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Computer tomography (CT) - colonundersökning är en undersökning som ökar alltmer på grund av att coloncancer blir mer uppmärksammat i dagens samhälle. Vid en CT-colonundersökning krävs det förberedelser som måste utföras för att undersökningen ska gå att genomföra. Det krävs en tydlig information till patienten så att denne förstår innebörden av förberedelserna. Syftet med studien är att undersöka om information som patienterna får ta del av inför en CT-colonundersökning är tillräcklig, samt jämföra om patienternas upplevelse av informationen skiljer sig åt mellan två olika sjukhus och om det finns någon skillnad mellan ålder och kön. Även undersöka om det finns förbättringsförslag hos patienterna. Designen på studien var en kvantitativ enkätstudie med egenkonstruerade påståenden. Studien innefattade 51 deltagare som fick fylla i enkäten anonymt mellan perioden mars till april 2018. Majoriteten av deltagarna hade ett gott intryck av informationen och fann den därmed som tillräcklig. Mellan männen och kvinnorna fanns ingen skillnad i upplevelse av informationen. Enkätsvaren visade på att det inte råder någon skillnad mellan åldersgrupperna. Få deltagare hade åsikter om eventuella förbättringsområden men av de deltagare som velat utveckla informationen var det "minska mängden information" som flest deltagare funnit som en potentiell förbättring till patientinformationen. Resultatet visade att deltagarna var nöjda med informationen och att det inte fanns någon signifikant skillnad mellan sjukhusen, kön eller ålder. / Computer tomography (CT) - colonography is an examination which is on the rise since coloncancer is more common and acknowledged in todays’ community. In conjunction with a CT-colonography the preparations are demanding and requires the patients' full compliance to get a successful examination. This means that the patient needs a comprehensive information leaflet to understand the extent of the preparations. This study's purpose was to examine if the patient information was sufficient enough in conjunction with the CT-colonography and determine if the experience of the patient information differ between the two hospitals. Also examine if there were and differences genders between each other as well as age. The study will also overhaul if there were any improvement proposals. This study's design followed a quantitative survey with own constructed questions. The number of participants were 51 which filled the survey anonymously during the period March to April 2018. The majority of the participants had a good impression of the information. Between the men and the women there were no differences of the information, the survey answers also showed that the ages was no differnce based on age of the subjects. Few participants had any opinions about improvements but the ones who had wanted to evolve the information in a way that decreased the amount of information. The participants were pleased with the information and there was no significant difference between the two hospitals, gender or age.

Bakgrund: I magnetisk resonanstomografi (MR) är kontrastmedel baserat på gadolinium vanligast. Den senaste forskningen har visat att gadolinium kan lagras långvarigt i hjärnvävnad. Röntgensjuksköterskan administrerar vanligtvis kontrastmedlet till patienten vid undersökningen.  Syfte: Syftet är att belysa deponering av gadolinium i hjärnvävnaderna nucleus dentatus och globus pallidus efter administrering av gadoliniumbaserade kontrastmedel samt eventuella risker till följd av deponeringen. Metod: Litteraturstudien inkluderar 16 vetenskapliga artiklar varav den äldsta artikeln är från 2014. Sökningen av artiklarna gjordes via Jönköpings högskolebibliotek och har kvalitetsgranskats av författarna. Resultat: Deponering i hjärnvävnad kunde påvisas bland linjära gadoliniumbaserade kontrastmedel. Liknande mätning med makrocykliska kontrastmedel gav ej samstämmiga resultat. Risker av deponeringen kunde ej påvisas. Slutsats: En litteraturstudie som belyser deponeringsrisker kring användandet av gadoliniumbaserade kontrastmedel. Verksamma röntgensjuksköterskor bör ha kunskap om dessa deponeringsrisker vid administrering av gadoliniumbaserat kontrastmedel.

