Radiological Facilities Research Articles

Exploring the implementation of role extension for Namibian radiographers: Perspectives on intravenous injection of contrast media

IntroductionRole extension to include intravenous (IV) injection of contrast media has been formally embraced by radiographers and their regulatory bodies in developed countries. The revised scope of practice, in our Namibian context, has formalised IV injection as an extended role for radiographers. This study aimed to explore the perspectives of radiographers regarding this new role of IV injection of contrast media. MethodsA qualitative design with a descriptive phenomenological approach was employed to collect data from 15 radiographers working in both public and private radiology facilities. Participants were purposively selected to participate in focus group discussions and individual interviews. An interview guide was used to facilitate the discussions and interviews, and a voice recorder was used for recording. Data were transcribed verbatim and analysed using Tesch's 8-step method. ResultsFrom the 15 participants, three themes were developed: enhanced service delivery with two subthemes (improved departmental workflow and patient care), training needs with two subthemes (inadequate contrast media reaction training and standardised training requirement), and medical-legal issues with two subthemes (regulatory blurriness and role conflict distress). ConclusionThe participants expressed mixed perceptions towards the IV injection role of radiographers, emphasising the benefits for the department and patients while raising concerns regarding standardisation of training and associated medico-legal issues. Furthermore, a large-scale evaluation is necessary to uncover the challenges and barriers to the successful adoption of this new role. Implications for practiceThe role extension for radiographers to include IV injections is a long-awaited development, but it should be accompanied by the necessary training and guidelines to fully realise its benefits.

Evaluation of radiation safety levels in the monitor rooms of selected diagnostic centres in Lagos State using thermoluminescent dosimeter

The hazard of exposure to ionizing radiation at low doses has been scientifically proven to be possible for cancer and non-cancer diseases. International and national regulatory bodies have recommended dose limits for occupationally exposed workers to ionizing radiation and the general public. The objective of this study was to assess the radiation safety levels in monitor rooms of x-ray diagnostic radiology facilities. Sixty monitored rooms in twenty radio diagnostic centers were visited. Three tissue-equivalent thermoluminescent dosemeters (TLD-100 (LiF: Mg. Ti)) chips were placed in strategic places a few centimeters from the viewing glass in the monitored rooms for two weeks. The TLDs were analyzed using the RADOS RE 2000 TLD reader. Questionnaires were also distributed to ascertain compliance with the basic principles of radiation protection. The average personnel dose equivalents in the monitored rooms of conventional x-rays, mammography, computed tomography, and fluoroscopy were 0.33, 0.32, 0.28, and 0.34 mSv/year, respectively. The status of the radiation safety levels in the selected monitored rooms is satisfactory because the values obtained were below the international recommended dose limit of 50 mSv in a single year for occupationally exposed radiation workers.

Measurement of leakage radiation dose to patients undergoing chest x-ray in some x-ray facilities in Warri Town. Nigeria.

The increase in the application of x-ray in health management has necessitated the need to determine the risk associated with its use. This study is aimed at measuring the leakage radiation dose to patients undergoing chest x-ray in twenty (20) radiological facilities in Warri, Delta State. A portable GMC-600 digital Geiger Muller Counter (serial number: 36311386254310) was used to examine the facilities. The leakage radiation was measured from both the cathode and anode terminals of the machines across the facilities studied and their mean exposure readings were obtained. The leakage radiation (mR/hr) values for the cathode terminal ranges from 0.21 – 100.27 mR/hr with an average of 26.46 mR/hr while the anode terminal is from 0.21 – 99.70 mR/hr with an average of 24.88 mR/hr. From the obtained results, it was observed that only one machine, A10 (100.27 mR/hr) exceeded the recommended limit (100 mR/hr) for leakage radiation as stipulated by American Association of Physicist in Medicine (AAPM). This indicates that the workers and members of the public in the said facility could be exposed to some level of harmful radiations.

