radiographic image interpretation

  • 文章类型: Journal Article
    背景:人们对标准化成像标准(SIC)的开发和应用越来越感兴趣,以最大程度地减少变异性并提高头颈部鳞状细胞癌(HNSCC)图像解释的可重复性。
    方法:使用PubMed和GoogleScholar搜索了\"鳞状细胞癌\"和\"标准化解释标准\"或\"放射学反应评估\"2009年至2024年发表的文章,返回56篇出版物。经过抽象审查,选择18人进行进一步评估,和6个不同的SICs(即,专家,Porceddu,霍普金斯,NI-RADS,修改过的多维尔,和Cuneo)被纳入这篇综述。在标准化报告系统的8个期望特征的背景下评估每个SIC。
    结果:两个SIC具有社会认可(即,专家,NI-RADS);四个可用于评估局部和全身性疾病(即,专家,霍普金斯,NI-RADS,Cuneo),四个对模棱两可的成像结果有特定的类别(即,Porceddu,NI-RADS,修改过的多维尔,和Cuneo)。在8个期望性状的背景下,所有都证明了未来改进的领域。
    结论:已经开发了多个SIC,并证明了其在HNSCC后处理成像中的价值;但是,这些系统仍未得到充分利用。选择具有最符合个人实践需求的功能的SIC有望最大限度地提高成功实施的可能性。
    BACKGROUND: There is growing interest in the development and application of standardized imaging criteria (SIC), to minimize variability and improve the reproducibility of image interpretation in head and neck squamous cell carcinoma (HNSCC).
    METHODS: \"Squamous cell carcinoma\" AND \"standardized interpretation criteria\" OR \"radiographic response assessment\" were searched using PubMed and Google Scholar for articles published between 2009 and 2024, returning 56 publications. After abstract review, 18 were selected for further evaluation, and 6 different SICs (i.e., PERCIST, Porceddu, Hopkins, NI-RADS, modified Deauville, and Cuneo) were included in this review. Each SIC is evaluated in the context of 8 desired traits of a standardized reporting system.
    RESULTS: Two SICs have societal endorsements (i.e., PERCIST, NI-RADS); four can be used in the evaluation of locoregional and systemic disease (i.e., PERCIST, Hopkins, NI-RADS, Cuneo), and four have specific categories for equivocal imaging results (i.e., Porceddu, NI-RADS, modified Deauville, and Cuneo). All demonstrated areas for future improvement in the context of the 8 desired traits.
    CONCLUSIONS: Multiple SICs have been developed for and demonstrated value in HNSCC post-treatment imaging; however, these systems remain underutilized. Selecting an SIC with features that best match the needs of one\'s practice is expected to maximize the likelihood of successful implementation.
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  • 文章类型: Journal Article
    一种使用二维直方图(即材料衰减分解图-MADplots)对水-光电衰减与水-散射衰减进行可视化和分析光谱CT扫描中包含的完整信息的方法。队列(跨患者的多项研究的组合),考试,系列,切片,和器官/ROI水平被描述。
    使用可从NIST和ICRU获得的理想材料特性来预测具有几种标准生物材料的MADplot的外观,以生成该非空间数据空间的图。开发了软件工具以生成MADplot作为新的DICOM系列,以促进光谱分析。说明性例子选自IRB批准的,使用预版本扫描的光谱基础图像(SBIs)的回顾性队列,双层探测器光谱CT。
    通过组合用于对比和非对比研究的所有体素,MADplot的预测外观得到证实.几种组织的位置,正常肺组织分布的形状,并且证明了肝脏和胰腺中脂肪存在的器官特异性MAD图随病理改变的方式的变化,突出了在光谱CT图像上识别病理的潜在用途。
    队列中显示的MADplots示例(组合研究),考试,系列,切片,器官,和ROI水平说明了它们在分析和显示光谱CT数据方面的潜在效用。未来的研究旨在开发基于MADplot的器官分割以及基于器官的病理的自动检测和显示。
    UNASSIGNED: A method for visualizing and analyzing the complete information contained in spectral CT scans using two-dimensional histograms (i.e. Material Attenuation Decomposition plots - MADplots) of the water-photoelectric attenuation versus water-scatter attenuation at the cohort (combination of multiple studies across patients), examination, series, slice, and organ/ROI levels is described.
