Browsing by Author "Foley, Shane"
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- Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll projectPublication . Rainford, Louise; Santos, Joana; Alves, Francisco; Figueiredo, João; Hoeschen, Christoph; Damilakis, John; Frija, Guy; Andersson, Jonas; McNulty, Jonathan; Foley, Shane; Bacher, Klaus; Nestle, Ursula; Hierath, Monika; Paulo, GracianoBackground: A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU. Results: Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. Conclusions: A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.
- Impact of a radiological protection campaign in emergency paediatric radiology: a multicentric observational study in BrazilPublication . Oliveira Bernardo, Mônica; Morgado, Flávio; dos Santos, Alair Augusto Sarmet Moreira Damas; Foley, Shane; Paulo, Graciano; de Almeida, Fernando AntônioPurpose: To evaluate the impact of a paediatric radiological protection campaign, implemented in the emergency units of a healthcare provider network in Brazil. This campaign aimed to promote awareness among emergency department physicians, regarding justifcation of paediatric X-ray referrals for paranasal sinus, chest and CT exams, as a strategy to reduce exposure to ionising radiation. Method: Frequency analysis of common paediatric imaging referrals from 19 emergency departments was performed for a 3-year period (2015–2018) to coincide with before, during and after the implementation of the radiation protection campaign. The campaign was multifaceted and involved dissemination of educational materials and imaging referral guidelines along with quarterly meetings with participating centres’ leaderships. Additionally, patient dose cards were distributed to patients/carers. The Chi-Square test was used to examine the association between the type of examination and the patient’s age group. Exact-Fisher test was performed to check for an association between participant engagement and the existence of the radiation protection committee. Results: Referrals reduced by 25% following the campaign with no reports of misdiagnosis. Many referrals in the youngest age groups. In 15 units, a radiological protection committee was created to raise awareness and to create a multi professional team to communicate the risks and benefits of radiological procedure in children. Conclusion: The campaign resulted in a substantial reduction in radiological referrals while promoting a radiation protection culture. Simple education initiatives can contribute to savings in both finances and radiation doses, particularly important in radiosensitive cohorts.
- Paediatric CT optimisation utilising Catphanw 600 and age-specific anthropomorphic phantomsPublication . Santos, Joana; Batista, Maria; Foley, Shane; Paulo, Graciano; McEntee, Mark; Rainford, LoiuseThe purpose of the study is to perform phantom-based optimisation of paediatric computed tomography (CT) protocols and quantify the impact upon radiation dose and image noise levels. The study involved three Portuguese paediatric centres. Currently employed scanning protocols for head and chest examinations and combinations of exposure parameters were applied to a Catphan(®)600 phantom to review the CT dose impact. Contrast-noise ratio (CNR) was quantified using Radia Diagnostic(®) tool. Imaging parameters, returning similar CNRs (<1) and dose savings were applied to three paediatric anthropomorphic phantoms. OsiriX software based on standard deviation pixel values facilitated image noise analysis. Currently employed protocols and age categorisation varied between centres. Manipulation of exposure parameters facilitated mean dose reductions of 33 and 28 % for paediatric head and chest CT examinations, respectively. The majority of the optimised CT examinations resulted in image noise similar to currently employed protocols. Dose reductions of up to 33 % were achieved with image quality maintained.
- The establishment of computed tomography diagnostic reference levels in PortugalPublication . Santos, Joana; Foley, Shane; Paulo, Graciano; McEntee, Mark; Rainford, LouiseThe aims of this study were to investigate the frequency of Portuguese computed tomography (CT) examinations, identify protocol application and establish diagnostic reference levels (DRLs). CT departments (n=5211) were surveyed nationally (June 2011-January 2012) and CT protocol information and dose data were collected, as were retrospective age-categorised paediatric CT data from three national paediatric centres. The proposed national CT DRLs (CTDIvol) for adults were 75, 18, 14, 18, 17, 36, 22, 27 and 16 mGy for head, neck, chest, abdomen, pelvis, cervical, dorsal, lumbar and joints, respectively. The levels for paediatric head and chest examinations were as follows: 48 and 2 mGy (newborns), 50 and 6 mGy (5 y olds), 70 and 6 mGy (10 y olds) and 72 and 7 mGy (15 y olds). A limited number of current paediatric protocols aligned to recommended international age categorisations. Portuguese DRLs were generally higher than European recommendations, suggesting potential for optimisation. The need for greater standardisation of age-categorised paediatric protocols was identified.
- The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomographyPublication . Santos, Joana; Foley, Shane; Paulo, Graciano; McEntee, Mark F.; Rainford, LouiseThe volume of CT examinations has increased with resultant increases in collective dose values over the last decade.Objective: To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations. Materials and methods: Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed. Results: Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693). Conclusion: Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings.