Radiography最新文献

Introduction: A standardised Medical Imaging Suite (MIS) request form was developed as an educational tool to simulate real-world clinical documentation and improve radiography students' ability to interpret and communicate medical imaging requests. This form was integrated into the radiography curriculum to support learning outcomes related to clinical reasoning, documentation, and communication. This study evaluates student perceptions of the MIS request form and its influence on their preparedness following their first clinical placement.

Methods: A closed-ended survey was administered to second-year undergraduate (n = 73) and first-year postgraduate (n = 75) diagnostic radiography students at an Australian tertiary institution. The survey captured demographic data; perceived preparedness; communication confidence; usability of the MIS form; and its impact on critical thinking. Quantitative data were analysed descriptively. Optional open-ended questions allowed participants to expand on their responses, and the frequency of each issue was counted and reported as descriptive statistics.

Results: Of 148 eligible students, 137 completed the survey (92.6 % response rate; 48 % undergraduate, 52 % postgraduate). Most respondents were female (78.1 %) and aged 18-25 (84.7 %). Over 75 % agreed that the standardised MIS request form improved their understanding of clinical requests, confidence in interpreting information, and overall preparedness for placement. The redesigned MIS request form was rated clearer and more complete by 84.7 % of students, with 94.5 % recommending its continued use in X-ray practical classes.

Conclusion: Embedding a standardised imaging request form into the radiography curriculum appears to enhance student's clinical preparedness. The form supports the development of critical thinking, documentation accuracy, and interprofessional communication.

Implications for practice: Continued evaluation and refinement of the MIS request form will help maintain strong alignment between university teaching and clinical expectations.

Introduction: Interventional radiology (IR) and interventional cardiology (IC) are rapidly evolving fields in medical imaging that require radiographers with advanced technical and clinical skills. However, education and training for these roles are not yet standardised across Europe. This study examined how undergraduate and postgraduate programmes prepare radiographers for IR and IC roles, with a focus on teaching structure, clinical exposure, graduate competence, and training needs.

Methods: A cross-sectional survey was distributed to radiography academics and clinical educators across Europe using purposive and snowball sampling methods. The online questionnaire comprised 17 items regarding programme duration, ECTS allocation, teaching approaches, clinical placements, and postgraduate study. Descriptive statistics were employed for quantitative data, while open-ended responses were analysed thematically.

Results: Twenty-seven institutions from nine countries participated in the survey. The findings revealed significant variation in programme design (60-240 ECTS) and limited content related to IR and IC. Approximately 44 % (n = 12) of respondents indicated less than 10 h of theoretical instruction, and 37 % (n = 10) provided only 1-2 weeks of clinical exposure, with 11 % (n = 3) offering none. Only 11 % (n = 3) of graduates were perceived as ready for independent practice, while 85 % (n = 23) required supervision. About 74 % (n = 20) reported the absence of postgraduate courses. Competence assessments were primarily conducted in-house, with no national guidelines in place. Identified themes included gaps in pre-registration education, inadequate access to structured training, and minimal utilisation of simulation.

Conclusion: Radiography education in IR and IC across Europe is inconsistent and fragmented hindering graduates' readiness and mobility. European stakeholders should collaborate to develop a harmonised education and competency framework for IR and IC radiographers.

Implications for practice: A harmonised framework will enhance training quality, improve patient safety, and ensure workforce mobility.

Objectives: Artificial intelligence (AI) and machine learning (ML) are increasingly integrated into diagnostic imaging. This review examines how AI adoption affects malpractice risk, the legal standard of care, liability distribution, and informed consent. It also evaluates regulatory developments and ethical concerns, including explicability, autonomy, and professional accountability.

