20.500.12556/RUL-172959 Pregled diagnostičnih referenčnih ravni v mamografiji: sistematični pregled literature diplomsko delo Review of diagnostic reference levels in mammography: systematic literature review diploma work Uvod: Mamografija je osnovna slikovna preiskava za zgodnje odkrivanje rakavih sprememb v dojkah, ki pomembno prispeva k zmanjšanju umrljivosti zaradi raka dojk. Ker temelji na uporabi ionizirajočega sevanja, je ključno zagotoviti optimalno razmerje med kakovostjo mamogramov in čim nižjo prejeto dozo sevanja. Pri tem imajo pomembno vlogo diagnostične referenčne ravni, ki služijo kot orodje za optimizacijo doz. Namen: Namen diplomske naloge je s sistematičnim pregledom literature predstaviti diagnostične referenčne ravni v mamografiji v Sloveniji in drugod po svetu ter raziskati, ali in zakaj se te vrednosti med državami razlikujejo. Poseben poudarek je na postopkih določanja diagnostičnih referenčnih ravni in dejavnikih, ki vplivajo na njihove vrednosti. Metode dela: Izveden je bil sistematični pregled znanstvene in strokovne literature v skladu s smernicami PRISMA. Diagnostične referenčne ravni v mamografiji smo predstavili z deskriptivno metodo. Ustrezno literaturo za sistematični pregled smo iskali v podatkovnih bazah PubMed, ScienceDirect in IOP Science, pri čemer smo uporabili iskalna niza v angleškem jeziku. V analizo smo vključili strokovne članke, ki so bili v celoti prosto dostopni, napisani v angleškem jeziku ter objavljeni v zadnjih petnajstih letih. Rezultati: V diplomsko nalogo smo vključili 12 najprimernejših študij, izvedenih v različnih državah sveta. Večina raziskav temelji na retrospektivni analizi podatkov, tri pa so presečne študije. Raziskave so pokazale, da na prejete doze pri mamografskih preiskavah pomembno vplivajo dejavniki, kot so debelina dojke ob kompresiji, uporabljena tehnologija in ekspozicijski parametri. Na podlagi analize povprečnih žleznih doz so v posameznih raziskavah predlagali nove smernice za diagnostične referenčne ravni v mamografiji. Razprava in zaključek: Ugotovili smo, da se vrednosti diagnostičnih referenčnih ravni v mamografiji med državami razlikujejo zaradi različnih protokolov slikanja, lastnosti preiskovane populacije in uporabe različne tehnologije. Za določanje referenčnih vrednosti je bistvena uporaba podatkov iz kliničnih slik, saj fantomi ne omogočajo natančne ocene žlezne doze, ki jo prejmejo dojke. Ključni dejavnik, ki najbolj vpliva na povprečno žlezno dozo je debelina dojke ob kompresiji. Na dozo pomembno vplivata tudi vrsta projekcij (višje doze pri mediolateralni poševni projekciji) in uporabljena tehnologija (digitalni detektorji omogočajo nižje odmerke). Standardizacija razponov debelin dojk in upoštevanje uporabljene tehnologije bi omogočila lažjo in zanesljivejšo primerjavo diagnostičnih referenčnih ravni med državami. Introduction: Mammography is a primary imaging method used for the early detection of malignant changes in breast tissue and plays an important role in reducing breast cancer mortality. As it relies on the use of ionizing radiation, it is essential to ensure an optimal balance between image quality and the lowest possible radiation dose. Diagnostic reference levels serve as an important tool for dose optimization. Purpose: The aim of this thesis is to present diagnostic reference levels in mammography in Slovenia and worldwide through a systematic literature review, and to investigate whether and why these values differ between countries. Special attention is given to the procedures used to determine DRLs and the factors that influence their values. Methods: A systematic review of scientific and professional literature was conducted in accordance with PRISMA guidelines. Diagnostic reference levels in mammography were presented using a descriptive method. Relevant literature for systematic review was searched in the databases PubMed, ScienceDirect, and IOP Science, using two search queries in English. Articles included in the analysis were freely accessible in full, written in English, and published within the last fifteen years. Results: Twelve of the most relevant studies from various countries around the world were included in the thesis. Most studies were based on retrospective data analysis, while three were cross-sectional studies. The studies showed that the radiation dose received during mammographic examinations is significantly influenced by factors such as compressed breast thickness, the technology used, and exposure parameters. Based on the analysis of average glandular doses, most studies proposed new guidelines for diagnostic reference levels in mammography. Discussion and conclusion: We found that diagnostic reference levels in mammography vary between countries due to variations in imaging protocols, characteristics of the examined population, and the technology used. For determining reference values, it is essential to use data obtained from clinical images, as phantoms do not allow accurate assessment of glandular dose received by the breast. The most influential factor on average glandular dose is compressed breast thickness. Dose is also significantly affected by the type of projection (higher doses with mediolateral oblique projection) and the technology used (digital detectors allow for lower doses). Standardizing compressed breast thickness ranges and considering the imaging technology used would enable easier and more reliable international comparisons of diagnostic reference levels. diplomska dela radiološka tehnologija mamografija diagnostične referenčne ravni optimizacija doze povprečna žlezna doza diploma theses radiologic technology mammography diagnostic reference levels dose optimization average glandular dose true false false [M. Blaško : V. Rihter] Slovenski jezik Angleški jezik Diplomsko delo/naloga 2025-09-12 07:46:19 2025-09-12 07:46:21 2025-10-29 03:41:54 0000-00-00 00:00:00 2025 0 Ljubljana 0 Ljubljana 42 str. 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616-07 149516 248693507 53661.pdf 53661.pdf 1 DA89B8E83701B4696EA47A4057BD8A47 319c0585d13e6df898067245d4400f13cac74ed02057da15fd05167a8ab791c6 a5f2b7d6-8f9b-11f0-9328-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=217111 Zdravstvena fakulteta 0 0 0