Unveiling the landscape: Investigating education, skills, job description, and challenges in sonography professions and framework development

INTRODUCTION

This paper discusses the current medical sonographer status in the United Arab Emirates (UAE). The paper explores the current education, skills, job description, and challenges towards developing sonography professions and a sonographer framework.

METHODS

The study employed a quantitative descriptive research approach using a cross-sectional study design to collect and analyse data from sonographers in the UAE. Data was collected through a structured survey that included sections addressing demographic information, education, skills, current practices, and challenges.

RESULTS

The data showed a relatively even distribution across different age groups, with a higher proportion falling in the 31-40 age range. Females constitute a slightly higher percentage (55.9 %) than males (44.1 %). The study found that sonographers have the necessary skills and knowledge to interpret the scan results and provide a formal report. A significant percentage of participants taught ultrasound to others and participated in research activities. The survey responses indicate difficulty in reporting sonograms.

CONCLUSIONS

The study found that sonographers possess the necessary expertise and skills to pass on their knowledge to trainees and colleagues. The participants expressing a desire to increase their knowledge and skills indicate that sonographers recognised that continuous professional development is crucial for staying updated with advancements in the field. The participant's "Advanced Practitioners" title recommendation suggests a desire for professional recognition, career progression, and specialisations in sonography. Effective interdisciplinary collaboration is important for providing quality patient care.

IMPLICATION FOR PRACTICE

The paper emphasises the importance of recognising sonography as a vital healthcare profession. It aims to raise awareness about the crucial role of sonographers in patient care. The study also stresses the need for a well-defined career progression framework to guide professional growth and acknowledgement.

Exploring Radiographers' Engagement in Research: Motivation and Barriers in Five Arab Countries

(1) Background: This study aims to comprehensively understand the motivations driving radiographers in five Arab countries to engage in research. (2) Methods: A cross-sectional study employing an anonymous online survey was conducted for 12 weeks from May to July 2023. The study sample consisted of 250 radiographers, with equal representation from Iraq, the Kingdom of Saudi Arabia, Palestine, Sudan, and the United Arab Emirates. (3) Results: Overall, the participants showed limited involvement in research-related activities in all five countries, particularly in presenting at conferences and publishing in peer-reviewed journals. Most participants believed research positively impacts their professional development (34.8%) and patient care and outcomes (40%). The participants perceived professional development (36.4%) as a key motivator for research engagement. A significant majority (81.6%) expressed motivation to start research in clinical practice. A total of 66.8% found research opportunities available during clinical practice. Barriers included time constraints (56%), limited resources (47.2%), and lack of support and skills (33.2% and 32%, respectively). (4) Conclusion: This study emphasises the need for targeted strategies to enhance research engagement among radiographers in the Arab region. Addressing barriers, such as time constraints and resource limitations, while leveraging intrinsic motivators, such as professional development, is crucial for fostering a culture of research-driven excellence in radiography.

Patient satisfaction with radiology services in the UAE: A comprehensive analysis of care, comfort, service, and accessibility

INTRODUCTION

This paper analyses patient satisfaction with radiology services in the United Arab Emirates (UAE). The study evaluates the care, comfort, service, and accessibility of the services and patient satisfaction with imaging procedures.

METHODS

The research design employed a descriptive, cross-sectional approach, and data were collected through a survey consisting of eight sections. A total of 444 participants completed the survey, providing valuable insights into their demographics, appointment experiences, waiting times, staff attitudes and overall satisfaction.

RESULTS

70.4% of the participants stated that it was easy to make appointments, and 66.1% stated that they were satisfied with the efficiency of check-ins. 54.9% felt they waited the right amount of time to make an appointment, and 56.1% were satisfied with the time waiting to receive the imaging report. The findings indicate that waiting times and staff attitudes significantly influence patient satisfaction, while demographic factors, such as nationality, education, and age, do not significantly impact them. The study concludes that healthcare providers should prioritise efficient appointment scheduling, reduce waiting times and foster positive patient-staff interactions to enhance patient satisfaction. The open-ended feedback provided by the participants also offers valuable suggestions for improving service quality.

CONCLUSION

This study is a foundation for future research and provides healthcare organisations with valuable insights to enhance patient satisfaction in UAE radiology services.

IMPLICATIONS FOR PRACTICE

Healthcare providers should focus on patient satisfaction to improve retention and loyalty, attract new patients and enhance their reputation.

Investigation of the Radiographer's adherence and compliance with radiation protection and infection control practices during COVID-19 mobile radiography

Radiological staff, especially radiographers, work as front liners against the COVID-19 outbreak. This study aims to assess compliance with radiation protection and infection control practices during COVID-19 mobile radiography procedures. This cross-sectional study included 234 radiographers (females, 56%, n = 131; males, 44%, n = 103) who were asked to complete an online questionnaire consisting of demographic data, radiation protection and infection control practices during COVID-19 portable cases, and knowledge and awareness. After informed consent was completed, SPSS statistical software was used for the data analysis. The most common age group of participants ranged from 18 to 25 years old (30.3%, n = 71). Bachelor's degree holders were 74.4% (n = 174). Most radiographers (39.7%, n = 93) had a working experience of 1-5 years, followed by 27.8% (n = 65) with more than 16 years of experience. Most respondents (62.4%, n = 146) handled approximately 1-5 cases daily, the majority of them (56%, n = 131) stated affirmatively they had obtained special training to handle COVID-19, and when inquired if they had received any special allowances for handling COVID-19 suspected/confirmed cases most of them stated negative (73.9%, n = 173). Most participants stated that they always wear a TLD during portable cases (67.1%, n = 157) and a lead apron (51.7%, n = 121). Around 73% (n = 171) knew the latest information on COVID-19 and attended the COVID-19 awareness course. A significant association was found between the work experience of the radiographers and their responses to following the best practices (p = 0.018, α = 0.05). Radiographers who had COVID-19 training (μ = 48.78) tend to adhere more to best practices than those who have not (p = 0.04, α = 0.05). Further, respondents who handled more than 16/more COVID-19 suspected/confirmed cases followed the best practices more (μ = 50.38) than those who handled less (p = 0.04, α = 0.05). This study revealed detailed information on radiation protection and infection control practices during COVID-19 mobile radiography. It has been observed that the participants/radiographers have good knowledge and awareness of radiation protection and infection-control practices. The present results may be used to plan future requirements regarding resources and training to ensure patient safety.

