Trauma care is the treatment of patients with injuries caused by external forces, for instance car crashes, assaults or fall accidents. These urgent patients typically arrive at the hospital’s Emergency Department, where they are treated by an interdisciplinary team of physicians and nurses, who collaborate to identify and address life-threatening injuries. In this thesis, the urgent phase of trauma care has been explored through observations of trauma calls and interviews with trauma care professionals, with the purpose of mapping the workflow and providing a basis for a discussion of IT systems within trauma radiology. The professionals, procedures and tools involved are collectively described as the initial trauma care system. There has been a focus on interaction between the units of this system, as well as on how decisions regarding treatment are made, often with the help of medical imaging. The initial trauma care system functions under significant time pressure, striving towards the well-defined objective of saving the life of the patient. To a great extent the system relies on standardized procedures, aiming for screening life-threatening injuries. The trauma team features a clear hierarchy and distinct roles, where the team leader role is considered vital for the team’s performance. Experience is valued and important for everyone, especially since the team often makes decisions, that may affect the future of the patient, based on incomplete information about the situation. Therefore, CT (computed tomography) images offer valuable decision-making support. The respondents are fairly satisfied with the current tools for viewing and manipulating radiological images. Little support for the need of improved or novel IT systems in trauma radiology is found, as is the use for 3D visualization of radiological images in this domain. Informants recognize communication failures and lacking teamwork as the major problems in trauma care. Difficulties like this may be decreased by education and training regarding these issues.

Portal hypertension (PHT) is a condition with serious complications, such as variceal bleeding, refractory ascites and bowel ischemia. The cause of PHT may be pre-, intra- or post-hepatic. Initial treatment is pressure-reducing drugs and the treatment of acute symptoms. Ten patients presented with severe abdominal pain and acute portomesenteric venous thrombosis. Their response to systemic anticoagulation was insufficient. Treatment with primary continuous thrombolysis by a transhepatic or transjugular approach in four patients resulted in major complications, incomplete recanalization and a 75% survival rate. Treatment with repeated transjugular thrombectomy (TT) combined with the creation of a transjugular intrahepatic portosystemic shunt (TIPS) achieved near complete recanalization, prompt symptom relief and 100% survival in five patients treated with this method as the primary intervention. In one patient, treated with TT and TIPS secondary to surgical thrombectomy and bowel resection, the outcome was fatal. Nineteen patients with portal vein thrombosis presented with acute or threatening variceal bleeding or refractory ascites. TIPS was feasible in 16 of the 18 patients in whom it was attempted and symptom relief was achieved in the majority of them. In 14 patients with Budd-Chiari syndrome, 13 patients were treated with TIPS, four of them after previous liver vein angioplasty. The 5-year transplantation-free survival rate was 100% in patients treated with primary TIPS. In 131 patients with variceal bleeding treated with TIPS, the survival at 12 months in patients with and without cirrhosis was 70% and 100% respectively and in accordance with previous studies. A high Child-Pugh score prior to TIPS and severe HE within 12 months after TIPS was related to an increased mortality. The occurrence of HE after TIPS did not correlate with the PSG after TIPS. Re-bleeding within 12 months after TIPS occurred in 10 patients and was associated with TIPS dysfunction. In conclusion, endovascular intervention, mainly TIPS, seems to be safe and effective for treating patients with complications of PHT, regardless of the underlying cause of disease and site of venous blood flow obstruction. HE may occur more frequently after TIPS than medical and endoscopic treatment, but is often mild and easily treated. In selected patients with PHT, TIPS may improve survival.

