A novel method for comparing radiation dose and image quality, between and within different x-ray units in a series of hospitals.

OBJECTIVES: To develop a novel method for comparing radiation dose and image quality (IQ) to evaluate adult chest x-ray (CXR) imaging among several hospitals. METHODS: CDRAD 2.0 phantom was used to acquire images in eight hospitals (17 digital x-ray units) using local adult CXR protocols. IQ was represented by image quality figure inverse (IQFinv), measured using CDRAD analyser software. Signal to noise ratio, contrast to noise ratio and conspicuity index were calculated as additional measures of IQ. Incident air kerma (IAK) was measured using a solid-state dosimeter for each acquisition. Figure of merit (FOM) was calculated to provide a single estimation of IQ and radiation dose. RESULTS: IQ, radiation dose and FOM varied considerably between hospitals and x-ray units. For IQFinv, the mean (range) between and within the hospitals were 1.42 (0.83-2.18) and 1.87 (1.52-2.18), respectively. For IAK, the mean (range) between and within the hospitals were 93.56 (17.26-239.15) µGy and 180.85 (122.58-239.15) µGy, respectively. For FOM, the mean (range) between and within hospitals were 0.05 (0.01-0.14) and 0.03 (0.02-0.05), respectively. CONCLUSIONS: The suggested method for comparing IQ and dose using FOM concept along with the new proposed FOM, is a valid, reliable and effective approach for monitoring and comparing IQ and dose between and within hospitals. It is also can be beneficial for the optimisation of x-ray units in clinical practice. Further optimisation for the hospitals/x-ray units with low FOM are required to minimise radiation dose without degrading IQ.

The perceptions and willingness of radiographers to extend their roles and become reporting radiographers in Abu Dhabi, the United Arab Emirates (UAE).

INTRODUCTION: There has been an increase in the need for diagnostic imaging services globally, which is faster than the capacity of radiologists. The current workforce model is not sustainable due to the predicted aging of the population and the contraction of the healthcare workforce. By extending the role of radiographers to a specific range of radiological reporting tasks. It may be possible to meet demand and relieve some pressure on radiologists and increase radiographer satisfaction and retention. The purpose of this study is to investigate the perceptions, and willingness of the Abu Dhabi radiographers to extend their role as reporting radiographers in skeleton radiography. METHODS: A cross-sectional study was conducted among radiographers in the UAE. The on-line questionnaire was designed to obtain demographic information about radiographers, their qualifications, their professional experience, their postgraduate training, their plans for professional development, as well as their interest in future career opportunities related to extended roles. RESULTS: This study had a response rate of 50% (n = 60). The government sector accounted for 75.3% of the survey's participants, while the private sector accounted for 24.7%. The main gains for role advancement were identified by 58.3% of the participants who were confident to start interpreting the upper and lower extremities in the emergency room (ER), and 86.3% were willing to be reporting radiographers. CONCLUSION: In conclusion, the Abu Dhabi radiographers are willing to extend their role in the interpretation of general X-ray images of skeletons. IMPLICATIONS FOR PRACTICE: Curriculum development in radiography and medical imaging education jointly with licensing health authority bodies is required to plan for the new radiographer reporting role.

Singapore radiographers' perceptions and expectations of artificial intelligence - A qualitative study.

INTRODUCTION: With the emergence of artificial intelligence (AI) in medical imaging, radiographers are likely to be at the forefront of this technological advancement. Studies have therefore been conducted recently to understand radiographers' opinions on AI adoption. This study extends that work by using a qualitative approach to further explore radiographers' knowledge, perceptions, and expectations of AI. METHOD: Six online focus groups were conducted with 22 radiographers from the three public healthcare clusters in Singapore. They were purposively sampled, and participants were recruited from a broad demographic background with varying years of working experience and designations. The focus group sessions were transcribed verbatim and thematic analysis was performed on their responses. RESULTS: Participants demonstrated limited knowledge of AI. Their perceptions of AI were mixed, recognising its benefits in increasing efficiency and improving patient care, but also aware of its limitations in accuracy and bias. On how patients may perceive AI, participants felt that patients would accept AI if they felt it improves their care but may reject it once they lose trust in it. Expectations wise, participants envisioned several applications in pre-, peri­, and post-procedural workflows including order vetting, patient positioning, language translation, and artefact removal. On radiographers' role and career opportunities, some participants see an opportunity for radiographers to specialise in AI, becoming involved in algorithm development and its clinical implementation. DISCUSSION: Our findings suggest that widespread implementation of AI would require limited knowledge amongst radiographers and current AI limitations to be addressed. While radiographers are positively anticipating the integration of AI into their practices, they should also become actively involved in the development of AI tools such that those they envisioned. This would help align optimal use of AI tools and radiographer role changes. Patients' acceptance and reactions to AI also warrant further research.

