Dr. Hla AungDr. Hla Aung

Department of Radiology & Imaging Department of Radiology & Imaging

Mandalay General HospitalMandalay General Hospital

MandalayMandalay

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Mandalay map

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Historical BackgroundHistorical Background(Radiology)(Radiology) After 2After 2ndnd World War World War

Department of Radiology was founded in Mandalay Department of Radiology was founded in Mandalay General Hospital.General Hospital.

The available services in this department areThe available services in this department are 1.Plain X-ray/ Dental X-ray1.Plain X-ray/ Dental X-ray 2.Contrast studies2.Contrast studies 3.Radiological intervention3.Radiological intervention 4. CT 4. CT 5. Ultrasonography5. Ultrasonography

6. MRI6. MRI 7. Mammography7. Mammography

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19601960 FluoroscopyFluoroscopy Plain tomogramPlain tomogram

19711971 Dental X-rayDental X-ray

19791979 Ultrasonography – Aloka SSD 256Ultrasonography – Aloka SSD 256

19971997 Ultrasonography – Sonoace 1500Ultrasonography – Sonoace 1500

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20002000•Computed Tomography Computed Tomography

SHIMADZU SPIRAL SCT. 6800 TXSHIMADZU SPIRAL SCT. 6800 TX

20022002•Colour Doppler UltrasoundColour Doppler Ultrasound

ATL HDI 3500ATL HDI 3500

20032003•LITHOTRIPTOR (ESWL)LITHOTRIPTOR (ESWL)•MAMMOGRAPHY – MAMMOGRAPHY – SOPHIE CLASICSOPHIE CLASIC

•DSADSA

20042004•MRIMRI

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Historical BackgroundHistorical Background(Nuclear Medicine)(Nuclear Medicine)

19631963 Department of Nuclear Medicine was founded in Department of Nuclear Medicine was founded in

Yangon General Hospital.Yangon General Hospital.

19651965 The first expertise service received.The first expertise service received. Organ uptake studies, flow rate measurement and Organ uptake studies, flow rate measurement and

basic haematological testsbasic haematological tests

19661966 Rectilinear ScannerRectilinear Scanner

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19681968 Three probe scintillation detector systemThree probe scintillation detector system Scintigraphy and renographyScintigraphy and renography

19741974 A gamma well counter with automatic sample changer A gamma well counter with automatic sample changer

and printer, liquid scintillation counterand printer, liquid scintillation counter Dr. L. Kertez (Agency Expert)Dr. L. Kertez (Agency Expert)

• In-house preparation of liver agentIn-house preparation of liver agent• Organ imaging studiesOrgan imaging studies

19751975 Japanese government – a gamma camera (Nuclear Japanese government – a gamma camera (Nuclear

Chicago)Chicago) 19821982

Radioimmunoassay (RIA)Radioimmunoassay (RIA)• Thyroid related hormones, cortisol and sex hormonesThyroid related hormones, cortisol and sex hormones

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19871987 JICA JICA

• A fully equipped Nuclear Medicine Unit at New Yangon A fully equipped Nuclear Medicine Unit at New Yangon General HospitalGeneral Hospital

19981998 Ministry of HealthMinistry of Health

• A new Department of Nuclear Medicine in Mandalay A new Department of Nuclear Medicine in Mandalay General HospitalGeneral Hospital

19991999 A post-graduate diploma course in Department of A post-graduate diploma course in Department of

Nuclear Medicine, YGH.Nuclear Medicine, YGH.

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LocationLocation

Lower MyanmarLower Myanmar Yangon General Hospital (YGH) - Yangon General Hospital (YGH) - 1500 bedded1500 bedded New Yangon General Hospital (NYGH) - New Yangon General Hospital (NYGH) - 200 bedded200 bedded North Okalapa General Hospital (NOGH) - North Okalapa General Hospital (NOGH) - 500 bedded500 bedded Thingangyun Sanpya Hospital (TSH) - Thingangyun Sanpya Hospital (TSH) - 200 bedded200 bedded

Upper MyanmarUpper Myanmar Mandalay General Hospital (MGH) - Mandalay General Hospital (MGH) - 800 bedded800 bedded

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Instrumentation in Nuclear Instrumentation in Nuclear Medicine Medicine

Yangon General HospitalYangon General Hospital Siemens E.Cam Dual head SPECT Siemens E.Cam Dual head SPECT

Gamma CameraGamma Camera GE 400T SPECT Gamma CameraGE 400T SPECT Gamma Camera Thyroid probeThyroid probe Gamma well countersGamma well counters

New Yangon General HospitalNew Yangon General Hospital Hitachi dual head Gamma CameraHitachi dual head Gamma Camera

