Radiology Services Research Articles

CT AND MRI REFERRAL PRACTICES UNDER MANDATORY SOCIAL HEALTH INSURANCE: A SURVEY OF RADIOLOGISTS AND GPS

Background. Modern imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), are vital for diagnosing and monitoring diseases. Despite their value, challenges include high costs, radiation risks, and limited accessibility. Effective use requires collaboration between general practitioners (GPs) and radiologists. Misguided referrals burden healthcare systems, while underuse delays diagnoses. Objective. This study assesses GPs’ awareness of CT/MRI indications, examines challenges in referrals under the mandatory social health insurance framework, and analyzes radiologists’ views on unjustified referrals. Methods. Two surveys were conducted: one among 108 radiologists in Almaty and Astana and another among 163 GPs in Almaty and the Almaty region. Questionnaires included closed and open-ended questions, and responses were analyzed to identify barriers and optimize diagnostic processes. Results. Among radiologists, 56.5% reported more than five unjustified referrals per month, with CT being the most overused modality (80.6%). Reasons included GPs’ lack of knowledge about indications (66.7%) and patient pressure (67.6%). GPs cited limited mandatory social health insurance framework quotas (29.3%) and long waiting times (19.9%) as significant barriers. Both groups emphasized the need for clear clinical guidelines, enhanced education, and better interprofessional communication. Conclusion: Systemic improvements in radiology services are necessary. Key recommendations include developing national clinical guidelines, educating GPs on CT/ MRI indications, and streamlining administrative processes. These measures will reduce unjustified imaging, improve resource use, and enhance patient care.

Assessment of the importance of teleradiology services in the opinion of electroradiologists in Poland

Teleradiology is a modern service that allows for the transmission of imaging studies between facilities, clinicians, and qualified medical staff. It requires employers to meet many important legal formal criteria to properly deliver services. Teleradiology has significantly improved access to radiological services, including radiological examinations, and to specialists in narrow fields of radiology. The development of teleradiology and telemedicine, despite many benefits, also brings many risks, such as technical errors and improper service delivery. The study aims to assess the importance of teleradiology in the perception of electroradiologists who mediate in the delivery of this service, often overlooked by employers in its organization. The survey was conducted among actively practicing electroradiologists, particularly those working with teleradiology services. Electroradiologists in the study identified the advantages and disadvantages of the service, as well as various aspects related to the organization of teleradiology services. The study also aimed to raise awareness among personnel providing telemedical services. To asses the normality of distribution of the result obtained the following were used Kolmogorov-Smirnov test of normality of distribution, and non-parametric tests were used in their analysis and correlations between the some of the values. The research group (N = 344) consisted of licensed electroradiologists (N = 99, 28.8%), master's degree holders in electroradiology (31.4%, N = 108), and electroradiology technicians (N = 137, 39.8%). Of these, 276 were female (80.2%) and 68 were male (19.8%) aged 23-67 years. Surveyed electroradiologists rated teleradiology services positively. The respondents most frequently pointed out 3 advantages of teleradiology: increased service accessibility, streamlining of radiology department work, and better allocation of human resources. The most commonly mentioned disadvantages of teleradiology among respondents include the possibility of errors in radiological procedures due to the lack of direct involvement of a radiologist in supervising the examination, the absence of a real-time monitoring system for the service, and the lack of standardization of hospital information systems. Med Pr Work Health Saf. 2024;75(6):511-519.

Imperative for a health-centred focus on climate change in radiology.

Climate change negatively impacts individual and population-level health through multiple pathways, including poor air quality, extreme heat and changes in infectious disease. These health effects will lead to higher health system and medical imaging utilisation. At the same time, the delivery of radiology services generates substantial greenhouse gas emissions. Mitigation strategies to reduce the environmental impact of medical imaging and adaptation strategies to build resiliency to current and future impacts of climate change in radiology should be centred on human health. A health-centred response in radiology reinforces the role of radiologists as physicians and emphasises the opportunity for medical imaging to promote health and advance our understanding of climate-related health effects. This review discusses the need for a health-centred focus on climate change in radiology, including the effects of climate change on human health and health systems, intersection of climate change with health equity, health benefits of climate action and opportunities to leverage medical imaging to improve human health.

Integrating Global Health Initiatives into Routine Radiology Workflow in the USA.

