Radiography Open <p><strong><em>Radiography Open</em></strong> is an open access scientific journal that publishes scientific original articles, review articles, and case studies, within a broad understanding of radiography. In addition, <strong><em>Radiography Open</em></strong> publishes columns that underpin evidence-based practice within radiography.</p> OsloMet - Oslo Metropolitan University, Norway en-US Radiography Open 2387-3345 Authors who publish with this journal agree to the following terms:<br /><br /><ol type="a"><li>Authors retain copyright and grant the journal right of first publication, with the work after publication simultaneously licensed under a <a href="" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li></ol><br /><ol type="a"><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li></ol><br /><ol type="a"><li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new">The Effect of Open Access</a>).</li></ol> Microorganism identification and environmental cleaning effectiveness in radiology settings: cross-sectional and experimental studies <p><strong>Introduction:</strong> Despite the large number of patients passing through and some invasive procedures, radiology may still be considered unlikely to transmit pathogens. However, radiation protection aprons touched by radiology professionals and shared between patients could be prone to contamination. Our goals were to (1) assess qualitatively and quantitatively the microorganisms present on the radiation protection aprons with a cross-sectional study, and (2) determine the effectiveness of routine cleaning with an experimental design.</p> <p><strong>Methods:</strong> For objective 1, 108 samples were collected on radiation protection aprons of two radiology settings: the diagnostic radiology (DR) setting, with a cleaning procedure in place, and the emergency setting without. Total cultivable bacteria, staphylococci, enterobacteria and fungi were quantified. For purpose 2, the number of total bacteria and staphylococci were compared between before and after cleaning the aprons.</p> <p><strong>Results:</strong> The median number of total bacteria were respectively 0.97 and 1.56 cfu/cm<sup>2</sup> in the DR and emergency settings, whereas the median number of <em>Staphylococcus</em> were 0.04 and 0.15 cfu/cm<sup>2</sup> in these settings (Objective 1). Thus the number of microorganisms were lower in the setting with the cleaning procedure, although significantly only for staphylococci (<em>p</em>&nbsp;=&nbsp;0.025). Enterobacteria, fungi and <em>Staphylococcus aureus</em> were not detected in any sample. In the second part of the study, the median number of total bacteria dropped from 0.80 to 0.17 cfu/cm<sup>2</sup> between before and after cleaning (<em>p</em> = 0.0017) and for <em>Staphylococcus </em>it decreased from 0.84 to 0.15&nbsp;cfu/cm<sup>2</sup> (<em>p</em> = 0.13).</p> <p><strong>Conclusion:</strong> A number of microorganisms have been found, although the absence of enterobacteria, fungi and <em>S. aureus</em> is reassuring as they can cause serious healthcare-associated infections. Our study showed that the cleaning of radiation protection aprons can significantly reduce the microbial load and should be encouraged.</p> Sandrine Ding Nicolas Weber Anne Oppliger Copyright (c) 2020 Sandrine Ding, Nicolas Weber, Anne Oppliger 2020-12-12 2020-12-12 6 1 1 12 10.7577/radopen.3647 Jämförelse av CKD-EPI och MDRD ekvationsformler för estimerad glomerulär filtrationshastighet. <p><strong>Introduction: </strong>In the profession as radiology nurse contrast media is used daily in radiologic examinations. In order to determine the volume of contrast media that patients should be administered and to prevent contrast-induced nephropathy equation formulas are applied to calculate the kidney function glomerular filtration rate. Two formulas were compared the CKD-EPI and MDRD. The aim was to compare which of the two most commonly used equation formulas is the most optimal for calculating estimated GFR.</p> <p><strong>Methods: </strong>This study was conducted as a literature study, where 11 articles were quality assessed and compiled.</p> <p><strong>Results: </strong>The CKD-EPI formula generally showed better performance for estimating GFR in accuracy, precision and bias than the MDRD formula. However, both equation formulas present inadequacies and are not universal as they are not applicable to all individuals.</p> <p><strong>Conclusions: </strong>At the moment the CKD-EPI formula appears to be the most applicable, although more research is required in order to develop equation formulas which cater to all types of patients.