Journal of Medical Radiation Sciences最新文献

{"title":"Clinical Judgement, Treatment Decisions and Frailty Management in Older Cancer Patients: A Qualitative Study Exploring the Experiences of Radiation Therapy Staff.","authors":"Sofia Axelsson, Per Fessé, Per Fransson, Agneta Schröder, Antonis Valachis, Emma Ohlsson-Nevo","doi":"10.1002/jmrs.70017","DOIUrl":"https://doi.org/10.1002/jmrs.70017","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of older cancer patients can be complex due to frailty that comes with age, and the benefits of radiation therapy for frail older patients are unclear. Radiation therapy staff play a crucial role in identifying and monitoring frailty and tailoring treatment. Research on radiation therapy in frail older patients is limited, and frailty assessments are not widely used in routine care. Understanding staff experiences with clinical judgement and frailty assessment is important for effective treatment. This study explored the radiation therapy staff's experiences of clinical judgement, treatment decision-making, and managing frail older cancer patients.</p><p><strong>Methods: </strong>The study has an inductive design in which 12 specialist oncology nurses and four clinical oncologists working with cancer patients at four radiation therapy units across four counties in Sweden were interviewed. In total, 16 participants were interviewed for the study. Data were collected in semi-structured individual interviews and were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three themes were identified from the interview analysis: Putting the patient first, Care with integrity and humanity and Receiving support in treatment decisions, along with nine sub-themes. None of the participants was using any structured instrument for assessing frailty.</p><p><strong>Conclusions: </strong>Radiation therapy staff face significant and complex challenges when treating frail older cancer patients, which can lead to feelings of doubt and powerlessness. Awareness and use of structured frailty assessment are limited. Integrating structured frailty assessment could address the complex challenges experienced by staff by improving decision-making, communication, and patient outcomes, contributing to more ethical and person-centred care.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing Professional Development—Radiation Therapy","authors":"","doi":"10.1002/jmrs.70016","DOIUrl":"10.1002/jmrs.70016","url":null,"abstract":"<p>Maximise your continuing professional development (CPD) by reading the following selected article and answering the five questions. Please remember to self-claim your CPD and retain your supporting evidence. Answers will be available via the QR code and published in JMRS—Volume 72, Issue 4, December 2025.</p><p>Scan this QR code to find the answers.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":"72 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmrs.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility of Total Body Photography (TBP) in Superficial Radiation Therapy (SXRT).","authors":"Briley Devonport, Julie Burbery, Katie L McMahon, Kate Stewart, Catriona Hargrave","doi":"10.1002/jmrs.70012","DOIUrl":"https://doi.org/10.1002/jmrs.70012","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to investigate the feasibility of total body photography (TBP) as a superficial radiation therapy (SXRT) treatment record, to overcome the limitations that tracings and two-dimensional (2D) photographs pose when patients return for future SXRT treatment.</p><p><strong>Methods: </strong>A retrospective audit included 44 patients treated with SXRT at the Royal Brisbane and Women's Hospital (RBWH), from January 2020 to December 2022, with lesion characteristics and patient setup information collected. A prospective study involved applying mock lesions to four healthy volunteers, who were imaged multiple times using a three-dimensional (3D) digital photometry system. The system's feasibility as a longitudinal digital record was assessed using the 3D images.</p><p><strong>Results: </strong>From the retrospective audit, 48 lesions were treated, 38 were located on the head and neck, and 9 on the limbs, with treatment areas ranging from 1.4-60.1 cm². This guided the creation of 16 mock lesions. The mean difference between the measured areas of face mock lesions from the captures and the actual mock lesion areas was < 0.4 cm². Neck and arm lesions showed greater mean variation (up to 3.05 cm²), particularly between sitting and standing captures. Registrations of captures found the distance between overlayed face lesions averaged < 2.7 mm. Reconstruction errors were limited to the hands, hair and ear regions.</p><p><strong>Conclusion: </strong>TBP has sound potential as a SXRT digital treatment record. Further studies should investigate neck, limbs and scalp lesions to confirm its practical use in SXRT for a larger patient cohort.