Radiographic Practice Research Articles

Risk-benefit analysis of a multi-site radiographer comment model for emergency departments.

Critical/urgent X-ray findings are not always communicated in an appropriate time frame to ED physicians. The practice of radiographers alerting referrers to clinically significant image findings (verbally, via image flags or written comment) is noted internationally but risk assessment data is unavailable in the literature. A hybrid radiographer comment and alert model was piloted in New South Wales and a risk-benefit assessment conducted for timely and safe communication of abnormal X-ray appearances to ED physicians. Radiographer comments (n = 1102) were provided to five New South Wales EDs by 69 radiographers for a period of 3-12 months. Site auditors classified comments as true positive (TP), false positive (FP) or indeterminate (ID) with respect to the radiology report. FP comments were investigated with ED referrers and a low-medium-high-risk assessment was provided by two independent reviewers. A total of 42 FP (3.9%; 95% confidence interval [CI] 2.9-5.3) comments were analysed for any adverse outcomes. Risk assessments demonstrated 37 low, 5 low-moderate and no high-risk cases. A total of 282 direct or potential patient benefits were identified (26.4%; 95% CI 23.8-29.1). A total of 42 radiology report discrepancies were incidentally found: (3.9%; 95% CI 2.9-5.3). Audit results demonstrated areas where the radiographer comment could mitigate risk. The provision of radiographer alerts with a written comment for ED was found to be low risk to patients in the pilot study. Radiographers communicating directly with the emergency team when abnormal image appearances are detected can reduce diagnostic error and improve patient safety and health outcomes.

360 - Advancing Radiography Practice in the UAE: A Comprehensive Overview

360 - Advancing Radiography Practice in the UAE: A Comprehensive Overview

Theory of optimising radiation protection among diagnostic radiographers depicted as a model.

When radiation protection practices are suboptimal, it becomes necessary to take additional steps to optimise practices. Therefore, this study aimed to develop a model to facilitate radiation protection among diagnostic radiographers. The study was conducted in South Africa. A theory-generating design consisting of three steps was used to develop the model: (1) the central concept was identified, defined and classified; (2) relationship statements were created and (3) the model was developed, described and evaluated. The model was premised on the central concept of facilitating a transformative radiation protection environment and occurs in four phases: (1) relationship, (2) working, (3) termination and (4) independent phases. The radiography manager and radiographer enter the relationship phase of the model because of discord regarding radiation protection in their department and work together to optimise radiation protection. The model's purpose, assumptions, context, structure and process are described. A model to facilitate radiation protection among radiographers was conceptualised to optimise radiation protection. The model details the steps the radiography manager and radiographer take to co-create optimal radiation protection practices. Radiation protection compliance among radiographers is paramount to ethical radiography practice, and the model provides a guide to optimise radiation protection. In any radiography department where radiation protection may be lacking, the model provides a road map of possibilities for change. Ultimately, radiation protection compliance improves patient care and outcomes.

Quality Assessment of Periapical Radiographs Taken by Dental Assistants Using the Recent Faculty of General Dental Practice (FGDP) Guidelines.

Periapical radiographs play a pivotal role in dentistry, offering invaluable insights essential for various dental procedures. This study aims to systematically assess the quality of intraoral periapical (IOPA) radiographs evaluating adherence to the recent guidelines established by the Faculty of General Dental Practice (FGDP). A cross-sectional study was conducted at the University College of Dentistry (UCD), employing a non-probability consecutive sampling technique to acquire a calculated sample of 300 IOPA radiographs from the operative, oral surgery, and oral radiology departments. Two senior faculty members evaluated the radiographs according to the recent two-tier grading system outlined in the FGDP guidelines. The study revealed that 197 (65.67%) of the assessed radiographs were diagnostically acceptable, while 103 (34.33%) were deemed diagnostically unacceptable. Contrast problems emerged as the most prevalent issue, accounting for 85 (28.3%) of the cases. Other common problems included incorrect film positioning in 66 (22%), incorrect vertical cone angulation in 37 (12.3%), incorrect horizontal cone angulation in 11 (3.7%), and incorrect processing in 15 (5%) of the IOPA radiographs. This study revealed that approximately two-thirds of the IOPA radiographs were deemed diagnostically acceptable. However, contrast issues emerged as the predominant concern affecting image quality. These findings highlight the critical importance of continuous quality improvement initiatives in radiographic practices to enhance diagnostic precision and ensure optimal patient care.

