Radiography RSS feed: Articles in Press. Radiography is an international, English language, peer-reviewed journal of radiographic imaging and radiation therapy. Radiography is the official professional journal of the Society and College of Radiographers and is published quarterly by Elsevier Ltd. Radiography aims to publish the highest quality clinical scientific and educational material, on all aspects of radiographic imaging (to include diagnostic radiography, computed tomography, nuclear medicine, sonography and magnetic resonance imaging) and all aspects of radiation therapy (to include patient care, dosimetry, treatment planning, verification, treatment delivery and oncology). Radiography includes original research, novel review articles, technical analyses, evaluations and case studies. In addition it provides a forum for the exchange of information and views on all matters related to the profession of radiography. Radiography promotes excellence in the profession of radiography by its commitment to the publication of original research, encouragement and dissemination of best clinical, scientific and educational practice and support for education. http://www.radiographyonline.com//inpress?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. Radiography1078-81742012-05-21 © 2012 Published by Elsevier Inc. healthpermissions@elsevier.comhttp://www.radiographyonline.com/article/PIIS1078817412000338/abstract?rss=yesAbstract: Introduction: Interpretation of trauma images by radiographers is a task substitution that has been debated for many years in Australia and enacted in various forms internationally since the 1980s. This paper describes the standardised test portion of a pilot project (which also had a clinical component) that investigated the potential for radiographers to describe abnormalities as a change to models of healthcare delivery being adopted in Queensland.Method: Randomly selected appendicular musculo-skeletal trauma images were reported by four radiologists to confirm image content. 102 images, matched for population injury incidence and body area proportionality served as a standardised image test. Ten radiographers described images before, immediately after and 8–10 weeks following an education programme. Receiver operator characteristic curves and kappa statistics were calculated to evaluate radiographer descriptive performance relative to the radiologist reports.Results: Using the Friedman and Wilcoxon signed ranks tests there was statistically significant improvement of sensitivity and accuracy of radiographer performance by the third standardised test with values: sensitivity (p = 0.023/0.012), accuracy (p = 0.012/0.021) specificity demonstrated no or very close statistically significant change (0.118/0.058). Kappa values (Cohen p = 0.019/0.011, Gwet 0.025/0.007 and Byrt et al. 0.021/0.047) demonstrated statistically significant change across the test sequence. Positive and negative predictive values with positive likelihood ratios were also calculated.Discussion: Most (9/10) radiographers demonstrated a high level of agreement of description accuracy with the radiologists used to create the standardised test.Conclusion: With appropriate education radiographers can match radiologist descriptions of appendicular musculo-skeletal trauma.The impact of a pilot education programme on Queensland radiographer abnormality description of adult appendicular musculo-skeletal trauma - Corrected ProofJonathan McConnell, Carron Devaney, Matthew Gordon, Mark Goodwin, Rodney Strahan, Marilyn Baird10.1016/j.radi.2012.04.005Radiography (2012)2012-05-21Radiography2012-05-21http://www.radiographyonline.com/article/PIIS1078817412000296/abstract?rss=yesAbstract: Introduction: This study reports the attitudes of UK radiographers to mandatory Continuing Professional Development (CPD) following the introduction of a mandatory policy, compared to a survey undertaken prior to the mandate being introduced.Methods and method of data collection: An electronic survey was advertised within 152 hospitals, across a range of hospital types (for example: rural, urban, teaching, district general) and geographic areas to minimise any potential bias through sampling. 406 radiographers responded to the survey, which was endorsed by the College of Radiographers.Results: The study showed that the overall attitude score had not increased significantly, demonstrating an ongoing relatively ambiguous attitude towards CPD. There was an increase in the number of radiographers recording CPD, though radiographers still expressed discontent over the need to evidence CPD activity. The study showed a change in the perceived primary barrier to CPD away from funding to time: time to undertake CPD; and time to record CPD activity. While the activity score had not significantly increased, a broader view of what constitutes CPD was evidenced, away from the previous narrow focus on attendance based activities. Support for CPD also showed no significant change, suggesting that the onus for CPD still predominantly remains with the individual radiographer.Conclusion: The introduction of a mandatory