Journal of Medical Imaging and Radiation Oncology最新文献

Introduction

Radiology education has evolved significantly with the rise of online learning resources. While digital platforms are now integral to trainee study, the growing volume of content and variable access present challenges. Globally, studies have highlighted the benefits of curated digital learning, yet there is limited data on how radiology trainees in Australia and New Zealand use online resources and integrate them with traditional materials. This study aimed to evaluate the study habits of RANZCR (Royal Australian and New Zealand College of Radiology) radiology trainees, focusing on resource usage, perceptions of teaching modalities, and engagement with the RANZCR curriculum.

Methods

A cross-sectional study of current RANZCR trainees was performed, with data collected via an anonymous, voluntary online questionnaire distributed to all accredited RANZCR trainees via official College communications and at key educational events. The questionnaire covered six domains: demographics, textbook use, online resource use, in-person and remote teaching, and attitudes towards the curriculum. Both quantitative and qualitative data were collected. Descriptive statistics and group comparisons were performed using SPSS and OpenEpi. Free-text responses underwent thematic analysis.

Results

A total of 145 trainees responded (22% response rate). 74% reported using online resources for over half of their learning, while only 15% relied similarly on textbooks. Cost was a major barrier, with 84% of trainees limited by subscription fees. Case-based, in-person teaching was consistently rated the most effective teaching method, though 89% also valued on-demand didactic content. Qualitative analysis revealed learners valued the convenience of online learning, but raised concerns over variability in teaching quality and a perceived disconnect between the curriculum structure and exam relevance.

Conclusion

This study demonstrates a clear shift towards online learning among Australian and New Zealand radiology trainees, reflecting broader global trends. While digital resources are preferred for their accessibility and targeted content, cost and content overload remain key barriers. Greater institutional support, structured guidance on resource use, and refinement of the RANZCR curriculum are needed to ensure the curriculum aligns with modern study habits and exam preparation needs.

Introduction

This paper reports the key findings of the Faculty of Radiation Oncology 2022 workforce census. This is the first census since the COVID-19 pandemic and questions have been updated to assess the impact on RANZCR trainees and fellows. This report focuses on the analysis of respondents from Australia, New Zealand and overseas members, with a separate paper to follow focusing exclusively on New Zealand respondents.

Method

The census was conducted in mid-late 2022 with many questions repeated from previous censuses. New questions were asked about theranostics, working remotely, hypofractionation and the impact of COVID-19 on work practices.

Results

The census was sent to 591 radiation oncologists with an overall response rate of 52%. Almost half of respondents (n = 94/210; 45%) indicated that COVID-19 had no impact on the uptake of hypofractionation. Hypofractionation was most used by respondents in breast and prostate treatment (n = 134/200; 67% and n = 112/194; 58% respectively). Five respondents (n = 5/270; 2%) currently practise in theranostics, with the majority treating thyroid cancers within the public sector.

Just under half (n = 81/167; 49%) of invited trainees responded. The majority felt that COVID-19 had a negative impact on their training. There has been a decrease in the number of new fellows seeking to complete further fellowships. Employment remains at very high levels for new fellows ( > 98%).

Conclusion

The impact of COVID-19 on local practices and workloads was not as significant as seen overseas. There continues to be an increasing trend of radiation oncologists working in the private sector. The lack of indigenous representation within our profession continues to be an area that needs further attention.

Introduction

Optimal radiotherapy (RT) use in cancer patients results in substantial 5-year local control (LC) and overall survival (OS) benefits at the population level. This study aimed to estimate the average per capita cost of the first course of RT treatment and the associated cost per LC and OS outcomes, both overall and by cancer stage.

Methods

Data on RT activities from 2017 to 2020 for lung, rectum, cervix, prostate, brain and head and neck (H&N) cancers were extracted from South-Western Sydney Local Health District electronic oncology information system MOSAIQ (Elekta, version 2.63). Costs were assigned based on activity codes and adjusted for yearly inflation rates. The average cost per treatment course was calculated (average cost per activity × number of fractions). Costs per 5- and 1-year LC and OS outcomes were estimated for all stages and for stages I–II and III.

Results

A total of 106,174 RT activities were extracted. The average cost of an RT treatment course was highest for prostate cancer ($10,332) and lowest for lung cancer ($5598). The lowest costs per 5-year outcome were observed for cervical cancers (LC: $15,780, OS: $28,370) and H&N cancers (LC: $17,500, OS: $29,750). The cost per 5-year LC and OS outcome remained below $100,000 across all stages for each cancer type, except for prostate cancer, where the cost per OS outcome exceeded this level.

Conclusion

This study demonstrates that the absolute costs associated with achieving 5-year local control and overall survival outcomes with radiotherapy are comparatively low across several major cancer types. These findings highlight the efficiency of radiotherapy in delivering meaningful clinical outcomes and can help inform service planning, investment decisions and prioritisation of radiotherapy within cancer care strategies.

Introduction

This study investigates the role of positron emission tomography-computed tomography in the treatment decision-making process for cancer patients aged 85 years and older.

Methods

Retrospective study including 137 patients. Patients aged ≥ 85 years with histopathological solid malignancy. Demographic characteristics and comorbidities as well as performance status (ECOG), tumour characteristics, imaging modalities and treatment choices were variables. Patients were categorised according to PET-CT use, and statistical analyses including Mann–Whitney U test, Bonferroni correction and binary logistic regression were performed to identify independent predictors of PET-CT use.

Results

The majority of patients had ECOG 2 (69%), thoracic (32%) cancer and metastatic (70%) at diagnosis, with a median age of 89 years (range: 85–99). Comorbidities were common (73%), and the most common organ dysfunctions were renal (25%) and heart failure (24%). PET-CT was performed in 47% of the patients. PET-CT was predominantly used in patients with metastatic disease, those who had received radiotherapy and those who were given best supportive care. However, patients undergoing PET-CT had significantly lower rates of curative treatment (3% vs. 18%, p = 0.0016). Binary logistic regression identified best supportive care decision as the only independent predictor of PET-CT use.

Conclusions

The findings indicated that PET-CT is commonly used for staging in patients who are ultimately managed with palliative care. Future research should address the cost-effectiveness of PET-CT, appropriate imaging indications, and its impact on cancer-related outcomes.

Introduction

Varicocele is a correctable cause of male infertility with management options including catheter embolisation of the testicular vein, done by Interventional Radiologists. Varicoceles can present in childhood and adolescence with scrotal pain or discomfort, or may be subclinical. It involves dilatation of the pampiniform plexus related to congestion and retrograde flow in the testicular vein. If left untreated, the pain and discomfort may impact the quality of life of the paediatric patient, and in the long term, infertility may ensue. However, limited data are available on the long-term clinical outcomes and complications of Varicocele embolisation in paediatric patients.

Method

Retrospective cohort study of 14 years of endovascular Varicocele embolisation at a single-operator tertiary paediatric centre.

Results

Eighty-four patients with a median age of 14 years (range 8–17 years) were identified. The varicoceles were predominantly of grade 1 or 2. 99% of patients had unilateral left-sided varicoceles. One patient had bilateral varicoceles. This study demonstrated that the technical success rate of endovascular embolisation is 94% and the clinical success rate is 98%. 84% reported feeling well in the immediate postprocedural period. 86% of cases reported excellent long-term progress. A small proportion (10%) experienced long-term discomfort or pain. There were no cases of relapse.

Conclusion

Endovascular embolisation is a successful technique for the management of Varicocele in paediatric patients, with good immediate and long-term clinical outcomes. It has low recurrence rates.