PDF(Pubmed)
Abstract：
The European-funded Health Effects of Cardiac Fluoroscopy and Modern Radiotherapy in Pediatrics (HARMONIC) project is a multicenter cohort study assessing the long-term effects of ionizing radiation in patients with congenital heart disease. Knowledge is lacking regarding the use of ionizing radiation from sources other than cardiac catheterization in this cohort.
This study aims to assess imaging frequency and radiation dose (excluding cardiac catheterization) to patients from a single center participating in the Norwegian HARMONIC project.
Between 2000 and 2020, we recruited 3,609 patients treated for congenital heart disease (age < 18 years), with 33,768 examinations categorized by modality and body region. Data were retrieved from the radiology information system. Effective doses were estimated using International Commission on Radiological Protection Publication 60 conversion factors, and the analysis was stratified into six age categories: newborn; 1 year, 5 years, 10 years, 15 years, and late adolescence.
The examination distribution was as follows: 91.0% conventional radiography, 4.0% computed tomography (CT), 3.6% diagnostic fluoroscopy, 1.2% nuclear medicine, and 0.3% noncardiac intervention. In the newborn to 15 years age categories, 4-12% had ≥ ten conventional radiography studies, 1-8% underwent CT, and 0.3-2.5% received nuclear medicine examinations. The median effective dose ranged from 0.008-0.02 mSv and from 0.76-3.47 mSv for thoracic conventional radiography and thoracic CT, respectively. The total effective dose burden from thoracic conventional radiography ranged between 28-65% of the dose burden from thoracic CT in various age categories (40% for all ages combined). The median effective dose for nuclear medicine lung perfusion was 0.6-0.86 mSv and for gastrointestinal fluoroscopy 0.17-0.27 mSv. Because of their low frequency, these procedures contributed less to the total effective dose than thoracic radiography.
This study shows that CT made the largest contribution to the radiation dose from imaging (excluding cardiac intervention). However, although the dose per conventional radiograph was low, the large number of examinations resulted in a substantial total effective dose. Therefore, it is important to consider the frequency of conventional radiography while calculating cumulative dose for individuals. The findings of this study will help the HARMONIC project to improve risk assessment by minimizing the uncertainty associated with cumulative dose calculations.
This study aims to assess imaging frequency and radiation dose (excluding cardiac catheterization) to patients from a single center participating in the Norwegian HARMONIC project.
Between 2000 and 2020, we recruited 3,609 patients treated for congenital heart disease (age < 18 years), with 33,768 examinations categorized by modality and body region. Data were retrieved from the radiology information system. Effective doses were estimated using International Commission on Radiological Protection Publication 60 conversion factors, and the analysis was stratified into six age categories: newborn; 1 year, 5 years, 10 years, 15 years, and late adolescence.
The examination distribution was as follows: 91.0% conventional radiography, 4.0% computed tomography (CT), 3.6% diagnostic fluoroscopy, 1.2% nuclear medicine, and 0.3% noncardiac intervention. In the newborn to 15 years age categories, 4-12% had ≥ ten conventional radiography studies, 1-8% underwent CT, and 0.3-2.5% received nuclear medicine examinations. The median effective dose ranged from 0.008-0.02 mSv and from 0.76-3.47 mSv for thoracic conventional radiography and thoracic CT, respectively. The total effective dose burden from thoracic conventional radiography ranged between 28-65% of the dose burden from thoracic CT in various age categories (40% for all ages combined). The median effective dose for nuclear medicine lung perfusion was 0.6-0.86 mSv and for gastrointestinal fluoroscopy 0.17-0.27 mSv. Because of their low frequency, these procedures contributed less to the total effective dose than thoracic radiography.
This study shows that CT made the largest contribution to the radiation dose from imaging (excluding cardiac intervention). However, although the dose per conventional radiograph was low, the large number of examinations resulted in a substantial total effective dose. Therefore, it is important to consider the frequency of conventional radiography while calculating cumulative dose for individuals. The findings of this study will help the HARMONIC project to improve risk assessment by minimizing the uncertainty associated with cumulative dose calculations.