CPD policy has not significantly impacted on the attitudes of radiographers towards CPD activity. The study raises a number of questions which would benefit from further study and highlights some ongoing issues which impact on CPD in practice.5 years on: Have attitudes towards continuing professional development in radiography changed? - Corrected ProofSuzanne M. Henwood, Dave M. Flinton10.1016/j.radi.2012.04.001Radiography (2012)2012-05-07Radiography2012-05-07http://www.radiographyonline.com/article/PIIS1078817412000302/abstract?rss=yesAbstract: Introduction: A study was conducted on final year diagnostic radiography students at a University of Technology in Durban. The aim of the study was to investigate the final year diagnostic radiography students' opinions and views on academic performance in order to inform teaching and learning methods.The objectives were: Method: A qualitative, interpretive approach was used to explain and understand the students' lived experiences of their academic performances. A short open ended questionnaire was administered to a cohort of final diagnostic radiography students following feedback on a written assessment. Questionnaire responses were then manually captured and analyzed.Results: Five (5) themes were identified that could possibly be associated with poor academic performance. These themes were, poor preparation, lack of independent study, difficulty in understanding learning content and misinterpretation of assessment questions, inefficient studying techniques as well as perceived improvement strategies.Conclusion: Students identified their inadequate preparation and the lack of dedicated independent studying as the main reasons for poor performance. Students preferred to be taught in an assessment oriented manner. However their identified improvement strategies were aligned with the learner centred approach.Poor academic performance: A perspective of final year diagnostic radiography students - Corrected ProofNtokozo Gqweta10.1016/j.radi.2012.04.002Radiography (2012)2012-05-07Radiography2012-05-07http://www.radiographyonline.com/article/PIIS1078817412000235/abstract?rss=yesAbstract: Aim: The purpose of the survey was to benchmark the progress with implementing the radiography profession's career progression framework within radiotherapy centres across the United Kingdom (UK).Methods: A survey questionnaire was constructed using the Survey Monkey™ tool to assess implementation of the career progression framework of the Society and College of Radiographers. Once constructed, an on line link to the survey questionnaire was emailed to all radiotherapy centre managers in the UK (N = 67) who were invited to provide one response per centre. The survey comprised twenty nine questions which were grouped into nine sections.Key results: The workforce profile indicates that increases in assistant, advanced and consultant level practitioners are required to meet National Radiotherapy Advisory Group recommendations with only a small number of centres having fully implemented the career progression framework. The overall vacancy level across the therapeutic radiography workforce was 4.6% at the time of the survey.Conclusions: and Recommendations: The survey has highlighted some progress with implementation of the career progression framework across the UK since its launch in 2000. However the current level of implementation demonstrated is disappointing considering it is a key recommendation within the NRAG Report 2007 with respect to England. It is recommended that all centres undertake a multi-professional workforce review to embed the career progression framework within their service in order to meet the workforce challenge associated with the required anticipated large growth in radiotherapy capacity.A survey on the progress with implementation of the radiography profession's career progression framework in UK radiotherapy centres - Corrected ProofSarah James, Charlotte Beardmore, Claire Dumbleton10.1016/j.radi.2012.03.002Radiography (2012)2012-04-16Radiography2012-04-16http://www.radiographyonline.com/article/PIIS1078817412000260/abstract?rss=yesAbstract: In 2009 an asynchronous on-line case discussion assessment was introduced, to replace an existing traditional case study assessment, within the Medical Ultrasound Programmes at City University London, to help extend collaborative, inter-professional student-led learning skills. Two clinical modules were used to develop the on-line learning method with associated assessments. Students selected and led a clinical case from their department, uploaded anonymised images and case details with questions, to encourage interaction from other colleagues.Thirty students participated in the on-line case discussions. The assessment was evaluated via informal feedback, end of module feedback and an on-line questionnaire. Some students completed two modules, using the on-line discussion, others were involved in only one module, of which 21 out of 26 students completed end of module feedback for the 1st module and 18 out of 20 students completed feedback from the 2nd module. Twelve students