    UNASSIGNED: The appearance of a MADplot with several standard biological materials was predicted using ideal material properties available from NIST and the ICRU to generate a map for this non-spatial data space. Software tools were developed to generate MADplots as new DICOM series that facilitate spectral analysis. Illustrative examples were selected from an IRB-approved, retrospective cohort of Spectral Basis Images (SBIs) scanned using a pre-release, dual-layer detector spectral CT.
    UNASSIGNED: By combining all of the voxels for contrast and non-contrast studies, the predicted appearance of the MADplot was confirmed. Locations of several kinds of tissue, the shape of the tissue distributions in normal lung, and the variations in the manner in which organ-specific MADplots change with pathology are demonstrated for the presence of fat in both the liver and pancreas highlighting the potential use for identifying pathologies on spectral CT images.
    UNASSIGNED: The examples of MADplots shown at cohort (combined studies), examination, series, slice, organ, and ROI levels illustrate their potential utility in analyzing and displaying spectral CT data. Future studies are directed at developing MADplot based organ segmentation and the automated detection and display of organ based pathologies.
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  • 文章类型: Journal Article
    目的:牙科X光片的解读是一个困难的过程,特别是对于没有经验的学生。这项研究为牙科学生引入了概念图,以帮助对常见颌骨病变进行影像学解释。我们旨在分析概念图(CM)在射线照相解释中的功效,讨论了诊断推理困境。
    方法:这项研究包括39名牙科学生。经过1小时的CM指导课程,并基于三个小组讨论和一对一的反馈,学生完成并提交了三种颌骨疾病的CM(成釉细胞瘤,牙源性角化囊肿,和简单的骨囊肿)。所有参与者都接受了知识和诊断的前测和后测;除一名学生外,所有学生都完成了关于CM使用的开放式问卷。
    结果:概念图有效地提高了诊断准确性。在知识测试和诊断测试中,参与者的测试后得分均优于他们的测试前得分。大多数学生尝试通过分析推理进行射线照相解释。学生绘制CM所需的时间从3-5小时到1-3天不等。
    结论:这项研究表明,CM可以通过提供分析推理的框架来提高牙科学生的影像学诊断能力。有必要进行持续的研究,以提高CM在牙科学生课堂上的口腔影像学解释中的有效性。
    OBJECTIVE: Interpretation of dental radiographs is a difficult process, particularly for inexperienced students. This study introduced concept mapping for dental students to help in the radiographic interpretation of common jaw lesions. We aimed to analyze the efficacy of the concept map (CM) in radiographic interpretation, with a discussion of the diagnostic reasoning dilemma.
    METHODS: This study included 39 dental students. After a 1-h class for CM guidance and based on three group discussions and one-on-one feedback, the students completed and submitted CMs for three jaw diseases (ameloblastoma, odontogenic keratocyst, and simple bone cyst). All participants underwent a pretest and posttest of knowledge and diagnosis; all students but one completed an open-ended questionnaire regarding the use of CMs.
    RESULTS: Concept mapping effectively improved diagnostic accuracy. The participants\' posttest scores were better than their pretest scores in both knowledge and diagnostic tests. Most of the students attempted radiographic interpretation through analytic reasoning. The time required for the students to draw a CM varied from student to student from 3-5 h to 1-3 days.
    CONCLUSIONS: This study shows that CMs can improve the radiographic diagnostic ability of dental students by providing a framework for analytic reasoning. Continuous research is warranted to improve the effectiveness of CM in oral radiographic interpretation in the dental student\'s class.
