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Hello, my name is Mard Ladd and I am head of the Department of Medical Physics in Radiology

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here at the German Cancer Research Center and our department is concerned with medical imaging

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in medicine and I would like to briefly explain today what the role of physics is in these imaging techniques.

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The occasion is the International Day of Medical Physics.

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This is a day that has been organized by the International Organization for Medical Physics

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and it is celebrated every year on November 7.

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Why? Because on this day in 1867 Marie Curie

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was born in Poland and she is a very prominent

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personality in medical physics. So she did

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band press research on radioactivity, discovered a

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polonium and was awarded the Nobel Prize in Physics for it in 1903

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as the first woman and even won a second Nobel Prize

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for Chemistry in 1911 and is therefore the only person

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who ever won the prize, the Nobel Prize in two different fields

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has. The German Cancer Research Center was founded in 1964

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and has been a member of the present-day consortium since 1975.

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This consortium is a network of various research centers financed by

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by the Federal Ministry of Education and Research, 8 in number, distributed throughout Germany.

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They deal with different topics, energy, health,

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Materie and AmdekarZett, we have over 3000 employees,

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where we are running for 400 scientists and researchers.

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The research at AmdekarZett is organized into five research areas.

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One research area is cell and tumor biology. Then we have

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cancer risk factors and prevention. Today, we are talking about the research area

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imaging and radio-oncology, because our department is embedded in this research area

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Yes, what kind of imaging modalities are there in medicine? I think

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most of you will know about torahs, and maybe some of you have even received a torah or another torah picture,

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maybe from the tens. Then there are other methods, such as computer tomography,

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magnetic resonance tomography and position in emission tomography.

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These procedures have the term “tomography” at the end because they all provide thin slices

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through the body, if you want to compare it with the upcoming whole-body imaging, which is a

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image through the entire body. Everything is superimposed and

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we can't see how deep something lies, but with a

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CT, where it is also based on Rundgen, we can see exactly where we are in the

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body. Imaging is extremely important in

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of modern conology, so about 13% of all deaths

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are due to cancer. And imaging plays a role

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in all treatment steps, e.g. in screening and prevention.

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It's about detecting cancer before symptoms even

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show up. A good example of this is Bruce-Krings,

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screening, then it's about detecting when symptoms are already present. We have to

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certain where-in-body that is Tummer. But we also have to

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decide whether the tumor has spread, whether there is a stasis

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or whether the tumor has grown beyond the organ, beyond the boundaries. And that

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Staging, then it's about the actual treatment

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or TRP and at the end the Naxorge. That means that if someone

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has ever had cancer, they will have regular imaging tests,

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to confirm that Klaus has not yet returned.

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If you look at how many examinations are done with which procedure

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you click on a similar distribution to the one shown here, which is

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data from Italy in 12/2012 and they are not

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cancer are sieved, but generally, if they are round chin and car scarf are very widespread,

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they are also very good for footbaths and many practices, and then there are the expensive methods,

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as always TCT and position, immission Tummer, which are used less frequently

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and are less for Fübbar. In industrial learning,

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the proportion of MTCT and so on is higher. This is simply

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procedures are very expensive and also require very good training of the personnel.

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You can categorize the procedure in different ways,

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one possibility is to see, yes, what kind of painting is used to shield magnetic beams.

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Here we see that magnetic beams are listed according to their

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nucleus frequency or wavelength. You can also see the energies of

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the individual photons. And the MT works in a

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range, say at around 100 MHz, so in

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the radio frequency or high-frequency range. Optical methods work

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with build or light or with light, which is at the Internet

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is, of itself, then there is the X-ray

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procedure, communication, X-ray, but computer tomography also works

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with it, and at the end we also have nuclear medicine

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procedures such as position emission spect, tomography or single-photon mission tomography spect.

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I have included X-ray and nuclear medicine procedures in red,

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because here we are dealing with the union and series of radiation. This means that when the photons pass through the

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body, they can go directly to the DNA packaging, for example,

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for causes and to lead to death.

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That's why you can even see with X-rays, cause cancer,

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whereby with modern imaging procedures, the dose,

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what you get is very low, so it plays a minor role

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One area that is not

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included here is the range of terahertz, imaging

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or millimeter, imaging, because the wavelength in the millimeter range is

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and the procedures are not used in medicine

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used, at least not frequently used here, because I have a very low depth of penetration

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have. However, most people will be familiar with this talk

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at the airport, where you have to put your arms above your head.

