Palyatif radyoterapi uygulanan metastatik hastalarda BT parametre değişikliği ve radyasyon dozuna etkisi
Öz
Amaç: Bu çalışmanın amacı
kemik ve diğer organ metastazı bulunan ve palyatif radyoterapi uygulanan
hastalarda görüntüleme esnasında radyasyon dozunu azaltma yöntemlerini ortaya
koymaktır. Metastazı bulunan hastalarda üç boyutlu (3D) konformal radyoterapi
planlama aşamasında, ilgili bölgenin Bilgisayarlı tomografi (BT) ile tomografik
görüntülemesi yapılmaktadır. BT çekimi için kullanılan parametrelerde
değişiklik yapılarak, görüntüleme aşamasında radyasyon dozunun ne kadar
azaltılabileceği araştırıldı.
Yöntem: Radyasyon Onkolojisi
bölümünde tedavi edilen metastazı olan 27 hasta (16E, 11K, yaş ortalaması 65.2
yıl ± 11.9) çalışmaya dahil edildi. 27 hastaya 30 palyatif radyoterapi
uygulandı. Radyoterapi planlaması için yapılan 1. BT çekimde 72 mili-amper-saniye
(mAs) ve 130 kilo-volt-pik (kVp) olan standart BT dozu 2. Çekimde 30mAs and
130kVp olacak şekilde değiştirildi.
Bulgular: Planlama
BT çekiminde yapılan değişiklik sonucunda radyasyon dozu %62.68±0.02 oranında
azaltıldı (p<0,0001). Elde edilen görüntüler incelendiğinde görüntü
kalitesinde minimal azalma olmakla birlikte bunun tedavi planlamasını
etkilemediği görüldü.
Sonuç: Çalışma sonucunda
palyatif radyoterapi planlaması aşamasında BT cihazının parametrelerinde
değişiklik yapılarak radyasyon dozunun azaltılabileceği düşünüldü.
Anahtar Kelimeler
Palyatif radyoterapi bilgisayarlı tomografi radyasyon yönetimi
Kaynakça
- 1- Vernon MR, Maheshwari M, Schultz CJ, Michel MA, Wong SJ, Campbell BH, et al. Clinical outcomes of patients receiving integrated PET/CT-guided radiotherapy for head and neck carcinoma. Int J Radiat Oncol Biol Phys 2008; 70: 678-84.
- 2- Ron E. Ionizing radiation and cancer risks: evidence from epidemiology. Pediatr Radiol 2002; 32: 232-7.
- 3- Kalra MK, Maher MM, Toth TL, Hamberg LM, Blake MA, Shepard JA, et al. Strategies for CT radiation dose optimization. Radiology 2004; 230: 619-28.
- 4- McCollough CH, Primak AN, Braun N, Kofler J, Yu L, Christner J. Strategies for Reducing Radiation Dose in CT. Radiol Clin North Am 2009; 47: 27-40.
- 5- Sağsöz ME, Alper F. Kardiyak Multi Dedektör Bilgisayarlı Tomografide (MDBT) Radyasyon Dozu. TRD Sem 2013; 1: 16-25.
- 6- International Commission on Radiation Units and Measurements (ICRU), Prescribing, Recording and Reporting Photon Beam Therapy (Report 50).
- 7- Berland LL, Smith JK. Multidetector-array CT: once again, technology creates new opportunities. Radiology 1998; 209: 327-9.
- 8- Golding SJ, Shrimpton PC. Radiation dose in CT: are we meeting the challenge? Br J Radiol 2002; 75: 1-4.
- 9- Brenner DJ. Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 2002; 32: 228-33.
- 10- Strom DJ, Cameron JR. Is it useful to assess annual effective doses that are less than 100 mSv? Radiat Prot Dosimetry 2002; 98: 239-45.
- 11- Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, et al. Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey. Eur Radiol 2003; 13: 1979-91.
- 12- Donnelly LF, Emery KH, Brody AS, Laor T, Gylys-Morin VM, Anton CG, et al. Minimizing radiation dose for pediatric body applications of single detector helical CT. Am J Roentgenol 2001; 176: 303-6.
- 13- Zhu X, Yu J, Huang Z. Low-dose chest CT: optimizing radiation protection for patients. Am J Roentgenol 2004; 183: 809-16.
- 14- Hagtvedt T, Aalokken TM, Notthellen J, Kolbenstvedt A. A new low-dose CT examination compared with standard-dose CT in the diagnosis of acute sinusitis. Eur Radiol 2003; 13: 976-80.
- 15- Strauss KJ, Kaste SC. The ALARA (As Low As Reasonably Achievable) Concept in Pediatric Interventional and Fluoroscopic Imaging: Striving to Keep Radiation Doses as Low as Possible during Fluoroscopy of Pediatric Patients A White Paper Executive Summary Radiology 2006; 240: 621-2.
