Journal of Medical Imaging and Radiation Sciences最新文献

{"title":"To Ring or Not To Ring","authors":"Rachelle Martell, Kathryn Moran, Leslie Hill","doi":"10.1016/j.jmir.2025.101948","DOIUrl":"10.1016/j.jmir.2025.101948","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>At the end of a course of cancer treatment (chemotherapy, radiotherapy or other) patients are sometimes given the option to ring a bell to celebrate treatment completion. This is widely done across cancer centers in Canada. The act of ringing a bell is generally intended to give patients a sense of closure, but despite best intentions there are many patient concerns that have begun to reach the scarce literature. Patient opinion pieces have described the bell ringing as divisive, reminding them of their own never-ending journey. Additionally, prospective studies have found increased distress in patient groups who rang the bell versus those who did not. The aim of this project was to find and implement a more private and inclusive means of celebrating the end of a course of radiation treatment.</div></div><div><h3>Methods/Process</h3><div>To start, cancer centers across Canada, Australia and the UK were surveyed to discover what methods of celebration were being used globally in addition to any feedback they had received from patients regarding the bell. All non-bell related options for celebration were gathered with support from the Cancer Patient and Family Engagement platform. From this a patient survey was created for our institution. Patients were surveyed for their opinions and given alternative options to choose from for future use. This survey was then re-opened to increase sample size.</div></div><div><h3>Results or Benefits/Challenges</h3><div>The benefit of finding a new way to celebrate the completion of a course of radiation treatment is to allow patients a more private means of celebrating that does not impact other patients. The current primary concern with bell ringing is that it can be heard by other patients in the clinic, leading to negative reactions. The challenge of this project will be the implementation process, it may require additional hospital resources and space which is already strained.</div></div><div><h3>Conclusions/Impact</h3><div>Of the 65 cancer centers polled, 46% used bell ringing, of those, 57% stated they had received some form of negative feedback from patients. After re-opening the survey, 17/56 patients surveyed were given the option to ring a bell at the end of their treatment. 24% chose not to ring, and 20% of those polled did not want to watch or hear others ring a bell. There were many poignant remarks from patients, for example one person stated, “I don't feel the need to see others celebrate - and I know if there comes a time when I will never finish, then I wouldn't want to see that”. When given four alternative options to the bell, most patients voted for an art installation, or a signed card by the treatment team. The results of this project highlight the need to re-examine the bell as an appropriate method of celebration for patients receiving cancer treatment. Our institution has removed the bell and are working towards mounting an art installation for our patient p","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101948"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242627","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 Remotely Collected Patient-Reported Outcomes to Triage Attendance at On-Treatment Review Visits: Early Findings","authors":"Tara Rosewall ,&nbsp;Vickie Kong ,&nbsp;Grace Lee ,&nbsp;Shaneel Pathak ,&nbsp;Jennifer Croke ,&nbsp;Peter Chung ,&nbsp;Colin Robertson ,&nbsp;Yat Tsang ,&nbsp;Philip Wong","doi":"10.1016/j.jmir.2025.101930","DOIUrl":"10.1016/j.jmir.2025.101930","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>To determine the impact of Radiation Therapists using remotely collected patient-reported outcomes (PROs) to triage attendance at on-treatment review visits.</div></div><div><h3>Methods/Process</h3><div>Patients who were able to communicate about medical issues in English, and were about to receive radical external beam radiation therapy (RT) for breast or prostate cancer, were approached for informed consent. Participants were randomly assigned to one of two groups: the standard of care (SOC) group attended every weekly on-treatment visit. For the intervention group (INT), their attendance was triaged by Radiation Therapists, based on PRO responses. PROs were entered by the the participants in an unsupervised manner via a smartphone application (App) less than18 hours before each scheduled review. The triggers to attend the on-treatment visit were: a PRO entry of ‘moderate’ grade or above in any domain; a specific request to attend the review visit by the participant; or last week of RT course. If these criteria were not met, the participant would skip the on-treatment review visit. Less than 24 hours after the review visit, all participants completed an evaluation of that week's on-treatment review using the App.</div></div><div><h3>Results or Benefits/Challenges</h3><div>To date, 36 patients have agreed to participate (30% of planned accrual). 56% were diagnosed with breast cancer, and 58% were randomized into the INT arm. The PRO completion rate was very high in both arms (97%). In the SOC arm, participants attended 96% of review visits. INT participants skipped 28% of review visits, none of these required alternative supportive services. More INT participants reported the review visits lasted more than 10 minutes compared to the SOC arm (39% vs. 18%; p 0.04). INT participants, who were triaged to attend the review visit were significantly more likely to report that all of their side effects were discussed, compared to the SOC arm (81% vs 56%; p 0.04). 