Loading...
5 results
Search Results
Now showing 1 - 5 of 5
- Perceção visual na avaliação diagnóstica em mamografia: uma revisão sistemáticaPublication . Lança, Carla; Reis, Cláudia; Lança, LuísIntrodução – Na avaliação diagnóstica em mamografia, o desempenho do radiologista pode estar sujeito a erros de diagnóstico. Objetivo – Descrever a importância da perceção visual na análise da mamografia, identificando os principais fatores que contribuem para a perceção visual do radiologista e que condicionam a acuidade diagnóstica. Metodologia – Estudo descritivo baseado numa revisão sistemática de literatura através da PubMed e da Science Direct. Foram incluídos 42 artigos que respeitavam, pelo menos, um dos critérios de inclusão no estudo. Para a seleção das referências foi utilizada a metodologia PRISMA, constituída por 4 fases: identificação, seleção preliminar, elegibilidade e estudos incluídos. Resultados – Na avaliação diagnóstica em mamografia, a perceção visual está intimamente relacionada com: 1) diferentes parâmetros visuais e da motilidade ocular (acuidade visual, sensibilidade ao contraste e à luminância e movimentos oculares); 2) com condições de visualização de uma imagem (iluminância da sala e luminância do monitor); e 3) fadiga ocular provocada pela observação diária consecutiva de imagens. Conclusões – A perceção visual pode ser influenciada por 3 categorias de erros observados: erros de pesquisa (lesões não são fixadas pela fóvea), erros de reconhecimento (lesões fixadas, mas não durante o tempo suficiente) e erros de decisão (lesões fixadas, mas não identificadas como suspeitas). Os estudos analisados sobre perceção visual, atenção visual e estratégia visual, bem como os estudos sobre condições de visualização não caracterizam a função visual dos observadores. Para uma avaliação correta da perceção visual em mamografia deverão ser efetuados estudos que correlacionem a função visual com a qualidade diagnóstica. ABSTRACT - Introduction – Diagnostic evaluation in mammography could be influenced by the radiologist performance that could be under diagnostic errors. Aims – To describe the importance of radiologist visual perception in mammographic diagnostic evaluation and to identify the main factors that contribute to diagnostic accuracy. Methods – In this systematic review 42 references were included based on inclusion criteria (PubMed and Science Direct). PRISMA method was used to select the references following 4 steps: identification, screening, eligibility and included references. Results – Visual perception in mammography diagnostic evaluation is related with: 1) visual parameters and ocular motility (visual acuity, contrast sensitivity and luminance and ocular movements); 2) image visualization environment (room iluminance and monitor luminance); and 3) eyestrain caused by image daily consecutive observation. Conclusions – Visual perception can be influenced by three errors categories: search errors (lesions are never looked at with high-resolution foveal vision), recognition errors (lesions are looked at, but not long enough to detect or recognize) and decision errors (lesions are looked at for long periods of time but are still missed). The reviewed studies concerning visual perception, visual attention, visual strategies and image visualization environment do not describe observer’s visual function. An accurate evaluation of visual perception in mammography must include visual function analysis.
- Plain radiography has a role to play in current clinical practice in Western SwitzerlandPublication . Reis, Cláudia; Gulizia, Marianna; Champendal, Mélanie; De Labouchere, Stephanie; Sun, Zhonghua; Silva, CarinaAim: The aim of the study was to investigate the current role of conventional radiography examinations in Western Switzerland and the main clinical indications required to justify the use of this imaging examination. Methods: Ethical approval was obtained from the Vaud Ethics Committee (Ref 2020–00311). An online questionnaire was specifically designed and implemented on the data collection tool LimeSurvey composed of two parts: a) to characterise the participants’ profile and their institutions and b) 169 projections for the different anatomical areas (upper and lower limbs, pelvis, skull, spine, thorax, abdomen) were presented to collect data about the frequency and main clinical indications. Statistical analysis was performed using the software IBM SPSS® (Statistical Package for the Social Sciences) version 26. Results: Radiographers from 60% (26/43) of the invited institutions participated in this survey, mainly from the Vaud region. The upper and lower limbs were the most commonly examined by using conventional radiography mainly for trauma and degenerative disorders. The thorax was also an anatomical area commonly explored by X-rays, and so was the spine (cervical and lumbar lateral). The skull radiographs were rarely performed in clinical practice and some of the projections were not being used, namely Hirtz, Tangential Nose Bones, Worms, and Caldwell's views. Conclusions: Plain radiography is being used in clinical practice mainly for appendicular skeleton studies and for trauma and degenerative pathologies. Adaptations in radiographers’ education and training and other healthcare professionals are needed to provide the judicious use of data that radiographs can give to better manage the patients’ imaging pathway.