A closer look at the current knowledge and prospects of artificial intelligence integration in dentistry practice: A cross-sectional study

Background

Healthcare professionals have expressed worries about using AI, while others anticipate more work opportunities in the future and better patient care. Integrating AI into practice will directly impact dentistry practice. The purpose of the study is to evaluate organizational readiness, knowledge, attitude, and willingness to integrate AI into dentistry practice.

Methods

a cross-sectional exploratory study of dentists, academic faculty and students who practice and study dentistry in UAE. Participants were invited to participate in a previously validated survey used to collect participants' demographics, knowledge, perceptions, and organizational readiness.

Results

One hundred thirty-four responded to the survey with a response rate was 78% from the invited group. Results showed excitement to implement AI in practice accompanied by medium to high knowledge and a lack of education and training programs. As a result, organizations were not well prepared and had to ensure readiness for AI implementation.

Conclusion

An effort to ensure professional and student readiness will improve AI integration in practice. In addition, dental professional societies and educational institutions must collaborate to develop proper training programs for dentists to close the knowledge gap.

Low-Dose Chest CT Protocols for Imaging COVID-19 Pneumonia: Technique Parameters and Radiation Dose

Chest computed tomography (CT) plays a vital role in the early diagnosis, treatment, and follow-up of COVID-19 pneumonia during the pandemic. However, this raises concerns about excessive exposure to ionizing radiation. This study aimed to survey radiation doses in low-dose chest CT (LDCT) and ultra-low-dose chest CT (ULD) protocols used for imaging COVID-19 pneumonia relative to standard CT (STD) protocols so that the best possible practice and dose reduction techniques could be recommended. A total of 564 articles were identified by searching major scientific databases, including ISI Web of Science, Scopus, and PubMed. After evaluating the content and applying the inclusion criteria to technical factors and radiation dose metrics relevant to the LDCT protocols used for imaging COVID-19 patients, data from ten articles were extracted and analyzed. Technique factors that affect the application of LDCT and ULD are discussed, including tube current (mA), peak tube voltage (kVp), pitch factor, and iterative reconstruction (IR) algorithms. The CTDIvol values for the STD, LDCT, and ULD chest CT protocols ranged from 2.79-13.2 mGy, 0.90-4.40 mGy, and 0.20-0.28 mGy, respectively. The effective dose (ED) values for STD, LDCT, and ULD chest CT protocols ranged from 1.66-6.60 mSv, 0.50-0.80 mGy, and 0.39-0.64 mSv, respectively. Compared with the standard (STD), LDCT reduced the dose reduction by a factor of 2-4, whereas ULD reduced the dose reduction by a factor of 8-13. These dose reductions were achieved by applying scan parameters and techniques such as iterative reconstructions, ultra-long pitches, and fast spectral shaping with a tin filter. Using LDCT, the cumulative radiation dose of serial CT examinations during the acute period of COVID-19 may have been inferior or equivalent to that of conventional CT.

Community and Policy Factors Influencing the Decision to Undergo Screening Mammography amongst Indian Women in the United Arab Emirates

OBJECTIVE

This study explored the expectations, requirements, and recommendations and identifies the socio-ecological determinants for the informed uptake of screening mammography amongst expatriate women residing in the UAE.

METHODOLOGY

A qualitative research approach was adopted using five focus group discussions. The study comprised two populations- those who had undergone screening mammography and those who had not. Thematic analysis- the six-phase model was adopted and modified for data analysis.

RESULTS

The factors that influence the rate of uptake of screening mammography by the participants were multifactorial and reciprocal. The community determinants identified are cultural beliefs, medical professionals, breast cancer survivors, community organizations, and media. The health policies in an expatriate's home country and adopted country were found to have a considerable influence on the health behaviors of the participants. A comprehensive approach to change in health behavior is required to increase the informed uptake of screening mammography by expatriate women residing in the UAE.

CONCLUSION

The study identified the need of developing migrant health units with community navigators, international health collaboration, migrant health directory, risk assessment team, automatic invitation system for screening, referral system, migrant cancer registry, and psychological support team in UAE. However, further studies are expected to give a wider perspective.

Infection control and radiation safety practices in the radiology department during the COVID-19 outbreak

RATIONALE AND OBJECTIVES

Radiology personnel must have good knowledge, experience and adherence to radiation protection and infection control practices to ensure patient safety and prevent the further spread of the COVID-19 virus. This study analysed compliance and adherence to radiation protection and infection control during COVID-19 mobile radiography.

METHODS

A cross-sectional using online survey was conducted from September to December 2021. Data on demographic characteristics, adherence to radiation protection and infection control practice were collected during mobile radiography for COVID-19 patients in the study. A random sample of the radiographers working in COVID-19 centres in the United Arab Emirates.

