Pub Date : 2026-01-18DOI: 10.1016/j.radi.2025.103316
A Spalding
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.
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Pub Date : 2026-01-15DOI: 10.1016/j.radi.2025.103324
H. Ayouni , S. Zarraa , B. Daoud , S. Saidi , S. Frikha , S. Yahyaoui , L. Ben Salem , C. Nasr
Introduction
Deep-inspiration breath-hold (DIBH) is a well-established technique for sparing organs-at-risk in breast cancer (BC) radiotherapy. Nonetheless, consensus on who benefits most remains elusive. This study aimed to establish dependable thresholds for anatomical parameters to identify these patients during three-dimensional conformal radiotherapy (3D-CRT) and volumetric modulated arc therapy (VMAT), and to confirm selection using multivariate logistic regression (MLR).
Methods
Forty-eight left BC patients were included in group A, subdivided into 20 undergoing breast-conserving surgery (group B) and 28 undergoing radical mastectomy (group C). Free-breathing 3D-CRT plans were replanned using DIBH, each plan generated using VMAT. Ratios of heart volume in field (%HVIF) and left lung volume (%LLV) between free-breathing/DIBH defined eligibility thresholds. Spearman correlation assessed relationships between %LLV/%HVIF and dosimetric parameters or normal tissue complication probabilities (NTCPs). MLR confirmed selection, and models' performance was evaluated using area under curve (AUC).
Results
Thresholds were 1.7 for %LLV and one for %HVIF. In 3D-CRT, %LLV significantly correlated with cardiac/left anterior descending artery (LAD) doses and LAD NTCP (groups A/C), while only mean heart dose (ΔMHD) and cardiac ΔV25 demonstrated significance (group B). In VMAT, %LLV significantly correlated with ΔMHD, heart maximum dose (ΔDmax), LAD mean dose (ΔDmean), and LAD ΔNTCP, independent of group. For %HVIF, significant correlations were found with heart %V25/%V40 (groups A/B) and LAD %Dmean (group A) in 3D-CRT but not in VMAT or group C. Thresholds of %LLV predicted DIBH with AUCs of 0.85/0.90/0.94 (3D-CRT) and 0.77/0.91/0.89 (VMAT). A similar trend was observed for %HVIF: 0.88/0.93/0.95 (3D-CRT) vs. 0.70/0.90/0.81 (VMAT).
Conclusion
%LLV is a useful tool for selecting DIBH across techniques, while %HVIF is more applicable to 3D-CRT.
Implications for practice
This streamlined approach supports more personalized clinical decision-making.
{"title":"Identification of selection criteria for DIBH in patients with left breast cancer using 3D-CRT and VMAT: An analysis with dosimetric parameters and NTCP models","authors":"H. Ayouni , S. Zarraa , B. Daoud , S. Saidi , S. Frikha , S. Yahyaoui , L. Ben Salem , C. Nasr","doi":"10.1016/j.radi.2025.103324","DOIUrl":"10.1016/j.radi.2025.103324","url":null,"abstract":"<div><h3>Introduction</h3><div>Deep-inspiration breath-hold (DIBH) is a well-established technique for sparing organs-at-risk in breast cancer (BC) radiotherapy. Nonetheless, consensus on who benefits most remains elusive. This study aimed to establish dependable thresholds for anatomical parameters to identify these patients during three-dimensional conformal radiotherapy (3D-CRT) and volumetric modulated arc therapy (VMAT), and to confirm selection using multivariate logistic regression (MLR).</div></div><div><h3>Methods</h3><div>Forty-eight left BC patients were included in group A, subdivided into 20 undergoing breast-conserving surgery (group B) and 28 undergoing radical mastectomy (group C). Free-breathing 3D-CRT plans were replanned using DIBH, each plan generated using VMAT. Ratios of heart volume in field (%HVIF) and left lung volume (%LLV) between free-breathing/DIBH defined eligibility thresholds. Spearman correlation assessed relationships between %LLV/%HVIF and dosimetric parameters or normal tissue complication probabilities (NTCPs). MLR confirmed selection, and models' performance was evaluated using area under curve (AUC).</div></div><div><h3>Results</h3><div>Thresholds were 1.7 for %LLV and one for %HVIF. In 3D-CRT, %LLV significantly correlated with cardiac/left anterior descending artery (LAD) doses and LAD NTCP (groups A/C), while only mean heart dose (ΔMHD) and cardiac ΔV25 demonstrated significance (group B). In VMAT, %LLV significantly correlated with ΔMHD, heart maximum dose (ΔDmax), LAD mean dose (ΔDmean), and LAD ΔNTCP, independent of group. For %HVIF, significant correlations were found with heart %V25/%V40 (groups A/B) and LAD %Dmean (group A) in 3D-CRT but not in VMAT or group C. Thresholds of %LLV predicted DIBH with AUCs of 0.85/0.90/0.94 (3D-CRT) and 0.77/0.91/0.89 (VMAT). A similar trend was observed for %HVIF: 0.88/0.93/0.95 (3D-CRT) vs. 0.70/0.90/0.81 (VMAT).</div></div><div><h3>Conclusion</h3><div>%LLV is a useful tool for selecting DIBH across techniques, while %HVIF is more applicable to 3D-CRT.</div></div><div><h3>Implications for practice</h3><div>This streamlined approach supports more personalized clinical decision-making.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 3","pages":"Article 103324"},"PeriodicalIF":2.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963215","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 : 2026-01-14DOI: 10.1016/j.radi.2025.103297
H. Stevens , F. Manning
Introduction
Research has shown elevated perceived stress (PS) and Imposter Phenomenon (IP) levels among healthcare students; however, apprenticeships remain understudied. This study aimed to compare the levels of PS and IP between Medical Imaging students on traditional (BSc UG) and apprenticeship (BSc DA and MSc DA) courses at one university in the United Kingdom.
