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Background: Radiologic technologists (RTs) are at the forefront of radiology departments and require optimal skills to demonstrate professionalism and effective provider-patient communication. Hence, the objective of this study was to determine the reliability of 360-degree evaluation as a feedback tool to improve competencies in this crucial workforce., Methods: A planned 360-degree evaluation was conducted using a 10-item tool to evaluate communication skills and professionalism among radiological technologists working at Dow University Hospital, Karachi. In total, 311 evaluations of fifteen radiological technologists were conducted while performing various diagnostic radiology procedures at the radiology department of Dow University Hospital. The data were analysed using SPSS version 26 to compute the evaluation scores and the reliability of 360-degree evaluation., Results: A total of 311 RT-patient interactions were recorded over 48 days, with scores from all three raters. The evaluation tool was found to have good internal consistency for patients, faculty, and RT, with Cronbach's alpha values of 0.89, 087, and 0.74, respectively. The study found an intraclass correlation of 0.66 (95% CI; 0.58-0.72), showing moderate reliability of the 360-degree evaluation across different raters., Conclusion: We conclude that 360-degree evaluation is a valid and reliable tool for determining the professionalism and communication skills of radiologic technologists and should be incorporated into training programs for formative and summative assessments. However, large-scale multicenter studies are crucial for generalizing these findings and incorporating 360 evaluations in radiological technologist training programs for formative and summative assessments., (© 2024. The Author(s).)

Purpose: To examine whether radiologic technologists' perceptions of imaging appropriateness differed based on their primary imaging modality, work shift, shift length, and primary practice type., Methods: A national, cross-sectional study was conducted in the fourth quarter of 2019 using a simple, randomized sample of American Society of Radiologic Technologists (ASRT) members. Study participants were employed in health care settings in radiography, computed tomography (CT), mammography, or radiology leadership. Seven potential reasons for inappropriate imaging procedures (ie, patient expectations, provide patient with a feeling of being taken seriously, lack of time, expectations from relatives, compensation for insufficient clinical examination, normal findings would reassure the patient, and fear of lawsuits) were evaluated for relationships with their primary imaging modality, work shift, shift length, and primary practice type., Results: Disparities in perceived reasons affecting imaging appropriateness were found. Providing the patient with a feeling of being taken seriously was related to primary practice type ( P = .022). Lack of time was related to primary imaging modality ( P = .005) and primary practice type ( P = .006). Expectations from relatives was related to primary imaging modality ( P = .016) and primary practice type ( P = .027). Compensation for insufficient clinical examination was related to primary imaging modality ( P < .001), shift length ( P = .011), work shift ( P = .002), and primary practice type ( P < .001). Fear of lawsuits was related to primary imaging modality ( P = .001)) and work shift ( P = .002)., Discussion: The study reveals that radiologic technologists' perceptions of patient-centered factors and defensive medicine-related factors differ among imaging modalities, shift types, and practice settings. However, more research is required to determine why radiologic technologists perceive these reasons to be present, investigate whether providers feel similarly, and determine perceptual alignment with evidence-based guidelines., Conclusion: The findings suggest that attention should focus on the appropriateness of CT imaging procedures performed in hospitals during night shifts., (© 2022 American Society of Radiologic Technologists.)

