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England A, Thompson J, Dorey S, Al Islam S, Long M, Maiorino C, McEntee MF. Corrigendum to "A comparison of perceived image quality between computer display monitors and augmented reality smart glasses" [Radiography 29 (3) (May 2023) 641-646]. Radiography (Lond) 2024; 30:1. [PMID: 37586969 DOI: 10.1016/j.radi.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- A England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland.
| | - J Thompson
- University Hospitals of Morecambe Bay NHS Foundation Trust, Barrow-in-Furness, UK
| | - S Dorey
- Tameside and Glossop Integrated Care NHS Foundation Trust, Tameside, UK
| | - S Al Islam
- East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - M Long
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - C Maiorino
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - M F McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
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Mellor FE, Smith L, England A, Snaith B, Cosson P. A retrospective evaluation of supine pelvic radiography image quality using centring points and anatomical axial rotation, including reliability of measurements (ARLEX-P STUDY). Radiography (Lond) 2023; 29:941-949. [PMID: 37531694 DOI: 10.1016/j.radi.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Pelvic radiographs are commonly used for the investigation of a variety of conditions. Comparison between examinations requires a consistent radiographic technique but variations in image quality and radiographic centring points are frequently reported in the literature. The aim of this study was to establish the amount of variation in the radiographic centring point (RCP) and pelvic axial rotation (PAR), with a secondary aim of reporting the reliability of such measures. METHODS Using a previously acquired imaging archive, 633 adult pelvis/hip radiographs were identified on a Picture Archiving and Communication System (PACS). Radiographs with bilateral prostheses, evidence of acute pelvic trauma, projections acquired on a stretcher/trolley and those demonstrating large discontinuity between the detector and X-ray field centre were excluded. To determine centring point variation (+ values denote superior variations) and axial rotation multiple measurements were obtained from each radiograph. A video was used to train five observers and each of these reviewed ten random cases to determine inter- and intra-rater reliability. One of the five observers then performed the measurements on all remaining radiographs. RESULTS Following exclusions 380 radiographs were evaluated. The median (IQR) RCP deviation from the inter-acetabular line was +22 (+2 to +43) mm where both iliac crests were present and -29 (-45 to -12) mm where they were not. Eleven (3%) cases demonstrate RCP variation from the midline of greater than 25 mm (no bias towards the left or right side). The median (IQR) PAR was 0.0 (-1.5 to 1.4) degrees with greater variance in PAR for male participants (p = 0.004). Almost 60% of inter-rater ICC measurements were categorised as excellent, good or moderate. CONCLUSION Variations in RCP and PAR exist when evaluating a sample of routinely acquired pelvis radiographs. Some initial factors, such as sex and sub-examination type (full pelvis [XPEL] or low centred pelvis [XHIPB]) have been identified as having a statistical affect on variability. Further research and methods to standardise radiographic techniques is required and must be multidimensional in nature. IMPLICATIONS FOR PRACTICE Selection of radiographic technique, including RCP, appears to influence components of the pelvis radiograph. Given the increasing clinical requirements for pelvic radiography further standardisation alongside individual optimisation is warranted.
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Affiliation(s)
- F E Mellor
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - L Smith
- United Lincolnshire NHS Trust, Lincoln, UK
| | - A England
- University College Cork, Cork, Ireland.
| | - B Snaith
- Radiology Department, Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Wakefield, UK; Faculty of Health Studies, University of Bradford, Bradford, UK
| | - P Cosson
- Teesside University, Middlesbrough, UK
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Gilley R, David LR, Leamy B, Moloney D, Moore N, England A, Waldron M, Maher M, McEntee MF. Establishing weight-based diagnostic reference levels for neonatal chest X-rays. Radiography (Lond) 2023; 29:812-817. [PMID: 37276688 DOI: 10.1016/j.radi.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION As weights among neonates can vary from <900 g to >2.5 kg, weight-based Diagnostic Reference Levels (DRLs) specific to the neonatal intensive care unit (NICU) are essential. Repeated radiation exposure to this sensitive patient group raises concerns regarding high cumulative radiation doses and the potential for long-term health detriment. This study aimed to establish weight-based DRLs for neonates undergoing mobile chest radiography (CXR) in the NICU. METHODS Neonates were classified into three discrete groups; <1000, 1000-2500 and >2500 g. Data were collected prospectively over three months; 95 DAP values were collected, and five were excluded due to poor technique, leaving 90 patients that met the inclusion criteria for mobile CXR in the NICU. Dose-area-product (DAP) in mGycm2, the peak kilovoltage (kVp) and the product of tube current and exposure time (mAs) were retrieved from the Picture Archiving and Communication System (PACS). Images and radiological reports were also analysed to confirm diagnostic image quality (IQ). Local DRLs (LDRLs) were derived using the median DAP, and national DRLs were suggested using the 3rd quartile value. RESULTS The proposed LDRLs for neonates weighing <1000 g was 2.7 mGycm2, for neonates weighing between 1000 g and 2500 g, it was 3.7 mGycm2, and for neonates weighing >2500 g it was 6.6 mGycm2. The radiation dose received by the 90 (100%) neonates included in the study fell below 11.4 mGycm2; of these, 82% of the DAP values fell below the study institution's existing LDRL of 7.25 mGycm2. CONCLUSION Weight-based DRLs provide crucial information on doses to this specific radiation-sensitive group. This work recommends using weight-based categories for DRLs and serves as a benchmark for neonatal CXR standardisation and optimisation. IMPLICATIONS FOR PRACTICE The proposed weight-based DRLs can be adopted for neonates' locally, nationally and internationally.
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Affiliation(s)
- R Gilley
- Medical Imaging and Radiation Therapy, University College Cork, Ireland
| | - L R David
- Department of Medical Diagnostic Imaging, College of Health of Sciences, University of Sharjah, United Arab Emirates
| | - B Leamy
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - D Moloney
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - N Moore
- Medical Imaging and Radiation Therapy, University College Cork, Ireland
| | - A England
- Medical Imaging and Radiation Therapy, University College Cork, Ireland.
| | - M Waldron
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - M Maher
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - M F McEntee
- Medical Imaging and Radiation Therapy, University College Cork, Ireland
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England A, Thompson J, Dorey S, Al-Islam S, Long M, Maiorino C, McEntee MF. A comparison of perceived image quality between computer display monitors and augmented reality smart glasses. Radiography (Lond) 2023; 29:641-646. [PMID: 37130492 DOI: 10.1016/j.radi.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Augmented-reality (AR) smart glasses provide an alternative to standard computer display monitors (CDM). AR smart glasses may provide an opportunity to improve visualisation during fluoroscopy and interventional radiology (IR) procedures when there can be difficulty in viewing intra-procedural images on a CDM. The aim of this study was to evaluate radiographer perception of image quality (IQ) when comparing CDM and AR smart glasses. METHODS 38 radiographers attending an international congress evaluated ten fluoroscopic-guided surgery and IR images on both a CDM (1920 × 1200 pixels) and a set of Epson Moverio BT-40 AR smart glasses (1920 × 1080 pixels). Participants provided oral responses to pre-defined IQ questions generated by study researchers. Summative IQ scores for each participant/image were compared between CDM and AR smart glasses. RESULTS Of the 38 participants, the mean age was 39 ± 1 years. 23 (60.5%) participants required corrective glasses. In terms of generalisability, participants were from 12 different countries, the majority (n = 9, 23.7%) from the United Kingdom. For eight out of ten images, the AR smart glasses demonstrated a statistically significant increase in perceived IQ (median [IQR] 2.0 [-1.0 to 7.0] points) when compared to the CDM. CONCLUSION AR smart glasses appear to show improvements in perceived IQ when compared to a CDM. AR smart glasses could provide an option for improving the experiences of radiographers involved in image-guided procedures and should be subject to further clinical evaluations. IMPLICATIONS FOR PRACTICE Opportunities exist to improve perceived IQ for radiographers when reviewing fluoroscopy and IR images. AR smart glasses should be further evaluated as a potential opportunity to improve practice when visual attention is split between positioning equipment and image review.
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Affiliation(s)
- A England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland.
| | - J Thompson
- University Hospitals of Morecambe Bay NHS Foundation Trust, Barrow-in-Furness, UK
| | - S Dorey
- Tameside and Glossop Integrated Care NHS Foundation Trust, Tameside, UK
| | - S Al-Islam
- East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - M Long
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - C Maiorino
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - M F McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
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Partner A, England A, Young R, Shiner N, Bridge P. Post COVID-19 trends in simulation use within diagnostic radiography and radiation therapy education. Radiography (Lond) 2023; 29:684-689. [PMID: 37187065 DOI: 10.1016/j.radi.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/30/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE Simulation is used within medical radiation science training. Recent global events and simulation resource uptake has led to significant changes. The aim of this study was to capture post COVID-19 trends and activity of simulation-based education (SBE) in diagnostic radiography and radiation therapy. METHODS An online survey was designed to investigate the role of simulation within diagnostic radiography and radiation therapy education. Survey design was based on literature and experience within the research team. Questions were based around access and use of simulation, future trends and the effects of COVID-19. Participants were diagnostic radiography and/or radiation therapy educators. Data captured in this study was undertaken in March 2022 and compared with previous data from Bridge and colleagues (2021). RESULTS Sixty-seven responses were received across five continents (two from North/South America), Europe was the most widely represented (n = 58, 87%). Fifty-three (79%) of participants reported that they use simulation as part of their teaching and learning. Twenty-seven (51%) respondents reported that they had increased their use of simulation because of COVID-19. Sixteen (30%) respondents stated that they were now able to enrol more students because of the pandemic. Fixed models and immersive environments were the two most common simulation activities. Participants reported, to different degrees, that simulation was used across all parts of the curriculum. CONCLUSIONS Simulation is deeply embedded into diagnostic radiography and radiation therapy education. Evidence suggests that the growth of simulation may be slowing. Opportunities exist for the development of guidance, training and best practice resources around simulation. IMPLICATIONS FOR PRACTICE Simulation is a key pedagogical approach for diagnostic radiography and radiation therapy education. Key stakeholders now need to work collaboratively to define standards and best practices.
