Ageist Attitudes Among Radiologic Science Professionals.

PURPOSE: To measure radiologic science professionals' current attitudes toward older adults. METHODS: The Geriatrics Attitude Scale (GAS) paper survey was distributed to radiology and radiation oncology personnel in a large, single teaching hospital system. The GAS provides a global measure of ageist attitudes using 14 questions and 4 subscales. Demographic information also was collected. RESULTS: The total sample (N = 74) comprised radiology and radiation oncology practitioners from rural and nonrural facilities in the health system. Of the 14 questions, 3 yielded significant differences between medical imaging and radiation therapy practitioners. There were no significant effects for gender, race, years of experience, or facility type. DISCUSSION: Although significant differences were found between medical imaging and radiation therapy professionals for some of the constructs, both groups had positive attitudes overall toward older adults as measured by the GAS and subscales. Interventions to disrupt ageism should be introduced to make positive shifts in attitudes. CONCLUSION: The United Nations has declared 2021 to 2030 the Decade of Healthy Ageing; people are challenged to change how they think, feel, and act toward aging and older adults. This pilot study provides a timely baseline for further research as older adults continue to challenge the U.S. health care system for the near future.

Occupational Radiation Dose Trends in U.S. Radiologic Technologists Assisting with Fluoroscopically Guided Interventional Procedures, 1980-2020.

PURPOSE: To summarize dose trends from 1980 to 2020 for 19,651 U.S. Radiologic Technologists who reported assisting with fluoroscopically guided interventional procedures (FGIPs), overall and by work history characteristics. MATERIALS AND METHODS: A total of 762,310 annual personal dose equivalents at a 10-mm reference depth (doses) during 1980-2020 for 43,823 participants of the U.S. Radiologic Technologists (USRT) cohort who responded to work history questionnaires administered during 2012-2014 were summarized. This population included 19,651 technologists who reported assisting with FGIP (≥1 time per month for ≥12 consecutive months) at any time during the study period. Doses corresponding to assistance with FGIP were estimated in terms of proximity to patients, monthly procedure frequency, and procedure type. Box plots and summary statistics (eg, medians and percentiles) were used to describe annual doses and dose trends. RESULTS: Median annual dose corresponding to assistance with FGIP was 0.65 mSv (interquartile range [IQR], 0.60-1.40 mSv; 95th percentile, 6.80). Higher occupational doses with wider variability were associated with close proximity to patients during assistance with FGIP (median, 1.20 mSv [IQR, 0.60-4.18 mSv]; 95th percentile, 12.66), performing ≥20 FGIPs per month (median, 0.75 mSv [IQR, 0.60-2.40 mSv]; 95th percentile, 9.44), and assisting with high-dose FGIP (median, 0.70 mSv [IQR, 0.60-1.90 mSv]; 95th percentile, 8.30). CONCLUSIONS: Occupational doses corresponding to assistance with FGIP were generally low but varied with exposure frequency, procedure type, and proximity to patients. These results highlight the need for vigilant dose monitoring, radiation safety training, and proper protective equipment.

Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?

PURPOSE OF REVIEW: In patients with hematological malignancies, high-resolution computed tomography (CT) is the recommended imaging approach for diagnosis, staging and monitoring of invasive fungal disease (IFD) but lacks specificity. We examined the status of current imaging modalities for IFD and possibilities for more effective applications of current technology for improving the specificity of IFD diagnosis. RECENT FINDINGS: Although CT imaging recommendations for IFD are largely unchanged in the last 20 years, improvements in CT scanner technology and image processing algorithms now allow for technically adequate examinations at much lower radiation doses. CT pulmonary angiography can improve both the sensitivity and specificity of CT imaging for angioinvasive molds in both neutropenic and nonneutropenic patients, through detection of the vessel occlusion sign (VOS). MRI-based approaches also show promise not only for early detection of small nodules and alveolar hemorrhage but can also be used to detect pulmonary vascular occlusion without radiation and iodinated contrast media. 18F-fluorodeoxyglucose (FDG) PET/computed tomography (FDG-PET/CT) is increasingly used to monitor long-term treatment response for IFD, but could become a more powerful diagnostic tool with the development of fungal-specific antibody imaging tracers. SUMMARY: High-risk hematology patients have a considerable medical need for more sensitive and specific imaging approaches for IFD. This need may be addressable, in part, by better exploiting recent progress in CT/MRI imaging technology and algorithms to improve the specificity of radiological diagnosis for IFD.