100% of INT participants felt the questions in the PRO surveys helped them talk about their side effects with their RT team. There were no differences in Patient Satisfaction with Cancer Care scores between the cohorts (p 0.59). Both cohorts were very satisfied with the review visits (69%), but those in the INT arm were more likely to report that the visits were a valuable use of their time (66% vs. 55%). 92% of study arm participants felt that Radiation Therapists always or frequently made a correct triage decision.</div></div><div><h3>Conclusions/Impact</h3><div>The early findings from this study suggests that PRO-based triage by Radiation Therapists allowed almost 30% of patients to skip unnecessary on-treatment review visits. This improved the perceived value of on-treatment review visits, while reducing the burden on patients and healthcare systems, without compromising satisfaction with cancer care.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101930"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242455","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":"Empowering Minds: A Quality Improvement Initiative on Educating Radiation Therapists on Navigating Difficult Conversations Surrounding Anxiety and Depression in Palliative Patients","authors":"Neva Pang ,&nbsp;Tara Rosewall","doi":"10.1016/j.jmir.2025.101952","DOIUrl":"10.1016/j.jmir.2025.101952","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Radiation Therapists are knowledgeable and confident in supporting patients with anxiety and depression based on recognizing the signs and symptoms, discussing anxiety and depression and providing emotional support. However, when it comes to referring patients for additional support such as Psychosocial Oncology (PSO) or community programs, there is a knowledge gap. It is important for Radiation Therapists (RT) to have this knowledge so that they can better support the mental health needs of their patients and ensure they receive the additional support to get them through their radiation treatments. The aim of this project was to increase the number of psychosocial support referrals and disseminated psychosocial toolkits in palliative patients receiving fractionated radiation treatment with an ESAS score of 7 or more by 70% by March 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;This change idea engaged two focus groups –RTs &amp; patients from October 2023 – December 2024. Within the RT focus group, a needs assessment survey was conducted and based on the responses a series of webinars and resources were developed to meet the interest of RTs. Following the delivery of these resources, a survey was sent out to staff to evaluate the effectiveness of the resources in increasing confidence among staff. The second focus group was patient – driven where 10 palliative patients were interviewed on interest in learning about community support programs. A 1-pager document (psychosocial toolkit) was developed highlighting community support programs of interest. This document was shared with staff to give to palliative patients with an ESAS score of 7 or more.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;The results showed that there is still work to be done in ensuring that RTs still have these conversations, however through the process measures it was identified that there is an increase in interest among RTs in having these conversations and to learn more. Despite competing learning demands, there was still engagement among staff. One challenge was low attendance for some of the webinars/workshops due to scheduling conflicts. However, a number of these webinars were recorded and as a result we have created a diverse repository of resources for staff to refer to. Another challenge was that it was difficult to measure the number of community referrals that were generated through this initiative.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;Since the implementation of this initiative the number of PSO referrals in our institution has increased to 29 referrals (November 2023 – December 2024) in comparison to 5 from November 2022 – February 2023. Among this group only 3 of the patients had an ESAS score of 7 or more, which shows the impact of having these discussions with patients regardless of their ESAS scores. After the webinars, there was an increase in RT confidence levels (N=30, 58%) in entering Epic r","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101952"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242539","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":"The Role of Preparatory Mobile App Breath-Hold Coaching for Left-Sided Breast Radiotherapy in Patient Preparedness and Anxiety","authors":"Shannah Murland ,&nbsp;Tehreem Khalid ,&nbsp;Bradley Dreher ,&nbsp;Kaitlyn Hennessey ,&nbsp;Sarah McAvena ,&nbsp;Justina Wong ,&nbsp;Kurian Joseph","doi":"10.1016/j.jmir.2025.101937","DOIUrl":"10.1016/j.jmir.2025.101937","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Deep Inspiration Breath Hold (DIBH) technique is standard of practice for treating left-sided breast cancers as it reduces cardiac dose and limits late cardiac toxicities. The success of DIBH depends on patients’ ability to hold their breath, which may not be intuitive. Recent studies suggest that DIBH technique provokes patient anxiety which can interfere with breath-hold performance. Preparatory training for DIBH has been shown to reduce