Implementing safety standards in radiographic practices: challenges and solutions

Ensuring the safety of patients and healthcare workers in radiographic practices is a critical concern in modern healthcare. The use of ionizing radiation, while invaluable for diagnostic and therapeutic purposes, carries inherent risks that necessitate stringent safety standards. Despite advances in technology and regulatory frameworks, the consistent implementation of these safety standards remains a challenge across various healthcare settings. The discussion addresses the complexities of navigating diverse regulatory environments, where enforcement and adherence to safety guidelines can vary significantly. These inconsistencies are particularly pronounced in low-resource regions, where limited access to modern radiographic equipment and inadequate training further exacerbate the risks of radiation exposure. Technological advancements in radiography, such as digital radiography, dose-reduction software, and advanced imaging modalities, offer significant benefits in terms of diagnostic accuracy and efficiency. However, they also introduce new challenges in maintaining up-to-date safety protocols. The rapid pace of innovation often outstrips the ability of regulatory bodies to update guidelines, leading to gaps in safety practices. Additionally, the effectiveness of these technologies depends heavily on proper usage and understanding by radiographic professionals, highlighting the need for continuous education and training. A strong safety culture within radiographic practices is essential for minimizing radiation risks. Leadership commitment, ongoing education, effective communication, and the empowerment of radiographic professionals are critical components of this culture. When these elements are in place, they foster an environment where safety is prioritized, and all staff members are actively engaged in maintaining and improving safety standards. The multifaceted approach required to enhance radiographic safety underscores the importance of harmonizing regulatory efforts, investing in modern technologies, and cultivating a safety-first mindset among healthcare professionals. These efforts collectively contribute to the safe and effective use of radiographic technology, ultimately protecting both patients and healthcare workers from unnecessary radiation exposure.

Patient, public and practitioner partnership within imaging and radiotherapy: An exploration of the implementation and use of the college of radiographers guiding principles

IntroductionIn 2014 the National Health Service (NHS) in England released the Five Year Forward plan1, envisioning a shift in power from health professionals to patients and the public. In response the Society and College of Radiographers (SCoR) produced the “Patient, Public and Practitioner Partnership within Imaging and Radiotherapy: Guiding Principles” (P4) document which was implemented within four domains of radiography practice; service delivery, service development, education and research2. This project explored how these guidelines were implemented; and whether improvement to the quality and scope were needed, leading to making recommendations for updating the document. MethodsA mixed methods design was adopted with two phases. Phase 1 – a survey exploring use of the P4 document’s guiding principles. There was no maximum number of participants to ensure inclusivity. Phase 2 - one focus group and four one-to-one interviews from the four domains3. Results626 participants completed the phase 1 survey. 18.85% (n=118) of participants were aware of the document and used it as a reference tool for practice, teaching, and research. 81.15% (n=508) of participants stated they were unaware of the document. Themes from phase 2; importance of service user involvement in service delivery and evaluation, resources to ensure service user involvement, suggestions to update the P4 document and use of the P4 document in radiographer education.Participants acknowledged guidance in the document was best practice. They reported more awareness of patients’ needs and the effect this has on radiographers in supporting their needs. ConclusionParticipants recommended the document be given greater visibility. The voices of patients and the public must be heard within radiography practice. Implications for practiceFeedback from this study can be used for the future development of the P4 document.

Use of Smart Glasses (Assisted Reality) for Western Australian X-ray Operators' Continuing Professional Development: A Pilot Study.

Previous studies have explored use of smart glasses in telemedicine, but no study has investigated its use in teleradiography. The purpose of this study was to implement a six-month pilot program for Western Australian X-ray operators (XROs) to use smart glasses to obtain assisted reality support in their radiography practice from their supervising radiographers, and evaluate its effectiveness in terms of XROs' competence improvement and equipment usability. Pretest-posttest design with evaluation of the XROs' competence (including their X-ray image quality) and smart glasses usability by XROs in two remote centers and their supervising radiographers from two sites before and after the program using four questionnaire sets and X-ray image quality review was employed in this experimental study. Paired t-test was used for comparing mean values of the pre- and post-intervention pairs of 11-point scale questionnaire and image quality review items to determine any XROs' radiography competence improvements. Content analysis was used to analyze open questions about the equipment usability. Our study's findings based on 13 participants (11 XROs and 2 supervising radiographers) and 2053 X-ray images show that the assisted reality support helped to improve the XROs' radiography competence (specifically X-ray image quality), with mean post-intervention competence values of 6.16-7.39 (out of 10) and statistical significances (p < 0.001-0.05), and the equipment was considered effective for this purpose but not easy to use.