Radiologist shortages and lack of access to radiology services are common issues in low- and middle-income countries around the world. Teleradiology offers radiologists an opportunity to contribute to global health and support hospital systems in low-resource regions remotely. Challenges can occur when determining how to integrate the new remote worklist, how radiologists will view and report exams, and how a US host site can ensure safety and privacy across the different systems. In this manuscript, we describe our experience integrating exams performed at a remote hospital system in Ethiopia into a routine radiology worklist in the USA.

P001 The patient journey to diagnosis for axial Spondyloarthritis - The challenges in primary care and the positive impact of specialist axial SpA services

Abstract Background and aims The mean average time to diagnosis (TTD) in the UK for axial SpA is currently 8.29 yearsi. However, it should be possible to ensure diagnosis within 12 months of symptom onset to optimise clinical outcomesii. Current evidence suggests significant variability in the patient journey, particularly within primary care, where patients have repeat consultations for axial SpA related symptoms before being referred onward to rheumatologyiii. The National Axial Spondyloarthritis Society (NASS) TTD patient survey assesses where in the pathway patients experience most delays and the factors that may be driving these pinch points. Methods We developed a patient self-administered post-diagnosis axial SpA online survey form, and analysed the results along the pathway. Data were collected from 534 patients diagnosed since January 2021. Results The average time from first GP appointment to rheumatology referral was the longest wait, at 4.33 years (53% of the total delay). Other elements of the pathway were (mean): • 2.49 years (31%) from experiencing symptoms to seeking help from a GP, • 0.39 years (5%) waiting for a first rheumatology appointment following referral, • 0.88 years (11%) for the time from first appointment in rheumatology to formal diagnosis. Patients also reported seeing healthcare practitioners multiple times pre diagnosis. Physiotherapists (66%, n = 353) and GPs (63%, n = 337) were seen most frequently, with chiropractors (19%, n = 103) and osteopaths (17%, n = 93) seeing around a fifth of patients repeatedly. P001 Figure 1.Proportional split of average (mean) time to diagnosis by pathway. P001 Figure 2.Number of visits to other Health Care Professionals (HCPs) before receiving a formal diagnosis. Whilst specialist clinics are not possible everywhere, patients in these settings get a swifter diagnosis due to increased expertise, greater access to co-located MSK radiology services and expedited triage out of general rheumatology pools.

INTRA-ARTERIAL MIGRATION OF A BLUNT GUIDEWIRE DURING FEMORAL VENOUS CATHETERIZATION: A CLINICAL CASE REPORT

The use of a central venous catheter in an intensive care unit is a common practice. The femoral line is the emergency venous access of choice because it is quickly accessible and easily identifiable by the operator. However, the complications associated with this procedure remain quite considerable. The accidental migration of the guidewire during the Seldinger technique is exceptional but potentially dangerous complications given the risk of vascular and cardiac perforation. We report a rare case of an accidental intra-arterial femoral migration of a blunt guidewire when the venous central line passed mistakenly over the guidewire in the femoral artery. The removal of the guidewire by interventional radiology remains the solution of choice in such a situation, which could not be achieve due to the impossibility of moving the patient to radiology service because of her unstable hemodynamic conditions.

Assessing readiness of health facilities for implementing a social health insurance programme in Khyber Pakhtunkhwa, Pakistan

Objective: To assess the readiness of empanelled health facilities, encompassing secondary and tertiary care hospitalsunder the SCP Programme, to effectively implement the benefits package.Method: A cross-sectional survey was conducted in 38 public and private hospitals providing services under the SCPProgramme across 10 districts of KP. The study utilized a Health Facility Assessment tool adapted from WHO's ServiceAvailability Readiness Assessment and other frameworks. The readiness was measured across 8 domains includingInfrastructure, Governance, Health Information System, Infection Control, Sehat Card desk services, Billing & Reimbursement,Clinical Services, and Clinical Support Services. Data was collected from October 2022 to February 2023.Results: Based on our assessment, tertiary hospitals generally demonstrated a higher level of readiness compared tosecondary hospitals across various domains. Tertiary hospitals demonstrated better readiness for access and infrastructure(92%), governance and leadership (97%) and infection prevention (79%). Secondary hospitals showed lower readinessscores in areas like HMIS (65%), billing & reimbursements (75%), and infection control (64%). The tertiary facilitiesoutperformed secondary ones in clinical and support services, including emergency rooms, intensive care, surgery,obstetrics, laboratory services, blood banks, radiology, and pharmaceutical services. The overall preparedness wassignificantly higher in urban, relative to rural, hospitals across most indicators.Conclusion: The study underscores the need for targeted capacity building in KP's health facilities, particularly secondaryand remote hospitals. These improvements are crucial for successful implementation and expansion of the SCP programme.Keywords: Health Facility Readiness, Social Health Insurance, Sehat Card Plus Programme, Khyber Pakhtunkhwa, HealthServices Evaluation.

