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They’re replacing the gantry to our CT scanner this weekend. They moved it a few meters towards the...

Thu, 09 May 2013 07:34:00 -0400

They’re replacing the gantry to our CT scanner this weekend. They moved it a few meters towards the door today so the place where it was once standing is now vacant, aside from the huge globs of hardened Isovue-370 that made its way under the scanner over the last couple years. I’ve been trying to dissolve it with hot wet facecloths but is doesn’t seem to be doing the trick.

Anyone have any secret magic tricks for getting contrast off stuff?

The Next 3 Years: Open Heart Bypass Surgery

Fri, 26 Apr 2013 14:51:47 -0400

The Next 3 Years: Open Heart Bypass Surgery:

When I was a student I had the opportunity to watch an open-heart surgery. It’s pretty amazing to see the heart and lungs working away with your own eyes, rather than 2D in black and white.

They’ve been doing TAVIs at my hospital for a little less than a year. So, I do pre-TAVI and post-TAVI CTs. For the pre-TAVI we do a Coronary CT angiogram followed by a CT angio chest,abdo,pelvis for planning and to make sure the valve will fit through the artery. Post-TAVI is just a regular coronary CTA to confirm correct placement.

thenext3years:

Today. TODAY. Was just amazing. I trekked upstairs to the cardiothoracic operating theatres and observed a mini Aortic Valve Replacement (mini AVR) and a Coronary Artery Bypass Graft (CABG) surgery. AMAZING.

I stood so I could directly see what the surgeons saw. I visualised the heart beating…

theboringworldofnielsbohr: mouseinscrubs: thenext3years: radio...

Fri, 12 Apr 2013 18:41:00 -0400

theboringworldofnielsbohr:

mouseinscrubs:

thenext3years:

radiopaedia:

Q: How sure can you be that there is a bony injury here? ANSWER: http://goo.gl/vPf1J

via our Facebook page

On seeing these pictures I would most certainly have done an oblique view, just to see if it showed any more information.

I don’t think the oblique view would have helped much. Sometimes the nail needs to be taken out before one can assess the damage properly. Frankly said, I’d have used fluoroscopy to check for a fracture and, had I seen none, I’d have taken out the nail and redone the x-ray.

I was told by one of my lecturers that you should take a tangential view with the foreign body end on, so you can see exactly what route its taken into the patient. That way you can assess if it is interacting with the bone.

I second that, theboringworldofnielsbohr. Tangential views (beam perpendicular to the nail) and en-face views (beam “down the barrel” of the nail) are really helpful in trying to tell whether the nail is in bone or not. And if you can get an image where the tip of the nail is projected clear of the bone, then you can know it isn’t in bone.

This is a really great article on imaging nail gun injuries: http://www.wikiradiography.com/page/Imaging+Nail+Gun+Injuries

Image Interpretation for Radiological Technologists

Sun, 07 Apr 2013 22:14:00 -0400

Image Interpretation for Radiological Technologists:

This looks like an interesting course.

From the course website: “Radiological technologists learn to recognize pathologies as they gain more experience in a clinical setting and interest in radiographer role extension is growing. With the implementation of radiographer abnormality detection schemes (RADS) or “red-dot systems” in countries such as the UK, RTs have an opportunity to expand their knowledge and understanding of the images they produce. This course will introduce the concept of “red dot systems”, provide the MRT (R) with a systematic method for reviewing radiographs and will provide information on the clinical assessment, radiography and image interpretation of each anatomical area.“

I hate it when I’m not even finished my current degree and I already want to do so many things after I graduate!

edit: Thanks for your comment spearfame. Red-dot/radiographer abnormality detection schemes may be outdated in the UK but as far as I know there is no radiographer reporting in Canada at all. A small number of radiological technologists provide impressions/comments in some places according to a survey (CAMRT, 2008), but not around here.

Reference

CANADIAN ASSOCIATION OF MEDICAL RADIATION TECHNOLOGISTS 2008 “Advanced Practice Survey for Radiological Technologists” Canadian Association of Medical Radiation Technologists http://www.camrt.ca/abouttheprofession/advancedpractice/08advanced_practice_survey.pdf (accessed April 2013)

General questions for anyone in the radiography/ology field: Do...

Mon, 01 Apr 2013 21:57:00 -0400

General questions for anyone in the radiography/ology field: Do radiographers/radiologic(al) technologists at your institution inject Hyoscine Butylbromide/Buscopan?

We don’t at my site, the radiologist or resident does. I am writing a paper on this so, just curious!

MRI Education in Canada

Sat, 30 Mar 2013 19:56:00 -0400

Recently I’ve been thinking a lot about studying MRI after I finish my masters. In Canada, there are basically 6 options for studying MRI as a second discipline. My selection criteria are I want to be able to take the didactic portion through distance education so I can continue working while I study. I want to be able to do my clinical practicum at the hospital where I currently work. And, I want to complete the program as quickly as possible.

