41 completeness of the request form while also identifying any deficiencies in the subsequent radiology reports. We have retrospectively reviewed all request forms and radiology reports in a period of one week at a three campus major hospital in Melbourne. This includes all medical imaging modalities (CT, Plain film X-ray, US and MRI). Our goal is to provide a snapshot of radiology in Australia. We hope this research will provide useful data that can be beneficial to future research and to promote the importance of communication between medical professionals. Methods: This study was a retrospective analysis of all request forms and radiology reports tendered to our department over a one-week period. The extensive data collected was analysed with SPSS version 21 statistical software. Results: More than 1,700 request forms and subsequent radiology reports were reviewed. Clinical questions were not provided in over 17% of cases and other information deemed relevant omitted in more than 30% of cases. This implies significant inadequacies in the completion of radiology request forms. Improvement in the effectiveness of communication between referrer and radiology is needed to utilize radiology to its full potential. 14.5. Plain radiography image evaluation – development at HUS Medical Imaging Center Presenter: Merja Wirtanen, HUS Medical Imaging Center, Finland Authors: M Wirtanen Introduction: HUS Medical Imaging Center (HUS MIC) (Helsinki and Uusimaa, Finland) offers imaging services for special and primary health care providers. HUS MIC made nearly 1 million examinations in the year 2013. This is almost 1/3 of all examinations made in Finland. HUS MIC has 31 x-ray departments and 51 CR/DR x-ray rooms. Patients with a referral can almost freely choose the plain x-ray department where they want to be examined. This is possible only by having equal imaging protocols and guidelines. In the year 2007 HUS MIC (named HUS-Röntgen) began a project to develop a common direction for plain radiography. The first common guidelines were published in the year 2008. Today we have directions for each plain radiographic examination, altogether 50. For example, views are listed by indication. In the year 2011 the first versions of good image criteria defined by HUS MIC were published in Finnish. Every view mentioned in direction had its own criteria. The first documented “common” image quality evaluations at HUS MIC were made in the year 2008 as a part of an internal audit. At that time we had no common good image criteria. Radiologists fulfilled a Word document and calculation of “criteria fulfilled” was made. First Excel-based evaluation form was ready in the year 2012 for lumbar spine. Radiologists made selfassessments of department’s examinations using Excel. When making a summary of HUS MIC, I noticed some need for further develop and suggested a change from “criteria fulfill or not” to 3-step evaluation. As a result, in the year 2013 radiologists evaluated some 460+460 thorax x-rays using 3-step scale. This evaluation included referrals and reports as well. Methods: I will present development of our evaluation form from Worddocument to Excel we use now. I will explain how I selected criteria, calculations and graphics. I will describe how radiographers and radiologist were informed about the results. Results: Word-type form is simple and easy to begin with. Word-like form and simple calculations can be made even without a computer. When having more data, well planned Excel-form may be more informative. After evaluation each x-ray department makes their own improvement plans, if necessary. A good evaluation form supports this by giving limits and visualizing results. 14.6. Physical image quality in digital radiography: Comparison of three types of flat-panel detectors within the same imaging system Presenter: Elli-Noora Salo, Oulu University of Applied Sciences, Oulu, Finland Authors: Salo E-N, Wahlberg J, Väisänen P, Henner A Introduction: The three main types of digital flat-panel detectors in use today, namely amorphous selenium (a-Se), cesium iodide (CsI) and gadolinium oxysulfide (GOS) –based detectors, exhibit markedly different image quality characteristics depending on dose level and tube voltage used. Furthermore, the comparison of the image quality between detectors is often hindered by factors related to the imaging system itself. This study aims to evaluate the physical image quality of three different flat-panel detectors (a-Se, CsI and GOS) within the same imaging system using two image quality phantoms (DIGRAD and CDRAD). The knowledge of the differences in image quality between the detector types could lead to better optimization of imaging protocols. Methods: High- and low-contrast visibility, resolution and contrast-detail performance were evaluated on three detectors. Imaging was performed with three dose levels and three tube voltages. The images were graded by three independent observers manually. Results: The preliminary results demonstrate significant differences in lowcontrast visibility, resolution and contrast-detail performance between the detectors. Low-contrast visibility was best with a-Se detector, followed by CsI and GOS detectors. The performance of the CsI detector, however, was close to the a-Se detector. Similar trend was observed with resolution. Contrast-detail performance was markedly lower in a-Se detector, whereas the CsI detector exhibited the best contrast-detail visibility. 14.7. Closed Loop System for the Communication of Critical Radiology Results Presenter: Michael Ong, Department of Diagnostic Imaging, National University Hospital, Singapore Authors: Ong, M.1, Tan, F1., Lim, R.F.2, Lim, J1, Kok, M.C.1, Lee, K.Y.1, Chong, F.H.1 1 Department of Diagnostic Imaging, National University Hospital 2 Integrated Health Information Systems Pte Ltd (IHIS) Background: The Radiology Information System (RIS) and Picture Archiving and Communication System (PACS) manage and share Radiology images and results. The communication of critical results to the requesting clinician is necessary so that timely and appropriate patient management can be promptly initiated. However, the communication of critical results is often met with challenges and proper loop closure may not be achieved. Purpose: The Department of Diagnostic Imaging (DDI) at the National University Hospital (NUH) implemented an automated closed loop system for the communication of critical Radiology results. This study was to determine if the automated communication system was reliable and if loop closure was achieved within the target timeframe of 1 hour from the report generation. Method: A web-based SMS application which is interfaced to the Radiology Information System (RIS) automatically triggers a text message via short message system (SMS) to the requesting clinician’s mobile phone when a critical result is reported. The clinician needs to acknowledge the receipt of the notification by replying to the SMS. Failing to do so will trigger an escalation protocol until the communication loop is closed. Data from the system logs is interrogated to determine the percentage of successful SMS triggers and loop closure within 1 hour. Results: The results from 2010–2013 revealed that critical results were successfully triggered within 10 minutes for more than 99% of the time and more than 99% of the results are acknowledged within 1 hour. Conclusion: The automated closed loop system for communicating critical Radiology results proved to be reliable and effective in communicating critical Radiology results to the requesting clinician and achieving loop closure within 1 hour of the report generation. 15. RADIOTHERAPY 15.1. Multienergetic verification of dynamic wedge angles in medical accelerators using multichannel Linear array Presenter: Anna Kowalik, Greater Poland Cancer Centre, Poland Authors: Anna Kowalik, Marcin Litoborski Introduction: The aim of the modern radiotherapy is to get the homogenous dose distribution in PTV, which is obtained using for example of physical or dynamic wedges. The using of physical wedge have provided such isodose distributions but their use resulted in detrimental dosimetric consecquences for example beam hardening effects and the practical consecquences of filter handling or possible misalignment. The linear accelerators are now equipped with collimator jaws system and controlled by modern computer and it is possible to generate wedge shaped isodose distributions dynamically. Because of more comfortable using of dynamic wedge there are alternative to the standard physical wedge. During the
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