Background/Objectives: In 2024, Lithuania developed a national lung cancer screening program (the Program), targeting individuals aged 50 to 70 years, regardless of their smoking history, with screenings conducted once every three years. The Program aims not only to actively detect lung nodules (lung cancer) but also to identify clinically significant concomitant findings. The pilot study aimed to evaluate the screening process’s feasibility and organizational efficiency of the screening process, as well as its potential clinical effectiveness. Methods: Three family medicine centers were selected for participation. The Coordinating Center contacted individuals aged 50 to 70 sequentially and invited them to participate, regardless of smoking status. In total, 1014 individuals were prospectively enrolled and underwent low-dose chest computed tomography (LDCT) screening between 26 September 2024 and 14 February 2025. Results: Of the individuals invited, 76.1% agreed to participate. Lung-RADS v2022 category 4 nodules were identified in 1.4% of participants (n = 14), including six smokers and eight non-smokers. Additionally, one participant with a Lung-RADS category 2 nodule was diagnosed with squamous cell carcinoma originating from peripheral lung changes. Newly identified significant incidental findings were detected in 25.9% of participants: 5.1% had pulmonary or mediastinal findings (most commonly emphysema, interstitial lung changes, and bronchiectasis), 18.7% had cardiovascular findings (usually coronary artery calcification, aortic valve calcification, and aorta dilation), and 2.1% had other clinically relevant conditions (e.g., thyroid nodules, diaphragmatic changes). Following assessment by family physicians, 17.6% of all participants were referred to medical specialists, including pulmonologists, cardiologists, and others. Conclusions: This pilot study demonstrated that the Lithuanian lung cancer screening model is feasible, well-organized, and clinically valuable. The findings support the Program’s readiness for broader implementation at the national level.

Introduction. Personal radiation protective equipment (PRPE) means such vests and skirts, aprons, thyroid collars and other means reduce radiation exposure of personnel working with X-rays and gamma ray sources. The composition of PRPE worn by X-ray personnel to shield against secondary radiation is changing. Lead is being replaced by either lead-free or composite (lead with other high atomic numbered elements) materials. In clinical practice, PRPEs with different lead equivalents are used. PRPE from lead or lead-equivalent material (LEM) are essential in providing necessary shielding from secondary radiation exposure to workers. Methods. Quality assessment of the PRPE was performed evaluating integrity and lead equivalence of more than 800 units, 0.25, 0.35, 0.5 and 1 mm LEM provided by ten manufacturers in the period 2022–2024. Results. Siemens Luminos dRF MAX 3D radiography, Philips Incisive CT computed tomography, Philips BV Endura mobile C-arm, and FLOWD 8020 mobile protective clothing testing X-ray units were used for obtaining images of PRPE for checking the integrity and lead equivalence. A calibrated solid-state meter Piranha R&F/M 657 with RTI Dose Probe was used for checking the radiation attenuation. In order to check the integrity, PRPE were categorized into four categories: I (good quality), II (small cracks), III (large cracks not in critical areas and smaller than 5 cm2), IV (very large cracks, cracks in critical areas, bigger than 5 cm2). PRPE lead equivalence deviations were analysed and grouped into three categories: DI (less than 5 %), DII (less than 10 %), DIII (more than 10 %). Conclusions. The results of the integrity tests showed that about 85 % of the PRPE were in good quality. The analysis of lead equivalence deviations showed that about 76 % of the PRPE met the criteria for category DI. The aim of the study was to evaluate the lead equivalence and the integrity of the PRPE used in clinical practice with different screening methods.

Objectives: This study compares recurrent CT imaging practices across European centers using incidence and prevalence metrics and evaluates the feasibility of a novel benchmarking tool for recurrent imaging practice. Methods: CT exposure data were collected from 31 facilities across 18 European countries. The single-year incidence proportion (I100;1), 3-year cumulative incidence (I100;3), and 3-year prevalence proportion (P100;3) of patients with cumulative effective dose (CED) ≥ 100 mSv were calculated and statistically analyzed against relevant indicators. The reference year was 2023, and the 3-year period covered 2022-2024. Results: The database comprised 711 749 patients in 2023 who underwent 1 658 246 CT exams, with an average of 1.5 ± 0.6 CT exams per patient in this year and 2.4 ± 0.6 exams over 3 years. Across facilities, I100;1 ranged from 0% to 2.9%, I100;3 from 0% to 8.6%, and P100;3 ranged from 0% to 4.4%. A strong linear correlation was found between the third quartile values of yearly CED and I100;1. Multiple linear relationship was identified between I100;3, third quartile of yearly CED and percentage of recurrent patients. Third quartiles of yearly CED varied between 7.5 and 29.5 mSv, with the 75th percentile of their distribution 17.6 mSv, lower than in previous studies. Conclusion: Incidence proportion is preferred for assessing recurrent imaging rates as prevalence substantially underestimates these rates. The 75th percentile of distribution of third quartiles of yearly CED is a reasonable benchmark level to trigger optimization. Investigating the underlying factors and addressing high recurrent rates can contribute to enhanced patient care. Advances in knowledge: This first European multicenter study showed that the epidemiological index incidence proportion is a better metric to quantify recurrent imaging compared to prevalence. The distribution of early CED values can be used to benchmark recurrent imaging practices and inform patient management strategies.

Background: Computed tomography is a highly informative diagnostic tool, but its use poses the challenge of managing potentially high radiation exposure to patients. Children are particularly vulnerable to the harmful effects of ionizing radiation, and the growing use of paediatric Computed Tomography (CT) scans has been linked to an elevated lifetime risk of cancer and an increased mortality. The aim of this study was to evaluate local radiation exposure doses in paediatric thoracic and abdominal-pelvic CT exams, to establish Diagnostic Reference Level (DRL) curves, propose local diagnostic reference levels, and compare them with the existing literature and the European Guidelines on Diagnostic Reference Levels for Paediatric Imaging (PiDRL).Materials and Methods: A dataset of thoracic and abdominal-pelvic CT exams performed on children was analysed. Scan data entries were grouped according to the patient weight in the following intervals: 5 to 14 kg, 15 to 29 kg, 30 to 49 kg, and 50 to 79 kg. In each weight group, the minimum, first quartile, median, third quartile, and the maximum values of Volumetric Computed Tomography Dose Index (CTDIvol) and the Dose Length Product (DLP) were calculated. The relationship between CTDIvol, DLP, and the patient body weight was assessed by using exponential curves.Results: The local DRLs were established for thoracic CT exams, while, for abdominal-pelvic CT exams, the DRL curve was set as a substitute due to limited data. The proposed local DRL values for thoracic computed tomography examinations are 2.0, 2.4, 3.6, and 5.0 mGy for CTDIvol and 40, 60, 116, and 156 mGy·cm for DLP in the corresponding weight groups of 5 to 14 kg, 15 to 29 kg, 30 to 49 kg, and 50 to 79 kg. The median values of CTDIvol for paediatric abdominal-pelvic computed tomography were 2.8 mGy in the 5-to-14 kg weight group, 3.6 mGy in the 15-to-29 kg group, 4.8 mGy in the 30-to-49 kg group, and 7.9 in the 50-to-79 kg group. The median DLP values were 81, 127, 203, and 304 mGy·cm, respectively.Conclusions: The set local DRLs for thoracic and the median dose values in abdominal-pelvic CT exams are generally lower than the European DRLs. The derived DRL curves fulfil the same purpose as weight-group DRLs, serving as benchmarks for dose optimization.