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  • 文章类型: Review
    重要牙髓治疗(VPT)的主要目的是保持牙髓的完整性和功能。已经提出了各种各样的材料和技术来改善治疗结果,其中,激光的利用已经获得了极大的关注。近年来,激光在VPT不同阶段的应用取得了显着增长,超越以前的方法。本研究旨在回顾激光在VPT不同步骤中的应用,并评估相关的临床和影像学结果。使用Scopus的电子搜索,MEDLINE,2000年至2023年的WebofScience和GoogleScholar数据库由两名独立研究人员进行。重点是人体研究,这些研究检查了VPT中不同激光类型的临床和/或放射线照相效果。这篇叙述性综述文章共纳入4243项研究。根据汇编的数据,可以得出结论,尽管目前的文献表明激光可能被提议作为VPT中某些程序步骤的辅助模式,需要采用标准化方法和标准进行更多研究,以获得更可靠和结论性的结果。
    The main purpose of vital pulp therapy (VPT) is to preserve the integrity and function of the pulp. A wide variety of materials and techniques have been proposed to improve treatment outcomes, and among them, the utilization of lasers has gained significant attention. The application of lasers in different stages of VPT has witnessed remarkable growth in recent years, surpassing previous approaches.This study aimed to review the applications of lasers in different steps of VPT and evaluate associated clinical and radiographic outcomes. An electronic search using Scopus, MEDLINE, Web of Science and Google Scholar databases from 2000 to 2023 was carried out by two independent researchers. The focus was on human studies that examined the clinical and/or radiographic effects of different laser types in VPT. A total of 4243 studies were included in this narrative review article. Based on the compiled data, it can be concluded that although current literature suggests laser may be proposed as an adjunct modality for some procedural steps in VPT, more research with standardized methodologies and criteria is needed to obtain more reliable and conclusive results.
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  • 文章类型: Journal Article
    金属伪影减少(MAR)算法通常用于涉及金属植入物的计算机断层扫描(CT)扫描中。然而,MAR算法还具有在重建图像中产生新的伪影的潜力。我们在CT上介绍了一例由于MAR引起的螺钉假性骨折。
    Metal artifact reduction (MAR) algorithms are commonly used in computed tomography (CT) scans where metal implants are involved. However, MAR algorithms also have the potential to create new artifacts in reconstructed images. We present a case of a screw pseudofracture due to MAR on CT.
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  • 文章类型: Multicenter Study
    背景:卷积神经网络(CNN)在磁共振成像(MRI)上的脑膜瘤分割中产生了最新的结果。然而,从不同机构获得的图像,协议,或者扫描仪可能显示出显著的域偏移,导致实际临床场景中的性能下降和具有挑战性的模型部署。
    目的:本研究旨在调查在不同医疗保健中心部署的训练有素的脑膜瘤分割模型的现实表现,并验证增强其泛化的方法。
    方法:本研究在四个中心进行。2015年1月至2021年12月,共有606例患者纳入了606例MRI。手动分割,通过神经放射学家的共识读数确定,被用作地面真相面具。该模型之前是使用名为DeeplabV3+的标准监督CNN进行训练的,并在四个医疗保健中心分别进行了部署和测试。为了确定减轻观察到的性能下降的适当方法,使用了两种方法:无监督域适应和监督再训练。
    结果:经过训练的模型在两个医疗机构的肿瘤分割中显示了最先进的性能,中心A的骰子比率为0.887(SD0.108,95%CI0.903-0.925),中心B的骰子比率为0.874(SD0.800,95%CI0.854-0.894),而在其他医疗机构,业绩下滑,中心C的骰子比率为0.631(SD0.157,95%CI0.556-0.707),中心D的骰子比率为0.649(SD0.187,95%CI0.566-0.732),当他们使用不同的扫描协议获得MRI时。无监督域适应在性能分数上显示出显著的改善,中心C的骰子比率为0.842(SD0.073,95%CI0.820-0.864),中心D的骰子比率为0.855(SD0.097,95%CI0.826-0.886)。尽管如此,它没有超越监督再培训,C中心的Dice比率为0.899(SD0.026,95%CI0.889-0.906),D中心的Dice比率为0.886(SD0.046,95%CI0.870-0.903)。
    结论:在不同的医疗保健机构中部署经过训练的CNN模型可能会由于MRI的域移位而显示出明显的性能下降。在这种情况下,应考虑使用无监督域自适应或监督再训练,考虑到临床需求之间的平衡,模型性能,以及可用数据的大小。
    Convolutional neural networks (CNNs) have produced state-of-the-art results in meningioma segmentation on magnetic resonance imaging (MRI). However, images obtained from different institutions, protocols, or scanners may show significant domain shift, leading to performance degradation and challenging model deployment in real clinical scenarios.
    This research aims to investigate the realistic performance of a well-trained meningioma segmentation model when deployed across different health care centers and verify the methods to enhance its generalization.
