Radiography最新文献

Introduction

Rapid adolescent growth is associated with an increased risk of disease and disease progression. This study assesses the reliability and validity of non-ionising B-mode ultrasound for the assessment of skeletal maturity (Risser Grade) and offers procedural guidelines for its use.

Methods

Twenty-three female adolescents with primary-right-thoracic scoliosis (age: 13.8 (1.6) years) and twenty age-matched female control participants without scoliosis (age: 13.1 (1.8) years) were recruited.

Skeletal maturity was determined from (i) a series of nine B-mode ultrasound images collected at sites equally spaced between the anterior and posterior superior iliac spines of the pelvis and (ii) clinical spine radiographs obtained as part of standard scoliosis care. Inter-rater reliability was assessed between a novice researcher and an experienced medical doctor. Concurrent-validity was assessed by comparing the location and degree of apophysis growth and fusion obtained via ultrasound with that obtained using radiograph Risser grading for scoliosis participants only.

Results

The inter-rater reliability of ultrasound Risser grading was strong [ICC(2,1): 0.99, p < 0.001]. High concurrent-validity was determined, with no difference in Risser grading identified between the radiograph and ultrasound grading methods (Wilcoxon signed-rank: Z = −1.93, p = 0.053).

Conclusion

Ultrasound provides a reliable non-ionising alternative to the gold standard of Risser grading from radiographs to determine and monitor skeletal maturity. This study provides a detailed methodology for using ultrasound to assess skeletal maturity.

Implications for practice

Rapid adolescent growth is associated with an increased risk of disease and disease progression. Therefore, accurately determining and monitoring skeletal maturity in these adolescents is crucial. This study assesses the reliability and validity of non-ionising B-mode ultrasound for the assessment of skeletal maturity and offers procedural guidelines for its use.

Introduction

Diffusion-weighted imaging (DWI) with radial acquisition regime (RADAR; RADAR-DWI) is a fast spin echo (FSE)–based DWI imaging technique that is known to be robust to magnetic susceptibility artifacts and distortions as compared with echo planar imaging DWI (EPI-DWI). Several reports have suggested that the apparent diffusion coefficient (ADC) values obtained with FSE-based DWI are different from those obtained with EPI-DWI. The purpose of this study was to create phantoms that mimic the T₂ and ADC values of various tissues and to demonstrate the ADC values obtained with RADAR-DWI and EPI-DWI in low-field magnetic resonance imaging (MRI) systems.

Methods

Several phantoms were created using sucrose and manganese (II) chloride tetrahydrate mimicking various tissues. RADAR-DWI and EPI-DWI were used to scan the phantoms, and the obtained ADC values were compared.

Results

The ADC values obtained with RADAR-DWI were significantly higher than those obtained with EPI-DWI for all phantoms (P < 0.05). The ADC values obtained by RADAR-DWI ranged from 0.70 ± 0.01 to 1.21 ± 0.02 ( × 10⁻³mm²s⁻¹). Meanwhile, the ADC values obtained with EPI-DWI ranged from 0.59 ± 0.01 to 1.08 ± 0.05 ( × 10⁻³mm²s⁻¹).

Conclusions

We created phantoms mimicking T₂ and ADC values of various tissues and demonstrated the differences in ADC values obtained with RADAR-DWI and EPI-DWI using low-field MRI systems.

Implications for practice

ADC values obtained by RADAR-DWI are significantly higher than those obtained by EPI-DWI, with different cutoff values for various tumor malignancies between them.

Introduction

Radiology played a leading role in the transformation of medicine to a digital environment. To ensure the smooth operation and managing workflow in a digital imaging environment, dedicated, well-trained individuals are needed. The objective of this study was to develop a teaching and learning model for imaging informatics.

Methods

Quantitative and qualitative data were collected through a literature review and three structured questionnaires. Results from literature and questionnaires informed the Delphi statements. Three Delphi rounds with medical informatics and higher education experts were completed – all data contributed to developing the teaching and learning model.

Results

Literature provided the frame of reference related to regulation and inclusions in the model. Six summated imaging informatics themes with categories that included topics, teaching, learning and assessment as well as project management, and clinical engineering were included in the first Delphi questionnaire. The three-round Delphi resulted in consensus achieved for 142 of the 184 statements and the stability of 37 statements. The model created aligns with the context, goals, content, learning experiences and assessment that lead to holistic student development.

