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Publications (6 of 6) Show all publications
Bäck, A., Savvopoulos, C., Funk, E. & Geijer, H. (2018). Diuretic decision seven minutes post Tc-99m-MAG3 administration in a renography. Paper presented at 31st Annual Congress of the European-Association-of-Nuclear-Medicine (EANM'18), Düsseldorf, Germany, October 13-17, 2018. European Journal of Nuclear Medicine and Molecular Imaging, 45(Suppl. 1), S765-S765, Article ID E-TPW52.
Open this publication in new window or tab >>Diuretic decision seven minutes post Tc-99m-MAG3 administration in a renography
2018 (English)In: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 45, no Suppl. 1, p. S765-S765, article id E-TPW52Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Aim: The F+10 method in supine position, which has been implemented at our Nuclear Medicine department since 2015, involves a 30- minute long dynamic acquisition. The diuretic is only administered when necessary and decision is taken by the radiographers in a semi-automated fashion without consulting a physician, by calculating the remaining activity in the kidneys seven minutes post 99mTc-MAG3 injection and comparing the value with an arbitrary threshold of 75 %. If needed, the diuretic is injected three minutes later. The aim of this study was to correlate our method with the established previously used F+20 protocol in adults. Is the currently used threshold of 75% of activity left in any kidney at seven minutes the optimal cut-off value for diuretic administration?

Material and Methods: This is an ongoing retrospective study which include 320 F+20 examinations of adult patients performed during 2013-2015. They were all re-evaluated according to the currently used F+10 method, categorized as requiring diuretic or not and correlated to the original F+20 examination. A ROC-curve was drawn to delineate the best cut-off value for remaining renal activity. Sensitivity, specificity and accuracy were calculated.

Results: Preliminary results indicate that the F+10 re-evaluations with the currently used cut-off value of 75% did not correlate with the original F+20 examinations. In 80% (255 examinations) of the F+10 re-evaluations diuretic would have been considered necessary while only 52% (167 examinations) received diuretics in the original F+20 renographies (sensitivity 1.0, specificity 0.42). However, all the patients who required furosemide in the original F+20 renographies would have received diuretic if they had been imaged with the F+10 protocol. Furthermore, examination time is considerably reduced. After an evaluation of the ROC-curve the optimal cut-off value was 94% (sensitivity 0.92, specificity 0.84, accuracy 0.88). However, by implementing this value, 13 patients (4%) would have been falsely categorized as not requiring diuretic.

Conclusions: The 99mTc-MAG3 renography with the F+10 protocol in supine position is a feasible and acceptable method in clinical practice.

Place, publisher, year, edition, pages
Springer, 2018
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:oru:diva-70372 (URN)10.1007/s00259-018-4148-3 (DOI)000449266207098 ()
Conference
31st Annual Congress of the European-Association-of-Nuclear-Medicine (EANM'18), Düsseldorf, Germany, October 13-17, 2018
Available from: 2018-11-29 Created: 2018-11-29 Last updated: 2018-11-29Bibliographically approved
Funk, E., Anderzen-Carlsson, A. & Thunberg, P. (2016). Patient participation in MRI: patient experiences and image quality addressing breath-hold acquisitions. In: ECR 2016 Book of Abstracts: B. Scientific Sessions and Clinical Trials in Radiology. Paper presented at European Congress of Radiology (ECR 2016), Vienna, Austria, March, 2-6, 2016 (pp. S379-S379). Springer
Open this publication in new window or tab >>Patient participation in MRI: patient experiences and image quality addressing breath-hold acquisitions
2016 (English)In: ECR 2016 Book of Abstracts: B. Scientific Sessions and Clinical Trials in Radiology, Springer, 2016, p. S379-S379Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Purpose: To investigate two different breath-hold techniques, in terms of patient experience and image quality, and describe patients' experiences of magnetic resonance imaging.

Methods and Materials: Thirty patients referred for an MRI of the liver conducted two separate breath-hold acquisitions in a randomised order, radiographer-directed and patient-initiated. Semi-structured interviews were held and analysed, and images were reviewed according to image quality.

Results: The patients' general experiences of the MRI were that they felt a loss of control, and almost half of the patients seemed to prefer the self-initiated breath-hold. About 20 % of the patients preferred to hand over the responsibility to the radiographer, and for some the technique did not matter.The patients empathized in general the importance of achieving the best image quality. There were no significant differences identified between the two breath-hold techniques, in regards to image quality.

Conclusion: The results show that self-initiated breath-hold acquisitions can be seen as a new alternative worth considering in clinical MRI since it is appreciated by the patients and give similar image quality compared to conventional breath-hold acquisitions. It also offers a possibility to achieve some control over the situation.

