Radiography Open 2019-12-06T10:29:48+01:00 Borgny Ween Open Journal Systems <p><strong><em>Radiography Open</em></strong> is an open access scientific journal that publishes scientific original articles, review articles, and case studies, within a broad understanding of radiography. In addition, <strong><em>Radiography Open</em></strong>&nbsp;publishes columns that underpins evidence-based practice within radiography.</p> Contrast media routines in Norwegian hospitals – a mapping study 2019-11-30T12:06:49+01:00 Tor Høye Dalen Dennis Årre Høynes Albertina Rusandu <p>Introduction <br>Optimal contrast enhancement in the organ of interest is crucial for the image quality of a CT examination. Potential side effects of contrast media range from mild to potentially severe. The use of the smallest possible amount, without compromising the image quality, is therefore preferable considering patient safety. Different methods of calculations, that consider different factors, are used to calculate the relevant amount. Our project focuses on the contrast media used in a "CT liver" examination among the public hospitals in Norway, and we wish to present the differences in contrast media routines.<br>Methods <br>Inquiries were sent to every public hospital that have a CT-lab in Norway, asking for their liver protocol, also including a short questionnaire. Eight example patients with different characteristics (sex, weight and body composition) were created. Information from the protocols and the questionnaires were used to calculate the amount of contrast media each of the hospitals would give to each example patient. Previous studies were used to calculate the recommended amounts of contrast media based on patient safety and optimal image quality. <br>Results<br>Calculations show differences between 66% and 117% (from lowest to highest amount) of contrast media given to the example patients. Out of the 30 participating hospitals, 6 use software, 17 use weight tables, 2 use fixed amounts and 5 use weight tables that takes body composition into consideration as their methods of calculating the amount of contrast media. None would have given more than the recommended amounts, considering patient safety, while between 6,7% and 36,7% would have given less than the recommended amounts, considering image quality. <br>Conclusion <br>The results show significant differences in contrast media usage among Norwegian hospitals. In conclusion, there is room for improvement and standardization of contrast media routines. Optimization of contrast media routines will benefit both patient safety, image quality and cost.</p> 2019-11-29T17:23:27+01:00 Copyright (c) 2019 Tor Høye Dalen, Dennis Årre Høynes , Albertina Rusandu Medical Imaging in Guyana, development and status 2019-11-30T11:01:04+01:00 Ramona Chanderballi <p>Medical imaging services have been rapidly advancing in Guyana over the last decade. It is time to look back, and state the todays’ situation.<br>With a population, under 1 million, Guyana, according to the World Factbook (1), is the third smallest country in South America. Guyana was originally a Dutch colony in the 17th century, by 1815 had become a British possession. The abolition of slavery led to settlement of urban areas by former slaves and the importation of indentured servants from India to work the sugar plantations. Tropical rainforests cover over 80 percent, and its agricultural lands are fertile. A resulting ethno-cultural divide has persisted and has led to turbulent politics. Guyana achieved independence from the UK in 1966. In 1992, the country is first free and fair election since independence. The economy is growing; still at a high unemployment. <br>According to the World Factbook, it is (per 2018) a young population; mean age for both females and males are 28 years, and life expectancy 68y. Compared with other neighboring countries, Guyana ranks poorly concerning basic health indicators (2), basic health services in the interior are primitive to non-existent.</p> 2019-11-29T18:45:17+01:00 Copyright (c) 2019 Ramona Chanderballi The unnecessary dose behind cropped radiographs 2019-11-30T12:23:16+01:00 Jónína Guðjónsdóttir <p>Objectives:</p> <p>In this study it was evaluated how common image cropping, or electronic collimation, is in digital radiography, how large an area of the images is cropped and how high the radiation dose is that corresponds to the cropped area.<br>Methods: A sample of images were taken from three medical imaging departments. The images were reviewed; and if cropped, the extent was recorded.</p> <p><br>Results:</p> <p>A total of 1.270 images were reviewed. 10.6 % of them were cropped; 19 %, 7 % and 6 % in sites A, B and C, respectively. 26 % of all chest images were cropped as well as 18 %, 13 %, 10 %, 10 %, 3 % and 2 % of lumbar spine, shoulder, hip, knee, hand and foot images, respectively. The proportion of cropped images was significantly different between sites and between examinations (p &lt; 0.05). Considering only the cropped images, the average cropped fraction of each image was from 16.0 % to 36.3 % and the corresponding unnecessary dose were estimated to be from 19.0 % to 56.9 % of the dose actually needed for the final image. Averaging the cropped area over all images in the same type of examination showed that up to 4.6 % of the dose in the examinations in the study was unnecessary.