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Estimation of average doses of the population of the Czech Republic from medical sources
ŠÍPOVÁ, Aneta
The intention of my diploma thesis was estimate the effective doses from different examinations in the area of the nuclear medicine and radiodiagnosis and find out what numbers are of the examinations in the Czech republic. In the theoretical part I worked with the professional literature, the applicable legal regulations and the internet links. The diploma thesis on the topic "Estimation of average doses of the population of the Czech republic from medical sources" is partition to the two parts. The introductory part of the theoretical work is dedicated to the importance of medical radiation within radiological methods and to the brief description the whole thesis. In the other part od the thesis are summarized the informations about the ionizing radiation - about his history, species, sources, interactions with the environment and biological effects on the organism. In the other part of the thesis which is devoted to radiation protection is listed the basic czech legislation which relates on the given topic. Further are in this thesis within the radiation protection listed her objectives, conception, principles, radiation protection methods, radiation monitoring and basic monitored quantities which are important in terms of the radiation protection. In the last part of the theoretical thesis is listed the medical radiation and his possibilities of use in the medical. In this thesis were to established three objectives. The first objective was to estimate the average effective doses in various examinations in the nuclear medicine and the radiodiagnosis. For selected examinations was calculated the average effective dose for patients who underwent the selected examination in January 2022. In the framework of nuclear medicine, it was an skeletal scintigraphy (96 patients), myocardial perfusion scintigraphy (51 patients), perfusion and ventilation lung scintigraphy (166 patients) and dynamic renal scintigraphy (12 patients). The results of these examinations were compared with data listed in UNSCEAR Report 2020/2021. In the famework of the radiodiagnosis, it was an CT brain natively (226 patients), abdominal CT natively (91 patients), CT chest native (33 patients) and CT of the lumbrar spine natively (46 patients). The results of these examinations were compared with data listed in UNSCEAR Report 2020/2021 and the results listed in the document "Medical radiation assessment" released by the SÚJB in the year 2021. The second objective was to find out how are numbers of examinations mentioned above in Czech republic. For this purpose I was provided with data from ÚZIS. Within this objective were estimated the collective effective doses. The third objective was estimated the relative probability of emergence of stochastic effects (the cancer). For this purpose was used the program named X-ray risk.
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Received dose analysis of the Hospital Třebíč, p.o. staff during the radiodiagnostic examinations
ŠOTKOVSKÝ, Aleš
The discovery of X-rays, made by Wilhelm Conrad Röntgen in 1895, was a major turning point not only in medical diagnostics but also in medical science as a whole. The discovery gave rise to a new field of medicine - radiodiagnostics. The field of radiodiagnostics has seen a rapid development, mainly since 1970s. Today, radiodiagnostic imaging methods have an indispensable place in medicine and no medical facility can possibly work without them. With the current fast development in the field of radiodiagnostics, both the extent of X-ray examinations available to patients and the number of patients examined by X-rays have multiplied. Unfortunately, this brings along a higher risk of exposing medical staff to ionizing radiation effects and associated undesirable consequences. To keep the risk at the minimum level and at the same time maintain the number and quality of examinations performed, it is necessary to strictly obey the principles of radiation protection at facilities with sources of ionizing radiation. I addition, regular inspections must be done to check if these principles are obeyed in reality. That is why the doses of ionizing radiation received by staff working at such facilities are monitored and regularly assessed. The objective of this thesis is to analyse the doses received by staff working with sources of ionizing radiation at Třebíč Hospital during the past ten years, when the hospital saw a significant increase in patients examined by radiodiagnostic imaging methods. The thesis is divided into two parts - a theoretical section and a practical section. The theoretical section is based on both domestic and foreign literature. It describes the X-ray radiation itself, its origin, properties, effects and possible use. The theoretical section also explores ways to detect the radiation and the effects it has on living cells. There is a special focus on the protection from ionizing radiation, including the relevant legislation related to this subject and the individual principles of protection. The final chapter deals with dosimetry and thus relates to the research conducted in the practical section. The practical section is based on research. The objective of the research was to analyse the values of effective doses and equivalent doses measured in staff working at the Department of Radiodiagnostics and the central operation theatres in Třebíč Hospital from 2011 to 2021. The research sample included 51 staff members working at those departments for the whole ten-year-long period. The participants were divided into categories according to their departments and their job titles. During the period all staff members were monitored by personal film dosimeters produced by VF, a.s. company. The research was based on the data measured during the period in question.
