Introduction To investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning. Methods Between mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases. Results 1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use. Conclusion Student radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience. Implications for practice As the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.

We reviewed technical parameters, acquisition protocols and adverse reactions (ARs) for contrast-enhanced spectral mammography (CESM). A systematic search in databases, including MEDLINE/EMBASE, was performed to extract publication year, country of origin, study design; patients; mammography unit/vendor, radiation dose, low-/high-energy tube voltage; contrast molecule, concentration and dose; injection modality, ARs and acquisition delay; order of views; examination time. Of 120 retrieved articles, 84 were included from 22 countries (September 2003–January 2019), totalling 14012 patients. Design was prospective in 44/84 studies (52%); in 70/84 articles (83%), a General Electric unit with factory-set kVp was used. Per-view average glandular dose, reported in 12/84 studies (14%), ranged 0.43–2.65 mGy. Contrast type/concentration was reported in 79/84 studies (94%), with Iohexol 350 mgI/mL mostly used (25/79, 32%), dose and flow rate in 72/84 (86%), with 1.5 mL/kg dose at 3 mL/s in 62/72 studies (86%). Injection was described in 69/84 articles (82%), automated in 59/69 (85%), manual in 10/69 (15%) and flush in 35/84 (42%), with 10–30 mL dose in 19/35 (54%). An examination time < 10 min was reported in 65/84 studies (77%), 120 s acquisition delay in 65/84 (77%) and order of views in 42/84 (50%) studies, beginning with the craniocaudal view of the non-suspected breast in 7/42 (17%). Thirty ARs were reported by 14/84 (17%) studies (26 mild, 3 moderate, 1 severe non-fatal) with a pooled rate of 0.82% (fixed-effect model). Only half of CESM studies were prospective; factory-set kVp, contrast 1.5 mL/kg at 3 mL/s and 120 s acquisition delay were mostly used; only 1 severe AR was reported. CESM protocol standardisation is advisable.

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Considering all guidelines, only one had a "low" overall score, while half of them were rated as of "high" quality. Future guidelines might take this into account to improve clinical applicability.

Breast cancer (BC) is the most common female cancer and the second cause of death among women worldwide. The 5-year relative survival rate recently improved up to 90% due to increased population coverage and women’s attendance to organised mammography screening as well as to advances in therapies, especially systemic treatments. Screening attendance is associated with a mortality reduction of at least 30% and a 40% lower risk of advanced disease. The stage at diagnosis remains the strongest predictor of recurrences. Systemic treatments evolved dramatically over the last 20 years: aromatase inhibitors improved the treatment of early-stage luminal BC; targeted monoclonal antibodies changed the natural history of anti-human epidermal growth factor receptor 2-positive (HER2) disease; immunotherapy is currently investigated in patients with triple-negative BC; gene expression profiling is now used with the aim of personalising systemic treatments. In the era of precision medicine, it is a challenging task to define the relative contribution of early diagnosis by screening mammography and systemic treatments in determining BC survival. Estimated contributions before 2000 were 46% for screening and 54% for treatment advances and after 2000, 37% and 63%, respectively. A model showed that the 10-year recurrence rate would be 30% and 25% using respectively chemotherapy or novel treatments in the absence of screening, but would drop to 19% and 15% respectively if associated with mammography screening. Early detection per se has not a curative intent and systemic treatment has limited benefit on advanced stages. Both screening mammography and systemic therapies continue to positively contribute to BC prognosis.

Background MRI allows quantitatively assessing muscle quantity and quality. Purpose To summarize the role of MRI as a noninvasive technique for the identification of in vivo surrogate biomarker of sarcopenia. Study Type Systematic review. Population In April 2019, a systematic literature search (Medline/EMBASE) was performed to identify articles on the topic at issue. Field Strength/Sequence No field strength or sequence restrictions. Assessment After a literature search, study design, aim, sample size, demographics, magnetic field strength, imaged body region, MRI sequences, and imaging biomarker were extracted. Statistical Tests Data are presented as frequencies and percentages. Results From 69 records identified through search query, 18 articles matched the inclusion criteria. All articles were published from 2012 and had a mainly prospective design (14/18, 78%). Sample size ranged from 9 to 284 subjects, for a total of 1706 enrolled subjects. Healthy subjects were enrolled or retrospectively selected in 8/18 (44%) articles, corresponding to 658 (39%) healthy subjects. Magnetic field strength was 1.5 or 3T in 14/18 (78%) studies. The most analyzed body regions were the thigh (7/18, 39%) and the trunk (6/18, 33%). Stratifying studies according to their aim, 13/18 (72%) studies focused on muscle quality and quantity, 3/18 (17%) studies on outcome prediction, and 2/18 articles (11%) addressed both aims. A wide set of MRI biomarkers have been proposed. Muscle cross‐sectional area was the most used for muscle quantity estimation, while quantitative biomarkers of muscle fat content or fiber architecture were proposed to assess muscle quality. Data Conclusion The proposed biomarkers were assessed using different MRI sequences for different body regions in different subjects/patient cohorts, pointing out a lack of standardization on this topic. Future studies should test and compare the performance of proposed MRI biomarkers for sarcopenia characterization and quantification using a standardized experimental setup. Level of Evidence: 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1117–1127.

Because of coronavirus disease 2019 (COVID-19) high contagiousness, it is crucial to identify and promptly isolate COVID-19 patients. In this context, chest imaging examinations, in particular chest x-ray (CXR), can play a pivotal role in different settings, to triage in case of unavailability, delay of or first negative result of reverse transcriptase-polymerase chain reaction (RT-PCR), and to stratify disease severity. Considering the need to reduce, as much as possible, hospital admission of patients with suspected or confirmed infection, the use of mobile x-ray equipment could represent a safe approach. We picture a potential sequence of events, involving a team composed by a radiographer and a nurse, going to patient's home to perform CXR, nasopharyngeal swab (and, if needed, also a blood sample), with fast radiologist tele-reporting, and resulting patient management approach (home isolation or emergency room admission, when needed). This approach brings healthcare to patient's home, reducing the risk of infected subjects referring to family doctors' office or emergency departments, and strengthening community medicine while maintaining a strong connection with radiology departments.