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Imaging methods in the diagnosis of pulmonary embolism
KUBEŠOVÁ, Karolína
The bachelor´s thesis consists of theoretical and practical parts. In the theoretical part, the reader gets acquainted with the definition and method of genesis of pulmonary embolism. Furthermore, in the work there is given a division into clinical categories, symptoms of pulmonary embolism, its treatment and prevention. An important part of this work is the diagnosis of this disease, which includes laboratory methods as well as imaging ones. The work aims to determine the advantages and disadvantages of the mentioned imaging methods. This enables us to find out the guidelines and studies that compare individual imaging methods. Using a research question, we want to ascertain which of the imaging methods is used most in the hospital in České Budějovice. The Nuclear Medicine and the Radiology Departments provided me with data showing the total number of examinations in the years 2016 to 2020. For each individual year, a graphical representation was prepared comparing the number of examinations in these departments. Furthermore, their percentage was calculated. This processing and subsequent comparison of data enables us to determine which imaging method used to diagnose the pulmonary embolism is indicated more often by the doctors.
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Development of the number of the whole body skeletal scintigraphy in recent years (in the context of the number of PET and the numbers of patients with prostate, breast, and lung cancer)
KINSKÁ, Jana
This bachelor thesis deals with development of the number of the whole-body skeletal scintigraphy in recent years in the context of the numbers of PET and the number of patients with prostate, breast and lung cancer. The aim of this thesis is to give an overview of the development of the number of the whole-body skeletal scintigraphy in connection with the number of PET and the number of patients with prostate, breast and lung cancer from selected Departments of Nuclear Medicine since 2010. This thesis focuses on one particular question: "Has the number of the whole-body skeletal scintigraphy increase during the years?". The defined aim has been fulfilled and the question asked has been answered. The overview of the development of the number of the whole-body skeletal scintigraphy and of the numbers of PET, PET/CT scans was obtained by means of quantitative research in 13 Departments of Nuclear Medicine in the Czech Republic. The overview of the number of patients with prostate, breast and lung cancer is based on data available from the Institute of Health Information and Statistics of the Czech Republic. The results of the research show that the development of the number of the whole-body skeletal scintigraphy has a clear downward tendency during the evaluated years. An upward trend is observable in the course of the evaluated years in development of the number of PET, PET/CT scans compared to the skeletal scintigraphy. The upward development is also evident in the number of patients with prostate, breast and lung cancer in the evaluated years. For this reason, the PET, PET/CT scan is increasingly used as the number of patients with prostate, breast and lung cancer increase. This is a possible conclusion from the results generated. This examination is very suitable and very often used for their diagnosis, the measurement of the extent of cancer, but also for the evaluation of the therapy's efficiency and the possibility of relapse.
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Accumulation 99mTc-pertechnetate in the thyroid gland
BARTOŠ, Štěpán
The objective of this bachelor thesis is to answer the following research question: "What is the extent of normal values of Technetium-99m accumulation in the thyroid gland?" I gained the answer by collecting data and subsequently assessing results of static scintigraphy of thyroid gland examined in 34 patients at the Department of Nuclear Medicine in the hospital Nemocnice České Budějovice. The reference file of patients was collected from January to December 2017. On the basis of clinical data on the examination request form, the supervisor excluded results that showed symptoms of hypothyroidism, hyperthyroidism or thyroiditis. The anatomy and physiology of the thyroid gland and parathyroid glands are described in the introduction of the theoretical part of the bachelor thesis. The following chapter characterizes thyroid disorders. The last chapter describes the examination of thyroid gland using methods of nuclear medicine, check-up, radiopharmaceutical drugs used and making and processing an image. The practical part describes the procedure of elaborating my bachelor thesis at the Department of Nuclear Medicine in the hospital Nemocnice České Budějovice. There I worked with evaluating computer program Xeleris with the Thyroid Uptake Index application. I plotted the region of interest around the thyroid gland manually and calculated the value of accumulation in the thyroid gland with a programme. I processed the gained values statistically using formulas to count the average, standard deviation and percentile in Microsoft Excel. I fixed the percentile for 10 % and 90 %. Calculations show that a normal value of Technetium-99m accumulation in the thyroid gland ranges from 0.4 % to 1.8 % and the average is 0.85 %. This work can serve as evaluation of normal values of accumulation during examining thyroid gland at departments of nuclear medicine.
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The role of the radiologist assistant in radionuclide brain examination
Horčičková, Zuzana ; Vlček, Petr (referee) ; Špalková, Ingrid (advisor)
Bachelor's thesis "The Role of the radiotherapist in radionuclide brain examinations" is engaged Nuclear medicine imaging methods in the examination of the brain and the role of the radiotherapist at radioisotope nuclear examination in the brain. The work is divided into nine parts. In the first and second part describes anatomy and physiology of the nervous system. The third part is devoted to regional brain blood perfusion - an examination of brain perfusion and assessment of cerebrovascular reserve capacity, which is described preparation and advance in examination, used radiofarmaceutical, evaluation of SPECT examination and contraindication. For testing cerebrovascular reserve capacity are described options burdens. Furthermore, in this chapter refers to the differential diagnostics of dementia, the detection of epileptic focus, the diagnosis of brain death and diagnostics of brain trauma. The fourth part is direct on receptor diagnostics. With respect to commercially supplied by diagnostic ligand is the most common examination dopamine system. The fifth part deals with 18F-FDG - PET examination of the brain. Distribution and intensity of glucose metabolism in the brain can be visualized. The sixth part deals with the diagnosis of brain tumors. In this chapter described the examination using of SPECT...