Amyloid PET imaging with [11C]PIB enabled detection of Aβ for the first time in vivo. However, [11C]PIB is a small molecule that binds only the insoluble Aβ plaque. Rather, the soluble Aβ aggregates are considered the cause of Alzheimer’s disease (AD). As such, a more sensitive and specific PET tracer is needed for tracking longitudinal AD pathology. Soluble Aβ aggregates likely interact with the metabotropic glutamate receptor 5 (mGluR5) to cause neurotoxic effects. However, with [11C]ABP688 PET we were unable to detect aberrant mGluR5 binding in AD mouse models, although we find elevated mGluR5 protein levels with immunoblotting. Antibodies are highly specific large molecules that can bind specifically to soluble Aβ aggregates, thus they can be a good marker for AD pathology. Unfortunately, due to their large size they cannot cross the blood-brain barrier (BBB). However, it is possible to shuttle antibodies into the brain by taking advantage of endogenous transporter systems on the BBB. By creating bispecific antibodies binding both to soluble Aβ aggregates and to the transferrin receptor (BBB target), we successfully transported the antibody into the brain and could visually detect soluble Aβ aggregates with PET. Recombinant expression further improved and optimized antibody design, creating smaller bispecific antibody-based constructs that had better pharmacokinetic properties allowing for earlier PET scanning (1 day instead of 3), and more sensitive signal. Lastly, using TCO-tetrazine click chemistry, we indirectly labeled our antibodies with fluorine-18, and could successfully perform PET already 11 h post-injection with a fluorine-18 labeled antibody.

Den senaste utvecklingen av artificiell intelligens (AI) och djupinlärning (DL) har gjort bild- och funktionsmedicin till en högst trolig kandidat att tidigt anta tekniken. AI inom mammografiscreening syftar till hälsofrämjande effekter genom en förhoppning om säkrare bilddiagnostik. Röntgensjuksköterskans (RSS) arbete präglas av korrekt utförd bildtagning och ett aktivt aktualiserande av den egna yrkesrollen gällande såväl tekniska framsteg som förnyade arbetssätt. Litteraturstudien har upprättats i syfte att belysa potentiella effekter av AI på bilddiagnostik inom mammografiscreening. Genom manifest innehållsanalys av resultat erhållna ur ämnesrelevanta vetenskapliga studier publicerade i databaserna Cinahl och Medline under år 2019–2020 identifierades och beskrevs kategorier sammanställda av subkategorier med liknande innehåll. Effekter inom granskningsprocessen och diagnostisk säkerhet skildrar flera perspektiv gällande AI:s effekter på bilddiagnostik. Utöver en stundtals ökad förmåga till cancerdetektion vid AI-assistans har artificiell bildgranskning även visat sig kunna reducera arbetsbördan för radiologer i form av friskrivning av mammogram med låg sannolikhet för bröstcancer. Vid tillämpning av AI ses lovande effekter inom framförallt klassificering av bröstvävnad samt vid reducering av falska positiva svar. Forskningen förbehålls dock med kvarstående etiska dilemman och avsaknad av ett juridiskt ramverk, vilket lämnar utrymme för vidare studier. / Recent developments in artificial intelligence (AI) and deep learning (DL) have made diagnostic imaging a prime candidate to adopt the technology. AI in mammography screening aims at promoting health with hopes of higher diagnostic accuracy. The radiographers work is characterized by properly performed imaging and actively updating the profession regarding technical developments and renewed working methods. The aim of this systematic review was to illustrate feasible effects of AI on diagnostic imaging within mammography screening. Through manifest content analysis of results obtained from subject related scientific studies published 2019–2020 in the databases Cinahl and Medline the authors identified and described categories compiled by subcategories with similar contents. Effects within the image interpretation process and diagnostic accuracy describes several perspectives regarding the outputs of AI on diagnostic imaging. AI-systems have proven to be useful in both assisting with image interpretation and reducing the workload for radiologists by disclaiming mammograms with low probability of breast cancer. Most promising effects are seen in the classification of breast tissue and reduction of false positives, but research is challenged by ethical dilemmas and the need for a legal framework, which are areas suggested for future research.