</p> Amanda Lundén Ulrika Hafstad Sara Larsson Copyright (c) 2020 Amanda Lundén, Ulrika Hafstad, Sara Larsson 2020-12-12 2020-12-12 6 1 13 31 10.7577/radopen.3984 The Investigation of RIS/PACS Information Systems’ Incorporation in Greek Public Hospitals <p align="JUSTIFY"><span style="font-size: medium;"><em><strong>Purpose:</strong></em></span><span style="font-size: medium;"> The objective of this study is to assess the current level of Radiological Information Systems (RIS) and Picture Archiving and Communication Systems (PACS) incorporation in greek public hospitals through a national web-based survey. Since there are no previous studies on this field of medical imaging management in Greece, we look forward to export useful conclusions about RIS/PACS incorporation and set the foundation for further investigation.</span></p> <p align="JUSTIFY"><span style="font-size: medium;"><em><strong>Material and Methods:</strong></em></span><span style="font-size: medium;"> A comprehensive measurement instrument that integrates the existing theoretical and empirical literature knowledge on Information Systems (IS) evaluation was properly modified and used for the purpose of this study. A web-based survey was conducted via Google Form questionnaire, which was distributed to the entire population of radiologists and radiologic technologists (potential users) of all greek public hospitals (urban and rural), in order to identify the availability of RIS/PACS Information Systems (IS), the level of incorporation through system’s impact on users satisfaction and their operating capacities (i.e. computerized activities and processes).</span></p> <p align="JUSTIFY"><span style="font-size: medium;"><em><strong>Results:</strong></em></span><span style="font-size: medium;"> A total of 49 valid responses out of 77 collected questionnaires were received from all 124 greek public hospitals, which represents a response rate of 39.5%. Our very first findings indicate that establishment of RIS/PACS has not been fulfilled so far for the vast majority of greek public hospitals. </span><span style="font-size: medium;"><span lang="en-US">Almost half of the participants (51%) responded that they use only the capabilities of PACS as a repository for medical images, instead of implementing all capabilities of RIS. Also, although 85.7% of the participants responded that they use disc publisher for medical imaging exams copies, only 6.1% responded that has gone totally filmless or paperless. 59.2% of the respondents has access to 5 or more workstations and 100% of the respondents agrees that ER and clinics should connect on hospital's RIS/PACS for viewing medical images, receiving electronic reports and updating patients' electronic files. </span></span><span style="font-size: medium;">Overall findings </span><span style="font-size: medium;"><span lang="en-US">from statistical techniques</span></span><span style="font-size: medium;"> demonstrate </span><span style="font-size: medium;"><span lang="en-US">a statistically significant difference in perceived information (p-value=0.021) and service quality (p-value=0.036) with age of respondents.</span></span> <span style="font-size: medium;"><span lang="en-US">Finally,</span></span><span style="font-size: medium;"> open feedback </span><span style="font-size: medium;"><span lang="en-US">answers</span></span><span style="font-size: medium;"> indicate that greek public hospitals have still many to set to successfully incorporate and exploit the wide range of RIS/PACS capabilities to improve quality, effectiveness and efficiency of patient care services.</span></p> <p align="JUSTIFY"><span style="font-size: medium;"><span lang="en-US"><em><strong>Discussions</strong></em></span></span><span style="font-size: medium;"><em><strong>: </strong></em></span><span style="font-size: medium;">Although, most of the respondents have an adequate level in the operation of information systems, lack of RIS/PACS usage training is noted, as well as users’ support from their own organization IT staff. Also, structural deficiencies worry system’s users, making them intolerant to adopting the system in daily practice. The recommendations of this study include RIS/PACS incorporation in every medical imaging department of greek hospitals, users training and support, as well as updating infrastructures where needed.</span></p> Kleanthis Konstantinidis Ioannis Apostolakis Copyright (c) 2020 Kleanthis Konstantinidis, Ioannis Apostolakis 2020-12-12 2020-12-12 6 1 32 44 10.7577/radopen.4007 How Patients Evaluate the Patient Information Leaflet for Abdominal CT Examinations: A health literacy survey <p><strong>Keywords:</strong> Patient information, Information leaflet, CT, Patient empowerment, Health literacy study</p> <p> </p> <p><strong>Abstract</strong></p> <p><strong>Introduction: </strong>Health literacy is a prerequisite for patient empowerment. In order to be able to participate in decisions about their own health, patients must have insight and knowledge; they must understand the information included in the leaflet they receive prior to the examination. Lack of patient preparation is a problem experienced by radiographers. The aim was to investigate if the information leaflets contributed to adequate knowledge about the CT examination and to look into patients' views on possible improvements.</p> <p><strong>Methods: </strong>A health literacy study (HL survey) was conducted among patients who received an appointment letter and were subjected to CT examinations.