For several years, the profession of radiographer has been unattractive and is in search of professional recognition. Increasingly complex therapeutic and diagnostic evolutions forces professionals to develop their skills to ensure quality and safe care for all patients. The primary role of the radiographer is to support patients and to accompany them during their examination or treatment, combining caregiver and technician's roles. Transversal missions and delegation of tasks are inherent to the profession but are not widely recognized. Cooperation between radiotherapy professionals is a response to offer the therapeutic radiographer/radiation therapist (RTT) opportunities in terms of attractiveness, career prospects, and increased skills. In radiotherapy, advanced practice activities already exist in some departments but require regulatory adjustments, in particular regarding the redistribution of the roles of RTT but also the status of these professionals. The formalization of these practices can be largely inspired by the many feedbacks around the world. This article aims to reflect the evolution's perspectives in the career of an RTT and on the valorisation of this profession in the current context., (Copyright © 2021 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Background: Although there are concerns that inadequate breast positioning in mammographic examinations may lead to cancers being missed, few studies have examined the quality of breast positioning, especially in the Canadian context. Our objective was to assess the quality of breast positioning in mammographic examinations in a Quebec-wide representative sample of technologists., Methods: This quality improvement study was part of a professional inspection launched by the Ordre des technologues en imagerie médicale, en radio-oncologie et en électrophysiologie médicale du Québec among its members. The inspection was conducted between May and July 2017 on a proportionate stratified random sample of all active technologists certified in mammography in Quebec. Each technologist provided images from 15 consecutive mammographic examinations they performed in the previous 6 months. The quality of positioning was then evaluated by senior technologists using a quality assessment tool specifically developed for this inspection. A technologist was deemed to have failed the professional inspection when at least 7 of the 15 mammographic examinations were scored as critical failures. Proportions were calculated accounting for sampling weights and correction for finite population., Results: Among the 520 technologists certified in mammography in Quebec, 76 technologists (14.6%) were randomly selected for the professional inspection and contributed images from 1127 mammographic examinations. Thirty-eight technologists (weighted percentage 50.3%, 95% confidence interval [CI] 37.6% to 63.0%) failed the professional inspection. Overall, 492 mammographic examinations (43.7%, 95% CI 38.6% to 48.8%) had at least 1 image scored as a critical failure., Interpretation: Half of the technologists performing mammographic examinations in Quebec who participated in this study failed the inspection, and a substantial proportion of their mammographic examinations demonstrated critical failures in breast positioning. Overall, our findings are concordant with those of previous studies and highlight the need for additional investigations assessing the quality of breast positioning in mammographic examinations in other jurisdictions., Competing Interests: Competing interests: Julie Rouette has received consulting fees from Biogen for work unrelated to this study. Nathaniel Bouganim has received consulting fees from Amgen, Novartis and Roche for work unrelated to this study. Nathaniel Lasry is a shareholder of iMD Research, which received a contract to assist with the design of the professional inspection of technologists from the Ordre des technologues en imagerie médicale, en radio-oncologie et en électrophysiologie médicale du Québec. Laurent Azoulay has received consulting fees from Janssen and Pfizer for work unrelated to this study. No other competing interests were declared., (© 2021 CMA Joule Inc. or its licensors.)

Introduction/background: A peer learning program includes the process of peer review, which is the act of performing a secondary review of a peer's work using pre-defined criteria. The Technologist Image Quality Assessment Criteria Project (TIQACP) was initiated to develop and evaluate such criteria for use by technologists for assessment of image quality in Nuclear Medicine (NM)., Methods: A NM clinical expert panel was assembled, comprising 14 technologists, radiologists, and educators from five imaging centres and an academic institution with associated medical imaging training programs. Project design was guided by consensus-based methodology that included three phases: (1) image quality assessment criteria development, based on literature search and expert review (2) image quality assessment criteria refinement, based on consensus-building exercises (panel surveys, discussions, ranking exercise, and time trial) (3) external validation performed via a national survey of NM technologists, facilitated by the Canadian Association of Medical Radiation Technologists., Results: The first phase generated 8 key evidence sources, including textbooks, NM journals and guidelines from professional associations that were reviewed by the expert panel leads and led to a preliminary list of 11 criteria. As part of the second phase, the preliminary list was reviewed via online surveys and panel discussions. Preliminary discussions led to an initial expansion of the list to include 18 criteria. This list required an average of 9 min (range: 7-11 min) for review, which was deemed prohibitive by the panel. A ranking exercise identified 'all required anatomy is clearly identified' as the most relevant criteria and 'Image quality demonstrates no breakdown of the radiopharmaceutical' as the least relevant criteria. Panel discussion also highlighted need to eliminate criteria that were not applicable to all settings. These insights led to an updated list of nine criteria organized into four categories. National validation was supported by 47 NM technologists from across Canada. Respondents were in agreement that the criteria reflected the core elements of image quality in NM (94% agree to strongly agree), were familiar (97%) and were relevant to their current practice setting (88%). The final list was thus not changed based on the survey., Discussion/conclusion: The TIQACP utilized an inclusive process that engaged a range of subject matter experts and the broader NM community to ensure buy-in of the final criteria. These criteria have subsequently been embedded in peer review software that has been implemented into a robust peer learning program for technologists designed to promote a culture of continuous improvement and knowledge sharing amongst front-line staff., (Copyright © 2020. Published by Elsevier Inc.)

