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- Cancer patient experience in a nuclear medicine department: comparison between bone scintigraphy and 18F-FDG PET/CTPublication . Grilo, Ana Monteiro; Vieira, Lina Oliveira; Carolino, Elisabete; Costa, Melissa; Galaio, Salomé; Melo, Inês; Geão, Ana; Santos, Andrea; Colarinha, PaulaObjective: To assess the emotional impact on cancer patients undergoing Nuclear Medicine scans and identify how professionals can improve patient experience. Methods: 94 patients undergoing a Bone Scan (BS) or a Positron emission tomography/Computed Tomography (18F-FDG PET/CT) completed two Scan Experience Questionnaires and the State Anxiety Inventory (STAI-S) prior to the scan and after image acquisition. Results: Before the exam, the mean anxiety levels were higher for the BS patients compared to the 18F-FDG PET/CT group. For the post-scan STAI-S mean score, the opposite is true. Both groups experienced a reduction in levels of anxiety after the scan (BS - STAI score pre-scan = 51.75, and post-scan = 36.70; 18F-FDG PET/CT - STAI score pre-scan = 44.67, and post-scan = 38.82). The greatest anxiety factor for the BS group was the duration of the exam - 5.34 ± 2.08 (mean ± SD), while for the 18F-FDG PET/CT group it was the result - 5.40±1.80 (mean ± SD). Conclusion: Patients undergoing NM exams in an oncological context revealed significant anxiety levels prior to and after their scans. However, the BS and 18F-FDG PET/CT have different triggers. It is of extreme importance that healthcare professionals are aware of these peculiarities and adjust their procedures accordingly.
- MUGA processing: intra and interoperator variability impact using manual and automated methodsPublication . Belo, Rita; Alves, Cláudia; Carvalhal, Cristiana; Figueiredo, Sérgio; Carolino, Elisabete; Vieira, Lina OliveiraIntroduction – Multigated acquisition (MUGA) scan is mainly used for the assessment of left ventricular ejection fraction (LVEF) in patients who undergo cardiotoxic chemotherapy drugs. When applying automatic (A) or manual (M) processing methods, some biases in the quantitative metrics can be obtained. The aim of this study is to evaluate the influence of A and M methods, specifically, the inter and intraoperative variability in accordance with the professional experience. Methods – A retrospective study was performed with 14 MUGA exams available in ESTeSL’s Xeleris™ Functional Imaging Workstation v. 1.0628 database. Three operators (OP) with no professional experience and two with more than 10 years of experience, processed every study five times for each method, using the EF Analysis™ and the Peak Filling Rate™. To perform the multiple comparisons, the Repeated Measures ANOVA, Friedman, t-test and Wilcoxon tests were used, considering α=0.05. Results – Four of the OP presented statistically significant differences between methods in one or more parameters; similar values between experienced OP and between the non-experienced were observed when the A method was applied, and higher discrepancies were present for all parameters obtained by the M mode; higher LVEF, peak filling rate, and peak empying rate values were observed for the M method. Conclusion – Variability was found when comparing M and A processing methods, as well as interoperator variability associated with their level of experience. Despite that, there was a trend of less variability between the two experienced OP and in the A method.
- Exposição dos técnicos de medicina nuclear durante testes de ventilação pulmonarPublication . Alves, M.; Duarte, Ana Cristina; Mylkivska, A.; Pereira, E.; Jerónimo, V.; Carolino, Elisabete; Vieira, Lina OliveiraIntrodução – O teste da ventilação requer a inalação de um radiofármaco pelo paciente, o que pode conduzir a contaminações dos técnicos de medicina nuclear (TMN) pelo gás radioativo. Objetivo – Avaliar a exposição à radiação ionizante do TMN durante testes de ventilação pulmonar com 99mTc-Technegas® através da monitorização de contaminações externas das mãos e rosto. Métodos – Monitorização de quatro TMN de dois serviços diferentes durante a realização de estudos de ventilação pulmonar, utilizando para o efeito o monitor de radiação Geiger-Müller. Foram medidos os valores de radiação de fundo da sala onde é realizado o teste de ventilação pulmonar antes e após o procedimento, com e sem a presença do paciente; foi medida a taxa de dose nas mãos (com e sem as luvas utilizadas no procedimento) e no rosto (com e sem a máscara utilizada no procedimento). Os dados foram analisados no software estatístico SPSS, v. 22.0 para Windows. Resultados – Verificou-se que em ambos os serviços de medicina nuclear estudados os valores de taxa de dose mais elevados foram medidos após o teste de ventilação, com o paciente dentro da sala. O serviço Y apresentou valores de taxa de dose superiores ao nível de significância de 5% nas mãos com as respetivas luvas, nas luvas usadas durante o procedimento, no rosto com a respetiva máscara e na máscara. Conclusão – A contaminação na sala é tanto maior quanto maior o número de estudos de ventilação realizados. As luvas constituem uma barreira externa contra a contaminação direta nas mãos. As máscaras reduzem o risco de contaminação do rosto do TMN.