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Affiliation(s)
- A Partner
- Discipline of Diagnostic Imaging, University of Derby, UK
| | - A England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Ireland.
| | - R Young
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Ireland
| | - N Shiner
- Faculty of Medicine & Health Sciences, Keele University, UK
| | - P Bridge
- School of Health Sciences, University of Liverpool, UK
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England A, Beardmore C, Cunha A. The EFRS patient centred care awards: Supporting the identification, promotion and propagation of high-quality care across Europe. Radiography (Lond) 2023; 29 Suppl 1:S3-S4. [PMID: 36759223 DOI: 10.1016/j.radi.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 02/10/2023]
Affiliation(s)
- A England
- University College Cork, Cork, Ireland.
| | - C Beardmore
- Society & College of Radiographers', London, UK
| | - A Cunha
- European Federation of Radiographer Societies, Portugal.
| | -
- European Federation of Radiographer Societies, Portugal
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Bockhold S, McNulty J, Abdurakman E, Bezzina P, Drey N, England A, Flinton D, Khine R, McEntee M, Mekiš N, Precht H, Rainford L, Sá Dos Reis C, Santos A, Syrgiamiotis V, Willis S, Woodley J, Beardmore C, Harris R, O'Regan T, Malamateniou C. Research ethics systems, processes, and awareness across Europe: Radiography research ethics standards for Europe (RRESFE). Radiography (Lond) 2022; 28:1032-1041. [PMID: 35964488 DOI: 10.1016/j.radi.2022.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The Radiography Research Ethics Standards for Europe (RRESFE) project aims to provide a cross-sectional snapshot of current research ethics systems, processes, and awareness of such, across Europe together with identifying the associated challenges, education, and training needs. METHODS A cross-sectional online survey targeting radiography researchers in Europe was conducted. Data collection took place between April 26 and July 12, 2021, using a snowball sampling approach. Descriptive and analytical statistics were used to identify trends in research ethics frameworks across Europe. RESULTS 285 responses were received across 33 European and 23 non-European countries. Most (n = 221; 95%) European respondents stated ethics approval is required before commencing research in their country. Requirements around research ethics approval and awareness of such requirements varied by European region (X2 (2, n = 129) = 7.234, p = 0.013) and were found to differ depending on the type of research participant and study design. Additionally, European respondents reported ethics approval is a national requirement more often than their non-European counterparts (X2 (1, n = 282) = 4.316, p = 0.049). Requirements for ethics approval were also associated with the undergraduate programme duration (2-year vs. 3-year vs. 3.5 year vs. 4-year vs. multiple programme durations; X2 (4, n = 231) = 10.075, p = 0.016) and availability of postgraduate training (postgraduate training available vs. postgraduate training not available; X2 (1, n = 231) = 15.448, p = <0.001) within respondents' country. CONCLUSION Respondents from countries with longer programme durations/availability of multiple programme lengths, availability of postgraduate training, and establishment of European Qualifications Framework Level 6 were generally associated with less uncertainty and more comprehensive research ethics requirements. IMPLICATIONS FOR PRACTICE Results are informative of the current status of research ethics within evidence-based radiography.
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Affiliation(s)
- S Bockhold
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - J McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - E Abdurakman
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - P Bezzina
- Radiography, Faculty of Health Sciences, L-Università ta' Malta, Malta
| | - N Drey
- Division of Nursing, School of Health Sciences, City University of London, United Kingdom
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - D Flinton
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - R Khine
- School of Health Care and Social Work, Buckinghamshire New University, United Kingdom
| | - M McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Mekiš
- Medical Imaging and Radiotherapy, Faculty of Health Sciences, University of Ljubljana, Slovenia
| | - H Precht
- Diagnostic and Treatment and Radiography Education, Health Sciences Research Centre, UCL University College, Denmark
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - C Sá Dos Reis
- Radiological Medical Imaging Technology, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - A Santos
- Medical Imaging and Radiotherapy, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - V Syrgiamiotis
- CT-MRI Department, General Children's Hospital of Athens Agia Sophia, and University of West Attica, Greece
| | - S Willis
- Health Education England, National Health Service, London, United Kingdom
| | - J Woodley
- School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - C Beardmore
- Society and College of Radiographers, London, United Kingdom
| | - R Harris
- Society and College of Radiographers, London, United Kingdom
| | - T O'Regan
- Society and College of Radiographers, London, United Kingdom
| | - C Malamateniou
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom.
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Bockhold S, McNulty J, Abdurakman E, Bezzina P, Drey N, England A, Flinton D, Khine R, McEntee M, Mekiš N, Precht H, Rainford L, Sá Dos Reis C, Santos A, Syrgiamiotis V, Willis S, Woodley J, Beardmore C, Harris R, O'Regan T, Malamateniou C. Research ethics training, challenges, and suggested improvements across Europe: Radiography research ethics standards for Europe (RRESFE). Radiography (Lond) 2022; 28:1016-1024. [PMID: 35939960 DOI: 10.1016/j.radi.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 07/07/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The Radiography Research Ethics Standards for Europe (RRESFE) project aimed to provide a cross-sectional view of the current state of radiography research ethics across Europe. This included investigating education and training in research ethics, and identifying the key challenges and potential improvements associated with using existing research ethics frameworks. METHODS This cross-sectional online survey targeting radiography researchers in Europe was conducted between April 26 and July 12, 2021. Descriptive and analytical statistics were used to identify research ethics education and training trends. Content analysis of qualitative responses was employed to identify significant challenges and proposed improvements in research ethics frameworks of practice. RESULTS There were 232 responses received across 33 European countries. Most (n = 132; 57%) respondents had received some research ethics training; however, fewer participants had received training on safeguarding vulnerable patients (n = 72; 38%), diversity and inclusivity (n = 62; 33%), or research with healthy volunteers (n = 60; 32%). Training was associated with a greater perceived importance of the need for research ethics review (p = 0.031) and with the establishment of EQF Level 6 training (p = 0.038). The proportion of formally trained researchers also varied by region (p = <0.001). Time-to-ethics-approval was noted as the biggest challenge for professionals making research ethics applications. CONCLUSION Early and universal integration of research-oriented teaching within the radiography education framework which emphasises research ethics is recommended. Additionally, study findings suggest research ethics committee application and approval processes could be further simplified and streamlined. IMPLICATIONS FOR PRACTICE The survey contributes to a growing body of knowledge surrounding the importance of education and training in research ethics for assuring a high standard of research outputs in Radiography and has identified hurdles to obtaining research ethics approval for further investigation and address.
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Affiliation(s)
- S Bockhold
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - J McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - E Abdurakman
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - P Bezzina
- Radiography, Faculty of Health Sciences, L-Università ta' Malta, Malta
| | - N Drey
- Division of Nursing, School of Health Sciences, City University of London, United Kingdom
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - D Flinton
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - R Khine
- School of Health Care and Social Work, Buckinghamshire New University, United Kingdom
| | - M McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Mekiš
- Medical Imaging and Radiotherapy, Faculty of Health Sciences, University of Ljubljana, Slovenia
| | - H Precht
- Diagnostic and Treatment and Radiography Education, Health Sciences Research Centre, University College Lillebælt, Vejle, Denmark
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - C Sá Dos Reis
- Radiological Medical Imaging Technology, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - A Santos
- Medical Imaging and Radiotherapy, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - V Syrgiamiotis
- CT-MRI Department, General Children's Hospital of Athens Agia Sophia, and University of West Attica, Greece
| | - S Willis
- Health Education England, National Health Service, London, United Kingdom
| | - J Woodley
- School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - C Beardmore
- Society and College of Radiographers, London, United Kingdom
| | - R Harris
- Society and College of Radiographers, London, United Kingdom
| | - T O'Regan
- Society and College of Radiographers, London, United Kingdom
| | - C Malamateniou
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
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England A, McConnell J. COVID-19 Pandemic: A Process of Recovery and Renewal. Radiography (Lond) 2022; 28 Suppl 1:S1-S2. [PMID: 36109265 PMCID: PMC9424518 DOI: 10.1016/j.radi.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022]
Affiliation(s)
- A England
- University College Cork, Cork, Ireland.
| | - J McConnell
- Yorkshire Imaging Collaborative, Visiting Professor University of Ulster, United Kingdom
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Coakley S, Young R, Moore N, England A, O'Mahony A, O'Connor OJ, Maher M, McEntee MF. Radiographers' knowledge, attitudes and expectations of artificial intelligence in medical imaging. Radiography (Lond) 2022; 28:943-948. [PMID: 35839662 DOI: 10.1016/j.radi.2022.06.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Artificial intelligence (AI) is increasingly utilised in medical imaging systems and processes, and radiographers must embrace this advancement. This study aimed to investigate perceptions, knowledge, and expectations towards integrating AI into medical imaging amongst a sample of radiographers and determine the current state of AI education within the community. METHODS A cross-sectional online quantitative study targeting radiographers based in Europe was conducted over ten weeks. Captured data included demographical information, participants' perceptions and understanding of AI, expectations of AI and AI-related educational backgrounds. Both descriptive and inferential statistical techniques were used to analyse the obtained data. RESULTS A total of 96 valid responses were collected. Of these, 64% correctly identified the true definition of AI from a range of options, but fewer (37%) fully understood the difference between AI, machine learning and deep learning. The majority of participants (83%) agreed they were excited about the advancement of AI, though a level of apprehensiveness remained amongst 29%. A severe lack of education on AI was noted, with only 8% of participants having received AI teachings in their pre-registration qualification. CONCLUSION Overall positive attitudes towards AI implementation were observed. The slight apprehension may stem from the lack of technical understanding of AI technologies and AI training within the community. Greater educational programs focusing on AI principles are required to help increase European radiography workforce engagement and involvement in AI technologies. IMPLICATIONS FOR PRACTICE This study offers insight into the current perspectives of European based radiographers on AI in radiography to help facilitate the embracement of AI technology and convey the need for AI-focused education within the profession.