SAMMANFATTNING Nyckelord: barnröntgen, patientinformation, röntgensjuksköterska, barnkonventionen Bakgrund: För röntgensjuksköterskor är det utmanande att informera barnpatienter utifrån barnkonventionens riktlinjer, som är svensk lag sedan 2020.  Syfte: Syftet med denna enkätstudie var att ta reda på vilken patientinformation som röntgensjuksköterskan ansåg var viktig att ge till barnpatienter i samband med konventionell skelettröntgenundersökning samt vilka förutsättningar som var viktiga för att kunna tilldela den informationen. Ett ytterligare syfte var att ta reda på om röntgensjuksköterskan hade kännedom om barnkonventionen och dess betydelse i samband med barnröntgenundersökning samt om det fanns någon skillnad mellan röntgensjuksköterskor verksamma på sjukhus A och sjukhus B gällande deras uppfattning om information till barnpatienter.  Metod: En empirisk kvantitativ enkätstudie genomfördes. Urvalet bestod av röntgensjuksköterskor med erfarenhet att utföra konventionella skelettundersökningar på barn. Totalt 35 enkäter analyserades.  Resultat: Som viktigaste information valdes allmän strålsäkerhet och varför barnet ska ligga/sitta stilla. De viktigaste förutsättningarna för att ge information ansågs vara förberedda föräldrar, förberett röntgenlabb samt att vända sig till barnet vid samtal. Majoriteten svarade att röntgenmottagningarna inte erbjöd en barnanpassad miljö och instämde delvis till att kommunikationen skulle underlättas på ett barnanpassat labb. Röntgensjuksköterskorna instämmer till stor del att de har kännedom om barnkonventionens riktlinjer och att dessa har stor betydelse vid barnröntgenundersökningar. Ingen signifikant skillnad visades mellan sjukhusen. Slutsats: Respondenterna från sjukhusen enades om att viktigast att informera om var strålsäkerhet och vikten av att vara still. Röntgenmottagningarna ansågs inte ha en barnanpassad miljö. Röntgensjuksköterskornas kännedom om barnkonventionen behöver ständigt aktualiseras och diskuteras i vårdsammanhang. / ABSTRACT Key words: pediatric radiography, access to information, radiographer, Convention on the Rights of the Child Background: It is challenging for radiographers to inform pediatric patients based on the guidelines of the Convention on the Rights of the Child (CRC), Swedish law since 2020.  Purpose: The purpose was to find out what radiographers from two hospitals considered to be important information and conditions for providing it to pediatric patients undergoing x-ray examinations. The aim was also to investigate whether the radiographers carry knowledge of the CRC and its significance regarding child radiographs as well as to compare the perception of radiographers from hospital A and B on what information is of importance. Method: An empirical quantitative survey study was made.The sample included radiographers experienced in performing x-ray examinations of children. In total 35 surveys were analyzed.  Results: Information about general radiation safety and why the patient should keep still was considered most important.  The main conditions for providing information were considered to be a prepared lab, prepared parents and paying attention to the child. The majority replied that radiology clinics did not offer a child-friendly environment. The radiographers broadly agree that they are aware of the CRC’s guidelines and that these are of great importance in x-ray examinations. No significant difference was shown between the hospitals. Conclusion: Respondents agreed that informing pediatric patients about radiation safety and the importance of being still is most important. Radiology clinics were not considered to have a well-adapted environment. Radiographers’ knowledge of the CRC needs to be constantly updated.

