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The role of radiologist assistant in radioiodine diagnostics and treatment of thyroid cancer
Hrbek, Jaroslav ; Táborská, Kateřina (referee) ; Vlček, Petr (advisor)
The bachelors thesis on the task of a radiological assistant during radioiodine diagnostics and treatment of thyroid gland carcinomas deals with the issue of thyroid gland carcinomas in the Czech Republic. It contains a brief overview of the types of carcinomas that affect the thyroid gland, their classification, diagnostics and therapy, concentrating on utilisation of modern examination methods and therapeutic practices, including among others application of radioiodine. The thesis also contains cases of four patients with similar diagnoses, the comparison of the development of whose respective illnesses I found interesting. Last but not least, the thesis includes a number of annexes comprising among others tables with important instructions for patients before and after application of radioiodine, and photographs from the site where the radioiodine application takes place Powered by TCPDF (www.tcpdf.org)
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Radioactive Waste in Hospital Facilities
Bradáč, Antonín ; Houdková, Lucie (referee) ; Tabasová, Andrea (advisor)
The thesis is focused on a little-known issue of institutional waste produced by hospitals, the creation, collection and subsequent disposal. This thesis described the distribution of waste from various aspects, especially the characteristics and their subsequent use in the effective elimination. This thesis deals with not only this issue, but trying to get closer to negative impact of ionizing radiation on the human body, not only in the current level of radiation protection, but also in terms of the historical development of different sources and work with them, especially in connection with the use of ionizing radiation in normal human activity but also through the list of nuclear accidents. The practical part of this thesis compares the three types of hospitals primarily on the basis of a personal meeting with the heads of various departments involved in the management of institutional waste, and materials derived their visit. Specifically, the hospital Atlas and Tomas Bata Regional Hospital (both situated in Zlin) and specialized workplace Masaryk cancer institute in Brno.
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Development of Imaging Methods and its Importance to Biomechanics
Sedláček, Tomáš ; Houfek, Martin (referee) ; Florian, Zdeněk (advisor)
The main objective of this bachelor thesis is to collect all available literature, from which can reader obtain basic knowledge of imaging methods. The methods are divided by its origin into four categories: x-rays, magnetic resonance, ultrasound and nuclear medicine. Each of them is described from the historical, physics and technological view. At the end the importance of each method to medicine and biomechanics is summarized.
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Values of accumulation of Tc-99m-DMSA in kidneys of children
HOMOLKOVÁ, Markéta
Scintigraphic examination of the kidneys and urinary tract allow you to get a lot of information about the condition of the urinary tract. The main contribution of nuclear medicine today is the ability to do a precise quantitative assessment of the various functions of the kidneys and urinary tract. Currently for static scintigraphy and renal SPECT uses the nuclear medicine Tc-99m-dimercaptosuccinic acid or DMSA. For children is being used Tc-99m-DMSA activity of at least 20 MBq. Static scintigraphy is usually performed to demonstrate acute pyelonephritis. In such a renal disease arises one or more bearings with reduced accumulation of the radiopharmaceutical, wherein the scar appears as a wedge-shaped defect, which has regular edges and kidney loses its volume. Another illness diagnosed by static scintigraphy is hypoplastic kidney, which has a smooth outer edge without defects in the crust. The above diagnostic method is also used to evaluate local changes in the transplanted kidney. The practical part of this work was to answer the following questions: "What is the normal accumulation of Tc-99m-DMSA in kidneys for children?" I got the answer through the exploration and evaluation of the results from a static scintigraphy examination of the reference group of 28 kidney of children done by Department of Nuclear Medicine, Hospital Ceske Budejovice. The reference data set was collected from September 2014 to March 2015 and consist of patients aged 0 18 years. The physician determined the patients without abnormal kidney or focal renal impairment to be selected for the reference group. I worked with the renal scintigraphy program, typing in specifying data about each individual patient and subsequently plotting areas of interest on the right and the left kidney for each of them. This program evaluated the percentage of accumulation of Tc-99m-DMSA in each kidney. Such a data I enrolled into a Microsoft Excel table and used statistical calculations to determine the normal accumulation of Tc-99-DMSA in child kidney. For statistical evaluation was used the formula for the average, standard deviation and percentiles. From the thus processed values may be noted that the normal value of accumulation of Tc-99m-DMSA child kidney ranges from 10.9% to 32.9%.