Are Antimony-Bismuth Aprons as Efficient as Lead Rubber Aprons in Providing Shielding against Scattered Radiation?

AIM: The aim of this study is to compare the absorption ability of two lead-free aprons with a lead apron. METHOD: The absorption ability of three aprons was measured and compared; Opaque Fusion 0.35 mm (OpaqFu) bilayer apron containing bismuth and antimony, No Lead 0.35 mm (NoLead) one-layer apron containing antimony, and a lead apron. The measurements were repeated with and without each of the aprons present in both primary and scattered beams. The selected tube voltages were between 60 and 113 kVp with constant mAs, a fixed field size, and fixed source-to-object distance. RESULTS: No significant difference in absorption ability of the two lead-free aprons compared with that of the lead apron was observed when the dose was measured in the primary beam. When measurements were performed in the scatter radiation field, the absorption ability of the OpaqFu apron was 1.3 times higher than that of NoLead apron and nearly equal to the absorption ability of the lead apron. An increase in the difference between the OpaqFu and NoLead aprons was observed for the tube energies higher than 100 kVp in favour of OpaqFu apron. CONCLUSION: It is safe to use the lead-free aprons that were tested in this study in a clinical environment for the tube energy range of 60 kVp-113 kVp.

Sisprad: software for radiological protection management in a hospital environment / Sisprad: software para gestión de protección radiológica en entorno hospitalario / Sisprad: software para gestão da proteção radiológica em ambiente hospitalar

ABSTRACT Objective: to describe the software for the management of radiological protection, SisPRad, and its construction process, as well as to analyze its implementation and use in a radiodiagnosis service. Method: a methodological and quasi-experimental research study carried out between November 2016 and October 2019. The study population consisted of the professionals who make up the Radiological Protection Committee of the service. The model chosen for software engineering was the cascade model. In the implementation phase, an evaluation and analysis of the usability of the software was carried out. Results: the software for radiological protection management presents the structure of the technology and its functionalities. The usability evaluation showed that SisPRad is a tool that will assist the multi-professional and interdisciplinary team of the hospital radiology service in the management of radiological protection. The computerization of the systems and the integration of the sectors that need shared data in the work routines enhance the management of hospital radiological protection for the multi-professional team. The technology was positively evaluated by the multi-professional team working in the hospital radiodiagnosis service. SisPRad generated registration n.. 512019002125-8 by the National Institute of Industrial Property. Conclusion: this tool was developed aiming at the safety of the professionals working in the radiodiagnosis service and of its users, in addition to enabling the constant improvement of the tool, and it can be adapted in other institutions.

RESUMEN Objetivo: describir el software para la gestión de protección radiológica, SisPRad, su proceso de construcción y analizar su implementación y uso en un servicio de radiodiagnóstico. Método: investigación metodológica y cuasiexperimental realizada entre noviembre de 2016 y octubre de 2019. La población de estudio estuvo constituida por los profesionales que integran el Comité de Protección Radiológica del servicio. Para la ingeniería de software, se eligió el modelo en cascada. En la etapa de implementación se realizó la evaluación y el análisis de usabilidad del software. Resultados: el software de gestión de protección radiológica presenta la estructura de la tecnología y sus funcionalidades. La evaluación de usabilidad mostró que SisPRad es una herramienta que ayudará al equipo multidisciplinario e interdisciplinario del servicio de radiología del hospital en la gestión de la protección radiológica. La informatización de sistemas y la integración de sectores que requieren datos en común en las rutinas de trabajo potencian la gestión de la protección radiológica hospitalaria del equipo multidisciplinario. La tecnología fue valorada positivamente por el equipo multiprofesional que cumple sus funciones en el servicio de radiodiagnóstico del hospital. SisPRad generó el registro 512019002125-8 en el Instituto Nacional de Propiedad Industrial. Conclusión: esta herramienta fue desarrollada con el objetivo de promover la seguridad de los profesionales que trabajan en el servicio de radiodiagnóstico y de sus usuarios, además de permitir la mejora constante de la herramienta, que puede ser adaptada a otras instituciones.