RESULTS

Responses were received from 140 participants, with a response rate of 87.5%. Females were the predominant participants (n = 81; 58%). Participants aged ages between 18-25 years (n = 46; 33%) and 26-35 years (n = 42; 30%), (n = 57; 41%) had less than five years of experience, followed by participants who had more than 15 years (n = 38; 27%). Most participants (n = 81; 57.9%) stated that they performed approximately 1-5 suspected or confirmed COVID-19 cases daily. The participants had moderate to high adherence to radiation protection, with a mean and standard deviation of 42.3 ± 6.28. Additionally, infection control adherence was high, with 82% of the participants showing high adherence.

CONCLUSION

Continuous guidance, training and follow-up are recommended to increase adherence and compliance to radiation protection and infection control compliance. Educational institutions and professional organisations must collaborate to provide structured training programmes for radiology practitioners to overcome the practice and knowledge gap.

A focusing study on radioprotective and antioxidant effects of Annona muricata leaf extract in the circulation and liver tissue: Clinical and experimental studies

Objectives

This study investigates the effect of Annona muricata (AM) leaf extract against irradiation-induced damage by the evaluation of hepatic tissue and the levels of oxidative and inflammatory stress in the circulation.

Methods

An experimental study with 37 female Wistar albino rats randomized into four groups (controls and three intervention groups) was performed. The first interventional group (group 2) received 300 mg/kg of AM leaf extract by oral gavage once a day for 9 days, group 3 received a single dose of whole-body radiation (8.3 Gy) after a 9-day oral gavage treatment with saline, and the last group received the same irradiation of 8.3 Gy after being treated with 300 mg/kg of AM leaf extract by oral gavage once a day for 9 days.

Results

Radiation was found to elevate reactive oxygen species parameters, and AM administration before irradiation was found to decrease total oxidant status (TOS), increase caspase 9, and improve hepatic damage when compared with the group that received only irradiation.

Conclusion

The damage caused by irradiation may be ameliorated by the use of the AM extract, which appears to be effective in preventing oxidative stress and inflammatory activity.

Integration of artificial intelligence into nursing practice

Background

Methods

Results

Conclusions

The impact of COVID-19 on the clinical experience and training of undergraduate Student radiographers internationally: The clinical tutors' perspective

Introduction

The impact on the clinical training and education of healthcare students by COVID-19 has been documented. However, the thoughts and experiences of clinical tutors (CTs) about radiography students attending for clinical training and education during this now elongated period beyond first recognition of the virus has not been explored. This paper will discuss data collected from CTs in the UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) who were compared because of their similarities in delivery based on individual ‘rules of engagement’ devised by their various health departments.

Aim

The purpose of this study was to examine the clinical tutors' thoughts and experiences of supervising radiography students attending clinical placement during the COVID-19 pandemic.

Methods

The UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) were selected for comparison on an international level as they are geographically distinct with a comparable population and education accredited/acknowledged by the Society and College of Radiographers (SCoR). Data was collected data from CTs across the UKDN and the UAE. The study used an online questionnaire (Google Forms) with closed questions in four themes including: students' experiences, impact on students' clinical placement, attitude of the clinical staff and the potential effects of COVID-19 on future graduates’ skills and competencies. Further data was gathered on the experience of CTs mentoring students during the COVID-19 pandemic.

Results

Data were collected from 59 CTs (81%, n = 48) from UKDN and (19%, n = 11) UAE. Twenty-seven (46%) respondents reported that COVID-19 had a negative impact on clinical practical experience. However, 32 (54%) identified that COVID-19 had no impact on student supervision/feedback or on clinical achievements. Eleven (19%) respondents thought that students should not have been on clinical placement during the pandemic but a further 51% (n = 30) were happy with the students on placement and expressed willingness to delegate work to students. Interestingly, 58% (n = 34) of CTs suggested that future graduates may need a longer preceptorship after they graduate due to receiving decreased clinical experience during the pandemic. Overall, 78% (n = 46) of respondents thought that students improved their clinical confidence by working directly with COVID-19 positive patients.

Conclusion

The current study has identified conflicting opinions across CTs in different clinical departments. Whilst some felt that students should not be in the hospital during the pandemic, others reported that working directly with COVID-19 patients had a positive impact on students as it improved their clinical confidence. Despite the challenges presented by COVID-19, CTs were able to provide direct clinical supervision and feedback to students on clinical placement throughout the pandemic. Nevertheless, future graduates may need a longer preceptorship period due to decreased clinical experience during the pandemic.

Implications for practice

Clinical placements should continue during subsequent COVID-19 waves of infection or future pandemics to ensure development of skills in resilience and adaptability. Underdeveloped skills due to a decreased range of examinations can be rectified when any wave of the infection subsides by providing tailored training based on individual student's needs.

The changing concept of radiographer's role in UAE: An analysis of radiologists' opinions and acceptance

INTRODUCTION

The role of radiographers in the United Arab Emirates (UAE) is currently focused on image acquisition. However, many advances have been made in different countries in recent years whereby radiographers who receive appropriate education and training, can provide image interpretation/reports. When implemented, this role development has enabled a more cost effective and efficient service delivery whilst relieving the burden off radiologists, allowing them to concentrate on more complex imaging examinations. This role development is commonplace in many countries but not in the UAE.

AIM

This study aims to investigate the radiologists' opinions, perceptions, and willingness to accept the advanced practice role of reporting radiographers in the UAE and determine their level of support for implementing these roles.