Assessment of image quality in digital radiology using the CDRAD contrast-detail phantom in pediatrics / Evaluación de la calidad de la imagen en radiología digital utilizando el fantoma de detalle de contraste CDRAD en pediatría

ABSTRACT The transition from analog to digital radiology has expanded the capabilities of radiological imaging but has also made it possible to increase the radiation dose received by patients. Image quality in radiology is determined by factors such as radiographic techniques (kVp and mAs), which directly impact the dose and image quality. This study focuses on pediatric radiological exams considering their greater radiosensitivity and longer life expectancy. The study aimed to investigate the correlation between image quality and applied radiographic techniques using the CDRAD contrast-detail phantom. The results showed a direct linear relationship between the increase in kVp and the corresponding increase in image quality. Nonetheless, there was a significant variation in image quality between current-time products ranging from 0.5 to 2.5 mAs, in contrast to the nearly linear relationship observed within the 2.5 and 10 mAs range

RESUMEN La transición de la radiología analógica a la digital ha ampliado las capacidades de las imágenes radiológicas, pero ha también permitió aumentar la dosis de radiación que reciben los pacientes. La calidad de la imagen en radiología está determinada por factores como las técnicas radiográficas (kVp y mAs), que impactan directamente en la dosis y la calidad de la imagen. Este estudio se centra en exámenes radiológicos pediátricos considerando su mayor radiosensibilidad y mayor espe ranza de vida. El estudio está dirigido a investigar la correlación entre la calidad de la imagen y las técnicas radiográficas aplicadas utilizando el detalle de contraste CDRAD fantasma. Los resultados mostraron una relación lineal directa entre el aumento de kVp y el correspondiente aumento de calidad de la imagen. No obstante, hubo una variación significativa en la calidad de la imagen entre los productos actuales que van desde 0,5 a 2,5 mAs, en contraste con la relación casi lineal observada dentro del rango de 2,5 y 10 mAs.

Perceptions of Radiation Safety Culture in Medical Imaging by Role.

PURPOSE: To determine whether radiologic technologists' perceptions of determinants of radiation safety culture differ significantly based on their primary role. METHODS: A secondary analysis of deidentified data from 425 radiologic technologists who participated in the Radiation Actions and Dimensions of Radiation Safety questionnaire, a 35-item survey with valid and reliable psychometric properties, was performed. Nine determinants (dependent variables) of radiation safety culture were analyzed in this study. The radiologic technologists worked primarily as staff technologists; shift, team, or modality leads; and managers or directors. Descriptive statistics were used to analyze differences in favorability for the determinants of radiation safety culture by primary role. Games-Howell post hoc tests were conducted to analyze the hypothesis for each determinant. RESULTS: Four determinants demonstrated significant differences with appropriate observed power between staff technologists, leads, and managers and directors: questioning attitude (P < .001), feedback loops (P < .001), leadership actions (P < .001), and nonpunitive response (P < .001). DISCUSSION: The findings indicate that dialogue is needed between all stakeholders to improve the radiation safety culture and that power imbalances caused by the hierarchical system should be considered when seeking to improve the safety culture. CONCLUSION: Positional hierarchies in the medical imaging profession affect the perception of radiation safety, with managers and directors having different perceptions of leadership actions, questioning attitudes, feedback loops, and nonpunitive responses than staff technologists. Therefore, radiologic technologist subgroups must be included purposefully in the process of establishing a radiation safety culture in the imaging department.

Além do câncer de mama: estudo das lesões mamárias raras / Beyond breast cancer: study of rare breast lesions

Lesões incomuns da mama podem representar um desafio diagnóstico. Essas lesões incluem doenças sistêmicas, tumores benignos e malignos primários da mama, e até mesmo tumores metastáticos. É importante que os radiologistas estejam familiarizados com a aparência de uma variedade de lesões mamárias incomuns, não só na mamografia como também na tomossíntese, na ultrassonografia e na ressonância magnética. Essas lesões incluem doenças sistêmicas, tumores benignos raros, tumores malignos primários incomuns e lesões metastáticas. Este trabalho consiste num ensaio iconográfico, observacional, descritivo e retrospectivo, realizado através da avaliação dos prontuários e exames de imagens de pacientes com lesões mamárias suspeitas de câncer primário das mamas, ainda que sem diagnóstico, ou mesmo com diagnóstico de lesões benignas ou malignas, mas que não primárias das mamas, e referenciadas ao Instituto Nacional de Câncer (INCA) para tratamento. A presente revisão da literatura visa facilitar o aprendizado dos médicos radiologistas, permitindo um diagnóstico mais precoce reduzindo a morbimortalidade das pacientes acometidas

