Radiographers Research Articles

Assessment of Occupational Radiation Exposure Among Various Medical Professions in Interventional Cardiology: A Five-Year Study (2018-2022)

Background: Occupational radiation exposure in medical settings is a growing concern, especially in interventional cardiology. This study aims to assess the occupational radiation exposure among medical personnel in interventional cardiology from 2018 to 2022. Methods: We conducted a retrospective analysis of the annual mean effective doses (AMED) and the average over a five-year period (MED-5y) among various medical professionals, including anesthesiologists, cardiologists, nurses, radiologists, and radiologic technologists. The effective doses were estimated using thermoluminescent dosimeters and analyzed to compute the AMED and MED-5y. Statistical significance was determined using T-tests and ANOVA, with subsequent Tukey Post-Hoc Tests for specific group comparisons. Results: The AMED varied significantly among professions, with cardiologists experiencing the highest exposure (3.469 ± 7.81 mSv in 2022). An overall increase in AMED doses was observed from 2018 to 2022. The results of the T-Test showed a significant difference in the radiation exposure across the years under study (p < .001). The MED-5y were anesthesiologists (0.62 ± 0.30), cardiologists (3.23 ± 7.37), nurses (1.17 ± 0.56), radiologic technologists (1.13 ± 0.38), and radiologists (0.86 ± 0.26). The study also found significant differences in MED-5y across professions (F = 14.8, p < .001). Gender-based analysis indicated significant differences in MED-5y, particularly among nurses and radiologists. Conclusion: The results of this study revealed that the annual effective dose received by anesthesiologists, cardiologists, nurses, radiologists, and radiologic technologists was below the recommended occupational dose limit of 20 mSv per year, as stipulated by both national and international standards.

A Workflow-Efficient Approach to Pre- and Post-Operative Assessment of Weightbearing Three-Dimensional Knee Kinematics.

Knee kinematics during daily activities reflect disease severity pre-operatively and are associated with clinical outcomes after total knee arthroplasty (TKA). It is widely believed that measured kinematics would be useful for preoperative planning and postoperative assessment. Despite decades-long interest in measuring three-dimensional (3D) knee kinematics, no methods are available for routine, practical clinical examinations. We report a clinically practical method utilizing machine-learning-enhanced software and upgraded C-arm fluoroscopy for the accurate and time-efficient measurement of pre-TKA and post-TKA 3D dynamic knee kinematics. Using a common C-arm with an upgraded detector and software, we performed an 8-second horizontal sweeping pulsed fluoroscopic scan of the weight-bearing knee joint. The patient's knee was then imaged using pulsed C-arm fluoroscopy while performing standing, kneeling, squatting, stair, chair, and gait motion activities. We used limited-arc cone-beam reconstruction methods to create 3D models of the femur and tibia/fibula bones with implants, which can then be used to perform model-image registration to quantify the 3D knee kinematics. The proposed protocol can be accomplished by an individual radiology technician in ten minutes and does not require additional equipment beyond a step and stool. The image analysis can be performed by a computer onboard the upgraded c-arm or in the cloud, before loading the examination results into the Picture Archiving and Communication System (PACS) and Electronic Medical Record (EMR) systems. Weight-bearing kinematics affect knee function pre-TKA and post-TKA. It has long been exclusively the domain of researchers to make such measurements. We present an approach that leverages common, but digitally upgraded, imaging hardware and software to implement an efficient examination protocol for accurately assessing 3D knee kinematics. With these capabilities, it will be possible to include dynamic 3D knee kinematics as a component of the routine clinical workup for patients who have diseased or replaced knees.

Exploring the lived experiences of diagnostic radiographers after transitioning to non-emergency imaging settings.