Conclusion

Feedback from a variety of sources assisted the development of the teaching model for image informatics. The model can be regarded as having a broad scope but also depth since expert refinement strengthened the final inclusions. The flexible, holistic nature of this model addresses not only the educational impediments associated with curriculum development but additionally catalyses a pragmatic approach to implementation and operationalisation thereof.

Implications for practice

The developed teaching and learning model could serve to improve the training of radiographers and IT specialists to become certified imaging informatics professionals. This model may be incorporated to assist the integration of all systems – to improve quality and service.

Introduction

The demand for iodine has increased in the last years, among other factors due to increased medical use. There is no consensus regarding iodinated contrast media (ICM)'s damaging impact on the environment and therefore the producers encourage collecting and recycling ICM waste. The aim of the study was to investigate the ICM waste management in hospitals in Central Norway and to explore the radiographers' attitudes regarding ICM recycling and possible causes of suboptimal waste management.

Methods

The link to the electronic survey was sent to all radiographers working with computed tomography within the Central Norway Regional Health Authority. Descriptive and inferential statistics were performed.

Results

Results reported from 100 radiographers from eight hospitals show that ICM leftovers are recycled or reused in most cases (26% collect them for recycling and 38% use them for oral administration) while 25% send them to the pharmacy together with other pharmaceutical waste and 8% discard them in the sink or the garbage bin. 25% reported that they are not familiar with their department's procedures related to ICM waste. 84% were concerned about the consequences of ICM waste for the environment.

Conclusion

There were considerable differences in the management of ICM waste amongst the hospitals and also internally within the hospitals. Improper practices, likely caused by lack of disposal plans and/or suboptimal information flow, were reported to a low extent.

Implications for practice

Local ICM waste management guidelines which are easily available for radiographers may increase both reuse and recycle rates. Including ICM waste management in the educational curriculum for radiographers can provide early understanding of the rationale behind the procedures and their environmental impact.

Introduction

This study evaluated a pilot intervention to reduce low-value Magnetic Resonance Imaging (MRI) referrals for Low Back Pain (LBP).

Methods

This before-after intervention study analysed MRI referrals for LBP at two private imaging centres in Norway. MRI referrals for LBP obtained before and after an intervention of information campaigns and sending a return letter to clinicians for declined referrals were evaluated on information, quality, and justification rates. Four radiologists and two radiographers assessed the referrals. A point system was used to calculate referral quality. Each referral was given a score ‘good’ when rated above 5.5 and ‘poor’ below 2.5. Justification was based on assessors categorised rating as justified, unjustified or need more information. Stata Statistical Software (Release 18) was used for analysis. A mixed model analysed variations of the referrals pre- and post-intervention. A p-value of <.05 in variations was considered statistically significant.

Results

A total n = 300 patients’ referrals (150 referrals pre- and post-intervention) were collected and assessed. Post-intervention, 68% of referrals were justified, up from 63% pre-intervention. The assessment showed a 4% decrease in referrals with poor scores and a 2% increase in those rated as good or intermediate quality post-intervention. These changes were not statistically significant.

Conclusion

It is important to state that it was not possible in our study to identify the subgroup of referrals that are known to be from clinicians who had received a return letter, although the information campaign targeted all referrers. Despite the limitations our findings suggest that providing reasons for declined referrals can serve as an educational tool for clinicians and contribute to the reduction of low value MRI for LBP.

Implications for practice

Radiology department initiatives that raise awareness and offer referral criteria guidance to clinicians can serve as valuable educational tools, and further emphasize the importance of providing comprehensive information in MRI referrals for LBP.

Introduction

This study evaluates adverse events (AEs) in dentomaxillofacial radiology (DMFR) in Finland, including their quantity, nature, and outcomes. It also compares reporting activity between public and private healthcare organizations, as they share same legal obligations to report AEs. Two-thirds of dental images are taken in public, the rest in private healthcare.

Methods

In Finland, radiation-related AEs are reported to the Radiation and Nuclear Safety Authority (STUK). We categorized DMFR-related AEs by nature, outcome, and imaging modality. We also submitted a questionnaire to STUK to gather information on their observations and remarks made during inspections of establishments providing dental imaging services.

