A research partnership model frames university-clinical collaboration as central to strengthening medical radiation sciences research capacity. By aligning students, academics, clinicians, resources, ethics processes, skills development and outputs, the model supports sustainable, evidence-informed practice with potential benefits for patients and professionals.
Consumer engagement, meaning the active involvement of patients and carers with lived experience, is increasingly recognised as central to high-quality, patient-centred healthcare, and in Australia it is embedded in national accreditation standards. Within diagnostic imaging departments, however, consumer perspectives remain under-represented in workplace education and continuing professional development (CPD), where educational activities have traditionally prioritised technical competency and workflow. This is despite the fact that clinicians frequently meet patients at vulnerable moments. This paper describes how a tertiary imaging department embedded consumer engagement across workplace education and CPD, governance and service improvement, and outlines practical lessons for departments wishing to implement similar initiatives. It draws on a series of initiatives undertaken within a tertiary imaging department between 2024 and 2025, including consumer storytelling within multidisciplinary workshops and continuing professional development, consumer co-design of patient information resources, a dedicated patient-experience role, and consumer participation in departmental governance. We considered these activities alongside established frameworks for patient involvement in health-professions education and for consumer participation, and we reflected on the practical conditions that distinguish meaningful engagement from tokenism: clarity of purpose, attention to consumer wellbeing, and a shift from symbolic inclusion towards genuine partnership. The activities are illustrated with feedback volunteered by clinicians and consumers, although we are careful to note that these reflections are not a formal evaluation. We argue that consumer storytelling and structured engagement are feasible, low-resource strategies that may promote reflection on empathy, communication and patient-centred practice, while offering practical approaches for embedding consumer engagement within imaging departments. Formal evaluation of educational and patient outcomes remains the necessary next step.
INTRODUCTION:Clinical educator roles support workforce capability, training consistency, and quality and safety across allied health professions. Large multi-site medical imaging services face challenges in delivering consistent education and credentialing across diverse craft groups. In 2024, an operationally funded multidisciplinary medical imaging clinical educator (CE) team was established across a tertiary health network; the aim of this study was to evaluate the short-term outcomes of this workforce education model. METHODS:A multidisciplinary CE model was implemented across radiography, sonography, nuclear medicine, nursing, and administrative roles. Education initiatives were organised across four interrelated domains: training and credentialing, cross-disciplinary collaboration, learning culture, and innovation. Outcomes were evaluated using participation metrics, credentialing data, and anonymous pre- and post-education confidence surveys. Evaluation was conceptually aligned with Kirkpatrick's framework, with reported outcomes reflecting Levels 1 (engagement) and 2 (self-reported learning), and emerging Level 3 indicators. RESULTS:Education reach and engagement increased following implementation of network-wide communication, digital infrastructure, structured CPD delivery, and simulation-based education. Simulation programs demonstrated improved self-reported confidence, including first-trimester communication (mean confidence increased from 2.7 to 3.5 on a 4-point Likert scale). These findings indicate early engagement and learning gains, with emerging behavioural indicators. CONCLUSION:An operationally embedded multidisciplinary medical imaging CE model can strengthen education visibility, workforce engagement, and early credentialing outcomes across a large multi-site service. Although longer-term organisational (Level 4) outcomes require further evaluation, this model provides a scalable and structured approach to workforce education delivery in complex medical imaging environments.
INTRODUCTION:Determining the appropriate volume of iodinated contrast media (ICM) for portal venous phase abdominal computed tomography (CT) remains challenging. Evidence is limited regarding the volume required for consistent enhancement and whether this translates into optimal subjective image quality. To address this gap, we compared fixed-volume and weight-based dosing strategies, utilising objective enhancement and subjective image quality to identify approaches that may optimise diagnostic performance. METHOD:The abdominal CT ICM dosing protocol was revised from fixed (100 mL) to weight-based (1 mL/kg, 10 kg increments) volume dosing. Data from 90 fixed and 90 weight-based ICM volume procedures were matched by age, gender, weight and kVp. Objective measures of ICM enhancement (Hounsfield unit, HU) were obtained in key vessels and organs. Subjective image quality scores were obtained from 24 cases per group, matched by weight and kVp, followed by visual grading characteristic (VGC) analysis. RESULTS:Weight-based dosing reduced the dependence of key vessel and organ enhancement on patient size compared with fixed dosing. VGC analysis comparing patients < 90 kg and ≥ 90 kg suggests light patients require greater HU enhancement than heavy patients to achieve equal subjective image quality. CONCLUSION:Consistent HU enhancement across all patient sizes can be achieved by using weight-based ICM volume dosing in abdominal CT, although this does not necessarily translate to consistent subjective image quality. Our findings suggest that lighter patients may benefit from greater enhancement to achieve equivalent subjective image quality to larger patients, highlighting the need for further optimisation of ICM dose strategies beyond standard weight-based approaches.