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Evaluation of patient radiation load due to radiodiagnostic examinations
Drobílková, Daniela ; Daneš, Jan (advisor) ; Vrána, Jiří (referee)
The aim of this study is to determination of local diagnostic reference levels for radiodiagnostic examination in the General Teaching Hospital in Prague. Local diagnostic reference levels are used for an evaluation of radiation load which patients receive during medical examinations of specific parts of the human body. The evaluation can be on the level of a hospital and its department or on the level of concrete X-ray machine. The theoretical part describes a ionizing radiation, including its interaction with matter, creating, formation of radiodiagnostic image, legislation during optimization of radiodiagnostic examination, radiological protection and determination of values for radiation dose. The practical part describes the determination of local diagnostic reference levels with the help of entrance surface kerma and the median dose in the mammary gland. Both of these variables are relevant for determination of the risk of adverse effects of ionizing radiation which is applied during radiographic examination. Data for this study was collected with the help of operating diaries and PACS system. It has been rated twenty-six kinds of examinations from twelve mobile and nine stationary (including two mammographs) X-ray machines. All resulting values were statistically processed and compared with...
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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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Polymer carriers for nuclear medicine
Sedláček, Ondřej ; Hrubý, Martin (advisor) ; Smrček, Stanislav (referee) ; Sedláková, Zdeňka (referee)
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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Evaluation of patient radiation load due to radiodiagnostic examinations
Drobílková, Daniela ; Daneš, Jan (advisor) ; Vrána, Jiří (referee)
The aim of this study is to determination of local diagnostic reference levels for radiodiagnostic examination in the General Teaching Hospital in Prague. Local diagnostic reference levels are used for an evaluation of radiation load which patients receive during medical examinations of specific parts of the human body. The evaluation can be on the level of a hospital and its department or on the level of concrete X-ray machine. The theoretical part describes a ionizing radiation, including its interaction with matter, creating, formation of radiodiagnostic image, legislation during optimization of radiodiagnostic examination, radiological protection and determination of values for radiation dose. The practical part describes the determination of local diagnostic reference levels with the help of entrance surface kerma and the median dose in the mammary gland. Both of these variables are relevant for determination of the risk of adverse effects of ionizing radiation which is applied during radiographic examination. Data for this study was collected with the help of operating diaries and PACS system. It has been rated twenty-six kinds of examinations from twelve mobile and nine stationary (including two mammographs) X-ray machines. All resulting values were statistically processed and compared with...
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Investigative algorithm of the gastrointestinal tract
BAUEROVÁ, Anna
Digestive diseases are increasing constantly due to the lifestyle of the people. For that reason number of the people with necessity to have some of the radiodiagnostic examinations of the digestive tract is increasing. The radiodiagnostics is one the fundamental pillars to discover not only cancers, but also other digestive diseases. Every part of the digestive tract has its specific and unique role and may be affected by a disease. A wide range of diseases may be very dangerous given the digestive function importance. So, it is necessary not to underestimate disease signs and to detect the disease at the earliest stages. The bachelor thesis Gastrointestinal tract examination algorithm resumes the methods necessary to early and proper diagnosis of the structural, functional and other diseases. The theoretic part of the bachelor thesis includes an overview of the radiodiagnostic methods used to examine particular parts of the gastrointestinal tract. The direction of the particular digestive tract part description is craniocaudal. Every digestive tract part contains examination progress description, patient preparation and a list of the most common indications. Additionally, the paper includes a chapter about the liver, bile ducts, pancreas and spleen. The bachelor thesis aims are to create algorithms to examine the gastrointestinal tract using radiodiagnostic examination methods along with information leaflets which may make a contribution to patients better knowledge before gastrointestinal tract examination. Quantitative data collection method is used in the practival part. The anonymous questioning method was used to get responded the research questions about the preliminary information of patients before the gastrointestinal tract examination and preference regarding the oral or written form of communication. The questionnare contains 13 closed questions regarding the patient information on the received examinations. The questionnares were answered by the patients receiving a gastrointestinal tract examination at the radiodiagnostic department of the Hospital of České Budějovice a. s. and at another anonymous hospital. In total 66 respondents got the questionnares of which 64 has been returned. Gathered data were evaluated, then sorted and processed into graphical output including descriptions. The results confirmed legitimacy of the initial research question and the fact that patients feel to be enough informed. Nevertheless, there is obvious the information should be continually improved in quality. The results indicate that patients like live interviewing with health care personnel as well as having the written information - leaflets, brochures. This finding also answered the second research question of the thesis. The bachelor thesis output presents a coherent review including the description of radiodiagnostic methods to examine gastrointestinal tract. The results are prepared for the real use in form of leaflets. This means fluoroscopy of pharynge, esophagus, stomach and duodenum, digestive tract, enteroclysis, CT enteroclysis, CT enterography, MRI enterography, irigography, defecography, virtual CT colonoscopy, ultrasonography, ERCP and PTC. The leaflets are aimed to prepare patient for various upcoming examinations completed with adequate psychosocial information. Also the information associated with pain or accompanying person, hospital stay, etc. were included. The leaflets are created to be easy to understand. The leaflets are to avoid specific technical terms as much as possible.