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On Validation of Algorithms for Dynamic Medical Data Separation
Tichý, Ondřej
The problem of dynamic medical image sequence separation is studied. We introduced the state of the art algorithms for medical sequence decomposition together with those that are proposed by us. The validation and the comparison of the algorithms are nontrivial and challenging task. We propose to use a synthetic data where a ground truth is available so it is possible to compute a significant statistics for comparison reason. Moreover, we proposed a comparison on 99 real data from renal scintigraphy where relative renal functions are automatically computed and compared with those obtained by physician.
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Evalution of renal function in patient with urinary obstrution
PLOCKOVÁ, Irena
Kidneys, ranking among the most important organs of the human body, have been affected with various diseases. Some of these diseases slow down or completely stop the elimination of urine from the kidneys. In this study, I focused on patients with such problems. A sample of 41 patients with a physiological urine elimination and a disorder of urine elimination was selected from those having visited the Clinic of Nuclear Medicine (CNM) of the University Hospital (UH) in Brno within the period of 3 months. Tmax, T1/2, MTT and a part of single kidney function from the overall renal activity were determined in all these patients. The patients were examined in accordance with the valid SOPs (Standard Operating Procedures) prepared for the personal and instrument conditions of the CNM UH Brno. A dynamic renal scintigraphy was performed under the using of MB 9200 gammacamera with LEAP collimator and DIAG evaluation equipment. After an intravenous application of 75 ? 200 MBq 99mMAG3, we initiated acquisition (1 scintigram in 20 seconds) over a total period of 20 minutes. Tmax, T1/2 and the separated renal function were evaluated as a standard. MTT (Mean Transit Time) was evaluated for the purpose of this study. Based on the acquired data, we compared both groups of patients because the aim of this study was to confirm or disprove the hypothesis saying that Tmax and T1/2 cannot be evaluated in patients with obstructive type of the curve. These values cannot be used to describe the function of renal parenchyma. The used statistical methods have shown that the age is a statistically insignificant parameter, while the statistical significance of Tmax. And MTT was confirmed. Measurement results and conclusions of this study will be used for constitution of new new SOPs for the dynamic renal scintigraphy at the Clinic of Nuclear Medicine of the University Hospital in Brno. Furthermore, the measurement results and conclusions will be published and presented to scientific public at congresses.
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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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Automated Functional Analysis in Dynamic Medical Imaging
Tichý, Ondřej
Dynamic medical imaging is concerned with acquisition and analysis of a sequence of images of the same region of a body during time. In nuclear medicine, each pixel of an image is the sum of particles coming from an applied radioactive tracer from the body in a specific time-interval. Hence, each observed image is a superposition of an unknown number of underlaying organ images. The aim of functional analysis is to separate the images of biologic organs and related time-activity curves from the sequence of images.
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Factor Analysis of Scintigraphic Image Sequences with Integrated Probabilistic Mask of Factor Images
Tichý, Ondřej
Factor analysis is a well established mathematical method for factor separation in the analysis of scintigraphical sequences. The results are typically an input to the next step, e.g. factor analysis for computing significant diagnostic coefficients. However, this computing highly depends on proper identification of factors and their biological meaning, which is not ensure only by factor analysis. The main issue is separation overlaping factors from themselves and from tissue background covering the whole sequence. Factor analysis highly depends on prior information which allows us to set biologically reasonable conditions to a mathematical model. In this paper, we propose a mathematical model which estimates the probability mask of each image factor and sets it as a prior information for the next step of iterative algorithm based on Variational Bayes method. The new proposed model provides more realistic estimates of factors than the standard factor analysis.
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The Scintigrafic detection of inflammation in patients examined in the Motol University Hospital since 2007 to 2009.
BRHEL, Jan
This bachelor?s thesis outlines an attempt to describe, to the professional public, the principles of imaging of inflammation in the human body using the methods of nuclear medicine. Two types of imaging of inflammation are described: scintigraphy of labeled leukocytes in vitro and scintigraphy of labeled leukocytes in vivo. The course of the examination, preparation and use of radiopharmaceuticals, indications, contraindications, imaging, etc. are described for both types of methods. The next section of thesis consists in comparsion and evaluation of the data obtained from the hospital system (UNIS), relating to the above tests in 2007 ? 2009 at the University Hospital in Motol employing European standards in nuclear medicine. The results are presented in the from of tables and graphs. The work was intended to confirm the hypothesis mentioned in the bachelor?s thesis and to create an overall idea of the quantities of these tests. Last but not least, it is useful to compare the competitiveness of nuclear medicine with other imaging methods, such as computer tomography and magnetic resonance imaging.
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