RELATIONSHIP BETWEEN KNOWLEDGE LEVEL AND ATTITUDES OF DENTAL PROFESSION STUDENTS IN INFECTION CONTROL PROCEDURES AT THE RSIGM SULTAN AGUNG RADIOLOGY INSTALLATION DURING THE COVID-19 PANDEMIC

Background: Transmission in radiology facilities must be prevented by taking additional infection control precautions during the COVID-19 pandemic. A number of variables, including knowledge and attitudes, affect how an action is applied. The association between dentistry professional students’ knowledge and attitudes about the COVID-19 pandemic infection control protocol at the RSIGM Sultan Agung radiology installation is to be evaluated.
 Method: Analytic-observational research was used in this case, with a cross-sectional analysis of 139 samples. Validity and reliability tests have been done on the questionnaire. This study was conducted online using Google Forms for data collection, and SPSS 25 was used for the correlation test.
 Result: The results of the analysis show a significant correlation with a positive direction. Correlation strength (r) 0.263 indicates a weak correlation strength between the two variables.
 Conclusion: The conclusion of this study is that there is a relationship between these two variables. The implementation of infection control procedures at the Sultan Agung RSIGM radiology installation during pandemic COVID-19 from a knowledge and attitude perspective was still imperfect.

The use of low‐density polyethylene‐molybdenum oxide polymer composites as radiation shielding laminates in dental radiology physical structures

AbstractRadiation protection is crucial in the protection of humans from the harmful effects of ionizing radiation. One of the most reliable ways of reducing the risk of occupationally exposed workers and the public in dental radiology is the installation of an effective radiation shielding barrier at the facility. Concrete barriers are predominantly used for dental shielding, however there is need to consider the use of lighter, ready‐made, and lower half value layer (HVL) materials as shielding materials in dental radiology facilities. In this work, low‐density polyethylene‐molybdenum oxide polymer composites were prepared (85C2H4‐15MoO3, 90C2H4‐10MoO3, and 95C2H4‐5MoO3), and the radiation attenuation measurements were carried out experimentally. The composites displayed acceptable x‐ray absorbing capabilities. 85C2H4‐15MoO3 polymer composite (DT1) showed optimal shielding in comparison with concrete. DT1 has an approximate HVL like concrete while it is 54.3% lighter than concrete. 85C2H4‐15MoO3 polymer composite is 1.5%, 0.8%, and 6.3% higher in linear attenuation coefficient than concrete at 60, 70, and 80 kVps, respectively. This implies that DT1 can effectively replace concrete at dental diagnostic energies.

Exploring the perceptions of radiographers pertaining to the provision of quality radiological services in Zimbabwe

IntroductionRadiology is part of the service industry; therefore, there is a need to understand quality and its associated factors. The cost of poor service quality is a loss of competitive advantage, increased litigation, misdiagnosis, unnecessary radiation exposure, and patient mortality. There has been little research into the factors influencing the quality of radiological services in Zimbabwe. This work, therefore, aimed to explore the radiographer's perceptions of the factors that affect the quality of radiological services at central hospitals in the Harare Metropolitan Province. MethodsA qualitative, explorative study applying the SERVQUAL model was carried out. One-on-one interviews with 10 purposively sampled radiographers employed at central hospitals in the Harare Metropolitan Province were conducted. The data were managed by Nvivo 12 (QSR International) and analyzed by framework analysis. ResultsRadiographer's perceptions of the factors that affect the quality of radiological services were categorized by five themes namely; i. Tangibles - the physical appearance of the radiology department and facilities, ii. Reliability and dependability – the ability to perform the promised service dependably and accurately, iii. Responsiveness - the willingness to help patients and provide prompt service, iv. Assurance - the knowledge and courtesy of radiology staff and their ability to inspire trust and confidence, and v. Empathy - caring, the individualized attention the radiology department provides to its patients. ConclusionEconomically viable, well-designed national strategies are needed to prioritize and fund radiology in Zimbabwe and other resource-constrained settings. Recognition of acquired specialist skills by radiographers to halt the exodus and training of radiologists, radiology nurses, medical physicists, and biomedical engineers by local institutions will go a long way in improving the quality of radiological services.

Establishing national diagnostic reference levels in radiography, mammography, and dual-energy x-ray absorptiometry services in Ireland and comparing these with European diagnostic reference levels.

