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Comparison of diagnostic yield of different MRI protocols and PET in relation to time an finance demands in patients with temporal epilepsy
FILÍPKOVÁ, Brigita
This Thesis called Comparison of diagnostic yield of different MRI protocols and PET in relation to time and finance demands in patients with temporal epilepsy deals with time and economic aspects of diagnostics of pharmacoresistant temporal epilepsies. Temporal epilepsies are the most frequent focal epilepsies (up to 85 %) and pharmacologic control is only successful in about 25 % cases. On the other hand it is the best type of epilepsy to be solved surgically. Timely and precise diagnostics enables a timely surgical intervention. The time and economic demands increase the same way as the demands for technical staff. The Thesis was aimed at finding a protocol advantageous in terms of both, time and cost saving, maintaining the diagnostic yield in comparison of two neuroimaging methods - functional (PET) and morphological (MR), where we also compared two protocols for brain examination - a standard one and a special epileptological one. Methodology: A retrospective study of 44 patients with clinically confirmed focal epilepsy examined by MR and PET, who underwent a microsurgical intervention and have been without fits since then. We compared the individual protocols on MR - standard (sequence T2/PD tse tra, FLAIR tra, T2* tra and T1 se sag) and epileptological (extended by 3DT1 ge, T2 tse fs cor and FLAIR cor) in terms of possible diagnostics (examination read by an experienced radiologist) and evaluated their time and cost demands. We also evaluated a PET examination, which is performed by one protocol, the same way. The results demonstrate the difference in examination time and costs between the standard and the epileptological protocols on MR and between the MR and PET methods. There are also results of reading MR and PET images and their correlates presented there. We may conclude that the epileptological protocol on MR cannot be substituted by a standard protocol. Time may be saved by better organization of work or by suitable adjustment of parameters of the individual sequences maintaining sufficient MR image quality. We are also convinced that both the methods, MR and PET are important for safe diagnosis. Cost saving is impossible in pre-operation diagnostics.
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Staff radiation exposure in application of the PET-CT method
BERTOVÁ, Eva
In my Bachelor-of Science work I have studied the issue of the PET-CT method application and its influence on the radiation exposure of nuclear medicine department staff at Faculty Hospital in Lochotín in Plzeň (FN Plzeň-Lochotín). In the opening chapter, the origin and recent developments in the nuclear medicine is reviewed with special focus on the PET history in the world, the physical principles of PET and the first installations of PET and PET-CT in Czech Republic and FN Plzeň-Lochotín. Then the issue of radiation protection is taken up including its history, the recent status including the relevant legal regulations, the basic principles of radiation protection, the physical methods of protection, exposure monitoring programmes and protection against radiation at the PET-CT section of nuclear medicine department of FN Plzeň-Lochotín. The reason why I chose this subject is the high energy radiation associated with PET-CT requiring special measures to ensure staff protection. The target of this work is comparison of the radiation exposure of the nuclear medicine department staff prior to and following introduction of the PET-CT method and verification of the organisation changes and radiation protection measures adopted. In practical part of my work I compared the values of personal dose equivalents Hp (10) detected with the department staff prior to and following the PET-CT method implementation. The values are shown in tables and graphs. The monthly dose equivalent values detected prior to and following the PET-CT equipment installation have been compared using the statistical method of double sample t-test. The conclusions of this study have been used to verify the efficiency of the radiation protection measures adopted at FN Plzeň-Lochotín, and to compare the status of affairs in Plzeň with those in the Nuclear Medicine Clinic of Medical Faculty and Faculty Hospital in Olomouc and at the PET Centre of the Na Homolce hospital in Prague.
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Confrontation of radiation dose of professional in nuclear medicine department in Hradec Králové before and after installation PET/CT, possibilities of monitoring
JANSOVÁ, Martina
This Bachelor Thesis deals with the radiation load of Nuclear Medicine employees of University Hospital Hradec Králové before and after the introduction of PET/CT examinations. Compared with usual examinations with gamma emitters and therapy with open beta emitters, the PET/CT examination method uses positron emitters and is carried out at the Department of Nuclear Medicine of University Hospital Hradec Králové (DNM UHHK). The use of positron emitters leads to increased demand in respect of radiation protection and work organisation. I made an evaluation of doses from personal dosimetry from 2004 until 2008 prior to the introduction of the PET/CT examination methodology; and year 2009 is subsequently assessed in respect of the situation after the introduction of PET/CT examinations. The results of doses are provided in tables. Film dosimeters and thermoluminescence (TL) ring dosimeters had been used for personal dosimetry until 2008. Digital dosimeters have been also used for personal dosimetry since 2009, and they are further included in the comparison of the received radiation doses of employees. The results were used for an evaluation of optimisation of radiation protection at the DNM UHHK.
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