Orientador: Sonia Marta Moriguchi / Resumo: O câncer de mama é o tipo mais comum entre as mulheres no Brasil e no mundo, com 28% de novos casos a cada ano. O diagnóstico tardio pode identificar carcinoma de mama localmente avançado (CMLA) que necessita tratamento sistêmico quimioterápico pré-operatório que visam reduzir o tamanho do tumor e da carga tumoral. A quimiorresistência pode estar relacionada à expressão de glicoproteína P (GpP), que promove o efluxo celular da droga, diminuindo o tempo de permanência da droga na célula e, consequentemente a apoptose celular. O sestamibi-99mTc utilizado na realização da cintilografia de mamas (CM) é um substrato dessas proteínas, similar às drogas quimioterápicas, sendo o único método de imagem a representar o tempo de permanência dessa droga. O índice preditor da resposta quimioterápica por cintilografia tem sido utilizado para prever o tempo de permanência dessas drogas nessas células. O objetivo desse estudo foi verificar se o índice preditor de resposta quimioterápica neoadjuvante obtido por cintilografia de mamas com sestamibi-99mTc proposto por Alonso e cols. relacionou-se com resposta quimioterápica do estudo anatomopatológico da mama pós-cirurgia (AP), considerado padrão ouro, analisando-se os índices isolados: índice precoce (IP) e índice tardio (IT) e associados (IP+IT). Tratou-se de estudo transversal, observacional e descritivo, com coleta retrospectiva de dados de prontuários de portadores de CMLA atendidas nessa Instituição no período de 2012-2017, que foram subm... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Breast cancer is the most common cancer among women, both in Brazil and globally, with 28% of cases each year being new. Delayed diagnosis can identify locally advanced breast carcinoma (LABC), which requires preoperative systemic chemotherapy that aims to reduce the size and load of the tumor. The chemo-resistance may be related to expression of glycoprotein P (GpP) that promotes cellular efflux of the drug, diminishing not only its time within the cell but consequently cellular apoptosis. Sestamibi99mTc, utilized in performing scintimammography (SMM), is a substrate of these proteins, similar to chemotherapeutic drugs, being the only imaging method to represent the permanence time of this drug. The predictive index of chemotherapeutic response by SMM has been utilized to predict the permanence time of chemotherapeutic drugs into these cells. This study aimed to verify whether the predictive index of neoadjuvant chemotherapeutic response, obtained by SMM with sestamibi99mTc proposed by Alonso and colleagues, is related to the chemotherapeutic response, as shown by postoperative anatomopathological study of the breasts (AP), considered the gold standard, analyzing the isolated indices, early index (EI) and late index (LI), and associated index (EI+LI). This was a transversal, observational and descriptive study, with retrospective data collected from charts of patients who were carriers of LABC attended at this Institution in the period from 2012 to 2017, that were submitted ... (Complete abstract click electronic access below) / Mestre

Bakgrund: Prostatacancer diagnostiseras oftast med en prostatabiopsi ledd utav ett transrektalt ultraljud (TRUS). Magnetisk resonanstomografi kan också användas för att upptäcka prostatacancer och en diagnos kan sedan ställas utifrån bildtagningen. Vanligare är dock att MR används som underlag inför en biopsitagning gjord med TRUS där MR-kameran används för att lokalisera misstänkt patologiska områden i prostatan och på så sätt bestäms ett lämpligt insticksställe för biopsin. Syfte: Att undersöka MR-kamerans sensitivitet vid prostatacancer, både vid enbart bildtagning och vid MR-ledd biopsi. Metod: En systematisk litteraturstudie genomfördes där 12 artiklar granskades och sammanställdes till ett resultat i form av tabell. Resultat: Studierna visar en hög sensitivitet hos MR för att upptäcka både allmän och signifikant prostatacancer.   Slutsats: Resultatet från detta arbete visar att MR har en hög sensitivitet för prostatacancer och kan därför med stor säkerhet upptäcka patologiska områden inom prostatan. MR-bilderna kan även med fördel användas som ett effektivt diagnostiseringsverktyg av allmän och signifikant prostatacancer, särskilt i samband med transrektalt ultraljud. / Abstract: Prostate cancer is most often diagnosed by a prostate biopsy led by a transrectal ultrasound. Magnetic resonance tomography can also be used to find prostate cancer, and a diagnosis can then be made from the images. More commonly MRI is used as a basis for a biopsy done with TRUS where the MRI is used to localise suspected pathological areas in the prostate and in this way a suitable biopsy spot is chosen. Purpose: To examine the sensitivity of the MRI-camera for prostate cancer, both for imaging alone and for MRI-led biopsy. Method: A systematic literature review was performed where 12 articles were examined and compiled into a result presented as a chart.   Result: Shows a high sensitivity with MRI for finding both unsignificant and significant prostate cancer.   Conclusion: The results from this study shows that MRI has a high sensitivity for prostate cancer and can with great accuracy discover pathological areas in the prostate. The MRI images can advantageously be used as an effective diagnosing tool for general and significant prostate cancer, a specially combined with transrectal ultrasound.