RESUMO Objetivo: descrever o software para gestão da proteção radiológica, SisPRad, seu processo de construção e analisar sua implantação e utilização em um serviço de radiodiagnóstico. Método: pesquisa metodológica e quase-experimental realizada entre novembro de 2016 e outubro de 2019. A população do estudo foi constituída pelos profissionais que compõem o Comitê de Proteção Radiológica do serviço. O modelo escolhido para a engenharia do software foi o modelo em cascata. Na fase de implantação foi realizada avaliação e análise da usabilidade do software. Resultados: o software de gestão para proteção radiológica apresenta a estrutura da tecnologia e suas funcionalidades. A avaliação da usabilidade evidenciou que o SisPRad é uma ferramenta que irá auxiliar a equipe multiprofissional e interdisciplinar do serviço de radiologia hospitalar na gestão da proteção radiológica. A informatização dos sistemas e a integração dos setores que necessitam de dados em comum nas rotinas de trabalho potencializam a gestão da proteção radiológica hospitalar para a equipe multiprofissional. A tecnologia foi avaliada positivamente pela equipe multiprofissional atuante no serviço de radiodiagnóstico hospitalar. O SisPRad gerou o registro 512019002125-8 pelo Instituto Nacional de Propriedade Industrial. Conclusão: essa ferramenta foi desenvolvida visando a segurança dos profissionais atuantes no serviço de radiodiagnóstico e seus usuários, além de possibilitar a melhora da ferramenta constantemente, podendo ser adaptada em outras instituições.

Visual Function Assessment in Medical Imaging Research.

BACKGROUND: Medical image perception research relies on visual data to study the diagnostic relationship between observers and medical images. A consistent method to assess visual function for participants in medical imaging research has not been developed and represents a significant gap in existing research. METHODS: Three visual assessment factors appropriate to observer studies were identified: visual acuity, contrast sensitivity, and stereopsis. A test was designed for each, and 30 radiography observers (mean age 31.6 years) participated in each test. RESULTS: Mean binocular visual acuity for distance was 20/14 for all observers. The difference between observers who did and did not use corrective lenses was not statistically significant (P = .12). All subjects had a normal value for near visual acuity and stereoacuity. Contrast sensitivity was better than population norms. CONCLUSION: All observers had normal visual function and could participate in medical imaging visual analysis studies. Protocols of evaluation and populations norms are provided. Further studies are necessary to understand fully the relationship between visual performance on tests and diagnostic accuracy in practice.

Lesion detection performance: comparative analysis of low-dose CT data of the chest on two hybrid imaging systems.

UNLABELLED: Incidental findings on low-dose CT images obtained during hybrid imaging are an increasing phenomenon as CT technology advances. Understanding the diagnostic value of incidental findings along with the technical limitations is important when reporting image results and recommending follow-up, which may result in an additional radiation dose from further diagnostic imaging and an increase in patient anxiety. This study assessed lesions incidentally detected on CT images acquired for attenuation correction on two SPECT/CT systems. METHODS: An anthropomorphic chest phantom containing simulated lesions of varying size and density was imaged on an Infinia Hawkeye 4 and a Symbia T6 using the low-dose CT settings applied for attenuation correction acquisitions in myocardial perfusion imaging. Twenty-two interpreters assessed 46 images from each SPECT/CT system (15 normal images and 31 abnormal images; 41 lesions). Data were evaluated using a jackknife alternative free-response receiver-operating-characteristic analysis (JAFROC). RESULTS: JAFROC analysis showed a significant difference (P < 0.0001) in lesion detection, with the figures of merit being 0.599 (95% confidence interval, 0.568, 0.631) and 0.810 (95% confidence interval, 0.781, 0.839) for the Infinia Hawkeye 4 and Symbia T6, respectively. Lesion detection on the Infinia Hawkeye 4 was generally limited to larger, higher-density lesions. The Symbia T6 allowed improved detection rates for midsized lesions and some lower-density lesions. However, interpreters struggled to detect small (5 mm) lesions on both image sets, irrespective of density. CONCLUSION: Lesion detection is more reliable on low-dose CT images from the Symbia T6 than from the Infinia Hawkeye 4. This phantom-based study gives an indication of potential lesion detection in the clinical context as shown by two commonly used SPECT/CT systems, which may assist the clinician in determining whether further diagnostic imaging is justified.

IMPLEMENTATION OF A RADIATION PROTECTION PROGRAM: OPINION OF THE HEALTH TEAM WORKING IN A RADIOLOGY SERVICE / IMPLEMENTACIÓN DEL PROGRAMA DE PROTECCIÓN RADIOLÓGICA: UNA MIRADA DEL EQUIPO DE SALUD ACTUANTE EN UN SERVICIO DE RADIOLOGÍA / IMPLEMENTAÇÃO DO PROGRAMA DE PROTEÇÃO RADIOLÓGICA: OLHAR DA EQUIPE DE SAÚDE ATUANTE EM UM SERVIÇO DE RADIOLOGIA