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Centre of rotation stability setting for the INFINIA camera
BAKI, Marcel
My bachelor thesis focus on Centre of rotation stability for Infinia cameraAt my work I got closely familiarize with scintillation camera Infinia Hawkeye, which is located in the department of nuclear medicine in the České Budějovice. The aim of my work was to determine whether the centre of rotation (C.O.R.) takes place around a fixed axis, and thus whether there is not movement. The method that I chose to accomplish my goals, was to test the camera , which was performing by 360° acquisition around a point source 99mTc. The point source was fitted to a rod and placed on the Infinia camera on patient's pallet. Testing was carried out with two collimators LEHR and LEGP in modes H and L. The testing was performed by radiological physicist, always in the afternoon to ensure smooth running of the workplace. The test confirmed my hypothesis that the value will be within the values specified by the manufacturer. Testing was performed once a month for half a year. In In this days because we are apperceiving tremendous technological progress, and devices which allow us to produce more perfectly and detailed images and contribute to better diagnosis and treatment are created it is very important to ensure the quality control. Over the last few years progress in gamma camera designs , have improved all aspects of image quality, particularly in tomographic images. As the system complexity increases, it becomes more important that all nuclear medicine employees are able to recognize the various types of aberrations or artefacts that can occur in nuclear medicine imaging systems. The primary purpose of the quality control program in department for nuclear medicine is to verify that the images accurately reflect distribution of the radiopharmaceutical within the patient. The purpose of quality control is detect changes of gamma camera system that may adversely affect the interpretation of clinical studies. There are large number of factors that contribute to the final quality of the image ( including uniformity, resolution - both intrinsic and energy, pulse frequency, centre of rotation system, rotational stability of the detector head). On a everyday examinations there is a limited amount of time that can be reasonably devoted to quality control system. Hence the main goal of quality control program should be to monitor those parameters that are most sensitive to changes in system performance and are most likely to impact clinical studies. Therefore , the main objective of quality control program should be monitor the parameters that are most sensitive to changes in system performance and most likely have a impact on the clinical studies. Specials series of quality control tests were designed to ensure the optimal performance of the camera. Over the whole time of the entire period of clinical operation, technicians or physicists regularly perform various quality control tests, some daily, others weekly or monthly. The purpose of these tests is monitor day to day camera performance and detect changes from the baselines values. Additional quality control test may be performed to compare characteristics of different systems and to optimize the quality of clinical studies.
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The Radiation protection of Patients and staff in Nuclear Medicine.
