Radiology Training Research Articles

SRMADNet: Swin ResUnet3+-based mammogram image segmentation and heuristic adopted multi-scale attention based DenseNet for breast cancer detection

Breast tumor is the second wide largest mortality rate of all the other cancers that are found in women and it is also thought to be the main factor in a high death rate. Mammographic pictures are mostly examined by the trained and expert radiologists to identify the abnormalities in the breast such as microcalcifications and masses. A correct diagnosis and early detection can aid in the fight against this form of dangerous disease. Breast cancer identification and categorization have been found to benefit greatly from the segmentation of mammography lesions. Segmentation can help with both shape-related feature extraction and precise lesion localization. Therefore, specialists implemented the latest image segmentation for mammogram images and the identification architecture for the identification of breast cancers, most importantly for the women. The wanted mammogram pictures are collected from traditional global databases. The gathered pictures are fed into the segmentation process, where the images are segmented employing Swin ResUnet3+. Thus, the mammogram segmented pictures are forwarded to the identification stage, where Adaptive Multi-scale Attention-based Densenet with Extreme Learning Machine (AMAD-ELM) model is implemented to identify the breast tumor effectively from the mammogram pictures. The parameters from AMAD-ELM are optimized through the suggested Position-based Improved invasive Weed and Crisscross Optimization (PIWCO). The effectiveness of the recommended breast tumor identification system with the help of deep learning is analyzed through various existing models to show its effectiveness.

Advancing IR in Underserved Regions: Interventional Radiology Simulation Near and Far.

Simulation facilitates learning by imitating real-world systems or processes utilizing educational tools and models. Various fields, including business, aviation, and education use simulation for training. In healthcare, simulation provides trainees opportunities to develop procedural skills in a safe environment, building their understanding through hands-on interactions and experiences rather than passive didactics. Simulation is classified into low, medium, and high fidelity, based on how closely it mimics real-life experience. Its use in education is a valuable adjunct to instructional support and training with multiple potential benefits. Interventional radiology (IR) trainees can build technical and clinical proficiency prior to working directly on a patient. Simulation promotes experiential learning, constructivist learning, and student centeredness, thus giving students control over their learning and knowledge acquisition. More recently, the creative use of remote simulation has augmented traditional virtual didactic lectures, thereby further engaging international learners and enhancing remote collaboration. Despite the challenges to implementation, the addition of simulation in IR education is proving invaluable to supporting trainees and physicians in underserved regions.

Los estudiantes de medicina en los Servicios de Radiología: ¿problema u oportunidad?

University Radiology training has been carried out for years out of the Radiology Departments, where radiologists play their professional role. However, the educational needs and the leadership of the Scientific Societies make the Radiology Departments to be involved more and more in that training, though it has to be done in overloaded professional environments where medical students can be seen as a drawback. Nevertheless, radiologists must play an important role in the Radiology training of the future doctors for optimising the use of diagnostic imaging techniques and enhance the future of the specialty by bringing to our departments those medical students who had demonstrated the most adequate personal profiles. The Radiology Department is that place to succeed by increasing the healthcare outcomes, the research results and the visibility of Radiology through a fruitful interaction between radiologists and medical students.

Surgical Repair of Hypermobile Lateral Meniscus Secondary to Popliteomeniscal Fascicle Tears Improves Pain and Mechanical Symptoms

