Pub Date : 2025-02-06DOI: 10.1016/j.jmir.2025.101859
Sergio M. Solis-Barquero , Andrea Astorga Ramirez , Jennifer Sanchez Portuguez , Ignacio Montero Ureña
{"title":"Medical device specialist: An emerging role for medical radiation technologists in Costa Rica","authors":"Sergio M. Solis-Barquero , Andrea Astorga Ramirez , Jennifer Sanchez Portuguez , Ignacio Montero Ureña","doi":"10.1016/j.jmir.2025.101859","DOIUrl":"10.1016/j.jmir.2025.101859","url":null,"abstract":"","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-05DOI: 10.1016/j.jmir.2025.101856
Gavin Cain , Beverly Snaith
The Multi-professional Framework (MPF) for Advanced Clinical Practice in England defines the essential capabilities required of advanced clinical practitioners. The Centre for Advanced Practice ePortfolio (supported) route provides a pathway for these practitioners to gain formal recognition, confirming that they meet the educational and experiential standards for advanced practice. This narrative review examines how a diagnostic radiographer from the first cohort successfully demonstrated these capabilities, using excerpts from their ePortfolio and examples of supporting evidence. The review aims to highlight activities characteristic of advanced practice in diagnostic radiography and radiographic reporting, and how they can be effectively documented to demonstrate fulfilment of the MPF capabilities.
{"title":"Recognition of education, training and experience in advanced clinical practice through a national multiprofessional scheme: A narrative review from a radiographer participant","authors":"Gavin Cain , Beverly Snaith","doi":"10.1016/j.jmir.2025.101856","DOIUrl":"10.1016/j.jmir.2025.101856","url":null,"abstract":"<div><div>The Multi-professional Framework (MPF) for Advanced Clinical Practice in England defines the essential capabilities required of advanced clinical practitioners. The Centre for Advanced Practice ePortfolio (supported) route provides a pathway for these practitioners to gain formal recognition, confirming that they meet the educational and experiential standards for advanced practice. This narrative review examines how a diagnostic radiographer from the first cohort successfully demonstrated these capabilities, using excerpts from their ePortfolio and examples of supporting evidence. The review aims to highlight activities characteristic of advanced practice in diagnostic radiography and radiographic reporting, and how they can be effectively documented to demonstrate fulfilment of the MPF capabilities.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 3","pages":"Article 101856"},"PeriodicalIF":1.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.jmir.2024.101845
Cyndi Logan
{"title":"Medical imaging? “Yes Please!”","authors":"Cyndi Logan","doi":"10.1016/j.jmir.2024.101845","DOIUrl":"10.1016/j.jmir.2024.101845","url":null,"abstract":"","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 3","pages":"Article 101845"},"PeriodicalIF":1.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jmir.2024.101849
Amnuay Kleebayoon , Viroj Wiwanitkit
{"title":"Letter to the Editor re: How does intelligent noise reduction software influence the image quality in pelvic digital radiography","authors":"Amnuay Kleebayoon , Viroj Wiwanitkit","doi":"10.1016/j.jmir.2024.101849","DOIUrl":"10.1016/j.jmir.2024.101849","url":null,"abstract":"","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 3","pages":"Article 101849"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1016/j.jmir.2024.101848
Rogério Lopes , Pedro Teles , Joana Santos
Background
Currently, there is an increase in procedures across various clinical specialties involving the use of ionising radiation.
Objective
The primary objective of this systematic review is to analyse and compare the existing literature regarding the effectiveness of leaded glasses for healthcare professionals.
Methods
Comprehensive literature searches were conducted for relevant studies published between 2018 and 2023 using the Scopus, PubMed, and Web of Science databases according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology.
Results
After the complete text screening, 11 articles were deemed suitable for inclusion in the review. Leaded glasses significantly reduce eye radiation exposure, with studies showing shielding effects ranging from 10 % to 88,9 %, depending on the configuration and thickness of the glasses. For instance, lightweight glasses achieved a shielding effect of 61.4 %, while thicker lead equivalents (≥0.5 mm) offered up to ninefold dose reductions. Studies also noted the importance of lateral shielding and ergonomic designs for optimal protection. Leaded glasses significantly reduce eye lens doses but are most effective when combined with other protective measures. Factors such as head orientation, procedural complexity, and operator movement influence their performance. The findings underscore the need for standardised guidelines on protective eyewear use and further research under real-world clinical conditions.