Relationship between Implementation and Performance of Integrated Information System with Service Efficiency in Improving Service Quality in Radiology Installation of Bogor City Regional General Hospital

Radiology services are a crucial component of the healthcare system that requires efficiency in its processes. Resource limitations and increasing demand for services underscore the importance of improving efficiency. To enhance service quality and operational efficiency, the implementation of an integrated information system has become a key focus for hospital management. Improving service quality and operational efficiency through the application of an integrated information system is also dependent on the reliability and performance of the system itself. This study aims to examine the relationship between the implementation and performance of an integrated information system with service efficiency in enhancing service quality in the radiology department of RSUD Kota Bogor. The research uses a quantitative approach with two independent variables: the implementation of the integrated information system and the reliability and quality of the integrated information system. The dependent variable is the quality of radiology services, and the intervening variable is radiology service efficiency. Data collection methods include observations, questionnaires, and documentation studies. The sample consists of 30 employees working in the radiology department of RSUD Kota Bogor and 30 patients receiving services in the radiology department. Data processing and presentation were conducted using path analysis with Structural Equation Modeling (SEM-PLS) using SmartPLS software. The results of the data analysis indicate that: (1) The implementation of the integrated information system does not have a significant relationship with radiology service efficiency; However, the reliability and performance of the system do have a strong relationship with radiology service efficiency. (2) The implementation and performance of the integrated information system do not have a significant relationship with service quality in the radiology department. (3) Radiology service efficiency has a significant relationship with service quality in the radiology department. (4) Radiology service efficiency, as a mediator, is not strong enough to enhance the relationship between the implementation and performance of the integrated information system and service quality in the radiology department. This study is expected to provide a comprehensive overview of the relationship between the implementation and performance of an integrated information system with service efficiency in enhancing service quality in the radiology department. The findings may serve as input for the management of RSUD Kota Bogor in optimizing the use of an integrated information system to improve radiology service efficiency, which is expected to impact the quality of services in the radiology department.

A strategy for achieving optimisation of radiological protection in digital radiology proposed by ICRP

Radiology is now predominantly a digital medium and this has extended the flexibility, efficiency and application of medical imaging. Achieving the full benefit of digital radiology requires images to be of sufficient quality to make a reliable diagnosis for each patient, while minimising risks from radiation exposure, and so involves a careful balance between competing objectives. When an optimisation programme is undertaken, a knowledge of patient doses from surveys can be valuable in identifying areas needing attention. However, any dose reduction measures must not degrade image quality to the extent that it is inadequate for the clinical purpose. The move to digital imaging has enabled versatile image acquisition and presentation, including multi-modality display and quantitative assessment, with post-processing options that adjust for optimal viewing. This means that the appearance of an image is unlikely to give any indication when the dose is higher than necessary. Moreover, options to improve performance of imaging equipment add to its complexity, so operators require extensive training to be able to achieve this. Optimisation is a continuous rather than single stage process that requires regular monitoring, review, and analysis of performance feeding into improvement and development of imaging protocols. The ICRP is in the process of publishing two reports about optimisation in digital radiology. The first report sets out components needed to ensure that a radiology service can carry optimisation through. It describes how imaging professionals should work together as a team and explains the benefits of having appropriate methodologies to monitor performance, together with the knowledge and expertise required to use them effectively. It emphasises the need for development of organisational processes that ensure tasks are carried out. The second ICRP report deals with practical requirements for optimisation of different digital radiology modalities, and builds on information provided in earlier modality specific ICRP publications.

