Conformity Assessment of Lead Aprons Used in Conventional Radiology: A Multi-Centre Survey in Togo

Aim: Lead aprons are used to protect against scattered radiation from the patient during interventional procedures and certain special conventional radiological examinations. Given the importance of the role lead aprons are supposed to play in radiation protection, we propose to assess their conformity in medical imaging departments in public and religious hospitals in Togo. Materials and method: A multi-centre survey conducted from 26 November to 06 December 2021 in the radiology departments of public and religious health facilities in Togo. All aprons in use were included. The evaluation criteria were physical (visual), quantitative (radiographic) and qualitative (dosimetric). Results: We had registred 43 aprons among wich 27 (62.79%) leaded aprons were labelled non-compliant and 16 (37.21%) were labelled compliant. Of the aprons judged to be non-compliant, 70.37% were more than 10 years old and 96.30% showed defects on the radiographic images. The most common defects were vampire marks (18.64%), multiple folds (16.96%), cracks (16.96%), multiple cracks (15.25%), tears (8.47%), absence of lead (5.08%), holes (3.39%) and lead corrosion (1.69%). Defective aprons (62.96%) had at least two defects. The defects were of thoraco-abdomino-pelvic (74.07%), thoracic (14.82%) and abdomino-pelvic (11.11%) topography. For indirect exposure at 50 and 70 kilovolts, all the aprons had an attenuation factor greater than 90%. After dosimetric measurement, 13.95% of aprons had attenuation factors below 90% for indirect exposure at 100 kilovolts. Conclusion: The compliance of the leaded decks is trifactorial (physical, radiographic and dosimetric). However, there is no significant difference in X-ray attenuation capacity between defective and normal decks.

Interdepartmental miscommunication regarding radiology:Addressing chronic challenges and exploring solutions

Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care.Interdepartmental miscommunication poses a significant challenge to healthcare systems,potentially undermining the quality of healthcare services provided.In the same manner,communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes.This article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical practice.Practical solutions are explored and proposed,which should be tailored to the specific needs and issues that each individual institution may face.

Profile of Radiological Examinations in the Radiology and Medical Imaging Department of the Medical Clinic “KALALE” in Mali

Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magnetic resonance, reflection of ultrasound waves or radioactivity, with which we sometimes associate optical imaging techniques such as endoscopy. The objective of our study was to study the profile of radiological examinations in the radiology and medical imaging department of the “KALALE” medical clinic. Methodology: This was a descriptive, prospective study that took place over a period of six (6) months in the radiology and medical imaging department of the “KALALE” medical clinic and the centers of health of communes III and IV of Bamako in Mali. Data collection was carried out on a survey form. The parameters studied were sociodemographic data, clinical data, radiological data. Results: We recorded 6030 radiology examinations of which 19% of the examination frequency cases came from the “KALALE” medical clinic and 81% of the cases were referrals from the reference health centers of communes III and IV. There were 1500 X-rays or 24.9% of cases including 54% cases of bone X-rays;5% of cases of skull and face X-rays;5% of cases of Intravenous Urography (IVU);4% of cases of Hysterosalpingography (HSG);3% of cases of Retrograde Ureterocystography (UCR) and 1% of cases of X-ray of the Abdomen without preparation (ASP). We found 4530 ultrasounds or 75.1% of cases. Conclusion: Medical imaging has become essential in the study of the human body and now constitutes an essential tool for the detection and treatment of most pathologies, from simple fractures to the most serious tumors.

