Now showing 1 - 10 of 36
  • Publication
    High-resolution MRI (HR-MRI) of atherosclerotic plaque in symptomatic carotid stenosis – relationship with risk factors, treatment, and CT angiographic features
    Purpose: Traditional imaging techniques rely on arterial lumen stenosis as an indirect measure of mural plaque. HR-MRI allows direct imaging of mural plaque burden and composition. However, few data exist on the relationship of these parameters to clinical factors in patients with symptomatic carotid stenosis. We investigated the relationship between MR plaque features, clinical characteristics, and plaque morphology on CT angiography. Methods: A sub-group of patients included in the prospective BIOVASC plaque imaging study were included. Inclusion criteria were: (1) Speech/motor TIA or non-severe stroke (Rankin≤3) <72hours (2) Ipsilateral carotid stenosis ≥50% (3) Age≥50 (4) Carotid HR-MRI and CTA performed. Exclusions were pregnancy, malignancy, dementia, renal impairment, cervical irradiation/endarterectomy/stent. Semi-automated analysis of HR-MRI axial plaque images was done using PlaqueView and manual analysis of co-registered CTA performed. Results: 27 patients met inclusion criteria (78% men, mean age 66 years, 36% stroke/64%TIA, 39% current smoking). By HR-MRI, maximum plaque wall area was greater in patients with index stroke compared with TIA (p=0.007). Plaque maximum wall thickness was greater in diabetes (p=0.016) and statin-untreated patients (p=0.003). Volume of lipid-rich necrotic core was less (p=0.018) and fibrous cap thickness (p=0.05) greater in aspirin-treated patients. When HR-MRI was compared with CTA, high correlations were observed for lumen area (rho=0.976, p<0.001), maximum wall thickness (rho=0.878, p<0.001), and maximum wall area (Pearson r=0.981, p<0.001). Conclusion: If replicated, our findings may inform the application of plaque HR-MRI and CTA as surrogate markers in future clinical practice and randomised trials for stroke prevention.
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  • Publication
    Artificial intelligence: The opinions of radiographers and radiation therapists in Ireland
    Introduction: Implementation of Artificial Intelligence (AI) into medical imaging is much debated. Diagnostic Radiographers (DRs) and Radiation Therapists (RTTs) are at the forefront of this technological leap, thus an understanding of their views, in particular changes to their current roles, is key to safe, optimal implementation. Methods: An online survey was designed, including themes: role changes, clinical priorities for AI, patient benefits, and education. It was distributed nationally in the Republic of Ireland via the national professional body, clinical management, and social media. Results: 318 DRs and 77 RTTs participated. Priority areas for development included quality assurance, clinical audit, radiation dose optimisation, and improved workflow for DRs and treatment planning algorithm optimisation, clinical audit, and post processing for RTTs. There was resistance regarding AI use for patient facing roles and final image interpretation. 27.6% of DRs and 40.3% of RTTs currently use AI clinically and 46.1% of DRs and 41.2% of RTTs anticipate reduced staffing levels with AI. 64.9% of DRs and 70.6% of RTTs felt AI will be positive for patients, with the majority promoting AI regulation through national legislation. 86.1% of DRs and 94.0% of RTTs were favourable to AI implementation. Conclusion: This research identifies priority AI development and implementation areas for DRs and RTTs. It thus highlights that DRs and RTTs should be involved in development of AI tools that would best support practice, and that clearly defined pathways for AI implementation into these key professions requires discussion so that optimum use and patient safety can ensue. Implications for practice: Understanding opinions of AI has significant implications for practice, for ensuring optimal product development, implementation, and training, together with planning for potential DR and RTT role changes.
