Radiološke tehnologije

PATIENT SATISFACTION AND AWARENESS DURING CT EXAMINATIONS AT THE CROATIAN HOSPITAL “DR. FRA MATO NIKOLIĆ” NOVA BILA

Darko Tomić — 2025-11-10

Introduction: The WHO defines the quality of healthcare services as the degree to which health system goals that lead to improved health and meet the needs and expectations of the population are achieved. One of the most important changes relates to patients’ rights during hospitalization – every patient has the right to be fully informed and to give consent for all procedures performed on them. The aim of this paper is to examine patient satisfaction and awareness regarding the quality of CT services provided by medical radiology engineers in our hospital, as well as to identify possibilities for improvement.

Methods: An anonymous survey was conducted as a cross-sectional study. The questionnaire consisted of a total of 8 questions. The first part of the questionnaire included sociodemographic data (gender, age). The rest of the questions focused on patient satisfaction with the information provided about the procedures to be performed during the CT examination.

Results: The obtained results provide insight into patients’ perceptions of the quality of provided services and the communication of healthcare staff, and can serve as a basis for improving work processes and raising the standards of care.

Conclusion: it was confirmed that the majority of patients were satisfied and well informed during CT scans. The majority of respondents (70.8%) rated their level of awareness as extremely high, while almost all patients stated that they had enough time to ask questions and that the medical radiology engineers clearly explained the examination procedure to them. Patients also noted the attentiveness of the staff during both the preparation and the examination itself, and most received information about the risks or possible side effects of the procedure (adverse reactions to the contrast agent).

MRI mapping of knee cartilage in early diagnosis of osteoarthritis: a comparative analysis of advanced sequences

Armin Papracanin — 2025-11-10

Abstract

Introduction: Osteoarthritis (OA) of the knee is the leading cause of disability in the middle-aged and elderly population. Early detection of degenerative cartilage changes is crucial for timely therapeutic intervention and slowing the progression of the disease. Standard radiological methods often do not provide insight into the biochemical changes preceding morphological degeneration.

Objective: This review aims to evaluate the diagnostic value of different MRI mapping sequences (T2, T1ρ, dGEMRIC, UTE, 3D DESS and MMF) in the early detection of biochemical changes in knee cartilage in OA, and to compare their technical and clinical characteristics.

Methodology: 15 reviews of research published in the last ten years were analyzed, which used quantitative MRI sequences in assessing cartilage changes. Comparative analysis was performed based on the number of subjects, MRI techniques applied, results obtained and clinical validation.

Results: T2 and T1ρ sequences are highly sensitive to disturbances in the collagen network and proteoglycan content, while dGEMRIC remains the reference method for the evaluation of glycosaminoglycans, despite the need for contrast. UTE and MMF provide additional insight into the surface and calcified zones of the cartilage, while 3D DESS enables high morphological resolution within a short time. The combination of multiple sequences shows the best diagnostic value. Most studies confirm that quantitative MRI mapping allows the detection of OA in the preclinical phase.

Conclusion: MRI mapping techniques are an extremely promising tool for early diagnosis of knee OA, with the potential to replace conventional methods in clinical practice. Additional prospective research on larger samples, as well as standardization of protocols, is needed to enable wider application of these methods.

BREAST RADIOLOGICAL TREATMENT IN THE SCREENING PROGRAM

Andrej Galić — 2025-11-10

ABSTRACT

Objective: The main objective of this paper is to define and explain radiological diagnostic procedures used in the detection of various diseases and changes in the breast, and to present their advantages and disadvantages. To prove that mammography remains the gold standard in early detection of breast cancer, despite newer imaging methods and techniques. The paper will also present the results and advantages of the "Early Breast Cancer Detection Program". The Cantonal Early Breast Cancer Detection Program is the first such program implemented in Bosnia and Herzegovina.

Materials and methods: The study was conducted as a cross-sectional study. The participants were not actively involved, and their personal data remained fully protected. The data were collected retrospectively from official data sources provided by the Ministry of Health, Labor and Social Care through RIS (Radiology Information System) for the University Clinical Hospital in Mostar for our county. It included data from 01.01.2019. until 31.12.2024. The target population consisted of patients older than 45 to 69 years. A total of 3,432 patients in our county were included who were recorded on a mammogram at the University Clinical Hospital in Mostar. Statistical analysis was performed using SPSS for Windows and Microsoft Office Excel 2010.

