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[en] This article examines the need for research in radiography as a means to provide the evidence base for radiographic practice. The review examines the role of the consultant radiographer in providing potential research leadership and outlines possible avenues for research. The article uses three main themes to set out its proposals: - The need for patient focus. - The need for a greater mix of research methods and, specifically, more studies which utilise qualitative methods. - The need for consultant leadership in research and some potential studies. The article concludes by arguing the need for a greater academic community in radiography with consultant radiographers stepping up to play their part in that community
[en] This case study describes a qualitative investigation of the experiences of 14 experienced mammography radiographers who successfully undertook a formal programme of education and training in stereotactic needle core biopsy (SNCB) of the breast. They now routinely perform SNCB within symptomatic and screening breast services in a variety of NHS hospitals across the country. All 14 radiographers completed a semi-structured postal questionnaire approximately six months after the end of the course. A tentative theory derived from the data suggests that the professional challenge associated with radiographer-performed SNCB builds personal confidence and effects positive change. Three main categories emerging from the data - challenge, confidence and change are underpinned by two main themes - educational, professional and service drivers that promote the realisation of goals and vision; and personal, peer and external motivation sustained by respect, recognition and reward. SNCB role extension as explored in this study is having a positive and transformational impact on patient users of breast diagnostic clinical services and on the professional health carers providing them. The key drivers for this as identified in the study are a formal educational experience, professional role extension opportunities and the NHS modernisation process. The participants experienced positive change as individuals and as professional breast cancer multidisciplinary team members. Academic and financial rewards, respect and recognition from colleagues across professional disciplines and from patients, were key motivators that sustained the process. This study indicates that radiographer-performed SNCB can help deliver the NHS Plan and the NHS Cancer Plan and in doing so has the potential to improve the working lives of health care professionals and ultimately to improve the quality of care for patients
[en] This article is based partly upon the Presidential Address of the Manchester Medical Society (Imaging Section) in 2008. It reviews the development of radiology services in the Manchester (UK) area from their inception in 1896 to the installation of the first EMI body CT scanner in Europe. It considers some of the innovative people in the Manchester area and some milestone events that occurred in that area to help establish the role and value of X-ray in diagnostic imaging. In this article the first recorded case of when X-ray imaging was used in a forensic domiciliary case is also outlined; this occurred approximately 35 miles north of Manchester on 23rd April 1896. The article also explains some interesting background information on the development of the first EMI CT scanner, drawing particularly on the revenue stream generated by the music section of EMI through the success of The Beatles - a band which emanated 35 miles from Manchester in Liverpool.
[en] Contrast-enhanced MRI is recognised as one of the most accurate imaging methods for investigating diseases of the liver. Uniquely several different types of contrast agents are available for liver MRI. They can be divided into non-specific extracellular fluid space (ECF), hepatocyte specific and reticulo-endothelial system (RES) specific agents. They are used to improve the detection of focal liver lesions by increasing normal-abnormal tissue contrast and to assist in lesion characterisation by demonstrating tissue perfusion and cellular function. ECF-gadolinium (Gd) chelates have been widely used in abdominal MRI for many years. They provide valuable information regarding the vascularisation and perfusion characteristics of lesions and assist in lesion detection, particularly of hypervascular lesions. The hepatocyte and RES-specific agents further improve lesion detection, provide important functional information and allow the distinction between hepatocellular and non-hepatocellular tumours. This article describes the different MR contrast agents and discusses their current status for diagnosing focal liver lesions. The importance of optimised technique and appropriate selection of contrast agent is emphasised
[en] By 1945, 50 years after Roentgen's discovery, conventional X-ray was still the only tool generally available for radiological investigation. In the following 30 years, building particularly on wartime work in nuclear physics, acoustics, and digital technology, a powerful new set of tools emerged, based largely on the concept of 'scanning'. Much of this resulted from the work of a relatively small number of individuals. Some of these were so far ahead of the conventional wisdom that they were dismissed as cranks by most of their contemporaries. This paper briefly outlines some of the early developments, particularly in the areas of ultrasound, CT, and radioisotope imaging, and recalls some of the characters involved, and very different welcomes that accorded them by the radiological community of the day. It also comments on the remarkably large part played in these developments by British workers, and contrasts this with the general failure of British industry to capitalise on the opportunities that were presented.
