Vpliv osebne varovalne opreme na izpostavljenost pacientk pri mamografskem slikanju : magistrsko delo

Krajnc, Sara (author), Žontar, Dejan (mentor), Mekiš, Nejc (co-mentor)

Uvod: Zaradi povečanega števila mamografij, še posebej po uvedbi organiziranega, sistematičnega zgodnjega odkrivanja raka dojke (presejanja) v Sloveniji, moramo nameniti več pozornosti izpostavljenosti pacientk. Na izpostavljenost lahko vplivamo tudi tako, da jih primerno zaščitimo z osebno varovalno opremo. Na podlagi novih ugotovitev Mednarodne komisije za varstvo pred sevanji (International Commission of Radiation Protection – ICRP) za najbolj radiosenzibilne organe s tkivnim utežnim faktorjem 0,12 veljajo debelo črevo, pljuča, kostni mozeg, želodec in dojke. Namen: Z raziskavo želimo ugotoviti, ali se in za koliko se zmanjša doza ionizirajočega sevanja na debelo črevo in pljuča pri klasični mamografiji in dodatnem slikanju dojk s povečavo, če svinčeno gonadno zaščito postavimo do baze pljuč namesto običajno uporabljane postavitve v višini medenice. Metode dela: Za izdelavo magistrske naloge smo uporabili deskriptivno in eksperimentalno metodo raziskovanja. Najprej smo meritve izvedli na fantomu PBU 60. Z elektronskim dozimetrom smo merili dozo ionizirajočega sevanja na debelo črevo in pljuča. V drugi del raziskave so bile vključene pacientke, ki so bile napotene na mamografsko slikanje dojk v Zdravstveni dom dr. Adolfa Drolca Maribor. Pri teh pacientkah smo dozo, ki jo ob mamografiji prejmejo pljuča in debelo črevo, izmerili na primerljiv način kot pri fantomu. Rezultati in razprava: Pri slikanju dojk se je uporaba osebne varovalne opreme izkazala kot izjemno učinkovita pri ščitenju pljuč in debelega črevesja tako v osnovnih projekcijah kot pri povečavi. Pri fantomu se je doza na pljuča z uporabo osebne varovalne opreme v CC-projekciji zmanjšala za približno 99 %, v MLO pa za 89 %. Pri slikanju s povečavo se je doza na pljuča v osnovni CC-projekciji zmanjšala za 93 %. Prav tako se je znižala doza na debelo črevo, in sicer v CC- in MLO-projekciji ter pri povečavi za okoli 93 %. Približno enake rezultate kot na fantomu smo dobili tudi pri merjenju doze na pacientkah. Zaključek: Glede na dobljene rezultate potrjujemo, da se je doza na pljuča in debelo črevo z uporabo osebne varovalne opreme pri slikanju dojk v obeh osnovnih projekcijah in pri povečavi bistveno zmanjšala. Kljub majhnim dozam, ki jih pri slikanju prejmejo ti organi, jih lahko z ustrezno uporabo osebne varovalne opreme dodatno zmanjšamo, ne da bi vplivali na kakovost mamografskih slik.

• Language: Slovenian
• Keywords: mamografija, osebna varovalna oprema, debelo črevo, pljuča
• Work type: Master's thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-97742
• COBISS.SI-ID: 5343083
• Publication date in RUL: 08.11.2017

Secondary language

• Language: English
• Title: Influence of personal protective equipment on patients' exposure in mammographic imaging

Abstract

Introduction: Due to the increased number of mammographies, especially after introduction of organized and systematic early detection of breast cancer (screening) in Slovenia, we should pay more attention to the exposure of patients. Patients’ exposure can also be influenced by proper protection with personal protective equipment (PPE). Based on the new findings of International Commission of Radiation Protection (ICRP), the most radio-sensible organs with tissue weighting factor 0.12 are large intestine, lungs, bone marrow, stomach, and breasts. Purpose: With the research, we want to establish whether and for how much the dose of ionising radiation on large intestine and lungs in classical mammography and additional breast imaging with enlargement is decreased if lead gonadal shields are placed to the lung basis instead of usually used placement in the height of the pelvis. Methods: For the master’s thesis, we used a descriptive and experimental research method. First, the measurements were carried out in PBU 60 phantom. We used electronic dosimeter to measure a dose of ionising radiation on large intestine and lungs. The second part of the survey included patients who were sent to the mammographic breast imaging to the Adolf Drolc Health Centre in Maribor. In these patients, we measured the dose received by lungs and large intestine during mammography in a comparable way, the same as in phantom. Results and discussion: In breast imaging, use of PPE proved to be extremely effective in protecting lungs and large intestine in basic projections, as well as in enlargement. In phantom, the dose to lungs in CC projection was reduced by approximately 99%, and in MLO projection by 89%, using PPE. In imaging with enlargement, the dose to lungs in the basic CC projection was reduced by 93%. Also the dose to large intestine was decreased, namely in the CC and MLO projection and in enlargement by approximately 93%. In patients, almost the same results as in phantom were detected. Conclusion: In regard to the obtained results, I confirm that dose to the lungs and large intestine during breast imaging using PPE was significantly decreased in both basic projections and enlargement. Despite small doses received by these organs in imaging, we can additionally reduce them by using PPE without affecting the quality of mammographic images

• Keywords: mammography, personal protective equipment, large intestine, lungs