patient anxiety, however no research has explored preparatory DIBH training via mobile device apps. The aim of this study was to determine whether preparatory DIBH training with a mobile app improved anxiety and preparedness for breath-hold at CT simulation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;This prospective parallel study consisted of two groups. The control group received the standard DIBH information sheet as education at time of radiation oncology consult, while the experimental cohort received the information sheet with additional breath-hold practice instructions using an app. In the experimental group, CT simulation was booked to occur no earlier than one week after consult so there could be time to practice with the app. Upon completion of the CT simulation appointment, both groups completed a short questionnaire. Survey results were compiled and analyzed using Fischer's Exact test and nonparametric Mann-Whitney tests.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;A total of fifty participants were recruited to the study, with twenty-five participants in each group. There were no significant differences in age (p=0.65), education level p=0.085), or anxiety prior to the CT simulation appointment (p=0.75), measured using a distress thermometer tool, between the two groups. Both groups felt the education they received prior to simulation was adequate, with 92% in the control group and 95.5% in the app group indicating they were very satisfied or satisfied. And both groups felt similar levels of confidence about holding their breath during their simulation, with 88% and 90.9% in the control and experimental groups, respectively, feeling very confident or confident. However, the proportion who felt prepared or somewhat prepared for their simulation appointment was higher in the experimental group (95.4%) compared to the control group (84%), and this difference was significant (p=0.042). For those patients in the experimental group, 77.3% found the app easy to use and 86.4% felt it helped with preparation for simulation. The same proportion (86.4%) felt that it reduced their anxiety level.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;Preparatory DIBH training with a mobile device app did not have a statistically significant effect on patient anxiety or confidence of performing breath-holds during CT simulation. Patients in the experimental cohort did feel significantly better prepared for their simulation appointment and most found the app very easy to","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101937"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242624","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":"Adapting to the Unknown: Development of an Education and Training Plan for the Implementation of a Cone-Beam Computed Tomography Based Online Adaptive Treatment System","authors":"Natasha McMaster ,&nbsp;Jennifer DeGiobbi ,&nbsp;Amanda Cherpak ,&nbsp;Hannah Dahn ,&nbsp;Kenny Zhan","doi":"10.1016/j.jmir.2025.101943","DOIUrl":"10.1016/j.jmir.2025.101943","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Rapid technological advancements within radiation therapy present challenges in education and training. Historically, advancements within existing technology allow for the relation of current practice to new advancements in a linear fashion. The implementation of a new treatment platform is not a linear transition, requiring novel thinking, planning, and workflows This discussion aims to explore processes developed for the implementation of an Ethos treatment platform with online adaptive technology from a Radiation Therapist's (MRT(T)) perspective.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;Implementation of the Ethos treatment platform and online adaptive workflow required a multidisciplinary approach including Radiation Therapists, Medical Physicists (MP), and Radiation Oncologists (RO). A working group comprised of key stakeholders was formed and tasked with outlining the basic structure for implementation, draft treatment protocols, and standard operating procedures and training checklists. Within the adaptive workflow, MRT(T)s would be responsible for contouring organs at risk (OAR) known as influencer structures in addition to routine patient setup, imaging and treatment delivery. Initially, the MRT(T)s were to contour practice cases which would be reviewed by a certified Medical Dosimetrist. After completing a number of approved cases, the MRT(T) was signed off as competent. Unfortunately, it became evident that this process was resource intensive and unsustainable. MRT(T)s were however able to utilize a virtual imaging and treatment environment to practice the adaptive process including contouring. While still available, its use has been limited as we are now able to practice live in the treatment environment under the guidance of the RO.