| 1. |
- Jönsson, Lena M, et al.
(författare)
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Management of Radioactive Waste in Nuclear Medicine
- 2022. - 1
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Ingår i: Handbook of Nuclear Medicine and Molecular Imaging for Physicists : Radiopharmaceuticals and Clinical Applications, Volume III - Radiopharmaceuticals and Clinical Applications, Volume III. - 9781138593312 - 9780429489501 ; 3
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Bokkapitel (refereegranskat)abstract
- The use of radionuclides in medicine will inevitably result in various forms of radioactive waste. The waste emerges from the production of radionuclides and radiopharmaceuticals, diagnostic and therapeutic use, and in biomedical research. Radioactive waste can also include spent sealed sources used for calibration, or quality control of different kind of medical equipment. The waste can lie within a wide range of activities and half-lives and be in different forms, solids, liquids, or airborne. In nuclear medical applications the main part of the radioactive waste consists of radionuclides with short half-life and low radiotoxicity, but other risks associated with the waste must also be considered. The philosophy of all work with radioactive material is to minimize any hazards on human health and impact on the environment both in the short and long term. To meet this, the basic principles of radiation safety must be applied – that is, justification, optimization, and the use of dose limits. This also includes radioactive waste management, and therefore the radioactive waste generated must be kept to a minimum as well as adapted to the work situation. The management of radioactive waste from medical applications is guided by international recommendations and regulated by regional and national authorities. The organization and regulations may vary in different countries due to the national legal framework, but the purpose is the same – to minimize a negative impact of the waste in all aspects.
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| 2. |
- Jönsson, Lena
(författare)
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Staff Radiation Protection
- 2022
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Ingår i: Handbook of Nuclear Medicine and Molecular Imaging for Physicists : Modelling, Dosimetry and Radiation Protection, Volume II - Modelling, Dosimetry and Radiation Protection, Volume II. - New York : CRC Press. - 9781138593299 - 9780429952227 ; 2, s. 275-292
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Bokkapitel (refereegranskat)abstract
- From a radiation protection point of view, nuclear medicine is a complex medical specialty that includes both radionuclide and radiopharmaceutical production and patient diagnostics and therapy. The practical work with radiation sources includes a variety of procedures, activity levels, dose rates, and risks of contamination. The radiation dose to the worker is largely determined by the knowledge and awareness of health risks associated with working with unsealed sources. It is important to utilise time, distance, and radiation shielding to the extent possible to minimise the radiation dose to the staff. After injection of the radiopharmaceutical, the patient is the radiation source, and the staff have to keep this in mind while positioning the patient in the imaging system. In addition, there is also the handling of blood samples, urine samples, and radioactive waste. Handling open radiation sources involves the risk of contamination and possible accidental inhalation or oral intake of radiopharmaceuticals, which can lead to internal irradiation to the worker. In addition, contamination can give rise to misleading examination results if patients, measuring equipment, or premises become contaminated. Factors affecting the effective dose as well as the equivalent dose to hands and fingers, and to the lens of the eye, are described. This chapter also includes examples of work rules to minimize the staff radiation dose and the risk of external and internal contamination.
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| 3. |
- Stenvall, Anna, et al.
(författare)
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Relationships between uptake of [68Ga]Ga-DOTA-TATE and absorbed dose in [177Lu]Lu-DOTA-TATE therapy
- 2022
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Ingår i: EJNMMI Research. - : Springer Science and Business Media LLC. - 2191-219X. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Somatostatin receptor 68Ga PET imaging is standard for evaluation of a patient’s suitability for 177Lu peptide receptor radionuclide therapy of neuroendocrine tumours (NETs). The 68Ga PET serves to ensure sufficient somatostatin receptor expression, commonly evaluated qualitatively. The aim of this study is to investigate the quantitative relationships between uptake in 68Ga PET and absorbed doses in 177Lu therapy. Method: Eighteen patients underwent [68Ga]Ga-DOTA-TATE PET imaging within 20 weeks prior to their first cycle of [177Lu]Lu-DOTA-TATE. Absorbed doses for therapy were estimated for tumours, kidney, spleen, and normal liver parenchyma using a hybrid SPECT/CT–planar method. Gallium-68 activity concentrations were retrieved from PET images and also used to calculate SUVs and normalized SUVs, using blood and tissue for normalization. The 68Ga activity concentrations per injected activity, SUVs, and normalized SUVs were compared with 177Lu activity concentrations 1 d post-injection and 177Lu absorbed doses. For tumours, for which there was a variable number per patient, both inter- and intra-patient correlations were analysed. Furthermore, the prediction of 177Lu tumour absorbed doses based on a combination of tumour-specific 68Ga activity concentrations and group-based estimates of the effective half-lives for grade 1 and 2 NETs was explored. Results: For normal organs, only spleen showed a significant correlation between the 68Ga activity concentration and 177Lu absorbed dose (r = 0.6). For tumours, significant, but moderate, correlations were obtained, with respect to both inter-patient (r = 0.7) and intra-patient (r = 0.45) analyses. The correlations to absorbed doses did not improve when using 68Ga SUVs or normalized SUVs. The relationship between activity uptakes for 68Ga PET and 177Lu SPECT was stronger, with correlation coefficients r = 0.8 for both inter- and intra-patient analyses. The 177Lu absorbed dose to tumour could be predicted from the 68Ga activity concentrations with a 95% coverage interval of − 65% to 248%. Conclusions: On a group level, a high uptake of [68Ga]Ga-DOTA-TATE is associated with high absorbed doses at 177Lu-DOTA-TATE therapy, but the relationship has a limited potential with respect to individual absorbed dose planning. Using SUV or SUV normalized to reference tissues do not improve correlations compared with using activity concentration per injected activity.