Methods
The study used an online survey applying the Perceived Stress Scale (PSS-10) and the Clance Imposter Phenomenon Scale (CIPS). Statistical analysis and thematic analysis were undertaken.
Results
PSS-10 (n = 49 responses)- BSc DA students had a lower level of PS (mean = 18, p < 0.05) than BSc UG and MSc DA students (mean = 24). Most respondents reported moderate or high levels of stress. Thematic analysis highlighted stressors included university and personal factors and overlap between the two areas. CIPS (n = 45 responses)- The highest levels of IP were in BSc UG students (mean = 71) and the lowest in the BSc apprentices (mean = 63), however, p > 0.05. Over 60 % of all students had clinically significant IP levels. Thematic analysis found feelings of ‘not belonging’ and ‘self-perception’ enhanced feelings of IP, and self-belief was protective.
Conclusion
Most students continue to have high levels of PS and IP regardless of course. Qualitative responses for both found similar contributing factors for all courses; however, ‘not belonging’ only contributed to IP for BSc UG students and protective factors for PS and IP were only mentioned by apprentices.
Implications for practice
Due to high levels of PS and IP, educational interventions may aid implementation of coping measures to support students. Further research on PS and IP in the first year of practice would allow a greater understanding of the impact of different educational models.
{"title":"Comparison of perceived stress levels and imposter syndrome in medical imaging students on the traditional degree versus apprenticeship degree programmes at a UK university","authors":"H. Stevens , F. Manning","doi":"10.1016/j.radi.2025.103297","DOIUrl":"10.1016/j.radi.2025.103297","url":null,"abstract":"<div><h3>Introduction</h3><div>Research has shown elevated perceived stress (PS) and Imposter Phenomenon (IP) levels among healthcare students; however, apprenticeships remain understudied. This study aimed to compare the levels of PS and IP between Medical Imaging students on traditional (BSc UG) and apprenticeship (BSc DA and MSc DA) courses at one university in the United Kingdom.</div></div><div><h3>Methods</h3><div>The study used an online survey applying the Perceived Stress Scale (PSS-10) and the Clance Imposter Phenomenon Scale (CIPS). Statistical analysis and thematic analysis were undertaken.</div></div><div><h3>Results</h3><div>PSS-10 (<em>n</em> = 49 responses)- BSc DA students had a lower level of PS (mean = 18, <em>p</em> < 0.05) than BSc UG and MSc DA students (mean = 24). Most respondents reported moderate or high levels of stress. Thematic analysis highlighted stressors included university and personal factors and overlap between the two areas. CIPS (<em>n</em> = 45 responses)- The highest levels of IP were in BSc UG students (mean = 71) and the lowest in the BSc apprentices (mean = 63), however, <em>p</em> > 0.05. Over 60 % of all students had clinically significant IP levels. Thematic analysis found feelings of ‘not belonging’ and ‘self-perception’ enhanced feelings of IP, and self-belief was protective.</div></div><div><h3>Conclusion</h3><div>Most students continue to have high levels of PS and IP regardless of course. Qualitative responses for both found similar contributing factors for all courses; however, ‘not belonging’ only contributed to IP for BSc UG students and protective factors for PS and IP were only mentioned by apprentices.</div></div><div><h3>Implications for practice</h3><div>Due to high levels of PS and IP, educational interventions may aid implementation of coping measures to support students. Further research on PS and IP in the first year of practice would allow a greater understanding of the impact of different educational models.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103297"},"PeriodicalIF":2.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977676","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 : 2026-01-10DOI: 10.1016/j.radi.2025.103323
J. Zhu , Y. Wang , Y. Xu
Objectives
This narrative review aims to critically appraise the technical advantages, clinical applications, and limitations of 3D-Venography specifically in the context of IVCFT, and to compare its diagnostic performance with traditional and emerging imaging modalities.
