A snapshot of patients' awareness of radiation dose and risks associated with medical imaging examinations at an Australian radiology clinic

BackgroundCumulative radiation exposure is linked to increasing the lifetime attributable risk of cancer. To avoid unnecessary radiation exposure and facilitate shared decision making, patients should be aware of these issues. This paper examines patients' awareness of radiation dose and risks associated with medical imaging examinations.MethodsConsecutive patients attending a private radiology clinic over a nine week period in 2014 in Metropolitan Melbourne were surveyed while waiting to undergo an imaging examination. Patients who were under 18 years of age, did not speak English and/or were referred for interventional imaging procedures were excluded from participation. Survey questions addressed patients' awareness of radiation dose associated with various imaging modalities' and patients' experience and preferences regarding communication of information about radiation. Data was analysed using SPSS (Ver 20.1).ResultsA total of 242 surveys were completed. Most participants were male (143/239, 59.8%) and aged between 33 and 52 years (109/242, 45%). Over half of participants were not concerned about radiation from medical imaging (130/238, 54.6%). Only a third of participants (80/234, 34.2%) correctly reported that CT has a higher radiation dose than X-ray. Very few participants correctly identified mammography, DEXA, PET and PET/CT as radiation emitting examinations. The majority of participants (202/236, 85.6%) indicated that they were not informed about radiation dose and risks by their referring doctor in advance.ConclusionThis paper provides information relevant to a single private radiology clinic in Australia. Nevertheless, our results have shown that patients presenting for medical imaging have little awareness of radiation dose and risks associated with these examinations and received little information by their referring physicians or staff at the radiology clinic.     

A narrative review of e-learning in professional education of healthcare professionals in medical imaging and radiation therapy

ObjectivesThis literature review attempts to explore the characteristics of e-learning tools used to develop the qualifications and skills of healthcare professionals in medical imaging and radiation therapy, and to promote the effectiveness and acceptance of e-learning through highlighting the outcomes of its implementation where applicable.Key findingsFrom the literature search in the PubMed and ResearchGate databases we concluded to 21 articles, which were included in the qualitative synthesis. Acceptance of e-learning tools was confirmed. Also, e-learning can be part of healthcare professionals' blended learning. The acquisition of new or improvement of existing knowledge, the improvement of clinical skills and the increase of the self-confidence of healthcare professionals in their daily practice were recorded, as outcomes of the e-learning implementation. The importance of human–computer interaction for the comprehension of theoretical concepts and practical aspects using multimedia was also captured. No significant findings emerged among the 21 articles against the adoption of the e-learning for the training of healthcare professionals. The Internet is the channel used for synchronous and asynchronous interaction of trainees with instructors.ConclusionsWe concluded that e-learning is an attractive training method, equally or occasionally more effective than the traditional educational methods for the lifelong training of healthcare professionals in the field of medical imaging and radiation therapy. Also, many collaborative web-based applications provide the necessary means to build an e-learning program, according to the training needs of each professional team.Implications for practiceThis new knowledge corroborates the perspective of e-learning beneficial contribution to remote interaction and collaboration of healthcare professionals in medical imaging and radiation therapy. Collaborative web-based tools are already available to decision makers and stakeholders, who want to develop an e-learning program.     

Compression force and radiation dose in the Norwegian Breast Cancer Screening Program