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Affiliation(s)
- S Coakley
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - R Young
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Moore
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland.
| | - A O'Mahony
- Department of Radiology, Cork University Hospital, Ireland
| | - O J O'Connor
- Department of Radiology, Cork University Hospital, Ireland
| | - M Maher
- Department of Radiology, Cork University Hospital, Ireland
| | - M F McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
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Ogenyi P, Chiegwu HU, England A, Akanegbu UE, Ogbonna OS, Abubakar A, Luntsi G, Zira DJ, Dauda M. Appraisal of trimester-specific fetal heart rate and its role in gestational age prediction. Radiography (Lond) 2022; 28:926-932. [PMID: 35820355 DOI: 10.1016/j.radi.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate and report normal sonographic FHR values among low-risk singleton women across the three trimesters of pregnancy and determine FHR role in gestational age prediction. METHOD A prospective cross-sectional study of 2727 low-risk singleton pregnant women was undertaken. FHR measurements were obtained by a consultant radiologist and three experienced sonographers using transabdominal approach from January 2019 to December 2020. Two FHR measurements were taken for each participant. The fetal lie and presentation were also documented in the first trimester. Data were analysed using SPSS version 24 (IBM, Armonk, NY, USA). RESULT The maternal mean ± SD age was 25.8 ± 6.5 years and mean FHR for first, second and third trimesters were 151 ± 16, 145 ± 6 and 125±6 bpm respectively. The mean ± SD gestational age were 10 ± 2, 19 ± 3 and 34 ± 2 weeks for the first, second and third trimester respectively. Using ANOVA, there were statistically significant differences in FHR across the three trimesters (p ≤ 0.05). A positive correlation existed between maternal age and FHR (r = 0.57, p ≤ 0.05). CONCLUSION This study has established normal values for FHR in first, second and third trimester respectively. Referring physicians, radiologists, sonographers, obstetricians and gynaecologists may consider FHR of (135-167) bpm (139-151) bpm and (119-131) bpm as normal FHR ranges for the first, second and third trimester respectively. This study has also revealed the possibility of gestational age prediction using FHR with the equation [Gestational Age = 87.8 - (0.47) FHR]. IMPLICATIONS FOR PRACTICE This paper provides the most up-to-date sonographic FHR recommendations for fetal management. More importantly, findings from this study also suggests that ultrasound practitioners can use FHR measurements as a reliable alternative for fetal dating.
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Affiliation(s)
- P Ogenyi
- Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
| | - H U Chiegwu
- Department of Radiography, Nnamdi Azikiwe University, Awka
| | - A England
- School of Medicine, University College Cork, Ireland
| | - U E Akanegbu
- Department of Radiography, Nnamdi Azikiwe University, Awka
| | - O S Ogbonna
- Department of Radiography, Nnamdi Azikiwe University, Awka
| | - A Abubakar
- Department of Radiography, University of Maiduguri, Nigeria
| | - G Luntsi
- Department of Radiography, University of Maiduguri, Nigeria
| | - D J Zira
- Department of Radiography, Federal University Lafia, Nigeria
| | - M Dauda
- Department of Medical Physics, Nasarawa State University, Keffi, Nigeria
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12
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Robertson S, Olanloye E, Hon Y, England A, McNair H, Cruickshank S. Are radiographers suffering from symptoms of compassion fatigue due to occupational stress: A systematic review. Radiography (Lond) 2022; 28:857-864. [DOI: 10.1016/j.radi.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/04/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
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13
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England A, Thompson JD, Littler E, Tugwell-Allsup J, Edwards E. Predicting the role of touchless technologies within diagnostic radiography: Results of an international survey. Radiography (Lond) 2021; 28:524-530. [PMID: 34961676 DOI: 10.1016/j.radi.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The evolution of technology within healthcare is continuing at a rapid rate. Touchless technologies (i.e. those involving gestures and voice commands) are rapidly being integrated into daily life. The aim of this study was to investigate the potential role for such technologies within diagnostic radiography. METHODS An online survey was developed, piloted and deployed using SurveyMonkey as part of an online radiology congress. Eligible respondents were radiographers or radiologic technologists, including students. The survey covered ten themes relating to the potential role of touchless technologies within diagnostic radiography. Results were analysed using descriptive and inferential statistics. RESULTS 155 people completed the questionnaire. 100 (64.9%) were women and clinical experience ranged from 13.5 (0-40) years. The majority, 54 (35.1%), had a Bachelor's degree with respondents being from 23 different countries (five continents). 34 (21.9%) respondents did not personally own nor intended to purchase touchless technologies. 89 (84.8%) respondents saw themselves using touchless technologies, if available on current imaging equipment. 25 (16.0%) respondents reported that they currently have access to touchless technologies within their workplace. 88 (81.5%) and 67 (65.0%) respondents reported that they saw voice and gesture controls as being key in improving exam efficiency. CONCLUSION Participants clearly perceived a role for touchless technologies within diagnostic radiography. Access to such technologies is not yet widely available within X-ray rooms. Voice activated technologies appear more appealing that gesture-based aids. The primary role for such technologies was defined by participants as focusing on improving examination efficiency. IMPLICATIONS FOR PRACTICE Touchless technologies have been identified and as important and potentially useful in diagnostic radiography. Collaboration between healthcare institutions, industry and academia is required to design and successfully implement these technologies into practice.
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Affiliation(s)
- A England
- School of Allied Health Professions, Keele University, UK; School of Medicine, University College Cork, Ireland.
| | - J D Thompson
- School of Health & Society, University of Salford, UK
| | - E Littler
- Warrington & Halton Teaching Hospitals NHS Trust, UK
| | | | - E Edwards
- School of Allied Health Professions, Keele University, UK
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Singh T, Muscroft N, Collier N, England A. A comparison of effective dose and risk for different collimation options used in AP shoulder radiography. Radiography (Lond) 2021; 28:394-399. [PMID: 34887196 DOI: 10.1016/j.radi.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/01/2021] [Accepted: 11/19/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Radiography forms the cornerstone of the evaluation of shoulder disorders. While the benefits of radiography exceed the risks, there continues to be a compelling case for reduction of radiation exposure from diagnostic radiography. The aim of this project was to evaluate the radiation dose and risk for a variety of collimation settings used during anteroposterior (AP) shoulder radiography. METHODS This was a phantom based study where an ATOM adult dosimetry phantom was loaded with 272 thermoluminescent dosimeters (TLDs). Following loading, the phantom was setup for an AP shoulder X-ray projection with standard 25 × 30 cm rectangular collimation. The phantom was exposed three times and then the TLDs were removed and read. The experiment was repeated using a diamond shaped collimation and rectangular collimation with a minimum field of view to portray only relevant anatomy. Using the TLD dose measurements the effective doses and radiation risks were determined and compared. RESULTS As expected, organs neighbouring the shoulder experienced the highest absorbed doses (greater than 0.01 mGy); these organs included breast, lung and thyroid gland. The effective doses for standard rectangular, small rectangular and diamond collimation were 0.011, 0.008 and 0.016 mSv, respectively. When compared to standard collimation, a small field of view reduced effective dose by 27.3% and when moving to a diamond shape there was a 45.5% increase. The differences are likely driven by differences in the coverage of the radiosensitive lung and breast tissue. CONCLUSION By utilising a variety of different collimation settings, effective dose can be reduced. Reducing the radiation dose is both financially beneficial and results in a lower stochastic risk for patients. Image quality must also be considered when choosing different collimation settings. It stands to reason that by reducing the field size, dose will be reduced, and our study has served to quantify the effects in a practical situation. IMPLICATIONS FOR PRACTICE The utilisation of smaller/tight collimation is recommended as it offers the lowest dose when compared with other types of collimations. Although well-known this study serves to remind practitioners of the practical importance of collimation and is associated effect on effective dose and risk.
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Affiliation(s)
- T Singh
- School of Allied Health Professions, Keele University, Keele, Staffordshire, UK
| | - N Muscroft
- Warrington & Halton Teaching Hospitals NHS Trust, Warrington, UK
| | - N Collier
- Lancashire Teaching Hospitals NHS Trust, Preston, UK
| | - A England
- School of Allied Health Professions, Keele University, Keele, Staffordshire, UK; Discipline of Medical Imaging, School of Medicine, University College Cork, Ireland.
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Saint J, England A, Ali AM, Bonnett L. The effect of different statistical approaches on image quality data obtained from radiological examinations. Radiography (Lond) 2021; 28:518-523. [PMID: 34848136 DOI: 10.1016/j.radi.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Selection of optimal image acquisition protocols in medical imaging remains a grey area, the superimposed use of the Likert scale in radiological image quality evaluations creates an additional challenge for the statistical analysis of image quality data. Using a simulation study, we have trialled a novel approach to analysing radiological image quality Likert scale data. METHODS A simulation study was undertaken where simulated datasets were generated based on the distribution of Likert scale values according to varying image acquisition protocols from a real dataset. Simulated Likert scale values were pooled in four different ways; the mean, median, mode and the summation of patient Likert scale values of which the total was assigned a categorical Likert scale value. Estimates of bias, MAPE and RMSPE were then calculated for all four pooling approaches to determine which method most accurately represented an expert's opinion. RESULTS When compared to an expert's opinion, the method of summation and categorisation of Likert scale values was most accurate 49 times out of the 114 (43.0%) tests. The mean 28 times out of 114 (24.6%), the median 23 times out of 114 (20.2%) and the mode 17 times out of 114 (14.9%). CONCLUSION We conclude that our method of summation and categorisation of Likert scale values is most often the best representation of the simulated data compared to the expert's opinion. IMPLICATIONS FOR PRACTICE There is scope to reproduce this simulation study with multiple observers to reflect clinical reality more accurately with the dynamic nature of multiple observers. This also prompts future investigation into other anatomical areas, to see if the same methods produce similar results.
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Affiliation(s)
- J Saint
- Department of Biostatistics, University of Liverpool, United Kingdom.
| | - A England
- Directorate of Radiography, University of Salford, United Kingdom
| | - A M Ali
- Directorate of Radiography, University of Salford, United Kingdom
| | - L Bonnett
- Department of Biostatistics, University of Liverpool, United Kingdom
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16
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Malamateniou C, McFadden S, McQuinlan Y, England A, Woznitza N, Goldsworthy S, Currie C, Skelton E, Chu KY, Alware N, Matthews P, Hawkesford R, Tucker R, Town W, Matthew J, Kalinka C, O'Regan T. Artificial Intelligence: Guidance for clinical imaging and therapeutic radiography professionals, a summary by the Society of Radiographers AI working group. Radiography (Lond) 2021; 27:1192-1202. [PMID: 34420888 DOI: 10.1016/j.radi.2021.07.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Artificial intelligence (AI) has started to be increasingly adopted in medical imaging and radiotherapy clinical practice, however research, education and partnerships have not really caught up yet to facilitate a safe and effective transition. The aim of the document is to provide baseline guidance for radiographers working in the field of AI in education, research, clinical practice and stakeholder partnerships. The guideline is intended for use by the multi-professional clinical imaging and radiotherapy teams, including all staff, volunteers, students and learners. METHODS The format mirrored similar publications from other SCoR working groups in the past. The recommendations have been subject to a rapid period of peer, professional and patient assessment and review. Feedback was sought from a range of SoR members and advisory groups, as well as from the SoR director of professional policy, as well as from external experts. Amendments were then made in line with feedback received and a final consensus was reached. RESULTS AI is an innovative tool radiographers will need to engage with to ensure a safe and efficient clinical service in imaging and radiotherapy. Educational provisions will need to be proportionately adjusted by Higher Education Institutions (HEIs) to offer the necessary knowledge, skills and competences for diagnostic and therapeutic radiographers, to enable them to navigate a future where AI will be central to patient diagnosis and treatment pathways. Radiography-led research in AI should address key clinical challenges and enable radiographers co-design, implement and validate AI solutions. Partnerships are key in ensuring the contribution of radiographers is integrated into healthcare AI ecosystems for the benefit of the patients and service users. CONCLUSION Radiography is starting to work towards a future with AI-enabled healthcare. This guidance offers some recommendations for different areas of radiography practice. There is a need to update our educational curricula, rethink our research priorities, forge new strong clinical-academic-industry partnerships to optimise clinical practice. Specific recommendations in relation to clinical practice, education, research and the forging of partnerships with key stakeholders are discussed, with potential impact on policy and practice in all these domains. These recommendations aim to serve as baseline guidance for UK radiographers. IMPLICATIONS FOR PRACTICE This review offers the most up-to-date recommendations for clinical practitioners, researchers, academics and service users of clinical imaging and therapeutic radiography services. Radiography practice, education and research must gradually adjust to AI-enabled healthcare systems to ensure gains of AI technologies are maximised and challenges and risks are minimised. This guidance will need to be updated regularly given the fast-changing pace of AI development and innovation.