METHODS

Data was collected utilizing a mixed-methods study design that included a survey and focus group discussions (FGD). Study participants included radiologists who currently work in UAE public and private health organizations. The survey link was emailed directly to the radiologists, together with a covering letter and participants' information sheet outlining the study's aim. Participants indicated on the survey if they wanted to participate in FGD. Two online FGD were conducted using Zoom software (Zoom Video Communications Inc., San Jose, California, United States) and aimed to explore possible reasons for participant's opinions. Ethical approval was obtained from the Ministry of Health, and all methods were performed as per study protocol.

RESULTS

A total of 69 radiologists participated in the survey, 48 males and 21 females aged between 41 and 60 years and with between 11 and 16 years of experience. Most participants (n = 54, 78.2%) believe that radiographers should only perform advanced tasks in image interpretation after obtaining adequate training and under the supervision of a radiologist. According to 55% of radiologists, the development of the radiographer role could draw more UAE nationals to the field. Six participants were recruited to FGD and declared mixed opinions that emphasized the need to improve the radiographers knowledge and experience to enable role development.

CONCLUSION

Radiologists' worries about radiographer engagement in image interpretation may be alleviated if they participate in education and training for new responsibilities. In addition, this could boost the confidence of radiologists and improve trust in radiographer competency and training.

IMPLICATIONS FOR PRACTICE

Guidelines and work standards must be developed jointly by radiologists and radiographers to ensure the governance and acceptability of new radiographer reporting roles. Some radiologists perceive that radiographer reporting is possible in UAE when radiographers are trained to set guidelines and with supervision from radiologists. Change is taking place, and many radiologists express optimism for the future, though the rate of change will be determined by a willingness to change attitudes and perceptions.

Utilization of artificial intelligence approach for prediction of DLP values for abdominal CT scans: A high accuracy estimation for risk assessment

Purpose

This study aimed to evaluate Artificial Neural Network (ANN) modeling to estimate the significant dose length product (DLP) value during the abdominal CT examinations for quality assurance in a retrospective, cross-sectional study.

Methods

The structure of the ANN model was designed considering various input parameters, namely patient weight, patient size, body mass index, mean CTDI volume, scanning length, kVp, mAs, exposure time per rotation, and pitch factor. The aforementioned examination details of 551 abdominal CT scans were used as retrospective data. Different types of learning algorithms such as Levenberg-Marquardt, Bayesian and Scaled-Conjugate Gradient were checked in terms of the accuracy of the training data.

Results

The R-value representing the correlation coefficient for the real system and system output is given as 0.925, 0.785, and 0.854 for the Levenberg-Marquardt, Bayesian, and Scaled-Conjugate Gradient algorithms, respectively. The findings showed that the Levenberg-Marquardt algorithm comprehensively detects DLP values for abdominal CT examinations. It can be a helpful approach to simplify CT quality assurance.

Conclusion

It can be concluded that outcomes of this novel artificial intelligence method can be used for high accuracy DLP estimations before the abdominal CT examinations, where the radiation-related risk factors are high or risk evaluation of multiple CT scans is needed for patients in terms of ALARA. Likewise, it can be concluded that artificial learning methods are powerful tools and can be used for different types of radiation-related risk assessments for quality assurance in diagnostic radiology.

Changing the model of radiography practice: Challenges of role advancement and future needs for radiographers working in the UAE

INTRODUCTION

The radiographers' role in the United Arab Emirates (UAE) is focused on image acquisition with a willingness to accept advanced practice roles after appropriate education and training. Radiographers working in the UAE are highly motivated and ambitious to achieve those internationally identified levels of professional recognition and opportunities for role advancement. This study investigates the radiographers' perspectives, perceptions and hopes for role advancement in the UAE.

METHODS

A qualitative research study design using Focus Group Discussions (FGD) was used to elicit the perceptions of radiographers. Participants were radiographers working in the hospitals and clinics supervised by the Ministry of Health and Prevention. Participants were asked about the recognized tasks defined as advancement roles, needs for roles clinically, challenges and requirements to prepare radiographers to participate in extended/developed roles. The discussions were audio recorded and later transcribed by an independent research assistant. Thematic analysis was used for data analysis RESULTS: 29 radiographers participated in the FGDs, and 83% (n = 24) were interested in role advancement. FGD revealed that their current practice showed some informal extended role that may promote career progression. The most significant challenges identified by participants was their knowledge level as provided by the current curriculum and the need for education and licensing body support to accommodate change.

CONCLUSION

The study identified a need for education and licensing body support to enable change in roles by radiographers, through improving radiographer knowledge and experience for role advancement.

IMPLICATIONS FOR PRACTICE

To sustain role advancement, formal intense training and education are necessary, normally above bachelor's degree level. Furthermore, establishing standards, licensing organizations/professional bodies should be part of the transformation of the profession to enable internationally recognized models to be followed.