    This study was performed in four centers. A total of 606 patients with 606 MRIs were enrolled between January 2015 and December 2021. Manual segmentations, determined through consensus readings by neuroradiologists, were used as the ground truth mask. The model was previously trained using a standard supervised CNN called Deeplab V3+ and was deployed and tested separately in four health care centers. To determine the appropriate approach to mitigating the observed performance degradation, two methods were used: unsupervised domain adaptation and supervised retraining.
    The trained model showed a state-of-the-art performance in tumor segmentation in two health care institutions, with a Dice ratio of 0.887 (SD 0.108, 95% CI 0.903-0.925) in center A and a Dice ratio of 0.874 (SD 0.800, 95% CI 0.854-0.894) in center B. Whereas in the other health care institutions, the performance declined, with Dice ratios of 0.631 (SD 0.157, 95% CI 0.556-0.707) in center C and 0.649 (SD 0.187, 95% CI 0.566-0.732) in center D, as they obtained the MRI using different scanning protocols. The unsupervised domain adaptation showed a significant improvement in performance scores, with Dice ratios of 0.842 (SD 0.073, 95% CI 0.820-0.864) in center C and 0.855 (SD 0.097, 95% CI 0.826-0.886) in center D. Nonetheless, it did not overperform the supervised retraining, which achieved Dice ratios of 0.899 (SD 0.026, 95% CI 0.889-0.906) in center C and 0.886 (SD 0.046, 95% CI 0.870-0.903) in center D.
    Deploying the trained CNN model in different health care institutions may show significant performance degradation due to the domain shift of MRIs. Under this circumstance, the use of unsupervised domain adaptation or supervised retraining should be considered, taking into account the balance between clinical requirements, model performance, and the size of the available data.
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    文章类型: Journal Article
    这项研究评估了具有修改的灰度范围的锥形束计算机断层扫描(CBCT)的诊断准确性,用于检测与牙种植体相邻的颊皮质板缺损。
    在这项体外实验研究中,将钛植入物插入168个新鲜牛骨块中,颊皮质板厚度为1-1.5mm。将这些块随机分为四组(n=42)。在控制块中没有创建缺陷。在三个实验组中,在子宫颈中随机产生皮质板缺损,中间,或顶部三分之一是直径为2毫米的圆形钻头(n=42)。所有块都进行了CBCT,灰度范围有和没有变化。两名观察者评估了关于缺陷的存在/不存在的所有图像。Kappa检验用于观察者的同意。通过计算受试者工作特征曲线下面积(AUC)(P≤0.05),比较了两种模式的诊断准确性。还比较了敏感性和特异性值。
    两种模式之间的AUC没有显着差异(0.754vs.分别为0.762,P=0.716)。有和没有灰度范围变化的CBCT的诊断灵敏度分别为51%和52%,分别,两者的特异性均为100%。有灰度范围改变的CBCT对根尖和中三缺损的诊断准确率差异无统计学意义(P>0.05),明显高于对颈椎第三缺损的诊断准确率(P<0.05)。
    改变灰度范围并不能提高CBCT用于检测与牙种植体相邻的颊皮质板缺损的诊断准确性。
    UNASSIGNED: This study assessed the diagnostic accuracy of cone-beam computed tomography (CBCT) with a modified grayscale range for the detection of buccal cortical plate defects adjacent to dental implants.
    UNASSIGNED: In this in vitro experimental study, titanium implants were inserted in 168 fresh bovine bone blocks with 1-1.5 mm of buccal cortical plate thickness. The blocks were randomly divided into four groups (n = 42). No defect was created in the control blocks. In the three experimental groups, cortical plate defects were randomly created in the cervical, middle, or apical third by a round bur with a 2-mm diameter (n = 42). All blocks underwent CBCT with and without change in the grayscale range. Two observers evaluated all images regarding the presence/absence of defects. Kappa test is used for the agreement of the observers. The diagnostic accuracy of the two modalities was compared by calculating the area under the receiver operating characteristic curve (AUC) (P ≤ 0.05). The sensitivity and specificity values were also compared.
    UNASSIGNED: The AUC was not significantly different between the two modalities with and without altered grayscale range (0.754 vs. 0.762, respectively, P = 0.716). The diagnostic sensitivity of CBCT with and without change in the grayscale range was 51% and 52%, respectively, with a specificity of 100% for both. The diagnostic accuracy of CBCT with and without altered grayscale range had no significant difference for apical and middle third defects (P > 0.05) and was significantly higher than that for the cervical third defects (P < 0.05).
