Journal of medical imaging and radiation sciences最新文献

Introduction: Policymakers wish to extend access to medical records, including medical imaging. Appreciating how patients might review radiographs could be key to establishing future training needs for healthcare professionals and how image sharing could be integrated into practice.

Method: A pilot study in the UK using a survey was distributed to adult participants via the online research platform Prolific. All subjects were without prior professional healthcare experience. Participants reviewed ten radiographs (single projection only) and were asked a two-stage question. Firstly, if the radiograph was 'normal' or 'abnormal' and secondly, if they had answered 'abnormal', to identify the abnormality from a pre-determined list featuring generic terms for pathologies.

Results: Fifty participants completed the survey. A mean of 65.8 % of participants were able to correctly identify if radiographs were normal or abnormal. Results in relation to the identification of a pathology were not as positive, but still notable with a mean of 46.4 % correctly identifying abnormalities. Qualitative data demonstrated that members of the public are enthralled with reviewing radiographs and intrigued to understand their performance in identifying abnormalities.

Conclusion: In the pilot, members of the public could identify if a radiograph is normal or abnormal to a reasonable standard. Further detailed interpretation of images requires supportive intervention. This pilot study suggests that patients can participate in image sharing as part of their care. Image sharing may be beneficial to the therapeutic relationship, aiding patient understanding and enhancing consultations between healthcare professional and patient. Further research is indicated.

Background: Computed Tomography Pulmonary Angiography (CTPA) is currently the gold standard for diagnosing Pulmonary Embolism (PE), with a high flowrate (>4.5ml/s) for contrast media (CM) administration recommended for sufficient pulmonary artery opacification. However, this may not be achievable for patients with challenging IV access.

Aim: To determine if a low volume CM, low flowrate (LVLF) CTPA protocol produces images of similar image quality compared to a standard protocol in two aspects, in terms of peak arterial enhancement through the quantitative measurement of Hounsfield unit (HU) and based on subjective overall image quality.

Methods: Retrospective collection of 151 patients who underwent CTPA via 320 slice multi-detector CT due to clinical suspicion of PE. 80 patients underwent the standard protocol, with a fixed flowrate of 4.5ml/s and 50ml of CM, while 71 patients underwent the LVLF protocol with up to a 37% and 30% reduction in flowrate and CM administered, respectively. Two independent radiographers measured the attenuation of multiple pulmonary arteries in HU, with ≥200HU being considered diagnostic. Overall image quality was also reviewed using a 5-point close-ended questionnaire by two independent radiologists.

Results: There was no significant difference in terms of attenuation measured in HU for the seven regions of interest (main pulmonary trunk, right and left pulmonary arteries, right and left lobar arteries, and right and left subsegmental arteries (RSA and LSA)) between the LVLF and standard CTPA protocol. Similarly, there were no significant differences in the overall image quality score obtained from standard and LVLF protocols reported by both radiologists.

Conclusion: The LVLF protocol can achieve similar enhancement and subjective image quality as the standard CTPA protocol, potentially allowing for further optimisation in the CM dosage.

Introduction: Radiographer commenting is a written account of suspected abnormalities identified on medical imaging examinations by the radiographer at the time of image acquisition. Radiographer comments were originally implemented to support emergency clinicians; however, they may also have the potential to support radiologists in reducing missed findings. Therefore, the aim of this study was to investigate if a newly implemented radiographer comment system could reduce the number of errors made in radiology reports for general X-rays. Incidental findings from multisite collaborative research led to the hypothesis that in some cases radiographer comments could accurately detect abnormal X-ray appearances that were not otherwise documented in the radiologist report, thereby enabling results to be revised and errors collaboratively reduced [1].

Methods: This study was conducted at an 800-bed hospital, where 92% of general radiographers self-selected to participate. Radiographer comments were provided to referring physicians through the electronic medical record and could be made for any emergency or inpatient general X-ray examinations. All comments made over a 12-month period were audited against the corresponding radiologist report. Radiologists were blinded to radiographer comments at the time of reporting. Where discrepancies between the radiographer comment and radiologist report arose, additional radiologist review or subsequent imaging reports were used to determine the accurate interpretation. The number of discrepant radiographer comments that were deemed true positive (TP) and provided new and correct diagnostic information compared to the radiologist report were identified. These were converted to a percentage of total radiographer comments that were therefore able to positively influence radiologist report accuracy. The number of discrepant cases where radiographer comments were deemed false positive (FP) was also measured and converted to a percentage of the total comments. Confidence intervals for both TP and FP binomial proportions were calculated using the Wilson Score Interval.

Results: Over 12 months, 282 radiographer comments were made to alert clinically significant radiographic appearances on general X-ray. Of these, 32 radiographer comments were discrepant with the report. Of these 32 comments, 24 were deemed TP meaning they correctly identified a pathological imaging appearance that was not otherwise documented in the radiology report. Therefore, 8.5% of all radiographer comments added value by correctly identifying a pathology that was not otherwise documented, 95% CI (5.8% - 12.4%). This enabled results to be promptly amended and reporting errors collaboratively reduced. Conversely, eight (2.8%) radiographer comments were discrepant with the report but deemed FP and did not add value to the investigation, 95% CI (1.4% - 5.5%). The remaining 250 non-discrepa