DAŇOVÁ, Kristína
Open radioactive sources are used at the department of nuclear medicine for diagnoses and therapy, as well as for research purposes. Ionizing radiation is applied in all cases. Since a negative impact of this radiation has been depicted, it is necessary to systematically reduce the radiation on people, and protect the environment. The title of this bachelor thesis is: "Radiation protection of staff and operatives at the Department of Nuclear Medicine". This thesis is devided into several parts. The beginning of the theoretical part focuses on history of origins of radiation protection and institutions which deal with it. Further, nuclear medicine as such, its equipment, and structure of the department in general is described. The conclusion then introduces the DNM in the town of České Budějovice. Ionizing radiation and its biological effects on organisms were defined, as well as quantities and units which characterize it. A considerable part of this work focuses on principles of radiation protection, monitoring of the staff, workplace and releases. This work also deals with dosimetry and lists types of used dosimeters. It assesses the risks of outer and inner radiation. The aim of this thesis was to analyse laws and regulations which are connected to radiation protection and identify its effective application for staff and patiens of the DNM in České Budějovice. Another aim was to examine the radiation protection of patients at the Department of Nuclear Medicine, as well as the radiation protection of patients and staff at the inpatient ward. The research question was: "Is the radiation protection of patients and staff at the Department of Nuclear Medicine in hospital in the town of České Budějovice sufficiently optimized?" The method of research was assembling and recording materials of nuclear medicine in České Budějovice, compare doses of thermoluminescent dosimeters of the staff in outpatient and inpatient wards, and compare doses of finger and whole-body thermoluminescent dosimeters. The practical part provides detail information, charts and graphs of effective and equivalent doses of staff of outpatient and inpatient wards of the DNM in the town of České Budějovice between years 2009 and 2013. The outpatient ward comprises of fifteen employees. The inpatient ward of three nurses and one hospital attendant. These were observed in details for effective dose equivalents Hp(10) during each individual month for the period of five years. Results from the personal whole-body and finger dosimeters have been used for the analysis. The values of equivalent doses of HT from finger TLD are recorded for two of the employees. The data for the hospital in the town of České Budějovice was assessed by CSOD Ltd. In Prague, a company which has been providing dosimetric calculations in the Czech Republic for over tweny years. This data was compared with limits for radiation workers, which are regulated by State Office for Nuclear Safety no.389/2012 Sb., from November 16th, 2012, which changes the public notice of State Office for Nuclear Safety no.307/2002 Sb., about radiation protection as amended by public notice no.499/2005 Sb. The outcomes of the thesis have remitted a very high level of radiation protection and well-established measures in the protection of staff and patients against negative effects of ionizing radiation in the hospital of the town of České Budějovice. The thesis is then enhanced by a discussion, which reflects the outcomes compared with professional findings summarised in the theoretical part. The answer to the research quesion is: "Yes, radiation protection of the staff and patients at the Department of Nuclear Medicine in the hospital of the town of České Budějovice is sufficiently optimized." This bachelor thesis can be used as a study material for students of the field of study Radiology Assistant.
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The Dependency of the Volume Activity of I-131 in a Hospital Sewage Treatment Plant on the Amount of I-131 Used as a Medical Treatment in the Nuclear Medicine Ward
KAMPELSHEIMEROVÁ, Šárka
The subject of the work is radiation protection at a nuclear medicine workplace with a bed section in connection with the therapy of thyroid gland diseases using radioisotope 131I. In the theoretical part, the work briefly deals with the anatomy and pathology of the thyroid gland and ways of therapy, and outlines the basic characteristics of radioisotope 131I and history of nuclear medicine and radiation protection. In the practical part, there is a verification of the efficiency of radiation protection when handling liquid waste and a verification of the correlation of the activity of liquid waste with the activity of radiopharmaceutical administered. The malignant tumours of the thyroid gland constitute 0,5?1 % of all tumoral diseases. Some types