Conclusion
It is essential to ensure the proper use of leaded glasses to minimize the risks of ionising radiation for healthcare professionals in fluoroscopy procedures.
背景:目前,在不同的临床专业中使用电离辐射的程序有所增加。目的:本系统综述的主要目的是分析和比较现有文献关于医疗保健专业人员使用含铅眼镜的有效性。方法:使用Scopus、PubMed和Web of Science数据库,根据系统评价和荟萃分析(PRISMA)方法的首选报告项目,对2018 - 2023年发表的相关研究进行综合文献检索。结果:经过完整的文本筛选,11篇文章被认为适合纳入本综述。含铅眼镜可显著降低眼睛的辐射暴露,研究表明,根据眼镜的配置和厚度,屏蔽效果在10%至88.9%之间。例如,轻质玻璃达到了61.4%的屏蔽效果,而较厚的铅当量(≥0.5 mm)提供了高达9倍的剂量减少。研究还指出了侧向屏蔽和人体工程学设计对最佳保护的重要性。含铅眼镜可显著减少镜片剂量,但与其他保护措施结合使用时效果最好。诸如头部方向、程序复杂性和操作员运动等因素影响其性能。研究结果强调,需要制定防护眼镜使用的标准化指南,并在实际临床条件下进行进一步研究。结论:应正确使用含铅玻璃,以降低医疗人员在透视过程中电离辐射的风险。
{"title":"A systematic review of the effectiveness of leaded glasses for ensuring safety among healthcare professionals in fluoroscopy","authors":"Rogério Lopes , Pedro Teles , Joana Santos","doi":"10.1016/j.jmir.2024.101848","DOIUrl":"10.1016/j.jmir.2024.101848","url":null,"abstract":"<div><h3>Background</h3><div>Currently, there is an increase in procedures across various clinical specialties involving the use of ionising radiation.</div></div><div><h3>Objective</h3><div>The primary objective of this systematic review is to analyse and compare the existing literature regarding the effectiveness of leaded glasses for healthcare professionals.</div></div><div><h3>Methods</h3><div>Comprehensive literature searches were conducted for relevant studies published between 2018 and 2023 using the Scopus, PubMed, and Web of Science databases according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology.</div></div><div><h3>Results</h3><div>After the complete text screening, 11 articles were deemed suitable for inclusion in the review. Leaded glasses significantly reduce eye radiation exposure, with studies showing shielding effects ranging from 10 % to 88,9 %, depending on the configuration and thickness of the glasses. For instance, lightweight glasses achieved a shielding effect of 61.4 %, while thicker lead equivalents (≥0.5 mm) offered up to ninefold dose reductions. Studies also noted the importance of lateral shielding and ergonomic designs for optimal protection. Leaded glasses significantly reduce eye lens doses but are most effective when combined with other protective measures. Factors such as head orientation, procedural complexity, and operator movement influence their performance. The findings underscore the need for standardised guidelines on protective eyewear use and further research under real-world clinical conditions.</div></div><div><h3>Conclusion</h3><div>It is essential to ensure the proper use of leaded glasses to minimize the risks of ionising radiation for healthcare professionals in fluoroscopy procedures.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101848"},"PeriodicalIF":1.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.1016/j.jmir.2024.101843
Minh Chau , Clare L Singh , Tricia Bowman
Introduction/Background
Group work plays a crucial role in healthcare education by fostering collaboration, communication, and teamwork skills. However, students often face challenges such as unequal workload distribution, conflict, and anxiety. Group learning contracts have been introduced to improve group dynamics by setting clear expectations, enhancing accountability, and promoting effective collaboration. This systematic review explores the impact of group learning contracts on students’ experiences in healthcare education.
Methods
A comprehensive search across six databases, including Medline, ProQuest, and SCOPUS, identified studies published from inception to 2023. Keywords related to group work, healthcare education, and learning contracts were used. Data extraction and quality appraisal followed the PRISMA guidelines, with the Mixed Methods Appraisal Tool (MMAT) used for bias assessment.
Results
All four studies demonstrated positive outcomes from using group learning contracts. Improvements included better workload distribution, increased communication, reduced anxiety, and enhanced collaboration. One study reported greater effectiveness of these contracts in online learning settings. Some students, however, found the additional paperwork burdensome. Despite overall low bias risk, methodological limitations, including small sample sizes and absence of control groups, were noted.