Les maladies cardiovasculaires représentent la première cause de mortalité dans le monde, et un tiers de ces décès sont causés par la maladie coronaire et la rupture de plaques d'athérome vulnérables. L'altération hétérogène de la microcirculation coronaire est un phénomène précoce lié à de nombreux facteurs de risque cardiovasculaire qui peut fortement présager du développement ultérieur de la maladie coronaire, et conduire à l'apparition d'une hétérogénéité de la perfusion myocardique. La médecine nucléaire permet l'étude de la perfusion myocardique en routine clinique grâce à la réalisation de scintigraphies après injection d'un traceur radioactif du débit sanguin coronaire. L'analyse des images scintigraphiques de la perfusion permet actuellement le dépistage de l'ischémie myocardique, mais la capacité de la technique à mesurer l'hétérogénéité de la perfusion dans des zones apparemment normalement perfusées est inconnue. La première partie de cette thèse porte sur une étude clinique rétrospective visant à déterminer la faisabilité de la quantification de l'hétérogénéité de la perfusion du myocarde mesurée par tomographie d'émission monophotonique (TEMP) au Thallium-201 chez des patients diabétiques par rapport à des sujets sains. L'étude clinique a démontré la capacité du Thallium-201 en imagerie TEMP de routine à quantifier une hétérogénéité de la perfusion du myocarde plus importante chez des patients diabétiques par rapport à des individus normaux. La seconde partie de cette thèse teste l'hypothèse que l'hétérogénéité de la perfusion du myocarde pourrait être quantifiée en imagerie du petit animal TEMP au Thallium-201 et/ou au Technetium-99m-MIBI par une étude expérimentale chez deux modèles animaux de diabète, et serait en corrélation avec des altérations histologiques. L'absence de différence d'hétérogénéité de la perfusion myocardique entre les animaux diabétiques et contrôles suggère que les modèles animaux sont peu adaptés, ou que la technologie actuellement disponible ne semble pas satisfaisante pour obtenir des résultats similaires à l'étude clinique. / Cardiovascular diseases are the leading cause of mortality worldwide, and third of these deaths are caused by coronary artery disease and rupture of vulnerable atherosclerotic plaques. The heterogeneous alteration of the coronary microcirculation is an early phenomenon associated with many cardiovascular risk factors that can strongly predict the subsequent development of coronary artery disease, and lead to the appearance of myocardial perfusion heterogeneity. Nuclear medicine allows the study of myocardial perfusion in clinical routine through scintigraphic scans performed after injection of a radioactive tracer of coronary blood flow. Analysis of scintigraphic perfusion images currently allows the detection of myocardial ischemia, but the ability of the technique to measure the perfusion heterogeneity in apparently normally perfused areas is unknown. The first part of this thesis focuses on a retrospective clinical study to determine the feasibility of myocardial perfusion heterogeneity quantification measured by Thallium-201 single photon emission computed tomography (SPECT) in diabetic patients compared with healthy subjects. The clinical study has demonstrated the ability of routine thallium-201 SPECT imaging to quantify greater myocardial perfusion heterogeneity in diabetic patients compared with normal subjects. The second part of this thesis tests the hypothesis that the myocardial perfusion heterogeneity could be quantified in small animal SPECT imaging by Thallium-201 and/or Technetium-99m-MIBI in an experimental study using two animal models of diabetes, and is correlated with histological changes. The lack of difference in myocardial perfusion heterogeneity between control and diabetic animals suggests that animal models are poorly suited, or that the technology currently available does not seem satisfactory to obtain similar results as the clinical study.