PurposeCompression force is used in mammography to reduce breast thickness and by that decrease radiation dose and improve image quality. There are no evidence-based recommendations regarding the optimal compression force. We analyzed compression force and radiation dose between screening centers in the Norwegian Breast Cancer Screening Program (NBCSP), as a first step towards establishing evidence-based recommendations for compression force.Materials and methodsThe study included information from 17 951 randomly selected screening examinations among women screened with equipment from four different venors at fourteen breast centers in the NBCSP, January-March 2014. We analyzed the applied compression force and radiation dose used on craniocaudal (CC) and mediolateral-oblique (MLO) view on left breast, by breast centers and vendors.ResultsMean compression force used in the screening program was 116N (CC: 108N, MLO: 125N). The maximum difference in mean compression force between the centers was 63N for CC and 57N for MLO. Mean radiation dose for each image was 1.09 mGy (CC: 1.04mGy, MLO: 1.14mGy), varying from 0.55 mGy to 1.31 mGy between the centers. Compression force alone had a negligible impact on radiation dose (r² = 0.8%, p = < 0.001).ConclusionWe observed substantial variations in mean compression forces between the breast centers. Breast characteristics and differences in automated exposure control between vendors might explain the low association between compression force and radiation dose. Further knowledge about different automated exposure controls and the impact of compression force on dose and image quality is needed to establish individualised and evidence-based recommendations for compression force.     

A review of the impact of the COVID-19 pandemic on pre-registration medical radiation science education

ObjectiveThe COVID-19 pandemic has changed traditional ways to provide pre-registration medical radiation science (MRS) (medical imaging and radiation therapy) education. This literature review explores the published pre-registration MRS education curriculum adaptations implemented in response to the pandemic and effects of the adaptations on stakeholders.Key findingsEleven articles were identified through a systematic literature search. The included articles covered the pre-registration MRS curriculum adaptations implemented in response to the pandemic in 12 countries of five continents. Through changing content delivery and assessment modes from face-to-face to online, non-practical classes and academic assessments could continue without significant interruptions. However, cancellation/postponement of practical classes and clinical placements was common during COVID-19 lockdown. Simulated learning was used by some institutions to replace some practical classes and placements. Among the stakeholders of MRS education (students, academics and clinical educators), the students were most affected. The main impacts were negative psychological effects and learning experiences. For the academics, they had common concerns about online learning quality and assessment integrity.ConclusionThis review of the early publications in the first year of the pandemic provides an illustration of the MRS curriculum adaptations implemented in five continents covering both English and non-English speaking countries and their effects on the stakeholders as yet. It is expected that more articles on this area will be published over time and hence allowing a more comprehensive review in the future.Implications for practiceThe included articles show provision of wellbeing support, good planning of online content delivery based on sound pedagogical approaches, implementation of computer-based simulation tools suitable for home-based learning environment and use of authentic online assessments would address the impacts on the students and academics.     

The use of real time ultrasound scanning as a teaching method of anatomy in an undergraduate sonography and medical imaging degree in an Australian university

BackgroundReal-time ultrasound scanning is increasing in popularity as a teaching tool for human anatomy because it is non-invasive, offers real-time 3-D anatomy and is cheaper than dissections.AimTo assess real-time ultrasound scanning as a teaching method of human anatomy, and to determine what teaching methods medical imaging and sonography students consider effective for understanding human anatomy.MethodSurveys were distributed to two consecutive cohorts of first year medical imaging and medical sonography students at CQUniversity. Participation was voluntary. Comparisons among teaching methods were made using repeated measures ANOVA.ResultsReal-time ultrasound scanning was the most preferred method of delivery for anatomy classes overall especially compared to computer programs, videos, 3-D radiological images and dissection. Specifically, students indicated that ultrasound scanning was the preferred method to encourage learning from experience (F_7,231 = 2.942, p = 0.006), to develop team skills (F_7,231 = 4.550, p < 0.006), to follow complex instructions (F_7,231 = 4.656 p < 0.001) and to appreciate anatomical variation (F_7,231 = 2.067, p = 0.048). Dissection was the least favoured teaching method.ConclusionReal-time ultrasound scanning is a useful tool for teaching anatomy, and animal dissections are a poor substitute for the use of human cadavers.     