- Effectiveness of educational videos on patient’s preparation for diagnostic procedures: systematic review and meta-analysisPublication . Grilo, Ana; Ferreira, Ana Catarina; Ramos, Marta Pedro; Carolino, Elisabete; Pires, Ana Filipa; Vieira, Lina OliveiraAlthough diagnostic procedures are crucial for secondary prevention and patient disease control, they often trigger fear and anxiety. These reactions highlight the need to adopt effective interventions to improve patients' experience and satisfaction. Recently, educational videos have been employed in preparing diagnostic procedures; however, there is no integrated understanding of their effects. This systematic review and meta-analysis aimed to assess the effectiveness of educational videos on patients' anxiety and satisfaction regarding preparation for diagnostic procedures. Three scientific databases (PubMed; Web of Science, Scopus), were used in this systematic review. Studies about educational videos as a form of preparation for patients undergoing diagnostic procedures published between 2000 and 2021 were included. A meta-analysis was also conducted. Sixteen studies met the inclusion criteria for systematic review, and seven were included in the meta-analysis. Nine studies of the total sample were about vascular procedures and seven studies about other medical image procedures. Of the fourteen studies that evaluated the use of educational videos on patients' anxiety, nine proved to reduce it significantly. Of the thirteen studies that evaluated satisfaction, seven showed a significant increase in the experimental group. Studies included in the meta-analysis show that educational video patient groups had lower anxiety levels than the control groups after the procedure. Although future studies are required, the results suggest that educational videos effectively prepare patients for diagnostic procedures, improving care quality.
- Effects of a music-based intervention on psychophysiological outcomes of patients undergoing medical imaging procedures: a systematic review and meta-analysisPublication . Vieira, Lina Oliveira; Carvalho, Catarina; Grilo, Ana; Reis, Jaime; Pires, Ana Filipa; Pereira, Edgar; Carolino, Elisabete; Almeida-Silva, MarinaIntroduction: Musical intervention (MI) is a valuable strategy for addressing the psychological and emotional challenges faced by patients undergoing imaging procedures. This study explores MI's impact on psychophysiological outcomes during imaging procedures, detailing the sound repertoire and technical characteristics employed in MI. Methods: A systematic review (SR) and meta-analysis (MA) were conducted. Electronic database searches of PubMed, Web-of-Science, and Scopus were performed encompassing original randomised research and quasi-experimental articles published until June 2023. Results: Thirteen articles were included in this SR, scoring between 23 and 68 on the Joanna Briggs Institute (JBI) Checklist. Four articles were included to perform a MA concerning anxiety and heart rate (HR) outcomes. Most studies utilised digital playlists as the medium for MI. Headphones were commonly used, with an average volume of 50-60 dB and a musical frequency of 60-80 beats/min. While authors generally preferred selecting musical genres for the repertoire, two articles specifically chose Johann Pachelbel's "Canon in D major" as their musical theme. In terms of psychological parameters, the experimental groups exhibited lower anxiety values than the control groups, with further reductions after MI. However, MA shows that this trend is only marginally significant. Patient comfort and overall examination experience showed improvement with MI. Regarding physiological parameters, HR, especially in the final phase of the examination, was significantly lower in the experimental group compared to the control group. Conclusion: Across multiple studies, MI demonstrated the ability to reduce anxiety and HR. However, no specific music repertoire emerged as the most effective. Implications for practice: MI arises as a painless, reliable, low-cost, and side-effect-free strategy, presenting imaging departments with a practical means to enhance patient comfort and mitigate anxiety and stress during medical procedures.
- Influence of adipose tissue in myocardial counts using attenuation correction in SPECT/CT imaging: study in phantomPublication . Galvão, Tiago; Roberto, João; Figueiredo, Sérgio; Carolino, Elisabete; Marques, Andreia; Pintão, Sophia; Vieira, Lina OliveiraMyocardial perfusion imaging (MIP) with single photon emission computed tomography is one of the most accurate procedures for the detection of coronary artery disease. Tissue attenuation artifacts are a significant limitation of MIP, especially in obese patients. CT-based attenuation correction (AC) is widely used to undermine these artifacts. The objective of this study was to evaluate the influence of an adipose tissue equivalent in the total myocardial counts after AC in SPECT/CT imaging. To accomplish this a Heart Thorax Phantom was filled with 99m TcO4-(simulating the uptake of 99m Tc-tetrofosmin in the cardiac walls and liver) for SPECT/CT imaging using an additional layer of 100% lipid fat and a torso phantom. The acquired data were reconstructed with Filtered Back Projection (FBP), iterative algorithms without AC (IRNC) and iterative algorithms with AC (IRAC) for posterior evaluation of total cardiac wall count (Anterior, Inferior, Lateral and Septal). There was a significant reduction in total mean counts of the lateral and septal walls, with the addition of a layer of fat and the torso phantom, when FBP and IRNC reconstructions were applied (p ≤ 0,05) which may have been caused by tissue attenuation artifacts. The addition of a layer of fat and of the torso phantom, directly increased the total mean counts of the septal, lateral and inferior walls, when IRAC reconstruction was used (p ≤ 0,05) suggesting a benefit in the use of AC in larger body habitus. In conclusion, the adipose tissue equivalent directly influenced the total myocardium counts when AC methods were applied, and further research is advised.