ABSTRACT Objective: to identify the participation of a multi-professional healthcare team in a Radiation Protection Program, and to describe the implementation of this program by the staff working in the service. Method: qualitative, exploratory and descriptive research, performed through a semi-structured interview with professionals of the radiology service of a public hospital in the South of Brazil. A sample of 25 participants was considered sufficient after data saturation. The content analysis was used, with Atlas-Ti 7.0 software for treatment and data analysis. Two main categories emerged: Participation of the multi-professional healthcare team in the Radiation Protection Program and Implementation of the program by the multi-professional healthcare team. Results: the program is not known by a large part of the team, indicating that the professionals would have difficulties in identifying intercurrences involving ionizing radiation, as well as in finding fast solutions in emergency situations. Conclusion: in the service researched, the Radiation Protection Program is only known by those who participated in its creation, and most of the members of the multi-professional team did not participate in it, which allows to deduce that its implementation by part of the team is, for this reason, impaired.

RESUMO Objetivo: identificar a participação da equipe multiprofissional de saúde no Programa de Proteção Radiológica e descrever a implementação deste programa pela equipe atuante no serviço. Método: pesquisa qualitativa, exploratória e descritiva, realizada por meio de entrevista semiestruturada com profissionais do serviço de radiologia hospitalar de um hospital público do Sul do Brasil. A amostra de 25 participantes foi considerada suficiente após saturação dos dados. Utilizou-se a análise de conteúdo, com auxílio do software Atlas-Ti 7.0 para tratamento e análise dos dados. Emergiram duas categorias principais: Participação da equipe multiprofissional de saúde no Programa de Proteção Radiológica Implementação do Programa pela equipe multiprofissional. Resultados: o programa é desconhecido por grande parte da equipe, indicando que os trabalhadores teriam dificuldades em identificar intercorrências envolvendo radiações ionizantes, bem como encontrar rápidas soluções em situações emergenciais. Conclusão: no serviço pesquisado, o Programa de Proteção Radiológica só é conhecido por quem participou de sua elaboração, ou seja, grande parte dos integrantes da equipe multiprofissional não participou da elaboração do Programa de Proteção Radiológica, o que permite deduzir que a implementação dele por parte da equipe está, justamente por este motivo, comprometida.

Proteção radiológica: da legislação à prática de um serviço / Radiation protection: from legislation to practice of a service

Objetivos: comparar o Programa de Proteção Radiológica de um hospital público na região Sul do Brasil com o estabelecido na legislação brasileira vigente e descrever o cotidiano do serviço. Metodologia: estudo qualitativo, exploratório e descritivo desenvolvido por observação não participante e análise documental do Memorial Descritivo. Participaram 14 trabalhadores ocupacionalmente e para-ocupacionalmente expostos. Adotada Análise de Conteúdo para a análise de dados. Resultados: evidenciaram-se inconsistências no Programa de Proteção Radiológica e necessidade de inserção de outros itens, além dos indicados na Portaria 453. As dificuldades burocráticas e financeiras, inerentes a maioria dos hospitais públicos, repercutem na adequação ágil às situações emergentes e importantes com relação à Proteção Radiológica. Conclusão: a formação continuada mostra-se necessária para atualização dos profissionais ocupacionalmente e para-ocupacionalmente expostos.

Objectives: to compare the Radiological Protection Program of a public hospital in Southern Brazil, with the stated in Brazilian legislation and describe their daily lives. Methodology: qualitative, exploratory and descriptive study developed by nonparticipant observation and documentary analysis of the Descriptive Memorial. Thirteen workers occupationally and paraoccupationally exposed participated. Adopted Content Analysis to analyze data. Results: showed up inconsistencies in the Radiation Protection Program and necessity of including other items, than those specified in Ordinance 453. The bureaucratic and financial difficulties, inherent to most public hospitals, affects the agile adaptation to emerging and important situations regarding Radiation Protection. Conclusion: continuing education is shown to be necessary for updating professionals occupationally and para-occupationally exposed.

Objetivos: comparar el Programa de Protección Radiológica de un hospital público en el sur de Brasil, con lo dispuesto en la legislación brasileña y describir su cotidiano. Metodologia: estudio cualitativo, exploratorio y descriptivo mediante observación no participante y análisis documental del Memorial Descriptivo. Participaron 13 trabajadores ocupacionalmente y para-ocupacionalmente expuestos. Adoptada Análisis de Contenido para analizar los datos. Resultados: se presentaron inconsistencias en el Programa de Protección Radiológica y necesidad de incluir otros elementos, además de los especificados en la Ordenanza 453. Las dificultades burocráticas y financieras inherentes a la mayoría de los hospitales públicos, afecta la adaptación ágil para situaciones emergentes y importantes en relación con la Protección Radiológica. Conclusion: la educación continua se demuestra necesaria para la actualización de los profesionales ocupacionalmente y para-ocupacionalmente expuestos.