INTRODUCTION:Autistic individuals referred for medical imaging examinations may face barriers without appropriate adjustments. Strengthening the relationship between patients and the healthcare system is crucial, as positive patient experiences can improve adherence and future engagement with healthcare services. This study explored Australian radiographers' experiences and perceptions of imaging autistic patients. Terminology preferences among autistic individuals vary across countries, communities and individuals. This paper adopts identity-first language, 'autistic person' or 'autistic patient', aligned with recommendations from Australian organisations and medical imaging researchers. METHODS:Semi-structured online interviews were conducted via Zoom with 10 diagnostic radiographers. Anonymised transcripts were analysed using reflexive thematic analysis to identify patterns of meaning across participants' experiences. RESULTS:All radiographers (n = 10) reported experience performing medical imaging procedures for autistic patients. Four themes were identified: (1) Educational resources and recommendations, (2) Organisational factors affecting radiographic practice, (3) Patient and carer factors affecting radiographic practice, and (4) Key strategies that facilitate positive patient care. CONCLUSION:Although radiographers lacked formal training specific to caring for autistic individuals, they attributed positive patient experiences to their patient-centred approach, existing knowledge, communication skills, teamwork, and personal attitudes. Radiographers expressed interest in targeted training and remain committed to high-quality patient care. Improving the accessibility of radiology departments through collaboration with autism organisations and the broader community is essential to support better imaging experiences for all patients. Future research should prioritise the perspectives of autistic individuals and their families to comprehensively understand their medical imaging experiences and identify the range of meaningful, patient-defined indicators of quality care.
INTRODUCTION:In 2016 the National Institute for Health and Care Excellence (NICE) published guidance in England recommending computed tomography (CT) as the first line imaging for cervical spine (C-spine) injury in adults. However anecdotal evidence suggests that X-rays are still being performed. The aim of this evaluation was to determine the imaging referral patterns following C-spine trauma and compare with national guidance. METHODS:Within a single English organisation emergency department patient attendance data, X-ray and CT referral criteria and acquisition information for patients ≥ 16 years undergoing imaging of the C-spine was collated from a 12-month period (01.01.23-31.12.23). RESULTS:The cohort contained 302 females and 301 males, with a median age of 55 years. According to the clinical information 12.1% (n = 73/603) of the patients had no risk of C-spine injury and therefore should not have required diagnostic imaging. Almost two thirds of patients (n = 395/603; 65.5%) had first line CT imaging consistent with national guidance. Of those where imaging was justified, 135 patients had the incorrect initial diagnostic test (X-ray as opposed to CT) with 26 also having a subsequent CT. The quality of all of the X-rays were reviewed and only 39.5% (n = 73/185) of cases were diagnostic. CONCLUSIONS:In 2023, the organisation was 65.5% compliant with the guidance, with a number of patients referred for unjustified imaging examinations and/or the wrong initial imaging modality. The consequences of this included treatment delays, prolonged immobilisation, over-irradiation and impact upon resources, along with potentially missed pathology due to inconclusive X-rays.