Introduction: Radiation protection knowledge is essential for medical personnel in ensuring that the possible risks do not outweigh the benefits of diagnostic imaging. This study aimed to assess the radiation protection knowledge of radiographers in Cyprus., Methods: A cross-sectional study was carried out among radiographers in Cyprus through the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. The study was a quantitative descriptive analysis, using a questionnaire with 22 multiple-choice questions. Analysis of the data was done using the statistical software Stata, by performing mean knowledge score comparisons by different participants' characteristics, using t-test and analysis of variance test. Statistical significance was assumed as a p-value < 0.05., Results: The answers provided for each question indicate that some areas of radiation protection are less known compared to others, as there is quite a wide range of correct-to-incorrect ratios. The analysis based on participant characteristics in relation to overall radiation effects knowledge, identified important determinants, namely the workplace of the participant (p = 0.006), the type of work licence the participant held at the time of the questionnaire (p = 0.024), and the years of clinical experience of the participant (p = 0.021)., Conclusion: The study showed that the levels of knowledge in radiation protection are of a very good standard. However, work is needed to clarify the specifics of dose limits and the national radiation protection legislation with regards to informing patients about the possible effects of ionising radiation., Implications for Practice: The study results indicate the importance of educating radiographers about the requirements of national radiation protection legislation and how this new knowledge can be linked with practise., Competing Interests: Conflict of interest statement None., (Copyright © 2019 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.)

Aims: To assess the clinical effectiveness of a sonographer-led, cardiologist-interpreted stress echocardiography (SE) service in a rapid access stable chest pain clinic (RACPC) setting., Methods and Results: Baseline data was collected prospectively on 768 consecutive patients, referred from the RACPC, who underwent SE between May 2014 and May 2015. Retrospective analysis was performed on follow-up data for outcomes. Among 768 patients (mean age 58 years, 57.8% males) with a mean pre-test probability of coronary artery disease (CAD) of 31%, 675 (88%) underwent SE on the same day as the RACPC consultation. Diagnostic tests were obtained in 749 (97.5%) cases with 62 (8.1%) demonstrating inducible ischemia. Coronary angiography was performed in 61 patients of whom 54 demonstrated flow-limiting CAD (positive predictive value: 88.5%). There was no occurrence of serious adverse events. During a mean follow-up period of 2.5 years, 20 first cardiac events were recorded, of which annualised events in the normal SE group were 0.64% versus 5.8% in patients with an abnormal SE (log rank p < 0.001)., Conclusion: Sonographer-led SE interpreted by a cardiologist is feasible, safe and efficacious. It impacted on the management of patients with appropriate outcomes and may be a cost-efficient and safer alternative to other non-invasive imaging modalities in the RACPC setting., (Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.)

On January 1, 2017, the U.S. Food and Drug Administration launched an initiative to improve mammography image quality. This initiative, called the Enhancing Quality Using the Inspection Program, or EQUIP, entails a series of questions that have become part of annual mammography facility inspections required under the Mammography Quality Standards Act. This article examines the EQUIP initiative, discusses the initiative's early results, and explores the criteria for quality mammography images, with a focus on optimal positioning and compression.