out of 30 completed the on-line questionnaire.Feedback suggested that the on-line case discussions were a good learning tool, providing a wide range of cases for students to participate in or read and learn from each other. All students found the cases interesting, engaging and useful, but time consuming.Despite the small numbers involved, useful feedback was provided to assist further development of the assessment, particularly in relation to the number of cases being assessed and length of availability. On-line case discussions are an innovative, engaging method to encourage self directed, collaborative learning which could be utilised in the health care setting to share interesting cases, promote inter-professional and self-directed learning.On-line case discussion assessment in ultrasound: The effect on student centred and inter-professional learning - Corrected ProofG. Harrison, B. Mulloy, A. Harris, D. Flinton10.1016/j.radi.2012.03.003Radiography (2012)2012-04-16Radiography2012-04-16http://www.radiographyonline.com/article/PIIS1078817412000272/abstract?rss=yesAbstract: Aims: Medical image interpretation by non-medically trained staff continues to court controversy. This article aims to show that any potential risks associated with radiographer reporting can be monitored and mitigated if a robust peer review system is introduced. A search of the evidence base illustrates a paucity of guidance on how reporting radiographers should be audited or how a peer review process should be implemented. A practical framework for designing a reporting radiographer peer review process is provided.Methods: Following a literature review, key issues faced when designing a peer review protocol were identified. The following questions are answered: How frequent should peer review take place? How many reports should be reviewed? How are reports selected for review? Who should peer review the radiographer reports? How should radiographer's reporting performance be measured? What standard of reporting is acceptable?Results: Details are provided of the process that has been used for over three years at a busy inner-city teaching hospital for auditing musculoskeletal plain film radiographer reporting. The peer review method presented is not intended to produce robust statistical data; it is a practical method of locally assessing the reporting competency. As such, our protocol should be viewed as part of a larger programme for continuing professional development.Conclusion: It is hoped that this practical protocol will encourage radiology departments to engage in a programme of peer review for reporting radiographers.An evidence based protocol for peer review of radiographer musculoskeletal plain film reporting - Corrected ProofPaul Stephenson, April Hannah, Helen Jones, Rosemary Edwards, Kate Harrington, Sally-Anne Baker, Nicole Fitzgerald, Jane Belfield10.1016/j.radi.2012.03.004Radiography (2012)2012-04-09Radiography2012-04-09http://www.radiographyonline.com/article/PIIS1078817412000065/abstract?rss=yesAbstract: Bayes' theorem has proven to be one of the cornerstones in medical decision making. It allows for the derivation of post-test probabilities, which in case of a positive test result become positive predictive values. If several test results are observed successively Bayes' theorem may be used with assumed conditional independence of test results or with incorporated conditional dependencies. Herein it is examined whether radiographic image features should be considered conditionally independent diagnostic tests when post-test probabilities are to be derived. For this purpose the mammographic mass dataset from the UCI (University of California, Irvine) machine learning repository is analysed. It comprises the description of 961 (516 benign, 445 malignant) mammographic mass lesions according to the BI-RADS (Breast Imaging: Reporting and Data System) lexicon. Firstly, an exhaustive correlation matrix is presented for mammography BI-RADS features among benign and malignant lesions separately; correlation can be regarded as measure for conditional dependence. Secondly, it is shown that the derived positive predictive values for the conjunction of the two features “irregular shape” and “spiculated margin” differ significantly depending on whether conditional dependencies are incorporated into the decision process or not. It is concluded that radiographic image features should not generally be regarded as conditionally independent diagnostic tests.Conditional non-independence of radiographic image features and the derivation of post-test probabilities – A mammography BI-RADS example - Corrected ProofMatthias Benndorf10.1016/j.radi.2012.02.003Radiography (2012)2012-03-22Radiography2012-03-22http://www.radiographyonline.com/article/PIIS1078817412000077/abstract?rss=yesAbstract: Introduction: CT examination has been shown to be effective in detecting bladder cancer. Proper evaluation of the bladder requires it to be well distended. The purpose of the present study was to establish a preparation protocol to achieve satisfactory bladder distension without causing unacceptable