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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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Composition of atomic nucleus. Radioactivity - units, half-life. Types of ionizing radiation - alpha, beta, gamma. Positron radiation. Interaction of ionizing radiation with matter. Photoelectric effect. Compton scattering. Excitation. Ionization. Physical characteristics of frequently used radionuclides in nuclear medicine - energy, type of emitted radiation, half-lifes. Energy spectrum. Ionizing radiation detectors. GM detectors. Ionization chambers. Semiconductor detectors. Scintillation detectors - design of scintillation probes. Photomultipliers - principle, design. Well counters. Geometry of measurement. Spectrometry. Energy spectrum. Scintigraphy - principle of scintigraphic imaging. Absorption and scattering of radiation. Scintillation cameras. Scintillation detector, NaI(Tl) crystal. Planar scintigraphy - static, dynamic. Emission tomography - SPECT. Hybrid systems SPECT/CT, PET/CT. Filtered back projection. Iterative reconstruction. Collimators - design, types, principles for selecting collimator. Quality control and phantom scintillation measurements - homogeneity of visual field, measurement with planar and point irradiator. Resolution of the camera - Jaszczak phantom. Relation of scintigraphy and other imaging methods - common features and differences between scintigraphy, x-ray, CT. Layout of nuclear medicine workplace from the point of view of radiation protection. Declaration of a controlled area, movement of patients and staff. Preparation of radio-pharmaceuticals. Storage and disposal of radioactive waste. Radioactive wastewater tanks. Workplace categories. Czech Act no. 18/1997 Coll. on Peaceful Utilisation of Nuclear Energy and Ionising Radiation (the Atomic Act) + Subsequent regulatory decrees on requirements to ensure radiation protection. Programme of nuclear medicine workplace monitoring - dose rate measurement, surface contamination measurement xenon beta + gamma detector. Personal monitoring - personal dosimetry principle, effective dose, units, personal film badge dosimeters, thermoluminescent ring dosimeters and personal dosimeters, digital dosimeters. Liquid and solid Waste monitoring. External contamination - surface contamination, origin, measurement of decontamination. Internal emergency plan. Internal contamination - measurement, scintillation measurement of thyroid uptake - examination and intervention levels for I 125 a I 131. Prevention of internal contamination. Policy of staff radioactive protection, work organization of a nuclear medicine department, protection aids (aprons, instruments, shields). Radiation load in radioisotope examination. Division of radio-pharmaceuticals according to radiation risk. Application of radio-pharmaceuticals to children - selection of applied activity according to EANM, radiation load in children. Threshold and recommended doses. Application of radio-pharmaceuticals in women of child-bearing potential and pregnant women.
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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.
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Prerequisites
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Student will acquire capability to provide independently radionuclide examination and treatment methods, operate gamma camera, SPECT, SPECT/CT, PET/CT, apply treatment using radionuclides and dispose of radioactive waste.
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Assessment methods and criteria
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Oral examination, Home assignment evaluation
Completion of compulsory 80% attendance at the practicum sessions and seminars.
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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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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-.
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KORANDA, P.; MYSLIVEČEK, M. et al. Nukleární medicína v endokrinologii a terapie otevřenými zářiči. Olomouc: Vydavatelství Univerzity Palackého, 2002.
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KUPKA, K.; KUBINYI, J.; ŠÁMAL, M. et al. Nukleární medicína. Praha: Nakladatelství P3K, 2007.
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LIN CL. et al. PET and PET/CT. USA, New York: Thieme Medical Publisher, 2009.
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MYSLIVEČEK, M.; KORANDA, P. et al. Nukleární medicína v diagnostice nádorů a zánětů. Olomouc: Vydavatelství Univerzity Palackého, 2002.
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VOTRUBOVÁ J. et al. Klinické PET a PET/CT. Praha: Galen, 2009.
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ZIESSMAN HA et al. Nuclear Medicine - TheRequisitis. USA, Philadelphia: Elsevier Mosby, 2006.
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