The diagnosis of emergent conditions during pregnancy can be delayed due to insufficient knowledge of fetal radiation doses in different imaging modalities. The aim of this article is to investigate the ranges of fetal doses in most common diagnostic and interventional radiology procedures. Procedures were carried out on an anthropomorphic phantom, Tena, representing a pregnant woman in the 18th week of pregnancy with the fetus in breech position. Different clinical scenarios using computer tomography (CT), radiography, fluoroscopy and digital subtraction angiography were selected in three teaching hospitals. Measurements were performed using radiophotoluminescent glass dosimeters placed in dedicated holes in the fetal head and fetal body. Measured fetal doses were below 1 mGy when the fetus was not in the primary beam. The highest fetal doses, up to 47 mGy, were measured after a CT scan for polytrauma and up to 24 mGy after a CT scan of the abdomen and pelvis. Significant variability in fetal doses for the same procedure was found between different hospitals but within the same hospital also. All obtained results are below the threshold for deterministic effects given by the International Commission for Radiation Protection but can be reached with two or more imaging procedures employed. The variability in fetal doses for the same procedures highlights the need for the improved optimization of imaging protocols.

Background/Objectives: Blood vessel tortuosity can complicate endovascular procedures such as endovascular thrombectomy in acute ischemic stroke. This study aimed to assess the morphometric characteristics of carotid arteries and investigate the association between the tortuosity of the carotid arteries and the technical aspects of endovascular thrombectomy, patient demographics and clinical characteristics, and treatment outcome. Methods: This retrospective study included 84 patients with ischemic stroke treated by endovascular thrombectomy at the newly established thrombectomy-capable stroke center. The following data were collected from prethrombectomy computed tomography angiography: aortic arch type, type of carotid artery tortuosity, and tortuosity index (TI). The technical aspects of the procedure, as well as patient demographics, were collected from the radiological information system. Results: Time from arterial puncture to the first pass was significantly shorter in patients with a nontortuous carotid artery compared to a tortuous one (p = 0.006). There were no significant differences in the number of passes, total duration of the procedure, and the difference in National Institutes of Health Stroke Scale (NIHSS) score before and after the procedure regarding the form of tortuosity. Patients with hypertension had significantly higher tortuosity index values compared to those without hypertension (p = 0.008), and patients with a nontortuous carotid tree were significantly younger compared to those with all forms of tortuosity (p = 0.003). Conclusions: The majority of patients had tortuous carotid arteries, which were associated with older age and hypertension. A high index of tortuosity was associated with a longer time from arterial puncture to the first pass, but not to the treatment outcome. Preprocedural recognition of carotid artery tortuosity may aid in endovascular thrombectomy procedural planning.

Aim: In the last decade, an increase in the incidence of autoimmune thyroid disease in children has been observed. The aim of the study was to determine the incidence of thyroid disease in the pediatric population treated at the Pediatric Clinic in Osijek; to determine if there was a rise in thyroid disease incidence in pediatric population in the observed period; and to determine whether there was any association of certain factors with an increased incidence of thyroid disease.Methods: This study was a two-year retrospective study in two separately observed one-year periods (2010 and 2017). All patients with thyroid endocrinological disorders treated at the Pediatric Clinic of the University Hospital Centre Osijek were included in the study. Their medical records were used to obtain data. Differences between variables were tested by the χ2 test, Fisher's exact test and Mann-Whitney U test. The level of statistical significance was accepted for p <0.05.Results: There was a 2.4-fold increase in the approximate incidence of thyroid disease, 9.7-fold higher approximate incidence of autoimmune thyroiditis, 9.75-fold higher approximate incidence of unspecified hypothyroidism and a triple increase in the approximate incidence of non-toxic goiter. Other unspecified thyroid diseases are also statistically significantly on the rise. An analysis of factors such as anamnestic features, age, gender, comorbidities and other relevant data could not explain the increased incidence of thyroid disease.Conclusion: The incidence of thyroid disease has increased considerably in the observed years, following world trends. Efforts should be taken to clarify the mechanisms and factors involved in causing thyroid diseases in the pediatric population.

When pregnant patients undergo diagnostic and therapeutic radiological procedures, the unborn child is exposed to an increased risk due to the use of ionizing radiation; therefore, the fetal dose must be estimated and optimized. Tools and methods routinely used for fetal dose estimation lack better personalization of patients. To address this, we developed a software tool for creating phantoms at different pregnancy stages and with varying patient anatomies to further personalize fetal dose estimation using measurements and Monte Carlo simulations. The tool is developed and incorporated into 3DSlicer version 5.6.2 as a plugin. Phantoms are created based on a real patient phantom, Tena, and physiological data for use in radiological protection. Phantoms are developed with only soft, lung, and bone tissue substitutes, represented for the mother and unborn child. This enables the construction of segmented voxel models as well as mesh models (with the ability to export geometries to DICOM format) of the anatomical structures of pregnant women. Additionally, it allows real patient image registration to enable better personalization of the phantom. The tool can help decrease uncertainty in fetal dose estimation, as well as simplify and accelerate the process of fetal dose estimation. It is released publicly to enable further research.