Results: The Cantonal Breast Cancer Early Detection Program is the first such program implemented in Bosnia and Herzegovina. The program covers all women aged 45 to 69, regardless of health insurance status, and the goal of the program is to detect breast cancer at an early stage, which will reduce breast cancer mortality by 23-31%, prolong the life of breast cancer patients and improve the quality of life of breast cancer patients. All patients were first imaged with mammography. After reading the findings, depending on the stage, patients were referred for additional tests such as biopsy, ultrasound or magnetic resonance imaging. Initially, the program was planned in two phases. The first phase starts in 2019 and ends in December 2022. Given the number of women included in the program (32,444) and the planned response rate of 60%, the first phase (2019-2020) covers approximately 19,500 women. The second phase also lasted two years (2021-2022) and included women who were not included in the first phase, women who had meanwhile reached the target age, and women who were recommended for control mammography in our county in the first phase. In the first and second phases from 2019 to 2022, 933 patients were examined at the University Clinical Hospital Mostar, of whom 9 had a positive result. In the third phase of the program (2022-2024), 2,499 patients were examined at the University Clinical Hospital in Mostar. Of these, 18 had positive results.

Conclusions: Despite advances in technology, mammography remains the gold standard in early detection of breast cancer. This program demonstrates the importance of timely screening and following the recommendations of the World Health Organization to prevent the spread and early detection of breast cancer. When this program was launched, it was agreed that it would be worthwhile if one breast cancer was detected in time through the program.

RADIATION PROTECTION IN THE PEDIATRIC POPULATION

Merjema Imamović — 2025-11-10

Radiation protection in the pediatric population is essential due to the increased sensitivity of children to the harmful effects of ionizing radiation, such as leukemia and brain tumors. This systematic literature review aims to provide a comprehensive overview of current knowledge on this topic, analyzing the results of metaanalyses and identifying key factors affecting the level of radiation exposure in children. The paper describes in detail the sources of radiation
in the pediatric population, including medical diagnostics, radiotherapy and exposure to ambient radiation, and analyzes the effectiveness of various protection measures. The results of the meta-analyses indicate an increased risk of malignancies, especially leukemia and brain tumors, in children exposed to ionizing radiation, especially when using computed tomography(CT). The paper emphasizes the importanceof optimizing the protocol of imaging and
treatment, the use of protective equipment and educating healthcare professionals about the principles of radiation protection. In conclusion, adequate radiation protection in the pediatric population is necessary to minimize potential risks and ensure the health of children.

Quality of the image representation of stent structure, stent enhancement algorithm, in assessing the optimal prevalence of stent in long chronic lesions

Haris Porobić — 2025-11-10

During percutaneous coronary intervention, proper stent implantation is often challenging. Stent enhancement (SE) may be used to visualize implanted stents. SE is an angiographic technique that digitally enhances the visibility of stent metal struts, in order to better assess whether it has been adequately implanted. It is a faster and cheaper alternative to intravascular methods (IVUS, OCT), but it is still less detailed. We perform SE after stent implantation using balloon markers; and it can help us to verify some complications or abnormalities after stent implantation such as stent malposition (stent not pressed against vessel wall), insufficient stent expansion (the stent not being sufficiently expanded), stent deformation (mechanical change of stent shape), edge dissection at stent edge, or stent fracture (stent-structure break). Any of these complications significantly increase the risk of in-stent occlusion or stenosis.

Hypothesis: The change in electrical conditions of diascopy and image acquisition significantly affects the quality of the SE representation of the stent structure

Patients: The study was conducted at the Department of Invasive Cardiology, University Clinical Center of Sarajevo (KCUS), from January 1, 2022, to December 31, 2022. The study included patients of both sexes and different age structures. Hemodynamically stable patients were
included in the study, who underwent stenting of chronic lesion on coronary
vessels with stents longer than 18 mm of different diameter.

Methods: The procedures were performed in the cardiac catheterization laboratory using a TOSHIBA INFINIX fluoroscopic system. The stent is imaged natively, without contrast application, for 4 seconds to acquire a minimum of 34 images. After deflation, the stent balloon must not be moved until the native imaging is completed, as the reconstruction software performs image stacking by marking the balloon markers.

Results: In the control group of 287 participants, selected based on the study inclusion criteria, the image quality was evaluated. There were 196 (68.6%) males and 91 (31.4%) females. By applying the chi-squared test, a statistically significant difference was found in the gender distribution of participants, with males being more prevalent, χ² = 7.078; p = 0.008. According to the subjective assessment of image quality with implanted stents, the evaluators rated the images on a scale from 1 to 5. The quality scores of two groups of images (Table 3) were compared: with (90 kV and 900 mA) and (150 kV and 600 mA), where a statistically significant difference was found in the image quality score of the two groups depending on the electrical potential (p<0.05).