The demand for diagnostic imaging in emergency clinical settings has increased in recent years, placing pressure on the available workforce. However, challenges including staff shortages and inflexible shift patterns may prompt radiographers to leave emergency settings. This study explores the lived experiences of radiographers who have transitioned to non-emergency settings and factors that might influence their decision to return. A descriptive phenomenological approach was used. Semi-structured interviews were conducted with 12 diagnostic radiographers working in the UK, who had transitioned to non-emergency settings within the last one to five years. Participants provided insight into (1) the past: reasons for transitioning, (2) the present: current thoughts on wellbeing and professional development, and (3) the future: possibility of returning to the emergency setting. Occupational pressures including excessive workloads, physical exhaustion, and time constraints leading to moral distress, were commonly cited reasons for transitioning to non-emergency setting. Since transitioning, participants reported improvement in their physical and mental well-being, renewed job satisfaction, and enhanced work-life balance. Career advancement opportunities, a better work environment, competitive salaries, and improved mental health support, could encourage a return to the emergency setting. This study highlights the valuable learning experiences that emergency settings offer diagnostic radiographers, greatly enhancing their skills and overall competence. However, challenging work conditions can lead to job dissatisfaction and burn out. Instead of leaving the profession altogether, some radiographers found renewed satisfaction by transitioning to non-emergency settings. The majority of participants would consider returning to emergency imaging under the right conditions. Flexibility regarding work arrangements, career advancement opportunities, competitive salary offers, and improved mental health support through interventions such as debriefing, could help retain radiographers in emergency settings.

Increased Risk of Femoral Neck Stress Fractures in Patients With Cam or Pincer Morphology.

Previous studies suggest a relationship between femoroacetabular impingement (FAI) and femoral neck stress fractures (FNSF), due to pathologic biomechanics in the setting of femoral head abutment (cam morphology) and/or acetabular overcoverage (pincer morphology). The purpose of this study is to evaluate the association between cam or pincer morphology and FNSF, compared to a control group of patients without hip pain. A retrospective review of the electronic medical record at a single institution was queried for patients with FNSF over a 10-year time period from January 2011-2021. These patients were compared to a control group with diagnostic radiographs and a chief complaint that was not hip pain presenting to the institution's emergency department. Hip morphology was evaluated radiographically. A multivariate logistic regression was used to investigate an association between FNSF and cam or pincer morphology. Eighty-three patients with FNSF and a mean age of 38.6 years were compared to 55 healthy controls with a mean age of 35.8 years. Patients in the FNSF group were more often female, white, and had lower BMI. These patients were also more likely to have associated cam morphology (p = 0.010). Binary logistic regression demonstrated a statistically significant independent association between both cam (OR 5.2, p = 0.01) and pincer (OR 4.6, p = 0.022) morphology with FNSF when controlling for demographic variables. Black race and higher BMI were protective factors for FNSF (OR 0.09, OR 0.84, p < 0.01). In summary, radiographic cam morphology, superolateral acetabular overcoverage, female sex, and lower BMI are risk factors for sustaining FNSF, while the black race was found to be protective.

CPT® Codes for MRI Safety - A User's Guide.

The magnetic fields of the MR environment present unique safety challenges. Medical implants and retained foreign bodies can prevent patients from undergoing MR imaging due to interactions between the magnetic fields of the MR environment and the implant or foreign body. These hazards can be addressed through careful MR safety screening and MR examination customization, often allowing these patients with implants to undergo management-altering MR imaging. However, mitigating these risks takes additional time, expertise, and effort. Effective in 2025, this additional work is formally acknowledged with a new series of CPT® codes to report the work of assessing and addressing safety concerns associated with implants and foreign bodies in the MR environment. This user guide provides guidance on how to report these codes so physician led MR safety teams can be appropriately reimbursed for the additional work performed in preparing patients with implants or foreign bodies for MR imaging.ABBREVIATIONS: ACR = American College of Radiology™; ASNR = American Society of Neuroradiology; CPT® = Common Procedural Terminology; QHP = Qualified Healthcare Professional; ARRT® = American Registry of Radiologic Technologists; ABMRS = American Board of Magnetic Resonance Safety; MRSO = Magnetic Resonance Safety Officer; MRMD = Magnetic Resonance Medical Director; MRSE = Magnetic Resonance Safety Expert.

Pilot Study on Using Large Language Models for Educational Resource Development in Japanese Radiological Technologist Exams

Pilot Study on Using Large Language Models for Educational Resource Development in Japanese Radiological Technologist Exams

Influence of obtaining medical records and laboratory data on the sensitivity of diagnostic imaging assessment by radiological technologists.