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Affiliation(s)
- C Malamateniou
- Department of Radiography, Division of Midwifery and Radiography, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK; Perinatal Imaging and Health, King's College, London, UK.
| | - S McFadden
- School of Health Sciences, Ulster University, Belfast, Northern Ireland, BT37OQB, UK
| | - Y McQuinlan
- Mirada Medical, UK; Honorary Dosimetrist, Guy's and St Thomas' NHS Trust, UK
| | - A England
- School of Allied Health Professions, Keele University, Staffordshire, UK
| | - N Woznitza
- Radiology Department, University College London Hospitals, UK; School of Allied and Public Health Professions Canterbury Christ Church University, UK
| | - S Goldsworthy
- Beacon Radiotherapy, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, TA1 5DA, UK
| | - C Currie
- Programme Lead MSc Diagnostic Imaging, Glasgow Caledonian University, UK; MRI Specialist Radiographer, Queen Elizabeth University Hospital, Glasgow, UK
| | - E Skelton
- Department of Radiography, Division of Midwifery and Radiography, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK; Perinatal Imaging and Health, King's College, London, UK
| | - K-Y Chu
- Department of Oncology, University of Oxford, UK; Radiotherapy Department, Oxford University Hospitals, NHS FT, UK
| | - N Alware
- King George Hospital, BHRUT NHS Trust, London, UK
| | - P Matthews
- Diagnostic Imaging Department, Surrey & Sussex Healthcare NHS Trust, UK
| | | | - R Tucker
- School of Allied Health and Social Care, College of Health, Psychology and Social Care, University of Derby, UK; Radiology Department, Nottingham University Hospital NHS Trust, UK
| | - W Town
- Dartford and Gravesham NHS Trust, UK
| | - J Matthew
- Department of Radiography, Division of Midwifery and Radiography, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - C Kalinka
- Society and College of Radiographers, UK; Programme Manager, Strategic Programme Unit, NHS Collaborative, Wales, United Kingdom
| | - T O'Regan
- The Society and College of Radiographers, 207 Providence Square, Mill Street, London, UK
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Chan TY, Shaikh U, England A, McWilliams RG. Variability in the perception and application of force used in IVC filter retrievals among interventional radiologists. Radiography (Lond) 2021; 28:68-74. [PMID: 34417104 DOI: 10.1016/j.radi.2021.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION A long dwell time is associated with higher inferior vena cava (IVC) filter retrieval complication rates. Manufacturers advise that "excessive force should not be used" during filter retrieval; however, the term "excessive" is subjective and is likely to lead to variability amongst operators. The aims of this study were to 1) ascertain what interventional radiologists consider to be excessive force during filter retrieval and 2) to understand the variability in interventional radiologists' perception of force. METHODS The authors recruited interventional radiologists to perform a benchtop simulated filter retrieval. Participants were invited to pull on a modified force tester attached to a Gunther Tulip filter retrieval set (GTRS). The participants were asked to pull as if they were retrieving an IVC filter and stop when they felt it was clinically unsafe to apply greater force. They were then asked to replicate forces of 10N and 50N, respectively. Each of the three tasks was completed three times. Data were obtained on the clinical experience of the participants with specific questions focusing on their filter retrieval practices. RESULTS The range of maximum forces applied during filter retrieval varied between 0.8 and 79.8N. When asked to replicate 10N and 50N, for attempt-1, the median forces produced were 23.5N and 38.1N, respectively. A trend analysis showed that those who overestimate 10N are more likely to apply a greater overall maximum force (rs = 0.622; P < 0.001). CONCLUSION There is wide variation in what interventional radiologists consider to be the maximum safe force to apply during IVC filter retrieval. IMPLICATIONS FOR PRACTICE Manufacturers and operators should consider methods in which only a safe range of forces can be applied during an IVC filter retrieval. Operators may wish to undertake 'personal' force calibration as part of training in interventional radiology.
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Affiliation(s)
- T Y Chan
- Interventional Radiology Department, Royal Liverpool University Hospital, Prescot St, L78XP, Liverpool, United Kingdom.
| | - U Shaikh
- Interventional Radiology Department, Royal Liverpool University Hospital, Prescot St, L78XP, Liverpool, United Kingdom
| | - A England
- University of Salford, L613, Allerton Building, M5 4WT, Salford, Manchester, United Kingdom
| | - R G McWilliams
- Interventional Radiology Department, Royal Liverpool University Hospital, Prescot St, L78XP, Liverpool, United Kingdom
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18
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Uhanowita Marage R, McWilliams RG, Fisher RK, England A, Karouki M, Yafawi A, Torella F. 298 Incidence and Causes of Aneurysm Growth Following Endovascular Sealing of Abdominal Aortic Aneurysms. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
To analyse the incidence of aneurysm growth after endovascular aneurysm sealing (EVAS) and its relationship with adherence to the instructions for use (IFU).
Method
This study observed the clinical outcomes of patients who had an elective infrarenal EVAS procedure performed at the Royal Liverpool Hospital between 2013 and 2018. The primary outcome measure was the occurrence of aneurysm growth after EVAS. Aneurysm growth was defined as a 5% increase in the aortic volume between the renal arteries and the aortic bifurcation from the 1-month scan to subsequent annual scans.
Results
There were 71 patients with a mean (standard deviation) age of 76 (6) years who were eligible for inclusion in this study. Aneurysm growth was observed in 8 of 19 (42%) within IFU and 14 of 52 (27%) outside IFU (P ¼ .35). There was no relationship between aneurysm growth and adherence to IFU. Among the patients with aneurysm growth, the median (range) increase in abdominal aortic aneurysm volume was 11% (5%-20%).
Conclusions
Abdominal aortic aneurysm growth occurs in a significant proportion of patients at 1 year after EVAS and is not associated with adherence to IFU. Longer follow-up on a larger sample size is essential to understand the long-term clinical outcomes after EVAS.
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Affiliation(s)
| | | | - R K Fisher
- Royal Liverpool Hospital, Liverpool, United Kingdom
| | - A England
- Royal Liverpool Hospital, Liverpool, United Kingdom
| | - M Karouki
- Royal Liverpool Hospital, Liverpool, United Kingdom
| | - A Yafawi
- University of Liverpool, Liverpool, United Kingdom
| | - F Torella
- Royal Liverpool Hospital, Liverpool, United Kingdom
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19
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McNulty JP, England A, Shanahan MC. International perspectives on radiography practice education. Radiography (Lond) 2021; 27:1044-1051. [PMID: 33934944 DOI: 10.1016/j.radi.2021.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The radiography profession is built upon strong educational foundations which help ensure graduate radiographers have the required knowledge, skills, and competence to practise safely and effectively. Changing clinical practices, service needs, technological developments, regulatory changes, together with our growing professional evidence-base, all contribute to the need for our curricula to responsive and continually reviewed and enhanced. This study aims to explore similarities and differences in training curricula and follows a 2012 global survey on radiography education and more recent surveys undertaken by the European Federation of Radiographer Societies (EFRS). METHODS An online questionnaire, based on previous EFRS education and clinical education surveys, which comprised of open and closed questions and consisted of sections designed to ascertain data on: type, level and duration of education programmes leading to an initial or pre-registration qualification in radiography/medical radiation practice, pre-clinical skill development and clinical placement within programmes. The survey was distributed via social media channels and through an international network of professional societies. Descriptive statistics are reported for most analyses while open questions were analysed thematically. RESULTS Responses were received from 79 individuals from 28 identified countries across four continents. This represented a total of 121 different pre-registration/entry level programmes offered across these institutions. While dedicated diagnostic radiography programmes were most common (42/121), almost one-third of programmes (40/121) offered two or more areas of specialisation within the curriculum. The average of total hours for clinical placement were 1397 h for diagnostic radiography programmes; 1300 h for radiation therapy programmes; 1025 h for nuclear medicine programmes; and 1134 h for combined specialisation programmes, respectively. Institutions provided a range of physical and virtual systems to support pre-clinical skills development. CONCLUSION Around the world, radiography programmes vary considerably in terms of their level, duration, programme type, pre-clinical and clinical training, use of simulation, and also in terms of class sizes, student/staff ratios, and graduate employment prospects. The ability of graduates to work independently in areas covered within their programmes varied considerably. While some changes around simulation use were evident, given the impact of COVID-19 it would be beneficial for future research to investigate if pre-clinical and clinical education hours or use of simulation resources has changed due to the pandemic. IMPLICATIONS FOR PRACTICE The heterogeneity that exists between radiography programmes presents a significant challenge in terms of the mutual recognition of qualifications and the international movement of the radiographer workforce.
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Affiliation(s)
- J P McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - A England
- School of Allied Health Professions, Keele University, Staffordshire, UK.
| | - M C Shanahan
- Discipline of Medical Radiation Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia.
