Now showing 1 - 10 of 18
  • Publication
    Validation of the educational effectiveness of a mobile learning app to improve knowledge about MR image quality optimisation and artefact reduction
    Aim: The aim was to design an app-based eLearning tool to provide radiographers with information about the physical basis of MR artefacts and practical elimination or/and minimisation strategies to optimise image quality, and to evaluate the impact of a smartphone app on radiographers’ knowledge. Methods: The study used the comparison-experimental approach (pre- and post-test). Thirty-five MR radiographers independently reviewed a prepared series of MR images (n = 25). The participants were requested to identify image quality related errors, to specify error-correction strategies and to score how confident they were in their responses. Participants were then divided into experimental (n = 19) and control cohorts (n = 16). The app was provided to the experimental cohort for 3 months; after this period both cohorts re-reviewed the MR image datasets and repeated their identification of image quality errors. Results: The results showed a statistically significant difference between control and experimental cohorts relative to participants’ pre- to post-test knowledge level. For the experimental cohort, years of experience, qualification and type of hospital were not associated with radiographer knowledge level and confidence in recognising the presence of an image quality error, naming the error and specifying appropriate correction strategies (p > 0.05). Conclusion: The study identified the potential of the smartphone app as an effective educational tool to support MR radiographers’ knowledge in recognising and characterising MR image quality errors.
      284Scopus© Citations 9
  • 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.
      14Scopus© Citations 1
  • Publication
    Variability of Breast Density Classification Between US and UK Radiologists
    Purpose: To assess whether subjective breast density categorization remains the most useful way to categorize mammographic breast density and whether variations exist across geographic regions with differing national legislation. Methods: Breast radiologists from two countries (UK, USA) were voluntarily recruited to review sets of anonymized mammographic images (n = 180) and additional repeated images (n = 70), totaling 250 images, to subjectively rate breast density according to the Breast Imaging Reporting and Data system (BI-RADS) categorization. Images were reviewed using standardized viewing conditions and Ziltron software. Inter-rater reliability was analyzed using the Kappa test. Results: The US radiologists (n = 25) judged fewer images as being “mostly fatty” than UK radiologists (n = 24), leading a greater number of images classified in the higher BI-RADS categories, particularly in BI-RADS 3. Overall agreement for all data sets was k = 0.654 indicating substantial agreement between the two cohorts. When the data were split into BI-RADS categories, the level of agreement varied from fair to substantial. Conclusion: Variations in how radiologists from the USA and UK classify breast density was established, especially when the data were divided into breast density categories. This variation supports the need for a reliable breast density assessment method to enhance the individualized supplemental screening pathways for dense breasts. The use of two-scale categorization method demonstrated improved agreement.
      334Scopus© Citations 11
  • Publication
    An evaluation of in-plane shields during thoracic CT
    (Oxford University Press, 2013-08) ; ;
    The object of this study was to compare organ dose and image quality effects of using bismuth and barium vinyl in-plane shields with standard and low tube current thoracic CT protocols. A RANDO phantom was scanned using a 64-slice CT scanner and three different thoracic protocols. Thermoluminescent dosemeters were positioned in six locations to record surface and absorbed breast and lung doses. Image quality was assessed quantitatively using region of interest measurements.Scanning was repeated using bismuth and barium vinyl in-plane shields to cover the breasts and the results were compared with standard and reduced dose protocols. Dose reductions were most evident in the breast, skin and anterior lung when shielding was used, with mean reductions of 34, 33 and 10 % for bismuth and 23, 18 and 11 % for barium, respectively. Bismuth was associated with significant increases in both noise and CT attenuation values for all the three protocols, especial-ly anteriorly and centrally. Barium shielding had a reduced impact on image quality. Reducing the overall tube current reduced doses in all the locations by 20-27% with similar increases in noise as shielding, without impacting on attenuation values. Reducing the overall tube current best optimises dose with minimal image quality impact. In-plane shields increase noise and attenuation values, while reducing anterior organ doses primarily. Shielding remains a useful optimisation tool in CT and barium is an effective alternative to bismuth especially when image quality is of concern.