Objective: The aim of this study was to determine the cumulative effective doses (CED) from digital radiographic imaging in very low birth weight infants treated in a tertiary care neonatal intensive care unit (NICU)., Study Design: The CED for each infant was retrospectively calculated using a voxel-based model. The results were compared with previous studies applying conventional radiography., Results: Two hundred and six preterm infants were included into this study. Neonates received a median of four radiographs (range: 1-68) and a CED of 50 µSv (4-883 µSv). Overall mean CED was lower than in previously published data applying conventional radiography. Factors contributing to a lower radiation dose per infant in our study were a lower number of radiographs and smaller field sizes per radiographic image., Conclusions: The number of conducted radiographs per patient and the employed field size had a higher impact on the CED than the applied radiographic technology.

Objective: Consistent excellence in radiologic technologist performance, including ensuring high technical image quality, patient safety and comfort, and efficient workflow, largely depends on individual technologist skill. However, sustained growth in the size and complexity of health care organizations has increased the difficulty in developing and maintaining technologist expertise. In this article, we explore underlying organizational structures that contribute to this problem and propose organizational models to promote continued excellence in technologist skill., Conclusion: We have found that a relatively modest investment in medical directorship combined with a coaching model can bring about a significant level of improvement in skilled clinical performance. We believe that widespread implementation of similar programs could contribute to substantial improvements in quality in radiology and other health care settings.

Introduction: Recent research has identified the issue of 'dose creep' in diagnostic radiography and claims it is due to the introduction of CR and DR technology. More recently radiographers have reported that they do not regularly manipulate exposure factors for different sized patients and rely on pre-set exposures. The aim of the study was to identify any variation in knowledge and radiographic practice across Europe when imaging the chest, abdomen and pelvis using digital imaging., Methods: A random selection of 50% of educational institutes (n = 17) which were affiliated members of the European Federation of Radiographer Societies (EFRS) were contacted via their contact details supplied on the EFRS website. Each of these institutes identified appropriate radiographic staff in their clinical network to complete an online survey via SurveyMonkey. Data was collected on exposures used for 3 common x-ray examinations using CR/DR, range of equipment in use, staff educational training and awareness of DRL. Descriptive statistics were performed with the aid of Excel and SPSS version 21., Results: A response rate of 70% was achieved from the affiliated educational members of EFRS and a rate of 55% from the individual hospitals in 12 countries across Europe. Variation was identified in practice when imaging the chest, abdomen and pelvis using both CR and DR digital systems. There is wide variation in radiographer training/education across countries., Conclusion: There is a need for standardisation of education and training including protocols and exposure parameters to ensure that there is continued adherence to the ALARA principle., (Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.)

A study was conducted to determine the current employment practices and future preferences of Nebraska hospitals regarding multicredentialed technologists. A survey was mailed to 104 hospital radi- ology departments in the state of Nebraska, asking for voluntary and confidential responses by radiology managers charged with hiring of radiologic technologists with a response rate of 51%. Nearly all respondents (93%) said it was very likely or fairly likely that they would hire a multicredentialed technologist in the future. Results suggest that there is a trend among Nebraska hospital radiology managers toward needing or hiring multicredentialed radiologic technologists in the future. There appears to be a greater emphasis in the pairing of credentialing in diagnostic radiography with computed tomography, ultra- sound, and mammography in current and future needs.

Accurate detection of lesions throughout the body is of paramount importance in contrast-enhanced magnetic resonance imaging (MRI). Optimal contrast agent performance is therefore of great importance and given the number of MRI contrast agent options today, this topic is of much ongoing study. The goal of this review article is to bring the read up to date on pertinent articles that relate to the evolution of radiological clinical practice and dose optimization pertaining to gadolinium contrast agents.

The purpose of this study was to survey health service workers regarding their radiation safety knowledge and practice. Participants were health service workers (n = 721) who received an anonymous online survey by email to test their radiation safety knowledge. A knowledge test of 15 questions was completed by 412 respondents. The overall average percent correct was 77.9%. Health physicists/medical physicists had the highest average percent score (93.5%), while physician assistants scored the lowest (60.0%). Of all the respondents, only 64.0% reported they participated in periodic radiation safety training at their place of employment. The most common topic selected where participants wanted additional training was in biological effects of radiation (41.0%). In conclusion, radiation safety training and education needs to be developed and planned effectively. Areas or specialties with poor radiation safety knowledge need to be addressed with corresponding safety measures.

