深度学习在肺结核影像诊断中的应用

肺结核的影像学形态往往呈多样性,因此,如何鉴别诊断肺结核一直以来是常规影像学研究的重点与难点。近年来,深度学习在辅助影像诊断方面有了飞快发展。深度学习擅长识别大量图像数据中的复杂模式,可大大提高医师的诊断准确性及工作效率。笔者将对深度学习在影像诊断及肺结核影像诊断中的应用、不足及展望进行综述。     

北京地区介入放射诊疗资源与防护状况调查与分析

目的 调查北京地区介入放射诊疗资源分布和放射防护状况,规范介入放射诊疗行为并促进放射防护监管措施的落实。方法 以北京地区开展介入放射诊疗工作的各级各类医疗机构为调查对象,设计专门的调查表并成立市区两级调查组,逐级调查各区域截至2020年底介入放射工作基本情况和介入放射工作人员职业健康监护情况,依据国家有关法规标准对指标参数进行分析评估。结果 截至2020年底,北京地区开展介入放射工作的医疗机构93家,800 mA(含)以上数字减影血管造影机(DSA)236台;开展介入放射学手术135 593例,年介入手术量在1 000例以上的40家,10~1 000例的41家;介入放射工作人员3 539人,持有《放射工作人员证》者为99.0%,职业健康检查、个人剂量监测和放射防护培训通过率分别为96.9%、99.5%和95.8%;配置的工作人员防护用品3 532件,其中98.9%的机构配备了分体式铅衣或一体式铅衣,但6.5%的机构未配置铅防护眼镜、54.9%的机构未配置铅防护手套。结论 北京地区介入放射诊疗防护状况和防护管理总体较好,但应结合介入放射诊疗资源分布的现况进一步完善监管机制,强化人员的在岗期间职业健康检查、放射防护培训和防护用品的配置与使用。     

Sensitivity and specificity of nuclear phase analysis versus ejection fraction in coronary artery disease

Phase standard deviation (SD) and skew characteristics of the first Fourier harmonic of equilibrium radionuclide volume curves were examined and compared during rest and during supine bicycle exercise with ejection fraction (EF) changes and the development of ischemia in 17 control subjects and in 2 groups of patients (n = 57) with coronary artery disease (CAD). Group I comprised 37 patients with CAD; IA was a subgroup of 20 patients with previous myocardial infarction (MI) and IB a subgroup of 17 patients with CAD without MI (all with coronary stenosis greater than 75% diameter narrowing). Group II comprised 20 patients with CAD who had undergone coronary bypass surgery. In the Group I subjects, phase SD was the most sensitive indicator of CAD at rest (Group I, 56%; Group IA, 70%, and Group IB, 29%), and the EF was the most sensitive indicator at submaximal (Group I, 78%; Group IA, 86%, and Group IB, 64%) and maximal exercise (Group I, 70%; Group IA, 93%, and Group IB, 53%). When phase SD and skewness were combined with EF changes, little increase in sensitivity occurred in Group I (rest 61%, submaximal exercise 88% and maximal exercise 76%). The results from Group II subgroups were qualitatively similar to those observed with Group I subgroups. These data reveal a marginally improved sensitivity for detection of CAD during supine bicycle radionuclide ventriculography when phase measurements were added to changes in global EF values.     

Impact of COVID-19 pandemic on radiographers in the Republic of Cyprus. A questionnaire survey

IntroductionImaging is essential for the initial diagnosis and monitoring of the novel coronavirus, which emerged in Wuhan, China. This study aims to assess the insight of radiographers on how the COVID-19 pandemic has affected their work routine and if protective measures are applied.MethodA prospective observational study was conducted among radiographers registered in the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. A questionnaire composed of 28 multiple choice questions was utilised, and the data analysis was performed using SPSS software with the statistical significance assumed as p-value < 0.05.ResultsOut of 350 registered radiographers, 101 responses were received. The results showed that there are statistically significant differences regarding the working hours, the feeling of stress, the work effectiveness, the average examination time, the presence of a protocol used among the different workplaces of the participants; a private radiology centre, a private hospital or a public hospital, with a p-value 0.0022, 0.015, 0.027, 0.001, 0.0001 respectively. Also, statistically significant differences were observed in the decontamination methods used for equipment (p-value 0.007), for air (p-value 0.04) and when decontamination takes place (p-value 0.00032) among the different workplaces of the participants. Nonetheless, the majority of radiographers believe that their workplace is sufficiently provided with PPE, cleaning supplies, equipment, and with cleaning personnel and are optimistic regarding the adequacy of these provisions in the next three months.ConclusionThis study showed that in the Republic of Cyprus, there are protocols regarding protective measures against COVID-19, and the radiographers are adequately trained on how to face an infectious disease outbreak. However, work is needed in order to develop protocols that reassure the safety of patients and medical personnel while managing the excess workload effectively.Implications for practiceThis study indicates the importance of applying protective measures and protocols in the radiology departments in order to minimise the spread of the virus.     

Unprofessional practice and student professionalism dilemmas: What can radiography learn from the other health professions?

ObjectiveProfessionalism in radiography is a complex, multidimensional concept seldom investigated. During clinical placements, students may observe or be involved in unprofessional practice/professionalism lapses which result in professionalism dilemmas. Establishing what constitutes a professionalism dilemma and what action to take may be challenging for students and also practitioners. This is due to unclear reporting pathways and fear of retribution, both deterrents to raising concerns. The aim of this integrative literature review was to investigate how and why professionalism dilemmas occur. In addition, to explore the types of dilemma students experience during clinical placement and to contextualise and reflect on these findings within radiography. Ovid MEDLINE, PubMed, Google Scholar and the grey literature were reviewed, analysed and themed.Key findingsTwenty-eight papers (published between 2004 and 2020) were analysed and summarised. Four themes emerged, and were discussed within the radiography context; the nature of professionalism lapses (mistreatment, verbal abuse, exclusion and intimidation), reasons for professionalism lapses (burnout and poor role modelling), student response at the time of the professionalism dilemma (accept, resist or report) and long-term impacts on students (moral/emotional distress, professional development and choice of career).ConclusionProfessionalism dilemmas are not reported in the radiography literature but are cited in radiology and other health professions studies. Student experiences of such dilemmas can be profound and long lasting. Thus, research is required to investigate specifically the professional dilemmas experienced by radiography students in the unique environment in which they develop their clinical skills.Implications for practiceThe literature review findings can be used to support the development of strategies to enhance future teaching and modelling of professionalism and develop related research in radiography.     

2020 SCCT Guideline for Training Cardiology and Radiology Trainees as Independent Practitioners (Level II) and Advanced Practitioners (Level III) in Cardiovascular Computed Tomography: A Statement from the Society of Cardiovascular Computed Tomography

Cardiovascular computed tomography (CCT) is a well-validated non-invasive imaging tool with an ever-expanding array of applications beyond the assessment of coronary artery disease. These include the evaluation of structural heart diseases, congenital heart diseases, peri-procedural electrophysiology applications, and the functional evaluation of ischemia. This breadth requires a robust and diverse training curriculum to ensure graduates of CCT training programs meet minimum competency standards for independent CCT interpretation. This statement from the Society of Cardiovascular Computed Tomography aims to supplement existing societal training guidelines by providing a curriculum and competency framework to inform the development of a comprehensive, integrated training experience for cardiology and radiology trainees in CCT.