Empowering junior doctors: A study on the feasibility and efficacy of ultrasound AAA screening in rural Australia

Purposes Abdominal Aortic Aneurysm (AAA) screening via ultrasound in Caucasian males aged 65 and older has proven cost-effective in metropolitan areas. Evidence suggests that with adequate training, individuals without prior sonography experience can achieve accurate aortic measurements. This study evaluates the capability of junior doctors, after brief training, to conduct reliable AAA ultrasound screenings in a rural hospital setting, addressing the gap in speciality surgical services. Methods Three junior doctors participated in a 2-hour practical ultrasound training, subsequently performing scans on both inpatients and community volunteers at a regional hospital. The analysis focused on measurement discrepancies within a 5 mm clinically acceptable difference, scanning efficiency, and aneurysm detection accuracy. Results A total of 71 participants were included. Among the screenings, 81.7% fell within the clinically acceptable discrepancy range, with 72.7% accuracy in inpatient scans and 95.5% in volunteer scans. Measurement reproducibility improved significantly with the standardisation of ultrasound techniques, and there was excellent agreement among operators in detecting aneurysms. Notably, scanning efficiency improved from the inpatient group to the volunteer group with statistical significance. Conclusions Junior doctors demonstrated the ability to efficiently and reproducibly measure the infrarenal aortic diameter at a level comparable to experienced sonographers after only 2 hours of training. A single day of supervised practice is recommended to ensure standardised ultrasound technique. This approach offers a practical, cost-effective supplement to specialist radiology services in rural areas, enhancing access to critical screening procedures without proposing the replacement of professional sonographers.

EDI&S SO04 Accuracy of Outsourced Radiology Reports in Emergency Surgical Care; Do they provide a high-quality cost-effective service?

Abstract Background Computed Tomography (CT) scans play a crucial role in emergency surgical care enabling proper management and prompt decision making. In our study we aimed to compare abdominal CT scan reports created by inhouse radiologists to those created by outsourced radiology reporting service for patients admitted with acute surgical pathologies. The study also looked at the impact of the reporting style (free text or structured format) on the quality of scan reports. Method The study was conducted in a busy general surgery unit located in the North West of England. Patients who were admitted acutely under the surgical specialty and had abdominal CT scans over a period of three months from August 2023 to October 2023 were included. Patients who were admitted following trauma or had non abdominal CT scans have been excluded. Statistical analysis was conducted to compare inhouse radiology reports to outsourced ones. Scan reports were thoroughly scrutinised to identify whether they included all relevant information needed and whether they were written in structured or free text format. Results A total of 192 patients were identified with a median age of 59 years. Outsourced radiology reports were found to be significantly underreporting comments on the biliary system (OR=0.369, P=0.046), spleen (OR=0.414, P=0.044), kidneys (OR=0.354, P=0.027), lymph nodes (OR=0.412, P=0.011), mesentery and peritoneum (OR=0.364, P=0.004), vasculature (OR=0.381, P=0.002), bones and soft tissues (OR=0.273, P=0.003), as well as lung bases (OR=0.300, P=0.009). Structured format was found to outperform free text style on comments on spleen (OR=8.064, P=0.044), adrenals (OR=8.468, P=0.039), mesentery and peritoneum (OR=4.618, P=0.000), as well as bone and soft tissues (OR=9.295, P=0.031). Conclusion CT scans reported by outsourced radiology service were found to be significantly underreporting certain key elements. Additionally, free style reporting format was found to miss some crucial aspects of abdominal scan reports. That adds further challenges to clinicians assessing and managing acute surgical patients. Further studies auditing different outsourced companies are recommended to ensure patients are provided with high-quality cost-effective emergency service.

OGC SO22 - Accuracy of CT and FDG/PET clinical staging within a dedicated multidisciplinary service for patients with oesophago-gastric cancer