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Measuring of personal doses of radiodiagnostics workers with electronic personal dosimeter.
CHMELÍKOVÁ, Helena
Radiodiagnostics is a relatively young field of medicine the objective of which is imaging of anatomic structures and physiological and pathological processes in order to determine diagnoses or prognoses of diseases. For this purpose radiodiagnostics uses ionizing radiation with both its positive and negative effects. The effects are demonstrated also in healthy cells and healthy tissues of the human organism. A radiation protection system therefore establishes, among other things, limit doses to which individuals working with ionizing radiation may be exposed while performing their jobs. The received doses are kept under control by means of a dosimetric system. Essentially, there are two types of dosimeters: passive and active, i.e. electronic. The purpose of this thesis is to compare results from personal film dosimeters with results obtained from electronic dosimeters DMC 2000 XB made by Merlin Gerin and to determine whether electronic dosimeters are suitable for radiodiagnostics and whether they can replace film dosimeters. I performed the measurements at the radiodiagnostics ward of the hospital Nemocnice Sušice, o.p.s. X-ray assistants in the ward are routinely equipped with personal film dosimeters. In addition to their film dosimeters, they were given personal electronic dosimeters for a period of seven months. They were wearing both types of the dosimeters in compliance with the Decree issued by the State Office for Nuclear Safety (SÚJB) No. 307/2002 Coll., as amended, at the reference place, i.e. on the left upper part of the chest on their clothing. Measurements were conducted on five X-ray assistants and one additional personal electronic dosimeter was used to measure the natural background. I have used results from electronic personal dosimeters to evaluate the collective dose of all workers in the individual months, the total collective dose and the sum of dose equivalents in all months for the individual workers. The collective dose from dose equivalents Hp(10) was stable most of the time and in November and December it was slightly higher. This was due to a higher frequency of surgeries which required presence of an assistant with an X-ray device in the operating room. The highest sum of dose equivalents Hp(10) was found for the worker No. 1 due to his more frequent presence in the operating room. Although the X-ray workers take turns at the workplace regularly they perform their tasks at random. I can definitely exclude that the worker No. 1 was in any way different from the other workers - when it comes to radiation protection all X-ray assistants observe the same principles of radiation protection. For better understanding the thesis also includes information about working activities performed by X-ray assistants. Despite the fact that the measurements using electronic dosimeters several times indicated monthly values of personal dose equivalent Hp(10) higher than 0.1 mSv, the evaluation of the respective film dosimeters from the same period of time indicated values lower than 0.1 mSv or lower than 0.05 mSv. Subsequent investigations have shown that CSOD, s.r.o. is capable of measuring values = 0.01 mSv. The discrepancy between the measured results therefore does not come from the evaluation but from a lower sensitivity of the film dosimeter. The thesis also includes evaluation of advantages and disadvantages of both the types of personal dosimeters. Based on results of the measurements, evaluation of advantages and disadvantages of the two types of personal dosimeters and based on working activities of X-ray assistants I can conclude that the personal electronic dosimeter DMC 2000 XB made by Merlin Gerin is suitable for activities at the radiodiagnostics ward and that it may fully replace the film dosimeter.
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