Radiography最新文献

Introduction: Fluoroscopy and Computed Tomography (CT) are the reference standards for verifying needle placement when undertaking an Intra-articular (IA) Sacroiliac Joint (SIJ) injection. The use of Ultrasound (US) for performing SIJ injections has become a focus in recent years, as it eliminates radiation exposure. This systematic review aimed to compare the efficacy of US, CT, and Fluoroscopy when undertaking SIJ injections.

Methods: A systematic search was conducted using the databases Embase, PubMed, CINAHL, and Scopus. The included studies were published in English (January 2003 to March 2025) and assessed adult patients who had undergone SIJ injections and the efficacy of one or more modalities using diagnostic accuracy measurements or patient pain and function scores.

Results: There were 509 papers identified in the search. Following application of the inclusion and exclusion criteria, eight papers were included in the review. Needle placement accuracy ranged from 40 % to 100 %. CT accuracy ranged from 76 % to 100 %, US from 40 % to 96 %, and Fluoroscopy from 65 % to 92 %.

Conclusion: While CT guidance provides precise anatomical detail and high accuracy, and fluoroscopy is accessible and accurate, both involve radiation exposure. US guidance provides real-time visualisation without radiation exposure. Further assessment is required to determine the exact role of US.

Implications for practice: Current guidelines recommend fluoroscopy or CT guidance for SIJ injections, but US has merit in this area without the use of ionising radiation exposure. Image fusion could be a feasible alternative guidance for SIJ injections. It combines a previous CT scan with real-time US guidance for precise IA placement, reducing a patient's radiation exposure.

Introduction: Neurointerventional stroke imaging involves prolonged fluoroscopy and multiple angiographic acquisitions, potentially delivering meaningful radiation doses to radiosensitive head and neck organs. This study quantified organ-specific absorbed doses under clinically realistic conditions.

Methods: Organ doses were measured using calibrated MTS-100 LiF:Mg,Ti thermoluminescent dosimeters (TLD-100) placed in an Alderson Rando anthropomorphic phantom. Simulated stroke imaging was performed on a Siemens Artis Zee C-arm system using routine clinical parameters. TLDs were calibrated under RQR-9 beam quality at an accredited SSDL and read with a Harshaw 4500 reader.

Results: The highest absorbed doses occurred in the left parotid gland and C1-C2 vertebral level. Bilateral thyroid doses averaged ∼4.6 mGy, and eye lens doses ranged from 5.6 to 11.5 mGy. Dose distribution showed marked spatial variability, reflecting projection geometry and scatter contributions.

Conclusion: Although measured single-session doses were below deterministic thresholds, cumulative exposure during repeated or prolonged interventions may become clinically significant.

Implications for practice: The findings support the need for strict collimation, optimized projection angles, pulsed fluoroscopy, and continuous dose monitoring to minimize patient and staff exposure while maintaining diagnostic image quality.

Introduction: Alongside medical specialists, radiographers and nurses form core members of the interventional imaging teams within radiology and cardiology. Despite these being seen as key functions there is little documented evidence of the requirements of employers for such roles.

Method: The requirements of employers for advertised radiographer or nurse vacancies in interventional cardiology (IC) or interventional radiology (IR) were assessed across England and Wales. Over a six-month period vacancies advertised on the NHS website (jobs.nhs.uk) were collated and the advert, job description and person specification subjected to document analysis.

Results: 185 unique roles were advertised, encompassing 92 individual employers. The posts were based within IR (n = 89/185; 48.1 %), IC (n = 72/185; 38.9) or spanning both areas (n = 24/185; 13.0 %). 60 % of the roles were for a nurse, although another 12.4 % were also open to allied health professions such as operating department practitioners or paramedic. A significantly higher number of band 6 posts were advertised in radiography compared to nursing (X² = 26.674; p < 0.01), although few roles required any formal postgraduate education. The clinical elements of the jobs spanned pre-, peri- and post-procedural elements, however common themes in relation to leadership, education and research were evident.

Conclusion: There is an apparent disparity in the level of pay between nurses and radiographers working in the interventional setting, although the cause is unknown. Employers expect autonomy in the complex clinical environment, although opportunities for advancement appear limited.

Implications for practice: Core capabilities for nursing and radiographers working in the interventional imaging environment do not exist although there is opportunity to look for transferable skills from the peri-procedural setting. Development of postgraduate education to support the expected skills may underpin future developments.

Introduction: Global healthcare systems, including the UK's, face a supply-demand imbalance exacerbated by the COVID-19 pandemic. Interventional radiology (IR) is expanding, but workforce shortages persist, with a 30 % shortfall in clinical radiologists in England, projected to increase to 40 % by 2028.

Methods: This service evaluation (SE) employs a mixed-methods approach to evaluate an advanced practice (AP) radiographer-led nephrostomy exchange (NE) service, aiming to reduce the interval between NEs from 94 to 84 days.

Results: The study found that the AP service successfully performed NE with lower radiation doses (RD) and fluoroscopy screening times (FST) compared to radiologists. The service also reduced minor complication rates and created additional appointment slots for radiologists. Patient and stakeholder feedback indicated high satisfaction.

Conclusion: This service evaluation (SE) demonstrates that AP skills, backed by master 's-level education, can effectively address the growing demands and workforce shortages in IR. The evidence from this project shows that AP radiographers can provide a comparable, and in some aspects, improved service with lower RD and FST.

Implications to practice: By training radiographers to perform select, routine procedures, healthcare systems can alleviate the burden on radiologists.