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Lecturer(s)
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Doležal Jiří, doc. MUDr. Ph.D.
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Course content
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Production of radionuclides. Generators - types, principles, advantages, disadvantages. Cyclotron radioisotopes. Quality control of radiopharmaceuticals - radionuclide purity, radiochemical purity, chemical purity. Sterility and apyrogenity. In vitro methods. Survival of erythrocytes. Localization of destruction of erythrocytes. Survival of thrombocytes. Localization of destruction of thrombocytes. Dilution methods - determining blood volume, determining erythrocyte mass volume, determining plasma volume. Radionuclide examination of kidneys and urinary system. Radiopharmaceuticals used in nuclear nefrology. Clearance techniques - ERPF, TER, and glomerular filtration, separate clearance. Dynamic scintigraphy of kidneys - types of functional curves. Captopril scintigraphy of kidneys. Scintigraphy of transplanted kidney. Static scintigraphy of kidneys. Radioisotope voiding cystography - direct, indirect. Determining bladder residuum. Examination of vascular system. Imaging arterial system using autologous marked erythrocytes. Detection of bleeding into gastrointestinal system. Imaging venous system - detection of deep venous thrombosis. Radionuclide venography. Radionuclide lymfography. Radioimmunoanalysis a radioimmunometry. Ligand + binding substance. Radionuclides used for RIA or IRMA (I 125). Calibration curves RIA a IRMA. Detection possibilities of immunoanalytic methods - hormones, cancer markers, immunoglobulins, ferritin, D-dimers, HAMA, prostaglandins, drugs. Cancer markers. Quality control RIA and IRMA. Static scintigraphy of spleen and liver. Scintigraphy of autotransplanted spleen. Scintigraphy of bone marrow - RES imaging of bone marrow, imaging precursors of granulocytes in bone marrow, imaging of haematopoietic component of bone marrow. Indication and Clinique interpretation. Dynamic scintigraphy of liver and bile duct system - radiopharmaceutical, performance, evaluation. Determining ejection fraction of gallbladder. Examining resorption of substances in small intestine - vitamin B12 - Schilling test. Measurement by total body detector. In vitro methods of examination. Dilution principle. Blood volume. Survival of erythrocytes. Static scintigraphy. Examination of thyroid gland and parathyroid gland. Accumulation test. Radionuclide perfusion and ventilation examination of lungs. Static scintigraphy of liver and spleen. Isotope lymphography. Dynamic scintigraphy. Fázová scintigrafie ledvin. Furosemid's test. Static scintigraphy of kidneys. SPECT of kidneys. Venography of lower limbs. Dynamic scintigraphy of the gullet, scintigraphic evaluation of stomach evacuation. Scintigraphy of skeleton - total body bone scintigraphy, three-phase bone scintigraphy, static scintigraphy of skeleton, SPECT of spine, Dynamic scintigraphy of liver and bile duct system, EF of gall bladder.
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Learning activities and teaching methods
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Monologic (reading, lecture, briefing), Demonstration, Skills training
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Learning outcomes
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The aim of the subject is to acquaint students with history and development of radionuclide functional and imaging methods, and their position within current diagnostic and therapeutic algorithm. This subject discusses in detail individual radionuclide imaging methods, health state and pathological findings in planar and dynamic scintigraphy, single photon emission computed tomography (SPECT, SPECT/CT) and positron emission computed tomography (PET, PET/CT) according to particular organ systems. The subject provides practical knowledge of operating devices used in nuclear medicine, e.g. scintillation detector, scintillation gamma camera, SPECT, SPECT/CT, PET, PET/CT. The subject also focuses on use of therapeutic radionuclides in medicine (treatment of painful bone metastasis, thyroid cancer, hyperthyroidism, endocrine ophthalmopathy, etc.). Last but not least, the subject deals with effects of ionizing radiation on organism and protection against it.
Student will gain competence to independently perform radionuclide examining and treatment methods, operate a gamma camera SPECT, SPECT/CT, PET/CT, provide treatment by radionuclides, and dispose of radioactive waste.
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Prerequisites
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unspecified
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Assessment methods and criteria
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Oral examination
mandatory 80% participation in seminars credit (test) oral examination (debate)
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Recommended literature
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APPELBAUM D. et al. Nuclear Medicine. USA, New York: Thieme Medical Publisher, 2012.
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BENNETT P., OZA U. D. et al. Diagnostic Imaging: Nuclear Medicine. Philadelphia, USA: Elsevir, 2016. ISBN 978-0-323-37753-9.
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BLODGETT TM. et al. Speciality Imaging - PET/CT. USA, Salt Like City: Amirsys, 2009.
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FANTI S. et al. Atlas of SPECT-CT. Berlin: Springer, 2011.
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CHERRI SROV et al. Physics in Nuclear Medicine. USA, Philadelphia: Elsevier Saunders, 2012.
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CHRISTIAN PE. et al. Nuclear Medicine and PET/CT. USA, Philadelphia: Elsevier Mosby, 2011.
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KAMINEK, M.; LANG, O.; TROJANOVÁ, H. Nukleární kardiologie. Praha: Galen, 2008. ISBN 978-80-7262-481-2.
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LIN CL. et al. PET and PET/CT. USA, New York: Thieme Medical Publisher, 2009.
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MORTON K. A., CLARK P. B. et al. Diagnostc Imaging: Nuclear Medicine. Salt Lake City, Utah: Amirsys, 2007. ISBN 978-1-416-03339-4.
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VOTRUBOVÁ J. et al. Klinické PET a PET/CT. Praha: Galen, 2009.
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ZIESSMANN H. A., O'MALLEY et al. Nuclear medicine. Philadelphia, USA: Elsevier/Saunders, 2014. ISBN 978-0-323-08299-0.
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