To describe the clinical and radiographic features associated with isolated hypermobile lateral meniscus (HLM), and report patient outcomes following surgically repaired isolated HLM. All patients diagnosed with HLM from 2000 to 2020 at a single academic institution were identified and reviewed. Patients were excluded if they had concomitant ligament injury or lacked 2-year follow-up. Preoperative and postoperative visual analog scale (VAS) pain scores were determined from clinical notes. Statistical analysis was performed in JMP, and statistical significance was determined with use of a paired t-test. Eighteen knees in 17 patients met inclusion criteria. Mean patient age was 24.1 (range: 6-61) years. Mean follow-up was 73 months (25-151 months). All 18 knees reported pain at presentation; 94% (17/18) had mechanical symptoms. All 18 knees had preoperative MRIs, but only 1 (5.6%) knee was correctly diagnosed by a musculoskeletal trained radiologist. Most repairs were performed with an all-inside technique (61%, 11/18). VAS score improved significantly from 7.2 ± 2.9 preoperatively to 0.7 ± 1.9 postoperatively, with average improvement of VAS score of 6.5 (P < .001). Only one (5.6%) knee required revision meniscal surgery. Hypermobile lateral meniscus patients commonly see multiple providers, fail to have their HLM diagnosed on MRI, and undergo various treatments prior to a successful diagnosis. Localized lateral joint line pain, mechanical symptoms, and absence of distinct meniscus tear on MRI are the most frequent clinical presentations. Surgery with meniscus repair is a reliable solution to improve pain and mechanical symptoms. Level IV, therapeutic case series.

Core and Advanced Thoracic Imaging Curricula to Guide Residency and Fellowship Training: A Framework From the Canadian Society of Thoracic Radiology

A well-defined curriculum with goals and objectives is an inherent part of every radiology training program. Following a needs assessment, the Canadian Society of Thoracic Radiology Education Committee developed a thoracic imaging curriculum using a mixed- method approach, complimentary to the cardiac curriculum published as a separate document. The Thoracic Imaging Curriculum consists of two separate yet complimentary parts: a Core Curriculum, aimed at residents in-training, with the main goal of building a strong foundational knowledge, and an Advanced Curriculum, designed to build upon the core knowledge and guide a more in-depth subspecialty training. The curricular frameworks aim to enhance the educational experience of residents and fellows and provide an educational framework for clinical supervisors and residency and fellowship program directors. The Canadian Society of Thoracic Radiology championed the creation of Cardiovascular and Thoracic Imaging curricula encompassing clinical knowledge and technical, communication, and decision-making skills with the goal of providing direction to a strong foundational knowledge for residents and to guide specialty training for fellowship programs.

Psychological Safety as a New ACGME Requirement: A Comprehensive All-in-One Guide to Radiology Residency Programs

With the Accreditation Council for Graduate Medical Education recently updating their common program requirements to include components of psychological safety as a core principle, radiology training programs and academic radiology institutions will need to evaluate psychological safety within their residency programs and implement practices to sustain a safety culture. This article reviews current literature to present a concise guide for radiology programs on best practices for implementing psychological safety, considering the plethora of literature that is available. We searched PubMed for published studies evaluating safety culture in medical education and residency. The key words used were Psychological Safety, Education, Radiology, Workplace Culture, and Leadership. Ninety two studies were reviewed that contributed to the topics examined throughout this manuscript, including a brief history of psychological safety, evolving challenges, and a summation of best practices at the institutional, interpersonal, and individual levels that can result in a sustainable psychologically safe culture for radiology residents. This article will highlight unique considerations pertinent to a radiology residency program, including suggestions for creating a less stressful environment during case conferences, fostering and supporting residents who are struggling, and inclusive psychological safety practices that also consider non-resident contributors to a residency program, such as attending physician faculty and non-physician radiology technicians.

Smartphone application with 3D-printed needle guide for faster and more accurate CT-guided interventions in a phantom.

This study is to determine whether a needle guidance device combining a 3D-printed component with a smartphone would decrease the number of passes and time required to perform a standard CT-guided needle procedure in a phantom study. A 3D-printed mechanical guide with built-in apertures for various needle sizes was designed and printed. It was mounted on a smartphone and used to direct commercially available spring-loaded biopsy devices. A smartphone software application was developed to use the phone's sensors to provide the real-time location of a lesion in space, based on parameters derived from preprocedural CT images. The physical linkage of the guide, smartphone, and needle allowed the operator to manipulate the assembly as a single unit, with real-time graphical representation of the lesion shown on the smartphone display. Two radiology trainees and 3 staff radiologists targeted 5 lesions with and without the device (50 total procedures). The number of passes and time taken to reach each lesion were determined. Use of the smartphone needle guide decreased the mean number of passes (with guide, 1.8; without guide, 3.4; P < 0.001) and mean time taken (with guide, 1.6 min; without guide, 2.7 min; P = 0.005) to perform a standard CT-guided procedure. On average, the decreases in number of passes and procedure time were more pronounced among trainees (P < 0.001). The combination of a mechanical guide and smartphone can reduce the number of needle passes and the amount of time needed to reach a lesion in a phantom for both trainees and experienced radiologists.