      50Scopus© Citations 14
  • Publication
    A Risk Score Including Carotid Plaque Inflammation and Stenosis Severity Improves Identification of Recurrent Stroke
    Background and Purpose— In randomized trials of symptomatic carotid endarterectomy, only modest benefit occurred in patients with moderate stenosis and important subgroups experienced no benefit. Carotid plaque 18F-fluorodeoxyglucose uptake on positron emission tomography, reflecting inflammation, independently predicts recurrent stroke. We investigated if a risk score combining stenosis and plaque 18F-fluorodeoxyglucose would improve the identification of early recurrent stroke. Methods— We derived the score in a prospective cohort study of recent (<30 days) non-severe (modified Rankin Scale score ≤3) stroke/transient ischemic attack. We derived the SCAIL (symptomatic carotid atheroma inflammation lumen-stenosis) score (range, 0–5) including 18F-fluorodeoxyglucose standardized uptake values (SUVmax <2 g/mL, 0 points; SUVmax 2–2.99 g/mL, 1 point; SUVmax 3–3.99 g/mL, 2 points; SUVmax ≥4 g/mL, 3 points) and stenosis (<50%, 0 points; 50%–69%, 1 point; ≥70%, 2 points). We validated the score in an independent pooled cohort of 2 studies. In the pooled cohorts, we investigated the SCAIL score to discriminate recurrent stroke after the index stroke/transient ischemic attack, after positron emission tomography-imaging, and in mild or moderate stenosis. Results— In the derivation cohort (109 patients), recurrent stroke risk increased with increasing SCAIL score (P=0.002, C statistic 0.71 [95% CI, 0.56–0.86]). The adjusted (age, sex, smoking, hypertension, diabetes mellitus, antiplatelets, and statins) hazard ratio per 1-point SCAIL increase was 2.4 (95% CI, 1.2–4.5, P=0.01). Findings were confirmed in the validation cohort (87 patients, adjusted hazard ratio, 2.9 [95% CI, 1.9–5], P<0.001; C statistic 0.77 [95% CI, 0.67–0.87]). The SCAIL score independently predicted recurrent stroke after positron emission tomography-imaging (adjusted hazard ratio, 4.52 [95% CI, 1.58–12.93], P=0.005). Compared with stenosis severity (C statistic, 0.63 [95% CI, 0.46–0.80]), prediction of post-positron emission tomography stroke recurrence was improved with the SCAIL score (C statistic, 0.82 [95% CI, 0.66–0.97], P=0.04). Findings were confirmed in mild or moderate stenosis (adjusted hazard ratio, 2.74 [95% CI, 1.39–5.39], P=0.004). Conclusions— The SCAIL score improved the identification of early recurrent stroke. Randomized trials are needed to test if a combined stenosis-inflammation strategy improves selection for carotid revascularization where benefit is currently uncertain.
      318Scopus© Citations 35
  • Publication
    Patient safety: At the centre of all we do
    The December 2016 special issue of Radiography (Volume 22, Supplement 1) revolved around the important topic of patient safety. In their editorial, Nightingale and Snaith open by describing patient safety as "a topic clearly of immense importance to our profession and to the public we serve". This view is not likely to change, and patient-safety related topics will remain a constant in terms of the papers published in Radiography and indeed in all journals linked to the fields of medical imaging / radiology and radiation oncology. There are many ways to define patient safety. The top two definitions, ranked by leading institutions across Europe, involved in radiography education, were: "Reducing the incidence of unnecessary disease, injuries, adverse events and deaths caused topatients through the delivery of therapeutic or diagnostic procedures." and "A safe healthcare environment based on having access to the best technology available, the best trained professionals, the best designed healthcare processes and facilities."
      24Scopus© Citations 3
  • Publication
    Palestinian Conference on Medical Radiation Sciences 2022 Selected Abstracts
    The Palestinian Association of Medical Radiation Technologists (PAMRT) became a member of the European Federation of Radiographer Societies (EFRS) in February 2021. Through this relationship, the EFRS has been supportive of the activities undertaken by PAMRT to raise the profile of the profession in Palestine; to enhance the education and training of professionals; to open international collaborative opportunities for PAMRT and their members; and, to promote research opportunities within the profession in Palestine. It is regarding these final two points that the EFRS, together with the Society and College of Radiographers (SCoR) as the owners of the journal, and the Radiography journal leadership, were happy to collaborate with PAMRT for the Palestinian Conference on Medical Radiation Sciences (PCMRS) 2022.
