OAR@UM Collection:

Investigating radiographers’ socio-demographics in relation to the detection rate of incidental adrenal nodules seen on Computed Tomography (CT) scans

2022-02-01T16:01:23Z

Title: Investigating radiographers’ socio-demographics in relation to the detection rate of incidental adrenal nodules seen on Computed Tomography (CT) scans Abstract: Purpose: The aim of this research was to locally investigate whether radiographers’ sociodemographic characteristics affect the detection rate of incidental adrenal nodules, also known as adrenal incidentalomas (AIs). Objectives: To retrospectively determine the monthly rate of recalled CT scans due to an AI finding (Phase 1). To prospectively correlate the radiographers’ socio-demographics to the detection rate of AIs, and to assess their self-rated confidence and opinions for further training in this area (Phase 2). Methodology: The research consisted of 2 phases. In both phases, a non-experimental, crosssectional approach was employed. Phase 1 (Quantitative) comprised a data collection sheet used to retrospectively determine the occurrence of recalled CT scans as a result of an AI finding. In phase 2, (Quantitative with an element of qualitative) a structured questionnaire including anonymised CT scans (n=30) presented on Viewdex, was completed by the radiographers working in CT and PET/CT (n=23). Both research tools were self-designed by the researcher, to suit the aim and objectives of the study. Results: Phase 1 of the study determined that AIs were present in 1.4% of contrast-enhanced CT (CECT) scans (n=12,139), out of which, 79.82% were not acknowledged by the radiographers and had to be recalled for a dedicated adrenal CT scan. In phase 2, a statistical significant correlation (p<0.05) between the radiographers’ educational level, roster status, workplace and years of experience, to the detection rate of AIs was found. When asked to self-rate their confidence, the majority of participants (52.2%) were fairly confident. In addition, most (73.9%) favoured the need for more training, with continuous professional development (CPD) being the preferred approach. Conclusions: Findings suggest that certain socio-demographics of radiographers may affect their ability to recognise AIs. Therefore, this can potentially contribute to one of the reasons for recalling patients, in turn causing an added burden to both the patient and the Medical Imaging Department (MID). Description: B.Sc. (Hons)(Melit.)

Evaluating clinical criteria in patients being referred for a pre-operative chest X-ray in a state general hospital in Malta

2022-02-01T15:59:53Z

Title: Evaluating clinical criteria in patients being referred for a pre-operative chest X-ray in a state general hospital in Malta Abstract: Objectives: A pre-operative chest x-ray (CXR) is a radiological investigation widely used before surgeries. The objective of this study was to determine patient clinical referral criteria for pre-operative CXRs and to investigate if referrals adhered to the local, European and/or international guidelines for requesting such X-rays. The reports of the CXRs were also compared to the referral criteria used. Methods: In this prospective cross-sectional study, 271 participants were recruited using convenience sampling. Adult patients performing a pre-op CXR prior to an elective surgery were recruited by intermediaries. Medical and clinical information of patients was obtained through a self-designed close-ended questionnaire and complimented by a data sheet. Results: 41 (15%) participants had an abnormality on the pre-operative CXR, and the prevalence of abnormalities increased with an increasing American Society of Anaesthesiology (ASA) score. However, within all ASA populations the absence of abnormalities on the pre-operative CXR was significantly high. Cardiomegaly was the most common abnormality accounting for 24.3% (n=10) of findings. Moreover, a significant association was found (p=0.007) between increasing age and CXR abnormalities whilst no significant association was registered between the presence of cardiopulmonary diseases or risk factors and abnormalities detected on a CXR. Conclusions: In 36 patients the abnormalities detected on the pre-op CXR were coexistent with co-morbidities or risk factors and could have been diagnosed on a physical exam and through a clinical history. Consequently, 64.2% of CXRs were not requested in accordance with the local guidelines whilst 70.1% of CXRs were not requested according to the European and international guidelines. Description: B.Sc. (Hons)(Melit.)

Perception of radiographers’ awareness and management of occupational biological hazards

2022-02-01T15:58:54Z

Title: Perception of radiographers’ awareness and management of occupational biological hazards Abstract: Purpose: The purpose of this study was to assess the perception of radiographers’ awareness and preparedness in managing occupational biological hazards. The study also includes the occupational biohazards which radiographers perceive as most commonly encountered during their daily practices and provides an outline of the protective measures used in the local hospital to protect from these hazards. Methodology: This research design of this study adopted a quantitative, non-experimental, cross-sectional approach. The data collection tool included a structured 10-minute online staff questionnaire and a total of 71 participants took part in this study. All radiographers in Malta were invited to participate in this study through the Radiotherapy and Medical Imaging departments of the main hospital in Malta together with the Society of Medical Radiographers Malta (SRM). Results: From a list of 16 infective agents, only 8 occupational biohazards were correctly identified by the majority of participants. However, in this study radiographers showed that they frequently use the appropriate protective measures to manage the different occupational biohazards. The majority of the participants agreed that there is the need for improvement with regards to the management of occupational biological hazards. Conclusions and Recommendations: The lack of awareness of the correct mode of transmission of the most common occupational biological hazards can have an impact on radiographers’ and patient’s safety. Nonetheless, participants agree that improvement in the management of occupational biological hazards is necessary, which can be led by radiographers or management. Description: B.Sc. (Hons)(Melit.)

Evaluating the use of higher kVp and copper filtration as a dose optimisation tool in digital planar radiography

2022-02-01T15:57:01Z

Title: Evaluating the use of higher kVp and copper filtration as a dose optimisation tool in digital planar radiography Abstract: Purpose: This phantom-simulated study aims to evaluate the use of higher kVp and additional copper filtration as a dose reducing strategy in optimising the AP abdomen, AP knee, AP lumbar spine, and lateral lumbar spine projections. Objectives: To establish the optimised combination of kVp and copper filtration thickness, for each of the projections, considering both radiation dose and image quality. Methodology: In phase 1, an anthropomorphic phantom was exposed at different kVp (-10kVp, standard kVp, +10kVp and +20kVp from standard kVp) and copper filtration thickness (at 0mm, 0.1mm, 0.2mm of copper). The DAP, mAs and exposure time were recorded for each projection. During phase 2, objective image quality was measured using Contrast-Noise Ratio (CNR) calculations, and subjective image quality was tested via a group of radiographers and radiologists who performed Visual Grading Analysis (VGA) by grading the image quality criteria of each projection. Results: The optimised protocol for the AP-abdomen, AP-knee, AP-lumbar spine and lateral lumbar spine was at 100kVp and 0.2mm of copper, 85kVp and 0.1mm of copper, 110kVp and 0.2mm of copper, 110kVp and 0.2mm of copper, respectively. The application of the selected protocols resulted in 71.98%, 62.50%, 64.51% and 71.85% reduction in DAP. Areas Under the Curve (AUC) of 0.883, 0.664, 0.708 and 0.516, respectively, of which the AP-abdomen showed that image quality is statistically improved compared with the standard (p<0.05). CNR values decreased linearly as both kVp and copper filtration thickness increases for all the projections. Conclusion: The results support using the higher kVp and additional copper filtration protocols mentioned above when imaging the AP abdomen, AP knee, AP lumbar spine, and lateral lumbar spine. A significant dose reduction was recorded whilst an acceptable level of image quality was maintained, which must be confirmed with clinical studies. Description: B.Sc. (Hons)(Melit.)