patient discomfort.Material and method: We used four different preparation protocols (1: 0.5 L of fluid intake during a 1-h period, 2: Same as 1 with the addition of IV diuretics when the patient was examined, 3: 1 L of fluid intake during a 2-h period, 4: Same as 3 with the additional instruction to empty the bladder after 1 h. In protocols 1–3, the patients were asked not to empty their bladder during the preparation time). Bladder volume was calculated and bladder distension was judged as satisfactory or not by the radiologist. The patients answered questions about their ability to follow the preparation protocol and were requested to rate their need to empty the bladder pre-, during and post-examination.Results: Protocol 1 had the lowest bladder volume. Protocols 2, 3 and 4 were similar in bladder volume. However, Protocol 2 caused unacceptable patient discomfort, and the compliance was lowest in Protocol 4.Conclusion: Protocol 3, drinking 1 L of fluid during a 2-h period, gave satisfactory bladder distension, did not cause unacceptable discomfort in patients and did not have the lowest compliance.Comparison of four different preparation protocols to achieve bladder distension in patients with gross haematuria undergoing a CT urography - Corrected ProofMalin Helenius, Monica Segelsjo, Par Dahlman, Anders Magnusson10.1016/j.radi.2012.02.004Radiography (2012)2012-03-19Radiography2012-03-19http://www.radiographyonline.com/article/PIIS1078817412000053/abstract?rss=yesAbstract: Pain has been highlighted as a main concern for children in conjunction with an acute radiographic examination. The aim of this study was to further investigate children’s pain and distress while undergoing an acute radiographic examination.The study comprised 29 participants with an age range of 5–15 years who were injured and submitted to an acute radiographic examination of the upper or lower extremity when the question at issue was fracture. The Coloured Analogue Scale (CAS) and the Facial Affective Scale (FAS) were used as self-reporting scales to measure the children’s pain and distress. The Face, Legs, Activity, Cry and Consolability Behavioural scale (FLACC) was used as an observation tool to assess behaviours associated with pain in children.Descriptive statistics were used when analysing the scores, and the results showed that children experience pain and distress in conjunction with a radiographic examination after an injury. Spearman’s correlation was used to compare variables, and significant correlations were obtained between the self-reported pain and the observed pain behaviour. Fischer’s Exact test was used to compare groups, and when using the cut-off 3.0 on the self-reporting scale no significant correlation was found concerning the pain reported by children diagnosed with and without a fracture. No significant correlations were found concerning the self-reported distress and pain either, regardless of whether it was a first-time visit and whether a parent was near during the examination.Children’s pain and distress while undergoing an acute radiographic examination - Corrected ProofB. Björkman, S. Nilsson, B. Sigstedt, K. Enskär10.1016/j.radi.2012.02.002Radiography (2012)2012-03-09Radiography2012-03-09http://www.radiographyonline.com/article/PIIS107881741200003X/abstract?rss=yesAbstract: A case of left atrial leiomyosarcoma is reported. A forty year-old woman presented to hospital with a history of shortness of breath and tachycardia. Imaging revealed a left atrial mass which was surgically resected and shown to be a leiomyosarcoma. Adjuvant treatment with external beam radiotherapy was prescribed. The treatment planning was complicated by previous radiotherapy for a left sided primary breast tumour one year previously. Primary cardiac neoplasms are rare, with leiomyosarcoma representing a tiny proportion of these. Limited data is available on the effectiveness of treatment regimes for cardiac leiomyosarcoma due to its rarity. Treatment planning considerations and the strategy adopted for this case are discussed.Leiomyosarcoma of the left atrium. A case study - Corrected ProofSimon Smith, Stuart Grange, Paula Wilson10.1016/j.radi.2012.01.002Radiography (2012)2012-02-20Radiography2012-02-20CASE REPORThttp://www.radiographyonline.com/article/PIIS1078817411001684/abstract?rss=yesAbstract: Portal hypertension and variceal bleeding are complications due to cirrhosis. Transjugular Intraphepatic Portosystemic shunt (TIPS) procedure is a well-established treatment for recurrent ascites and variceal bleeding related to portal hypertension. After a TIPS has been placed, the potential of TIPS occlusion or stenosis is high. A TIPS redo procedure has been used in treatment of progressive clinical symptoms. The standard approach is via the jugular route to recannulate the TIPS shunt. Rarely, it cannot be performed from the jugular approach. Therefore, a fluoroscopically -guided transhepatic approach has been devised for these difficult situations. This case describes the use of the transhepatic route through an indwelling Viatorr covered stent utilizing an En-Snare device to help