Journal of Medical Imaging and Radiation Sciences最新文献

Introduction

This work reports on an unusual finding observed during image quality assessment in the preparation for the clinical implementation of breast magnetic resonance image-guided radiotherapy (MRIgRT) on a 1.5 Tesla (T) magnetic resonance linear accelerator (MR-Linac) (Elekta AB, Stockholm, Sweden).

Case and outcomes

A patient with T2 N0 M0 right breast invasive ductal carcinoma, receiving adjuvant radiotherapy, underwent two imaging sessions on the MR-Linac. The imaging protocol included T1- and T2-weighted (W) turbo spin echo (TSE) sequences, a T1W mDixon, and a T2W TSE navigated sequence acquired on end-expiration. All images were reconstructed in the axial plane.

Images were assessed for image quality and appropriateness for use within the treatment pathway using visual grading analysis (VGA). An artefact in the right breast was noted independently by all observers. The patient's skin and medical notes were reviewed for possible explanation. The findings were discussed with the patient's responsible clinician, and subsequent referral to the local multi-disciplinary team (MDT) for radiologist review was made.

On further investigation, the patient's images demonstrated a signal void in the subareolar region of the right breast coinciding with the surgical site. This was distal from the tumour bed and deemed unlikely to be related to a Magseed marker or intraoperative clips. The patient reported no history of nipple tattoo or piercing. There was nothing on clothing that this could be attributed to.

Discussion

Following MDT review, where all potential sources of signal void were considered, it was concluded that the cause was Magtrace, a superparamagnetic iron oxide tracer, recommended for sentinel lymph node localisation in patients with breast cancer in the United Kingdom. The artefact was characteristic of a magnetic susceptibility artefact. These can arise from local magnetic field inhomogeneities caused by the presence of the metal compounds in MagTrace. For breast MRIgRT on the MR-Linac, treatment verification and the possibility of real-time replanning is a critical aspect. The magnetic susceptibility artefact significantly inhibited plan adaption and confidence in the online image registration process making the patient ineligible for treatment on the MR-Linac.

Conclusion

As part of ongoing work-up for breast MRIgRT, the screening of patients for Magtrace is now included. Optimisation of MR imaging sequences for radiotherapy planning and image review to minimise distortion are being developed.

Introduction

A digital twin is a virtual representation of the real world. This paper presents the concept of a digital twin system that reflects the movements of the human skeleton as the body is repositioned. Digital twin technology has the ability to be used as a training tool for new radiographers to build their competencies due to its ability to provide visual feedback without the use of radiation. This study aims to evaluate the perceptions of radiography trainers and trainees regarding the utility of digital twin technology.

Methods

The concept of digital twin technology was demonstrated to 46 trainers and trainees. Surveys were distributed online on the same day as the demonstration to gather feedback from the participants regarding the perceived usefulness of digital twin technology. For dichotomized and categorical variables, the relationships among these variables were examined using either the chi-squared test or Fisher's exact test. Inductive thematic analysis was used to analyze the open-ended questions.

Results

Most respondents were willing to use digital twin technology (91.1 %) and agreed that it would be useful for education and training purposes (95.5 %). They also felt that it would improve radiographic skills (84.4 %) and confidence (93.3 %). Concerns regarding the product included its sensitivity to capturing subtle changes in positioning and its user-friendliness in terms of customization, and potential dependence on technology when positioning patients.

Conclusion

Digital twin technology has the potential to be a valuable training tool by allowing radiographers to hone their radiographic skills in a safe environment without the need for radiation exposure.

Background

Despite the benefits of forensic radiography (FR), its practice is in its infancy in Ghana. Radiographers, knowingly or unknowingly undertake forensic imaging despite a lack of guidelines, protocols and proper training in Ghana. This study aimed to explore Ghanaian radiographers’ perceptions of FR and identify their experiences.

Methods

A cross-sectional study design with an online survey was employed. Study participants included consecutively sampled qualified radiographers practising in Ghana. Data were descriptively and inferentially analysed. The significance for inferential analysis was set at p < 0.05. The key ideas from the narrative response to open-ended questions were presented as frequencies on a bar graph representing the frequency of each response.

Results

Completed responses were received from 124 qualified radiographers. Participants demonstrated a fair knowledge of FR (overall mean score (oms) = 3.95). Most participants (75% n=93) believed FR was within their professional scope of practice though the majority (57.2% n=71) believed they lacked formal training in FR. FR was perceived to be challenging among participants (ms= 3.52). Participants agreed on the provision of guidelines for FR practice by Ghanaian radiography stakeholders (oms= 4.23). Participants’ experiences revealed diverse roles in investigations and emotional/psychological reflections. Regarding cadaveric FR, most participants (59.7% n=74) expressed willingness to undertake. Specifically, male participants were 4 times more likely to report willingness than females (odd ratio (OR)= 4.147).

Discussion

Ghanaian radiographers demonstrated fair knowledge of FR despite a lack of awareness regarding cross-sectional techniques in FR. They presented a multitude of positive and negative perspectives regarding FR. Training in FR and guidelines are imperative to transform future practices in Ghana. The study highlighted reluctance and willingness among radiographers to perform cadaveric FR, emphasising the need for emotional preparedness.

Conclusion

This study offers insight into the perspectives of Ghanaian radiographers on FR, which would be helpful for future developments regarding its practice.

Introduction

Artificial Intelligence (AI) is revolutionizing medical imaging and radiation therapy. AI-powered applications are being deployed to aid Medical Radiation Technologists (MRTs) in clinical workflows, decision-making, dose optimisation, and a wide range of other tasks. Exploring the levels of AI education provided across the United States is crucial to prepare future graduates to deliver the digital future. This study aims to assess educators’ levels of AI knowledge, the current state of AI educational provisions, the perceived challenges around AI education, and important factors for future advancements.

Methods

An online survey was electronically administered to all radiologic technologists in the American Society of Radiologic Technologists (ASRT) database who indicated that they had an educator role in the United States. This was distributed through the membership of the ASRT, from February to April 2023. All quantitative data was analysed using frequency and descriptive statistics. The survey's open-ended questions were analysed using a conceptual content analysis approach.

Results

Out of 5,066 educators in the ASRT database, 373 valid responses were received, resulting in a response rate of 7.4%. Despite 84.5% of educators expressing the importance of teaching AI, 23.7% currently included AI in academic curricula. Of the 76.3% that did not include AI in their curricula, lack of AI knowledge among educators was the top reason for not integrating AI in education (59.1%). Similarly, AI-enabled tools were utilised by only 11.1% of the programs to assist teaching. The levels of trust in AI varied among educators.

Conclusion

The study found that although US educators of MRTs have a good baseline knowledge of general concepts regarding AI, they could improve on the teaching and use of AI in their curricula. AI training and guidance, adequate time to develop educational resources, and funding and support from higher education institutions were key priorities as highlighted by educators.

Introduction

The Coronavirus (COVID-19) pandemic resulted in an emphasis on external factors affecting the wellbeing of staff within the National Health Service. There is a national shortage of diagnostic radiographers in the United Kingdom, so maintaining the health and satisfaction of the current radiographic workforce is important. The aim of this literature review is to determine workplace-related factors affecting the wellbeing of diagnostic radiographers in their clinical practice.

Methods

An interpretive phenomenological approach was selected to gain an insight of wellbeing from the perspective of radiographers and radiology managers. A systematic literature search was conducted, resulting in 10 core articles which were then thematically analysed.

Results

Five themes were identified: Initial waves of COVID-19, Workload and Working Patterns, Mental Health, Sources of Support, and Recognition and Development.

Discussion

COVID-19 has had a short and long-term impact on the working practices of radiographers, leading to a risk of burnout. Radiographers appreciated different forms of recognition from managers and support within their team but felt a lack of professional recognition outside the radiology department. Radiographers displayed resilience during the pandemic, using various strategies to cope with emotional challenges. A variety of external support was available to radiographers, but this was often self-directed, with in-person support difficult to access due to working patterns.

