Optimizacija protokola rentgenskega slikanja prsnih organov z uporabo dodatnega bakrenega filtra : magistrsko delo

Maček, Anamarija (author), Škrk, Damijan (mentor), Mekiš, Nejc (comentor), Fošnarič, Miha (reviewer)

Uvod: Najpogostejše rentgensko slikanje na svetovni ravni predstavlja slikanje prsnih organov, zato je iz tega vidika izjemno pomembna optimizacija protokola slikanja, da dosežemo čim manjšo dozo ob še ustrezni kakovosti rentgenogramov. Namen: Z raziskavo želimo ugotoviti, kako se pri slikanju prsnih organov v dveh smereh spremeni doza pri uporabi dodatne filtracije bakra, ter ali se ob tem spremeni kakovost rentgenogramov. Metode dela: Raziskavo smo izvedli v dveh delih. V prvem delu smo raziskavo izvedli na antropomorfnem fantomu. Drugi del raziskave smo izvedli na 400 pacientih, ki so bili naključno razdeljeni v 4 skupine glede na debeline filtracije (0 mm, 0,1 mm, 0,2 mm, 0,3 mm). Merili smo DAP, na podlagi česar smo izračunali še VKD, efektivno dozo in absorbirano dozo na organe, ki smo jo izračunali v programu PCXMX 2.0. Na vseh rentgenogramih smo v programu ImageJ ocenili vrednosti SNR in CNR. Rentgenograme 200 pacientov so vizualno ocenili še trije zdravniki specialisti radiologi s pomočjo programa ViewDex 3.0. Rezultati: Iz raziskave izvedene na pacientih smo lahko ugotovili, da doza občutno pade pri vseh debelinah filtracije v obeh projekcijah. Največje zmanjšanje DAP-a je opazno pri 0,3 mm (48, 34 % v PA in 46,11 % v stranski projekciji). Podobno se je znižala tudi VKD, efektivna doza in absorbirana doza na organe. Pri meritvah SNR smo največji padec opazili pri stranski projekciji z debelino 0,3 mm bakra, pri drugih kvantitativnih parametrih kakovosti (EXI, DI, CNR, SNR) pa pomembnih razlik nismo opazili. Rezultati pri ocenah kakovosti rentgenogramov s strani zdravnikov specialistov radiologov je pokazala statistično pomembne razlike pri kriteriju splošna kakovost slike med skupinama 0 in 0,3 mm. Razprava in zaključek: Z izvedbo raziskave smo dokazali, da z dodajanjem dodatne filtracije bakra vplivamo na več vidikov doze ionizirajočega sevanja. Znižal se je DAP, VKD, efektivna doza kot tudi absorbirana doza na organe. Ob vseh teh znižanjih doze pa se kakovost rentgenogramov ni bistveno poslabšala. Glede na vse rezultate, se nam zdi smiselno uporabljati dodatno filtracijo bakra, največje znižanje doze prinese debelina 0,3 mm, v kakovosti pa ob tem ni pomembne razlike.

• Language: Slovenian
• Keywords: magistrska dela, radiološka tehnologija, rentgensko slikanje prsnih organov, dodatna filtracija, baker, optimizacija, 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: [A. Maček]
• Year: 2026
• Number of pages: 123 str., [3] str. pril.
• PID: 20.500.12556/RUL-181500
• UDC: 616-07
• COBISS.SI-ID: 274616835
• Publication date in RUL: 09.04.2026

Secondary language

• Language: English
• Title: Optimisation of chest radiography with the use of additional copper filtration : master thesis

Abstract

Introduction: Chest radiography is the most common X-ray examination worldwide, which makes optimization of imaging protocols crucial in order to achieve the lowest possible radiation dose while maintaining adequate image quality. Purpose: The aim of the study is to determine how the dose changes in two-view chest radiography when using additional copper filtration, and whether image quality is affected. Methods: The study was conducted in two parts. In the first part, the study was carried out using an anthropomorphic phantom. The second part of the study was carried out on 400 patients, who were randomly divided into four groups according to filtration thickness (0 mm, 0.1 mm, 0.2 mm, 0.3 mm). We measured DAP, and from it calculated ESD, effective dose, and absorbed organ doses that we calculated using the PCXMX 2.0 program. SNR and CNR values were assessed on all radiographs using the ImageJ program. Radiographs of 200 patients were visually evaluated by three board-certified radiologists using the ViewDex 3.0 program. Results: The patient study showed that radiation dose decreased significantly at all filtration thicknesses in both projections. The greatest reduction in DAP was seen with 0.3 mm filtration (48.34% in PA and 46.11% in lateral projection). Similarly, ESD, effective dose and absorbed organ doses were reduced. Regarding SNR measurements, the largest decrease was observed in the lateral projection with 0.3 mm copper filtration. For other quantitative image-quality parameters (EXI, DI, CNR, SNR), no substantial differences were observed. Radiologists visual assessments showed statistically significant differences in the criterion overall image quality between the 0 mm and 0.3 mm groups. Discussion and conclusion: This study proved that the addition of copper filtration affects multiple aspects of patient radiation dose. DAP, ESD, effective dose, and absorbed organ doses were all reduced. Despite these reductions, image quality did not substantially deteriorate. Based on the results, the use of additional copper filtration appears reasonable, with 0.3 mm providing the greatest dose reduction without significant image-quality degradation.

• Keywords: master's theses, radiologic technology, chest radiography, additional filtration, copper, optimization, dose reduction, image quality