Katarina Ružić, Ana Buinac, Mihaela Justić, Ivana Kralik, Ivana Bjelobrk, Dario Faj
{"title":"Optimization of diagnostic and interventional procedures","authors":"Katarina Ružić, Ana Buinac, Mihaela Justić, Ivana Kralik, Ivana Bjelobrk, Dario Faj","doi":"10.55378/rv.48.1.6","DOIUrl":"https://doi.org/10.55378/rv.48.1.6","url":null,"abstract":"S obzirom na značajan porast primjene oslikavanja uporabom rendgenskih uređaja u medicini te još uvijek nedovoljno poznati utjecaj niskih doza ionizirajućeg zračenja i povezanost s pojavnosti karcinoma, optimizacija dijagnostičkih i intervencijskih postupaka koji se provode uporabom rendgenskih uređaja ima važnu ulogu u zaštiti od ionizirajućeg zračenja pri medicinskom ozračenju. Proces optimizacije ne predstavlja samo prilagodbu parametara protokola za oslikavanje, već obuhvaća niz aktivnosti i struka koje su uključene u proces. Liječnik, radiološki tehnolog i medicinski fizičar imaju glavne i nezamjenjive uloge u procesu optimizacije, stoga je bitno da je tema optimizacije uključena u dio njihove osnovne edukacije i daljnjeg usavršavanja. Uspostava programa osiguranja kvalitete neizostavan je korak u optimizaciji s obzirom da sam program propisuje aktivnosti poput kontrole kvalitete, analize odbačenih i nekvalitetnih radioloških slika, bilježenja doza pacijenata, izračuna tipičnih vrijednosti i usporedbu s dijagnostičkim referentnim razinama. U novije doba primjena umjetne inteligencije u procesu optimizacije također ima svoju ulogu. Obuhvaćanje svih koraka procesa optimizacije u konačnici ima za cilj ostvarenje kvalitete slike koja je prikladna za odgovoriti na kliničko pitanje uz minimalno ozračenje pacijenta.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"120 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roko Barišić, Boris Barac, Doris Šegota Ritoša, Zvonimir Katić, Maja Karić
{"title":"Pulmonary vein isolation by cryoablation on patients with paroxysmal atrial fibrillation","authors":"Roko Barišić, Boris Barac, Doris Šegota Ritoša, Zvonimir Katić, Maja Karić","doi":"10.55378/rv.48.1.1","DOIUrl":"https://doi.org/10.55378/rv.48.1.1","url":null,"abstract":"Aim: Atrial fibrillation is just one of many arrhythmias that affects the cardiac rhythm and the heart as a pump which consequently increases the chance of an embolic insult. Due to the electric stimuli that originate from pulmonary vein ostia and their lumen, an isolation procedure is initiated, mostly by cryoablation. The main goals of this study were to investigate the relationship between measured nadir temperatures during cryoablation of each individual pulmonary vein and to compare the success of first-time cryoablation between left and right pulmonary veins. Participants and methods: The study involved 40 participants who underwent pulmonary vein isolation by cryoablation due to paroxysmal atrial fibrillation, irrespective of gender and age. The procedures were carried out throughout the year 2022 at the University Hospital Centre Zagreb, where the data were collected. All necessary patient data were permanently recorded and saved in a separate cryoconsole used to dictate the entire procedure. Results: Given the 40 participants in the study, a total of 160 pulmonary veins were analyzed. The t-test shows that the left upper pulmonary vein was the most advantageous vein to isolate, and the lower right pulmonary vein was the least advantageous. p-value analysis has also shown significant differences between left and right pulmonary veins, with that difference being lower in value between the left-sided pulmonary veins. Additionally, the chi-squared test confirmed a statistically significant difference between successful cryoablations of left-sided and right-sided pulmonary veins. This has shown that the left-sided pulmonary veins are easier to isolate on first cryoablation, rather than their right-sided counterparts. Conclusion: Pulmonary vein isolation by cryoablation is an excellent proof of incorporating fundamental physical principles in medicinal purposes. This study keeps the doors open for further research into optimal approaches in atrial fibrillation treatment. Therefore, comparing our study with recent publications and literature suggests higher success in isolating left pulmonary veins compared to right pulmonary veins.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"103 46","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Best Practice in Radiation Oncology — A Workshop to Train RTT Trainers","authors":"Endira Al-Khazae, Vedrana Hertl, Ivan Balentović","doi":"10.55378/rv.48.1.7","DOIUrl":"https://doi.org/10.55378/rv.48.1.7","url":null,"abstract":"U organizaciji Međunarodne Agencije za Atomsku Energiju (International Atomic Energy Agency – IAEA) i Europskog Društva za Radioterapiju i Onkologiju (European SocieTy for Radiotherapy and Oncology – ESTRO) održao se drugi i posljednji dio trogodišnjeg edukacijskog projekta pod nazivom „Best Practice in Radiation Oncology: Train the RTT (Radiation Therapist) Trainers“, u Beču, 20. – 23.11.2023. Prvi dio projekta održan je 2022. godine u Briselu, Belgija, te su svi sudionici preuzeli obavezu sudjelovanja i u drugom dijelu tečaja, u kojem je prisustvovalo 17 sudionika iz Albanije, Azerbajdžana, Bugarske, Gruzije, Kirgistana, Srbije, Uzbekistana te Hrvatske. Učesnici su bili uglavnom radiološki tehnolozi / radioterapijski tehnolozi (RTT), te onkolozi i medicinski fizičari.