Introducing Paediatric Radiology As A Subspecialty In Pakistan: Bridging The Gap In Healthcare.

Madam, Radiology is a rapidly progressing field that significantly contributes to disease diagnosis and treatment monitoring. Recent advancements in the field have improved evidence-based medicine for patient care. Despite substantial growth in Pakistan, limited opportunities for sub-specialisation training in radiology are available in Pakistan. Just a few institutions offer training in sub-specialties such as women's imaging, neurologic radiology, interventional radiology, and body imaging. There has been significant evolution in pediatric radiology, which has now emerged as a distinct field requiring solid foundations. Unfortunately, due to undefined training opportunities, pediatric radiology is being neglected in Pakistan. Pediatric radiology requires specialized training due to anatomical variations and unique disease presentations in children. Even senior general radiologists may lack confidence when reporting pediatric cases. Radiology demands updated knowledge and expertise in diagnostic tools, making it challenging to keep up. Reporting pitfalls in pediatrics differ from adults due to varying growth patterns and myelination making expert knowledge essential for accurate reporting in multiple conditions. The acceptable radiation doses and protocols for imaging studies are also different, considering children’s susceptibility to ionizing radiation3. The European Society of Radiology highlighted the importance of integrating pediatric radiology training4. Many other countries, including the USA and Europe, have sub-specializations and accreditations despite having lower proportions of children in their populations compared to Pakistan. Advocacy movements for pediatric radiology have also emerged in other developing nations like Nigeria5. Pakistan is a largely populated country, with approximately 35% being pediatric population and multiple radiological cases being reported daily. It seems a gross neglect not to cater specifically to such a large proportion of the people. Therefore, there is a dire need to recognize pediatric radiology as a formal subspeciality that requires redrafting of the curriculum. The subspecialty should focus on a particular area and offer comprehensive and consistent training to interested individuals.

Inter-reader variability and reproducibility of the PI-QUAL score in a multicentre setting

PurposeTo assess the inter-reader reproducibility of the Prostate Imaging Quality (PI-QUAL) score between readers with varying clinical experience and its reproducibility at assessing imaging quality between different institutions. MethodsFollowing IRB approval, we assessed 60 consecutive prostate MRI scans performed at different academic teaching and non-academic hospitals uploaded to our institutes’ PACS for second opinion or discussion in case conferences. Anonymized scans were independently reviewed using the PI-QUAL scoring sheet by three readers - two radiologists (with 1 and 12 years Prostate MRI reporting experience), and an experienced MRI technician with interest in image acquisition and quality. All readers were blinded to the site where scans were acquired. ResultsAgreement coefficients between the 3 readers in paired comparison for each individual PI-QUAL score was moderate. When the scans were clustered into 2 groups according to their ability to rule in or rule out clinically significant prostate cancer [i.e., PI-QUAL score 1–3 vs PI-QUAL score 4–5], the Gwet AC1 coefficients between the three readers in paired comparison was good to very good [Gwet AC 1:0.77, 0.67, 0.836 respectively] with agreement percentage of 88.3%, 83.3% and 91.7% respectively. Agreement coefficient was higher between the experienced radiologist and the experienced MRI technician than between the less experienced trainee radiologist and the other two readers.The mean PI-QUAL score provided by each reader for the scans was significantly higher in the academic hospitals (n = 32) compared to the community hospital (n = 28) [experienced radiologist 4.6 vs 2.9; trainee radiologist 4.5 vs 2.4; experienced technologist 4.4 vs 2.4; p value < 0.001]. ConclusionWe observed good to very good reproducibility in the assessment of each MRI sequence and when scans were clustered into two groups [PI-QUAL 1–3 vs PI-QUAL 4–5] between readers with varying clinical experience. However, the reproducibility for each single PI-QUAL score between readers was moderate. Better definitions for each PI-QUAL score criteria may further improve reproducibility between readers.Additionally, the mean PI-QUAL score provided by all three readers was significantly higher for scans performed at academic teaching hospitals compared to community hospital.