of this tumour, which are histologically differentiated, retain the capability of extracting iodine from blood and are thus suitable for being treated using iodine radioisitope. That's why these types of tumour are treated most frequently at nuclear medicine departments. The basis of therapy is the surgical removal of tumoral tissue, usually of the whole thyroid gland, and administration of radioisotope 131I. When treating the thyroid gland, the patient is always hospitalized at a nuclear medicine department with a bed section. Radioisotope 131I is mixed ? and ? emitter and after being administred to a patient, it is the source of radiation danger for hospital personnel, possibly for others individuals. At the same time it is excreted from the organism by urine, stool and sweat. On that score due attention must be paid to safety measures. In view of the magnitude of this problem and the emphasis that is currently laid to protection against ionizing radiation, I chose this issue as a subject of my bachelor's work. The goal of the practical part of the work was to verify whether the limits set by Decree No. 307/2002 Coll., as amended by Decree No. 499/2005 Coll. on radiation protection were observed under the current system of handling liquid waste in the bed section of the Nuclear Medicine Department of the České Budějovice Hospital. Two hypotheses were set: Operation regulations and current programme equipment of the technical installations for the automatic draining of waste water from the bed section of the Nuclear Medicine Department are sufficient for the limits set by Decree not being exceeded; the other hypothesis assumes that the values of the volume activity of waste water in the drainage tank of the hospital's sewage plant conform to the activity of a radiopharmaceutical administered to patients treated at the Nuclear Medicine Department of the České Budějovice Hospital. For the purposes of this work, the activity of waste in the drainage tank of the hospital's sewage plant was measured with a well detector once a week for a period of two month to verify that the activity does not exceed a release level of 455 Bql-1 set in an addendum to Decree No. 307/2002 Coll. It was ascertained by measuring that the average activity of waste in the watched period was 279,8 Bql-1, the highest activity measured on March 18, 2013 being 373 Bql-1. In the watched period, the release activity set by the law was not exceeded in any week. At the same time, the correlation of the values of radioactivity administered with the radioactivity of waste water was proved. Consequently, both hypotheses of the work were proved. The work proved that the limits set by Decree No. 307/2002 Coll., as amended by Decree No. 499/2005 Coll. on radiation protection, were observed under the current system of handling liquid waste in the bed section of the Nuclear Medicine Department of the České Budějovice Hospital.
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Computation of relative function of kydney at dynamic scintigraphy - influence of time period applied for computation.
HRTÁŇOVÁ, Jana
The topic of my bachelor thesis is a computation of relative renal function at dynamic scintigraphy and an influence of the time period applied for computation. The main aim of the thesis is to establish if the usage of two different time periods for computation of relative function of kidneys at dynamic scintigraphy of kidneys has any influence on computed function. Precisely, whether the choice of time period affects the result of processing the study is acquired by dynamic scintigraphy of kidneys. Expressed hypothesis assumes that time periods between 60s and 180s which were chosen for the calculation have not the influence on calculated relative function. Dynamic scintigraphy of kidneys enabling to display function of kidney´s ability to clean blood from the observed substance and consider possible defect of kidney excretion, it is the important method of examination mainly by children patients which are the vast majority of examined patients. For the hypothesis confirmation, there was created a reference file. This file consists of children patients who were examined by dynamic scintigraphy of kidneys in the Department of Nuclear Medicine Hospital in Czech Budejovice. With a help of program of dynamic scintigraphy the relative function of kidney was computed and defined by the percentage portion of each kidney on the whole renal function. The different time periods were used for the function curve for the computation. The function curve is designed like a graph from the marked region of interest and it is the result of computer processing data which were obtained from the scintigraphic study. From obtained values, the tested criteria are subsequently determined by statistical calculations they are confirmed and given as a zero hypothesis.
