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Lymphedema of the upper extremity as a complication after breast tumour curative radiotherapy.
LOUDA, Marek
Lymphedema of the upper extremity is a serious complication after breast cancer treatment. This thesis concerns lymphedema of the upper extremity after a curative treatment for breast cancer. Describes breast cancer therapy, its methods and curative purposes. Explain what sentinel node disection is and what compliactins expect after its removal. Becouse essential part in breast cancer treatment také radiotherapy, thesis intoduces radiation dozes, radiation volums and radiation therapy technique. The goal of this thesis was to evaluate number of lymphedema of the upper extremity at patients after axilary node disection and at patients after sentinel node disection and adjuvant radiation therapy treatment. The explorative question was whether a sentinel node disection reduces origin of lymphedema upper extremity independently on radiation therapy extent and iradiation volum. The metholodgy was based on collecting data of patients with breast cancer tumour from register of oncological patients in Hospital České Budějovice joint stock company. Data were subsequently processed and compared to data obtained from vocational literature.
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Evaluation of the clinical results of in-vivo dosimetry in oncology in České Budějovice
ČAJANOVÁ, Nikola
Today radiotherapy or treatment using ionizing radiation effects is one of the main methods of treatment of oncological diseases. Sufficiently high doses of ionizing radiation are able to inactivate and kill cancer cells. The surrounding healthy tissue, however, these effects of radiation is harmful. The strategic aim of radiotherapy is the removal of tumor bearing the least damage to the surrounding healthy tissue. The task of the radiotherapy is to find the optimum compromise between these two conflicting requirements. Radiation treatment planning is a very lengthy and complex process. It should be precisely executed, in order to maintain the highest efficiency and safety of the treatment. The destination volume identified by the radiation oncologist must be using various imaging techniques (CT) exactly localize before start the exposure. It is also necessary to make the determination of the size of the individual and the total dose, fractionation, irradiation conditions, the size and arrangement of irradiation fields, etc. The entire planning process is the need to constantly verify. Verification is carried out during the planning of the patient, irradiation conditions (System verification), the target volume (verification) and verification of dose (measurement) to ensure the highest quality of radiotherapy. Ensuring quality in radiotherapy deals with international Quality Assurance (QA), which by law must have each of the departments of radiation oncology in the Czech Republic drawn. This program defines the procedures to be followed in order to eliminate all inaccuracies that could lead to sub-optimal treatment of radiation excessive or insufficient exposure. One of the tools for QA in radiotherapy is also the in-vivo dosimetry, which is the main subject of this Bachelor's study. Part of the verification system, and as the last fuse QA throughout the algorithm of radiation treatment is in-vivo dosimetry. Using this technique, measure input and output radiation dose in terms of in-vivo, i.e.. directly on the patient. The measurement shall be verified, that the scheduled dose agree with a dose of radiation. In-vivo dosimetry is performed on radical cancer patients during external radiation on a Linear Collider. The radiation dose is detected by using semiconductor diodes or termoluminescent materials. In-vivo measurement is not only to control the dose delivered to the target volume, but also absorbed dose in critical organs or in situations where it is difficult to predict the dose. Through the in-vivo dosimetry in time can reveal various system inaccuracies or random errors for individual patients. To detect incorrect radiation doses are used tolerance limits. When exceeding the limits it is necessary to perform a detailed inspection of all steps of the radioterapeutic process. To get acquainted with the issue of in-vivo dosimetry and its representation in the current radiotherapy was handled by the theoretical part of the Bachelor´s thesis with the use of specialized information sources...
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Reduction of radiation exposure by the use of the fluoroscopic spinal navigation system during the transpedicular screw placement of the lumbal spine.
ŠRŮTKOVÁ, Eva
RADIATION EXPOSURE REDUCTION BY THE USE OF FLUOROSCOPIC NAVIGATION IN TRANSPEDICULAR INSTRUMENTATION OF THE LUMBAR SPINE SUMMARY The topic of this thesis is a comparison of radiation exposure during standard fluoroscopy and navigated transpedicular instrumentation of the lumbar spine, in compliance with standard techniques and accuracy of screw placement. Material and the Method: A group of 60 patients, divided into two equal groups, was statistically processed. In the first group 1.9 lumbar spine segments were stabilized. The patients´ average age was 60.8 years (from 35 to 75 years). Screws were inserted transpedicularly under the X-ray image intensifier navigation. In the second group stabilization of 1.8 segments was performed on average. The average age was 61.1 years (from 38 to 75 years). The screws were inserted postoperatively by using 2D fluoroscopic navigation technique (VectorVision, BrainLAB, Germany). The duration of skiascopy was collected from the X-ray image intensifier and recorded for each surgery (with navigation and without). The measured values were compared with each other. In both groups the screw positioning was checked continuously according to the rules defined by Learch, Acikbas and Whitecloud in the anteroposterior and lateral projection by meticulous pedicle palpation Results: The radiation exposure was calculated to one vertebra (2 screws) in both groups. In the second (navigated) group the radiation exposure time was significantly shorter (3.4 s) than in the first (standard) group (14.4 s). The mean duration of data registration was 6.0 minutes (range 3 to 11 minutes). The mean ratio according to Acikbas's calculation method was 43.2 % (range 32 % to 74 %) in the first group and 44.1% (range 35% - 76%) in the second group. The mean exposure dose of the first group was 243 ?G/m2 and 138 ?G/m2 in the second group. Exposition doses are smaller by 105 ?G/m2 in the second group Conclusion: Based on the results, the hypothesis that navigation allows the same accuracy of pedicle screws insertion while reducing radiation exposure of the patients and the operating room staff to about ? can be confirmed. This reduction is more pronounced in multiple-level spinal stabilizations and in the centers for spinal surgeries, where numerous spinal instrumentations are performed every day.
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Digitization, the advantages and disadvantages, compared with analog processing of X-ray method with respect to radiation dose
TONCROVÁ, Silvie
Many years have passed since the discovery of X-rays, and yet X-ray examination remains one of the most frequently used examinations today. During the course of existence of radiological science, high-performance X-ray machines have been developed for basic radioscopy and radiographic techniques. In recent decades, computing technology has been increasingly applied in X-ray devices, and has become the basis for new X-ray examination techniques, introducing digitalization to the field of X-ray diagnosis. The objective of my work is to compare the advantages and disadvantages of digital processig of X-ray images versus analogue techniques, and to compare the economic and operational costs of these systems and the doses used in the respective devices. The comparisons were made at departments and units equipped with systems of direct digitalization, indirect digitalization, and analogue image processing. My hypothesis that the use of digital devices entails a lesser radiation burden for patients was confirmed. This is well apparent from the tables and graphs documenting the results of my measurements. I also provide a basic description of the generation and processing of X-ray images using the respective systems, some legislative requirements, and an explanation of basic terms and technicals data about the diagnostic devices used. This work indicates that digitalization in the field of radiodiagnostics contributes to the reduction of radiation dose for patients and is more economical for major healthcare facilities. Digitalized systems place greater demand on the software for image creation, but when properly used, they facilitate and expedite the work of radiology assistants and improve the quality of patient care.
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