摘要：
背景：欧洲资助的儿科心脏透视和现代放射治疗对健康的影响（HARMONIC）项目是一项多中心队列研究，评估电离辐射对先天性心脏病患者的长期影响。在该队列中，缺乏有关使用心脏导管以外的其他来源的电离辐射的知识。
目的：本研究旨在评估来自参与挪威HARMONIC项目的单个中心的患者的成像频率和辐射剂量（不包括心脏导管插入术）。
方法：在2000年至2020年之间，我们招募了3,609例先天性心脏病患者（年龄<18岁），33,768项检查按模态和身体区域分类。从放射学信息系统检索数据。使用国际放射防护委员会出版物60转换因子估算有效剂量，分析分为六个年龄段：新生儿；1岁，5年,10年,15年,和青春期后期。
结果：检查分布如下：91.0%常规X线摄影，4.0％计算机断层扫描（CT），3.6%诊断透视,1.2%核医学，0.3%的非心脏介入治疗。在新生儿到15岁的类别中，4-12%的人接受了10项以上的常规射线照相研究，1-8%接受了CT检查，0.3%至2.5%接受了核医学检查。胸部常规X线摄影和胸部CT的中位有效剂量范围为0.008-0.02mSv和0.76-3.47mSv，分别。在不同年龄段，胸部常规X线摄影的总有效剂量负担介于胸部CT剂量负担的28-65％之间（所有年龄段的40％）。核医学肺灌注的中位有效剂量为0.6-0.86mSv，胃肠道透视的中位有效剂量为0.17-0.27mSv。由于频率低,与胸部X线照相术相比,这些手术对总有效剂量的贡献较小.
结论：这项研究表明，CT对成像（不包括心脏介入）的辐射剂量贡献最大。然而,尽管每个常规X光片的剂量很低，大量的检查导致了相当大的总有效剂量.因此,在计算个体的累积剂量时，考虑常规射线照相术的频率很重要。这项研究的结果将有助于HARMONIC项目通过最小化与累积剂量计算相关的不确定性来改善风险评估。
目的：本研究旨在评估来自参与挪威HARMONIC项目的单个中心的患者的成像频率和辐射剂量（不包括心脏导管插入术）。
方法：在2000年至2020年之间，我们招募了3,609例先天性心脏病患者（年龄<18岁），33,768项检查按模态和身体区域分类。从放射学信息系统检索数据。使用国际放射防护委员会出版物60转换因子估算有效剂量，分析分为六个年龄段：新生儿；1岁，5年,10年,15年,和青春期后期。
结果：检查分布如下：91.0%常规X线摄影，4.0％计算机断层扫描（CT），3.6%诊断透视,1.2%核医学，0.3%的非心脏介入治疗。在新生儿到15岁的类别中，4-12%的人接受了10项以上的常规射线照相研究，1-8%接受了CT检查，0.3%至2.5%接受了核医学检查。胸部常规X线摄影和胸部CT的中位有效剂量范围为0.008-0.02mSv和0.76-3.47mSv，分别。在不同年龄段，胸部常规X线摄影的总有效剂量负担介于胸部CT剂量负担的28-65％之间（所有年龄段的40％）。核医学肺灌注的中位有效剂量为0.6-0.86mSv，胃肠道透视的中位有效剂量为0.17-0.27mSv。由于频率低,与胸部X线照相术相比,这些手术对总有效剂量的贡献较小.
结论：这项研究表明，CT对成像（不包括心脏介入）的辐射剂量贡献最大。然而,尽管每个常规X光片的剂量很低，大量的检查导致了相当大的总有效剂量.因此,在计算个体的累积剂量时，考虑常规射线照相术的频率很重要。这项研究的结果将有助于HARMONIC项目通过最小化与累积剂量计算相关的不确定性来改善风险评估。
