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Methods of Segmentation and Identification of Deformed Vertebrae in 3D CT Data of Oncological Patients
Jakubíček, Roman ; Flusser, Jan (referee) ; Kozubek, Michal (referee) ; Jan, Jiří (advisor)
In this doctoral thesis, the design of algorithms enabling the implementation of a fully automatic system for vertebrae segmentation in 3D computed tomography (CT) image data of possibly incomplete spines, in patients with bone metastases and vertebral compressions is presented. The proposed algorithm consists of several fundamental problems: spine detection and its axis determination, individual vertebra localization and identification (labeling), and finally, precise segmentation of vertebrae. The detection of the spine, specifically identifying its ends, and determining the course of the spinal canal, combines several advanced methods, including deep learning-based approaches. A novel growing circle method has been designed for tracing the spinal cord canal. Further, the innovative spatially variant filtering of brightness profiles along the spine axis leading to intervertebral disc localization has been proposed and implemented. The discs thus obtained are subsequently identified via comparing the tested vertebrae and model of vertebrae provided by a machine-learning process and optimized by dynamic programming. The final vertebrae segmentation is provided by the deformation of the complete-spine intensity model, utilizing a proposed multilevel registration technique. The complete proposed algorithm has been validated on testing databases, including also publicly available datasets. This way, it has been proven that the newly proposed algorithms provide results at least comparable to other author’s algorithms, and in some cases, even better. The main strengths of the algorithms lie in high reliability of the results and in the robustness to even strongly distorted vertebrae of oncological patients and to the occurrence of artifacts in data; moreover, they are capable of identifying the vertebra labels even in incomplete spinal CT scans. The strength is also in the complete automation of the processing and in its relatively low computational complexity enabling implementation on standard PC hardware. The system for fully automatic localization and labeling of distorted vertebrae in possibly incomplete spinal CT data is presented in this doctoral thesis. The design of algorithms enabling the implementation utilizes several novel approaches, which were presented at international conferences and published in the journal Jakubicek et al. (2020). Based on the results of the experimental validation, the proposed algorithms seem to be routinely usable and capable of providing fully acceptable input data (identified and precisely segmented vertebrae) as needed in the subsequent automatic spine bone lesion analysis.
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Role of nurses in postoperative care in patients with lung cancer.
PLECEROVÁ, Jana
At present time the lung/ bronchial carcinoma is the most frequent malignant disease but not only in our country but worldwide. It is an insidious disease that at the beginning is asymptomatic (i.e. without clinical symptoms), however it has an extraordinary unfavourable prognosis. The lung/ bronchial carcinoma is painless disease therefore the sick people (adversely affected by lung/ bronchial carcinoma) do not suffer from any significant health trouble for very long time. In a later stage some of the patients realize the fact, that they are facing some health troubles. They find out that something go wrong as far as their health condition is concerned, the most frequent case is reported as breathlessness or difficulties in breathing in general. Their difficulties in breathing is frequently attributed to their weight, physical strain, stress, workload, work environment they work in. These patients usually make an appointment with the physician not sooner than they observe further manifestations of the illness which testifies to advanced stage of the illness, however. These symptoms often are the following: haemoptysis, rhonchus/hoarseness, chronic cough, dysphagia, pains, loss of weight. The lung carcinoma is frequently discovered on a random basis within a preoperative preparation for another surgical intervention i.e. the centre of lung carcinoma is identified when heart and lungs are X-rayed. The very sad moment of this disease (lung carcinoma) is the fact that overwhelming majority of the patients bring about this insidious illness or contract the illness themselves. The reason is smoking. Present youth regard smoking fashionable and modern. They feel and perceive smoking as their need to try something new and majority of them persist with smoking. They become smoking addict and only small percentage of them seek a help or assistance of an expert in making people give up smoking. In the past we encountered the diagnosis of lung carcinoma with the patients whose age fell in between 60 (sixty) and 70 (seventy). At present time the patients with such a diagnosis are rather younger. Their age fall within the interval 40 (forty) and 50 (fifty). I can express my belief that the public should be not only better informed but also keep informed about the life-threatening lung carcinoma, malignant lung tumour, ways and means of healing, primary and secondary prevention and help and assistance in making people to give up smoking. The public should be informed and be kept informed about risk factors that lead to the origin and development of this insidious disease. The media should do whatever possible to present statistics, research investigations dealing with the origin and development of lung carcinoma, case reports regarding patients with this diagnosis. Several years ago, there were cigarette packets provided with various pictures on them presenting risks of smoking as well as possible complications and troubles accompanied with smoking including lung carcinoma. Unfortunately, this campaign did not achieve such effect as it had been expected. This diploma work has been worked out by focusing on theory. Its goal is to present the problem of lung carcinoma, malignant lung tumours in the Czech Republic and in the world. The crucial area of the diploma work is devoted to the surgical therapy of the lung carcinoma, malignant lung tumours that is subject of permanent development and still brings new pieces of knowledge in the field of therapy of lung malignity. Another aim of this diploma work is to clarify, map out and visualize the position and role of nurses in postoperative care for the patients with lung carcinoma/ tumour. The conclusion of the diploma work focuses on specific questions and requirements of the palliative care and its models. This diploma work makes it possible to get an overall view of the specialized field of malignant lung tumours, their statistics, the numbers of which has been rising.
