MyT3 12 - Radiographers

Purpose:

To determine the dimensions of normal pituitary gland and correlate with age and gender, in order to obtain standard reference values.

Methods and materials:

Head MRI scans of 410 patients with clinically normal pituitary function (173 males and 237 females) were retrospectively analysed and in the age range 10-90 years. T1-weighted images were reviewed in order to obtain volumetric measurements of the pituitary gland using RadiAnt DICOM Viewer software® (V.4.2.1). The height, width and depth of the pituitary were obtained from mid-sagittal and coronal planes, while the volume was calculated from these measured parameters. The data obtained were stratified based on age and gender for analysis.

Results:

Females had greater pituitary height (5.59±1.29 mm), width (13.08±2.21 mm), and volume (398.98±123.80 mm³) compared to males (5.53±1.23 mm, 12.59±2.09 mm and 378.58±106.46 mm³, respectively). However, males had greater depth values (10.56±1.34 mm) compared to females (10.54±1.49 mm), having a positive correlation between depth and gender (r = 0.113, P= 0.022). Significant differences between pituitary height, width and volume with age were found and they correlated negatively with increasing age (r = −0.157, P= 0.001; r = −0.129, P = 0.009; and r = −0.140, P = 0.004, respectively). Also, it was possible to identify that these parameters have a peak at age range 41-50 for females, that may result due the intense hormonal activity at this age. Regarding the gender, no significant differences between pituitary height, width and volume were found.

Conclusion:

We have provided reference values for the normal pituitary gland dimensions in the Portuguese population, in order to facilitate assessment and diagnosis in patients with abnormalities of the hypothalamic-pituitary axis.

Limitations:

N/A

Ethics committee approval

Ethics committee approved the study.

Funding:

No funding was received for this work.

Purpose:

Effective communication is at the heart of quality health care. In radiography a considerable part of the working day is spent relating to others. Radiographers should base themselves on interpersonal competences throughout their daily work routine, to promote quality in diagnosis, patient safety and technical excellence. The aim of this study was the exploration of patient's perceptions regarding the performance of the Radiographer in terms of interpersonal communication skills in private imaging facilities.

Methods and materials:

The instrument used was the questionnaire "Communication Assessment Tool" adapted to the professional reality of the radiographer. A final sample of 150 valid questionnaires including 15 questions with a five-point Likert scale ("poor" to "excelent") was used. The paper-based instrument was delivered and filled by the patients after the performance of imaging procedures from two private hospitals. The results were reported as a percentage of "excellent" ratings and mean scores.

Results:

The average "excellent" response rate was 45% (= 4). The issues rated "excellent" relate to respect (55.3%, = 4.43) and to the use of accessible language (57.3%, = 4.41). The worst-rated "excellent" issues are related to the encouragement to ask questions (29.3%, = 3.75) and the understanding of the radiographer in face of patients' health problems (32%, = 3.99). Significant differences were found between age, gender, context and shift.

Conclusion:

Radiographers' communication skills were evaluated with good levels of patient confidence with the radiological examinations. Despite the overall positive results, radiographers should have a marked impact on their communication with patients because they are often one of the first health professionals that patients see.

Limitations:

n/a

Ethics committee approval

Ethics committee approved the study and written informed consent.

Funding:

No funding was received for this work.

Purpose:

Abdominal muscles are one of the important elements to support the lumbar spine. Evaluation of muscle thickness using ultrasonography is considered to be a source of information from muscles characteristics. The aim of this study was to investigate whether there were differences between chronic low back pain (CLBP) and healthy subjects in abdominal muscles thickness using ultrasound.

Methods and materials:

A sample of 23 CLBP patients and 20 controls was recruited. Four abdominal muscles (Rectus Abdominis (RA), External Oblique (EO), Internal Oblique (IO) and Transversus Abdominis (TA)), were bilaterally measured by a trained radiographer at rest and while contracted.

Results:

The pattern of relative muscle thickness was IO > RA > EO > TA, bilaterally, both at rest and while contracted. The mean for RA, EO, IO and TA muscles thickness in asymptomatic subjects were (11.05, 3.735, 14.335, 4.015) at rest and (11.03, 3.295, 12.685, 3.63) while contracted, respectively. The mean for RA, EO, IO and TA muscles thickness in patients with CLBP were (11.11, 2.945, 15.565, 3.955) at rest and (10.99, 2.525, 13.645, 3.44) while contracted, respectively. Significant differences in the thicknesses of the abdominal muscles were measured during rest and while contracted, as well as between both genders. However, no significant differences were found between CLBP patients and control group.

Conclusion:

Despite the results, ultrasound measurements of abdominal muscles are reliable, and radiographer can play a key role in this field. However, the validity of using thickness change as a measure of muscle function, their correlation with other clinical features and the effect of specific retraining all require further investigation.