Sustainability in radiography education: A case study of a tertiary institution in Zimbabwe

IntroductionTo equip radiographers to tackle the negative impacts of climate change, it is crucial to offer in-depth education on planetary health and sustainability. This study aimed to use a tertiary institution in Zimbabwe as a case study to assess radiography students' views on the integration of sustainability into their curriculum. MethodsA quantitative cross-sectional study using a questionnaire took place at a tertiary institution in Harare, Zimbabwe, where students were sampled consecutively. Categorical variables were described using frequencies and percentages. Data analysis was carried out using Stata 13.1. ResultsA total of 96 out of 111 students participated, with an 86% response rate. The majority of students believed in the importance of environmentally friendly radiography practices (90.62%) and felt that sustainability is crucial for better patient care. While sustainability teaching was acknowledged in the curriculum, many students were not confident about the topic in exams. There was no consensus on the preferred methods of teaching sustainability. University lecturers specializing in climate-related fields were seen as the most suitable teachers for sustainability education. ConclusionsThe curriculum reflects efforts in sustainability education, but student confidence and awareness of climate-focused research units require improvement. Continuous education is crucial to link sustainability awareness with practical implications in radiography. Future studies should investigate tailored teaching methods to engage students effectively in sustainable radiography practices. Implications for practiceThe findings highlight the importance of ongoing education and awareness campaigns to address the disconnect between understanding the importance of sustainability and implementing it effectively in radiography practice.

A RETROSPECTIVE CLINICAL AUDIT OF QUALITY OF INDIRECT DIGITAL INTRAORAL RADIOGRAPHS TAKEN BY STUDENTS AND DENTAL ASSISTANTS IN AN UNDERGRADUATE DENTAL CLINIC

Background: Intraoral radiographs are essential diagnostic tools in dentistry. Ensuring their quality is crucial for accurate diagnosis and treatment planning. This study compared the quality of radiographs produced by undergraduate dental students and qualified dental assistants to identify common errors and assess improvements following feedback and interventions. Methods: This retrospective, observational study compared the quality of digital bitewing and periapical radiographs taken by students and assistants across two audit cycles, with feedback provided between cycles. The radiographs were assessed using a modified quality assessment scale based on the Faculty of General Dental Practice (FGDP, UK) guidelines. Data were collected from the radiology imaging software, and a total of 100 intraoral digital radiographs were analyzed for each group in both cycles. Results: Initially, radiographs from both groups had issues, primarily positioning errors. After providing feedback and additional training, significant improvements were observed from Cycle 1 to Cycle 2. Dental assistants had a higher percentage of acceptable periapical radiographs, while students excelled in bitewing radiographs. Both groups demonstrated marked improvements, reflecting the effectiveness of the interventions. Conclusions: Continuous training, feedback, and quality assurance measures are vital for improving radiograph quality. A multifaceted approach, including updated equipment and adherence to quality control protocols, can significantly enhance patient care. The study highlights the importance of regular calibration and training for dental professionals to maintain high standards in radiographic practices. Further research is recommended to identify additional strategies for improving radiographic quality.

Opinions on advanced practice among diagnostic and therapeutic radiographers: Survey results of an European congress of radiology study

IntroductionThe exploration of Advanced Practice (AP) in both diagnostic and therapeutic radiography has become a prominent topic of discussion within the radiographic community, prompting an investigation into radiographers' perceptions and the current global status of advanced roles. This study aimed collect data on radiography and radiation therapy AP career paths, and understand radiographers' perceptions of advanced practice at the European Congress of Radiology (ECR) 2020. MethodsA concise, 15-question web-based survey was distributed through the EFRS Research Hub during ECR 2020. Topics covered included respondents' demographics, educational background, current radiography skills, the landscape of AP in radiography, potential progression avenues in their countries, and key benefits linked to role advancement. ResultsThe survey garnered responses from 83 radiographers, with a predominant 79.5% (n = 66) representing Europe. Information on the total number of participants approached during the ECR and thus the resulting response rate is not available. Among the findings, a meaningful portion (30%, n = 25) of participants indicated the absence of AP opportunities in their respective country. Notably, an overwhelming majority (97.5%, n = 81) expressed a personal willingness to embrace AP roles. Areas of particular interest to the respondents included radiography reporting (38.6%, n = 32), performing ultrasound examination (13.2%, n = 11), conducting interventional procedures (13.2%, n = 11) and engaging in radiography research (10.8%, n = 9). ConclusionThe study indicates a keen interest among surveyed radiographers in pursuing AP, emphasizing the necessity for role recognition. Education, research and job satisfaction emerged as pivotal for AP progression. Despite this, AP availability in Europe is limited. Implication for practiceThere is a need to recognize and address barriers, provide targeted education and training, and promote job satisfaction to facilitate the development of AP in radiography.