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  • Publication
    The risk of burnout in academic radiographers during the COVID-19 pandemic
    Introduction: The COVID-19 pandemic created major challenges across society, healthcare provision and also for those delivering healthcare education programmes. Clinical placements were disrupted and, in many incidences cancelled. Higher education institutions were required to move completely to online delivery methods with little notice. This created significant additional workload, stress and the need to learn new skills at a time of great uncertainty. This study explored the risks of burnout in academic radiographers during the first 12 months of the pandemic. Methods: A survey was circulated using SurveyMonkey™ via personal, national and international networks, including the European Federation of Radiographer Societies (EFRS), to reach as many academic radiographers as possible. Disengagement and exhaustion were measured using the Oldenburg burnout inventory. Descriptive statistics and a one-way ANOVA were used to analyse the quantitative data using STATA V16 (Statacorp, TA). Results: 533 academic radiographers responded to the survey from 43 different countries. Mean disengagement was in the medium range and exhaustion was high for the total dataset. In a subset of countries with 10 or more responses, there was significant variation between countries, with the UK having highest mean exhaustion score and the UK, Ireland and France sharing the highest mean disengagement score. In the total dataset, 86% agreed workload had increased during the pandemic and 35% had considered leaving academia in the last year. Conclusion: These data demonstrate the stark reality of the impact of the COVID-19 pandemic on academic radiographers’ workload, wellbeing, and intention to leave their roles. Implications for practice: COVID-19 has had a significant impact on academic radiographers and this study highlights the urgent need for remedial measures to better support academic radiographers in order to ensure a sufficient, and sustainable workforce.
    Scopus© Citations 3  48
  • Publication
    Valedictory editorial - New horizons
    Radiography will celebrate the publication of its 28th Volume in 2022. Guided by our mission to be recognised as the ‘premier peer reviewed journal in radiographic imaging and radiation therapy both within the UK and internationally',3 our revised strategic plan (2019–2023) ensures that the journal continues to showcase excellent radiography research while supporting the development of publishing capability and capacity within the profession. In this editorial we will first reflect on significant strategic developments which have been introduced to continue to address our ambitious mission. We will then share with you some of the journal metrics4 which our Editorial Board regularly reviews against our challenging Key Performance Indicators. Finally we will engage in some ‘horizon scanning’ to consider the challenges and opportunities that may lie ahead for our journal.
    Scopus© Citations 4  64
  • Publication
    Toward Autism-Friendly Magnetic Resonance Imaging: Exploring Autistic Individuals' Experiences of Magnetic Resonance Imaging Scans in the United Kingdom, a Cross-Sectional Survey
    Background: Autistic individuals might undergo a magnetic resonance imaging (MRI) examination for clinical concerns or research. Increased sensory stimulation, lack of appropriate environmental adjustments or lack of streamlined communication in the MRI suite may pose challenges to autistic patients and render MRI scans inaccessible. This study aimed to i) explore the MRI scan experiences of autistic adults in the UK, ii) identify barriers and enablers towards successful and safe MRI examinations, iii) assess autistic individuals’ satisfaction with MRI service, and iv) inform future recommendations for practice improvement. Methods: We distributed an online survey to the autistic community on social media, using snowball sampling. Inclusion criteria were: being older than 16, have an autism diagnosis or self-diagnosis, self-reported capacity to consent and having had an MRI scan in the UK. We used descriptive statistics for demographics, inferential statistics for group comparisons/correlations, and content analysis for qualitative data. Results: We received 112 responses. A total of 29.6% of the respondents reported not being sent any information before the scan. Most participants (68%) confirmed that radiographers provided detailed information on the day of the examination but only 17.1% reported that radiographers offered some reasonable environmental adjustments. Only 23.2% of them confirmed they disclosed their autistic identity when booking MRI scanning. We found that quality of communication, physical environment, patient emotions, staff training and confounding societal factors impacted autistic people’s experiences. Autistic individuals rated their overall MRI experience as neutral and reported high levels of claustrophobia (44.8%). Conclusion: The study highlighted a lack of effective communication and coordination of care, either between healthcare services or between patients and radiographers, and lack of reasonable adjustments as vital for more accessible and person-centred MRI scanning for autistic individuals. Enablers of successful scans included effective communication, adjusted MRI environment, scans tailored to individuals’ needs/preferences, and well-trained staff.
