ERCP 검사 시 방사선 피폭량과 암 위험도 분석

Analysis of Radiation Exposure and Cancer Risk of Patients during Therapeutic ERCP

  • 이양섭 (서울아산병원 영상의학과) ;
  • 서대건 (서울아산병원 영상의학과) ;
  • 조재환 (안산대학교 방사선과)
  • Lee, Yang-Sub (Department of Radiology, Asan Medical Center) ;
  • Suh, Dae-Keon (Department of Radiology, Asan Medical Center) ;
  • Cho, Jae-Hwan (Department of Radiological Technology, Ansan University)
  • 투고 : 2018.07.07
  • 심사 : 2018.08.27
  • 발행 : 2018.09.30

초록

Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) requires fluoroscopic and radiographic exposures, which impose radiation risks to patients. The aim of the study was to calculate radiation doses for patients and cancer risk for patients during procedures by department. In this study, a total of 288 patients (Male: 182, female: 106), conducted using a ERCP system from January to March of 2016, were analyzed. A total of 288 patients were eligible, regardless of gender, with an average age of $61.28{\pm}13.4$ (19~91) years. The procedures were performed in the radiology department using a fluoroscopy X-ray machine (multidiagnost ELEVA FD). In study, fluoroscopy time, DAP (Dose area product) values, effective dose and cancer risk by department were measured. DAP measurements can be used to estimate an effective dose (ED) and cancer risk to patients undergoing ERCP. Mean fluoroscopy time of all departments was $7.05{\pm}7min$ (0.4~71.2 min). LTS (liver transplantation & hepatobiliary surgery) had the highest fluoroscopy time with $10.58{\pm}7.93min$, and HBP (hepatobiliary pancreatic surgery) had the lowest fluoroscopy time with $3.38{\pm}1.93min$ (p<0.01). Mean DAP values of all departments was $8.40{\pm}7.77mGy{\cdot}cm^2$. LTS had the highest DAP value with $11.96{\pm}9.03mGy{\cdot}cm^2$, and HBP had the lowest DAP value with $4.15{\pm}2.73mGy{\cdot}cm^2$ (p<0.01). Mean effective dose of all departments was $0.68{\pm}0.63mSv$. LTS had the highest effective dose with $0.97{\pm}0.73mSv$, and HBP had the lowest effective dose with $0.34{\pm}0.22mSv$ (p<0.01). Mean cancer risk of all departments was $1.007{\pm}0.006$ time, and LTS had the highest cancer risk with 1.06 time (p<0.01). LTS had the highest cancer risk with 1.06 time but the risk is low in the approximate 1.0 times. Therapeutic ERCP procedure is beneficial to the patient, but may be necessary comprehensive management and efforts to reduce radiation dose.

키워드

참고문헌

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