    UNASSIGNED: Changing the grayscale range does not improve the diagnostic accuracy of CBCT for the detection of buccal cortical plate defects adjacent to dental implants.
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  • 文章类型: Journal Article
    澳大利亚医学放射实践委员会(MRPBA)最低能力框架要求所有澳大利亚放射技师在放射图像中识别重要的病理,并采取适当的行动来警告这些紧急发现并确保患者安全。尽管专业机构认可以书面形式提供初步图像评估(PIE),放射技师图像解释往往不一致,非正式,或无证件。这篇叙述性评论的目的是评估文献,以确定以书面放射线摄影师评论形式的PIE是否对澳大利亚医疗保健系统具有价值。使用四个健康研究数据库完成了结构化搜索:CINAHL,Medline,Scopus和WebofScience研究表明,由于成像服务压力的增加,存在评论的上下文需要,放射科医生短缺和随后的报告延误。放射技师似乎处于有利地位,并愿意提供准确的初始输入,并提供证据证明这将在多学科团队中得到重视和赞赏。放射技师的评论也已被证明可以减少诊断和沟通错误,并有可能改善患者管理。最后,研究表明,参与形象解读实践可以加强招聘,放射技师的保留率和工作满意度。因此,当前的文献支持在澳大利亚医疗保健系统中实施放射线照相员评论。
    The Medical Radiation Practice Board of Australia (MRPBA) minimum competency framework requires all Australian radiographers to identify significant pathology in radiological images and take appropriate action to alert these urgent findings and ensure patient safety. Despite professional bodies endorsing the provision of preliminary image evaluations (PIE) in written format, radiographer image interpretation often remains inconsistent, informal, or undocumented. The purpose of this narrative review was to assess the literature to determine if PIE in the form of written radiographer comments is of value to the Australian healthcare system. A structured search was completed using four health research databases: CINAHL, Medline, Scopus and Web of Science. Studies have suggested that there is a contextual need for commenting due to increased imaging service pressures, radiologist shortages and subsequent reporting delays. Radiographers appear well placed and willing to provide accurate initial input with evidence that this would be valued and appreciated within the multidisciplinary team. Radiographer commenting has also been shown to reduce diagnostic and communicative errors with the potential to improve patient management. Finally, it was shown that participation in image interpretation practices can enhance recruitment, retention and job satisfaction among radiographers. Therefore, the current literature supports implementation of radiographer commenting within the Australian healthcare system.
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  • 文章类型: Journal Article
    目的:为了研究CT纹理分析是否可以区分腺癌,鳞状细胞癌,类癌,小细胞肺癌和机化性肺炎以及癌和神经内分泌肿瘤之间。
    方法:这项回顾性研究包括133例患者(30例机化性肺炎,30例腺癌,30例鳞状细胞癌,23例小细胞肺癌患者,20例类癌患者),他们接受了CT引导下的肺活检,并有相应的组织病理学诊断。肺部病变由两名放射科医师在三维中具有和不具有-50HU阈值的情况下一致分割。进行分组比较以评估所有上述五个实体之间以及癌和神经内分泌肿瘤之间的差异。
    结果:五个实体的成对比较显示,当不使用HU阈值时,有53个具有统计学意义的纹理特征,有6个具有统计学意义的特征,阈值为-50HU。当不使用HU阈值时,特征小波-HHH_glszm_SmallAreaEmphasis发现了最大的AUC(0.818[95CI0.706-0.930]),用于区分类癌与其他实体。在区分神经内分泌肿瘤和癌中,在不使用HU阈值时,有173个参数被证明具有统计学意义,而在使用-50HU阈值时,有52个参数被证明具有统计学意义。当不使用HU阈值时,对于区分神经内分泌肿瘤与癌的参数原始_glcm_相关性,发现了最大的AUC(0.810[95CI0.728-0,893])。
    结论:CT纹理分析显示,恶性肺部病变和机化性肺炎之间以及肺癌和神经内分泌肿瘤之间的特征有显著差异。应用HU阈值进行分割会大大影响纹理分析的结果。
    OBJECTIVE: To investigate whether CT texture analysis allows differentiation between adenocarcinomas, squamous cell carcinomas, carcinoids, small cell lung cancers and organizing pneumonia and between carcinomas and neuroendocrine tumors.