Red River College, Winnipeg, Manitoba, Fanshawe College of Applied Arts & Technology, London, Ontario and Cambrian College of Applied Arts and Technology, Sudbury, Ontario are not available through distance education. So, lets take a look at the other options: 

British Columbia Institute of Technology, Burnaby, British Columbia
• Duration 19-20 months 
• Courses:
⁃ Sectional anatomy of the abdomen and pelvis
⁃ Sectional anatomy of the thorax and neck
⁃ Sectional anatomy of the head
⁃ Sectional anatomy of musculoskeletal system
⁃ MRI practicum
⁃ Magnetic Resonance Imaging: Physical Principles
⁃ Magnetic Resonance Imaging: Imaging Techniques Q.C. and Artifacts
⁃ Magnetic Resonance Imaging: MR procedures and clinical applications
• Having worked in CT for >1 year, I could potentially challenge the 4 anatomy courses which brings the price down to 370.30 CAD each. This would bring the program course from 5916.80 CAD to 4439.60. If I could challenge all 4 courses at once the program might be able to be shortened to 1 year. I don’t know if it works like this though. Anyone have experience with this program?
• Textbooks are not listed on website :(

Northern Alberta Institute of Technology, Edmonton, Alberta
• Duration: 20 months
• Courses
⁃ Physics 1
⁃ Physics 2
⁃ Cross sectional anatomy I
⁃ Cross sectional anatomy II
⁃ Patient Care and Safety
⁃ Techniques and applications
⁃ Clinical Practicum
• Tuition: 7650.00 CAD
• Textbooks:
⁃ Hashemi RH, Bradley WG, MRI the Basics, 3rd ed.
⁃ Westbrook C, Kaut C, MRI in Practice, 3rd ed.
⁃ Kelly LL, Peterson CM, Sectional Anatomy for Imaging Professionals, 2nd ed.
⁃ Shellock F, Magnetic Resonance Procedures: Health Effects and Safety Issues, 1st ed.
⁃ Westbrook C, Handbook of MRI Technique, 3rd ed.
⁃ Grey ML, CT & MRI Pathology A Pocket Atlas, 1st ed.

Michener Institute, Toronto, Ontario
• Duration: 19 months
• Courses:
⁃ Physics of MRI
⁃ Patient care, Safety, and Professionalism
⁃ Introduction to anatomy and pathology
⁃ Cross sectional anatomy & Physiology
⁃ Methodology I
⁃ Methodology II
⁃ Clinical Education
• Tuition: 8829 CAD
• Textbook list:
⁃ Eisenberg RL, Comprehensive Radiographic Pathology, 5th ed.
⁃ Torres LS, Patient Care in Imaging Technology, 7th ed.
⁃ Westbrook C, MRI in practice, 4th ed.
⁃ Westbrook C, MRI at a glance, 2nd ed.
⁃ Kshitii M, MRI of the whole body: Illustrated guide to common pathologies, 1st ed.
⁃ Grey M, CT & MRI Pathology: A Pocket Atlas, 2nd ed.
⁃ McRobbie DW, MRI from picture to proton, 2nd ed.
⁃ Hashemi RH, Bradley WG, MRI the Basics, 3rd ed.
⁃ Bayer Healthcare: MRI for Technologists: A continuing education program, 2nd ed (http://www.icpme.us/)
⁃ Weir J, Imaging Atlas of Human Anatomy, 4th ed.
⁃ Westbrook C, Handbook of MRI Technique, 3rd ed.
⁃ Roth CK, Rad Tech’s Guide to MRI: Procedures, Patient Care and Safety, 1st ed.
⁃ Runge V, The Physics of Clinical MR Taught through Images, 2nd ed.
⁃ Bright A, Planning and Positioning in MRI, 1st ed.

Conclusion: It looks like all the courses would take about the same amount of time. Except the BCIT course, if I can challenge the cross sectional anatomy exams. Whether I can challenge the x-sectional courses of not, BCIT would be the cheapest.

24 hours in the NHS

Thu, 28 Mar 2013 06:02:00 -0400

omgitsalex:

it’s only 15 minutes in, and I have seen a lot of imaging equipment, and a lot of images, but zero sightings or mention of a radiographer. Frankly, it seems like the radiologists just performed that ct brain. Unlikely.

And we wonder why people don’t know who we are!

I’ll keep you all posted.

My national association, the Canadian Association of Medical Radiation Technologists did a survey of the public and found that only 10.5% of Canadians knew that Medical Radiation Technologists performed their diagnostic imaging study. A larger percentage (26.6%!!!!!) thought that we were Doctors, Lab technicians (15.6%) or Nurses (7.4%). This isn’t really surprising though is it? How many times during the day do patients mistake you for one of these other professionals. This is a good opportunity to correct them so they can learn who we are and what we do.