Should radiographs of the thoracolumbar spine remain part of the pre‐purchase examination?

SummaryThe inclusion of thoracolumbar radiographs in a pre‐purchase examination (PPE) is a topic of current and intense debate, subsequent to a statement from the Federation of European Equine Veterinary Associations (FEEVA) advocating the exclusion of spinous process radiography from the PPE. This review will consider the reasons behind the addition of such radiographs into PPEs, the limitations of radiography in ambulatory practice and therefore, the diagnostic limitations to the practitioner, the diagnostic benefit of a complete radiographic examination, and discussion of common and less‐frequent thoracolumbar pathologies. We will focus on laterolateral radiographs of the spinous processes as these are most commonly acquired during the PPE. The lack of consistent and repeatable grading systems highlights the subjective nature and variability in assessing this region radiographically. Coupled with the sparse scientific evidence of correlation between clinical signs of primary back pain, future performance in different levels and disciplines of equine athletes and radiographic abnormalities of the thoracolumbar spine leads us to conclude that taking radiographs of the back during PPEs should not be performed unless the clinical examination indicates otherwise.

구강방사선 실습 시 가상현실 시뮬레이션 교육과 팬텀 모형 교육방법에 따른 비교 연구

구강방사선 실습 시 가상현실 시뮬레이션 교육과 팬텀 모형 교육방법에 따른 비교 연구

Perspective of radiography science - a document analysis of dissertations.

The aim of this study was to clarify the perspective of radiography science as an academic discipline. A discipline can be studied by discovering the collective use of concepts, especially core concepts. We have previously identified the core concepts as clinical practices in radiography, radiographers' profession, safe and high-quality radiation use, and technology in radiography. The relationships between these concepts have not been studied previously. In order to clarify the perspective of radiography science we have investigated further the core concepts, their interrelationships and interdependencies. Altogether, 53 dissertations meeting the inclusion criteria were selected for a qualitative document analysis. The data were first analysed deductively using an extraction matrix comprising four core concepts developed from previous studies, then relational statements were synthesised, and the statements were analysed semantically. Analysis revealed the bilateral interrelationships between the concepts and their dependencies. All the concepts were used within healthcare. The rationale for radiography science research was the clinical practice of radiography and the improvement of services in a complex environment as a part of patients' pathways. Safe and high-quality radiation use was investigated as a means to deliver optimal services. Technology was studied as being functional or a means to deliver services. The perspective of the discipline was seen as the combination of humanistic interaction with advanced technology, where safety and quality were a necessity. Defining core concepts and their interrelations clarifies the perspective of the discipline and gives radiography researchers a way to argue their viewpoint.

Technical Quality and Diagnostic Impact of Chest X-rays in Tuberculosis Screening: Insights From a Saudi Teleradiology Cohort.

Objectives To assess the standard of chest X-ray techniques in tuberculosis (TB) screening within Saudi Arabian healthcare facilities and evaluate the impact of technical quality on radiological interpretation. Materials and methods Analysis of 250 posteroanterior chest radiographs sourced from a network of five clinics was conducted. These images were scrutinized for technical quality by a radiologist. Results Of the radiographs analyzed, 57% exhibited technical issues, with overexposure and clothing artifacts being the most commonly encountered. Notably, only 14% of these radiographs were deemed to have compromised diagnostic ability. Conclusion The presence of technical issues in most chest X-rays for TB screening highlights a significant area for improvement. However, the relatively low percentage of radiographs impacting diagnostic quality indicates that most issues do not critically hinder the radiologist's interpretative capability. This underscores the importance of balanced quality control measures in radiographic practices for effective TB detection in the region.

Fast solution-phase growth of centimeter-sized Cs3Cu2X5 (X = Cl, I) single crystals for high-performance scintillators

Fast and convenient synthesis of zero-dimensional (0D) cesium-copper(i) halide (Cs3Cu2X5 (X = Cl, I)) single crystals (SCs) is critical to achieve practical radiography.