The purpose of this study is to clarify the influence of acquiring medical record information and laboratory data on the sensitivity of detecting imaging findings among Japanese radiological technologists (RTs). RTs were presented with patient'sinformation in three distinct sequences for detecting imaging findings. True positives (TP) were identified and categorized into three groups: Group 1 (image + chief complaint), Group 2 (image + chief complaint + medical record), and Group 3 (image + chief complaint + medical record + laboratory data). Compared with Group 1, Groups 2 and 3 exhibited up to 8.3% and 16.7% higher sensitivity, respectively. Notably, Group 3 demonstrated up to 13.3% higher sensitivity than that of Group 2. Obtaining medical record information and laboratory data improved the sensitivity of imaging findings detected by RTs. This study provides valuable insights for optimizing diagnostic protocols and improving patient outcomes by leveraging supplementary clinical data to augment diagnostic accuracy.

Development of an image quality evaluation system for bedside chest X-ray images using scatter correction processing.

In plain radiography, scattered X-ray correction processing (Virtual Grid: VG) is used to estimate and correct scattered rays in images. We developed an objective evaluation system for bedside chest X-ray images using VG and investigated its usefulness. First, we trained the blind/referenceless image spatial quality evaluator (BRISQUE) on 200 images obtained by portable chest radiography. We then evaluated optimal chest phantom VG images as well as those that deviated from the VG setting conditions using BRISQUE. Furthermore, we conducted a subjective evaluation using the mean opinion score (MOS) and established an objective evaluation system for VG images. Finally, the degree of agreement between the MOS subjectively evaluated by 14 radiological technologists and that determined by the objective evaluation system for 100 clinical images obtained by portable chest radiography was calculated using Cohen's kappa coefficient. The correlation coefficient between the BRISQUE score and MOS for chest phantom images was - 0.96 (p < 0.05). The two scores showed a very high linear correlation, indicating the potential of the BRISQUE score as an alternative to MOS. The Cohen's kappa coefficient for the objective evaluation system using the optimal conversion table was 0.42. Conversely, there was a very high detection rate of 82.86% for poor-quality images. An objective evaluation system for bedside chest X-ray images using VG that uses no-reference image quality evaluation helps provide proper image quality. Furthermore, such a system can be constructed with a small amount of training data, which increases the possibility of introducing it to a variety of facilities.

Influence of Hospital Bed Count on the Positioning of Cardiovascular Interventional Radiology (IR) Nurses: Online Questionnaire Survey of Japanese IR-Specialized Radiological Technologists.

Interventional radiology (IR) utilizing X-rays can lead to occupational radiation exposure, posing health risks for medical personnel in the field. We previously conducted a survey on the occupational radiation exposure of IR nurses in three designated emergency hospitals in Japan. Our findings indicated that a hospital with 214 beds showed a higher lens-equivalent dose than hospitals with 678 and 1182 beds because the distance between the X-ray irradiation field and the IR nurse's position of the hospital with 214 beds was shorter than those of 678 and 1182 beds. Based on these observations, we hypothesized that the number of hospital beds affects the distance between the X-ray irradiation field and the IR nurse's position. To verify this hypothesis, we conducted a more extensive online questionnaire survey, focusing exclusively on hospitals that perform cardiovascular IR. We analyzed data from 78 facilities. The results of this study confirmed our earlier findings, showing that both the number of physicians performing IR procedures and the distance from the X-ray irradiation field to the IR nurse's position are influenced by the number of hospital beds. Additionally, factors such as the type of hospital, emergency medical system, annual number of IR sessions, location of medical equipment, and the positioning of IR nurses appear to be associated with the number of hospital beds. Understanding these relationships could enable the development of individualized and prioritized radiation exposure reduction measures for IR nurses in high-risk settings, provided that comprehensive occupational radiation risk assessments for cardiovascular IR consider the number of hospital beds and related factors. This study was not registered.

Radiology Technologists certified as Radioprotection Supervisors in Nuclear Medicine: current scenario

The presence of a radiological protection supervisor is mandatory in the staff of a nuclear medicine service according to the CNEN-NN-3.05 standard. To obtain the certification of qualification as a radiological protection supervisor, it is necessary, in addition to taking the general and specific tests, to graduate from a higher education course recognized by the Ministry of Education in the areas specified by legislation. This study analyzed the number of professionals trained in radiology technology certified as supervisors of radiological protection in nuclear medicine in Brazil. For this analysis, only the list available on the regulatory agency's website up to the date of preparation of this study was considered. Of the 326 professionals found, only 2.76% have academic training in radiology technology, while physicists and physicians together represent more than half of the radiological protection supervisors (65.65%). These results show that, although the field of radiological sciences and the Radiology Technology course, specifically the one offered by the Federal University of Minas Gerais, allow students to complete their undergraduate studies able to enter this job market and act as radiological protection supervisors, there is a lower number of these professionals' certificates in this field. The study provided a parameter on the state of the art of higher education in Radiologic Technology and the insertion and interest of these professionals in certification when compared to other fields of study.

