Evaluation of a radiographer-provided barium enema service.

AIM: Radiographers performed and reported 5516 double contrast barium enemas (RDCBEs) over 4 years to October 2001. This study was undertaken to assess the accuracy of RDCBE and the sensitivity for diagnosing colorectal cancer (CRC). METHOD: A total of 224 consecutive outpatient RDCBEs were reported; normal (C1), diverticulosis (C2), diverticulosis with filling defect (C3), diverticulosis & other pathology (C4) and abnormal (C5). RDCBEs were then reported by a radiologist (AL, NS) and the two reports compared. Of 450 CRCs, 153 had undergone DCBE; 152 RDCBEs. Reports were analysed to establish concurrence between radiographer and radiologist and final CRC diagnosis. RESULTS: By category: C1 - 37%, C2 - 31%, C3 - 21%, C4 - 11%, C5 - 0%. C4s included polyps (50%), cancer (12.5%), disrupted anastomosis (8%) and colitis (4%). There was no discrepancy between RDCBE and radiologist reports. Radiology and CRC diagnosis agreed in 145 of 152 DCBEs. There were three exclusions: DCBEs occurred outside the study period (2), one only with raised possibility of malignancy. Of eight remaining RDCBEs, seven were false negatives and one false positive. Sensitivity score for RDCBE was 94.5%. Double reporting by a radiologist did not improve sensitivity. CONCLUSION: RDCBEs are as accurate as those performed by radiologists and have a very high sensitivity for CRC. In a time of ever increasing demands for complex staging investigations for CRC and interventional radiology, the ACPGBI needs to reconsider its guidelines on radiographers not only performing but also reporting DCBE.

A retrospective 5-year study on the accuracy of the barium enema examination performed by radiographers.

Barium enema examinations have been undertaken by radiographers at the Frenchay Hospital for more than 10 years. We have performed a retrospective study to assess the accuracy of this radiographer service by reviewing those patients who have been examined by both Barium enema and colonoscopy/flexible sigmoidoscopy to determine agreement, and reasons for disagreement. This paper does not attempt to compare the two techniques. In the 5 years between 1992 and 1996, 595 patients had both barium enema and colonoscopy or flexible sigmoidoscopy. In 488 (82%) of these patients the barium enema examination was performed by a radiographer. Comparisons with endoscopy indicate that 96% of polyps >1 cm, and 97% of carcinomas were detected radiologically. We conclude that radiographer performed barium enemas with double reporting produces a very high standard of examination with detection rates for significant lesions comparable with published data.

Technical report: a 'new' tube providing rapid insertion for the small bowel enema.

Small bowel enteroclysis (SBE) is considered to be diagnostically superior to the conventional barium follow through examination (Sanders and Ho 1976; Maglinte et al., 1982; Herlinger, 1982) and would be more generally acceptable if jejunal intubation could be undertaken rapidly with minimum fluoroscopy and patient discomfort. Using a modified Merck 'Coresafe' tube 75 out of 80 patients referred for SBE were intubated, with considerably reduced fluoroscopic and intubation times. No tube related difficulty was encountered and patient tolerance was good.

Optically phase-locked electronic speckle pattern interferometer.

The design, theory, operation, and characteristics of an optically phase-locked electronic speckle pattern interferometer (OPL-ESPI) are described. The OPL-ESPI system couples an optical phase-locked loop with an ESPI system to generate real-time equal Doppler speckle contours of moving objects from unstable sensor platforms. In addition, the optical phase-locked loop provides the basis for a new ESPI video signal processing technique which incorporates local oscillator phase shifting coupled with video sequential frame subtraction.