The purpose of this study was to develop the JJ1017 Knowledge-based Application (JKA) to support the continuing maintenance of a site-specific JJ1017 master defined by the JJ1017 guideline as a standard radiologic procedure master for medical information systems that are being adopted by some medical facilities in Japan. The method consisted of the following three steps: (1) construction of the JJ1017 Ontology (JJOnt) as a knowledge base using the Hozo (an environment for building/using ontologies); (2) development of modules (operation, I/O, graph modules) that are required to continue the maintenance of a site-specific JJ1017 master; and (3) unit testing of the JKA that consists of the JJOnt and the modules. As a result, the number of classes included in the JJOnt was 21,697. Within the radiologic procedure classes included in the above, the ratio of a JJ1017 master code for an external beam radiotherapy was the highest (51%). In unit testing of the JKA, we checked the main operations (e.g., keyword search of a JJ1017 master code/code meaning, editing the description of classes, etc.). The JJOnt is a knowledge base for implementing features that medical technologists find necessary in medical information systems. To enable medical technologists to exchange/retrieve semantically accurate information while using medical information systems in the future, we expect the JKA to support the maintenance and improvement of the site-specific JJ1017 master.

Although the implementation of picture archiving and communication system (PACS) could increase productivity of radiology departments, this depends on factors such as the PACS competence of radiologic technologists (RTs). The purpose of this study was to investigate the RTs' perceptions of PACS competence and educational issues in Western Australia (WA). A hardcopy questionnaire was distributed to WA RTs for obtaining their perceptions of PACS competence and educational issues. Descriptive (percentage of frequency, mean and standard deviation) and inferential statistics (t test and analysis of variance) were used to analyze the responses of the multiple choice and five-point scale questions from the returned questionnaires. The questionnaire response rate was 57.7% (173 out of 300). The mean values of all PACS competence questions except questions 2e-g are in the range of 3.9-4.9, i.e., around competent to very competent. Participants indicated they received adequate PACS training (mean 3.8). Statistically significant variables influencing RTs' perceptions of their PACS competence and educational issues including the age (p < 0.01), gender (p < 0.05), years of practice (p < 0.005-0.05), primary duty (p < 0.05), medical imaging qualification (p < 0.001), general computer skills (p < 0.001), and type of PACS education received (p < 0.001-0.05). The WA RTs indicated that they were competent in using the modality workstation, PACS and radiology information system, and received adequate training. However, future PACS education programs should be tailored to different RTs' groups. For example, multiple training modules might be necessary to support the PACS competence development of older RTs and those with lower general computer literacy.

Interventional cardiology (IC) procedures can be responsible for relatively high radiation doses compared to conventional radiology especially for young patients. The aim of this study was to assess current exposure levels in a French reference centre of pediatric IC. Dosimetric data including dose area product (DAP), fluoroscopy time (FT) and number of cine frame (NF) were analysed taking into account patient weight. Doses to the lungs, esophagus, breast and thyroid were evaluated using anthropomorphic phantoms and thermoluminescent dosimeters. Finally, effective doses (E) were calculated using DAP and conversion factors calculated with PCXMC 2.0 software. 801 IC procedures performed between 2010 and 2011 were analysed. Large variations were observed for DAP, FT and NF values for a given procedure and a given weight group. The assessment of organ doses showed high levels of dose to the lungs and esophagus especially in new-born babies. For diagnostic procedures, E varied from 0.3 to 23 mSv with a mean value of 4.8 mSv and for therapeutic procedures, values ranged from 0.1 to 48.4 mSv with a mean value of 7.3 mSv. The highest values were recorded for angioplasty procedures (mean 13 mSv, range 0.6-48.4 mSv). The increasing use of IC in pediatric population stresses the need of setting up reference levels and keeping doses to children as low as possible.