BACKGROUND: Although the Image Quality (IQ) indices calculated by objective Model observers contains more favourable characteristics compared to Figure Of Merits (FOM) derived from the more common subjective evaluations of modern digital diagnostic fluoroscopy units, like CDRAD or the Leeds test-objects, practical issues in form of limited access to unprocessed raw data and intricate laboratory measurements have made the conventional computational methods too inefficient and laborious. One approach of the Statistical Decision Variables (CDV) analysis, made available in the FluoroQuality software, overcome these limitations by calculating the SNR2rate from information entirely based on image frames directly obtained from the imaging system, operating in its usual clinical mode.      AIM: The overall aim of the project has been to make the proposed Model observer methodology readily available and verified for use in common IQ tests that takes place in a hospital based on simple measuring procedures with the default image enhancement techniques turned on. This includes conversion of FluoroQuality to MATLAB, assessment of its applicability on a modern digital unit by means of comparisons of measured SNR2rate with the expected linear response predicted by the classical Rose model, assessment of the methods limiting and optimized imaging conditions (with regard to both equipment and software parameters) and dose-efficiency measurements of the SNR2rate/Doserate Dose-to-information (DI) index including both routine quality control of the detector and equipment parameter analyses.      MATERIALS AND METHODS: A Siemens Axiom Artis Zee MP diagnostic fluoroscopy unit, a Diamentor transmission ionisation chamber and a small T20 solid state detector have been used for acquisition of image data and measurements of Air Kerma-area product rate (KAP-rate) and Entrance Surface Air Kerma rate (ESAK-rate without backscatter). Two sets of separate non-attached test-details, of aluminium and tissue equivalent materials respectively, and a Leeds test object were used as contrasting signals. Dose-efficiency measurements consisted of variation of 4 different parameters: Source-Object-Distance, Phantom PMMA thickness, Field size and Dose rate setting. In addition to these, dimensions of the test details as well as computational parameters of the software, like ROI size and number of frames, were included in the theoretical analyses.      RESULTS: FluoroQuality has successfully been converted to MATLAB and the method has been verified with SNR2rate in accordance with the Rose model with only small deviations observed in contrast analyses, most likely reflecting the methods sensitivity in observing non-linear effects. Useful guidelines for measurement procedures with regard to accuracy and precision have been derived from the studies. Results from measurements of the (squared) DI-indices indicates comparable precision (≤ 8%) with the highest performing visual evaluations but with higher accuracy and reproducibility. What still remains for the method to compete with subjective routine QC tests is to integrate the SNR2rate measurements in an efficient enough QA program.

Inledning: Miktionsuretrocystografi (MUCG) är en röntgenundersökning som används vid diagnostisering av vesikoureteral reflux på barn. Undersökningen är både fysiskt och psykiskt påfrestande och för barn kan det upplevas som en ångestfylld undersökning. Föräldrarna har en viktig roll vid undersökningen och röntgensjuksköterskan behöver ha kunskap om hur barnens ångest kan lindras för att kunna hjälpa föräldrar att stötta sina barn. Syfte: Syftet med denna litteraturöversikt var att belysa faktorer som kan minska ångest hos barn inför och under en MUCG-undersökning. Metod: Studien genomfördes som en allmän litteraturöversikt. En systematisk litteratursökning i databaserna PubMed och CINAHL utfördes. Tolv vetenskapliga artiklar vilka svarade på syftet valdes ut till kvalitetsgranskning, analyserades därefter och resultatet av detta identifierades i kategorier. Resultat: Ur dataanalysen identifierades tre kategorier som beskriver faktorer som kan minska barns ångest; information och förberedelser, vuxnas påverkan på barnet och alternativa metoder. Konklusion: Information och förberedelser samt påverkan från föräldrarna har en stor betydelse för barns ångest. Genom ökad förståelse för dessa faktorer kan röntgensjuksköterskan stötta både barnen och föräldrarna under undersökningen samt medverka till utformning av nya rutiner. / Introduction: Voiding cystourethrogram (VCUG) is an x-ray examination that is used to diagnose vesicoureteral reflux in children. The examination is both physically and mentally stressful and for children it can be experienced as an anguished examination. Parents have an important role in the examination and the radiographer needs to know how children's anxiety can be eased in order to help parents support their children. Children’s anxiety can be demonstrated in several ways during the examination, which may complicate the diagnosis. Purpose: The aim of this literature review was to highlight factors that may reduce anxiety in children before and during a VCUG examination. Method: The study was performed as a literature review. A systematic literature search in the databases PubMed and CINAHL was performed. Twelve scientific articles which replied to the aim of this study were collected for quality review, then those articles were analyzed and the result were divided into categories. Results: From the data analysis three categories were identified to describe factors that can reduce children’s anxiety; information and preparation, adult influence on the child and alternative methods. Conclusion: Information and preparation as well as the influence of parents have great importance to children’s anxiety. Through increased understanding, the radiographer can support both the children and parents during the examination and also contribute to the design of new routines.

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