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Evaluation of patient radiation load due to radiodiagnostic examinations
Drobílková, Daniela ; Daneš, Jan (advisor) ; Vrána, Jiří (referee)
The aim of this study is to determination of local diagnostic reference levels for radiodiagnostic examination in the General Teaching Hospital in Prague. Local diagnostic reference levels are used for an evaluation of radiation load which patients receive during medical examinations of specific parts of the human body. The evaluation can be on the level of a hospital and its department or on the level of concrete X-ray machine. The theoretical part describes a ionizing radiation, including its interaction with matter, creating, formation of radiodiagnostic image, legislation during optimization of radiodiagnostic examination, radiological protection and determination of values for radiation dose. The practical part describes the determination of local diagnostic reference levels with the help of entrance surface kerma and the median dose in the mammary gland. Both of these variables are relevant for determination of the risk of adverse effects of ionizing radiation which is applied during radiographic examination. Data for this study was collected with the help of operating diaries and PACS system. It has been rated twenty-six kinds of examinations from twelve mobile and nine stationary (including two mammographs) X-ray machines. All resulting values were statistically processed and compared with...
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Optimization of Operation of a Workplace with MD and CT
Vachek, Tomáš ; Daneš, Jan (advisor) ; Steyerová, Petra (referee)
The aim of my diploma thesis is to find optimised solution for work places equipped with multi-detector computer tomograph (further on just MD CT). This apparatus is located at the First Medical Faculty and General Hospital of Prague. At the beginning of my thesis I focus on the formation of X-rays and its character, as the main principle that computer tomography uses. Further on I mention history and evolution of this method from the very beginning towards present. The main part of my thesis then tries to find optimised solution for work places mentioned above. The first thing I am dealing with is the patient's examination itself. The amount of time the patient needs all the way from preparing for the examination, the examination itself to leaving the examination room. For an objective evaluation of these time periods I made up my own examination time schedule, which I followed during my research. This time schedule is also discussed in this chapter. Second part focuses on data processing and evaluation of the examination. I also tried to find out the time necessary for examination, but it is technically impossible; each diagnosis is different, we cannot find any objective aspects which we could follow to determine time necessary for establishing the diagnosis.
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Marking of axillary lymphatic nodes in breast cancer patients.
Dostálek, Lukáš ; Pavlišta, David (advisor) ; Daneš, Jan (referee) ; Zikán, Michal (referee)
Introduction Axillary dissection has little diagnostic and therapeutic benefit in the node-positive breast cancer patients in whom axillary disease has been completely eradicated after neoadjuvant chemotherapy (ypN0). We sought to assess the efficacy of an algorithm used for the identification of the ypN0 patients consisting of intraoperative evaluation of sentinel and tattooed (initially positive) lymph nodes. Methods Included were T1 and T2 breast cancer patients with one to three positive axillary lymph nodes marked with carbon who were referred for neoadjuvant chemotherapy followed by a surgery. Axillary dissection was performed only in the patients with residual axillary disease after neoadjuvant chemotherapy on ultrasound or with metastases described in the sentinel or tattooed lymph nodes either intraoperatively or in the final histology. Results Out of 62 included initially node-positive patients, 15 (24%) were spared axillary dissection. The detection rate of tattooed lymph node after neoadjuvant chemotherapy was 81%. The ypN0 patients were identified with 91% sensitivity and 38% specificity using ultrasound and intraoperative assessment of both sentinel and tattooed lymph node according to the final histology. Discussion/Conclusion Lymph node marking with carbon dye is a useful and...
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New diagnostic methods in bronchology
Votruba, Jiří ; Daneš, Jan (advisor) ; Marel, Miloslav (referee) ; Pešek, Miloš (referee)
The aim of this work has been the development and optimization of methods for early diagnosis of lung cancer, their utility and integration into daily practice. Firstly, we developed a device for measurement of endobronchial temperature (thermobronchoscopy) and found significant difference in endoluminal temperature above tumors and infiltrated lymph nodes compared to healthy regions. We further designed an appliance for near infrared spectroscopy of the bronchial mucosa and identified spectroscopic features useful for localization of solitary pulmonary nodule. The use of the appliance improved yield of endobronchial biopsy compared to endobronchial ultrasound. In the next part of the study, we describe further techniques for early diagnosis of lung cancer including endobronchial ultrasound, optical coherence tomography, confocal fluorescence microendoscopy, reflectance spectroscopy, autofluorescence bronchoscopy, fluorescence bronchoscopy, and narrow band imaging with concise introduction of our experience gained in several pilot projects. Next, we showed the utility of measurement of acetic acid in exhaled air as a promising biomarker for non-invasive identification of patients with symptomatic acid gastroesophageal reflux. Lastly, we demonstrated significant difference in radiation dose in HRCT...
