컴퓨터단층촬영 검사의 방사선 피폭 저감화 방안 = Strategies of computed tomography radiation dose reduction: justification and optimization

다국어 초록 (Multilingual Abstract)

Medical imaging is an indispensible diagnostic tool in modern medicine enabling fast and accurate diagnosis. Recent technological advances in medical equipment and increased utilization of the imaging modality have resulted in a significant increase in the exposure to ionizing radiation. After the rapid adoption of multi-detector computed tomography, computed tomography (CT) is now the single largest source of diagnostic radiation exposure to patients. The risks and benefits from radiation must be carefully considered in all examinations using ionizing radiation, and the principles of justification and optimization should be considered in the proper use of CT examination. Justification means that the examination must be medically indicated and useful. Optimization means that the imaging should be performed using doses that are ALARA (as low as reasonably achievable), consistent with the diagnostic task. This includes understanding and changing CT protocols to perform the same diagnostic task with the minimal amount of radiation exposure while maintaining diagnostic accuracy. Protocols and guidelines are important tools for radiation dose reduction. Understanding the parameters and dose information for CT examination is essential for optimization. If the exam is justified, then the parameters must be optimized to the imaging indication, scan area, body size, age, and weight of the patients. The physician should always assess the radiation risk-benefit ratio for each patient before ordering an examination that uses radiation. Continuing education is essential for the implementation of the principles of patient radiation dose reduction.

Physicians and radiologists must be aware of the radiation risks associated with CT exams.

참고문헌 (Reference)

• 1 정아영, "소아촬영의 방사선 피폭과 저감화 방법" 대한의사협회 54 (54): 1277-1283, 2011
• 2 Korley FK, "Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998-2007" 304 : 1465-1471, 2010
• 3 Image Gently, "The alliance for radiation safety in pediatric imaging"
• 4 International Commission on Radiological Protection, "The 2007 recommendations of the International Commission on Radiological Protection : ICRP publication 103" Elsevier 2007
• 5 Krille L, "Systematic review on physicianʼs knowledge about radiation doses and radiation risks of computed tomography" 76 : 36-41, 2010
• 6 Jung SE, "Research for national medical exposure reduction infrastructure" National Institute of Food and Drug Safety Evaluation 2012
• 7 International Commission on Radiological Protection, "Re-commendations of the International Commission on Radio-logical Protection : ICRP publication 26" Pergamon Press 1977
• 8 National Council on Radiation Protection and Measurements, "Ionizing radiation exposure of the population of the United States" National Council on Radiation Protection and Measurements 2009
• 9 Broder J, "Increasing utilization of computed tomography in the pediatric emergency depart-ment, 2000-2006" 14 : 227-232, 2007
• 10 United Nations, Scientific Committee on the Effects of Atomic Radiation, "Effects of ionizing radiation : UNSCEAR 2006 re-port to the General Assembly with scientific annexes" United Nations 2008
• 11 Lee CI, "Diagnostic CT scans : assessment of patient, physician, and radiologist awareness of radiation dose and possible risks" 231 : 393-398, 2004
• 12 Brenner DJ, "Computed tomography : an increasing source of radiation exposure" 357 : 2277-2284, 2007
• 13 Borgen L, "Cliniciansʼ justification of imaging : do radiation issues play a role?" 1 : 193-200, 2010
• 14 박용구, "CT검사의 방사선 피폭과 저감화 방법" 대한의사협회 54 (54): 1262-1268, 2011
• 15 World Health Organization, "Bonn call-for-action : joint posi-tion statement by IAEA and WHO"
• 16 You JJ, "Attitudes of family physi-cians, specialists and radiologists about the use of computed tomography and magnetic resonance imaging in Ontario" 5 : 54-65, 2009
• 17 Kim JH, "Appropriate management method for high cost ad-vanced imaging" Health Insurance Review and Assess-ment Service 2013
• 18 International Commission on Radiological Protection, "1990 Recommendations of the International Commission on Radiological Protection : ICRP publication 60" Perga-mon Press 1991