Optimizacija protokola rentgenskega slikanja ledvene hrbtenice z uporabo dodatne filtracije bakra : magistrsko delo

Kočar, Nina (author), Mekiš, Nejc (mentor), Škrk, Damijan (reviewer)

Uvod: Slikanje ledvene hrbtenice sodi med radiološke preiskave z največjo dozno obremenitvijo v splošni radiografiji, saj bolnik prejme relativno visoko dozo ionizirajočega sevanja. Učinkovit način za zmanjšanje prejete doze pri slikanju ledvene hrbtenice je uporaba dodatne bakrene filtracije. Namen: Namen je ugotoviti, koliko se z uporabo dodatnih Cu filtrov spremeni doza sevanja pri rentgenskem slikanju ledvene hrbtenice in ali se spremeni kakovost rentgenogramov. Metode dela: Raziskavo smo izvedli v dveh delih na Siemens Multix (DR) in Siemens Vertix/Multix (CR). V prvem delu raziskave smo merili dozo (DAP) na fantomu, kjer smo naredili 5 slik v AP in 5 slik v LAT projekciji z 0 mm, 0,1 mm in 0,2 mm Cu filtracije na obeh rentgenskih aparatih. Drugi del raziskave smo izvedli na 120 pacientih, ki so bili naključno razdeljeni v 6 skupin po 20. 20 pacientov smo slikali z 0 mm, 20 pacientov z 0,1 mm in 20 pacientov z 0,2 mm Cu filtracije v AP in LAT projekciji. Pri vseh pacientih smo beležili maso in višino za izračun indeksa telesne mase (ITM), hkrati pa smo primerjali tudi DAP in efektivno dozo. Vse rentgenograme so na koncu neodvisno ocenili trije specialisti radiologi s pomočjo programa ViewDEX. Pred raziskavo smo pridobili dovoljenje Komisije Republike Slovenije za medicinsko etiko. Rezultati in razprava: Raziskava na pacientih je pokazala, da se DAP vrednosti znižajo z uporabo dodatne filtracije 0,1 mm Cu in 0,2 mm Cu pri DR in CR tehnologiji. Vrednosti efektivnih doz se pri DR tehnologiji v AP in LAT znižajo, vendar je najbolj učinkovita uporaba 0,1 mm Cu filtracije, medtem ko je pri CR tehnologiji v AP projekciji najbolj učinkovita uporaba 0,2 mm Cu, pri LAT projekciji pa so se vrednosti efektivne doze pri uporabi Cu filtrov celo zvišale. Zaključek: Na podlagi pridobljenih rezultatov lahko zaključimo, da v kolikor se uporablja dodatna filtracija bakra pri slikanju ledvene hrbtenice je ta smiselna samo za vrednost 0,1 mm Cu pri DR tehnologiji. Za bolj podkrepljene zaključke pa predlagamo še dodatne raziskave pri čemer bi imeli večji nabor pacientov s primerljivim ITM, ter da bi upoštevali dejanski spekter rtg svetlobe iz različnih naprav.

• Language: Slovenian
• Keywords: magistrska dela, radiološka tehnologija, ledvena hrbtenica, Cu filtracija, zmanjšanje doze, kakovost slike
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [N. Kočar]
• Year: 2021
• Number of pages: 71 str., [3] str. pril.
• PID: 20.500.12556/RUL-125630
• UDC: 616-07
• COBISS.SI-ID: 58155779
• Publication date in RUL: 28.03.2021

Secondary language

• Language: English
• Title: Optimisation of lumbar spine radiography using additional copper filtration : master thesis

Abstract

Introduction: Radiography of the lumbar spine is one of the radiological examinations with the highest dose in classical radiography. The effective way to reduce the radiation dose is an application of additional Cu filters. Purpose: The purpose is to determine how radiation dose in X-ray examination of the lumbar spine is changed when using additional Cu filters and if the image quality changes. Methods: The research was carried out in two parts on Siemens Multix MT (DR) and Siemens Vertix/Multix (CR). In the first part of the study, we measured the dose on the phantom, where we made five images in the AP and five images in the LAT projection with 0 mm, 0,1 mm, and 0,2 mm Cu filter on each X-ray. The second part of the study was carried out on 120 patients, randomly divided into six groups of 20. We took images of 3 groups in the AP and LAT projection, where we examined 20 patients with 0 mm, 20 patients with 0,1 mm, and 20 patients with 0,2 mm Cu filter. We recorded the mass and height for the body mass index (BMI) for all the patients and compared DAP and effective dose. In the end, all radiographs were evaluated independently by three radiologists with the use of ViewDEX imaging software. Prior to the study, the National medical Ethics committee approval was obtained. Results and discussion: Research has shown that DAP values are reduced with the use of additional filtration 0.1 mm Cu and 0,2 mm Cu in DR and CR technology. Regarding the values of effective doses, no additional filtration led to a significant decrease; somewhere, the absolute values were even increased (without statistical characteristics). Effective dose is reduced in DR technology in AP and LAT projection, but the most efficient is the use of 0,1 mm Cu filtration. In CR technology in AP projection the most efficient is the use of 0,2 mm Cu filtration, while the use of additional Cu filtration in LAT projection even increased the effective dose. Conclusion: Based on the obtained results, we can conclude that the additional copper filtration of 0.1 mm is appropriate for the lumbar spine imaging. For more substantiated conclusions, we suggest further research.

• Keywords: master's theses, radiologic technology, lumbar spine, Cu filter, dose reduction, image quality