Key findings
A comprehensive literature search was conducted in PubMed, Embase, and Web of Science (January 2010–December 2024) using keywords: (“3D-Venography” OR “three-dimensional venography”) AND (“inferior vena cava filter thrombosis” OR “IVCFT”) AND (“diagnosis” OR “imaging”). 3D-Venography technology, characterized by its capability to comprehensively assess both intra- and extra-vascular lesions and perform real-time vascular lumen data measurement, has emerged as a critical supplement to traditional digital subtraction angiography (DSA). 3D-venography provides multi-angle anatomical visualization and real-time hemodynamic assessment of IVCFT, addressing limitations of 2D-digital subtraction angiography (2D-DSA) (e.g., projection overlap) and non-invasive modalities (CTA/MRA, e.g., lack of real-time data). However, it is associated with higher radiation exposure than 2D-DSA and requires specialized equipment.
Conclusions
Based on current available evidence, 3D-venography shows potential for IVCFT assessment, particularly in guiding interventional procedures, though its long-term clinical benefits require further validation by large-scale comparative studies. Its widespread adoption is limited by gaps in comparative outcome data, radiation concerns, and cost. Future research should prioritize dose optimization and large-scale diagnostic accuracy studies.
Implications for practice
Clinicians should prioritize 3D-Venography as a key imaging tool in the evaluation of IVCFT, leveraging its advantages in multi-modal, real-time, and high-resolution vascular visualization to potentially optimize treatment planning (e.g., filter placement/removal) and postoperative monitoring, with such benefits yet to be confirmed by prospective outcome studies. Further integration of 3D-Venography with emerging non-invasive techniques (e.g., CTA, MRA) may enhance diagnostic accuracy and guide personalized therapeutic strategies.
目的：这篇叙述性综述旨在批判性地评估3d静脉造影的技术优势、临床应用和局限性，特别是在IVCFT的背景下，并将其诊断性能与传统和新兴成像方式进行比较。主要发现：在PubMed、Embase和Web of Science（2010年1月- 2024年12月）中进行了全面的文献检索，检索关键词为：“3d静脉造影”或“三维静脉造影”、“下腔静脉滤镜血栓形成”或“IVCFT”、“诊断”或“成像”。3d血管造影技术的特点是能够全面评估血管内和血管外病变，并进行实时血管腔数据测量，已成为传统数字减影血管造影（DSA）的重要补充。3d静脉造影提供了IVCFT的多角度解剖可视化和实时血流动力学评估，解决了2d数字减影血管造影（2D-DSA）（例如投影重叠）和非侵入性模式（CTA/MRA，例如缺乏实时数据）的局限性。然而，与2D-DSA相比，它的辐射暴露更高，需要专门的设备。结论：基于现有证据，3d静脉造影显示了IVCFT评估的潜力，特别是在指导介入手术方面，尽管其长期临床益处需要通过大规模比较研究进一步验证。它的广泛采用受到比较结果数据、辐射问题和成本差距的限制。未来的研究应优先考虑剂量优化和大规模诊断准确性研究。实践意义：临床医生应优先考虑将3d静脉造影作为评估IVCFT的关键成像工具，利用其在多模式、实时和高分辨率血管可视化方面的优势，潜在地优化治疗计划（例如，滤镜放置/移除）和术后监测，这些益处有待于前瞻性结果研究的证实。3d静脉造影与新兴的非侵入性技术（如CTA， MRA）的进一步整合可能会提高诊断的准确性并指导个性化的治疗策略。
{"title":"A narrative review of 3D-venography for the assessment of IVC filter-related thrombosis","authors":"J. Zhu , Y. Wang , Y. Xu","doi":"10.1016/j.radi.2025.103323","DOIUrl":"10.1016/j.radi.2025.103323","url":null,"abstract":"<div><h3>Objectives</h3><div>This narrative review aims to critically appraise the technical advantages, clinical applications, and limitations of 3D-Venography specifically in the context of IVCFT, and to compare its diagnostic performance with traditional and emerging imaging modalities.</div></div><div><h3>Key findings</h3><div>A comprehensive literature search was conducted in PubMed, Embase, and Web of Science (January 2010–December 2024) using keywords: (“3D-Venography” OR “three-dimensional venography”) AND (“inferior vena cava filter thrombosis” OR “IVCFT”) AND (“diagnosis” OR “imaging”). 3D-Venography technology, characterized by its capability to comprehensively assess both intra- and extra-vascular lesions and perform real-time vascular lumen data measurement, has emerged as a critical supplement to traditional digital subtraction angiography (DSA). 3D-venography provides multi-angle anatomical visualization and real-time hemodynamic assessment of IVCFT, addressing limitations of 2D-digital subtraction angiography (2D-DSA) (e.g., projection overlap) and non-invasive modalities (CTA/MRA, e.g., lack of real-time data). However, it is associated with higher radiation exposure than 2D-DSA and requires specialized equipment.</div></div><div><h3>Conclusions</h3><div>Based on current available evidence, 3D-venography shows potential for IVCFT assessment, particularly in guiding interventional procedures, though its long-term clinical benefits require further validation by large-scale comparative studies. Its widespread adoption is limited by gaps in comparative outcome data, radiation concerns, and cost. Future research should prioritize dose optimization and large-scale diagnostic accuracy studies.</div></div><div><h3>Implications for practice</h3><div>Clinicians should prioritize 3D-Venography as a key imaging tool in the evaluation of IVCFT, leveraging its advantages in multi-modal, real-time, and high-resolution vascular visualization to potentially optimize treatment planning (e.g., filter placement/removal) and postoperative monitoring, with such benefits yet to be confirmed by prospective outcome studies. Further integration of 3D-Venography with emerging non-invasive techniques (e.g., CTA, MRA) may enhance diagnostic accuracy and guide personalized therapeutic strategies.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103323"},"PeriodicalIF":2.8,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953400","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 : 2026-01-10DOI: 10.1016/j.radi.2025.103300
L.A. Gower , G. Lovric , N.P. Nkosi , N. Mountford , N. Ndlovu
Introduction
The Health Professions Council of South Africa recognises forensic radiography as an aspect of the diagnostic radiographer's scope of practice. In contrast, the International Association of Forensic Radiographers asserts that forensic imaging should be voluntary and undertaken only by radiographers who have received formal training in the field. This study aimed to explore diagnostic radiographers' understanding, experiences, and attitudes towards forensic radiography as encountered in their daily practice.