Regional Differences in Education: Can We Bridge that Gap with Simulation-Based Training?

AbstractInterventional radiology (IR) training is not uniform throughout the world with clear limitations to education, training, and procedural exposure based on regions within different countries and the world. Varying technical exposure can lead to limitations in technical and therapeutic opportunities for patients. Since hands-on exposure to specific procedural skills may not occur in some locations, high fidelity endovascular simulation training can provide an opportunity for technical skills to be learned with an effort to increase patient exposure to care as well as improve technical procedural skill learning.

Behavioral Economics in Radiology Training: Overcoming Irrational Behavior

Behavioral economics studies how external influences subconsciously affect decision making. Everyone is subject to a range of cognitive biases, which can affect the radiology training environment and can impact resident selection, resident education, feedback, workflow, and report composition. Understanding the cognitive sources of error and patterns of deviation can help faculty and trainees better engage in an optimal learning environment. This review focuses on the role of cognitive biases as they impact multiple facets of radiology education and training environments.

Performance Anxiety in Radiology Education and Clinical Practice

Performance anxiety is fear, anxiety, or avoidance of performative tasks, due to possible evaluation or criticism by others. Performance anxiety is well described in public speakers, musicians, and even surgeons. Its impact on radiologists and especially radiology trainees has not been explored. This article details performance anxiety, framing radiologists as performers, and highlights its potential impact on trainees and practicing radiologists. We offer strategies to manage and enhance the effects of performance anxiety that can be implemented in a training environment.

“Are They Listening, and Do They Find It Useful?”—Evaluation of Mid-Rotation Formative Subjective and Objective Feedback to Radiology Trainees

Residents commonly receive only end-of-rotation evaluations and thus are often unaware of their progress during a rotation. In 2021, our neuroradiology section instituted mid-rotation feedback in which rotating residents received formative subjective and objective feedback. The purpose of this study was to describe our feedback method and to evaluate if residents found it helpful. Radiology residents rotate 3-4 times on the neuroradiology service for 1-month blocks. At the midpoint of the rotation (2 weeks), 7-10 neuroradiology attendings discussed the rotating residents' subjective performance. One attending was tasked with facilitating this discussion and taking notes. Objective metrics were obtained from our dictation software. Compiled feedback was relayed to residents via email. A 16-question anonymous survey was sent to 39 radiology residents (R1-R4) to evaluate the perceived value of mid-rotation feedback. Odds ratios and 95% confidence intervals were computed using logistic regression. Sixty-nine percent (27/39) of residents responded to the survey; 92.6% (25/27) of residents reported receiving mid-rotation feedback in ≥50% of neuroradiology rotations; 92.3% (24/26) of residents found the subjective feedback helpful; 88.4% (23/26) of residents reported modifying their performance as suggested (100% R1-R2 vs 70% R3-R4; OR: 15.4 CI:1.26, >30.0);59.1% (13/22) of residents found the objective metrics helpful (75% R1-R2 vs 40% R3-R4; OR: 3.92 CI:0.74, 24.39) and 68.2% (15/22) stated they modified their performance based on these metrics (83.3% R1-R2 vs 50.0% R3-R4; OR:4.2 CI:0.73, 30.55); and 84.6% (22/26) of residents stated that mid-rotation subjective feedback and 45.5% (10/22) stated that mid-rotation objective feedback should be implemented in other sections. Majority of residents found mid-rotation feedback to be helpful in informing them about their progress and areas for improvement in the neuroradiology rotation, more so for subjective feedback than objective feedback. The majority of residents stated all rotations should provide mid-rotation subjective feedback.

Global pediatric radiology education: responding to training-level specific needs.