Introduction: Extravasation is a well-recognized complication estimated to be between 0.1% and 0.9% of contrast medium administrations. According to the UC San Diego (UCSD) health system policy, all contrast medium extravasation (CME) reports are reviewed by the department of Risk Management, and the appropriate action is taken. Despite this strategy, a decrease in the incidence of CME could not be demonstrated., Aim: The aims of this study were to determine the frequency, management, and outcome of CME in UC San Diego patients and to assess the knowledge regarding CME among radiology technologists based on policy and guidelines. The secondary aim was to assess the manual ability of the radiology technologists in the performance of the procedure., Methods: The study has 2 parts; the first was retrospective, including data collection and interpretation of all radiology procedures using intravenous contrast medium injection between January 1, 2010, and September 30, 2011, and the second was prospective, including proactive observations and knowledge questionnaire., Results: There were 83 (0.48%) cases of CME of 17,200 patients, 54 women (0.64%) and 29 men (0.33%), P = 0.005. The patients with CME were older, and their cannula was inserted in other departments than Radiology Department, P < 0.000. There was a gap between the high theoretical knowledge that was found in the knowledge questionnaire and its implementation that was demonstrated in the proactive observation., Conclusions: Our data demonstrate that sex, age, and where the cannula was inserted are predictive factors for CME. We believe that CME could be prevented by proper educational program and establishment of efficient strategy.

Purpose: To assess radiation safety knowledge of radiologic technologists in India, assess the effect of current technologist training programs on radiation safety knowledge, and identify knowledge gaps., Method: A total of 174 radiologic technologists from 31 centers completed a survey containing theoretical and practical questions assessing radiation knowledge. Scores were analyzed based on years of experience and prior radiation training. Group mean scores were analyzed with students' t test and one-way analysis of variance. The Fisher exact test was used to analyze the difference in performance between the trained and untrained groups., Results: Thirty-two percent of the 174 respondents had received formal radiation safety training. The mean score on the questionnaire was 6.98 out of 14 total points; 66.67% of respondents scored 7 (50%) or above. The mean theoretical and practical scores (out of 7 total points each) were 4.48 and 2.49, respectively. There was no statistically significant difference between theoretical and practical scores based on years of experience. The untrained group had higher mean total and practical scores but lower mean theory scores, with a statistically significant difference for total and practical scores between the trained and untrained groups., Discussion: Although many radiologic procedures are performed in India, most technologists reported not being trained in radiation safety, even though most realized that training is necessary. The lack of improvement in scores with years of experience indicates the need for continuing professional education focusing on the practical aspects of safety., Conclusion: Professional continuing education programs for radiologic technologists should be integrated into every radiology department and monitored with quality and performance audits.

Background: With the increasing prevalence of Picture Archiving and Communication Systems (PACS) in healthcare institutions, there is a growing need to measure their success. However, there is a lack of published literature emphasizing the technical and social factors underlying a successful PACS., Methods: An updated Information Systems Success Model was utilized by radiology technologists (RTs) to evaluate the success of PACS at a large medical center in Taiwan. A survey, consisting of 109 questionnaires, was analyzed by Structural Equation Modeling., Results: Socio-technical factors (including system quality, information quality, service quality, perceived usefulness, user satisfaction, and PACS dependence) were proven to be effective measures of PACS success. Although the relationship between service quality and perceived usefulness was not significant, other proposed relationships amongst the six measurement parameters of success were all confirmed., Conclusions: Managers have an obligation to improve the attributes of PACS. At the onset of its deployment, RTs will have formed their own subjective opinions with regards to its quality (system quality, information quality, and service quality). As these personal concepts are either refuted or reinforced based on personal experiences, RTs will become either satisfied or dissatisfied with PACS, based on their perception of its usefulness or lack of usefulness. A satisfied RT may play a pivotal role in the implementation of PACS in the future.