医用X射线CT主要检查类型所致成年受检者剂量研究

研究与掌握广泛普及的医用X射线CT(X-CT)所致受检者的剂量水平,是加强医疗照射防护的一个关键课题.在上海市“十一五”期间医疗照射水平调查研究中,根据全市拥有X-CT机各种品牌及其在各级医院实际应用比例情况,抽取全市约占30％的X-CT机计45台进行现场调研.累计针对8种常见主要检查类型的500例成年受检者,调查他们进行X-CT检查时所用的扫描参数及其相关剂量学信息,借助剂量转换系数等估算其所致典型有效剂量.研究结果表明,头颅、胸部和腹部的X-CT扫描中,各自加权CT剂量指数(CTDIw)的均值分别为55.4 mGy、12.5 mGy和18.4 mGy,而相应的剂量长度乘积(DLP)的均值分别为603 mGy·cm、294 mGy·cm和415mGy·cm.由此估算出头颅、胸部和腹部X-CT扫描所致成年受检者有效剂量的典型值分别为1.4 mSv、5.3 mSv和7.5 mSv.头颅扫描检查的CTDIw值通常高于耳道、眼部或鼻窦的诊断检查.显然,必须进一步加强X-CT扫描检查的影像质量及其所致剂量的优化匹配研究,尤其必须注意恰当选取各类X-CT检查所用的扫描参数,并不断完善相应的X-CT检查医疗照射指导(参考)水平,推动X-CT检查的医疗照射防护最优化.     

CT检查个体化辐射剂量估算研究现状

2011年和2014年美国医学物理学会分别发布204号和220号报告,描述基于个体体征估算CT受检者的辐射剂量。204号报告介绍应用受检者前后径和左右径等描述个体体征,220号报告介绍用水当量直径描述受检者的体型特异性,利用体型特异性的转换因子估算CT扫描受检者体型相关的辐射剂量(SSDE)。近年来,国外一系列的文章在SSDE方面进行了深入的研究,本文首先介绍两则报告的主要内容,并对SSDE在儿童和成年人群CT检查诊断参考水平的制定、CT断层图像的质量、受检者器官剂量和有效剂量的估算方面的研究现状进行综述,为开展国内SSDE相关研究和应用提供参考。     

CT-W_4(日立)躯干扫描时患者的剂量分布

本文介绍在 CT—W_4(日立)全身扫描机分别对胸部、腹部和盆腔部器官扫描时利用人体模型测量并估计了扫描受检者的最大体表照射量、器官剂量和加权剂量当量;特别是下腹部及盆腔器官扫描时测量了性腺剂量,并导出了男女性腺剂量的估算公式。     

北京市X线摄影检查所致受检者的剂量

本文报道北京市 X 线摄影检查所致受检者剂量的调查和实验研究结果。在对北京市 X 线摄影检查所致受检者体表照射量及其投照条件进行调查的基础上,采用非均匀人体模型,用 LiF(Mg,Cu,P)热释光剂量计,对19种主要摄影检查的器官剂量进行了模拟实验测量。由体模实验结果,给出了各项 X 线摄影检查的器官剂量与体表照射量之间的关系,估算了每摄一张片和每人次检查所致受检者的器官剂量和加权剂量当量。最后对所得结果进行了初步分析,并与国外资料作了比较。     

北京市X线诊断检查所致公众剂量的估算及评价

本文报道了北京市 X 线诊断检查所致公众剂量的估算方法和结果。通过分层抽样调查,取得了北京市1983年各种 X 线诊断检查的年频率及其随年龄和性别的分布。用自制的可布放25—106个热释光剂量计〔LiF(Mg,Cu,P)〕的专用衣,测量了各种 X 线诊断所致受检者的平均体表照射量。用切刈为17层、在16个器官(或组织)中布放267个热释光剂量计的人体模型进行模拟照射实验,得到了各种 X 线诊断检查所致受检者平均体表照射量与平均器官吸收剂量间的转换系数。采用的加权剂量当量,考虑了性别之差别。所得主要结果如下:(1)1983年北京市居民 X 线诊断检查的总年频率为671.7人次/10~3人,其中胸部透视和消化道检查分别占67.6%和1.9%。(2)北京市居民 X 线诊断检查年频率按受检者性别、年龄的分布。总频率中男性占51.5%,女性占48.5%,检查频率高峰出现在20—39岁的几个年龄组中。(3)37种 X 线诊断检查所致受检者的平均体表照射量及其分布情况。(4)北京市各种 X 线诊断检查所致受检者的平均体表照射量与器官吸收剂量的转换系数(以mGy/R表示),由人体模型模拟照射实验所得到的这些系数可用于相应条件下的剂量估算。(5)北京市平均每次 X 线诊断检查所致受检者的器官吸收剂量和加权剂量当量。(6)北京市 X 线诊断检查所致公众总集体     

