radhydРадиационная гигиенаRadiatsionnaya Gygiena = Radiation Hygiene1998-426X2409-9082NIIRG10.21514/1998-426X-2025-18-2-131-140radhyd-1159Research ArticleКРАТКИЕ СООБЩЕНИЯBRIEF REPORTSНакопленные дозы пациентов при проведении КТ–исследований в российской клинической практикеPatients` cumulative doses during CT-examinations in Russian clinical practicehttps://orcid.org/0000-0003-2921-067XДружининаП. С.DruzhininaP. S.

Дружинина Полина Сергеевна – младший научный сотрудник, лаборатория радиационной гигиены медицинских организаций

197101, Санкт-Петербург, ул. Мира, д. 8 

Polina S. Druzhinina – Junior Research Fellow, Laboratory of Radiation Hygiene of Medical Facilities  

Mira Str., 8, Saint Petersburg, 197101 

druzhininapauline@gmail.comСанкт-Петербургский научно-исследовательский институт радиационной гигиены имени профессора П.В. Рамзаева, Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человекаРоссияSaint Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance of Consumer Rights Protection and Human WellbeingRussian Federation202514072025182131140Copyright © Дружинина П.С., 20252025Дружинина П.С.Druzhinina P.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.radhyg.ru/jour/article/view/1159

В условиях современной клинической практики многократные компьютерно-томографические исследования становятся все более распространёнными, что может приводить к накоплению значительных доз облучения у пациентов. Целью данного исследования являлось выявление случаев высоких накопленных эффективных доз (свыше 100 мЗв) у взрослых пациентов, проходивших компьютерно-томографические исследования в двух отделениях Ленинградского областного клинического онкологического диспансера. Материалы и методы: Работа основывалась на анализе данных об эффективных дозах пациентов, полученных из журналов регистрации компьютерно-томографических исследований за периоды 2020–2021 гг. (отделение № 1) и 2019–2021 гг. (отделение № 2). Эффективные дозы были рассчитаны на основании значений DLP с применением соответствующих коэффициентов перехода в соответствии с методическими указаниями МУ 2.6.1.3584-19. Результаты и обсуждение: Результаты показали, что в отделении № 1 1 % пациентов (18 человек) получили накопленные дозы свыше 100 мЗв, с максимальным значением в 239 мЗв. В отделении № 2 аналогичный показатель составил 0,3% (9 человек), с максимальной дозой 147 мЗв. Накопление дозы происходило как в течение длительного времени (до года), так и в течение коротких временных интервалов (менее месяца). Сопоставление полученных результатов с зарубежными данными показало, что накопленные эффективные дозы свыше 100 мЗв нередко выявляются и у неонкологических пациентов, включая пациентов моложе 40 лет. В исследуемой выборке преимущественно преобладали пациенты старше 40 лет. Обоснование и оптимизация КТ-исследований являются основными инструментами по управлению высоких накопленных эффективных доз пациентов. Необходимо отметить важность оценки не только эффективной, но и поглощённых доз в органах при проведении многократных компьютерно-томографических исследований, особенно при планировании лучевой терапии. Заключение: Необходим системный мониторинг высоких накопленных эффективных доз пациентов в Российской Федерации, особенно для молодых пациентов.

In modern clinical practice, multiple computed tomography examinations are increasingly common, which can lead to the accumulation of significant effective doses of patients. The aim of this study was to identify cases of high cumulative effective doses (more than 100 mSv) of adult patients undergoing computed tomography examinations in two departments of the Leningrad Regional Clinical Oncological Dispensary. Materials and Methods. The study is based on the analysis of patient effective dose data obtained from computed tomography examination logbooks for the periods 2020–2021 (Department No. 1) and 2019–2021 (Department No. 2). Effective doses were calculated based on dose-length product values using appropriate conversion coefficients in accordance with methodological guidelines MU 2.6.1.3584-19. Results. The study results showed that in Department No. 1, 1 % of patients (18 individuals) received cumulative doses exceeding 100 mSv, with a maximum value of 239 mSv. In Department No. 2, the corresponding figure was 0.3 % (9 individuals), with a maximum dose of 147 mSv. The dose accumulated over both extended periods (up to a year) and short intervals (less than a month). A comparison of the obtained results with international data showed that cumulative effective doses more than 100 mSv are often observed in non-oncological patients, including patients under the age of 40. In the study sample, most patients were over 40 years old. Justification and optimization of computed tomography examinations are the main tools for managing high cumulative effective doses in patients. It is important to emphasize the need to assess not only effective but also absorbed organ doses during multiple computed tomography examinations, especially when planning radiation therapy. Conclusions. Systematic monitoring of high cumulative effective doses in patients is necessary in the Russian Federation, particularly among younger patients.

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The authors declare that there are no conflicts of interest present.