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Purpose: For pregnant patients the imaging choice between computed tomography pulmonary angiography (CTPA) and ventilation-perfusion scintigraphy (VQ) in the investigation of pulmonary emboli (PE) is clouded by perceptions of radiation dose levels reaching the foetus. There is also uncertainty amongst medical professionals regarding the subsequent need to implement measures directed at reducing this dose. The aim of this article is to clarify the various theories surrounding CTPA of the pregnant patient and provide radiographers and medical professionals with a clear, concise understanding of how to reduce the radiation dose to the foetus during CTPA scanning. Methods: In a review of the current data surrounding foetal doses in relation to CTPA this paper is able to compare CTPA and VQ foetal doses. By collating information from the limited number of studies performed on foetal dose reduction techniques for CTPA a number of conclusions were drawn in order to formulate a scanning guide for radiographers. Results: Current opinion suggests that the benefits of CTPA outweigh those of VQ with respect to foetal radiation dose. Survey evidence suggests that oft en no foetal dose reduction strategies are implemented when scanning a pregnant woman for CTPA. Recently published studies have shown that simply by altering the CTPA scanning parameters, such as kVp, mAs, and scan length, using lead protection on the abdomen, and even ingesting barium sulphate solution the dose received by the foetus can be reduced by at least half. Conclusion: Since the stochastic effects of radiation are relatively unknown it is prudent to use any practical techniques aimed at reducing the foetal dose during a CTPA study. Since most of the measures investigated are practical and cause little patient discomfort the authors suggest that consideration should be given to integrating these modifications into current routine scanning protocols.

Adverse delayed reactions (ADRs) to the intravenous injection of non-ionic iodinated contrast media (NICM) were fi rst recognised in the mid-1980s and a growing number of articles in the literature have described such reactions as increasingly common. Th e aim of this article is to increase the understanding of the risk factors, frequency, signs and symptoms of ADRs amongst healthcare staff especially radiographers, nurses, radiologists and physicians who regularly use contrast media (CM). A literature review of multiple studies assessing ADRs performed from 1990-2010 has revealed various misconceptions, particularly in the frequency of ADRs and the infl uence of ethnic background most likely due to methodological limitations. Th erefore, the use of improved research methods and design has the potential to increase our knowledge in this area. Furthermore, new areas of study such as blood testing as a screening tool can assist in risk assessment and prevention of ADRs.

Purpose: To investigate the perceptions of newly qualified radiographers in the Sydney metropolitan area regarding their preparedness for clinical practice. Methods: Twenty-three newly qualified radiographers (corresponds to a 43% return) from nine public hospitals and nine private practices within the Sydney metropolitan area were surveyed. The questionnaire assessed newly qualified radiographers' preparedness against a number of items derived from published radiography standards by the Australian Institute of Radiography (AIR) pertaining to knowledge, skills and values radiographers should acquire upon graduation and completion of the Professional Development Year (PDY) programme. Statistical analysis examined differences in preparedness between those who work in public hospitals and those who work in private practices. Results: Significant differences in perceived preparedness between newly qualified radiog raphers who practice in public hospitals and those who practice in private practices were found in two criteria which include the ability to care for patients with physical or mental disability and equipment manipulation. Positive feedback was given in regards to university degree and PDY programme preparation. Suggestions for degree and PDY programme improvement were provided. Conclusion: Overall, newly qualified radiographers perceived themselves as well prepared for their role as an accredited practitioner.

Purpose: This study investigated advanced practices carried out by radiographers in New South Wales (NSW). Background: Due to a chronic shortage of radiologists, radiographers in the United Kingdom have extended their clinical roles. These additional responsibilities have increased professional accountability, as well as improved the quality of care provided to patients. While it is likely that such professional role extension occurs in Australia, no known study has been performed to date on this topic. Methods: Questionnaires were mailed to Chief Radiographers of medical imaging departments (MIDs) across NSW. Questions related to MIDs demographics and advanced practices of radiographers including triage systems, formal and informal reporting, cannulation, intravenous contrast media administration, roles during diagnostic enemas, and involvement in research. Returned questionnaires were analysed. Results: A total of 69 questionnaires were returned from 115 distributed (60%). Seventeen percent of MIDs with an Emergency department had radiographers involved in the triage process; 39% of MIDs utilised a radiographer-reported abnormality detection system, whilst 30% provided a verbal report. Radiographer-performed cannulations and intravenous contrast media administration occurred in 77% and 79% of MIDs respectively. A total of 40% reported radiographers performing roles other than image acquisition during diagnostic enemas, radiographers participated in research in 13% of MIDs while radiographer clinical presentations, journal club participation and conference organisation occurred in 45%, 7%, and 38% of MIDs respectively. Conclusions: This exploratory study provides important baseline information on the extended roles of radiographers in NSW. The results could be used for future planning of radiographer roles and health service delivery techniques.

