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CT Research

My name is Jenna Tugwell-Allsup and I’m one of two research radiographers employed by BCUHB. Myself and Bethan Wyn Owen were fortunate to win Best Research Poster at the BCU Quality Improvement, Innovation and Research Conference 2019 for the work we did on low dose CT chest for nodule detection.

I have completed my MPhil and am currently on a PhD by publication route with my work on image quality and radiation dose optimisation. In radiology, there is always a balance between achieving optimal diagnostic images but at the lowest possible radiation dose owing to its harmful effects. This low dose CT chest imaging was one of many optimisation studies done in the last few years and there are also more on the horizon such as imaging neonates in incubators. Although these particular projects (optimisation of image quality and radiation dose) are very much specific to radiography and it’s technical side (physics, physics physics), there are also numerous aspects that other healthcare professional can learn and translate to their own speciality. From undertaking this type of work, the different methods of measuring image quality is a minefield from subjective to objective methods (human v computers) and learning about inter and intra rater variability - all relevant in many aspect of healthcare.

The CT low dose work was about highlighting variability in current practice between 6 different CT scanners but it was also about pushing boundaries and seeing how low could we take the radiation dose before small lung nodules become invisible to experienced observer eyes (the radiologists). This then helps us define diagnostic (is it a pretty clear picture or is it something that shows us what we need without being pretty) and helps us not only standardise protocols but optimise them too.

Although optimisation is my niche, myself and Bethan also participate in further research projects. Currently we are recruiting and consenting patients into a radiology led oncology trial where we offer women with suspected ovarian cancer the chance to have both CT and MRI scans (instead of just CT as per standard practice).

My advice to anybody wanting to starts a research project or a quality improvement project is GO FOR IT. Start small to gain your confidence and read a bit around PDSA cycles. Research and Quality Improvement projects to me are like baking, they have a recipe and you need to find that one recipe that you understand and already have all the ingredients and tools to proceed. You need to follow that recipe, do not skip steps because of time constraints or other reasons, or you will get a poorly baked project. Many individuals will offer you various different recipes, all with a similar end results, but you need to find that one recipe that is right for you and that you understand. Also ask for help, whether that is borrowing some tools, asking advice, asking someone else to taste a piece of your cake before you go onto the next batch......there is always someone keen to help. Finally good recipes may come with some form of template/format – use them, you save yourself a lot of work using other peoples template/formats!!

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