{"title":"为斯里兰卡腹部、KUB 和腰椎 X 光检查建立国家诊断参考水平:一项多中心研究。","authors":"Sachith Welarathna, Sivakumar Velautham, Sivananthan Sarasanandarajah","doi":"10.1088/1361-6498/ad3837","DOIUrl":null,"url":null,"abstract":"<p><p>Diagnostic reference levels (DRLs) and achievable doses (ADs) provide guidance to optimise radiation doses for patients undergoing medical imaging procedures. This multi-centre study aimed to compare institutional DRLs (IDRLs) across hospitals, propose ADs and multi-centric DRLs (MCDRLs) for four common x-ray examinations in Sri Lanka, and assess the potential for dose reduction. A prospective cross-sectional study of 894 adult patients referred for abdomen anteroposterior (AP), kidney-ureter-bladder (KUB) AP, lumbar spine AP, and lumbar spine lateral (LAT) x-ray examinations was conducted. Patient demographic information (age, sex, weight, BMI) and exposure parameters (tube voltage, tube current-exposure time product) were collected. Patient dose indicators were measured in terms of kerma-area product (P<sub>KA</sub>) using a P<sub>KA</sub>meter. IDRLs, ADs, and MCDRLs were calculated following the International Commission on Radiological Protection guidelines, with ADs and MCDRLs defined as the 50th and 75th percentiles of the median P<sub>KA</sub>distributions, respectively. IDRL ranges varied considerably across hospitals: 1.42-2.42 Gy cm<sup>2</sup>for abdomen AP, 1.51-2.86 Gy cm<sup>2</sup>for KUB AP, 0.83-1.65 Gy cm<sup>2</sup>for lumbar spine AP, and 1.76-4.10 Gy cm<sup>2</sup>for lumbar spine LAT. The proposed ADs were 1.82 Gy cm<sup>2</sup>(abdomen AP), 2.03 Gy cm<sup>2</sup>(KUB AP), 1.27 Gy cm<sup>2</sup>(lumbar spine AP), and 2.21 Gy cm<sup>2</sup>(lumbar spine LAT). MCDRLs were 2.24 Gy cm<sup>2</sup>(abdomen AP), 2.40 Gy cm<sup>2</sup>(KUB AP), 1.43 Gy cm<sup>2</sup>(lumbar spine AP), and 2.38 Gy cm<sup>2</sup>(lumbar spine LAT). Substantial intra- and inter-hospital variations in P<sub>KA</sub>were observed for all four examinations. Although ADs and MCDRLs in Sri Lanka were comparable to those in the existing literature, the identified intra- and inter-hospital variations underscore the need for dose reduction without compromising diagnostic information. Hospitals with high IDRLs are recommended to review and optimise their practices. These MCDRLs serve as preliminary national DRLs, guiding dose optimisation efforts by medical professionals and policymakers.</p>","PeriodicalId":50068,"journal":{"name":"Journal of Radiological Protection","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study.\",\"authors\":\"Sachith Welarathna, Sivakumar Velautham, Sivananthan Sarasanandarajah\",\"doi\":\"10.1088/1361-6498/ad3837\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Diagnostic reference levels (DRLs) and achievable doses (ADs) provide guidance to optimise radiation doses for patients undergoing medical imaging procedures. This multi-centre study aimed to compare institutional DRLs (IDRLs) across hospitals, propose ADs and multi-centric DRLs (MCDRLs) for four common x-ray examinations in Sri Lanka, and assess the potential for dose reduction. A prospective cross-sectional study of 894 adult patients referred for abdomen anteroposterior (AP), kidney-ureter-bladder (KUB) AP, lumbar spine AP, and lumbar spine lateral (LAT) x-ray examinations was conducted. Patient demographic information (age, sex, weight, BMI) and exposure parameters (tube voltage, tube current-exposure time product) were collected. Patient dose indicators were measured in terms of kerma-area product (P<sub>KA</sub>) using a P<sub>KA</sub>meter. IDRLs, ADs, and MCDRLs were calculated following the International Commission on Radiological Protection guidelines, with ADs and MCDRLs defined as the 50th and 75th percentiles of the median P<sub>KA</sub>distributions, respectively. IDRL ranges varied considerably across hospitals: 1.42-2.42 Gy cm<sup>2</sup>for abdomen AP, 1.51-2.86 Gy cm<sup>2</sup>for KUB AP, 0.83-1.65 Gy cm<sup>2</sup>for lumbar spine AP, and 1.76-4.10 Gy cm<sup>2</sup>for lumbar spine LAT. The proposed ADs were 1.82 