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Compliance with the royal college of radiologists' guidelines on the use of pre-operative chest radiographs

The sensitivity of human tissues to changes in dose fractionation: Deductions from the RCR survey among UK radiotherapists

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Radiology reporting of incidental osteoporotic vertebral fragility fractures present on CT studies: results of UK national re-audit

On the basis of a national survey (Shrimpton et al, 1986) of doses to adult patients from routine X-ray examinations, the National Radiological Protection Board (NRPB) has formulated a set of guideline entrance surface doses for some common radiographic projections. These guideline doses are shown in Table I. They have been recommended by a joint working party of NRPB and the Royal College of Radiologists (RCR) as a useful step in reducing unnecessary medical exposures (RCR & NRPB, 1990). The doses were set at the third quartiles of the exposures found in the national survey, i.e. 75% of radiography rooms achieved a mean dose lower than each guideline.

There is little formal coordination or understanding between UK radiology departments in terms of standards relating to departmental work output or consultant workload. As a result, there are likely to be significant variations in work patterns, individual consultants' workload and work intensity in different units around the country.

An Evaluation Report on Radiotherapy Contouring Workshops During the Royal College of Radiologists' Annual Meeting 2018

BackgroundNeuroimaging is a crucial component in the assessment of patients with suspected dementia, aiding in diagnostic confirmation, subtype differentiation, and the exclusion of reversible causes. The Royal College of Radiologists (RCR) provides standards to guide the structured and comprehensive reporting of imaging scans, aiding in diagnostic accuracy and clinical decision-making. Local compliance with RCR standards may vary, which could influence the clinical utility of the scans. This audit was undertaken to evaluate local compliance with RCR reporting standards and identify areas for improvement.MethodologyA total of 50 referrals from the Memory Assessment Service to the Old Age Community Mental Health Team (April 2024-September 2025) were reviewed. Radiology reports were analyzed for compliance with RCR standards, focusing on documentation of atrophy pattern, vascular pathology, reversible causes, use of rating scales, and inclusion of diagnostic conclusions. Data were also organized by imaging modality and indication to assess reporting consistency and completeness.ResultsOf the 50 referrals, nine (18%) patients were diagnosed with dementia without neuroimaging, consistent with clinical guidelines. Among 41 imaged patients, 33 had CT and four had MRI scans. Cerebral atrophy was described in 85% of reports, increasing to 100% for cognitive impairment cases; however, standardized scoring systems were infrequently used (Medial Temporal Atrophy score 7/22). Vascular pathology was mentioned in most reports with severity markers, but Fazekas scoring was used in 3/22 scans. Reversible causes were more comprehensively covered in scans done for indications other than cognitive impairment. Overall, 15/22 (68%) cognitive impairment reports included a diagnostic conclusion.ConclusionsLocal neuroimaging reports for dementia patients showed comprehensive recognition of atrophy and vascular changes but inconsistent use of standardized scoring, documentation of reversible causes, and diagnostic conclusions. Structured reporting templates and multidisciplinary feedback could improve adherence to RCR standards and enhance clinical utility.