IMPACT OF RADIATION FIELD SIZE ON ABSORBED ORGAN DOSES IN NEONATES UNDERGOING CHEST RADIOGRAPHY IN AN ANTERIOR-POSTERIOR PROJECTION: A MONTE CARLO SIMULATION STUDY

Electronic image cropping and poor collimation practices are used by some radiographers during paediatric radiography. Advantages of collimation should be investigated to disseminate convenient use among radiographers and create awareness. The aim of this study was to use Monte Carlo simulation to investigate the extent of the effect of collimation on the absorbed organ dose in neonates undergoing anterior-posterior chest examination. The minimum field size recommended by the European guidelines was calculated experimentally using a neonate phantom. A PCXMC version 2.0 simulation calculated the organ and effective doses at the minimum field size and at different field sizes. Increasing the field size by 1 cm in the head-to-feet direction increases the dose to the urinary bladder and prostate, whereas increasing the field size by 1 cm on all sides increases the dose to the upper limbs, ovaries, testicles and prostate. The use of an optimal field size reduces organ doses for neonates undergoing chest X-ray. Cropping X-ray images to reduce unnecessarily large field sizes results in unnecessary patient dosages and should be avoided. The primary beam should be restricted to expose only the area of interest, and image cropping should be discouraged.

Assessment of the Willingness of Radiologists and Radiographers to Accept the Integration of Artificial Intelligence Into Radiology Practice

RATIONALE AND OBJECTIVES

This study aimed to investigate radiologists' and radiographers' knowledge, perception, readiness, and challenges regarding Artificial Intelligence (AI) integration into radiology practice.

MATERIALS AND METHODS

An electronically distributed cross-sectional study was conducted among radiologists and radiographers in the United Arab Emirates. The questionnaire captured the participants' demographics, qualifications, professional experience, and postgraduate training. Their knowledge, perception, organisational readiness, and challenges regarding AI integration into radiology were examined.

RESULTS

There was a significant lack of knowledge and appreciation of the integration of AI into radiology practice. Organisations are stepping toward building AI implementation strategies. The availability of appropriate training courses is the main challenge for both radiographers and radiologists.

CONCLUSION

The excitement of AI implementation into radiology practise was accompanied by a lack of knowledge and effort required to improve the user's appreciation of AI. The knowledge gap requires collaboration between educational institutes and professional bodies to develop structured training programs for radiologists and radiographers.

Correlation between Computed Tomography Clinical Diagnosis and Findings in Pediatric Computed Tomography

<b>Background and Objective:</b> Pediatric Computed Tomography (CT) is a fast, accurate imaging examination using ionizing radiation to create detailed images of pathological conditions. The radiation benefit should be outweighing the risk through the procure justification and dose optimization. The study aimed to investigate the correlation between the physician's initial diagnosis and the CT findings to build procedure justification for a pediatric patient's head scan. <b>Materials and Methods:</b> The study included 81 children examined clinically and by CT scan to diagnose cranial and cerebral pathology. Eighty-one pediatric patients were investigated by CT scan and clinical diagnosis. <b>Results:</b> The patient age ranged between 1-15 years old, (44%) were male and (56%) females. The patients referred to the CT scan from emergency department n = 10 (7%), outpatient clinics n = 66, (84%) and inpatients clinics n = 5, (9%). The study showed that 46% of patients were normal with no CT findings. Almost half of the cases were negative and did not confirm the clinical diagnosis. <b>Conclusion:</b> The study concluded that most head CT scans in children were not justified. An effort towards improving the refereeing physician's awareness about radiation dose and request justification should be conducted.

COMPARISON OF RADIATION DOSE AND IMAGE QUALITY IN HEAD CT SCANS AMONG MULTIDETECTOR CT SCANNERS

The present study compares three different multidetector CT (MDCT) scanners for routine brain imaging in terms of image quality and radiation doses. The volume CT dose index (CTDIvol), dose-length product (DLP), and effective dose (E) were calculated. Subjective image assessment was obtained based on a scale ranging from 1 (unacceptable) to 5 (optimum). All images scored 3.5 or over, with the 160-slice MDCT images being favoured. For the 4-, 16- and 160-slice MDCT scanners, the respective median values for CTDIvol were 57 mGy, 41 mGy, and 28 mGy; DLP values were 901 mGy.cm, 680 mGy.cm, and 551 mGy.cm; and effective doses were 2 mSv, 1.5 mSv, and 1 mSv, respectively. Compared to the 160-slice MDCT, the dose values for the 4- and 16-slice units were significantly greater. In practice, the CT modality used must be carefully selected to avoid elevated radiation doses and maintain image quality.

ESTIMATION OF RADIATION RISK AND ESTABLISHMENT OF DIAGNOSTIC REFERENCE LEVELS FOR PATIENTS UNDERGOING COMPUTED TOMOGRAPHY CHEST-ABDOMEN-PELVIC EXAMINATIONS IN SUDAN

Establishment of diagnostic reference levels (DRLs) is an essential radiation optimization tool used to indicate optimum practice and radiation protection. This study aimed to report the current computed tomography (CT) of the chest-abdomen-pelvis radiation practice in Sudan as a part of the DRL establishment effort and dose optimization. CT radiation doses were collected from 530 patients of age ranging between 28 and 85 y and body weight ranging between 65 and 120 kg. DRLs were calculated based on the 75th percentile of dose length product (DLP) and CT dose index volume (CTDIvol). Effective and organ doses were calculated using the National Cancer Institute dosimetry system for the CT programme. The proposed DRLs are CTDIvol, 6 mGy, and DLP, 970 mGy.cm, and an effective dose of 9.9 mSv. Organ dose estimation showed that the thyroid received the highest dose during the scan.

