Availability and utilisation of radiation protection and safety measures by Medical Imaging Technologists in Rwandan Hospitals

Abstract: Medical imaging technologists (MITs) are taught and use techniques and protective devices to keep radiation to a minimum, to themselves, patients and the environment, through but not limited to shielding, employing appropriate distances, optimum radiographic exposures, and use of techniques such as good communication, immobilization, beam limitation, justification for radiation exposure and quality control programmes. Following the enactment of the new law relating to radiation protection in 2018, it was relevant to interrogate the current state of radiology departments to establish whether they are equipped for implementation of the new regulations. The aim of this study therefore, was to assess the availability and utilization of radiation and safety measures by medical imaging technologists in Rwandan Hospitals. A quantitative non-experimental descriptive method study design was used and data was collected by means of a questionnaire which was developed by the researcher using studies conducted in other jurisdictions and adapted to suit the local context to achieve the aim and target all the MITs in the public hospitals. One hundred and sixteen (116) representing 96.67% of expected participants from public hospitals participated in the study. The participants came from 44 (91.67%) of the total of 48 public hospitals. The study found that radiation safety measures were not adequately implemented as 40.87% of MITs did not have radiation-measuring devices, with 29% of those having the devices, not receiving results consistently. Lead rubber aprons were mostly vi available for 99.13%, however, 59% of participants had never checked their integrity. A Pigg-o-stat was the least available at 0.86%. 36.8% of MITs blamed neglect by administrators as a reason for non-availability of the radiation equipment. Participants mostly used lead rubber aprons (93.04%) and lead equivalent barriers (83.62%). There was a lack of adequate radiation safety equipment while quality management, use of exposure charts and use of immobilizing devices as techniques for radiation safety were not implemented. It was evident that education and experience did not influence the radiation safety practice. Barriers to radiation safety were negligence, lack of equipment and difficulty in using some of the equipment. There is a need for a concerted effort between RURA, the Ministry of Health, training institutions and hospital managements to improve the culture of radiation safety.M.Tech. (Radiography

Developing Unique Engineering Solutions to Improve Patient Safety

Many efforts to improve healthcare safety have focused on redesigning processes of care or retraining clinicians. Far less attention has been focused on the use of new technologies to improve safety. We present the results of a unique collaboration between the VA National Center for Patient Safety (NCPS) and the Thayer School of Engineering at Dartmouth College. Each year, the NCPS identifies safety problems across the VA that could be addressed with newly-engineered devices. Teams of Thayer students and faculty participating in a senior design course evaluate and engineer a solution for one of the problems. Exemplar projects have targeted surgical sponge retention, nosocomial infections, surgical site localization, and remote monitoring of hospitalized patients undergoing diagnostic testing and procedures. The program has served as an avenue for engineering students and health care workers to solve problems together. The success of this academic-clinical partnership could be replicated in other settings

Study of bone-metal interface in orthopaedic application using spectral CT

This thesis investigates the diagnostic potential of MARS spectral photon counting computed tomography (CT) in assessing musculoskeletal disorders such as bone fractures and crystal arthritis. The hypothesis states that the high spatial resolution, quantitative material specific information and reduced metal artefacts of spectral photon counting CT makes the MARS spectral CT scanner a promising imaging tool to confirm or rule out a diagnosis. Being a new imaging modality, a protocol to scan samples with metal implants has to be optimised, before it can be implemented clinically for patient imaging. I contributed to optimising a protocol for imaging bone-implant specimens. Different biomaterials (titanium and stainless steel) used for fracture fixation were imaged. The artefacts were evaluated in both the energy and material domain. A bone analysis tool for measuring bone morphological parameters such as trabecular thickness and spacing was developed in collaboration with the Human Interface Technology Lab. Bone healing at the bone-metal interface was studied and the results were compared with plain radiographs, dual energy x-ray absorptiometry and clinical single and dual energy CT. The advantages of photon counting spectral CT in the early assessment of bone healing due to reduced artefacts was demonstrated. This thesis also investigated the potential of spectral photon counting CT to differentiate calcium crystals present in phantoms and osteoarthritic human meniscus samples. Our results show that MARS spectral CT can moderately discriminate calcium pyrophosphate (crystals inducing pseudogout) and calcium hydroxyapatite crystals. The results were compared with plain radiographs, polarised light microscopy and x-ray diffraction methods. In conclusion, this thesis demonstrated the clinical potential of MARS preclinical spectral photon counting CT scanner for the non-invasive and non-destructive imaging of bone-metal interfaces, for early assessment of bone healing, and for the detection and characterisation of articular crystals