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"101 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"SECT and DECT coronarography","authors":"Tara Stojaković, Krešimir Dolić","doi":"10.55378/rv.48.1.2","DOIUrl":"https://doi.org/10.55378/rv.48.1.2","url":null,"abstract":"Coronary artery disease is an atherosclerotic disease of the coronary arteries with consequent development of ischemic heart disease and is one of the leading causes of death in developed and developing countries. The “golden” standard in the diagnosis of coronary disease is invasive coronarography, but with the development of coronary CT angiography, a sub-millimetre precise assessment of the anatomy of coronary arteries and heart has been made possible. While in the earlier stages, SECT devices were used for the needs of coronary CT angiography with synchronization with the ECG, the development of DECT devices enabled a significant rise in the performance of coronary CT angiography in the form of a better assessment of anatomy and stenoses of the coronary arteries caused by plaque, the possibility of assessing heart perfusion, obtaining an image with a minimal amount of artifacts, a smaller amount of applied iodine contrast agent, better characterization of the atherosclerotic plaque and its components, and all of the above with a lower radiation dose for the patient. While most of the conducted research speaks in favour of DECT devices versus SECT devices, the issue of inadequate utilization of the numerous possibilities of DECT devices in everyday clinical practice remains. The DECT technique can be implemented in several ways, depending on the structure of the DECT device (on the number of radiation sources, the structure/arrangement of detectors, or the use of filters), but the question of which type of DECT technique/device to use depends on the disadvantages and advantages of individual devices as well as on the final goal of diagnostic procedures.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"124 39","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of low dose CT radiation","authors":"Ivan Ćosić, Krešimir Dolić","doi":"10.55378/rv.48.1.4","DOIUrl":"https://doi.org/10.55378/rv.48.1.4","url":null,"abstract":"With the technological advancements, we have witnessed a proliferation of innovative and beneficial methods in the utilization of CT devices. The contemporary application of low-dose CT (LDCT), both in adults and children, is considered the gold standard due to its wide range of indications. The aim of this study is to delineate the positive and negative impacts that LDCT imposes on the human body. The routine use of LDCT in practice raises numerous questions regarding its harmfulness and influence. Diverse opinions exist within the scientific community regarding the association between LDCT and cancer development; therefore, it is exceptionally important to consider the population involved in the study, the characteristics of the radiation itself, and the various body parts exposed to radiation prior to its application. Despite the considerable number of conducted studies advocating for the use of LDCT, its utilization and the development of potential consequences cannot be completely excluded. That is why one of the necessary prerequisites for the professional use of CT as the method of choice in diagnostics is knowledge and understanding of scientific studies and their results in accordance with the modern development of CT devices. What remains crucial in everyday practice is that the knowledge used is always scientifically based and ultimately — reasonable.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141127148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Failure Mode and Effects Analysis Application in External Beam Radiotherapy","authors":"Vedran Manestar, Anita O'Donovan, Sarah Barrett","doi":"10.55378/rv.48.1.3","DOIUrl":"https://doi.org/10.55378/rv.48.1.3","url":null,"abstract":"Background: Radiotherapy is a medical procedure with potential high risk to harm patients. In order to reduce that risk and create a workflow safe for patients, prospective analysis tools are used. Failure modes and effect analysis (FMEA) is one such tool, used to evaluate potential risks. As FMEA originated from industry, there is a constant effort to adjust FMEA methodology for use in radiotherapy. This has caused a variety of approaches and inhomogeneous practices. Purpose: To investigate the current practice of FMEA in external