Purpose: The Australian Institute of Radiography's Continuing Professional Development programme provides activities for radiographers, radiation therapists and sonographers. This article aims to investigate the perceptions of radiographers in New South Wales (NSW) of the current AIR CPD programme. Methods: 400 questionnaires were distributed within NSW. The questionnaire was designed to investigate the perceptions of radiographers concerning CPD using five themes: motivation for CPD participation; appropriateness of activities; constraints experienced; effectiveness of programme; and mandatory CPD. Results: One hundred and eight-eight questionnaires (47%) were returned. A total of 68% (n=127) of the participants were participating in CPD activities. The participants were most motivated by gaining knowledge through CPD. A total of 80% (n=151) of the participants considered the activities listed in the Credit Recognition Framework to be adequate. The main constraint experienced by the radiographers in the rural setting was the lack of access to CPD activities, while in the metropolitan area, it was lack of time. A total of 59% (n=111) of the participants commented that the current AIR CPD programme is an effective programme and 66% (n=125) of the participants stated that CPD should be voluntary for all radiographers. Conclusion: Overall, radiographers identified the strengths and weaknesses of the AIR CPD programme. They were motivated to engage in CPD. This study also highlighted the constraints experienced, which need to be addressed to encourage more participation in the CPD programme.

A method was sought by which to measure the cortical thickness of long bones, as a prelude to a large comparative study of cortical bone thickness. Radiography presents a simple, non-destructive method for visualising internal features of bones. Radiogrammetry, though frequently used for cortical bone measurements, has predominantly focused on the metacarpals in the literature, while studies examining the method for large long bones are less plentiful. The tibia was used in this study, with samples from humans, kangaroos, sheep, dogs, pigs and cattle. Digital radiographs were obtained from the anterior and medial sides of the bone; images were then displayed on screen, magnified and measured. Bone diameter, medulla diameter and cortical thickness were measured for each projection, at the midpoint of the tibia. Some difficulty was encountered due to the lack of clarity of the endosteal border of the cortex, though intra-observer tests found the method to be largely reproducible. Magnification and distortion of the image were observed, particularly on larger bones as they were situated a greater distance above the film surface. These factors were not considered too limiting; furthermore, the simplicity of the method means it would be generally suitable for the proposed study.

Purpose: Through a study of the literature this paper aims to investigate the imaging pathway which should be undertaken by patients presenting to the emergency department with renal colic and flank pain. Method: The British Journal of Radiology, Journal of Endourology, Radiology, RadioGraphics, American Journal of Radiology and Adult Urology were searched to find any previous studies into this area through the use of keywords: calculi, renal, computed tomography (CT), plain imaging, abdominal, ultrasound, intravenous urogram (IVU) and x-ray. Conclusion: This literature review determined that the use of non-enhanced helical CT scanning of the abdomen and pelvis should be utilised as the initial imaging technique. CT is able to demonstrate all stones, can be performed rapidly and can diagnose other pathologies which may be mimicking renal colic. Plain film and contrast imaging studies including intravenous urography (IVU) are seen as being of little diagnostic value for frontline identification due to their inability to demonstrate a large number of stones due to size, location and composition. Ultrasound has been shown to be of use as a tool for pregnant or paediatric patients, however its inability to accurately demonstrate the ureters and diagnose extra-urinary pathology limits its use for the general population. The use of low-dose CT is also discussed, and its use advocated for patients with repeat presentation of these symptoms. As more education is provided into this area, the authors believe this will become the modality and technique of choice. An imaging pathway flowchart devised by this review is provided.

Aim: To investigate the perceptions of radiographers in the Greater Sydney metropolitan area concerning the performance of intravenous contrast media injections by radiographers. Methods: 90 radiographers (corresponds to a 40.9% return) from five randomly selected private radiology practices and five randomly selected public hospitals within the Greater Sydney metropolitan area were surveyed. The survey was structured such that each section of the survey related to a specific objective of the study. This study focuses on training, departmental workflow and medicolegal issues. Results: Radiographers from private practices were more in favour of performing intravenous contrast media administration, although the majority of the radiographers surveyed felt that it should be performed as part of their normal duties. They felt that it would greatly aid department workflow and patient throughput. However, there were concerns about the medicolegal implications of this added responsibility. Conclusions: Most respondents were in favour of radiographers performing contrast media injections. Standardised and accredited training, including education on the medicolegal coverage available to them, may be needed to allay their concerns and adequately prepare them to take on this extended role. (author abstract)

Introduction: This article presents a review of a new clinical assessment technique designed to encourage student learning by utilising choice, negotiation and reflection as part of the assessment process. The students' perceptions of this assessment were requested as part of a quality review. Methods: A questionnaire was distributed to all first year students (101) and subsequently the same questionnaire was distributed to the same students in the third year (92) to gain a longitudinal perspective. The questionnaire included 10 closed item statements related to a five point Likert scale and one open ended question. Descriptive analysis was carried out on the closed ended statements and thematic analysis on the open-ended statement. Result: The students surveyed agreed with the majority of statements. They agreed that the assessment had given them a deeper understanding of the activities they chose to perform. Conclusion: This review has provided important feedback to improve this new assessment technique in the future. (author abstract)

This article examines the issues concerning the assessment of observer performance and the process by which abnormalities are perceived and reported upon in screening mammography. The assessment of observer accuracy and the perception of abnormality are discussed to gain some insight into the image interpretation process. It is surmised that, with further research into these areas, it may be possible to inform educators to adopt teaching strategies that can improve the detection of breast cancers in screening mammography. (author abstract)