The aim of this work was to establish national diagnostic reference levels (DRLs) in Ireland and compare these to existing European DRLs where available. This work surveyed all radiological facilities providing radiography, mammography, and dual-energy x-ray absorptiometry (DXA) services in Ireland. A list of common procedures and clinical tasks was established. A national database of service providers was used to identify the appropriate medical radiological facilities providing these services. These facilities were issued with an online survey. National DRLs were set as the 75th percentile of the distribution of median values obtained. A national median dose was also established. The broad categorisation of equipment type was also considered. Where differences between DRLs established using different detector types were deemed statistically significant, equipment-specific national DRLs were established. National DRLs were established for 12 adult radiography projections. Equipment-specific (computed radiography and digital radiography) adult DRLs were established for four radiography projections. Paediatric DRLs were established for 11 radiography projections, including two based on clinical indications, for a range of paediatric weight categories. National DRLs were established for unilateral two-view mammography and breast tomosynthesis as well as for four DXA clinical indications and projections. All but one Irish DRL figure was found to be below or equal to European data. This work provided a unique opportunity to establish national DRLs based on census data for a range of procedures and clinical tasks across radiography, mammography and DXA and compare these with European levels. This work established national diagnostic reference levels (DRLs) based on census data for a range of procedures and clinical tasks across radiography, mammography and dual-energy x-ray absorptiometry. The establishment of national DRLs is an essential component in the optimisation of patient radiation dose. • Diagnostic reference levels are easily measured quantities intended for use as an aid to optimise patient dose and to identify when levels of patient dose are unusually high. • Data from all medical radiological facilities in Ireland was obtained to establish national diagnostic reference level (DRL) values and national median dose values in radiography, x-ray breast imaging and dual-energy x-ray absorptiometry (DXA) scanning and these were compared to existing European DRLs where available. • National DRL values were established for the first time in breast tomosynthesis, DXA scanning, and paediatric radiography.

Mobile X-ray services in nursing homes as an enabler to healthcare-in-place for residents: informal carers’ views

BackgroundInformal carers (ICs) of residents living in nursing homes (NH) have a key role in the care of residents, including making decisions about and providing care. As radiology has a role in decision making about care, it is important to understand IC’s perspectives about resident’s use of mobile X-ray services (MXS). The aim was to explore the perspectives of ICs of residents living in nursing homes about the use of MXS.MethodsFrom November 2020 to February 2021, twenty ICs of residents living in four nursing homes in different areas of one Australian city participated. Their perspectives of MXS, including benefits and barriers, were explored in semi-structured interviews. Data were analysed using thematic analysis.ResultsICs were resident’s children (80%) and spouses (20%). One resident had received a MXS. Four themes were developed: (1) a priority for resident well-being, where ICs were positive about using MXS, because residents could receive healthcare without transfer; (2) MXS could reduce carer burden; (3) economic considerations, where MXS could reduce health system burden but the MXS call-out fee could result in health inequities; and (4) pathways to translation, including the need to improve consumer awareness of MXS, ensure effective processes to using MXS,, consider nursing home staff levels to manage MXS and ICs expectations about quality and availability of MXS.ConclusionsICs consider MXS can benefit resident well-being by potentially reducing transfers to hospital or radiology facilities and advocated equitable access. ICs cautioned that the quality and safety of healthcare delivered in nursing homes should equal what they would receive in hospitals.

Insights From a Clinically Orientated Workshop on Health Care Cybersecurity and Medical Technology: Observational Study and Thematic Analysis.

Health care professionals receive little training on the digital technologies that their patients rely on. Consequently, practitioners may face significant barriers when providing care to patients experiencing digitally mediated harms (eg, medical device failures and cybersecurity exploits). Here, we explore the impact of technological failures in clinical terms. Our study explored the key challenges faced by frontline health care workers during digital events, identified gaps in clinical training and guidance, and proposes a set of recommendations for improving digital clinical practice. A qualitative study involving a 1-day workshop of 52 participants, internationally attended, with multistakeholder participation. Participants engaged in table-top exercises and group discussions focused on medical scenarios complicated by technology (eg, malfunctioning ventilators and malicious hacks on health care apps). Extensive notes from 5 scribes were retrospectively analyzed and a thematic analysis was performed to extract and synthesize data. Clinicians reported novel forms of harm related to technology (eg, geofencing in domestic violence and errors related to interconnected fetal monitoring systems) and barriers impeding adverse event reporting (eg, time constraints and postmortem device disposal). Challenges to providing effective patient care included a lack of clinical suspicion of device failures, unfamiliarity with equipment, and an absence of digitally tailored clinical protocols. Participants agreed that cyberattacks should be classified as major incidents, with the repurposing of existing crisis resources. Treatment of patients was determined by the role technology played in clinical management, such that those reliant on potentially compromised laboratory or radiological facilities were prioritized. Here, we have framed digital events through a clinical lens, described in terms of their end-point impact on the patient. In doing so, we have developed a series of recommendations for ensuring responses to digital events are tailored to clinical needs and center patient care.

Bilateral hydatid cyst of the breast: a case report and review of the literature.