Syfte: Att beskriva den organisationsförändring som fem röntgenkliniker i Sverige genomgick i samband med att radiologin digitaliserades. Frågeställningar: Hur förändrades antalet genomförda radiologiska undersökningar och undersökningstyper från tidpunkten två år före digitaliseringen till två, fyra och sex år efter digitaliseringen? Hur förändrades antalet arbetade timmar och fördelningen av arbetade timmar mellan de olika personalkategorierna från tidpunkten två år före digitaliseringen till två, fyra och sex år efter digitaliseringen? Hur förändrades arbetsuppgifterna inom och mellan de olika personalkategorierna på röntgenklinikerna efter digitaliseringen? Hur beskriver personal med en nyckelfunktion genomförandet av digitaliseringen och eventuell förändring av arbetet efter digitaliseringen? Metod: Kvantitativ och kvalitativ metod har använts och kombinerats för att besvara studiens frågeställningar. Fem svenska röntgenkliniker ingick i studien och material avseende produktionsutfall samlades in från respektive röntgenklinik. Totalt intervjuades 22 personer, med tre till sex intervjuer per röntgenklinik. Teoretiska ramverk: För att försöka förstå de positiva fynden, avseende utökade antalet undersökningar och minskning av arbetade timmar, efter digitaliseringen, genomfördes vid en av röntgenklinikerna en fallstudie med ytterligare två frågeställningar: Hur genomfördes digitaliseringen? Hur har uppföljningen vad avser arbetsflöden, genomförandet och förändringar i detalj genomförts efter digitaliseringen? Delar av Bramson m.fl. (2005) perspektiv och Kotter och Cohens (2002) framgångsfaktorer har applicerats vid analysen av det resultatet. Resultat: Samtliga röntgenkliniker uppvisade en liten ökning av antalet radiologiska undersökningar, medan datortomografi- och magnetkameraundersökningarna ökade markant under den studerade tiden. Efter digitaliseringen genomförs således fler komplicerade undersökningar, vilket anses ha medfört en kvalitativt bättre och säkrare diagnosticering. Övriga undersökningstyper uppvisar varierande resultat. Vid tre av röntgenklinikerna minskade den totala arbetade tiden, och vid två ökade den. Antalet arbetade timmar ökade för röntgenläkare och röntgensjuksköterskor, men minskade för sekreterare och undersköterskor under den studerade tiden. Generellt utför röntgenläkarna och röntgensjuksköterskorna fler arbetsuppgifter efter digitaliseringen, och många av de traditionella arbetsuppgifterna för sekreterare och undersköterskor har försvunnit eller tagits över av datorn. Bättre tillgänglighet, förhöjd kvalitet och utökad diagnostik, tydligare arbetslistor som styr arbetsflödet, förbättrad ergonomi och miljö samt samordning med andra har möjliggjorts efter digitaliseringen. Utifrån intervjuerna i fallstudien framkom teman som beskriver: information, superanvändare, utbildning, tydliga arbetsflöden och rutiner, personalbehov och motivation, liksom ett tydligt ledarskap som genomsyrat förändringsprocessen. Dessa teman är, enligt Bramson och Bramson (2005) och Kotter och Cohen (2002), viktiga att beakta för att lyckas med en förändring. Konklusion: Ingen av de intervjuade vill återgå till ett analogt arbetssätt. Digitaliseringen har inneburit att mycket förändrats för de berörda personalkategorierna, men fördelarna anses uppväga nackdelarna. För att lyckas med en förändring bör Bramsons perspektiv och Kotters framgångsfaktorer tas i beaktande. / Background: Since Wilhelm Conrad Röntgen’s discovery of X-rays in 1896, radiology has undergone great changes. In Sweden, the process of digitalisation radiology was initiated in the mid 1990s. Aim: To describe the organisational changes that took place in five radiol- ogy clinics in Sweden in connection with the digitalisation of radiology. Study questions: How did the number and type of radiological examinations change when comparing two years before with two, four and six years after digitalisation? How did the number and distribution of hours worked change among different staff categories when comparing two years before with two, four and six years after digitalisation? How did the duties change after digitalisation within and between different staff categories at the radiology clinics? How do staff members in key positions describe the implementa- tion of digitalisation and any changes in their professional prac- tice after digitalisation? Method: Quantitative and qualitative methods were combined in order to answer the study questions. Five Swedish radiology clinics took part in the study, and production outcome data were gathered from each clinic. A total of 22 individuals were interviewed, with three to six interviews per radiology clinic. In order to gain an understanding of the positive results at one of the radiology clinics in terms of the increased number of exami- nations and reduction in the number of hours worked after digitalization a case study was conducted at this clinic, in which two questions were posed: How was the digitalisation