Celebrating resilience and innovation within the Medical Imaging and Radiation Therapy community


2 - 8 November 2020


World Radiography Day (WRD) and National Radiographers and Radiation Therapists’ Week (NRRTW) provides us with an opportunity to acknowledge the resilience and innovation shown by frontline staff in our hospitals and clinics when dealing with the COVID-19 pandemic. The announcement of a coronavirus disease 2019 (COVID-19) pandemic by the World Health Organisation on 11th March 20201 created a ‘new normal’ in which many areas of our known existence underwent forced change. Spread of the COVID-19 virus was found to be close contact, a major challenge for frontline health care workers; resilience and innovation were clearly needed going forward and the medical imaging and radiation therapy community have risen to the occasion.

Resilience and Innovation During the COVID-19 Pandemic


World Radiography Day (WRD) and National Radiographers and Radiation Therapists’ Week (NRRTW) provides us with an opportunity to acknowledge the resilience and innovation shown by frontline staff in our hospitals and clinics when dealing with the COVID-19 pandemic. The announcement of a coronavirus disease 2019 (COVID-19) pandemic by the World Health Organisation on 11th March 20201 created a ‘new normal’ in which many areas of our known existence underwent forced change. Spread of the COVID-19 virus was found to be close contact, a major challenge for frontline health care workers; resilience and innovation were clearly needed going forward and the medical imaging and radiation therapy community have risen to the occasion.

In medical imaging departments, change management was necessary to accommodate the exigencies of COVID-19; devising innovative methods of service delivery were essential. Chest imaging consisting of plain chest images, CT scans and lung ultrasound became critical for assessing the extent of lung infiltration due to the virus2; radiologists interpreting CT scans have identified them as a significant part of the management of the virus rather than a tool for diagnosis3. Department managers have been forced to change processes and protocols to ensure the protection of staff and patients; the separation of COVID-19 patients included reimagining departments into specific zones and walkways and providing resources such as personal protective equipment (PPE), mobile x-ray units and tools for digital communication.

Radiographers and sonographers have been required to minimise their face to face proximity to patients while maximising performance. The PPE provides a distinct and threatening barrier between staff and patients and so supportive communication however possible is critical; infection control procedures have increased in frequency and rigour and positioning techniques have been adjusted where appropriate to accommodate the need for distancing4.

Distancing however is not possible in mammography screening and so minimising proximity to the client is essential. Women attending are assured that face to face contact will be minimal while innovative radiographers have devised ways to adjust their technique by repositioning the orientation of the client, ensuring the woman’s comfort and safety at all times5. In ultrasound, suspected and confirmed COVID-19 cases were provided with a simplified approach to comply with infection control, minimise close contact and time with the patient4,6.

Cancer patients are in the high-risk category of COVID-19 infection7. Since radiation therapy patients require daily hospital visits for a few days or weeks they are more likely to be in close contact with others that are infected with COVID-19.  Radiation oncologists are therefore faced with the challenge to assess which patients could safely defer their radiation therapy treatment,  alter the dose and fractionation and/or provide other treatment options7,8. Radiation therapists are required to be in close proximity with the patient during the treatment set-up.  Radiation therapists have developed innovative and safe practices in reducing COVID-19 transfer such as the removal of unnecessary movements of staff between radiation therapy units, pre-treatment screening of COVID-19, educating patients on ways to reduce infection and PPE. Telehealth communication with patients was also introduced to reduce close contact and visits to the hospital9.

During the pandemic, virtual conferences attended by delegates from their homes became the new norm10. Within the departments of medical imaging and radiation therapy there were quick implementation of video conferencing and Microsoft Teams for education and training4,9 .

Health care workers caring for COVID-19 patients frequently report poor mental health symptoms11.  Peer group supervision12 and successful leadership strategies13 are possible solutions to combat stress and burnout symptoms of staff. Adequate and reliable communication within a department undergoing constant change also relieves stress; too much can induce fear while a ‘single credible point of truth’ can ensure information for staff is current and reliable4.

Acknowledgement is also due to the development and implementation of innovations in practice aside from COVID-19 that have occurred in the medical radiation scenario and have led to improvements for patients in diagnosis, treatment, and outcomes.