Discussion
The findings highlight the potential of group learning contracts to mitigate common challenges in group work and enhance students' learning experiences. Aligning with previous research, structured agreements foster accountability and reduce group-related stress.
Conclusion
Group learning contracts are valuable tools in healthcare education, promoting positive group dynamics and improving student outcomes. Further research with larger, more diverse samples is needed to confirm these findings and optimize implementation across various educational contexts.
{"title":"Group learning contracts in healthcare education: A systematic review","authors":"Minh Chau , Clare L Singh , Tricia Bowman","doi":"10.1016/j.jmir.2024.101843","DOIUrl":"10.1016/j.jmir.2024.101843","url":null,"abstract":"<div><h3>Introduction/Background</h3><div>Group work plays a crucial role in healthcare education by fostering collaboration, communication, and teamwork skills. However, students often face challenges such as unequal workload distribution, conflict, and anxiety. Group learning contracts have been introduced to improve group dynamics by setting clear expectations, enhancing accountability, and promoting effective collaboration. This systematic review explores the impact of group learning contracts on students’ experiences in healthcare education.</div></div><div><h3>Methods</h3><div>A comprehensive search across six databases, including Medline, ProQuest, and SCOPUS, identified studies published from inception to 2023. Keywords related to group work, healthcare education, and learning contracts were used. Data extraction and quality appraisal followed the PRISMA guidelines, with the Mixed Methods Appraisal Tool (MMAT) used for bias assessment.</div></div><div><h3>Results</h3><div>All four studies demonstrated positive outcomes from using group learning contracts. Improvements included better workload distribution, increased communication, reduced anxiety, and enhanced collaboration. One study reported greater effectiveness of these contracts in online learning settings. Some students, however, found the additional paperwork burdensome. Despite overall low bias risk, methodological limitations, including small sample sizes and absence of control groups, were noted.</div></div><div><h3>Discussion</h3><div>The findings highlight the potential of group learning contracts to mitigate common challenges in group work and enhance students' learning experiences. Aligning with previous research, structured agreements foster accountability and reduce group-related stress.</div></div><div><h3>Conclusion</h3><div>Group learning contracts are valuable tools in healthcare education, promoting positive group dynamics and improving student outcomes. Further research with larger, more diverse samples is needed to confirm these findings and optimize implementation across various educational contexts.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101843"},"PeriodicalIF":1.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.1016/j.jmir.2024.101836
Jennifer Anderson
{"title":"Into the light: A story about breast cancer radiation treatment","authors":"Jennifer Anderson","doi":"10.1016/j.jmir.2024.101836","DOIUrl":"10.1016/j.jmir.2024.101836","url":null,"abstract":"","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 2","pages":"Article 101836"},"PeriodicalIF":1.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jmir.2024.05.005
Allie Tonks , Caitlin Tu , Ingrid Klobasa
<div><h3>Introduction</h3><div>Radiographer commenting is a written account of suspected abnormalities identified on medical imaging examinations by the radiographer at the time of image acquisition. Radiographer comments were originally implemented to support emergency clinicians; however, they may also have the potential to support radiologists in reducing missed findings. Therefore, the aim of this study was to investigate if a newly implemented radiographer comment system could reduce the number of errors made in radiology reports for general X-rays. Incidental findings from multisite collaborative research led to the hypothesis that in some cases radiographer comments could accurately detect abnormal X-ray appearances that were not otherwise documented in the radiologist report, thereby enabling results to be revised and errors collaboratively reduced <span><span>[1]</span></span>.