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Ethical issues in connection with patient and physician involvement in clinical research
Norková, Olga ; Haškovcová, Helena (advisor) ; Holmerová, Iva (referee) ; Jedličková, Anetta (referee)
(in English): The subject of my dissertation is the decision of the subjects to participate in the early phase of clinical trial. The aim of this disseration is to detect and understand the ethical aspects of decision making of subjects with oncological diseases to participate in the early phase of clinical trial. In the theoretical part of my dissertation, I define the field of clinical research, describe the phases of clinical research and ethical codes important for clinical research. The current ethical dilemmas related to the participation of subjects in the early phase of clinical trial, which are being discussed by the professional public, are presented. The research part contains the results of interviews with seventeen respondents whose content correlates with the aim of the research part and it is to understand the decision- making of subjects to participate in the early phase of clinical trial in terms of subjectively constructed realities, which are different for individual respondents. The results of the research show that fourteen respondents identified one of the most important aspects of the decision-making to participate in the early phase of clinical trial of the recommendation of principal investigator and trust in a physician. Twelve respondents stated the most frequent reason...
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Methods of Segmentation and Identification of Deformed Vertebrae in 3D CT Data of Oncological Patients
Jakubíček, Roman ; Flusser, Jan (referee) ; Kozubek, Michal (referee) ; Jan, Jiří (advisor)
In this doctoral thesis, the design of algorithms enabling the implementation of a fully automatic system for vertebrae segmentation in 3D computed tomography (CT) image data of possibly incomplete spines, in patients with bone metastases and vertebral compressions is presented. The proposed algorithm consists of several fundamental problems: spine detection and its axis determination, individual vertebra localization and identification (labeling), and finally, precise segmentation of vertebrae. The detection of the spine, specifically identifying its ends, and determining the course of the spinal canal, combines several advanced methods, including deep learning-based approaches. A novel growing circle method has been designed for tracing the spinal cord canal. Further, the innovative spatially variant filtering of brightness profiles along the spine axis leading to intervertebral disc localization has been proposed and implemented. The discs thus obtained are subsequently identified via comparing the tested vertebrae and model of vertebrae provided by a machine-learning process and optimized by dynamic programming. The final vertebrae segmentation is provided by the deformation of the complete-spine intensity model, utilizing a proposed multilevel registration technique. The complete proposed algorithm has been validated on testing databases, including also publicly available datasets. This way, it has been proven that the newly proposed algorithms provide results at least comparable to other author’s algorithms, and in some cases, even better. The main strengths of the algorithms lie in high reliability of the results and in the robustness to even strongly distorted vertebrae of oncological patients and to the occurrence of artifacts in data; moreover, they are capable of identifying the vertebra labels even in incomplete spinal CT scans. The strength is also in the complete automation of the processing and in its relatively low computational complexity enabling implementation on standard PC hardware. The system for fully automatic localization and labeling of distorted vertebrae in possibly incomplete spinal CT data is presented in this doctoral thesis. The design of algorithms enabling the implementation utilizes several novel approaches, which were presented at international conferences and published in the journal Jakubicek et al. (2020). Based on the results of the experimental validation, the proposed algorithms seem to be routinely usable and capable of providing fully acceptable input data (identified and precisely segmented vertebrae) as needed in the subsequent automatic spine bone lesion analysis.
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Fatigue in cancer patients
NEJEDLÁ, Gabriela
This bachelor thesis deals with the topic and problematics of the role, aspect and contribution of the proffesional nurses in the case of the oncology patient's fatigue.. The aim is To find out not only what are the possibilities of influencing the whole process of onkology patients' fatigue but how they are applied in practice as well. Furthermore the process of how is the cancer patients' fatigue documented and evaluated is also pointed out as well as the patients' perception of tiredness. In the practical part of the thesis was used qualitative research in the form of semi-structured interviews. The research group consisted of nine nurses and nine patients of selected oncology departments in the Czech hospitals. The choice of all the respondents was deliberate. The given interviews were processed by the open coding technique using pencil and paper. Nine categories were created during the process of evaluation of the interviews with nurses. Patient interviews were evaluated in seven categories. Some of the groups are divided into subcategories according to their specialization. The research shows that this - the whole process of fatigue is a symptom that is often neglected by nursing staff. The research also points out has shown that nurses do not follow up with assessing and recording fatigue in the patient's documentation as they should. They don´t carry out all possible interventions to affect fatigue. The results also showed that the majority of nurses do not educate the patients about the possibilities of affecting tiredness despite the fact that the nurse can influence not only the patient's physical condition but the psychological state as well by good nursing care, which is directly reflected in the level of patients' fatigue.