Abstract Background Accurate staging for oesophago-gastric cancer is important in ensuring correct treatment pathways, avoiding unnecessary surgery and providing prognostication for patients. Previously, cross sectional imaging in accurately providing tumour (T) and nodal (N) staging has been variable for upper GI malignancies, with usage of invasive investigations such as EUS to provide more specific local staging. With the increased utilisation of specialist multidisciplinary involvement and improved technology, we aimed to assess whether CT and PET imaging may be able to provide sufficiently accurate staging required for treatment decision making. Method All patients who underwent oesoophagogastric resections between January 2022 and March 2024 were identified from our surgical database. Patients were included if they had oesophago-gastric cancer, and underwent curative resection without neo-adjuvant treatment. Data collected included age, gender, location of primary tumour, CT/PET staging, and final histology. Outcomes assessed included rate of understaging in clinical and pathological T and N staging, and sensitivity and specificity of imaging in identifying presence of nodal disease. Results 38 patients were included in this analysis. For oesophageal and GOJ cancers, T stage under-reporting occurred in 6/27 (22%) patients, and N under-reporting in 7/27 (27%) patients. Radiological staging correlated with final pathological staging in 55% of T staging and 59% of N staging. Sensitivity (55.56%, 95% CI 21-86%) and specificity (72.2%, 95% CI 46.5-90.3%) for nodal disease on CT/PET was low, however no tumour or nodal under-staging would have impacted management. Gastric cancer staging accuracy assessment was limited by small numbers (n=12), however T under-staging occurred in 5/12 (42%) patients and N under-staging occurred in 5/11 patients (45%). Conclusion Involvement of dedicated radiology services in multidisciplinary care for oesophago-gastric cancer provides adequate radiological staging to guide treatment. Gastric cancer clinical staging requires laparoscopic and endoscopic assessment for accurate tumour assessment and management guidance. Radiological under-staging is less common in oesophageal and GOJ tumours than gastric cancer and has minimal impact on patient management.

Bridging the gap: opportunities, challenges, and future directions for teleradiology in rural healthcare

Teleradiology, the electronic transmission of radiological images and data for diagnostic purposes, holds significant promise for improving healthcare access in rural and underserved regions. This review explores the opportunities and challenges of implementing teleradiology in rural settings, where limited access to radiology services exacerbates healthcare disparities. Teleradiology offers multiple benefits, including improved access to timely diagnostics, enhanced decision-making, and cost savings for rural patients who would otherwise need to travel to urban centers for radiology services. It has shown positive outcomes globally, with examples in India, Mali, the Democratic Republic of Congo, and Brazil, demonstrating its feasibility and potential to reduce geographic health inequities. However, implementing teleradiology in these settings faces several challenges, such as technological limitations, workforce shortages, regulatory and legal barriers, data security concerns, and cultural acceptance issues. Solutions and recommendations include investments in infrastructure, workforce training, supportive regulatory frameworks, secure data management, and adaptable telehealth models that consider socioeconomic factors in rural areas. By addressing these challenges, stakeholders can enhance the impact of teleradiology in rural healthcare systems, ultimately contributing to reduced disparities and improved healthcare outcomes. This review provides a comprehensive overview of the current landscape and suggests actionable pathways for advancing teleradiology in rural settings worldwide.

ESTIMATION OF DOSE ESTIMATION USING THE SPECIFIC DOSE SIZE METHOD OF RADIOGRAPH IMAGE REPEAT ANALYSIS AS A FORM OF RADIATION SAFETY IN THE RADIOLOGY INSTALLATION OF KLATEN ISLAMIC HOSPITAL

Repeat analyses are radiographs that are not clinically acceptable and are requested to be retaken. The primary purpose of the repeat analyses program is to take corrective action, record the repeated radiographic images, and determine the cause of the repetition so that it can be minimized or even eliminated. Klaten Islamic Hospital needs to keep its radiology services optimal and safe for patients as a referral hospital. One indicator of the quality of service is the low repetition rate of radiographic images. This study aims to determine the percentage of factors causing the repetition of radiographic images and suggested solutions to minimize repeat radiographic images in the Radiology Department. Survey research with a quantitative approach to repeating radiographic images at the Radiology Department. The study was conducted in February-May 2024 using observation, survey, and documentation. The percentage of repetition of radiographic images at the Radiology Installation of Klaten Islamic Hospital in the first month was 2.72%, in the second month was 3.04%, in the third month was 4.05%, and in the fourth month was 3.43%. Factors causing the repetition of radiographic images include miscollimation (clipped), artifacts, exposure factors, tools, and patient movement. Suggested solutions to minimize the factors causing the repetition of radiographic images in the Radiology Installation of Klaten Islamic Hospital are good communication between radiographers and patients, double checking before exposure, clear instructions to patients, ensuring there are no objects that can become artifacts, using appropriate exposure parameters, calibrating and testing suitability regularly, reporting if there is equipment damage, and using immobilization techniques. Keywords: Repeat Analyses, Digital Radiography, radiation safety for patient.

Environmental Life Cycle Assessment of a U.S. Hospital-based Radiology Practice.