</p> <p><br>Conclusions:</p> <p>This study confirms that radiographs cropped, is a latent source of additional radiation dose to the patients. This needs be considered in the optimization of radiographic imaging procedures.</p> 2019-11-29T19:54:17+01:00 Copyright (c) 2019 Jónína Guðjónsdóttir MUCG ved vesiko-ureteral reflux hos barn 2019-11-30T15:46:58+01:00 Tayla Christie Kamilla Petersén <p>Vesikoureteral reflux, et backflöde av urin skjer från urinblåsan till uretärerna och njurbäckenet, drabbar barn. För att diagnostisera reflux används ultraljud, njurscintigrafi och främst miktionsuretrocystografi under genomlysning. Syftet var att dokumentera skillnader i undersøkning av reflux, vid en empirisk kvantitativ tvärsnittsstudie. Nio röntgenklinikers metodböcker samt deres stråldoser ble dokumentert.. Olika antal projektioner används för flickor respektive pojkar, og variasjoner i utførelsen av dem. &nbsp;Stråldoserna varierar; dock ses att samtliga kliniker i åldersgruppen 0–3 år har stråldoser under referensnivåerna enligt finska strålsäkerhetscentralen. &nbsp;</p> 2019-11-29T22:25:17+01:00 Copyright (c) 2019 Tayla Christie, Kamilla Petersén Factors that may contribute to an inadequate radiology request form 2019-12-06T10:29:48+01:00 Mitch Otterberg Johan Gunneröd <p>The radiology request/referral is an important part of the communication between the referring physician and the radiology department. It forms the basis for radiologists and radiographers to be able to carry out their work. Through the radiologic request form, the referrer orders an examination for a patient, as part of the patient's medical examination or follow-up. In conjunction with education and practice, we have noticed that reduced quality of the referrals is not uncommon. The aim was to identify the main contributing factors to unjustified referrals for diagnostic imaging procedures. A literature review was undertaken.</p> <p>Analyzing the literature, the overall themes emerged, and resulted in five subcategories; 1) insufficient, inaccurate or lack of clinical information or questioning, 2) weaknesses in choosing the desired modality, 3) missing routines and 4) need for further standardization of the referring-practice, and 5) insufficient knowledge of radiological diagnostics on behalf of the referring physicians. Weaknesses in clinical history and questioning were the most frequently presented contributing factors.</p> 2019-11-29T22:41:11+01:00 Copyright (c) 2019 Mitch Otterberg, Johan Gunneröd, Helene Mork-Knudsen Can pediatric radiography be practiced appropriately in a hospital, without a dedicated diagnostic imaging unit? A case study. 2019-11-30T10:59:20+01:00 Albertina Rusandu Erling Stranden <p><strong>Introduction</strong></p> <p>Due to Norway’s population density, demographic scatter and topography, performing radiological examinations in children in the same unit as in adults is quite common despite international guidelines recommending use of dedicated pediatric radiology units. Children examined in non-dedicated pediatric facilities are therefore a unique patient group who requires special attention.</p> <p>This study investigates pediatric radiography practice at a small local hospital lacking a dedicated pediatric radiology department by comparing it with the ideals of good practice as stated by international agencies. The aspects analyzed are organization, radiation safety and optimization.</p> <p><strong>Methods </strong></p> <p>The approach is qualitative, based on participant observation, document investigation and interviews with radiographers.</p> <p><strong>Results</strong></p> <p>Radiologists evaluated referrals. Age specific pediatric CT-protocols were being used. Awareness of the greater radiation risk in children and radiation safety concern were common among the radiographers.&nbsp; Some radiographers had experience from pediatric imaging departments while none of them had postgraduate studies in pediatric radiography. Lack of extensive practice due to reduced pediatric patient volume makes sometimes the examination of children be a challenging task. Communication with children seemed to go well.</p> <p><strong>Conclusion</strong></p> <p>Despite variations in experience with children among radiographers and lack of specialization in pediatric radiography, the practice is largely in accordance with international recommendations. Radiation protection and optimization requirements met, although the departmental organization slightly diverges from prevailing guidelines. Slightly different practice and experience with children among radiographers indicate the need for special guidelines for pediatric imaging for non-dedicated pediatric radiology departments.</p> 2019-11-29T23:39:59+01:00 Copyright (c) 2019 Albertina Rusandu, Erling Stranden