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Methodology for breast ultrasound examination
Vydra, J. ; Daneš, J. ; Bartoš, Michal ; Šroubek, Filip ; Petr, L. ; Zitová, Barbara
The aim of the proposed project is the development of a new ultrasonic equipment (US), allowing early detection of breast cancer and reduce the need to use the ionizing radiation during examinations. The aim is to eliminate the disadvantages of current ultrasonic systems in the diagnosis of breast cancer, which hinders its use. The target parameters include prospecting and automated description using parameters (size, texture), description of the situation, which is able to testify about the disease, combining individual images (registration) leading to the creation of 3D display - thus ensuring reproducibility UZ shaping and security testing the entire organ. At the same time the newly developed ultrasonic probe allows better capture the characteristics of bearings including microcalcifications. Software solution enables to follow the coverage of the breast examination. The areas which were omitted are detected and highlighted.
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New diagnostic methods in bronchology
Votruba, Jiří ; Daneš, Jan (advisor) ; Marel, Miloslav (referee) ; Pešek, Miloš (referee)
The aim of this work has been the development and optimization of methods for early diagnosis of lung cancer, their utility and integration into daily practice. Firstly, we developed a device for measurement of endobronchial temperature (thermobronchoscopy) and found significant difference in endoluminal temperature above tumors and infiltrated lymph nodes compared to healthy regions. We further designed an appliance for near infrared spectroscopy of the bronchial mucosa and identified spectroscopic features useful for localization of solitary pulmonary nodule. The use of the appliance improved yield of endobronchial biopsy compared to endobronchial ultrasound. In the next part of the study, we describe further techniques for early diagnosis of lung cancer including endobronchial ultrasound, optical coherence tomography, confocal fluorescence microendoscopy, reflectance spectroscopy, autofluorescence bronchoscopy, fluorescence bronchoscopy, and narrow band imaging with concise introduction of our experience gained in several pilot projects. Next, we showed the utility of measurement of acetic acid in exhaled air as a promising biomarker for non-invasive identification of patients with symptomatic acid gastroesophageal reflux. Lastly, we demonstrated significant difference in radiation dose in HRCT...
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Evaluation of patient radiation load due to radiodiagnostic examinations
Drobílková, Daniela ; Daneš, Jan (advisor) ; Vrána, Jiří (referee)
The aim of this study is to determination of local diagnostic reference levels for radiodiagnostic examination in the General Teaching Hospital in Prague. Local diagnostic reference levels are used for an evaluation of radiation load which patients receive during medical examinations of specific parts of the human body. The evaluation can be on the level of a hospital and its department or on the level of concrete X-ray machine. The theoretical part describes a ionizing radiation, including its interaction with matter, creating, formation of radiodiagnostic image, legislation during optimization of radiodiagnostic examination, radiological protection and determination of values for radiation dose. The practical part describes the determination of local diagnostic reference levels with the help of entrance surface kerma and the median dose in the mammary gland. Both of these variables are relevant for determination of the risk of adverse effects of ionizing radiation which is applied during radiographic examination. Data for this study was collected with the help of operating diaries and PACS system. It has been rated twenty-six kinds of examinations from twelve mobile and nine stationary (including two mammographs) X-ray machines. All resulting values were statistically processed and compared with...
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Automatic Registration of Images Using Distance Transform
Viták, Tomáš ; Daneš, Jan (advisor) ; Šámal, Martin (referee) ; Chudáček, Zdeněk (referee)
The distance transform is used for the preprocessing of image data for correlation methods of automatic registration of digital images. In our department the algorithm of automatic registration of images with the distance transform calculation by 4SSED+ method is used for the images of control and dynamic investigations, where there was a change in the position of the patient. In this thesis we analyze six best known distance transform algorithms on the simplified set of image data (4SSED, 4SSED+, SaitoXY, SaitoYX, Maurer, Eggers algorithms) and from those we choose the most suitable one for the purposes of automatic registration (4SSED+) and subsequently we use it in automatic registration of T1W images of a set of 76 MR examinations of head in patients with multiple sclerosis. This thesis proves that appropriately chosen and implemented algorithm of automatic registration with the use of distance transform can be as accurate as a manual method of registration and much faster. We performed the assessment of accuracy of 7 automatic registration with manual correction. From the nearly negligible correction values of subpixel shift and small rotation angles in the aforementioned set of 76 MR investigations and subsequently from their statistical characteristics the high accuracy of the used algorithm is apparent.
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Optimization of Operation of a Workplace with MD and CT
Vachek, Tomáš ; Daneš, Jan (advisor) ; Steyerová, Petra (referee)
The aim of my diploma thesis is to find optimised solution for work places equipped with multi-detector computer tomograph (further on just MD CT). This apparatus is located at the First Medical Faculty and General Hospital of Prague. At the beginning of my thesis I focus on the formation of X-rays and its character, as the main principle that computer tomography uses. Further on I mention history and evolution of this method from the very beginning towards present. The main part of my thesis then tries to find optimised solution for work places mentioned above. The first thing I am dealing with is the patient's examination itself. The amount of time the patient needs all the way from preparing for the examination, the examination itself to leaving the examination room. For an objective evaluation of these time periods I made up my own examination time schedule, which I followed during my research. This time schedule is also discussed in this chapter. Second part focuses on data processing and evaluation of the examination. I also tried to find out the time necessary for examination, but it is technically impossible; each diagnosis is different, we cannot find any objective aspects which we could follow to determine time necessary for establishing the diagnosis.
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