元宇宙对放射医学领域的影响

元宇宙依托虚拟现实、增强现实、混合现实、5G、人工智能、区块链等技术,创建一个与现实世界紧密相连且互补的"平行世界",以沉浸式用户体验,给社交、游戏、医疗、教育等带来颠覆式变革。随着放射医学在疾病诊疗、核能安全、载人航天等领域的地位日益凸显,可以预见,元宇宙将对放射医学领域的发展发挥巨大的推动作用。本文综述元宇宙对放射医学领域发展可能带来的影响,建议我国尽快启动放射医学元宇宙(Radiomediverse)的建设与应用。     

Evaluating the distribution of research in radiation sciences as published in general medical physics journals

Introduction

The aim of this study was to evaluate the distribution and trends of studies in different areas of medical physics science. This assessment can reflect the past and current status of the field, and it can also predict the future of this science.

医用加速器机房迷路辐射水平的测量与分析

目的 通过医用加速器机房迷路内辐射水平的测量与分析,为职业照射的控制提供科学依据,为理论模拟计算积累实验数据。方法 利用剂量率仪测量加速器机房迷路内的辐射水平,并对测量结果进行理论分析。结果 医用加速器机房出入口处杂散X-γ射线剂量率与机头朝向有关,并随照射野的减小而降低;杂散中子剂量率水平主要取决于加速器粒子的能量和输出剂量,随照射野的变化不明显。同时,医用加速器机房出入口处杂散X-γ射线和中子剂量率与医用加速器机房迷路的辐射防护设计密切相关。结论 合理改善医用加速器机房迷路的辐射防护设计是降低医用加速器机房出入口处X-γ射线和中子剂量率水平的行之有效的措施。     

International audit of simulation use in pre-registration medical radiation science training

IntroductionSimulation-based education (SBE) can replicate the challenging aspects of real-world clinical environments, while providing a safe and less intimidating setting. Literature supports its use within medical radiation science (MRS) training for safe practice of psychomotor skills, development of problem solving, team working, interpersonal and decision-making skills and embedding awareness of patient safety. This project aimed to quantify usage of SBE resources and activities internationally and to evaluate how this changed during COVID-19 restrictions.MethodsAn anonymous online survey tool gathered data relating to programme demographics, simulation resources, simulation activities and future plans. A link to the survey was distributed to programme leads via social media, professional bodies and national networks.ResultsA total of 72 responses were received from a range of countries and representing a range of programme structures. Most respondents reported up to 100 h of SBE per student per year with low fidelity resources and image viewing software featuring most prominently. There was low reported engagement of service users within simulation activities. Respondents also indicated that COVID-19 had been a trigger for rapid uptake of simulation resources.ConclusionSBE forms an important aspect of MRS training internationally with low-fidelity resources being widely deployed. Where available, high fidelity virtual reality and specialised profession-specific resources were used heavily. There was a low level of reported engagement with service users or expert patients in simulation activities. Future research will identify whether the rapid uptake of SBE during COVID-19 continues and clarify the role of service users in SBE provision.Implications for practiceIncreased collaboration between MRS education providers may help to improve parity of SBE provision and identify additional opportunities to engage service users within SBE.     

Low dose four-dimensional computerized tomography with volume rendering reconstruction for primary hyperparathyroidism: How I do it?

Modification of 4-dimensional computed tomography (4D-CT) technique with volume rendering reconstructions and significant dose reduction is a safe and accurate method of pre-operative localization for primary hyperparathyroidism. Modified low dose 4D-CT with volume rendering reconstructions provides precise preoperative localization and is associated with a significant reduction in radiation exposure compared to classic preoperative localizing techniques. It should be considered the preoperative localization study of choice for primary hyperparathyroidism.     

The ethical commitment of Australian radiographers: Does medical dominance create an influence?

There is a lack of awareness and openness surrounding ethical debate in Diagnostic Radiography literature and culture, perpetuated in part by the historical growth of the technical realm of radiography, radiology and medicine. Hence, the impact of Australian radiographers' current level of professional autonomy, combined with the influence of medical dominance and radiographers' ethical commitment was undocumented. This study investigated the role, importance and attitudes of Australian radiographers towards ethics through a qualitative study following a grounded theory approach. Semi-structured interviews were conducted with 25 Australian. A conceptual framework mapping the causal conditions affecting the ethical commitment was developed.This study argues that a number of internal and external variables weave an intricate fabric of poor identity, subservience and negative workplace culture. Australian radiographers, whist attempting to set a standard of ethical commitment, are hindered by difficulties of medical dominance, relatively poor professional autonomy and difficulty in accepting responsibility. The presence of private radiology enterprise and the association between patient referral and money has eroded the radiographer-patient relationship and introduced the potential for unethical practice in the radiographer-radiologist-referring practitioner relationship.     