[en] The preparedness for practice of newly qualified healthcare professionals (including radiographers) has been the focus of attention in recent years as the practice environment continues to place great demands on its workforce. This paper reports an aspect of the findings from an oral history project on the career history of radiographers conducted as an academic research investigating the changes that have occurred in radiography and the impact these have had on the profession and the practice of radiography. The main focus of this paper is the lived experience of the informants of the oral history project as newly qualified radiographers. The findings are discussed in the context of current practice environment and developments in radiography. Analysis of the textual materials generated from informants' oral historical accounts, suggest radiographers trained in this time frame perceived their training as 'fit for purpose. The findings further suggest there is a general norm of 'get-on-with-it' as a coping strategy which is still prevalent in the profession today. The paper concludes by drawing on lessons that can be learned from the lived experiences of radiographers' oral historical accounts.
[en] The College of Radiographers state that the role of a Consultant Radiographer comprises four core functions [College of Radiographers. Developing a business case for consultant radiographers. London: College of Radiographers; 2003; Hardy M, Snaith B. How to achieve consultant practitioner status: a discussion paper. Radiography, in press. doi:10.1016/j.radi.2006.04.003 [accessed 16.08.07]]. The following reflective case study attempts to illustrate the value of these functions for improving patient care and service delivery. The project has made positive changes to the way practice, for patients requiring feeding tubes, is being undertaken. The emphasis is on reflection and the case study also shows how an action research approach can be used to tackle practice-based problems [Schoen Donald. The reflective practitioner. New York: Basic Books; 1983] and that the consultant practitioner is ideally placed to take advantage of the collaborative working opportunities fundamental to action research
[en] Interest in new blood vessel formation in tumours (angiogenesis) has led to the development of imaging strategies for investigating the microvascular structure and function of tumours. One such technique is dynamic contrast-enhanced MRI (DCE-MRI), where gadolinium based contrast agents are injected intravenously and serial image acquisitions are performed as the contrast agent passes through the tumour vascular bed. Sophisticated analyses can then be applied in order to produce indirect measures of parameters that represent blood flow, vascular volume, capillary permeability and surface area. The technique has been used to characterise malignant disease and to evaluate the effect of therapies that target tumour blood vessels. This article reviews the important image acquisition and data analysis principles behind DCE-MRI and highlights its use in clinical and research medicine to date
[en] Although much of the activity around D-day is recorded many of the support services such as radiography do not feature. This account of a radiographer at the Normandy landings gives an insight into the everyday work of a lone radiographer in the Armed Forces in the 1940s. This work is the product of an oral history taken by Jean Barrett in accordance with the acknowledged ethical requirements of oral history. Eric Wood has given his permission for the publication of his stories. The work was presented at the conference for the British Society for the History of Radiology 2008 (Sheffield).
[en] At the time of Roeentgen's discovery of X-rays, Australia was in a period of social transition. Federation under a centralised Australian government was at hand, while regional population centres were growing rapidly under various influences, such as the gold rush of the 1850s, the opening up of new pastoral land and the Great Drought of the 1890s. Reports of Roeentgen's discovery first appeared in Australian newspapers towards the end of January 1896. The first limited description of his experimental techniques appeared on the 15th February, arousing excitement in the antipodean scientific community. Independent attempts were made to produce X-ray images at several locations in Australia, the necessary apparatus being widely available. Three men have been separately credited with having been the first to produce a radiographic image using the techniques described by Roeentgen. Thomas Rankin Lyle, a Professor at Melbourne University performed a demonstration on the 3rd March 1896, X-raying a colleague's foot. The image was reproduced in the newspaper the following day. Lyle also performed a pre-surgical foreign body localisation on 12th June. Meanwhile, electrician and amateur scientist, Walter Filmer, produced a radiograph at Newcastle, also to localise a needle prior to surgical removal. Although the date of this examination is uncertain, it reportedly took place within days of the 15th February newspaper story, making it both the first successful attempt at radiography and the first medical use of X-rays in Australia. Filmer was later appointed to Newcastle Hospital as honorary 'X-ray operator'. The third was a catholic priest and Science Master at St Stanislaus' College at Bathurst in western New South Wales, Father Joseph Slattery. On 25th July 1896 he X-rayed the hand of a former student to locate gunshot pellets, saving the hand from amputation. All three men were remarkable for their scientific knowledge and ability and all are deserving of the title of early Australian X-ray pioneer. This paper tells each of their stories.