치과 파노라마 촬영에서 환자의 피폭선량에 관한 연구 = A Study on the Patient Exposure Doses from the Panoramic Radiography using Dentistry

국문 초록 (Abstract)

본 연구는 파노라마 표준 촬영에서 환자의 피폭 선량을 측정하여 방사선 생물학적 위험인자를 평가하고 환자의 피폭 선량 저감화 방안을 제시하고자 하였다. 피폭 선량의 측정 오차를 최소화하기 위하여 각 OSL 선량계의 교정상수를 구하였으며 파노라마 표준 촬영에서 간접적으로 포함되는 좌·우측 수정체와 갑상선, 직접적으로 포함되는 상·하 입술, 하악골 첨부, 촬영 중심점을 대상으로 ICRP에서 권고하는 인체 모형 표준 팬텀을 이용하여 측정하였다. 측정 결과, 촬영 중심점의 선량이 413.67±6.53 μGy로 최대였으며 상·하 입술의 경우 각각 217.80±2.98 μGy, 215.33±2.61 μGy이었다. 또한 파노라마 표준 촬영에서 간접적으로 포함되는 좌·우측 수정체의 등가선량은 각각 30.73±2.34 μGy, 31.87±2.50 μGy이었으며 하악골 첨부 및 갑상선의 등가선량은 276.73±14.43 μGy, 162.07±4.13 μGy이었다. 결론적으로 측정된 피폭 선량은 방사선 생물학적 효과를 유발할 수 있었으며 치과 의료기관의 파노라마 표준 촬영에서 환자의 피폭 선량에 대한 저감화 방안으로 국제기구에서 권고하고 있는 방사선 방어 원칙에 대한 정당한 해석과 제도적 뒷받침(regulation)이 필요하다. 이에 파노라마 검사에 의한 피폭 선량은 기술적·경제적 측면뿐 만 아니라 사회적 인자를 고려하여 합리적으로 용인 가능한 수준까지 최소화하기 위한 체계화된 프로토콜의 제정과 주변 결정 장기를 방어하기 위한 방사선 보호 기구에 대한 추가적 연구가 필요할 것으로 판단되었다.

다국어 초록 (Multilingual Abstract)

This study estimate radiation biological danger factor by measuring patient's exposed dose and propose the low way of patient's exposed dose in panoramic radiography. We seek correcting constant of OSL dosimeter for minimize the error of exposed dose's measurement and measure the Left, Right crystalline lens, thyroid, directly included upper, lower lips, the maxillary bone and the center of photographing that indirect included in panoramic radiography by using the human body model standard phantom advised in ICRP. In result, the center of photographing's level of radiation maximum value is 413.67±6.53 μGy and each upper, lower lips is 217.80±2.98 μGy, 215.33±2.61 μGy. Also in panoramic radiography, indirect included Left, Right crystalline lens's level of radiation are 30.73±2.34 μGy, 31.87±2.50 μGy, and thyroid's level of measured exposed dose can cause effect of radiation biological and we need justifiable analysis about radiation defense rule and substantiation advised international organization for the low way of patient's exposed dose in panoramic radiography of dental clinic and we judge need the additional study about radiation defense organization for protect the systematize protocol's finance and around internal organs for minimize until accepted by many people that is technological, economical and social fact by using panoramic measurement.

목차 (Table of Contents)

• Abstract
• 요약
• Ⅰ. 서론
• Ⅱ. 대상 및 방법
• Ⅲ. 결과
• Ⅳ. 고찰
• Ⅴ. 결론
• 참고문헌

참고문헌 (Reference)

1 김창규, "유리선량계를 이용한 파노라마 검사의 피폭선량 측정" 한국산학기술학회 12 (12): 2624-2628, 2011

2 L. M. Rozhdestvenskiĭ, "The threshold for radiation stochastic effects : arguments"pro"and"contra". Applied realization" 51 (51): 576-594, 2011

3 International Commission on Radiological Protection (ICRP), "The 2007 Recommendations of the International Commission on Radiological Protection" 2007

4 International Commission on Radiological Protection(ICRP), "The 1990 Recommendations of the International Commission on Radiological Protection" 1991

5 P. K. Kuba, "Radiation dosimetry in Panorex roentgenography. Part 3, Radiation dose measurements" 25 (25): 393-404, 1968

6 Korea Food and Drug Adiminizatration (KFDA), "Radiation Health Newsletter, No.65, Vol.1 8, No. 4"

7 R. L. Mini, "Radiation Exposure of Patients Who Undergo CT of the Trunk" 195 (195): 557-562, 1995

8 H. Kato, "Method of calculating percentage depth dose for diagnostic X-rays" 60 (60): 1107-1115, 2004

9 International Atomic Energy Agency (IAEA), "International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation sources" 1996

10 G, Kaeppler, "Influence of the rotation centre in panoramic radiography" 128 (128): 239-244, 2008

11 A. Brindhaban, "Estimation of radiation dose during diagnostic X-ray examinations of newborn babies and 1-year-old infants" 15 (15): 260-265, 2006

12 K. Nishizawa, "Estimation of Effective Dose from CT Examination" 55 (55): 763-768, 1995

13 United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), "Effect of Ionizing Radiation" UNSCEAR 2006

14 D. Hart, "Doses to Patients from Radiographic and Fluoroscopic X-ray Imaging Procedures in the UK: 2005 Review" 2007

15 S. C. Choi, "Difference in radiation absorbed dose according to the panoramic radiographic machines" 30 (30): 11-15, 2000

16 Y. Fukushima, "Diagnostic reference level of computed tomography (CT) in japan" 151 (151): 51-57, 2012

17 E. K. Kim, "Development of Diagnostic Reference Level in Dental X-ray Examination in Korea" KFDA 35-, 2009

18 K. Nishizawa, "Determinations of organ doses and effective dose equivalents from computed tomographic examination" 64 (64): 20-28, 1991

19 National Research Council (NRC), "Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII phase 2" National Academies Press 2006

20 International Commission on Radiological Protection (ICRP), "Basic Anatomical and Physiological Data for Use in Radiological Protection: Reference Values" 2002

21 International Atomic Energy Agency (IAEA)., "Absorbed Dose Determination in External Beam Radiotherapy. An International Code of Practice for dosimetry Based on Standards of Absorbed Dose to Water" 2001