carried out? How were workflow, im- plementation and changes followed up in detail after digitalisation? Ele- ments of Bramson and Bramson ́s (2005) perspectives and Kotter and Cohen’s (2002) success factors were applied. Findings: All radiology clinics had a small increase in the number of radio- logical examinations, while computed tomography and magnetic reso- nance imaging examinations increased significantly during the period un- der investigation. Thus, more complex examinations were carried out post digitalisation, a fact considered to have led to qualitatively better and safer diagnoses. The total working time was reduced at three clinics, while two exhibited an increase. The total number of hours worked increased for radiologists and radiographers but decreased for secretaries and assistant nurses. In general, radiologists and radiographers performed more tasks post digitalisation, and many of the traditional duties of secretaries and assistant nurses were eliminated or taken over by the computer. Digitalisa- tion enabled greater access to radiological images and patient data in addi- tion to improved quality and diagnostics of the radiological examination. Digitalisation also allowed a better-controlled workflow, as well as im- proving ergonomics, the environment and the coordination with other clinics. The case study interviews revealed themes describing: information, super users, education, clear work flows and routines, staff needs and motiva- tion as well as clear leadership throughout the change process. According to Bramson and Kotter, these themes are important for successful change. Conclusion: None of the individuals interviewed wished to return to the analogue mode of working. The digitalisation led to great changes for the different staff categories, with the advantages outweighing the disad- vantages. To succeed with change, Bramson’s perspectives and Kotter’s success factors should be taken into consideration.

Introduktion: Barnmisshandel är ett problem som ökat senaste tiden och kan visa sig påolika sätt. Den fysiska barnmisshandeln innefattar ofta frakturer. För att kunna härleda frakturer till barnmisshandel behöver röntgensjuksköterskan ha kunskap om frakturernas utseende och dess placering. Syfte: Studiens syfte var att kartlägga frakturer och dess lokalisation som indikerar på fysisk barnmisshandel. Metod: Denna studie är en allmän litteraturöversikt. Utifrån syftet har tio artiklar analyserats och kategoriserats. Resultat: Studien kunde påvisa olika typer av frakturer som ofta var förekommande vid barnmisshandel. Dessa kategoriserades in i thorax, extremiteter, huvud och multipla frakturer. Det konstaterades bland annat att vänstersidiga frakturer, särskilt vid förekomst av revbensfrakturer, var överrepresenterade vid misshandel av barn under 18 månader. Små barn har dessutom högre risk att drabbas av skallfrakturer i samband med misshandel än äldre barn samt att de oftare har fler än en fraktur. Slutsats: Det finns frakturer som kan sättas mer i samband med barnmisshandel än andra. Genom ökad kunskap om dessa frakturer kan röntgensjuksköterskan lära sig att uppmärksamma dessa i tid och förhoppningsvis förhindra ytterligare misshandel av barnet. Om konventionell röntgen är rätt metod kan ifrågasättas då en datortomografi lättare kan upptäcka frakturerna. Det behöver dock vidare forskning av områden där det är svårt att avgöra om det rör sig om en fraktur eller inte. / Introduction: Child abuse is a problem that has increased recently and can manifest itself in different ways. Physical child abuse often involves fractures. To trace fractures related to child abuse, the radiographer needs to have knowledge of the appearance of the fractures and their location. Aim: The aim of the study was to map fractures and their location that indicates physical child abuse. Method: This study is a general literature review. Based on the purpose, ten articles have been analyzed and categorized. Results: The study was able to identify different types of fractures that were common in child abuse. These were categorized into thorax, extremities, head, and multiple fractures. It was found, among other things, that left-sided fractures, especially in the presence of rib fractures, were overrepresented in the abuse of children under 18 months. In addition, young children are at higher risk of suffering from skull fractures in connection with abuse than older children and that they more often have more than one fracture. Conclusion: There are fractures that can be associated more with child abuse than others. Through increased knowledge of these fractures, the radiographer can learn to pay attention to these in time and hopefully prevent further abuse of the child. Whether conventional X-ray is the right method can be questioned as a computed tomography scan can more easily detect the fractures. However, it needs further research of areas where it is difficult to determine whether it is a fracture or not.