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And then something rotates around the body, and usually these talks work with

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ter heart, imaging, that is, they can see an over-inflated bottle of body,

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but not what lies deep inside the body.

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One procedure that is not listed here is Utrischau imaging, because Utrischau imaging

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does not work directly with electromagnetic radiation, but with muscharnischen waves,

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that is, this is a vibration with a high frequency in the fabric

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introduced. And the frequencies are in the range of, let's say, one is

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a mag heart to 20 mag hearts. And therefore you need a physical

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medium where these waves can be conducted,

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and you must not have strong differences in the tissue

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parameters. That means, if you do an ultrashort imaging

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a Geil is smeared on, what between the Schalkopf and the body.

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The air is pushed away so that you don't see these strong reflections at the air layer.

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We don't have enough time to go through all the procedures, but I would like to follow the

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in four short presentations and start with X-rays. This was invented in 1895

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by Mr. Röntgen in November. And I ask you to

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to keep this in mind for a moment, because this procedure

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spread extremely rapidly worldwide. They very quickly

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in the following few years, it was also used for full body examinations.

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Here we see a few examples where we can see that the person is still clothed

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because we can see the boots, the chains

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and rings worn. It was very easy

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realized that you can't just fatten up one image, but a series of images

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very shortly after each other. This is possible with X-rays. And that leads

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to the possibility of making films. And here we can see someone playing the violin or

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someone who is here and swallows. This swallowing procedure

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is still interesting medicine today. And X-rays

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was also used not only in the medical field, but

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it has found its way into shoe stores, for example, where it is then used to

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could tell whether a shoe was too big or too small. You wouldn't do that with Freizeitag

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you wouldn't do that, but you would feel with your hand whether the shoe fits well.

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But that was the kind of gimmick that was to be found in shoe stores back then.

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At that time, no one knew how damaging wonder could be. And today, of course, something like that is

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forbidden. In medicine, you have to be aware of this date: November

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55. But the first medical examination took place

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on January 19, 1896. And this

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investigation in the USA. And it was

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a fracture in the arm. And you

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you see, the quality is not great, but at least you could do something like that.

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And you have to change that, that's at this point,

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it was not possible for the first to look inside the body without cutting open the body.

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You could maybe look at papers from the outside. And identify a tumor or something

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find a problem, but really look inside without

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destroying something, that was not possible at that point in time. For example, we were

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the right of Bitcoinity, which you get within a few milliseconds. So

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back then you had to record for minutes because they only had milliseconds for days.

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The round procedure is useful, but as I mentioned earlier, you get a

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image, which is an overlay of all structures. And with computer tomography,

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you can overcome this problem and then obtain individual slices,

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from the body, which is very thin, one millimeter to five millimeters, let's say. And with that,

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it is possible to see exactly where a structure is located. This is helpful for shoes,

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if you also want to operate. This is shown here as an overview, so I

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seen, an image where everything is superimposed, and then we see the course of you in

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the picture, in the vertebrae, where the heart can be seen very well

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but also this lesion here in the lung. And the first computer tomographs were

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in the 7th year and they started with very

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simple structures to experiment with how these images could be generated.

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And then you quickly found other setups

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where you can examine patients. And this foundation of geometrics

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has been preserved to this day. And I will explain in a moment how it works.

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This is a modern computer tomography, as we use it for example

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the Cape Time. And within this device,

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there is a round generator, on one side of the opening, or on the other

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side, there is at least one row of detectors, usually several rows, and

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to create an image, this round generator,

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around which the body rotates. And you record data continuously, and from these different

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perspectives, it is possible to reconstruct a crash image.

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You can understand this in a simplified way,

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by thinking of round holes. You take a projection image from the front, and you

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you see, maybe there's a depth somewhere, a lesion. And then

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you take a second projection from the side of the body. And

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then you can see how deep this lesion lies. And if you then take this

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360-degree rotation around the body and calculating all this data together,

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you can get a cross-section image. This is a video where we will see

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how it works. Live, so in this so-called gantry,

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we have the detectors on this side. This is the main circuit, so to speak, to the structure. And then on

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on the other side, we have a round generator from the source. And then you just

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you just need to push this, this object, the patient, or in this case a test subject, through this opening

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And then you can take more leshifts very quickly. Let's

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take a look at that.

