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Značaj osiguranja i kontrole kvaliteta u dijagnostičkoj i skrining mamografiji

The importance of quality insurance and control in diagnostic and screening mammography.

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2016
Disertacija.pdf (1.302Mb)
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Author
Stantić, Tomislav
Mentor
Šaranović, Đorđije
Committee members
Ciraj-Bjelac, Olivera
Hodolič, Marina
Milošević, Zorica
Plešinac-Karapandžić, Vesna
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Abstract
Uvod: Mamografija je metoda izbora – zlatni standard - za ranu detekciju karcinoma dojke i dobro prihvaćen skrining metod za ţene određene ţivotne dobi. Koristeći mamografiju, moguće je otkriti tumor u stadijumu kada je lečenje najefektivnije, ali samo u slučaju da je obezbeđena produkcija snimaka konstantnog kvaliteta u smislu kontrasta i rezolucije. Sa druge strane, upotreba jonizujućeg zračenja je rizičan deo mamografske procedure. Iz tog razloga, kontrola doze i rizik za visoko radiosenzitivno glandularno tkivo dojke su podjednako vaţni i svi mamografski pregledi moraju biti opravdani u smislu koristi i rizika. Cilj prve faze studije je bio identifikacija slabih tačaka mamografske prakse u Srbiji, u smislu tehničkih parametara mamografije, te definisanje predloga korektivnih mera. Cilj druge faze je evaluacija analogne i digitalne mamografije, u smislu kvalteta slike i primljene doze zračenja, kao prvi korak optimizacije mamografskog procesa te uvođenja digitalne mamografije u ruti...nsku kliničku praksu u Srbiji. Materijal i metode: U prvoj fazi analizirano je 20 reprezentativnih mamografskih jedinica (engl. Mammography unit - MU), korišćenjem Protokola kontrole kvaliteta za analognu mamografsku opremu. Proučavani su rentgenska cev, generator, obrada filma, kvalitet snimka i primljena doza zračenja. Druga faza studije je uključila 387 asimptomatskih pacijentkinja, distribuiranih na pregled na analognim i digitalnim mamografskim aparatima (109 i 287 pacijentkinja, respektivno), uz naknadno računanje srednje glandularne doze, te procenu kvaliteta slike...

Introduction: Mammography is the method of choice – the golden standard – for early detection of breast cancer and a well accepted screening method for women of certain age groups. Using mammography, it is possible to detect cancer in a phase when treatment is the most effective, but only if a production of images of the constant quality in terms of contrast and resolution is assured. On the otherhand, the use of ionizing radiation is an intrinsic part of mammography. Thus, the control of the dose and risk to the highly radiosensitive glandular breast tissue is equally important and all mammographic examinations have to be justified in terms of corresponding benefits and risks. Objective: The goal of the first phase of the study was to identify weak points of mammography practice in Serbia , in terms of technical parameters of mammography , and suggest corrective measures. The goal of the second phase is the evaluation of analogue and digital mammography in terms of the quality of pict...ure and patient dose , as a first step in optimization of the mammography process and the introduction of digital mammography in routine clinical practice in Serbia. Materials and methodology: In the first phase 20 representative mammographic units ( Mammography unit - MU ) were analyzed using the Protocol of quality control for analogue mammography equipment. The X-ray tube , generator, film processing , image quality and patient dose were studied. The second phase of the study included 387 asymptomatic patients, distributed for examination on analogue and digital mammography devices ( 109 and 287 patients , respectively) , followed by mean glandular dose calculation and evaluation of image quality...

Faculty:
Универзитет у Београду, Медицински факултет
Date:
22-09-2016
Keywords:
mamografija / mammography / mamografski skrining / kontrola kvaliteta / radijaciona doza / screening mammography / quality control / radiation dose
[ Google Scholar ]
Handle
https://hdl.handle.net/21.15107/rcub_nardus_7320
URI
https://nardus.mpn.gov.rs/handle/123456789/7320
http://eteze.bg.ac.rs/application/showtheses?thesesId=4299
https://fedorabg.bg.ac.rs/fedora/get/o:14084/bdef:Content/download
https://fedorabg.bg.ac.rs/fedora/get/o:14245/bdef:Izvestaj/download
http://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=48486671

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