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Complications during PET / CT examinations and frequency of occurration at the Department of Nuclear Medicine in České Budějovice Hospital, a.s.
HOUDKOVÁ, Tamara
This thesis is focused on complications at PET/CT examinations. The complications at these examinations are either processes which complicate the progress of examination within the meaning of affection of the quality of outcome efficiency or health complications as the linear after effect of PET/CT examination. In the first example it concerns of uncooperative patients with the excessive movements during examination or complicated venous acces for giving off intravenous screening substances. In the second example the most substantial complications are allergic reaction after delivery of jodinate contrasti substance. The object of this work was to follow complications at PET/CT examinations at the department of nuclear medicine of hostpital in České Budějovice, a.s. (here in after NEMČB), to do their analysis and in case of possibilities to suggest some systemic preventive measures. At the teoretical part of work I foccused on basic information about PET/CT device, the process of examination and all the facts related with it. At the description of particular complications I used my experience from the internship directly at the department of nuclear medicine at the NEMČB. Based on the inspection of actual state of affairs was set the hypothesis: 1. The most frequent complication at the PET/CT examinations are caused by the patients who do not cooperate. For the practical part was undertaken quantitative analysis. Data acquisition was done at the department of nuclear medicine of NEMČB by analysis of documentation of performed examinations in the term from January 2019 to June 2019. Datas were found out from application documents, the complications were then divided into four categories similarly teoretical part. Datas were statisticaly and graphicaly processed. The results of the work is possible to use as a basis for better quality of screening processes at the department of nuclear medicine and equally as the study material.
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Preparation of radiopharmaceuticals at the department of nuclear medicine
ČERNOHORSKÁ, Eliška
The bachelor thesis deals with the preparation of radiopharmaceuticals for the department of nuclear medicine. The theoretical part describes the basic terminology related to radiopharmaceuticals, their production, acquisition, methods of preparation or dosage forms in which they are applied. Part of the work is also devoted to no less important effects of ionizing radiation and protection against it, which is related to the preparation of radiopharmaceuticals. The theoretical part is processed from professional publications, articles and websites in the form of literary review. The aim of this thesis was to describe the preparation of most used individual radiopharmaceuticals for certain examinations at the Department of Nuclear Medicine of the Hospital of České Budějovice, a.s. This aim was fulfilled in the practical part, where were described the individual radiopharmaceuticals, the detailed procedure of their preparation and the principles of their storage. The practical part also includes requirements for workplace equipment, cleanliness of the operational environment (clean room construction, cleanliness classes, air conditioning, requirements for workers and their work, which is based on aseptic work procedures and the principles of radiation protection. The work contributes to the knowledge of the operation and equipment of the workplace and the requirements placed on it, as well as to the understanding of the preparation of individual radiopharmaceuticals at the department of preparation of radiopharmaceuticals. The work is conceived as an educational text especially for students and staff of the field of radiology assistant. I also focused on outlining the operation and layout of the OPR, the requirements for work in this department, which is based on aseptic work and protection against ionizing radiation. Both research questions were fullfiled by this. This work can be, in my opinion, used as an educational text especially for students and staff of the field of radiology assistant.
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Ligand design for medicinal applications
Paúrová, Monika ; Kotek, Jan (advisor) ; Trávníček, Zdeněk (referee) ; Řezanka, Pavel (referee)
In recent years, copper radioisotopes have been extensively studied for their suitable coordination and physical properties. Nuclides 61 Cu, 64 Cu and 67 Cu are used in nuclear medicine - in diagnostic as well as in therapeutic applications. The aim of the Thesis is a study of the coordination properties of divalent copper as a stepping stone for the next potential applications. The presented Thesis consists of two thematic parts. The first part deals with the synthesis of cyclam derivatives. Sixteen new macrocyclic ligands with different phosphorus acid coordinating pendant arms (phosphinate, phosphonate, germinal P-C-P) were prepared; an analogous ligand endowed by carboxylic acid pendant arm as well as tetramethylcyclam without coordinating arm were prepared for comparison. The influence of the nature of coordinating acid pendant arms on selectivity and on the rate of copper(II) complexation was studied in detail. The protonation constants of the free ligands and the stability constants of the complexes with selected transition metal ions were determined by potentiometric titrations and by 1 H and 31 P NMR spectroscopy. Kinetic properties - i.e. studies of the formation rate and kinetic inertness of the copper(II) complexes - were performed by UV-Vis spectroscopy. The formation kinetics of the selected...
