{"title":"建立乳腺癌和前列腺癌放疗计划CT的bmi特异性诊断参考水平：一项回顾性葡萄牙研究。","authors":"M J Pereira, M Abrantes, P Matafome, J Santos","doi":"10.1016/j.radi.2025.103180","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Given the increase in obesity prevalence, there is also a higher number of patients with high body mass index (BMI) undergoing radiotherapy treatments. Besides the fact that diagnostic reference levels (DRLs) are defined for standard patients, they are an important tool to promote all patient safety. This study aimed to analyse typical radiotherapy planning computed tomography (CT) dose levels for breast and prostate cancer, for three BMI patient categorisations.</p><p><strong>Methods: </strong>Radiotherapy planning CT for the clinical indication of breast and prostate radiotherapy were retrospectively selected. Data of exposure and dose levels were collected and compared between three Portuguese institutions of excellence on Oncology and based on BMI categorisation according to WHO recommendations: Normal weight 18.5-24.99 kg/m<sup>2</sup>; Overweight 25-29.99 kg/m<sup>2</sup>; Obesity ≥30 kg/m<sup>2</sup>.</p><p><strong>Results: </strong>248 breast and 281 prostate radiotherapy planning CTs were analysed (total n = 529). Significant differences were found for CT dose index (CTDI<sub>vol</sub>), total dose length product (DLP<sub>t</sub>), and size-specific dose estimate (SSDE) values per BMI categorisations and institutions. The obtained dose values for breast cancer clinical indication were 8.56, 10.49, and 14.62 mGy (CTDI<sub>vol</sub>); 319.22, 393.44, and 558.87 mGy cm (DLP<sub>t</sub>), and 12.72, 14.65, and 17.96 mGy (SSDE) for normal weight, overweight, and obesity categorisation, respectively. For prostate cancer clinical indication, the obtained values were 11.02, 13.31, and 16.67 mGy (CTDI<sub>vol</sub>); 506.50, 629.13, and 814.15 mGy cm (DLP<sub>t</sub>), and 14.89, 16.37, and 18.45 mGy (SSDE) for normal weight, overweight, and obesity categories, respectively. CTDI<sub>vol</sub> and DLP<sub>t</sub> are mostly lower for patients with a normal weight and overweight than the European DRLs published.</p><p><strong>Conclusion: </strong>Dose levels of radiotherapy planning CT were established for BMI patient categorisations. This approach will contribute to personalised procedures optimisation.</p><p><strong>Implications for practice: </strong>This approach could promote the optimisation of radiotherapy planning CT and contribute to dedicated radiation protection.</p>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":" ","pages":"103180"},"PeriodicalIF":2.8000,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Establishing BMI-specific diagnostic reference levels for radiotherapy planning CT in breast and prostate cancer: A retrospective Portuguese study.\",\"authors\":\"M J Pereira, M Abrantes, P Matafome, J Santos\",\"doi\":\"10.1016/j.radi.2025.103180\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Given the increase in obesity prevalence, there is also a higher number of patients with high body mass index (BMI) undergoing radiotherapy treatments. Besides the fact that diagnostic reference levels (DRLs) are defined for standard patients, they are an important tool to promote all patient safety. This study aimed to analyse typical radiotherapy planning computed tomography (CT) dose levels for breast and prostate cancer, for three BMI patient categorisations.</p><p><strong>Methods: </strong>Radiotherapy planning CT for the clinical indication of breast and prostate radiotherapy were retrospectively selected. Data of exposure and dose levels were collected and compared between three Portuguese institutions of excellence on Oncology and based on BMI categorisation according to WHO recommendations: Normal weight 18.5-24.99 kg/m<sup>2</sup>; Overweight 25-29.99 kg/m<sup>2</sup>; Obesity ≥30 kg/m<sup>2</sup>.</p><p><strong>Results: </strong>248 breast and 281 prostate radiotherapy planning CTs were analysed (total n = 529). Significant differences were found for CT dose index (CTDI<sub>vol</sub>), total dose length product (DLP<sub>t</sub>), and size-specific dose estimate (SSDE) values per BMI categorisations and institutions. The obtained dose values for breast cancer clinical indication were 8.56, 10.49, and 14.62 mGy (CTDI<sub>vol</sub>); 319.22, 393.44, and 558.87 mGy cm (DLP<sub>t</sub>), and 12.72, 14.65, and 17.96 mGy (SSDE) for normal weight, overweight, and obesity categorisation, respectively. For prostate cancer clinical indication, the obtained values were 11.02, 13.31, and 16.67 mGy (CTDI<sub>vol</sub>); 506.50, 629.13, and 814.15 mGy cm (DLP<sub>t</sub>), and 14.89, 16.37, and 18.45 mGy (SSDE) for normal weight, overweight, and obesity categories, respectively. CTDI<sub>vol</sub> and DLP<sub>t</sub> are mostly lower for patients with a normal weight and overweight than the European DRLs published.