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Prior Mammograms on Radiologists and Radiographers' Detection of Different Breast Cancer Lesion Types.","authors":"Judith D Akwo, Phuong Dung Yun Trieu, Melissa L Barron, Tess Reynolds, Sarah J Lewis","doi":"10.1002/jmrs.70015","DOIUrl":"https://doi.org/10.1002/jmrs.70015","url":null,"abstract":"<p><strong>Introduction: </strong>Mammographic interpretation relies on the detection of suspicious abnormal changes, and reference to prior mammograms may support the detection of these changes. However, the influence of prior mammograms on the detection of different breast lesions is unclear. This paper assesses the influence of prior mammograms on the detection of different lesion types in mammograms.</p><p><strong>Methods: </strong>Mammographic test sets comprising different lesion types were interpreted in two stages. In Stage 1, eight radiologists interpreted current mammograms of 72 women (normal: n = 40; cancer: n = 32) with and without access to the prior mammograms. In Stage 2, 13 radiographers interpreted another test set containing 28 mammograms (normal: n = 19; cancer: n = 9) with and without access to the prior mammograms. Radiologists and radiographers' performances in detecting different lesion types with and without prior mammograms were compared separately using a paired t-test.</p><p><strong>Results: </strong>In Stage 1, reference to prior mammograms did not improve sensitivity for architectural distortions (p = 0.48), calcifications (p = 0.85), discrete masses (p = 0.45), and non-specific density (p = 0.22). However, prior mammograms improved the detection of spiculated/stellate lesions (p = 0.05) and diagnostic accuracy for architectural distortions (p = 0.006) and discrete/spiculated/stellate masses (p = 0.01). Prior mammograms had no impact on lesion sensitivity (p > 0.05). In Stage 2, no differences were observed in sensitivity and lesion sensitivity when compared to without prior mammograms for all lesion types (p > 0.05), but prior mammograms improved overall diagnostic accuracy (p ≤ 0.002).</p><p><strong>Conclusions: </strong>Prior mammograms improve the detection of spiculated/stellate lesions but have no impact on the detection of other lesion types when measuring radiologists' and radiographers' performance.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-Free Palliative Radiation Therapy: Implementing the Value-Based and Easier-Access Model of Care in a Rural Setting","authors":"Matthew Fuller,&nbsp;Catherine Osbourne,&nbsp;Rachael Beldham-Collins,&nbsp;Zoe Clarke,&nbsp;Yae Joo Jun,&nbsp;Denise Andree-Evarts,&nbsp;George Warr,&nbsp;Wen-Long Hsieh,&nbsp;Shiaw Juen Tan,&nbsp;Eugene,&nbsp;Caitlin Allen,&nbsp;Rodney Hammond,&nbsp;Thomas Eade","doi":"10.1002/jmrs.70011","DOIUrl":"10.1002/jmrs.70011","url":null,"abstract":"<p>Palliative radiation therapy (RT) is a vital treatment modality for managing symptoms from metastatic disease, but access barriers and workflow inefficiencies can delay or preclude care delivery. Simulation-free RT (SFRT) offers an effective, value-based solution by eliminating the traditional computed tomography (CT) simulation process and utilising existing diagnostic or staging CT scans for treatment planning. This process reduces patient burden and accelerates time to treatment, prioritising patient-centred care over traditional treatment pathways. Key technical considerations include managing dosimetric and geometric variations through appropriate patient selection and quality assurance processes. The successful implementation of SFRT requires a collaborative, multidisciplinary team approach, drawing on expertise from established centres to familiarise the team with the process. Access to diverse diagnostic imaging datasets and collaboration with various imaging providers is crucial. While careful patient selection is essential, our experience demonstrates that SFRT exemplifies value-based healthcare principles by optimising resource utilisation while prioritising patient-centred care, particularly valuable in rural settings where travel distances significantly impact treatment access. This paper aims to review the benefits and technical aspects, as well as provide key considerations for implementing SFRT in palliative RT settings.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":"72 S2","pages":"S85-S93"},"PeriodicalIF":2.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmrs.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Justification for Spinal Computed Tomography (CT) Scans Performed in Togo.","authors":"Kokou Adambounou, Komla Nyinèvi Anayo, Amara Youla, Kossivi Pierre Gbodjomé, Akoeté Beleave Kouevidjin, Gilles David Houndetoungan","doi":"10.1002/jmrs.70014","DOIUrl":"https://doi.org/10.1002/jmrs.70014","url":null,"abstract":"<p><strong>Introduction: </strong>The undeniable benefits of irradiating examinations such as computed tomography (CT) scans should not overshadow their potential harmful effects, particularly late risks. Hence, it is important to justify CT scans requested for patients. The aim of this study is to analyse the justification for CT scans in all health facilities with a functional medical scanner in Togo.