Marcus Oliveira

Objective: To describe the operationalization of risk assessment in health services in the light of the Risk Potential Assessment Model (MARP). Method: Descriptive study of multiple cases, whose “cases” were hospitals in greater Florianópolis, Santa Catarina. The Operating Room (OR), Sterile Processing Department (SPD), and Intensive Care Unit (ICU) were evaluated using Objective Inspection Guides. The risk classification of these units resulted in three risk levels: acceptable, tolerable, and unacceptable. Results: It was observed that the ORs and the ICUs have the highest percentages of acceptable risk levels, with 76%, and SPDs the lowest, with 50%. The percentages of acceptable risk are higher in small hospitals, with 87% for ORs and 89% for ICUs. In medium-sized hospitals, the acceptable risk is 50% for OR and ICU, and in large hospitals, an acceptable risk of 63% was identified for ORs and 40% for ICUs. Conclusion: This study confirms the importance of adopting a quantitative methodological framework for assessing risk and benefit in complex systems such as health services and, in this regard, this study consolidate the MARP as a feasible model, easy to apply and with technology of great relevance for Health Surveillance, responsible for the health control of health services.

The aim of the present study was to present an updated set of regional diagnostic reference levels (DRLs) for paediatric interventional cardiology procedures in Latin America and the Caribbean countries using the quantity kerma area-product (P _ka) and P _ka per body weigth, classified by age and weight groups within the framework of OPRIPALC international programme. Data based on diagnostic and therapeutic procedures were collected between December 2020 and December 2023. Regional DRLs have been set as the 3rd quartile of P _ka collected in 23 hospitals from 11 countries in a final sample of 2906 procedures. DRLs have been set for four age groups and five weight groups. The proposed set of regional DRLs for different diagnostic and therapeutic procedures by age and weight groups for P _ka quantity, were 4.3–5.4 Gy cm² (2 (10 to 2 (2 (50-< 80 kg), respectively. The proposed set of regional DRLs for P _ka /weight values were 0.885–1.181 Gy cm² kg⁻¹ (2 kg⁻¹ (10 to 2 kg⁻¹ (2 kg⁻¹ (50-< 80 kg), respectively. The values proposed as DRLs in OPRIPALC can be adopted by other countries and centers performing paediatric interventional cardiology procedures to compare their own dose values. The OPRIPALC methodology for establishing DRLs, with its variations and limitations, can also be considered in other regions of the world to develop their own regional DRLs.

This study presented the role of regulatory bodies in promoting patient safety and benefits within mammography facilities. The model of potential risk assessment method was applied over 4 yrs (2019–2023). An instrument based on national and state mammography normative objective inspection script was created to harmonize the regulatory actions. The study recorded average glandular dose (AGD) over 4 y, with data categorized by mammography unit manufacturer and model. According to the mammographic manufacturer and model, the AGD ranged from 1.03 to 5 mGy. The inspection results related to the risk potential assessment; the onsite inspection resulted in 29 mammography services as acceptable, 12 as unacceptable, and 14 as tolerable. The potential risk assessment strategy implemented provided a robust regulatory framework and reflected a positive impact on patient safety.

A crescente importância da simulação e da tecnologia na educação em saúde apresenta-se como uma solução promissora para otimizar a formação de profissionais na área radiológica. Este estudo objetiva criar e implementar um software desktop inovador que simula uma estação de trabalho de tomografia computadorizada, integrando banco de dados e ambiente e-learning. A formação na área radiológica enfrenta limitações na prática e acesso a equipamentos, tornando a simulação uma ferramenta essencial para superar esses obstáculos e melhorar o aprendizado. A metodologia baseou-se no desenvolvimento em Python®, devido à sua legibilidade, facilidade de implementação e versatilidade. O software foi estruturado de forma modular, permitindo desenvolvimento iterativo e futuras expansões. O sistema proporciona ao usuário uma experiência completa, desde a tela de carregamento até a visualização detalhada dos exames, com ênfase na eficácia operacional e na interação intuitiva. A gestão eficiente do banco de dados permite atualizações em tempo real, facilitando a administração das informações dos pacientes.