Limitations:

Sample size

Ethics committee approval

Ethics committee approved the study and written informed consent was delivered to the participants.

Funding:

No funding was received for this work.

Purpose:

A well-trained workforce is essential in a PET/CT department. There is a lack of published literature regarding the training and education of PET/CT radiographers in Ireland. This study investigated the PET/CT training offered in Ireland and investigated in which areas further training might be beneficial for PET/CT radiographers in Ireland.

Methods and materials:

An online questionnaire was distributed to PET/CT radiographers across Irish centres. Open and closed questions were asked about PET/CT training and further training areas. The questionnaire sought information regarding participants’ individual training, important areas for training, and participant demographics.

Results:

Questionnaire responses (n=26) were received from 7 of 9 sites nationally (estimated staff response rate of 74% within these sites). ‘In-house’ induction PET/CT training programmes varied in duration from 1-2 weeks long to more than 9 weeks long. Observation and shadowing were among the most commonly used approaches to training. The use of a competency checklist during training and the level of agreement that the training fully prepared the participant to work independently in PET/CT were significantly associated (p<0.024, r=0.672). Radiation protection, pathology, radiopharmaceutical administration, artefactual variants and critical situations associated with contrast media/radiopharmaceuticals were identified as important training topics.

Conclusion:

Key training areas were identified. Changes in practice - for example the introduction of a new Gallium service - were identified as matters that may affect future training needs. Further research is warranted to identify how the training needs identified should be addressed.

Limitations:

The participant responses are representative of Irish PET/CT radiographers therefore further research is recommended to collect data from other European countries for comparison.

Ethics committee approval

This study was performed following ethical permission from the School of Medicine, University College Dublin.

Funding:

No funding was received for this work.

Purpose:

To scrutinise the changes in radiographer’s practice regarding the use of the anti-scatter grid in flat-panel digital imaging.

Methods and materials:

The scoping review method was applied to identify gaps in the existing literature and to formulate recommendations for practice and/or policy changings. The three major databases for healthcare literature have been consulted: Medline, CINAHL and EMBASE using a combination of key-words (anti-scatter grid, digital radiography, radiographers practice).

Results:

149 studies were identified. After title and abstract reading, 25 articles were selected and 12 were retained for analysis/discussion based on inclusion criteria. The studies were divided into four groups: paediatric imaging, musculoskeletal and chest imaging in adults and “virtual-grid-like” radiographies. Based on phantom-studies of paediatric abdomen, specific recommendations were provided for grid-use decision-making: the patient should be over 14cm thickness with small FOV (21x18cm) at 80kVp. For adults, the removal of the anti-scatter grid can promote a dose reduction (up to a maximum of 418%) on specific anatomical areas such as shoulder and “virtual-grid-like” bedside chest radiographies, while keeping diagnostic image quality. This study was already clinically assessed, being possible a direct introduction on practice. The non-grid lateral cervical spine and horizontal beam hip radiographies need a further clinical assessment before changing the practice.

Conclusion:

The introduction of digital detectors has potential to change radiographers practice regarding the use of anti-scatter grid. However, this change can be clinically implemented in just 2 specific radiographic examinations: AP shoulder and bedside chest acquisitions. Further clinical research should be designed considering the irradiated volume (measured thickness multiplied by the displayed FOV), through multiple parameters variations and different anatomical areas.

Limitations:

This was an extensive scoping review but no experimental research was conducted to complement the findings.

Ethics committee approval

Not applicable.

Funding:

Not applicable.

Purpose:

This study aimed to explore the perceptions of radiographers employed in an oncology centre regarding their ability to identify patients needing nutritional advice and to provide patients with the appropriate dietary support.

Methods and materials:

A non-experimental, quantitative approach was employed. An existing questionnaire was modified, using published guidelines to suit the aim of this study, and distributed to all radiographers working in the radiotherapy department of the selected oncology centre. Data were analysed using descriptive statistics.

Results:

With a response rate of 85% (n=22), 86% (n=19) of participants indicated that patients asked for nutritional advice. 36% (n=8) of the respondents did not have previous training on nutritional interventions. All participants expressed interest in receiving additional information or training regarding nutritional management of side effects and identification of cases needing a referral to a dietitian. 82% (n=18) of participants stated that a protocol for referrals to dietitians was available at their clinical site, however, only two respondents indicated that they referred patients to a dietitian. All radiographers are self-rated as knowledgeable in identifying patients in need of dietary interventions and delivering the appropriate nutritional support. This was supported by the high level of agreement between literature recommendations and radiographers’ responses.