Unusual breast lesions can pose a diagnostic challenge. These lesions include systemic diseases, primary benign and malignant breast tumors, and even metastatic tumors. It is important for radiologists to be familiar with the appearance of a variety of unusual breast lesions, not only on mammography but also on tomosynthesis, ultrasound, and MRI. These lesions include systemic diseases, rare benign tumors, uncommon primary malignant tumors, and metastatic lesions. This work consists of an iconographic, observational, descriptive and retrospective essay, carried out through the evaluation of medical records and image exams of patients with breast lesions suspected of primary breast cancer, even if without diagnosis, or even with a diagnosis of benign or malignant lesions, but not breast primary, and referred to the Brazilian National Cancer Institute (INCA) for treatment. This literature review aims to facilitate the learning of radiologists, allowing an earlier diagnosis, reducing the morbidity and mortality of affected patients.

Radiologic Technologists' Knowledge of And Comfort Explaining Effective Dose.

PURPOSE: To examine U.S. radiologic technologists' perceived level of knowledge of radiation effective dose, their level of comfort communicating effective dose information for common imaging procedures to patients, and their ability to compare effective doses for different medical imaging procedures. METHODS: A national cross-sectional study was conducted using a simple randomized sample of American Society of Radiologic Technologists (ASRT) members employed in radiography, computed tomography (CT), mammography, or radiology management. Survey items were created; descriptive and categorical statistics were analyzed; and relationships among knowledge of effective dose, comfort explaining effective dose, and procedural rank-order accuracy scores were evaluated with chi-square tests. RESULTS: More than half (56.5%) of participants perceived themselves as knowledgeable about radiation effective dose and 67.5% were comfortable discussing radiation effective dose information with patients. More than three-quarters (75.1%) of participants achieved a rank-order accuracy score of 75% or higher. A significant relationship was found between perceived knowledge of effective dose and perceived level of comfort explaining effective dose. DISCUSSION: Perceived knowledge of radiation effective dose, comfort explaining effective dose, and rank-order accuracy scores were higher among U.S. radiologic technologists in this study compared with similar assessments reported in the literature. However, rank-order derived methodology might not represent an in-depth assessment of radiologic technologists' radiation effective dose knowledge. CONCLUSION: The findings demonstrate that radiologic technologists have average-to-good perceived radiation effective dose knowledge, neutral-to-good levels of comfort explaining effective dose information to patients, and, in general, can rank-order common medical imaging procedures by effective dose.

Radiologic Technologists' Perceived Reasons for Inappropriate Imaging.

PURPOSE: To examine whether radiologic technologists' perceptions of imaging appropriateness differed based on their primary imaging modality, work shift, shift length, and primary practice type. METHODS: A national, cross-sectional study was conducted in the fourth quarter of 2019 using a simple, randomized sample of American Society of Radiologic Technologists (ASRT) members. Study participants were employed in health care settings in radiography, computed tomography (CT), mammography, or radiology leadership. Seven potential reasons for inappropriate imaging procedures (ie, patient expectations, provide patient with a feeling of being taken seriously, lack of time, expectations from relatives, compensation for insufficient clinical examination, normal findings would reassure the patient, and fear of lawsuits) were evaluated for relationships with their primary imaging modality, work shift, shift length, and primary practice type. RESULTS: Disparities in perceived reasons affecting imaging appropriateness were found. Providing the patient with a feeling of being taken seriously was related to primary practice type (P = .022). Lack of time was related to primary imaging modality (P = .005) and primary practice type (P = .006). Expectations from relatives was related to primary imaging modality (P = .016) and primary practice type (P = .027). Compensation for insufficient clinical examination was related to primary imaging modality (P < .001), shift length (P = .011), work shift (P = .002), and primary practice type (P < .001). Fear of lawsuits was related to primary imaging modality (P = .001)) and work shift (P = .002). DISCUSSION: The study reveals that radiologic technologists' perceptions of patient-centered factors and defensive medicine-related factors differ among imaging modalities, shift types, and practice settings. However, more research is required to determine why radiologic technologists perceive these reasons to be present, investigate whether providers feel similarly, and determine perceptual alignment with evidence-based guidelines. CONCLUSION: The findings suggest that attention should focus on the appropriateness of CT imaging procedures performed in hospitals during night shifts.

