Vpliv indeksa telesne mase na obsevanost pacientov pri slikanju v splošni radiografiji : magistrsko delo

Petrinjak, Barbara (author), Mekiš, Nejc (mentor), Škrk, Damijan (reviewer)

Uvod: Indeks telesne mase (ITM) je eden od najbolj vplivnih dejavnikov, ki pacientu določa prejeto dozo, pri pacientu z zvečanim ITM se v telesu absorbira več fotonov, rezultat so višji ekspozicijski parametri, ki doprinesejo k višji prejeti dozi sevanja. Namen: Namen raziskave je bilo ugotoviti kako povišanje ITM vpliva na povišanje DAP, efektivno dozo in dozo na posamezne organe pri izbranih preiskavah v splošni radiografiji. Metode dela: Dozo smo merili pri 600 preiskavah in sicer pri RTG PC, LSH, medenice, kolena in rame. Pacientom smo izmerili telesno višino in težo na podlagi katerih smo izračunali ITM in jih razvrstili v skupine z normalno telesno maso, prekomerno telesno maso in debeli. Med skupinami smo primerjali vrednosti DAP, efektivne doze in doze na izbrane organe, slednja dva smo izračunali s pomočjo programa PCXMC 2.0. Rezultati: Vrednosti DAP-a in efektivne doze so se v primerjavi z normalno telesno maso zvišale pri vseh preiskavah v področju trupa. DAP se je pri prekomerni telesni masi zvišal pri RTG PC PA > 29 % in stransko > 59 %, pri RTG LSH AP > 62 % in stransko > 46 % in pri RTG medenice AP > 69 %. Pri debelih se je DAP zvišal pri RTG PC PA > 96 % in stransko > 216 %, pri RTG LSH AP > 272 % in stransko > 117 % in pri RTG medenice AP > 291 %. Razlike DAP vrednosti pri RTG kolen in ram so bile minimalne in so pri prehranjenih in debelih pacientih celo nižje. Vrednosti efektivne doze in absorbirane doze na organe so korelirale povišanim DAP vrednostim. Razprava in zaključek: Na podlagi rezultatov lahko zaključimo, da ima ITM močan vpliv na izmerjeni DAP, efektivno dozo in dozo na izbrane organe pri slikanju LSH, medenice in RTG PC, manjši vpliv ima pri RTG kolen in ram. Temu je tako, ker pri slikanju kolen in ram nismo uporabljali avtomatskega nadzora ekspozicije.

• Language: Slovenian
• Keywords: magistrska dela, radiološka tehnologija, indeks telesne mase, debelost, ionizirajoče sevanje, povečanje dozne obremenitve
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [B. Petrinjak]
• Year: 2021
• Number of pages: 76 str., [4] str. pril.
• PID: 20.500.12556/RUL-127033
• UDC: 616-07
• COBISS.SI-ID: 63207939
• Publication date in RUL: 14.05.2021

Secondary language

• Language: English
• Title: The influence of body mass index on radiation dose in general radiography : master thesis

Abstract

Introduction: Body mass index (BMI) is one of the critical factors affecting the radiation dose received by the patient because the patients with higher BMI have higher attenuation factor, therefore the higher exposure parameters must be used. Purpose: The aim of the study was to investigate how BMI affects the DAP, effective dose and dose to selected radiosensitive organs during various examinations in general radiography. Methods: Dose was measured in 600 patients referred for imaging of the chest, lumbar spine, pelvis, knees, and shoulder in general radiography. The height and weight of the patients were measured and from this the BMI for each patient was calculated. Patients were then categorized into three different groups based on their BMI (normal weight patients, overweight patients, and obese patients). The DAP value for each imaging was compiled, and the effective dose and absorbed dose for selected radiosensitive organs were calculated using PCXMC 2.0 Monte Carlo simulation program. Results: The DAP and effective dose values increased in overweight and obese patients in the trunk region. The DAP values were on average more than 29% higher in PA and more than 59% higher in lateral projection in overweight patients in chest imaging, more than 62% higher in AP and more than 46% higher in lateral projection in lumbar imaging, and more than 69% higher in pelvic imaging. In obese patients, the increase in DAP values was more than 96% in PA projection and more than 216% in lateral projection for chest imaging, more than 272% in AP and more than 117% in lateral projection for lumbar spine imaging and more than 291% in pelvic imaging. The DAP values for knee and shoulder radiography showed only slightly lower dose values for overweight and obese patients. The values of effective dose and absorbed dose for selected radiosensitive organs corresponded with the increase in DAP values. Discussion and conclusion: From the results presented, we can conclude that BMI has a large effect on DAP, effective dose, and dose to selected radiosensitive organs chest imaging, lumbar spine, and pelvic imaging, and a smaller effect for knee and shoulder imaging in general radiography. This is because we did not use automatic exposure control for the imaging of the extremities.

• Keywords: master's theses, radiologic technology, body mass index, obesity, ionizing radiation, increase in radiation dose