An analysis of the status of diagnostic radiology equipment in China

Objective:To analyze the current situation of diagnostic radiology equipment in Chinese mainland and to understand changes in the past 20 years,including gaps with other countries,in order to provide a scientific basis for the government to formulate relevant policies and regulations,and supplement Chinese data for international organizations.Methods:This survey adopted a uniformly designed questionnaire,which was completed by the investigators or the respondents.The survey was distributed to all medical institutions that provided diagnostic radiology services in 31 provinces,autonomous regions,and municipalities,excluding Hong Kong,Macao,Taiwan,and military,China.Results:The survey showed that in the past 20 years,the number of medical institutions and diagnostic radiology equipment per million population in China has increased substantially.Dental radiology equipment increased nine-fold,and mammography equipment and computed tomography scanners showed a nearly five-fold increase.The four types of diagnostic radiology equipment,general diagnostic,fluoroscopic,mammography,and computed tomography,were associated with the population.Dental radiology equipment and bone mineral densitometers were related only to the gross domestic product(GDP).A large gap remains in the diagnostic radiology equipment per million population between China and the equipment of health-care level(HCL)I countries.Conclusions:An imbalance in the number of units of diagnostic radiology equipment per million population was observed in the different regions,China.Various types of diagnostic radiology equipment,especially mammography equipment and computed tomography scanners,need to be deployed to meet the medical needs of different populations.

Management of infection control and radiological protection in diagnostic radiology examination of COVID-19 cases

Since the COVID-19 outbreak,diagnostic imaging has been providing valuable radiological support for disease diagnosis and prognosis prediction.Radiological staff,especially radiographers working on the front line in the battle against the COVID-19 outbreak.They are in direct contact with the patients,bearing the responsibility and pressure of both the infection prevention and control and the radiation protection.A number of relevant professionals and experts reached a consensus,which clarifies the detailed implementing rules with respective to infection control and protection of the radiation workers,disinfection of diagnostic radiology equipment and workplace,and radiological protection.The aim is to further normalize the clinical procedures of radiological staff,reduce the infection risk,especially the radiation risk to medics and patients.

Establishment of Local Diagnostic Reference Levels in Conventional Radiography: A Pilot Study in Dakar, Senegal

Diagnostic Reference Levels (DRLs) are indicators that allow assessing the quality of equipment and procedures from the point of view of the doses delivered to patients and subsequently initiate corrective actions if necessary. The purpose of this study is to encourage health professionals to investigate patient radiation doses and to determine whether those doses comply with the principles of radiation protection in medical fields so as to improve practices by reducing patient exposure without reducing clinical effectiveness. To perform this work, we have investigated patient doses for different radiological examinations from six (6) medical centers in Dakar, including the following nine routine types: chest (PA), abdomen (AP), pelvis (AP), cervical spine (AP), lumbar spine (AP, Lat), hip (AP), thoracic spine (AP, Lat). Three types of data were collected, i.e., X-ray tube machine data, patient data and output measurements. The data were analyzed statistically and the median, minimum, maximum, and third quartile values were calculated and displayed throughout boxplots graphs for all exams and medical centers. The two sigma range (95% confidence interval) was also checked. Comparison of third quartiles of Entrance Surface Dose (ESD) and Dose Area Product (DAP) by type of examination with recommended international DRLs was performed. The third quartile of ESD for pelvis (AP) and thoracic spine (AP) was up to 16% and 38% higher, respectively than their corresponding DRLs in the European Commission Report RP 180 Part 2. For all exams, except thoracic spine (lat), the third quartiles of the dose area product were higher than the corresponding DRLs in the above report. The source of dose variability between medical centers was related to many parameters such as poor radiographic techniques, lack of modern X-ray machines and adequately documented radiation protection practices. The results show the need to develop protocols for dose measurement as well as to carry out quality assurance programs and dose optimization in Senegal.

Influence of quality assurance on patients dose reduction in some hospitals

The radiation dose received by patients undergoing chest radiography was included. 200 patients who attended these investigations in 10 hospitals in Iran were randomly selected from all ages groups and both female and male. Critically ill patients were excluded. This paper presents the work, which was implemented on 200 patients and evaluated using the entrance skin dose （ESD） in the posterior anterior （PA） chest projection measured directly at the center of the X-ray field. In addition, the machine room, and dark room .parameters, as well as work practices and repeat rates were studied. The quality control （QC） parameters and the ESD before and after QC were evaluated utilizing an anthropomorphic phantom to define the optimal exposure condition at all hospitals. This research shows that after using the QC parameters and after optimization of the exposure conditions, the ESD was decreased by 42% on average. Also the qua/ity of the radiographs generally increased. The reported method is easily implemented in any clinical situation where optimization of chest radiography is needed.

Hepatocellular Carcinoma:Diagnosis, Treatment Algorithms, and Imaging Appearance after Transarterial Chemoembolization

Hepatocellular carcinoma(HCC)is a common cause of cancer-related death,with incidence increasing worldwide.Unfortunately,the overall prognosis for patients with HCC is poor and many patients present with advanced stages of disease that preclude curative therapies.Diagnostic and interventional radiologists play a key role in the management of patients with HCC.Diagnostic radiologists can use contrast-enhanced computed tomography(CT),magnetic resonance imaging,and ultrasound to diagnose and stage HCC,without the need for pathologic confirmation,by following established criteria.Once staged,the interventional radiologist can treat the appropriate patients with percutaneous ablation,transarterial chemoem-bolization,or radioembolization.Follow-up imaging after these liver-directed therapies for HCC can be characterized according to various radiologic response criteria;although,enhancement-based criteria,such as European Association for the Study of the Liver and modified Response Evaluation Criter in Solid Tumors,are more reflective of treatment effect in HCC.Newer imaging technologies like volumetric analysis,dual-energy CT,cone beam CT and perfusion CT may provide additional benefits for patients with HCC.