European Journal of Radiography最新文献

Radiographer's professional title and terms related to radiographer's work vary between countries, and there has so far been little systematic conceptual investigation on the subject. In this article, the content of radiographer's work and related terminology in a Finnish context are reviewed by means of the HMCD concept analysis method. In addition, the appropriateness of “nursing” is reviewed, as it has traditionally been closely connected to radiographer's work and education in Finland. Data consisted of literature, expert interviews and written material, and were analysed with qualitative content analysis.

Terms describing radiographer's work were found to be diverse. As a result, a new term, clinical radiography and radiotherapy (CRR), was introduced to label radiographer's work in Finland. CRR seems to consist of three main aspects: technical radiation usage and radiation protection, patient care and service, and service for a health care context. The results suggest CRR including qualities such as: actions based on theoretical and practical–technical expertise of radiographer; guidance by individuality-respectful client-orientation and interactive collaboration; implementation as a process; and emphasis on responsibility for safety and optimizing decision-making.

The results support the previous conceptions of the content of radiographer's work, its multi-dimensional nature, and demand for expertise. Technical radiation usage and radiation protection seems to be the focal aspect, although the aspect of patient care and service seems to be an essential part of CRR in Finland. The concept of nursing (as defined in nursing science) was not found suitable for describing radiographer's work in health care in its entirety.

Purpose

The purpose of the present study was to identify the factors having the largest influence on the patients, experiences of mammography screening and if these factors can be generalised for different centres.

Material and methods

Three-hundred-and-ninety-three women attending mammography examination during two randomly selected days at four screening centres in the Southern Health Region of Norway were approached. A questionnaire designed to survey socio-demographic variables and their experience with mammography screening was distributed upon attendance. The answers to the questionnaire were related to the level of breast compression which was recorded for every patient. Statistical analyses were performed to assess women's satisfaction, discomfort and level of pain during mammography screening.

Results

Eighty-two percent (324/393) completed the questionnaire. Ninety-one percent were ‘satisfied’ or ‘very satisfied’ with the service at the mammography screening centres. Still, 80% reported high level of discomfort related to the examination. ‘Moderate’, ‘strong’ or ‘intense’ pain during breast compression was reported by 25% of the women. Mean breast compression ranged from 8.5 ± 1.2 kg to15.7 ± 2.2 kg. In all, 23% of women experienced strong and intense pain at a compression of more than 16 kg, while none of the women experienced strong or intense pain for compression less than 8 kg.

Conclusion

Our results concur with earlier studies showing high level of satisfaction among Norwegian women undergoing breast screening. The present study clearly demonstrates that the level of compression is vital to the patients' experience of pain, but do not seem to influence their level of satisfaction with the procedure.

Medical radiation science (MRS) professionals are required to maintain a high standard of knowledge and therefore need satisfactory information literacy skills. Information literacy skills are required to seek, evaluate and synthesise information sources. With the vast amount of information that can be accessed it is important to ensure students are taught how to identify and locate information sources and evaluate them for credibility. Recent studies have shown that students prefer to access information sources on the internet via a search engine, often not considering the credibility of the information they are accessing. The information sources that are available on the internet are unfiltered, and the content of a website can be inaccurate and unreliable. There are numerous methods available for students to evaluate information sources for credibility and accuracy, and these should be considered before accepting presented data at face value. In the rapidly changing field of medical radiation science, graduates must be independent learners who can locate relevant information and perform critical analysis of information sources. To achieve this information literate students must be cultivated.

Purpose

This study recorded and analysed streak and motion artifacts in spiral CT examinations and evaluated the elimination and minimization of them by the use of segmental reconstruction with and without alterations of the initial examination protocol.

Materials and methods

One hundred CT scans of the chest and 300 CT scans of the brain have been included in this study. All studies were performed by a helical CT scanner (Philips 5000 SR) with the standard protocol and were randomly selected due to the presence of either streak or motion artifacts. Segmental reconstruction was applied in all cases by the same experienced radiographer. Image evaluation was performed by two experienced radiologists using a scoring system for each artifact and a grading system for classifying post-processing images.

Results

Among series of images that were evaluated after the application of segmental reconstruction, brain examinations demonstrated the following results: 10.9% of the cases showed no artifact improvement, 19.6% showed slight artifact improvement 31.5% showed moderate improvement and 38% showed significant improvement. The results of chest examinations were as follows: 27% of the cases showed no artifact improvement, 23% showed slight artifact improvement, 26% showed moderate improvement and 24% of showed significant improvement. Spatial reconstruction was useless in brain CT images when a patient moved during the entire scan and in chest CT images when streak and motion artifacts co-existed.

Conclusions

Spatial reconstruction may improve the image quality in brain and chest CT examinations and thus may contribute to more diagnostic images. Elimination of motion artifacts is also suggested due to the limitation of intravenous contrast medium that can be administered per patient per day and in cases of non-cooperative patients.