Introduction A significant increase in the demand for radiography examinations and the corresponding rise in the workload of radiographers has been noted. Radiography imaging departments serve patients presenting with a wide range of conditions and abilities, and student radiographers have reported feeling unprepared, lacking confidence and experiencing stress and anxiety during such interactions. Additionally, they encounter challenges with effective communication and interpersonal engagement, making it difficult for them to recover from difficult experiences. These challenges highlight the need for research on resilience among student radiographers. The aim of the paper is to describe the process undertaken to develop a model to facilitate resilience in DR students, and to present the developed model.Method A qualitative, exploratory, descriptive, contextual and theory-generative approach was used to develop a model for facilitating resilience among diagnostic radiography (DR) students. Data were collected through focus groups with first-year DR students. Finalisation of the model was informed through input by experts in model development, radiography and nursing education.Results Five focus groups were analysed using thematic analysis, yielding four themes: students' understanding of resilience, students' readiness to commence in the clinical workplace, interpersonal interactions as they relate to the clinical environment and adapting to the clinical environment. Through inductive reasoning, central concepts were identified with facilitation, self-efficacy and social connections, forming the basis of the resilience model.Conclusion The model designed for the facilitation of resilience is recommended for use as a framework for educators to foster resilience among DR students.
INTRODUCTION:Over-scanning in CT refers to extending the scan range beyond intended anatomical boundaries, resulting in unnecessary ionising radiation exposure. Despite its frequent occurrence, it remains poorly defined and inadequately addressed within the radiological community. This scoping review examines the extent of over-scanning in CT imaging, including its definitions, assessment methods, contributing factors and mitigation strategies. METHODS:A scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed, Embase, Ovid and Scopus were searched for studies published between January 2010 and December 2025. Extracted data included definitions, assessment methods, prevalence, dose implications, contributing factors and mitigation strategies. RESULTS:Thirty-eight studies covering brain, chest, abdominal and multi-region CT protocols were included. Over-scanning was prevalent, averaging 75% (range 13%-100%), with excess coverage from 12 mm to about 90 mm, exceeding recommended anatomical margins. Associated effective dose increases ranged from 0.03 to 3.4 mSv, with organ-specific doses markedly higher in paediatric imaging and radiosensitive organs (thyroid, lungs, breasts, testes), amplifying long-term cancer risk. Directional patterns (superior/inferior) varied by protocol, influenced by anatomical complexity, scout-image limitations and radiographer caution to avoid under-coverage. CONCLUSION:Over-scanning in CT is a multifactorial issue driven by technical, operator, patient and system-level factors. Mitigation requires standardised protocols, radiographer training, education on over-irradiation risks, optimised scout image utilisation and technological support. Key strategies include consistent osseous landmarks, lateral scout views and AI-based planning tools, which offer promising solutions for automating scan range planning, detecting and reducing over-scanning through real-time monitoring and retrospective analysis and enhancing patient radiation safety.
Accelerated partial breast irradiation (APBI) delivers a higher dose to a smaller breast volume with equivalent tumour control to whole breast irradiation and improved cosmesis. The MR-Linac offers superior soft tissue visualisation and adaptive planning, but limited bore size may result in skin-couch contact, potentially affecting skin dose. This retrospective pilot study evaluated the effect of MR-Linac couch contact on skin dose. Three patients with left-sided breast cancer positioned prone with unavoidable skin-couch contact were included. MR images were acquired using a 1.5 T MR simulator and contoured for target and organs-at-risk. Step-and-shoot IMRT plans (30Gy in 5 fractions) were optimised and recalculated with and without magnetic field presence. Dose to the whole skin rind (Skin_Rind) and couch-contact region (Skin_Rind_Ant) were compared. All plans met target and OAR constraints. Mean Skin_Rind dose was consistently higher with magnetic field presence, while dose to Skin_Rind_Ant was consistently lower. These findings contrast with conventional linac data, suggesting magnetic field and interface effects may alter skin dose deposition.