Conclusion: The stent strut visualization using the SE algorithm can be useful in assessing proper stent implantation and determining the potential need for post-dilatation. The use of the SE algorithm is limited due to artifacts caused by pacemaker electrodes or patient obesity, as well as cardiac motion artifacts that prevent SE reconstruction in certain positions. According to the study results, stent strut visualization is of better quality at higher mA values and lower kv values.

Comparison of mammography and ultrasound in preoperative assessment of suspected breast lesion

Zerina Pojskić — 2025-11-10

Aim of the study: The aim of this study is to present the role of mammography in assessing the size of malignant breast lesions, to present the role of ultrasound in the evaluation of malignant breast lesions, and to demonstrate mammography as the gold standard in the assessment of breast cancer. A retrospective-prospective study was conducted at the Radiology Clinic of the Clinical Center of the University of Sarajevo. The study included 50 female patients with a mean age of 52.94 ± 11.46 years, the youngest patient was 32 and the oldest was 77 years.

Results: Analysis of the reasons for visiting a doctor showed that 21 patients (42%) had no prior diagnosis, while 24 patients (48%) came for follow-up examinations. All patients underwent mammography imaging, breast ultrasound examination, and histopathological (HP) analysis. The analysis revealed that, out of 40 evaluated mammographic images of the right breast, a suspicious lesion was identified in 27.5% of the images. Analysis of the distribution of patients according to the BI-RADS score showed that BI-RADS categories 1 and 2 were observed in 48.89% of cases on ultrasound and in 55.32% of cases on mammography. BI-RADS categories 5 or 6 were observed in 6.66% of patients on ultrasound and in 8.59% of patients on mammography. There was no significant difference in the distribution of patients (x2=3.214, p=0.782). Based on the available data on the size of histopathological samples, it was determined that 40.91% were smaller than 15 mm, as well as within the range of 15 to 30 mm. Histopathological samples larger than 30 mm accounted for 18.18% of the cases. The analysis showed that, out of 50 histopathologically examined samples, 35 (70%) had a benign diagnosis, 6 (12%) patients had a suspicious lesion, and 9 (18%) patients were diagnosed with carcinoma. The analysis also revealed that the sensitivity of ultrasound was 44.44%, with a confidence interval of 13.70 to 78.8%, while the sensitivity of mammography was 55.56% (21.20–86.30%). The specificity of ultrasound was 97.14%, with a confidence interval of 85.08–99.93%. Specificity of mammography was 97.37% (86.19-99.93%). The positive predictive value was 80% for ultrasound and 83.33% for mammography.

FETAL CARDIAC MR

Damir Jaganjac — 2025-11-10

Magnetic resonance imaging is a non-invasive method that does not use ionizing radiation to produce images, which is its greatest advantage for visualizing fetal pathology. Fetal magnetic resonance imaging is used to visualize pathologies of the central nervous system, abdomen, thoracic organs, and heart, particularly when ultrasound examination is insufficient. FCMR allows detailed visualization of the fetal heart and surrounding structures during pregnancy. It is particularly useful in diagnosing congenital heart defects and assessing fetal circulation, especially when other methods such as ultrasound are inconclusive.

Transarterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma of the liver - case report

Armin Papraćanin — 2025-11-10

Introduction: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, with significant mortality and limited therapeutic options in advanced stages of the disease. In patients who are not candidates for resection or ablative procedures, transarterial chemoembolization (TACE) has established itself as standard therapy.

Case report: We show a male patient, 69 years of age, diagnosed with an extensive right hepatic lobe tumor based on the CTA of the abdomen, unsuitable for surgical resection and thermal ablation. The TACE procedure using doxorubicin and embolization material was successfully performed in the catheterization laboratory (cath lab) of the Clinic of Radiology of KCUS, after which the control CTA showed a complete therapeutic response according to mRECIST criteria.

Discussion: The case presented confirms that TACE is an effective treatment modality in patients with intermediate HCC, even in those with large tumor lesions. A multidisciplinary approach, adequate patient selection and precise intervention technique are key success factors. This case further emphasizes the need to integrate the TACE procedure with modern systemic therapies, including immunotherapy and targeted drugs.

Conclusion: The TACE method has significant therapeutic potential in the treatment of HCC, and achieving a complete response in this case highlights the importance of an individualized approach and further research aimed at optimizing the procedure.