ISSN 1004-4140
CN 11-3017/P

基于器官剂量调制技术在男性盆腔CT扫描中的探究

Exploration of Organ Dose Modulation in Male Pelvic CT Scanning

  • 摘要: 目的:基于器官剂量调制(ODM)技术应用于男性盆腔电子计算机断层(CT)扫描中的探究。在不影响临床诊断的前提下,降低男性盆腔内组织器官所受有效辐射剂量,为将来应用此技术于男性盆腔疾病的流行病学大规模CT筛查,减少人群的辐射损伤提供理论基础。方法:运用随机对照临床试验,连续采集拟行盆腔CT扫描的成年男性受试者150例。本研究中,将受试者按随机表法分为AODM组、BATCM组和CLOW组。AODM组CT扫描开启自动管电流调制(ATCM)技术基础上,同时开启ODM技术;BATCM组仅开启ATCM技术,其余扫描条件一致;CLOW组关闭ATCM技术,设置为固定管电流,其余条件一致。通过在受试者盆腔四方位,前、左、后、右安置DLVA-A CT伏安特性测试仪,测定并记录人体四方位管电流峰值。根据扫描后CT自动生成的辐射剂量表数据,计算出受试者所受有效剂量(ED)。依据AAPM220号报告计算SSDEprostate,估算出前列腺所受有效辐射剂量。选取盆腔内前列腺中心层面,在前列腺区域和臀大肌区域选取感兴趣区(ROI),比较客观噪声(SD)、信噪比(SNR)。在盆腔软组织窗下对重建所得横轴位和冠状位图像,进行李克特5分制主观评分。结果:客观测定数据显示,AODM组前方管电流显著低于BATCM组,具有显著统计学意义;其余方向无统计学差异。三组前列腺区域图像的SD、SNR水平之间两两比较,具有统计学意义;臀大肌区域的SD、SNR水平之间比较,AODM组和BATCM组无统计学意义。三组受试者经CT剂量指数(CTDIvol)估算出的单器官所受有效辐射剂量(EDOS)和整体有效辐射剂量(ED)差异均具有统计学意义。AODM组比较于BATCM组,管电流降低,有效剂量降低。主观评估结果显示,AODM组和BATCM组的横轴位和冠状位图像无统计学差异(P > 0.05);CLOW组和AODM组、CLOW组和BATCM组的横轴位和冠状位图像均具有统计学意义。结论:与传统CT扫描方式相比较,器官剂量调制技术应用于男性盆腔电子计算机断层扫描中,在获得符合临床标准的医学影像前提下,可降低盆腔内辐射敏感器官的辐射强度,减少单器官和总体辐射有效剂量。

     

    Abstract: Objective: Organ dose modulation (ODM) was used in male pelvic electronic computed tomography (CT) scans. To avoid affecting clinical diagnosis, the effective radiation dose of pelvic tissues and organs in men should be reduced to provide a theoretical basis for the future application of this technology in the epidemiological large-scale CT screening of male pelvic diseases and reduce radiation damage in the population. Methods: 150 adult male subjects with planned pelvic CT scans were selected in a randomized controlled clinical trial. In this study, the subjects were divided into AODM, BATCM, and CLOW groups according to the randomization table method. In the ODM group, the ODM utilized automatic tube current modulation (ATCM); only ATCM and the other scanning conditions were consistent; in the CLOW group, the ATCM was set to fixed tube current, and the other conditions were consistent. The peak human square tubular current was measured and recorded by placing the DLVA-ACT voltammetric characteristic tester in the anterior, left, posterior, and right sides. The effective dose (ED) was calculated from the radiation dose table data automatically generated after the CT scan. The effective radiation dose of the prostate was estimated by calculating SSDEprostate from the AAPM220 report. At the central level of the pelvic prostate, the region of interest (ROI) was selected in the prostate and gluteus muscle regions to compare standard deviation (SD) and signal-to-noise ratio (SNR). The reconstructed transaxial and coronal images were scored under the pelvic soft tissue window. Results: The objective data showed that the anterior tube current was significantly lower than that in the BATCM group; no statistical difference was observed in the other directions. Pairwise comparisons between the SD and SNR levels in the three prostate regions were statistically significant; the SD and SNR levels in the gluteus maximus region were not significant between the AODM and BATCM groups. The difference in the signal organ effective dose (EDOS) and overall effective radiation dose (ED) between the volumetric CT dose Index (CTDIvol). Compared with the BATCM group, the tube current and ED in the AODM group decreased. Conclusion: Compared with traditional CT scanning, ODM is used in male pelvic electronic CT, which can reduce the radiation intensity of radiation-sensitive organs in the pelvic cavity and ED of single organs to obtain medical images that satisfy clinical standards.

     

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