Vpliv kompresijske sile pri mamografskem slikanju : magistrsko delo

Dovečar, Nuša (author), Mekiš, Nejc (mentor), Alukić, Erna (comentor), Marolt-Mušič, Maja (reviewer)

Uvod: Mamografsko slikanje je najbolj razširjena metoda za zgodnje odkrivanje raka na dojkah, ki je najpogostejši rak pri ženskah v Sloveniji. Presejalni program DORA izvaja mamografsko slikanje in ocenjevanje mamografskih slik skladno s strokovnimi smernicami, s tem pa zagotavlja kakovostno mamografsko sliko, ki mora biti dobro pozicionirana, primerno osvetljena, visoko kontrastna, brez artefaktov in narejena z najnižjo dozo sevanja. Ti parametri so med seboj povezani in vplivajo drug na drugega. Z uporabo kompresije zmanjšamo debelino dojke, s tem pa povečamo kontrastno in prostorsko ločljivost, zmanjšamo tveganje za artefakte in s tem pacient prejme najnižjo dozno obremenitev. Namen: Namen je zbrati in primerjati podatke o kompresiji in debelini dojke pri pacientkah slikanih v presejalnem programu DORA med različnimi obiski, med različnimi mamografskimi aparati, med ustanovami in radiološkimi inženirji. Metode dela: V raziskavi smo uporabili retrospektivno metodo s sekundarno analizo podatkov in zajeli 2000 pacientk, ki so se udeležile mamografskega slikanja v programu DORA med leti 2013 in 2017. Zajeli in primerjali smo podatke iz treh zaporednih mamografskih slikanj; treh različnih proizvajalcev mamografskih aparatov, ki so se do leta 2017 uporabljali za mamografsko slikanje v programu DORA;, štirih ustanov, kjer se izvaja program DORA in 64 radioloških inženirjev, ki so med leti 2013 in 2017 izvajali mamografsko slikanje v programu DORA. Za statistično analizo smo uporabili IBM SPSS statistics verzije 26. Rezultati: Rezultati so pokazali statistične razlike med zaporednimi obiski, ustanovami slikanja, mamografskimi aparati in radiološkimi inženirji pri vseh projekcijah mamografskega slikanja. Ugotovili smo, da lahko radiološke inženirje glede na povprečno uporabljeno kompresijo razvrstimo v 3 skupine: prva skupina s povprečno kompresijo <100 N (14 %), druga skupina s povprečno kompresijo 100 - 120 N (52 %) in tretja skupina s povprečno kompresijo >120 N (34 %). Razprava in zaključek: Priporočili bi uvedbo standariziranega protokola mamografskega slikanja z natančnim razponom uporabljene kompresije za posamezno projekcijo pri slikanju, ob upoštevanju velikosti dojke in bolečine pacientke med samim slikanjem. To bi po našem mnenju optimiziralo mamografsko slikanje znotraj celotnega programa DORA, pripomoglo k zmanjšanju razlik v povprečni kompresiji in omogočilo pacientkam primerljivo zaporedno izkušnjo, potencialno pa tudi večjo odzivnost v preventivni program DORA.

• Language: Slovenian
• Keywords: magistrska dela, radiološka tehnologija, mamografsko slikanje, DORA, kompresija, debelina dojke, radiološki inženirji
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [N. Dovečar]
• Year: 2022
• Number of pages: 64 str., [7] str. pril.
• PID: 20.500.12556/RUL-138079
• UDC: 616-07
• COBISS.SI-ID: 114928131
• Publication date in RUL: 09.07.2022

Secondary language

• Language: English
• Title: Impact of compression force in mammographic screening : master thesis

Abstract

Introduction: Mammography imaging is the most widespread method for early detection of breast cancer, which is the most common cancer in women in Slovenia. DORA screening program performs mammography imaging and grading of mammography images in accordance with professional guidelines, ensuring a quality mammography image that must be well positioned, adequately lit, high contrast, no artifacts and made with the lowest radiation dose. These parameters are interrelated and affect each other. By using compression, we reduce the thickness of the breast, increasing the contrast and spatial resolution, reducing the risk of artifacts, and patient receives the lowest radiation dose.Purpose: The purpose is to collect and compare data on compression and breast thickness in patients imaged in DORA screening program during different visits, between different mammography machines, between institutions and radiological engineers. Methods: In the study, we used a retrospective method with secondary data analysis and captured 2000 patients who participated in mammography imaging in DORA program between 2013 and 2017. We captured and compared data from sequential mammography imaging, on three different mammography machines, in four institutions and 64 radiological engineers. IBM SPSS 26 statistics were used for statistical analysis. Results: The results showed statistical differences between subsequent visits, imaging institutions, mammography machines, and radiological engineers in all mammography imaging projections. We found that radiological engineers can be divided into 3 groups according to the average compression force: the first group with average compression <100 N (14 %), the second group with average compression 100 - 120 N (52 %) and the third group with average compression > 120 N (34 %). Discussion and conclusion: We would recommend the implementation of a standardized mammography imaging protocol with the exact range of compression used for each projection during imaging, taking into account the size of the breast and the patient's pain during the imaging itself. In our opinion, this would optimize mammography imaging within the entire DORA program, help reduce differences in average compression, and allow patients a comparable sequential experience, and potentially greater responsiveness to the DORA prevention program.

• Keywords: master's theses, radiologic technology, mammography imaging, DORA, compression, breast thickness, radiological engineers