European Journal of Radiography最新文献

Purpose

To explore the correlation of morphological and kinetic DCE-MRI features with histopathological prognostic factors of invasive breast cancer.

Material and methods

Fifty-one women with 57 cancerous lesions underwent DCE-MRI prior to surgery. DCE-MRI findings were interpreted with a multifactorial classification system that included morphological (shape, margins and pattern of enhancement) and kinetic characteristics (initial signal increase and post-initial behaviour of the time-signal intensity curve). Each morphological and kinetic parameter was scored with 0, 1 or 2 points and the total score was estimated. Finally each lesion was classified into one of the five categories that correspond to the five ACR BI-RADS categories. Statistical analysis was performed to correlate DCE-MR imaging parameters and histopathological findings using Fisher's exact test and stepwise multiple regression analysis.

Results

Increase of the signal intensity at the initial phase >100% was strongly correlated with positive lymph nodes (p = 0.008, OR 0.054). Types I and II time-signal intensity curves at the post-initial phase were associated with a fourfold increase in the likelihood of progesterone receptors positivity (p = 0.022, OR 4). Finally, high total score was positively correlated with affected lymph nodes (p = 0.033, OR 0.29).

There was a trend regarding ill-defined margins of the tumor (p = 0.08) and vascular infiltration and also high score and neural infiltration (p = 0.072).

Conclusion

A multivariate interpretation model for DCE-MRI that includes morphological and kinetic characteristics has prognostic value for invasive breast cancer. Early initial contrast agent uptake and a high overall score are associated with poor prognostic factors.

Purpose

To determine whether radiation therapists (RTT) can correctly identify field placement errors and recommend appropriate isocentre moves using electronic portal imaging.

Methods

A systematic review of the literature was made using the keywords: “radiation therapy OR radiotherapy AND electronic portal imaging”; radiation therapist OR radiographer OR radiologic technologist AND electronic portal imaging”; “electronic portal imaging”; “verification AND electronic portal imaging”; “verification AND radiation therapist”; “verification films”; “image approval”; “radiation therapist AND role expansion”; and “radiation therapist experience”.

Results

Eighteen relevant articles were found. These were collated into three topic areas: 1) current practice, 2) ability to assess EPIs, and 3) experience/education needed. It is common practice for RTTs to review EPIs in Canada, Australia and New Zealand. Education is carried out in the clinic. Concordance between RTTs and radiation oncologists (ROs) in error detection and iso-move decisions was between 90.1% and 97.3%. RTT inter-observer variability was 0.7–1.4 mm and intra-observer variability was 0.4–0.7 mm.

Conclusions

RTTs provide acceptable alternatives to ROs for rapid review of EPIs, enabling prompt corrections to be made with the patient on the treatment couch. It is recommended that RTTs take on this role, using an internal accrediting program and ongoing continual professional education.

Background

A substantial number of patients with psychiatric illnesses present to the Imaging Department across the Irish Republic each year. Patients who have a psychiatric illness may present difficulties for the radiographer during a radiographic examination. These difficulties may include communication difficulties, and an increased prevalence to become violent due to their illness.

Aims

To investigate if radiographers feel confident interacting with psychiatric patients. To ascertain if radiographers need more training in this area of patient interaction.

Method

A qualitative approach was used drawing upon six radiographers working in a regional hospital with a psychiatric unit attached. The radiographers were interviewed individually and the results were thematically analysed.

Results

The results indicated that the level of the radiographers own confidence in relation to interacting with psychiatric patients was influenced by the number of years since qualification. The majority of radiographers in the study displayed a poor knowledge of psychiatric conditions and how they affect patients.

Conclusion

Based upon this small study, the results suggest that newly qualified radiographers do not feel confident in their own abilities when interacting with psychiatric patients and would welcome and benefit from specific training with regards to strategies to deal with psychiatric patients. The radiographers reported that particular areas which may be improved upon are more information on psychiatric illnesses, manifestations of different types of psychiatric illness and the subsequent effect on patients. A larger study encompassing the whole of the Republic of Ireland would be valuable as a precursor to a European comparative study in order to investigate this phenomenon at a deeper level. Additionally it is recommended that further research is conducted within a wider European context on student radiographers and lecturers teaching on undergraduate radiography courses to ascertain if this topic is addressed at undergraduate level.