Prevalence and factors associated with workplace violence against diagnostic radiographers in Ghana: A nationwide cross-sectional study.

Workplace violence is associated with anxiety, depression, job dissatisfaction, burnout, absenteeism, staff replacement costs and productivity loss. However, no study has investigated the issue of workplace violence against diagnostic radiographers in Ghana. The aim of this study was to determine the prevalence and factors associated with workplace violence against diagnostic radiographers in Ghana. An anonymous, online, nationwide cross-sectional study was conducted from 31st January to 22nd July 2024. The survey contained questions on socio-demographic characteristics, physical violence, verbal abuse, bullying/mobbing, sexual harassment and cultural/ethnic harassment. Binomial and multivariate logistic regression analysis was performed to predict the factors associated with workplace violence. A p-value of less than 0.05 was considered statistically significant. A total of 209 diagnostic radiographers responded to the online survey. In total, 26.3% (n=55/209) of the respondents were within the age group 25-29 years, and 53.6% (n=112/209) were males. The 12-month prevalence of workplace violence among the respondents was 93.8% ([95% CI: 89.6-96.6]; p<0.001). The most prevalent forms of workplace violence were verbal abuse (n=175/209, 83.7%), physical violence (n=110/209, 52.6%) and cultural/ethnic threat (n=93/209, 44.5 %). Factors significantly linked to experiencing any form of workplace violence in both unadjusted and adjusted models were level of education and being worried about violence. Workplace violence is common among diagnostic radiographers in Ghana and victims hardly report the incident to the relevant authorities. It is recommended that future research use a qualitative approach to gain a comprehensive understanding of the factors that facilitate or hinder the reporting of workplace violence among diagnostic radiographers. Investigating workplace violence could help design and implement multifaceted interventions to ensure safe and healthy working environments for healthcare professionals, including diagnostic and therapeutic radiographers in Ghana.

The scope of practice for diagnostic radiographers in Singapore: A preliminary survey

IntroductionThere has been an increased demand for medical imaging procedures through the years. This demand requires the diagnostic radiographers in the workforce to be equipped with adequate training and understanding of their roles. The aims of this research are to distill and further describe the current scope of practice as established by the Allied Health Professional Council and map the diffusion of tasks, roles and responsibilities within Singapore’s radiography imaging modalities. MethodsA structured questionnaire was distributed to all diagnostic radiographers in Singapore through emails sent out by the Singapore Society of Radiographers. Information collected included respondents' duties in their respective imaging modalities, the professional tracks they specialised in, and their demographical information. Quantitative data analysis was conducted using SPSS and Fisher’s Exact test of independence was used to determine correlations between variables. ResultsA total of 120 questionnaire responses were obtained and after exclusion, 99 responses were analysed. It was observed that there was a significant positive correlation in radiography experience and performing specialised Computed Tomography examinations (p = 0.005). Additionally, higher radiographer designation was shown to be correlated with the ability to perform more specialised Ultrasound examinations (p < 0.001). The study demonstrated a diverse range of tasks by radiographers which was determined by education, disparity in experience, institutional practice and training provided. ConclusionThis preliminary study on Singapore diagnostic radiographers provided valuable insight and mapping of their activities in several imaging modalities, allowing for future development of a scope of practice document for Singapore. Implication for practiceThe tasks undertaken by the diagnostic radiographers were integral to imaging service delivery and play a significant role in the advancement of radiography to further enhance the quality of patient care.