</p><p><strong>Methods: </strong>This was a prospective descriptive study of spinal CT scans performed between 1st June and 31st August 2021 and interpreted by a radiologist in seven functional CT units in Togo. The analysis of the justification was based in particular on the formulation of the clinical indication, the consistency of the clinical indication with the requested CT scan, and the compliance of the clinical indication with the Best Practice Guidelines of the Société Française de Radiologie (SFR) and the Société Française de Médecine Nucléaire (SFMN).</p><p><strong>Results: </strong>The 355 spinal CT scans included were exclusively cervical, dorsal and lumbar in 15.5%, 3.1% and 68.2% of the patients, respectively. The mean age of the patients was 48.2 years, with a sex ratio of 1.1:1.0. Approximately 69% of patients had a spinal CT scan within 3 days or less. Specialist (70.2%) and general practitioner (22.3%) were the most frequent requesters; 92.1% of the patients requested a non-radiating or less radiating imaging test before the CT scan. Non-physician staff (paramedics) accounted for 2.5% of requesters. The formulation of the clinical indication was good in 89.9%, acceptable in 7.6% and wrong in 2.5% of the patients. These indications were consistent with the examination requested in 98.9% of the cases and complied with the SFR's best practice guidelines in 72.1% of the cases. Spinal CT scans were pathological in 91% of the patients. The more clearly the clinical indications were formulated, the more significantly the results were pathological. Overall, in 34.1% of the cases, the CT scans performed were deemed not to be justified.</p><p><strong>Conclusion: </strong>A significant number of spinal CT scans performed in Togo were not justified. Efforts must be made by both requesters and providers of medical imaging examinations to ensure judicious medical use of irradiating examinations in Togo.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic Anatomy and Imaging of the Extracranial Component of the Hypoglossal Nerve (CNXII).","authors":"Michelle Fenech, Jodie Gallagher, Laurelie R Wishart, Clare Berry, Michael Foster-Greenwood","doi":"10.1002/jmrs.70010","DOIUrl":"https://doi.org/10.1002/jmrs.70010","url":null,"abstract":"<p><p>The hypoglossal nerve (HN) provides motor innervation to tongue muscles responsible for tongue movement, speech, mastication, swallowing, respiratory functions and management of oral secretions. Injury, compression, entrapment or lesions of the HN at any point along its path can result in HN palsy and subsequent dysphagia, dysarthria and tongue muscular atrophy. A combined imaging approach is required to investigate the HN and causes of HN palsy. Magnetic resonance imaging (MRI) and computed tomography (CT) imaging are used to investigate the intracranial HN and where it emerges in the upper neck. The extracranial HN can be assessed by sonographic imaging along with the muscles directly and indirectly innervated by the HN. Ultrasound imaging can be challenging without an appropriate understanding of the detailed relative anatomy of the HN and the muscles it innervates, the associated sonographic technique and sonographic appearances, all of which are outlined in this paper.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Factors Influencing Fatigue and Medical Imaging Technologist Performance on Night Shift: An Initiative to Improve Healthcare Delivery.","authors":"Trevor Gillbard, Dane Thompson, Nicole Emma Andrews","doi":"10.1002/jmrs.70013","DOIUrl":"https://doi.org/10.1002/jmrs.70013","url":null,"abstract":"<p><strong>Introduction: </strong>It is widely recognised that night shifts can cause fatigue, negatively impact cognitive performance and increase the risk of accidents. This quality improvement project aimed to better understand factors impacting on fatigue levels of medical imaging technologists who perform night shifts at metropolitan hospitals in Australia.</p><p><strong>Methods: </strong>All medical imaging technologists (i.e., radiographers and sonographers) employed at two Australian metropolitan hospitals who had performed night shifts within the last year were invited to complete a custom-made electronic survey. Quantitative survey responses were examined using a combination of descriptive and comparative statistics. An applied thematic analysis was used to examine qualitative findings from open-ended questions.</p><p><strong>Results: </strong>Medical imaging technologists perceive roster patterns with more consecutive night shifts and more rostered days off following night shifts to be less fatiguing and more sustainable. Fatiguing factors, including being awake at night and longer shift lengths, were perceived as significantly more fatiguing during the first 3 days of night shifts. The self-reported time taken to return to a normal sleep routine following night shifts was a mean of 3.2 days. Workload was rated as the factor that caused the highest levels of fatigue throughout a night shift roster. The majority of participants expressed that organisation-level changes are needed to reduce fatigue levels.