The 3D printing techniques have found applications across diverse fields, significantly enhancing design and manufacturing processes. The impact of this growth is particularly notable in radiology, where 3D printing has been applied to developing quality control tools and advancing dosimetry techniques. 3D printing has the advantage of having a wide variety of plastic materials which can be used in the manufacturing process; there is a scarcity of work developed to evaluate the attenuation of the x-ray beam of the materials used in printing 3D models for phantom development. This paper aims to show our results on the imaging characteristics investigation of 15 3D printable materials. 3D objects were printed as cubes of 20 x 20 x 20 mm3 with a 100% infill and 45°/45° rectilinear structural pattern, and images acquired in a DR X-ray unit were analyzed with ImageJ software. Imaging pixel values, Signal-to-Noise Ratio – SNR and Contrast-to-Noise Ratio – CNR were evaluated and compared between the 3D-printed cubes and a standard chest phantom. When comparing the SNR for plastic materials and chest structures, significant differences were found. Similar results were found for the CNR. The differences were noted for both plastic materials, Tungsten and Bismuth, that demonstrated statistically significant values of SNR compared to the lung (p < 0.0001) and right rib (p < 0.0001). Tungsten and Bismuth filaments were found to have the potential to represent the SNR for intermediary and high-density structures. Scapula was the only anatomical structure with no statistically significant difference of the CNR for SILK (p ≥ 0.074), ABS (p ≥ 0.086), PVA (p ≥ 0.917) and ABSpremium (p ≥ 0.955). The study of potential radiological 3D printing materials for diagnostic radiology phantom development revealed important imaging characteristics for the plastic materials using the Fused Filament Fabrication technique.

Editorial DE INAUGURAÇÃO Inaugurar uma revista científica é uma realização coletiva, pois representa o esforço de pesquisadores das diversas áreas da ciência e inovação tecnológica, a fim de promover a comunicação e disseminação científica. Sendo assim, aplaudimos a Associação Brasileira de Tecnólogos em Radiologia (ABTER) pela decisão de lançar uma revista para publicação científica, de acesso aberto, oportunamente intitulada Brazilian Journal of Radiation Technology Research. De fato, ao longo das décadas, as ciências radiológicas vêm estabelecendo amplas aplicações para as políticas públicas de saúde e o bem-estar da vida no planeta Terra [1, 2]. Sendo assim, é fundamental a divulgação dos estudos científicos que apresentam conceitos atualizados e novas tecnologias em radiologia, como parte da solução dos problemas vivenciados pela sociedade.

This study presented a model applied for potential risk assessment in an interventional radiology setting. The model of potential risk assessment (MARP) consisted of the creation of a scale of indicators ranging from 0 to 5. The radiation levels were categorized according to gender, kind of procedure, value of kerma air product (Pka), and accumulated radiation dose (mGy). The MARP model was applied in 121 institutions over 8 y. A total of 201 656 patient radiation doses (Dose-area product and accumulated kerma) data were launched into the system over time, with an average of 22 406 doses per year. In the context of the workers (cardiologists, radiographers, and nurses) monitored during the MARP application, 8007 cases (with an average of 890 per year) of occupational radiation doses were recorded. This study showed a strategy for quality evaluation in fluoroscopy using a model with a compulsory information system for monitoring safety.

Diagnostic reference levels (DRLs) are a pivotal strategy to be implemented since pediatric interventional cardiology procedures are increasing. This work aimed to propose an initial set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic (D&T) procedures. A retrospective study was carried out in four Brazilian states, distributed across the three regions of the country. Data were collected from pediatric patients undergoing cardiac interventional procedures (CIPs), including their age and anthropometric characteristics, and at least four parameters (number of images, exposure time, air kerma–area product—P_KA, and cumulative air kerma). Data from 279 patients undergoing CIPs were gathered (147 diagnostic and 132 therapeutic procedures). There were no significant differences in exposure time and the number of images between the D&T procedures. A wide range of P_KA was observed when the therapeutic procedures were compared to diagnostics for all age groups. There were significant differences between the D&T procedures, whether grouping data by patient weight or age. In terms of cumulative air kerma, it was noted that no value exceeded the level to trigger a monitoring process for patients. This study shows that it is possible to adopt them as the first proposal to establish national DRLs considering pediatric patient groups.