    METHODS: This retrospective study included patients 133 patients (30 patients with organizing pneumonia, 30 patients with adenocarcinoma, 30 patients with squamous cell carcinoma, 23 patients with small cell lung cancer, 20 patients with carcinoid), who underwent CT-guided biopsy of the lung and had a corresponding histopathologic diagnosis. Pulmonary lesions were segmented in consensus by two radiologists with and without a threshold of -50HU in three dimensions. Groupwise comparisons were performed to assess for differences between all five above-listed entities and between carcinomas and neuroendocrine tumors.
    RESULTS: Pairwise comparisons of the five entities revealed 53 statistically significant texture features when using no HU-threshold and 6 statistically significant features with a threshold of -50HU. The largest AUC (0.818 [95%CI 0.706-0.930]) was found for the feature wavelet-HHH_glszm_SmallAreaEmphasis for discrimination of carcinoid from the other entities when using no HU-threshold. In differentiating neuroendocrine tumors from carcinomas, 173 parameters proved statistically significant when using no HU threshold versus 52 parameters when using a -50HU-threshold. The largest AUC (0.810 [95%CI 0.728-0,893]) was found for the parameter original_glcm_Correlation for discrimination of neuroendocrine tumors from carcinomas when using no HU-threshold.
    CONCLUSIONS: CT texture analysis revealed features that differed significantly between malignant pulmonary lesions and organizing pneumonia and between carcinomas and neuroendocrine tumors of the lung. Applying a HU-threshold for segmentation substantially influenced the results of texture analysis.
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  • 文章类型: Journal Article
    背景:放射科医师的短缺给南非的卫生部门带来了负担,导致放射学图像报告不足,最终导致患者管理不善。先前的研究建议对射线照相图像解释方面的射线照相技师进行培训,以改善报告。关于射线技师解释射线照相图像所需的知识和培训的信息很少。因此,这项研究的目的是探讨放射诊断技师所需的知识和培训,根据放射科医生的说法,用于解释射线照片。
    方法:采用标准抽样的定性描述性研究,以选择在夸祖鲁纳塔尔省eThekwini区执业的合格放射科医师,进行了。一对一深入,半结构化访谈用于收集3名参与者的数据.由于Covid19大流行和社会距离的调节,采访没有面对面进行。这不允许与研究社区接触。使用Tesch的八个步骤分析定性数据,对访谈中的数据进行了分析。
    结果:研究结果表明,放射科医生支持农村地区放射技师对放射图像的解读,并对放射技师的实践范围进行重组,以包括胸部和肌肉骨骼系统图像的报告。分析中出现的主题包括知识,培训,放射技师在解释放射图像时需要的临床能力和医学法律责任。
    结论:尽管放射科医师支持对放射技师进行放射影像解读的培训,放射科医生认为,实践范围应仅限于解释的胸部和肌肉骨骼系统在农村地区。
    The health sector of South Africa is burdened by the shortage of radiologists leading to the under-reporting of radiographic images and ultimately mismanagement of patients. Previous studies have recommended training of radiographers in radiographic image interpretation in order to improve the reporting. There is paucity of information regarding the knowledge and training required by radiographers to interpret radiographic images. The purpose of this study was therefore to explore the knowledge and training required by diagnostic radiographers, according to radiologists, for the interpretation of radiographs.
    A qualitative descriptive study employing criterion sampling to select qualified radiologists practicing in the eThekwini district of the KwaZulu Natal province, was conducted. One-on-one and in-depth, semi-structured interviews were used to collect data from three participants. The interviews were not carried out face to face as a result of the Covid 19 pandemic and the regulation of social distancing. This did not permit engagement with research communities. The data from the interviews were analysed using Tesch\'s eight steps for analysing qualitative data.
    Findings revealed that radiologists supported the interpretation of radiographic images by radiographers in rural settings, and for the radiographer\'s scope of practice to be restructured to include the reporting of chest and the musculoskeletal system images. The themes that emerged from the analysis included knowledge, training, clinical competencies and medico-legal responsibilities required by radiographers in the interpretation of radiographic images.
    Although the radiologists support the training of radiographers in the interpretation of radiographic images, radiologists think that the scope of practice should be limited to the interpretation of the chest and musculoskeletal systems in rural areas only.
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