Methods
A purposive sampling method was employed to recruit radiographers who were knowledgeable about forensic radiography through their daily practice. Participants were required to have performed forensic radiographic imaging on both living and deceased individuals and to have practised in either the public or private clinical sectors. Semi-structured interviews were conducted with 17 consenting diagnostic radiographers via the online platform Microsoft Teams. Thematic analysis was performed using an inductive approach.
Results
Four distinct themes emerged; Learning and understanding forensic radiography; Practicing forensic radiography; Emotional and psychological responses; Attitudes and motivation.
Conclusion
Findings highlighted the complex and emotionally demanding nature of this domain, which intersects clinical and legal responsibilities. Variability in knowledge and preparedness was evident, influenced by limited undergraduate exposure, informal on-the-job learning, and inconsistent institutional support. While many radiographers valued contributing to justice, others reported apprehension and emotional distress, especially when imaging deceased individuals.
Implications for practice
These findings underscore the need for structured education, standardised forensic protocols, and psychological support to prepare radiographers for the complexities of forensic imaging. Formalised postgraduate training and maintaining voluntary participation are critical to building professional competence and resilience in this demanding field.
{"title":"The understandings, experiences and attitudes of diagnostic radiographers regarding forensic radiography as part of their daily practice working in South Africa","authors":"L.A. Gower , G. Lovric , N.P. Nkosi , N. Mountford , N. Ndlovu","doi":"10.1016/j.radi.2025.103300","DOIUrl":"10.1016/j.radi.2025.103300","url":null,"abstract":"<div><h3>Introduction</h3><div>The Health Professions Council of South Africa recognises forensic radiography as an aspect of the diagnostic radiographer's scope of practice. In contrast, the International Association of Forensic Radiographers asserts that forensic imaging should be voluntary and undertaken only by radiographers who have received formal training in the field. This study aimed to explore diagnostic radiographers' understanding, experiences, and attitudes towards forensic radiography as encountered in their daily practice.</div></div><div><h3>Methods</h3><div>A purposive sampling method was employed to recruit radiographers who were knowledgeable about forensic radiography through their daily practice. Participants were required to have performed forensic radiographic imaging on both living and deceased individuals and to have practised in either the public or private clinical sectors. Semi-structured interviews were conducted with 17 consenting diagnostic radiographers via the online platform Microsoft Teams. Thematic analysis was performed using an inductive approach.</div></div><div><h3>Results</h3><div>Four distinct themes emerged; Learning and understanding forensic radiography; Practicing forensic radiography; Emotional and psychological responses; Attitudes and motivation.</div></div><div><h3>Conclusion</h3><div>Findings highlighted the complex and emotionally demanding nature of this domain, which intersects clinical and legal responsibilities. Variability in knowledge and preparedness was evident, influenced by limited undergraduate exposure, informal on-the-job learning, and inconsistent institutional support. While many radiographers valued contributing to justice, others reported apprehension and emotional distress, especially when imaging deceased individuals.</div></div><div><h3>Implications for practice</h3><div>These findings underscore the need for structured education, standardised forensic protocols, and psychological support to prepare radiographers for the complexities of forensic imaging. Formalised postgraduate training and maintaining voluntary participation are critical to building professional competence and resilience in this demanding field.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103300"},"PeriodicalIF":2.8,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953371","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 : 2026-01-08DOI: 10.1016/j.radi.2025.103319
M.T. Chau , K.M. Spuur , H. Vu
Objectives
Health Human Resources (HHR) are critical for the effective functioning of healthcare systems, yet significant shortages exist, particularly in radiography. The increasing demand for diagnostic radiography services, driven by advancements in medical technology, an aging population, and the prevalence of chronic diseases, exacerbates these shortages. The COVID-19 pandemic further highlighted workforce vulnerabilities, increasing workloads and burnout. This review examines HHR shortages in radiography in Australia and proposes strategies for sustainable workforce development.