北京市X线胸透检查所致受检者的剂量

本文报道了北京市X线胸透检查所致受检者剂量的调查和研究结果。这些结果是在体表照射量调查工作的基础上,利用组织等效非均匀体模,用 LiF(Mg,Cu,P)热释光剂量计进行模拟测量得到的。通过对胸透检查所致受检者体表照射量分布的分析,将体表受照区分为高、中、低三个照射量区,采用大小不同的三个照射野,分别对体模进行投照和测量,然后将分次测得的器官剂量按适当比例叠加,使所得结果更接近于受检者的受照剂量。本文除了给出胸透检查所致受检者的器官剂量外,还采用 Drexler 等人给出的权重因子,对男女受检者分别计算了一人次胸透检查所致受检者的加权剂量当量。一人次门诊胸透和一人次体检胸透所致受检者的加权剂量当量,对男性分别为0.37和0.18msv,对女性分别为0.31和0.15mSv。     

多排(层)螺旋CT的辐射剂量表达及其影响因素探讨

多排(层)螺旋CT反映了放射学影像设备与技术的最新进展.它的迅速推广应用有益于临床医学诊断,但同时也增加了受检者医疗照射,随之可能增加一定的电离辐射风险.然而相应的放射防护监测及评价的前提是准确表达并测量其辐射剂量.因此本文侧重辐射剂量学角度,从总结归纳多排(层)螺旋CT的主要特点入手;系统评述X射线CT所致辐射剂量的表征量及其测量或估算方法;进而分析探讨影响多排(层)螺旋CT扫描所致辐射剂量的主要因素.显然,正确掌握这些X射线CT所致辐射剂量的表达及其测量与评价方法,进而统筹兼顾优化提高影像质量与合理降低受检者剂量,已经成为放射防护学界、医学物理学界、临床医学放射学界以及医疗器械研发部门等共同关注的重点和热点.     

北京市X线透视检查节育环所致受检者的剂量

本文报道北京市医疗照射剂量水平调查中,X线透视检查育龄妇女子宫内避孕环(俗称透环)所致受检者的剂量。在前阶段受检者体表照射量及其分布的调查与监测基础上,通过非均匀人体模型模拟照射实验,求得受检者平均体表照射量与器官(或组织)吸收剂量的转换系数,进而推算出北京市平均每次X线透视检查节育环所致受捡者的器官剂量和加权剂量当量。每次检查的加权剂量当量为0.09msV。     

头部CT扫描时受检者的体表剂量分布

本文应用热释光剂量计,测定了CT-W500(日立)全身扫描机在多层和单层扫描时受检者的体表剂量分布。结果表明,多层扫描时各层次的体表照射量之间差异无显著性(P>0.05),而环头不同角度的体表照射量之间差异有显著或非常显著性(P<0.05或P<0.01),确定头部颞侧体表作为群体剂量调查的最大照射量参考点;9层扫描时最大体表照射量为1.65×10~(-3)C.kg~(-1),平均照射量为1.55±0.23×10~(-3)C.kg~(-1);多层与单层扫描射野体表平均剂量的比值为1.3,并计算得到散射辐射的贡献。本文同时测定了头部CT扫描时双眼、甲状腺、胸部和性腺的体表剂量,并分别与头部X线摄片和儿童头部CT扫描时相应器官的体表剂量进行了比较分析和评价。     

北京市 X 线透视检查宫内节育器所致受检者的体表照射量及其分布

本文报道北京市医疗照射剂量调查中,有关 X 线透视检查育龄妇女宫内节育器(俗称透环)所致受检者的体表照射量及其分布情况。第一阶段调查19个医院89例受检者,初步得到受检者参考点平均体表照射量值。第二阶段正式调查中,对13个抽样医院275例受检者进行测量,得到北京市 X 线透视检查宫内节育器所致受检者体表照射量的平均结果为:体表照射量最大值0.899R,位于图1的点A_(43);简化平均体表照射野为13×13cm~2(见图1粗线方框);简化平均体表照射量的0.805R。     

A way forward for the development of an exposure computational model to computed tomography dosimetry