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Polymer carriers for nuclear medicine
Sedláček, Ondřej
In the thesis, we developed and studied a novel polymer delivery system for the DNA-intercalator bearing radioisotope iodine-125. Auger electrons emitting radioisotopes (such as iodine-125 or indium-111) are a potentially effective cancer treatment. Their use as an effective cancer therapy requires that they will be transported within close proximity of DNA, where they induce double-strand breaks leading to the cell death. This type of therapy may be even more beneficial when associated with drug delivery systems. The DNA intercalators proved to be effective carriers for the delivery of Auger electron emitters into DNA. Therefore, the new radioiodinated DNA-intercalating ellipticinium derivatives were synthesized and characterized. These compounds were linked to N-(2-hydroxypropyl) methacrylamide copolymer with narrow molecular weight distribution via acid-sensitive hydrazone linker. The structure of the linker plays a crucial role in the biological effectivity of the delivery system, so it was optimized to be stable at pH 7.4 (representing the pH of blood plasma), whereas in slightly acidic pH in endosomes after the cell internalization, the radioiodine-containing biologically active intercalator is rapidly released from its polymer carrier. The intercalating ability of the active compound was...
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Polymer carriers for nuclear medicine
Sedláček, Ondřej
In the thesis, we developed and studied a novel polymer delivery system for the DNA-intercalator bearing radioisotope iodine-125. Auger electrons emitting radioisotopes (such as iodine-125 or indium-111) are a potentially effective cancer treatment. Their use as an effective cancer therapy requires that they will be transported within close proximity of DNA, where they induce double-strand breaks leading to the cell death. This type of therapy may be even more beneficial when associated with drug delivery systems. The DNA intercalators proved to be effective carriers for the delivery of Auger electron emitters into DNA. Therefore, the new radioiodinated DNA-intercalating ellipticinium derivatives were synthesized and characterized. These compounds were linked to N-(2-hydroxypropyl) methacrylamide copolymer with narrow molecular weight distribution via acid-sensitive hydrazone linker. The structure of the linker plays a crucial role in the biological effectivity of the delivery system, so it was optimized to be stable at pH 7.4 (representing the pH of blood plasma), whereas in slightly acidic pH in endosomes after the cell internalization, the radioiodine-containing biologically active intercalator is rapidly released from its polymer carrier. The intercalating ability of the active compound was...
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Radiolabeling of aluminum and gallium complexes with radioisotope 18F
Kuncová, Lucie ; Kubíček, Vojtěch (advisor) ; Vojtíšek, Pavel (referee)
The most widely used emitter in positron emission tomography is the fluorine isotope 18 F, which can bind to a number of atoms, and thus allows the formation of imaging agents for positron emission tomography. This work will summarize methods for labeling complexes containing aluminum or gallium as a central cation, which can serve as stable carriers of the positron emitter in a human body. Both of these elements have unique physical and chemical properties suitable for molecular imaging. Therefore the development of complex labeling, their structure, coordination environment and some applications in nuclear medicine will be described here.
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Radiation safety in the nuclear medicine department
ANTONÍNOVÁ, Eva
The practice in the department of nuclear medicine requires the involvement of radiation protection with care of patients and occupational safety of radiation workers. Nuclear medicine involves the handling of radioactive substances that may cause external or internal irradiation of workers. The amount of the dose depends on the type of radionuclide, the amount of energy, the work performed by the worker within the department. Patients or staff may be exposed to the external or internal irradiation. The topic of this thesis is the analysis of the current state of radiation protection in the department of nuclear medicine according to the new legislation. The part of the work is the evaluation of monitoring of workers and patients. The research results of the average annual effective dose of total body irradiation at radiation workers ranged from 1.35 to 1.73 mSv, monthly ranged from 0.1? 0.65 mSv. The average annual equivalent dose of Hp (0,07) ranged from 1.15 to 117.68 mSw. The lowest monthly Hp (0.07) was 0.07 mSw and the highest one was 19.92 mSw. At SSK-treated patients the doses applied were 4% lower than diagnostic reference level and the dose at DSSL-treated patients was 22% less than DRU. In conclusion, it was found that the values from personal dosimeters were below the limit and in the case of finger dosimeters in two cases the values were above the examination level. The values of other workers were below the monitoring level during the monitored period. The applied doses of radiopharmaceuticals were less in the observed group of patients than the established diagnostic reference level. On the basis of the presented results it can be stated that radiation protection is in the Department of Nuclear Medicine of Znojmo Hospital f.o, secured in accordance with the applicable legislation.
