Uncover the radiation truth of PET-CT inspection

The simplest metaphor: a whole body examination of PET-CT, equivalent to 30 years of radiation from a normal person, accepted in an hour. It is equivalent to one day on the second day of the leak at the Fukushima nuclear power plant in Japan.

At the end of 2011, the Ministry of Health proposed in a document to regulate the use of PET-CT to protect the legitimate rights and interests of patients, requiring their positive rate to be no less than 70%. This statement means that PET-CT must be used in the future. In practice, the proportion of cancer detected by various medical institutions through PET-CT is less than 2%. What is driving 98% of healthy people to spend nearly 10,000 yuan to take unnecessary risks?

PET---CT is used for profit-seeking medical examinations, and PET-CT is used for healthy human body examinations. Real experts never support healthy people. Doctors who work on PET-CT will not make themselves or let their families Go and do it.

"Mainly because of the low rate of tumor detection." Tian Jiahe, chairman of the Nuclear Medicine Branch of the Chinese Medical Association and professor of nuclear medicine at the 301 Hospital of the People's Liberation Army, said that the relevant statistics at home and abroad were between 1% and 2%. Among the people who do PET-CT in hospitals, 20% are for physical examination, and the proportion of malignant tumors detected is 1.3%. In addition, 20% of people have other potential diseases such as coronary heart disease.

For healthy people using PET-CT physical examination, Tian Jiahe's attitude is "not advocating, nor against." However, Tian Jiahe found that some of his peers prefer to do the most direct health economic evaluation – using PET-CT to make money.

The cost of PET-CT examination in China is different. For example, the total price of Shanghai is 7,500 yuan, and that of Guangzhou is 8,000-10,000 yuan, and "Beijing is the most expensive", which is 10,000-15,000 yuan. The intermediary website said that “a group purchase of 5 or more people can help apply for a 10% discount”.

The head of the nuclear medicine department of a well-known hospital in Beijing told the Southern Weekend reporter that the operating cost of PET-CT is quite high, the import price is more than 20 million yuan, plus the cost of personnel and maintenance, the cost is about 30 million yuan. However, due to the sufficient source of disease, only one PET-CT income in 2011 reached 45 million yuan, and the cost was recovered in one year.

Yan Hongwei, a tumor surgeon at the 306 Hospital of the People's Liberation Army, first publicly criticized PET-CT for being "abuse" on Weibo. He called: "PET-CT is not used for health checkups!"

He once asked many doctors, "Would you let your healthy family do a PET-CT medical examination?" The answer is usually "no." You can ask the doctor around you, will he check it? Will his family check it?

Concealed and ignored risk

In fact, under the circumstance of PET-CT, practitioners concealed the risk of PET-CT. The safety of PET-CT has been questioned. An article in April 2009 pointed out that radiation dose studies in Hong Kong and the United States indicate that current systemic PET-CT scans are accompanied by large doses of radiation and cancer risk.

In April 2009, the North American Society of Radiology research reported that whole body PET-CT scans were accompanied by a large number of radiation doses and cancer risks.

Professor Pek-Lan Khong, head of the Department of Radiation Diagnostics at the University of Hong Kong, and other researchers used three current mainstream PET-CT instruments, which showed a radiation dose between 13 and 32 millisieverts; "relevant to PET-CT The incidence of cancer is 0.2%-0.8%, and the lower the age, the greater the risk.

Therefore, the investigators suggest that PET-CT should be performed after sufficient clinical reasons and measures should be taken to reduce the dose.

Professor Robert E. Reiman of the Radiation Safety Department of the Duke University Medical Center in the United Kingdom said in an interview with the Southern Weekend reporter that "the scientific community recognizes that radiation damage to the body will accumulate as the number of exposures to radiation increases. Every PET-CT examination increases the risk, which will eventually lead to significant radiation doses over time." Robert E. Reiman stressed that children are at greater risk.

However, there is almost no appointment site to actively remind people who have just finished PET-CT examination, as a potential source of radiation, should avoid excessive contact with pregnant women and children in a short period of time.

Japan was the first and most widely used PET-CT for medical examinations, which led to the international “medical inspection tour” service. The service is currently attracting a large number of Chinese. But even in Japan, the controversy over PET-CT medical examinations has not been avoided.

“The cost of medical examination with PET-CT is not enough. There is not enough evidence in this regard.” said Mr. Noda, the director of the Statistical Analysis Department of the National Cancer Center of Japan, “The current PET-CT medical examination is mainly driven by the interests of some medical institutions. Still waiting for more evidence, will not be used as a guide to promote."

The study found that when PET-CT was used for physical examination of healthy Japanese people aged 50-59, the positive predictive value was only 3.3%.

At the 2012 European Radiology Annual Meeting, a multicenter study showed that PET-CT is no more advantageous than CT or MRI in either of these areas.