</div></div><div><h3>Methods</h3><div>This study was conducted at an 800-bed hospital, where 92% of general radiographers self-selected to participate. Radiographer comments were provided to referring physicians through the electronic medical record and could be made for any emergency or inpatient general X-ray examinations. All comments made over a 12-month period were audited against the corresponding radiologist report. Radiologists were blinded to radiographer comments at the time of reporting. Where discrepancies between the radiographer comment and radiologist report arose, additional radiologist review or subsequent imaging reports were used to determine the accurate interpretation. The number of discrepant radiographer comments that were deemed true positive (TP) and provided new and correct diagnostic information compared to the radiologist report were identified. These were converted to a percentage of total radiographer comments that were therefore able to positively influence radiologist report accuracy. The number of discrepant cases where radiographer comments were deemed false positive (FP) was also measured and converted to a percentage of the total comments. Confidence intervals for both TP and FP binomial proportions were calculated using the Wilson Score Interval.</div></div><div><h3>Results</h3><div>Over 12 months, 282 radiographer comments were made to alert clinically significant radiographic appearances on general X-ray. Of these, 32 radiographer comments were discrepant with the report. Of these 32 comments, 24 were deemed TP meaning they correctly identified a pathological imaging appearance that was not otherwise documented in the radiology report. Therefore, 8.5% of all radiographer comments added value by correctly identifying a pathology that was not otherwise documented, 95% CI (5.8% - 12.4%). This enabled results to be promptly amended and reporting errors collaboratively reduced. Conversely, eight (2.8%) radiographer comments were discrepant with the report but deemed FP and did not add value to the investigation, 95% CI (1.4% - 5.5%
简介:放射技师评论是放射技师在采集图像时对医学影像检查中发现的疑似异常情况进行的书面说明。放射技师评论最初是为了支持急诊临床医生而实施的,但也有可能支持放射医师减少漏诊。因此,本研究旨在探讨新实施的放射技师评论系统能否减少普通 X 射线放射报告中的错误数量。多地点合作研究的偶然发现提出了一个假设,即在某些情况下,放射技师的评论可以准确发现放射医师报告中没有记录的异常 X 光片,从而可以修改结果并共同减少错误[1]:本研究在一家拥有 800 张床位的医院进行,92% 的普通放射技师自愿参加。放射技师的意见通过电子病历提供给转诊医生,可用于任何急诊或住院普通 X 光检查。在 12 个月内提出的所有意见都要与相应的放射科医生报告进行核对。放射科医生在报告时对放射技师的意见是保密的。如果放射技师的评论与放射医师的报告之间出现差异,则会使用放射医师的补充审查或后续成像报告来确定准确的解释。与放射科医生的报告相比,放射科医生的意见被视为真阳性 (TP),并提供了新的、正确的诊断信息。这些意见被转换成放射技师意见总数的百分比,从而对放射技师报告的准确性产生积极影响。此外,还测量了放射技师意见被视为假阳性(FP)的差异病例数量,并将其转换为占总意见的百分比。使用 Wilson Score Interval 计算了 TP 和 FP 二项比例的置信区间:在 12 个月内,共有 282 条放射技师意见提醒普通 X 光片上有临床意义的影像学表现。其中有 32 条放射技师意见与报告不符。在这 32 条意见中,有 24 条被认为是 TP,这意味着它们正确识别了放射学报告中没有记录的病理影像。因此,在所有的放射技师意见中,有 8.5% 的意见通过正确识别病理而增加了价值,95% CI (5.8% - 12.4%)。这样就能及时修正结果,共同减少报告错误。相反,有八条(2.8%)放射技师意见与报告不符,但被认为是 FP,没有增加调查价值,95% CI (1.4% - 5.5%)。其余的 250 条非差异意见无助于减少错误,但提供了实时异常检测,使管理团队受益:这些研究结果与之前的文献一致,即放射技师的评论可为放射技师提供安全网,原因包括直接接触患者、扩展临床病史的能力以及专业知识积累的差异。这项研究表明,放射技师的评论可作为一种多学科减少错误的工具,有效协助放射技师履行其重要职责并改善临床结果。
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Pub Date : 2025-01-01DOI: 10.1016/j.jmir.2023.11.009
Wan Chin Lee , Jun Kai Poon , Jacqueline Jin Hui Siah , Mei Choo Chong , Christopher Lai
Background
Computed Tomography Pulmonary Angiography (CTPA) is currently the gold standard for diagnosing Pulmonary Embolism (PE), with a high flowrate (>4.5ml/s) for contrast media (CM) administration recommended for sufficient pulmonary artery opacification. However, this may not be achievable for patients with challenging IV access.
Aim
To determine if a low volume CM, low flowrate (LVLF) CTPA protocol produces images of similar image quality compared to a standard protocol in two aspects, in terms of peak arterial enhancement through the quantitative measurement of Hounsfield unit (HU) and based on subjective overall image quality.
Methods
Retrospective collection of 151 patients who underwent CTPA via 320 slice multi-detector CT due to clinical suspicion of PE. 80 patients underwent the standard protocol, with a fixed flowrate of 4.5ml/s and 50ml of CM, while 71 patients underwent the LVLF protocol with up to a 37% and 30% reduction in flowrate and CM administered, respectively. Two independent radiographers measured the attenuation of multiple pulmonary arteries in HU, with ≥200HU being considered diagnostic. Overall image quality was also reviewed using a 5-point close-ended questionnaire by two independent radiologists.