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The activity ratio of 30. minute/2.-3. minute in the Dynamic renal scintigraphy
KUKAČKOVÁ, Jana
The objective of the present Bachelor thesis is to determine normal values of the ratio of activity in the Region of Interest (ROI) of a healthy kidney in the 30th minute of the examination compared to the 2nd - 3 rd minutes in patients up to 18 years of age at the Nuclear Medicine Department in České Budějovice. For the purposes of comparison, values of the ratio of activity in ROI of the kidney in the 30th minute are compared with the peak in the same patients. Dynamic kidney scintigraphy with 99mTc-MAG3, generally modified by a furosemide test, is carried out in case of child patients with respect to whom simple dilatation of the pelvicalyceal system must be distinguished from obstruction. A set of 35 patients at the age of 0-18 was selected for the purposes of statistical processing in the period from 01 January 2018 to 13 November 2018, whereupon these patients underwent dynamic kidney scintigraphy with 99mTc-MAG3. As a result, 47 usable renal units were obtained. Renal units with pathological findings were removed from the set. In these renal units, the ratio of activity 30th min./3rd min. and the ratio 30th min./peak were observed. For comparison, the total of 4 selective statistical sets (VSS) were formed - a group of patients at the age of 0-18 and a more restricted group of patients at the age of 0-10 years for both ratios of activity. The collected data were subsequently used for parametric testing. The contribution of this thesis consists in the determination of normal values of the ratio of activity 30th minute/2nd - 3 rd minutes, which will be useful in differentiating mild dilatation from other pathological conditions (obstruction, reductions in function, etc.) in patients examined by dynamic kidney scintigraphy at the Nuclear Medicine Department in České Budějovice. The elementary static processing implies that normal values of the ratio of activity 30th min./3rd min. oscillate in the interval of values (0.058; 0.238) in patients up to 18 years of age, and in the interval (0,05; 0.27) in patients up to 10 years of age. For the sake of comparison, values of the ratio of activity 30th min./peak oscillate in the interval of values (0,026; 0.246) in patients up to 18 years of age, and in the interval (0.04; 0.26) in case of patients up to 10 years of age. It may be stated that values of ratios of activity 30th min./3rd min. and 30th min./peak are approximately comparable. Based on the applied double-selection t-test, the zero hypothesis was adopted, meaning that the selective statistical sets originate from the same basic statistical set on the given significance level.
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The evaluation of radiation burden of patients and the possibility of radiation emergence and management of emergencies at the nuclear medicine department of the Hospital České Budějovice, PLC
DAŇOVÁ, Kristína
The aim of my thesis was to evaluate radiation consequences in patients, and to evaluate unusual occurrences stemming from radiation at the department of nuclear medicine in hospital Ceske Budejovice. In the theory part, I worked with professional literature, applicable laws and internal documentation provided by the department of nuclear medicine in hospital Ceske Budejovice Plc The thesis reacted to the need of the department of nuclear medicine (dept. NM) in hospital Ceske Budejovice to evaluate the optimisation of doses for the patients and set local diagnostic levels. Different organisations worldwide deal with the question of optimising radiation protection, and their recommendations and standards are used in the Czech Republic. For this purpose, it is necessary to know the real activity of radiopharmaceuticals applied in each examination and to conduct a forecast resulting in effective doses also based on CT scans. The thesis also evaluates the occurrence of special radiation events really experienced at the department of NM (nuclear medicine) in the hospital mentioned above, the reasons for these events happening and precautions preventing them from happening in future. The owner of the permission for this activity, meaning the use of the source of ionizing radiation, has the duty to keep all documentation and paperwork in accordance with the law regulating nuclear power, abide by the rules of good practices and the real state of allowed practice. The occurrence of unusual events is closely connected with the documentation - internal emergency plan and monitoring program. (Law 263/2016) Therefore, it was recommended to compare these to the actual state and to review them based on the facts found. The values of applied activities and effective doses found were compared to the values published in the last report from UNSCEAR in 2016 and national referential values published in the bill about radiation protection no 422/ 2016. All results were inputted into tables and graphs. It was found that the applied activities at the department of NM in hospital Ceske Budejovice are in agreement with the values presented in UNSCEAR report and that they are lower than the national referential levels, which shows that there is optimised state of radiation protection for patients. The occurrence of concrete unusual radiation events at the department of NM in hospital Ceske Budejovice and their analysis revealed certain shortcomings in the process and the absence of security elements needed while holding radioactive liquid waste in storage at the hospital. It was necessary to find and implement such precautions, which will prevent similar type of events in future. The thesis will be handed in to the person tending to the radiation protection for the use of evaluation and providing the protection at the department of NM at the hospital Ceske Budejovice and to enable the documentation to be completed for the allowed activity.
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Differentiation of radiological assistants in particular branches (X-ray, Nuclear medicine, Radiotherapy)
PROKOPOVÁ, Šárka
Bachelor thesis is divided into theoretical and practical part. The theoretical part is about the details of the work of the departments, which include x-ray, nuclear medicine and radiotherapy. The entire work is supplemented by my own photographs, as well as photographs from public information sources. There is also a brief history of radiology. I also stated the most important personalities of this scope and their inventions. Next, I put in the work tables and charts from the Institute of Health Information and Statistics of the Czech Republic and compared them with my results. In the practical section, I focused on creating questionnaires for doctors and radiology assistants. These questionnaires were designed for employees of branches RTG, NUM and RTO. For physicians was prepared 12 questions and for radiological assistants 14 questions. Respondents answered in the form of a check mark one or more responses. There are also questions, where the answer must be indicated in written form. Then were the collected results sorted into the different categories according to the scope. Then I transferred the resulting data in a graphical form. At the end of the practical part I commented on the data and added my own opinions and insights. The survey was carried out in the form of personally or electronic distributing the questionnaires to individual hospitals throughout the Czech Republic. The results were then delivered to me by a mail or I had to go for them into concrete hospitals personally. It depended on the willingness of a particular hospital. The work will be used for educational purposes and to raise awareness among university students and professional public.
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