Impact of Eye and Breast Shielding on Organ Doses During Cervical Spine Radiography: Design and Validation of MIRD Computational Phantom

Purpose: The study aimed to design and validate computational phantoms (MIRD) using the MCNPX code to assess the impact of shielding on organ doses. Method: To validate the optimized phantom, the obtained results were compared with experimental results. The validation of the optimized MIRD phantom was provided by using the results of a previous anthropomorphic phantom study. MIRD phantom was designed by considering the parameters used in the anthropomorphic phantom study. A test simulation was performed to compare the dose reduction percentages (%) between the experimental anthropomorphic phantom study and the MCNPX-MIRD phantom. The simulation was performed twice, with and without shielding materials, using the same number and locations of the detector. Results: The absorbed dose amounts were directly extracted from the required organ and tissue cell parts of output files. Dose reduction percentages between the simulation with shielding and simulation without shielding were compared. The highest dose reduction was noted in the thymus (95%) and breasts (88%). The obtained dose reduction percentages between the anthropomorphic phantom study and the MCNPX-MIRD phantom were highly consistent and correlated values with experimental anthropomorphic data. Both methods showed Relative Difference (%) ranges between 0.88 and 2.22. Moreover, the MCNPX-MIRD optimized phantom provides detailed dose analysis for target and non-target organs and can be used to assess the efficiency of shielding in radiological examination. Conclusion: Shielding breasts and eyes during cervical radiography reduced the radiation dose to many organs. The decision to not shield patients should be based on research evidence as this approach does not apply to all cases.

An extensive survey of radiographers from the Middle East and India on artificial intelligence integration in radiology practice

Assessing the current Artificial intelligence (AI) situation is a crucial step towards its implementation into radiology practice. The study aimed to assess radiographer willingness to accept AI in radiology work practice and the impact of AI in work performance. An exploratory cross-sectional online survey conducted for radiographers working within the Middle East and India was conducted from May–August 2020. A previously validated survey used to obtain radiographer's demographics, knowledge, perceptions, organization readiness, and challenges of integrating AI into radiology. The survey was accessible for radiographers and distributed through the societies page. The survey was completed by 549 radiographers distributed as (77.6%, n = 426) from the Middle East while (22.4%, n = 123) from India. A majority (86%, n = 773) agreed that AI currently plays an important role in radiology and (88.0%, n = 483) expected that AI would play a role in radiology practice and image production. The challenges for AI implementation in practice were developing AI skills (42.8%, n = 235) and AI knowledge development (37.0%, n = 203). Participants showed high interest to integrate AI in under and postgraduate curriculum. There is excitement about what AI could offer, but education input is a requirement. Fears are expressed about job security and how radiology may work across all ages and educational backgrounds. Radiographers become aware of AI role and challenges, which can be improved by education and training.

Assessment of MRI technologists in acceptance and willingness to integrate artificial intelligence into practice

INTRODUCTION

The integration of AI in medical imaging has tremendous exponential growth, especially in image production, image processing and image interpretation. It is expected that radiographers working across all imaging modalities have adequate knowledge as they are part of the end-user team. The current study aimed to investigate the knowledge, willingness and challenges facing the Magnetic Resonance Imaging (MRI) technologists in the integration of Artificial Intelligence (AI) into MRI practice.

METHODS

Total of 120 participants were recruited using a snowball sampling technique. A two-phase study was undertaken using survey and focus group discussion (FGD) to capture participants' knowledge, interpretations, needs and obstacles toward AI integrations in MRI practice. The survey and FGD provided the base to understand the participant's' knowledge, acceptance and needs for AI.

RESULTS

Results showed medium to high knowledge, excitement about AI integration without disturbance of MRI practice. Participants thought that AI can improve MRI protocol selection (91.8%), reduce the scan time (65.3%), and improve image post-processing (79.5%). Education and learning resources concerning AI were the main obstacles facing MRI technologists.

CONCLUSION

MRI technologists have the knowledge and possess basic technical information. The application of AI in MRI practice might greatly influence and improve MRI technologist's work. A structured and professional program should be integrated in both undergraduate and continuous education to prepare for effective AI implementation.

IMPLICATIONS FOR PRACTICE

Application of AI in MRI can be used in many aspects, such as optimize image quality and avoidance of image artifacts. Moreover, AI can play an important role in patient's safety at the MRI unit to reduce incidents. Education, infrastructure, and knowledge of end-users are keys for the incorporation of AI use, development and optimisation.

In-Silico Monte Carlo Simulation Trials for Investigation of V2O5 Reinforcement Effect on Ternary Zinc Borate Glasses: Nuclear Radiation Shielding Dynamics

In the current study, promising glass composites based on vanadium pentoxide (V₂O₅)-doped zinc borate (ZnB) were investigated in terms of their nuclear-radiation-shielding dynamics. The mass and linear attenuation coefficient, half-value layer, mean free path, tenth-value layer, effective atomic number, exposure-buildup factor, and energy-absorption-buildup factor were deeply simulated by using MCNPX code, Phy-X PSD code, and WinXcom to study the validation of ZBV1, ZBV2, ZBV3, and ZBV4 based on (100−x)(0.6ZnO-0.4B₂O₃)(x)(V₂O₅) (x = 1, 2, 3, 4 mol%) samples against ionizing radiation. The results showed that attenuation competencies of the studied glasses slightly changed while increasing the V₂O₅ content from 1 mol% to 4 mol%. The domination of ZnO concentration in the composition compared to B₂O₃ makes ZnO substitution with V₂O₅ more dominant, leading to a decrease in density. Since density has a significant role in the attenuation of gamma rays, a negative effect was observed. It can be concluded that the aforementioned substitution can negatively affect the shielding competencies of studied glasses.