The Canadian Government-funded non-profit organization, the Canadian Medical Services Research Foundation, also pointed out that PET-CT scans not only prevent cancer-related deaths, but also pose risks to patients. The Foundation's report states that a good test should be susceptibility and specificity with a low error rate. It should be able to reduce the mortality rate of a disease and should not cause people to suffer undue harm.

“There is no evidence that PET-CT scans can prevent cancer-related deaths.” After reviewing several papers on the evaluation of PET-CT examinations in recent years, the report stated that “PET-CT scans are neither susceptibility. It is also not specific, it also brings a lot of risks to patients, including unnecessary examinations, excessive radiation exposure and high error rates. In addition, it increases the chance of over-medical."

Scientifically ethical doctors

A chief physician of the Department of Digestive Oncology, Beijing Cancer Hospital pointed out that PET-CT has a blind spot in the detection of hollow organs (stomach, intestine, etc.), so it can not replace routine examinations such as gastroscopy and colonoscopy.

Ouyang Xuenong, director of the Department of Oncology, Fuzhou General Hospital of Nanjing Military Region, said: "Generally, health people are not recommended as medical examinations. Because this examination is expensive, radiation is large, and hollow organs (such as esophagus, stomach, intestines, etc.) are found. There are also blind spots in the lesions, which cannot replace the gastroscope and colonoscopy."

The aforementioned top three tumor hospital doctors pointed out that PET-CT examination is not a substitute for CT and MRI. “Each inspection has its advantages. Sometimes when we do a PET-CT, we will ask the patient to perform further CT, MRI or even B-ultrasound.”

In fact, PET-CT examination does not detect all tumors. In the diagnosis of primary liver cancer, PET-CT is not effective.

Some opinions even challenge the necessity of the entire health checkup. “Regular health checkups for healthy people themselves need to be questioned.” A radiologist at Peking Union Medical College Hospital said, “PET-CT can detect some small masses, but sometimes it doesn’t make sense even if it is found. Because it’s too small The method of testing, such an examination can only cause the patient's anxiety, triggering a round of unnecessary inspections."

In fact, although the imaging examination progresses rapidly, it is still only a "gold standard" to judge whether it is a malignant tumor, that is, pathological examination of the diseased tissue. "The new inspection methods are endless, the images are getting clearer, but must it be a good thing?"

Professor Qiao Youlin, a cancer epidemiologist at the Chinese Academy of Medical Sciences and Peking Union Medical College, also held a negative attitude toward the use of PET-CT for the inspection of ordinary people. He pointed out that many cancers now have mature, simple and inexpensive detection methods, and PET-CT examinations are too expensive and risky. "There is no value to promote to the whole population."

“It is definitely not a good medical practice for every healthy person to receive a PET-CT scan.” Professor David W. Townsend of the National University of Singapore, who was the first to participate in PET-CT research in the world, told Southern Weekend reporters.

When I visited the Finnish Cancer Testing Center, I specifically consulted the scope of PET-CT. Dean Markku Mattila told me that I would not use PET-CT for physical examination. "It doesn't work if you have more money. You have to check with other instruments. The doctor thinks it is necessary to do it."

“It’s not because of price, but because of risk,” said Cornelis A. Hoefnagel, an expert in nuclear medicine at the Netherlands Cancer Institute. “A PET-CT examination like Japan may be 100 people. Only three people were checked. It is not worth it for the other 97 people to bear the radiation risk for three people."

The amount of radiation of PET-CT

The developer used in PET-CT examination is generally radioisotope fluorine-18 (18F-FDG), which is calculated according to the injection measurement of 0.1 mCi/kg body weight. Generally, the measurement of the radioactive developer injected by the subject will not be measured. More than 10mCi. That is to say, the amount of radiation for a whole body PET-CT examination is about 10-32 millisieverts, and the natural radiation that ordinary people receive every year is 1000-2000 microsieverts. (Note: 1000 microsieverts = 1 millisievert The accident level of the Fukushima Daiichi nuclear power plant in Japan was level 5, the next day the nuclear power plant was 1.1 kilometers, and the radiation amount was 351.4 microsievert per hour.

Orange Diamond Nitrile Gloves

Disposable Gloves orange black composite nitrile diamond texture oil resistant thickened protective gloves

Diamond Textured Nitrile Gloves have three features that set them apart from other nitrile gloves: bright orange color, thickened material and unique diamond texture.

The bright orange color provides good recognition. In workshop operations, orange is used as a labor protection warning color, which is not only easy to identify, but also convenient for work type management.

Orange Diamond Nitrile Gloves,Gloveworks Hd Orange Nitrile,Diamond Nitrile Gloves,Diamond Grip Nitrile Gloves

Jiangsu Asbao Medical Technology Co., Ltd. , https://www.iigloves.com