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20
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England A, Littler E, Romani S, Cosson P. Modifications to mobile chest radiography technique during the COVID-19 pandemic - implications of X-raying through side room windows. Radiography (Lond) 2021; 27:193-199. [PMID: 32855021 PMCID: PMC7396953 DOI: 10.1016/j.radi.2020.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Modifications to common radiographic techniques have resulted from the challenges presented by the COVID-19 pandemic. Reports exist regarding the potential benefits of undertaking mobile radiography through side room windows. The aim of this study was to evaluate the impact on image quality and exposure factors when undertaking such examinations. METHODS A phantom based study was undertaken using a digital X-ray room. Control acquisitions, using a commercially available image quality test tool, were performed using standard mobile chest radiography acquisition factors. Image quality (physical and visual), incidence surface air kerma (ISAK), Exposure Index (EI) and Deviation Index (DI) were recorded. Image quality and radiation dose were further assessed for two additional (experimental) scenarios, where a side room window was located immediately adjacent to the exit port of the light beam diaphragm. The goal of experimental scenario one was to modify exposure factors to maintain the control ISAK. The goal of experimental scenario two was to modify exposure factors to maintain the control EI and DI. Dose and image quality data were compared between the three scenarios. RESULTS To maintain the pre-window (control) ISAK (76 μGy), tube output needed a three-fold increase (90 kV/4 mAs versus 90 kV/11.25 mAs). To maintain EI/DI a more modest increase in tube output was required (90 kV/8 mAs/ISAK 54 μGy). Physical and visual assessments of spatial resolution and signal-to-noise ratio were indifferent between the three scenarios. There was a slight statistically significant reduction in contrast-to-noise ratio when imaging through the glass window (2.3 versus 1.4 and 1.2; P = 0.005). CONCLUSION Undertaking mobile X-ray examinations through side room windows is potentially feasible but does require an increase in tube output and is likely to be limited by minor reductions in image quality. IMPLICATIONS FOR PRACTICE Mobile examinations performed through side room windows should only be used in limited circumstances and future clinical evaluation of this technique is warranted.
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Affiliation(s)
- A England
- School of Allied Health Professions, Keele University, Staffordshire, UK.
| | - E Littler
- Department of Radiology, Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK
| | | | - P Cosson
- Medical Imaging Department, Teesside University, Middlesbrough, UK
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Dastan K, Henning MK, England A, Aalokken TM, Johansen S. An investigation into the variability of radiographers assessing body composition prior to CT contrast media administration. Radiography (Lond) 2020; 27:168-172. [PMID: 32855023 DOI: 10.1016/j.radi.2020.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/29/2020] [Accepted: 07/15/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION To evaluate and report the variability of radiographers in determining a patient's body type and using this to determine contrast media (CM) volumes for chest computed tomography (CT). METHODS This prospective study recruited 50 patients undergoing chest CT examinations. Three radiographers independently used two methods to determine patient body type and consequently CM volume. In Method 1, subjective evaluation of body type together with patient weight determined CM volume. In Method 2, patient weight along with additional criteria applied by the radiographer determined CM volume. Both the determination of body type and CM volumes were compared in terms of agreement and variability between radiographers, and between methods. RESULTS Fleiss' kappa was lower (0.583) for Method 1 when compared to Method 2 (0.926) indicating stronger agreement in the radiographer determination of body type for Method 2. Median (IQR) CM volume was 95.0 mL (85.0-110.0) for Method 1, compared to 92.5 mL (85.0-100.0) for method 2 (P < 0.001). CONCLUSION Method 2 provided greater agreement in determination of body type, and reduction of CM volumes compared to Method 1. IMPLICATIONS FOR PRACTICE Determining body type as part of a CT CM strategy can be subjective and enhanced methods are required to ensure that the most appropriate CM volumes are reliably used.
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Affiliation(s)
- K Dastan
- Directorate of Radiography, University of Salford, Salford, UK
| | - M K Henning
- Oslo University Hospital, Diagnostic and Nuclear Medicine Department, Oslo, Norway
| | - A England
- School of Allied Health Professions, Keele University, Staffordshire, UK
| | - T M Aalokken
- Oslo University Hospital, Diagnostic and Nuclear Medicine Department, Oslo, Norway; University of Oslo, Medicine Faculty, Oslo, Norway
| | - S Johansen
- Oslo Metropolitan University, Oslo, Norway; Oslo University Hospital, Cancer Treatment Department, Oslo, Norway.
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Tugwell-Allsup J, Kenworthy D, England A. Mobile chest imaging of neonates in incubators: Optimising DR and CR acquisitions. Radiography (Lond) 2020; 27:75-80. [PMID: 32636056 DOI: 10.1016/j.radi.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Neonates are a particularly vulnerable patient group with complex medical needs requiring frequent radiographic examinations. This study aims to compare computed radiography (CR) and direct digital radiography (DDR) portable imaging systems used to acquire chest x-rays for neonates within incubators. METHODS An anthropomorphic neonatal chest phantom was imaged under controlled conditions using one portable machine but captured using both CR and DDR technology. Other variables explored were: image receptor position (direct and incubator tray), tube current and kV. All other parameters were kept consistent. Contrast-to-noise ratio (CNR) was measured using ImageJ software and dose-area-product (DAP) was recorded. Optimisation score was calculated by dividing CNR with the DAP for each image acquisition. RESULTS The images with the highest CNR were those acquired using DDR direct exposures and the images with lowest CNR were those acquired using CR with the image receptor placed within the incubator tray. This is also supported by the optimisation scores which demonstrated DDR direct produced the optimal combination with regards to CNR and radiation dose. The CNR had a mean increase of 50.3% when comparing DDR direct with CR direct respectively. This was also evident when comparing DDR and CR for in-tray acquisitions, with CNR increasing by a mean of 43.5%. A mean increase of 20.4% was seen in CNR when comparing DDR tray exposures to CR direct. CONCLUSION DDR direct produced images of highest CNR, with incubator tray reducing CNR for both CR and DDR. However, DDR tray still had better image quality compared to CR direct. IMPLICATIONS FOR PRACTICE Where possible, DDR should be the imaging system of choice for portable examinations on neonates owing to its superior image quality at lower radiation dose.
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Affiliation(s)
- J Tugwell-Allsup
- Besti Cadwaladr University Health Board, Ysbyty Gwynedd, Pnerhosgarnedd Road, Bangor, Gwynedd, LL57 2PW, UK.
| | - D Kenworthy
- Bangor University, College Road, Bangor, LL57 2DG, UK.
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Tugwell-Allsup J, Owen BW, England A. Low-dose chest CT and the impact on nodule visibility. Radiography (Lond) 2020; 27:24-30. [PMID: 32499090 DOI: 10.1016/j.radi.2020.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The need to continually optimise CT protocols is essential to ensure the lowest possible radiation dose for the clinical task and individual patient. The aim of this study was to explore the effect of reducing effective mAs on nodule detection and radiation dose across six scanners. METHODS An anthropomorphic chest phantom was scanned using a low-dose chest CT protocol, with the effective mAs lowered to the lowest permissible level. All other acquisition parameters remained consistent. Images were evaluated by five radiologists to determine their sensitivity in detecting six simulated nodules within the phantom. Image noise was calculated together with DLP. RESULTS The lowest possible mAs achievable ranged from 7 to 19 mAs. The two highest mAs setting (17 mAs + 19 mAs) had kV modulation enabled (100 kV instead of 120 kV) which consequently resulted in a higher nodule detection rate. Overall nodule detection averaged at 91% (range 80-97%). Out of a possible 180 nodules, 16 were missed, with 12 of those 16 being the same nodule. Noise was double for the Somatom Sensation scanner when compared to the others; however, this scanner did not have iterative reconstruction and it was installed over 10 years ago. There was a strong correlation between image noise and scanner age. CONCLUSION This study highlighted that nodules can be detected at very low effective mAs (<20 mAs) but only when other acquisition parameters are optimised i.e. iterative reconstruction and kV modulation. Nodule detection rates were affected by nodule location and image noise. IMPLICATIONS FOR PRACTICE This study consolidates previous findings on how to successfully optimise low-dose chest CT. It also highlights the difficulty with standardisation owing to factors such as scanner age and different vendor attributes.
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Affiliation(s)
- J Tugwell-Allsup
- Betsi Cadwaladr University Health Board, Bangor, Gwynedd, Wales, LL57 2PW, UK.
| | - B W Owen
- Betsi Cadwaladr University Health Board, Bangor, Gwynedd, Wales, LL57 2PW, UK.
| | - A England
- School of Health Sciences, Salford University, Manchester, M6 6PU, UK.
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England A, McNulty JP. Inclusion of evidence and research in European radiography curricula. Radiography (Lond) 2020; 26 Suppl 2:S45-S48. [PMID: 32444326 DOI: 10.1016/j.radi.2020.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To provide a short reflective article discussing the extent to which evidence and research are included within radiography training curricula and whether there is a need for change and greater standardisation. FINDINGS Great steps have been taken to harmonise aspects of radiography training programmes across Europe, however, variations do exist, especially in the areas of clinical practice, training hours and inclusion of specific curriculum topics. Limited evidence exists regarding the inclusion of evidence and research; thus, diversity is likely. The majority of training curricula follow the Bologna cycle and both research and evidence components are likely to be included within teaching and assessment. Wider questions exist regarding maintaining and developing the research and evidence culture within the radiography profession. Education institutions will play an important role in this process. CONCLUSION Limited evidence exists regarding the inclusion of 'evidence' and 'research' themes within European radiography training curricula. Undoubtedly, there is a need for these themes, but this must be balanced with other demands on the curriculum and how research is likely to evolve within the profession. IMPLICATIONS FOR PRACTICE Greater clarity is needed on how evidence and research are to be included within radiography training curricula. A single model is unlikely to be suitable for all, curricula should focus on the requirements for the newly qualified graduate and the radiography profession as a whole.
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Affiliation(s)
- A England
- School of Health & Society, University of Salford, UK; European Federation of Radiographer Societies, Utrecht, the Netherlands.
| | - J P McNulty
- European Federation of Radiographer Societies, Utrecht, the Netherlands; School of Medicine, University College Dublin, Dublin, Ireland
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Tugwell-Allsup J, Morris RW, Hibbs R, England A. Optimising image quality and radiation dose for neonatal incubator imaging. Radiography (Lond) 2020; 26:e258-e263. [PMID: 32279922 DOI: 10.1016/j.radi.2020.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Neonates often require imaging within incubators however limited evidence exists as to the optimal method and acquisition parameters to achieve these examinations. This study aims to standardise and optimise neonatal chest radiography within incubators. METHODS A neonatal anthropomorphic phantom was imaged on two different incubators under controlled conditions using a DR system. Exposure factors, SID and placement of image receptor (direct v tray) were explored whilst keeping all other parameters consistent. Image quality was evaluated using absolute visual grading analysis (VGA) with contrast-to-noise ratio (CNR) also calculated for comparison. Effective dose was established using Monte Carlo simulation using entrance surface dose within its calculations. RESULTS VGA and CNR reduced significantly (p < 0.05) whilst effective dose increased significantly (p < 0.05) for images acquired using the incubator tray. The optimal combinations of parameters for incubator imaging were: image receptor directly behind neonate, 0.5 mAs, 60 kV at 100 cm SID, however, if tray needs to be used then these need to be adapted to: 1 mAs at maximum achievable SID. Effective dose was highest for images acquired using both incubator tray and 100 cm SID owing to a decrease in focus to skin distance. There is significant increase (p < 0.01) in VGA between using 0.5 mAs and 1 mAs but an apparent lack of increase between 1 and 1.5 mAs. CONCLUSION Using the incubator tray has an adverse effect on both image quality and radiation dose for incubator imaging. Direct exposure is optimal for this type of examination but if tray needs to be used, both mAs and SID need to be increased slightly to compensate. IMPLICATIONS FOR PRACTICE This study can help inform practice in order to both standardise and optimise chest imaging for neonates in incubators.