A way forward for the development of an exposure computational model to computed tomography dosimetry has been presented. In this way, an exposure computational model (ECM) for computed tomography (CT) dosimetry has been developed and validated through comparison with experimental results. For the development of the ECM, X-ray spectra generator codes have been evaluated and the head bow tie filter has been modelled through a mathematical equation. EGS4 and EGSnrc have been used for simulating the radiation transport by the ECM. Geometrical phantoms, commonly used in CT dosimetry, have been modelled by IDN software. MAX06 has also been used to simulate an adult male patient submitted for CT examinations. The evaluation of the X-ray spectra generator codes in CT dosimetry showed dependence with tube filtration (or HVL value). More generally, with the increment of total filtration (or HVL value) the X-raytbc becomes the best X-ray spectra generator code for CT dosimetry. The EGSnrc/X-raytbc combination has calculated C_100,c in better concordance with C_100,c measured in two different CT scanners. For a Toshiba CT scanner, the average percentage difference between the calculated C_100,c values and measured C_100,c values was 8.2%. Whilst for a GE CT scanner, the average percentage difference was 10.4%. By the measurements of air kerma through a prototype head bow tie filter a third-order exponential decay equation was found. C_100,c and C_100,p values calculated by the ECM are in good agreement with values measured at a specific CT scanner. A maximum percentage difference of 2% has been found in the PMMA CT head phantoms, demonstrating effective modelling of the head bow tie filter by the equation. The absorbed and effective doses calculated by the ECM developed in this work have been compared to those calculated by the ECM of Jones and Shrimpton for an adult male patient. For a head examination the absorbed dose values calculated by the ECM developed by Jones and Shrimpton overestimates up to three times the absorbed dose to brain compared to the ECM developed in this work. The effective dose calculated by the ECM of Jones and Shrimpton was 26% greater than effective dose calculated by the ECM developed in this work.     

10岁中国儿童参考人面元体模的建立

本文基于首都儿科研究所提供的中国儿童真实CT扫描图像建立了10岁中国儿童参考人面元体模。采用了多边形网格模型与NURBS曲面模型相结合的方法，建立了10岁中国儿童的多边形网格面元。体模包括85个器官，经过优化和调整，各组织和器官质量与GBZ/T 200 2-2007和亚洲参考人的参考值差异小于1%，各器官位置和形态符合中国儿童解剖学特征。该面元体模为10岁中国儿童剂量的准确计算提供了重要工具。     

锥束CT平行双丝法获取几何参数研究

几何参数的精确获取是锥束CT高质量成像的关键条件，因此锥束CT几何参数的精确获取是CT技术研究的重点之一。本文设计了一种易于制作、操作简便、集成化的模体，提出了锥束CT几何参数获取方法：平行双丝法。首先介绍了平行双丝法获取重要参数的原理及公式推导，通过仿真计算，论证了方法的鲁棒性。然后对该方法进行了实验验证，结果表明，平行双丝法具有参数获取精度高、鲁棒性好等优点，是一种较好的锥束CT几何参数获取方法。     

基于电子束扫描阵列微焦点射线源的倒置结构Micro-CT成像研究

倒置几何结构CT成像系统理论上具有扫描视场大、图像信噪比好、锥束伪影小等优点,但其多焦点、稀疏角的扫描模式亦会带来投影数据截断、稀疏和局部数据冗余等问题。本文利用电子束扫描阵列微焦点射线源和高分辨率小面积探测器等构建了一种新型高分辨率、大视场的倒置几何结构Micro CT实验系统(IG Micro CT)。针对该系统多焦点、稀疏角扫描模式下的投影数据截断和稀疏等特点,提出一种图像先验约束的全变分正则化SART迭代CT图像重建算法。首先通过仿真实验对图像重建算法进行了验证,并对阵列微焦点数量、旋转扫描分度数量等扫描参数进行优化,最后在IG Micro CT实验系统上获得了高分辨的Micro CT测试图像。实验结果表明,本文提出的算法适用于IG Micro CT系统,解决了投影数据截断、稀疏采样和局部数据冗余带来的条状等伪影问题,并验证了IG Micro CT这种新型成像方式的可行性。     

医用CT受检者剂量的调查研究

本文介绍了用ＣＴ标准电离室及剂量检测模体，调查研究北京、河北、河南、浙江、内蒙古等省、市、自治区８３台医用ＣＴ的受检者头部剂量和１２台ＣＴ的受检者体部剂量。结果表明，其中有６４台ＣＴ机受检者头部模体中心轴上的多层扫描平均剂量（ＭＳＡＤ）低于国际电离辐射防护与辐射源安全基本标准（ＩＢＳＳ）推荐的ＣＴ剂量指导水平（５０ｍＧｙ），占７７％，高于指导水平的１９台，占２３％；体部模体中心的ＭＳＡＤ均低于ＩＢ     

Low-dose exposure energy-resolved X-ray computed tomography using a contrast agent with a high-energy K-edge

X-ray computed tomography (CT) with iodine contrast agent is widely employed to locate cancers. However, this method has shortcomings such as high-radiation dose exposure, iodine side effects, and a beam hardening effect. We have been working on the energy-resolved CT measurement method using a novel X-ray detection system, the “transXend” detector, which measures X-rays as electric currents and gives the energy distribution of incident X-rays after analysis. In the present study, we propose a method for low-dose exposure CT that involves the combination of the energy-resolved CT method, which is free from the beam hardening effect, and a harmless contrast agent with high-energy K-edge absorption, such as gold nanoparticles expected as a future contrast agent. Comparisons of radiation dose exposures as functions of aluminum filter thickness at the exit aperture of an X-ray tube and the K-edge energies of contrast agents are described.     

