Search

Introduction To investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning. Methods Between mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases. Results 1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use. Conclusion Student radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience. Implications for practice As the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.

Background The dynamic range of modern detectors tolerates a higher detector dose or Detector Air Kerma (DAK) without negative effect on image quality. Necessary image quality is closely related to the clinical question: in order to keep the patient dose as low as possible, image quality criteria are needed for each type of radiography. The purpose of this study was to investigate the relation between image quality, described as an overall judgement versus the visibility of well-defined structures, and DAK in clinically accepted radiographs. Methods and materials 168 AP radiographs of the knee and 152 radiographs of the pelvis were collected randomly in 19 radiologic centres. Six radiologists with at least five-years experience scored the overall image quality and the visibility of seven different anatomic structures, in a controlled environment on a five-point scale, using a Visual Grading Analysis (VGA). The relation between the DAK and the VGA Score (VGAS) was evaluated. Results The VGAS was 3.92 for the knee and 3.71 for the pelvis. The VGAS for CR and DR were significantly different ( p Conclusion The VGA revealed an image quality higher than diagnostically necessary in both datasets, and high inter-observer correlation. Based on the DAK-range, it could be hypothesized that below a certain noise level no further visible improvement of the image quality was reached.

Background Higher Detector Air Kerma (DAK) lowers the noise level, delivering crisp and sharp radiographs, favoured by the radiologist. Expecting a linear relation between DAK and image quality, a higher DAK should deliver a higher image quality. Lowering the DAK and consequently also the signal, delivers more visible noise that can mask a detail. However, previous analyses of clinically approved radiographs demonstrated a lack of such a relation. The aim is to investigate the contribution of post-processing on the Contrast-Noise Ratio (CNR) as an attempt to clarify the absence of relationship between image quality and DAK in a set of clinical radiographs. Methods and Materials A TOR18FG phantom, enveloped with 5 cm of PMMA, is exposed to a large range of dose levels. To investigate the impact of post-processing on a low and high contrast element, the radiographs were analysed with and without post-processing. The effect of post-processing is evaluated by calculating the CNR for contrast both elements. Results The post-processing nullifies the relation between DAK and CNR for the low contrast element. It has a smaller influence on the high contrast element, weakening the DAK-CNR relationship above 4 μGy. Conclusion The hypothesis of CNR saturation, a stagnation of CNR in function of DAK, may explain the absence of a relation between DAK and image quality found in the previous study. These findings indicate that post-processing should be handled with care and raises the question how and if guidelines for the daily practice concerning DAK and image quality can be defined.

Introduction: Radiographers evaluate anatomical structures to judge clinical acceptability of a radiograph. Whether a radiograph is deemed acceptable for diagnosis or not depends on the individual decision of the radiographer. Individual decisions cause variation in the accepted image quality. To minimise these variations definitions of acceptability, such as in RadLex, were developed. On which criteria radiographers attribute a RadLex categories to radiographs is unknown. Insight into these criteria helps to further optimise definitions and reduce variability in acceptance between radiographers. Therefore, this work aims the evaluation of the correlation between the RadLex classification and the evaluation of anatomical structures, using a Visual Grading Analysis (VGA) Methods: Four radiographers evaluated the visibility of five anatomical structures of 25 lateral cervical spine radiographs on a secondary class display with a VGA. They judged clinical acceptability of each radiograph using RadLex. Relations between VGAS and RadLex category were analysed with Kendall’s Tau correlation and Nagelkerke pseudo-R². Results: The overall VGA score (VGAS) and the RadLex score correlate (rτ= 0.62, p Conclusion: RadLex scores and VGAS correlate positively, strongly and significantly. The predictive value of bony structures may support the use of these in the judgement of clinical acceptability. Considerable inter-observer variations in the VGAS within a certain RadLex category, suggest that observers use of observer specific cut-off values.