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Determination of radiochemical purity of radiopharmaceuticals TechneScan HDP by chromatography using different mobile and stationary phases
RAUS, Klára
Nuclear medicine is a relatively young medical field. The nuclear medicine department performs both diagnostic tests and therapies using open radiation sources whereas the diagnostic use currently prevails. The imaging method used is called scintigraphy and uses a scintillation camera capturing the distribution of administered radiopharmaceutical. Using a scintillation detector, which is incorporated in a gamma camera, the distribution of the radiopharmaceutical in the target tissue can be observed, either after a certain period of time from the administration of the radiopharmaceutical (static scintigraphy) or over time (dynamic scintigraphy). One of the most common examinations performed at the nuclear medicine department is bone scintigraphy. The examination is carried out using osteotropic radiopharmaceutical that binds to bones, thus revealing pathologies caused by the change of metabolic activity. The examination in itself takes place through external detection of the administered radiopharmaceutical. Bone scintigraphy is a very useful examination that is used to detect bone metastases in cancer diseases, to diagnose primary malignant bone tumors, to detect infectious processes in the bones, to diagnose joint diseases, metabolic diseases of the skeleton, and bone injuries. The examination in itself is performed by using radiopharmaceuticals. Once administered, the radiopharmaceutical serves as a diagnostic indicator. This is a medicine that incorporates a radionuclide that emits ionizing radiation. The radionuclides used in nuclear medicine are artificially prepared and transported either as ready-to-use products or as radionuclide generators to the nuclear medicine department. The generator that is the most commonly used at the nuclear medicine department is the 99Mo/99mTc generator. The above mentioned radionuclide generator consists of a glass chromatography column which is located in a lead shielding cylinder. The column contains the adsorbent material (alumina) in which the parent radionuclide is adsorbed. Due to different chemical properties of the parent and the daughter element the daughter radionuclide can be washed out (eluted) by means of a suitable solution. In practice, the radiopharmaceuticals are commonly prepared using kits that are commercially available. The kits are labeled by using sodium pertechnetate solution obtained from the 99Mo/99mTc generator. Prior to the administration of the radiopharmaceutical to the patient it is necessary to carry out the determination of radiochemical purity. The most commonly used is a paper chromatography and thin layer chromatography. In the Czech Republic, 99mTc labelled diphosphonates (e.g. the kits TechneScan HDP, 6-MDP or 8-MDP are used for bone scintigraphy. These osteotropic radiopharmaceuticals are prepared in a shielded laminar box in the radiopharmaceutical laboratory at the nuclear medicine department. The preparation is subject to the manufacturer's instructions. After preparation, prior to administration to the patient, the determination of radiochemical purity needs to be performed. The determination of radiochemical purity of the radiopharmaceutical TechneScan HDP is carried out by using thin layer chromatography (ITLC-SG) by means of 13.6% solution of sodium acetate and methyl ethyl ketone as eluent. However, this determination is demanding for the normal operation of the department in terms of design as well as costs. Therefore, a suitable alternative method was sought. The new method consists in paper chromatography by using 0.9% solution of sodium chloride and acetone as eluent. After 50 determinations of radiochemical purity using pharmacopoeial and alternative methods was found that the alternative method is applicable for the routine determination of radiochemical purity during normal operation of the nuclear medicine department
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Risk assessment associated with the release of radioactive iodine from nuclear medicine department during a fire
RAMBOUSKOVÁ, Lucie
Nuclear medicine is the branch of medicine that is used to diagnosis and treatment with radioactive isotopes. Nuclear medicine is one of the least burdensome non-invasive methods of investigation. In contrast to diagnostic radiology, which shows the structure of organs , nuclear medicine provides information not only anatomical , but also on organ functions and metabolism. In many cases it is a unique diagnostic test that can detect the disease or its extent before, and thus increase the chance of successful treatment. When working with open emitters for nuclear medicine department can be assumed that may occur in the expected manner of use of radioactive sources only incident of First Instance ( spilling or splashing radiopharmaceuticals, patient pollution ) and very rarely an emergency occurs the second stage (the loss or theft of resources radiation). An extraordinary event is the third-degree radiation accident with very minimal probability of occurrence. The aim of the Bachelor thesis is to map the distribution and the storage of radioactive iodine in the Department of nuclear medicine of the hospitals in the Czech Republic, to determine the level of knowledge of the medical staff and members of the fire rescue Corps and their application in practice, in the release of radioactive iodine, and assess the degree of risk associated with the release of radioactive iodine in the fire. The hypothesis assumes that the medical staff and members of the fire rescue Corps know how to proceed in cases of leakage of radioactive iodine from the Department of nuclear medicine, and that the level of risks associated with the release of radioactive iodine in the fire is negligible. It is a form of qualitative research, research-questionnaire and interview-driven method. In an interview, polootevřený will be used and the type of closed questions. The research staff of the Department consists of a set of nuclear medicine and the members of the fire rescue Corps. Thesis will be used for more detailed study of the issue. It may also be used in lectures and seminars, health workers, and a fire department Rescue Corps.
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