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Ethical issues in connection with patient and physician involvement in clinical research
Norková, Olga ; Haškovcová, Helena (advisor) ; Holmerová, Iva (referee) ; Jedličková, Anetta (referee)
(in English): The subject of my dissertation is the decision of the subjects to participate in the early phase of clinical trial. The aim of this disseration is to detect and understand the ethical aspects of decision making of subjects with oncological diseases to participate in the early phase of clinical trial. In the theoretical part of my dissertation, I define the field of clinical research, describe the phases of clinical research and ethical codes important for clinical research. The current ethical dilemmas related to the participation of subjects in the early phase of clinical trial, which are being discussed by the professional public, are presented. The research part contains the results of interviews with seventeen respondents whose content correlates with the aim of the research part and it is to understand the decision- making of subjects to participate in the early phase of clinical trial in terms of subjectively constructed realities, which are different for individual respondents. The results of the research show that fourteen respondents identified one of the most important aspects of the decision-making to participate in the early phase of clinical trial of the recommendation of principal investigator and trust in a physician. Twelve respondents stated the most frequent reason...
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Medical communications with oncological disease patients.
SLABOVÁ, Markéta
The aim of this thesis is to find out the current state of communication between paramedic and patients with cancer. This work created a manual which is going to be a hand book for nurses who encounter them selves with serious or incurable sick people. In this hand book can nurses find principles of communicaton with oncological patients. The theoretical part contains information about problematic of communication, types of communication or purpose of communication. It also contains issues of oncological diseases, their causes, diagnoses, treatment and an increase in the Czech Republic and in the South Bohemian Region. Theoretical part also deals with process of approach and communication with oncological patients and with posssibilities of care for incurable sick people. Empirical part is based on research of several issues which should accomplish two elected objectives. The research questions are answered using qualitative research through halfstructured interviews by nurses and oncological patients. Data were congregate during February and March 2016 in two South Bohemian hospitals. After the processing of interviews in Microsoft Office Word were created identification data of respondents and nurses. The objectives of bachelor thesis were approached witch qualitative research. The analysis of interviews was done by using categorization of data and subsequent encoding. Data analysis showed that patients are satisfied with the communication and attitude of medics. Nurses are against burnout syndrom very resistant.
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Special access of the radiology assistant to interventional procedures in diagnostics of oncological patients
CANDROVÁ, Daniela
In my work I deal with the peculiarities in approach of a radiology assistant to interventions in diagnostics of oncological patients. Biopsy has a special importance in diagnostics of neoplasm. It is essential for histological and cytological diagnostics. The aim of this work was to find out the incidence of bioptic interventions on oncological patients during one year at radiology department at České Budějovice hospital plc, and to compare the advantages and disadvantages of used modalities. The work proceeds from the presumption that the number of interventions carried out under the sight control without the use of ionizing radiation methods is growing. In the theoretical part of my work appear descriptions of bioptic methods of intervention radiology regarding oncology and its methods, biopsies, screening methods used at biopsy (ultrasound controlled biopsy, computer tomography controlled biopsy, magnetic resonance controlled biopsy, skiascopic controlled biopsy), instrumentarium, especially the needles used for tissue extraction (puncture and bioptic needles), characteristics of oncological patients, the principle of tumour disease, carcinogenesis, oncologically changed tissue, and basic diagnostics of oncology disease. The practical part reveals the number of biopsies performed in 2012 at České Budějovice hospital plc, under computer tomography, ultrasound and mammography machine control, and the number of other interventions on oncological patients, namely localization of impalpable breast lesion, percutaneous drainage of the urinary tract under skiascopic control. Standard methods regarding these interventions and biopsies are described focusing on the advantages and disadvantages of their use for different organs in the body. I also described radiology assistant?s work and created photo documentation of given interventions. In 2012, 96 biopsies were performed under any of the mentioned diagnostic screening methods at radiology department of České Budějovice hospital. They represent 0,06% of the total of 171 466 diagnostic interventions at this department in the respective year. At the same time they represent 3,4% of the total of 2844 interventions of the ČB radiodiagnostic department of that period. From the whole number of 96 biopsies, 79% were performed on oncological patients. No biopsies were performed under magnetic resonance or skiascopic- skiagraphic control. Since the formation of a tumour is supposed to be the main somatic risk which an individual after a low intensity radiation faces, I supposed that the number of bioptic samples taken under sight control without the use of non ionizing radiation is rising, which significantly contributes to radiation protection. It is not univocally assigned which screening method is the best for biopsy. Usually we chose the biopsy that can screen best the site in different organs and that allows the safest, the fastest and the economically most convenient procedure. The chosen method should allow the doctor chose the site for sample extraction. The choice also depends on the habits and the technical equipment of given hospital. In view of the fact that according to this work computer tomography is the most commonly used method for bioptic extractions, and under magnetic resonance control no biopsies are performed, the prestige and importance of a radiology assistant grows up, because their presence at modalities using ionizing radiation is commonly indispensable. The hypothesis of my work has not been proved. Concrete results do not support the operative hypothesis of y work. However, I can recommend concessive long-term type and multicentrically elaborated sample studies. I would be grateful if this work provided an information base for radiology assistants´ training and for interventions in the diagnostics of oncologically ill people.
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