Patients in emergency departments are being assisted by a Preliminary Image Evaluation (PIE) created by Neep et al14, an innovation that impacts on delivery of services. The radiographer provides a PIE for the medical practitioner in emergency to assist in clinical decision making and to expedite the patient through the subsequent steps of diagnosis and treatment.

Artificial intelligence (AI) is changing the delivery of medical imaging services in innovative ways15. These changes are related to workflow and include image acquisition, image registration and interpretation of images. Significantly the potential for a personalised approach to medicine is enhanced by AI through its ability to facilitate clinical decision-making.

As well, the innovation of 3D printing has transformed medical imaging and radiation therapy by translating medical imaging data from CT and MRI into physical models16,17. These anatomical models enhance visualisation of lesions, planning of surgical procedures and communication with patients. Importantly, 3D printing is also used to create individual devices and implants that have improved lives worldwide18.

In highlighting the resilience and innovations of our communities, we wish to acknowledge the achievements of many individuals who have contributed to innovations that have been essential on account of COVID-19 and also those innovations that transform current practice for the benefit of patients.

We must also remember those frontline health care workers who have died from COVID-19, their courage and resolve in caring for their patients in dangerous situations is commendable. 

Ann Poulos, Journal of Medical Radiation Sciences Deputy Editor – Medical Imaging