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North Okalapa General HospitalNorth Okalapa General Hospital MB 9100 Gamma Muvek Gamma CameraMB 9100 Gamma Muvek Gamma Camera Probe counterProbe counter

Thingangyun Sanpya HospitalThingangyun Sanpya Hospital Hitachi Gamma CameraHitachi Gamma Camera

Mandalay General HospitalMandalay General Hospital Siemens E.Cam Single head SPECT Siemens E.Cam Single head SPECT

Gamma CameraGamma Camera Captus 600 Thyroid uptake Probe counterCaptus 600 Thyroid uptake Probe counter Gamma well counterGamma well counter

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Instrumentation in Instrumentation in Radiology Department Radiology Department

Yangon General HospitalYangon General Hospital Conventional X-ray machineConventional X-ray machine Fluoroscopy X-ray & AngiographyFluoroscopy X-ray & Angiography UltrasoundUltrasound MammogramMammogram CT & MRICT & MRI

Mandalay General HospitalMandalay General Hospital Same as aboveSame as above

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Organization chart ofNuclear Medicine Department

A ss is tan t P h ys ic ian

Tech n o log is tIn - vivo

S ta ff N u rse

Tech n o log is tIn - vivo

Tech n o log is tIn - vitro

P h ys ic is t

A ss is tan t P h ys ic ian A ss is tan t P h ys ic ian

C on su ltan t

L ec tu re r / C on su ltan t

P ro fessor/ H ead

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Organization chart ofRadiology Department

A ss is tan t R ad io log is t

R ad iog rap h er

S ta ff N u rse

R ad iog rap h er R ad iog rap h er

C h ie f R ad iog rap h er

A ss is tan t R ad io log is t A ss is tan t R ad io log is t

C on su ltan t

L ec tu re r / C on su ltan t

P ro fessor/ H ead

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Clinical Services in Nuclear Clinical Services in Nuclear MedicineMedicine

In-vivo diagnosticIn-vivo diagnostic

Organ imagingOrgan imaging•StaticStatic•DynamicDynamic

Functional StudiesFunctional Studies•ThyroidThyroid•RenalRenal

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In-vitro diagnosticIn-vitro diagnosticHormonesHormones

•Thyroid related hormonesThyroid related hormones•Sex hormonesSex hormones•Cortisol, ProlactinCortisol, Prolactin

Tumor markersTumor markers•CEA, TgCEA, Tg•CA-153CA-153

Therapeutic drug monitoringTherapeutic drug monitoring•Serum level of cyclosporineSerum level of cyclosporine

EnzymesEnzymes•MicroalbuminuriaMicroalbuminuria

TherapeuticTherapeutic•131131I therapy in the treatment of thyrotoxicosis and well I therapy in the treatment of thyrotoxicosis and well differentiated thyroid carcinomas. differentiated thyroid carcinomas.

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IAEA (RCA) ProjectIAEA (RCA) Project Thematic program on Health Care ( Asia and Pacific Thematic program on Health Care ( Asia and Pacific

Region)Region) Breast cancerBreast cancer

• ScintimammographyScintimammography• RIA of CEA, CA-153RIA of CEA, CA-153

Diabetic nephropathyDiabetic nephropathy • RIA of microalbuminuriaRIA of microalbuminuria

Myocardial Perfusion ScintigraphyMyocardial Perfusion Scintigraphy Neonatal Hypothyroid ScreeningNeonatal Hypothyroid Screening

InstrumentationInstrumentation TelemaintenanceTelemaintenance Upgrading of GE Camera and Gamma Muvek cameraUpgrading of GE Camera and Gamma Muvek camera

• Pip softwarePip software Upgrading of probecountersUpgrading of probecounters

• Uptake softwareUptake software• Renogram softwareRenogram software

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Clinical Services in Radiology Clinical Services in Radiology DepartmentDepartment

In diagnosticIn diagnostic Organ imagingOrgan imaging

• StaticStatic• DynamicDynamic

In therapeuticIn therapeutic TAETAE

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Outcome of the trainingOutcome of the training

Proposal to the higher authorities for purchase of Proposal to the higher authorities for purchase of PET. PET.

Confident that the Ministry of Health will agree Confident that the Ministry of Health will agree with my request.with my request.

With the knowledge gained from this training With the knowledge gained from this training course; able to manage the PET technologies.course; able to manage the PET technologies.

Technical assistance and know-how are Technical assistance and know-how are expected to be received from KOICA & expected to be received from KOICA & ARCCNM co-operation program or Inter ARCCNM co-operation program or Inter government agreement.government agreement.