Results

During 2012–2022, STUK received reports of 1343 DMFR-related AEs, mostly causing patient harm (92.9%) leading almost always to excessive radiation doses (99.7%). Private healthcare reported most AEs (65.2%), with municipal institutions reporting the remainder (34.8%). Intraoral-related AEs (20.0%) slightly outnumbered panoramic-related ones (18.7%), but the majority (56.7%) didn't specify the imaging modality. CBCT-related incidents were least reported (4.5%). During STUK's inspections, remarks mostly concerned deficiencies in practical quality assurance (31.3%) or technical quality assurance (32.9%).

Conclusion

DMFR-related AEs may be underreported despite legal obligations, with most stemming from human error, highlighting the need to enhance patient safety culture. There's a notable reporting gap between private and public healthcare providers relative to the number of dental radiographs conducted. Organizational deficiencies in practical and technical quality assurance underscore the importance of ongoing education, as well as monitoring by STUK.

Implications for practice

Enhancing patient safety culture in dentistry, including dentomaxillofacial radiology, demands customized multiprofessional development, as unaltered patient safety procedures from medicine and secondary care may not align with dentistry's requirements.

Introduction

MRI often induces anxiety, leading to incomplete scans and claustrophobia-related distress. Open MRI systems aim to enhance patient comfort. This study examines how prior MRI experiences impact subsequent encounters in an open upright MRI scanner.

Methods

In this cross-sectional study, 118 adult patients completed a self-administered questionnaire from August 2022 to October 2023. It covered previous MRI experiences, including questions about claustrophobia, premature scan terminations, sedative medication usage, general MRI experiences, and interactions with radiology technologists.

Results

Patients in open upright MRI reported less claustrophobia compared to closed MRI systems (18.4% vs. 58.3%), fewer premature scan terminations (5.3% vs. 31.0%), and less sedative use (5.3% vs. 46.9%). Moderate positive correlations were found between past and current claustrophobic events and premature scan terminations. Effective communication with radiology technologists was essential for patient comfort and reduced claustrophobia. Scan duration and noise triggered discomfort in 26.1% and 21.6% of study participants respectively. Persons without prior MRI experience were more satisfied with the examination and expressed no clear preference for future MRI settings, contrasting those with previous exposure favoring the open MRI setup.

Conclusion

The study emphasizes the benefits of open upright MRI for high-risk claustrophobic patients. It identifies the lasting impact of negative MRI experience on future examinations and highlights the crucial role of radiology technologists.

Implications for practice

Integrating open MRI scanners in medical facilities and prioritizing effective communication with radiology technologists enhances patient comfort. Positive experiences with open MRI may improve patient compliance and offer greater flexibility for future examinations.

Method

2D/3D kV imaging and CBCT data using 6 degrees of freedom (6DoF) were compared to evaluate inter and intrafraction motion.

Results

Results showed that intrafraction errors were low and interfraction levels were within institutional protocols.

Conclusion

Confidence was given to use low dose 2D/3D kV imaging to confirm daily patient set up errors, and to use pre-treatment CBCT only once weekly for additional imaging information.

Implications for practice

Further research is necessary to assess other uncertainties, to enable the calculation of a margin and determining the feasibility of further reduction of this.

Introduction

Advanced practice is well established in the health professions with multiprofessional capabilities in place in England. To recognise achievement of these capabilities an ePortfolio (supported) route was initiated in 2022. This study aimed to review the demographics and experiences of radiographers applying for recognition in the first year of operation.

Methods

The multi method evaluation consisted of quantitative data analysis of information regarding the first three cohorts of radiographers (n = 40) participating in the NHS England (NHSE) scheme. Interviews with 12 participants was undertaken with thematic analysis of the transcripts.

Results

Self-rated scores of expertise were significantly higher by therapeutic radiographers (n = 8) compared to their 32 diagnostic colleagues (t = 5.556; p < 0.01). Radiographers saw the ePortfolio as an opportunity to validate their experience and to evidence parity with other professions. Participants felt the process also enabled critical reflection and gave unseen insight into themselves and their roles. The support of experienced educational supervisors was felt to be vital in this process and for successful completion of portfolio.

Conclusions

Several radiographers have now achieved the necessary standards to achieve NHSE recognition. The evaluation exposed that most radiographers did not have the relevant evidence to hand and the ongoing collection of evidence around capabilities and impact is critical to evidencing advanced practice capabilities.

Implications for practice

Radiographers are able to achieve the capabilities expected for multiprofessional practice. Cultural change is required to normalise recording of evidence within practice including case-based discussions, clinical supervision and feedback from colleagues and patients. The support of an experienced educational supervisor aided the critical reflection on practice level.