Key findings
The aging radiography workforce, with a significant portion nearing retirement, intensifies HHR shortages. The pandemic disrupted education and training, delaying the entry of new professionals and increasing turnover intentions among existing staff. The result being delayed imaging services, increased wait times, and potentially compromised patient outcomes. To address these challenges, a multifaceted strategy is proposed. Policy changes and government initiatives, including funding educational programs and recognizing internationally trained radiographers, can provide immediate relief. Expanding enrolment capacities and developing new training programs are essential. Retention strategies, including improving working conditions and career advancement opportunities, are crucial for workforce stability. Promoting advanced practice models can optimize task distribution and better utilize specialized skills. Leveraging technology, such as artificial intelligence and telehealth, can enhance productivity and extend service reach.
Conclusion
A comprehensive approach combining policy changes, educational initiatives, retention strategies, technology integration, international recruitment, and awareness campaigns is essential for addressing HHR shortages in radiography. By implementing these strategies, the radiography workforce can be better equipped to meet the growing demands of healthcare, ensuring optimal patient outcomes and the sustainability of health services.
Implications for practice
Strengthening the radiography workforce will ensure timely and effective healthcare delivery, support health interventions, and progress towards universal health coverage and Sustainable Development Goals.
{"title":"Health human resources shortages in radiography and sustainable workforce development in Australia","authors":"M.T. Chau , K.M. Spuur , H. Vu","doi":"10.1016/j.radi.2025.103319","DOIUrl":"10.1016/j.radi.2025.103319","url":null,"abstract":"<div><h3>Objectives</h3><div>Health Human Resources (HHR) are critical for the effective functioning of healthcare systems, yet significant shortages exist, particularly in radiography. The increasing demand for diagnostic radiography services, driven by advancements in medical technology, an aging population, and the prevalence of chronic diseases, exacerbates these shortages. The COVID-19 pandemic further highlighted workforce vulnerabilities, increasing workloads and burnout. This review examines HHR shortages in radiography in Australia and proposes strategies for sustainable workforce development.</div></div><div><h3>Key findings</h3><div>The aging radiography workforce, with a significant portion nearing retirement, intensifies HHR shortages. The pandemic disrupted education and training, delaying the entry of new professionals and increasing turnover intentions among existing staff. The result being delayed imaging services, increased wait times, and potentially compromised patient outcomes. To address these challenges, a multifaceted strategy is proposed. Policy changes and government initiatives, including funding educational programs and recognizing internationally trained radiographers, can provide immediate relief. Expanding enrolment capacities and developing new training programs are essential. Retention strategies, including improving working conditions and career advancement opportunities, are crucial for workforce stability. Promoting advanced practice models can optimize task distribution and better utilize specialized skills. Leveraging technology, such as artificial intelligence and telehealth, can enhance productivity and extend service reach.</div></div><div><h3>Conclusion</h3><div>A comprehensive approach combining policy changes, educational initiatives, retention strategies, technology integration, international recruitment, and awareness campaigns is essential for addressing HHR shortages in radiography. By implementing these strategies, the radiography workforce can be better equipped to meet the growing demands of healthcare, ensuring optimal patient outcomes and the sustainability of health services.</div></div><div><h3>Implications for practice</h3><div>Strengthening the radiography workforce will ensure timely and effective healthcare delivery, support health interventions, and progress towards universal health coverage and Sustainable Development Goals.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103319"},"PeriodicalIF":2.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927115","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 : 2026-01-08DOI: 10.1016/j.radi.2025.103273
A. Clancy Roche, M. Davis
Introduction
With technological advancements reshaping medical imaging, virtual reality (VR) has emerged as a promising tool for managing procedural anxiety in paediatric patients. This research addressed a critical gap in the literature regarding radiographers' opinions on the technology. Specifically, it investigates their views on VR's dual role as both a distraction technique and a preparatory tool in departments.
Methods
Firstly, a semi-structured interview was conducted with a radiographer experienced in implementing innovative technologies. Key insights from the interview discussion were then used to formulate a focus group framework of five radiographers working in paediatric hospitals. Thematic analysis was employed to generate themes within the data.
Results
Four main themes were generated, including managing paediatric anxiety, the impact of VR on radiographers, VR vs. traditional tools, and potential barriers to VR. Participants expressed overall support for the use of VR in paediatric imaging, particularly during invasive procedures. However, participants didn't think it was feasible in the X-ray department, or as a sedation alternative.