Assessing the Impact of Regulations on Radiation Safety Culture and Practices in Radiology Departments

Background: The need to establish a strong culture around radiation safety is derived from the assertion that medical practitioners, patients, and third parties should not be exposed to unnecessary radiation. Authorities have endeavored to enact policies to protect all employers and patients in radiology departments. Objectives: To assess the impact of radiation safety practices and regulations on the ongoing improvements in radiation safety culture and practices in radiology departments. This will be achieved through a subjective assessment of national and international rules and regulations by healthcare professionals. Materials and Methods: We conducted a questionnaire survey in the radiology departments of three JCI-accredited hospitals in the Riyadh region to identify and assess the impact of national radiation regulations and the accompanying processes on the improvement of radiation safety culture and practices in radiology departments. Results: There were statistically significant differences in the grading system results among various groups of respondents, based on their educational level. Also, there are statistically significant differences between the assessments of safety level results in the answers provided by various groups of respondents according to education level in favor of the master’s degree. Conclusion: The study concludes that technicians with a diploma degree require stricter regulation. Furthermore, the results of this study suggest that an exposure tracking system and a regulatory action supporting it may be useful in the ongoing task of improving patients’ radiation safety.

Investigation of bubbles escape behavior from low basicity mold flux for high-Mn high-Al steels using 3D X-ray microscope

During the continuous casting process of high-Mn high-Al steels,various types of gases such as Ar need to escape through the top of the mold.In which,the behavior of bubbles traversing the liquid slag serves as a restrictive link,closely associated with viscosity and the thickness of liquid slag.In contrast to two-dimensional surface observation,three-dimensional(3D)analysis method can offer a more intuitive,accurate,and comprehensive information.Therefore,this study employs a 3D X-ray microscope(3D-XRM)to obtained spatial distribution and 3D morphological characteristics of residual bubbles in mold flux under different basicity of liquid slag,different temperatures,and different holding times.The results indicate that as basicity of slag increases from 0.52 to 1.03,temperature increases from 1423 to 1573 K,the viscosity of slag decreases,the floating rate of bubbles increases.In addition,when holding time increases from 10 to 30 s,the bubbles floating distance increases,and the volume fraction and average equivalent sphere diameter of the bubbles solidified in the mold flux gradually decreases.In one word,increasing the basicity,temperature,and holding time leading to an increase in the removal rate of bubbles especially for the large.These findings of bubbles escape behavior provide valuable insights into optimizing low basicity mold flux for high-Mn high-Al steels.

Importance of establishing radiation protection culture in Radiology Department

The increased use of ionization radiation for diagnostic and therapeutic purposes, the rapid advances in computed tomography as well as the high radiation doses delivered by interventional procedures have raised serious safety and health concerns for both patients and medical staff and have necessitated the establishment of a radiation protection culture(RPC) in every Radiology Department. RPC is a newly introduced concept. The term culture describes the combination of attitudes, beliefs, practices and rules among the professionals, staff and patients regarding to radiation protection. Most of the time, the challenge is to improve rather than to build a RPC. The establishment of a RPC requires continuing education of the staff and professional, effective communication among stakeholders of all levels and implementation of quality assurance programs. The RPC creation is being driven from the highest level. Leadership, professionals and associate societies are recognized to play a vital role in the embedding and promotion of RPC in a Medical Unit. The establishment of a RPC enables the reduction of the radiation dose, enhances radiation risk awareness, minimizes unsafe practices, and improves the quality of a radiation protection program. The purpose of this review paper is to describe the role and highlight the importance of establishing a strong RPC in Radiology Departments with an emphasis on promoting RPC in the Interventional Radiology environment.

Role of interventional radiology in the management of acute gastrointestinal bleeding

Acute gastrointestinal bleeding(GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB.

Spectrum of diagnostic errors in radiology

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. Since the early 1970s,physicians have been subjected to an increasing number of medical malpractice claims. Radiology is one of the specialties most liable to claims of medical negligence.Most often,a plaintiff's complaint against a radiologist will focus on a failure to diagnose. The etiology of radiological error is multi-factorial.Errors fall into recurrent patterns.Errors arise from poor technique,failures of perception,lack of knowledge and misjudgments.The work of diagnostic radiology consists of the complete detection of all abnormalities in an imaging examination and their accurate diagnosis. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation.Error traps need to be uncovered and highlighted,in order to prevent repetition of the same mistakes.This article focuses on the spectrum of diagnostic errors in radiology, including a classification of the errors,and stresses the malpractice issues in mammography,chest radiology and obstetric sonography.Missed fractures in emergency and communication issues between radiologists and physicians are also discussed.