Radiologic Technologists' Perceptions of Imaging Appropriateness in Radiography, CT, and Mammography.

PURPOSE: To determine U.S.-based radiologic technologists' perceptions of imaging appropriateness by imaging modality and to examine relationships between descriptive variables and perception of imaging appropriateness scores. METHODS: A cross-sectional survey was used to collect data and guide testing of the hypotheses. Radiologic technologists working in radiography, computed tomography, and mammography were eligible to participate in the study. The survey instrument items were evaluated for validity and reliability. Categorical and descriptive data were calculated, and 1-way analysis of variance tests were used to analyze hypotheses. RESULTS: Survey results found that the radiologic technologists perceived that 16% to 30% of completed examinations were inappropriate, with the primary reasons being fear of lawsuits and patient expectations. Technologists indicated that imaging ordering should be based on the effect that an imaging procedure can have on the patient's diagnosis or treatment. The study found 6 main effects with mean differences between groups for the perception of imaging appropriateness score, including primary employed imaging modality (P < .001), shift length (P < .001), work shift (P < .001), primary practice facility (P < .001), primary patient population (P = .009), and level of education (P = .044). Employment status, primary role, age, years of experience, number of imaging credentials, gender, and practice location were not significant at the level of P ≤ .05. DISCUSSION: Study findings demonstrate the complexity and interconnectedness of imaging appropriateness, the potential reasons driving ordering practices, and the importance of increasing radiologic technologists' familiarity with appropriate use criteria. Further, the results show the importance of using clinical decision support mechanisms and ensuring that potential risk from ionizing radiation exposure remains a core component of the decision-making process when choosing among imaging examinations of similar diagnostic value. CONCLUSION: Further research needs to be conducted to better understand perceptions of imaging appropriateness, how perceptions align or deviate from appropriate use criteria, and improvements in imaging appropriateness from enhanced radiologic technologist-provider collaboration.

Intrapersonal and Institutional Influences On Overall Perception of Radiation Safety Among Radiologic Technologists.

PURPOSE: The purpose of the study was to examine mean differences between intrapersonal and institutional variables and the overall perception of radiation safety (OPRS) among U.S. radiologic technologists. The study also sought to demonstrate the applicability of the socioecological model for radiation safety decision-making. METHODS: A quantitative, cross-sectional design with the Radiation Actions and Dimensions of Radiation Safety survey instrument was used to collect data and guide hypotheses testing. The 425 research participants included radiologic technologists working in radiography, mammography, computed tomography, and radiology management. Categorical and descriptive data were calculated, and 1-way analysis of variance tests were used to analyze hypotheses. RESULTS: Seven main effects demonstrated mean differences between groups for the OPRS, including age (F5,419 = 2.55, P = .03), years of experience (F5,419 = 4.27, P = .001), primary employed imaging modality (F2,422 = 9.04, P < .001), primary role (F2,422 = 4.58, P = .01), shift length (F3,421 = 10.33, P < .001), primary practice facility (F4,404 = 5.00, P = .001), and work shift (F3,405 = 4.14, P = .007), with shift length having the largest effect. Level of education, employment status, number of imaging credentials, gender, patient population, and practice location were not significant at the level of P ≤ .05. DISCUSSION: Radiation safety culture is a multidimensional topic that requires consideration of several intervening influences, making the socioecological model well aligned when considering radiation safety culture and radiation safety perception in medical imaging. Previous research on radiation safety perception among radiologic technologists demonstrated that leadership actions, teamwork across imaging stakeholders, organizational learning, and questioning behavior are drivers of OPRS. However, this study's findings demonstrate that radiologic technologist scheduling practices and primary employed imaging modalities also should be considered when seeking to improve OPRS. CONCLUSION: This study presents an extensive examination of intrapersonal and institutional variables on OPRS among U.S.-based radiologic technologists and provides findings to support radiation safety culture decision-making in medical imaging, particularly for shift length considerations.

Added Value of Prereading Screening Mammograms for Breast Cancer by Radiologic Technologists on Early Screening Outcomes.