Conclusion
This study suggests that VR would be accepted by radiographers as a valuable tool, recognising its possibilities to enhance patient care and streamline workflow. Although some challenges were identified, with targeted training, patient screening, and cost-effective alternatives, VR could be an effective tool for Irish paediatric hospitals.
Implications for practice
VR's successful implementation could improve the paediatric imaging experience by reducing procedural anxiety and minimising reliance on sedation. This would be a critical innovation to address the growing safety concerns regarding the use of pharmacological interventions in children. The technology may also enhance departmental efficiency through reduced sedation costs and improving the workflow.
{"title":"Exploring radiographers' perspectives toward virtual reality in paediatric imaging: Implications for patient care and workflow","authors":"A. Clancy Roche, M. Davis","doi":"10.1016/j.radi.2025.103273","DOIUrl":"10.1016/j.radi.2025.103273","url":null,"abstract":"<div><h3>Introduction</h3><div>With technological advancements reshaping medical imaging, virtual reality (VR) has emerged as a promising tool for managing procedural anxiety in paediatric patients. This research addressed a critical gap in the literature regarding radiographers' opinions on the technology. Specifically, it investigates their views on VR's dual role as both a distraction technique and a preparatory tool in departments.</div></div><div><h3>Methods</h3><div>Firstly, a semi-structured interview was conducted with a radiographer experienced in implementing innovative technologies. Key insights from the interview discussion were then used to formulate a focus group framework of five radiographers working in paediatric hospitals. Thematic analysis was employed to generate themes within the data.</div></div><div><h3>Results</h3><div>Four main themes were generated, including managing paediatric anxiety, the impact of VR on radiographers, VR vs. traditional tools, and potential barriers to VR. Participants expressed overall support for the use of VR in paediatric imaging, particularly during invasive procedures. However, participants didn't think it was feasible in the X-ray department, or as a sedation alternative.</div></div><div><h3>Conclusion</h3><div>This study suggests that VR would be accepted by radiographers as a valuable tool, recognising its possibilities to enhance patient care and streamline workflow. Although some challenges were identified, with targeted training, patient screening, and cost-effective alternatives, VR could be an effective tool for Irish paediatric hospitals.</div></div><div><h3>Implications for practice</h3><div>VR's successful implementation could improve the paediatric imaging experience by reducing procedural anxiety and minimising reliance on sedation. This would be a critical innovation to address the growing safety concerns regarding the use of pharmacological interventions in children. The technology may also enhance departmental efficiency through reduced sedation costs and improving the workflow.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103273"},"PeriodicalIF":2.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927026","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 : 2026-01-08DOI: 10.1016/j.radi.2025.103317
F. MacGregor , J. Boyes , K. Swainston
Introduction
Care and compassion are fundamental components underpinning healthcare practice. Evidence suggests that healthcare practitioners witnessing the suffering of others may result in emotional reactions impacting upon their ability to demonstrate empathy and compassion. Diagnostic radiographers are often overlooked as a profession when evaluating compassion and interaction with patients due to the perceived solely technical aspects of their role. This qualitative research aimed to explore the psychological effects of clinical radiography practice on radiographers in the UK.
Methods
The data was generated through in-depth one-to-one semi-structured interviews with twenty-three radiography practitioners working in the UK. Participants were recruited through the research teams' professional networks, the Society of Radiographers Live and via the UK radiography congress research hub. The collated anonymized and transcribed data was analysed using reflexive thematic analysis.
Results
The analysis generated four themes pertaining to the remit of radiography practice influences on radiographers' psychological wellbeing: trauma and burnout, role perception and normalization, overlooked and unsupported, and safeguarding wellbeing: awareness and training. These themes provide meaningful insights into the current status of radiography practice and its potential psychological impacts from the radiographers' perspective.
Conclusion
The four themes suggest that there can be detrimental effects on the psychological wellbeing of radiographers in carrying out their clinical roles. Improved pre and post graduate education together with the addressing of radiographers' role perceptions and expectations is needed to enhance and maintain radiographers' wellbeing in clinical practice.
Implications for practice
Enhanced education, awareness, openness and accessible support mechanisms are essential for radiographers whose psychological wellbeing continues to be at risk through undertaking their clinical duties. Without these, significant risks of increased absenteeism and loss of practitioners from the profession remain.