Pediatric radiology education for pediatric and radiology trainees and practicing professionals must be adapted to the target audience. In efforts to narrow the gaps in global pediatric radiology education, the Children's Hospital of Philadelphia's radiology department's Global Outreach and Education Program has designed specific interventions and curricula according to different levels of training and desired expertise. Our initiatives include an online "Introduction to Pediatric Imaging" lecture series for pediatrics residents in Botswana, Ethiopia and Vietnam; access to a learning management system (Outreach RADIAL) for radiology residents; case-based review sessions for pediatric radiology fellows; and in-person seminars for professionals from Eastern Europe and Africa. Here, we highlight our global education efforts to encourage other departments to take a similar systematic approach to outreach activities.

Precision Education for Personalized Learning

Today's radiology trainee must sort through an enormous volume of web-based information and learning resources amidst expanding volumes and complexity of clinical cases. In addition, the complexity of the practicing radiologist's work has become such that there is a need for ready access to the most current and highest-value information to guide image interpretation "in the moment" to support mastery-level practice. Personalized Learning is based on an adaptable computer-based system to deliver contextual knowledge to support every learner based on their preferences, prior experience, and evolving knowledge. We review the historical evolution of personalized education including Intelligent Tutor, the first-of-its-kind machine-learning based model for radiology designed to replace the one-size-fits-all approach to education and training.

Medical volume segmentation by overfitting sparsely annotated data.

Semantic segmentation is one of the most significant tasks in medical image computing, whereby deep neural networks have shown great success. Unfortunately, supervised approaches are very data-intensive, and obtaining reliable annotations is time-consuming and expensive. Sparsely labeled approaches, such as bounding boxes, have shown some success in reducing the annotation time. However, in 3D volume data, each slice must still be manually labeled. We evaluate approaches that reduce the annotation effort by reducing the number of slices that need to be labeled in a 3D volume. In a two-step process, a similarity metric is used to select slices that should be annotated by a trained radiologist. In the second step, a predictor is used to predict the segmentation mask for the rest of the slices. We evaluate different combinations of selectors and predictors on medical CT and MRI volumes. Thus we can determine that combination works best, and how far slice annotations can be reduced. Our results show that for instance for the Medical Segmentation Decathlon-heart dataset, some selector, and predictor combinations allow for a Dice score 0.969 when only annotating 20% of slices per volume. Experiments on other datasets show a similarly positive trend. We evaluate a method that supports experts during the labeling of 3D medical volumes. Our approach makes it possible to drastically reduce the number of slices that need to be manually labeled. We present a recommendation in which selector predictor combination to use for different tasks and goals.

MRI in the Diagnosis of Bucket Handle Tears: What Is the Current Situation?

Introduction The purpose of this study was to determine the utility of current magnetic resonance imaging (MRI) in the diagnosis of bucket-handle meniscal tears. Materials and methods Patients treated for arthroscopic meniscal tears between March 2019 and March 2022 were reviewed. The current study included all patients with bucket handle tears diagnosed arthroscopically and having MRI scans (n=51). A control group of 58 individuals with similar demographic characteristics and meniscal tears apart from bucket handle tears was also formed. The assessment of bucket handle and non-bucket handle tears was performed blindly by a musculoskeletal (MSK) radiologist with 20 years of experience and a trainee radiologist, achieving consensus on group allocation.The MRIs were examined for various findings, including the presence of a bucket handle tear, tear location, presence of anterior cruciate ligament (ACL) rupture, intercondyler notch sign, double anterior horn sign, flipped meniscus sign, double posterior cruciate ligament (PCL) sign, absent bow sign, and the disproportionate posterior horn sign. These well-known signs, detailed in the literature, were evaluated. Additionally, less studied and less commonly known signs such as the V sign and double anterior cruciate ligament sign were assessed.The V sign appears similarly to the letter V, resulting from the displacement of the bucket handle tear and the angle of the intact meniscus on axial images. The double anterior cruciate ligament sign is the appearance formed by the compression of the displaced meniscal part behind the anterior cruciate ligament in bucket handle tears. Results Following the retrospective evaluation of MRI scans, 44 out of 51 tears diagnosed as bucket handle tears by arthroscopy were accurately identified (sensitivity: 86.27%). The same conclusion was reached for MRI scans in 52 out of 58 tears where arthroscopy did not detect a bucket handle tear (specificity: 89.66%). The most prevalent MRI signs in patients with bucket handle tears identified by arthroscopy in the study were the intercondylar notch sign (84.31%), V sign (72.55%), double PCL sign (56.86%), double anterior horn sign (49.02%), absent bow sign (43.14%), flipped meniscus sign (19.61%), disproportionate posterior horn sign (9.80%), and double ACL sign (5.88%). The intercondylar notch sign, V sign, and double PCL sign exhibited the highest sensitivity, while flipped meniscus, disproportionate posterior horn, and double ACL sign demonstrated the highest specificity. Conclusion MRI demonstrates a high level of sensitivity and specificity in identifying meniscal bucket handle tears, particularly when considering the eight MRI signs investigated in this study.

