Introduction: Obesity increases the risk of developing diseases that may require several medical procedures, including radiographic examinations. Obtaining radiographs can sometimes be challenging for radiology technicians when dealing with obese patients, as they may need to repeat imaging multiple times to achieve diagnostic quality. Inadequate equipment or scanning techniques can lead to poor images, which prolongs the time needed for diagnosis and the initiation of treatment. Purpose: The aim of this thesis is to determine whether a patient's obesity affects the quality of radiographic images in standard radiography as well as in other diagnostic methods, such as mammography, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Methods: Using articles summarising the topic of this dissertation, we conducted a systematic literature review using a descriptive method. Relevant scientific articles were reviewed from the following databases: PubMed, Google Scholar, ScienceDirect, and Mendeley. Results: From a total of 13,679 retrieved articles, 15 were selected for analysis after applying the exclusion criteria and reviewing the full content of the articles. Discussion and conclusion: We found that obesity can affect the performance of all imaging diagnostics. Obtaining diagnostic images in obese patients can be challenging due to equipment limitations and the need for appropriate image quality. In radiographic diagnostics, body fat affects photon penetration, so it is crucial to adjust technical parameters, position the patient correctly, and prevent distortion due to movement. In mammography, obesity reduces contrast and geometric sharpness of the image, making breast cancer detection more difficult. In ultrasound (US), obesity can weaken ultrasound waves, and solutions include low frequencies, adjustment of the ultrasound beam speed, and filters to improve the signal-to-noise ratio. In CT, issues such as noise, limited field of view, and ring artefacts arise. Iterative reconstruction is key to improving image quality, along with faster detectors and a wider gantry. Among all imaging diagnostics, obesity has the least impact on MRI, as radio waves can penetrate fat more easily than ionising radiation. However, obesity still affects MRI image quality by worsening the signal-to-noise ratio, decreasing image resolution, and increasing the examination time. Furthermore, obese patients are more likely to experience claustrophobia and an increased risk of burns, which can be mitigated by using open MRI scanners.
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