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| 4. |
- Oddstig, Jenny, et al.
(författare)
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Comparison of conventional and Si-photomultiplier-based PET systems for image quality and diagnostic performance
- 2019
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Ingår i: BMC Medical Imaging. - : Springer Science and Business Media LLC. - 1471-2342. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A new generation of positron emission tomography with computed tomography (PET-CT) was recently introduced using silicon (Si) photomultiplier (PM)-based technology. Our aim was to compare the image quality and diagnostic performance of a SiPM-based PET-CT (Discovery MI; GE Healthcare, Milwaukee, WI, USA) with a time-of-flight PET-CT scanner with a conventional PM detector (Gemini TF; Philips Healthcare, Cleveland, OH, USA), including reconstruction algorithms per vendor's recommendations. METHODS: Imaging of the National Electrical Manufacturers Association IEC body phantom and 16 patients was carried out using 1.5 min/bed for the Discovery MI PET-CT and 2 min/bed for the Gemini TF PET-CT. Images were analysed for recovery coefficients for the phantom, signal-to-noise ratio in the liver, standardized uptake values (SUV) in lesions, number of lesions and metabolic TNM classifications in patients. RESULTS: In phantom, the correct (> 90%) activity level was measured for spheres ≥17 mm for Discovery MI, whereas the Gemini TF reached a correct measured activity level for the 37-mm sphere. In patient studies, metabolic TNM classification was worse using images obtained from the Discovery MI compared those obtained from the Gemini TF in 4 of 15 patients. A trend toward more malignant, inflammatory and unclear lesions was found using images acquired with the Discovery MI compared with the Gemini TF, but this was not statistically significant. Lesion-to-blood-pool SUV ratios were significantly higher in images from the Discovery MI compared with the Gemini TF for lesions smaller than 1 cm (p < 0.001), but this was not the case for larger lesions (p = 0.053). The signal-to-noise ratio in the liver was similar between platforms (p = 0.52). Also, shorter acquisition times were possible using the Discovery MI, with preserved signal-to-noise ratio in the liver. CONCLUSIONS: Image quality was better with Discovery MI compared to conventional Gemini TF. Although no gold standard was available, the results indicate that the new PET-CT generation will provide potentially better diagnostic performance.
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| 5. |
- Hindorf, Cecilia, et al.
(författare)
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Radiation protection in nuclear medicine
- 2016
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Ingår i: Radiation Protection in Medical Imaging and Radiation Oncology. - 9781482245370 - 9781482245387 ; , s. 111-135
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Bokkapitel (refereegranskat)
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| 6. |
- Jönsson, Lena S, et al.
(författare)
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The ordinary work environment increases symptoms from eyes and airways in mild steel welders.
- 2015
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 88:8, s. 1131-1140
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to follow diary-registered symptoms from eyes and airways in mild steel welders and relate them to different exposure measures. Furthermore, we would clarify the influence of possible effect modifiers.
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| 7. |
- Jönsson, Lena S, et al.
(författare)
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Is acculturation associated with physical activity among female immigrants in Sweden?
- 2013
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Ingår i: Journal of Public Health. - : Oxford University Press (OUP). - 1741-3850 .- 1741-3842. ; 35:2, s. 270-277
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Immigrant women in Sweden have lower levels of leisure time physical activity (LTPA) than Swedish-born women. The reasons are unclear, although acculturation has been suggested to play a role. METHODS: We used a cross-sectional study design to investigate the association between LTPA and two indicators of acculturation: (i) language proficiency (ability to understand news reports on the radio and television) and (ii) age at the time of migration, and if there existed a modifying effect on these hypothesized associations. The study sample consisted of 1651 women, aged 18-65, living in Sweden and born in Finland, Chile or Iraq. A postal questionnaire (translated into the women's native language) was used to collect the variables. The International Physical Activity Questionnaire was used to assess LTPA. Data were collected in 2002-05 and analyzed in 2009-10. A partial-proportional odds model was used for the analysis. RESULTS: Increased language proficiency was associated with increased LTPA [odds ratio (OR) = 2.31, 95% confidence interval (CI) = 1.57-3.41]. Country of birth modified the association. Furthermore, younger age at migration was associated with increased LTPA (OR = 1.44, 95% CI = 1.01-2.03). CONCLUSIONS: Increased language proficiency has the potential to be an important health-promoting factor among immigrant women.
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| 8. |
- Calling, Susanna, et al.
(författare)
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Preterm birth and unintentional injuries: risks to children, adolescents and young adults show no consistent pattern.
- 2012
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Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253.
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Preterm birth is associated with a number of physical and mental health issues. The aim of this study was to find out if there was also any association between individuals born preterm in Sweden between 1984 and 2006 and the risk of unintentional injuries during childhood, adolescence and young adulthood METHODS: The study followed 2,297,134 individuals, including 5.9% born preterm, from 1985 to 2007 for unintentional injuries leading to hospitalisation or death (n=244,021). The males and females were divided into four age groups: 1-5 years, 6-12 years, 13-18 years and 19-23 years. Hazard ratios were calculated for falls, transport injuries and other injuries RESULTS: After adjusting for a comprehensive set of covariates, some of the preterm subgroups demonstrated slightly increased risks of unintentional injuries, while others showed slightly decreased risks. However, most of the estimates were borderline or non-significant in both males and females. In addition, the absolute risk differences between individuals born preterm and full term were small CONCLUSION: Despite the association between preterm birth and a variety of physical and mental health consequences, this study shows that there is no consistent risk pattern between preterm birth and unintentional injuries in childhood, adolescence and young adulthood. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.
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