{"title":"An evaluation of the clinical factors impacting the psychological wellbeing of diagnostic radiographers within the UK","authors":"F. MacGregor , J. Boyes , K. Swainston","doi":"10.1016/j.radi.2025.103317","DOIUrl":"10.1016/j.radi.2025.103317","url":null,"abstract":"<div><h3>Introduction</h3><div>Care and compassion are fundamental components underpinning healthcare practice. Evidence suggests that healthcare practitioners witnessing the suffering of others may result in emotional reactions impacting upon their ability to demonstrate empathy and compassion. Diagnostic radiographers are often overlooked as a profession when evaluating compassion and interaction with patients due to the perceived solely technical aspects of their role. This qualitative research aimed to explore the psychological effects of clinical radiography practice on radiographers in the UK.</div></div><div><h3>Methods</h3><div>The data was generated through in-depth one-to-one semi-structured interviews with twenty-three radiography practitioners working in the UK. Participants were recruited through the research teams' professional networks, the Society of Radiographers Live and via the UK radiography congress research hub. The collated anonymized and transcribed data was analysed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>The analysis generated four themes pertaining to the remit of radiography practice influences on radiographers' psychological wellbeing: trauma and burnout, role perception and normalization, overlooked and unsupported, and safeguarding wellbeing: awareness and training. These themes provide meaningful insights into the current status of radiography practice and its potential psychological impacts from the radiographers' perspective.</div></div><div><h3>Conclusion</h3><div>The four themes suggest that there can be detrimental effects on the psychological wellbeing of radiographers in carrying out their clinical roles. Improved pre and post graduate education together with the addressing of radiographers' role perceptions and expectations is needed to enhance and maintain radiographers' wellbeing in clinical practice.</div></div><div><h3>Implications for practice</h3><div>Enhanced education, awareness, openness and accessible support mechanisms are essential for radiographers whose psychological wellbeing continues to be at risk through undertaking their clinical duties. Without these, significant risks of increased absenteeism and loss of practitioners from the profession remain.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103317"},"PeriodicalIF":2.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927028","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 : 2026-01-08DOI: 10.1016/j.radi.2025.103305
D. Hutton , M. Bates , K. Lowery , P. Booker , L. McKie , H. Wong , H. Stewart , H.P. White
Introduction
Emphasised through the radiotherapy service specification alongside a range of policies, there is a need to ensure the patient voice is listened to and heard. Ensuring patients are ‘cared about’ throughout their radiotherapy treatment is essential. Reviewing the expectations of patients and capturing their experiences of radiotherapy, enables improvement to our radiotherapy services.
Methods
An online survey including open and closed questions about patient experience was distributed to adult external beam radiotherapy patients (EBRT), attending radiotherapy within 10 Radiotherapy Operational Delivery Networks in England. Patients completing radiotherapy treatment 4th - 29th September 2023 were eligible to participate.
Results
A 30.6 % response rate was gained (calculated from RTDS data). Over 2500 responses were received, with 2486 suitable for analysis.
Respondents stated ‘complete understanding’ of knowledge of late effects of radiotherapy was 58.6 %, with early effects at 73.7 %. Most patients (93.8 %) were happy or very happy with information received prior to EBRT starting. The vast majority (95 %) stated they were treated with dignity and respect, with a few describing examples where this had not been the case.
Conclusion
The majority of patients responding to this survey indicated they experienced high quality care:‘… the staff, from top to bottom, are quite exceptional. They represent the very best of the NHS and I am truly grateful.’
From a service improvement perspective, also highlighted was the need to review delivery and content of information given both pre- and post-radiotherapy treatment.
Implications for practice
The need for a biennial National Radiotherapy Patient Experience Survey is required. This needs to be available in a range of alternative formats to ensure all voices can be heard.
{"title":"Listening to and learning from patients: A review of the results from the 2023 national radiotherapy patient experience survey in England","authors":"D. Hutton , M. Bates , K. Lowery , P. Booker , L. McKie , H. Wong , H. Stewart , H.P. White","doi":"10.1016/j.radi.2025.103305","DOIUrl":"10.1016/j.radi.2025.103305","url":null,"abstract":"<div><h3>Introduction</h3><div>Emphasised through the radiotherapy service specification alongside a range of policies, there is a need to ensure the patient voice is listened to and heard. Ensuring patients are ‘cared about’ throughout their radiotherapy treatment is essential. Reviewing the expectations of patients and capturing their experiences of radiotherapy, enables improvement to our radiotherapy services.</div></div><div><h3>Methods</h3><div>An online survey including open and closed questions about patient experience was distributed to adult external beam radiotherapy patients (EBRT), attending radiotherapy within 10 Radiotherapy Operational Delivery Networks in England. Patients completing radiotherapy treatment 4th - 29th September 2023 were eligible to participate.</div></div><div><h3>Results</h3><div>A 30.6 % response rate was gained (calculated from RTDS data). Over 2500 responses were received, with 2486 suitable for analysis.</div><div>Respondents stated ‘complete understanding’ of knowledge of late effects of radiotherapy was 58.6 %, with early effects at 73.7 %. Most patients (93.8 %) were happy or very happy with information received prior to EBRT starting. The vast majority (95 %) stated they were treated with dignity and respect, with a few describing examples where this had not been the case.</div></div><div><h3>Conclusion</h3><div>The majority of patients responding to this survey indicated they experienced high quality care:<em>‘… the staff, from top to bottom, are quite exceptional. They represent the very best of the NHS and I am truly grateful</em>.’</div><div>From a service improvement perspective, also highlighted was the need to review delivery and content of information given both pre- and post-radiotherapy treatment.</div></div><div><h3>Implications for practice</h3><div>The need for a biennial National Radiotherapy Patient Experience Survey is required. This needs to be available in a range of alternative formats to ensure all voices can be heard.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103305"},"PeriodicalIF":2.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927116","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 : 2026-01-07DOI: 10.1016/j.radi.2025.103307
G. Jia , K. Zhang , M. Qiang , X. Jia, T. Shi, Y. Cai, Z. Yang, Y. Chen
Introduction
Various 2D imaging techniques have been introduced to define the tibial anatomical axis and measure the posterior tibial slope (PTS), but their reliability remains uncertain.