Hydatid cyst disease is a parasitic infestation caused by the tapeworm Echinococcus granulosus. The incidence of the disease is 1-200 cases per 100000. The usual presentation is the formation of fluid-filled cysts in the liver or lungs and, less commonly, in the brain. The breast is a rare site of presentation for this disease. An isolated hydatid cyst in the breast is very rare, even in endemic regions, occurring in only 0.27% of all hydatid cases. Although these cases are very rare, they should be considered severe. A hydatid breast cyst may mimic a fibroadenoma, phyllodes tumor, chronic abscess, or even carcinoma. Therefore, a high incidence of misdiagnosis may occur. Preoperative diagnosis can be made using needle aspiration and imaging facilities such as breast ultrasonography, mammograms, and computerized topographic images. Nevertheless, in most cases, the final diagnosis cannot be made until the pathological report is obtained postsurgery. This paper reports the first case of a bilateral hydatid cyst of the breast that was diagnosed preoperatively by radiological facilities. We present the patient history, physical examination, and investigations, discuss the risk factors, and present our treatment plan.

Number of computed tomography scanners and regional disparities based on population and medical resources in Japan.

This study aimed to discover the associations between the number of computed tomography (CT) scanners and the population, as well as number of medical resources to identify regional disparities in Japan. The number of CT scanners was tabulated for each detector row of CT scanners for hospitals and clinics in each prefecture. The number of CT scanners, patients, medical doctors, radiological technologists, facilities, and beds per 100,000 population was compared. Additionally, the number of hospitals with ≥ 200 beds and multidetector-row CT scanners with ≥ 64 rows were tabulated, and their ratios were calculated. Medical institutions in Japan have installed 14,595 scanners. CT scanners per 100,000 population were the highest in Kochi Prefecture, although the number of CT scanners in hospitals was the highest in Tokyo Prefecture. Multivariate analysis revealed the number of radiological technologists (β coefficient: 0.49; P = 0.03), facilities (β coefficient: 0.12; P < 0.01) and beds (β coefficient: 0.46; P < 0.01) as independent factors for the number of CT scanners. Prefectures with a high proportion of hospitals with ≥ 200 beds also had a relatively high proportion of CT scanners with ≥ 64 rows (P < 0.01). Our survey revealed an association between regional disparities in the number of CT scanners in Japan, the population, and number of medical resources. A positive correlation was found between hospital size and number of CT scanners with ≥ 64 rows.

A Review of Radiation Protection Standards for Workers in Hospital Radiology: A Narrative Literature Review

One of the goals of radiation protection is to prevent stochastic effects from occurring and to limit the chances of stochastic effects occurring to a limit value that is acceptable to society. This literature review aims to describe radiation protection standards for workers in hospital radiology. To prevent non-stochastic effects, a limit of 0.5 Sv (50 rem) in 1 year was used for all tissues except the lens of the eye. For eyepieces, the recommended annual limit is 0.15 Sv (15 rem). This limit value is used either for radiation reception by a single tissue or for radiation reception by multiple organs. To limit stochastic effects, the annual effective equivalent dose (HE) limit for whole-body radiation reception is 50 mSv (5 rem). The radiation protection equipment that must be available at a radio diagnostic facility is a lead apron, thyroid shield, gonad protectors, gloves, Pb goggles, and lead curtains. In conclusion, radiation protection equipment must be provided by radiology facility operators and used by radiation workers, especially radiologists and other competent doctors. Periodic inspection and standardized maintenance of radiation shields must be carried out for the sake of public safety.

A COMPUTER PROGRAM FOR THE DETERMINATION OF ABSOLUTE ACTIVITIES IN CONTAMINATIONS AND SKIN DOSES.

At radiological facilities, protocols are in place to guide radiation protection personnel in the event of the radioactive contamination of surfaces. A count rate measurement is performed with a portable contamination survey meter and a sample of the contamination is taken for later analysis and identification of the radionuclides. If the contaminated surface was of a worker's skin, then a skin dose assessment is made. The determination of the absolute activity of the radionuclides of the contamination often rests on the assumed detection efficiency of the survey meter used in the initial counting. This may lead to important underestimation or overestimation of the radionuclides' activities as the detection efficiency of the instrument must depend on the radiation type, the energy and the backscatter characteristics of the surface. This paper reports on a user-friendly computer application that relies on databases of pre-calculated detection efficiencies and skin dose rate conversion factors for the accurate assessment of contamination activities and skin doses. The results of some cases are compared with the available data in the literature.

A New Approach to the Improvement of Energy Efficiency in Radiology Practices.