Background Climate change, driven primarily by human-induced greenhouse gas (GHG) emissions, poses major risks to human health. Health care contributes 8.5% of GHG emissions in the United States. Purpose To estimate the life cycle environmental impact of diagnostic radiology services within a single academic medical center. Materials and Methods This process-based life cycle assessment (LCA) of a diagnostic radiology department serving adult inpatient, outpatient, and emergency department patients in a U.S. hospital followed International Organization for Standardization (ISO 14040:2006) guidelines. System components included production and distribution of imaging equipment; energy use of imaging equipment, including MRI, CT, radiography and fluoroscopy, and US; production and use of other capital equipment; production of single-use, semidurable, and durable supplies and linens; and production and energy use from onsite data storage. Meters monitored the power usage of selected imaging equipment during April 2023. Modeling assumed an equipment lifespan of 10 years. Results are reported in kilotons of CO2 equivalent (kt CO2e) emissions per scan and over a 10-year period. A sensitivity analysis assessed variability of data. Results Over a decade, these radiology services generated 4.6 kt CO2e GHG emissions, with MRI responsible for 48% (2.2 of 4.6 kt CO2e) and CT responsible for 24% (1.1 of 4.6 kt CO2e) of cumulative emissions. Clinical use of imaging equipment (all modalities) accounted for 54% of departmental GHGs (2.5 of 4.6 kt CO2e). Other notable contributions include the production of imaging equipment (11%, 0.49 of 4.6 kt CO2e), the production and use of picture archiving and communication system workstations (11%, 0.48 of 4.6 kt CO2e), and linens production and laundering (10%, 0.47 of 4.6 kt CO2e). Conclusion Energy consumption from clinical use of imaging equipment accounted for more than 50% of departmental GHG emissions, with MRI and CT equipment as the major emitters. Other notable GHG contributors include the production of imaging equipment, the production and use of picture archiving and communication system workstations, and linens production and laundering. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Thrall in this issue.

Effect of Interprofessional Crisis Simulation Training in a Non-Operating Room Anesthesia Setting on Team Coordination: A Mixed Methods Study

Crisis resource management in non-operating room anesthesia (NORA) locations is challenging but can potentially be improved through interprofessional crisis simulation training (ICST). This mixed methods study aimed to evaluate the effect of a one-time training on team coordination in diagnostic and interventional magnetic resonance imaging locations. Personnel from anesthesia, radiology, and perioperative services (n = 87) underwent ICST over eight months. Team coordination among participants was assessed and compared at baseline, immediately after, and at three months after ICST using a validated instrument-the relational coordination index (RCI)-and a questionnaire on role perceptions and task confidence. Open-ended interviews on a purposive sample of participants were conducted before and after training and analyzed for recurring themes. Response rates for the RCI were 71.3% at baseline, 65.5% immediately after, and 36.8% three months after training. For subjects responding at baseline and at the respective post-training time point, there were no statistically significant differences in composite RCI scores immediately after or at three months after ICST. However, some individual RCI domain scores increased from baseline to three months after training. For instance, mutual respect increased from (mean ± standard deviation) 3.67 ± 0.49 to 4.42 ± 0.67 (p = 0.003) among non-anesthesia personnel rating anesthesia personnel; and shared knowledge rose from 3.58 ± 0.79 to 4.08 ± 0.51 (p = 0.010) among non-anesthesia personnel rating anesthesia personnel. Thematic analysis from 15 interviews revealed increased familiarity with roles and crisis procedures after ICST as well as improved communication. A single interprofessional crisis simulation training in a NORA setting, though it did not change overall relational coordination scores, had positive effects on some aspects of team coordination by improving role clarity, task confidence, trust, and communication.

The Role of Interventional Radiology in Patients Management during Sudan War 2023-2024: A Western Sudan Experience