Methods
This study included 104 patients who underwent full-length tibial computed tomography (CT) scans. The anatomical axis was defined at two levels in tomographic imaging: at the tibial head and below the tibial tubercle. For the lateral projection technique, the axis was manually drawn. A 3D tibial coordinate system was established to define the standard anatomical axis and measure the medial and lateral PTS (MPTS and LPTS). The anatomical axes defined by the 2D techniques were imported into the 3D coordinate system to evaluate their deviation angles. The agreements of MPTS and LPTS measurements across the three techniques were evaluated.
Results
Defining the anatomical axis at the tibial head using tomographic imaging introduced instability, leading to only moderate agreement with the 3D reference values for MPTS (intraclass correlation coefficient (ICC) = 0.659, 95 % CI: 0.535–0.756) and LPTS (ICC = 0.622, 95 % confidence interval [CI]: 0.489–0.727). In contrast, establishing the axis below the tibial tubercle improved stability and produced strong agreement with the 3D reference for MPTS (ICC = 0.788, 95 % CI: 0.702–0.851) and LPTS (ICC = 0.78, 95 % CI: 0.692–0.846). The lateral projection technique yielded a minimal anatomical axis deviation angle and strong MPTS agreement with the 3D reference (ICC = 0.774, 95 % CI: 0.684–0.841), but LPTS agreement was poor (ICC = 0.4, 95 % CI: 0.259–0.574).
Conclusion
In tomographic imaging, the anatomical axis definition below the tibial tubercle yields greater stability and more reliable PTS measurements. Although the lateral projection technique accurately defines the axis, it is only applicable to MPTS assessment.
Implications for practice
The tibial anatomical axis should be defined below the tibial tuberosity when measuring PTS using tomographic imaging.
{"title":"Evaluating the reliability of 2D techniques for tibial anatomical axis definition and posterior tibial slope measurement using a 3D model","authors":"G. Jia , K. Zhang , M. Qiang , X. Jia, T. Shi, Y. Cai, Z. Yang, Y. Chen","doi":"10.1016/j.radi.2025.103307","DOIUrl":"10.1016/j.radi.2025.103307","url":null,"abstract":"<div><h3>Introduction</h3><div>Various 2D imaging techniques have been introduced to define the tibial anatomical axis and measure the posterior tibial slope (PTS), but their reliability remains uncertain.</div></div><div><h3>Methods</h3><div>This study included 104 patients who underwent full-length tibial computed tomography (CT) scans. The anatomical axis was defined at two levels in tomographic imaging: at the tibial head and below the tibial tubercle. For the lateral projection technique, the axis was manually drawn. A 3D tibial coordinate system was established to define the standard anatomical axis and measure the medial and lateral PTS (MPTS and LPTS). The anatomical axes defined by the 2D techniques were imported into the 3D coordinate system to evaluate their deviation angles. The agreements of MPTS and LPTS measurements across the three techniques were evaluated.</div></div><div><h3>Results</h3><div>Defining the anatomical axis at the tibial head using tomographic imaging introduced instability, leading to only moderate agreement with the 3D reference values for MPTS (intraclass correlation coefficient (ICC) = 0.659, 95 % CI: 0.535–0.756) and LPTS (ICC = 0.622, 95 % confidence interval [CI]: 0.489–0.727). In contrast, establishing the axis below the tibial tubercle improved stability and produced strong agreement with the 3D reference for MPTS (ICC = 0.788, 95 % CI: 0.702–0.851) and LPTS (ICC = 0.78, 95 % CI: 0.692–0.846). The lateral projection technique yielded a minimal anatomical axis deviation angle and strong MPTS agreement with the 3D reference (ICC = 0.774, 95 % CI: 0.684–0.841), but LPTS agreement was poor (ICC = 0.4, 95 % CI: 0.259–0.574).</div></div><div><h3>Conclusion</h3><div>In tomographic imaging, the anatomical axis definition below the tibial tubercle yields greater stability and more reliable PTS measurements. Although the lateral projection technique accurately defines the axis, it is only applicable to MPTS assessment.</div></div><div><h3>Implications for practice</h3><div>The tibial anatomical axis should be defined below the tibial tuberosity when measuring PTS using tomographic imaging.</div></div>","PeriodicalId":47416,"journal":{"name":"Radiography","volume":"32 2","pages":"Article 103307"},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927027","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}
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