ABSTRACT Breath‐hold techniques, including Deep Inspiration Breath Hold (DIBH) and Exhalation Breath Hold (EBH), are commonly used in radiation therapy to reduce radiation exposure to organs at risk while maintaining accurate tumour targeting. However, high failure rates during breath‐hold simulations have been associated with patient anxiety and insufficient preparation—particularly when instruction is given only 20 min prior to the procedure. These challenges are amplified for patients from culturally and linguistically diverse (CALD) backgrounds. To address this, a multilingual mobile application (app) has been developed to improve patient education, communication, and compliance, with a particular focus on supporting CALD patients. Replacing traditional pamphlets with interactive instructional videos, visual aids, and real‐time translation in seven languages, the app allows patients to familiarise themselves with breath‐hold techniques before their Computed Tomography (CT) simulation. A General Radiation Therapy (RT) section in the app further supports communication between radiation therapists (RTs) and their patients by providing translated commands for standard patient positioning and movement instructions, improving accuracy and workflow efficiency. The app integrates with in‐room sound systems, allowing RTs to provide remote coaching while maintaining clear and consistent communication. Additionally, the Frequently Asked Questions (FAQ) section of the app addresses common concerns that patients have about radiation therapy, helping them gain a better understanding with the possibility of reducing anxiety. The app has been implemented at the Northern Sydney Cancer Centre (NSCC) and is expected to improve patient compliance in breath‐hold techniques and streamline clinical workflows.
INTRODUCTION:Beyond improving target delineation, functional imaging holds significant promise in identifying critical functional brain regions. It enables a more personalised approach to radiation therapy (RT) planning, where organs-at-risk can be spared more effectively, potentially preserving neurocognitive function and quality of life in patients with glioma. This systematic review aims to identify the role of functional imaging in preserving neurocognitive function in patients with glioma undergoing RT. METHODS:A systematic review was conducted in December 2024 according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. Searches were performed in Scopus, MEDLINE and EMBASE using medical subject headings and keywords related to glioma, functional imaging, cognition and RT. Only English-language publications were included. The Critical Appraisal Skills Programme (CASP) checklist was used to assess the validity and applicability of the studies included in this systematic review. RESULTS:Five studies published between 2019 and 2023 were included in the review. The studies included retrospective cohort studies (n = 2), a pilot study (n = 1), a cross-sectional study (n = 1) and a theoretical study (n = 1). Quality assessment using the CASP checklist indicated moderate methodological quality, with limitations including small sample sizes, predominantly retrospective designs and limited prospective validation of neurocognitive outcomes. Functional imaging was shown to reduce the dose to cognitive areas and potentially protect important cognitive functions. CONCLUSION:Functional imaging identifies critical cognitive regions in the brain and guides radiation dose to avoid these vulnerable regions while maintaining therapeutic efficacy. Integrating functional imaging into treatment planning allows for neuroprotective strategies in RT planning and potentially minimises the risk of cognitive impairment. This review sets the stage for future research to expand the benefit of functional imaging in glioma RT planning.
This letter comments on Nagumo et al.'s study evaluating 1024-matrix reconstruction for intracranial perforating artery visualisation in 64-slice cerebral CTA, affirming its cost-effective value for standard CT scanners (https://doi.org/10.1002/jmrs.70055). We endorse the key finding that 1024-matrix improves small artery detection via higher sampling density, while highlighting the need for cross-vendor validation, workflow impact quantification, and clinical outcome assessment. This simple post-processing strategy is highly scalable, and further multicentre studies are warranted to confirm its universal utility.
INTRODUCTION:The Diagnostic Imaging Pathways (DIP) are a tool that has been developed to assist physicians with selecting appropriate imaging tests. Adherence to these imaging pathways and their impact on patient outcomes have not been explored. This study aims to assess the impact that adherence to the acute abdomen DIPs has on the number of imaging tests performed and patients' exposure to imaging modalities that utilise radiation. METHOD:Imaging requests and radiologist's reports of 1257 patients who presented to emergency departments with abdominal pain and had abdominopelvic computed tomography (CT) scans were collected over a period of 1 year. These data were classified into whether or not patients' imaging investigations followed the DIPs for undifferentiated acute abdominal pain. Based on this classification, we assessed the impact that adherence to the DIP had on diagnostic yield, patients' exposure to imaging tests that utilise radiation, and the number of diagnostic imaging tests performed. DISCUSSION:The results highlight poor adherence to DIPs with 71% of acute abdomen presentations not following the recommended pathways. While the proportion of pathologies detected when DIPs were followed compared to when DIPs were not followed was similar, there were significant reductions in the number of imaging tests performed and radiation dose burden to patients. Given the risks associated with radiation exposure and the need to optimise health resources, these results suggest that the DIPs are a useful tool for optimising radiation dose and cost in patients presenting with abdominal pain. CONCLUSIONS:Adherence to imaging guidelines shows a strong positive correlation in reducing patient exposure to radiation and multiple imaging.