Conclusion

This review highlights the lack of tailored support addressing radiographers’ unique experiences. As imaging modalities have different workloads and varying emotional involvement with patients, further research to provide evidence-based interventions to improve radiographers’ mental health is advised.

Background

Moral distress has been an issue under consideration in healthcare practice. The COVID-19 pandemic became a critical factor that contributed to heightened moral distress and injury among healthcare professionals, including radiographers. Despite the substantial engagement of radiographers in the management of COVID-19 patients, the consequent moral distress and injury states experienced by this critical frontline workforce have not been widely explored. This study investigated the level of moral distress and the coping mechanisms employed by radiographers in Ghana during the pandemic to provide valuable information to support radiographers and prepare the workforce better against any future pandemics.

Methods

Utilising a cross-sectional design, a survey approach was employed for data collection between June 2023 and August 2023 from clinically-active radiographers who worked before and during the pandemic in Ghana. Both descriptive and inferential statistics were generated using Microsoft Excel 2019 and the Statistical Package for the Social Sciences (v.26).

Results

Hundred (100) radiographers participated in the study. The result demonstrated that the COVID-19 pandemic escalated the risk of moral distress among radiographers from 22 % (n = 22) to 43 % (n = 43), with 33 % (n = 33) exhibiting signs of moral injury. This escalation impacted the mental health of 12 % (n = 12) of respondents and was reported as a contributor to career-changing decisions among radiographers. Notably, many of those affected did not seek formal support but relied on personal coping strategies and family support. Inadequate resources (69 %, n = 69), particularly regarding consumables, emerged as the primary cause of moral distress. The study underscored that the most effective means of mitigating moral distress in radiographers was through the provision of resources and additional staff support (66 %, n = 66).

Conclusion

This study sheds light on the state of moral distress and injury among radiographers during the COVID-19 pandemic, impacting the mental health of a minority and contributing to career-changing decisions. The findings emphasise the importance for healthcare institutions to proactively implement systems, such as resource provision, improved staffing, and emotional support, now and during similar future pandemics. This is crucial to address moral distress and cater to the mental health needs of radiographers, ensuring a resilient clinical radiography workforce.

Background and purpose

This narrative review focuses on the role of mobile MRI and CT units in addressing the challenges of healthcare accessibility and patient wait times in Saudi Arabia. It underscores the growing demand for diagnostic imaging amid infrastructural and geographical barriers, emphasizing mobile units as innovative solutions for enhancing radiological services across diverse Saudi landscapes. The purpose of this study is to assess how these mobile technologies can mitigate service delays, improve patient outcomes, and support healthcare delivery in remote or underserved areas, reflecting on global trends towards more dynamic, patient-centered healthcare models.

Methods

This review utilizes an expanded database search and refined keywords to ensure comprehensive literature coverage. The study focused on peer-review articles and grey literatures that directly examined the impact of these mobile units on healthcare accessibility, wait times, and service delivery. A thematic analysis identified significant contributions to accessibility improvements, emergency responses, and rural healthcare, highlighting areas for further research and policy development.

Discussion

Mobile units have advanced technical specifications with high-field magnets and multi-slice CT scanners on par with fixed facilities. They prioritize patient comfort and safety with examination areas, control rooms, and waiting areas. Telemedicine capabilities allow real-time image transmission to specialists. Strategic deployment can address workforce shortages by distributing services equitably. Mobile units represent cost-effective solutions to expand healthcare access without fixed infrastructure.

Conclusion

Integration of mobile MRI and CT units in Saudi Arabia can transform access to diagnostic imaging by decentralizing services and directly reaching patients, including rural areas. Evidence shows mobile units reduce diagnostic delays and optimize resource use. Despite challenges, strategic investments and collaborations can overcome obstacles to make radiological services more equitable, flexible and patient-focused in Saudi Arabia.