Cherry Agustin, Journal of Medical Radiation Sciences Editor in Chief

References

  1. WHO characterizes COVID-19 as a pandemic , 11 March 2020 (viewed 19 August 2020). https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
  2. Baker K. Lung ultrasound in a COVID pandemic – choosing wisely. Australasian Journal of Ultrasound in Medicine 2020. https://onlinelibrary.wiley.com/doi/10.1002/ajum.12213" https://onlinelibrary.wiley.com/doi/10.1002/ajum.12213
  3. The Royal Australian and New Zealand College of Radiologists (RANZCR). Guidelines for CT Chest and Chest Radiograph reporting in patients with suspected COVID-19 infection. RANZCR, 2020, [Cited 2020 August 21]. Available from:https://www.ranzcr.com/fellows/clinical-radiology/professional-documents/guidelines-for-ct-chest-and-chest-radiograph-reporting-in-patients-with-suspected-covid-19-infection
  4. Eastgate P, Neep M, Steffens T, Westerink A. COVID-19 Pandemic - considerations and challenges for the management of medical imaging departments in Queensland. Journal of Medical Radiation Sciences 2020. https://onlinelibrary.wiley.com/doi/  WEBSITE TO INCLUDE ONCE AVAILABLE
  5. Spuur K. The COVID-19 BreastScreen Department - beyond the pandemic. Journal of Medical Radiation Sciences 2020. https://onlinelibrary.wiley.com/doi/  WEBSITE TO INCLUDE ONCE AVAILABLE
  6. Basseal J, Collingon P. How do healthcare workers in diagnostic imaging minimise risks but maximise performance during the COVID‐19 pandemic? Australasian Journal of Ultrasound in Medicine 2020. https://onlinelibrary.wiley.com/doi/10.1002/ajum.12207
  7. Al-Shamsi HO, Alhazzani W, Alhuraiji A, Coomes EA, Chemaly RF, Almuhanna M, Wolff RA, Ibrahim NK, Chua MLK, Hotte SJ, Meyers BM, Elfiki T, Curigliano G, Eng C, Grothey A, Xie C. A practical approach to the management of cancer patients during the novel Coronavirus disease 2019 (COVID-19) pandemic: An international collaborative Group. The Oncologist 2020; https://theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2020-0213
  8. Veness  M. Hypofractionated radiotherapy in patients with non‐melanoma skin cancer in the post COVID‐19 era: Time to reconsider its role for most patients. Journal of Medical Imaging and Radiation Oncology 2020. https://onlinelibrary.wiley.com/doi/10.1111/1754-9485.13070
  9. Anderson N, Thompson K, Andrews J, Chesson B, Cray A, Phillips D, Ryan M, Soteriou S, Trainor G, Touma N. Planning for a pandemic: Mitigating risk to radiation therapy service delivery in the COVID‐19 era. Journal of Medical Radiation Sciences 2020. https://onlinelibrary.wiley.com/doi/full/10.1002/jmrs.406
  10. McDowell L, Goode S, Sundaresan P.  Adapting to a global pandemic through live virtual delivery of a cancer collaborative trial group conference: The TROG 2020 experience.  Journal of Medical Imaging and Radiation Oncology 2020. https://onlinelibrary.wiley.com/doi/10.1111/1754-9485.13047
  11. Di Tella M, Romeo A, Benfante A, Castelli L. Mental health of healthcare workers during the COVID‐19 pandemic in Italy. Journal of Evaluation in Clinical Practice 2020; https://onlinelibrary.wiley.com/doi/10.1111/jep.13444
  12. Dungey G, Neser H, Sim D. New Zealand radiation therapists’ perceptions of peer group supervision as a tool to reduce burnout symptoms in the cjmrslinical setting. Journal of Medical Radiation Sciences 2020. https://onlinelibrary.wiley.com/doi/full/10.1002/jmrs.398
  13. Hunter D, Wright C, Pearson S. Employing positive psychology to improve radiation therapy workplace culture. Journal of Medical Radiation Sciences 2019. https://onlinelibrary.wiley.com/doi/10.1002/jmrs.321
  14. Brown C, Neep M, Pozzias E, McPhail SM.  Reducing risk in the emergency department: a 12‐month prospective longitudinal study of radiographer preliminary image evaluations. Journal of Medical Radiation Sciences 2019. https://onlinelibrary.wiley.com/doi/full/10.1002/jmrs.341
  15. Lewis S, Gandomkar Z, Brennan PC. Artificial Intelligence in medical imaging practice: looking to the future. Journal of Medical Radiation Sciences 2019. https://onlinelibrary.wiley.com/doi/10.1002/jmrs.369
  16. Searle B, Starkey D. An investigation into the effect of changing the computed tomography slice reconstruction interval on the spatial replication accuracy of three‐dimensional printed anatomical models constructed by fused deposition modelling. Journal of Medical Radiation Sciences 2020. https://onlinelibrary.wiley.com/doi/10.1002/jmrs.382
  17. Albantow C, Hargrave C, Brown A, Halsall C. Comparison of 3D printed nose bolus to traditional wax bolus for cost‐effectiveness, volumetric accuracy and dosimetric effect. Journal of Medical Radiation Sciences 2020. https://onlinelibrary.wiley.com/doi/10.1002/jmrs.378
  18. Abdullah KA, Reed W. 3D printing in medical imaging and healthcare services. Journal of Medical Radiation Sciences 2018. https://onlinelibrary.wiley.com/doi/10.1002/jmrs.292

 

Ann Poulos Deputy Editor Medical Imaging, Journal of Medical Radiation Sciences
Cherry Agustin, Editor in Chief, Journal of Medical Radiation Sciences

 

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Australasian Journal of
Ultrasound in Medicine

Australasian Journal of Ultrasound in Medicine


How do healthcare workers in diagnostic imaging minimise risks but maximise performance during the COVID‐19 pandemic?
Jocelyne M. Basseal, Peter Collignon

COVID‐US: A simplified approach to cardiopulmonary ultrasound in suspected and confirmed COVID‐19 patients in surge crisis
Yang Yang, James Anstey, Konstantin Yastrebov, Vinodh Bhagyalakshmi Nanjayya, Sam Orde, Marek Nalos, Cartan Costello, Nicholas Patrick George Ryan

Lung ultrasound in a COVID pandemic – Choosing wisely
Kylie Baker, James Rippey

COVID‐19: Infection prevention and control guidance for all ultrasound practitioners
Jocelyne M. Basseal, Susan Campbell Westerway, Terry McAuley

Prevention of pathogen transmission during ultrasound use in the Intensive Care Unit: Recommendations from the College of Intensive Care Medicine Ultrasound Special Interest Group (USIG)
Cartan Costello, Jocelyne M Basseal, Yang Yang, James Anstey, Konstantin Yastrebov