核医学诊断工作场所辐射水平及防护现状调查

目的 对我国核医学诊断工作场所辐射防护现状进行调查.方法 2013年2—12月期间,在东北、华中和华北地区分别选择1家三甲医院,用γ剂量率仪巡测核医学诊断制药、淋洗、分装、注射、扫描过程中工作场所周围剂量当量率,光致发光剂量计测量放射工作人员个人有效剂量和当量剂量.结果 在放射性药物分装、注射和受检者摆位等操作环节中周围剂量当量率较高, 分装时最高达1.92 mSv/h,注射时距针管5 cm处剂量率最高达1.2 mSv/h,受检者体表30 cm处剂量率范围为5.36~240 μSv/h,某医院护士手部当量剂量为0.01~0.02 mGy,部分工作场所存在人员路线交叉及注射后受检者停留在公众区域的现象.结论 核医学实践中放射工作人员应加强个人防护,提高操作熟练程度以缩短作业时间,应优化放射工作人员出入路线,加强注射后受检者的管理,以免公众人员受到不必要的照射.     

浅议放射卫生在医用辐射防护领域的几个问题

电离辐射在医学中的应用发展迅猛,与之紧密相连的医用电离辐射安全与防护问题始终是放射卫生工作的重要内容之一。本文从国民医疗照射水平与现状、医疗照射正当性判定、放射诊疗设备质量控制与保证、放射工作人员职业照射防护和放射诊疗患者健康效应研究等几个方面介绍我国当前的工作情况,分析存在的问题,提出相关建议。     

单双面阅读成像板影像质量与辐射剂量的对比研究

目的对比研究单面阅读和双面阅读2种成像板（IP）成像质量与辐射剂量的关系。方法对单、双面阅读IP，分别采用不同的辐射剂量对对比度．细节模体（CDRAD2．0）进行曝光，记录每次曝光时模体表面的辐射剂量，模体的影像在图像诊断工作站显示器上由2名放射学专家进行视读，计算影像质量因子（IQF）并应用Spearman相关性检验和Wilcoxon秩和检验进行分析，比较2种IP成像的图像质量与辐射剂量的差异。结果在管电流量分别为5．6、12．0、20．0、25．0和40．0mAs时，单面阅读IP的IQF值分别是47．95、37．68、34．31、28．61、24．65；双面阅读IP的IQF值分别是38．83、29．81、29．65、25．16、21．43，2种阅读方式所得的IQF值差异有统计学意义（P〈0．05）。结论辐射剂量相同时，双面阅读IP对于低对比度组织细节的检测能力优于单面阅读IP；在获得相同影像信息时，应用双面阅读IP可比单面阅读IP降低约25％的辐射剂量。     