We examined ways to improve energy efficiency in radiology by using regenerative and energy-friendly technology in the construction and operation of two radiological facilities. In the years 2009 to 2010 an energy-optimized medical center with different clinical disciplines and a radiology practice was built. We used regenerative energy production (photovoltaic system, 29.92 kWp). A heat exchanger was also used to regain thermal energy to support heating of the building, thereby reducing cooling energy consumption. The practice operates a 1.5 T MRI machine and a computed tomography scanner. Derived from our experiences, an open MRI practice was built nearby in 2019. The building was constructed using an energy-saving technique. A photovoltaic system with a 10 kWh lithium-ion battery was installed. The practice operates a 0.35 T open MRI machine. Energy optimization of the medical center resulted in an annual CO2 reduction of about 54 % from 153 146 to 70 631 kg/year. Energy costs were reduced by 32.5 %. The heat exchanger proved to be highly efficient. For the open MRI practice, energy consumption in 2020 was 38 810 kWh: 14 800 kWh for the heating/cooling of the building, and 24 010 kWh for the imaging systems and IT. Net energy production of the solar array was 30 846 kWh. Net energy consumption for the whole project was 8397 kWh/year. CO2 production of the practice was 1839 kg CO2/year. Regenerative energy, energy recuperation, and use of energy-efficient imaging systems can yield considerable improvement of the CO2 footprint in radiology practices. · Radiology, in particular MRI, has high energy consumption.. · A heat exchanger can regain thermal energy from MRI machines to support room heating.. · Low-field MRI with permanent magnets consumes far less energy.. · Energy optimization results in less CO2 production and lower operation costs.. · Klein HM. A New Approach to the Improvement of Energy Efficiency in Radiology Practices. Fortschr Röntgenstr 2023; 195: 416 - 425.

The Optimizing Lung Screening Trial (WF-20817CD): Multicenter Randomized Effectiveness Implementation Trial to Increase Tobacco Use Cessation for Individuals Undergoing Lung Screening

One-half of all people who undergo lung cancer screening (LCS) currently use tobacco. However, few published studies have explored how to implement effective tobacco use treatment optimally during the LCS encounter. Was the Optimizing Lung Screening intervention (OaSiS) effective at reducing tobacco use among patients undergoing LCS in community-based radiology facilities? The OaSiS study (National Cancer Institute [NCI] Protocol No.: WF-20817CD) is an effectiveness-implementation hybrid type II cluster randomized trial of radiology facilities conducted in partnership with the Wake Forest National Cancer Institute Community Oncology Research Program research base. We randomly assigned 26 radiology facilities in 20 states to the intervention or usual care group. Staff at intervention facilities implemented a variety of strategies targeting the clinic and care team. Eligible patient participants were aged 55 to 77 years undergoing LCS and currently using tobacco. Of 1,094 who completed a baseline survey (523 intervention group, 471 control group) immediately before the LCS appointment, 956 completed the 6-month follow-up (86%retention rate). Fifty-four percent of those who reported not using tobacco at 6months completed biochemical verification via mailed cotinine assay. Generalized estimating equation marginal models were used in an intention-to-treat analysis to predict 7-day tobacco use abstinence. The average self-reported abstinence among participants varied considerably across facilities (0%-27%). Despite a significant increase in average cessation rate over time (0%at baseline to approximately 13%at 6months; P< .0001), tobacco use did not differ by trial group at 14days (OR, 0.96; 95%CI, 0.46-1.99; P= .90), 3months (OR, 1.17; 95%CI, 0.69-1.99; P= .56), or 6months (OR, 0.97; 95%CI, 0.65-1.43; P= .87). The OaSiS trial participants showed a significant reduction in tobacco use over time, but no difference by trial arm was found. ClinicalTrials.gov; No.: NCT03291587; URL: www. gov.

The Impact of Extreme Neighborhood Socioeconomic Deprivation on Access to American College of Radiology-accredited Advanced Imaging Facilities.

The Impact of Extreme Neighborhood Socioeconomic Deprivation on Access to American College of Radiology-accredited Advanced Imaging Facilities.