Background In the Dutch breast cancer screening program, mammograms are preread by technologists to identify possible abnormalities, leading to "warning signals" (an audible and visual alert if the technologist observed an abnormality suspicious for cancer) for radiologists. The best moment to present these warning signals is unknown. Purpose To determine the effect that blinding of technologists' warning signals has on radiologists' early screening outcome measures during interpretation of mammograms. Materials and Methods In this prospective study from September 2017 to May 2019, on alternating months, radiologists were either blinded or nonblinded to the warning signals of the technologist when interpreting screening mammograms for breast cancer. All discrepancies between radiologists and technologists were reviewed during quality assurance sessions every 6 weeks, which could result in secondary recalls. The outcome measures of this study were recall rate, cancer detection rate, and positive predictive value of recall. A χ2 test was used to test for differences between the two groups. Results During the study period, 109 596 women (mean age, 62 years ± 7 [standard deviation]), including 53 291 in the blinded and 56 305 in the nonblinded groups, participated. The overall recall rate (including secondary recalls) was lower for women in the blinded group than in the nonblinded group (blinded: 1140 of 53 291 women [2.1%], nonblinded: 1372 of 56 305 women [2.4%]; P = .001). There was no evidence of cancer detection rate differences between the groups (blinded: 349 of 53 291 women [6.5 per 1000 screening examinations], nonblinded: 360 of 56 305 women [6.4 per 1000 screening examinations]; P = .75). The blinded group thus had a higher positive predictive value of recall (blinded: 349 of 1140 women [30.6%], nonblinded: 360 of 1372 women [26.2%]; P = .02). Conclusion While interpreting screening mammograms for breast cancer, radiologists blinded to technologists' warning signals had lower recall rates with higher positive predictive values than nonblinded radiologists, yet cancer detection rates seemed to remain unchanged. See also the editorial by Hofvind and Lee in this issue. © RSNA, 2021.

Pectus excavatum em uma ninhada de Buldogue Francês: relato de caso / Pectus excavatum in a French Bulldog Litter: case report

RESUMO O pectus excavatum é considerado uma patologia da parede torácica, onde há convexidade no aspecto ventral do esterno, o que gera complicações secundárias, como alongamento ventrodorsal do tórax e aumento da pressão intratorácica, entre outras. No presente caso, o corpo de um cachorro Buldogue Francês nasceu com sinais prévios de decaimento e baixo consumo de leito materno, além de uma avaliação médica forense. De acordo com a avaliação patológica, foi encontrada uma fenda no peito esternal relacionada às esternas caudais próximas à cartilagem xifóide, conteúdo espumoso na cartilagem epiglótica da laringe e sinais graves de enfisema nos lobos caudal, craniano e médio pulmonar. Na avaliação cardiológica, foi observada assimetria morfológica invaginante no septo interventricular na mesma área em que a fenda esternal ocorre, por sua vez, na avaliação radiográfica, evidencia uma depressão dorsal do terço caudal do esterno com alterações consideráveis na silhueta cardíaca. Na Colômbia não há relatos de ninhadas completas que apresentem esta alteração, portanto, pretende-se que este seja o primeiro relatório anatomopatológico e de imagem que descreva a patologia em caninos.

ABSTRACT Pectus excavatum is considered a pathology of the chest wall where there is convexity in the ventral aspect of the sternum, which generates secondary complications, such as ventrodorsal stretching of the chest and increased intrathoracic pressure, among others. In the present case, the body of a French bulldog dog was born with previous signs of decay and low consumption of maternal waste, in addition to a forensic medical evaluation. According to the pathological evaluation, a crack was found in the sternal chest related to the caudal sternum close to the xiphoid cartilage, frothy content in the laryngeal epiglottis cartilage and severe signs of emphysema in the caudal, cranial and middle lung lobes. In the cardiological evaluation, an invaginating morphological asymmetry was observed in the interventricular septum in the same area in which the sternal cleft occurs, in turn, in the radiographic evaluation, it shows a dorsal depression of the caudal third of the sternum with considerable changes in the cardiac silhouette. In Colombia there are no reports of complete litters that present this alteration, so it is intended that this is the first anatomopathological and imaging report that describes the pathology in canines.

Determinants of Overall Perception of Radiation Safety Among Radiologic Technologists.

