Z = -142.4, -86.0, -97.6, P<0.01). For indicators including DLP, effective dose, lung organ dose, lung cancer LAR, breast organ dose, and breast cancer LAR, the STD group was 3.0–4.0 times that of the LDCT group. Conclusions LDCT demonstrated a significant protective effect against radiation risks. Gender factors significantly influenced radiation risk-related indicators, providing critical insights for establishing gender-specific diagnostic reference levels. |
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