Place, publisher, year, edition, pages
Springer, 2016
Series
Insights into Imaging, E-ISSN 1869-4101 ; Vol. 7 (2016): 1 Suppl.
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:oru:diva-63446 (URN)10.1007/s13244-016-0475-8 (DOI)
Conference
European Congress of Radiology (ECR 2016), Vienna, Austria, March, 2-6, 2016
Available from: 2017-12-19 Created: 2017-12-19 Last updated: 2017-12-19Bibliographically approved
Funk, E. (2015). Aspects on patient experiences and participation in magnetic resonance imaging including breath-hold acquisitions. (Licentiate dissertation). Örebro: Örebro universitet
Open this publication in new window or tab >>Aspects on patient experiences and participation in magnetic resonance imaging including breath-hold acquisitions
2015 (English)Licentiate thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2015. p. 46
Keywords
MRI, participation, image quality, patient experience
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-44769 (URN)
Supervisors
Available from: 2015-06-01 Created: 2015-06-01 Last updated: 2017-10-17Bibliographically approved
Funk, E., Anderzén-Carlsson, A., Ingverud, P., Leander, A. & Thunberg, P. (2015). Patient-initiated breath-holds in MRI: an alternative for reducing respiratory artifacts and improving image quality. Clinical imaging, 39(4), 619-622
Open this publication in new window or tab >>Patient-initiated breath-holds in MRI: an alternative for reducing respiratory artifacts and improving image quality
Show others...
2015 (English)In: Clinical imaging, ISSN 0899-7071, E-ISSN 1873-4499, Vol. 39, no 4, p. 619-622Article in journal (Refereed) Published
Abstract [en]

Purpose: To investigate MRI image quality using two different breath-hold techniques.

Materials and methods: Thirty patients remitted for MRI, 2D-dual gradient echo acquisition of the liver conducted two separate breath-hold acquisitions in randomized order, operator-instructed and patient-initiated. The images were reviewed by two radiologists.

Results: There were no significant differences in image quality between the two breath-hold techniques either in overall image quality or respiratory motion artifacts. This assessment was equal and concordant for both radiologists.

Conclusion: In terms of image quality, the patient self-initiated breath-hold was shown to be an equal alternative to conventional breath-hold imaging.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Liver MRI, image quality, breath-hold, patient cooperation
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Radiology
Identifiers
urn:nbn:se:oru:diva-40685 (URN)10.1016/j.clinimag.2014.12.007 (DOI)000356906300014 ()25555833 (PubMedID)2-s2.0-84954197578 (Scopus ID)
Available from: 2015-01-09 Created: 2015-01-09 Last updated: 2018-09-04Bibliographically approved
Funk, E., Thunberg, P. & Anderzen-Carlsson, A. (2014). Patients' experiences in magnetic resonance imaging (MRI) and their experiences of breath holding techniques. Journal of Advanced Nursing, 70(8), 1880-1890
Open this publication in new window or tab >>Patients' experiences in magnetic resonance imaging (MRI) and their experiences of breath holding techniques
2014 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 8, p. 1880-1890Article in journal (Refereed) Published
Abstract [en]

Aims: To describe patients' experiences of magnetic resonance examination of the liver and their experiences of two breath-hold techniques.

Background: Traditionally, patients are instructed by the radiographer to hold their breath during the examination. Alternatively, the patient can initiate the breath hold and start the image acquisition. Studies have revealed that magnetic resonance examinations can be experienced as challenging.

Design: Descriptive qualitative.

Methods: Semi-structured interviews were conducted with 28 patients and analysed using qualitative content analysis. The data collection was carried out from autumn 2010 to spring 2011.

Results: The patients' main experience was that they felt loss of control. This was described in terms of feeling trapped, being lost in time and lost as a result of uncertainty. They had many questions in their mind that they did not ask. Although their statements often revealed no clear preference regarding the techniques, almost half of the patients seemed to prefer self-initiated breath hold, as it was easier and less stressful. Those who preferred the radiographer-directed technique felt more confident leaving the responsibility to the radiographer. In general, the patients understood the importance of achieving the best quality images possible.

Conclusion: Magnetic resonance examination can be experienced as being in loss of control. Nevertheless, not all patients wished to actively participate in magnetic resonance examination. Some preferred to hand over the responsibility to the radiographer. These results can form a base for radiographers' reflections of how to individualize and optimize the nursing care of patients undergoing magnetic resonance examinations.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
Breath hold; information; magnetic resonance imaging; participation; patient experience
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-35791 (URN)10.1111/jan.12351 (DOI)000339492500019 ()24456491 (PubMedID)2-s2.0-84904672742 (Scopus ID)
Note

Funding Agencies:

Research Committee of Orebro County Council, Sweden

Örebro University

Available from: 2014-07-23 Created: 2014-07-23 Last updated: 2018-06-07Bibliographically approved
Funk, E., Thunberg, P. & Anderzen-Carlsson, A. (2013). Instructed or patient-initiated breath holds: what do the patients prefer?. In: : . Paper presented at European Congress of Radiology (ECR 2013), Vienna, Austria, March 7-11, 2013.
Open this publication in new window or tab >>Instructed or patient-initiated breath holds: what do the patients prefer?
2013 (English)Conference paper, Poster (with or without abstract) (Other academic)
Keywords
Technology assessment, MR, Abdomen, Artifacts
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:oru:diva-63520 (URN)10.1594/ecr2013/C-1000 (DOI)
Conference
European Congress of Radiology (ECR 2013), Vienna, Austria, March 7-11, 2013
Available from: 2017-12-21 Created: 2017-12-21 Last updated: 2017-12-21Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-3901-2634

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