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Affiliation(s)
- J Tugwell-Allsup
- Besti Cadwaladr University Health Board, Ysbyty Gwynedd, Penrhosgarnedd Road, LL57 2PW, Bangor, Gwynedd, UK.
| | - R W Morris
- Besti Cadwaladr University Health Board, Ysbyty Gwynedd, Penrhosgarnedd Road, LL57 2PW, Bangor, Gwynedd, UK.
| | - R Hibbs
- Independent Statistician, Integral Business Support Ltd, UK.
| | - A England
- Salford University, Manchester, Greater Manchester, UK.
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Al-Murshedi S, Peter Hogg, England A. Neonatal chest radiography: Influence of standard clinical protocols and radiographic equipment on pathology visibility and radiation dose using a neonatal chest phantom. Radiography (Lond) 2020; 26:282-287. [PMID: 32169312 DOI: 10.1016/j.radi.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/15/2020] [Accepted: 02/19/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Little is known about the variations in pathology visibility (PV) and their corresponding radiation dose values for neonatal chest radiography, between and within hospitals. Large variations in PV could influence the diagnostic outcome and the variations in radiation dose could affect the risk to patients. The aim of this study is to compare the PV and radiation dose for standard neonatal chest radiography protocols among a series of public hospitals. METHODS A Gammex 610 neonatal chest phantom was used to simulate the chest region of neonates. Radiographic acquisitions were conducted on 17 X-ray machines located in eight hospitals, utilising their current neonatal chest radiography protocols. Six qualified radiographers assessed PV visually using a relative visual grading analysis (VGA). Signal to noise ratios (SNR) and contrast to noise ratios (CNR) were measured as a measure of image quality (IQ). Incident air kerma (IAK) was measured using a solid-state dosimeter. RESULTS PV and radiation dose varied substantially between and within hospitals. For PV, the mean (range) VGA scores, between and within the hospitals, were 2.69 (2.00-3.50) and 2.73 (2.33-3.33), respectively. For IAK, the mean (range), between and within the hospitals, were 24.45 (8.11-49.94) μGy and 34.86 (22.26-49.94) μGy, respectively. CONCLUSION Between and within participating hospitals there was wide variation in the visibility of simulated pathology and radiation dose (IAK). IMPLICATIONS FOR PRACTICE X-ray units with lower PV and higher doses require optimisation of their standard clinical protocols. Institutions which can offer acceptable levels of PV but with lower radiation doses should help facilitate national optimisation processes.
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Affiliation(s)
- S Al-Murshedi
- University of ALZahraa for Women, College of Health and Medical Technology, Karbala, Iraq.
| | - Peter Hogg
- School of Health and Society, University of Salford, Salford, M6 6PU, United Kingdom
| | - A England
- School of Health and Society, University of Salford, Salford, M6 6PU, United Kingdom
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Nelson DJ, England A, Cheptoo M, Mercer CE. A comparative study of pain experienced during successive mammography examinations in patients with a family history of breast cancer and those who have had breast cancer surgery. Radiography (Lond) 2020; 26:76-81. [PMID: 31902459 DOI: 10.1016/j.radi.2019.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION To measure mammography-related pain in two groups of women undergoing regular surveillance as a baseline for future care. METHODS Following ethical approval, two hundred and forty two women aged 32-84 years (mean 54), were invited by written invitation to participate in the study. Two hundred women accepted the invitation, 100 women had a family history (FH) of breast cancer, 100 had undergone conservative surgery (FU) for breast cancer and were currently asymptomatic. A validated pain scale was used to score the participants' perceived pain before compression based on memory, immediately after compression and one week later. A series of baseline parameters were also captured including compression force, breast size/density, menstrual history and any adverse events following mammography to allow the investigation of relationships. RESULTS There was a strong correlation (r = 0.79, p < 0.001) between previous pain scores and current pain scores, no significant correlations were found between breast size, breast density or total compression force and pain. Pain scores reduced between previous and current examinations and there was consistency in overall pain scores, despite variations in the compression forces applied. CONCLUSION Physical side effects from mammography can develop and extend beyond the examination period. Patients' prior experience of pain was the only significant predictor of current pain in this study. IMPLICATIONS FOR PRACTICE Data on past mammography experiences are essential to improve future pain outcomes. Post-mammography aftercare should be a routine feature of the examination.
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Affiliation(s)
- D J Nelson
- Breast Imaging Unit, Tameside and Glossop Integrated Care NHS Foundation Trust, United Kingdom.
| | - A England
- Directorate of Radiography, University of Salford, United Kingdom
| | - M Cheptoo
- Directorate of Radiography, University of Salford, United Kingdom
| | - C E Mercer
- Directorate of Radiography, University of Salford, United Kingdom
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Tugwell-Allsup J, England A. Imaging neonates within an incubator - A survey to determine existing working practice. Radiography (Lond) 2020; 26:e18-e23. [PMID: 31902464 DOI: 10.1016/j.radi.2019.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/19/2019] [Accepted: 07/21/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION There is limited and confusing evidence within the literature regarding the optimal techniques when imaging neonates within incubators; in particular, whether to place the image receptor directly behind the neonate or in the incubator tray. For this reason, radiology departments across Wales and North West England were surveyed to explore existing working practice with regards to incubator imaging. METHOD A self-designed survey was developed using a systematic approach. The survey was sent to 31 radiology departments across Wales and North West England whom had a neonatal unit in order to assess existing techniques used when imaging neonates within the incubator. The survey was split into three main domains: 1) general/demographics, 2) exposure factors and technique, and 3) incubator design. RESULTS Nineteen departments responded (64%) demonstrating a wide variation in practice for incubator imaging. The minimum and maximum exposure factors used for neonatal chest x-ray imaging varied from 55 kV to 65 kV and 0.5 mAs-2 mAs. Fifty-eight percent of departments used the incubator tray as standard practice with the remaining forty two percent not using the tray for various reasons including, image quality, artefacts and misalignment. Sixty-three percent of departments use the maximum achievable SID for incubator imaging which demonstrates wide variability as the SID would be dependent upon: incubator design, portable machine and radiographer height. CONCLUSION The survey demonstrates a wide variation in existing practice for neonatal incubator imaging. IMPLICATIONS FOR PRACTICE This study supports the need for standardisation and further optimisation work to ensure best practice for this vulnerable patient group.
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Affiliation(s)
- J Tugwell-Allsup
- Betsi Cadwaladr University Health Board, Ysbyty Gwynedd, Penhosgarnedd Road, Bangor, Gwynedd, LL57 2PW, United Kingdom.
| | - A England
- Salford University, Manchester, Greater Manchester, United Kingdom.
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Hoddes R, Hattab A, England A. Initial single centre experiences of a radiographer advanced practitioner led nephrostomy exchange programme. Radiography (Lond) 2019; 26:163-166. [PMID: 32052766 DOI: 10.1016/j.radi.2019.11.091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/01/2019] [Accepted: 11/10/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION To evaluate the technical success, radiation dose, complications and costs from the introduction of a radiographer-led nephrostomy exchange service. METHODS Post-graduate qualified interventional radiographers with several years' experience in performing other interventional procedures began performing nephrostomy exchanges. Training was provided by an interventional radiologist. Each radiographer performed ten procedures under direct supervision followed by independent practice with remote supervision. Each radiographer was then responsible for the radiological report, discharge, re-referral for further exchange and, where indicated, sending urine samples for culture and sensitivity. Data extraction included the time interval between exchanges, radiation dose/screening time and complications. RESULTS Thirty-eight long-term nephrostomy patients had their histories interrogated back to the time of the initial insertion. The mean (range) age at nephrostomy insertion was 67 (35-93) years and 65% were male. Indications for nephrostomy were prostatic or gynaecological malignancy, ureteric injury, bulky lymphoma and post-transplant ureteric stricture. A total of 170 nephrostomy exchanges were performed with no statistically significant differences in the radiation dose, fluoroscopy time nor complication rates between consultants and radiographers. There was, however, a statistically significant reduction in the time interval between nephrostomy exchanges for the radiographer group (P = 0.022). CONCLUSION Interventional radiographers can provide a safe, technically successful nephrostomy exchange program with radiation doses equivalent to radiologists. This is a cost-effective solution to the capacity issues faced in many departments, whilst providing career progression, job satisfaction and possibly improved care. IMPLICATIONS FOR PRACTICE Radiographer-led interventional services should be considered by other institutions as a means of providing effective nephrostomy exchanges.
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Affiliation(s)
- R Hoddes
- Department of Radiology, Manchester Royal Infirmary, Manchester, UK.
| | - A Hattab
- University of Salford, Salford, UK
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England A, Thompson J. Evolving the Landscape of Research. Radiography (Lond) 2019; 25 Suppl 1:S1-S3. [DOI: 10.1016/j.radi.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 11/28/2022]
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Alzyoud K, Hogg P, Snaith B, Preece S, England A. Video rasterstereography of the spine and pelvis in eight erect positions: A reliability study. Radiography (Lond) 2019; 26:e7-e13. [PMID: 31902465 DOI: 10.1016/j.radi.2019.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/03/2019] [Accepted: 06/06/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION To investigate the reliability and variability of Video Rasterstereography (VR) measurements of the spine and pelvis, for eight proposed standing postures, in order to help define an optimal standing position for erect pelvis radiography. METHODS Surface topography data were collected using the formetic 4D dynamic modelling (Diers) system. 61 healthy participants were recruited; each participant performed eight different standing positions. Four positions were performed with the feet shoulder width apart and parallel, and four positions were performed with the feet shoulder width apart and internally rotated. For the upper extremity, each of the (two sets of) four positions were performed with different arm positions (arms by the sides, arms crossed over the chest, arms 30° flexed and touching the medial end of the clavicle, arms 30° flexed with the hands holding a support). Three sets of surface topography were collected in the eight positions (n = 24). The variability was assessed by calculating standard error of the measurement (SEm) and the coefficient of variation (CV). Reliability was assessed using intra-class correlation coefficients (ICC ± 95% CI). RESULTS No significant differences in the SEm were found between the three paired measurements for all standing positions (P > 0.05). ICC values demonstrated excellent reliability for all measurements across the eight standing positions (range 0.879-1.00 [95% CI 0.813-1.00]). CONCLUSION Evaluating eight standing positions radiographically would be unethical as it would involve repeat radiation exposures. Using the formetic 4D dynamic modelling (Diers) system, provides an alternative and has shown that there was only a minimal, non-statistically significant, differences between the eight different standing positions. IMPLICATION FOR PRACTICE Different standing positions were proposed for erect pelvis radiography.