The CAMRT actually stated a campaign to try to increase public awareness of our profession (see that beautiful web-banner?). One of the initiatives promoted through this campaign is to get Medical Radiation Technologists to “N.O.D.” which is an abbreviation for Name, Occupation, Do. They suggest when you first meet your patient, you should tell them your name, job title and what you are going to be doing for them. That way, gradually, the public will become more aware of who we are.

Got the latest issue of the Journal of Medical Imaging and...

Tue, 26 Mar 2013 10:40:37 -0400

Got the latest issue of the Journal of Medical Imaging and Radiation Sciences in the mail. I find this journal is very therapy dominated. In this issue, out of 6 articles, 5 are therapy and 1 is diagnostic/therapy. The 1 diagnostic/therapy article is:

SNAITH BA 2013 “Peer-review publication patterns: A comparison of international radiography journals” Journal of Medical Imaging and Radiation Sciences 18(1) pp 37-43

The author looked at 4 radiography journals, The Journal of Medical Imaging and Radiation Sciences (Canada), Radiography (UK), The South African Radiographer, and The Radiographer (Australia).

I hadn’t previously read anything from The Radiographer so I searched for it online to have a look-see. According to their website (http://onlinelibrary.wiley.com/doi/10.1111/jmrs.2013.60.issue-1/issuetoc) the journal has just partnered with the New Zealand journal, Shadows, to form a new journal, the Journal of Medical Radiation Sciences. The first issue was published just this month.

Anyway, back to Snaith (2012). The aim of the paper was to “review the radiography profession in terms of [its] publications to explore the evidence base and identify its evolution internationally”.

The article confirms my accusation that the JMIRS is mostly therapy articles. Both the JMIRS and The Radiographer had more therapy than diagnostic articles in the 8-year period but overall, the 4 journals had more diagnostic articles than therapy. The author found that Radiography had the most international authors. And, over time, all journals had fewer articles by a single author and more international authors.

It is also interesting that the author, a UK based radiographer, chose to publish the article in a Canadian journal, therefore increasing the internationality of the JMIRS.

I think these metrics all demonstrate a growth of research being performed in our profession. However, it doesn’t demonstrate an increase of the use of research in practice. It seems like many articles I read speak to how most of radiography practice isn’t based on research. In fact, in a recent response to a letter to the editor in Radiography, the authors wrote: “In many areas conventional radiographic practice is still based on techniques developed for film-screen with little or no formal evidence base” (Manning-Stanley et al, 2013).

References

Manning-Stanley AS, Ward AJ, England A 2012 “Response to: ‘Considerations for AEC selection in radiography of the pelvis’” Radiography, In Press.

SNAITH BA 2013 “Peer-review publication patterns: A comparison of international radiography journals” Journal of Medical Imaging and Radiation Sciences 18(1) pp 37-43

xraykinny: theviewbox: xraykinny: The shiny new x-ray...

Tue, 26 Mar 2013 07:23:00 -0400

xraykinny:

theviewbox:

xraykinny:

The shiny new x-ray machine

It’s precious <3333

*hugs it forever*

Just out of curiosity, is the orientation of the AEC detectors marked anywhere on the table? My journal club is reading “Manning-Stanlet AS, Ward AJ, England A “Options for radiation dose optimisation in pelvic digital radiography: A phantom study” Radiography 18(4) pp 256-263” tonight. In the article they discuss how whether the AEC chambers are cranially oriented like on your wall bucky or caudally oriented. I took a look around my department and its only marked on the digital room, not the CR rooms. In theory the concept should apply to CR as well as DR. Now I’m wondering if it is usually marked or not?

Hello there! That’s a good question and if I remember correctly then no the AEC detectors weren’t marked on the table at all, in fact now that you mention it I have not seen them marked on the tables of the other machines in the department (There’s 3) as well so I guess they are not usually marked though like you mentioned in theory the concept should be applied to CR too.

That is a very interesting article you are all discussing i’m interested to know more about it are there any other articles of this?

I initially heard of this idea at the ISRRT congress last year in Toronto when I attended a presentation by Louise Harding and Paula Evans who actually worked on this research. Here is a link to the presentation they gave:

http://www.2012isrrt.org/presentations/Sunday/0900-1000/RAD-8%20Harding%20Louise.pdf

In their presentation they show that the actually did a study on patients, rather than just the anthropomorphic phantom. Also, they used both CR and DR! They found the same results as the published paper by Manning-Standley et al (2012).

I have’t seen any other research looking at the effect of AEC orientation on dose. There is also a letter to the editor in press in Radiography called “Considerations for AEC selection in radiography of the pelvis” and then the original authors’ response, ”Response to: ‘Considerations for AEC selection in radiography of the pelvis’”

There is lots of discussion about whether the dose is so low that image quality is too low and therefore not diagnostic. In the phantom paper, they did not allow for adjusting windows so I don’t know if thats clinically relevant. In the conference presentation it doesn’t specify if windowing was allowed.