</p><p><strong>Conclusion: </strong>Dose levels of radiotherapy planning CT were established for BMI patient categorisations. This approach will contribute to personalised procedures optimisation.</p><p><strong>Implications for practice: </strong>This approach could promote the optimisation of radiotherapy planning CT and contribute to dedicated radiation protection.</p>\",\"PeriodicalId\":47416,\"journal\":{\"name\":\"Radiography\",\"volume\":\" \",\"pages\":\"103180\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-10-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiography\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.radi.2025.103180\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiography","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.radi.2025.103180","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
导论：随着肥胖患病率的增加，接受放疗的高体重指数（BMI）患者也越来越多。除了诊断参考水平（drl）是为标准患者定义的事实外，它们是促进所有患者安全的重要工具。本研究旨在分析乳腺癌和前列腺癌的典型放射治疗计划计算机断层扫描（CT）剂量水平，针对三种BMI患者分类。方法：回顾性选择放疗计划CT对乳腺、前列腺放疗的临床指征。根据世界卫生组织建议的BMI分类，收集并比较了葡萄牙三家肿瘤学卓越机构的暴露和剂量水平数据：正常体重18.5-24.99 kg/m2；超重25-29.99 kg/m2；肥胖≥30kg /m2。结果：共分析乳腺放疗计划ct 248张，前列腺放疗计划ct 281张（共529张）。各BMI分类和机构的CT剂量指数（CTDIvol）、总剂量长度积（DLPt）和尺寸特异性剂量估计值（SSDE）存在显著差异。获得的乳腺癌临床指征剂量值分别为8.56、10.49和14.62 mGy (CTDIvol)；正常体重、超重和肥胖分类分别为319.22、393.44和558.87 mGy cm （DLPt）和12.72、14.65和17.96 mGy （SSDE）。前列腺癌临床指征分别为11.02、13.31、16.67 mGy (CTDIvol)；正常体重、超重和肥胖类别分别为506.50、629.13和814.15 mGy cm （DLPt）和14.89、16.37和18.45 mGy （SSDE）。正常体重和超重患者的CTDIvol和DLPt大多低于欧洲公布的DRLs。结论：建立了放疗计划CT剂量水平对BMI患者的分类。这种方法将有助于个性化的程序优化。实践意义：该方法可以促进放疗计划CT的优化，并有助于专门的辐射防护。
Establishing BMI-specific diagnostic reference levels for radiotherapy planning CT in breast and prostate cancer: A retrospective Portuguese study.
Introduction: Given the increase in obesity prevalence, there is also a higher number of patients with high body mass index (BMI) undergoing radiotherapy treatments. Besides the fact that diagnostic reference levels (DRLs) are defined for standard patients, they are an important tool to promote all patient safety. This study aimed to analyse typical radiotherapy planning computed tomography (CT) dose levels for breast and prostate cancer, for three BMI patient categorisations.
Methods: Radiotherapy planning CT for the clinical indication of breast and prostate radiotherapy were retrospectively selected. Data of exposure and dose levels were collected and compared between three Portuguese institutions of excellence on Oncology and based on BMI categorisation according to WHO recommendations: Normal weight 18.5-24.99 kg/m2; Overweight 25-29.99 kg/m2; Obesity ≥30 kg/m2.
Results: 248 breast and 281 prostate radiotherapy planning CTs were analysed (total n = 529). Significant differences were found for CT dose index (CTDIvol), total dose length product (DLPt), and size-specific dose estimate (SSDE) values per BMI categorisations and institutions. The obtained dose values for breast cancer clinical indication were 8.56, 10.49, and 14.62 mGy (CTDIvol); 319.22, 393.44, and 558.87 mGy cm (DLPt), and 12.72, 14.65, and 17.96 mGy (SSDE) for normal weight, overweight, and obesity categorisation, respectively. For prostate cancer clinical indication, the obtained values were 11.02, 13.31, and 16.67 mGy (CTDIvol); 506.50, 629.13, and 814.15 mGy cm (DLPt), and 14.89, 16.37, and 18.45 mGy (SSDE) for normal weight, overweight, and obesity categories, respectively. CTDIvol and DLPt are mostly lower for patients with a normal weight and overweight than the European DRLs published.
Conclusion: Dose levels of radiotherapy planning CT were established for BMI patient categorisations. This approach will contribute to personalised procedures optimisation.
Implications for practice: This approach could promote the optimisation of radiotherapy planning CT and contribute to dedicated radiation protection.
RadiographyRADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.70
自引率
34.60%
发文量
169
审稿时长
63 days
期刊介绍：
Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.
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