Prostatacancer är den vanligaste cancerformen hos män. Prostatan tillhör de manliga reproduktionsorganen och producerar bland annat prostataspecifikt antigen (PSA) som kan påvisas i blodet. Förhöjda värden av PSA kan bero på prostatacancer. Transrektalt ultraljuds (TRULS)-ledda systematiska biopsier används i högre frekvens än magnetkamera med riktad biopsi. Röntgensjuksköterskans möte med dessa patienter är före, under och efter bildtagningen med magnetkameran. Syftet var att göra en översikt av den diagnostiska träffsäkerheten för TRULS-ledda systematiska biopsier och magnetresonans (MR)-undersökning med riktade biopsier vid misstanke om prostatacancer. Metoden bestod av en litteraturöversikt med systematisk ansats. Inkluderingskriterier var vetenskapliga artiklar skrivna mellan 2015–2020. Artiklarna skulle vara peer-reviewed och etiskt granskade. Databasen Medline användes till sökningen. Kvalitetsgranskning gjordes med granskningsprotokoll hämtade från Avdelningen för omvårdnad på Hälsohögskolan. I resultatet inkluderades 15 artiklar som visade att skillnaden i den diagnostiska träffsäkerheten för prostatacancer hos män inte var stor mellan metoderna. Däremot hittade MR-undersökning med riktade biopsier större andel kliniskt signifikanta cancrar och mindre del insignifikanta cancrar än vad TRULS-ledda systematiska biopsier gjorde. MR-undersökning med riktad biopsi är en bra metod för att öka träffsäkerheten att hitta kliniskt signifikant cancer. Dock går det inte utesluta TRULS-ledda systematiska biopsier då kontraindikationer och missade cancrar på MR-undersökning med riktade biopsier förkommer. / Prostate cancer is the most common cancer in men. The prostate belongs to the male reproductive organs and produces, among other things, prostate-specific antigen (PSA) that can be detected in the blood. Elevated levels of PSA may be due to prostate cancer. Transrectally ultrasound (TRULS)-guided systemic biopsies are used at higher frequency than magnetic cameras with directed biopsy. The X-ray nurse's meeting with these patients is before, during and after the imaging with the magnetic camera. The aim was to make an overview of the diagnostic accuracy of TRULS guided systematic biopsies and MRI with targeted biopsies on suspicion of prostate cancer. The method consisted of a literature review with systematic approach. Inclusion criteria were scientific articles written between 2015-2020. The articles would be peer-reviewed and ethically approved. The Medline database was used for the search. Quality review was done with review protocols obtained from the Department of Nursing at the School of Health. The result included 15 articles showing that there was no big difference in the diagnostic accuracy of prostate cancer in men between the methods. In contrast, MRI with targeted biopsies found a greater proportion of clinically significant cancers and a smaller proportion of insignificant cancers than TRULS guided systematic biopsies did. MRI with targeted biopsy is a good method for increasing the accuracy of finding clinically significant cancer. However, TRULS guided systematic biopsies cannot be ruled out as contraindications and missed cancers on MRI with targeted biopsies occur.