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;A significant benefit has been the implementation of a truly multi-disciplinary treatment environment. The adaptive workflow necessitates the teamwork of the MRT(T)s, MP, and RO for the treatments to be efficient and successful. For the MRT(T)s, there was a unique opportunity to be involved in implementation from the “ground up”. Other opportunities included research, policy development, novel working groups, and the opportunity to be part of a first in the world Ethos with Hypersight treatment platform. Within the adaptive workflow, MRT(T)s developed new skills in contouring and an improved understanding of clinical decision making and plan evaluation from the MP and RO groups. Developing a training process for the MRT(T)s was at times a “trial and error” process. While vendor training and practice sessions were paramount to our success, it was still difficult anticipate what the live treatment environment would be like. This led to uncertainties when attempting to develop training processes. Training was also a resource intensive process in a time of staffing shortages. Other challenges arose with integrating o","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101943"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242450","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":"Advancing Education for Prostate Brachytherapy: Evaluation of a Virtual Reality Simulator and Needle Insertion Module","authors":"Anton Varlukhin ,&nbsp;Mackenzie Smith ,&nbsp;Fahad Alam ,&nbsp;Amandeep Taggar ,&nbsp;Gerard Morton ,&nbsp;Moti Paudel ,&nbsp;Raffi Karshafian ,&nbsp;Humza Nusrat","doi":"10.1016/j.jmir.2025.101922","DOIUrl":"10.1016/j.jmir.2025.101922","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Clinicians face challenges in prostate brachytherapy education, partly because in-person training is constrained by limited time and space in the operating room (OR). Currently, radiation therapy curriculum does not effectively integrate brachytherapy education and clinical training. Virtual reality (VR) offers a scalable, accessible, and asynchronous solution for health professions education, making it a promising tool for addressing training challenges. To bridge the educational gap, our institution developed a VR training simulator with a needle insertion module designed to improve understanding of prostate brachytherapy workflows. The aim of this phase of the project was to evaluate the effectiveness of the VR simulator in improving the perceived confidence levels of radiation therapists, medical physicists, and radiation oncologists in prostate brachytherapy practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;An open-sourced three-dimensional modeling tool and game engine were used to develop a simulation allowing users to view and interact with a virtual replica of a brachytherapy OR using a commercially available VR headset. An iterative feedback loop was used during development to ensure that the VR simulator features were realistic and intuitive for users. A prostate brachytherapy training module was developed to simulate a needle insertion workflow. Participants in this study were asked to complete a virtual needle insertion and then answer questions regarding their experiences. Pre- and post-surveys were developed to assess the perceived confidence of users in recalling and explaining the needle insertion workflow before and after completing the module, as well as documenting any VR-related adverse effects. Each survey consisted of 6 Likert-scale questions, including 4 paired questions that were identical in both the pre- and post-survey to enable direct comparison of responses. Open ended questions were also included to gather participant demographics, feedback, and suggestions for improvement. Responses from paired questionnaires were analyzed using Wilcoxon signed-rank tests.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;The prostate brachytherapy needle insertion training module was completed by 27 participants, including radiation therapists (59%), radiation oncologists (26%), and medical physicists (15%). Wilcoxon signed-rank test results of participant pre- and post-survey responses demonstrated improved confidence rankings for recalling workflow steps (W=355, p&lt;0.01), explaining steps (W=347, p&lt;0.01), identifying equipment (W=355, p&lt;0.01) and explaining equipment function (W=354, p&lt;0.01) following completion of the module. Minor motion sickness with use of the VR simulator was experienced by 19% of participants. Feedback gathered from open-ended questions was positive, while highlighting areas for improvement.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;The results ","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101922"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242621","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":"Imaging Rejection Rate Analysis in Four-Field Breast Radiotherapy","authors":"Jasmine Chen,&nbsp;Michelle Chan,&nbsp;Ryan Hyvarinen","doi":"10.1016/j.jmir.2025.101954","DOIUrl":"10.1016/j.jmir.2025.101954","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;At Princess Margaret Cancer Centre, two-dimensional megavoltage portal imaging is predominately used to verify positional accuracy for breast cancer patients undergoing 4-field radiotherapy. It is acquired and assessed daily by radiation therapists with an online correction of 0.5 cm translational tolerance. Depending on the dose fractionation, an offline approval of all day 1 images was required by radiation oncologists prior to the second or fourth fractions of treatments. A quality assurance task was conducted in 2023. The purpose was to evaluate the imaging rejection rate, reasons of rejection, and to implement strategies in further reducing rejection rates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;Between Oct 2018 and August 2021, forty-four patients receiving 4-field breast radiotherapy had at least one day 1 image rejected by oncologists. There was a total of 51 rejections (38 supra-clavicular fields and 13 chestwall/breast fields). This was about 5% of all 879 patients treated with this technique during this time. All patients were treated on Elekta Agility linear accelerators equipped with iView electronic portal imager. All relevant images and documentation were retrieved in Mosaiq information system. Among all the reasons, the clavicle displacement of ≥ 0.5 cm accounted for 52% of the rejection. Inadequate lung distance of breast fields had the second highest rate of 34%. Poor imaging preprocessing and preparation occurred in 9%. Next, an experienced frontline therapist undertook a routine registration process for all rejected images, this peer-review process aimed to identify any variation in decision making between therapists and oncologists.