The specific nature of work in nuclear medicine departments involves the use of isotopes and handling procedures, which contribute to the considerable value of the equivalent dose received, in particular, by the fingertips. Workers of nuclear medicine units who label radiopharmaceuticals are exposed to ionizing radiation. The doses of nuclear medicine workers determined by individual dosimeters, which supply data on the magnitude of personal dose equivalent. The dosimetry pointing to a considerable optimization of the radiological protection among that professional group. However, the problem of the excessive hand exposure had been noted already in the early 1980s. Systematic studies were undertaken in West Scotland. The difficulties associated with automation of radiopharmaceutical preparation process are responsible for the continuing growth of exposure to the hands of the workers. Similar studies have also been undertaken, e.g. in Chile, Norway, Australia, Italy, USA, Belgium(1). In each case, special attention has been paid to the exposure of nuclear medicine worker hands. The radiopharmacists who label various ligands can be exposed to high radiation doses to their fingertips (primarily of the thumb, index finger and middle finger). Quite frequently, the Hp(0.07) to the fingertips of those three fingers may exceed the dose limit, i.e. value of 500 mSv/y for the skin of human fingers, this dose limit refers to the maximum dose recorded(2). Specific difficulty in assessing the exposures of the most affected finger parts is aggravated by the fact that the universally employed method for the determination of the radiation doses received by the hands using a ring with attached thermoluminescence detectors is not adequate in this particular case. This measurement method is inadequate because distribution of the doses received by the skin of the hands and fingers is extremely non uniform. The main aim of the study was to measure the absorbed dose at the hands of the personnel by using thermoluminescent detectors / -

Renogram in Nuclear Medicine is the main examination for the diagnosis of several diseases in children such as kidney failure or obstructive uropathy. The dosimetry of this examination is based on the group-specific values presented by the ICRP publications. The need for person-specific dosimetry in the Nuclear Medicine urged in the creation of a new image-based dosimetric method, based on the outcome of the examination of the renogram of each patient. With the help of an experimental procedure, the percentage of self-absorption inside the “source” organs and the absorption from the surrounding tissues of the transmitted radiation of the radiopharmaceutical (99m-Tc-MAG3) is calculated, leading with the use of the MIRD method, to the measurement of the activity of Technetium inside the patient’s organs during the renogram’s duration. Afterwards with the help of theoretical models, conclusions and assumptions the total cumulated activity of the patient’s organs is calculated. The results show similar values with other projects published, which were more invasive and less cost-effective for the department. / Στην πυρηνική ιατρική, τα νεφρογράμματα είναι η κύρια εξέταση για την διάγνωση ασθενειών στα παιδιά, όπως η νεφρική ανεπάρκεια και η ουροφρακτική ανεπάρκεια. Η δοσιμετρία αυτών των εξετάσεων στηρίζεται πάνω στα group-specific όρια του ICRP. Η ανάγκη για person-specific δοσιμετρία και στην Πυρηνική Ιατρική ώθησε στη δημιουργία μιας δοσιμετρικής μελέτης που στηρίζεται στην εικόνα (image-based) από το αποτέλεσμα της εξέτασης του νεφρογράμματος του κάθε ασθενή. Με τη βοήθεια μιας πειραματικής διάταξης υπολογίζεται το ποσοστό αυτο-απορρόφησης στα όργανα «στόχους» και το ποσοστό απορρόφησης της εκπεμπόμενης ακτινοβολίας από τους περιβάλλοντες ιστούς, οδηγώντας μαζί με την μέθοδο του MIRD, στον υπολογισμό της ενεργότητας του ραδιοφαρμάκου (99m-Tc-MAG3) μέσα στα όργανα του ασθενή καθ’ όλη την διάρκεια της εξέτασης. Με την βοήθεια θεωρητικών μοντέλων, συμπερασμάτων και υποθέσεων υπολογίζεται η συνολική ακτινική επιβάρυνση του ασθενούς και τα αποτελέσματα δίνουν παραπλήσιες τιμές με άλλες δημοσιευμένες εργασίες, που ακολούθησαν πιο επεμβατικές ή πιο κοστοβόρες για το τμήμα, μεθόδους.