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Affiliation(s)
- K Alzyoud
- School of Health Sciences, University of Salford, Salford, M6 6PU, United Kingdom; Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan.
| | - P Hogg
- School of Health Sciences, University of Salford, Salford, M6 6PU, United Kingdom.
| | - B Snaith
- The Mid Yorkshire Hospitals NHS Trust, Wakefield, WF1 4DG, United Kingdom; University of Bradford, Bradford, BD7 1DP, United Kingdom.
| | - S Preece
- School of Health Sciences, University of Salford, Salford, M6 6PU, United Kingdom.
| | - A England
- School of Health Sciences, University of Salford, Salford, M6 6PU, United Kingdom.
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Deane L, Robinson L, England A. An investigation into the perceived value of the College of Radiographers voluntary accreditation scheme for advanced and consultant practitioners in breast imaging. Radiography (Lond) 2019; 25:207-213. [PMID: 31301777 DOI: 10.1016/j.radi.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/07/2019] [Accepted: 01/15/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A voluntary accreditation scheme has been introduced, requiring advanced (AdP) and consultant practitioners (CP) to submit several pieces of work to the College of Radiographers (CoR). However, few individuals have opted to become voluntary accredited. This study investigated the reasons behind becoming voluntary accredited, the value that was gained and why there appears to be a lack of support for the scheme. METHODS An online electronic survey was conducted using a mixed methods approach. Open questions enabled individual opinions and thoughts to be expressed, Likert scale style questions allowed further understanding of the level of agreement and closed questions identified the support for and against the scheme. RESULTS A total of 55 respondents participated, including 18 AdPs, 25 CPs, 1 consultant trainee practitioner, 5 practitioners and 6 listed as 'other'. Forty-four participants were non-accredited, citing too much clinical work; no recognition from employers and too much effort for little reward. Motivations for joining the scheme were to improve the profession; help create a new consultant post and protect the non-clinical element of the consultant role. CONCLUSION The CoR voluntary accreditation scheme has a small perceived value but overall, the majority of respondents believed the scheme did not warrant the work needed to apply. Concern was raised about the risk of creating a two-tier profession by the scheme's instigation. The results of this study suggest that the CoR's voluntary accreditation scheme would need to address these barriers before more practitioners would apply.
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Affiliation(s)
- L Deane
- The Shrewsbury and Telford Hospital NHS Trust, Mytton Oak Rd, Shrewsbury, Shropshire, SY3 8XQ, United Kingdom.
| | - L Robinson
- University of Salford, Allerton Building, Salford, M5 4WT, United Kingdom
| | - A England
- University of Salford, Allerton Building, Salford, M5 4WT, United Kingdom
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Alzyoud K, Hogg P, Snaith B, Flintham K, England A. Impact of body part thickness on AP pelvis radiographic image quality and effective dose. Radiography (Lond) 2018; 25:e11-e17. [PMID: 30599841 DOI: 10.1016/j.radi.2018.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/04/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Within medical imaging variations in patient size can generate challenges, especially when selecting appropriate acquisition parameters. This experiment sought to evaluate the impact of increasing body part thickness on image quality (IQ) and effective dose (E) and identify optimum exposure parameters. METHODS An anthropomorphic pelvis phantom was imaged with additional layers (1-15 cm) of animal fat as a proxy for increasing body thickness. Acquisitions used the automatic exposure control (AEC), 100 cm source to image distance (SID) and a range of tube potentials (70-110 kVp). IQ was evaluated physically and perceptually. E was estimated using PCXMC software. RESULTS For all tube potentials, signal to noise ratio (SNR) and contrast to noise ratio (CNR) deceased as body part thickness increased. 70 kVp produced the highest SNR (46.6-22.6); CNR (42.8-17.6). Visual grading showed that the highest IQ scores were achieved using 70 and 75 kVp. As thickness increases, E increased exponentially (r = 0.96; p < 0.001). Correlations were found between visual and physical IQ (SNR r = 0.97, p < 0.001; CNR r = 0.98, p < 0.001). CONCLUSION To achieve an optimal IQ across the range of thicknesses, lower kVp settings were most effective. This is at variance with professional practice as there is a tendency for radiographers to increase kVp as thickness increases. Dose reductions were experienced at higher kVp settings and are a valid method for optimisation when imaging larger patients.
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Affiliation(s)
- K Alzyoud
- School of Health Sciences, University of Salford, Salford M6 6PU, United Kingdom; Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan.
| | - P Hogg
- School of Health Sciences, University of Salford, Salford M6 6PU, United Kingdom.
| | - B Snaith
- The Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, United Kingdom; University of Bradford, Bradford BD7 1DP, United Kingdom.
| | - K Flintham
- The Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, United Kingdom.
| | - A England
- School of Health Sciences, University of Salford, Salford M6 6PU, United Kingdom.
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M.Ali R, England A, McEntee M, Mercer C, Tootell A, Hogg P. Effective lifetime radiation risk for a number of national mammography screening programmes. Radiography (Lond) 2018; 24:240-246. [DOI: 10.1016/j.radi.2018.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 11/29/2022]
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M. Ali R, England A, McEntee M, Mercer C, Tootell A, Hogg P. RE: Effective lifetime radiation risk for a number of national mammography screening programmes. Radiography (Lond) 2018; 24:273. [DOI: 10.1016/j.radi.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 05/13/2018] [Indexed: 11/24/2022]
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England A, Fisher RK, McWilliams RG, Torella F. Estimating the error of CT-based measurements of aortic lumen volume used in endovascular planning. Radiography (Lond) 2017; 23:287-291. [PMID: 28965890 DOI: 10.1016/j.radi.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/22/2017] [Accepted: 08/04/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Planning of endovascular sealing of abdominal aortic aneurysms requires measurement of the aortic lumen volume. The aim of this study was to investigate mathematically the effect of intra- and inter-observer variability error, as well as cardiac cycle-related variability, on these measurements. METHODS Mean (±2SD) intra- and inter-observer error in lumen measurements and mean (+2SD) cardiac cycle-related variability were obtained from published literature and added to the measurement of the flow lumen volume of a 57 mm abdominal aortic aneurysm to calculate average and extreme error possibilities. RESULTS The aneurysm volume was measured at 165 ml. The calculated possible mean measurement error due to cardiac cycle variation, intra- and inter-observer variability was +11.0%, resulting in a potential measurement of 183.1 ml. The calculated extreme errors were +24.3% (if 2SD of all errors were added to the mean) and +3.5% (if 2SD of all errors, except cardiac cycle, were subtracted from the mean), resulting in potential measurements of 170.8 ml and 205.1 ml, respectively. When considering the errors combined, the proportion of patients who may have volume measurement errors of up to ±2.5 ml, ±2.6 to ±5.0 ml and ±5.1 to ±7.5 ml were 18%, 17% and 15%, respectively. CONCLUSION Measurement of CT-based aortic lumen volumes in abdominal aortic aneurysms is imprecise. This has practical implications for the planning and the performance of complex endovascular therapies.
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Affiliation(s)
| | - R K Fisher
- Liverpool Vascular & Endovascular Service, Liverpool, UK.
| | - R G McWilliams
- Royal Liverpool & Broadgreen University Hospital, Liverpool, UK.
| | - F Torella
- Liverpool Vascular & Endovascular Service, Liverpool, UK.