Key findings: AI-supported image interpretation can improve diagnostic accuracy and efficiency. Its integration is reshaping expectations of reasonable clinical practice, with the potential for negligence claims both when clinicians fail to use validated systems and when they rely on insufficiently tested tools. Liability is uncertain because diagnostic responsibility is distributed across clinicians, healthcare organisations, and developers. Existing negligence frameworks assume human reasoning and struggle to accommodate opaque algorithmic decision-making, limiting courts' ability to assess whether AI-assisted diagnoses meet accepted standards. "Black box" models heighten automation bias, hinder legal scrutiny of error, and complicate professional accountability. Informed consent case law suggests AI involvement should be disclosed when it introduces material differences in risk or outcome, although this remains inconsistently applied. Ethical challenges include threats to patient trust, potential clinician deskilling, and reduced transparency in clinical communication. Regulatory initiatives such as the European Union's General Data Protection Regulation and AI Act move toward clearer governance through requirements for data quality, human oversight, and post-market monitoring, yet explicit malpractice guidance remains under-developed globally.

Conclusion: Traditional legal and ethical frameworks insufficiently address accountability for AI-driven diagnostic errors. Clarifying responsibility, decision authority, and validation requirements is essential to safeguard patient safety and clinician protection.

Implications for practice: Clinical protocols should specify approved use cases, oversight expectations, documentation of AI involvement, and management of clinician-algorithm disagreement. Training should support critical review of outputs to mitigate automation bias.

Introduction: Radiographic quality is the degree to which technical requirements are met that result in clear and accurate reproduction of structures, to enable confident assessment and correct diagnosis. Radiographic image quality therefore comprises technical adequacy and diagnostic utility. It has been suggested that radiographer participation in the image interpretation process may improve their understanding of how these two elements are linked and therefore improve delivery of X-ray quality; however, this has not been directly examined. Therefore, the aim of this study was to investigate radiographers' perspectives on X-ray image quality following the implementation of radiographer commenting.

Methods: Radiographers who worked at hospitals that had implemented a Radiographer Comment and Alert model were invited to participate in one of four online focus groups recorded by Zoom in May-June 2024. The 13 participants, six females and seven males, had between two and 18 years of clinical experience across a range of modalities. Qualitative data was analysed using Braun & Clarke's Reflexive Thematic Analysis to generate themes and subthemes relevant to the study aim.

Results: Six main themes were identified. The overarching finding was that image interpretation improved understanding and delivery of X-ray quality. The remaining five themes recognised mechanisms contributing to this; increased thought and reflection, enhanced performance expectations radiographers sought to meet, deeper knowledge-building and learning practices, improved technical decision making, and increased collaboration.

Conclusion: Introduction of formal image interpretation practices can be used as a tool to improve radiographers' understanding and production of high-quality X-rays, which provide clinical and economic healthcare benefits.

Implications for practice: Radiographer commenting is within scope for all registered practitioners and can therefore be easily and widely utilised to benefit image quality in the clinical setting.

Introduction: Breast cancer is among the worldwide list of commonly diagnosed cancers and one of the leading causes of highest mortality rate worldwide. Prompt detection facilitates timely and accurate diagnostic investigations required for determining the course of disease and managing it. This meta-analysis aimed to evaluate the sensitivity, specificity, and diagnostic reliability of Axillary Ultrasound (AUS) in detecting axillary lymph node involvement in breast cancer patients.

Methods: On May 17, 2024, a systematic search was performed in PubMed and Embase in accordance with the inclusion criteria of the study. The index test consisted of ultrasonographic diagnostic methods and Fine Needle Aspiration (FNA)-guided Axillary Ultrasound, whereas the reference standard was Sentinel Lymph Node Biopsy (SLNB).

Results: Out of 4874 studies, 19 studies encompassing 9886 patients met the inclusion criteria. The summary sensitivity and specificity of axillary ultrasound were 65.25 % and 87.18 % before outlier adjustment; and 62.20 % and 88.43 % after outlier adjustment respectively. The diagnostic odds ratio (DOR) was 0.27 before outlier and 0.20 after outlier assessment indicating moderate diagnostic performance. Subgroup analysis revealed significant variation in specificity based on risk of bias but not in sensitivity or DOR. The hierarchal Summary receiver operator curve (SROC) demonstrated moderate sensitivity and high specificity in heterogenous studies.

Conclusion: Axillary ultrasound demonstrates high specificity but moderate sensitivity in detecting nodal metastasis in breast cancer. While useful as a preliminary diagnostic tool, it should not replace biopsy-based confirmation. Combining AUS with tissue sampling or advanced imaging may improve preoperative staging accuracy.

