The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
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Analyzed the Computed Tomography Dose Index (CTDI) to the Pediatric Brain CT by Reason of the Observation for the Exposure Dose: Base on a Hospital

소아 두부 전산화단층촬영 선량지표 분석을 통한 피폭선량 모니터링: 일개병원 사례 중심으로

  • 이재승 (동의대학교 방사선학과) ;
  • 김현진 (동의대학교 대학원 보건의과학과) ;
  • 임인철 (동의대학교 방사선학과)
  • Received : 2015.02.12
  • Accepted : 2015.03.18
  • Published : 2015.06.28
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Abstract

The purpose of this study was to derive the proposals and to suggest the exposure dose reduction scheme on pediatric head CT scan by analyzing and comparing CT dose index (CTDI) and the national diagnostic reference levels. From January 2014 to December, 231 children under 10years who were requested a pediatric head CT scan with head injury were examined. Research methods were to research and analyze the general characteristics kVp, mA test coverage $CTDI_{vol}$ and DLP referring to dose reports and electronic medical record (EMR). As a result, 7.4%(17 patients) of the total subjects in $CTDI_{vol}$ showed a national diagnostic reference levels exceeding. For DLP 41.6%(96 patients) in excess was relatively higher than $CTDI_{vol}$. DLP was exceeded more than about 60% that is higher than the CT dose index presented by Korea Food & Drug Administration. it is cause of high DLP that scan range increased more than about 30% wider than the standard test coverage presented in Health Insurance Review & Assessment Service. In conclusion, it is able to significantly lower the dose if it is complied with checking the baseline scan range of pediatric head CT scan and appropriately adjusting the protocol.

본 연구는 일개병원에서 시행된 년간 소아 두부 CT 검사에 대한 CT 선량지표(CTDI)를 국내 진단참고 준위와 비교하여 분석함으로써 제안점을 도출하고 피폭 방사선량 저감화 방안을 제시하고자 하였다. 이를 위하여 2014년 1월부터 12월까지 두부 손상으로 소아 두부 CT 검사를 의뢰 받은 10세 미만의 소아 231명을 후향적으로 조사하였다. 조사 방법은 선량 보고서와 의료전자차트를 참조하여 일반적 특성, 관전압(kVp), 관전류(mA), 검사 범위, $CTDI_{vol}$, DLP를 조사하여 분석하였다. 결과적으로 $CTDI_{vol}$은 전체 연구대상자의 7.4%(17명)가 국내 진단참고준위를 초과한 것으로 나타났으며 DLP의 경우 41.6%(96명)가 초과 되어 $CTDI_{vol}$ 보다 비교적 높게 나타났다. DLP는 한국식품의약품안전처에서 제시한 CT 선량 지표보다 대부분 약 60% 이상 초과되었으며 건강보험심사평가원에서 제시한 기준 검사 범위보다 약 30%이상 증가된 검사 범위가 DLP가 높게 나타난 원인으로 분석되었다. 결론적으로 임상에서 CT 검사 시 건강보험심사 평가원에서 제시하는 소아 두부 CT 검사의 기준 검사 범위를 준수하여 검사하고 프로토콜을 적절히 조절한다면 피폭선량을 상당히 낮출 수 있을 것으로 판단된다.

Keywords

References

  1. J. Sherck, C. Shatney, K. Sensaki, and V. Selivanov, "The accuracy of computed tomography in the diagnosis of blunt small-bowel perforation," The American journal of surgery, Vol.168, No.6, pp.670-675, 1994. https://doi.org/10.1016/S0002-9610(05)80142-4
  2. Neil. Bhattacharyya and Marvin P. Fried, "The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis," The Laryngoscope, Vol.113, No.1, pp.125-129, 2003. https://doi.org/10.1097/00005537-200301000-00023
  3. D. J. Brenner and E. J. Hall, "Computed tomography an increasing source of radiation exposure," N Engl J Med, Vol.357, No.22, pp.2277-2284, 2007. https://doi.org/10.1056/NEJMra072149
  4. E. Dougeni, K. Faulkner, and G. Panayiotakis, "A review of patient dose and optimisation methods in adult and pediatric CT scanning," Eur J Radiol, Vol.81, No.44, pp.e665-683, 2011.
  5. D. H. Yang and H. W. Goo, "Pediatric 16-slice CT protocol: radiation dose and image quality," J. Korean Raiol. Soc., Vol.59, No.1, pp.333-347, 2008. https://doi.org/10.3348/jkrs.2008.59.5.333
  6. 이정근, 장성주, 장영일, "소아 CT 촬영 시 방사선피폭과 저감화 방법", 한국콘텐츠학회논문지 Vol.14, No.1, pp.356-363, 2014. https://doi.org/10.5392/JKCA.2014.14.01.356
  7. D. H. Yang and H. W. Goo, "Pediatric 16-slice CT protocol: radiation dose and image quality," J. Korean Raiol. Soc., Vol.59, pp.289-296, 2001.
  8. D. J. Brenner and E. J. Hall, "Computed tomography: an incerasing source of radiation exposuer," N. Engl. J. Med., Vol.357, pp.2277-2284, 2007. https://doi.org/10.1056/NEJMra072149
  9. ICRP, "2007 recommendations of the International Commission on Radiological Protection," ICRP publication No.103, 2007.
  10. 한국식품의약품안전처, "일반 영상의학검사의 환자선량권고량 가이드라인", 방사선안전관리 시리즈, No.30, 2012.
  11. 한국식품의약품안전처, "어린이 CT 영상의학검사의 환자선량권고량 가이드라인", 방사선안전관리 시리즈, No.31, 2012.
  12. ICRP, "Managing patient dose in computed tomography," ICRP publication, No.87, 2000.
  13. IEC, "Evaluation and routine testing in medical imaging departments, part 2-6: constancy tests X-ray equipment for computed tomography," International Electrotechnical Commission (Geneva, Switzerland), IEC 1223-2-6, 1994.
  14. S. Edyvean, "Type testing of CT scanners: methods and methodology for assessing imaging performance and dosimetry," Medical Devices Agency (London, UK), Report No.mA/98/25, 1998.
  15. Health Insurance Review & Assessment Service, "CT Examination and Repeat CT Examination Guidelines," p.39, 2014.
  16. UNSCEAR 2000 Report Vol.1. "Sources and Effects of Ionization Radiation," Annex D Medical radiation exposure, UNSCER, 2000.