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That's already rotating relatively fast, but if you set motion to

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set a heartbeat, for example. Who knows if it can go even faster. And we

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will see how this gantry silences it. * Music

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* You can tell

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that it happens very quickly, so it only takes a few seconds to record a few body parts

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In the beginning it wasn't that fast. And the resolution wasn't that high either,

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because you can see here the progress that has been made over the years. And

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this also went hand in hand with the further development of computers,

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because you need a lot of computing power to record so much data, and

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then to reconstruct and process it. So today,

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it is possible to take the entire body in a few seconds. This

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shot in 25 seconds, for example, and that at a

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very high resolution. This is not usually done because of the risk of

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exposure, but for certain clinical pictures it is full. And

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just shows how the progress has been. So that

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we come to the position in emissions's graph. And this is a

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to drive imaging results, which are based on radioactivity, to get back to

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the record. And unlike computer tomography,

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where the source is outside, we will see in the position in emission geography

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that the source is actually entered into the body

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and that the beam comes out of the body. And the basic idea is that you

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somehow a radio-tivist substance in, say, an armband is,

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radiation that spreads throughout the body, you might wait an hour. It is

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absorbed by the tumors in the body. This radioactive

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floor-iso-top will fall into oxygen,

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and gives off a positron and a neutrino. And

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a positron is more or less an electron, but with a positive charge,

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it's a kind of anti-material. And as soon as it finds an electron somewhere,

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the two will cancel each other out and become

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which then decay into two photons. And

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these two photons, these gamma photons, come out of one of them at 180 degrees

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other coming out of the body. And that is the basis

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for this imaging. So as I said, we don't have an external source, as in the case of round genders. That

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means that we now have a detector that covers the entire body. And the

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source decays somewhere here in the center of the body. And it emits two

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gamma photons. And we then know that if we have a photon here

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and a photon here. That somewhere along that line, the source

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must be. Well, that's not particularly helpful for a decay process

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not particularly helpful, but if you imagine that there will be millions

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of photons that will be exposed. And that

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these lines kept overlapping right here at this point,

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where the source is located. Imagine how you could calculate an image from this.

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And this is an example of a picture where you can see

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okay, this one glows in this heart. But what's a problem are these lesions

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here, so these are all cancer lesions. Yes, what radioactive substances

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are injected. So in any case, we need something like floor aksing, but this vor aksing

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is associated with some chemical substance. A common example in

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of the PET imaging is glad that there is a sugar monacule and it is

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so that in the morning you take in more sugar because that is a very

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primitive, inefficient metabolism and therefore need a lot of sugar to grow.

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And another example is something that is a bit larger and more complicated.

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Is this molecule here. This is the so-called P sma, or post-translational

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membrane association. And that is utilized

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for patients with cancer, because it is very good for finding metastases in the body

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find metastases in the body. Here is the image again that I showed earlier, which was before the

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therapy, it's about a Lumpon. Then the therapy

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you can see that the patient is responding very well to the therapy because all the lesions are regressing.

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There is less activity, which is recorded. And after the end of therapy,

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you see that almost everything has disappeared, that it is a very good

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sign. And then you could re-evaluate that patient in six months,

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to confirm that the cancer has remained in remission. And that was the position

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in the emission domain, now we come to the magnet, the resonance tomography. Why is MRI so

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often used? First of all, it has the option of accessing these kraschnetz images.

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But as we have seen, this can also be done with CT or PET. But in

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MRI, we have a very high contrast. That means the same

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to CT, if you take an image from here and, the difference between gray and white

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material is much greater. And that usually means you can

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also cover pathologies better in synthesis. Another

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reason for the MRI is that it has no E-uniser of the stranding. That means we can repeat the examination

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repeated as we like without any danger to the patient. Yes,

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MRI is also in the 70s, and then especially in the Axelgören.

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Introduced. Nowadays there are about 50,000 MIT systems,

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because far more than 100 million examinations are carried out annually.