Journal of Medical Imaging and
Radiation Oncology

Journal of Medical Imaging and Radiation Oncology


Adapting to a global pandemic through live virtual delivery of a cancer collaborative trial group conference: The TROG 2020 experience
Lachlan McDowell, Susan Goode, Puma Sundaresan

What is a modern Interventional Radiologist in Australia and New Zealand?
Warren Clements, Gerard S Goh, Matthew W Lukies, Tim Joseph, Ashu Jhamb, Andrew O’Brien, Jim Koukounaras

Machine learning in radiology
Peter Brotchie

Hypofractionated radiotherapy in patients with non‐melanoma skin cancer in the post COVID‐19 era: Time to reconsider its role for most patients
Michael J Veness MBBS, MMed, MD(UNSW), MD(USyd), FRANZCR

Journal of Medical Radiation Sciences

Journal of Medical Radiation Sciences


COVID 19

Planning for a pandemic: Mitigating risk to radiation therapy service delivery in the COVID‐19 era
Nigel Anderson PhD, Kenton Thompson BAppSc, MHlthSc, MBA Judy Andrews DipAppSci, GDipEBus, Brent Chesson BAppSci (Hons), Alison Cray GDipAppSc et al.

COVID-19 Pandemic – considerations and challenges for the management of medical imaging departments in Queensland
Patrick Eastgate BNurs, BAppSci (Med Rad Tech) MSci, Michael J. Neep BAppSci (Med Rad Tech), MSci, PhD, Tom Steffens BAppSci (Med Rad Tech) Grad Dip Rad Image Interp, Adam Westerink BAppSci (Med Rad Tech)

The COVID-19 BreastScreen Department - beyond the pandemic
Kelly Maree Spuur BApSc(MedImag), GradCertLearn&TeachHigherEd, PhD

INNOVATIONS IN PRACTICE

New Zealand radiation therapists’ perceptions of peer group supervision as a tool to reduce burnout symptoms in the clinical setting
Gay Dungey MEd, Hazel Neser MA, Dalice Sim PhD

Employing positive psychology to improve radiation therapy workplace culture
Darren Hunter GradCertLead, BAppSci (RT), Caroline Wright PhD, GradCertEd, MSc, BSc (Hons), DCR (T), Sue Pearson PhD, GradCertEd, BA (Hons Psych)

VIRTUAL LEARNING

VERT, a virtual clinical environment, enhances understanding of radiation therapy planning concepts
Aidan Leong MHealSc, Patries Herst PhD, Paul Kane MHealSc (Clinical Ed)

ARTIFICIAL INTELLIGENCE

Artificial Intelligence in medical imaging practice: looking to the future
Sarah J Lewis PhD, MEd, BAppSci(DR) Hons, Ziba Gandomkar PhD, MSc, BSc(EEng), Patrick C Brennan PhD, BSc(DR) Hons

PRELIMINARY IMAGE EVALUATION

Reducing risk in the emergency department: a 12‐month prospective longitudinal study of radiographer preliminary image evaluations
Cameron Brown BApp Sci (Med Rad Tech), Michael J. Neep PhD, MSci, BApp Sci (Med Rad Tech), Efrosini Pozzias BApp Sci (Med Rad Tech), Steven M. McPhail PhD, BPhty

3D PRINTING

An investigation into the effect of changing the computed tomography slice reconstruction interval on the spatial replication accuracy of three‐dimensional printed anatomical models constructed by fused deposition modelling
Ben Searle BMedImg (Honours), Deborah Starkey MAppSc, MEd, FIR, SFHEA

Comparison of 3D printed nose bolus to traditional wax bolus for cost‐effectiveness, volumetric accuracy and dosimetric effect
Christine Albantow BSc, MRadTher, Catriona Hargrave PhD, MAppSc, BAppSc (MRT), Amy Brown MSc (Research), BAppSc (MRT), Christopher Halsall BMed Rad Sc

Sonography


Australasian Society for Ultrasound in Medicine
The Royal Australian and New Zealand College of Radiologists
Australasian Sonographers Association
Australian Society of Medical Imaging and Radiation Therapy
New Zealand Institute of Medical Radiation Technology