Accuracy of interpretation of nasogastric tube position on chest radiographs by diagnostic radiographers: A multi-case, multi-reader study

IntroductionFeeding via a misplaced nasogastric tube (NGT) is a common but preventable cause of patient harm. The aim of this study was to determine the accuracy of diagnostic radiographers’ assessment of NGT position on chest radiographs (CXRs) and safe-to-feed decisions. MethodsA multi-case, multi-reader study was conducted using an online image interpretation platform. A test bank consisting of 15 CXRs with an NGT in-situ was created. Diagnostic radiographers without formal qualifications in CXR interpretation were recruited via two international conferences. Participants placed an electronic marker on each CXR to identify the location of the tip of the NGT and indicated whether or not they believed that the tube was safely positioned. Results68 participants were recruited. Each participant reviewed 15 CXRs, providing 1020 unique image assessments. 76 % (n = 778/1020) image assessments were completely correct (both the position of the tip of the NGT was accurately located and an appropriate safe-to-use decision made). In 5 % (n = 56/1020) of cases the NGT was safely positioned and the location of the tip was correctly identified by the participant but the tube was erroneously determined to be unsafe for feeding. In a further 6 % (n = 59/1020) of cases the participant correctly located the tip of an NGT in an unsafe position but indicated that the tube was safe to use. Participants failed to correctly identify the tip of the NGT in the remaining 12 % (n = 127/1020) of cases. ConclusionConsistent with previous studies involving other staff groups, diagnostic radiographers without formal qualification in CXR interpretation can assess NGT positioning on radiographs with moderate accuracy but require further training, including strategies for the identification of poorly-visualised tube tips, to achieve the 100 % accuracy necessary for this safety-critical task. Implications for practiceA bespoke training programme which includes teaching on image quality, tube tip identification and assessment of tube positioning using the National Patient Safety Agency (NPSA) four criteria, should be delivered prior to implementation of a radiographer-led NGT CXR evaluation service.

Analysis of Factors That Promote Awareness of Breast MRI Surveillance for Carriers of Hereditary Breast Cancer Risk Genes ( BRCA1/2)

Hereditary breast and ovarian cancers (HBOC) carry a high risk of breast cancer, and detailed screening with contrast-enhanced breast MRI (breast MRI surveillance) is recommended. With the increase in the number of individuals diagnosed with HBOC, the demand for breast MRI surveillance is also rising. However, the current system is inadequate, with factors such as lack of knowledge and indifference among healthcare professionals, and insufficient understanding of breast MRI surveillance being cited. This study aims to investigate the knowledge of HBOC and the awareness of breast MRI surveillance among radiological technologists, and to analyze the factors that promote these practices. A web-based survey was conducted among radiological technologists at 1278 facilities with MRI installations. Responses were obtained from 433 individuals. The knowledge of HBOC was insufficient, with 49.6% unaware that breast MRI surveillance is recommended. Factors promoting awareness included the amount of knowledge about HBOC, age, and the presence of MRI specialists and mammography screening specialists. By enhancing the acquisition of knowledge about HBOC and raising awareness of breast MRI surveillance, it is expected that discussions towards building a robust system will deepen.

Measuring the effectiveness of career education at a medical university and future issues from the perspective of students’ transformation: impact of a new career education program at a medical university on entrepreneurship effectiveness

The current study aimed to examine the effectiveness of a new career education course, "Career Development Theory," at a medical university. This course is designed to enable students to plan their careers and consider various career options. This class was introduced to improve students' entrepreneurial qualities and broaden their career choices. The research methods included a survey to measure entrepreneurial qualities before and after attending the class and an analysis of students' reports of what they had learned from the class. A total of 243 students who plan to qualify to participate in the national examinations for clinical technologists, clinical engineering technologists, and radiology technologists participated in the research. The results revealed that autonomy and creativity scores significantly increased, whereas risk-taking scores decreased. This suggests that the class may have taught students accurate self- and risk-assessment skills while fostering a cautious attitude toward avoiding unnecessary risks. The report analysis indicated that students' self-awareness and attitudes toward their careers changed because of the class. Many students felt that their career options had expanded and found avenues outside the medical profession. This research demonstrates the need for and effectiveness of career education in medical universities and provides valuable suggestions for improving educational programs. The future goal is for more students to design their careers freely and choose the path that best suits them from various career options. The current results may provide a useful reference for career education curriculum development at other medical universities.

Anatomy of a Radiologic Technologist Workforce Crisis.

Anatomy of a Radiologic Technologist Workforce Crisis.