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Three areas of improvement were identified. First, an inter-observer variability exists when choosing different anatomical references. For example, therapists routinely used central-lung distance to guide the anterior-to-posterior shifts while oncologists may follow maximal heart distance. Second, the use of different measurement and visualization tools in iView and Mosaiq may contribute to additional few millimeters of difference, for example, using different bordering enhancement or performing template matching versus point measurements. Finally, day 1 procedures can be quite lengthy and patients may alter arm position in between imaging fields. Continuous monitoring of the stability of patient position was needed on subsequent treatments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;This quality analysis of breast imaging improves inter-professional communication. The benefits and pitfalls of different registration strategies were discussed during breast qa rounds. The recommendations were disseminated to frontline therapists in an one hour imaging refresher training. This quality assessment was repeated six months after the training. In a group of 180 patients, the imaging rejection rate decrease","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101954"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242541","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":"Implementation of Central Venous Access Device Option for IV Contrast Administration during CT Simulation","authors":"Joy Peltier,&nbsp;Tanya Bigg,&nbsp;Vanessa Hribar,&nbsp;Amanda Lula,&nbsp;Julie Diemert","doi":"10.1016/j.jmir.2025.101940","DOIUrl":"10.1016/j.jmir.2025.101940","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Intravenous (IV) contrast is frequently utilized at the time of radiation CT Simulation to enhance visibility of critical anatomical structures, providing important information for the clinical team when planning for radiation treatments. At our institution, when IV contrast is ordered by the Radiation Oncologist (RO), patients are booked for an appointment with a nurse immediately prior to CT Simulation, during which they have an IV inserted. For some patients, IV initiation is extremely challenging or impossible and often this information is known in advance of the CT Simulation appointment. These challenges have resulted in scenarios where IV contrast was not a feasible option and in discussion with the Radiation Oncologist (RO), CT Simulation was performed without contrast. This is less than ideal for radiation treatment planning, as ROs must then rely on diagnostic images for target delineation, where image fusion can be difficult due to differences in patient position and anatomy. Many radiation patients have existing Central Venous Access Devices (CVAD), for the purposes of systemic therapy treatment delivery. The aim of the practice innovation was to explore the feasibility of implementing a CVAD option to administer IV contrast for CT Simulation purposes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;The Diagnostic Imaging (DI) Department at our institution routinely utilizes CVADs for the purposes of contrast administration during CT scans. Radiological Technologists in the DI department access, administer contrast and de-access lines via CVADs. During a visit with the lead charge technologist in DI at our institution, members of our working group were able to gain knowledge and insights regarding their processes and procedures with safety being the priority and goal. Subsequently, the working group sought specific feedback from various radiation therapy departments to confirm any adjustments required to contrast and scanning protocols. Utilizing the expertise of our IT department, the working group developed a new order set within the clinical information system that would support the option for the RO to order contrast administration through CVAD. This order set includes specific appointments, orders for accessing and de-accessing the CVAD for nursing as well as orders for as needed emergency medications in the event of contrast induced anaphylaxis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;This is a significant benefit to patients with poor venous access with an existing CVAD. This provides patients with equitable care and the ability to ensure adequate delineation of CT images for radiation planning purposes. A potential challenge foreseen was a large number of requests for CVAD and therefore the initial implementation included a select patient population of those who had known difficulties rather than all patients with existing CVADs. This was to allow a gradual implementation to asses","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101940"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242544","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":"Inter-rater concordance in the classification of COVID-19 in chest X-ray images using the RANZCR template for COVID-19 infection","authors":"Peter O’Reilly ,&nbsp;Dania Abu Awwad ,&nbsp;Sarah Lewis ,&nbsp;Warren Reed ,&nbsp;Ernest Ekpo","doi":"10.1016/j.jmir.2025.101911","DOIUrl":"10.1016/j.jmir.2025.101911","url":null,"abstract":"<div><h3>Introduction</h3><div>The Royal Australian and New Zealand College of Radiologists (RANZCR) has developed a reporting template to assist in the categorization of COVID-19 in chest X-ray (CXR) images and the levels of COVID-19 infection. Whilst CXRs are reported by radiologists, radiographers are often the first to assess the CXRs, and have the potential to support immediate triaging of patients with COVID-19. However, inter-reader concordance in the use of this reporting template remains underexplored.