Implications for practice: Axillary ultrasound can aid early detection of nodal metastasis but should not replace biopsy confirmation. Integrating AUS with tissue sampling enhances diagnostic accuracy and surgical planning.

Objectives: Imaging is used in a wide range of contexts in clinical research projects, but adds complexity to the design, conduct and analysis. This paper is the first of two in which we use a consensus approach to bring together multidisciplinary perspectives on the challenges in conducting prospective clinical trials and research studies that include imaging. In this first part we consider challenges in ethics, participant information and consent, recruitment, trial/study and site set-up, training and trial or study conduct.

Key findings: Effective communication with patients regarding the purpose, benefits and risks, and potential future use of imaging data is essential to build trust and support informed participation. Transparency around data handling, including de-identification processes and the right to withdraw consent, underpins ethical research practice. Successful recruitment requires strong collaboration between clinical and imaging teams to ensure clarity, consistency, and efficiency. To reduce participant burden, flexibility should be offered in scheduling and scan requirements, taking into account accessibility and personal commitments. Site setup and staff training benefit from feasibility assessments that evaluate equipment capabilities and identify specific imaging training needs. Clearly defined roles and responsibilities of key personnel support streamlined workflows and accountability. Communication of planned changes to procedures during the study to all stakeholders is key to avoid delays and risks to data integrity. Effective monitoring of procedures, radiation doses (where applicable) and data quality should be pre-planned.

Conclusion: These considerations derived from a multidisciplinary team will be useful for funding applications, protocol design, trial implementation, conduct, commercialisation and uptake of new imaging techniques.

Implications for practice: Many prospective imaging studies could be improved by the upfront awareness of potential challenges and understanding of real-world examples these considerations provide.

Introduction: The development of radiographers to the enhanced, advanced and consultant levels relies on appropriate post-registration education to develop capabilities across four pillars of practice. In an evolving landscape, higher education institutions (HEIs) need to ensure provision is viable, meets demand, and aligns with professional frameworks. This study aimed to scope the current UK post-registration radiography provision to support advancing practice and explore future directions and challenges in delivery.

Methods: The multi-method qualitative study comprised two stages. Content analysis was undertaken of online information pertaining to programmes. Semi-structured online interviews were undertaken with HEI representatives from programme teams. Content and frequency analysis of education provision and thematic analysis of interviews using Braun and Clark's methodology was undertaken.

Results: 49 post-registration radiography programmes, at 25 HEIs, were identified during content analysis. Ultrasound, projectional radiograph reporting, and breast imaging were well provided for, yet options in radiotherapy, nuclear medicine, and DXA were limited, especially outside of England. 16 (64 %) of HEIs were represented at interview and four key themes were identified; sustainability and viability of provision, fragmentation of provision, ambiguity of levels of practice and accreditation, and addressing the four pillars of practice.

Conclusion: HEIs have identified significant challenges to viability of provision, placing programmes at significant risk. Saturation of some areas of practice, uncertain funding streams, and low student numbers were perceived to present a challenge to the sustainability of UK post-registration radiography education. The provision, and how it meets the requirements of the advancing practice workforce, presents a very mixed picture.

Implications for practice: Without a sustainable and collaborative approach to post-registration radiography education, support for the future advancing practice workforce is under threat, particularly in some discipline areas.

Introduction: Evaluating patient comfort and acceptance is essential when introducing new imaging technologies. The compact 3T (C3T) MRI system features a unique ergonomic design compared to conventional 60-cm bore whole-body 3T MRI systems (WB3T). This study focuses on comparing the patient experience for brain exams between the C3T and WB3T systems.

Methods: Fifty adult patients undergoing clinically indicated brain MRI exams were imaged using both the C3T and WB3T systems. After completing both scans, participants completed a 12-item questionnaire assessing various aspects of their MRI experience using a 5-point Likert scale. Key areas of evaluation included comfort, noise, vibration, and overall preference.

Results: Survey responses showed that patients reported a more favorable experience with the C3T scanner in several categories, particularly regarding the exam room environment, noise levels, perceived vibrations, and preference for future scans. Both systems were rated as "very desirable" overall, indicating high levels of patient acceptance for each platform.

