Introduction: Overweight and obesity are major public health issues and have been classified by the World Health Organization as chronic metabolic diseases. According to WHO data, their prevalence has tripled in most European countries since 1980. This presents a challenge in radiological diagnostics, as such patients receive higher radiation doses and image quality is reduced. Purpose: The aim of this thesis is to investigate and determine how increasing exposure parameters (tube voltage) can achieve the lowest radiation dose while maintaining acceptable image quality. Methods: The study used quantitative, experimental, and descriptive methods. In the experimental and quantitative part, 120 abdominal radiographs of an anthropomorphic phantom were obtained, with additional fat layers applied and exposure parameters varied. The data were analysed and compared using a descriptive method. Literature sources were obtained through Google Scholar, ScienceDirect, PubMed, Cobiss+ and RUL. Results: Results showed that BMI significantly affected ED, DAP and image quality (SNR, CNR), as the Kruskal-Wallis test demonstrated statistically significant differences (p < 0.001), while tube voltage also influenced DAP. DAP increased by 741.57 at BMI 40. The largest SNR reduction was observed at BMI 32 (50.3% in soft tissue, 58.1% in bone), while CNR increased by up to 10.4% in soft tissue and 7.2% in bone. Effective dose increased fourfold at the highest BMI. At BMI 40, the highest organ doses were received by the uterus, bladder, stomach, colon, skin and lymph nodes. Discussion and conclusion: The results indicate that BMI significantly influences both patient radiation dose and image quality. With increasing BMI, DAP increases, while image quality deteriorates. Additionally, effective dose to radiosensitive organs increases, particularly in the uterus, bladder, stomach, colon, lymph nodes and skin. Therefore, optimisation of radiological protocols according to the ALARA principle is essential.
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