magistrsko delo
Špela Temnikar (Author), Damijan Škrk (Reviewer), Nejc Mekiš (Mentor), Dejan Žontar (Co-mentor)

Abstract

Uvod: V dentalni medicini so dozne obremenitve nizke, vendar zaradi stohastične narave učinka ionizirajočega sevanja (IS) vseeno zvišajo tveganje za nastanek malignih in dednih obolenj. Dentalne preiskave z uporabo IS morajo biti zato kljub nizkim doznim obremenitvam upravičene in optimizirane. Optimizacija zagotavlja doseganje kakovostnih diagnostičnih ciljev z najnižjo možno izpostavljenostjo pacientov. Eno izmed orodij optimizacije je uporaba diagnostičnih referenčnih nivojev (DRN). Namen: Optimizacija obstoječih protokolov za panoramsko rentgensko slikanje zob na rentgenskem aparatu NewTom GiANO HR v Zdravstvenem domu Ravne na Koroškem. Metode dela: Raziskavo smo razdelili na pet delov. V prvem delu smo analizirali podatke doznih obremenitev pred optimizacijo retrospektivno pridobljenih rentgenogramov. Drugi del je vključeval rentgensko slikanje fantoma glave in vratu ter izračun vrednosti CNR za oceno kakovosti in ponovljivosti, izvedli pa smo tudi subjektivni pregled kakovosti retrospektivno pridobljenih rentgenogramov v odvisnosti od dozne obremenitve. V tretjem delu smo s pomočjo zobozdravnikov ocenili kakovost retrospektivno pridobljenih rentgenogramov in na podlagi ocen določili najprimernejšo kombinacijo programa in nastavitve za optimizacijo. To smo izvedli v četrtem delu in za izbrano kombinacijo določili nove ekspozicijske parametre ter povprečne dozne obremenitve glede na spol. V zadnjem, petem delu smo z zobozdravniki ocenili še kakovost rentgenogramov po optimizaciji. Rezultati: Z optimizacijo smo povprečne dozne obremenitve moških znižali s 182 mGy cm2 na 148 mGy cm2 (znižanje za 19 %), povprečne dozne obremenitve žensk pa s 144 mGy cm2 na 128 mGy cm2 (znižanje za 11 %), kar v obeh primerih predstavlja statistično značilno razliko (p = 0,001). Analizirali smo tudi ocene rentgenogramov in ugotovili, da pri 17 od 20 kriterijev kakovosti med rentgenogrami, zajetimi pred in po optimizaciji, ni statistično značilnih razlik, pri treh kriterijih, kjer so bile razlike statistično značilne, pa smo po pogovoru z zobozdravnico potrdili, da za diagnostiko niso ključnega pomena. Razprava in zaključek: Z optimizacijo smo znatno znižali dozne obremenitve za oba spola, ob tem pa ohranili kakovost rentgenogramov. Kljub optimizaciji pa je dozna obremenitev pacientov in pacientk ostala nad nacionalnim DRN (100 mGy cm2). Rezultati analize kakovosti slik po optimizaciji dopuščajo možnosti, da bi z nadaljnjo optimizacijo dozne obremenitve še dodatno znižali, optimizacijo pa bi predvidoma lahko nadgradili tudi z naknadno obdelavo rentgenogramov.

Keywords

magistrska dela;radiološka tehnologija;panoramsko rentgensko slikanje;optimizacija protokolov;kakovost slike;ponovljivost;dozna obremenitev;znižanje doznih obremenitev;

Data

Language: Slovenian
Year of publishing:
Typology: 2.09 - Master's Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [Š. Temnikar]
UDC: 616-07
COBISS: 211317507 Link will open in a new window
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Other data

Secondary language: English
Secondary title: Optimization of the protocol for panoramic imaging on NewTom GiANO HR device
Secondary abstract: Introduction: In dental medicine, patient doses are low, but due to the stochastic nature of the effects of ionizing radiation (IR), they still increase the risk of developing malignant and hereditary diseases. Therefore, dental examinations using IR must be justified and optimized. Optimization ensures diagnostically adequate radiographs with the lowest possible patient exposure. One of the tools for optimization is the use of diagnostic reference levels (DRLs). Purpose: Optimization of existing imaging protocols for panoramic dental X-ray imaging on the NewTom GiANO HR X-ray unit at the Health Center Ravne na Koroškem. Methods: We divided the study into five parts. In the first part, we analyzed patient doses from retrospectively obtained radiographs before optimization. The second part involved X-ray imaging of a head and neck phantom to determine CNR values to assess quality and reproducibility of the radiographs. Additionally, we conducted a subjective review of the image quality depending on the dose. In the third part, dentists evaluated quality of retrospectively obtained radiographs. Based on their assessments, we determined the best combination of program and settings for optimization. In the fourth part we carried out optimisation and determined new exposure parameters for the chosen combination. For the optimized protocols, we determined the average dose loads by gender. Finally in the fifth part, dentists assessed the quality of the radiographs after optimization. Results: Through optimization, we reduced the average dose loads for males from 182 mGy cm² to 148 mGy cm² (a decrease of 19 %), and for females from 144 mGy cm² to 128 mGy cm² (a decrease of 11 %). In both cases, this reduction represents a statistically significant difference (p=0.001). We also analysed the scores of the radiographs and found that in 17 criteria out of 20 quality criteria, there were no statistically significant differences between the radiographs taken before and after optimization. For the remaining three criteria where differences were detected, after consulting with the dentist, we confirmed that these differences were not clinically significant. Discussion and conclusion: Through optimization, we significantly reduced dose loads for both genders while maintaining the quality of the radiographs. Despite optimization, the dose loads for male and female patients remained above the national DRL (Diagnostic Reference Level) of 100 mGy cm². However, the results of the image quality analysis after optimization suggest that further reduction in dose loads is feasible with continued optimization. Additionally, optimization could potentially be enhanced by post-processing of radiographs.
Secondary keywords: master's theses;radiologic technology;panoramic X-ray imaging;protocol optimization;image quality;repeatability;dose exposure;reduction of dose exposure;
Type (COBISS): Master's thesis/paper
Study programme: 0
Embargo end date (OpenAIRE): 1970-01-01
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za radiološko tehnologijo
Pages: 93 str., [8] str. pril.
ID: 25266649