Magnetic Resonance Imaging (MRI) techniques have been increasingly applied to the study of molecular displacement (diffusion) in biologic tissue. The magnetic resonance measurement of an effective diffusion tensor of water in tissues can provide unique biologically and clinically relevant information that is not available from other imaging modalities. For this purpose Diffusion Tensor Imaging (DTI) is applied. DTI is an MRI variation that may significantly improve our understanding of brain structure and neural connectivity. DTI measures are thought to be representative of brain tissue microstructure and are particularly useful for examining organized brain regions, such as white matter tract areas. DTI measures the water diffusion tensor using diffusion weighted pulse sequences sensitive to microscopic random water motion. The resultant images display and allow for quantification of how water diffuses along axes or diffusion encoding directions. This can help measure and quantify a tissue's orientation and structure, making it an ideal tool for examining cerebral white matter and neural fiber tracts. In this article we discuss the theory on which DTI depends on, how can be used in mapping fiber tracts. Also the fiber tracking algorithms are presented.

This study compared the proportion of mammograms classified as perfect, good, moderately good or inadequate by a radiographer specially trained for doing such a classification at a breast centre (local-PGMI radiographer) with the proportion similarly assessed by an expert-PGMI radiographer. The results were compared with the recommendations given in the quality assurance manual of the Norwegian Breast Cancer Screening Programme. The reasons for classifying the mammograms into other than perfect, such as good, moderately good or inadequate were investigated.

The quality of the mammograms was measured by using the PGMI system, which is a quality-review model that classifies the images into the four categories according to positioning, compression, exposure, noise, artefacts, and movement. A total of 1280 mammograms from all 16 breast centres in the screening programme were classified.

The distribution of perfect, good, moderately good, and inadequate mammograms differed between the local-PGMI radiographers and the expert radiographer, for both the cranio-caudal (CC) and mediolateral–oblique (MLO) mammograms (P < 0.001 for both). The expert radiographer classified a higher proportion of both CC (28%) and MLO (14%) mammograms as inadequate than did the local-PGMI radiographers (7% and 3%, respectively; P < 0.001 for both). The guidelines recommend ≤3% of the mammograms to be inadequate. The reason given for the inadequate classifications by the expert radiographer was predominantly “parts of the breast missing” for both the CC and the MLO mammograms.

There is room to improve the quality of the mammograms in the screening programme in Norway. Attention should be given to positioning and the use of standardized terms in the PGMI classification.

Purpose

The purpose of the study was to demonstrate the effectiveness of scrotum shields and to find out if scrotum shields are used according to national guidelines. The reasons for not utilizing scrotum shields were also investigated.

Material and methods

A questionnaire was presented to radiographers in order to monitor their actual use of scrotum shield and the main reasons for not using it. Seventy Norwegian and 21 Danish radiographers answered the questions. Images from PACS at the Norwegian hospital were scrutinized. The effectiveness of the shields was studied by phantom measurements using an EDD diode instrument.

Results

For an unshielded dose of 1 mGy in the primary field, omitted doses of 0.8 mGy or more could be expected in the primary field and 0.2–0.3 mGy at a distance of 5 cm from the edge of the field. PACS information showed that scrotum shield was applied only in 63 out of 359 images. Thirty five percent of the Norwegian and 10% of the Danish radiographers answered that the use of scrotum shields increases the examination time. Twenty five of the 70 Norwegian and none of the Danish radiographers found it embarrassing to ask the patient to use the shields.

Conclusions

Utilization of a scrotum shield is effective even when the scrotum is outside the primary radiation field. Shields are seldom used at three Norwegian hospitals, but are used almost in every case at the Danish hospital. Embarrassment and lack of time are the main reasons for not using the shields.

In the past two decades radiography has experienced a wealth of changes, involving the teaching site, learning methods, curriculum, professional status, educational funding, and public expectations. Consequently this period witnessed the transition of radiography from a mainly hospital-linked to a mainly university-linked degree, from a knowledge-based discipline to an evidence-based practice. The early 1990s saw the establishment of graduate programs, the role expansion of radiographers, the technological advancements in medical imaging, the participation of the Radiography Schools in Research Assessment Exercise (RAE) schemes.

Given the educational, technological and social advancements the engagement of radiographers in research is emphasized as a priority that will bring the profession forward and help to maintain high standards of patient care.

Research in radiography is a requirement, as by definition professions are expected to contribute to the body of knowledge necessary for a profession to progress. Funding, ethical considerations, mentorship, proficiency in research methodology, commitment, and ability to work in a multi-disciplinary team are just a few of the requirements for high quality radiography research.

There has been a definite increase in the number of radiographers who are research aware and active as well as in the number of radiographers who pursue purely academic and research careers. However intensification of personal efforts and formulation of strategic decisions are required so that research forms an integral part of the profession. Recent developments in strengthening the research base of radiography are encouraging.