Background: The purpose of this study is to evaluate the availability of interventional radiology services in Western Sudan from 2023 to 2024, during the Sudan War. This study aimed to evaluate the role of interventional radiology in the country's ongoing conflict. Methodology: This is a retrospective descriptive study with a prospective component that was conducted at El-Obeid International Hospital in North Kordofan State, Sudan, in August and September 2024. All information on patients who had interventional radiology operations between August 15th, 2023 and August 15th, 2024 was obtained from the hospital. Results: The findings revealed that 41% of the 131 patients received operations in the Interventional Radiology Clinic and 59% in the Catheterization Laboratory department. Among the 131 patients, 55% were men and 45% were women. The most common age group for undergoing IR treatments was 46-65 years, followed by ≥65 and 18-45 years, with incidence rates of 40%, 34%, and 25%, respectively. 41% of the procedures were performed in the interventional radiology clinic, with 59% performed in the catheterization laboratory. The most common technique was permacath implantation (36%). Conclusion: The ongoing conflict between 2023 and 2024 aggravated the situation. As a result, our study discovered that the only IR facility in Western Sudan during this difficult time is based in El-Obeid and serves seven states. This was exemplified by a severe breakdown in the healthcare system, the loss of basic needs, great poverty, and the plight of the refugees.

Analysis of Tuberculosis Control (Case Study in The City of Mojokerto) Year 2024

This study aims to analyze the tuberculosis (TB) situation in Mojokerto City, focusing on the increase in cases among children and identifying effective countermeasures. TB, a preventable and curable infectious disease caused by Mycobacterium tuberculosis, is particularly problematic in developing countries like Indonesia due to high incidence and mortality rates, necessitating a comprehensive control strategy. Employing qualitative methods, this research delves into the practices, perceptions, and social dynamics affecting TB control efforts in Mojokerto, illuminated by the latest data showing a significant increase in pediatric TB cases and the public health situation. Findings reveal a TB incidence rate of 385 per 100,000 inhabitants, a case detection rate of 75%, and a notably high pediatric TB case proportion of 32%. The effectiveness of case tracking by health centers varies, with an average of only 54% receiving Tuberculosis Preventive Therapy (TPT). Major obstacles include limited access to radiology services, social stigma, and the need for adequate health facilities. Innovations such as the "Mbak Desi Fights TB" program and enhanced cross-sector cooperation are deemed crucial to strengthen control strategies. The study concludes that a multifaceted strategy is essential for combating TB in Mojokerto, which should include enhanced case detection, health system strengthening, and community integration in control efforts. Increased collaboration across sectors and advancements in research and development are expected to accelerate TB elimination. This research offers efficient recommendations to improve TB control strategies, based on an in-depth analysis of the current conditions and social dynamics in Mojokerto.

Women in Radiology Education (WIRED): An actionable step towards closing the gender gap in radiology

As the representation of women in medicine has grown and reached parity in some specialties over the past two decades, radiology has not only lagged behind, but has remained stagnant. To strengthen the pipeline, the field must institute policies and practices to retain women in radiology and must effectively recruit and mentor women in medical school to enter the field. Women in medical school who are pursuing radiology, however, often struggle to find women mentors, opportunities for research, leadership, and service, and critically, often struggle to find a community that speaks to their experience. WIRED (Women in Radiology Education) is a student-led group dedicated to community building and advancing radiology mentorship, research, and service opportunities for women in medical school. This step-by-step guide to founding a WIRED chapter with examples of successful chapter events can enable radiology programs to provide targeted mentorship to women in medical school, and ultimately, increase the representation of women in radiology.

Paranoid About Androids: A Review of Robotics in Radiology.

In tandem with the ever-increasing global population, the demand for diagnostic radiology service provision is on the rise and at a disproportionate rate compared to the number of radiologists available to practice. The current "revolution in robotics" promises to alleviate personnel shortages in many sectors of industry, including medicine. Despite negative depictions of robots in popular culture, their multiple potential benefits cannot be overlooked, in particular when it comes to health service provision. The type of robots used for interventional procedures are largely robotic-assistance devices, such as the Da Vinci surgical robot. Advances have also been made with regards to robots for image-guided percutaneous needle placement, which have demonstrated superior accuracy compared to manual methods. It is likely that artificial intelligence will come to play a key role in the field of robotics and will result in an increase in the levels of robotic autonomy attainable. However, this concept is not without ethical and legal considerations, most notably who is responsible should an error occur; the physician, the robot manufacturer, software engineers, or the robot itself? Efforts have been made to legislate in order to protect against the potentially harmful effects of unexplainable "black-box" decision outputs of artificial intelligence systems. In order to be accepted by patients, studies have shown that the perceived level of trustworthiness and predictability of robots is crucial. Ultimately, effective, widespread implementation of medical robotic systems will be contingent on developers remaining cognizant of factors that increase human acceptance, as well as ensuring compliance with regulations.