At my journal club last night we were split about 50/50 as to whether we would want to adopt this in clinical practice. Some thought that it wouldn’t be practical in a clinical setting because they said they don’t usually use AEC anyway because they can’t be sure it is overlying bone. The other half (myself included) thought that if a clinical study was performed assessing for clinical utility in the diagnosis of a pathology rather than just an overall image quality assessment, and the images were still diagnostic then it would be worth incorporating into practice to achieve a ~40% reduction in dose.

xraykinny: The shiny new x-ray machine It’s precious...

Mon, 25 Mar 2013 16:53:29 -0400

xraykinny:

The shiny new x-ray machine

It’s precious <3333

*hugs it forever*

Just out of curiosity, is the orientation of the AEC detectors marked anywhere on the table? My journal club is reading “Manning-Stanlet AS, Ward AJ, England A “Options for radiation dose optimisation in pelvic digital radiography: A phantom study” Radiography 18(4) pp 256-263” tonight. In the article they discuss how whether the AEC chambers are cranially oriented like on your wall bucky or caudally oriented. I took a look around my department and its only marked on the digital room, not the CR rooms. In theory the concept should apply to CR as well as DR. Now I’m wondering if it is usually marked or not?

gloq: When you’re in the xray department for 8 hours and you...

Mon, 25 Mar 2013 15:48:08 -0400

gloq:

When you’re in the xray department for 8 hours and you walk outside at the end of the day..

chordae—tendineae: So apparently it’s my fault that no-one in theatre or on the ward checked...

Fri, 01 Mar 2013 15:19:29 -0500

chordae—tendineae:

So apparently it’s my fault that no-one in theatre or on the ward checked the LMP of a patient even though it’s in the pre-op checklist and even though I went to theatre as soon as they called for me, I was “late” and couldn’t ask the patient myself as she was already asleep. Ugh.

Not our responsibility at my site either but I wonder what would happen in your situation. I had a near scare the other day: CT abdomen on a woman of child-bearing age. I asked her if there was any chance of pregnancy and she said no, about 10 mins after the scan the reporting rad rushed in and asked if I asked her about pregnancy because there was something in her uterus on the scan. Sometimes I wish our policy was a little more formal. Even though I followed our policy, I wonder what would have happened if she had been pregnant.

thenext3years: So I’m rushing down the corridor back to X-ray...

Wed, 20 Feb 2013 17:51:00 -0500

thenext3years:

So I’m rushing down the corridor back to X-ray from an urgent portable on the wards and all I can hear in the 3am deserted hospital corridor is the sound of something trailing along the floor! What!?

I look down to see the exposure cord dragging along the floor!

Not only do me and my friend wear a thyroid shield on portables, but it has become apparent that we pull that cord out so far that it’s permanently stretched it!

Radiation Protection at it’s extreme! I don’t be playing that genetic mutation game!

Mine is stretched out like that too. I loop it over the holder so it doesn’t drag on the floor. We don’t wear thyroid shields or lead aprons on mobiles here though, unless we have to stand < 3m from the patient/tube.

Lots of MRI music videos lately.

Thu, 07 Feb 2013 01:53:31 -0500

Lots of MRI music videos lately.

Charlotte Gainsbourg had a waterskiing accident and had a few...

Sat, 19 Jan 2013 19:45:52 -0500

Charlotte Gainsbourg had a waterskiing accident and had a few MRIs and then wrote this song using MRI sounds as a percussion instrument!

Off to work to do this!!!

Sun, 13 Jan 2013 09:58:10 -0500

Off to work to do this!!!

Photo

Thu, 10 Jan 2013 15:21:13 -0500

So professional. Also, post-processing collimation is a bad...

Thu, 10 Jan 2013 15:06:00 -0500

So professional. Also, post-processing collimation is a bad habit!

"Gentlemen, damn the sphenoid bone!"

Mon, 31 Dec 2012 10:55:55 -0500

“Gentlemen, damn the sphenoid bone!”

- Oliver Wendell Holmes (1809-1894)

Radiography Nerd: cannobeans: omgitsalex: uninnocentelegantfall: I can’t even with how...

Tue, 25 Dec 2012 20:41:00 -0500

Radiography Nerd: cannobeans: omgitsalex: uninnocentelegantfall: I can’t even with how...:

cannobeans:

omgitsalex:

uninnocentelegantfall:

I can’t even with how badly house portrays imaging procedures… Let’s look at the scout scan to diagnose the CT (which coincidentally didn’t look like a CT scanner at all…)

OR the time they went for an MRI scan. The scanner…

Please do, Radiography Nerd!!! Please do!