Analysis of Acceptance of Radiation Doses for Radiation Workers in the Radiology Facility of Bali Mandara Hospital

Aims:&#x0D; &#x0D; To determine the dose of radiation received by radiation workers at the Radiology Facility of Bali Mandara Hospital based on differences in work professions,&#x0D; Knowing the suitability of the amount of radiation dose received by radiation workers is still within the limits determined by BAPETEN&#x0D; To find out the difference in receiving external radiation doses to the radiation worker profession at Bali Mandara Hospital.&#x0D; &#x0D; Place and Duration of Study: Radiology Facility at Bali Mandara Hospital, between August 2022 and October 2022.&#x0D; Methodology: Using quartile value determination and statistical tests, namely the one sample t-test and manova test.&#x0D; Results: The data used is radiation dose data that has been measured/read by Surabaya Health Facilities Security Center in the 2018-2021 period. First quartile value (, second quartile ( and third quartile ( for the profession of Doctor Sp.Rad. of 0.149 mSv, 0.191 mSv and 0.211 mSv, Radiographer profession of 0.169 mSv, 0.184 mSv and 0.198 mSv, Nursing profession of 0.167 mSv, 0.185 mSv and 0.195 mSv, Medical Physicist profession of 0.148 mSv, 0.185 mSv and 0.196 istrative Personnel profession of 0.091 mSv, 0.181 mSv and 0.209 mSv. From the results of the statistical test, namely the t-test, decision-making was obtained, namely there was no difference between the radiation dose received by radiation workers and the NBD that had been determined by BAPETEN.&#x0D; Conclusion: In this study, it was known that the radiation dose received by radiation workers based on professional differences was still within the dose limit value set by BAPETEN.

The Potential Interactions of Novec 1230 and Its Thermal Degradation Products with Actinide Metals and Oxides

The environmentally friendly and mainly chemically inert fire suppressant, Novec 1230, is being increasingly used worldwide. However, no published study has considered using Novec 1230 with fires involving radioactive material including actinides; therefore, this research note focuses on the possible interactions between Novec 1230 and its thermal degradation products (TDPs) with some actinide compounds (e.g., actinide metal and oxides) commonly present in a radiological facility in the event of a fire. Previous studies of halogenated fire suppressants used in actinide metal fires indicate a possibility for Novec 1230 or its TDPs to chemically interact with actinide compounds at elevated temperatures; however, these reactions are highly unlikely to cause either runaway exothermic reactions or gaseous actinide release.

Ensuring security when using radioactive materials in a radiological facility

Ensuring security when using radioactive materials in a radiological facility

Dying Undiagnosed: Challenges of Management of Ovarian Tumours in a Resource-Poor Setting in North-western Nigeria.

Ovarian cancer is the second most prevalent but most lethal gynaecologic malignancy in our institution. This study aimed at determining the rate of non-diagnosis in suspected lesions and reviewing the management challenges of ovarian tumours highly suspicious for malignancy in our hospital. A three-year retrospective review of patients' records from the ward, clinic, theatre, and histopathology laboratory was carried out. Cases with high indices of suspicion for ovarian cancer (ovarian tumour with malignant radiologic features with any of ascites, pleural effusion, as well as cachexia, anaemia, or evidence of metastasis) were included. In-depth interviews were carried out with a consultant from each specialty of Radiology, Radio-oncology, Pathology, and Gynaecologic oncology at the gynaecologic oncology multidisciplinary team meeting. One hundred and twenty-two cases of highly suspicious ovarian malignancies were seen with a mean age of 40.6 years. Of these, 28 (23%) had surgery and 77% did not have any form of histological diagnosis. Of those that had surgery, 13 (46.4%) had upfront surgery and 15 (53.6%) neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Only two cases had documented complete (R0) debulking. Among those that had upfront surgery, one case (7.7%) was an ovarian fibroid and one (7.7%) was a fibrosarcoma while two cases (15.4%) were borderline ovarian tumours. Chemotherapy was commenced based on malignant cells on ascitic or pleural fluid cytology in three cases. Of all the malignant cases, epithelial carcinomas were commonest accounting for 48%. Aside from the general late presentation of cases, insufficient funds for treatment, poor coverage of health insurance for cancer care, unavailability of routine immunohistochemistry, lack of germline and somatic testing, non-availability or prohibitive cost of some chemotherapeutic agents, unavailability of maintenance therapies, inadequate capacity to manage toxicities, inadequate skill across all specialties, unavailability / erratic function of computerized tomography scans and unavailable positron emission tomography, lack of interventional radiology facility amongst others were all identified as challenges to management. Most patients with tumours highly suspicious for ovarian cancers did not get a histologic diagnosis and probably died undiagnosed. Management of ovarian cancer remains a challenge despite advances in surgical and chemotherapeutic options. Health insurance for all, infrastructure development, and training of all disciplines involved is recommended.