PURPOSE: To examine the determinants of radiation safety culture among radiologic technologists in the United States. The specific aims were to report descriptive statistics related to radiation safety culture determinants and examine relationships between specific determinants of radiation safety culture and overall perception of radiation safety (OPRS). METHODS: Radiologic technologists working in radiography, mammography, and computed tomography were identified using the American Society of Radiologic Technologists membership database. The researcher implemented a quantitative cross-sectional design using the Radiation Actions and Dimensions of Radiation Safety (RADS) survey instrument, which contained the study's determinants and OPRS variable, to guide hypotheses testing. Descriptive statistics were used to report RADS survey item outcomes, and Pearson correlation and multiple linear regression tests were conducted to analyze the hypothesis. RESULTS: A total of 425 radiologic technologists completed the survey. Ten variables significantly correlated with OPRS. The variables of leadership actions (ß = .402; P < .001), teamwork across imaging stakeholders (ß = .304; P = .011), organizational learning (ß = .121; P = .007), and questioning attitude (ß = .110; P = .001) predicted OPRS, with leadership actions being most important in the model. DISCUSSION: The correlation between OPRS scores and the 10 determinants suggests that each variable is a relevant determinant of radiation safety culture among radiologic technologists in the United States. The outcomes establish key priorities and provide an actionable foundation to facilitate a positive radiation safety culture in medical imaging. CONCLUSION: The study presented a unique examination of OPRS determinants among American radiologic technologists. Findings can be used to support clinically-oriented interventions in improving radiation safety culture.

[Cooperation protocol and advanced practice, an evolutionary perspective for the French radiation therapist]. / Protocole de coopération et pratique avancée, une perspective d'évolution pour le manipulateur en radiothérapie français.

For several years, the profession of radiographer has been unattractive and is in search of professional recognition. Increasingly complex therapeutic and diagnostic evolutions forces professionals to develop their skills to ensure quality and safe care for all patients. The primary role of the radiographer is to support patients and to accompany them during their examination or treatment, combining caregiver and technician's roles. Transversal missions and delegation of tasks are inherent to the profession but are not widely recognized. Cooperation between radiotherapy professionals is a response to offer the therapeutic radiographer/radiation therapist (RTT) opportunities in terms of attractiveness, career prospects, and increased skills. In radiotherapy, advanced practice activities already exist in some departments but require regulatory adjustments, in particular regarding the redistribution of the roles of RTT but also the status of these professionals. The formalization of these practices can be largely inspired by the many feedbacks around the world. This article aims to reflect the evolution's perspectives in the career of an RTT and on the valorisation of this profession in the current context.

Validity and Reliability of a Radiation Safety Culture Survey Instrument for Radiologic Technologists.

PURPOSE: To design and evaluate a survey instrument to quantitatively examine radiologic technologists' perception of radiation safety culture. METHODS: A survey instrument with determinants related to radiation actions and dimensions of radiation safety (RADS) was designed through a multisequential process involving content and scale validity and internal reliability. A 6-member panel evaluated content validity, and 425 radiologic technologists participated in the study to determine the reliability of the survey instrument items and determinant scales. RESULTS: The 35-items in the survey instrument were found to be valid (content validity index = 0.995) and reliable (α = .94). In addition, 10 determinant scales also were found to be reliable (α = .70-.84). The scales included teamwork in imaging, teamwork across imaging stakeholders, questioning attitude, feedback loops, organizational learning, leadership actions, nonpunitive response, error reporting, radiation policy, and overall perception of radiation safety. DISCUSSION: The survey instrument meets recommendations to have a quantitative tool to assess radiation safety culture perception and represents the first instrument of its kind for radiologic technologists. The survey instrument is intended to assess perception of radiation safety culture, but the tool should be paired with clinically relevant outcome data to assess the alignment between radiologic technologist perception and objective radiation safety-related performance indicators. CONCLUSION: The RADS survey instrument is a reliable and valid tool to examine radiologic technologists' perceptions of radiation safety culture in medical imaging. Survey use and subsequent process improvement and leadership intervention for areas of deficiency can strengthen radiation safety culture in medical imaging.

[Source blocking in HDR brachytherapy: Practical situation and experience feedback at the Eugène Marquis-Rennes]. / Blocage de source en curiethérapie de haut débit de dose : mise en situation pratique et retour d'expérience au centre Eugène Marquis- Rennes.

At the Eugene Marquis Center, high dose rate brachytherapy is part of the care offering. The risk analysis and the national experience feedback linked to the use of high activity sources show that blocking the source outside its storage position, during treatment, would be the main risk of exposure of ionizing radiation. In a process of radiation protection of patients and workers, and to limit the consequences of such an accident, the Eugene Marquis Center has set up periodic training with practical experience for all brachytherapy professionals. This article describes the experience feedback from this training by brachytherapy technicians.