TOWARD NATIONAL CT DIAGNOSTIC REFERENCE LEVELS IN THE UNITED ARAB EMIRATES: A MULTICENTER REVIEW OF CT DOSE INDEX AND DOSE LENGTH PRODUCT

This multicenter study evaluated computed tomography dose index volume (CTDIvol) and dose length product (DLP) to contribute to establishing computed tomography (CT) national diagnostic reference levels (NDRLs) in the United Arab Emirates (UAE). Data from 240 patients, who underwent CT head, chest, abdomen-pelvis and urography examinations, were analyzed, including patient age, sex and weight, CTDIvol (mGy) and DLP (mGy cm). The proposed DRLs for each examination were calculated as the third quartile. DRLs are proposed using CTDIvol (mGy) and DLP (mGy cm) for CT head (67 and 1189, respectively), chest (8 and 302, respectively), abdomen-pelvis (28 and 1122, respectively) and urography (20 and 714, respectively). These values are comparable with the initial NDRLs and published international DRLs. Baseline values for International Radiology Center (IRC) CT DRLs were calculated on frequently performed CT examinations. Implementation of DRL values improves dose optimization based on procedures, scanner type and patient characteristics while maintaining acceptable image quality and diagnostic confidence.

Radiography Advanced Practice in the United Arab Emirates: The Perceptions and Readiness of Mammographers

INTRODUCTION

This study is a part of an effort to determine the challenges faced by the United Arab Emirates (UAE) radiographers towards role extension and advanced practice. It reflects the current practice and challenges facing role extension compared to international advancement. The study aimed to assess the radiographers who worked at mammography screening perception and readiness to accept role extension and advanced practice in mammography.

METHODS

A cross-sectional descriptive study using an online survey was conducted among radiographers who practice mammography. The survey captured demographics, qualifications, professional education, future development plans, interest in role extension, and incentive to pursue the mammography profession.

RESULTS

Forty-five radiographers were invited to participate in the study the response rate was 71% (n=32), 34.4 (11%) were UAE nationals with the remainder being expats. The majority were young between 25 and 45 years old (84.4%), 81.3% hold a BSc qualification. 56.3% completed a post-qualification training specialized mammography certificate. 81% of the participants showed interest in role extension after appropriate education, training, and supervision by radiologists.

CONCLUSION

This study reports on the perceptions and readiness of radiographers on advanced practice within breast-screening centers. The results show acceptance and support after proper training, clear career pathway, and licensing body recognition. The role of the radiographer in the UAE is still growing.

Computed tomography radiation doses for common computed tomography examinations: a nationwide dose survey in United Arab Emirates

OBJECTIVES

Computed tomography (CT) scanning is an essential part of diagnostic and treatment plans, providing swift and accurate diagnostic images. The aim of this study is to develop diagnostic reference levels (DRLs) for the adult common CT examination in the United Arab Emirates (UAE).

METHODS

This study presents results of the survey of CT dose indices. The data were collected from 91% of the scanners registered at the Ministry of Health and Prevention (MOHAP) for five common examinations: head, chest, and abdomen-pelvis with and without CM.

RESULTS

CT dose index, dose-length product, and patient weight were analyzed; the reference dose was calculated on the 75th percentile, and an achievable dose was proposed from the median value. The results were compared with the UAE initial National Dose Report as well as the international reports. The proposed dose for CTDI_vol (mGy) and DLP (mGy cm) is as follows: head without CM 40 and 695, head with CM 48 and 820, chest 10 and 275, abdomen-pelvis without CM 14 and 810, and abdomen-pelvis with CM 20 and 1025.

CONCLUSIONS

The results show low dose variations between the MOHAP scanners. The data also revealed CTDI_vol and DLP values comparable to those in the initial NDRL report and international standards. The establishment of diagnostic reference levels will require a continuous dose monitoring system.

Effectiveness of Breast and Eye Shielding During Cervical Spine Radiography: An Experimental Study

Purpose

This study assessed the effectiveness of breast and eye shielding and measured the radiation dose to radiosensitive tissues (eyes and breasts) due to scatter radiation during cervical spine X-ray radiography examinations.

Methods

Using an anthropomorphic phantom, the scattered radiation dose was measured before and after the placement of the lead shield over the eyes and breasts in the anteroposterior (AP) and left lateral projection. A regression formula was utilized to determine the exposure. Mean values and standard deviation of breasts and eyes doses were calculated. The paired two sample t-test was used to compare the recorded dose before and after shielding placement.

Results

Radiation shielding of eyes and breasts during AP cervical spine X-ray decreased radiation dose to the breasts by 99.9% and to the left and right eye by 91% and 89%, respectively. For the left lateral cervical spine X-ray, the radiation dose decreased by 26% and 31% for the left and right eye, respectively, and by 23% and 99% for the left and right breast, respectively. A significant difference was noted comparing the dose before and after the implementing shielding on the eye and breast.

Conclusion

According to the results presented, the dose is significantly reduced, especially considering that they are not in the area of interest but are exposed to scatter radiation.

Assessment of the professional practice knowledge of computed tomography preceptors

OBJECTIVES

This study aimed to assess the knowledge and practice of computed tomography (CT) clinical practice preceptors in terms of CT parameters affecting patient dose and image quality.

MATERIAL AND METHODS

A self-administered questionnaire that surveyed the participants' demographic information and knowledge about CT parameters and radiation doses was distributed to 60 CT preceptors.

RESULTS

The response rate of the invited technologists was 92 %. 38 (69 %) males and 17 (31 %) females aged between 24 and 59 years, with a mean age of 37.8. The participants' experience ranged between 2 and 24 years, with a mean of 15.5 years. The average knowledge score was 72.2 %, with a range of correct answers of 9-18 and a mean (±SD) of 13.1 ± 2.1. The participants showed a low awareness of diagnostic reference levels (DRLs). However, they demonstrated good overall knowledge, with a potential for improvement and confidence in practice.