      146Scopus© Citations 1
  • Publication
    Research ethics training, challenges, and suggested improvements across Europe: Radiography research ethics standards for Europe (RRESFE)
    Introduction: The Radiography Research Ethics Standards for Europe (RRESFE) project aimed to provide a cross-sectional view of the current state of radiography research ethics across Europe. This included investigating education and training in research ethics, and identifying the key challenges and potential improvements associated with using existing research ethics frameworks. Methods: This cross-sectional online survey targeting radiography researchers in Europe was conducted between April 26 and July 12, 2021. Descriptive and analytical statistics were used to identify research ethics education and training trends. Content analysis of qualitative responses was employed to identify significant challenges and proposed improvements in research ethics frameworks of practice. Results: There were 232 responses received across 33 European countries. Most (n = 132; 57%) respondents had received some research ethics training; however, fewer participants had received training on safeguarding vulnerable patients (n = 72; 38%), diversity and inclusivity (n = 62; 33%), or research with healthy volunteers (n = 60; 32%). Training was associated with a greater perceived importance of the need for research ethics review (p = 0.031) and with the establishment of EQF Level 6 training (p = 0.038). The proportion of formally trained researchers also varied by region (p = <0.001). Time-to-ethics-approval was noted as the biggest challenge for professionals making research ethics applications. Conclusion: Early and universal integration of research-oriented teaching within the radiography education framework which emphasises research ethics is recommended. Additionally, study findings suggest research ethics committee application and approval processes could be further simplified and streamlined. Implications for practice: The survey contributes to a growing body of knowledge surrounding the importance of education and training in research ethics for assuring a high standard of research outputs in Radiography and has identified hurdles to obtaining research ethics approval for further investigation and address.
      88Scopus© Citations 1
  • Publication
    The Effects of Cone-Beam Computed Tomography Imaging Guidance on Patient Radiation Exposure in Trans-Arterial Chemoembolisation for Hepatocellular Carcinoma
    This study investigated the effects of cone-beam computed tomography (CBCT) guidance in trans-arterial chemoembolisation (TACE) procedures on the number of digital subtraction angiography (DSA) runs acquired and total patient radiation exposure in patients with hepatocellular carcinoma (HCC). A retrospective, analytical cross-sectional, single institution, study was conducted. Dose data were compared across the control (DSA guidance alone) and study (DSA and CBCT guidance) groups. A total of 122 procedures were included within the study. There was a significant reduction in the number of DSA runs (3 vs 5, p < 0.001) and DSA air kerma-area product (PKA) (3077.3 vs 4276.6 μGym2, p = 0.042) for the study group when compared to the control group. Total procedural PKA and total procedural reference air kerma (Ka,r) were shown to be 50 and 73% higher, respectively, for the study group when compared to the control group. CBCT imaging guidance does reduce the number of DSA runs and DSA PKA required to complete the TACE procedure for patients diagnosed with HCC; however, a substantial increase in total procedural PKA is to be expected and it is thus important that this increased dose is carefully considered and justified.
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