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Murakami M, Arunasalam V, Bell J, Bell M, Bitter M, Blanchard W, Boody F, Boyd D, Bretz N, Bush C, Callen J, Cecchi J, Colchin R, Coonrod J, Davis S, Dimock D, Dylla H, Efthimion P, Emerson L, England A, Eubank H, Fonck R, Fredrickson E, Furth H, Grisham L, von Goeler S, Goldston R, Grek B, Grove D, Hawryluk R, Hendel H, Hill K, Hulse R, Johnson D, Johnson L, Kaita R, Kamperschroer J, Kaye S, Kikuchi M, Kilpatrick S, Kugel H, LaMarche P, Little R, Ma C, Manos D, Mansfield D, McCarthy M, McCann R, McCune D, McGuire K, Meade D, Medley S, Mikkelsen D, Mueller D, Nieschmidt E, Owens D, Pare V, Park H, Prichard B, Ramsey A, Rasmussen D, Roquemore A, Rutherford P, Sauthoff N, Schivell J, Schwob JL, Scott S, Sesnic S, Shimada M, Simpkins J, Sinnis J, Stauffer F, Stratton B, Suckewer S, Tait G, Taylor G, Tenney F, Thomas C, Towner H, Ulrickson M, Wieland R, Williams M, Wong KL, Wouters A, Yamada H, Yoshikawa S, Young K, Zarnstorff M. Confinement Studies In TFTR. ACTA ACUST UNITED AC 2017. [DOI: 10.13182/fst85-a40115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Murakami
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - V. Arunasalam
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - J.D. Bell
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - M.G. Bell
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - M. Bitter
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - W.R. Blanchard
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - F. Boody
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D. Boyd
- Permanent Address: University of Maryland, College Park, MD
| | - N. Bretz
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - C.E. Bush
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - J.D. Callen
- Permanent Address: University of Wisconsin, Madison, WI
| | - J.L. Cecchi
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R.J. Colchin
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - J. Coonrod
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - S.L. Davis
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D. Dimock
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - H.F. Dylla
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - P.C. Efthimion
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - L.C. Emerson
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - A.C. England
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - H.P. Eubank
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R. Fonck
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - E. Fredrickson
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - H.P. Furth
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - L.R. Grisham
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - S. von Goeler
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R.J. Goldston
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - B. Grek
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D.J. Grove
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R.J. Hawryluk
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - H. Hendel
- Permanent Address: RCA David Sarnoff Research Center, Princeton, NJ
| | - K.W. Hill
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R. Hulse
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D. Johnson
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - L.C. Johnson
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R. Kaita
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - J. Kamperschroer
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - S.M. Kaye
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - M. Kikuchi
- Permanent Address: Japan Atomic Energy Research Institute, Japan
| | - S. Kilpatrick
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - H. Kugel
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - P.H. LaMarche
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R. Little
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - C.H. Ma
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - D. Manos
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D. Mansfield
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - M. McCarthy
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R.T. McCann
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D.C. McCune
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - K. McGuire
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D.M. Meade
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - S.S. Medley
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D.R. Mikkelsen
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D. Mueller
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | | | - D.K. Owens
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - V.K. Pare
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - H. Park
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - B. Prichard
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - A. Ramsey
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - D.A. Rasmussen
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - A.L. Roquemore
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - P.H. Rutherford
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - N.R. Sauthoff
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - J. Schivell
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - J-L. Schwob
- Permanent Address: Hebrew University of Jerusalem, Israel
| | - S.D Scott
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - S. Sesnic
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - M. Shimada
- Permanent Address: Japan Atomic Energy Research Institute, Japan
| | - J.E. Simpkins
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - J. Sinnis
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - F. Stauffer
- Permanent Address: University of Maryland, College Park, MD
| | - B. Stratton
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - S. Suckewer
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - G.D. Tait
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - G. Taylor
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - F. Tenney
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - C.E. Thomas
- Permanent Address: Oak Ridge National Laboratory, Oak Ridge, TN
| | - H.H. Towner
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - M. Ulrickson
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - R. Wieland
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - M. Williams
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - K-L. Wong
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - A. Wouters
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - H. Yamada
- Permanent Address: Univeristy of Tokyo, Japan
| | - S. Yoshikawa
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - K.M Young
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
| | - M.C. Zarnstorff
- Plasma Physics Laboratory, Princeton University P.O. Box 451, Princeton, NJ 08544
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Burdakov A, England A, Kim C, Koidan V, Kwon M, Postupaev V, Rovenskikh A, Sulyaev Y. Detection of Fusion Neutrons on the Multimirror Trap GOL-3. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A.V. Burdakov
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - A.C. England
- Korea Basic Science Institute, National Fusion R&D Center, 52 Yeoeun-Dong Yuseong-Gu, Daejeon 305-806, Republic of Korea
| | - C.S. Kim
- Korea Basic Science Institute, National Fusion R&D Center, 52 Yeoeun-Dong Yuseong-Gu, Daejeon 305-806, Republic of Korea
| | - V.S. Koidan
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - M. Kwon
- Korea Basic Science Institute, National Fusion R&D Center, 52 Yeoeun-Dong Yuseong-Gu, Daejeon 305-806, Republic of Korea
| | - V.V. Postupaev
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - A.F. Rovenskikh
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - Yu.S. Sulyaev
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
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Tugwell JR, England A, Hogg P. Antero-posterior (AP) pelvis x-ray imaging on a trolley: Impact of trolley design, mattress design and radiographer practice on image quality and radiation dose. Radiography (Lond) 2017; 23:242-248. [PMID: 28687293 DOI: 10.1016/j.radi.2017.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/31/2017] [Accepted: 04/01/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Physical and technical differences exist between imaging on an x-ray tabletop and imaging on a trolley. This study evaluates how trolley imaging impacts image quality and radiation dose for an antero-posterior (AP) pelvis projection whilst subsequently exploring means of optimising this imaging examination. METHODS An anthropomorphic pelvis phantom was imaged on a commercially available trolley under various conditions. Variables explored included two mattresses, two image receptor holder positions, three source to image distances (SIDs) and four mAs values. Image quality was evaluated using relative visual grading analysis with the reference image acquired on the x-ray tabletop. Contrast to noise ratio (CNR) was calculated. Effective dose was established using Monte Carlo simulation. Optimisation scores were derived as a figure of merit by dividing effective dose with visual image quality scores. RESULTS Visual image quality reduced significantly (p < 0.05) whilst effective dose increased significantly (p < 0.05) for images acquired on the trolley using identical acquisition parameters to the reference image. The trolley image with the highest optimisation score was acquired using 130 cm SID, 20 mAs, the standard mattress and platform not elevated. A difference of 12.8 mm was found between the image with the lowest and highest magnification factor (18%). CONCLUSION The acquisition parameters used for AP pelvis on the x-ray tabletop are not transferable to trolley imaging and should be modified accordingly to compensate for the differences that exist. Exposure charts should be developed for trolley imaging to ensure optimal image quality at lowest possible dose.
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Affiliation(s)
- J R Tugwell
- Betsi Cadwaladr University Health Board (BCUHB), North Wales, Ysbyty Gwynedd, Penrhosgarnedd Road, Bangor LL57 2PW, Wales, UK; University of Salford, Allerton Building, Frederick Road, Manchester M5 4WT, UK.
| | - A England
- University of Salford, Allerton Building, Frederick Road, Manchester M5 4WT, UK
| | - P Hogg
- University of Salford, Allerton Building, Frederick Road, Manchester M5 4WT, UK
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England A, Geers-van Gemeren S, Henner A, Kukkes T, Pronk-Larive D, Rainford L, McNulty JP. Clinical radiography education across Europe. Radiography (Lond) 2017; 23 Suppl 1:S7-S15. [PMID: 28780956 DOI: 10.1016/j.radi.2017.05.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/17/2017] [Accepted: 05/20/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE To establish a picture of clinical education models within radiography programmes across Europe by surveying higher education institutions registered as affiliate members of the European Federation of Radiography Societies (EFRS). METHOD An online survey was developed to ascertain data on: practical training, supervisory arrangements, placement logistics, quality assurance processes, and the assessment of clinical competencies. Responses were identifiable in terms of educational institution and country. All educational institutions who were affiliate members at the time of the study were invited to participate (n = 46). Descriptive and thematic analyses are reported. RESULTS A response rate of 82.6% (n = 38) was achieved from educational institutions representing 21 countries. Over half of responding institutions (n = 21) allocated in excess of 60 European Credit Transfer and Accumulation System (ECTS) credits to practical training. In nearly three-quarters of clinical placements there was a dedicated clinical practice supervisor in place; two-thirds of these were employed directly by the hospital. Clinical practice supervisors were typically state registered radiographers, who had a number of years of clinical experience and had received specific training for the role. Typical responsibilities included monitoring student progress, providing feedback and completing paperwork, this did however vary between respondents. In almost all institutions there were support systems in place for clinical placement supervisors within their roles. CONCLUSIONS Similarities exist in the provision of clinical radiography education across Europe. Clinical placements are a core component of radiography education and are supported by experienced clinical practice supervisors. Mechanisms are in place for the selection, training and support of clinical practice supervisors. Professional societies should work collaboratively to establish guidelines for effective clinical placements.
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Affiliation(s)
- A England
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Directorate of Radiography, School of Health Sciences, University of Salford, Allerton Building, Salford M5 4WT, United Kingdom.
| | - S Geers-van Gemeren
- Nederlandse Vereniging Medische Beeldvorming en Radiotherapie, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands.
| | - A Henner
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; School of Health and Social Care, Oulu University of Applied Sciences, Kiviharjuntie 8, FI-90220 Oulu, Finland.
| | - T Kukkes
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Tartu Health Care College, Nooruse 5, 50411, Tartu, Estonia.
| | - D Pronk-Larive
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands.
| | - L Rainford
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.
| | - J P McNulty
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.
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Mraity H, England A, Hogg P. Gonad dose in AP pelvis radiography: Impact of anode heel orientation. Radiography (Lond) 2017; 23:80-81. [DOI: 10.1016/j.radi.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
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Mraity H, England A, Hogg P. Gonad dose in AP pelvis radiography: Impact of anode heel orientation. Radiography (Lond) 2017; 23:14-18. [DOI: 10.1016/j.radi.2016.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 06/02/2016] [Accepted: 06/08/2016] [Indexed: 11/26/2022]
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England A. Response to letter: ‘Re: Gonad dose in AP pelvis radiography: Impact of anode heel orientation’. Radiography (Lond) 2017; 23:81. [DOI: 10.1016/j.radi.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Charnley C, England A, Martin A, Taylor S, Benson N, Jones L. An option for optimising the radiographic technique for horizontal beam lateral (HBL) hip radiography when using digital X-ray equipment. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2016.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sanderud A, England A, Hogg P, Fosså K, Svensson S, Johansen S. Radiation dose differences between thoracic radiotherapy planning CT and thoracic diagnostic CT scans. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2015.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mraity H, England A, Akhtar I, Aslam A, De Lange R, Momoniat H, Nicoulaz S, Ribeiro A, Mazhir S, Hogg P. Development and validation of a psychometric scale for assessing PA chest image quality: A pilot study. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2014.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Husain T, Liu Y, Fernando R, Nagaratnam V, Sodhi M, Tamilselvan P, Venkatesh S, England A, Columb M. How UK obstetric anaesthetists assess neuraxial anaesthesia for caesarean delivery: National surveys of practice conducted in 2004 and 2010. Int J Obstet Anesth 2013; 22:298-302. [DOI: 10.1016/j.ijoa.2013.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/26/2013] [Accepted: 07/07/2013] [Indexed: 10/26/2022]
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Bae Y, Park Y, Kim J, Han W, Kwak S, Chang Y, Park H, Song N, Yang H, Yoon S, Jeon Y, Hahn S, Lee S, Ko W, England A, Kim W, Oh Y, Kwak J, Kwon M, Chang D, Jeong S, Kim T, Oh B, Jin J, In S, Lee K, Chang D, Watanabe K, Dairaku M, Tobari H, Kashiwagi M, Hanada M, Inoue T, Ikeda Y, Kawai M, Komata M, Mogaki K, Usui K, Yamamoto T, Matsuoka M, Nagaoka K, Grisham L. Commissioning of the first KSTAR neutral beam injection system and beam experiments. Fusion Engineering and Design 2012. [DOI: 10.1016/j.fusengdes.2012.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
The 2003-2005 Confidential Enquiry into Maternal and Child Health report recommended the introduction of the modified early obstetric warning system (MEOWS) in all obstetric inpatients to track maternal physiological parameters, and to aid early recognition and treatment of the acutely unwell parturient. We prospectively reviewed 676 consecutive obstetric admissions, looking at their completed MEOWS charts for triggers and their notes for evidence of morbidity. Two hundred patients (30%) triggered and 86 patients (13%) had morbidity according to our criteria, including haemorrhage (43%), hypertensive disease of pregnancy (31%) and suspected infection (20%). The MEOWS was 89% sensitive (95% CI 81-95%), 79% specific (95% CI 76-82%), with a positive predictive value 39% (95% CI 32-46%) and a negative predictive value of 98% (95% CI 96-99%). There were no admissions to the intensive care unit, cardio respiratory arrests or deaths during the study period. This study suggests that MEOWS is a useful bedside tool for predicting morbidity. Adjustment of the trigger parameters may improve positive predictive value.
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