An evaluation of radiographers' extended practice in the detection of brain metastases on magnetic resonance images
Affiliation
Department of Radiotherapy, The Christie NHS Foundation Trust, Manchester, UK. Department of Quality and Standards, The Christie NHS Foundation Trust, Manchester, UK Division of Cancer Sciences, Faculty of Medicine, Biology and Health University of Manchester, UK.Issue Date
2024
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INTRODUCTION: Patients who undergo magnetic resonance (MR) imaging to confirm or rule out metastatic brain disease are required to wait for image review by a radiologist before leaving the department at the institute where this study was carried out. The aim was to evaluate whether radiographers can review images and reduce waiting times in those patients without metastases. METHODS: Prospective observational study of MR radiographers (n = 11) was undertaken. Radiographers commented on images to confirm whether the images showed evidence of metastatic disease, pathology but no metastases, or no pathology. Responses were compared to the radiological report (reference standard). Online questionnaires determined the views and opinions of radiographers (n = 8) and consultant radiologists (n = 6) towards radiographers expanding their scope of practice to include the confirmation or exclusion of brain metastases. RESULTS: Despite a lack of formal training for image reviewing, overall level of agreement between the radiographer reviews and reference standard was 77.9 % (κ = 0.45). Pooled sensitivity and specificity were 88.6 % & 71.3 % respectively. Kendall's τ = -0.03 (bootstrap 95 % CI -0.73 to 0.61, p = 0.925). Positive predictive value (PPV) was 65.5 % (CI 59.2%-71.4 %) and negative predictive value (NPV) 91.1 % (CI 84.9%-94.9 %). Radiographers and radiologists surveyed demonstrated a willingness to engage with role expansion. CONCLUSION: Based on our small study and interdisciplinary survey, local radiographers and radiologists agree, following a program of radiographer training, screening for brain metastases by radiographers could be implemented. IMPLICATIONS FOR PRACTICE: With appropriate governance and training support, the introduction of formal radiographer screening for patients referred to exclude brain metastases could provide more efficient working practice.Citation
McDaid L, Eccles CL, Yorke J. An evaluation of radiographers' extended practice in the detection of brain metastases on magnetic resonance images. Radiography (London, England : 1995). 2024 Jan;30(1):313-8. PubMed PMID: 38118376. Epub 2023/12/21. eng.Journal
Radiography (Lond)DOI
10.1016/j.radi.2023.12.003PubMed ID
38118376Additional Links
https://dx.doi.org/10.1016/j.radi.2023.12.003Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1016/j.radi.2023.12.003
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