Conclusion:

Findings suggest that radiographers perceive themselves as knowledgeable and provide patients with the appropriate nutritional support. However, only two radiographers referred patients to dietitians and all radiographers indicated that they would like additional support. The researcher, therefore, proposed additional training, implementation of scripted nutritional advice and further studies into the lack of referrals to the dietetic team.

Limitations:

Participants may have responded in their favour or sought assistance, leading to biased results. Use of close-ended questionnaires may have restricted data, limiting explanation of complex issues.

Ethics committee approval

N/A

Funding:

No funding was received for this work.

Purpose:

The effect of cigarette smoking on the brain is not clearly understood but is probably multidirectional and complex, predominantly affecting the circulatory system, both general and cerebral. Transcranial Doppler (TCD) ultrasonography is a noninvasive bedside monitoring technique that can evaluate cerebral blood flow haemodynamics in the intracranial arterial vasculature. This study aims to evaluate haemodynamic changes induced by smoking habits in the middle cerebral artery.

Methods and materials:

Mean flow velocity (MFV), peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) were determined in the middle cerebral artery by a trained radiographer. A sample of 34 volunteer participants (17 smokers and 17 non-smokers) were examined using a dedicated ultrasound equipment for the TCD and a comparative study of the haemodynamic parameters measured in both groups was performed.

Results:

The mean values ​​of the blood flow velocities measured in the smoking volunteer participants (MFV=53.74cm/s; PSV=89.02cm/s; EDV=38.10cm/s) were lower compared to non-smokers (MFV=59.85cm/s; PSV=99.94cm/s; EDV=39.82cm/s), worsening with the intensity of their smoking habits. Smoking subjects also had a higher blood pressure on average. All these phenomena presented a greater magnitude in male subjects.

Conclusion:

The findings provide additional novel evidence of the adverse effects of cigarette smoking on the human brain since smoking has negative effects on middle cerebral artery and haemodynamics. Therefore, smoking is a risk factor for alterations in middle cerebral artery haemodynamics and male smokers are more likely to develop vascular changes. Radiographers can play a key role in the detection of pathophysiological changes from a preventive perspective.

Limitations:

This study is limited by the sample size.

Ethics committee approval

Ethics committee approved the study and written informed consent was delivered to the participants.

Funding:

No funding was received for this work.

Purpose:

To evaluate the influence of physical activity level, body mass index (BMI) and gender on the ultrasound measurement of abdominal aortic caliber and quadriceps femoris muscle thickness.

Methods and materials:

The International Physical Activity Questionnaire (IPAQ) was applied to 52 healthy volunteers to evaluate the health-related physical activity (PA) and BMI values were determined through a body composition analysis scale. Measurements of quadriceps femoris muscle thickness and abdominal aortic caliber were performed from B-mode ultrasound images, acquired twice by two independent radiographers. The thickness of the rectus femoris and vastus intermedius (RFVIMT), vastus medialis (VMMT) and vastus lateralis (VLMT) were measured. Standardised images of the aorta were recorded at three different levels: below the level of the origin of the splenic artery (AAC-SA), below the level of the origin of the renal arteries (AAC-RA) and 1-3 cm above the bifurcation (AAC-B).

Results:

IPAQ showed that 21.2% of participants had a low PA level, 25.0% had a moderate PA level and 53.8% had a high PA level. Regarding BMI, 7.7% of the volunteers were classified as underweight, 63.5% as normal, 21.2% as overweight and 7.7% as obese. Significant positive correlations were observed between BMI and ACC-RA (r = 0.298, P= 0.032), BMI and RFVMIT (r = 0.638, P= 0.000), BMI and VLMT (r = 0.442, P= 0.001). Significant negative relationships were observed between gender and AAC-B (r = - 0.424, P= 0.002) and between gender and VMMT (r = - 0.536, P= 0.000).

Conclusion:

A healthy lifestyle with proper physical activity levels is essential for the prevention of major cardiovascular diseases, obesity, muscular weakness, among others. However, further studies in this field are required.

Limitations:

This study was limited by the sample size.

Ethics committee approval

Ethics committee approved the study.

Funding:

No funding was received for this work.

Purpose:

There is a wide variety of diagnostic equipment for breast cancer and is becoming more technologically advance as years go by. A lot of female radiological technologists are worried about returning to work after taking maternity leave or childcare leave, some might be worried about being rusty with their skills and knowledge when returning to work, so we wanted to conduct this study to be able to help them with their reinstatement at work. The study aims to determine the necessary environment in order to balance work and child-rearing of female radiological technologists.

Methods and materials:

Questionnaire surveys and interviews were conducted for technologists who can’t participate in study sessions due to various problems including parenting, and examine the responses and what's the necessary environment in order to balance work and child-bearing.

Results:

The results showed that regular study meetings should be done, where they can learn with children in the community, can freely participate, and can allow them to deepen the connection and share their concerns between technologists participating in the study group, and this kind of study will help support female radiological technologists who would like to continue working while reducing anxiety on return after childcare leave.