What do the revised UK standards of proficiency mean for diagnostic radiography training? A regional radiographer focus group study

IntroductionRevisions to the UK Health and Care Professions Council (HCPC) standards of proficiency for diagnostic radiographers came into effect on September 1st 2023. Changes include an increase of proficiencies in CT and extended to MRI imaging. As workforce support the development of learners to meet stage outcomes in practice, this study aimed to understand the radiographers' expectations of future learners' training to meet the new standards of proficiency. MethodsSnowball sampling was used to invite practice educators/student supervisors and department leads within the 21 NHS Trusts in the North East and Yorkshire region providing diagnostic radiography practice placements. Online focus groups used a semi structured topic guide to explore the expectations of student performance during different stages of their training, and on different types of pre-registration programmes. Participants views were sought on considerations for appropriate assessment. Thematic analysis was supported by NVivo software. ResultsFifteen diagnostic radiographers across 11 NHS trusts participated in 5 focus groups in November 2022. The findings showed consistency in expectations of student performance in projectional radiography, patient care and communication. Participants felt some standards of proficiency were beyond threshold competency, or current practices were a barrier in supporting learning. Participants felt assessment over a period and range of examinations in the clinical environment gave a fairer picture of student performance. ConclusionThere is uncertainty and perceived barriers in supporting future diagnostic radiography training in the practice setting. Implications for practiceFurther work will be needed to identify and support appropriate learning opportunities and stage outcomes if learners are to meet the breadth of HCPC standards of proficiency with some consistency.

Drawing on lessons learnt in allied health & medicine: Exploring pain science in radiography practice

Drawing on lessons learnt in allied health & medicine: Exploring pain science in radiography practice

Approaches to Establishing National Diagnostic Reference Levels for Computed Tomography: A Systematic Review

Background: The international commission on radiation protection (ICRP) publican 135 recommends that Diagnostic Reference Levels (DRLs) should be tied to defined technical and patient parameters for the imaging task. Whereas for computed tomography (CT) examinations, DRLs are defined in terms of two established technical parameters namely, Volume-based Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP), a debate has ensued as to whether patient size, age and weight or clinical indication should be used as patient parameters. The objective of diagnostic reference levels (DRLs) is to assist in the optimisation of radiation dose to the patients while maintaining diagnostic image quality. It is generally accepted that each country requires having national DRLs to guide the practice of radiography regarding dose optimization as a prerequisite to good radiation protection practice. Objective: This review aimed to establish commonly used approaches to establishing national diagnostic reference levels for computed tomography. Methods: A systematic literature search in databases containing leading journals in radiography, radiology and medical physics was performed aided by the use of carefully selected search terms that relate to CT and DRLs. The literature search was achieved by the use of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) flow chart. A total of 109 studies were screened out of which 54 were excluded and 55 sought for retrieval. After further assessment for quality, 20 studies were included in this study for review. Key Findings: 95% of the studies in this review used CTDIvol and DLP as technical parameters indicating dose. 70% of the studies reviewed used patient size, age and weight while 30% used clinical indication as patient parameters. 30% of the reviewed articles did indicate that the surveys to establish NDRLs employed a retrospective approach, while 35% employed a prospective approach and 35% did ..

Postmobilization Plain Radiography After Lateral Compression Type 1 Pelvic Ring Injury Does Not Affect Treatment.

The purpose of this study was to describe the practice of postmobilization radiography after lateral compression type 1 pelvis ring injury. We hypothesized that postmobilization radiographs would be more frequent over time and would not influence treatment. Displacement of pelvis ring injury on initial and final plain radiographs was measured. Frequency of postmobilization radiography was determined, and the impact on treatment and final radiographical outcome were assessed. Of the 156 patients reviewed, 98 (62.8%) were women and mean age was 60.1 years. Thirty-three of 156 patients (21.2%) had a postmobilization radiograph. Over 5 years, radiographs increased to 67% of presenting patients. None of the patients who received postmobilization plain radiographs (n = 33) had any change in clinical plan afterward; all continued with nonsurgical care. Initial fracture characteristics and alignment were no different for patients with postmobilization radiographs. Final alignment was unchanged in nearly 70%. Overall, 74% of all nonsurgical patients experienced no change in alignment, with similar rates among the patients with postmobilization radiographs. Patients with an lateral compression type 1 fracture demonstrated no changes in care after receiving postmobilization radiographs. However, the frequency of postmobilization radiographs increased over time, denoting opportunities to reduce costs and to improve efficiency and safety.

A Journey Through Rural Community Radiography Practice in South-South Nigeria: Radiographers’ Perceptions, Willingness and Barriers

A Journey Through Rural Community Radiography Practice in South-South Nigeria: Radiographers’ Perceptions, Willingness and Barriers