Gy cm<sup>2</sup>(abdomen AP), 2.03 Gy cm<sup>2</sup>(KUB AP), 1.27 Gy cm<sup>2</sup>(lumbar spine AP), and 2.21 Gy cm<sup>2</sup>(lumbar spine LAT). MCDRLs were 2.24 Gy cm<sup>2</sup>(abdomen AP), 2.40 Gy cm<sup>2</sup>(KUB AP), 1.43 Gy cm<sup>2</sup>(lumbar spine AP), and 2.38 Gy cm<sup>2</sup>(lumbar spine LAT). Substantial intra- and inter-hospital variations in P<sub>KA</sub>were observed for all four examinations. Although ADs and MCDRLs in Sri Lanka were comparable to those in the existing literature, the identified intra- and inter-hospital variations underscore the need for dose reduction without compromising diagnostic information. Hospitals with high IDRLs are recommended to review and optimise their practices. These MCDRLs serve as preliminary national DRLs, guiding dose optimisation efforts by medical professionals and policymakers.</p>\",\"PeriodicalId\":50068,\"journal\":{\"name\":\"Journal of Radiological Protection\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-04-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Radiological Protection\",\"FirstCategoryId\":\"93\",\"ListUrlMain\":\"https://doi.org/10.1088/1361-6498/ad3837\",\"RegionNum\":4,\"RegionCategory\":\"环境科学与生态学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENVIRONMENTAL SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Radiological Protection","FirstCategoryId":"93","ListUrlMain":"https://doi.org/10.1088/1361-6498/ad3837","RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study.
Diagnostic reference levels (DRLs) and achievable doses (ADs) provide guidance to optimise radiation doses for patients undergoing medical imaging procedures. This multi-centre study aimed to compare institutional DRLs (IDRLs) across hospitals, propose ADs and multi-centric DRLs (MCDRLs) for four common x-ray examinations in Sri Lanka, and assess the potential for dose reduction. A prospective cross-sectional study of 894 adult patients referred for abdomen anteroposterior (AP), kidney-ureter-bladder (KUB) AP, lumbar spine AP, and lumbar spine lateral (LAT) x-ray examinations was conducted. Patient demographic information (age, sex, weight, BMI) and exposure parameters (tube voltage, tube current-exposure time product) were collected. Patient dose indicators were measured in terms of kerma-area product (PKA) using a PKAmeter. IDRLs, ADs, and MCDRLs were calculated following the International Commission on Radiological Protection guidelines, with ADs and MCDRLs defined as the 50th and 75th percentiles of the median PKAdistributions, respectively. IDRL ranges varied considerably across hospitals: 1.42-2.42 Gy cm2for abdomen AP, 1.51-2.86 Gy cm2for KUB AP, 0.83-1.65 Gy cm2for lumbar spine AP, and 1.76-4.10 Gy cm2for lumbar spine LAT. The proposed ADs were 1.82 Gy cm2(abdomen AP), 2.03 Gy cm2(KUB AP), 1.27 Gy cm2(lumbar spine AP), and 2.21 Gy cm2(lumbar spine LAT). MCDRLs were 2.24 Gy cm2(abdomen AP), 2.40 Gy cm2(KUB AP), 1.43 Gy cm2(lumbar spine AP), and 2.38 Gy cm2(lumbar spine LAT). Substantial intra- and inter-hospital variations in PKAwere observed for all four examinations. Although ADs and MCDRLs in Sri Lanka were comparable to those in the existing literature, the identified intra- and inter-hospital variations underscore the need for dose reduction without compromising diagnostic information. Hospitals with high IDRLs are recommended to review and optimise their practices. These MCDRLs serve as preliminary national DRLs, guiding dose optimisation efforts by medical professionals and policymakers.
期刊介绍:
Journal of Radiological Protection publishes articles on all aspects of radiological protection, including non-ionising as well as ionising radiations. Fields of interest range from research, development and theory to operational matters, education and training. The very wide spectrum of its topics includes: dosimetry, instrument development, specialized measuring techniques, epidemiology, biological effects (in vivo and in vitro) and risk and environmental impact assessments.
The journal encourages publication of data and code as well as results.