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The magnetic field strength that you will find in a clinic today is 1.5 Tesla. And

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now there are a lot of 3 Tesla systems. And a few

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locations in Germany also have 7 Tesla systems that are clinically approved, the first

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were clinically approved in 2017. And the image quality is

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which has improved over time. Yes, this is an example from 1977

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of one of the 1.1. images. And the question is, what is that? It took

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4.5 hours to record it at all. And you can maybe

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androids, okay, that's probably the outer

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edge of the body. We have two black areas here, which are the

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lungs, because the lungs have a lot of air, and air cannot be represented with MIT.

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And that means that this is the heart. And today we see

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you can see that you can record in a few seconds

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in a few seconds, with much better quality. You can display the beating heart,

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which has also been recorded in HD, although that's not really

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the case, but you just assume that the heart is in a Zuglisch

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and you can then stitch the image data at these different points in time to

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heart closed. That means this image was recorded over 20 seconds.

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And you can see a 1.5-tassel system up here,

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3-tassel system, not much different than compared to the

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CT, which I had shown earlier, except that this opening is slightly smaller. And

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the talk lasts longer than with

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PET or with computer tomography. And that is also something that I, since

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the first devices had a diameter of 50 centimeters. For the opening,

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then came devices with 60 centimeters. That is still the standard

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technology, when it comes to devices with very high performance, so for the best image quality. Then with

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the 2000s, devices with 70 centimeters aperture came onto the market

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and recently, a device with an 80-centimeter opening was introduced. And at

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80 centimeters, which is very similar to a CT or a PET device. So that's one

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today's complainant of patients, in the MRI, the claustrophobia is that they already

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don't like it, but with these modern, more open devices, it's easier to get them to accept it.

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What do we usually measure with MRI?

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we look at hydrogen? Hydrogen is the most abundant element in the body. And

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it's very abundant in water, for one thing, but also

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in fat. And when you look at an MRI image, you will usually look at

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water and fat. If you look at a water molecule, you have

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two hydrogen atoms. And these

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atoms have a charge, a positive charge, and have a property,

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called spin. That means they rotate around their own axis and by

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because of this spin, you can see that the people are a little bit like magnets. And

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when you don't have an external magnetic field, these little magnets are all randomly oriented. But when

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you put the body into a strong magnetic field, then the little

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magnets in the body all line up. Line up with the external magnetic field's

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oriented. And unfortunately it is the case that the

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thermal energy in the body is a bit against it. So

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that only very, very few more

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Spinz in plan, the magnetic field will show a surge in the opponent's magnetic field

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direction. But it is still enough to take a measurement. And

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if you shine radio frequency, or radio waves, with a certain resonance frequency,

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you can tip this spin out of balance. And in the

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transverse plane, and with an external coil,

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you can detect an induced voltage.

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So maybe you know this, when you turn a magnet.

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Near an electric coil, a voltage can be induced

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in the coil. This is exactly the principle of the sky temple.

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I said earlier that the Himmerte is popular because it has no Ehne in the tension. Therefore

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I don't for the patient, however, we must still pay attention to things. And that

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primary, the primary danger, that this great attraction

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of the magnets, these magnets are significantly stronger than, for example, the magnets on a shopping center,

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which are used to lift cars. And you can see here how this coil, from

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the magnet has been drawn in. And now the two gentlemen are trying to remove this coil

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*Music*

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Therefore, when you have an MIT examination, it is very important that

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you take all magnetic objects out of your pockets. And you want to tell the staff that you are wearing implants

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in the body, that you announce it to the staff, so that they can decide

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whether it is safe to carry out the examination. Well,

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just as with CT imaging, the images have steadily

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better, and what is a great strength of magnetic resonance imaging,

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The great strength of magnetic resonance imaging is the ability to take images with different contrasts.

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The two basic contrasts are so-called T1-gibbstob images, or T2-gibbstob images. These

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T1-T2 times are properties of the tissue and

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they also vary between different types of tissue. And also,

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are also different between healthy tissue and pathologies. Therefore

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you can use it to detect diseases in the blankets. And a third contrast,

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what is important is the fork of a contrast agent through the wines. This is usually Gottlinie in

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And these contrast agents are not able to

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usually, across this brain barrier to cross, however, in the case of

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a tumor or stroke behavior. So on, this barrier is no longer

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disappointed. And that's why we'll see that these contrast agents accumulate

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in the affected area. Nowadays, MRI is often

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used for various issues, especially for many pathologies

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in the brain, many tumors in the abdominal pelvis, vascular diseases,

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if you are planning a trip, if you are likely to have an MRI, for example,

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heart examinations and so on. Another area is secondary prevention,

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what is secondary prevention, is the early detection of a disease

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before it shows itself in a tumor. And then you can examine the whole body

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scan the whole body and try to detect certain diseases early on.