Interventional radiology procedures in adult patients who underwent liver transplantation

Interventional radiology has acquired a key role in every liver transplantation(LT)program by treating the majority of vascular and non-vascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or re-transplantation.The aim of this paper is to review indications,technical consideration,results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

Evaluation of CdZnTe spectrometer performance in measuring energy spectra during interventional radiology procedure

Interventional radiology has been beneficial for patients for over 30 years of age with the combination of diagnostic and therapeutic methods. The radiation affecting occupationally exposed workers should be evaluated by means of the energy spectra and flux of X-rays in the treatment room. The present study aims to obtain the energy spectra of interventional procedures and study the capability of some detectors to evaluate the dose in interventional procedures. These measurements were taken by silicon-drift, CdTe, and CdZnTe detectors. The energy spectra were corrected by the energy-response curve of each detector. The energy-response curves of silicon-drift and CdTe detectors provided by the manufacturers specification were used. The energy response of the CdZnTe detector was measured by 133Ba and 152Eu γ sources. The experimental data were compared with the simulation results, and their perfect agreement provides a way to correct the energy or dose response, which can be used for the personal dosimeter developed by our group. Moreover, the measured energy spectra can be used in individual radiation protection. The present study shows that the CdZnTe detector is a good candidate detector in interventional procedures.

100 classic papers of interventional radiology: A citation analysis

AIM: To define the 100 citation classic papers of interventional radiology.METHODS: Using the database of Journal Citation Reports the 40 highest impact factor radiology journals were chosen. From these journals the 100 most cited interventional radiology papers were chosen and analysed.RESULTS: The top paper received 2497 citations and the 100 th paper 200 citations. The average number of citations was 320. Dates of publication ranged from 1953- 2005. Most papers originated in the United States(n = 67) followed by Italy(n = 20) and France(n = 10). Harvard University(n = 18) and Osped Civile(n = 11) were the most prolific institutions. Ten journals produced all of the top 100 papers with "Radiology" and "AJR" making up the majority. SN Goldberg and T Livraghi were the most prolific authors. Nearly two thirds of the papers(n = 61) were published after 1990.CONCLUSION: This analysis identifies many of the landmark interventional radiology papers and provides a fascinating insight into the changing discourse within the field. It also identifies topics, authors and institutions which have impacted greatly on the specialty.

Risk management in radiology departments

Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as aresult of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients.

The Journey of Interventional Radiology in China

The first balloon angioplasty performed by Dr.Charles T.Dotter in 1964 marked the birth of a new discipline in radiology(1),which was initially named'interventional diagnostic radiology'by Dr.Alexander R.Margulis in 1967(2),and later defined as'Interventional Radiology(IR)'by Dr.Sidney Wallace in 1976(3).Along with the wide adaptation of Seldinger’s technique for percutaneous vascular access(4),interventional radiology expanded the horizon of traditional radiology.

Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions.

Radiology education in Europe: Analysis of results from 22 European countries

AIMTo assess the state of radiology education across Europe by means of a survey study.METHODSA comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo (January-April 2016). Survey questions include length of medical school and residency training; availability of fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize data.RESULTSRadiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55% (12 out of 22) European countries. Subspecialty fellowship training is offered in 55% (12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22 (41%) European countries have research requirements during residency. The types of certifying exam show variation where 64% (14 out of 22) European countries require both written and oral boards, 23% (5 out of 22) require oral examinations only, and 5% (1 out of 22) require written examinations only. A degree in medical physics is offered in 59% (13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are required.CONCLUSIONComparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide.