Chronic stigmatisation and social exclusion of neurodivergent people have resulted in poorer quality of life and adverse health outcomes. Language has been weaponised and has furthered their suffering and isolation. With this paper, we propose some considerations of optimal communication interactions in healthcare with neurodivergent people, in general, and autistic people, in particular, to ensure respectful and human-centred patient and practitioner interactions across both clinical and academic practice.
As agentic artificial intelligence systems become increasingly embedded in medical imaging, practice is moving from episodic decision support to workflow-based architectures that alter how practitioners think and practise. Medical imaging practice is traditionally conceptualised using Dual Process Theory, which describes how practitioners use their System 1 (intuitive decision making) and System 2 (analytic decision making) in practice. However, as more practitioners incorporate agentic artificial intelligence systems into their workflow, a Tri-System framework may be required. This Perspective paper will show how the practitioner and an agentic artificial intelligence system become part of a cognitive team known as System 3. It will argue that an appropriate level of cognitive surrender should be considered and that current decision making should be reframed through diagnostic complementarity, with added emphasis on structured human and AI interaction to achieve optimal performance. We recommend the implementation of the following educational methods in radiography programmes: (a) training students using fault-injected medical images to reinforce the importance of human verification in image interpretation; (b) preparing students to supervise the performance of agentic artificial intelligence systems; (c) normalising AI-assisted activities to mitigate potential deskilling.
Clinical placements are vital for radiography students to consolidate knowledge and develop computed tomography (CT) skills. Whilst CT principles are commonly introduced in university curricula, teaching approaches during clinical placements remain variable and under-described. Clinical radiographers supervising students often balance service delivery with education, frequently without structured guidance. This educational article presents a practical framework to support CT education in clinical settings, organised into five interrelated domains: psychological safety, logistics, key CT teaching points, approaches to clinical instruction and competence assessment. Drawing on existing literature and authors' collective clinical and academic experience, the paper outlines strategies embedded within routine CT workflow to support intentional and staged student learning. Practical examples include orientating students to the CT environment, establishing baseline knowledge, aligning teaching with clinical workflow, scaffolding learning according to student readiness and using performance-based assessment methods appropriate to workplace learning. Challenges, including limited scanner access, variable student preparedness and time constraints, are addressed with pragmatic recommendations to support learning. The framework aims to support consistent, learner-centred CT education and strengthen collaboration between clinical supervisors and academic educators. Our team's future work will focus on developing co-designed resources for clinical CT education, designed to be cross-institutional and adaptable to local needs.
INTRODUCTION:Diagnostic radiographers work in environments where ionizing radiation is used, making radiation protective measures essential for occupational safety. Personal Radiation Monitoring Devices (PRMDs) are used by diagnostic radiographers to monitor cumulative occupational exposure, resulting from faulty equipment or unsafe work practices; however, research indicates that strict adherence to PRMD use is not consistent. The study aimed to explore radiographers' knowledge, awareness and adherence to PRMD use in five major state hospitals in Namibia. METHODS:A quantitative, cross-sectional and descriptive study was conducted using an online questionnaire. Fifty radiographers from five major Namibian public hospitals were targeted through convenience sampling. Data were analysed using IBM SPSS version 26 to assess levels of knowledge, awareness and adherence. RESULTS:Thirty radiographers participated in the study with a mean age of 32 years. Most respondents, n = 23 (77%), demonstrated adequate knowledge regarding PRMDs, with n = 26 (87%) 'strongly agreeing' that they understood the purpose of PRMDs. Regarding awareness, n = 14 (47%) showed good awareness; however, n = 22 (73%) reported not knowing their cumulative radiation exposure. Access to dose results was limited, with only n = 7 (23%) regularly reviewing their readings. Additionally, n = 22 (73%) reported that they would continue working without a PRMD. CONCLUSION:Namibian radiographers demonstrated adequate knowledge and awareness of PRMDs; however, adherence was low. It highlights the need for stricter compliance policies and enforcement. Further research is needed to investigate barriers to consistent usage and identify effective strategies to improve adherence.