complete the TIPS redo procedure. With this newer approach to TIPS redo procedures, endovascular specialists can achieve TIPS patency despite difficult venous anatomical challenges and the various types of available TIPS stents presently on the market.Flouroscopically–guided transhepatic puncture for difficult TIPS re-do procedures utilizing the En Snare retrieval device: A new approach to occluded TIPS in patients with recurrent ascites - Corrected ProofGlenn W. Stambo, Matthew H. Berlet10.1016/j.radi.2011.12.001Radiography (2012)2012-01-09Radiography2012-01-09TECHNICAL NOTEhttp://www.radiographyonline.com/article/PIIS1078817411001489/abstract?rss=yesAbstract: Aim: To investigate the changes in rabbit foetal body composition in terms of bone mineral density (BMD) after ultrasound exposure (insonation) was given during different stages of gestation at different lengths of exposure time.Methods: Three groups of pregnant rabbits; A, B, and C were given an ultrasound exposure of 30, 60 and 90min, respectively; during “Trimester 1”, “Trimester 2”, and “Trimester 3”, using a 2-D B-mode Philips HD3 ultrasound system with a 9MHz 50mm broadband high-resolution linear array transducer. A fourth group of pregnant rabbits, O, was used as control. Each full-term newborn rabbits were scanned using a Lunar DPX-IQ dual energy X-ray absorptiometry (DEXA) scanner for whole-body BMD measurement in grams per centimetre square (g/cm2).Results: The results suggested that insonation for 90min in the 1st and 2nd trimester produced significant increase in BMD of rabbit foetus.Conclusion: This in-vivo study revealed that a 90min B-mode diagnostic ultrasound exposure during the 1st and the 2nd trimesters caused significant increase in foetal BMD. A further study should be instituted to determine whether this finding in rabbit may also occur in human by means of clinical trials.The effect of B-mode diagnostic ultrasound exposure on rabbit foetal bone mineral density (BMD) - Corrected ProofSulaiman M. Dom, Md. Saion Salikin, Hamzah Fansuri Hassan, Nadzri Mohd Yusoff10.1016/j.radi.2011.11.011Radiography (2011)2011-12-23Radiography2011-12-23http://www.radiographyonline.com/article/PIIS1078817411001465/abstract?rss=yesAbstract: The aim of this study was to profile the Trait emotional intelligence (EI) of the radiography profession, explore any differences between subgroups, compare the profession with a normative group and investigate the relationship between EI and the leaders of the profession. An online UK-wide survey was conducted using the Trait Emotional Intelligence Questionnaire, a self-report measure. Three main analyses were undertaken to investigate any differences between the sample and population, the radiographer subgroups and the sample and a normative group. The sample had similar characteristics to the population. There were differences between types of radiographer, with nuclear medicine radiographers scoring consistently lower than other groups. There were differences between the leaders and other members of the profession particularly in the Sociability factor. Radiographers scored higher than the TEIQue normative group for Global EI and three of the four factors. The study has benchmarked the Trait EI of one healthcare profession and identified areas for future research to develop our understanding of emotional intelligence.A UK-wide analysis of trait emotional intelligence within the radiography profession - Corrected ProofS.J. Mackay, P. Hogg, G. Cooke, R.D. Baker, T. Dawkes10.1016/j.radi.2011.11.009Radiography (2011)2011-12-16Radiography2011-12-16http://www.radiographyonline.com/article/PIIS1078817411001386/abstract?rss=yesAbstract: There is a spectrum of musculoskeletal disorders which can be associated with dermatologic findings, the fundamental component of which is a nonbacterial osteitis. CRMO (Chronic recurrent multifocal osteomyelitis) and SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) describe paediatric and adult conditions, respectively, of inflammatory osteitis that can be associated with palmoplantar pustulosis and acne. Imaging findings are similar and a key component to the diagnosis in both conditions. This report describes two patients with strikingly similar radiologic presentations of clavicular osteitis in whom the diagnosis was made predominantly on the basis of imaging findings. The typical imaging features and radiographic hallmarks of both conditions will also be discussed.Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis (SAPHO) and chronic recurrent multifocal osteomyelitis (CRMO): Role of imaging in diagnosis - Corrected ProofUma Thakur, Marcia Blacksin, Kathleen Beebe, J.C. Neilson, Barry Dashefsky, Gino Tagoylo10.1016/j.radi.2011.11.001Radiography (2011)2011-12-02Radiography2011-12-02CASE REPORThttp://www.radiographyonline.com/article/PIIS1078817410001446/abstract?rss=yesThis article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicyWITHDRAWN: Citation analysis as a measure of the impact of research - Corrected ProofJulie M. Nightingale, Gill Marshall10.1016/j.radi.2010.11.007Radiography (2010)2010-12-17Radiography2010-12-17