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However, there are now many other contrasts beyond T1 and T2,

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I mentioned earlier, but you can also show the magnetic

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sitting stability of tissue. You can show the orientation

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of the nerve phases in the brain, which can be done using

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Brownian motion, so-called defusion imaging, is used, and

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other methods in covers, with which one can also detect proteins. And

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there are not only hydrogen nuclei, which are MRI, but also other nuclei,

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we can take, for example phosphorus, or there is a certain isotope of oxygen,

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or there is a certain isotope of oxygen, or there is a certain isotope of oxygen, or there is a certain isotope of oxygen, or there is a certain isotope of oxygen, or there is a certain isotope of oxygen, or there is a particular isotope of oxygen, or there is a particular isotope of oxygen, or there is a particular isotope of oxygen, or there is a particular isotope of oxygen, or there is a particular isotope of oxygen, or there is a particular isotope of oxygen,

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or there is a certain isotope of oxygen, or there is a certain isotope of oxygen,

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or there is a certain isotope of oxygen, or there is a certain isotope of oxygen,

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or there is a certain isotope of oxygen, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain isotope, or

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there is a certain isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain isotope, or

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there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain

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00:38:36,800 --> 00:38:42,800
isotope, or there is a certain isotope, or there is a certain isotope, or there is a

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particular isotope, or there is a particular isotope, or there is a particular isotope, or there is a

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particular isotope, or there is a particular isotope, or there is a particular isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain

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00:39:08,400 --> 00:39:14,933
isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain isotope,

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or there is a certain isotope, or there is a certain isotope, or there is a certain isotope, or there is a certain

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isotope, or there is a certain isotope, or there is a certain isotope, or there

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there is a certain isotope, or there is a certain isotope, or a certain isotope, or

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a certain isotope, or a certain isotope, or a certain isotope, or a certain isotope, or a certain isotope,

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or a particular isotope, or a particular isotope, or a particular isotope, or a particular isotope, or

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a particular isotope, or a particular isotope, or a particular isotope, or a particular isotope, or a particular isotope,

365
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or a particular isotope, or a particular isotope, or a particular isotope, or a particular

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isotope, or a certain isotope, or a certain isotope,

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or a particular isotope, or a particular isotope, or a particular

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isotope, or a particular isotope, or a particular isotope, or a particular

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isotope, or a particular isotope, or a particular isotope, or a particular

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00:40:44,100 --> 00:40:50,100
isotope, or a certain isotope, or a certain isotope, or a certain

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00:40:50,766 --> 00:40:57,266
isotope, or a particular isotope, or a particular isotope, or a particular

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00:40:57,300 --> 00:41:03,933
isotope, or a particular isotope, or a particular isotope, or a particular

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isotope, or a particular isotope, or a particular isotope, or a particular

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isotope, or a particular isotope, or a particular isotope, or a particular

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00:41:16,800 --> 00:41:22,833
isotope, or a particular isotope, or a particular isotope, or

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00:41:22,866 --> 00:41:28,899
a particular isotope, or a particular isotope, or a particular

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00:41:28,900 --> 00:41:35,433
isotope, or a certain isotope, or a certain isotope, or a certain

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isotope, or a particular isotope, or a particular isotope, or a particular isotope, or a particular isotope,

379
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or a certain isotope, or a certain isotope, or a certain

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isotope, or a particular isotope, or a particular isotope, or a particular

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00:41:54,833 --> 00:42:01,566
isotope, or a particular isotope, or a particular isotope, or a particular

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isotope, or a certain isotope, or a certain isotope, or a certain isotope, or

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a certain isotope, or a certain isotope, or a certain isotope, or a certain isotope,

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00:42:14,200 --> 00:42:20,433
or a particular isotope, or a particular isotope, or a particular isotope, or a

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particular isotope, or a particular isotope, or a particular isotope, and the

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show the role of physics in this.