</p><p><strong>Conclusion: </strong>Organisation level strategies to: (1) reduce workloads, and (2) enable rosters with more consecutive night shifts are needed to help medical imaging technologists effectively manage fatigue levels. The small sample size may limit the generalisability of findings.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Convolutional Neural Networks for the Classification of Suboptimal Chest Radiographs.","authors":"Emily Huanke Liu, Daniel Carrion, Mohamed Khaldoun Badawy","doi":"10.1002/jmrs.70006","DOIUrl":"https://doi.org/10.1002/jmrs.70006","url":null,"abstract":"<p><strong>Introduction: </strong>Chest X-rays (CXR) rank among the most conducted X-ray examinations. They often require repeat imaging due to inadequate quality, leading to increased radiation exposure and delays in patient care and diagnosis. This research assesses the efficacy of DenseNet121 and YOLOv8 neural networks in detecting suboptimal CXRs, which may minimise delays and enhance patient outcomes.</p><p><strong>Method: </strong>The study included 3587 patients with a median age of 67 (0-102). It utilised an initial dataset comprising 10,000 CXRs randomly divided into a training subset (4000 optimal and 4000 suboptimal) and a validation subset (400 optimal and 400 suboptimal). The test subset (25 optimal and 25 suboptimal) was curated from the remaining images to provide adequate variation. Neural networks DenseNet121 and YOLOv8 were chosen due to their capabilities in image classification. DenseNet121 is a robust, well-tested model in the medical industry with high accuracy in object recognition. YOLOv8 is a cutting-edge commercial model targeted at all industries. Their performance was assessed via the area under the receiver operating curve (AUROC) and compared to radiologist classification, utilising the chi-squared test.</p><p><strong>Results: </strong>DenseNet121 attained an AUROC of 0.97, while YOLOv8 recorded a score of 0.95, indicating a strong capability in differentiating between optimal and suboptimal CXRs. The alignment between radiologists and models exhibited variability, partly due to the lack of clinical indications. However, the performance was not statistically significant.</p><p><strong>Conclusion: </strong>Both AI models effectively classified chest X-ray quality, demonstrating the potential for providing radiographers with feedback to improve image quality. Notably, this was the first study to include both PA and lateral CXRs as well as paediatric cases and the first to evaluate YOLOv8 for this application.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring the Safety of MRI Patients With Medical Implants or Devices In Situ: A Snapshot in Time of the Role and Responsibilities of New Zealand and Australian MRI Technologists (Radiographers).","authors":"Adrienne Young, Lisa Mittendorff, Jenny Hiow Hui Sim","doi":"10.1002/jmrs.70007","DOIUrl":"https://doi.org/10.1002/jmrs.70007","url":null,"abstract":"<p><strong>Introduction: </strong>Poor clinical decision-making in MRI can lead to significant patient injuries and, in some cases, prove fatal. With the ever-increasing range and numbers of MR-conditional implants and devices, the complexity of decision-making in this environment has increased. While historically performed by radiologists, this decision-making is becoming integrated into the MRI technologists' (radiographers') role. The aim of this paper is to document the evolving role and responsibilities of MRI technologists (MRITs) in New Zealand (NZ) and Australia when scanning patients with medical implants.</p><p><strong>Methods: </strong>Utilising a mixed-methods case study research design, quantitative and qualitative data were collected via an online questionnaire and semistructured interviews. The questionnaire was completed by 235 MRITs, 12 of whom were also interviewed.</p><p><strong>Results: </strong>Findings confirm that the MRIT role in NZ and Australia in 2018 had evolved over the preceding decade from one focused on technical proficiency to a role involving a higher level of cognitive function and competency relating to MRI safety. Participants identified that all MRITs must be responsible for MRI safety clinical decision-making, not just a select few. Some concerns were raised that radiologists are no longer sufficiently educated in MRI safety, supporting the need for a team effort instead.</p><p><strong>Conclusion: </strong>Aligning with recent global calls to standardise MRIT education and regulation requirements, this study provides evidence to support a separate registerable MRI scope of practice. This will enable MRI-specific knowledge and continuing professional development (CPD) in MRI safety to be mandated and audited so that clinical decisions are informed and safe.</p>","PeriodicalId":16382,"journal":{"name":"Journal of Medical Radiation Sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}