核医学检查受检者所受辐射剂量分析

目的 对核医学检查受检者所受辐射剂量进行测量和分析,以有效剂量表征受检者受到的辐射强度。方法 对核医学检查受检者进行分类,并测量计算所受放射性药物的辐射剂量,受检者所受计算机断层扫描(CT)辐射剂量,通过CT扫描参数和受检者信息等计算得到,上述两者相加换算得到受检者检查所受的有效剂量,并分析受检者所受辐射剂量的影响因素。结果 受检者正电子发射断层计算机成像(PET-CT)检查受到正电子放射性药物¹⁸F-氟代脱氧葡萄糖(¹⁸F-FDG)、¹⁸F-氟代胸苷(¹⁸F-FLT)、¹¹C-胆碱(¹¹C-choline)、¹¹C-蛋氨酸(¹¹C-MET)和¹¹C-乙酸盐(¹¹C-Ac)辐射所致有效剂量分别为(5.06±0.73)、(4.74±1.29)、(1.71±0.05)、(3.18±0.69)和(1.08±0.19)mSv;CT常规扫描辐射有效剂量为(8.80±0.58)mSv,若增加诊断CT扫描,接受的有效剂量可增大至27 mSv;单光子发射计算机断层成像(ECT)检查受到单光子放射性药物⁹⁹Tc^m-亚甲基二磷酸盐(⁹⁹Tc^m-MDP)、⁹⁹Tc^m-大颗粒聚合白蛋白(⁹⁹Tc^m-MAA)、⁹⁹Tc^m-二乙基三胺五乙酸(⁹⁹Tc^m-DTPA)、⁹⁹Tc^m-甲氧基异丁基异腈(⁹⁹Tc^m-MIBI)和⁹⁹Tc^m-焦磷酸盐(⁹⁹Tc^m-PYP)辐照所致的有效剂量分别为(4.63±0.01)、(1.71±0.01)、(1.18±0.01)、(7.19±0.03)和(4.18±0.01)mSv。结论 核医学检查受检者受到放射性药物辐射的有效剂量在1.08~7.19 mSv之间,PET-CT检查中CT所致有效剂量是8.80 mSv。     

Tina Pro软件在医学影像学教学中的应用

在以往的医学影像学教学模式中,电子电路及数字电路等的学习是教学实践中既重要而又难理解的部分,利用Tina Pro软件结合多媒体能明显提高教学效果。     

Information literacy skills: Medical radiation science students and the internet

Medical radiation science (MRS) professionals are required to maintain a high standard of knowledge and therefore need satisfactory information literacy skills. Information literacy skills are required to seek, evaluate and synthesise information sources. With the vast amount of information that can be accessed it is important to ensure students are taught how to identify and locate information sources and evaluate them for credibility. Recent studies have shown that students prefer to access information sources on the internet via a search engine, often not considering the credibility of the information they are accessing. The information sources that are available on the internet are unfiltered, and the content of a website can be inaccurate and unreliable. There are numerous methods available for students to evaluate information sources for credibility and accuracy, and these should be considered before accepting presented data at face value. In the rapidly changing field of medical radiation science, graduates must be independent learners who can locate relevant information and perform critical analysis of information sources. To achieve this information literate students must be cultivated.     

Awareness of radiation protection and dose levels of imaging procedures among medical students,radiography students,and radiology residents at an academic hospital: Results of a comprehensive survey

PurposeTo evaluate the awareness of radiation protection issues and the knowledge of dose levels of imaging procedures among medical students, radiology residents, and radiography students at an academic hospital.Material and methodsA total of 159 young doctors and students (including 60 radiology residents, 56 medical students, and 43 radiography students) were issued a questionnaire consisting of 16 multiple choice questions divided into three separated sections (i.e., demographic data, awareness about radiation protection issues, and knowledge about radiation dose levels of common radiological examinations).ResultsMedical students claimed to have at least a good knowledge of radiation protection issues more frequently than radiology residents and radiography students (94.4% vs 55% and 35.7%, respectively; P < 0.05), with no cases of perceived excellent knowledge among radiography students. However, the actual knowledge of essential radiation protection topics such as regulations, patient and tissue susceptibility to radiation damage, professional radiation risk and dose optimisation, as well as of radiation doses delivered by common radiological procedures was significantly worse among medical students than radiology residents and radiography students (P < 0.05). Those latter significantly outperformed radiology residents as to knowledge of radiation protection issues (P < 0.01). Overall, less than 50% of survey respondents correctly answered all questions of the survey.ConclusionsRadiology residents, radiography students and medical students have a limited awareness about radiation protection, with a specific gap of knowledge concerning real radiation doses of daily radiological examinations. Both undergraduate and postgraduate teaching needs to be effectively implemented with radiation safety courses.