진폐요양기관에서 흉부방사선촬영을 위해 사용되는 선량과 화질의 관계: 국내 진단참고준위와 비교 = Relationship of Image Quality and Radiation Dose for Chest Radiography in the Medical Institutions for Pneumoconiosis: A Comparison to the Korean Diagnostic Reference Level

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the relationship of image quality to the measurement of radiation dose for chest radiography in the medical institutions for pneumoconiosis (MIPs).
Materials and Methods: Film-screen radiography (FSR) (n = 24) and digital radiography (DR) (n = 5) were used as chest radiography modalities. The entrance surface dose (ESD) was measured from the exposure conditions routinely used for chest radiography using an ionization chamber dosimeter. All images were randomly selected for evaluating image quality from each of the MIPs, and independently rated by two experienced radiologists using a 3-point scale.
Results: ESD of DR was higher than FSR, excluding flat panel. However, image quality of DR was significantly higher than that of FSR, especially in flat panel and the charge-coupled device. ESD and tube voltage were not significantly correlated with image quality. DR more frequently exceeded the Korean diagnostic reference level for ESD than FSR (41.7% vs. 20.0%), though the difference was not statistically significant.
Conclusion: DR used a higher radiation dose than FSR; however, there was a possibility of a radiation dose reduction in relation to image quality. We suggest that the MIPs transfer to a flat panel with automatic exposure control for a more effective radiation dose management.

국문 초록 (Abstract)

목적: 진폐요양환자의 흉부방사선촬영에서 사용되는 노출조건으로부터 선량을 측정하여 화질과의 관련성을 분석하였고, 국내 진단참고준위에 적합하게 사용되는지 알아보았다.
대상과 방법: 전국 29개 진폐요양기관을 대상으로 진폐요양환자에게 사용되는 흉부방사선촬영 표준 노출조건에서 이온 챔버를 이용하여 조사선량을 측정한 후 입사표면선량으로 변환하였다. 각 기관으로부터 10장씩 무작위 추출한 흉부방사선영상은 2명의 흉부 영상의학과전문의가 화질 평가를 실시하였다.
결과: 디지털방사선촬영에서 flat panel 시스템을 제외하고 image plate와 charge-coupled devices 시스템은 필름-스크린 촬영보다 높은 선량이 측정되었고, 화질은 디지털방사선촬영의 flat panel과 charge-coupled devices 시스템에서 필름-스크린 촬영보다 유의하게 높았다. 디지털방사선촬영에서 선량과 관전압은 화질에 유의한 영향을 주지 않았고, 디지털방사선촬영이 필름-스크린 촬영보다 국내 진단참고준위를 초과하는 빈도가 높았다(41.7% vs. 20.0%, p = 0.622).
결론: 디지털방사선촬영이 필름-스크린 촬영보다 높은 선량을 사용하고 있었지만, 화질과의 관계를 고려할 때 충분한 선량 감소 가능성을 보였고, 향후 진폐요양기관이 디지털방사선촬영으로 전환시 flat panel 시스템의 자동노출 사용이 선량관리에서 가장 바람직할 것으로 사료된다.

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