Conclusion:

This type of study that can participate with children can hope to raise the level of child bearing generations of technicians and furthermore continue education during the childcare period that had previously hindered female career progress.

Limitations:

This study conducted a survey of specific people and organisations.

Ethics committee approval

Obtained approval from our ethics committee (ECD2018-002).

Funding:

No funding was received for this work.

Purpose:

Radiographers are limited human resources. From the long-term perspective of hospital administration, staff training is also an important issue. Allocating appropriate shifts is difficult for radiographers who manage the scheduling. Our objective is to construct an integer programming model of radiographer scheduling that considers the skills and training of radiographers to compare the results of computational experiments using real data.

Methods and materials:

A mathematical optimisation model was constructed with the scheduling of radiographers as an integer programming problem. More than one staff member is allocated each day by modality, room, and time zone as a shift. Radiographer skills were set at three skills: self, trainer, and responsible skill. We included 32 restrictions, such as off-duty and the upper limit of the number of night shifts. Shifts were scheduled by minimising each radiographer’s workload. We compared the workload of radiographers between shifts using actual data collected over two months in 2018 and the radiographer scheduling model to derive shifts. Analysis conditions were as follows: the number of staff 59, shifts 2379, trainee staff 2, modalities 15, rooms 57, days 38, the workload of daytime shift 1, swing shifts 3, and graveyard shifts 5.

Results:

All staff were allocated shifts and off-duty without constraint violation. By optimising scheduling, the staff workload was equalised. The workload of each staff member could be reduced as compared to scheduling performed by the shift creator (average workload of optimisation model 36.8, real data 37.0), and the load of the shift creator could be reduced (calculation time was short, i.e. <30s).

Conclusion:

It was useful for radiographer scheduling management to allocate shifts by optimising the workload.

Limitations:

n/a

Ethics committee approval

n/a

Funding:

This work was supported by JSPS KAKENHI (Grant-in-Aid for Scientific Research (C), Grant Number JP17KO9235).

Purpose:

This study aims to assess medical ultrasound students’ empathy scores in response to interaction with ‘experts by experience’.

Methods and materials:

Students completed the Toronto Empathy Questionnaire⁵ before and after an interactive teaching and learning session with four ‘patients’. Students completed a short questionnaire and were asked to reflect on what they had learnt and how it might impact their future practice. 23 students (48%) participated in the study at a single institution across two cohorts. A further cohort will be recruited.

Results:

Twenty empathy scores were valid. Females had higher mean empathy scores initially and after the session, however males had a higher overall increase in mean empathy score after the interactions. Empathy scores increased or stayed the same for 75% of students. The event met or exceeded students’ expectations.

Conclusion:

Mean empathy levels were higher than published norms and increased or remained the same for three quarters of students after the session. Empathy can lead to improved trust between health care provider and patient, compliance with instructions and treatment, patient satisfaction and outcomes,so it is important to ensure ways to increase empathy and compassion are incorporated into the curriculum.Students highlighted various ways to change practice in light of this session, which would impact on patient care and communication.

Limitations:

Students were self-selecting, which may impact on the results.

Ethics committee approval

Ethics approval was granted from the School of Health Sciences, City, University of London.

Funding:

No funding was received for this work.

Purpose:

Third-year radiological technology students at Dalhousie University must demonstrate the required knowledge, skills, and competence to safely, accurately, and efficiently perform complex radiographic examinations on a trauma patient. Student competency is assessed by a simulation; this simulation was not previously designed following established standards of best practice and lacked authenticity. Adding a standardised patient to simulation has been reported to improve authenticity in nursing and medical literature, but this has not been investigated in a radiography programme.

Methods and materials:

Fourteen third-year radiological technology students completed a timed (30 minute) trauma simulation; this was the first time a standardised patient has been used as part of a simulation. Using open-ended interview questions students were individually interviewed and they described their experience participating in a trauma simulation that used a standardised patient. The transcripts were compiled and coded; phenomenological thematic analysis was used and resultant themes were verified with participants.

Results:

Students enjoyed having a standardised patient as part of the simulation and stated that it made the experience realistic and authentic. Students found that they needed to employ their patient care and communication skills much more than in previous simulation experiences.

Conclusion:

Standardised patients add authenticity to the radiological technology trauma simulation and students’ patient care and communication skills can be more accurately assessed. This model of simulation will continue to be part of the Dalhousie radiological technology programme.

Limitations:

The authors acknowledge they are both the designers of the simulation and educators of the students participating in the simulation; participation in the study was completely voluntary. As this is a qualitative study the results cannot be generalisable.

Ethics committee approval

The study went through REB and a written consent form was completed.

Funding:

No funding was received for this work.