Are the Pilots Onboard? Equipping Radiologists for Clinical Implementation of AI.

The incorporation of artificial intelligence into radiological clinical workflow is on the verge of being realized. To ensure that these tools are effective, measures must be taken to educate radiologists on tool performance and failure modes. Additionally, radiology systems should be designed to avoid automation bias and the potential decline in radiologist performance. Designed solutions should cater to every level of expertise so that patient care can be enhanced and risks reduced. Ultimately, the radiology community must provide education so that radiologists can learn about algorithms, their inputs and outputs, and potential ways they may fail. This manuscript will present suggestions on how to train radiologists to use these new digital systems, how to detect AI errors, and how to maintain underlying diagnostic competency when the algorithm fails.

Gender differences in self-assessed performance and stress level during training of basic interventional radiology maneuvers

ObjectivesGender differences have been reported to influence medical training. We investigated gender differences encountered during training in interventional radiology maneuvers.MethodsCatheter handling was analyzed under standardized conditions in 64 participants naïve to endovascular procedures (26 women, 38 men). Objective (e.g., catheter pathway, catheter movements, required time) and subjective parameters (stress level) were recorded. The NASA-Task Load Index (NASA-TLX; 1–20 points) was used to assess participants’ stress levels and perceived workload.ResultsIn the easier tasks, no significant differences between male and female participants regarding catheter handling were observed. In the most complex task, female participants took themselves more time (688 ± 363 vs. 501 ± 230 s; p = 0.02), asked for help more frequently (n = 19 vs. n = 8) and earlier than men (203 ± 94 vs. 305 ± 142 s; p = 0.049), whereas men stood out by more agitated catheter handling (6.0 ± 1.8 vs. 4.8 ± 1.6 movements/s; p = 0.005). Overall, female participants perceived tasks to be more difficult (11.5 ± 4.2 vs. 9.6 ± 3.3; p = 0.016), perceived higher stress levels (8.9 ± 4.9 vs. 6.3 ± 4.4; p = 0.037), and rated their own performance lower (9.12 ± 3.3 vs. 11.3 ± 3.3; p = 0.009). However, female participants were able to correlate self-assessed with objective parameters correctly (r between −0.555 and −0.469; p = 0.004–0.018), whereas male participants failed to correctly rate their performance (p between 0.34 and 0.73). Stress levels correlated with objective parameters in males (r between 0.4 and 0.587; p < 0.005), but not in female participants.ConclusionPerceived stress levels, self-evaluation skills, and catheter handling differ greatly between untrained male and female participants trying to solve interventional radiological tasks. These gender-specific differences should be considered in interventional radiology training.Clinical relevance statementAs psychological aspects may influence individual working strategies gender-specific differences in self-perception while learning interventional radiology maneuvers could be essential regarding success in teaching and treatment outcomes.Key Points• After performing standardized training, 38 male and 26 female volunteers showed significant differences regarding objective and self-assessed performance, as well as in perceived workload while performing simulated endovascular catheter maneuvers.• After solving simulated endovascular radiological tasks, female participants were able to self-assess their objective performance much more accurately than male participants.• Women took more time to solve simulated endovascular tasks and asked earlier and more frequently for help than men.

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.