CONCLUSIONS

Continuous medical education and professional development are a priority for improvement to ensure reliable delivery of health care and best practice. The findings of this study can be used by education institutes and health organizations when designing educational programs to ensure the highest training and performance of their technologists.

Characterization of Foot Mycetoma Using Sonography and Color Doppler Imaging

BACKGROUND AND OBJECTIVE

Mycetoma of the foot, commonly referred to as Madura foot, is a chronic granulomatous infection, which impacts vascularization of the affected region. This study aimed to evaluate foot mycetoma using Doppler and sonography techniques to identify the principle sonographic features and blood flow patterns associated with the condition.

MATERIALS AND METHODS

This was a cross-sectional prospective single-center study conducted at the Mycetoma Research Center (MCR) in Khartoum State, Sudan. Sixty patients with Madura foot were examined using a Duplex ultrasound machine with a 7-10 MHZ linear probe. Data was analyzed using SPSS software. The distribution of demographic data was evaluated by simple descriptive statistics. Statistical tests was performed using Student's independent t-tests to compare different forms of mycetoma and Chi-square tests to examine differences in blood flow patterns between fungal (eumycetoma) and bacterial (actinomycetoma) forms of the infection.

RESULTS

The presence of multiple cavities and aggregated grains were more common in eumycetoma than in actinomycetoma. The echotexture was significantly more heterogeneous in eumycetoma than in actinomycetoma (p = 0.03). Eumycetoma had higher vascularity than actinomycetoma.

CONCLUSION

Mycetoma has characteristic sonographic features and patterns of vascularity, which are essential to differentiate between the fungal and bacterial forms of mycetoma.

Acceptability and potential impacts of innovative E-Portfolios implemented in E-Learning systems for clinical training

Objective

There is growing evidence that use of E-portfolios has a positive effect on learning experience. However, literature has not shown sufficient data about the effectiveness of E-portfolios in medical education. This study was conducted to assess the acceptability and potential impacts of E-portfolio use for undergraduate radiography students.

Methods

This cross-sectional quantitative study was conducted during the academic year 2016-2017 on students studying clinical courses. A self-administered questionnaire was distributed to the selected cohort of students. All participants completed the consent form before answering the questionnaire.

Results

Of 75 students, 66 completed the survey (response rate; 88%). Students' experience, students' learning support, and the challenges of E-portfolio use were identified. Forty-one (62%) students perceived that E-portfolios facilitated the effective organization of their work, and 40 (61%) agreed that E-portfolios enhanced their professional skills. In contrast, the students perceived a negative correlation between students' learning support and future utilization of E-portfolios (correlation coefficient -0.394, p = 0.05). Future utilization of E-portfolios was found to be positively correlated with challenges and commitment to deadlines, with correlation coefficients of 0.371 and 0.152, respectively.

Conclusion

The study found that continuous technical support for E-portfolios throughout the course had a potential role in enhancing learning experience. Appropriate training for integrating E-portfolios into teaching and learning can potentially enrich the educational environment. Student and faculty feedback is the main cornerstone for E-portfolio success.

MEASUREMENTS OF RADIATION EXPOSURE OF RADIOGRAPHY STUDENTS DURING THEIR CLINICAL TRAINING USING THERMOLUMINESCENT DOSIMETRY

Radiation dose monitoring for radiography students during clinical training is necessary to demonstrate the extent of radiation protection issues present, as well as to instill in them an awareness of safe practices that they will carry with them throughout their careers. The study assess the radiation dose incurred by the undergraduate during clinical training. 312 students were monitored using (thermoluminescence dosimetry) between 2009 and 2015. The results establish that the radiation dose received by the students is well below the dose recommended by national and international authorities. Findings indicate that the dose did not reach the value of 1 mSv, which indicate that current radiation protection measures are acceptable and there was no risk of overexposure, as well as reinforces the importance of nuturing a culture of radiation protection and provides evidence to students that their future as professionals will be a safe one.

Radiation Dose Associated with Multi-Detector 64-Slice Computed Tomography Brain Examinations in Khartoum State, Sudan

Background

Radiation exposure due to computed tomography (CT) has become an important issue, as the number of CT examinations has been increasing worldwide. Radiation doses associated with CT are higher in comparison to other imaging procedures. CT-related radiation doses should be monitored and controlled in order to ensure reduction of radiation exposure and optimization of image quality. The aim of this study was to evaluate radiation doses in adult patient who underwent routine CT brain examinations, and to assess how CT scanning protocols affect patient doses in practice.

Material/Methods

A total of 118 patients underwent brain CT at two radiology departments equipped with 64-slice CT scanners, Khartoum, Sudan. Patient doses regarding weighted CT dose index (CTDI_w) and dose length product (DLP) values were recorded. Quality control tests were performed for both scanners.

Results

The mean CTDI_w values ranged from 62.9 to 65.8 mGy, DLP values ranged from 1003.7 to 1192.5 mGy, and the effective dose varied from 2.4 to 3.7 mSv.

Conclusions

Patient doses in this study was higher compared to previous research, suggesting that patients exposed to unnecessary radiation. Therefore, optimization of radiation doses with the use of specified imaging protocols, well-documented indications for CT, training of technicians, and quality control programs will reduce the necessary radiation doses. Establishment of the diagnostic reference level is recommended for further dose reduction.