| Abstract | Samim tehnološkim napretkom došli smo do velikog broja inovativnih i korisnih metoda u korištenju kompjutorizirane tomografije. Suvremenu upotrebu niskodoznog CT-a (low dose CT, LDCT), kako u odrasloj tako i u dječjoj dobi, smatramo zlatnim standardom zbog vrlo širokog spektra različitih indikacija. Unatoč širokoj primjeni CT dijagnostike danas, prije 17 godina razmišljalo se čak i o ukidanju samog CT pregleda pod kampanjom “Image Gently”, koja je inicirana od strane pedijatrijskih radiologa 2006. godine, te zamjenom s ultrazvučnim pregledom (UZV) odnosno magnetskom rezonancom (MR) kao metodama izbora dijagnostike kod djece. No, samu kampanju zaustavio je razvoj i usvajanje Flash CT tehnike koja osim što samo vrijeme snimanja čini kraćim, smanjuje i dozu zračenja. Uz naveden razlog nastavka korištenja CT-a, u korist spomenutom pregledu idu i hitne kliničke indikacije koje zahtijevaju CT preglede te neprestano izlaganje određenoj pozadinskoj količini ionizirajućeg zračenja, neovisno radi li se o djeci ili odraslima. S te strane, današnja praksa sve češće preporučuje upotrebu LDCT-a, gdje je protokol svakome pacijentu individualno prilagođen s najmanjom mogućom dozom ionizirajućeg zračenja uz dostatnu kvalitetu dobivenih snimaka.
Svakodnevno korištenje LDCT-a u praksi također postavlja brojna pitanja o njegovoj štetnosti i utjecaju. Pronalazimo različita mišljenja unutar same znanstvene zajednice o povezanosti LDCT-a i razvoju karcinoma, stoga je iznimno važno razmotriti populaciju uključenu u istraživanje, karakteristike samog zračenja i različite dijelove tijela izloženima zračenju prije primjene samog zračenja s ciljem osiguranja da je korišteno znanje znanstveno utemeljeno i razumno. Usprkos doista velikom broj provedenih istraživanja koja zagovaraju korištenje LDCT-a, postoje i drugačija mišljenja o korištenju i posljedicama LDCT-a s kojom nisu upoznati svi profesionalci koji svakodnevno u praksi koriste CT kao metodu izbora. |
| Abstract (english) | Through technological progress alone, we have come up with a large number of advanced and useful methods in the use of CT devices. We consider the modern use of low-dose CT (LDCT), both in adults and in children, to be the gold standard due to a very wide range of different indications. Despite the widespread use of CT diagnostics today, 17 years ago there was an idea of abolishing the CT examination itself under the “Image Gently” campaign, which was initiated by pediatric radiologists in 2006, and replacing it with an ultrasound examination or magnetic resonance imaging as a choice of diagnostic methods for children. However, the campaign itself was stopped by the development and adoption of the Flash CT technique, which, in addition to shortening the imaging time, also reduces the radiation dose. In addition to the aforementioned reason for the sustained utilization of CT, urgent clinical imperatives that require CT examinations and ongoing exposure to varying degrees of background ionizing radiation are also beneficial to the mentioned examination, irrespective of whether the patient demographic is pediatric or adult. On the other hand, contemporary medical practice increasingly endorses the usage of LDCT, where the imaging protocol is custom-tailored to each patient, with the primary objective being the minimization of ionizing radiation dosage while maintaining image quality.
The daily use of LDCT in practice also raises numerous questions about its harmfulness and impact. Different viewpoints within the scientific community regarding the connection between LDCT and cancer development are indeed well-founded. Therefore, when contemplating the application of ionizing radiation in clinical contexts, it becomes essential to meticulously account for key variables, including the specific population under research, the characteristics of the radiation employed, and the anatomical regions subjected to radiation in order to insure the adherence to a scientifically grounded and rational approach. Despite the large number of conducted studies advocating the use of LDCT, there are also different opinions about the use and consequences of LDCT, with which not all professionals who use CT as the method of choice in daily practice are familiar. |