- Optimisation of exposure parameters using a phantom for thoracic spine radiographs in antero-posterior and lateral viewsPublication . Reis, Cláudia; Caso, M.; Dolenc, L.; Howick, K.; Lemmen, R.; Meira, A.; Shatku, F.; Aymon, E.; Ghotra, S. S.Introduction: To investigate the exposure parameters for thoracic spine/(TS) radiography that allows the image acquisition at the lowest dose possible, while maintaining an adequate image quality/(IQ) to identify all relevant anatomical criteria. Methods: An experimental phantom study was conducted, and 48 different radiographs of TS (24 AP/24 lateral) were acquired. The Automatic Exposure Control/(AEC) with the central sensor was used to select the beam intensity, while Source-to-Detector-Distance/(SDD) (AP:115/125 cm; Lateral:115/150 cm), tube potential (AP:70/81/90 kVp; Lateral: 81/90/102 kVp), use of grid/no grid and focal spot (fine/broad) were manipulated. IQ was assessed by observers with ViewDEX. Effective Dose (ED) was estimated using PCXMC2.0 software. Descriptive statistics paired with the intraclass correlation coefficient (ICC) were applied to analyze data. Results: The ED increased with a greater SDD for lateral view, presenting a significant difference (p = 0.038), however, IQ was not affected. For both AP and lateral, the use of a grid had a significant effect on ED (p < 0.001). Despite the images acquired without a grid had lower IQ scores, the observers considered the IQ adequate for clinical use. A 20% reduction in ED (0.042mSv–0.033 mSv) was observed when increasing the beam energy from 70 to 90 kVp for the AP grid in. The observers ICC ranged from moderate to good (0.5–0.75) in lateral and good to excellent (0.75–0.9) for AP views. Conclusions: The optimized parameters in this context were 115 cm SDD and 90 kVp with a grid for the best IQ and lowest ED. Further studies in clinical settings are necessary to enlarge the context and cover different body habitus and equipment.
- Optimisation of paediatrics computed radiography for full spine curvature measurements using a phantom: a pilot studyPublication . Reis, Cláudia; Ndlovu, Junior; Serrenho, Catarina; Akhtar, Ifrah; de Haan, Seraphine; Garcia, José António; de Linde, Daniel; Thorskog, Martine; Franco, Loris; Lança, Carla; Hogg, PeterAim: Optimise a set of exposure factors, with the lowest effective dose, to delineate spinal curvature with the modified Cobb method in a full spine using computed radiography (CR) for a 5-year-old paediatric anthropomorphic phantom. Methods: Images were acquired by varying a set of parameters: positions (antero-posterior (AP), posteroanterior (PA) and lateral), kilo-voltage peak (kVp) (66-90), source-to-image distance (SID) (150 to 200cm), broad focus and the use of a grid (grid in/out) to analyse the impact on E and image quality (IQ). IQ was analysed applying two approaches: objective [contrast-to-noise-ratio/(CNR] and perceptual, using 5 observers. Monte-Carlo modelling was used for dose estimation. Cohen’s Kappa coefficient was used to calculate inter-observer-variability. The angle was measured using Cobb’s method on lateral projections under different imaging conditions. Results: PA promoted the lowest effective dose (0.013 mSv) compared to AP (0.048 mSv) and lateral (0.025 mSv). The exposure parameters that allowed lower dose were 200cm SID, 90 kVp, broad focus and grid out for paediatrics using an Agfa CR system. Thirty-seven images were assessed for IQ and thirty-two were classified adequate. Cobb angle measurements varied between 16°±2.9 and 19.9°±0.9. Conclusion: Cobb angle measurements can be performed using the lowest dose with a low contrast-tonoise ratio. The variation on measurements for this was ±2.9° and this is within the range of acceptable clinical error without impact on clinical diagnosis. Further work is recommended on improvement to the sample size and a more robust perceptual IQ assessment protocol for observers.
- A comparative study about motivations, expectations and future plans for professional development in four European radiography programsPublication . Reis, Cláudia; Jorge, José; York, H.; Flaction, L.; Johansen, S.; Mæhle, S.Introduction: This study aims to compare motivations, expectations and work plans of students and teaching staff from four different European radiography programs, it aims also to explore areas that could be included to advance postgraduate studies. Methods: Two different questionnaires (open- and closed-end questions) were applied to key-informants, students who had just completed their bachelor thesis and teaching staff, to collect data regarding motivations, expectations, challenges, and potentials for radiography education and, plans for further work. Descriptive statistics and thematic analysis were performed according to the nature of the questions. Results: The response rates were 45% (students) and 68% (teaching-staff). The motivations to study radiography were similar between students: to work in a healthcare-service, helping people, manipulating high-end technologies, providing service while combining different knowledge (physics, patient-care, physiology, and anatomy). 75% of the students did not reach all their expectations due to the lack of focused and updated content for some areas. The teaching staff was expecting an extension of the radiographers' role. The development of advanced studies in computed tomography and magnetic resonance was highlighted as important by students. Future work plans included: self-improvement, the continuation of studies, specialization, research, and collaborations. Conclusions: This study increased the understanding of radiography education and provides insights into future perspectives. Participants have similar motivations, expectations, and future plans. Improvements in education should focus on technological developments and meeting job market demands. Further studies should be performed to identify approaches that acknowledge the specific needs of each country, while also providing strategies to harmonize radiography education in Europe.