</div></div><div><h3>Methods</h3><div>70 CXR examinations comprising of the four categories in the RANZCR chest X-ray (CXR) COVID-19 reporting template were used for the study. These included: ‘typical’ (for COVID-19) (<em>n</em> = 30); ‘indeterminate’ (for COVID-19) (<em>n</em> = 20); ‘other diagnoses favoured’ (<em>n</em> = 10) and ‘normal’ (<em>n</em> = 10). These images were independently categorised using the RANZCR reporting template by three cohorts of readers: 12 radiologists, 13 registered radiographers, and 12 final-year radiography students. A Weighted Kappa (κ_w) was used to evaluate inter-reader agreement within and between the cohort of readers.</div></div><div><h3>Results</h3><div>Radiologists demonstrated fair (κ<em>_w</em> = 0.32) to substantial (κ<em>_w</em> = 0.77) inter-reader agreement, and their overall inter-reader was moderate (κ<em>_w</em> = 0.56). Registered radiographers demonstrated no (κ<em>_w</em> = -0.01) to moderate agreement (κ<em>_w</em> = 0.59), and their overall agreement was fair (κ<em>_w</em> = 0.31). Fourth year student radiographers demonstrated slight (κ<em>_w</em> = 0.004) to substantial (κ_w ₌ 0.8) agreement, with a moderate (κ<em>_w</em> = 0.47) overall agreement among final year student radiographers.</div></div><div><h3>Conclusion</h3><div>There are wide variations in the classification of the CXRs using the RANZCR reporting template. Overall, radiologists exhibit superior concordance in CXR categorization using the COVID-19 reporting template. Radiographers demonstrate wide variability, highlighting the need for enhanced education and training to standardise the triaging of these patients undergoing CXR imaging for COVID-19 symptoms.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 5","pages":"Article 101911"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894799","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":"Current trends in therapeutic radiographers' research: A scoping review","authors":"Irene Maran ,&nbsp;Marta Assenza ,&nbsp;Angela Peghetti ,&nbsp;Federico Tabarrini ,&nbsp;Gaia Angelini ,&nbsp;Gabriele Spoltore ,&nbsp;Elisa Gilli ,&nbsp;Filippo Casarotti ,&nbsp;Laura Chierico ,&nbsp;Alessio Giuseppe Morganti ,&nbsp;Stefano Durante","doi":"10.1016/j.jmir.2025.101916","DOIUrl":"10.1016/j.jmir.2025.101916","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of Therapeutic Radiographers (RTTs) is evolving alongside advancements in radiotherapy (RT) technology and techniques, and the principal research areas of the therapeutic radiographers (RTTs) are directly correlated with the development opportunities within the same context. This scoping review aims to explore current research trends relevant to RTTs, with a focus on professional development and the expanding scope of their roles in clinical practice. This will require a shift from an intuitive approach to one based on bibliographic evidence and trends that warrant greater emphasis.</div></div><div><h3>Methods</h3><div>A literature search was conducted using PubMed, Scopus, Web of Science, and CINAHL, covering studies published between 2018 and 2023, and it was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) extension for scoping reviews. The inclusion criteria focused on research related to RTTs, excluding general radiographer studies, clinical-only studies, and conference papers. The screening process was completed by eight reviewers.</div></div><div><h3>Results</h3><div>A total of 39 studies were selected for inclusion. Key research trends included the Evaluation of patient engagement in radiotherapy (13 articles), the potential role of Artificial Intelligence (AI) in RT (6 articles), the expanding roles of Advanced Practice Radiation Therapists (APRTs) across different countries (7 articles), and the increasing involvement of RTTs in Image-Guided Radiotherapy (IGRT) and Adaptive Radiation Therapy (ART) in implementation, quality assurance, and training (9 articles). The literature also highlighted the importance of RTT-patient engagement, particularly in palliative care, and the need for advanced training in areas such as treatment contouring, digital competencies, and personalized care approaches.</div></div><div><h3>Conclusions</h3><div>RTTs are progressively assuming more autonomous roles in RT, particularly in treatment planning and contouring. The integration of AI and new technologies requires ongoing education and certification for RTTs to ensure they remain equipped to handle the evolving demands of RT. Increased involvement in research and interdisciplinary collaboration will enhance their contributions to patient care and clinical practice. However, further efforts are needed to standardize the APRT role and ensure consistent professional development opportunities.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 5","pages":"Article 101916"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891193","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}