Conclusion: The compact 3T MRI system offers a patient experience that is comparable to or better than conventional whole-body MRI systems for brain exams. These findings support the integration of the C3T system into clinical practice, especially in environments prioritizing patient comfort and satisfaction.

Implications for practice: By understanding the patient experience on the C3T, it will help to inform future designs and benefits for MRI systems. This study shows that patients find the C3T system comparable or superior to conventional whole-body 3T scanners in comfort, noise, and overall preference. These results suggest the C3T may support improved patient compliance, reduced motion, and greater efficiency in clinical workflows. Findings may also guide MRI manufacturers toward ergonomic, patient-centered innovations in both research and practice.

Introduction: our purpose was to assess the role of diffusion tensor (DT) Magnetic Resonance Imaging (MRI) in prediction of luminal versus non-luminal breast cancer in correlation with pathological findings.

Methods: This prospective study included 89 consecutive female patients (mean age 48.1 years) diagnosed with breast cancer, they were categorized into luminal (n 72) and non-luminal type (n 17) cases. They underwent breast MRI with DTI. DTI metrics - mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and relative anisotropy (RA) - were measured for breast lesions and correlated with histological findings.

Results: The mean MD and RD values were marginally significantly higher in non-luminal vs. luminal cases, (1 × 10-³ mm²/s vs. 1.2 × 10-³ mm²/s), and (1 × 10-³ mm²/s vs. 1.2 × 10-³ mm²/s), p value = 0.059 and 0.051, respectively. FA, AD, and RA values were not significantly different between both groups. Participants with MD > 1.1 had 3.1-times higher odds to exhibit non-luminal type. Others with RD > 1.19 had 3.2-times higher odds to exhibit non-luminal type. Correlation of the DTI parameters with the pathological data revealed that MD and AD were significantly lower in ER positive vs. ER negative cases. AD was low in cases with positive LVI. Cases associated with DCIS had significantly low FA and high MD, AD and RD values.

Conclusion: DTI parameters can be useful in discriminating luminal vs. non-luminal breast cancer, some of these parameters are well correlated with the important pathological findings.

Implications for practice: Using different DTI parameters can enhance the accuracy of breast cancer characterization reducing unnecessary biopsies, provide valuable data to correlate with tumor grade, differentiate luminal from non-luminal lesions, thus providing insights into the aggressiveness of the tumor.

Introduction: Low-dose computed tomography (LDCT) is an effective tool for early lung cancer detection, although radiation doses may differ between institutions. This study evaluated patient dose variability across three LDCT screening centers in Vojvodina, Serbia, during baseline examinations in 2024, assessing compliance with international recommendations.

Methods: A total of 3479 high-risk participants (43.2 % male, 56.8 % female; mean age 62.2 ± 6.6 years; BMI 26.7 ± 4.8 kg/m²) underwent baseline LDCT. Inclusion criteria were age 50-74 years and smoking status (current smokers with ≥30 pack-years, ≥20 pack-years with additional risks, or former smokers who quit ≤10 years ago). Exclusion criteria were prior chest CT within 12 months or previous lung cancer. Recorded parameters included CT dose index (CTDIvol), dose-length product (DLP), tube voltage (kVp), and tube current-time product (mAs). Multiple linear regression identified CTDIvol predictors, including center, kVp, mAs, and patient factors.

Results: Significant inter-center dose variability was found for all parameters (p < 0.001). Mean CTDIvol ranged 0.58-1.63 mGy, DLP 21.0-65.2 mGy cm, and effective dose 0.29-0.92 mSv. Center Screening site (β = -0.756) and kVp (β = 0.544) were the strongest predictors of CTDIvol, explaining 91 % of dose variance (R² = 0.910, p < 0.001). All doses were below 2 mSv, corresponding to a low lifetime cancer risk (∼0.05-0.1 %), consistent with ALARA principles.

Conclusion: This first multicenter analysis in Serbia confirms LDCT screening doses comply with international recommendations and ALARA principles. Inter-site variability highlights the need for continuous monitoring to optimize image quality and minimize exposure.

Implications for practice: Systematic dose tracking, protocol harmonization, and medical physicist involvement are essential to ensure consistent, safe, and effective LDCT lung cancer screening.