基于蒙特卡罗数学模型评价不同螺距冠状动脉CCTA受检者辐射剂量的特点与验证

收集61例采用双源CT Flash大螺距冠状动脉CCTA (Coronary Computed Tomography Angiography,CCTA)受检者资料,按WHO亚洲人体质量指数(BMI )标准将研究对象分为三组:正常组(12例)、超重组(41例)和肥胖组(8例),应用蒙特卡罗(Monte Carlo)数学模型软件计算三组受检者大螺距与常规螺距行CCTA的器官剂量,比较两种螺距CCTA时受检者的器官剂量分布特点及两种螺距CCTA的有效剂量变化幅度,并与大螺距模式下CT设备直接读取法所得有效剂量值进行比较。结果表明,用蒙特卡罗软件计算的双源CT大螺距CCTA受检者的器官剂量比常规螺距技术的剂量降低约70%,其中心脏、胸腺的器官剂量下降最为明显,降幅最大约80%;三组CCTA受检者大螺距较常规螺距的有效剂量(E)均降低明显(p<0.05),正常组使用大螺距技术后有效剂量E降幅最为明显;大螺距模式下数学模型软件模拟有效剂量E与CT设备所测有效剂量E间的偏差度小于50%。说明Monte Carlo数学模型软件可用于检查前预估或回顾性分析CCTA扫描时受检者的器官剂量与有效剂量的分布情况,并预判CCTA大螺距模式对受检者的胸部器官剂量和有效剂量,从而达到了降低辐射剂量的目的,尤其对BMI较小的受检者(如儿童)控制辐射风险更具意义。对开展低剂量CT技术具有一定实际意义。     

An analytical simulation technique for cone-beam CT and pinhole SPECT

This study was aimed at developing an efficient simulation technique with an ordinary PC.The work involved derivation of mathematical operators,analytic phantom generations,and effective analytical projectors developing for cone-beam CT and pinhole SPECT imaging.The computer simulations based on the analytical projectors were developed by ray-tracing method for cone-beam CT and voxel-driven method for pinhole SPECT of degrading blurring.The 3D Shepp-Logan,Jaszczak and Defrise phantoms were used for simulation evaluations and image reconstructions.The reconstructed phantom images were of good accuracy with the phantoms.The results showed that the analytical simulation technique is an efficient tool for studying cone-beam CT and pinhole SPECT imaging.     

Development of a diagnostic expert system for eddy current data analysis using applied artificial intelligence methods

A diagnostic expert system that integrates database management methods, artificial neural networks, and decision-making using fuzzy logic has been developed for the automation of steam generator eddy current test (ECT) data analysis. The new system, known as EDDYAI, considers the following key issues: (1) digital eddy current test data calibration, compression, and representation; (2) development of robust neural networks with low probability of misclassification for flaw depth estimation; (3) flaw detection using fuzzy logic; (4) development of an expert system for database management, compilation of a trained neural network library, and a decision module; and (5) evaluation of the integrated approach using eddy current data. The implementation to field test data includes the selection of proper feature vectors for ECT data analysis, development of a methodology for large eddy current database management, artificial neural networks for flaw depth estimation, and a fuzzy logic decision algorithm for flaw detection. A large eddy current inspection database from the Electric Power Research Institute NDE Center is being utilized in this research towards the development of an expert system for steam generator tube diagnosis. The integration of ECT data pre-processing as part of the data management, fuzzy logic flaw detection technique, and tube defect parameter estimation using artificial neural networks are the fundamental contributions of this research.     

Radiation protection lessons learned from the TEPCO Fukushima No.1 NPS accident

Lessons learned from the TEPCO Fukushima No.1 NPS accident are discussed from the viewpoint of radiation protection in the situation of nuclear emergency. It became clear from the discussion that the protective measures should be practiced by taking into account the time profiles of the radiological disaster after the nuclear accident and that the land and coastal sea areas monitoring had to be practiced immediately after the nuclear accident and the communication methods to tell the public about the radiation information and the meaning of protective measures should be developed for mitigation of the sociological aspects of disaster impacts. And it was pointed out from the view point of practicing countermeasures that application of the reference levels, above which it was judged to be inappropriate to plan to allow exposure to occur, played an important role for practicing protective measures in an optimized way and that the quantities and units used for quantifying radiation exposure of individuals in terms of radiation doses have caused considerable communication problems. Finally, the occupational exposures and the public exposures that have been reported so far are shown, and it is concluded that there is no conclusive evidence on low dose exposures that would justify a modification of the radiation risk recommended by the International Commission on Radiological Protection.