beam radiotherapy and to propose a more standardised approach. Materials and Methods: The search was performed in PubMed, Ovid and Embase databases, resulting in 312 articles retrieved. Using PRISMA methodology the number of unique articles meeting inclusion and exclusion criteria was reduced to a total of 35, containing 38 analyses. The data on FMEA methodology implemented, scope of analysis, expert team composition, number of failure modes (FM) detected, relative priority number (RPN) threshold, number of FM exceeding the threshold, minimum, maximum and mean RPN, RPN calculation method and risk mitigation strategies were selected as important properties of FMEA. Results: Data retrieved showed large variation in how FMEA is conducted. There is a considerable underreporting of minimum and mean RPN values. Large variations in RPN threshold value selection were also observed. Two different approaches to RPN calculation procedure were reported, and it is unclear what the best practice is. Expert teams were assembled according to the guidelines, but the optimal number of members is unclear. The vast majority of risk mitigation measures were applied directly, without the use of systematic tools. Conclusion: FMEA is a well-established and widely used tool for prospective risk assessment in radiotherapy. As a result of this analysis, recommendations for more standardized approaches were proposed. Possible additional research goals were proposed in order to provide evidence for best practice in some areas of FMEA.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"125 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidencija planocelularnog karcinoma u pacijenata s karcinomom pluća dijagnosticiranim kompjuteriziranom tomografijom i patohistološki u 2022.godini u KBC-u Rijeka","authors":"Elizabeta Daus, Ena Mršić, Melita Kukuljan","doi":"10.55378/rv.47.2.7","DOIUrl":"https://doi.org/10.55378/rv.47.2.7","url":null,"abstract":"Cilj: utvrditi histološke tipove raka pluća među bolesnicima kojima je kompujeriziranom tomografijom toraksa i patohistološki dijagnosticiran rak pluća te odrediti prevalenciju planocelularnog karcinoma. Nadalje, utvrditi spolnu i dobnu zastupljenost te udio pušača i nepušača među ispitanicima s dijagnosticiranim planocelularnim karcinom u odnosu na bolesnike oboljele od adenokarcinoma. Metode: ova retrospektivna studija uključuje sve bolesnike kod kojih je u 2022.g. u KBC-u Rijeka, dijagnosticiran rak pluća. Svi podaci potrebni za provođenje ovog istraživanja (dob i spol bolesnika, patohistološki nalaz, dijagnostička metodu pomoću koje je pribavljen materijal za patohistološku analizu te pušački status), dobiveni su pretraživanjem bolničkih baza podataka (IBIS i ISSA). Rezultati: u ovom istraživanju utvrđeno je sveukupno 147 novodijagnosticiranih primarnih karcinoma pluća. Udio bolesnika muškog spola s primarnim karcinoma pluća iznosio je 65,3%, a ženskog 34,7%. Najzastupljeniji histološki tip raka pluća bio je adenokarcinom, potvrđen kod 40,8% bolesnika, a potom planocelularni karcinom, dijagnosticiran kod 22,4% bolesnika. Pripadnika muškog spola među ispitanicima s adenokarcinomom bilo je 63,3%, a među ispitanicima s planocelularnim karcinomom 75,5%. U grupi oboljelih od adenokarcinomom bilo je 80% aktivnih ili bivših pušača cigareta, a među ispitanicima s dijagnosticiranim planocelularnim karcinomom 94 %. Udio pušača kod muškaraca oboljelih od adenokarcinoma iznosio je 92,2%, a kod planocelularnog 92%. U skupini žena oboljelih od adenokarcinoma bilo je 59,1% pušača, a u skupini oboljelih od planocelularnog karcinoma 100%. Zaključci: planocelularni karcinom je drugi po učestalosti u bolesnika kod kojih je u 2022.g. u KBC-u Rijeka dijagnosticiran karcinom pluća nemalih stanica, nakon adenokarcinoma, s udjelom od 22,4%. Među bolesnicima oboljelim od planocelularnog karcinoma znatno veći je bio udio pripadnika muškog spola (75,8% naprema 24,2%), kao i udio pušača (94% naprema 80%) nego u onih oboljelih od adenokarcinoma.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136360826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Characteristics of the new Photon counting CT detector","authors":"Petra Mimica, Tatjana Matijaš","doi":"10.55378/rv.47.2.3","DOIUrl":"https://doi.org/10.55378/rv.47.2.3","url":null,"abstract":"Radiology is one of the fastest growing branches of medicine, and precisely one of the devices that follows this development the fastest is the computerized tomography device. Scientists are most focused on research into improving the parameters of the X-ray tube and detector as the most important parts of this imaging modality. In addition to the detector with energy integration, which is widely used today as part of everyday clinical practice, the subject of research is also a Photon countng detector. The numerous virtues that stand out in the new type of detector are responsible for the general opinion that in the future this new technology