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Inledning: När en höftfraktur är ockult betyder det att den inte syns på en konventionell röntgenbild. Cirka fem procent av alla cervikala höftfrakturer är ockulta. För att diagnostisera en ockult höftfraktur behöver patienten undersökas vidare med en annan modalitet. En sådan potentionell modalitet är datortomografin, som på ett detaljrikt sätt återger patientens anatomi. Fördröjning till operation ökar risken för dödlighet under tiden patienten är hospitaliserad och det är därför viktigt att patienten får sin diagnos så snabbt som möjligt. Syfte: Att skapa en översikt om kunskapsläget gällande datortomografi vid diagnostisering av ockulta höftfrakturer som inte detekterats på konventionell röntgen. Metod: Studien genomfördes som en allmän litteraturöversikt. Tio vetenskapliga artiklar av kvantitativ metod inkluderades. Resultat: Modaliteten datortomografi detekterade inte alla ockulta höftfrakturer utan patienter fick i flera fall genomgå ytterligare undersökning. Det gemensamma medelvärdet av sensitiviteten hos fyra av de vetenskapliga studierna var 83,3 % och det gemensamma medelvärdet för specificiteten var 99,15 %. Vidare visade sex studier att datortomografi tillsammans missat totalt 15 ockulta höftfrakturer hos 595 patienter. Tiden efter första undersökning med konventionell röntgen till dess att patienten fått genomgå en datortomografiundersökning skiljde sig mellan patienterna och de olika studierna. Det snabbaste medelvärdet för tiden mellan konventionell röntgen och undersökning med datortomografi var 3 timmar och 42 minuter. Slutsats: Datortomografi detekterar inte alla ockulta höftfrakturer och patienter behöver i många fall genomgå ytterligare undersökning för att rätt diagnos ska ställas. / Background: A hip fracture is occult when it is not visible on plain x-rays. About five percent of all cervical hip fractures are occult. To diagnose the occult hip fracture, the patient must undergo further examination with another modality. Computed tomography can be such a potential examination since it gives a clear picture of the patient’s anatomy. Delay to surgery increases the risk of mortality while the patient is hospitalized, and it is therefore important that the patient get the diagnosis as quickly as possible. Purpose: To create an overview of the knowledge situation regarding computed tomography in the diagnosis of occult hip fractures not detected by plain x-rays. Method: The study was conducted as a general literature review. Ten scientific articles of quantitative method were included. Results: Computed tomography did not detect all occult hip fractures and in many cases patients had to undergo further examination. The common meantime of the sensitivity based on four of the scientific articles was 83.3 % and the common specificity was 99.15 %. Of the remaining six articles computed tomography missed a total of 15 occult hip fractures in 595 patients. The meantime after the first examination with plain x-ray until the patient received a computed tomography differed between the patients and studies. The fastest meantime was 3 hours and 42 minutes. Conclusion: Computed tomography does not detect all occult hip fractures, and in many cases patients need to undergo further examination for the correct diagnosis.

Bakgrund: Att genomgå en magnetisk resonanstomografi (MR) undersökning kan för patienter som lider av klaustrofobi och ångest innebära att de har svårt att genomföra undersökningen. Röntgensjuksköterskan kan ge stesolid intravenöst till patienten som då oftast klarar av att genomföra undersökningen. Syfte: Det övergripande syftet med studien var att undersöka patienters upplevelse vid MR med stesolid. Studien skulle också ge svar på vid vilken typ av undersökning som stesolid var mest förekommande samt om det fanns en skillnad i upplevelsen beroende på kön och ålder.  Metod: Studien var en kvantitativ enkätstudie med egenkonstruerade frågor om patienters upplevelse under MR med stesolid. Från februari till och med april 2018 delades enkäter ut på fem utvalda sjukhus i södra Sverige till patienter som genomgick MR med stesolid. Resultat: Resultatet visade att de patienter som genomgick MR med stesolid hade en god upplevelse av undersökningen och det fanns ingen signifikant skillnad i upplevelsen beroende på kön eller ålder. Huvud/hals var den vanligaste undersökningen med stesolid. Slutsats: Patienterna hade en god upplevelse av MR med stesolid. I stort sett alla patienter fick stesolid på grund av att de tyckte det var trångt utrymme i kameran. Med detta resultat kan patienter som önskar sövas på grund av oro och ångest inför undersökningen istället få stesolid med god effekt. / Background: Undergoing magnetic resonance imaging (MRI) examinations can be difficult to endure for patients suffering from claustrophobia and anxiety. The radiographer can give the patient stesolid and then usually all of them can perform the examination. Purpose: The overall purpose of the study was to investigate patients experience undergoing MRI with sedation. The study would also provide the most frequent examinated part of body with stesolid and if there was any difference in the experience depending on gender and age. Method: The study was a quantitative questionnaire study with self-designed questions about patients experience during MRI with stesolid. From February to April 2018, the questionnaire was distributed at five selected hospitals in southern Sweden to patients who underwent MRI with stesolid. Result: The result showed that patients who underwent MRI with stesolid had a good experience of the examination and there was no significant difference between the gender and age. Head/throat was the most common examination with stesolid. Conclusion: The patients had a good experience of MRI with stesolid. Almost all of the patients got stesolid because they thought there was a restricted space in the camera. With this result, patients who want anaesthesia because of anxiety may be able to get stesolid instead with good effect.

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