INTRODUCTION:Ultrasound measures of perirenal adipose tissue (PRAT) have emerged as potentially efficient, cost-effective, and accessible methods for assessing cardiovascular disease (CVD) risk. Our recent systematic review supported the utility of PRAT measurement using ultrasound but highlighted a lack of standardised protocols for its clinical implementation. This measurement could be added to abdominal ultrasound examinations for little added time or cost to provide an important indicator of cardiovascular-significant obesity. The aim of this survey was to explore current practices and awareness of PRAT measurement among Australasian sonographers. METHODS:We conducted an online survey of Australasian sonographers aiming to explore respondents' knowledge of the distinct types of renal adipose tissue, and their understanding of PRAT thickness and its association with CVD. We asked if they measure it and, if so, what technique they use. Responses were assessed in terms of answers to knowledge questions or ability, and of interest or engagement. RESULTS:Albeit a low response rate, n = 42, both student and qualified sonographers were represented from metropolitan, rural, and remote settings, with a broad range of professional experience. Knowledge of renal anatomy, PRAT links with metabolic disease, and peri-renal fat layers varied. There was no consensus in the ultrasound technique for measuring PRAT. CONCLUSION:Findings revealed considerable variations in knowledge of PRAT and its clinical relevance. These differences are influenced by workplace setting, patient demographics, and level of sonographer experience. The results underscore the need for a standardised protocol to support the broader implementation of PRAT measurement in routine ultrasound practice.
Professional identity (PI) encompasses the values, knowledge, skills and attitudes aligned with an individual's role in the workplace and the expectations of a professional group. Due to the changing landscape of healthcare and the extended scope of practice of medical radiation practitioners (MRPs), their PI is also evolving. A well-formed PI can assist individuals, organisations and professions. For individuals, understanding PI can provide role clarity, a clear sense of purpose and direction, career progression opportunities, enhance work motivation and satisfaction, and improve well-being. For professions or organisations, a well-defined PI can increase workforce retention, improve work productivity and professional performance, support the professional development of individuals, and the way the profession is perceived by society. An understanding of the evolving PI of MRPs is required. Collaborative autoethnography (CAE) qualitative research can be feasibly used by MRPs to investigate their PI. To undertake CAE, the steps involved in the research process must be appreciated.
ABSTRACT Introduction Chest X‐rays (CXRs) play a crucial role in determining the placement of medical lines and tubes. However, visualisation of these devices can be limited due to imaging and patient factors, increasing the risk of undetected misplacements, repeated radiation exposure and delayed patient management. These challenges may be more pronounced for student radiographers who are still developing their radiography skills. Although X‐ray post‐processing algorithms, such as grey‐scale inversion (GSI) and Advanced Edge Enhancement (AEE), have the potential to optimise line and tube conspicuity, their effectiveness is not well established. Hence, this study aimed to evaluate the usefulness of GSI and AEE algorithms in enhancing visual image quality and reader confidence among student radiographers. Methods Twenty standard CXRs, demonstrating lines or tubes, were copied and processed using GSI and AEE algorithms. Images were paired as follows: Setting 1 (Standard—GSI), Setting 2 (Standard—AEE), Setting 3 (GSI—AEE). In each setting, participants used a relative visual grading characteristics (VGC) assessment to compare algorithms and indicated reader confidence using a 5‐point Likert scale. Results Twenty‐five students completed the VGC assessment. The Friedman test revealed a significant increase in reader confidence (χ2 (3) = 48.02, p < 0.001) in Settings 2 and 3. VGC analysis showed significantly higher visual grading scores with both GSI (AUCVCG = 0.72, p < 0.001) and AEE (AUCVCG = 0.91, p < 0.001) compared with the standard CXRs, with AEE outperforming GSI. Conclusion GSI and AEE appear to be valuable tools that merit integration into imaging protocols to promote best practices by optimising the use of resources, supporting diagnostic accuracy and potentially helping to minimise radiation exposure.