Bakgrund: Den snabba spridningen av COVID-19 viruset har inneburit förändringar i röntgensjuksköterskors arbetsmiljö, men det finns inte många studier kring röntgensjuksköterskans arbetsmiljö under en pandemi.  Syfte: Studiens syfte var att belysa hur röntgensjuksköterskor upplever sin arbetsmiljö under pågående pandemi. Metod: En kvalitativ forskningsmetod användes i denna studie och data samlades in via en enkätundersökning. Urvalet var riktad till röntgensjuksköterskor som urvalsgrupp. Enkäterna (n=100) distribuerades ut på två universitetssjukhus i två olika län. Totalt 58 (universitetssjukhus A=30 och universitetssjukhus B=28) röntgensjuksköterskor svarade på enkäterna.  Resultat: Arbetsbelastningen har ökat i samband med pandemin, men röntgensjuksköterskor beskrev situationen som hanterbar. Att få information och stöd från sin arbetsgivare ansågs vara viktiga trygghetsaspekter för röntgensjuksköterskorna.  Fler röntgensjuksköterskor på universitetssjukhus B hade fått obekväma arbetstider på grund av personalbrist jämfört med röntgensjuksköterskor på universitetssjukhus A. Totalt 46 (79,3%) röntgensjuksköterskor från både universitetssjukhus A och B upplevde att deras arbetsmiljö hade påverkats under pandemin på ett negativt sätt.  Faktorerna som påverkade röntgensjuksköterskornas arbetsmiljö mest var: 1) de var oroliga över att bli smittade och föra smittan vidare till andra, 2) kände sig mer stressade och 3) de var trötta och slitna på grund av att de inte kunde återhämta sig helt.  Slutsats: Generellt upplevde röntgensjuksköterskor att pandemin har påverkat deras arbetsmiljö på ett negativt sätt. Vidare studier behövs för ta reda på hur arbetsrutiner kan förbättras samt hur bättre beredskap skulle kunna spela en viktig roll i röntgensjuksköterskans arbetsmiljö. / Background: The rapid spread of the COVID-19 virus has led to changes in the radiographer’s work environment, but there are not many studies regarding radiographers work environment during a pandemic. Purpose: The purpose of the study was to find out how radiographers experience their work environment during the pandemic. Method: A qualitative research method was used in this study and data were collected via a questionnaire. The selection was aimed at radiographers as a group. The questionnaires (n=100) were distributed to two university hospital in two different counties. A total of 58 (hospital A=30 and hospital B=28) radiographers responded to the questionnaires. Results: The workload increased during the pandemic, but radiographers considered the situation manageable. Receiving information and support from their employer was considered an important safety aspect. Several of the radiographers at hospital B had uncomfortable working hours due to the staff shortage, compared with radiographers at hospital A. A total of 46 (79,3%) radiographers from both hospital A and B experienced that the work environment had been negatively affected during the pandemic. Factors that affected radiographers mostly: 1) they were worried about becoming infected and spreading the infection, 2) they felt more stressed and 3) they were tired because they could not fully recover. Conclusion: In general, radiographers felt that the pandemic had a negative effect on the work environment. Further studies are necessary to find out how the work routines can improve and how better preparedness could play an important role in the radiographer’s work environment.

Prostate cancer is the most common cancer in Sweden. Patients with the condition have a good prognosis in general and most cases can be treated. Localized prostate cancer is primarily treated via surgery or radiation therapy and is diagnosed with the help of different imaging modalities, such as magnetic resonance imaging, MRI, and positron emission tomography, PET. The diagnosis is confirmed and the aggressiveness of the cancer is determined through biopsies. Samples from a small part of the prostate are extracted and then examined. This could mean that parts of higher aggressiveness may be missed, which in turn could lead to under-treatment of the cancer. The aggressiveness of a lesion can be described by Gleason Score, GS, which is determined by an visual assessment of the shape, size and arrangement of the cells. The aim of this study was to correlate GS with in-vivo images using MRI and PET. This was accomplished by investigating image data from PSMA PET, Acetate PET, Ktrans MRI and T2-weighted MRI from a cohort of 26 prostate cancer patients containing 74 lesions. Regions of interests, ROI:s, were created and applied on all images. Statistics such as median and max value were extracted from each ROI. The statistics were combined to get a wide range of descriptive variables for each respective imaging modality. These were normalised against a certain zone of the prostate or only the absolute value. The results indicated that PSMA PET, Acetate PET and Ktrans MRI were correlated to GS, while T2-weighted MRI was not. Data also indicated that PSMA PET, Acetate PET and Ktrans MRI give complementary information to each other, which could indicate that a combination of the modalities would better predict GS. The implications of these findings could affect both the diagnostics and the treatment of prostate cancer.