Results
There was no significant difference in terms of attenuation measured in HU for the seven regions of interest (main pulmonary trunk, right and left pulmonary arteries, right and left lobar arteries, and right and left subsegmental arteries (RSA and LSA)) between the LVLF and standard CTPA protocol. Similarly, there were no significant differences in the overall image quality score obtained from standard and LVLF protocols reported by both radiologists.
Conclusion
The LVLF protocol can achieve similar enhancement and subjective image quality as the standard CTPA protocol, potentially allowing for further optimisation in the CM dosage.
背景:计算机断层扫描肺血管造影术(CTPA)是目前诊断肺栓塞(PE)的黄金标准,建议使用高流速(>4.5ml/s)造影剂(CM)以获得足够的肺动脉通透性。目的:通过对 Hounsfield 单位(HU)的定量测量和基于主观整体图像质量的测量,确定低容量 CM、低流速(LVLF)CTPA 方案与标准方案相比是否能在两个方面产生相似的图像质量:回顾性收集了 151 名因临床怀疑 PE 而通过 320 片多切面 CT 进行 CTPA 的患者。80名患者接受了标准方案,流量固定为4.5毫升/秒,CM剂量为50毫升;71名患者接受了LVLF方案,流量和CM剂量分别减少了37%和30%。两名独立的放射技师以 HU 为单位测量了多条肺动脉的衰减,≥200HU 被认为是诊断性的。两位独立的放射科医生还使用 5 点封闭式问卷对整体图像质量进行了评估:LVLF 和标准 CTPA 方案在七个相关区域(主肺动脉干、左右肺动脉、左右肺叶动脉、左右肺段下动脉(RSA 和 LSA))的衰减(以 HU 计)方面无明显差异。同样,两位放射科医生报告的标准和 LVLF 方案获得的总体图像质量评分也无明显差异:结论:LVLF 方案能达到与标准 CTPA 方案相似的增强效果和主观图像质量,有可能进一步优化 CM 剂量。
{"title":"Feasibility of low contrast volume and low injection flow rate in CT pulmonary angiography","authors":"Wan Chin Lee , Jun Kai Poon , Jacqueline Jin Hui Siah , Mei Choo Chong , Christopher Lai","doi":"10.1016/j.jmir.2023.11.009","DOIUrl":"10.1016/j.jmir.2023.11.009","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Computed Tomography </span>Pulmonary Angiography (CTPA) is currently the gold standard for diagnosing </span>Pulmonary Embolism<span> (PE), with a high flowrate (>4.5ml/s) for contrast media (CM) administration recommended for sufficient pulmonary artery opacification. However, this may not be achievable for patients with challenging IV access.</span></div></div><div><h3>Aim</h3><div>To determine if a low volume CM, low flowrate (LVLF) CTPA protocol produces images of similar image quality compared to a standard protocol in two aspects, in terms of peak arterial enhancement through the quantitative measurement of Hounsfield unit (HU) and based on subjective overall image quality.</div></div><div><h3>Methods</h3><div>Retrospective collection of 151 patients who underwent CTPA via 320 slice multi-detector CT due to clinical suspicion of PE. 80 patients underwent the standard protocol, with a fixed flowrate of 4.5ml/s and 50ml of CM, while 71 patients underwent the LVLF protocol with up to a 37% and 30% reduction in flowrate and CM administered, respectively. Two independent radiographers measured the attenuation of multiple pulmonary arteries in HU, with ≥200HU being considered diagnostic. Overall image quality was also reviewed using a 5-point close-ended questionnaire by two independent radiologists.</div></div><div><h3>Results</h3><div>There was no significant difference in terms of attenuation measured in HU for the seven regions of interest (main pulmonary trunk, right and left pulmonary arteries, right and left lobar arteries, and right and left subsegmental arteries (RSA and LSA)) between the LVLF and standard CTPA protocol. Similarly, there were no significant differences in the overall image quality score obtained from standard and LVLF protocols reported by both radiologists.</div></div><div><h3>Conclusion</h3><div>The LVLF protocol can achieve similar enhancement and subjective image quality as the standard CTPA protocol, potentially allowing for further optimisation in the CM dosage.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101349"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/S1939-8654(24)00571-X
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