Journal of Medical Radiation Sciences最新文献

Value-based health care (VBHC) is an evolving paradigm in healthcare that prioritises patient outcomes relative to the costs incurred. VBHC emphasises efficiency, quality, and patient satisfaction as metrics and determinants of healthcare. A VBHC approach is becoming increasingly significant as healthcare systems worldwide grapple with rising costs, staff shortages, and the ongoing need for improved patient care. Online adaptive radiotherapy (oART) is a promising innovation in radiation oncology, allowing for the adaptation of radiation treatment plans to account for daily anatomical changes. This innovation has the potential to improve patient outcomes; however, it requires investment in the technology, manpower, and training to deliver an adaptive radiotherapy service. This commentary aims to explore the role of radiation therapists (RTs) in oART, using RT-led workflows within the context of the broader models of care that involve radiation oncologists and multidisciplinary teams. This commentary also aims to highlight the potential benefits and challenges of adopting an RT-led approach within VBHC principles, focusing on key themes such as treatment accuracy, patient satisfaction, training, and cost implications.

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Palliative radiation therapy (RT) is a vital treatment modality for managing symptoms from metastatic disease, but access barriers and workflow inefficiencies can delay or preclude care delivery. Simulation-free RT (SFRT) offers an effective, value-based solution by eliminating the traditional computed tomography (CT) simulation process and utilising existing diagnostic or staging CT scans for treatment planning. This process reduces patient burden and accelerates time to treatment, prioritising patient-centred care over traditional treatment pathways. Key technical considerations include managing dosimetric and geometric variations through appropriate patient selection and quality assurance processes. The successful implementation of SFRT requires a collaborative, multidisciplinary team approach, drawing on expertise from established centres to familiarise the team with the process. Access to diverse diagnostic imaging datasets and collaboration with various imaging providers is crucial. While careful patient selection is essential, our experience demonstrates that SFRT exemplifies value-based healthcare principles by optimising resource utilisation while prioritising patient-centred care, particularly valuable in rural settings where travel distances significantly impact treatment access. This paper aims to review the benefits and technical aspects, as well as provide key considerations for implementing SFRT in palliative RT settings.

The hypoglossal nerve (HN) provides motor innervation to tongue muscles responsible for tongue movement, speech, mastication, swallowing, respiratory functions and management of oral secretions. Injury, compression, entrapment or lesions of the HN at any point along its path can result in HN palsy and subsequent dysphagia, dysarthria and tongue muscular atrophy. A combined imaging approach is required to investigate the HN and causes of HN palsy. Magnetic resonance imaging (MRI) and computed tomography (CT) imaging are used to investigate the intracranial HN and where it emerges in the upper neck. The extracranial HN can be assessed by sonographic imaging along with the muscles directly and indirectly innervated by the HN. Ultrasound imaging can be challenging without an appropriate understanding of the detailed relative anatomy of the HN and the muscles it innervates, the associated sonographic technique and sonographic appearances, all of which are outlined in this paper.