      344Scopus© Citations 14
  • Publication
    Establishment of CT diagnostic reference levels in Ireland
    (British Institute of Radiology, 2012-10) ; ;
    Objective: To propose Irish CT diagnostic reference levels (DRLs) by collecting radiation doses for the most commonly performed CT examinations. Methods: A pilot study investigated the most frequent CT examinations. 40 CT sites were then asked to complete a survey booklet to allow the recording of CT parameters for each of 9 CT examinations during a 12-week period. Dose data [CT volume index (CTDIvol) and dose–length product (DLP)] on a minimum of 10 average-sized patients in each category were recorded to calculate a mean site CTDIvol and DLP value. The rounded 75th percentile was used to calculate a DRL for each site and the country by compiling all results. Results are compared with international DRL data. Results: Data were collected for 3305 patients. 30 sites responded with data for 34 scanners, representing 54% of the national total. All equipment had multislice capability (2–128 slices). DRLs are proposed using CTDIvol (mGy) and DLP (mGy cm) for CT head (66/58 and 940, respectively), sinuses (16 and 210, respectively), cervical spine (19 and 420, respectively), thorax (9/11 and 390, respectively), high resolution CT (7 and 280, respectively), CT pulmonary angiography (13 and 430, respectively), multiphase abdomen (13 and 1120, respectively), routine abdomen/pelvis (12 and 600, respectively) and trunk examinations (10/12 and 850, respectively). These values are lower than current DRLs and comparable to other international studies. Wide variations in mean doses are noted across sites. Conclusions: Baseline figures for Irish CT DRLs are provided on the most frequently performed CT examinations. The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimisation of examinations.
      429Scopus© Citations 122
  • Publication
    Paediatric CT optimisation utilising Catphan® 600 and age-specific anthropomorphic phantoms
    The purpose of the study is to perform phantom-based optimisation of paediatric computed tomography (CT) protocols and quantify the impact upon radiation dose and image noise levels. The study involved three Portuguese paediatric centres. Currently employed scanning protocols for head and chest examinations and combinations of exposure parameters were applied to a Catphan®600 phantom to review the CT dose impact. Contrast–noise ratio (CNR) was quantified using Radia Diagnostic® tool. Imaging parameters, returning similar CNRs (<1) and dose savings were applied to three paediatric anthropomorphic phantoms. OsiriX software based on standard deviation pixel values facilitated image noise analysis. Currently employed protocols and age categorisation varied between centres. Manipulation of exposure parameters facilitated mean dose reductions of 33 and 28 % for paediatric head and chest CT examinations, respectively. The majority of the optimised CT examinations resulted in image noise similar to currently employed protocols. Dose reductions of up to 33 % were achieved with image quality maintained.
      436Scopus© Citations 5
  • 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.
      16Scopus© Citations 3
  • Publication
    Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll project
    Background: A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU. Results: Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. Conclusions: A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.
      18Scopus© Citations 1
  • Publication
    The establishment of computed tomography diagnostic reference levels in Portugal
    The aims of this study were to investigate the frequency of Portuguese computed tomography (CT) examinations, identify protocol application and establish diagnostic reference levels (DRLs). CT departments (n=211) were surveyed nationally (June 2011–January 2012) and CT protocol information and dose data were collected, as were retrospective age-categorised paediatric CT data from three national paediatric centres. The proposed national CT DRLs (CTDIvol) for adults were 75, 18, 14, 18, 17, 36, 22, 27 and 16 mGy for head, neck, chest, abdomen, pelvis, cervical, dorsal, lumbar and joints, respectively. The levels for paediatric head and chest examinations were as follows: 48 and 2 mGy (newborns), 50 and 6 mGy (5 y olds), 70 and 6 mGy (10 y olds) and 72 and 7 mGy (15 y olds). A limited number of current paediatric protocols aligned to recommended international age categorisations. Portuguese DRLs were generally higher than European recommendations, suggesting potential for optimisation. The need for greater standardisation of age-categorised paediatric protocols was identified.
      704Scopus© Citations 47
  • Publication
    Establishment of diagnostic reference levels for CT trunk examinations in the Western region of Saudi Arabia
    (Oxford University Press, 2014-12-02) ; ;
    Diagnostic reference levels (DRLs) are an important optimisation tool, which aid in identifying abnormally high dose levels. These are currently not available in Saudi Arabia, and this research aims to remedy this. CT dose data (DLP and CTDIvol) were collected for a minimum number of 10 adult patients of average size (60–80 kg) presenting for a range of CT examinations from public hospitals in the western region of Saudi Arabia. These include routine chest, high-resolution chest (HRCT), pulmonary angiography (CTPA), abdomen and pelvis (AP) and the combined chest, abdomen and pelvis (CAP) CT examinations. Mean values for each site were calculated, and the 75th percentile of DLP and CTDIvol was used as a basis for DRLs. Data for 550 patients were collected from 14 hospitals over a 7-month period. The rounded third-quartile CTDIvol and DLP were 18 mGy and 630 mGy cm−1 for chest CT, 20 mGy and 600mGy cm−1 for HRCT, 18 mGy and 480 mGy cm−1 for CTPA, 15 mGy and 800 mGy cm−1 for AP, and 16 mGy and 1040 mGy cm−1 for CAP, respectively. Regional DRLs have been proposed from this study. Dose variations across CT departments have identified an urgent need for optimisation to improve distribution of observed doses for CT examinations.
      464Scopus© Citations 22