Are Radiology Technologists Satisfied with Their Work? A Cross-Sectional Study from Taif Hospitals

Background: Job satisfaction can affect workers’ behaviour, thereby influencing organisational performance. Workers with low levels of job satisfaction have negative attitudes toward their jobs and may cause depression and anxiety. Purpose: The main aim of this study is to measure the overall job satisfaction among radiographers in Taif city. Methods: This study used the Minnesota Scoring Questionnaire to measure job satisfaction. The data collection was conducted between September 2018 and April 2019 in all major hospitals in Taif. Results: This study revealed that the overall job satisfaction of radiographers was moderate. It is, however, higher among radiographers in armed forces hospitals compared with their counterparts in the Ministry of Health hospitals. The job satisfaction of male radiographers was greater than their female peers. Finally, job satisfaction was high in those who work in advanced modality departments. Conclusion: Job satisfaction is critical for healthcare workers. This study indicated that job satisfaction is moderate for radiographers in Taif hospitals. Factors affecting their satisfaction include the feel of independence and recognition.

The Role of Interventional Radiology in Splenic Trauma

The purpose of this case report is to discuss the different treatment options available in splenic trauma patients by following the story of Mr. H. I will focus particularly on the role of splenic arterial embolisation (SAE)—an interventional radiological procedure—and how it weighs up against its surgical counterparts. In order to give a balanced view this case report includes a literature review around splenic artery embolisation. This report concludes that when managing splenic trauma, interventional radiology (IR) is a useful tool particularly when used in conjunction with surgery. The future of this field needs to allow SAE to become a stand-alone therapy. Furthermore, research needs to investigate which cohorts of patients are best suited to which intervention such that we can capitalise on the advantages of each intervention for the benefit of all.

Interventional radiology treatment for pulmonary embolism

Venous thromboembolism(VTE) is an illness that has a potentially life-threatening condition that affects a large percentage of the global population. VTE with pulmonary embolism(PE) is the third leading cause of death after myocardial infarction and stroke. In the first three months after an acute PE, there is an estimated 15% mortality among submassive PE, and 68% mortality in massive PE. Current guidelines suggest fibrinolytic therapy regarding the clinical severity, however some studies suggest a more aggressive treatment approach. This review will summarize the available endovascular treatments and the different techniques with its indications and outcomes.

Interventional Radiology in Côte d’Ivoire: Analysis and Assessment of the Radiological Risk of the Surgical Team

Ionizing radiation is widely used in medical practice for both diagnostic and therapeutic purposes. However, they are not devoid of adverse health effects on exposed operators. Therefore, we propose to assess the radiological risk of the interventional radiology team of the International Polyclinic of Indénié of Abidjan during the procedures of Embolization of uterine fibromyomas. The effective and equivalent doses to the extremities and crystals were estimated by TLD dosimeters positioned at different body areas selected on the basis of a radiological analysis of the exposure of personnel during five procedures. The analysis of fluoroscopic and record times showed variability in or an average fluoroscopy time of 32.37 min with extremes of 25.14 to 56.32 min;average record time of 0.52 min with extremes of 0.12 min to 1 min. The annual effective doses were respectively, 4.04 mSv, 3.42 mSv, 2.84 mSv;2.28 mSv, in the Radiologist (R), Operator Assistant (O2);Anesthesiologist (A2), Manipulator (M2). The annual equivalent doses to the radiologist’s predominant extremities and lenses were left index and left lens with values of 37.07 mSv and 9.46 mSv. The estimated doses in our study are reassuring from a regulatory point of view of dose limits. The results of our work have shown no significant short-term danger to the health of personnel.

Management and Reconfiguration of a Radiology Department under the Threat of Coronavirus Disease 2019:Experience from Wuhan

Summary:The corona virus disease 2019(COVID-19)is an emerging respiratory infectious disease caused by SARS-CoV-2,which first occurred in December 2019 in Wuhan,China.These days,in China,chest CT is used for diagnosis of COVID-19,as an important complement to the reverse-transcription polymerase chain reaction(RT-PCR)test.Because of contacting with a large number of suspected or probable cases closely during chest CT examination,radiographers are easily infected with COVID-19.This article included the rearrangement of CT examination room in fever clinic,the rearrangement of human resources in radiology department,and the drafting of new operating procedures for radiologists who carry out CT examination on COVID-19 patients.This article also introduced the emergency management procedures of the department of radiology during the outbreak,and the experience of infection prevention for the staff of the department of radiology.