Exploring diagnostic radiography students’ experiences of transitioning from online to face-to-face teaching and learning, Johannesburg, South Africa

BackgroundThe COVID-19 pandemic necessitated educational institutions adopting online learning as a measure to limit the spread of the virus. When restrictions were eased, teaching and learning at higher education institutions returned to face-to-face teaching and learning. Although there have been studies on the experiences of diagnostic radiography students with online teaching and learning, there is a lack of research on students' experiences when transitioning back to face-to-face teaching and learning. Therefore, this study explored diagnostic radiography students' experiences in transitioning from online to face-to-face teaching and learning. MethodsA qualitative explorative and descriptive research design was conducted in two phases. Phase one used an open-ended online questionnaire with a single central question. In phase two, the responses from phase one were explored through in-depth interviews with diagnostic radiography students at a higher education institution. The results from phases one and two were analysed to generate themes. ResultsTwo themes were generated: 1. varying experiences and 2. online and face-to-face teaching and learning engagement. Change and preferences were categorised under theme one, the flexibility of online learning, face-to-face learning interaction, and active and responsible learning development under theme two. ConclusionDiagnostic radiography students experienced the change to face-to-face learning from online learning as challenging but were able to adapt. They preferred the flexibility of online teaching and learning and the enhanced engagement of face-to-face teaching and learning. Therefore, blended learning should be considered for radiography education in the future. They appreciated the skills they developed during online learning and incorporated these skills into their face-to-face learning.

High workload and under-appreciation lead to burnout and low job satisfaction among radiographers

IntroductionBurnout and low job satisfaction in healthcare can impact patient safety and staff retention. This study aims to gain information on the factors influencing burnout and job satisfaction among radiographers in the UK, Ireland and internationally. This can inform strategies for improving the workforce supply and demand imbalance. MethodsAn online questionnaire was developed, which included demographic questions and two validated instruments, the Maslach Burnout Inventory (MBI) and the Job Satisfaction Survey (JSS). The questionnaire was distributed to diagnostic radiographers through the EFRS Research Hub at the European Congress of Radiology, Vienna, in early March 2023. It was disseminated online through Twitter, Facebook, and email over six weeks. Results245 radiographers completed the questionnaire, with the majority (n = 207, 84.5 %) female. Not all respondents responded to all questions. The numbers of respondents for each section were: Pay n = 205, Promotion = 206, supervision = 212, fringe benefits = 211, CR = 212, OC = 214, Co-workers = 213, NoW = 211, Communication = 213 and overall JS = 205. The questionnaire had participants from twenty-one countries, with 66.5 % from Ireland. The mean values for emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) indicate moderate levels of burnout among responding radiographers. 44.2 % of radiographers were dissatisfied, 43.7 % were ambivalent, and 12.1 % were satisfied overall. Workload, under-appreciated work, and time pressures were ranked as the top three factors contributing to burnout. Staff numbers, workload and poor management were the top three factors reducing job satisfaction. ConclusionBurnout levels were moderate, and overall job satisfaction was very low among radiographers. Workload and under-appreciation were key factors impacting low job satisfaction and high burnout. Implications for practiceHealthcare policies that address radiographer burnout through wage structure adjustments, targeted human capital investment, and management practices aligned with staff needs are needed. Implementing these strategies is essential for improving healthcare efficiency, staff wellbeing, and patient care outcomes.

Evaluation of Electro-magnetic Radiation Exposure Due to Backscatter from the Walls of a Diagnostic Radiography Room

Evaluation of Electro-magnetic Radiation Exposure Due to Backscatter from the Walls of a Diagnostic Radiography Room

Multidisciplinary Partnership to Upgrade Patient Satisfaction and Healthcare Performance

Healthcare systems today demand a collaborative approach to meet the rising expectations of patient satisfaction and healthcare performance. This article examines the pivotal roles of Medical Device Specialists, Radiology Technologists, Midwives, Family Medicine Practitioners, Anesthesia Technicians, Medical Secretaries, Health Services Managers, and Nursing Scientists in achieving these goals. Each profession contributes distinct expertise that ensures high-quality, patient-centered care across various healthcare settings. Through a synergistic partnership, these roles address complex challenges such as workflow efficiency, diagnostic precision, and patient safety. The review provides actionable strategies for fostering multidisciplinary teamwork, optimizing healthcare delivery, and enhancing clinical outcomes.