</p> <p><strong>Results: </strong>The total number of respondents was 25. Most were satisfied with the information leaflet when it came to both content and appearance, and they felt that the leaflet included all information necessary to be prepared for the examination, and that the content was easy to understand. Respondents with a background in the healthcare sector had higher expectations when it came to the leaflet's contents compared to those without. A small number of respondents wanted more information on contrast agents, among other things.</p> <p><strong>Conclusion: </strong>The contents of the information leaflet was perceived slightly differently based on the patients' background. The patients provided useful comments in the survey, which allows for improved shared decision making.</p> Marie Abrahamsen Sylwia Popłońska Stephanie Gonzaga Lanuza Copyright (c) 2020 Marie Abrahamsen, Sylwia Popłońska, Stephanie Gonzaga Lanuza 2020-12-22 2020-12-22 6 1 45 55 10.7577/radopen.3963 Estimation of effective dose from CT scanning using dose length product in a Nepalese hospital <p><strong>Keywords:</strong> Effective dose, Dose Length Product, Computed Tomography Dose Index<br />volume, Dose Reference Level</p> <p><br /><strong>Abstract</strong><br /><strong>Aim</strong>: The aim of this study was to estimate the effective doses from CT scans using Dose<br />Length Product (DLP) in a Nepalese hospital.<br /><strong>Materials and methods</strong>: This prospective study was conducted in 150 patients above 18<br />years of age who were referred for CT scan of head, chest and abdomen. The CT scan was<br />performed on a 128 slice multi detector scanner. All the subjects who met the inclusion<br />criteria were included in the study. Following the non-contrast imaging phases of the head,<br />chest and abdomen CTDIvol, DLP, kVp and pitch were recorded for each patient from the<br />console display of the scanner. The effective dose was calculated for each examination using<br />DLP which were graphically analyzed and correlated with the age of the patient.<br /><strong>Results</strong>: The study showed the mean CTDIvol for head, chest and abdomen to be 53.95±4.83<br />mGy, 5.28±1.17 mGy and 11.15±2.71 mGy respectively along with mean DLP to be<br />923.52±71.11 mGycm, 229.32±48.70 mGycm and 517.02±148.32 mGycm respectively. Using<br />these values, the mean effective doses were calculated and found to be 1.93±0.14 mSv,<br />3.20±0.68 mSv and 7.75±2.19 mSv respectively.<br /><strong>Conclusion</strong>: The calculated effective dose values were lower than in other studies for CT<br />examinations of chest and abdomen while higher or similar for CT examination of head. The<br />results of this survey could motivate other researchers to investigate the radiation doses in<br />other hospitals and help establish national diagnostic reference levels.</p> <p> </p> Pooja Shah Copyright (c) 2020 Pooja Shah 2020-12-21 2020-12-21 6 1 56 63 10.7577/radopen.3565 Quality of radiation protection aprons and quality control routines at different diagnostic imaging modalities <p><strong>Keywords:</strong> Radiation protection apron, Quality control, Routines, Radiation protection, Radiation doses</p> <p> </p> <p><strong>Abstract</strong></p> <p><strong>Introduction: </strong>The purpose of this project was to assess the quality of lead aprons at different departments at two hospitals and to investigate whether there was a connection between routines for controlling lead aprons and the actual condition of the lead aprons.</p> <p><strong>Methods: </strong>Lead aprons were tested in several diagnostic modalities in two hospitals. The lead aprons were inspected visually and by palpation. Furthermore, the lead aprons were scanned with a fluoroscopy unit and the size of the defect was recorded. The radiation dose was measured behind defects exceeding 0,4 cm in length. Radiation protection officers at the two hospitals were contacted for a review of the procedures.</p> <p><strong>Results: </strong>Defects were detected in 19% of the tested aprons. Most findings were discovered in emergency room 1, where 62,5% of the lead aprons had one or more defects. The measured radiation doses behind the defects ranged from 3.996 nGy to 83.370 nGy. No defects were detected on nuclear medicine 1, emergency room 2, CT 2 and intervention 2. Both hospitals' routines were based on the Norwegian Radiation Protection Regulations. Hospital 2 controlled most of the lead aprons one month prior to this project.</p> <p><strong>Conclusion: </strong>A possible connection between the hospitals’ routines and the quality of the lead aprons is indicated by the fact that the hospital with the most defective lead aprons also had the least follow-up of the routines.</p> Linda Wie Bjørkås Sandra Blø Magnus Kristoffersen Rekdal Albertina Rusandu Copyright (c) 2020 Linda Wie Bjørkås , Sandra Blø, Magnus Kristoffersen Rekdal, Albertina Rusandu 2020-12-22 2020-12-22 6 1 64 74 10.7577/radopen.4050