Free AccessLetter to the EditorThe importance of safe working legislation for neuroradiologistsSanjeev Ramachandran, Robert William Foley and Harish VenkateshSanjeev RamachandranDepartment of Radiology, University Hospitals of Leicester NHS Trust, Leicester, UKSearch for more papers by this author, Robert William FoleyDepartment of Radiology, University Hospitals Bristol NHS Foundation Trust, Bristol, UKSearch for more papers by this author and Harish VenkateshDepartment of Anaesthetics, Royal Berkshire NHS Foundation Trust, Reading, UKSearch for more papers by this authorPublished Online:11 Oct 2018https://doi.org/10.1259/bjr.20180583SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations AboutWe read with interest the parallels drawn between the working patters of air-traffic controllers and neuroradiologists by Reicher and colleagues.1 We support their conclusion that more robust legislation should be established to allow safer working practices by neuroradiologists, in line with the aviation industry. From our observations, we present two further factors that underline the importance of reducing fatigue-related errors from unsafe working patterns amongst neuroradiologists.Firstly, the on-call burden of neuroradiologists in the United Kingdom is particularly onerous. Patient load and complexity from tertiary centres with large neurosurgical, stroke, neurology and neurocritical care departments mean that neuroradiologists need to be called upon frequently overnight. For example, the increasing use of the National Institute of Health and Care Excellence (NICE) guidelines on the role of mechanical thrombectomy in the management of stroke will increase demand for out-of-hours input from neuroradiologists. Sleep deprivation from the workload and frequency of such shifts will significantly affect performance.2 Secondly, in addition to spending time performing cognitively demanding tasks using data from computer screens, neuroradiologists often perform a range of practical procedures (such as myelography and angiographic procedures), train specialty registrars and lead clinico-radiological meetings. Indeed, a report on safe working by the British Society of Neuroradiologists (BSNR) has outlined the increasing time commitments required for these duties.3 This variety in work schedules may be a key difference between air-traffic controllers and neuroradiologists. Whilst the effect of task shifting on cognitive and motor performance is not entirely clear, it is reasonable to conclude that adequate rest periods may improve performances across the board.To conclude, the aforementioned report on safe working by the BSNR reflects Reicher and colleagues’ concerns but has not provided recommendations on breaks, reporting periods and shift patterns. We advocate that the publication of specific guidance on what is deemed safe practice is an important first step towards formulating adequate, specialty-specific legislation. However, stakeholders will need to be aware of the challenges in implementing such legislation in the context of ever-increasing demand from a finite pool of neuroradiologists, reflected in the recent workforce planning report by the Royal College of Radiologists.4REFERENCES1. Reicher J, Currie S, Birchall D. Safety of working patterns among UK neuroradiologists: what can we learn from the aviation industry and cognitive science? Br J Radiol 2018; 91: 20170284. doi: https://doi.org/10.1259/bjr.20170284 Link ISI, Google Scholar2. Rohatgi S, Hanna TN, Sliker CW, Abbott RM, Nicola R. After-hours radiology: challenges and strategies for the radiologist. AJR Am J Roentgenol 2015; 205: 956–61. doi: https://doi.org/10.2214/AJR.15.14605 Crossref Medline ISI, Google Scholar3. British Society of Neuroradiologists. Safe Neuroradiology. United Kingdom: The British Institute of Radiology.; 2012. Google Scholar4. The Royal College of Radiologists. Information submitted to Health Education England workforce planning and education and commissioning round - 2015/16. United Kingdom: The British Institute of Radiology.; 2016. Google ScholarResponse to letter: “The importance of safe working legislation for neuroradiologists” by Ramachandran et al1John Reicher, BA, BM, BCh, MRCP, 1Daniel Birchall, MA, MB, BChir, MRCP, FRCR, MD MBA and 2Stuart Currie, FRCR, PhD1Department of Neuroradiology, Newcastle Upon Tyne Hospitals, Newcastle Upon Tyne, UK2Department of Radiology, Leeds General Infirmary, Leeds, UKThe authors would like to thank Ramachandran and colleagues for their interesting contribution.We wholeheartedly concur with their conclusions in relation to the pressing need for official determination of guidelines for safe reporting practice. We support their points regarding the additional challenges posed by neuroradiologists’ varied workload and increasingly onerous on-call commitments.They hint that non-radiologist stakeholders might take a different view, demanding ever-greater reporting output from the limited workforce. This emphasises the necessity of developing and entrenching safe working practices in an increasingly pressurised working environment. Previous article FiguresReferencesRelatedDetails Volume 91, Issue 1091November 2018 © 2018 The Authors. Published by the British Institute of Radiology History ReceivedJune 30,2018AcceptedJuly 24,2018Published onlineOctober 11,2018 Metrics Download PDF

Peer Review Report For: Towards equality: gender representation at the Royal College of Radiologists’ Annual Scientific Meeting 2014-2021 [version 1; peer review: 1 approved, 1 approved with reservations

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The trainees become the trainers: a specialty trainee-led introduction to an undergraduate radiology placement