will dominate CT devices in clinical practice, improving the acquisition of numerous diagnostic and interventional procedures. It is believed that this technology ushers radiology into a new era precisely with its improved spatial and contrast resolution, noise reduction and increase of contrast to noise ratio, but also with new possibilities such as simultaneous imaging of multiple contrast agents and multi-energy imaging. Improvements in the visibility of iodine contrast agent provide additional diagnostic possibilities and more accurate differentiation of benign and malignant suspected lesions. The significantly smaller pixel size on this detector offers an almost two-fold increase in spatial resolution, and thus an increase in radiation dose efficiency. The use of a detector with a photon counter is therefore also suitable for pediatric patients, and there is also a wide range of low-dose imaging options for the purpose of preventive cancer screening. Processes such as the material decomposition and spectral imaging are still in the research process, but have great potential to optimize future daily clinical practice. More work and published research results are needed, but surely this technology will one day make the work of radiologic technologists and radiologists easier.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136360941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Umjetna inteligencija u oslikavanju koljena magnetnom rezonancijom","authors":"Petra Kujundžić, Tatjana Matijaš","doi":"10.55378/rv.47.2.5","DOIUrl":"https://doi.org/10.55378/rv.47.2.5","url":null,"abstract":"Introduction: Technological progress leads to an increasing use of radiological imaging, and an increase in the number of imaging results in an increased workload for radiologists. The driver of the application of AI in radiology is considered to be the reduction of the workload of radiologists and the need for faster and more accurate diagnosis. Aim: The aim of this paper is to bring the reader closer to the implementation of AI in radiology, especially in the MRI modality, and how deep learning algorithms improve image reconstruction. Discussion: Numerous studies have confirmed the importance of implementing machine learning, a subset of artificial intelligence, in the radiology system. In this review paper, numerous researches on the application of deep learning in magnetic resonance imaging are highlighted, and the emphasis is on models for automatic segmentation. Automatic segmentation has shown excellent results in the early detection of osteoarthritis, then in anterior cruciate ligament and meniscus tears, the most common knee injuries, and more recently, the deep learning model has excelled in automatic bone age estimation. Automatic segmentation has achieved, above all, high accuracy and precision, objectivity and time saving. Conclusion: Previous research has already highlighted the significant advantage of using machine learning in radiology and the exceptional compatibility between the work of radiologists and machine learning, which achieves precise and quick diagnoses. All this is a great incentive for further research, and technological progress will certainly speed up its integration into clinical practice.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136360976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivana Kralik, Ivana Bjelobrk, Ana Buinac, Danijel Cvetko, Mihaela Justić, Dajana Meštrić, Jelena Popić, Katarina Ružić, Tajana Turk, Dario Faj
{"title":"Indication based vs anatomical region based diagnostic reference levels","authors":"Ivana Kralik, Ivana Bjelobrk, Ana Buinac, Danijel Cvetko, Mihaela Justić, Dajana Meštrić, Jelena Popić, Katarina Ružić, Tajana Turk, Dario Faj","doi":"10.55378/rv.47.2.8","DOIUrl":"https://doi.org/10.55378/rv.47.2.8","url":null,"abstract":"Korištenje dijagnostičkih referentnih razina u svakodnevnoj kliničkoj praksi s ciljem optimizacije postupaka koji se provode rendgenskim uređajima za računalnu tomografiju može predstavljati poseban izazov ako su dane za pojedina anatomska područja. Razlog tome je činjenica da se za oslikavanje istog anatomskog područja mogu koristiti različiti protokoli, ovisno o potrebnoj razini kvalitete radiološke snimke koja je određena kliničkom indikacijom. Usporedba tipičnih vrijednosti dozimetrijskih veličina s takvim dijagnostičkim referentnim razinama može rezultirati pogrešnim poimanjem potrebe za poduzimanjem korektivnih mjera bilo s ciljem smanjenja ozračenja pacijenta bilo s ciljem poboljšanja kvalitete dijagnostičke informacije. Zbog toga je važno uspostaviti i koristiti dijagnostičke referentne razine koje su dane za pojedinu indikaciju što će u ovom radu biti pokazano na nekoliko primjera iz svakodnevne kliničke prakse.","PeriodicalId":500956,"journal":{"name":"Radiološki vjesnik","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136360938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}