Job satisfaction is an important issue both because of its meaning as a staff well being factor as well as because of its associations with central implications of health care quality and productivity e.g. quality of care, organizational commitment, and health care staff's intention to leave.

The aim of the study was to explore factors associated with the job satisfaction of the radiological departments' staff. It was studied associations of job satisfaction and 1) personal, 2) work and organization related and 3) psychosocial work environment factors and 4) intention to stay in their work.

The study was performed in co-operation with the imaging units of two Finnish municipalities in spring 2007. The sample comprised two specialised care radiological departments facilities and eight primary care radiological departments. The data was collected via Internet in the spring 2007 from the personnel of the radiological departments. The response rate was 49% (n = 73/150). The data was analysed by using Spearman correlation and univariate and multivariate logistic regression.

The best predictors for the job satisfaction were work control and goal commitment. Correlation between job satisfaction and intention to stay at the radiological department person was working in was 0.68 (p = 0.001). The article suggests several means for enchancing job satisfaction and retention of the imaging units staff.

A survey of 25 hospitals in Nigeria has been conducted to assess the level of compliance to the Commission for European Communities (CEC) criteria for good radiographic practice in four adult radiographic examinations. Chest, skull, abdominal and lumbar spine radiographic examinations were assessed. Using a simple scoring system of ‘0’ for unfulfilled and ‘1’ for fulfilled criteria, the results show an average compliance level of 50 ± 8% for chest, 57 ± 8% for skull, 56 ± 10% for abdomen and 51 ± 7% for lumbar spine radiography. Findings show that the level of compliance could be corrected by the adoption of quality control programmes in the country.

Background

Any Medical imaging practice or education which is not based on current best evidence is unscientific and lacks the capability for sustainable quality and improvement. From literature search, there has not been any structured or empirical research to determine the knowledge attitudes and perceptions of radiographers to evidence based medical imaging in Nigeria.

Purpose

The purpose of this study was to assess the knowledge and attitudes towards the use of evidence based medical imaging among medical imaging scientists (radiographers) in south eastern Nigeria.

Methods

Quantitative research methods were employed. A questionnaire was sent to all radiographers working in hospitals in south eastern Nigeria for whom contact could be established (n = 60). The questionnaire included questions seeking information on radiographer’s definition of EBMI, attendance at EBMI courses, beliefs regarding patients’ willingness and capability to participate in EBMI and their perceived barriers to use of EBMI. Data analysis involved descriptive statistics and theme analysis of suggestions made by radiographers. SPSS (11.0) was used.

Results

Fifty out of the sixty questionnaires were returned. None of the respondents have ever attended an EBMI course, reads regularly or subscribes to a journal. 88% of respondents ticked the correct definition of EBMI. 62% of radiographers commented that EBMI is new to them. Analysis of barriers to the use of EBMI showed that no access to EBMI resources was the dominant barrier (36%). 15 (30%) of radiographers believe that 10% of patients can participate in EBMI, while 4 (8%) of radiographers believe that 100% of patients can participate. The majority of respondents (48%) believe that mass education of radiographers will improve the practice of EBMI.

Conclusions

We conclude that there is poor knowledge and attitude towards the use of EBMI by most radiographers (medical imaging scientists) in the south east Nigeria. Individual and organizational barriers to the use of evidence based medical imaging were identified. Mass education and better organizational platforms are needed to improve the practice of EBMI in Nigeria. A broad-based approach that integrates EBMI into practical clinical, teaching, administration and research domains is canvassed for Nigerian radiographers.

Saphenous varix is a rare vascular malformation occurring in the groin and its recognition may pose a diagnostic challenge.

This paper highlights the importance of differentiating saphenous varix from femoral hernia amongst a wide range of possible groin masses, using ultrasound as a front-line imaging modality which clinical examination could not diagnose.

We present a case report of a 39 year old male patient with saphenous varix, a sacculated varix of the greater saphenous vein closely simulating femoral hernia.

Our report highlights the key points to note in correctly diagnosing this rare condition and the role of ultrasound as a cheap, non-invasive and readily available modality.