Radiology Technology: An Examination of the Transfer of Training through Continuing Education

This paper discusses the transfer of training as it relates to mandatory continuing education for the radiologic technologist. Through continuing education the technologists' satisfy their requirements for recertification and/or licensure. Continuing education should provide a method to maintain competency, however, attitudes determine the success of learning outcomes.

Interventional radiology and the care of the oncology patient.

Interventional Radiology (IR) is occupying an increasingly prominent role in the care of patients with cancer, with involvement from initial diagnosis, right through to minimally invasive treatment of the malignancy and its complications. Adequate diagnostic samples can be obtained under image guidance by percutaneous biopsy and needle aspiration in an accurate and minimally invasive manner. IR techniques may be used to place central venous access devices with well-established safety and efficacy. Therapeutic applications of IR in the oncology patient include local tumour treatments such as transarterial chemo-embolisation and radiofrequency ablation, as well as management of complications of malignancy such as pain, organ obstruction, and venous thrombosis.

Bespoke Radiology e-Learning

Introduction: Foundation doctors are expected to assess and interpret plain x-ray studies of the chest/abdomen before a definitive report is issued by senior staff. The Royal College of Radiologists have published guidelines (RCR curriculum) on the scope of plain film findings medical students should be familiar with.1 Studies have shown that the x-ray interpretation without feedback does not significantly improve diagnostic ability. 2 Queen’s University, Belfast Trust Radiology and Experior Medical developed an online system to assess individual student ability to interpret X-ray findings. Over a series of assessments each student’s profile is built up, identifying strengths and weakness. The system can then create bespoke individual assessments re-evaluating previously identified weak areas and quantifying interpretative skill improvement. Aim: To determine how readily an online system is adopted by senior medical students, investigating if increasing exposure to x-ray interpretation combined with cyclical formative feedback enhances performance. Methods: The system was offered to all 270 final year medical students as an online resource. The system comprised a series of 20 weekly 30 minute assessments, containing normal and abnormal x-rays within the RCR curriculum. After each assessment students were given formative feedback, including their own result, annotated answers, peer group comparison and a breakdown of areas of strength and weakness. Focus groups of 4-5 students addressed student perspectives of the system, including ease of use, image resolution, system performance across different operating platforms, perceived value of formative feedback loops, breakdown of performance and the value of bespoke personalised assessments. Research Ethics Approval was granted for the study. Data analysis was via two-sided one-sample t-test; initial minimal recruitment was estimated as 60 students, to detect a mean 10% change in performance, with a standard deviation of 20%. Results and Discussion: Over 80% (n = XXX/270) of the student cohort engaged with the study. Student baseline average was 39%, increasing to 62% by the exit test. The steadily sustained improvement (57% relative performance in interpretative diagnostic accuracy) was despite increasing test difficulty. Student feedback via focus groups was universally positive throughout the examined domains. Conclusion: The online resource proved to be valuable, with high levels of student engagement, improving performance despite increasingly difficulty testing and positive learner experience with the system. References: 1. Undergraduate Radiology Curriculum, The Royal College of Ra, April 2012. Ref No. BFCR(12)4 The Royal College of Radiologists, April 2012 2. I Satia, S Bashagha, A Bibi, R Ahmed, S Mellor, F Zaman. Assessing the accuracy and certainty in interpretating chest x-rays in the medical division. Clin Med August 2013 Vol.13 no. 4 349-352

Organizational responses to technological discontinuities: the case of the American College of Radiology (ACR)

A long history of organizational research has shown that organizations are affected significantly by changes in technology. Scholars have given particular attention to the effects of so-called disruptive or discontinuous technological changes. Studies have repeatedly shown that established, incumbent organizations tend to suffer deep performance declines (and even complete demise) in the face of such changes, and researchers have devoted much attention to identifying the organizational conditions and processes that are responsible for this persistent and widespread pattern of adaptation failure. This dissertation, which examines the response of the American College of Radiology (ACR) to the emergence of nuclear magnetic resonance imaging technology (NMR), aims to contribute to this well-established research tradition in three distinct and important ways. First, it focuses on a fundamentally different type of organization, a professional association, rather than the technology producers examined in most prior research. Although technologies are well known to be embedded in “communities” that include technology producers, suppliers, customers, governmental entities, professional societies, and other entities, most prior research has focused on the responses and ultimate fate of producers alone. Little if any research has explored the responses of professional organizations in particular. Second, the study employs a sophisticated process methodology that identifies the individual events that make up the organization’s response to technological change, as well as the overall sequence through which these events unfold. This process approach contrasts sharply with the variance models used in most previous studies and offers the promise of developing knowledge about how adaptation ultimately unfolds (or fails to). Finally, the project also contributes significantly through its exploration of an apparently successful case of adaptation to technological change. Though nuclear magnetic resonance imaging posed a serious threat to the ACR and its members, this threat appears to have been successfully managed and overcome. Although the unique nature of the organization and the technology under study place some important limits on the generalizablity of this research, its findings nonetheless provide some important basic insights about the process through which social organizations can successfully adapt to discontinuous technological changes. These insights, which may also be of substantial relevance to technology producer organizations, will also be elaborated.

Radiological treatment of HCC: Interventional radiology at the heart of management

International audience

Generation of a 3D proximal femur shape from a single projection 2D radiographic image.

Summary Generalized Procrustes analysis and thin plate splines were employed to create an average 3D shape template of the proximal femur that was warped to the size and shape of a single 2D radiographic image of a subject. Mean absolute depth errors are comparable with previous approaches utilising multiple 2D input projections. Introduction Several approaches have been adopted to derive volumetric density (g cm-3) from a conventional 2D representation of areal bone mineral density (BMD, g cm-2). Such approaches have generally aimed at deriving an average depth across the areal projection rather than creating a formal 3D shape of the bone. Methods Generalized Procrustes analysis and thin plate splines were employed to create an average 3D shape template of the proximal femur that was subsequently warped to suit the size and shape of a single 2D radiographic image of a subject. CT scans of excised human femora, 18 and 24 scanned at pixel resolutions of 1.08 mm and 0.674 mm, respectively, were equally split into training (created 3D shape template) and test cohorts. Results The mean absolute depth errors of 3.4 mm and 1.73 mm, respectively, for the two CT pixel sizes are comparable with previous approaches based upon multiple 2D input projections. Conclusions This technique has the potential to derive volumetric density from BMD and to facilitate 3D finite element analysis for prediction of the mechanical integrity of the proximal femur. It may further be applied to other anatomical bone sites such as the distal radius and lumbar spine.

X-ray computed tomography

X-ray computed tomography (CT) is a medical imaging technique that produces images of trans-axial planes through the human body. When compared with a conventional radiograph, which is an image of many planes superimposed on each other, a CT image exhibits significantly improved contrast although this is at the expense of reduced spatial resolution.----- A CT image is reconstructed mathematically from a large number of one dimensional projections of the chosen plane. These projections are acquired electronically using a linear array of solid-state detectors and an x ray source that rotates around the patient.----- X-ray computed tomography is used routinely in radiological examinations. It has also be found to be useful in special applications such as radiotherapy treatment planning and three-dimensional imaging for surgical planning.