- 16- Shapiro BP, Young PM, Kantor B, Choe YH, McCollough CH, Gerber TC. Radiation dose reduction in CT coronary angiography. Curr Cardiol Rep 2010; 12: 59-67.
CT parameter change and radiation dose effect for metastatic patients treated with palliative radiotherapy
Öz
Objective: The aim of the
present study was to determine the methods to reduce the radiation dose during
imaging carried out for patients with bone or other organ metastases who were
treated with palliative radiotherapy. In planning stages of treatment for these
patients, tomographic imaging with computed tomography (CT) is performed on
affected area using three-dimensional (3D) conformal radiotherapy. To what
level the radiation dose could be lowered in imaging was investigated via
changing the parameters used in CT scanning.
Method: Twenty seven patients with metastases treated in the
Radiation Oncology department (16M, 11F, mean age 65.2 ± 11.9 years) were
included in the study. These patients underwent a total of 30 palliative
radiotherapy treatments. Standard CT dose of 72 milli-ampere-second (mAs) and
130 peak kilo voltage (kVp) in CT 1 scanning carried out for radiotherapy
planning was lowered to 30mAs and 130kVp in CT 2 scanning.
Results: Radiation dose was reduced by 62.68% ± 0.02 percent as
a result of changes made in planning CT scan (p<0.0001). Analysis of the
images obtained revealed that despite the minimal reduction in image quality,
results had no effect on treatment planning.
Conclusions: It was concluded that the
radiation dose could be reduced via making changes in the parameters of CT
scanning during palliative radiotherapy planning stage.
Anahtar Kelimeler
Palliative radiotherapy computed tomography radiation management
Kaynakça
- 1- Vernon MR, Maheshwari M, Schultz CJ, Michel MA, Wong SJ, Campbell BH, et al. Clinical outcomes of patients receiving integrated PET/CT-guided radiotherapy for head and neck carcinoma. Int J Radiat Oncol Biol Phys 2008; 70: 678-84.
- 2- Ron E. Ionizing radiation and cancer risks: evidence from epidemiology. Pediatr Radiol 2002; 32: 232-7.
- 3- Kalra MK, Maher MM, Toth TL, Hamberg LM, Blake MA, Shepard JA, et al. Strategies for CT radiation dose optimization. Radiology 2004; 230: 619-28.
- 4- McCollough CH, Primak AN, Braun N, Kofler J, Yu L, Christner J. Strategies for Reducing Radiation Dose in CT. Radiol Clin North Am 2009; 47: 27-40.
- 5- Sağsöz ME, Alper F. Kardiyak Multi Dedektör Bilgisayarlı Tomografide (MDBT) Radyasyon Dozu. TRD Sem 2013; 1: 16-25.
- 6- International Commission on Radiation Units and Measurements (ICRU), Prescribing, Recording and Reporting Photon Beam Therapy (Report 50).
- 7- Berland LL, Smith JK. Multidetector-array CT: once again, technology creates new opportunities. Radiology 1998; 209: 327-9.
- 8- Golding SJ, Shrimpton PC. Radiation dose in CT: are we meeting the challenge? Br J Radiol 2002; 75: 1-4.
- 9- Brenner DJ. Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 2002; 32: 228-33.
- 10- Strom DJ, Cameron JR. Is it useful to assess annual effective doses that are less than 100 mSv? Radiat Prot Dosimetry 2002; 98: 239-45.
- 11- Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, et al. Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey. Eur Radiol 2003; 13: 1979-91.
- 12- Donnelly LF, Emery KH, Brody AS, Laor T, Gylys-Morin VM, Anton CG, et al. Minimizing radiation dose for pediatric body applications of single detector helical CT. Am J Roentgenol 2001; 176: 303-6.
- 13- Zhu X, Yu J, Huang Z. Low-dose chest CT: optimizing radiation protection for patients. Am J Roentgenol 2004; 183: 809-16.
- 14- Hagtvedt T, Aalokken TM, Notthellen J, Kolbenstvedt A. A new low-dose CT examination compared with standard-dose CT in the diagnosis of acute sinusitis. Eur Radiol 2003; 13: 976-80.
- 15- Strauss KJ, Kaste SC. The ALARA (As Low As Reasonably Achievable) Concept in Pediatric Interventional and Fluoroscopic Imaging: Striving to Keep Radiation Doses as Low as Possible during Fluoroscopy of Pediatric Patients A White Paper Executive Summary Radiology 2006; 240: 621-2.
- 16- Shapiro BP, Young PM, Kantor B, Choe YH, McCollough CH, Gerber TC. Radiation dose reduction in CT coronary angiography. Curr Cardiol Rep 2010; 12: 59-67.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Medical Science Research Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Mart 2018 |
| Kabul Tarihi | 11 Ocak 2018 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 40 Sayı: 1 |